Limited data exist regarding metabolic risk factors for deaths from hepatocellular carcinoma (HCC) in aging individuals. We investigated the association between diabetes, dyslipidemia, and HCC mortality in those aged 40 years or more (middle-aged and elderly). In this prospective cohort study based on nationwide health screening units, we consecutively followed middle-aged and elderly participants who had no chronic hepatitis B or C virus infection and received health screening from January 1 1998 to December 31 2008. There were 235 deaths from HCC among 50,080 individuals, ascertained by validated death certificates and the national death registry. Diabetes (adjusted hazard ratio [HR], 3.38; 95% confidence interval [CI], 2.35 to 4.86) was positively associated with deaths from HCC. However, hypertriglyceridemia (HR, 0.38; 95% CI, 0.26 to 0.55) and hypercholesterolemia (HR, 0.50; 95% CI, 0.37 to 0.67) were inversely associated with HCC mortality. The above significant associations remained in the lag time analyses, applied to check for reverse causation. Metabolic syndrome, as defined by the American Heart Association / National Heart Lung Blood Institute criteria (HR, 0.63; 95% CI, 0.46 to 0.86) or by the International Diabetes Federation criteria (HR, 0.62; 95% CI, 0.43 to 0.89), was inversely associated with deaths from HCC, especially in men. Conclusion: Middle-aged and elderly individuals, once having diabetes, deserve HCC surveillance to reduce HCC mortality. More research is needed to elucidate why having baseline dyslipidemia relates to lower future HCC mortality. (HEPATOLOGY 2014;59:2207-2215

Hepatocellular carcinoma (HCC) is the leading cause of cancer mortality in Asia. This study evaluated the growth inhibition effect of quercetin and 2-methoxyestradiol in vitro in human HCC cell lines. Combination treatment enhanced the cytotoxic effect in HA22T/VGH and HepG2 cell lines as compared with quercetin or 2-methoxyestradiol alone. The cell population of sub-G0/G1 phase and the level of annexin V binding were increased synergistically after combination treatment with quercetin and 2-methoxyestradiol in both cell lines. Moreover, quercetin combined with 2-methoxyestradiol increased superoxide levels, mitochondrial superoxide dismutase (MnSOD) in mRNA, protein levels, and SOD activity. Finally, we also found the mitochondrial membrane potential was decreased after combination treatment. The changes of reactive oxygen species and mitochondrial disruption were likely to be involved in the mechanism for the synergistic cytotoxicity effects of combination treatment in human hepatoma cells. These results provided a basis for further study of the potential usage of quercetin combination with hormonal agents for the treatment of human hepatoma.

Among various preventive strategies annual Pap smear screening programme is still the most cost-effective and additional HPV DNA testing is a cost-effective choice under a reasonable threshold of willingness to pay. Vaccination programme in combination with triennial screening would be cost-effective if vaccine cost can be greatly reduced in a large economic scale.

Universal vaccination against seasonal influenza was found to be very cost-effective, particularly when herd immunity is considered. The probability of being cost-effective was almost certain given the maximum amount of WTP within two-thirds of the GDP.

The stable dispersion of nanoparticles in organic solvents, essential for their practical application, is often achieved by the grafting of organic dispersants. Good dispersion is usually assumed when a transparent colloidal sol is formed. However, even in such a case, the dispersion may not be in the form of distinct nanoparticles. In this study, zirconia nanoparticles have been modified with a series of carboxylic acids so that they can be dispersed in polar protic/aprotic solvents or nonpolar organic solvents as transparent colloidal sols. The dispersed state in these solvents was characterized by SAXS and SANS. In most cases, the transparent sol consists of “soft” secondary clusters generated from the ZrO2 nanoparticles. The size and fractal structure of the dispersed clusters varied with the acid modifier. Only in the linoleic acid-modified case and with chloroform as the solvent was the ZrO2 dispersed as primary particles. However, the same modification leads to secondary clusters in other solvents, such as toluene and benzene, with similar solubility parameters. The difference in the dispersion states calls for a molecular-level interpretation. It was proposed that the grafted LOA exists as a swollen and extended brush in benzene and toluene, but as a folded and compact shell in chloroform. The proposed shell structures were then confirmed by the proximity of the chain tail with the middle section observed on 2D NOESY 1H NMR spectra.