Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide. Although it has become one of the leading causes of cirrhosis and hepatocellular carcinoma in the Western world, the proportion of NAFLD patients developing these complications is rather small. Therefore, current guidelines recommend noninvasive tests for the initial assessment of NAFLD. Among the available non-invasive tests, transient elastography by FibroScan® (Echosens, Paris, France) is commonly used by hepatologists in Europe and Asia, and the machine has been introduced to the United States in 2013 with rapid adoption. Transient elastography measures liver stiffness and the controlled attenuation parameter simultaneously and can serve as a one-stop examination for both liver steatosis and fibrosis. Liver stiffness measurement also correlates with clinical outcomes and can be used to select patients for varices screening. Although obesity is a common reason for measurement failures, the development of the XL probe allows successful measurements in the majority of obese patients. This article reviews the performance and limitations of transient elastography in NAFLD and highlights its clinical applications. We also discuss the reliability criteria for transient elastography examination and factors associated with false-positive liver stiffness measurements.

OBJECTIVETo investigate the knowledge about safety/unsafety of sexual acts relating to HIV transmission, levels of embarrassment related to condom and condom usage among medical postgraduates.

METHODSFrom August to December, 1998, a self-administered anonymous questionnaire was given to 271 new medical postgraduates from two medical colleges of Beijing and Hebei Province.

RESULTSThere was a hazy understanding of the protective function of condom from AIDS among medical postgraduates. Only 14.4% medical postgraduates persisted in using condom, and 27.94% had never or almost never used it. The levels of embarrassment about condom were high. The median score was 3.55 +/- 0.98. Whether to use condom was related with the attitudes to condom, but not to AIDS.

CONCLUSIONThere was some misunderstanding about condom and inconsistent condom usage in medical postgraduates. So it is essential to strengthen the sexual health education among them.

Acquired Immunodeficiency Syndrome ; prevention & control ; transmission ; Adult ; China ; Condoms ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Sexually Transmitted Diseases, Viral ; prevention & control ; Students, Medical ; Surveys and Questionnaires

For the detection of steatosis, quantitative ultrasound imaging techniques have achieved great progress in past years. Magnetic resonance imaging proton density fat fraction is currently the most accurate test to detect hepatic steatosis. Some blood biomarkers correlate with non-alcoholic steatohepatitis, but the accuracy is modest. Regarding liver fibrosis, liver stiffness measurement by transient elastography (TE) has high accuracy and is widely used across the world. Magnetic resonance elastography is marginally better than TE but is limited by its cost and availability. Several blood biomarkers of fibrosis have been used in clinical trials and hold promise for selecting patients for treatment and monitoring treatment response. This article reviews new developments in the non-invasive assessment of non-alcoholic fatty liver disease (NAFLD). Accumulating evidence suggests that various non-invasive tests can be used to diagnose NAFLD, assess its severity, and predict the prognosis. Further studies are needed to determine the role of the tests as monitoring tools. We cannot overemphasize the importance of context in selecting appropriate tests.
Elasticity Imaging Techniques/methods* ; Humans ; Liver/pathology* ; Liver Cirrhosis/pathology* ; Magnetic Resonance Imaging/methods* ; Non-alcoholic Fatty Liver Disease

This review focuses on our effort in addressing the development and lesion-induced plasticity of the gravity sensing system. After severance of sensory input from one inner ear, there is a bilateral imbalance in response dynamics and spatial coding behavior between neuronal subpopulations on the two sides. These data provide the basis for deranged spatial coding and motor deficits accompanying unilateral labyrinthectomy. Recent studies have also confirmed that both glutamate receptors and neurotrophin receptors within the bilateral vestibular nuclei are implicated in the plasticity during vestibular compensation and development. Changes in plasticity not only provide insight into the formation of a spatial map and recovery of vestibular function but also on the design of drugs for therapeutic strategies applicable to infants or vestibular disorders such as vertigo and dizziness.
Animals ; Humans ; Neuronal Plasticity ; Neurons ; physiology ; Otolithic Membrane ; innervation ; physiology ; Vestibule, Labyrinth ; innervation ; physiology

OBJECTIVETo explore the association of Parkinson's disease (PD) with cigarette smoking.

METHODSOne hundred of fourteen PD patients were compared with 205 control subjects who were matched by gender, race and residency. A previously validated questionnaire including smoking, alcohol/tea consumption as well as some other environmental exposure data was administered.

RESULTSWith never-smokers as the reference category, we observed reduced risk for PD among ever smokers (OR=0.49, 95% CI: 0.30 to 0.79) current smokers (OR=0.44, 95% CI: 0.23 to 0.86) and ex-smokers (OR=0.54, 95% CI: 0.30 to 0.96). When ever smokers were stratified by years of smoking, there was an inverse correlation between those whose smoking history was longer than 20 years (OR=0.40 95% CI: 0.21 to 0.81) and an even mild protective correlation between those who smoked less than 20 years (OR=0.57, 95% CI: 0.33 to 0.99). Those who had quitted smoking for more than 20 years were less likely to have the disease than never smokers, and those who had quitted for less than 20 years were least likely to have PD, while those who were current smokers were still least likely to have the disease. We found significant inverse gradient with pack-day smoking (trend P<0.05), and the inverse correlation between cigarette smoking and PD was not confounded by alcohol/tea consumption and other confounding bias.

CONCLUSIONSThe inverse correlation between Parkinson's disease risk and smoking as well as the trend of gradient dose response is again observed in our study. More future researches are needed to confirm these correlations and to explore further biochemical evidence.

Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Parkinson Disease ; etiology ; physiopathology ; Risk Factors ; Smoking ; adverse effects

OBJECTIVESTo investigate discrimination against people living with HIV (PLWH) and its impacts.

METHODSForty people who were either HIV positive (7/40) or had high risk behavior (33/40) were interviewed. Focus group discussion was held in the interview with people who were suspected to be infected with HIV, and in-depth interview was conducted in the survey of HIV positive persons whose privacy was strictly protected to ensure the confidentiality of the collected information.

RESULTSIt was identified that six forms of discrimination against people living with HIV occurred in health care service in Gejiu, including speaking to patients in an insulting manner, refusing to provide health care service, delaying treatment, treating differently, uncovering patients' privacy, and over-protecting themselves against patients. Discrimination against people living with HIV greatly affected their health conditions.

CONCLUSIONSDiscrimination against people living with HIV in health service has negative impact on their physical and mental health.

Adult ; China ; Cross-Sectional Studies ; Female ; HIV Infections ; Health Services ; Humans ; Male ; Middle Aged ; Prejudice

OBJECTIVETo examine the association between Ponderal index (PI) at birth and metabolic syndrome during middle age.

METHODSTotally, 975 adults (494 men and 481 women) aged 41-52 from the study cohort of Fetal Origin of Adult Disease were recruited in the study for clinic examinations, involving anthropometry and measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum lipid profile. Their HOMA-insulin resistance (IR) index was estimated. Metabolic syndrome (MS) was diagnosed according to 1999 WHO definition. Multivariate logistic regression analysis was used to estimate the effect of PI on MS and the interaction between PI at birth and body mass index (BMI) in adulthood.

RESULTSPrevalence of MS was 18.7% in this mid-aged population, 24.8%, 19.4%, 16.3% and 14.0% in those with less than the 25th percentile, the 25th to less than the 50th percentile, the 50th to less than the 75th percentile and more than 75th percentile of PI at birth, respectively, in a decreasing trend (chi2 M-H for trend=9.938 adjusted for gender, P=0.002). Logistic regression analysis showed that both PI at birth and BMI during adulthood could influence their occurrence of MS (beta=-0.125, P=0.002, for PI; and beta=0.430, P=0.000, for BMI). A synergistic effect between PI at birth and BMI in adulthood was observed in this population. Persons who were thin at birth with PI less than the 25th percentile, and became overweight with BMI greater than or equal to 24 kg/m2 later in their life, were at higher risk of suffering from metabolic syndrome (OR=29.1, 95% CI=13.6-62.1), in comparison with those who became overweight during adulthood from a higher PI at birth (OR=16.0, 95% CI=7.9-32.3) and those who were thin at birth and remained a appropriate BMI during their adulthood (OR=2.0, 95% CI=0.7-5.7). Attributable fraction of the interaction to MS was 34.6%.

CONCLUSIONSThin at birth was a predictor for later occurrence of metabolic syndrome, as well as an effect modifier for the association between of later BMI and metabolic syndrome, i.e., overweight later in his life was most deleterious for a person with growth retardation at birth.

Adult ; Birth Weight ; Blood Glucose ; metabolism ; Body Mass Index ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Insulin Resistance ; physiology ; Lipids ; blood ; Logistic Models ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Prevalence ; Risk Factors

BACKGROUNDThe prevalence of HIV/AIDS in Chinese ethnic minorities is an important component of China's AIDS issues. In this study, we launched an intervention programme in Yunnan Province of China, where the Dai people live, to carry out the community-based HIV/AIDS health education and behavioral interventions on ordinary Dai farmers. The Dai people believe in Theravada Buddhism.

METHODSFour rural communities were randomly divided into two groups. In one group (Buddhist group), HIV/AIDS health education and behavioral intervention were carried out by monks. The other group (women group) was instructed by women volunteers. The intervention continued for one year and the data were collected before and after the intervention project.

RESULTSIn the Buddhist group, the villagers' AIDS related knowledge score was boosted from 3.11 to 3.65 (P < 0.001), and some indices of the villagers' behavior using condoms improved after the intervention. But this improvement was poorer than that in the women group. In the Buddhist group, the villager's attitude score towards the people living with HIV and AIDS (PLWHA) also increased significantly from 1.51 to 2.16 (P < 0.001).

CONCLUSIONThe results suggested that the Buddhist organization has limited success in promoting the use of condoms, but plays an important role in eliminating HIV/AIDS related discrimination.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adolescent ; Adult ; Buddhism ; China ; Condoms ; Female ; HIV Infections ; prevention & control ; Health Education ; methods ; Humans ; Male ; Middle Aged ; Young Adult

Adolescent ; Adult ; Analysis of Variance ; China ; Cross-Sectional Studies ; Homosexuality, Male ; statistics & numerical data ; Humans ; Internet ; statistics & numerical data ; Male ; Middle Aged ; Surveys and Questionnaires ; Young Adult

OBJECTIVEIn order to explore the features of discrimination against people with HIV/AIDS in rural areas, a community-based intervention was carried out in two pilot communities of X County of Shanxi Province from September 2002 to October 2003.

METHODSData were collected using qualitative methods (in-depth interview and focus group discussion) and anonymously structured questionnaires.

RESULTS(1) Severe discrimination against people infected with HIV/AIDS was revealed in the target communities. However, the response to HIV/AIDS was different in each community. (2) People were reluctant to disclose their HIV status or get tested for HIV, which endangered their sexual partners to contract HIV through unprotected sexual intercourses. (3) Attitudes towards people infected with HIV/AIDS varied. (4) Public education promoted a better understanding of HIV/AIDS which in turn improved community attitudes and behaviors towards people with HIV/AIDS.

CONCLUSIONHIV/AIDS-related discrimination undermines both individuals' and communities' responses to HIV/AIDS and may be a serious obstacle towards effective HIV/AIDS prevention and control.

Acquired Immunodeficiency Syndrome ; prevention & control ; psychology ; Attitude to Health ; China ; HIV Infections ; prevention & control ; psychology ; Health Education ; Humans ; Interviews as Topic ; Prejudice ; Rural Population ; Sexually Transmitted Diseases ; epidemiology ; prevention & control ; Surveys and Questionnaires