Objective: To analyze the developmental trajectories of clustered health risk behaviors and their association with self-esteem and lonelinesss among junior high school students, so as to provide a reference for formulating comprehensive prevention and control measures of health risk behaviors among adolescents. Methods: In October 2023, 1 165 first year junior high school students from two schools of Jishou City in Hunan Province were selected by convenient sampling method for three follow up surveys (T1:October 2023; T2:April 2024; T3:October 2024). The Adolescent Health Risk Behavior Questionnaire, Rosenberg Self esteem Scale and Loneliness Scale were used to assess health risk behaviors, self esteem and loneliness, respectively. Latent growth curve modeling and latent growth mixture modeling were applied to analyze the developmental trajectories of clustered health risk behaviors among junior high school students. Logistic regression was used to analyze the association of the developmental trajectories of clustered health risk behaviors with self esteem and loneliness among junior high school students. Results: The overall developmental trajectories among junior high school students showed a declining trend (intercept=0.15, slope=-1.65, both P <0.05), with three heterogeneous categories:low risk improvement group ( n =862, 74.0%), moderate risk stable group ( n =260, 22.3%), and high risk deterioration group ( n =43, 3.7%). After adjusting the status of the left behind individuals，using the low risk improvement group as the reference category in multinomial Logistic regression analysis, results indicated that higher loneliness scores among junior high school students increased the risks of belonging to the moderate risk stable group ( OR=1.02, 95%CI =1.00- 1.04 ) and the high risk deterioration group ( OR=1.04, 95%CI =1.00-1.08), while higher self esteem scores reduced the risks of belonging to the moderate risk stable group ( OR=0.93, 95%CI =0.91-0.96) and the high risk deterioration group ( OR=0.88, 95%CI =0.83-0.94) (all P <0.05). Conclusions The overall trend of clustered health risk behaviors among junior high school students gradually improves, and the self esteem and loneliness are significant correlative factors. Targeted intervention measures should be developed for the junior high school students, with a focus on enhancing their self esteem and alleviating loneliness.

Mass spectrometry imaging （MSI） is an emerging molecular imaging technique that combines high spatial resolution and the ability to acquire molecular information. This technology can directly obtain spatial distribution maps of metabolites, proteins, lipids and other molecules in tumor tissues, reveal the abnormal molecular changes during the occurrence and development of liver cancer, and make up for the deficiency of information at the molecular level in traditional imaging （such as CT, MRI）. In liver cancer research, MSI has demonstrated unique advantages and application potential in early diagnosis and screening, precise classification, tumor heterogeneity analysis, and exploration of molecular mechanisms. The principle characteristics of MSI technology and its latest progress in the early diagnosis, classification and molecular mechanism research of liver cancer were reviewed, and the current challenges and future development directions were discussed, which aimed to provide a new perspective and theoretical basis for an in-depth understanding of the pathological mechanism of liver cancer and promoted its precise diagnosis and treatment.

Objective:To describe and analyze the incidence, mortality and epidemiological trends of liver cancer in China and selected regions worldwide, providing data references for liver cancer prevention and control.Methods:Data on the incidence, mortality, historical trends, and projected estimates for 2050 of liver cancer were extracted from the GLOBOCAN 2022 database. Epidemiological characteristics of liver cancer in China and other region were described and compared by region, age, sex and human development index (HDI). Spearman's test was used to examine the relationships between HDI and age-standardized incidence rate (ASIR) or age-standardized mortality rate (ASMR) across regions. The average annual percentage change (AAPC) in ASIR was calculated using Joinpoint regression analysis.Results:In 2022, the number of new cases and deaths of liver cancer in the global were 866 000 and 759 000 respectively, and the ASIR and ASMR were 8.6/10 5 and 7.4/10 5, respectively. Both ASIR and ASMR were higher in males than in females. In China, there were 368 000 new cases and 317 000 deaths in 2022, with an ASIR of 15.0/10 5 and an ASMR of 12.6/10 5. Globally, the incidence of liver cancer in males peaked in the 65-69 age group, while in Chinese males, two incidence peaks were observed in the 50-54 and 65-69 age groups. Among the elderly (≥65 years), the global ASIR and ASMR were 7.4 and 8.1 times higher, respectively, than those in the working-age population (15-64 years). In China, the ratios of ASIR and ASMR between the elderly and working-age populations were 5.9 and 7.0, respectively. Both ASIR and ASMR were negatively correlated with HDI (ASIR: r=-0.18, P=0.018; ASMR: r=-0.31, P＜0.001). From 2002 to 2017, ASIR of liver cancer showed a declining trend in both males and females in China, Japan, and South Korea (all P＜0.001), with AAPCs of -1.96% for Chinese males and -2.75% for Chinese females. In contrast, the United States experienced an increasing trend in ASIR, with AAPCs of 3.13% for males and 3.12% for females (both P＜0.001). Projections indicate that by 2050, the number of new cases and deaths globally will reach 1.564 million and 1.421 million, representing increases of 80.6% and 87.2% compared to 2022, respectively. In China, the number of new cases and deaths are projected to be 560 000 and 514 000, increases of 52.2% and 62.1% from 2022, respectively. Conclusions:The burden of liver cancer varies significantly across regions, sexes, and age groups worldwide. Incidence and mortality rates are negatively correlated with HDI. The global burden of liver cancer is expected to continue increasing, underscoring the need for enhanced comprehensive prevention and control strategies.

Objective:To describe the epidemiological characteristics and trends of lung cancer incidence in Qidong City, Jiangsu Province, China, between 1972 and 2021, and provide guidelines for prevention and control.Methods:Data on lung cancer with onset from January 1, 1972 to December 31, 2021 and coded as C33-C34 in the International Classification of Diseases (10th edition) were extracted from the tumor registry database of Qidong City. Population data of Qidong City for each year from 1972 to 2021 were extracted from the annual report of household registration of the Public Security Bureau of Qidong City. The crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), 35-64 years truncated rate, 0-74 years cumulative rate, and cumulative risk were calculated. Average annual percentage change (AAPC) was calculated by Joinpoint software for CR, ASRC, and ASRW. The age-period-cohort (APC) model was used to analyze the influence of age, period, and birth cohort on the changes in the incidence trend of lung cancer.Results:From 1972 to 2021, there were 26 996 patients of lung cancer in Qidong, accounting for 18.30% (26 996/147 519) of all cancer new cases. The CR of lung cancer was 48.13/10 5, the ASRC was 29.65/10 5, and the ASRW was 29.67/10 5. The truncated incidence of 35-64 years old was 42.64/10 5, the cumulative incidence rate between the ages between 0-74 years old was 3.71%, and the cumulative risk was 3.64%. There were 18 572 male patients, with the CR, ASRC, and ASRW being 67.15/10 5, 43.82/10 5, and 43.87/10 5, respectively. The number of female patients was 8 424, and the CR, ASRC, and the ASRW were 29.62/10 5, 17.63/10 5, and 17.55/10 5, respectively. Temporal analysis indicated significant upward trends in the ASRCs for both genders combined, males, and females, with AAPC values of 2.21%, 1.76%, and 2.98% (all P<0.001), respectively. Age-specific incidence rates increased with age, peaking at 275.34/10 5 in the 75+ years age group, with an increasing trend in all age groups and the greatest increase in the 75+ years age group, with an AAPC value of 3.53% ( P<0.001). The results of the APC model showed that the net drift value of lung cancer incidence was 2.06% (95% CI: 1.72%-2.41%), and the highest value of local drift was 3.93% (95% CI: 3.20%-4.68%) in the 80+ years old group. The risk of cancer increases with age in the age effect. The period effect of the incidence rate ratio (RR) value increased from 1.12 during 1997-2001 to 2.09 during 2017-2021. The cohort effect of the RR value for risk of incidence increased from 0.17 during 1892-1896 to 2.54 during 1987-1991. Conclusions:From 1972 to 2021, the incidence rate of lung cancer in Qidong City showed an upward trend. Age, period, and cohort are all major factors influencing the incidence of lung cancer. It is necessary to develop precise and comprehensive prevention and control strategies to curb this increasing trend of lung cancer incidence.

Objective Responding to the imperative to modernize vocational education and establish competency-oriented systems,this study investigates the development of on-campus training bases for speech and hearing rehabilitation(SHR)programs within Chinese higher vocational colleges(HVC).It analyzes their functional role and essential compo-nents,and propose a competency-oriented,modular framework for on-campus training based on World Health Organization(WHO)rehabilitation competency framework(RCF),and professional education standards.Methods This research synthesized theories of higher vocational education and practical pedagogy(e.g.,situated learn-ing,experiential learning and constructivism)with analyses of domestic and international SHR educational poli-cies and standards.It examined the strategic importance and essential components(hardware,software,human re-sources,management)of on-campus training bases in the context of higher vocational education.Synthesizing RCF with standards from ASHA(knowledge and skills acquisition,KASA),International Association of Logope-dics and Phoniatrics(IALP),and Teaching Standards for Higher Vocational Schools from Ministry of Education of the People's Republic of China,a core SHR professional competency model tailored for HVC was developed.This model subsequently guided the design of a modular on-campus training curriculum and associated pedagogi-cal approaches.Results On-campus training bases were pivotal platforms that bridge theory and practice,facilitating'teaching-learning-doing'integration within HVC SHR programs.Effective base construction necessitated synergistic integration across four key domains:hardware facilities(meeting specialized acoustic/equipment needs),software resources(case libraries,standard operating procedure and digital tools),'dual-role'human resources and robust manage-ment systems(operations,evaluation,industry-education linkages).Derived from RCF and related standards,a core SHR competency framework was developed,encompassing dimensions such as foundational knowledge and ethics,assessment(audiological;speech-language),intervention(audiological rehabilitation and technology;speech-language),and communication and collaboration.Consequently,eight core training modules were de-signed,including basic operations of hearing testing,introduction to objective hearing testing,preliminary hear-ing aid fitting,application of standardized speech-language assessment tools,simulation of articulation and voice disorder assessment and intervention,simulation of swallowing disorder screening and basic training,comprehen-sive case analysis and rehabilitation plan development,and practice of professional literacy and communication skills;detailing objectives,activities,and resources,and intended for seamless integration with theoretical cours-es and off-campus practicum,establishing a cohesive'curriculum-training-practicum'continuum.Furthermore,a suite of adaptable pedagogical models,including problem-based learning,case-based learning,simulation-based training,project-based learning and the flipped classroom,were recommended for implementing these modules.Conclusion The effective development of on-campus training bases for SHR programs in HVC necessitates establishing a systematic,competency-oriented practical teaching environment.Grounded in RCF,and essential SHR knowl-edge,skills and abilities,this study proposes a framework incorporating eight core training modules and comple-mentary pedagogical models,providing a theoretically grounded,practically applicable blueprint for enhancing the educational quality and substance of these bases within HVC.Successful realization hinges upon the synergis-tic development of the four key elements(hardware,software,human resources,management),deep integration between training activities,the curriculum,and practicum experiences,and the application of innovative pedago-gy to cultivate student potential.

Objective:To analyze pancreatic cancer incidence and mortality data in China and worldwide and to provide data for pancreatic cancer prevention and control efforts.Methods:Data of pancreatic cancer incidence and mortality rates, along with historical and predictive data, were obtained from the GLOBOCAN 2022 database. Epidemiological characteristics of pancreatic cancer was analyzed by region, sex, age and Human Development Index (HDI). Spearman's correlation coefficient test was used to assess the relationship between HDI and age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR).Results:In 2022, the global number of new cases and deaths of pancreatic cancer will be 511 thousand and 467 thousand, respectively, with an ASIR and ASMR of 4.7/10 5 and 4.2/10 5, respectively. North America and Europe had the highest pancreatic cancer incidence and mortality rates of 8.5/10 5 and 7.3/10 5, respectively. Global ASIR and ASMR in men were both 1.4 times higher than those in women. HDI levels were positively correlated with ASIR ( r=0.79, P＜0.001) and ASMR ( r=0.78, P＜0.001) of pancreatic cancer in all regions. The number of pancreatic cancer cases and deaths in China were 119 thousand and 106 thousand, respectively, while the ASIR and ASMR of pancreatic cancer were 4.4/10 5 and 3.9/10 5, respectively. Both ASIR and ASMR in men were both 1.5 times higher than those in women in China. The number of pancreatic cancer incidence and death cases in China in 2050 is predicted to be 216 thousand and 204 thousand cases, with an increase of 81.5% and 92.5% compared with 2022, respectively. Conclusions:The disease burden of pancreatic cancer varies significantly among different regions, genders and ages. Pancreatic cancer incidence and mortality are positively correlated with HDI. The incidence and mortality rates of pancreatic cancer in China are close to the global average, but the number of new cases and deaths is high. Prevention and control should be strengthened to improve the survival of pancreatic cancer patients.

Objective:To describe the epidemiological characteristics of breast cancer incidence in Qidong City between 1972 and 2021, and provide guidelines for preventive and control measures and strategies.Methods:The cancer registry data were collected and breast cancer incidences during 1972 and 2021 in Qidong by sex, age, and time were analyzed. Crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), annual percentage change (APC), and average annual percentage change (AAPC) were calculated by Joinpoint software. The age-period-cohort model was used to analyze the influence of age, period, and birth cohort on the changes in the incidence trend of breast cancer.Results:From 1972 to 2021, there were 6 929 patients with breast cancer in Qidong, accounting for 4.70% of all new cancer cases, with a CR of 12.35/10 5, a ASRC of 6.63/10 5, and a ASRW of 8.89/10 5. The truncated incidence rate among people aged 35-64 years was 21.90/10 5. The cumulative incidence rate of the ages between 0 and 74 years was 0.96%. The cumulative risk was 0.96%. There were 98 male patients, whose CR, ASRC, and ASRW were 0.35/10 5, 0.17/10 5, and 0.25/10 5, respectively. The number of female patients was 6 831, and the CR, ASRC, and ASRW were 24.02/10 5, 12.86/10 5, and 17.13/10 5, respectively. The AAPC of ASRW of female breast cancer was 3.45% (95% CI: 2.90%-4.01%). The increasing trend of the incidence rate was statistically significant ( P＜0.05). The AAPCs of females aged 25-34, 35-44, 45-54, 55-64, 65-74, and ≥75 years were 2.78% (95% CI: 0.88%-4.72%), 2.20% (95% CI: 0.83%-3.60%), 3.81% (95% CI: 2.45%-5.19%), 4.48% (95% CI: 3.12%-5.85%), 3.79% (95% CI: 2.19%-5.43%), and 2.87% (95% CI: 1.14%-4.63%). The increasing trends of the incidence rates in all age groups were statistically significant ( P＜0.05). The age-period-cohort model showed that the risk of breast cancer increased with age, and people born later were faced with a higher risk of the disease ( P＜0.05). Conclusion:The incidence of breast cancer presented a rising trend in the past fifty years in Qidong. The increasing trend of the incidence rate was statistically significant since the beginning of this century. The health administrative department should formulate preventive and control measures to reduce the burden of breast cancer.

Objective:To analysis the prevalence characteristics of cancer mortality among the elderly in Qidong City, Jiangsu Province, from 1972 to 2021, and to provide scientific basis for the development of precise prevention and control strategies for cancer in the elderly.Methods:Data of cancers were obtained from Qidong Cancer Registry, a descriptive study method was used to calculate the crude mortality rate (CMR) of cancer among the elderly (≥60 years old). The China age-standardized rate (ASR-C) was calculated using the age structure of the Chinese population in 2000, and world age-standardized rate (ASR-W) was calculated using Segi's world standard population. Joinpoint regression analysis was performed using Joinpoint 4.9.1.0 software to calculate the annual percentage change (APC) and average annual percentage change (AAPC) of mortality.Results:From 1972 to 2021, there were 74 723 cancer deaths in the elderly in Qidong, with CMR of 752.08/10 5, ASR-C of 666.03/10 5 (994.22/10 5 for males and 470.29/10 5 for females) and ASR-W of 681.11/10 5. The ASR-C showed little fluctuation before 2000, increased rapidly from 2001 to 2011, and then decreased from 2011 to 2021. From 2017 to 2021, the CMR was 791.01/10 5, the ASR-C was 689.80/10 5 (956.77/10 5 for males and 469.98/10 5 for females), and the ASR-W was 657.53 /10 5. The CMR for the 60-64, 65-69, 70-74, 75-79, and 80+ age groups from 2012 to 2021 were 385.42/10 5 505.51/10 5, 721.64/10 5, 1 213.28/10 5, and 1 705.32/10 5, respectively. The CMR of elderly under 75 years old were lower from 2012 to 2021 than in other periods, while those of elderly people aged more than 75 years were higher from 2012 to 2021 than in other periods. The AAPC for ASR-C of all cancers over the 50 years was 0.22%, with APC of -1.59% in 2008-2021 (both P＜0.05). Over the 50 years, the top five cancers in terms of mortality were lung cancer, gastric cancer, liver cancer, colorectal cancer, and esophageal cancer. Their AAPCs of ASR-C were 1.61%, -2.36%, -0.10%, 1.44%, and -2.03%, respectively. The increasing trends of mortality rates for lung cancer and colorectal cancer and the decreasing trends for gastric cancer and esophageal cancer were statistically significant ( P＜0.05). Conclusions:The mortality of cancers among elderly is at a high level in Qidong. The overall mortality since 2008 have shown a decreasing trend, and the prevention and control of some cancers have been effective.

Objective:To analyze the trend of ovarian cancer incidence in Qidong City from 1972 to 2021 and evaluate the age, period, and cohort effect.Methods:The ovarian cancer incidence data from 1972 to 2021 were extracted from the Qidong Cancer Registry Database, the crude incidence rate (CR), age standardized rate by Chinese population (ASR-C), age standardized rate by world population (ASR-W), and average annual percent change (AAPC) were calculated. The age-period-cohort model was used to analyze the age, period, and birth cohort effects of the ovarian cancer incidence in Qidong from 1972 to 2021.Results:From 1972 to 2021, a total of 1 007 cases of ovarian cancer occurred in Qidong. The AAPC values of CR, ASR-C, and ASR-W were 7.02% , 5.17%, and 5.12% , respectively (all P＜0.001). The time trends showed that, the AAPC values of the age groups of 0-34, 35-44, 45-54, 55-64, 65-74, and over 75 years old were 4.10%, 4.74%, 6.02%, 4.86%, 4.23%, and 5.18%, respectively (all P＜0.05). The age effect showed that the incidence rate of ovarian cancer increased obviously from the 45-49 year-old group, reaching a peak of 20.67/100 000 in the 75-79 year-old group. Compared with the 1992-1996 group, the period of 2002-2021 had significant effects on the incidence rise of ovarian cancer (all P＜0.05), and the incidence rate ratio ( RR) increased with the period: in 2017-2021 the RR was 3.86 (95% CI: 2.72-5.47). Using births from 1952 to 1956 as the reference group, the RR increased slowly from 0.12 (95% CI: 0.02-0.91) in 1892-1896, and peaked in 2007-2011 with an RR of 18.05 (95% CI: 3.51-92.87). The birth cohorts in 1967-2011 had significant effects on the incidence rise of ovarian cancer (all P＜0.05). The Waldχ 2 test of the age-period-cohort model showed that there were significant differences in the age, period, and birth cohort effects (all P＜0.001). Conclusions:The incidence of ovarian cancer in Qidong was on the rise. Age, period, and cohort were the main factors affecting the incidence of ovarian cancer. The middle-aged and elderly women were the focus of ovarian cancer prevention and control.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.