Performance of a novel eight-color flow cytometry panel for measurable residual disease assessment of chronic lymphocytic leukemia.

BACKGROUND: Measurable residual disease (MRD) is an important prognostic indicator of chronic lymphocytic leukemia (CLL). Different flow cytometric panels have been developed for the MRD assessment of CLL in Western countries; however, the application of these panels in China remains largely unexplored. METHODS: Owing to the requirements for high accuracy, reproducibility, and comparability of MRD assessment in China, we investigated the performance of a flow cytometric approach (CD45-ROR1 panel) to assess MRD in patients with CLL. The European Research Initiative on CLL (ERIC) eight-color panel was used as the "gold standard." RESULTS: The sensitivity, specificity, and concordance rate of the CD45-ROR1 panel in the MRD assessment of CLL were 100% (87/87), 88.5% (23/26), and 97.3% (110/113), respectively. Two of the three inconsistent samples were further verified using next-generation sequencing. In addition, the MRD results obtained from the CD45-ROR1 panel were positively associated with the ERIC eight-color panel results for MRD assessment (R = 0.98, p < 0.0001). MRD detection at low levels (≤1.0%) demonstrated a smaller difference between the two methods (bias, -0.11; 95% CI, -0.90 to 0.68) than that at high levels (>1%). In the reproducibility assessment, the bias was smaller at three data points (within 24, 48, and 72 h) in the CD45-ROR1 panel than in the ERIC eight-color panel. Moreover, MRD levels detected using the CD45-ROR1 panel for the same samples from different laboratories showed a strong statistical correlation (R = 0.99, p < 0.0001) with trivial interlaboratory variation (bias, 0.135; 95% CI, -0.439 to 0.709). In addition, the positivity rate of MRD in the bone marrow samples was higher than that in the peripheral blood samples. CONCLUSIONS: Collectively, this study demonstrated that the CD45-ROR1 panel is a reliable method for MRD assessment of CLL with high sensitivity, reproducibility, and reliability.

[Quantitative Assessment of the Impact of Climate Change on the Growing Season of Vegetation Gross Primary Productivity in the Middle and Lower Reaches of the Yangtze River].

Quantitatively determining the direct, indirect, and comprehensive effects of climatic factors on the growing season of the vegetation GPP (GPPGS) in the middle and lower reaches of the Yangtze River at the regional and vegetation type scales can provide a scientific basis for the management and restoration of regional vegetation resources under the background of global climate change. Using MODIS GPP data, meteorological data, and vegetation type data, combined with Theil-Sen Median trend analysis and the Mann-Kendall significance test, the spatiotemporal characteristics of the GPPGS in the middle and lower reaches of the Yangtze River were investigated at different temporal and spatial scales. Path analysis was used to further reveal the direct, indirect, and comprehensive effects of climate factors on GPPGS variation in different vegetation types. The results showed that:① from 2000 to 2021, the vegetation GPPGS in the middle and lower reaches of the Yangtze River showed a fluctuating upward trend, with a rising rate (in terms of C, same below) of 2.70 g·(m2·a)-1 (P<0.01). The GPPGS of different vegetation types all showed a significant upward trend (P<0.01), with shrubs having the highest upward rate of 3.31 g·(m2·a)-1 and cultivated vegetation having the lowest upward rate of 2.54 g·(m2·a)-1. ② The proportion of the area with an upward trend in GPPGS in the middle and lower reaches of the Yangtze River was 88.11%. The proportion of the area with an upward trend in GPPGS was greater than 84% for all different vegetation types, with shrubs (49.76%) and cultivated vegetation (44.36%) having significantly higher proportions of the area with an upward trend than that in other vegetation types. ③ The path analysis results showed that precipitation and the maximum temperature had a significant positive direct effect on vegetation GPPGS (P<0.05), whereas solar radiation had a non-significant positive effect (P ≥ 0.05). The indirect effects of maximum temperature, precipitation, and solar radiation on vegetation GPPGS were all non-significantly negative (P ≥ 0.05). Under the combined effects of direct and indirect influences, precipitation and maximum temperature had a non-significant positive effect on vegetation GPPGS (P ≥ 0.05), whereas solar radiation had a non-significant negative effect on vegetation GPPGS (P ≥ 0.05). Among different vegetation types, precipitation was the main climate factor affecting the changes in GPPGS of cultivated vegetation, whereas the maximum temperature was the main climate factor affecting the changes in GPPGS of coniferous forests, broad-leaved forests, shrubs, and grasslands. ④ The changes in vegetation GPPGS in the middle and lower reaches of the Yangtze River were mainly influenced by the direct effects of maximum temperature, precipitation, and solar radiation, with the direct effect of precipitation dominating 56.72% of the changes in GPPGS. The research results can provide a reference for quantifying the carbon sequestration potential of vegetation in the middle and lower reaches of the Yangtze River and formulating ecological restoration governance policies tailored to local conditions under the background of global climate change.

[Spatio-temporal Variation in PM2.5 Concentration and Its Relationship with Vegetation Landscape Patterns in Typical Economic Zones in China from 2000 to 2020].

This study explored the temporal and spatial variation in PM2.5 concentration and its relationship with the vegetation landscape pattern in three typical economic zones in China, which is of great significance for regional PM2.5pollution control and atmospheric environmental protection. In this study, the pixel binary model, Getis-Ord Gi* analysis, Theil-Sen Median analysis, Mann-Kendall significance test, Pearson correlation analysis, and multiple correlation analysis were used to explore the spatial cluster and spatio-temporal variation in PM2.5 and its correlation with the vegetation landscape index in the three economic zones of China on the basis of PM2.5 concentration data and MODIS NDVI data set. The results showed that PM2.5 in the Bohai Economic Rim was mainly dominated by the expansion of hot spots and the reduction in cold spots from 2000 to 2020. The proportion of cold spots and hot spots in the Yangtze River Delta showed insignificant changes. Both cold and hot spots in the Pearl River Delta had expanded. PM2.5 showed a downward trend in the three major economic zones from 2000 to 2020, and the magnitudes of increasing rates were higher in the Pearl River Delta, followed by those in the Yangtze River Delta and Bohai Economic Rim. From 2000 to 2020, PM2.5 exhibited a downward trend in the context of all vegetation coverage grades, and PM2.5 had most significantly improved within extremely low vegetation coverage in the three economic zones. On the landscape scale, PM2.5 values were mostly correlated with aggregation index in the Bohai Economic Rim, with the largest patch index in the Yangtze River Delta and Shannon's diversity in the Pearl River Delta, respectively. Under the context of different vegetation coverage levels, PM2.5showed the highest correlation with aggregation index in the Bohai Economic Rim, landscape shape index in the Yangtze River Delta, and percent of landscape in the Pearl River Delta, respectively. PM2.5 showed significant differences with vegetation landscape indices in the three economic zones. The combined effect of multiple vegetation landscape pattern indices on PM2.5 was stronger than that of the single vegetation landscape pattern index. The above results indicated that the spatial cluster of PM2.5 in the three major economic zones had changed, and PM2.5 showed a decreasing trend in the three economic zones during the study period. The relationship between PM2.5 and vegetation landscape indices exhibited obvious spatial heterogeneity in the three economic zones.

An Annealing Model Analysis and Research on the In of Community Public Sports on Economic Development.

The state vigorously develops the application of community sports and takes it as an important unit of social and economic development. With the development of the economy, residents' living standards are getting better, which also greatly promotes the development of community public sports. Community public sports have made great progress in terms of scale, hardware, and services, and their impact on society is getting worse. Come bigger. However, there are still some deficiencies in the development of community sports. How to accurately evaluate and predict its facilities, construction, and service levels and put forward corresponding development strategies is an urgent problem to be solved in the field of community public sports. In this paper, an iterative simulated annealing algorithm is proposed to evaluate the level of public sports services and help community public sports institutions identify their own development deficiencies. Through the simulation analysis of the community sports organizations, community members, venue facilities and funds, venue facilities and funds, administrators, and the community sports activities, it is found that the identification accuracy of the evaluation results of the five indicators is above 95%, while the initial threshold of community public sports and social and economic development and the prediction accuracy required by the standard of development status are both 10%. At the same time, the recognition time of the evaluation results in the five indicators is less than 7 seconds. In community public sports development trend prediction and service level judgment, the identification time of the evaluation result is less than 4 seconds, and the overall judgment result is better.

Cost-effectiveness analysis of different screening strategies for colorectal cancer in Guangzhou, southern China: a Markov simulation analysis based on natural community screening results.

OBJECTIVES: To evaluate the cost-effectiveness of four different primary screening strategies: high-risk factor questionnaire (HRFQ) alone, single immunochemical faecal occult blood test (iFOBT), double iFOBT and HRFQ+double iFOBT for colorectal cancer (CRC) screening compared with no screening using the Markov model. METHODS: Treeage Pro V.2011 software was used to simulate the Markov model. The incremental cost-effectiveness ratio, which was compared with the willingness-to-pay (WTP) threshold, was used to reflect the cost-effectiveness of the CRC screening method. One-way sensitivity analysis and probabilistic sensitivity analysis were used for parameter uncertainty. RESULTS: All strategies had greater effectiveness because they had more quality-adjusted life years (QALYs) than no screening. When the WTP was ¥435 762/QALY, all screening strategies were cost-effective compared with no screening. The double iFOBT strategy was the best-buy option compared with all other strategies because it had the most QALYs and the least cost. One-way sensitivity analysis showed that the sensitivity of low-risk adenoma, compliance with colonoscopy and primary screening cost were the main influencing factors comparing single iFOBT, double iFOBT and HRFQ+double iFOBT with no screening. However, within the scope of this study, there was no fundamental impact on cost-effectiveness. Probabilistic sensitivity analysis showed that when the WTP was ¥435 762/QALY, the probabilities of the cost-effectiveness acceptability curve with HRFQ alone, single iFOBT, double iFOBT and HRFQ+double iFOBT were 0.0%, 5.3%, 69.3% and 25.4%, respectively. CONCLUSIONS: All screening strategies for CRC were cost-effective compared with no screening strategy. Double iFOBT was the best-buy option compared with all other strategies. The significant influencing factors were the sensitivity of low-risk polyps, compliance with colonoscopy and cost of primary screening.

Can Pets Replace Children? The Interaction Effect of Pet Attachment and Subjective Socioeconomic Status on Fertility Intention.

A growing number of young people tend to regard their pets as their surrogate children, yet research examining the relationship between pet attachment and fertility intention remains scarce. Moreover, individuals' fertility intention is affected by economic resources. Therefore, we conducted two studies to examine the interaction effect of pet attachment and subjective socioeconomic status (SES) on childbearing-aged individuals' fertility intention. In Study 1, we utilized questionnaires to measure Chinese pet owners' pet attachment, subjective SES, and fertility intention. In Study 2, participants' pet attachment was experimentally manipulated by reading articles about the benefits of petkeeping. The results of the two studies consistently demonstrated that the effect of pet attachment on fertility intention was moderated by subjective SES. Specifically, pet attachment was negatively associated with fertility intention when individuals had a high level of subjective SES, whereas this effect disappeared when individuals had low subjective SES. These findings suggest an explanation for why individuals with high subjective SES delay or even opt out of childbearing. The limitations and implications of the current study are discussed.

Assessment of the impact of hydrolysis on bound sulfonamide residue determination in honey using stable isotope dilution ultrahigh performance liquid chromatography tandem mass spectrometry.

In this study, an analytical method based on isotope dilution-liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) was developed as a candidate reference method for the determination of sulfonamides (SAs) in honey. To guarantee the accuracy and authenticity, the impact of hydrolysis on bound SA residues was first investigated by enabling (i) identification of sugar-bound SAs, (ii) clarifying the binding reaction rule between the SAs and sugar, (iii) detection of free SAs and sugar-bound SAs, and (iv) preparation of SA-contaminated honey. Thus, the efficiency of different hydrolysis conditions was assessed by comparing the bound SA content before and after hydrolysis. In addition, optimization of the sample pretreatment procedures and LC conditions to minimize matrix effects by separation from significant matrix interferences was also performed. Satisfactory results in terms of hydrolysis efficiency (approximately 88.3%-99.2%), extraction efficiency (84.2%-105.3%), recovery (95.9%-103.1%), and limit of quantification (0.6-1.5 µg·kg-1) were obtained.

Daily mean temperature and HFMD: risk assessment and attributable fraction identification in Ningbo China.

BACKGROUND: Hand, foot, and mouth disease (HFMD) remains a significant public health issue, especially in developing countries. Many studies have reported the association between environmental temperature and HFMD. However, the results are highly heterogeneous in different regions. In addition, there are few studies on the attributable risk of HFMD due to temperature. OBJECTIVES: The study aimed to assess the association between temperature and HFMD incidence and to evaluate the attributable burden of HFMD due to temperature in Ningbo China. METHODS: The research used daily incidence of HFMD from 2014 to 2017 and distributed lag non-linear model (DLNM) to investigate the effects of daily mean temperature (Tmean) on HFMD incidence from lag 0 to 30 days, after controlling potential confounders. The lag effects and cumulative relative risk (CRR) were analyzed. Attributable fraction (AF) of HFMD incidence due to temperature was calculated. Stratified analysis by gender and age were also conducted. RESULTS: The significant associations between Tmean and HFMD incidence were observed in Ningbo for lag 0-30. Two peaks were observed at both low (5-11 °C) and high (16-29 °C) temperature scales. For low temperature scale, the highest CRR was 2.22 (95% CI: 1.61-3.07) at 7 °C on lag 0-30. For high temperature scale, the highest CRR was 3.54 (95% CI: 2.58-4.88) at 24 °C on lag 0-30. The AF due to low and high temperature was 5.23% (95% CI: 3.10-7.14%) and 39.55% (95% CI: 30.91-45.51%), respectively. There was no significant difference between gender- and age-specific AFs, even though the school-age and female children had slightly higher AF values. CONCLUSIONS: The result indicates that both high and low temperatures were associated with daily incidence of HFMD, and more burdens were caused by heat in Ningbo.

A Data-Driven Approach to Transfer Function Analysis for Superior Discriminative Power: Optimized Assessment of Dynamic Cerebral Autoregulation.

Transfer function analysis (TFA) is extensively used to assess human physiological functions. However, extracting parameters from TFA is not usually optimized for detecting impaired function. In this study, we propose to use data-driven approaches to improve the performance of TFA in assessing blood flow control in the brain (dynamic cerebral autoregulation, dCA). Data were collected from two distinct groups of subjects deemed to have normal and impaired dCA. Continuous arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV) were simultaneously recorded for approximately 10 mins in 82 subjects (including 41 healthy controls) to give 328 labeled samples of the TFA variables. The recordings were further divided into 4,294 short data segments to generate 17,176 unlabeled samples of the TFA variables. We optimized TFA post-processing with a generic semi-supervised learning strategy and a novel semi-supervised stacked ensemble learning (SSEL) strategy for classification into normal and impaired dCA. The generic strategy led to a performance with no significant difference to that of the conventional dCA analysis methods, whereas the proposed new strategy boosted the performance of TFA to an accuracy of 93.3%. To our knowledge, this is the best dCA discrimination performance obtained to date and the first attempt at optimizing TFA through machine learning techniques. Equivalent methods can potentially also be applied to assessing a wide spectrum of other human physiological functions.

Assessment of coronary artery abnormalities and variability of Z-score calculation in the acute episode of Kawasaki disease-A retrospective study from China.

BACKGROUND: Accurate classification of coronary artery abnormalities (CAAs) is essential for clinical decision-making and long-term management in Kawasaki disease (KD) patients. To date, there are several echocardiographic criteria of CAA assessment. MATERIALS AND METHODS: The Japanese Ministry of Health (JMH) criteria and the Z-score criteria from 2004 American Heart Association guidelines were adopted and their detective efficacies for CAAs were compared in 251 Chinese patients with KD Z scores were calculated by 6 published methods. RESULTS: According to the JMH criteria, 19 (7.57%) KD patients were classified as CAAs during the acute KD episode. However, the detective number of CAAs was highest and had a 0.68-fold increase by the Dallaire et al method with a Z-score cut point of ≥2.5 as compared with the JMH criteria; in contrast, more than 78.95% of patients with CAAs identified by the JMH criteria had a coronary artery Z score ≥2.5. All 6 different Z-score methods had satisfactory accuracies with a range from 93.23% to 97.61% in screening CAAs. For the 19 patients with CAAs identified by the JMH criteria, their Z scores presented the widest variation calculated by the McCrindle et al method. CONCLUSIONS: The JMH criteria underestimate the prevalence of CAAs as compared with the Z-score criteria. Quantitative assessment of coronary artery luminal dimensions, normalized as Z scores adjusted for body surface, should be recommended. The larger coronary artery luminal dimensions vary, the more heterogeneous Z scores calculated by different methods have.

Comparison of 2013 and 2009 versions of Caprini risk assessment models for predicting VTE in Chinese cancer patients: a retrospective study.

This study aimed to compare the predictive value of 2009 and 2013 version of Caprini risk assessment models (RAM) for venous thromboembolism (VTE) in cancer patients by receiver operating characteristic (ROC) analysis. This retrospective study reviewed a total of 1439 VTE and 1439 non-VTE Chinese cancer inpatients. The baseline demographic data of these patients were recorded. 2009 and 2013 versions Caprini RAMs were applied, and cumulative risk scores were obtained by adding the scores of each risk factor. The specificity, sensitivity, positive predictive value and negative predictive value of these two models were analyzed. ROC curve was drawn to calculate the area under the curve (AUC) and the Youden index. Significant differences were observed in the risk factors between VTE and non-VTE Group. The specificity and negative predictive value of 2013 version were higher than those of 2009 version (P < 0.05). No significant differences were found in the sensitivity or positive predictive value between 2009 and 2013 versions of the Caprini RAM (P > 0.05). The AUC and Youden index of 2013 Caprini RAM were significantly higher than those of 2009 Caprini RAM (P < 0.001), whereas the Youden index of the 2009 Caprini RAM at critical point 4 was higher than that at critical point 3 (0.362 vs 0.067, P < 0.05). Compared with 2009 version, 2013 version of the Caprini RAM provides a more accurate and efficacious method for the risk assessment of VTE in Chinese cancer patients.

Label-free detection of pepsinogen 1 and 2 by polyethylene coating Lamb microfluidic device.

Early screening of gastric cancer is a critical importance for the improvement of patients' survival rate. Here, a polyethylene coating Lamb (PE-Lamb) microfluidic device with immune layer for gastric cancer label-free detection was constructed. Two serum pepsinogen 1 (PG1) and pepsinogen 2 (PG2) biomarkers were applied to screen and predict the appearance of gastric cancer. Compared with enzyme-linked immunosorbent assay (ELISA), this method achieved a higher sensitivity and less time (40 min vs 120 min). The limit of detections (LOD) were reached 60 pg/mL for PG1 and 30 pg/mL for PG2, which have two orders of magnitude lower than traditional ELISA. The linearity coefficient indexes (R2) for PG1 and PG2 were 0.992 and 0.953 respectively, which is similar to that of ELISA. In addition, PG1 and PG2 mixed antigens sample with human serum was detected by PE-Lamb approach, and the frequency response showed high reproducibility and specificity. The results indicate that PE-lamb diagnostic technique is a novel and promising method for high-throughput screening and early diagnosis of gastric cancer.

Willingness to pay for colorectal cancer screening in Guangzhou.

AIM: To measure the willingness to pay for colorectal cancer screening in Guangzhou, and to identify those factors associated with it. METHODS: A face-to-face questionnaire survey for pre-screening population from free and non-free colonoscopy districts was used to collect information on demographic characteristics, health behaviours, the intention of the cancer screenings and willingness to pay for colorectal cancer screening. A total of 1243 participants who took part in the pre-screening for colorectal cancer in Guangzhou were collected in the study. Categorical data were compared using the χ2 test to analyse significant differences. Non-conditional logistic regression and multi-class logistic regression were also performed for multivariate analysis and to estimate the odds ratios. RESULTS: The percentage of participants willing to pay for colorectal cancer screening was 91.7%. "Unnecessary" was the dominant reason that participants gave for their unwillingness, accounting for 63.1%. Of those who were willing to pay, 29.2%, 20.7%, 14.8%, 13.0% and 22.4% of participants were willing to pay less than \100, \100-\199, \200-299, \300-\399 and more than \400, respectively. Non-logistic regression analysis showed that respondents who were male, had a high level of education, were from the family with more children/older to raise, and accepted colorectal cancer screening were willing to pay for this screening. Multi-class logistic regression analysis showed that respondents with higher annual household income per capita, from government and private enterprises, government agency/institution and peasants, and less family medical expenditure were willing to pay more. CONCLUSION: Willingness to pay for colorectal cancer screening in Guangzhou is high, but the amount of willing to pay is not much.

Quantitative assessment of the effect of pre-gestational diabetes and risk of adverse maternal, perinatal and neonatal outcomes.

Pregnancies complicated by pre-gestational diabetes (PGD) are associated with a higher rate of adverse outcomes, including an increased rage of preterm delivery, pregnancy-induced hypertension, pre-eclampsia, caesarean section, perinatal mortality, stillbirth, shoulder dystocia, macrosomia, small for gestational age, large for gestational age, low birth weight, neonatal hypoglycemia, neonatal death, low Apgar score, NICU admission, jaundice and respiratory distress. In the past two decades, numerous reports have been published regarding associations between PGD and risk of adverse outcomes. However, study results are inconsistent. To provide a synopsis of the current understanding of PGD for risk of adverse pregnancy outcomes, a random-effects meta-analysis over 40 million subjects from 100 studies was performed to calculate the pooled ORs. Potential sources of heterogeneity were systematically explored by multiple strata analyses and meta-regression. Overall, PGD were significantly associated with increased risk of preterm delivery (OR=3.48), LGA (OR=3.90), perinatal mortality (OR=3.39), stillbirth (OR=3.52), pre-eclampsia (OR=3.48), caesarean section (OR=3.52), NICU admission (OR=3.92), and neonatal hypoglycemia (OR=26.62). Significant results were also observed for 7 adverse outcomes with OR range from 1.54 to 2.82, while no association was found for SGA and respiratory distress after Bonferroni correction. We found that women with T1DM had higher risks for most of adverse pregnancy outcomes compared with women with T2DM. When stratified by study design, sample size, type of diabetes, geographic region, and study quality, significant associations remains. Our findings demonstrated that PGD is a strong risk-conferring factor for adverse maternal, perinatal and neonatal outcomes.

Evaluation on island ecological vulnerability and its spatial heterogeneity.

The evaluation on island ecological vulnerability (IEV) can help reveal the comprehensive characteristics of the island ecosystem and provide reference for controlling human activities on islands. An IEV evaluation model which reflects the land-sea dual features, natural and anthropogenic attributes, and spatial heterogeneity of the island ecosystem was established, and the southern islands of Miaodao Archipelago in North China were taken as the study area. The IEV, its spatial heterogeneity, and its sensitivities to the evaluation elements were analyzed. Results indicated that the IEV was in status of mild vulnerability in the archipelago scale, and population pressure, ecosystem productivity, environmental quality, landscape pattern, and economic development were the sensitive elements. The IEV showed significant spatial heterogeneities both in land and surrounding waters sub-ecosystems. Construction scale control, optimization of development allocation, improvement of exploitation methods, and reasonable ecological construction are important measures to control the IEV.

[Effect of a clinical pathway in patients with Crohn's disease complicated with intestinal obstruction].

OBJECTIVE: To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction. METHODS: CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group. The other 108 CD patients from September 2012 to February 2014 received treatment according to the management strategy made by individual attending physician as non-CP group. Rate of operation, rate of stoma, morbidity of surgical complications, hospital stay, hospital cost, and 6-month unplanned re-admission were compared between two groups. RESULTS: The baseline data were similar between the two group (all P > 0.05). No significant differences were noted between these the two groups in terms of rate of operation (73.9% vs. 77.8%, P = 0.605), rate of stoma (15.9% vs. 25.0%, P = 0.197), and morbidity of surgical complications (23.9% vs. 27.4%, P = 0.724). However, the mean postoperative hospital stay was shorter (10.9 d vs. 13.2 d, P = 0.000), the mean hospital cost was less (78 325 Yuan vs. 85 310 Yuan, P = 0.031) and the rate of 6-month unplanned re-admission was lower(3.4% vs. 11.1%, P = 0.035) in CP group. CONCLUSION: Treatment based on this CP for CD patients complicated with intestinal obstruction can reduce the rate of 6-month unplanned re-admission, shorten the postoperative hospital stay and decrease the hospital cost in patients requiring surgery.

Quantitative assessment of common genetic variations in HLA-DP with hepatitis B virus infection, clearance and hepatocellular carcinoma development.

Hepatitis B virus (HBV) infection is the predominant risk factor for chronic hepatitis B (CHB), liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Recently, genome-wide association studies have identified human leukocyte antigen (HLA)-DP polymorphisms (rs3077 and rs9277535) as a new chronic HBV infection susceptibility locus. Since then, the relationship between HLA-DP polymorphisms and various outcomes of HBV infection has been reported. However, the results have been inconclusive. To derive a more precise estimation of the relationship between HLA-DP polymorphisms and various outcomes of HBV infection, a meta-analysis of 62,050 subjects from 29 case-control studies was performed. We found that rs3077 and rs9277535 in HLA-DP significantly decreased HBV infection risks and increased HBV clearance possibility in a dose-dependent manner. In the subgroup analysis by ethnicity, study design and sample size, significant associations were found for these polymorphisms in almost all comparisons. Meanwhile, haplotype analyses of the two polymorphisms revealed a significant association between the combination of these alleles and HBV infection outcomes. However, no significant results were observed in HCC development. Our results further confirm that genetic variants in the HLA-DP locus are strongly associated with reduced HBV infection and increased the likelihood of spontaneous viral clearance.

Impact of Disease Activity on Resting Energy Expenditure and Body Composition in Adult Crohn's Disease: A Prospective Longitudinal Assessment.

BACKGROUND: There is controversy about nutrition status and calorie needs during phases of active versus inactive adult Crohn's disease (CD). Results have been reported in cross-sectional studies, but longitudinal data are unavailable. Our aim was to explore whether disease activity had an impact on resting energy expenditure (REE) and body composition in adult patients with CD. MATERIALS AND METHODS: Adult patients were studied on 2 occasions with active and inactive CD. REE was measured by indirect calorimetry. Body composition was estimated from bioelectrical impedance analysis. Disease activity was measured using the Crohn's Disease Activity Index (CDAI). Regression analyses of REE with CDAI score, C-reactive protein, and erythrocyte sedimentation rate were also performed. RESULTS: Seventy-five patients were included. Patients with active CD had increased REE/body weight compared with patients with inactive disease (28.8 ± 5.4 vs 25.9 ± 4.3 kcal/kg, P < .001). Disease behavior and location, but not sex, had an impact on REE/body weight. Body mass index was lower in active disease than in remission (17.4 ± 3.0 vs 18.1 ± 2.6 kg/m(2), P = .010). Body composition was not affected by disease behavior or location. CONCLUSION: Patients with remission had a better nutrition status and decreased REE compared with those with active CD. REE could also be affected by disease location and behavior.