This paper focuses on the application of health big data in cancer screening. Firstly, the sources and characteristics of health big data are introduced, then the commonly used epidemiological designs and analytical techniques in hospital-based cancer screening studies are summarized and the application scenarios of such studies are described. Finally, the challenges and future development in the application of health big data are analyzed to provide reference for the future studies.

AIM:To investigate the roles of up-regulated inwardly rectifier potassium channel 2.1(Kir2.1)in macrophage activation and cardiac inflammatory injury,in order to clarify the mechanism of Kir2.1 regulation in inflam-matory injury and cardiac repair.METHODS:The RAW264.7 macrophages were activated by lipopolysacharide(LPS)and treated with Kir2.1 agonist zacopride or lentivirus-Kir2.1 overexpression(Kir2.1-OE).Macrophages were randomly divided into control,LPS,LPS+zacopride(or LPS+Kir2.1-OE),and LPS+zacopride+BaCl2 groups.The effects of Kir2.1-OE and AG490[Janus kinase 2(JAK2)inhibitor]on the JAK2/signal transducer and activator of transcription 3(STAT3)signaling pathway in macrophages were also investigated.The expression of CD86,interleukin-6(IL-6)and Kir2.1 in M1 macrophages was detected by RT-qPCR or immunofluorescence staining.The expression of JAK2/STAT3 molecules was detected by Western blot.The RAW264.7 macrophages were incubated with LPS,LPS+zacopride or LPS+zacopride+BaCl2 for 12 h,and then co-cultured with H9C2(2-1)cardiomyocytes for 48 h.The expression of Kir2.1,IL-4,IL-6,IL-1β,B-cell lymphoma-2(Bcl-2),Bcl-2-associated X protein(Bax),caspase-3,cleaved caspase-3,calcium/calmodulin-dependent protein kinase II(CaMKII)and p-CaMKII in cardiomyocytes was detected by Western blot.We fur-ther compared the effects of zacopride and KN-93,a known CaMKII inhibitor,on cardiac CaMKII.After being incubated with LPS for 12 h and changed the medium,RAW264.7 macrophages were co-cultured with H9C2(2-1)cardiomyocytes which was pretreated with KN-93.The cardiomyocytes were divided into control,LPS,and LPS+KN-93 groups.The ex-pression of CaMKII and p-CaMKII were detected by Western blot.RESULTS:Zacopride inhibited LPS-induced M1-type polarization of macrophages in a Kir2.1-dependent manner as showed by a significant decrease in CD86(M1-type marker)and IL-6(P<0.05).Zacopride or Kir2.1-OE inhibited LPS-induced activation of JAK2/STAT3 inflammatory signaling pathway in macrophages,with effects similar to the JAK2 inhibitor AG490.The H9C2(2-1)cardiomyocytes were co-cul-tured with M1-polarized macrophages(P<0.05).Zacopride inhibited M1 macrophage-induced inflammatory injury in car-diomyocytes,which was manifested as decreased expression of IL-1β and IL-6,increased expression of IL-4,and de-creased apoptosis.Zacopride also inhibited activation of CaMKII in a Kir2.1-dependent manner in H9C2(2-1)cells co-cultured with macrophages(P<0.05).CONCLUSION:Up-regulation of Kir2.1 may inhibit LPS-induced M1-type polar-ization of macrophages via inhibiting JAK2/STAT3 signaling pathway.Up-regulation of macrophage Kir2.1 may play a pro-tective role in cardiac repair after myocardial infarction by negative regulation of CaMKII signaling.

Objective To investigate the correlation between salivary interleukin-33(IL-33)and anti-salivary gland protein 1(SP-1)antibody levels and salivary gland injury in primary Sjogren's syndrome(pSS).Methods A total of 91 patients with pSS admitted to Yixing People's Hospital from March 2020 to January 2025 were recruited as the observation group.Meanwhile,42 healthy individuals who were matched for gender and age and visited the same hospital during the same period were selected as the control group.The levels of IL-33 and anti-SP-1 antibodies in saliva,along with clinical data,were compared between the observation group and the control group.Additionally,the levels of IL-33 and anti-SP-1 antibodies in saliva were compared among patients with different salivary gland ultrasound(SGUS)scores.Moreover,the correlations between the levels of IL-33 and anti-SP-1 antibodies in saliva of pSS patients and saliva flow rate,clinical indicators,and SGUS scores were analyzed.Results The levels of IL-33 and anti-SP-1 antibodies in the observation group were significantly higher than those in the control group(P<0.05).The dynamic saliva flow rate and static saliva flow rate in the observation group were notably lower than those in the control group(P<0.05),while the neutrophil count,CD4+cell count,and immunoglobulin G(IgG)levels in the observation group were significantly higher than those in the control group(P<0.05).In patients with a submandibular gland Sj?gren's Ultrasound Scoring(SGUS)score≥2,the levels of salivary IL-33 and anti-SP-1 antibodies were significantly higher than those in patients with a submandibular gland SGUS score<2(P<0.05).Similarly,in patients with a parotid gland SGUS score≥2,the levels of salivary IL-33 and anti-SP-1 antibodies were significantly higher than those in patients with a parotid SGUS score<2(P<0.05).Correlation analysis indicated that the levels of IL-33 and anti-SP-1 antibodies in the saliva of pSS patients were positively correlated with the dynamic saliva flow rate,static saliva flow rate,CD4+cell count,and SGUS score(P<0.05).However,the levels of IL-33 and anti-SP-1 antibodies in the saliva of pSS patients were not correlated with the IgG level and neutrophil count(P>0.05).Conclusions The levels of IL-33 and anti-SP-1 antibodies in saliva are positively correlated with the saliva flow rate,CD4+cell count,and SGUS score in pSS patients.These findings suggest that these factors can serve as valuable indicators for evaluating salivary gland injury in pSS patients.

Objective:To develop outcome indicators for the implementation of comprehensive inter-ventions targeting the multimorbidity of myopia and obesity in children and adolescents,providing a basis for the co-prevention of multimorbidity and the outcome measurement of implementation research in children and adolescents.Methods:Based on the RE-AIM framework,a preliminary set of indicators was constructed.The Delphi method was employed,with experts scoring and providing feedback on the proposed indicators via questionnaires.After each round of consultation,expert enthusiasm index,authority coefficient,coordination degree,and consensus level were calculated.Expert opinions were col-lected and analyzed to modify,delete,or add indicators based on consultation results and screening crite-ria.Two Delphi rounds were conducted until consensus was achieved.Results:A total of 28 experts par-ticipated actually in both rounds.The Kendall's W coefficients for the two rounds of expert consultation were0.352(x2=413.952,P＜0.001)and 0.499(x2=405.044,P＜0.001),both statistically sig-nificant.The final outcome indicators for implementation research on comprehensive interventions for myopia and obesity comorbidity in children and adolescents included five primary dimensions with 13 secondary and 20 tertiary indicators.The dimension of reach included the number of children and adoles-cents involved,participant representativeness,and full-course participation representativeness.The di-mension of effectiveness included multimorbidity incidence,myopia incidence,spherical equivalent,body mass index(BMI),overweight and obesity prevalence,waist-to-height ratio,comprehensive health knowledge score,and comprehensive health behavior score.The dimension of adoption covered school representativeness and representativeness of school nurses and teachers involved in implementation.The dimension of implementation included fidelity,content modification,and cost.The dimension of mainte-nance included individual health outcomes and organizational sustainment.Conclusion:This study developed implementation outcome indicators for comprehensive interventions targeting multimorbidity of myopia and obesity among the children and adolescents based on the RE-AIM framework.These indica-tors can serve as a reference for optimizing intervention research strategies related to common multimor-bidity among children and adolescents in China.

Objective:To evaluate the efficacy and safety of a new plasma radiofrequency generator and a disposable mucosal incision knife for endoscopic submucosal dissection (ESD) of gastrointestinal lesions.Methods:This study is a prospective, randomized, non-inferiority multicenter study (Chinese Clinical Trial Registry No.: ChiCTR2000041394). The inclusion criteria for cases are as follows: (1) being able to understand and voluntarily participate in this clinical trial, and voluntarily signing the informed consent form; (2) being 18-70 years old, regardless of gender; (3) having a gastrointestinal lesion and meeting the endoscopic treatment conditions for the indications of endoscopic submucosal dissection (ESD). The exclusion criteria are: (1) meeting the contraindications for ESD; (2) having a surgical contraindication due to coagulation dysfunction or still taking anticoagulants 1 week before surgery; (3) having coagulation dysfunction, that is, the prothrombin time is prolonged by more than 3 seconds (more than 5 seconds in patients with liver disease), or the activated partial thromboplastin time is prolonged by more than 10 seconds, and the platelet count is < 70×10?/L; (4) having severe cardiopulmonary insufficiency and being unable to tolerate the surgery; (5) being a reproductive-aged woman with a positive blood or urine pregnancy test or a lactating woman; (6) the investigator deems that there are other factors that are not suitable for inclusion or affect the subject's participation. Patients who underwent ESD treatment for gastrointestinal lesions from March 2019 to April 2023 at the Endoscopy Center of Zhongshan Hospital Affiliated to Fudan University, the Department of Gastroenterology of Minhang District Central Hospital in Shanghai, and the Department of Gastroenterology of Quzhou People's Hospital were prospectively included. The experimental group used a new plasma radiofrequency therapy instrument and a disposable mucosal incision knife, while the control group used a high-frequency electrosurgical system and a disposable mucosal incision knife. The primary efficacy indicator was the en bloc resection success rate, the secondary efficacy indicators included the coagulation success rate, and the operation stability of the plasma radiofrequency therapy instrument and the disposable mucosal incision knife; the safety indicators included the incidence of intraoperative bleeding, intraoperative perforation, and postoperative complications. Results:The study cohort comprised 194 patients, 95 in the experimental group and 99 in the control group. Analysis of the full set showed rates of en bloc resection of 97.89% (93/95) and 96.97% (96/99) in the experimental and control groups, respectively; the difference being 0.53% (-5.58%, 6.64%). Analysis of the compliance set showed rates of en bloc resection of 97.83% (90/92) and 96.88% (93/96) in the experimental and control groups, respectively; the difference being 0.58% (-5.79%, 6.94%). These data indicate that the rate of en bloc resection in the experimental group using plasma radiofrequency therapy and disposable mucosal incision was not inferior to that of the control group. The rates of achieving intraoperative coagulation in the experimental and control groups were 7.14% (5/70) and 5.97% (4/67), respectively; this difference is not statistically significant ( P=1.000). The control group had a significantly better rate of using the same instruments throughout the procedure than did the experimental group ( P<0.001). In the safety analysis set, the incidences of intraoperative and postoperative adverse events did not differ significantly between the two groups (both P>0.05). Conclusion:Plasma radiofrequency therapy equipment and a disposable mucosal incision knife are safe and effective instruments for performing ESD of gastrointestinal lesions.

Objective To compare the differences in ambulatory blood pressure monitoring(ABPM)parameters and cardiac struc-ture and function indicators in patients with essential hypertension complicated with tumor,then to summarize the relationship between tumor and blood pressure and structural and function of the heart.Methods A retrospective study was conducted to select patients with essential hypertensive admitted to the Second Hospital of Lanzhou University from January 2018 to July 2024.A total of 109 patients with tumor combined with hypertension and 98 patients with hypertension were identified.General information,ABPM parameters,and echo-cardiography results of patients in the two groups were collected,to analyze the differences in ABPM parameters and cardiac structure and function between the two groups.Results Compared with the hypertension group,the tumor combined with hypertension group had a re-duced nighttime systolic blood pressure fall rate,nighttime diastolic blood pressure fall rate,daytime and 24-hour systolic and diastolic blood pressure standard deviations,and left ventricular ejection fraction(all P＜0.05),while the left ventricular end-diastolic diameter and interventricular septum thickness were increased(all P＜0.05).Pearson correlation analysis revealed that the nighttime systolic blood pressure fall rate was negatively correlated with age,nighttime systolic blood pressure,and morning systolic blood pressure(all P＜0.05).In the tumor combined with hypertension patients,the interventricular septum thickness was positively correlated with body mass index,nighttime systolic blood pressure,nighttime diastolic blood pressure,and 24-hour diastolic blood pressure(all P＜0.05).Multi-ple linear regression analysis results indicated that tumor and increasing age were independent risk factors for the reduction in nighttime systolic blood pressure fall rate.Conclusion Compared with hypertensive patients,patients with tumor combined with hypertension ex-hibit abnormal blood pressure circadian rhythm,increased left ventricular end-diastolic diameter,thickening of the interventricular sep-tum,and reduced ejection fraction.The presence of tumor and increasing age in patients with essential hypertension are the main risk fac-tors affecting the nighttime blood pressure fall rate.

Objective To investigate the predictive value of serum interleukin-6(IL-6)and procalcitonin(PCT)levels on the prognosis of patients with acute respiratory distress syndrome(ARDS).Methods A total of 99 ARDS patients admitted to Lianyungang Hospital affiliated to Xuzhou Medical University from January 2021 to December 2023 were included in the study.According to the Berlin definition,the patients were divided into mild group(n=22),moderate group(n=42)and severe group(n=35)groups.Based on their 28-day outcomes,they were also divided into survival group(n=65)and death group(n=34).The levels of IL-6 and PCT in each group were compared.The predictive value of IL-6 and PCT for the prognosis of ARDS patients was analyzed using receiver operat-ing characteristic(ROC)curve and the area under the curve(AUC).The Kaplan-Meier method was used to plot survival curves for ARDS patients with different levels of IL-6 and PCT.Results Among the three groups with varying severity of ARDS,the severe group had the highest IL-6 and PCT levels,followed by the moderate group,and the mild group had the lowest levels.The differences among the groups were statistically significant(P＜0.05).The levels of IL-6 and PCT in the death group were significantly higher than those in the survival group,and the difference was statistically significant(P＜0.05).The AUC of IL-6 and PCT in predicting the prognosis of ARDS patients were 0.793 and 0.776,with the sensitivity of 79.4％and 94.1％,and the specificity of 70.8％and 61.5％,respective-ly.Kaplan-Meier survival curve analysis showed that when IL-6 was ≥110.700pg/ml and PCT was ≥ 1.700ng/ml,the 28-day sur-vival rate of ARDS patients was significantly lower than that of patients with IL-6＜110.700pg/ml and PCT＜1.700ng/ml(P＜0.001).Conclusion PCT and IL-6 levels have good value in predicting the short-term prognosis of ARDS patients,and can be used as effective indicators for prognosis evaluation in ARDS patients.

Objective:To evaluate the efficacy and safety of intrasaccular flow disruptor in wide-necked intracranial aneurysms.Methods:One hundred and seventeen patients with wide-necked intracranial aneurysms treated with intrasaccular flow disruptor were collected from Department of Neurointervention (First Affiliated Hospital of Zhengzhou University), Department of Neurosurgery (Beijing Tiantan Hospital, Capital Medical University), Department of Cerebrovascular Surgery, Neurosurgery Center (Zhujiang Hospital, Southern Medical University), and Department of Neurosurgery (First Affiliated Hospital of Harbin Medical University) from August 2022 to March 2024. Raymond-Roy Occlusion Classification (RROC) was employed to evaluate aneurysm embolization immediately after procedure; cranial CT or MRI within 48 hours of embolization were performed to identify any new intracranial hemorrhage, subarachnoid hemorrhage, or new symptomatic cerebral infarction related to the intracranial aneurysms. Modified Rankin Scale (mRS) was used to assess the neurological function at discharge. Imaging follow-up and outpatient follow-up were performed at 6 months after embolization to evaluate the aneurysm occlusion degree and complications.Results:A total of 117 intrasaccular flow disruptors were implanted in 117 patients, with a technical success rate of 100%; 115 patients (98.3%) enjoyed successful one-time release of their disruptors, and 2 patients (1.7%) required retrieval and redirection of the disruptors before second successful attempt. Flow disruptor plus stent was performed in 13 patients (11.1%). Immediately after procedure, RROC grading I was noted in 3 patients, grading II in 51 patients and grading III in 63 patients. Cranial CT or MRI within 48 hours of embolization indicated no new intracranial hemorrhage, subarachnoid hemorrhage, or symptomatic cerebral infarction related to the intracranial aneurysms. All patients had mRS score of 0 at discharge. Eighty-three patients completed a 6-month follow-up (RROC grading I in 41 patients, grading II in 33 patients and grading III in 9 patients), without ischemic or hemorrhagic adverse events.Conclusion:The results of this study preliminarily suggest that intrasaccular flow disruptor is effective and safe in wide-necked intracranial aneurysms.

Objective:To evaluate the efficacy and safety of Neuroform Atlas stent-assisted coil embolization in patients with middle cerebral artery bifurcation aneurysms.Methods:A retrospective analysis was performed; the clinical data of 46 patients with middle cerebral artery bifurcation aneurysms accepted Neuroform Atlas stent-assisted coil embolization in First Affiliated Hospital of Zhengzhou University, Beijing Tiantan Hospital Affiliated to Capital Medical University, First Affiliated Hospital of Harbin Medical University, Zhujiang Hospital of Southern Medical University and First Affiliated Hospital of Chongqing Medical University from January 2022 to March 2024 were collected. There were 28 ruptured aneurysms (60.87%) and 18 unruptured aneurysms (39.13%). Follow-up was performed for more than 3 months; Raymond-Roy grading was used to evaluate the aneurysm embolization immediately after embolization and during follow-up; perioperative hemorrhagic or ischemic complications were recorded; modified Rankin Scale (mRS) was used to evaluate the prognosis of the patients at discharge and during follow-up (mRS score≤2: good prognosis, and mRS score>2: poor prognosis).Results:Coil embolization was successful in all 46 patients. DSA immediately after embolization showed that 41 patients (89.13%) had completely occluded aneurysms (Raymond-Roy grading I), 2 patients (4.35%) had residual aneurysm neck (Raymond-Roy grading Ⅱ) and 3 patients (6.52%) had partially occluded aneurysms (Raymond-Roy grading Ⅲ). Perioperative complications occurred in 5 patients, including 2 with postoperative cerebral infarction, 1 with hydrocephalus, 1 with postoperative pneumonia leading to respiratory failure, and 1 with stent thrombosis during embolization. Both at discharge and 3 months after embolization, 43 patients (93.48%) had good prognosis and 3 patients (6.52%) had poor prognosis. No obvious ischemic complications (such as stent restenosis) or hemorrhagic complications (such as re-rupture of the aneurysms) were found in all patients. Thirty patients (65.22%) had imaging follow-up for 6-12 months: 26 (86.67%) had Raymond-Roy grading I, 3 (10.00%) had Raymond-Roy grading II, and 1 (3.33%) had Raymond-Roy grading III.Conclusion:Neuroform Atlas stent-assisted coil embolization has good short-term efficacy and high safety in middle cerebral artery bifurcation aneurysms, but long-term follow-up observation is still needed to verify its efficacy.

This paper focuses on the application of health big data in cancer screening. Firstly, the sources and characteristics of health big data are introduced, then the commonly used epidemiological designs and analytical techniques in hospital-based cancer screening studies are summarized and the application scenarios of such studies are described. Finally, the challenges and future development in the application of health big data are analyzed to provide reference for the future studies.