[Epidemiological trend of early-onset gastric cancer and late-onset gastric cancer in China from 2000 to 2019].

Objective: In order to understand the changing trends of gastric cancer incidence and mortality in early-onset and late-onset in China from 2000 to 2019. Methods: The Global Burden of Disease research data was collected, and Excel and R 4.2.1 softwares were used to examine the incidence rate, mortality rate, and disability-adjusted life years (DALY) of Chinese people from 2000 to 2019, with a focus on gender, age, and year. Results: In 2019, the crude incidence rates were 7.06/100 000 (95%UI: 6.63/100 000-7.59/100 000) and 114.52/100 000 (95%UI: 108.79/100 000-121.63/100 000) for early- and late-onset gastric cancer, respectively. The crude mortality rate for early-onset gastric cancer was 3.29/100 000 (95%UI: 3.11/100 000- 3.50/100 000), while the crude mortality rate for late-onset gastric cancer was 81.88/100 000 (95%UI: 78.15/100 000-86.04/100 000). Additionally, the crude DALY rates for these two types of gastric cancer were 156.48/100 000 (95%UI: 148.82/100 000-165.84/100 000) and 1 750.13/100 000 (95%UI: 1 661.21/100 000-1 852.99/100 000). The standardized incidence of early-onset gastric cancer decreased from 5.49/100 000 in 2000 to 4.76/100 000 in 2019, and that of late-onset gastric cancer decreased from 143.45/100 000 in 2000 to 123.02/100 000 in 2019.The standardized mortality rate of early-onset gastric cancer decreased from 4.16/100 000 in 2000 to 2.18/100 000 in 2019, and that of late-onset gastric cancer decreased from 140.82/100 000 in 2000 to 91.49/100 000 in 2019. The standardized DALY rate for early-onset gastric cancer in 2019 was 105.87/100 000 (95%UI: 87.98/100 000 -125.60/100 000), lower than 198.84/100 000 (95%UI: 179.47/100 000- 219.83/100 000) in 2000. The standardized DALY rate for late onset gastric cancer in 2019 was 1 821.11/100 000 (95%UI: 1 509.42/100 000-2 158.53/100 000), lower than 2 932.52/100 000 (95%UI: 2 665.92/100 000-3 252.60/100 000) in 2000. Conclusions: The standardized mortality rate of early-onset gastric cancer in China showed a decreasing trend from 2000 to 2019. The standardized mortality rate of late onset gastric cancer showed a trend of first increasing and then decreasing. Notably, the incidence, mortality, and DALY of late-onset gastric cancer were significantly higher than those of early-onset gastric cancer during this period. Additionally, male incidence, mortality, and crude DALY rates were higher than female.

[Current consensus and controversy in neoadjuvant therapy for pancreatic cancer].

Pancreatic cancer is malignant and has a poor prognosis.At present, the treatment mode has changed from "Surgery First" to systemic therapy under multi-disciplinary team, but surgical resection is still the only way to cure pancreatic cancer. In systemic treatment of pancreatic cancer, the effect of postoperative adjuvant therapy is significant, and preoperative neoadjuvant therapy has gradually attracted widespread attention. Neoadjuvant therapy can improve the rate of R0 resection in patients with pancreatic cancer.There is a consensus on neoadjuvant therapy for patients who with borderline resectable and locally advanced, but for the patients who with resectable remains controversial.

Shared genetic etiology of hypertension and stroke: evidence from bioinformatics analysis of genome-wide association studies.

Hypertension is the most significant modifiable risk factor for cerebrovascular disease. It has been estimated that about 54% of strokes worldwide can be attributed to hypertension. However, there has not been a systematic study assessing the shared genetic susceptibility to hypertension and stroke on a genome-wide level. In this study, SNPs associated with essential hypertension and stroke were collected from the NHGRI-EBI GWAS catalog, and genotype imputation were conducted using information from the 1000 Genomes Project. Subsequently, the SNPs and the mapped genes were compared between the two diseases. Finally, functional clustering was performed, and the enriched GO terms and KEGG pathways were further compared between hypertension and stroke. Comparison of these two groups of SNPs and genes identified only one shared SNP (rs3184504) and 11 shared genes. After genotype imputation, 129 shared SNPs and 16 shared genes were identified. These genes were significantly enriched in 10 GO terms, which were mainly involved in lipoprotein and triglyceride metabolism. Additionally, KEGG analysis identified one pathway, glycerolipid metabolism, as being significantly enriched in both diseases. The present study strongly suggests that the gene network regulating lipid metabolism and blood circulation is the major shared genetic etiology of hypertension and stroke.

Are genetic polymorphisms in the renin-angiotensin-aldosterone system associated with essential hypertension? Evidence from genome-wide association studies.

In candidate gene era, dozens of single-nucleotide polymorphisms (SNPs) within renin-angiotensin-aldosterone system (RAAS) have been reported to be significantly associated with hypertension. However, the unbiased genome-wide association studies (GWAS) rarely identified the SNPs within RAAS were associated with hypertension or blood pressure (BP) traits. In order to figure out whether genetic polymorphisms of RAAS are really associated with hypertension, we systemically searched the GWAS Catalogue and identified all the known RAAS genes and relevant diseases/traits. After data processing, we found that polymorphisms within REN, AGT, ACE2, CYP11B2, ATP6AP2 and HSD11B2 were not associated with any disease or trait. SNPs within ACE, AGTR1, AGTR2, MAS1, RENBP and NR3C2 were associated with other diseases or traits, but showed no direct connection with hypertension. The only SNP associated with a BP trait, systolic BP was rs17367504. However, it is located in the intronic region of MTHFR near many plausible candidate genes, including CLCN6, NPPA, NPPB and AGTRAP. Therefore, the effect of RAAS polymorphisms may have been overestimated during the 'candidate gene era'. In the time of 'precision medicine', the power of RAAS variants needs to be reconsidered when evaluating one's susceptibility of hypertension.

Lack of association between STK39 and hypertension in the Chinese population.

Genome-wide association study (GWAS) has identified serine/threonine kinase 39 (STK39) as a candidate gene for hypertension. A replication study provided supporting evidence that STK39 functional polymorphism rs35929607 was associated with hypertension. Recently, another study also showed rs6749447 within the STK39 was associated with blood pressure responses. However, these studies were all conducted in Caucasians. Thus, we carried out a case-control study to test whether STK39 is a common candidate gene for hypertension, and to examine the interaction of genetic factors and non-genetic risk factors in the Chinese population. Thousand twenty four hypertensive cases and 1024 controls were genotyped for five polymorphisms. Four single-nucleotide polymorphisms (SNPs) are located within STK39, and rs4977950, the SNP that showed the strongest signal is located in a gene desert. Results indicated that none of these SNPs was associated with hypertension in the Chinese population. Logistic regression analysis found body mass index (BMI) and triglyceride level were higher in the hypertension group when compared with the control group. Multifactor dimensionality reduction analysis indicated that the interaction between BMI and rs4977950 may have an impact on hypertension. Taken together, the present study found no evidence that STK39 was associated with hypertension in the Chinese population. Instead, non-genetic risk factors such as BMI have an important role in Chinese hypertensive subjects, and the 'missing inheritability' requires further investigation.