Objective To detect the level of serum Klotho in chronic kidney disease (CKD) 3-5 stage patients and explore its relationship with the progress of renal function.Methods Twenty-nine patients with CKD 3-5 stage (CKD group) and 10 cases of age-matched non-CKD patients (control group) were enrolled in the study.The level of serum Klotho and fibroblast growth factor 23 (FGF23) were measured by enzyme-linked immunosorbent assay.Results The level of serum Klotho in CKD group was significantly lower than that in control group [(670.07 ± 146.22) ng/L vs.(1 125.50 ± 126.96) ng/L] (P ＜ 0.01).The level of serum FGF23 in CKD group was significantly higher than that in control group[(48.89 ± 44.28) ng/L vs.(10.48 ± 8.93) ng/L] (P ＜ 0.01).Pearson correlation analysis showed that the level of Klotho in CKD patients was positively correlated with estimated glomerular filtration rate (eGFR) and hemoglobin,and Klotho was negatively correlated with log urea nitrogen,log serum creatinine,log FGF23 and phosphate.Multiple regression analysis showed that log FGF23 and serum phosphorus were independent factors for serum Klotho level in patients with CKD.CKD patients were divided into rapid progression of renal function group (10 cases) and renal stability group (19 cases) according to annual rate of eGFR dechne.The patients in rapid progression of renal function group with lower serum Klotho [(580.27 ± 162.15) ng/L vs.(717.33 ± 115.22) ng/L],higher uric acid and more severe proteinuria [(448.00 ±65.21) mmol/L vs.(368.32 ±78.80) mmol/L,(1.99 ± 1.57) g/d vs.(0.60 ± 1.00) g/d] (P ＜0.05).Conclusions Serum Klotho level of CKD 3-5 stage patients decreases with the decline in renal function.Serum phosphate and FGF23 are the independent factors for serum Klotho.Serum Klotho may become the prediction index of renal function progress for patients with CKD.

Objective To investigate the relations between serum adiponectin and coronary artery calcification score (CACS) and to find the risk factors for coronary artery calcification in maintenance hemodialysis(MHD) patients.Methods Twenty-seven MHD patients(MHD group) and 13 healthy persons (control group) were enrolled in this study.The serum adiponectin was measured by enzyme-linked immunosorbent assay method.CACS was calculated by multi-row spiral CT.The circulating parameters such as hemoglobin (Hb),calcium,phosphate,calcium-phosphate product,intact parathyroid hormone (iPTH),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),albumin (Alb),high sensitive C-reactive protein (hs-CRP),and so on were detected.Results The level of serum adiponectin in MHD group [(15.00 ± 7.47) mg/L] was significantly higher than that in control group [(2.07 ± 0.83) mg/L],and there was significant difference (P＜ 0.01).Coronary artery calcification(CACS ＞ 0 score) was observed in 88.9％ (24/27) in MHD group and 10/13 in control group.The mean CACS in MHD group was significantly higher than that in control group [655 (0-3 570) scores vs.126 (0-731)scores],and there was significant difference (P ＜ 0.05).Eleven MHD patients and 1 healthy person had severe coronary artery calcifications,(CACS ≥ 400 scores).There was significan t difference in dialysis duration,diastolic pressure,phosphate calcium-phosphate product and adiponectin (P ＜ 0.05 or ＜ 0.01).Spearman analysis showed that CACS of MHD patients was positively correlated with dialysis duration,phosphate,calcium-phosphate product,serum creatinine and adiponectin (P ＜ 0.01 or ＜ 0.05).Only calcium-phosphate product remained as independent predictor of CACS in multivariate analysis (P ＜0.01).Conclusion Coronary artery calcification is common in MHD patients and which is correlated with dialysis duration,serum phosphate,calcium-phosphate product,serum creatinine and adiponectin.

Objective To analyze the cerebral autoregulation capability in patients with chronic insomnia disorder (CID).Methods Sixty CID patients (54 with generalized anxiety disorder) and 40 healthy controls were enrolled in this study.Polysomnography was done in all the participants.Noninvasive continuous cerebral blood flow velocity of bilateral middle artery and arterial blood pressure were recorded simultaneously using transcranial Doppler and a servo-controlled plethysmograph.Transfer function analysis was used to derive the autoregulatory parameters, including phase difference and coherence function.Results The phase difference values of CID patients with generalized anxiety disorder were significantly lower than that of the healthy controls ((46.89±15.39)°vs (56.00±12.05)°, t=3.439, P=0.001).In the correlation analysis, we further found that there was no correlation among phase difference values and the score of Hospital Anxiety and Depression scale.Conclusions The dynamic cerebral autoregulation was compromised in CID patients with generalized anxiety disorder regardless of the degrees of anxiety and depression.Dynamic cerebral autoregulation may be a potential therapeutic target in improving neurological symptoms in patients with CID.

Objective: To understand the energy and major nutrients intake of high school students in Shanghai, and to provide basis for formulating target nutritional interventions and health education. Methods: The probability-proportional-to-size sampling technique was used to select 19 high schools, from which 9 boys and 9 girls from same class were randomly recruited for each grade. A total of 900 high school students were surveyed on their energy and major nutrients intake. Results: The medians of intake of energy, protein, fat, carbohydrate, calcium, sodium, iron, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber were 2 353 kcal/d, 97.3 g/d, 95.4 g/d, 265.4 g/d, 602.1 mg/d, 4 373 mg/d, 24.3 mg/d, 495.6 μgRE/d, 1.08 mg/d,1.21 mg/d, 83.2 mg/d and 1.01 g/d, respectively. Among of them, the medians of intake of energy, calcium, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber for boys and girls were lower than reference standard(P<0.05). The medians of intake of energy and major nutrients in high school students who lived in countryside were less than those lived in suburban and urban(P<0.05), except carbohydrates and iron. The percentages of energy supplied byprotein, fat and carbohydrate were 16.9%, 37.2%and 46.0%, respectively. Conclusion The energy and calorigenic nutrients intake can meet the demand of daily consumption in high school students in Shanghai, but the intake of dietary fiber, some minerals and vitamins have a various degrees of deficiency. The proportion of energy supplied bycalorigenic nutrients is unbalanced.

Objective:To analyze the molecular characteristics of Echovirus 11 (Echo11) strains isolated in Xiangyang, Hubei Province from 2016 to 2017 based on the sequences of VP1 gene.Methods:Rectal and throat swab specimens were collected from children with hand, foot and mouth disease (HFMD) in Xiangyang from 2016 to 2017. Echo11 strains were detected by real-time reverse transcriptase PCR (RT-PCR) and isolated after cultured in human rhabdosarcoma (RD) cells. The VP1 regions of Echo11 strains isolated from RD cells and the whole genomes of three representative Echo11 strains were amplified by conventional RT-PCR and the sequences were analyzed. DNAStar7.0 (MegAlign) and MEGA6.0 (Data) were used to analyze the homology and mutation sites in nucleotide and amino acid sequences. Neighbor-joining method was used to construct phylogenetic trees. Recombination analysis was performed with SimPlot software (BootScanning).Results:A total of 11 Echo11 strains were isolated from 3 494 HFMD cases, accounting for 0.31%. They were highly homologous in the VP1 gene. These strains shared 98.4%-100.0% homology in nucleotide sequences and 98.3%-100.0% homology in amino acid sequences. The homology between the 11 Echo11 strains and the prototype strain (Echo11/Gregory, X80059) was 73.9%-74.8% in nucleotide sequences and 87.7%-88.7% in amino acid sequences. All of the Echo11 strains circulating in Xiangyang were classified into lineage D, having a similarity to the strains circulating in some regions of mainland China since 2013. In multiple regions of the genome, the Echo11 strains isolated in Xiangyang were highly similar to the Henan Echo1 strains in 2010 and the Hubei Echo6 strains in 2015, suggesting there was recombination within the genome of Echo11 strains in Xiangyang.Conclusions:The Echo11 strains circulating in Xiangyang from 2016 to 2017 belonged to lineage D and were recombinant strains.