Risk due to Elevated Uric Acid Levels in Children With Henoch-Schonlein Purpura.

PURPOSE: To compare uric acid levels in children with Henoch-Schonlein purpura (HSP)without nephritis and with renal damage, and at different pathological grades. METHODS: A total of 451 children were enrolled in this study, including 64 with HSP without nephritis and 387 HSP with kidney damage. Age, gender, uric acid, urea, creatinine and cystatin C levels were reviewed. Pathological findings of those with renal impairment were also reviewed. RESULTS: Among the HSP children with renal damage, 44 were grade I, 167 were grade II and 176 were grade III. There were significant differences in age, uric acid, urea, creatinine and cystatin C levels between the two groups (p<0.05, all). Correlation analysis showed that uric acid levels in children with HSP without nephritis were positively correlated with urea and creatinine levels (p<0.05). Uric acid levels in HSP children with renal damage was positively correlated with age, urea, creatinine and cystatin C levels (p<0.05, all). Regression analysis found that, without adding any correction factors, there were significant differences in uric acid levels between the two groups; however, after adjusting for pathological grade, there was no longer a significant difference. CONCLUSIONS: There were significant differences of uric acid levels in children with HSP without nephritis and with renal impairment. Uric acid levels in the renal impairment group were significantly higher than that in the HSP without nephritis group. Uric acid levels were related to only the presence or absence of renal damage, not to the pathological grade.

RUMA and RUPCR in children with Henoch-Schonlein purpura.

OBJECTIVE: The aim of this study was to compare the qualitative and quantitative targets in the detection of proteinuria in children with HSP. METHODS: Three hundred and forty children were taken as the research subjects. Qualitative and a series of quantitative indicators of urine protein were tested. RESULTS: The qualitative and quantitative of protein in 340 children were analyzed retrospectively. Correlation analysis found that 24hUTP had a strong correlation with age, RUMA, RUPCR, and qualitative urine occult blood (p < 0.01, for all). After regression analysis, RUMA and RUPCR were still significantly correlated with 24hUTP (p < 0.01). At the same time, RUMA and RUPCR had good diagnostic accuracy for proteinuria. When the RUPCR ratio was set as 0.415, the diagnostic sensitivity was 83%, and the specificity was 98.7%. When RUMA was set as 68.215, the sensitivity was 94.3% and the specificity was 96.2%. CONCLUSION: Compared with 24hUTP, RUMA and RUPCR had high sensitivity and specificity for monitoring proteinuria in children with HSP.

The variants of SARS-CoV-2 and the challenges of vaccines.

Since the outbreak of coronavirus disease 2019 (COVID-19), countries all over the world have suffered severe losses. It affects not only human life and health but also the economy. In response to COVID-19, countries have made tremendous efforts to vaccine development. The newly discovered variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have brought major challenges to the effectiveness and research of vaccines. This article reviews the existing literature and summarizes the main variants of the SARS-CoV-2 and its impact on vaccines, and provides new ideas for the later development of vaccines. An excellent job in developing and applying vaccines will be an important measure for epidemic prevention and control.

Analysis of COVID-19 vaccines: Types, thoughts, and application.

OBJECTIVE: To deal with COVID-19, various countries have made many efforts, including the research and development of vaccines. The purpose of this manuscript was to summarize the development, application, and problems of COVID-19 vaccines. METHODS: This article reviewed the existing literature to see the development of the COVID-19 vaccine. RESULTS: We found that different types of vaccines had their own advantages and disadvantages. At the same time, the side effects of the vaccine, the dose of vaccination, the evaluation of the efficacy, and the application of the vaccine were all things worth studying. CONCLUSION: The successful development of the COVID-19 vaccine concerns almost all countries and people in the world. We must do an excellent job of researching the immunogenicity and immune reactivity of the vaccines. We hope this review can help colleagues at home and abroad.

The Relationship between Serum Uric Acid Level and Liver Function in Patients with Hepatitis B in China.

BACKGROUND: To explore the correlation between serum uric acid (UA) level and liver function indexes in patients with hepatitis B, so as to provide guidance for the prediction and treatment of liver function damage in patients with hepatitis B. METHODS: Four hundred and eighty-five patients with hepatitis B were selected as the case group and 312 patients without hepatitis B matched in the same period as the control group. The difference of blood UA level in each group was analyzed, and the correlation between UA and ALT, AST and CREA in each group was analyzed. RESULTS: UA in the hepatitis B group was significantly higher than that in non-hepatitis B group, and the difference was statistically significant (p = 0.000). Correlation analysis showed that UA was correlated with ALT in non-hepatitis B group (p < 0.001), while UA was significantly correlated with ALT and AST in hepatitis B group (p < 0.001). Correlation analysis showed that UA was correlated with ALT in male group, but not in female group. The results of logistic multivariate regression analysis showed that the increase of serum UA level was a risk factor for liver function damage in patients with hepatitis B. CONCLUSIONS: The level of UA in patients with hepatitis B was significantly higher than that in patients without hepatitis B. The level of UA was positively correlated with the damage of liver function indexes. The correlation between UA and liver function indexes was stronger in males than that in females.

Kidney involvement in COVID-19 and its treatments.

The lungs are the most commonly affected organ by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the kidneys are also frequently affected. Infection with SARS-CoV-2 can not only cause new kidney damage but also increase the difficulty of treatment and care as well as mortality for people with underlying kidney diseases. Kidney involvement in SARS-CoV-2 infection mainly manifests as kidney tubular injury. Proteinuria is the main clinical sign. To reduce patient mortality, kidney complications should be given increased attention in the diagnosis and treatment of coronavirus disease 2019 (COVID-19). This study reviews the existing literature and discusses COVID-19 infection in combination with kidney diseases in terms of kidney damage, pathogenesis, and treatment to guide clinical anti-epidemic responses.

Red Cell Distribution Width is a Predictor of Patients with Liver Cell Damage by EBV Infectious Mononucleosis in Children in Southeast China.

BACKGROUND: Epstein-Barr virus infection is common in children. The aim of this study was to find new laboratory indices of infectious mononucleosis in children. METHODS: In this prospective study, a total of 141 children with infectious mononucleosis and 146 children without signs of infectious mononucleosis were enrolled. The number of white blood cell count (WBC) and red blood cell count (RBC), levels of hemoglobin (HB), mean blood cell volume (MCV), red blood cell distribution width (RDW), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), uric acid (UA), and creatinine (CREA) in the peripheral blood were evaluated. RESULTS: WBC, RDW, ALT, AST, GGT, and UA in patients were significantly higher compared to controls (p < 0.01, for all), while RBC and HB were significantly lower in patients (p < 0.01, for each). In the stepwise regression analysis, we found that RDW had the highest ratio compared to other parameters, and its 95% confidence interval was 1.362 - 7.929 (p < 0.01). RDW was positively correlated with ALT, AST, and GGT elevations (p < 0.01). While RDW was negatively correlated with HB (p = 0.01). When using the criteria of RDW (%) = 12.55, the sensitivity was 80.9%, and the specificity was 78.8% in IM patients. CONCLUSIONS: RDW may be used as a further indicator supporting early IM diagnosis and indirectly predicting the degree of liver cell damage in EBV infectious mononucleosis.

Fasting C-peptide is a significant indicator of nonalcoholic fatty liver disease in obese children.

AIMS: Whether fasting C-peptide can be a potential indicator for nonalcoholic fatty liver disease (NAFLD) in obese children is unknown. This study aimed to assess whether fasting C-peptide represented a risk factor for NAFLD. METHODS: A total of 520 obese children (376 male, 144 female) aged 3.4-17.1 years were divided into two groups, obese with NAFLD and non-NAFLD, according to hepatic ultrasound results. Fasting plasma glucose, fasting C-peptide, hemoglobin A1c, renal function, liver function, blood lipid, fasting insulin and blood routine indices were measured. Insulin resistance by homoeostasis model (HOMA-IR) was calculated. RESULTS: Compared with the non-NAFLD group, the obese children with NAFLD had higher fasting C-peptide, fasting insulin and HOMA-IR (P < 0.001). Stepwise multiple logistic regression models showed that fasting C-peptide (odds ratio: OR = 2.367) was independent indicator of the presence of NAFLD in obese children as well as white blood cell (OR = 1.113), albumin (OR = 1.124), alanine aminotransferase (OR = 1.030), triglycerides (OR = 1.335), and waist circumference (OR = 1.047). Furthermore, after adjustment for confounding variables, the prevalence of NAFLD in obese children was significantly higher according to increased serum fasting C-peptide levels. The adjusted OR for NAFLD according to fasting C-peptide tertiles were 1.00 (as references), 1.896(1.045-3.436), and 4.169(1.822-9.537). CONCLUSION: Our data suggested that obese children with high level of fasting C-peptide had an increased risk for developing NAFLD.

High mean platelet volume-to-platelet count ratio as a diagnostic maker for increased risk of liver function damage in pediatric patients with infectious mononucleosis in China.

The aim of the present study was to provide novel laboratory indexes for infectious mononucleosis (IM) in pediatric patients. In the present prospective study, a total of 141 pediatric patients with IM and 146 healthy subjects were enrolled. The white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HB), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), uric acid (UA), urea, creatinine, total cholesterol (TC) and triglycerides (TG) in peripheral blood were evaluated. WBC, ALT, AST, GGT, UA, TG, MPV and the MPV/PLT ratio in the patients were significantly higher compared with those in the controls (P<0.01), while RBC, HB, urea, TC, PLT and PDW were significantly lower in the patients (P<0.05 for PDW and P<0.01 for others). Regression analysis under stepwise adjustment indicated that PLT and MPV/PLT were significantly associated with IM (P<0.01). Furthermore, MPV/PLT was positively correlated with ALT, AST, GGT, UA and TC (P≤0.01). In the receiver operating characteristic analysis, a sensitivity of 83.7% and specificity of 76.0% regarding the prediction of IM in pediatric patients using the MPV/PLT ratio was achieved at the cutoff of MPV/PLT(%)=3.42. In conclusion, the MPV/PLT ratio may be a novel diagnostic indicator for pediatric IM and indirectly predict damage to liver function.

Cytokine profiles as novel diagnostic markers of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children.

PURPOSE: The aim of this study was to identify specific laboratory indices to distinguish Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children. MATERIALS AND METHODS: In this prospective study, Th1/Th2 cytokines, including IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ, were analyzed in patients with EBV-HLH or sepsis at the onset of disease by flow cytometry. RESULTS: IL-10, IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 were higher and IL-6 was lower in EBV-HLH patients compared to sepsis patient levels. When using the criteria of IL-10 >20.9 pg/mL, IFN-γ >17.9 pg/mL, IL-10/IL-6 >0.5 and IFN-γ/IL-6 >0.7, the sensitivity was 89.8%, 93.2%, 93.2%, and 91.5%, while the specificity was 89.8%, 100%, 94.9%, and 100%, respectively. After treatment of EBV-HLH patients, IL-6, IL-10, TNF-α, and IFN-γ were significantly reduced (IL-6: P<.001; IL-10: P<.001; TNF-α: P=.011; IFN-γ: P<.001). CONCLUSIONS: This study showed that IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 are novel specific indicators for differential diagnosis of EBV-HLH. Additionally, IL-6, IL-10, TNF-α, and IFN-γ are useful indices for monitoring the effects of treatment on EBV-HLH.

Association between IL17A and IL17F polymorphisms and risk of Henoch-Schonlein purpura in Chinese children.

Previous studies suggested that interleukin-17 and Th17 cell play an important role in the pathogenesis of childhood Henoch-Schonlein purpura (HSP). The purpose of our study is to elucidate whether the IL17A and IL17F gene polymorphisms are susceptibility genes for the development of HSP in Chinese children. A total of 148 HSP patients and 202 controls were enrolled for analyzing the single nucleotide polymorphisms (SNP) of IL17A (rs2275913, rs8193037 and rs3819025) and IL17F (rs763780 and rs9463772). TaqMan Real-Time polymerase chain reaction method was used in SNP genotyping. Compared to the healthy controls, the IL17A rs2275913 variant allele A showed a significant association with HSP [odds ratio (OR) 0.70; 95 % CI 0.51-0.94, P = 0.018]. Genotyping analysis demonstrated rs2275913 was associated with a decreased HSP risk (G/A vs. G/G: OR 0.56; 95 % CI 0.33-0.95; A/A vs. G/G: OR 0.46; 95 % CI 0.24-0.86; P = 0.032). Also, our findings showed that the A allele of IL17A rs3819025 was associated with a higher risk of HSP nephritis (OR 1.61; 95 % CI 1.00-2.58; P = 0.047). In addition, a risk haplotype of IL17A (GGA) was found (OR 1.84; 95 % CI 1.17-2.88; P = 0.008). However, no significant differences between HSP patients and healthy controls were observed when comparing genotype, allele or haplotype frequencies of the IL17F rs763780 and rs9463772 polymorphisms. In this study, we confirmed that the rs2275913 polymorphism of the IL17A gene was associated with susceptibility to HSP in Chinese children. However, there was no relationship between IL17F rs763780 and rs9463772 polymorphisms and HSP susceptibility.

Characterization of microRNAs expression profiling in one group of Chinese urothelial cell carcinoma identified by Solexa sequencing.

OBJECTIVE: The goal of this study was to extend the known repertoire of microRNAs (miRNAs) expressed in urothelial bladder cancer (BCa) of the Chinese population and further understand the molecular events of miRNAs underlying urothelial bladder tumorigenesis at the global genome level. MATERIALS AND METHODS: We separated well-characterized epithelial tumor cells from 20 moderately differentiated or poorly differentiated BCa specimens by laser capture microdissection (LCM) and pooled these cells of interest prior to RNA analysis. Ten normal bladder epithelia (NBE) samples were pooled as the control. After preparation of small RNAs library, the 2 samples were sequenced simultaneously by the next generation high through-put Solexa sequencing technology. RESULTS: We employed the next generation high through-put Solexa sequencing technology to clone and identify miRNAs in BCa and NBE, and generated 11,146,610, and 10,263,845 high quality sequence reads, respectively. According to the analysis of size distribution, 22 nt class was the most abundant group of small RNAs in the BCa. Likewise, the 20 and 22 nt sequences were significantly greater than shorter or longer sequences, and accounted for 59.55% of the total sequence number of NBE library. The whole-genome-scale data mining suggested that BCa and NBE libraries both contained multiple and heterogeneous small RNA species. On further analysis, the sequencing data revealed that different miRNAs showed clearly in-house differential expression levels in BCa and NBE and 74 miRNAs aberrantly expressed between BCa and NBE at the global genome level. We also predicted 13 novel miRNAs in both BCa and NBE libraries. CONCLUSIONS: Our results suggest that BCa miRNAs include a large proportion of conserved miRNAs and a set of non-conserved miRNAs with low expression levels. These known and newly identified miRNAs at the population level significantly enhance our knowledge of BCa miRNAs expression profiling and provide insights into miRNAs oncogenesis and oncotherapy in BCa. Further studies are necessary to elucidate the roles of miRNAs in urothelial bladder tumorigenesis and determine the potential of miRNAs as diagnostic and prognostic tools or therapeutic targets for BCa in the future.

Association of short tandem repeat polymorphism in the promoter of prostate cancer antigen 3 gene with the risk of prostate cancer.

BACKGROUND: PCA3 (prostate cancer antigen 3) gene is one of the most prostate cancer-specific genes at present. Consequently, the prostate-specific expression and the sharp up-regulation of PCA3 mRNA in prostate cancer suggest a unique transcriptional regulation, which possibly can be attributed to promoter polymorphism. In our study, we evaluated whether there is polymorphism in PCA3 promoter region and also assess the association of the polymorphism with prostate cancer. METHODOLOGY/PRINCIPAL FINDINGS: We designed a specific primer set to screen the promoter of PCA3 gene by polymerase chain reaction (PCR)-based cloning and sequencing with the DNA extracted from peripheral blood samples of prostate cancer (PCa) cases (n = 186) and healthy control cases (n = 135). Genotype-specific risks were estimated as odds ratios (ORs) with associated 95% confidence intervals (CIs) by chi-square test. Possible deviation of the genotype frequencies from controls and PCa cases expected under Hardy-Weinberg equilibrium was assessed by the chi-square test. Short tandem repeat polymorphism of TAAA was found in the promoter region of PCA3 gene, five polymorphisms and eight genotypes were identified. The eight genotypes were divided into three groups: ≤10TAAA, 11TAAA, ≥12TAAA. The group 11TAAA and ≥12TAAA were associated with higher relative risk for prostate cancer than group ≤10TAAA (OR = 1.76, 95%CI = 1.07-2.89[for group 11TAAA]; OR = 5.28, 95%CI = 1.76-15.89[for group ≥12TAAA]). CONCLUSIONS/SIGNIFICANCE: The presence of the (TAAA)n short tandem repeat polymorphisms in the PCA3 promoter region may be a risk factor for prostate cancer in the Chinese population.