[HIV resistance in men who have sex with men: a Meta-analysis].

OBJECTIVE: To assess the prevalence of HIV primary drug resistance and drug resistance gene mutations among men who have sex with men (MSM).
 Methods: We searched eight electronic databases (CNKI, VIP, CBM, Wanfang Database, PubMed, Web of Knowledge, Springer, Medline) for the studies of HIV drug resistance relevant to MSM. Drug resistance and drug resistance mutations data were pooled and analyzed according to statistical test of homogeneity. Subgroups were further divided according to sample size, location, race, quality rating score, sampling time.
 Results: Forty-three studies were included in this Meta-analysis. The pooled rate of total to protease inhibitor (PI), nucleoside reverse transcriptase inhibitor(NRTI) or non-nucleoside reverse transcriptase inhibitor (NNRTI) were 10.21% (95% CI 8.65% to12.03%), 2.98% (95% CI 2.25% to 3.93%), 4.05% (95% CI 3.14% to 5.21%), 4.42% (95% CI 3.31% to 5.88%), respectively. The pooled rates of PI major mutation, PI secondary mutations, NRTI mutations and NNRTI mutations were 0.55% (95% CI 0.38% to 0.80%), 1.31% (95% CI 0.98% to 1.75%), 0.85% (95% CI 0.51% to 1.40%), 1.19% (95% CI 0.70% to 2.01%), 0.79% (95% CI 0.55% to 1.13%), 1.73% (95% CI 1.21% to 2.46%), 0.86% (95% CI 0.61% to 1.21%), 2.24% (95% CI 1.77% to 2.83%), respectively. Sample size, region, and race were heterogeneous sources; the rate of resistance mutations and gene mutation rate were different in different subgroups.
 Conclusion: The prevalence of primary drug resistance among MSM was high in Americas and Europe, and it was gradually increased in Asia. We should pay attention to the high incidence of PI secondary mutations.

[Localization of the assessment of chronic illness care and item evaluation].

OBJECTIVE: To translate the English version of the assessment of chronic illness care (ACIC) to Chinese, to conduct a trial in Hunan province and to develop a Chinese version ACIC. METHODS: According to the WHO rules, we translated the English version of the ACIC to Chinese and took the culture factor into account. Three hundred and ninety persons, who engaged in the work of chronic disease management in primary medical and health services in Hunan province, were enrolled for this study. One hundred and eighty three valid questionnaires were randomly selected. Six methods including discrete tendency method, good-poor analysis, correlation analysis, stepwise regression analysis, Cronbach's alpha coefficient and factor analysis were used for evaluation the questionnaire items. RESULTS: The items in Chinese version ACIC showed as follows: 1) good sensitivity. The standard deviation of each item was more than 2 and the P value from the t test between the good and poor group was less than 0.001; 2) good representation. The correlation coefficients range of each item with the total score and each dimension score was 0.588-0.916; 3) high internal consistency. Cronbach's alpha coefficient for the total scale was 0.975, and for each dimension range was 0.854-0.936; 4) independent. Factor loadings were greater than 0.40 entries, and factor loadings ranged from 0.487-0.798; 5) importance. Stepwise regression analysis α(in)=0.01, α(out)=0.05) showed 34 items were kept in the equation. CONCLUSION: Items of Chinese version ACIC retains ACIC 7 dimensions of 34 items in the original English version, which are sensitivity and typical with the internal consistency, independence and importance.

[Risk factors for unintentional injury among children in rural areas of Liling, Hunan Province, China].

OBJECTIVE: To evaluate the risk factors for unintentional injury among children in the rural areas of Liling, Hunan Province, China, as a basis for developing prevention and intervention measures for unintentional injury in rural children. METHODS: A total of 3 257 students, aged between 5 and 16 years from 4 middle schools and 2 primary schools in eastern and western rural areas of Liling were recruited in October 2013 by stratified sampling and cluster sampling. The general personal information and data on family backgrounds, living environment, and incidence of unintentional injury were collected from all subjects through a self-designed questionnaire. The risk factors for childhood unintentional injury were assessed by an unconditional multiple logistic regression analysis. RESULTS: Out of the 3 257 subjects, 356 (10.93%) were injured during the 12-month period prior to the study. The univariate analysis showed that unintentional injury in these subjects was related to sex, left-behind status, times of internet surfing in internet bars per week, parent companion or not, age of guardian, degree of harmony of parents' marital relationship, employment status of one or both parents as a migrant worker, storage of fireworks and firecrackers at home or not, violence in residential areas, and participation or not in violence in residential areas. The unconditional multiple logistic regression analysis showed that the major risk factors for unintentional injury in these subjects were male gender (OR=0.751, P=0.013), left-behind status (OR=1.779, P<0.001), storage of fireworks and firecrackers at home (OR=1.337, P=0.028) and violence around residential areas (OR=1.517, P<0.001). CONCLUSIONS: Risk for unintentional injury is multifactorial among children in the rural areas of Liling, Hunan. To reduce the incidence of unintentional injury in children in Liling, particular attention should be paid to boys, left-behind children, children who have home storage of fireworks and firecrackers and children who are living in areas with frequent violence.

[Tubulointerstitial nephritis antigen expression in chronic kidney disease and its clinical significance].

OBJECTIVE: To explore tubulointerstitial nephritis antigen (TIN-ag) expression of chronic kidney disease (CKD) patients' renal tissue and the correlation to clinical phenotype. METHODS: Through digital drawing lots, a total of 77 CKD patients from October 2012 to February 2013 at our department were randomly selected. All of them underwent biopsy. Based upon their pathological findings, they were divided into 2 groups of minimal change disease (MCD) and non-minimal change disease (NMCD). The stains of hematoxylin and eosin and Masson were used to observe renal pathological changes and immunofluorescence for detecting the TIN-ag expression of kidney tissue. The serum levels of creatinine, blood urea nitrogen, estimated glomerular filtration rate (eGFR), 24-hour urine output, 24-hour urine protein, α1-microglobulin, ß2-microglobulin, pathological casts, N-acetyl-beta-glucosaminidase (NAG), specific gravity and other clinical parameters were monitored to examine their relationship between renal tissue TIN-ag expression. RESULTS: TIN-ag expression was distinct in renal tubular basement membrane of MCD patients while weak in primary focal segmental glomerulosclerosis (FSGS)(n = 16), IgA nephropathy (n = 23), MN (n = 14) and LN (n = 15) renal tissue. Immunofluorescence quantitative analysis showed that tubular TIN-ag fluorescence intensity of NMCD group was significantly lower than that of MCD group (4.84(3.02, 10.73) vs 20.79(8.19, 37.00), P < 0.01). In addition, TIN-ag expression in renal interstitial collagen area deposition of 0 grade group was higher than that of collagen area deposition 1-3 grades group (all P < 0.05). Serum α1-microglobulin and pathological urine cast, 24-hour urine protein of CKD patients were negatively correlated with kidney tubules TIN-ag expression (r = -0.312, -0.298, -0.214, all P < 0.05). Serum creatinine, blood urea nitrogen, serum ß2-microglobulin and eGFR of CKD patients had no significant correlations with TIN-ag expression (P > 0.05). TIN-ag expression of CKD patients with lower expression levels of NAG was significantly higher than that of normal levels of NAG expression. TIN-ag expression of low urine specific gravity group was lower than that of normal urine specific gravity group (P < 0.05). CONCLUSIONS: TIN-ag expression of renal tissue tubule basement membrane in NMCD group is significantly lower than that in MCD group. TIN-ag expression is negatively correlated with renal tissue fibrosis. Expression of serum α1-microglobulin and concentrations of urinary pathology tube, 24-hour urine protein, NAG expression and urine specific gravity are negatively correlated with renal tissue TIN-ag expression in CKD patients.

Two novel functional single nucleotide polymorphisms of ADRB3 are associated with type 2 diabetes in the Chinese population.

AIMS: The purpose of this study was to investigate the association of two novel ß3-adrenergic receptor (ADRB3) gene polymorphisms (Ser165Pro and Ser257Pro) with type 2 diabetes (T2DM) in the Chinese population. METHODS: A total of 650 patients with T2DM and 1337 health volunteers were enrolled to conduct the association study. Two candidate polymorphisms were recreated by site-directed mutagenesis and tested for their effect on ADRB3 expression and function in stable transfected human embryonic kidney 293 and Chinese hamster ovary-K1 cells. Real-time PCR, Western blot, confocal microscopy, and cAMP assay were used to determine mRNA, protein expression, trafficking, and ADRB3 function, respectively. RESULTS: We found that both polymorphisms were significantly associated with T2DM (odds ratio = 2.060 and 95% confidence interval = 1.303-3.258 for Ser165Pro and odds ratio = 7.588, 95% confidence interval = 1.639-35.138 for Ser257Pro). Patients with T2DM with the Ser165Pro C allele had higher hemoglobin A1c, fasting plasma glucose and postprandial plasma glucose values than those in TT genotypes. We also found that patients with T2DM with the Ser257Pro C allele had lower fasting serum insulin, postprandial serum insulin, and homeostasis model assessment for insulin resistance levels than TT genotype carriers. Further in vitro study indicated that cell lines stably expressing Ser165Pro and Ser257Pro mutants of the ADRB3 gene showed impaired cAMP accumulation activity. However, both polymorphisms had no effect on ADRB3 expression and trafficking. CONCLUSIONS: Ser165Pro and Ser257Pro polymorphisms affected ADRB3 function and were significantly associated with susceptibility to and development of T2DM.

[Protective effect of SjC23-Hsp70 DNA vaccine and interleukin-12 on Schistosoma japonicum infection in water buffalos].

OBJECTIVE: To determine the immune-protective effect of Japan Schistosoma (Chinese mainland strain) 23 kD membrane protein-heat shock protein (SjC23-Hsp70) DNA vaccine plus adjuvantinduced interleukin-12 (IL-12) plasmid DNA on Schistosoma japonicum infection in water buffalos. METHODS: Forty-five health water buffalos (8-10 months old) in non-endemic area of schistosomiasis were randomly assigned into group A (SjC23-Hsp70+IL-12, 300 µg), group B (SjC23+IL-12, 300 µg) and group C (pVAX+IL-12, 300 µg), 15 in each group. Each buffalo was immuned by shoulder intramuscular injection for 3 times, at an interval of 28 days. Twenty-eight days after the last immunization, each buffalo was infected with 1000 Japan cercariae of Schistosoma. Fecal examinations were conducted 2 days and 1 day before the perfusion, and on the day of perfusion. The number of hatching miracidia and eggs per gram feces was recorded. Fifty-six days after the infection, the buffalos were sacrificed and perfused via the descending aorta. The recovered adult worms and eggs in the liver tissue were counted. RESULTS: We compared group A and B with group C: the estrogen reduction rate was 45.7% and 26.61%; bug reduction rate was 44.51% and 25.84%; the fecal egg reduction rate was 41.1% and 31.63%; the miracidium reduction rate was 48.11% and 38.07%; and the liver egg reduction rate was 43.39% and 31.95%. The above rates in group A were higher than those in group B (P<0.05). CONCLUSION: SjC23-Hsp70 DNA vaccine combined with IL-12 may have a significant immunoprotective effect on buffalos.

Impact of genetic polymorphisms of leptin and TNF-alpha on rosiglitazone response in Chinese patients with type 2 diabetes.

BACKGROUND: Leptin and tumor necrosis factor-alpha (TNF-alpha) play important role in homeostasis and insulin resistance in the treatment of Type 2 diabetes (T2DM). The aims of the present study were to investigate the association between leptin G-2548A and TNF-alpha G-308A polymorphisms and rosiglitazone response in T2DM patients. MATERIALS: 245 patients with T2D and 122 health volunteers were enrolled to identify leptin G-2548A and TNF-alpha G-308A genotypes by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Forty-two T2D patients with different leptin G-2548A and TNF-alpha G-308A genotypes received orally rosiglitazone as a single-agent therapy (4 mg day(-1) p.o.) for 12 weeks. Serum triglyceride (TG), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting serum insulin (FINs), glycated hemoglobin (HbAlc), postprandial serum insulin (PINS), homeostasis model assessment for insulin resistance (HOMA-IR), low-density lipoprotein-cholesterol (LDL-c), and high-density lipoprotein-cholesterol (HDL-c) were determined before and after rosiglitazone treatment. RESULTS: A significant association between the variation of G-2548A allele with body mass index (BMI), serum leptin levels and FPG was observed in T2DM patients. Moreover, patients with G allele of leptin G-2548A had lower BMI and serum leptin concertration as well as bigger FPG than that in AA genotypes (P < 0.05). Moreover, we found an enhanced rosiglitazone effect in patients with AA genotype of leptin G-2548A on FINS and PINS compared with GG+GA genotype (P < 0.05). Finally, our results showed an attenuated rosiglitazone effect in patients with GA+AA genotype of TNF-alpha G-308A on FINS compared with GG genotype (P < 0.05). CONCLUSIONS: These data suggest there were not significantly differences in the frequencies of leptin G-2548A and TNF-alpha G-308A between patients with T2DM and health control. TNF-alpha G-308A polymorphism might be associated with the therapeutic efficacy of rosiglitazone in T2DM patients.