Background and Aim Reported incidence and prevalence rates of autoimmune hepatitis (AIH) have been sparse and heterogeneous. The aim of this meta‐analysis was to estimate the worldwide incidence and prevalence rates of AIH and reveal population difference. Methods Published articles on the epidemiology of AIH in PubMed, Embase, and Cochrane Library were systematically searched from inception to April 28, 2019. Two investigators independently reviewed these literatures and evaluated their quality. A random‐effects model was used to pool the overall incidence and prevalence rates. The impact of population difference, gender, age, study period, study quality, diagnostic criteria, and study design was further analyzed with subgroup analysis and meta‐regression. Results A total of 22 studies were included in the meta‐analysis. The pooled worldwide annual incidence and prevalence of AIH were 1.37 (95% confidence interval [CI]: 0.95–1.80) and 17.44 (95% CI: 12.01–22.87) per 100 000 persons, respectively. Subgroup analysis showed that the pooled annual incidence for Asian, European, and American population was 1.31 (95% CI: 0.42–2.20), 1.37 (95% CI: 1.10–1.64), and 1.00 (95% CI: 0.44–1.56) per 100 000 persons, respectively; the pooled prevalence for Asian, European, and American population was 12.99 (95% CI: 2.05–23.92), 19.44 (95% CI: 15.63–23.24), and 22.80 (95% CI: −13.48 to 59.07) per 100 000 persons, respectively. In addition, higher incidence and prevalence rates were observed in women than men, and a higher prevalence rate was observed in elderly than young people. Conclusions Autoimmune hepatitis is a rare disease, with a similar incidence worldwide and a higher prevalence in European and American than in Asian population.

Background and Aim We aimed to estimate the worldwide incidence and prevalence, with focus on the geographical differences and temporal trends. Methods Studies on epidemiology of primary biliary cholangitis (PBC) in PubMed, Embase, and Cochrane Library were systematically retrieved from inception to October 2, 2020. Random‐effect model was applied to estimate the pooled PBC incidence and prevalence rates. Subgroup analysis, meta‐regression, and sensitivity analysis were conducted to find out the cause for heterogeneity. Results Out of 3974 records identified through database searching, 47 population‐based studies were finally included. The pooled global incidence and prevalence of PBC were 1.76 and 14.60 per 100 000 persons, respectively. Both the PBC incidence and prevalence were lower in the Asia‐Pacific region (0.84, 9.82 per 100 000 persons) than that in North America (2.75, 21.81 per 100 000 persons) and Europe (1.86, 14.59 per 100 000 persons) (P < 0.05). The incidence and prevalence showed an increasing tendency in all three regions, with the fastest growth of prevalence in North America (P < 0.05). We found a similar incidence and a lower prevalence of PBC in Northern Europe than that in Southern Europe. A higher incidence and prevalence were observed in female individuals and in the elderly (60–79). Conclusion The PBC incidence and prevalence varied widely across regions, with North America being the highest, followed by Europe, and the lowest in the Asia‐Pacific region. Both the incidence and prevalence showed an increasing tendency worldwide, especially in North America.

A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.

Circular RNAs (circRNAs) are a new class of noncoding singlestranded RNAs that differ from linear microRNAs (miRNAs), since they form covalently closed loop structures without free 3 0 poly(A) tails or 5 0 caps. circRNAs are the competitive endogenous RNAs (ceRNAs) by binding to miRNA through miRNA response elements (MREs) (i.e., "miRNA sponge"), thereby reducing the quantity of miRNA available to target mRNA, subsequently promoting mRNA stability or protein expression, which involves the initiation and progress of human diseases. Owing to these features of abundance, stability, conservative property, and tissue and stage specificity, widely distributing in the extracellular space and in various bodily fluids, circRNAs can be considered as potential biomarkers for various diseases. Here, we reviewed the promising circRNAs being disease biomarkers, focused on their regulatory function by acting as miRNA sponges, and described their roles in cancer, cardiovascular or neurodegenerative diseases, osteoarthritis, rheumatoid arthritis, diabetes, and other human aging-related diseases, which provide a new direction for pathogenesis, diagnosis, and treatment of human aging-related diseases.Circular RNAs (circRNAs) are a new class of noncoding singlestranded RNA, 1 characterized by covalently closed loop structures without free 3 0 poly(A) tails or 5 0 caps. These features differentiate them from linear RNAs, 2 long noncoding RNAs (lncRNAs), and mi-croRNAs (miRNAs). 3 Although circRNAs were first discovered in the 1990s in viruses, viroids, and tetrahymena, 4 little attention has been paid to their function. 4,5 At that time, they were considered abnormal products, resulting from splicing errors. 3,6 In addition, circRNAs are often found in low abundance, and the traditional methods used to study linear RNAs are not applicable. With recent developments in biochemical-enrichment methods, especially high-throughput RNA sequencing and circRNAs microarray, more than 30,000 circRNAs have been discovered. 7 They are widely expressed in yeasts, plants, protists, fruit flies, worms, zebrafish, mice, rats, and humans. 8 Compared with the levels of their linear isomers, circRNA expression levels can be increased by 10-fold or more, 9 an indication of their potential abundance. Owing to their distinctive structure, they can resist exonuclease activity and are extremely stable. 1 The average lifetime of a 3 0 / 5 0 -linked circRNA is 2$5 times longer than that of a linear mRNA. 1 In addition, the expression levels of circRNAs are tissue and stage specific, and a number of highly abundant circRNAs have been found to exist in human peripheral blood (PB), 10 indicating that circRNAs can act as biomarkers to screen, diagnose, characterize, and monitor various diseases. circRNAs have many biological functions, including regulating host gene splicing and transcription, 11 acting as miRNA 12 and protein sponges, 8 reacting with proteins, 13 and serving as protein-coding circRNAs. 14 Many studies [15][16][17] have indicated that circRNAs con...

Chronic sustained stimulation of β-adrenoceptor is closely related to cardiac fibrosis which is bad for cardiac function. Growing evidence showed that the high prevalence of β1-adrenoceptor autoantibody (β1-AA) in the sera of patients with various types of cardiovascular diseases decreased cardiac function. In the current study, we demonstrated that β1-AA impaired the cardiac function evaluated by echocardiography and that β1-AA triggered cardiac fibrosis in terms of increased expression of α-smooth muscle actin as the marker of myofibroblast and collagen deposition in a passive β1-AA immunized mice model during 16 weeks. Further, we showed that β1-AA activated β1-AR/cAMP/PKA pathway and promoted proliferation in primary cardiac fibroblasts through specific binding to β1-AR but not to β2-AR. Moreover, β1-AA was also likely to promote proliferation in cardiac fibroblasts through activating p38MAPK and ERK1/2 as p38MAPK inhibitor SB203580 and ERK1/2 inhibitor PD98059 partially reversed the proliferative effect. The persistent activating signalling of PKA and P38MAPK in 1 h induced by β1-AA was associated with lacking agonist-induced desensitization phenomena. The conditioned medium from β1-AA-stimulated cardiac fibroblasts induced cardiomyocyte apoptosis, which indicated that β1-AA changed the secretion of cardiac fibroblasts contributing to cardiac injury. These findings will contribute to our understanding of the pathological mechanisms of β1-AA.

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Background and Aim The impact of male sex and past hepatitis B virus (HBV) infection on survival of primary biliary cholangitis (PBC) are issues at discussion. The aim of the present study was to identify risk factors for transplant‐free survival (TRS) in Chinese PBC patients who received ursodeoxycholic acid (UDCA), with special focus on the impact of male sex and past HBV infection. Methods We followed up PBC patients who received UDCA at our institute between January 2000 and December 2017 until their death, liver transplantation, or censored on April 1, 2018, by interview and review of medical records. We used Cox proportional hazards model and Kaplan–Meier method. Results Out of 976 PBC patients, 732 UDCA‐treated patients (female : male = 6.2:1) with required clinical and laboratory data were enrolled in this study. The median follow‐up period were 4.8 years (interquartile range: 2.8–7.1 years). The overall 5‐, 10‐, and 15‐year TRS rates were 86.7% (95% CI: 83.8–88.1), 71.1% (95% CI: 65.0–77.2), and 59.2% (95% CI: 44.5–73.9), respectively. The survival was significantly worse for male patients and older patients (≥ 55 years) (log‐rank test: P < 0.05 for both). On multivariate analysis, male sex, cirrhosis, serum bilirubin, and serum albumin were independent predictors for TRS. There was no significant difference in survivals between patients with (n = 167) and without (n = 219) past HBV infection (log‐rank test: P = 0.293). Conclusions In this large Chinese cohort of UDCA‐treated PBC patients, male sex was associated with shorter survival, whereas past HBV infection was not associated with poorer outcome.