Vesical Imaging-Reporting and Data System (VI-RADS) as a grouping imaging biomarker combined with a decision-tree mode to preoperatively predict the pathological grade of bladder cancer

AIM

To investigate whether the Vesical Imaging-Reporting and Data System (VI-RADS) could be used to develop a new non-invasive preoperative grade-prediction system to partially predict high-grade bladder cancer (HG-BC).

MATERIALS AND METHODS

The present study enrolled 89 primary BC patients prospectively from March 2022 to June 2023. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of VI-RADS for predicting HG-BC and muscle-invasive bladder cancer (MIBC) in the entire group. In the low VI-RADS (≤2) group, the decision tree-based method was used to obtain significant predictors and construct the decision-tree model (DT model). The performance of the DT model and low VI-RADS scores for predicting HG-BC was determined using ROC, calibration, and decision curve analyses.

RESULTS

At a cut-off of ≥3, the specificity and positive predictive value of VI-RADS for predicting HG-BC in the entire group was 100%, and the area under the ROC curve (AUC) was 0.697. Among 65 patients with low VI-RADS scores, the DT model showed an AUC of 0.884 in predicting HG-BC compared to 0.506 for low VI-RADS scores. Calibration and decision curve analyses showed that the DT model performed better than the low VI-RADS scores.

CONCLUSION

Most VI-RADS scores ≥3 correspond to HG-BCs. VI-RADS could be used as a grouping imaging biomarker for a pathological grade-prediction procedure, which in combination with the DT model for low VI-RADS (≤2) populations, would provide a potential preoperative non-invasive method of predicting HG-BC.

Rhodamine-based fluorescent probe for dynamic STED imaging of mitochondria

Stimulated emission depletion (STED) microscopy holds tremendous potential and practical implications in the field of biomedicine. However, the weak anti-bleaching performance remains a major challenge limiting the application of STED fluorescent probes. Meanwhile, the main excitation wavelengths of most reported STED fluorescent probes were below 500 nm or above 600 nm, and few of them were between 500-600 nm. Herein, we developed a new tetraphenyl ethylene-functionalized rhodamine dye (TPERh) for mitochondrial dynamic cristae imaging that was rhodamine-based with an excitation wavelength of 560 nm. The TPERh probe exhibits excellent anti-bleaching properties and low saturating stimulated radiation power in mitochondrial STED super-resolution imaging. Given these outstanding properties, the TPERh probe was used to measure mitochondrial deformation, which has positive implications for the study of mitochondria-related diseases.

Long-term prognostic value of thyroid hormones in left ventricular noncompaction

PURPOSE

Thyroid function is closely related to the prognosis of cardiovascular diseases. This study aimed to explore the predictive value of thyroid hormones for adverse cardiovascular outcomes in left ventricular noncompaction (LVNC).

METHODS

This longitudinal cohort study enrolled 388 consecutive LVNC patients with complete thyroid function profiles and comprehensive cardiovascular assessment. Potential predictors for adverse outcomes were thoroughly evaluated.

RESULTS

Over a median follow-up of 5.22 years, primary outcome (the combination of cardiovascular mortality and heart transplantation) occurred in 98 (25.3%) patients. For secondary outcomes, 75 (19.3%) patients died and 130 (33.5%) patients experienced major adverse cardiovascular events (MACE). Multivariable Cox analysis identified that free triiodothyronine (FT3) was independently associated with both primary (HR 0.455, 95%CI 0.313-0.664) and secondary (HR 0.547, 95%CI 0.349-0.858; HR 0.663, 95%CI 0.475-0.925) outcomes. Restricted cubic spline analysis illustrated that the risk for adverse outcomes increased significantly with the decline of serum FT3. The LVNC cohort was further stratified according to tertiles of FT3 levels. Individuals with lower FT3 levels in the tertile 1 group suffered from severe cardiac dysfunction and remodeling, resulting in higher incidence of mortality and MACE (Log-rank P < 0.001). Subgroup analysis revealed that lower concentration of FT3 was linked to worse prognosis, particularly for patients with left atrial diameter ≥ 40 mm or left ventricular ejection fraction ≤ 35%. Adding FT3 to the pre-existing risk score for MACE in LVNC improved its predictive performance.

CONCLUSION

Through the long-term investigation on a large LVNC cohort, we demonstrated that low FT3 level was an independent predictor for adverse cardiovascular outcomes.

Implementation of the American Society of Anesthesiologists 2022 paediatric guidelines in a child with mandibular metastasis

The 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway differ significantly from prior guidelines, particularly regarding paediatric patients. These guidelines place new emphasis on establishing a multidisciplinary team led by an anaesthetist trained in paediatric anaesthesia. Here, we demonstrate the clinical application of the new guidelines by presenting the case of a 16-month-old girl with a rapidly growing mandibular mass. The new guidelines stipulated the need for multidisciplinary team assembly; planning with indirect laryngoscopy; the availability of surgical tracheostomy and extracorporeal membrane oxygenation; and multiple 'time out' stops to confirm team members and plans. The patient tolerated induction of general anaesthesia and mask-ventilation and tracheal intubation was achieved uneventfully on the first attempt. Her trachea was extubated uneventfully 5 days later. We emphasise the importance of paediatric anaesthesia training and videolaryngoscopy and discuss components of the 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway with reference to a successful outcome in a paediatric difficult airway scenario.

Total iron binding capacity: an independent predictor of prognosis for pulmonary arterial hypertension in systemic lupus erythematosus

OBJECTIVE

To investigate the role of parameters of iron metabolism in systemic lupus erythematosus (SLE) patients with pulmonary arterial hypertension (PAH).

METHOD

This was a prospective observational study recruiting patients diagnosed with systemic lupus erythematosus-associated pulmonary arterial hypertension (SLE-PAH). Patients with other factors that might lead to PAH were excluded from the study. All patients were assessed for PAH every 1-3 months and were followed up for 6 months. The primary outcome was considered improved if the grade of risk stratification declined at the endpoint; otherwise, it was considered unimproved.

RESULTS

In total, 29 patients with SLE-PAH were included in this study. The mean of serum ferritin was higher than normal, and total iron binding capacity (TIBC) decreased in 48% of patients. Correlation analyses showed that serum iron (SI) was negatively correlated with World Health Organization functional class (WHO-FC) (r = -0.409, p = 0.028), and positively correlated with Six-Minute Walk Test distance (6MWD) (r = 0.427, p = 0.021) and tricuspid annular plane systolic excursion (TAPSE) (r = 0.388, p = 0.037). Primary outcomes improved in 12 patients at the endpoint, and univariate logistic regression analyses indicated that TIBC was associated with improved primary outcomes in patients with SLE-PAH (odds ratio 12.00, 95% confidence interval 1.90-75.72).

CONCLUSION

SI was negatively correlated with WHO-FC, and positively correlated with 6MWD and TAPSE. Furthermore, TIBC was associated with improved outcomes of patients with SLE-PAH, which could be an independent predictor of prognosis. Further research is needed to verify the findings.

General practitioners' attitudes towards and frequency of collaboration with pharmacists in China: a cross-sectional study

BACKGROUND

Building interprofessional working relationships between general practitioners (GPs) and pharmacists is essential to ensure high-quality patient care. However, there is limited Chinese literature on GP-pharmacist collaboration, and few studies have explored GPs' experiences with pharmacist integration into general practices. This study aimed to investigate GPs' attitudes towards and frequency of collaboration with pharmacists in China.

METHODS

This cross-sectional study used an online self-administered questionnaire integrating two scales, ATCI-GP and FICI-GP, which had been translated and validated to investigate 3,248 GPs from February 15 to March 15, 2023 across Zhejiang Province, China. Descriptive analyses were used, and the factors associated with GPs' frequency of collaboration with pharmacists were explored using logistic regression analysis.

RESULTS

A total of 2,487 GPs (76.6%) responded and consented to participate in the survey; 52.3% were male and the mean age was 35.4 years. Most GPs agreed that they shared common goals and objectives with pharmacists when caring for patients (90.0%), and pharmacists were open to working with them on patients' medication management (80.8%). However, half of the GPs did not change or seldom changed the patient's medication on the pharmacist's advice (51.4%). Logistic regression analysis showed that GPs who were older and had more years of practice were more likely to agree that pharmacists were willing to collaborate, had common goals for treatment and that they would change the patient's medication on the advice of the pharmacist. GPs who had regular communication protocols (adjusted odds ratio1 [aOR1] = 1.88, 95% CI 1.45-2.45; aOR2 = 3.33, 95% CI 2.76-4.02), participated in joint continuing education (aOR1 = 1.87, 95% CI 1.44-2.43; aOR2 = 2.27, 95% CI 1.91-2.70), provided recommendations for medication review (aOR1 = 3.01, 95% CI 2.07-4.38; aOR2 = 3.50, 95% CI 2.51-4.86), and communicated with pharmacists during resident training (aOR1 = 2.15, 95% CI 1.78-2.60; aOR2 = 1.38, 95% CI 1.18-1.62) were associated with a more positive attitude towards and higher frequency of cooperation.

CONCLUSIONS

GPs in China displayed a positive attitude towards cooperating with pharmacists, but they did not demonstrate a similar level of practice. As environmental determinants impact interdisciplinary collaboration, healthcare managers and policy-makers need to implement measures that foster a supportive environment conducive to interdisciplinary collaboration.

Xanthene, cyanine, oxazine and BODIPY: the four pillars of the fluorophore empire for super-resolution bioimaging

In the realm of biological research, the invention of super-resolution microscopy (SRM) has enabled the visualization of ultrafine sub-cellular structures and their functions in live cells at the nano-scale level, beyond the diffraction limit, which has opened up a new window for advanced biomedical studies to unravel the complex unknown details of physiological disorders at the sub-cellular level with unprecedented resolution and clarity. However, most of the SRM techniques are highly reliant on the personalized special photophysical features of the fluorophores. In recent times, there has been an unprecedented surge in the development of robust new fluorophore systems with personalized features for various super-resolution imaging techniques. To date, xanthene, cyanine, oxazine and BODIPY cores have been authoritatively utilized as the basic fluorophore units in most of the small-molecule-based organic fluorescent probe designing strategies for SRM owing to their excellent photophysical characteristics and easy synthetic acquiescence. Since the future of next-generation SRM studies will be decided by the availability of advanced fluorescent probes and these four fluorescent building blocks will play an important role in progressive new fluorophore design, there is an urgent need to review the recent advancements in designing fluorophores for different SRM methods based on these fluorescent dye cores. This review article not only includes a comprehensive discussion about the recent developments in designing fluorescent probes for various SRM techniques based on these four important fluorophore building blocks with special emphasis on their effective integration into live cell super-resolution bio-imaging applications but also critically evaluates the background of each of the fluorescent dye cores to highlight their merits and demerits towards developing newer fluorescent probes for SRM.

[Research on the association between unhealthy lifestyle and psychological distress among Chinese children and adolescents aged 9-18 years]

Objective: To evaluate the level of psychological distress among Chinese children and adolescents and analyze its lifestyle influencing factors. Methods: Data were obtained from the 2019 Chinese National Survey on Students' Constitution and Health. A lotal of 120 285 Han Chinese children and adolescents aged 9-18 years with complete information on the psychological distress scale and lifestyle factors were selected, including 58 432 boys and 61 853 girls. The Kessler Psychological Distress Scale (K10) measured psychological distress, and lifestyles such as physical activity, sedentary behavior, diet, and sleep were also investigated. K10 scores of different genders were compared using the t-test, and the levels of psychological distress were compared using the χ2 test. Logistic regression was used to analyze lifestyle risk factors associated with high psychological distress, and multiple linear regression was used to find the relationship between K10 scores and lifestyle scores. Results: The average K10 score for Han Chinese children and adolescents aged 9-18 years was 21.25±7.35, with girls (21.43±7.35) scoring higher than boys (21.06±7.36), the difference was statistically significant (t=8.72, P<0.001). The rate of high psychological distress was 29.81%, with girls (31.08%) reporting higher rates than boys (28.46%), the difference was statistically significant (χ2=98.54,P<0.001). 56.10% of children and adolescents have unhealthy lifestyles, with girls (58.77%) reporting higher rates than boys (53.27%), the difference was statistically significant (χ2=368.53,P<0.001). Except for insufficient outdoor activities for girls (P=0.128), lifestyles such as insufficient physical activity, insufficient muscle-and-bone exercises, long screen time, not eating breakfast, eggs and dairy products every day, drinking sugary beverages once or more per day, and not having enough sleep are all risk factors for high psychological distress (all P<0.001). For every additional healthy lifestyle score, the K10 score decreased by 0.98 [β=-0.98 (95%CI: -1.01- -0.95)] points (P<0.001). K10 scores in each region negatively correlate with lifestyle scores (all P<0.001). Among them, the K10 score in the eastern region showed the slightest decrease as the lifestyle score increased, while the western region showed the most decrease. Conclusions: The prevalence of psychological distress and unhealthy lifestyle in Chinese children and adolescents are high and interrelated. Compared those with healthy lifestyles, children and adolescents with unhealthy lifestyles are at greater risk of high psychological distress. Therefore, promoting healthy lifestyles for children and adolescents may be one of the important ways to improve their mental health.

[Research on the association between the occurrence of spermarche and menarche and psychological distress among Chinese children and adolescents aged 9-18 years]

Objective: To analyze the association between the occurrence of spermarche and menarche and psychological distress among Chinese Han children and adolescents aged 9 to 18 years. Methods: Data were drawn from the 2019 Chinese National Survey on Students' Constitution and Health, and a total of 54 438 boys aged 11 to 18 years and 76 376 girls aged 9 to 18 years with psychological distress, spermarche/menarche records were included in the final analysis. The occurrence of spermarche/menarche was recorded by physicians, and psychological distress was classified according to the Kessler Psychological Distress Scale scores. The chi-square test was used to compare the difference between groups in the occurrence of spermarche/menarche, and the multinomial logistic regression model and stratification analysis was established to analyze the association between psychological distress and spermarche/menarche. Results: The incidence of spermarche/menarche in 2019 ranged from 6.3% to 96.5% for eight age groups of Chinese boys and 2.8% to 99.0% for ten age groups of girls. The rates of high psychological distress among boys and girls were 32.5% and 32.7%. Among boys aged 11 to 18 years, the rate of high psychological distress increased with age, with a trend test P<0.001, and the difference in the rate of high psychological distress between those who had and had not had their spermarche was not statistically significant in all age groups. Among girls aged 9 to 18 years, the rate of high psychological distress increased with age, with a trend P<0.001; the rate of high psychological distress was higher in the group with menarche at age 10 and 12 than in the group without menarche (all P<0.05). High psychological distress was positively correlated with spermarche among boys aged 13-15 years living in urban areas and hight level economic development areas (OR=1.11, 95%CI: 1.02-1.21;OR=1.18, 95%CI: 1.06-1.32). Overall, high psychological distress was positively correlated with menarche in girls aged 9-12 and 13-15 years (OR=1.33, 95%CI: 1.25-1.42; OR=1.22, 95%CI: 1.07-1.39). High psychological distress was positively correlated with menarche among girls aged 9-12 years living in different regions except for the Northeast region, in areas with different levels of economic development, and in urban and rural areas, in girls aged 13-15 years living in urban, central, and western regions, and in girls aged 16-18 years residing in the central region. Conclusions: This study found an association between the occurrence of spermarche/menarche and psychological distress among Chinese Han children and adolescents aged 9 to 18 years in 2019, which was particularly significant among girls aged 9 to 12 years and boys aged 13 to 15 years living in areas with higher levels of socioeconomic development.

[Research on the association between the status of physical fitness and psychological distress among Chinese children and adolescents aged 13-18 years]

Objective: To describe the status of physical fitness of children and adolescents aged 13-18 years in China in 2019 and analyze its association with psychological distress. Methods: Data were drawn from the 2019 Chinese National Survey on Students' Constitution and Health, and 90 633 Han children and adolescents aged 13-18 years were included. Physical fitness was evaluated by "National Students Constitutional Health Standards" (2014 revised edition). Psychological distress was classified according to the scores of the Kessler Psychological Distress Scale: ≤19, 20-24, 25-29, and ≥30 scores indicated no, mild, moderate, and severe psychological distress, respectively, with moderate and severe psychological distress collectively referred to as high psychological distress. The χ2 test was used to compare the distribution differences between boys and girls, the Cochran-Armitage test was used to analyze the trend, and the multinomial logistic regression in the mixed effect model was established to analyze the association between physical fitness and psychological distress. Results: In 2019, the unqualified rate of physical fitness among children and adolescents aged 13-18 years in China was 17.2%, and the prevalence of excellent and good physical fitness was 18.2%, which was lower among boys (15.9%) than girls (20.5%) with a statistically significant difference (P<0.05). The excellent and good physical fitness rate showed a significantly decreasing trend with age (trend test P<0.05). The rate of high psychological distress among children and adolescents aged 13-18 years in China in 2019 was 39.3%, with boys (37.0%) having a lower prevalence than girls (41.6%), supported by a statistically significant difference (P<0.05), and a decreasing trend with the degree of physical fitness was observed both in boys and girls (trend test P<0.05). The multinomial logistic regression model showed that the prevalence of moderate (OR=0.83, 95%CI: 0.79-0.88, P<0.001) and severe (OR=0.81, 95%CI: 0.77-0.86, P<0.001) psychological distress were both lower in children and adolescents with excellent and good physical fitness. Conclusion: The status of physical fitness and psychological distress of Chinese children and adolescents aged 13-18 in 2019 was not optimistic, with physical fitness showing a significantly negative association with psychological distress.

[Prevalence of psychological distress among Chinese children and adolescents aged 9-18 years]

Objective: To describe the prevalence of psychological distress and to analyze its influencing factors among Chinese children and adolescents aged 9-18 years in 2019. Methods: Data was from the 2019 Chinese National Survey on Students' Constitution and Health, and 148 892 children and adolescents were included. Psychological distress was measured using the Kessler Psychological Distress Scale (K10): scores ≤19 were defined as no psychological distress, scores between 20-24 were defined as mild psychological distress, scores between 25-29 were defined as moderate psychological distress, and scores ≥30 were defined as severe psychological distress (moderate to severe psychological distress were defined as high psychological distress). The ANOVA, t test, and χ2 test were used to compare the differences in K10 scores and high psychological distress rates among children and adolescents with different characteristics. The ANOVA and trend χ2 test were used to analyze the trends. Modified-Poisson regression models were used to determine influencing factors of high psychological distress. Results: The K10 scores for Chinese children and adolescents aged 9-18 years in 2019 was 21.5±9.2, and their rate of high psychological distress was 31.6%. The rates of high psychological distress among children and adolescents aged 9-12, 13-15, and 16-18 years were 22.3%, 35.9%, and 38.8%. K10 scores and rates of high psychological distress showed an increasing trend as age increased (trends test all P<0.001). K10 scores and rates of high psychological distress were higher among children and adolescents who were older, female, rural, in areas with medium to low GDP per capita level, and with lower parental education (all P<0.001). Multifactorial modified-Poisson regression analysis showed that children and adolescents aged 13-15 years, 16-18 years, female, rural, and in areas with low to moderate GDP per capita level were at higher risk of high psychological distress (all P<0.05), with aOR (95%CI) of 1.55 (1.52-1.58), 1.66 (1.63-1.69), 1.07 (1.05-1.09), 1.02 (1.01-1.04), 1.10 (1.07-1.12). Children and adolescents in areas with medium to high GDP per capita level, whose father had a secondary or high school degree, whose father had a college degree or above, whose mother had a secondary or high school degree, and whose mother had a college degree or above were at lower risk of high psychological distress (all P<0.05), with aOR (95%CI) of 0.96 (0.94-0.98), 0.92 (0.90-0.93), 0.84 (0.82-0.86), 0.95 (0.93-0.97), 0.86 (0.83-0.88). Conclusions: The prevalence of psychological distress was high among Chinese children and adolescents aged 9-18 years in 2019, which is a vital problem. Mental health interventions need to be implemented among children and adolescents that were older, girls, rural, live in areas with lower economic levels, and whose parents have a lower education level.

[Research on the association between overweight and obesity mediated by Chinese children and adolescent aged 13-18 years physical exercise and psychological distress]

Objective: To analyze the association between overweight and obesity, psychological distress, and the influence of physical exercise among Chinese children and adolescents. Methods: The study used data from the 2019 Chinese National Survey on Students' Constitution and Health. A total of 95 280 Han Chinese children and adolescents aged 13 to 18 years were included in the study based on complete information on overweight and obesity, psychological distress assessment, and physical exercise variables. The Kessler Psychological Distress Scale was used to measure their psychological distress, with scores above 25 indicating high psychological distress. The BMI group of the adolescents was evaluated according to the Chinese standard "WS/T 586-2018 Screening for Overweight and Obesity in School-age Children and Adolescents", including underweight, normal weight, overweight, and obesity. The individual's BMI Z-score (BMIZ) was evaluated using the WHO standard and divided into ten groups based on the population percentile distribution. The survey collected the subjects' average daily physical exercise time and divided them into two groups: less than 1 hour and greater than or equal to 1 hour. Logistic regression analysis was used to analyze the relationship between overweight and obesity and high psychological distress among children and adolescents and the differences in association between different physical exercise groups. Results: The detection rates of overweight and obesity among Han Chinese children and adolescents aged 13 to 18 years in 2019 were 14.5%, and 7.6%, respectively. The rate of high psychological distress was 37.6%, and the rate of average daily physical exercise time exceeding 1 hour was 17.1%. Using the population with a BMIZ P10 below as a reference, the association strength between high psychological distress and the population gradually increased, with an OR (95%CI) value of 1.08 (1.02-1.14), 1.09 (1.02-1.14), 1.10 (1.03-1.16), and 1.16 (1.09-1.23) for BMIZ in the P60-, P70-, P80-, >P90 groups. Compared to normal weight, both overweight and obesity were positively associated with high psychological distress in children and adolescents, with obesity showing a more significant correlation, while underweight was negatively associated with high psychological distress. The detection rates of high psychological distress in normal weight, underweight, overweight, and obese groups were 37.6%, 37.0%, 38.2%, and 38.7%, respectively, with an OR (95%CI) value of 0.93 (0.88-0.98) for the underweight group and 1.05 (1.01-1.10) and 1.13 (1.07-1.19) for the overweight and obese groups, respectively. The positive correlation between BMIZ, overweight, and obesity with high psychological distress was significant only in adolescents who exercised less than 1 hour per day on average. Conclusions: Chinese children and adolescents face the problem of obesity and high psychological distress, with a positive correlation between these two problems. Physical activity may moderate the association between obesity and psychological distress in children and adolescents. Adequate physical exercise may offset the potential high psychological distress caused by obesity in children and adolescents. Thus, strengthening physical exercise among children and adolescents reduces the risks of both obesity and psychological health problems effectively.

Green Tea Derivative (-)-Epigallocatechin-3-Gallate (EGCG) for Prevention of Acute Radiation-Induced Intestinal Injury: A Prospective Phase II Clinical Study in Pelvic Cancer Patients

PURPOSE/OBJECTIVE(S)

Radiation-induced intestinal injury (RIII) remains the most common dose-limiting toxicity following radiotherapy (RT) for pelvic malignancies. However, few efficient and safe methods for the prevention of RIII are available in the clinical practice. Our previous study proved that the green tea polyphenol (-)-epigallocatechin-3-gallate (EGCG) efficiently attenuates radiation-induced intestinal injury (RIII) in animal level. Therefore, this prospective phase II clinical study (ChiCTR2100053703) evaluated the efficacy of EGCG in the prevention of RIII.

MATERIALS/METHODS

Cervical or endometrial cancer patients who received adjuvant or radical RT in our department were enrolled, 400mg EGCG was taken daily, and RIII was evaluated weekly according to the RTOG criteria.

RESULTS

Between February 2022 to January 2023, 37 patients were enrolled (30 were cervical cancer and the other 7 were endometrial cancer), and were followed-up regularly. Among them, the majority patients (75.7%, 28 patients) developed grade 0 or 1 RIII, for which no medical intervention was required. Meanwhile, the occurrence of grade 2 RIII was 24.3% (9 patients), which was significantly lower than that in the historical controls (usually 60% to 80%). Besides that, no patients developed grade 3 or worse RIII.

CONCLUSION

In this phase II clinical trial, compared to historical controls, the prophylactic use of EGCG significantly reduced the incidence and severity of RIII in patients receiving pelvic RT. Therefore, EGCG has the potential to become a novel medical countermeasure for the prevention of RIII for pelvic cancer patients.

[Association of outdoor artificial light at night exposure with overweight and obesity among children and adolescents aged 9 to 18 years in China]

OBJECTIVE

To analyze the association between outdoor artificial light-at-night (ALAN) exposure and overweight and obesity among children and adolescents aged 9 to 18 years in China.

METHODS

Using follow-up data of 5 540 children and adolescents aged 9 to 18 years conducted from November 2019 to November 2020 in eight provinces of China, latitude and longitude were determined based on school addresses, and the mean monthly average nighttime irradiance at the location of 116 schools was extracted by the nearest neighbor method to obtain the mean outdoor ALAN exposure [unit: nW/(cm²·sr)] for each school. Four indicators of overweight and obesity outcomes were included: Baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. Mixed effects Logistic regression was used to explore the association between ALAN exposure levels (divided into quintiles Q1-Q5) and baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. In addition, a natural cubic spline function was used to explore the exposure response association between ALAN exposure (a continuous variable) and the outcomes.

RESULTS

The prevalence of baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence among the children and adolescents in this study were 21.6%, 16.3%, 2.9% and 12.8%, respectively. The OR value for the association between ALAN exposure and baseline overweight and obesity was statistically significant when ALAN exposure levels reached Q4 or Q5, 1.90 (95%CI: 1.26-2.86) and 1.77 (95%CI: 1.11-2.83), respectively, compared with the children and adolescents in the Q1 group of ALAN exposure. Similar to the results for baseline overweight and obesity, the OR values for the association with persistent overweight and obesity were 1.89 (95%CI: 1.20-2.99) and 1.82 (95%CI: 1.08-3.06) when ALAN exposure levels reached Q4 or Q5, respectively, but none of the OR values for the association between ALAN and overweight and obesity progression and overweight and obesity incidence were statistically significant. Fitting a natural cubic spline function showed a non-linear trend between ALAN exposure and persistent overweight and obesity.

CONCLUSION

There is a positive association between ALAN exposure and overweight and obesity in children and adolescents, and the promotion of overweight obesity in children and adolescents by ALAN tends to have a cumulative effect rather than an immediate effect. In the future, while focusing on the common risk factors for overweight and obesity in children and adolescents, there is a need to improve the overweight and obesity-causing nighttime light exposure environment.

WeChat official accounts' posts on medication use of 251 community healthcare centers in Shanghai, China: content analysis and quality assessment

Background

The dissemination of online health information (OHI) on medication use via WeChat Official Accounts (WOAs) is an effective way to help primary care practitioners (PCPs) address drug-related problems (DRPs) in the community. Although an increasing number of primary care institutions in China have published WOA posts on medication use, their content and quality have not yet been assessed.

Objective

This study aimed to explore the general features and content of WOA posts on medication use published by community healthcare centers (CHCs) in Shanghai, China and to assess their quality of content. It also aimed to explore the factors associated with the number of post views.

Methods

From June 1 to October 31, 2022, two coauthors independently screened WOA posts on medication use published throughout 2021 by the CHCs in Shanghai. Content analysis was performed to analyze their general features (format, length, and source, etc.) and content (types of medicines and diseases). The QUEST tool was used to assess the quality of the posts. We compared the differences among posts published by CHCs in central urban areas and suburban areas, and used multiple linear regression to explore the factors associated with the number of post views.

Results

A total of 236 WOAs of interest published 37,147 posts in 2021, and 275 (0.74%) of them were included in the study. The median number of post views was 152. Thirty percent of the posts were reviewed by the CHCs' staff before publication and only 6% provided information on PCPs' consultations. The most commonly mentioned medicines and diseases in the posts were Chinese patent medicines (37.1%) and respiratory diseases (29.5%). The posts frequently provided information on indications (77%) and usage (56%) but rarely on follow-up (13%) and storage (11%). Of the posts, 94.9% had a total QUEST score < 17 (full score = 28). The median number of post views and total post quality scores did not significantly differ among the CHCs in central urban and suburban areas. In the multiple linear regression model, the number of post views was associated with scores of complementarity (B = 56.47, 95% CI 3.05, 109.89) and conflict of interest (B = -46.40, 95% CI -56.21, -36.60).

Conclusion

The quantity and quality of WOA posts on medication use published by CHCs in China need improvement. The quality of posts may partially impact the dissemination effect, but intrinsic causal associations merit further exploration.

[Association between vitamin D level and blood eosinophil count in healthy population and patients with chronic obstructive pulmonary disease]

OBJECTIVE

To investigate the prevalence of vitamin D deficiency and its association with blood eosinophil count in healthy population and patients with chronic obstructive pulmonary disease (COPD).

METHODS

We analyzed the data of a total 6163 healthy individuals undergoing routine physical examination in our hospital between October, 2017 and December, 2021, who were divided according to their serum 25(OH)D level into severe vitamin D deficiency group (< 10 ng/mL), deficiency group (< 20 ng/mL), insufficient group (< 30 ng/mL) and normal group (≥30 ng/mL). We also retrospectively collected the data of 67 COPD patients admitted in our department from April and June, 2021, with 67 healthy individuals undergoing physical examination in the same period as the control group. Routine blood test results, body mass index (BMI) and other parameters were obtained from all the subjects, and logistic regression models were used to investigate the association between 25(OH)D levels and eosinophil count.

RESULTS

The overall abnormal rate of 25(OH)D level (< 30 ng/mL) in the healthy individuals was 85.31%, and the rate was significantly higher in women (89.29%) than in men. Serum 25(OH)D levels in June, July, and August were significantly higher than those in December, January, and February. In the healthy individuals, blood eosinophil counts were the lowest in severe 25(OH)D deficiency group, followed by the deficiency group and insufficient group, and were the highest in the normal group (P < 0.05). Multivariable regression analysis showed that an older age, a higher BMI, and elevated vitamin D levels were all risk factors for elevated blood eosinophils in the healthy individuals. The patients with COPD had lower serum 25(OH)D levels than the healthy individuals (19.66±7.87 vs 26.39±9.28 ng/mL) and a significantly higher abnormal rate of serum 25(OH)D (91% vs 71%; P < 0.05). A reduced serum 25(OH)D level was a risk factor for COPD. Blood eosinophils, sex and BMI were not significantly correlated with serum 25(OH)D level in patients with COPD.

CONCLUSION

Vitamin D deficiency is common in both healthy individuals and COPD patients, and the correlations of vitamin D level with sex, BMI and blood eosinophils differ obviously between healthy individuals and COPD patients.

[Trend of age of menarche among Chinese Han girls aged 9 to 18 years from 2010 to 2019]

Objective: To analyze the trends of the age of menarche among Chinese Han girls aged 9 to 18 years from 2010 to 2019. Methods: Data were extracted from the Chinese National Surveys on Students' Constitution and Health in 2010, 2014 and 2019. A total of 253 037 Han girls aged 9 to 18 years with complete data on menarche were selected in this study. They were asked one-on-one about their menstrual status, age and residence information. The median age of menarche was estimated by probability regression. U tests were used to compare the difference in median age at menarche in different years. Results: The median age at menarche (95%CI) among Chinese Han girls was 12.47 (12.09-12.83) years in 2010, 12.17 (11.95-12.38) years in 2014 and 12.05 (10.82-13.08) years in 2019, respectively. Compared with that in 2010, the median age at menarche in 2019 decreased by 0.42 years (U=-77.27, P<0.001). The annual average changes were -0.076 years from 2010 to 2014 (U=-57.19, P<0.001) and -0.023 years from 2014 to 2019 (U=-21.41, P<0.001), respectively. The average annual changes in urban areas in the periods of 2010 to 2014 and 2014 to 2019 were -0.071 years and 0.006 years, respectively, while those in rural areas were -0.082 years and -0.053 years, respectively. The average annual changes in the regions of north, northeast, east, south central, southwest and northwest were -0.064, -0.099, -0.091, -0.080, -0.096 and -0.041 years in the period of 2010 to 2014 and 0.001, -0.040, -0.002, -0.005, -0.043 and -0.081 years in the period of 2014 to 2019. Conclusion: The age of menarche among Chinese Han girls aged 9 to 18 years shows an advanced trend from 2010 to 2019, and the trends in urban and rural areas and different regions have different characteristics.

[Perceived exercise benefits and barriers and their association with physical activity time in Chinese Han children and adolescents aged 9 to 18 years]

Objective: To analyze the perceived exercise benefits and barriers and their association with physical activity time in Chinese Han children and adolescents aged 9-18 years. Methods: Data were extracted from the 2019 Chinese National Survey on Students' Constitution and Health and a total of 163 656 children and adolescents aged 9-18 years in Han ethnic group were included in the analysis. Mann-Whitney U test and Kruskal-Wallis test were used to compare the perceived exercise benefits score, perceived exercise barriers score and perceived exercise benefits to barriers ratio in the children and adolescents with different demographic characteristics and physical activity time. The differences in physical activity time in subgroups were compared with χ² tests. log-binomial regression model was used to evaluate the association between physical activity time and perceived exercise benefits and barriers. Results: The M (Q₁,Q₃) of the perceived exercise benefits score, perceived exercise barriers score, and perceived exercise benefits to barriers ratio in the children and adolescents were 4.11 (3.78, 4.78), 2.70 (2.10, 3.20) and 1.55 (1.22, 2.07), respectively. Children and adolescents living in urban area, boys, those at younger age and those with physical activity time ≥1 hour had higher perceived exercise benefits score and perceived exercise benefits to barriers ratio, but lower perceived exercise barriers score (all P<0.001). The prevalence of physical activity time ≥1 hour was 41.4% in the children and adolescents. In the log-binomial model with two variables of perceived exercise benefits score and perceived exercise barriers score, for each 1-point increase in the perceived exercise benefits, the possibility of physical activity time ≥1 hour increased by 11% (OR=1.11, 95%CI: 1.10-1.12), and for each 1-point increase in the perceived exercise barriers, the possibility of physical activity time ≥1 hour decreased by 15% (OR=0.85, 95%CI: 0.84-0.85). In the log-binomial model with variable of perceived exercise benefits to barriers ratio, for each 1-point increase in the perceived exercise benefits to barriers ratio, the possibility of physical activity time ≥1 hour increased by 12% (OR=1.12, 95%CI: 1.11-1.12). Conclusion: The perceived exercise benefits and barriers are significantly associated with physical activity time in children and adolescents in China.

[Trends of age of menarche among Chinese Han girls aged 9 to 18 years from 2010 to 2019]

Objective: To analyze the trends of the age of menarche among Chinese Han girls aged 9 to 18 years from 2010 to 2019. Methods: Data were extracted from the Chinese National Surveys on Students' Constitution and Health in 2010, 2014 and 2019. A total of 253 037 Han girls aged 9 to 18 years with complete data on menarche were selected in this study. They were asked one-on-one about their menstrual status, age and residence information. The median age of menarche was estimated by probability regression. U tests were used to compare the difference in median age at menarche in different years. Results: The median age at menarche (95%CI) among Chinese Han girls was 12.47 (12.09-12.83) years in 2010, 12.17 (11.95-12.38) years in 2014 and 12.05 (10.82-13.08) years in 2019, respectively. Compared with that in 2010, the median age at menarche in 2019 decreased by 0.42 years (U=-77.27, P<0.001). The annual average changes were-0.076 years from 2010 to 2014 (U=-57.19, P<0.001) and-0.023 years from 2014 to 2019 (U=-21.41, P<0.001), respectively. The average annual changes in urban areas in the periods of 2010 to 2014 and 2014 to 2019 were-0.071 years and 0.006 years, respectively, while those in rural areas were-0.082 years and-0.053 years, respectively. The average annual changes in the regions of north, northeast, east, south central, southwest and northwest were-0.064, -0.099, -0.091, -0.080, -0.096 and-0.041 years in the period of 2010 to 2014 and 0.001, -0.040, -0.002, -0.005, -0.043 and-0.081 years in the period of 2014 to 2019. Conclusion: The age of menarche among Chinese Han girls aged 9 to 18 years shows an advanced trend from 2010 to 2019, and the trends in urban and rural areas and different regions have different characteristics.

[Trend of the detection rate of myopia among Chinese Han children and adolescents aged 7-18 years from 2010 to 2019]

Objective: To analyze the trend of the detection rate of myopia among Chinese Han children and adolescents aged 7-18 years from 2010 to 2019. Methods: Data from the Chinese National Survey on Students' Constitution and Health in 2010, 2014 and 2019 were used, and about 213 833, 212 742 and 209 942 Han students aged 7-18 years were included in this study. The χ² test was used to compare the differences in the prevalence of myopia among the subgroups in the survey year, and logistic regression was used to compare the differences in the prevalence of myopia between different years. A curve-fitting method was used to obtain the growth rate of myopia among Han Chinese students from 2010 to 2019, and the differences in the change of myopia between different age groups were analyzed. Results: In 2019, the overall detection rate of myopia among Chinese Han children and adolescents aged 7-18 was 60.1%. The detection rate of urban students (62.7%) was higher than that of rural students (57.4%) and the detection rate of girls (63.5%) was higher than that of boys (56.7%). In 2019, the regional disparities were large in the detection rate of myopia in various provinces, with the lowest in Guizhou (49.6%) and the highest in Zhejiang (71.3%). The detection rate of myopia showed an upward trend from 2010 to 2019, from 55.5% in 2010 to 57.1% in 2014, and finally to 60.1% in 2019. The gap in the detection rate of myopia between urban and rural children and adolescents gradually shrank. The average annual growth rate of myopia detection rate from 2014 to 2019 was 0.6 percentage points per year, higher than that from 2010 to 2014 about 0.4 percentage points per year. The peak age of the growth rate of myopia detection rate decreased from 12 years in 2010 to 10 years in 2014, and finally to 7 years in 2019. Conclusions: The detection rate of myopia among Chinese Han children and adolescents is still at a high level, and the peak age of the growth rate of myopia detection rate continues to advance.

[Long-term trend of the age of spermarche and its association with nutritional status among Chinese Han boys aged 11-18 from 2010 to 2019]

Objective: To analyze the long-term trend of the age of spermarche among Chinese Han boys aged 11 to 18 from 2010 to 2019 and its association with nutritional status. Methods: The data from Chinese National Surveys on Students' Constitution and Health in 2010, 2014 and 2019 were used. The age, residence and spermarche of the participants were collected by questionnaire, and their height and weight were measured. A total of 184 633 Han boys aged 11‒18 years with complete data on spermarche, height, and weight were included in this study. The probability regression method was used to calculate the median age (95%CI) at spermarche in different areas, and the trend of age at spermarche in different groups was compared. The multivariate logistic regression model was used to analyze the association between nutritional status and spermarche of Chinese Han boys aged 11‒18 years. Results: The median age of spermarche (95%CI) was 13.85 (13.45-14.22) years old among Chinese Han boys aged 11‒18 years in 2019, with 0.18 years earlier than that in 2010. The median age at spermarche in urban and rural boys was 13.89 and 13.81 years, respectively. Compared with that in 2010, the age at spermarche in urban and rural boys was 0.08 and 0.27 years earlier, respectively. After adjusting for age, province and urban/rural areas, compared with normal weight, spermarche was negatively associated with wasting and positively associated with overweight and obesity, with OR (95%CI) about 0.73 (0.67-0.80), 1.09 (1.02-1.17) and 1.09 (1.01-1.18), respectively. Conclusion: The age of spermarche generally shows an advanced trend among Chinese Han boys and is associated with nutritional status.

A Digital Twin of the Coaxial Lamination Mixer for the Systematic Study of Mixing Performance and the Prediction of Precipitated Nanoparticle Properties

The synthesis of nanoparticles in microchannels promises the advantages of small size, uniform shape and narrow size distribution. However, only with insights into the mixing processes can the most suitable designs and operating conditions be systematically determined. Coaxial lamination mixers (CLM) built by 2-photon polymerization can operate long-term stable nanoparticle precipitation without fouling issues. Contact of the organic phase with the microchannel walls is prevented while mixing with the aqueous phase is intensified. A coaxial nozzle allows 3D hydrodynamic focusing followed by a sequence of stretch-and-fold units. By means of a digital twin based on computational fluid dynamics (CFD) and numerical evaluation of mixing progression, the influences of operation conditions are now studied in detail. As a measure for homogenization, the mixing index (MI) was extracted as a function of microchannel position for different operating parameters such as the total flow rate and the share of solvent flow. As an exemplary result, behind a third stretch-and-fold unit, practically perfect mixing (MI>0.9) is predicted at total flow rates between 50 µL/min and 400 µL/min and up to 20% solvent flow share. Based on MI values, the mixing time, which is decisive for the size and dispersity of the nanoparticles, can be determined. Under the conditions considered, it ranges from 5 ms to 54 ms. A good correlation between the predicted mixing time and nanoparticle properties, as experimentally observed in earlier work, could be confirmed. The digital twin combining CFD with the MI methodology can in the future be used to adjust the design of a CLM or other micromixers to the desired total flow rates and flow rate ratios and to provide valuable predictions for the mixing time and even the properties of nanoparticles produced by microfluidic antisolvent precipitation.

NIR-II multifocal structured illumination microscopy

Optical microscopy has been widely used as a versatile tool in biological research. However, its penetration depth and spatial resolution are desperately limited by light scattering during deep propagation in turbid medium. Here, we implement near-infrared second window (1000-1700 nm) multifocal structured illumination microscopy (NIR-II MSIM) capable of deep penetration, high contrast, and enhanced spatial resolution. Raster-scanning multifocal illumination patterns ensure homogeneous illumination of the sample. By integrating NIR-II photoemission into multifocal photoexcitation, NIR-II MSIM affords deep imaging with improved lateral resolution (∼1.49 µm) at a depth of 2.5 mm in an Intralipid/agar phantom and outstanding contrast. Additionally, imaging at longer wavelength in the NIR-II region shows superior performance. This NIR-II MSIM system will afford a promising platform for studying physiological phenomena in turbid specimens in the future.

Horseshoe lamination mixer (HLM) sets new standards in the production of monodisperse lipid nanoparticles

Microfluidic mixers promise unique conditions for the controlled and continuous preparation of nanoparticles by antisolvent precipitation. Nanoparticles may enable encapsulation of drug or mRNA molecules in the form of carrier nanoparticles or can provide higher bioavailability in the form of drug nanoparticles. The ultimate goal in microfluidic approaches is the production of nanoparticles with narrow size distributions while avoiding contaminations and achieving sufficiently high throughput. To achieve this, a novel microfluidic precipitation device was developed and realized by two-photon polymerization: mixing elements were designed in such a way that the liquids undergo a repeated Smale horseshoe transformation resulting in an increased interfacial area and mixing times of less than 10 ms. These elements and an additional 3D flow focusing ensure that no organic phase is exposed to the channel walls. The integration of a fluidic shield layer in the flow focusing proved to be useful to delay the precipitation process until reaching a sufficient distance to the injection nozzle. Lipid nanoparticle preparation with different concentrations of castor oil or the hard fat Softisan® 100 were performed at different flow rates and mixing ratios with and without a shield layer. Flow rates of up to 800 μl min^-1 and organic phase mixing ratios of up to 20% resulted in particle sizes ranging from 42 nm to 166 nm with polydispersity indices from 0.04 to 0.11, indicating very narrowly distributed, and in most cases even monodisperse, nanoparticles. The occurrence of fouling can be completely suppressed with this new type of mixing elements, as long as Dean vortices are prevented. Moreover, this parameter range in the horseshoe lamination mixer provided a stable and continuous process, which enables a scalable production.

[Clinical research progress and implications of therapeutic vaccines for cervical cancer and precancerous lesions: a qualitative systematic review]

Objective: To systematically summarize and analyze the clinical research progress of therapeutic vaccines for cervical cancer or precancerous lesions. Methods: English databases (PubMed, Embase, Web of Science, Cochrane library, Proquest, and ClinicalTrails.gov) and Chinese databases (SinoMed, CNKI, WanFang, and VIP Database) were systematically searched to collect literature on therapeutic vaccines for cervical cancer or precancerous lesions from inception to February 18, 2021. After screening, we evaluated the risk of bias of included studies, and combed the basic information of the literature, research designs, information of vaccines, study patients, outcome indicators and so on, qualitatively summarized the clinical research progress. Results: A total of 71 studies were included in this systematic review, including 14 random controlled trials, 15 quasi-random controlled trials, 4 cohort studies, 1 case-control study, 34 case series studies and 3 case reports. The study patients included women aged 15~79 with cervical cancer or precancerous lesions in 18 countries from 1989 to 2021. On the one hand, there were 40 studies on therapeutic vaccines for cervical precancerous lesions (22 867 participants), involving 21 kinds of vaccines in 6 categories. Results showed 3 marketed vaccines (Cervarix, Gardasil, Gardasil 9) as adjuvant immunotherapies were significant effective in preventing the recurrence of precancerous lesions compared with the conization only. In addition, MVA E2 vaccine had been in phase Ⅲ clinical trials as a specific therapeutic vaccine, with relative literature showing it could eliminate most high-grade precancerous lesions. Therapeutic vaccines for precancerous lesions all showed good safety. On the other hand, there were 31 studies on therapeutic vaccines for cervical cancer (781 participants), involving 19 kinds of vaccines in 7categories, with none had been marketed. 25 studies were with no control group, showing the vaccines could effectively eliminate solid tumors, prevent recurrence, and prolong the median survival time. However, the vaccines effectiveness couldn't be statistically calculated due to the lack of a control group. As for the safety of therapeutic vaccines for cervical cancer, 9 studies showed that patients experienced serious adverse events after treatments, where 7 studies reported that serious adverse events occurred in patients couldn't be ruled out as the results of therapeutic vaccines. Conclusions: The literature review shows that the literature evidence for the therapeutic vaccines for cervical precancerous lesions is relatively mature compared with the therapeutic vaccines for cervical cancer. The four kinds of vaccines on the market are all therapeutic vaccines for precancerous lesions, but they are generally used as vaginal infection treatments or adjuvant immunotherapies for cervical precancerous lesions, not used for the specific treatments of cervical precancerous lesions. Other specific therapeutic vaccines are in the early stage of clinical trials, mainly phase Ⅰ/Ⅱ clinical trials with small sample size. The effectiveness and safety data are limited, and further research is still needed.

Halogen-doped phosphorescent carbon dots for grayscale patterning

Flexible organic materials that exhibit dynamic ultralong room temperature phosphorescence (DURTP) via photoactivation have attracted increasing research interest for their fascinating functions of reversibly writing-reading-erasing graphic information in the form of a long afterglow. However, due to the existence of a nonnegligible activation threshold for the initial exposure dose, the display mode of these materials has thus far been limited to binary patterns. By resorting to halogen element doping of carbon dots (CDs) to enhance intersystem crossing and reduce the activation threshold, we were able to produce, for the first time, a transparent, flexible, and fully programmable DURTP composite film with a reliable grayscale display capacity. Examples of promising applications in UV photography and highly confidential steganography were constructed, partially demonstrating the broad future applications of this material as a programmable platform with a high optical information density.

Mitochondrial structural variations in the process of mitophagy

Mitochondrion is one of significant organelles inside cells because it serves as a hub for energy management and intracellular signaling. Internal/external damages on mitochondria would lead to mitochondrial stresses with the malfunctions, accompanying with the changes of morphological structure and abnormal local environments (pH values). Mitophagy is capable of degradation of damaged mitochondrial segments to restore its normal metabolism, dynamics, and biogenesis. The dynamic structural visualization and pH quantification can be helpful for the understanding of mitochondrial functions as well as the diagnosis of disorders linking with this process. In this work, we use confocal laser scanning microscopy, STED super-resolution nanoscopy and fluorescence lifetime imaging microscopy, in conjunction with a mitochondrial probe to image the dynamic changes in the mitochondrial morphology and microenvironmental pH values during mitophagy in live cells, in particular, the structural changes of mitochondrial cristae beyond optical diffraction can be distinguished by STED nanoscopy with/without treatment by CCCP, which will provide a new view for the diagnosis and personalized treatment of mitochondrial dysfunction-related diseases.

Novel near-infrared spectroscopic probe for visualizing hydrogen sulfide in lysosomes

Considering the scarcity of hydrogen sulfide (H₂S) probes with subcellular organelle targeting, especially probes with near-infrared (NIR) emission wavelengths fluorophores, our group has been working to overcome this problem and looking forward to providing potential practical tools for exploring the relationship between the physiology and pathology of H₂S at subcellular level. In this paper, a novel colorimetric and NIR fluorescent probe SHCy-H₂S for the specific detection of H₂S in lysosome over other biological thiols was designed and synthesized. The xanthene-benzothiozolium fluorophore was chosen to provide fluorescence emission maxima over 735 nm, and 2,4-dinitrophenyl group was chosen as fluorescence quenching group and specific H₂S response site. Impressively, SHCy-H₂S exhibited high selectivity, fast response and detection limit as low as 0.116 μM for H₂S, marked obvious color changes in naked-eye and fluorescence. Specially, SHCy-H₂S was capable of specifically imaging endogenous lysosomal hydrogen sulfide, providing a potential tool for exploring the function of H₂S at subcellular level.

Rational design of a large Stokes shift xanthene-benzothiozolium dyad for probing cysteine in mitochondria

Xanthene-modified cyanine dyes are considered to be an effective means to extend the emission wavelength and improve the photo-stability of cyanine dyes. However, the fluorophores obtained by this strategy generally have narrow Stokes shifts, which severely limits their application in biological imaging. Herein, a reasonable design strategy is adopted to provide an effective strategy to commendably improve the Stokes shift of xanthene-benzothiozolium fluorophores via the simultaneous expansion of a molecular π-conjugated system and heteroatomic substitution. Combined with density functional theory calculation guidance, the O atom is replaced with the S atom in the xanthene moiety and a π-conjugated benzene ring is introduced in the benzothiozolium moiety. Surprisingly, the results of the spectroscopic experiment showed that the fluorescence emission wavelength of PhCy-OH was extended to 803 nm, and the Stokes shift was improved to 68 nm. PhCy-Cys can effectively distinguish Cys from homocysteine (Hcy) and glutathione (GSH) with an extremely low detection limit of 0.166 μM. Importantly, PhCy-Cys has the ability to image endogenous Cys in mitochondria, providing the potential for exploring the specific function and mechanism of Cys in regulating oxidative stress in mitochondria.

A highly sensitive sensor for colorimetric detection of palladium(II) in lysosomes and its applications

Considering the scarcity of palladium ion probes with subcellular organelle targeting, especially probes with near-infrared (NIR) emission wavelength fluorophores, our group has been working to overcome this problem and looking forward to providing potential practical tools for exploring the toxicity of palladium ions at the subcellular level. In this paper, a novel colorimetric and NIR fluorescent probe, BHCy-Pd, for the specific detection of palladium ions (Pd²⁺) in lysosomes via an internal charge-transfer (ICT) mechanism was designed and synthesized. As expected, BHCy-Pd exhibited a rapid, selective, and sensitive response for palladium with an ultralow limit of detection at 5.9 nM, accompanied by a distinct color change from purple to blue. Furthermore, BHCy-Pd can be made into a simple test strip for rapid and easy detection of Pd²⁺ in practical applications. Importantly, BHCy-Pd is capable of specific distribution in lysosomes, and thus can detect Pd²⁺ in real-time, thereby providing a potential tool for studying the cytotoxicity of Pd²⁺ ions at the subcellular level.

A new near-infrared fluorescent probe for sensing extreme acidity and bioimaging in lysosome

Since the intracellular pH plays an important role in the physiological and pathological processes, however, the probes that can be used for monitoring pH fluctuation under extreme acidic conditions are currently rare, so it is necessary to construct fluorescent probes for sensing pH less than 4. In this work, we developed a new near-infrared (NIR) fluorescent probe Cy-SNN for sensing pH fluctuation under extremely acidic conditions. For the preparation of this probe, benzothiozolium moiety was chosen as lysosomal targeting unit and NIR fluorophore, and barbituric acid moiety was fused in the polymethine chain of probe to introduce protonation center. Surprisingly, on the basis of the balance of quaternary ammonium salts and free amines, the pKa value of Cy-SNN was calculated as low as 2.96, implying that Cy-SNN can be used in acidic conditions with pH < 4. Moreover, Cy-SNN exhibited highly selective response to H+ over diverse analytes in real-time with dependable reversibility. Importantly, Cy-SNN can be used to specifically target lysosome, providing potential tools for monitoring the function of lysosome in autophagy process.

[Mechanism of PI3K/AKT/mTOR signaling pathway for mediating anti-inflammatory and anti-oxidant effects of chrysin: a protein microarray-based study]

OBJECTIVE

To investigate the mechanism of PI3K/AKT/mTOR signaling pathway for mediating the anti-inflammatory and anti-oxidant effects of chrysin.

METHODS

RAW264.7 cells were treated with different concentrations of chrysin for 24 h, and the changes in cell viability were detected using CCK-8 method. The cells with or without chrysin pretreatment for 2 h were stimulated with lipopolysaccharide (LPS) for different lengths of time, and the related signal molecules were screened using protein chip technique. In cells pretreated with chrysin for 2 h followed by LPS stimulation for 18 h, the release of IL-6, MCP-1 and TNF-α by the cells was detected with ELISA, and NO production was examined using Griess method, and ROS level was determined using DCFH-DA. The effects of chrysin, LPS, and their combination on the mRNA expressions of iNOS and COX-2 were detected using RT-PCR; Western blotting was performed to examine the changes in cellular expressions of p-AKT, p-PRAS40, p-mTOR, mTOR, p-P70S6k, p-S6RP and S6RP following the treatments with LPS, N-Acetyl-L-cysteine, and chrysin, alone or in combinations.

RESULTS

Chrysin below 60 μg/mL did not significantly affect the viability of RAW264.7 cells (P>0.05). Chrysin treatment significantly reduced the release of IL-6, MCP-1, and TNF-α and the level of NO (P < 0.01), and inhibited the mRNA and protein expressions of iNOS and COX-2 (P < 0.01) in the cells. The results of protein chip screening suggested that LPS could activate the AKT/mTOR pathway, which was significantly inhibited by chrysin pretreatment, and the results were verified by Western blotting (P < 0.01). Chrysin treatment significantly reduced the generation of endogenous ROS, and treatment with N-Acetyl-L-cysteine to eliminate intracellular ROS obviously reduced the expressions of iNOS and COX-2 (P < 0.05) and blocked the AKT/mTOR pathway (P < 0.05).

CONCLUSION

Chrysin can inhibit the synthesis of the upstream signaling molecule ROS to inhibit the activation of AKT/mTOR signaling pathway, regulate the translation process of ribosomes, down-regulate the synthesis and release of pro-inflammatory cytokines and inflammatory mediators, and thus produce anti-inflammatory effects.

Whole genome survey and genetic markers development of crocodile flathead Cociella crocodilus

Flatheads in family Platycephalidae are ecologically and commercially important marine fish species in the Indo-West Pacific. Due to similar morphological characters, the taxonomy and phylogenetics of flatheads are in confusion. Studies on phylogenetics and molecular marker development are required to discriminate congeners of flatheads. In the present study, we performed whole genome survey sequencing of crocodile flathead Cociella crocodilus to provide genomic information and genetic markers of this species. In total, 54.03 Gb of clean genomic data were generated. The genome size was estimated to be 732.99 Mb with the heterozygosity ratio of 0.73% and the repeat sequence ratio of 33.48%. The preliminary assembled genome sequences were 794.07 Mb with contig N50 of 1504 bp. We detected 2 624 875 genome-wide SNPs with transition/transversion ratio of 1.422. A total of 313 842 microsatellite motifs were identified, most of which were dinucleotide motifs with a frequency of 74.89%. In addition, we assembled the complete mitogenome of C. crocodilus and subsequent phylogenetic analysis were performed. Phylogenetic analyses revealed numbers of polyphyletic groups in family Platycephalidae. The reported genomic data and genetic markers in our study should be useful in further phylogeny and phylogenomics studies of flathead species.

P–371 Clinical value assessment between endometrial receptivity array and immune profiling in patients with implantation failure

Study question

To evaluate whether the pregnancy outcomes could be improved in implantation failure patients by endometrial receptivity array, endometrial immune profiling, or a combination of both.

Summary answer

There was no statistical difference between different endometrial receptivity evaluation and treatment in improving the clinical pregnancy rate.

What is known already

Both endometrial receptivity array and endometrial immune profiling were promised to improve the endometrial receptivity and subsequent clinical pregnancy. However, less is known about the efficiency between each other and whether the combination could further enhance their clinical value.

Study design, size, duration

Between November 2019 and September 2020, 143 women with a history of at least two or more consecutive implantation failure in IVF/ICSI treatment in Chengdu Xinan Gynecology Hospital were included. They were divided into three groups: ‘ERA + Immune Profiling’ (n = 70), ‘Immune Profiling’ (n = 41), and ‘ERA’ (n = 32).

Participants/materials, setting, methods

Inclusion criteria were age ≤ 38, with normal uterus and uterine cavity. All patients were suggested to evaluate endometrial receptivity by ERA test (Igenomix, Valencia, Spain) and endometrial immune profiling based on immunohistochemistry simultaneously, who would be free to choose each or both evaluation approaches. Personal Embryo Transfer and/or personal medical care were adopted according to evaluation results. Clinical pregnancy was confirmed by gestational sacs observed under ultrasonography.

Main results and the role of chance

The overall prevalence of displaced window of implantation (WOI) is 84.3%, and nearly 74.8% (83/111) patients were diagnosed as endometrial immune dysregulation. Clinical Pregnancy rate and embryonic implantation rate decreased in the ‘Immune Test’ groups, but without a statistical difference (P = 0.311, and 0.158, respectively). Multivariable logistic regression analysis showed that different endometrial receptivity evaluation and treatment was not associated the clinical pregnancy rate, suggesting the performance of different endometrial receptivity evaluation and treatment is similar in improving the clinical pregnancy rate. Neither the immune profiling (CD56, P = 0.591; FOXP3, P = 0.195; CD68, P = 0.820; CD163, P = 0.926; CD1a, P = 0.561; CD57, P = 0.221; CD8, P = 0.427; CD138 CE, P = 0.372) nor histologic endometrial dating defined by Noyes criteria (P = 0.374) were associated with ERA phases.

Limitations, reasons for caution

Although the selection of evaluation approaches was based on patients’ willingness, the variances of baseline characteristics and immune profiling existed in different groups. The immunological treatment efficacy based on immune profiling was not evaluated before embryo transfer.

Wider implications of the findings: To our knowledge, this is the first study comparing the pregnancy outcomes after two typical endometrial receptivity evaluation approaches. The findings highlight the unsubstitutability for each assessment, indicating that both asynchronous and pathological WOI contribute to implantation failure.

Trial registration number

X2019004

Prevalence and genotype distribution of human papillomavirus among 29 263 women from the Longgang community of Shenzhen

BACKGROUND

Human papillomavirus (HPV) vaccination and screening have been demonstrated to be effective methods for controlling cervical cancer. To provide evidence for effective targeted interventions, we investigated the HPV prevalence and genotypic distribution in women of different age groups in the Longgang community of Shenzhen, China.

METHODS

A total of 29 263 women were enrolled in the Longgang District Central Hospital from January 2018 to October 2020. Cervical specimens were collected at enrolment. We used a polymerase chain reaction diagnostic kit to detect the genotypes of HPV.

RESULTS

The prevalence of overall, high-risk, probable high-risk (PHR) and low-risk HPV infection was 8.2% (95% confidence interval [CI] 7.9 to 8.5), 6.9% (95% CI 6.6 to 7.2), 0.9% (95% CI 0.8 to 1.1) and 1.6% (95% CI 1.5 to 1.8), respectively. High-risk HPV genotype infections accounted for 84.4% (95% CI 82.8 to 85.8) of the overall HPV infections. The five most predominant genotypes were HPV-52, HPV-16, HPV-58, HPV-53 and HPV-51.

CONCLUSION

Our study found that the prevalence of HPV infection increased with age and women 55-59 y of age presented the highest HPV prevalence. As a PHR subtype, HPV-53 has a higher infection rate in women. HPV-52, HPV-16 and HPV-58 are common infection genotypes.

Blocking HOTAIR protects human chondrocytes against IL-1β-induced cell apoptosis, ECM degradation, inflammatory response and oxidative stress via regulating miR-222-3p/ADAM10 axis

BACKGROUND

Long non-coding RNA (lncRNA) HOX transcript antisense RNA (HOTAIR) contributes to cartilage damages including osteoarthritis (OA). While, its role and mechanism in chondrocytes is incompletely clear.

METHODS

HOTAIR, microRNA (miR)-222-3p and ADAM metalloproteinase-like domain 10 (ADAM10) expressions were detected by real-time quantitative PCR and western blotting. The interaction between miR-222-3p and HOTAIR or ADAM10 was confirmed by dual-luciferase reporter assay. Cell injury was measured by MTS method, flow cytometry, western blotting, enzyme-linked immunosorbent assay for collagen Type II, type X, sex determining region Y-box 9 (SOX9), matrix metalloproteinase (MMP)-13, interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α, and special assay kits for malondialdehyde (MDA), reactive oxygen species (ROS) and superoxide dismutase (SOD).

RESULTS

HOTAIR was highly expressed in human OA cartilages and IL-1β-induced OA model in immortalized chondrocytes (C-28/I2). Under IL-1β stress, blocking HOTAIR was responsible to high mitochondrial activity and low early apoptosis rate, accompanied with increased B cell lymphoma (Bcl)-2 and LC3B-II/I proteins, boosted IL-10 and SOD productions, suppressed cleaved caspase-3 and p62 proteins, and decreased MDA and ROS levels, as well as elevated secretions of Type II collagen, Type X collagen, SOX9, MMP-13, IL-6, and TNF-α. Moreover, miR-222-3p was a target of HOTAIR, and its overexpression and knockdown could suppress and aggravate IL-1β-induced chondrocytes injury. Furthermore, restoring ADAM10, a target gene of miR-222-3p, counteracted the protective role of miR-222-3p upregulation.

CONCLUSION

HOTAIR might contribute to IL-1β-induced chondrocytes death, inflammation, extracellular matrix degradation, and oxidative stress in OA via miR-222-3p/ADAM10 axis.

Dietary Inflammatory Index in relation to bone mineral density, osteoporosis risk and fracture risk: a systematic review and meta-analysis

Our systematic review and meta-analysis indicated that pro-inflammatory diets, as measured by higher Dietary Inflammatory Index scores, are significantly associated with lower BMD of lumbar spine and total hip as well as elevated risk of osteoporosis and fractures. These findings may contribute to the development of public health strategies.

INTRODUCTION

Inflammatory Index (DII) is a method to assess the inflammatory potential of diets; it has been reported to be associated with several diseases. However, the relation between DII and bone health remains controversial for the inconsistent findings from previous studies. This systematic review and meta-analysis aimed to ascertain the underlying relationships between DII and bone mineral density (BMD), osteoporosis risk, and fracture risk.

METHODS

We systematically searched PubMed and Web of Science for all relevant epidemiological studies published up to May 1, 2020. Fixed-effects model or random-effects model was employed to pool the study-specific effect sizes (ESs) and 95% confidence intervals (CIs).

RESULTS

Eleven studies with a total of 127,769 participants were included. We found that continuous DII was negatively associated with BMD of lumbar spine (odds ratios [OR]: 0.990; 95% CI: 0.984, 0.995) and total hip (OR: 0.995; 95% CI: 0.990, 0.999), but not femoral neck (OR: 0.998; 95% CI: 0.994, 1.002). Moreover, the highest category of DII displayed significantly associations to increased risk of osteoporosis (ES: 1.31; 95% CI: 1.16, 1.48) and fractures (ES: 1.28; 95% CI: 1.03, 1.59) compared with the lowest category of DII, respectively.

CONCLUSION

Our analysis indicated that diets with high pro-inflammatory components might increase the risk of osteoporosis and fractures and lower BMD of lumbar spine and total hip. More prospective studies involving populations of diverse ages and genders are expected to further verify the universality of the results.

Public health information on COVID-19 for international travellers: lessons learned from a mixed-method evaluation

OBJECTIVES

In the containment phase of the response to the COVID-19 outbreak, Public Health England (PHE) delivered advice to travellers arriving at major UK ports. We aimed to rapidly evaluate the impact and effectiveness of these communication materials for passengers in the early stages of the pandemic.

STUDY DESIGN

The study design used is the mixed-methods evaluation.

METHODS

A questionnaire survey and follow-up interviews with passengers arriving at London Heathrow Airport on scheduled flights from China and Singapore. The survey assessed passengers' knowledge of symptoms, actions to take, and attitudes towards PHE COVID-19 public health information; interviews explored their views of official public health information and self-isolation.

RESULTS

One hundred and twenty-one passengers participated in the survey and 15 in follow-up interviews. Eighty three percentage of surveyed passengers correctly identified all three COVID-19 associated symptoms listed in PHE information at that time. Most could identify the recommended actions and found the advice understandable and trustworthy. Interviews revealed that passengers shared concerns about the lack of wider official action, and that passengers' knowledge had been acquired elsewhere as much from PHE. Respondents also noted their own agency in choosing to self-isolate, partially as a self-protective measure.

CONCLUSION

PHE COVID-19 public health information was perceived as clear and acceptable, but we found that passengers acquired knowledge from various sources and they saw the provision of information alone on arrival as an insufficient official response. Our study provides fresh insights into the importance of taking greater account of diverse information sources and of the need for public assurance in creating public health information materials to address global health threats.

A lysosome-targeted near-infrared fluorescent probe for imaging endogenous cysteine (Cys) in living cells

Cysteine (Cys) is one of the most important essential biothiols in lysosomes. Highly selective probes for specific detection and imaging of lysosomal Cys over other biological thiols are rare. Herein, we developed a lysosome-targeted near-infrared fluorescent probe SHCy-C based on a novel NIR-emitting thioxanthene-indolium dye. Due to the turn-on fluorescence response elicited by the intramolecular charge transfer (ICT) processes before and after the reaction with Cys, probe SHCy-C exhibits high selectivity and sensitivity (16 nM) for the detection of Cys. More importantly, probe SHCy-C is found to precisely target lysosomes and achieves the "turn-on" detection and imaging of endogenous Cys in lysosomes.