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ObjectiveTo further verify the ability of noninvasive diagnostic method for liver fibrosis in predicting liver fibrosis in chronic hepatitis C patients followed up after sustained virologic response (SVR) based on liver biopsy. MethodsA prospective cohort study was performed for the chronic hepatitis C patients who attended Beijing YouAn Hospital, Capital Medical University, from October 2015 to December 2017, and all patients were followed up regularly after SVR and underwent liver biopsy. The diagnostic efficiency of the noninvasive diagnostic method for liver fibrosis was verified based on pathological results. The receiver operating characteristic (ROC) curve was used to evaluate the ability of LSM, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) in the diagnosis of liver fibrosis, and STATA and R language were used to compare the area under the ROC curve (AUC). ResultsA total of 96 patients were successfully enrolled. The LSM after SVR was significantly lower than that at baseline, and LSM had a significantly larger AUC than APRI (0.89 vs 0.67, P＜0.05) and FIB (0.89 vs 0.69, P＜0.05) in the diagnosis of liver cirrhosis after SVR. LSM at a cut-off value of 795 kPa, and based on the best specificity, the diagnosis of liver cirrhosis could be considered when LSM was greater than 9.15 kPa, with a positive likelihood ratio of 5.91%; progressive liver fibrosis could be excluded based on LSM ＜6.85 kPa, with a negative predictive value of 0.98. Follow-up time and antiviral regimen had no influence on the diagnostic ability of LSM. ConclusionThe cut off value of LSM needs to be lowered to predict liver fibrosis after SVR in chronic hepatitis C patients.

ObjectiveTo investigate the diagnostic efficacy of FibroScan in the diagnosis of progressive liver fibrosis in patients with chronic hepatitis C and related influencing factors. MethodsA total of 131 patients with chronic hepatitis C who attended Beijing YouAn Hospital, Capital Medical University from June 2015 to June 2018 were enrolled, and all of them underwent liver biopsy. Fibrosis stage was defined as F1 to F4 stages according to the METAVIR scoring system. General information was collected, and liver stiffness measurement (LSM), liver function test, routine blood test, and viral quantification were performed for all patients. Aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) were calculated according to equations. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous between multiple groups, and the Wilcoxon rank-sum test was used for further comparison between two groups. A Spearman correlation analysis was performed. The receiver operating characteristic (ROC) curve was used to analyze the value of three noninvasive methods in the diagnosis of liver fibrosis, and STATA was used to investigate whether there was a significant difference between the three methods. ResultsA total of 131 patients were enrolled, with 60 male patients (45.80%) and 71 female patients (5420%), and the mean age was 54.00(45.00-58.25）years. The median values of FibroScan, APRI, and FIB-4 were 7.80 (5.60-14.30）kPa, 0.63(0.37-1.28), and 2.28(1.43-3.60), respectively. LSM gradually increased with the progression of liver fibrosis, and there was a significant difference between groups (H=47.83, P＜0.01). For progressive liver fibrosis (≥F3 stage), FibroScan had a larger area under the ROC curve (AUC) than APRI and FIB-4, and further analysis based on STATA showed that there was a significant difference in AUC between FibroScan and APRI (P＜001), while there was no significant difference in AUC between FibroScan and FIB-4 (P=0.07). FibroScan was correlated with alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), and platelet count (r=0.271, 0507, 0.444, and -0.263, all P＜0.01). The AUC of FibroScan was not significantly improved after adjustment for the above influencing factors. ConclusionFibroScan has good diagnostic efficacy in the diagnosis of progressive liver fibrosis in patients with hepatitis C, with better comprehensive diagnostic efficacy than APRI and FIB-4. The accuracy of FibroScan in diagnosis is not affected by the indicators such as ALT, AST, and GGT.

Additional file 2: Table S1 Detection rate of hyperlipidemia with basic characteristics of different populations. Table S2. Comparison of detection rates and differences of hyperlipidemia in different lifestyles and eating habits. Table S3. Comparison of the detection rates and differences of hyperlipidemia in different physiological conditions and comorbidities. Table S4. Variables and their assignments. Table S5. Different BMI central type obesity detection rate. Fig. S1. Risk reasoning of BMI and central obesity. Fig. S2. Risk reasoning for hyperlipidemia and average daily oil intake.

Additional file 3. R codes for building the BNs.

Additional file 2: Questionnaire (in English)

Additional file 1. Data sources and definitions.

Additional file 1: Table S1. Sampling process of survey subjects for chronic disease surveillance in China; Table S2. Survey subject general information; Table S3. Classification model evaluation index; Table S4. Confusion Matrix

ObjectiveTo investigate the application of a modified diagnostic scale in the diagnosis of acute drug-induced liver injury (DILI). MethodsA total of 82 patients with acute DILI who were treated in Beijing YouAn Hospital, Capital Medical University from January 2011 to December 2015 were enrolled, among whom 52 were enrolled in DILI group and 30 were enrolled in non-DILI group. On the basis of Roussel Uclaf Causality Assessment Method (RUCAM) scale and with reference to Digestive Disease Week Japan scale, three parameters, i.e., “report of liver injury induced by single Chinese materia medica or Chinese patent medicine”, “eosinophil count”, and “drug lymphocyte stimulation test based on Cell Counting Kit-8”, were added to establish a modified diagnostic scale. The RUCAM scale and the modified diagnostic scale were used to evaluate each suspected drug to verify the sensitivity and specificity of this new scale in the diagnosis of DILI. The chi-square test was used for comparison of categorical data between groups. ResultsThere were 75 suspected drugs in the DILI group and 41 suspected drugs in the non-DILI group. Compared with the RUCAM scale, the modified diagnostic scale increased the number of drugs evaluated as “highly probable” and “probable” from 74.7% to 94.7% (χ2=11.554, P=0.001) in the DILI group. In the non-DILI group, only 2 drugs (4.9%) were changed from “possible” to “probable”, and the other drugs were maintained as “possible”, “unlikely”, or “excluded”; the specificity of diagnosis was reduced from 100% to 95.1% (χ2=0.512, P=0.474). ConclusionCompared with the RUCAM scale, this modified diagnostic scale has an increased sensitivity and a reduced specificity of diagnosis and needs to be further validated in clinical practice.