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Jia JD, Niu JQ, You H, Kong YY, Hou JL. [A 2020 update on the progress of treatment and new drug clinical trials for hepatitis B]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:97-101. [PMID: 33685074 DOI: 10.3760/cma.j.cn501113-20210201-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Long term antiviral therapy with nucleos(ti)ide analogues could suppress HBV viral load thereby prevent the progression to cirrhosis and hepatocellular carcinoma. Interferon-based therapy could result in sustained virological response in a fair proportion of patients and even HBsAg loss in a small proportion of them. Novel therapies aiming at functional cure (loss of HBsAg) are under active development. Among the categories of many, HBV core protein inhibitors are safe and could suppress the HBV DNA and HBV RNA, but only with modest effect on the level of HBsAg; silencing of HBV mRNA by siRNA or antisense oligonucleotides could produce meaningful and sustainable declining in HBsAg levels; immune modulators with different mode of action showed modest effect on the reduction of HBsAg, but with noticeable adverse event (especially transaminase flares) related to the mode of action. Novel clinical trial design on the combination or sequential use of innovative molecules will ultimately lead to the functional cure of CHB in the near future.
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Affiliation(s)
- J D Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing 100050, China
| | - J Q Niu
- Department of Hepatology & Phase I Clinical Research Center, The First Hospital of Jilin University, Changchun 130021, China
| | - H You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing 100050, China
| | - Y Y Kong
- Clinical Epidemiology & EBM Unit, National Clinical Research Center for Digestive Diseases; Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - J L Hou
- Clinical Epidemiology & EBM Unit, National Clinical Research Center for Digestive Diseases; Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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2
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Niu JQ, Zhang H, You H, Ding YH, Dong RH, Hou JL, Jia JD. [Clinical considerations in the design of clinical trial for innovative hepatitis B drugs]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:654-657. [PMID: 32911902 DOI: 10.3760/cma.j.cn501113-20200722-00412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The research and development of chronic hepatitis B (CHB) therapeutic drugs has been undergoing rapid development in recent years in order to achieve the World Health Organization's goal of eliminating viral hepatitis as a major public health threat by 2030. The focus of early stage clinical trials (including the first human trial) is the selection of subjects, study design, dose selection, administration method, dose escalation, monitoring, observation and reporting procedures for adverse events/reactions (tolerability evaluation), and criteria for subjects to continue and discontinue administration. Therefore, quantitative pharmacology knowledge is required to analyze the relationship between in vivo drug exposure, efficacy and adverse reactions, and the inclusion of exploratory indicators such as HBV RNA, hepatitis B virus core-related antigen (HBcrAg), etc., to analyze the mechanism and target of innovative drugs and the efficacy of cccDNA in anti-hepatocytes. On the other hand, Phase II-III clinical trials prioritize the optimal dose, efficacy and safety indicators to verify the efficacy and safety of new drugs in a wider range of subjects. This paper refers to the relevant domestic and foreign literature, combined with the author's practical experience in early clinical research, and then briefly introduces the clinical issues that should be paid attention to in the design of clinical trials of CHB innovative drugs.
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Affiliation(s)
- J Q Niu
- Department of Hepatobiliary Pancreatic Medicine & Phase I Drug Clinical Trial Ward, The First Hospital of Jilin University, Changchun 130021, China
| | - H Zhang
- Department of Hepatobiliary Pancreatic Medicine & Phase I Drug Clinical Trial Ward, The First Hospital of Jilin University, Changchun 130021, China
| | - H You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Diseases; Beijing 100050, China
| | - Y H Ding
- Department of Hepatobiliary Pancreatic Medicine & Phase I Drug Clinical Trial Ward, The First Hospital of Jilin University, Changchun 130021, China
| | - R H Dong
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Diseases; Beijing 100050, China
| | - J L Hou
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J D Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Diseases; Beijing 100050, China
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3
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Liu YW, Xu HQ, Zhou Q, Niu JQ. [Effect of aspirin on hepatocellular carcinoma and its related mechanism]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:799-802. [PMID: 33053982 DOI: 10.3760/cma.j.cn501113-20190929-00360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aspirin, as a traditional non-steroidal anti-inflammatory drug, has therapeutic and preventive effects on gastrointestinal tumors. Hepatocellular carcinoma is one of the most common malignant tumors in the digestive tract, so it is necessary to find effective preventive and therapeutic measures. This article reviews the research progress and mechanism of aspirin on hepatocellular carcinoma with a view to provide references for future clinical treatment.
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Affiliation(s)
- Y W Liu
- Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, China
| | - H Q Xu
- Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, China
| | - Q Zhou
- Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, China
| | - J Q Niu
- Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, China
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4
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Li J, Yao PT, Niu JQ, Sun X, Ren JS, Chen HD, Li X, Wei LP, Lyu ZY, Feng XS, Chen WQ, Li N, Dai M. [Systematic review of the methodology quality and reporting quality in colorectal cancer screening guidelines]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:398-404. [PMID: 30982275 DOI: 10.3760/cma.j.issn.0253-9624.2019.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To systematically review the quality and reporting quality of colorectal cancer screening guidelines, and to provide reference for the update of colorectal cancer screening guidelines and colorectal cancer screening in China. Methods: "Colorectal cancer", "colorectal tumor", "screening", "screening", "guide", "consensus", "Colorectal cancer", "Colorectal neoplasms", "Screening", "Early Detection of Cancer", "Guideline" and "recommendation" were used as search keywords. The literature retrieval for all the Chinese and English guidelines published before April 2018 was conducted by using PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBMdisc), Cochrane Library, Guideline International Network, China Guidelines Clearinghouse (CGC) and the official website of the US Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), International Agency for Research on Cancer (IARC), Australia Cancer Council (ACC) and Association of Coloproctology of Great Britain & Ireland (ACPGBI). The inclusion criteria were independent guidance documents for colorectal cancer screening. The language is limited to Chinese and English. The exclusion criteria were literature on interpretation, evaluation, introduction, etc., as well as the translated version of the guide and old guides. The quality and reporting norms of colorectal cancer screening guidelines were compared and evaluated using the European Guideline Research and Assessment Tool (AGREE Ⅱ) and the Practice Guideline Reporting Standard (RIGHT). Results: A total of 15 guides were included. The results of the AGREE Ⅱ quality evaluation showed that the overall quality of 15 guides was high. Among them, there were 9 guides with an overall score of 50 or more, 10 with a recommendation level of "A", and 2 with a rating of "B". There were 3 guides for "C"; each guide scores higher in scope and purpose, and clarity, and scores vary greatly in the areas of participants, rigor, applicability, and independence. The results of the RIGHT evaluation showed that 15 guides were insufficient in six areas except for background information, evidence, recommendations, reviews and quality assurance, funding and conflict of interest statements and management, and other aspects. Conclusion: The overall quality of included guidelines for colorectal cancer screening is high, but the normative nature needs to be strengthened.
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Affiliation(s)
- J Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - P T Yao
- School of Health Management and Education, Capital Medical University, Beijing 100069, China
| | - J Q Niu
- Hospital Lanzhou University, Lanzhou 730000, China
| | - X Sun
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - J S Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - H D Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - X Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - L P Wei
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z Y Lyu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - X S Feng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - W Q Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - N Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medial Sciences and Peking Union Medical College, Beijing 100021, China
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5
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Wang XM, Niu JQ. [New serological markers as a monitoring indicator for clinical cure of chronic hepatitis B]. Zhonghua Gan Zang Bing Za Zhi 2019; 26:565-567. [PMID: 30317786 DOI: 10.3760/cma.j.issn.1007-3418.2018.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The elimination of hepatitis B virus is not straightforward in chronic hepatitis B patients. A prolonged treatment and chance of recurrence after stopping the drug is a matter of concern for majority of specialists and patients. The traditional monitoring indicators and new serological markers for strengthening the determination of standard antiviral treatment of hepatitis B virus (HBV) has an important meaning towards clinical treatment and treatment protocol guiding regulations.
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Affiliation(s)
- X M Wang
- Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, China
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6
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Hou FQ, Yin YL, Zeng LY, Shang J, Gong GZ, Pan C, Zhang MX, Yin CB, Xie Q, Peng YZ, Chen SJ, Mao Q, Chen YP, Mao QG, Zhang DZ, Han T, Wang MR, Zhao W, Liu JJ, Han Y, Zhao LF, Luo GH, Zhang JM, Peng J, Tan DM, Li ZW, Tang H, Wang H, Zhang YX, Li J, Zhang LL, Chen L, Jia JD, Chen CW, Zhen Z, Li BS, Niu JQ, Meng QH, Yuan H, Sun YT, Li SC, Sheng JF, Cheng J, Sun L, Wang GQ. [Clinical effect and safety of pegylated interferon-α-2b injection (Y shape, 40 kD) in treatment of HBeAg-positive chronic hepatitis B patients]. Zhonghua Gan Zang Bing Za Zhi 2019; 25:589-596. [PMID: 29056008 DOI: 10.3760/cma.j.issn.1007-3418.2017.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion: In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.
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Affiliation(s)
- F Q Hou
- Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing 100034, China
| | - Y L Yin
- Xiamen Amoytop Biotech Co., Ltd, Xiamen 361028, China
| | - L Y Zeng
- Xiamen Amoytop Biotech Co., Ltd, Xiamen 361028, China
| | - J Shang
- Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - G Z Gong
- The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - C Pan
- Fuzhou Infectious Disease Hospital, Fuzhou 350025, China
| | - M X Zhang
- The Sixth People's Hospital of Shenyang, Shenyang 110006, China
| | - C B Yin
- Guangzhou Eighth People's Hospital, Guangzhou 510060, China
| | - Q Xie
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Y Z Peng
- Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - S J Chen
- Jinan Infectious Disease Hospital, Jinan 250021, China
| | - Q Mao
- Southeast Hospital, Third Military Medical University, Chongqing 400038, China
| | - Y P Chen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Q G Mao
- Xiamen Hospital of T.C.M, Xiamen 361001, China
| | - D Z Zhang
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - T Han
- Tianjin Third Central Hospital, Tianjin 300170, China
| | - M R Wang
- 81th Hospital of People's Liberation Army, Nanjing 210002, China
| | - W Zhao
- The Second Affiliated Hospital of the Southeast University, Nanjing 210003, China
| | - J J Liu
- The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Y Han
- Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - L F Zhao
- The First Affiliated Hospital of Shanxi University, Taiyuan 030001, China
| | - G H Luo
- The First Affiliated Hospital of Guangxi Medical Universtiy, Nanning 530021, China
| | - J M Zhang
- Huashan Hospital, Shanghai 200040, China
| | - J Peng
- Nangfang Hospital, Southern Medical University, Guangzhou 510510, China
| | - D M Tan
- Xiangya Hospital Central South University, Changsha 410008, China
| | - Z W Li
- Shengjing Hospital of China Medical University, Shenyang 110022, China
| | - H Tang
- West China Hospital, Sichuan University, Chengdu 610041, China
| | - H Wang
- Peking University People's Hospital, Beijing 100044, China
| | - Y X Zhang
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - J Li
- Jiangsu Provincial People's Hospital, Nanjing 210029, China
| | - L L Zhang
- The First Affiliated Hospital of Nanchang University, Nanchang 360102, China
| | - L Chen
- Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - J D Jia
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - C W Chen
- 85th Hospital of People's Liberation Army, Shanghai 200052, China
| | - Z Zhen
- The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 050051, China
| | - B S Li
- 302 Military Hospital of China, Beijing 100039, China
| | - J Q Niu
- The First Bethune Hospital of Jilin University, Chanchun 130062, China
| | - Q H Meng
- Beijing Youan Hospital, Captial Medical University, Beijing 100069, China
| | - H Yuan
- The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Y T Sun
- Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - S C Li
- The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - J F Sheng
- The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China
| | - J Cheng
- Beijing Ditan Hospital Capital Medical University, Beijing 100015, China
| | - L Sun
- Xiamen Amoytop Biotech Co., Ltd, Xiamen 361028, China
| | - G Q Wang
- Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing 100034, China
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Liu X, Gao YH, Niu JQ. [Hepatitis C-related hepatocellular carcinoma and the treatment with direct-acting antiviral agents]. Zhonghua Gan Zang Bing Za Zhi 2019; 25:944-947. [PMID: 29325299 DOI: 10.3760/cma.j.issn.1007-3418.2017.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
With the wide use of direct-acting antiviral agents (DAAs), more and more patients with chronic hepatitis C achieve sustained virological response; however, no consensus has been reached on the application of DAAs in the treatment of hepatitis C virus-related hepatocellular carcinoma (HCC). This article summarizes and evaluates related issues in this field, including whether antiviral therapy with DAAs in patients with hepatitis C can increase the incidence or recurrence rate of HCC, as well as whether DAAs can be used for hepatitis C in HCC patients after antitumor treatment and the efficacy of DAAs in such patients.
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Affiliation(s)
- X Liu
- Department of Hepatology, First Hospital of Jilin University, Changchun 130021, China
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8
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Zhang XC, Li YM, Li JY, Kang XD, He XY, Niu JQ, Wen XY, Liu ZN. [HBV genotyping based on key epitopes of PreS1 antigen and its correlation with genotyping by full-length PreS1 sequencing]. Zhonghua Gan Zang Bing Za Zhi 2018; 26:371-376. [PMID: 29996206 DOI: 10.3760/cma.j.issn.1007-3418.2018.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: The aim was to investigate the genotype distribution of two major epitopes of large surface protein (PreS1) of hepatitis B in Chinese patients and to explore the association between the genotypes of these two epitopes, and to determine whether PreS1 full-length genotype could be revealed according to the polypeptide sequence of key epitopes. Methods: HBV DNA was extracted from the serum of patients for PCR amplification. 278 samples amplified successfully were sequenced and compared with the known HBV sequences in Genbank to determine the two key epitopes of HBV PreS1 genotype (amino acid epitope 21-47 and 94-117, abbreviated as P21 and P94) and PreS1 full-length genotypes. The correlation among three genotyping approaches was analyzed by Cohen's kappa coefficient to verify the consistency between the key-epitope genotyping and the full-length preS1 genotyping. Results: 232 samples were successfully sequenced. The genotyping based on the kind of P21 epitope protein sequence, 201 cases for genotype C, 23 cases for genotype B and 8 cases for uncertain genotypes and genotyping based on the form of P94 epitope protein sequence, 199 cases for genotype C, 25 cases for genotype B and 8 cases for indeterminate genotypes. Lastly, the genotyping based on sequence of the full-length PreS1 sequence, 207 and 25 cases for genotype C and B. P21 or P94 epitope genotyping and PreS1 full length genotyping were highly consistent, respectively, 96.55% and 96.12%, and the two epitopes (P21and P94) genotyping have parallel consistency (93.10%). Conclusion: In this study, an innovatively genotyping method based on the amino acid sequence of key epitopes was proposed. The genotypes of HBV in china were mainly B and C genotypes, and the genotypes of key conserved epitopes of HBV PreS1 were highly consistent with the full-length genotyping ( > 96%). Moreover, genotyping with one or two key epitopes can be used in place of the full-length genotyping.
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Affiliation(s)
- X C Zhang
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun 130000, China
| | - Y M Li
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun 130000, China
| | - J Y Li
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun 130000, China
| | - X D Kang
- the First Hospital of Jilin University, Changchun 130000, China
| | - X Y He
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun 130000, China
| | - J Q Niu
- the First Hospital of Jilin University, Changchun 130000, China
| | - X Y Wen
- the First Hospital of Jilin University, Changchun 130000, China
| | - Z N Liu
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun 130000, China
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Nie L, Wang XC, Niu JQ, Shang J, Han Y, Xin GJ, Jia G, Li JL, Ding GW, Liu ZF. [Analysis of related factors for primary hepatic carcinoma caused by chronic hepatitis B and hepatitis C]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 51:546-550. [PMID: 28592101 DOI: 10.3760/cma.j.issn.0253-9624.2017.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the related factors for primary hepatic carcinoma (PHC) caused by chronic hepatitis B (CHB) and hepatitis C (CHC). Methods: According to the principle of cross-sectional study, a cluster random sample method was used, a total of 366 chronic hepatitis patients in hospitals were recruited from three provincial tertiary hospitals in Shanxi, Henan and Jilin between July 2016 and October 2016, respectively. Using a self-designed unified questionnaire, face-to-face interviews was conducted on subjects, including sex, age, alcohol consumption, coffee consumption, green tea consumption, fish consumption, smoking, HBV/HCV diagnosis and treatment, diabetes mellitus, family history of PHC (whether PHC in first-degree relatives), etc. Multivariate unconditional logistic regression were performed to identify the related factors for PHC with CHB and CHC. According to the clinical diagnosis the patients were divided into a chronic hepatitis group (not developing to PHC) and a PHC group. Results: Among 366 cases patients, 287 (78.4%) cases were male, 79 cases were female (21.6%), average age was (52.7±9.3) years. 202 cases were chronic hepatitis group, 164 cases were PHC group. Multivariate unconditional logistics regression analysis indicated that alcohol consumption (odds ratio (OR)=2.11, 95%CI: 1.18-3.75), family history of PHC (OR=5.12, 95%CI: 2.60-10.08) were positively correlated with the development of PHC in chronic b, green tea consumption (OR=0.45, 95%CI: 0.23-0.88), antiviral treatment (OR=0.19, 95%CI: 0.11-0.32) were negatively correlated. Alcohol consumption (OR=3.98, 95%CI: 1.14-13.85) was positively correlated with the development of PHC in chronic c, antiviral treatment (OR=0.14, 95%CI: 0.04-0.50) was negatively correlated. Conclusion: Alcohol consumption, family history of PHC, green tea consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis b. Alcohol consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis c.
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Affiliation(s)
- L Nie
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing 102206, China
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Feng B, Shang J, Wu SH, Chen H, Han Y, Li YQ, Zhang DZ, Zhao LF, Wei SF, Mao Q, Yin CB, Han T, Wang MR, Chen SJ, Li J, Xie Q, Zhen Z, Gao ZL, Zhang YX, Gong GZ, Yang DL, Pan C, Sheng JF, Tang H, Ning Q, Shi GF, Niu JQ, Luo GH, Sun YT, You H, Wang GQ, Zhang LL, Peng J, Zhang Q, Liu JJ, Chen CW, Chen XY, Zhao W, Wang RH, Sun L, Wei L. [Efficacy and safety of pegylated interferon α-2b injection (Y shape, 40 kD) in treatment of patients with genotype 1/6 chronic hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2017; 25:187-194. [PMID: 28482405 DOI: 10.3760/cma.j.issn.1007-3418.2017.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion: In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.
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Affiliation(s)
- B Feng
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
| | - J Shang
- Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - S H Wu
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Lanzhou University, Lanzhou 730000, China
| | - Y Han
- Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Y Q Li
- Department of Infectious Diseases, 302 Military Hospital, Beijing 100039, China
| | - D Z Zhang
- Department of Infectious Diseases, Institute for Viral Hepatitis, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - L F Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Shanxi University, Taiyuan 030001, China
| | - S F Wei
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Q Mao
- Department of Infectious Disease, Southeast Hospital, Third Military Medical University, Chongqing 400038, China
| | - C B Yin
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou 510060, China
| | - T Han
- Department of Hepatology, Tianjin Third Central Hospital, Tianjin Medical University, Tianjin 300170, China
| | - M R Wang
- Institute of Liver Disease, Nanjing 81 Hospital, Nanjing 210002, China
| | - S J Chen
- Department of Hepatology, Jinan Infectious Disease Hospital, Jinan 250021, China
| | - J Li
- Department of Infectious Diseases, Jiangsu Provincial People's Hospital, Nanjing 210029, China
| | - Q Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Z Zhen
- Department of Infectious Diseases, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 050051, China
| | - Z L Gao
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y X Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Xinjiang Medical University, Wulumuqi 830054, China
| | - G Z Gong
- Department of Infectious Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - D L Yang
- Department of Infectious Disease, Institute of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - C Pan
- Department of Hepatology, Fuzhou Infectious Disease Hospital, Fuzhou, 350025, China
| | - J F Sheng
- The First Affiliated Hospital of Zhengjiang University, Hangzhou 310003, China
| | - H Tang
- Department of Infectious Diseases, Sichuan University West China Hospital, Chengdu 610041, China
| | - Q Ning
- Department of Infectious Disease, Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - G F Shi
- Department of Infectious Diseases, Huashan Hospital, Shanghai 200040, China
| | - J Q Niu
- Department of Infectious Diseases, The First Affiliated Hospital of Jilin University, Changchun 130062, China
| | - G H Luo
- Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical Universtiy, Nanning 530021, China
| | - Y T Sun
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - H You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - G Q Wang
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - L L Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang 360102, China
| | - J Peng
- Department of Infectious Diseases, Nangfang Hospital, Southern Medical University, Guangzhou 510510, China
| | - Q Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - J J Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - C W Chen
- Nanjing Military Command Liver Disease Research Center, Shanghai 200000, China
| | - X Y Chen
- Hepatology Department, Youan Hospital, Capital Medical University, Beijing 100069, China
| | - W Zhao
- Department of Hepatology, The Second Affiliated Hospital of the Southeast University, Nanjing 210003, China
| | - R H Wang
- Xiamen Amoytop Biotech Co., Ltd, Xiamen, 361022, China
| | - L Sun
- Xiamen Amoytop Biotech Co., Ltd, Xiamen, 361022, China
| | - L Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
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11
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Ren H, Chen CW, Niu JQ. [Working together to promote the development of hepatology in China]. Zhonghua Gan Zang Bing Za Zhi 2016; 24:2. [PMID: 26983382 DOI: 10.3760/cma.j.issn.1007-3418.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- H Ren
- Editorial Board of the Chinese Journal of Hepatology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - C W Chen
- Publishing House of Chinese Hepatology, Shanghai 200235, China
| | - J Q Niu
- Editorial Board of the Journal of Clinical Hepatology, Jilin University, Changchun 130061, China
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12
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Hou JL, Gao ZL, Xie Q, Zhang JM, Sheng JF, Cheng J, Chen CW, Mao Q, Zhao W, Ren H, Tan DM, Niu JQ, Chen SJ, Pan C, Tang H, Wang H, Mao YM, Jia JD, Ning Q, Xu M, Wu SM, Li J, Zhang XX, Ji Y, Dong J, Li J. Tenofovir disoproxil fumarate vs adefovir dipivoxil in Chinese patients with chronic hepatitis B after 48 weeks: a randomized controlled trial. J Viral Hepat 2015; 22:85-93. [PMID: 25243325 DOI: 10.1111/jvh.12313] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Tenofovir disoproxil fumarate (TDF) has demonstrated long-term efficacy and a high barrier to resistance in multiple chronic hepatitis B (CHB) populations outside of China. This study aimed to evaluate the efficacy and safety of TDF compared with adefovir dipivoxil (ADV) in Chinese patients with CHB during 48 weeks of treatment (ClinicalTrial.gov number, NCT01300234). A Phase 3, multicentred, randomized, double-blind, controlled trial compared the efficacy and safety of TDF with ADV in Chinese patients with CHB. The primary endpoint was the proportion of patients with HBV DNA <400 copies/mL in each treatment group at Week 48, using an unpooled Z-test for superiority. Secondary endpoints included viral suppression, serologic response, histological improvement, normalization of alanine aminotransferase (ALT) levels and the emergence of resistance mutations. A total of 509 patients, 202 hepatitis B e antigen (HBeAg)-positive and 307 HBeAg-negative, with HBV DNA ≥10(5) copies/mL received either TDF 300 mg od or ADV 10 mg od. At Week 48, TDF demonstrated superior viral suppression compared with ADV in both HBeAg-positive (76.7% vs 18.2%, P < 0.0001) and HBeAg-negative (96.8% vs 71.2%, P < 0.0001) patients. The majority of patients in both treatment arms achieved ALT normalization (>85%). No resistance to TDF was observed. The frequency of adverse events was comparable between treatment arms (TDF 3.9% vs ADV 4.8%). In this double-blind, randomized, clinical trial, TDF demonstrated superiority over ADV with respect to viral suppression in Chinese patients with CHB at 48 weeks of treatment and without the development of resistance.
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Affiliation(s)
- J L Hou
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Guangzhou, China
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13
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Deng YR, Yoshida K, Jin QL, Murata M, Yamaguchi T, Tsuneyama K, Moritoki Y, Niu JQ, Matsuzaki K, Lian ZX. Reversible phospho-Smad3 signalling between tumour suppression and fibrocarcinogenesis in chronic hepatitis B infection. Clin Exp Immunol 2014; 176:102-11. [PMID: 24372395 DOI: 10.1111/cei.12259] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2013] [Indexed: 12/24/2022] Open
Abstract
Transforming growth factor (TGF)-β, type I receptor (TβRI) and c-Jun N-terminal kinases (JNK) phosphorylate Smad3 differentially to create 2 isoforms phosphorylated (p) at the COOH-terminus (C) or at the linker region (L) and regulate hepatocytic fibrocarcinogenesis. This study aimed to compare the differences between how hepatitis B virus (HBV) infection affected hepatocytic Smad3 phosphorylated isoforms before and after anti-viral therapy. To clarify the relationship between Smad3 phosphorylation and liver disease progression, we studied 10 random patients in each stage of HBV-related fibrotic liver disease (F1-4) and also 10 patients with HBV-associated HCC. To examine changes in phosphorylated Smad3 signalling before and after anti-HBV therapies, we chose 27 patients with chronic hepatitis B who underwent baseline and follow-up biopsies at 52 weeks from the start of nucleoside analogue treatments (Lamivudine 100 mg daily or Telbivudine 600 mg daily). Fibrosis stage, inflammatory activity and phosphorylated Smad3 positivity in the paired biopsy samples were compared. Hepatocytic pSmad3C signalling shifted to fibrocarcinogenic pSmad3L signalling as the livers progressed from chronic hepatitis B infection to HCC. After nucleoside analogue treatment, serum alanine aminotransferase (ALT) and HBV-DNA levels in 27 patients with HBV-related chronic liver diseases were decreased dramatically. Decrease in HBV-DNA restored pSmad3C signalling in hepatocytes, while eliminating prior fibrocarcinogenic pSmad3L signalling. Oral nucleoside analogue therapies can suppress fibrosis and reduce HCC incidence by successfully reversing phosphorylated Smad3 signalling; even liver disease progressed to cirrhosis in chronic hepatitis B patients.
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Affiliation(s)
- Y-R Deng
- Liver Immunology Laboratory, Institute of Immunology and School of Life Sciences, University of Science and Technology of China, Hefei, China; Intensive Care Unit, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
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14
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Wei Q, Sun J, Liu YL, Liu XX, Niu JQ, Shi XD. Epidemiology of hypertension and associated with risk factors in rural areas in Changchun of China. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht311.5958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Shi XD, He SM, Tao YC, Wang CY, Jiang YF, Feng XW, Sun J, Niu JQ. Prevalence of obesity and associated risk factors in Northeastern China. Diabetes Res Clin Pract 2011; 91:389-94. [PMID: 21130515 DOI: 10.1016/j.diabres.2010.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 09/25/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022]
Abstract
AIM To investigate the prevalence of obesity and associated risk factors in the Northeastern Chinese city of Dehui. METHODS A cross-sectional study involving random sampling methods generated 3598 completed questionnaires by permanent residents of Dehui. Binary multivariate logistic regression analysis was used to identify factors that were significantly associated with obesity. RESULTS Based on the 2000 WHO diagnostic criterion regarding populations in the Asia-Pacific region, the prevalence of obesity was 37.71% (34.77% of females; 41.11% of males). Elevated body mass index (BMI) was significantly associated with cardiovascular disease (CVD)-associated conditions (P<0.05), and increased prevalence of abnormally high transaminase levels (P<0.05). Binary logistic regression analysis demonstrated the following variables were associated with obesity: increased age (odds ratio [OR]: 1.01, 95% confidence interval [CI]: 1.0-1.02), high total cholesterol (TC) (OR: 1.26, 95% CI: 1.03-1.54), high triglycerides (TG) (OR: 1.38, 95% CI: 1.16-1.64), hypertension (OR: 1.62, 95% CI: 1.39-1.90), fatty liver (OR: 2.91, 95% CI: 2.41-3.49), living in an urban setting (OR: 2.84, 95% CI: 2.39-3.38), and advanced education (OR: 1.22, 95% CI: 1.06-1.40). CONCLUSIONS Obesity is prevalent among the adult population in Northeastern China and is significantly associated with CVD risk factors such as hypertension, dyslipidemia, as well as transaminase abnormalities.
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Affiliation(s)
- X D Shi
- Department of Hepatology, First Hospital, Jilin University, Changchun, Jilin, China
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16
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Wang W, Kong J, Sun J, Wang CY, Chen HY, Jiang YF, Feng XW, He SM, Niu JQ. Epidemiological Investigation of Metabolic Syndrome and Analysis of Relevant Factors in North-Eastern China. J Int Med Res 2010; 38:150-9. [PMID: 20233524 DOI: 10.1177/147323001003800117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This epidemiological study was conducted to investigate the prevalence of metabolic syndrome and associated risk factors in Chinese subjects from Dehui in northeastern China. Using a random sampling method, a questionnaire was completed by 3785 permanent residents aged 18-72 years and relevant clinical data were collected from each subject. Binary multivariate logistic regression analysis was used to identify factors that were significantly associated with metabolic syndrome. Based on the International Diabetes Federation definition, the prevalence of metabolic syndrome was 22.4%, which is higher than that of the general Chinese population. Metabolic syndrome occurred more frequently in females and the prevalence gradually increased with age. Living in an urban setting and being female, > 50 years old, overweight, having total cholesterol ≥ 5.18 mmol/l, low-density lipoprotein cholesterol ≥ 3.1 mmol/l, and a fatty liver were significant risk factors associated with metabolic syndrome.
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Affiliation(s)
- W Wang
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - J Kong
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - J Sun
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - CY Wang
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - HY Chen
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - YF Jiang
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - XW Feng
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - SM He
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
| | - JQ Niu
- Department of Internal Medicine, The First Hospital of Jilin University, Changchun, Jilin, China
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17
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Niu JQ. [Adverse drug reaction of dextran-40: analysis of 57 cases]. Zhonghua Wai Ke Za Zhi 1991; 29:599-601, 652. [PMID: 1726147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Dextran-40 has long been used as a potential anticoagulant in hand surgery. From 1982 to 1989, it was given to 148 cases undergoing hand surgery. 57 of them developed adverse drug reaction due neither to overdose nor inappropriate use. Clinical manifestations and varieties of these reactions were verified. According to the standards issued by WHO, the reactions in these 57 cases were classified as having Grade I 9 cases, Grade II 26 cases; and other reactions 22 cases. The factors inducing reaction and the characteristics of the clinical manifestations were discussed. In spite of adverse reactions, Dextran-40 is still an effective anticoagulant widely used in the field of hand surgery. But it should be used with care.
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Affiliation(s)
- J Q Niu
- Beijing Ji Shui Tan Hospital
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18
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Zhan MY, Liu CB, Li CM, Zhang WY, Zhu C, Pang QF, Zhao TX, Wang CA, Wang JL, Yu CY, Li SF, Tong ZG, Lin ZH, Niu JQ. [A preliminary study of hepatitis A virus in Chinese tupaia (author's transl)]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 1981; 3:148-52. [PMID: 6274524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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