The risk factors of avascular necrosis in patients with systemic lupus erythematosus: a meta-analysis.

The aim of this study was to determine the risk factors for avascular necrosis (AVN) in patients with systemic lupus erythematosus (SLE). Four electronic databases (PubMed, EMBASE, Ovid, and Science Direct) were searched for. The search was performed to identify the articles as to SLE with AVN before September 2013. The clinical and laboratory data were extracted, and a meta-analysis was performed to identify the risk factors for AVN in patients with SLE. Publication bias was assessed with funnel plot and Egger's test. A total of 995 papers were found from the four databases; 16 studies were finally included. Pooled analysis showed the following result. The result showed that arthritis (odds ratio (OR)=2.448, 95 % confidence interval (CI)=1.617-3.707), cushingoid (OR=3.890, 95 % CI=1.591-9.510), gastrointestinal involvement (OR=2.054, 95 % CI=1.283-3.290), hypertension (OR=1.482, 95 % CI=1.093-2.008), oral ulcers (OR=1.877, 95 % CI=1.182-2.979), pleuritis (OR=2.302, 95 % CI=1.325-4.001), renal disease (OR=1.475, 95 % CI=1.124-1.936), and vasculitis (OR=2.591, 95 % CI=1.358-4.944) were relevant with AVN in SLE patients. Cytotoxic drug (OR=1.834, 95 % CI=1.065-3.156, P=0.029), the total cumulative dose (Standard Mean Difference (SMD) = 1.104, 95 % CI = 0.118-2.090, P = 0.028), maximum daily dose (SMD = 0.484, 95 % CI = 0.288-0.678, P < 0.001), and mean daily dose (SMD=1.305, 95 % CI=0.061-2.549, P=0.040) were significantly higher in AVN group. There were no significantly laboratory features that appeared in this pooled analysis. We conclude that arthritic, cushingoid, gastrointestinal involvement, hypertension, oral ulcers, pleuritis, renal disease, vasculitis, cytotoxic drug, and steroid treatment may contribute to AVN in SLE patients.

[A cross-sectional survey on hepatitis B among general population in areas along Yangzi River in Anhui province].

OBJECTIVE: To describe the epidemic status of hepatitis B along the Yangzi River area, in Anhui province. METHODS: A cross-sectional seroepidemiological survey was conducted and the samples were collected by stratified cluster sampling. Serological biomarkers to hepatitis B virus were tested using enzyme-linked immunosorbent assay (ELISA) reagents. RESULTS: Among 2282 people, the prevalence rates of HBsAg, HBsAb, HBeAg, HBeAb, HBcAb and hepatitis B virus infection were 9.8%, 43.5%, 1.0%, 7.8%, 10.3% and 40.6% respectively. The prevalence rate of HBsAg among males was higher than that of females (P < 0.05). The vaccination rate was 24.7%, higher in urban than in rural areas. The vaccination rate was high in children younger than ten years old and in students. The prevalence rates of HBsAg and HBV among people who had received vaccines were lower than those who had not. CONCLUSION: The standardized prevalence rates of HBsAg (9.3%) was high in the area along the Yangzi River in Anhui province. The vaccinate rate was low in the country side. Expanded vaccinate which can obviously reduce the prevalence rate of HBsAg should be enhanced.