[The impact of uncertainty resection on the prognosis of non-small cell lung cancer].

Objective: To explore the impact of uncertain resection on postoperative survival in non-small cell lung cancer. Methods: This is a retrospective cohort study. A retrospective analysis was conducted on the data of 477 patients with non-small cell lung cancer who underwent lobectomy in the Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University from December 2012 to December 2013. There were 302 males and 175 females, aged (59±8) years (range: 27 to 79 years). According to the surgical resection criteria issued by the International Association for the Study of Lung Cancer, the patients were divided into the intact resection group (R0 group, 286 cases) and the uncertain resection group (R (un) group, 191 cases). Clinical data between the two groups were compared using χ2 test, and propensity score matching (PSM) was performed on patients using the R language, with matching variables including gender, age, smoking history, adjuvant therapy, TNM stage, pathological type, and tumor site. The nearest-neighbor method was used for 1∶3 matching and the caliper value was 0.02. The survival curve was plotted using the Kaplan-Meier method and compared using the Log-rank test. The Cox proportional hazards regression model was used to identify risk factors in overall survival (OS). Subgroup analysis was based on TNM staging and mediastinal lymph node metastasis status. Results: In the R (un) group, 68 patients had positive lymph in the highest group and 129 patients did not undergo complete dissection of the mediastinal lymph nodes. The baseline data for the R0 group and the R (un) group were corrected using PSM, and a total of 369 patients were successfully matched, including 227 cases in the R0 group and 142 cases in the R (un) group. After PSM, the 5-year survival rates of the R0 group and the R (un) group were 64.3% and 52.1%, respectively (P=0.021). The 5-year survival rates of stage Ⅰ, Ⅱ, and Ⅲ patients were 85.2%, 65.9%, and 34.8%, respectively (P<0.01). TNM stage (χ2=46.913, P<0.01), pathological classification of adenosquamous cell carcinoma (HR=5.970, 95% CI: 3.117 to 11.431, P<0.01) and R (un) resection (HR=1.512, 95% CI: 1.065 to 2.147, P=0.021) were prognostic factors for postoperative survival. Subgroup analysis showed that in stage Ⅲ patients, 5-year survival rates of the R0 group and the R (un) group after resection were 45.8% and 9.5%, respectively (P=0.002). Among patients with mediastinal lymph node metastasis, 5-year survival rates of the R0 group and the R (un) group were 50.6% and 7.1%, respectively (P<0.01). Conclusions: TNM staging, pathological type, and R (un) resection are prognostic factors for overall postoperative survival in non-small cell lung cancer. In stage Ⅰ and Ⅱ patients, R (un) is not a prognostic factor for postoperative survival of non-small cell lung cancer. In patients with stage Ⅲ and mediastinal lymph node metastasis, R (un) is a prognostic factor for non-small cell lung cancer after surgery.

[Cancer statistics in China, 2016].

Objective: Data for 2016 from cancer registries were used to estimate cancer incidence and mortality in China in 2016. Methods: According to the quality control process of the National Central Cancer Registry, the data from 683 cancer registries submitted by each province were evaluated, and the data of 487 cancer registries were qualified and included in the final analysis. Age-specific incidence and mortality rates were calculated by area (urban/rural), sex, age and cancer site, combined with national population data to estimate cancer incidence and mortality in China in 2016. Chinese population census in 2000 and Segi's population were used for age-standardized incidence and mortality rates. Results: Total population covered by 487 cancer registries was 381 565 422 (192 628 370 in urban and 188 937 052 in rural areas). The percentages of morphologically verified (MV%) and death certificate-only cases (DCO%) accounted for 68.31% and 1.40%, respectively, and the mortality to incidence ratio was 0.61. It was estimated about 4 064 000 new cases occurred in China in 2016, with the crude incidence rate being 293.91/100 000 (the rates of males and females were 315.52/100 000 and 271.23/100 000), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.76/100 000 and 186.46/100 000, with the cumulative incidence rate (0-74 years old) being 21.42%. The crude incidence and ASIRC were 314.74/100 000 and 196.38/100 000 in urban areas, whereas in rural areas, they were 265.90/100 000 and 182.21/100 000, respectively. It was estimated about 2 413 500 cancer deaths occurred in China in 2016, the crude mortality rate was 174.55/100 000 (216.16/100 000 in males and 130.88/100 000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.00/100 000 and 105.19/100 000, and the cumulative mortality rate (0-74 years old) was 11.85%. The crude mortality and ASMRC were 180.31/100 000 and 104.44/100 000 in urban areas, whereas in rural areas, they were 166.81/100 000 and 108.01/100 000, respectively. The most common cancer cases include lung, colorectal, stomach, liver and female breast cancers. The top five cancers accounted for about 57.27% of all cancer cases. The most common cancer deaths included lung, liver, stomach, colorectal and esophageal cancers. The top five cancers accounted for about 69.25% of all cancer deaths. Conclusions: The burden of cancer shows a continuous increasing trend in China. Regional and gender differences in cancer burden are obvious. The cancer patterns still show the coexistence of cancer patterns in developed countries and developing countries. The situation of cancer prevention and control is still serious in China.

[Exploration and thinking on functional preservation after orthotopic neobladder construction].

The concept of functional preservation after orthotopic neobladder construction has gradually attracted attention. Reconstruction of urine storage and voiding is the basic function preservation of orthotopic neobladder. Clinical exploration mainly focuses on the optimization of neobladder reconstruction methods and procedures, and there is still a lack of summary of existing surgical characteristics and high-quality functional comparative studies. For strictly selected patients, on the basis of tumor control and standardized postoperative rehabilitation guidance, most patients with preserved nerve can retain satisfied sexual function after surgery. The protection of neurovascular bundle and ancillary structures combined with postoperative exercise is crucial to the improvement of urinary continence. According to the characteristics of patients, choosing the appropriate urinary diversion methods and function preserving can help patients establish a normal life style after surgery and improve their self-image and quality of life.

[The incidence and mortality of endometrial cancer in China, 2015].

Objective: To estimate endometrial cancer (EC) incidence and mortality in China in 2015. Methods: Qualified cancer registry data collected in 2011-2015 were pooled for analysis, from which EC cases and deaths were extracted. EC cases were classified into endometrioid, nonendometrioid and other & unspecified according to their histologic types. Incidence and mortality rates stratified by region and age group were calculated. Population data of 2015 was used to estimate cancer cases and deaths in China. Segi's population was used for the calculation of age-standardized rates by world standard population (ASW). Results: Data from 158, 176, 239, 235, 231 qualified cancer registries of 2011 to 2015 were pooled together. These registries covered about 488 million population, including about 255 million population in urban area and 233 million population in rural area. In 2015, a total of 53 600 EC cases were estimated, with a crude incidence rate of 7.74/100 000 and an ASW of 5.13/100 000. Incidence rates were higher in urban areas (9.15/100 000) than in rural areas (6.20/100 000). A total of 10 700 deaths were estimated, with a crude mortality rate of 1.60/100 000 and an ASW of 0.98/100 000. Mortality rate was higher in urban areas (1.78/100 000) than in rural areas (1.40/100 000). Among reported EC cases during 2011-2015, 70.92% (23 641 cases) were endometrioid, 5.13% (1 709 cases) were nonendometrioid and 23.95% (7 982 cases) were other & unspecified. The mean age at onset of all EC cases was 55.9±10.6. The mean age at onset of endometrioid cases (55.7±10.0) was younger than that of nonendometrioid cases (57.7±10.8) (P<0.001). The mean age at onset of all histologic types in urban areas was higher than that in rural areas (P<0.001). The mean age at death for EC deaths was 63.9±12.5. The mean age at death in urban areas (65.3±12.5) was higher than that in rural areas (61.4±12.2) (P<0.001). Conclusion: EC disease burden differs between urban and rural areas. Targeted cancer prevention and control strategies should be made for each region.

[Effects of oral bacterial metabolites on systemic diseases].

The oral cavity is the second largest microbial habitat in the whole body. Due to the divergence of oxygen, metabolic substrates and rate-limiting enzymes, oral bacteria are classified into sugar-metabolizing and nitrogen-compound-metabolizing bacteria according to their metabolic characteristics. The metabolites include organic acids, carbon dioxide, amino acids, proteins, and ammonia. Oral bacterial metabolites are very important for oral bacteria growth and reproduction, and also play an important role in systemic diseases such as periodontitis, oral cancer, intestinal diseases, diabetes and atherosclerosis. Therefore, in-depth exploration of oral bacterial metabolism is of great significance to understand the impact of oral cavity on systemic health. This article reviews the metabolic characteristics of oral bacteria and their correlation with systemic diseases.

[Correlation analysis between ICG-R15 and modified Scheuer score in liver tissues of patients with hepatitis B e antigen-positive/negative chronic hepatitis B].

Objective: To analyze the correlation between indocyanine green retention rate at 15 minutes (ICG-R15) and modified Scheuer score in liver tissues of patients with hepatitis B e antigen-positive/negative chronic hepatitis B (CHB), and further explore the indocyanine green clearance test (ICGCT) applied value in judging the progress of CHB-related liver disease. Methods: 407 HBeAg (+) / HBeAg (-) CHB inpatients with normal or slightly elevated serum alanine aminotransferase (ALT) [< 2 times the upper limit of normal (ULN)] and modified Scheuer score were collected, and divided into mild liver disease group (M group, 131 cases, modified Scheuer score < G2S2) and progressive liver disease group (A group, 276 cases, modified Scheuer score≥G2 and / or S2). Furthermore, the groups were sub-divided into HBeAg (+) - M group, HBeAg (-) - M group, HBeAg (+) - A group and HBeAg (-) - A group. The correlation between ICG-R15 and modified Scheuer score was analyzed retrospectively. The data were analyzed by SPSS 24.0 software. Results: Basic clinical characteristics: Among the 407 CHB cases with normal or mildly elevated serum ALT, 171 were HBeAg(+) CHB and 236 were HBeAg(-) CHB. The baseline mean serum HBV DNA was higher in HBeAg(+) CHB patients [(6.06 ± 1.95) log10IU/ml] than HBeAg(-) CHB patients [(3.60±1.37)log10IU/ml (P = 0.000)]. Included patients ICG-R15 detection characteristics: (1) The baseline mean value of ICG-R15 was not statistically significant between the two groups of HBeAg(+) CHB and HBeAg(-) CHB, and was basically within the normal range (< 10%); (2) Comparison of ICG-R15 baseline mean value among the subgroups showed that the patients in the HBeAg(+)-A group/HBeAg(-)-A group were higher than the HBeAg(+)-M group/HBeAg(-)-M group patients, and the difference was statistically significant (P = 0.013/P = 0.000). Included patients' correlation analysis between ICG-R15 and modified Scheuer score: (1) ICG-R15 and modified Scheuer score had shown weak positive correlation with inflammatory activity grade (g) in HBeAg (+) / HBeAg (-) CHB (r = 0.237, P = 0.002); r = 0.244, P = 0.000); (2) There was a weak positive correlation between ICG-R15 and fibrosis stage (s) in HBeAg (+) / HBeAg (-) CHB (r = 0. 254, P = 0; r = 0.225, P = 0.001). Included patients ICG-R15 predictive value for the severity of liver histological progression: when the cut-off value of ICG-R15 was 5.1%, the area under the receiver operating characteristic curve from M group to A group was 0.601 (P = 0.001) for predicting HBeAg (+) / HBeAg (-) CHB patients. Conclusion: ICG-R15 is positively correlated with the modified Scheuer score of liver tissue in HBeAg (+)/HBeAg (-) CHB patients with normal or slightly elevated ALT. In addition, when the cut-off value of ICG-R15 was 10%, it could not accurately reflect the effective hepatocyte reserve function of HBeAg (+) / HBeAg (-) CHB patients with normal or slightly elevated ALT. Importantly, when the cut-off value of ICG-R15 is 4.0% ~ 5.0%, it may have predictive value for liver disease progression to modified Scheuer score ≥ G2 and / or ≥S2 in HBeAg (+) / HBeAg (-) CHB patients with normal or slightly elevated ALT.

[Advances in application of tissue clearing technique in hard tissues].

Tissue clearing is a novel technique developed within recent years, which could make the tissue optical transparency using physical or chemical methods by refractive index matching. Combined with fluorescence imaging and three-dimensional reconstruction technology, it could achieve three-dimensional observing and analyze the tissue structure at the cellular resolution. The tissue clearing technique is mainly applied to soft tissues, as less to hard tissues. In recent years, many researchers have modified tissue clearing methods and made them suitable for hard tissues, such as bone and teeth. The present paper reviews the recent application of tissue clearing techniques in hard tissues.

[Bladder cancer incidence, mortality and temporal trends in China].

Objective: To describe the epidemiological characteristics of bladder cancer in 2015 and temporal trends in China. Methods: From 501 cancer registries in China, we collected data of cancer new cases, deaths and populations in 2015. After qualified, sex-specific, area-specific, age-specific and overall incidence/mortality rates (including age-standardized rates by Chinese standard population and by world standard population) and estimated cases of bladder cancer were calculated. Annual Percent Change (APC)/Average Annual Percent Change (AAPC) fitted from Log-line model was applied to evaluate the temporal trends of bladder cancer incidence/mortality rates from 1998 to 2015. Results: Bladder cancer is the 13(th) most common cancer in China. The crude, age-standardized by China standard population and by world standard population rates were 5.80/10(5), 3.60/10(5) and 3.57/10(5) for incidence, and 2.37/10(5), 1.31/10(5) and 1.32/10(5) for mortality, respectively. The incidence of bladder cancer ranked 7(th) in male. The incidence and mortality of male were 3.8 and 4.0 times as high as those of female. Bladder cancer incidence in urban area was 1.4 times as high as that in rural area. Incidence in western areas and middle areas of China were similar, which were lower than that in eastern areas. Geographical distribution characteristics of mortality was along with incidence.Both incidence and mortality remained low before 45 and 55 years old, then they increased rapidly and peaked at 80-84 and over 85 years old age group. Temporal trend analysis suggested that bladder cancer incidence in China increased in 1998-2007 (APC=2.58, P<0.001), while decreased from 2007 to 2015 (APC=-3.82, P<0.001). Bladder cancer mortality declined gradually, with APCs for 1998-2003 and 2003-2015 of 3.65% (P=0.002) and 1.42% (P<0.001). Conclusions: Bladder cancer is one of the main cancers in China. Its epidemiological distributions varies among different sex, area and age group. Both incidence and mortality of bladder cancer decline. More efforts on tobacco control should be made, and awareness of early diagnosis and early treatment could be enhanced for the middle-aged and elderly.

[Incidence and mortality of corpus uteri cancer in China, 2015].

Objective: To estimate the incidence and mortality of corpus uteri cancer in China, 2015. Methods: Quality audit and evaluation of the data from 2015 cancer registration reported by 501 cancer registries were conducted, and 368 cancer registries were included in the analysis. The incidence rate and mortality rate of corpus uteri cancer were calculated according to the factors of the region (urban, rural, east, central, western), sex and age groups. The incidence and mortality of corpus uteri cancer with the 2015 population were estimated. Chinese standard population in 2000 and world Segi's population were used for the calculation of age-standardized rates (ASR) of incidence and mortality. Results: In 2015, 368 cancer registries included in the analysis covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. It is estimated that there were about 68 900 new cases of corpus uteri cancer in 2015, the incidence rate was 10.28/10(5), age-standardized incidence rates by Chinese standard population (ASR China) and world standard population (ASR world) were 6.86/10(5) and 6.66/10(5), respectively. The incidence rate of urban area (11.35/10(5)) was higher than that of rural area (8.90/10(5)), and the incidence of eastern region (12.12/10(5)) was higher than the central region (9.94/10(5)) and the western region (8.25/10(5)). It is estimated that in 2015, there were about 16 000 deaths of corpus uteri cancer, the mortality rate was 2.39/10(5), ASR China was 1.49/10(5), ASR world was 1.47/10(5). The mortality in urban areas (2.40/10(5)) is close to rural areas (2.39/10(5)); the mortality in central areas (2.55/10(5)) was higher than the eastern areas (2.32/10(5)) and the western areas (2.31/10(5)). Conclusions: In China, the incidence of corpus uteri cancer is on the rise and has a trend of youth, the burden of disease is gradually increasing, which threatens the health of women. Targeted prevention and control measures should be carried out in the different regions.

[Cancer incidence and mortality of kidney and unspecified urinary organs in China, 2015].

Objective: To estimate cancer incidence and mortality of kidney and unspecified urinary organs in China using cancer registry data in 2015. Methods: The cancer registry data from 501 local cancer registries in China were collected, checked and assessed based on the criteria of data quality control of the National Central Cancer Registry of China (NCCRC), and data from 368 registries were qualified for the analysis. Cancer incidence and mortality rates of kidney and unspecified urinary organs stratified by geographical location (eastern, middle, western areas), gender, age groups were calculated. Population data of 2015 was used to estimate the cancer cases and deaths of kidney and unspecified urinary organs in China. Chinese standard population in 2000 and Segi's world population were used for the calculation of age-standardized incidence and mortality rates. Results: A total of 74.2 thousand new cancer cases of kidney and unspecified urinary organs were diagnosed in 2015, 46.9 thousand of them were male, while 27.3 thousand were female, with a crude incidence rate of 5.40/10(5). The age-standardized incidence rates by Chinese (ASIRC) and world standard population (ASIRW) were 3.57/10(5) and 3.56/10(5), respectively. A total of 53.4 thousand and 20.8 thousand new cases were diagnosed in urban and rural area, with incidence rates of 6.93/10(5) and 3.45/10(5), respectively. The ASIRC of urban area was higher than that of rural area. There were 39.2 thousand, 20.6 thousand, and 14.4 thousand new cases diagnosed in eastern, middle, and western areas of China, respectively. The crude incidence rates were 7.60/10(5), 4.47/10(5), and 3.63/10(5), respectively, with a descend ASIRC of each area. A total of 27.1 thousand death cases reported, of them 16.9 thousand were male, while 10.2 thousand were female, with a crude mortality rate of 1.97/10(5), both of the ASIRC and ASMRW were 1.21/10(5). The deaths of urban and rural area were 19.5 thousand and 7.6 thousand cases, with the crude mortality rates of 2.53/10(5) and 1.26/10(5), respectively. The ASIRC of urban area was higher than that of rural area. There were 13.4 thousand, 8.4 thousand, and 5.1 thousand death cases reported in eastern, middle, and western areas, respectively, the crude mortality rates were 2.61/10(5), 1.83/10(5) and 1.30/10(5), respectively, with a descend ASIRC of each area. Conclusion: The disease burden of kidney cancer differs between urban area and rural area, and differs among eastern, middle, and western areas of China, therefore, different prevent and treatment strategies should be taken in different areas of China.

[Statistical analysis of incidence and mortality of prostate cancer in China, 2015].

Objective: To estimate the incidence and mortality rates of prostate cancer in China in 2015. Methods: The data from 501 cancer registries in China collected by the National Cancer Center were reviewed and evaluated, and the qualified data were included in the final analysis. According to the national population data in 2015, the nationwide incidence and mortality of the prostate cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: After data review, the data reported by 368 registries were included in the final analysis, covering a total population of 309 553 499, accounting for 22.52% of the national population at the end of 2015. There were 72 thousand new prostate cancer cases estimated in China in 2015, with a crude incidence rate of 10.23/100 000. The ASR China and ASR world are 6.59/100 000 and 6.47/100 000, respectively, which is the sixth incidence of male malignant tumor.The estimated number of prostate cancer death was 3.07 thousand in China in 2015, with a crude mortality rate of 4.36/100 000; The ASR China and ASR world mortality rates were 2.61/100 000 and 2.65/100 000, respectively, which is the tenth leading cause of death in male malignant tumor.The ASR China incidence and mortality of prostate cancer in males were higher in urban areas (8.40/100 000 and 3.11/100 000) than those in rural areas (4.16/100 000 and 1.90/100 000). The incidence and mortality rates in the eastern areas (8.54/100 000 and 2.99/100 000) were higher than those in the central (5.28/100 000 and 2.34/100 000) and western areas (5.32/100 000 and 2.37/100 000) of China. Conclusions: The incidence and mortality rates of prostate cancer in China are lower than the global average, but there is an increasing trend. The incidence and mortality of prostate cancer in China have obvious regional differences.

[The clinical significance of osteotomy angle prediction for sagittal alignment reconstruction].

As an effective way to reconstruct the spinal alignment, osteotomy has been widely used to reconstruct the sagittal alignment of spine and achieved significant results.In order to avoid the secondary sagittal disequilibrium caused by the inaccurate osteotomy angle, it is very important to make an appropriate operation plan before the operation and evaluate the osteotomy angle accurately.At present, scholars have proposed different targets for sagittal reconstruction of the spine with different patients and diseases.They also proposed various prediction methods of osteotomy angle according to different reconstruction standards and principles, as well as the selection of osteotomy sites and methods.In this paper, the preoperative evaluation of the osteotomy angle was reviewed in terms of the target of sagittal reconstruction, the prediction of osteotomy angle and the selection of osteotomy method and osteotomy site.

[Application of meticulous anatomy skills with straight bipolar electric coagulation forceps in thyroid surgery].

Objective: To compare the efficacies of the two techniques of "micro-hemostasis and micro-cutting" with straight bipolar electrocoagulation forceps and traditional clamp-ligation for hemostasia in thyroid surgery. Methods: A total of 228 patients who underwent surgical treatment for thyroid neoplasms in our hospital between January 2015 and December 2018 were retrospectively analyzed, including 50 males and 178 females, aged 23-68 years old. Of those, 150 cases as electric knife group received traditional thyroid surgery between January 2015 and December 2018 and 78 cases as bipolar electrocoagulation group received thyroid surgery by using the technique of bipolar electrocoagulation with meticulous anatomy between January 2018 and December 2018. The total operation time, single operation time, intraoperative hemorrhage, postoperative drainage volume on the first day, postoperative hoarseness and hypocalcemia were compared between the two groups. SPSS 16.0 was used to analyze the data. Results: The total operation time and intraoperative hemorrhage in the bipolar electrocoagulation group were significantly lower than those in the electric knife group ((59.33±18.29)min vs (77.21±25.39)min, (14.83±9.22)ml vs (36.86±11.80)ml, all P<0.01). The single operation time of the bipolar electrocoagulation group was shorter than that of the electric knife group((10.25±6.16) min vs (20.34±7.24)min, (16.25±7.15)min vs (35.68±8.25)min, (12.12±5.25)min vs (20.68±7.26)min, t value was 3.948,16.262,8.238, all P<0.01).There was no significant difference between the two groups in postoperative drainage volume on the first day (P>0.05) and the incidence of postoperative hoarseness (P>0.05), while the incidence of hypocalcemia in the bipolar electrocoagulation group(10.26%) was lower than that in the electric knife group(21.33%,χ(2)=4.353, P<0.05). Conclusions: The fine dissection for thyroid operation can be achieved by using straight bipolar electrocoagulation tweezers. The use of "micro-hemostasis" and "micro-cutting" technique with bipolar electrocoagulation tweezers can greatly reduce intraoperative bleeding, operation time and postoperative complication.

[Analysis of incidence and mortality of esophageal cancer in China, 2015].

Objective: To estimate the incidence and mortality rates of esophageal cancer in China in 2015. Methods: Based on the data quality review and assessment, the esophageal cancer data from 368 cancer registries in 31 provinces (autonomous regions and municipalities) in China were included in this study. According to the national population data in 2015, the nationwide incidence and mortality of the esophageal cancer were estimated. Chinese standard population in 2000 and world Segi's population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively). Results: The 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. There were 245 651 new esophageal cancer cases estimated in China in 2015, with a crude incidence rate of 17.87/100 000. The ASR China and ASR world were 11.14/100 000 and 11.28/100 000, respectively. The estimated number of esophageal cancer death was 188 044 in China in 2015, with a crude mortality rate of 13.68/100 000; The ASR China and ASR world mortality rates were 8.33/100 000 and 8.36/100 000, respectively. The ASR China incidence and mortality of esophageal cancer in males were higher in males (16.50/100 000 and 12.66/100 000) than those in females (5.92/100 000 and 4.17/100 000), and they were higher in rural areas (15.95/1100 000 and 11.67/100 000) than those in urban areas (7.59/100 000 and 5.87/100 000). Conclusion: The incidence and mortality of esophageal cancer in China are higher than the global average. The disparity of the incidence and mortality rates of esophageal cancer significantly differed in genders and areas.

Effect of thermosonication process on physicochemical properties and microbial load of goat's milk.

In this study, thermosonication was used as a combined treatment of raw goat milk (RGM) using pasteurization (72 °C for 15 s) and ultrasound treatments (20 kHz at the power variance of 150 W, 200 W, 300 W and 400 W for 10 min). Investigation on the impact of the microbial load, protein content, protein aggregation, the particle size of fat and casein micelles, pH, viscosity, turbidity, color, and soluble calcium and phosphorus contents were carried out, whiles RGM and PGM served as the control. Our results revealed that at 400 W, that thermosonication resulted in a significant reduction (α = 0.05) in the microbial load of the samples to less than 2.3 log cfu/mL in comparison to those of RGM and pasteurized goat milk (PGM) at 5.94 log cfu/mL and 4.76 log cfu/mL respectively. In RGM, the fat size (3.5 µm) decreased to 0.4 µm at 300 W; while those of casein micelles also decreased from 406 to 256.4 nm at 400 W. However, no significant effect was observed in the color and soluble calcium and phosphorus contents of all samples. The effect on the microbial load and fat homogenization would promote thermosonication process in the dairy industry.

[Liver cancer epidemiology in China, 2015].

Objective: Using updated population-based cancer registration (PBCR) data, we estimated nation-wide liver cancer statistics overall, by sex and by areas in China. Methods: Qualified PBCR data of liver cancer in 2015 which met the data quality criteria were stratified by geographical locations, sex, and age groups. Age-specific incidence and mortality rates by sex and area were calculated. The burden of liver cancer was evaluated by multiplying these rates by the year of 2015 population. Chinese standard population in 2000 and World Segi's population were used for the calculation of age-standardized rates (ASR) of incidence and mortality. Results: Qualified 368 cancer registries covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. It is estimated that there were 370 000 new cases (274 000 males and 96 000 females) of liver cancer in China. The age-standardized incidence rates by Chinese standard population (ASR China) and World Segi's population (ASR World) were 17.64 per 100 000 and 17.35 per 100 000, respectively. Rural areas showed higher incidence (ASR China: 20.07 per 100 000, ASR World: 19.67 per 100 000) than urban areas (ASR China: 15.90 per 100 000, ASR world: 15.67 per 100 000). Subgroup analysis showed that western areas of China had highest incidence rate of liver cancer, with the ASR China of 20.65 per 100 000 and 20.22 per 100 000 for ASR world, respectively. For new cases of liver cancer deaths, there were 326 000 new deaths (242 000 males and 84 000 females) in China, with age-standardized mortality rate by Chinese standard population and World Segi's population of 15.33 per 100 000 and 15.09 per 100 000, respectively. Rural areas showed higher mortality (ASR China: 17.17 per 100 000, ASR world: 16.86 per 100 000) than urban areas (ASR China: 14.00 per 100 000, ASR World: 13.81 per 100 000). Conclusions: There is still a heavy burden of liver cancer in China. Rural residents have higher incidence and mortality of liver cancer compared with urban counterparts. It is likely that many factors such as hepatitis virus infection, and aflatoxin exposure play a dominating role. Prevention and control strategies should be enhanced in the future.

[Analysis of the clinical characteristics of 8 081 primary lung cancer].

Objective: To characterize the clinical epidemiological features of primary lung cancer patients based on massive clinical data. Methods: The demographic and histological information of 8 081 primary lung cancer patients who were initially identified from 1 January 2012 to 31 December 2013 in 16 hospitals from 6 provinces were retrospectively analyzed to determine the characteristics of different histological subtypes among different gender, age-group and birth cohort. Results: Among the 8 081 lung cancer patients, 5 422 (67.10%) were male and 2 659 (32.90%) were female, the average age was (60.96±10.14) years. The most common histological subtypes of lung cancer successively were adenocarcinoma (ADC), squamous cell carcinoma (SCC), small cell carcinoma and large cell carcinoma, and the proportions of these subtypes were 53.13%, 24.51%, 14.59% and 0.66%, respectively, which collectively accounted for 92.89%. The current highest smoking rate was observed in SCC patients, which was 62.45%, while lowest in ADC, which was 29.68%. The incidence of lung cancer in male was significantly higher that that of female, with a sex ratio of 2.04∶1. The highest sex ratio was observed in SCC, which was 9.14∶1, while lowest in ADC, which was 1.14∶1. The distribution of histological subtypes in male lung cancer patients was consistent with the general situation.While among the female lung cancer patients, the proportion of ADC was the highest (75.42%), followed by SCC (10.08%), squamous cell carcinoma (7.34%) and large cell carcinoma (0.39%). Analyzed by the birth cohort, the proportion of ADC gradually increased with the age, while the reduced tendency was observed in SCC (P<0.000 1). Conclusion: Adenocarcinoma is the most important histological subtype of lung cancer, and the distribution characteristics of histological subtypes of lung cancer differs among genders, age and birth cohort.

[Gastrectomy with either wedge resection of the pancreas or pancreaticosplenectomy for adenocarcinoma of the esophagogastric junction invading the pancreas: a comparison study].

Objective: To compare the outcomes of gastrectomy with either wedge resection of the pancreas or pancreaticosplenectomy for adenocarcinoma of the esophagogastric junction (AEG) invading pancreas. Methods: From May 2005 to December 2015, a total of 64 patients with AEG invading pancreas underwent gastrectomy with either wedge resection of pancreas (n=25) or pancreaticosplenectomy (n=39) at Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University. There were 53 males and 11 females, with a mean age of 60.2 years (range: 39 to 77 years). According to the AJCC esophageal cancer staging system, 8(th) edition, there were 27 patients in phase T4N0M0, 18 in phase T4bN1M0, 9 in phase T4bN2M0 and 10 in phase T4bN3M0. Follow-up was carried out every 6 months. The t-test for the measurement data and the χ(2) test, Fisher exact test or Wilcoxon ran-sum test for the enumeration data were used between the two groups. Survival curves were generated using the Kaplan-Meier method, and compared using the Log-rank test. Multivariate analysis was undertaken using the Cox proportional hazard model (forward stepwise regression). Results: In 39 patients who underwent pancreaticosplenectomy, incision infection occurred in 5 patients, anastomotic leak, peritoneal infection, lung infarction each occurred in 1 patient. There was 1 respiratory failure and 1 peritoneal infection in 25 patients undergoing wedge resection of the pancreas. There were no significant difference in the incidence of postoperative complications between the 2 groups (8/39 vs. 2/25, P=0.292), and no postoperative death in the study. Fifty-seven patients were followed up, with a follow-up rate of 89.1%. The 5-year overall survival rate was 32.3% in patients who underwent simultaneous gastrectomy and pancreaticosplenectomy, compared to 0 in those who underwent gastrectomy and wedge resection of the pancreas (χ(2)=4.484, P=0.034). The 5-year overall survival rate for patients who undergoing adjuvant chemotherapy was 32.3%, compared to 17.2% in whom underwent surgery alone (χ(2)=4.186, P=0.041). Conclusions: Survival benefit from R0 resection by simultaneous gastrectomy and pancreaticosplenectomy for AEG invading the pancreas can be achieved. Adjuvant chemotherapy is necessary for these patients.