Sarcopenia and physical deconditioning are common complications in patients with liver cancer,which are frequently caused by insufficient physical activity and poor nutritional status,resulting in physical frailty and a significant impact on the patient's physical fitness.Notably,sarcopenia,frailty,and poor cardiopulmonary endurance have all been linked to higher mortality rates among patients with liver cancer.Exercise intervention significantly improves various health parameters in liver cancer patients,including metabolic syndrome,muscle wasting,cardiorespiratory endurance,health-related quality of life,and reduction in hepatic venous pressure gradient.However,the link between physical exercise and liver cancer is commonly overlooked.In this article,we will examine the impact of exercise on liver cancer and present the most recent evidence on the best types of exercise for various stages of liver cancer.This article also summarizes and discusses the molecular mechanisms that control metabolism and systemic immune function in tumors.In brief,physical exercise should be considered an important intervention in the prevention and treatment of liver cancer and its complications.

To establish a disease risk prediction model based on genetic susceptibility genes and environmental risk factors， which can target high-risk population as early as possible， and intervene in the environmental risk factors in this population. Moreover， accurate screening of genetically susceptible populations can enhance the efficiency of health system. In recent years， with the maturation and cost reduction of high-throughput gene testing， gene testing has been widely used in individual clinical decision-making and will play a more important role in medical and health decision-making. The correlation between genetic testing and disease risk prediction is increasing， making it a prominent research topic in this field. This review summarizes the approaches for establishing and evaluating risk prediction models and discusses potential future challenges and opportunities.

When facing two or more choices， sound decision-making is critical. In the field of clinical medical practice and public health， more and more researchers use decision-making analysis as an important tool to assist in making the optimal choices. Public health emergencies have the characteristics of group cases， sudden and uncertain. In addition to causing serious damage to public health， they may also have varying degrees of impact on socio-economic， psychological and even social stability. At present， we have not seen the application of mature and sound decision analysis in public health emergency response. This paper reviewed the development of decision analysis in the medical field and the application of common decision-making models in clinical practice. Combined with the current situation of global infectious disease outbreaks and prevention and control， this paper puts forward the concepts and prospects of establishing an auxiliary decision-making system for public health emergencies， aiming to provide a scientific method for medical and health workers to respond to public health emergencies.

The continuous development of high-throughput and single-cell sequencing technologies and the emergence of spatial transcriptome sequencing have allowed the continuous discovery of temporal and spatial molecular events in the progression of colorectal cancer (CRC) to better understand its mechanism of malignant progression. Genetic variations (mutation of APC and P53, etc.) and mismatch repair of DNA, posttranscriptional regulation, such as epigenetic alteration, and dynamic alteration of complex molecular networks have their own special molecules that play key roles. Drug resistance and metastasis in the late stage of CRC progression are closely related to these key molecular events. This article reviews the research progress and explores key molecular events in the malignant progression of CRC to provide scientific basis and ideas for elucidating the regulatory mechanism of CRC and evaluating its prognosis prediction and treatment.

Objective:To compare the geographical differences and time trends of liver cancer incidence and mortality in different regions around the world so as to predict the future burden of liver cancer.Methods:The incidence and mortality data of liver cancer in different Human Development Index (HDI) countries from 2000 to 2020 were collected from the GLOBOCAN 2020 database. The joinpoint model and annual percent change (APC) were used to analyze the liver cancer global incidence and mortality as well as future epidemic trends from 2000 to 2020.Results:ASMR for male liver cancer was increased from 8.0/100, 000 in 2000 to 7.1/100,000 in 2015 (APC = -0.7, 95% CI: -1.2 ~ -0.3, P = 0.002), while ASMR for female liver cancer was increased from 3.0/100, 000 in 2000 to 2.8/100, 000 in 2015 (APC = -0.5, 95% CI: -0.8 ~ -0.2, P < 0.001). The ratio of male to female ASMR was 2.67:1 in 2000 and 2.51:1 in 2015, indicating a slight narrowing of the difference in mortality between men and women. In 2020, the global ASIR and ASMR for liver cancer were 9.5/100 000 and 8.7/100 000, respectively. Male ASIR and ASMR (14.1/100, 000 and 12.9/100, 000, respectively) were 2 ~ 3 times higher than females (5.2/100, 000 and 4.8/100, 000, respectively). There were significant differences between ASIR and ASMR in different HDI countries and regions ( PASIR = 0.008, PASMR < 0.001), and the distributions of ASMR and ASIR were very similar. New cases and deaths were expected to increase by 58.6% (143,6744) and 60.9% (133, 5 375) in 2040, with the number of cases and deaths increasing by 39,7003 and 37,4208 in Asia, respectively. Conclusion:ASMR due to liver cancer worldwide has had a downward trend between 2000 and 2015. However, the latest epidemiological status and predictions of liver cancer in 2020 indicate that prevention and control will still be a major challenge globally in the next 20 years.

Objective:To explore the association between grip strength and cognitive function in elderly people aged 65 years and over.Methods:Information on grip strength, cognitive function, and lifestyle in the elderly population aged 65 years and over in Wuhan was collected by unified professionally trained investigators.A total of 533 study subjects aged(70.7±5.1)years were grouped by quartile into four grip strength groups of Q1(<18.6 kg), Q2(18.6~24.1 kg), Q3(24.2~31.1 kg), Q4(>31.1 kg).Multiple linear regression and Logistic regression analyses were used to analyze the relationship of grip strength with cognitive function scores and cognitive impairment.Results:The mean grip strength of the 533 subjects was(24.94±9.15)kg.After adjusting for sociodemographic characteristics, lifestyle factors, history of diseases, as compared with grip strength Q1 group, the linear regression coefficients(Beta value)of cognitive scores and 95% confidence intervals(95% CI)showed statistically significantly positive correlation[0.45(-0.36, 1.26)、0.40(-0.52, 1.32)and 1.19(0.07, 2.31), all P<0.05]only between cognitive scores and grip strength Q2、Q3 and Q4 value; and the odds ratio and 95% CI of incidence of cognitive impairment were 0.97(0.43, 2.21)for grip strength Q2, 0.79(0.30, 2.06)for grip strength Q3, and 0.22(0.05, 0.92)for grip strength Q4.Considering grip strength as the continuous variable, the risk of cognitive impairment was decreased by 6% and the cognitive score was increased by 0.07 with per 1kg increase of grip strength. Conclusions:The results of this study suggest that there is a positive correlation between grip strength and cognitive function in the elderly population, and a lower grip strength is related to increased risk of cognitive impairment.More attention should be paid to the grip strength of the elderly in the community.

Malignant tumors can be classified into three categories， rapidly progressing tumors， slowly progressing tumors， and "indolent" tumors. Rapidly progressing tumors （such as liver cancer， pancreatic cancer， and cholangiocarcinoma） have acute onset， shorter time duration from onset to death， and poorer treatment effects， which warrants primary prevention. Slowly progressing tumors （such as lung cancer， colorectal cancer， breast cancer， and gastric cancer） have slow onset， clear precancerous lesions， longer time duration from onset to death， and better therapeutic effects， which is accordingly suitable for secondary prevention. “Indolent” tumors （such as prostate and thyroid cancer） do not affect the life expectancy and are suitable for tertiary prevention. Early screening of “indolent” tumors may lead to overtreatment. Furthermore， early screening of rapidly progressing tumors is difficult to identify early cancers， which results in low cost-effectiveness. In contrast， for slowly progressing tumors suitable for secondary prevention， early screening may have cost-effectiveness， though there might be over-diagnosis. It is crucial to adopt appropriate prevention and treatment strategies for diverse types of tumors. Currently， large-scale cohort studies and randomized controlled clinical trials with complete follow-up may accurately evaluate the effect of cancer prevention strategies. This review discusses the significance of screening in precision prevention of tumors based on the characteristics of tumor progression and patients’ prognosis.

ObjectiveTo explore the underlying mechanism of Bushen Huatan prescription in alleviating postmenopausal osteoporosis （PMOP） by maintaining the balance of osteogenesis and adipogenic differentiation in ovariectomized rats with osteoporosis. MethodSeventy-five 6-month-old non-pregnant female SD rats were randomly divided into sham-operation group， model group， atorvastatin group， liviol group， and Bushen Huatan prescription group. Bilateral ovaries were removed in the four groups except the sham-operation group， while only the same mass of adipose tissue around the ovaries was removed in the sham-operation group. On the 5^th week after surgery， drugs were consecutively administrated for 8 weeks. Rats in the Bushen Huatan prescription group received 9.4 mg·kg^-1 of the prescription， rats in the atorvastatin group received 0.92 mg·kg^-1 of atorvastatin， rats in the Liviol group received 0.23 mg·kg^-1 of liviol， and rats in the model group and the sham-operation group received saline once a day. Micro-computed tomography （Micro CT） was used to detect bone mineral density （BMD） of rat tibia in each group. Hematoxylin-eosin （HE） staining was used to detect the relative area of rat bone marrow adipose tissue （BMAT） in each group. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to detect the relative expression levels of Runt-related transcription factor 2 （Runx2）， peroxisome proliferator-activated receptor （PPARγ）， leptin （LPN）， and leptin receptor （OBR） in bone tissues. ResultAs compared with the sham operation group， the BMD of rats in the model group decreased （P<0.05）， while the relative area of BMAT increased （P<0.05）. In addition， the expression levels of LPN， OBR， and Runx2 decreased in the model group （P<0.05）， while the level of PPARγ increased （P<0.05）. As compared with the model group， the BMD of rats in the atorvastatin group， the Livial group， and the Bushen Huatan prescription group increased （P<0.05）， and the relative area of BMAT decreased （P<0.05）. The expression levels of LPN， OBR， and Runx2 in these groups increased （P<0.05）， while the expression level of PPARγ decreased （P<0.05）. ConclusionBushen Huatan prescription plays the anti-osteoporosis role in the rat model of PMOP through up-regulating LPN and OBR in bone tissues and maintaining the balance of osteogenesis and adipogenic differentiation， thereby reducing postmenopausal bone loss and playing a role in the prevention and treatment of PMOP.

To investigate the safety and effectiveness of endovascular treatment for non-acute symptomatic intracranial occlusive disease of internal carotid artery. Methods The general data，surgical data and follow-up data of the patients with non-acute intracranial occlusion of internal carotid artery admitted to the Affiliated Hospital of Qingdaso Univerity from July 2016 to February 2021 were retrospectively analyzed，including the success rate of recanalization，the incidence of perioperative complications，imaging follow-up data and clinical follow-up data. Thrombolysis test for cerebral infarction （TICI） was used to evaluate the success of recanalization，the National Institutes of Health Stroke Scale （NIHSS） score was used to evaluate the degree of neurological impairment before and after treatment，and the degree of postoperative neurological recovery was evaluated by the modified Rankin Scale （MRS）. Results 28 of the 30 cases of intracranial internal carotid artery were successfully opened （technical success rate was 93.3%）. The difference of mTICI grading before operation was statistically significant compared with that after operation （P<0.05）.Surgical complications occurred in 6 cases （20.0%），including dissection in 2 cases，hyperperfusion syndrome in 1 case，and subarachnoid hemorrhage in 3 cases. Follow-up imaging of the 18 patients showed that 3 patients had restenosis of the offending vessels. One of them had TIA in the offending vessels and presented with paroxysmic contralateral limb weakness，and the other one had asymptomatic stenosis. In the 30 cases of clinical follow-up，there was a statistically significant difference in the MRS score between the 28 cases with successful operation and that before operation （P<0.05），and there was no significant change in the MRS score during clinical follow up between the 2 cases with intraoperative complications and unsuccessful operation. Conclusion endovascular therapy is safe and effective in highly selected cases of non-acute symptomatic intracranial internal carotid occlusion. The long-term NIHSS score and MRS score can be used to follow up the neurological deficit and recovery，and then to evaluate the long-term efficacy of endovascular therapy.

Objective To evaluate curative effect and related prognosis factors of synchronous colorectal cancer with liver metastasis.Methods The clinicopathological and follow-up data of 47 patients undergoing surgical treatment with synchronous colorectal cancer with liver metastasis at Shanghai Jiaotong University Affiliated Sixth People's Hospital and Tongji University Affiliated Yangpu Hospital from Jun 2013 to Jan 2018 were retrospectively analyzed.Results All 47 patients were followed up and themedian followup time was 38 months (2-65 months),after simultaneous colorectal and hepatic neoplasm radical surgery,added in 41 patients by postoperative chemotherapy.There was no perioperative mortality and the postoperative complication rate was 34％.The 1-,3-,and 5-year overall-survival rates were 87％,53％,and 15％,respectively.The disease-free survival rates were 81％,43％,and 9％,respectively.Multivariate results showed tumor differentiation,serum CEA level and adjuvant chemotherapy are independent prognostic factors for patients with synchronous colorectal cancer liver metastasis (P ＜ 0.05).Conclusions Colorectal cancer with synchronous liver metastasis treated by simultaneous resection of colorectal cancer and liver metastases are the widerly adopted treatments.Long-term survival is closely related to the degree of primary neoplasm differentiation,serum CEA level at diagnosis,and postoperative adjuvant chemotherapy.