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BACKGROUND Many studies have examined associations between dietary isoflavones and atherosclerosis, but few used objective biomarkers. OBJECTIVES We examined the associations of isoflavone biomarkers (primary analyses) and equol production (secondary analyses) with the progression of carotid intima-media thickness (cIMT), and whether inflammation, systolic blood pressure (SBP), blood lipids, and sex hormone-binding globulin (SHBG) mediated these associations, in Chinese adults. METHODS This 8.8-y prospective study included 2572 subjects (40-75 y old) from the GNHS (Guangzhou Nutrition and Health Study; 2008-2019). The concentrations of daidzein, genistein, and equol were assayed by an HPLC-tandem MS in serum (n = 2572) at baseline and in urine (n = 2220) at 3-y intervals. The cIMT of the common carotid artery (CCA) and bifurcation segment were measured by B-mode ultrasound every 3 y, and the progressions of cIMT ( ∆cIMT) were estimated using the regression method. RESULTS Multivariable linear mixed-effects models (LMEMs) and ANCOVA revealed that subjects with higher serum isoflavones tended to have lower increases of CCA-cIMT. The mean ± SEM differences in 8.8-y ∆CCA-cIMT between extreme tertiles of serum isoflavones were -17.1 ± 8.4, -20.6 ± 8.3, and -23.3 ± 10.4 μm for daidzein, total isoflavone, and equol (P-trends

The relationship of polyunsaturated fatty acids (PUFAs) with cardiovascular risk is still controversial. We aimed to determine whether erythrocyte n-3 and n-6 PUFAs are related to the risk of carotid atherosclerosis.From 2008 to 2019, baseline erythrocyte n-3 and n-6 PUFAs were determined in a cohort of 4040 Chinese adults (40-75 ys). The intima-media thickness (IMT) at the common carotid artery (CCA) and bifurcation of the carotid artery (BIF) and carotid plaque were assessed using ultrasonography at baseline and every 3 years.During a median follow-up of 8.8 years, we identified the following newly diagnosed cases: 535 cases of CCAIMT thickening, 654 cases of BIFIMT thickening, and 850 cases of carotid plaque. Higher erythrocyte docosahexaenoic acid (DHA) and arachidonic acid (ARA) and lower gamma-linolenic acid (GLA) were associated with decreased risks of BIFIMT thickening. N-3 eicosatrienoic acid (ETrA), docosapentaenoic acid (DPA), and n-6 dodecylthioacetic acid (DTA) presented a significant beneficial association with carotid IMT thickening in the short-term (2.8 y) follow-up (all p trend0.02), although the association was attenuated in the relatively long-term (8.8 y) follow-up. In addition, carotid plaque risk was found to be inversely associated with ETrA and DHA but positively associated with alpha-linolenic acid (ALA). N-6 linolenic acid (LA) and eicosadienoic acid (EDA) were not significantly associated with carotid atherosclerosis risk.Higher erythrocyte very-long-chain n-3 and n-6 PUFAs (especially DHA and ARA) and lower erythrocyte GLA are associated with lower carotid atherosclerosis risk, suggesting potential cardioprotective roles of very-long-chain PUFAs.

Presently, in the context of the novel coronavirus pneumonia epidemic, several antibiotics are overused in hospitals, causing heavy pressure on the hospital’s wastewater treatment process. Therefore, developing stable, safe, and efficient hospital wastewater treatment equipment is crucial. Herein, a bench-scale electrooxidation equipment for hospital wastewater was used to evaluate the removal effect of the main antibiotic levofloxacin (LVX) in hospital wastewater using response surface methodology (RSM). During the degradation process, the influence of the following five factors on total organic carbon (TOC) removal was discussed and the best reaction condition was obtained: current density, initial pH, flow rate, chloride ion concentration, and reaction time of 39.6 A/m2, 6.5, 50 mL/min, 4‰, and 120 min, respectively. The TOC removal could reach 41% after a reaction time of 120 min, which was consistent with the result predicted by the response surface (40.48%). Moreover, the morphology and properties of the electrode were analyzed. The degradation pathway of LVX was analyzed using high-performance liquid chromatography–mass spectrometry (LC–MS). Subsequently, the bench-scale electrooxidation equipment was changed into onboard-scale electrooxidation equipment, and the onboard-scale equipment was promoted to several hospitals in Dalian.

Background: Little is known about the interplay among dairy intake, gut microbiota and cardiometabolic health in human prospective cohort studies. Methods: The present study included 1780 participants from the Guangzhou Nutrition and Health Study. We examined the prospective association between habitual dairy consumption (total dairy, milk, yogurt) and gut microbial composition using linear regression after adjusting for socio-demographic, lifestyle and dietary factors. The cross-sectional association of dairy-associated microbial features with cardiometabolic risk factors was examined with a linear regression model, adjusting for potential confounders. Serum metabolomic profiles were analyzed by partial correlation analysis. Findings: There was a significant overall difference in gut microbial community structure (β-diversity) comparing the highest with the lowest category for each of total dairy, milk and yogurt (P < 0.05). We observed that dairy-associated microbes and α-diversity indices were inversely associated with blood triglycerides, while positively associated with high-density lipoprotein cholesterol. A follow-up metabolomics analysis revealed the association of targeted serum metabolites with dairy-microbial features and cardiometabolic traits. Specifically, 2-hydroxy-3-methylbutyric acid, 2-hydroxybutyric acid and L-alanine were inversely associated with dairy-microbial score, while positively associated with triglycerides (FDR-corrected P < 0.1). Interpretation: Dairy consumption is associated with the gut microbial composition and a higher α-diversity, which provides new insights into the understanding of dairy-gut microbiota interactions and their relationship with cardiometabolic health. Funding: This work was supported by the National Natural Science Foundation of China, Zhejiang Ten-thousand Talents Program, Westlake University and the 5010 Program for Clinical Researches of the Sun Yat-sen University.

Objective Isoflavones and lignans are phytoestrogens present in plant-based foods, which have a potential preventive effect on breast carcinogenesis. The effects of phytoestrogens on breast cancer may differ according to the hormonal environment. This case-control study aimed to investigate the association between serum phytoestrogens and odds of breast cancer among Chinese pre- and postmenopausal women. Methods A total of 792 cases and 813 age-matched controls were included. Serum isoflavone (daidzein, genistein, glycitein, equol, and formononetin) and lignan (enterodiol and enterolactone) concentrations were measured using a liquid chromatography-tandem mass spectrometry method. Results Significant inverse associations were found between serum total soy isoflavone precursors, daidzein, genistein, formononetin, total lignans, enterodiol, enterolactone, and the odds of breast cancer in premenopausal but not postmenopausal women. For premenopausal women, the adjusted odds ratios (95% confidence intervals) for the highest versus the lowest serum concentration groups were 0.60 (0.41-0.87) for total soy isoflavones precursors, 0.64 (0.44-0.93) for daidzein, 0.62 (0.43-0.90) for genistein, 0.49 (0.35-0.68) for formononetin, 0.38 (0.25-0.57) for total lignans, 0.49 (0.33-0.73) for enterodiol, and 0.49 (0.33-0.74) for enterolactone. However, the interaction between serum phytoestrogens and menopausal status on odds of breast cancer was statistically significant only for daidzein. No significant association was found between serum equol or gycitein and the odds of breast cancer among either pre- or postmenopausal women. Conclusions Higher levels of certain serum isoflavones and lignans were associated with reduced odds of breast cancer in premenopausal women, but the interaction was statistically significant only for daidzein.

Background Little is known about the inter-relationship among fruit and vegetable intake, gut microbiota and metabolites, and type 2 diabetes (T2D) in human prospective cohort study. The aim of the present study was to investigate the prospective association of fruit and vegetable intake with human gut microbiota and to examine the relationship between fruit and vegetable-related gut microbiota and their related metabolites with type 2 diabetes (T2D) risk. Methods This study included 1879 middle-age elderly Chinese adults from Guangzhou Nutrition and Health Study (GNHS). Baseline dietary information was collected using a validated food frequency questionnaire (2008–2013). Fecal samples were collected at follow-up (2015–2019) and analyzed for 16S rRNA sequencing and targeted fecal metabolomics. Blood samples were collected and analyzed for glucose, insulin, and glycated hemoglobin. We used multivariable linear regression and logistic regression models to investigate the prospective associations of fruit and vegetable intake with gut microbiota and the association of the identified gut microbiota (fruit/vegetable-microbiota index) and their related fecal metabolites with T2D risk, respectively. Replications were performed in an independent cohort involving 6626 participants. Results In the GNHS, dietary fruit intake, but not vegetable, was prospectively associated with gut microbiota diversity and composition. The fruit-microbiota index (FMI, created from 31 identified microbial features) was positively associated with fruit intake (p p = 0.003) and the FMI-T2D association (OR 0.90, 95%CI 0.84–0.97) were both successfully replicated in the independent cohort. The FMI-positive associated metabolite sebacic acid was inversely associated with T2D risk (OR 0.67, 95%CI 0.51–0.86). The FMI-negative associated metabolites cholic acid (OR 1.35, 95%CI 1.13–1.62), 3-dehydrocholic acid (OR 1.30, 95%CI 1.09–1.54), oleylcarnitine (OR 1.77, 95%CI 1.45–2.20), linoleylcarnitine (OR 1.66, 95%CI 1.37–2.05), palmitoylcarnitine (OR 1.62, 95%CI 1.33–2.02), and 2-hydroglutaric acid (OR 1.47, 95%CI 1.25–1.72) were positively associated with T2D risk. Conclusions Higher fruit intake-associated gut microbiota and metabolic alteration were associated with a lower risk of T2D, supporting the public dietary recommendation of adopting high fruit intake for the T2D prevention.

Saturated fatty acids with different chain lengths have different biological activities, but little is known about very-long-chain saturated fatty acids (VLCSFAs). This study investigated the associations between the circulating VLCSFAs and cardiovascular health. This community-based cohort study included 2198 adults without carotid artery plaques (CAPs) at baseline. The percentage of baseline erythrocyte VLCSFA (arachidic acid (C20:0), behenic acid (C22:0), and lignoceric acid (C24:0)) was measured by gas chromatography. The presence of CAPs was determined at baseline and every 3 years thereafter by ultrasound examination. A meta-analysis was conducted to summarize the pooled associations between circulating VLCSFAs and the risk of cardiovascular diseases (CVDs). During a median of 7.2 years of follow-up, 573 women (35.1%) and 281 men (49.6%) were identified as CAP incident cases. VLCSFAs were inversely related with CAP risk in women (all p-trend &lt, 0.05) but not in men. Multivariate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of CAPs for the highest (vs. lowest) quartile were 0.80 (0.63&ndash, 1.01) for C20:0, 0.71 (0.56&ndash, 0.89) for C22:0, 0.75 (0.59&ndash, 0.94) for C24:0, and 0.69 (0.55&ndash, 0.87) for total VLCSFAs in women. The pooled HRs (95% CIs) of CVDs for the highest (vs. lowest) circulating VLCSFAs from seven studies including 8592 participants and 3172 CVD events were 0.67 (0.57&ndash, 0.79) for C20:0, 0.66 (0.48&ndash, 0.90) for C22:0, and 0.57 (0.42&ndash, 0.79) for C24:0, respectively. Our findings suggested that circulating VLCSFAs were inversely associated with cardiovascular health.

In vitro and in vivo studies suggested that flavonols, flavones, flavanones and flavan-3-ols have preventive effects on breast carcinogenesis. Epidemiological evidence about the associations between these flavonoid biomarkers and breast cancer risk is limited. This study aimed to investigate the association between serum concentration of these flavonoids and breast cancer risk among Chinese women. This hospital-based case–control study recruited 792 breast cancer cases and 813 age frequency-matched (5-year interval) controls who provided eligible blood samples in Guangdong Province, China. Ultra-high-performance liquid chromatography–tandem mass spectrometry was used to measure flavonoids. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence internal (CI). Higher concentrations of serum flavonols, isorhamnetin, kaempferol, flavanones and naringenin were significantly associated with lower breast cancer risk, with adjusted ORs (95% CIs) for the highest versus the lowest group of 0.66 (0.49–0.89) for flavonols, 0.52 (0.38–0.70) for isorhamnetin, 0.60 (0.45–0.80) for kaempferol, 0.65 (0.49–0.87) for flavanones and 0.45 (0.34–0.60) for naringenin, respectively. Significant positive associations were observed between serum flavan-3-ols, epigallocatechin, epigallocatechin-3-gallate and breast cancer risk. No significant associations were observed for serum quercetin, flavones, apigenin, luteolin, hesperetin, catechin, epicatechin and epicatechin-3-gallate with overall breast cancer risk. This study suggested that serum flavonols and flavanones were inversely associated with breast cancer risk and serum flavan-3-ols were positively associated with breast cancer risk. Serum flavones were not associated with overall breast cancer risk. These findings warrant further confirmation in prospective studies.

As one of the indispensable components in lithium–sulfur batteries, the binders greatly impact battery performance. Herein, we report a new multifunctional supramolecular eutectic liquid (SEL) binder, consisting of diphenylamine (DP) and benzophenone (BP), which enables a strongly improved conductive network and anchored polysulfides for high-performance lithium–sulfur batteries. Compared with the traditional polyvinylidene fluoride (PVDF) binder, the SEL binder demonstrates remarkable improvement in both the mechanical performance and the capacity retention (83% over 200 cycles at 1C).

Loading of Au nanoparticles (AuNPs) onto environmentally sensitive polymer microgels is increasingly used to regulate their optical properties and catalytic activities. Herein, we synthesized composite polymer microgels composed of poly(N-isopropylacrylamide-co-3-methacryloxypropyltrimethoxysilane)/poly(acrylic acid) with a core–shell structure, and AuNPs were controllably loaded onto/into the network chains of the polymer microgels using seed-mediated growth. The prepared AuNPs composite materials possessed good pH sensitivity; the electromagnetic coupling between the AuNPs could thus be tuned via the swelling/deswelling of the polymer microgels under various acidic/alkaline conditions. More importantly, the coordination interaction between the carboxyl groups in the PAA chains and Cu2+ ions changed by varying the copper ion content under various pH conditions, thus enabling regulation of the localized surface plasmon resonance of the AuNPs. These structural features of the prepared composite microgels enabled to tailor the optical performance of the AuNPs by varying the pH of the surrounding medium.

Functional nanonetwork-structured polymers with inbuilt poly(acrylic acid) linings were successfully synthesized by combining surface-initiated atom transfer radical polymerization (SI-ATRP) and hypercrosslinking chemistry, and demonstrated superior adsorption performances toward basic dyes and heavy metal ions.

Herein, we present a universal bottom-up interface self-assembly of hairy nanoparticle strategy for 2D monolayered composite and functional nanosheets, including polymeric composite nanosheets and functional porous polymer and carbon nanosheets. By using diverse hairy nanoparticles as building blocks, a series of 2D monolayered polymeric composite nanosheets was prepared, demonstrating the universality of our strategy. Furthermore, the 2D polymeric composites could be easily transformed into 2D monolayered functional porous polymer and carbon nanosheets. We hope that this strategy will open a new door for the design and fabrication of advanced 2D composite and functional nanosheets and thus provide new opportunities for different fields including the environment, energy, catalysis and medicine.

The loading resistance of slip critical steel connection is determined by the slip factor between faying surfaces and pretension force in bolts. The shot-blasting treatment is a commonly used and simple type of surface treatments. In order to avoid the risk of rusting of shot-blasted surfaces which threatens the structure safety, shot-blasted surfaces are generally coated with aluminum or zinc-based product. In this study, the slip factors of high strength steels (Q550, Q690 and Q890) with inorganic zinc-rich coating are investigated. Two values of coating thickness (60 μ m and 80 μ m ) are selected and the influence of thickness of coating on slip factor is studied. Based on classical friction mechanism theory, compared with slip factor of shot-blasted surface, the decreasing of slip factor of surface with inorganic zinc-rich coating is analyzed. Moreover, the coating thickness effect on slip factor is also investigated. Because the difference between the measured slip displacement at 5 min (short-term tests) and 3 h (long-term tests) exceed 2 μ m , corresponding creep tests are carried out to evaluate long-term effects. Based on tests results, the recommended values of slip factor of high strength steel surface with inorganic zinc-rich coating is 0.30.

Atherosclerosis is characterized by endothelial dysfunction, lipid deposition, fibro-proliferative reactions and inflammation. Octacosanol is a high-molecular-weight primary aliphatic alcohol. As the main component of a cholesterol-lowering drug, octacosanol could inhibit lipids accumulation and cholesterol metabolism. To explore the indication of octacosanol on endothelial protection, we evaluated its effects on the proliferation and migration of human umbilical vein endothelial cells (HUVEC). Cell viability assay using methyl thiazolyl tetrazolium and 5-ethynyl-2'-deoxyuridine revealed that 3.125 μg/ml octacosanol promoted the proliferation of HUVEC. A cell migration assay indicated that 0.781 and 3.125 μg/ml octacosanol increased the migration of HUVEC. Moreover, the phosphorylation levels of Akt and Erk1/2 were significantly elevated under exposure to octacosanol. Blocking the activation of Akt and Erk with their potent inhibitors LY294002 and PD98059, respectively, markedly attenuated the octacosanol-induced proliferation and migration of HUVEC. These findings demonstrated for the first time that octacosanol enhanced the proliferation and migration of HUVEC and mediated these effects through activation of the PI3K/Akt and MAPK/Erk1/2 signaling pathways.

Bi2 (Mg1/3Nb2/3-xSnx)2O7(BMNS)(x=0.1,x=0.15,x=0.2,x=0.25 mol) ceramics was prepared by traditional solid-state reaction method and the influence of tin ion doped amount on the dielectric properties and structure of BMNS ceramics were investigated. The results show that all of the doped samples keep a single monoclinic pyrochlore phase and there is no second phase observed. The grain size of ceramics gradually increases, the dielectric constant decreases first and then increases, the dielectric loss increases first and then decreases and the density reduces with the increase of tin ion doped amount. The density of ceramics increases first then decreases with the increase of sintering temperature. The BMNS ceramics sintered at 980 °C with 0.25 mol tin ion doping amount has a biggest density and the best properties,whose εr is 155(1MHz),tanδ is 0.0011(1MHz), the bulk density is 7.62 g/cm3.

This work aims to experimentally and theoretically study the effects of ethylene–propylene copolymers as compatibilizer on the phase morphologies, interfacial properties, rheological behaviors and mechanical properties of ultrahigh molecular weight polyethylene/homopolymerized polypropylene (UHMWPE/HPP) blends. The results indicate that the addition of ethylene–propylene block copolymer EPS30R or random copolymer DP3000 ranging within 1–3 parts per hundred parts (phr) of UHMWPE/HPP blends can remarkably reduce the sizes of the UHMWPE particles and significantly improve the mechanical property such as tensile strength and elongation at break. Moreover, the ternary blends still show two-phase morphologies, and the favorable melt flowability of the UHMWPE/HPP blends can be basically maintained. Besides, dissipative particle dynamics simulations on the ternary UHMWPE/HPP/ethylene–propylene copolymer blends indicate that with fixed mole number of the block copolymer, longer block chains have higher efficiency on reducing the interfacial tension than the shorter ones. But for the block copolymers with fixed volume fraction, interfacial tensions firstly decrease and then increase with increasing the chain length of block copolymer.

In this work, montmorillonite (Mt) was modified by octadecyl amine ethoxylate ether (A) which has two poly(ethylene oxide) segments. Montmorillonite/polypropylene (Mt/PP) nanocomposites were prepared by a melt blending technique using different contents of modified Mt with and without maleic anhydride grafted polypropylene (PPg). The intercalated and exfoliated structures of Mt/PP nanocomposites were characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM). Because of the typical intercalated and exfoliated structures, the mechanical properties of Mt/PP nanocomposites were improved significantly. The modified Mt in a PP matrix led to a significant reduction of melt viscosity and enhancement in Izod-notched impact strength and elongation at break. The Izod-notched impact strength and elongation at break of Mt/PP nanocomposites were 1.95 and 2.77 times as high as those of pure PP. The tensile strength of Mt/PP nanocomposites was also improved in the presence of PPg.

Calcineurin (CaN) is a member of ser/thr protein phosphatase family. Earlier, we have reported that CaN is present in all eye tissues, although the activity and protein expression varied (Seitz et al., Invest Opthalmol Vis Sci, 43:15-21, 2002). We have isolated a full-length cDNA encoding bovine retina CaN. The CaN A subunit consists of 511 amino acid residues. A 10 amino acid (ATVEAIEADE) deletion before the autoinhibitory domain was observed in bovine retina CaN A compared to bovine brain CaN A. The study on CaN activity and regulation demonstrated that different metal ions have different effects on its phosphatase activity. Ni(2+) was found to be the strongest stimulator, while Zn(2+) was found to inhibit CaN phosphatase activity. Mn(2+) was a relatively less effective stimulator compared to Ni(2+). Fe(2+) was also able to stimulate CaN phosphatase activity; in contrast, a previous study found Fe(2+) slightly inhibited CaN activity from bovine brain. The residues at 97-201 were found to be essential for bovine retina CaN A phosphatase activity. The residues at 407-456 also had an inhibitory effect on CaN A phosphatase activity in addition to the previously known autoinhibitory domain at 457-480. These observations suggest that bovine retina CaN A might possess some distinct structural characteristics.

As an excellent artificial photosynthetic reaction center, the carotene (C)-porphyrin (P)-fullerene (F) triad was extensively investigated experimentally. To reveal the mechanism of the intramolecular charge transfer (ICT) on the mimic of photosynthetic solar energy conversion (such as singlet energy transfer between pigments, and photoinduced electron transfer from excited singlet states to give long-lived charge-separated states), the ICT mechanisms of C-P-F triad on the exciton were theoretically studied with quantum chemical methods as well as the 2D and 3D real space analysis approaches. The results of quantum chemical methods reveal that the excited states are the ICT states, since the densities of HOMO are localized in the carotene or porphyrin unit, and the densities of LUMO are localized in the fullerene unit. Furthermore, the excited states should be the intramolecular superexchange charge transfer (ISCT) states for the orbital transition from the HOMO whose densities are localized in the carotene to the LUMO whose densities are localized in the fullerene unit. The 3D charge difference densities can clearly show that some excited states are ISCT excited states, since the electron and hole are resident in the fullerene and carotene units, respectively. From the results of the electron-hole coherence of the 2D transition density matrix, not only 3D results are supported, but also the delocalization size on the exciton can be observed. These phenomena were further interpreted with non-linear optical effect. The large changes of the linear and non-linear polarizabilities on the exciton result in the charge separate states, and if their changes are large enough, the ICT mechanism can become the ISCT on the exciton.

Numerous studies suggest that two-phase morphology and thick interface are separately beneficial to the viscosity reduction and mechanical property maintainence of the matrix when normal molecular weight polymer (NMWP) is used for modification of ultrahigh molecular weight polyethylene (UHMWPE). Nevertheless, it is very difficult to obtain a UHMWPE/NMWP blend which may demonstrate both two-phase morphology and thick interface. In this work, dissipative particle dynamics simulations and Flory-Huggins theory are applied in predicting the optimum NMWP and the corresponding conditions, wherein the melt flowability of UHMWPE can be improved while its mechanical properties can also be retained. As is indicated by dissipative particle dynamics simulations and phase diagram calculated from Flory-Huggins theory, too small Flory-Huggins interaction parameter (χ) and molecular chain length of NMWP (N NMWP) may lead to the formation of a homogeneous phase, whereas very large interfacial tension and thin interfaces might also appear when parameters N NMWP and χ are too large. When these parameters are located in the metastable region of the phase diagram, however, two-phase morphology occurs and interfaces of the blends are extremely thick. Therefore, metastable state is found to be advisable for both the viscosity reduction and mechanical property improvement of the UHMWPE/NMWP blends.

Mycoplasma hyopneumoniae is an important pathogen of pigs causing enzootic pneumonia of swine. The pathogen remains largely enigmatic as far as the host-pathogen interactions are concerned. In the present study, the protein profiles of two strains of M. hyopneumoniae were compared by two-dimensional gel electrophoresis and mass spectrometry. The results indicate that the major adhesin P97, the 50-kDa protein derived from P159 adhesin, and the 43-kDa cleavage product of P102 are expressed at much higher levels in the pathogenic strain 232. In contrast, the avirulent strain J switches its focus to metabolism and expresses more glyceraldehyde 3-phosphate dehydrogenase in gluconeogenesis and lactate dehydrogenase, pyruvate dehydrogenase, and phosphate acetyltransferase in the pyruvate metabolism pathway. We speculate that the avirulent strain may have developed better capabilities to cope with the rich environment during repeated inoculations. Simultaneously, the capability to infect host cells may become less important so that the adhesion-related protein genes are down-regulated.

Concerns have arisen regarding the risk of ischemic heart disease with the novel antiangiogenic agent bevacizumab, a recombinant humanised monoclonal antibody to the vascular endothelial growth factor that is widely used in cancer treatment. Currently, the role of bevacizumab in ischemic heart disease is controversial. This meta-analysis was therefore performed to assess the overall risk of ischemic heart disease associated with the use of bevacizumab. The databases of PubMed, EMBASE and Web of Science were searched for English language studies of randomised controlled trials comparing bevacizumab with control therapy published through October 25, 2012. Summary incidence rates, relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects models based on the heterogeneity of the included studies. A total of 4,617 patients from 7 randomised controlled trials were identified and included for analysis. Among those patients receiving bevacizumab, the summary incidence of ischemic heart disease was 1.0% (95% CI, 0.6%–1.4%). Patients treated with bevacizumab had a significantly increased risk of ischemic heart disease with an RR of 2.49 (95% CI, 1.37–4.52) compared with controls. In addition, both high doses and low doses of bevacizumab increased the risk of cardiac ischemia (low dose at 2.5 mg/kg per week: RR, 2.14 [95% CI, 1.09–4.19]; high dose at 5 mg/kg per week: RR, 4.81 [95% CI, 1.03–22.42]). Bevacizumab was also found to significantly increase the risk of cardiac ischemia in patients with colorectal cancer (RR, 2.13; 95% CI, 1.11–4.06) compared with controls. This meta-analysis shows the use of bevacizumab was associated with an increased risk of developing ischemic heart disease in colorectal cancer patients receiving this drug. Our conclusions are limited by the available data. Further evaluations of high-quality RCTs are needed.