Cervical cancer prevention in China: where are we now, and what's next?

Cervical cancer(CC) epidemiology CC, the fourth most frequently diagnosed malignancy in women worldwide, is a major global health challenge, particularly in low-resource regions. Approximately 88.1% of the 604,000 CC new cases occurred in low-and middle-income countries in 2020, and more than 90% of the 342,000 CC deaths occurred in low-and middle-income countries in 2020~1.

Adolescent suicide risk factors and the integration of socialemotional skills in school-based prevention programs

Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.

Recent advances in promising drugs for primary prevention of gastroesophageal variceal bleeding with cirrhotic portal hypertension

Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with cirrhosis.Although primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incidence of bleeding,their efficacy is limited due to side effects and related contraindications.With recent advances in precision medicine,precise drug treatment provides better treatment efficacy.Data sources:Literature search was conducted in PubMed,MEDLINE and Web of Science for relevant articles published up to May 2022.Information on clinical trials was obtained from https://clinicaltrials.gov/and http://www.chictr.org.cn/.Results:The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising drugs.According to the site of action,these drugs could be classified into four classes:intrahepatic,extrahepatic,both intrahepatic and extrahepatic targets and others.All these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.Conclusions:This review classified and summarized the promising drugs,which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension,demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.

Navigating nephrotoxic waters:A comprehensive overview of contrast-induced acute kidney injury prevention

Contrast-induced acute kidney injury(CI-AKI)is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality.Its pathophysiology,although not well-established,revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney.Critically ill patients,as well as those with pre-existing renal disease and cardiovascular comorbidities,are more susceptible to CI-AKI.Despite the continuous research in the field of CI-AKI prevention,clinical practice is based mostly on periprocedural hydration.In this review,all the investigated methods of prevention are presented,with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.

Unlocking the potential-vitamin D in prostate cancer prevention

Prostate cancer poses a significant health challenge globally,demanding proactive prevention strategies.This editorial explores the emerging role of vitamin D in prostate cancer prevention.While traditionally associated with bone health,vitamin D is increasingly recognized for its broader impact on immune function,cellular signaling,and cancer prevention.Epidemiological studies suggest an intriguing link between vitamin D deficiency and elevated prostate cancer risk,particularly in regions with limited sunlight exposure.Mechanistically,vitamin D regulates cellular processes,inhibiting unchecked cancer cell growth and bols-tering immune surveillance.Personalized prevention strategies,considering individual factors,are deemed essential for harnessing the full potential of vitamin D.To unlock this potential,the future calls for robust research,public awareness campaigns,dietary improvements,and vigilant medical guidance.Collaborative efforts are poised to pave the way toward a future where vitamin D stands as a sentinel in prostate cancer prevention,ushering in hope and improved health for men worldwide.

Effectiveness of serological markers of gastric mucosal atrophy in the gastric precancer screening and in cancer prevention

BACKGROUND New markers are needed to improve the effectiveness of serological screening for atrophic gastritis.AIM To develop a cost-effective method for serological screening of atrophic gastritis with a high level of sensitivity.METHODS Of the 169 patients with atrophic gastritis,selected by the visual endoscopic Kimura-Takemoto method,165 showed histological mucosal atrophy using the updated Kimura-Takemoto method.All 169 patients were examined for postprandial levels of gastrin-17(G17)and pepsinogen-1(PG1)using Gastro-Panel®(Biohit Plc,Helsinki,Finland).RESULTS We used the histological standard of five biopsies of the gastric mucosa,in accordance with the Kimura-Takemoto classification system to assess the sensitivity of G17 in detecting gastric mucosal atrophy.We also compared the morphofunctional relationships between the detected histological degree of gastric mucosal atrophy and the serological levels of G17 and PG1,as the markers of atrophic gastritis.The sensitivity of postprandial G17 was 62.2%for serological levels of G17(range:0-4 pmol/L)and 100%for serological G17(range:0-10 pmol/L)for the detection of monofocal severe atrophic gastritis.No strong correlation was found between the levels of PG1 and degree of histological atrophy determined by the Kimura-Takemoto classification system to identify the severity of mucosal atrophy of the gastric corpus.In the presented clinical case of a 63-year-old man with multifocal atrophic gastritis,there is a pronounced positive long-term dynamics of the serological marker of atrophy-postprandial G17,after five months of rennet replacement therapy.CONCLUSION Serological screening of multifocal atrophic gastritis by assessment of postprandial G17 is a cost-effective method with high sensitivity.Postprandial G17 is an earlier marker of regression of atrophic gastritis than a morphological examination of a gastric biopsy in accordance with the Sydney system.Therefore,postprandial G17 is recommended for dynamic monitoring of atrophic gastritis after treatment.

Helicobacter pylori eradication for primary prevention of gastric cancer:progresses and challenges

Gastric cancer remains a significant global health challenge,causing a substantial number of cancer-related deaths,particularly in China.While the exact causes of gastric cancer are still being investigated,Helicobac-ter pylori(H.pylori)infection has been identified as the primary risk factor,which triggers chronic inflammation and a multistage progression of gastric lesions that may lead to carcinogenesis over a long latency time.Since the 1990s,numerous efforts have focused on assessing the effectiveness of H.pylori eradication in preventing new cases of gastric cancer among both the general population and patients who have undergone early-stage cancer treatment.This body of work,including several community-based interventions and meta-analyses,has shown a reduction in both the incidence of and mortality from gastric cancer following H.pylori treatment,alongside a decreased risk of metachronous gastric cancer.In this review,we seek to consolidate current knowledge on the effects of H.pylori treatment on gastric cancer prevention,its systemic consequences,cost-effectiveness,and the influence of antibiotic resistance and host characteristics on treatment outcomes.We further discuss the potential for precision primary prevention of H.pylori treatment and comment on the efficient implementation of test-and-treat policies and allocation of health resources towards minimizing the burden of gastric cancer globally.

Comprehensive approach to esophageal variceal bleeding:From prevention to treatment

Esophageal variceal bleeding is a severe complication often associated with portal hypertension,commonly due to liver cirrhosis.Prevention and treatment of this condition are critical for patient outcomes.Preventive strategies focus on reducing portal hypertension to prevent varices from developing or enlarging.Primary prophylaxis involves the use of non-selective beta-blockers,such as propranolol or nadolol,which lower portal pressure by decreasing cardiac output and thereby reducing blood flow to the varices.Endoscopic variceal ligation(EVL)may also be employed as primary prophylaxis to prevent initial bleeding episodes.Once bleeding occurs,immediate treatment is essential.Initial management includes hemodynamic stabilization followed by pharmacological therapy with vasoactive drugs such as octreotide or terlipressin to control bleeding.Endoscopic intervention is the cornerstone of treatment,with techniques such as EVL or sclerotherapy applied to directly manage the bleeding varices.In cases where bleeding is refractory to endoscopic treatment,transjugular intrahepatic portosystemic shunt may be considered to effectively reduce portal pressure.Long-term management after an acute bleeding episode involves secondary prophylaxis using betablockers and repeated EVL sessions to prevent rebleeding,complemented by monitoring and managing liver function to address the underlying disease.In light of new scientific evidence,including the findings of the study by Peng et al,this editorial aims to review available strategies for the prevention and treatment of esophageal varices.

Overview on Mangrove Forest Disaster Prevention and Mitigation Functions

This paper provides a comprehensive overview on coastal protection and hazard mitigation by mangroves.Previous stud-ies have made great strides to understand the mechanisms and influencing factors of mangroves’protection function,including wave energy dissipation,storm surge damping,tsunami mitigation,adjustment to sea level rise and wind speed reduction,which are sys-tematically summarized in this study.Moreover,the study analyzes the extensive physical models,based on indoor flume experi-ments and numerical models,that consider the interaction between mangroves and hydrodynamics,to help our understanding of mangrove-hydrodynamic interactions.Additionally,quantitative approaches for valuing coastal protection services provided by man-groves,including index-based and process-resolving approaches,are introduced in detail.Finally,we point out the limitations of previous studies,indicating that efforts are still required for obtaining more long-term field observations during extreme weather events,to create more real mangrove models for physical experiments,and to develop numerical models that consider the flexible properties of mangroves to better predict wave propagation in mangroves having complex morphology and structures.

Mechanism,prevention,and control of mining-induced dynamic disasters in underground metal mines in China:Challenges and solutions

Metal mineral resources play an indispensable role in the development of the national economy.Dynamic disasters in underground metal mines seriously threaten mining safety,which are major scientific and technological problems to be solved urgently.In this article,the occurrence status and grand challenges of some typical dynamic disasters involving roof falling,spalling,collapse,large deformation,rockburst,surface subsidence,and water inrush in metal mines in China are systematically presented,the characteristics of mining-induced dynamic disasters are analyzed,the examples of dynamic disasters occurring in some metal mines in China are summarized,the occurrence mechanism,monitoring and early warning methods,and prevention and control techniques of these disasters are highlighted,and some new opinions,suggestions,and solutions are proposed simultaneously.Moreover,some shortcomings in current disaster research are pointed out,and the direction of efforts to improve the prevention and control level of dynamic disasters in China’s metal mines in the future is prospected.The integration of forward-looking key innovative theories and technologies in the abovementioned aspects will greatly enhance the cognitive level of disaster prevention and mitigation in China’s metal mining industry and achieve a significant shift from passive disaster relief to active disaster prevention.

Beyond dentistry:could prevention and screening for neurodegenerative diseases start in the dental office?

The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological assessment.The efforts of the scientific community are focused on two aspects:a)the discovery of minimally invasive biomarkers;b)the discovery of early biomarkers that can predict the progression to clinical disease in the presymptomatic stage of a disease.Considering the impact of the number of patients affected by chronic neurodegenerative diseases on public health expenditures,early diagnosis seems to be a primary need of our society.

Physical activity with or without dietary intervention for the prevention of cardiovascular diseases

We and others have published extensively on the benefits of physical activity(PA),exercise training,and cardiorespiratory fitness(CRF)to decrease the prevalence of cardiovascular diseases(CVDs)and CVD and all-cause morbidity and mortality.^(1-5)Both PA and CRF are important;however,CRF,which is mostly obtained through PA,although there is a genetic component,seems to be even more important than PA for predicting prognosis.^(1,4-6)Certainly,the wealth of data from across the world has indicated that increasing PA to enhance CRF while mitigating sedentary behavior would go a long way to lessen the world-wide obesity epidemic and reduce CVD and all-cause mortality.

Effects of Seasonal and Temperature Variations on the Association between Nitrogen Dioxide Exposure and First-Aid Incidence for Neurological Diseases in Shenzhen,China

Neurological disorders,including headaches(tension-type headaches,medication-overuse headaches,and migraines)and dementias that include Alzheimer’s disease,are among the most prevalent and debilitating global conditions.In 2016,these disorders affected 276 million people worldwide and were the second leading cause of death that year[1].This highlights the urgent need for effective prevention,treatment,and support strategies.The etiology of neurological disorders is multifaceted and involves genetic,environmental,physiological,and social factors[2].

Community-based prevention and treatment of cardiovascular diseases

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases(CVD).This section of the report underscores the importance of initiatives outlined in the"Healthy China 2030 Plan,"emphasizing the comprehensive prevention and control strategy for chronic diseases.A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic diseases.By 2020,488 such areas had been set up across China,surpassing the initial target and covering a significant proportion of counties and districts.The report highlights the successful implementation of these strategies in Lishan district,Anshan city,where demonstration areas for comprehensive prevention and control of chronic diseases were launched in 2013.Over the course of seven years,the number of healthy units increased substantially,leading to improvements in managing risk factors for CVD among residents.Significant reductions in prevalence rates of overweight,obesity,smoking,passive smoking,and drinking were observed,along with the development of healthier behaviors among residents.Similarly,Qiaokou district in Wuhan City,designated as a national demonstration area in 2014,implemented comprehensive public health promotion initiatives.Notably,special clinics for hypertension intervention were established,contributing to an increase in self-reported rates of hypertension,a slight decrease in prevalence,and a remarkable improvement in the control rate among treated patients.Overall,these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases,particularly cardiovascular diseases,in China.

Identification of Early Warning Signals of Infectious Diseases in Hospitals by Integrating Clinical Treatment and Disease Prevention

The global incidence of infectious diseases has increased in recent years,posing a significant threat to human health.Hospitals typically serve as frontline institutions for detecting infectious diseases.However,accurately identifying warning signals of infectious diseases in a timely manner,especially emerging infectious diseases,can be challenging.Consequently,there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals.This paper examines the role of medical data in the early identification of infectious diseases,explores early warning technologies for infectious disease recognition,and assesses monitoring and early warning mechanisms for infectious diseases.We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems,in compliance with national strategies to integrate clinical treatment and disease prevention.Furthermore,hospitals should establish institution-specific,clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.

Unraveling colorectal cancer prevention:The vitamin D-gut flora-immune system nexus

Colorectal cancer(CRC)is one of the most common cancers diagnosed in the world.Although environmental and genetic factors play a major role in the pathogenesis of CRC,extensive research has suggested that vitamin D may play a pivotal role in the development of CRC.Vitamin D,primarily obtained through sunlight exposure,dietary sources,and supplements,has long been recognized for its essential functions in maintaining health,including immune regulation.This article delves into the intricate relationship between vitamin D,the immune system,gut flora,and the prevention of CRC.It presents a synthesis of epidemiological data,experimental studies,and clinical trials,highlighting the mechanisms by which vitamin D influences immune cell function,cytokine production,and inflammation.By enhancing the immune system’s surveillance and antitumor activity,vitamin D may offer a promising avenue for CRC prevention.Furthermore,this comprehensive review delves into the prospective clinical applications of vitamin D supplementation and delineates the forthcoming avenues of research in this dynamic domain.Additionally,the paper tentatively outlines a spectrum of prophylactic impacts of vitamin D on CRC,emphasizing its significant potential in reducing CRC risk through shedding light on its mechanisms,encompassing antineoplastic mechanisms,influences on the immune system,and modulation of the gut microbiome.

Orthopedic manifestations of Li-Fraumeni syndrome:Prevention and treatment of a polymorphic spectrum of malignancies

Li-Fraumeni syndrome(LFS)is a rare hereditary cancer predisposition syndrome characterized by a heightened risk of developing various malignancies at an early age.Emerging evidence suggests a correlation between LFS and orthopedic manifestations,underscoring the importance of orthopedic screening in individuals with this syndrome.Pediatric cancer is rare.It is estimated that more than 10%-15%of tumors are secondary to a pathogenic variant in a cancer predisposition gene.More than 100 cancer predisposition genes and their association with syndromes or isolated tumors have been identified.LFS is one of those who have been most widely described.Patients with this syndrome present a high risk of developing one or more tumors.Its knowledge enables the establishment of a follow-up protocol for the patient and affected family members,facilitating early detection of new tumors and reducing tumor and treatment-related morbidity and mortality.The primary objective of this invited editorial article is to provide a thorough review of the existing knowledge of LFS and its polymorphic spectrum of related malignancies,with a focus on aspects directly linked to orthopedic manifestations.Another objective is to offer an update on the most modern prevention,treatment and follow up guidelines that could be useful for the physicians dealing with this cohort of patients.

Global strategy for prevention of gastric cancer

Global prevention of gastric cancer needs to increase its level of effectiveness.The prevention strategy should include all stages of primary and secondary prevention.The necessary steps to prevent gastric cancer are the following:Maintaining a healthy lifestyle and diet,avoiding smoking and alcohol;serological screening of Helicobacter pylori infections and eradication;serological screening of atrophic gastritis in the population over 45 years of age and identification of severe atrophic gastritis with a high risk of developing gastric cancer;verification of atrophic gastritis and precancerous changes in the gastric mucosa using modern endoscopic(confocal laser endomicroscopy,narrow-spectrum imaging,and magnifying endoscopy)and morphological methods among patients with severe atrophic gastritis who were identified using serological screening;treatment of patients with atrophic gastritis during diagnosis verification;annual endoscopic and morphological monitoring of patients with atrophic gastritis during permanent treatment;annual serological monitoring of patients with atrophic gastritis who refused endoscopic and morphological monitoring;and radical treatment of patients with verified early gastric cancer.Ways to implement the algorithm for the global strategy for the prevention of gastric cancer(protocol of practical recommendations)are:State,government,and municipal programs;departmental programs of health departments;family doctors for patients who have a contract at the initiative of the doctor;family doctors for patients with a contract at the patient’s initiative;and within private healthcare system where both doctors and patients can initiate the implementation of algorithm.

Occurrence and prevention of incisional hernia following laparoscopic colorectal surgery

Among minimally invasive surgical procedures,colorectal surgery is associated with a notably higher incidence of incisional hernia(IH),ranging from 1.7% to 24.3%.This complication poses a significant burden on the healthcare system annually,necessitating urgent attention from surgeons.In a study published in the World Journal of Gastrointestinal Surgery,Fan et al compared the incidence of IH among 1614 patients who underwent laparoscopic colorectal surgery with different extraction site locations and evaluated the risk factors associated with its occurrence.This editorial analyzes the current risk factors for IH after laparoscopic colorectal surgery,emphasizing the impact of obesity,surgical site infection,and the choice of incision location on its development.Furthermore,we summarize the currently available preventive measures for IH.Given the low surgical repair rate and high recurrence rate associated with IH,prevention deserves greater research and attention compared to treatment.

Contemporary concepts of prevention and management of gastroesophageal variceal bleeding in liver cirrhosis patients

This editorial describes the contemporary concepts of prevention and management of gastroesophageal variceal bleeding in liver cirrhosis(LC)patients according to the current guidelines.Gastroesophageal variceal bleeding is the most dangerous complication of portal hypertension in LC patients.Risk stratification and determination of an individual approach to the choice of therapeutic measures aimed at their prevention and management has emerged as one of the top concerns in modern hepatology.According to the current guidelines,in the absence of clinically significant portal hypertension,etiological and nonetiological therapies of LC is advisable for the primary preventing gastroesophageal variceal bleeding,whereas its presence serves as an indication for the administration of non-selectiveβ-blockers,among which carvedilol is the drug of choice.Non-selectiveβ-blockers,as well as endoscopic variceal ligation and transjugular intrahepatic portosystemic shunt can be used to prevent recurrence of gastroesophageal variceal bleeding.Pharmacotherapy with vasoactive drugs(terlipressin,somatostatin,octreotide),endoscopic variceal ligation,endovascular techniques and transjugular intrahepatic portosystemic shunt are recommended for the treatment of acute gastroesophageal variceal bleeding.Objective and accurate risk stratification of gastroesophageal variceal bleeding will allow developing individual strategies for their prevention and management,avoiding the first and further decompensation in LC,which will improve the prognosis and survival of patients suffering from it.