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This analysis aimed to investigate the candidate biomarkers associated with overall survival (OS) in hepatocellular carcinoma (HCC) patients.In the GSE14520 dataset, candidate parameters were selected and included in the Cox regression and Nomogram models through bioinformatic enrichment methods and LASSO analysis, survivor functions of candidate biomarkers were also assessed.Complement and coagulation cascades including 36 differential expressed genes (DEGs) and ribosome pathway including 27 DEGs were significantly enriched (both p0.05 and adjusted p0.05). LASSO model, Cox regression and nomogram analysis indicated that RPS3, together with BCLC and TNM staging, were significantly associated with OS in HCC patients. Validated in the GEO series, TCGA and Human Protein Atlas (HPA) datasets, RPS3 mRNA and RPS3 protein were significantly upregulated in tumor tissues compared to that in nontumor tissues (all p0.05). Upregulation of RPS3 has been linked to high alpha fetoprotein (AFP), advanced tumor stages and multinodular (all p0.05). After adjusting AFP, tumor stage and multinodular, log rank analysis revealed that HCC patients with high RPS3 had unfavorable OS compared to those with low RPS3 (all p0.05).RPS3 upregulation in tumors might contribute to unfavorable OS in HCC patients.

The crosstalk between Toll-like receptor 4 (TLR-4) and lipopolysaccharide (LPS) accounts for liver fibrosis progression. This study aimed to investigate the predictive performance of altered genes induced by TLR-4 and LPS challenge for advanced liver fibrosis.The overlapping differentially expressed genes (DEGs) of TLR-4 and LPS challenge models from the Gene Expression Omnibus (GEO) database were screened and included in the random forest analysis to identify potential candidates for predicting advanced liver fibrosis in the GSE84044 dataset. The roles of the identified candidates in liver injury development and activation of hepatic stellate cells (HSCs) were also addressed.Among the overlapping DEGs in the GSE30485, GSE33446 and GSE166488 datasets, vimentin (VIM) was the most important gene for predicting advanced liver fibrosis (S ≥ 2) by the random forest model. In the GSE84044 dataset, VIM was positively correlated with liver fibrosis (r = 0.68, 95% CI = 0.57-0.76, p0.0001), and accurately predicted advanced liver fibrosis (AUC = 0.85, 95% CI = 0.78-0.91), both in males (AUC = 0.84, 95% CI = 0.76-0.92) and females (AUC = 0.87, 95% CI = 0.76-0.99). VIM was significantly upregulated in various liver diseases (cirrhosis, liver failure, chronic hepatitis B and fatty liver disease) and liver injury models (ANIT, BDL, CCl4 and DMN). Additionally, VIM was correlated with HSC regulators (TGFβ, PDGF, CTGF and BMP7) and overexpressed in activated HSCs (p0.05). Enrichment analysis indicated that VIM-induced gene alterations were involved in the cytosolic DNA-sensing pathway, Toll-like receptor signaling pathway, etc. CONCLUSIONS: VIM could predict advanced liver fibrosis in CHB patients and is mainly involved in the activation of HSCs and profibrotic signaling pathways.

To investigate the heterogeneity of decidual endothelial cells and their changes during delivery.Single-cell RNA sequencing was used to characterize the transcriptomes of decidual endothelial cells before and after the onset of labor.Decidual endothelial cells (9748 cells) were divided into five subgroups with different functions according to differences in the transcriptome. The functions of cluster 5 were enriched in vascular development and response to growth factors. After the onset of labor, the activities of each cluster were different, including the interleukin 17 pathway and regulation of ERK1 and ERK2 cascade. The downregulated genes were related to scavenger receptor (cluster 5), which may reflect the process of endothelial activation. In terms of genetic changes, cluster 5 may be more actively involved in labor than the other clusters.Peripartum decidual endothelial cells are heterogeneous and participate in labor to varying degrees. One of the five subtypes of endothelial cells may be more actively involved in labor onset. Our findings may enable the assessment of decidual endothelial cells and labor onset.

Aim Whether different adiposity measures predict incident diabetes differentially in general Chinese populations is unclear. We investigated this in Chinese people aged 50+ years in the Guangzhou Biobank Cohort Study. Methods Waist circumference and BMI were measured at baseline, and fasting glucose was measured at both baseline and follow-up examinations. Incident diabetes was defined as fasting glucose ≥ 7.0 mmol/l, glucose after 2-h oral glucose tolerance test ≥ 11.1 mmol/l, and/or self-reported physician-diagnosed diabetes during the follow-up period. Results Of 15 752 people without diabetes at baseline from 2003 to 2008, 1779 (11.3%) developed incident diabetes during the follow-up from 2008 to 2012 (mean = 3.6 years, sd = 1.0). After mutually adjusting each other and adjusting for other potential confounders, waist circumference showed a higher predictive value than BMI. The odds ratio (OR) (95% confidence interval (CI) was 1.50 (95% CI 1.37–1.64) for a 1 sd increment in waist circumference and 1.21 (95% CI 1.11–1.33), for a 1 sd increment in BMI. Similarly, after mutual adjustment, abdominal obesity was associated with an almost twofold odds of incident diabetes (OR 1.93, 95% CI 1.71–2.17), which was higher than that for general obesity (OR 1.76, 95% CI 1.50–2.06). The area under receiver operating characteristic curve (AUC) for waist circumference was higher than that for BMI [AUC = 0.676 (95% CI 0.660–0.686) vs. 0.665 (95% CI 0.651–0.678), P = 0.02]. Conclusion Abdominal obesity predicted incident diabetes in older people better than general obesity. Our findings may be an early warning signal for local government or public health practitioners to develop and investigate more effective intervention programmes for diabetes, and should also be disseminated to the public to pay more attention to this important public health issue. This article is protected by copyright. All rights reserved.

Cross-sectional associations between white blood cell (WBC) count, lymphocyte and granulocyte numbers, and carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (PWV) were examined in a novel older Chinese community sample. A total of 817 men and 760 women from a sub-study of the Guangzhou Biobank Cohort Study had a full blood count measured by an automated hematology analyzer, carotid IMT by B-mode ultrasonography and brachial-ankle PWV by a non-invasive automatic waveform analyzer. Following adjustment for confounders, WBC count (β=0.07, P

Background Impaired liver function has been shown to be associated with incident diabetes. The independent role of the different liver enzymes, including γ-glutamyltransferase (GGT), alanine transaminase (ALT) and aspartate transaminase (AST), has not been addressed properly, taking into account their high collinearity. We used partial least squares (PLS) regression to identify the contribution of ALT, AST and GGT, which appears causally associated with diabetes as a validation factor, to incident diabetes in a South China population where liver impairment and diabetes are common. Methods Participants were from the Guangzhou Biobank Cohort Study recruited in 2003–2008, with follow-up re-examination up to the end of 2012. Multivariable generalised linear models and PLS were used to examine the adjusted associations of ALT, AST and GGT with diabetes. Incident diabetes was defined as self-reported diabetes, and/or initiation of hypoglycaemia medication or insulin during follow-up, or fasting glucose ≥7.0 mmol/L, or 2 h oral glucose tolerance test, glucose ≥11.1 mmol/L at follow-up examination. Results In 10 764 Chinese participants aged ≥50 years with no diabetes at baseline, 1228 (11.4%) developed diabetes during the median 4 years of follow-up. Using PLS, the risk for incident diabetes was higher by 18% (95% CI 8% to 27%) per 1 SD increment in log-ALT, and expectedly higher by 36% (95% CI 26% to 52%) for log-GGT, adjusted for age, sex, education, smoking, alcohol, physical activity, waist circumference and body mass index. Similarly adjusted, no association for log-AST (relative risk 0.92, 95% CI 0.85 to 1.01) was found. Conclusions ALT but not AST was associated with incident diabetes. Further experimental studies are needed to confirm the causal association and clarify the underlying mechanisms.

This cross-sectional study aimed to describe the pattern of smoking in relation to occupational hazard exposure in a working population in Guangzhou, China. In 1994, data on smoking and occupational hazard exposure from occupational health records of 8,304 subjects aged 35 years or older from 47 randomly selected factories were studied. About 49% of the men and 55% of the women were exposed to dust, chemicals or other hazards. The prevalence of smoking was 56.1% in men and 2.0% in women. The prevalence of smoking in men was higher in those who were younger, with primary education or who were workers. In women, those who were older, with primary education or in management jobs had higher smoking prevalence. In men and women, subjects who were exposed to occupational hazards had higher smoking prevalence: the highest (71.6%) was found in male workers exposed to dust. Urgent tobacco control measures are needed to prevent the epidemic of smoking-related and occupation-related diseases in the workplace in China.

In countries that have been industrialized for a long time, but not always elsewhere, low socioeconomic position (SEP) is associated with ischemic heart disease in men. The authors hypothesized that socioeconomic development could, via pubertal sex steroids, promote an atherogenic lipid profile and body shape in men but not in women. Therefore, they examined the associations of SEP with ischemic heart disease risk in a developingcountry population. The authors used multivariable regression to examine the associations of SEP with the metabolic syndrome and its components in 9,746 Chinese adults aged � 50 years from the Guangzhou Biobank Cohort Study, phase 2, recruited in 2005–2006. After adjustment for age, smoking, alcohol use, and physical activity, high SEP at each of three life stages, proxied by parental possessions in childhood, education, and longest held-occupation, was inversely associated with the metabolic syndrome in women but not in men. Higher SEP in men was associated with lower pulse pressure and fasting plasma glucose level but also with greater waist circumference and a lower high density lipoprotein cholesterol level. With socioeconomic development, diet-related hormonal changes at puberty may outweigh the usual protective effect of social advantage in men, with corresponding implications for boys currently undergoing the nutrition transition in the developing world. China; developing countries; gonadal steroid hormones; metabolism; myocardial ischemia; risk factors; social class

Objectives: Previous studies on drivers focused on the effect of their exposure to vehicle exhaust and there is little evidence of the effect of smoking. This cohort analytical study aimed to examine the mortality of drivers relative to smoking and professional driving in Guangzhou, China. Methods: Information on demographic characteristics, type of driver (professional and non-professional), smoking, and drinking were retrieved from medical records of drivers who applied for driving licences from March to December 1992. Vital status and causes of death of 81 344 men aged 30 or above were ascertained to the end of September 1999 (follow up, mean=7.14 years, median=7.17 years). Results: At baseline, the mean (SD) age was 40.8 (5.6) years. One third were professional drivers; 49.0% were daily smokers. 858 Deaths were identified. The relative risk of overall mortality for ever smoking was 1.24 (95% confidence interval (95% Cl) 1.07 to 1.44) after adjusting for age, alcohol drinking, education, and type of drivers. Compared with non-professional drivers, professional drivers had similar risks of death, and their relative risk of overall mortality for ever smoking was 1.35 (1.06 to 1.71). Conclusions: Smoking is a more important cause of death than professional driving itself. The results show serious public health problems in the early stage of the tobacco epidemic and support urgent measures to help drivers stop smoking., published_or_final_version

To develop a case finding strategy for STD among pregnant women based on risk assessment in China.A prospective, random/double blind study of the high risk factors for STD in 1,656 pregnant women was conducted from June 1995 to February 1996. It was carried out at four Guangzhou hospitals on nine types of STD, their relative risk factor questionnaire and gynecologic examination.The total prevalence of six main STD was 20.89% (346/1656); No HIV and syphilis cases were found; The most common disease is cervical chlamydial trachomatis at (19.08% 316/1,656). Through statistical calculations with COX proportional hazard model, STD symptoms' high risk factors scoring system revealed the following: (1) More than one sexual partner in the preceding one year; (2) Vulvular lesion vegetation; (3) Dysusia/increased vaginal discharge; plus one of the following: 1. unemployed status; 2. sex partner unemployed; 3. age (less than 25 years of between 30-34 years of age). These six items with "three-three" scoring system can be used as a model to primary screening new STD cases using clinical data. Both sensitivity and specificity exceeded 60% (61.7% and 67.3% respectively).These are significantly better than the foreign recommended model and the scoring system in China. It is simple, convenient and applicable.