Proton Sponge Nanocomposites for Synergistic Tumor Elimination via Autophagy Inhibition-Promoted Cell Apoptosis and Macrophage Repolarization-Enhanced Immune Response

Cytoprotective autophagy and an immunosuppressive tumor microenvironment (TME) are two positive promoters for tumor proliferation and metastasis that severely hinder therapeutic efficacy. Inhibiting autophagy and reconstructing TME toward macrophage activation simultaneously are of great promise for effective tumor elimination, yet are still a huge challenge. Herein, a kind of dendrimer-based proton sponge nanocomposites was designed and constructed for tumor chemo/chemodynamic/immunotherapy through autophagy inhibition-promoted cell apoptosis and macrophage repolarization-enhanced immune response. These obtained nanocomposites contain a proton sponge G5AcP dendrimer, a Fenton-like agent Cu(II), and chemical drug doxorubicin (DOX). When accumulated in tumor regions, G5AcP can act as an immunomodulator to realize deacidification-promoted macrophage repolarization toward antitumoral type, which then secretes inflammatory cytokines to activate T cells. They also regulate intracellular lysosomal pH to inhibit cytoprotective autophagy. The released Cu(II) and DOX can induce aggravated damage through a Fenton-like reaction and chemotherapeutic effect in this autophagy-inhibition condition. Tumor-associated antigens are released from these dying tumor cells to promote the maturity of dendritic cells, further activating T cells. Effective tumor elimination can be achieved by this dendrimer-based therapeutic strategy, providing significant guidance for the design of a promising antitumor nanomedicine.

Trajectory of gestational weight gain is related to birthweight: The TAWS cohort study in China

Few studies have reported the timing and amount of gestational weight gain (GWG) to prevent large-for-gestational-age (LGA) or small-for-gestational-age (SGA). This study aimed to evaluate the association of GWG velocity in each trimester with LGA or SGA based on data from the Taicang and Wuqiang cohort study (TAWS, n = 2008). We used a linear mixed model to evaluate the association of trimester-specific GWG velocity with birthweight categories and stratified by prepregnancy body mass index category and parity. For normal-weight pregnant women, mothers with LGA births had higher GWG velocities than mothers with appropriate-for-gestational-age (AGA) births in the first trimester (0.108 vs. 0.031 kg/week, p < 0.01), second trimester (0.755 vs. 0.631 kg/week, p < 0.01) and third trimester (0.664 vs. 0.594 kg/week, p < 0.01); in contrast, mothers with SGA births had lower GWG velocities than mothers with AGA births in the second trimester (0.528 vs. 0.631 kg/week, p < 0.01) and third trimester (0.541 vs. 0.594 kg/week, p < 0.01). For normal-weight pregnant women with AGA births, multiparous women had lower GWG velocities than primiparous women in the second (0.602 vs. 0.643 kg/week, p < 0.01) and third trimesters (0.553 vs. 0.606 kg/week, p < 0.01). Therefore, for normal-weight women, LGA prevention would begin in early pregnancy and continue until delivery and the second and third trimesters may be critical periods for preventing SGA; in addition, among normal-weight pregnant women with AGA births, multiparous women tend to have lower weight gain velocities than primiparous women.

Clinical laboratory characteristics and gene mutation spectrum of Ph-negative MPN patients with atypical variants of JAK2, MPL, or CALR

OBJECTIVE

To evaluate the incidence, clinical laboratory characteristics, and gene mutation spectrum of Ph-negative MPN patients with atypical variants of JAK2, MPL, or CALR.

METHODS

We collected a total of 359 Ph-negative MPN patients with classical mutations in driver genes JAK2, MPL, or CALR, and divided them into two groups based on whether they had additional atypical variants of driver genes JAK2, MPL, or CALR: 304 patients without atypical variants of driver genes and 55 patients with atypical variants of driver genes. We analyzed the relevant characteristics of these patients.

RESULTS

This study included 359 patients with Ph-negative MPNs with JAK2, MPL, or CALR classical mutations and found that 55 (15%) patients had atypical variants of JAK2, MPL, or CALR. Among them, 28 cases (51%) were male, and 27 (49%) were female, with a median age of 64 years (range, 21-83). The age of ET patients with atypical variants was higher than that of ET patients without atypical variants [70 (28-80) vs. 61 (19-82), p = 0.03]. The incidence of classical MPL mutations in ET patients with atypical variants was higher than in ET patients without atypical variants [13.3% (2/15) vs. 0% (0/95), p = 0.02]. The number of gene mutations in patients with atypical variants of driver genes PV, ET, and Overt-PMF is more than in patients without atypical variants of PV, ET, and Overt-PMF [PV: 3 (2-6) vs. 2 (1-7), p < 0.001; ET: 4 (2-8) vs. 2 (1-7), p < 0.05; Overt-PMF: 5 (2-9) vs. 3 (1-8), p < 0.001]. The incidence of SH2B3 and ASXL1 mutations were higher in MPN patients with atypical variants than in those without atypical variants (SH2B3: 16% vs. 6%, p < 0.01; ASXL1: 24% vs. 13%, p < 0.05).

CONCLUSION

These data indicate that classical mutations of JAK2, MPL, and CALR may not be completely mutually exclusive with atypical variants of JAK2, MPL, and CALR. In this study, 30 different atypical variants of JAK2, MPL, and CALR were identified, JAK2 G127D being the most common (42%, 23/55). Interestingly, JAK2 G127D only co-occurred with JAK2V617F mutation. The incidence of atypical variants of JAK2 in Ph-negative MPNs was much higher than that of the atypical variants of MPL and CALR. The significance of these atypical variants will be further studied in the future.

[Prevalence of and risk factors for perceived absence of breast milk supply in Chinese lactating women in 2013]

OBJECTIVE

To investigate the prevalence and influencing factors of postpartum perceived absence of breast milk supply among Chinese mothers in 2013.

METHODS

This is a cross-sectional study based on the data collected from children and mothers under 2 years of age in 2013 as part of the nutrition and health surveillance of Chinese residents. In this study, multistage stratified cluster sampling method was used to select subjects from 55 countires/districts in 30 provinces in China. The perceived absence of breast milk supply was defined as the mother's self-reported absence of breast milk and failure to breastfeed. Breastfeeding knowledge, maternal breastfeeding knowledge and general characteristics were collected through a structured questionnaire. Univariate analysis and Logistic regression were used to analyze the factors associated with perceived absence of breast milk supply.

RESULTS

A total of 12091 mothers were included in the study, including 419 in the perceived non-breastfeeding group, the prevalence of perceived absence of breast milk supply was 3.5%. Multivariate Logistic regression showed maternal age(OR=1.04, 95%CI 1.02-1.06), postpartum hemorrhage(OR=2.03, 95%CI 1.30-3.16), and belief that breastfeeding should continue beyond 12 months of age(OR=0.27, 95%CI 0.17-0.45), not knowing how to breastfeed(OR=3.31, 95%CI: 2.31-4.74) were the main influencing factors for perceived absence of breast milk supply after delivery.

CONCLUSION

Age, postpartum hemorrhage and knowledge level of breastfeeding are the main risk factors for perceived absence of breast milk supply, and knowledge level of breastfeeding is a modifiable factor.

Reticulate evolution of the tertiary relict Osmanthus

When interspecific gene flow is common, species relationships are more accurately represented by a phylogenetic network than by a bifurcating tree. This study aimed to uncover the role of introgression in the evolution of Osmanthus, the only genus of the subtribe Oleinae (Oleaceae) with its distribution center in East Asia. We built species trees, detected introgression, and constructed networks using multiple kinds of sequencing data (whole genome resequencing, transcriptome sequencing, and Sanger sequencing of nrDNA) combined with concatenation and coalescence approaches. Then, based on well-understood species relationships, historical biogeographic analyses and diversification rate estimates were employed to reveal the history of Osmanthus. Osmanthus originated in mid-Miocene Europe and dispersed to the eastern Tibetan Plateau in the late Miocene. Thereafter, it continued to spread eastwards. Phylogenetic conflict is common within the 'Core Osmanthus' clade and is seen at both early and late stages of diversification, leading to hypotheses of net-like species relationships. Incomplete lineage sorting proved ineffective in explaining phylogenetic conflicts and thus supported introgression as the main cause of conflicts. This study elucidates the diversification history of a relict genus in the subtropical regions of eastern Asia and reveals that introgression had profound effects on its evolutionary history.

Effects of prepregnancy dietary patterns on infant birth weight: a prospective cohort study

BACKGROUND

Maternal nutrition can have a profound effect on fetal growth, development, and subsequent infant birth weight. However, little is known regarding the influence of prepregnancy dietary patterns.

OBJECTIVES

This study aimed to explore the effects between prepregnancy dietary patterns on birth weight.

METHODS

This study included 911 singleton live-born infants from the Taicang and Wuqiang Mother-Child Cohort Study (TAWS). Baseline information and prepregnancy diet data were collected during early pregnancy. Newborn birth information was obtained from the Wuqiang County Hospital. Macrosomia, defined as a birth weight of ≥4000 g, and large for gestational age (LGA), defined as a birth weight higher than the 90th percentile for the same sex and gestational age, were the outcomes of interest. The dietary patterns were extracted using principal component analysis. Logistic regression models were used to investigate the association between prepregnancy dietary patterns (in tertiles) and macrosomia and LGA, and subgroup analysis was further explored by pre-pregnancy body mass index (BMI).

RESULTS

Four dietary patterns were identified based on 15 food groups. These patterns were named as "cereals-vegetables-fruits," "vegetables-poultry-aquatic products," "milk-meat-eggs," and "nuts-aquatic products-snacks." After adjusting for sociodemographic characteristics, pregnancy complications, and other dietary patterns, greater adherence to the "cereals-vegetables-fruits" pattern before pregnancy was associated with a higher risk of macrosomia (adjusted OR = 2.220, 95% CI: 1.018, 4.843), while greater adherence to the "nuts-aquatic products-snacks" pattern was associated with a lower risk of macrosomia (adjusted OR = 0.357, 95% CI: 0.175, 0.725) compared to the lowest tertile. No significant association was observed between prepregnancy dietary patterns and LGA. However, after subgroup analysis of pre-pregnancy BMI, "cereals-vegetables-fruits" pattern was associated with an increased risk of LGA in overweight and obese mothers (adjusted OR = 2.353, 95% CI: 1.010, 5.480).

CONCLUSIONS

An unbalanced pre-pregnancy diet increases the risk of macrosomia and LGA, especially in overweight or obese women before pre-pregnancy.

PD-1 Inhibitors and Chemotherapy Combined with or without Radiotherapy for Patients with Oligometastatic Esophageal Cancer

PURPOSE/OBJECTIVE(S)

Oligometastatic esophageal cancer (OMEC) is an intermediate state between local advanced and widespread metastatic disease, which is associated with better prognosis compared to poly-metastatic esophageal cancer (EC). The previous studies demonstrated the survival benefit from local radiotherapy for OMEC patients. But the data of PD-1 inhibitors combined with radiotherapy for OMEC is still scarce. The purpose of the present study was to determine the efficacy and safety of PD-1 inhibitors plus radiotherapy in OMEC.

MATERIALS/METHODS

OMEC was defined as "up to five measurable metastatic lesions and up to three organs involved". Patients with OMEC receiving PD-1 inhibitors plus chemotherapy in a single center were retrospectively analyzed in this study. They were dichotomized according to whether or not they had received radiotherapy. The efficacy and safety of immunochemotherapy combined with radiotherapy (RT group) and immunochemotherapy alone (NRT group) were investigated.

RESULTS

A total of 226 patients were included; 108 patients received PD-1 inhibitors plus chemotherapy and radiotherapy, while other 118 patients were treated with immunochemotherapy alone. Baseline characteristics were well balanced between the groups. The overall response rate (ORR) was 58.3% in the RT group and 41.5% in the NRT group (P = 0.012), respectively. The median PFS was 13.5 months (95% CI, 10.0-17.1) for the RT group and 8.8 months (95% CI, 9.2-12.0) for the NRT group (P = 0.000). The addition of radiotherapy was the major prognostic factor for PFS (hazard ratio, 0.56; 95% CI, 0.406-0.761; P = 0.000) by univariate Cox regression analysis. Patients were well-tolerated, and the overall incidence of adverse events was similar between the RT group and NRT group. In addition, the incidence of treatment-related pneumonitis did not differ between the two groups. Grade 3-5 pneumonitis was observed in 3.7% and 5.1% of patients in the RT and NRT groups, respectively.

CONCLUSION

The additional of radiotherapy to PD-1 inhibitors and chemotherapy improved PFS of patients with OMEC and showed acceptable toxicity. Further prospective studies investigating the combination of immunochemotherapy and radiotherapy are warranted.

Evaluating the Effects of Bone Marrow Sparing Radiotherapy on Acute Hematologic Toxicity for Patients with Locoregionally Advanced Cervical Cancer: A Prospective Phase II Randomized Controlled Trial

PURPOSE/OBJECTIVE(S)

Bone marrow sparing intensity modulated radiotherapy (BMS-IMRT) can reduce the incidence of acute hematologic toxicity (HT) for locoregionally advanced cervical cancer (LACC) patients receiving concurrent chemoradiotherapy (CCRT), but the norm has been controversial. The purpose of the study was to evaluate the effects of bone marrow (BM) V40 <25% on decreasing the incidence of acute HT in a prospective clinical trial.

MATERIALS/METHODS

A total of 242 LACC patients were recruited from May 2021 to May 2022, who were evenly randomized into BMS-IMRT group and standard IMRT group according to a computer-generated random number list. All patients received pelvic irradiation with concurrent cisplatin (40 mg/m2 weekly), followed by brachytherapy. For patients in BMS-IMRT group, the outer contour of pelvic bone, lumbar spine and left and right femur heads were additionally delineated as a surrogate for BM, and V40 <25% was prescribed. Blood counts were tested weekly, of which nadirs during external beam radiotherapy (EBRT) were graded to assess acute HT as primary observation index. Second observation index were dosimetric parameters of EBRT plan from the dose volume histograms (DVHs). Binary logistic regression model and receiver operating characteristic (ROC) curve were used for predictive value analysis.

RESULTS

Baseline demographic, disease and treatment characteristics were all balanced between BMS-IMRT group and standard IMRT group. BMS-IMRT was associated with a lower incidence of grade ≥2 and grade ≥3 acute HT, leukopenia and neutropenia (72.70% vs 90.90%, P <0.001*; 16.50% vs 65.30%, P <0.001*; 66.10% vs 85.10%, P = 0.001*; 13.20% vs 54.50%, P <0.001*; 37.20% vs 66.10%, P <0.001*; 10.70% vs 43.80%, P <0.001*). Plan target volume (PTV) for all patients satisfied the clinical requirement of V(100%) ≥95%, and conformity and homogeneity were both comparable between 2 groups. BMS also decreased dose delivered to the organs at risk (OARs) including rectum, bladder and left and right femur head. Univariate and multivariate analyses showed that BM V40 was an independent risk factor for grade ≥3 acute HT (odds ratio [OR] = 2.734, 95% confidence interval [CI] = 1.959-3.815, P <0.001*). Cutoff value was 25.036% and area under the curve (AUC) was 0.786. The nomogram was constructed, which was rigorously evaluated and internally cross-validated, showing good predictive performance.

CONCLUSION

BM V40 <25% can reduce the risks of acute HT for LACC patients receiving CCRT while the dose delivery of target volume and other normal tissues were not compromised. With great practicality and applicability, BM V40 <25% is a promising strategy, making BMS-IMRT widespread especially in the area where application of image guided radiotherapy (IGRT) such as 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET)/CT is not popularized. Chinese clinical trial registry (ChiCTR2200066485).

[Influence of family with sequence similarity 134, member B-mediated reticulophagy on lipopolysaccharide-induced apoptosis of mouse dendritic cells]

Objective: To investigate the influence of family with sequence similarity 134, member B (FAM134B)-mediated reticulophagy on lipopolysaccharide (LPS)-induced apoptosis of mouse dendritic cells (DCs), so as to provide a basis for improving the immune suppression of sepsis caused by wound infection and other factors. Methods: The experimental research methods were used. The DC line DC2.4 of the 3rd to 10th passage in the logarithmic growth stage was collected for experiments. DCs were divided into LPS stimulation 0 h (no stimulation) group, LPS stimulation 6 h group, LPS stimulation 12 h group, LPS stimulation 24 h group, and LPS stimulation 72 h group, which were cultured with 1 μg/mL LPS (the same concentration below) for the corresponding time. The protein expressions of FAM134B, microtubule-associated protein 1 light chain 3B (LC3B), and transporter protein SEC61B were determined by Western blotting, and the ratio of LC3B-Ⅱ/LC3B-Ⅰ was calculated (n=3). DCs were divided into phosphate buffer solution (PBS) group and LPS group for corresponding treatment. After 24 hours of culture, the expression of FAM134B and its co-localization with lysosomal probes and LC3B were detected using immunofluorescence method, while the number of autolysosomes in cells were observed through transmission electron microscope. DCs were divided into the FAM134B-knockdown group that were transfected with lentivirus containing small interfering RNA (siRNA) sequence of FAM134B gene and the empty vector group with empty lentivirus transfected. At post transfection hour 72, the fluorescence expression of cells was observed under the inverted fluorescence phase contrast microscope, meanwhile, the normally cultured DCs were set as blank control group, and the same observation was performed at the corresponding time point. DCs were divided into PBS alone group and LPS alone group, DCs successfully transfected with lentivirus containing siRNA sequence of FAM134B gene were divided into FAM134B-knockdown+PBS group and FAM134B-knockdown+LPS group, and DCs successfully transfected with empty lentivirus were divided into empty vector+PBS group and empty vector+LPS group. These cells were stimulated correspondingly and cultured for 24 hours. The protein expression of FAM134B was detected using Western blotting (n=3); the apoptotic rate of cells was determined by flow cytometry (n=3); the situation of apoptosis was observed by Hoechst staining, and the apoptotic rate was calculated (n=5); the protein expressions of cleaved cysteine aspartic acid specific protease-3 (caspase-3), B cell lymphoma 2 (Bcl-2), and Bcl-2-associated X protein (Bax) were detected using Western blotting, and the ratio of Bax/Bcl-2 was calculated (n=5). Data were statistically analyzed with one-way analysis of variance (ANOVA), least significant difference test, and ANOVA for factorial design. Results: Compared with those in LPS stimulation 0 h group, the protein expressions of FAM134B of cells in LPS stimulation 12 h group and LPS stimulation 24 h group were significantly increased (P<0.05), the protein expressions of SEC61B of cells in LPS stimulation 6 h group, LPS stimulation 12 h group, LPS stimulation 24 h group, and LPS stimulation 72 h group were significantly decreased (P<0.05), and the ratios of LC3B-Ⅱ/LC3B-Ⅰ of cells in LPS stimulation 24 h group and LPS stimulation 72 h group were obviously increased (P<0.05). As the most significant changes of three proteins were seen in the cells of LPS stimulation 24 h group, 24 h was used as the duration of subsequent LPS stimulation. After 24 hours of culture, the expression of FAM134B and its co-localization with LC3B and lysosomal probes in the cells of LPS group were all significantly enhanced, with a significant increase in the number of autolysosomes in comparison with those in PBS group. Both the empty vector group and the FAM134B-knockdown group showed high intensity fluorescence in the cells at post transfection hour 72, but the blank control group showed no fluorescence in the cells at the corresponding time point. After 24 hours of culture, the protein expression of FAM134B of cells in FAM134B-knockdown+PBS group was significantly lower than the expressions in PBS alone group and empty vector+PBS group (with P values all <0.05), the protein expression of FAM134B of cells in FAM134B-knockdown+LPS group was significantly lower than the expressions in LPS alone group and empty vector+LPS group (with P values all <0.05), the protein expression of FAM134B of cells in LPS alone group was significantly higher than that in PBS alone group (P<0.05), while the protein expression of FAM134B of cells in empty vector+LPS group was significantly higher than that in empty vector+PBS group (P<0.05). After 24 hours of culture, flow cytometry assay revealed that the apoptotic rate of cells in PBS alone group, LPS alone group, empty vector+PBS group, empty vector+LPS group, FAM134B-knockdown+PBS group, and FAM134B-knockdown+LPS group were (13.3±0.8)%, (32.6±4.3)%, (17.0±1.5)%, (51.7±3.3)%, (52.4±3.1)%, and (62.3±2.6)%, respectively. After 24 hours of culture, compared with those in LPS alone group and empty vector+LPS group, the protein expression of cleaved caspase-3, the ratio of Bax/Bcl-2, and the apoptotic rates of cells detected by flow cytometry and Hoechst staining were significantly increased in FAM134B-knockdown+LPS group (P<0.05); compared with those in the corresponding PBS treatment group, namely, PBS alone group, empty vector+PBS group, and FAM134B-knockdown+PBS group, the protein expression of cleaved caspase-3, the ratio of Bax/Bcl-2, and the apoptotic rates of cells detected by flow cytometry and Hoechst staining were significantly increased in LPS alone group, empty vector+LPS group, and FAM134B-knockdown+LPS group (P<0.05). Conclusions: The activation of reticulophagy mediated by FAM134B in mouse DCs is enhanced and peaked in 24 hours under LPS stimulation, and the activated reticulophagy has a significant inhibitory effect on cell apoptosis.

[Status of infant and young child feeding in China in 2016-2017]

OBJECTIVE

To describe the feeding status and related factors of infant and young child aged 6-23 months in China.

METHODS

Data was from the China Nutrition and Health Surveillance among 0-17 Years Old Children and Lactating Women in 2016-2017, and 20 423 children aged 6-23 months were involved in 275 surveillance sites from 31 provinces(autonomous regions and municipalities). The introduction of solid, semi-solid or soft foods, minimum dietary diversity, minimum meal frequency were analyzed with WHO and UNICEF 2021 updated infant and young child feeding indicators. Data analyses were conducted using the complex weight based on national census from National Bureau of Statistics in 2010. Rao-Scott Chi-square was used test for statistical difference.

RESULTS

The percentage of infants 6-8 months of age who consumed solid, semi-solid or soft foods was 83.2%(95%CI 80.5%-85.9%) in 2016-2017. No significant difference were observed between boys and girls; there was significant difference in different areas(Rao-Scott χ~2=30.85, P<0.01), it was 90.3% in medium and small cities, and reached 75.0% even in poor rural areas. The proportions of children aged 6-23 months meeting minimum dietary diversity(MDD) was 60.6%(95%CI 58.1%-63.1%). It was 71.1% in medium and small cities, and 50.5% in poor rural areas. Except for breast milk, the percentage of eggs(34.4%) and legumes(19.0%) consumption was low, the percentage of grains, vitamin A-rich fruits or vegetables consumption was 89.7%(95%CI 88.4%-91.1%). The percentage of consuming egg and/or flesh food was 76.4%(95%CI 74.2%-78.7%). The percentage of zero vegetables or fruits consumption was 9.1%(95%CI 7.8%-10.4%). The proportions of children aged 6-23 months meeting minimum meal frequency(MMF) was 72.4%(95%CI 70.1%-74.7%). It was over 70% in large cities, medium and small cities, general rural areas; and 60.2% in poor rural areas. The proportions of children aged 6-23 months meeting minimum acceptable diet was 43.4%(95%CI 40.7%-46.1%), it was over 50% in urban areas, and less than 40% in rural areas, 30.1% in poor rural areas. No consistent differences were observed between boys and girls for all 3 indicators(MDD, MMF and MAD), and there was significant difference in different areas and various months of age(P<0.01).

CONCLUSION

There was no gender difference in the feeding status of children aged 6-23 months in China, the complementary feeding was relatively timely, and the minimum dietary diversity and meal frequency of children were relatively ideal, but the minimum acceptable diet of children in poor rural areas was poor.

Transgenic ferret models define pulmonary ionocyte diversity and function

Speciation leads to adaptive changes in organ cellular physiology and creates challenges for studying rare cell-type functions that diverge between humans and mice. Rare cystic fibrosis transmembrane conductance regulator (CFTR)-rich pulmonary ionocytes exist throughout the cartilaginous airways of humans1,2, but limited presence and divergent biology in the proximal trachea of mice has prevented the use of traditional transgenic models to elucidate ionocyte functions in the airway. Here we describe the creation and use of conditional genetic ferret models to dissect pulmonary ionocyte biology and function by enabling ionocyte lineage tracing (FOXI1-CreERT2::ROSA-TG), ionocyte ablation (FOXI1-KO) and ionocyte-specific deletion of CFTR (FOXI1-CreERT2::CFTRL/L). By comparing these models with cystic fibrosis ferrets3,4, we demonstrate that ionocytes control airway surface liquid absorption, secretion, pH and mucus viscosity-leading to reduced airway surface liquid volume and impaired mucociliary clearance in cystic fibrosis, FOXI1-KO and FOXI1-CreERT2::CFTRL/L ferrets. These processes are regulated by CFTR-dependent ionocyte transport of Cl- and HCO3-. Single-cell transcriptomics and in vivo lineage tracing revealed three subtypes of pulmonary ionocytes and a FOXI1-lineage common rare cell progenitor for ionocytes, tuft cells and neuroendocrine cells during airway development. Thus, rare pulmonary ionocytes perform critical CFTR-dependent functions in the proximal airway that are hallmark features of cystic fibrosis airway disease. These studies provide a road map for using conditional genetics in the first non-rodent mammal to address gene function, cell biology and disease processes that have greater evolutionary conservation between humans and ferrets.

Prussian blue nanozymes: progress, challenges, and opportunities

Prussian Blue Nanozymes (PBNZs) have emerged as highly efficient agents for reactive oxygen species (ROS) elimination, owing to their multiple enzyme-like properties encompassing catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD) activities. As a functional nanomaterial mimicking enzyme, PBNZs not only surmount the limitations of natural enzymes, such as instability and high manufacturing costs, but also exhibit superior stability, tunable activity, low storage expenses, and remarkable reusability. Consequently, PBNZs have gained significant attention in diverse biomedical applications, including disease diagnosis and therapy. Over the past decade, propelled by advancements in catalysis science, biotechnology, computational science, and nanotechnology, PBNZs have witnessed remarkable progress in the exploration of their enzymatic activities, elucidation of catalytic mechanisms, and wide-ranging applications. This comprehensive review aims to provide a systematic overview of the discovery and catalytic mechanisms of PBNZ, along with the strategies employed to modulate their multiple enzyme-like activities. Furthermore, we extensively survey the recent advancements in utilizing PBNZs for scavenging ROS in various biomedical applications. Lastly, we analyze the existing challenges of translating PBNZs into therapeutic agents for clinical use and outline future research directions in this field. By presenting a comprehensive synopsis of the current state of knowledge, this review seeks to contribute to a deeper understanding of the immense potential of PBNZs as an innovative therapeutic agent in biomedicine.

The Association between Macrosomia and Amino Acids' Levels in Maternal and Cord Sera: A Case-Control Study

This study aims to explore the relationship between macrosomia and amino acids in maternal and cord sera.

METHODS

In the case-control study, 78 pairs of mothers and newborns were recruited from December 2016 to November 2019. Participants were divided into the macrosomia group (BW ≥ 4000 g, n = 39) and the control group (BW between 2500 g and 3999 g, n = 39) according to the birth weight (BW) of newborns. Maternal vein blood samples were collected before delivery and cord vein blood samples were collected after birth. The levels of amino acids in maternal and cord sera were measured by liquid chromatography and mass spectrometry (LC-MS/MS) in the year 2021. The difference in amino acid levels in maternal and cord sera between the two groups was compared, and the contribution of each amino acid to the difference between the two groups was analyzed. Unconditional logistic regression analysis was used to test the relationship between macrosomia and amino acids.

RESULTS

In maternal serum during the antepartum, the levels of asparagine, glutamine, methionine, alanine, and threonine in the macrosomia group were higher but arginine was lower than that in the control group (p < 0.05). In cord serum, the levels of lysine, histidine, phenylalanine, arginine, tryptophan, valine, isoleucine, glutamate, tyrosine, and total essential amino acid (EAA) in the macrosomia group were lower while glutamine was higher than that in the control group (p < 0.05). The ratios of EAA, valine, threonine, methionine, tryptophan, and alanine in maternal serum to those in cord serum were higher, while the ratio of glutamine was lower in the macrosomia group (p < 0.05). Arginine and threonine in maternal serum and glutamate, glutamine, and histidine in cord serum were associated with macrosomia (p < 0.05).

CONCLUSION

Most of the amino acid levels in the maternal sera of the macrosomia group are higher than those in the control group, while most of the amino acids' levels in the cord sera of the macrosomia group are lower than those in the control group. The ratios of some amino acids in maternal serum to those in cord serum were different between the two groups. Arginine and threonine in maternal serum and glutamate, glutamine, and histidine in cord serum are closely related to macrosomia.

Prevention of the social isolation of older persons: the impact of community environmental satisfaction on social isolation

Background

To explore how to prevent the social isolation of the older adult, this study constructed a model of the influence of community environmental satisfaction on the social isolation of the older adult from the three dimensions of environmental facilities, transportation, and supporting facilities around the community. Methods: The social network scale and environmental satisfaction scale were used to collect the sample data of nine communities in Xi'an, and the maximum likelihood estimation method was used to analyze the data and test the model.

Results

(1) Environmental facilities, transportation, and community surrounding facilities promoted community environment satisfaction (R² = 0.904). Among them, environmental facilities (β = 0.869) had the greatest impact on community environmental satisfaction, followed by transportation (β = 0.118), and surrounding facilities (β = 0.084) had the least impact on community environmental satisfaction. (2) Environmental satisfaction had a direct positive impact on social isolation. Among them, the impact of environmental satisfaction on friend isolation (R² = 0.895, β = 0.829) was greater than that on family isolation (R² = 0.718, β = 0.747).

Conclusion

Environmental satisfaction can directly affect the social isolation of the older adult in the community and can be used as an intermediate variable of environmental facilities, transportation, and surrounding facilities in the community so that it can indirectly affect the social isolation of the older adult. The results of this study provide a scientific basis for the design of aging environments in the future.

Alternative Splicing Analysis Revealed the Role of Alpha-Linolenic Acid and Carotenoids in Fruit Development of Osmanthus fragrans

Alternative splicing refers to the process of producing different splicing isoforms from the same pre-mRNA through different alternative splicing events, which almost participates in all stages of plant growth and development. In order to understand its role in the fruit development of Osmanthus fragrans, transcriptome sequencing and alternative splicing analysis was carried out on three stages of O. fragrans fruit (O. fragrans "Zi Yingui"). The results showed that the proportion of skipping exon events was the highest in all three periods, followed by a retained intron, and the proportion of mutually exclusive exon events was the lowest and most of the alternative splicing events occurred in the first two periods. The results of enrichment analysis of differentially expressed genes and differentially expressed isoforms showed that alpha-Linolenic acid metabolism, flavonoid biosynthesis, carotenoid biosynthesis, photosynthesis, and photosynthetic-antenna protein pathways were significantly enriched, which may play an important role in the fruit development of O. fragrans. The results of this study lay the foundation for further study of the development and maturation of O. fragrans fruit and further ideas for controlling fruit color and improving fruit quality and appearance.

Human Milk Oligosaccharides Are Associated with Lactation Stage and Lewis Phenotype in a Chinese Population

Background: Human milk oligosaccharides (HMOs) are the third most abundant component of human milk. Various factors may affect the concentration of HMOs, such as the lactation period, Lewis blood type, and the maternal secretor gene status. Objectives: The purpose of this study is to investigate factors associated with HMO concentrations in Chinese populations. Methods: A sub-sample of 481 was randomly selected from a large cross-sectional study in China (n = 6481) conducted in eight provinces (Beijing, Heilongjiang, Shanghai, Yunnan, Gansu, Guangdong, Zhejiang, and Shandong) between 2011 and 2013. HMO concentrations were determined by a high-throughput UPLC-MRM method. Various factors were collected through face-to-face interviews. Anthropometric measurement was conducted by trained staff. Results: Median total HMO concentration was 13.6 g/L, 10.7 g/L, and 6.0 g/L for colostrum, transitional milk, and mature milk, respectively. HMO concentration decreased significantly as the lactation period increased (p < 0.0001). There were significant differences of average total HMO concentration between secretor mothers and non-secretor mothers (secretor 11.3 g/L vs. non-secretor 5.8 g/L, p < 0.0001). There were significant differences of average total HMO concentrations among three Lewis blood types (p = 0.003). Comparing with the concentration of total oligosaccharides of Le+ (a−b+), average of total oligosaccharides concentrations increased by 3.9 (Le+ (a+b−), p = 0.004) and 1.1 g/L (Le− (a−b−), p = 0.049). The volume of breast milk expressed and the province the mother came from affected the concentration of total oligosaccharides (all p < 0.0001). Maternal BMI (p = 0.151), age (p = 0.630), prematurity (p = 0.850), mode of delivery (p = 0.486), infants’ gender (p = 0.685), maternal education level (p = 0.989), maternal occupation (p = 0.568), maternal allergic history (p = 0.370), maternal anemia (p = 0.625), pregnancy-induced hypertension (p = 0.739), gestational diabetes (p = 0.514), and parity (p = 0.098) were not significantly correlated with the concentration of milk oligosaccharides. The concentrations of 2′-fucosyllactose (2′-FL), lacto-N-neotetraose (LNnT), sialyllacto-N-tetraose c (LSTc), lacto-N-fucopentaose I (LNFP-I), disialylated lacto-N-tetraose (DSLNT), difucosyl-para-lacto-N-neohexaose (DFpLNnH), difucosyl-lacto-N-hexaose (DFLNH[a]), and 3-sialyllactose (3′-SL) showed a gradual downward trend, while the concentration of 3-fucosyllactose (3-FL) showed a gradual upward trend among three lactation stages (p < 0.05). Conclusions: The concentration of HMOs changes throughout lactation, and it varies between different HMOs. HMO concentrations differed between lactation stage, maternal secretor gene status, Lewis blood type, volume of breast milk expressed, and the province the mother came from. Prematurity, mode of delivery, parity, infants’ gender, and maternal characteristics did not affect the HMO concentration. Geographical region may be not associated with HMOs concentration in human milk. There may be a mechanism for co-regulation of the secretion of some of the oligosaccharides such as 2′FL vs. 3FL, 2′FL vs. LNnT, and lacto-N-tetraose (LNT).

Population data and phylogenetic analysis of 37 Y-STR loci in the Hui population from Yunnan Province, Southwest China

Background: Previous studies of the genetic polymorphism of the Y-chromosomal short tandem repeat (Y-STR) of Huis were focused on the northwest of China. However, the population genetic characteristics of Chinese Hui residing in Yunnan province, Southwest China, remain unclear.Aim: To provide genetic data for 37 Y-STRs in the Chinese Hui population of Yunnan province, as well as to investigate population genetic relationships between the Chinese Hui and another 26 populations from China and neighbouring countries.Subjects and methods: 326 unrelated healthy male individuals were genotyped using the Goldeneye^TM Y Plus PCR Amplification Kit. Genetic relationships between different populations were analysed using YHRD's AMOVA tools.Results: A total of 279 haplotypes were detected, out of which 244 were unique. The overall haplotype diversity (HD) and discrimination capacity (DC) were 0.9989 and 0.8611, respectively. The gene diversity (GD) ranged from 0.0544 (DYS645) to 0.9656 (DYS385).Conclusions:  The population comparison indicated that Muslim populations (Hui, Salar, and Uighur) showed significant genetic affinity than other populations. Our results could be applied in forensic practice and population genetic studies.

Enhanced Na+ and Cl- sequestration and secretion selectivity contribute to high salt tolerance in the tetraploid recretohalophyte Plumbago auriculata Lam

Enhanced secretion of Na⁺ and Cl^- in leaf glands and leaf vacuolar sequestration of Na⁺ or root retention of Cl^-, combined with K⁺ retention, contribute to the improved salt tolerance of tetraploid recretohalophyte P. auriculata. Salt stress is one of the major abiotic factors threatening plant growth and development, and polyploids generally exhibit higher salt stress resistance than diploids. In recretohalophytes, which secrete ions from the salt gland in leaf epidermal cells, the effects of polyploidization on ion homeostasis and secretion remain unknown. In this study, we compared the morphology, physiology, and ion homeostasis regulation of diploid and autotetraploid accessions of the recretohalophyte Plumbago auriculata Lam. after treatment with 300 mM NaCl for 0, 2, 4, 6, and 8 days. The results showed that salt stress altered the morphology, photosynthetic efficiency, and chloroplast structure of diploid P. auriculata to a greater extent than those of its tetraploid counterpart. Moreover, the contents of organic osmoregulatory substances (proline and soluble sugars) were significantly higher in the tetraploid than in the diploid, while those of H₂O₂ and malondialdehyde (MDA) were significantly lower. Analysis of ion homeostasis revealed that the tetraploid cytotype accumulated more Na⁺ in stems and leaves and more Cl^- in roots but less K⁺ loss in roots compared with diploid P. auriculata. Additionally, the rate of Na⁺ and Cl^- secretion from the leaf surface was higher, while that of K⁺, Mg²⁺, and Ca²⁺ secretion was lower in tetraploid plants. X-ray microanalysis of mesophyll cells revealed that Na⁺ mainly accumulated in different cellular compartments in the tetraploid (vacuole) and diploid (cytoplasm) plants. Our results suggest that polyploid recretohalophytes require the ability to sequester Na⁺ and Cl^-(via accumulation in leaf cell vacuoles or unloading by roots) and selectively secrete these ions (through salt glands) together with the ability to prevent K⁺ loss (by roots). This mechanism required to maintain K⁺/Na⁺ homeostasis in polyploid recretohalophytes under high salinity provides new insights in the improved maintenance of ion homeostasis in polyploids under salt stress.

Mesoporous polydopamine-based nanoplatform for enhanced tumor chemodynamic therapy through the reducibility weakening strategy

Polydopamine (PDA)-based Fenton agents attract increasing attention in tumor photothermal-enhanced chemodynamic therapy (CDT) due to their good biocompatibility and excellent loading capacity. However, PDA tends to eliminate the Fenton reaction-generated hydroxyl radical (∙OH) by its strong reducibility, which is an intractable hinder to the efficacy of CDT that need to be solved. Herein, a kind of mesoporous PDA-gold-manganese dioxide (MPDA-Au-MnO₂, MPAM) nanoplatform was constructed for photothermal-enhanced CDT against tumor through the reducibility weakening strategy. The reducibility of original MPDA is effectively weakened by the oxidation role of HAuCl₄ and KMnO₄ during the preparation process, reducing the ∙OH scavenging ability of MPDA and benefiting the production of ∙OH. The MnO₂ shell could react with GSH to release Mn²⁺, acting as the Fenton-like agent to generate ∙OH. The exposed Au NPs can further deplete GSH through the Au-S bond interaction. MPDA acts as the photothermal agent to generate hyperthermia under laser irradiation. MPAM shows excellent intracellular GSH scavenging ability and enhanced ∙OH production ability. After intravenous injection, MPAM can significantly suppress the growth of tumors under laser irradiation, meanwhile showing good biosafety. The developed MPDA-based nanoplatform can not only display good potential in further tumor treatments but also provide meaningful enlightenment for developing high-performance PDA or MPDA-based nanoplatforms in CDT-related applications.

Polyethylene mulching film degrading bacteria within the plastisphere: Co-culture of plastic degrading strains screened by bacterial community succession

As an ecological niche close to the polymer, microorganisms in the plastisphere possess the advantage of degrading plastics. This study aims to investigate the bacterial community succession and obtain degrading bacteria in the plastisphere, as well as identify the most efficient degradation combination by co-culture of multiple strains. The findings demonstrate the alpha-diversity indices of the plastisphere bacterial community are significantly lower, and the community structure is regularly and significantly altered. With the time of culture, the plastisphere community composition alters regularly, and the hydrocarbon-degrading genera become the core members. Functional prediction of community reveals the potential for Xenobiotics Biodegradation and Metabolism of plastisphere, and the apparent variations detections of polyethylene mulching film (PMF) indicating the PMF degrading ability of plastisphere. Besides, three PMF-degrading bacterial strains, Rhodopseudomonas sp. P1 (P), Rhodanobacter sp. Rs (R) and Microbacterium sp. M1 (M), are screened for co-culture with PMF degrading strain Bacillus aryabhattai 5-3 (B). By considering bacterial growth, biofilm adhesion, and apparent degradation of different samples, RB (R. sp. Rs + B. aryabhattai 5-3) is ultimately selected as the best PMF degradation combination. This study provides a new possibility for plastisphere-related research from the perspective of mitigating plastic pollution on agricultural land.

Plant-Based Diet and Risk of Frailty in Older Chinese Adults

OBJECTIVES

This study examined the relationship between the consumption of plant-based diet and frailty in older Chinese adults.

DESIGN

Prospective cohort study.

SETTING

Community-based setting in 22 provinces of China.

PARTICIPANTS

The final sample included data from 3990 older adults from 2011-2014 from the Chinese Longitudinal Healthy Longevity Survey.

MEASUREMENTS

A plant-based diet index (PDI) was calculated based on a qualitative food frequency questionnaire. Frailty was defined using modified Fried criteria. A Generalized Estimating Equation was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for frailty. We further performed subgroup analyses stratified by sex and lifestyle factors.

RESULTS

557 cases of frailty were observed. After adjustment for covariates, the RR for frailty of a high PDI was 0.792 (95% CI: 0.644-0.973), relative to a low PDI. During follow-up, compared with respondents with a continually low PDI, the respondents with a continually high PDI had a significantly reduced risk of frailty (RR = 0.683, 95% CI: 0.514-0.908). In further subgroup analysis, a consistently high PDI over time resulted in a significantly reduced risk of frailty for male (RR = 0.591, 95% CI: 0.391-0.893); for never smokers (RR = 0.670, 95% CI: 0.458-0.979); for people who did never consume alcohol (RR = 0.654, 95% CI: 0.454-0.941); and for people with current or former exercise habits (RR = 0.488, 95% CI: 0.313-0.762).

CONCLUSION

Plant-based diet was associated with low risk of frailty in men and in older adults with healthy lifestyle. These findings stress that plant-based diet should be recommended as a dietary strategy to prevent and reduce frailty in older adults; in addition, more dietary interventions along with lifestyle modification should be adopted to promote successful ageing, especially for women.

[Dietary micronutrient intake of children aged 2-5 years in China in 2019-2021]

OBJECTIVE

To describe dietary intake of calcium, iron, zinc, selenium, vitamin A, vitamin B_1, vitamin B_2 and vitamin C and compare the intake between urban and rural areas among preschool children aged 2-5 years based on the data from the National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China.

METHODS

Children from 14 provinces were selected by multi-stage stratified random cluster sampling, and the dietary data of preschool children aged 2-5 years were recorded using the 3 day 24-hour weighted food records method. SAS 9.4 was used to calculate dietary intake of these micronutrients based on the Chinese Food Composition Table and to compare the intake between urban and rural areas. The risk of insufficient or excessive intake of micronutrients among Chinese children aged 2-5 years was assessed according to the Chinese Dietary Reference Intakes(DRIs) 2013 edition.

RESULTS

A total of 820 children aged 2 to 5 years were selected. The median daily dietary calcium intake of children aged 2-5 years in China was 433.7, 338.9, 356.4 and 347.4 mg, respectively. The median daily dietary intake of vitamin B_1 of children aged 2-5 years was 0.5 mg for all age groups. The median daily dietary vitamin B_2 intake of children aged 2-5 years was 0.7, 0.6, 0.6 and 0.6 mg, respectively. The median daily dietary intake of vitamin C of children aged 2-5 years was 37.9, 37.4, 44.0 and 40.0 mg, respectively. The median daily dietary selenium intake of children aged 2-5 years was 17.1, 20.5, 22.7 and 22.3 μg, respectively. Dietary calcium intake for aged 2-5 years, dietary vitamin B_2 intake for aged 2-4 years, dietary iron, selenium, zinc and vitamin B_1 intake for aged 2-3 years was significantly greater in urban children than rural children. Among all nutrients, the proportion of dietary calcium intakes below the estimated average requirement(EAR) was the highest in aged 2-5 years(61.4%, 76.4%, 91.4% and 91.5%, respectively). The proportions of dietary vitamin B_1, vitamin C and selenium intake lower than EAR of children aged 2-5 years in China were 52.4%-63.2%, 42.8%-50.2% and 46.6%-58.7%, respectively.

COUCLUSION

The dietary calcium intake of children aged 2-5 years in China remains insufficient for these children, especially for rural children. Dietary vitamin B_1, vitamin C and selenium intake should be improved.

Effects of different colored polyethylene mulching films on bacterial communities from soil during enrichment incubation

Studies have shown that mulching agricultural fields with plastic residues can influence microbial communities in the environment, but few studies have investigated the differences in the soil microbial communities in distinct areas under mulching with different colored plastic products. Thus, in this study, we explored how different colored polyethylene mulching films (PMFs) might affect soil bacterial communities during enrichment incubation. We found significant differences in the bacterial communities under different colored PMFs after incubation. Treatment with the same colored PMF obtained more similar bacterial community compositions. For instance, at the class level, Gammaproteobacteria and Bacteroidia were most abundant with black PMF, whereas Actinobacteria and Bacteroidia were most abundant with white PMF. The most abundant genera were Acinetobacter and Chryseobacterium with black PMF but Rhodanobacter and Paenarthrobacter with white PMF. Polyethylene- and hydrocarbon-degrading bacteria were the core members detected under both treatments, and the bacterial communities were predicted to have the potential for the biodegradation and metabolism of xenobiotics after enrichment culture according to the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) tool. In addition, the bacterial communities in soil from Xinjiang treated with white PMF and in soil from Yangling treated with black PMF were strongly correlated and stable. Our results suggest that the color of the PMF applied affected the soil bacterial communities, where plastics with the same color may have recruited similar species of microorganisms, although the origins of these microorganisms were not the same.

[Effects of gestational diabetes mellitus on gut microbiota of 3-month-old infants: a prospective control study]

OBJECTIVE

To explore the effect of gestational diabetes mellitus on the gut microbiota of their offsprings, the gut microbiota of 3-month-old infants whose mothers diagnosed with and without gestational diabetes mellitus(GDM) was compared.

METHODS

Pregnant women and their 3-month-old infants who were examined, delivered and follow-up visited in a county in Hebei Province from June 2016 to December 2019 were included in our study. The pregnants and their infants with result of fasting venous blood glucose≥5.1 mmol/L in the second or third trimester were included in GDM group. Fecal samples of 3-month-old infants were collected and 16 S rDNA high-throughput sequencing technology was used to explore the change of gut microbiota.

RESULTS

A total of 48 pairs of subjects were included, 16 in GDM group and 32 in control group. Comparison of gut microbiota diversity: analysis of the Alpha diversity index showed that the Observed Species index, margalef index and menhinick index of GDM group were(141.4±17.2), (13.66±1.66) and(0.83±0.10), respectively, which were significantly lower than that of control group(154.9±21.7), (15.00±2.11) and(0.91±0.13), respectively. Sequence analysis: at phylum level, the abundance of the Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria were 54.28(47.84), 23.58(23.48), 11.20(30.99) and 0.12(0.07), respectively, while the control group were 42.05(36.23), 29.64(21.30), 9.31(15.82) and 0.15(10.14), respectively. The two groups were mainly composed of these 4 phyla and Actinobacteria was the most abundant. At genus level, there were mainly Bifidobacteria, lactobacillus, Enterobacteria, Bacteroidales and Clostridiales in both groups. The abundance of Erysipelotrichales in GDM group(0.01(0.01)) was significantly lower than that in control group(0.04(0.06))(P&lt;0.05). The abundance of Micrococcales in GDM group(0.13(0.24) was significantly lower than that in control group(0.29(0.78))(P&lt;0.05). PCoA analysis showed that the gut microbiota structure of GDM group and control group was similar. LEfSe analysis showed Erysipelatoclostridium was significantly increased in control group(P&lt;0.05).

CONCLUSION

GDM can reduce the diversity and richness of gut microbiota of 3-month-old infants and has no significant effect on the phylum level but has effect on some genus level. It suggests that GDM may still have some potential effect on slightly elder infants.

Limited accumulation of high-frequency somatic mutations in a 1700-year-old Osmanthus fragrans tree

Lifespan varies greatly between and within species. Mutation accumulation is considered an important factor explaining this life-history trait. However, direct assessment of somatic mutations in long-lived species is still rare. In this study, we sequenced a 1700-year-old sweet olive tree and analysed the high-frequency somatic mutations accumulated in its six primary branches. We found the lowest per-year mutation accumulation rate in this oldest tree among those studied via the whole-genome sequencing approach. Investigation of mutation profiles suggests that this low rate of high-frequency mutation was unlikely to result from strong purifying selection. More intriguingly, on a per-branching scale, the high-frequency mutation accumulation rate was similar among the long-lived individuals such as oak, wild peach and sweet olive investigated here. We therefore suggest the possibility that the accumulation of high-frequency somatic mutations in very long-lived trees might have an upper boundary due to both the possible limited number of stem cell divisions and the early segregation of the stem cell lineage.

[Clinical and StAR genetic characteristics of 33 children with congenital lipoid adrenal hyperplasia]

Objective: To analyze the clinical and genetic characteristics of 33 children with congenital lipoid adrenal hyperplasia (CLAH) caused by StAR gene defects. Methods: The clinical, biochemical, genetic, and follow-up (until December 2021) data of 33 children diagnosed with CLAH from 2006 to 2021 were retrospectively analyzed in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Results: Of the 33 children with CLAH, 17 had a karyotype of 46, XX and 16 had a karyotype of 46, XY; 31 were female and 2 were male by social gender. Classic type and non-classic type were found in 30 and 3 children respectively. The age at diagnosis was 9.0 (3.0, 34.5) months. All the 30 cases with classic CLAH presented within the first year of life with skin hyperpigmentation (28 cases, 93%), vomiting and(or) diarrhea (19 cases, 63%), no increase in body weight (8 cases, 27%), elevated adrenocorticotropic hormone levels (21cases (70%)>275 pmol/L), decreased cortisol levels (47 (31,126) nmol/L), hyponatremia ((126±13) mmol/L), hyperkalemia ((5.7±1.1) mmol/L), and normal 17α-hydroxyprogesterone levels (30 cases, 100%). All these with classic CLAH exhibited female external genitalia. Three children with non-classic CLAH (including 2 cases of 46, XY and 1 case of 46, XX) also showed signs and symptoms of adrenal insufficiency, but 2 of them had an age of onset later than 1 year of age, including 1 case of 46, XY with male external genitalia and 1 case of 46, XX with female external genitalia. The other 46, XY patient with non-classic CLAH presented with adrenal insufficiency at 2 months of age, showing micropenis and hypospadias. In the 17 females with 46, XX, 4 older than 10 years of age showed spontaneous pubertal development. A total of 25 StAR gene pathogenic variants were identified in 33 patients, with p.Q258* (18/66, 27%), p.K236Tfs*47 (8/66, 12%) and p.Q77* (6/66, 9%) being the common variantion. Six novel variants were found, including c.358T>G, c.713_714del, c.125del, c.745-1G>A, c.179-2A>C, and exon 1 deletion. Conclusions: Patients with classic CLAH typically present with signs and symptoms of primary adrenal insufficiency in the early infancy period and female external genitalia. p.Q258*, p.K236Tfs*47 and p.Q77* are common variants in CLAH patients.

Identification of miRNAs and Target Genes at Key Stages of Sexual Differentiation in Androdioecious Osmanthus fragrans

Androdioecy is the crucial transition state in the evolutionary direction of hermaphroditism to dioecy, however, the molecular mechanisms underlying the formation of this sex system remain unclear. While popular in China for its ornamental and cultural value, Osmanthus fragrans has an extremely rare androdioecy breeding system, meaning that there are both male and hermaphroditic plants in a population. To unravel the mechanisms underlying the formation of androdioecy, we performed small RNA sequencing studies on male and hermaphroditic O. fragrans. A total of 334 miRNAs were identified, of which 59 were differentially expressed. Functional categorization revealed that the target genes of differentially expressed miRNAs were mainly involved in the biological processes of reproductive development and the hormone signal transduction pathway. We speculated that the miRNA160, miRNA167, miRNA393 and miRNA396 families may influence the sex differentiation in O. fragrans. Overall, our study is the first exploration of miRNAs in the growth and development process of O. fragrans, and is also the first study of androdioecious plants from the miRNA sequencing perspective. The analysis of miRNAs and target genes that may be involved in the sex differentiation process lay a foundation for the ultimate discovery of the androdioecious molecular mechanism in O. fragrans.

POS0081 LONG-TERM EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS WITH PSORIATIC ARTHRITIS: 2-YEAR RESULTS FROM THE PHASE 3 SELECT-PsA 1 STUDY

Background

In SELECT-PsA 1, patients (pts) with psoriatic arthritis (PsA) and an inadequate response or intolerance to ≥1 non-biologic disease-modifying antirheumatic drug showed improvement in the signs and symptoms of PsA with upadacitinib 15 mg (UPA15) or 30 mg (UPA30), an oral Janus kinase (JAK) inhibitor, through week (wk) 56.1

Objectives

To evaluate the efficacy and safety of UPA and UPA vs adalimumab (ADA) at wk 104 from the ongoing long-term extension of SELECT-PsA 1.

Methods

Pts received UPA15, UPA30, ADA 40 mg, or placebo (PBO) for 24 wks, at which point, PBO pts switched to UPA15 or UPA30. Efficacy endpoints were analyzed using non-responder imputation (NRI) and as observed (AO) (binary endpoints) or mixed-effect model repeated measures and AO (continuous endpoints), with nominal P-values shown, for continuous UPA and ADA treatment groups. Treatment-emergent adverse events were summarized for pts who received ≥1 dose of study drug using a visit-based cut-off at wk 104.

Results

1704 pts received ≥1 dose of study drug. At wk 104, 25.4% of patients had discontinued study drug. The proportions of pts who achieved ACR20/50/70, MDA, PASI75/90/100, and resolution of enthesitis or dactylitis showed consistent responses, or further improvements, from wk 561 to wk 104 (Table 1). ACR20/50/70 and MDA responses, as well as mean change from baseline (BL) in HAQ-DI, patient’s assessment of pain, BASDAI, and ASDAS, were greater with UPA vs ADA. Mean change from BL in modified total Sharp/van der Heijde Score (mTSS) was generally similar across groups and comparable to wk 56.1 The safety profile of UPA was generally comparable to ADA (Figure 1) and consistent with wk 561 data. Rates of serious infection, herpes zoster, lymphopenia, and elevated CPK remained numerically higher with UPA30 vs UPA15; rates in both UPA groups were higher vs ADA. Rates of malignancies, MACE, or VTE were similar across groups, and consistent with wk 561 data. Two deaths were reported with UPA15, 1 with UPA30, and 1 with ADA.

Table 1.

Efficacy Endpoints at Week 104

EndpointUPA15(n=429)UPA30(n=423)ADA(n=429)Proportion of Pts (%)aNRIAONRIAONRIAOACR2069.087.969.587.963.485.1ACR5053.667.459.3*74.147.162.3ACR7038.0*47.443.5*54.429.439.1Minimal Disease Activity (MDA)42.054.845.9*56.837.850.3PASI75b57.973.462.478.658.876.5PASI90b46.759.053.366.548.863.3PASI100b34.143.442.451.434.144.0Resolution of enthesitis by LEIc53.375.552.272.049.173.9Resolution of dactylitis by LDId69.994.571.796.272.495.2Change from BLeMMRMAOMMRMAOMMRMAOHealth Assessment Questionnaire - Disability Index (HAQ-DI)-0.55*-0.57-0.55*-0.59-0.45-0.47Patient’s assessment of pain (numeric rating scale)-3.3-3.5-3.4*-3.6-3.0-3.2Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)f-3.0-3.2-3.3-3.6-2.7-2.6Ankylosing Spondylitis Disease Activity Score (ASDAS)f-1.6-1.8-1.9*-2.1-1.5-1.6Modified total Sharp/van der Heijde Score (mTSS)0.030.010.010.000.110.11

ACR20/50/70, ≥20%/50%/70% improvement in American College of Rheumatology criteria; ADA, adalimumab; AO, as observed; BL, baseline; LDI, Leeds Dactylitis Index; LEI, Leeds Enthesitis Index; MMRM, mixed effect model repeated measurement; NRI, non-responder imputation; PASI75/90/100, ≥75%/90%/100% improvement in Psoriasis Area and Severity Index; pts, patients; UPA, upadacitinib.

aData shown as NRI and AO for binary endpoints.

bFor pts with psoriasis affecting ≥3% of body surface area at BL.

cFor pts with LEI >0 at BL; resolution LEI=0.

dFor pts with LDI >0 at BL; resolution LDI=0.

eData shown as MMRM (LS mean) and AO (mean) for continuous endpoints.

fFor pts with psoriatic spondylitis at BL.

Nominal *P<0.05, UPA15 or UPA30 vs ADA for NRI and MMRM; AO descriptive only.

Conclusion

In PsA pts, efficacy responses were similar or greater with UPA15 or UPA30 vs ADA at wk 104, and inhibition of radiographic progression was maintained. No new safety signals were identified with long-term exposure to UPA up to 2 years.

References

[1]McInnes I, et al. RMD Open, 2021; 7(3):e001838.

Acknowledgements

AbbVie and the authors thank the patients, study sites, and investigators who participated in this clinical trial (NCT03104400). AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, reviewing, and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship. Medical writing support was provided by Monica R.P. Elmore, PhD of AbbVie.

Disclosure of Interests

Iain McInnes Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sanofi Regeneron, and UCB Pharma, Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sanofi Regeneron, and UCB Pharma, Koji Kato Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Marina Magrey Consultant of: UCB, Novartis, Eli Lilly, Pfizer, and Janssen, Grant/research support from: Amgen, AbbVie, and UCB Pharma, Joseph F. Merola Consultant of: Merck, Bristol-Myers Squibb, AbbVie, Dermavant, Eli Lilly, Novartis, Janssen, UCB, Celgene, Sanofi, Regeneron, Arena, Sun Pharma, Biogen, Pfizer, EMD Sorono, Avotres, and Leo Pharma, Mitsumasa Kishimoto Consultant of: AbbVie, Amgen-Astellas BioPharma, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, BMS, Celgene, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Kyowa Kirin, Novartis, Ono Pharma, Pfizer, Tanabe-Mitsubishi, Teijin Pharma, and UCB Pharma, Derek Haaland Speakers bureau: AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Novartis, Pfizer, Roche, Sanofi Genzyme, Takeda, Consultant of: AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Eli-Lilly, GlaxoSmithKline, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi Genzyme, Takeda, UCB, Grant/research support from: AbbVie, Adiga Life-Sciences, Amgen, Bristol-Myers Squibb, Can-Fite Biopharma, Celgene, Eli-Lilly, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, Regeneron, Sanofi-Genzyme, UCB, Liang Chen Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Yuanyuan Duan Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Jianzhong Liu Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Ralph Lippe Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Peter Wung Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie

Cohort profile: the Taicang and Wuqiang mother-child cohort study (TAWS) in China

PURPOSE

The Taicang and Wuqiang cohort study (TAWS) was established to examine the association between early-life nutrition and children's health, and to explore the potential roles of maternal health, metabolites and microbiota in children's health in two different regions of China.

PARTICIPANTS

A total of 7041 mother-child pairs were recruited during early pregnancy (n=4035, 57.3%) or delivery phase (n=3006, 42.7%) from health centres or hospitals in Taicang and Wuqiang. Mother-child pairs were followed up three times during pregnancy, once during delivery, and 7-10 times in the 3 years after delivery. Questionnaires were used to collect data on diet, supplementary intake, physical activity, depression scale, disease occurrence, feeding practice and development quotient of children. Anthropometric measurements of mothers and their children were assessed at each visit. Pregnancy outcomes were extracted from medical records. Biospecimens were collected and stored, including venous blood, cord blood, urine, stool, breast milk, cord and placenta.

FINDINGS TO DATE

Data from the TAWS cohort showed different baseline characteristics of participants at the two sites of TAWS. Abnormal metabolism occurred among newborns whose mothers were diagnosed with gestational diabetes mellitus. Maternal serum folic acid above 14.5 ng/mL at early pregnancy was associated with a reduced risk of delivering small-for-gestational-age newborns.

FUTURE PLANS

The association between maternal nutrition and the health of offspring will be examined at various follow-up visits. Biomarkers will be analysed to assess the associations between early-life nutrition and child development, immunity and health. Strategic recommendations for optimal infant feeding practices, obesity prevention and routine healthcare items will be developed and proposed based on the findings from the study. Children in this prospective cohort study will be followed up once a year until age 12 years to further examine the relationships between early-life nutrition and children's long-term development and health.

OP0016 EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS WITH ACTIVE NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED PHASE 3 TRIAL

Background

Janus kinase (JAK) inhibitors have been recognized as a potential therapeutic option in ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis (r-axSpA).1 Upadacitinib (UPA), a JAK inhibitor, has demonstrated efficacy and safety in the treatment of AS2; however, no JAK inhibitor studies have been conducted in non-radiographic axSpA (nr-axSpA) to date.

Objectives

To assess the efficacy and safety of UPA in patients (pts) with active nr-axSpA.

Methods

SELECT-AXIS 2 (NCT04169373) was conducted under a master protocol comprising two independent studies, one in an AS population with an inadequate response to biologic disease-modifying antirheumatic drugs and one in an nr-axSpA population. The nr-axSpA study is a randomized, double-blind, placebo(PBO)-controlled, phase 3 trial that enrolled adults ≥18 years with a clinical diagnosis of nr-axSpA (who also fulfilled 2009 ASAS classification criteria for axSpA but did not meet the radiologic criterion of modified New York criteria), who had objective signs of active inflammation consistent with axSpA on MRI of the sacroiliac (SI) joints and/or high sensitivity C-reactive protein (hs-CRP) >upper limit of normal (2.87 mg/L) at screening, and who had BASDAI and pt’s assessment of total back pain scores ≥4 based on a 0 to 10 numeric rating scale at study entry. Pts were randomized 1:1 to receive oral UPA 15 mg once daily (QD) or PBO during a 52-week (wk) double-blind treatment period. The primary endpoint was ASAS40 response at wk 14. Multiplicity-controlled secondary endpoints assessed at wk 14 included BASDAI50, ASDAS ID (<1.3), ASDAS LDA (<2.1), ASDAS PR, and ASAS20, and the change from baseline (Δ) in ASDAS (CRP), SPARCC MRI SI joint inflammation score, total and nocturnal back pain, BASFI, ASQoL, ASAS HI, BASMI, and MASES. Treatment-emergent adverse events (TEAEs) are reported through wk 14 for pts who received ≥1 dose of study drug.

Results

Of 314 pts randomized at baseline, 313 received study drug (UPA 15 mg, n=156; PBO, n=157) and 295 (94%) received study drug through wk 14. Baseline demographic and disease characteristics were balanced across treatment groups and consistent with an active nr-axSpA population (58% female; mean age 42.1 years; mean BASDAI 6.9; mean hs-CRP 12.1 mg/L). A significantly higher ASAS40 response rate at wk 14 was achieved with UPA vs PBO (45% vs 23%; P<0.0001; Figure 1). Statistical significance was also achieved in the first 12 of the 14 multiplicity-controlled secondary endpoints (ie, all endpoints except BASMI and MASES) at wk 14 for UPA compared with PBO (P<0.01; Figure 1). The proportion of pts who experienced a TEAE was similar between treatment groups (UPA, 48%; PBO, 46%). Serious TEAEs and TEAEs leading to discontinuation were reported in 4 (2.6%) pts treated with UPA and 2 (1.3%) pts treated with PBO, respectively. Few pts had serious infection or herpes zoster (each 2 [1.3%] pts on UPA; each 1 [0.6%] pt on PBO, respectively). Uveitis was reported in 1 (0.6%) pt on UPA who had a history of uveitis and none on PBO. No malignancy other than non-melanoma skin cancer, major adverse cardiovascular events, venous thromboembolic events, inflammatory bowel disease (IBD), or death were reported in the study; 1 event of basal cell carcinoma occurred with PBO.

Conclusion

UPA 15 mg QD demonstrated significantly greater improvements in disease activity, pain, function, quality of life, and MRI-detected SI joint inflammation than PBO after 14 wks of treatment in pts with active nr-axSpA. The safety profile of UPA was consistent with what has been observed with other inflammatory musculoskeletal diseases,3–5 and no new risks were identified. These results support the potential use of UPA in pts with active nr-axSpA.

References

[1]Ward MM, et al. Arthritis Rheumatol. 2019;71(10):1599–63.

[2]van der Heijde D, et al. Arthritis Rheumatol. 2021;73(suppl 10).

[3]Cohen SB, et al. ARD. 2021;80:304–311.

[4]Burmester G, et al. Rheumatol Ther. 2021;1–19.

[5]van der Heijde D, et al. Lancet. 2019;394(10214):2108–2117.

Acknowledgements

AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Julia Zolotarjova, MSc, MWC, of AbbVie.

Disclosure of Interests

Atul Deodhar Consultant of: AbbVie, Amgen, Aurinia, BMS, Celgene, GSK, Janssen, Lilly, MoonLake, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, GSK, Lilly, Novartis, Pfizer, and UCB, Filip van den Bosch Speakers bureau: AbbVie, Celgene, Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Celgene, Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Denis Poddubnyy Speakers bureau: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Consultant of: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Walter P Maksymowych Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Novartis, and Pfizer, Désirée van der Heijde Consultant of: AbbVie, Bayer, BMS, Cyxone, Eisai, Galapagos, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, UCB, Employee of: Director of Imaging Rheumatology BV, Tae-Hwan Kim Speakers bureau: AbbVie, Celltrion, Kirin, Lilly, and Novartis, Mitsumasa Kishimoto Consultant of: AbbVie, Amgen Astellas BioPharma, Asahi-Kasei Pharma, Astellas, Ayumid Pharma, BMS, Chugai, Daiichi Sankyo, Eisai, Gilead, Janssen, Kyowa Kirin, Lilly, Novartis, Ono Pharma, Pfizer, Tanabe-Mitsubishi, Teijin Pharma, and UCB, Yuanyuan Duan Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Yihan Li Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Aileen Pangan Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Peter Wung Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, In-Ho Song Shareholder of: May own AbbVie stock or options, Employee of: AbbVie.

[Gestational weight gain and associated factors of Chinese women in the second and third trimester of pregnancy in 2015]

OBJECTIVE

To describe gestational weight gain status of pregnant women in China, and to explore potential factors related to gestational weight gain of pregnant women in the 2 nd and 3 rd trimester in 2015.

METHODS

Participants were from Chinese National Nutrition and Health Surveillance in 2012 and in 2015. Using a multi-stage stratified cluster random sampling method, a total of 8512 pregnant women were recruited in 2015. A standard questionnaire was used to collect general information and pre-pregnancy weight. Body weight and height of pregnant women were measured using a unified weighing scale and stadiometer.

RESULTS

In 2015, the prevalences of underweight, normal weight, overweight and obesity in pre-pregnancy were 16.0%, 66.0%, 14.9%, 3.1% according to Chinese BMI standard, respectively. In the 2 nd trimester, the prevalences of inadequate gestational weight gain, appropriate gestational weight gain and excess gestational weight gain were 14.6%, 27.2% and 58.2% based on IOM gestational weight gain standard, respectively. In the 3 rd trimester, the prevalences of inadequate gestational weight gain, appropriate gestational weight gain and excess gestational weight gain were 12.7%, 31.5%, 55.8% based on IOM gestational weight gain standard, respectively. The odds of excess gestational weight gain was 1.53(95%CI 1.19-1.99) in the second trimester, and 2.05(95% CI 1.59-2.63) in the third trimester for overweight women, compared to normal weight women during pre-pregnancy. The prevalence of excess gestational weight gain showed an increasing trend in both urban and rural areas, which was not related to pregnant women&apos;s age and education. Second parity might be a protective factor for appropriate weight gain in late pregnancy.

CONCLUSION

Compared to 2012, the prevalence of underweight before pregnancy and inadequate gestaional weight gain decreased in 2015. By contrast, the prevalence of overweight, obesity and excess gestational weight gain showed an upward trend.

Plastid genomes reveal evolutionary shifts in elevational range and flowering time of Osmanthus (Oleaceae)

Species of Osmanthus are economically important ornamental trees, yet information regarding their plastid genomes (plastomes) have rarely been reported, thus hindering taxonomic and evolutionary studies of this small but enigmatic genus. Here, we performed comparative genomics and evolutionary analyses on plastomes of 16 of the 28 currently accepted species, with 11 plastomes newly sequenced. Phylogenetic studies identified four main lineages within the genus that are here designated the: “Caucasian Osmanthus” (corresponding to O. decorus), “Siphosmanthus” (corresponding to O. sect. Siphosmanthus), “O. serrulatus + O. yunnanensis,” and “Core Osmanthus: (corresponding to O. sect. Osmanthus + O. sect. Linocieroides). Molecular clock analysis suggested that Osmanthus split from its sister clade c. 15.83 Ma. The estimated crown ages of the lineages were the following: genus Osmanthus at 12.66 Ma; “Siphosmanthus” clade at 5.85 Ma; “O. serrulatus + O. yunnanensis” at 4.89 Ma; and “Core Osmanthus: clade at 6.2 Ma. Ancestral state reconstructions and trait mapping showed that ancestors of Osmanthus were spring flowering and originated at lower elevations. Phylogenetic principal component analysis clearly distinguished spring‐flowering species from autumn‐flowering species, suggesting that flowering time differentiation is related to the difference in ecological niches. Nucleotide substitution rates of 80 common genes showed slow evolutionary pace and low nucleotide variations, all genes being subjected to purifying selection.

What are the determinants of low exclusive breastfeeding prevalence in China? A cross‐sectional study

Exclusive breastfeeding (EBF) status is far from the national target in China. To identify the modifiable factors associated with EBF of infants aged under 6 months in China. A cross‐sectional study was conducted in 12 provinces/municipalities across China in 2017–2018. We used multistage stratified cluster sampling and collected data through face‐to‐face interviews with mothers using an electronic questionnaire. Totally, 5287 pairs of mother–infant aged <6 months were investigated. The EBF prevalence was 29.2% (1544/5287). Mothers with correct knowledge of colostrum (adjusted odds ratio [AOR]:1.32, 95% confidence interval [CI]: 1.07, 1.62), EBF (AOR: 1.39, 95% CI: 1.06, 1.81) and the highest scores of perceptions for breastfeeding benefits (AOR: 1.36, 95% CI: 1.14, 1.61) were more likely to exclusively breastfeed. However, mothers with more frequent unwillingness of breastfeeding during the first month postpartum were less likely to practice EBF (AOR: 0.68, 95% CI: 0.52, 0.90). Infants having their first breast milk within 24 h of birth increased the odds of EBF (AOR: 2.41, 95% CI: 1.86, 3.13). Infants were less likely to be exclusively breastfed in the families in which the main caregiver was the grandmothers. Mothers without receiving infant formula feeding suggestions via the health facilities, media, or the Internet (AOR: 1.57, 95% CI: 1.33, 1.85) or without the experience of infant formula feeding in public (AOR: 1.45, 95% CI: 1.23, 1.72) might more likely to practice EBF. To acquire comprehensively correct knowledge and keep a positive attitude of breastfeeding for the mothers are crucial for improving the EBF prevalence. Family supports are potential interventions worth focusing on. Infant formula promotion remains a great barrier for EBF in China.

This is the first study with a large sample size that examined determinants at individual, family, community and social levels potentially affecting EBF practice in China.

In this cross‐sectional study, mothers with completely correct knowledge and positive attitude of breastfeeding, infants having their first breast milk within 24 h of birth, and without exposure to infant formula feeding suggestions or experience might more likely to practice EBF.

Dissemination of comprehensively correct knowledge and operational skills of breastfeeding, initiation of breastfeeding as soon as possible, reducing the influence of infant formula might be effective methods for improving the EBF prevalence in China.

Transcriptome Analysis Revealed a Cold Stress-Responsive Transcription Factor, PaDREB1A, in Plumbago auriculata That Can Confer Cold Tolerance in Transgenic Arabidopsis thaliana

The tropical plant Plumbago auriculata can tolerate subzero temperatures without induction of apoptosis after cold acclimation in autumn, making it more cold tolerant than conventional tropical plants. In this study, we found that low temperatures significantly affected the photosynthetic system of P. auriculata. Using transcriptome sequencing, PaDREB1A was identified as a key transcription factor involved in the response to cold stress in P. auriculata. This transcription factor may be regulated by upstream JA signaling and regulates downstream ERD4 and ERD7 expression to resist cold stress. Overexpression of PaDREB1A significantly enhanced freezing resistance, protected the photosynthetic system, and enhanced the ROS scavenging mechanism under cold stress in Arabidopsis thaliana. Additionally, PaDREB1A significantly enhanced the expression of CORs and CAT1 in A. thaliana, which further activated the downstream pathway to enhance plant cold tolerance. This study explored the possible different regulatory modes of CBFs in tropical plants and can serve as an important reference for the introduction of tropical plants to low-temperature regions.

Acceleration of Brain Susceptibility-Weighted Imaging with Compressed Sensitivity Encoding: A Prospective Multicenter Study

BACKGROUND AND PURPOSE

While three-dimensional susceptibility-weighted imaging has been widely suggested for intracranial vessel imaging, hemorrhage detection, and other neuro-diseases, its relatively long scan time has necessitated the clinical verification of recent progresses of fast imaging techniques. Our aim was to evaluate the effectiveness of brain SWI accelerated by compressed sensitivity encoding to identify the optimal acceleration factors for clinical practice.

MATERIALS AND METHODS

Ninety-nine subjects, prospectively enrolled from 5 centers, underwent 8 brain SWI sequences: 5 different folds of compressed sensitivity encoding acceleration (CS2, CS4, CS6, CS8, and CS10), 2 different folds of sensitivity encoding acceleration (SF2 and SF4), and 1 without acceleration. Images were assessed quantitatively on both the SNR of the red nucleus and its contrast ratio to the CSF and, subjectively, with scoring on overall image quality; visibility of the substantia nigra-red nucleus, basilar artery, and internal cerebral vein; and diagnostic confidence of the cerebral microbleeds and other intracranial diseases.

RESULTS

Compressed sensitivity encoding showed a promising ability to reduce the acquisition time (from 202 to 41 seconds) of SWI while increasing the acceleration factor from 2 to 10, though at the cost of decreasing the SNR, contrast ratio, and the scores of visual assessments. The visibility of the substantia nigra-red nucleus and internal cerebral vein became unacceptable in CS6 to CS10. The basilar artery was well-distinguished, and diseases including cerebral microbleeds, cavernous angiomas, intracranial gliomas, venous malformations, and subacute hemorrhage were well-diagnosed in all compressed sensitivity encoding sequences.

CONCLUSIONS

Compressed sensitivity encoding factor 4 is recommended in routine practice. Compressed sensitivity encoding factor 10 is potentially a fast surrogate for distinguishing the basilar artery and detecting susceptibility-related abnormalities (eg, cerebral microbleeds, cavernous angiomas, gliomas, and venous malformation) at the sacrifice of visualization of the substantia nigra-red nucleus and internal cerebral vein.

[Concentration of osteopontin in human milk and associated factors in Chinese populations from 2011 to 2013]

OBJECTIVE

To analyze content of human milk osteopontin(OPN) and to explore associated factors in Chinese populations.

METHODS

The samples and data were extracted from the database for human milk composition in China between 2011 and 2013. A sub-sample of 459 mothers was randomly selected after stratification according to lactation stage, and human milk OPN concentrations were determined by ultra performance liquid chromatography-tandem mass spectrometer(UPLC/MS).

RESULTS

The average OPN concentration(M(P25, P75)) in breast milk was 44.0(30.1-72.0) mg/L within 0-330 days postpartum. OPN concentrations were independent of lactation stage, which were 45.6(31.8, 80.7) mg/L in colostrum, 41.3(29.2, 70.0) mg/L in transitional milk and 46.9(30.2, 71.9) mg/L in mature milk, corresponding to 0.40%、0.42% and 0.65% of the total milk protein content(OPN/protein%). The percentage of OPN to total protein in milk showed an increasing trend with lactation progression(r=0.21, P&lt;0.001). Multivariate analysis showed that sleep quality of mothers within one week prior to milk collection was correlated with the breast milk OPN level(P=0.04). The OPN level in breast milk from mothers with good sleep quality was significantly higher than that from mothers with poor sleep quality(46.5 mg/L vs.34.7 mg/L). The median level of milk OPN concentration in mothers from Yunnan was higher than mothers from Beijing(50.5 mg/L vs.36.1 mg/L, P=0.03). Maternal age, mode of delivery, prepregnancy body mass index, weight gain during pregnancy, passive smoking and outdoor activities 24 hours prior to milk collection were not correlated with milk OPN concentration. OPN concentration in breast milk was not related to preterm birth. Also, milk OPN concentration did not correlate with diarrhoea, respiratory disease, or allergic disease in infants during two weeks before milk collection.

CONCLUSION

The concentration of OPN in breast milk of Chinese woman may be similar among different lactation stages. Geographic region and sleep quality of mothers may be related to the milk OPN concentration.

Alzheimer's Disease Classification Based on Image Transformation and Features Fusion

It has become an inevitable trend for medical personnel to analyze and diagnose Alzheimer's disease (AD) in different stages by combining functional magnetic resonance imaging (fMRI) and artificial intelligence technologies such as deep learning in the future. In this paper, a classification method was proposed for AD based on two different transformation images of fMRI and improved the 3DPCANet model and canonical correlation analysis (CCA). The main ideas include that, firstly, fMRI images were preprocessed, and subsequently, mean regional homogeneity (mReHo) and mean amplitude of low-frequency amplitude (mALFF) transformation were performed for the preprocessed images. Then, mReHo and mALFF images were extracted features using the improved 3DPCANet, and these two kinds of the extracted features were fused by CCA. Finally, the support vector machine (SVM) was used to classify AD patients with different stages. Experimental results showed that the proposed approach was robust and effective. Classification accuracy for significant memory concern (SMC) vs. mild cognitive impairment (MCI), normal control (NC) vs. AD, and NC vs. SMC, respectively, reached 95.00%, 92.00%, and 91.30%, which adequately proved the feasibility and effectiveness of the proposed method.

Associations between Feeding Patterns and Infant Health in China: A Propensity Score Matching Approach

Breastmilk is the optimal food for infants. Feeding pattern is closely related to physical development and health during infancy. Understanding the associations between feeding patterns and health status can inform related policy interventions and advocacy in China. This study aimed to investigate the relationship between infant feeding patterns and health status in China infants. The China National Nutrition and Health Surveillance 2013 was a national-representative cross-sectional study performed particularly for children aged 0-5 years. A total of 3974 infants aged under 1 year were included in the analysis, of whom 1082 (27.2%) made up the formula feeding group, and 2892 (72.8%) made up the breastfeeding group. The associations between feeding patterns and physical development and health were investigated using propensity score matching and multivariable logistic regression models. Among breastfeeding and formula feeding infants aged 9-11 months old, weight-for-age z score was 1.1 ± 1.1 and 0.9 ± 1.3, respectively, and weight-for-length z score was 1.0 ± 1.3 and 0.7 ± 1.4, respectively. Hemoglobin in 0-2, 3-5, 6-8, and 9-11 months old breastfeeding infants was 121.4 ± 15.2 g/L, 117.1 ± 13.0 g/L, 113. 9 ± 11.9 g/L, and 114.4 ± 14.0 g/L, while in 0-2, 3-5, 6-8, and 9-11 months formula feeding infants was 116.3 ± 14.8 g/L, 120.4 ± 11.3 g/L, 119.8 ± 11.2 g/L, and 120.0 ± 11.5 g/L, respectively. Breastfeeding was associated with lower risk of respiratory disease (OR: 0.79; 95% CI: 0.64, 0.99) and diarrhea (OR: 0.75; 95% CI: 0.57, 0.98). Breastfeeding could slightly improve infant physical development, and had a protective effect on the diarrheal and respiratory diseases. Infants aged 3-11 months who were breastfeeding showed lower hemoglobin than that of formula-fed infants and thus should increase intake of iron rich complementary foods.

[Analysis of the detection of metals and metalloids in the bronchoalveolar lavage fluid for the etiological diagnosis value of pneumoconiosis]

Objective: To analyze the differences of the concentrations of metals and metalloids in bronchoalveolar lavage fluid (BALF) of patients with pneumoconiosis, so as to provide reference for the etiological diagnosis of pneumoconiosis. Methods: From September 2019 to August 2020, 47 pneumoconiosis patients hospitalized in Chongqing Prevention and Treatment Center for Occupational Diseases and undergoing bronchoalveolar lavage were selected as the research objects using cluster sampling method. The general situation and occupational history of patients were investigated by questionnaire, The BALF of 47 pneumoconiosis patients was collected, and the concentrations of metals and metalloids in BALF were detected by inductively coupled plasma mass spectrometry (ICP-MS) , the differences among patients with different types of pneumoconiosis, different stages of silicosis and different occupational history were analyzed by one-way ANOVA. Results: The concentrations of 50 metals and metalloids in BALF were detected, and 21 of them were analyzed. Compared with different types of pneumoconiosis, the concentrations of Zn, Mn and Sn in BALF were statistically significant (F=9.959, 3.635, 9.488, P<0.05) . The concentrations of K, Mg, Fe, Zn, Cu and Ni in BALF were significantly different in different stages of silicosis (F=4.271, 4.334, 3.588, 5.120, 7.340, 3.905, P<0.05) . The concentrations of Zn and Sn in pneumoconiosis patients with different types of work and types of exposed dust were significantly different (P<0.05) . Conclusion: The detection of Zn, Mn, Sn, and other metals in BALF can provide reference basis for the etiological diagnosis of pneumoconiosis and provide a new idea for the diagnostic method of pneumoconiosis.

[Prevalence and risk factors for anemia of Chinese lactating women in 2013]

OBJECTIVE

To investigate the prevalence of anemia and its risk factors for lactating women in China.

METHODS

Data was extracted from Chinese National Nutrition and Health Surveillance-Mothers for children under 2 years of age(2013). Totally, 11 178 mothers of children under 2 years old were selected from 55 counties of 30 provinces in China by using the multi-stage stratified cluster randomization sampling method. Among these women 7129 are lactating. The basic information of lactating women was collected through the questionnaire survey. Hemoglobin concentration was measured by photometric determination of haemiglobincyanide(HiCN) method. Participants without blood sample and basic information were excluded. Finally, 6255 lactating women were included in the analysis. Complex sampling method with weighted analysis was used.

RESULTS

Totally, with a complex sampling method with weighted analysis, the prevalence of anemia for lactating women was 9.3%. The mean hemoglobin level was(136.1±0.9) g/L. The mild and moderate anemia accounted for 98.8% of all anemic cases. Compared with those lactating time&lt;6 months, lactating time between 6 to 12 months had a lower risk of anemia(OR=0.74, 95%CI 0.61-0.90). Compared with those living in large cities, the maternal living in poor rural areas had a higher risk of anemia(OR=1.69, 95%CI 1.29-2.20).

CONCLUSION

In 2013, the prevalence of anemia was mild for the lactating women in China. Lactating women in poor rural areas, within 6 months after deliveryhad the higher risk for anemia.