Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study

BACKGROUND

The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched.

OBJECTIVE

We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents.

METHODS

A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as △) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent-adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of △SFUI with △CES-D and the association of △EFUI with △CES-D were tested using hierarchical regression models.

RESULTS

The association between △SFUI and △CES-D was partially mediated by △mother-adolescent conflict (mediation effect size 5.11%, P=.02) and △social nonconfidence (mediation effect size 20.97%, P<.001) but partially suppressed by △friendship quality, △perceived family support, and △perceived friend support, with suppression effects of -0.011 (P=.003), -0.009 (P=.003), and -0.022 (P<.001), respectively. The association between △EFUI and △CES-D was partially mediated by △social nonconfidence (mediation effect size 30.65%, P<.001) but partially suppressed by △perceived family support and △perceived friend support, with suppression effects of -0.036 (P<.001) and -0.039 (P<.001), respectively.

CONCLUSIONS

The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother-adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents.

[Mechanism of scavenger receptor-A in high glucose-induced inflammatory injury of mesangial cells]

Objective: To investigate the effect of high glucose on scavenger receptor-A (SR-A) in human glomerular mesangial cells (HMC) and explore the mechanism of inflammatory injury mediated by SR-A in HMC cultured in high-glucose medium. Methods: According to the concentration of D-glucose in culture medium, HMC were divided into normal glucose group (5.5 mmol/L) and high glucose group (30 mmol/L), with mannitol group as hypertonic control. High glucose group was transfected with SR-A small interfering RNA (siSR-A) and the transfection control (siNC) group were set up. Western blotting technology was used to detect the levels of SR-A, NOD-like receptor family pyrin domain-containing 3 (NLRP3), interleukin-1β (IL-1β) protein. Immunofluorescent staining was applied to measure the SR-A in HMC. The mRNA of NLRP3, Caspase-1, IL-1β, FN, ColⅣ, α-SMA and GRP78 were detected by real-time quantitative PCR. The relative activity of Caspase-1 was detected by enzyme method and the concentration of IL-1β in culture medium was detected by enzyme linked immunosorbent assay. Flow cytometry was used to measure the cell cycles of HMC. One-way ANOVA and SNK-q test were used for statistical analysis. Results: The protein level of SR-A in high glucose group was higher than that in normal glucose group and mannitol group (1.23±0.21 vs. 0.68±0.10, 1.23±0.21 vs. 0.78±0.13, all P<0.05). In addition, mean fluorescence intensity of SR-A, protein levels of NLRP3 and IL-1β, mRNA of NLRP3, Caspase-1 and IL-1β, relative activity of Caspase-1 as well as the concentration of IL-1β in high glucose group were all significantly higher than those in normal glucose group and mannitol group (all P<0.05).After transfection induced silencing, SR-A protein in high glucose siNC group was higher than that in high glucose siSR-A group and normal glucose siNC group (1.23±0.10 vs. 0.20±0.01, 1.23±0.10 vs. 0.87±0.01, all P<0.01). In high glucose siNC group, the NLRP3, IL-1β proteins, the NLRP3, Caspase-1 and IL-1β mRNA, all of the mRNA levels of FN, ColⅣ, α-SMA, GRP78 and the proportion of DNA synthesis phase were all higher than those in high glucose siSR-A group and normal glucose siNC group (all P<0.05). Conclusion: High glucose can promote abnormal cell proliferation, increase mesangial matrix production and enhance oxidative stress response through upregulating SR-A expression, and ultimately aggravate cellular inflammatory damage in HMC, which may be associated with NLRP3-Caspase-1-IL-1β pathway regulated by SR-A expression.

[Associations between pre-pregnancy body mass index and occurrence and clinical features of preeclampsia]

Objective: To investigate the associations between pre-pregnancy body mass index (BMI) and occurrence and clinical features in pregnant women complicated by preeclampsia (PE). Methods: We recruited 42 427 pregnant women who were diagnosed with intrauterine pregnancy at Shenzhen Maternity and Child Healthcare Hospital from July 2017 to December 2019, with a gestational age of 6~8⁺⁶ weeks, excluding those with basic diseases and incomplete medical records. Among them, 659 were diagnosed with PE. According to the pre-pregnancy BMI, the pregnant women were divided into underweight group (42 cases), normal body weight group (422 cases), overweight group (138 cases) and obesity group (57 cases). Maternal outcomes (the occurrence of preeclampsia, cesarean delivery rate) and neonatal outcomes (birth weight, Apgar score and neonatal ICU admission) were recorded. The maternal outcomes, gestational age of delivery, delivery mode, newborn birth weight, Apgar score and admission to neonatal ICU were compared among the pregnant women in each group. Logistic regression model was established to analyze the influence of different pre-pregnancy BMI on the occurrence and clinical features of PE. Results: The incidence of PE was 1.55% (659/42 427), and the incidence of PE was 0.61% (42/6 941), 1.44% (422/29 297), 2.62% (138/5 273) and 6.22% (57/916) in the underweight group, the normal weight group, the overweight group and the obesity group, respectively. After adjustment for age, parity, educational level, history of preeclampsia, and in vitro fertilization and embryo transfer (IVF-ET), compared with normal group, the adjusted OR for developing early-onset PE were 0.57 (95%CI: 0.29-1.02) for underweight, 1.03 (95%CI: 0.65-1.56) for overweight and 2.15 (95%CI: 1.03-4.02) for obesity groups. The OR for developing late-onset PE were 0.50 (95%CI: 0.33-0.72) for underweight, 1.57 (95%CI: 1.23-1.99) for overweight and 4.25 (95%CI: 3.00-5.91) for obesity group. The OR for PE without severe features were 0.54 (95%CI: 0.30-0.89), 1.40 (95%CI: 0.97-1.99) and 5.11 (95%CI: 3.22-7.84) for underweight, overweight and obesity groups, respectively. The OR for severe PE were 0.51 (95%CI: 0.33-0.75), 1.42 (95%CI: 1.10-1.83) and 2.97 (95%CI: 1.95-4.38) for underweight, overweight and obesity groups, respectively. The median neonate birth weight in women with PE were 2 420 g (1 602-2 845 g), 2 435 g (1 692-3 030 g), 2 540 g (1 922-3 132 g), and 2 950 g (2 050-3 360 g) for underweight, normal, overweight and obesity groups, respectively. The neonatal birth weight in obesity group was heavier than that in normal group (P<0.05). The incidence rates of large for gestational age (LGA) in PE women were 0 (0/42), 3.3% (14/422), 7.3% (10/138) and 17.5% (10/57) for underweight, normal, overweight and obesity groups, respectively. The incidence rate of LGA in obesity group was higher than that in normal group (P<0.05). Conclusions: Pre-pregnancy obesity is an independent risk factor for PE. Obesity related PE is more likely associated with late-onset PE and LGA. It is recommended to control weight before pregnancy, limit weight gain during pregnancy and control blood pressure to reduce the incidence of PE and ensure the safety of mother and child.

[C-reactive protein and direct bilirubin as the early diagnostic indicators of primary hepatocellular carcinoma combined with macrovascular invasion]

Objective: To explore the early clinical diagnostic indicators in patients with primary hepatocellular carcinoma (HCC) combined with macrovascular invasion. Methods: The clinical data of 180 cases of HCC diagnosed by histopathology examination in the Second Affiliated Hospital of Chongqing Medical University from 2012 to 2019 were retrospectively analyzed. The factors influencing the development of macrovascular invasion in HCC patients were analyzed. The receiver operating characteristic curve (ROC curve) was used to evaluate the sensitivity and specificity. Results: Serum C-reactive protein (CRP) level was significantly correlated with various clinical characteristics of HCC patients, including the maximum tumor diameter, tumor number, and macrovascular invasion. Further analysis of the risk factors showed that serum direct bilirubin and CRP were independent risk factors for macrovascular invasion in HCC patients, with odds ratios of 1.747 (95% CI 1.119-2.728, P = 0.014) and 2.376 (95% CI 1.495-3.775, P < 0.001). ROC curve analysis showed that serum CRP, direct bilirubin, and the combination of the both had certain diagnostic value for hepatocellular carcinoma combined with macrovascular invasion. The area under the curve, sensitivity and specificity was 0.724, 0.668, 0.743, 79.1%, 70.1%, 79.1%, and 61.9%, 62.8%, 67.3%, respectively. Conclusion: The combination of CRP with direct bilirubin can be used as an important clinical diagnostic indicator for early diagnosis and prevention of hepatocellular carcinoma combined with macrovascular invasion.

[Clinical analysis of 30 cases with asbestos-related occupational tumors]

Asbestos is classified as a Class 1 carcinogen by the International Cancer Organization (IARC) , and almost all types of asbestos are carcinogenic. The clinical data of 30 asbestos-induced occupational tumor patients in Qingdao city from January 2002 to May 2019 were analyzed, including 24 cases of asbestos-induced lung cancer and 6 cases of asbestos-induced malignant mesothelioma. Mesothelioma was significantly worse than lung cancer in terms of malignancy, the survival time of patients is shorter, and the mortality rate was higher. Both its diagnostic methods and treatment methods should be improved. The high incidence of asbestos-caused tumors is coming. It is recommended that workers exposed to asbestos dust should undergo regular chest CT examinations for early detection, early diagnosis and early treatment.

[Establishment and implementation of hepatitis C screening and referral channels in the hospitals]

Discovering and treating potential hepatitis C infections has become an important strategy to eliminate hepatitis C in China. Currently, the rate of screening and misdiagnosis of hepatitis C antibodies in Chinese hospitals is high, but the rate of physician consultation is low. Therefore, with the cooperation of multiple departments of the hospital, the establishment and implementation of hepatitis C screening and referral channels can effectively improve the diagnosis, referral and treatment rate of hepatitis C patients. This article summarizes the recent research progress of hepatitis C screening and referral in the hospitals.

Classification of probable online social networking addiction: A latent profile analysis from a large-scale survey among Chinese adolescents

BACKGROUND AND AIMS

Problematic online social networking use is prevalent among adolescents, but consensus about the instruments and their optimal cut-off points is lacking. This study derived an optimal cut-off point for the validated Online Social Networking Addiction (OSNA) scale to identify probable OSNA cases among Chinese adolescents.

METHODS

A survey recruited 4,951 adolescent online social networking users. Latent profile analysis (LPA) and receiver operating characteristic curve (ROC) analyses were applied to the validated 8-item OSNA scale to determine its optimal cut-off point.

RESULTS

The 3-class model was selected by multiple criteria, and validated in a randomly split-half subsample. Accordingly, participants were categorized into the low risk (36.4%), average risk (50.4%), and high risk (13.2%) groups. The highest risk group was regarded as "cases" and the rest as "non-cases", serving as the reference standard in ROC analysis, which identified an optimal cut-off point of 23 (sensitivity: 97.2%, specificity: 95.2%). The cut-off point was used to classify participants into positive (probable case: 17:0%) and negative groups according to their OSNA scores. The positive group (probable cases) reported significantly longer duration and higher intensity of online social networking use, and higher prevalence of Internet addiction than the negative group.

CONCLUSIONS

The classification strategy and results are potentially useful for future research that measure problematic online social networking use and its impact on health among adolescents. The approach can facilitate research that requires cut-off points of screening tools but gold standards are unavailable.

Zbtb20 deficiency causes cardiac contractile dysfunction in mice

The zinc-finger protein ZBTB20 regulates development and metabolism in multiple systems, and is essential for postnatal survival in mice. However, its potential role in the cardiovascular system remains undefined. Here, we demonstrate that ZBTB20 is critically involved in the regulation of cardiac contractility and blood pressure in mice. At the age of 16 days, the relatively healthy Zbtb20-null mice exhibited hypotension without obvious change of heart rate or other evidence for heart failure. Moreover, Zbtb20 deletion led to a marked reduction in heart size, left ventricular wall thickness, and cell size of cardiomyocytes, which was largely proportional to the decreased body growth. Notably, echocardiographic and hemodynamic analyses showed that cardiac contractility was greatly impaired in the absence of ZBTB20. Mechanistically, ZBTB20 deficiency decreased cardiac ATP contents, and compromised the enzyme activity of mitochondrial complex I in heart as well as L-type calcium current density in cardiomyocytes. Furthermore, the developmental activation of some mitochondrial function-related genes was significantly attenuated in Zbtb20-null myocardium, which included Hspb8, Ckmt2, Cox7a1, Tfrc, and Ogdhl. Put together, these results suggest that ZBTB20 plays a crucial role in the regulation of heart development, energy metabolism, and contractility.

Classification of probable online social networking addiction: A latent profile analysis from a large-scale survey among Chinese adolescents

BACKGROUND AND AIMS

Problematic online social networking use is prevalent among adolescents, but consensus about the instruments and their optimal cut-off points is lacking. This study derived an optimal cut-off point for the validated Online Social Networking Addiction (OSNA) scale to identify probable OSNA cases among Chinese adolescents.

METHODS

A survey recruited 4,951 adolescent online social networking users. Latent profile analysis (LPA) and receiver operating characteristic curve (ROC) analyses were applied to the validated 8-item OSNA scale to determine its optimal cut-off point.

RESULTS

The 3-class model was selected by multiple criteria, and validated in a randomly split-half subsample. Accordingly, participants were categorized into the low risk (36.4%), average risk (50.4%), and high risk (13.2%) groups. The highest risk group was regarded as "cases" and the rest as "non-cases", serving as the reference standard in ROC analysis, which identified an optimal cut-off point of 23 (sensitivity: 97.2%, specificity: 95.2%). The cut-off point was used to classify participants into positive (probable case: 17:0%) and negative groups according to their OSNA scores. The positive group (probable cases) reported significantly longer duration and higher intensity of online social networking use, and higher prevalence of Internet addiction than the negative group.

CONCLUSIONS

The classification strategy and results are potentially useful for future research that measure problematic online social networking use and its impact on health among adolescents. The approach can facilitate research that requires cut-off points of screening tools but gold standards are unavailable.

Improved Constraints on Sterile Neutrino Mixing from Disappearance Searches in the MINOS, MINOS+, Daya Bay, and Bugey-3 Experiments

Searches for electron antineutrino, muon neutrino, and muon antineutrino disappearance driven by sterile neutrino mixing have been carried out by the Daya Bay and MINOS+ collaborations. This Letter presents the combined results of these searches, along with exclusion results from the Bugey-3 reactor experiment, framed in a minimally extended four-neutrino scenario. Significantly improved constraints on the θ_{μe} mixing angle are derived that constitute the most constraining limits to date over five orders of magnitude in the mass-squared splitting Δm_{41}^{2}, excluding the 90% C.L. sterile-neutrino parameter space allowed by the LSND and MiniBooNE observations at 90% CL_{s} for Δm_{41}^{2}<13  eV^{2}. Furthermore, the LSND and MiniBooNE 99% C.L. allowed regions are excluded at 99% CL_{s} for Δm_{41}^{2}<1.6 eV^{2}.

Research Progress on Forensic Palynology and Its Application in Forensic Science

Abstract

Forensic palynology is to apply palynology to the field of forensic science, using pollen and spores to solve issues in juridical practice, such as civil and criminal issues. Sporopollens have a small size, wide distribution, diverse morphology, can be easily transferred, have durability, and is not easily noticed. It can provide strong investigation and related evidence for case detection as good trace evidence. The application of palynology in forensic science has achieved certain success, but it is underutilized in most countries. This paper analyzes the evidence value provided by sporopollen, collection of the sporopollen samples, the progress in detection technology and challenges ahead, based on the biological characteristics of sporopollen, combined with recent successful cases in forensic science, to comprehensively discuss the research progress in forensic palynology and its application prospects in forensic science.

Application of Eye Tracker in Lie Detection

Objective To investigate the application value of eye tracking in lie detection. Methods The 40 subjects were randomly divided into two groups. The pupil diameter, fixation duration, points of fixation and blink frequency of the subjects in the experimental group in observing target stimulation and non-target stimulation were recorded with eye tracker after they accomplished the mock crime. The eye movement parameters of subjects in the control group were directly collected. The differences in eye movement parameters of the experimental group and the control group in observing target stimulation and non-target stimulation were analyzed by t-test. Pearson coefficient analysis of correlation between eye movement parameters that had differences was conducted. The effectiveness of eye movement parameters to distinguish between the experimental group and the control group was calculated by the receiver operator characteristic （ROC） curve. Results Participants from the experimental group had shorter average pupil diameter, longer average fixation duration and fewer fixation points （P<0.05）, but the differences in blink frequency had no statistical significance. The differences in the above indicators of the control group in observing target stimulation and non-target stimulation had no statistical significance. The average fixation duration showed a negative correlation with fixation points （r=-0.255, P<0.05）; the average fixation duration showed a negative correlation with average pupil diameter （r=-0.218, P<0.05）; the fixation points showed a positive correlation with average pupil diameter （r=0.09, P<0.05）. The area under the curve of average pupil diameter, average fixation duration and fixation points was 0.603, 0.621 and 0.580, respectively. Conclusion The average pupil diameter, average fixation duration and fixation points obtained by the eye tracker under laboratory conditions can be used to detect lies.

Liver ChREBP Protects Against Fructose-Induced Glycogenic Hepatotoxicity by Regulating L-Type Pyruvate Kinase

Excessive fructose consumption is closely linked to the pathogenesis of metabolic disease. Carbohydrate response element-binding protein (ChREBP) is a transcription factor essential for fructose tolerance in mice. However, the functional significance of liver ChREBP in fructose metabolism remains unclear. Here, we show that liver ChREBP protects mice against fructose-induced hepatotoxicity by regulating liver glycogen metabolism and ATP homeostasis. Liver-specific ablation of ChREBP did not compromise fructose tolerance, but rather caused severe transaminitis and hepatomegaly with massive glycogen overload in mice fed a high-fructose diet, while no obvious inflammation, cell death, or fibrosis was detected in the liver. In addition, liver ATP contents were significantly decreased by ChREBP deficiency in the fed state, which was rendered more pronounced by fructose feeding. Mechanistically, liver contents of glucose-6-phosphate (G6P), an allosteric activator of glycogen synthase, were markedly increased in the absence of liver ChREBP, while fasting-induced glycogen breakdown was not compromised. Furthermore, hepatic overexpression of LPK, a ChREBP target gene in glycolysis, could effectively rescue glycogen overload and ATP reduction, as well as mitigate fructose-induced hepatotoxicity in ChREBP-deficient mice. Taken together, our findings establish a critical role of liver ChREBP in coping with hepatic fructose stress and protecting from hepatotoxicity by regulating LPK.

Application of 18S rDNA Clone Library to Detect Diatom Population Diversity in Dianchi

Abstract

Objective To detect the diatom population diversity in Dianchi by constructing a 18S rDNA clone library. Methods DNA from diatoms in 6 water samples of Dianchi was amplified with diatom 18S rDNA specific primer.The 18S rDNA clone library was constructed, and clones were randomly selected for sequence. Sequence alignment was performed by BLAST. The diatom population distribution in Dianchi was analyzed and the phylogenetic tree of diatom 18S rDNA in Dianchi waters was established with the MEGA v7.0.14 software. Results Two hundred and forty clones were sequenced, with 167 diatom sequences obtained, including 11 diatom species such as Stephanodiscus, Diatoma, and Melosira. There were certain differences in diatom population distribution among the 6 samples. Conclusion The population distribution of diatom species in Dianchi shows unique features and the sequence analysis of diatom 18S rDNA has a certain reference value to the inference of forensic drowning sites.

Extraction of the ^{235}U and ^{239}Pu Antineutrino Spectra at Daya Bay

This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.

[Clinical study on traditional Chinese medicine syndrome differentiation and treatment of pneumoconiosis]

Objective: To explore the clinical effect of traditional Chinese medicine (TCM) syndrome differentiation in the treatment of pneumoconiosis. Methods: We selected 160 pneumoconiosis patients who were hospitalized in our hospital from July 2015 to July 2016. 102 patients were divided into experimental groups, and the other 58 patients were assigned to the control group. These patients were randomly assigned. The control group was given routine treatment, while the experimental group received conventional treatment combined with TCM syndrome differentiation. We rated patients' quality of life using the SF-36 Quality of Life Scale. C-reactive protein levels in both groups before and after treatment were detected by ELISA. Furthermore, we detected the expression levels of IL-6 mRNA and TGF-β mRNA in serum before and after treatment by RT-PCR.The analysis was performed with SPSS19.0 software. The normal distribution measurement data was expressed by Mean±SD, and the t-test was used for statistical analysis. Non-normal distribution measurement data were expressed as median(M) and interquartile range (P(25), P(75)), and non-parametric test was used for statistical analysis. Results: Compared with the control group, the readmission rate in the experimental group decreased within 3 months; The SF-36 quality of life score results of the two groups showed a statistically significant difference in BP, VT and RE (P<0.05);The levelofCRPdecreasedsignificantlyafter treatment in bothgroups,and thedifferencewasstatistically significant (P<0.05).Comparedwith thecontrolgroup, the levelsofIL-6mRNAandTGF-β1mRNA alsodecreased (P<0.05). Conclusion: TCM syndromedifferentiation and treatmentofpneumoconiosis can effectively improve the patient's condition and life quality. We predict that it may inhibit the progression of pulmonary fibrosis in pneumoconiosis.

[Clinical analysis of 24 cases of occupational chromium rhinopathy]

Occupational chromium rhinopathy is chronic nasal damage caused by chromic anhydride, chromate and dichromate 6-valent chromium compounds. In 2016, 700 people who were exposed to chromium slag in steel plant were checked out. 24 people were found to have nasal injuries. The expert group confirmed 1 case of occupational severe chromium rhinosis and 23 cases of occupational mild chromium rhinosis.There was no significant difference in the incidence, type of work and duration of injury among 24 patients (P>0.05) . Active measures should be taken to prevent chromium rhinopathy and the technological process should be reformed. Occupational health education and occupational health monitoring should be strengthened to avoid exposure of chromium and its compounds through nose and respiratory tract, and to reduce or eliminate the occurrence of chromium rhinosis.

Analysis of two pheromone-responsive conjugative multiresistance plasmids carrying the novel mobile optrA locus from Enterococcus faecalis

Background: The acquired optrA gene, which encodes a ribosomal protection protein of the ABC-F family, can confer cross-resistance to linezolid and florfenicol, posing a serious therapeutic challenge to both human and veterinary medicine.

Purpose: The objective of this study was to investigate the two Enterococcus faecalis (E. faecalis) plasmids for their fine structure, their transferability and the presence of mobile antimicrobial resistance loci.

Methods: To elucidate their fine structure, the two plasmids were completely sequenced and the sequences analysed. Besides conjugation experiments, inverse PCR assays were conducted to see whether minicircles are produced from the mobile antimicrobial resistance loci.

Results: Two pheromone-responsive conjugative optrA-carrying plasmids from E. faecalis, pE211 and pE508 were identified, which can transfer with frequencies of 2.6 ×10⁻² and 3.7 ×10⁻² (transconjugant per donor), respectively. In both plasmids, optrA was located on the novel mobile optrA locus with different sizes (12,834 bp in pE211 and 7,561 bp in pE508, respectively), flanked by two copies of IS1216 genes in the same orientation. Inverse PCR revealed that circular forms can be generated, consisting of optrA and one copy of IS1216, indicating they are all active. The 77,562 bp plasmid pE211 also carried Tn558 and a mobile bcrABDR locus, and the 84,468 bp plasmid pE508 also harbored the genes fexA, tet(L), tet(O/W/32/O) and a mobile aac(A)-aph(D) locus.

Conclusion: The presence of mobile genetic elements in these plasmids renders them flexible and these elements will aid to the persistence and dissemination of these plasmids among enterococci and potentially also other gram-positive bacteria.

[Emotional and behavioral problems associated with sleep problems in preschool aged children]

Objective: To examine whether sleep problems are related to both emotional and behavioral problems in children aged 3-6 years. Methods: A large cross-sectional study was conducted in Anqing, Wuhu, Tongling and Yangzhou from March to June 2015. A total of 8 900 preschool aged children were included. Sleep problems were obtained by using adapted BISQ completed by the parents or the people who took care of children. Emotional and behavioral problems of the children were accessed by using Strengths and Difficulties Questionnaire (SDQ), and multivariate logistic regression model was used for statistical analyses. Results: The detected rates of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior in preschool aged children were 9.0%, 13.9%, 18.9%, 25.5%, 13.6% and 16.2% respectively. All the detected rates were higher in boys than in girls except the higher rate of emotional symptoms. The proportions of children with high sleep quality, moderate sleep quality and poor or worse sleep quality were 3.9%, 52.9% and 43.2% respectively. After controlling the confounding factors of demographic variables, including gender, age, delivery mode, birth weight, birth height and patent's educational level, multinomial logistic regression analysis showed that the risk of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior in children with longer sleep duration was lower than that in children with shorter sleep duration, the ORs were 0.86 (95%CI: 0.77-0.95), 0.85 (95%CI: 0.78-0.93), 0.85 (95%CI: 0.79-0.92), 0.87(95%CI: 0.81-0.93), 0.83 (95%CI: 0.76-0.91) and 0.82 (95%CI: 0.76-0.89) respectively. Compared with the children with good sleep quality, the risk of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior were higher in children with poor or worse sleep quality, the ORs were 3.26 (95%CI: 2.40-4.42), 2.86 (95%CI: 2.16-3.78), 2.60 (95%CI: 2.00-3.38), 1.96 (95%CI: 1.52-2.54), 4.02 (95%CI: 3.06-5.27) and 2.56 (95%CI: 1.96-3.35) respectively. Conclusion: There was a negative impact of shorter sleep and poor or worse sleep on emotional and behavioral problems of preschool aged children.

[From evidence to clinical practice: myopia control among children in refraction clinics]

Over the past decade, breakthrough has been made on myopia progression control with a lot of evidence from clinical trials, but the effective clinical application of many of them remained immature. Though refraction clinics have been set up in many specialized hospitals offering spectacles to correct refractive error, there was few protocol or standard of treatment for reducing myopia progression. This commentary reviews the latest and essential publications and presents critical advice on applying the research findings to clinical practice. (Chin J Ophthalmol, 2019, 55: 89-92).

[Clinical characteristics and risk factors in pregnancy with severe community-acquired pneumonia]

Objective: To analyze clinical characteristics of severe community-acquired pneumonia during pregnancy and its outcomes, and to explore the relevant risk factors. Methods: From September 2012 to September 2017, 324 398 pregnancies admitted in 7 tertiary hospitals were included. Clinical data of 33 cases of pregnancies with severe community-acquired pneumonia (severe pneumonia group) and 214 cases of pregnancies with common community-acquired pneumonia (control group) were reviewed retrospectively, including the clinical information, manifestations, laboratory examinations and pregnancy outcomes. Relevant risk factors were analyzed by multivariate logistic regression analysis. Results: (1) General data: pregnancies with severe community-acquired pneumonia accounted for 0.010% (33/324 398) of hospitalized pregnancies, the gestational age of two groups were (28±8) and (23±8) weeks, body mass index were (21.7±2.1) and (25.5±3.4) kg/m(2), rate of low income were 54.5% (18/33) and 31.8% (68/214) , respectively. The differences between two groups were all statistically significant (all P<0.05). No significant differences were found in age, pregnancy and parity times, rate of main pregnant complications such as diabetes and hypertension, educational level, asthma and onset seasons between two groups (all P>0.05). (2) Clinical data: the severe pneumonia group had significantly higher incidence of fever [100.0% (33/33) vs 75.2% (161/214) ], shortness of breath (90.9% vs 16.8%) compared with the control group (all P<0.05) .The median peripheral leukocytes counts were 12.3×10(9)/L and 10.2×10(9)/L, the hemoglobin level were (84±18) and (107±14) g/L,the albumin level were (26±4) and (37±3) g/L, the median serum urea nitrogen level were 3.7 and 2.4 mmol/L, the serum creatinine level were (72±25) and (45±11) μmol/L, respectively in two groups. The differences were all statistically significant (all P<0.05). No significantly statistical differences were found in coagulation indicator and cardiac function between two groups (all P>0.05). (3) Treatments: in severe pneumonia group, 12 patients (36.4%,12/33) needed invasive mechanical ventilation, 9 patients (27.3%,9/33) needed non-invasive mechanical ventilation, average time of mechanical ventilation was (7±4) days;8 patients (24.2%,8/33) with septic shock needed vasoactive drugs. However, there was no patient in control group needing mechanical ventilation and vasoactive drugs. (4) Pregnant outcomes: one patient (3.0%,1/33) died in the severe pneumonia group, while no death occurred in the control group. The hospital stay between two groups were (15.1±4.1) and (7.0±1.9) days, the rates of abortion and stillbirth between two groups were 42.4% (14/33) and 3.3% (7/214) , the rates of premature were 10/19 and 6.3% (13/207) , the rates of cesarean were 15/19 and 43.0% (89/207) , the rates of low birth weight newborn were 17/19 and 14.0% (29/207) , the rates of infected newborn were 15/19 and 10.1% (21/207) , the birth weights were (2 165±681) and (3 102±400) g, respectively. The differences between two groups were all statistically significant (all P<0.05). (5) Multivariate logistic regression analysis demonstrated that anemia, low body mass index, hypoproteinemia were risk factors for severe pneumonia in pregnancy (all P<0.05) . Conclusions: Pregnancy with severe community-acquired pneumonia may be complicated by multiple organ dysfunctions, lead to adverse outcomes. Anemia, malnutrition are risk factors for pregnancy with severe pneumonia. Active and effective treatment may improve its prognosis.

Measurement of the Electron Antineutrino Oscillation with 1958 Days of Operation at Daya Bay

We report a measurement of electron antineutrino oscillation from the Daya Bay Reactor Neutrino Experiment with nearly 4 million reactor ν[over ¯]_{e} inverse β decay candidates observed over 1958 days of data collection. The installation of a flash analog-to-digital converter readout system and a special calibration campaign using different source enclosures reduce uncertainties in the absolute energy calibration to less than 0.5% for visible energies larger than 2 MeV. The uncertainty in the cosmogenic ^{9}Li and ^{8}He background is reduced from 45% to 30% in the near detectors. A detailed investigation of the spent nuclear fuel history improves its uncertainty from 100% to 30%. Analysis of the relative ν[over ¯]_{e} rates and energy spectra among detectors yields sin^{2}2θ_{13}=0.0856±0.0029 and Δm_{32}^{2}=(2.471_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the normal hierarchy, and Δm_{32}^{2}=-(2.575_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the inverted hierarchy.