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BACKGROUND: As the major protein (approximately 36%) in rice bran, globulin exhibits excellent foaming and emulsifying properties, endowing its useful application as a foaming and emulsifying agent in the food industry. However, the low water solubility restricts its commercial potential in industrial applications. The present study aimed to improve this protein's processing and functional properties. RESULTS: A novel covalent complex was fabricated by a combination of the Maillard reaction and alkaline oxidation using rice bran globulin (RBG), chitooligosaccharide (C), quercetin (Que) and resveratrol (Res). The Maillard reaction improved the solubility, emulsifying and foaming properties of RBG. The resultant glycosylated protein was covalently bonded with quercetin and resveratrol to form a (RBG-C)-Que-Res complex. (RBG-C)-Que-Res exhibited higher thermal stability and antioxidant ability than the native protein, binary globulin-chitooligosaccharide or ternary globulin-chitooligosaccharide-polyphenol (only containing quercetin or resveratrol) conjugates. (RBG-C)-Que-Res exerted better cytoprotection against the generation of malondialdehyde and reactive oxygen species in HepG2 cells, which was associated with increased activities of antioxidative enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) through upregulated genes SOD1, CAT, GPX1 (i.e. gene for glutathione peroxidase-1), GCLM (i.e. gene for glutamate cysteine ligase modifier subunit), SLC1A11 (i.e. gene for solute carrier family 7, member 11) and SRXN1 (i.e. gene for sulfiredoxin-1). The anti-apoptotic effect of (RBG-C)-Que-Res was confirmed by the downregulation of caspase-3 and p53 and the upregulation of B-cell lymphoma-2 gene expression. CONCLUSION: The present study highlights the potential of (RBG-C)-Que-Res conjugates as functional ingredients in healthy foods. © 2024 Society of Chemical Industry.
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Antioxidantes , Quitosana , Oligossacarídeos , Oryza , Quercetina , Resveratrol , Humanos , Quercetina/química , Quercetina/análogos & derivados , Oryza/química , Oligossacarídeos/química , Resveratrol/química , Resveratrol/farmacologia , Antioxidantes/química , Antioxidantes/farmacologia , Quitosana/química , Células Hep G2 , Quitina/química , Quitina/análogos & derivados , Superóxido Dismutase/metabolismo , Superóxido Dismutase/genética , Proteínas de Plantas/química , Proteínas de Plantas/metabolismo , Reação de Maillard , Catalase/metabolismo , Catalase/genética , Glutationa Peroxidase/metabolismo , Glutationa Peroxidase/genéticaRESUMO
OBJECTIVES: To investigate awareness, prevalence, and knowledge of dry eye among Internet professionals in China. METHODS: A cross-sectional study was conducted among 1,265 randomly selected Internet professionals aged ≥18 years. A self-administered questionnaire was used to assess dry eye awareness, dry eye symptoms, and knowledge about dry eye risk factors. Data on demographics and complete medical history were also collected. The primary outcome was the rate of dry eye awareness determined by the answer to the question "Have you seen or heard anything about dry eye recently?" RESULTS: Of the 1,265 included individuals aged 20 to 49 years, 519 (41.0%) were women. 54.4% (688 of 1,265) of participants had seen or heard something about dry eye recently and most had obtained information through Internet. 50.8% (643 of 1,265) of participants were identified as subjects with symptoms of dry eye. Dry eye awareness was greater in contact lens wearers (odds ratio [OR], 6.49; 95% confidence interval [CI], 3.70-11.38; P <0.001), those with a refractive surgical history (OR, 5.09; 95% CI, 2.34-11.08; P <0.001), relatives and/or friends of ophthalmologists (OR, 2.76; 95% CI, 1.39-5.49; P =0.004), those with symptoms of dry eye (OR, 1.87; 95% CI, 1.47-2.38; P <0.001) and female subjects (OR, 1.44; 95% CI, 1.13-1.86; P =0.004). Knowledge of nonmodifiable and modifiable risk factors for dry eye was poor in substantial numbers of the participants. CONCLUSIONS: The level of dry eye awareness and knowledge of its risk factors is suboptimal in Internet professionals, although the Internet professionals are at high risk of the disease.
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Síndromes do Olho Seco , Humanos , Feminino , Adolescente , Adulto , Masculino , Estudos Transversais , Prevalência , Fatores de Risco , Inquéritos e Questionários , Síndromes do Olho Seco/diagnóstico , ChinaRESUMO
OBJECTIVES: Rural widowed elderly women living alone may face higher risks of depression and loneliness than general elderly people, which will have an impact on their quality of life. This study aims to explore the correlation of depression and loneliness with quality of life among rural widowed elderly women living alone. METHODS: A two-stage cluster sampling method was used to select 234 rural widowed older women living alone in Longshan county, Xiangxi autonomous prefecture, Hunan Province, and a questionnaire survey was conducted with the General Situation Questionnaire, the Geriatric Depression Scale-15 (GDS-15), the University of California, Los Angeles (UCLA) Loneliness Scale-8 (ULS-8), and the 36 Items Short Form Health Survey (SF-36). RESULTS: The ages of 234 rural widowed older women living alone were (73.29±7.36) years. Among them, 103 (44.0%) women were detected as depressed, 114 (48.7%) were not lonely or mildly lonely, 111 (47.4%) were moderately lonely, and 9 (3.9%) were severely lonely. The total quality of life scores were 63.39±19.70. Depression and loneliness were negatively correlated with quality of life (all P<0.001). After adjusting for confounding factors, multiple linear regression analysis showed that age, number of acute and chronic diseases, personal monthly income, depression, and loneliness independently impacted the quality of life among rural widowed older women (all P<0.05). CONCLUSIONS: Depression and loneliness can affect the quality of life of rural widowed older women living alone. In healthy aging efforts, the quality of life of these rural widowed older women can be improved by strengthening the management of underlying illnesses, increasing income, and alleviating depression and loneliness.
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Qualidade de Vida , Viuvez , Idoso , Feminino , Humanos , Depressão/epidemiologia , Ambiente Domiciliar , SolidãoRESUMO
BACKGROUND: Iron plays an important role in neurodevelopmental functions in the brain. Serum ferritin levels are different in children with attention deficit hyperactivity disorder and tic disorder than in healthy children. AIM: To explore the current status of iron deficiency in children with neurodevelopmental disorders and its sex and age effects. METHODS: A total of 1565 children with attention deficit hyperactivity disorder (ADHD), 1694 children with tic disorder (TD), 93 children with ASD and 1997 healthy control children were included between January 1, 2020, and December 31, 2021 at Beijing Children's Hospital. We describe the differences in age levels and ferritin levels between different disease groups and their sex differences. The differences between the sexes in each disease were analyzed using the t test. The incidence rate of low serum ferritin was used to describe the differences between different diseases and different age groups. A chi-square test was used to analyze the difference in the incidence of low serum ferritin between the disease group and the control group. Analysis of variance was used for comparisons between subgroups, and regression analysis was used for confounding factor control. RESULTS: A total of 1565 ADHD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 36.82 ± 20.64 µg/L and 35.64 ± 18.56 µg/L, respectively. A total of 1694 TD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 35.72 ± 20.15 µg/L and 34.54 ± 22.12 µg/L, respectively. As age increased, the incidence of low serum ferritin in ADHD and TD first decreased and then increased, and 10 years old was the turning point of rising levels. The incidence of ADHD with low serum ferritin was 8.37%, the incidence of TD with low serum ferritin was 11.04%, and the incidence of the healthy control group with low serum ferritin was 8.61%, among which male children with TD accounted for 9.25% and female children with TD accounted for 11.62%. There was a significant difference among the three groups (P < 0.05). In addition, there were 93 children with ASD with an average serum ferritin level of 30.99 ± 18.11 µg/L and a serum ferritin incidence of 15.05%. CONCLUSION: In conclusion, low serum ferritin is not a risk factor for ADHD or TD. The incidence of low serum ferritin levels in children with ADHD and TD between 5 and 12 years old decreases first and then increases with age.
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Wheat bran was solid state fermented by Fomitopsis pinicola. The results showed that the processing properties were increased by fermentation and the content of total phenol and alkylresorcinols was 5.91 and 1.55 times of the unfermented bran respectively by the 6th day. The total antioxidant capacity was 5.73 times of the unfermented sample by the 4th day. Electronic nose analysis showed that the fermented wheat bran had a special flavor. GC-MS analysis found that 4-ethyl-2-methoxy-phenol was the main flavor substance, which was sharply increased during the fermentation. Furthermore, the textural properties of the dough and bread containing fermented bran were significantly improved. The content of phytic acid in the bread was significantly decreased, while the protein, total phenol and alkylresorcinols contents were significantly increased. Results suggest that solid state fermentation by Fomitopsis pinicola is a promising way to improve wheat bran to a nutritious and flavorful cereal food ingredient.
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Coriolaceae/metabolismo , Fibras na Dieta/análise , Antioxidantes/química , Técnicas de Cultura Celular por Lotes , Pão/análise , Nariz Eletrônico , Aromatizantes/análise , Cromatografia Gasosa-Espectrometria de Massas , Fenóis/química , Fenóis/metabolismo , Resorcinóis/química , Resorcinóis/metabolismo , Compostos Orgânicos Voláteis/análiseRESUMO
BACKGROUND: Ultrasound-targeted microbubble destruction (UTMD) has been shown to be a promising noninvasive technique to change the tumor circulation, thus providing a potential method to increase reactive oxygen species (ROS) levels in tumors by inducing tumor tissue ischemia-reperfusion (IR). In this study, we investigated the feasibility of local tumor IR through UTMD to enhance the anti-tumor efficacy of doxorubicin (DOX) chemotherapy. METHODS: UTMD was used to induce local tumor IR. After the major blood supply of the tumor was restored, DOX was intravenously injected into the tumor-bearing mice. The superoxide dismutase (SOD) and catalase (CAT) activity and ROS levels were examined, and the anti-tumor efficacy was evaluated. RESULTS: UTMD blocked the circulation to the tumor for 30 mins. Slow reperfusion began to occur after 30 mins, and major blood supply was restored after 1 hr. The blood perfusion of the tumor completely recovered at 2 hrs. The activity of SOD in the tumors was significantly decreased at 2 hrs and 1 day after IR treatment with or without DOX treatment. The CAT activity showed no obvious changes at 2 hrs after IR treatment, whereas a significant decrease was found after 1 day in both the IR and DOX/IR groups. Moreover, higher levels of ROS were produced in the IR group and IR/DOX group. In vivo anti-tumor study indicated that the local tumor IR strategy may significantly enhance the anti-tumor efficacy of DOX chemotherapy. CONCLUSION: UTMD provides a novel, simple and non-invasive technique for tumor IR. In combination with chemotherapy, UTMD may have high great potential to improve the anti-tumor efficacy of chemotherapeutic drugs.
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The aim of the study was to compare CE-MRV with DANTE-SPACE on a 1.5T MRI system for the diagnosis of DVT. The patients were diagnosed with deep venous thrombosis of the lower extremities based on swelling, pain, and superficial varicose veins of the lower extremities. MRI examination confirmed the diagnosis. DANTE-SPACE images were obtained before the conventional contrast-enhanced MRV, which uses gadolinium. The scanning field started from the end of the inferior vena cava to the end of the ankle, divided into five observation segments, namely, the common iliac vein, external iliac vein, femoral vein, popliteal vein, and calf vein. The DANTE-SPACE and CE-MRV results were used for a consistency analysis. For the DANTE-SPACE and CE-MRV images, the signal intensity ratios of the thrombus/cavity and thrombus/muscle were calculated, and the ratio difference was compared using the paired t test. Twenty-six patients completed the examination; one of the patients underwent a right lower limb amputation, yielding a total of 255 lower limb vascular segments. The analysis of the DANTE-SPACE images showed that there were 14 iliac vein thromboses, 18 external iliac vein thromboses, 23 femoral vein thrombi, 21 popliteal vein thromboses, and 18 calf vein thromboses; these findings were consistent with the diagnostic results of CE-MRV. The ratio of the thrombus/cavity signal intensity measured in the DANTE-SPACE and CE-MRV images were as follows: 20.51 ± 12.96 vs. 0.51 ± 0.46; P < 0.05, n = 51; the difference was statistically significant. The ratio of the thrombus/muscle signal intensity measured on the DANTE-SPACE and CE-MRV images were as follows: 1.74 ± 0.57 vs. 0.99 ± 0.53; P < 0.05, n = 51; the difference was statistically significant. Compared with CE-MRV, DANTE-SPACE showed no significant difference in the ability to detect deep venous thrombosis of the lower extremities. DANTE-SPACE did not use contrast-enhancing agents and showed no evidence of inflammatory enhancement, and the display effect of small diameter veins was slightly poor. However, deep venous thrombosis of the lower extremities presents different levels of high signal in the DANTE-SPACE images, making it easy to identify and diagnose. It can also indicate the different components and age of the thrombus and help with the selection of a more accurate clinical treatment plan. MRI DANTE-SPACE is the preferred imaging modality for patients with deep venous thrombosis who are unable or unwilling to use gadolinium contrast agents.
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Meios de Contraste/administração & dosagem , Veia Femoral/diagnóstico por imagem , Gadolínio DTPA/administração & dosagem , Veia Ilíaca/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Angiografia por Ressonância Magnética/métodos , Veia Poplítea/diagnóstico por imagem , Varizes/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos TestesRESUMO
Transparent wood samples were fabricated from an environmentally-friendly hydrogen peroxide (H2O2) bleached basswood (Tilia) template using polymer impregnation. The wood samples were bleached separately for 30, 60, 90, 120 and 150 min to evaluate the effects on the changes of the chemical composition and properties of finished transparent wood. Experimental results showed decreases in cellulose, hemicellulose, and lignin content with an increasing bleaching time and while decreasing each component to a unique extent. Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscope (SEM) analysis indicated that the wood cell micro-structures were maintained during H2O2 bleaching treatment. This allowed for successful impregnation of polymer into the bleached wood template and strong transparent wood products. The transparent wood possessed a maximum optical transmittance up to 44% at 800 nm with 150 min bleaching time. Moreover, the transparent wood displayed a maximum tensile strength up to 165.1 ± 1.5 MPa with 90 min bleaching time. The elastic modulus (Er) and hardness (H) of the transparent wood samples were lowered along with the increase of H2O2 bleaching treatment time. In addition, the transparent wood with 30 min bleaching time exhibited the highest Er and H values of 20.4 GPa and 0.45 GPa, respectively. This findings may provide one way to choose optimum degrees of H2O2 bleaching treatment for transparent wood fabrication, to fit the physicochemical properties of finished transparent wood.
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There is a dearth of data on the iodine balance studies of Chinese population. In the present study, we aimed to explore the appropriate recommended nutrient intake (RNI) of iodine based on healthy Chinese women. A 4-week study was conducted in twenty-five Chinese euthyroid women. Uniform diets with different iodine contents were provided in two different periods, in which non-iodised salt was given in the first 3 weeks, followed by 1 week of iodised salt administration. The total iodine intake from diet, water and air as well as the total iodine excretion through urine, faeces and respiration were monitored and determined. The sweat iodine loss was also considered. Moreover, the regression curve model was established between the 24 h iodine intake and 24 h iodine excretion. The 24 h iodine intake in the two periods was 194·8 (sd 62·9) and 487·1 (sd 177·3) µg/d, respectively. The 24 h iodine excretion was 130·9 (sd 39·5) and 265·4 (sd 71·8) µg/d, respectively. Both 24 h iodine intake and 24 h iodine excretion of the two periods were significantly different (all P<0·05). The iodised salt contributed approximately 62·7 % of the total daily iodine intake. Moreover, 92·3 % (277/300) of samples were in positive balance, while twenty-three cases were in negative balance. Our data show that the estimated average requirement for iodine was 110·5 µg/d. Therefore, the RNI for iodine to non-pregnant, non-lactating Chinese women was 154·7 µg/d.
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The presence of blood-brain barrier (BBB) greatly limits the availability of drugs and their efficacy against glioma. Focused ultrasound (FUS) can induce transient and local BBB opening for enhanced drug delivery. Here, we developed polysorbate 80-modified paclitaxel-loaded PLGA nanoparticles (PS-80-PTX-NPs, PPNP) and examined the enhanced local delivery into the brain for glioma treatment by combining with FUS. Our result showed PPNP had good stability, fast drug release rate and significant toxicity to glioma cells. Combined with FUS, PPNP showed a stronger BBB permeation efficiency both in the in vitro and in vivo BBB models. Mechanism studies revealed the disrupted tight junction, reduced P-glycoprotein expression and ApoE-dependent PS-80 permeation collectively contribute to the enhanced drug delivery, resulting in significantly stronger antitumour efficacy and longer survival time in the tumour-bearing mice. Our study provided a new strategy to efficiently and locally deliver drugs into the brain to treat glioma.
Assuntos
Antineoplásicos Fitogênicos/farmacologia , Neoplasias Encefálicas/terapia , Sistemas de Liberação de Medicamentos/métodos , Glioblastoma/terapia , Nanopartículas/química , Paclitaxel/farmacologia , Polissorbatos/química , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/antagonistas & inibidores , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/genética , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Animais , Antineoplásicos Fitogênicos/farmacocinética , Apolipoproteínas E/genética , Apolipoproteínas E/metabolismo , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/metabolismo , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/patologia , Modelos Animais de Doenças , Composição de Medicamentos/métodos , Liberação Controlada de Fármacos , Tratamento por Ondas de Choque Extracorpóreas/métodos , Feminino , Expressão Gênica , Glioblastoma/metabolismo , Glioblastoma/mortalidade , Glioblastoma/patologia , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Nanopartículas/administração & dosagem , Nanopartículas/metabolismo , Paclitaxel/farmacocinética , Análise de Sobrevida , Junções Íntimas/efeitos dos fármacos , Junções Íntimas/metabolismo , Junções Íntimas/patologiaRESUMO
Rationale: Treatment for Parkinson's disease (PD) is challenged by the presence of the blood-brain barrier (BBB) that significantly limits the effective drug concentration in a patient's brain for therapeutic response throughout various stages of PD. Curcumin holds the potential for α-synuclein clearance to treat PD; however, its applications are still limited due to its low bioavailability and poor permeability through the BBB in a free form. Methods: Herein, this paper fabricated curcumin-loaded polysorbate 80-modified cerasome (CPC) nanoparticles (NPs) with a mean diameter of ~110 nm for enhancing the localized curcumin delivery into the targeted brain nuclei via effective BBB opening in combination with ultrasound-targeted microbubble destruction (UTMD). Results: The liposomal nanohybrid cerasome exhibited superior stability towards PS 80 surfactant solubilization and longer circulation lifetime (t1/2 = 6.22 h), much longer than free curcumin (t1/2 = 0.76 h). The permeation was found to be 1.7-fold higher than that of CPC treatment only at 6 h after the systemic administration of CPC NPs. Notably, motor behaviors, dopamine (DA) level and tyrosine hydroxylase (TH) expression all returned to normal, thanks to α-synuclein (AS) removal mediated by efficient curcumin delivery to the striatum. Most importantly, the animal experiment demonstrated that the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD mice had notably improved behavior disorder and dopamine depletion during two-week post-observation after treatment with CPC NPs (15 mg curcumin/kg) coupled with UTMD. Conclusion: This novel CPC-UTMD formulation approach could be an effective, safe and amenable choice with higher therapeutic relevance and fewer unwanted complications than conventional chemotherapeutics delivery systems for PD treatment in the near future.
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Encéfalo/metabolismo , Curcumina/administração & dosagem , Curcumina/farmacologia , Sistemas de Liberação de Medicamentos , Microbolhas , Doença de Parkinson/diagnóstico por imagem , Polissorbatos/química , Animais , Encéfalo/efeitos dos fármacos , Curcumina/química , Curcumina/farmacocinética , Dopamina/metabolismo , Hidrodinâmica , Lipossomos , Camundongos Endogâmicos C57BL , Modelos Biológicos , Atividade Motora , Neostriado/metabolismo , Doença de Parkinson/patologia , Doença de Parkinson/fisiopatologia , Tamanho da Partícula , Permeabilidade , Eletricidade Estática , Distribuição Tecidual , UltrassonografiaRESUMO
Gastroenteropancreatic neuroendocrine tumors (GEPNETs) are relatively uncommon. Unfortunately, epidemiological studies on the incidence of GEPNETs worldwide have reported a marked increase in the detection of these tumors. Although they often exhibit relatively indolent clinical courses, GEPNETs have the potential for lethal progression, especially in patients who present with advanced disease. Early detection and surgical removal is currently the only reliable curative treatment for GEPNET patients. The objective of this study was to analyze the clinicopathological characteristics of GEPNETs and explore the metastasisrelated risk factors of patients with GEPNETs. One hundred and fortysix patients diagnosed pathologically with GEPNETs from January 2001 to January 2015 at the Second Xiangya Hospital of Central South University were retrospectively evaluated. We retrieved and analyzed information concerning clinical characteristics and metastasisrelated risk factors, and used Chisquare test and logistic regression analysis to analyze the clinicopathological characteristics of GEPNETs and explore the association between tumor metastasis and possible related risk factors. The results revealed that the most common clinical manifestations were abdominal pain (n=88), alteration in the character of stool (n=58) and melaena (n=33). Rectum (91/146, 62.3%) and stomach (19/146, 13.0%) were the main sites of metastasis. Both Chisquare test and logistic regression analysis showed that tumor size (P<0.05), tumor type (P=0.008) and peritumoral lymphatic vessel density (LVD) (P=0.004) were significantly correlated with tumor metastasis. Neither Chisquare test nor logistic regression analysis indicated that gender (P>0.05), age (P>0.05), tumor location (P>0.05), tumor number (P>0.05), chromaffin granule protein A [chromogranin A (CgA), P>0.05], synaptophysin (Syn, P>0.05) or intratumoral LVD (P>0.05) had a significant correlation with tumor metastasis. Chisquare test revealed that tumor grade was significantly correlated with tumor metastasis. In conclusion, GEPNETs may occur in multiple sites of the digestive system and lack specific clinical manifestations. Tumor size, tumor type, peritumoral LVD, total LVD and tumor grade are metastasisrelated risk factors for GEPNET patients.
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Neoplasias Intestinais/patologia , Tumores Neuroendócrinos/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Gástricas/patologia , Adulto , Biomarcadores Tumorais/metabolismo , Proliferação de Células , Cromogranina A/metabolismo , Feminino , Humanos , Neoplasias Intestinais/metabolismo , Antígeno Ki-67/metabolismo , Masculino , Análise Multivariada , Gradação de Tumores , Metástase Neoplásica , Tumores Neuroendócrinos/metabolismo , Neoplasias Pancreáticas/metabolismo , Fatores de Risco , Neoplasias Gástricas/metabolismo , Sinaptofisina/metabolismoRESUMO
BACKGROUND: Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reasons for drop out, and behavioural changes. METHOD: Chinese and English databases of literature are searched for studies reporting retention rates, drug use and sexual behaviours among MMT participants in China between 2004 and 2013. The estimates are summarized through a systematic review and meta-analysis. RESULTS: A total of 74 studies representing 43,263 individuals are included in this analysis. About a third of MMT participants drop out during the first three months of treatment (retention rate 69.0% (95% CI 57.7-78.4%)). Police arrest and detention in compulsory rehabilitation was the most common cause of drop out, accounting for 22.2% of all those not retained. Among retained participants, changing unsafe drug use behaviours was more effective than changing unsafe sexual behaviours. At 12 months following MMT initiation, 24.6% (15.7-33.5%) of MMT participants had a positive urine test, 9.3% (4.7-17.8%) injected drugs and only 1.1% (0.4-3.0%) sold sex for drugs. These correspond to 0.002 (<0.001-0.011), 0.045 (0.004-0.114) and 0.209 (0.076-0.580) times lower odds than baseline. However, MMT participants did not have substantial changes in condom use rates. CONCLUSION: MMT is effective in drug users in China but participant retention is poor, substantially related to compulsory detention. Reforming the compulsory drug user detention system may improve MMT retention and effectiveness.
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Comportamento , Quimioterapia de Manutenção , Tratamento de Substituição de Opiáceos , Participação do Paciente , China , Humanos , Metadona , Pacientes Desistentes do Tratamento , Viés de Publicação , Comportamento SexualRESUMO
BACKGROUND: Infantile spasms is a severe epileptic encephalopathy, which is refractory to conventional antiepileptic drugs. Adrenocorticotropic hormone (ACTH) has been the major therapy for infantile spasms; however, ACTH therapy is ineffective for some patients. The variations in the receptor genes can contribute to antiepileptic drug resistance. This study was to elucidate the possible associations between the variations of the MC2R gene and ACTH responsiveness in patients with infantile spasms. METHODS: We screened for variations in the promoter and coding region of the MC2R gene in 91 Chinese patients with infantile spasms and 94 controls, using PCR and a direct sequencing method. The frequencies of the genotypes, alleles and reconstructed haplotypes were analyzed in the cases and controls. The association between ACTH responsiveness and genetic variations of the MC2R gene was also assessed. RESULTS: Four single nucleotide polymorphisms (SNPs) were identified in the MC2R promoter, one of which was a novel specimen at position-2 from the transcription start site ATT, -2T > C. Three SNPs (rs1893220, rs2186944 and -2T > C) showed a significant difference between the cases and controls (P < 0.05 for all). The frequency of the common TCCT haplotype carrying four-SNP major alleles was significantly lower in the cases (39%) than in the controls (60%) (P = 0.00003). The homozygous carriers of the TCCT haplotype had a much lower relative risk than the non-carriers (RR = 0.42, 95% CI 0.26-0.70, P = 0.0001). ACTH responsiveness was strongly associated with the TCCT haplotype (P = 0.000082). Compared with non-carriers of the TCCT haplotype, the homozygous and heterozygous carriers were more responsive to ACTH therapy (P = 0.0002; P = 0.0003, respectively). CONCLUSIONS: Our results indicated that the TCCT haplotype in the MC2R promoter is strongly associated with the responsiveness of the ACTH therapy performed on patients with infantile spasms. The polymorphisms of the MC2R promoter might be one important factor that influences the efficacy of ACTH therapy on infantile spasms.