Is Increasing Diet Diversity of Animal-Source Foods Related to Better Health-Related Quality of Life among Chinese Men and Women?

Diet plays a crucial role in regulating individuals' lifestyles and is closely related to health. The intake of animal-sourced foods (ASF) provides the human body with high-quality protein and various micronutrients. This study aimed to investigate whether the diversity of animal foods has a positive impact on the health-related quality of life (HRQoL) among residents. The data came from the Shaanxi baseline survey of the Northwest Chinese Regional Ethnic Cohort Study, which recruited more than 100 thousand participants aged 35 to 74 from five provinces between June 2018 and May 2019. A total of 39,997 participants in Shaanxi (mean age: 50 years; 64% women) were finally included in this current study. The animal source food diet diversity score (ASFDDS) was established based on the frequency of consuming pork, mutton, beef, poultry, seafood, eggs, pure milk, and yogurt. The physical component score (PCS) and mental component score (MCS), ranging from 0 to 100 on the 12-Item Short Form Survey (SF-12), were used to assess participants' HRQoL. Better PCS/MCS was defined as scores higher than the 90th percentile. The results showed that men had a higher intake of ASF and ASFDDS than women. After adjusting for potential confounders, compared with those who never or rarely consumed animal foods, the likelihood of having better PCS and MCS increased by 16% (OR = 1.16, 95%CI: 1.01-1.34) and 24% (OR = 1.24, 95%CI: 1.03-1.448), respectively, in men with an ASFDDS ≥ 2. In women, a 34% increase (OR = l.34, 95%CI: 116-l.54) likelihood for better PCS was observed for an ASFDDS ≥ 2, but no association was observed for MCS. Increasing each specific animal source's food intake was associated with better PCS after adjusting for all covariates. However, for MCS, positive associations were only observed in seafood consumption among men and eggs among women. Restricted cubic splines showed a substantial dose-response association between intake frequency of animal-source foods and PCS, both in men and women. The study suggests that a diverse intake of animal-sourced foods can potentially improve the HRQoL of Chinese adults.

A predicted structure of NADPH Oxidase 1 identifies key components of ROS generation and strategies for inhibition.

NADPH oxidase 1 (NOX1) is primarily expressed in epithelial cells and responsible for local generation of reactive oxygen species (ROS). By specifically manipulating the local redox microenvironment, NOX1 actively engages in epithelial immunity, especially in colorectal and pulmonary epithelia. To unravel the structural basis of NOX1 engaged epithelial immune processes, a predicted structure model was established using RaptorX deep learning models. The predicted structure model illustrates a 6-transmembrane domain structure, a FAD binding domain, and an NADPH binding/NOXO1 interacting region. The substrate/cofactor binding scheme with respect to this proposed model highly correlates with published reports and is verified in our site-directed mutagenesis assays. An electron transport chain, from NADPH to FAD and the two heme groups, was well supported by the predicted model. Through molecular docking analysis of various small molecule NOX1 inhibitors and subsequent experimental validation, we identified pronounced active sites for potent NOX1 inhibition. Specifically, LEU60, VAL71, MET181, LEU185, HIS208, PHE211, TYR214, and TYR280 in the transmembrane domain form an active pocket for insertion of the small molecule inhibitors to inhibit electron transfer between the heme groups, thus affecting extracellular ROS generation. Altogether, our study provides structural information to help elucidate the role of NOX1 in epithelial generation of ROS and sheds light on the development of therapeutics for NOX1 related illnesses.

Staple Food Preference and Obesity Phenotypes: The Regional Ethnic Cohort Study in Northwest China.

Staple food preference vary in populations, but evidence of its associations with obesity phenotypes are limited. Using baseline data (n = 105,840) of the Regional Ethnic Cohort Study in Northwest China, staple food preference was defined according to the intake frequency of rice and wheat. Overall and specifically abdominal fat accumulation were determined by excessive body fat percentage and waist circumference. Logistic regression and equal frequency substitution methods were used to evaluate the associations. We observed rice preference (consuming rice more frequently than wheat; 7.84% for men and 8.28% for women) was associated with a lower risk of excessive body fat (OR, 0.743; 95%CI, 0.669-0.826) and central obesity (OR, 0.886; 95%CI, 0.807-0.971) in men; and with lower risk of central obesity (OR, 0.898; 95%CI, 0.836-0.964) in women, compared with their wheat preference counterparties. Furthermore, similar but stronger inverse associations were observed in participants with normal body mass index. Wheat-to-rice (5 times/week) reallocations were associated with a 36.5% lower risk of normal-weight obesity in men and a 20.5% lower risk of normal-weight central obesity in women. Our data suggest that, compared with wheat, rice preference could be associated with lower odds ratios of certain obesity phenotypes in the Northwest Chinese population.

Association between physical activity and major adverse cardiovascular events in northwest China: A cross-sectional analysis from the Regional Ethnic Cohort Study.

Background: To examine the association between daily physical activity (PA) and major adverse cardiovascular events (MACEs) in northwest China. Methods: The data in this analysis were part of the baseline survey of the Regional Ethnic Cohort Study in Northwest China from June 2018 to May 2019 in Shaanxi Province. This study used standardized self-reported total physical activity (continuous and categorical variables) and self-reported outcomes of MACEs. All analyses were conducted using the logistic regression model and stratified by age, sex, body mass index (BMI), and region. The dose-response relationships were assessed with a restricted cubic spline. Results: The average level of total PA was 17.60 MET hours per day (MET-h/d). Every increase of four MET-h/d of total PA was associated with a lower risk of MACEs [adjusted OR = 0.95 (95% CI, 0.93~0.98)]. Compared with participants in the bottom quartile of total PA, a lower risk of MACEs was observed in the top quartile group [≥23.3 MET-h/d, 0.68 (0.55~0.83)]. Stratified analyses showed similar results in males, females, participants over 45 years old, participants in the rural region, and normal weight range participants (BMI < 24 kg/m2). Total participants also observed a dose-response relationship after adjusting for socioeconomic and lifestyle factors. Conclusions: A higher level of PA was associated with a lower MACE risk. Future research should examine the longitudinal association of prospectively measured PA and the risk of MACEs.

Key Genes Associated with Pyroptosis in Gout and Construction of a miRNA-mRNA Regulatory Network.

This study aimed to analyze key hub genes related to pyroptosis in gout and construct a miRNA-mRNA regulatory network using bioinformatic tools to elucidate the pathogenesis of gout and offer novel ideas to develop targeted therapeutic strategies for gout. METHODS: The GSE160170 dataset was downloaded from the GEO database. The expression data extracted from the dataset were used to screen for differentially expressed genes (DEGs), which intersected with pyroptosis-related genes. These DEGs were analyzed via Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, and a protein-protein interaction (PPI) network was constructed to identify pyroptosis-related hub DEGs. The relationship between upstream miRNAs and the hub genes was analyzed, miRNA-mRNA networks belonging to gout disease were constructed and samples from patients with gout were used for experimental verification. The CTDbase tool was used to analyze the identified hub genes and construct a molecular docking model. RESULTS: A total of 943 DEGs (380 upregulated and 563 downregulated) were identified by analyzing the data of patients with early-stage gout and healthy control individuals in the GSE160170 dataset. DEGs and pyroptosis-related genes were intersected to obtain 17 pyroptosis-related DEGs associated with gout; of which, 12 were upregulated, and five were downregulated. The results of GO and KEGG analyses revealed that the DEGs were enriched in inflammatory and immune signaling pathways. Additionally, the DEGs were found to regulate inflammatory responses and were associated with apoptosis. TNF, IL-1ß, NLRP3, CXCL8, PTGS2, NFE2L2, CASP8, and CD274 were identified as key hub genes in the PPI network, and a miRNA-mRNA network was constructed, which had 16 edges. Experimental validation revealed that PTGS2 and NFE2L2 were significantly upregulated, and CASP8 and CD274 were significantly downregulated in gout. In addition, miR-128-3p, miR-16-5p, miR-155-5p, and miR-20a-5p (associated with the miRNA-mRNA regulatory network) were significantly downregulated in gout. Five potential therapeutic drugs with stable PTGS2 binding were selected to develop a molecular docking model. CONCLUSION: A miRNA-mRNA potential regulatory network was constructed based on pyroptosis-related DEGs associated with gout. miR-16-5p, miR-128-3p, miR-20a-5p, and miR-155-5p can potentially influence pyroptosis and the occurrence and development of gout by affecting the expression of the PTGS2, CASP8, NFE2L2, and CD274 genes. Screening of celecoxib and resveratrol and other targeted drugs with stable binding. The findings of this study offer valuable insights into the regulatory mechanisms of gout and may help to identify Biomarkers and develop targeted therapeutic strategies for gout.

Diagnostic model for predicting hyperuricemia based on alterations of the gut microbiome in individuals with different serum uric acid levels.

Background: We aimed to assess the differences in the gut microbiome among participants with different uric acid levels (hyperuricemia [HUA] patients, low serum uric acid [LSU] patients, and controls with normal levels) and to develop a model to predict HUA based on microbial biomarkers. Methods: We sequenced the V3-V4 variable region of the 16S rDNA gene in 168 fecal samples from HUA patients (n=50), LSU patients (n=61), and controls (n=57). We then analyzed the differences in the gut microbiome between these groups. To identify gut microbial biomarkers, the 107 HUA patients and controls were randomly divided (2:1) into development and validation groups and 10-fold cross-validation of a random forest model was performed. We then established three diagnostic models: a clinical model, microbial biomarker model, and combined model. Results: The gut microbial α diversity, in terms of the Shannon and Simpson indices, was decreased in LSU and HUA patients compared to controls, but only the decreases in the HUA group were significant (P=0.0029 and P=0.013, respectively). The phylum Proteobacteria (P<0.001) and genus Bacteroides (P=0.02) were significantly increased in HUA patients compared to controls, while the genus Ruminococcaceae_Ruminococcus was decreased (P=0.02). Twelve microbial biomarkers were identified. The area under the curve (AUC) for these biomarkers in the development group was 84.9% (P<0.001). Notably, an AUC of 89.1% (P<0.001) was achieved by combining the microbial biomarkers and clinical factors. Conclusions: The combined model is a reliable tool for predicting HUA and could be used to assist in the clinical evaluation of patients and prevention of HUA.

NLRP3 Susceptible Gene Polymorphisms in Patients with Primary Gouty Arthritis and Hyperuricemia.

Polymorphisms have been identified to predispose to primary gouty arthritis (GA) and hyperuricemia (HUA). Here, we accessed the five polymorphisms of rs10754558, rs35829419, rs3738448, rs3806268, and rs7525979 in NLRP3 on GA and HUA susceptibility. We collected 1198 samples (314 GA, 377 HUA, and 507 controls) for this case-control study. Our data detected that the rs3806268 (GA vs. AA: OR = 0.65, p = 0.012) was significantly associated with the susceptibility to GA. The rs3738448 (TT vs. GG: OR = 2.05, p = 0.024) and rs7525979 (TT vs. CC: OR = 1.96, p = 0.037) were significantly associated with the susceptibility to HUA. The rs3806268 AG genotype presented decreased risk of GA among the hypertension (OR = 0.54, p = 0.0093), smoking (OR = 0.59, p = 0.018), and no obesity (OR = 0.60, p = 0.0097) subjects compared to the GG genotype group. The rs3738448 TT genotype demonstrated increased risk of HUA among the hypertension (OR = 4.10, p = 0.0056) and no drinking population (OR = 3.56, p = 0.016) compared to the GG genotype group. The rs7525979 TT genotype demonstrated increased risk of HUA among the hypertension (OR = 4.01, p = 0.0064) and no drinking population (OR = 3.24, p = 0.034) compared to the CC genotype group. Furthermore, a significant haplotype effect of rs10754558/C-rs35829419/C-rs3738448/G-rs3806268/A-rs7525979/C was found (OR = 1.60, p = 0.0046) compared with GCGAC haplotype. Bioinformatics analyses indicated that rs3738448, rs3806268, and rs7525979 might influence the gene regulation, while the T-allele of rs3738448 increased the stability of NLRP3-mRNA. Collectively, our case-control study confirms NLRP3 polymorphisms might participate in regulating immune and inflammation responses in GA and HUA.

Structural basis for recognition of N-formyl peptides as pathogen-associated molecular patterns.

The formyl peptide receptor 1 (FPR1) is primarily responsible for detection of short peptides bearing N-formylated methionine (fMet) that are characteristic of protein synthesis in bacteria and mitochondria. As a result, FPR1 is critical to phagocyte migration and activation in bacterial infection, tissue injury and inflammation. How FPR1 distinguishes between formyl peptides and non-formyl peptides remains elusive. Here we report cryo-EM structures of human FPR1-Gi protein complex bound to S. aureus-derived peptide fMet-Ile-Phe-Leu (fMIFL) and E. coli-derived peptide fMet-Leu-Phe (fMLF). Both structures of FPR1 adopt an active conformation and exhibit a binding pocket containing the R2015.38XXXR2055.42 (RGIIR) motif for formyl group interaction and receptor activation. This motif works together with D1063.33 for hydrogen bond formation with the N-formyl group and with fMet, a model supported by MD simulation and functional assays of mutant receptors with key residues for recognition substituted by alanine. The cryo-EM model of agonist-bound FPR1 provides a structural basis for recognition of bacteria-derived chemotactic peptides with potential applications in developing FPR1-targeting agents.

The Association between Dietary Purine Intake and Mortality: Evidence from the CHNS Cohort Study.

Objectives: To investigate the association between dietary purine intake and mortality among Chinese adults. Methods: Based on data from the 2004−2015 China Health and Nutrition Survey (CHNS) and the corresponding edition of China Food Composition, the average purine intake per day (mg/day) from 2004 to 2011 was calculated, and the surveyed population was divided into five groups by quintiles. The outcome event and timepoint of concern were defined as death and time, respectively, as reported by family members, recorded until the 2015 survey. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for death. The possibly nonlinear relationship between purine intake and mortality was examined with restricted cubic splines. Results: We included 17,755 subjects, and the average purine intake among them was 355.07 ± 145.32 mg/day. Purine intake was inversely associated with mortality (Ptrend < 0.001). Compared with the lowest quintiles of purine intake, the highest quintiles (HR = 0.60; 95% CI: 0.46, 0.77) showed a significant association with lower mortality. The negative association with mortality was mainly found in plant-derived purine (Ptrend = 0.001) and, weakly, in animal-derived purine (Ptrend = 0.052). In addition, a U-shaped relationship between purine intake and mortality was observed in males; however, there was no statistically significant dose−response relationship in females. Conclusion: Considering the low-purine-intake levels of the Chinese population, we observed a U-shaped relationship between purine intake and mortality in males, but purine intake may not relate to mortality in females. Future studies should investigate the causal relationship between purine intake and disease burden in China.

Impaired p47phox phosphorylation in neutrophils from patients with p67phox-deficient chronic granulomatous disease.

Superoxide production by the phagocyte reduced NAD phosphate (NADPH) oxidase is essential for innate immunity as shown in chronic granulomatous disease (CGD), an immunodeficiency disease resulting from mutations in 1 of its genes. The NADPH oxidase is composed of 2 membrane proteins (gp91phox/NOX2 and p22phox) and 4 cytosolic proteins (p47phox, p67phox, p40phox, and Rac1/2). The phosphorylation of p47phox is required for NADPH oxidase activation in cells. As p47phox and p67phox can form a tight complex in cells, we hypothesized that p67phox could regulate p47phox phosphorylation. To investigate this hypothesis, we used phospho-specific antibodies against 5 major p47phox-phosphorylated sites (Ser304, Ser315, Ser320, Ser328, and Ser345) and neutrophils from healthy donors and from p67phox-/- CGD patients. Results showed that formyl-methionyl-leucyl-phenylalanine and phorbol myristate acetate induced a time- and a concentration-dependent phosphorylation of p47phox on Ser304, Ser315, Ser320, and Ser328 in healthy human neutrophils. Interestingly, in neutrophils and Epstein-Barr virus-transformed B lymphocytes from p67phox-/- CGD patients, phosphorylation of p47phox on serine residues was dramatically reduced. In COSphox cells, the presence of p67phox led to increased phosphorylation of p47phox. In vitro studies showed that recombinant p47phox was phosphorylated on Ser304, Ser315, Ser320, and Ser328 by different PKC isoforms and the addition of recombinant p67phox alone or in combination with p40phox potentiated this process. Thus, p67phox and p40phox are required for optimal p47phox phosphorylation on Ser304, Ser315, Ser320, and Ser328 in intact cells. Therefore, p67phox and p40phox are novel regulators of p47phox-phosphorylation.

Prognostic significance of excision repair cross complementation group 1 rs2298881 in patients with gastric cancer receiving platinum-based chemotherapy: A PRISMA-compliant meta-analysis.

BACKGROUND: Gastric cancer (GC) is a strong cause of global cancer mortality. Nucleotide excision repair (NER) can modulate platinum-based chemotherapeutic efficacy by removing drug-produced DNA damage. Some studies have found a link between excision repair cross complementation group 1 (ERCC1) rs2298881, one gene in NER pathway, and response to chemotherapy. However, the results have been disputed. METHODS: We conducted a meta-analysis to reevaluate the association between polymorphisms of NER gene (ERCC1 rs2298881) and the clinical outcomes in gastric cancer patients receiving platinum-based chemotherapy. Searching PubMed, Web of Science, EMBASE, Google Scholar, and China National Knowledge Infrastructure, 2 independent searchers found all pertinent literatures up to May 1, 2021. We enrolled studies according to consistent selection criteria, extracted and vitrified data. Crude odds ratios (ORs) and hazard ratios (HRs) with 95% confidence interval (CI) were applied to evaluate the effect of ERCC1 rs2298881 on patients treated by platinum-based chemotherapy. RESULTS: By the data gathered from 6 independent studies, 1940 cases diagnosed with gastric cancer and treated with chemotherapy were included, containing 1208 Good-Responders and 732 Poor-Responders. With a comprehensive meta-analysis, we found that the patients with ERCC1 rs2298881A allele had a worse response to chemotherapy than those who with rs2298881C allele under allelic model (A vs C), with the pooled OR of 0.780 (95% CI: 0.611-0.996, P = .046). And our analysis indicated that AA genotype was associated with unfavorable overall survival (HR = 1.540, 95% CI = 1.106-2.144, P = .011) compared with CC genotype. CONCLUSIONS: ERCC1 rs2298881 is suggested as a marker of clinical outcome in gastric cancer patients treated by platinum-based chemotherapy.

Efficient Low-Grade Heat Harvesting Enabled by Tuning the Hydration Entropy in an Electrochemical System.

Harvesting of low-grade heat (<100 °C) is promising, but its application is hampered by a lack of efficient and low-cost systems. The thermally regenerative electrochemical cycle (TREC) is a potential alternative system with high energy-conversion efficiency. Here, the temperature coefficient (α), which is a key factor in a TREC, is studied by tuning the hydration entropy of the electrochemical reaction. The change of α in copper hexacyanoferrate (CuHCFe) with intercalation of different monovalent cations (Na+ , K+ , Rb+ , and Cs+ ) and a larger α value of -1.004 mV K-1 being found in the Rb+ system are observed. With a view to practical application, a full cell is constructed for low-grade heat harvesting. The resultant ηe is 4.34% when TREC operates between 10 and 50 °C, which further reaches 6.21% when 50% heat recuperation is considered. This efficiency equals to 50% of the Carnot efficiency, which is thought to be the highest ηe reported for low-grade heat harvesting systems. This study provides a fundamental understanding of the mechanisms governing the TREC, and the demonstrated efficient system paves the way for low-grade heat harvesting.

Selective Ion Sweeping on Prussian Blue Analogue Nanoparticles and Activated Carbon for Electrochemical Kinetic Energy Harvesting.

Kinetic energy is an ideal energy source for powering wearable devices or internet of things (IoTs) because of its abundant availability. Currently, most kinetic energy harvesting systems are based on friction or deformation, which require high-frequency motion or high material durability for sustainable energy harvesting. Here, we introduce selective ion sweeping in a hybrid cell consisting of an ion-adsorbing activated carbon and an ion-hosting Prussian blue analogue nanoparticle for electrochemical kinetic energy harvesting. The flow of electrolyte induced by kinetic motion of the cell causes ion sweeping only on the surface of the supercapacitor and induces current flow between the supercapacitor and the battery electrode. This method exhibits 24.9 µW cm-2 as maximum power of system with 34 Ω load in half-cell test, which is several thousand times smaller than the load used in conventional methods. In a long-term test with full cell, this method supplies a continuous current flow ∼6 µA cm-2 at the flow of 40 mL min-1 for 500 cycles without performance decay. The prototype of the hybrid cell demonstrated kinetic energy harvesting from bare hand press with the various flow speeds from 0.41 to 1.39 cm s-1 as well as walking, running, and door closing, which are representative examples of low-frequency kinetic motions in daily life. We believe that the simple structure of the hybrid cell will enable power supply to various applications from miniaturized systems (e.g., IoTs and wearables) to large-scale systems (e.g., ocean wave energy harvesting).

Maternal dietary patterns during pregnancy derived by reduced-rank regression and birth weight in the Chinese population.

Few studies have investigated the association between maternal dietary patterns (DP) during pregnancy, derived from reduced-rank regression (RRR), and fetal growth. This study aims to identify DP during pregnancy associated with macro- and micronutrient intakes, using the RRR method, and to examine their relationship with birth weight (BW). We used data of 7194 women from a large-scale cross-sectional survey in Northwest China. Dietary protein, carbohydrate, haem Fe density and the ratio of PUFA and MUFA:SFA were used as the intermediate variables in the RRR model to extract DP. Generalised estimating equation models were applied to evaluate the associations between DP and BW and related outcomes (including BW z-score, low birth weight (LBW) and small for gestational age (SGA)). Four DP during pregnancy were identified. Socio-demographically disadvantaged pregnant women were more likely to have lower BW and lower adherence to DP1 (high legumes, soyabean products, vegetables and animal-source foods, with relative low wheat and oils). Women with medium and high adherence to DP1 had significantly increased BW (medium 28·6 (95 % CI 7·1, 50·1); high 25·2 (95 % CI 2·7, 47·6)) and BW z-score and had significantly reduced risks of LBW and SGA. The associations were stronger among women with babies <3100 g. There is no association between other DP and outcomes. Higher adherence to the DP that was high in legumes, soyabean products, vegetables and animal-source foods was associated with improved BW in the Chinese pregnant women, particularly among those with disadvantageous socio-demographic conditions.

Iron intake and iron status during pregnancy and risk of congenital heart defects: A case-control study.

BACKGROUND: The relationships between iron nutritional status and congenital heart defects (CHDs) among humans are still unclear. This study aimed to explore the associations of maternal iron intake during pregnancy and maternal and neonatal iron status with CHDs. METHODS: This hospital-based case-control study analyzed 474 cases and 948 controls in Shaanxi China. Eligible women waiting for delivery in the hospital were interviewed to report their diets and characteristics during pregnancy. We conveniently collected maternal blood before delivery and neonatal cord blood to get a subgroup of 50 cases and 100 controls. Mixed logistic regression models were used to estimate ORs (95%CIs) for CHDs associated with iron intake. Mixed linear regression models were used to assess the relationships between CHDs and iron status. RESULTS: Mothers whose fetuses have CHDs were less likely to have higher intakes of total iron and heme iron during pregnancy, and the tests for linear trend were significant (all P < 0.05). Mothers whose fetuses have CHDs were less likely to take iron supplements during pregnancy (OR = 0.28, 95%CI: 0.21, 0.36) and during the first trimester (OR = 0.32, 95%CI: 0.12, 0.84). Maternal SF and Hb concentrations before delivery were lower and maternal sTfR/SF before delivery was higher among the cases than the controls. CONCLUSIONS: Mothers whose fetuses have CHDs are less likely to have higher intakes of total iron and heme iron and take iron supplements during pregnancy compared to their counterparts. Maternal iron status before delivery is low among mothers whose fetuses have CHDs.

The association of maternal dietary folate intake and folic acid supplementation with small-for-gestational-age births: a cross-sectional study in Northwest China.

The effect of maternal folate intake on small-for-gestational-age (SGA) births remains inconclusive. The present study aimed to investigate the associations of maternal folate intake from diet and supplements with the risk of SGA births using data from a cross-sectional study in Shaanxi Province of Northwest China. A total of 7307 women who were within 12 months (median 3; 10th-90th percentile 0-7) after delivery were included. Two-level models were adopted to examine the associations of folate (dietary folate, supplemental folic acid and total folate) intake with the risk of SGA births and birth weight Z score, controlling for a minimum set of confounders that were identified in a directed acyclic graph. Results showed that a higher supplemental folic acid intake during the first trimester was negatively associated with the risk of SGA births (≤60 d v. non-use: OR 0·80; 95 % CI 0·66, 0·96; >60 d v. non-use: OR 0·78; 95 % CI 0·65, 0·94; Ptrend = 0·010; per 10-d increase: OR 0·97; 95 % CI 0·95, 0·99). A higher total folate intake during pregnancy was associated with a reduced risk of SGA births (highest tertile v. lowest tertile: OR 0·77; 95 % CI 0·64, 0·94; Ptrend = 0·010; per one-unit increase in the log-transformed value: OR 0·81; 95 % CI 0·69, 0·95). A similar pattern was observed for the birth weight Z score. Our study suggested that folic acid supplementation during the first trimester and a higher total folate intake during pregnancy were associated with a reduced risk of SGA births.

Impact of XPF rs2276466 polymorphism on cancer susceptibility: a meta-analysis.

Association between the xeroderma pigmentosum complementation group F (XPF)rs2276466 located in the excision repair cross complementation group 4 (ERCC4) gene and cancer susceptibility has been widely investigated. However, results thus far have remained controversial. A meta-analysis was performed to identify the impact of this polymorphism on cancer susceptibility. PubMed, Embase and Science-Web databases were searched systematically up to May 20, 2018, to obtain all the records evaluating the association between the rs2276466 polymorphism and the risk of all types of cancers. We used the odds ratio (OR) as a measure of effect, and pooled the data in a Mantel-Haenszel weighed random-effects meta-analysis to provide a summary estimate of the impact of this polymorphism on gastrointestinal cancer, neurogenic cancer and other cancers (breast cancer and SCCHN). All the analyses were carried out in STATA 14.1.11 case-control studies that consisted of 5730 cases and 6756 controls, were eventually included in our meta-analysis. The significant association was observed between the XPFrs2276466 polymorphism and neurogenic cancer susceptibility (recessive model: OR = 1.648, 95% CI = 1.294-2.098, P<0.001). Furthermore, no significant impact of this polymorphism was detected on decreased gastrointestinal cancer risk (dominant model: OR = 1.064, 95%CI = 0.961-1.177, P = 0.233). The rs2276466 polymorphism might play different roles in carcinogenesis of various cancer types. Current evidence did not suggest that this polymorphism was directly associated with gastrointestinal susceptibility. However, this polymorphism might contribute to increased neurogenic cancer risk. More preclinical and epidemiological studies are still imperative for further evaluation.

Laparoscopic versus open gastrectomy for high-risk patients with gastric cancer: A systematic review and meta-analysis.

BACKGROUND: It is still remains unclear whether high-risk patients with gastric cancer can benefit from the application of laparoscopic gastrectomy (LG). The aim of this systematic review was to evaluate the surgical and long-term outcomes after LG and open gastrectomy (OG) for high-risk patients with gastric cancer. METHODS: We performed a systematic literature search in various databases from January 1994 to June 2018. Patients who had≥1 of the following conditions were defined as high-risk patients: (1) age≥70 years; (2) BMI≥30 kg/m2; (3) ASA (American Society of Anesthesiologists) grade≥3; or (4) clinical T4 stage (cT4). The results were analyzed according to predefined criteria. RESULTS: In the present meta-analysis, the outcomes of 12 non-randomized controlled studies enrolling 1651 patients (873 in the LG group and 778 in the OG group) were pooled. The estimated blood loss was significantly lower in the LG group than those in the OG group (P < 0.01). There was no significant difference between two groups in operative time (P = 0.17) and number of harvested lymph nodes (P = 0.21). In the LG group, the time to flatus (P < 0.01), time to food intake (P < 0.01), and postoperative hospital stay (P < 0.01) were significantly shorter than those in the OG group. A lower overall postoperative complication rate was observed in the LG group (P < 0.01). The incidence of surgical (P < 0.01) and non-surgical (P < 0.01) complication was significantly lower in the LG group than that in the OG group. The pooled analysis showed no significant difference in overall survival (OS) between LG and OG groups (P = 0.98). CONCLUSIONS: LG can be a safe and feasible procedure for high-risk patients with gastric cancer.

Surgical and long-term oncologic outcomes of laparoscopic and open gastrectomy for serosa-positive (pT4a) gastric cancer: A propensity score-matched analysis.

BACKGROUND: To date, it has been unclear whether laparoscopic gastrectomy (LG) is suitable for patients with serosa-positive (pT4a) gastric cancer. The purpose of this study was to compare the surgical and long-term oncologic outcomes of LG and open gastrectomy for pT4a gastric cancer. METHODS: We prospectively collected data from 987 patients with pathological confirmed pT4a gastric cancer who underwent LG or OG at our institution between June 2009 and May 2015. A 1:1 matched propensity score matching (PSM) analysis was performed to reduce confounding bias. The primary outcome was 5-year overall survival (OS). RESULTS: After PSM, a well-balanced cohort of 202 pairs patients was analyzed. The LG group showed a longer operation time (261.42 vs. 171.00 min, P = 0.001), less blood loss (185.47 vs. 217.84 ml, P = 0.000), and shorter postoperative hospital stay (7.56 vs. 8.22 days, P = 0.007). The overall complication rate was 14.4% in the LG group and 16.3% in the OG group (P = 0.581). The minor (grade II) and severe (grade ≥ IIIa) complication rates were similar (LG, 6.9% vs. OG, 9.9%, P = 0.282; LG, 7.4% vs. OG, 6.4%, P = 0.695, respectively). The LG and OG groups showed similar survival 5-year OS and 5-year Disease-free survival (DFS) rates (44.6% vs. 42.1%, P = 0.403; 40.1 vs. 37.6%, P = 0.321, respectively). The recurrence rate and pattern did not differ between the two groups during the follow-up stage (P > 0.05). CONCLUSIONS: For patients with pT4a gastric cancer, LG with D2 lymph node dissection can be a safe and feasible procedure in terms of surgical and long-term oncologic outcomes.