Background:Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease(GERD).In response to the conflicting results in previous studies,we performed a systematic review and meta-analys...Background:Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease(GERD).In response to the conflicting results in previous studies,we performed a systematic review and meta-analysis to investigate this association.Methods:Relevant studies published until January 2023 were retrieved from 6 databases,and the prevalence of symptomatic gastroesophageal reflux(GER)or GERD was determined from the original studies.A random effects model was employed to meta-analyze the association by computing the pooled relative risk(RR)with 95%confidence intervals(95%CIs).Furthermore,subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity(PA)time and GERD.Results:This meta-analysis included 33 studies comprising 242,850 participants.A significant negative association was observed between PA and the prevalence of symptomatic GER(RR=0.74,95%CI:0.66-0.83;p<0.01)or GERD(RR=0.80,95%CI:0.76-0.84;p<0.01),suggesting that engaging in PA might confer a protective benefit against GERD.Subgroup analyses consistently indicated the presence of this association across nearly all subgroups,particularly among the older individuals(RR_(<40 years):RR_(≥40 years)=0.85:0.69,p<0.01)and smokers(RR_(smoker):RR_(non-smoker)=0.67:0.82,p=0.03).Furthermore,a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09%lower risk of developing GERD.Conclusion:Maintaining high levels of PA decreased the risk of GERD,particularly among older adults and smokers.Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.展开更多
Background:Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies.However,comprehensive reports on the burden of digestive system diseases in China are lacking.Our stu...Background:Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies.However,comprehensive reports on the burden of digestive system diseases in China are lacking.Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.Methods:This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence,mortality rate,disability-adjusted life years(DALYs),years of life disability,years of life lost,and changes in the burden of digestive diseases across Chinese provinces from 1990 to 2019.The analysis of disease burden primarily examines the characteristics of sub-disease distribution,time trends,age distribution,and sex distribution.Additionally,we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index(SDI).Results:In 2019,there were 499.2 million cases of digestive system diseases in China,resulting in 1,557,310 deaths.Stomach cancer,colon and rectal cancer,and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases.Meanwhile,cirrhosis and other chronic liver diseases,gastroesophageal reflux disease,and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases.The risk of gastric cancer sharply increases among men after the age of 40 years,leading to a significant disparity in burden between men and women.As the SDI increased,the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.Conclusion:Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI.展开更多
Background:Early detection of esophageal squamous cell carcinoma(ESCC)can considerably improve the prognosis of patients.Aberrant cell-free DNA(cfDNA)methylation signatures are a promising tool for detecting ESCC.Howe...Background:Early detection of esophageal squamous cell carcinoma(ESCC)can considerably improve the prognosis of patients.Aberrant cell-free DNA(cfDNA)methylation signatures are a promising tool for detecting ESCC.However,available markers based on cell-free DNA methylation are still inadequate.This study aimed to identify ESCC-specific cfDNA methylation markers and evaluate the diagnostic performance in the early detection of ESCC.Methods:We performed whole-genome bisulfite sequencing(WGBS)for 24 ESCC tissues and their normal adjacent tissues.Based on the WGBS data,we identified 21,469,837 eligible CpG sites(CpGs).By integrating several methylation datasets,we identified several promising ESCC-specific cell-free DNA methylation markers.Finally,we developed a dual-marker panel based on methylated KCNA3 and OTOP2,and then,we evaluated its performance in our training and validation cohorts.Results:The ESCC diagnostic model constructed based on KCNA3 and OTOP2 had an AUC of 0.91[95%CI:0.85-0.95],and an optimal sensitivity and specificity of 84.91%and 94.32%,respectively,in the training cohort.In the independent validation cohort,the AUC was 0.88[95%CI:0.83-0.92],along with an optimal sensitivity of 81.5%and specificity of 92.9%.The model sensitivity for stage I-II ESCC was 78.4%,which was slightly lower than the sensitivity of the model(85.7%)for stage III-IV ESCC.Conclusion:The dual-target panel based on cfDNA showed excellent performance for detecting ESCC and might be an alternative strategy for screening ESCC.展开更多
Esophageal cancer remains a leading cause of cancer-related death worldwide.Its incidence and mortality rank seventh and sixth among all cancers in 2020[1],respectively.The geographical regions with most esophageal ca...Esophageal cancer remains a leading cause of cancer-related death worldwide.Its incidence and mortality rank seventh and sixth among all cancers in 2020[1],respectively.The geographical regions with most esophageal cancer cases and deaths include central and eastern Asia(known as the Asian esophageal cancer belt),parts of Africa,and some South American countries,with esophageal squamous cell carcinoma(ESCC)being the major histological subtype(comprising nearly 90%of cases).Due to the asymptomatic nature of early-stage lesions,more than 80%of ESCC were diagnosed at an advanced stage.This have led to an extremely poor prognosis of ESCC,with 5-year survival rates less than 20%in most countries.展开更多
Background:Worldwide,the volume and availability of digestive endoscopy have undergone dramatic development in recent years,with increasing attention on quality assurance.We investigated the utilization and quality of...Background:Worldwide,the volume and availability of digestive endoscopy have undergone dramatic development in recent years,with increasing attention on quality assurance.We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions.Methods:We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually.The questionnaires included the personnel,annual volume,and quality indicators of endoscopy.An endoscopy quality index(EQI)was developed based on recorded quality indicators using principal component analysis to determine the relative weight.Results:From 2015 to 2019,806,1412,2644,2468,and 2541 hospitals were respectively enrolled in this study.The average annual volume of endoscopy increased from 12,445 to 16,206(1.30-fold)and from 2938 to 4255(1.45-fold)in tertiary and secondary hospitals,respectively.The most obvious growth was observed in diagnostic colonoscopy(1.44-fold for all hospitals after standardization).The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3%(55,210/448,861)to 17.7%(85,429/482,647)and from 11.4%(69,411/608,866)to 16.9%(107,192/634,235),respectively.The adenoma detection rate of diagnostic colonoscopy increased from 14.9%(2,118,123/14,215,592)to 19.3%(3,943,203/20,431,104).The EQI model included 12 quality indicators,incorporating 64.9%(7.792/12)of the total variance into one comprehensive index.According to the EQI measurements,the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals.Conclusions:Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality.The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.展开更多
文摘Background:Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease(GERD).In response to the conflicting results in previous studies,we performed a systematic review and meta-analysis to investigate this association.Methods:Relevant studies published until January 2023 were retrieved from 6 databases,and the prevalence of symptomatic gastroesophageal reflux(GER)or GERD was determined from the original studies.A random effects model was employed to meta-analyze the association by computing the pooled relative risk(RR)with 95%confidence intervals(95%CIs).Furthermore,subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity(PA)time and GERD.Results:This meta-analysis included 33 studies comprising 242,850 participants.A significant negative association was observed between PA and the prevalence of symptomatic GER(RR=0.74,95%CI:0.66-0.83;p<0.01)or GERD(RR=0.80,95%CI:0.76-0.84;p<0.01),suggesting that engaging in PA might confer a protective benefit against GERD.Subgroup analyses consistently indicated the presence of this association across nearly all subgroups,particularly among the older individuals(RR_(<40 years):RR_(≥40 years)=0.85:0.69,p<0.01)and smokers(RR_(smoker):RR_(non-smoker)=0.67:0.82,p=0.03).Furthermore,a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09%lower risk of developing GERD.Conclusion:Maintaining high levels of PA decreased the risk of GERD,particularly among older adults and smokers.Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.
基金supported by the First Affiliated Hospital of Naval Medical University(2019YXK006)the Science and Technology Commission of Shanghai Municipality(21Y31900100)
文摘Background:Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies.However,comprehensive reports on the burden of digestive system diseases in China are lacking.Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.Methods:This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence,mortality rate,disability-adjusted life years(DALYs),years of life disability,years of life lost,and changes in the burden of digestive diseases across Chinese provinces from 1990 to 2019.The analysis of disease burden primarily examines the characteristics of sub-disease distribution,time trends,age distribution,and sex distribution.Additionally,we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index(SDI).Results:In 2019,there were 499.2 million cases of digestive system diseases in China,resulting in 1,557,310 deaths.Stomach cancer,colon and rectal cancer,and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases.Meanwhile,cirrhosis and other chronic liver diseases,gastroesophageal reflux disease,and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases.The risk of gastric cancer sharply increases among men after the age of 40 years,leading to a significant disparity in burden between men and women.As the SDI increased,the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.Conclusion:Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI.
基金supported by the Science and Technology Commission of Shanghai Municipality(No.21Y31900100).
文摘Background:Early detection of esophageal squamous cell carcinoma(ESCC)can considerably improve the prognosis of patients.Aberrant cell-free DNA(cfDNA)methylation signatures are a promising tool for detecting ESCC.However,available markers based on cell-free DNA methylation are still inadequate.This study aimed to identify ESCC-specific cfDNA methylation markers and evaluate the diagnostic performance in the early detection of ESCC.Methods:We performed whole-genome bisulfite sequencing(WGBS)for 24 ESCC tissues and their normal adjacent tissues.Based on the WGBS data,we identified 21,469,837 eligible CpG sites(CpGs).By integrating several methylation datasets,we identified several promising ESCC-specific cell-free DNA methylation markers.Finally,we developed a dual-marker panel based on methylated KCNA3 and OTOP2,and then,we evaluated its performance in our training and validation cohorts.Results:The ESCC diagnostic model constructed based on KCNA3 and OTOP2 had an AUC of 0.91[95%CI:0.85-0.95],and an optimal sensitivity and specificity of 84.91%and 94.32%,respectively,in the training cohort.In the independent validation cohort,the AUC was 0.88[95%CI:0.83-0.92],along with an optimal sensitivity of 81.5%and specificity of 92.9%.The model sensitivity for stage I-II ESCC was 78.4%,which was slightly lower than the sensitivity of the model(85.7%)for stage III-IV ESCC.Conclusion:The dual-target panel based on cfDNA showed excellent performance for detecting ESCC and might be an alternative strategy for screening ESCC.
文摘Esophageal cancer remains a leading cause of cancer-related death worldwide.Its incidence and mortality rank seventh and sixth among all cancers in 2020[1],respectively.The geographical regions with most esophageal cancer cases and deaths include central and eastern Asia(known as the Asian esophageal cancer belt),parts of Africa,and some South American countries,with esophageal squamous cell carcinoma(ESCC)being the major histological subtype(comprising nearly 90%of cases).Due to the asymptomatic nature of early-stage lesions,more than 80%of ESCC were diagnosed at an advanced stage.This have led to an extremely poor prognosis of ESCC,with 5-year survival rates less than 20%in most countries.
基金supported by the National Health Commission of China, First Affiliated Hospital of Naval Medical University(No. 2019YXK006)the Science and Technology Commission of Shanghai Municipality(No. 21Y31900100)
文摘Background:Worldwide,the volume and availability of digestive endoscopy have undergone dramatic development in recent years,with increasing attention on quality assurance.We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions.Methods:We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually.The questionnaires included the personnel,annual volume,and quality indicators of endoscopy.An endoscopy quality index(EQI)was developed based on recorded quality indicators using principal component analysis to determine the relative weight.Results:From 2015 to 2019,806,1412,2644,2468,and 2541 hospitals were respectively enrolled in this study.The average annual volume of endoscopy increased from 12,445 to 16,206(1.30-fold)and from 2938 to 4255(1.45-fold)in tertiary and secondary hospitals,respectively.The most obvious growth was observed in diagnostic colonoscopy(1.44-fold for all hospitals after standardization).The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3%(55,210/448,861)to 17.7%(85,429/482,647)and from 11.4%(69,411/608,866)to 16.9%(107,192/634,235),respectively.The adenoma detection rate of diagnostic colonoscopy increased from 14.9%(2,118,123/14,215,592)to 19.3%(3,943,203/20,431,104).The EQI model included 12 quality indicators,incorporating 64.9%(7.792/12)of the total variance into one comprehensive index.According to the EQI measurements,the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals.Conclusions:Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality.The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.
