ObjectiveTo develop a gastric cancer (GC) risk prediction rule as an initial prescreening tool to identify individuals with a high risk prior to gastroscopy.DesignThis was a nationwide multicentre cross-sectional study. Individuals aged 40–80 years who went to hospitals for a GC screening gastroscopy were recruited. Serum pepsinogen (PG) I, PG II, gastrin-17 (G-17) and anti-Helicobacter pylori IgG antibody concentrations were tested prior to endoscopy. Eligible participants (n=14 929) were randomly assigned into the derivation and validation cohorts, with a ratio of 2:1. Risk factors for GC were identified by univariate and multivariate analyses and an optimal prediction rule was then settled.ResultsThe novel GC risk prediction rule comprised seven variables (age, sex, PG I/II ratio, G-17 level, H. pylori infection, pickled food and fried food), with scores ranging from 0 to 25. The observed prevalence rates of GC in the derivation cohort at low-risk (≤11), medium-risk (12–16) or high-risk (17–25) group were 1.2%, 4.4% and 12.3%, respectively (p<0.001).When gastroscopy was used for individuals with medium risk and high risk, 70.8% of total GC cases and 70.3% of early GC cases were detected. While endoscopy requirements could be reduced by 66.7% according to the low-risk proportion. The prediction rule owns a good discrimination, with an area under curve of 0.76, or calibration (p<0.001).ConclusionsThe developed and validated prediction rule showed good performance on identifying individuals at a higher risk in a Chinese high-risk population. Future studies are needed to validate its efficacy in a larger population.

Gut microbiotas and their functions were significantly changed in obesity. More prospective studies on association and causality between microbiota and obesity are imperative and might contribute to the prevention, diagnosis, and treatment of obesity.

BackgroundThe quality of life in patients receiving chronic hemodialysis is compromised despite of the substantial achievements in treatments. Quality of life in hemodialysis patients have been shown to be associated with decreased survival and increased hospitalization. Therefore, it is necessary to incorporate the managements of symptoms and patient self-perceived well-being as measurements of effective treatments for these patients.MethodsA survey of symptom distress, quality of sleep and quality of life was performed in 301 maintenance hemodialysis patients using Dialysis Symptom Index, Short Form-36, and Pittsburgh Quality of Sleep Index table. Patients were recruited from five hospitals in Guangdong area of China by convenience sampling.ResultsThe prevalence of various symptoms in maintenance hemodialysis patients was between 23.3 and 80.4 %. These patients had compromised sleep and poor quality of life. Moreover, poor quality of sleep and impaired quality of life were associated with high symptom burden of these patients.ConclusionThe patients receiving chronic hemodialysis generally have heavy symptom distress, which could contribute to the disturbed sleep and impaired quality of life of these patients. Measurements of clinical outcomes for hemodialysis patients should include the management of symptoms and morbidity. The ultimate goal of treatments is to improve patient self-perceived quality of life.

The objective of the present study was to construct an alginate (AG)-based phase-changeable and injectable hydrogel for imaging-guided tumor hyperthermia and chemotherapy. Based on the binding between the α-l-guluronic blocks of AG and calcium ions, the AG/MoS/BiS-poly(ethylene glycol) (MBP)/doxorubicin (DOX) solution formed a cross-linked hydrogel to simultaneously encapsulate MBP nanosheets and DOX within the hydrogel matrix. The in situ formed hydrogel can act as a reservoir to control the release of entrapped drug molecules, and the doped MBP nanosheets and DOX can realize computed tomography/photoacoustic dual-modal imaging-guided in vivo tumor photothermal therapy and chemotherapy, respectively. The AG/MBP/DOX hydrogel exhibited excellent photothermal conversion properties with mass extinction coefficient of 45.1 L/g/cm and photothermal conversion efficiency of 42.7%. Besides, the heat from the photothermal transformation of MBP can promote drug diffusion from the hydrogel to realize on-demand drug release. Additionally, the hydrogel system can restrain MBP and DOX from entering into the blood stream during therapy, and therefore substantially decrease their side effects on normal organs. More importantly, the drug loading of the AG hydrogel was general and can be extended to the encapsulation of antibiotics, such as amoxicillin, for the prevention of postoperative infections.