1.Single-port versus conventional laparoscopic surgery in treatment of tubal pregnancy: a meta-analysis
Bihui WU ; Lili TAO ; Shaochan PENG ; Xiukui HE
China Journal of Endoscopy 2017;23(4):35-42
Objective To evaluate the safety, feasibility and other potential advantages of laparoendoscopic single-site surgery (LESS) compared to conventional laparoscopic surgery (CLS) for tubal pregnancy. Methods We manually searched Pubmed, the Cochrane Library, web of science, CNKI and China Biology Medicine for the relevant references about comparison of single-port laparoscopic salpingectomy with multi-port laparoscopic salpingectomy in the treatment of tubal pregnancy. The quality of the studies was evaluated, then meta-analysis was conducted using RevMan 5.3 software. Result Eventually, 2 RCTS and 14 retrospective studies including a total of 1541 cases were identi昀ed. The results of the meta-analysis for LESS versus CLS were as follows: a longer operative time [WMD=8.54, 95%CI (2.43, 14.64), P = 0.006], no significant differences in terms of total complications [OR= 0.68, 95%CI (0.27,1.71), P = 0.410]/operative blood loss [WMD = -0.01, 95%CI (-2.51,2.48), P = 0.990]/gastrointestinal function recovery time [WMD = -0.45, 95%CI (-1.72,0.82), P = 0.490], but shorter hospital stay [WMD=-0.40, 95% (-0.75, -0.06), P = 0.020], less postoperative analgesic treatment [OR= 0.38, 95%CI (0.22,0.67), P = 0.000]. Conclusions LESS for surgical treatment of tubal pregnancy is safe and feasible with shorter hospitalstay, less postoperative pain. LESS may therefore be a feasible alternative of CLS in the surgical approach of tubal pregnancy.
2.Expression and significance of IL-21 in patients infected with hepatitis B virus at different stages
Jiayan YAO ; Kang CHAO ; Minrui LI ; Yanqin WU ; Junzhao YE ; Bihui ZHONG
The Journal of Practical Medicine 2015;(7):1061-1064
Objective To determine the expression of interleukin-21 (IL-21) in patients infected with hepatitis B virus (HBV) and its association with HBV-DNA and ALT. Methods Clinical dates and blood specimen were collected from 25 unrelated healthy controls (HC) and 101 independent chronic HBV infected patients, including 25 patients in immune tolerant phase (IT), 25 in immune clearance phase (IC), 26 patients in inactive HBV carrier state (IA) and 25 patients in immune reactive phase (IR). Serum IL-21 levels were measured by Cytometric Bead Array (CBA). IL-21 mRNA and IL-21 receptor mRNA were measured by real-time PCR. Results Chronic HBV-infected patients had higher levels of serum IL-21 and IL-21 mRNA , with P <0.001 for both. In subgroup analysis, both serum IL-21 and IL-21 mRNA levels in IC, IR were higher than those in IT, IA and HC (all P < 0.001). Serum IL-21 level in IA was higher than that in HC and IT (P <0.001, P = 0.036). IL-21R mRNA levels were different between groups. Serum IL-21 level was associated with HBV-DNA (r = -0.472, P < 0.001), but not with ALT. Conclusion IL-21, up-regulated in chronic HBV infection, is associated with immune activity and may play a key role in HBV control.
3.Factors influencing accuracy of fibrosis diagnosis using shear wave elastrography in patients with chronic hepatitis B
Junzhao YE ; Wei WANG ; Bing LIAO ; Yang WANG ; Yanqin WU ; Xianhua LIAO ; Bihui ZHONG
The Journal of Practical Medicine 2016;32(15):2454-2458
Aims The purpose of this study is to investigate thediagnostic value of SWEfor fibrosis in patients with CHBand the factorsinfluencing the accuracy. Methods From July 2013 to October 2015, 261 patients with CHB were recruited from the First Affiliated Hospital of Sun Yat-sen University.All patients received SWE, anthropometry measurement, blood cell count, liver function test and virological indicators measurement. Liver fibrosis was staged from F0 to F4 by METAVIR scorebased onliver biopsy results of 133 CHB patients , while 128 patients were diagnosed as decompensated cirrhosis. Diagnostic accuracyof SWE were evaluated by Receiver Operating Characteristic Curve (ROC) using liver hepatic pathology and decompensated cirrhosis as gold standards. Logistic model was used to find out confounding factors that influence the accuracy of SWE. Results The Area Under ROC (AUC) for liver stiffness measurement with SWE were 0.891, 0.932 and 0.910 for the diagnosis of significant fibrosis (≥ F2), advanced fibrosis (≥F3) and cirrhosis (F4), respectively. A multifactor logistic regression combined modelwas built and showed that hepatic steatosis will decrease the accuracy of SWE. Conclusion SWE could be a valuable method for the noninvasive liver fibrosis assessment. The accuracy of SWE may be influenced by hepatic steatosis.
4.Epidemiology of nonalcoholic fatty liver disease in some regions of China
Tingfeng WU ; Xianhua LIAO ; Bihui ZHONG
Journal of Clinical Hepatology 2020;36(6):1370-1373
Nonalcoholic fatty liver disease (NAFLD) has replaced viral hepatitis and become the most important chronic liver disease in the world. Abdominal ultrasound remains the main method for the diagnosis of NAFLD in China. The studies in China showed that in the last two decades, the prevalence rate of NAFLD was 13%-43% and tended to increase year by year, and the new cases accounted for about 4% each year, with a certain proportion of patients with non-obese NAFLD. There is a significant difference in prevalence rate between the populations from different regions, with a higher prevalence rate of NAFLD in the well-developed southeast coastal regions where people have a similar lifestyle to those in Western countries. Metabolic disorders, such as type 2 diabetes, obesity, hyperlipidemia, hyperuricemia, and hypertension, are risk factors for NAFLD. National-wide large-sample epidemiological investigation is still needed in China to help support the diagnosis, treatment, and prevention of NAFLD.
5.Distinct Dose-Dependent Association of Free Fatty Acids with Diabetes Development in Nonalcoholic Fatty Liver Disease Patients
Fuxi LI ; Junzhao YE ; Yanhong SUN ; Yansong LIN ; Tingfeng WU ; Congxiang SHAO ; Qianqian MA ; Xianhua LIAO ; Shiting FENG ; Bihui ZHONG
Diabetes & Metabolism Journal 2021;45(3):417-429
Background:
Excessive delivery of free fatty acids (FFAs) to the liver promotes steatosis and insulin resistance (IR), with IR defined as reduced glucose uptake, glycogen synthesis and anti-lipolysis stimulated by normal insulin levels. Whether the associations between FFAs and diabetes development differ between patients with and without nonalcoholic fatty liver disease (NAFLD) remains unclear.
Methods:
Consecutive subjects (2,220 NAFLD subjects and 1,790 non-NAFLD subjects according to ultrasound imaging) were enrolled from the First Affiliated Hospital of Sun Yat-sen University between 2009 and 2019. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated.
Results:
There was an approximate J-shaped relationship between FFA levels and HOMA-IR in the NAFLD group. Higher FFA concentration quartiles were associated with higher risks of IR (odds ratio [OR], 9.24; 95% confidence interval [CI], 6.43 to 13.36), prediabetes (OR, 10.48; 95% CI, 5.66 to 19.39), and type 2 diabetes mellitus (T2DM; OR, 19.43; 95% CI, 12.75 to 29.81) in the NAFLD group but not in the non-NAFLD group. The cut-off points for the FFA levels increased in a stepwise manner in discriminating IR, prediabetes and T2DM (573, 697, and 715 μmol/L) in the NAFLD group but not in non-NAFLD individuals.
Conclusion
A distinct dose-dependent relationship of FFA levels was found with IR, prediabetes and T2DM in NAFLD patients. Screening serum FFA levels in NAFLD patients would be valuable in preventing diabetes development.
6.Distinct Dose-Dependent Association of Free Fatty Acids with Diabetes Development in Nonalcoholic Fatty Liver Disease Patients
Fuxi LI ; Junzhao YE ; Yanhong SUN ; Yansong LIN ; Tingfeng WU ; Congxiang SHAO ; Qianqian MA ; Xianhua LIAO ; Shiting FENG ; Bihui ZHONG
Diabetes & Metabolism Journal 2021;45(3):417-429
Background:
Excessive delivery of free fatty acids (FFAs) to the liver promotes steatosis and insulin resistance (IR), with IR defined as reduced glucose uptake, glycogen synthesis and anti-lipolysis stimulated by normal insulin levels. Whether the associations between FFAs and diabetes development differ between patients with and without nonalcoholic fatty liver disease (NAFLD) remains unclear.
Methods:
Consecutive subjects (2,220 NAFLD subjects and 1,790 non-NAFLD subjects according to ultrasound imaging) were enrolled from the First Affiliated Hospital of Sun Yat-sen University between 2009 and 2019. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated.
Results:
There was an approximate J-shaped relationship between FFA levels and HOMA-IR in the NAFLD group. Higher FFA concentration quartiles were associated with higher risks of IR (odds ratio [OR], 9.24; 95% confidence interval [CI], 6.43 to 13.36), prediabetes (OR, 10.48; 95% CI, 5.66 to 19.39), and type 2 diabetes mellitus (T2DM; OR, 19.43; 95% CI, 12.75 to 29.81) in the NAFLD group but not in the non-NAFLD group. The cut-off points for the FFA levels increased in a stepwise manner in discriminating IR, prediabetes and T2DM (573, 697, and 715 μmol/L) in the NAFLD group but not in non-NAFLD individuals.
Conclusion
A distinct dose-dependent relationship of FFA levels was found with IR, prediabetes and T2DM in NAFLD patients. Screening serum FFA levels in NAFLD patients would be valuable in preventing diabetes development.
7. Status of child health services in less developed areas in Sichuan province, 2014-2018
Xujing GUAN ; Xianping WU ; Bihui JIN ; Xuefeng TANG
Chinese Journal of Epidemiology 2020;41(1):79-84
Objective:
To understand the status of child health services by primary medical institutions in less developed areas in Sichuan province and provide evidence for the development of health policy for poverty alleviation.
Methods:
Annual child health records in the primary medical institutions selected through multistage stratified sampling in 21 prefectures in Sichuan were extracted during 2014-2018. Field survey and telephone interview were used to evaluate the performance of child health services provided and the child guardian’s satisfaction degree. Sample descriptive statistics, pair sample