Objective Analyzing the trends and driving factors of China's population structure changes from a global perspective, revealing its commonalities and specificities in reference to global levels, to provide a scientific basis for optimizing public health policies. Methods Integrating the latest authoritative data from sources such as the National Bureau of Statistics, GBD 2023, and the UN Population Division, this study utilizes Joinpoint regression to identify trend inflection points and conducts multidimensional analysis combined with methods such as ArcGIS spatial visualization. Results China's population is characterized by the triple overlapping trends of ^“negative growth, low birth rates, and aging^”. The total population has experienced continuous negative growth since 2022. Taking 2023 as an example, the population pyramid exhibited features of a ^“narrowing base and expanding top^”. The number of people in the 0-year age group was only 42.80% of the 1990 figure, while the population aged 60 and above was 2.89 times that of 1990. Significant interprovincial disparities exist, with some provinces showing a clustering phenomenon of ^“high mortality and low birth rates^”. According to the Seventh National Population Census, the male population was larger, with an overall sex ratio of 105. The sex ratio reached balance (i.e., 100) at age 58 and dropped to just 42 by age 100. The disease spectrum is undergoing rapid transformation: the proportion of deaths attributable to chronic non-communicable diseases increased from 74.26% in 1990 to 90.69% in 2023. Conclusion China's population structure is undergoing accelerated changes characterized by declining fertility and population aging, which have formed a self-reinforcing negative cycle, posing multiple challenges to public health and services. There is an urgent need to establish a targeted policy framework focused on enhancing childbearing support, improving health services and chronic disease management for the elderly, and optimizing long-term care systems to foster a virtuous cycle in the demographic structure and enhance the overall health of the population.

Objective To systematically analyze the trends in life expectancy and healthy life expectancy in China from 1990 to 2023, identify the factors influencing changes in life expectancy, and provide scientific evidence for the Healthy China Strategy. Methods Based on the most recent authoritative data from the Global Burden of Disease Study 2023 (GBD 2023), the United Nations Population Division, the World Bank, and Our World in Data, complete life tables and cause-deleted life tables were constructed. Analytical methods including Joinpoint regression and ARIMA forecasting were comprehensively applied to systematically evaluate life expectancy, survival probability, and the burden of diseases and risk factors. Results From 1990 to 2023, life expectancy at birth in China exhibited sustained and rapid growth (average annual percentage change, AAPC = 0.63%), with a growth rate significantly higher than those observed in the United States, Japan, and the global average (AAPC = 0.12%, 0.21%, and 0.45%, respectively). Survival probability improved across all age groups, with particularly notable gains in children and the oldest-old. Interprovincial and sex-based disparities persisted. Cause-deleted analysis revealed that cardiovascular disease (CVD) accounted for the greatest loss in life expectancy at birth. From 2004 to 2020, years of life lost due to CVD increased annually, reaching 8.70 years in 2020 for the zero-age group in China. Neoplasm ranked second in causing life expectancy loss, which remained relatively stable at approximately 3 years over the study period. Among risk factors, tobacco use, hypertension, air pollution, dietary risks, and high fasting plasma glucose were identified as prominent contributors to life expectancy loss. Strong positive correlations were observed between health resources, economic growth, and life expectancy. Conclusion China has made remarkable progress in extending lifespan and improving quality of life, but it still faces challenges such as chronic diseases limiting lifespan and life quality, diverse health risks, and disparities in health levels and life expectancy across regions and populations.

Objective:To analyze the incidence and influencing factors of lymphopenia in prostate cancer patients undergoing pelvic radiotherapy.Methods:A retrospective analysis was conducted on 123 prostate cancer patients treated at the Department of Radiation Oncology, Peking University First Hospital, from November 2011 to May 2015. Radiotherapy was administered using conventional fractionated intensity-modulated radiotherapy. Blood routine, including absolute lymphocyte count (ALC), was performed on patients before radiotherapy, weekly during radiotherapy, and at the end of radiotherapy. Severe lymphopenia was defined as an ALC <500 cells/μl. Based on whether the minimum ALC during radiotherapy was lower than 500 cells/μl, the entire cohort and 55 patients (excluding those with undelineated pelvic bone marrow due to radiotherapy planning system issues) with delineated pelvic bone marrow (divided into pelvic bone marrow, iliac bone marrow, and lower pelvic bone marrow) were stratified into a severe lymphopenia group (33 cases and 16 cases, respectively) and a mild lymphopenia group (90 cases and 39 cases, respectively). Differences in clinical factors and dosimetric parameters were compared between the groups using the chi-square test (or Fisher's exact test), t-test, and Wilcoxon rank-sum test. Univariate and multivariate logistic regression analyses were performed to identify the clinical and dosimetric factors influencing severe lymphopenia. Results:All 123 prostate cancer patients experienced lymphopenia during radiotherapy, with a median minimum ALC of 0.6×10 9/L [range: (0.2-2.3)×10 9/L]. Severe lymphopenia occurred in 26.8% (33 cases) of patients. Univariate analysis of the entire cohort showed that pre-radiotherapy baseline ALC, initial neutrophil-to-lymphocyte ratio, prostate-specific antigen value, Gleason score, and pelvic radiotherapy were promoting factors for severe lymphopenia ( P<0.05). Multivariate analysis identified pre-radiotherapy baseline ALC ( OR=0.217, 95% CI: 0.072-0.650, P=0.006) and pelvic radiotherapy ( OR=23.852, 95% CI: 2.834-200.787, P=0.004) as promoting factors for severe lymphopenia. In patients with delineated pelvic bone marrow, univariate analysis showed that pelvic bone marrow V 30 Gy and V 40 Gy, iliac bone marrow V 30 Gy and V 40 Gy, lower pelvic bone marrow V 30 Gy and V 40 Gy were promoting factors for severe lymphopenia during treatment ( P<0.05). Conclusions:Lymphopenia is common in prostate cancer patients undergoing radiotherapy, with a high incidence of severe lymphopenia. Pre-radiotherapy baseline ALC, as well as pelvic, iliac, and lower pelvic bone marrow V 30 Gy and V 40 Gy, are promoting factors for severe lymphopenia during radiotherapy.

Objective To investigate the effect of long noncoding RNAMCTP1-AS1 on the proliferation and invasion of cervical cancer cells and its related mechanisms.Methods The Cancer Genome Atlas database was used to analyze the expression of MCTP1-AS1 in cervical cancer tissues and normal cervical tissues,and the correlation between the expression level of MCTP1-AS1 and the pathological stage of cervical cancer patients was analyzed.The expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,C33A and normal cervical epithelial cells H8 was detected.Hela cells were transfected with pcDNA-Ctrl plasmid(Ctrl group)and pcDNA-MCTP1-AS1 plasmid(MCTP1-AS1 group),respectively.the proliferation and invasion ability of Hela cells were detected,respectively.the expression of proliferation proteins CDK2 and Cyclin A and invasion proteins N-cadherin and ZEB1 in Hela cells were detected,the targeting relationship between MCTP1-AS1 and miR-10a-5p were verified.The expression of miR-10a-5p in Hela cells was detected.Results Compared with normal cervical tissue,the expression of MCTP1-AS1 in cervical cancer tissue was significantly decreased(P＜0.01).The expression level of MCTP1-AS1 was negatively correlated with the pathological stage of cervical cancer patients(P＜0.01).Compared with H8 cells,the expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,and C33A were significantly decreased(P＜0.01).Compared to Ctrl group,overexpression of MCTP1-AS1 significantly reduced the levels of proliferative proteins CDK2 and Cyclin A,as well as invasive proteins N-cadherin and ZEB1 in Hela cells.MCTP1-AS1 directly binds to miR-10a-5p(P＜0.01).Compared to Ctrl group,MCTP1-AS1 group showed a significant decrease in miR-10a-5p expression in Hela cells(P＜0.01).Conclusion MCTP1-AS1 expression is downregulated in cervical cancer tissues and cells,and MCTP1-AS1 expression is negatively correlated with the pathological stage of cervical cancer patients.MCTP1-AS1 inhibits the proliferation and invasion of cervical cancer cells by targeting miR-10a-5p.

Objective To investigate the effect of long noncoding RNAMCTP1-AS1 on the proliferation and invasion of cervical cancer cells and its related mechanisms.Methods The Cancer Genome Atlas database was used to analyze the expression of MCTP1-AS1 in cervical cancer tissues and normal cervical tissues,and the correlation between the expression level of MCTP1-AS1 and the pathological stage of cervical cancer patients was analyzed.The expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,C33A and normal cervical epithelial cells H8 was detected.Hela cells were transfected with pcDNA-Ctrl plasmid(Ctrl group)and pcDNA-MCTP1-AS1 plasmid(MCTP1-AS1 group),respectively.the proliferation and invasion ability of Hela cells were detected,respectively.the expression of proliferation proteins CDK2 and Cyclin A and invasion proteins N-cadherin and ZEB1 in Hela cells were detected,the targeting relationship between MCTP1-AS1 and miR-10a-5p were verified.The expression of miR-10a-5p in Hela cells was detected.Results Compared with normal cervical tissue,the expression of MCTP1-AS1 in cervical cancer tissue was significantly decreased(P＜0.01).The expression level of MCTP1-AS1 was negatively correlated with the pathological stage of cervical cancer patients(P＜0.01).Compared with H8 cells,the expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,and C33A were significantly decreased(P＜0.01).Compared to Ctrl group,overexpression of MCTP1-AS1 significantly reduced the levels of proliferative proteins CDK2 and Cyclin A,as well as invasive proteins N-cadherin and ZEB1 in Hela cells.MCTP1-AS1 directly binds to miR-10a-5p(P＜0.01).Compared to Ctrl group,MCTP1-AS1 group showed a significant decrease in miR-10a-5p expression in Hela cells(P＜0.01).Conclusion MCTP1-AS1 expression is downregulated in cervical cancer tissues and cells,and MCTP1-AS1 expression is negatively correlated with the pathological stage of cervical cancer patients.MCTP1-AS1 inhibits the proliferation and invasion of cervical cancer cells by targeting miR-10a-5p.

Objective:To analyze the incidence and influencing factors of lymphopenia in prostate cancer patients undergoing pelvic radiotherapy.Methods:A retrospective analysis was conducted on 123 prostate cancer patients treated at the Department of Radiation Oncology, Peking University First Hospital, from November 2011 to May 2015. Radiotherapy was administered using conventional fractionated intensity-modulated radiotherapy. Blood routine, including absolute lymphocyte count (ALC), was performed on patients before radiotherapy, weekly during radiotherapy, and at the end of radiotherapy. Severe lymphopenia was defined as an ALC <500 cells/μl. Based on whether the minimum ALC during radiotherapy was lower than 500 cells/μl, the entire cohort and 55 patients (excluding those with undelineated pelvic bone marrow due to radiotherapy planning system issues) with delineated pelvic bone marrow (divided into pelvic bone marrow, iliac bone marrow, and lower pelvic bone marrow) were stratified into a severe lymphopenia group (33 cases and 16 cases, respectively) and a mild lymphopenia group (90 cases and 39 cases, respectively). Differences in clinical factors and dosimetric parameters were compared between the groups using the chi-square test (or Fisher's exact test), t-test, and Wilcoxon rank-sum test. Univariate and multivariate logistic regression analyses were performed to identify the clinical and dosimetric factors influencing severe lymphopenia. Results:All 123 prostate cancer patients experienced lymphopenia during radiotherapy, with a median minimum ALC of 0.6×10 9/L [range: (0.2-2.3)×10 9/L]. Severe lymphopenia occurred in 26.8% (33 cases) of patients. Univariate analysis of the entire cohort showed that pre-radiotherapy baseline ALC, initial neutrophil-to-lymphocyte ratio, prostate-specific antigen value, Gleason score, and pelvic radiotherapy were promoting factors for severe lymphopenia ( P<0.05). Multivariate analysis identified pre-radiotherapy baseline ALC ( OR=0.217, 95% CI: 0.072-0.650, P=0.006) and pelvic radiotherapy ( OR=23.852, 95% CI: 2.834-200.787, P=0.004) as promoting factors for severe lymphopenia. In patients with delineated pelvic bone marrow, univariate analysis showed that pelvic bone marrow V 30 Gy and V 40 Gy, iliac bone marrow V 30 Gy and V 40 Gy, lower pelvic bone marrow V 30 Gy and V 40 Gy were promoting factors for severe lymphopenia during treatment ( P<0.05). Conclusions:Lymphopenia is common in prostate cancer patients undergoing radiotherapy, with a high incidence of severe lymphopenia. Pre-radiotherapy baseline ALC, as well as pelvic, iliac, and lower pelvic bone marrow V 30 Gy and V 40 Gy, are promoting factors for severe lymphopenia during radiotherapy.

Cervical cancer is a malignant tumor of the female reproductive system, which is closely related to persistent infection with high-risk human papillomavirus (HPV). Locally advanced cervical cancer (LACC) refers to cervical cancer of stage IB3 to IVA [International Federation of Gynecology and Obstetrics (FIGO) 2018 staging], characterized by tumor diameter greater than 4 cm or invasion of adjacent tissues. The standard treatment for LACC is concurrent chemoradiotherapy, with cisplatin as the preferred chemotherapeutic agent. However, there is still a clinical need for further improvement of the overall prognosis of LACC, and exploring effective adjuvant treatment strategies after concurrent chemoradiotherapy to increase the cure rate and quality of life of LACC patients is an important topic in clinical practice. This article reviews the types, indications, effects and existing problems of adjuvant treatment after concurrent chemoradiotherapy for LACC.

Objective:To evaluate the effects of different imaging frequencies and matching strategies of cone-beam computed tomography (CBCT) on dose-volume parameters in target and organs at risk (OAR) during image-guided radiotherapy for prostate cancer.Methods:A total of 561 sets of CBCT images from 21 patients treated with radical prostate radiotherapy who were admitted to Peking University First Hospital from June 2022 to May 2023 were retrospectively analyzed. All patients received volumetric intensity modulated arc therapy (VMAT) at a prescribed dose of 70 Gy divided into 25 times, 2.8 Gy per time. Clinical target volume (CTV) and OAR were delineated by the same oncologist on each CBCT image. The planned CT (pCT) was rigorously registered to CBCT after calibration of positioning errors according to different image guidance modes and frequencies, and CT values and structures were propagated to CBCT through deformable image registration (DIR). The daily dose was mapped to pCT according to the deformation vector field (DVF) for dose accumulation. The actual cumulative dose of daily online CBCT validation was compared with the weekly CBCT validation regimen (days 1, 2, 3, 6, 11, 16 and 21 online imaging). The dosimetric comparison was also made between bone-based matching and soft tissue-based matching (after automatic bone-based matching, manual prostate-based matching was performed and fine-tuning was made regarding the anterior wall of rectum). Wilcoxon signed rank-sum test was utilized to analyze dose-volume parameters between planned and cumulative doses that exhibited non-normal distribution, while paired t-test was employed for assessing shift values and average dose parameters that demonstrated normal distribution. Results:Compared with daily CBCT image guidance, the CTV_D 98% in weekly CBCT was significantly reduced [(69.08±1.58) vs. (65.24±3.64) Gy, P<0.001]. The CTV_D 98% of bone-based matching was (69.27±2.14) Gy, but the high-dose volume of the rectum were significantly increased: V 60 Gy was 3.18%±3.10%, V 65 Gy was 0.77%±1.23%. The target area coverage using soft tissue-based matching is sufficient, with a CTV_D 98% of (69.08±1.58) Gy. And the percentage volume of high-dose volume of the rectum was significantly reduced, with V 60 Gy being 2.02%±2.42% and V 65 Gy being 0.34%±0.68%. Conclusions:In prostate cancer patients undergoing moderately-fractionated radiotherapy, daily CBCT image guidance demonstrates superior target coverage compared to a weekly scheme. Soft tissue-based matching, which is automatic bone-based matching followed by manual soft tissue-based matching and fine-tuning according to the anterior rectal wall, offers better rectal protection while maintaining target coverage.

Radical chemoradiotherapy is the standard treatment for unresectable locally advanced esophageal carcinoma, but its efficacy needs to be further improved, and combined immunotherapy is a potential direction to solve this issue. At present, the combination of radical radiotherapy and chemotherapy with immunotherapy mainly includes three modes: induction chemotherapy combined with immunotherapy before radiotherapy and chemotherapy, concurrent immunotherapy during radiotherapy and chemotherapy, and immune maintenance therapy after radiotherapy and chemiotherapy. A number of phase I and Ⅱ clinical trials have shown that radiotherapy and chemotherapy combined with immunotherapy can be tolerated by patients with good clinical efficacy, and more research data and long-term follow-up results are expected. At the same time, the adverse reactions caused by immunotherapy still deserve attention. Finding the optimal combination therapy mode, screening the patient population suitable for the treatment mode, and predicting and identifying serious adverse reactions as early as possible are the directions that need to be explored continuously.

Objective:To investigate the advantage of three dimensional(3D)-printed tissue compensators in radiotherapy for superficial tumors at irregular sites.Methods:A subcutaneous xenograft model of prostate cancer in nude mice was established. Mice were randomly divided into no tissue compensator group( n=6), common tissue compensator group( n=6), and 3D-printed tissue compensator group( n=6). Computed tomography (CT) images of nude mice in the 3D-printed tissue compensator group were acquired. Compensator models were made using polylactic acid, and material properties were evaluated by measuring electron density. CT positioning images of the three groups after covering the corresponding tissue compensators were acquired to delineate the gross tumor volume (GTV). Nude mice in the three groups were irradiated with 6 MV X-rays at the prescribed dose. The prescribed dose for the three groups was 1 500 cGy. The dose distribution in the GTV of the three groups was calculated and compared using the analytical anisotropic algorithm in the Eclipse 13.5 treatment planning system. The metal-oxide-semiconductor field-effect transistor was used to verify the actual dose received on the skin surface of nude mice. Results:The air gap in the 3D-printed tissue compensator group and the common tissue compensator group was 0.20±0.07 and 0.37±0.07 cm 3, respectively ( t=4.02, P<0.01). For the no tissue compensator group, common tissue compensator group, and 3D-printed tissue compensator group, the D95% in the target volume was (1 188.58±92.21), (1 369.90±146.23), and (1 440.29±45.78) cGy, respectively ( F=9.49, P<0.01). D98% was (1 080.13±88.30), (1 302.76±158.43), and (1 360.23±48.71) cGy, respectively ( F=11.17, P<0.01). Dmean was (1 549.08±44.22), (1 593.05±65.40), and (1 638.87±40.83) cGy, respectively ( F=4.59, P<0.05). The measured superficial dose was (626.03±26.75), (1 259.83±71.94), and (1 435.30±67.22) cGy, respectively ( F=263.20, P<0.001). The percentage variation in tumor volume growth after radiation was not significantly different between the common tissue compensator group and the 3D-printed tissue compensator group ( P>0.05). Conclusions:3D-printed tissue compensators fit well to the body surface, which reduces air gaps, effectively increases the dose on the body surface near the target volume, and provides ideas for radiotherapy for superficial tumors at some irregular sites.