Effects of n-3 polyunsaturated fatty acids from seal oils on nonalcoholic fatty liver disease associated with hyperlipidemia

AIM: To investigate the efficacy and safety of n-3 polyunsaturated fatty acids (PUFA) from seal oils for patients with nonalcoholic fatty liver disease (NAFLD) associated with hyperlipidemia. METHODS: One hundred and forty-four patients with NAFLD associated with hyperlipidemia were included in the 24-wk, randomized, controlled trial. The patients were randomized into two groups. Group A (n = 72) received recommended diet and 2 g n-3 PUFA from seal oils, three times a day. Group B (n = 72) received recommended diet and 2 g placebo, three times a day. Primary endpoints were fatty liver assessed by symptom scores, liver alanine aminotransferase (ALT) and serum lipid levels after 8, 12, 16, and 24 wk. Hepatic fat inf iltration was detected by ultrasonography at weeks 12 and 24 after treatment. RESULTS: A total of 134 patients (66 in group A, 68 in group B) were included in the study except for 10 patients who were excluded from the study. After 24 wk of treatment, no change was observed in body weight, fasting blood glucose (FBG), renal function and blood cells of these patients. Total symptom scores, ALT and triglyceride (TG) levels decreased more significantly in group A than in group B (P < 0.05). As expected, there was a tendency toward improvement in aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), and total cholesterol (TCHO) and high- density lipoprotein (HDL) cholesterol levels (P < 0.05) after administration in the two groups. However, no significant differences were found between the two groups. The values of low-density lipoprotein (LDL) were significantly improved in group A (P < 0.05), but no significant change was found in group B at different time points and after a 24-wk treatment. After treatment, complete fatty liver regression was observed in 19.70% (13/66) of the patients, and an overall reduction was found in 53.03% (35/66) of the patients in group A. In contrast, in group B, only f ive patients (7.35%, 5/68) achieved complete fatty liver regression (P = 0.04), whereas 24 patients (35.29%, 24/68) had a certain improvement in fatty liver (P = 0.04). No serious adverse events occurred in all the patients who completed the treatment. CONCLUSION: Our results indicate that n-3 PUFA from seal oils is safe and effi cacious for patients with NAFLD associated with hyperlipidemia and can improve their total symptom scores, ALT, serum lipid levels and normalization of ultrasonographic evidence. Further study is needed to confi rm these results.

Endoscopy dissection of small stromal tumors emerged from the muscularis propria in the upper gastrointestinal tract:Preliminary study

AIM:To investigate the feasibility and safety of the treatment of an upper gastrointestinal(GI) submucosal tumor with endoscopic submucosal dissection(ESD).METHODS:A total of 20 patients with esophageal and gastric submucosal tumors emerged from the muscular layer identified by endoscopic ultrasonography were collected from January 2009 to June 2010.Extramural or dumbbell-like lesions were excluded by an enhanced computerized tomography(CT) scan.All patients had intravenous anesthesia with propofol and then underwent the ESD procedure to resect these submucosal tumors.The incision was closed by clips as much as possible to decrease complications,such as bleeding or perforation,after resection of the tumor.All the specimens were collected and evaluated by hematoxylin,eosin and immunohistochemical staining,with antibodies against CD117,CD34,desmin,α-smooth muscle actin and vimentin to identify the characteristics of the tumors.Fletch's criteria was used to evaluate the risk of gastrointestinal stromal tumors(GISTs).All patients underwent a follow-up endoscopy at 3,6 and 12 mo and CT scan at 6 and 12 mo.RESULTS:The study group consisted of 5 men and 15 women aged 45-73 years,with a mean age of 60.2 years.Three tumors were located in the esophagus,9 in the gastric corpus,4 in the gastric fundus,3 lesions in the gastric antrum and 1 in the gastric angulus.Apart from the one case in the gastric angulus which was abandoned due to being deeply located in the serosa,94.7%(18/19) achieved complete gross dissection by ESD with operation duration of 60.52±30.32 min.The average maximum diameter of tumor was 14.8±7.6 mm,with a range of 6 to 30 mm,and another lesion was ligated by an endoscopic ligator after most of the lesion was dissected.After pathological and immunohistochemical analysis,12 tumors were identified as a GI stromal tumor and 6 were leiomyoma.Mitotic count of all 12 GIST lesions was fewer than 5 per 50 HPF and all lesions were at very low(9/12,75.0%) or low risk(3/12,25.0%) according to Fletch's criteria.Procedure complications mainly included perforation and GI bleeding;perforation occurred in 1 patient and conservative treatment succeeded by a suturing clip and no post-operative GI bleeding occurred.All patients were followed up for 6.5±1.8 mo(range,3-12 mo) by endoscopy and abdominal CT.Local recurrence and metastasis did not occur in any patient.CONCLUSION:ESD shows promise as a safe and feasible technique to resect esophageal and gastric submucosal tumors and the incidence of complications was very low.Clinical studies with more subjects and longer follow-up are needed to confirm its treatment value.

Combined detection of plasma GATA5 and SFRP2 methylation is a valid noninvasive biomarker for colorectal cancer and adenomas

AIM:To investigate GATA5,SFRP2,and ITGA4 methylation in plasma DNA as noninvasive biomarkers for colorectal cancer(CRC) or adenomas.METHODS:There were 57 CRC patients,30 adenomas patients,and 47 control patients enrolled in this study.Methylation-specific polymerase chain reaction was used to determine the promoter methylation status of GATA5,SFRP2,and ITGA4 genes in plasma DNA,and their association with clinical outcome in CRC.The predictive ability of GATA5,SFRP2,and ITGA4 methylation,individually or in combination,to detect CRC or adenomas was further analyzed.RESULTS:Hypermethylated GATA5 was detected in plasma in 61.4%(35/57) of CRC cases,43.33%(13/30) of adenoma cases,and 21.28%(10/47) of control cases.The hypermethylation of SFRP2 was detected in 54.39%(31/57),40.00%(12/30),and 27.66%(13/47) in plasma samples from CRC,adenomas,and controls,respectively.ITGA4 methylation was detected in 36.84%(21/57) of plasma samples of CRC patients and in 30.00%(9/30) of plasma samples from patients with colorectal adenomas,and the specificity of this individual biomarker was 80.85%(9/47).Moreover,GATA5 methylation in the plasma was significantly correlated with larger tumor size(P =0.019),differentiation status(P =0.038),TNM stage(P =0.008),and lymph node metastasis(P =0.008).SFRP2 and ITGA4 methylation in plasma significantly correlated with differentiation status(SFRP2,P =0.012; ITGA4,P =0.007),TNM stage(SFRP2,P =0.034; ITGA4,P =0.021),and lymph node metastasis(SFRP2,P =0.034; ITGA4,P =0.021).From the perspective of predictive power and cost-performance,using GATA5 and SFRP2 together as methylation markers seemed the most favorable predictor for CRC(OR =8.06;95%CI:2.54-25.5; P < 0.01) and adenomas(OR =3.35; 95%CI:1.29-8.71; P =0.012).CONCLUSION:A combination of GATA5 and SFRP2 methylation could be promising as a marker for the detection and diagnosis of CRC and adenomas.

Endogenous hydrogen sulfide and ERK1/2-STAT3 signaling pathway may participate in the association between homocysteine and hypertension

Background Homocysteine(Hcy)is a risk factor for hypertension,although the mechanisms are poorly understood.Methods We first explored the relationship between Hcy levels and blood pressure(BP)by analyzing the clinical data of primary hypertensive patients admitted to our hospital.Secondly,we explored a rat model to study the effect of Hcy on blood pressure and the role of H2S.An hyperhomocysteinemia(HHcy)rat model was induced to explore the effect of Hcy on blood pressure and the possible mechanism.We carried out tissue histology,extraction and examination of RNA and protein.Finally,we conducted cell experiments to determine a likely mechanism through renin-angiotensin-aldosterone system(RAAS)and extracellular signal-regulated kinase 1/2(ERK1/2)signaling pathway.Results In primary hypertensive inpatients with HHcy,blood pressure was significantly higher as compared with inpatient counterparts lacking HHcy.In the rat model,blood pressure of the Wistar rats was significantly increased with increases in serum Hcy levels and decreased after folate treatment.Angiotensin converting enzyme 1(ACE1)expression in the Wistar Hcy group was enhanced comparing to controls,but was decreased in the Wistar folate group.Angiotensin II receptor type 1(AGTR1)levels in the kidney tissue increased in the Wistar folate group.Both serum H2S and kidney cystathionineγ-lyase decreased with elevated levels of serum Hcy.In vitro,increased concentrations and treatment times for Hcy were associated with increased expression of collagen type 1 and AGTR1.This dose and time dependent response was also observed for p-STAT3 and p-ERK1/2 expression.Conclusion Endogenous H2S might mediate the process of altered blood pressure in response to changes in serum Hcy levels,in a process that is partly dependent on activated RAAS and ERK1/2-STAT3 signaling pathway.

Mutation of cytotoxin-associated gene A affects expressions of antioxidant proteins of Helicobacter pylori

AIM: To determine if disruption of the cagA gene of Helicobacter pylori (H pylori) has an effect on the expression of other proteins at proteome level. METHODS: Construction of a cagA knock out mutant Hp27 _△cagA (cagA -) via homologous recombination with the wild-type strain Hp27 (cagA+) as a recipient was performed. The method of sonication-urea-CHAPS-DTT was employed to extract bacterial proteins from both strains. Soluble proteins were analyzed by two-dimensional electrophoresis (2-DE). Images of 2-DE gels were digitalized and analyzed. Only spots that had a statistical signif icance in differential expression were selected and analyzed by matrix-assisted laser desorption/ionizationtime of flight mass spectrometry (MALDI-TOF-MS). Biological information was used to search protein database and identify the biological function of proteins. RESULTS: The proteome expressions between wild-type strain and isogenic mutant with the cagA gene knocked-out were compared. Five protein spots with high abundance in bacteria proteins of wild-type strains, down-regulated or absently expressed in bacteria proteins of mutants, were identified and analyzed. From a quantitative point of view, the identified proteins are related to the cagA gene and important antioxidant proteins of H pylori , including alkyl hydroperoxide reductase (Ahp), superoxide dismutase (SOD) and modulator of drug activity (Mda66), respectively, suggesting that cagA is important to maintain the normal activity of antioxidative stress and ensure H pylori persistent colonization in the host. CONCLUSION: cagA gene is relevant to the expressions of antioxidant proteins of H pylori, which may be a novel mechanism involved in H pylori cagA pathogenesis.

Impact of GPS Almanac Broadcast Strategy on the Signal Acquisition Time

This paper investigates the problem of almanac affecting the signal acquisition time with two constraints: different age of data and multi-sets of almanac. The contributions made in this paper include: 1) the exploiting of signal acquisition concept to extend well-known almanac function of predicting visible satellite and initializing signal acquisition to minimizing the signal acquisition time; 2) a model based on code phase and Doppler frequency to reflect the impact of multi-sets of almanac on the signal acquisition time; 3) the evaluation of the existing GPS almanac with different broadcast strategy. The theoretical analyses and simulations conducted on three sets of almanac show that the model proposed in this paper is general and efficient for almanac design and application.

Author correction to‘Amino-functionalized poloxamer 407 with both mucoadhesive and thermosensitive properties:Preparation,characterization and application in vaginal drug delivery system'[Acta Pharm Sin B 7(2017)593-602]

The authors regret that there was a picture error in Fig.8.In Fig.8B,a copy mistake of H&E photographs was made when combining the images of different groups.The revisions do not affect any results and conclusions of the current work.The original data of these figures have been provided to the Editorial Office,and the corresponding authors or the Editorial Office can be contacted for original data access.