Search

Objective: This study aims to systematically examine Chinese cancer patients' and families' preferences for information disclosure to the patient, patient awareness, and predictors of patient awareness. Methods: The Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines were followed. Web of Science, Scopus, Proquest, Taylor & Francis Online, and China National Knowledge Infrastructure were searched in April 2022 and Chinese Biomedical Literature Database in July 2022 for quantitative studies. The Mixed Methods Appraisal Tool was used for quality assessment. Results: A total of 22 studies were included, and the average quality score was 0.65/1. Meta‐analyses showed that 89.6% and 81.8% of cancer patients wanted to know their diagnosis and prognosis, respectively. Meanwhile, 50.0% and 32.4% of families prefer diagnosis disclosure and prognosis disclosure to the patient, respectively. Significantly more patients than families favored disclosure to the patient. In reality, only 59.3% of cancer patients know their diagnosis, and 19.9% know their prognosis. For predictors, while patients' gender, cancer type (breast cancer or not), treatment method (operation or other), or complications (yes or no) do not influence diagnosis awareness, being younger, being married, having higher educational attainment, having early‐stage rather than late‐stage cancer, and being in a higher‐grade hospital all predict better chances of knowing a diagnosis. No study explored predictors of patients' prognosis awareness. The findings did not vary according to publication time or sample size. Conclusions: Chinese cancer patients are eager to know their diagnosis and prognosis, but families are hesitant about disclosure to the patient, and patients' awareness is low. While cultural, legal, and medical backgrounds lay the foundation for information disclosure in Mainland China, case‐by‐case practical factors also make a difference. [ABSTRACT FROM AUTHOR]

Objective: The present study was aimed to comprehensively characterize the epidemiological, clinicopathological characteristics, treatments, and prognosis of intraoral spindle cell carcinoma (SpCC). Materials and Methods: Patients diagnosed with intraoral SpCC at our institution in the past 15 years (2005–2019) were screened from inpatient disease registry. All relevant data concerning patients with intraoral SpCC were retrieved. Previous reports about intraoral SpCC with adequate clinicopathological data in both English literature and Chinese literature were collected. Eligible cases were further reviewed and pooled for statistical analyses. Results: Six patients (5 females and 1 male; average age: 59 years) with intraoral SpCC were histopathologically diagnosed and surgically treated at our institution. The literature review identified another 63 published cases from 34 articles. Most cases were presented in the fifth to seventh decade of life with a male preponderance. Gingiva (23/69, 33.3%) was the most common site followed by the tongue (19/69, 27.5%) and buccal mucosa (8/69, 11.6%). Complete surgical ablation remains the primary treatment option. Tumor size, pathological grades, cervical node metastasis, and distant metastasis were significantly associated with reduced survival. Conclusions: Intraoral SpCC is an uncommon and aggressive malignancy with dismal prognosis. Much attention and effort are needed to characterize this rare entity and improve its clinical outcomes. [ABSTRACT FROM AUTHOR]

Coriolus versicolor (L.) Quél. is a higher fungi or mushroom which is now known by its accepted scientific name as Trametes versicolor (L.) Lloyd (family Polyporaceae). The polysaccharides, primarily two commercial products from China and Japan as PSP and PSK, respectively, have been claimed to serve as adjuvant therapy for cancer. In this paper, research advances in this field, including direct cytotoxicity in cancer cells and immunostimulatory effects, are scrutinised at three levels: in vitro, in vivo and clinical outcomes. The level of activity in the various cancers, key targets (both in cancer and immune cells) and pharmacological efficacies are discussed. [ABSTRACT FROM AUTHOR]

Introduction and aims: Cancer anorexia-cachexia syndrome (CACS) is a common multifactorial syndrome, which affects up to 80% patients with advanced cancer. At present, evidence to support the benefit of pharmacological intervention in the management of CACS is limited. Patients would benefit from standard procedures for early assessment and identification of cancer anorexia-cachexia, and using nonpharmacological strategies to manage patients with CACS. This best practice implementation project aimed to implement an evidence-based practice in assessing and managing patients with CACS, thereby improving the compliance of clinical practice with the best evidence and the quality of life of patients with CACS. Methods: This was an evidence-based audit and feedback project that used a three-phase approach at a public hospital in China. Phase 1 included the development of seven evidence-based audit criteria and carrying out a baseline audit on 30 patients using the JBI's Practical Application of Clinical Evidence System in the Department of Radiation Oncology of Nanfang Hospital. Phase 2 utilized the Getting Research into Practice component of the Practical Application of Clinical Evidence System to identify barriers to compliance with best practice principles and developed strategies and resources to improve compliance. Phase 3 involved conducting a follow-up audit using the same sample size and audit criteria to assess the results of interventions implemented to improve practice and identify issues that would be addressed in future audit. Results: The compliance rates of audit criteria 1, 2 and 6 were 100% at both baseline and follow-up audit. After the application of evidence, the compliance rate increased from 0 to 100% for audit criterion 3, from 0 to 76.6% for audit criterion 4, from 23 to 70% for audit criterion 5, and from 0 to 40% for audit criterion 5. Conclusion: The best evidence for the assessment and nonpharmacological management of cancer patients with CACS can improve clinical practice, the quality of clinical nursing, and patient satisfaction. The application of electronic informatization promotes the implementation and maintenance of best practice. [ABSTRACT FROM AUTHOR]

Pien-Tze-Huang (PTH) is a famous and commonly used traditional Chinese medicine formula in China. It was first formulated by a royal physician of the Ming Dynasty (around 1555 AD). Recently, PTH has attracted attention worldwide due to its beneficial effects against various diseases, especially cancer. This paper systematically reviewed the up-to-date information on its chemical composition, pharmacology, and clinical application. A range of chemical compounds, mainly ginsenosides and bile acids, have been identified and quantified from PTH. Pharmacological studies indicated that PTH has beneficial effects against various cancers, hepatopathy, and ischemic stroke. Furthermore, PTH has been used clinically to treat various diseases in China, such as colorectal cancer, liver cancer, and hepatitis. In summary, PTH is a potential agent with extensive therapeutic effects for the treatment of various diseases. However, the lack of information on the side effects and toxicity of PTH is a non-negligible issue, which needs to be seriously studied in the future. [ABSTRACT FROM AUTHOR]

Purpose: The goal of our study was to evaluate the reliability, validity, responsiveness and acceptability of the Mandarin (simplified) Chinese version of the EORTC QLQ‐OH45. Methods: From October 2017 to February 2018, 393 cancer patients were enrolled from three different hospitals in China. A forward and backward translation was made to develop the Mandarin (simplified) Chinese version of EORTC QLQ‐OH15. The QLQ‐C30 and QLQ‐OH15 questionnaires (which we have assembled and named QLQ‐OH45 in this paper) were self‐administered. Results were statistically analysed using SPSS 21.0. The reliability and validity tests of the questionnaires were assessed by Cronbach's α coefficient, Pearson correlation test and Mann–Whitney U tests. Responsiveness to change was measured in an independent sample of patients with head and neck cancer undergoing surgery or radiotherapy or chemotherapy. Results: An acceptable internal consistency reliability for most multiple‐item scales was demonstrated, as Cronbach's α coefficients were greater than 0.7 for most multiple‐item scales, excepting for cognitive functioning (0.36) and oral health‐related QoL functioning (0.55). All domain's test–retest reliability coefficients (r) was higher than 0.8. Multi‐trait scaling analysis showed good convergent and discriminant validity. A difference in the quality of life (QoL) between older (≥65 years) and younger (<65 years) groups of patients was showed by the known‐group comparisons. Low correlations were found between the scales of the QLQ‐OH15 and QLQ‐C30 in all areas. Conclusion: The Mandarin (simplified) Chinese version of QLQ‐OH45 demonstrates satisfactory psychometric properties and can be used to measure the oral health‐related QoL (OHRQoL) for Chinese cancer patients. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an ongoing global pandemic of COVID-19. It has been found that COVID-19 has an influence on the changes of blood coagulation parameters and the high incidence of thrombosis. Changchun experienced the epidemic of the Omicron BA.2 variant SARS-CoV-2 in March 2022 in China. Once infected, BA.2 spreads rapidly and most of them are asymptomatic. The purpose of this study is to research venous thrombosis and laboratory changes (including PLT, PT, APTT, DD, FDP, CRP, WBC, IL-6 and lymphocyte subsets) among 92 cancer patients with COVID-19 and 73 COVID-19 patients with non-cancer by Mann-Whitney U and Chi-square test. It was found that the levels of D-dimer, FDP, CRP and IL-6 in cancer patients were significantly higher than those in the COVID-19 cohort. There were 9 (9.8%) cancer patients and 2 (2.7%) noncancer patients found VTE, with no significant difference. The results showed that WBC, lymphocytes and B cells in cancer patients were significantly lower than those in the other group. Prophylactic anticoagulation was recommended for cancer patients with high risk factors, while paying attention to the occurrence of bleeding events. The detection of leukocyte classification, Ddimer, prothrombin time and fibrinogen at different time points are helpful for the diagnosis and anticoagulation of COVID-19 patients with cancer. [ABSTRACT FROM AUTHOR]

Introduction: Major depressive disorder (MDD) is associated with an increased risk of suicide and suicide attempt among cancer patients. However, we do not know how many cancer patients without MDD have suicidal ideation (SI). Objectives: This study aimed to investigate the prevalence, characteristics and correlated factors of SI among advanced cancer patients without MDD. Methods: This is a multi‐center, cross‐sectional study based on an electronic patient‐reported outcome systems in patients who were diagnosed with advanced lung, liver, gastric, esophageal, colorectal or breast cancer, the top six prevalent cancers in China. A total of 2930 advanced cancer patients were recruited from 10 regional representative cancer centers across China from August 2019 to December 2020. Patients completed the Patient Health Questionnaire‐9 regarding if they had thoughts of being better off dead or of hurting themselves in some way in the previous 2 weeks. Patients also completed the symptom inventory and quality of life assessment. Generalized estimating equation model was performed to explore the correlated factors associated with SI among the patients without MDD. Results: The overall prevalence of SI among advanced cancer patients without MDD was 13.1%. The prevalence was higher in older patients. After adjusted for existing conditions, patients with vomiting symptom (p < 0.001), poorer life quality (p < 0.001), and middle education level (p = 0.031) were correlated factors of SI. Conclusions: The suicidal ideation is common in advanced cancer patients without MDD. Patients with vomiting, poor quality of life, and middle education level should be screened and monitored for suicidal ideation even without MDD. Clinical Trial Information: ChiCTR1900024957. [ABSTRACT FROM AUTHOR]

Qualitative meta‐synthesis is a coherent approach to answering an overarching research question by synthesising past qualitative studies so as to create new meanings from their results. We conducted a qualitative meta‐synthesis to systematically evaluate and integrate the caregiving experiences of adult children providing care for an elderly parent with cancer. The search was conducted in the databases Web of Science, PubMed, Embase, MEDLINE, Cochrane Library, Grew Literature in the Health Sciences, CNKI, WanFang Data, VIP, SINOMED and China Academic Journals as well as Chinese grey literature databases (China Academic Conference Literature Database/中国学术会议文献数据库, National Science and Technology Library) from inception to June 9, 2021. Thirteen studies were included in the final synthesis. The caregiver experiences they describe are synthesised into three primary themes: care needs, care burden and care gains, with numerous secondary themes. Besides our findings that seem to align with those from studies focused on other cultures, we have highlighted three main discoveries from the synthesis that stand out in the Chinese context: (1) many sub‐themes related to specific caregiving skills; (2) a strong expectation for health professionals to improve their communication skills with family caregivers; (3) the negative and positive influences of filial piety in caregiving experiences. Our findings can help multidisciplinary healthcare teams in China support adult children as caregivers in their emphasis on improving caregiver education and training, ways of making the most of potential care gains, and ways of easing care burdens. [ABSTRACT FROM AUTHOR]

Background: SNGH14 is a newly discovered long non-coding RNA (lncRNA) highly associated with tumorigenesis. However, whether the level of SNHG14 is related to the prognosis of patients with different cancer types is unclear. Methods: PubMed, Web of Science, Cochrane Library, and Embase were searched to identify eligible studies from inception to November 2021. The odds ratio (OR) and 95% confidence interval (CI) were utilized to analyze dichotomous variables, while the hazard ratio (HR) and 95% CI were used for survival outcomes. We also included trial sequential analysis (TSA) to assess whether the current evidence was sufficiently conclusive. Stata 15.0 and TSA 0.9 software were used for data analyses. Results: A total of 21 studies involving 1,080 patients, mainly from China, were included. Our results revealed that high SNHG14 expression was associated significantly with poor overall survival (OS) [HR = 1.39; 95% CI: (1.06--1.83); p = 0.017]. In addition, elevated SNHG14 expression was related to tumor size (> 3.5 cm) [OR = 1.60; 95% CI: (1.20--2.14); p = 0.001], TNM staging [OR = 0.54; 95% CI: (0.40--0.71); p < 0.001], lymph node metastasis [OR = 1.86; 95% CI: (1.35--2.55); p < 0.001], differentiation grade [OR = 1.95; 95% CI: (1.36--2.80); p < 0.001], and distant metastasis [OR = 2.44; 95% CI: (1.30--4.58); p = 0.005]. However, no significant difference was observed between age [OR = 0.98; 95% CI: (0.72--1.35); p = 0.915] and gender [OR = 0.98; 95% CI: (0.72--1.35); p = 0.915] from the enhanced expression of SNHG14. Conclusion: The current study revealed that overexpression of SNGH14 is associated with low OS rate and clinicopathological characteristics. SNGH14 can be a novel tumor marker that aids in tumor diagnosis, thereby improving patient prognosis. [ABSTRACT FROM AUTHOR]

Background. Cancer palliative care is recommended by guidelines for patients with early stage of cancer. Unlike the Western countries, in mainland China, cancer patients receive specialist-led cancer palliative care. Nurse-led cancer palliative care (NUC) is not well established yet. Objectives. To compare the clinical outcome measures, quality of life and symptom distress in patients suffering from cancer who received NUC with the same results in patient who received consulting oncologist-led cancer palliative care (ONC). Materials and methods. The study was a chart review of a database of patients suffering from cancer. Data regarding clinical outcome measures, quality of life and symptom distress of patients suffering from cancer who were receiving chemotherapy and NUC (NUC cohort, n = 185) or ONC (ONC cohort, n = 170) were collected and analyzed. One oncologist or 1 nurse was involved in treating 1 patient during the patient's hospital visit. Each visit took 30 min. The Chinese version of the Symptom Distress Scale was used for the evaluation of the degree of symptom distress. The simplified Chinese version of the European Organization for Research and Treatment Quality of Life Questionnaire (the EORTC QLQ-C30) v. 3.0 was used for evaluation of the quality of life. Results. Female patients preferred NUC (p < 0.0001). The pain intensity (4.13 ±1.71 compared to 3.35 ±1.01, p < 0.0001), dyspnea (3.89 ±1.48 compared to 2.82 ±0.97, p < 0.0001), constipation (3.56 ±1.78 compared to 3.06 ±1.89, p = 0.0107), and degree of symptom distress (38.09 ±7.26 compared to 35.05 ±7.92, p = 0.0002) were reported higher among patients from the ONC cohort than among those from the NUC cohort. Patients from the NUC cohort reported a better quality of life than those from the ONC cohort (70.41 ±13.62 compared to 45.63 ±7.94, p < 0.0001). Conclusions. The NUC results in better clinical outcome measures and higher quality of life than ONC for patients receiving chemotherapy. [ABSTRACT FROM AUTHOR]

Simple Summary: Parathyroid carcinoma (PC) is a rare endocrine malignancy with poor outcomes. Surgery remains the mainstay of PC treatment. However, due to the rarity of this malignancy, the optimal extent of PC surgery remains inconclusive, including whether to perform central lymph node dissection (LND). In the present study, we reported the patterns and predictors of cervical lymph node metastasis in PC based on a cohort of 68 PC patients. The results showed that the percentage of cervical lymph node metastasis in PC was 19.4% at initial surgery and 25.0% including reoperations for recurrencies. High-risk Schulte staging and CDC73 abnormalities were identified as risk factors for cervical lymph node metastasis. Central LND should be considered during remedial surgeries performed after previous local resection of PC for patients with high risk factors. Background: Parathyroid carcinoma (PC) is a rare endocrine malignancy with poor outcomes. Over 60% of PC patients experience repeated disease recurrence or metastasis. The significance of cervical lymph node dissection (LND) for PC remains inconclusive. Methods: PC patients diagnosed at Peking Union Medical College Hospital between 1992 and 2021 were reviewed retrospectively. Clinical data, initial tumor histological staging, parafibromin histochemical staining results, Ki67 index, CDC73 gene mutation status and outcome information were collected systemically. The risk factors for recurrence and lymph node or distant metastasis were explored. Results: Sixty-eight PC patients receiving LND were enrolled. Cervical lymph node metastasis was identified in 19.4% of patients at initial surgery and 25.0% of patients including reoperations for recurrences. The independent risk factor for PC recurrence was a Ki67 index ≥ 5% (HR4.41, 95% confidence interval (CI)1.30–14.95, p = 0.017). Distant metastasis was an independent prognostic factor for PC patient overall survival (HR 5.44, 95% CI 1.66–17.82, p = 0.005). High-risk Schulte staging (p = 0.021) and CDC73 abnormalities (p = 0.012) were risk factors for cervical lymph node metastasis. Conclusion: Most PCs were slow-growing, but lymph node metastasis was not rare. For patients planning to undergo remedial surgery after previous local resection of PC, central LND is suggested for tumors with high-risk Schulte staging or CDC73 abnormalities. [ABSTRACT FROM AUTHOR]

Background: N6-methyladenosine (m6A) is crucial in cancer and is being intensively studied. Aim: This bibliometric analysis seeks a broad picture of the role of m6A in cancer to guide and broaden future research. Methods: Publications were retrieved from Web of Science Core Collection and PubMed from 2000 to 2021, with keywords 'm6A' and 'cancer', and analyzed in biblioshiny and VOSviewer. Results: A total of 1013 documents were included, and China and the USA were the top countries with close collaboration. Mechanisms and predictive biomarkers of m6A regulator genes were highlighted. Cross-integration of m6A and other research hot spots, including 'immunotherapy', 'hypoxia' and 'polymorphism', were frontiers of m6A in cancer. Conclusion: This bibliometric study offered an updated perspective on m6A in cancer. [ABSTRACT FROM AUTHOR]

Two genetic variants that alter alcohol metabolism, ALDH2‐rs671 and ADH1B‐rs1229984, can modify oesophageal cancer risk associated with alcohol consumption in East Asians, but their associations with other cancers remain uncertain. ALDH2‐rs671 G>A and ADH1B‐rs1229984 G>A were genotyped in 150 722 adults, enrolled from 10 areas in China during 2004 to 2008. After 11 years' follow‐up, 9339 individuals developed cancer. Cox regression was used to estimate hazard ratios (HRs) for site‐specific cancers associated with these genotypes, and their potential interactions with alcohol consumption. Overall, the A‐allele frequency was 0.21 for ALDH2‐rs671 and 0.69 for ADH1B‐rs1229984, with A‐alleles strongly associated with lower alcohol consumption. Among men, ALDH2‐rs671 AA genotype was associated with HR of 0.69 (95% confidence interval: 0.53‐0.90) for IARC alcohol‐related cancers (n = 1900), compared to GG genotype. For ADH1B‐rs1229984, the HRs of AG and AA vs GG genotype were 0.80 (0.69‐0.93) and 0.75 (0.64‐0.87) for IARC alcohol‐related cancers, 0.61 (0.39‐0.96) and 0.61 (0.39‐0.94) for head and neck cancer (n = 196) and 0.68 (0.53‐0.88) and 0.60 (0.46‐0.78) for oesophageal cancer (n = 546). There were no significant associations of these genotypes with risks of liver (n = 651), colorectal (n = 556), stomach (n = 725) or lung (n = 1135) cancers. Among male drinkers, the risks associated with higher alcohol consumption were greater among ALDH2‐rs671 AG than GG carriers for head and neck, oesophageal and lung cancers (Pinteraction <.02). Among women, only 2% drank alcohol regularly, with no comparable associations observed between genotype and cancer. These findings support the causal effects of alcohol consumption on upper aerodigestive tract cancers, with ALDH2‐rs671 AG genotype further exacerbating the risks. [ABSTRACT FROM AUTHOR]

Objective: China is a developing country with urban-rural disparities and accelerating population aging. Therefore, quantifying the effects of population aging on the cancer mortality burden is urgently needed. Methods: Using data from China's death surveillance datasets (2004-2017), we decomposed and quantified the effects of population aging and factor variations on cancer mortality rates in urban and rural China during 2004-2017 through a decomposition method. R ratios were used to assess the extent of the mortality decreases attributable to factor variations offsetting the increases attributable to population aging for 4 aging-related cancers (lung, colorectal, esophageal, and stomach cancer). Results: Overall, population aging has led to continued increases in cancer mortality rates in China during 2004-2017 (mortality rates attributable to population aging: 8.63/100,000 for urban men, 4.21/100,000 for urban women, 11.95/100,000 for rural men, and 5.66/100,000 for rural women). The 4 cancers displayed 3 patterns. The mortality rates from lung cancer in rural China and from colorectal cancer nationwide increased because of both population aging and factor variations. Population aging was primarily responsible for the growing mortality due to lung cancer in urban areas. However, for esophageal and stomach cancer, the effect of population aging was not dominant, thus resulting in decreases in mortality rates. Conclusions: Health resource allocation should prioritize areas or cancers more adversely affected by population aging. The burden of cancer will continue to increase in the future, because of rapid population aging, but can still be offset or even reversed with enhanced cancer control and prevention. [ABSTRACT FROM AUTHOR]

Background: A study conducted in China on patients with coronavirus disease 2019 (COVID-19) showed that cancer conferred a five times increased risk for needing intensive care admission and mortality; No data has yet been collected and published from the Philippines. Thus, the investigators conducted this substudy to determine the association of having a history of cancer with clinical outcomes among patients included in the Philippine CORONA Study. Methodology: Multi-center, retrospective cohort design Results: A total of 244 patients had a history of cancer, out of 10,881 COVID-19 hospital admissions. After adjusting for different confounding variables of interest, having cancer was significantly associated with a 75% increased odds of having severe/critical COVID-19 at nadir (CI 95% 1.32, 2.33; p < 0.001). After adjusting for different confounding variables of interest, having cancer was significantly associated with the following time-to-event outcomes: 72% increase in hazard of in-hospital mortality (CI 95% 1.37, 2.16; p < 0.001), 65% increase in hazard of respiratory failure (CI 95% 1.31, 2.08; p < 0.001), and 57% increase in hazard of being admitted to ICU (CI 95% 1.24, 1.97; p < 0.001). Conclusion: A history of cancer conferred poorer clinical outcomes on adult, hospitalized COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: Nondrug treatments are potentially beneficial for cancer patients. However, the effect of sleep on cancer-related fatigue (CRF) and quality of life (QOL) in cancer patients remains unclear. We conducted a meta-analysis of randomized controlled trials to examine the efficacy of sleep in cancer patients undergoing treatment. Methods: The PubMed, Ovid, Embase, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure databases were searched to identify suitable studies. Stata 15.0 software was used for statistical analyses. Sensitivity analyses were conducted. Fourteen studies (6 in English and 8 in Chinese) involving 1151 patients were included in the meta-analysis. Ten, five, and six studies that assessed the effects of sleep on CRF, QOL, and quality of sleep, respectively, in cancer patients undergoing treatment were identified. Results: Sleep interventions significantly affected overall CRF (standardized mean difference (SMD) = −1.52, P < 0.01), overall QOL (SMD = 1.20, P < 0.01), physical fatigue (SMD = −0.66, P < 0.01), cognitive fatigue (SMD = −0.38, P = 0.015), and physical function (SMD = 0.64, P < 0.01). Comprehensive intervention measures focusing on sleep, sleep nondrug interventions, and interventions for ≥3 or <3 months affect CRF. However, no significant effects on emotional fatigue, emotional function, perpetual fatigue, depression, or quality of sleep were observed. Conclusions: Comprehensive interventions focusing on sleep are helpful for CRF. Sleep interventions may only affect physiological function and have no effect on emotional function, perpetual function, or sleep quality. Future research should focus on how to combine sleep interventions with psychological, social, cognitive, and emotional interventions and provide targeted comprehensive nursing measures to better improve CRF, sleep quality, and QOL. [ABSTRACT FROM AUTHOR]

Background: The association between obstructive sleep apnea (OSA) and the incidence and mortality of cancer remain unclear, especially in Asian populations. Thus, this study was conducted to explore the relationship between OSA and the incidence and mortality of cancer in hospitalized patients. Methods: This retrospective cohort study evaluated inpatients from Guangdong Provincial People's Hospital for suspected OSA between January 2005 and December 2015. Cancer incidence, all-cause mortality, and cancer mortality and were determined using data from the hospital information system and Centers for Disease Control. Between-group comparisons were carried out by performing a chi-square test and analysis of variance. Kaplan–Meier analysis and the Cox proportional risk model were applied to investigate the association between OSA and cancer incidence and mortality. Results: Of the 4,623 hospitalized patients included, 3,786 (81.9%) patients were diagnosed with OSA. After a median follow-up of 9.1 years (interquartile range, 9.79–11.44), the incidence of cancer was 6.6% (251/3,786), with lung cancer having the highest incidence at 1.6% (60/3,786). The mortality rate of OSA patients was higher than that of non-OSA patients (16.83% vs.12.78%, p=0.008), but the relationship between apnea-hypopnea index (AHI), oxygen saturation less than 90% (TSat90), and cancer mortality was not statistically significant (p>0.05).The mortality rate for all types of cancer was 2.8% (105/3,786), with lung cancer having the highest mortality rate at 0.8% (32/3,786). The cumulative incidence of cancer in the severe OSA group was 8.2%, which was higher than that in the normal, mild, and moderate OSA groups (P =0.010). Further, the Cox proportional risk regression model showed a progressive enhancement in the risk of cancer incidence as the AHI increased (adjusted hazard ratio [HR]: 1.009 [95% confidence interval (CI): 1.003–1.016], P =0.005). Based on subgroup analysis, the risk of cancer increased as the AHI increased in patients aged <65 years (adjusted HR: 1.019 [95% CI: 1.007–1.031], P =0.002). In addition, the cancer incidence was significantly higher in the severe OSA group than in the normal, mild, and moderate OSA groups (adjusted HR: 2.825 [95% CI: 1.358–5.878], P =0.019). Conclusion: The incidence of cancer is higher in patients with OSA than in non-OSA patients and is significantly positively associated with the severity of OSA. Particularly, for OSA patients aged <65 years, lung cancer is the main cause of death in those with new-onset cancer. Mortality was higher in OSA patients than in non-OSA patients. [ABSTRACT FROM AUTHOR]

Background: For children with cancer, the experience during treatment can be challenging. There is a limited number of studies on self-reported treatment experiences of younger Chinese children with cancer using qualitative methods. Objectives: This study aimed at exploring the experience of Chinese children aged 5 to 7 years during cancer treatment reflected through interviews and drawings. Methods: This study used a descriptive qualitative design with the technique of "draw-and-tell." Participants were enrolled from the pediatric oncology inpatient department of one national children's medical center in China. They were asked to draw a picture of "your feelings in the hospital." An inductive content analysis approach was used. Results: Twelve participants were enrolled (8 male, mean age 5.7 years). Four themes were established: (1) suffering from adverse treatment effects; (2) perceiving changed relationships; (3) being thankful for others; and (4) trying out coping strategies. Conclusion: Chinese children aged 5 to 7 years expressed multiple cancer treatment impacts. They appreciated others' support and had their own way to cope with treatment demands. The authors also extended the dynamic nature of using the "draw-and-tell" methodology. Study findings highlight the importance of inviting and hearing the voice of young children during their cancer treatment, with particular consideration of the influence of disease, treatment, child development, family dynamics, and culture. [ABSTRACT FROM AUTHOR]

Background: Fear of cancer recurrence (FCR) is a significant issue for most cancer patients. Until now, a detailed investigation of the structure of FCR and the interaction among its constituent elements is lacking. This study aims to investigate the phenomenon of FCR by means of network analysis in Chinese cancer patients. Methods: This is a multi-center, cross-sectional study that included 996 cancer patients from southern China. All participants were assessed by the 7-item Chinese version Fear of Cancer Recurrence Scale (FCR-7). Multivariate logistic regression, and network analyses were conducted. Central symptoms (nodes) in the FCR network were identified. Results: Among the 996 patients, 543 (54.52%) reported moderate FCR, and 137 (13.76%) reported high FCR. Chemotherapy (OR = 2.954, P = 0.016), and childhood severe illness experience (OR = 2.331, P = 0.016) were positively associated with high FCR, while higher monthly income (OR = 0.403, P = 0.046) was negative associated with high FCR. The node #FCR2 (Worried/anxious about recurrence) was the most central node within the FCR network (Strength = 1.190), while node #FCR6 (Examining for physical signs) was the least central node (Strength = 0.373). The edge FCR1-FCR2 (" Afraid"-"Worried/anxious") was the thickest and most saturated edge in the network. After controlling for age and gender, an almost identical network was obtained with respect to edges magnitude and strength. Conclusion: Fear of recurrence is a frequently reported issue among Chinese cancer patients. Patients with chemotherapy and childhood severe illness experience were more vulnerable and should be particularly monitored. Compared to behavioral component (i.e., body checking, overscreening and overtreatment) and cognitive component (i.e., intrusions), emotional component (i.e., worry/anxious) is more central to identify FCR and might be potential targets for further interventions. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a new respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It started in China and spread quickly to all continents. This virus has changed the life style and the education system in many countries. As for other viruses, mathematical models have been rated as a useful tool to support the research on COVID-19. In this work, we develop a reaction–diffusion model to describe the within-host dynamics of SARS-CoV-2 in cancer patients. This model studies the interactions between nutrient, healthy epithelial cells, cancer cells, SARS-CoV-2 particles, and immune cells. The model incorporates the spatial mobility of the cells and viruses. The model includes parameters for measuring the effect of lymphopenia on SARS-CoV-2/cancer patients. We verify the basic features of the model's solutions including the uniqueness, nonnegativity and boundedness. We list all equilibrium points of the proposed model. We show the global stability and the local instability of the most meaningful equilibria. We display some numerical simulations to enhance our theoretical results. The results indicate that diffusion can have a clear effect at the beginning of SARS-CoV-2 infection. Lymphopenia in SARS-CoV-2/cancer patients impairs the immune responses against cancer and SARS-CoV-2, and worsens the health state of patients. [ABSTRACT FROM AUTHOR]

Background: Oral mucositis is a common complication after radiotherapy or chemotherapy in cancer patients. Oral mucositis can affect the patient's food intake and their confidence in treatment as patients are more likely to suffer severe pain, experience weight loss, encounter an interruption or change of cancer treatment plan, and are reported to have a reduced survival from the disease. Nutritional intervention is the primary nursing focus in patients with oral mucositis treated by chemoradiotherapy. Objectives: The current best practice implementation project aimed to establish best practice principles in nutritional interventions for patients with cancer treatment-related oral mucositis. Methods: This was an evidence-based audit and feedback project that used a three-phase approach at a public hospital in China. Phase 1 involved developing five evidence-based audit criteria informed by current best available evidence, and undertaking a clinical audit of current practice on 50 patients in the Department of Radiation Oncology of Nanfang Hospital using the JBI's Practical Application of Clinical Evidence System. Phase 2 utilized the Getting Research into Practice component of the Practical Application of Clinical Evidence System to identify barriers to compliance with best practice principles and developed strategies and resources to improve compliance. Phase 3 involved conducting a postaudit using the same sample size and audit criteria to re-evaluate compliance with best practice. Results: Baseline results showed that compliance rates were 0% for criteria 1 and 2, 76% for criteria 3 and 5, and 82% for criterion 4. The implementation of strategies, including establishing a multidisciplinary team with a dietitian, creating training and education programs for all staff and patients, utilizing a scale regarding diet to assess patients' current diet, and establishing a nutrition intervention nursing procedure to supervise implementation of the nutritional intervention for patients with cancer treatment-related oral mucositis, increased compliance with best practice, achieving compliance rates of at least 82% for all five audit criteria. Conclusion: The implementation of context-specific strategies improved compliance with evidence-based practice in the nutritional intervention for patients with cancer treatment-related oral mucositis. Sustainability of best practice is important, with further audits planned to evaluate the sustainability of these practice changes. What is known about the topic? * Oral mucositis is a common complication after radiotherapy or chemotherapy in cancer patients. * Oral mucositis can affect patients' food intake and their confidence in treatment. * Nutritional care is a nursing responsibility among patients with oral mucositis treated by chemoradiotherapy. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence indicates that nutritional status could influence the survival of cancer patients. This study aims to develop and validate a nomogram with nutrition-related parameters for predicting the overall survival of cancer patients. Patients and methods: A total of 8749 patients from the multicentre cohort study in China were included as the primary cohort to develop the nomogram, and 696 of these patients were recruited as a validation cohort. Patients' nutritional status were assessed using the PG-SGA. LASSO regression models and Cox regression analysis were used for factor selection and nomogram development. The nomogram was then evaluated for its effectiveness in discrimination, calibration, and clinical usefulness by the C-index, calibration curves, and decision curve analysis. Kaplan–Meier survival curves were used to compare the survival rate. Results: Seven independent prognostic factors were identified and integrated into the nomogram. The C-index was 0.73 (95% CI, 0.72 to 0.74) and 0.77 (95% CI, 0.74 to 0.81) for the primary cohort and validation cohort, which were both higher than 0.59 (95% CI, 0.58 to 0.61) of the TNM staging system. DCA demonstrated that the nomogram was higher than the TNM staging system and the TNM staging system combined with PG-SGA. Significantly median overall survival differences were found by stratifying patients into different risk groups (score < 18.5 and ≥ 18.5) for each TNM category (all Ps < 0.001). Conclusion: Our study screened out seven independent prognostic factors and successfully generated an easy-to-use nomogram, and validated and shown a better predictive validity for the overall survival of cancer patients. [ABSTRACT FROM AUTHOR]

Because of the long-term and phased nature of tumor's treatment, most tumor patients need to survive with cancer for a long time. The remote management of tumor-related symptoms has become a problem that needs to be solved urgently in the clinic. However, due to the lack of relevant guidance and specifications, the remote management of tumor symptoms in China still faces many obstacles. Learning from mature and successful tumor symptom remote management projects abroad is the only way to improve China's remote management norms. Therefore, this article will introduce the Canadian tumor symptom remote management project and its constipation symptom management guide, and provide a guide for the development of tumor symptom remote management projects in China reference. [ABSTRACT FROM AUTHOR]

Objective: There is limited prospective evidence on the association of physical activity with hepatobiliary cancer subtypes and other major hepatobiliary diseases, especially in China. We aimed to quantify the associations with risk of these diseases.Methods: The study population involved 460 937 participants of the prospective China Kadoorie Biobank aged 30-79 years from 10 diverse areas in China without history of cancer or hepatobiliary disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with self-reported total and domain-specific physical activity (occupational and non-occupational, ie, leisure time, household and commuting).Results: During ~10 years of follow-up, 22 012 incident cases of hepatobiliary diseases were recorded. The overall mean (SD) total physical activity was 21.2 (13.9) metabolic equivalent of task (MET)-hours/day, with 62% from occupational activity. Total physical activity was inversely associated with hospitalised non-alcoholic fatty liver disease (HR comparing top vs bottom quintile: 0.62, 95% confidence interval (CI) 0.53 to 0.72), viral hepatitis (0.73, 95% CI 0.62 to 0.87), cirrhosis (0.76, 95% CI 0.66 to 0.88) and liver cancer (0.81, 95% CI 0.71 to 0.93), as well as gallstone disease (0.86, 95% CI 0.81 to 0.90), gallbladder cancer (0.51, 95% CI 0.32 to 0.80) and biliary tract cancer (0.55, 95% CI 0.38 to 0.78). The associations for occupational physical activity were similar to those for total physical activity, but for non-occupational physical activity they differed by disease subtype. For leisure-time physical activity, there was an inverse association with liver cancer and an inverse trend for gallstone disease (HR comparing ≥7.5 MET-hours/day with none: 0.83, 95% CI 0.75 to 0.91 and 0.82, 95% CI 0.66 to 1.01).Conclusion: Among Chinese adults, high total physical activity, particularly occupational physical activity, was inversely associated with risk of major hepatobiliary cancers and diseases, including non-alcoholic fatty liver disease, cirrhosis and certain types of cancer. [ABSTRACT FROM AUTHOR]

Background: Pharmacist-led clinical pathways/order sets (PLCOs) were first applied for designated diseases and surgical operations, such as cancer. They were not used in pharmacotherapy until recently. After screening a large number of publications, we found that PLCOs were rarely accessible. Objective: To evaluate the effects and the changes of relevant medical outcomes of PLCOs. Methods: Articles from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang database, and China Biology Medicine disc (CBM) were systematically retrieved. Clinical research comparing cancer patients' clinical effects with or without clinical pathway/order sets was performed. Two reviewers performed quality assessment, and the data were abstracted independently. A narrative synthesis of the extracted data was performed due to heterogeneity. Results: Nine studies were identified, including six uncontrolled before–after studies and three case-series studies. The scopes of PLCOs of included research can be divided into two types, one focusing on chemotherapy agents and the other on the managements of chemotherapy-induced complications. The PLCOs shortened hospital length of stay, decreased initial antibiotic time intervals in patients with febrile neutropenia, reduced medication error incidence, and increased physicians' adherence rate to clinical pathway/order sets. Moreover, three articles included economic effects showing positive savings on medication costs through PLCOs. Conclusion: PLCOs can have beneficial effects on medication effectiveness, safety, and economic outcomes. Nevertheless, clinical pathway/order sets need to be further optimized and expanded to other clinical areas. [ABSTRACT FROM AUTHOR]

Background: With increasing cancer incidence and decreasing cancer mortality, there is a growing need for a valid and culturally adapted tool to measure health-related quality of life in children with cancer. This study validated the DISABKIDS Chronic Generic Module (DCGM-37) in Chinese children and adolescents with cancer.Methods: The DCGM-37 was translated and adapted for use in China following the guidelines from its copyright holders. In total, 140 children and adolescents with cancer and their guardians were included in this cross-sectional study. Internal consistency and test-retest reliability were evaluated. Convergent validity was examined using Pearson correlation between the DCGM-37 and the PedsQL 4.0 Generic Core Scale. Dimensionality was clarified using exploratory factor analysis. Discriminant validity was evaluated by comparing DCGM-37 scores by sex, age, family income, and clinical characteristics.Results: Internal consistency (Cronbach's alpha 0.91) and test-retest reliability were good (intraclass correlation coefficient 0.87, 95% confidence interval 0.73-0.94). Strong correlations between the DCGM-37 and the PedsQL 4.0 (r = 0.83) suggest good convergent validity. Six factors explained 51.94% of the total variance. Children with leukemia scored higher than those with sarcoma in all subscales (effect size ranged from 0.39 to 0.83), especially the "social exclusion" subscales (effect size 0.83). Small to moderate differences (effect size ranged from 0.38 to 0.58) were observed by sex, age, and family income. Neither floor nor ceiling effects were observed.Conclusion: The DCGM-37 is reliable and valid for measuring health-related quality of life in Chinese children and adolescents with cancer. [ABSTRACT FROM AUTHOR]

The notion of biosociality has been employed in the understanding of forging new forms of social groupings and other forms of social solidarity, with its feasibility and basis challenged in non-Western contexts. According to our study of a Chinese cancer self-help organization, an emergent biosociality occurs through an increasingly common diagnostic biomedical category, cancer. But what truly binds these people tighter is the pre-modern local knowledge of qi, as well as state ideology about living a useful life. A new form of biosocial citizenship, "a good guy (haoren yige)," linked to cancer, is thus endowed. [ABSTRACT FROM AUTHOR]

Abstract: Regulatory T cells (Tregs) are subsets of T cells that are specifically dedicated to controlling immune responses. It has been established that Tregs play a key role in regulating autoimmune disease, allergy, cancer, infectious disease, and in the induction of transplantation tolerance. The latest progress in the development, function, mechanism of action, and homeostasis of regulatory T cells, and their translation to the clinic were presented at the International Conference on Regulatory T Cells and Clinical Application in Human Diseases in Beijing on 25–27 October 2008 (China Tregs 2008). In this Special Issue of International Immunopharmacology, several papers submitted to the China Tregs 2008 will highlight some of the recent advances in the biology of regulatory T cells and current strategies to translate regulatory T cells into the clinic. [Copyright &y& Elsevier]

• Identification of highly-reliable and easierly-detectable biomarkers capable of secreting into blood, urine and saliva by integrating transcriptomics and proteomics data at the system biology level. • Obtainment of the effective candidate biomarkers ESM1, CTHRC1, AZGP1 for colorectal cancer capable of secreting into blood, urine and saliva. • Spanning the huge gap between transcriptome and proteomics. • Easily to be applied to identify biomarkers of other types of tumors. Colorectal cancer is one of the top leading causes of cancer mortality worldwide, especially in China. However, most of the current treatments are invasive and can only be applied to very few cancers. The earlier a malignant tumor is diagnosed, the higher the patient's survival rate. In this study, we proposed a computational framework to identify highly-reliable and easierly-detectable biomarkers capable of secreting into blood, urine and saliva by integrating transcriptomics and proteomics data at the system biology level. First, a large number of transcriptome data were processed to identify candidate biomarkers for colorectal cancer. Second, three classified models are constructed to predict biomarkers for colorectal cancer capable of secreting into blood, urine and saliva, which are effective disease diagnosis media to facilitate clinical screening. Then biological functions and molecular mechanisms of the candidate biomarkers of colorectal cancer are inferred utilizing multi-source biological knowledge and literature mining. Furthermore, the classification power of different combinations of candidate biomarkers is verified by machine learning models. In addition, the targeted drugs of the predicted biomarkers are further analyzed to provide assistance for clinical treatment of colorectal cancer. In this paper, our proposed computational model not only provides the effective candidate biomarkers ESM1, CTHRC1, AZGP1 for colorectal cancer capable of secreting into blood, urine and saliva, but also helps to understand the molecular mechanism of colorectal cancer. This computational framework can span the huge gap between transcriptome and proteomics, which can easily be applied to the biomarker research for other types of tumor. [ABSTRACT FROM AUTHOR]

Thyroid nodule has been a common and serious threaten to human health. With the identification and diagnosis of thyroid nodules in the general population, large volumes of examination reports in clinical practice have been accumulated. They provide data basics of analyzing radiologists’ behavior of diagnosing thyroid nodules. To conduct data-driven analysis of radiologists’ behavior, an experimental framework is designed based on belief rule base, which is essentially a white box for knowledge representation and uncertain reasoning. Under the framework, with 2744 examination reports of thyroid nodules in the period from January 2012 to February 2019 that have been collected from a tertiary hospital located in Hefei, Anhui, China, experimental results are obtained from conducting missing validation, self-validation, and mutual validation. Three principles are then concluded from the results and corresponding analysis. The first is that missing features on some criteria are considered as benign ones by default, the second is that there is generally inconsistency between the recorded features on criteria and the overall diagnosis, and the third is that different radiologists have different diagnostic preferences. These three principles reflect three diagnostic behavioral characteristics of radiologists, namely reliability, inconsistency, and independence. Based on the three principles and radiologists’ behavioral characteristics, managerial insights in a general case are concluded to make the findings in this study available in other situations. [ABSTRACT FROM AUTHOR]

The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) in China, which spread to the rest of the world, led the World Health Organization to classify it as a global pandemic. COVID-19 belongs to the Bettacoronavirus genus of the Coronaviridae family, and it mainly spreads through the respiratory tract. Studies have now confirmed a human-to-human transmission as the primary pathway of spread. COVID-19 patients with a history of diseases such as respiratory system diseases, immune deficiency, diabetes, cardiovascular disease, and cancer are prone to adverse events (admission to the intensive care unit requiring invasive ventilation or even death). The current focus has been on the development of novel therapeutics, including antivirals, monoclonal antibodies, and vaccines. However, although there is undoubtedly an urgent need to identify effective treatment options against infection with COVID-19, it is equally important to clarify management protocols for the other significant diseases from which these patients may suffer, including cancer. This review summarizes the current evidence regarding the epidemiology, pathogenesis, and management of patients with COVID-19. It also aims to provide the reader with insights into COVID-19 in pregnant patients and those with cancer, outlining necessary precautions relevant to cancer patients. Finally, we provide the available evidence on the latest potent antiviral drugs and vaccines of COVID-19 and the ongoing drug trials. [ABSTRACT FROM AUTHOR]

Background: Leukemia can create a significant economic burden on the patients and their families. The objective of this study is to assess the medical expenditure and compensation of pediatric leukemia, and to explore the incidence and determinants of catastrophic health expenditure (CHE) among households with pediatric leukemia patients in China. Methods: A cross‐sectional interview was conducted among households living with pediatric leukemia using a questionnaire in two tertiary hospitals. CHE was defined as out‐of‐pocket (OOP) payments that were greater than or equal to 40% of a household's capacity to pay (CTP). Chi‐square tests and logistic regression analysis were performed to identify the determinants of CHE. Results: Among 242 households living with pediatric leukemia, the mean OOP payment for pediatric leukemia healthcare was $9860, which accounted for approximately 35.7% of the mean household's CTP. The overall incidence of CHE was 43.4% and showed a downward trend with the lowest income group at 69.0% to the highest income group at 16.1%. The logistic regression model found that medical insurance, frequency of hospital admissions, charity assistance, and income level were significant predictors of CHE. Conclusion: The results revealed that pediatric leukemia had a significant catastrophic effect on families, especially those with lower economic status. The occurrence of CHE in households living with pediatric leukemia could be reduced by addressing income disparity. In addition, extending coverage and improving compensation from medical insurance could also alleviate CHE. Some other measures that can be implemented are to address the barriers of charity assistance for vulnerable groups. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors (ICIs) have significant clinical efficacy in the treatment of non‐small cell lung cancer (NSCLC); however, the incidence of immune‐related adverse events (irAEs) of up to 50% has prevented their widespread use. With the increase in the use of ICIs alone or as combination therapy, clinicians are required to have a better understanding of irAEs and be able to manage them systematically. In this study, we aimed to assess the incidence of irAEs associated with ICIs. Methods: We searched PubMed, Embase, and the Web of Science databases, and also included relevant literature references to widen our search. The relevant data with inclusion criteria were performed using RevMan 3.6.0 for meta‐analysis. We undertook a systematic literature search which included published data up to December 2019. Results: Overall, 147 articles and 23 761 cancer patients with 11 different ICI treatment‐related (grade 1–5 and 3–5) irAEs were included in the study. There were 46 articles on pembrolizumab (6598 patients), 27 on nivolumab (3576 patients), 13 on atezolizumab (2787 patients), 12 on avelumab (3213 patients), 10 on durvalumab (1780 patients), 22 on ipilimumab (4067 patients), eight on tremelimumab (1158 patients), three on JS001 (223 patients), four on camrelizumab (SHR‐1210) (178 patients), one on sintilimab (96 patients), and one on cemiplimab (85 patients). Grade 1–5 irAEs were: cytotoxic T lymphocyte antigen 4 (CTLA‐4) (82.87%), programmed cell death 1 (PD‐1) (71.89%), and programmed cell death ligand‐1 (PD‐L1) (58.95%). Subgroup analysis was: Avelumab (44.53%), durvalumab (66.63%), pembrolizumab (67.25%), atezolizumab (68.77%), nivolumab (76.25%), Ipilimumab (82.18%), and tremelimumab (86.78%). Grade 3–5 irAEs were: CTLA‐4 (27.22%), PD‐1(17.29%), and PD‐L1(17.29%). Subgroup analysis was: Avelumab (5.86%), durvalumab (13.43%), atezolizumab (14.45%), nivolumab (15.72%), pembrolizumab (16.58%), tremelimumab (22.04%), and ipilimumab (28.27%). Conclusions: This meta‐analysis confirmed that anti‐PD‐1 and anti‐PD‐L1 inhibitors had a lower incidence of irAEs compared with anti‐CTLA‐4 inhibitors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of art therapy on cancer patients' quality of life and physical and psychological symptoms. Methods: The databases PubMed, Embase, Web of Science, The Cochrane Library, Clinical Trial.gov, the China National Knowledge Infrastructure (CNKI), Wanfang and the Chinese Biomedical Literature Database (CBM) were searched from their inception up to 20 August 2019. Trials examining the effects of art therapy on physical and psychological symptoms and quality of life versus a control group were included. The methodological quality of the included randomised controlled trials was assessed using the risk of bias tool of Cochrane Handbook. Meanwhile, the Newcastle‐Ottawa Quality Assessment Scale (NOS) was used to evaluate the methodological quality of the non‐randomised studies. Results: Twelve studies involving 587 cancer patients were included. The results revealed that art therapy significantly reduced anxiety symptoms (standard mean difference [SMD] = −0.46, 95% confidence interval [CI] [−0.90, 0.02], p =.04), depression symptoms (SMD = −0.47, 95% CI [−0.72, 0.21], p <.01), and fatigue (SMD = −0.38, 95% CI [−0.68, −0.09], p =.01) in cancer patients. Art therapy also significantly improved the quality of life of cancer patients (SMD = 0.43, 95% CI [0.18, 0.68], p <.01). Conclusions: Art therapy had a positive effect on quality of life and symptoms in cancer patients and can be used as a complementary treatment for cancer patients. [ABSTRACT FROM AUTHOR]

Purpose: Safeguarding the perceived dignity of cancer patients has been recently attracting attention, but its development is constrained by the ambiguous construct of dignity. This study aims to describe the perceived dignity of cancer patients undergoing chemotherapy on the basis of the dignity model and to provide insights into the promotion of dignity-conserving care in China.Methods: A qualitative descriptive design was conducted with face-to-face, semi-structured, and individual interviews. Consecutive sampling of cancer patients undergoing chemotherapy in a public hospital was conducted. Semi-structured interviews were performed by a registered nurse with experience in palliative care research. Data were analysed using the framework method with inductive and deductive approaches.Results: Twenty patients aged 28-70 years old completed the interviews. Perceived dignity themes were classified into three categories, namely illness-related concerns, dignity-conserving repertoire, and social dignity inventory. In comparison with the dignity model, social dignity inventory had two added themes: communication openness and financial burden. These themes affect the perceived dignity of Chinese patients.Conclusions: The perceived dignity of patients can be affected by various issues, including illness, personal attitudes and practices and social environments. Culture and economics considerably affect the construct of dignity among the Chinese population. Family-oriented approaches are recommended to create an environment where patients feel valued, respected and supported. This method will help cancer patients adapt to the changes brought on by their illness and maintain dignity. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis is associated with increased risk of cancer. However, the impact of tuberculosis on global cancer burden is unknown.Methods: We performed random-effects meta-analyses and meta-regressions of studies reporting the association between tuberculosis and cancer risks by searching PubMed, Web of Science, Embase, Cochrane library, and CINAHL from inception to 1 June 2019. Population attributable fractions (PAFs) of cancer incidence attributable to tuberculosis were calculated using relative risks from our meta-analyses and tuberculosis prevalence data from Global Health Data Exchange by age, sex, and country. The study has been registered with PROSPERO (CRD42016050691).Results: Fourty nine studies with 52,480 cancer cases met pre-specified inclusion criteria. Tuberculosis was associated with head and neck cancer (RR 2.64[95% CI 2.00-3.48]), hepatobiliary cancer (2.43[1.82-3.25]), Hodgkin's lymphoma (2.19[1.62-2.97]), lung cancer (1.69[1.46-1.95]), gastrointestinal cancer (1.62[1.26-2.08]), non-Hodgkin's lymphoma (1.61[1.34-1.94]), pancreatic cancer (1.58[1.28-1.96]), leukaemia (1.55[1.25-1.93]), kidney and bladder cancer (1.54[1.21-1.97]), and ovarian cancer (1.43[1.04-1.97]). We estimated that 2.33%(1.14-3.81) or 381,035(187145-623,404) of global cancer incidences in 2015 were attributable to tuberculosis. The PAFs varied by Socio-demographic Index (SDI)-ranging from 1.28% (0.57-2.31%) in the high-SDI countries to 3.51% (1.84-5.42%) in the middle-SDI countries. Individually, China and India accounted for 47% of all tuberculosis-related cancer cases.Conclusions: Tuberculosis is associated with increased risk of cancer at ten sites. The burden of tuberculosis attributable cancer skewed towards lower resource countries. Research priorities are to better understand regional disparities and underlying mechanism linking tuberculosis and cancer development. [ABSTRACT FROM AUTHOR]

Colorectal neoplasms are a type of malignant digestive system tumor that has become the third‐highest morbidity tumor in China and the fourth leading cause of cancer‐related death worldwide. The role of the gastrointestinal (GI) microbiome in bile acid metabolism, inflammation, and insulin resistance and its strong correlation with the occurrence and development of colorectal neoplasms have gradually led to it becoming a target area of tumor research. Fibroblast growth factor (FGF) 19 is a hormone that is secreted in mainly the ileum and can regulate bile acid biosynthesis, improve inflammation, and regulate insulin resistance. The relationship of the GI microbiome, FGF19 and its carcinogenic activities in colorectal neoplasms enticed us to search for potential targets and research ideas for the clinical diagnosis and treatment of colorectal neoplasms. [ABSTRACT FROM AUTHOR]

A novel coronavirus causing severe acute respiratory syndrome (SARS), named SARS-CoV-2, was identified at the end of 2019. The spread of coronavirus disease 2019 (COVID-19) has progressively expanded from China, involving several countries throughout the world, leading to the classification of the disease as a pandemic by the World Health Organization (WHO). According to published reports, COVID-19 severity and mortality are higher in elderly patients and those with active comorbidities. In particular, lung cancer patients were reported to be at high risk of pulmonary complications related to SARS-CoV2 infection. Therefore, the management of cancer care during the COVID-19 pandemic is a crucial issue, to which national and international oncology organizations have replied with recommendations concerning patients receiving anticancer treatments, delaying follow-up visits and limiting caregiver admission to the hospitals. In this historical moment, medical oncologists are required to consider the possibility to delay active treatment administration based on a case-by-case risk/benefit evaluation. Potential risks associated with COVID-19 infection should be considered, considering tumor histology and natural course, disease setting, clinical conditions, and disease burden, together with the expected benefit, toxicities (e.g., myelosuppression or interstitial lung disease), and response obtained from the planned or ongoing treatment. In this study, we report the results of proactive measures including social media, telemedicine, and telephone triage for screening patients with lung cancer during the COVID-19 outbreak in the European Institute of Oncology (Milan, Italy). Proactive management and containment measures, applied in a structured and daily way, has significantly aided the identification of advance patients with suspected symptoms related to COVID-19, limiting their admission to our cancer center; we have thus been more able to protect other patients from possible contamination and at the same time guarantee to the suspected patients the immediate treatment and evaluation in referral hospitals for COVID-19. [ABSTRACT FROM AUTHOR]

Background: New Rural Cooperative Medical Scheme (NRCMS) was developed to improve the health security for rural residents. This study aimed to assess the trend of disparity between coastland and inland in medical expenditure burden for rural inpatients with malignant tumor from 2007 to 2016 under the effect of NRCMS.Methods: The data from medical records of 1,306,895 patients with malignant tumor who had NRCMS in 2932 hospitals was collected. The relative differences [95% confidence intervals (CIs)] between coastland and inland in four medical expense indicators were calculated using generalized linear models to assess the trend of disparity over time.Results: In total, there were 769,484 (58.88%) coastland patients and 537,411 (41.12%) inland patients. Male and patients aged older than 44 years accounted for 56.87 and 80% of 1,306,895 patients, respectively. After adjusting for gender, age, tumor site and hospital level, coastland patients had higher hospitalization expenses which were all medical expenses incurred during the hospitalization, lower reimbursement ratio and ratio of out-of-pocket expenses to disposable income than inland patients in most years. The surgery expenses of coastland patients were lower than those of inland patients in 2016. The relative differences (95% CIs) between coastland and inland in medical expense indicators were moving closer to 1.0 from 2007 to 2010 among patients without surgery, implying that the disparity between two areas significantly narrowed. The range of change was similar between two areas from 2011 to 2016 whether among patients without or with surgery, implying that the disparity did not significantly change. The disparity between coastland and inland depended on the household income situation. For low-income patients, the differences between two areas in medical expense indicators were not statistically significance in most cases and the disparity between two areas did not significantly change over time.Conclusions: Under the effect of NRCMS, the medical expenditure burden of rural inpatients reduced but suffering from malignant tumor was still catastrophic. As a whole, the inland patients had heavier medical expenditure burden than coastland patients. Because of economic factors and medical assistance policies, the medical expenditure burden was similar between coastland and inland low-income patients. [ABSTRACT FROM AUTHOR]

Current evidence on selenium and its effects on cancer is conflicting. This study aimed at assessing the association between dietary intake of selenium and incidence of cancers by performing systematic review and meta-analysis of population-based prospective studies. We systematically searched for articles in Medline (Ovid), Embase, Web of Science (Thomson Reuters), China National Knowledge Infrastructure, Wanfang Database and VIP Chinese Scientific Journals. Analysis was performed in Stata version 14.2. Of the 2,564 articles obtained from the databases, 39 met our inclusion criteria, 37 were included in the final analysis. Selenium at recommended daily allowance levels of ≥55 μg/day decreased the risk of cancer [relative risk (RR) = 0.94, 95% confidence interval (CI): 0.90-0.98]. A protective effect was found in men at levels ≥55 μg/day (RR = 0.97, 95% CI: 0.94-0.99). Extra selenium intake from supplements was protective at levels ≥55 μg/day (RR = 0.89, 95% CI: 0.82-0.97). There was an inverse relationship (p value = 0.020) between selenium intake and overall cancer risk after adjusting for age, body mass index, and smoking but there was no evidence of nonlinear relationship (p value = 0.261). The findings in this study suggest that selenium is protective against cancer however the effects vary with different cancers. [ABSTRACT FROM AUTHOR]

Background: With the rapid development of the socioeconomic status, the mortality of several cancers has been changed in China during the past 30 years. We aimed to estimate the trends of mortality and years of life lost (YLLs) of various cancers in urban and rural areas of China from 1990 to 2017. Methods: The mortality data were collected from Chinese yearbooks and the age structure of population from the Chinese sixth population census were used as reference to calculate age‐standardized mortality rates (ASMRs) and YLLs rates. Joinpoint regression analysis was implemented to calculate the annual percent change (APC) of mortality rates and YLL rates for cancers. YLLs owing to premature death were calculated as age‐specific cancer deaths multiplied by the reference life expectancy at birth of 80 years for male and 82.5 years for female. Results: The ASMRs of all cancers showed significant decreasing trends for urban residents from 1990 to 2017, such downward trend without significance was also observed among rural residents. Interestingly, ASMRs of lung cancer and breast cancer have raised continuously in rural areas since 1990. The age‐standardized YYL rates for urban and rural residents decreased with 1.02% and 0.85% per year, respectively. YLLs in rural areas were higher than those in urban areas, whereas YLLs of urban outstripped those of rural finally with the increasing in YLLs of urban areas (216.71% for men and 207.87% for women). Conclusion: The ASMRs and YLL rates of all cancers have declined in urban and rural areas from 1990 to 2017. YLLs increased in urban areas and remained higher level in rural areas after 2014 year. Preventive measures should be strengthened to against cancer, especially for lung cancer. [ABSTRACT FROM AUTHOR]

Since the first discovery in 1961, more than 1300 ent-kaurane diterpenoids have been isolated and identified from different plant sources, mainly the genus Isodon. Chemically, they consist of a perhydrophenanthrene subunit and a cyclopentane ring. A large number of reports describe the anticancer potential and mechanism of action of ent-kaurane compounds in a series of cancer cell lines. Oridonin is one of the prime anticancer ent-kaurane diterpenoids that is currently in a phase-I clinical trial in China. In this review, we have extensively summarized the anticancer activities of ent-kaurane diterpenoids according to their plant sources, mechanistic pathways, and biological targets. Literature analysis found that anticancer effect of ent-kauranes are mainly mediated through regulation of apoptosis, cell cycle arrest, autophagy, and metastasis. Induction of apoptosis is associated with modulation of BCL-2, BAX, PARP, cytochrome c, and cleaved caspase-3, -8, and -9, while cell cycle arrest is controlled by cyclin D1, c-Myc, p21, p53, and CDK-2 and -4. The most common metastatic target proteins of ent-kauranes are MMP-2, MMP-9, VEGF, and VEGFR whereas LC-II and mTOR are key regulators to induce autophagy. [ABSTRACT FROM AUTHOR]

Purpose: Readmissions are common after colorectal cancer surgery. There are limited data related one-year unplanned readmission after colorectal cancer surgery. The aim of this study was to ascertain the incidence rate of unplanned readmission in Western China, identify causes and risk factors of one-year unplanned readmission (UR) in patients who underwent enhanced recovery pathways for colorectal cancer (CRC) surgery. Materials and Methods: A retrospective study using a CRC surgery database of patients treated in West China Hospital was performed. Patients who underwent enhanced recovery pathways for colorectal cancer surgery between January 2013 and May 2016 were investigated. The postoperative follow-up data were all routinely recorded for up to one year or more, the one-year unplanned readmission rate after initial discharge and major reasons for UR were recorded. Multivariate logistic regression analyses was used to identify risk factors of UR. Results: A total of 446 patients were included, with 18.6% of patients readmitted. In a multivariable analysis, preoperative comorbidity was associated with the largest risk of readmission (odds ratio, 2.91[95% CI, 1.32– 6.99]). The main reason of readmission within 30 days after discharge was wound bleeding or infection. While intestinal obstruction was the major cause for readmission after 3 months of discharge. Conclusions: One-year unplanned readmission occurs frequently after CRC in Western China and is strongly associated with preoperative comorbidity. Attention should be paid to wound healing at the early stage of discharge, and bowel obstruction 3 months after discharge. [ABSTRACT FROM AUTHOR]

Purpose: To test the reliability and validity of the Chinese version of the Cancer Stigma Scale (CASS). Methods: After translation, back-translation and cross-cultural adaptation of the CASS into Chinese (C-CASS), a random online survey of the general population in China was conducted. Reliability was analyzed by internal consistency (Cronbach's α) and construct validity was analyzed by confirmatory factor analysis. The C-CASS was evaluated in a sample of 382 non-cancer patients through online format. Results: The study found that the C-CASS had satisfactory internal reliability (Cronbach's α of the overall scale and six components was 0.88 and 0.70–0.89, respectively). Confirmatory factor analysis confirmed the six-factor structure (χ2/df = 2.2, GFI = 0.91, CFI = 0.94, RMSEA = 0.056, SRMR = 0.065). Younger individuals and those who had less knowledge of cancer showed more negative attitudes towards cancer. Conclusion: The C-CASS had adequate internal consistency, reliability and indices of model fit, allowing its feasible use to assess levels of cancer stigma in Chinese populations. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the characteristics of colonic neuroendocrine neoplasms (NENs) and to validate the prognostic value of the European Neuroendocrine Tumor Society (ENETS) and American Joint Committee on Cancer (AJCC) 8th staging systems. Methods: A total of 167 and 1248 patients with colonic NENs from 12 medical centers across China and from the Surveillance, Epidemiology, and End Results (SEER) cancer registry in the United States, respectively, were reviewed. Patients were staged according to the ENETS and AJCC 8th staging systems. Results: Clinicopathological features of colonic NENs in the Chinese cohort and SEER cohort were significantly distinct. In both the Chinese cohort and the SEER cohort, colonic neuroendocrine carcinoma (NEC) and mixed adeno‐neuroendocrine carcinoma (MANEC) were more frequent in the midgut than in the hindgut. Tumors originating from the midgut tended to be larger and at a more advanced stage than those from the hindgut. The AJCC 8th staging system and the ENETS system appeared to have similar prognostic ability for colonic NEC/MANEC. Conclusions: Our study revealed that tumors originating from the midgut and the hindgut shared different clinicopathological features. The AJCC 8th staging system and the ENETS system appeared to have similar prognostic ability for colonic NEC/MANEC. [ABSTRACT FROM AUTHOR]

Background: China accounts for approximately 27% of global cancer deaths. However, to the authors' knowledge, the lasting effects of cancer and cancer treatments on patients have not been investigated in China. The authors developed a questionnaire, the China Survey of Experiences with Cancer, for Chinese cancer survivors. This article introduces the study design and domains covered in the questionnaire.Methods: The Cancer Survivorship Supplement of the Medical Expenditure Panel Survey (MEPS) was used as a reference to develop the questionnaire. The final in-person surveys were conducted in 2015 and 2016. Samples were chosen through multistage sampling. The authors described the characteristics of the study participants and their cancer experiences.Results: At the time of last follow-up, a total of 1166 patients had completed at least 1 component of the survey. Approximately 59% of the cancer survivors were aged ≥60 years. Greater than one-half of the participants had an elementary education level or less (51%) and a yearly family income of <$3174. Chinese cancer survivors were more likely to retire earlier than planned compared with American cancer survivors (37% vs 9%). The majority of Chinese cancer survivors (84%) reported that their work abilities were hindered by their cancer or cancer treatments. Approximately one-half of patients in China had to incur debt because of cancer, whereas <10% of patients in the United States reported having incurred debt.Conclusions: The survey provides information regarding the burden of cancer in China that to the authors' knowledge currently is unavailable from other sources, including medical care use, financial impacts, employment patterns, and life experience after a cancer diagnosis for survivors and their families. [ABSTRACT FROM AUTHOR]