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Background Pegylated interferon (PEG-IFN) alfa-2b is recommended for chronic hepatitis B (CHB). We aimed to investigate the sustainability of off-treatment responses among Chinese HBeAg-positive CHB patients treated with PEG-IFN alfa-2b from a randomized trial. Methods Eligible Chinese patients (n = 322) were followed up by one visit after a median of 6 years (LTFU) following their participation in a randomized trial evaluating the efficacy of three PEG-IFN alfa-2b dosing regimens (1.0 or 1.5 μg/kg/wk. 24 weeks or 1.5 μg/kg/wk. 48 weeks). Primary endpoints at the LTFU were sustained SR and CR (SR/CR at the end of original study [EOS] and at the LTFU). SR was defined as HBeAg loss and seroconversion to anti-HBe and CR as HBeAg loss and seroconversion to anti-HBe and HBV-DNA

Aims: The study aimed to investigate the relationship between metabolic syndrome (MS) and risk of cancer in patients with type 2 diabetes (T2DM). Methods: We enrolled 6587 patients with T2DM who were hospitalized in Qingdao Endocrine and Diabetes Hospital from Feb 2005 to Jan 2016. According to the number of MS component each patient had, they were divided into isolated T2DM, T2DM plus 1 component,2 components, 3 components and 4 components, respectively. The IDF Worldwide Definition of the Metabolic Syndrome was applied. Information on the diagnosis of cancer was obtained by matching ICD-10 codes recorded in local Healthcare medical records database. Prevalence of cancer was compared using Chi-square test. Logistic regression model was used to evaluate risk of cancer associated with MS. Results: The prevalence of cancer was 4.2% among 6587 patients with T2DM. Female patients had higher prevalence than did male in total or in the MS subgroup. The prevalence of cancer were 3.8%, 3.9%, 3.8%, 5.1% and 5.0% in isolated DM, T2DM plus 1 component of MS, T2DM plus 2, T2DM plus 3 and T2DM plus 4 components, respectively (P for trend Conclusions: A cluster of metabolic disorders consisting of increased waist, elevated TG and decreased HDL-C seems to be oncogenic among Chinese patients with T2DM. For patients in combination with 3 or 4 MS components, it is important to conduct early cancer screening and prevention. Disclosure L. Zhang: None. Y. Yang: None. W. Meng: None. J. Wang: None. S. Chen: None. Y. Dong: None.

Objectives: Adult-onset autoimmune diabetes, defined as having latent autoimmune diabetes in adults (LADA), is characterized by a less intensive autoimmune process, in which a lymphocytic infiltration of the exocrine pancreas is involved. immunosuppressive agents may have potential therapeutic benefit. This is a pilot study examining the therapeutic effects of ciclosporin A on insulin secretion in patients with LADA. Methods: The study was an open label, single arm, pilot trial. A total of 18 patients (12 men and 6 women with mean age of 40.6 yrs old) diagnosed with LADA were prospectively evaluated. All patients underwent insulin treatment at least for 3 months without any oral anti-hyperglycemic agent. All patients were prescribed ciclosporin A (50mg/day) for 12 weeks. Serum C-peptide concentrations were measured at baseline and 3 months after ciclosporin A intervention. We also evaluated total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine (Cre) before and after ciclosporin A treatment. The primary outcome of the study was the change in serum C-peptide concentrations. Results: A total of 17 patients completed the study. One patient was withdrawn at day 32 due to discontinuation of medication. Serum fasting C-peptide concentrations significantly increased from 0.12 ng/ml up to 0.32 ng/ml (P0.05), DBIL (4.70 vs. 4.65 umol/L, P>0.05), AST (17.41 vs. 17.82 U/L, p>0.05), ALT (18.19 vs. 18.08 U/L, p>0.05), or Cre (67.40 vs. 67.53 umol/L, P>0.05) compared with the corresponding baseline levels. Conclusions: This pilot study demonstrates the potential therapeutic effects of oral administration of ciclosporin A for patients with LADA. Larger, controlled studies are needed to verify the findings. Disclosure L. Zhang: None. W. Meng: None. S. Chen: None. Y. Yang: None. J. Wang: None. Y. Dong: None.

Nonalcoholic fatty liver disease (NAFLD) is independently associated with cardiovascular disease and chronic kidney disease. Among patients with type 2 diabetes (T2DM), the relationship between NAFLD and diabetic macrovascular and microvascular complications is unclear. The study population consisted of 2504 patients (M/F: 1520/984, mean age 60.8 ± 10.4 years) with T2DM who have been hospitalized between 2007 and 2011. All subjects had data on anthropometric parameters, total cholesterol (TC), low-density lipoprotein cholesterol, HbA1C, creatinine (Scr), tumor necrosis factor- α (TNF-α), and 24h urine albumin exerting rate (24hUAER). Doppler ultrasound examination was used to diagnose fatty liver and to measure carotid artery intima-media thickness (IMT). Carotid artery intimal thickening was diagnosed as IMT≧1mm. Diabetic nephropathy (DN) was diagnosed if 24hUAER≧30mg/24h. NAFLD accounted for 57.4% of all patients. After adjusting for age, gender, disease duration, systolic blood pressure (SBP), waist and other factors, patients with NAFLD had increased carotid artery IMT (1.11 ± 0.25 vs. 0.87 ±0.18 mm, P Disclosure L. Zhang: None. N. Wang: None. J. Wang: None. X. Yin: None. Y. Yang: None. W. Gao: None. Y. Dong: None.

Vitamin D deficiency is not only related to bone-related diseases but also associated with cardiovascular disease, diabetes, cancer and autoimmune diseases. Previous studies show that vitamin D deficiency increases risk of diabetic peripheral neuropathy (DPN). Data is limited among Chinese patients with type 2 diabetes. In this cross-sectional study, we enrolled 5362 patients (2359 men and 3003 women aged 30 to 89 years) with type 2 diabetes from Jan 1, 2016 to Oct 31, 2018. Serum 25-hydroxyvitamin D (25(OH)D) level was measured by electrochemiluminescence assay. Vitamin D deficiency was defined as Serum 25(OH)D level < 20 ng/mL according to the Endocrine Society Clinical Practice Guideline 2011. Diabetic peripheral neuropathy was diagnosed by motor/sensory nerve conduction velocity. Patients with diabetic peripheral neuropathy had lower serum 25(OH)D concentration (16.81±3.83 ng/mL vs. 18.05±4.11 ng/mL, P Disclosure L. Zhang: None. Y. Gu: None. Y. Yang: None. Y. Zhu: None. X. Yin: None. Y. Dong: None.

The study aimed to investigate the effect of 7-point or 5-point glucose monitoring on medical costs, glycemic control and the incidence of hypoglycemia in hospitalized patients with type 2 diabetes (T2DM). A total of 4002 patients with T2DM (1490 male and 2512 female cases) with complete medical records were included between 2012 and 2017. The average age was 61.5 years and the mean disease duration 8.68 years. According to the frequency of daily monitoring of blood glucose during hospitalization, patients were divided into 2 subgroups of 5-point group and 7-point group. Patients in 5-point group received fasting blood glucose (FBG), 2h blood glucose (2hBG) after breakfast, 2hBG after lunch, 2hBG after dinner and bedtime blood glucose tests. Patients in 7-point group received additional tests of pre-lunch glucose and pre-dinner blood glucose. Blood glucose monitoring was performed using Johnson & Johnson SureStep blood glucose meter. Comparison of two groups includes duration of in-hospital stay, medical costs, glycemic control and the incidence of hypoglycemia. Patients in 7-point glucose monitoring group had significantly shorter hospital stay (14.4 vs. 16.6 days, P0.05). At discharge, both fasting and 2-h glucose decreased significantly compared with baseline levels in either 5-point or 7-point group. In 7-point group, FPG decreased by 2.41mmol/L and 2hPG by 3.9mmol/L. In the 5-point group, the corresponding figures were 2.07mmol/L and 3.6mmol/L, respectively. The incidence of hypoglycemia were 24.2% in 7-point group and 33.1% in 5-point group (P Disclosure L. Zhang: None. Y. Gu: None. Y. Yang: None. N. Wang: None. W. Gao: None. J. Wang: None. X. Yin: None. Y. Dong: None.

Adult-onset autoimmune diabetes, defined as having latent autoimmune diabetes in adults (LADA), is characterized by a less intensive autoimmune process, in which a lymphocytic infiltration of the exocrine pancreas is involved. Immunosuppressive agents may have potential therapeutic benefit. This is a pilot study examining the therapeutic effects of oral administration of ciclosporin A on insulin secretion in patients with LADA. The study was an open label, single arm, pilot trial. A total of 12 patients (8 men and 4 women with mean age of 40.2 years old) diagnosed with LADA were prospectively evaluated. All patients underwent insulin treatment at least for 3 months without any oral anti-hyperglycemic agent. Serum C-peptide concentrations were measured at baseline and after ciclosporin A intervention. We also evaluated clinical parameters including total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine (Cre) before and after ciclosporin A treatment. The primary outcome of the study was the change in serum C-peptide concentrations. A total of 12 patients completed the study. No patient was withdrawn. Serum fasting C-peptide concentrations significantly increased from 0.10 ng/ml up to 0.32 ng/ml, following treatment with ciclosporin A (50mg/day) for 4 weeks (P Disclosure L. Zhang: None. J. Wang: None. N. Wang: None. Y. Yang: None. X. Yin: None. Y. Dong: None.

Patients with diabetes (DM) are at high risk for restenosis after coronary stenting. Information relating the outcome of percutaneous transluminal coronary angioplasty (PTCA) to prediabetes is, however, limited. The study objective was to investigate the relationship between restenosis after PTCA and baseline glucose categories. We retrospectively analyzed data of 1003 patients (mean age 58.5±4.2 years, 61.5% of men, mean history of coronary heart disease 9.5±1.1 years) who undertook PTCA at Emergency Department between Jan 2008 and Dec 2011. Baseline measures included blood pressure (BP), fasting plasma glucose, lipid profile, HbA1c, C-reactive protein (C-RP), and 2-hour capillary glucose. All patients had follow-up coronary angiography 2 year after PTCA. Restenosis was defined as ≧ 50% stenosis in stent or within 5 mm adjacent to stent. The rate of restenosis was compared among patients with normal glucose tolerance (NGT, n=436), impaired glucose regulation (IGR, n=275), and DM (n=292) according to their baseline glucose levels or prior history of DM. Patients with DM had highest levels of body mass index (BMI), BP, triglycerides (TG), and C-RP, followed by those with IGR and NGT (P8% had increased rate of restenosis (14.6% vs. 11.2%, P Disclosure L. Zhang: None. Y. Gu: None. X. Yin: None. J. Wang: None. N. Wang: None. Y. Yang: None. Y. Dong: None.

// Bin Yan 1, * , Zhongsheng Lu 1, * , Zhizheng Ge 2 , Side Liu 3 , Xuegang Guo 4 , Dean Tian 5 , Yuxiu Yang 6 , Xiaobo Li 2 , Wei Gong 3 , Zhiguo Liu 4 , Mei Liu 5 , Bingxi Zhou 6 , Kabing Zhao 1 , Jing Yang 1 and Yunsheng Yang 1 1 Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China 2 Department of Gastroenterology and Hepatology, Renji Hospital, Shanghai, China 3 Department of Gastroenterology and Hepatology, Nanfang Hospital, Guangzhou, Guangdong Province, China 4 Department of Gastroenterology and Hepatology, Xijing Hospital, Xian, Shanxi province, China 5 Department of Gastroenterology and Hepatology, Tongji Hospital, Wuhan, Hubei province, China 6 Department of Gastroenterology and Hepatology, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, China * These authors contributed equally to this work Correspondence to: Yunsheng Yang, email: sunny301ddc@126.com Keywords: randomized clinical trial; endoscopic submucosal dissection; ulcer; lansoprazole; rebamipide Received: September 29, 2017 Accepted: November 15, 2017 Published: January 02, 2018 ABSTRACT Objective: To evaluate the healing efficacy of rebamipide and lansoprazole combination therapy with lansoprazole alone for endoscopic submucosal dissection (ESD)–induced ulcers and clarify the ulcer healing-associated factors. Materials and Methods: Three hundred patients were randomized into control and experimental groups after undergoing ESD. The patients received intravenous pantoprazole (30 mg) every 12 hours and oral rebamipide (100 mg, experimental group) or placebo (control group) three times daily on days 1–3. On days 4–56, patients received oral lansoprazole (30 mg daily) and rebamipide (100 mg) or placebo three times daily. Endoscopic evaluations were performed at postoperative 4 and 8 weeks. Results: At week 4, the ulcer reduction rate was significantly higher in the experimental than in the control group (0.94 ± 0.078 vs. 0.97 ± 0.034; P < 0.001). The ulcer healing (20.3% vs 18.2%; P = 0. 669) and ulcer improvement rates (88.7% vs 94.2%; P = 0. 109) in the two groups were not significantly different. At week 8, the ulcer healing and ulcer improvement rates were 90.6% and 100%, respectively, in both groups. Multivariate analysis showed that the combination treatment was an independent factor associated with ulcer area reduction after ESD. The maximum diameter of the initial ulcer (≥ 35.5 mm vs. < 35.5 mm) was an independent factor associated with the ulcer improvement rate after ESD. Conclusions: The rebamipide and lansoprazole combination therapy can help accelerate the reduction rate of post-ESD ulcer compared with the lansoprazole monotherapy at four weeks of therapy.

BackgroundIn mainland China, peginterferon (PEG-IFN) alfa-2b 1.0μg/kg/wk for 24 weeks is the approved treatment for HBeAg-positive chronic hepatitis B.ObjectiveThis multicenter, randomized trial evaluated the safety and efficacy of regimens utilizing increased dose or treatment duration in treatment-naive Chinese patients with chronic hepatitis B.Study design670 HBeAg-positive patients from China, Malaysia, Taiwan area, Singapore, and Thailand were enrolled. Patients received PEG-IFN alfa-2b 1.0μg/kg/wk (arm A) or 1.5μg/kg/wk (arm B) for 24 weeks, or 1.5μg/kg/wk for 48 weeks (arm C). The primary end point was loss of HBeAg 24 weeks after end of treatment.ResultsAt the end of follow-up, HBeAg loss was significantly greater in arm C compared with arm A (31.3% vs. 17.3%; P=0.001) and arm B (31.3% vs. 18.1%; P=0.001). No significant difference in the rate of HBeAg loss was observed between arms A and B. The proportions of patients with HBe seroconversion, HBV DNA levels

OBJECTIVES: To evaluate the healing efficacy of rebamipide and lansoprazole combination therapy with lansoprazole alone for endoscopic submucosal dissection (ESD)–induced ulcers and clarify the ulcer healing-associated factors. METHODS: Three hundred patients were randomized into control and experimental groups after they underwent ESD. The patients received intravenous pantoprazole (30 mg) every 12 hours and oral rebamipide (100 mg, experimental group) or placebo (control group) 3 times daily on days 1–3. On days 4–56, patients received oral lansoprazole (30 mg daily) and rebamipide (100 mg) or placebo 3 times daily. Endoscopic evaluations were performed at postoperative weeks 4 and 8. RESULTS: At week 4, the ulcer reduction rate was significantly higher in the experimental than in the control group (0.97 ± 0.034 vs. 0.94 ± 0.078; P < 0.001). The ulcer healing (18.2% vs 20.3%; P = 0.669) and ulcer improvement rates (94.2% vs 88.7%; P = 0.109) in the 2 groups were not significantly different. At week 8, the ulcer healing and ulcer improvement rates were 90.6% and 100%, respectively, in both groups. Multivariate analysis showed that the combination treatment was an independent factor associated with ulcer area reduction after ESD. The maximum diameter of the initial ulcer (≥35.5 mm vs

Summary Influenza pandemics are a serious threat to public health in today's world. In the past 10 years, the outbreak of three forms of severe influenza – H5N1, H1N1, and H7N9 – has caused tremendous loss of life and property. In order to better cope with pandemics, antivirals such as oseltamivir are being stockpiled in great quantities, placing a substantial burden on government budgets and potentially resulting in massive waste because of the uncertainty as to when an influenza pandemic will strike and whether emerging virus strains will be resistant to the stockpiled drugs. Complementary and alternative medicine (CAM) is generally available, affordable, and commonly used in China and many other countries and CAM has a long track record of fighting influenza. The Chinese Government appropriated funds to intensively investigate herbal medicines in accordance with the principles of evidence-based medicine in order to identify effective, inexpensive, and easily stockpiled medicines. Thus far, several drugs including Shufeng Jiedu capsules, Lianhua Qingwen capsules, Maxing Shigan decoction, Yinqiao powder, and Jinhua Qinggan granules have demonstrated effectiveness in fighting influenza. In the future, CAM is expected to make greater contribution in controlling the prevalence of influenza pandemics.