Objective: To investigate the trends in incidence and mortality of prostate cancer in Huangpu District, Shanghai Municipality from 2002 to 2019, so as to provide insights into the prevention and treatment of prostate cancer. Methods: The incidence and mortality of prostate cancer among men in Huangpu District from 2002 to 2019 were collected from the Shanghai Cancer Registry System. The crude incidence, crude mortality, truncated age-standardized incidence (aged 35 to 64 years) and cumulative incidence (aged 0 to 74 years) of prostate cancer were calculated. The Chinese Fifth National Population Census in 2000 and the Segi's world standard population in 1960 were used to calculate Chinese-standardized rate and world-standardized rate. The trends in incidence and mortality of prostate cancer were evaluated using annual percent change (APC) and average annual percent change (AAPC). Results: A total of 2 672 cases of prostate cancer were reported in Huangpu District from 2002 to 2019, and the crude incidence was 33.35/105, the Chinese-standardized incidence was 14.93/105 and the world-standardized incidence was 12.37/105 (AAPC=7.675%, 4.886% and 4.983%, all P<0.05). The incidence of prostate cancer among males at ages of 60 to <70 years and 70 to <80 years appeared increasing trends (AAPC=4.554% and 5.045%, both P<0.05). A total of 1 214 deaths of prostate cancer were reported, and the crude mortality was 15.15/105, the Chinese-standardized mortality was 6.01/105 and the world-standardized mortality was 4.61/105 (AAPC=5.500%, 2.057% and 1.784%, all P<0.05). The mortality of prostate cancer among males at ages of 80 years and above appeared an increasing trend (AAPC=4.220%, P<0.05). Conclusions The incidence and mortality of prostate cancer appeared increasing trends in Huangpu District from 2002 to 2019, and the incidence among males at ages of 60 years and above also increased. The screening for prostate cancer among males at ages of 60 years and above should be strengthened.

Objective To explore the molecular mechanism of Xiaojin Pills in the treatment of breast cancer using an integrated network pharmacology and experimental verification.Methods The chemical components and potential targets of Xiaojin Pills were obtained from TCMSP,TCM-ID,ETCM and SwissTargetPrediction databases.Breast cancer related targets were collected from GeneCards,OMIM and KEGG databases.The overlapped targets were imported into STRING database to analysis a protein-protein interaction(PPI).The key targets of PPI networks were screened based on node topology parameter values through Cytoscape 3.8.0.DAVID database was used to analyze the GO and KEGG pathway enrichment to build drug-chemical components-key targets-signaling pathway network.The breast cancer cell lines MDA-MB-231 and SK-BR-3 were used to study the effects of Xiaojin Pills extract on cell apoptosis,migration and invasion,and to verify the key pathway obtained by enrichment analysis.Results Totally 181 chemical components in Xiaojin Pills were obtained,including quercetin,myricetin,pinocembrin and β-sitosterol.615 potential targets were identified for the anti-breast cancer effects of Xiaojin Pills.After overlapping,170 key targets against breast cancer were identified based on the topological analysis,which included SRC,ERK1/2,AKT1,EGFR,etc.KEGG analysis enriched pathways including pathways in cancer,MAPK signaling pathway,endocrine resistance,PI3K-AKT signaling pathway,EGFR tyrosine kinase inhibitor resistance,apoptosis,and HIF-1 signaling pathway,which may play important roles in the therapeutic effects of Xiaojin Pills against breast cancer.GO enrichment was involved in protein phosphorylation,inflammatory response,negative regulation of apoptosis,and positive regulation of ERK1 and ERK2 cascades.Cell experiments showed that Xiaojin Pills further induced mitochondria-dependent apoptosis by inhibiting the activation of MAPK and PI3K-AKT pathways.At the same time,the expressions of ZO-1 and β-catenin increased,and the epithelial-mesenchymal transformation process was reversed to inhibit the metastasis of breast cancer cells.Conclusion The key targets and signaling pathways of Xiaojin Pills in the treatment of breast cancer are studied through network pharmacology combined with in vitro experiments,which provided a basis for further study of its pharmacodynamic material basis,mechanism of action and clinical application.

The increasing frequency of radiographic diagnostic imaging and the cumulative dose to the public from radiation has raised widespread concerns. However, accurate measurement of the radiation dose received by the human body is difficult to achieve. Monte Carlo simulation, as a numerical computational method guided by probability statistics theory, has been applied to various dose assessments, imaging optimizations, and radiation protection in radiographic diagnostic imaging. We provide a comprehensive review of the principles of the Monte Carlo method, the modelling process of Monte Carlo simulation and the progress of its application to diagnostic radiological dose estimation.

Objective:To analyze the existing problems in maternal and child health services in Shanghai′s communities, so as to provide references for the continuous improvement and enhancement of maternal and child health work in community.Methods:Retrieve relevant literature on community maternal and child health services in Shanghai from databases such as CNKI, Wanfang, VIP, Chinese biomedical literature database and PubMed for text analysis, with a search period from 2009 to 2023. From August 2022 to May 2023, a purposive sampling method was used to select community health service centers in Shanghai for participatory observation. Interviews were conducted with maternal and child health service providers in community, management personnel at all levels, and obstetric experts from tertiary hospitals participating in the construction of medical alliances to understand the problems that exist in the process of providing maternal and child health services in community service centers. Based on text analysis, participatory observation, and interview results, a structure-process-outcome theory model was used to sort out a list of problems of maternal and child health services in Shanghai′s community. An electronic questionnaire was created based on the list of questions, and maternal and child health service personnel in each jurisdiction were invited to rate the existing problems from three aspects: importance, severity, and solvability. The key issues was determined based on the total score of each problem.Results:A list of 24 issues related to maternal and child health services in Shanghai′s community has been formed, with the structural dimension including team building and hardware facilities, the process dimension including mechanism construction, implementation process, and institutional coordination, and the result dimension only including system result category. According to the survey results, the three key questions with a total score greater than 7 were identified as the need for improvement in the maternal and child health knowledge and skills of service personnel; Insufficient staffing of service personnel, lack of dedicated personnel and specialized talents; The health information platform was not well-established, and institutions could not fully and timely share diagnosis and treatment data.Conclusions:This study has identified a problem list for maternal and child health care services in Shanghai′s communities, as well as key issues that urgently need to be addressed, which can provide reference for improving the quality of maternal and child health care services in Shanghai′s communities.

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the efficacy of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects who were previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extended or switched TMF treatment for 48 weeks. Efficacy was evaluated based on virological, serological, biological parameters, and fibrosis staging. Statistical analysis was performed using the McNemar test, t-test, or Log-Rank test according to the data. Results:593 subjects from the initial TMF group and 287 subjects from the TDF group were included at week 144, with the proportions of HBV DNA<20 IU/ml at week 144 being 86.2% and 83.3%, respectively, and 78.1% and 73.8% in patients with baseline HBV DNA levels ≥8 log10 IU/ml. Resistance to tenofovir was not detected in both groups. For HBeAg loss and seroconversion rates, both groups showed a further increase from week 96 to 144 and the 3-year cumulative rates of HBeAg loss were about 35% in each group. However, HBsAg levels were less affected during 96 to 144 weeks. For patients switched from TDF to TMF, a substantial further increase in the alanine aminotransferase (ALT) normalization rate was observed (11.4%), along with improved FIB-4 scores.Conclusion:After 144 weeks of TMF treatment, CHB patients achieved high rates of virological, serological, and biochemical responses, as well as improved liver fibrosis outcomes. Also, switching to TMF resulted in significant benefits in ALT normalization rates (NCT03903796).

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the safety profile of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects that previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extending or switching TMF treatment for 48 weeks. Safety profiles of kidney, bone, metabolism, body weight, and others were evaluated.Results:666 subjects from the initial TMF group and 336 subjects from TDF group with at least one dose of assigned treatment were included at week 144. The overall safety profile was favorable in each group and generally similar between extended or switched TMF treatments from week 96 to 144. In subjects switching from TDF to TMF, the non-indexed estimated glomerular filtration rate (by non-indexed CKD-EPI formula) and creatinine clearance (by Cockcroft-Gault formula) were both increased, which were (2.31±8.33) ml/min and (4.24±13.94) ml/min, respectively. These changes were also higher than those in subjects with extending TMF treatment [(0.91±8.06) ml/min and (1.30±13.94) ml/min]. Meanwhile, switching to TMF also led to an increase of the bone mineral density (BMD) by 0.75% in hip and 1.41% in spine. On the other side, a slight change in TC/HDL ratio by 0.16 (IQR: 0.00, 0.43) and an increase in body mass index (BMI) by (0.54±0.98) kg/m 2 were oberved with patients switched to TMF, which were significantly higher than that in TMF group. Conclusion:CHB patients receiving 144 weeks of TMF treatment showed favorable safety profile. After switching to TMF, the bone and renal safety was significantly improved in TDF group, though experienceing change in metabolic parameters and weight gain (NCT03903796).

Objective:To study the clinical value of lung ultrasound score (LUSsc) within 2 h after birth for pulmonary surfactant (PS) use in preterm infants with respiratory distress syndrome (RDS).Methods:From July 2019 to May 2021, preterm infants with RDS hospitalized in our hospital and received pulmonary ultrasound within 2 h after birth were prospectively enrolled. 12-area LUSsc was calculated. The infants were assigned into <32 weeks group and 32-36 weeks group according to gestational age (GA). Simple random sampling was carried out in each group with 1/5 as the validation set and the other 4/5 as the training set. The infants were also assigned into PS group and non-PS group according to PS usage within 24 h after birth. Receiver operator characteristic (ROC) curve of LUSsc predicting PS usage was drawn and validated.Results:A total of 857 RDS infants were enrolled, including 313 in <32 weeks group and 544 in 32-36 weeks group. For <32 weeks group, area under curve (AUC) of LUSsc>8.5 predicting PS use was 0.779 (95% CI 0.722-0.837), with 76.4% sensitivity and 81.4% specificity. The accuracy of using LUSsc>8.5 as cut-off predicting actual clinical PS application was 82.3% (Kappa value 0.692, P<0.05, McNemar's test P>0.05).For 32-36 weeks group, AUC of LUSsc>9.5 predicting PS use was 0.785 (95% CI 0.723-0.848), with 71.1% sensitivity and 81.7% specificity. The accuracy of using LUSsc>9.5 as cut-off predicting actual clinical PS application was 92.6% (Kappa value 0.772, P<0.05, McNemar's test P>0.05). Conclusions:LUSsc within 2 h after birth is independent predictor of PS use in preterm infants with RDS. For <32 weeks group, LUSsc>8.5 suggests PS application and for 32-36 weeks group the cut-off is LUSsc>9.5.

Objective:To investigate the thyroid volume of adults in Lanzhou City, and analyze its influencing factors.Methods:In June 2016, according to the principle of multi-stage stratified cluster sampling, Han residents aged 18 and above in Chengguan, Xigu and Qilihe districts of Lanzhou City who had lived there for more than 5 years were selected as research subjects, and a portable B-ultrasound machine was used for thyroid examination. Morning urine samples of the subjects were collected to test urinary iodine; fasting venous blood samples of the subjects were collected to test serum thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TgAb), blood lipids [triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL)] and blood uric acid (Ua) levels. At the same time, body indexes systolic blood pressure (SP), diastolic blood pressure (DP), waist circumference, height and weight were measured, and the body mass index (BMI) was calculated. Multiple linear regression was used to analyze the influencing factors of thyroid volume.Results:A total of 1 009 subjects were included, aged (43.50 ± 15.16) years, and the thyroid volume was (8.74 ± 3.39) ml. Among them, 534 males had a thyroid volume of (9.46 ± 3.43) ml; 475 females had a thyroid volume of (7.93 ± 3.15) ml, the thyroid volume of males was larger than that of females ( t = 7.36, P < 0.01). Thyroid volume was positively correlated with age, height, weight, BMI, SP, waist circumference, LDL, Ua and TgAb ( r = 0.07, 0.23, 0.33, 0.27, 0.10, 0.27, 0.10, 0.08, 0.07, P < 0.05), and it was negatively correlated with thyroid nodules, TPOAb, TSH and urinary iodine ( r = - 0.16, - 0.07, - 0.10, - 0.08, P < 0.05). After multiple linear regression analysis, TSH, TPOAb, TgAb and thyroid nodules were included in the regression equation, and the standardized B values were - 0.135, - 0.065, 0.123 and - 0.197, respectively. Conclusions:The thyroid volume of males is larger than that of females in Lanzhou City. TSH, TPOAb, TgAb and thyroid nodules are influencing factors of thyroid volume.

Objective:To investigate the detection rate and related factors of thyroid nodules in people with abnormal lipid metabolism.Methods:From September 4, 2016 to February 1, 2017, community residents living in Lanzhou City, Longnan City, Dingxi City and Linxia City of Gansu Province for more than 5 years were selected as the respondents. General data were recorded, venous blood was collected, blood lipid related biochemical indexes were detected, and thyroid ultrasound was performed. By comparing the general data and biochemical indexes, the detection of abnormal lipid metabolism and thyroid nodules were analyzed, and the risk factors of thyroid nodules in people with abnormal lipid metabolism were analyzed by logistic regression.Results:Two thousand and fifty-nine residents were included in this study (1 049 males and 1 010 females). The total detection rate of thyroid nodules was 23.17% (477/2 059). The detection rate of thyroid nodules in people with abnormal lipid metabolism [34.16%(151/442)] was significantly higher than that in people with normal lipid metabolism [20.16% (326/1 617) , P < 0.01], and the detection rate of thyroid nodules of women [43.37% (85/196) ] was higher than that of men [26.83% (66/246) , P < 0.01]. Among the people with abnormal lipid metabolism, the highest detection rate of thyroid nodules was in mixed hyperlipidemia [57.14% (16/28)], followed by hypertriglyceridemia [34.59% (92/266)]. The detection rates of thyroid nodules in the groups with elevated total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels [35.16% (32/91), 34.85% (23/66)] were higher than those in the marginal elevated group [27.04%(86/318), 30.42% (73/240)] and the normal groups [21.76% (359/1 650), 21.73% (381/1 753), P < 0.05]. The results of logistic regression analysis showed that the risk factors of thyroid nodules in people with abnormal lipid metabolism were increased age, elevated fasting blood glucose (FPG), elevated blood glucose 2 hours (2 h PG) after oral glucose tolerance test (OGTT) load and elevated glycosylated hemoglobin [HbA1c, odds ratio ( OR)=1.065, 1.387, 1.866, 1.384, P < 0.05]. Conclusions:The prevalence of TN is higher in populations with abnormal lipid metabolism. The control of blood sugar and blood lipid levels may play a role in the prevention of thyroid nodules.

With continuous discovery of tumor immune targets and continuous changes in antibody research and development technology, antibody drugs are becoming more and more widely used in clinical practice. However, some targets are not only expressed on tumor cells, but also on red blood cells. Therefore, the clinical application of antibodies against the corresponding targets may interfere with the detection of blood transfusion compatibility, resulting in difficulty in blood matching or delay of blood transfusion. This consensus summarizes the current solutions for the interference of CD38 monoclonal antibody (CD38 mAb) in transfusion compatibility testing. After analyzing the advantages and disadvantages of different methods, polybrene and sulfhydryl reducing agents [dithiothreitol (DTT) or 2-mercaptoethanol (2-Me)], as a solution for CD38 mAb interference in blood compatibility testing, are recommended for Chinese patients, so as to eliminate blood transfusion interference produce by CD38 mAb and further provide a pre-transfusion workflow for clinicians and technicians in Department of Blood Transfusion.