Serum selenium and colonic neoplastic risk

BACKGROUND: Selenium deficiency has been associated with cancer risk in several organs. This association was investigated in neoplasia of the colorectum. DESIGN: A case-control study is reported with two patient series, colorectal cancer and colorectal adenomatous polyps, and a control group found to be free of colorectal neoplasia. Diagnosis was determined by colonoscopy and histologic review of suspected neoplasms. Serum drawn at the time of colonoscopy was subsequently assayed for selenium content, and quartiles based on selenium were defined. Crude and adjusted odds ratios with 95 percent confidence intervals for adenoma related to selenium were calculated, controlling for known or suspected risk factors including gender, age, race, body mass index, family history, tobacco use, alcohol consumption, serum beta carotene, serum alpha tocopherol, and serum ferritin. RESULTS: There were 138 controls who had no neoplastic disease, 139 adenoma patients, and 25 cancer patients. For adenoma,comparing higher quartiles of selenium to the first (lowest selenium), the adjusted odds ratio for the second quartile was 1.7 (95 percent confidence interval, 0.8–3.7), the third quartile was 1.4 (0.7–3.2), and the fourth (highest selenium) quartile was 1.8 (0.9–4). The odds ratios for cancer patients were 0.8 for the second quartile, 1 for the third quartile, and 1.7 for the fourth quartile. CONCLUSION: No trend could be detected toward a protective effect of higher levels of serum selenium for colonic benign or malignant tumors.Supported by grants from The American Society of Colon and Rectal Surgeons Research Foundation, the Department of Clinical Investigation of Walter Reed Army Medical Center, and Public Health Service Grant CA 36978.Address reprint requests to Dr. Nelson: 1740 West Taylor, Room 2204, M/C 957, Chicago, Illinois 60612.     

The prevalence of nonalcoholic fatty liver disease in Chinese adults screened by vibration controlled transient elastography and its diagnostic discrepancy compared with ultrasound

BackgroundThe prevalence of non-alcoholic fatty liver disease (NAFLD) in China as assessed using vibration-controlled transient elastography (VCTE) and its consistency with ultrasound is still unknown. We aimed to conduct a head-to-head comparison of consecutive measurements of NAFLD with ultrasound or VCTE to evaluate the discrepancy in the prevalence and distribution of NAFLD screened by two non-invasive techniques.MethodsWe collected VCTE and ultrasound examination data from 4,388 participants who underwent health check-ups at the Health Promotion Center of Jiangsu Province Hospital between January 2017 and December 2019. The major outcome was the presence of hepatic steatosis, which was defined as a median controlled attenuation parameter (CAP) ≥ 248 dB/m by VCTE or the definition of steatosis by ultrasound.ResultsAmong the 4,388 participants, 2,214 were diagnosed with NAFLD by VCTE (CAP ≥ 248 dB/m, 50.46%). Participants with severe steatosis (CAP ≥ 280 dB/m) were commonly male (77.94% vs. 50.38%, P < 0.001), were obese (45.09% vs. 1.79%, P < 0.001), had a worse metabolic profile, had elevated liver enzyme levels, and had advanced fibrosis. The prevalence of ultrasound-diagnosed NAFLD was 56.42%. After consistency analysis, VCTE and ultrasound showed moderate agreement regarding the diagnosis of NAFLD (κ = 0.475). We then compared the characteristics and clinical features of the four groups classified by the diagnosis results of the two techniques. NAFLD participants diagnosed by VCTE only were older, more obese, and had worse metabolic and biochemical profiles than NAFLD participants diagnosed by ultrasound only; in particular, the former had a higher proportion of abnormal alanine aminotransferase and aspartate aminotransferase levels and a higher proportion of advanced fibrosis than the latter.ConclusionsMore than half of Chinese adults were affected by NAFLD according to VCTE. Screening based on VCTE is more likely to identify NAFLD patients with severe clinical features than ultrasound. Therefore, VCTE is a more practical non-invasive tool for the screening and follow-up of NAFLD in China.     

Variants of Interleukin-7/Interleukin-7 Receptor Alpha are Associated with Both Neuromyelitis Optica and Multiple Sclerosis Among Chinese Han Population in Southeastern China

Background:

Neuromyelitis optica (NMO) and multiple sclerosis (MS) are autoimmune demyelinating diseases of the central nerve system. Interleukin-7 (IL-7) and interleukin-7 receptor alpha (IL-7Rα) were proved to be important in the pathogenesis of both diseases because of the roles they played in the differentiations of autoimmune lymphocytes. The variants of both genes had been identified to be associated with MS susceptibility in Caucasian, Japanese and Korean populations. However, the association of these variants with NMO and MS has not been well studied in Chinese Southeastern Han population. Here, we aimed to evaluate the association of six IL-7 variants (rs1520333, rs1545298, rs4739140, rs6993386, rs7816065, and rs2887502) and one variant of IL-7RA (rs6897932) with NMO and MS among Chinese Han population in southeastern China.

Methods:

Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MassARRAY system) and Sanger sequencing were used to determine the variants of IL-7 and IL-7RA in 167 NMO patients, 159 MS patients and 479 healthy controls among Chinese Han population in southeastern China. Samples were excluded if the genotyping success rate <90%.

Results:

Statistical differences were observed in the genotypes of IL-7 rs1520333 in MS patients and IL-7RA rs6897932 in NMO patients, compared with healthy controls (P = 0.035 and 0.034, respectively). There was a statistically significant difference in the genotypes of IL-7 rs2887502 between MS and NMO patients (P = 0.014). And there were statistically significant differences in the rs6897932 genotypes (P = 0.004) and alleles (P = 0.042) between NMO-IgG positive patients and healthy controls.

Conclusions:

The study suggested that among Chinese Han population in southeastern China, the variant of IL-7RA (rs6897932) was associated with NMO especially NMO-IgG positive patients while the variant of IL-7 (rs1520333) with MS patients. And the genotypic differences of IL-7 rs2887502 between MS and NMO indicated the different genetic backgrounds of these two diseases.     

Severe α1-antitrypsin deficiency (PiZ homozygosity) with membranoproliferative glomerulonephritis and nephrotic syndrome, reversible after orthotopic liver transplantation

Background/Aims: Nephropathy associated with α₁-antitrypsin deficiency is assumed to be an unusual entity. We describe the case of a 23-year-old woman with severe α₁-antitrypsin (PiZ homozygosity) deficiency who developed hepatic cirrhosis in childhood, and glomerulonephritis and nephrotic syndrome in adult life.Methods/Results: A renal biopsy was consistent with membranosproliferative glomerulophritis. An immunofluorescence study revealed the presence of α₁-anti-trypsin (PiZ) in the subendothelial region of the glomerular basement membrane. The renal disease was reversible after orthotopic liver transplantation.Conclusions: The presence of abnormal PiZ protein in the subendothelial region of the glomerular basement membrane may suggest a possible role for this protein in the pathogenesis of glomerulonephritis. The case should add impetus to the search for α₁-antitrypsin deficiency in any patient presenting with combined liver and renal disease, in the absence of evidence of hepato-renal syndrome, and illustrates that liver transplantation alone may reverse the neophropathy associated with α₁-antitrypsin deficiency.     

Renal tumor with alpha b crystallin expression

In human, proximal convoluted tubules and thin limbs of Henle show expression of αB crystallin. Renal cell carcinoma also showed expression of αB crystallin in previous reports. We aimed to study the association between αB crystallin expression and renal cell carcinoma and urothelial carcinoma. Furthermore, we also investigated αB crystallin expression depending on the subtype of renal cell carcinoma and examined the relationship between αB crystallin expression and survival in patients with renal cell carcinoma. In our study, αB crystallin expression was different according to the type of tumor. A greater proportion of the clear cell type (52/77, 67.5%) and papillary type (4/4, 100%) showed reactivity compared to the chromophobe type (0/10, 0%). In the present study, a significantly greater number of renal cell carcinomas showed strong expression of αB crystallin (56/91, 61.5%) compared to urothelial carcinoma (P=7.967e-07). Therefore, αB crystallin might be a significant marker of renal cell carcinoma and might help to determine the type of renal tumor in cases of poorly differentiated kidney lesions and metastatic lesions. αB crystallin expression was not related to overall survival in univariate and multivariate models. In our study, alpha B crystallin could not be considered a prognostic marker of renal cell carcinoma.     

盐酸多柔比星脂质体治疗晚期肝细胞癌的临床研究

目的探讨盐酸多柔比星脂质体治疗晚期肝细胞癌的临床疗效。方法选取2017年1月—2018年3月在东莞市人民医院接受治疗的93例晚期肝细胞癌患者,随机分成对照组46例和治疗组47例。两组患者均接受TACE治疗,对照组术中使用盐酸多柔比星注射液,治疗组使用盐酸多柔比星脂质体注射液,每日20mg/m2。两组患者均接受1次治疗。观察两组的临床疗效,比较两组治疗前后肿瘤最大直径、Child-Pugh评分和甲胎蛋白的变化情况。结果治疗后,对照组和治疗组的总有效率分别是54.35%、74.47%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者肿瘤最大直径、Child-Pugh评分、甲胎蛋白显著下降,同组治疗前后比较差异有统计学意义(P0.05);治疗后,治疗组肿瘤最大直径、Child-Pugh评分和甲胎蛋白显著低于对照组,两组比较差异具有统计学意义(P0.05)。对照组和治疗组的生存率分别是32.61%、42.55%,两组比较差异有统计学意义(P0.05)。结论脂质体多柔比星治疗肝细胞癌晚期临床效果明显,能够有效减少肿瘤直径、改善肝功能,降低甲胎蛋白水平,具有一定的临床推广应用价值。     

Estrogen Receptor Alpha Expression and Liver Fibrosis in Chronic Hepatitis C Virus Genotype 1b: A Clinicopathological Study

Background:

Hepatic damage due to chronic hepatitis C virus (HCV) genotype 1b infection varies widely.

Objectives:

We aimed to investigate whether estrogen receptor alpha (ERα) plays a role in liver fibrosis in patients infected with HCV genotype 1b.

Patients and Methods:

All the consecutive patients who received the same standard treatment protocol for HCV genotype 1b were subdivided into two subgroups according to their fibrosis scores as fibrotic stages < 2 in mild fibrosis group and fibrotic stages ≥ 2 in advanced fibrosis group, depending on the presence of septal fibrosis. ERα was stained in liver biopsy specimens. Demographics and clinical properties were compared between the groups. Multivariate logistic regression analysis was performed to predict advanced fibrosis.

Results:

There were 66 patients in the mild fibrosis group and 24 in the advanced fibrosis group. Among the mild and advanced fibrosis groups, 65.1% and 50%were female, respectively (P = 0.19). There was an inverse correlation between ERα and fibrotic stage (r: -0.413; P < 0.001). Age, platelet counts, neutrophil counts, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Gamma glutamyl transferase (GGT) and ERα were statistically significant in the univariate analysis. In multivariate logistic regression analyses, ERα expression continued to be an independent predicting factor of liver fibrosis in patients infected with chronic HCV genotype 1b (OR: 0.10; 95% CI: 0.018-0.586; P < 0.001).

Conclusions:

ERα expression in liver was inversely correlated with liver fibrosis among patients infected with chronic HCV genotype 1b.     

Direction of SMR and Beta Change with Attention in Adults

Introduction. The aim of this study was to clarify the interpretation of sensory-motor rhythm (SMR; 13–15 Hz) and beta (16–20 Hz) changes with respect to attention states.

Method. For this purpose, EEG was recorded from 11 participants during (a) a multiple object tracking task (MOT), which required externally directed attention; (b) the retention phase of a visuo-spatial memory task (VSM), which required internally directed attention and avoidance of sensory distraction; and (c) the waiting intervals between trials, which constituted a no-task-imposed control condition. The 2 active tasks were consecutively presented at 2 difficulty levels (i.e., easy and hard). Two analyses of variance were conducted on EEG log spectral amplitudes in the alpha (8–12 Hz), SMR, and beta bands from F3, F4, C3, C4 and P3, P4.

Results. The first 15 analysis compared the MOT to the VSM by difficulty levels and revealed a significant task effect (p < .0005) but no effect of difficulty. The results showed that externally directed attention (MOT) resulted in lower values than internally directed attention (VSM) in all three bands. The second analysis averaged the difficulty levels together and added the no-task-imposed reference condition. The results again showed a significant task effect that did not interact with site, hemisphere, or, more important, band. Post hoc tests revealed that both MOT and VSM produced significantly smaller means than the no-task-imposed condition. This pattern of log-amplitude means and the lack of task interaction with any other factor indicate that task-induced attention reduces EEG power in the same proportion across the 3 bands and the 6 channels studied.

Conclusions. These results contradict a frequent interpretation concerning the relationship between the brain's aptitude to increase low beta in neurofeedback programs and improved sustain attention capacities.