BACKGROUND: Chronic liver disease (CLD), mainly non-alcoholic fatty liver disease (NAFLD), is a significant public health concern worldwide. This study aims to quantify the burden of NAFLD in CLD globally and within China, using data from the Global Burden of Disease (GBD) Study 2021, providing crucial insights for global and local health policies. METHODS: The study used comprehensive data from the GBD study 2021. It included estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Age-standardized rates and average annual percent change (AAPC) from 2011 to 2021 were reported. A meticulous decomposition analysis was conducted. RESULTS: In 2021, there were 1582.5 million prevalent cases, 47.6 million incident cases, 1.4 million deaths, and 44.4 million DALYs attributable to CLD, globally. Among these, NAFLD has emerged as the predominant cause, accounting for 78.0% of all prevalent CLD cases (1234.7 million) and 87.2% of incident cases (41.5 million). Correspondingly, NAFLD had the highest age-standardized prevalence (15,017.5 per 100,000 population) and incidence (876.5 per 100,000 population) rates among CLDs. In addition, China's CLD age-standardized prevalence rate was 21,659.5 per 100,000 population, and the age-standardized incidence rate was 752.6 per 100,000 population, higher than the global average. From 2011 to 2021, the global prevalence rate of CLD increased slowly (AAPC = 0.17), consistent with the trend in China (AAPC = 0.23). Furthermore, the prevalence rate of NAFLD rose significantly in China (AAPC = 1.30) compared with the global average (AAPC = 0.91). Decomposition analysis also showed the worldwide increase in deaths and DALYs for NAFLD, which were primarily attributable to population growth and aging. CONCLUSIONS The burden of CLD and NAFLD remains substantial globally and within China in terms of high prevalence and incidence. As such, this underscores the need for targeted prevention and treatment strategies. These findings emphasize the importance of continued surveillance and research to mitigate the growing impact of liver diseases on global and Chinese health systems.
Humans ; Non-alcoholic Fatty Liver Disease/mortality* ; Global Burden of Disease ; China/epidemiology* ; Prevalence ; Male ; Disability-Adjusted Life Years ; Female ; Incidence ; Middle Aged ; Chronic Disease ; Adult ; Quality-Adjusted Life Years ; Liver Diseases/epidemiology* ; Aged

Objective:To dynamically assess liver fibrosis using magnetic resonance elastography (MRE) and explore factors associated with fibrosis reversal in patients with metabolic dysfunction-associated steatohepatitis (MASH).Methods:This study included data from patients diagnosed with MASH by liver biopsy who underwent at least two MRE examinations. Patients were divided into a fibrosis reversal group and a non-reversal group according to whether MRE values decreased by 20% during follow-up. Differences in clinical data between the groups were compared using analysis of variance, the Kruskal-Wallis test, and the chi-square test. Univariate and multivariate logistic regression analyses were used to explore independent risk factors for fibrosis reversal in MASH.Results:A total of 46 cases were included in this study (mean age 50.1±12.3 years, BMI 26.1±3.1 kg/m2). Among them, the reversal group accounted for 26.1%. The rate of decrease in MRI proton density fat fraction (PDFF) was significantly higher in the reversal group (-50.0% vs. -8.1%, P=0.001) than in the non-reversal group between the two MRE examinations. The reversal group showed a more significant change rate of decreases in fasting insulin (-37.3% vs. -3.6%, P=0.011), insulin resistance index (-38.6% vs. -6.5%, P=0.044), and ALP (-24.9% vs. 0, P=0.004). Multivariate logistic regression analysis indicated that the rate of change in MRI PDFF was an independent predictor of fibrosis reversal ( OR=0.96, 95% CI: 0.92-1.00, P=0.046). Conclusion:A decrease in MRI proton density fat fraction levels is independently associated with liver fibrosis reversal in MASH, suggesting that intervention targeting liver fat content may be an effective treatment strategy.

Objective:To dynamically assess liver fibrosis using magnetic resonance elastography (MRE) and explore factors associated with fibrosis reversal in patients with metabolic dysfunction-associated steatohepatitis (MASH).Methods:This study included data from patients diagnosed with MASH by liver biopsy who underwent at least two MRE examinations. Patients were divided into a fibrosis reversal group and a non-reversal group according to whether MRE values decreased by 20% during follow-up. Differences in clinical data between the groups were compared using analysis of variance, the Kruskal-Wallis test, and the chi-square test. Univariate and multivariate logistic regression analyses were used to explore independent risk factors for fibrosis reversal in MASH.Results:A total of 46 cases were included in this study (mean age 50.1±12.3 years, BMI 26.1±3.1 kg/m2). Among them, the reversal group accounted for 26.1%. The rate of decrease in MRI proton density fat fraction (PDFF) was significantly higher in the reversal group (-50.0% vs. -8.1%, P=0.001) than in the non-reversal group between the two MRE examinations. The reversal group showed a more significant change rate of decreases in fasting insulin (-37.3% vs. -3.6%, P=0.011), insulin resistance index (-38.6% vs. -6.5%, P=0.044), and ALP (-24.9% vs. 0, P=0.004). Multivariate logistic regression analysis indicated that the rate of change in MRI PDFF was an independent predictor of fibrosis reversal ( OR=0.96, 95% CI: 0.92-1.00, P=0.046). Conclusion:A decrease in MRI proton density fat fraction levels is independently associated with liver fibrosis reversal in MASH, suggesting that intervention targeting liver fat content may be an effective treatment strategy.

Talent is the foundation of hospital development.Since the independent operation of a third grade children's hospital,it is faced with some difficulties such as imperfect construction of talent echelon,large gap of talent demand,insufficient funds for talent introduction and weak talent training.The Party committee of the hospital adheres to the party management of tal-ents,and on the basis of improving the talent introduction,training and incentive mechanism,builds a"1+1＞2 ecosystem"of Party management talents in view of the difficulties and blind spots in the construction of talent teams,focuses on the introduction and training of talents,quantity and quality,and production capacity input and output,and promotes the"induction and reten-tion"of talent construction to achieve actual results.Lay a talent foundation for the high-quality development of the hospital.

Objective To explore the correlation between marginal zone two-dimensional ultrasound features,enhancement fea-tures and quantitative parameters of contrast-enhanced ultrasound and Ki-67 in the invasive breast carcinoma of no specific type(IBC-NST).Methods From October 2019 to October 2023,84 patients with IBC-NST(84 unilateral lesions),aged 25 to 78 years,confirmed by surgical pathology and immunohistochemistry were collected from the First Hospital of Shanxi Medical University.All patients had not received preoperative chemoradiotherapy,and underwented two-dimensional ultrasound and contrast-enhanced ultrasound exam-ination.They were divided into high expression group and low expression group according to the expression degree of Ki-67.The two-dimensional ultrasound features and contrast-enhanced ultrasound features and quantitative parameters of two groups were analyzed and compared,and their correlation between the quantitative parameters and Ki-67 was analyzed.Results The proportion of margin indis-tinct of IBC-NST lesion in Ki-67 high expression group was higher than that in Ki-67 low expression group,and the differences were statistically significant(P＜0.05).The proportion of adial enhancemen and the range enlargement after angiography of IBC-NST lesion in Ki-67 high expression group was higher than those in Ki-67 low expression group,and the differences were statistically significance(P＜0.05).The quantitative parameters peak intensity(PI),area under the curve(AUC)of IBC-NST lesion in Ki-67 high expres-sion group were higher than those in Ki-67 low expression group,and the differences were statistically significant(P＜0.05).IBC-NST marginal zone quantitative parameters PI,AUC were positively correlated with Ki-67 expression,and the differences were statistical-ly significant(P＜0.05).Conclusion In patients with IBC-NST,the marginal zone of the lesion is margin indistinct,the radial en-hancement,the srange enlargement after angiography,and the quantitative parameters PI,AUC are increased,indicating the high expres-sion of Ki-67,providing certain imaging guidance for clinical individualized precision treatment.

Objective To explore the correlation between marginal zone two-dimensional ultrasound features,enhancement fea-tures and quantitative parameters of contrast-enhanced ultrasound and Ki-67 in the invasive breast carcinoma of no specific type(IBC-NST).Methods From October 2019 to October 2023,84 patients with IBC-NST(84 unilateral lesions),aged 25 to 78 years,confirmed by surgical pathology and immunohistochemistry were collected from the First Hospital of Shanxi Medical University.All patients had not received preoperative chemoradiotherapy,and underwented two-dimensional ultrasound and contrast-enhanced ultrasound exam-ination.They were divided into high expression group and low expression group according to the expression degree of Ki-67.The two-dimensional ultrasound features and contrast-enhanced ultrasound features and quantitative parameters of two groups were analyzed and compared,and their correlation between the quantitative parameters and Ki-67 was analyzed.Results The proportion of margin indis-tinct of IBC-NST lesion in Ki-67 high expression group was higher than that in Ki-67 low expression group,and the differences were statistically significant(P＜0.05).The proportion of adial enhancemen and the range enlargement after angiography of IBC-NST lesion in Ki-67 high expression group was higher than those in Ki-67 low expression group,and the differences were statistically significance(P＜0.05).The quantitative parameters peak intensity(PI),area under the curve(AUC)of IBC-NST lesion in Ki-67 high expres-sion group were higher than those in Ki-67 low expression group,and the differences were statistically significant(P＜0.05).IBC-NST marginal zone quantitative parameters PI,AUC were positively correlated with Ki-67 expression,and the differences were statistical-ly significant(P＜0.05).Conclusion In patients with IBC-NST,the marginal zone of the lesion is margin indistinct,the radial en-hancement,the srange enlargement after angiography,and the quantitative parameters PI,AUC are increased,indicating the high expres-sion of Ki-67,providing certain imaging guidance for clinical individualized precision treatment.

OBJECTIVE:To provide reference for rational use of antidepressive drugs. METHODS:In retrospective study,the utilization of antidepressive drugs in 31 hospitals of Nanjing area during 2013-2015 was analyzed statistically in respects of consump-tion sum,DDDs,DDC,B/A,etc. RESULTS:There were a total of 20 kinds of antidepressive drugs in 31 hospitals of Nanjing ar-ea,and total consumption sum increased year by year,increasing from 76 085 200 yuan in 2013 to 100 812 500 yuan in 2015,in-creased by 17.43% compared to 2014 and by 12.83% compared to 2015. The top 4 drugs in the list of consumption sum and DDDs were paroxetine,escitalopram,sertraline and venlafaxine. The sum of their consumption sum accounted for more than 60% of total consumption sum. The consumption sum of plant antidepressive drugs increased rapidly. B/A and DDC of antidepressive drugs kept sta-ble each year compared to last year,among which DDC of doxepin,clomipramine and amitriptyline was less than 2 yuan,B/A val-ues of sertraline,fluvoxamine,flupentixol and melitracen,doxepin,clomipramine and amitriptyline were all more than 1.00. CON-CLUSIONS:Of antidepressive drugs in 31 hospitals of Nanjing area during 2013-2015,selective serotonin reuptake inhibitors and se-lective serotonin-norepinephrine reuptake inhibitors took up dominant place,and plant antidepressive drugs is promising in the future.

OBJECTIVE: To analyze the causes of misdiagnosis in patients with familial nasal bleeding and to improve the level of diagnosis and treatment. METHOD: The clinical characteristics of 7 families with nose blood were analyzed retrospectively and 2 typical cases were reported, including their treatment and misdiagnosis in consulting, out-patient and in-patient. RESULT: Typical case 1 was misdiagnosed and mistreated for 42 years, misdiagnosed as blood disease so that the patient was biopsied in bone marrow, misdiagnosed as endometriosis so that the patient was performed uterus resection. Typical case 2 was misdiagnosed and mistreated for 17 years, misdiagnosed as upper digestive tract hemorrhage so that the patient was performed endoscopic sleeve ligation, misdiagnosed as inferior turbinate hemangioma so that the patient was performed nasal endoscopic surgery. CONCLUSION Neglect of family history and the typical signs are the causes of misdiagnosis. So asking about the family history and checking for the typical signs in patients with nose blood can avoid misdiagnosis.
Diagnostic Errors ; Endoscopy ; Epistaxis ; diagnosis ; Female ; Humans ; Nasal Surgical Procedures ; Retrospective Studies ; Turbinates

Objective To analyze the clinical characteristics of primary ciliary dyskinesia(PCD) so as to improve the diagnostic level of this rarely seen disease.Methods Ten patients with PCD were retrospectively reviewed,the medical history,symptoms,signs,lung CT or chest X-ray,rhinosinus CT scan,nasal nitric oxide (NO) levels,nasal ciliary ultrastructure,DNAH5 and DNAH11 genetic mutation,as well as treatment outcome were analyzed.Results All 10 patients had recurrent chronic sinusitis,otitis media,bronchitis/bronchiectasis since childhood.Nine cases with translocation of heart and big vessels were diagnosed as Kartagener syndrome.One woman was suffering from barrenness and one man sterility after marriage for long time without birth control.Nasal NO levels were significantly lower in 2 patients with PCD but it was almost normal in one patient.Ciliary ultrastructure investigated by transmission electron microscope were almost normal in 4 cases without missing of inner or outer dynein arms.Two cases taking exome capture sequencing showed that mutations happened in DNAH5 and DNAH11.Five subjects underwenting sanger sequencing on 6 common exon fragments of DNAH5 and DNAH11 did not show any abnormality.Ten cases took medication therapy,while 5 patients once underwent functional endoscope sinus surgery.All of the 10 patients had improvement of their symptoms and signs after treatment.Conclusions The PCD is so rare in clinic that it is easily misdiagnosed.Clinical characteristics,nasal NO levels,ciliary ultrastructure and genetic testing are significant for clinical diagnosis.

OBJECTIVE: To study the early gene diagnosis of hereditary hemorrhagic telangiectasia (HHT) induced severe nosebleed. METHOD: Clinical features of 23 family members in two HHT pedigrees were examined. Genomic DNA was extracted from peripheral blood samples. PCR amplification was conducted to screen ENG and ACVRL-1 genes with their specific primers. Direct sequencing was performed to detect the mutation. Mutation analysis was carried out to evaluate its significance. RESULT: A heterozygous c. 263A > G mutation was identified in exon 3 of ACVRL-1 in 6 out of 11 members in NMG-1 pedigree. In GD-2 pedigree, 5 of 11 members carried c. 199C > G mutation. Mutation detection rate was 100% in subjects with nosebleed history and 25% in family members without epistaxis. CONCLUSION Gene diagnosis characterized by high sensitivity and specificity is of great practi-cal significance and early genetic screening should be a clinical routine test for HHT induced severe nosebleed.
Activin Receptors, Type II ; genetics ; Adolescent ; Adult ; Antigens, CD ; genetics ; DNA Mutational Analysis ; Endoglin ; Epistaxis ; diagnosis ; etiology ; genetics ; Exons ; Female ; Genetic Testing ; Humans ; Male ; Middle Aged ; Pedigree ; Receptors, Cell Surface ; genetics ; Telangiectasia, Hereditary Hemorrhagic ; complications ; diagnosis ; genetics ; Young Adult