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Risk factors and metabolic abnormality of patients with non-alcoholic fatty liver disease: either non-obese or obese Chinese population

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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 45-48页

作者： Shou-Wu Lee Teng-Yu Lee Sheng-Shun Yang Chun-Fang Tung Hong-zen.Yeh Chi-sen Chang Division of Gastroenterology Department of Internal Medicine Taichung Veterans General Hospital

Background: Non-alcoholic fatty liver disease(NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese ***: Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver(normal or NAFLD), and body mass index(BMI) levels(non-obese if BMI < 25 kg/m~2 or obese if BMI ≥ 25 kg/m~2).Results: There were 745, 208, 770 and 285 patients enrolled in four groups labeled non-obese normal liver(group A), non-obese NAFLD(group B), obese normal liver(group C) and obese NAFLD(group D),respectively. The highest ratio of metabolic syndrome existed in the group B(26.9%), followed by group A(11.7%), group D(10.9%) and finally the group C(5.2%). The positive association with NAFLD in non-obese individuals was significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02) and glucose(OR = 1.02; 95% CI:1.01–1.03), while the positive association with NAFLD in obese subjects was only significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02). The positive association was most significant in all cases(adjusted OR = 2.41; 95% CI: 1.78–3.24), especially in non-obese individuals(OR = 2.81; 95% CI: 1.92–4.12).Conclusions: Non-obese NAFLD subjects displayed a higher proportion of metabolic abnormality. Hyperlipidemia and hyperglycemia had the most positive strength association with NAFLD.

关键词： Fatty liver Non-alcoholic fatty liver disease Obese Chinese population

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The association of non-alcoholic fatty liver disease and metabolic syndrome in a Chinese population

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Hepatobiliary & Pancreatic Diseases International 2017年第2期16卷 176-180页

作者： Shou-Wu Lee Teng-Yu Lee Sheng-Shun Yang Yen-Chun Peng Hong-zen.Yeh Chi-sen Chang Division of Gastroenterology Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan China

BACKGROUND： Non-alcoholic fatty liver disease（NAFLD） is associated with features of metabolic syndrome. The aim of this study was to investigate the association between NAFLD and metabolic syndrome in a Chinese population. METHODS： Data from subjects were retrospectively collected from 2006 to 2009. The exclusion criteria included significant consumption of alcohol and chronic hepatitis B and C. The patients were assigned to two groups according to ultrasound findings： normal group and fatty liver group. The liver function of patients was determined by assessing serum alanine aminotransferase（ALT）. Metabolic syndrome was diagnosed based on the 2005 International Diabetes Federation criteria. RESULTS： A total of 7568 subjects were enrolled and 5736（75.8%） and 1832（24.2%） patients were assigned to the normal and fatty liver groups, respectively. The fatty liver group had significant male predominance（69.7% vs 56.0%）, higher body mass index（mean, 26.67 vs 23.55 kg/m^2） compared with the normal group. There were 441（7.7%） and 377（20.6%） cases with metabolic syndrome in the normal and fatty liver groups, respectively, with significant difference（P=0.001）, and the subgroup of 385 cases with fatty liver and elevated ALT had higher prevalence（28.8%） of metabolic syndrome. The strongest association of an individual component of metabolic syndrome with NAFLD was hyperlipidemia（adjusted OR=2.55, 95% CI： 2.22-2.94）.CONCLUSION： The individuals with NAFLD had a higher ratio of metabolic syndrome. Hyperlipidemia had the strongest positive association with NAFLD.

关键词： fatty liver hyperlipidemia metabolic syndrome

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Relationship between use of selective serotonin reuptake inhibitors and irritable bowel syndrome: A populationbased cohort study

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World Journal of Gastroenterology 2017年第19期23卷 3513-3521页

作者： Wan-Tzu Lin Yi-Jun Liao Yen-Chun Peng Chung-Hsin Chang Ching-Heng Lin Hong-zen.Yeh Chi-sen Chang Division of Gastroenterology and Hepatology Department of Internal MedicineTaichung Veterans General Hospital Division of Gastroenterology and Hepatology Department of Internal MedicinePuli Branch of Taichung Veterans General Hospital Faculty of Medicine College of MedicineNational Yang-Ming University Taichung Veteran General Hospital

AIM To investigate the relationship between selective serotonin reuptake inhibitor(SSRI)use and the subsequent development of irritable bowel syndrome(IBS).METHODS This retrospective,observational,population-based cohort study collected data from Taiwan’s National Health Insurance Research Database.A total of 19653patients newly using SSRIs and 78612 patients not using SSRIs,matched by age and sex at a ratio of 1:4, were enrolled in the study from January 1,2000 to December 31,*** patients were followed until IBS diagnosis,withdrawal from the National Health Insurance system,or the end of *** analyzed the effects of SSRIs on the risk of subsequent IBS using Cox proportional hazards regression *** A total of 236 patients in the SSRI cohort(incidence,2.17/1000 person-years)and 478 patients in the comparison cohort(incidence,1.04/1000 person-years)received a new diagnosis of *** mean follow-up period from SSRI exposure to IBS diagnosis was *** incidence of IBS increased with advancing *** with anxiety disorders had a significantly increased adjusted hazard ratio(a HR)of IBS(a HR=1.33,95%CI:1.11-1.59,P=0.002).After adjusting for sex,age,urbanization,family income,area of residence,occupation,the use of anti-psychotics and other comorbidities,the overall a HR in the SSRI cohort compared with that in the comparison cohort was1.74(95%CI:1.44-2.10;P<0.001).The cumulative incidence of IBS was higher in the SSRI cohort than in the non-SSRI cohort(log-rank test,P<0.001).CONCLUSION SSRI users show an increased risk of subsequent diagnosis of IBS in Taiwan.

关键词： Brain-gut axis Irritable bowel syndrome Selective serotonin reuptake inhibitor

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Etiologies of Dyspepsia among a Chinese Population: One Hospital-Based Study

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Open Journal of Gastroenterology 2014年第6期4卷 249-254页

作者： Shou-Wu Lee Han-Chung Lien Teng-Yu Lee Sheng-Shun Yang Hong-zen.Yeh Chi-sen Chang Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei

Background and Methods: Dyspepsia refers to a collection of upper gastrointestinal symptoms, and the causes may be either organic or functional. The aim of this study was to investigate the etiologies of dyspepsia among a Chinese population in Taiwan. Patients who underwent upper endoscopy for symptoms of dyspepsia were retrospectively analyzed between January and December 2008. Exclusion criteria included cirrhosis with varices, heart-burn sensation as the main symptom, gastrointestinal bleeding, hepatobiliary abnormalities, prior gastric surgery, and use of anti-acid medication for more than 2 months. Patients were classified according to the findings of upper endoscopy. Results: Data from the medical records of 2062 patients were collected and retrospectively analyzed. Normal endoscopic findings, gastritis, gastric ulcers, duodenal ulcers, reflux esophagitis and esophageal or gastric malignancy accounted for 1174 (56.9%), 215 (10.4%), 254 (12.3%), 194 (9.4%), 182 (8.8%) and 43 (2.1%) cases, respectively. The overall ratio of H. pylori infection was 28.4%. The ratio was the highest in duodenal ulcers and the lowest in reflux esophagitis. A significantly higher ratio of patients with gastric ulcers had a history of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) usage. Conclusion: Patients with organic dyspepsia, compared to those with functional dyspepsia, were older, male, and had a higher H. pylori infection ratio, a positive relationship with aspirin or NSAIDs usage, and more risk factors. These findings demonstrate that upper endoscopy has a high diagnostic yield in patients in this group.

关键词： Duodenal Ulcer Dyspepsia Gastric Ulcer Gastritis Malignancy

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The impact of intravenous cefazolin to the outcomes of cirrhotic patients with esophageal varices bleeding

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Open Journal of Gastroenterology 2013年第3期3卷 190-195页

作者： Shou-Wu Lee Teng-Yu Lee Sheng-Shun Yang Chung-Wang Ko Hong-zen.Yeh Chi-sen Chang Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Chung Shan Medical University Taichung Chinese Taipei Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Chung Shan Medical University Taichung Chinese Taipei Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Yang-Ming University School of Medicine Taipei Chinese Taipei

Background and Method: Prophylatic antibiotics in cirrhotic patients with acute esophageal varices (EV) bleeding has been shown to increase survival and decrease the rate of bacterial infections and recurrent bleeding. This study aimed to compare the outcome of intravenous cefazolin, a first-generation cephalosporin, in the cirrhotic patients with EV bleeding. 92 consecutive cirrhotic patients with EV bleeding but without evidence of infection were retrospectively analyzed from December 2006 to February 2009, and 50 with cefazolin prophylaxis and 42 without antibiotic prophylaxis were enrolled in the antibiotic prophylaxis group and control group respectively. The outcomes were compared between both groups. Results: The incidence of infection was significantly lesser in the antibiotic prophylaxis group than that of the control group (6% vs. 33.3%, P prophylaxis group when compared with control group (6.6 vs. 7.8 days). Conclusion: Intravenous cefazolin can effectively reduce the rate of infection in cirrhotic patients with acute EV bleeding, but cannot significant benefit for preventing recurrent EV bleeding and mortality within 10 days after initial bleeding.

关键词： Cirrhosis Esophageal Variceal Hemorrhage Mortality Rebleeding

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Transarterial embolization of metastatic mediastinal hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第22期19卷 3512-3516页

作者： Chia-Chang Chen Hong-zen.Yeh Chi-sen Chang ChungWang Ko Han-Chung Lien Chun-Ying Wu Siu-Wan Hung Department of Gastroenterology and Hepatology Taichung Veterans General Hospital Department of Radiology Taichung Veterans General Hospital

This paper introduces an innovative treatment for extrahepatic metastasis of hepatocellular carcinoma. A 71-yearold patient had a stable liver condition following treatment for hepatocellular carcinoma, but later developed symptomatic mediastinal metastasis. This rapidly growing mediastinal mass induced symptoms including cough and hoarseness. Serial sessions of transarterial embolization (TAE) successfully controlled this mediastinal mass with limited side effects. The patient's survival time since the initial diagnosis of the mediastinal hepatocellular carcinoma was 32 mo, significantly longer than the 12 mo mean survival period of patients with similar diagnoses: metastatic hepatocellular carcinoma and a liver condition with a Child-Pugh class A score. Currently, oral sorafenib is the treatment of choice for metastatic hepatocellular carcinoma. Recentstudies indicate that locoregional treatment of extrahepatic metastasis of hepatocellular carcinomas might also significantly improve the prognosis in patients with their primary hepatic lesions under control. Many effective locoregional therapies for extrahepatic metastasis, including radiation and surgical resection, may provide palliative effects for hepatocellular carcinoma-associated mediastinal metastasis. This case report demonstrates that TAE of metastatic mediastinal hepatocellular carcinoma provided this patient with tumor control and increased survival time. This finding is important as it can potentially provide an alternative treatment option for patients with similar symptoms and diagnoses.

关键词： Embolization Hepatocellular carcinoma Lymphatic metastasis Endosonography Mediastinal neoplasm

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胆源性胰腺炎内镜治疗的现状和进展

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中国内镜杂志 2007年第9期13卷 936-939页

作者：史学森郝慧菁侯培珍内蒙古包头市第四医院消化内科内蒙古包头014030 内蒙古科技大学医学院内蒙古包头014010 内蒙古包头医学院第一附属医院消化内科内蒙古包头014010

急性胆源性胰腺炎(ABP)约占急性胰腺炎的15%～50%。目前对于内镜介入治疗ABP的作用较为肯定,即内镜逆行性胆胰管造影(ERCP)在ABP的病因诊断中仍具有其他方法不可替代的作用,而相应的介入治疗可清除胆管结石,恢复胆流,减少胆汁胰管反流,... 详细信息

急性胆源性胰腺炎(ABP)约占急性胰腺炎的15%～50%。目前对于内镜介入治疗ABP的作用较为肯定,即内镜逆行性胆胰管造影(ERCP)在ABP的病因诊断中仍具有其他方法不可替代的作用,而相应的介入治疗可清除胆管结石,恢复胆流,减少胆汁胰管反流,从而使病情迅速缓解并可以减少复发,改善总体预后,疗效明显优于传统常规治疗。尽管在内镜介入治疗的时机及指征上仍存在一定争议,但多数学者倾向于早期ERCP及内镜治疗,从而阻断急性胰腺炎的病理过程,同时也减少有关并发症的发生。

关键词：胆源性胰腺炎急性胰腺炎内镜治疗

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水生动物和大鼠线粒体的呼吸链比较

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动物学报 1998年第2期44卷 219-225页

作者：肖燕刘树森曾陇梅古练权中山大学化学系中国科学院动物研究所生物膜与膜生物工程国家重点实验室

用陆生哺乳动物线粒体呼吸链与水生动物线粒体呼吸链相比较的研究方法，探讨了呼吸链的功能与环境相适应的关系。研究了淡水中生活的草鱼肝线粒体，观察到琥珀酸脱氢酶的活性非常低，而ＮＡＤＨ脱氢酶和泛醌细胞色素Ｃ还原酶的活性较高... 详细信息

用陆生哺乳动物线粒体呼吸链与水生动物线粒体呼吸链相比较的研究方法，探讨了呼吸链的功能与环境相适应的关系。研究了淡水中生活的草鱼肝线粒体，观察到琥珀酸脱氢酶的活性非常低，而ＮＡＤＨ脱氢酶和泛醌细胞色素Ｃ还原酶的活性较高。但海洋生物海绵的线粒体ＮＡＤＨ脱氢酶和琥珀酸脱氢酶的活性都非常低。陆生动物线粒体呼吸链的特异性抑制剂霉素Ａ，鱼藤酮和氰化钾对水生动物线粒体也有抑制作用，只是抑制率明显降低。通过与陆生哺乳动物大鼠的肝线粒体呼吸链对比，讨论了呼吸链电子传递酶系的和酶活性与环境相适应的关系。

关键词：草鱼海绵大鼠线粒体呼吸链

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静电和疏水效应对SARS冠状病毒3CL蛋白酶二聚体稳定性的影响

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高等学校化学学报 2005年第1期26卷 55-60页

作者：郑柯文俞庆森蒋勇军马国正赵文娜曾敏浙江大学化学系杭州310027 浙江大学宁波理工学院

从 TGEV 3 CL蛋白酶二聚体结构出发 ,研究了 TGEV 3 CL蛋白酶二聚体单体之间的静电和疏水相互作用 .蛋白质的静电相互作用通过有限差分方法求解 Poisson-Boltzmann方程得到 ,疏水相互作用通过分析溶剂可及性表面模型得到 .考察了不同 p ... 详细信息

从 TGEV 3 CL蛋白酶二聚体结构出发 ,研究了 TGEV 3 CL蛋白酶二聚体单体之间的静电和疏水相互作用 .蛋白质的静电相互作用通过有限差分方法求解 Poisson-Boltzmann方程得到 ,疏水相互作用通过分析溶剂可及性表面模型得到 .考察了不同 p H值对 SARS3 CL蛋白酶二聚体静电和疏水相互作用的影响 ,在p H=5 .5～ 8.5时 ,二聚体静电相互作用能、静电去溶剂化能和疏水自由能都具有较小的数值 ,表明在该条件下静电和疏水相互作用有利于二聚体的稳定存在 .由于 SARS 3 CL蛋白酶活性模式为二聚体 ,因此 ,在该p H值范围内 ,有利于蛋白酶保持活性 .在 p H=7.0条件下 ,蛋白酶单体之间具有最强的静电和疏水相互作用 ,从而使蛋白酶具有最强的活性 ,这与实验结果相一致 .p H值对静电去溶剂化能的影响大于疏水自由能 ,表明静电作用是造成强酸或强碱条件下二聚体不能稳定存在的主要原因 .

关键词： SARS 3CL蛋白酶二聚体静电作用疏水作用 pH值

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海天背景红外成像仿真系统

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红外技术 2007年第5期29卷 288-290,296页

作者：李良超吴振森杨瑞科西安电子科技大学理学院陕西西安710071

设计了海天背景红外成像仿真系统:利用大气传输软件Modtran计算天空背景和太阳的红外辐射;基于JONSWAP海谱模型构建二维海面;基于热辐射理论和粗糙面散射理论分别计算海面和目标的红外辐射及对背景辐射的散射;最终可获得海天背景红外仿... 详细信息

设计了海天背景红外成像仿真系统:利用大气传输软件Modtran计算天空背景和太阳的红外辐射;基于JONSWAP海谱模型构建二维海面;基于热辐射理论和粗糙面散射理论分别计算海面和目标的红外辐射及对背景辐射的散射;最终可获得海天背景红外仿真图像。对于海天背景辐射特性和目标识别算法研究具有重要实际意义。

关键词：红外图像仿真海天背景辐射粗糙面光散射

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