LipoCol Forte capsules reduce the risk of liver cancer: A propensity score-matched, nationwide, population-based cohort study.

BACKGROUND: Liver cancer is among the top five most common cancers globally. Lipid-lowering drugs such as statins can lower the risk of liver cancer, but may also cause liver damage. LipoCol Forte capsules (LFC), a red yeast rice product, have demonstrated significant antihypercholesterolemic effects and a good safety profile in clinical studies. AIM: To evaluate whether LFC lowers the risk of liver cancer in adults in this propensity score-matched, nationwide, population-based cohort study. METHODS: We used data from Taiwan's National Health Insurance Research Database, which includes electronic medical records for up to 99.99% of Taiwan's population. LFC users and LFC non-users were matched 1:1 by propensity scores between January 2010 and December 2017. All had follow-up data for at least 1 year. Statistical analyses compared demographic distributions including sex, age, comorbidities, and prescribed medications. Cox regression analyses estimated adjusted hazard ratios (aHRs) after adjusting for potential confounders. RESULTS: We enrolled 33231 LFC users and 33231 non-LFC users (controls). No significant differences between the study cohorts were identified regarding comorbidities and medications [standardized mean difference (SMD) < 0.05]. At follow-up, the overall incidence of liver cancer was significantly lower in the LFC cohort compared with controls [aHR 0.91; 95% confidence interval (CI): 0.86-0.95; P < 0.001]. The risk of liver cancer was significantly reduced in both females (aHR 0.87; 95%CI: 0.8-0.94; P < 0.001) and males (aHR 0.93; 95%CI: 0.87-0.98; P < 0.01) in the LFC cohort compared with their counterparts in the non-LFC cohort. The antitumor protective effects applied to patients with comorbidities (including hypertension, ischemic stroke, diabetes mellitus, hyperlipidemia, hepatitis B infection and hepatitis C infection). Those using LFC for more than 84 drug days had a 0.64-fold lower risk of liver cancer compared with controls (P < 0.001). Compared with controls, the risk of developing liver cancer in the LFC cohort progressively decreased over time; the lowest incidence of liver cancer occurred in LFC users followed-up for more than 6 years (27.44 vs 31.49 per 1,000 person-years; aHR 0.75; 95%CI: 0.68-0.82; P < 0.001). CONCLUSION: This retrospective cohort study indicates that LFC has a significantly protective effect on lowering the risk of liver cancer, in a dose-dependent and time-dependent manner.

Utilization of Anterolateral Thigh Flap and Transverse Cervical Recipient Vessels for Head and Neck Cancer Patients With Former Neck Dissection and Irradiation: A Case Series Study.

PURPOSE: Free flap reconstruction in head and neck cancer patients with prior tumor resection, neck dissection, and irradiation is clinically challenging. The purpose of this study was to investigate the reliability and outcome of using the anterolateral thigh (ALT) flap and transverse cervical recipient vessels for microvascular reconstruction in patients with depleted vessels in the head and neck region caused by previous surgery and irradiation. METHODS: Between January 2015 and December 2017, microsurgical head and neck reconstruction was performed using the ALT flap and transverse cervical artery (TCA) as the recipient vessel in 15 patients who had undergone previous neck dissections and irradiation for cancer treatment. All patients had a "vessel-depleted neck" resulting from severe scarring and radiation fibrosis. Clinical data of each patient were recorded. RESULTS: All ipsilateral TCAs were found to be damage free. Subsequently, free ALT flaps were revascularized using the TCAs. One patient developed venous thrombosis, and another patient developed arterial thrombosis. They were both salvaged within 6 hours postoperatively. No flap failure or mortalities were reported within the 30-day postoperative period. Two patients developed orocutaneous fistula and were further managed with wound care. The mean follow-up time was 11.9 ± 6.0 months (range, 5-23 months). Five patients died during the follow-up period from cancer progression. CONCLUSIONS: The use of the free ALT flap and TCA as the recipient vessel provides favorable microsurgical outcomes in patients with depleted recipient vessels in the head and neck region caused by previous neck dissections and radiation therapy.

1-Butyl-3-methylimidazolium-based ionic liquids and an anionic surfactant: excellent background electrolyte modifiers for the analysis of benzodiazepines through capillary electrophoresis.

In this study, we found that adding 1-butyl-3-methylimidazolium-based ionic liquids (ILs) and sodium dodecyl sulfate (SDS) as modifiers in the background electrolyte (BGE) for capillary electrophoresis enhanced the separation of benzodiazepines. In particular, 1-butyl-3-methylimidazolium bis(trifluoromethanesulfonyl)imide ([BMIM][NTf2]) was the best IL additive for the separation system because its anionic moiety interacted favorably with the benzodiazepines. We added SDS because of its known effect on the separation of hydrophobic analytes. We optimized the separation conditions in terms of the concentrations of the IL, SDS, and organic solvent, the pH, and the BGE's ionic strength. The optimal BGE, containing 170 mM [BMIM][NTf2] and 10 mM SDS, provided baseline separation, high efficiency, and satisfactory peak shapes for the benzodiazepines. The separation mechanism was based on heteroassociation between the anionic moiety of the IL and the benzodiazepines, with SDS improving the resolution of the separation. The limits of detection for the seven analytes ranged from 2.74 to 4.42 microg/mL. We subjected a urine sample to off-line solid phase extraction (SPE) prior to the analysis of its benzodiazepine content. Our experimental results reveal that the combination of [BMIM][NTf2] and SDS provides adequate separation efficiency for its application to CE analyses of benzodiazepines after SPE concentration.

Chaotropic salts: novel modifiers for the capillary electrophoretic analysis of benzodiazepines.

This paper describes a CE method for analyzing benzodiazepines using the chaotropic salts lithium trifluoromethanesulfonate (LiOTf), lithium hexafluorophosphate (LiPF(6)), and lithium bis(trifluoromethanesulfonyl)imide (LiNTf(2)) as modifiers in the running buffer. Although adequate resolution of seven benzodiazepine analytes occurred under the influence of each of the chaotropic anions, the separation efficiency was highest when bis(trifluoromethanesulfonyl)imide (Tf(2)N(-)) was the modifier. We applied affinity CE in conjunction with linear analysis to determine the association constants for the formation of complexes between the Tf(2)N(-) anion and the benzodiazepines. According to the estimated Gibbs free energies, the interactions between this chaotropic anion and the benzodiazepines were either ion-dipole or ion-induced dipole interactions. Adding chaotropic salts as modifiers into CE buffers is a simple and reproducible technique for separating benzodiazepines.

Electrooxidation of catecholamines at carbon nanotube-modified indium tin oxide electrodes.

In this study, we prepared carbon nanotube (CNT)/Nafion-modified ITO electrodes and investigated their electrochemical behavior. The CNTs were dissolved in a solution of the ionic polymer Nafion and then CNT/Nafion composite films were deposited onto ITO electrodes through spin-coating of this homogeneous solution. We studied the effects of chemical pretreatment of the CNTs and the pH of the buffer on the electroanalytical behavior of the CNT/Nafion-modified ITO electrodes toward catecholamines. The modified electrodes enhanced the peak current and lowered the overpotentials. We observed high electrooxidative performance for the modified ITO electrodes: the oxidative currents of the catecholamines were up to 125-fold higher than those obtained using bare ITO electrodes.

In-channel simplified decoupler with renewable electrochemical detection for microchip capillary electrophoresis.

Electrochemical (EC) detection is comparable to fluorescence detection in that it is simple to perform, economical, and highly sensitive. In this study, we used replica molding to fabricate a PDMS microchip for microchip capillary electrophoresis (CE). A decoupler electrode and a working electrode were implanted into the PDMS chip during the molding process to prevent leakage into the electrode channel. The working electrode could be renewed readily through its slight withdrawal (ca. 3 mm) from the PDMS; its detection ability was highly reproducible in the microchip CE-EC system. The relative standard deviation (R.S.D.) of the detecting current for the renewed working electrode was 1.2% (n=5). The calibration curves were linear for both dopamine and catechol analytes over the concentration range 10-1000 microM, with coefficients of determination (R(2)) of 0.999 and 0.976, respectively. The number of theoretical plates (N/m) for these analytes was greater than 133,000.

Fabrication of microfluidic devices using dry film photoresist for microchip capillary electrophoresis.

An inexpensive, disposable microfluidic device was fabricated from a dry film photoresist using a combination of photolithographic and hot roll lamination techniques. A microfluidic flow pattern was prefabricated in a dry film photoresist tape using traditional photolithographic methods. This tape became bonded to a poly(methyl methacrylate) (PMMA) sheet with prepouched holes when passed through a hot roll laminator. A copper working electrode and platinum decoupler was readily incorporated within this microchip. The integrated microchip device was then fixed in a laboratory-built Plexiglas holder prior to its use in microchip capillary electrophoresis. The performance of this device with amperometric detection for the separation of dopamine and catechol was examined. The separation was complete within 50 s at an applied potential of 200 V/cm. The relative standard deviations (RSD) of analyte migration times were less than 0.71%, and the theoretical plate numbers for dopamine and catechol were 3.2 x 10(4) and 4.1 x 10(4), respectively, based on a 65 mm separation channel.

A new fabrication process for a microchip electrophoresis device integrated with a three-electrode electrochemical detector.

We report here a novel and simple process for the fabrication of a poly(methyl methacrylate) (PMMA)-based microchip electrophoresis device, integrated with a screen-printed three-electrode electrochemical detector that does not require a replicate mold. In this approach, a photoresist layer constitutes both an adhesion layer and side walls of 50 mum wide and 50 mum tall microfluidic channels on a screen-printed three-electrode PMMA substrate. Openings were drilled for buffer reservoirs on an additional piece of PMMA, then the final device was bonded in a PMMA/photoresist/PMMA sandwich configuration. This process is inexpensive, less time-consuming, and simpler compared with traditional fabrication methods. The combination of this PMMA-based microchip fabrication together with screen-printed electrode technology holds great promise for the mass production of a single-use micrototal analytical system. Successful determination of uric acid and L-ascorbic acid with the presented system validates its utility. In combination with a suitable electrochemical detector, this device holds much promise for the determination of other analytes in various biological samples for medical and clinical diagnosis.