The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis.

OBJECTIVE: To identify patients in the subclinical psoriatic arthritis (Sub-PsA) phase by ultrasound (US) and provide a solution to screen them. METHODS: A total of 490 participants with moderate-to-severe psoriasis were evaluated. Among them, 384 participants without arthritis symptoms were enrolled into the silent psoriasis group and 106 participants with arthritis symptoms, called prodromal/active PsA phase, were enrolled into the clinical PsA group. Another 80 non-psoriasis participants were enrolled into the control group. Each participant received clinical assessments and US examinations of 60 joints, 38 tendons, and 40 entheses. We compared the incidences of synovio-enthesitis, synovitis, tenosynovitis, erosion, and dactylitis detected on US among the three groups. Subsequently, on the basis of significant US findings, we distinguished Sub-PsA from psoriasis alone (PsO) in the silent psoriasis group and analyzed the clinical characteristics, mainly including basic clinical characteristics, body surface area (BSA), and Psoriasis Area and Severity Index (PASI) score. RESULTS: Only synovio-enthesitis significantly differed between the control group and the silent psoriasis group (1.3% vs. 16.1%, p < 0.001). The knee was the most commonly involved site of synovio-enthesitis (79.0%). Taking synovio-enthesitis as the standard, 16.1% of silent psoriasis participants and 12.7% of all psoriasis participants were in the Sub-PsA phase. Furthermore, there were no differences in BSA and PASI among the three phases of PsO, Sub-PsA, and prodromal/active PsA. CONCLUSIONS: Since the psoriasis patients in Sub-PsA phase was as high as 12.7% in all patients with moderate-to-severe psoriasis, US-detected synovio-enthesitis was recommended routinely for screening them regardless of arthritis symptoms, especially in the lower limbs. KEY POINTS: • Synovio-enthesitis on ultrasound was significantly associated with subclinical psoriatic arthritis, especially in the lower limbs. • Routine ultrasound evaluation could help screen psoriasis patients in the subclinical psoriatic arthritis phase, which was as high as 12.7% in all psoriasis patients.

Association between thyroid dysfunction and type 2 diabetes: a meta-analysis of prospective observational studies.

BACKGROUND: Diabetes mellitus and thyroid disease are two areas of broad interest in the field of endocrinology and metabolism. Variation of thyroid hormone concentration, even within the normal range, may portend the onset of type 2 diabetes mellitus (T2DM), especially among those with prediabetes. However, current evidence is mixed. METHODS: Prospective studies which assessed diabetes incidence were identified using a database search of MEDLINE and Embase through May 1, 2021. The Sidik-Jonkman random-effects model and cubic spline model were used to evaluate the associations and dose-response relationships between thyroid function/hormone levels and risk of T2DM and cardiovascular disease (CVD) risk among T2DM patients. RESULTS: A total of 12 prospective studies were included. We found that high baseline TSH levels were related to a 17% higher risk of T2DM (RR 1.17, 95% CI 1.01, 1.36; I2=78%, P<0.01), compared with normal TSH levels. Low FT3 (RR 1.40, 95% CI 1.09, 1.80; I2=59%, P=0.03) and low FT4 (RR 1.33, 95% CI 1.04, 1.71; I2=62%, P=0.02) levels were significantly associated with risk of T2DM. The cubic spline model indicated a J-shaped relationship with TSH, but inverted-J-shaped relationships with FT3 and FT4. CVD events and all-cause deaths were prospectively evaluated in four studies, but were not associated with abnormal thyroid function. CONCLUSIONS: Our meta-analysis determined that abnormal thyroid hormone level is associated with an increased risk of T2DM, showing a J-shaped relationship with TSH and inverted-J-shaped relationships with FT3 and FT4. TRIAL REGISTRATION: Registered number in PROSPERO: CRD42021225695 .

Association of procalcitonin levels with the progression and prognosis of hospitalized patients with COVID-19.

Rationale: Coronavirus disease 2019 (COVID-19) was first announced in Wuhan, and has rapidly evolved into a pandemic. However, the risk factors associated with the severity and mortality of COVID-19 are yet to be described in detail. Methods: We retrospectively reviewed the information of 1525 cases from the Leishenshan Hospital in Wuhan. Univariate and multivariate Cox regression analyses were generated to explore the relationship between procalcitonin (PCT) level and the progression and prognosis of COVID-19. Univariate and multivariate logistic regression analyses were performed to explore the relationship between disease severity in hospitalized patients and their PCT levels. Survival curves and the cumulative hazard function for COVID-19 progression were conducted in the two groups. To further detect the relationship between the computed tomography score and survival days, curve-fitting analyses were performed. Results: Patients in the elevated PCT group had a higher incidence of severe and critical severity conditions (P < 0.001), death, and higher computed tomography (CT) scores. There was an association between elevated PCT levels and mortality in the univariate ((hazard ratio [1], 3.377; 95% confidence interval [2], 1.012-10.344; P = 0.033) and multivariate Cox regression analysis (HR, 4.933; 95% CI, 1.170-20.788; P = 0.030). Similarly, patients with elevated PCT were more likely to have critically severe disease conditions in the univariate (odds ratio [2], 7.247; 95% CI, 3.559-14.757; P < 0.001) and multivariate logistic regression analysis (OR, 10.679; 95% CI, 4.562-25.000; P < 0.001). Kaplan-Meier curves showed poorer prognosis for patients with elevated PCT (P = 0.024). The CT score 1 for patients with elevated PCT peaked at day 40 following the onset of symptoms then decreased gradually, while their total CT score was relatively stable. Conclusion: PCT level was shown as an independent risk factor of in-hospital mortality among COVID-19 patients. Compared with inpatients with normal PCT levels, inpatients with elevated PCT levels had a higher risk for overall mortality and critically severe disease. These findings may provide guidance for improving the prognosis of patients with critically severe COVID-19.

Meta-analysis of efficacy and safety of the new anticoagulants versus warfarin in patients with atrial fibrillation.

OBJECTIVE: To assess the efficacy and safety of the new oral anticoagulants versus warfarin in patients with atrial fibrillation by the meta-analyses performed for 5 studies ARISTOTLE, ENGAGE AF-TIMI 48, RE-LY, ROCKET-AF, and J-ROCKET. METHODS: The events including primary efficacy endpoint (stroke and systemic embolism), ischemic stroke, hemorrhagic stroke, all-cause mortality, and myocardial infarction were used for efficacy analysis and those including major bleeding, intracranial hemorrhage, and gastrointestinal bleeding were used for safety analysis. Instead of combining both doses to 1 meta-analysis, the high-dose groups of RE-LY (150 mg twice daily) and ENGAGE AF-TIMI 48 (60 mg twice daily) were combined with the single dose studies ARISTOTLE, ROCKET-AF, and J-ROCKET. A separate meta-analysis was done for the low-dose groups of RE-LY (110 mg twice daily) and ENGAGE AF-TIMI 48 (30 mg twice daily). RESULTS: The high-dose regimen had better performance than low dose in efficacy. In addition, low-dose regimen demonstrated to significantly reduce the risk of hemorrhagic stroke, all-cause mortality, and intracranial hemorrhage. CONCLUSIONS: The new oral anticoagulants demonstrated promising alternatives to warfarin in prevention of stroke in patients with atrial fibrillation.

Progress and hotspot of diet or exercise therapy in the treatment of non-alcoholic fatty liver disease.

Introduction: The primary treatment for non-alcoholic fatty liver disease (NAFLD) is modifying lifestyle through dietary or exercise interventions. In recent decades, it has received increasing attention. However, the lack of bibliometric analysis has posed a challenge for researchers seeking to understand the overall trends in this field. Methods: As of February 3rd, 2024, 876 articles on treating NAFLD through diet or exercise therapy from 2013 to 2023 had been retrieved. Two software tools, VOSviewer and CiteSpace, were utilized to analyze the growth of publications, countries, institutions, authors, journals, citations, and keywords. Additionally, the keywords with strong citation burstiness were identified to determine the changes and future trends of research hotspots in this field. Results: China had the highest number of articles, followed by the United States and South Korea. Yonsei University and Nutrients were the institutions and journals with the most significant contributions. Professor Younossi Zobair M, from the United States, is the most prolific author in this field. Through analyzing the keywords, three research hotspots were identified: research on the pathogenesis of NAFLD, research on the treatment modalities of NAFLD, and research on the risk factors and diagnosis methods of NAFLD. In recent years, the research emphasis in this field has changed, suggesting that future research will focus on two frontier keywords: "oxidative stress" and "aerobic capacity." Conclusion: In the past eleven years, the attention in this field was still rising, and the authors, journals, countries and so on had formed a considerable cooperative relationship. There were also many highly influential and productive researchers in this field. It is speculated that new research will continue around "aerobic exercise" and "oxidative stress" in the future.

Measurement of serum IgG4 levels by an established ELISA system and its clinical applications in autoimmune diseases.

IgG4-related disease (IgG4-RD) is a novel and rare autoimmune disease entity. Elevated serum IgG4 level is strongly suggestive of IgG4-RD. But it is still unknown whether serum IgG4 elevation commonly occurs in other autoimmune diseases. In this study, the serum IgG4 levels were detected by an established enzyme-linked immunosorbent assay (ELISA) in a variety of autoimmune diseases including systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), polymyositis or dermatomyositis (PM/DM) and IgG4-RD. To evaluate the reliability of this ELISA system, some of our samples were sent to a lab in Kanazawa Medical University, Japan, and detected by using the nephelometric assay. The results showed that our findings were consistent with theirs. Moreover, it was found that the serum IgG4 levels were 0.23±0.16 g/L in 53 healthy controls, 0.16±0.15 g/L in 103 SLE patients, 0.22±0.18 g/L in 41 SS patients and 0.40±0.32 g/L in 21 PM/DM patients. No significant difference in the serum IgG4 level was observed among these groups (P>0.05). The serum IgG4 levels of two cases of IgG4-RD were 1.63 and 4.65 g/L respectively, and both decreased markedly after treatment with glucocorticoids. These data indicated that this established ELISA system can be used for detecting serum IgG4 levels. Elevated serum IgG4 levels help diagnose IgG4-RD and evaluate the curative effect of this condition rather than other autoimmune diseases.

[Investigation and study on influencing factors of overweight and obesity of children aged 10 to 14 in Wuxi].

OBJECTIVE: To learn the prevalence of overweight and obesity of children aged 10 to 14 in Wuxi and to analyze its potential influencing factors. METHODS: With a stratified cluster random sampling method, 2870 children aged 10 to 14 in three districts of Wuxi were surveyed by means of questionnaire and physical examination. RESULTS: The incidence of overweight was 11.39% (Boys' was 10.03% and girls' was 1.36%) and that of obesity was 2.23% (Boys' was 1.64% and girls' was 0.59%). The incidence of overweight and obesity of boys was much higher than that of girls (P < 0.01). The result of multiple linear regression analysis indicated the influencing factors of BMI in childhood might include birth weight, BMI of father and mother and preference for fried foods. CONCLUSION: The prevalence of overweight and obesity of children aged 10 to 14 in Wuxi was between the rich rural areas and small and middle-sized cities in China. To prevent overweight developing to obesity is an important measure. Birth weight, BMI of father and mother, preference for fried foods were the main factors affecting children's BMI. A comprehensive prevention and control measure of family intervention should be taken.

Cavernous hemangioma of the ileum in a young man: A case report and review of literature.

BACKGROUND: Small intestinal cavernous hemangioma is a rare disease, especially in the ileum. It is difficult to accurately diagnose due to its hidden location and nonspecific clinical symptoms. Here, we reported a case of ileal cavernous hemangioma with chronic hemorrhage in a 20-year-old man and review the literature to gain a better understanding of this disease. CASE SUMMARY: The patient complained of intermittent melena and hematochezia for > 3 mo. The lowest hemoglobin level revealed by laboratory testing was 3.4 g/dL (normal range: 12-16 g/dL). However, the gastroscopy, colonoscopy and peroral double-balloon enteroscopy (DBE) showed no signs of bleeding. The transanal DBE detected a lesion at about 340 cm proximal to the ileocecal valve. Thus, we performed an exploratory laparoscopy and the lesion was resected. After the operation, the patient had no melena. Finally, the pathological examination identified the neoplasm as an ileal cavernous hemangioma, thereby resulting in gastrointestinal hemorrhage. CONCLUSION: This report might improve the diagnosis and treatment of ileal cavernous hemangioma.

Efficacy of Banxia Xiexin decoction for chronic atrophic gastritis: A systematic review and meta-analysis.

BACKGROUND: Banxia Xiexin decoction (BXD), a classical formula of traditional Chinese medicine (TCM), has been wildly used for chronic atrophic gastritis (CAG) patients with the cold-heat complex syndrome in China, and achieved satisfied effects. However, the clinical effects of it remains unclear. PURPOSE: The purpose of this article is to evaluate the clinical efficacy and safety of BXD for CAG treatment. METHODS: We searched seven electronic databases including Ovid, Embase, PubMed, Cochrane Library, Wan-fang database, VIP (Chinese Scientific Journals Database) and CNKI (China National Knowledge Infrastructure) from their inception to September 21, 2020. We used Jadad scale and Cochrane Collaboration's risk of bias tool to make evaluation of methodological quality. Revman 5.3 statistical software was used for statistical processing to evaluate the clinical efficacy and safety of BXD. RESULTS: 26 randomized controlled trials (RCTs) totaling 1985 patients were identified for analysis. Meta-analysis showed that BXD treatment was more effective (RR 1.29; 95%CI 1.24, 1.35; P<0.00001) and safe (MD 0.33; 95%CI 0.18, 0.58; P = 0.0002) than Chinese patent medicine + western medicine. Furthermore, BXD had improvement on symptoms scores such as stomach distending pain, and belching. Besides, BXD was more effective in inhibiting Helicobacter Pylori (HP), improving HP-related inflammation, and relieving the degree of glandular atrophy, intestinal metaplasia (IM), and dysplasia of gastric mucosa (GM). CONCLUSIONS: The meta-analysis showed that BXD was more effective and safer for CAG patients than the control group. However, due to limitations of methodological quality and small sample size of the included studies, further standardized research of rigorous design should be needed.

Prevalence and Risk Factors for Refractive Error in Adult Chinese Americans: The Chinese American Eye Study.

PURPOSE: To estimate the prevalence of refractive errors in adult Chinese Americans, and to evaluate factors associated with myopia and high myopia. DESIGN: A population-based, cross-sectional study. METHODS: Chinese Americans 50 years and older residing in Monterey Park, California, were recruited. Noncycloplegic automated refraction with supplemental subjective refraction was performed. Myopia, high myopia, hyperopia, and high hyperopia were defined as a spherical equivalent of <-0.5 diopter (D), <-5.0 D, >+0.5 D, and ≥+3.0 D, respectively. Astigmatism and high astigmatism were defined as a cylinder of >0.5 D and >2.25 D, respectively. Risk factor assessment was guided by a conceptual model. RESULTS: Data from 4144 participants were analyzed. The overall prevalence of myopia, high myopia, hyperopia, high hyperopia, astigmatism, and high astigmatism in the right eye was 35.1% (95% confidence interval, 33.6%-36.6%), 7.4% (6.6%-8.3%), 40.2% (38.7%-41.8%), 2.7% (2.2%-3.3%), 45.6% (44.1%-47.2%), and 3.7% (3.1%-4.3%), respectively. The prevalence of myopia and high myopia was lower among older individuals (P < .05). Reversed age trends were observed for the other refractive errors (P < .05). There was no sex difference in the prevalence of refractive errors, except for a higher prevalence of hyperopia among female subjects (P = .010). Age, acculturation, education, income, marital status, birth country, history of ocular disease, nonocular comorbidities, and recent eye examination were associated with prevalence of myopia. All of these factors, except for acculturation, were also associated with high myopia. CONCLUSIONS: Our data present the first population-based estimates of the prevalence of refractive errors among adult Chinese Americans. Compared with whites, Hispanics, and blacks, Chinese Americans have a higher burden of myopia, high myopia, and astigmatism.

Safety of the direct-acting anticoagulants in patients with atrial fibrillation: a meta-analysis.

INTRODUCTION: Atrial fibrillation (AF) is known as one of the independent risk factors for stroke and might significantly increase its risk. Nowadays, direct-acting oral anticoagulants (DOACs) have been developed and demonstrated a more promising option to warfarin, the conclusion for safety is heterogeneous in different studies. It indicates the importance of comprehensive comparison of safety between DOACs and warfarin. MATERIAL AND METHODS: Four studies including ARISTOTLE, ENGAGE AF-TIMI 48, RE-LY and ROCKET-AF were included in the meta-analysis to perform separate meta-analyses for high-dose regimen, low-dose regimen and their combination. The events included major bleeding, intracranial haemorrhage, gastrointestinal bleeding, non-major clinically relevant and minor bleeding. RESULTS: Regardless of high dose or low dose regimen, DOACs were associated with lower risk of intracranial haemorrhage but due to no significant association for gastrointestinal bleeding, the overall effect measured by the major bleeding was also insignificant (High dose: RR=0.86, 95% CI 0.73 to 1.01; Low dose: RR=0.63, 95% CI 0.38 to 1.04). However, the combined result of high-dose and low-dose regimens showed DOACs were associated with lower risk of major bleeding events (RR=0.77, 95% CI 0.63 to 0.95). CONCLUSIONS: Meta-analyses have showed the comparative safety of the direct-acting oral anticoagulants than warfarin in most endpoints and even better in intracranial haemorrhage. Therefore, without the need of INR monitoring, DOACs demonstrated promising alternatives to warfarin in prevention of stroke in patients with AF.

Imaging diagnosis of 12 patients with hepatic tuberculosis.

AIM: To assess CT, MR manifestations and their diagnostic value in hepatic tuberculosis. METHODS: CT findings in 12 cases and MR findings in 4 cases of hepatic tuberculosis proved by surgery or biopsy were retrospectively analyzed. RESULTS: (1) CT findings: One case of serohepatic type of hepatic tuberculosis had multiple-nodular lesions in the subcapsule of liver. Parenchymal type was found in 10 cases, including multiple, miliary, micronodular and low-density lesions with miliary calcifications in 2 cases; singular, low-density mass with multiple flecked calcifications in 3 cases; multiple cystic lesions in 1 case; multiple micronodular and low-density lesions fusing into multiloculated cystic mass or "cluster" sign in 3 cases; and singular, macronodular and low-density lesion with multiple miliary calcifications in 1 case. One case of tuberculous cholangitis showed marked dilated intrahepatic ducts with multiple flecked calcifications in the porta hepatis. (2) MR findings in 4 cases were hypointense on both T1-weighted imagings and T2-weighted imagings in one case, hypointense on T1-weighted imagings and hyperintense on T2-weighted imagings in 3 cases. Enhanced MR in 3 cases was slightly shown peripheral enhancement or with multilocular enhancement. CONCLUSION: Various types of hepatic tuberculosis have different imaging findings, and typical CT and MR findings can suggest the diagnosis.

Expression and identification of recombinant soluble single-chain variable fragment of monoclonal antibody MC3.

AIM: To generate soluble single chain variable fragments (ScFv) of monoclonal antibody MC3 recognizing colorectal and gastric carcinomas. METHODS: mRNA was isolated from the hybridoma cell line producing MC3 and the DNAs encoding variable domains of heavy and light chains (VH and VL) of the antibody were amplified separately by RT-PCR and assembled into ScFv DNA with a linker DNA. The ScFv DNA was ligated into the phagemid vector pCANTAB5E and the ligated sample was transformed into E.coli TG1. The transformed cells were infected with M13KO7 helper phage to yield recombinant phages. After two rounds of panning with gastric carcinoma cell line AGS highly expressing MC3-binding antigen, the phage clones displaying ScFv fragments of the antibody were selected by ELISA. 4 phage clones showing strong signal in ELISA were used to infect E.coli HB2151 to express soluble ScFvs. The soluble ScFvs were identified by Dot blot and Western blot, and their antigen-binding activity was assayed by ELISA. The VH and VL DNAs of the ScFv DNA derived from phage clone 19 were sequenced. RESULTS: The VH,VL and ScFv DNAs were about 340 bp, 320 bp and 750 bp respectively. After two rounds of panning to the recombinant phages, 18 antigen-positive phage clones were selected from 30 preselected phage clones by ELISA. All the soluble ScFvs derived from the 4 out of the 18 antigen-positive phage clones were about M(r)32000 and concentrated in periplasmatic space under the given culture condition. The soluble ScFvs could bind the antigen, and they shared the same binding site with MC3. The sequences of the VH and VL DNAs of the MC3 ScFv showed that the variable antibody genes belonged to the IgG1 subgroup,kappa-type. CONCLUSION: The soluble ScFv of MC3 is successfully produced, which not only provides a possible novel targeting vehicle for in vivo and in vitro study on associated cancers, but also offers the antibody a stable genetic source.

[Effects of mifepristone of different doses on emergency contraception, a randomized double-blind study].

OBJECTIVE: To compare the effects of mifepristone of different doses on emergency contraception. METHODS: 3,052 healthy women with regular menstrual cycle who visited the 10 family planning institutes and hospitals in Beijing, Shanghai, Shangdong, Sichuan, Tianjin, Guangdong, and Liaoning for emergency contraception within the period of 120 hours after a single act of unprotected sex were given a single dose of 10 mg or 25 mg mifepristone randomly and double-blindly. They were asked to record the vaginal hemorrhage that would occur and not to have unprotected sex until the next menstrual onset when they were followed up. The trial for a specific subject ended when she menstruated. If the menstruation was irregular or a specific subject failed to menstruate on time a blood or urine human chorionic gonadotropin (hCG) test was made. If the hCG test was negative, an appointment was made to follow up once one week later. If the hCG test was positive ultrasound examination was made to detect pregnancy. If the subject still failed to menstruate and the hCG test was still negative follow-up for this subject could be finished. RESULTS: Twenty-two of the 3,052 subjects were lost to follow up. Among the remaining 3,030 women 1,516 were in the 10 mg group and 1 514 in the 25 mg group. Seventeen pregnancies occurred in each group, with a pregnancy rate of 1.1% for both groups. The relative risk of pregnancy of treatment of 25 mg mifepristone in comparison with treatment of 10 mg mifepristone was 1.0 (95% CI: 0.51-1.95). Both doses prevented about 85% approximately 86% of the anticipated pregnancy if no measure had been adopted. The pregnancy rate nearly doubled in the women who had unprotected sex after treatment of mifepristone. The efficacy of mifepristone decreased along with the delay of mifepristone administration. Side effects were uncommon and mild. Delay of 7 days or more in the onset of next menstruation occurred in 9%-10% of the women. CONCLUSION: Mifepristone of the dose of 10 mg is safe and effective for emergency contraception. Earlier administration is preferable, although the method can be used effectively up to five days after the unprotected sex.

Functional characterization of the 5' proximal flanking fragment of Plasmodium falciparum GBP130 gene.

OBJECTIVE: To identify the putative regulation elements with strength- and stage-specificity in 5' proximal flanking sequence of P. falciparum GBP130 gene. METHODS: Plasmids containing different deletions of upstream of the GBP130 promoter were constructed. For strength-specific analysis, pGBPCAT delta 2, pGBP delta 2/400 and pGBP delta 2/800 were electroporated into ring-stage P. f. respectively, and the expression level of CAT in each plasmid was detected by liquid scintillation counts(LSC). For stage-specific analysis, transfectants with pGBP delta 2/400 and pGBP delta 2/800 were harvested at 5 hours post-transfection(h), 15 h and 46 h respectively, and the CAT expression levels were detected. RESULTS: In strength-specific analysis, the expression level of CAT in pGBP delta 2/800 and pGBPCAT delta 2 was similar, down-regulated significantly in pGBP delta 2/400. The CAT level showed significant difference between pGBP delta 2/400 and the control. In stage-specific analysis, the CAT level of pGBP delta 2/400 was higher than that of pGBP delta 2/800 at the time point of 5 h, and lower at 15 h and 46 h. CONCLUSION: This strength-specific promoter activity was due to the difference of 5'UTR length: the longer the 5'UTR the higher the promoter strength, and two poly (dA:dT) tracts in the proximal sequence could enhance the promoter activity. The length of 5'UTR regulated the promoter activity in a stage-specific manner. The shorter 5'UTR was functional at ring stage, while the longer one prompted transcription at trophozoite and schizont stage. The functional role of poly (dA:dT) tracts in stage-specific regulation of GBP130 remains unclear.

[Protective antibody response to recombinant fragments of Plasmodium falciparum apical membrane antigen 1].

OBJECTIVE: To determine the role of putative apical membrane antigen (AMA)1 domains in inducing protective immunity and to provide basis for selection of vaccine applicable segments. METHODS: Encoding gene segments of AMA1 were amplified and cloned into pET prokaryotic expression vectors. Recombinant proteins were expressed and purified. Groups of BALB/c mice were immunized by using recombinant protein in Freund's adjuvant, and the IgG titer and specificity of the immune sera were analyzed by IFA and Western blotting. Efficiency of the immune sera in inhibiting Plasmodium falciparum in vitro growth was evaluated. RESULTS: Recombinant AMA1 fragments including the entire ectodomain E and subdomain I + II, I, II and III were successfully expressed and purified. Different levels of antibody were induced in mice by individual proteins and all the immune sera recognized native antigen in the parasites. Sera from protein E and I + II immunized mice inhibited the growth of parasites. CONCLUSION: The integrality of the ectodomain of AMA1 determines the conformation of the protective antibody epitopes, and these protective epitopes distribute mainly in the subdomain I.

Association of FTO polymorphisms with obesity and metabolic parameters in Han Chinese adolescents.

BACKGROUND: Previous studies have suggested that fat mass-and obesity-associated (FTO) gene is associated with body mass index (BMI) and the risk of obesity. This study aims to assess the association of five FTO polymorphisms (rs9939609, rs8050136, rs1558902, rs3751812 and rs6499640) with obesity and relative parameters in Han Chinese adolescents. METHODS: We examined a total of 401 adolescents, 223 normal weights (58.7% boys, 41.3% girls), 178 overweight (60.1% boys, 39.9% girls), aging from 14 to 18-years-old, recruited randomly from public schools in the central region of Wuxi, a southern city of China. DNA samples were genotyped for the five polymorphisms by Sequenom Plex MassARRAY. Association of the FTO polymorphisms with BMI, serum fasting plasm glucose (FPG), fasting insulin (FIns), triglyceride (TG) and cholesterol (TC) were investigated. RESULTS: 1) Serum FPG, FIns, TG and TC were statistically significant higher than that in normal control group. 2) We found that BMI was higher in the rs9939609 TA+AA, rs8050136 AC+AA, rs1558902 TA+AA and rs3751812 GT+TT genotypes than in wild TT genotypes (rs9939609: P = 0.038; rs1558902: P = 0.038;), CC genotypes(rs8050136: P = 0.024) and GG genotypes (rs3751812: P = 0.024), which were not significant on adjusting for multiple testing. 3) In case-control studies, five polymorphisms were not significantly associated with overweight (p>0.05), haplotype analyses showed non-haplotype is significantly associated with a higher risk of being overweight (p>0.05). 4) There existed no significant statistical difference about FPG, FIns, TG and TC in genotype model for any SNP. CONCLUSIONS: Our study has conducted a genetic association study of the FTO polymorphisms with BMI, serum fasting plasm glucose (FPG), fasting insulin (FIns), triglyceride (TG) and cholesterol (TC). Our study found BMI of subjects with A allele of FTO rs9939609 is higher than that with T allele. Further studies on other polymorphisms from FTO and increasing the sample size are needed.

The effect of high birth weight on overweight and obesity in childhood and adolescence. A cohort study in China.

OBJECTIVES: To determine the association of high birth weight (HBW) with the risk of obesity in childhood and adolescence. We also aimed to explore the interactions of HBW with physical activity and dietary habits. METHODS: In a birth cohort born in 1993, 1994, and 1995 in Wuxi, China, subjects with a birth weight (BW) of >/=4000 g were selected as the exposed group. For each exposed subject, one non-exposed subject with a BW of 2500-3999 g, matched by year of birth, gender, and type of institute at birth was chosen. Two follow-ups were performed from October 2005 to February 2007 and July 2010 to December 2011. RESULTS: A total of 1108 exposed and 1128 non-exposed subjects were included. Overweight/obesity rates were significantly higher in the exposed group (16.2% in childhood and 14.2% in adolescence) than those in the non-exposed group (12.1% in childhood and 8.2% in adolescence). There was no significant interaction between BW and the growth period (F=2.10, p=0.147). The relative excess risk due to interaction (RERI) of HBW with physical activity was -0.20 (95% CI=-2.85-2.45), and the RERI of HBW with dietary habits was 1.19 (95% CI=0.14-2.23). CONCLUSION: Infants with HBW are at increased risk of childhood and adolescent overweight/obesity, and this relationship is not influenced by the growth period. There is an additive interaction between HBW and dietary habits.

[The influence of smoking on the routine parameters of semen quality].

OBJECTIVE: To explore the effect and heaviness of smoking on the routine parameters of semen quality. METHODS: A total of 727 eligible subjects including 421 smokers and 306 nonsmokers were selected in 2004 - 2006 in Hebei, Shanxi, Guizhou, Zhejiang and Shandong provinces. Data on background information, general demographic characteristics, exposure to smoking and related confounding factors were obtained through a questionnaire survey. Semen samples of all the subjects were collected during the period of study. Parameters of semen were examined according to the manual recommended by WHO. RESULTS: Four models from the multiple logistic regression regarding the semen routine parameters were used as the dependent variables to be fitted in descending order respectively, while six confounders including area, age, abstinence time, education level, history of alcohol intake and the exposure to pesticides etc., were adjusted. RESULTS: showed that smoking could affect the sperm viability, with significantly higher proportion of abnormal sperm viability seen in the smoking group (OR = 1.77, 95% CI: 1.12 - 2.80). Proportions regarding the abnormal mobility and morphology of sperms in the smoking group were also significantly higher than in the control group, with OR values as 1.51 (95%CI: 1.00 - 2.27) and 2.55 (95%CI: 1.68 - 3. 88) respectively. The density of sperms was significantly decreased in the smoking groups who smoked more than 20 cigarettes per day (OR = 1.70, 95%CI: 1.05 - 2.76) or the total numbers of cigarette consumption exceeding 150 000 (OR = 1.84, 95% CI: 1.03 - 3.29). CONCLUSION: Smoking showed adverse effects on the quality of semen, especially for heavy or long-term smokers.

[The influence of high birth weight on the blood pressure during childhood - a cohort study].

OBJECTIVE: To explore the effects of high birth weight (HBW) on blood pressure (BP) during childhood. METHODS: A total of 1435 couples with high or normal birth weight were selected from a birth cohort who were born between 1993 and 1995 in Wuxi, China and, followed between 2005 and 2007. A questionnaire survey was conducted, with their height, weight and blood pressure measured. RESULTS: The medians of systolic blood pressure (SBP) and diastolic BP (DBP) of HBW group were 100 mm Hg (Q(1)-Q(3): 90 - 110 mm Hg), 64 mm Hg (Q(1)-Q(3): 60 - 70 mm Hg) in the high birth weight group, respectively, while they were 100 mm Hg (Q(1)-Q(3): 90 - 108 mm Hg), 62 mm Hg (Q(1)-Q(3): 60 - 70 mm Hg) in the normal weight group. No statistical significant difference was found between the exposed and unexposed groups. The proportion of elevated BP, including pre-hypertension and hypertension, in exposed group was 13.66%, a bit higher than that (11.57%) of the unexposed group (P = 0.055). The relative risk (RR) of HBW on elevated BP was 1.06 (0.92 - 1.21), after adjusted the following parameters as BMI in childhood, sex, age during the follow-up period, age of mother at delivery, gestational age, type of feeding at infancy, dietary habit as well as the frequencies of exercise during childhood. CONCLUSION: No statistically significant correlation was found between high birth weight and blood pressure of children.