[show abstract][hide abstract] ABSTRACT: An association between cholecystectomy and metabolic syndrome has not been fully established. Here we analyzed the association between cholecystectomy and metabolic syndrome in a Chinese population of 5672 subjects who undergone annual health checkups at the First Affiliated Hospital, College of Medicine, Zhejiang University between January 2011 and December 2012. The prevalences of gallstones, cholecystectomy and metabolic syndrome were 6.0%, 3.6%, and 32.5%, respectively. The prevalence of metabolic syndrome was significantly higher in subjects with a history of cholecystectomy (63.5%) than in those with gallstones (47.0%) or in those without gallstone disease (30.3%; P<0.01 for both). Multivariate logistic regression analysis showed that cholecystectomy was significantly associated with increased risk of metabolic syndrome (OR = 1.872; 95% CI: 1.193-2.937). However, the association of gallstones with metabolic syndrome was not statistically significant (OR = 1.267; 95% CI: 0.901-1.782). Altogether, our results suggest that cholecystectomy significantly increases the risk of metabolic syndrome.
PLoS ONE 01/2014; 9(2):e88189. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Chronic abdominal pain is one of the most common chief complaints, but the underlying pathophysiology often remains unknown after routine clinical evaluation. Capsule endoscopy (CE) is a new technique for the visualization of the entire small bowel. The aim of this study was to evaluate the diagnostic efficacy of CE in patients with chronic abdominal pain of obscure origin.
Two hundred forty three patients with chronic abdominal pain with no significant lesions were enrolled in this study. CE was performed in all patients.
A diagnosis was made in 23.0% of patients screened with CE. Of the 243 patients, 19 (7.8%) were diagnosed with Crohn's disease, 15 (6.2%) with enteritis, 11 (4.5%) with idiopathic intestinal lymphangiectasia, 5 (2.1%) with uncinariasis, and a number of other diagnoses including small bowel tumor, ascariasis, and anaphylactoid purpura. Five patients had abnormal transit time, and capsule retention occurred in two patients.
In contrast to other previous studies, we found that CE is an effective diagnostic tool for patients with abdominal pain.
PLoS ONE 01/2014; 9(1):e87396. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: The incidence of esophageal and gastric cancer has been increasing rapidly worldwide in recent years, although the reason for this increase is unclear. Here, a statistical synthesis of studies that evaluated the association between physical activity, a well-known protecting factor against death and other chronic diseases, and the risk of esophageal and gastric cancer was performed.
Potentially suitable studies were identified using Medline and Embase. The reference lists of all included articles and those of several recent reviews were searched manually. Studies were included if they (1) were published as case-control or cohort studies evaluating the association between physical activity and risk of esophageal or gastric cancer; and (2) reported point estimates (i.e., risk ratios, odds ratios) and measures of variability (i.e., 95% confidence intervals [CIs]) for physical activity and risk of esophageal or gastric cancer.
Fifteen studies were identified (7 cohorts, 8 case-controls; 984 esophageal and 7,087 gastric cancers). Collectively, they indicated that the risk of gastric cancer was 13% lower among the most physically active people than among the least active people (RR = 0.87, 95% confidence interval [CI] = 0.78 to 0.97) and that of esophageal cancer was 27% lower (RR = 0.73, 95% CI = 0.56 to 0.97).
Pooled results from observational studies support a protective effect of physical activity against both esophageal and gastric cancer.
PLoS ONE 01/2014; 9(2):e88082. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Background
Alcohol, overweight and lipid metabolism contribute to fatty liver and atherosclerosis pathogenesis.
To study the association of alcoholic intake, overweight and dyslipidemia.
We randomly selected 482 age- and sex-matched individuals from East China. Gender, age, education level, smoking, hypertension, daily alcohol intake, drinking duration and body mass index (BMI) were evaluated in association with triglyceride (TG), total cholesterol (TCh), high-density (HDLc), and low-density lipoprotein (LDLc).
The association between dyslipidemia and eight predictors of disease was made by regression analysis through the generalized additive model. The results showed that age, daily alcohol intake and BMI were all closely associated with hypertriglyceridemia. Age, duration of drinking and BMI were all closely associated with hypercholesterolemia. Age and BMI status were both closely associated with high LDLc levels. By contrast, none of the eight predictors was closely associated with low HDLc levels (all P < 0.05).
Conclusions: Daily alcohol intake was a risk factor for hypertriglyceridemia. By contrast, drinking duration was a protective factor against hypercholesterolemia. Age and BMI were important risk factors for dyslipidemia (excluding HDLc).
[show abstract][hide abstract] ABSTRACT: MicroRNAs (miRNAs) are a group of small non-coding RNAs with modulator activity of gene expression. The role of microRNAs in hepatic ischemia-reperfusion (IR) injury is currently largely unknown. The aim of this study was to investigate the potential role of miR-370 in hepatic IR injury.
The expression levels of hepatic miR-370 in male C57BL/6 mice subjected to hepatic IR injury or ischemia preconditioning were assessed by quantitative real-time PCR. The effect of miR-370 on hepatic IR injury was investigated by serum enzyme analysis and histological examination of liver following treatment of mice with antagomir-370 or control. The levels of proinflammatory cytokines and apoptosis- and proliferation-related genes were also determined by quantitative real-time PCR. Furthermore, the potential targets of miR-370 in this injury were studied by bioinformatics analysis, luciferase assays, quantitative real-time PCR and western blot.
The results showed that miR-370 expression was significantly upregulated in the mice subjected to hepatic IR injury as compared with the sham-operated mice. Inhibition of miR-370 led to the downregulation of serum aminotransferase and proinflammatory cytokines, as well as the improvement of hepatic histological damage. Reporter assays confirmed that miR-370 directly targeted the 3' untranslated region of transforming growth factor-β receptor II (TβRII). Inhibition of miR-370 was sufficient to reinstate the expression of TβRII and its downstream target phosphorylated Smad3.
Our data suggest that miR-370 acting via TβRII might play a potential role in hepatic IR injury, and inhibition of miR-370 efficiently attenuated the damage to the liver. This article is protected by copyright. All rights reserved.
Liver international: official journal of the International Association for the Study of the Liver 12/2013; · 3.87 Impact Factor
[show abstract][hide abstract] ABSTRACT: Vitamin D receptor (VDR) is a member of the nuclear receptor family of transcription factors that play a critical role in innate immunity. This study examined the role of VDR in gastric innate immune defence against the gastric pathogen Helicobacter pylori.
Seventeen H. pylori-infected patients and sixteen controls participated in the study. The GES-1 cells were transfected with siRNA or incubated with or without 1α,25(OH)2 D3 (100 nmol/L) then infected with H. pylori. VDR, cathelicidin antimicrobial protein (CAMP), and cytokine mRNA expression levels in normal and H. pylori-infected gastric mucosa and GES-1 cells was determined by qRT-PCR and correlated with the histopathologic degree of gastritis. Bactericidal activity was measured by using a colony-forming unit assay.
Vitamin D receptor mRNA expression levels were significantly upregulated in H. pylori-infected patients and positively correlated with chronic inflammation scores. There was a significant positive correlation between VDR and CAMP mRNA expression in H. pylori-positive gastric mucosa. VDR siRNA reduced H. pylori-induced CAMP production and conversely increased IL-6 and IL8/CXCL8 expression levels. The vitamin D agonist 1α,25(OH)2 D3 increased CAMP expression and reduced cytokine activation in GES-1 cells infected with H. pylori. 1α,25(OH)2 D3 could enhance the intracellular killing of the replicating bacteria, but the presence of siVDR and siCAMP led to a decline in its bactericidal ability.
The expression of VDR and CAMP in the gastric epithelium is up-regulated in the case of H. pylori infection; thus, VDR plays an important role in gastric mucosa homeostasis and host protection from H. pylori infection.
[show abstract][hide abstract] ABSTRACT: The role of p38 mitogen-activated protein kinase (MAPK) inhibitors for treating rheumatoid arthritis (RA) is debated. Therefore, we performed a meta-analysis of all published randomized controlled trials (RCTs) to evaluate the efficacy and safety of p38 MAPK inhibitors in patients with active RA. Searches were conducted in the databases PubMed, EMBASE, and Cochrane Library. We identified three articles including four RCTs with analysis on the efficacy and safety of p38 inhibitors for the treatment of RA. Our meta-analysis showed that a better American College of Rheumatology 20 % improvement (ACR20) was observed in the p38 inhibitors group compared with the placebo group, but there were no meaningful differences in ACR50, Disease Activity Score in 28 joints response, and CRP levels between two groups past week 12. The overall adverse events were similar between placebo and treatment groups. In conclusion, p38 MAPK inhibitors showed modest efficacy in patients with RA. However, this conclusion is based on the small number of available studies and inadequate sample size, and more well-designed RCTs will be necessary to determine the role of p38 MAPK inhibitors in RA.
[show abstract][hide abstract] ABSTRACT: OBJECTIVES:The precise prevalence and risk factors for the development of nonalcoholic fatty liver disease (NAFLD) in nonobese adults remains unclear. The objective of this study was to investigate the prevalence of NAFLD and risk factors for its development in a nonobese Chinese population.METHODS:We firstly investigated the prevalence and factors associated with the presence of NAFLD in nonobese (body mass index (BMI) <25 kg/m(2)) Chinese subjects via a cross-sectional study, and then analyzed the risk factors for the development of NAFLD via a subsequent prospective 5-year follow-up of the same population.RESULTS:A total of 6,905 nonobese subjects were enrolled in the cross-sectional study. Baseline evaluation revealed that the prevalence of NAFLD was 7.27%. A total of 5,562 subjects who were free of NAFLD at baseline completed the follow-up study, and 494 (8.88%) had developed NAFLD during the 5-year follow-up. Further analyses revealed that age, gender, BMI, waist circumference, triglyceride, high-density lipoprotein (HDL) cholesterol, serum uric acid, hemoglobin, and platelet count were independently associated with the presence and development of NAFLD.CONCLUSIONS:NAFLD is prevalent in the nonobese Chinese population, and a substantial proportion of subjects developed NAFLD over the 5-year follow-up period. Special attention should be paid to the factors associated with the presence and development of NAFLD in nonobese subjects, to improve prevention and management of NAFLD.Am J Gastroenterol advance online publication, 9 April 2013; doi:10.1038/ajg.2013.104.
The American Journal of Gastroenterology 04/2013; · 7.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: The objective of this study was to perform a meta-analysis of randomized controlled trials (RCTs) investigating whether a remote ischemic preconditioning (RIPC) protocol provides renal protection to patients undergoing cardiac and vascular interventions. Searches were conducted in the databases PUBMED, EMBASE and Cochrane Library. RCTs that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. We identified ten studies with a total of 924 patients undergoing cardiac and vascular interventions with or without RIPC. There was a significantly lower incidence of acute kidney injury in the RIPC group compared with control group using the fixed effect model (RR 0.69, 95%CI 0.53 to 0.90, P = 0.007), but not with the random effects model (RR 0.73, 95%CI 0.50 to 1.06, P = 0.10). There was no difference in the levels of renal biomarkers, incidence of renal replacement therapy, mortality, hospital stay, and intensive care unit stay between two groups. In conclusion, there is no enough evidence that RIPC provided renal protection in patients undergoing cardiac and vascular interventions. Large-scale RCTs are necessary to confirm the potential role of RIPC on renal impairment.
Journal of Cardiothoracic Surgery 03/2013; 8(1):43. · 0.90 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: To investigate the association between serum glycosylated hemoglobin (HbA1c) levels and nonalcoholic fatty liver disease (NAFLD) in an elderly Chinese population. METHODS: A cross-sectional study was performed among the 949 retired elderly employees of Zhenhai Refining & Chemical Company Ltd., Ningbo, China. RESULTS: A total of 257 (27.08%) subjects fulfilled the diagnostic criteria of NAFLD, and NAFLD patients had significantly higher serum HbA1c levels than controls (P <0.001). The prevalence of NAFLD was significantly higher in subjects with increased serum HbA1c level (HbA1c [greater than or equal to]6.5%) than in those with normal range of serum HbA1c level (51.71% vs. 25.20%; P <0.001), and the prevalence increased along with progressively higher serum HbA1c levels (P for trend <0.001). Stepwise logistic regression analysis showed that serum HbA1c level was significantly associated with the risk for NAFLD (odds ratio: 1.547, 95% confidence interval: 1.054 - 2.270; P =0.026). CONCLUSIONS: Our results suggest that serum HbA1c level is associated with NAFLD, and increased serum HbA1c level is an independent risk factor for NAFLD in elderly Chinese.
[show abstract][hide abstract] ABSTRACT: Helicobacter pylori infection is associated with extragastric diseases. The thyroid may be one of the targets of chronic inflammation. Here, we sought to investigate whether H. pylori infections were associated with the presence of thyroid nodules. A total of 988 euthyroid subjects from China were included in this cross-sectional study. Four hundred thirty-five (44.0%) subjects were diagnosed as having thyroid nodules, and 486 (49.2%) were diagnosed with H. pylori infections. The thyroid nodules group had a higher proportion of H. pylori infections than the control group (P = 0.002). Free thyroxine (FT4) levels were lower and the prevalence of thyroid nodules was higher in patients with H. pylori infection compared to those without infection, even after adjustment for age, gender, and body mass index (BMI; all P < 0.05). The prevalence of H. pylori infection showed a decreasing trend as serum FT4 level increased (P trend = 0.020). Stepwise logistic regression analysis showed that H. pylori infection was significantly associated with the risk of thyroid nodules (odds ratio: 1.390, 95% confidence interval: 1.059-1.824, P = 0.018). Our results suggested that H. pylori infections were positively associated with the presence of thyroid nodules in the euthyroid population, whose thyroid functions were in the reference range.
PLoS ONE 01/2013; 8(11):e80042. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Growth hormone (GH) is an important regulator of metabolism and body composition. GH deficiency is associated with increased visceral body fat and other features of the metabolic syndrome. Here we performed a cross-sectional study to explore the association of GH levels with nonalcoholic fatty liver disease (NAFLD), which is considered to be the hepatic manifestation of the metabolic syndrome. A total of 1,667 subjects were diagnosed as NAFLD according the diagnostic criteria, and 5,479 subjects were defined as the controls. The subjects with NAFLD had significantly lower levels of serum GH than the controls. Those with low GH levels had a higher prevalence of NAFLD and the metabolic syndrome. A stepwise logistic regression analysis showed that GH levels were significantly associated with the risk factor for NAFLD (OR = 0.651, 95%CI = 0.574-0.738, P<0.001). Our results showed a significant association between lower serum GH levels and NAFLD.
PLoS ONE 01/2012; 7(8):e44136. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Vitamins C and E can act as potent antioxidants to reduce the damage caused by reactive oxygen species in gastric mucosa. Whether vitamin supplements for Helicobacter pylori eradication regimen could improve the rate of eradication remains uncertain. Therefore, we performed a meta-analysis to evaluate the efficacy of vitamins C and E supplementation for the eradication of H. pylori. Searches were conducted in the databases PubMed, EMBASE and Cochrane Library. Randomised controlled trials (RCT) that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Of the six RCT included, five had a low methodological quality. Of the six RCT, three compared the efficacy of the eradication regimen v. eradication regimen plus vitamins C and E. The result of the meta-analysis showed a non-significant difference in the eradication rate of H. pylori between the two groups (risk ratio (RR) 0·93, P = 0·76). Another three RCT compared the eradication regimen v. eradication regimen plus vitamin C only, and there too there was no significant difference in the eradication rate (RR 0·83, P = 0·32). In conclusion, vitamins C and/or E supplements to the H. pylori eradication regimen could not improve the eradication rate. However, currently available data do not draw a definitive conclusion about the effectiveness of antioxidant vitamins on H. pylori eradication, owing to the small sample size and low-to-moderate methodological quality.
The British journal of nutrition 08/2011; 106(11):1632-7. · 3.45 Impact Factor
[show abstract][hide abstract] ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. The two linked studies presented herein aimed to identify and verify new biomarkers for NAFLD.
First, 70 serum samples were analyzed using proteomics approaches to identify potential biomarkers for NAFLD. Second, a total of 6944 initial NAFLD-free subjects were followed up for 3 years to evaluate the predictive value of hemoglobin for NAFLD.
In the first study, 20 differentially expressed protein peaks (11 up-regulated and nine down-regulated) were observed in NAFLD patients upon comparison to the controls. With the aid of bioinformatic tools, we established a biomarker pattern for NAFLD with a sensitivity of 89% and a specificity of 83%. Further analysis suggested a protein peak to be hemoglobin subunit alpha. In the second study, prospective analysis showed that subjects with higher baseline hemoglobin levels were associated with higher incidence of NAFLD. Cox proportional hazards regression analyses showed that the age, gender, and body mass index adjusted hazard ratio (95% CI) for subjects with baseline hemoglobin level in quintile 2, 3, 4, and 5 vs. quintile 1 was 1.36 (1.02-1.81), 1.66 (1.23-2.25), 1.76 (1.28-2.41), and 1.83 (1.33-2.53), respectively.
Our study showed that serum hemoglobin may have significant predictive value for NAFLD.
Journal of Hepatology 07/2011; 56(1):241-7. · 9.86 Impact Factor
[show abstract][hide abstract] ABSTRACT: This study was undertaken to discover novel biomarkers for the noninvasive early diagnosis of nonalcoholic fatty liver disease (NAFLD). A methionine and choline deficient (MCD) diet was used to represent different stages of NAFLD in male C57BL/6 mice. (1)H NMR spectroscopy and principal components analysis (PCA) were used to investigate the time-related biochemical changes in mice sera induced by the MCD diet. Many serum metabolites' concentrations changed between control and MCD-fed mice. Hierarchical cluster analysis (HCA) and artificial neural networks (ANNs) were used to select the least number of metabolites to be used for the noninvasive diagnosis of various stages of NAFLD; four potential biomarkers, serum glucose, lactate, glutamate/glutamine, and taurine were selected. To verify the diagnostic accuracy of these selected metabolites, their serum concentrations were measured in healthy controls (n = 28), NAFLD patients with steatosis (n = 15), steatosis patients with necro-inflammatory disease (n = 11), and NASH patients (n = 6). On the basis of results from MCD-fed mice model, clinical tests, and previous reports, we propose using the levels of the four metabolites for diagnosing NAFLD at various stages. Furthermore, the probability of developing NAFLD at a particular stage was assessed by multinomial logistic regression (MLR) based on the clinical results of the four serum metabolites.
Journal of Proteome Research 06/2011; 10(6):2797-806. · 5.06 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aims of this study were to compare disk diffusion with E-test method for levofloxacin susceptibility testing of Helicobacter pylori and standardized breakpoints for disk diffusion as a stable and reliable method for determining qualitative levofloxacin susceptibility.
We determined the levofloxacin susceptibility of 45 H. pylori strains isolated from Chinese patients by the E-test method. Disk diffusion was evaluated as an alternative method to determine susceptibility and compared with the E-test results by linear regression analysis.
The minimum inhibitory concentration (MIC) values tested by E-test method ranged from 0.047 to 32 μg/mL. Resistance to levofloxacin was detected in 16 (35.6%) isolates. The levofloxacin disk zone sizes obtained by disk diffusion method correlated well (r² = .877) with the MICs obtained by E-test method. As a consequence of regression analysis, isolates with inhibition diameters < 12 mm were considered resistant to levofloxacin. There was 100% agreement between the two methods for levofloxacin, applying the regression-based breakpoints.
The disk diffusion method is equivalent to the E-test method for testing levofloxacin susceptibility of H. pylori strains; it is more practical and inexpensive, and it is suitable for the analysis of a small number of isolates compared with the E-test method.
[show abstract][hide abstract] ABSTRACT: To conduct a meta-analysis of published, full-length, randomized controlled trials evaluating the efficacy of endoscopic band ligation (EBL) versus pharmacological therapy for the primary and secondary prophylaxis of variceal hemorrhage in patients with cirrhosis.
Literature searches were conducted using the PubMed, EMBASE and Cochrane Library databases. Eighteen randomized clinical trials that fulfilled the inclusion criteria were further pooled into a meta-analysis.
Among 1023 patients in 12 trials comparing EBL with beta-blockers for primary prevention, there was no significant difference in gastrointestinal bleeding (RR 0.79 [95% CI 0.61 to 1.02]), all-cause deaths (RR 1.06 [95% CI 0.86 to 1.30]) or bleeding-related deaths (RR 0.66 [95% CI 0.38 to 1.16]). There was a reduced trend toward significance in variceal bleeding with EBL compared with betablockers (RR 0.72 [95% CI 0.54 to 0.96]). However, variceal bleeding was not significantly different between the two groups in high-quality trials (RR 0.84 [95% CI 0.60 to 1.17]). Among 687 patients from six trials comparing EBL with beta-blockers plus isosorbide mononitrate for secondary prevention, there was no effect on either gastrointestinal bleeding (RR 0.95 [95% CI 0.65 to 1.40]) or variceal bleeding (RR 0.89 [95% CI 0.53 to 1.49]). The risk for all-cause deaths in the EBL group was significantly higher than in the medical group (RR 1.25 [95% CI 1.01 to 1.55]); however, the rate of bleeding related deaths was unaffected (RR 1.16 [95% CI 0.68 to 1.97]).
Both EBL and beta-blockers may be considered first-line treatments to prevent first variceal bleeding, whereas betablockers plus isosorbide mononitrate may be the best choice for the prevention of rebleeding.
Canadian journal of gastroenterology = Journal canadien de gastroenterologie 03/2011; 25(3):147-55. · 1.53 Impact Factor
[show abstract][hide abstract] ABSTRACT: Thyroid dysfunction commonly occurs in the elderly population and overt thyroid dysfunction is associated with some liver abnormalities. This study aimed to investigate the association of thyroid function with nonalcoholic fatty liver disease (NAFLD) in euthyroid elderly Chinese.
A cross-sectional study was performed among 878 euthyroid elderly Chinese who took their annual healthy examination at Zhenhai Lianhua Hospital, Ningbo, China.
A total of 227 (25·85%) subjects fulfilled the diagnostic criteria of NAFLD. Patients with NAFLD had significantly lower levels of serum-free thyroxine (FT4) than controls (11·12 ± 1·43 vs 11·58 ± 1·47 pmol/l; P < 0·001). The prevalence rate of NAFLD decreased along with progressively higher serum FT4 levels (P for trend < 0·001). Age, gender and smoking status-adjusted correlation analysis showed that serum FT4 level was negatively correlated with body mass index, waist circumference, triglyceride and serum uric acid levels (All with P < 0·05). Stepwise logistic regression analysis showed that serum FT4 level was significantly associated with the risk for NAFLD [odds ratio (OR): 0·847, 95% confidence interval (CI): 0·743 - 0·966; P = 0·013].
Our findings suggest that thyroid function, even within the reference range, is associated with NAFLD in elderly Chinese.