Zhaojun Lu

Clinical features and etiology of Budd-Chiari syndrome in Chinese patients: a single-center study.

The clinical features and etiology of Budd–Chiari syndrome (BCS) vary from region to region, and there is lack of large sample studies about BCS in China. The aim of the present study was to study the clinical features and etiology of patients with incident BCS in China prospectively.

JAK2 V617F mutation and 46/1 haplotype in Chinese Budd‐Chiari syndrome patients

The presence of JAK2V617F was reported to be associated with JAK2 46/1 haplotype, which was considered as an independent risk factor for Budd‐Chiari syndrome (BCS) in Western countries. However, little is known in China. Therefore, the aim of this study was to determine whether the 46/1 haplotype is associated with such patients.

Association between MTHFR C677T polymorphism and venous thromboembolism risk in the Chinese population: a meta-analysis of 24 case-controlled studies.

The association between methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and venous thromboembolism (VTE) risk in the Chinese population has been widely reported, but results were inconsistent and underpowered. To elucidate the variable results, a meta-analysis and systematic review were performed from all case-controlled studies relating MTHFR C677T polymorphism by pooling data on them. We estimated the pooled odds ratio with its 95% confidence intervals to assess this possible association. Finally, a total of 24 studies with 2339 cases and 4048 controls were included in the current meta-analysis. Significant association was found with VTE risk for all genetic models. Subgroup analyses by type of VTE further identified the above-mentioned association in deep vein thrombosis/pulmonary embolism and splanchnic vein thrombosis. The findings from our meta-analysis support the associations of MTHFR C677T polymorphism with VTE risk in the Chinese population.

CALR mutations in Chinese Budd-Chiari syndrome patients.

alcohol since the past 3 months. His physical examination was normal. Results of laboratory investigations were as follows: aspartate transaminase, 472 U/l (0–35); alanine transaminase, 890 U/l (0–35); alkaline phosphatase, 236 U/l (0–120); γ glutamyltransferase, 225 U/l (0–55), and bilirubin, 2.30mg/dl. Hepatobiliary sonography was normal. Detailed viral, autoimmune serological assays were within normal limits. Liver function tests were normal in previous medical records, dated 3 months ago. Risperidone was discontinued and paliperidone was started. The follow-up showed liver function to have returned to normal in 2 weeks [aspartate transaminase, 31 U/l (0–35); alanine transaminase, 28 U/l (0–35); alkaline phosphatase, 77 U/l (0–120); γ glutamyltransferase, 33 U/l (0–55); bilirubin, 0.8 mg/dl]. In the follow-up the patient was seen to be completely normal and was discharged. To the best of our knowledge, this is the first patient addicted to synthetic cannabis in the literature who developed risperidone-induced hepatoxicity. Drug withdrawal therapy is always challenging. Therefore, in conclusion, to attain best results risperidone hepatotoxicity should always be considered in patients addicted to synthetic cannabis.

Risk factors of recurrence among 471 Chinese patients with Budd-Chiari syndrome

BACKGROUND AND AIM Budd-Chiari syndrome (BCS) is a rare form of vascular disease. There is limited literature available regarding the prognosis of this disease. The aim of this study was to characterize the cumulative recurrence rates and to investigate the risk factors of recurrence in Chinese patients with BCS. METHODS Four hundred and seventy-one patients were diagnosed as having BCS in the Affiliated Hospital of Xuzhou Medical College (Jiangsu, China) between January 2008 and December 2012. Follow-ups were conducted by phone calls or correspondence. Cumulative recurrence rates were assessed with the Kaplan-Meier curves. Independent risk factors of recurrence were calculated with the Coxs proportional hazards regression model. RESULTS Four hundred and twenty-five patients with BCS had complete follow-up data, in which 24 patients died, 98 patients had recurrence, with the median duration of follow-up being 19.3 months (range 3 to 61.4). The cumulative 1-, 2-, 3-, 4- and 5-year recurrence rates were 12%, 22%, 27%, 35% and 42%, respectively. Univariable and multivariable Coxs proportional hazards regression models showed that the risk factors of recurrence include: age ≤ 30 years (HR=2.261, 95% CI: 1.412-3.621), differentiated typology (hepatic vein type: HR=1.885, 95% CI: 1.045-3.402; combined type: HR=2.088, 95% CI: 1.233-3.536), elevated lactate dehydrogenase (LDH) levels (HR=1.125, 95% CI: 1.101-1.212) and the Child-Pugh class B/C (B: HR=1.758, 95% CI: 1.057-2.926; C: HR=2.626, 95% CI: 1.396-4.940). CONCLUSIONS Regardless of thrombophilia and haematological causes, exceptionally found in Chinese patients, the 5-year recurrence rate of BCS was as high as 42%. Age ≤ 30 years, hepatic vein type, combined type, increased LDH levels and the Child-Pugh class B/C were independent predictors of BCS recurrence.

Risk of Budd-Chiari syndrome associated with factor V Leiden and G20210A prothrombin mutation: a meta-analysis.

Background Various studies have demonstrated that factor V Leiden (FVL) and G20210A prothrombin mutation contribute to the risk of Budd-Chiari syndrome (BCS), while other studies provided conflicting findings. In order to derive more precise estimations of the relationships, a meta-analysis was performed. Methods Eligible articles were identified through search of databases including Pubmed, Chinese Biomedical Database (CBM, Chinese), and Chinese National Knowledge Infrastructure (CNKI, Chinese). Odd ratios (ORs) with 95% confidence intervals (CIs) were calculated using random- or fixed- model. Results Finally, twelve studies were included for FVL and nine studies were included for G20210A prothrombin mutation. With respect to FVL, significantly increased BCS risk was found in the overall population (OR = 6.29, 95%CI = 4.23–9.36). Subgroup analyses suggested that FVL was associated with an increased risk of BCS in the population with high background mutation prevalence (>1% in the normal population). No significant association was found between BCS and G20210A prothrombin mutation (OR = 1.78, 95%CI = 0.77–4.11). Conclusion The presence of FVL should be evaluated in patients with BCS. Conversely, G20210A prothrombin mutation is not significantly associated with risk of BCS. Large-scale well designed studies are necessary to be conducted to further confirm or refute the observed association.

Association Between Interleukin-6 -572 C>G and -174 G>C Polymorphisms and Hypertension: A Meta-analysis of Case-control Studies

AbstractWhether hypertension is associated with −572 C>G or −174 G>C polymorphism in interleukin (IL)-6 genes still remains hazy and ambiguous.We conducted a meta-analysis to offer a more reliable and clearer evaluation about the association.Electronic literature databases including PubMed, Web of Science, EMBASE, Google Scholar, Chinese National Knowledge Infrastructure and Wanfang database were searched.The study included the following: evaluating associations between −572 C>G or −174 G>C polymorphism in IL-6 gene and hypertension; case-control design; essential information must be offered; precise diagnostic criteria of hypertension; and no language restriction.Patients who met the diagnostic criteria and controls without a history of hypertension were included. Interventions were not available.A quality assessment was conducted using Newcastle-Ottawa scale. Combined odds ratios with 95% confidence intervals were calculated in 5 genetic models. Sources of heterogeneity were explored by subgroup analysis, meta-regression, and Galbraith plots. Finally, test for publication bias was performed to prove the stabilization.Fifteen studies were finally included. Eleven articles were judged high-quality reports. Overall, the −572 C>G polymorphism was proved to be significantly associated with hypertension in 4 genetic models. Subgroup analysis based on ethnicity revealed significant associations in Asian population in recessive model and homozygote comparison. The association in Europeans and Mid-East required further confirmation. No significant association was observed between the −174 G>C polymorphism and hypertension under all of the genetic models.The limitations of the study were the following: restrictive number of eligible studies limited the extrapolation range in subgroup analysis; gene–environment factors could not be described due to lack of data; some relevant studies could not be included because of various reasons.Current researches supported the association between the development of hypertension and the −572 C>G rather than −174 G>C polymorphism. Future well designed epidemiological studies may evaluate the possible gene–environment interactions.

Association between thrombin-activatable fibrinolysis inhibitor gene polymorphisms and venous thrombosis risk: a meta-analysis

Thrombin-activatable fibrinolysis inhibitor (TAFI) is an important antifibrinolytic factor that has been shown in increased concentrations to be associated with an increased risk for venous thrombosis. However, the effect of TAFI gene polymorphisms on the risk of venous thrombosis remains debatable. The aim of the current study was to evaluate the association of three single nucleotide polymorphisms: 505G>A (rs3742264), 1040 C>T (rs1926447) and −438G>A (rs2146881) with venous thrombosis risk using a meta-analysis. A systematic literature search for eligible studies published before 20 January 2015 was conducted in PubMed, EMBASE, Web of Science, WanFang database and Chinese National Knowledge Infrastructure. We assessed the possible association by pooled odds ratio and its 95% confidence interval. A total of 14 independent case–control studies including 2970 cases and 3049 controls were enrolled in the final meta-analysis. A significant reduction of venous thrombosis risk in the 505G>A polymorphism was observed under allele comparison, homozygote comparison and recessive models, but opposite results were seen in Asians. Likewise, there was a significant decreased susceptibility to venous thrombosis in the 1040C>T polymorphism in homozygote comparison and recessive models. In the subgroup analysis, the nonvenous thromboembolism disease group showed a significantly increased venous thrombosis risk. Pooled estimates did not show evidence of association between −438G>A and venous thrombosis risk in any genetic model. This meta-analysis suggested that although the −438G>T polymorphism is not correlated with venous thrombosis risk in all models, a trend toward reduced risk still could be observed. The A allele and AA genotype of 505G>A in whites and the TT genotype of 1040C>T were significantly associated with a decreased risk of venous thrombosis, except in the non-venous thromboembolism group.

Effectiveness and safety of rilpivirine, a non-nucleoside reverse transcriptase inhibitor, in treatment-naive adults infected with HIV-1: a meta-analysis.

Abstract Objectives: The aim of this study was to determine the effectiveness and safety of rilpivirine in treatment-naive adults infected with HIV-1. Methods: We ran duplicate searches of multiple databases and searchable websites of major HIV conferences (up to October 2013) to identify randomized controlled trials reporting the effectiveness and safety of rilpivirine in treatment-naive adults infected with HIV-1. Reference lists from retrieved articles were also reviewed. Data were extracted independently in duplicate using predefined data fields. All analyses used random-effects models to calculate the summary treatment effect estimates. Results: Four randomized controlled trials with a total of 2522 patients were included in the inclusion criteria. The primary efficacy endpoint was the proportion of patients with confirmed HIV-1 RNA levels of  < 50 copies/ml (viral load) at 48 weeks. Rilpivirine demonstrated non-inferior antiviral efficacy in viral load comparable with efavirenz at 48 weeks [relative risk (RR) = 1.03, 95% confidence interval (CI): 0.99–1.07]. The mean changes from baseline in CD4 count were similar in both rilpivirine and efavirenz (RR = 1.05, 95% CI: 0.85–1.24). Rilpivirine showed higher and significant difference in virological failure rates comparing with the efavirenz group (RR = 1.70, 95% CI: 1.21–2.38). The incidences of the most commonly reported adverse events related to study medication, including rash, and neurological events, were lower with rilpivirine than with efavirenz (RR = 0.11, 95% CI: 0.03–0.33; RR = 0.52, 95% CI: 0.45–0.60, respectively). Conclusions: Current evidence suggests a range of favorable effects and a generally favorable safety profile of rilpivirine in treatment-naive adults infected with HIV-1 at week 48.

The correlation analysis of tumor necrosis factor-alpha-308G/A polymorphism and venous thromboembolism risk: A meta-analysis

Objective Venous thromboembolism is a common complex disorder, being the resultant of gene–gene and gene–environment interactions. Tumor necrosis factor-alpha is a proinflammatory cytokine which has been implicated in venous thromboembolism risk. A promoter 308G/A polymorphism in the tumor necrosis factor-alpha gene has been suggested to modulate the risk for venous thromboembolism. However, the published findings remain inconsistent. Methods In this study, we conducted a meta-analysis of all available data regarding this issue. Eligible studies were identified through search of Pubmed, EBSCO Medline, Web of Science, and China National Knowledge Infrastructure (CNKI, Chinese) databases up to June 2014. Pooled Odd ratios (ORs) with 95% confidence intervals were applied to estimating the strength of the genetic association in the random-effects model or fixed-effects model. Results A total of 10 studies involving 1999 venous thromboembolism cases and 2166 controls were included in this meta-analysis to evaluate the association between tumor necrosis factor-alpha-308G/A polymorphism and venous thromboembolism risk. Overall, no significantly increased risk venous thromboembolism was observed in all comparison models when all studies were pooled into the meta-analysis. However, in stratified analyses by ethnicity, there was a pronounced association with venous thromboembolism risk among West Asians in three genetic models (A vs. G: OR = 1.82, 95%CI = 1.13–2.94; GA vs. GG: OR = 1.82, 95%CI = 1.08–3.06; AA/GA vs. GG: OR = 1.88, 95%CI = 1.12–3.16). When stratifying by source of controls, no significant result was detected in all genetic models. Conclusion This meta-analysis demonstrates that tumor necrosis factor-alpha 308G/A polymorphism may contribute to susceptibility to venous thromboembolism among West Asians. Studies are needed to ascertain these findings in larger samples and different racial groups.