A cluster randomized controlled trial to evaluate the efficacy of esophageal and gastric cancer screening in mortality reduction in a non-high-incidence area: methodology and initial results.

Background: A cluster randomized controlled trial of endoscopy-based screening for esophageal cancer (EC) and gastric cancer (GC) was conducted to evaluate the efficacy and feasibility of this strategy in a non-high-incidence rural area of China. The trial design and baseline findings are presented here. Methods: A total of 33 eligible villages in Luoshan County in Henan Province were assigned randomly to the intervention or control group in a 1:1 ratio by a computer-generated randomization list. Local residents aged 40 to 69 years were enrolled from the villages. Participants in the intervention group were risk-stratified with a questionnaire, and high-risk individuals were subsequently screened by endoscopy. The primary outcomes were EC and GC mortality. The secondary outcomes comprised the detection rate, stage distribution, and the treatment rate. In this study, baseline characteristics were assessed by a questionnaire. Multivariate logistic regression analysis was performed to explore factors associated with endoscopy compliance. Results: Trial recruitment was completed in 2017, and ultimately, there were 12,475 and 11,442 participants allocated to the intervention (17 clusters) and the control group (16 clusters), respectively. We included 23,653 participants in the analysis, with 12,402 in the intervention group and 11,251 in the control group. A total of 6,286 (50.7%) participants in the intervention group were estimated as high-risk individuals, and 2,719 (43.3%) underwent endoscopy. Multivariate logistic regression analysis demonstrated that some factors including age, gender, education, personality and mental health, and upper gastrointestinal diseases or symptoms might affect endoscopy compliance. The detection rates for positive cases of EC and GC were 0.22% and 0.55%, respectively. The rates for esophageal and gastric precancerous lesions were 0.70% and 2.35%, respectively. The early detection rates for EC and GC were 50.0% and 33.3%, respectively. Additionally, the overall treatment rate for positive cases was 90.0%. Conclusions: The diagnostic yield of endoscopy-based screening for EC and GC was relatively low in a non-high-incidence rural area. The study may offer clues for the improvement of endoscopy compliance and the optimization of screening strategies for upper gastrointestinal cancer in non-high-incidence areas. Trial Registration: Chinese Clinical Trial Registry ChiCTR-EOR-16008577.

Time-trend of the incidence and mortality of esophageal cancer from 2010 to 2018 and its statistics in 2018 in Henan, China.

Background: It is great of significance to figure the time-trend of esophageal cancer (EC) and its current status for effective prevention and control, especially in EC high risk areas. As one of world-renowned high-risk areas, the epidemiology of EC in Henan has not been recently updated. Therefore, we aimed to depict the status quo of EC and analyze its time-trend in Henan. Methods: The EC data were extracted from the Henan Provincial Cancer registry database derived from the population based cancer registry system, which covered 30.51% of the whole population in Henan and were qualified according to national and international guidelines. The incidence and mortality of EC were estimated by area (rural/urban), gender, and age groups. The age-standardized rates (ASRs) were calculated according to the Segi's population. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to evaluate the time-trend of EC. Results: As estimated, there were 29,913 new EC cases in Henan, 2018. The crude incidence and the age-standardized incidence rate by world standard population (ASIRW) was 27.43/105 and 19.96/105, respectively. The incidence in males and rural was 1.83 and 1.51 times higher than that in females and urban areas, respectively. Meanwhile, it was estimated that 22,688 deaths occurred in 2018. The crude mortality and the age-standardized mortality rate by world standard population (ASMRW) were 20.80/105 and 14.47/105, respectively. Similarly, males and rural areas had higher mortality compared with females and urban areas. The age-specific incidence and mortality of EC showed significant increasing after 60-64 years group. In general, the time-trend of incidence (APC: -8.9, P<0.001) and mortality (APC: -7.6, P<0.001) of EC showed a significant decreasing trend since 2014, and downward trend were also observed in rural areas for incidence (APC: -5.2, P<0.001) and mortality (APC: -3.9, P<0.001) from 2010 to 2018. Conclusions: The EC incidence and mortality in Henan has exhibited a significant declining trend in past years. Nonetheless, the disease burden remains high, especially in males and rural areas. Therefore, the ongoing prevention and control strategies of EC should be maintained alongside the establishment of more effective strategies.

[Performance and Mechanisms of Advanced Nitrogen Removal via FeS-driven Autotrophic Denitrification Coupled with ANAMMOX].

Synergy among members of complex microbial communities in the transformation of elements is a key ecological regulation strategy in nature. Making full use of this phenomenon and achieving functional combinations of different microorganisms may have a significant effect on developing new wastewater treatment processes. In this study, nitrogen-containing pollutants were applied in a static batch experiment. The dosage of FeS, the ratio of NO3--N/NO2--N, and the ratio of ANAMMOX (AN) to autotrophic denitrification (AD) biomass were the controlled reaction conditions. The cooperation mechanism resulting from the metabolic complementation of AN and AD is discussed, and the concept of a (AN+AD)TN 0 nitrogen removal process is proposed. This study showed that the excessive dosage of FeS could ensure the more thorough reaction of AD without significantly affecting the metabolic activity of AN bacteria. A complex microbial community was involved in the competition for metabolic substrates when the proportion of NO2--N in the electron acceptor was increased, resulting in a negative impact on the removal of TN. The increase of AN biomass contributed to the strengthening of the cooperation between AN and AD. When the stoichiometric ratio of NH4+-N to NO3--N was less than 0.85, TN could be completely removed. The results showed that a more effective wastewater treatment process may be established by understanding the interactions between microorganisms, and by manipulating or regulating complex microbial communities. This could achieve the efficient removal of pollutants under low material consumption conditions.

[Comparison of clinical outcome of mild-stimulation and conventional ovarian stimulation in in vitro fertilization-embryo transfer (IVF-ET)].

OBJECTIVE: To investigate the practical application value of the mild-stimulation method used in in vitro fertilization and embryo transfer (IVF-ET) treatment for IVF patients with normal ovarian function. METHODS: The patients (ages from 26 to 38 years) with normal ovarian function, who were treated with IVF-ET in Affiliated Reproductive Center of China Medical University from January 2004 to July 2012 were selected as our samples. We compared the clinical results of treatment between the mild-stimulation (104 cycles in experimental group) and the conventional stimulation (198 cycles in control group). RESULTS: The number of retrieved oocytes (3.1±1.6 vs. 10.2±5.7, P<0.05) and clinical pregnancy rate [34% (33/97) vs. 49.7% (93/187), P<0.05] of the mild-stimulation group (104 cycles) were lower than those of the control group (198 cycles), however, the duration of stimulation (4.7±2.1 vs. 9.16±1.87) and total doses of 75 U gonadotropins used (5.7±3.7 vs. 30.9±10.3) were also lower in the mild-stimulation group than in the control group obviously (P<0.05). CONCLUSION: For the normal ovarian function patients, the mild-stimulation method has clear clinical effects, but not as good as the conventional-stimulation one.

[Rapid detection of Escherichia coli O157 : H7 using surface plasmon resonance (SPR) biosensor].

A biosensor based on surface plasmon resonance (SPR) was developed for rapid detection of Escherichia coli O157 : H7. BIACORE 3000 SPR instrument and a dextran-modified sensor chip (CM5) were used. After activation with EDC/NHS, anti-E. coli O157 : H7 antibody was immobilized on the gold surface of the SPR sensor, and then following ethanolamine was injected, and the chip was ready for E. coli O157 : H7. Regeneration was achieved using NaOH in order to detect several samples. The limit of detection was found to be 3 x 10(5) CFU x mL(-1) for E. coli O157 : H7, and the change of RU was linearly correlated with the concentration of E. coli O157 : H7 cells (R2 = 0.99). The detection time ranged from 5 to 7 min, and the result of regeneration was effective which allowed the chip to be reused for more than 50 samples. This method is convenient, and stable, and shows potentials for applications in food areas.

[Study on the anticancer activities (in vivo) of the extract from Citrus reticulata Blanco and its influence on sarcoma-180 cells cycle].

OBJECTIVE: To study the anticancer activity of the extract from Citrus reticulata in vivo. METHOD: Anticancer activities were tested with tumor model in vivo (Sarcoma-180 cells, Heps cells, EAC cells implanted in mice). RESULT: The extract from Citrus reticulata showed marked anticancer activities on Sarcoma-180 cells and Heps cells implanted in mice, had no marked anticancer activities on EAC cells implanted in mice and induced apoptosis of Sarcoma-180 cell. CONCLUSION: The extract from Citrus reticulata will have promising prospects as an anticancer Chinese medicine, but further studies will be needed.