This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

OBJECTIVE To evaluate the cost-effectiveness of acalabrutinib， zanubrutinib， and ibrutinib as first-line treatments for patients with chronic lymphocytic leukemia （CLL）. METHODS A partitioned survival model was developed to simulate the 10-year disease progression of treatment-naive CLL patients. The model used a 4-week cycle length， and an annual discount rate of 4.5% was applied to both costs and health outcomes. Relevant clinical trial literature was systematically reviewed， and survival data for each treatment strategy were extracted. Using the ibrutinib arm from the RESONATE-2 trial as the anchor arm， an anchored indirect comparison approach was performed to estimate the relative treatment effects of acalabrutinib group and zanubrutinib group versus ibrutinib group. Survival curves for progression-free survival and overall survival for each treatment strategy were generated by combining the relative efficacy estimates with the survival data from the anchor arm. Quality-adjusted life year （QALY） were used as the model outcome measure. The incremental cost-effectiveness ratio and incremental net monetary benefit （INMB） were calculated to assess the economic value of the three treatment regimens. The willingness-to-pay （WTP） threshold was set at twice the 2025 per capita gross domestic product of China， corresponding to 199 330 yuan/QALY. One-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analyses were conducted to evaluate the robustness of the base-case results. RESULTS In the base-case analysis， compared with ibrutinib group， both acalabrutinib group and zanubrutinib group demonstrated cost-saving and health-improving advantages. The INMBs were 149 361.37 yuan for acalabrutinib group and 194 783.94 yuan for zanubrutinib group， indicating that both strategies were dominant over ibrutinib. One-way sensitivity analysis showed that drug prices， hazard ratios between treatment strategies， and utility values were the major factors influencing the results. Probabilistic sensitivity analysis demonstrated that when the WTP threshold was below 450 000 yuan/QALY， acalabrutinib group and zanubrutinib group regimens consistently had higher probabilities of being cost-effective than ibrutinib group. Scenario analyses showed that acalabrutinib group and zanubrutinib group remained cost-effective compared with ibrutinib group under alternative assumptions， including different anchor arms， high-risk patient cohorts， and an extended 20-year time horizon. CONCLUSIONS Compared with ibrutinib， zanubrutinib and acalabrutinib can provide greater economic value as first-line treatments for CLL， with zanubrutinib demonstrating a more pronounced cost-effectiveness advantage.

Objective The aim of the study is to analyze the incidence patterns and epidemiological characteristics of parasitic and vector-borne diseases in the Minhang and Jinshan districts of Shanghai, and provide evidence-based information for optimizing prevention and control measures. Methods We collected information from epidemic reports and epidemiological investigation forms for cases of parasitic and vector-borne diseases from 2005 to 2024 in Shanghai's Minhang and Jinshan districts. Descriptive epidemiological method were adopted to conduct a comparative analysis of incidence trends, epidemic characteristics, and infection sources. Results A total of 229 cases in 7 categories were reported between 2005 and 2024, with an average annual incidence rate of 0.36/100 000. The average annual incidence rate in Minhang District was significantly higher than that in Jinshan District. The most prevalent diseases were malaria and dengue fever, followed by Japanese encephalitis. Monthly case reports were available, predominantly from June to October, with a peak in July-August. A statistically significant difference was observed between the two districts in case distribution during June-October (P＜0.001), whereas no significant difference was found for July-August (P=0.331). The majority of cases were young men (111/229,48.47%), aged 20-39 years. Migrant workers/farmers constituted the largest occupational group (55/229, 24.02%). Registered residents of other provinces and cities (147/229,64.19%), and the main source of infection was overseas importation (112/229,48.91%). There were no statistically significant differences in gender and household-registration composition between the two districts (P＞0.05). Significant differences existed in age, occupation, and source of infection (P＜0.05). The imported diseases were malaria and dengue fever, with Africa and Southeast Asia being the primary source locations. Malaria was the predominant disease imported from other provinces and cities, with cases having been imported from abroad since 2012. Local infections were mainly Japanese encephalitis, followed by malaria (with the last local case reported in 2010). Cases between 2005 and 2009 were predominantly imported from other provinces and cities. The proportion of cases imported from abroad increased sharply after 2010, particularly in Minhang District. Local infections sometimes arise in Jinshan District, with Japanese encephalitis serving as the primary type. Conclusions Incidence rates of parasitic and vector-borne diseases in Minhang and Jinshan districts have generally remained low. To further reduce this disease burden, it will be necessary to strengthen joint measures for prevention and control, eliminate the environmental risk factors of vector organisms, enhance monitoring and precise control of the environment and inbound personnel to prevent the occurrence and transmission of parasitic and vector-borne diseases.

Objective To investigate the relationship between the levels of type Ⅲ procollagen(PCⅢ)and heme-binding protein(HPX)in peripheral blood,blood lipid and liver fibrosis in patients with nonalcoholic steatohepatitis(NASH).Methods Totally 126 patients with NASH admitted to the hospital from January 2021 to December 2023 were selected as NASH group,and they were divided into 3 subgroups according to the degree of liver fibrosis:no liver fibrosis group(22 cases),mild group(63 cases),moderate and severe group(41 cases).In addition,150 healthy subjects in the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect and compare the levels of PC Ⅲ and HPX in periph-eral blood of all groups,and Pearson correlation analysis was used to explore the correlation between peripher-al blood PC Ⅲ and HPX levels and related indexes of blood lipids in NASH patients.The predictive value of peripheral blood PC Ⅲ and HPX for liver fibrosis in NASH patients was evaluated by receiver operating char-acteristic(ROC)curve.Results The levels of PC Ⅲ and HPX,as well as total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in NASH group were higher than those in control group,and the levels of high density lipoprotein cholesterol(HDL-C)were lower than those in control group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that the lev-els of PCⅢ and HPX in peripheral blood of NASH patients were positively correlated with TC,TG and LDL-C(P＜0.05),while negatively correlated with HDL-C(P＜0.05).The levels of PC Ⅲ and HPX in peripheral blood of the non-fibrosis group were lower than those of the mild and moderate severe groups,and the mild group was lower than that of the moderate and severe group,and the differences were statistically significant(P＜0.05).The area under the curve(AUC)of peripheral blood PC Ⅲ and HPX in predicting liver fibrosis in NASH patients were 0.757 and 0.861,respectively,and the cut-off values were 135.51 ng/mL and 804.86 mg/L,respectively.The AUC of the combined prediction for liver fibrosis was 0.905,which was higher than that predicted by the two alone.Conclusion The level of PC Ⅲ and HPX in peripheral blood is closely related to the level of blood lipids and the degree of liver fibrosis in NASH patients,which can be used as potential bi-omarkers to predict liver fibrosis in NASH patients.

Objective To investigate the correlation between serum fibroblast growth factor 2(FGF2)and angiotensin converting enzyme 2(ACE2)levels with the severity of chronic obstructive pulmonary disease(COPD)and their predictive value for prognosis.Methods A total of 114 COPD patients treated in Hainan Cancer Hospital from June 2020 to June 2022 were selected as the study group.According to the severity of the disease,COPD patients were divided into acute exacerbation stage and stable stage.Another 114 healthy subjects were selected as control group.Serum FGF2 and ACE2 levels were detected by enzyme-linked immu-nosorbent assay.Pearson method was used to analyze the correlation between serum FGF2 and ACE2 and pul-monary function indicators.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in COPD patients,and receiver operating characteristics(ROC)curve was plotted to analyze the predictive value of serum FGF2 and ACE2 for poor prognosis in COPD patients.Results Serum FGF2 level in the study group was significantly higher than that in the control group(P＜0.05),and serum ACE2 level,the ratio of exertional expiratory volume in the first second to predicted(FEV1％),the ratio of FEV1 to forced vi-tal capacity(FEV1/FVC),and peak expiratory flow rate(PEF)in the study group were significantly lower than those in the control group(P＜0.05).Serum FGF2 level in acute exacerbation was significantly higher than that in stable stage(P＜0.05),serum ACE2 level,FEV1％,FEV1/FVC and PEF were significantly low-er than that in stable stage(P＜0.05).Pearson correlation analysis showed that serum FGF2 and ACE2 levels were negatively correlated(P＜0.05),and serum FGF2 and ACE2 were correlated with FEV1％,FEV1/FVC and PEF(P＜0.05).The serum FGF2 level in the poor prognosis group was significantly higher than that in the good prognosis group(P＜0.05),and the serum ACE2 level was significantly lower than that in the good prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that FGF2 was a risk factor for adverse prognosis in COPD patients(P＜0.05),and ACE2 was a protective factor(P＜0.05).According to ROC curve,the combination of serum FGF2 and ACE2 predicted the AUC of poor prognosis in COPD patients better than that predicted separately(Z=2.514,2.610,both P＜0.05).Conclusion Serum FGF2 level in-creased and ACE2 level decreased in COPD patients,both of which are closely related to the severity of the disease.Combined detection has certain predictive value for poor prognosis in COPD patients.

Malignant tumors(commonly referred to as cancer)represent a major global public health challenge and contribute significantly to the worldwide disease burden.Early screening plays a critical role in improving detection rates,enabling timely intervention,and enhancing pa-tient survival rates.However,current cancer screening guidelines primarily focus on site-specific screening,which may not fully address the need for comprehensive early detection.A scientifical-ly rational,multi-cancer screening approach offers several advantages:it optimizes the use of bio-logical samples,reduces time costs for participants,enhances the efficiency and comprehensive-ness of screening,and minimizes overall expenses.Such an approach also facilitates the rational allocation of healthcare resources,ultimately helping to reduce the societal burden of cancer.To address this need,the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China.This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and interna-tional researches on cancer screening,early detection,and treatment for prevalent malignancies.Drawing upon China's unique demographic and healthcare context,as well as practical screening experiences,the consensus provides evidence-based recommendations on target populations,screening technologies,and procedural workflows for multi-cancer screening.These guidelines align with the principles and methodologies established by the World Health Organization(WHO),aiming to:enhance the effectiveness of combined cancer screening in China,improve early detec-tion rates,and provide a scientific foundation for national cancer prevention and control strategies.

Objective:To evaluate the long-term efficacy of second-course radiotherapy for patients with locally recurrent rectal cancer (LRRC) following pelvic radiotherapy.Methods:Data of 34 patients with in-field pelvic recurrence of rectal cancer that could not be resected with R0 surgery admitted to Peking University Third Hospital from October 2012 to April 2024 were retrospectively analyzed. All patients received second-course intensity-modulated radiotherapy and the median radiation dose for the first course was 50 Gy (range 45-66 Gy), and for the second course, the median dose was 45 Gy (range 10-60.4 Gy). Regular follow-up visits and imaging examination were performed during follow-up. The recurrence of all patients was analyzed. According to the site of recurrence, all patients were divided into the presacral, pelvic wall and central recurrence groups. Local recurrence-free survival (LRFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method. The survival among groups was compared by two-sided log-rank test.Results:The median follow-up period was 22 months. Among 34 patients, recurrence was observed in 38 sites, primarily at the central region (24 sites, 63%) and 23 patients (68%) had initial recurrence. The median OS was 47 months, and the median LRFS was 19 months. The 1-, 2-, 3- and 5-year OS rates were 93.1%, 75.3%, 69.1% and 38.4%, respectively. The 1- and 2-year LRFS rates were 69.8% and 27.2%. There were no significant differences in OS among the presacral, pelvic wall and central recurrence groups ( P=0.616). Conclusions:For patients with locally recurrent rectal cancer that cannot be resected with R0 margins, second-course radiotherapy offers higher clinical efficacy compared with alternative therapeutic options previously reported.

Objective:To evaluate the role of a single PET-CT scan in predicting survival and prognosis in patients with non-small cell lung cancer (NSCLC) who did not undergo surgery but received radiotherapy after neoadjuvant chemotherapy combined with immunotherapy.Methods:A retrospective analysis was conducted on the data of 23 NSCLC patients treated at the Cancer Hospital of the Chinese Academy of Medical Sciences from May 2022 to June 2024. All patients were pathologically confirmed, received neoadjuvant chemotherapy combined with immunotherapy, did not undergo surgery for various reasons, and instead received radiotherapy. Each patient underwent only one PET-CT scan after neoadjuvant chemotherapy combined with immunotherapy and before radiotherapy. According to the maximum standardized uptake value (SUV max) on PET-CT, patients were divided into the low-uptake group (SUV max < 8, n=12) and high-uptake group (SUV max ≥ 8, n=11). Survival analysis was performed using the Kaplan-Meier method with survival curves plotted. Univariate analysis of influencing factors of survival was conducted using the Cox proportional hazards regression model. Clinical characteristics and survival outcomes of the two groups were compared, including progression-free survival (PFS) and overall survival (OS). Results:The 1-year PFS rates were 100% in the low-uptake group, 54.5% in the high-uptake group. This difference was statistically significant ( P=0.007). The 1-year and 2-year OS rates were both 100% in the low-uptake group, the 1-year and 2-year OS rates were both 90.9% in the high-uptake group, with no statistically significant difference ( P=0.394). Univariate Cox analysis identified age as an independent factor affecting PFS. Conclusions:For NSCLC patients who did not undergo surgical resection but received radiotherapy after neoadjuvant chemotherapy combined with immunotherapy, a single PET-CT scan before radiotherapy has potential value in predicting PFS. However, clinical studies with larger sample size and longer follow-up are required to evaluate its predictive value for OS.

Malignant tumors (commonly referred to as cancer) represent a major global public health challenge and contribute significantly to the worldwide disease burden. Early screening plays a critical role in improving detection rates, enabling timely intervention, and enhancing patient survival rates. However, current cancer screening guidelines primarily focus on site-specific screening, which may not fully address the need for comprehensive early detection. A scientifically rational, multi-cancer screening approach offers several advantages: it optimizes the use of biological samples, reduces time costs for participants, enhances the efficiency and comprehensiveness of screening, and minimizes overall expenses. Such an approach also facilitates the rational allocation of healthcare resources, ultimately helping to reduce the societal burden of cancer. To address this need, the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China. This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and international researches on cancer screening, early detection, and treatment for prevalent malignancies. Drawing upon China's unique demographic and healthcare context, as well as practical screening experiences, the consensus provides evidence-based recommendations on target populations, screening technologies, and procedural workflows for multi-cancer screening. These guidelines align with the principles and methodologies established by the World Health Organization (WHO), aiming to enhance the effectiveness of combined cancer screening in China, improve early detection rates, and provide a scientific foundation for national cancer prevention and control strategies.