Research Progress of Targeted Drug Delivery Nanocarriers Through Blood-brain Barrier / 中国实验方剂学杂志

The small size， moderate drug loading， and targeting properties of nano-preparations make them can be excellent delivery tools for drugs， genes or proteins crossing the cell or blood-brain barrier （BBB）. Currently， facilitating drug crossing BBB with innovative nano-drug delivery systems is considered as a strategic approach for the prevention， diagnosis and treatment of central nervous system （CNS） diseases. However， with the deepening of the research， the adverse reactions and toxicity of nanocarriers have gradually attracted the attention of researchers. Based on this， this paper summarized the situation of BBB-penetrating targeted nano-preparations at home and abroad in recent years from the perspective of classification of types and properties of nanocarriers， and analyzed the advantages and disadvantages of each carrier. The results showed that nano-preparations with active ingredients of traditional Chinese medicine （TCM） as carriers have become a promising way of cancer treatment， but the complexity and diversity of TCM components limited its application to a certain extent. Further studies should be strengthened to lay a foundation for the application and development of TCM nano-preparations in the field of CNS diseases.

Research Status of Zexietang / 中国实验方剂学杂志

Zexietang is derived from Jingui Yaolue （《金匮要略》）， which is composed of Alismatis Rhizoma and Atractylodis Macrocephalae Rhizoma， and has the effect of inducing diuresis and invigorating the spleen to produce water. Compared with western medicine in the treatment of related diseases， Zexietang can not only improve the curative effect， but also reduce the occurrence of adverse reactions， so as to achieve long-term stable administration. The authors sorted out and analyzed the chemical composition， pharmacological effect and clinical application of Zexietang in recent years. It was found that the main active components of Zexietang were alismol A and B， 23-acetyl-alismol B and C， atractylenolides （atractylenolide Ⅰ， Ⅱ， Ⅲ） and polysaccharides. Pharmacological experiments showed that they had diuretic， hypolipidemic， anti-inflammatory and others. And it can be used in the treatment of hypertension， hyperlipidemia， vertigo， cerebral vascular insufficiency and other diseases combined with other Chinese materia medica， and the curative effect is obvious. By summarizing the research status of Zexietang in recent years， its active components and pharmacological mechanism can be further clarified， which provides the basis for the clinical application of Zexietang and guides the direction of its further research.

Preparation of paclitaxel-loaded and folic acid-modified poly (lactic-co-glycolic acid) nano-micelles and in vitro anticancer effect on cervical cancer HeLa cells / 中国中药杂志

The paclitaxel-loaded and folic acid-modified poly(lactic-co-glycolic acid) nano-micelles(PTX@FA-PLGA-NMs) were prepared by the emulsion solvent evaporation method, and the parameters of paclitaxel-loaded nano-micelles were optimized with the particle size and PDI as evaluation indexes. The morphology of the nano-micelles was observed by transmission electron microscopy(TEM), and the stability, drug loading and encapsulation efficiency were systematically investigated. In vitro experiments were performed to study the cytotoxic effects of nano-micelles, apoptosis, and cellular uptake. Under the optimal parameters, the nano-micelles showed the particle size of(125.3±1.2) nm, the PDI of 0.086±0.026, the zeta potential of(-20.0±3.8) mV, the drug loading of 7.2%±0.75%, and the encapsulation efficiency of 50.7%±1.0%. The nano-micelles were in regular spherical shape as observed by TEM. The blank FA-PLGA-NMs exhibited almost no inhibitory effect on the proliferation and growth of tumor cells, while the drug-loaded nano-micelles and free PTX exhibited significant inhibitory effects. The IC_(50) of PTX@FA-PLGA-NMs and PTX was 0.56 μg·mL~(-1) and 0.66 μg·mL~(-1), respectively. The paclitaxel-loaded nano-micelles were potent in inhibiting cell migration as assessed by the scratch assay. PTX@FA-PLGA-NMs had good pro-apoptotic effect on cervical cancer HeLa cells and significantly promoted the uptake of HeLa cells. The results of in vitro experiments suggested that PTX@FA-PLGA-NMs could target and treat cervical cancer HeLa cells. Therefore, as nanodrug carriers, PTX@FA-PLGA-NMs with anti-cancer activity are a promising nano-system for improving the-rapeutic effects on tumors.

Preparation and Evaluation of β-Cyclodextrin Inclusion Complex of Volatile Oil in Couplet Medicines of Moslae Herba and Pogostemonis Herba / 中国实验方剂学杂志

Objective::To investigate the pharmacodynamics of volatile oil in couplet medicines of Moslae Herba and Pogostemonis Herba, to establish a method for simultaneous determination of three essential ingredients (thymol, carvacrol and patchouli alcohol) in volatile oil of the couplet medicines by gas chromatography (GC), to optimize the preparation process of β-cyclodextrin (β-CD) inclusion complex of volatile oil in the couplet medicines and to confirm the formation of the inclusion complex. Method::An in vitro inflammatory response model was established by hyaluronidase activity inhibition test in order to detect the anti-inflammatory activity of the volatile oil. Also, the antioxidant activity of the volatile oil was assessed by 1, 1-diphenyl-2-trinitrophenylhydrazine (DPPH) free radical scavenging method. The inclusion of volatile oil in couplet medicines of Moslae Herba and Pogostemonis Herba was prepared by scaturated aqueous solution method, colloid milling method and grinding method, respectively. GC was used to determine the contents of thymol, carvacrol and patchouli alcohol in volatile oil for optimizing extraction and inclusion processes of volatile oil. Scanning electron microscope, infrared spectroscopy, thermal differential analysis, and X-ray diffraction (XRD) were used to verify the formation of the inclusion complex. Result::The volatile oil not only inhibited hyaluronidase activity to a certain extent, but also eliminated DPPH and increased with the increase of concentration. There was a good linear relationship between the peak area and concentration of thymol, carvacrol and patchouli alcohol at 0.021 3-0.426, 0.020 04-0.400 8, 0.022 6-0.452 g·L-1 (R2>0.999), respectively. Their recoveries were 99.59%(RSD 1.6%), 100.15%(RSD 1.5%), 100.70%(RSD 1.4%), respectively. The colloid milling method was optimized, and the formation of the inclusion complex was verified by the aforementioned methods. Conclusion::The volatile oil in couplet medicines of Moslae Herba and Pogostemonis Herba has certain anti-inflammatory activity and anti-oxidation ability. The colloid milling method was the best inclusion process for the volatile oil. The established GC has the advantages of simple, sensitive, accurate, reliable and reproducible, which can meet the requirements of simultaneous determination of thymol, carvacrol and patchouli alcohol in the inclusion complex.

Performance of Automatic Blood Cell Analysis Parameters for Differential Diagnosis of Myelodysplastic Syndromes and Aplastic Anemia / 现代检验医学杂志

Objective To evaluate the performance of automated blood cell analysis parameters for differential diagnosis of myelodysplastic syndromes (MDS) and aplastic anemia (AA).Methods Data of automatic blood cell analysis parameters at diagnosis of confirmed patients with MDS and AA from December 2002 to February 2011 in Peking University Shenzhen Hospital were retrospectively reviewed.Results 33 cases of MDS and 36 cases of AA were recruited in this study.Based on the evaluable data,mean corpuscular hemoglobin concentration (MCHC) (328.58 ± 17.24 g/L vs 342.47±18.75 g/L,n=33/36) was significantly lower (P=0.002 1),while monocyte percentage (MONO％) (11.48±9.99 vs 6.94±2.50,n=32/34),platelet distribution width (PDW％) (13.51±4.24 vs 10.62±3.68,n=20/22) and platelet hematocrit (PCT％)(0.11 ±0.10 vs 0.04±0.07,n=11/15) were markedly higer (all P＜0.05) in patients with MDS than that of AA.No significantly differences for other blood cell analysis parameters were seen between patients with MDS and AA.Under the condition of best cut-off value,areas under the ROC curve of MCHC,MONO％,PDW and PCT were 0.706 (95％ confidence interval:0.584～0.809),0.666 (0.540～0.778),0.668 (0.506～0.805) and 0.745 (0.538～0.894) respectively.MONO％ and MCHC had high specificities (97.06％ and 88.89％) and positive predictive values (93.3％ and 80.0％) for differential diagnosis of MDS from AA.Conclusion MONO％ and MCHC may be used as simple indicators for differential diagnosis of MDS and AA.

Analysis on management of patients with hypertension in communities in Shanghai / 上海预防医学

Objective To understand the status of community-based management of hypertensive patients aged thirty-five or above in Shanghai . Methods Data from Shanghai Chronic Disease and Risk Factors Surveillance carried out in 2013 were used to analyze the community-based management and treat-ment and control of blood pressure of hypertensive patients aged thirty-five or above in Shanghai .Sample was weighted according to complex sampling scheme and post-stratification to calculate the rates with95 %confidence intervals ( CI) for the subgroups according to different characteristics .The Rao-Scottχ2 test was performed to test for the differences of the rates of the subgroups . Results There were 10 510 hyperten-sion patients were included in the study among which 7 343 patients were aware of their diagnosis , and a total of 3 815 patients had been under management in communities .After being weighted the rate of management of hypertensive patients in communities was 49.74%(95%CI:45.66%-53.83%).There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ2 =68 .120 , P=0 .002 ) , the rate of management among the patients aged sixty-five or above was 55.49%(95%CI:51.58%-59.32%), while among the patients aged thirty-five to forty-four was only 41.20% (95%CI: 30.73% -52.54%).The rate of management among females was 51.12%(95%CI:47.17%-55.05%), while males was 48.46% (95%CI:43.34%-53.61%), with no statistical significance (χ2 =5.194, P =0.216 ).The rates of management in urban areas , sub-urban areas and rural areas were 47 .66% ( 95%CI: 42 .55%-52 .82%) , 52 .92% ( 95%CI:43.41% -62.24%), 52.84% ( 95%CI: 44.96% -60.58%), respectively, with no statistical significance (χ2 =19 .281 , P =0 .432 ) . The follow-up rate in patients with hypertension under standardized management in communities was 21 .97%( 95%CI: 18 .61% -25 .74%) .There was a significant difference between different genders (χ2 =65.048, P =0.000 ).The rate of females was 27.42%(95%CI:227.7 %-32.61%), which was higher than the rate of males (16.61%,95%CI:13 .02%-209.3 %) .There were no significant differences among different age groups (χ2 =2 .017 , P=0 .834 ) and regions (χ2 =21 .244 , P=0 .111 ) .The treatment rate was 95 .47% ( 95%CI: 94 .08% -96 .54%) .There was a significant difference among different age groups (χ2 =403.46 , P=0 .006 ) .The treatment rate among the patients aged sixty-five or above was 96 .90% ( 95%CI:95 .39%-97 .93%) , while among the patients aged thirty-five to forty-four was 89.31%(95%CI:77.94% -95.19%).There were no significant differences among gender (χ2 =7.983 , P=0.055 ) and regions (χ2 =0.881, P=0 .807 ) .The control rate of hypertensive patients managed in communities was 38 .98% ( 95%CI:35 .55%-42 .51%) , There were no significant differences among different age groups (χ2 =23 .188 ,P=0.103), gender(χ2 =1.050,P =0.468) and regions( χ2 =0.529,P =0.938). Conclusion We should further expand the coverage of the standardized management of hypertension patients in the community , and make personalized intervention plan , so as to improve blood pressure control rates of hypertension patients in the community .

Estimating risk of stroke in elderly people by use of Framingham Stroke Risk Profile / 上海预防医学

Objective To explore the application of Framingham Stroke Risk Profile in elderly people. Methods A total of 5 148 people aged 55 years and older who received physical examination in a community were enrolled.Information of their healthy status and risk factors were collected by interview using a questionnaire.Height, weight, waist circumference (WC), and blood pressure as well as fasting plasma glucose ( FPG) , and serum lipid were measured. Results The average 10-year probabilities of stroke in elderly people were 9.79% in men and 6.20% in women ( P <0.05).Besides aging factor, higher risk probability in men might be related to their higher proportions of smoking and atrial fibrillation. In addition to blood pressure and FPG which were variables associated with risk profile, WC/height ratio ( WHR) and serum triglyceride level were associated with increased risk of stroke estimated by stroke risk profile (OR=1.598, 95%CI:1.371~1.864;OR=1.487, 95%CI:1.225~1.783), respectively. Conclusion Besides factors which had been included by risk profile, it is important to pay attention to weight control and triglyceride level.For elderly male, to quit smoking is an important measure that decreases their risk of stroke.

Achievement of ABC goals and thrir association with serum creatinine and urea nitrogen among community middle aged and elderly diabetics / 上海预防医学

Objective To investigate the achievement of HbAlc ( A) ,blood pressure ( B) ,and LDL-C ( C) control goals of diabetes and explore their association with indices of renal function among diabetics in community. Methods A total of 388 diabetes patients aged 45 years and older were enrolled who received physical examination in a community.In addition to blood pressure (BP),were measured fasting blood glucose,glycated hemoglobin ( HbAlc) ,serum lipid,creatinine,and urea nitrogen. Results In this investigation only 1.8%of diabetes patients achieved ABC goals.And 34.0% achieved none of the three and 45.9%reached only one of the three.In the 388 diabetes patients,54.6%had HbAlc<7%,25.0%LDL-C <2.6 mmol/L,and 8.2% BP<130/80 mmHg.The levels of serum creatinine and urea nitrogen were elevated with age and not found to have association with the achievement of ABC goals. Conclusion Poor achievement of ABC goals was among diabetics in community.The effective control of blood pressure and LDL contributes to improvement of comprehensive control levels for diabetics.

Study on risk factors and behavior features related to chronic diseases among adults in Shanghai / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the risk factors and behavior features related to chronic diseases among adults in Shanghai.</p><p><b>METHODS</b>A total of 15 516 subjects aged over 18 years old were selected from the investigation project on chronic diseases and relevant risk factors in Shanghai in 2010. Questionnaire were used to investigate the general information of the subjects, such as behavior features as smoking, drinking, diet, physical activity as well as the prevalence and control of chronic diseases as hypertension and diabetes. The physical examination included height, weight, waist circumference, blood pressure, blood glucose and blood lipids.</p><p><b>RESULTS</b>Being preprocessed by complex weighting method, the data showed that the overweight rate of Shanghai adults aged above 18 was 32.4% (5288), separately 32.2% (2506) and 32.5% (2782) (χ(2) = 0.10, P = 0.844) in urban and rural areas; the obesity rate was 8.8% (1538), separately 8.7% (738) and 8.8% (800) (χ(2) = 0.06, P = 0.901) in urban and rural areas. The overweight rate was separately 36.0% (2888) in males and 28.6% (2400) in females (χ(2) = 96.61, P < 0.01); while the obesity rate was separately 8.7% (745) in males and 8.9% (793) in females (χ(2) = 0.06, P = 0.851). Abdominal obesity rate was 44.3% (7419), separately 47.8% (3892) in males and 40.6% (3527) in females (χ(2) = 81.23, P < 0.01), 46.5% (3703) in urban areas and 42.6% (3716) in rural areas (χ(2) = 24.37, P = 0.069). Current smoking rate was 25.0% (3813), separately 48.4% (3722) and 1.2% (91) in males and females (χ(2) = 4572.06, P < 0.01); 23.6% (1609) and 26.0% (2204) in urban and rural areas (χ(2) = 11.92, P = 0.018). The regular smoking rate was 22.1% (3402). The rate of having the habit of drinking at least once a month in males was 39.5% (3102), separately 35.1% (1262) and 42.7% (1840) in urban and rural areas (χ(2) = 45.98, P = 0.012). The rate of drinking almost every day was 16.3% (1380), and the percentage of excessive alcohol consumption was 28.9% (2483). The percentage in group of subjects aging between 45-59 years old was 38.5% (1191), which was higher than that in any other groups (22.8% (641) in group aging 18-44 years old and 22.9% (651) in group aging ≥ 60 years old) (χ(2) = 241.38, P < 0.01). The percentage of over-drinking in rural area was higher than that in urban area, which was 33.5% (1578) and 22.8% (905) respectively (χ(2) = 117.12, P < 0.01). The percentage of once over-drinking was 11.3% (903). It was higher in group aging between 45-49 years old (15.3% (461)) than in other groups (9.0% (222) in group aging 18-44 years old and 8.2% (220) in group aging ≥ 60 years old) (χ(2) = 78.21, P < 0.01). It was also higher in rural area (13.5% (605)) than in urban area (8.3% (298)) (χ(2) = 51.74, P < 0.01). There were 75.0% (11 993) of the Shanghai adults never took physical activity. And the most important problems in dietary habit were insufficient intake of dairy products (98.0%, 15 218), vegetables (53.0%, 7864) and fruits (84.6%, 13 372), excess consumption of sodium (52.0%, 8257) and oil (51.7%, 7884).</p><p><b>CONCLUSION</b>The risk factors of chronic diseases were highly prevalent in Shanghai. The prevalence of risk factors as overweight or obesity, lack of physical activity, smoking, over-drinking and unhealthy dietary habits were higher among adults living in suburban areas than those living in urban areas; the prevalence was also higher among the young adults than that among the elderly people, higher among males than that among females.</p>

Awareness of healthy lifestyle content among residents aged 18 -69 years in Shanghai / 上海预防医学

[Objective] To investigate the awareness of healthy lifestyle content among residents in Shanghai and to provide basis for future efforts . [ Methods] Stratified random sampling covered all 18 districts in Shanghai .A total of 8548 participants were recruited and questionnaire with them was completed by face to face interview. [Results] Among Shanghai residents aged 18-69 years, 67.8%of them had awareness of all five items of healthy lifestyle content .And 94.6%, 92.3%, 80.7%, 77.3%, and 81 .7%of them respectively had awareness of balanced diet , regular exercise , no smoking , no alcohol a-buse, and keeping mental balance .Analysis of Logistic regression showed that gender , age, area of resi-dence, and education level were factors influencing awareness rates mentioned above . [ Conclusion] The information about healthy lifestyle content was effectively spread by various departments concerned and the Shanghai government .And the above results suggest that specific information spread for different demo-graphic characteristics of different populations is beneficial for future improvement of healthy knowledge a -mong them.

Serglycin in human cancers / 癌症

Serglycin belongs to a family of small proteoglycans with Ser-Gly dipeptide repeats, and it is modified with different types of glycosaminoglycan side chains. Intracellular serglycin affects the retention and secretion of proteases, chemokines, or other cytokines by physically binding to these factors in secretory granules. Extracellular serglycin has been found to be released by several types of human cancer cells, and it is able to promote the metastasis of nasopharyngeal carcinoma cells. Serglycin can bind to CD44, which is another glycoprotein located in cellular membrane. Serglycin's function of promoting cancer cell metastasis depends on glycosylation of its core protein, which can be achieved by autocrine as well as paracrine secretion mechanisms. Further investigations are warranted to elucidate serglycin signaling mechanisms with the goal of targeting them to prevent cancer cell metastasis.

Construction of a Novel Eukaryotic Expression Plasmid pcDNA6/myc-his-EGFP Band Its Applications in Expression of Recombinant Genes / 中国生物工程杂志

Enhanced green fluorescent protein( EGFP), myc epitope and polyhistidine metal-binding tag are often used as a marker for recombinant fusion protein in many gene expression vectors, each marker has its own function, EGFP emits green fluorescence for direct detection, myc epitope facilitates recombinant fusion protein detection using its antibodies, polyhistidine tag allows purification of recombinant fusion protein using resin.Hitherto, no a plasmid vector can integrate all of these functions. In this study we constructed a novel eukaryotic expressive plasmid, designated as pcDNA6/myc-his-EGFP B, which integrated the functions of EGFP, myc epitope and polyhistidine tag. Importantly, a linker octo - peptide in N terminal of EGFP was designed using LINKER program. A DNA fragment encoding a putative protein containing a signal peptide of human interleukin 2(IL-2) in N terminal was cloned into pcDNA6/myc-his-EGFP B in frame with the C-terminal peptide to construct pMHES. 2.2.15 Cells were transfected with pcDNA6/myc-his-EGFP B and pMHES, and Balb/c mice were intravenously injected with pcDNA6/myc-his-EGFP B by tails, results revealed that both of the plasmids worked in 2.2.15 Cells and livers of Balb/c mice. Assuming gene of the IL-2 was inserted into pcDNA6/myc-his -EGFP B in frame with EGFP, myc and 6 × His, three-dimensional structure for this putative expression product was simulated using Modeller8V2, results revealed that IL-2, EGFP, myc and 6 × his did not interfere each other and octo- peptide linker owned certain flexibility. The results suggest that pcDNA6/myc-his-EGFP B may be useful as a genetic tool for mammalian cells and a vector for gene therapy.

Construction of a Novel Eukaryotic Expression Plasmid pcDNA6/myc-his-EGFP Band Its Applications in Expression of Recombinant Genes / 中国生物工程杂志

Enhanced green fluorescent protein( EGFP), myc epitope and polyhistidine metal-binding tag are often used as a marker for recombinant fusion protein in many gene expression vectors, each marker has its own function, EGFP emits green fluorescence for direct detection, myc epitope facilitates recombinant fusion protein detection using its antibodies, polyhistidine tag allows purification of recombinant fusion protein using resin.Hitherto, no a plasmid vector can integrate all of these functions. In this study we constructed a novel eukaryotic expressive plasmid, designated as pcDNA6/myc-his-EGFP B, which integrated the functions of EGFP, myc epitope and polyhistidine tag. Importantly, a linker octo - peptide in N terminal of EGFP was designed using LINKER program. A DNA fragment encoding a putative protein containing a signal peptide of human interleukin 2(IL-2) in N terminal was cloned into pcDNA6/myc-his-EGFP B in frame with the C-terminal peptide to construct pMHES. 2.2.15 Cells were transfected with pcDNA6/myc-his-EGFP B and pMHES, and Balb/c mice were intravenously injected with pcDNA6/myc-his-EGFP B by tails, results revealed that both of the plasmids worked in 2.2.15 Cells and livers of Balb/c mice. Assuming gene of the IL-2 was inserted into pcDNA6/myc-his -EGFP B in frame with EGFP, myc and 6 × His, three-dimensional structure for this putative expression product was simulated using Modeller8V2, results revealed that IL-2, EGFP, myc and 6 × his did not interfere each other and octo- peptide linker owned certain flexibility. The results suggest that pcDNA6/myc-his-EGFP B may be useful as a genetic tool for mammalian cells and a vector for gene therapy.

Epidemiological survey of prevalence of fatty liver and its risk factors in a general adult population of Shanghai / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and major risk factors of fatty liver among adult residents in Shanghai.</p><p><b>METHODS</b>A cross-sectional survey with multiple-stage stratified cluster and random sampling was performed. All residents aged 16 and above were invited to participate in the survey; they came from four communities of Yangpu District and Pudong New District. Questionnaire, physical examination, serum lipid-profile, and 75 gram oral glucose tolerance test and ultrasonographic examination of liver were undertaken. Analysis of data was performed through SPSS 11.0 for Windows statistical package.</p><p><b>RESULTS</b>A total of 3175 residents took part in the survey, which was 75% of adult residents of the investigated communities and 2.26/10 000 of Shanghai municipal residents. Of the 3175, 1218 were males and 1957 were females. The mean age of the participants was 52.4+/-15.1 years and ranged from 16 to 88 years. Fatty liver was detected with ultrasound examination in 661 participants (20.82%), among which 3.48% had alcoholic fatty liver, 4.08% had suspected alcoholic fatty liver, and 92.43% had nonalcoholic fatty liver. The age-adjusted, sex-adjusted prevalence of fatty liver in Shanghai adult residents was 17.29%, the prevalence of alcoholic fatty liver, suspicious alcoholic fatty liver, and nonalcoholic fatty liver in Shanghai adult residents were 0.79%, 1.15%, and 15.35%, respectively. The prevalence of fatty liver was increased with aging in males and in females. Among participants younger than 50 years old, the prevalence of fatty liver in males was significantly higher than that in females, but in participants older than 50 years the case was just the opposite, higher in females. The mean age (years), body mass index (BMI), waist circumference, blood pressure, fasting and two hour serum glucose level, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and the presence of obesity, diabetes mellitus, hypertension, dyslipidemia, and gallstones in the fatty liver group was significantly higher than those in the group without fatty liver, but the high-density lipoprotein cholesterol (HDL-C) level and the educational level were both lower in the fatty liver group. Logistic regression analysis demonstrated that the prevalence of fatty liver was only positively correlated to nine risk factors, including male sex, educational level, waist circumference, BMI, fasting glucose level, HDL-C, TG, hypertension and diabetes mellitus. In heavy drinkers, obesity increased the risk for fatty liver by 4.8-fold, but heavy drinking only increased the risk for fatty liver 1.5-fold (95% CI 0.9-2.6, P=0.1685).</p><p><b>CONCLUSION</b>There is a high prevalence of fatty liver among adult residents in Shanghai, and nonalcoholic fatty liver is the major type. Metabolic disorders such as obesity and diabetes mellitus, hypertension and hyperlipidemia are more closely associated with fatty liver than heavy drinking in Shanghai.</p>

Prevalence of fatty liver in a district of Shanghai detected by B-type ultrasonography and serum activity of alanine aminotransferase / 中华全科医师杂志

Objective To study the prevalence of fatty liver and its risk factors in adult population of Pudong New District,Shanghai detected by combination of B-type uhrasonographic features and elevated serum activity of alanine aminotransferase (ALT).Methods A cross-sectional survey was performed in 2017 residents aged 16 years over recruited from four neighborhoods of Prdong New District of Shanghai with multi-phase cluster sampling,including interview with questionnaire,physical check-up,anthropometry, measurement of plasma glucose and lipid profile,ALT activity and real-time B-type ultrasnnography.Serum hepatitis B surface antigen (HBsAg) was further detected for those with elevated ALT activity.Results Prevalence of fatty liver was 21.32 percent (430/2017) in the residents of the District participated in this survey.Prevalence of abdominal obesity,hypertriglyceridemia,hyperlipoproteinemia (low-density lipoprotein-cholecterol),essential hypertension,impaired glucose tolerance,diabetes and metabolic syndrome were 71.16,71.16,11.86,66.74,35.58,24.40 and 47.21 percent in those with fatty liver, respectively,as compared to 26.34,12.73,4.79,39.57,24.01,6.81 and 11.28 percent in those without fatty liver (controls),respectively.Multivariate logistic regression analysis showed that body mass index, 2-h postprandial glucose level,diastolic blood pressure,serum level of triglyceride,abdominal obesity and diabetes all were independent risk factor for tatty liver,with odds ratio (OR) of 1.080,1.149,1.035, 1.526,1.960 and 1.391,respectively.Conclusions Prevalence of fatty liver was relatively high in Shanghai Pudong New District.Fatty liver closely associates with disturbance of carbohydrate and lipid metabolism.