Classification of metabolic-associated fatty liver disease subtypes based on TCM clinical phenotype

Objective:To classify the subtypes of metabolic-associated fatty liver disease(MAFLD)and provide new insights into the heterogeneity of MAFLD.Methods:Electronic medical records(EMR)of MAFLD diagnosed in accordance with the diagnostic criteria of Hubei Provincial Hospital of Traditional Chinese Medicine from 2016-2020 were included in the study.for physical annotation,and the data on each clinical phenotype was normalized according to corresponding aspirational standards.The MAFLD heterogeneous medical record network(HEMnet)was constructed using sex,age,disease diagnosis,symptoms,and Western medicine prescriptions as nodes and the co-occurrence times between phenotypes as edges.K-means clustering was used for disease classification.Relative risk(RR)was used to assess the specificity of each phenotype.Statistical methods were used to compare differences in laboratory indicators among subtypes.Results:A total of patients(12,626)with a mean age of 55.02(±14.21)years were included in the study.MAFLD can be divided into five subtypes:digestive diseases(C0),mental disorders and gynecological diseases(C1),chronic liver diseases and decompensated complications(C2),diabetes mellitus and its complications(C3),and immune joint system diseases(C4).Conclusions:Patients with MAFLD experience various symptoms and complications.The classification of MAFLD based on the HEMnet method is highly reliable.

非酒精性脂肪性肝病与骨骼肌质量相关性研究

目的:探讨非酒精性脂肪性肝病(NAFLD)与骨骼肌质量的关系,为研究NAFLD与肌肉减少症的相关性提供理论依据。方法:以2018年10月1日至2019年9月30日在湖北省中医院肝病科,肥胖专科及体检中心就诊的人群进行人体成分分析、肝脏硬度弹性检测、肝脏B超检测及生化指标分析,采用SPSS21.0软件进行t检验、Spearmen相关分析、logistic回归分析、Roc曲线分析和约登指数计算,判别骨骼肌质量指数预测可能发生NAFLD的临界值。结果:共纳入受试者428人,其中男性NAFLD组140例,非NAFLD组39例,女性NAFLD组126例,非NAFLD组123例。不同性别、年龄比较无统计学差异。无论男性组还是女性组,患有NAFLD的患者体脂质量、体脂率、未校正骨骼肌质量、BMI、内脏脂肪面积、身高校正的SMI均高于对照组,体重校正SMI低于对照组。Spearmen相关分析显示身高校正的SMI和肝脏硬度成正相关(r>0,p<0.01),体重校正的SMI与肝脏硬度成负相关(r<0,p<0.01)。多因素回归分析发现男性NAFLD发生的独立保护因素有经体重校正的SMI,女性NAFLD发生的独立保护因素有经体重校正的SMI和HDLC。ROC曲线和约登指数计算出体重校正的SMI的临界值男性为28.17%,女性为24.38%。结论:中青年NAFLD的发生与骨骼肌质量指数存在相关性。经体重校正的骨骼肌质量指数可能更好的预测NAFLD的发生。

Regional Evaluations of the Meteorological Drought Characteristics across the Pearl River Basin, China

Regional evaluation of drought characteristics provides critical information for water resource management. In this case, this study attempts to analyze the probability behaviors of drought events of a given severity in the Pearl River Basin and to construct severity-area-frequency curves of drought events. Due to possible impacts of complicated topographical properties and diverse climate types within the Pearl River Basin, the entire Pearl River Basin is subdivided into different homogeneous regions. In general, the Pearl River Basin can be categorized into four homogeneous regions, and the severity-area-frequency analysis results for the short-, medium- and long-term drought episodes within each homogeneous regions indicate stressful challenge for the water resource management in the Pearl River Basin due to the fact that severe droughts usually occur over the entire Pearl River Basin. Meanwhile, the Pearl River Delta will face a higher risk of drought when compared to other regions of the Pearl River Basin in terms of the medium-term drought. The Pearl River Basin is highly economically development and is heavily populated, thus impacts of droughts and related resilience resolutions or policies should be taken into account in the formulation of regional sustainable development of water resources and socio-economy within the Pearl River Basin, China.

Neutralization against SARS-CoV-2 Delta/Omicron variants and B cell response after inactivated vaccination among COVID-19 convalescents

Emerging SARS-CoV-2 variants have made COVID-19 convalescents susceptible to re-infection and have raised concern about the efficacy of inactivated vaccination in neutralization against emerging variants and antigen-specific B cell response.To this end,a study on a long-term cohort of 208 participants who have recovered from COVID-19 was conducted,and the participants were followed up at 3.3(Visit 1),9.2(Visit 2),and 18.5(Visit 3)months after SARS-CoV-2 infection.They were classified into three groups(no-vaccination(n=54),one-dose(n=62),and two-dose(n=92)groups)on the basis of the administration of inactivated vaccination.The neutralizing antibody(NAb)titers against the wild-type virus continued to decrease in the no-vaccination group,but they rose significantly in the one-dose and two-dose groups,with the highest NAb titers being observed in the two-dose group at Visit 3.The NAb titers against the Delta variant for the no-vaccination,one-dose,and two-dose groups decreased by 3.3,1.9,and 2.3 folds relative to the wild-type virus,respectively,and those against the Omicron variant decreased by 7.0,4.0,and 3.8 folds,respectively.Similarly,the responses of SARS-CoV-2 RBD-specific B cells and memory B cells were boosted by the second vaccine dose.Results showed that the convalescents benefited from the administration of the inactivated vaccine(one or two doses),which enhanced neutralization against highly mutated SARS-CoV-2 variants and memory B cell responses.Two doses of inactivated vaccine among COVID-19 convalescents are therefore recommended for the prevention of the COVID-19 pandemic,and vaccination guidelines and policies need to be updated.

Dynamics of the SARS-CoV-2 antibody response up to 10 months after infection

COVID-19 caused by SARS-CoV-2 infection has caused substantial morbidity and mortality worldwide and paralyzed the international economy.Understanding the magnitude and duration of the antibody response to SARS-CoV-2 is important to achieve a balance between curbing the pandemic and minimizing adverse effects on society.1 Although the antibody response to SARS-CoV-2 within 9 months has been extensively studied,2,3,4,5,6 little is known about the magnitude and kinetics of antibody responses for over 9 months.Moreover,with limited observations over 9 months(n<100),2,7,8 several studies have produced inconsistent conclusions about antibody dynamics,suggesting different rates of antiviral antibody positivity at the last follow-up.2,7,8 These studies have been limited by a lack of measurement of neutralizing antibodies(NAbs),7 of inclusion of mild or asymptomatic cases,2,8 and of further exploration of potential predisposing factors for antibody dynamics.2,7 Considering the individual heterogeneity(such as disease severity)8 and time-dependent nature1 of the immune response,in-depth characterization of SARS-CoV-2 antibody kinetics across disease severity groups over a long period is urgently needed.Therefore,we repeatedly tested IgM,IgG,viral spike protein receptor-binding dom(anti-RBD)IgG,and NAb titers in COVID-19 patients during a follow-up period of up to 10 months and explored potential predisposing factors of antibody titers during follow-up.

Distinct gut microbiota and health outcomes in asymptomatic infection,viral nucleic acid test re-positive,and convalescent COVID-19 cases

Gut microbiota composition is suggested to associate with coronavirus disease 2019(COVID-19)severity,but the impact of gut microbiota on health outcomes is largely unclear.We recruited 81 individuals from Wuhan,China,including 13 asymptomatic infection cases(Group A),24 COVID-19 convalescents with adverse outcomes(Group C),31 severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)re-positive cases(Group D),and 13 non-COVID-19 healthy controls(Group H).The microbial features of Groups A and D were similar and exhibited higher gut microbial diversity and more abundant short-chain fatty acid(SCFA)-producing species than Group C.Group C was enriched with opportunistic pathogens and virulence factors related to adhesion and toxin production.The abundance of SCFA-producing species was negatively correlated,while Escherichia coli was positively correlated with adverse outcomes.All three groups(A,C,and D)were enriched with the mucusdegrading species Akkermansia muciniphila,but decreased with Bacteroides-encoded carbohydrate-active enzymes.The pathways of vitamin B6 metabolic and folate biosynthesis were decreased,while selenocompound metabolism was increased in the three groups.Specifically,the secondary bile acid(BA)metabolic pathway was enriched in Group A.Antibiotic resistance genes were common among the three groups.Conclusively,the gut microbiota was related to the health outcomes of COVID-19.Dietary supplementations(SCFAs,BA,selenium,folate,vitamin B6)may be beneficial to COVID-19 patients.