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Xing QQ, Li JM, Chen ZJ, Lin XY, You YY, Hong MZ, Weng S, Pan JS. Global burden of common cancers attributable to metabolic risks from 1990 to 2019. Med (N Y) 2023; 4:168-181.e3. [PMID: 36868237 DOI: 10.1016/j.medj.2023.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/05/2022] [Accepted: 02/07/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is usually accompanied by metabolic syndrome, which is associated with increased risk of cancer. To inform a tailored cancer screen in patients at higher risks, we estimated the global burden of cancer attributable to metabolic risks. METHODS Data of common metabolism-related neoplasms (MRNs) were derived from the Global Burden of Disease (GBD) 2019 database. Age-standardized, disability-adjusted life year (DALY) rates and death rates of patients with MRNs were extracted from the GBD 2019 database and stratified by metabolic risk, sex, age, and level of socio-demographic index (SDI). The annual percentage changes of age-standardized DALYs and death rates were calculated. FINDINGS Metabolic risks, consisting of high body mass index and fasting plasma glucose, contributed substantially to the burden of neoplasms, including colorectal cancer (CRC), tracheal, bronchus, and lung cancer (TBLC), etc. Globally, in 2019, there was an estimated age-standardized DALY rate (ASDR) of 234 (95% confidence interval [CI] 124-376) per 100,000 person years for neoplasms attributable to metabolic risks. ASDRs of MRNs were higher for CRC, TBLC, men, patients aged ≥50 years, and patients with high or high-middle SDI. CONCLUSIONS The findings of this study further underpin the correlation between NAFLD and intrahepatic and extrahepatic cancers and highlight the possibility of tailored cancer screening for the NAFLD population at higher risks. FUNDING This work was supported by the National Natural Science Foundation of China and Natural Science Foundation of Fujian Province of China.
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Affiliation(s)
- Qing-Qing Xing
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian 350005, China; Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - Jing-Mao Li
- Department of Statistics, School of Economics, Xiamen University, Xiamen, Fujian 361000, China
| | - Zhi-Jian Chen
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian 350005, China; Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - Xiao-Yun Lin
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian 350005, China; Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - Yan-Ying You
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian 350005, China; Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - Mei-Zhu Hong
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian 350025, China.
| | - Shangeng Weng
- Hepatopancreatobiliary Surgery Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China.
| | - Jin-Shui Pan
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian 350005, China; Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, Fujian 350005, China.
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Dong X, Zeng DY, Xing QQ, Hong MZ, Pan JS. Liver chemistries in severe or non-severe cases of COVID-19: A systematic review and meta-analysis. World J Hepatol 2022; 14:2012-2024. [PMID: 36618330 PMCID: PMC9813841 DOI: 10.4254/wjh.v14.i12.2012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/21/2022] [Accepted: 12/21/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) patients exhibit different patterns of liver impairment, according to growing evidence.
AIM In this study, we sought to provide a comprehensive analysis of liver test parameters in patients with severe and non-severe COVID-19.
METHODS We performed a meta-analysis of published liver manifestations and described the liver damage in COVID-19. We searched PubMed, Google Scholar, Embase, Cochrane Library, medRxiv, bioRxiv, and three Chinese electronic databases through April 18, 2020, in accordance with the Preferred Reporting Items for Meta-Analyses. We analyzed pooled data on liver chemistries stratified by COVID-19 severity using a fixed or random-effects model.
RESULTS A meta-analysis of 56 studies, including 11052 patients, found that the pooled mean alanine aminotransferase (ALT) in severe COVID-19 cases was 35.9 IU/L whereas in non-severe COVID-19 cases was 27.3 IU/L. Average aspartate aminotransferase (AST) levels were 44.3 IU/L in severe cases compared to 27.9 IU/L in non-severe cases. In addition, AST levels are often higher than ALT levels regardless of disease severity. The severe cases tended to have a higher gamma-glutamyltransferase level but a lower albumin level than the non-severe cases.
CONCLUSION Severe COVID-19 was more likely to be associated with abnormal liver test results. Monitoring liver chemistry closely can help detect disease progression early.
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Affiliation(s)
- Xuan Dong
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Dan-Yi Zeng
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Qing-Qing Xing
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Mei-Zhu Hong
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Jin-Shui Pan
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
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Hong MZ, Qiu R, Chen W, Lin H, Xing QQ, Dong X, Pan JS, Li Q. Different clinical features of children and adults in regional outbreak of Delta COVID-19. BMC Infect Dis 2022; 22:728. [PMID: 36076167 PMCID: PMC9454403 DOI: 10.1186/s12879-022-07707-6] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/22/2022] [Indexed: 01/08/2023] Open
Abstract
Background This study compared clinical features of the Delta variant of coronavirus disease 2019 (COVID-19) in children and adults. Methods Clinical data included 80 children and 132 adults with the Delta variant of COVID-19, hospitalized in the Affiliated Hospital of Putian College between September and October 2021. The data was analyzed retrospectively. Results The proportion of mild patients in the children group (50%) was higher than that in the adults group (17.9%). Cough (25%, 20/80) and diarrhea (1.3%, 1/80) symptoms in children group were significantly less frequent. Compared with adults, there was no significant difference in the viral load of SARS-CoV-2 in samples collected by nasopharyngeal swabs. In children, lymphocyte count was higher [1.98 (0.25–4.25) vs 1.20 (0.29–4.27) ×109/L], whereas the interleukin-6 level was lower [5.87 (1.50–61.40) vs 15.15 (1.79–166.30) pg/mL] than that in adults group. Additionally, the incidence of liver injury in children group was lower than that in adults group. There was no significant difference in the incidence of proteinuria (22/75 vs 45/112) between the two groups, but the serum creatinine level in children was lower [42.0 (28.0–73.0) vs 57.0 (32.0–94.0) µmol/L]. Conclusion Compared with adults, children with the Delta variant of COVID-19 have differences in symptoms, clinical classification, inflammatory indices, and liver/kidney function injury. Children’s illness is relatively mild. Clinicians should pay attention to their differences and use drugs accurately. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07707-6.
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Affiliation(s)
- Mei-Zhu Hong
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, No. 312, Xihong Road, Fuzhou, 350025, Fujian, China
| | - Rongxian Qiu
- Department of Infectious Diseases, Affiliated Hospital of Putian College, Putian, Fujian, China
| | - Wei Chen
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, No. 312, Xihong Road, Fuzhou, 350025, Fujian, China
| | - Hui Lin
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, No. 312, Xihong Road, Fuzhou, 350025, Fujian, China
| | - Qing-Qing Xing
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Fuzhou, 350005, Fujian, China
| | - Xuan Dong
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Fuzhou, 350005, Fujian, China
| | - Jin-Shui Pan
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Fuzhou, 350005, Fujian, China. .,Hepatology Research Institute, Fujian Medical University, No. 20, Chazhong Road, Fujian, 350005, Fuzhou, China.
| | - Qin Li
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, No. 312, Xihong Road, Fuzhou, 350025, Fujian, China.
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Xing QQ, Li JM, Dong X, Zeng DY, Chen ZJ, Lin XY, Pan JS. Socioeconomics and attributable etiology of primary liver cancer, 1990-2019. World J Gastroenterol 2022; 28:2361-2382. [PMID: 35800181 PMCID: PMC9185214 DOI: 10.3748/wjg.v28.i21.2361] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/07/2022] [Accepted: 04/24/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary liver cancer (PLC) is a major contributor to cancer-related deaths. Data on global and country-specific levels and trends of PLC are essential for understanding the effects of this disease and helping policymakers to allocate resources.
AIM To investigate the association between the burden of PLC and socioeconomic development status.
METHODS Cancer mortality and incidence rates were obtained from the Global Burden of Disease (GBD) 2019, and the data were stratified by country and territory, sex, and the Socio-demographic Index (SDI) level. The association between the attributable etiology of PLC and socioeconomic development status, represented using the SDI, was described. The attributable etiology of PLC included hepatitis B, hepatitis C, alcohol use, and nonalcoholic steatohepatitis. The association between the attributable etiology of PLC and SDI was further stratified by sex and geographical location. A confidence analysis was also performed based on bootstrap draw.
RESULTS The age-standardized incidence rate of PLC was 6.5 [95% confidence intervals (CI): 5.9-7.2] per 100000 person-years, which decreased by -27.5% (-37.0 to -16.6) from 1990 to 2019. Several countries located in East Asia, South Asia, West Africa, and North Africa shouldered the heaviest burden of PLC in 2019. In terms of incidence rates, the first leading underlying cause of PLC identified was hepatitis B, followed by hepatitis C, alcohol use, and nonalcoholic steatohepatitis. Regarding stratification using the SDI, the incidence rate of PLC was the highest for high and middle SDI locations. Further, the leading attributable etiologies of PLC were hepatitis B for the middle and high middle SDI locations while hepatitis C and nonalcoholic steatohepatitis for the high SDI locations.
CONCLUSION The pronounced association between socioeconomic development status and PLC burden indicates socioeconomic development status affects attributable etiologies for PLC. GBD 2019 data are valuable for policymakers implementing PLC cost-effective interventions.
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Affiliation(s)
- Qing-Qing Xing
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
- Hepatology Research Institute, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Jing-Mao Li
- Department of Statistics, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Xuan Dong
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
- Hepatology Research Institute, Fujian Medical University, Fuzhou 350005, Fujian Province, China
- School of Medicine, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Dan-Yi Zeng
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
- Hepatology Research Institute, Fujian Medical University, Fuzhou 350005, Fujian Province, China
- School of Medicine, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Zhi-Jian Chen
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
- Hepatology Research Institute, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Xiao-Yun Lin
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
- Hepatology Research Institute, Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Jin-Shui Pan
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
- Hepatology Research Institute, Fujian Medical University, Fuzhou 350005, Fujian Province, China
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Chen WM, Fu M, Zhang CJ, Xing QQ, Zhou F, Lin MJ, Dong X, Huang J, Lin S, Hong MZ, Zheng QZ, Pan JS. Deep Learning-Based Universal Expert-Level Recognizing Pathological Images of Hepatocellular Carcinoma and Beyond. Front Med (Lausanne) 2022; 9:853261. [PMID: 35530044 PMCID: PMC9072864 DOI: 10.3389/fmed.2022.853261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aims We aim to develop a diagnostic tool for pathological-image classification using transfer learning that can be applied to diverse tumor types. Methods Microscopic images of liver tissue with and without hepatocellular carcinoma (HCC) were used to train and validate the classification framework based on a convolutional neural network. To evaluate the universal classification performance of the artificial intelligence (AI) framework, histological images from colorectal tissue and the breast were collected. Images for the training and validation sets were obtained from the Xiamen Hospital of Traditional Chinese Medicine, and those for the test set were collected from Zhongshan Hospital Xiamen University. The accuracy, sensitivity, and specificity values for the proposed framework were reported and compared with those of human image interpretation. Results In the human–machine comparisons, the sensitivity, and specificity for the AI algorithm were 98.0, and 99.0%, whereas for the human experts, the sensitivity ranged between 86.0 and 97.0%, while the specificity ranged between 91.0 and 100%. Based on transfer learning, the accuracies of the AI framework in classifying colorectal carcinoma and breast invasive ductal carcinoma were 96.8 and 96.0%, respectively. Conclusion The performance of the proposed AI framework in classifying histological images with HCC was comparable to the classification performance achieved by human experts, indicating that extending the proposed AI’s application to diagnoses and treatment recommendations is a promising area for future investigation.
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Affiliation(s)
- Wei-Ming Chen
- Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- School of Medicine, Xiamen University, Xiamen, China
| | - Min Fu
- School of Aerospace Engineering, Xiamen University, Xiamen, China
| | - Cheng-Ju Zhang
- Department of Anesthesiology, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Qing-Qing Xing
- Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Fei Zhou
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Meng-Jie Lin
- Department of Pathology, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Xuan Dong
- Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- School of Medicine, Xiamen University, Xiamen, China
| | - Jiaofeng Huang
- Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Su Lin
- Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Mei-Zhu Hong
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
| | - Qi-Zhong Zheng
- Department of Pathology, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China
- *Correspondence: Qi-Zhong Zheng,
| | - Jin-Shui Pan
- Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Jin-Shui Pan,
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Zeng DY, Li JM, Lin S, Dong X, You J, Xing QQ, Ren YD, Chen WM, Cai YY, Fang K, Hong MZ, Zhu Y, Pan JS. Global burden of acute viral hepatitis and its association with socioeconomic development status, 1990-2019. J Hepatol 2021; 75:547-556. [PMID: 33961940 DOI: 10.1016/j.jhep.2021.04.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [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] [Received: 02/03/2021] [Revised: 03/18/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Acute viral hepatitis (AVH) represents an important global health problem; however, the progress in understanding AVH is limited because of the priority of combating persistent HBV and HCV infections. Therefore, an improved understanding of the burden of AVH is required to help design strategies for global intervention. METHODS Data on 4 major AVH types, including acute hepatitis A, B, C, and E, excluding D, were collected by the Global Burden of Disease (GBD) 2019 database. Age-standardized incidence rates and disability-adjusted life year (DALY) rates for AVH were extracted from GBD 2019 and stratified by sex, level of socio-demographic index (SDI), country, and territory. The association between the burden of AVH and socioeconomic development status, as represented by the SDI, was described. RESULTS In 2019, there was an age-standardized incidence rate of 3,615.9 (95% CI 3,360.5-3,888.3) and an age-standardized DALY rate of 58.0 (47.3-70.0) per 100,000 person-years for the 4 major types of AVH. Among the major AVH types, acute hepatitis A caused the heaviest burden. There was a significant downward trend in age-standardized DALY rates caused by major incidences of AVH between 1990 and 2019. In 2019, regions or countries located in West and East Africa exhibited the highest age-standardized incidence rates of the 4 major AVH types. These rates were stratified by SDI: high SDI and high-middle SDI locations recorded the lowest incidence and DALY rates of AVH, whereas the low-middle SDI and low SDI locations showed the highest burden of AVH. CONCLUSIONS The socioeconomic development status and burden of AVH are associated. Therefore, the GBD 2019 data should be used by policymakers to guide cost-effective interventions for AVH. LAY SUMMARY We identified a negative association between socioeconomic development status and the burden of acute viral hepatitis. The lowest burden of acute viral hepatitis was noted for rich countries, whereas the highest burden of acute viral hepatitis was noted for poor countries.
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Affiliation(s)
- Dan-Yi Zeng
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China; School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jing-Mao Li
- Department of Statistics, School of Economics, Xiamen University, Xiamen, Fujian, China
| | - Su Lin
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China
| | - Xuan Dong
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China; School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jia You
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China
| | - Qing-Qing Xing
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China
| | - Yan-Dan Ren
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
| | - Wei-Ming Chen
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yan-Yan Cai
- School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Kuangnan Fang
- Department of Statistics, School of Economics, Xiamen University, Xiamen, Fujian, China
| | - Mei-Zhu Hong
- Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Yueyong Zhu
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China.
| | - Jin-Shui Pan
- Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China.
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