1.Impact of hepatic steatosis on viral load and hepatic fibrosis progression in chronic hepatitis B
Shi YIN ; Lianxin ZHU ; Guanghui REN ; Guiqun HUANG ; Yunpeng GUAN ; Ying ZHU
Journal of Clinical Hepatology 2026;42(6):1279-1286
ObjectiveTo investigate the association of hepatic steatosis with the level of viral replication and the progression of hepatic fibrosis in patients with chronic hepatitis B (CHB) through a real-world study, and to determine the independent influencing factors for hepatic fibrosis. MethodsA total of 887 CHB patients who attended the outpatient service and inpatient ward of Hepatology in The First Affiliated Hospital of Dalian Medical University from July 2021 to March 2025 were enrolled as subjects, and according to the presence or absence of metabolic dysfunction-associated steatotic liver disease (MASLD), they were divided into CHB group with 560 patients and CHB+MASLD group with 327 patients. The association between hepatic steatosis and HBV load in CHB patients was analyzed, as well as the impact of varying degrees of hepatic steatosis on hepatic fibrosis. The t-test or the Mann-Whitney U test was used for comparison of continuous data between groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups; a Spearman correlation analysis was performed; a Logistic regression analysis was used to investigate influencing factors. ResultsThe patients enrolled received antiviral therapy according to viral load; of all patients, 275 (31%) received nucleos(t)ide analogue combined with pegylated interferon-α, 532 (60%) received nucleos(t)ide analogue monotherapy, and 80 (9%) did not receive antiviral therapy. A total of 44 patients (5.0%) who were receiving PEG-IFN-α therapy and had marked thrombocytopenia were excluded, and finally 843 patients were included for comparison of aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4). Compared with the CHB group, the CHB+MASLD group had a significantly higher proportion of male patients (χ2=5.917, P<0.05) and a significant increase in CAP value (t=21.646, P<0.05). The median values of liver function parameters for the population enrolled were within the normal range, and no significant inflammatory activity was observed. The virological analysis showed that compared with the CHB group, the CHB+MASLD group had significantly lower serum level of pregenomic RNA (Z=-2.894, P<0.05) and HBeAg positivity rate (χ2=8.725, P<0.05), and CAP was significantly negatively correlated with pgRNA (r=-0.117, P<0.05). In the HBeAg-negative subgroup, compared with the CHB group, the CHB+MASLD group had a significantly lower level of hepatitis B surface antigen (Z=-0.765, P<0.05); in the HBeAg-positive subgroup, the CHB+MASLD group had a significantly higher level of HBV DNA than the CHB group (Z=-2.509, P<0.05). The analysis of hepatic fibrosis showed that the CHB+MASLD group had significantly lower values of APRI (Z=-3.418, P<0.05) and FIB-4 (Z=-6.237, P<0.05). Compared with the CHB group, the CHB+MASLD S1 group had a significantly higher proportion of patients without fibrosis and a significantly lower proportion patients with liver cirrhosis (χ2=7.935, P<0.05); in the CHB+MASLD S2 group, there was no significant difference in the proportion of patients with different fibrosis stages; the CHB+MASLD S3 group had a significantly lower proportion of patients without fibrosis and a significantly higher proportion of patients with early-stage fibrosis (χ2=9.101, P<0.05). The Logistic regression analysis showed that an increase in CAP (odds ratio [OR]=1.08, 95% confidence interval [CI]: 1.03 — 1.13, P<0.05), an increase in age (OR=1.02, 95%CI: 1.01 — 1.04, P<0.05), male sex (OR=1.77, 95%CI: 1.19 — 2.64, P<0.05), an increase in HBV DNA (OR=1.35, 95%CI: 1.15 — 1.57, P<0.001), an increase in aspartate aminotransferase (OR=1.02, 95%CI: 1.01 — 1.03, P<0.001), and an increase in gamma-glutamyl transpeptidase (OR=1.00, 95%CI: 1.00 — 1.01, P=0.028) were independent influencing factors for hepatic fibrosis. The risk of hepatic fibrosis in S3 patients was higher than that in patients without steatosis (OR=5.05, 95%CI: 2.48 — 10.29, P<0.001). ConclusionThere is a lower level of HBV replication in CHB patients comorbid with MASLD. Hepatic steatosis is associated with HBV-related virological markers and the progression of hepatic fibrosis, and severe fatty liver disease may promote the progression of hepatic fibrosis in CHB patients.
2.Surveillance and early warning index system for schistosomiasis in the middle and lower reaches of the Yangtze River basin
Sanhong JIANG ; Yibiao ZHOU ; Shizhu LI ; Dandan LIN ; Qingwu JIANG ; Liyong WEN ; Shengming LI ; Fei HU ; Benjiao HU ; Jie ZHOU ; Chunli CAO ; Jing XU ; Jianwen XIE ; Changming WU ; Xiaolan YAN ; Weimin XU ; Jun GE ; Guanghui REN ; Xiaoli LIU
Chinese Journal of Endemiology 2025;44(4):259-264
Under the current situation of "low prevalence and low infection" of schistosomiasis in China, and to provide a basis for achieving the goal of eliminating schistosomiasis by 2030 proposed by the Healthy China Action (2019 - 2030) as scheduled, the Hunan Provincial Corps Hospital of the Chinese People's Armed Police Force established a schistosomiasis monitoring and early warning index system based on the previous studies on schistosomiasis early warning index system and the recent literature analysis, combined with the current potential risk factors affecting the transmission and prevalence of schistosomiasis, and organized two rounds of expert consultation and carried out project promotion meetings. The experts reached a consensus on the comprehensiveness and practicability of the index system, aiming to lay a solid foundation for construction of China's schistosomiasis prevention and control early warning system.
3.Surveillance and early warning index system for schistosomiasis in the middle and lower reaches of the Yangtze River basin
Sanhong JIANG ; Yibiao ZHOU ; Shizhu LI ; Dandan LIN ; Qingwu JIANG ; Liyong WEN ; Shengming LI ; Fei HU ; Benjiao HU ; Jie ZHOU ; Chunli CAO ; Jing XU ; Jianwen XIE ; Changming WU ; Xiaolan YAN ; Weimin XU ; Jun GE ; Guanghui REN ; Xiaoli LIU
Chinese Journal of Endemiology 2025;44(4):259-264
Under the current situation of "low prevalence and low infection" of schistosomiasis in China, and to provide a basis for achieving the goal of eliminating schistosomiasis by 2030 proposed by the Healthy China Action (2019 - 2030) as scheduled, the Hunan Provincial Corps Hospital of the Chinese People's Armed Police Force established a schistosomiasis monitoring and early warning index system based on the previous studies on schistosomiasis early warning index system and the recent literature analysis, combined with the current potential risk factors affecting the transmission and prevalence of schistosomiasis, and organized two rounds of expert consultation and carried out project promotion meetings. The experts reached a consensus on the comprehensiveness and practicability of the index system, aiming to lay a solid foundation for construction of China's schistosomiasis prevention and control early warning system.
4.Clinical features and perinatal prognosis in fetuses with absence of ductus venosus: an analysis of 84 cases
Guanghui YAO ; Juan YANG ; Zhenling WEI ; Shumin REN ; Qinghua WU
Chinese Journal of Perinatal Medicine 2024;27(8):668-673
Objective:To summarize the ultrasonographic characteristics, genetic etiology, and perinatal prognosis of fetuses with absence of ductus venosus (ADV).Methods:A retrospective study enrolled 84 singleton pregnancies that underwent prenatal ultrasound examination and were diagnosed with fetal ADV at the First Affiliated Hospital of Zhengzhou University from June 2017 to July 2022. Based on prenatal ultrasonographic findings, the cases were divided into isolated ADV group ( n=37), ADV with ultrasound soft markers group ( n=9), and ADV with definite ultrasound abnormalities group ( n=38). According to the gestational age at the initial diagnosis of ADV, they were categorized into early pregnancy group (11-13 weeks of 6 days) with 17 cases, mid-pregnancy group (14-27 weeks of 6 days) with 45 cases, and late pregnancy group (≥28 weeks) with 22 cases. Depending on the direction of blood flow in the intra-abdominal segment of the umbilical vein, they were classified into umbilical vein directly entering the portal sinus group ( n=75), intrahepatic umbilical vein abnormal shunt group ( n=4), and extrahepatic umbilical vein shunt group ( n=5). The clinical characteristics of each group were summarized, and compared using the Chi-square, trend Chi-square tests, Fisher's exact test and Bonferroni correction test. Results:The common ultrasonographic abnormalities in the 84 cases of ADV fetuses were cardiac anomalies (27.4%, 23/84), cystic hygroma (10.7%, 9/84), fetal hydrops (9.5%, 8/84), and body cavity effusion (8.3%, 7/84). The proportions of fetuses with ADV and definite ultrasound abnormalities detected in the early, mid, and late pregnancy were 16/17, 44.4% (20/45), and 9.1% (2/22), respectively, with a higher proportion of definite ultrasound abnormalities associated with earlier detection of ADV ( χ 2trend=27.25, P<0.001). Among them, 21 cases underwent chromosomal karyotyping and/or chromosomal copy number variation sequencing or expanded non-invasive prenatal testing, with five abnormalities detected, including 45,X, trisomy 13, trisomy 22 mosaicism, trisomy 7 mosaicism, and a 14 Mb duplication at 22q12.3q13.33. The neonatal survival (28 days after birth) rates with ADV detected in the early, mid, and late pregnancy gradually increased, at 1/17, 43.9% (18/41), and 90.5% (19/21), respectively ( χ 2trend=27.04, P<0.001). The neonatal survival rates of the isolated ADV group and the group with ultrasound soft markers were higher than that of the group with definite ultrasound abnormalities [93.9% (31/33) and 6/9 vs. 2.7% (1/37), Bonferroni corrected, both P<0.001]. The neonatal survival rates of the umbilical vein directly entering the portal sinus group, intrahepatic umbilical vein abnormal shunt group, and extrahepatic umbilical vein shunt group were 50.0% (35/70), 0/4, and 1/5, respectively, with no statistically significant difference (Fisher's exact test, P=0.105). Conclusions:The earlier the detection of fetal ADV, the more likely it is to be associated with definite ultrasound abnormalities and have lower neonatal survival rates. This highlights the importance of ultrasonographic examination of the fetal ductus venosus. Once ADV is detected, attention should be paid to other potential ultrasound abnormalities, and genetic testing should be completed.
5.Comparison of three-dimensional position of maxillary dentition model treated with two digital transfer methods
Tiwu PENG ; Teng MA ; Zhikang YANG ; Mindi ZHANG ; Guanghui REN
Chinese Journal of Stomatology 2024;59(1):80-84
Objective:To compare and evaluate the difference in maxillary dentition position using an anatomical facebow and jaw movement analyzer.Methods:From March to May 2023, 15 medical interns from Yantai Stomatological Hospital were recruited, including 9 males and 6 females, aged 20-25 years. Digital models and plaster models of maxillary dentition were obtained from the 15 medical interns. The anatomical facebow group (AFB) and jaw movement analyzer group (JMA) were used to transfer the position of the maxillary dentition to the virtual articulator. The virtual occlusal articulator module of exocad denture design software was used to measure the inclination angle of the occlusal plane of the two groups, the distance between the mesio-incisal angle of the left maxillary central incisor and the lateral center point of the lateral condylar sphere of the virtual occlusal articulator, the distance between the mesial buccal cusp of the maxillary first molar and the lateral center point of the lateral condyle sphere of the virtual articulator. The same marks (mesial incisor point of left maxillary central incisor and mesial buccal cusp point of both maxillary first molars) were measured in two groups of maxillary dentition, and the root-mean-square error between 3 points was calculated.Results:The occlusal plane inclination angle in AFB group (9.11°±3.85°) was significantly larger than that in JMA group (4.94°±2.69°) ( t=10.45, P<0.001). There were significant differences between AFB and JMA groups. The distances from the mesial cusp of the left first molar to the lateral center of the left condylar, from the mesial cusp of the left maxillary central incisor to the lateral center of the left condylar[(91.75±3.05), (129.09±4.60) mm]were significantly smaller than those in the JMA group[(95.68±5.45), (132.41±5.64) mm]( t=-4.48, P=0.001; t=-4.21, P=0.001). In both groups of models, the distance of the mesial cusp of the left maxillary central incisor was (8.81±2.56) mm, and the distance between mesial buccal cusp of maxillary left first molar was (7.56±2.49) mm, the distance between mesial buccal cusp of maxillary right first molar was (7.13±2.77) mm; the root mean square error was (7.93± 2.94) mm. Compared with 0, the difference was statistically significant ( t=10.45, P<0.001). Conclusions:There were differences between the two methods (anatomical facebow and the jaw movement analyzer) for transferring the maxillary dentition position to the three-dimensional space position of the virtual articulator.
6.Correlation between physical exercise and semen quality in 1 059 men of childbearing age in Jinan City
Wenyu WANG ; Song LIU ; Zhida SHI ; Huijun YANG ; Jingchao REN ; Huidong JIN ; Guanghui ZHANG ; Ziyuan ZHOU ; Guanghong YANG
Journal of Army Medical University 2024;46(10):1164-1171
Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health.Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023.Their demographic data and physical exercise data were surveyed with questionnaires.Total sperm count,sperm concentration,total sperm motility,forward movement and normal sperm morphology were analyzed with computer aided analysis.Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality.Results After adjustment for confounding factors such as age,body mass index,alcohol consumption and smoking,logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity(OR=2.103,OR=2.229).Compared with the participants with physical exercise ≤10 min per session,those with>20 min per session had a lower risk of abnormal semen quality(OR=0.357,0.256,0.289 for exercise time for>20~30,>30~60,>60 min,respectively).There was no statistical significance between physical exercise frequency and semen quality(P>0.05).The participants having exercise well were at a lower risk for abnormal semen quality(OR=0.711).Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration(β=7.474,95%CI:4.800~10.149,P<0.05);the time of physical exercise per session was an influencing factor for total sperm count(β=20.632,95%CI:7.634~33.629);the intensity of physical exercise(β=-1.461,95%CI:-2.392~-0.530)and time of physical exercise per session(β=2.608,95%CI:1.404~3.812,P<0.05)were influencing factors for percentage of forward motility sperm(P<0.05);and physical exercise intensity(β=-1.934,95%CI:-3.238~-0.630),time of physical exercise per session(β=4.211,95%CI:2.525~5.897)and frequency of physical exercise(β=-2.008,95%CI:-3.480~-0.536)were influencing factors of total sperm motility(P<0.05).Conclusion Physical exercise may affect semen quality,greater intensity of physical exercise may be a risk factor for abnormal semen quality,and longer physical exercise time may be related to improving semen quality.Therefore,proper physical exercise can help improve semen quality.
7.Relationship between mixed exposure to heavy metals and seminal fructose in men of childbearing age
Jinhu CAO ; Fenglong LIN ; Zhongyi YUE ; Pingyang ZHANG ; Yufen HAN ; Guanghui ZHANG ; Jingchao REN
Journal of Environmental and Occupational Medicine 2023;40(11):1270-1277
Background The human body is usually exposed to a variety of heavy metals at the same time, and different types and concentrations of heavy metals may have complex interactions during their absorption and metabolism in the human body. Seminal fructose is an important energy source for sperm movement. A large number of studies have shown that metal exposure may impair semen quality, and seminal fructose is an important factor affecting male reproduction, so it is necessary to investigate the relationship between mixed heavy metal exposure and seminal fructose to explore the mechanism of semen quality damage caused by metal exposure. Objective To understand the status of common heavy metal exposure in men of childbearing age in Puyang City, Henan Province, and to study the relationship between mixed exposure to heavy metals and seminal fructose, as well as potential interactions among heavy metals. Methods Volunteers were recruited from the Puyang Maternal and Child Health Hospital Reproductive Center for a cross-sectional survey on general demographic characteristics, smoking, alcohol consumption, and other information. Semen samples were collected to detect 12 metals such as vanadium (V), manganese (Mn), cobalt (Co), nickel (Ni), zinc (Zn), selenium (Se), silver (Ag), cadmium (Cd), barium (Ba), thallium (Tl), iron (Fe), and lead (Pb) in seminal plasma and seminal fructose. After correcting for selected confounding factors, a Bayesian kernel machine regression (BKMR) model was used to evaluate the impact of seminal plasma heavy metal mixed exposure and its interactions on seminal fructose. Results A total of 825 adult males were enrolled. The concentrations in M (P25, P75) of V, Mn, Co, Ni, Zn, Se, Ag, Cd, Ba, Tl, Fe, and Pb in seminal plasma were 0.39 (0.28, 0.54), 12.31 (8.92, 17.52), 0.26 (0.18, 0.38), 5.15 (3.32, 8.64), 182159.80 (121847.80, 199144.50), 13.61 (10.55, 17.68), 0.03 (0.02, 0.04), 0.34 (0.27, 0.46), 8.64 (5.94, 13.43), 0.06 (0.05, 0.08), 168.74 (114.17, 259.45), and 1.69 (1.15, 2.36) μg·L−1 respectively. The Spearman correlation results indicated that there was a negative correlation between V, Mn, Co, Zn, Se, Ba, Tl, or Fe in seminal plasma and seminal fructose (P<0.05), and the values of r (95%CI) were −0.044 (−0.087, −0.001), −0.129 (−0.171, −0.087), −0.055 (−0.099, −0.012), −0.099 (−0.143, −0.056), −0.053 (−0.097, −0.010), −0.068 (−0.111, −0.025), −0.095 (−0.138, −0.052), and −0.082 (−0.125, −0.039), respectively. The results of multiple linear regression indicated that there was a negative correlation between the exposure level of Cd, Mn, Zn, Ag, Ba, Tl, or Fe in seminal plasma and seminal fructose (P<0.05), the values of associated β (95%CI) were −0.551 (−0.956, −0.147), −0.315 (−0.419, −0.212), −0.187 (−0.272, −0.103), −0.161 (−0.301, −0.021), −0.188 (−0.314, −0.062), −1.159 (−2.170, −0.147), and −0.153 (−0.230, −0.076), respectively. The BKMR model analysis showed that seminal fructose level decreased with the increase of plasma metal mixed exposure concentration. Compared with all metal exposure at P50, the seminal fructose level decreased by 0.2374 units when all metal exposure was at P75. Seminal plasma Zn [posterior inclusion probabilities (PIPs)=1.0000] had the strongest effect on seminal fructose, followed by Mn (PIPs=0.5872), Se (PIPs=0.5656), and Ba (PIPs=0.5398). The univariate exposure-response curve showed a negative approximate linear correlations between Ba or Mn and seminal fructose, a positive linear correlation between Se and seminal fructose, and an approximate inverted U-shaped association between Zn and seminal fructose. No significant interaction between studied metals was found. Conclusion Mixed metal exposure may lead to decrease of seminal fructose, in which Zn, Mn, Se, and Ba may play an important role. Mn and Zn exposure may reduce the level of seminal fructose, Se may increase the level of seminal fructose, and there may be a threshold effect between Zn exposure and seminal fructose level. No interaction between different metals on seminal fructose is found.
8.Outcome comparison of pyrotinib with current standard of care in the second/third line setting in advanced non-small cell lung cancer patients with HER2 mutation.
Shiqi MAO ; Libo LUO ; Shuo YANG ; Yan WANG ; Fei ZHOU ; Jia YU ; Bin CHEN ; Guanghui GAO ; Xuefei LI ; Chao ZHAO ; Lei CHENG ; Yiwei LIU ; Wanying WANG ; Keyi JIA ; Chuchu SHAO ; Xinyu LIU ; Xiaoxia CHEN ; Chunxia SU ; Caicun ZHOU ; Fengying WU ; Shengxiang REN
Chinese Medical Journal 2023;136(7):848-850
9.Association of Glial Activation and α-Synuclein Pathology in Parkinson's Disease.
Rui WANG ; Haigang REN ; Elena KAZNACHEYEVA ; Xiaojun LU ; Guanghui WANG
Neuroscience Bulletin 2023;39(3):479-490
The accumulation of pathological α-synuclein (α-syn) in the central nervous system and the progressive loss of dopaminergic neurons in the substantia nigra pars compacta are the neuropathological features of Parkinson's disease (PD). Recently, the findings of prion-like transmission of α-syn pathology have expanded our understanding of the region-specific distribution of α-syn in PD patients. Accumulating evidence suggests that α-syn aggregates are released from neurons and endocytosed by glial cells, which contributes to the clearance of α-syn. However, the activation of glial cells by α-syn species produces pro-inflammatory factors that decrease the uptake of α-syn aggregates by glial cells and promote the transmission of α-syn between neurons, which promotes the spread of α-syn pathology. In this article, we provide an overview of current knowledge on the role of glia and α-syn pathology in PD pathogenesis, highlighting the relationships between glial responses and the spread of α-syn pathology.
Humans
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Parkinson Disease/pathology*
;
alpha-Synuclein/metabolism*
;
Dopaminergic Neurons/metabolism*
;
Pars Compacta/metabolism*
10.Effect of internal structures on the accuracy of 3D printed full-arch dentition preparation models in different printing systems
Teng MA ; Tiwu PENG ; Yang LIN ; Mindi ZHANG ; Guanghui REN
The Journal of Advanced Prosthodontics 2023;15(3):145-154
PURPOSE:
. The objective of this study was to investigate how internal structures influence the overall and marginal accuracy of full arch preparations fabricated through additive manufacturing in different printing systems.
MATERIALS AND METHODS:
. A full-arch preparation digital model was set up with three internal designs, including solid, hollow, and grid. These were printed using three different resin printers with nine models in each group. After scanning, each data was imported into the 3D data processing software together with the master cast, aligned and trimmed, and then put into the 3D data analysis software again to compare the overall and marginal deviation whose results are expressed using root mean square values and color maps. To evaluate the trueness of the resin model, the test data and reference data were compared, and the precision was evaluated by comparing the test data sets. Color maps were observed for qualitative analysis. Data were statistically analyzed by one-way analysis of variance and Bonferroni method was used for post hoc comparison (α = .05).
RESULTS:
. The influence of different internal structures on the accuracy of 3D printed resin models varied significantly (P < .05). Solid and grid models showed better accuracy, while the hollow model exhibited poor accuracy. The color maps show that the resin models have a tendency to shrink inwards.
CONCLUSION
. The internal structure design influences the accuracy of the 3D printing model, and the effect varies in different printing systems. Irrespective of the kind of printing system, the printing accuracy of hollow model was observed to be worse than those of solid and grid models. [J Adv Prosthodont 2023;15:145-54]

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