Relationship between hepatitis C virus infection and type 2 diabetes mellitus:Meta-analysis

AIM:To investigate the association between hepatitis C infection and type 2 diabetes mellitus.METHODS:Observational studies assessing the relationship between hepatitis C infection and type 2 diabetes mellitus were identified via electronic and hand searches.Studies published between 1988 to March 2011 were screened,according to the inclusion criteria set for the present analysis.Authors performed separate analyses for the comparisons between hepatitis C virus(HCV) infected and not infected,and HCV infected and hepatitis B virus infected.The included studies were further subgrouped according to the study design.Heterogenity was assessed using I2 statistics.The summary odds ratios with their corresponding 95% CIs were calculated based on a random-effects model.The included studies were subgrouped according to the study design.To assess any factor that could potentially affect the outcome,results were further stratified by age group(proportion of ≥ 40 years),gender(proportion of male gender),body mass index(BMI)(pro-portion of BMI ≥ 27),and family history of diabetes(i.e.,self reported).For stability of results,a sensitivity analysis was conducted including only prospective studies.RESULTS:Combining the electronic database and hand searches,a total of 35 observational studies(in 31 articles) were identified for the final analysis.Based on random-effects model,17 studies(n = 286 084) compared hepatitis C-infected patients with those who were uninfected [summary odds ratio(OR):1.68,95% CI:1.15-2.45].Of these 17 studies,7 were both a cross-sectional design(41.2%) and cohort design(41.2%),while 3 were case-control studies(17.6%).Nineteen studies(n = 51 156) compared hepatitis C-infected participants with hepatitis B-infected(summary OR:1.92,95% CI:1.41-2.62).Of these 19 studies,4(21.1%),6(31.6%) and 9(47.4%) were cross-sectional,cohort and case-control studies,respectively.A sensitivity analysis with 3 prospective studies indicated that hepatitis C-infected patients had a higher risk of developing type 2 diabetes compared with uninfected controls(summary odds ratio:1.41,95% CI:1.17-1.7;I2 = 0%).Among hepatitis C-infected patients,male patients(OR:1.26,95% CI:1.03-1.54) with age over 40 years(summary OR:7.39,95% CI:3.82-9.38) had an increased frequency of type 2 diabetes.Some caution must be taken in the interpretation of these results because there may be unmeasured confounding factors which may introduce bias.CONCLUSION:The findings support the association between hepatitis C infection and type 2 diabetes mellitus.The direction of association remains to be determined,however.Prospective studies with adequate sample sizes are recommended.

Gastric neuroendocrine neoplasms type 1: A systematic review and meta-analysis

BACKGROUND To date, the histopathological parameters predicting the risk of lymph node (LN) metastases and local recurrence, associated mortality and appropriateness of endoscopic or surgical resection in patients with gastric neuroendocrine neoplasms type 1 (GNENs1) have not been fully elucidated. AIM To determine the rate of LN metastases and its impact in survival in patients with GNEN1 in relation to certain clinico-pathological parameters. METHODS The PubMed, EMBASE, Cochrane Library, Web of Science and Scopus databases were searched through January 2019. The quality of the included studies and risk of bias were assessed using the Newcastle-Ottawa Scale (NOS) in accordance with the Cochrane guidelines. A random effects model and pooled odds ratios (OR) with 95%CI were applied for the quantitative meta-analysis. RESULTS We screened 2933 articles. Thirteen studies with 769 unique patients with GNEN1 were included. Overall, the rate of metastasis to locoregional LNs was 3.3%(25/769). The rate of LN metastases with a cut-off size of 10 mm was 15.3% for lesions > 10 mm (vs 0.8% for lesions < 10 mm) with a random-effects OR of 10.5 (95%CI: 1.4 -80.8;heterogeneity: P = 0.126;I2 = 47.5%). Invasion of the muscularis propria was identified as a predictor for LN metastases (OR: 17.2;95%CI: 1.8-161.1;heterogeneity: P = 0.165;I2 = 44.5%), whereas grade was not clearly associated with LN metastases (OR: 2;95%CI: 0.3-11.6;heterogeneity: P = 0.304;I2 = 17.4%). With regard to GNEN1 local recurrence, scarce data were available. The 5-year disease-specific survival for patients with and without LN metastases was 100% in most available studies irrespective of the type of intervention. Surgical resection was linked to a lower risk of recurrence (OR: 0.3;95%CI: 0.1-1.1;heterogeneity: P = 0.173;I2 = 31.9%). The reported complication rates of endoscopic and surgical intervention were 0.6 and 3.8%, respectively. CONCLUSION This meta-analysis confirms that tumor size ≥ 10 mm and invasion of the muscularis propria are linked to a higher risk of LN metastases in patients with GNEN1. Overall, the metastatic propensity of GNEN1 is low with favorable 5- year disease-specific survival rates reported;hence, no clear evidence of the prognostic value of LN positivity is available. Additionally, there is a lack of evidence supporting the prediction of local recurrence in GNEN1, even if surgery was more often a definitive treatment.

Association between ApoE Polymorphism and Type 2 Diabetes: A Meta-Analysis of 59 Studies

Objective To identify the important risk factors for type 2 Diabetes Mellitus(T2 DM) and develop effective strategies to address the problem of T2 DM. Our study aimed to evaluate the association between apolipoprotein E(Apo E) genetic polymorphism and type 2 diabetes, and to provide clues for the etiology of T2 DM.Methods Based on the criteria of inclusion and exclusion, we extracted, pooled, analyzed and assessed the case-control studies of Apo E polymorphism and T2 DM published in Pub Med, Web of Science,Medline, Wan Fang, VIP, and CNKI databases by R soft-ware(version 3.4.3). We used Random-effect models when heterogeneity was present in between-study, and fixed-effect models otherwise.Results We had 59 studies covering 6,872 cases with T2 DM and 8,250 controls, and compared the alleles and genotypes of Apo E between cases and controls. When we conducted a comparison between Apo E ε4 and ε3 alleles, we produced a pooled OR of 1.18(95% CI: 1.09-1.28;P < 0.001). Apo E ε2/ε2 genotype displayed a possible association with T2 DM(OR = 1.46;95% CI: 1.11-1.93;P = 0.007), ε3/ε4 genotype showed a 1.11-fold risk(OR = 1.11;95% CI: 1.01-1.22;P = 0.039) and ε4/ε4 genotype had a1.71-fold risk of developing T2 DM(OR = 1.71;95% CI: 1.33-2.19;P < 0.001) when they were compared with ε3/ε3 genotype.Conclusions There is an association between Apo E polymorphism and T2 DM: allele ε4 and genotypes(ε2/ε2, ε3/ε4, and ε4/ε4) are associated with the increased risk for the development of T2 DM, and they may be risk factors for T2 DM.

Association of Interleukin-6-174G/C Polymorphism with the Risk of Diabetic Nephropathy in Type 2 Diabetes:A Meta-analysis

Previous studies reported the association between interleukin-6(IL-6)-174G/C gene polymorphism and the risk of diabetic nephropathy in type 2 diabetes mellitus(T2DN).However,the results remain controversial.In the present study,we conducted a meta-analysis to further examine this relationship between IL-6-174G/C gene polymorphism and T2DN.Three databases(PubMed,SinoMed and ISI Web of Science)were used to search clinical case-control studies about IL-6-174G/C polymorphism and T2DN published until Apr.14,2018.Fixed-or random-effects n lodels were used to calculate the effect sizes of odds ratio(OR)and 95%confide nee intervals(95%CI).Moreover,subgroup analysis was performed in tenns of the excretion rate of albuminuria.All the statistical analyses were con ducted using Stata 12.0.A total of 11 case-control studies were included in this study,involving 1203 cases of T2DN and 1571 cases of T2DM without DN.Metaanalysis showed that there was an association between IL-6-174G/C polymorphism and increased risk of T2DN under the allelic and recessive genetic models(G vs.C:OR=1.10,95%CI 1.03-1」&P=0.006;GG vs.CC+GC:OR=1.11,95%CI 1.02-1.21,P=0.016).In the subgroup analysis by albuminuria,a significant association of IL-6-174G/C polymorphism with risk of T2DN was noted in the microalbuminuria group under the recessive model(OR=1.54,95%CI 1.02-2.32,P=0.038).In conclusion,this meta-analysis suggests that IL-6-174G/C gene polymorphism is associated with the risk of T2DN.

Association of obesity with hypertension and type 2 diabetes mellitus in India:A meta-analysis of observational studies

AIM To perform a meta-analysis of the association of obesity with hypertension and type 2 diabetes mellitus(T2DM) in India among adults. METHODS To conduct meta-analysis, we performed comprehensive, electronic literature search in the PubM ed, CINAHL Plus, and Google Scholar. We restricted the analysis to studies with documentation of some measure of obesity namely; body mass index, waist-hip ratio, waist circumference and diagnosis of hypertension or diagnosis of T2DM. By obtaining summary estimates of all included studies, the meta-analysis was performed using both RevM an version 5 and "metan" command STATA version 11. Heterogeneity was measured by I^2 statistic. Funnel plot analysis has been done to assess the study publication bias.RESULTS Of the 956 studies screened, 18 met the eligibility criteria. The pooled odds ratio between obesity and hypertension was 3.82(95%CI: 3.39 to 4.25). The heterogeneity around this estimate(I^2 statistic) was 0%, indicating low variability. The pooled odds ratio from the included studies showed a statistically significant association between obesity and T2DM(OR = 1.14, 95%CI: 1.04 to 1.24) with a high degree of variability.CONCLUSION Despite methodological differences, obesity showed significant, potentially plausible association with hypertension and T2DM in studies conducted in India. Being a modifiable risk factor, our study informs setting policy priority and intervention efforts to prevent debilitating complications.

Effect of motivational interviewing on selfmanagement in patients with type 2 diabetes mellitus: A meta-analysis

Objective:The objective of this meta-analysis was to evaluate the effect of motivational interviewing(MI)on self-management in patients with type 2 diabetes.Methods:Randomised controlled trials that assessed the effects of MI on self-management and HbA1c levels in patients with type 2 diabetes were systematically reviewed using multiple electronic databases.Weighted mean differences with 95%confidence intervals were calculated for continuous data.Results:Ten trials were included in this meta-analysis.The self-management ability of patients with type 2 diabetes who underwent MI was significantly better than that of patients in the control group(WMD,2.37;95%CI,1.77e2.98;p<0.00001).Subgroup analysis showed that short-term MI(
6 months)resulted in a significant decrease in the HbA1c level(p<0.05)but that this advantage was not present for relatively long-term MI(>6 months)(p>0.05).Conclusions:MI was associated with improved self-management abilities among patients with type 2 diabetes,and short-term MI(
6 months)effectively decreased the HbA1c level.The effect of long-term MI(>6 months)on the HbA1c level remains uncertain.Large-scale,higher-quality randomised controlled trials are needed to confirm the present findings.

Probiotics supplementation for management of type Ⅱ diabetes risk factors in adults with polycystic ovarian syndrome: a meta-analysis of randomized clinical trial

This meta-analysis of randomized controlled trials aimed to evaluate the effects of probiotic supplementation on glucose homeostasis in patients with polycystic ovary syndrome(PCOS).The meta-analysis was performed in accordance with the Cochrane Handbook guidelines and relevant the preferred reporting items for systematic reviews and meta-analyses(PRISMA)statement criteria.Of 825 identified reports,11 randomized clinical trials were included in the meta-analysis.An analysis of pooled extracted data revealed that supplementation with probiotics significantly decreased fasting blood glucose(FBG,n=7;standardized mean difference(SMD)=−0.40;95%confidence interval(CI):−2.02,−0.02;P=0.04)and insulin levels(n=6;SMD=−0.57;95%CI:−0.89,−0.25;P=0.0004)and the homeostatic model assessment of insulin resistance(n=7;SMD=−0.64;95%CI:−0.96,−0.31;P=0.0001)while increasing the quantitative insulin sensitivity check index(QUICKI,n=5;SMD=0.58;95%CI:0.08,1.09;P=0.02)in patients with PCOS.The FBG-reducing effect decreased as the baseline body mass index(BMI)and mean age of the participants increased.Indeed,a greater number of bacterial species and a higher bacterial dose were shown to reduce QUICKI effectively.The systematic review indicated that probiotic supplementation may help to control glucose homeostasis in adults with polycystic ovarian syndrome.

Effects of Tai Chi on health outcomes in patients with type 2 diabetes mellitus: A systematic review and meta-analysis

Objective:To explore the effects and dose-response relationship of Tai Chi for type 2 diabetes mellitus(T2DM)and to evaluate the methodological quality of the included trials and evidence quality of the outcomes.Methods:Nine major English and Chinese databases were searched for randomized controlled trials of Tai Chi for T2DM from inception to December 2021.The effects and dose-response relationships were assessed with a meta-analysis and meta-regression using Stata.16.The methodological quality of the included studies was assessed using the risk of bias tool.The evidence quality of the outcomes was assessed using the GRADE tool.Results:A total of 24 studies with 1314 patients were included.Compared with the usual care,Tai Chi improved HbA1c(MD¼0.80%,95%CI[1.05,0.54],P<.001,I2¼18.29%,very low-quality evidence),FBG(SMD¼0.58,95%CI[0.86,0.31],P<.001,I2¼53.2%,low-quality evidence),fasting insulin(FIN),diastolic blood pressure,BMI,and the outcomes of quality of life(QoL)in patients with T2DM.However,when Tai Chi was compared with other exercise,there was no between-group difference in the HbA1c,FBG,TC,TG,HDL,LDL,BMI,and waist circumference(WC).Furthermore,the findings showed that an increase at every 18 weeks in length or an 823-h increase in the total time of Tai Chi intervention resulted in approximately a one unit reduction in the SMD of FBG.Conclusion:Compared with usual care,Tai Chi may improve HbA1c(with clinical significance),FBG,FIN,BMI,diastolic blood pressure,and outcomes of QoL in T2DM patients.The effects of Tai Chi were similar to those of other exercises on the HbA1c,FBG,TC,TG,HDL,LDL,BMI,and WC.Given the overall poor methodological quality and evidence quality,these findings should be treated cautiously.

Text Type and C-E Translation of Public Signs

This paper contends that the public sign is a kind of text with such vocative functions as indicating,instructing,restricting,prohibiting,persuading,and publicizing,so it falls into the type of vocative texts.The paper suggests that conveying the vocative function of the public sign is the essential task of the translator,so as to achieve the intended effect of the public sign.

A Meta-analysis of Salicylates for Type 2 Diabetes Mellitus

The aim of this study was to assess the effects and safety of salicylates on type 2 diabetes mellitus （T2DM）. We searched six databases （Cochrane Central Register of Controlled Trials, MED- LINE, EMBASE, CBM, CNKI and VIP） for all randomized controlled trials （RCTs） and self-control studies which investigated the effects of salicylates on T2DM. We included 34 RCTs and 17 self-control studies involving 13 464 patients with T2DM. It was demonstrated that salicylates had obvious effects on several parameters for patients with T2DM. （1） Any dose of salicylates could significantly reduce HbAIc level [mean difference （MD） -0.39%; 95% C1-0.47 to -0.32] in RCTs, but only high doses of salicylates （〉3000 mg/day） could effectively reduce fasting plasma glucose （FPG） level [standardized mean difference （SMD） -1.05; 95% CI -1.47 to -0.62] for patients with T2DM in both RCTs and self-control studies. Furthermore, high doses of salicylates could also increase plasma fasting insulin level （MD 12.20 mU/L; 95% CI 3.33 to 21.07）; （2） In both RCTs and self-control studies, high doses of salicylates could significantly reduce plasma triglycerides concentration. The results for RCTs were MD -0.44 mmol/L, 95% CI -0.71 to 4）.18, and those for self-control studies were 227±29 mg/dL （pre-treatment） and 117±8 mg/dL （post-treatment） （P=-0.009）; （3） All trials which reported cardiovascu- lar events were RCTs using low doses （〈1000 mg/day） of salicylates, and it was revealed that aspirin could significantly reduce the risk of myocardial infarction （OR 0.73; 95% CI 0.57 to 0.92）; （4） Two RCTs and two self-control studies with 〉3000 mg/day salicylates reported adverse effects, and the over- all effects were mild, and tinnitus occurred most frequently. No evidence of gastrointestinal bleeding was found in all these studies. In conclusion, from our systematic review, the anti-diabetic effect of salicylates is in a dose-dependent manner. High doses of salicylates may have beneficial effects on re- ducing FPG, HbAlc level and increasing fasting insulin concentration, and may also have some positive effects on lipidemia and inflammation-associated parameters for patients with T2DM, without serious adverse effects.

Association between the SUMO4 M55V Polymorphism and Susceptibility to Type 2 Diabetes Mellitus:A Meta-analysis

Objective The aim of this study is to determine whether the SUMO4 M55V polymorphism is associated with susceptibility to type 2 diabetes mellitus （T2DM）. Methods A meta-analysis was performed to detect the potential association of the SUMO4 M55V polymorphism and susceptibility to T2DM under dominant, recessive, co-dominant （homogeneous and heterogeneous）, and additive models. Results A total of eight articles including 10 case-control studies, with a total of 2932 cases and 2679 controls, were included in this meta-analysis. The significant association between the SUMO4 M55V polymorphism and susceptibility to T2DM was observed in the dominant model （GG ＋ GA versus AA： OR = 1.21, 95% CI = 1.05-1.40, P = 0.009）, recessive model （GG versus GA ＋ AA： OR = 1.29, 95% CI = 1.07-1.356, P = 0.010）, homozygous model （GG versus AA： OR = 1.41, 95% CI = 1.06-1.56, P = 0.001）, and additive model （G versus A： OR = 1.18, 95% CI = 1.08-1.29, P = 0.001）, and marginally significant in the heterozygous model （GA versus AA： OR = 1.16, 95% CI = 0.98-1.36, P = 0.080）. In subgroup analyses, significant associations were observed in the Chinese population under four genetic models excluding the heterozygous model, whereas no statistically significant associations were observed in the Japanese population under each of the five genetic models. Conclusion The meta-analysis demonstrated that the G allele of the SUMO4 M55V polymorphism could be a susceptible risk locus to T2DM, mainly in the Chinese population, while the association in other ethnic population needs to be further validated in studies with relatively large samples.

Efficacy of blood glucose self-monitoring on glycemic control in patients with non-insulin-treated type 2 diabetes: A meta-analysis

Objective:To evaluate the efficacy of blood glucose self-monitoring on glycemic control in patients with non-insulin-treated type 2 diabetes by performing a meta-analysis.Methods:Randomized controlled trials(RCTs)of the efficacy of blood glucose selfmonitoring were collected from the PubMed,EMBASE,Cochrane Library,CNKI,and VIP databases.Data were analyzed by RevMan 5.1 software.Results:Seven RCTs were included in this meta-analysis.The results indicated that blood glucose self-monitoring significantly reduced the glycated hemoglobin(HbA1c)level by 0.41%.Subgroup analysis showed that while implementation of a diabetes management regimen based on the blood glucose self-monitoring results effectively reduced the HbA1c level by 0.42%,no significant improvement in HbA1c level control was observed with the implementation of blood glucose self-monitoring alone.Conclusion:Blood glucose self-monitoring combined with diabetes management effectively improves glycemic control in patients with non-insulin-treated type 2 diabetes.

Berberine and Metformin in the Treatment of Type 2 Diabetes Mellitus: A Systemic Review and Meta-Analysis of Randomized Clinical Trials

Objective: To assess the effects of berberine and metformin on glucose in patients with type 2 diabets mellitus (T2DM) with a systematic review and meta-analysis. Methods: The databases including PubMed, Excerpta Medica Database (EMBase), Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI), WanFang, the Chinese Scientific and Technical Journals database (VIP), China Doctor Dissertation Full-text Database (CDFD) and China Master Dissertation Full-text Database (CMFD) from the inception to April 2021 in Chinese or English language were searched. Randomized controlled trials (RCTs) of berberine only or combined with metformin versus metformin were included. Data extraction and paper quality assessment were conducted according to the Cochrane Handbook. RevMan 5.4 was used for the meta-analysis. Results: A total of thirteen studies were included, covering 1173 participants. The clinical heterogeneity of the included trials was relatively high. The methodological quality of most trials was generally low with bias in terms of random sequence generation, allocation concealment, blinding method, outcome data and selective reporting. Interventions were divided into two subgroups for analysis. Meta-analysis suggested that there was no statistical significance in the hypoglycemic effect between berberine and metformin for T2DM. However, berberine combined with metformin could reduce fasting plasma glucose (FPG) [MD = −1.49, 95% CI (−2.22, −0.76), P < 0.0001], 2-hour postprandial blood glucose (2hPG) [MD = −1.89, 95% CI (−2.94, −0.84), P = 0.0004], glycosylated hemoglobin A1c (HbA1c) [MD = −0.65, 95% CI (−0.91, −0.40), P < 0.00001] and homeostasis model assessment of insulin resistance (HOMA-IR) [MD = −0.53, 95% CI (−1.03, −0.03), P = 0.04] levels significantly compared with metformin group. No severe adverse effects were reported in all trials. Conclusions: The hypoglycemic effect of berberine alone is not better than metformin. But berberine combined with metformin has good efficacy and safety in the treatment of T2DM. The current clinical studies are low in methodology and reporting quality, which needs to be further proved by more high quality, large sample size and multi-center RCTs.

Efficacy of empowerment education in self-management with Type 2 Diabetes Mellitus:A systematic review and meta-analysis

Objective:To evaluate the impact of empowerment education in self-management with Type 2 Diabetes Mellitus.Methods:A literature search was performed in PubMed,Web of Science,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),WanFang Data,CQVIP and China Biology Medicine disc(CBMdisc)and for randomized controlled trials published before November 2018.RevMan5.3 software was used for metaanalysis.Results:A total of 11 articles were included,involving 1139 patients.The group of empowerment education included 574 participants,and the regular education groups 565 participants.Meta-analysis showed that the group of empowerment education has an advantage over the control group in the levels of self-efficacy[MD=17.55,95%CI(14.14,20.96),P<0.00001],self-management[SMD=0.85,95%CI(0.60,1.11),P<0.00001],as well as the effectiveness of short-term empowerment education(within 6 months)on reducing HbA1c(P<0.05);however failed to long-term empowerment education(beyond 12 months)(P=0.05).Conclusion:This meta-analysis indicates that empowerment education can be an acceptable and appropriated nursing intervention for type 2 diabetes mellitus patients.

Meta-Analysis on Safety of Dapagliflozin in Patients with Type 2 Diabetes Mellitus

Objective: To evaluate the safety of dapagliflozin for Type 2 Diabetes Mellitus (T2DM). Methods: A systematic search of Pubmed, Embase, Cochrance Library, Web of Science, CNKI, Wanfang Data and VIP database for randomized controlled trials (RCTs) comparing dapagliflozin with placebo was performed up to February 2018. The index words included dapagliflozin, type 2 diabetes mellitus and randomized controlled trial. Results: A total of 19 RCTs involving 7704 participants were incorporated into the study. Compared with placebo, dapagliflozin did not increase the risk of hypoglycemia [OR = 1.14, 95%CI (0.95, 1.36), P = 0.17] and hypotension [OR = 1.43, 95%CI (0.94, 2.17), P = 0.10], but significantly increased the incidences of renal adverse events [OR = 1.57, 95%CI (1.17, 2.09), P = 0.002], genital tract infection [OR = 3.65, 95%CI (2.93, 4.56), P Conclusions: Generally, dapagliflozin had no risk of hypoglycemia and hypotension in patients with T2DM, but there were risks of renal adverse events and urogenital tract infection. Due to the limitations of this study, larger samples and RCTs with long-term follow-up are needed for further verification.

Branched-chain/aromatic amino acids as integrated biomarker of type 2 diabetes mellitus: a systematic review and meta-analysis

Background:As type 2 diabetes mellitus(T2DM)biomarkers,branched-chain amino acids(BCAAs:valine,leucine and isoleucine)and aromatic amino acids(AAAs:phenylalanine,tryptophan and tyrosine)may be correlated with the occurrence and development of T2DM.However,there is still no consensus on the disperse and isolated biomarkers of T2DM.Purpose:To explore the correlation between amino acids and T2DM based on integrated biomarker approach revealed.Methods:PubMed,Web of Science and CNKI were selected to search the literature published until August 31,2019.The included studies described the association between BCAAs,AAAs and T2DM.Random effect model and fixed effect model were adopted in pooled analysis to determine mean difference and 95 percent confidence interval of metabolites.Integrated biomarker was constructed in form of concentration change ratios or risk ratio(RR),relative risk(HR)and odds ratio(OR)of BCAAs and AAAs to reflect the integrated change information of amino acids.Results:The selected 20 studies contained 14942 healthy individuals and 3615 T2DM patients.The levels of BCAAs,phenylalanine and tyrosine both in plasma and serum samples were increased among all T2DM patients compared with those of the healthy control subjects(P<0.00001).However,the mean difference of tryptophan concentration was not statistically significant(P=0.60).The concentration change ratios or HR/RR/OR of BCAAs and AAAs were connected to form integrated biomarker.Conclusion:The integrated biomarker including BCAAs and AAAs could reflect the basic characteristics of T2DM,which has the potential clinical value on comprehensive diagnosis of T2DM.

A Meta-Analysis on the Correlation Between Herpes Simplex Virus Type II Infection and Adverse Pregnancy Outcomes in China

Objective:To systematically evaluate the relationship between herpes simplex virus type II(HSV-2)infection in pregnant women and the adverse pregnancy outcomes(preterm delivery,spontaneous abortion,stillbirth,monstrum,low birth weight,intrauterine growth retardation,premature rupture of membranes),so as to provide clinical guidance for the prevention and treatment of adverse pregnancy outcomes caused by HSV-2 infection in pregnant women.Methods:2140 articles were collected from PubMed,China National Knowledge Infrastructure(CNKI),and other databases for the past 20 years.According to the inclusion criteria,the literatures about the relationship between HSV-2 infection of pregnant women and adverse pregnancy outcomes were screened.The effect model was determined by heterogeneity test results,and the meta-analysis was carried out by RevMan 5.3 software.Results:The results of meta-analysis showed that the positive rate of HSV-2 was higher in the adverse pregnancy group than in the control group(odds ratio[OR]:7.92,95%confidence interval[Cl]:3.91-16.01),and the difference was statistically significant.Conclusion:HSV-2 infection will increase the risk of adverse pregnancy outcomes.Prevention and effective control of HSV-2 infection in early pregnancy can reduce the rate of adverse pregnancy outcome,which is of great significance to the promotion of eugenics.

New exercises of Health Qigong and patients with type 2 diabetes mellitus:a systematic review and meta-analysis

OBJECTIVE: To systematically assess the effect of new exercise of Health Qigong(NEHQ) on fasting plasma glucose(FPG), 2 hour postprandial plasma glucose(2 hPG), Hemoglobin A1C(HbA1C), triglycerides(TG), total cholesterol(TC), low density lipoprotein(LDL), and high density lipoprotein(HDL)in patients with type 2 diabetes mellitus(T2DM).METHODS: Data were retrieved by searching EMBASE,MEDLINE, The Cochrane Library, China Biology Medicine,China National Knowledge Infrastructure, Wanfang Data and Chongqing VIP Database. The random-ized controlled trials(RCTs) related to NEHQ were searched. The search terms were "fasting plasma glucose","2 hour postprandial plasma glucose","Hemoglobin A1C","TG(triglycerides)","total cholesterol","low density lipoprotein",and "high density lipoprotein". Meta-analysis were conducted with the Collaboration's Revman 5.3.RESULTS: Fourteen RCTs including 999 patients were analyzed. The levels of FPG in the patients with the intervention of NEHQ-Ba Duan Jin in 2, 6, 9 months respectively, and of NEHQ·Mawangdui Daoyin in 12 months were lower than those in the control group(P<0.05); the levels of 2hPG in the patients with the intervention of NEHQ-Ba Duan Jin in 2, 4, 6 months respectively were lower than those in the control group(P<0.05);the levels of HbAlc in the patients with the intervention of NEHQ·Ba Duan Jin in 2, 3, 4, 6, 9 months respectively, and of NEHQ·Mawangdui Daoyin 12 months were lower than those in the control group(P<0.05); the levels of TG in the patients with the intervention of NEHQ·Ba Duan Jin in 4 and 6 months respectively, and of NEHQ·Mawangdui Daoyin in 12 months were lower than those in the control group(P<0.05);the levels of TC in the patients with the intervention of NEHQ·Ba Duan Jin in 2,6, 9 months respectively were lower than those in the control group(P<0.05); the levels of LDL in the patients with the intervention of NEHQ-Ba Duan Jin in 3 and 6 months respectively were lower than those in the control group(P<0.05);the level of HDL in the patients with the intervention of NEHQ·Mawangdui Daoyin in 12 months was higher than those in the control group(P<0.05).CONCLUSION: The outcomes of the patients with T2DM in NEHQ group was better than those in the control group in terms of FPG, 2hPG, HbA1C, TQ LDL, and HDL.

Association between the presence of H pylori in the liver and hepatocellular carcinoma: A meta-analysis

AIM： To evaluate the arguments for and against the possible roles of H pylori in hepatocellular carcinoma （HCC）. METHODS： We performed a systematic review of all relevant studies published in the literature. A total of 103 clinical trials and reports were identified, but only 10 trials qualified under our selection criteria. A metaanalysis was carried out by a biostatistician according to the Cochrane Reviewers＇ Handbook recommended by The Cochrane Collaboration. RESULTS： Nine case-control studies and one retrospective cross sectional study were included in the final analysis. Overall the prevalence of H pylori infection was 53.3% （129 of 242） in cases and 10.4% （29 of 280） in controls, and the summary odds ratio for the association of H pylori infection with the risk for HCC （using the fixed-effects model, which accounted for the homogeneity across the 10 studies） was determined to be 13.63 （95% CI, 7.90-23.49）. CONCLUSION： Our analysis showed a positive association between F1 pylori infection and the risk of HCC, with an indication of possible publication bias and possible confounders due to study designs that showed results of less pronounced associations.

FTO Polymorphisms Are Associated with Obesity But Not with Diabetes in East Asian Populations:A Meta-analysis

Objective To clarify the contradictory findings in patients with obesity and type 2 diabetes by meta-analysis. Methods PubMed and Embase were searched for articles published up to March 2009. All studies on the association of FTO polymorphisms with obesity and type 2 diabetes were included. Pooled odds ratio was calculated using the model of fixed or random effects. Sensitivity analysis was performed to evaluate the stability of meta-analytic results. Results Meta-analysis suggested that rs9939609 A allele was more significantly associated with obesity risk than T allele （3 studies / 2 004 cases and 4 544 control subjects）： random effect odds ratio （OR）-1.28, 95%CI=1.05 and 1.55, P heterogeneity =0.05, I^2=66.6%. Similar results were observed in rs8050136 polymorphism （3 studies/2 404 cases and 5 713 control subjects）： fixed effect OR =1.25, 95%CI-1.13, 1.37, Pheterogeneity =0.12, 12=51.9%. However, no significant association was found between genetics and risk of type 2 diabetes after control of potential confounders （at least for BMI） either for rs9939609 （fixed effect OR=1.05, 95% CI 0.97,1.13） or for rs8050136 polymorphism （fixed effect OR -1.07, 95%CI： 0.99, 1.16）. Furthermore, the sensitivity analysis strengthened our confidence in validity of the association. Conclusion FTO polymorphisms are associated with obesity but not with type 2 diabetes in East Asian populations. Further large-scale studies are required to conclusively establish the association.