The Māori people are indigenous to Aotearoa New Zealand,and their language and culture are considered vital components of the nation’s cultural heritage.However,Te Reo Māori is regarded as a lowresource language ou...The Māori people are indigenous to Aotearoa New Zealand,and their language and culture are considered vital components of the nation’s cultural heritage.However,Te Reo Māori is regarded as a lowresource language outside of New Zealand,and its literary works usually rely on English as a pivot language for translation and communication.Therefore,in the process of promoting Māori literature as part of world literature by translating it into non-English languages,the accurate translation of cultural keywords is crucial to prevent dilemmas such as information loss and cultural misappropriation.In this article,we aim to explore effective translation strategies to enhance the international visibility and readership of Māori literature by analysing the rendition of Māori cultural keywords in the Chinese translation of“The Whale Rider”.展开更多
1 The Haka,a traditional war dance of the Māori people,exhibits the history,strength and spirit of New Zealand.It is an art form that has been carefully preserved and handed down through generations,maintaining its c...1 The Haka,a traditional war dance of the Māori people,exhibits the history,strength and spirit of New Zealand.It is an art form that has been carefully preserved and handed down through generations,maintaining its cultural significance and impact from ancient times to modern‑day performances in diverse settings such as sports events and wedding ceremonies.展开更多
Language is an important carrier of human culture and a specific method for communication between humans.It is one of the most important symbols of human identity and flags of dividing group identity.At present,in the...Language is an important carrier of human culture and a specific method for communication between humans.It is one of the most important symbols of human identity and flags of dividing group identity.At present,in the modern national state,the government is paying more attention to language policy and being more and more prudent to it.In the process of making and implementing language policy,the government must take into account a range of factors such as the country’s national history,politics,culture,economy,and relations between different social groups.From the mid-nineteenth century,when New Zealand became a British colony,until the mid-twentieth century,the Maori people were inspired to defend their rights and respect for themselves by the rise of Maori nationalist ideology and Maori political radicalism in a struggle that lasted more than 100 years.Until 1994,there were more than 800 kohanga reo,early childhood institutions that established Maori language instruction independent of the school system,and the nationalism drives to revitalize the Maori national language was at its peak.The process of revolution on Maori language policies in New Zealand reflects a trend of nationalist thoughts from Maori becoming more deep.Exploring the process of change in New Zealand’s Maori language policy will help to develop the study of the social history of indigenous peoples during the colonial period and will contribute to the study of the development of colonized countries and regions in the post-colonial period.The change in New Zealand’s Maori language policy has provided an important example of the preservation and revitalization of the indigenous languages of the world’s former colonies,which is of great significance for the preservation of linguistic and cultural diversity.展开更多
AIM- To investigate if and how the proinflammatory cytokine interferon γ （IFNγ） affects ghrelin expression in mice. METHODS： The plasma concentration of ghrelin, and gastric ghrelin and somatostatin expression, w...AIM- To investigate if and how the proinflammatory cytokine interferon γ （IFNγ） affects ghrelin expression in mice. METHODS： The plasma concentration of ghrelin, and gastric ghrelin and somatostatin expression, were ex- amined in wild-type mice and mice infected with Helico- bacter pylori （H. pylorO. Furthermore, ghrelin expression was examined in two achlorhydric mouse models with varying degrees of gastritis due to bacterial overgrowth. To study the effect of IFNγ, alone, mice were given a subcutaneous infusion of IFNγ, for 7 d. Finally, the influ- ence of IFNγ, and somatostatin on the ghrelin promoter was characterized. RESULTS： H. py/ori infection was associated with a 50% reduction in ghrelin expression and plasma concentration. Suppression of ghrelin expression was in- versely correlated with gastric inflammation in achlorh- dyric mouse models. Subcutaneous infusion of IFNγ, suppressed fundic ghrelin mRNA expression and plasma ghrelin concentrations. Finally, we showed that the ghrelin promoter operates under the control of soma- tostatin but not under that of IFNγ. CONCLUSION： Gastric infection and inflammation is associated with increased IFNγ, expression and reduced ghrelin expression. IFNγ, does not directly control ghre- lin expression but inhibits it indirectly via somatostatin.展开更多
This paper studies the finite element method for some nonlinear hyperbolic partial differential equations with memory and dampling terms.A Crank\|Nicolson approximation for this kind of equations is presented.By using...This paper studies the finite element method for some nonlinear hyperbolic partial differential equations with memory and dampling terms.A Crank\|Nicolson approximation for this kind of equations is presented.By using the elliptic Ritz\|Volterra projection,the analysis of the error estimates for the finite element numerical solutions and the optimal H \+1\|norm error estimate are demonstrated.展开更多
Giant duodenal ulcers （GDUs） are a subset of duodenal ulcers that have historically resulted in greater morbidity than usual duodenal ulcers. Until recently, few cases had been successfully treated with medical ther...Giant duodenal ulcers （GDUs） are a subset of duodenal ulcers that have historically resulted in greater morbidity than usual duodenal ulcers. Until recently, few cases had been successfully treated with medical therapy. However, the widespread use of endoscopy, the introduction of H-2 receptor blockers and proton p^Jmp inhibitors, and the improvement in surgical techniques all have revolutionized the diagnosis, treatment and outcome of this condition. Nevertheless, GDUs are still associated with high rates of morbidity, mortality and complications. Thus, surgical evaluation of a patient with a GDU should remain an integral part of patient care. These giant variants, while usually benign, can frequently harbor malignancy. A careful review of the literature highlights the important differences when comparing GDUs to classical peptic ulcers and why they must be thought of differently than their more common counterpart.展开更多
The geometrical structures, relative stabilities, electronic and magnetic properties of small BnAl-（2〈n〈9）clusters are systematicalyy investigated by using the first-principles density functional theory. The resul...The geometrical structures, relative stabilities, electronic and magnetic properties of small BnAl-（2〈n〈9）clusters are systematicalyy investigated by using the first-principles density functional theory. The results show that the A1 atom prefers to reside either on the outer-side or above the surface, but not in the centre of the clusters in all of the most stable BnAl-（2〈n〈9） isomers and the one excess electron is strong enough to modify the geometries of some specific sizes of the neutral clusters. All the results of the analysis for the fragmentation energies, the second-order difference of energies, and the highest occupied-lowest unoccupied molecular orbital energy gaps show that B4A1- and B8A1- clusters each have a higher relative stability. Especially, the BsA1-cluster has the most enhanced chemical stability. Furthermore, both the local magnetic moments and the total magnetic moments display a pronounced oddeven oscillation with the number of boron atoms, and the magnetic effects arise mainly from the boron atoms except for the B7A1- and BgA1- clusters.展开更多
In addition to regulating acid secretion, the gastric antral hormone gastrin regulates several important cellular processes in the gastric epithelium including proliferation, apoptosis, migration, invasion, tissue rem...In addition to regulating acid secretion, the gastric antral hormone gastrin regulates several important cellular processes in the gastric epithelium including proliferation, apoptosis, migration, invasion, tissue remodelling and angiogenesis. Elevated serum concentrations of this hormone are caused by many conditions, particularly hypochlorhydria (as a result of autoimmune or Helicobacter pylori (H pylori)-induced chronic atrophic gastritis or acid suppressing drugs) and gastrin producing tumors (gastrinomas). There is now accumulating evidence that altered local and plasma concentrations of gastrin may play a role during the development of various gastric tumors. In the absence of H pylori infection, marked hypergastrinemia frequently results in the development of gastric enterochromaffi n cell-like neuroendocrine tumors and surgery to remove the cause of hypergastrinemia may lead to tumor resolution in this condition. In animal models such as transgenic INS-GAS mice, hypergastrinemia has also been shown to act as a cofactor with Helicobacter infection during gastric adenocarcinoma development. However, it is currently unclear as to what extent gastrin also modulates human gastric adenocarcinoma development. Therapeutic approaches targeting hypergastrinemia,such as immunization with G17DT, have been evaluated for the treatment of gastric adenocarcinoma, with some promising results. Although the mild hypergastrinemia associated with proton pump inhibitor drug use has been shown to cause ECL-cell hyperplasia and to increase H pylori-induced gastric atrophy, there is currently no convincing evidence that this class of agents contributes towards the development of gastric neuroendocrine tumors or gastric adenocarcinomas in human subjects.展开更多
AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.e.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high ris...AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.e.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high risk of gastric cancer or peptic ulcer diseases.METHODS:Among 162 Japanese outpatients,pepsinogen-(Pg-)and(Pg)were measured using a conventional Japanese technique,and the European GastroPanel examination(Pg and Pg,gastrin-17 and H pylori antibodies).Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa,H pylori non-atrophic gastritis or atrophic gastritis.RESULTS:Pg-and Pg assays with the GastroPanel and the Japanese method showed a highly significant correlation.For methodological reasons,however,serum Pg-,but not Pg,was twice as high with the GastroPanel test as with the Japanese test.The biomarker assays revealed that 5%of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies.GastroPanel examination revealed an additional seven patients who had either advanced atrophic gastritis limited to the antrum or antrum-predominant H pylori gastritis.When compared to the endoscopic biopsy findings,the GastroPanel examination classified the patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy,95% sensitivity and 93% specifi city.CONCLUSION:Serum biomarker tests can be used to differentiate between subjects with healthy and diseased gastric mucosa with high accuracy.展开更多
Upper gastrointestinal tract hemorrhage （UGIH） remains a common presentation requiring urgent evaluation and treatment. Accurate assessment, appropriate intervention and apt clinical skills are needed for proper man...Upper gastrointestinal tract hemorrhage （UGIH） remains a common presentation requiring urgent evaluation and treatment. Accurate assessment, appropriate intervention and apt clinical skills are needed for proper management from time of presentation to discharge. The advent of pharmacologic acid suppression, endoscopic hemostatic techniques, and recognition of Helicobacter pylori as an etiologic agent in peptic ulcer disease （PUD） has revolutionized the treatment of UGIH. Despite this, acute UGIH still carries considerable rates of morbidity and mortality. This review aims to discuss current areas of uncertainty and controversy in the management of UGIH. Neoadjuvant proton pump inhibitor （PPI） therapy has become standard empiric treatment for UGIH given that PUD is the leading cause of non variceal UGIH, and PPIs are extremely effective at promoting ulcer healing. Howeve, neoadjuvant PPI administration has not been shown to affect hard clinical outcomes such as rebleeding or mortality. The optimal timing of upper endoscopy in UGIH is often debated. Upon completion of volume resuscitation and hemodynamic stabilization, upper endoscopy should be performed within 24 h in all patientswith evidence of UGIH for both diagnostic and therapeutic purposes. With rising healthcare cost paramount in today＇s medical landscape, the ability to appropriately triage UGIH patients is of increasing value. Upper en- doscopy in conjunction with the clinical scenario allows for accurate decision making concerning early discharge home in low risk lesions or admission for further moni toring and treatment in higher risk lesions. Concomitant pharmacotherapy with non steroidal antiinflammatory drugs （NSAIDs） and antiplatelet agents, such as clopidogrel, has a major impact on the etiology, severib/, and potential treatment of UGIH. Long term PPI use in patients taking chronic NSAIDs or clopidogrel is discussed thoroughly in this review.展开更多
ASYMMETRIC crying facies （ACF） is characterized by facial asymmetry only when crying. It may present as an exclusive symptom, or be con-comitant with other congenital malformations nd even some fatal birth defects. ...ASYMMETRIC crying facies （ACF） is characterized by facial asymmetry only when crying. It may present as an exclusive symptom, or be con-comitant with other congenital malformations nd even some fatal birth defects. Clinically, ACF is fea-tured by drooping of the intact corner of the mouth during crying, while the face appears symmetric at rest. The facial nerve function is symmetric, as determined by frowning, forehead wrinkling, eye closure, and nasolabial fold depth. When ACF alone is present, the cause is often compression of the mandibular branch of the facial nerve that is prob-ably due to birth trauma or abnormal fetal posture in utero. ACF with other congenital anomalies is usually caused by hypoplasia of the depressor anguli oris muscle （DAOM） on one side of the mouth.展开更多
AIM:To compare the costs and effectiveness of no screening and no eradication therapy, the population- based Helicobacter pylori (H pylori) serology screening with eradication therapy and 13C-Urea breath test (UBT) wi...AIM:To compare the costs and effectiveness of no screening and no eradication therapy, the population- based Helicobacter pylori (H pylori) serology screening with eradication therapy and 13C-Urea breath test (UBT) with eradication therapy. METHODS:A Markov model simulation was carried out in all 237 900 Chinese males with age between 35 and 44 from the perspective of the public healthcare provider in Singapore. The main outcome measures were the costs, number of gastric cancer cases prevented, life years saved, and quality-adjusted life years (QALYs) gained from screening age to death. The uncertainty surrounding the cost-effectiveness ratio was addressed by one-way sensitivity analyses. RESULTS:Compared to no screening, the incremental cost-effectiveness ratio (ICER) was $16 166 per life year saved or $13 571 per QALY gained for the serology screening, and $38 792 per life year saved and $32 525 per QALY gained for the UBT. The ICER was $477 079 per life year saved or $390 337 per QALY gained for the UBT compared to the serology screening. The cost- effectiveness of serology screening over the UBT was robust to most parameters in the model. CONCLUSION:The population-based serologyscreening for H pylori was more cost-effective than the UBT in prevention of gastric cancer in Singapore Chinese males.展开更多
基金supported by Victoria University of Wellington 2024 PhD Faculty Grant HSSE(Grant No.:FG-HSSE-12486).
文摘The Māori people are indigenous to Aotearoa New Zealand,and their language and culture are considered vital components of the nation’s cultural heritage.However,Te Reo Māori is regarded as a lowresource language outside of New Zealand,and its literary works usually rely on English as a pivot language for translation and communication.Therefore,in the process of promoting Māori literature as part of world literature by translating it into non-English languages,the accurate translation of cultural keywords is crucial to prevent dilemmas such as information loss and cultural misappropriation.In this article,we aim to explore effective translation strategies to enhance the international visibility and readership of Māori literature by analysing the rendition of Māori cultural keywords in the Chinese translation of“The Whale Rider”.
文摘1 The Haka,a traditional war dance of the Māori people,exhibits the history,strength and spirit of New Zealand.It is an art form that has been carefully preserved and handed down through generations,maintaining its cultural significance and impact from ancient times to modern‑day performances in diverse settings such as sports events and wedding ceremonies.
文摘Language is an important carrier of human culture and a specific method for communication between humans.It is one of the most important symbols of human identity and flags of dividing group identity.At present,in the modern national state,the government is paying more attention to language policy and being more and more prudent to it.In the process of making and implementing language policy,the government must take into account a range of factors such as the country’s national history,politics,culture,economy,and relations between different social groups.From the mid-nineteenth century,when New Zealand became a British colony,until the mid-twentieth century,the Maori people were inspired to defend their rights and respect for themselves by the rise of Maori nationalist ideology and Maori political radicalism in a struggle that lasted more than 100 years.Until 1994,there were more than 800 kohanga reo,early childhood institutions that established Maori language instruction independent of the school system,and the nationalism drives to revitalize the Maori national language was at its peak.The process of revolution on Maori language policies in New Zealand reflects a trend of nationalist thoughts from Maori becoming more deep.Exploring the process of change in New Zealand’s Maori language policy will help to develop the study of the social history of indigenous peoples during the colonial period and will contribute to the study of the development of colonized countries and regions in the post-colonial period.The change in New Zealand’s Maori language policy has provided an important example of the preservation and revitalization of the indigenous languages of the world’s former colonies,which is of great significance for the preservation of linguistic and cultural diversity.
基金Supported by The Danish MRC Grant271-08-0378(LFH)the ALF grant(TW)The Lundbeck foundation(KBVD)
文摘AIM- To investigate if and how the proinflammatory cytokine interferon γ （IFNγ） affects ghrelin expression in mice. METHODS： The plasma concentration of ghrelin, and gastric ghrelin and somatostatin expression, were ex- amined in wild-type mice and mice infected with Helico- bacter pylori （H. pylorO. Furthermore, ghrelin expression was examined in two achlorhydric mouse models with varying degrees of gastritis due to bacterial overgrowth. To study the effect of IFNγ, alone, mice were given a subcutaneous infusion of IFNγ, for 7 d. Finally, the influ- ence of IFNγ, and somatostatin on the ghrelin promoter was characterized. RESULTS： H. py/ori infection was associated with a 50% reduction in ghrelin expression and plasma concentration. Suppression of ghrelin expression was in- versely correlated with gastric inflammation in achlorh- dyric mouse models. Subcutaneous infusion of IFNγ, suppressed fundic ghrelin mRNA expression and plasma ghrelin concentrations. Finally, we showed that the ghrelin promoter operates under the control of soma- tostatin but not under that of IFNγ. CONCLUSION： Gastric infection and inflammation is associated with increased IFNγ, expression and reduced ghrelin expression. IFNγ, does not directly control ghre- lin expression but inhibits it indirectly via somatostatin.
文摘This paper studies the finite element method for some nonlinear hyperbolic partial differential equations with memory and dampling terms.A Crank\|Nicolson approximation for this kind of equations is presented.By using the elliptic Ritz\|Volterra projection,the analysis of the error estimates for the finite element numerical solutions and the optimal H \+1\|norm error estimate are demonstrated.
文摘Giant duodenal ulcers （GDUs） are a subset of duodenal ulcers that have historically resulted in greater morbidity than usual duodenal ulcers. Until recently, few cases had been successfully treated with medical therapy. However, the widespread use of endoscopy, the introduction of H-2 receptor blockers and proton p^Jmp inhibitors, and the improvement in surgical techniques all have revolutionized the diagnosis, treatment and outcome of this condition. Nevertheless, GDUs are still associated with high rates of morbidity, mortality and complications. Thus, surgical evaluation of a patient with a GDU should remain an integral part of patient care. These giant variants, while usually benign, can frequently harbor malignancy. A careful review of the literature highlights the important differences when comparing GDUs to classical peptic ulcers and why they must be thought of differently than their more common counterpart.
基金supported by the National Natural Science Foundation of China (Grant Nos. 10974139 and 10964002) the Doctoral Program Foundation of the Institution of Higher Education of China (Grant No. 20050610010)
文摘The geometrical structures, relative stabilities, electronic and magnetic properties of small BnAl-（2〈n〈9）clusters are systematicalyy investigated by using the first-principles density functional theory. The results show that the A1 atom prefers to reside either on the outer-side or above the surface, but not in the centre of the clusters in all of the most stable BnAl-（2〈n〈9） isomers and the one excess electron is strong enough to modify the geometries of some specific sizes of the neutral clusters. All the results of the analysis for the fragmentation energies, the second-order difference of energies, and the highest occupied-lowest unoccupied molecular orbital energy gaps show that B4A1- and B8A1- clusters each have a higher relative stability. Especially, the BsA1-cluster has the most enhanced chemical stability. Furthermore, both the local magnetic moments and the total magnetic moments display a pronounced oddeven oscillation with the number of boron atoms, and the magnetic effects arise mainly from the boron atoms except for the B7A1- and BgA1- clusters.
基金Supported by Wellcome Trust Clinical Research Training Fellowship to MDB
文摘In addition to regulating acid secretion, the gastric antral hormone gastrin regulates several important cellular processes in the gastric epithelium including proliferation, apoptosis, migration, invasion, tissue remodelling and angiogenesis. Elevated serum concentrations of this hormone are caused by many conditions, particularly hypochlorhydria (as a result of autoimmune or Helicobacter pylori (H pylori)-induced chronic atrophic gastritis or acid suppressing drugs) and gastrin producing tumors (gastrinomas). There is now accumulating evidence that altered local and plasma concentrations of gastrin may play a role during the development of various gastric tumors. In the absence of H pylori infection, marked hypergastrinemia frequently results in the development of gastric enterochromaffi n cell-like neuroendocrine tumors and surgery to remove the cause of hypergastrinemia may lead to tumor resolution in this condition. In animal models such as transgenic INS-GAS mice, hypergastrinemia has also been shown to act as a cofactor with Helicobacter infection during gastric adenocarcinoma development. However, it is currently unclear as to what extent gastrin also modulates human gastric adenocarcinoma development. Therapeutic approaches targeting hypergastrinemia,such as immunization with G17DT, have been evaluated for the treatment of gastric adenocarcinoma, with some promising results. Although the mild hypergastrinemia associated with proton pump inhibitor drug use has been shown to cause ECL-cell hyperplasia and to increase H pylori-induced gastric atrophy, there is currently no convincing evidence that this class of agents contributes towards the development of gastric neuroendocrine tumors or gastric adenocarcinomas in human subjects.
文摘AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.e.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high risk of gastric cancer or peptic ulcer diseases.METHODS:Among 162 Japanese outpatients,pepsinogen-(Pg-)and(Pg)were measured using a conventional Japanese technique,and the European GastroPanel examination(Pg and Pg,gastrin-17 and H pylori antibodies).Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa,H pylori non-atrophic gastritis or atrophic gastritis.RESULTS:Pg-and Pg assays with the GastroPanel and the Japanese method showed a highly significant correlation.For methodological reasons,however,serum Pg-,but not Pg,was twice as high with the GastroPanel test as with the Japanese test.The biomarker assays revealed that 5%of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies.GastroPanel examination revealed an additional seven patients who had either advanced atrophic gastritis limited to the antrum or antrum-predominant H pylori gastritis.When compared to the endoscopic biopsy findings,the GastroPanel examination classified the patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy,95% sensitivity and 93% specifi city.CONCLUSION:Serum biomarker tests can be used to differentiate between subjects with healthy and diseased gastric mucosa with high accuracy.
文摘Upper gastrointestinal tract hemorrhage （UGIH） remains a common presentation requiring urgent evaluation and treatment. Accurate assessment, appropriate intervention and apt clinical skills are needed for proper management from time of presentation to discharge. The advent of pharmacologic acid suppression, endoscopic hemostatic techniques, and recognition of Helicobacter pylori as an etiologic agent in peptic ulcer disease （PUD） has revolutionized the treatment of UGIH. Despite this, acute UGIH still carries considerable rates of morbidity and mortality. This review aims to discuss current areas of uncertainty and controversy in the management of UGIH. Neoadjuvant proton pump inhibitor （PPI） therapy has become standard empiric treatment for UGIH given that PUD is the leading cause of non variceal UGIH, and PPIs are extremely effective at promoting ulcer healing. Howeve, neoadjuvant PPI administration has not been shown to affect hard clinical outcomes such as rebleeding or mortality. The optimal timing of upper endoscopy in UGIH is often debated. Upon completion of volume resuscitation and hemodynamic stabilization, upper endoscopy should be performed within 24 h in all patientswith evidence of UGIH for both diagnostic and therapeutic purposes. With rising healthcare cost paramount in today＇s medical landscape, the ability to appropriately triage UGIH patients is of increasing value. Upper en- doscopy in conjunction with the clinical scenario allows for accurate decision making concerning early discharge home in low risk lesions or admission for further moni toring and treatment in higher risk lesions. Concomitant pharmacotherapy with non steroidal antiinflammatory drugs （NSAIDs） and antiplatelet agents, such as clopidogrel, has a major impact on the etiology, severib/, and potential treatment of UGIH. Long term PPI use in patients taking chronic NSAIDs or clopidogrel is discussed thoroughly in this review.
文摘ASYMMETRIC crying facies （ACF） is characterized by facial asymmetry only when crying. It may present as an exclusive symptom, or be con-comitant with other congenital malformations nd even some fatal birth defects. Clinically, ACF is fea-tured by drooping of the intact corner of the mouth during crying, while the face appears symmetric at rest. The facial nerve function is symmetric, as determined by frowning, forehead wrinkling, eye closure, and nasolabial fold depth. When ACF alone is present, the cause is often compression of the mandibular branch of the facial nerve that is prob-ably due to birth trauma or abnormal fetal posture in utero. ACF with other congenital anomalies is usually caused by hypoplasia of the depressor anguli oris muscle （DAOM） on one side of the mouth.
文摘AIM:To compare the costs and effectiveness of no screening and no eradication therapy, the population- based Helicobacter pylori (H pylori) serology screening with eradication therapy and 13C-Urea breath test (UBT) with eradication therapy. METHODS:A Markov model simulation was carried out in all 237 900 Chinese males with age between 35 and 44 from the perspective of the public healthcare provider in Singapore. The main outcome measures were the costs, number of gastric cancer cases prevented, life years saved, and quality-adjusted life years (QALYs) gained from screening age to death. The uncertainty surrounding the cost-effectiveness ratio was addressed by one-way sensitivity analyses. RESULTS:Compared to no screening, the incremental cost-effectiveness ratio (ICER) was $16 166 per life year saved or $13 571 per QALY gained for the serology screening, and $38 792 per life year saved and $32 525 per QALY gained for the UBT. The ICER was $477 079 per life year saved or $390 337 per QALY gained for the UBT compared to the serology screening. The cost- effectiveness of serology screening over the UBT was robust to most parameters in the model. CONCLUSION:The population-based serologyscreening for H pylori was more cost-effective than the UBT in prevention of gastric cancer in Singapore Chinese males.
