Concomitant Diseases and Co-contribution on Progression of Liver Stiffness in Patients with Hepatitis B Virus Infection.

BACKGROUND: The association between hepatitis B and concomitant diseases, such as fatty liver, T2DM, MetS, and Hp infection, remains unclear. AIM: The present study was to illustrate the association and explore the co-contribution on abnormal transaminase and progression of liver stiffness. METHODS: A total of 95,998 participants underwent HBsAg screening in West China Hospital from 2014 to 2017. Multivariable logistic regression was used to determine the adjusted odds ratios. RESULTS: The prevalence of HBsAg-positive rate was 8.30% of our included study population. HBsAg positive was associated with negative risk of fatty liver (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.65-0.78, p < 0.001) and MetS (OR 0.74, 95% CI 0.67-0.84, p < 0.001), and with positive risk of Hp infection (OR 1.09, 95% CI 1.02-1.17, p = 0.012) and T2DM (OR 1.18, 95% CI 1.01-1.40, p = 0.043). Besides, HBsAg-positive patients with T2DM had higher risk of elevated ALT (OR 2.09, 95% CI 1.69-2.83, p < 0.001 vs OR 1.59, 95% CI 1.51-1.68, p < 0.001), AST (OR 2.69, 95% CI 1.98-3.65, p < 0.001 vs OR 1.89, 95% CI 1.76-2.02, p < 0.001) than HBV alone. In addition to HBV, T2DM also can increase the risk of liver fibrosis (OR 3.23, 95% CI 1.35-7.71, p = 0.008) and cirrhosis (OR 4.31, 95% CI 1.41-13.20, p = 0.010). CONCLUSION: Hepatitis B patients have a lower risk of fatty liver and MetS, and a higher risk of T2DM and Hp infection. Besides, T2DM might be possibly associated with abnormal liver transaminase and fibrosis progression in HBsAg-positive patients.

Association of serum pepsinogens and gastrin-17 with Helicobacter pylori infection assessed by urea breath test.

Background: Association of gastric atrophy or cancer with levels of serum pepsinogens, gastrin-17 and anti-Helicobacter pylori IgG antibody have been extensively studied. However, the association of serum pepsinogen and gastrin-17 with H. pylori infection has not been studied in a large population. Aim: To investigate the impact of H. pylori infection on serum levels of pepsinogens and gastrin-17. Methods: A total of 354, 972 subjects who underwent health check-ups were included. Serum levels of pepsinogens and gastrin-17 were measured using the enzyme-linked immunosorbent assay. H. pylori infection was detected using 14C-urea breath test (UBT). Multivariable logistic regression analysis was used to investigate the association of serum pepsinogen and gastrin-17 with H. pylori infection. Results: H. pylori prevalence was 33.18% in this study. The mean levels of pepsinogens and gastrin-17 were higher, while the mean pepsinogen-I/II ratio were lower among H. pylori-positive than -negative subjects. In H. pylori-positive subjects, pepsinogen and gastrin-17 levels correlated positively, whereas the pepsinogen-I/II ratio correlated negatively with UBT values (e.g., the mean serum level of pepsinogen-I in subjects with UBT values in the range of 100-499dpm, 500-1499dpm, and ≥1500dpm was 94.77 ± 38.99, 102.77 ± 43.59, and 111.53 ± 47.47 ng/mL, respectively). Compared with H. pylori-negative subjects, the adjusted odds ratio (aOR) of having pepsinogen-I ≤ 70 ng/mL in the three H. pylori-positive but with different UBT value groups was 0.31 (p<0.001), 0.16 (p<0.001), and 0.08 (p<0.001), respectively; while the aOR of having G-17>5.70 pmol/L was 4.56 (p<0.001), 7.43 (p<0.001), and 7.12 (p<0.001). This suggested that H. pylori-positive subjects with higher UBT values were less likely to have pepsinogen-I ≤70 ng/mL (a serum marker for gastric atrophy), but more likely to have gastrin-17 >5.70 pmol/L (a marker for peptic ulcer). Conclusions: H. pylori-positive subjects with higher UBT values are unlikely to have gastric atrophy, but may have greater risk of severe gastritis or peptic ulcers. Our study suggests that H. pylori-positive patients with high UBT values may benefit the most from H. pylori eradication.

Abnormal transaminase and lipid profiles in coexisting diseases in patients with fatty liver: a population study in Sichuan.

Among chronic liver diseases, fatty liver has the highest incidence worldwide. Coexistence of fatty liver and other chronic diseases, such as diabetes, hepatitis B virus (HBV) and Helicobacter pylori (Hp) infection, is common in clinical practice. The present study was conducted to analyze the prevalence and association of coexisting diseases in patients with fatty liver and to investigate how coexisting diseases contribute to abnormal transaminase and lipid profiles. We enrolled participants who were diagnosed with fatty liver via ultrasound in the physical examination center of West China Hospital. Multivariable logistic regression was used to determine the adjusted odds ratios (ORs). We found that 23.6% of patients who underwent physical examinations were diagnosed with fatty liver. These patients had higher risks of metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and hypertension and a lower risk of HBV infection. The risks of Hp infection and hyperthyroidism did not statistically differ. When fatty liver coexisted with T2DM, MetS and thyroid dysfunction, it conferred a higher risk of elevated transaminase. Fatty liver was positively correlated with triglycerides, cholesterol and low-density lipoprotein cholesterol (LDL-C) and negatively correlated with HBV; thus, HBV had a neutralizing effect on lipid metabolism when coexisting with fatty liver. In conclusion, patients with fatty liver that coexists with T2DM, MetS and thyroid dysfunction are more prone to elevated transaminase levels. Patients with both fatty liver and HBV may experience a neutralizing effect on their lipid metabolism. Thus, lipid alterations should be monitored in these patients during antiviral treatment for HBV.

Associations between hepatitis B virus exposure and the risk of extrahepatic digestive system cancers: A hospital-based, case-control study (SIGES).

OBJECTIVES: This case-control study was aimed to investigate associations between HBV infection and extrahepatic digestive system cancers. METHODS: The patients of gastric, small intestinal, colonic, rectal, anal, biliary tract, and pancreatic cancers were retrospectively collected between 2016.5 and 2017.12. Simultaneously, the healthy controls were collected from the health check-up registry, and cancer-free status was confirmed based on medical records. Propensity score matching was performed to reduce bias. Multinomial logit model and conditional logistic regression model were used to assess the risk of individual cancer according to HBV serological markers and classifications. RESULTS: Totally, 4748 patients involving seven cancers, and 57,499 controls were included. After matching, HBsAg was associated with increased risk of gastric cancer (aOR = 1.39, 95% CI: 1.05-1.85), and anti-HBs served as a protective factor for gastric (aOR = 0.72, 95% CI: 0.61-0.85), colonic (aOR = 0.73, 95% CI: 0.60-0.89), rectal (aOR = 0.73, 95% CI: 0.63-0.85), and pancreatic (aOR = 0.58, 95% CI: 0.42-0.82) cancers. Compared to subgroups with non-infection and vaccination status, inactive HBsAg carriers and active HBV infection subgroup were correlated with gastric carcinogenesis (aOR = 1.41, 95% CI: 1.03-1.93). However, no clear association was found between HBV infection and other cancers. CONCLUSIONS: HBV infection was potentially associated with an increased risk of gastric cancer. The development mechanism of HBV-associated gastric cancer needs to investigate further.

Effect of silibinin capsules combined with lifestyle modification on hepatic steatosis in patients with chronic hepatitis B.

The coexistence of HBV infection and hepatic steatosis is a novel characteristic of liver disease. Silibinin capsules (SC) is a silybin-phospholipid complex containing silybin as the bioactive component, which exerts a remarkable biological effect on various liver diseases, including nonalcoholic fatty liver disease (NAFLD). The purpose of this study was to investigate (1) the prevalence of hepatic steatosis in the general population and patients with chronic hepatitis B (CHB) and (2) to evaluate the effect of SC combined with therapeutic lifestyle changes (TLC) compared with TLC alone on hepatic steatosis in patients with CHB. A total of 16,451 individuals underwent transient elastography (TE) with the control attenuation parameter (CAP) measurement, among which the prevalence of hepatic steatosis was 31.1% in patients with CHB and 42.2% in the general population. The prevalence of hepatic steatosis differed between patients with CHB and the general population at an age of 40 years or older but was similar in individuals aged 39 years or younger (p < 0.05). Furthermore, in patients with CHB presenting hepatic steatosis, the post-6-month relative reduction in CAP in the SC combined with TLC group (p = 0.001) was significantly greater than in the TLC alone group (p = 0.183). The CAP distribution of different steatosis grades (S1, S2, and S3) in the SC combined with TLC group was decreased and S0 (CAP < 248 dB/m) increased significantly, but not significant in the TLC group. Thus, SC combined with TLC may effectively improve hepatic steatosis in patients with CHB.

Association between Hepatitis B Virus Infection and Metabolic Syndrome in Southwest China: A Cross-sectional Study.

The correlation between hepatitis B virus (HBV) infection and metabolic syndrome (MetS) remains to be clarified. In this study, we explored this association in a large population in Southwest China. This was a cross-sectional study, with pooled adult health data. Multivariate logistic regression analysis, controlling for age, sex, HBV status, alanine aminotransferase, and fatty liver, was used to identify predictor(s) of MetS. Of the 96,175 participants, positive HBV was identified in 7984 (8.30%) and MetS in 12,092 (12.57%). The MetS prevalence was lower among HBV positive than negative individuals (11.64% versus 12.66%, P < 0.001). The adjusted odds (aOR) of positive HBV among individuals with MetS was 0.841 (95% confidence interval (CI), 0.771-0.916) in men and 0.834 (95% CI, 0.672-0.925) in women. Elevated triglyceride level, a component of MetS, was inversely associated with HBV status in both men and women: aOR, 0.551 (95% CI, 0.514-0.590) and 0.683 (95% CI, 0.605-0.769), respectively. Among HBV positive individuals, liver cirrhosis was more common among those with than without MetS (4.83% versus 2.93%, respectively; P = 0.002). HBsAg-seropositive are inversely associated with MetS, especially elevated triglycerides. Liver cirrhosis was more common among HBV infection patients with MetS.

[Component Changes of Metabolic Syndrome in Pre-elderly People with Healthy Obese Phenotype].

OBJECTIVE: To determine component changes of metabolic syndrome in pre-elderly people with healthy obese phenotype. METHODS: A total of 1 686 adults aged between 45-59 yr. who underwent health examinations from 2010 to 2016 in West China Hospital of Sichuan University participated in this study. The participants had healthy obese phenotype at the baseline but no history of diabetes,high blood pressure,high cholesterol and cardiovascular disease. Component changes of metabolic syndrome (MS) and associated factors over the seven-year period were analysed using logistic regression modeling. RESULTS: The number of MS components increased over the years in centrally obese individuals,and 11.0% developed MS,including 118 men [(53.29±4.00) years old,66.95% current smokers,5.93% past smokers,24.58% alcohol drinkers] and 67 women [(52.01±4.06) years old,26.87% current smokers,1.49% past smokers,11.94% alcohol drinkers]. The most frequently presented MS components included higher fasting glucose,higher blood pressure and higher triglyceride. Healthy status (0 MS component) resumed in 44 participants who had abdominal obesity (1 MS component) at the baseline: 27 women and 17 men. Age (OR=1.732, 95%CI：1.594-1.882, P<0.000 1),smoking (OR=7.188, 95%CI：4.311-11.986, P<0.000 1) and drinking (OR=3.986, 95%CI：2.283-6.959, P<0.000 1) were identified as risk factors of MS. CONCLUSION: MS components increase over years in both men and women. Smoking and drinking are the main risk factors of MS progression. Regular MS surveillance and behavioral interventions are recommended for pre-elderly people with healthy obese phenotype.

Value of free/total prostate-specific antigen (f/t PSA) ratios for prostate cancer detection in patients with total serum prostate-specific antigen between 4 and 10 ng/mL: A meta-analysis.

BACKGROUND: Prostate carcinoma is a common disease that occurs in men over 50 years old. Many studies have explored the effect of free/total prostate-specific antigen (f/t PSA) ratio in monitoring prostate cancer. We conducted a meta-analysis to identify the accuracy of the f/t PSA ratio in the diagnosis of prostate cancer in patients who have PSA levels of 4 to 10 ng/mL. METHODS: Databases searched included PubMed and OVID databases, from inception to March 2017, after a systematical review, sensitivity, specificity, and other measures of accuracy of the f/t PSA ratio in the diagnosis of prostate cancer were pooled. We used summary receiver operating characteristic curves to summarize overall test performance. RESULTS: Fifteen case-control studies from 14 articles were identified. The results indicated that the sensitivity of the f/t PSA ratio in the diagnosis of prostate cancer ranged from 0.5 to 0.94 (pooled sensitivity 0.70, 95% CI: 0.67-0.72), whereas its specificity ranged from 0.31 to 0.93 (pooled specificity 0.55, 95% CI: 0.57-0.60). The positive likelihood ratio was 1.85 (95% CI: 1.56-2.20), negative likelihood ratio was 0.42 (95% CI: 0.34-0.53), and diagnostic odds ratio was 4.81 (9.53% CI: 3.33-6.94). CONCLUSIONS: The f/t PSA ratio determination has a low sensitivity and specificity for the diagnosis of prostate cancer; it would not be useful for the diagnosis of prostate cancer by itself. The results of f/t PSA ratio measurements should refer to the clinical manifestations and the results of conventional tests such as biopsies.

The value of 18F-FDG-PET/CT in the diagnosis of solitary pulmonary nodules: A meta-analysis.

BACKGROUND: Solitary pulmonary nodules (SPNs) are common imaging findings. Many studies have indicated that F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG-PET/CT) is an accurate test for distinguishing benign and malignant SPNs. The aim of this study was to investigate the value of F-FDG-PET/CT in the diagnosis of malignant SPNs. METHODS: We systematically searched the PubMed and Embase databases up to March 2017, and published data on sensitivity, specificity, and other measures of diagnostic accuracy of F-FDG-PET/CT in the diagnosis of malignant SPNs were meta-analyzed. Statistical analyses were undertaken using Meta-DiSc 1.4 software and Stata version 12.0. The measures of accuracy of F-FDG-PET/CT in the diagnosis of malignant SPNs were pooled using random-effects models. RESULTS: A total of 20 publications reporting 21 studies were identified. Pooled results indicated that F-FDG-PET/CT showed a diagnostic sensitivity of 0.89 (95% confidence interval [CI], 0.87-0.91) and a specificity of 0.70 (95% CI, 0.66-0.73). The positive likelihood ratio was 3.33 (95% CI, 2.35-4.71) and the negative likelihood ratio was 0.18 (95% CI, 0.13-0.25). The diagnostic odds ratio was 22.43 (95% CI, 12.55-40.07). CONCLUSIONS: F-FDG-PET/CT showed insufficient sensitivity and specificity for diagnosing malignant SPNs; it cannot replace the "gold standard" pathology by resection or percutaneous biopsy. Larger studies are required for further evaluation.

[Obesity and Osteoporosis in Men Aged Above 50].

OBJECTIVES: To investigate the association between obesity and osteoporosis in men aged above 50 in Chengdu. METHODS: Male participants aged above 50 were recruited from those who visited West China Hospital of Sichuan University for health examinations. Bone mineral density was measured by MetriScan Bone Densitometry. The participants were divided into three groups according to T values: normal, osteopenia and osteoporosis. RESULTS: About 5.75% (525 cases) of the 9 135 male participants had osteoporosis. The three groups had significant different anthropometric parameters, including body mass, waist circumference, hip circumference, body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI)( P<0.01). The participants with the highest quartile (Q4) of BMI, BRI, WHtR, WHR, ABSI, waist circumference and height had an age-adjusted odds ratios (OR) of 0.443 [95% confidence interval ( CI): 0.342-0.574), 0.580 (95% CI: 0.454-0.740), 0.587 (95% CI: 0.460-0.751), 0.664 (95% CI: 0.516-0.854], 1.369 (95% CI: 1.069-1.751), 0.634 (95% CI: 0.497-0.809), and 1.357 (95% CI: 1.047-1.758), respectively, for osteoporosis compared with those with the lowest quartile (Q1). The area under cures (AUC) of receiver operator characteristic (ROC) curve of BMI for osteoporosis was 0.606 (95% CI:0.580-0.632). CONCLUSIONS: Large body mass was negatively associated with osteoporosis in middle and old aged men. BMI is the strongest predictor of osteoporosis. Further longitudinal studies are required to verify such asscoiations.

Genetic Polymorphisms of Glutathione S-Transferase P1 (GSTP1) and the Incidence of Anti-Tuberculosis Drug-Induced Hepatotoxicity.

BACKGROUND: Anti-tuberculosis drug-induced hepatotoxicity (ATDH) is one of the most common adverse effects associated with tuberculosis (TB) therapy. Animal studies have demonstrated important roles of glutathione S-transferases in the prevention of chemical-induced hepatotoxicity. The aim of this study was to investigate the relationship between single nucleotide polymorphisms (SNPs) of glutathione S-transferase P1 (GSTP1) and ATDH in TB patients. METHODS: We used two independent samples for this genetic association study. In the initial prospective study, 322 newly diagnosed TB patients were followed up for three months after initiating anti-TB therapy. In an independent retrospective study, 115 ATDH patients and 116 patients without ATDH were selected to verify the results of the prospective study. Tag-SNPs of GSTP1 were genotyped either with the MassARRAY platform or the improved multiple ligase detection reaction (iMLDR) method. The associations between SNPs and ATDH were analyzed by logistic regression analysis adjusting for confounding factors. RESULTS: Of the 322 patients recruited in the prospective cohort, 35 were excluded during the 3 months of follow-up, and 30 were diagnosed with ATDH and were considered as the ATDH group. The remaining 257 subjects without ATDH were considered as the non-ATDH group. After correction for potential confounding factors, significant differences were found for rs1695 (A>G) under an allelic model (OR = 3.876, 95%CI: 1.258011.905; P = 0.018). In the retrospective study, rs1695 allele A also had a higher risk of ATDH (OR = 2.10, 95%CI: 1.17-3.76; P = 0.012). We only found rs4147581AA genotype under a dominant model was related to ATDH in the prospective study (OR = 2.578, 95%CI: 1.076-6.173; P = 0.034). CONCLUSIONS: This is the first study to suggest that GSTP1 genotyping can be an important tool for identifying patients who are susceptible to ATDH. This result should be verified in independent large sample studies and also in other ethnic populations.

[Value of fGGO in diagnosing stage I lung cancers].

OBJECTIVE: To determine the value of focal area of ground-glass opacity (fGGO) for early detection and diagnosis of lung cancers. METHODS: We reviewed clinical data of all patients whose chest CT images showed isolated lesions < or = 5 cm in diameter in the Department of Chest Surgery at West China Hospital, Sichuan University between 2007 and 2010. According to the volume of solid components, the lesions were classified as pure ground-glass opacity (pGGO), mixed ground-glass opacity (mGGO) or solid lesions. The malignant ratio and stage of lesions were calculated based on the postoperative pathological tests. The characteristics of CT signs were compared between the benign and malignant lesions. RESULTS: Of the 202 cases, 63 (included 15 pGGO and 48 mGGO) had fGGO with a malignant ratio of 71.4% (45/63). The percentage of malignant tumors in the mGGO, pGGO and solid lesions was 75.0%, 60.0% and 48.2% respectively. Stage I lung cancers had an occurrence of spiculation, lobulation and vascular convergence in fGGO of over 70%, higher than that of the benign tumors (P < 0.05). CONCLUSION: fGGO is an important indicator of lung cancer. mGGO is highly likely to be malignant, particularly when one or more signs of spiculation, lobulation and vascular convergence appear.

[Changes of bone mineral density and bone metabolic marker in patients with subclinical hypothyroidism].

OBJECTIVE: To investigate the change of bone mineral density and bone metabolism biochemical markers in subclinical hypothyroidism. METHODS: This study included total 122 patients with subclinical hypothyroidism and 153 healthy age and gender matched people as control. All the patients and controls were subjected to the measurements of bone density by dual energy X-ray absorptiometry (DEXA), and serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), Ca2+, PO4(3+), alkaline phosphatase (ALP) levels. All the data was analyzed statistically with the stratification of gender and menopause status. RESULTS: Compared to the control, the patients with subclinical hypothyroidism had significantly higher incidence of bone mass loss (P < 0.005) and lower level of Serum Ca2+ (P < 0.05) and higher levels of serum PO4(3+), T-value and Z-value (P < 0.05). Furthermore, premenopausal women had higher Z-value (P < 0.01) , but no significantly differences of T-value, serum PO4(3+) was found either in pre-menopause or post-menopause women when compared to the control. Multiple linear regression analysis showed gender (B = 0.543, P < 0.0001) was positive correlation with T value, female had lower T values. Moreover, T value was negative correlated to menopausal status (B = -0.274, P = 0.001), age (B = -0.161, P < 0.0001) and TSH (B = -0.108, P < 0.0001). CONCLUSION: Subclinical hypothyroism appears decreased serum calcium and low bone density.

[Blood lipid, glucose and uric acid in people with subclinical hypothyroidism].

OBJECTIVE: To investigate the changes of blood lipid, fasting blood glucose and blood uric acid and its clinical significance in people with subclinical hypothyroidism. METHODS: Body mass index (BMI), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG) and uric acid (UA) were measured and compared in 356 people with subclinical hypothyroidism and 331 health people (controls). RESULTS: Compared to the control group, people with subclinical hypothyroidism had higher levels of BMI, TSH, TC, LDL-C, TG, FBG, UA (P < 0.05) and non-significant decrease of HDL-C (P > 0.05). The level of TSH was positively correlated with TC (r = 0.254), LDL-C (r = 0.110), TG (r = 0.218), BMI (r = 0.119) and FBG (r = 0.210) (P < 0.05). The level of HDL-C was not correlated with TSH (P > 0.05). CONCLUSION: Thyroid dysfunction may have an effect on the metabolism of blood lipid, FBG and UA.

Associations of fibroblast growth factor 21 gene 3' untranslated region single-nucleotide polymorphisms with metabolic syndrome, obesity, and diabetes in a Han Chinese population.

Fibroblast growth factor 21 (FGF-21) is a novel regulator for metabolic syndrome (MetS), diabetes, and obesity. However, no study has been performed on the association of these diseases with FGF-21 gene polymorphism. The aim of the study was to investigate the association of 3' untranslated region (UTR) single-nucleotide polymorphisms (SNPs) in the FGF-21 gene with MetS, obesity, and diabetes in the Han Chinese population. A total of 291 subjects were recruited from the Han Chinese population in Sichuan province. The genotypes of FGF-21 were determined by polymerase chain reaction-restriction fragment length polymorphism. The genotypes were confirmed by sequencing. No polymorphisms were found in rs11665841 (1 of 291) and rs3745706 (2 of 291). We did not find an association between genotype frequencies of SNP rs11665896 and lipid concentration, glucose concentration, or blood pressure. The TG/GG genotype relative to the TT genotype had an age- and sex-adjusted odds ratio of 1.41 for MetS (p=0.149), 1.84 (p=0.016) for obesity (body mass index ≥25 kg/m(2)), and 1.19 (p=0.492) for diabetes. Genetic variation of the 3' UTR of the FGF-21 gene was associated with obesity, however, not with MetS or diabetes.

[Source of variations of serum urea levels and consideration of reference interval in urban Chengdu].

OBJECTIVE: To determine the serum Urea levels in healthy adults living in urban Chengdu and to identify factors that influence the serum urea levels for the purpose of establishing reference interval. METHODS: Serum urea levels were determined in 17 787 healthy adults in urban Chengdu who underwent physical examinations. The characteristics of distribution of serum urea levels in the population and its relationships with liver function, renal function, serum glucose, and serum lipid were analyzed. RESULTS: Increased Crea, Uric, Glu, and HDL-C levels and decreased Glb level were associated with increased serum urea levels, which was independent of the impact of sex and age. The association between serum urea and Crea, Glu, and HDL-C existed in normal healthy adults. Men had higher urea levels than women. Regardless of gender, serum urea increased with age (with a cut off point at 30, 50, 60 and 70 years). CONCLUSION: Serum urea levels in healthy adults living in urban Chengdu vary in different gender and age groups. Serum urea levels are associated with serum Crea, Glu, the HDL-C levels. It is necessary to establish gender and age-specific reference intervals for serum urea.

[Plasma fibroblast growth factor-21 and abdominal obesity].

OBJECTIVE: To investigate the association of plasma fibroblast growth factor-21 (FGF-21) with abdominal obesity and other metabolic indicators. METHODS: Sixty one people with abdominal obesity and 113 healthy controls were recruited. The stature, avoirdupois, waist circumference and blood pressure of the participants were measured. Serum lipid, glucose, insulin and plasma FGF-21 levels of those participants were also determined. RESULTS: 1) The participants with abdominal obesity had significantly higher FGF-21 levels than the healthy controls [(1.91 +/- 0.40) ng/mL vs. (1.75 +/- 0.45) ng/mL, P = 0.020]. 2) Plasma FGF-21 levels were positively associated with BMI (r = 0.24, P = 0.001), waist circumference (r = 0.16, P = 0.033), body fat contents (r = 0.24, P = 0.001), and triglycerides (r = 0.16, P = 0.036) after adjustment for age and sex. The multiple liner regression analysis identified BMI, waist circumference, body fat contents, and triglycerides as factors associated with FGF-21 (P < 0.05). 3) Plasma FGF-21 levels were found to be independently associated with abdominal obesity (OR = 2.413, 95% CI 1.115-5.221, P = 0.025). CONCLUSION: FGF-21 is an independent risk factor for abdominal obesity. It is perhaps an important factor in the occurrence and development of abdominal obesity.

Effectiveness and safety of bevacizumab for unresectable non-small-cell lung cancer: a meta-analysis.

BACKGROUND: Non-small-cell lung cancer (NSCLC) accounts for more than 85% of all cases of lung cancer. The 5-year survival of patients presenting with advanced stage NSCLC is less than 15%, indicating that additional treatment options are needed. Bevacizumab is a recombinant humanized version of the murine anti-human vascular endothelial growth factor (VEGF) monoclonal antibody with a high binding specificity for VEGF. OBJECTIVE: The aim of this meta-analysis was to evaluate the effectiveness and safety of bevacizumab in patients with unresectable non-small-cell lung cancer (NSCLC) on the basis of evidence-based methodology. METHODS: The electronic database PubMed was searched to identify randomized, controlled trials (RCTs) of bevacizumab for the treatment of unresectable NSCLC. Other databases such as the Cochrane Library Trials Register, the WHO Trial Registration, the National Cancer Institute, ClinicalTrials.gov, the European Organization for Research and Treatment of Cancer, the Southwest Oncology Group, the Eastern Cooperative Oncology Group, the European Society of Clinical Oncology and the American Society of Clinical Oncology were also searched. The meta-analysis was performed using Reviewer Manager Version 5.0 software provided by the Cochrane Collaboration. Outcome measures were overall survival rates, progression-free survival, tumour response rate, incidence of severe adverse events (SAEs) and treatment-related death. RESULTS: Four eligible studies that included 2101 patients were found; in these studies, bevacizumab was administered to 1237 patients. Neither high-dose (15 mg/kg) nor low-dose (7.5 mg/kg) bevacizumab increased 1-year overall survival rates compared with patients not treated with bevacizumab. However, high-dose bevacizumab, rather than low-dose, increased 2-year overall survival rate (risk ratio [RR] = 1.24; 95% confidence interval [CI] 1.04, 1.49) and tumour response rate (RR = 1.69; 95% CI 1.21, 2.35) compared with patients not treated with bevacizumab. Progression-free survival was also significantly improved in both the low- (hazard ratio [HR] = 0.76; 95% CI 0.64, 0.90) and high-dose groups (HR = 0.73; 95% CI 0.65, 0.81). There was a clear and significant increase in the rate of treatment-related death in the high-dose group (RR = 2.07; 95% CI 1.19, 3.59) compared with patients not treated with bevacizumab. No significant differences were noted in the rate of treatment-related death in the low-dose group or in the incidences of SAE in the low- or high-dose groups compared with patients not treated with bevacizumab. Neutropenia was easily induced in both the low- and high-dose bevacizumab groups. Patients who received high-dose bevacizumab tended to experience hypertension, neutropenia, haemoptysis, rash and headache more frequently than patients not treated with bevacizumab. CONCLUSIONS: Low-dose bevacizumab may significantly improve progression-free survival in patients with unresectable NSCLC, whereas high-dose bevacizumab may increase 2-year overall survival rates, prolong progression-free survival and improve tumour response rate but at the cost of higher treatment-related death. Larger well designed RCTs should be carried out in the future to clarify the role of bevacizumab in the treatment of NSCLC.

Eukaryotic expression of extracellular ligand binding domains of murine Tie-2 and its anti-angiogenesis effect in SGC-7901 cell lines.

BACKGROUND AND AIMS: Researches about blocking angiogenesis to treat tumor have become one of the most promising and active fields in anticancer research. This study aimed to investigate the eukaryotic expression of extracellular ligand binding domains of murine Tie-2 and its anti-angiogenesis effect. METHODS: A eukaryotic expression vector pcDNA3.1(+) integrating with a DNA fragment which encode extracellular ligand binding domains of murine Tie-2 was transfected into SGC-7901 gastric cancer cell line. The protein expression was detected by western blot analysis and immunocytochemistry staining. Following the construction of nude mouse tumor xenograft model with and without transfected cells, tumor microvessel density was determined by counting per high power field in the sections stained with an antibody to CD31 to test its inhibition of angiogenesis. RESULTS: The extracellular ligand binding domains of murine Tie-2 receptor was highly expressed in SGC-7901 gastric cancer cells with plasmid transfection. The mean tumor sizes of groups with and without transfection were 1.27 +/- 0.35 and 1.75 +/- 0.17 cm(3), respectively (P = 0.025). The mean inhibitory rate of tumor was 27.18 +/- 19.93%. The comparison between highest microvessel density of group with transfection (14.00 +/- 3.80) and that of group without transfection (22.30 +/- 5.91) was statistically significant at P = 0.030. CONCLUSION: The protein of extracellular ligand binding domains of murine Tie-2 can be expressed at high level in the eukaryotic expression system, and the expressed protein may have the anti-angiogenesis effect.

[The effect or rosiglitazone on signal pathways of transforming growth factor-beta1 in human lung fibroblast].

OBJECTIVE: To investigate the expression of CTGF, CTGF mRNA, NF-kappaB and AP-1 induced by TGF-beta1 in human lung fibroblast (HLF-02), and study the effect and possible mechanism of rosiglitazone on signal pathways of TGF-beta1 in HLF-02. METHODS: The effects of TGF-beta1, curcumin, PDTC and rosiglitazone on the expression of CTGF, NF-kappaB and AP-1 were evaluated with Western blot. The expression of CTGF was also detected with immunohistochemistry assay. The level of CTGF mRNA was detected with RT-PCR. RESULTS: (1) The CTGF protein levels of HLF-02 cells were significantly up-regulated after incubated with 1 ng/mL TGF-beta1 for 15 min (P<0.01 vs Control). The CTGF mRNA was also up-regulated. The levels of CTGF protein and CTGF mRNA expression was up-regulated by TGF-beta1 in a time-dependent manner. (2) The expression of NF-kappaB and AP-1 increased after HLF-02 cells were incubated with 1 ng/mL TGF-beta1 for 30 min (P<0.01 vs Control). The CTGF protein levels were inhibited obviously after HLF-02 cells were incubated with PDTC or curcumin. (3) The expression of CTGF, NF-kappaB and AP-1 decreased after pre-incubation with different doses of rosiglitazone (P<0.01 vs TGF-beta1 group). The CTGF mRNA were also markedly inhibited (P<0.01 vs TGF-beta1 group). CONCLUSION: It is supposed that rosiglitazone inhibits CTGF expression induced by TGF-beta1 in HLF-02 cells by activating PPARgamma through NF-kappaB and AP-1 signal transduction pathways.