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Background: Perfluoroalkyl substances (PFASs) are a large family of synthetic chemicals, some of which are mammary toxicants and endocrine disruptors. Recent studies have implicated exposure to PFASs as a risk factor for breast cancer in Europe and America. Little is known about the role of PFASs with respect to breast cancer in the Chinese population., Methods: Participants who were initially diagnosed with breast cancer at Tianjin Medical University Cancer Institute and Hospital between 2012 and 2016 were recruited as cases. The controls were randomly selected from the participants with available blood samples in the Chinese National Breast Cancer Screening Program (CNBCSP) cohort. Ultimately, we enrolled 373 breast cancer patients and 657 controls. Plasma PFASs were measured by an ultra-performance liquid chromatography (UPLC) system coupled to a 5500 Q-Trap triple quadrupole mass spectrometer. A logistic regression model with least absolute shrinkage and selection operator (LASSO) regularization was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationships between PFASs and breast cancer. The three most predictive variables in the LASSO model were selected from 17 PFASs, which was based on the optimal penalty coefficient (λ = 0.0218) identified with the minimum criterion. Additionally, Bayesian kernel machine regression (BKMR) and quantile g-computation models were applied to evaluate the associations between separate and mixed exposure to PFASs and breast cancer., Results: Perfluorooctanesulfonic acid (PFOS) exhibited the highest concentration in both the cases and controls. Perfluorooctanoic acid (PFOA) and perfluoro-n-decanoic acid (PFDA) were positively associated with breast cancer, and perfluoro-n-tridecanoic acid (PFTrDA) was negatively associated with breast cancer according to both the continuous-PFASs and the quartile-PFASs logistic regression models. Of note, PFOA was associated with the occurrence of estrogen receptor (ER)-, progesterone receptor (PR)-, and human epidermal growth factor receptor 2 (HER2)-positive breast cancer (OR ER+  = 1.47, 95% CI: 1.19, 1.80; OR PR+  = 1.36, 95% CI: 1.09, 1.69; OR HER2  = 1.62, 95% CI: 1.19, 2.21)., Conclusions: Overall, we observed that PFASs were associated with breast cancer in Chinese women. Prospective cohort studies and mechanistic experiments are warranted to elucidate whether these associations are causal., (© 2022. The Author(s).)

Objective: To investigate the potential pleiotropism of cancer-related single nucleotide polymorphisms (SNPs) among Chinese population. Methods: Based on the catalogue of GWAS jointly constructed by the National Human Genome Research Institute and the European Institute of Bioinformatics, according to population origin (Chinese population and non-Chinese population) and disease traits (cancer and non-cancer traits). All SNPs found by GWAS before August 2020 were divided into four categories: cancer in Chinese population, non-cancer in Chinese population, cancer in non-Chinese population and non-cancer in non-Chinese population. The number, correlation and linkage of the four categories of SNPs were described. Results: By August 2020, a total of 196 813 SNPs from 4 096 GWAS were included in the GWAS directory. The information that SNPs refer to unknown or were not related to the disease was excluded, and 117 441 independent SNPs were finally included. There were 619 SNPs related to cancer and 9 569 SNPs related to non-cancer disease in Chinese population, respectively. There were 4 624 SNPs related to cancer and 106 448 SNPs related to non-cancer disease (trait) in non-Chinese population, respectively. Three SNPs, rs2736100, rs6983267 and rs401681, were associated with two or more types of cancer in both Chinese and non-Chinese populations. Seven SNPs, rs7705526, rs2736100, rs10993994, rs2735839, rs4430796, rs174537 and rs9271588, were associated with cancer and non-cancer diseases in both Chinese and non-Chinese populations, respectively. Conclusion: There is a potential pleiotropism of cancer-related SNPs in Chinese population.

Ethnopharmacological Relevance: Acanthus ilicifolius L. has been used as a folk medicine in the treatment of acute and chronic hepatitis in China for a long time. Phenylethanoid glycosides are one of main components in A. ilicifolius L., Aim of the Study: The aim of present study was to assess the hepatoprotective activities of total phenylethanoid glycosides from A. ilicifolius L. (APhGs) against carbon tetrachloride (CCl 4 )-induced liver injury in vivo and in vitro., Materials and Method: The APhGs was separated by resin column chromatography. The purity of total phenylethanoid glycosides was determined by UV-Vis spectrophotometry using acteoside as a standard. The hepatoprotective activities of APhGs against CCl 4 -induced liver injury were performed on experimental mice and L-02 hepatocytes. Moreover, the antioxidant activities of APhGs were tested in vitro., Results: The results showed that pre-administration of APhGs to mice decreased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in serum, and improved superoxide dismutase (SOD) activity and decreased malondialdehyde (MDA) level in serum and liver tissue induced by CCl 4 . Specifically, the SOD activities of APhGs-H and APhGs-M treatment groups were stronger than that of silymarin treatment group. The protective activities of APhGs were confirmed by histopathological results. Moreover, immunohistochemical analysis showed that APhGs could remarkably down-regulate the protein expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). In vitro experiment, APhGs was observed to increase L-02 hepatocyte viability against CCl 4 -induced hepatotoxicity. In addition, antioxidation assays revealed that APhGs showed 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, and ferric reducing ability., Conclusion: Overall, total phenylethanoid glycosides from A. ilicifolius L. displayed promising hepatoprotective effects. These results offer a support for the medicine uses of A. ilicifolius L., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background The participation of clinical pharmacists in the treatment of acute pancreatitis has rarely been reported. Objective The aim of this study was to retrospectively evaluate the impact of intervention of clinical pharmacists on the treatment of acute pancreatitis. Setting An academic teaching hospital in Taizhou, Jiangsu, China. Method Two hundred and twenty-eight patients with acute pancreatitis were retrospectively enrolled from July 2017 to July 2018 and divided into an intervention group (n = 119) and a control group (n = 109) according to whether a clinical pharmacist was involved. No significant differences in the baseline clinical characteristics were found between the groups. Clinical pharmacists participated in drug formulation and adjustment, pharmaceutical care, and follow-up. Main outcome measure Clinical outcomes, average hospital stays, costs, incidence of adverse drug reactions, 1-month subsequent visit rate, and patient satisfaction between the two groups were measured. Results The clinical symptoms of patients in both groups were relieved after treatment. There were no significant differences between the groups in computed tomography grades after treatment, incidence of adverse drug reactions, or average hospital stays. However, the intervention group had lower total costs of hospitalization, drugs and antibiotics but higher rates of 1-month subsequent visits and satisfaction compared with the control group. Conclusion The intervention of clinical pharmacists in the treatment of acute pancreatitis can effectively reduce costs of hospitalization, drug and antibiotics and improve follow-up compliance and patient satisfaction.

Air pollution in China comes from multiple sources, including coal consumption, construction and industrial dust, and vehicle exhaust. Coal consumption in particular directly determines the emissions of three major air pollutants: dust, sulfur dioxide (SO(2)), and nitrogen oxide (NOx). The rapidly increasing number of civilian vehicles is expected to bring NOx emission to a very high level. Contrary to expectations, however, existing data show that the concentrations of major pollutants [particulate matter-10 (PM10), SO(2), and nitrogen dioxide (NO(2))] in several large Chinese cities have declined during the past decades, though they still exceed the national standards of ambient air quality. Archived data from China does not fully support that the concentrations of pollutants directly depend on local emissions, but this is likely due to inaccurate measurement of pollutants. Analyses on the cancer registry data show that cancer burden related to air pollution is on the rise in China and will likely increase further, but there is a lack of data to accurately predict the cancer burden. Past experience from other countries has sounded alarm of the link between air pollution and cancer. The quantitative association requires dedicated research as well as establishment of needed monitoring infrastructures and cancer registries. The air pollution-cancer link is a serious public health issue that needs urgent investigation.

Objective: To analyze the trend of the incidence of prostate cancer in urban Tianjin area between 1981 and 2004 so as to provide scientific rationales for the prevention and control of prostate cancer., Methods: The data of prostate cancer cases were provided by the Tianjin Cancer Registry. The SAS system V9 was used to calculate the crude incidence, age-adjusted incidence and age specific incidence of prostate cancer in Tianjin between 1981 and 2004. And the Join point 3.0 software was used to analyze secular trends., Results: Between 1981 and 2004, a total of 1060 prostate cancer cases were diagnosed in Tianjin. And the age-adjusted incidence rate was 2.84/100 000 in 2004. The incidence of prostate cancer showed 3 incremental stages during the 24-year period at an annual average of 4.02%. An aging trend was observed for prostate cancer patients. The elder patients had a faster increment in incidence. Specifically, it increased annually at 4.63% for age group 65 - 74 year versus 5.18% for age group 75 years or more., Conclusion: Despite a low incidence of prostate cancer in Tianjin, it is increasing at a fast rate. The prevention and control of prostate cancer should be strengthened.

Objective: To explore the secular trend in incidence and mortality rate of gastric cancer in Tianjin and to provide evidence and reference for making prevention and control strategy for gastric cancer., Methods: Data derived from Tianjin cancer registry system were analyzed by descriptive epidemiological method and Joinpoint model. A total of 17990 gastric cancer cases reported in Tianjin from 1981 to 2002, including 12755 males and 5235 females were studied., Results: The annual percent change (APC) of crude incidence rate for males and females was -0.92% (Z = -3.85, P = 0.001) and -0.79% (Z = -2.67, P = 0.015), while the APC of standard incidence rate was -3.55% (Z = -13.52, P = 0.000) and -3.47% (Z = -12.85, P = 0.000). There was a descending trend of incidence rate in males and females above 45-years-old, however, in male under 45 years it showed an increased trend and in females it kept stable. The APC of crude mortality rate was -1.66% ( Z = -5.79, P = 0.000) for males and -1.84% (Z = -6.02,P = 0.000) for females, while the APC of standard mortality rate was -4.60% ( Z = -15.79, P = 0.000) for females and -5.36% ( Z = -8.28, P = 0.000) for males during 1989-2002. Mortality and incidence ratio also indicated a downward trend., Conclusion: Despite its declining trend in Tianjin, gastric cancer still remains an important public health problem in facing of the aging society and many risk factors.

Objective: To investigate the trend of clinical characteristics and prognosis of breast cancer in women during the past 2 decades (1981 - 2000)., Methods: 1678 cases were sampled randomly from the 11400 breast cancer patients who were hospitalized in Tianjin Medical University Cancer Hospital 1981 - 2000. Retrospective analysis of the clinical characteristics and prognosis between different eras was conducted., Results: The numbers of hospitalized female breast cancer patients during the periods 1981 - 1985, 1986 - 1990, 1991 - 1995, 1996 - 2000 were 209, 316, 449, and 704 respectively with an increase of 237% within 20 years and an annual increase rate of 11.8%. The mean onset age remained 46 - 47. The detection rate of breast cancer at early stages (stages 0 approximately I) was 15.5% during 1996 - 2000, higher than that during 1981 - 1985 (12%), and the detection rate of breast cancer at stage III during 1996 - 2000 was 16.5%, lower than that during 1981 - 1985 (24.9%). The proportion of carcinoma in situ during 1996 - 2000 was 4.4%, higher than that during 1981 - 1985 (3.7%). The axillary lymph node positive rate during 1996 - 2000 was 46.3%, lower than that during 1981 - 1985 (51.8%s), and the local recurrence/distance metastasis rate during 1996 - 200 was 13.5%, lower than that during 1981 - 1985 (27.8%). The 5-year and 10-year survival rates during 1996 - 2000 were 86% and 74%, both higher than those during 1981 - 1985 (76% and 63% respectively)., Conclusion: During the past 2 decades, the incidence of breast cancer shows an uptrend. The proportion of early stage breast cancer increases gradually and the proportion of axillary lymph node positive rate and metastasis rate show a downtrend. The prognosis of the breast cancer patients has been improved during these periods.

Severe acute respiratory syndrome (SARS) is a newly emerged infectious disease with a high case-fatality rate and devastating socio-economic impact. In this report we summarized the results from an epidemiological investigation of a SARS outbreak in a hospital in Tianjin, between April and May 2003. We collected epidemiological and clinical data on 111 suspect and probable cases of SARS associated with the outbreak. Transmission chain and outbreak clusters were investigated. The outbreak was single sourced and had eight clusters. All SARS cases in the hospital were traced to a single patient who directly infected 33 people. The patients ranged from 16 to 82 years of age (mean age 38.5 years); 38.7% were men. The overall case fatality in the SARS outbreak was 11.7% (13/111). The outbreak lasted around 4 weeks after the index case was identified. SARS is a highly contagious condition associated with substantial case fatality; an outbreak can result from one patient in a relatively short period. However, stringent public health measures seemed to be effective in breaking the disease transmission chain.

Aim: To analyze the data from Tianjin Cancer Registry of mortality due to colon cancer from 1981 to 2000 in Tianjin, China., Methods: Tumors diagnosed in this study were coded according to ICD-9. Mortality rates were calculated by sex and calendar year of diagnosis., Results: Seventy point four percent of colon cancer deaths occurred in the age group of 55-79 years and the mortality rate reached its peak in the age group of 75-80 years. The average age at death was 64.10 years. An ascending trend was observed in the mean age of death due to colon cancer from 1981 through 2000. However, as for the sex ratio, there was no clear trend exhibited. During 1981-2000, the total number of deaths was 2147, 1041 males and 1106 females. The mean mortality rate of colon cancer was 3.04/100,000. The mortality caused by colon cancer ascended from 1981 to 2000., Conclusion: The epidemic trend of colon cancer in Tianjin and its risk factors and prevention should be studied further.

Objective: Leukemia is a major cause of death of children in China, which accounts for 50 % of all cancers of children. Data from Tianjin Cancer Hospital was analyzed for mortality of leukemia in children under 20 years from 1981 to 2000 in the city of Tianjin., Methods: All physicians and medical staff of the hospitals and clinics in the registry area were responsible for filling out the report forms for every new case diagnosed as malignant tumors. Death certificates for malignant tumors have been registered at the local police station and the residential files were checked. All cancer cases with insufficient information were traced to his/her family and relevant persons worked in the clinic. Tianjin Cancer Registry Center periodically conducted an active re-checking program to review all patient records on cancers that was not registered in this period. Tumors diagnosed in this study were coded according to the International Classification of Diseases for Oncology (ICD-O). Mortality rates were calculated by age, sex and date of death., Results: The types of acute lymphoid leukemia, acute myeloid leukemia and chronic myeloid leukemia were the most common types of childhood leukemia in Tianjin, comprised 69.3%, 20.9 % and 8.0%, respectively. The mortality for childhood leukemia decreased slowly during the period of 1981 to 2000 in Tianjin. Mortality and morbidity ratios were 0.51., Conclusion: Combined with characteristics of individual forms of childhood leukemia mortality, further epidemiological research is needed to prevent childhood leukemia.

Aim: To examine the regional variations in mortality rates of pancreatic cancer in China., Methods: Aggregated mortality data of pancreatic cancer were extracted from the 1990-1992 national death of all causes and its mortality survey in China. Age specific and standardized mortality rates were calculated at both national and provincial levels with selected characteristics including sex and residence status., Results: Mortality of pancreatic cancer ranked the ninth and accounted for 1.38 percent of the total malignancy deaths. The crude and age standardized mortality rates of pancreatic cancer in China in the period of 1990-1992 were 1.48/100,000 and 1.30/100,000, respectively. Substantial regional variations in mortality rates across China were observed with adjusted mortality rates ranging from 0.43/100,000 to 3.70/100,000 with an extremal value of 8.7. Urban residents had significant higher pancreatic mortality than rural residents., Conclusion: The findings of this study show different mortality rates of this disease and highlight the importance of further investigation on factors, which might contribute to the observed epidemiological patterns.

The objective of this study was to describe trends in the incidence rates of primary liver cancer in a geographically defined Chinese population. Primary liver cancer cases (N=13 685) were diagnosed between 1981 and 2000 and identified by the Tianjin Cancer Registry. Age-adjusted and age-specific incidence rates were examined in both males and females. Poisson regression was employed to assess the incidence rate trends. Crude and age-adjusted incidence rates in the study period were: 27.4/100 000 and 16.4/100 000 in males and 11.5/100 000 and 6.4/100 000 in females, respectively. While the results from Poisson regression analyses suggest statistically significant trends of declining incidence rates of primary liver cancer overall, trends were not consistent across age and sex groups. The decline in incidence was observed, for the most part, in the 40-69 age group, with a greater decrease in males. Our findings provide a new evidence of a downward trend in incidence rates of this disease in China for a period of 20 years. As the observed decline is relatively small and inconsistent across sex and age groups, a continued epidemiological observation on this condition is required.

Aim: To examine the survival patterns and determinants of primary liver cancer in a geographically defined Chinese population., Methods: Primary liver cancer cases (n=13 685) diagnosed between 1981 and 2000 were identified by the Tianjin Cancer Registry. Age-adjusted and age-specific incidence rates were examined in both males and females. Proportional hazards (Cox) regression was utilized to explore the effects of time of diagnosis, sex, age, occupation, residence, and hospital of diagnosis on survival., Results: Crude and age-adjusted incidence rates in the study period were: 27.4/100 000 and 26.3/100 000 in males; and 11.5/100 000 and 10.4/100 000 in females, respectively. Cox regression analyses indicated that there was a significant improvement in survival rates over time. Industrial workers and older people had relatively poor survival rates. The hospital in which the liver cancer was diagnosed was a statistically significant predictor of survival; patients diagnosed in city hospitals were more likely to have better survival than those diagnosed in community/district hospitals., Conclusion: Patients diagnosed in recent years appeared to have a better outcome than those diagnosed in early times. There were also significant survival disparities with respect to occupation and hospital of diagnosis, which suggest that socioeconomic status may play an important role in determining prognosis.