Gastrointestinal preparation for gynecological surgery is a key link in perioperative management,and its standardization and scientific nature directly affect surgical safety,patient prognosis,and the rational utilization of medical resources.There are significant regional differences in the implementation of preoperative bowel preparation in medical institutions at all levels in China.With the popularization of minimally invasive surgical techniques and the promotion of the enhanced recovery concept after surgery,it is urgent to establish a clinical decision-making system that is scientific,standardized,and practical.This consensus aims to reduce the incidence of postoperative complications such as surgical site infections and ileus by proposing standardized and precise intestinal preparation strategies,providing practical guidance for perioperative management and clinical decision-making in gynecological surgery.

Objective The aim of this study was to analyze the proportion of disability adjusted life years(DALYs)attributed to aging population in common digestive system malignancies in China,and predict the proportion and the trends of DALYs attributed to aging proportion from 2022 to 2046. Methods Based on the Global Burden of Disease Study 2021,the DALY data of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer of Chinese people aged ≥25 years from 1990 to 2021 were selected.The age-period-birth models were used to predict the DALY of malignant tumors from 2022 to 2046.The changes of DALY from 1990 to 2046 were decomposed into population growth,population aging,and age-specific DALY rate changes,and analyze the proportion of DALY changes attributable to population aging and its change trend. Results From 1990 to 2021,the DALY change rates of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer in Chinese people aged ≥25 years were 18.20%,-0.34%,98.10%,164.16%,58.21% and 90.62%,respectively.Compared with 2021,the proportion of DALY changes attributed to population aging for six types of malignant tumors in 1990 was from -38.32% to -19.72%.The top three cancer types with the highest attribution ratios were stomach cancer(-38.32%),esophageal cancer(-38.07%),gallbladder and biliary tract cancer(-29.78%).The expected change rates of DALY for the six types of malignant tumors from 2021 to 2046 were 20.72%,11.50%,58.19%,57.38%,21.36% and 48.39%,respectively.By compared with 2021,the proportion of DALY changes of six malignant tumors attributed to population aging in 2046 was from 18.82% to 47.83%,and the top three cancers attributed to the proportion were gallbladder and biliary tract cancer(47.83%),colorectal cancer(43.07%)and pancreatic cancer(38.76%).From 2022 to 2046,the proportion of DALY changes attributed to aging population for the six types of malignant tumors would continue to rise(P＜0.001).The proportions of colorectal cancer and pancreatic cancer attributed to population aging and the proportion of age-specific DALY rate were both positive and rising(P＜0.001),which would eventually promote the further increase of DALY. Conclusion Population aging has become the main driving factor for the growth of DALY in digestive system malignant tumors in China.The impact on DALY of colorectal cancer and pancreatic cancer will be prominent in the future.Targeted prevention and control strategies should be developed to actively respond to population aging.

Objective The aim of this study was to analyze the incidence,mortality,and epidemiological trends of malignant tumors in the cancer registration areas of Qinghai Province and provide a reference for the prevention and control strategies and measures of malignant tumors. Methods According to the quality control standards for cancer registration,the data on malignant tumor incidence and mortality from 8 national cancer registration areas in Qinghai Province from 2014 to 2021 were collated.The crude incidence/mortality,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)and World standard population(ASIRW/ASMRW),the cumulative rates(0-74 years old),and the age-specific incidence/mortality of malignant tumors were calculated for different sexes and regions.The Joinpoint 4.9.0.0 software was used to calculate the average annual percentage change(AAPC)and conduct trend analysis. Results The crude incidence of malignant tumors in the cancer registration areas of Qinghai Province from 2014 to 2021 was 221.25/100,000(243.31/100,000 for males and 198.68/100,000 for females),the ASIRC was 199.48/100,000(229.13/100,000 for males and 173.34/100,000 for females),the ASIRW was 196.38/100,000(228.32/100,000 for males and 167.97/100,000 for females).The cumulative rate for those aged 0-74 years was 21.57%;the crude mortality of malignant tumors was 131.90/100,000(163.86/100,000 for males and 99.20/100,000 for females),the ASMRC was 121.07/100,000(157.33/100,000 for males and 87.45/100,000 for females),the ASMRW was 120.53/100,000(157.54/100,000 for males and 86.31/100,000 for females),and the cumulative rate for those aged 0-74 years was 12.79%.The crude incidence,ASIRC,ASIRW,crude mortality,ASMRC and ASMRW were all higher in males than those in females.Both the crude incidence and mortality of malignant tumors increased with age.The crude incidence rate increased rapidly after age 45,peaked in the 80-84 age group(2,352.29 per 100,000),and declined slightly in the 85+ age group.The crude mortality increased rapidly after age 50,peaked in the 85+ age group(2,305.44 per 100,000).The crude incidence(AAPC=5.68%,95% CI:3.48%-7.93%,P＜0.05)and crude mortality(AAPC=3.67%,95% CI:2.44%4.91%,P＜0.05)of malignant tumors showed an overall upward trend from 2014 to 2021.The ASIRC(AAPC=-0.12%,95% CI:-3.70%3.59%,P＞0.05)remained stable,while the ASMRC(AAPC=-2.81%,95% CI:-3.28%-2.03%,P＜0.05)showed a downward trend.The top five malignant tumors in terms of crude incidence were stomach cancer,lung cancer,liver cancer,female breast cancer,and cervical cancer,respectively;the top five malignant tumors in terms of crude mortality were stomach cancer,lung cancer,liver cancer,esophagus cancer,and colorectal cancer,respectively. Conclusion From 2014 to 2021,the incidence and mortality of malignant tumors in the Qinghai Province cancerregistration areas showed an increasing trend,with higher rates in males than those in females.It is recommended that targeted prevention and control measures should be implemented for people aged 45 and older,with stomach cancer,liver cancer,and cervical cancer as key cancers.

Objective The aim of this study was to analyze the incidence and mortality of lymphoma and their changing trends in cancer registration areas of Liaoning Province from 2016 to 2020,and to provide data support for lymphoma prevention and treatment. Methods The data of tumor registration areas in Liaoning province from 2016 to 2020 were collected and sorted out,and the crude incidence,mortality,China standardized incidence and mortality,world standardized incidence and mortality,and cumulative rate of lymphoma were calculated;Joinpoint 5.0.2 software was used to analyze the changing trends of the above indicators from 2016 to 2020. Results From 2016 to 2020,the crude incidence of lymphoma in tumor registration areas of Liaoning Province was 7.43/100,000,age-standardized incidence by Chinese standard population(ASIRC)was 4.07/100,000,and age-standardized incidence by world standard population(ASIRW)was 3.95/100,000;the crude mortality was 4.29/100,000,age-standardized mortality by Chinese standard population(ASMRC)was 2.07/100,000,and age-standardized mortality by world standard population(ASMRW)was 2.02/100,000.The ASIRC and ASMRC were higher in males(4.62/100,000 and 2.53/100,000,respectively)than in females(3.56/100,000 and 1.61/100,000,respectively),also higher in urban areas(4.65/100,000 and 2.32/100,000,respectively)than in rural areas(2.46/100,000 and 1.65/100,000,respectively).The incidence and mortality of lymphoma increased with age.The incidence reached its peak in the 70-79 age group,and the mortality reached its peak in the 80+ age group.From 2016 to 2020,the crude incidence of lymphoma increased from 6.86/100,000 to 8.22/100,000,with a statistically significant trend(APC=5.06%,95% CI:1.13%-9.14%,P=0.026).ASIRC increased from 4.01/100,000 to 4.45/100,000,with no statistical significance(P＞0.05). The crude mortality increased from 3.85/100,000 to 4.53/100,000,while ASMRC decreased from 2.02/100,000 to 2.01/100,000,with no statistically significant trend in the two changes(P＞0.05). Conclusions The incidence and mortality of lymphoma in cancer registration areas of Liaoning Province are higher in men than those of women,and higher in cities than those in rural areas,and reach the peak in the elderly group.The prevention and control of key populations and health management should be strengthened,especially pay attention to the health needs of the elderly population,and explore possible directions for multidisciplinary collaborative diagnosis and treatment to reduce the disease burden.

Objective The aim of this study was to analyze the incidence trend and age-specific characteristics of esophageal cancer in cancer registration areas of Gansu Province from 2010 to 2021,and predict the incidence of esophageal cancer from 2022 to 2030. Methods Based on the incidence data of esophageal cancer in 15 cancer registries in Gansu Province from 2010 to 2021,the incidence was calculated by age,sex,urban and rural areas.The age-standardized incidence by Chinese standard population(ASIRC)was standardized using the 2000 Chinese standard population.Joinpoint regression model was used to analyze the change trend of esophageal cancer incidence,and the average annual percentage change(AAPC)was calculated to quantify the overall rate of change.A birth cohort model was constructed to analyze incidence trend of different birth groups from 1930 to 2021,and the Bayesian age-period-cohort(BAPC)model was used to predict incidence. Results From 2010 to 2021,the ASIRC of esophageal cancer in Gansu Province showed a significant downward trend(AAPC=-14.47%,95% CI:-18.72%-9.99%,P＜0.001).The ASIRC in men decreased at an annual rate of 13.02%(AAPC=-13.02%,95% CI:-17.28%-8.54%,P＜0.001),the incidence of esophageal cancer in women at a rate of 15.80% per year(AAPC=-15.80%,95% CI:-20.69%-10.61%,P＜0.001).The ASIRC of esophageal cancer in urban areas decreased at an annual rate of 15.32%(AAPC=-15.32%,95% CI:-21.04%-9.18%,P＜0.001);ASIRC of esophageal cancer in rural areas decreased at a rate of 5.33% per year(AAPC=-5.33%,95% CI:-8.94%-1.58%,P＜0.001).From 2010 to 2021,the incidence of esophageal cancer in all age groups showed a significant downward trend(AAPC:-19.59% to -9.18%).The birth cohort analysis revealed that the incidence of esophageal cancer in people over 40 years old in the province,men,women,urban and rural areas showed a downward trend with increase of birth years.BAPC model predicted that that the ASIRC of esophageal cancer for the total province population,men and women would decrease from 6.47/100,000,10.02/100,000,and 2.95/100,000 in 2021 to 1.31/100,000,1.72/100,000,and 0.91/100,000 in 2030,respectively. Conclusions The incidence of esophageal cancer in Gansu Province showed a downward trend from 2010 to 2021,but men and rural areas were still the focus of high incidence.The prediction indicates that the incidence of esophageal cancer in Gansu Province will further decline by 2030,suggesting that the prevention and control measures have achieved results;however,it is still necessary to strengthen the intervention and long-term monitoring of high-risk groups.

Objective The aim of this study was to investigate the incidence and mortality of malignant tumors among urban residents in Yingkou City in 2021,and to explore the key points of prevention and treatment of malignant tumors. Methods Based on the cancer registration data of Yingkou urban area in 2021,the incidence,crude mortality,age-standardized incidence by Chinese standard population(ASIRC),age-standardized mortality by Chinese standard population(ASMRC),age-standardized incidence by world standard population(ASIRW),age-standardized mortality by world standard population(ASMRW),and the ranks of incidence and mortality of malignant tumors were calculated and analyzed. Results In 2021,the incidence of malignant tumors among urban areas of Yingkou City was 475.86/100,000,ASIRC was 234.93/100,000 and ASIRW was 224.76/100,000.The top five most cancers by incidence were lung cancer,female breast cancer,colorectal cancer,thyroid cancer and gastric cancer.The crude mortality was 271.99/100,000;ASMRC was 118.42/100,000,and ASMRW was 115.80/100,000.The top five most cancers by mortality were lung cancer,colorectal cancer,liver cancer,breast cancer and pancreatic cancer.Both the incidence(χ²=1,950.616,P＜0.001)and mortality(χ²=2,283.237,P＜0.001)of malignant tumors increased with age,and reached the peak at the age of 80-84(incidence:1,619.35/100,000 and mortality:1,629.11/100,000). Conclusion Lung cancer,female breast cancer,colorectal cancer and thyroid cancer are the key types of cancer that need to be focused on prevention and treatment in urban areas of Yingkou City;The elderly people are at a high-risk group for malignant tumors;Effective tertiary prevention measures should be comprehensively implemented for this high-risk populations to reduce the burden of malignant tumor diseases.

Objective The aim of this study was to analyze the gastroscopic screening results of high-risk populations for gastric cancer in Gejiu City from 2021 to 2023,and to provide theoretical basis for gastric cancer prevention and treatment in this city. Methods A questionnaire survey was conducted to assess the risk of gastric cancer among residents aged 40 and above in Gejiu City.Gastroscopy and pathological biopsy were performed on those assessed as high-risk for gastric cancer,and the screening results were statistically analyzed. Results From 2021 to 2023,a total of 24,391 residents were evaluated,of which 7,978 were at high-risk of gastric cancer.Among them,2,473 individuals completed gastroscopy and pathological examination,with a screening rate of 31.00%.Twenty-eight cases of gastric cancer were detected,and the detection rate of gastric cancer in high-risk populations was 1.13%;Among them,there were 9 cases of early-stage gastric cancer,with an early diagnosis rate of 46.43%.The overall infection rate of Helicobacter pylori(HP)was 62.00%,and it increased significantly with the severity of gastric mucosal lesions(P＜0.001).The detection rates of gastric cancer and precancerous lesions were significantly higher in males,ethnic minorities,and HP-infected individuals was higher than those in females,Han people,and non-HP-infected individuals,and the differences were statistically significant(P＜0.05).Following-up results showed that 1 case(2.08%)of severe atrophic gastritis progressed to early gastric cancer,and 2 cases(6.67%)of low-grade intraepithelial neoplasia progressed to early gastric cancer. Conclusion The detection rate of gastric cancer among high-risk populations in Gejiu City was relatively high,however the proportion of early-stage cases remained low,indicating that the rate of early diagnosis still needs to be improved.Males,ethnic minorities,and HP-infected individuals are key target groups for gastric cancer prevention and control in this region.HP infection may be closely related to the progression of gastric mucosal lesions and the occurrence of gastric cancer,and relevant interventions should be strengthened.

Objective The aim of this study was to explore the acceptance and influencing factors of self-collected urine samples for human papillomavirus(HPV)testing in cervical cancer screening among eligible women,and to provide scientific evidence for promoting this testing in low resource areas. Methods A population-based cross-sectional study was conducted from 2022 to 2023 at the Maternal and Child Health Hospital in Shuangliu district,Chengdu City Sichuan Province.The study subjects were women aged 21 to 69 years old,and a customized questionnaire was used to conduct general information and acceptance surveys on the participants. Results A total of 2,062 women were included,with an average age of 51.58±9.34 years.Among them,1,501(72.79%)women believed that self-sampling urine was very easy.However,although 1,333(64.65%)women were still willing to accept doctor sampling as a cervical cancer screening method,only 729(35.35%)were more willing to accept self-sampling urine HPV testing.Age,educational level,annual household income,awareness of HPV,HPV vaccination status,and a sense of shame about the doctor's sampling process were all associated with the acceptance of self-collected urine HPV testing among women undergoing cervical cancer screening(P＜0.001).The results of multivariate logistic regression analysis indicated that older women(OR=0.965,95% CI:0.951-0.979)and those who were not familiar with HPV(OR=0.760,95% CI:0.602-0.961)were more likely to undergo self sampling urine HPV testing,while those with junior high school education(OR=1.330,95% CI:1.053-1.682),high school education or above(OR=1.990,95% CI:1.401-2.827),and a sense of shame towards the doctor's sampling process(OR=2.314,95% CI:1.706-3.142)were more likely to undergo self sampling urine for HPV testing. Conclusions Most women believe that self sampling urine for HPV testing is very easy,but compared to doctor sampling,only some women choose to self sample urine for HPV testing.Key health education interventions should be carried out for older and lower educated populations to promote acceptance of urine HPV testing.

Objective The aim of this study was to systematically analyze the molecular characteristics of breast cancer metastasis from the primary focus to lymph node based on single-cell transcriptomic technology,and screen potential biomarkers that could be used to assess the risk of lymph node metastasis of breast cancer and predict survival prognosis. Methods A single-cell RNA sequencing dataset of breast cancer(GSE161529)was integrated to construct a single-cell transcriptomic map by normal breast tissues,primary lesion and paired lymph node metastasis samples.Through CNV analysis,and combining cell trajectory analysis,functional enrichment,and differential expression analyses,epithelial cell subsets and key genes closely related to tumor progression were screened,and survival analysis was conducted based on the TCGA breast cancer cohort to verify the clinical prognostic value of key genes. Results A total of 86,825 high-quality cells were obtained,and 7 main cell types were identified.The epithelial cells in both the primary lesion and metastatic lymph nodes had malignant characteristics,and there were two main differentiation pathways:NT→PT and NT→PT→MLN.Epithelial cells were further divided into 8 subclusters(C1-C8).Among them,the C4 subgroup was mainly associated with tumor proliferation,whereas the C8 subgroup was closely related to metastasis.The high expression of core genes PCLAF and ERO1A was significantly correlated with poor prognosis in patients(P＜0.001). Conclusion This study reveals the cellular differentiation lineage of breast cancer from primary to metastasis,and identifies PCLAF and ERO1A as key genes driving the progress of breast cancer,which can be used as potential biomarkers to predict lymph node metastasis of breast cancer and evaluate the prognosis of patients.

In recent years,the incidence and mortality of malignant tumors have been increasing year by year,becoming a serious challenge to global public health.Unlike traditional treatment methods,tumor immunotherapy activates the body's own immune system to against tumors,and has significant advantage such as minimal side effects,long-lasting efficacy,and strong targeting.However,immunotherapy also has issues such as frequent adverse reactions and high treatment costs.In order to enhance the efficacy of immunotherapy,some phytochemicals are used in the field of immunotherapy as modulators.These phytochemicals not only increase the sensitivity of tumor cells to immune cells,but also reduce the expression of immune checkpoint proteins.Therefore,this article provides a review of phytochemicals that play an important role in tumor immunotherapy and their related mechanisms of action.

Post-translational modification of protein is a key mechanism for regulating cancer development and immune responses,and has become an important target for cancer diagnosis and treatment.Among them,lactylation modification provides a new perspective for the precise prevention and control of tumors by affecting metabolism and epigenetics.Lactylation modification precisely regulates the functions of histone and non-histone,affecting tumor cell characteristics,microenvironment acidification,and immune cell functions,becoming a key hub connecting metabolic reprogramming and malignant phenotypes.This article reviews the regulatory roles of lactylation modification in tumor development,immune escape,clinical translation,and explores the potential of targeted inhibition of lactylation modification and its related pathways,as well as the inhibition of key enzyme activity.

Oral adenoid cystic carcinoma(OACC)is one of the malignant tumors from the oral cavity,with strong invasion and infiltration ability,and poor prognosis for patients.Studies have shown that epigenetic mechanisms such as DNA methylation,histone modification,non-coding RNAs,and chromatin remodeling are involved in regulating the occurrence,development,invasion,and metastasis of OACC.The in-depth research of epigenetic regulatory mechanisms has important clinical significance for the prevention,diagnosis,and targeted therapy of OACC.This article reviews the epigenetic regulatory mechanisms and new advances in therapeutic research of OACC.

Prostate cancer is one of the common malignant tumors in men.With the aging of the population and the progress of diagnostic technology,its incidence continues to rise.Radical prostatectomy is an effective treatment for localized prostate cancer.However,the incidence of inguinal hernia after surgery is high,which seriously affects patients'postoperative recovery and quality of life.This article provides a systematic review for the pathogenesis of inguinal hernia after prostate cancer surgery,including changes in anatomical structure,scar formation in the retroperitoneal space,no closure of sheath process,and increased intra-abdominal pressure after surgery.It also summarizes the relevant influencing factors,such as surgical methods,patients'own conditions,and postoperative recovery status.On this basis,surgical prevention and treatment strategies are explored,such as intraoperative preventive repair,refined surgical procedures,and postoperative targeted treatment.At the same time,future research directions are proposed,focusing on the in-depth exploration of molecular biological mechanisms,research and development of new materials,and application of artificial intelligence technology,aiming to reduce the incidence of inguinal hernia after prostate cancer surgery and improving patients' postoperative quality of life.

In comparison with other malignancies,the diagnosis and treatment of primary breast cancer are relatively mature.However,the clinical management of breast cancer bone metastasis primarily relies on drugs,but this approach struggles to completely eliminate tumor cells and is often accompanied by drug resistance,leading to osteolytic destruction and aggressive tumor proliferation,severely compromising patients'quality of life and survival.Previous studies have focused primarily on breast cancer cells themselves,with less attention paid to how they exploit the protective mechanisms of the bone microenvironment to resist drug therapy.The study reviews the relevant literature to explore the role of the bone microenvironment in the development of drug resistance in breast cancer bone metastasis,hoping to provide new insights into the treatment of breast cancer bone metastasis.