Effectiveness of teaching psychopathology through the analysis of movie characters: a randomized controlled trial in Shandong Province, China.

We studied the effectiveness of movie character analysis for teaching psychotic symptomatology to medical undergraduates. We randomly selected two of six medical schools in Shandong Province, China, then randomly assigned eight undergraduate classes at those schools to intervention or control groups. The intervention group (n = 162) participated in seminars in which psychotic symptoms were explored through analysis of movie characters. The control group (n = 165) participated in conventional seminars. The participants in both groups were surveyed with a custom-designed questionnaire, and their knowledge was assessed using a written exam. Compared to the control group, the intervention group showed greater interest in the topic (t = 5.63, p < 0.001), better understanding of psychotic symptoms (t = 2.37, p = 0.02), and greater acceptance (t = 9.80, p < 0.001). In addition, the intervention group showed significantly greater knowledge on the written exam (t = 5.78, p < 0.001). Analyzing movie characters can improve the teaching of psychotic symptomatology and should be further explored and promoted.

Prevalence and influencing factors of sleep disorders among preschool children in Urumqi city: a cross-sectional survey.

BACKGROUND: Sleep disorders refer to physiological and psychological states that cause adverse consequences due to the inability to fall asleep or poor sleep quality. The prevalence of sleep disorders varies greatly in different countries and regions due to different causes. This study aimed to investigate the prevalence and influencing factors of sleep disorders among preschool children in Urumqi city, China. METHODS: A cross-sectional study was conducted with stratified random cluster sampling. Children aged 3-6 years old in one kindergarten randomly selected from each of the 8 districts of Urumqi from March to July 2022, and their parents were surveyed with a sleep quality questionnaire. RESULTS: The prevalence of sleep disorders among preschool children in Urumqi was 14.29% (191/1336), and the prevalence of different symptoms was 42.81% for limb movements, 19.61% for snoring, 18.11% for bruxism, 16.39% for sleep talking, 12.57% for sweating, 11.60% for nocturnal awakening, 8.46% for nightmares, 6.89% for bed wetting, 3.74% for apnea, and 3.29% for sleepwalking. The prevalence of body movements, snoring, sweating, night-wake, nightmares, bed-wetting, apnea, and sleepwalking among different ethnicities were significantly different (P < 0.05). Multivariate analysis revealed that the major risk factors of sleep disorders were difficulty adapting to new environments, unwillingness to express emotions, inconsistent attitudes of the family toward children's education, running before bedtime, strict family education methods, etc. CONCLUSION: The prevalence of sleep disorders in preschool children in Urumqi is lower than the average level reported in other studies. Many factors affect the prevalence of sleep disorders in preschool children, but it is necessary to focus on the ability to adapt to new environments, psychological problems, and the impact of family education on sleep disorders. Further studies on the prevention and treatment of sleep disorders are needed for different ethnicities.

Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China.

Objective: To examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations. Methods: This community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored. Results: The age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7-7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6-6.9, 8-8.9, and ≥ 9 h were 1.280 (1.053-1.557), 1.425 (1.175-1.728), 1.294 (1.068-1.566), and 1.360 (1.109-1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60-80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108-1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055-1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080-1.534) and those aged 81-97 years (OR: 2.128, 95%CI: 1.152-3.934). For cognitive impairment, the group aged 81-97 years with daytime dysfunction was associated with a higher odds ratio than other age groups. Conclusion: The present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81-97 years exhibiting the strongest association.

Tiotropium as an add-on treatment to inhaled corticosteroids in children with severe and mild symptomatic asthma: Multi-center observational study for efficacy and safety analysis.

Children aged 6-11 years with uncontrolled asthma are treated with low-dose inhaled corticosteroid (ICS) with stepwise increase in ICS dosage and/or add-on maintenance treatment, as necessary. The objective of the present study was to evaluate the efficacy and safety of tiotropium add-on treatment in children with severe and mild symptomatic asthma. The present prospective cohort study included 144 children with severe and mild asthma (age, 6-11 years) who received ICS (budesonide) with ≥1 controller treatment combination therapies for ≥1 month and score ≥1.5 based on Asthma Control Questionnaire-Interviewer-Administered. In addition to ICS with ≥1 controller treatment, children received 5 µg once-daily tiotropium (treatment group; n=72) or did not receive tiotropium (control group; n=72). The peak forced expiratory volume in 1-sec change from the baseline 3 h post-administration of tiotropium was significantly improved in the treatment group compared with the control group (384±31 vs. 248±28 ml; P<0.0001). The trough forced expiratory volume in 1-sec (224±28 vs. 140±31 ml; P<0.0001) and forced expiratory flow at 25-75% of forced vital capacity (389±36 vs. 116±27 ml/sec; P<0.0001) showed significant improvement following treatment with tiotropium. Significant differences were noted for trough forced vital capacity (153±29 vs. 139±30 ml/sec; P<0.0001), mean weekly rescue treatment usage (0.29±0.08 vs. 0.36±0.09; P<0.0001), mean weekly peak expiratory flow measurement (4.12±3.56 vs. 7.46±3.29 l/min; P<0.0001) and mean weekly symptom-free time (0.19±0.04 vs. 0.16±0.04 days; P<0.0001) between both cohorts. Children of both groups tolerated any adverse effects. Tiotropium 5 µg administered once/day as an add-on treatment to ICS with ≥1 controller treatments in children (6-11 years of age) with severe and mild symptomatic asthma was found to be efficacious and safe (level of evidence 2; technical efficacy stage 4).

Associations of Four sensitization patterns revealed by Latent Class Analysis with Clinical symptoms: A multi-center study of China.

Background: Because of the significant regional differences in the distribution of allergens, the relationship between anaphylaxis and allergic sensitization is complex in China. Using this large-scale epidemiologic survey, we explore the potential patterns of sensitization to common allergens in mainland China and investigate their relationship with various clinical symptoms. Method: The participants were recruited from 13 medical centers in mainland China from October 2019 to June 2021. Skin prick test (SPT) results that cover 18 common allergens were utilized to diagnose atopic sensitization. The demographic characteristics and clinical information were collected through questionnaires during routine medical follow-up. Latent class analysis (LCA) was conducted to determine the optimal sensitization patterns. The logistic regression was used to assess the associations of different sensitization patterns with allergy symptoms. Findings: A total of 1089 patients who had a positive SPT to at least one of 18 allergens were included for formal analysis. An optimal LCA model with 4 classes was obtained in this study, and the corresponding labels were as follows: Class1, house dust mite sensitization; Class2, low pollen sensitization; Class3, middle pollen sensitization; Class4, high pollen sensitization. The prevalence of different classes varied widely in geographical distribution, which was characterized by Class1 being very common in south and east as well as Class2 in north and west of China. Compared with patients in Class1, those in middle and high pollen sensitization clusters had the higher odds ratios (ORs) of allergic rhinitis and allergic conjunctivitis when controlling for other confounders. However, there was no significant difference between low pollen sensitization and house dust mite sensitization groups in the risks for various clinical performances except dermatitis. Additionally, the adjusted ORs (95% confidence interval) of allergic conjunctivitis and dermatitis for participants in pollen sensitization clusters (Class2, 3 and 4) were 1.56 (1.18, 2.06) and 1.43 (1.09, 1.88) respectively compared with those in Class1. Interpretation: In this study, we identified four sensitization clusters with specific risks of various clinical symptoms using common allergens by adopting LCA. Our findings may contribute to improved diagnosis and potential immunotherapy approaches to allergy in mainland China. Funding: This study was supported by the National Natural Science Foundation of China (81802076 and 81871736), the Guangzhou Science and Technology Foundation (202102010327), the Foundation of SKLRD (MS-2019-06 and Z-2022-09), and the Foundation of GYYY (ZH201904) and ZNSA-2020012.

[Associations of hyperlipidemia and its subtypes with blood lead levels in Lu'an City community older adults in 2016].

OBJECTIVE: To explore associations of hyperlipidemia and its subtypes with blood lead levels in community older adults. METHODS: From June to September, 2016, a rural and an urban community in Lu'an City, Anhui Province were randomly selected. Older adults aged 60 years old or over in two communities were recruited to participate, receiving a questionnaire interview(including gender, age, region, education, occupation, marital status, lifestyle, and chronic medical history, etc. ), physical examinations(height, weight, and blood pressure) and laboratory tests(blood glucose, blood lipid, and blood lead levels). A total of 1080 older adults volunteered to participate, of which 1008 had completedata. Inductively coupled plasma mass spectrometry was used to measure concentrations of blood lead. The interquartile range was used to divide the distribution of lead in blood. Logistic regression model was used to examine associations of hyperlipidemia and its subtypes with blood lead levels. Restrictive cubic splineswere used to further determine potential dose-response relationships. RESULTS: Of 1008 older adults, the mean age was(71.9±6.5) years old, 459(45.5%)were male, and 557(55.3%) were from the rural community. The prevalence of hyperlipidemia was 51.2%(n=516). The detection rate and geometric mean of blood lead were 100% and 28.08 µg/L(ranged from 7.89 to 278.33 µg/L), respectively. Univariate analysis showed that older adults in the highest quartile group of blood lead(≥75%) had higher odds of hyperlipidemia(OR=1.42, 95%CI 1.00-2.02) and two subtypes(high total serum cholesterol(OR=1.83, 95%CI 1.25-2.68)and mixed hyperlipidemia(OR=1.49, 95%CI 0.83-2.67)) compared to counterparties in the lowest quartile group(≤25%). After adjustment for gender, age, region, education, occupation, marital status, smoking, drinking, exercise conditions, diet, high blood pressure, diabetes, and body mass index, the ORs for hyperlipidemia and mixed hyperlipidemia in the highest quartile group of blood lead were 1.55(95%CI 1.02-2.36) and 2.87(95%CI 1.44-5.70). The restricted cubic spline curves showed approximate linear relationships between blood lead levels and ORs of hyperlipidemia and mixed hyperlipidemia. CONCLUSION: Linear associations of blood lead levels with hyperlipidemia and mixed hyperlipidemia were found in community older adults.

Family alcohol use, rather than childhood trauma, is more likely to cause male alcohol use disorder: findings from a case-control study in northern China.

OBJECTIVE: To explore the influence of childhood trauma and family alcohol use on male alcohol use disorder. METHODS: We conducted a case-control study using Childhood Trauma Questionnaire (CTQ) and a structured interview involving 129 men with alcohol use disorder and 129 healthy male volunteers. The two groups were compared in terms of childhood trauma, parental drinking behavior, and attitudes toward childhood drinking. RESULTS: Patients showed higher scores of CTQ than controls on childhood trauma experiences, including on the subscales of physical abuse, emotional abuse, sexual abuse, and emotional neglect. Higher proportions of patients than controls had fathers who drank seven or more times a week, and had mothers who were opposed to childhood drinking. Conversely, a smaller proportion of patients than controls had fathers who opposed childhood drinking. Patients were more likely than controls to have been induced to drink as children. Logistic regression analysis identified three risk factors for alcohol use disorder: induced drinking during childhood [odds ratio (OR) 6.09, 95% confidence interval (CI) 2.56-14.51], the father's weekly alcohol consumption during the respondent's childhood (OR 4.40, 95%CI 2.94-6.58) and history of smoking (OR 3.39, 95%CI 1.48-7.77). Conversely, more years of education were a protective factor against alcohol use disorder (OR 0.88, 95% CI 0.78-0.99). CONCLUSIONS: Men whose fathers drank frequently during their childhood and were encouraged to drink may be at increased risk of alcohol use disorder in adulthood. In fact these factors of family alcohol use appear to increase risk of alcohol use disorder among adult men more than exposure to childhood trauma does.

The associations between urinary metals and metal mixtures and kidney function in Chinese community-dwelling older adults with diabetes mellitus.

BACKGROUND: Previous studies have found associations between single toxic metals, such as arsenic and cadmium, and kidney function in adults with diabetes. However, studies with regards to other metals and metal mixtures are still limited. OBJECTIVE: Our study aimed to investigate the associations between urinary concentrations of 5 selected metals and metal mixtures and kidney function using a sample of older adults with diabetes mellitus in Chinese communities. METHODS: In a sample of older adults (n = 5186), 592 eligible subjects were included in this study. Urinary concentrations of 5 metals, i.e., arsenic (As), cadmium (Cd), vanadium (V), cobalt (Co), and thallium (Tl), were measured by inductively coupled plasma mass spectrometer (ICP-MS). Estimated glomerular filtration rate (eGFR) was calculated and dichotomized into indicator of chronic kidney disease (CKD). Logistic analysis and Bayesian kernel machine regression (BKMR) were used to explore the associations between single metals and metal mixtures and CKD, respectively. RESULTS: Urinary levels of As and V were positively correlated with CKD (OR=2.37, 95% CI: 1.31-4.30 for As; OR=2.24, 95% CI: 1.25-4.03 for V), when compared the 4th quartile with the 1st quartile. After adjustment for potential confounders, the significant association between As and CKD still existed (OR=2.73, 95% CI: 1.23-6.07). BKMR analyses showed strong linear positive associations between As and V and CKD. Higher urinary levels of the mixture were significantly associated with higher odds of CKD in a dose-response pattern. As and V showed the highest posterior inclusion probabilities. CONCLUSION: Urine As and V were positively associated with CKD in older adults with diabetes mellitus, separately and in a mixture. The metals mixture showed a linear dose-response association with the odds of CKD. The analyses of mixtures, rather than of single metals, may provide a real-world perspective on the relationship between metals and kidney function.

Levels and determinants of urinary phthalate metabolites in Chinese community-dwelling older adults.

BACKGROUND: Biomonitoring studies have demonstrated extensive exposure of infants, children, and pregnant women to phthalates, but data on phthalate exposure and their determinants in Chinese older adults remain insufficient. This study aims to assess urinary phthalate metabolite levels, individual and cumulative exposure risk, and their determinants in Chinese community-dwelling older adults. METHODS: A total of 987 individuals aged 60 years or over were included in this study. The urinary levels of seven phthalate metabolites were measured using high-performance liquid chromatography-tandem mass spectrometry. The estimated daily intake (EDI), hazard quotient (HQ), and hazard index (HI) of phthalates were calculated based on urinary metabolite levels. The associations between phthalate metabolite levels and potential determinants were examined using multiple linear regressions. RESULTS: Detection rates of seven phthalate metabolites from the study population ranged from 63.83% to 99.39%. The highest median concentration was 43.64 µg/L (42.59 µg/g creatinine) for mono-butyl phthalate (MBP). The highest median EDI was 1.55 µg/kg-bw/day for diethyl phthalate (DBP). Nearly 5% of participants had high HI values exceeding 1, mainly attributed to DBP and di-2-ethylhexyl phthalate (DEHP). Furthermore, we found that females, higher body mass index (BMI), smoking, having two or more chronic diseases, and vegetable-based diets were significantly associated with higher levels of parts of phthalate metabolites. More interestingly, higher urine levels of high-molecular-weight (HMW) phthalate metabolites and lower urine levels of low-molecular-weight (LMW) phthalate metabolites were found in rural older adults than in urban older adults. CONCLUSIONS: Chinese community-dwelling older adults are extensively exposed to phthalates, especially to DBP and DEHP. More attention should be paid to urban-rural differences in exposure to HMW and LMW phthalates and to phthalate exposure among older adults with overweight/obesity, females, and individuals who are current heavy smokers, have two or more chronic diseases, and consume vegetable-based diets.

The association of marital status with cognitive function and the role of gender in Chinese community-dwelling older adults: a cross-sectional study.

BACKGROUND: Evidence of the association between marital status and cognitive function in Chinese older adults is limited. AIMS: To examine the relationship between marital status and cognitive function and to explore the role of gender amongst older adults from three Chinese communities. METHODS: A total of 1376 participants aged 60 years or over were included in this cross-sectional study. Cognitive function was assessed using the Chinese version of the mini-mental state examination (MMSE). Marital status and other variables were collected using a standardized questionnaire. Multiple linear regression models were used to examine associations between marital statuses and cognitive function amongst the target population. The moderating role of gender in these potential associations has also been explored. RESULTS: In univariate linear regression models, compared to being married, both being widowed (ß [95% CI]: -1.46[-2.78 to - 0.13]) and being single (ß [95% CI]: - 4.88[-6.43 to - 3.38]) were associated with lower MMSE scores. After adjustment for confounding factors, the significant association of being widowed with MMSE scores disappeared (ß [95% CI: - 0.08[- 1.04 to 0.86]), but the association of being single with MMSE scores still existed (ß [95% CI]: - 1.87[- 3.17 to - 0.58]). Furthermore, the association of being single with MMSE scores was statistically significant in men (ß [95% CI]: - 5.25[- 7.17 to - 3.33]) but not in women (ß [95% CI: 0.88[- 0.87 to 2.64]). DISCUSSION AND CONCLUSIONS: Being single was associated with poorer cognitive function compared with their married counterparts in older Chinese men but not in women. More preventive measurements should be implemented for single men to reduce or delay cognitive decline. This is particularly important in the context of an aging population in China.

Correlation between asthmatic infants with rickets and vitamin D, inflammatory factors and immunoglobulin E.

Correlation between asthmatic infants with rickets and vitamin D, inflammatory factors and immunoglobulin was investigated. A total of 60 child patients with asthma who met the inclusion criteria and received treatment from January 2016 to October 2017 were collected. Among them, 17 asthmatic infants with rickets were set as observation group, while 43 child patients with simple asthma were regarded as the control group. Venous blood was drawn from the two groups of subjects after admission. The levels of interleukin-1 (IL-1), IL-6 and IL-17 in serum were determined by ELISA, vitamin D and immunoglobulin E levels in serum were detected using a fully-automatic biochemical analyzer, and wheezing duration during asthma attack was recorded. IL-1, IL-6, IL-17 and immunoglobulin E levels in serum of observation group were significantly higher than those of the control group (P<0.05). The vitamin D level in the observation group was remarkably lower than that in the control group (P<0.05). Wheezing duration in observation group was evidently longer than that in control group (P<0.05). Moreover, IL-1, IL-6, IL-17 and immunoglobulin E levels in serum were positively related to wheezing duration, but the vitamin D level was negatively associated with wheezing duration. Infantile asthma with rickets is closely correlated with vitamin D, inflammatory factors and immunoglobulin E, which are major risk factors in infantile asthma with rickets.

Sex- and age-specific mild cognitive impairment is associated with low hand grip strength in an older Chinese cohort.

BACKGROUND: Few studies have demonstrated the impact of characteristics like age and sex on the association between hand grip strength (HGS) and mild cognitive impairment (MCI). In this cross-sectional study, we aimed to examine the effects of sex and age on the relationship between HGS and MCI. METHODS: We enrolled older adults age ≥60 years (n = 1009) and measured HGS and MCI in all participants. We analyzed the differences in MCI prevalence among the different variables. The role of sex and age in the association between MCI and HGS was analyzed using binary logistic regression. RESULTS: Women had significantly higher prevalence of MCI than men, as did the older group (age ≥70 years) compared with the younger group (age 60-70 years). In men, the low and middle HGS tertiles were significantly associated with MCI. In contrast, only the low tertile of HGS was associated with MCI in women. In the older group, the low tertile of HGS was significantly associated with MCI, which was not observed in the younger group. CONCLUSIONS: HGS was associated with MCI in older adults, and this association was stronger in men. HGS may be useful for evaluating MCI in older adults.

Bacterial respiratory tract inflammation in neonatal rat model is attenuated by benzofuran through inhibition of GATA3.

The current study was aimed to investigate the effect of benzofuran on asthma neonatal rat model. Twenty-five neonatal rats were assigned into five groups; Normal control, untreated, 1 mg/kg, 8 mg/kg and 10 mg/kg treatment groups. Methacholine was administered orally to the rats of untreated and treatment groups. Animals in the normal control group were given PBS as a vehicle. FlexiVent system employing a computer-controlled mouse ventilator along with respiratory mechanics was used for the analysis of airway resistance in the rats. Cytokine level and IFN-γ in the rat serum samples was performed by ELISA in accordance with the instructions of manufacturer. Methacholine administration into the rats caused a marked increase in lung airway resistance. However, treatment with 8 and 10 mg/kg doses of benzofuran led to marked decrease in the airway resistance. Benzofuran treatment prevented accumulation of macrophages and inflammatory cells in the lung airways. Inhibition of inflammation in methacholine administered rats by benzofuran was also confirmed by hematoxylin & eosin-staining. Examination of the rat serum showed significantly higher level of Th2 cytokines (IL-4, -5 and -13) in the untreated rats. However, treatment of methacholine administered rats with benzofuran significantly inhibited Th2 cytokine expression. The level of IFN-γ was increased by benzofuran treatment in methacholine administered rats. In methacholine administered rats the level of IgE was markedly higher however treatment of asthma rats with benzofuran inhibited up-regulation of IgE significantly. The expression of T-bet is decreased and that of GATA-3 is increased by methacholine administration in the rat lungs. Benzofuran treatment of methacholine administered rats prevented reduction in T-bet and up-regulation of GATA-3 expression in the rat lungs. The effect of benzofuran was significant at the doses of 8 and 10 mg/kg and non-significant at 1 mg/kg. These finding suggest that benzofuran inhibits expression of dominant T-helper 2 cytokines through targeting GATA-binding protein 3 transcription factor. Thus benzofuran can be of therapeutic importance for the treatment of asthma.

[Clinical features of invasive candidiasis and risk factors for Candida bloodstream infection in children: a multicenter study in Urumqi, China].

OBJECTIVE: To investigate the clinical features of invasive candidiasis in children and the risk factors for Candida bloodstream infection. METHODS: A retrospective study was performed on 134 children with invasive candidiasis and hospitalized in 5 tertiary hospitals in Urumqi, China, between January 2010 and December 2015. The Candida species distribution was investigated. The clinical data were compared between the patients with and without Candida bloodstream infection. The risk factors for Candida bloodstream infection were investigated using multivariate logistic regression analysis. RESULTS: A total of 134 Candida strains were isolated from 134 children with invasive candidiasis, and non-albicans Candida (NAC) accounted for 53.0%. The incidence of invasive candidiasis in the PICU and other pediatric wards were 41.8% and 48.5% respectively. Sixty-eight patients (50.7%) had Candida bloodstream infection, and 45 patients (33.6%) had Candida urinary tract infection. There were significant differences in age, rate of use of broad-spectrum antibiotics, and incidence rates of chronic renal insufficiency, heart failure, urinary catheterization, and NAC infection between the patients with and without Candida bloodstream infection (P<0.05). The multivariate logistic regression analysis showed that younger age (1-24 months) (OR=6.027) and NAC infection (OR=1.020) were the independent risk factors for Candida bloodstream infection. CONCLUSIONS: The incidence of invasive candidiasis is similar between the PICU and other pediatric wards. NAC is the most common species of invasive candidiasis. Candida bloodstream infection is the most common invasive infection. Younger age (1-24 months) and NAC infection are the risk factors for Candida bloodstream infection.

[Leptin gene C2549A polymorphism in minority Hui and Uygur children with obesity].

OBJECTIVE: To investigate the relationship of leptin gene polymorphism with obesity in ethnic minority Hui and Uygur children in China. METHODS: Sixty-eight ethnic minority (35 Hui and 33 Uygur) children with obesity and 69 age-matched minority (36 Hui and 33 Uygur) children without obesity were recruited from six primary schools in the sub-urban areas of Urumqi. Venous blood was sampled from all subjects after fasting for 12 hours. Leptin gene C2549A polymorphism was determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism methods. Blood concentrations of lipids, leptin and insulin were measured with biochemical methods and radioimmunoassys, respectively. RESULTS: In the 137 children tested, the prevalence of AA, AC and CC genotype was 9.5%, 33.6% and 56.9%, respectively. A allele frequency was significantly different between the two ethnic (i.e. Hui and Uygur) groups (P<0.05). A allele frequency and AA+ AC genotype frequency were not significantly different between obese and non-obese children in both ethnic groups (P>0.05). Blood leptin levels were not significantly different between obese and non-obese children with an AA+AC or CC genotype in both ethnic groups (P>0.05). CONCLUSIONS: Leptin gene polymorphisms exist in Hui and Uygur children. The C2549A polymorphism is not significantly associated with the prevalence of obesity in both Hui and Uygur children.

[Epidemiological characteristics of metabolic syndrome among Kazakh children aged from 6 to 13 in Xinjiang, China].

OBJECTIVE: This study was designed to evaluate the epidemiology and clinical characteristics on metabolic syndrome (MetS) among overweight and obese children aged from 6 to 13 years old in Kazakh ethnic populations. METHODS: Based on the data including body mass index (BMI), waist circumference (WC) and blood pressure measured from the 'Kazakh ethnic child Health examination study in Yili', 5360 Kazakh children aged 6 - 13 were screened for overweight and obesity in Xinjiang, using the Chinese BMI cutoffs for schoolchildren (7 - 18 years) and WHO growth reference for school-aged children and adolescents (6 year). Simultaneously a group of children with normal BMI were selected as the control group. Fasting plasma glucose (FPG), insulin (FINS), serum high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were examined. HOMA-IR index was calculated to estimate the individual insulin resistance. Children under study were older than or equal to 10 years and met the criteria according to the definition of metabolic syndrome, prophylaxis and treatment on Chinese children and adolescents, proposed by the Society of Pediatrics in China or NCEP-ATPIII definition as MetS. Risk factors related to cardiovascular diseases were analyzed according to the criteria by the Society of Pediatrics among those aged from 6 to 10 years old children. Connection between waist-to-height ratio (WHtR) and biochemical indexes was explored. RESULTS: Prevalence rates of MetS according to the criteria from Society of Pediatrics in China were: 0%, 9.57%, 19.64% in the normal weight, overweight and obese children, respectively. The rates diagnosed by NCEP-ATPIII definition were 0.64%, 2.61%, 16.07% respectively. The detective rates of individual MetS component among obese children were: 78.95% for abdominal obesity, 29.82% for elevated BPs, 26.32% for high TG, 22.81% for low HDL-C, 0.88% for FPG. High TG (31.15%), abdominal obesity (23.77%) and low HDL-C (22.95%) appeared as the leading three abnormal indices among the overweight children. With increased BMI, the clustering of MetS components were also remarkably increasing. The detective rates of cardiovascular-related risk factors among overweight or obesity children from 6 to 10 years old were:abdominal obesity or obesity, low HDL-C, high TG, impaired FPG, elevated BPs. Differences were seen between overweight or obesity children and normal weight children on the detective rates of high TG, low HDL-C, abdominal obesity or obesity. WHtR was related with FINS, HOMA-IR index and LDL-C. CONCLUSION: MetS seemed epidemic among obese Hazakh children. Abdominal obesity, elevated BPs and high TG were the leading three abnormal factors among obese children. Compare to NCEP-ATPIII, abnormal biochemical indices on overweight Kazakh children seemed to be more sensitive, proposed by the Society of Pediatrics in China.

Characterization of erythromycin-resistant Streptococcus pneumoniae isolates causing invasive diseases in Chinese children.

BACKGROUND: Erythromycin-resistant Streptococcus pneumoniae isolates that causing invasive pneumococcal diseases (IPD) in Chinese children remain uncharacterized. This study aims to identify the resistance genes associated with erythromycin resistance and to determine the genetic relationships of IPD isolates in Chinese children. METHODS: A total of 171 S. pneumoniae strains were isolated from 11 medical centers in China from 2006 to 2008. All the isolates were characterized via serotyping and antibiotic susceptibility determination. The erythromycin-resistant isolates were further characterized via ermB and mefA gene detection, multi-locus sequence typing analysis, and pulsed-field gel electrophoresis. RESULTS: A total of 164 (95.9%) isolates showed resistance to erythromycin, of which 162 strains with high high-level resistance (MIC ≥ 256 µg/ml). A total of 104 (63.4%) isolates carry the ermB gene alone, whereas 59 (36.0%) harbor both ermB and mefA genes. Of the 59 strains, 54 were of serotypes 19A and 19F and were identified as highly clonal and related to the Taiwan(19F)-14 clone. CONCLUSIONS: The erythromycin resistance rate in IPD isolates is significantly high and is predominantly mediated by the ermB gene. Isolates that carry both ermB and mefA genes are predominantly of serotypes 19A and 19F.

Correlation of intestinal microbiota with overweight and obesity in Kazakh school children.

BACKGROUND: This study sought to investigate a possible correlation between the intestinal microbiota, Bacteroidetes and Firmicutes, and obesity in Kazakh school children, aged 7-13 (n = 175). RESULTS: Obese subjects had significantly greater systolic blood pressure, waist and hip circumference, as well as HOMA-IR as compared to normal and overweight participants. In addition, Bacteroides copy number and Bact/Firm ratios were significantly lower in the obese group as compared to the normal and overweight groups (P < 0.0167). This difference is only significant in girls, but not in boys when stratified by gender. Furthermore, a negative correlation between BMI and Bacteroidetes copy number (r = -0.18, P = 0.017) as well as Bact/Firm (r = -0.22, P = 0.003) was observed. CONCLUSION: An association between reduced gut Bacteroidetes and Bact/Firm ratio with obesity in female Kazakh children was identified. Further studies are necessary to elucidate the mechanism behind these changes as well as the value of determining their presence for predicting obesity.

[Correlation between obesity index and blood pressure in Kazak childhood from Yili, Xinjiang].

OBJECTIVE: To investigate the correlations between obesity index such as waist circumference, hip circumference, skin-fold thickness, body mass index, waist to hip ratio, waist to height ratio etc, and blood pressure among Kazak children living in Yili of Xinjiang. METHODS: In May-June 2009, 2438 Kazak children aged 7 to 14 at primary schools in Yili of Xinjiang, were investigated. Waist circumference, hip circumference, skin-fold thickness, systolic and diastolic blood pressure were measured to calculate the body mass index, waist to hip ratio and waist to height ratio. Analysis on the differences in age and gender, blood pressure (BP) between hypertensive or normal BP group under the standard set for children. SPSS 17.0 software was used for statistical analysis on its correlation. RESULTS: The total prevalence of hypertension was 5.7% in Kazak ethnic school-age children in Yili, with 4.4% in the boys and 7.0% in girls. Data from waist circumference, hip circumference, waist-height-ratio, waist-hip ratio, systolic and diastolic blood pressure showed gender and age differences (P = 0.000). Average systolic blood pressure was correlated to waist circumference, hip circumference, skin-fold thickness, body mass index and waist to hip ratio (P = 0.000), with hip circumference the most (man: r = 0.618, female: r = 0.655). The average diastolic blood pressure was correlated to waist circumference, hip circumference, skin-fold thickness, body mass index and waist to hip ratio (P = 0.000), with hip having the strongest relation (r = 0.489 for male and r = 0.548 for females). Significant differences were seen between Hypertension group and normal blood pressure group on waist circumference, hip circumference, skin-fold thickness, body mass index and waist-hip ratio (P < 0.05). CONCLUSION: In Yili of Xinjiang, the prevalence of hypertension was at the low level in Kazak ethnic school-aged children when comparing to data from national and foreign standards. Indicators related to obesity as waist circumference, hip circumference, body mass index and waist to hip ratio were positively correlated with blood pressure, with hip in particular.

[Childhood benign acanthosis nigricans and metabolic abnormality].

OBJECTIVE: To observe the relationship of childhood benign acanthosis nigricans to anthropometric and metabolic indexes, with the aim of studying the association between childhood benign acanthosis nigricans and metabolic diseases. METHODS: A retrospective analysis was performed on the clinical data of 29 children who presented with benign acanthosis nigricans between February 2007 and October 2011. Thirty-two age, sex- and ethnic-matched normal children were selected as control group. The two groups were compared according to obesity (body mass index, waist-to-hip ratio, body fat content and body fat percentage) and metabolic indexes (blood glucose, insulin level and blood lipids). RESULTS: Body mass index, body fat content, body fat percentage, waist-to-hip ratio, fasting blood glucose, insulin level and triglyceride in the 29 patients with benign acanthosis nigricans were higher than in the control group (P<0.05), but the level of high-density lipoprotein in the 29 patients was lower than in the control group (P<0.05). Of the 29 patients, 16 had impaired glucose tolerance and 3 were diagnosed with diabetes (1 case with type 1, two cases with type 2). CONCLUSIONS: Childhood benign acanthosis nigricans is closely associated with obesity, insulin resistance and dyslipidemia.