Background: To investigate the frequency of rectal tenesmus in urolithiasis patients presented with renal colic, and describe the clinical characteristics of these patients. Methods: A retrospective study across three large hospitals in Guangzhou was conducted, and all Emergency Department (ED) visits with renal colic during 2016 were included. Finally a total of 4758 patients were enrolled, and we collected then analyzed their medical histories, including general information, characteristics of renal colic, accompanying symptoms, as well as the signs, the typical examination results and the therapeutic effects. Results: The frequency of tenesmus in the patients with renal colic was 72.5%, higher than urinary irritation symptoms (23.4%) and the upper gastrointestinal symptoms (54.9%). Patients with tenesmus tended to suffer from renal colic during morning time (0:00-12:00) and at sleep or rest status. Higher likelihood of stones located in lower ureter (p<0.001) were found in this cohort of patients. Conclusions: Rectal tenesmus is a common accompanying symptom in patients presented with renal colic. This manifestation is related to certain characteristics of the patients and the stones. Future studies will be conducted to explore the feasibility of using rectal tenesmus in differential diagnosis for renal colic and other acute abdominal pain in ED. Trial registration The study was approved by the Institute Research Ethics Committee at the Sun Yat-sen University. The approval number is 2016 No. 59 of Sun Yat-sen Memorial Hospital. The study was retrospectively registered at http://www.chictr.org.cn/index.aspx (registration number: ChiCTR-RRC-17012373) in 15 August 2017.

Interleukin-21 (IL-21) is a cytokine that plays a crucial role in pathogenesis and activity of the rheumatoid arthritis (RA). Meanwhile, genetic polymorphisms in the IL-21 gene may alter its expression. Previous studies have reported conflicting results assessing the association between the IL-21 rs6822844 G/T polymorphism and RA risk. Thus, it's necessary to perform a meta-analysis to definite above relationship. PubMed database was searched for all papers published until October 20, 2019. Nine case-control studies with 9998 cases and 10742 controls were retrieved based on the search criteria at last. Odds ratio (95% confidence interval) was used to calculate the strength of this association. Publication bias was detected using both Begg's and Egger's tests. Overall, the IL-21 rs6822844 G/T polymorphism was found to be significantly associated with decreased RA risk (e.g. T-allele versus G-allele: OR = 0.81, 95% CI = 0.72-0.91, P < 0.001). In addition, decreased RA risk was also detected both in Asians (eg: TT+TG versus GG: OR = 0.42, 95% CI = 0.31-0.56, P < 0.001) and Caucasians (eg: TT+TG versus GG: OR = 0.85, 95% CI = 0.80-0.91, P < 0.001). A similar trend in association was found in the source of the control and genotype method subgroups. Furthermore, subgroup analysis of rheumatoid factor status revealed a protective relationship between the IL-21 rs6822844 G/T polymorphism and RF+/RF- RA risk. A similar relationship was noted in the anti-citrullinated protein antibody status subgroup. The results of the present study suggest that the IL-21 rs6822844 G/T polymorphism was significantly associated with decreased RA susceptibility.

Previous studies have suggested that serum carotenoids might be inversely associated with non-alcoholic fatty liver disease (NAFLD), but little data came from longitudinal studies. We prospectively examined the associations between serum-carotenoid levels and NAFLD severity and the intermediary effects of retinol-binding protein 4 (RBP4), HOMA insulin-resistance index (HOMA-IR), body mass index (BMI), and serum triglycerides in middle-aged and elderly Chinese adults.

Several studies have suggested that higher carotenoid levels may be beneficial for atherosclerosis patients, but few studies have examined this relationship in the Chinese population. This cross-sectional study examined the association between the levels of carotenoids in diet and serum and carotid intima-media thickness (IMT) in Chinese adults aged 50-75 years in Guangzhou, China. Dietary intake was assessed using a FFQ. HPLC was used to assay the serum concentrations of α-carotene, β-carotene, lutein+zeaxanthin, β-cryptoxanthin and lycopene. The IMT at the common carotid artery (CCA) and bifurcation of the carotid artery was measured by B-mode ultrasound. A total of 3707 and 2947 participants were included in the analyses of dietary and serum carotenoids. After adjustment for demographic, socio-economic and lifestyle factors, all the serum carotenoids levels except lycopene were found to be inversely associated with the IMT at the CCA and bifurcation (P trend<0·001 to 0·013) in both men and women. The absolute mean differences in the IMT between the subjects in the extreme quartiles of serum carotenoid levels were 0·034 mm (α-carotene), 0·037 mm (β-carotene), 0·032 mm (lutein+zeaxanthin), 0·030 mm (β-cryptoxanthin), 0·015 mm (lycopene) and 0·035 mm (total carotenoids) at the CCA; the corresponding values were 0·025, 0·053 0·043, 0·050, 0·011 and 0·042 mm at the bifurcation. The favourable associations were also observed between dietary carotenoids (except lycopene) and the CCA IMT. In conclusion, elevated carotenoid levels in diet and serum are associated with lower carotid IMT values (particular at the CCA) in Chinese adults.

Aim: To investigate the analgesic efficacy and safety of combined therapy using drotaverine and ketorolac vs ketorolac in the treatment of acute renal colic. Methods: This was a retrospective study of a consecutive cohort that included 322 emergency department (ED) patients with a diagnosis of renal colic from our hospital, from June 2014 to September 2015. Pain intensity (PI) was recorded using a visual analog scale (VAS) at different time-points after treatment. The primary outcome was defined as a decrease of 50% or more in the mean PI. The need for rescue analgesics in 120 min and occurrence of adverse effects were considered as secondary outcomes. Results: Of 322 eligible patients, 249 patients were analyzed in this study: 125 patients received ketorolac plus drotaverine and 124 patients received ketorolac only. There were significant differences in PI between the two groups at 30min and 120 min (PI: [OR 1.573, 95% Cl: 1.007-3.054, P-30 min = 0.047], [OR 2.938, 95% Cl: 1.11-7.78, P-120 min = 0.03] in multivariable logistic regression) (PI: [OR 1.869, 95% Cl: 1.119-3.121, P-30 min = 0.017], [OR 2.938, 95% Cl: 1.117.78, P-120 min = 0.03] in univariable logistic regression). Moreover, significant differences were also found in PI in subgroup analysis of patients with mid and proximal ureteric stones (PI: [OR 3.888, 95% Cl: 1.409-10.729, P-30 min = 0.009] in multivariable logistic regression) (PI: [OR 3.476, 95% Cl: 1.363-8.865, P-30 min = 0.009] in univariable logistic regression). Pain relief at 120 min was obtained in 119 patients (95.2%) receiving combined therapy and in 106 patients (85.5%) receiving ketorolac (P = 0.011). Rescue analgesics were required in six patients (4.8%) receiving combined therapy and 18 patients (14.5%) receiving ketorolac (P = 0.009). Adverse events were similar between the two groups: 20 (16%) in the combined group and 16 (13%) in the ketorolac group (P = 0.843). Conclusion: Ketorolac combined with drotaverine is effective in relief of acute renal colic, especially pain due to mid and proximal ureteric lithiasis, but did not decrease PI significantly in renal colic patients with renal and distal ureteral stones. On the other hand, combined therapy with ketorolac and drotaverine was associated with a reduced use of rescue analgesics.

Background Several epidemiological studies revealed associations between carotenoids and the metabolic syndrome (MetS), but limited longitudinal cohort studies have been conducted to regard this association. Objective The objective of this study was to investigate whether serum carotenoids predict the incidence of the Mets and what is accounted for the associations by changes of lipids in a large population‐based study. Method We conducted a follow‐up study on 2773 men and women aged 40–75 years without Mets at baseline from the Guangzhou Nutrition and Health Study (GNHS). Blood pressure, waist circumference, blood lipids, glucose and other covariates data were collected in average every 3 years surveys. Serum carotenoids (α‐, β‐carotene, β‐cryptoxanthin, lycopene and lutein/zeaxanthin) were examined by HPLC at baseline. Results Over the average 5.4 years follow‐up, 1979 subjects with serum carotenoids assessed at baseline took part in the follow‐up survey at least once and 554 subjects developed new MetS during the follow‐up period. Inverse associations between serum carotenoids and the incidence of MetS were observed. After adjustments for confounders, HRs (95% CIs) of MetS for the highest (v.s. the lowest) quartile were 0.72(0.57, 0.90) for lutein/zeaxanthin, 0.39 (0.31, 0.51) for lycopene, 0.42 (0.32, 0.54) for α‐carotene, 0.45 (0.34, 0.56) for β‐carotene and 0.47(0.37, 0.61) for total carotenoids (all P ‐trend <0.05). Other significant favorable associations between changes of HDLc with serum carotenoids were also revealed. Conclusion Our results revealed associations between higher serum carotenoid levels and a lower incidence of MetS in Chinese adults and the favorable influence of carotenoids might be partially driven by an improvement of serum HDLc. Support or Funding Information The present study was jointly supported by the National Natural Science Foundation of China (81472965, 81130052) and by the 5010 Program for Clinical Researches (No. 2007032) of the Sun Yat‐sen University (Guangzhou, China)

Diabetes mellitus is frequently accompanied by chronic complications like delayed wound healing, which is consider to be attributed to the accumulation of advanced glycosylation end product (AGE). However, the impacts of AGE on epidermal stem cells (ESCs) are largely unknown. This study aims to address the influence and mechanism of AGE on ESCs. ESCs isolated from rats were cultured in AGE-modified bovine serum albumin and transfected with small interfering RNA to knock down AGE-specific receptor (AGER). Expression of stem cell markers integrin β1 (ITGB1) and keratin 19 (KRT19), cell viability, apoptosis and reactive oxygen species (ROS) were examined. Wnt pathway-related factors Wnt family member 1 (WNT1), WNT3A, β-catenin, v-myc avian myelocytomatosis viral oncogene homolog (MYC), cyclin D1 (CCND1) and matrix metallopeptidase 7 (MMP7) were quantified. The interaction between forkhead box O1 (FOXO1) and β-catenin was assessed by co-immunoprecipitation. Results indicated that AGE down-regulated ITGB1 and KRT19 expression, suppressed ESC viability and promoted apoptosis, and ROS level (P < 0.01), implying decreased capacities of ESCs. AGE also promoted AGER and FOXO1, while AGER knockdown had the opposite effects. Moreover, AGER knockdown elevated the level of WNT1, WNT3A, MYC, CCND1 and MMP7 that were suppressed by AGE (P < 0.01). Immunoprecipitation analysis showed that FOXO1 could compete with lymphoid enhancer binding factor 1 to interact with β-catenin, which might help to elucidate the mechanism of AGE repressing ESCs. This study helps to understand the mechanism of accumulated AGE in affecting ESC capacities, and provides potential therapeutic targets to meliorate diabetic wound healing.

The interaction of human serum albumin (HSA) with propofol has been studied by fluorescence spectroscopy, Fourier transform infrared (FT-IR) spectroscopy, circular dichroism (CD) spectroscopy and docking methods. A gradual decrease in Stern–Volmer quenching constants with the increase in temperature showed the static mode of fluorescence quenching. The obtained binding constant (KA) was 8.18×105M−1. Gibbs free energy (ΔG), enthalpy (ΔH) and entropy (ΔS) changes were calculated, which revealed that the reaction is spontaneous, exothermic and hydrophobic force driven. FT-IR test revealed conformational changes of the protein and destruction of H-bonding upon interaction. Moreover, propofol induced a decrease in α-helical contents probably with increment of random coils or/and β-sheets of HSA, as observed from the far-UV CD spectra. Molecular docking and site probing study depicted that propofol fits into the hydrophobic pocket close to Sudlow site I in domain IIA of HSA. The present study will be helpful in understanding the binding mechanism of propofol and associated stability and conformational changes.

ObjectivesPrevious studies have suggested that blood values of carotenoids may be inversely associated with various chronic diseases, but limited data are available in Asian populations. This study examined the associations of serum carotenoids with metabolic sysndrome (MS), non‐alcoholic fatty liver disease (NAFLD), carotid intima‐media thickness (cIMT), bone mineral density (BMD) and skeletal muscle mass in adults.MethodsIn this community‐based study, we enrolled 4008 Chinese aged between 40–75 years in Guangzhou, China in 2011–2013. We completed the measurements of overnight fasting serum carotenoids of α‐carotene, β‐carotene, β‐cryptoxanthin, Lutein+zeaxanthin, total of them using a HPLC method, cIMT at the common carotid artery (CCA) and at the bifurcation (BIF) and presence and degree of NAFLD by B‐mode ultrasound, serum lipids, glucose, blood pressure and body measurements, and BMD at the whole body (WB), lumbar spine (LS) and hip (total and neck), and skeletal muscle mass at the limbs using a dual energy x‐ray absorptiometry in about 3000 subjects. Covariates were collected using interviewer‐adminstrated structured questionnaires. Up to date, 1628 subjects had completed the follow‐up measurements of the above outcome variables after a mean interval of 3.1 years (lost rate: 22%).ResultsIn the cross‐sectional analyses after adjusted for multiple covariates, the odds ratios (95%CI) for the individual carotenoids (quartile 4 vs. 1) were ranged between 0·23 (0·15, 0·36) (β‐carotene) to 0·44 0·29, 0·67 (lycopene) for the presence of MS (all p‐trend<0.01), and between 0.32 (0.25,0.41) (β‐carotene) to 0.62 (0.49,0.79) (β‐cryptoxanthin) for the presence of NAFLD (all p‐trend<0.01). The values of IMT in quartie 4 (vs. 1) were lower by 4.16%–5.12% and 2.69%–5.63% for all carotenoids (p‐trend: <0.001), except for lycopene (2.09% & 1.19%) at the CCA and BIF. Greater levels of α‐carotene, β‐carotene, and β‐cryptoxanthin were significantly associated with higher BMD values (difference for quartile 4 vs. 1: 1.5%–4.0%). All carotenoids (except β‐cryptoxanthin) had significant and favorable associations with skeletal muscle mass index (SMI, total muscle mass/height2, kg/m2). The percent differences for quartile 4 (vs. 1) were 1.77%–2.34%. In the follow‐up analyses, the favorable associations of the carotenoids with the changes in IMT, the severity of NAFLD, BMD and SMI were less significant possibly due to smaller number of subjects followed‐up at present, although similar trends were observed to those in the cross‐sectional results.ConclusionsGreater concentrations of serum carotenoids was associated with lower presenc of MS and NAFLD, lower values of cIMT, and higher levels of BMD and skeletal muscle mass, and might be benefit to their changes in middle‐aged and elderly adults.Support or Funding InformationThe study was jointly supported by the National Natural Science Foundation of China (no. 81472965, 81273049, 81130052) and the 5010 Program for Clinical Researches (No. 2007032) by the Sun Yat‐sen University, Guangzhou, China

OBJECTIVE To investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and understand the relationship between NAFLD and metabolic risk factors in middle-aged and elderly adults. METHODS This cross-sectional study recruited 2 935 subjects in Guangzhou, Guangdong province. Face-to-face interviews and laboratory analyses were conducted to collect general information and other covariates. Analysis of covariance and logistic regression analysis were performed to investigate the relationship between metabolic factors and the prevalence of NAFLD. NAFLD was diagnosed based on standard criteria recommend by the Fatty Liver Disease and Alcoholic Liver Disease Branch of Chinese Hepatology Society, and the degree of steatosis was assessed (mild, moderate or severe). RESULTS Compared with normal subjects, those with NAFLD had higher levels of WC, BMI, FPG, TG, SBP, DBP and greater prevalence of metabolic syndrome, but lower levels of physical activity and HDL-C. After adjusted for covariates, the OR for each standard deviation change was 2.70 (95% CI: 2.45-2.98) for WC, 1.47 (95% CI: 1.35-1.59) for SBP, 1.48 (95% CI: 1.37-1.60) for DBP, 1.88 (95% CI: 1.66-2.12) for TG, 1.25 (95% CI: 1.15-1.36) for FPG and 0.51 (95% CI: 0.47-0.56) for HDL-C (all P<0.001). Higher levels of WC, BMI, TG, SBP, DBP and FPG were significantly related with the increase in degree of NAFLD (P-trend<0.001). CONCLUSION There is a relatively high prevalence of NAFLD in middle-aged and elderly adults in China. NAFLD is closely related with the different forms of metabolic syndrome, and WC is the leading risk factor for NAFLD.

Background: Former studies suggested an adverse effect of hypervitaminosis A on bone health, while the effects of retinol and its precursor (beta-carotene) remain uncertain in populations consuming vitamin A (VA) mainly from plant sources.Objective: We investigated the association of serum, dietary retinol, and beta-carotene with bone mineral density (BMD) in Chinese adults.Methods: We recruited 2101 women and 1053 men (aged 40-75 years) in Guangzhou, China. Dietary intake was assessed through face-to-face interviews with food-frequency questionnaires at baseline and 3 years later. Serum levels of retinol and beta-carotene were determined by HPLC using a baseline specimen, and the BMD for the whole body (WB), lumbar spine (LS), total hip (TH), and femur neck (FN) were measured using dual energy X-ray absorptiometry at follow-up.Results: In general, greater levels of serum retinol, beta-carotene, and the beta-carotene-to-retinol ratio were associated with a higher BMD after adjustment for potential covariates in the total sample. BMD values in the top (vs. bottom) quartile were increased by 2.06% (TH) for retinol; 2.87% (WB), 2.51% (LS), 3.10% (FN) for beta-carotene; 2.21% (WB) and 2.05% (FN) for the beta-carotene-to-retinol ratio in the total sample (all p <0.05). A significant positive association with BMD was observed for dietary intake of beta-carotene and total VA in retinol equivalents at the hip sites in the total sample.Conclusion: Higher circulating and dietary levels of VA and beta-carotene and higher serum p-carotene-to-retinol ratios were positively associated with BMD in Chinese adults consuming relatively low levels of VA, mainly from plant foods. (C) 2015 Elsevier Inc. All rights reserved.

Previous studies have suggested that serum carotenoids may be inversely associated with liver injury, but limited data are available from population-based studies. We examined the relationship between serum carotenoid levels and the prevalence of nonalcoholic fatty liver disease (NAFLD) in Chinese adults. A total of 2935 participants aged 40–75 years were involved in this community-based cross-sectional study. General information, lifestyle factors, serum levels of carotenoid and the presence and degree of NAFLD were determined. After adjusting for potential covariates, we observed a dose-dependent inverse association between NAFLD risk and each individual serum carotenoid and total carotenoids (all p-values < 0.001). The ORs of NAFLD for the highest (vs. lowest) quartile were 0.44 (95% CI 0.35, 0.56) for α-carotene, 0.32 (95% CI 0.25, 0.41) for β-carotene, 0.62 (95% CI 0.49, 0.79) for β-cryptoxanthin, 0.54 (95% CI 0.42, 0.68) for lycopene, 0.56 (95% CI 0.44, 0.72) for lutein + zeaxanthin and 0.41 (95% CI 0.32, 0.53) for total carotenoids. Higher levels of α-carotene, β-carotene, lutein + zeaxanthin and total carotenoids were significantly associated with a decrease in the degree of NAFLD (p-trend: < 0.001 to 0.003). Serum carotenoids are inversely associated with prevalence of NAFLD in middle aged and elderly Chinese.

Abstract Previous studies have suggested that vitamin E (VE) may affect bone health, but the findings have been inconclusive. We examined the relationship between VE status (in both diet and serum) and bone mineral density (BMD) among Chinese adults. This community-based study included 3203 adults (2178 women and 1025 men) aged 40–75 years from Guangzhou, People’s Republic of China. General and dietary intake information were collected using structured questionnaire interviews. The serum α-tocopherol (TF) level was quantified by reversed-phase HPLC. The BMD of the whole body, the lumbar spine and left hip sites (total, neck, trochanter, intertrochanter and Ward’s triangle) were measured using dual-energy X-ray absorptiometry. In women, the dietary intake of VE was significantly and positively associated with BMD at the lumbar spine, total hip, intertrochanter and femur neck sites after adjusting for covariates (P trend: 0·001–0·017). Women in quartile 3 of VE intake typically had the highest BMD; the covariate-adjusted mean BMD were 2·5, 3·06, 3·41 and 3·54 % higher, respectively, in quartile 3 (v. 1) at the four above-mentioned sites. Similar positive associations were observed between cholesterol-adjusted serum α-TF levels and BMD at each of the studied bone sites (P trend: 0·001–0·022). The covariate-adjusted mean BMD were 1·24–4·83 % greater in quartile 4 (v. 1) in women. However, no significant associations were seen between the VE levels (dietary or serum) and the BMD at any site in men. In conclusion, greater consumption and higher serum levels of VE are associated with greater BMD in Chinese women but not in Chinese men.

Previous studies suggested that magnesium (Mg) might protect against atherosclerosis, but data were scarce in an Asian population. We examined the association of Mg levels in serum and urine with carotid intima-media thickness (cIMT) and serum lipids in Chinese adults.

The association between serum carotenoids and the metabolic syndrome (MetS) remains uncertain, and little is known about this relationship in the Chinese population. The present study examined the association between serum carotenoid concentrations and the MetS in Chinese adults. We conducted a community-based cross-sectional study in which 2148 subjects (1547 women and 601 men) aged 50–75 years were recruited in urban Guangzhou, China. Dietary data and other covariates were collected during face-to-face interviews. Blood pressure, waist circumference, blood lipids, glucose and serum carotenoids (α-, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin) were examined. We found dose–response inverse relationships between individual serum carotenoid concentrations and total carotenoids and the prevalence of the MetS after adjusting for potential confounders (P for trend < 0·001). The OR of the MetS for the highest (v. lowest) quartile were 0·31 (95 % CI 0·20, 0·47) for α-carotene, 0·23 (95 % CI 0·15, 0·36) for β-carotene, 0·44 (95 % CI 0·29, 0·67) for β-cryptoxanthin, 0·39 (95 % CI 0·26, 0·58) for lycopene, 0·28 (95 % CI 0·18, 0·44) for lutein+zeaxanthin and 0·19 (95 % CI 0·12, 0·30) for total carotenoids. Higher concentrations of each individual carotenoid and total carotenoids were significantly associated with a decrease in the number of abnormal MetS components (P for trend < 0·001–0·023). Higher serum carotenoid levels were associated with a lower prevalence of the MetS and fewer abnormal MetS components in middle-aged and elderly Chinese adults.

Several studies report that the OPG is an important candidate gene in the pathogenesis of osteoporosis. This study aimed to detect the potential association of OPG gene polymorphisms with osteoporosis in postmenopausal women. We recruited 928 subjects containing 463 with primary postmenopausal osteoporosis and 465 healthy volunteers as controls. The BMD of neck hip, lumbar spine (L-2 (4)), and total hip were assessed by dual-energy X-ray absorptiometry (DEXA). Through the created restriction site-polymerase chain reaction (CRS-PCR), PCR-restriction fragment length polymorphism (PCR-RFLP), and DNA sequencing methods, the g.18873C>T and g.27522G>A have been investigated. As for g.18873C>T, our data indicated that subjects with CC genotype have significantly higher BMD value than those of CT and TT genotypes (all P values < 0.05). As for g.27522G>A, the BMD values of subjects with GG genotype were significantly higher than those of GA and AA genotypes (all P values < 0.05). Our findings suggest that the OPG g.18873C>T and g.27522G>A genetic polymorphisms are associated with the decreased risk for osteoporosis in Chinese postmenopausal women.

Objective: The aim of this study was to detect the influence of g.19124G>A genetic polymorphism in the osteoprotegerin (OPG) gene on bone mineral density (BMD) and osteoporosis in Chinese postmenopausal women. Methods: A total of 403 primary osteoporosis subjects and 409 healthy controls were enrolled in this study. The BMD value of the femoral neck hip, lumbar spine (L2-4), and total hip was analyzed by Norland XR-46 dual energy X-ray absorptiometry. The polymerase chain reaction-restriction fragment length polymorphism method was utilized to investigate the genotype of g.19124G>A genetic polymorphism. Results: We found significant differences of the femoral neck hip, lumbar spine (L2-4), and total hip of BMD among different genotypes of g.19124G>A genetic polymorphism, individuals with the genotype GG had significantly higher BMD than those of genotype GA and AA (p<0.05). Conclusion: These findings indicate that the g.19124G>A genetic polymorphism in the OPG gene is potentially related to BMD and osteoporosis in Chinese postmenopausal women, and the allele A could be associated with a lower BMD and an increased risk factor for osteoporosis.