Background: The aims of this study were to analyze the metastasis pattern and prognosis of male breast cancer (MBC) and compare it with female breast cancer (FBC), and to determine the independent factors affecting the prognosis of MBC patients. Methods: Metastatic MBC diagnosed in the Surveillance, Epidemiology and End results (SEER) database from 2010 to 2015 were selected. Chi-squared test was used to compare clinicopathological characteristics. Survival differences were compared by Kaplan–Meier analysis. Cox proportional hazard model was used to determine the prognostic factors affecting overall survival. Results: A total of 2754 MBC patients were identified, of which 196 had distant metastasis. Compared with nonmetastatic MBC, metastatic MBC patients had a higher proportion of <60 years old and grade III–IV, and were more likely to receive chemotherapy and radiotherapy, while the proportion of surgery, central portion of the breast, and Her2–/HR+ was lower. Compared with metastatic FBC, metastatic MBC patients had a higher proportion of ⩾60 years old, central portion of the breast, surgery, simultaneous bone and lung metastasis, while the proportion of Her2+/HR–, triple negative, liver metastasis only, and simultaneous bone and liver metastasis was lower. MBC patients with lung alone, bone alone, and simultaneous lung and bone metastasis had a higher hazard ratio (2.41; 3.06; 2.52; p < 0.0001) compared with nonmetastatic patients. Conclusions: Compared with nonmetastatic MBC patients, metastatic MBC patients had unique clinicopathological features, and were also different from metastatic FBC patients. However, there was no difference in prognosis between metastatic MBC and FBC patients. Distant metastasis was an independent risk factor for the prognosis of MBC patients.

Background: B7-H7 is a newly identified member of the B7 immune checkpoint family, but has not been investigated in epithelial ovarian cancer (EOC). This study aimed to determine the B7-H7 expression profile and its potential clinical significance in EOC.Methods: A tissue microarray (TMA) containing 160 ovarian cancer tissues was used in this study and 119 EOC cases were valid for analysis. B7-H7 expression was analyzed separately by multiplex immunohistochemistry (mIHC) staining in different compartment according to tissue segmentation.Correlations of B7-H7 expression and pathological characteristics, including overall survival (OS) and disease-free survival (DFS), were explored.Results: Multiplex immunohistochemistry staining showed that B7-H7 was broadly expressed in EOC. B7-H7 expression was significantly higher in the tumor compartment than in stromal compartment of EOC.In EOC tissues, B7-H7 expression in tumor compartment was significantly associated with age (P<0.05); B7-H7 expression in stromal compartment was significantly associated with Federation of Obstetrics and Gynecology (FIGO) stage, lymph nodes metastasis, distant metastasis, and OS (all, P<0.05). The Kaplan-Meier survival analysis revealed that high B7-H7 expression in stromal compartment was significantly correlated with the poor OS of EOC patients (P<0.05), but B7-H7 expression in tumor compartment was not.Conclusions: Stromal B7-H7 expression is significantly associated with tumor progression and prognosis in EOC patients, which might be a prognostic predictor and a potential therapeutic target.

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Background and Aims: To analyze the factors affecting preoperative blood pressure fluctuations in patients undergoing elective surgical surgery. Methods and Results: In 776 elective surgical patients from January to October 2021, the changes of BP and base BP (1 day before the operation) were analyzed by more than 20%, divided into elevated BP group (n=328) and non-fluctuating group (n=448), and analyzed by multivariate logistic regression. Results 776 patients were included, including 335 men and 441 women; SBP increased 12.98±19.33mmHg 1 day before surgery and DBP increased 6.67±13.20mmHg 1 day before surgery. There were 328 patients with more than 20% fluctuation range, and the incidence of preoperative blood pressure increase reached 42.27%. After a multivariate logistic regression analysis, age, preoperative association with hypertension, and sleep duration at 1 day before surgery were independent risk factors for preoperative BP fluctuations. Older blood pressure is more likely to fluctuate (OR=1.021,95%CI: 1.007-1.035, P =0.0030); 1.785 times more frequently (OR=1.785,95%CI: 1.142 ~ 1.807, P =0.0114) before 1 day (OR=0.835,95%CI: 0.747~0.932, P =0.0014) by stepwise regression. Conclusion: The blood pressure in the operating room increased significantly from 1 day before surgery. Age, preoperative association with hypertension, and sleep duration of 1 day before surgery were independent risk factors affecting preoperative blood pressure fluctuations. And the older the age, the greater the fluctuation of blood pressure; the shorter the sleep time, the greater the difference of blood pressure.

21Objectives: This study aims to estimate the losses of quality-adjusted life expectancy (QALE) due to the 22 joint effect of cognitive impairment and multimorbidity, and further to confirm additional losses 23 attributable to their interaction among the middle-aged and elderly Chinese. 24 Methods: The National Cause of Death Monitoring Data were linked with the China Health and 25 Retirement Longitudinal Study (CHARLS). A mapping and assigning method was used to estimate 26health utility values, which were further used to calculate QALE. Losses of QALE were measured by 27 comparing the differences between subgroups. And all the losses of QALE were displayed at two levels:28 the individual and the population level. 29Results: At age 45, the individual-level and population-level losses of QALE (95% CI) attributed to the 30 combination of cognitive impairment and multimorbidity were 7. 606 (5.679, 9.566) years and 4.297 31 (3.425, 5.200) years. The losses (95% CI) for cognitive impairment alone were 3.104 (2.287, 3.954) years 32 and 1.709 (1.318, 2.132) years at two levels. Similarly, the losses (95% CI) for multimorbidity alone 33 were 3.526 (2.528, 4.556) years and 1.914 (1.235, 2.625) years at two levels. Additional losses due to34 their interaction were indicated by the 0.976 years of the individual-level gap and 0.674 years of the 35 population-level gap.36 Conclusion: Among the middle-aged and elderly Chinese, cognitive impairment and multimorbidity 37 resulted in much losses of QALE, and additional QALE losses were seen due to their interaction at both 38 individual and population levels.39 40 3 Introduction 41 Age-associated cognitive impairment is a transition link between healthy aging and dementia with 42 the 10% conversion rate, featuring declines in memory, attention, and cognitive function [1]. At the end 43 of 2019, the population aged 65 and above in China accounted for 176.0 million [2]. And a large-sample, 44multi-region study showed that the prevalence (95% CI) of total dementia for the population aged 65 45 years and older in China was 5.60% (3.50%, 7.60%) in 2019 [3]. Moreover, mild cognitive impairment 46 (MCI) is estimated >4 times more common than dementia [1, 4]. 47Meanwhile, age-dependent noncommunicable diseases (NCD) are proved to experience a 48 continuous increase among the elders in the near decades [5]. Nearly 50% of the NCD burden in China 49 occurred in people aged 65 years and older [6], while 47.5% of the elderly aged 65+ had ≥ 2 chronic 50 conditions [7]. Multimorbidity, which is defined as the co-occurrence of two or more chronic diseases in 51 an individual, is widely observed beyond two-thirds of older adults [8, 9]. Many patient-based studies 52 suggested that older adults with at least two diseases were more susceptible to develop cognitive 53 impairment [10][11][12][13][14][15][16][17][18]. The hypothesis that multimorbidity may increase the risk of cognitive impairment 54 has also been verified in population-based researches [10][11][12] 14]. 55Despite the documented ris...