Epidemiology of congenital diaphragmatic hernia among 24 million Chinese births: a hospital-based surveillance study.

BACKGROUND: The prevalence of congenital diaphragmatic hernia (CDH) varies across countries, with limited information available on its epidemiology in China. Our study aimed to investigate the prevalence, time trends, and perinatal outcomes of CDH in China, as well as its associated malformations and potential associations with maternal and infant characteristics. METHODS: This study included all birth and CDH cases from the Chinese Birth Defects Monitoring Network between 2007 and 2019, with CDH cases classified as either isolated or associated. We employed the joinpoint regression model to calculate the trends of prevalence and the annual percent change, with Poisson regression used for adjusted prevalence rate ratios. A P value ≤ 0.05 was considered statistically significant. RESULTS: A total of 4397 CDH cases were identified among 24,158,029 births in the study period, yielding prevalence rates of 1.82, 1.13 and 0.69 per 10,000 for overall, isolated, and associated CDH, respectively. The prevalence of each type of CDH increased over time. The prevalence of overall CDH varied significantly by infant sex (male vs. female, 1.91/10,000 vs. 1.63/10,000), maternal residence (urban vs. rural, 2.13/10,000 vs. 1.45/10,000), maternal age (< 20 years, 1.31/10,000; 20-24 years, 1.63/10,000; 25-29 years, 1.80/10,000; 30-34 years, 1.87/10,000; ≥ 35 years, 2.22/10,000), and geographic region (central, 1.64/10,000; east, 2.45/10,000; west, 1.37/10,000). Cardiovascular anomalies were the most common malformations associated with CDH. Infants with associated CDH had a higher risk of premature birth and perinatal death than those with isolated CDH. CONCLUSION: The increasing prevalence and high perinatal mortality rate of CDH highlight the need for further etiological, epidemiological, and clinical studies among the Chinese population. Video Abstract.

The changing epidemiology of syndactyly in Chinese newborns: a nationwide surveillance-based study.

BACKGROUND: Little is known about the epidemiologic features of syndactyly (SD) in Chinese newborns. METHODS: Using 2007-2019 data from the Chinese Birth Defects Monitoring Network, we conducted a prevalence analysis on overall, isolated and associated syndactyly according to birth year, maternal age, maternal residence, geographic region and infant sex, with special interests in time trends, perinatal outcomes and clinical phenotypes. RESULTS: A total of 13,611 SD cases were identified among 24,157,719 births in the study period, yielding the prevalence of 5.63, 4.66 and 0.97 per 10,000 for overall, isolated, and associated SD, respectively. The prevalence of each type of SD exhibited an upward trend over the period. The prevalence of overall SD varied significantly by maternal residence (urban vs. rural, 6.69/10,000 vs. 4.35/10,000), maternal age (< 20 years, 5.43/10,000; 20-24 years, 5.03/10,000; 25-29 year, 5.65/10,000; 30-34 years, 6.07/10,000; ≥ 35 years, 5.76/10,000), geographic region (central, 5.07/10,000; east, 6.75/10,000; west, 5.12/10,000), and infant sex (male vs. female, 6.28/10,000 vs. 4.86/10,000). Newborns with associated SD were more likely to be born prematurely (29.2% vs. 10.6%) or with low birthweight (30.5% vs.9.8%) than those with isolated SD. The bilaterally, and unilaterally affected cases accounted for 18.4% and 76.7%, respectively. The feet were more frequently involved (64.3%) in those bilaterally affected cases, while right side preference (right vs left: 53.8% vs 46.2%) and upper limbs preference (hand vs foot: 50.8% vs 48.0%) were found in unilateral cases. CONCLUSIONS: The prevalence of syndactyly in China is on the rise and notably higher than that in other Asian and European countries, highlighting the importance of investigating the etiology, epidemiology, and clinical implications of this condition in the Chinese population.

Primary repair for concurrent bilateral intertrochanteric fracture and femoral head necrosis with prolonged shank biologic total hip replacement: A case report and surgical techniques.

For the treatment of an intertrochanteric fracture combined with femoral head necrosis in middle-age patients, it has been controversial whether to perform fracture reduction and fixation first then total hip replacement, or direct total hip replacement. We present a rare case of 53-year-old male patient suffered from bilateral intertrochanteric fracture caused by a road traffic injury. The patient had a history of femoral head necrosis for eight years, and the Harris score was 30. We performed total hip replacement with prolonged biologic shank prostheses for primary repair. One year after the surgery, nearly full range of motion was achieved without instability (active flexion angle of 110°, extension angle of 20°, adduction angle of 40°, abduction angle of 40°, internal rotation angle of 25°, and external rotation angle of 40°). The Harris score was 85. For the middle-aged patient with unstable intertrochanteric fractures and osteonecrosis of the femoral head, we can choose primary repair for concurrent bilateral intertrochanteric fracture and femoral head necrosis with prolonged shank biologic total hip replacement.

Preparation and Characterization of In Situ (TiC-TiB2)/Al-Cu-Mg-Si Composites with High Strength and Wear Resistance.

This study involved the preparation and characterization of in situ (TiC-TiB2)/Al-4.7Cu-0.32Mg-0.44Si composites with excellent mechanical and abrasive wear properties. The composites were synthesized in an Al-Ti-B4C system by combining combustion reaction synthesis with hot-pressed sintering and hot extrusion. The in situ TiB2 and TiC particles were of multi-scaled sizes ranging from 20 nm to 1.3 µm. The TiB2 and TiC particles effectively increased the yield strength (σ0.2), ultimate tensile strength (σUTS), hardness (HV), and abrasive wear resistance of the composites. The 40 wt.% (TiC-TiB2)/Al-4.7Cu-0.32Mg-0.44Si composite exhibited the highest σ0.2 (569 MPa), σUTS (704 MPa) and hardness (286 HV), which were 74%, 51% and 110% higher than those of the matrix alloy, respectively. Compared with the matrix alloy, the abrasive wear resistance of the 40 wt.% (TiC-TiB2)/Al-4.7Cu-0.32Mg-0.44Si composite was increased by 4.17 times under an applied load of 5 N and Al2O3 abrasive particle size of 13 µm. Micro-ploughing and micro-cutting were the main abrasive wear mechanisms for the Al-Cu-Mg-Si alloy and the composites.

Targeting ROS-AMPK pathway by multiaction Platinum(IV) prodrugs containing hypolipidemic drug bezafibrate.

Alterations in lipid metabolism, commonly disregarded in the past, have been accepted as a hallmark for cancer. Exploring cancer therapeutics that interrupt the lipid metabolic pathways by monotherapy or combination with conventional chemotherapy or immunotherapy is of great importance. Here we modified cisplatin with an FDA-approved hypolipidemic drug, bezafibrate (BEZ), via the well-established Pt(IV) strategy, affording two multi-functional Pt(IV) anticancer agents cis,cis,trans-[Pt(NH3)2Cl2(BEZ)(OH)] (CB) and cis,cis,trans-[Pt(NH3)2Cl2(BEZ)2] (CP) (BEZ = bezafibrate). The Pt(IV) prodrug CB exhibited an enhanced anticancer activity up to 187-fold greater than the clinical anticancer drug cisplatin. Both CB and CP had less toxicity to normal cells, showing higher efficacies and superior therapeutic indexes than cisplatin. Mechanism studies revealed that the bezafibrate-conjugated Pt(IV) complex CB, as a representative, could massively accumulate in A549 cells and genomic DNA, induce DNA damage, elevate intracellular ROS levels, perturb mitochondrial transmembrane potentials, activate the cellular metabolic sensor AMPK, and result in profound proliferation inhibition and apoptosis. Further cellular data also provided evidence that phosphorylation of AMPK, as a metabolic sensor, could suppress the downstream HMGB1, NF-κB, and VEGFA, which may contribute to the inhibition of angiogenesis and metastasis. Our study suggests that the antitumor action of CB and CP mechanistically distinct from the conventional platinum drugs and that functionalizing platinum-based agents with lipid-modulating agents may represent a novel practical strategy for cancer treatment.

A novel double target fluorescence probe for Al3+/Mg2+ detection with distinctively different responses and its applications in cell imaging.

The metal cations, Al3+ and Mg2+, could affect human health and cell biological processes. Their fast and selective detection using one probe remains a challenge. A novel fluorescence probe, N'-((1-hydroxynaphthalen-2-yl)methylene)isoquinoline-3-carbohydrazide (NHMI), was developed for selectively monitoring Al3+ and Mg2+. The probe NHMI showed a distinctive "turn-on" fluorescence signal towards Al3+ and Mg2+ (cyan for Al3+ with 2556-folds enhancement and yellow for Mg2+ with 88-folds enhancement), which is quite distinct from other metal cations and allows for naked-eye detection. This interesting response was attributed to the influence of PET, ESIPT process and CHEF effect, when Al3+ or Mg2+ chelated with NHMI. Furthermore, the fluorescence titration experiments manifested that the detection limit of probe NHMI for Al3+/Mg2+ was as low as 1.20 × 10-8 M and 7.69 × 10-8 M, respectively. The formed complexes NHMI-Al3+ and NHMI-Mg2+ were analyzed by Job's plot, ESI-MS, 1H NMR and FT-IR. The coordination pockets and fluorescence mechanisms of two metal complexes were explored by density functional theory calculation. Moreover, NHMI showed low cytotoxicity and good cell permeability. Fluorescence bioimaging of Al3+/Mg2+ in MCF-7 cells with NHMI indicated its potential application in biological diagnostic analysis.

[Nutritional Knowledge and Skills of Fast-food Takeout Practitioners in Chengdu City].

Objective To investigate the current status of nutritional knowledge and skills of fast-food takeout practitioners in Chengdu City,so as to provide evidence for nutritional literacy education among takeout practitioners.Methods A questionnaire survey was conducted among 832 employees of fast-food takeout restaurants in Chengdu from April to September in 2019 through a multi-stage random sampling strategy.Results The awareness rate of nutritional knowledge of fast-food takeout practitioners in Chengdu was 77.28%,and the correct rates of answers to daily oil intake for adults,daily drinking water for adults and daily salt intake for adults in the Dietary Guidelines for Chinese Residents were respectively 17.43%,22.60% and 25.36%.In addition,the proportion of practitioners with the ability to estimate the recommended intake of food for a meal,the ability to estimate condiments intake and the ability to interpret nutrition labels were 8.77%,8.77% and 15.02%,respectively.The awareness rate of nutritional knowledge was the lowest(71.47%)in the practitioners aged≤25 and the highest(84.53%)in those aged 26-39,and the difference was statistically significant(χ 2 =14.419,P=0.001).High awareness rate of nutritional knowledge was found in the practitioners of Han ethnic group(78.45%)compared with those of ethnic minorities(57.14%)(χ 2=10.346,P=0.001).Besides,the practitioners with a high degree of education showed high awareness rate of nutritional knowledge( [Formula: see text]=36.514,P<0.001),and the correct rate of chefs(17.86%)was higher than that(12.82%)of food matching staff(χ 2=4.068,P=0.044).Conclusions The fast-food takeout practitioners in Chengdu generally have good nutritional knowledge while have some knowledge gaps.At the same time,the nutrition-related skills of takeout practitioners are not good.We should focus on strengthening the training of takeout restaurant employees for the Dietary Guidelines for Chinese Residents and nutrition labeling-related knowledge,carry out targeted nutritional knowledge training,and comprehensively strengthen the training of nutrition-related skills.

Transcriptome-Wide m6A Analysis Provides Novel Insights Into Testicular Development and Spermatogenesis in Xia-Nan Cattle.

Testis is the primary organ of the male reproductive tract in mammals that plays a substantial role in spermatogenesis. Improvement of our knowledge regarding the molecular mechanisms in testicular development and spermatogenesis will be reflected in producing spermatozoa of superior fertility. Evidence showed that N6-Methyladenosine (m6A) plays a dynamic role in post-transcription gene expression regulation and is strongly associated with production traits. However, the role of m6A in bovine testis has not been investigated yet. In this study, we conducted MeRIP-Seq analysis to explore the expression profiles of the m6A and its potential mechanism underlying spermatogenesis in nine bovine testes at three developmental stages (prepuberty, puberty and postpuberty). The experimental animals with triplicate in each stage were chosen based on their semen volume and sperm motility except for the prepuberty bulls and used for testes collection. By applying MeRIP-Seq analysis, a total of 8,774 m6A peaks and 6,206 m6A genes among the studied groups were identified. All the detected peaks were found to be mainly enriched in the coding region and 3'- untranslated regions. The cross-analysis of m6A and mRNA expression exhibited 502 genes with concomitant changes in the mRNA expression and m6A modification. Notably, 30 candidate genes were located in the largest network of protein-protein interactions. Interestingly, four key node genes (PLK4, PTEN, EGR1, and PSME4) were associated with the regulation of mammal testis development and spermatogenesis. This study is the first to present a map of RNA m6A modification in bovine testes at distinct ages, and provides new insights into m6A topology and related molecular mechanisms underlying bovine spermatogenesis, and establishes a basis for further studies on spermatogenesis in mammals.

[Young Children's Family Sex Education in Rural Areas of Sichuan Province and Its Influencing Factors].

Objective To understand the family sex education for young children in rural areas of Sichuan province and analyze the influencing factors. Methods A multi-stage random sampling method was used to select 2246 parents of kindergarten children from rural areas in Sichuan province for a questionnaire-based survey.The Chi-square test and Logistic regression model were used for data analysis. Results It was found 1132(52.33%)parents had implemented family sex education for young children and 1031(47.67%)had not.Young children having asked sex-related questions(OR=1.536,95%CI=1.257-1.878),parents thinking that early childhood sex education is necessary(OR=3.691,95%CI=2.029-6.717),and parents having the intention to know early childhood sex education(OR=1.700,95%CI=1.274-2.269),and kindergarten having implemented early childhood sex education(OR=3.316,95%CI=2.515-4.372)were promoting factors for parents to conduct early childhood sex education,whereas a total annual household income at the middle level(OR=0.664,95%CI=0.456-0.968)was a hindering factor for parents to conduct early childhood sex education. Conclusions Parents of young children in rural areas of Sichuan province have poor awareness of sex education,and the proportion of parents who have never conducted sex education for children is high.The total annual income of the family,whether the children have asked about sex-related questions,parents' attitude towards early childhood sex education,and whether the kindergarten has conducted the early childhood sex education are important factors that influence the level of children's family sex education.

[Analysis on the Health-related Quality of Life and Influencing Factors among the Older Generation of Migrant Workers in Chengdu City].

OBJECTIVE: To understand the status and distribution characteristics of health-related quality of life (HRQOL) of the older generation of migrant workers in Chengdu, and analyze the factors influencing the quality of life of the older generation of migrant workers, so as to provide reference for formulating relevant policies to improve the health of the older generation of migrant workers. METHODS: From June 2017 to June 2018, the respondent-driven sampling (RDS) method was used to select 1 492 non-registered migrant workers born before 1980 living in Chengdu city. The investigation was performed with questionnaire including demographic characteristics, working status, economic status, disease status, living environment and HRQOL. RESULTS: The scores of physical component summary (PCS), mental component summary (MCS) and the total score of HRQOL in the older generation of migrant workers were 50.78±7.54, 50.67±10.24 and 101.45±12.34, respectively. Multiple linear regression analysis showed that older age (standard regression coefficient ( Sß)=-0.061, P=0.026), low education level ( Sß=-0.053, P=0.038), being unmarried, divorced or widowed ( Sß=-0.064, P=0.009), chronic diseases ( Sß=-0.156, P<0.001), or two-week illness ( Sß=-0.190, P<0.001) were the risk factors of low HRQOL; High income level ( Sß=0.069, P=0.013), having a steady job ( Sß=0.126, P<0.001), having endowment insurance ( Sß=0.055, P=0.027) and satisfactory with the living environment ( Sß=0.060, P=0.016) were the contributing factors factors of high HRQOL. CONCLUSION: The HRQOL of the older generation of migrant workers in Chengdu is generally good. More attention should be paid to the migrant workers of older age, having lower income, suffering from chronic diseases, being unmarried/divorced/widowed, and lacking endowment insurance. Appropriate measures should be taken to improve the health status of the key groups.

[Prevalence and Metabolic Abnormalities of Fatty Liver Disease among Adults in Mianyang City,Sichuan Province].

Objective To understand the prevalence and metabolic abnormalities of fatty liver disease among adults in Mianyang City,Sichuan Province,and to analyze their influencing factors.Methods Totally 294 603 adults aged 18 years and older were enrolled by using a multi-stage stratified random sampling method in Mianyang City from November 1,2014 to September 30,2015.Fatty liver was diagnosed by abdominal ultrasound.The general demographic characteristics,smoking history,drinking history,and history of chronic disease were collected through questionnaires.Meanwhile,10 217 subjects were randomly selected for biochemical tests[fasting plasma gluose(FPG),triacylglycerol(TG),total cholesterol(TC),and alanine aminotransferase(ALT)].Results Of these 294 603 subjects,17 105(5.81%)had fatty liver.After having been age-adjusted based on the results of the sixth national census in 2010,the standardized prevalence was 5.32%.The prevalence was significantly higher in males(6.76%;standardized prevalence:7.24%)than in females(5.09%;standardized prevalence:4.08%)(χ 2=365.814,P<0.001)。The prevalence of fatty liver disease was significantly higher in people with current smokers(8.52%)/ex-smokers(8.89%),occasional alcohol users(6.79%)/regular alcohol users(10.51%)/daily alcohol users(10.62%),and patients with hypertension(12.14%)/diabetes(15.19%)/coronary heart disease(10.22%)than those without corresponding characteristics(all P<0.001).Abnormal increase in body mass index,diastolic blood pressure,FPG,TG,TC,and ALT were risk factors for fatty liver in Logistic regression model.Conclusions The prevalence of fatty liver in adults is relatively low in Mianyang City.Patients with fatty liver usually have varying degrees of abnormal increase in blood lipids,blood glucose,blood pressure,and ALT.Healthy lifestyles and comprehensively assessment of metabolic status are conducive to the prevention and treatment of fatty liver and extrahepatic complications.

Effects of Carbon Source on TiC Particles' Distribution, Tensile, and Abrasive Wear Properties of In Situ TiC/Al-Cu Nanocomposites Prepared in the Al-Ti-C System.

The in situ TiC/Al-Cu nanocomposites were fabricated in the Al-Ti-C reaction systems with various carbon sources by the combined method of combustion synthesis, hot pressing, and hot extrusion. The carbon sources used in this paper were the pure C black, hybrid carbon source (50 wt.% C black + 50 wt.% CNTs) and pure CNTs. The average sizes of nano-TiC particles range from 67 nm to 239 nm. The TiC/Al-Cu nanocomposites fabricated by the hybrid carbon source showed more homogenously distributed nano-TiC particles, higher tensile strength and hardness, and better abrasive wear resistance than those of the nanocomposites fabricated by pure C black and pure CNTs. As the nano-TiC particles content increased, the tensile strength, hardness, and the abrasive wear resistance of the nanocomposites increased. The 30 vol.% TiC/Al-Cu nanocomposite fabricated by the hybrid carbon source showed the highest yield strength (531 MPa), tensile strength (656 MPa), hardness (331.2 HV), and the best abrasive wear resistance.

Microstructures and Compressive Properties of Al Matrix Composites Reinforced with Bimodal Hybrid In-Situ Nano-/Micro-Sized TiC Particles.

Bimodal hybrid in-situ nano-/micro-size TiC/Al composites were prepared with combustion synthesis of Al-Ti-C system and hot press consolidation. Attempt was made to obtain in-situ bimodal-size TiC particle reinforced dense Al matrix composites by using different carbon sources in the reaction process of hot pressing forming. Microstructure showed that the obtained composites exhibited reasonable bimodal-sized TiC distribution in the matrix and low porosity. With the increasing of the carbon nano tube (CNT) content from 0 to 100 wt. %, the average size of the TiC particles decreases and the compressive strength of the composite increase; while the fracture strain increases first and then decreases. The compressive properties of the bimodal-sized TiC/Al composites, especially the bimodal-sized composite synthesized by Al-Ti-C with 50 wt. % CNTs as carbon source, were improved compared with the composites reinforced with single sized TiC. The strengthening mechanism of the in-situ bimodal-sized particle reinforced aluminum matrix composites was revealed.