Genomic Elucidation of a COVID-19 Resurgence and Local Transmission of SARS-CoV-2 in Guangzhou, China.

While China experienced a peak and decline in coronavirus disease 2019 (COVID-19) cases at the start of 2020, regional outbreaks continuously emerged in subsequent months. Resurgences of COVID-19 have also been observed in many other countries. In Guangzhou, China, a small outbreak, involving less than 100 residents, emerged in March and April 2020, and comprehensive and near-real-time genomic surveillance of SARS-CoV-2 was conducted. When the numbers of confirmed cases among overseas travelers increased, public health measures were enhanced by shifting from self-quarantine to central quarantine and SARS-CoV-2 testing for all overseas travelers. In an analysis of 109 imported cases, we found diverse viral variants distributed in the global viral phylogeny, which were frequently shared within households but not among passengers on the same flight. In contrast to the viral diversity of imported cases, local transmission was predominately attributed to two specific variants imported from Africa, including local cases that reported no direct or indirect contact with imported cases. The introduction events of the virus were identified or deduced before the enhanced measures were taken. These results show the interventions were effective in containing the spread of SARS-CoV-2, and they rule out the possibility of cryptic transmission of viral variants from the first wave in January and February 2020. Our study provides evidence and emphasizes the importance of controls for overseas travelers in the context of the pandemic and exemplifies how viral genomic data can facilitate COVID-19 surveillance and inform public health mitigation strategies.

Distribution of Microbiota in Fine Particulate Matter Particles in Guangzhou, China.

OBJECTIVE: High PM 2.5 concentration is the main feature of increasing haze in developing states, but information on its microbial composition remains very limited. This study aimed to determine the composition of microbiota in PM 2.5 in Guangzhou, a city located in the tropics in China. METHODS: In Guangzhou, from March 5 th to 10 th, 2016, PM 2.5 was collected in middle volume air samplers for 23 h daily. The 16S rDNA V4 region of the PM 2.5 sample extracted DNA was investigated using high-throughput sequence. RESULTS: Among the Guangzhou samples, Proteobacteria, Bacteroidetes, Firmicutes, Cyanobacteria, and Actinobacteria were the dominant microbiota accounting for more than 90% of the total microbiota, and Stenotrophomonas was the dominant gram-negative bacteria, accounting for 21.30%-23.57%. We examined the difference in bacterial distribution of PM 2.5 between Beijing and Guangzhou at the genus level; Stenotrophomonas was found in both studies, but Escherichia was only detected in Guangzhou. CONCLUSION: In conclusion, the diversity and specificity of microbial components in Guangzhou PM 2.5 were studied, which may provide a basis for future pathogenicity research in the tropics.

Effect of age at first use of oral contraceptives on breast cancer risk: An updated meta-analysis.

BACKGROUND: We evaluated the relationship between the age at first use of oral contraceptives (OC) and breast cancer (BC) risk. METHODS: We searched PubMed, Embase, and related reviews published through June 28, 2018, and used summary relative risk (RR) and 95% confidence intervals (CIs) to evaluate the cancer risks, and fixed-effects dose-response meta-analysis to assess potential linear and non-linear dose-response relationships. RESULTS: We included 10 studies, with 8585 BC cases among 686,305 participants. The pooled RR for BC was 1.24 (95% CI: 1.10-1.41), with moderate heterogeneities (I = 66.5%, P < .001). No significant publication bias was found (P = .584 for Begg test, P = .597 for Egger test). A linear dose-response relationship between the age at first OC use and BC risk was detected (P = .518 for non-linearity). Subgroup analyses were restricted to studies done by BC subtypes, region, sample size, follow-up time and study quality. Inconsistent consequences with no statistical significance were explored when limited to studies from Western countries, study quality <7, sample size <10,000, follow-up time <5 years, and BC subtypes defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) expression status in tumor tissue. Sensitivity analyses indicated that our results were stable and reliable after removing each study in turn and omitting studies of adjusted unreported variables. CONCLUSION: A significant linear relationship between the age at first OC use and BC risk was confirmed. No further consistent differences are noted in multiple aspects of BC subtypes defined by progesterone or ER status.

Admission serum sodium and potassium levels predict survival among critically ill patients with acute kidney injury: a cohort study.

BACKGROUND: Patients suffering from acute kidney injury (AKI) were associated with impaired sodium and potassium homeostasis. We aimed to investigate how admission serum sodium and potassium independently and jointly modified adverse clinical outcomes among AKI patients. METHODS: Patient data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III. Participants were categorized into three groups according to admission serum sodium and potassium, and the cut-off values were determined using smooth curve fitting. The primary outcome was 90-day mortality in the intensive care unit (ICU). Cox proportional hazards models were used to evaluate the prognostic effects of admission serum sodium and potassium levels. RESULTS: We included 13,621 ICU patients with AKI (mean age: 65.3 years; males: 55.4%). The middle category of admission serum sodium and potassium levels were 136.0-144.9 mmol/L and 3.7-4.7 mmol/L through fitting smooth curve. In multivariable Cox models, compared with the middle category, patients with hyponatremia or hypernatremia were associated with excess mortality and the HRs and its 95%CIs were 1.38 (1.27, 1.50) and 1.56 (1.36, 1.79), and patients with either hypokalemia or hyperkalemia were associated with excess mortality and the hazard ratios (HRs) and its 95% confidential intervals (95% CIs) were 1.12 (1.02, 1.24) and 1.25 (1.14, 1.36), respectively. Significant interactions were observed between admission serum sodium and potassium levels (P interaction = 0.001), with a higher serum potassium level associated with increased risk of 90-day mortality among patients with hyponatremia, whereas the effects of higher sodium level on prognostic effects of potassium were subtle. CONCLUSIONS: Admission serum sodium and potassium were associated with survival in a U-shaped pattern among patients with AKI, and hyperkalemia predict a worse clinical outcome among patients with hyponatremia.

Association of PICALM Gene Polymorphisms with Alzheimer's Disease: Evidence from an Updated Meta-Analysis.

BACKGROUND: Previous studies have examined the roles of three polymorphisms (rs3851179, rs541458, and rs592297) of the PICALM gene in susceptibility to Alzheimer's disease (AD) with inconclusive findings. OBJECTIVE: We performed a meta-analysis to explore whether these three polymorphisms in the PICALM gene were associated with susceptibility to AD. METHODS: Bibliographical searches were conducted in the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. Summary Odds Ratios (ORs) with 95% Confidence Intervals (CIs) were used to assess the strength of association in a random effects model. Potential sources of heterogeneity were identified by subgroup and meta-regression analyses. RESULTS: Twenty studies (9,017 cases and 15,448 controls) on rs3851179, 12 studies (8,077 cases and 12,022 controls) on rs541458, and 4 studies (2,106 cases and 2,234 controls) on rs592297 were considered eligible for meta-analyses. For both rs3851179 and rs541458, the overall ORs were significant under all genetic models with mild heterogeneity. Compared with G carriers, A carriers of rs3851179 were associated with a decreased risk of AD (OR = 0.88; 95% CI 0.84, 0.91, P for Z-test <0.001, I2 = 0.0%). Compared with T carriers, C carriers of rs541458 were inversely associated with AD risk (OR = 0.86; 95% CI 0.81, 0.92, P for Z-test <0.001, I2 = 39.5%). No association was observed for rs592297. Subgroup and meta-regression analyses indicated that the protective effect of the rs541458 C allele was observed only among Caucasians, not among Asians (P for interaction: 0.021~<0.001). CONCLUSION: rs3851179 and rs541458 appear to be associated with decreased AD risk. The null associations for rs592297 with AD risk need further confirmation with a larger number of participants.

Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies.

OBJECTIVE: There has been growing body of literatures showing that chronic inflammation might play an important role in cancer development. This meta-analysis aimed to assess the association between the dietary inflammation index (DII) score and gynecological cancers. METHODS: A systematic search of PubMed, EMBASE and Web of Science up until October 20, 2018 was carried out to retrieve all related cohort and case-control studies. The summary risk assessments were pooled using random-effects models. The dose-response relationship was estimated by linear relationship model. RESULTS: Twelve case-control studies (10,774 cases/15,958 controls) and six prospective cohort studies (330,363 participants/23,133 incident cases) were included in this meta-analysis. The pooled adjusted relative risk (RR) of gynecological cancers for the highest DII category compared to the lowest category was 1.38, (95% confidence intervals [CIs], 1.21-1.56, p<0.001]. A positive dose-response relationship was also noticed. Stratified by study design indicated that, the pooled RRs was significantly higher for case-control studies than cohort studies (p for interaction<0.001), for studies conducted among participants with body mass index (BMI) ≥25 kg/m² than participants with BMI <25 kg/m² (p for interaction=0.026), among participants with ovarian cancer and endometrial cancer than participants with breast cancer (p for interaction = 0.038). Meta-regression analysis further confirmed that study design significantly contributed to inter-study heterogeneity (p<0.001). CONCLUSION: This meta-analysis suggests that elevated DII is independently associated with a higher risk of gynecological cancers, especially patients with ovarian cancer and endometrial cancer and among obese participants.

Pretreatment lymphocyte-to-monocyte ratio as a predictor of survival among patients with ovarian cancer: a meta-analysis.

INTRODUCTION: In this meta-analysis, we analyzed retrospective cohort studies that assessed the prognostic potential of the pretreatment lymphocyte-to-monocyte ratio (LMR) among patients with ovarian cancer (OC). MATERIALS AND METHODS: We comprehensively searched electronic databases, including PubMed and Embase, from inception through October 2018. A random-effects model was used to calculate pooled HRs and their 95% CIs for overall survival (OS) and progression-free survival (PFS). The low LMR group was treated as the reference group. RESULTS: Twelve studies, including 3,346 OC cases at baseline, were included. Overall, our results indicated that LMR was positively associated with both OS (HR: 1.85, 95% CI: 1.50-2.28, P<0.001; I 2=76.5%) and PFS (HR: 1.70, 95% CI: 1.49-1.94, P<0.001; I 2=24.4%) among OC patients. Stratified analyses indicated that, for OS, the LMR's protective effect was more evident in studies conducted among younger patients (<55 years) than in those conducted among older patients (≥55 years; P for interaction =0.017), which was confirmed by meta-regression analysis (P=0.004). CONCLUSION: This study suggested that a higher pretreatment LMR level was associated with a favorable prognosis among OC patients. Future large-scale prospective clinical trials are needed to confirm the prognostic value of LMR among OC patients.

Association Between SLC30A8 rs13266634 Polymorphism and Risk of T2DM and IGR in Chinese Population: A Systematic Review and Meta-Analysis.

Introduction: Published data regarding the association between solute carrier family 30, member 8 (SLC30A8) rs13266634 polymorphism and type 2 diabetes mellitus (T2DM) and impaired glucose regulation (IGR) risks in Chinese population are in-consistent. The purpose of this meta-analysis was to evaluate the association between SLC30A8 rs13266634 and T2DM/IGR in a Chinese population. Material and Methods: Three English (PubMed, Embase, and Web of Science) and three Chinese databases (Wanfang, CNKI, and CBMD database) were used for searching articles from January 2005 to January 2018. Odds ratio (OR) and 95% confidence interval (95%CI) were calculated with the random-effect model. Trial sequential analysis was also utilized. Results: Twenty-eight case-control studies with 25,912 cases and 26,975 controls were included for SLC30A8 and T2DM. Pooled risk allele C frequency for rs13266634 was 60.6% (95%CI: 59.2-62.0%) in the T2DM group and 54.8% (95%CI: 53.2-56.4%) in the control group which had estimated OR of 1.23 (95%CI: 1.17-1.28). Individuals who carried major homozygous CC and heterozygous CT genotype were at 1.51 and 1.23 times higher risk of T2DM, respectively, than those carrying minor homozygous TT. The most appropriate genetic analysis model was the co-dominant model based on comparison of OR1, OR2 and OR3. Five articles that involved 4,627 cases and 6,166 controls were included for SLC30A8 and IGR. However, no association was found between SLC30A8 rs13266634 and IGR (C vs. T, OR = 1.13, 95%CI: 0.98-1.30, p = 0.082). TSA revealed that the pooled sample sizes of T2DM exceeded the estimated required information size but not the IGR. Conclusion: The present meta-analysis demonstrated that SLC30A8 rs13266634 was a potential risk factor for T2DM, and more studies should be performed to confirm the association between rs13266634 polymorphism and IGR.

Lack of associations between the FTO polymorphisms and gestational diabetes: A meta-analysis and trial sequential analysis.

BACKGROUND: Molecular epidemiological studies have sought associations between Fat mass and obesity associated (FTO) gene polymorphisms and gestational diabetes mellitus (GDM) risk, but findings are inconsistent. Hence, we performed a meta-analysis to clarify this problem. METHODS: Case-control studies reporting the relationship of three FTO polymorphisms (rs9939609, rs8050136, and rs1421085) and GDM published before June 2018 were searched in 6 electronic databases such as PubMed and Embase. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of associations. Trial sequential analysis (TSA) was performed to evaluate the type 1 and type 2 errors. RESULTS: A total of 5 studies involving 703 GDM cases and 2700 controls for rs9939609, 3 studies involving 1144 GDM cases and 909 controls for rs8050136, and 2 studies involving 207 GDM cases and 205 controls for rs1421085, were included in the meta-analysis. No association was observed between the three polymorphisms with the GDM risk under all genetic models. For example, the ORs and its 95% CIs under dominant genetic model were 0.88 (0.59, 1.33) for rs9939609, 1.11 (0.91, 1.35) for rs8050136, and 0.91 (0.58, 1.41) for rs1421085, respectively. Under TSA, there are insufficient levels of evidence for all of these three polymorphisms. CONCLUSION: The present meta-analysis provides statistical evidence indicating a lack of association between FTO polymorphismsand GDM risk. More studies with larger sample size are needed to confirm these null associations.

Association of variants of miRNA processing genes with cervical precancerous lesion risk in a southern Chinese population.

The miRNA processing genes play essential roles in the biosynthesis of mammalian miRNAs, and their genetic variants are involved in the development of various cancers. Our study aimed to determine the potential association between miRNA processing gene polymorphisms and cervical precancerous lesions. Five single nucleotide polymorphisms (SNPs), including Ran-GTP (RAN) rs14035, exportin-5 (XPO5) rs11077, DICER1 rs3742330, DICER1 rs13078, and TARBP2 rs784567, were genotyped in a case-control study to estimate risk factors of cervical precancerous lesions. The gene-environment interactions and haplotype association were estimated. We identified a 27% decreased risk of cervical precancerous lesions for individuals with minor G allele in DICER1 rs3742330 (odds ratio (OR) = 0.73, 95% confidence interval (95% CI) = 0.58-0.92, P = 0.009). The AG and AG/GG genotypes in DICER1 rs3742330 were also found to decrease the risk of cervical precancerous lesions (AG compared with AA: OR = 0.51, 95% CI = 0.35-0.73, P <0.001; AG/GG compared with AA: OR = 0.54, 95% CI = 0.39-0.77, P = 0.001). The GT haplotype in DICER1 had a risk effect on cervical precancerous lesions compared with the AT haplotype (OR = 1.36, 95% CI = 1.08-1.73, P = 0.010). A two-factor (DICER1 rs3742330 and human papillomavirus (HPV) infection) and two three-factor (model 1: rs3742330, passive smoking, and HPV infection; model 2: rs3742330, abortion history, and HPV infection) interaction models for cervical precancerous lesions were identified. In conclusion, the genetic variants in the miRNA processing genes and interactions with certain environmental factors might contribute to the risk of cervical precancerous lesions in southern Chinese women.

Association of LPP and TAGAP Polymorphisms with Celiac Disease Risk: A Meta-Analysis.

Background: Lipoma preferred partner (LPP) and T-cell activation Rho GTPase activating protein (TAGAP) polymorphisms might influence the susceptibility to celiac disease. Therefore, we performed a meta-analysis by identifying relevant studies to estimate the risks of these polymorphisms on celiac disease. Methods: The PubMed, Web of Science and Embase databases were searched (up to October 2016) for LPP rs1464510 and TAGAP rs1738074 polymorphisms. Results: This meta-analysis included the same 7 studies for LPP rs1464510 and TAGAP rs1738074. The minor risk A allele at both rs1464510 and rs1738074 carried risks (odds ratios) of 1.26 (95% CI: 1.22-1.30) and 1.17 (95% CI: 1.14-1.21), respectively, which contributed to increased risks in all celiac disease patients by 10.72% and 6.59%, respectively. The estimated lambdas were 0.512 and 0.496, respectively, suggesting that a co-dominant model would be suitable for both gene effects. Conclusions: This meta-analysis provides robust estimates that polymorphisms in LPP and TAGAP genes are potential risk factors for celiac disease in European and American. Prospective studies and more genome-wide association studies (GWAS) are needed to confirm these findings, and some corresponding molecular biology experiments should be carried out to clarify the pathogenic mechanisms of celiac disease.

The relationships between HLA class II alleles and antigens with gestational diabetes mellitus: A meta-analysis.

Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset or first recognition during pregnancy. It is associated with an increased risk of pregnancy complications. Susceptibility to GDM is partly determined by genetics and linked with type 1 diabetes-associated high risk HLA class II genes. However, the evidence for this relationship is still highly controversial. In this study, we assessed the relationship between HLA class II variants and GDM. We performed meta-analysis on all of literatures available in PubMed, Embase, Web of Science and China National Knowledge Infrastructure databases. The odds ratio and 95% confidence interval of each variant were estimated. All statistical analyses were conducted using the Comprehensive Meta Analysis 2.2.064 software. At the allelic analysis, DQB1*02, DQB1*0203, DQB1*0402, DQB1*0602, DRB1*03, DRB1*0301 and DRB1*1302 reached a nominal level of significance, and only DQB1*02, DQB1*0602 and DRB1*1302 were statistically significant after Bonferroni correction. At the serological analysis, none of DQ2, DQ6, DR13 and DR17 was statistically significant following Bonferroni correction although they reached a nominal level of significance. In sum, our meta-analysis demonstrated that there were the associations between HLA class II variants and GDM but more studies are required to elucidate how these variants contribute to GDM susceptibility.

Meta-Analysis on Associations of RGS1 and IL12A Polymorphisms with Celiac Disease Risk.

The pathogenesis of celiac disease (CD) has been related to polymorphisms in the regulator of G-protein signaling 1 (RGS1) and interleukin-12 A (IL12A) genes, but the existing findings are inconsistent. Our aim is to investigate the associations of two single-nucleotide polymorphisms (SNPs) (rs2816316 in RGS1 and rs17810546 in IL12A) with CD risk using meta-analysis. We searched PubMed and Web of Science on RGS1 rs2816316 and IL12A rs17810546 with CD risk. Odds ratio (OR) and 95% confidence interval (CI) of each SNP were estimated. All statistical analyses were performed on Stata 12.0. A total of seven studies were retrieved and analyzed. The available data indicated the minor allele C of rs2816316 was negatively associated with CD (C vs. A: OR = 0.77, 95% CI = 0.74-0.80), and a positive association was found for the minor allele G of rs17810546 (G vs. A: OR = 1.37, 95% CI = 1.31-1.43). The co-dominant model of genotype effect confirmed the significant associations between RGS1 rs2816316/IL12A rs17810546 and CD. No evidence of publication bias was observed. Our meta-analysis supports the associations of RGS1 and IL12A with CD and strongly calls for further studies to better understand the roles of RGS1 and IL12A in the pathogenesis of CD.

The association of PTPN22 rs2476601 polymorphism and CTLA-4 rs231775 polymorphism with LADA risks: a systematic review and meta-analysis.

Although the polymorphisms of PTPN22 and the variants of CTLA-4 have been reported to be the susceptibility genes, which increased risk of latent autoimmune diabetes in adults (LADA), the results remained inconclusive. The aim of this meta-analysis was to evaluate the association between the polymorphisms of two genes and LADA. We performed a systematic review by identifying relevant studies and applied meta-analysis to pool gene effects. Data from ten studies published between 2001 and 2013 were pooled for two polymorphisms: rs2476601 in the PTPN22 gene and rs231775 in the CTLA-4 gene. Data extraction and assessments for risk of bias were independently performed by two reviewers. Fixed-effect model and random-effect model were used to pool the odds ratios; meanwhile, heterogeneity test, publication bias and sensitive analysis were explored. The minor T allele at rs2476601 and the minor G at rs231775 carried estimated relative risks (odds ratio) of 1.52 (95 % CI 1.29-1.79) and 1.39 (95 % CI 1.11-1.74), respectively. These alleles contributed to an absolute lowering of the risk of all LADA by 4.88 and 14.93 % when individuals do not carry these alleles. The estimated lambdas were 0.49 and 0.63, suggesting a codominant model of effects was most likely for two genes. In summary, our systematic review has demonstrated that PTPN22 rs2476601 and CTLA-4 rs231775 are potential risk factors for LADA. An updated meta-analysis is required when more studies are published to increase the power of these polymorphisms and LADA.

Association of blood antioxidants and vitamins with risk of age-related cataract: a meta-analysis of observational studies.

BACKGROUND: Observational studies have been inconsistent regarding the association between blood antioxidants or vitamins and risk of age-related cataract. OBJECTIVE: We performed a meta-analysis to determine whether an association exists between blood levels of antioxidants or vitamins and age-related cataract in observational studies. DESIGN: We searched PubMed, EMBASE, and the Web of Science for relevant studies from inception to October 2012. Study-specific risk estimates were combined by using a random-effects model. RESULTS: A total of 13 studies with 18,999 participants were involved in this meta-analysis. A pooled estimate showed vitamin E (OR: 0.75; 95% CI: 0.58, 0.96), α-carotene (OR: 0.72; 95% CI: 0.59, 0.88), lutein (OR: 0.75; 95% CI: 0.65, 0.87), and zeaxanthin (OR: 0.70; 95% CI: 0.60, 0.82) were inversely associated with age-related cataract. Vitamins A (OR: 0.69; 95% CI: 0.58, 0.83) and C (OR: 0.67; 95% CI: 0.57, 0.78) were inversely associated with age-related cataract in Asian populations but not in Western populations. ß-Carotene (OR: 0.90; 95% CI: 0.78, 1.05), lycopene (OR: 0.86; 95% CI: 0.65, 1.15), and ß-cryptoxanthin (OR: 0.83; 95% CI: 0.68, 1.02) had no significant association with risk of cataract. CONCLUSIONS: This meta-analysis provides additional evidence supporting the view that blood levels of certain antioxidants are inversely associated with risk of age-related cataract. However, the role of antioxidant or vitamin supplement intake in preventing cataract should be further investigated in interventional studies.

[The effects of human cytomegalovirus infection on college students' neurobehaviors].

OBJECTIVE: To explore relevant between human cytomegalovirus (HCMV) infection and college students' neurobehaviors. METHODS: 87 college students were enlisted. They were tested with Bole. Neurobehavioral evaluation system (B. NES), and HCMV IgG antibody was detected after separation of serum. We analyzed the test results of B. NES by SPSS software. RESULTS: 76 college students were infected by HCMV in the past and 11 college students were not infected. The infected group scored 8.89 +/- 6.60 in depression aspect of emotion state test, while control group got 15.73 +/- 9.00. There was Significant difference between infection group and control (P < 0.05). There were no significant differences in other aspects of emotion states, study and memory, perception and mental movement (P > 0.05). CONCLUSION: HCMV infection is associated with depression status.

Comparison of fibrin glue versus suture for conjunctival autografting in pterygium surgery: a meta-analysis.

PURPOSE: To evaluate the safety and clinical efficacy of fibrin glue in pterygium surgery with conjunctival autografting. DESIGN: The use of fibrin glue has been introduced in the treatment of pterygium. However, its role versus traditional suturing is still a matter of debate. We performed a meta-analysis to compare the safety and clinical efficacy of fibrin glue with suture for conjunctival autograft attachment in pterygium surgery. PARTICIPANTS: A total of 342 participants with 366 eyes in 7 studies were analyzed. METHODS: We searched Medline, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for relevant randomized controlled trials (RCTs). MAIN OUTCOME MEASURES: The methodological quality of all the included trials was assessed with the Jadad score. The meta-analysis was performed with the fixed-effects model for complication rate and recurrence rate, and random-effects model for operating time. RESULTS: Fibrin glue was associated with a significantly decreased operating time (weighted mean difference -17.61 minutes, 95% confidence interval [CI], -26.03 to -9.18, P<0.0001) and was more effective in reducing the recurrence rate (Peto odds ratio [OR] 0.33, 95% CI, 0.15-0.71, P = 0.004) compared with suture. There were no significant differences in the complication rate (Peto OR 1.82, 95% CI, 0.63-5.27, P = 0.27) between the 2 groups. CONCLUSIONS: Our meta-analysis supports the superiority of fibrin glue to suture in pterygium surgery with conjunctival autografting in that the use of fibrin glue can significantly reduce the recurrence rate without increasing the risk of complications. Ophthalmologists should consider the use of fibrin glue in pterygium surgery. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

[Association of glycosylated hemoglobin A1c control with the complications in type 2 diabetic patients].

OBJECTIVE: To investigate the status of glycosylated hemoglobin A1c (GHbA(1c)) control in type 2 diabetic patients and its relation to diabetic complications. METHODS: A total of 676 patients with type 2 diabetes were investigated for GHbA(1c) level and the diabetic complications. The patients were divided into two groups with GHbA(1c) >7% and GHbA(1c)< or =7%, and the relation of GHbA(1c) with the complications was analyzed. RESULTS: The rate of good GHbA(1c) control (GHbA(1c)< or =7%) was 35.1% (237/676) in these patients, and 64.9% (439/676) of the patients showed poor GHbA(1c) control (GHbA(1c)>7%). The rates of hypertension and cerebralovascular complications were significantly higher in patients with GHbA(1c)>7% than in those with GHbA(1c)< or =7% (69.9% vs 55.7%, and 21.8% vs 8.9%, respectively, P<0.001), but the rate of coronary heart disease was comparable between the two groups (18.7% vs 17.3%, P>0.05). The patients with poor GHbA(1c) control had significantly higher incidences of diabetic peripheral neuropathy and fatty liver than those with good GHbA(1c) control (46.0% vs 35.0%, and 36.9% vs 25.3%, respectively, P<0.01), but no significant differences were found in the incidences of diabetic nephropathy (18.7% vs 16.5%), diabetic retinopathy (30.8% vs 27.4%) or diabetic feet (5.0% vs 3.8%) between the two groups (P>0.05). CONCLUSION: Type 2 diabetic patients have generally low rate of successful GHbA(1c) control, which can be associated with the occurrence of diabetic complications, suggesting the necessity of more rigorous diabetic health education and GHbA(1c) monitoring in these patients.

Intraperitoneal administration of gonadotropin-releasing hormone-PE40 induces castration in male rats.

AIM: To evaluate the long-term effects of gonadotropinreleasing hormone (GnRH)-based vaccine on levels of GnRH antibody and testosterone, and vaccine-induced immunocastration on sexual behavior of male rats. METHODS: The rats were treated with GnRH-PE40 intraperitoneally every other day for 12 wk. GnRH antibody and testosterone level in rat blood were determined by ELISA and radioimmunoassay, respectively. Morphological changes in testes and sexual behavior of rats were evaluated. RESULTS: GnRH-PE40 induced a high production in GnRH antibody, decreased the serum testosterone level, testis atrophy and sexual function in rats. CONCLUSION: Intraperitoneal administration of GnRHPE40 produces structural and functional castration of male rat reproductive system by inducing anti-GnRH antibody.