The midgut epithelium of mosquitoes adjusts cell proliferation and endoreplication to respond to physiological challenges.

BACKGROUND: Hematophagous mosquitoes transmit many pathogens that cause human diseases. Pathogen acquisition and transmission occur when female mosquitoes blood feed to acquire nutrients for reproduction. The midgut epithelium of mosquitoes serves as the point of entry for transmissible viruses and parasites. RESULTS: We studied midgut epithelial dynamics in five major mosquito vector species by quantifying PH3-positive cells (indicative of mitotic proliferation), the incorporation of nucleotide analogs (indicative of DNA synthesis accompanying proliferation and/or endoreplication), and the ploidy (by flow cytometry) of cell populations in the posterior midgut epithelium of adult females. Our results show that the epithelial dynamics of post-emergence maturation and of mature sugar-fed guts were similar in members of the Aedes, Culex, and Anopheles genera. In the first three days post-emergence, ~ 20% of cells in the posterior midgut region of interest incorporated nucleotide analogs, concurrent with both proliferative activity and a broad shift toward higher ploidy. In mature mosquitoes maintained on sugar, an average of 3.5% of cells in the posterior midgut region of interest incorporated nucleotide analogs from five to eight days post-emergence, with a consistent presence of mitotic cells indicating constant cell turnover. Oral bacterial infection triggered a sharp increase in mitosis and nucleotide analog incorporation, suggesting that the mosquito midgut undergoes accelerated cellular turnover in response to damage. Finally, blood feeding resulted in an increase in cell proliferation, but the nature and intensity of the response varied by mosquito species and by blood source (human, bovine, avian or artificial). In An. gambiae, enterocytes appeared to reenter the cell cycle to increase ploidy after consuming blood from all sources except avian. CONCLUSIONS: We saw that epithelial proliferation, differentiation, and endoreplication reshape the blood-fed gut to increase ploidy, possibly to facilitate increased metabolic activity. Our results highlight the plasticity of the midgut epithelium in mosquitoes' physiological responses to distinct challenges.

Retraction Note: The carcinogenic complex lncRNA FOXP4-AS1/EZH2/LSD1 accelerates proliferation, migration and invasion of gastric cancer.

The article "The carcinogenic complex lncRNA FOXP4-AS1/EZH2/LSD1 accelerates proliferation, migration and invasion of gastric cancer, by R.-Y. Chen, Q. Ju, L.-M. Feng, Q. Yuan, L. Zhang, published in Eur Rev Med Pharmacol Sci 2019; 23 (19): 8371-8376-DOI: 10.26355/eurrev_201910_19148-PMID: 31646567" has been retracted by the authors. After publication, the authors raised concerns about the reliability of the data used to conduct the study by stating that some data cannot be repeated by further research. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/19148.

[Survey on tobacco use and associated factors in population in Shandong province, 2016-2017].

Objective: To understand the status of tobacco use and related influencing factors in population in Shandong province. Methods: Stratified multi-stage cluster sampling was used to select respondents from 216 villages (communities) of 36 districts (counties) in Shandong province. Influencing factors on smoking were analyzed by logistic regression model. Results: The adequate sample size was 6 271 participants. After complex weighted, the current smoking prevalence was 23.93%,45.58% in males and 1.18% in females. The Public's smoking rates varied widely among different groups in the population. 45-64 age group had the highest smoking rate (25.07%). Smoking rates were substantially different in education levels, with the highest in junior high school (28.94%). The rate was higher in the rural area (24.98%) than that in the urban areas (23.08%). The average daily smoking rate was 20.23%. The average age of initiating smoking was 21.21 years. The average daily cigarette intake was 16.31 cigarettes. Among all the former and current smokers, the quitting rate was 20.79%. Multiple logistic regression model analysis showed that gender, age, occupation, region, and health knowledge score were correlated with smoking behavior. The current smoking rate of men was much higher than that of women (OR=49.625, 95%CI: 37.832-65.093). The current smoking rate in 45-64 age group was higher than that in the 15-24 age group (OR=1.830, 95%CI: 1.048-3.194). The current smoking rate of medical (OR=0.403, 95%CI: 0.187-0.866) and retired personnel (OR=0.648, 95%CI: 0.481-0.873) were lower than those engaging in agriculture, forestry, animal husbandry and the fishery ,respectively. The prevalence of residents living in the central part showed lower rate on current smoking than that in the eastern region (OR=0.724, 95%CI: 0.606-0.865). The current smoking prevalence of smoke hazard in 1-3 score group was higher than that in the group with 4-6 score (OR=1.432, 95%CI: 1.240-1.654). Conclusions: Smoking rate in adults in Shandong remained stable and at a high level. Comprehensive intervention measures such as tobacco control and health education should be carried out to reduce the smoking rate.

Curcumin improves experimentally induced colitis in mice by regulating follicular helper T cells and follicular regulatory T cells by inhibiting interleukin-21.

To determine whether curcumin (Cur) can treat mice with experimentally-induced colitis by regulating follicular helper T cells (Tfh) and follicular regulatory T cells (Tfr) by inhibiting interleukin (IL)-21. In this study, 40 male C57BL/6 mice were randomly grouped into four groups, i.e., normal, trinitrobenzene sulfonic acid (TNBS), TNBS + curcumin, and TNBS + anti-IL-21. Mice with experimental colitis were induced by 100 mg/kg TNBS. The mice in the TNBS + Cur group were treated with 100 mg/kg curcumin for seven days, and mice in the TNBS + anti-IL-21 group were treated with anti-IL-21 (150 µg/mouse) once per week, intraperitoneally, starting on the second day after establishing the experimental colitis model. On day eight, the therapeutic effect of curcumin was evaluated by colon mucosa damage index (CMDI), histological examination, and disease activity index (DAI). Furthermore, the number of CD4 + CXCR5 + PD-1 + Tfh and CD4 + CXCR5 + FoxP3 + Tfr cells were measured by flow cytometry. The mRNA and protein expression of IL-21, Bcl-6, FOXP3, ICOS, and PD-1 in colonic mucosa was detected by reverse transcription polymerase chain reaction and the Western blot technique. Compared with the TNBS group, the DAI, CMDI, histological score, the number of CD4 + CXCR5 + PD-1 + Tfh cells, the expression of IL-21, Bcl-6, ICOS, and PD-1 were significantly decreased in the TNBS + curcumin group and TNBS + anti-IL-21 group; body weight, number of CD4 + CXCR5 + FoxP3 + Tfr cells, and the expression of FoxP3 were observably elevated in the TNBS + curcumin group (all P < 0.05). Curcumin may have a potential therapeutic effect on mice with colitis treated experimentally through regulation of the balance of Tfh and Tfr cells via inhibiting the synthesis of IL-21.

A multi-center study on recurrent inguinal hernias: assessment of surgeons' compliance to guideline-based repair and evaluation of short-term outcomes.

INTRODUCTION: As patients with recurrent inguinal hernia (RIH) are at a higher risk of perioperative complications, international guidelines have been developed to mitigate these risks by recommending the reverse approach for repair. We aim to study the characteristics of RIH, compliance to guidelines-based repair (GR) and determine factors influencing compliance to guidelines. METHODS: A retrospective study of patients with RIH was carried out at two tertiary institutions in Singapore, over 10 years from January 2010 to 2020. RESULTS: There were 16 patients with bilateral recurrences and 214 patients with unilateral recurrences. The characteristics of patients with non-guidelines-based repair (NGR) versus GR were similar, p > 0.05. GR was performed for 128 (52.1%) hernias as compared to NGR for 118 (47.9%) hernias. The open approach was more common in NGR than GR, 115/118 (89.8%) versus 58/128 (45.3%), p < 0.001. Forty (n = 40, 16.3%) RIH presented emergently, of which 37 underwent NGR while 3 underwent GR, p < 0.0001. More consultants were present during GR 103/128 (80.5%) as compared to NGR 78/118 (66.1%), p = 0.018. Emergency presentation of hernia recurrence, OR 7.74 (CI 6.11-9.20), p = 0.005, and open repair during the index repair were significantly associated with NGR, OR 6.63 (CI 4.42-8.84), p = 0.01. Median length of stay was shorter in the GR 1 day (IQR 1-2 days) versus 2 days (IQR 2-5 days) in the NGR group, p = 0.02. CONCLUSION: The compliance rate of GR for RIH is 52%. NGR for RIH had acceptable short-term outcomes. For elective presentation of RIH, GR should be encouraged given a shorter length of hospital stay.

[Prevalence and associated factors regarding electronic cigarette smoking among adults in Shandong province].

Objective: To understand the awareness, current or past behavior on electronic cigarette smoking (ECS) and associated factors, among adults aged ≥15 years old in Shandong province. Relationship between ECS and cessation of smoking was also studied. Methods: Using the global standard questionnaire, a cross-sectional survey was conducted among 6 401 adults selected by stratified multi-stage cluster sample method. Electronic data was collected by handheld computer. Data were weighted and analyzed by SPSS 19.0 complex program. Results: The prevalence rates of awareness, ever or current smoking of e-cigarettes appeared as 37.6%, 3.8% and 0.6% respectively. Data from logistic regression analysis showed that risk factors for ECS were living in urban area, at younger age, being current or former cigarettes smoker and with knowledge on the risks of smoking or being encouraged to stop smoking. Among the electronic cigarettes smokers, those who tried to quit smoking (30.1%) had a significantly higher rate than that of the non-smokers (19.5%) (P<0.05), however, the successful quitting rate was much lower than that in the non-ECS users (P<0.05). Conclusions: Rates on the awareness and uptake of electronic cigarettes are on the rise. It is necessary to strengthen and standardize the monitoring programs to provide evidence for setting up targeting intervention strategies.

The carcinogenic complex lncRNA FOXP4-AS1/EZH2/LSD1 accelerates proliferation, migration and invasion of gastric cancer.

OBJECTIVE: To clarify the role of lncRNA FOX4-AS1 in the progression of gastric cancer (GC) via interacting with EZH2/LSD1. PATIENTS AND METHODS: Relative level of FOXP4-AS1 in GC tissues and adjacent normal tissues was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The potential influences of FOXP4-AS1 on cellular behaviors of GC cells were evaluated via a series of functional experiments. Bioinformatics prediction, RNA immunoprecipitation (RIP) assay, and Western blot were conducted to verify the potential of EZH2/LSD1 as a target of FOXP4-AS1. RESULTS: FOXP4-AS1 was upregulated in GC tissues relative to controls. Its level was higher in GC patients with stage III-IV than those with stage I-II. The survival rate was lower in GC patients presenting the high expression of FOXP4-AS1 compared with those presenting low expression. Transfection of sh-FOXP4-AS1 1# or sh-FOXP4-AS1 2# attenuated proliferative, migratory, and invasive abilities of AGS and BGC7901 cells. FOXP4-AS1 could bind to LSD1 and EZH2, and positively regulated their expression levels. Transfection of sh-LSD1 or sh-EZH2 reduced the proliferative ability of GC cells. CONCLUSIONS: FOXP4-AS1 binds to EZH2/LSD1 to form a carcinogenic complex, thus accelerating GC cells to proliferate, migrate and invade.

[Study on the relationship between smoking behavior and health literacy among grade 4-6 primary students in Shandong province].

Objective: To investigate the associations between smoking and literacy on health among 4-6 grade primary school students. Methods: A questionnaire survey was conducted to research on health literacy and smoking among 4-6 grade pupils in Shandong province, through a multi-stage stratified cluster random sampling method. Sociodemographic characteristics, health literacy level and smoking rate were collected from respondents. Binary logistic regression analysis was used to evaluate the association of smoking and health literacy. Results: A total of 9 240 questionnaires were distributed, with the rate of valid response as 99.7%. The current smoking rate of the students was 2.6%, on higher in boys (3.1%) than in girls (2.0%). 60.8% of 4-6 grade students were found to have adequate health literacy level. Levels of literacy health in both boy and girl school students appeared 56.7% and 64.9%, respectively. Results indicated that health literacy in smokers (14.4%) was lower than that in non-smokers (62.0%). Results from the binary logistic regression analysis showed that the independent influencing factors would include grade, father's education level, economic situation of the family, self-assessment on the school record and literacy on health (P<0.01). After controlling the other independent variables, the smoking rate was 8.62 (1/0.116) times in students with low literacy level on health, than those with high literacy level. Conclusions: Literacy on health was significantly associated with smoking in the 4-6 grade pupils of Shandong province.

Progress in Cr- and Mn-based superconductors: a key issues review.

The presence of magnetic ions was first believed to be detrimental to superconductivity. However, unconventional superconductivity has been widely induced by doping or applying external pressure in magnetic systems such as heavy fermion, cuprate and iron-based superconductors in which magnetic fluctuations are suggested to serve as the pairing glue for Cooper pairs. The discovery of superconductivity in the magnetic compounds CrAs and MnP under high pressures has further expanded this family of superconductors and provided new platforms for investigating the interplay between magnetism and superconductivity. CrAs and MnP represent the first superconductors among the transition metal Cr- and Mn-based compounds in which the electronic states near the Fermi level are dominated by Cr/Mn 3d electrons. Shortly after their discovery, new types of Cr-based quasi-one-dimensional superconductors A2Cr3As3 and ACr3As3 (A [Formula: see text] K, Rb, Cs or Na) were discovered at ambient pressure. The close proximity of superconductivity to magnetic instability in these systems suggests that spin fluctuations may play crucial roles in mediating the Cooper pairing. In this article we review the basic physical properties of these novel superconductors and the progress achieved in recent studies.

[The analysis of clinical characteristics and disease activity in ankylosing spondylitis patients with hyperuircemia].

Objective: to investigate the clinical characteristics and disease activity in ankylosing spondylitis (AS) patients with hyperuricemia. Method: Laboratory tests, magnetic resonance imaging, disease activity and functional index of AS patients from Fudan University Zhongshan Hospital were collected. T test, square test were applied to investigate the difference between AS patients with hyperuricemia and AS patients with normal serum uric acid in clinical characteristics and disease activity in AS patients. Result: Among all the AS patients, 23.4% (22/94) patients accompanied with hyperuricemia. AS patients accompanied with hyperuricemia showed significant younger age (28.9±7.9 vs 35.8±11.1, P=0.002); higher serum alanine aminotransferase (33.6±23.6 vs 19.8±12.4, P=0.014), aspartate aminotransferase (23.8±8.7 vs 18.6±9.6, P=0.025) and creatinine (78.4±12.5 vs 69.8±13.3, P=0.009), lower Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (11.2±8.8 vs 17.9±12.0, P=0.027) and Bath Ankylosing Spondylitis Functional Index (BASFI) (0.7±0.9 vs 1.8±2.2, P=0.002) compared with AS patients whose serum uric acid level is normal. Conclusion: AS Patients with younger age, impaired hepatic and renal funtion and lower scores in BASDAI and BASFI tend to accompany with hyperuricemia.

Three-dimensional magnetic resonance pelvimetry: A new technique for evaluating the female pelvis in pregnancy.

OBJECTIVE: To describe three-dimensional (3D) magnetic resonance imaging (MRI) pelvimetry methods and to establish the pelvimetric reference in a large population of Chinese females at term pregnancy. METHODS: Three-hundred one pregnant women at term who underwent MRI were included. Three-dimensional pelvic models were reconstructed using Mimics. 10.0 software based on MRI data sets, and measurements of these models were made. Pelvimetric results according to delivery modality were presented. Additionally, the previously described CT 3D pelvimetry method for predicting cephalopelvic disproportion (CPD) was used to validate its accuracy. RESULTS: Two hundred ten women underwent vaginal delivery, and 13 underwent caesarean delivery for CPD. 3D modelling of the pelvis of pregnant women was feasible using MR data sets. Pelvimetric parameters in the vaginal delivery group were as follows: transverse diameter, 134.7 mm ±â€¯7.5; obstetric conjugate, 126.9 mm ±â€¯8.3; interspinous distance, 113.4 mm ±â€¯8.2; sagittal midpelvis, 117.8 mm ±â€¯8.1; intertuberous distance, 127.1 mm ±â€¯10.4; sagittal outlet, 110.2 mm ±â€¯8.9, and posterior sagittal outlet, 59.7 mm ±â€¯8.1. According to the previously described CT 3D pelvimetry method for predicting CPD, 67.6% (142/210) of women in the vaginal delivery group were diagnosed with CPD. CONCLUSION: 3D MR pelvimetry is a novel method for determining pelvic dimensions at term pregnancy. A prospective trial is needed to establish a useful value for predicting CPD in Chinese females at high risk of CPD.

Interferon-gamma response to the treatment of active pulmonary and extra-pulmonary tuberculosis.

BACKGROUND: Interferon-gamma (IFN-γ) release assays (IGRAs) are used to diagnose tuberculosis (TB) but not to measure treatment response. OBJECTIVE: To measure IFN-γ response to active anti-tuberculosis treatment. DESIGN: Patients from the Henan Provincial Chest Hospital, Henan, China, with TB symptoms and/or signs were enrolled into this prospective, observational cohort study and followed for 6 months of treatment, with blood and sputum samples collected at 0, 2, 4, 6, 8, 16 and 24 weeks. The QuantiFERON® TB-Gold assay was run on collected blood samples. Participants received a follow-up telephone call at 24 months to determine relapse status. RESULTS: Of the 152 TB patients enrolled, 135 were eligible for this analysis: 118 pulmonary (PTB) and 17 extra-pulmonary TB (EPTB) patients. IFN-γ levels declined significantly over time among all patients (P = 0.002), with this decline driven by PTB patients (P = 0.001), largely during the initial 8 weeks of treatment (P = 0.019). IFN-γ levels did not change among EPTB patients over time or against baseline culture or drug resistance status. CONCLUSION: After 6 months of effective anti-tuberculosis treatment, IFN-γ levels decreased significantly in PTB patients, largely over the initial 8 weeks of treatment. IFN-γ concentrations may offer some value for monitoring anti-tuberculosis treatment response among PTB patients.

Revealing Extremely Low Energy Amplitude Modes in the Charge-Density-Wave Compound LaAgSb_{2}.

Using infrared spectroscopy and ultrafast pump probe measurement, we have studied the two charge-density-wave (CDW) instabilities in the layered compound LaAgSb_{2}. The development of CDW energy gaps was clearly observed by optical spectroscopy, which removed most of the free carrier spectral weight. More interestingly, our time-resolved measurements revealed two coherent oscillations that softened by approaching the two phase transition temperatures, respectively. We addressed that these two oscillations come from the amplitude modes of CDW collective excitations, the surprisingly low energies (0.12 THz and 0.34 THz for the higher and lower temperature ones, respectively) of which are associated with the extremely small nesting wave vectors. Additionally, the amplitude and relaxation time of photoinduced reflectivity of LaAgSb_{2} single crystals stayed unchanged across the CDW phase transitions, which is quite rare and deserves further investigation.

Spectroscopic evidence for bulk-band inversion and three-dimensional massive Dirac fermions in ZrTe5.

Three-dimensional topological insulators (3D TIs) represent states of quantum matters in which surface states are protected by time-reversal symmetry and an inversion occurs between bulk conduction and valence bands. However, the bulk-band inversion, which is intimately tied to the topologically nontrivial nature of 3D Tis, has rarely been investigated by experiments. Besides, 3D massive Dirac fermions with nearly linear band dispersions were seldom observed in TIs. Recently, a van der Waals crystal, ZrTe5, was theoretically predicted to be a TI. Here, we report an infrared transmission study of a high-mobility [∼33,000 cm2/(V ⋅ s)] multilayer ZrTe5 flake at magnetic fields (B) up to 35 T. Our observation of a linear relationship between the zero-magnetic-field optical absorption and the photon energy, a bandgap of ∼10 meV and a [Formula: see text] dependence of the Landau level (LL) transition energies at low magnetic fields demonstrates 3D massive Dirac fermions with nearly linear band dispersions in this system. More importantly, the reemergence of the intra-LL transitions at magnetic fields higher than 17 T reveals the energy cross between the two zeroth LLs, which reflects the inversion between the bulk conduction and valence bands. Our results not only provide spectroscopic evidence for the TI state in ZrTe5 but also open up a new avenue for fundamental studies of Dirac fermions in van der Waals materials.

Immunohistochemical studies and fluorodeoxyglucose uptake on positron emission tomography in pharyngeal cancer for predicting radiotherapy-based treatment outcomes.

OBJECTIVES: This study correlated immunohistochemical studies with fluorodeoxyglucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) and identified prognostic factors for radiotherapy (RT)-based treatment outcomes in patients with squamous cell carcinoma of the oropharynx and hypopharynx. METHODS: Genomic data from pre-treatment biopsy specimens (Glut1, CAIX, VEGF, HIF-1α, EGFR, Ki-67, Bcl-2, CLAUDIN-4, YAP-1, c-Met and p16) of 76 patients were analysed using tissue microarrays. FDG uptake was evaluated using the maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG). RESULTS: The overexpression of Glut1 positively associated with increased values of the SUVmax, MTV and TLG, whereas VEGF and HIF-1α expression with the MTV and TLG, respectively. A VEGF immunoreactive score (IRS) >2 (P = 0.001, hazard ratio [HR] = 3.94) and an MTV defined by an SUV of 2.5 (MTV2.5) >14.5 mL (P = 0.004, HR = 3.31) were prognostic factors for low cause-specific survival, whereas a VEGF IRS >2 (P = 0.02, HR = 2.83) for low primary relapse-free survival. CONCLUSION: The overexpression of Glut1, VEGF and HIF-1α associated with increased FDG uptake. For patients with pharyngeal cancer requiring RT, the treatment outcome can be stratified by VEGF and MTV2.5.

Infrared properties of heavy fermions: evolution from weak to strong hybridizations.

In this article, we review the charge excitations of heavy fermion compounds probed by infrared spectroscopy. The article is not meant to be a comprehensive survey of experimental investigations. Rather it focuses on the dependence of charge excitations on the hybridization strength. In this context, the infrared properties of the Ce m M n In3m+2n family are discussed in detail since the hybridization strengths differ dramatically in different members despite their similar lattice structures. Investigations on some mixed valent compounds are also presented, aiming to elucidate the generic trend of the evolution. In particular, we address the scaling between hybridization energy gap [Formula: see text] and hybridization strength [Formula: see text]([Formula: see text]) in a wide range of heavy fermion compounds, which demonstrates that the periodic Anderson model can generally and quantitatively describe the low-energy charge excitations.

Magnetoinfrared Spectroscopy of Landau Levels and Zeeman Splitting of Three-Dimensional Massless Dirac Fermions in ZrTe(5).

We present a magnetoinfrared spectroscopy study on a newly identified three-dimensional (3D) Dirac semimetal ZrTe(5). We observe clear transitions between Landau levels and their further splitting under a magnetic field. Both the sequence of transitions and their field dependence follow quantitatively the relation expected for 3D massless Dirac fermions. The measurement also reveals an exceptionally low magnetic field needed to drive the compound into its quantum limit, demonstrating that ZrTe(5) is an extremely clean system and ideal platform for studying 3D Dirac fermions. The splitting of the Landau levels provides direct, bulk spectroscopic evidence that a relatively weak magnetic field can produce a sizable Zeeman effect on the 3D Dirac fermions, which lifts the spin degeneracy of Landau levels. Our analysis indicates that the compound evolves from a Dirac semimetal into a topological line-node semimetal under the current magnetic field configuration.

Comparing the effects of meal replacements with reduced-fat diet on weight, sexual and endothelial function, testosterone and quality of life in obese Asian men.

Sexual dysfunction is more prevalent in obese than in normal-weight men. Meal replacements (MRs) are useful weight-loss strategies. We randomized obese (body mass index 27.5 kg m(-2), waist circumference (WC) 90 cm) Asian men (mean age 40.5 years, range 30-61) to a conventional reduced-fat diet (CD) (n=24) or MR-based plan (n=24) to reduce daily intake by 400 kcal for 12 weeks. There were significantly greater reductions in weight (4.2 ± 0.8 kg), WC (4.6 ± 0.7 cm), calorie and fat intake in the MR group, compared with the CD group (2.5 ± 0.4 kg, 2.6 ± 0.5 cm). Erectile function (International Index of Erectile Function 5-item score) improved comparably in the MR (3.4 ± 0.7 points) and CD (2.5 ± 0.5 points) groups, as did the Sexual Desire Inventory score (5.5 ± 2.3 vs 7.7 ± 2.1 points), quality of life (36-item Short Form survey score), plasma testosterone and endothelial function (Reactive Hyperemia Index). Subjects were switched to or continued CD for another 28 weeks. Weight, WC and erectile function were maintained at 40 weeks. MR induces greater reductions in weight and abdominal obesity than conventional diet, and comparable improvements in sexual and endothelial function, testosterone and quality of life.

Comparing the effects of meal replacements with an isocaloric reduced-fat diet on nutrient intake and lower urinary tract symptoms in obese men.

BACKGROUND: Lower urinary tract symptoms (LUTS) in men are associated with obesity, particularly central obesity as measured by waist circumference (WC), and may improve with weight loss. We aimed to compare effects of a meal-replacement based diet with isocaloric reduced-fat plan on LUTS and nutrient intake in obese Asian men. METHODS: Obese Asian [mean (range) body mass index of 32.9 (30.5-42.3) kg m(-2) ] men [mean (range) age 40.2 (30-61) years] were randomised to a reduced-fat (< 30% of energy) diet [conventional reduced-fat diet (CD) group; n = 23] or meal-replacement-based plan [meal replacement (MR) group; n = 23], to reduce daily intake by 2000 kJ for 12 weeks. RESULTS: CD and MR groups had statistically significant and similar reductions in weight (-2.6 ± 1.9 kg versus -4.2 ± 3.8 kg), overall LUTS severity measured with International Prostate Symptom Scale (IPSS) scores (-1.71 ± 1.93 points versus -2.42 ± 2.12 points) and insulin resistance [homeostasis model assessment (HOMA) calculated from plasma glucose and insulin]. The MR group had significantly greater decreases in WC (-4.8 ± 3.3 cm versus -2.5 ± 2.3 cm), fat mass (-2.47 ± 3.63 kg versus -1.59 ± 2.32 kg), fat intake, plasma C-reactive protein, and in storage LUTS score (-1.59 ± 1.33 points versus -1.00 ± 0.87 points), which was associated with a decreased fat intake (r = 0.48, P = 0.03). A decrease in overall IPSS score was associated with reductions in weight, WC and HOMA. CONCLUSIONS: Weight loss as a result of CD or MR had similar efficacy in relieving LUTS. MR produced greater reductions in fat intake, adiposity and storage LUTS.