Screening for gastric cancer in China:Advances,challenges and visions

Gastric cancer(GC)is one of the major cancers in China and all over the world.Most GCs are diagnosed at an advanced stage with unfavorable prognosis.Along with some other countries,China has developed the government-funded national screening programs for GC and other major cancers.GC screening has been shown to effectively decrease the incidence of and mortality from GC in countries adopting nationwide screening programs(Japan and Korea)and in studies based on selected Chinese populations.The screening of GC relies mostly on gastroendoscopy,the accuracy,reliability and safety of which have been indicated by previous studies.However,considering its invasive screening approach,requirements on skilled endoscopists and pathologists,and a high cost,developing noninvasive methods to amend endoscopic screening would be highly needed.Numerous studies have examined biomarkers for GC screening and the combination of biomarkers involving pepsinogen,gastrin,and Helicobacter pylori antibodies has been proposed for risk stratification,seeking to narrow down the high-risk populations for further endoscopy.Despite all the achievements of endoscopic screening,evidence on appropriate screening age,intervals for repeated screening,novel biomarkers promoting precision prevention,and health economics need to be accumulated to inform policymakers on endoscopic screening in China.With the guide of Health China 2030 Planning Outline,we have golden opportunities to promote prevention and control of GC.In this review,we summarize the characteristics of screening programs in China and other East Asian countries and introduce the past and current approaches and strategies for GC screening,aiming for featuring the latest advances and key challenges,and illustrating future visions of GC screening.

The associations between multiple circulating biomarkers and the occurrence of atrial fibrillation in hypertrophic cardiomyopathy with or without left ventricular outflow tract obstruction

Objective Atrial fibrillation(AF)is the most common arrhythmia that can portend adverse prognosis in patients with hypertrophic cardiomyopathy(HCM).Data regarding the correlations of different biomarkers and AF in HCM patients are rather limited.In this study,we sought to explore the associations between the occurrence of AF and circulating biomarkers reflecting cardiovascular function(N-terminal pro-Brain natriuretic peptide,NT-proBNP),endothelial function(big endothenlin-1,big ET-1),inflammation(high-sensitivity C-reactive protein,hs-CRP)and myocardial damage(cardiac troponin I,cTnI)in HCM patients with or without left ventricular outflow tract obstruction(LVOTO),respectively.

Tricuspid regurgitation following pacemaker implantation for bradycardia:a two-year study comparing different pacing strategies

To the Editor:Tricuspid regurgitation(TR)is a known complication of cardiac implantable electrical device(CIED)implantation with a prevalence of up to 10–30%.Due to the detrimental effects of right ventricular pacing(RVP)on cardiac function,His bundle pacing(HBP)and left bundle branch area pacing(LBBAP)have been increasingly used as physiological pacing modalities.This observational study aimed to assess the lead-related significant TR(moderate and severe)in patients with HBP,LBBAP,right ventricular apical pacing(RVAP),and right ventricular septal pacing(RVSP)in bradycardia patients during the two-year follow-up.