[Prevalence of chronic kidney disease and its risk factors in subjects with different glucose metabolism status].

OBJECTIVE: To investigate the prevalence of chronic kidney disease (CKD) in subjects with different glucose metabolism status. METHODS: Between January, 2015 and October, 2015, a total of 934 subjects without a previous diagnosis of diabetes visiting the Department of Endocrinology or Health Examination Center underwent oral glucose tolerance test (OGTT), which identified 266 subjects with normal glucose tolerance (NGT group), 243 pre-diabetic subjects, and 425 patients with diabetes mellitus group. The baseline characteristics and laboratory test data of the subjects were collected. The diagnosis of CKD was established for an eGFR <60 mL/min/1.73 m(2) or a ACR≥30 mg/g, and the prevalence of CKD were compared among the 3 groups. Logistic regression model was used to analyze the OR value of the risk factors of CKD. RESULTS: The prevalences of CKD in NGT, pre-diabetic and diabetic groups were 10.2%, 26.3% and 32.5%, respectively. Pairwise comparisons showed that the prevalence of CKD was significantly higher in pre-diabetic group (P<0.001, OR=3.17, 95% CI 1.94-5.17) and diabetic group (P<0.001, OR=4.27, 95% CI 2.72-6.65) than in NGT group, and was comparable between the pre-diabetic and diabetic groups (P=0.115, OR=1.35, 95% CI 0.95-1.91). Logistic regression analysis, after adjustment for age, gender, blood pressure, hypertension, blood lipids and uric acid, showed that pre-diabetes (OR=2.03, P=0.044) and diabetes mellitus (OR=2.22, P=0.016) were independently associated with CKD. CONCLUSION: Glucose metabolism status has a significant independent impact on the incidence of CKD, suggesting the importance of early detection of pre-diabetes and timely interventions in pre-diabetic subjects in prevention CKD.

[Characteristics of Mycobacterium tuberculosis genotype and the relationship between Beijing genotype and drug-resistant phenotypes in Tianjin].

OBJECTIVE: To explore the distribution and characteristics on genotype of Mycobacterium tuberculosis and the relationship between Beijing genotype and drug-resistant phenotypes in Tianjin city. METHODS: 656 clinical strains were collected from Tianjin Center for Tuberculosis Control and ten other Tuberculosis Institute in Tianjin from January 2008 to June 2009. Information regarding administration, clinical as well as laboratory findings of patients were collected. Proportion method was adopted to detect the susceptibility on four anti-tuberculosis drugs, namely streptomycin (SM), isoniazid (INH), rifampicin (RFP) and ethambutol (EMB). Both Beijing and non-Beijing genotypes were differentiated by multiplex PCR. The relationship between Beijing genotype and drug-resistant phenotypes was analyzed. RESULTS: In this study, the overall resistance rate of MTB was 26.98%, with multidrug-resistant rate was 6.25%. Among 656 MTB strains, 600 isolates (91.46%) belonged to Beijing genotype. There was significant difference between Beijing and non-Beijing genotype (χ(2) = 4.26, P = 0.039) among the Tianjin household registered population. Concerning the drug resistance, there was no significant difference between the two groups. CONCLUSION: Beijing genotype strains were the predominant one in Tianjin. The proportion of people infected with the Beijing genotype strains in Tianjin household registration of patients was significantly higher than the proportion of patients in the floating population in the same region. Results from the statistical analysis did not reveal any statistically significant association between Beijing genotype and drug resistance.

Molecular characterization of drug-resistant Beijing family isolates of Mycobacterium tuberculosis from Tianjin, China.

OBJECTIVE: Tuberculosis remains a severe public health issue, and the Beijing family of mycobacterium tuberculosis (M. tuberculosis) is widespread in East Asia, especially in some areas in China, like Beijing and Tianjin. This study aimed at determining the mutation patterns of drug-resistant Beijing strains of M. tuberculosis isolated from Tianjin, China. METHODS: A total of 822 M. tuberculosis isolates were screened for drug resistance by an absolute concentration method and the genotype was identified by PCR. 169 drug-resistant isolates of the Beijing family were analyzed for the potential mutations in the rpoB, katG, inhA promoter region and in rpsL, rrs and embB genes, which are associated with resistance to rifampin (RFP), isoniazid (INH), streptomycin (SM) and ethambutol (EMB) respectively by PCR and DNA sequencing. RESULTS: Fifty-eight out of 63 RFP-resistant isolates were found to carry the mutations within the 81-bp RFP resistance determining region (RRDR) of the rpoB gene and the most frequent mutations occurred at codon 531 (44.4%), 526 (28.6%), and 516 (7.9%) respectively. 16 mutation patterns affecting 12 different codons around the RRDR of rpoB were found. Of 116 INH-resistant isolates, 56 (48.3%) had the mutation of katG 315 (AGC-->ACC) (Ser-->Thr), 3 (2.6%) carried S315N (AGC-->AAC) and 27 (16.0%) had the mutation of inhA-15A-->T. 84 out of 122 SM-resistant isolates (68.9%) displayed mutations at the codons 43 or 88 with AAG-->AGG (Lys-->Arg) of the rpsL gene and 22 (18.0%) with the mutations at positions 513A-->C, 516C-->T or 905 A-->G in the rrs gene. Of 34 EMB-resistant isolates, 6 had mutation with M306V (ATG-->GTG), 3 with M306I (ATG-->ATT), 1 with M306I (ATG-->ATA), 1 with D328Y (GAT-->TAT), 1 with V348L (GTC-->CTC), and 1 with G406S (GGC-->AGC) in the embB gene. CONCLUSION: These novel findings extended our understanding of resistance-related mutations in the Beijing strains of M. tuberculosis and may provide a scientific basis for development of new strategies for diagnosis and control of tuberculosis in China and other countries where Beijing strains are prevalent.

[A comparison study on clinical chromatographic fingerprintings of mycolic acids analysis of 18 standard strains of Mycobacteria in China].

OBJECTIVE: A clinical chromatographic fingerprinting of 18 standard strains of Mycobacteria commercialized in China by high-performance liquid chromatography approach was developed and improved in this laboratory. A comparison of clinical chromatographic fingerprintings of mycolic acids was carried out. METHODS: Mycolic acids were extracted from whole cultured cells of Mycobacteria by biochemical methods, and then samples was prepared for analysis after the mycolic acids were saponified, acidified and derived. The samples were detected by high-performance liquid chromatography under optimum conditions. RESULTS: Using above techniques a clinical chromatographic fingerprinting of Mycolic acids analysis was successfully established. The repeatability of the mycolic acids fingerprinting was evaluated. Coefficient of variation (CV) of chromatographic fingerprinting was between 0.20% - 0.83%. CONCLUSIONS: The first clinical chromatographic fingerprinting of 18 standard strains of Mycobacteria in China was established in this laboratory. Mycobacteria can be accurately identified according to chromatographic fingerprinting in a short time. Moreover, there was significant difference between BCG vaccine and Mycobacterium bovis when their peak was compared, which may lead to research of new tools for identifying insidious infection of tuberculosis and for the study of the mechanism of drug tolerance.