Association of Cognitive Impairment With Chronic Viral Hepatitis Among Older Adults in Taiwan.

OBJECTIVE: To evaluate the risk of cognitive impairment among patients with chronic viral hepatitis. DESIGN: A cross-sectional study. SETTING: Population-based. PARTICIPANTS: Individuals 60 years or older were enrolled from the Taiwan Biobank database from 2012. EXPOSURE: Hepatitis B virus and hepatitis C virus infections. MEASUREMENT: Cognitive impairment was evaluated using the mini-mental state examination (MMSE). Logistic regression models were used to calculate odds ratios and 95% confidence intervals (CIs). The effects of APOE ε4 polymorphisms on the association between viral hepatitis and the risk of cognitive impairment were also investigated. RESULTS: We recruited 912 participants with cognitive impairment and 22 869 participants without cognitive impairment. The adjusted odds ratio (aOR) for cognitive impairment was 1.38 (95% CI: 1.03-1.85, p = 0.033) among participants with hepatitis C virus infection and 1.14 (95% CI: 0.91-1.43, p = 0.257) among participants with hepatitis B virus infection. Participants with hepatitis C virus infection and without hepatitis B virus infection had a higher risk of cognitive impairment (aOR: 1.52, 95% CI: 1.13-2.04, p = 0.006). The MMSE subcategories most associated with hepatitis C virus infection were orientation and design copying. The association between hepatitis C virus infection and cognitive impairment was higher among participants with ε4 alleles of the APOE gene than among those without alleles (aOR: 2.18, 95% CI: 1.21-3.91, p = 0.009). CONCLUSIONS: Our findings suggest that individuals 60 years or older with chronic hepatitis C virus infection are at increased risk of cognitive impairment.

Risk Prediction Models for Patients with Head and Neck Cancer among the Taiwanese Population.

Epidemiological evidence has suggested that modifiable lifestyle factors play a significant role in the risk of head and neck cancer (HNC). However, few studies have established risk prediction models of HNC based on sex and tumor subsites. Therefore, we predicted HNC risk by creating a risk prediction model based on sex- and tumor subsites for the general Taiwanese population. This study adopted a case-control study design, including 2961 patients with HNC and 11,462 healthy controls. Multivariate logistic regression and nomograms were used to establish HNC risk prediction models, which were internally validated using bootstrap sampling. The multivariate logistic regression model indicated that age, education level, alcohol consumption, cigarette smoking, passive smoking, coffee consumption, and body mass index are common HNC predictors in both sexes, while the father's ethnicity, betel-nut-chewing habits, and tea consumption were male-specific HNC predictors. The risk factors of the prediction model for the HNC tumor subsite among men were the same as those for all patients with HNC. Additionally, the risks of alcohol consumption, cigarette smoking, and betel nut chewing varied, based on the tumor subsite. A c-index ranging from 0.93 to 0.98 indicated that all prediction models had excellent predictive ability. We developed several HNC risk prediction models that may be useful in health promotion programs.

Clinical Efficacy of Modified Fangji Huangqitang on Early Renal Damage with Qi Deficiency and Dampness Obstruction Syndrome in Hypertension / 中国实验方剂学杂志

Objective:To observe the efficacy of modified Fangji Huangqitang on early renal damage in hypertension (Qi deficiency and dampness obstruction syndrome) and its effect in resisting inflammation and protecting vascular endothelium. Method:One hundred and forty-four patients were randomly divided into control group and observation group by random number table. Patients in control group got losartan potassium tablets, 50 mg/time, 1 time/day, and nifedipine controlled-release tablets, 30 mg/time, 1 time/day. In addition to the therapy of control group, patients in observation group were alsog given modified Fangji Huangqitang, 1 dose/day. The qualification rate of blood pressure was recorded for every week, and ambulatory blood pressure was detected before and after treatment. Standard deviation of systolic blood pressure for 24 h (24 hSSD), standard deviation of diastolic pressure for 24 h (24 hDSD), mean systolic blood pressure for 24 h (24 hSBP), average diastolic pressure for 24 h (24 hDBP) were recorded, and dynamic pulse pressure index (PPI), dynamic arteriosclerosis index (AASI), and ratio of UmALB and creatinine (CR) were calculated, levels of beta 2 microglobulin (β2-MG), urinary N-acetyl-beta-glucosaminidase (NAG), serum cystatin C (CysC), urinary microalbumin (UmALB), interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nitric oxide (NO), endothelin-1 (ET-1) were detected, and symptoms and signs were scored. Result:During the 12-week observation period, the qualification rate of blood pressure in observation group was 89.09%, which was higher than 81.52%in control group (χ2=18.776, Pβ2-MG, CysC, NAG, UmALB, UACR, IL-6, IL-1β, TNF-α and ET-1 were lower than those in control group (PPZ=2.146, PConclusion:In addition of the western medicine therapy, modified Fangji Huangqitang can be added to control blood pressure level, improve blood pressure compliance rate, reduce blood pressure variability, protect renal function, prevent and relieve clinical symptoms, improve the clinical efficacy, inhibit inflammatory reaction and improve endothelial function.