Global burden of cirrhosis and other chronic liver diseases due to nonalcoholic fatty liver disease, 1990-2019

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) has become the leading cause of cirrhosis and other chronic liver diseases (COCLDs).

AIM

To conduct a comprehensive and comparable updated analysis of the global, regional, and national burden of COCLDs due to NAFLD in 204 countries and territories from 1990 and 2019 by age, sex, and sociodemographic index.

METHODS

Data on COCLDs due to NAFLD were collected from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Numbers and age-standardized prevalence, death, and disability-adjusted life years (DALYs) were estimated through a systematic analysis of modelled data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. The estimated annual percentage change was used to determine the burden trend.

RESULTS

In 2019, the global age-standardized prevalence rate of COCLDs due to NAFLD was 15022.90 per 100000 population [95% uncertainty interval (UI): 13493.19-16764.24], which increased by 24.51% (22.63% to 26.08%) from 1990, with an estimated annual percentage change of 0.78 (95% confidence interval: 0.74-0.82). In the same year, however, the age-standardized death rate and age-standardized DALYs per 100000 population were 1.66 (95%UI: 1.20-2.17) and 43.69 (95%UI: 31.28-58.38), respectively. North Africa and the Middle East had the highest prevalence rates of COCLDs due to NAFLD. The death rate increased with age up to the 95+ age group for both sexes. Males had higher numbers of prevalence, death rate, and DALYs than females across all age groups before the 65-69 age group. The sociodemographic index was negatively correlated with the age-standardized DALYs.

CONCLUSION

Globally, the age-standardized prevalence rate has increased during the past three decades. However, the age-standardized death rate and age-standardized DALYs decreased. There is geographical variation in the burden of COCLDs due to NAFLD. It is strongly recommended to improve the data quality of COCLDs due to NAFLD across all countries and regions to facilitate better monitoring of the burden of COCLDs due to NAFLD.

The non-contact-based determination of the membrane permeability to water and dimethyl sulfoxide of cells virtually trapped in a self-induced micro-vortex

The cell-membrane permeabilities of a cell type toward water (L_p) and cryoprotective agents (P_s) provide crucial cellular information for achieving optimal cryopreservation in the biobanking industry. In this work, cell membrane permeability was successfully determined via directly visualizing the transient profile of the cell volume change in response to a sudden osmotic gradient instantaneously applied between the intracellular and extracellular environments. A new micro-vortex system was developed to virtually trap the cells of interest in flow-driven hydrodynamic circulation passively formed at the expansion region in a microfluidic channel, where trapped cells remain in suspension and flow with the streamline of the localized vortex, involving no physical contact between cells and the device structure; furthermore, this supports a pragmatic assumption of 100% sphericity and allows for the calculation of the active surface area of the cell membrane for estimating the actual cell volume from two-dimensional images. For an acute T-cell lymphoma cell line (Jurkat), moderately higher values (L_p = 0.34 μm min^-1 atm^-1 for a binary system, and L_p = 0.16 μm min^-1 atm^-1 and P_s = 0.55 × 10^-3 cm min^-1 for a ternary system) were measured than those obtained from prior methods utilizing contact-based cell-trapping techniques, manifesting the influence of physical contact on accuracy during the determination of cell membrane permeability.

Predictive Value of Electrophysiology for Presence of Thymic Pathology in Myasthenia Gravis

OBJECTIVE

Single fibre electromyography (SFEMG) and repetitive nerve stimulation (RNS) are routinely performed investigations in evaluation of patients with myasthenia gravis (MG). Significant number of MG patients have a thymic pathology. We aimed to explore the relationship between the SFEMG and RNS findings with the presence of thymic pathology.

METHODS

We studied 159 consecutive patients with MG over a 10 year period. The SFEMG parameters - mean jitter (MJ) and percentage of abnormal fibres (POAF) and the RNS result were correlated with the thymic findings.

RESULTS

As compared to patients with normal thymus (MJ:58.3 μsec; POAF:63.5%), patients with thymic pathology had a significantly higher MJ (80.9 μsec; p < 0.0005) and POAF (83.5%; p < 0.0005). MG patients with thymic hyperplasia had the highest MJ (87.6 μsec) and POAF (84.4%) followed by patients with thymoma (MJ:78.6 μsec; POAF:83.2%). The MJ and POAF did not correlate with the stage of thymoma. Mean jitter values above 34.9 μsec and POAF above 31% had 100% sensitivity for the presence of thymic pathology. A positive RNS increased the risk of thymic pathology (OR = 3.9, CI = 1.8-8.5) and thymoma. (OR = 3.5; CI = 1.5-8.1).

CONCLUSION

Electrophysiology could be valuable complimentary tool to identify MG patients at high risk for thymic pathology. However, it does not aid us to identify the exact thymic pathology and does not correlate with the stage of thymoma. All OMG patients with higher MJ and PAOF values should also be screened for thymoma. The results reinforce the immunological role of thymic pathology in neuromuscular transmission interference.

The GSTP1 A1578G polymorphism and the risk of childhood acute lymphoblastic leukemia: results from an updated meta-analysis

Studies investigating the association between the glutathione S-transferase P1 (GSTP1) A1578G polymorphism and the risk of childhood acute lymphoblastic leukemia (ALL) report conflicting results. The aim of this study was to quantitatively summarize the evidence for such a relationship. Two investigators independently searched the Medline, Embase, China National Knowledge Infrastructure, and Wangfang databases for studies of the polymorphism and ALL. Summary odds ratios (ORs) and 95% confidence intervals (CIs) for the GSTP1 polymorphism and childhood ALL were calculated in a fixed-effect model. Pooled ORs were calculated for a co-dominant model (GG vs AA, AG vs AA), a dominant model (GG + AG vs AA), and a recessive model (GG vs AA + AG). Analyses were also performed in subgroups stratified by race, study design, genotyping methods, and study sample size. This meta-analysis included 8 case-control studies with 1384 childhood ALL cases and 1755 controls. Overall, the variant genotypes (GG and AG) of A1578G were not associated with childhood ALL risk, when compared with the wild-type homozygote AA genotype (GG vs AA, OR = 1.09, 95%CI = 0.84-1.43; AG vs AA, OR = 1.05, 95%CI = 0.91-1.23). Similarly, no associations were found in the dominant and recessive models (dominant model, OR = 1.06, 95%CI = 0.92-1.23; recessive model, OR = 1.09, 95%CI = 0.84-1.43). Stratified analyses did not detect significant association in any subgroup. No heterogeneity or publication bias was observed in the present study. This updated meta-analysis indicates that the GSTP1 A1578G polymorphism is not associated with the risk of childhood ALL. In the future, additional studies in Asian and African-American patients should be performed to re-evaluate the association in these populations.

Correlation between acetylcholine receptor antibody levels and thymic pathology in myasthenia gravis: a review

Myasthenia gravis is the most common chronic autoimmune neuromuscular disease. Anti-acetylcholine receptor (AChR) antibodies are found in at least 80% of patients with generalized myasthenia and have been implicated in disease pathogenesis. Thymic abnormalities are frequently found in seropositive patients, and the thymus is thought to be involved in generation of autoimmunity. This article reviews existing literature on the role of AChR antibodies in the pathogenesis of myasthenia gravis, and the correlation between AChR antibody titers and thymic pathology. Most studies found that highest titers are seen in thymic hyperplasia, followed by intermediate titers in thymoma, and lowest titers in atrophic or normal thymus. One publication found no difference between titers in thymoma and normal thymus.

Common properties between synaptic plasticity in the main olfactory bulb and olfactory learning in young rats

Aversive olfactory learning was established in young rats after odor exposure paired with foot shock through a classical conditioning paradigm. Using behavioral pharmacology and Western blotting, we previously reported that plasticity in the main olfactory bulb (MOB) underlies aversive olfactory learning. Since long-term potentiation (LTP) observed in the hippocampus is believed to be a cellular substrate for aspects of memory, we attempted to induce LTP in the MOB. Using brain slices containing the MOB, we found that five tetani of the lateral olfactory tract evoked LTP that was blocked by the N-methyl-d-aspartate (NMDA) receptor antagonist AP5. Although three tetani induced no significant changes in control slices, with noradrenaline (NA) application they produced clear LTP (NA-mediated LTP), which was not dependent on NMDA receptors. NA's facilitating effect on LTP induction was blocked by the beta-adrenoceptor antagonist timolol but not by the alpha-adrenoceptor antagonist phentolamine, and was mimicked by the beta-adrenoceptor agonist isoproterenol. The l-type calcium channel blocker nifedipine completely blocked LTP as well as NA-mediated LTP. In addition, we found that aversive olfactory learning was impaired by beta-adrenoceptor antagonist, timolol but not by alpha-adrenoceptor antagonist, phentolamine, and only odor training established olfactory learning by isoproterenol infusion. Moreover, we found that nifedipine but not AP5 prevented olfactory learning formation. These common properties provided evidence for neural correlates between NA-mediated LTP aversive olfactory learning in young rats.

[A preliminary study on the changes of expression of PDGF-beta, PDGFR-beta, TGF-beta 1, TGFR, bFGF and its relationship with the wound age in wound healing]

OBJECTIVE

To explore the relationship between the expression change of cytokines and the wound age during the healing process of rats skin wound.

METHODS

Immunohistochemical and image-analysis methods were performed on vital skin wounds(after incision 0.5-168 h am) and postmortem damage(after incision 0.5-6 h pm).

RESULTS

The expression of the cytokines PDGF-beta, PDGFR-beta, TGF-beta 1, and bFGF in the epithelial cells was already enhanced since 0.5 h am after damage and their strongest expression reaction was seen at 24-96 h am. In addition, the expression of PDGF-beta, PDGFR-beta, TGF-beta 1 and bFGF was also found in the macrophages and the fibroblasts of the granulation tissue, and the expression changes in the postmortem damage group showed that the skin tissue within 0.5-3 h after incision showed immunohistochemical changes but weakly expression and 3 h thereafter no any change was found.

CONCLUSION

The expression characteristics of the above mentioned cytokines in wound repair should be related to the wound age and it reminds therefore that they may be used as immunohistochemical criteria for accurate determining the wound age.

Involvement of complexin II in synaptic plasticity in the CA1 region of the hippocampus: the use of complexin II-lacking mice

An electrophysiological study was performed with mice lacking complexin II, a presynaptic protein. The long-term potentiation (LTP) by high-frequency stimulation, recorded in the hippocampal CA1 area, was decreased in complexin II-lacking mice (CPXII KO mice). The overall postsynaptic currents elicited by low frequency stimulation on the Schaffer collateral/commissural fibers in the hippocampal CA1 pyramidal cells were not different between wild-type and mutant mice. Excitatory postsynaptic currents (EPSCs) recorded in the presence of 50 microM bicuculline and inhibitory postsynaptic currents (IPSCs) recorded in the presence of 50 microM AP-5 (DL-2-amino-5-phosphonopentanoic acid) + 30 microM CNQX (6-cyano-7-nitroquinoxaline-2,3-dione) were also identical between wild-types and mutants. Furthermore, the EPSCs following repetitive stimulation (10 Hz) in CPXII KO mice did not show any difference with wild-types. These findings suggest that complexin II does not play a crucial role in ordinary neural transmission, short-term synaptic plasticity or synaptic transmission during high-frequency repetitive stimulation. Therefore, the protein is thought to be involved in the LTP process following tetanic stimulation, including the induction and/or maintenance of the LTP.

[Enzymehistochemical and immunohistological changes of skeletal muscle motor end-plates and muscle fibers and their relation to the time of death]

In order to investigate the relationship between the retrograde changes of the skeletal muscle and the time of death in various postmortem intervals (PMI), a systemic study of the enzymehistochemical activity of AChE, SDH, LDH, Ca(2+)-ATPase and the immunohistochemical reaction of SYN in motor end-plates and muscle fibers was conducted in rats under different temperatures and at various PMI. The results were analyzed and compared by an image processing system. It was found that these changes were related to the PMI, especially AChE changes. The AChE could be used as a sign-enzyme of skeletal muscle to date death.

Reduced hippocampal LTP in mice lacking a presynaptic protein: complexin II

The SNAP receptor (SNARE) complex is a core complex specialized for synaptic vesicle exocytosis, and the binding of SNAPs to the complex is an essential step for neurotransmitter release. Complexin I and II have been identified as SNARE-complex-associated proteins. Importantly, complexins compete with alpha-SNAP for binding to the complex, suggesting that complexins may modulate neurotransmitter release process. To examine this possibility and to understand the physiological function of complexins, we generated complexin II knockout mice. The complexin-II-deficient mice (-/-) were viable and fertile, and appeared normal. Electrophysiological recordings in the mutant hippocampus showed that ordinary synaptic transmission and paired-pulse facilitation, a form of short-term synaptic plasticity, were normal. However, long-term potentiation (LTP) in both CA1 and CA3 regions was impaired, suggesting that complexin II may not be essential for synaptic vesicle exocytosis, but it does have a role in the establishment of hippocampal LTP.

Forensic pathological expertise of medical tangle analysis of 139 autopsy cases

In this article, we report 139 autopsy cases of medical tangle, which were examined by the Department of Forensic Pathology, Faculty of Medicine, Tongji Medical University from Jan. 1972 to Dec. 1992. The emphasis is put on analyses of the status of medical tangle autopsy in forensic pathology, involved medical departments, distribution of victim's age and sex, differences between clinical diagnosis and autoptical conclusion, the composition and causes of medical tangle. The associated problems in forensic pathological autopsy are also discussed.

Design of intracavitary microwave applicators for the treatment of uterine cervix carcinoma

A 915 MHz intracavitary applicator was designed to heat tumours in the cervical and upper vaginal regions. The applicator has a 3.5-turn helical coil wound around the distal 19 mm of a dielectric rod 43 mm long and 30 mm in diameter. For treating uterine cancer, a 2450 MHz, 4 mm diameter helical applicator was made by replacing 6 cm of the outer conductor of a coaxial cable with six turns of copper wire soldered to the outer conductor. The heating patterns were determined thermographically in a muscle phantom. The maximum heating rates were 0.42 and 0.83 degrees C/W-min, respectively, for the 915 and 2450 MHz applicators. Intracavitary temperature distributions in the upper vagina, cervix and uterus were measured at the surface of the applicators with thermocouples. The average temperature was 46.0 +/- 2.1 degrees C (S.D.) at mid-tumour and 44.5 +/- 0.8 degrees C at the tumour periphery. The maximum temperature, up to 51.5 degrees C, was measured at the surface of the cervical applicator. The majority of the patients (28/30) tolerated the investigational treatment without burns or pain. Rectal temperatures were also monitored. The location of the hot-spot (40.7 degrees C) in the rectum, 5-7 cm above the anus, corresponded to the tip of the cervical applicator (47.1 degrees C).

Poisoning by toxic plants in China. Report of 19 autopsy cases

In this article, we report on 19 autopsy cases in China in which the cause of death was poisoning by toxic plants. The emphasis is on analyses of the target organs or tissues affected by these plants. The mechanism of poisoning and cause of death are approached on the basis of the pathologic changes, and associated problems relating to forensic medicine are discussed.