[Cost-effectiveness and cost-benefit analysis of upper gastrointestinal cancer screening in Yangzhong City, Jiangsu Province, from 2009 to 2015].

Objective: To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods: From 2009 to 2015, 31 natural villages with high-incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub-district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost-effectiveness analysis and cost-benefit analysis, were performed to evaluate the current screening schemes. Results: The mean age of all respondents were (53.60±8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high-grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness-cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions: The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.

[The analysis of the relationship between the fungal microbiota from soil and tongue coating of 18 patients with precancerous lesions of upper gastrointestinal].

The fungal microbiota from self-retained soil and tongue coating of 18 patients with precancerous lesions of upper gastrointestinal (PLUG) were sequenced. The diversity of α, ß in and the structure of the microbial community were analyzed, and the association of them was quantified by using the Spearman rank correlation method. The richness index (1.67±2.79) and the diversity index (0.25±0.10) of the fungal microbiota from tongue coating of PLUG patients were significantly lower than those from soil (4.00±4.69; 0.99±0.18) (all P values<0.001). The relative abundance of 11 taxa from tongue coating of these PLUG patients was positively associated with that from soil (all P values<0.05).

[Status of non-steroidal anti-inflammatory drugs use in areas with a high incidence of upper gastrointestinal cancer in China: a multi-center cross-sectional survey].

Objective: To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods: This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ(2) test and Cochran-Armitage trend analysis method. Results: Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). Conclusion: The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.

[Efficacy of esophageal cancer screening program on population at high risk: a survey carried out in people aged 40-69 years in Yangzhong, Jiangsu province].

Objective: To understand the incidence of esophageal cancer in population at high risk in Yangzhong of Jiangsu province. Methods: Cluster random sampling method was conducted to select several natural villages from the high risk area of esophageal cancer in Yangzhong during 2011-2017. Local residents aged 40-69 years were selected as the target population and a total of 14 687 persons were diagnosed esophageal cancer by endoscopy and pathology. Results: Precancerous lesions were detected in 341 persons, with the detection rate as 2.32% (341/14 687). Among them, there were 234 (1.59%) cases with mild and 107 (0.73%) cases with moderate esophageal hyperplasia. There were 77 positive cases with esophageal hyperplasia and the detection rate was 0.52%. Among these positive cases, 41 showed severe esophageal hyperplasia/carcinoma in situ (0.28%), with another 19 as early esophageal cancer (0.13%) and 17 with invasive carcinoma (0.12%). The overall early detection rate of positivity through active screening was 77.92% (60/77), with trends of upwarding and then downwarding. The detection rate of esophageal lesions in men was higher than that in women (P<0.05), but without significant gender specific differences seen in the detection rates of early esophageal cancer or invasive carcinoma (P>0.05). The detection rates of all lesions other than invasive carcinoma, gradually increased with age (P<0.05). The detection rate of invasive carcinoma reached the highest (0.39%, 10/2 547) in the age group of 60-years and slightly decreased in the age group of 65-years old. Conclusions: Considerable numbers of patients with cancer and precancerous lesions in groups at high-risk can be found through the screening program for esophageal cancer, suggesting that the screening program is of great significance in improving the survival rate and quality of life. Attention should be paid to men, with elderly groups in particular, at high-risk in order to increase the detection rate of early cases.

Ultrafast and large third-order nonlinear optical properties of CdS nanocrystals in polymeric film.

We report the ultrafast and large third-order nonlinear optical properties of CdS nanocrystals (NCs) embedded in a polymeric film. The CdS NCs of 2 nm radius are synthesized by an ion-exchange method and highly concentrated in the two layers near the surfaces of the polymeric film. The two-photon absorption coefficient and the optical Kerr coefficient are measured with laser pulses of 250 fs duration at 800 nm wavelength. The one-photon and two-photon figures of merit are determined to be 3.1 and 1.3, respectively, at irradiance of 2 GW/cm(2). The observed nonlinearities have a recovery time of approximately 1 ps. The two-photon-generated free carrier effects have also been observed and discussed. These results demonstrate that CdS NCs embedded in polymeric film are a promising candidate for optical switching applications.

Efficacy and safety of capecitabine as maintenance therapy after capecitabine-based combination chemotherapy for patients with advanced esophagogastric junction adenocarcinoma.

OBJECTIVE: The aim of the present study was to investigate the efficacy and safety of single-agent capecitabine therapy after capecitabine-based combination chemotherapy for patients with advanced adenocarcinoma of the esophagogastric junction (EGJ). PATIENTS AND METHODS: Seventy-two patients with pathologically proven advanced EGJ adenocarcinoma underwent 2-6 cycles of capecitabine-based first-line combination chemotherapy between January 2010 and October 2014. When initial disease control had been achieved, 60 patients were randomly assigned to receive the capecitabine treatment (oral capecitabine 1,250 mg/m2 twice daily on days 1-14 every 3 weeks) to see whether it is involved in maintenance regimen or not, while 12 patients were excluded. The primary endpoint of this study was progression-free survival (PFS). Secondary endpoints were overall survival (OS) and major adverse events were monitored. RESULTS: The median PFS was 11.0 months (95% confidence interval [CI], 0-23.2 months) and OS was 17.0 months (95% CI, 2.1-31.9 months) for the maintenance group. In contrast, median PFS was 7.0 months (95% CI, 5.8-8.2 months) and OS was 11.0 months (95% CI, 2.07-31.9 months) for the control group. Compared to controls, patients who received capecitabine maintenance therapy showed significantly prolonged PFS and OS. The capecitabine-related adverse events included leukopenia, anemia, and thrombocytopenia, hand-foot syndrome, nausea/vomiting, neuropathy, and liver dysfunction. Treatment-related adverse events were tolerable, and there were no significant differences in the prevalence of adverse events between patients who received maintenance therapy and controls. CONCLUSIONS: Our finding shows that single-agent capecitabine maintenance therapy was effective, well-tolerated and safe after first-line capecitabine-based combination chemotherapy in patients with advanced EGJ adenocarcinoma.