Diverse phenotype of Méenière’s disease associated with family history,thyroid disorder,migraine and associated disorders

Objective:To better understand the clinical phenotype of Méenière’s disease(MD),we examined family history,thyroid disorder,migraine,and associated disorders in complaints of people living with MD.Method:We designed the study as a retrospective and examined data gathered from 912 participants with MD.Their data were originally collected by the Finnish M′eni`ere Federation(FMF).The survey data included individual case histories for environmental factors,comorbidities,disease-specific complaints,impact-related questions,cognitive complaints,health-related quality of life(HRQoL),and sense of coherence(SOC).Results:We observed significant differences between those with and without sporadic occurrence,family history,thyroid disorder,and migraine-associated complaints.Family history explained 20%of variability in patient complaints.Patients with a family history of MD whose disease started at younger age experienced balance problems,more severe vertigo spells,more severe vestibular drop attacks(VDA),and less nausea,although they had good SOC.Thyroid disorder explained 14%of variability in patient complaints.MD patients with a thyroid disorder comorbidity suffered more often from constant dizziness,balance problems,greater impact of hearing problems,cognitive complaints,and poor HRQoL.Migraine explained 12%of variability in patients’complaints and was associated with poor SOC and cognitive balance problems.MD patients with both thyroid disorder and migraine used antidepressants more often than other groups.Logistic regression analysis showed comorbidities of ischemic brain disorder(among 7.1%),kidney insufficiency(among 1.2%),and diabetes(among 7.3%)had statistically significant but restricted association with balance and gait problems,VDA,and reduced HRQoL.Conclusions:Family history of MD and thyroid disorder or migraine comorbidities in MD influence the complaint pattern and partially explain complex symptom profiles,including symptoms of cognitive problems.Confounders play a minimal role in complaint profile and impact of MD whereas comorbidities influence the complaint structure and partly explain the complex symptom profile in MD.

The impact of family history of hepatocellular carcinoma on its patients' survival

BACKGROUND:Family history of hepatocellular carcinoma(HCC) has been identified as a risk factor for the development of the disease.The aim of this study is to evaluate the impact of such a history on HCC patients’ survival.METHODS:Data of all HCC patients(n=4532) managed at our center from 1989 to 2008 were prospectively collected.The patients were quizzed on their various characteristics including family HCC history.RESULTS:Totally 475(10.48%) patients had a family history of HCC.They presented the disease at a significantly earlier age(median 53 vs 59 years,P<0.0001) and at an earlier stage(the United Network for Organ Sharing staging system).They had significantly better liver function in terms of ChildPugh classification and serum albumin and bilirubin levels.Significantly more of them presented the disease without symptoms(44.0% vs 29.4%,P<0.0001).They also had significantly better overall survival under these specifications:patients in the whole study cohort,patients who had minor hepatectomy,patients with stage I disease,patients with stage II disease,and patients with stage III disease.CONCLUSIONS:Contrary to what is generally believed,we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a history.We believe this was in part due to earlier diagnosis of the disease and better liver function in this group of patients.However,the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified.

Comparison of patients by family history with gastric and non-gastric cancer

AIM:To compare the gastric cancer(GC) patients by their family history with gastric and non-GC.METHODS:Positive family histories within seconddegree relatives and clinicopathological features were obtained for 256 patients.RESULTS:Of the 256 probands,112(76 male,36 female) were incorporated into familial GC(FGC) group:at least two GC members;144(98 male,46 female) were included in the non-FGC group(relatives only affected with non-GCs).Of 399 tumors in relatives(181 from FGC against 212 from non-FGC),GC was the most frequent,followed by esophageal,hepatocellular,and colorectal cancer.Nasopharyngeal cancer was next to lung cancer but prior to breast and urogenital cancers.Most affected members aggregated within first-degree relatives(FGC:66 siblings,48 fathers,31 mothers,four offspring;non-FGC:56 fathers,55 siblings,43 mothers,and 15 offspring).The ratio of males to females in affected first-degree relatives was usually higher in male probands.Paternal history of GC was a slight risk for GC in males(OR = 1.19,95% CI:0.53-2.69),while risk of GC by maternal history of non-GCs was increased in females(OR = 0.46,95% CI:0.22-0.97).Diffuse-GC was the major histological type in all subgroups.Difference in tumor sites between thetwo groups was derived from an excess of upper sites in non-FGC female probands.CONCLUSION:Distribution of associated non-GCs in a family history of GC may vary with geographic areas.GC may have different genetic and/or environmental etiology in different families,and a certain subtype may be inherited in a female-influenced fashion.

Family history and disease outcomes in patients with Crohn's disease:A comparison between China and the United States

AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn's disease(CD) residing in China and the United States.METHODS We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States.We compared the prevalence of IBD family history and history of ileal involvement,CD-related surgeries and IBD medications in China and the United States,adjusting for potential confounders.RESULTS We recruited 49 participants from China and 145 from the United States.The prevalence of family history of IBD was significantly lower in China compared with the United States(China:4.1%,United States:39.3%).The three most commonly affected types of relatives were cousin,sibling,and parent in the United States compared with child and sibling in China.Ileal involvement(China:63.3%,United States:63.5%) and surgery for CD(China:51.0%,United States:49.7%) were nearly equivalent in the two countries.CONCLUSION The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States.Despite the potential difference in etiology,surgery and ileal involvement were similar in the two countries.Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.

Family history influences the early onset of hepatocellular carcinoma

AIM: To evaluate the relationship between a positive family history of primary liver cancer and hepatocellular carcinoma (HCC) development in Korean HCC patients. METHODS: We studied a total of 2242 patients diagnosed with HCC between January 1990 and July 2008, whose family history of primary liver cancer was clearly described in the medical records.positive family history of HCC and 2077 (92.6%) did not. The male to female ratio was 3.6:1, and the major causes of HCC were chronic hepatitis B virus (HBV) infection in 75.1%, chronic hepatitis C virus infection in 13.2% and alcohol in 3.1%. The median ages at diag- nosis in the positiveand negative-history groups were 52 years (range: 29-79 years) and 57 years (range: 18-89 years), respectively (P < 0.0001). Furthermore, among 1713 HCC patients with HBV infection, the number of patients under 45 years of age out of 136 patients with positive family history was 26 (19.1%), whereas those out of 1577 patients with negative family history was 197 (12.5%), suggesting that a positive family history may be associated with earlier development of HCC in the Korean population (P = 0.0028). CONCLUSION: More intensive surveillance maybe recommended to those with a positive family history of HCC for earlier diagnosis and proper management especially when HBV infection is present.

Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain

AIM： To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain （RAP） or irritable bowel syndrome （IBS）. METHODS： A group of 67 children with RAP referred to the department from January 1986 to December 1995 was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview. We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history oflBS in comparison with adults with no persistent abdominal complaint. RESULTS： Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up （29%） whereas the majority （37 subjects） did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining （40.0% vs 16.0%）, respectively （P 〈 0.05 at Student t test）. Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances. CONCLUSION： The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms, possibly through the learning of a specific illness behavior.

Combined Effects of Family History of Cardiovascular Disease and Serum C-reactive Protein Level on the Risk of Stroke: A 9.2-year Prospective Study among Mongolians in China

Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Methods A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels. Results We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio（HR） of 1.78 [95% confidence interval（CI）, 1.03‐3.07; P = 0.039] of stroke, and an HR of 2.14（95% CI, 1.09‐4.20; P = 0.027） of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant（all P 〉 0.05）. Conclusion Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.

Family history of cancer in Chinese gastric cancer patients

Objective:The aim of the study was to investigate the influence of gastric cancer family history in the gastric cancer (GC) patients. Methods: Gastric cancer family histories within second degree relatives and clinicopathological features were obtained for 497 patients. Results:Of the 497 probands,235 probands were incorporated into familial gastric cancer (FGC) group (there were at least two GC members in the family); 262 probands were included in the non-FGC group (relatives only affected with non-GCs). Of 614 tumors in relatives,GC was the most frequent,followed by lung cancer,esophageal cancer,hepatocellular cancer,colorectal cancer,urogenital cancer,breast cancer,and pancreatic cancer. Most affected members aggregated within first-degree relatives. The ratio of males to females in affected first-degree relatives was usually higher in male probands. Paternal history of GC was a strong risk for GC in males,while risk of GC by maternal history of GCs was increased in females. Difference in tumor histological types between the two groups was derived from an excess of diffuse GC in non-FGC male probands. The lower site was the most frequent tumor location in all subgroups. Conclusion:Distribution of associated non-GCs in a family history of GC may vary with geographic areas. GC may have different genetic and/or environmental etiology in different families,and a certain subtype may be inherited in a male-influenced fashion.

Depressed-type (0-IIc) colorectal neoplasm in patients with family history of first-degree relatives with colorectal cancer:A cross-sectional study

AIM： TO investigate the correlation of depressed-type （0-IIc） colorectal neoplasm and family history of firstdegree relatives （FDR） with colorectal cancer （CRC）. METHODS： This cross-sectional study was conducted from June 2000 to October 2002 at National Cancer Center Hospital East. Eligible patients undergoing initial total colonoscopy were surveyed regarding family history of CRC among FDR by a questionnaire prior to colonoscopic examinations. All endoscopic findings during colonoscopy were recorded and the macroscopic classification of the early stage neoplasm/cancer was classified into two types （0-IIc vs non 0-IIc）. Odds ratios （OR） and 95% confidence intervals （CI） were calculated by univariate and multivariate logistic regression to estimate the association between macroscopic features and clinicopathological data including gender, age, and family history of FDR with CRC. RESULTS： The OR of an association between family history of FDR with CRC and overall early stage neoplasm adjusted by gender and age was 1.85 （95% CI： 1.31-2.61, P = 0.0004）, that for non 0-IIc neoplasm was 1.71 （95% CI： 1.22-2.41, P = 0.0017） and for 0-IIc colorectal neoplasm was 2.78 （95% CI： 1.49-5.16, P = 0.0031）. CONCLUSION： Our study shows a significant association between a family history of FDR with CRC and 0-IIc colorectal neoplasm. When patients with a family history of FDR with CRC undergo colonoscopy, colonoscopists should check carefully for not only polypoid, but also depressed-type （0-IIc） lesions.

Prevalence of Family History of Cancer among Gastric Cancer Patients at Brazilian National Cancer Institute

Background: Gastric cancer is the third most incident malignancy and the fifth leading cause of death in the world. In Brazil, it is the fourth most common tumour in men and the fifth in women. Familial aggregation of this tumour is being studied and discussed by experts. Aim: Determine the frequency of family history of cancer in patients with gastric cancer, suggesting familial aggregation or increased risk for hereditary cancer syndromes. Methods: This is a retrospective cross-sectional study carried out from January 2011 to March 2015 at the Department of Abdominal and Pelvic Surgery of the Brazilian National Cancer Institute (INCA). Data were collected from electronic medical records and analyzed using SPSS Statistics? version 20. Results: 873 patients with gastric adenocarcinoma were analyzed. A family history of cancer was reported by 451 patients (51.6%), which reported cancer in 878 relatives, of which 110 (12.6%), reported having more than three relatives with any type of cancer. The most prevalent malignancies among these relatives were gastric cancer (21.3%) and breast cancer (9.5%). Conclusion: Most of the patients had cancer family history, being gastric cancer the most common. The high percentage of cancer family history confirms the importance of collecting this information, whose lack reflects professional negligence, as family history study can serve as a low-cost tool, favoring prevention and early diagnosis, situations where morbidity and mortality are smaller, thus reducing health costs and assistance and preserving lives.

Analysis on Family History of Diabetes, Weight Gain during Pregnancy and Pre-pregnancy Body Mass Index on 82 Pregnant Women with Gestational Diabetes Mellitus

Objective:To investigate the effects of family history of diabetes mellitus,Gestational Weight Gain(GWG)and Body Mass Index(BMI)before pregnancy on Gestational Diabetes Mellitus(GDM).Method:82 pregnant women with GDM who were hospitalized and delivered in the obstetrics department of our hospital from September 2017 to September 2019 were selected as the observation group,and 60 pregnant women with normal glucose tolerance test in the same period were selected as the control group;The relationship between family history of diabetes,weight gain during pregnancy and pre-pregnancy Body Mass Index and GDM were analyzed.Results:The age,pre-pregnancy weight and weight gain during pregnancy were significantly higher in the observation group than in the control group(P<0.05),and the family history of diabetes and pre-pregnancy Body Mass Index were higher in the observation group than in the control group(P<0.05),and the differences were statistically significant.Conclusion:It is suggested that family history of diabetes is related to gestational diabetes mellitus.Excessive GWG growth during pregnancy and high Body Mass Index before pregnancy may increase the risk of gestational diabetes mellitus in pregnant women.

Multiple lentigines syndrome with positive family history:a case report and review of the literature

Multiple lentigines syndrome is an autosomal dominant genetic disease,and its expressivity and penetrance are variable.It is also known as LEOPARD syndrome(LS).The genes known to be associated with LS include PTPN11,RAF1 and BRAF.The diagnosis of LS(OMIM 151100)is based on the observation of key features in the clinical background.LS caused by a germline PTPN11 mutation are characterized as multisystemic anomalies and variable marked phenotypes such as multiple lentigines and cafénoir spots,electrocardiographic conduction abnormalities,ocular hypertelorism/obstructive cardiomyopathy,pulmonary stenosis,abnormal genitalia,retardation of growth,and deafness.Phenotype overlap complicates clinical discrimination within RASopathies,making the diagnosis of LS more confusing and challenging.Besides,LS patients do not usually present with all these typical clinical features,increasing the possibility of underdiagnosis or misdiagnosis.Herein,we report a case of a 41-year-old male presenting with multiple dark pigmented macules all over the body,thoracic deformity and family history.And we followed up the patients.

The Application of Newmark’s Metaphor Theory in Novel Translation--A Case Study of“the Jade King:History of a Chinese Muslim Family”

This paper examines the metaphorical part of“The Jade King:History of a Chinese Muslim Family”,Hoda’s novel,under the guidance of Newmark’s theory of metaphor.Newmark proposes six categories of metaphors,namely Dead Metaphor,ClichéMetaphor,Stock or Standard Metaphor,Adapted Metaphor,Recent Metaphor,Original Metaphor;and seven strategies of metaphor translation,including reproducing the same image in the target language,replacing the image in the source language with a standard target language image,translation of metaphor by simile,translation of metaphor(or simile)by simile plus sense,conversion of metaphor to sense,deletion and same metaphor combined with sense.They can provide a strong theoretical support for analyzing the expressions of metaphors in novels and their translation methods.By deeply analyzing the expressions of metaphor and its translation methods in novels,it not only helps to understand the metaphorical meaning and cultural connotation of the original works,but also helps to explore the cultural differences and challenges faced by English and Chinese bilingualism in the process of metaphor translation,thereby significantly improving the translation level and promoting the development of translation research.

Younger age of onset and multiple primary lesions associated with esophageal squamous cell carcinoma cases with a positive family history of the cancer suggests genetic predisposition

Background Previous epidemiological studies have consistently found a positive family history of esophageal cancer is associated with a significantly increased risk of the cancer.However,whether the elevated risk could be attributed to common household exposure or inherited susceptibility is uncertain.This study aimed to highlight the effect of genetic predisposition by noting the significant differences in onset age and multiple primary cancers between esophageal squamous cell carcinoma （ESCC） cases with or without a positive family history of the cancer.Methods Age at onset and the percentage of multiple primary cancers were compared between ESCCs with （n=766） or without （n=1 776） a positive family history of the cancer in a consecutive surgery cohort at the Department of Thoracic Surgery of Hebei Tumor Hospital and the Fourth Hospital of Hebei Medical University.Results Overall,ESCCs with a positive family history of the cancer featured both a significantly younger age of onset and significantly more multiple primary cancers than those with a negative family history （onset age 51.83 vs.53.49 years old,P 〈0.01; percent of multiple primary cancers 5.50% vs.1.70%,x2=25.42,P 〈0.01）.Both the differences were evident in subgroup analyses,but did not correlate.While age at onset differed significantly by family history among the male,smoking,and drinking groups,the difference of multiple primary cancers was significant among the otherwise nonsmoking,nondrinking,and younger onset age groups.Conclusions Younger age of onset and multiple primary cancers associated with ESCCs with a positive,as opposed to a negative family history of the cancer,suggest a genetic predisposition.The results of subgroup analyses indicate a younger age of ESCC development results from the interaction of environmental and genetic risk factors,but multiple primary cancers may be related only to genetic predisposition.

Associations between cancer family history and esophageal cancer and precancerous lesions in high-risk areas of China

Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been comprehensively reported in recent years.This study aimed to provide evidence for identification of high-risk populations.Methods:This study was conducted in five high-risk areas in China from 2017 to 2019,based on the National Cohort of Esophageal Cancer.The permanent residents aged 40 to 69 years were examined by endoscopy,and pathological examination was performed for suspicious lesions.Information on demographic characteristics,environmental factors,and cancer family history was collected.Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.Results:Among 33,008 participants,6143(18.61%)reported positive family history of EC.The proportion of positive family history varied significantly among high-risk areas.After adjusting for risk factors,participants with a family history of positive cancer,gastric and esophageal cancer or EC had 1.49-fold(95%confidence interval[CI]:1.36-1.62),1.52-fold(95%CI:1.38-1.67),or 1.66-fold(95%CI:1.50-1.84)higher risks of ECPL,respectively.Participants with single or multiple first-degree relatives(FDR)of positive EC history had 1.65-fold(95%CI:1.47-1.84)or 1.93-fold(95%CI:1.46-2.54)higher risks of ECPL.Participants with FDRs who developed EC before 35,45,and 50 years of age had 4.05-fold(95%CI:1.30-12.65),2.11-fold(95%CI:1.37-3.25),and 1.91-fold(95%CI:1.44-2.54)higher risks of ECPL,respectively.Conclusions:Participants with positive family history of EC had significantly higher risk of ECPL.This risk increased with the number of EC positive FDRs and EC family history of early onset.Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.Trial registration:ChiCTR-EOC-17010553.

Chronic complications risk among type 2 diabetes patients with a family history of diabetes

Family history of diabetes(FH+)has been associated with early metabolic alteration including insulin resistance,lipid metabolism,and ectopic fat accumulation even in healthy individuals.1-3 Furthermore,normoglycemic firstdegree relatives of type 2 diabetes mellitus(T2DM)have been documented having increased carotid intimamedia thickness_and pro-inflammatory cytokines.4.s Taken together,individuals with FH+,who were otherwise healthy,have shown to possess susceptibility for diabetes mellitus(DM)chronic complication.Hence,this study aimed to investigate whether FH+increased the risk of chronic complications in patients with overt T2DM.

Family history of esophageal cancer modifies the association of serum lipids and malignant esophageal lesions:a nested case-control study from the"Endoscopic Screening for Esophageal Cancer in China"trial

Background:The association of lipids and cancer has varied greatly among different cancer types,lipid components and study populations.This study is aimed to investigate the association of serum lipids and the risk of malignant lesions in esophageal squamous epithelium.Methods:In the"Endoscopic Screening for Esophageal Cancer in China"(ESECC)trial,serum samples were collected and tested for total cholesterol(TC),triglycerides,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol at the time of subject enrollment.Cases were defined as malignant esophageal lesions identified by baseline endoscopic examination or by follow-up to May 31,2018.Controls were randomly selected using incidence density sampling in the same cohort.Conditional logistic models were applied to identify the association of serum lipids and the risk of malignant esophageal lesions.Effect modification was evaluated by testing interaction terms of the factor under assessment and these serum lipid indicators.Results:No consistent association between serum lipid levels and esophageal malignant lesions were found in a pooled analysis of 211 cases and 2101 controls.For individuals with a family history of esophageal cancer(EC),high TC,and LDL-C were associated with a significantly increased risk of having malignant lesions(odds ratio[OR]Highvs.Low TC=2.22,95%confidence interval[CI]:1.14-4.35;ORHighvs.Low LDL-C=1.93,95%CI:1.01-3.65).However,a negative association was observed in participants without an EC family history(ORHighvs.Low TC=0.69,95%CI:0.48-0.98,Pinteraction=0.002;ORHighvs.Low LDL-C=0.50,95%CI:0.34-0.76,Pinteraction<0.001).Conclusions:In this study,we found that the association of serum lipids and malignant esophageal lesions might be modified by EC family history.The stratified analysis would be crucial for population-based studies investigating the association of serum lipids and cancer.The mechanism by which a family history of EC modifies this association warrants further investigation.

A comparison of genetic risk score with family history for estimating prostate cancer risk

Prostate cancer （PCa） testing is recommended by most authoritative groups for high-risk men including those with a family history of the disease. However, family history information is often limited by patient knowledge and clinician intake, and thus, many men are incorrectly assigned to different risk groups. Alternate methods to assess PCa risk are required. In this review, we discuss how genetic variants, referred to as PCa-risk single-nucleotide polymorphisms, can be used to calculate a genetic risk score （GRS）. GRS assigns a relatively unique value to all men based on the number of PCa-risk SNPs that an individual carries. This GRS value can provide a more precise estimate of a man＇s PCa risk. This is particularly relevant in situations when an individual is unaware of his family history. In addition, GRS has utility and can provide a more precise estimate of risk even among men with a positive family history. It can even distinguish risk among relatives with the same degree of family relationships. Taken together, this review serves to provide support for the clinical utility of GRS as an independent test to provide supplemental information to family history. As such, GRS can serve as a platform to help guide-shared decision-making processes regarding the timing and frequency of PCa testing and biopsies.

Changes of insulin resistance and plasma levels of Ang Ⅱ and NO in normal offspring with a family history of es sential hypertension

Backgound Essential hypertension （EH） is a polygenic inheritable disease,generally known as a combined result of genetic and environmental elements.It is possible that IR、AngiotensinⅡ（AngⅡ） and NO play important roles in the pathogenesis of EH.Methods Sixty normal subjects with a family history of EH,aged 30 to 40 years old,were recruited and randomized into two groups：30 with one parent and 30 with both parents with EH,and 30 subjects without family history of EH as controls.The plasma level of NO was determined by electrophotometer while the plasma level of fast insulin （FINS） and AngⅡ were determined by radioimmuno-assay,and insulin resistance index （IRI） was calculated.Results ① The plasma levels of FINS,AngⅡ,NO increased significantly in study groups compared with those in the control group（P 0.01）,while there were no differences in the levels of AngII,NO between the two study groups （P 0.05）.② The plasma level of AngII were positively correlated with that of NO（r=0.378,P 0.01）.Conclusions The higher levels of IR and plasma AngII and NO exist before the development of EH in normal offspring with a family history of EH,and maybe they are initial agents in the pathogenesis of EH.It indicates that the people with IR and high levels of plasma AngⅡand NO with a family history of EH are at higher risk to develop EH.

Family Health History and Behavioral Change among Undergraduate Students: A Mixed Methods Study

Background: We examined family health history (FHH) as a public health intervention tool in undergraduate students. We hypothesized that the FHH assignment would positively relate to students’ FHH knowledge and health and healthcare-seeking behavioral change. Methods: Health professional students’ (n = 103) pre/post-test surveys and research papers were collected in 2011-2012, from a mid-western and southern university in the United States of America, using mixed methods research. Results: The majority of students were aged 18 - 30, women, White, had healthcare access and health insurance, and awareness of the term FHH. Significant logistic regression relationships existed between: 1) helping students understand important strengths and weaknesses in their health and quality of life and outcomes of talking with family and doctors about FHH;and 2) improving students’ understanding of what they needed to do to maintain their health and the outcome statement “FHH tells you about inherited genes.” Key themes from the research papers included actions and FHH and proposed behavioral changes. Conclusions: Quantitative findings supported the relationship between students’ assignment evaluation and knowledge change, while qualitative findings supported relationships between assignment evaluation and knowledge and behavioral change. This study highlights regional differences in students’ FHH and the need to address family support barriers to behavioral change.