Clinical diagnostic performance of a fully automated TSI immunoassay vs. that of an automated anti‑TSHR immunoassay for Graves' disease: a Chinese multicenter study

BACKGROUND

Both thyroid-stimulating immunoglobulins immunoassay (TSI IA) and thyrotrophin receptor antibody immunoassay (TRAb IA) are commonly used for the diagnosis of Graves' disease (GD). The aim of the present study was to compare the clinical diagnostic performance of these two methods.

METHODS

Sera were obtained from 1103 subjects presenting a variety of clinical conditions from three centers: 100 subjects with untreated GD, 200 with treated GD, 62 with autoimmune thyroid disease(AIT), 216 with other thyroid diseases (OTHER-T), 214 with non-thyroid autoimmune diseases (NTAD), 191 with other diseases (OD), and 120 healthy subjects (HS). Both TSI and TRAb IAs were performed for all 1013 serum samples. Bioassay was performed for 86 samples whose TSI results were inconsistent the TRAb assay results.

RESULTS

Comparing untreated GD patients with the control groups (AIT, NTAD, OTHER-T, OD, and HS) resulted in an area under the curve (AUC) of 0.992 for the TSI IA and 0.989 for the TRAb IA with no statistically significant difference observed between these AUC values (P = 0.2733). The best TSI CDP (clinical decision point) value was 0.42 IU/L. The differences in sensitivity (100% vs. 95%, P = 0.7991) and specificity (97.1% vs. 97.6%, P = 0.9426) between the TSI and TRAb IA were not statistically significant. TSI IA had a higher agreement with the TSI bioassay than TRAb IA.

CONCLUSION

The clinical diagnostic performance of the TSI IA for diagnosing Graves' disease was very similar to that of the TRAb IA. TSI IA can be used to diagnose GD in the Chinese.

Role of lactic acid bacteria in flavor development in traditional Chinese fermented foods: A review

Traditional Chinese fermented foods are favored by consumers due to their unique flavor, texture and nutritional values. A large number of microorganisms participate in the process of fermentation, especially lactic acid bacteria (LAB), which are present in almost all fermented foods and contribute to flavor development. The formation process of flavor is complex and involves the biochemical conversion of various food components. It is very important to fully understand the conversion process to direct the flavor formation in foods. A comprehensive link between the LAB community and the flavor formation in traditional Chinese fermented foods is reviewed. The main mechanisms involved in the flavor formation dominated by LAB are carbohydrate metabolism, proteolysis and amino acid catabolism, and lipolysis and fatty acid metabolism. This review highlights some useful novel approaches for flavor enhancement, including the application of functional starter cultures and metabolic engineering, which may provide significant advances toward improving the flavor of fermented foods for a promising market.

Heterophilic antibody interference with TSH measurement on different immunoassay platforms

INTRODUCTION

Interference due to the presence of heterophilic antibodies may lead to falsely low or high analyte concentrations, but falsely elevated values are more common in most immunoassay platforms. We report a case of a 53-y old female patient underwent radical thyroidectomy for thyroid papillary carcinoma and the results of TSH in the Siemens Advia Centaur XP after surgery were not suppressed, ranging from 5.73 and 6.61 μIU/ml.

METHODS

The status of the thyroid was then assessed using 4 assay platforms from Siemens, Abbott, Roche and Beckman.

RESULTS

The results of TSH were 5.52, 0.54, 0.12, and <0.015 μIU/ml, respectively. After the samples were pretreated with the heterophilic antibody blocker, results given by Siemens, Abbott, and Roche showed significant decreases of 0.003, 0.001, and 0.005 μIU/ml, respectively. Therefore, it was confirmed that the presence of heterophilic antibodies in the patient samples interfered with the TSH measurements in multiple assay systems.

CONCLUSIONS

Clinicians must be aware of the possible assay interference, including the measurements of FT4, FT3 and TSH, results may be misleading in the presence of heterophilic antibodies, in particular when the results of thyroid function tests do not fit the patient clinical presentation.

Insight on adsorption of cellulase on wet ground corncob residues and its evaluation by multivariate linear analysis

Understanding the adsorption behavior and the interaction between substrates and enzymes are critical to improving enzymatic hydrolysis efficiency and reducing bioconversion cost. Herein, the adsorption of cellulase on wet ground corncob residues was studied, and the effects of main characteristics of wet ground corncob residues on adsorption capacity were quantitatively analyzed with the combination of principal component analysis and multiple linear regression models. The results showed that the adsorption of cellulase on wet ground corncob residues was fitted well with Langmuir isotherm adsorption and pseudo second-order kinetics model, the adsorption rate and adsorption capacity were greatly enhanced with increasing grinding time; the multiple linear regression models describing the relationship between main characteristics of corncob residues and adsorption capacity to cellulase were established; the significance of these characteristics were in the following order: average particle size, crystallinity index, specific surface area, surface lignin concentration, water retention value, and surface charge density.

Combining 18F-FDG PET/CT and Serum Lactate Dehydrogenase for Prognostic Evaluation of Small Cell Lung Cancer

Objective: To investigate the value of using ¹⁸F-FDG PET/CT in combination with serum lactate dehydrogenase (LDH) for prognostic evaluation of newly diagnosed small cell lung cancer (SCLC). Methods: We reviewed 118 patients with pathologically proven SCLC who underwent ¹⁸F-FDG PET/CT imaging evaluation in our hospital. Among these patients, 64 patients had extensive disease (ED) and 54 patients had limited disease (LD). The maximum standardized uptake value (SUV_max) of primary tumor was measured. A Cox proportional hazards model was used to evaluate age, sex, performance status, serum LDH, tumor stage and SUV_max on the prediction of overall survival (OS) and median survival time (MST) of patients. Subgroup analysis was performed based on the SUV_max in combination with serum LDH. Results: According to the Receiver Operating Characteristic (ROC) curve, the optimal cut-off value of SUV_max was 10.95. The AUC was 0.535 (95% CI: 0.407-0.663). The patients were divided into four groups according to the SUV_max (higher or lower than 10.95) and LDH (higher or lower than 245 U/L). The univariate and multivariate analyses showed that curative thoracic radiotherapy, Prophylactic Cranial Irradiation (PCI) and the combination of primary tumor SUV_max ≤ 10.95 and LDH ≤ 245 U/L were prognostic factors of OS in patients with all patients (p < 0.05). Smoking status, PCI, the combination of primary tumor SUV_max ≤ 10.95 and LDH ≤ 245 U/L were prognostic factors of OS in patients with LD (p < 0.05). N stage and PCI were significant predictors in both of univariate and multivariate analysis of OS for ED SCLC (p < 0.05). Among all patients, 27 had low SUV_max and normal LDH, and their MST was 36 months (95% CI: 12.98-59.02). Ninety-one patients had high SUV_max and/or high LDH, and their MST was 20 months (95% CI: 15.47-24.53). The difference between these two groups was significant (p = 0.045). In patients with LD, 16 patients had low SUV_max and normal LDH, and their MST was 72 months (95% CI: 26.00-118.0). Thirty-eight patients had high SUV_max and/or high LDH, and their MST was 27 months (95% CI: 20.80-33.21). The difference between these two groups was significant (p = 0.012). In patients with ED SCLC, 10 patients had low SUV_max and normal LDH, with an MST of 18 months (95% CI: 13.69-22.32. Fifty-four patients had high SUV_max and/or high LDH, and their MST was 12 months (95% CI: 10.61-13.39). The difference of MST between these two groups was not statistically significant (p = 0.686). Conclusion: ¹⁸F-FDG PET/CT in combination with serum LDH were prognostic factors of overall survival in patients with SCLC. The prognosis of patients with LD SCLC who had low SUV_max of primary tumor and normal LDH was better than those with high SUV_max and/or high LDH.

Predicting the local COVID-19 outbreak around the world with meteorological conditions: a model-based qualitative study

OBJECTIVES

This study aims to investigate the relationship between daily weather and transmission rate of SARS-CoV-2, and to develop a generalised model for future prediction of the COVID-19 spreading rate for a certain area with meteorological factors.

DESIGN

A retrospective, qualitative study.

METHODS AND ANALYSIS

We collected 382 596 records of weather data with four meteorological factors, namely, average temperature, relative humidity, wind speed, and air visibility, and 15 192 records of epidemic data with daily new confirmed case counts (1 587 209 confirmed cases in total) in nearly 500 areas worldwide from 20 January 2020 to 9 April 2020. Epidemic data were modelled against weather data to find a model that could best predict the future outbreak.

RESULTS

Significant correlation of the daily new confirmed case count with the weather 3 to 7 days ago were found. SARS-CoV-2 is easy to spread under weather conditions of average temperature at 5 to 15°C, relative humidity at 70% to 80%, wind speed at 1.5 to 4.5 m/s and air visibility less than 10 statute miles. A short-term model with these four meteorological variables was derived to predict the daily increase in COVID-19 cases; and a long-term model using temperature to predict the pandemic in the next week to month was derived. Taken China as a discovery dataset, it was well validated with worldwide data. According to this model, there are five viral transmission patterns, 'restricted', 'controlled', 'natural', 'tropical' and 'southern'. This model's prediction performance correlates with actual observations best (over 0.9 correlation coefficient) under natural spread mode of SARS-CoV-2 when there is not much human interference such as epidemic control.

CONCLUSIONS

This model can be used for prediction of the future outbreak, and illustrating the effect of epidemic control for a certain area.

Predicting the local COVID-19 outbreak around the world with meteorological conditions: a model-based qualitative study

OBJECTIVES

This study aims to investigate the relationship between daily weather and transmission rate of SARS-CoV-2, and to develop a generalised model for future prediction of the COVID-19 spreading rate for a certain area with meteorological factors.

DESIGN

A retrospective, qualitative study.

METHODS AND ANALYSIS

We collected 382 596 records of weather data with four meteorological factors, namely, average temperature, relative humidity, wind speed, and air visibility, and 15 192 records of epidemic data with daily new confirmed case counts (1 587 209 confirmed cases in total) in nearly 500 areas worldwide from 20 January 2020 to 9 April 2020. Epidemic data were modelled against weather data to find a model that could best predict the future outbreak.

RESULTS

Significant correlation of the daily new confirmed case count with the weather 3 to 7 days ago were found. SARS-CoV-2 is easy to spread under weather conditions of average temperature at 5 to 15°C, relative humidity at 70% to 80%, wind speed at 1.5 to 4.5 m/s and air visibility less than 10 statute miles. A short-term model with these four meteorological variables was derived to predict the daily increase in COVID-19 cases; and a long-term model using temperature to predict the pandemic in the next week to month was derived. Taken China as a discovery dataset, it was well validated with worldwide data. According to this model, there are five viral transmission patterns, 'restricted', 'controlled', 'natural', 'tropical' and 'southern'. This model's prediction performance correlates with actual observations best (over 0.9 correlation coefficient) under natural spread mode of SARS-CoV-2 when there is not much human interference such as epidemic control.

CONCLUSIONS

This model can be used for prediction of the future outbreak, and illustrating the effect of epidemic control for a certain area.

Dl-3-n-butylphthalide attenuates hypoxic-ischemic brain injury through inhibiting endoplasmic reticulum stress-induced cell apoptosis and alleviating blood-brain barrier disruption in newborn rats

Dl-3-n-butylphthalide (NBP) has been demonstrated to exert neuroprotective effects in experimental models and human patients. This study was performed to assess the therapeutic effects and the underlying molecular mechanisms of NBP in a neonatal hypoxic-ischemic rat model. The results showed that NBP treatment significantly reduced the infarct volume, improved histological recovery, decreased neuronal cell loss, enhanced neuronal cell rehabilitation, promoted neurite growth and decreased white matter injury. In addition, NBP treatment effectively improved long-term neurobehavioral development and prognosis after HI injury. We further demonstrated an inhibitory effect of NBP on endoplasmic reticulum (ER) stress-induced apoptosis, evidenced by reduction in ER stress-related protein expressions (GRP78, XBP-1, PDI and CHOP), decrease in TUNEL-positive cells, down-regulation in pro-apoptosis protein (Bax and cleaved caspase-3), up-regulation in anti-apoptosis protein (Bcl-2). Moreover, NBP exerted a protective effect in blood-brain barrier disruption, which ameliorated brain edema and reduced the degeneration of the tight junction proteins (Occludin and Claudin-5) and adherens junction proteins (P120-Catenin, VE-Cadherin and β-Catenin). Overall, our findings demonstrated that NBP treatment attenuated HI brain injury through inhibiting ER stress-induced apoptosis and alleviating blood-brain barrier disruption in newborn rats. This work provides an effective therapeutic strategy to reduce brain damage and enhance recovery after neonatal HI brain injury.

[A survey on sexual needs and factors of HIV risky sexual behaviors among elderly men at different ages in two communities of Qiandongnan Miao and Dong autonomous prefecture]

Objective: To understand sexual needs and factors of risky sexual behaviors among elderly men at different ages in two communities of Qiandongnan Miao and Dong autonomous prefecture and provide basis for targeted HIV prevention and intervention. Methods: Two communities in the prefecture were selected as study sites. Questionnaire surveys were carried out among elderly men aged 50 and over who visited or consulted in the communities from June to December 2018, and they were tested for HIV and syphilis antibodies. Results: Among 400 elderly men, 209 (52.2%) were 50-64 years old, and 191(47.8%) were above 65 years old. They were mainly Miao people, accounting for 66.3% (265/400), and 235 (58.8%) had an education no more than 6 years. HIV awareness of the two age groups were only 25.8% (54/199) and 26.2% (50/191), respectively. Among those aged 50-64, 142 (68.0%) felt normal sexual desire, and 153 (73.6%) reported penile erections or erections in most cases whenever sex, and 52.9% (110) ejaculated most of the time. HIV prevalence was 1.0% (4/400). Compared with the over 65-year-old group, the proportion of having sex with spouse/stable partners (89.5%, 179/200), proportion of no condom use with their spouse/stable sexual partners during the most recent sex (93.8%, 168/179), proportion of having casual sex (11.0%, 23/209) and commercial sex (3.8%, 8/209) were all higher among 50-64 age group. In comparison to those aged over 65 years old, average monthly income>3 000, and use of sex helper, aged 50-64 (OR=2.70, 95%CI: 1.22-5.95), average monthly income ≤1 000 yuan (OR=2.79, 95%CI: 1.25-6.21), and no use of sex helper (OR=3.78) (95%CI: 1.65-8.67) were related factors of HIV risky sexual behavior last time. Conclusion: Elderly men in the minority prefecture had low HIV awareness. Compared with those≥65 years old, the 50-64 age group had more active sexual behaviors and higher sexual needs. Those from 50-64 age group, with lower economic level and good sexual ability were more likely to have HIV risky sexual behaviors.

Improving enzymatic hydrolysis of mechanically refined poplar branches with assistance of hydrothermal and Fenton pretreatment

The combination of different pretreatment methods can effectively overcome recalcitrance of lignocellulosic biomass to ensure its highly efficient conversion into bio-based products. In this study, the combined pretreatments of chemical methods (hydrothermal treatment and Fenton treatment) with mechanical refining were used to improve the enzymatic hydrolysis efficiency of poplar branches. The results indicated that hydrothermal pretreatment and Fenton pretreatment can effectively improve the enzymatic hydrolysis of poplar substrates, e.g., the maximum glucose conversion yield and glucose concentration reached 92.4% and 20.8 g/L, respectively. The pre-hydrolysates contained some valuable components such as monosaccharides, oligosaccharides, acetic acid, furfural, and hydroxymethylfurfural. The main characteristics (specific surface area, water retention value, fines content, and surface lignin concentration) of poplar substrates were obviously changed by the combined pretreatment, which benefit the enzymatic hydrolysis.

Long Non-Coding RNA NLIPMT as a Tumor Suppressor and Inhibitor of Cell Proliferation and Metastasis in Papillary Thyroid Carcinoma

Introduction

Gene expression association studies of tumor samples have uncovered several long non-coding RNAs (lncRNAs) closely related to various types of cancer. Several lncRNAs have been reported to play essential roles in the progression of papillary thyroid carcinoma (PTC). Novel lncRNA inhibiting proliferation and metastasis (lnc-NLIPMT) is a known regulator of mammary cell proliferation and motility, but its involvement in PTC is unclear.

Materials and Methods

We investigated the role of lnc-NLIPMT in PTC by quantitative real-time polymerase chain reaction (qRT-PCR) on various PTC tissue samples and cell lines. We assessed the effects of overexpression or knockdown of lnc-NLIPMT on the proliferation, migration, and invasion of PTC cells using CCK-8, cell clone formation, and transwell assays. Changes in the expression of N-cadherin and vimentin were detected by immunoblotting.

Results

Our results revealed a downregulation of the expression of lnc-NLIPMT in PTC and a negative correlation between lnc-NLIPMT expression and tumor size (P=0.006). Overexpression of lnc-NLIPMT in TPC-1 and B-CPAP cells significantly suppressed cell proliferation, migration, and invasion, while lnc-NLIPMT knockdown had the opposite effect. In addition, lnc-NLIPMT played an important role in the regulation of the expression of N-cadherin and vimentin.

Conclusion

lnc-NLIPMT inhibits cell proliferation and metastasis of PTC cells and is a potential diagnostic and prognostic biomarker in PTC.

Characterisation of the flavour profile of dry fermented sausages with different NaCl substitutes using HS-SPME-GC-MS combined with electronic nose and electronic tongue

The effects of different sodium substitutes on the physical and bacterial properties, flavour profile and sensory evaluation of dry fermented sausage were investigated. There were three different salt formulations, including control (C: 100%NaCl), S1 (70%NaCl and 30%KCl) and S2 (70%NaCl, 20%KCl and 10% flavour enhancers). Higher moisture content and lactic acid bacteria count, and lower pH and Staphylococcus count were observed in NaCl substitution treatments compared to the control (P < 0.05). Sixty-two volatiles were detected in sausages, and 26 compounds were regarded as key volatile compounds based on the odour activity values. The electronic tongue result and sensory evaluation showed that the taste profile of S2 treatment was similar to control treatment; and the electronic nose, volatile compound results and hierarchical cluster analysis showed that the sodium substitutes had a more significant effect on the odour profile. Overall, S2 may be an ideal low-sodium substitute to achieve a 30% reduction in NaCl and provide a better flavour profile of fermented sausages.

Lymphopenia During Definitive Chemoradiotherapy in Esophageal Squamous Cell Carcinoma: Association with Dosimetric Parameters and Patient Outcomes

BACKGROUND

The objective of this study was to investigate the relationship between clinical characteristics, as well as dosimetric parameters, and the risk of treatment-related lymphopenia in esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (CRT).

MATERIALS AND METHODS

Clinical characteristics and dosimetric parameters were collected from 436 patients with ESCC who received definitive CRT from 2010 through 2017. Absolute lymphocyte counts (ALCs) were obtained before, during, and 1 month after CRT. Grade 4 (G4) lymphopenia was defined as ALC <0.2 × 10⁹ /L during CRT. Logistic regression analysis was used to evaluate the effect of each factor on predicting G4 lymphopenia. The relationship between lymphopenia and overall survival (OS) was examined, and a nomogram was developed to predict OS.

RESULTS

G4 lymphopenia was observed in 103 patients (23.6%) during CRT. Multivariate analysis indicated that planning target volume (PTV), lung V₁₀ , heart V₁₀ , performance status, and pretreatment lymphopenia were significant risk factors for G4 lymphopenia. Patients with G4 lymphopenia had significantly worse survival than those without. Based on multivariate analysis, clinical TNM stage, radiotherapy modality, pretreatment ALC, and G4 lymphopenia were predictive of OS and were incorporated into the nomogram, yielding a concordance index of 0.71.

CONCLUSIONS

G4 lymphopenia during definitive CRT was associated with larger PTVs, higher lung V₁₀ and heart V₁₀ , and worse survival.

IMPLICATIONS FOR PRACTICE

The purpose of this study was to investigate the relationship between clinical characteristics, as well as dosimetric parameters, and the risk of treatment-related lymphopenia in 436 patients with esophageal squamous cell carcinoma who received definitive chemoradiotherapy. Grade 4 (G4) lymphopenia was observed in 23.6% of patients during radiotherapy. G4 lymphopenia was associated with larger planning target volumes, higher lung V₁₀ and heart V₁₀ , and worse survival. Then, a nomogram was built based on multivariate analysis, yielding excellent performance to predict overall survival. Prospective studies are needed to investigate potential approaches for mitigating severe lymphopenia, which may ultimately convert into survival benefits.

Notoginsenoside R1 Protects Against the Acrylamide-Induced Neurotoxicity via Upregulating Trx-1-Mediated ITGAV Expression: Involvement of Autophagy

Acrylamide (ACR) is a common chemical used in various industries and it said to have chronic neurotoxic effects. It is produced during tobacco smoking and is also generated in high-starch foods during heat processing. Notoginsenoside R1 (NR1) is a traditional Chinese medicine, which is used to improve the blood circulation and clotting. The objective of this study was to investigate the mechanism of ACR-triggered neurotoxicity and to identify the protective role of NR1 by upregulating thioredoxin-1 (Trx-1). Our results have shown that NR1 could block the spatial and cognitive impairment caused by ACR administration. Bioinformatics analysis revealed that Trx-1 regulated autophagy via Integrin alpha V (ITGAV). NR1 could resist the ACR-induced neurotoxicity by upregulating thioredoxin-1 in PC12 cells and mice. The autophagy-related proteins like autophagy-related gene (ATG) 4B, Cathepsin D, LC3 II, lysosomal-associated membrane protein 2a (LAMP2a), and ITGAV were restored to normal levels by NR1 treatment in both PC12 cells and mice. Besides, we also found that overexpression of Trx-1 resisted ACR-induced autophagy in PC12 cells and downregulation of Trx-1 triggered autophagy induced by ACR in PC12 cells. Therefore, it could be concluded that Trx-1 was involved in the autophagy pathway. Besides, we also found that ITGAV was an intermediate node linking Trx-1 and the autophagy pathway.

Highly Enhanced Antitumor Immunity by a Three-Barreled Strategy of the l-Arginine-Promoted Nanovaccine and Gene-Mediated PD-L1 Blockade

Weak T cell responses and immune checkpoints within tumors could be two key factors for limiting antitumor efficacy in the field of cancer immunotherapy. Thus, the combined strategy of tumor vaccines and immune checkpoint blockade has been widely studied and expected to boost antitumor immune responses. Herein, we first developed a two-barreled strategy to combine the nanovaccine with a gene-mediated PD-L1 blockade. On the one hand, polyethyleneimine (PEI) worked as a vaccine carrier to codeliver the antigen ovalbumin (OVA) and the adjuvant unmethylated cytosine-phosphate-guanine (CpG) to formulate the PEI/OVA/CpG nanovaccine through electrostatic binding, which realized both dendritic cell activation and antigen cross-presentation enhancement. On the other hand, the PD-L1 silence gene was loaded by PEI to form PEI/pshPD-L1 complexes, which were further in situ shielded by aldehyde-modified polyethylene glycol (OHC-PEG-CHO) via pH-responsive Schiff base bonds. The formed pshPD-L1@NPs could decrease PD-L1 expression on the tumor cells. However, such a combined two-barreled strategy improved feebly for tumor inhibition in comparison with monotherapy, exhibiting the antagonistic effect, which might be due to the limited T cell response enhancement in the tumor microenvironment. To solve this problem, we have further developed a three-barreled strategy to combine oral administration of l-arginine, which worked as an amplifier to induce robust T cell response enhancement, without causing the upregulation of other negative immune regulators. Superior antitumor behavior and tumor rechallenge protection were realized by the three-barreled strategy in B16F10-OVA (B16-OVA)-bearing mice. The unique three-barreled strategy we developed might offer a novel clinical therapeutic treatment.

SMS-based family planning communication and its association with modern contraception and maternal healthcare use in selected low-middle-income countries

BACKGROUND

The objectives of this study were to 1) measure the percentage of women who received SMS-based family planning communication, and 2) its association with modern contraception and maternal healthcare services among mothers. In recent years, there has been a growing interest surrounding mobile phone-based health communication and service delivery methods especially in the areas of family planning and reproductive health. However, little is known regarding the role of SMS-based family planning communication on the utilisation of modern contraception and maternal healthcare services in low-resource settings.

METHODS

Cross-sectional data on 94,675 mothers (15-49 years) were collected from the latest Demographic and Health Surveys in 14 low-and-middle-income countries. The outcome variables were self-reported use of modern contraception and basic maternal healthcare services (timely and adequate use of antenatal care, and of facility delivery services). Data were analysed using multivariate regression and random effect meta-analyses.

RESULTS

The coverage of SMS-based family planning communication for the pooled sample was 5.4% (95%CI = 3.71, 7.21), and was slightly higher in Africa (6.04, 95%CI = 3.38, 8.70) compared with Asia (5.23, 95%CI = 1.60, 8.86). Among the countries from sub-Saharan Africa, Malawi (11.92, 95%CI = 11.17, 12.70) had the highest percent of receiving SMS while Senegal (1.24, 95%CI = 1.00, 1.53) had the lowest. In the multivariate analysis, SMS communication shown significant association with the use of facility delivery only (2.22 (95%CI = 1.95, 2.83). The strength of the association was highest for Senegal (OR = 4.70, 95%CI = 1.14, 7.33) and lowest for Burundi (OR = 1.5; 95%CI = 1.01, 2.74). Meta analyses revealed moderate heterogeneity both in the prevalence and the association between SMS communication and the utilisation of facility delivery.

CONCLUSION

Although positively associated with using facility delivery services, receiving SMS on family planning does not appear to affect modern contraceptive use and other components of maternal healthcare services such as timely and adequate utilisation of antenatal care.

Selective determination of Ag+ in the presence of Cd2+, Hg2+ and Cu2+ based on their different interactions with gold nanoclusters

In this work, a fluorescence method was developed for selective detection of Ag⁺ in the presence of Cd²⁺, Hg²⁺, and Cu²⁺ based on gold nanoclusters (AuNCs). That is, bovine serum albumin (BSA) templated AuNCs with double emission peaks were synthesized using BSA as a protective agent. AuNCs with uniform distribution and average size between 2.0 and 2.2 nm were synthesized using a green and simple method, and showed bright orange-red fluorescence under ultraviolet light. AuNCs have two emission peaks at 450 nm and 630 nm with an excitation wavelength of 365 nm. Under alkaline conditions, Cd²⁺ can combine with the surface sulfhydryl groups of BSA–AuNCs to form Cd–S bonds, which cause AuNCs to aggregate, resulting in an increase in fluorescence intensity at 630 nm. Conversely, due to the d¹⁰–d¹⁰ metal affinity interaction, the addition of Hg²⁺ can reduce the fluorescence peak at 630 nm. Ag⁺ was reduced to Ag⁰ by gold nuclei in AuNCs, forming a stable hybrid Au@ AgNCs species with blue-shifted and enhanced fluorescence. Finally, the paramagnetic behavior of Cu²⁺ combined with BSA causes the excited electrons of the gold cluster to lose their energy via ISC, eventually leading to simultaneous quenching of the two emission peaks. The results show that the limit of detection (LOD) of Ag⁺, Hg²⁺, Cd²⁺ and Cu²⁺ is 1.19 μM, 3.39 μM, 1.83 μM and 5.95 μM, respectively.

A fluorescence method was developed for selective detection of Ag⁺ in the presence of Cd²⁺, Hg²⁺, and Cu²⁺ based on gold nanoclusters. The limit of detection for Ag⁺, Hg²⁺, Cd²⁺ and Cu²⁺ is 1.19 μM, 3.39 μM, 1.83 μM and 5.95 μM, respectively.

Reference Intervals for Thyroid-Associated Hormones and the Prevalence of Thyroid Diseases in the Chinese Population

BACKGROUND

Thyroid diseases are highly prevalent worldwide, but their diagnosis remains a challenge. We established reference intervals (RIs) for thyroid-associated hormones and evaluated the prevalence of thyroid diseases in China.

METHODS

After excluding outliers based on the results of ultrasound screening, thyroid antibody tests, and the Tukey method, the medical records of 20,303 euthyroid adults, who visited the Department of Health Care at Peking Union Medical College Hospital from January 2014 to December 2018, were analyzed. Thyroid-associated hormones were measured by the Siemens Advia Centaur XP analyzer. The RIs for thyroid-associated hormones were calculated according to the CLSI C28-A3 guidelines, and were compared with the RIs provided by Siemens. The prevalence of thyroid diseases over the five years was evaluated and compared using the chi-square test.

RESULTS

The RIs for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were 0.71-4.92 mIU/L, 12.2-20.1 pmol/L, 3.9-6.0 pmol/L, 65.6-135.1 nmol/L, and 1.2-2.2 nmol/L, respectively. The RIs of all hormones except TT4 differed significantly between males and females. The RIs of TSH increased with increasing age. The prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was 0.5% and 0.8%, 0.2% and 0.6%, 3.8% and 6.1%, and 3.3% and 4.7% in males and females, respectively, which differed from those provided by Siemens.

CONCLUSIONS

Sex-specific RIs were established for thyroid-associated hormones, and the prevalence of thyroid diseases was determined in the Chinese population.

Synthesis of Carbon Dots by Varying Doped Elements and Application in Serine Detection

Carbon dots (CDs) with different doping elements were successfully synthesized via a simple hydrothermal strategy. 3-amino-4-chlorophenylboronic acid, 3-aminobenzeneboronic acid, aniline, and benzene were used as precursors, respectively. The B/N co-doping CDs (BNCDs) derived from 3-aminobenzeneboronic acid show brightest fluorescence among the CDs products with quantum yield at 0.15. The fluorescence of BNCDs exhibits good photostability and excitation-independent emission behavior. The bright blue emission of BNCDs can be quenched by serine, which is a kind of neutral aliphatic amino acid containing hyroxyl groups with polarity. It is possibly due to the molecular collision between excited state of BNCDs and the ground state of serine. BNCDs can be served as fluorophore probe for the assay of serine based on the efficient quenching effect. The approach for the determination of serine shows a high sensitivity with a detection limit at 0.14 nM, which is lower than those of previous works. Furthermore, the present BNCDs system can be employed to monitor serine in real food and biological samples. The strategy may be a potential way for the application in food safety and biomedicine fields.

Developing a risk prediction model for multidrug-resistant bacterial infection in patients with biliary tract infection

BACKGROUND/AIMS

The aim of this study was to develop a tool to predict multidrug-resistant bacteria infections among patients with biliary tract infection for targeted therapy.

PATIENTS AND METHODS

We conducted a single-center retrospective descriptive study from January 2016 to December 2018. Univariate and multivariable logistic regression analysis were used to identify independent risk factors of multidrug-resistant bacterial infections. A nomogram was constructed according to multivariable regression model. Moreover, the clinical usefulness of the nomogram was estimated by decision curve analysis.

RESULTS

121 inpatients were randomly divided into a training cohort (n = 79) and validation cohort (n = 42). In multivariate analysis, 5 factors were associated with biliary tract infections caused by multidrug-resistant bacterial infections: aspartate aminotransferase (Odds ratio (OR), 13.771; 95% confidence interval (CI), 3.747-64.958; P < 0.001), previous antibiotic use within 90 days (OR, 4.130; 95% CI, 1.192-16.471; P = 0.032), absolute neutrophil count (OR, 3.491; 95% CI, 1.066-12.851; P = 0.046), previous biliary surgery (OR, 3.303; 95% CI, 0.910-13.614; P = 0.079), and hemoglobin (OR, 0.146; 95% CI, 0.030-0.576; P = 0.009). The nomogram model was constructed based on these variables, and showed good calibration and discrimination in the training set [area under the curve (AUC), 0.86] and in the validation set (AUC, 0.799). The decision curve analysis demonstrated the clinical usefulness of our nomogram. Using the nomogram score, high risk and low risk patients with multidrug-resistant bacterial infection could be differentiated.

CONCLUSIONS

This simple bedside prediction tool to predict multidrug-resistant bacterial infection can help clinicians identify low versus high risk patients as well as choose appropriate, timely initial empirical antibiotics therapy. This model should be validated before it is widely applied in clinical settings.

HMGB1 aggravates lipopolysaccharide-induced acute lung injury through suppressing the activity and function of Tregs

BACKGROUND

CD4⁺CD25⁺FoxP3⁺ T helper cells (Tregs), a subgroup of CD4⁺ T helper cells, are critical effectors that protect against acute lung injury (ALI) by contact-dependent suppression or releasing anti-inflammatory cytokines including interleukin-10 (IL-10), and transforming growth factor (TGF-β). HMGB1 (High mobility group box 1 protein) was identified as a nuclear non-histone DNA-binding chromosomal protein, which participates in the regulation of lung inflammatory response and pathological processes in ALI. Previous studies have suggested that Tregs overexpresses the HMGB1-recognizing receptor. However, the interaction of HMGB1 with Tregs in ALI is still unclear.

OBJECTIVE

To investigate whether HMGB1 aggravates ALI by suppressing immunosuppressive function of Tregs.

METHODS

Anti-HMGB1 antibody and recombinant mouse HMGB1 (rHMGB1) were administered in lipopolysaccharide (LPS)-induced ALI mice and polarized LPS-primed Tregs in vitro. The Tregs pre-stimulated with or without rHMGB1 were adoptively transferred to ALI mice and depleted by Diphtheria toxin (DT). For coculture experiment, isolated Tregs were first pre-stimulated with or without rHMGB1 or anti-HMGB1 antibody, then they were cocultured with bone marrow-derived macrophages (BMMs) under LPS stimulation.

RESULTS

Tregs protected against acute lung pathological injury. HMGB1 modulated the suppressive function of Tregs as follows: reduction in the number of the cells and the activity of Tregs, the secretion of anti-inflammatory cytokines (IL-10, TGF-β) from Tregs, the production of IL-2 from CD4⁺ T cells and CD11c⁺ DCs, and the M2 polarization of macrophages, as well as inducing proinflammatory response of macrophages.

CONCLUSIONS

HMGB1 could aggravate LPS induced-ALI through suppressing the activity and function of Tregs.

Breastfed 13 month-old infant of a mother with COVID-19 pneumonia: a case report

BACKGROUND

In China, mothers with confirmed or suspected COVID-19 pneumonia are recommended to stop breastfeeding. However, the evidence to support this guidance is lacking. There have been relatively few cases reported about direct breastfeeding an infant by a mother with SARS-CoV-2 pneumonia. Therefore, it is necessary to assess the safety of breastfeeding and the possible protective effects of breast milk on infants.

CASE PRESENTATION

This report analyzes the case of a mother who continued breastfeeding her 13 month-old child when both were diagnosed with confirmed COVID-19 pneumonia. We describe the clinical presentation, diagnosis, treatment, and outcome. The presence of SARS-CoV-2 nucleic acid was determined in maternal serum, breast milk, nasopharyngeal (NP) swabs and feces, and in infant serum, NP swabs and feces. IgM and IgG antibodies against SARS-CoV-2 were assessed in maternal serum and breast milk and in infant serum. SARS-CoV-2 nucleic acid was not detected in the breast milk, and antibodies against SARS-CoV-2 were detected in the mother's serum and milk.

CONCLUSIONS

The present case further confirms that the possibility of mother-to-child transmission about SARS-CoV-2 via breast milk alone was very small, and breast milk is safe for direct feeding of infants.

Peroxisome proliferator activated receptor γ promotes mineralization and differentiation in cementoblasts via inhibiting Wnt/β-catenin signaling pathway

Peroxisome proliferator activated receptor γ (PPARγ) is a member of the nuclear receptor family of transcription factors, which involved in inflammation regulating and bone remodeling. Rare studies explored the effects of PPARγ on mineralization and differentiation in cementoblasts. To explore the potential approaches to repair the damaged periodontal tissues especially for cementum, the present study aims to investigate the effects and the regulating mechanism of PPARγ on mineralization and differentiation in cementoblasts. Murine cementoblast cell lines (OCCM-30) were cultured in basic medium for 24 hours/48 hours or in mineralization medium for 3/7/10 days, respectively at addition of dimethyl sulphoxide, rosiglitazone (PPARγ agonist), GW9662 (PPARγ antagonist), lithium chloride (LiCl), tumor necrosis factor-α (TNF-α), or respective combination. Expression of mineralization genes alkaline phosphatase (ALP), runt related transcription factors 2 (RUNX2), and osteocalcin (OCN) were detected by quantitative real-time polymerase chain reaction or/and Western blot. ALP staining and alizarin red staining were used to evaluate the mineralization in OCCM-30 cells. The change of β-catenin expression and translocation in cytoplasm/nucleus was analyzed by Western blot and immunofluorescence. The results showed that PPARγ agonist rosiglitazone improved the expression of ALP, RUNX2, and OCN, deepened ALP staining, increased mineralized nodules formation, and decreased β-catenin expression in the nucleus. LiCl, an activator of the Wnt signaling pathway, inhibited the expression of mineralization genes and reversed the upregulated expression of mineralization genes resulted from rosiglitazone. Under inflammatory microenvironment, rosiglitazone not only suppressed the expression of interleukin-1β caused by TNF-α, but improved the expression of mineralization genes in OCCM-30 cells. In conclusion, PPARγ could promote mineralization and differentiation in cementoblasts via inhibiting the Wnt/β-catenin signaling pathway, which would shed new light on the treatment of periodontitis and periodontal tissue regeneration.