Impact of Food Intake on Liver Stiffness Determined by 2-D Shear Wave Elastography: Prospective Interventional Study in 100 Healthy Patients

The aim was to evaluate the influence of food intake on liver stiffness measurement (LSM), performed with 2-D shear wave elastography (Logiq E9, GE Medical Systems, Wauwatosa, WI, USA). One hundred healthy volunteers were prospectively enrolled. Mean age was 25.8 (19–55) y, and mean body mass index was 22.43 (17.3–30.8) kg/m². Patients fasted for at least 3 h and subsequently ingested a liquid meal of 800 kcal. Liver stiffness and portal vein velocity were measured before and after food intake. Food intake resulted in significantly higher LSM values compared with baseline LSM (5.74 ± 0.94 kPa vs. 4.80 ± 0.94 kPa, p < 0.001). On multiple linear regression analysis, body mass index was significantly positively correlated with the LSM increase after food intake (p?=?0.01). No correlation between the increase in LSM and the increase in post-prandial portal vein velocity was observed (r?=?0.09). In summary, food intake has a significant influence on LSM. There is an 11% risk of misclassifying non-fasting, healthy patients as having significant fibrosis.     

Rotavirus vaccination compliance and completion in a Medicaid infant population

We examined completion and compliance rates of rotavirus (RV) vaccination according to the recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Food and Drug Administration approved Prescribing Information (PI) for Rotarix^® (RV1, GlaxoSmithKline Vaccines) and RotaTeq^® (RV5, Merck and Co.) among infants under one year of age covered by Medicaid programs. Healthcare claims data from state Medicaid programs that constituted the Truven Health MarketScan^® Multi-State Medicaid Database were retrieved from May 2008–June 2012. Infants were grouped under PI and ACIP cohorts based on the dosing regimens followed. The overall compliance per PI (n = 673,956) and ACIP (n = 695,612) recommendations were 24.5% and 28.2%, respectively; completion rates were 30.3% and 32.6%, respectively. In the PI cohort, infants who received RV1 had significantly higher compliance as compared with infants who received RV5 (65.2% vs. 31.3%; p < 0.0001); completion rates among infants receiving RV1 and RV5 were 65.3% and 46.4%, respectively (p < 0.0001). In the ACIP cohort, compliance with RV1 was significantly higher than RV5 (68.8% vs. 45.9%; p < 0.0001) as was the overall completion rate (73.5% vs. 48.8%; p < 0.0001). While compliance is increasing year over year, overall compliance of RV vaccines is suboptimal, with over 40% of eligible infants unvaccinated in both populations. The 2-dose RV vaccine showed better completion rates and higher compliance than the 3-dose RV vaccine in the United States. Public health initiatives focusing on suboptimal compliance and completion rates of RV vaccination in the Medicaid population could improve these metrics, thereby offering protection against RV infection.     

Estimating the herd immunity effect of rotavirus vaccine

IntroductionDiarrhea is one of the leading causes of death in children under 5, and an estimated 39% of these deaths are attributable to rotavirus. Currently two live, oral rotavirus vaccines have been introduced on the market; however, the herd immunity effect associated with rotavirus vaccine has not yet been quantified. The purpose of this meta-analysis was to estimate the herd immunity effects associated with rotavirus vaccines.MethodsWe performed a systematic literature review of articles published between 2008 and 2014 that measured the impact of rotavirus vaccine on severe gastroenteritis (GE) morbidity or mortality. We assessed the quality of published studies using a standard protocol and conducted meta-analyses to estimate the herd immunity effect in children less than one year of age across all years presented in the studies. We conducted these analyses separately for studies reporting a rotavirus-specific GE outcome and those reporting an all-cause GE outcome.ResultsIn studies reporting a rotavirus-specific GE outcome, four of five of which were conducted in the United States, the median herd effect across all study years was 22% [19–25%]. In studies reporting an all-cause GE outcome, all of which were conducted in Latin America, the median herd effect was 24.9% [11–30%].ConclusionsThere is evidence that rotavirus vaccination confers a herd immunity effect in children under one year of age in the United States and Latin American countries. Given the high variability in vaccine efficacy across regions, more studies are needed to better examine herd immunity effects in high mortality regions.     

先天性马蹄内翻足基因学研究进展CSCD

先天性马蹄内翻足(congenital talipes equinovarus,CTEV)是儿童最常见的骨骼肌肉出生缺陷畸形之一,临床特征包括跟骨内翻、前足内收、高弓足和后足跖屈畸形。目前CTEV的发病机制仍不清楚,不同的学说包括:神经细胞损伤、肌肉异常、血管缺陷、子宫内限制、遗传因素、特发性先天性畸形、基因-环境的相互作用、骨骼发育不良、细胞外基质异常、分子转运和代谢异常等。遗传因素对于CTEV的致病起着重要作用,但尚未发现主要的致病基因。普遍认为CTEV是环境因素和遗传因素共同作用的结果。现对CTEV致病基因的研究进展做一综述。     

关爱先行 创新突破——访GE医疗集团生命科学事业部大中华区总经理李庆

<正>GE医疗集团自1979年起在中国开展业务,通过提供革新性的医疗技术和服务,开创了医疗服务的新时代。GE医疗集团在医学成像、信息技术、医疗诊断、患者监护系统、药物研发、生物制药技术、卓越运营和整体运营解决方案等领域拥有广泛的专业技术,能够帮助客户以更低的成本为全世界更多的人提供更优质的服务。如今,中国的生物医药市场正在蓬勃发展,以每年20%以上的速度在增长;另一方面,随着医保的全面     

湖南中部地区高血压人群CYP2D6和β1肾上腺素能受体基因多态性调查

【目的】探讨湖南中部娄底和湘潭地区高血压人群CYP2D6和β1肾上腺素能受体（β1-AR）基因多态性分布。【方法】湖南中部地区高血压患者403名,采用聚合酶链反应（PCR）和聚合酶链反应-限制性片断长度多态性方法（PCR-RFLP）进行CYP2D6和β1-AR基因分型。【结果】403例高血压患者中CYP2D6检测出CYP2D6的＊1、＊2、＊5、＊10四种等位基因,频率由高到低依次为＊10（67.5%）、＊1（17.5%）、＊2（9.2%）、＊5（5.8%）,突变基因型频率最高为CYP2D6＊10＊10（47.4%）。β1-AR 49位Ser和Gly等位基因频率分别为83.9%和16.1%;Ser/Ser、Ser/Gly和Gly/Gly基因型分布频率分别为68.7%、30.3%和1.0%。β1-AR 389位Arg和Gly等位基因频率分别为76.1%和23.9%,Arg/Arg、Gly/Arg和Gly/Gly基因型分布频率为55.3%、41.4%和3.2%。各基因型及等位基因频率在不同性别中分布无差异（均P〉0.05）。【结论】湖南中部地区高血压人群CYP2D6和β1-AR基因多态性分布符合Hardy-Weinberg遗传平衡,其中CYP2D6＊10和β1-AR 389位基因突变率最高,可能成为影响β受体阻滞剂降压疗效的显著因素之一。     

膀胱移行细胞癌多药耐药基因与p53基因表达的临床研究

【目的】探讨膀胱癌中多药耐药基因（MDR1）与p53基因表达的临床意义。【方法】采用免疫组化（SABC）法对32例膀胱移行细胞癌中MDR1表达产物P—GP与p53基因产物p53蛋白进行了检测。【结果】32例膀胱移行细胞癌中P—GP、p53阳性率分别为41．0％和47．0％,且随膀胱癌的病理分级和临床分期而增高。T2～T4期同Tis～T1期相比,MDR1及p53的表达均差异有显著性。【结论】临床检测MDR1及p53可对膀胱癌患者提供更多的预后信息。