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Objective: There is an economic evaluation on the family‐based Helicobacter pylori screen‐and‐treat strategy (FBHS) in China. This study aimed to compare the cost‐effectiveness of the FBHS with the traditional H. pylori screen‐and‐treat strategy (TBHS). Materials and Methods: A seven‐state microsimulation model, including H. pylori infection and gastric cancer states, was constructed on the basis of the target family samples from 29 provinces in China. Taking a lifetime horizon from a healthcare system perspective, the long‐term costs and health outcomes of the FBHS and TBHS screening strategies were simulated separately, and economic evaluations were performed. The model parameters were primarily derived from real‐world data, published literature, and expert opinions. The primary outcome was the incremental cost‐effectiveness ratio (ICER) expressed as cost/quality‐adjusted life‐year (QALY) gained. One‐way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis were performed to assess the uncertainty of the results. Results: The base‐case analysis revealed that the average costs for FBHS and TBHS were 563.67 CNY and 574.08 CNY, respectively, with corresponding average QALYs of 14.83 and 14.79. The ICER for the comparison between the two strategies was −214.07, indicating that FBHS was an absolutely dominant strategy with better cost‐effectiveness. The results of both one‐way sensitivity analysis and probabilistic sensitivity analysis were robust. When taking into account the added benefit of the higher H. pylori eradication rate in FBHS, the average costs were further reduced, and the average QALYs were increased, solidifying its position as an unequivocally dominant strategy. Conclusion: The FBHS is an absolutely dominant and cost‐effective strategy that enables an optimized allocation of screening resources. Decision‐makers should prioritize FBHS when developing H. pylori prevention and control strategies. [ABSTRACT FROM AUTHOR]

Background: Acute pancreatitis (AP) is an internal medical emergency disease, with fatal complications including acute lung injury (ALI). Recent studies have highlighted the critical roles of exosomal microRNAs (miRNAs) in AP-ALI. In the present study, we aim to investigate the role of serum exosomal miR-216a in AP-ALI and its underlying mechanisms., Methods: The levels of miR-216a in patients and rat models with AP and AP-ALI were assessed via real-time quantitative PCR (qRT-PCR) analysis. Patient and rat blood exosomes were isolated and co-cultured with HUVECs. The permeability of HUVECs was evaluated via trans-endothelial electrical resistance (TEER) assay. Bioinformatics predicting and luciferase reporter assays were used to identified potential targets of miR-216a. In addition, miR-216a mimic and LAMC1 overexpressed plasmid were constructed to identify the effects of miR-216a/LAMC1 axis on endothelial cell permeability in vitro. Anti-miR-216a and exosomes were used to identify the critical role of exosomal miR-216a in AP-ALI in vivo., Results: The findings indicated that there was a significant upregulation of miR-216a in AP-ALI patients and rat models. The occurrence of ALI during AP progression promoted the expression of serum exosomal miR-216a. Exosomal could promote HUVECs permeability by releasing miR-216a. For target studies, miR-216a was found to bind to LAMC1 to regulate its transcription level. MiR-216a-mediated downregulation of LAMC1 lead to increased permeability of HUVECs. Exosome-derived miR-216a has also been proved to promote lung damage in AP-ALI rats., Conclusions: In summary, serum exosomal miR-216a can promote the onset and progression of AP-ALI by augmenting endothelial cell vascular permeability. This finding presents a theoretical basis for exploring new therapeutic approaches targeting AP-ALI., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Aim: Gastric precancerous conditions are generally considered to play an essential role in the gastric carcinogenesis cascade. This study identified risk factors of gastric precancerous conditions in a nationwide multicenter cross-sectional study., Methods: Individuals who made their visit to 115 hospitals in China for gastric cancer screening were recruited. Lifestyle habits and personal information were collected through a series of questionnaires. Serum biomarker test (pepsinogen I, pepsinogen II, gastrin-17, and anti-Helicobacter pylori immunoglobulin G antibody) and endoscopy were then performed. Risk factors for gastric precancerous conditions were identified by univariate and multivariate analyses., Results: Of 14,929 subjects eligible for analysis, 4477 (30.0%) developed gastric precancerous conditions and 405 (2.71%) developed gastric cancer. In multiple logistic regression, precancerous conditions were associated with advanced age [odds ratio (OR)=1.027; 95% confidence interval (Cl), 1.023-1.032; P<0.001], male gender (OR=1.303; 95% Cl, 1.188-1.429; P<0.001), H. pylori infection (OR=1.377; 95% Cl, 1.272-1.490, P<0.001), and smoking (OR=1.142; 95% Cl, 1.005-1.298, P=0.004), whereas they were inversely correlated with white meat intake (OR=0.731; 95% Cl, 0.673-0.794; P<0.001) and pepsinogen I level (30 to 70 subgroup OR=1.536; 95% Cl, 1.163-2.028; P=0.002; <30 subgroup OR=1.354; 95% Cl, 1.206-1.520; P<0.001). Also, the authors observed a statistically lower prevalence of reflux esophagitis (2.8% vs. 4.7%) and of gastric polyps (11.0% vs. 13.7%) in H. pylori-infected population., Conclusions: Patients with H. pylori have a 1.4-fold higher risk of having gastric precancerous conditions. Besides, precancerous conditions were associated with advanced age, male gender, H. pylori infection, and smoking in a large population. However, regular white meat intake and higher pepsinogen I level were associated with reduced risk of having precancerous lesions., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)