Comparative Evaluation of Polysaccharide Binders on the Quality Characteristics of Plant-Based Patties

Polysaccharides have been used in the production of plant-based meat analogs to replicate the texture of real meat. However, there has been no study that comprehensively compares the effects of different polysaccharides, and a limited number of polysaccharides have been evaluated. Thus, we aimed to identify the most suitable polysaccharide and concentration for plant-based patties. Plant-based patties were manufactured by blending different concentrations (0%, 1%, and 2%) of six polysaccharides with other ingredients, and the quality characteristics and sensory properties were evaluated. The L* values of plant-based patties reduced during the cooking process resembled the color change of beef patty (BP). In particular, a 2% κ-carrageenan-added patty (Car-2) exhibited the lowest L* value among the plant-based patties, measured at 44.05 (p < 0.05). Texture parameters exhibited high values by adding 2% κ-carrageenan and locust bean gum, which was close to BP. In the sensory evaluation, Car-2 showed higher scores for sensory preferences than other plant-based patties. Based on our data, incorporating 2% κ-carrageenan could offer a feasible way of crafting plant-based meat analogs due to its potential to enhance texture and flavor. Further studies are required to evaluate the suitability of polysaccharides in various types of plant-based meat analogs.

Apoptosis-Inducing Effects of Short-Chain Fatty Acids-Rich Fermented Pistachio Milk in Human Colon Carcinoma Cells

Pistachio milk (PM), an extraction product of pistachio, is protein- and fat-dense food. Short-chain fatty acids (SCFAs) are known for inducing cytotoxicity and apoptosis in colon carcinoma cells. This study aimed to find an optimal combination of probiotics that can produce a higher amount of SCFAs in PM. In addition, the anti-cancer effect of fermented PM on human colon carcinoma cells (Caco-2) was determined. The combinations of probiotics were as follows: Streptococcus thermophilus + Lactobacillus bulgaricus (C); C + Lactobacillus acidophilus (C-La); C + Lactobacillus gasseri (C-Lg); C + Bifidobacterium bifidum (C-Bb). The results indicated that fermented PM was produced after a short fermentation time in all the probiotics combinations. C-Bb produced up to 1.5-fold more acetate than the other probiotics combinations did. A significant amount of cytotoxicity, i.e., 78, 56, and 29% cell viability was observed in Caco-2 cells by C-Bb-fermented PM at 1, 2.5 and 5%, respectively. C-Bb-fermented PM (5%) induced early and late apoptosis up to 6-fold. Additionally, Caco-2 cells treated with C-Bb-fermented PM significantly induced the downregulation of α-tubulin and the upregulation of cleaved caspase-3, as well as nuclear condensation and fragmentation. Our data suggest that fermented PM, which is rich in acetate, may have the potential as a functional food possessing anti-colon cancer properties.

[Effects of cinepazide maleate injection on blood pressure in patients with acute ischemic stroke and hypertension]

Objective: To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection. Methods: This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes. Results: This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%,P>0.05) between cinepazide maleate group and control group. Conclusion: Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.

Development of β-Cyclodextrin/Konjac-Based Emulsion Gel for a Pork Backfat Substitute in Emulsion-Type Sausage

Emulsion gel has been used to replace animal fats in meat products. Konjac is a widely used gelling agent; however, its low emulsion stability limits its use in meat products. This study aimed to examine the quality characteristics of β-cyclodextrin (CD)-supplemented konjac-based emulsion gel (KEG) (CD-KEG) and its application as a fat substitute in emulsion-type sausages. The supplementation of CD increased hydrogen bonds and hydrophobic interactions with konjac and oil in the gels, respectively. Additionally, CD increased the structural complexity and strength of KEG. Since adding more than 6% of CD to KEG did not increase the gel strength, 6% CD-added KEG was adopted to substitute for pork backfat in manufacturing low-fat emulsion-type sausages. The following formulations of the sausages were prepared: pork backfat 20% (PF20); pork backfat 10% + KEG 10% (KEG10); KEG 20% (KEG20); pork backfat 10% + CD-KEG 10% (CD-KEG10); CD-KEG 20% (CD-KEG20); and pork backfat 5% (PF5). The CD-KEG20 formulation exhibited higher viscosity and viscoelasticity than KEG20, which suggested that CD improves the rheological properties and the thermal stability of meat batter. Additionally, CD-KEG20 showed similar emulsion stability, cooking yield and texture parameters compared with PF20. Therefore, 6% CD-added KEG is a suitable fat substitute for preparing low-fat emulsion-type sausages.

Effects of Chitosan and Duck Fat-Based Emulsion Coatings on the Quality Characteristics of Chicken Meat during Storage

Chicken meat is a popular food commodity that is widely consumed worldwide. However, the shelf-life or quality maintenance of chicken meat is a major concern for industries because of spoilage by microbial growth. The aim of this study was to evaluate the effects of chitosan and duck fat-based emulsion coatings on the quality characteristics and microbial stability of chicken meat during refrigerated storage. The coated chicken meat samples were as follows: control (non-coated), DFC0 (coated with duck fat), DFC0.5 (coated with duck fat and 0.5% chitosan), DFC1 (coated with duck fat and 1% chitosan), DFC2 (coated with duck fat and 2% chitosan), and SOC2 (coated with soybean oil and 2% chitosan). The results showed that the apparent viscosity and coating rate were higher in DFC2 than in other groups. Physicochemical parameters (pH, color, and Warner-Bratzler shear force) were better in DFC2 than those in other groups during 15 days of storage. Moreover, DFC2 delayed lipid oxidation, protein deterioration, and growth of microorganisms during storage. These data suggest that chitosan-supplemented duck fat-based emulsion coating could be used to maintain the quality of raw chicken meat during refrigerated storage.

Toxicity Assessment of a Single Dose of Poly(ethylene glycol) Diglycidyl Ether (PEGDE) Administered Subcutaneously in Mice

Poly(ethylene glycol) diglycidyl ether (PEGDE) is widely used to cross-link polymers, particularly in the pharmaceutical and biomaterial sectors. However, the subcutaneous toxicity of PEGDE has not yet been assessed. PEGDE samples (500–40,000 μg/mouse) were subcutaneously injected into the paraspinal dorsum of BALB/c male mice. Cage-side observations were carried out with measurement of organ weight, body weight variation, and feed intake, as well as histopathological characterization on day 28 post-exposure. Mice that received 40,000 μg of PEGDE showed severe toxic response and had to be euthanized. Subcutaneous injection of PEGDE did not alter feed intake and organ weight; however, the body weight variation of mice injected with 20,000 μg of PEGDE was significantly lower than that of the other groups. Exposure to 10,000 and 20,000 μg of PEGDE induced epidermal ulcer formation and hair loss. The histology of skin tissue in mice administered with 20,000 μg of PEGDE showed re-epithelialized or unhealed wounds. However, the liver, spleen, and kidneys were histologically normal. Collectively, PEGDE, particularly above 10,000 μg/mouse, caused subcutaneous toxicity with ulceration, but no toxicity in the other organs. These results may indicate the optimal concentration of subcutaneously injected PEGDE.

Comparison of the Probiotic Potential between Lactiplantibacillus plantarum Isolated from Kimchi and Standard Probiotic Strains Isolated from Different Sources

In the present study, the properties of the Lactiplantibacillus (Lpb.) plantarum WiKim0112 isolated from kimchi were evaluated by comparing its probiotic properties to those of Lpb. plantarum WCFS1 and KACC 11451 isolated from different sources. In both pH 2 and 3, media containing pepsin, Wikim0112, and WCFS1 showed higher cell viability than KACC11451. Viability of all Lpb. plantarum strains in a medium containing pancreatin and bile salt oxgall was significantly decreased compared to the control. WCFS1 showed the highest thermotolerance, followed by Wikim0112 and KACC11451. Wikim0112 showed a similar level of antibacterial activity to WCFS1 and exhibited an overall higher antibacterial activity than KACC11451 against six pathogens. All Lpb. plantatum strains showed high antioxidant activities in SOD, DPPH, and ABTS assays, especially Wikim0112 and WCFS1 exhibited a higher antioxidant activity than KACC11451. All Lpb. plantarum strains showed approximately 60–62% adhesion rates to Caco-2 cells. Moreover, in LPS-stimulated Caco-2 cells, all Lpb. plantarum strains significantly decreased the mRNA expression of pro-inflammatory cytokines (i.e., IL-1β, IL-6, and TNF-α); Wikim0112 significantly increased the mRNA expression of IL-4 and IFN-γ. Wikim0112 was resistant to streptomycin and vancomycin, whereas WCFS1 and KACC11451 were resistant to four (clindamycin, ciprofloxacin, tetracycline, and vancomycin) and three (ciprofloxacin, tetracycline, and vancomycin) antibiotics, respectively. These results, taken together, indicated that compared to Lpb. plantarum strains isolated from different sources, Wikim0112 showed desirable probiotic properties, suggesting its potential applications in the food and pharmaceutical industries.

Effects of Flutriafol Fungicide on the Lipid Accumulation in Human Liver Cells and Rat Liver

Flutriafol (FTF) is a triazole fungicide that can cause liver toxicity through the ingestion of its residues in food and water. However, little is known about the liver toxicity of FTF, particularly nonalcoholic fatty liver disease (NAFLD) in humans. Therefore, the purpose of this study was to investigate whether FTF induces NAFLD in human liver cells and animal liver. HepG2 cells and Sprague Dawley (SD) rats were treated with FTF at doses of 0–640 µM for 24 h and 0–150 mg/kg bw/day for 28 days, respectively. FTF (80, 160, and 320 µM) treatment to cells induced lipid accumulation. FTF (80 and 160 µM)-treated cells had higher levels of cytochrome P450 enzymes and reactive oxygen species and increased mitochondrial membrane potential loss than the control. FTF also increased the mRNA levels of antioxidant enzymes through oxidative stress and nuclear factor erythroid 2-related factor 2 pathways in HepG2 cells. However, a higher level of FTF (320 µM) induced apoptosis. The treatment of SD rats with FTF (2.5–150 mg/kg bw/day) induced fatty infiltration in the liver by impairing liver metabolism and inducing apoptosis. Therefore, our data suggest that human exposure to FTF residues may be a risk factor for liver diseases, such as NAFLD.

Quality characteristics of yogurts fermented with short-chain fatty acid-producing probiotics and their effects on mucin production and probiotic adhesion onto human colon epithelial cells

Probiotics can ferment nondigestible carbohydrates and produce short-chain fatty acids (SCFA; acetate, propionate, and butyrate) in the human colon. In this study, the levels of SCFA were determined in the following yogurts fermented with different combinations of probiotics: (1) cocultures of Streptococcus thermophilus and Lactobacillus bulgaricus (control, C); (2) S. thermophilus, L. bulgaricus, and Bifidobacterium bifidum (C-Bb); (3) S. thermophilus, L. bulgaricus, and Lactobacillus acidophilus (C-La); and (4) S. thermophilus, L. bulgaricus, and Lactobacillus gasseri (C-Lg). Results showed that the acetate levels were significantly higher in C-Bb, C-La, and C-Lg yogurts than in C yogurt. Fermentation and physicochemical characteristics of all yogurts were identical. Treatment of mucus-secreting colon epithelial cells (HT29-MTX) with C-Bb, C-La, and C-Lg yogurt supernatants resulted in an increase in the expression of MUC2 and CDX2 and the production of mucin proteins. The adhesion of probiotics onto HT29-MTX cells increased following treatment with C-Bb, C-La, and C-Lg yogurt supernatants. Our data suggest that a yogurt diet rich in acetate improves the protective function of the intestinal epithelium.

Antioxidant Properties and Diet-Related α-Glucosidase and Lipase Inhibitory Activities of Yogurt Supplemented with Safflower (Carthamus tinctorius L.) Petal Extract

Recently, yogurt has been extensively studied to further enhance its functions using edible plant extracts. This study was conducted to investigate whether safflower petal (SP) as a natural food additive can be used to develop functional yogurt with improved health benefits. SPs were extracted with ethanol (SPE) and hot water (SPW), and then safflower yogurt was prepared by adding 0%-1.0% of those extracts to plain yogurt. With an increase in the fermentation duration, the pH of SPE and SPW yogurt samples was decreased, whereas titratable acidity and microbial counts were increased. The concentration of total polyphenols and total flavonoids, the activity of antioxidants, and the inhibitory effect on reactive oxygen species (ROS) were higher in SPW yogurt than SPE yogurt. Furthermore, α-glucosidase and lipase activity inhibitory effects of SPW yogurt were higher than those of SPE yogurt. In particular, free radical-scavenging activities, ROS inhibitory effect, and α-glucosidase activity inhibitory effects were significantly increased in SPW yogurt in a dose-dependent manner. Overall, these results suggest that SP extract possesses antioxidant activities and that it can downregulate α-glucosidase and lipase activities. The SP extract may have potential benefits as a natural food additive for the development of functional yogurt.

Short communication: Effects of moringa extract on adhesion and invasion of Escherichia coli O55 in bovine mammary epithelial cells

The objective of this study was to evaluate the antibacterial activities of extract derived from moringa leaves. In particular, the effect of moringa extract (Mor) on adhesion and invasion of Escherichia coli O55, Enterococcus faecalis, Staphylococcus simulans, and Serratia liquefaciens was evaluated in bovine mammary epithelial cells (MAC-T). Broth microdilution method, minimum inhibitory concentration and minimum bactericidal concentration assays, adhesion and invasion assays, and real-time PCR were performed. The minimum inhibitory concentration and minimum bactericidal concentration of Mor ranged from 12.5 to 50 mg/mL on 18 out of 27 tested isolates. Treatment of E. coli O55 with Mor (100 and 200 μg/mL) inhibited the adhesion and invasion on MAC-T cells via downregulation of adhesion factors (i.e., papC, f17c-A, and eaeA). Also, when MAC-T cells were pretreated with Mor (200 μg/mL, 12 h) and incubated with E. coli O55, Enterococcus faecalis, Staphylococcus simulans, or Serratia liquefaciens, both E. coli O55 and Enterococcus faecalis showed a significant decrease in adhesion and invasion. Staphylococcus simulans exhibited decreased adhesion and increased invasion. Serratia liquefaciens showed increased adhesion and decreased invasion. In addition, Mor increased mRNA expression of antioxidant enzymes (e.g., heme oxygenase-1, NAD(P)H:quinone oxidoreductase-1, and thioredoxin reductase 1) in MAC-T cells. In conclusion, 12.5 to 50 mg/mL of Mor exhibited antibacterial activity against 18 out of 27 tested isolates. Also, pretreatment of 200 μg/mL of Mor to MAC-T cells modulated adhesion and invasion of E. coli O55 and other mastitis-associated pathogens. Furthermore, Mor increased antioxidant capacities in MAC-T cells, but further in vivo studies are needed.

Dietary supplementation with combined extracts from garlic (Allium sativum), brown seaweed (Undaria pinnatifida), and pinecone (Pinus koraiensis) improves milk production in Holstein cows under heat stress conditions

OBJECTIVE

This study was conducted to examine the effects of a mixture of pinecone oil, garlic, and brown seaweed extracts (PGBE) on milk production traits as well as physiological and ethological parameters in Holstein cows during the summer season (24 May to 03 July 2015, Korea).

METHODS

Among the extract combinations tested, we found that the level of 2,2'-azino-bis (3-ethylberzothiazoline-6-sulphonic acid) cation radical scavenging activity of the 0.16% PBGE complex at ratio of 1:1:1 (vol/vol) was comparable to that of the control (ascorbic acid; 1 mg/mL). Additionally, the PBGE complex reduced lipopolysaccharide-induced COX-2 expression in bovine mammary epithelial cells. Based on these findings, 40 lactating Holstein cows were used to measure the effects of PBGE complex at ratio of 1:1:1 (vol/vol) on milk production, immune response, metabolites, and behavior patterns by dividing the cows into two groups fed diets containing PGBE complex (n = 20; 0.016%/kg feed dry matter basis) or not containing PGBE complex (control, n = 20) for 40 d.

RESULTS

Results showed that PGBE complex did not influence milk composition, eating and ear surface temperature patterns, immune response, or metabolic parameters but promoted average milk yield throughout the experimental period. Additionally, a tendency of higher total antioxidant capacity and glutathione in the PGBE group was observed compared to the those in the control. When the temperature-humidity index (THI) exceeded 72 (average THI = 73.8), PGBE complex-fed cows experiencing heat stress showed increased milk yield and a tendency of increased rumination compared to the control.

CONCLUSION

We suggest that incorporation of a combined mixture of 0.016% PGBE (1:1:1 ratio, vol/vol) to diet has the potential to improve milk yield and health status of cows under mild to moderate heat stress, denoting that it might be useful as an alternative anti-stressor in the diet of dairy cows under hot conditions.

[Experience of revision cochlear implantation]

Objective:To analyse the characteristics of the revision cochlear implantation （RCI）patients，the cause of the cochlear malfunction，and the choice of RCI operative approach. Method:A total of 39 patients with RCI were enrolled in this study. The cochlear use time, cause of failure and reoperation procedure are recorded and analyzed retrospectively. Result:There were 39 patients accepted cochlear reoperation，the ages ranges from 1 to 28，average age was 7.8 years, median age was 5 years old. The cochlear use time ranges from 1 month to 7 years，average was 2.2 years, median time was 1 year. Thirty-seven patients underwent RCI,30 cases right side and 7 cases left side. The reason of RCI contains device failure (28 cases)，infection (5 cases)，incorrect electrode implantation (3 cases)，facial nerve stimulation (2 cases)，and electrode prolapse (1 case).The choice of RCI procedure was dependent on the first operation procedure,contains facial nerve recess approach (35 cases) and mastoid approach (2 cases).Contralateral implantation was performed in 5 cases, the rest were ipsilateral. Conclusion:RCI has a variety causes and the common reason is trauma and device failure，the RCI should be completed as early as possible to avoid the ossified cochlear and hearing or speech stagnation，the electrode implantation through previous approach is the best method.

[Cochlear implant for elder patients over 75 years old]

Objective: To evaluate the operation safety, hearing as well as speech results of cochlear implantation that were applied in patients over 75 years old. Method: A series of patients who were diagnosed as severe to profound sensorineural hearing loss and received cochlear implantation were admitted. The clinical data and rehabilitation effects of the patients who were over 75 years old were summarized. Result: During this period, in which 7(1.31%) patients aged over 75 at implantation. The age ranged from 75 to 88, with an average of 80 years old. All of the 7 patients received a safe operation under general anesthesia. No major or minor complications happened related to surgery and anesthesia. Only one 84 years old male patient suffered from a transient mild balance problem. Follow up were carried out regularly, ranging from 4-40 months. The average of categories of auditory performance and speech intelligibility rating is 4 and 5 respectively. Conclusion: The cochlear implant surgery and general anesthesia are safe for patients over 75 years old, and these patients can benefit from cochlear implantation.

Arbuscular mycorrhizal fungi spore propagation using single spore as starter inoculum and a plant host

AIMS

The propagation of pure cultures of arbuscular mycorrhizal fungal (AMF) is an essential requirement for their large-scale agricultural application and commercialization as biofertilizers. The present study aimed to propagate AMF using the single-spore inoculation technique and compare their propagation ability with the known reference spores.

METHODS AND RESULTS

Arbuscular mycorrhizal fungal spores were collected from salt-affected Saemangeum reclaimed soil in South Korea. The technique involved inoculation of sorghum-sudangrass (Sorghum bicolor L.) seedlings with single, healthy spores on filter paper followed by the transfer of successfully colonized seedlings to 1-kg capacity pots containing sterilized soil. After the first plant cycle, the contents were transferred to 2·5-kg capacity pots containing sterilized soil. Among the 150 inoculated seedlings, only 27 seedlings were colonized by AMF spores. After 240 days, among the 27 seedlings, five inoculants resulted in the production of over 500 spores. The 18S rDNA sequencing of spores revealed that the spores produced through single-spore inoculation method belonged to Gigaspora margarita, Claroideoglomus lamellosum and Funneliformis mosseae. Furthermore, indigenous spore F. mosseae M-1 reported a higher spore count than the reference spores.

CONCLUSIONS

The AMF spores produced using the single-spore inoculation technique may serve as potential bio-inoculants with an advantage of being more readily adopted by farmers due to the lack of requirement of a skilled technique in spore propagation.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of the current study describe the feasible and cost-effective method to mass produce AMF spores for large-scale application. The AMF spores obtained from this method can effectively colonize plant roots and may be easily introduced to the new environment.

Effect of the Duck Skin on Quality Characteristics of Duck Hams

This study was conducted to investigate the effect of duck skin on cooking loss, emulsion stability, pH, color, protein solubility, texture profile analysis (TPA), apparent viscosity, and sensory characteristics of press type duck ham with different ratio of duck breast meat and duck skin. Five duck ham formulations were produced with the following compositions: T1 (duck breast 70% + duck skin 30%), T2 (duck breast 60% + duck skin 40%), T3 (duck breast 50% + duck skin 50%), T4 (duck breast 40% + duck skin 60%), and T5 (duck breast 30% + duck skin 70%). The cooking loss and fat separation were lower in T1, and the total expressible fluid separations were lower in T1 and T2 than others. The pH ranged from 6.48 to 6.59, with the highest values in T4 and T5. T5 had the highest CIE L*-value, and T1 and T2 had the highest CIE a*-values; however, CIE b*-values did not differ significantly between the duck ham samples. The protein solubility and TPA (hardness, springiness, cohesiveness, gumminess, and chewiness) were the highest in T1. T1 and T2 had higher scores for color, tenderness, and overall acceptability. T1, T2, and T3 showed significantly higher values, but there were no significant differences for flavor and juiciness. Regarding apparent viscosity properties, T1 and T2 had higher viscosity values than the other formulations. In conclusion, the T1 (duck breast 70% + duck skin 30%) and T2 (duck breast 60% + duck skin 40%) duck hams show the highest quality characteristics.

[Electrically evoked auditory brainstem responses in patients with absence of cochlear modiolus receiving cochlear implantation]

Objective:The purpose of this study was analyzing the characteristic of the electrically evoked auditory brainstem responses (EABR) of cochlear implantation (CI) patients with absence of cochlear modiolus (ACM) and comparing the EABR results in deaf patients with normal anatomic structures. Also we assessed the auditory rehabilitation of ACM patients after cochlear implantation.Method:Twenty-eight profoundly deaf patients were contained, 14 of them were ACM (group A) and the rest were normal anatomic structures (group B). They all received Austria cochlear implants from 2004 to 2015. Postoperative EABR were measured and recorded with No. 2, 6, 11 electrodes in patients receving cochlear implantation. The lead-out rate and threshold of EABR between groups were compared and analyzed. Result:The lead-out rates of EABR in group A was 71.4% and group B was 100%. The thresholds of EABR in group A were higher than group B (P< 0.05). In group A, there were no statistical difference in the thresholds of EABR among electrodes No.2,6 and 11. However, in group B, there were statistical difference in the thresholds of EABR between electrodes No.2 and 11 (P< 0.05), and the thresholds of No.2 was lower than No.11Conclusion:EABR could be used in assessing the objective auditory rehabilitation in ACM patients after cochlear implantation.

A case-control study of risk factors for hepatocellular carcinoma in Henan, China

A case-control study was carried out to investigate risk factors in the development of hepatocellular carcinoma (HCC) in Henan, China. A total of 152 patients with HCC and 115 control patients with nonhepatic disease were included in this study. The risk factor analysis indicated that individual history of liver disease (odds ratio [OR]=11.77; 95% confidence interval [CI]=3.94-35.18), family history of liver disease (OR=11.80, 95% CI=2.75-50.61), drinking of alcohol (OR=1.06, 95% CI=1.02-1.10), corn consumption (OR=19.43, 95% CI=3.67-102.98), peanut and peanut oil consumption (OR=13.75, 95% CI=3.69-51.16), and infection with hepatitis B virus (HBV) (OR=44.59, 95% CI=12.54-158.49) were significantly different between the case and control groups (P < 0.01). We also found that there was a dose-response relationship between drinking of alcohol and development of HCC, whereas heavy drinkers experienced an approximately 3-4-fold risk increase compared with nondrinkers. In further analysis, a 1:1 pair-matched case-control study was performed. One hundred thirteen of 152 HCC patients were randomly selected to be pair-matched by sex and age (+/-5 years) with the controls with nonhepatic disease. The results from the 1:1 pair-matched case-control study were consistent with the results from the group-matched case-control study. The findings of this study suggest that hepatitis virus (HBV, HCV) infection, drinking of alcohol, and dietary exposure to aflatoxin are likely etiologic agents of HCC in Henan, China.

A case-control study of hepatitis B and C virus infection as risk factors for hepatocellular carcinoma in Henan, China

BACKGROUND

Hepatocellular carcinoma (HCC) is one of the most common cancers in the world and is particularly prevalent in China. China is also a hyperendemic area for hepatitis B virus (HBV) infection. Although a strong association between HBV infection and HCC has been established previously, the role of hepatitis C virus (HCV) infection and the interaction between HBV and HCV in the development of HCC has not been adequately explored. The major objective of this study is to determine the relationship between HBV or HCV infection and HCC by use of case-control study in Henan, China.

METHOD

In all, 152 HCC patients and 115 control patients were collected from four hospitals in Henan, China between January 1994 and October 1995. The demographic characteristics of the two groups were comparable. In further analysis, a 1:1 pair-matched case-control study was performed. Of 152 HCC patients, 113 were randomly selected to be pair-matched by sex and age (+/-5 years) to controls with non-hepatic disease. All the cases and controls were interviewed during hospitalization by two specially trained interviewers using a standard questionnaire. All sera were tested for HBV and HCV markers. Odds ratios (OR) and 95% CI for HCC risk factors were calculated by logistic regression model controlling for possible confounding factors such as sex and age. The multivariate analysis was done on the basis of the univariate analysis.

RESULTS

The results of this study indicated that the prevalence of hepatitis B surface antigen (HBsAg) and antibody to HCV (anti-HCV) were much higher in HCC patients (63.2% and 11.2% respectively) than in the control patients (5.2%, 3.5%). The difference between two groups was significant (P < 0.05). Risk factor analysis revealed that both HBV and HCV infection were important factors for HCC in Henan, China and HBV appeared to have a key role in the development of HCC. Odds ratios of HBsAg and HBV infection were 28.82 (95% CI: 11.18-78.78) and 31.22 (95% CI: 13.86-72.15), respectively. Moreover, the risk of developing HCC increased significantly and showed an additive effect when both viral markers of HBV and HCV infection were considered (OR = 42.85). Results from the 1:1 pair-matched case-control study also showed that HBV infection was an important risk factor for HCC, which was consistent with the results from the group-matched case-control study.

CONCLUSION

This is the first reported case-control study of HCC in Henan, China. This study provides further evidence that chronic HBV infection is strongly associated with the development of HCC among this population. Our results have demonstrated that HCV and HBV infection are independent and probably additive risk factors for HCC.

[An epidemiological survey follow-up study on infant breast-feeding. III. Multiple stepwise regression analysis to factors affecting human milk amount]

This paper reports the result of multiple regression analysis to factors affecting human milk amount. By using survey follow-up study method, the data were obtained from 461 mothers who breast-fed their infants within six months after delivery. According to the results of stepwise regression, factors including the number of breast-feeding per day after one month post-partum, the number of breast-feeding per day within one month post-partum, breast-feeding infant regularly, menstruation recovery late are related to the amount of breast milk positively (increasing human milk amount), and factors including maternal poor appetite in lactation period, family deficient breast milk history, infant poor development, maternal disease in pregnancy and lactation period, contraceptive agents used, sunk or sore nipples are related to the amount of breast milk negatively (decreasing human milk amount). Because there are a lot of factors can affect human milk amount, it coincides with practical situation that multiple analysis is used to analysis these factors. It is also an attempt to use this method in mother and infant health care field.

Malignant small bowel neoplasm of enteric plexus derivation (plexosarcoma). Light and electron microscopic study confirming the origin of the neoplasm

An unusual small intestinal tumor was found in a 61-year-old male who complained of intermittent right lower quadrant burning pain, tenesmus, and bloody diarrhea. On gross examination, the tumor was located intramurally in the distal jejunum with no involvement of the overlying mucosa. Histologic examination revealed two elements: a spindle cell component with characteristics reminiscent of a Schwann cell neoplasm, and nests of larger epithelioid-like cells almost undistinguishable from the Zellballen of nonchromaffin paragangliomas. The neoplasm originated within the intestinal wall without apparent mucosal origin. Ultrastructural studies revealed features recapitulating the normal enteric plexus structure and quite unlike those described in normal or neoplastic smooth muscle, Schwann or paraganglion cells. On this basis, this neoplasm is considered as a malignant enteric plexus tumor or a plexosarcoma.