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Background: Patients with nonalcoholic fatty liver disease (NAFLD) are reported to have a higher risk of osteoporosis/fractures; however, the causal relationship remains unclear. Methods: Publicly available genome‐wide association studies (GWASs) were used for Mendelian randomization (MR) analysis. GWASs of NAFLD and fractures were obtained from the FinnGen Consortium. GWASs of bone mineral density (BMD) were derived from a meta‐analysis. GWASs of obesity, diabetes, liver function, and serum lipid‐related metrics were used to clarify whether the accompanying NAFLD symptoms contributed to fractures. Moreover, two additional GWASs of NAFLD were applied. Results: A causal association was not observed between NAFLD and BMD using GWASs from the FinnGen Consortium. However, a causal relationship between NAFLD and femoral neck‐BMD (FN‐BMD), a suggestive relationship between fibrosis and FN‐BMD, and between NAFLD and osteoporosis were identified in replication GWASs. Genetically proxied body mass index (BMI), high‐density lipoprotein (HDL), and hip circumference increased the likelihood of lower limb fractures. The waist‐to‐hip ratio decreased, whereas glycated hemoglobin (HbA1C) and homeostasis model assessment of β‐cell function (HOMA‐B) increased the risk of forearm fractures. Low‐density lipoprotein (LDL) reduced, whereas HbA1C increased the incidence of femoral fractures. Alkaline phosphatase (ALP) raised the risk of foot fractures. However, after a multivariate MR analysis (adjusted for BMI), all the relationships became insignificant. Conclusions: NAFLD caused reduced BMD, and genetically predicted HDL, LDL, HbA1C, HOMA‐B, ALP, hip circumference, and waist‐to‐hip ratio causally increased the risk of fractures. BMI may mediate causal relationships. Larger GWASs are required to verify this finding. [ABSTRACT FROM AUTHOR]

Emergomycosis (formerly called emmonsiosis) is an emerging dimorphic fungal disease, usually caused by Emergomyces pasteurianus or Es. africanus, usually disseminated and commonly identified and fatal in immunocompromised patients, especially HIV-positive [...]

Abstract Background Consensus interferon (CIFN) is a newly developed type I interferon. Aims This multicentre, controlled trial was conducted to determine the efficacy of CIFN and to compare it with alpha-1b-interferon (IFN-α1b) in the treatment of patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. Methods 144 Patients were randomly assigned to receive 9 μg CIFN (CIFN group) or 50 μg INF-α1b (IFN-alpha group) subcutaneously 3 times weekly for 24 weeks, followed by 24 weeks of observation. Efficacy was assessed by normalization of serum alanine transaminase (ALT) levels and the non-detectability of serum hepatitis B virus DNA or HBeAg at the end of treatment and 24 weeks after stopping treatment. Results There was no statistically significant difference in the serological, virological and biochemical parameters between CIFN and IFN-α1b groups at the end of the therapy and follow-up period (p > 0.05). Overall, at the end of treatment, 7.0% (5/71) and 35.2% (25/71) of patients in the CIFN group showed a complete or partial response compared with 7.4% (5/68) and 33.8% (23/68) of the IFN-alpha group (p = 0.10). At 24 weeks after stopping treatment, 6.9% (5/72) and 37.5% (27/72) of patients in the CIFN group showed complete response or partial response compared with 7.1% (5/70) and 34.3% (24/70) of the IFN-alpha group (p = 0.10). Conclusion These findings suggest that 9 μg CIFN is effective in the treatment of patients with HBeAg-positive chronic hepatitis B. It can gradually induce ALT normalization and HBV DNA clearance and HBeAg loss or HBeAg/HBeAb seroconversion.

Emergomyces is a newly described dimorphic fungus genus; it may cause fatal infections in immunocompromised patients, but diagnosis is often delayed. We report a case of disseminated emergomycosis caused by the novel species Emergomyces orientalis in a kidney transplant recipient from Tibet. Infection was diagnosed early by metagenomic next-generation sequencing. [ABSTRACT FROM AUTHOR]

Background: The incidence of cryptococcal meningitis (CM) and tuberculous meningitis (TBM) have gradually increased in recent years. These two types of meningitis are easily misdiagnosed which leads to a poor prognosis. In this study we compared differences of clinical features and prognostic factors in non-HIV adults with CM and TBM.Methods: We retrospectively reviewed the medical records of CM and TBM patients from January 2008 to December 2015 in our university hospital in China. The data included demographic characteristics, laboratory results, imaging findings, clinical outcomes.Results: A total of 126 CM and 105 TBM patients were included. CM patients were more likely to present with headache, abnormal vision and hearing, and they might be less prone to fever and cough than TBM patients (P < 0.05). Higher percentage of CM patients presented with cerebral ischemia/infarction and demyelination in brain MRI than TBM patients (P < 0.05). CM patients had lower counts of WBC in CSF, lower total protein in CSF and serum CD4/CD8 ratio than TBM patients (P < 0.05). After three months of treatment, CM group have worse outcome than TBM group (P < 0.05). Multivariate analysis showed that age more than 60y (OR = 4.981, 95% CI: 1.955-12.692, P = 0.001), altered mentation (OR = 5.054, 95% CI: 1.592-16.046, P = 0.006), CD4/CD8 ratios < 1 (OR = 8.782, 95% CI: 2.436-31.661, P = 0.001) and CSF CrAg ≥ 1:1024 (OR = 4.853, 95% CI: 1.377-17.098, P = 0.014) were independent risk factors for poor prognosis for CM patients. For TBM patients, hydrocephalus (OR = 7.290, 95% CI: 1.630-32.606, P = 0.009) and no less than three underlying diseases (OR = 6.899, 95% CI: 1.766-26.949, P = 0.005) were independent risk factors, headache was a protective factor of prognosis.Conclusions: Our study provided some helpful clues in the differential diagnosis of non-HIV patients with CM or TBM and identified some risk factors for the poor prognosis of these two meningitis which could help to improve the treatment outcome. Further studies are worth to be done. [ABSTRACT FROM AUTHOR]

Purpose: Pancreatic carcinoma is a malignant tumor with poor prognosis. This metaanalysis was conducted to investigate if there exists any association of cholesterol with pancreatic carcinoma risk., Methods: A literature search was performed in Cochrane Central Library, PubMed, MEDLINE, EMBASE, CNKI (China National Knowledge Infrastructure), China Biology Medical literature database (CBM), and WangFang database for relevant available articles. Dietary cholesterol and serum levels of total cholesterol (TC) were assessed and compared. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated., Results: A total 19 articles coming from Europe, Asia and north America were assessed in this study. There was a significant difference between highest and lowest dietary cholesterol intake for pancreatic carcinoma risk (RR=1.31, 95% CI:1.10 to 1.56, p=0.01). Moreover, in subgroup analysis, there was a significant difference between highest and lowest dietary cholesterol intake for pancreatic carcinoma risk for case-control studies (RR=1.52, 95% CI:1.23 to 1.90, p=0.04). However, no significant difference was noticed between highest and lowest dietary cholesterol intake for pancreatic carcinoma risk for cohort studies (RR=1.02, 95% CI:0.87 to 1.20, p=0.51). The meta analysis results showed a significant difference between highest and lowest dietary cholesterol for pancreatic carcinoma in Europeans (RR=1.15, 95% CI:0.86 to 1.53, p=0.05). Moreover, compared to the low serum level of TC, the high level serum TC was associated with pancreatic carcinoma risk (RR=1.00, 95% CI:0.86-1.17, p=0.03). There was a significant difference between high and low levels of serum TC for pancreatic carcinoma risk in Europeans (RR=1.03, 95% CI: 0.72 to 1.48, p=0.04)., Conclusion: Dietary or serum cholesterol may be associated with risk for increased pancreatic carcinoma.

Objective: Considering that the complement C3d plays a stronger positive role in the control of immunologic system, we constructed the recombinant plasmid of the molecular-adjuvant gene of the complement C3d in order to enhance the immunologic efficacy of the gene vaccine., Methods: The main points were amplifying the segment of complement C3d gene by using of PCR; inserting it into PGEM-T; detecting it by digesting with Eco RI and sequencing; the whole length being 897 bp; then sub-cloning it into pVAX1., Results: The DNA sequencing confirmed the C3d sequence., Conclusion: We have successfully cloned the gene of C3d and constructed the recombinant plasmid of pVAX1 C3d.