1.Genetic Variations and Nonalcoholic Fatty Liver Disease:Field Synopsis,Systematic Meta-Analysis,and Epidemiological Evidence
Li YAMEI ; Xiao XIANG ; Wang JIE ; Liu YIXU ; Pan XIONGFENG ; Yu HAIBIN ; Luo JIAYOU ; Luo MIYANG
Biomedical and Environmental Sciences 2024;37(7):762-773
Objective To systematically summarize the published literature on the genetic variants associated with nonalcoholic fatty liver disease(NAFLD). Methods Literature from Web of Science,PubMed,and Embase between January 1980 and September 2022 was systematically searched.Meta-analyses of the genetic variants were conducted using at least five data sources.The epidemiologic credibility of the significant associations was graded using the Venice criteria. Results Based on literature screening,399 eligible studies were included,comprising 381 candidate gene association,16 genome-wide association,and 2 whole-exome sequencing studies.We identified 465 genetic variants in 173 genes in candidate gene association studies,and 25 genetic variants in 17 genes were included in the meta-analysis.The meta-analysis identified 11 variants in 10 genes that were significantly associated with NAFLD,with cumulative epidemiological evidence of an association graded as strong for two variants in two genes(HFE,TNF),moderate for four variants in three genes(TM6SF2,GCKR,and ADIPOQ),and weak for five variants in five genes(MBOAT7,PEMT,PNPLA3,LEPR,and MTHFR). Conclusion This study identified six variants in five genes that had moderate to strong evidence of an association with NAFLD,which may help understand the genetic architecture of NAFLD risk.
2.The effect of local application of tranexamic acid on reducing drainage volume after thyroidectomy
Zhiwei LUO ; Hongli JI ; Jinshan LIAN ; Yamei CHEN ; Jiang GAO ; Jiaqi CHANG ; Longlong WANG
Chinese Journal of Postgraduates of Medicine 2024;47(5):456-460
Objective:To explore the effect and safety of local spraying tranexamic acid after thyroidectomy.Methods:Randomized double-blind placebo-controlled study method was used. Sixty-four patients underwent scheduled thyroidectomy from December 2022 to August 2023 in Baotou Cancer Hospital were selected. The patients were divided into tranexamic acid group and control group by random digits table method with 32 cases each. Before closing the wound during surgery, 16 ml of tranexamic acid injection with concentration of 25 mg/ml was used to wash the wound and 1 ml of tranexamic acid injection (tranexamic acid 100 mg) used to locally spray in tranexamic acid group; 16 ml of the sterile water for injection was used to wash the wound and 1 ml of sterile water for injection was used locally spray in control group, and then the drainage tube was clipped for 20 min. The neck drainage volume on the first to fourth day after surgery and complication were recorded; the C-reactive protein level before and after surgery was detected.Results:Two patients in each group withdrew from the study midway. The drainage volume on the first, second and third day and total drainage volume in tranexamic acid group were significantly lower than those in control group: (29.10 ± 8.04) ml vs. (38.50 ± 8.67) ml, (18.00 ± 7.33) ml vs. (27.20 ± 10.66) ml, (10.70 ± 5.75) ml vs. (14.60 ± 6.83) ml and (69.20 ± 24.48) ml vs. (96.70 ± 31.90) ml, and there was statistical difference ( P<0.01); there was no statistical difference in the drainage volume on the fourth day after surgery between two groups ( P>0.05). There was no statistical difference in C-reactive protein before and after surgery between two groups ( P>0.05). There was 1 case of fever (body temperature 37.5 ℃) in the control group, and there were no complications such as intermuscular thrombosis, venous thrombosis, incision infection and delayed wound healing in both groups. Conclusions:Local application of tranexamic acid after thyroidectomy can reduce postoperative drainage volume and does not increase the risk of thrombosis, infection and delayed healing.
3.Application value of anti-carbamylated protein antibody in the diagnosis of rheuma-toid arthritis
Zhengfang LI ; Cainan LUO ; Lijun WU ; Xue WU ; Xinyan MENG ; Xiaomei CHEN ; Yamei SHI ; Yan ZHONG
Journal of Peking University(Health Sciences) 2024;56(4):729-734
Objective:To investigate the expression level and application value of anti-carbamylated protein(CarP)antibody in rheumatoid arthritis(RA).Methods:Demographic data and laboratory test results of RA patients,non-RA patients and healthy controls in the physical examination center were re-viewed from December 2018 to June 2019 in the Rheumatology and Immunology Department of the Peo-ple's Hospital of Xinjiang Uygur Autonomous Region.The serum concentrations of anti-CarP antibodies in all the subjects were measured by ELISA and statistically analyzed.Results:A total of 259 subjects were included in this study,including 158 in the RA group(45 serum-negative RA patients),59 in the non-RA group and 42 in the healthy control group.The concentration of anti-CarP antibody in RA group[8.31(5.22,15.26)U/mL]was higher than that in non-RA group[4.50(3.35,5.89)U/mL]and healthy control group[3.46(2.76,4.92)U/mL].The concentration of anti-CarP antibody in non-RA group was not significantly different from that in healthy control group(P=0.10).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity of anti-CarP antibody in the diagnosis of RA was 58.2%,and the specificity was 93.1%.The sensitivity of the combined detection of anti-CarP antibody,anti-cyclic peptide containing citrulline(CCP)antibody and rheumatoid factor(RF)was 82.3%,and the specificity was 96.5%.The positive rate of anti-CarP antibody in serum-negative RA patients was 44.4%(20/45).Univariate Logisitic regression analysis showed that age,C-reactive pro-tein(CRP),erythrocyte sedimentation rate(ESR),RF,glucose-6-phosphate isomerase(GPI),anti-CCP antibody and anti-CarP antibody were risk factors for RA.Multivariate Logisitic regression analysis showed that anti-CCP antibody and anti-CarP antibody were independent risk factors for RA.Spearman correlation analysis showed that there was no significant correlation between anti-CarP antibody and swol-len joint count(SJC),tenderness joints count(TJC),ESR,disease activity score for 28 joints(DAS28),clinical disease activity index(CDAI),simplified disease activity index(SDAI).The concentration of anti-CarP antibody in RA with bone erosion(n=88)was higher than that in RA without bone erosion(n=70),and there was significant difference between the two groups(P<0.05).Conclusion:Anti-CarP antibody is an effective serological marker for the diagnosis of RA.The combined detection of RF,anti-CCP antibody and anti-CarP antibody can improve its diagnostic value,and anti-CarP antibody may be an effective assistant diagnostic tool for serum negative RA.The high serum concentration of anti-CarP antibody in patients with RA may indicate an increased risk of bone erosion and should be treated early,but further cohort studies are needed for follow-up observation.
4.The prevalence and related risk factors of hyperuricemia in Bozidum Kinghiz township of Xinjiang Aksu region
Yan ZHONG ; Nasha GU ; Zhengfang LI ; Xue WU ; Mansuer MIKELAYI· ; Yamei SHI ; Cainan LUO ; Xiaomei CHEN ; Qianqian WANG ; Chaohong YUE ; Yun FENG ; Xinyan MENG ; Guoli ZHANG ; Juan DENG ; Jing LI ; Lijun WU
Chinese Journal of Rheumatology 2024;28(5):312-320
Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .
5.Plasma Elabela in predicting short-term prognoses in large vessel occlusion-acute ischemic stroke patients accepted endovascular thrombectomy
Lang CHEN ; Rui LI ; Yamei YIN ; Cong LUO ; Peng HAO ; Shuo FENG ; Ming CAI ; Jun SUN ; Wei HU
Chinese Journal of Neuromedicine 2023;22(12):1242-1247
Objective:To explore the relation of plasma Elabela with 3-month prognoses in large vessel occlusion-acute ischemic stroke (LVO-AIS) patients accepted endovascular thrombectomy (EVT).Methods:A prospective study was performed; 94 LVO-AIS patients aceepted EVT in Department of Neurology, Anhui Provincal Hospital, Anhui Medical University from August 2020 to August 2022 were selected. Plasma Elabela was detected before EVT, and 24 and 72 h after EVT. Modified Rankin scale (mRS) was used to evaluate the prognoses of the patients 3 months after EVT; differences in clinical data and plasma Elabela level between the good prognosis group and poor prognosis group were compared. Independent influencing factors for prognoses of LVO-AIS patients 3 months after EVT were analyzed by multivariate Logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of Elabela in predicting prognoses of patients with LVO-AIS 3 months after EVT.Results:Compared with the poor prognosis group, the good prognosis group had significantly lower percentages of patients with stroke history and diabetes, and lower NIHSS scores at admission ( P<0.05). Elabela level in the good prognosis group was significantly higher than that in the poor prognosis group 72 h after EVT ( P<0.05). Multivariate Logistic regression analysis showed that stroke history ( OR=0.148, P=0.037, 95% CI: 0.025-0.889), diabetes mellitus ( OR=0.148, P=0.037, 95% CI: 0.025-0.889), hypertension history ( OR=3.488, P=0.024, 95% CI: 1.177-10.339), and Elabela level 72 h after EVT ( OR=1.064, P=0.005, 95% CI: 1.019-1.111) were independent influencing factors for prognoses of LVO-AIS patients 3 months after EVT. ROC curve showed that area under ROC curve of plasma Elabela level 72 h after EVT in predicting prognosies of LVO-AIS patients 3 months after surgery was 0.718 ( P<0.001, 95% CI: 0.614-0.822). Conclusion:Plasma Elabela level 72 h after EVT may be a potential prognostic biomarker for LVO-AIS patients after EVT.
6.Efficacy of repetitive transcranial magnetic stimulation or transcranial direct current stimulation in dysphagia after stroke: a Meta analysis
Weili LUO ; Xuzheng ZUO ; Yamei TANG
Chinese Journal of Neuromedicine 2023;22(12):1248-1254
Objective:To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in dysphagia after stroke.Methods:Six Chinese or English databases, including PubMed, Web of Science, Embase, CNKI, Wanfang and VIP, were searched by computer for randomized controlled trials of dysphagia after stroke with rTMS or tDCS (experimental group) from database construction to May 2023; those received conventional treatment+sham stimulation or conventional treatment only were enrolled as control group. Effective data were screened and extracted after literature quality evaluation by Cochrane. The outcome indexes included scores of penetration-aspiration scale (PAS), fiberoptic endoscopic dysphagia severity scale (FEDSS) and functional oral intake scale (FOIS). Reviewer Manager 5.4 software was used for Meta analysis of the extracted data, and mean difference ( MD) or standardized mean difference ( SMD) were used as effect indexes. Results:Twelve articles were finally included in the research literature, involving 637 subjects. Meta-analysis indicated that compared with the control group, the experimental group had significantly decreased PAS scores ( MD=-0.740, 95% CI: -1.020--0.460, P<0.001); FOIS scores in the experimental group were significantly increased compared with those in the control group ( MD=0.680, 95% CI: 0.220-1.130, P=0.003); FEDSS scores in the experimental group were significantly decreased compared with those in the control group ( SMD=-0.890, 95% CI: -1.110--0.670, P<0.001). Conclusion:The rTMS or tDCS can effectively alleviate dysphagia symptoms after stroke.
7.Tumor volume ratio as a predictive factor for lymph node metastases in thyroid papillary carcinoma in the central area
Yamei CHEN ; Jie XU ; Teng LI ; Zhiwei LUO ; Longlong WANG
Chinese Journal of General Surgery 2023;38(10):744-748
Objective:To investigate the correlation between thyroid tumor volume ratio to lymph node metastasis in papillary thyroid carcinoma (PTC).Methods:The ratio of thyroid tumors volume to resected thyroid volume was measured by imaging methods before surgery, and the correlation between volume ratio and other clinicopathological features and lymph node metastasis in 134 patients with single focal PTC was analyzed.Results:The number of lymph node metastases was associated with age <45 years and invasion of the capsule ( r<0.300, P<0.05), and weakly correlated with gender, maximum tumor diameter, tumor volume and volume ratio. Among them, the correlation between patho-volume ratio was strongest ( r=0.379, P<0.001). Male genter was an independent risk factor for central cervical lymph node metastasis (χ 2=13.597 P<0.05). The co-predictions of sex and volume ratio was AUC=0.760, sensitivity=0.574 and specificity=0.818. Conclusion:Compared to the maximum diameter of tumors, the volume ratio in papillary thyroid carcinoma better predicts the metastasis of lymph nodes of papillary thyroid carcinoma in the central region.
8.Analysis of the 15-year survival rate and its prognostic factors in late-onset systemic lupus erythematosus
Yamei SHI ; Xue WU ; Lijun WU ; Zhengfang LI ; Cainan LUO ; Kelayi MI
Chinese Journal of Geriatrics 2022;41(6):674-677
Objective:To analyze the 15-year survival rate, causes of death and prognostic factors of late-onset systemic lupus erythematosus(SLE).Methods:A total of 92 late-onset SLE patients aged >50 years hospitalized in the Rheumatology and Immunology Department of the People's Hospital of Xinjiang Autonomous Region from January 2006 to December 2016 were retrospectively collected.Clinical and serological data of the patients were analyzed and the diagnosis met the SLE classification criteria as revised by the American Society of Rheumatology in 1997.Survival rate, the cause of death, and the associated prognostic factors were analyzed.Outpatient or telephone follow-up was performed.Results:Of the 92 study patients, 8 were lost to follow-up(8 / 92, 8.7%)and 84 were able to follow up(84 / 92, 91.3%). Of the 84 able to follow up, 64 cases(64 / 84, 76.2%)survived, and 20 cases(20 / 84, 23.8%)died.Median survival time was 108 months.The 5-, 10-, and15-year survival rates were 86.0%, 77.9%and 59.6 %, respectively.Infection(55.0%)and multiple organ failure(15.0%)were the major cause of death in patients with late-onset SLE.Univariate analysis of the outcomes of patients with late-onset SLE showed that the age of onset( HR=1.113, P=0.001), hematology involvement( HR=3.610, P=0.023), and complicaed cardiovascular disease( HR=3.128, P=0.011)had a significant impact on the prognosis. Conclusions:The late-onset SLE has low survival rate and bad prognosis.Infection prevention and control of organ damage and focus on merging cardiovascular disease are critical to improve survival of late-onset SLE patients.
9.Clinical and immunological characteristics of Uygur systemic lupus erythematosus patients in Xinjiang Uygur Autonomous Region of China
Yamei SHI ; Xue WU ; Lijun WU ; Cainan LUO ; Xinyan MENG
Chinese Journal of Rheumatology 2021;25(1):38-42
Objective:To describe the clinical features and immunological of Uygur systemic lupus erythematosus (SLE) subjects.Methods:Atotal of 484 adult patients (≥18 years) followed in the People's Hospital of the Xinjiang Uygur Autonomous Region were included into this study including 211 Uygur patients with SLE and 273 Han patients with SLE.Results:① Of the 211 Uygur SLE patients, 195 (92.4%) were female and 16(7.6%) were male (female:male=12.2∶1), the mean age at SLE onset was 15-64(35±12) years, mean disease duration was 0.1-228(21±35) months.② Of the 211 Uygur SLE patients, the most prevalent clinical presentationswere renal involvement 56.4%(119/211), hematological 56.4%(119/211), rash 50.2% (106/211), arthralgia/arthritis 49.8%(105/211), weakness 47.9%(101/211). The significant difference observed between the Uygur and Han SLE patients was Raynaud phenomenon( χ2=6.066, P=0.014) .③ The positive rates of antinuclear antibodies were 94.8%(200/211), 54.5%(115/211) for anti-dsDNA antibodies, 47.9% (101/211) for anti-SSA antibodies, 35.1%(74/211) for anti-U 1-RNP antibodies, and 28.4%(60/211) for anti-AHA antibodies. The positivity of anti-AHA antibodies ( χ2=4.952, P=0.026) was higher in Uygur SLE patients than thatin Han SLE patients. More Uygur SLE patients were anemic ( χ2=6.904, P=0.009), with decrease of complement ( χ2=6.330, P=0.012). Conclusion:This study can not find any significant differences between the Uygur SLE patients and Han SLE patients in common clinical manifestations in Xinjiang. The Uygur SLE patients are more likely to have anemia and decrease of complement, which may be related to race and diet habits.
10.Investigation on depression of patients with systemic lupus erythematosus during coronavirus disease 2019 pandemic in Xinjiang
Yuan CAO ; Cainan LUO ; Lijun WU ; Xue WU ; Yamei SHI ; Cheng WANG
Chinese Journal of Rheumatology 2021;25(3):155-159
Objective:To explore the depression of patients with systemic lupus erythematosus (SLE) during the coronavirus disease 2019 (COVID-19) pandemic.Methods:Patients with SLE and healthy subjects(control group) from August 16, 2020 to September 2, 2020 in Urumqi, Xinjiang were collected. The depression and sleep quality were assessed by Self rating Depression Scale (SDS) and Pittsburgh sleep quality index (PSQI). The nonparametric data were represented by median (quartile spacing), and the rank sum test was used to compare the continuous variables between the two groups. Pearson correlation test was used for continuous variables, and Spearman correlation test was used for rank variables or classified variables. Statistical product and service solutions.Results:The prevalence rate of depression in the SLE group (41.9%) was significantly higher than that in healthy control group (32.1%). The difference was statistically significant ( χ2= 10.312, P<0.01). The prevalence rate of poor sleep in the SLE group (31.8%) was significantly higher than that in healthy control group (21.6%). The difference was statistically significant( χ2=3.885, P=0.049). The total score of VAS ( OR=1.366, P<0.01) , PSQI( OR=1.198, P<0.01) were the risk factor of depression in patients with SLE. Conclusion:SLE patients have a higher prevalence of depression during pandemic quarantinee-period, pain and poor sleep quality are risk factors. We need to pay attention to the psychological status of SLE patients.

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