1.Effect of volatile oil of Ligusticum chuanxiong on transdermal properties and cytotoxicity of triptolide in vitro
Cheng JIANG ; Zhenzhong ZANG ; Lihua CHEN ; Haiting ZHU ; Shihua FU ; Weifeng ZHU ; Wenting WU ; Wei SHI ; Yongmei GUAN
China Pharmacy 2024;35(4):413-418
OBJECTIVE To explore the effect of volatile oil of Ligusticum chuanxiong on the transdermal properties and cytotoxicity of triptolide in vitro. METHODS The chemical constituents of the volatile oil of L. chuanxiong were analyzed by gas chromatography-mass spectrometry. The lower abdominal skin of KM mice was separated and divided into triptolide group, triptolide in compatibility with volatile oil of L. chuanxiong groups at 1∶10, 1∶50, 1∶100 (hereinafter referred to as “compatibility 1∶10”“compatibility 1∶50”“compatibility 1∶100” groups). After the skin of mice in each group was fully exposed to 0.2 g of the corresponding cream for 24 h, the cumulative transdermal dose (Qn) of triptolide in the receiving solution of each group was determined by high-performance liquid chromatography, and the transdermal absorption rate (Jss) was calculated. Human immortalized keratinocytes (HaCat) were used as a model, the CCK-8 method was used to detect the cell survival rate of different concentrations of the volatile oil of L. chuanxiong and triptolide before and after compatibility. RESULTS A total of 62 chemical constituents of the volatile oil of L. chuanxiong were identified, including Z-ligustilide, senkyunolide, and β-selinene. The Qn (P< 0.01) and Jss of triptolide increased within 24 h in the compatibility 1∶10 and 1∶50 groups, while the Qn (P<0.05) and Jss decreased in the compatibility 1∶100 group as compared with the triptolide group. Compared with the triptolide group, the cell survival rate of HaCat was significantly increased in the compatibility 1∶10 and 1∶50 groups when the triptolide concentrations were 36, 72 and 144 ng/mL (P<0.05 or P<0.01); while the cell survival rate of HaCat was decreased in the compatibility 1∶100 group, but the difference was not statistically significant (P>0.05). CONCLUSIONS When the compatibility ratio of triptolide and volatile oil of L. chuanxiong was 1∶10 or 1∶50, it can promote the transdermal absorption of triptolide and reduce the cytotoxicity of triptolide to HaCat.
2.Toxic effects of sodium hypochlorite as disinfectants on human bronchial epithelial cells
Jiawei LI ; Jiangzheng LIU ; Xiaojie GUO ; Yongmei TU ; Minjie SHI ; Wenli LI ; Jinsuo LU
Journal of Environmental and Occupational Medicine 2024;41(7):822-827
Background There are a variety of microorganisms in ambient air, and susceptible people can be infected once contact with pathogenic microorganisms in the environment. In order to avoid the spread of pathogenic bacteria, disinfection is the simplest and most effective way of killing pathogenic bacteria in the environment to block the contact between pathogenic bacteria and humans. Sodium hypochlorite (NaClO) is the most widely used disinfectant, but its safety in ambient air disinfection is not clear yet. Objective To establish a model of bronchial epithelial cell (BEAS-2B) injury induced by NaClO, and to explore the mechanism of the toxic effect of NaClO disinfectants on BEAS-2B. Methods Cells were treated with concentration gradients of 0, 25, 50,100, 200, and 400 μmol·L−1 of the diluted NaClO (100 mmol·L−1) standard solution, respectively, and cell activity was measured by cell counting kit-8 (CCK-8) assay after 15 and 30 min. Cells treated with 0, 25, and 50 μmol·L−1 NaClO were selected to observe the cell morphology under an inverted microscope, apoptosis was determined by flow cytometry Annexin V FITC / PI double staining to determine the final experimental concentration. The morphology of organelles such as mitochondria was observed under a transmission electron microscope. Mitochondrial membrane potential of the cells was detected by JC-1 staining. Intracellular Ca2+ concentration was measured with a Fluo-4 AM fluorescent probe. Total cellular reactive oxygen species (ROS) was detected with a 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) fluorescent probe, cell mitochondrial ROS with a dihydroethidium (DHE) fluorescent probe, and lipid peroxidation intermediate malondialdehyde (MDA) with a commercial kit. Results Compared with 0 μmol·L−1, NaClO treatment group, cell morphology did not change a lot after 25 μmol·L−1 NaClO treatment for 30 min, and the cells began to wrinkle and become round after 30 min treatment with 50 μmol·L−1 NaClO, showing about 70% of normal cell viability (P<0.01). So 30 min 50 μmol·L−1 NaClO treatment was selected for the subsequent experiment. The experimental results found that compared with the 0 μmol·L−1 NaClO treatment group, the number of apoptotic cells increased (P<0.05), the mitochondrial membrane potential decreased (P<0.01), the intracellular Ca2+ concentration increased (P<0.05), the cellular ROS level increased (P<0.05), the mitochondrial ROS level increased (P<0.01), and the MDA content increased (P<0.01) in the NaClO treatment group.. Conclusion The study has successfully established a model of BEAS-2B injury induced by NaClO, and found that NaClO can lead to cell damage by inducing apoptosis and oxidative stress in BEAS-2B cells. According to the results, there are two possible reasons. First, NaClO solves in water to form hypochlorous acid (HClO) which is oxidative and increases the intracellular ROS level after entering cells, leading to cellular oxidative stress. Second, HClO enters cells to directly attack the mitochondrial membrane, resulting in the imbalance of potential inside and outside the mitochondrial membrane, and apoptosis caused by Ca2+ efflux.
3.Clinical characteristics and outcomes of psoriasis patients with COVID-19: A retrospective, multicenter cohort study in China
Yanhua LIU ; Zhongrui XU ; Jian ZHOU ; Aijun CHEN ; Junling ZHANG ; Xiaojing KANG ; Xian JIANG ; Chengzhi LYU ; Chunrui SHI ; Yuling SHI ; Xiaoming LIU ; Fuqiu LI ; Bin YANG ; Yongmei HUANG ; Chen YU ; Gang WANG
Chinese Medical Journal 2024;137(14):1736-1743
Background::Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection.Methods::A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with coronavirus disease 2019 (COVID-19)-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2.Results::Among the infected groups, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs. 39.8% [92/231] vs. 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685–11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068–2.343), traditional systemic (adjusted OR = 1.887, 95% CI= 1.263–2.818), and nonsystemic treatment (adjusted OR= 1.602, 95% CI= 1.117–2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680–1.274, compared to no treatment), according to multivariable logistic regression analysis. Conclusions::A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension.
4.Analysis of the current status of cancer incidence and mortality in Shanghai,2017 and trends of 2002-2017
Kai GU ; Yi PANG ; Chunxiao WU ; Chunfang WANG ; Liang SHI ; Yongmei XIANG ; Yangming GONG ; Peng PENG ; Jianming DOU ; Mengyin WU ; Xiaocong ZHANG ; Ganling DING ; Jianying YAN ; Yan SHI ; Chen FU
Tumor 2023;43(4):241-256
Background and purpose:The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on cancer occurrence and trends in Shanghai.This study aimed to investigate the cancer incidence and mortality in 201 7 and their trends from 2002 to 2017 in Shanghai. Methods:Data of new cancer diagnoses and deaths from 2002 to 2017 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.Cancer incidence and mortality stratified by year of diagnosis or death,gender and age group were analyzed.Number,proportion,crude rate,age-specific rate,age-standardized rate and others were calculated.The number,proportion and rates of common cancers in different groups were also calculated.Trends in age-standardized rate of incidence and death rates for all cancers combined and for the common cancer types by gender were estimated by joinpoint analysis and characterized by the annual percent change(APC)and average annual percent change(AAPC).Segi's 1960 world standard population was used for calculating age-standardized incidence and mortality. Results:The new cancer cases and deaths were 79 378 and 37 186 in Shanghai in 2017.The crude rate of incidence was 546.55/105,and the age-standardized rate was 246.31/105.The age-standardized rate of incidence was higher among females than among males.The crude rate of mortality was 256.04/1 05,and the age-standardized rate was 88.41/105.The age-standardized rate of mortality was higher among males than among females.The age-specific numbers and rates of incidence and mortality increased with age.The age-specific number and rate of incidence reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among males reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among females reached the peak at the age groups of older than 85 years,respectively.The sites of top 10 common cancer types sorted by the number of incidence cases among males were lung,colorectum,stomach,prostate,liver,thyroid,pancreas,bladder,kidney and oesophagus,and among females were lung,breast,thyroid,colorectum,stomach,pancreas,liver,brain,central nervous system(CNS),cervix uteri and gallbladder,the sites of those sorted by the number of deaths among males were lung,stomach,colorectum,liver,pancreas,prostate,oesophagus,bladder,lymphoma and gallbladder,among females were lung,colorectum,breast,stomach,pancreas,liver,gallbladder,brain,CNS,ovary and lymphoma.The top 10 common cancer types stratified by gender and the top 5 common cancer types stratified by common age groups merged of incidence and mortality had wide variations.Overall,the age-standardized rates of incidence were stable from 2002 to 2009,and increased 2.88%on average per year from 2009 to 201 7.The age-standardized rates of mortality were stable from 2002 to 2011,and decreased 2.66%on average per year from 2011 to 201 7.The trends differed by gender and cancer type. Conclusion:Lung cancer,colorectal cancer,pancreatic cancer,thyroid cancer,female breast cancer,cervical cancer and male prostate cancer are the most common cancers in Shanghai,the appropriate screening technical scheme should be formulated according to the current situation of malignant tumors in Shanghai,promote cancer opportunistic screening,promote appropriate technologies for intervention and management of cancer patients in the community,reduce the disease burden of malignant tumors.
5.Survival analysis of cancer cases diagnosed during 2002-2013 in Shanghai:a population-based study
Chunxiao WU ; Kai GU ; Yi PANG ; Chunfang WANG ; Liang SHI ; Yongmei XIANG ; Yangming GONG ; Peng PENG ; Jianming DOU ; Mengyin WU ; Xiaocong ZHANG ; Ganling DING ; Jiaying YAN ; Yan SHI ; Chen FU
Tumor 2023;43(4):257-265
Objective:To investigate the survival of cancer cases diagnosed during 2002-2013 in Shanghai. Methods:Data on new cancer cases with dead and follow-up information were obtained from the population-based cancer registry and vital statistics system of Shanghai Municipal Center for Disease Control and Prevention.Survival indicators stratified by year of diagnosis,gender,site and age were analyzed.Number of cases and proportion were calculated.The observed survival rates were calculated based on the life table.The probabilities of surviving from 0 to 99 years old were estimated according to the Elandt-Johnson model,and then the cumulative expected survival rates were calculated according to the Ederer Ⅱ method.Finally,the relative survival rates and average annual percent changes of their trends were calculated.The age-standardized relative survival rates adjusted by International Cancer Survival Standard weights were calculated. Results:Total 644 520 new cancer cases were diagnosed during 2002-2013 in Shanghai,accounting for 643 545(99.85%)cases included in the observed cohort for survival analysis.The 5-year observed survival rate increased from 37.61%to 46.47%.The 5-year relative survival rate increased from 42.1 8%to 51.11%.The 5-year age-standardized relative survival rate increased from 40.57%to 49.80%.Among the 5-year relative survival rates of cases diagnosed during 2011 to 2013,99.43%of thyroid cancer was the highest,followed by female breast cancer(88.35%)and corpus uteri cancer(85.56%);5.87%of pancreas cancer was the lowest,followed by gallbladder cancer(13.64%)and oesophagus cancer(17.72%).the rate of lung cancer with the largest number of cases was 23.59%,followed by colorectal cancer(59.82%)and stomach cancer(38.65%).The 5-year relative survival rate of total cases of all sites increased from 40.55%in 2002 to 52.77%in 2013,with an average annual percent change of 2.40%.13 cancer types showed increasing trends,such as liver cancer and lung cancer,while the trends of other cancer types were not statistically significant,such as pancreatic cancer and gallbladder cancer. Conclusion:The diagnostic levels and survival rates of cancer cases have been improved continuously in Shanghai.The trends of different cancer types were varied.
6.The incidence and mortality of lung cancer in 2016 and their trends from 2002 to 2016 in Shanghai
Jianming DOU ; Chunxiao WU ; Yi PANG ; Pingping BAO ; Chunfang WANG ; Yangming GONG ; Liang SHI ; Yongmei XIANG ; Mengyin WU ; Xiaocong ZHANG ; Yan SHI ; Chen FU ; Kai GU
Tumor 2023;43(4):266-276
Objective:To investigate the lung cancer incidence and mortality in 2016 and their trends from 2002 to 2016 in shanghai. Methods:The data of incidence and death on lung cancer in shanghai from 2002 to 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.Lung Cancer incidence and mortality stratified by age of diagnosis or death,gender and age-group were analyzed.The number of cases and deaths,proportion,crude rates,age-specific rates,age-standardized rates,corresponding truncated age-standardized rates(35-64 years)and cumulative rates were calculated.Segi's 1960 world standard population was used for calculating age-standardized rates of incidence and mortality as well as truncated age-standardized rates.Trends in age-standardized rates of incidence and death for lung cancer in Shanghai from 2002-2016 were estimated by Joinpoint analysis and characterized by the annual percent change(APC). Results:The new lung cancer cases and deaths were 14 395 and 9 170 in Shanghai in 2016.The crude rate of incidence was 99.41/105,and the age-standardized rate of incidence was 39.76/105.New cases of lung cancer accounted for 19.34%of all malignant tumors in shanghai,ranking the first in the incidence spectrum of malignant tumors.The crude rate of mortality was 63.33/105,and the age-standardized rate was 21.57/105.Deaths of lung cancer accounted for 24.78%of all malignant tumor deaths in shanghai,ranking the first in the mortality spectrum of malignant tumors.The age-standardized rates of incidence and mortality for males were higher than those for females.The age-specific numbers and rates of incidence and mortality increased with age.The age-specific number and rate of incidence reached the peak at the age group of 60-64 years and 80-84 years respectively,and those of mortality peaked at the age group of 80-84 years and older than 85 years respectively.The incidence of lung cancer increased from 33.70/105 in 2002 to 39.76/1 05 in 2016 in Shanghai.Joinpoint analyses showed that the age-standardized rate of lung cancer incidence remained stable from 2002 to 2010(APC=-0.79,t=-1.46,P=0.175)but showed a significant upward trend with an average annual increase rate of 5.12%from 2010 to 2016(APC=5.12,t=6.97,P<0.001).The standardized mortality showed a downward trend with an average annual decrease rate of 0.87%from 2002 to 2016(APC=-0.87,t=-2.87,P=0.013). Conclusion:The incidence of lung cancer in Shanghai during 2002-2016 presented an upward trend while the mortality of lung cancer showed a gradual downward trend.There are differences in the incidence and mortality of lung cancer among different gender and age groups.
7.Analysis on the current status of liver cancer incidence and mortality in Shanghai,2016 and trends during 2002-2016
Liang SHI ; Kai GU ; Chunxiao WU ; Yi PANG ; Yangming GONG ; Yongmei XIANG ; Jianming DOU ; Xiaocong ZHANG ; Mengyin WU ; Chunfang WANG ; Yan SHI ; Chen FU
Tumor 2023;43(4):277-286
Objective:To investigate the liver cancer incidence and mortality in 2016 and their trends during 2002 through 2016 in Shanghai. Methods:Data on new liver cancer diagnoses and deaths during 2002 through 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System,the numbers,crude rates and age-standardized rates of incidence and mortality of liver cancer were calculated.Segi's 1960 world standard population was used to calculate age-standardized rates.Joinpoint analysis was used to analyze the trend changes and to estimate the annual percent change of incidence and mortality rates. Results:There were 3 842 new liver cancer cases in Shanghai in 201 6,69.44%of which were males,and 3 275 deaths of liver cancer,69.44%of which were males.Mortality to incidence ratio was 0.85.The crude rate of incidence was 26.53/105,and the age-standardized rate was 10.60/105.The crude rate of mortality was 22.62/105,and the age-standardized rate was 8.65/105.The Sex ratios for age-standardized incidence and mortality were 2.91∶1 and 2.97∶1,respectively.The age-specific numbers and rates of incidence and mortality increased with age.Overall,the age-standardized rate of incidence of liver cancer was decreased 3.69%on average per year during 2002 through 2016,and the age-standardized rate of mortality of liver cancer was decreased 3.82%on average per year. Conclusion:The incidence and mortality of liver cancer in Shanghai have been remarkably decreased to a low level countrywide,while liver cancer is still one of the leading malignancies and it brings serious threat to public health,comprehensive prevention and control efforts should be strengthened according to its epidemic characteristics and risk factors.
8.Analysis on prostate cancer incidence and mortality in Shanghai 2016 and trends of 2002-2016
Yangming GONG ; Peng PENG ; Chunxiao WU ; Yi PANG ; Yongmei XIANG ; Yan SHI ; Chen FU ; Kai GU
Tumor 2023;43(4):297-306
Objective:To analyze the incidence and mortality of prostate cancer in Shanghai in 2016 and trends during 2002-201 6,and to provide a basis for prostate cancer prevention and treatment. Methods:The data of prostate cancer incidence and mortality in Shanghai from 2002-2016 were obtained from the Population-Based Cancer Registry and Vital Statistics of Shanghai Municipal Center for Disease Control and Prevention.The incidence,mortality,proportion,crude rate,age-specific rate and age standardized rate of prostate cancer were calculated.Age-standardized incidence and mortality were calculated using Segi's 1960 world standard population.Trends of prostate cancer incidence,mortality,age-standardized rate and age-specific rate were estimated by Joinpoint 4.9.1.0 software. Results:In 2016,there were 3 226 cases of newly diagnosed prostate cancer and 1 067 deaths in Shanghai,crude rate of incidence was 44.91/105,crude rate of mortality was 14.85/105,age-standardized incidence and mortality were 15.47/105 and 4.34/105.Age-specific incidence and mortality increased with age,and reached the highest level in the 80-84 year-old group and 85-year-old group.Urban incidence was higher than suburb in the 50-54 year-old group,75-79 year-old group,and 80-84 year-old group,with no statistical difference in mortality.Between 2002 and 2016,incidence and mortality increased gradually,the rise of age-standardized incidence slowed down after 2012,and the age-standardized mortality in urban area declined after 2012.The age-standardized incidence in suburb increased faster than that in urban area,and the incidence rate increased faster in the younger age groups. Conclusion:The incidence and mortality of prostate cancer in Shanghai were lower than the world level but higher than the national level,and the incidence increased gradually between 2002 and 2016.Incidence and mortality were higher in urban area than in suburb,but increased faster in suburb,and the incidence increased more rapidly in younger age groups,but the proportion of early stages at diagnosis was still low,suggesting that appropriate screening strategies should be considered.
9.Analysis on the current status of ovarian,fallopian tube and other uterine adnexa cancer incidence and mortality in Shanghai,2016 and trends of 2002-2016
Yi PANG ; Chunxiao WU ; Kai GU ; Chunfang WANG ; Jiaying YAN ; Yongmei XIANG ; Chen FU ; Yan SHI
Tumor 2023;43(4):307-315
Objective:To investigate the incidence and mortality of ovarian,fallopian tube and other uterine adnexa cancer in 2016 and their trends during 2002 through 2016 in Shanghai. Methods:Data on new ovarian,fallopian tube and other uterine adnexa cancer diagnoses and deaths during 2002 through 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.The incidence and mortality stratified by year of diagnosis or death,site and age-group were analyzed.The number,proportion,crude rate,age-specific rate,age-standardized rate and others were calculated.Trends in number,age-specific rate,age-standardized rate and others were estimated.Trends in age-standardized rate of incidence and mortality for the ovarian cancer were estimated by Joinpoint analysis and characterized by the annual percent change(APC).The number and proportion of selected indexes of diagnostic characteristics of new ovarian and fallopian tube cancer cases were also calculated.Segi's 1960 world standard population was used for calculating age-standardized rates. Results:The new uterine adnexa cancer cases and deaths were 813 and 440 in Shanghai in 2016.There were 751 cases(92.37%)and 419 deaths(95.23%)of ovarian cancer,and 48 cases(5.91%)and 17 deaths(3.86%)of fallopian tube cancer.The crude rate of ovarian cancer incidence was 10.29/105,and the age-standardized rate was 5.33/105.The crude rate of mortality was 5.74/105,and the age-standardized rate was 2.44/105.Overall,the age-specific rates of incidence and mortality increased with aging.They reached the peak at the age group of 55-59 years and 80-84 years,respectively.Joinpoint analyses showed a significant decreasing trend in the standardized incidence of ovarian cancer in Shanghai from 2002 to 2016,with an average annual increase of 1.78%(APC=-1.78,P<0.001),while the increase in standardized mortality was not statistically significant.The proportion of pathological diagnosis on ovarian cancer increased to 85.02%,and the proportions of stageⅢ and Ⅳ continued to increase.The incidence of ovarian cancer in Shanghai from 2002 to 2016 showed a decreasing trend,while the mortality showed a fluctuating trend. Conclusion:In Shanghai,the age-standardized incidence rate of ovarian cancer was declined steadily,but the proportion of diagnosed advanced increased.The number of fallopian tube cancer cases increased steadily.
10.Analysis of long-term trend changes in breast cancer incidence and death among females in Shanghai,1973-2017
Jiaying YAN ; Mengyin WU ; Kai GU ; Chunxiao WU ; Yi PANG ; Chunfang WANG ; Yangming GONG ; Yongmei XIANG ; Chen FU ; Yingbin LIU ; Yan SHI
Tumor 2023;43(4):316-324
Objective:To describe the long-term characteristics and trend changes in the incidence and mortality of female breast cancer in Shanghai from 1 973 to 2017,aiming to provide references for exploring the etiology of breast cancer and formulating strategies and measures for prevention,intervention and control. Methods:Joinpoint software was used to analyze the trend changes in the incidence and mortality of female breast cancer in Shanghai from 1 973 to 2017,and an age-period-cohort model was constructed to explore the effects of age,year of diagnosis,and birth cohort on long-term trend changes. Results:From 1 973 to 2017,there were 68 192 new cases of female breast cancer in Shanghai,with a diagnosed rate of 31.72/100 000.The incidence rate continued to rise,and the risk of the disease continued to rise from the age of 20 years,and the rise rate accelerated significantly after the age of 40 years.There were 21 535 female breast cancer deaths from 1 973 to 2017.The mortality rate was stable,with a death rate of 8.62/100 000,and the risk of death increased significantly from the age of 45 years.The effects of age,period and cohort had a significant impact on the incidence of breast cancer(P<0.01),while the increase in mortality rate was related to age and cohort effects(P<0.01). Conclusion:The incidence rate of female breast cancer in Shanghai is still rising rapidly,and the mortality trend is generally stable,suggesting that the treatment is effective and the quality of life is improved.However,breast cancer is still the main malignant tumor among females in Shanghai.It should be continued to implement prevention and control strategies such as lifestyle intervention and screening of high-risk individuals to further strengthen the prevention and control of breast cancer.

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