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Xue-Dong Wang, Yu Wang, Jing Liu, Ji-Wen Yao, Jing Zhang, Yi-Nan Zhang Department of Cardiology, Beijing Hepingli Hospital, Beijing, People’s Republic of ChinaCorrespondence: Xue-Dong Wang, Department of Cardiology, Beijing Hepingli Hospital, No. 18 of Hepingli North Street, Dongcheng District, Beijing, People’s Republic of China, Tel +86 10 5804 3212, Fax +86 10 6429 5714, Email wangxd_fjit@163.comObjective: To examine the effects of hypokalemia on the prognosis of older adult patients with atrial fibrillation (AF).Methods: We enrolled 794 older adult patients ≥ 75 years suffering from AF, and divided them into two groups according to the inclusion and exclusion criteria: Group 1, (hypokalemia group), 246 cases, serum K+< 3.5 mmol/L; Group 2, (normal blood potassium group), 548 cases, 3.5mmol/L≤serum K+< 5.5 mmol/L. The two groups of patients were followed for 70 months to observe the occurrence of clinical events. The primary endpoint was cardiovascular death and the secondary endpoint was all-cause death.Results: The median follow-up time was 15.00 months. In terms of baseline profile characteristics, serum creatinine levels were significantly lower in Group 1 than in Group 2 patients (P=0.002). In terms of the relationship between hypokalemia and clinical outcomes, Kaplan-Meier survival analysis revealed that the incidence of clinical primary endpoint in Group 1 was significantly higher than that in Group 2 (P < 0.001), and the incidence of the secondary endpoint did not differ significantly between the two groups (P> 005). Based on multivariate Cox regression risk model analysis, coronary heart disease, hemoglobin content, serum uric acid and usage of anticoagulant drugs were the independent variables related to the primary endpoint of cardiovascular death (all P< 0.01).Conclusion: The incidence of hypokalemia in older adult patients with AF was 30.98%. Hypokalemia was closely related to the cardiovascular death, and coronary heart disease, hemoglobin content, serum uric acid level, and usage of anticoagulant drugs were the independent risk factors for the primary endpoint event.Keywords: atrial fibrillation, older adult, hypokalemia, prognosis

Wei Liu,1,&ast; Di-Jun Lu,1,&ast; Xiao-Wen Li,1 Yu-Liang Zhang,2 Ming-Hua Shi,2 Xu-Dong Wang1 1Department of Emergency, Aerospace Center Hospital, Beijing, 100049, People’s Republic of China; 2Department of Emergency, Keyouqianqi People’s Hospital, Inner Mongolia, 137400, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xu-Dong Wang, Department of Emergency, Aerospace Center Hospital, No. 15 of Yuquan Street, Haidian District, Beijing, 100049, People’s Republic of China, Tel +86 10 59971968, Fax +86 10 59971199, Email xudongwang59@163.comObjective: To summarize the characteristics of patients calling the 120 emergency number for pre-hospital first aid in Keyouqian Banner, Hinggan League.Methods: The clinical data of adult patients with pre-hospital first aid from 2016 to 2018 were retrospectively analyzed.Results: There were 2711 cases with pre-hospital first aid. Males significantly outnumbered females. Young and middle-aged patients comprised 81.5%. Patients were mainly Han and Mongolians. Most injuries and illnesses occurred at home and on the road. The time to arrival of medical services was 30.34 ± 28.29 minutes. The proportion of pre-hospital first aid for trauma was the highest, followed by diseases concerning the cardiovascular and neurological systems. The proportion of patients with improved medical conditions after onsite first aid was 43.3%, the proportion with unchanged conditions was 51.7%, and the total mortality rate was 3.9%.Conclusion: The disease spectrum, ethnic distribution, age at onset, and pre-hospital first aid capabilities for outpatients were analyzed. These results may facilitate the establishment of a pre-hospital first aid system for the local prevention and control of acute and critical illnesses, increase the success rate of the region’s pre-hospital first aid services, and improve the prognosis.Keywords: Keyouqian Banner, Inner Mongolia, pre-hospital first aid, emergency medical service, epidemiological analysis

Ling-Yun Ma,1,&ast; Fangfang He,2,&ast; Shuai Liu,3 Xiao-Dan Wang,3 Yanqin Gao,2 Zhihong Shi,3,4 Jianping Niu,2 Yong Ji1,3,4 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Neurology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, People’s Republic of China; 3Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Dementia Institute, Tianjin Huanhu Hospital, Tianjin, People’s Republic of China; 4China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jianping Niu; Yong Ji, Tel +8618059218208 ; +8613612048681, Email jianpingniu@outlook.com; 549872685@qq.com; jiyongusa@126.comIntroduction: High blood pressure is one of the main modifiable risk factors for dementia. However, it remains unclear whether lowering the blood pressure effectively prevents cognitive impairment. Our objective was to explore the association between the prevalence, medication adherence and control of hypertension and mild cognitive impairment (MCI) among elderly individuals in northern China.Methods: A two-stage clustering sampling method was used, and 9036 participants aged ≥ 65 years were included in the analysis. The Mini-Mental State Examination and activities of daily living were used to assess participants’ cognitive function. Demographic characteristics (gender, age, marital status, education level, occupation), history and duration of hypertension, use of antihypertensive medications (AHMs) and its control effect were obtained.Results: The prevalence of MCI in all participants was 18.1%, and the prevalence of MCI was significantly higher in hypertensive subjects than in normotensive subjects (19.7% vs 16.2%, P

Yu Wang,1 Xue-Dong Wang,1 Ji-Wen Yao,1 Bei-Bei Shi,1 Qing-Xiang Gu,2 Jing Zhang,1 Xiao-Ting Cui,1 Yan Wang1 1Department of Cardiology, Beijing Hepingli Hospital, Beijing, 100013, People’s Republic of China; 2Department of Rheumatology, The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, People’s Republic of ChinaCorrespondence: Xue-Dong WangDepartment of Cardiology, Beijing Hepingli Hospital, No. 18 of Hepingli North Street, Dongcheng District, Beijing, 100013, People’s Republic of ChinaTel +86 10 5804 3212Fax +86 10 6429 5714Email wangxd_fjit@163.comObjective: This study aimed to investigate the impact of the duration of cardiac troponin I (TnI) elevation on the prognosis and incidence of new-onset atrial fibrillation (NOAF) in elderly patients with non-ST-elevation acute myocardial infarction (NSTE-AMI).Methods: A total of 383 NSTE-AMI patients ≥ 75 years old were enrolled in this study and divided into two groups: in 194 cases, the duration of TnI elevation was ≥ 14 days (group 1), and in 189 cases, the duration of TnI elevation was < 14 days (group 2). The patients were followed up for 60 months. The effect of TnI on prognosis was studied by cohort. The primary endpoint was a composite endpoint of cardiovascular death, reinfarction, ischemic stroke, and hospitalization for heart failure, and the secondary endpoint was all-cause death. A case–control study design was adopted to analyze the influencing factors of NOAF occurrence in Group 1 and Group 2.Results: The median duration of follow-up was 26 months. Multivariate Cox’s regression analysis revealed that the duration of TnI elevation ≥ 14 days and diuretic use were independent variables of the major composite endpoint (p < 0.01 for both), and the left ventricular ejection fraction and the duration of TnI elevation ≥ 14 days were independent related variables of all-cause death (p < 0.05). The duration of TnI elevation ≥ 14 days was correlated with the occurrence of NOAF, but, in the multivariate logistic regression model, only uric acid and high-sensitivity C-reactive protein were independently associated with NOAF (p < 0.05).Conclusion: The duration of TnI elevation ≥ 14 days was the independent correlation factor of the major composite endpoint and all-cause death; high sensitivity C-reactive protein and uric acid are independent risk factors for NOAF.Keywords: duration of TnI elevation, the elderly, non-ST-segment acute elevation acute myocardial infarction, prognosis, new-onset atrial fibrillation

Wei Liu,1 Li-Na Liu,1 Cai-Wei Lin,1 Hao-Yu Wang,2 Xu-Dong Wang1 1Department of Emergency, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), Beijing, 100049, People’s Republic of China; 2Department of Radiology, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), Beijing, 100049, People’s Republic of ChinaCorrespondence: Xu-Dong WangDepartment of Emergency, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), No. 15 of Yuquan Street, Haidian District, Beijing, 100049, People’s Republic of ChinaTel +86 10 59971968Fax +86 10 59971199Email xudongwang59@163.comAbstract: We present the case of a 60-year-old woman who suddenly suffered a witnessed cardiac arrest and did not achieve return of spontaneous circulation despite being given 150-minute ultra-long cardiopulmonary resuscitation (CPR). During CPR, pulmonary embolism was suspected and was eventually diagnosed based on refractory pulseless electrical activity, elevated serum D-dimmer, and a markedly enlarged right ventricle chamber. After rescue thrombolytic alteplase therapy, the patient was successfully resuscitated and had a good neurological recovery.Keywords: cardiac arrest, pulmonary embolism, thrombolysis

Xuan-Wei Huang,1,* Xu-Dong Wang,2,* Jie-Lan Lai,2 Ya-Li Lu,2 Kun Deng,3 Ren-Chun Lai2 1The First Affiliated Hospital of Sun Yat-Sen University, Department of Anesthesiology, Guangzhou 510080, People’s Republic of China; 2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Department of Anesthesiology, Guangzhou 510060, People’s Republic of China; 3Xifeng People’s Hospital, Department of Anesthesiology, Guiyang 520122, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ren-Chun Lai Email lairch@sysucc.org.cnBackground: Whether laryngeal cancer is directly implanted into the lungs during orotracheal intubation is still unclear. Therefore, this study aimed to find whether orotracheal intubation is an independent risk factor for postoperative pulmonary metastasis in patients undergoing laryngectomy.Patients and Methods: Medical records from January 1, 2006, to December 31, 2016, were reviewed. According to similar propensity scores, patients who received orotracheal intubation (tracheal intubation group, n = 515) were matched 1:1 with those who received tracheotomy (tracheotomy group, n = 326) in the induction of general anesthesia. The primary outcome was postoperative pulmonary metastasis. Secondary outcomes included local recurrence, lymphatic metastasis, tracheostomal recurrence and overall survival.Results: Between the two groups, there was no significant difference in postoperative pulmonary metastasis (P = 0.688), local recurrence (P = 0.215), lymphatic metastasis (P = 0.480), tracheostomal recurrence (P = 0.246) or all-cause death (P = 0.299). The primary site of cancer was an independent risk factor for pulmonary metastasis [HR 0.29, 95% CI 0.13– 0.68; P = 0.013] and local recurrence (HR 2.69, 95% CI 1.39– 5.21; P = 0.003). Type of surgery (HR 3.13, 95% CI 2.03– 4.84; P < 0.001) and N classification of TNM (HR 0.27, 95% CI 0.10– 0.75; P = 0.012) were risk factors for local recurrence. Postoperative chemotherapy was an independent risk factor for lung metastasis (HR 7.58, 95% CI 3.11– 18.47; P < 0.001) and lymphatic metastasis (HR 5.18, 95% CI 2.57– 11.91; P < 0.001), and 5-year overall survival was associated with age (P = 0.028), clinical stage (P < 0.001) and postoperative chemotherapy (P = 0.003) but not with anesthetic technique (P = 0.473).Conclusion: This retrospective study suggests that orotracheal intubation in laryngectomy is not a risk factor for postoperative pulmonary metastasis, local recurrence, lymphatic metastasis or overall survival.Keywords: laryngectomy, lung metastasis, local recurrence, tracheal intubation, tracheotomy

Zhi-Bin Kong,1 Xing-De Wang,2 Shu-Rong Shen,2 Hua Liu,1 Li Zhou,2 Bin Chen,2 Zhong Chen,2 Shao-Jun Yin1 1Department of Respiratory Medicine, Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Science, Shanghai 201306, People’s Republic of China; 2Department of Cardiology, Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Science, Shanghai 201306, People’s Republic of ChinaCorrespondence: Xing-De WangDepartment of Cardiology, Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Science, No. 222 Huanhu West Road, Lingang New City, Pudong New Area, Shanghai 201306, People’s Republic of ChinaTel +862138297277Email sd_wangxd@sumhs.edu.cnShao-Jun YinDepartment of Respiratory Medicine, Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Science, No. 222 Huanhu West Road, Lingang New City, Pudong New Area, Shanghai 201306, People’s Republic of ChinaTel +862138297762Email yinshaojun2010@163.comPurpose: Chronic obstructive pulmonary disease (COPD) is associated with increased incidence of arrhythmias, which has been attributed to autonomic dysregulation. Detection of autonomic function may facilitate stratification of COPD patients with respect to their risk of development of arrhythmias.Patients and Methods: A total of 151 COPD patients and 45 non-COPD patients were included in this study. Heart rate deceleration runs (DRs) were detected by dynamic electrocardiogram (ECG); DRs successively occurring in 2, 4, or 8 cardiac cycles were denoted as DR2, DR4, and DR8, respectively. Indicators of arrhythmias including isolated premature atrial contractions (PAC), supraventricular tachycardia (SVT), isolated premature ventricular contractions (PVC), and ventricular tachycardia (VT) were recorded. Occurrence of SVT or PAC ≥ 70/day was considered positive for supraventricular arrhythmias, while positive ventricular arrhythmias category (PVAC) was defined as occurrence of VT or PVC ≥ 10/hour.Results: Compared with non-COPD individuals, COPD patients were associated with increased number of PAC, PVC, higher incidence of PAC > 70/d, SVT, PVAC, and decreased DRs (DR2, DR4, DR8) (P< 0.05). In COPD patients, DRs showed a negative correlation with the incidence of PAC, PVC, SVT, and PVAC (P< 0.05). In receiver operating characteristic curve analysis, all the DRs were found to be significant predictors of PAC > 70/d, SVT, and PVAC. The predictive power of DRs was significantly different from one another with the order ranged as DR4>DR8>DR2 for PAC > 70/d, DR8>DR4>DR2 for SVT, and DR8>DR4>DR2 for PVAC.Conclusion: Our study provides evidence of significant autonomic dysregulation in COPD patients. DRs may serve as a marker of the risk of arrhythmias in COPD patients.Keywords: chronic obstructive pulmonary disease, arrhythmias, deceleration capacity runs, autonomic function, risk stratification

Shu-Wei Chen,1–3,* Quan Zhang,1–3,* Zhu-Ming Guo,1–3 Wen-Kuan Chen,1–3 Wei-Wei Liu,1–3 Yan-Feng Chen,1–3 Qiu-Li Li,1–3 Xue-Kui Liu,1–3 Hao Li,1–3 Dian Ou-Yang,1–3 Wei-Chao Chen,1–3 Xiao-Yan Fu,1–3 Xi-Di Wang,1–3 An-Kui Yang,1–3 Jin-Xin Bei,2–4 Ming Song1–3 1Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 2State Key Laboratory of Oncology in South China, 3Collaborative Innovation Center of Cancer Medicine, 4Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China *These authors contributed equally to this work Background: Global data demonstrate minimal improvement in the survival rate for oral cavity cancer (OCC) patients. We wished to know whether or not clinical features and survival rate have changed over time for OCC patients receiving initial treatment and follow-up at a large cancer center in China. Methods: Clinical features and survival data were collected on patients diagnosed during the successive decades of 1960–1969 (n=253), 1970–1979 (n=497), 1980–1989 (n= 659), 1990–1999 (n=793), and 2000–2009 (n=1,160) at the Sun Yat-sen University Cancer Center. Results: Over time, the overall 5-year survival rate for OCC patients was 52.0%. According to tumor localization, this rate was 71.4% for lip cancer, 56.3% for oral tongue cancer, and 42.7% for other parts of the oral cavity. From the 1960s to the 2000s, the 5-year survival rate steadily improved from 47.8% to 55.6% (P

Xing-De Wang,1 Li Zhou,1 Chao-Yu Zhu,2 Bin Chen,1 Zhong Chen,1 Li Wei2 1Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China; 2Department of Endocrinology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China Purpose: Sympathovagal imbalance is a common underlying disorder in hypertension and diabetes. This study characterized autonomic nervous system function, indicated by heart rate deceleration capacity (DC) and deceleration runs (DRs), in patients with type 2 diabetes mellitus (T2DM), with or without concomitant essential hypertension. Subjects and methods: We recruited 50 healthy subjects, 50 patients with T2DM, and 95 with T2DM and essential hypertension. DC, DRs (DR2, DR4, and DR8, ie, episodes of 2, 4, or 8 consecutive beat-to-beat heart rate decelerations, respectively), and heart rate variability were determined by dynamic electrocardiogram. Biochemical markers of glucose and lipid metabolism, including glycated hemoglobin (HbA1c) and high-density lipoprotein cholesterol (HDL-C), were measured from blood samples. Results: Both T2DM groups featured lower DC, SD of all normal-to-normal sinus RR intervals over 24 h (SDNN), root mean square of the successive normal sinus RR interval difference, and all DR values, but higher average heart rate (AHR) and acceleration capacity (AC), than healthy subjects. There were significant associations between the following: DC and HbA1c, systolic blood pressure (SBP), AHR, age, and HDL-C; DR2 and AHR, SBP, and HbA1c; DR4 and HbA1c, age, SBP, and HDL-C; and DR8 and HbA1c, AHR, and age. In both T2DM groups, HbA1c correlated negatively with DC, DR2, and SDNN, and positively with AC and AHR; homeostasis model assessment-insulin resistance index correlated negatively with DC, all DRs, and SDNN, and positively with AC. Conclusion: Compared with healthy subjects, T2DM patients with or without essential hypertension have lower DC and DRs. DC and DRs correlate negatively with blood glucose and insulin resistance index. Keywords: autonomic nervous system, deceleration capacity of heart rate, heart rate deceleration runs, insulin resistance, type 2 diabetes mellitus, hypertension

Yan-Hong Xu,1 Xing-De Wang,2 Jia-Jun Yang,1 Li Zhou,2 Yong-Chao Pan1 1Department of Neurology, 2Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China Background and purpose: Autonomic dysfunction is common after stroke, which is correlated with unfavorable outcome. Phase-rectified signal averaging is a newly developed technique for assessing cardiac autonomic function, by detecting sympathetic and vagal nerve activity separately through calculating acceleration capacity (AC) and deceleration capacity (DC) of heart rate. In this study, we used this technique for the first time to investigate the cardiac autonomic function of patients with acute hemispheric ischemic stroke. Methods: A 24-hour Holter monitoring was performed in 63 patients with first-ever acute ischemic stroke in hemisphere and sinus rhythm, as well as in 50 controls with high risk of stroke. DC, AC, heart rate variability parameters, standard deviation of all normal-to-normal intervals (SDNN), and square root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals (RMSSD) were calculated. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke. We analyzed the changes of DC, AC, SDNN, and RMSSD and also studied the correlations between these parameters and NIHSS scores. Results: The R–R (R wave to R wave on electrocardiogram) intervals, DC, AC, and SDNN in the cerebral infarction group were lower than those in controls (P=0.003, P=0.002, P=0.006, and P=0.043), but the difference of RMSSD and the D-value and ratio between absolute value of AC (|AC|) and DC were not statistically significant compared with those in controls. The DC of the infarction group was significantly correlated with |AC|, SDNN, and RMSSD (r=0.857, r=0.619, and r=0.358; P=0.000, P=0.000, and P=0.004). Correlation analysis also showed that DC, |AC|, and SDNN were negatively correlated with NIHSS scores (r=-0.279, r=-0.266, and r=-0.319; P=0.027, P=0.035, and P=0.011). Conclusion: Both DC and AC of heart rate decreased in patients with hemispheric infarction, reflecting a decrease in both vagal and sympathetic modulation. Both DC and AC were correlated with the severity of stroke. Keywords: acute ischemic stroke, autonomic dysfunction, deceleration capacity of heart rate, acceleration capacity of heart rate, heart rate variability

Hongliang Sun,1 Linfeng Xu,1 Tianyuan Fan,2 Hongzhi Zhan,3 Xiaodong Wang,3 Yanfei Zhou,2 Ren-jie Yang3 1Department of Interventional Therapy, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 2Pharmacy School of Beijing University, Beijing, 3Department of Interventional Therapy, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China Background: The purpose of this study was to observe the effect and feasibility of hyperthermia and the influence of heat on surrounding organs in a VX2 rabbit liver model exposed to an alternating magnetic field after embolization with ferromagnetic nanoparticles. Methods: Forty rabbits containing implanted hepatic VX2 carcinomas were divided into four groups, each containing ten rabbits. Fourteen days after tumor transplantation, we opened the abdomen to observe the size and shape of the tumor. A transfemoral retrograde approach was then used for hepatic arterial catheterization in groups B, C, and D to perform angiography and embolization. The next day, three rabbits in group B and all rabbits in group D were exposed to an alternating magnetic field, and the temperature was recorded simultaneously in the center of the tumor, at the edge of the tumor, and in the normal liver parenchyma. On day 28, all animals was euthanized to observe changes in the implanted liver tumor and the condition of the abdomen. A pathologic examination was also done. Results: Before surgery, there was no significant difference in tumor volume between the four groups. Three different temperature points (center of the tumor, edge of the tumor, and in the normal liver parenchyma) of group B under an alternating magnetic field were 37.2°C ± 1.1°C, 36.8°C ± 1.2°C, and 36.9°C ± 2.1°C, none of which were significantly different from pretreatment values. Three points basal temperature in group D showed no significant difference (F = 1.038, P = 0.413). Seven to 26 minutes after hyperthermia, the temperature at the center of the tumor and at the edge of the tumor in group D was significantly different from the corresponding points in group B and from normal liver tissue in group D (FB–D center = 5.431, PB–D center = 0.041, FB–D edge = 9.744, PB–D edge = 0.011; FD = 8.379, PD = 0.002). The highest temperature recorded at the rim of the tumor was 46°C in group D. Fourteen days later, the tumor volume in the four groups was group A 31.4 ± 20.6 cm3, group B 26.7 ± 18.2 cm3, group C 28.7 ± 9.1 cm3, and group D 25.8 ± 13.9 cm3, with no significant difference found between the groups (F = 0.218, P = 0.883). The increase in tumor volume was greatest in group A and least in group D, while that in groups B and D was similar. Conclusion: It is feasible to treat a VX2 tumor in an alternating magnetic field after embolization with magnetic nanoparticles without a significant effect on the surrounding normal liver parenchyma. Keywords: hyperthermia, ferromagnetic nanoparticles, Lipiodol®, hepatocellular carcinoma, animal model

Introduction: To evaluate the efficacy of probiotics in preventing nosocomial pneumonia in critically ill patients.Methods: We searched PubMed, EMBASE, and the Web of Science for relevant studies. Two reviewers extracted data and reviewed the quality of th

Lycopene has been shown to be beneficial in protecting against high-fat diet-induced fatty liver. The recent demonstration that lycopene can be converted by carotene 9',10'-oxygenase into a biologically active metabolite, ALA, led us to propose that the function of lycopene can be mediated by ALA. In the present study, male ob/ob mice were fed a liquid high-fat diet (60% energy from fat) with ALA supplementation (ALA group, 240 μg · kg body weight(-1) · d(-1)) or without ALA supplementation as the control (C group) for 16 wk. Steatosis, SIRT1 expression and activity, genes involved in lipid metabolism, and ALA concentrations in the livers of mice were examined. The results showed that ALA supplementation resulted in a significant accumulation of ALA in the liver and markedly decreased the steatosis in the ALA group without altering body and liver weights compared to the C group. The mRNA and protein levels of hepatic SIRT1 were higher in the ALA group compared to the C group. SIRT1 activity also was higher in the ALA group, as indicated by the lower levels of acetylated forkhead box class O1 protein levels. In addition, the mRNA level of acetyl CoA carboxylase 1 was significantly lower in the ALA group than in the C group. Because SIRT1 plays a key role in lipid homeostasis, the present study suggests that the lycopene metabolite, ALA, protects against the development of steatosis in ob/ob mice by upregulating SIRT1 gene expression and activity. [ABSTRACT FROM AUTHOR]

The effects of hepatitis and drug use on nutritional problems in HIV infection have rarely been examined despite the importance of drug use in the global HIV pandemic. We examined the effects of HIV, hepatitis C, and drug use on serum micronutrients in 300 US Hispanic adults. Chronic hepatitis C infection was associated with lower serum retinol (-8.2 microg/dl, P < 0.0001), alpha-tocopherol (-0.10 ln microg/dl, P = 0.024), and carotenoids (-19.8 microg/dl, P < 0.0001). HIV infection was associated with lower selenium (-6.1 microg/l, P = 0.028). Elevated triglycerides in HIV infection were associated with higher serum retinol and alpha-tocopherol. Drug use was not independently associated with micronutrient alterations. We conclude that hepatitis C is an important determinant of low serum micronutrients, and should be considered in any nutritional assessment of HIV infected populations. As the safety of micronutrient supplementation is not established, policy for appropriate HIV clinical care should distinguish between populations with and without hepatitis coinfection. [ABSTRACT FROM AUTHOR]