Xin-Yu Peng

Abdominal obesity is a crucial risk factor for the onset of metabolic dysfunction-associated fatty liver disease (MAFLD). Chinese visceral adiposity index (CVAI), body roundness index (BRI), lipid accumulation product (LAP), and waist-to-hip ratio (WHR) are established indices of abdominal obesity. This study investigates the relations between these abdominal obesity indices and MAFLD onset. A total of 10,703 rural residents were included in this cohort study. Kaplan–Meier graphs, Cox regression modeling, restricted cubic spline (RCS) scores, Subgroup analyses and sensitivity analysis were used to conduct the study. During the median follow-up period of 5.79 years, 596 participants (5.57%) developed MAFLD. As the quartiles of the abdominal obesity indices increased, the incidence of MAFLD exhibited an increasing pattern. CVAI had the strongest association with MAFLD risk both before and after adjusting for confounders(P < 0.05). The associations between the indices and MAFLD risk were largely consistent across most subgroups, and the findings remained robust in sensitivity analyses. The RCS curves displayed linear correlations of CVAI with MAFLD risk (p for non-linear = 0.146) . CVAI, LAP, BRI, and WHR are all significantly and positively correlated with the risk of MAFLD. Among the female population, CVAI exhibited the strongest correlation with MAFLD risk. CVAI could serve as the preferred indicator for developing future risk prediction models for MAFLD in women.

This study aimed to examine the association between the triglyceride-glucose (TyG) index, TyG-BMI index, and gallbladder disease (GBD) among Uyghurs in the Xinjiang Production and Construction Corps (XPCC), offering insights for GBD prevention and management. A prospective cohort design was utilized, enrolling 12,794 Uyghur participants from XPCC. The cumulative GBD incidence across quartiles of TyG, TyG-BMI, and BMI categories was estimated using the Kaplan-Meier method. The Cox proportional hazard regression model assessed the association between TyG, TyG-BMI, and GBD incidence, while mediation analysis investigated TyG’s potential mediating role in the relationship between BMI and GBD. Participants had a mean age of 37.68 ± 13.96 years, with 51.30% being male. Over a median follow-up of 6.00 years, 466 new GBD cases were identified, yielding a cumulative incidence of 4.3% and an incidence density of 7.68 per 1000 person-years. Women exhibited a higher cumulative incidence of GBD than men. The incidence of GBD gradually rises in both men and women with the increase of age. When the age exceeds 40, the incidence of GBD increases significantly. Following adjustments for gender, age, educational level, exercise frequency, diabetes, HDL-C, and LDL-C levels, individuals in the Q4 TyG index group demonstrated a significantly elevated GBD risk relative to the Q1 group (HR = 1.34, 95% CI:1.01–1.77). Similarly, GBD risk rose progressively across the Q2, Q3, and Q4 TyG-BMI index groups (HR = 1.97, 95% CI:1.23–3.16), (HR = 2.67, 95% CI:1.70–4.19), and (HR = 4.47, 95% CI:2.88–6.93), respectively. Overweight and obesity were also linked to a markedly greater GBD risk compared to normal weight (HR = 1.52, 95% CI:1.09–2.12) and (HR = 3.01, 95% CI:2.22–4.09). Among Uyghurs in the XPCC, elevated TyG and TyG-BMI indices were strongly associated with GBD risk, with TyG-BMI demonstrating the most pronounced association. Early TyG-BMI monitoring may aid in identifying individuals at high risk of developing GBD.

We report a case of a male patient who presented with multiple abdominal and pelvic echinococcosis. The patient had been diagnosed with hepatic echinococcosis for 7 years and developed intermittent distension and discomfort in the upper abdomen after an accidental fall. In recent years, the patient’s abdominal distention increased gradually. Computed tomography revealed multiple hydatid cysts in the liver, spleen, abdominal cavity, and pelvic cavity. Abdominal organs were severely compressed, such that he could not eat normally except for a liquid diet. The patient underwent radical surgical resection based on the multi-disciplinary treatment (MDT) and the operation lasted 10 h, nearly 100 hydatid cysts were excised, about 18 liters of cyst fluid and cyst contents were removed, and the patient lost 20 kg of weight after surgery. The operation was successful, but there were still some postoperative complications such as hypovolemic shock, postoperative ascites, postoperative bile leakage. Treatment measures for the patient were anti-infection, antishock, clamping the abdominal drainage tube, and negative pressure abdominal puncture drainage. At follow up the patient’s quality of life had been significantly improved with 15 kg weight gain compared to before.

Background: Gallbladder disease (GBD) can increase the risk of cardiovascular disease (CVD). However, GBD has rarely been reported in the less developed, rural areas of Xinjiang. This study aimed to determine the prevalence of GBD and incidence of CVD in a prospective cohort study in rural Xinjiang. Moreover, the study aimed to explore the association between GBD and CVD within this cohort. Methods: The study cohort included 11,444 Uyghur adults in Xinjiang, 3^rd division, from the 51st Mission. Study groups were classified according to whether GBD was present or absent at baseline. The occurrence of CVD was the end event. Demographic, anthropometric, and biochemical data were recorded, and the incidence of CVD in the GBD and non-GBD groups analysed. Cox proportional hazards regression models were used to assess the association between GBD and CVD and factors associated with their incidence. Several subgroup analyses were performed to assess CVD incidence in different subgroups. The interaction between GBD and cardiometabolic risk factors, and subsequent risk of developing CVD, was evaluated. Results: Prevalence of GBD in the study cohort was 10.29%. After a median follow-up of 4.92 years, the cumulative incidence of CVD in the study cohort was 10.49%, 8.43% in males and 12.65% in females. CVD incidence was higher in the GBD group (34.04% vs. 7.78%, HR = 4.96, 95% CI: 4.40–5.59). After multivariate adjustment, the risk of CVD remained higher in the GBD group (HR = 2.89, 95% CI: 2.54–3.29). Subgroup analyses showed male sex, smoking, alcohol consumption, lack of exercise, and abnormal renal function were all associated with increased risk of CVD. Moreover, the risk of CVD was markedly higher in GBD combined with cardiometabolic risk factors (hypertension, T2DM, dyslipidaemia, overweight, and abdominal obesity), than in cardiometabolic risk factors alone and this was higher in the GBD group than in the non-GBD group regardless of whether cardiometabolic risk factors were combined. Conclusion: GBD is an important independent risk factor for CVD development. Awareness of these associations will raise concerns among clinicians about the risk of cardiovascular disease in patients with GBD.

Introduction: Hepatocellular carcinoma (HCC) is 1 of the most common malignant neoplasms worldwide. Surgical resection is the first choice of treatment. However, surgical resection is unsuitable for certain types of HCC. Patient concerns: A 47-years-old male patient presented with Child-Pugh class A liver function and the indocyanine green retention rate at 15 min effectively was 3.5%. Computed tomography and magnetic resonance imaging indicated that the tumors were distributed in the anterior segment of right lobe, and near the hepatic portal area. The maximum size of the tumor was approximately 86mm×82 mm. Diagnosis: The patient was diagnosed with hepatocellular carcinoma Stage IIIB. After pre-operative evaluation, hepatic segmentectomy by Glisson pedicle approach was recommended. Interventions: Hepatic segmentectomy by Glisson pedicle approach was recommended. But there was heavy bleeding during hepatic resection after the ligation of the Glisson pedicle on the right anterior branches. Hence only Glisson pedicle ligation was performed without hepatic segmentectomy. Outcomes: During 1 year of postoperative follow-up, the patient had no obvious complications. The computed tomography and magnetic resonance imaging indicated significant reduction in the size of tumor. The tumor was observed to have undergone liquefaction necrosis after 6 months. The serum a-fetoprotein also decreased significantly. Conclusion: The Glisson pedicle ligation may be an optional treatment in selected cases of unresectable HCC. However, further research is needed to understand the effectiveness of this treatment.

Human cystic echinococcosis (CE) is one of the commonest zoonoses, and it is endemic in many parts of the world including China. Complications and recurrences after the surgical treatment of hepatic CE (HCE) incur a large personal, healthcare, and societal burden. There has been some progress in HCE prevention, diagnosis, and treatment, but there is no “one size fits all” approach, and surgery still remains the cornerstone of treatment for some cyst stages and locations or in areas with little knowledge or access to other treatment modalities. In 2009 we designed and implemented a program to improve surgical outcomes from HCE in Xinjiang province, China. A multimodal HCE training program was implemented in eleven primary hospitals in Xinjiang province, China, which provided education and training on HCE clinical knowledge and practice, the application of diagnostic and treatment options, and optimal surgery. The management of HCE cases was analyzed before and after program implementation. Contrast enhanced CT use, application of scoloicidal agents, removal of necrotic cyst wall remnants, appropriate perioperative drug use, and the use of optimal surgical approach increased after program implementation. Further, postoperative recurrences and residual cavity complications creased from 7.4% to 1.3% and 15.2% to 9.0% after program implementation, respectively. Tis integrated surgical training program is useful for improving outcomes of patients with HCE and can be used in institutions in other endemic areas. Hepatic cystic echinococcosis (HCE) is an endemic and neglected global disease. Many deprived areas in China still lack the knowledge and expertise to successfully treat HCE surgically, which results in high postoperative complication and recurrence rates that further decrease postoperative quality of life. In this study, we aimed to transfer our extensive experience in the development and implementation of effective surgery for HCE to eleven hospitals in the Echinococcus granulosus endemic province of Xinjiang to improve the surgical treatment of HCE. Our results indicate that our training program effectively reduces recurrence and complication rates and will be of use in other endemic areas.

This study aimed to investigate the pharmacology and anti-parasitic efficacy of albendazole–chitosan microspheres (ABZ-CS-MPs) for established intraperitoneal infections of Echinococcus multilocularis metacestodes in an experimental murine model. Male outbred Kunming mice infected with E. multilocularis Metacestodes were administered with three ABZ formulations, namely, ABZ-CS-MPs, Liposome–Albendazole (L-ABZ), and albendazole tablet (ABZ-T). Each of the ABZ formulations was given orally at three different doses of 37.5, 75, and 150mg/kg, three times a week for 12 weeks postinfection. After administering the drugs, we monitored the pharmacological performance and anti-parasitic efficacy of ABZ-CS-MPs compared with L-ABZ, and ABZ-T treated mice. ABZ-CS-MPs reduced the weight of tissues containing E. multilocularis metacestodes most effectively compared with the ABZ-T group and untreated controls. Metacestode grown was Highly suppressed during treatment with ABZ-CS-MPs. Significantly higher plasma levels of ABZ metabolites were measured in mice treated with ABZ-CS-MPs or L-ABZ compared with ABZ-T. In particular, enhanced ABZ-sulfoxide concentration profiles were observed in the mice given 150mg/kg of ABZ-CS-MPs, but not in the mice treated with L-ABZ. Histological examination showed that damages caused disorganization of both the germinal and laminated layers of liver hyatid cysts, demolishing their characteristic structures after treatment with ABZ-CS-MPs or L-ABZ. Over time, ABZ-CS-MPs treatment induced a shift from Th2-dominant to Th1-dominant immune response. CS-MPs As a new carrier exhibited improved absorption and increased bioavailability of ABZ in the treatment of E. multilocularis infections in mice. Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis and is a rare but life-threatening disease. Albendazole is the most frequently used anti-parasitic drugs in patients infected with AE. However, ABZ has only limited water solubility, and small differences in drug solubility may have a major influence on their absorption and resultant pharmacokinetic behavior. Chitosan microspheres as a new carrier increased ABZ absorption and bioavailability. The anti-parasitic efficacy of albendazole–chitosan microspheres (ABZ-CS-MPs) in mice infected with Echinococcus multilocularis was assessed. ABZ-loaded CS-MPs exhibited improved absorption and increased bioavailability in the treatment of E. multilocularis infections in mice compared with those treated with liposome–albendazole and albendazole tablet. ABZ-CS-MPs are in solid form that can be manufactured in capsules or tablets, which can be easily delivered to those in need, particularly those who are nomadic. Therefore, given the merits of low cost, portability, and simple manufacturing, ABZ-CS-MPs are a promising drug to treat alveolar echinococcosis.

Multiple hydatid cysts in the liver rarely occur in the pediatric population. Here, we present the case of a 16-year-old girl who presented with six hydatid cysts in the liver. The cysts were surgically removed and all found to be infertile. Interestingly, the patient had post-operative eosinophilia. From this experience, we conclude that individualized treatment is necessary for patients with multiple hydatid cysts.