Serum tumor markers expression(CA199,CA242,and CEA)and its clinical implications in type 2 diabetes mellitus

BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor markers in T2DM are important.AIM To evaluate the expression of serum tumor markers[CA199,CA242,and carcinoembryonic antigen(CEA)]and the clinical implications of the expression in T2DM.METHODS For this observational study conducted at Hefei BOE Hospital,China,we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020.Levels of fasting blood glucose(FBG),tumor markers(CA199,CEA,and CA242),glycosylated hemoglobin(HbA1c),etc.were measured and group index levels were compared.Moreover,FBG and HbA1c levels were correlated with tumor marker levels.Tumor markers were tested for diagnostic accuracy in patients with>9%HbA1c using the receiver operating curve(ROC)curve.RESULTS The T2DM group had high serum FBG,HbA1c,CA199,and CEA levels(P<0.05).A comparative analysis of the two groups based on HbA1c levels(Group A:HbA1c≤9%;Group B:HbA1c>9%)revealed significant differences in CEA and CA199 levels(P<0.05).The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809,respectively.CA199,CEA,and CA242 levels positively correlated with HbA1c(r=0.308,0.426,and 0.551,respectively)and FBG levels(r=0.236,0.231,and 0.298,respectively).CONCLUSION As compared to controls,serum CEA and CA199 levels were higher in patients with T2DM.HbA1c and FBG levels correlated with CA199,CEA,and CA242 levels.Patients with poorly controlled blood sugar must be screened for tumor markers.

Incidence of gastroesophageal reflux disease in Uygur and Han Chinese adults in Urumqi

AIM:To investigate the incidence of gastroesophageal reflux disease(GERD) and its related risk factors in Uygur and Han Chinese adult in Urumqi,China.METHODS:A population-based cross-sectional survey was undertaken in a total of 972 Uygur(684 male and 288 female) aged from 24 to 61 and 1023 Han Chinese(752 male and 271 female) aged from 23 to 63 years.All participants were recruited from the residents who visited hospital for health examination from November 2011 to May 2012.Each participant signed an informed consent and completed a GERD questionnaire(GerdQ) and a lifestyle-food frequency questionnaire survey.Participants whose Gerd Q score was ≥ 8 and met one of the following requirements would be enrolled into this research:(1) being diagnosed with erosive esophagitis(EE) or Barrett's esophagus(BE) by endoscopy;(2) negative manifestation under endoscopy(non-erosive reflux disease,NERD) with abnormal acid reflux revealed by 24-h esophageal pH monitoring;and(3) suffering from typical heartburn and regurgitation with positive result of proton pump inhibitor test.RESULTS:According to Gerd Q scoring criteria,340 cases of Uygur and 286 cases of Han Chinese were defined as GERD.GERD incidence in Uygur was significantly higher than in Han Chinese(35% vs 28%,χ2 = 11.09,P < 0.005),Gerd Q score in Uygur was higher than in Han Chinese(7.85 ± 3.1 vs 7.15 ± 2.9,P < 0.005),and Gerd Q total score in Uygur male was higher than in female(8.15 ± 2.8 vs 6.85 ± 2.5,P < 0.005).According to normalized methods,304(31%) cases of Uygur were diagnosed with GERD,including 89 cases of EE,185 cases of NERD and 30 cases of BE;256(25%) cases of Han Chinese were diagnosed with GERD,including 90 cases of EE,140 cases of NERD and 26 cases of BE.GERD incidence in Uygur was significantly higher than in Han Chinese(31% vs 25%,χ2 = 9.34,P < 0.005) while the incidences were higher in males of both groups than in females(26% vs 5% in Uygur,χ2 = 35.95,P < 0.005,and 19.8% vs 5.2% in Han,χ2 = 5.48,P < 0.025).GERD incidence in Uygur male was higher than in Han Chinese male(26% vs 19.8%,χ2 = 16.51,P < 0.005),and incidence of NERD in Uygur was higher than in Han Chinese(χ2 = 10.06,P < 0.005).Occupation(r = 0.623),gender(r = 0.839),smoking(r = 0.322),strong tea(r = 0.658),alcohol drinking(r = 0.696),meat-based diet(mainly meat)(r = 0.676) and body mass index(BMI)(r = 0.567) were linearly correlated with GERD in Uygur(r = 0.833,P = 0.000);while gender(r = 0.957),age(r = 0.016),occupation(r = 0.482),strong tea(r = 1.124),alcohol drinking(r = 0.558),meat diet(r = 0.591) and BMI(r = 0.246) were linearly correlated with GERD in Han Chinese(r = 0.786,P = 0.01).There was no significant difference between Gerd Q scoring and three normalized methods for the diagnosis of GERD.CONCLUSION:GERD is highly prevalent in adult in Urumqi,especially in Uygur.Male,civil servant,smoking,strong tea,alcohol drinking,meat diet and BMI are risk factors correlated to GERD.

Chymase inhibitor TY-51469 in therapy of inflammatorybowel disease

AIM: To investigate the effect of chymase inhibitor TY-51469 in the therapy of inflammatory bowel disease and the underlying mechanism. METHODS: Seventy-five healthy Sprague-Dawley rats were randomly assigned to one of the three groups(control group, model group and TY-51469 experiment group) and each group had twenty-five rats. The rats of the model group and experiment group were subjected to treatment with 3.5% dextran sulfate sodium(DSS) 10 mg/kg to induce colitis. The control group and model group were subjected to intraperitoneal injection of saline, while the experiment group was subjected to intraperitoneal injection of 10 mg/kg TY-51469 each day. Five rats of each group were sacrificed on 0, 7, 14, 21 and 28 d, respectively. The degree of inflammation was assessed by histopathological scoring; flow cytometry was performed to detect the proportion of CD4+CD25+ Tregs in peripheral blood; colon tissues of rats were collected to measure m RNA and protein expression by PCR, Western blot and immunohistochemistry; serum levels of interleukin(IL)-10, transforming growth factor(TGF)-β1 and IL-17A were detected by ELISA. RESULTS: The rats in the experiment group and model group had significantly more severe colitis than the ones in the control group(P < 0.05) before treatment on day 0; no significant difference was observed between the experiment group and model group(P > 0.05). After treatment with TY-51469, the rats in the experiment group had significantly less severe colitis compared with the model group on 7, 14, 21 and 28 d(P < 0.05). The proportion of CD4+CD25+ Tregs was lower in the model group and experiment group than in the control group; the experiment group had a significantly higher proportion of CD4+CD25+ Tregs than that in the model group(P < 0.05). The model group and experiment group demonstrated lower expression of Foxp3 than the control group; the experiment group had higher Foxp3 expression than the model group(P < 0.05). Cytokines IL-10, TGF-β1 and IL-17 A were lower in the model group and experiment group than in the control group; the experiment group had higher expression than the model group(P < 0.05). CONCLUSION: After treatment with chymase inhibitor TY-51469, the experiment group demonstrated more significantly reduced intestinal inflammation and higher expression of immune tolerance related cytokines(IL-10, TGF-β1, IL-17A) and Foxp3 which is specifically expressed in Tregs compared with the model group. Therefore, chymase inhibitor TY-51469 might ameliorate the progression of DSS-induced colitis possibly by increasing the expression of Tregs and cytokines.

Fast Screening of Chicken Egg Lysozyme in White Wine Products by Extractive Electrospray Ionization Mass Spectrometry

Fast detection of trace lysozyme,one of the most important food allergens in white wine samples,was achieved by extractive electrospray ionization mass spectrometry without sample pretreatment in this study.The multiply-charged ions of m/z1587 were chosen for the quantitative detection of lysozyme in white wine,showing linear dynamic signal responses in a range of 5―75μg/mL with a linearity coefficient of 0.999 and an acceptable relative standard deviation（RSD） of 8.0%―15.0% for directly measuring lysozyme in the complex food samples.The limit of detection for lysozyme in white wine sample was calculated to be 5 μg/mL,which was lower than the amounts that can provoke allergic reactions（oral test with 3 mg or labial test with 1 mg/mL）.A single sample analysis was completed within 1 min.The data demonstrate that extractive electrospray ionization mass spectrometry is a useful tool for fast screening lysozyme in the complex matrix,showing promising application in the rapid detection of food allergen.

Alcohol consumption and the risk of Barrett's esophagus:A meta-analysis

AIM： To evaluate the possible association between al-cohol consumption and Barrett’s esophagus （BE）.METHODS： We performed a systematic literaturesearch of multiple online electronic databases. Inclusioncriteria entailed studies about alcohol and BE. Meta-analysis was conducted to evaluate odds ratio （OR） and95%CIs for the association between alcohol consump-tion and BE. RESULTS： Twenty studies comprising 4758 patientswith BE were included in the meta-analysis. The risk ofBE in patients with alcohol consumption was increasedcompared with control groups （OR = 1.01; 95%CI： 1.00-1.02）, especially in case-control and cohort, Eu-ropean and Asian, and hospital studies, but there was a decreased risk of BE associated with alcohol con-sumption from American studies （OR = 0.86; 95%CI： 0.77-0.96）. At the same time, there was no signifcant association between BE and alcohol consumption in community studies （OR = 0.97; 95%CI： 0.84-1.12） and the type of alcohol （wine, beer and liquor） studies. CONCLUSION： Our meta-analysis found that alcohol consumption was associated with an increased risk of BE, especially for European and Asian drinkers.

Effect of brain reflex instrument combined with acupuncture on convalescent neurotrophic status and nerve cell apoptosis in patients with cerebral infarction

Objective:To study the effect of brain reflex instrument combined with acupuncture on convalescent neurotrophic status and nerve cell apoptosis in patients with cerebral infarction. Methods:A total of 116 patients with convalescent cerebral infarction who were treated in Chinese Medicine Hospital Affiliated to Xinjiang Medical University between October 2014 and December 2016 were selected and randomly divided into two groups, intervention group received brain reflex instrument combined with acupuncture intervention + conventional intervention, and the control group only received conventional intervention. Serum levels of neurotrophic cytokines, monoamine neurotransmitter, and nerve cell apoptosis molecules were detected before intervention as well as 10, 20 and 30 d after intervention.Results:Serum BDNF, VEGF, bFGF, NE, E, 5-HIAA, DOPAC, HVA and Bcl-2 levels of both groups 10, 20 and 30 d after intervention were significantly higher than those before intervention while sFas, sFasL and sTRAIL levels were significantly lower than those before intervention, and serum BDNF, VEGF, bFGF, NE, E, 5-HIAA, DOPAC, HVA and Bcl-2 levels of intervention group 10, 20 and 30 d after intervention were significantly higher than those of control group while sFas, sFasL and sTRAIL levels were significantly lower than those of control group.Conclusions: Brain reflex instrument combined with acupuncture can significantly improve the convalescent neurotrophic status and nerve cell apoptosis in patients with cerebral infarction.

Probiotics and irritable bowel syndrome

Irritable bowel syndrome(IBS)is common gastrointestinal problems.It is characterized by abdominal pain or discomfort,and is associated with changes in stool frequency and/or consistency.The etiopathogenesis of IBS may be multifactorial,as is the pathophysiology,which is attributed to alterations in gastrointestinal motility,visceral hypersensitivity,intestinal microbiota,gut epithelium and immune function,dysfunction of the brain-gut axis or certain psychosocial factors.Current therapeutic strategies are often unsatisfactory.There is now increasing evidence linking alterations in the gastrointestinal microbiota and IBS.Probiotics are living organisms which,when ingested in certain numbers,exert health benefits beyond inherent basic nutrition.Probiotics have numerous positive effects in the gastrointestinal tract.Recently,many studies have suggested that probiotics are effective in the treatment of IBS.The mechanisms of probiotics in IBS are very complex.The purpose of this review is to summarize the evidence and mechanisms for the use of probiotics in the treatment of IBS.

A specific objective supplemental factor in evaluating acute mountain sickness: ΔHR in combination with SaO_2

Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation(Sa O2) as objective risk factors in aiding the diagnosis of AMS.Methods: A total of 1,019 participants were assigned to either the acute exposure group(AEG): from 500 m to 3,700 m by flight within 2.5 hours(n=752); or the pre-acclimatization group(PAG): ascended to 4,400 m from 3,650 m within three hours by car after adapting 33 days at 3,650m(n=267). The questionnaires or measurements of resting Sa O2 and HR were completed between 18 and 24 hours before departure and after arrival.Results: Incidence of AMS was 61.3%(461) in AEG, with 46.1%(347) mild cases and 15.2%(114) severe cases. In PAG, the incidence was 38.9%(104), with 30.7%(82) mild cases and 8.2%(22) severe cases. The AMS subjects showed a significant increase in HR and a decrease in Sa O2 levels compared with the non-AMS subjects in both groups. ΔHR and post-exposure Sa O2 were significantly correlated with the Lake Louise Score(LLS) in both groups. Stepwise logistic regression analysis revealed the ΔHR >25 and Sa O2 <88% in AEG as well as ΔHR >15 and Sa O2 <86% in PAG to be independent risk factors of AMS. Combining these two measurements could specifically indicate participants with AMS, which showed a positive predictive value of 89% and specificity of 97% in AEG as well as 85% and 98% in PAG.Conclusion:ΔHR or Sa O2, as objective measurements, correlate with AMS. Combination of these two measurements may be useful as an additional specific and objective factor to further confirm the diagnosis of AMS.

A pH-Regulated Colorimetric Sensor Array for Discrimination of Biothiols Based on Two Different-Sized β-Cyclodextrin-Functionalized AuNPs

The abnormal changes of biothiols are directly related to health condition of human body,and the effective identification and quantification of biothiols is of great significance for screening and diagnosis of disease.This study described the development of a p H-regulated colorimetric sensor array for discrimination of five kinds of biothiols including cysteine(Cys),glutathione(GSH),homocysteine(Hcy),cysteamine(CA)and N-acetylcysteine(NAC).The proposed sensor array was established using 5-nm-and 20-nm-sizedβ-cyclodextrin-functionalized gold nanoparticles(β-CD@Au NPs)as nonspecific receptor and signal transduction elements.Due to the different binding affinity between biothiols andβ-CD@Au NPs in various p H environments,the different aggregation behaviors of nanoparticles produced unique colorimetric response patterns,which were able to be distinguished by bare eyes and UV-vis spectrophotometer.Accordingly,principal component analysis(PCA)and hierarchical cluster analysis(HCA)were employed for pattern recognition and generated a clustering map for a clear differentiation of biothiols at the level ofμmol/L.Furthermore,it can be proved that the method was successfully applied to the analysis of biothiols in human urine samples.

Validation of fatty liver index and hepatic steatosis index for screening of non-alcoholic fatty liver disease in adults with obstructive sleep apnea hypopnea syndrome

Background:Obstructive sleep apnea hypopnea syndrome(OSAHS)is a contributing factor for non-alcoholic fatty liver di:(NAFLD).Non-invasive algorithms including fatty liver index(FLI)and hepatic steatosis index(HSI)have been used as a screening test for NAFLD in epidemiologic studies.The aim of this study is to compare the diagnostic accuracy of FLI and HSI for NAFLD detection in adults with OSAHS.Methods:We enrolled consecutive adult subjects who were newly diagnosed with OSAHS from March 2016 to January 2018.NAFLD was diagnosed by ultrasonography.The accuracy and cut-off point of the FLI and HSI to detect NAFLD were assessed by analyzing the area under the receiver operating characteristic(AUROC)curve and the maximum Youden index analysis,respectively.Results:The 326 subjects were diagnosed as NAFLD according to ultrasound findings,while 105 subjects who had normal abdominal ultrasonography were grouped as controls.Both FLI and HSI values were significantly higher in patients with NAFLD compared with controls.The AUROC of FLI and HSI for predicting NAFLD was 0.802(95%confidence interval[CI]0.762-0.839)and 0.753(95%CI 0.710-0.793),respectively.The AUROC of FLI was significantly higher than that of HSI(P=0.0383).The optimal cut-off value of FLI and HSI was 60(sensitivity 66%and specificity 80%)and 35(sensitivity 81%and specificity 60%),respectively.Conclusions:Both FLI and HSI can serve as screening tools for NAFLD in OSAHS adults.The FLI shows better performance in diagnosing NAFLD than HSI.