Burden of Cirrhosis and Other Chronic Liver Diseases Caused by Specific Etiologies in China, 1990-2016: Findings from the Global Burden of Disease Study 2016 / 生物医学与环境科学（英文）

Objective@#To estimate the burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China.@*Methods@#Data from the Global Burden of Disease Study 2016 (GBD 2016) were used. We evaluated the burden by analyzing age-sex-province-specific prevalence, mortality, and disability-adjusted life-years (DALYs) of 33 provinces in China.@*Results@#From 1990 to 2016, prevalence cases in thousands increased by 73.7% from 6833.3 (95% : 6498.0-7180.6) to 11869.6 (95% : 11274.6-12504.7). Age-standardized mortality and DALY rates per 100,000 decreased by 51.2% and 53.3%, respectively. Male and elderly people (aged ≥ 60 years) preponderance were found for prevalence, mortality, and DALYs. The number of prevalence cases, deaths, and DALYs due to hepatitis C virus (HCV) increased by 86.6%, 8.7%, and 0.9%, respectively. Also, age-standardized prevalence rates decreased in 31 provinces, but increased in Yunnan and Shandong. The Socio-demographic Index (SDI) values were negatively correlated with age-standardized mortality and DALY rates by provinces in 2016; the correlation coefficients were -0.817 and -0.828, respectively.@*Conclusion@#Cirrhosis and other chronic liver diseases remain a huge health burden in China, with the increase of population and the aging of population. Hepatitis B virus (HBV) remains the leading cause of the health burden in China.

Gene polymorphisms of interleukin-28, p21-activated protein kinases 4, and response to interferon-α based therapy in Chinese patients with chronic hepatitis B / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Peg-Interferon-α treatment is expensive and associated with considerable adverse effects, selection of patients with the highest probability of response is essential for clinical practice. The objective of this study was to assess the relationship between the gene polymorphisms of interleukin-28 (IL-28), p21-activated protein kinase 4 (PAK4) and the response to interferon treatment in chronic hepatitis B patients.</p><p><b>METHODS</b>Two hundred and forty interferon-naive treatment HBeAg seropositive chronic hepatitis B patients were enrolled in the present prospective nested case-control study. Peripheral blood samples were collected, including 92 with favorable response and 148 without response to the interferon treatment. Rs8099917, rs12980602, and rs9676717 SNP was genotyped using matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS).</p><p><b>RESULTS</b>IL-28 genotype was not associated with response to interferon treatment (OR for GT/GG vs. TT, 0.881 (95%CI 0.388 - 2.002); P = 0.762; OR for CT/CC vs. TT, 0.902 (95%CI 0.458 - 1.778); P = 0.766). Rs9676717 in PAK4 genotype was independently associated with the response (OR for CT/CC vs. TT, 0.524 (95%CI 0.310 - 0.888); P = 0.016). When adjusting for age, gender, smoking, drinking, levels of hepatitis B virus DNA, and alanine aminotransferase (ALT), rs9676717 genotype TT appeared to be associated with a higher probability of response for interferon treatment (OR, 0.155 (95%CI 0.034 - 0.700); P = 0.015).</p><p><b>CONCLUSION</b>Genotype TT for rs9676717 in PAK4 gene and no drinking may be predictive of the interferon-a treatment success.</p>

Association between IFN-γ+874 polymorphisms and the clinical outcomes of hepatitis B and/or hepatitis C virus infection / 中华流行病学杂志

Objective To explore the association between polymorphisms of interferon-gamma gene intron 1 at position+874 (IFN-γ+874) gene and the susceptibility of HBV and/or HCV infection with different clinical outcomes. Methods IFN-γ+874 gene SNP were detected in 277 subjects including 79 chronic HBV/HCV coinfections,69 individuals only with HBV infection,55 individuals only with HCV infection and 74 controls,by sequence specific primers-PCR (SSP-PCR). Hepatocellular injury as suggested by alanine aminotransferase (ALT) was detected by Beckman LX-20. The status of viral particles in serum was determined by RT-nPCR. The possible association of the polymorphism of IFN-γ+874 with the susceptibility of HBV and/or HCV infection and the outcome of these infections were analyzed. Results (1) IFN-γ+874 AA frequency in individuals with chronic HBV,HCV,HBV/HCV coinfections were significant higher than that in controls (X~2=16.15,P=0.01); OR (95% CI) of IFNγ+874 AA in chronic infection with HBV,HCV,HBV/HCV coinfections appeared to be 2.70 (1.24-5.92),3.22 (1.43-7.25) and 4.02 (1.88-8.55) compared with + 874 TA. No significant differences were found among HBV,HCV,HBV/HCV coinfections (X~2=1.97,P=0.73). There were no significant association of IFN-γ +874 A/T allele frequency with HBV and/or with HCV infection (X~2=4.87,P=0.18). (2)The clinical outcomes of mild chronic hepatitis (CH),moderate/severe CH and cirrhosis with HBV and/or HCV infection were associated with IFN-γ+874 AA [X~2＝14.17,P＝0.03;OR＝3.09(1.51-6.33),3.85 (1.70-8.70),3.14 (1.08-9.17)]. No significant relationships were found between IFN-γ+874 A/T allele frequency and the clinical outcome of HBV/HCV infection (X~2＝6.07,P＝0.11). (3)There were no significant associations of IFN-γ+874 genotype/allele frequency with HCV duplication (X~2=2.36,P=0.31). (4) There were no significant associations of IFN-γ+874 genotype/allele frequency with abnormal ALT (X~2=0.15,P=0.93). Conclusion These results suggested that polymorphisms in the IFN-γ +874 had some influence on chronic HCV and/or HBV infection,and on the outcome of HCV and/or HBV infections. IFN-γ+874 AA genotype and T allele were possible risk to chronic HBV and/or HCV infections and to the outcomes of HBV and/or HCV infection. However,IFN-γ+874 TA genotype might serve as possible protective factors to them.

Relations between IL-2-330 polymorphisms and the outcome of hepatitis B and/or hepatitis C virus infection / 中华流行病学杂志

Objective To study the relationship between polymorphisms in interleukin-2gene at position-330 (IL-2-330) and the clinical outcome of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection. Methods 277 subjects were recruited including 79 chronic HCV co-HBV infection, 55 chronic HCV infection, 69 chronic HBV infection and 74 controls. Single nucleotide polymorphisms of IL-2-330 was investigated by restricted fragment long polymorphism-PCR (RFLP-PCR). Hepatocellular injury, as revealed by alanine aminotransferase (ALT) was detected by Beckman LX-20 analyzer. The presence of hepatitis C viral particles in serum was determined by RT-nPCR. Results ( 1 ) IL-2-330 polymorphisms showed close association with persistent HBV and/or HCV infection. IL-2-330 TT was associated with an increased risk, but IL-2-330 GG with a reduced risk of persistent HBV and/or HCV infection (χ2=14.24, P=0.03 ) with ORs (95%CI) as 7.14(2.13-23.81 ), 3.46 (1.17-10.02) and 2.93 (1.15-7.46) respectively. However,IL-2-330 TT/GG did not significantly differ between patients with HBV and/or HCV infection (χ2=2.09, P=0.72). IL-2-330 T allele was associated with an increased risk, but the -330G allele was associated with a reduced risk of chronic HBV/HCV infection (χ2=12.33,P=0.01),with ORs (95% CI) as 2.26 (1.39-3.69) , 1.82 ( 1.09-3.03 ) and 1.73 ( 1.10-2.73 ) respectively. (2) IL-2-330polymorphisms showed significant association with the outcome of HBV and HCV infection ( χ2=13.52, P=0.04). IL-2-330 TT was associated with an increased risk, but-330 GG with a reduced risk of mild CH, moderate/severe CH, and cirrhosis. The ORs (95%CI) appeared to be 3.33(1.75-6.32), 3.31 (1.75-6.26), 11.23 (3.09-40.76) respectively. IL-2-330 T allele was associated with an increased risk, but the -330 G allele was associated with a reduced risk of mild CH, moderate/severe CH and cirrhosis (χ2= 12.32, P=0.01 ), with ORs as 1.86(1.32-2.63), 1.71 (1.27-2.31) and 2.77(1.57-4.89) respectively. (3) The polymorphisms of IL-2-330 showed no association with HCV RNA replication (χ2=0.83, P=0.66; χ2=0.20, P=0.66). The polymorphisms of IL-2-330 were not significantly associated with abnormal ALT ( χ2= 1.10, P=0.58; χ2=0.08, P=0.78). Conclusion These results suggested that IL-2-330 TT/T was associated with an increased risk, but IL-2-330GG/G was associated with reduced risk of persistent HBV and/or HCV infection, and with the development of mild CH,moderated/severe CH,and cirrhosis.

Cut-off points of fasting fingertip capillary blood glucose for detecting both undiagnosed diabetes and pre-diabetes / 中华流行病学杂志

Objective To determine the efficient cut-off points of fasting fingertip blood glucose test for undiagnosed diabetes mellitus(DM), impaired glucose tolerance(IGT), and impaired fasting glucose(IFG)in community-based residents aged above 45 years old. Methods A cluster-randomized study was conducted from May 2008 to January 2009. A total of 3250 subjects aged above 45 years in two communities of Baoding city received questionnaire investigation and tested for fingertip blood glucose. Those subjects whose capillary blood glucose level ≥5.1 mmol/L were subjected to 75 g oral glucose tolerance test. Undiagnosed diabetes mellitus and pre- diabetes were identified by fasting plasma glucose and OGTT. In this study, the cut-off points of fasting capillary blood glucose for detecting undiagnosed diabetes and pre-diabetes were evaluated, using receiver operator characteristic curve(ROC). Results Of 1351 subjects that having had oral glucose tolerance test, 230 cases were diagnosed as diabetes mellitus(7.3%), 166 cases(5.2%)as IFG, and 204(6.7%)as IGT under fasting capillary blood glucose as test variable and state variables according to the following criteria.(1)FPG≥7.0 mmol/L or/and 2hPG≥11.1 mmol/L(2)FPG<5.6 mmol/L (3)FPG<7.0 mmol/L and 7.8 mmol/L≤2hPG≤ 11.1 mmol/L, areas under three ROC curves were 0.905, 0.633 and 0.719, respectively. The cut-offvalues of screening for undiagnosed DM, IGT and IFG were 6.0 mmol/L, 5.7 mmol/L, and 5.7 mmol/L, respectively. When cut-off value of screening for undiagnosed DM was 6.0 mmol/L, the maximal sensitivity was 78.0% and specificity was 89.3%.But there were both lower sensitivity and specificity in screening for IFG and IGT according to the best predicting value(5.7 mmol/L)from the ROC curves(50.3% and 28.0% vs. 60.8% and 28.0%). Conclusion Fasting capillary blood glucose with the lower cut-point of 6.0 mmol/L in screening for undiagnosed diabetes mellitus alone, was relatively reliable, whereas for both IFG and IGT the fasting fingertip blood glucose tests were fallible. It was convenient and could be used in screening the DM at the community level.

A case-control study on risk factors of type 2 diabetes mellitus related chronic complications in Baoding city / 中华流行病学杂志

<p><b>OBJECTIVE</b>To recognize the main risk factors and to provide evidence for prevention and intervention of type 2 diabetes chronic complications.</p><p><b>METHODS</b>A hospital-based frequency matched case-control study including 200 type 2 diabetes mellitus (T2DM) chronic complications cases and 200 controls without T2DM chronic complications was carried out in Baoding city. Relationships between factors and T2DM chronic complications were analyzed by non-conditional uni-variate and multivariate logistic regression methodologies.</p><p><b>RESULTS</b>High C-reactive protein (CRP) (OR = 5.568), dyslipidemia (OR = 4.400), high blood urea nitrogen (BUN) (OR = 4.399), high low density lipoprotein-cholesterol (LDL-C) (OR = 3.594), time of hospitalization (OR = 2.612), grease food intake before developing DM (OR = 2.300), high HbA1c% (OR = 1.747), lack of exercise after the development of DM (OR = 1.672), duration of DM (OR = 1.509), mental stress (OR = 1.427), high-quality sleep (OR = 0.606), well control of blood glucose (OR = 0.517), well control of blood fat (OR = 0.299), insulin injections (OR = 0.155) etc. were all significantly associated with T2DM chronic complications.</p><p><b>CONCLUSION</b>The main risk factors of T2DM chronic complications seemed to be related to high CRP, dyslipidemia, high BUN and high LDL-C. The main protective factors were insulin injections, well control of blood fat and blood glucose, good-quality of sleep, while the unique risk factors of cardiovascular disease seemed to be high LDL-C and mental stress. The unique risk factors of neuropathy were lack of exercise after developing DM and the amount of sweet food intake. The duration of DM appeared to be the common risk factor and the common protective factor on those three complications was insulin injection.</p>

Effects of taurine on type I and III collagen expression in rats lung exposed to silica / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the effects of taurine in diet on the expression of type I and III collagen and collagen ratio at different time points in rats lung by image process technology.</p><p><b>METHODS</b>Wistar rats were randomly divided into three groups: the saline instilled with a control diet (the saline treated group); silica instilled with a control diet (the silica treated group); and silica instilled with a diet containing 2.5% taurine (the taurine treated group). Animal models were established by the direct tracheal instillation of silica into rat lungs exposed surgically. The taurine concentration of serum was analyzed by means of HPLC. Paraffin embedded lung sections were stained with Sirius red. Polarization microscopy and Image Pro Plus Version 4.5 for windows were used for detecting type I and III collagen.</p><p><b>RESULTS</b>The concentration of taurine in serum of the taurine treated group was significantly elevated compared to the saline treated and silica treated group (P < 0.05 or P < 0.01). Sirius red polarization microscopy showed that type I and III collagen positive area percentage were elevated in the silica treated rats compared with the saline treated group. On the 7th, 14th, 21st, 28th day after silica instillation type I collagen positive area percentage was increased by 3.84, 3.77, 3.73, 9.83 respectively (P < 0.01), and type III collagen positive area percentage were elevated by a little in the silica treated rats compared with saline treated group. The taurine treatment significantly decreased elevation of silica type I collagen positive area percentage of lung by 2.39, 1.62, 7.13 at the 7th, 21st, 28th day respectively (P < 0.05 or P < 0.01), and type III collagen positive area percentage of lung by 2.62 at the 28th day (P < 0.05) compared with the silica treated group. The ratio of type I to III collagen was increased from the 7th day to 28th day after silica instillation, and reached 1.87 at the 28th day with the maximal ratio in the silica-treated group.</p><p><b>CONCLUSION</b>Treatment with taurine can effectively attenuate type I and III collagen expression in the rat lung induced by silica particles at different time points in our study.</p>

Effects of taurine on the expression of nitric oxide synthase in lung of rats exposed to silica / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the effects of taurine in diet on the expression of inducible nitric oxide synthase (iNOS) in rat lung induced by silica.</p><p><b>METHODS</b>Wistar rats were established by direct tracheal instillation of silica into rat lungs exposed surgically, and the animals of taurine-treated group were silica-instilled with a diet containing taurine. The taurine concentration of serum was analyzed by means of HPLC. The expression of iNOS protein in paraffin-embedded lung sections with Streptavidin/peroxidase (SP) immunohistochemistry on tissue microarray was measured by Image-Pro Plus.</p><p><b>RESULTS</b>The concentration of taurine in serum of taurine-treated group was significantly higher than those in saline-treated and silica-treated groups (P < 0.05). The activities of total NOS and iNOS in BALF supernatant and iNOS positive area percentage of rat lung in silica-treated group were at the peak on 14th day, which were 1.84 U/ml, 1.12 U/ml and 5.42% more respectively than those in saline-treated group (P < 0.05). There were no significant differences between taurine-treated group and silica-treated group in total NOS and iNOS activities of BALF supernatant, and iNOS positive area of the lung (P > 0.05).</p><p><b>CONCLUSION</b>Treatment with taurine hardly influences on the increase in expression of nitric oxide synthase in rat lung induced by silica dust.</p>

Stage-specific expression genes of the Spirometra erinaceieuropaei plerocercoid screened by mRNA differential display technique / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The stage-specific expression of genes is one of the most characteristics of parasites. It has been found that a lot of genes of Spriometra erinaceieuropaei are specifically expressed in pleroceroid in large amount, but not expressed when the plerocercoid development into adult worm. The study is to screen other stage-specific ecpression genes of plerocercoid of Spirtmetra erinceieuropaei.</p><p><b>METHODS</b>RNA was separately extracted by acid guanidinium thiocyanate-phenol-chloroform from plerocercoids and adult worms of Spirometra erinaceieuropaei, DNA contaminated in the RNA was digested by RNase-free DNase. After the RNA was reverse transcripted to cDNA using T12MA, T12MC, T12MG and T12MT anchor-primers, PCR was done using the same T12MN and one random primer with alpha 35S-dATP in the system. The PCR products were fractionated on an 8% denatured polyacrylamide gel. Differential bands of the plerocercoid found in the gel were cut out, amplified by PCR and sequenced. Northern hybridization was used to identify the stage-specific expression genes.</p><p><b>RESULTS</b>Eleven differential bands were selected from the gel and classified into 3 kinds of gene fragments by hybridization, after they were amplified by PCR. Fragments 1 (238 bp) and 2 (383 bp), were confirmed by Northern hybridization, as being expressed in the plerocercoid. However, fragment 3 (433 bp), was expressed in both the plerocercoid and the adult worm. Data from the 3 gene fragments underwent homological analysis in GenBank. The sequence which was homologous with fragments 1 and 2 was not found, but fragment 3 had high homology with many kinds of 28S rRNA.</p><p><b>CONCLUSIONS</b>The gene expressions of plerocercoids are different from adult worms because they live in different hosts. Two types of different gene fragments from the plerocercoid were found by mRNA differential display technique.</p>