Lung cancer risk in non-smoking females with a familial history of cancer:a multi-center prospective cohort study in China

Familial risk of lung cancer has been widely studied but whether this association holds in non-smoking females is largely unknown.We sought to determine the relationship between a family history of cancer and lung cancer risk among Chinese non-smoking females based on a multi-center prospective population-based cohort study involving 547,218 individuals between 2013 and 2019.A total of 1620 lung cancer cases occurred during a median follow-up of 3.9 years.Multivariable Cox regression showed that a family history of lung cancer in first-degree relatives significantly increased the risk of lung cancer(HR:1.50,95%CI:1.29,1.75,P<0.001).Relative to those with no relatives affected,the risk of lung cancer was 51%higher in females with one relative affected(HR:1.51,95%CI:1.29-1.76,P<0.001),123%higher in females with two relatives affected(HR:2.23,95%CI:1.57-3.15,P<0.001)and 143%higher in females with three or more relatives affected(HR:2.43,95%CI:1.21-4.91,P=0.013).Two nested case control studies stratified by age at diagnosis were conducted to verify potential disparities in this association between the early or late onset of lung cancer.A family history of lung cancer in first-degree relatives was significantly correlated with an elevated risk of lung cancer for both cases before and after age 65(OR:1.36,95%CI:1.07-1.74,P=0.013;OR:1.64,95%CI:1.15-2.33,P=0.006).Our analysis confirmed the importance of familial history of cancers on lung cancer risk in non-smoking females and highlighted the possibility of interaction between genetic and environmental effect on lung cancer.

Novel subtype of obesity influencing the outcomes of sleeve gastrectomy:Familial aggregation of obesity

BACKGROUND Differences in the preoperative characteristics and weight loss outcomes after sleeve gastrectomy(SG)between patients with familial aggregation of obesity(FAO)and patients with sporadic obesity(SO)have not been elucidated.AIM To explore the impact of SG on weight loss and the alleviation of obesity-related comorbidities in individuals with FAO.METHODS A total of 193 patients with obesity who underwent SG were selected.Patients with FAO/SO were matched 1:1 by propensity score matching and were categorized into 4 groups based on the number of first-degree relatives with obesity(1 SO vs 1FAO,2SO vs 2FAO).The baseline characteristics,weight loss outcomes,prevalence of obesity-related comorbidities and incidence of major surgeryrelated complications were compared between groups.RESULTS We defined FAO as the presence of two or more first-degree relatives with obesity.Patients with FAO did not initially show significant differences in baseline data,short-term postoperative weight loss,or obesity-related comorbidities when compared to patients with SO preoperatively.However,distinctions between the two groups became evident at the two-year mark,with statistically significant differences in both percentage of total weight loss(P=0.006)and percentage of excess weight loss(P<0.001).The FAO group exhibited weaker remission of type 2 diabetes mellitus(T2DM)(P=0.031),hyperlipidemia(P=0.012),and non-alcoholic fatty liver disease(NAFLD)(P=0.003)as well as a lower incidence of acid reflux(P=0.038).CONCLUSION FAO patients is associated with decreased mid-to-long-term weight loss outcomes;the alleviation of T2DM,hyperlipidemia and NAFLD;and decreased incidence of acid reflux postoperatively.

The Application of Newmark’s Metaphor Theory in Novel Translation--A Case Study of“the Jade King:History of a Chinese Muslim Family”

This paper examines the metaphorical part of“The Jade King:History of a Chinese Muslim Family”,Hoda’s novel,under the guidance of Newmark’s theory of metaphor.Newmark proposes six categories of metaphors,namely Dead Metaphor,ClichéMetaphor,Stock or Standard Metaphor,Adapted Metaphor,Recent Metaphor,Original Metaphor;and seven strategies of metaphor translation,including reproducing the same image in the target language,replacing the image in the source language with a standard target language image,translation of metaphor by simile,translation of metaphor(or simile)by simile plus sense,conversion of metaphor to sense,deletion and same metaphor combined with sense.They can provide a strong theoretical support for analyzing the expressions of metaphors in novels and their translation methods.By deeply analyzing the expressions of metaphor and its translation methods in novels,it not only helps to understand the metaphorical meaning and cultural connotation of the original works,but also helps to explore the cultural differences and challenges faced by English and Chinese bilingualism in the process of metaphor translation,thereby significantly improving the translation level and promoting the development of translation research.

Multiple lentigines syndrome with positive family history:a case report and review of the literature

Multiple lentigines syndrome is an autosomal dominant genetic disease,and its expressivity and penetrance are variable.It is also known as LEOPARD syndrome(LS).The genes known to be associated with LS include PTPN11,RAF1 and BRAF.The diagnosis of LS(OMIM 151100)is based on the observation of key features in the clinical background.LS caused by a germline PTPN11 mutation are characterized as multisystemic anomalies and variable marked phenotypes such as multiple lentigines and cafénoir spots,electrocardiographic conduction abnormalities,ocular hypertelorism/obstructive cardiomyopathy,pulmonary stenosis,abnormal genitalia,retardation of growth,and deafness.Phenotype overlap complicates clinical discrimination within RASopathies,making the diagnosis of LS more confusing and challenging.Besides,LS patients do not usually present with all these typical clinical features,increasing the possibility of underdiagnosis or misdiagnosis.Herein,we report a case of a 41-year-old male presenting with multiple dark pigmented macules all over the body,thoracic deformity and family history.And we followed up the patients.

Influence of Interrupted Childhood Biographies on Health Development: Evaluation of the Scientific Literature on the Example of Being Taken into Care*

Background: An interrupted family history, as is the case after taking someone into care, can complicate collecting family anamnesis data. In addition, the interrupted family history itself could be considered part of a person’s risk profile. Aim and methods: Literature analysis was conducted to examine whether there are scientific studies on health development after placement in out-of-home-care in order to recognise any existing medical characteristics that may be relevant for internal medical care. Results: There are few scientific publications on the health development of people after being placed in out-of-home-care. Direct reactions to the stress of being taken into custody include nausea and fever. However, effects that go beyond the acute situation and last into adulthood have also been described, such as AD(H)D, asthma, diabetes, cancer, hypertension and cardiovascular diseases (myocardial infarction, stroke), epilepsy and increased overall mortality in adulthood. Studies show that not only previous experience but also the stress of being taken into care is triggers for this. Conclusion: Information about a previous institutionalisation can hence be important for internal medical practice. The available scientific literature shows heterogeneous study methodology and no group of people with experience of out-of-home-placement has yet been scientifically accompanied for a long time period. Further studies on this could help to better weigh up the consequences of omitting and conducting an intervention for child/youth protection as well as to improve the medical care for this group of people.

The impact of family history of hepatocellular carcinoma on its patients' survival

BACKGROUND:Family history of hepatocellular carcinoma(HCC) has been identified as a risk factor for the development of the disease.The aim of this study is to evaluate the impact of such a history on HCC patients’ survival.METHODS:Data of all HCC patients(n=4532) managed at our center from 1989 to 2008 were prospectively collected.The patients were quizzed on their various characteristics including family HCC history.RESULTS:Totally 475(10.48%) patients had a family history of HCC.They presented the disease at a significantly earlier age(median 53 vs 59 years,P<0.0001) and at an earlier stage(the United Network for Organ Sharing staging system).They had significantly better liver function in terms of ChildPugh classification and serum albumin and bilirubin levels.Significantly more of them presented the disease without symptoms(44.0% vs 29.4%,P<0.0001).They also had significantly better overall survival under these specifications:patients in the whole study cohort,patients who had minor hepatectomy,patients with stage I disease,patients with stage II disease,and patients with stage III disease.CONCLUSIONS:Contrary to what is generally believed,we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a history.We believe this was in part due to earlier diagnosis of the disease and better liver function in this group of patients.However,the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified.

Evidence from a familial case suggests maternal inheritance of primary biliary cholangitis

Primary biliary cholangitis(PBC) is an idiopathic autoimmune liver disease characterized by chronic cholestasis and destruction of the intrahepatic bile ducts. Similar to other autoimmune diseases, the pathogenesis of PBC is considered to be a complex etiologic phenomenon involving the interaction of genetic and environmental factors. Although a number of common variants associated with PBC have been reported from genome-wide association studies, a precise genetic mechanism underlying PBC has yet to be identified. Here, we describe a family with four sisters who were diagnosed with PBC. After the diagnosis of the index patient who was in an advanced stage of PBC, one sister presented with acute hepatitis, and two sisters were subsequently diagnosed with PBC. Notably, one half-sister with a different mother exhibited no evidence of PBC following clinical investigation. Our report suggests the possibility of a maternal inheritance of PBC susceptibility. Moreover, judging from the highpenetrance of the disease observed in this family, we inferred that a pathogenic genetic variant might be the cause of PBC development. We describe a family that exhibited diverse clinical presentations of PBC that included asymptomatic stages with mildly increased liver enzyme levels and symptomatic stages with acute hepatitis or advanced liver fibrosis. Additional studies are needed to investigate the role of genetic factors in the pathogenesis of this rare autoimmune disease.

Comparison of patients by family history with gastric and non-gastric cancer

AIM:To compare the gastric cancer(GC) patients by their family history with gastric and non-GC.METHODS:Positive family histories within seconddegree relatives and clinicopathological features were obtained for 256 patients.RESULTS:Of the 256 probands,112(76 male,36 female) were incorporated into familial GC(FGC) group:at least two GC members;144(98 male,46 female) were included in the non-FGC group(relatives only affected with non-GCs).Of 399 tumors in relatives(181 from FGC against 212 from non-FGC),GC was the most frequent,followed by esophageal,hepatocellular,and colorectal cancer.Nasopharyngeal cancer was next to lung cancer but prior to breast and urogenital cancers.Most affected members aggregated within first-degree relatives(FGC:66 siblings,48 fathers,31 mothers,four offspring;non-FGC:56 fathers,55 siblings,43 mothers,and 15 offspring).The ratio of males to females in affected first-degree relatives was usually higher in male probands.Paternal history of GC was a slight risk for GC in males(OR = 1.19,95% CI:0.53-2.69),while risk of GC by maternal history of non-GCs was increased in females(OR = 0.46,95% CI:0.22-0.97).Diffuse-GC was the major histological type in all subgroups.Difference in tumor sites between thetwo groups was derived from an excess of upper sites in non-FGC female probands.CONCLUSION:Distribution of associated non-GCs in a family history of GC may vary with geographic areas.GC may have different genetic and/or environmental etiology in different families,and a certain subtype may be inherited in a female-influenced fashion.

Clinical features of familial adenomas polyps in Chinese and establishment of its immortal lymphocyte cell lines

AIM： To reserve the rare Chinese familial adenomas polyp （FAP） family resource and to investigate the clinical features of FAP in Chinese for its diagnosis. METHODS： Clinical features of patients with FAP were investigated. If there is any question, their medical records were verified. Blood sample was taken and lymphocyte immortal cell lines were established with modified EB-transformation methods. Congenital hypertrophy of retinal pigment epithelium （CHRPE） was checked by an experienced ophthalmologist. RESULTS： Twenty seven families including 21 classical FAP （CFAP） families, 3 attenuated FAP （AFAP） families, and 3 suspected AFAP families were investigated. A total of 116 lymphocyte immortal cell lines were established from 26 families. In all the FAP families, colorectal cancer occurred at the mean age of 42.84 years. Of the 16 families checked, 15 （93.75%） had CHRPE. The mean number of patients suffering from colorectal neoplasm was 3.14 in CFAP families and 2.0 in AFAP families （P 〈 0.01）. The mean oldest age at diagnosis of FAP was 41.75 years in CFAP families, and 58.67 years in AFAP families, respectively （P 〈 0.01）. Mean age of development of colorectal cancer was 42.23 in CFAP and 57.33 years old in AFAP （P 〈 0.01）. Mean of the earliest age at diagnosis of FAP was 29.95 years in the FAP families with a positive family history and 46.80 years in the FAP families with a negative family history （P 〈 0.01）. The ratio of extra-intestinal tumors to colorectal neoplasms was different in the two kinds of families with positive and negative family history （P 〈 0.01）. CONCLUSION： Additional use of ciclosporin will effectively improve to establish lymphocyte immortal cell lines with modified EB- transformation methods. In Chinese FAP, there was a high frequency of CHRPE, and a later age at diagnosis and a later age of development of colorectal cancer in AFAR And earlier age at diagnosis in FAP with positive family history was also found that will help to diagnose various kinds of FAP in Chinese.

Similar clinical characteristics of familial and sporadic inflammatory bowel disease in South Korea

AIM: To investigate differences of clinical characteristics and disease courses between familial and sporadic inflammatory bowel disease (IBD) patients.

Family history and disease outcomes in patients with Crohn's disease:A comparison between China and the United States

AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn's disease(CD) residing in China and the United States.METHODS We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States.We compared the prevalence of IBD family history and history of ileal involvement,CD-related surgeries and IBD medications in China and the United States,adjusting for potential confounders.RESULTS We recruited 49 participants from China and 145 from the United States.The prevalence of family history of IBD was significantly lower in China compared with the United States(China:4.1%,United States:39.3%).The three most commonly affected types of relatives were cousin,sibling,and parent in the United States compared with child and sibling in China.Ileal involvement(China:63.3%,United States:63.5%) and surgery for CD(China:51.0%,United States:49.7%) were nearly equivalent in the two countries.CONCLUSION The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States.Despite the potential difference in etiology,surgery and ileal involvement were similar in the two countries.Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.

Family history influences the early onset of hepatocellular carcinoma

AIM: To evaluate the relationship between a positive family history of primary liver cancer and hepatocellular carcinoma (HCC) development in Korean HCC patients. METHODS: We studied a total of 2242 patients diagnosed with HCC between January 1990 and July 2008, whose family history of primary liver cancer was clearly described in the medical records.positive family history of HCC and 2077 (92.6%) did not. The male to female ratio was 3.6:1, and the major causes of HCC were chronic hepatitis B virus (HBV) infection in 75.1%, chronic hepatitis C virus infection in 13.2% and alcohol in 3.1%. The median ages at diag- nosis in the positiveand negative-history groups were 52 years (range: 29-79 years) and 57 years (range: 18-89 years), respectively (P < 0.0001). Furthermore, among 1713 HCC patients with HBV infection, the number of patients under 45 years of age out of 136 patients with positive family history was 26 (19.1%), whereas those out of 1577 patients with negative family history was 197 (12.5%), suggesting that a positive family history may be associated with earlier development of HCC in the Korean population (P = 0.0028). CONCLUSION: More intensive surveillance maybe recommended to those with a positive family history of HCC for earlier diagnosis and proper management especially when HBV infection is present.

Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain

AIM： To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain （RAP） or irritable bowel syndrome （IBS）. METHODS： A group of 67 children with RAP referred to the department from January 1986 to December 1995 was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview. We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history oflBS in comparison with adults with no persistent abdominal complaint. RESULTS： Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up （29%） whereas the majority （37 subjects） did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining （40.0% vs 16.0%）, respectively （P 〈 0.05 at Student t test）. Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances. CONCLUSION： The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms, possibly through the learning of a specific illness behavior.

Combined Effects of Family History of Cardiovascular Disease and Serum C-reactive Protein Level on the Risk of Stroke: A 9.2-year Prospective Study among Mongolians in China

Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Methods A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels. Results We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio（HR） of 1.78 [95% confidence interval（CI）, 1.03‐3.07; P = 0.039] of stroke, and an HR of 2.14（95% CI, 1.09‐4.20; P = 0.027） of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant（all P 〉 0.05）. Conclusion Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.

Family history of cancer in Chinese gastric cancer patients

Objective:The aim of the study was to investigate the influence of gastric cancer family history in the gastric cancer (GC) patients. Methods: Gastric cancer family histories within second degree relatives and clinicopathological features were obtained for 497 patients. Results:Of the 497 probands,235 probands were incorporated into familial gastric cancer (FGC) group (there were at least two GC members in the family); 262 probands were included in the non-FGC group (relatives only affected with non-GCs). Of 614 tumors in relatives,GC was the most frequent,followed by lung cancer,esophageal cancer,hepatocellular cancer,colorectal cancer,urogenital cancer,breast cancer,and pancreatic cancer. Most affected members aggregated within first-degree relatives. The ratio of males to females in affected first-degree relatives was usually higher in male probands. Paternal history of GC was a strong risk for GC in males,while risk of GC by maternal history of GCs was increased in females. Difference in tumor histological types between the two groups was derived from an excess of diffuse GC in non-FGC male probands. The lower site was the most frequent tumor location in all subgroups. Conclusion:Distribution of associated non-GCs in a family history of GC may vary with geographic areas. GC may have different genetic and/or environmental etiology in different families,and a certain subtype may be inherited in a male-influenced fashion.

Depressed-type (0-IIc) colorectal neoplasm in patients with family history of first-degree relatives with colorectal cancer:A cross-sectional study

AIM： TO investigate the correlation of depressed-type （0-IIc） colorectal neoplasm and family history of firstdegree relatives （FDR） with colorectal cancer （CRC）. METHODS： This cross-sectional study was conducted from June 2000 to October 2002 at National Cancer Center Hospital East. Eligible patients undergoing initial total colonoscopy were surveyed regarding family history of CRC among FDR by a questionnaire prior to colonoscopic examinations. All endoscopic findings during colonoscopy were recorded and the macroscopic classification of the early stage neoplasm/cancer was classified into two types （0-IIc vs non 0-IIc）. Odds ratios （OR） and 95% confidence intervals （CI） were calculated by univariate and multivariate logistic regression to estimate the association between macroscopic features and clinicopathological data including gender, age, and family history of FDR with CRC. RESULTS： The OR of an association between family history of FDR with CRC and overall early stage neoplasm adjusted by gender and age was 1.85 （95% CI： 1.31-2.61, P = 0.0004）, that for non 0-IIc neoplasm was 1.71 （95% CI： 1.22-2.41, P = 0.0017） and for 0-IIc colorectal neoplasm was 2.78 （95% CI： 1.49-5.16, P = 0.0031）. CONCLUSION： Our study shows a significant association between a family history of FDR with CRC and 0-IIc colorectal neoplasm. When patients with a family history of FDR with CRC undergo colonoscopy, colonoscopists should check carefully for not only polypoid, but also depressed-type （0-IIc） lesions.

Prevalence of Family History of Cancer among Gastric Cancer Patients at Brazilian National Cancer Institute

Background: Gastric cancer is the third most incident malignancy and the fifth leading cause of death in the world. In Brazil, it is the fourth most common tumour in men and the fifth in women. Familial aggregation of this tumour is being studied and discussed by experts. Aim: Determine the frequency of family history of cancer in patients with gastric cancer, suggesting familial aggregation or increased risk for hereditary cancer syndromes. Methods: This is a retrospective cross-sectional study carried out from January 2011 to March 2015 at the Department of Abdominal and Pelvic Surgery of the Brazilian National Cancer Institute (INCA). Data were collected from electronic medical records and analyzed using SPSS Statistics? version 20. Results: 873 patients with gastric adenocarcinoma were analyzed. A family history of cancer was reported by 451 patients (51.6%), which reported cancer in 878 relatives, of which 110 (12.6%), reported having more than three relatives with any type of cancer. The most prevalent malignancies among these relatives were gastric cancer (21.3%) and breast cancer (9.5%). Conclusion: Most of the patients had cancer family history, being gastric cancer the most common. The high percentage of cancer family history confirms the importance of collecting this information, whose lack reflects professional negligence, as family history study can serve as a low-cost tool, favoring prevention and early diagnosis, situations where morbidity and mortality are smaller, thus reducing health costs and assistance and preserving lives.

Family Health History and Behavioral Change among Undergraduate Students: A Mixed Methods Study

Background: We examined family health history (FHH) as a public health intervention tool in undergraduate students. We hypothesized that the FHH assignment would positively relate to students’ FHH knowledge and health and healthcare-seeking behavioral change. Methods: Health professional students’ (n = 103) pre/post-test surveys and research papers were collected in 2011-2012, from a mid-western and southern university in the United States of America, using mixed methods research. Results: The majority of students were aged 18 - 30, women, White, had healthcare access and health insurance, and awareness of the term FHH. Significant logistic regression relationships existed between: 1) helping students understand important strengths and weaknesses in their health and quality of life and outcomes of talking with family and doctors about FHH;and 2) improving students’ understanding of what they needed to do to maintain their health and the outcome statement “FHH tells you about inherited genes.” Key themes from the research papers included actions and FHH and proposed behavioral changes. Conclusions: Quantitative findings supported the relationship between students’ assignment evaluation and knowledge change, while qualitative findings supported relationships between assignment evaluation and knowledge and behavioral change. This study highlights regional differences in students’ FHH and the need to address family support barriers to behavioral change.

Analysis on Family History of Diabetes, Weight Gain during Pregnancy and Pre-pregnancy Body Mass Index on 82 Pregnant Women with Gestational Diabetes Mellitus

Objective:To investigate the effects of family history of diabetes mellitus,Gestational Weight Gain(GWG)and Body Mass Index(BMI)before pregnancy on Gestational Diabetes Mellitus(GDM).Method:82 pregnant women with GDM who were hospitalized and delivered in the obstetrics department of our hospital from September 2017 to September 2019 were selected as the observation group,and 60 pregnant women with normal glucose tolerance test in the same period were selected as the control group;The relationship between family history of diabetes,weight gain during pregnancy and pre-pregnancy Body Mass Index and GDM were analyzed.Results:The age,pre-pregnancy weight and weight gain during pregnancy were significantly higher in the observation group than in the control group(P<0.05),and the family history of diabetes and pre-pregnancy Body Mass Index were higher in the observation group than in the control group(P<0.05),and the differences were statistically significant.Conclusion:It is suggested that family history of diabetes is related to gestational diabetes mellitus.Excessive GWG growth during pregnancy and high Body Mass Index before pregnancy may increase the risk of gestational diabetes mellitus in pregnant women.

Studies on the History of Pangda Family in Markham

The famous female writer Ma Lihua in her well- known book The Red Mountain Ranges in East Tibet described the social status and influence of the Pangda family.She wrote:"The famous Pangda family in Tibetan pre-modern society stands on both