Mediating Effect of Self-Efficacy on the Relationship Between Perceived Social Support and Resilience in Patients with Recurrent Schizophrenia in China.

Purpose: To explore the mediating effect of self-efficacy on the relationship between perceived social support and resilience in patients with recurrent schizophrenia in China. Patients and Methods: In this cross-sectional study, a total of 176 patients with recurrent schizophrenia who were hospitalized in a tertiary hospital in Hunan Province, China, completed a general data questionnaire, the Connor Davidson Resilience Scale (CD-RISC), the Perceived Social Support Scale (PSSS) and the General Self-Efficacy Energy Scale (GSES). Results: Among the 176 patients, the mean GSES score was 2.02±0.61, the mean PSSS score was 56.77±14.61, and the mean CD-RISC score was 58.06±17.26. Self-efficacy played a partial mediating role between social support and resilience, and the mediating effect accounted for 42.56% of the total effect. Conclusion: The resilience level of patients with recurrent schizophrenia in China is moderate and needs to be improved. This research revealed that self-efficacy played a part in mediating perceived social support and resilience in patients with recurrent schizophrenia in China. Perceived social support can indirectly affect resilience in patients with recurrent schizophrenia through self-efficacy. Comprehensive interventions in perceived social support and self-efficacy would help to improve the resilience of patients with recurrent schizophrenia.

Lineage Replacement Associated with Fitness Gain in Mammalian Cells and Aedes aegypti: A Catalyst for Dengue Virus Type 2 Transmission.

Shifting of virus serotypes and clade replacement events are known to drive dengue epidemics. However, only a few studies have attempted to elucidate the virus attributes that contribute to such epidemics. In 2007, Singapore experienced a dengue outbreak affecting more than 8000 individuals. The outbreak ensued with the shuffling of dominant clades (from clade I to clade II) of Dengue virus 2 (DENV-2) cosmopolitan genotype, at a time when the Aedes premise index was significantly low. Therefore, we hypothesized that clade II had higher epidemic potential and fitness than clade I. To test this hypothesis, we tested the replication and apoptotic qualities of clade I and II isolates in mammalian cells and their ability to infect and disseminate in a field strain of Ae. Aegypti. Our findings indicated that clade II replicated more efficiently in mammalian cells than clade I and possessed higher transmission potential in local vectors. This could collectively improve the epidemic potential of clade II, which dominated during the outbreak in 2007. The findings exemplify complex interactions between the emergence, adaptation and transmission potential of DENV, and testify the epidemiological importance of a deeper understanding of virus and vector dynamics in endemic regions.

Diagnostic challenges and case management of the first imported case of Plasmodium knowlesi in Sri Lanka.

BACKGROUND: Sri Lanka has achieved 'malaria-free' status and is now in the phase of prevention of re-introduction of malaria. Imported malaria remains a challenge to resurgence of the disease. The diagnostic challenges encountered and the rapid response initiated to manage a Plasmodium infection, which was later confirmed as Plasmodium knowlesi, the first reported case from Sri Lanka, is discussed. CASE PRESENTATION: An army officer who returned from Malaysia in October 2016 was found to be positive for Plasmodium both by microscopy and rapid diagnostic test (RDT) by the Anti Malaria Campaign Sri Lanka (AMC) during his third visit to a health care provider. Microscopy findings were suspicious of P. knowlesi infection as the smears showed parasite stages similar to both Plasmodium malariae and Plasmodium falciparum. Nested PCR at AMC confirmed Plasmodium genus, but not the species. In the absence of species confirmation, the patient was treated as a case of P. falciparum. The presence of P. knowlesi was later confirmed by a semi-nested PCR assay performed at the Environmental Health Institute, National Environmental Agency in Singapore. The parasite strain was also characterized by sequencing the circumsporozoite gene. Extensive case investigation including parasitological and entomological surveillance was carried out. CONCLUSIONS: Plasmodium knowlesi should be suspected in patients returning from countries in the South Asian region where the parasite is prevalent and when blood smear results are inconclusive.

Adjunctive targeted contrast-enhanced ultrasonography for the work-up of Breast Imaging Reporting and Data System category 3 and 4 lesions.

INTRODUCTION: The assessment and management of Breast Imaging Reporting and Data System category 3 and 4 lesions (BI-RADS 3 and 4 lesions respectively) present numerous challenges for breast radiologists and physicians due to the ambiguity in the classification guidelines. Different imaging modalities have been investigated for their ability to provide additional aid in classification and management. The aim of this study was to evaluate the utility of targeted contrast-enhanced ultrasonography (CEUS) as an adjunctive modality to mammography plus conventional ultrasound (MG + US) in the decision of whether further diagnostic work-up is needed for BI-RADS 3 and 4 lesions. METHODS: A total of 37 MG + US-detected BI-RADS 3 lesions and 60 MG + US-detected BI-RADS 4 lesions were analysed by targeted CEUS and biopsied. The effectiveness of CEUS in distinguishing benign from malignant entities among the breast lesions was evaluated by using the histological results of biopsied samples as the gold standard. RESULTS: Two BI-RADS 3 and 14 BI-RADS 4 lesions were diagnosed as true-positive findings by targeted CEUS, with negative predictive values (NPVs) of 100% and 89.2% respectively. CONCLUSIONS: Owing to the high NPV of targeted CEUS, a negative diagnosis of MG + US-detected BI-RADS 3 lesions by targeted CEUS can be helpful in avoiding unnecessary biopsies. However, targeted CEUS cannot be used to exclude patients with BI-RADS 4 lesions from further diagnostic work-up.

Membrane feeding of dengue patient's blood as a substitute for direct skin feeding in studying Aedes-dengue virus interaction.

BACKGROUND: Understanding the interaction between Aedes vectors and dengue viruses (DENV) has significant implications in determining the transmission dynamics of dengue. The absence of an animal model and ethical concerns regarding direct feeding of mosquitoes on patients has resulted in most infection studies using blood meals spiked with laboratory-cultured DENV. Data obtained from such studies may not reflect the natural human-mosquito transmission scenario. This study explored the potential of using membrane feeding of dengue patient's blood as a substitute for direct skin feeding. METHODS: Four to six-day old female Ae. aegypti were provided the opportunity to feed via direct exposure to a patient's forearm for 15 min or via exposure to EDTA-treated blood from the same patient through an artificial membrane for 30 min. Mosquitoes from both feeding methods were incubated inside environmental chambers. Mosquitoes were sampled at day 13 post-feeding. Midgut and salivary glands of each mosquito were dissected to determine DENV infection by RT-qPCR and viral titration, respectively. RESULTS: Feeding rates: Direct skin feeding assay (DSFA) consistently showed higher mosquito feeding rates (93.3-100%) when compared with the membrane feeding assay (MFA) (48-98.2%). Midgut infection: Pair-wise comparison between methods showed no significant difference in midgut infection rates between mosquitoes exposed via each method and a strong correlation was observed in midgut infection rates for both feeding methods (r = 0.89, P < 0.0001). Overall midgut viral titers (n = 20) obtained by both methods were comparable (P ≥ 0.06). Salivary gland infection: Pair-wise comparison between both methods revealed no significant difference in salivary gland infection rate. Strong correlation in salivary gland infection was observed between DSFA and MFA (r = 0.81, P < 0.0001). In general, mosquitoes fed directly on dengue patients and those on patients' blood (n = 11) had comparable virus titer (P ≥ 0.09). CONCLUSION: DENV midgut and salivary gland infection rates showed good concordance between DSFA and MFA blood meal exposure methods. Freshly-obtained venous blood in EDTA from dengue patients for MFA can be used as a substitute to DSFA, especially in circumstances where bioethics approval or patient recruitment is difficult to obtain for vector competence studies. Nevertheless, mosquito numbers will need to be increased to compensate for lower feeding rate in MFA.

Functional Connections of the Vestibulo-spino-adrenal Axis in the Control of Blood Pressure Via the Vestibulosympathetic Reflex in Conscious Rats.

Significant evidence supports the role of the vestibular system in the regulation of blood pressure during postural movements. In the present study, the role of the vestibulo-spino-adrenal (VSA) axis in the modulation of blood pressure via the vestibulosympathetic reflex was clarified by immunohistochemical and enzyme immunoassay methods in conscious rats with sinoaortic denervation. Expression of c-Fos protein in the intermediolateral cell column of the middle thoracic spinal regions and blood epinephrine levels were investigated, following microinjection of glutamate receptor agonists or antagonists into the medial vestibular nucleus (MVN) and/or sodium nitroprusside (SNP)-induced hypotension. Both microinjection of glutamate receptor agonists (NMDA and AMPA) into the MVN or rostral ventrolateral medullary nucleus (RVLM) and SNP-induced hypotension led to increased number of c-Fos positive neurons in the intermediolateral cell column of the middle thoracic spinal regions and increased blood epinephrine levels. Pretreatment with microinjection of glutamate receptor antagonists (MK-801 and CNQX) into the MVN or RVLM prevented the increased number of c-Fos positive neurons resulting from SNP-induced hypotension, and reversed the increased blood epinephrine levels. These results indicate that the VSA axis may be a key component of the pathway used by the vestibulosympathetic reflex to maintain blood pressure during postural movements.

Aedes (Stegomyia) albopictus (Skuse): a potential vector of Zika virus in Singapore.

BACKGROUND: Zika virus (ZIKV) is a little known arbovirus until it caused a major outbreak in the Pacific Island of Yap in 2007. Although the virus has a wide geographic distribution, most of the known vectors are sylvatic Aedes mosquitoes from Africa where the virus was first isolated. Presently, Ae. aegypti is the only known vector to transmit the virus outside the African continent, though Ae. albopictus has long been a suspected vector. Currently, Ae. albopictus has been shown capable of transmitting more than 20 arboviruses and its notoriety as an important vector came to light during the recent chikungunya pandemic. The vulnerability of Singapore to emerging infectious arboviruses has stimulated our interest to determine the competence of local Ae. albopictus to transmit ZIKV. METHODOLOGY/PRINCIPAL FINDINGS: To determine the competence of Ae. albopictus to ZIKV, we orally infected local mosquito strains to a Ugandan strain virus. Fully engorged mosquitoes were maintained in an environmental chamber set at 29°C and 80-85%RH. Twelve mosquitoes were then sampled daily from day one to seven and on day 10 and 14 post infection (pi). Zika virus titre in the midgut and salivary glands of each mosquito were determined using tissue culture infectious dose50 assay, while transmissibility of the virus was determined by detecting viral antigen in the mosquito saliva by qRT-PCR. High dissemination and transmission rate of ZIKV were observed. By day 7-pi, all mosquitoes have disseminated infection and 73% of these mosquitoes have ZIKV in their saliva. By day 10-pi, all mosquitoes were potentially infectious. CONCLUSIONS/SIGNIFICANCE: The study highlighted the potential of Ae. albopictus to transmit ZIKV and the possibility that the virus could be established locally. Nonetheless, the threat of ZIKV can be mitigated by existing dengue and chikungunya control program being implemented in Singapore.

[Correlation between interleukin-1 and the obesity of polycystic ovary syndrome].

OBJECTIVE: To investigate the correlation between interleukin-1ß (IL-1ß), interleukin-1 receptor antagonist (IL-1ra) and the obesity of polycystic ovary syndrome (PCOS). METHODS: (1) From Oct. 2006 to Jan. 2007, 118 PCOS patients were enrolled in this study in Peking University Third Hospital, which were divided into 56 patients in obese PCOS group and 62 patients in non-obese PCOS group according to the WHO International Obesity Task Force Asia-Pacific criteria [body mass index (BMI) 25 kg/m(2)]. The polymorphism of IL-1ß gene promoter region, exon-5 and intron 2 of IL-1ra gene were detected by PCR. (2) Twenty-nine obese PCOS patients and 31 non-obese PCOS patients were selected randomizedly serum levels of IL-1ß, IL-1ra were measured by ELISA, in the mean time, serum levels of fasting glucose, fasting insulin and the total white blood cell, hypersensitive C-reactive protein levels were measured. RESULTS: (1) Genetic test:the frequency of TT genotype and T allele of IL-1ß promoter region (-511) in obese PCOS patients were significantly higher than those in non-obese patients (44.6% vs. 11.3%, 63.4% vs. 39.5%, all P < 0.05). The frequency of IL-1raI/V genotype and V allele of IL-1ra gene were 19.6% and 9.8% in obese PCOS patients, which were significantly higher than those in non-obese group (3.2% and 1.6%, P < 0.05). (2) Serological test:serum level of IL-1ß and IL-1ra of (149 ± 36) and (284 ± 97) ng/L in obese PCOS group which were significantly higher than those in non-obese PCOS group [(96 ± 42) and (208 ± 84) ng/L, P < 0.05]. Fasting blood glucose, fasting insulin and hypersensitive C-reactive protein and white blood cell count were (5.1 ± 0.7) mmol/L, (17 ± 9) mU/L, (1.5 ± 0.6) mg/L and (7.0 ± 2.3) × 10(9)/L in obese PCOS group, which were significantly higher than in non-obese PCOS group [(4.9 ± 0.5) mmol/L, (11 ± 8) mU/L, (0.9 ± 0.4) mg/L and (5.9 ± 1.3) × 10(9)/L, P < 0.05]. (3)The correlation between interleukin and BMI: serum levels of IL-1ß (r = 0.673) and IL-1ra (r = 0.557) were positively correlated with BMI in PCOS patients (P < 0.05). CONCLUSIONS: Inflammatory factors IL-1ß and IL-1ra had correlation with obesity of PCOS patients, PCOS patients who carried T allele of IL-1ß gene promoter region (-511) and V allele of IL-1ra gene were high risk of obesity.

Evaluation of the Dengue NS1 Ag Strip® for detection of dengue virus antigen in Aedes aegypti (Diptera: Culicidae).

Dengue fever is currently one of the most important mosquito-borne diseases that affect humans. With neither vaccines nor treatment available, prevention of the disease relies heavily on surveillance and control of mosquito vectors. In the present study, we have evaluated and showed the potential use of the Dengue NS1 Ag Strip(®) for the detection of dengue virus (DENV) in Aedes aegypti. Initial results showed that the sensitivity of the test kit in detecting DENV in wild-caught mosquitoes is comparable to that of real-time reverse transcriptase-polymerase chain reaction. The detection of naturally infected Ae. aegypti with the NS1 rapid test kit in our dengue cluster investigation further illustrates its potential use for surveillance of DENV in wild mosquito populations. The kit can easily be used in a simple field station, and minimal training is required. The results can be obtained in less than an hour. Employment of the kit in the field could help guide mosquito control operations in the prioritization of resources in controlling the transmission of DENV. In this study the potential of the kit for field surveillance of infected dengue vectors, which are epidemiologically important, has been demonstrated.

Entomological investigation and control of a chikungunya cluster in Singapore.

In August 2008, a team from the National Environmental Agency conducted an entomological investigation of a chikungunya cluster in Singapore, with the primary aim of identifying the vector responsible for the outbreak and to assess the vector control operation. A total of 173 adult mosquitoes were caught using both the sweep-net method and the BG Sentinel Traps in and around the affected workers' quarters. Of these, 120 (69.4%) were Aedes albopictus and the rest were Culex quinquefasciatus. More than 2700 Ae. albopictus larvae were also collected from 33 breeding habitats detected. No Aedes aegypti was found. During the preintervention period, 6 (8.4%) out of 71 adult female Ae. albopictus were found positive for the chikungunya virus (CHIKV). Vector control measures resulted in a 90% reduction of adult Ae. albopictus caught by BG Sentinel Traps. Postintervention surveillance revealed the presence of CHIKV-positive mosquitoes. These findings led to continued intensive vector control operation in the affected area that further reduced vector population and interrupted the transmission of the disease. The E1 gene sequence of the CHIKV was identical to those of CHIKV isolated from human chikungunya cases working in the affected area, and contained the A226V mutation. The incrimination of Ae. albopictus as a major vector involved in the transmission of A226V CHIKV had led to the revision of chikungunya control strategy in Singapore. This study suggests the benefit of a vector control program that includes the evaluation of control measures in conjunction to virological surveillance in vector population.

Is interleukin-18 associated with polycystic ovary syndrome?

BACKGROUND: Recent research show that polycystic ovary syndrome (PCOS) may have an association with low-grade chronic inflammation, IL-18 is considered as a strong risk marker of inflammation. METHODS: To investigate serum IL-18 concentrations in PCOS patients and focus on its relationship between obesity and insulin resistance (IR). Sixty consecutive women with PCOS and thirty controls were recruited. Serum level of IL-18 and fasting blood glucose, fasting insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) were measured. RESULTS: Serum levels of IL-18 was significantly higher in the PCOS group than in the control group. Serum level of IL-18 was higher in the PCOS group with IR than in the PCOS group without IR. Serum level of IL-18 was higher in obese PCOS patients than in lean PCOS patients. Serum level of IL-18 was higher in lean PCOS patients than in the lean control group. Serum level of IL-18 in the PCOS group was positively related to BMI, IR index and T. CONCLUSION: IL-18 level was increased in PCOS patients, and correlated with insulin resistance, obesity and hyperandrogenism.

Molecular epidemiological investigation of Plasmodium knowlesi in humans and macaques in Singapore.

Singapore reported its first locally acquired human Plasmodium knowlesi infection in 2007, involving a soldier who had undergone training in a forested area where long-tailed macaques are frequently seen. Comprehensive disease surveillance and monitoring system that was set up after the initial case detected four additional human P. knowlesi cases in 2007 and one in 2008. All involved military personnel who had undergone training in the forested area, and none had traveled out of Singapore 1 month before the onset of symptoms. Screening for malaria parasites on blood obtained from long-tailed macaques revealed that wild monkeys (n=3) caught from the forested area were infected with P. knowlesi, whereas peri-domestic monkeys (n=10) caught from a nature reserve park were not infected with any malaria parasites. Phylogenetic analysis of the nonrepeat region of the P. knowlesi csp genes showed that the sequences obtained from the human cases were not distinct from those obtained from wild monkeys. Further, certain genotypes were shared between samples from humans and macaques. Our findings provide evidence that long-tailed macaques are the natural hosts of P. knowlesi in Singapore and the human cases acquired their infection in the same vicinity where these monkeys are found. Further, the risk of acquiring P. knowlesi infection among the general population of Singapore is small as evident from the absence of P. knowlesi in peri-domestic monkeys.

Association of polymorphisms of interleukin-18 gene promoter region with polycystic ovary syndrome in chinese population.

BACKGROUND: Recent research shows that polycystic ovary syndrome (PCOS) may have an association with low-grade chronic inflammation, and that PCOS may induce an increase in serum interleukin-18 (IL-18) levels. METHODS: To investigate the polymorphisms of the IL-18 gene promoters with PCOS, two single nucleotide polymorphisms (SNPs) in the promoter of the IL-18 gene (at positions -607C/A and -137G/C) in 118 Chinese women with PCOS and 79 controls were evaluated using polymerase chain reaction (PCR). RESULTS: No significant differences were found in the genotype distribution, allele frequency and haplotype frequency between the PCOS and control groups. Further analysis demonstrated a relationship between IL-18 gene promoter polymorphisms and PCOS insulin resistance (IR). Regarding the -137 allele frequency, G and C allele frequencies were 93.5% and 6.5%, respectively, in the PCOS with IR patients; G and C allele frequencies were 85.4% and 14.6%, respectively, in PCOS patients without IR (chi2 = 3.601, P = 0.048). CONCLUSIONS: The presence of a polymorphism in the IL-18 gene was found to have no correlation with the occurrence of PCOS. Carriage of the C allele at position -137 in the promoter of the IL-18 gene may play a protective role from the development of PCOS IR.

Genotype and haplotype determination of interleukin (IL) 1 beta (g. -511C>T and g. +3954C>T) and IL-1RN in polycystic ovary syndrome.

The distribution of genotype frequencies, allele frequencies, and haplotype frequencies of variable number of tandem repeats (VNTR) in interleukin (IL) 1RN and IL-1beta (-511C > T, exon-5C.>T) polymorphism demonstrated a positive association with the occurrence of polycystic ovary syndrome (PCOS). The carriage of allele V of IL-1RN and allele E1 of exon-5 on the IL-1beta gene may increase the risk of PCOS.

[Effect of hyperprolactinemia upon clinical symptoms of patients with polycystic ovary syndrome].

OBJECTIVE: To determine the effects of hyperprolactinemia (hyperPRL) upon the symptoms of patients with polycystic ovary syndrome (PCOS). METHODS: Age, body mass index, levels of hormone, lipid, beta-cell function and family medical history of 224 women with PCOS and 30 women with hyperPRL + PCOS were compared. RESULTS: Patients with hyperPRL + PCOS were younger to develop endocrine disturbances, an increased incidence of acne (64% vs 28% respectively), a high level of androstenedione (20 + or - 7 vs 13 + or - 5) nmol/L respectively and prolactine in serum (1492 + or - 1175 vs 367 + or - 164) mIU/L respectively; The PCOS patients were divided into the groups of hyperandrogenism PCOS and non-hyperandrogenism PCOS depending on the serum level of androgen. A higher level of T and A was found in serum in PRL-PCOS than non-hyperandrogenism patients and similar as hyperandrogenism PCOS patients. They had reduced ApoB (680 + or - 230 nmol/L vs 943 + or - 179 mmol/L respectively) and Lpa level (46 + or - 22 nmol/L vs 162 + or - 194 mmol/L respectively) and high HOMA-IR when compared with non-hyperandrogenism PCOS; Patients' sisters with hyperPRL + PCOS had a significantly greater incidence of acne, higher rates of infertility and PCOS when compared with PCOS patients. Levels of other hormones, metabolic profiles and other family histories did not differ between patients with PCOS and hyper-PRL+PCOS. CONCLUSION: Patients with hyperPRL + PCOS develop the endocrine disturbances at a younger age, a greater incidence rate of acne, level of prolactin and androstenedione, they have reduced ApoB and increased HOMA-IR. Patients' sisters with hyperPRL + PCOS have significantly greater incidence of acne, higher rates of infertility and PCOS as when compared with PCOS patients.

[Preliminary study of protein expression profiling of PCOS on different state].

OBJECTIVE: To screen the serum protein expression profiles in patients having polycystic ovary syndrome (PCOS) with or without insulin resistance (IR) and search for discriminatory proteins. METHOD: Fasting serum samples of 30 PCOS patients with IR, 30 PCOS patients without IR, and 30 control individuals from Reproductive Center of Peking University Third Hospital were studied. RESULTS: There were 27 differential protein peaks between PCOS IR patients and controls, 17 between PCOS non-IR patients and controls, and 19 between PCOS IR patients and non-IR patients. Marker proteins from differentially expressed proteins were screened out using support vector machine (SVM), and were used to establish three diagnostic models for PCOS IR, PCOS non-IR, and IR, respectively. CONCLUSIONS: There were significantly different serum proteomic patterns in different types of PCOS. Using Protein Chip combined with SVM, computer diagnostic models for PCOS with and without IR were set up quickly and efficiently. These discriminatory proteins may help us understand the proteomic changes in serum and find out potential biomarkers of PCOS and IR.

[Association of monocyte chemoattractant protein-1 and the clinical characteristics of polycystic ovary syndrome: analysis of 65 cases].

OBJECTIVE: To investigate the association of monocyte chemoattractant protein-1 (MCP-1) and the clinical characteristics of polycystic ovary syndrome: (PCOS). METHODS: Fasting peripheral venous blood samples were collected on the 2nd or 3rd day of the menstrual cycle or when there was no dominant follicle shown by ultrasonography after amenorrhea from 65 POCS patients, aged 30 +/- 3, 27 being attributed to the obese group according the body mass index (BMI) and 38 to the non-obese group, and 40 patients with infertility, aged 31 +/- 3, as controls, subdivided into obese and non-obese subgroups (both n = 20), and then the samples of serum. Were obtained. The level of MCP-1 was examined by ELISA. The levels of prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and testosterone (T) were assayed with chemoluminescence methods, and the level of androstenedione was detected by radioimmunoassay. The level of serum insulin was detected by chemoluminescence method and the serum glucose (SG) was detected by oxidase enzymic method. Insulin sensitivity index (ISI) and homeostasis model assessment insulin resistance (HOMA-IR) were calculated. RESULTS: (1) The levels of serum LH, T, and LH/FSH of the obese and non-obese POCS subgroups were all significantly higher than the corresponding obese and non-obese control subgroups (all P < 0.05). (2) The level of MCP-1 of the non-obese PCOS subgroup was (98 +/- 67) ng/ml, significantly higher than that of the non-obese controls [(58 +/- 41 mg/L, P < 0.05)]. (3) Pearson correlation showed that serum PCP-1 was significantly positively correlated with BMI (r = 0.339, P = 0.000). LH (r = 0.224, P = 0.024)), and HOMA-IR (r = 0.239, P = 0.016), and significantly negatively correlated with ISI (r = -0.250, P = 0.0006). (3) Multiple regression analysis showed that BMI and LH were the principal factors influencing the level of MCP-1 in the POCS patients. CONCLUSION: The serum level of MCP-1 is associated with the LH level in POCS patients. POCS may a chronic inflammatory disease. MCP-1 is likely to participate in obesity, hyperinsulinemia, and insulin resistance in POCS.

[Interrelationship of abnormal family history in the first degree relatives and clinical phenotype of patients with polycystic ovary syndrome].

OBJECTIVE: To study the relationship of abnormal family history in the first degree relatives and the clinical phenotype of patients with polycystic ovary syndrome (PCOS). METHODS: Clinical data of first degree relatives of 139 women with PCOS were collected by questionnaires, including body mass index (BMI), waist hip ratio (WHR), and hursutism score. Follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), androstenedione (A), oral glucose tolerance test (OGTT) and insulin releasing test were measured. RESULTS: (1) Compared with patients with a negative family history of diabetes mellitus, for women with a positive family history, WHR (0.99 +/- 0.10 vs 0.79 +/- 0.08) and score of hirsutism (1.9 +/- 1.2 vs 1.8 +/- 1.2) were increased, the duration of menstruation was longer [(108 +/- 10) vs (92 +/- 19) days]; A [(11 +/- 6) vs (8 +/- 5) nmol/L], homeostasis model assessment of insulin resistance (HOMA-IR, 3.5 +/- 2.0 vs 2.7 +/- 1.6), area under curve (AUC) glucose [(836 +/- 245) vs (748 +/- 139) nmol.L(-1).min(-1)], AUC insulin [(9670 +/- 4582) vs (7330 +/- 4311) mIU.L(-1).min(-1)], fasting glucose [(5.0 +/- 1.1) vs (4.8 +/- 0.5) mmol/L] and fasting insulin [(15 +/- 8) vs (11 +/- 8) mIU/L] were increased, while early insulin secretion function index (DeltaI60/DeltaG60, 32 +/- 22 vs 52 +/- 30), insulin sensitive index (ISI, 0.019 +/- 0.011 vs 0.033 +/- 0.014) and disposition index (DI, 18 +/- 10 vs 30 +/- 22; P < 0.05) were decreased. (2) For women with a positive family history of menstrual disorder, WHR and score of hirsutism (0.99 +/- 0.09 vs 0.80 +/- 0.10 and 1.9 +/- 1.0 vs 1.6 +/- 1.1) were increased respectively, the duration of menstruation [(105 +/- 28) vs (84 +/- 31) days] was longer, HOMA-IR (3.6 +/- 2.4 vs 2.5 +/- 1.7) and fasting insulin level [(15 +/- 14) vs (12 +/- 11) mIU/L] were increased, while HOMA-beta (178 +/- 134 vs 207 +/- 175), ISI (0.017 +/- 0.009 vs 0.033 +/- 0.012) and DI (23 +/- 18 vs 28 +/- 19, P < 0.05) were decreased. (3) For women with a positive family history of premature balding, BMI and the score of hirsutism [(26 +/- 4) vs (23 +/- 5) kg/m(2) and 2.1 +/- 1.1 vs 1.7 +/- 1.3] were increased respectively, while DI (20 +/- 11 vs 30 +/- 23, P < 0.05) was decreased. (4) DeltaI60/DeltaG60 (34 +/- 27 vs 50 +/- 30) was decreased and fasting insulin [FINS, (13 +/- 10) vs (10 +/- 9) mIU/L] was increased in PCOS women with a family history of hypertension (P < 0.05). (5) For women with or without a family history of coronary heart disease, they did not have any difference in every parameter mentioned before. CONCLUSIONS: The family history of diabetes mellitus has the most effect on the clinical phenotype in women with PCOS. The family history of other diseases such as menstrual disorder, premature balding and hypertension play less significant roles. A family history of positive coronary heart disease does not affect the clinical phenotype of such patients.

[Monocyte chemoattractant protein-1 and its correlation with lipoprotein in polycystic ovary syndrome].

OBJECTIVE: To measure serum monocyte chemoattractant protein-1 (MCP-1) levels and study its associations with lipoproteins in patients with polycystic ovary syndrome (PCOS). METHODS: Sixty-five PCOS women and 20 ovulating normal women with body mass index (BMI) < 25 kg/m2 as controls were recruited. PCOS women were divided to two groups: 27 BMI >or = 25 kg/m2 patients as obese group; 38 BMI < 25 kg/m2 as non-obese group. Serum MCP-1 was assayed by enzyme-linked immunosorbent assays (ELISA). Serum prolactin (PRL), follicle stimulating hormone (FSH), luteinizing (LH), estradiol (E2) and testosterone (T) were assayed by chemoluminescence method. Serum androstenedione (A) was assayed by radioimmunity method in patients. And triglycerides (TG), total cholesterol (TC), apoprotein A (ApoA), apoprotein B (ApoB) , lipoprotein (a) [LP(a)], high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol (HDL-C and LDL-C) were measured. RESULTS: MCP-1 (P = 0.001) and ApoB (P = 0.018) levels were found to be significantly increased in PCOS groups compared with that of controls, but the ratio of ApoA/ ApoB was significantly decreased in groups PCOS (P = 0.015). PCOS obese group had markedly higher MCP-1 serum levels than non-obese group (P = 0.012), and MCP-1 serum levels in PCOS non-obese group higher than controls (P = 0.03). Univariate analysis revealed that serum MCP-1 levels were significantly and positively correlated with BMI (r = 0.350, P = 0.001), LH(r = 0.262, P = 0.016), TG (r = 0.480, P = 0.000) and ApoB (r = 0.289, P =0.008); but significantly and negatively correlated with the ratio of ApoA/ ApoB (r = -0.282, P = 0.009). Partial correlation showed that serum MCP-1 levels were correlation with LH (r = 0.2577, P = 0.020) and TG (r = 0.4611,P = 0.000). Multiple regression analysis showed that MCP-1 levels was influenced by BMI and TG. Furthermore, TG showed more effect on MCP-1 levels. CONCLUSION: PCOS obese and non-obese patients had higher serum MCP-1 levels than controls. MCP-1 was correlated with BMI, LH ,TG, ApoB and the ratio of ApoA/ ApoB. BMI and TG were two major determining factors of MCP-1 in patients with PCOS. Furthermore,TG had more effect on MCP-1 levels. Based on the above findings, we presume that MCP-1 is likely to participate in the pathophysiology and long-term complication of PCOS.

[Follicular stimulating hormone receptor gene C566T mutation in premature ovarian failure].

OBJECTIVE: To investigate the incidence of follicular stimulating hormone receptor (FSHR) gene C566T mutation in Chinese women with premature ovarian failure (POF) and to explore the etiologies of POF. METHODS: This case-control study was carried out between 73 Chinese women with idiopathic POF (POF group) and 35 controls (control group), including 25 normal females with a regular menstrual history and 10 normal post-menopause women. DNA was extracted from the peripheral blood of patients and controls. The exon 7 of FSHR gene was amplified by PCR. PCR products were subsequently digested by the enzyme BsmI and then subjected to electrophoresis on agarose gels and stained with ethidium bromide to determine the C566T mutation. DNA samples of random sampling were further analysed by sequencing the PCR products to confirm the mutation. RESULTS: BsmI digestion resulting in two fragments of 51 and 27 base pairs was noted for all 73 POF patients and 35 controls. PCR sequencing confirmed that the 566 allele of FSHR gene is C, demonstrating normal FSHR allele. CONCLUSIONS: No FSHR gene C566T mutation is present in POF patients and controls. FSHR C566T mutation may be rare in Chinese women with POF.