Development of a modified ABC method among Helicobacter pylori infected but serum pepsinogen test-negative individuals.

BACKGROUND: Although the ABC method for gastric cancer (GC) screening has been widely adopted in Japan, it may not be suitable for other countries due to population heterogeneity and different tumor histology. We aim to develop a modified ABC method to improve GC screening performance, especially among Helicobacter pylori (Hp) infected but serum pepsinogen (sPG) test-negative individuals. METHODS: A total of 4745 participants were recruited from Tianjin, China, and were classified into four groups by combined assay for Hp infection and sPG concentrations: Group A (Hp [-], PG [-]), Group B (Hp [+], PG [-]), Group C (Hp [+], PG [+]), and Group D (Hp [-], PG [+]). We used receiver-operating characteristic (ROC) curves analysis and minimum p value method to determine the optimal cutoff point for PG II in Group B. We performed logistic regressions to examine the risk of GC across different subgroups. In addition to the derivation set, the performance of the modified ABC method was also evaluated in an external set involving 16,292 participants from Liaoning, China. RESULTS: In the modified ABC method, we further classified Group B as low-risk (Group B1) and high-risk subgroups (Group B2) using optimal sPG II cutoff point (20.0 ng/mL) by ROC curves analysis and minimum p value method. Compared with Group B1, Group B2 had a significantly higher risk of GC (adjusted OR = 2.54, 95% CI = 1.94-3.33). The modified ABC method showed good discrimination for GC (AUC = 0.61, 95% CI = 0.59-0.63) and improved risk reclassification (NRI = 0.11, p < .01). Similar results were observed in the validation dataset. CONCLUSIONS: The modified ABC method can effectively identify high-risk population for GC among Hp-infected but sPG test-negative participants in China.

A new risk stratification strategy for fatty liver disease by incorporating MAFLD and fibrosis score in a large US population.

BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a newly proposed definition of fatty liver disease (FLD) independent of excessive alcohol consumption (EAC) and hepatitis viral infection. Evidence on the mortality risk in different types of FLD [nonalcoholic FLD (NAFLD), alcoholic FLD (AFLD), and MAFLD] is sparse, hindering the identification of high-risk populations for preferential clinical surveillance. METHODS: A total of 11,000 participants in the Third National Health and Nutrition Examination Survey were enrolled. Participants were categorized into three groups [FLD( - ), MAFLD( - ), and MAFLD( +)] according to FLD and MAFLD criteria, and further categorized into six groups by EAC. Multivariate Cox proportional hazard model was used to estimate the risk of all-cause, cardiovascular-related, and cancer-related mortality. RESULTS: During a median follow-up of 23.2 years, a total of 3240 deaths were identified. Compared with FLD( - )/EAC( - ) participants, MAFLD( +) individuals had higher all-cause mortality risk [hazard ratio (HR) = 1.28, 95% confidence interval (CI) = 1.18-1.39] regardless of EAC status [MAFLD( +)/NAFLD: HR = 1.22, 95%CI = 1.11-1.34; MAFLD( +)/AFLD: HR = 1.83, 95%CI = 1.46-2.28], while not for MAFLD( - ) individuals. Furthermore, diabetes-driven-MAFLD had higher mortality risk (HR = 2.00, 95%CI = 1.77-2.27) followed by metabolic dysregulation-driven-MAFLD (HR = 1.30, 95%CI = 1.06-1.60) and overweight/obesity-driven-MAFLD (HR = 1.11, 95%CI = 1.00-1.22). Additionally, MAFLD( - ) participants with elevated fibrosis score were also associated with statistically significantly higher mortality risk (HR = 3.23, 95%CI = 1.63-6.40). CONCLUSIONS: Utilizing a representative sample of the US population, we proved the validity of MAFLD subtype and fibrosis score, rather than the traditional definition (NAFLD and AFLD), in the risk stratification of FLD patients. These findings may be applied to guide the determination of surveillance options for FLD patients.

The effect of morphine upon DNA methylation in ten regions of the rat brain.

Morphine is one of the most effective analgesics in medicine. However, its use is associated with the development of tolerance and dependence. Recent studies demonstrating epigenetic changes in the brain after exposure to opiates have provided insight into mechanisms possibly underlying addiction. In this study, we sought to identify epigenetic changes in ten regions of the rat brain following acute and chronic morphine exposure. We analyzed DNA methylation of six nuclear-encoded genes implicated in brain function (Bdnf, Comt, Il1b, Il6, Nr3c1, and Tnf) and three mitochondrially-encoded genes (Mtco1, Mtco2, and Mtco3), and measured global 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5 hmC) levels. We observed differential methylation of Bdnf and Il6 in the pons, Nr3c1 in the cerebellum, and Il1b in the hippocampus in response to acute morphine exposure (all P value < 0.05). Chronic exposure was associated with differential methylation of Bdnf and Comt in the pons, Nr3c1 in the hippocampus and Il1b in the medulla oblongata (all P value < 0.05). Global 5mC levels significantly decreased in the superior colliculus following both acute and chronic morphine exposure, and increased in the hypothalamus following chronic exposure. Chronic exposure was also associated with significantly increased global 5hmC levels in the cerebral cortex, hippocampus, and hypothalamus, but significantly decreased in the midbrain. Our results demonstrate, for the first time, highly localized epigenetic changes in the rat brain following acute and chronic morphine exposure. Further work is required to elucidate the potential role of these changes in the formation of tolerance and dependence.

Modified Sauve-Kapandji Procedure for Patients with Old Fractures of the Distal Radius.

OBJECTIVE: To evaluate the clinical and radiographic outcomes of a modified Sauve-Kapandji procedure for patients with old fractures in the distal radius. METHODS: Fifteen patients (10 male and 5 female patients with an average age of 40 years old) were treated by the modified Sauve-Kapandji procedure from January 2014 to April 2016. All patients had undergone at least one previous operation on the involved wrist, and they were still suffering from pain and functional limitations at the time of admission. The postoperative follow-up period was 12-26 months and the average was 20 months. Functional assessment was made at the last follow-up. All patients were evaluated according a Modified Mayo Wrist Score system. RESULTS: Of the fifteen patients with posttraumatic arthritis, thirteen had excellent results, two had good results, and one had fair results. There were no major complications. CONCLUSIONS: The modified Sauve-Kapandji procedure is a safe and effective surgical alternative for intractable disorders of the distal radioulnar joint and can be recommended as a salvage procedure when previous treatments fail.

Aerobic debromination of BDE-209 by Rhodococcus sp. coupled with zerovalent iron/activated carbon.

In this study, an aerobic strain identified as Rhodococcus sp. was isolated from the sediment of a typical electronic waste disassemble site, Taizhou, China. This strain could use BDE-209 as the sole carbon and energy source and degrade 65.1% of BDE-209 (initial concentration being 50 mg/L) within 144 h. To explore the BDE-209 degradation properties of this strain with the co-existed electronic donor, zerovalent iron/activated carbon (ZVI/AC) was introduced to build a microbial-chemical coupling system, which was found to promote the degradation of BDE-209 slightly (74.7% in 144 h). Moreover, the debromination products in both of the batch experiments were determined with GC/MS, which showed that lower brominated PBDE congeners were produced almost in order of the number of bromine ions, ranged from nona- to di-BDEs. In addition, the possible debromination pathways of BDE-209 for each system were proposed respectively, which confirmed the microbial activity of BDE-209 debromination. Since some of the lower-brominated BDE congeners are much toxic than BDE-209, these microbial activities might bring potential hazards to the environment with BDE-209 contamination. It is the first time to investigate the transformation of BDE-209 with microbial-chemical coupling system, which is universal in the nature, thus suggesting that the ecological safety of environment exposed to PBDEs should be focused in the future.

Insights into spatially and temporally co-occurring polybrominated diphenyl ethers in sediments of the East China Sea.

In this study, twenty-four core sediment samples were collected from monitoring stations in the East China Sea (ECS) to investigate the spatial and temporal distributions of polybrominated diphenyl ethers (PBDEs) and their potential sources. In surface sediment samples (the top 0-3 cm segment), the concentrations of Σ8PBDEs (sum of BDE15, 28, 47, 99, 100, 153, 154 and 183) and BDE209 were between 0.03 and 1.26 ng g(-1) d.w., and 0.20 and 3.15 ng g(-1) d.w., respectively. The PBDEs concentrations were decreased generally from the shore towards the sea, indicating that PBDEs are mainly derived from anthropogenic sources. As the predominant congener, BDE209 was primarily distributed in the nearshore regions, suggesting that it might be derived from runoff and sewage. In contrast, higher levels of BDE99 and BDE47 were detected in the offshore samples, and the concentrations of BDE47 were higher than those of BDE99. All of their concentrations were poorly correlated with TOC, suggesting BDE47 and BDE99 might be transferred mainly along with the atmosphere. In most sediment cores, the Σ8PBDEs and BDE209 concentrations increased from the bottom (18-30 cm), reached their maximum concentrations in the middle (6-15 cm) or upper (0-6 cm) sections, and leveled off near the surface (0-3 cm). This trend is consistent with the phasing-out of PBDEs and the strict management of recycling e-waste. This is the first study for network used to analyze the distribution properties of pollutant congeners in environment, which facilitates the visualization of cluster results among multivariable data and helps in tracing the potential sources of pollutants.