Objective: Sarcopenia, an age-related decline of muscle mass, strength, and physical function, was associated with falls, frailty, and poor quality of life. The aim of the current study is to examine the effect of nutritional supplement containing whey protein, vitamin D and E on measures of sarcopenia. Methods: A total of 60 sarcopenic older adult subjects participated in the current randomized, double-blind, placebo-controlled (iso-caloric control product) trial for 6 months. Muscle mass [Relative skeletal mass index (RSMI) measured by bioimpedance analysis (BIA)], muscle strength (handgrip strength), physical function (6-m gait speed, chair stand test, and timed-up-and-go test, TUG), quality of life (measured by Short-Form 36-Item Health Survey, SF-36), and blood biochemical indexes were measured before and after the 6-month intervention. Results: Compared to placebo group, nutritional supplementation improves RSMI (mean difference: 0.18 kg/m(2), 95%CI: 0.01-0.35, P = 0.040), handgrip strength (mean difference: 2.68 kg, 95%CI: 0.71-4.65, P = 0.009), SF-36 mental component summary (SF-36 MCS) (mean difference: 11.26, 95%CI: 3.86-18.65, P = 0.004), SF-36 physical component summary (SF-36 PCS) (mean difference: 20.21, 95%CI: 11.30-29.12, P < 0.001), serum IGF-1 (mean difference: 14.34 ng/mL, 95%CI: 2.06-26.73), IL-2 (mean difference: -575.32 pg/mL, 95%CI: -1116.94 similar to -33.70, P = 0.038), serum vitamin D-3 (mean difference: 11.01 ng/mL, 95%CI: 6.44-15,58, P < 0.001), and serum vitamin E (mean difference: 4.17 ng/L, 95%CI: 1.89 -6.45, P = 0.001). Conclusion: The current study demonstrated that the combined supplementation of whey protein, vitamin D and E can significantly improve RSMI, muscle strength, and anabolic markers such as IGF-I and IL-2 in older adults with sarcopenia. Further larger well-designed studies are warranted to evaluate whether long-term whey protein supplementation can blunt the declines of muscle function and mass in older adults with sarcopenia. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Purpose: Esophageal cancer is a common malignant tumor that develops rapidly and has a poor prognosis clinically. Astaxanthin (AST) is a carotenoid pigment with strong antioxidant, anti-inflammation, and antitumor activities. However, little is known about the effects of astaxanthin in esophageal cancer. The present study aimed to investigate the protective effects and related mechanisms of natural astaxanthin against N-nitrosomethylbenzylamine (NMBA)-induced esophageal cancer in rats. Methods: F344 rats were induced subcutaneously with NMBA dissolved in dimethyl sulfoxide (0.35 mg/kg body weight three times per week for 5 weeks). Rats were fed normal diets with or without 25 mg/kg/day AST at different stages. At different time points, levels of oxidative stress factors in serum and esophagus tissue were analyzed. Western blotting was performed to observe the expression of NFκB and COX2 in esophagus tissue. Results: AST clearly reduced the incidence of visible tumors in esophageal cancer during the early-stage intervention group. Furthermore, when compared with the simple exposed group, AST significantly increased levels of GPx and SOD activity, decreased the activity level of malondialdehyde (all P<0.05). Early-stage and whole-stage intervention groups effectively attenuated expression levels of NFκB and COX2 proteins compared with the simple exposed group (all P<0.05). Conclusion: Natural AST significantly suppressed the occurrence of esophageal cancer by increasing antioxidant capacity and anti-inflammation capacity by inhibiting expression levels of NFκB and COX2 proteins.

Objective To evaluate the influence of easting fast on esophageal cancer incidence in Chinese population, and to provide evidences for prevention of esophageal cancer. Methods We searched the China National Knowledge Infrastructure (CNKI), WanFang Database, PubMed and Web of Science for all relevant studies published from January 1980 through February 2017 in English or in Chinese. Stata 11.0 software was used for the meta-analysis. Results A total of 26 studies were included in this analysis, involving 8 418 esophageal cancer cases and 11 710 controls. All the studies were case-control studies. The overall random effect odds radio (OR) of esophageal cancer and its 95％ confidence interval (CI) for eating fast were 2.518 (2.024-3.131) in comparison with not eating fast. Subgroup analysis found that eating fast was associated with an increased risk of esophageal cancer compared to not eating fast among the participants of the studies published in different years and in various jornals (P＜0.01 for all). The results of sensitivity analysis and publication bias test showed that all the studies retrieved were good in stability and there was no publication bias. Conclusion The results suggest that eating fast can increase the risk of esophageal cancer in Chinese population.

Objective: Intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) may protect against mild cognitive impairment (MCI). However, there is still a lack of the n-3 PUFAs intervention in the elderly with MCI in China. The aim of the present study was to investigate the effect of n-3 PUFA supplementation on cognitive function in the Chinese elderly with MCI. Methods: Eighty six MCI individuals aged 60 years or older were randomly assigned to receive either n-3 PUFAs (480 mg DHA and 720 mg EPA per day, n = 44) or placebo (olive oil, n = 42) capsules. The changes of cognitive functions were assessed using Basic Cognitive Aptitude Tests (BCAT). Results: The mean age of participants was 71 years old, and 59% of the participants were men. n-3 PUFA supplementation was associated with improved total BCAT scores, perceptual speed, space imagery efficiency, and working memory (p < 0.01), but not with mental arithmetic efficiency or recognition memory (p > 0.05). Subgroup analysis by sex showed that n-3 PUFAs significantly improved perceptual speed (p = 0.001), space imagery efficiency (p = 0.013), working memory (p = 0.018), and total BCAT scores (p = 0.000) in males. However, in females, the significant beneficial effects can only be observed in perceptual speed (p = 0.027), space imagery efficiency (p = 0.006), and total BCAT scores (p = 0.015)—not working memory (p = 0.113). Conclusion: n-3 PUFAs can improve cognitive function in people with MCI. Further studies with different fish oil dosages, longer intervention periods, and larger sample sizes should be investigated before definite recommendations can be made.

Isoflavones, a class of phytoestrogenic compounds, are abundant in soybeans. A number of epidemiological studies have investigated the association between dietary isoflavones intake and the risk of gastric cancer. However, the results are inconclusive. Therefore, the meta-analysis was conducted to evaluate the effect of dietary isoflavones intake on the risk of gastric cancer.

Aim:To explore the prognostic value of pre-operative neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to lymphocyte ratio (MLR),prognostic nutritional index (PNI) in hepatitis B virus (HBV)-related hepatocellular carcinoma(HCC) after radical operation.Methods:A total of 331 HCC patients who had been undergone radical operation were followed up.The clinical and laboratory data of the patients were collected.The values of NLR,PLR,MLR,and PNI were calculated.Kaplan-Meier and Cox regression were used to analyze the risk factors.Results:The optimal cutoff levels of NLR,PLR,MLR and PNI were 2.41,106.80,0.24 and 45,respectively.The patients were allocated into two groups according to the cutoff levels.Multivariate analysis revealed that PVTT,pre-operative AFP,AST,intrahepatic metastasis,NLR and PNI were independent predictors of overall survival for HCC after hepatectomy,andHR(95％CI) were 2.652(1.863-3.776),1.476(1.027-2.120),1.437(1.047-1.972),1.596(1.065-2.390),1.563 (1.077-2.268),and 0.657 (0.468-0.922) (P ＜ 0.05).Conclusion:Pre-operative NLR and PNI were independent predictors of overall survival for HBV-related HCC after hepatectomy.The patients with low NLR and high PNI indicate better prognosis.

Aim: To evaluate the application value of body mass index ( BMI ) for sarcopenia screening in the elder people.Methods:According to the diagnostic criteria of Asian Working Group for Sarcopenia , a total of 1287 adults of Han nationality aged over 60 years in a community of Shangjie , District, Zhengzhou City , were screened for sarcopenia . The height and weight were measured to calculate the value of BMI .Receiver operator characteristic curve ( ROC) was used to evaluate the value of BMI for sarcopenia screening in the elder people .Results:The BMI values of the elderly male and female in the patients group was (22.06 ±2.56) and (22.74 ±2.7) kg/m2, respectively.It was (25.94 ±3.10) and (26.44 ±3.43) kg/m2 in contrast group,respectively.And the value of BMI in the patients group was lower than that of contrast group(P<0.001).The ROC curve analysis results showed that AUC of sarcopenia in male and female was 0.834 (0.769-0.899) and 0.804(0.757-0.850), respectively.The sensitivity and specificity of BMI were 73.2%, 82.2%in male and 78.2%, 73.1%in female,with their corresponding cut-off value of 23.0 and 24.3 kg/m2 .Conclusion:The measurement of BMI is simple and easy .The value of BMI can be used to screen sarcopenia in elder adults of Han nationality.

Objective: Intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) may protect against mild cognitive impairment (MCI). However, there is still a lack of the n-3 PUFAs intervention in the elderly with MCI in China. The aim of the present study was to investigate the effect of n-3 PUFA supplementation on cognitive function in the Chinese elderly with MCI. Methods: Eighty six MCI individuals aged 60 years or older were randomly assigned to receive either n-3 PUFAs (480 mg DHA and 720 mg EPA per day, n = 44) or placebo (olive oil, n = 42) capsules. The changes of cognitive functions were assessed using Basic Cognitive Aptitude Tests (BCAT). Results: The mean age of participants was 71 years old, and 59% of the participants were men. n-3 PUFA supplementation was associated with improved total BCAT scores, perceptual speed, space imagery efficiency, and working memory (p < 0.01), but not with mental arithmetic efficiency or recognition memory (p > 0.05). Subgroup analysis by sex showed that n-3 PUFAs significantly improved perceptual speed (p = 0.001), space imagery efficiency (p = 0.013), working memory (p = 0.018), and total BCAT scores (p = 0.000) in males. However, in females, the significant beneficial effects can only be observed in perceptual speed (p = 0.027), space imagery efficiency (p = 0.006), and total BCAT scores (p = 0.015)—not working memory (p = 0.113). Conclusion: n-3 PUFAs can improve cognitive function in people with MCI. Further studies with different fish oil dosages, longer intervention periods, and larger sample sizes should be investigated before definite recommendations can be made.

Aim: To investigate the prognostic value of lymphocyte-to-monocyte ratio ( LMR) in primary liver cancer ( PLC) patients after curative hepatectomy .Methods:Clinical and laboratory data of 447 PLC patients who were treated by curative hepatectomy were collected .None of the patients received any other treatments before surgery .LMR was calculat-ed.The optimal cutoff was determined by receiver operating characteristics ( ROC) curve analysis .Kaplan-Meier survival a-nalysis and COX proportional hazard model were used to evaluate the influence of LMR on patients ′overall survival .Re-sults:The optimal cutoff value of LMR for survival analysis was 3.03,and all the patients were accordingly allocated into high LMR(≥3.03) group and low LMR( <3.03) group.The COX univariate and multivariate analysis showed that en-hanced LMR was an independent favorable prognostic factor for overall survival (β=-0.329,HR=0.720; 95%CI =0.562-0.921).Conclusion:LMR is an independent prognostic factor for PLC patients underwent curative hepatectomy , and patients with high LMR indicate favorable overall survival.

Although several epidemiological studies have investigated the association between dietary calcium intake and the risk of esophageal cancer, the results are inconsistent. This study aimed to make a comprehensive evaluation regarding the association between calcium intake and risk of esophageal cancer through a meta-analysis approach. We searched for all relevant articles from the inception to April 2017, using PUBMED, EMBASE, and Web of Knowledge. The pooled odds ratio (ORs) with the 95% confidence interval (95% CI) for the highest versus the lowest categories of calcium intake was calculated using a Mantel–Haenszel fixed-effect model. In total, 15 articles reporting 17 studies including 3396 esophageal cancer cases and 346,815 controls were selected for the meta-analysis. By comparing the highest vs. the lowest levels of dietary calcium intake, we found that dietary calcium intake was inversely associated with the risk of esophageal cancer (OR = 0.80, 95% CI: 0.71–0.91, I2 = 33.6%). The subgroup analysis indicated that the protective function of dietary calcium intake were observed in esophageal squamous cell cancer, but not in esophageal adenocarcinoma in the studies conducted in Asia, but not those in Europe and America. In conclusion, our results suggest that higher dietary calcium intake is associated with a lower risk of esophageal cancer—especially esophageal squamous cell cancer—in Asian populations, though more data from prospective cohort studies are needed.

Objective To explore the association between esophageal cancer and serum vitamin E level and to provide evidences for researches and prevention of esophageal cancer.Methods Case-control studies on esophageal cancer and serum vitamin E level published from January 1980 to December 2015 were searched through China National Knowledge Infrastructure,Wanfang Database,PubMed,and Web of Science.Meta-analysis was performed with Stata 12.0.Results A total of 9 literatures (7 in Chinese and 2 in English),involving in 358 esophageal cancer cases and 538 controis,were included in the meta-analysis.The meta-analysis showed that the serum vitamin E level of esophageal cancer cases was lower than that of the controls (standardized mean difference [SMD] =-0.50,95 ％ confidence interval [95 ％ CI] =-0.65-0.36,P ＜ 0.001).Subgroup analysis found that the serum vitamin E levels of the esophageal cancer cases were lower than those of the controls for the studies conducted in China (SMD =-0.50,95％ CI =-0.67-0.33) and in United States (SMD =-0.51,95％ CI =-0.77-0.25),with the controls selected from communities (SMD =-0.54,95％ CI=-0.69-0.39),with the sample size of larger than 50 (SMD =-0.56,95％ CI=-0.71-0.41),with age-matched controls (SMD =-0.57,95％ CI =-0.72-0.42),and with serum vitamin E level detection using high performance liquid chromatography (HPLC) (SMD =-0.41,95％ CI =-0.59-0.24) and using method other than HPLC (SMD =-0.67,95％ CI =-0.91-0.43) (all P ＜ 0.001).Sensitivity analysis and publication bias test showed that the results of the study were stable and there was no publication bias for the literatures included in the study.Conclusion Serum vitamin E level is low in esophageal cancer patients.

The impact of nutritional status on survival among elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radiotherapy is unclear. In this study, we aimed at validating the performance of the geriatric nutritional risk index (GNRI) in predicting overall survival time in elderly ESCC patients with radiotherapy. A retrospective cohort study was conducted on 239 ESCC patients aged 60 and over admitted consecutively from January 2008 to November 2014 in the Department of Radiotherapy, Henan Tumor Hospital (Affiliated Tumor Hospital of Zhengzhou University), Zhengzhou, Henan, China. All patients were subjected to nutritional screening using GNRI, and were followed for the occurrence of lymphatic node metastasis, radiation complication and mortality. The Kaplan-Meier method with Log-rank test was used to estimate survival curves. Univariable Cox regression analysis was used to identify variables associated with overall survival time. Among the 239 patients, 184 patients (76.9%) took no nutritional risk, 32 patients (13.4%) took moderate risk of malnutrition, and 23 patients (9.7%) took a high risk of malnutrition. Univariable Cox regression showed that both high nutritional risk group and moderate nutritional risk group were significantly less likely to survive than no nutritional risk patients (hazard ratio (HR) = 1.688, 95% confidence interval (CI) = 1.019-2.798 for moderate risk group, and HR = 2.699, 95% CI = 1.512-4.819 for high risk group, respectively). The GNRI is an independent prognostic factor for overall survival time in elderly ESCC patients with radiotherapy. A GNRI ≤98 can be suggested as an indicator of surviving less.

Flavonoids have been suggested to play a chemopreventive role in carcinogenesis. However, the epidemiologic studies assessing dietary intake of flavonoids and esophageal cancer risk have yielded inconsistent results. This study was designed to examine the association between flavonoids, each flavonoid subclass, and the risk of esophageal cancer with a meta-analysis approach. We searched for all relevant studies with a prospective cohort or case-control study design published from January 1990 to April 2016, using PUBMED, EMBASE, and Web of Science. Pooled odds ratios (ORs) were calculated using fixed or random-effect models. In total, seven articles including 2629 cases and 481,193 non-cases were selected for the meta-analysis. Comparing the highest-intake patients with the lowest-intake patients for total flavonoids and for each flavonoid subclass, we found that anthocyanidins (OR = 0.60, 95% CI: 0.49–0.74), flavanones (OR = 0.65, 95% CI: 0.49–0.86), and flavones (OR = 0.78, 95% CI 0.64–0.95) were inversely associated with the risk of esophageal cancer. However, total flavonoids showed marginal association with esophageal cancer risk (OR = 0.78, 95% CI: 0.59–1.04). In conclusion, our study suggested that dietary intake of total flavonoids, anthocyanidins, flavanones, and flavones might reduce the risk of esophageal cancer.