Prevalence of fatty liver disease and its risk factors in the population of South China

AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province,China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province,China. Questionnaires,designed by co-working of epidemiologists and hepatologists,included demographic characteristics,current medication use,medical history and health-relevant behaviors,i.e. alcohol consumption,smoking habits,dietary habits and physical activities. Anthropometric measurements,biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects,609 (17.2%) were diagnosed having FLD (18.0% males,16.7% females,P > 0.05). Among them,the prevalence of confirmed alcoholic liver disease (ALD),suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%,1.8%,and 15.0%,respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age,gender and residency,the standardized prevalence of FLD in adults was 14.5%. Among them,confirmed ALD,suspected ALD and NAFLD were 0.5%,2.3%,and 11.7%,respectively,in adults and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%,P < 0.001). However,the opposite phenomenon was found over the age of 50 years (20.6% vs 27.6%,P < 0.05). Multivariate and logistic regression analysis indicated that male gender,urban residency,low education,high blood pressure,body mass index,waist circumference,waist to hip ratio,serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD,especially NAFLD,is prevalent in South China. There are many risk factors for FLD.

Association of Fusobacterium nucleatum infection with colorectal cancer in Chinese patients

AIM: To investigate Fusobacterium nucleatum(F. nucleatum) abundance in colorectal cancer(CRC) tissues and its association with CRC invasiveness in Chinese patients.METHODS: The resected cancer and adjacent normal tissues(10 cm beyond cancer margins) from 101 consecutive patients with CRC were collected. Fluorescent quantitative polymerase chain reaction(FQ-PCR) was applied to detect F. nucleatum in CRC and normal tissues. The difference of F. nucleatum abundance between cancer and normal tissues and the relationship of F. nucleatum abundance with clinical variables were evaluated. Fluorescence in situ hybridization(FISH) analysis was performed on 22 CRC tissues with the highest F. nucleatum abundance by FQ-PCR testing to confirm FQ-PCR results.RESULTS: The median abundance of F. nucleatum in CRC tissues [0.242(0.178-0.276)] was significantly higher than that in normal controls [0.050(0.023-0.067)](P < 0.001). F. nucleatum was over-represented in 88/101(87.1%) CRC samples. The abundance of F. nucleatum determined by 2^(-ΔCT) was significantly greater in tumor samples [0.242(0.178, 0.276)] than in normal controls [0.050(0.023, 0.067)](P < 0.001). The frequency of patients with lymph node metastases was higher in the over-abundance group [52/88(59.1%)] than in the under-abundance group [0/13(0%)](P < 0.005). No significant association of F. nucleatum with other clinico-pathological variables was observed(P > 0.05). FISH analysis also found more F. nucleatum in CRC than in normal tissues(median number 6, 25^(th) 3, 75^(th) 10 vs 2, 25^(th) 1, 75^(th) 5)(P < 0.01).CONCLUSION: F. nucleatum was enriched in CRC tissues and associated with CRC development and metastasis.

Gastric cancer stem cells in gastric carcinogenesis,progression,prevention and treatment

In recent decades,the study of the mechanism of tumorigenesis has brought much progress to cancer treatment.However,cancer stem cell(CSC)theory has changed previous views of tumors,and has provided a new method for treatment of cancer.The discovery of CSCs and their characteristics have contributed to understanding the molecular mechanism of tumor genesis and development,resulting in a new effective strategy for cancer treatment.Gastric CSCs(GCSCs)are the basis for the onset of gastric cancer.They may be derived from gastric stem cells in gastric tissues,or bone marrow mesenchymal stem cells.As with other stem cells,GCSCs highly express drug-resistance genes such as aldehyde dehydrogenase and multidrug resistance,which are resistant to chemotherapy and thus form the basis of drug resistance.Many specific molecular markers such as CD44 and CD133 have been used for identification and isolation of GCSCs,diagnosis and grading of gastric cancer,and research on GCSC-targeted therapy for gastric cancer.Therefore,discussion of the recent development and advancements in GCSCs will be helpful for providing novel insight into gastric cancer treatment.

Association of CD14/-260 polymorphism with gastric cancer risk in Highland Tibetans

AIM:To investigate the relationship between CD14-260and-651 polymorphisms and the risk of developing gastric cancer.METHODS:DNA was extracted from peripheral blood samples obtained from 225 Tibetans with gastric cancer and 237 healthy Tibetans,and analyzed using the polymerase chain reaction/ligase detection(PCR/LDR)method to determine the genotypes at-260 and-651loci of the CD14 promoter.The allele frequencies,genotype frequencies,and haplotypes were analyzed for their association with gastric cancer risk using online SHEsis software.The luciferase reporter assay and point mutation analysis were used to construct in vitro plasmids expressing a C/T homozygote at the-260 lo-cus of the CD14 promoter.RESULTS:The frequencies of CC,CT and TT genotypes in the CD14-260 C/T locus in gastric cancer patients were 19.1%,38.7%and 42.2%,respectively,whereas they were 33.3%,32.5%and 34.2%,respectively,in healthy control subjects.CT genotype carriers were more frequently found among gastric cancer patients than healthy controls(OR=2.076;95%CI:1.282-3.360).Also,TT genotype carriers were more frequently found among gastric cancer patients(OR=2.155;95%CI:1.340-3.466).Compared to the C allele of CD14/-260,the T allele was associated with an increased risk for gastric cancer(OR=1.574;95%CI:1.121-2.045).Furthermore,the frequencies of CC,CT and TT in the CD14-651 C/T locus in gastric cancer patients were 64.4%,29.3%and 6.2%,respectively,while they were 56.5%,35.0%and 8.4%,respectively,in the healthy control subjects(P>0.05).Data obtained using the luciferase reporter assay showed that the p260T homozygote was associated with greater CD14 promoter activity(P<0.01).CONCLUSION:CD14/-260 polymorphism is associated with gastric cancer risk in Highland Tibetans and affects CD14 promoter activity,thereby regulating CD14expression.

Nur-related receptor 1 gene polymorphisms and alcohol dependence in Mexican Americans

AIM:To investigate the association of polymorphisms of nur-related receptor 1 (Nurr1 ) and development of alcohol dependence in Mexican Americans. METHODS:Peripheral blood samples were collected from 374 alcoholic and 346 nonalcoholic Mexican Americans; these two groups were sex-and age-matched. Sample DNA was extracted and genomic DNA was amplified by polymerase chain reaction. The-2922(C) 2-3 polymerase chain reaction products were digested with Sau96I , alleles of 1345(G/C) , and -1198(C/G) in the regulatory region as well as Ex+132 (G/T/A/C) and Ex+715(T/-) in exon 3 were studied by sequencing. RESULTS:The C2/C2, C2/C3, C3/C3 genotype distribution of -2922(C) 2-3 was 34.4%, 38.2% and 27.5% inthe nonalcoholic group compared to 23.3%, 51.2% and 25.4% in the alcoholic group (P = 0.001). The C/C, C/G, G/G genotype distribution of -1198(C/G) was 23.5%, 46.1% and 30.3% in the nonalcoholic group compared to 13.9%, 50.9% and 35.3% in the alcoholic group (P = 0.007). However, the -1345 (G/C) , Ex3+132(G/T/A/C) and Ex3+715(T/-) alleles were not polymorphic in Mexican Americans, and all those studied had G/G, G/G and T/T genotype for these three alleles, respectively. The -2922(C) 2-3 did not show allele level difference between alcoholic and nonalcoholic individuals, but -1198 (C/G) showed a significant allele frequency difference between alcoholic (39.3%) and nonalcoholic (46.6%) populations (P = 0.005). Excluding obese individuals, significant differences were found at both genotypic and allelic levels for the -2922(C) 2-3 polymorphism (P = 0.000 and P = 0.049) and the -1198 (C/G) polymorphism (P = 0.008 and P = 0.032) between nonobese alcoholics and nonobese controls. Excluding smokers, a significant difference was found only at the genotypic level for the -2922(C) 2-3 polymorphism (P = 0.037) between nonsmoking alcoholics and nonsmoking controls, but only at the allelic level for the -1198(C/G) polymorphism (P = 0.034). CONCLUSION:Polymorphisms in the regulatory region of Nurr1 are implicated in pathogenesis of alcohol dependence and the Nurr1 /dopamine signaling pathway might be important for this dependence development in Mexican Americans.

Diagnostic Performance of Intestinal Fusobacterium nucleatum in Colorectal Cancer： A Meta-Analysis

Background： Increasing evidence has supported the link of intestinal Fusobacterium nucleatum infection to colorectal cancer （CRC）. However, the value of F. nucleatum as a biomarker in CRC detection has not been fully defined. In order to reduce the random error and bias of individual research, this meta-analysis aimed to evaluate the diagnostic performance of intestinal F. nucleatum in CRC patients and provide evidence-based data to clinical practice. Methods： An article search was performed from PubMed, Embase, Cochrane Library, and Web of Science databases up to December 2017, using the following key words： ＂Fusobacterium nucleatum＂, ＂Fusobacterium spp.＂, ＂Fn＂, ＂colorectal cancer（s）＂, ＂colorectal carcinoma（s）＂, ＂colorectal neoplasm（s）＂, and ＂colorectal tumor（s）＂. Articles on relationships between E nucleatum and CRC were selected according to the preestablished inclusion and exclusion criteria. This meta-analysis was performed using STATA 12.0 software, which included mapping of lbrest plots, heterogeneity tests, recta-regression, subgroup analysis, sensitivity analysis, and publication bias. The sensitivity, specificity, positive likelihood ratio （LR）, negative LR, diagnostic odds ratio （DOR）, and their corresponding 95% confidence interval （CI） of each eligible study were summarized. Results： Finally, data for 1198 participants （629 CRC and 569 healthy controls） in 10 controlled studies from seven articles were included. The summary receiver operator characteristic curve was mapped. The diagnostic performance of intestinal E nucleatum infection on CRC was as follows： the area under the curve： 0.86 （95% CI： 0.83-0.89）, the pooled sensitivity： 0.81 （95% CI：0.64 0.91 ）, specificity： 0.77 （95% CI： 0.59-0.89）, and DOR： 14.00 （95% CI： 9.00 -22.00）. Conclusion： Intestinal E nucleatum is a valuable marker for CRC diagnosis.