Background/Aims: Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients. Methods: We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development. Results: Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients. Conclusions Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.

Most of the active ingredients of herbs are secondary metabolites of plants. Cytochrome P450s (P450s) are hemoglobin-containing monooxygenases encoded by a super-gene family, which play important roles in the metabolic network of plants. This review focuses on the role of P450s on biosynthesis of secondary metabolites such as terpenoids, alkaloids, flavonoids and phenylpropanoids. This will provide references for biosynthesis and regulation of secondary metabolites in medicinal plants.

OBJECTIVE: To explore the changes in bone height of the maxillary sinus floor at different sinus ridge heights after transcrestal sinus floor elevation (tSFE) with the simultaneous implantation of short implants. METHODS: A total of 74 Bicon short implants were implanted into 37 patients during the same period of maxillary sinus elevation. The residual bone height (RBH)<4 mm group has 43 sites, and the RBH≥4 mm group has 31 sites. After 5 years of follow-up observation, the implant survival rate and the change in bone height achieved in the maxillary sinus over time were measured and analyzed via clinical examination and X-ray imaging. RESULTS: In the 74 implantation sites, the elevation height of the sinus floor was (6.64±1.32) mm and the bone height of the sinus floor was (3.35±1.29) mm 5 years after loading. No statistical difference was observed in the bone resorption of the implant neck between the RBH<4 mm and RBH≥4 mm groups. Meanwhile, a statistical difference was noted in the bone height obtained in the maxillary sinus between the two groups. CONCLUSIONS When RBH in the maxillary posterior tooth area was <4 mm, the simultaneous implantation of Bicon short implants with tSFE can achieve a high implant survival rate and bone gain in the maxillary sinus, but does not increase the absorption of the alveolar ridge bone.
Dental Implantation, Endosseous ; Dental Implants ; Humans ; Maxilla ; Maxillary Sinus/surgery* ; Retrospective Studies ; Sinus Floor Augmentation ; Treatment Outcome

Objective: To explore the relationship between plasma levels of soluble ST2 (sST2), galectin-3 (Gal-3) and clinical prognosis of ventricular septal myectomy in patients with obstructive hypertrophic cardiomyopathy (HOCM). Methods: A total of 200 consecutive HOCM patients received modified Morrow surgery in our hospital from 2011-03 to 2016-02 were studied. According to plasma levels of sST2, patients were divided into 3 groups: Low sST2 group (sST2<9.05 ng/ml), Middle sST2 group (sST2 9.05-16.74 ng/ml) and High sST2 group (sST2>16.74 ng/ml); based on plasma levels of Gal-3, patients were divided into another 3 groups: Low Gal-3 group (Gal-3<6.19 ng/ml), Middle group (Gal-3 6.19-8.22 ng/ml) and High Gal-3 group (Gal-3>8.22 ng/ml); in addition, Control group, n=42 volunteers without heart disease. Plasma levels of sST2 and Gal-3 were measured by ELISA, compared between Control group and HOCM group (n=42 patients with matched gender and age to Control group). The predictive value of sST2 and Gal-3 on major endpoint events including all cause death or cardiovascular hospitalization were assessed by Cox regression analysis.Results: Compared with Control group, plasma levels of sST2 and Gal-3 were increased in HOCM patients, P<0.01. The patients were followed-up for the average of 26 months, Kaplan-meier survival analysis showed that the incidences of composite endpoint event were similar at different levels of sST2 and Gal-3 (log-rank P=0.06 and P=0.68). Cox regression analysis indicated that either sST2 or Gal-3 could not independently predict the endpoint events, both P>0.05, while age was an independent risk factor for composite endpoint event occurrence (HR=1.06, 95% CI 1.02-1.11, P<0.01). Conclusion: Plasma levels of sST2 and Gal-3 were not related to clinical prognosis of ventricular septal myectomy in HOCM patients even they had increased sST2 and Gal-3; while advanced age was the independent predictor for endpoint event occurrence.

Objective To investigate the clinical improving effect on the symptoms of acupuncture at point Weizhong(BL40) plus following lumbar vertebra-stabilizing core muscle group training in patients with lumbar intervertebral disc herniation. Method Sixty patients with lumbar intervertebral disc herniation were randomized to a treatment group (30 cases) and a control group (30 cases). The treatment group received acupuncture at point Weizhong plus following lumbar vertebra-stabilizing core muscle group training and the control group, oral administration of celecoxib capsules. After treatment, the clinical improving effect on the symptoms was evaluated in the patients using the NRS, JOA Lumbar Scoring and ODI. Result The total efficacy rate was 100% in the treatment group and 53.3%in the control group. Post-treatment NRS, JOA and ODI scores were better in the treatment group than in the control group; there were statistically significant differences (P<0.001). Conclusion Acupuncture at point Weizhong plus following lumbar vertebra-stabilizing core muscle group training can effectively treat lumbar intervertebral disc herniation.

OBJECTIVETo investigate the risk factors for the development of congenital anal atresia in neonates.

METHODSA total of 70 neonates who were admitted to 17 hospitals in Foshan, China from January 2011 to December 2014 were enrolled as case group, and another 70 neonates who were hospitalized during the same period and had no anal atresia or other severe deformities were enrolled as control group. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for the development of congenital anal atresia.

RESULTSThe univariate analysis revealed that the age of mothers, presence of oral administration of folic acid, infection during early pregnancy, and polyhydramnios, and sex of neonates showed significant differences between the case and control groups (P<0.05). The multivariate logistic regression analysis revealed that infection during early pregnancy (OR=18.776) and male neonates (OR=9.304) were risk factors for congenital anal atresia, and oral administration of folic acid during early pregnancy was the protective factor (OR=0.086).

CONCLUSIONSInfection during early pregnancy is the risk factor for congenital anal atresia, and male neonates are more likely to develop congenital anal atresia than female neonates. Supplementation of folic acid during early pregnancy can reduce the risk of congenital anal atresia.

Anus, Imperforate ; etiology ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Pregnancy ; Risk Factors

OBJECTIVETo investigate the effect of short hairpin RNA (shRNA) and XAV939, a specific inhibitor for β-catenin, on growth and apoptosis of mantle cell lymphoma(MCL) Jeko-1 cell line.

METHODSβ-catenin shRNA eukaryotic expression vector was transfected into Jeko-1 cells, the antiproliferative effect of shRNA on Jeko-1 cells was detected by RT-PCR and Western blot. The proliferation inhibitory rate of Jeko-1 cells treated by different doses of XAV939 was assayed by MTT method; the level of apoptosis of Jeko-1 cells was detected by flow cytometry; the expression levels of apoptosis-related protein BCL-2, BAX, CyclinD1, C-MYC and Caspase-3 in Jeko-1 cells were determined by Western blot.

RESULTSThe expression of β-catenin mRNA and growth of Jeko-1 cell line were inhibited by shRNA; after Jeko-1 cells treated with 0,2 and 8 µmol/L XAV939 for 48 hours, the cell proliferation rate decreased, while the cell apoptosis rate increased, the expressions of apoptosis-related protein BCL-2, CyclinD1 and C-MYC were down-regulated, on the contrary, the expression of BAX and caspase-3 were up-regulated.

CONCLUSIONThe specific inhibition of β-catenin can inhibit Jeko-1 cell proliferation and promote the cell apoptosis.

Apoptosis ; Caspase 3 ; Cell Line, Tumor ; Cell Proliferation ; Heterocyclic Compounds, 3-Ring ; Humans ; Lymphoma, Mantle-Cell ; RNA, Messenger ; RNA, Small Interfering ; Transfection ; beta Catenin

OBJECTIVEThis study was purposed to detect the expressions of β-catenin and P-GSK-3 β in Wnt signaling pathway of patients with mantle cell lymphoma(MCL), and investigate its relationship with the pathogenesis of MCL.

METHODSThe expression levels of β -catenin protein and P-GSK-3 protein in mantle cell lymphoma and hyperplastic lymphadenitis were detected by using anti-β-catenin, P-GSK-3β polyclonal antibody and S-P staining technique.

RESULTSThe abnormal expression of β-catenin protein(73.33%) in mantle cell lymphoma group was significantly higher than that (6.7%) in reactive lymph node hyperplasia group (P<0.05); and the positive rate of P-GSK-3 β(66.67%) in mantle cell lymphoma group was significantly higher than that (16.67%) in reactive hyperplasia of lymph node group (P<0.05). Spearman correlation analysis showed that there was obvious positive correlation (R=0.852, P<0.01).

CONCLUSIONThe abnormal high expressions of β-catenin and P-GSK-3 β protein have been confirmed to appeare in mantle cell lymphoma.

Glycogen Synthase Kinase 3 ; Glycogen Synthase Kinase 3 beta ; Humans ; Lymphoma, Mantle-Cell ; Signal Transduction ; Wnt Signaling Pathway ; beta Catenin

OJBECTIVETo investigate the predictive value of the qualitative assessment of general movements (GMs) for adverse outcomes at 24 months of age in full-term infants with asphyxia.

METHODSA total of 114 full-term asphyxiated infants, who were admitted to the neonatal intensive care unit between 2009 and 2012 and took part in follow-ups after discharge were included in the study. All of them received the qualitative assessment of GMs within 3 months after birth. The development quotient was determined with the Bayley Scales of Infant Development at 24 months of age.

RESULTSThe results of the qualitative assessment of GMs within 3 months after birth showed that among 114 infants, 20 (17.5%) had poor repertoire movements and 7 (6.1%) had cramped-synchronized movements during the writhing movements period; 8 infants (7.0%) had the absence of fidgety movements during the fidgety movements period. The results of development quotient at 24 months of age showed that 7 infants (6.1%) had adverse developmental outcomes: 6 cases of cerebral palsy and mental retardation and 1 case of mental retardation. There was a poor consistency between poor repertoire movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=-0.019; P>0.05). There was a high consistency between cramped-synchronized movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=0.848; P<0.05), and the results of predictive values of cramped-synchronized movements were shown as follows: predictive validity 98.2%, sensitivity 85.7%, specificity 99.1%, positive predictive value 85.7%, and negative predictive value 99.1%. There was a high consistency between the absence of fidgety movements during the fidgety movements period and the developmental outcomes at 24 months of age (Kappa=0.786; P<0.05), and its predictive values were expressed as follows: predictive validity 97.4%, sensitivity 85.7%, specificity 98.1%, positive predictive value 75.0%, and negative predictive value 99.1%.

CONCLUSIONSCramped-synchronized movements and absence of fidgety movements can predict adverse developmental outcomes at 24 months of age in full-term infants with asphyxia.

Asphyxia Neonatorum ; physiopathology ; Child Development ; Humans ; Infant ; Infant, Newborn ; Movement ; Predictive Value of Tests ; Qualitative Research

The present study was designed to investigate the chemical constituents and bioactivities of the roots of Liriope muscari (Decne.) L.H. Bailey. The compounds were isolated through various chromatography techniques, including silica gel, Sephadex LH-20, and semi-preparative HPLC. The structures were elucidated by infrared (IR), mass spectrometric (MS), 1D- and 2D-NMR analyses in comparison with reference data. In addition, the cytotoxicity of these compounds against human breast cancer MDA-MB-435 cells was evaluated by the MTT assay. Two new steroidal glycosides, 25(R, S)-ruscogenin-1-O-[β-D-fucopyranosyl (1→2)]-[β-D-xylopyranosyl(1→3)]β-D-glucopyranoside (Liriopem I, 1) and 25(R, S)- ruscogenin-1-O-[β-D-fucopyranosyl (1→2)]-[β-D-xylopyranosyl(1→4)]-β-D-fucopyranoside (Liriopem II, 2 and two known compounds LM-S6 (3) and DT-13 (4) were isolated and identified. Liriopem I(1), liriopem II(2) and DT-13 (4) showed remarkable cytotoxicity with IC50 values being (0.58 ± 0.08), (0.05 ± 0.10), and (0.15 ± 0.09) μg·mL(-1), respectively. In summary, compounds 1 and 2 identified in the present study exerted cytotoxicity against breast cancer cells, providing a basis for future development of these compounds as novel anticancer agents.
Cell Line, Tumor ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; toxicity ; Glycosides ; chemistry ; isolation & purification ; toxicity ; Humans ; Liriope Plant ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Roots ; chemistry