Outbreak of Mycoplasma pneumoniae at a military academy

In 2019,an outbreak of Mycoplasma pneumoniae (M.pneumoniae) occurred at a military academy in China.The attack rate (10.08％,60/595) was significantly different among the units.High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M.pneumoniae.In-time prevention and control measures effectively controlled the spread of the epidemic.     

Quantification of circulating miR-125b-5p predicts survival in chronic hepatitis B patients with acute-on-chronic liver failure

Aims

To analyze the role of serum miR-125b-5p in reflecting liver damage and predicting outcomes in chronic hepatitis B (CHB) patients with acute-on-chronic liver failure (ACLF).

Histological Changes in Chinese Chronic Hepatitis B Patients with ALT Lower Than Two Times Upper Limits of Normal

The role of ALT as a predictor of liver injury has been questioned. The aim of this study is to use liver biopsy to assess the degree of liver injury in patients with chronic hepatitis B(CHB) whose ALT < 2 × upper limit of normal (ULN). A total of 49.2% of patients in this study had significant inflammation (grade ≥2) and 36.4% had significant fibrosis (stage ≥2). The frequency of serious inflammation and fibrosis was similar in patients with different ALT levels. The level of serum HBV DNA was not significantly associated with the extent of inflammation and fibrosis. Advanced age was a significant independent predictor of histological damage and the presence of more significant inflammation and fibrosis. We conclude that many CHB patients with ALT < 2 × ULN have significant liver inflammation or fibrosis and that liver biopsy is necessary to assess liver damage and should be used to assess the need for anti-viral therapy.     

Establishment of cell lines using a doxycycline-inducible gene expression system to regulate expression of hepatitis B virus X protein

The hepatitis B virus (HBV) X gene plays an important role in HBV-associated pathogenesis, especially hepatocarcinogenesis. Establishment of a stable and regulable HBx expression system will allow study of the function of this gene. Here, we describe the development of a doxycycline-inducible recombinant plasmid (pBPSTR3-FlagX) with the full-length HBV X gene and all components of the tetracycline-on (“Tet-on”) gene expression system. This vector exhibited dose-dependent doxycycline-dependent induction of the Flag-HBx protein in HepG2 and Hep3B cells. We also observed dose-dependent doxycycline transactivation of HBx in HepG2 cells. After transfecting HepG2 cells with the pBPSTR3-FlagX plasmid, we isolated five puromycin-resistant cell clones with stable HBx expression, two of which exhibited stable and tight control of HBx expression by doxycycline. This new system has great potential for functional studies of the HBV X gene.     

Prospective evaluation of FibroScan for the diagnosis of hepatic fibrosis compared with liver biopsy/AST platelet ratio index and FIB-4 in patients with chronic HBV infection

Background  

The FibroScan (FS), the aspartate aminotransferase-to-platelet ratio index (APRI), and the FIB-4 index are simple and inexpensive methods to detect liver fibrosis.     

Chinese guidelines on management of hepatic encephalopathy in cirrhosis

The Chinese Society of Hepatology developed the current guidelines on the management of hepatic encephalopathy in cirrhosis based on the published evidence and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of hepatic encephalopathy(HE) including minimal hepatic encephalopathy(MHE) and overt hepatic encephalopathy, emphasizing the importance on screening MHE in patients with end-stage liver diseases. The guidelines emphasized that early identification and timely treatment are the key to improve the prognosis of HE. The principles of treatment include prompt removal of the cause, recovery of acute neuropsychiatric abnormalities to baseline status, primary prevention, and secondary prevention as soon as possible.     

Changes in the spectrum of gastric polyps in the Chinese population

AIM: To evaluate the change in spectrum of gastric polyps in the Chinese population in the past ten years.METHODS: A total of 157902 consecutive patients undergoing esophagogastroduodenoscopy(EGD) from 2004 to 2013 in a tertiary hospital were retrospectively reviewed using an EGD database.Endoscopic records of 4043 patients diagnosed with gastric polyps were recalled for analysis.Data including demographics,information on polyps such as location,pathological diagnosis,reflux esophagitis and Helicobacter pylori infection were obtained.We focused on epithelial polyps,especially hyperplastic polyps,fundic gland polyps and adenomas,and histological classification of specimens from biopsy and endoscopic polypectomy was performed by professional pathologists,based on the updated guidelines.To explore the age distribution of gastric polyps over time,we divided patients with polyps into four groups: A(aged 30 years),B(aged 30-44 years),C(aged 45-59 years) and D(aged 60 years).Differences in localization,age,and sex distribution of gastric polyps were analyzed by statistical software.RESULTS: A total of 157902 EGD procedures were performed in ten years at our digestive endoscopy center,of which 4043 cases were diagnosed with gastric polyps confirmed by pathology.There were 2574(63%) female and 1469(37%) male patients with an average age of 54.7 years.The overall prevalence of gastric polyps was 2.6%(4043/157902).Our database demonstrated a rising prevalence of gastric polyps over the decade,increasing from 1.0%(80/8025) to 4.70%(828/17787) between 2004 and 2013.There has been a change in the spectrum of gastric polyps with the frequencies of FGPs increasing from 19%(15/80) to 77%(638/828) and hyperplastic polyps decreasing from 65%(52/80) to 15%(123/828).Moreover,data on 1921 polyps in 828 patients diagnosed with gastric polyps in 2013 showed that FGP was the most common type in the current polyp spectrum,making up 81.3%(1562/1921).Location and age distribution of gastric polyps have also altered.The prevalence of polyps located in the antrum decreased from 37.5%(30/80) to 9.30%(77/828),with an increasing prevalence of polyps in the corpus,from 45%(36/80) to 64.25%(532/828).The constituent ratio of older patients(aged 60 years) in the polyp population decreased from 62.5%(50/80) to 32.13%(266/828),while that of patients aged 45-60 years showed an increased trend.CONCLUSION: There was a shift change in the spectrum of gastric polyps in the Chinese population with altered location and age distribution in the past ten years.     

Esophageal variceal pressure influence on the effect of ligation

AIM: To explore the effect of in vitro porcine esophageal variceal pressure on complete ligation degree for polycyclic ligators. METHODS: An in vitro model of experimental porcine venous vessels was used to test various venous pressures. Three treatment groups were designated according to the preset pressure range: P1 = 25-30 cm H2O; P2 = 35-40 cm H2O; P3 = 45-50 cm H2 O. The effect of pressure on ligation was assessed and compared among the groups. RESULTS: Complete ligation was achieved at a rate of 56.25%(18/32) in group P1, 37.5%(12/32) in group P2, and 33.33%(11/33) in group P3(χ2 = 3.6126; P = 0.0573). CONCLUSION: Higher variceal pressures impair the ligation completion rate. Therefore, measuring variceal pressure may help predict the effect of endoscopic ligation and guide treatment choice.