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Objective To assess the predictive value of serum uric acid levels to the incident nonalcoholic fatty liver disease(NAFLD)in a cohort of healthy population. Methods A prospective cohort study of NAFLD incidence was conducted in Xinjiang province, from 2012 to 2014. A cohort study was performed on 2 207 subjects with no evidence of fatty liver disease by liver ultrasound and with no major risk factors for liver disease at baseline. All participants were interviewed to carry out the epidemiological questionnaire survey, physical examination, abdominal ultrasonography, as well as blood biochemistry measurements. The hazard ratios of NAFLD were compared among groups with different uric acid levels. All subjects were classified according to serum uric acid (within normal range grouped by quartile: Q1-Q4 group; above the normal range: Q5 group). Results NAFLD was newly diagnosed in 13.72% subjects within the 3-year period. The incidence of NAFLD was increased with elevated serum uric acid quartiles(P<0.01). In multivariate logistic regression, after adjustment for gender, age, race, metabolic syndrome and its components, OR for incident fatty liver in Q2 to Q5 of serum uric acid concentration as compared to Q1 were 2.509, 3.172, 3.392, and 4.041 respectively. Conclusion Elevated serum uric acid concentrations may predict NAFLD in the subjects for a regular health checkup.
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Objective To probe into the emergency triage efficiency between emergency rapid triage system (ERTS) and emergency severity classification of 4 level. Methods A total of 46965 emergency patients from January to December in 2015 were selected as the research object and utilized a data of patients from the electronic triage system, and triaged the emergency patients by means of ERTS retrospectively. A comparison was performed in patient visits, outcome and hospital rates between ERTS and emergency severity classification of 4 level. Results In both of these triage systems, almost 80％of patients are assigned to the lowest acuity (levelⅢandⅣ). The visits of patients with gradeⅢand grade IV diseases were 71.5％(33580/46965), 50.5％(23717/46965) in ERTS and 12.1％(5683/46965), 35.1％(16485/46965) in emergency severity classification of 4 level respectively. The outcomes of patient under the ERTS were better than emergency severity classification of 4 level at levelⅠandⅡ(χ2=11.79, 1100.62, P<0.05). At levelⅠandⅡ, ERTS in the patient's disease hospital admission rates were 70.5％(311/441), 72.6％(5274/7264), which higher than emergency severity classification of 4 level, 62.5％(371/594), 45.2％(2785/6161), the difference was statistically significant (χ2=7.32, 1043.13, P<0.05). At level Ⅲ and Ⅳ, ERTS in the patient's disease hospital admission rates were 9.6％(3676/38288), 7.9％(77/972) , which lower than emergency severity classification of 4 level, 19.3％(4578/23719) , 9.9％(1632/16491), the difference was statistically significant (χ2=1153.10, 4.05, P<0.05). Conclusions ERTS significantly improves the sensitivity and accuracy of emergency triage compared to emergency severity classification of 4 level. ERTS has obvious significance in the emergency patient distribution, and also has a certain advantage in the patient outcomes and hospitalization rates. It can be used as a auxiliary tool.
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ObjectiveTo analyze the correlation between serum 25-hydroxyvitamin D level and nonalcoholic fatty liver disease (NAFLD), and to provide a clinical basis for the prevention and treatment of NAFLD. MethodsFrom March to October, 2014, 200 Uyghur patients and 200 Han patients with NAFLD in our hospital were enrolled into NAFLD group, while an equal number of healthy Uyghurs and Hans were used as controls. For all subjects, questionnaire survey, physical examination, abdominal ultrasound examination, and blood biochemical examination were performed, and serum 25-hydroxyvitamin D level was determined using enzyme-linked immunosorbent assay. The relationship between 25-hydroxyvitamin D and NAFLD was analyzed by Spearman correlation analysis and multivariate logistic regression analysis. ResultsSerum 25-hydroxyvitamin D levels in the NAFLD group were significantly lower than those in the control group for both Uyghurs and Hans (P＜0.05), and serum 25-hydroxyvitamin D level was negatively correlated with NAFLD (rHan=-0.212, rUyghur=-0.220, P＜0.01). The results of multivariate logistic regression analysis showed that the rising serum 25-hydroxyvitamin D level was a protective factor for NAFLD (ORHan=0.894, PHan=0.015; ORUyghur=0.897, PUyghur=0.025). ConclusionSerum 25-hydroxyvitamin D level is closely associated with NAFLD in Uyghurs and Hans.