Prevalence and risk factors of Helicobacter pylori infection in Qinghai Province / 中华消化杂志

Objective:To investigate the prevalence and the risk factors of Helicobacter pylori( H. pylori) infection in Qinghai Province with a multi-center cross-sectional study. Methods:From May to December in 2021, stratified sampling was conducted in Xining City, Haidong agricultural district, Hainan Tibetan Autonomous Prefecture, Haibei Tibetan Autonomous Prefecture and Yushu Tibetan Autonomous Prefecture by 20 centers, including the Affiliated Hospital of Qinghai University, Qinghai Red Cross Hospital and Qinghai Renji Hospital, etc. A questionnaire survey was carried out among the individuals undergoing routine health checkups. The questionnaire included general information, lifestyle and family history, etc. 13C-urea breath test was performed to diagnose H. pylori infection. Chi-square test, trend Chi-square test, segmentation method and multivariate logistic regression analysis were performed for statistical analysis. Results:The infection rate of H. pylori in Qinghai area was 53.6% (2 531/4 724). The age distribution of infection was statistically significant ( χ2=15.95, P=0.007), the infection rate in individuals aged 15 to<30 was higher than that of individuals aged 60 to< 75 (57.6%, 626/1 086 vs.49.5%, 231/467), and the difference was statistically significant ( χ2=8.83, P=0.003). With the increase of age, the infection rate decreased in female over 30 years old ( χ2trend=5.89, P=0.015). There were statistically significant differences in H. pylori infection rate among different ethnic groups ( χ2=28.13, P<0.001); the infection rate of Tibetan population was higher than that of Han population (62.9%, 313/498 vs. 51.5%, 1 804/3 503), and the difference was statistically significant ( χ2=22.56, P<0.001). The H. pylori infection rate in people living at an altitude >3 500 m was higher than that of people living at an altitude between 1 500 m and 3 500 m (61.8%, 327/529 vs. 52.5%, 2 204/4 195), and the difference was statistically significant ( χ2=16.25, P<0.001). Compared with those without corresponding habits, the infection rate of H. pylori was higher in smokers (62.1%, 1 081/1 740 vs. 48.6%, 1 450/2 984), in people who had the habit of eating hand grabbed mutton (55.4%, 967/1 744 vs. 52.5%, 1 564/2 980), raw garlic (55.5%, 968/1 744 vs. 52.4%, 1 563/2 980), spicy food (55.6%, 1 471/2 647 vs. 51.0%, 1 060/2 077), sweet food (55.2%, 1 187/2 149 vs. 52.2%, 1 344/2 575), the infection rate of tea drinkers was lower (50.5%, 1 135/2 247 vs. 56.4%, 1 396/2 477), and the differences were statistically significant ( χ2=80.94, 3.89, 9.63, 4.36, 4.13 and 16.19, all P<0.05). The results of logistic regression analysis indicated that Tibetan ( OR=1.379, 95% confidence interval (95% CI) 1.120 to 1.699), the Hui people ( OR=1.362, 95% CI 1.117 to 1.662), living at an altitude over 3 500 m ( OR=1.355, 95% CI 1.107 to 1.657), smoking ( OR=1.847, 95% CI 1.629 to 2.094), and spicy food ( OR=1.224, 95% CI 1.084 to 1.382) were independent risk factors of H. pylori infection (all P<0.05). Conclusions:The infection rate of H. pylori in Qinghai Province is higher than the average level in inland China. The infection rate of people with different ages, nationalities, altitudes of residence, occupations, living and eating habits were different. The infection rate of female over 30 years old is decreasing year by year. The infection risk is high in Hui people and Tibetan, spicy food lovers, smokers and people living at an altitude >3 500 m.

Clinical significance of the determination of fecal short-chain fatty acids in patients with nonalcoholic fatty liver disease / 临床肝胆病杂志

Objective To investigate the association of the metabolism of intestinal short-chain fatty acids (SCFAs) with the development and progression of the disease spectrum of nonalcoholic fatty liver disease (NAFLD) by determining the content of fecal SCFAs in patients with different NAFLD diseases and the change in the content of fecal SCFAs after treatment in patients at a high risk of nonalcoholic steatohepatitis (NASH). Methods A total of 90 patients who were diagnosed with NAFLD in The Affiliated Hospital of Qinghai University from July 2020 to July 2021 were enrolled and divided into simple nonalcoholic fatty liver (NAFL) group with 30 patients, NASH group with 30 patients, and nonalcoholic fatty liver fibrosis group with 30 patients, and 40 individuals who underwent physical examination during the same period of time were enrolled as control group. Related case data and fecal SCFAs content were collected for the four groups, and related clinical indices and fecal SCFAs content were collected for 10 patients at a high risk of NASH after 3 months of intervention. The analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the paired samples t -test was used for comparison within each group; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the paired samples Wilcoxon signed rank sum test was used for comparison within each group; a Spearman correlation analysis was used to investigate the correlation between variables; the receiver operating characteristic (ROC) curve analysis was used for diagnostic evaluation. Results Compared with the control group, the nonalcoholic fatty liver fibrosis group had significantly higher contents of valeric acid and caproic acid, and the NAFL group had significantly lower contents of valeric acid and caproic acid (all P < 0.05); the nonalcoholic fatty liver fibrosis group had significantly higher contents of valeric acid and caproic acid than the NAFL group ( P < 0.05); the nonalcoholic fatty liver fibrosis group had a significantly higher content of valeric acid than the NASH group ( P < 0.05); the NASH group had a significantly higher content of caproic acid than the NAFL group ( P < 0.05). After treatment, the high-risk patients in the NASH group had significant reductions in HbA1c, fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), total bile acid (TBA), prothrombin time (PT), uric acid (UA), controlled attenuation parameter (CAP), and liver stiffness measurement (LSM) ( Z =-2.805, -2.703, -2.193, -2.599, -2.805, -2.701, -2.803, -1.988, -2.807, -2.803, -2.803, and -2.668, all P < 0.05); for these patients, the contents of acetic acid and propionic acid after treatment were significantly higher than those before treatment ( Z =-2.803 and -2.803, both P < 0.05), and the content of isobutyric acid after treatment was significantly lower than that before treatment ( Z =-2.803, P < 0.05). In the diagnosis of nonalcoholic fatty liver fibrosis, valeric acid had an area under the ROC curve (AUC) of 0.842, with a sensitivity of 86.7% and a specificity of 70% at the optimal cut-off value of 141.42 μg/g; caproic acid had an AUC of 0.819, with a sensitivity of 70% and a specificity of 85% at the optimal cut-off value of 6.93 μg/g. Conclusion Valeric acid and caproic acid may promote the development of NAFLD disease spectrum. Acetic acid and propionic acid may have a certain protective effect on the liver of NAFLD patients, and isobutyric acid may promote the development and progression of NASH. The protective effect of acetic acid and propionic acid on the liver may further lead to the reductions in HbA1c, FPG, TG, TC, ALT, AST, GGT, TBA, PT, UA, CAP, and LSM. Valeric acid and caproic acid have an inferior diagnostic value to PIIIP N-P and a superior diagnostic value to type IV collagen and hyaluronic acid. Valeric acid with the optimal cut-off value of 141.42 μg/g and caproic acid with the optimal cut-off value of 6.93 μg/g can be used as the auxiliary diagnostic indicators for the early diagnosis of nonalcoholic fatty liver fibrosis.

Association of visfatin with thyroid dysfunction in patients with nonalcoholic fatty liver disease / 临床肝胆病杂志

Recent studies have found that visfatin is involved in lipid metabolism in patients with nonalcoholic fatty liver disease (NAFLD), and about 25% of NAFLD patients have thyroid dysfunction. It has also been found that visfatin is involved in autoimmune regulation through the autocrine or paracrine pathways, which is associated with the involvement of the thyroid gland in autoimmune regulation of the body. This article preliminarily explores the association of visfatin with thyroid dysfunction in NAFLD patients and points out that the measurement of visfatin may help with the early identification of thyroid dysfunction in NAFLD patients.

Serum levels of adiponectin and ferritin and their clinical significance in patients with nonalcoholic fatty liver in Qinghai, China / 临床肝胆病杂志

ObjectiveTo investigate the changes in the levels of serum adiponectin (APN) and serum ferritin (SF) in patients with nonalcoholic fatty liver (NAFL) and normal populations in Qinghai, China, as well as the significance of APN and SF in the pathogenesis of NAFL. MethodsA total of 39 patients diagnosed with NAFL in The Affiliated Hospital of Qinghai University from February to October, 2015 were enrolled as NAFL group, and 34 healthy individuals who underwent physical examination were enrolled as control group. The anthropometric parameters and routine clinical biochemical parameters were measured and enzyme-linked immunosorbent assay and chemiluminescence immunoassay were used to measure the levels of serum APN and SF. The independent-samples t test was used for comparison between two groups, and the Pearson correlation analysis was also performed. ResultsCompared with the control group, the NAFL group had a significantly higher level of SF (291.97±38.82 ng/ml vs 93.21±8.74 ng/ml, t=31.085, P＜0.001) and a significantly lower serum level of APN (11.91±2.88 mg/L vs 16.18±2.80 mg/L, t=6.383, P＜0.001). The correlation analysis showed that in the NAFL group, serum APN level was negatively correlated with TG level (r=-0.466, P＜0.01). ConclusionThe patients with NAFL in Qinghai have a reduced serum APN level and an increased SF level, and in these patients, serum APN level is negatively correlated with TG level. Serum APN monitoring may be used as a reference index to evaluate the treatment outcome of hypertriglyceridemia.

Humoral Immunological State in Children with Recurrent Respiratory Infections / 西安交通大学学报(医学版)

60 cases with a history of recurrent respiratory infections were studied The serum levels of immunoglobulin G and A were measured by means of radial diffusion and the results were compared with 41 normal subjectsof the same age. In 23 cases (38. 3%), serum IgA level was below meanvalue-SD. It was remarkably decreased in 8 patients with prolonged pneu-monia(P≤0.05). The serum IgG concentration was elevated above mean va-lue + SD in 14 patients, 8 of whom suffered from bronchitis. There was,furthermore, another group of 7 patients with bronchitis whose IgA levelwas elevated above mean value + SD. The results suggested that deficiencyof serum IgA might be a cause of recurrent respiratory infections andmight give rise to a prolonged course of pneumonia in some patients.

CLINICAL ANALYSIS OF 150 CASES OF SCLEREMA NEONATORUM / 西安交通大学学报(医学版)

This paper analyses 150 cases of sclerema neonatorum admitted during the period 1956 to 1980. The results showed that the prognosis of sclerema neonatorum related to the sclerotic degree and infection, and that the mortality was higher in severe cases and cases with infection. The therapeutic effect of combined modality therapy was more significant. Pulmonary haemorrhage was the important cause of death and its clinical manifestations in the early stage were similar to those of acute left heart failure.