Zhanzhan Li

Prevalence of nonalcoholic fatty liver disease in mainland of China: a meta-analysis of published studies.

Nonalcoholic fatty liver disease (NAFLD) is becoming an increasingly important health issue. However, there are no data on the change in prevalence of NAFLD within a population over time, especially in the mainland of China. The goal of this study was to estimate the pooled prevalence of NAFLD in the mainland of China.

Prevalence of Depression in Patients With Hypertension: A Systematic Review and Meta-Analysis.

Abstract Prevalence estimates of depression in hypertensive patients varied widely in existing studies. We conducted a systematic review and meta-analysis of observational studies to summarize the point prevalence of depressive symptoms in adults with hypertension. Comprehensive electronic searches of PubMed, Web of Knowledge, China National Knowledge Internet (CNKI), Wangfang, and Weipu databases were conducted to identify any study in each database published from initial state to November 31, 2014, reporting the prevalence of depression in hypertensive patients. Random-effects model was used to estimate the prevalence of depressive symptoms. We also limited the analyses to studies using clinical interview and prespecified criteria for diagnosis. All statistical calculations were made by using the Stata Version 12.0 (College Station, TX) and Statsdirect Version 2.7.9. We identified 41 studies with a total population of 30,796 in the present meta-analysis. The summarized prevalence of depression among hypertensive patients is 26.8% (95% confidence interval (CI): 21.7%–32.3%). Subgroup analysis shows the following results: for male 24.6%, 95% CI: 14.8%–35.9%, for female 24.4%, 95% CI: 14.6%–35.8%. For China: 28.5% (95% CI: 22.2%–35.3%); for other region (22.1%, 95% CI: 12.1%–34.1%); for community: 26.3% (95% CI: 17.7%–36.0%), for hospital: 27.2% (95% CI: 20.6%–34.5%). Estimated prevalence by interview was 21.3% (95% CI: 14.2%–30.0%); prevalence of depressive symptoms adjudicated by self-rating scales was 29.8% (95% CI: 23.3%–36.7%). The observed heterogeneity in depression prevalence of hypertension may be attributed to differences in method of evaluation. Self-report scales should be cautious of estimating the presence of depression. Thus, interview-defined depression affects approximately one third of hypertensive patients. Effective interventions for depression on patient-centered are needed.

Prevalence of Suicidal Ideation in Chinese College Students: A Meta-Analysis

Background About 1 million people worldwide commit suicide each year, and college students with suicidal ideation are at high risk of suicide. The prevalence of suicidal ideation in college students has been estimated extensively, but quantitative syntheses of overall prevalence are scarce, especially in China. Accurate estimates of prevalence are important for making public policy. In this paper, we aimed to determine the prevalence of suicidal ideation in Chinese college students. Objective and Methods Databases including PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang (Chinese database) and Weipu (Chinese database) were systematically reviewed to identify articles published between 2004 to July 2013, in either English or Chinese, reporting prevalence estimates of suicidal ideation among Chinese college students. The strategy also included a secondary search of reference lists of records retrieved from databases. Then the prevalence estimates were summarized using a random effects model. The effects of moderator variables on the prevalence estimates were assessed using a meta-regression model. Results A total of 41 studies involving 160339 college students were identified, and the prevalence ranged from 1.24% to 26.00%. The overall pooled prevalence of suicidal ideation among Chinese college students was 10.72% (95%CI: 8.41% to 13.28%). We noted substantial heterogeneity in prevalence estimates. Subgroup analyses showed that prevalence of suicidal ideation in females is higher than in males. Conclusions The prevalence of suicidal ideation in Chinese college students is relatively high, although the suicide rate is lower compared with the entire society, suggesting the need for local surveys to inform the development of health services for college students.

Relationship between red blood cell distribution width and early-stage renal function damage in patients with essential hypertension.

Background: Red cell distribution (RDW) has been suggested to be associated with cardiovascular mortality and mortality. However, few studies have yet investigated the possible association between RDW and early-stage renal function damage in patients with primary hypertension without receiving drug treatment. Accordingly, the aim of the present study was to evaluate early-stage renal function status in patients with RDW levels. Results: The study included 513 primary hypertension patients (319 men and 194 women) without receiving drug treatment. Significant positive correlation was observed between albumin-to-creatinine ratio (ACR) and RDW in hypertensive patients (r = 0.531, P < 0.001). In multivariate line regression analysis, night-time SBP (B = 0.042, P < 0.001), ACR (B = 0.005, P < 0.001), and uric acid (B = 0.001, P = 0.022) were positive predictors of RDW independent of age, sex, hemoglobin, and other indexes, whereas daytime SBP (B = −0.019, P < 0.001) was inversely associated with RDW. The receiver operating characteristics curves (ROC) explored the relationship between renal function status and RDW, estimated glomerular filtration rate (eGFR), serum creatinine, and high-sensitivity C-reactive protein. The area under the curve was 0.81 (95% CI: 0.77–0.85; P < 0.001), 0.45 (95% CI: 0.39–0.50; P = 0.049), 0.49 (95% CI: 0.43–0.54; P = 0.583), and 0.49 (95% CI: 0.44–0.55; P = 0.811), respectively. Using a cutoff point of 12.8, the RDW predicted renal function status (ACR) with a sensitivity of 76% and a specificity of 70%. Conclusion: RDW, as an easy and quick measurable index, can predict early-stage renal function damage in essential hypertensive patients without receiving drug treatment.

MicroRNA-433 inhibits cell proliferation in hepatocellular carcinoma by targeting p21 activated kinase (PAK4)

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. P21-activated kinase 4 (PAK4) has been identified as an oncogenic protein in a variety of cancers. However, the contribution and regulation of PAK4 in HCC remain poorly understood. In the present study, we found that inhibition of PAK4 expression by specific shRNA significantly attenuated HCC cell proliferation. Moreover, we show that microRNA-433 (miRNA-433) could directly target PAK4 through the miRNA-433 binding sequence at the 3′-UTR of PAK4 mRNA, and inhibit PAK4 protein expression. We further show that miRNA-433 expression was downregulated in HCC tissues and cell culture as well, which inversely correlated with PAK4 expression levels. Overexpression of miRNA-433 significantly suppressed the proliferation of HepG2 cells, while this effect was partially rescued by forced expression of PAK4 through restoring PI3K/AKT signaling in HepG2 cells. These findings will shed light on the roles and mechanisms of miRNA-433 in regulating HCC proliferation, and may benefit future development of therapeutics targeting miRNA-433 and PAK4 in HCC.

Anemia increases the mortality risk in patients with stroke: A meta-analysis of cohort studies

The impact of anemia on the outcome of patients with stroke remains inconsistent. We performed a meta-analysis of cohort studies to assess the mortality risk in stroke patients with and without anemia. Systematic searches were conducted in the PubMed, China National Knowledge Infrastructure, Web of Science and Wanfang databases to identify relevant studies from inception to November 2015. The estimated odds ratio with a 95% confidence interval was pooled. subgroup analyses and sensitivity analyses were also conducted. We used Begg’s funnel plot and Egger’s test to detect the potential publication bias. Thirteen cohort studies with a total of 19239 patients with stroke were included in this meta-analysis. The heterogeneity among studies was slight (I2 = 59.0%, P = 0.031). The results from a random-effect model suggest that anemia is associated with an increased mortality risk in patients with stroke (adjusted odds ratio = 1.39, 95% confidence interval: 1.22–1.58, P < 0.001). The subgroup analyses are consistent with the total results. This meta-analysis of 13 cohort studies finds that anemia increases the mortality risk in patients with stroke. Future studies should perform longer follow-up to confirm this finding and explore its possible mechanism.

The Seroprevalence of Toxoplasma gondii in Chinese Population With Cancer: A Systematic Review and Meta-analysis.

AbstractToxoplasmosis is fatal in the immunocompromised individuals such as cancer patients with chemotherapy. Clinical toxoplasmosis in cancer patients is a great public health concern in China. We performed this meta-analysis to assess the seroprevalence and odds ratios (ORs) of Toxoplasma gondii in Chinese population with cancer compared with those without.A methodical literature search was conducted with the help of the PubMed, Web of Knowledge, Embase, Chinese Web of Knowledge, Wanfang, and Chongqing VIP database. Case-control studies published from their inception until April 2015, reporting the seroprevalence of T. gondii in Chinese population with cancer, were covered as well. The nonweighted prevalence, pooled random-effects estimates of ORs, and 95% confidence intervals (CIs) were all calculated.Nineteen studies including 4493 cases and 6797 controls were incorporated in the meta-analysis. The overall seroprevalence of T. gondii was higher in population with cancer compared with those without ((20.59% vs 6.31%, P < 0.001; OR 3.90, 95% CI 3.00–5.07). The OR of T. gondii in cancer patients is further subgrouped according to publication year, sample size, and diagnostic methods. The pooled OR estimates were 4.80 (95% CI 2.57–8.99) from 1991 to 1999, 4.96 (95% CI 3.03–8.12) during 2000 to 2005, and 2.94 (95% CI 2.46–3.50) during 2006 to 2015. The pooled OR estimates were 6.16 (95% CI 3.87–9.78) when the sample size was below 400, 5.37 (95% CI 3.84–7.53) when the sample size was between 400 and 500, and 2.58 (95% CI 2.17–3.07) when the sample size was above 500. The pooled OR estimates were 5.50 (95% CI 3.98–7.62) by using indirect hemagglutination assay method, and 3.15 (95% CI 2.67–3.72) by using enzyme-linked immunosorbent assay method.The meta-analysis study found Chinese population with cancer had higher seroprevalence rates of T. gondii compared with those without.

Prevalence of hypertension in rural areas of china: a meta-analysis of published studies.

Background Hypertension is one of the leading causes of disease burden across the world. In China, the latest nationwide survey of prevalence of hypertension was ten year ago, and data in rural areas is little known. More information about hypertension prevalence could help to improve overall antihypertensive health care. We aimed to estimate the pooled prevalence of hypertension in rural areas of China. Methods Comprehensive electronic searches of PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang, Weipu and SinoMed databases were conducted to identify any study in each database published from January 1, 2004 to December 31, 2013, reporting the prevalence of hypertension in Chinese rural areas. Prevalence estimates were stratified by age, area, sex, publication year, and sample size. All statistical calculations were made using the Stata Version 11.0 (College Station, Texas) and Statsdirect Version 2.7.9. Results We identified 124 studies with a total population of 3,735,534 in the present meta-analysis. Among people aged 18 years old in Chinese rural areas, the summarized prevalence is 22.81% (19.41%–26.41%). Subgroup analysis shows the following results: for male 24.46% (21.19%–27.89%, for female 22.17% (18.25%–26.35%). For 2004–2006: 18.94% (14.41%–23.94%), for 2007–2009, 21.24% (15.98%–27.01%) for 2010–2013: 26.68%, (20.79%–33.02%). For Northern region 25.76% (22.36%–29.32%), for Southern region 19.30%, (15.48%–24.08%). Conclusions The last decade witnessed the growth in prevalence of hypertension in rural areas of China compared with the fourth national investigation, which has climbed the same level as the urban area. Guidelines for screening and treatment of hypertension in rural areas need to be given enough attention.

Association between Tumor Necrosis Factor-α 308G/A Gene Polymorphism and Silicosis Susceptibility: A Meta-Analysis

Background Tumor necrosis factor-α (TNF-α) 308 G/A gene polymorphism has been reported to be associated with susceptibility to silicosis. However, the relevant study results are still inconsistent. Objective and Methods A meta-analysis was performed in order to drive a more precise estimation of the relationship between TNF-α-308 G/A gene polymorphism and susceptibility to silicosis. Electronic databases were searched and nine separate studies were included. The pooled odds ratios (ORs) and the corresponding 95% confidence internal (CI) were calculated by a fixed effect model. Results A total of 1267 cases and 1214 controls were included. In the overall analysis, significantly increased silicosis risk was found (for GA+AA vs. GG OR=1.45, 95%CI: 1.20-1.760, P=1.58E4; for GA vs. GG: OR=1.53, 95%CI=1.25-1.86, P=3.11E5; for A allele vs. G allele: OR=1.27, 95%CI=1.08-1.50, P= 0.004). In the subgroup analysis, significantly increased silicosis risk was also found among Asians (for GA+AA vs. GG: OR=1.63, 95%CI=1.27-2.08, P=1.01E4), for GA vs. GG: OR=1.71, 95%CI=1.33-2.20, P=3.44E5), for A allele vs. G allele: OR=1.45, 95%CI=1.17-1.80, P=0.001). However, no significantly increased risk was found among non-Asians for all genetic models. Conclusions TNF-α-308 G/A polymorphism might lead to an increased risk of silicosis susceptibility, especially for Asians. However, further studies with large sample sizes should be conducted to confirm the association.

Early versus Delayed Antiretroviral Therapy for HIV and Tuberculosis Co-Infected Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective To compare important clinical outcomes between early and delayed initiation of antiretroviral therapy (ART) in adults who had a co-infection of human immunodeficiency virus (HIV) and tuberculosis (TB). Methods We performed a systematic search for relevant publications on PubMed, EMBASE, and the International Clinical Trials Registry Platform. We included randomized controlled trials (RCTs) that compared early ART initiation (within four weeks after anti-TB treatment starting) and delayed ART initiation (after eight weeks but less than twelve weeks of anti-TB treatment starting) in the course of TB treatment. Pooled estimates with corresponding 95% confidence interval (95%CI) were calculated with random-effects model. Sensitivity analysis was performed to investigate the stability of pooled estimates. Results A meta-analysis was evaluated from six RCTs with 2272 participants. Compared to delayed ART initiation, early ART initiation significantly reduces all-cause mortality in HIV-positive patients with TB [incidence rate ratio (IRR) 0.75, 95%CI 0.59 to 0.95; I2 = 0.00%; p = 0.67], even though there is an increased risk for IRD [IRR 2.29, 95%CI 1.81 to 2.91; I22 = 0.00%; p = 0.56]. Additionally, early ART initiation was not associated with an increased risk for grade 3-4 drug-related adverse events [IRR 0.99, 95%CI 0.83 to 1.18; I2 = 0.00%; p = 0.56]. Conclusions Although limited evidence, our results provide support for early ART initiation in the course of anti-TB treatment. However, more well-designed cohort or intervention studies are required to further confirm our findings.