Computational Insights into SARS-CoV-2 Main Protease Mutations and Nirmatrelvir Efficacy: The Effects of P132H and P132H-A173V.

Nirmatrelvir, a pivotal component of the oral antiviral Paxlovid for COVID-19, targets the SARS-CoV-2 main protease (Mpro) as a covalent inhibitor. Here, we employed combined computational methods to explore how the prevalent Omicron variant mutation P132H, alone and in combination with A173V (P132H-A173V), affects nirmatrelvir's efficacy. Our findings suggest that P132H enhances the noncovalent binding affinity of Mpro for nirmatrelvir, whereas P132H-A173V diminishes it. Although both mutants catalyze the rate-limiting step more efficiently than the wild-type (WT) Mpro, P132H slows the overall rate of covalent bond formation, whereas P132H-A173V accelerates it. Comprehensive analysis of noncovalent and covalent contributions to the overall binding free energy of the covalent complex suggests that P132H likely enhances Mpro sensitivity to nirmatrelvir, while P132H-A173V may confer resistance. Per-residue decompositions of the binding and activation free energies pinpoint key residues that significantly affect the binding affinity and reaction rates, revealing how the mutations modulate these effects. The mutation-induced conformational perturbations alter drug-protein local contact intensities and the electrostatic preorganization of the protein, affecting noncovalent binding affinity and the stability of key reaction states, respectively. Our findings inform the mechanisms of nirmatrelvir resistance and sensitivity, facilitating improved drug design and the detection of resistant strains.

Identification of and Mechanistic Insights into SARS-CoV-2 Main Protease Non-Covalent Inhibitors: An In-Silico Study.

The indispensable role of the SARS-CoV-2 main protease (Mpro) in the viral replication cycle and its dissimilarity to human proteases make Mpro a promising drug target. In order to identify the non-covalent Mpro inhibitors, we performed a comprehensive study using a combined computational strategy. We first screened the ZINC purchasable compound database using the pharmacophore model generated from the reference crystal structure of Mpro complexed with the inhibitor ML188. The hit compounds were then filtered by molecular docking and predicted parameters of drug-likeness and pharmacokinetics. The final molecular dynamics (MD) simulations identified three effective candidate inhibitors (ECIs) capable of maintaining binding within the substrate-binding cavity of Mpro. We further performed comparative analyses of the reference and effective complexes in terms of dynamics, thermodynamics, binding free energy (BFE), and interaction energies and modes. The results reveal that, when compared to the inter-molecular electrostatic forces/interactions, the inter-molecular van der Waals (vdW) forces/interactions are far more important in maintaining the association and determining the high affinity. Given the un-favorable effects of the inter-molecular electrostatic interactions-association destabilization by the competitive hydrogen bond (HB) interactions and the reduced binding affinity arising from the un-compensable increase in the electrostatic desolvation penalty-we suggest that enhancing the inter-molecular vdW interactions while avoiding introducing the deeply buried HBs may be a promising strategy in future inhibitor optimization.

Retrospective analysis on incidence and risk factors of early onset acute kidney injury after lung transplantation and its association with mortality.

OBJECTIVES: Acute kidney injury (AKI) is a common complication after lung transplantation (LTx) which is closely related to the poor prognosis of patients. We aimed to explore potential risk factors and outcomes associated with early post-operative AKI after LTx. METHODS: A retrospective study was conducted in 136 patients who underwent LTx at our institution from 2017 to 2019. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guideline. Univariate and multivariate analyses were conducted to identify risk factors related to AKI. The primary outcome was the incidence of AKI after LTx. Secondary outcomes were associations between AKI and short-term clinical outcomes and mortality. RESULTS: Of the 136 patients analyzed, 110 developed AKI (80.9%). AKI was associated with higher baseline eGFR (odds ratio (OR) 1.01 (95% confidence interval (CI): 1.00-1.03)) and median tacrolimus (TAC) concentration (OR 1.15 (95% CI: 1.02-1.30)). Patients with AKI suffered longer mechanical ventilation days (p = .015) and ICU stay days (p = .011). AKI stage 2-3 patients had higher risk of 1-year mortality (HR 16.98 (95% CI: 2.25-128.45)) compared with no-AKI and stage 1 patients. CONCLUSIONS: Our results suggested early post-operative AKI may be associated with higher baseline eGFR and TAC concentrations. AKI stage 1 may have no influence on survival rate, whereas AKI stage 2-3 may be associated with increased mortality at 1-year.

A Scan of Obesogenic Environments and a Spatial Inference of Obesity Prevalence in Chinese Children and Adolescents: Based on the Chinese Health and Nutrition Survey 2011 Data.

OBJECTIVE: To identify the characteristics of Chinese obesogenic environments at a provincial level, infer a spatial distribution map of obesity prevalence in 31 provinces, and provide a foundation for development of policy to reduce obesity in children and adolescents. METHODS: After scanning obesity data on subjects aged 7-17 years from 12 provinces in the China Health and Nutrition Survey 2011 and environmental data on 31 provinces from the China Statistical Yearbook 2011 and other sources, we selected 12 predictors. We used the 12 surveyed provinces as a training sample to fit an analytical model with partial least squares regression and prioritized the 12 predictors using variable importance in projection. We also fitted a predictive model with Bayesian analysis. RESULTS: We identified characteristics of obesogenic environments. We fitted the predictive model with a deviance information criterion of 61.96 and with statistically significant (P < 0.05) parameter estimates of intercept [95% confidence interval (CI): 329.10, 963.11], log(oil) (CI: 13.11, 20.30), log(GDP) (CI: 3.05, 6.93), log(media) (CI: -234.95, -89.61), and log(washing-machine) (CI: 0.92, 5.07). The total inferred average obesity prevalence among those aged 7-17 was 9.69% in 31 Chinese provinces in 2011. We also found obvious clustering in occurrences of obesity in northern and eastern provinces in the predicted map. CONCLUSION: Given complexity of obesity in children and adolescents, concerted efforts are needed to reduce consumption of edible oils, increase consumption of vegetables, and strengthen nutrition, health, and physical activity education in Chinese schools. The northern and eastern regions are the key areas requiring intervention.

Gender difference in the association between food away-from-home consumption and body weight outcomes among Chinese adults.

OBJECTIVE: The present study aimed to explore the associations between food away-from-home (FAFH) consumption and body weight outcomes among Chinese adults. DESIGN: FAFH was defined as food prepared at restaurants and the percentage of energy from FAFH was calculated. Measured BMI and waist circumference (WC) were used as body weight outcomes. Quantile regression models for BMI and WC were performed separately by gender. SETTING: Information on demographic, socio-economic, diet and health parameters at individual, household and community levels was collected in twelve provinces of China. SUBJECTS: A cross-sectional sample of 7738 non-pregnant individuals aged 18-60 years from the China Health and Nutrition Survey 2011 was analysed. RESULTS: For males, quantile regression models showed that percentage of energy from FAFH was associated with an increase in BMI of 0·01, 0·01, 0·01, 0·02, 0·02 and 0·03 kg/m2 at the 5th, 25th, 50th, 75th, 90th and 95th quantile, and an increase in WC of 0·04, 0·06, 0·06, 0·04, 0·06, 0·05 and 0·07 cm at the 5th, 10th, 25th, 50th, 75th, 90th and 95th quantile. For females, percentage of energy from FAFH was associated with 0·01, 0·01, 0·01 and 0·02 kg/m2 increase in BMI at the 10th, 25th, 90th and 95th quantile, and with 0·05, 0·04, 0·03 and 0·03 cm increase in WC at the 5th, 10th, 25th and 75th quantile. CONCLUSIONS: Our findings suggest that FAFH consumption is relatively more important for BMI and WC among males rather than females in China. Public health initiatives are needed to encourage Chinese adults to make healthy food choices when eating out.

[Trend in meat consumption patterns among Chinese children in nine provinces(autonomous region) aged 6 to 17 years between 1991 and 2011].

OBJECTIVE: To examine the trend in meat consumption patterns between 1991 and 2011 in Chinese children in nine provinces(autonomous region) aged 6 to 17 years. METHODS: A multistage, random cluster sampling process was used to investigate 2720, 2702, 2525, 2405, 1509, 1238, 1085, and 936 children and adolescents aged 6-17 years in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011 respectively in 9 provinces (autonomous region) in China. Their consecutive 3 d 24 h dietary recall data were analyzed to compare meat intake pattern in children and adolescents with different characteristics and different years. RESULTS: The consumption rate increased from 60.9% (1657/2720) in 1991 to 87.2% (816/936) in 2011 for livestock meat (χ(2) = 458.23, P < 0.01), from 9.4% (257/2720) to 33.3% (312/936) for poultry (χ(2) = 446.07, P < 0.01) and from 27.3% (743/2720) to 40.6% (380/936) for seafood (χ(2) = 89.89, P < 0.01). The median of total meat intake increased from 47.4 g/d in 1991 to 100.0 g/d in 2011 (χ(2) = 516.77, P < 0.01), poultry intake from 33.3 g/d to 60.0 g/d (χ(2) = 420.13, P < 0.01), pork intake from 26.7 g/d to 50.0 g/d (χ(2) = 380.50, P < 0.01). The percentage of children whose livestock meat and poultry intakes higher than the recommended amount increased from 32.9% (896/2720) in 1991 to 59.8% (560/936) in 2011 (χ(2) = 392.97, P < 0.01); the percentage of children whose seafood intakes meeting the recommended amount increased from 6.9% (187/2720) in 1991 to 8.8% (82/936) in 2011 (χ(2) = 21.52, P < 0.01). The consumption rates of livestock meat in urban and rural children increased from 81.2% (536/660) and 54.4% (1121/2060) in 1991 to 94.7% (234/247) (χ(2) = 38.34, P < 0.01) and 84.5% (582/689) (χ(2) = 429.26, P < 0.01) in 2011. The intakes of livestock meat in rural children increased from 16.7 g/d in 1991 to 56.7 g/d in 2011 (χ(2) = 472.46, P < 0.01). CONCLUSION: The overall pattern of meat consumption in Chinese children in nine provinces(autonomous region) was unreasonable between 1991 and 2011. There was a significant improvement in meat consumption in rural children over time.

Galactagogue Food Consumption, Perception of Insufficient Milk Supply, and Exclusive Breastfeeding in Chinese Postpartum Women: An Analysis of Repeated Measures.

INTRODUCTION: Little research has explored galactagogue food consumption in China. This study aims to investigate consumption patterns and how they relate to perceived insufficient milk supply and exclusive breastfeeding. METHODS: Data were collected from postpartum women in China at six time points: baseline demographic questionnaire before hospital discharge (T0), galactagogue food questionnaire at 1 month postpartum (T1), Hill and Humenick Lactation Scale at 6 weeks postpartum (T2), and breastfeeding practices at 1, 2, 3 and 4 months postpartum (T1, T3, T4, T5). RESULTS: Of 218 participants who completed the galactagogue food questionnaire, 64.68% were consumers. No association was found between galactagogue food consumption and perceived insufficient milk supply. Consumers were less likely to breastfeed exclusively. DISCUSSION: Future research should emphasize a deeper understanding of consumer behaviors and family support in providing professional guidance on postpartum nutrition that considers not only social and cultural experiences but also broader medical aspects.

[Trend of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009].

OBJECTIVE: To examine the trends of energy intake among Chinese children and adolescents in nine provinces from 1989 to 2009. METHOD: Stratified multi-stage cluster sampling method was used to recruit 488, 2807, 2802, 2580, 2520, 1604, 1305 and 1159 children and adolescents aged 6 - 17 years in each year of 1989, 1991, 1993, 1997, 2000, 2004, 2006 and 2009 in 9 provinces. The descriptive analyses were carried out for three days 24-h dietary recall data to compare energy intake by year and demographic characteristics. RESULTS: The median of dietary energy intake among Chinese children and adolescents aged 6 - 17 years in 1989, 1991, 1993, 1997, 2000, 2004, 2006 and 2009 were 6645.7, 8314.8, 7849.3, 8115.0, 7970.5, 7598.0, 7345.0 and 7051.9 kJ/d (χ(2) = 239.75, P < 0.01), respectively. In 2009, children and adolescents from city (7820.4 kJ/d) and county (7356.0 kJ/d) consumed more energy than that from suburb (7168.2 kJ/d) and village (6863.5 kJ/d) (χ(2) = 8.00, P < 0.05). Cereal was the main food source of energy intake. In 2009, the percentage of energy intake from cereal was 44.0%, 45.6%, 52.9% and 61.0% (χ(2) = 36.75, P < 0.01)for city, suburb, county and village respectively. The percentage of population with > 30% of energy intake from dietary fat increased yearly and that with more than 60% of energy from carbohydrate decreased, from 25.4% (124/488) and 54.1% (264/488) in 1989 to 58.1% (637/1159) and 15.9% (184/1159) (χ(2) values were 811.24, 919.35 respectively;both P values < 0.05) in 2009. The percentage of children and adolescents whose energy intake was more than 80% recommended nutrient intake (RNI) declined from 60.2% (294/488) in 1989 to 47.8% (554/1159) in 2009(χ(2) = 227.66, P < 0.05). CONCLUSION: The current study demonstrated that energy intake of Chinese children and adolescents increased at early stage and then declined in the recent years. Average energy intake was higher in city and county than suburb and village.

[Trend in dietary vitamin C intake among Chinese children and adolescents between 1991 and 2009].

OBJECTIVE: To examine status and trend in dietary vitamin C intake between 1991 and 2009 in Chinese children and adolescents aged 6 to 17 years. METHODS: A stratified multistage, random cluster sampling process was used to investigate 2716, 2691, 2507, 2358, 1490, 1218 and 1073 children and adolescents aged 6 - 17 years in 1991, 1993, 1997, 2000, 2004, 2006 and 2009 respectively in 9 provinces. Their consecutive 3 d 24 h dietary recall data were analyzed to compare vitamin C intake in children and adolescents with different characteristics and different years. RESULTS: The median of dietary vitamin C intake in Chinese children and adolescents decreased from 69.7 mg/d in 1991 to 53.4 mg/d in 2009 (χ(2) = 188.1, P < 0.01). Vitamin C intake of rural children and adolescents decreased from 73.7 mg/d in 1991 to 52.5 mg/d in 2009 (χ(2) = 96.7, P < 0.01); vitamin C intake of children and adolescents in the low-income household decreased from 74.3 mg/d in 1991 to 47.5 mg/d in 2009 (χ(2) = 172.9, P < 0.01). The percentage of children and adolescents whose vitamin C intake equal or higher than recommended nutrient intake of vitamin C decreased from 35.9% (974/2716) in 1991 to 18.5% (198/1073) in 2009 (χ(2) = 284.7, P < 0.01). CONCLUSION: There was a decreased trend in dietary vitamin C in Chinese children and adolescents during the past two decades. The children and adolescents of low-income household in rural areas may pose a higher risk of inadequate vitamin C intake.

[Trends in dietary protein intake among Chinese children and adolescent between 1991 and 2009].

OBJECTIVE: To examine dietary protein intake and its trend between 1991 and 2009 among Chinese children and adolescents aged 6 to 17 years. METHODS: Consecutive 3 d-24 hr Dietary Recall and household income data of 14 053 children from the seven waves of the China Health and Nutrition Survey (CHNS), 1991, 1993, 1997, 2000, 2004, 2006 and 2009 were used to describe long-term changes in dietary protein intake, percentage energy, and food sources. RESULTS: The median of dietary protein intake of Chinese children and adolescents decreased from 60.0 g/d in 1991 to 52.6 g/d in 2009 (χ² = 109.0, P < 0.01). The dietary protein intake among children in rural areas and in low-income households decreased 8.8 g/d (χ² = 74.8, P < 0.01) and 9.8 g/d (χ² = 100.5, P < 0.01) respectively. The percentage of total energy intake from protein was 11.3%-13.0%. The percentage of protein intake equal or higher than Recommended Nutrient Intake of protein decreased from 29.5% in 1991 to 19.2% in 2009 (χ² = 259.6, P < 0.01). Furthermore, the proportion of high-quality dietary protein increased rapidly. The percentage of animal protein increased from 12.3% in 1991 to 32.2% in 2009 (χ² = 750.3, P < 0.01), while no big increase in soybean protein (lower than 5.0%). CONCLUSION: There is a decreasing trend in dietary protein intake among Chinese children from 1991 to 2009. The high-quality protein intake was improved but we should be concerned about the high proportion of animal protein. The children living in low-income households and in rural areas may be at risk of inadequate dietary protein.

[Texture variation of DCAA 5052 aluminum alloy slab at difference position through thickness by XRD].

For improvement the processing and gaining uniformity texture structure and performance the thickness direction of direct chill cast DCAA 5052 aluminum alloy band after first hot rolling with different reduction, the material was annealed at 454 degrees C and then cold rolling with different reduction, we test and examined the texture at surface, quarter and center layer of the sample by use X-ray diffraction method, we calculated the data by use special software and analyses the difference texture at surface, quarter and center layer. The intension gradient of beta texture was along the direction from surface to center layer gradually enhance at different reduction sample. For beta texture, the intension gradient was along the direction from surface to center layer gradually reduce, the volume fraction gradually augment and the intensity gradually were almost equal with the cold rolling reduction increased from 0% to 90%.

Mechanistic Origin of Different Binding Affinities of SARS-CoV and SARS-CoV-2 Spike RBDs to Human ACE2.

The receptor-binding domain (RBD) of the SARS-CoV-2 spike protein (RBDCoV2) has a higher binding affinity to the human receptor angiotensin-converting enzyme 2 (ACE2) than the SARS-CoV RBD (RBDCoV). Here, we performed molecular dynamics (MD) simulations, binding free energy (BFE) calculations, and interface residue contact network (IRCN) analysis to explore the mechanistic origin of different ACE2-binding affinities of the two RBDs. The results demonstrate that, when compared to the RBDCoV2-ACE2 complex, RBDCoV-ACE2 features enhanced dynamicsand inter-protein positional movements and increased conformational entropy and conformational diversity. Although the inter-protein electrostatic attractive interactions are the primary determinant for the high ACE2-binding affinities of both RBDs, the significantly enhanced electrostatic attractive interactions between ACE2 and RBDCoV2 determine the higher ACE2-binding affinity of RBDCoV2 than of RBDCoV. Comprehensive comparative analyses of the residue BFE components and IRCNs between the two complexes reveal that it is the residue changes at the RBD interface that lead to the overall stronger inter-protein electrostatic attractive force in RBDCoV2-ACE2, which not only tightens the interface packing and suppresses the dynamics of RBDCoV2-ACE2, but also enhances the ACE2-binding affinity of RBDCoV2. Since the RBD residue changes involving gain/loss of the positively/negatively charged residues can greatly enhance the binding affinity, special attention should be paid to the SARS-CoV-2 variants carrying such mutations, particularly those near or at the binding interfaces with the potential to form hydrogen bonds and/or salt bridges with ACE2.

[Milk consumption and its changing trend of Chinese adult aged 18 - 44 in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To investigate the age, gender and region specified milk consumption and its changing trends of Chinese 18 - 44 years old adults in 9 provinces (autonomous region) from 1991 to 2006. METHODS: The data of 18 - 44 aged old adults investigated in Chinese Health and Nutrition Survey from 1991 to 2006 in 9 provinces (autonomous region) were utilized. The numbers of the subjects selected in 1991, 1993, 1997, 2000, 2004 and 2006 were 5593, 5491, 5334, 4188 and 3908, respectively. Changes of the percentage of milk consumption, average intake of daily milk and dietary calcium intake were analyzed across different groups of gender, income levels, and areas. RESULTS: There was an increasing trend in the percentage of milk consumption and daily intake of milk from 1991 to 2006. The average percentage of Chinese adult milk consumption went up from 2.2% (123/5593) in 1991 to 7.6% (297/3908) in 2006 (Z = -22.16, P < 0.01). Specifically, urban adult and rural adult showed significant increase in the percentages from 9.7% (80/823) to 23.7% (112/472) (Z = -12.81, P < 0.01) and 0.1% (2/2937) to 1.8% (36/1987) (Z = -9.21, P < 0.01) respectively. Percentages of adult who ever drank milk at top income level and bottom income level increased from 4.7% (95/2006) to 14.6% (200/1373) (Z = -17.36, P < 0.01) and from 0.1% (2/1748) to 2.4% (28/1171) (Z = -9.58, P < 0.01), respectively. Meanwhile, the average daily intake of milk increased from (3.6 ± 24.6) g/d in 1991 to (11.8 ± 51.4) g/d in 2006 (F = 67.07, P < 0.01). The daily milk consumption among top income level adults and bottom income level adults increased from (8.5 ± 50.9) g/d to (23.1 ± 71.5) g/d and from (0.2 ± 6.5) g/d to (3.3 ± 23.5) g/d (F = 13.90, P < 0.01), respectively. From 1991 to 2006, milk consumers significantly promoted their percentage of achieving the Chinese dietary reference intake on calcium (800 mg/d) from 6.5% (8/123) to 12.8% (38/297) (Z = -1.67, P < 0.05), whereas this percentage increased from 1.6% (38/5470) to 3.6% (130/3611) among milk non-consumers (Z = -5.66, P < 0.01). CONCLUSION: Chinese adult milk intake still remains in quite low level, and the situation of milk consumption among rural adults requires further promotion.

[Milk consumption and effects on dietary nutrients and growth status among Chinese children in nine provinces (autonomous region) from 1991 to 2006].

OBJECTIVE: To investigate milk consumption and effects on dietary nutrients and growth status among 7 - 17 years-old Chinese children in 9 provinces (autonomous region) from 1991 to 2006. METHODS: Data was collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey, and 11 691 subjects aged 7 to 17 years old were included. The subjects were divided into the following groups according to milk consumption per day, 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d. Variables from different years were compared, such as milk categories, energy, protein, calcium intake, body mass index (BMI), as well as that dietary nutrients, height and weight among different milk consumption groups. RESULTS: From 1991 to 2006, milk drinking rate and milk consumption among Chinese children had great improvement: milk drinking rate reached to 14.1% (161/1145) in 2006, while that was 3.0% (73/2441) in 1991; milk consumption reached to (26.7 ± 85.0) g/d in 2006, which was 6.8 times of that in 1991 (3.9 ± 31.9) g/d (χ(2) = 474.5, P < 0.01). BMI increased from (17.3 ± 2.9) kg/m(2) in 1991 to (18.5 ± 6.0) kg/m(2) in 2006 (χ(2) = 123.5, P < 0.01). Meanwhile, energy intake decreased from (8653.3 ± 2789.2) kJ/d in 1991 to (8058.3 ± 2866.6) kJ/d in 2006 (χ(2) = 72.6, P < 0.01); protein intake decreased from (63.0 ± 22.8) g/d in 1991 to (57.3 ± 23.1) g/d in 2006 (χ(2) = 71.9, P < 0.01). Average height of 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d groups were (142.9 ± 16.9), (146.9 ± 18.8), (147.6 ± 16.2), (148.8 ± 16.0), (149.9 ± 15.3) cm, respectively (χ(2) = 29.4, P < 0.01); average weight were (37.1 ± 13.2), (40.3 ± 13.9), (41.3 ± 16.9), (41.7 ± 14.6), (41.4 ± 12.2) kg, respectively (χ(2) = 25.7, P < 0.01). CONCLUSION: In the period of 1991 to 2006, milk drinking rate and milk consumption has improved greatly. Main nutrient intake, height and weight increased with milk consumption.

[Status and trend of alcohol consumption among adults in nine provinces (antonomous region) of China from 1993 to 2006].

OBJECTIVE: To understand the status and trend of alcohol consumption among adult people living in 9 provinces (autonomous region) of China from 1993 to 2006. METHODS: The data was collected at the China Health and Nutrition Survey in 1993, 1997, 2000, 2004 and 2006, the subjects with complete drinking data of adult residents were involved. The sample of subjects were 7994, 8625, 9283, 9780 and 9746 among 5 round surveys respectively. Alcohol intake, drinking frequency, drinking type, drinking amount and trends of changing was analyzed. RESULTS: The average drinking rates were 60.2% (13 201/21 919) and 9.7% (2269/23 509) among male and female respectively. The average alcohol intake was (32.2 ± 35.6) g in male and (14.0 ± 19.4) g in female drinkers. Male drinkers with primary and secondary schools or below education had the lowest level of drinking rate, which was 59.7% (985/1651), 58.7% (941/1604), 57.0% (889/1560), 55.4% (885/1599) and 53.1% (812/1529) in the 5 round surveys respectively. However, the average daily alcohol intake was the highest, which was (31.1 ± 38.2) g, (39.8 ± 42.1) g, (38.9 ± 41.3) g and (38.4 ± 43.3) g at 1997, 2000, 2004, 2006 respectively. The male drinkers with college or above education had the lowest alcohol intake, which was (21.9 ± 24.5) g, (28.8 ± 30.9) g, (24.6 ± 22.0) g and (25.0 ± 26.4) g in 1997, 2000, 2004 and 2006 respectively. Female drinkers with college or above education had the highest drinking rate, which was 21.0% (13/62), 24.5% (26/106), 16.6% (27/163), 19.7% (38/193) and 18.8% (46/245) at 5 round surveys respectively. But their average daily alcohol intake was lowest, which was (4.7 ± 3.3) g, (12.5 ± 31.9) g, (9.9 ± 18.7) g and (8.2 ± 8.5) g at 1997, 2000, 2004, 2006 respectively. And the average daily alcohol intake was the highest among female drinkers with primary and secondary schools or below education, which was (13.4 ± 16.9) g, (16.3 ± 22.4) g, (19.9 ± 26.1) g and (16.4 ± 18.0) g respectively. According to the regional distribution, the highest drinking rate of female drinker was occurred at urban female, which was 17.4% (110/631), 19.9% (147/740), 17.4% (129/741), 14.4% (117/814) and 11.3% (88/781) at 5 round surveys. Drinking every day was most popular in male drinkers, the proportion was 32.6% (3533/10 844). Drinking 1 to 2 times per week, 1 to 2 times per month, no more than 1 time per month was most popular in female drinkers, the proportion was 23.0% (410/1786), 24.6% (440/1786) and 21.2% (379/1786) respectively. Male drinkers liked liquor more (drinking rate was 81.8%, 8875/10 844). The wine drinking rate of female (22.3%, 399/1786) is far higher than that of male's (9.0%, 976/10 844) (χ(2) = 280.4, P < 0.01). The daily alcohol intake equal to or greater than 25 g of male drinkers was 42.0% (4058/9654), and the daily alcohol intake equal to or greater than 15 g of female drinkers was 25.3% (349/1378). CONCLUSION: The drinking rate of adults among 9 provinces (autonomous region) was higher than that of national average level. The drinking rate and the average alcohol consumption among male and female was significantly different. Same differences was observed among education level and different regions.

[The status and trend of cereal consumption among Chinese adults in nine provinces (municipality) from 1989 to 2006].

OBJECTIVE: To explore the status and trend of cereal consumption among Chinese adults aged 18 to 59 years in nine provinces (municipality) from 1989 to 2006. METHODS: The survey data were collected by consecutive 3 d 24 h dietary recall method in 1989, 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey Project. The subjects aged 18-59 years with complete information on dietary survey were included. The sample number of the subjects were 5978, 7566, 7492, 7738, 8439, 7484 and 7157 in the 7 round surveys from 1989 to 2006, respectively. The trends of their cereal consuming rate and daily intake were analyzed by year, gender, age and regions. RESULTS: The cereal intake of 18 - 59 years old Chinese adults in 9 provinces (municipality) decreased from 522.3 g/d in 1989 to 431.9 g/d in 2006 (χ(2) = 2421.76, P < 0.01). The cereal intake of males decreased from 545.6 g/d in 1989 to 471.6 g/d in 2006 (χ(2) = 861.21, P < 0.01) and females decreased from 500.3 g/d in 1989 to 395.5 g/d in 2006 (χ(2) = 1844.13, P < 0.01). Compared with 1989, the average cereal consumption were reduced to 104.8, 134.4, 103.3 and 98.2 g in the suburban, female, 18 to 29 years old age group and level of education for college and above separately in 2006. The rice consuming rate among 18 - 59 year-old residents increased from 79.9% (4776/5978) in 1989 to 87.3% (6248/7157) (Z = 18.45, P < 0.01) in 2006, the wheat consuming rate increased from 63.3% (3784/5978) in 1989 to 80.2% (5740/7157) (Z = 27.28, P < 0.01) in 2006. CONCLUSION: The present study indicated that there was a decreasing trend of cereal intake among Chinese adults aged 18 - 59 years in 9 provinces (municipality). In the stratified groups, cereal intake in groups of female, suburb, aged 18 - 59 years and higher educational level decreased significantly.

[Trends of the dietary fiber intake among Chinese aged 18 - 45 in nine provinces (autonomous region) from 1989 to 2006].

OBJECTIVE: To analyze the status and trend of dietary fiber intake and its food sources among Chinese residents aged 18 - 45 years old in 9 provinces (autonomous region), from 1989 to 2006. METHODS: Twenty-four-hour dietary recall data of three consecutive days from China Health and Nutrition Survey (1989, 1991, 1993, 1997, 2000, 2004 and 2006) were used. And the 18 - 45 years old subjects with complete information on dietary survey were included. The sample size of these 7 surveys were 5597, 5596, 5323, 5485, 5308, 4144 and 3889, respectively. The trends of dietary fiber intake and food sources by time and sex were studied. RESULTS: From 1989 to 2000, the total of daily dietary fiber intake of 18 - 45 years old healthy residents decreased from 15.1 g/d to 11.6 g/d, insoluble dietary fiber intake decreased from 22.6 g/d to 17.8 g/d. In villages, from 1989 to 2000, the insoluble dietary fiber intake decreased 5.1 g/d in males and 5.2 g/d in females(13.2, 11.8 g in 2000, respectively;18.3, 17.0 g in 1989, respectively). In 2006, the insoluble dietary intake was 12.6 g/d in males and 11.2 g/d in females in villages. In cities, from 1989 to 2006, the insoluble dietary fiber intake was 9.4 - 11.8 g/d in males and 8.3 - 10.8 g/d in females. The total dietary fiber intake was 15.7 - 17.6 g/d in males and 13.5 - 16.4 g/d in females. The difference of insoluble and total dietary fiber intake between city and village was decreasing. In 2006, 70.6% (8.4/11.9) insoluble dietary fiber came from vegetables ((4.1 ± 3.1) g/d), wheat flour and its products ((2.6 ± 3.6) g/d), rice and its products ((1.7 ± 1.3) g/d). CONCLUSION: Dietary fiber intake among Chinese aged 18 - 45 in 9 provinces (autonomous region) decreased from 1989 to 2006. Vegetables, wheat flour, rice and their products were the major food sources of insoluble dietary fiber.

[Food consumption trend of Chinese adults in nine provinces (autonomous region) from 1989 to 2006].

OBJECTIVE: To analyze the trends of food consumption among Chinese residents aged from 18 to 59 years old in 9 provinces (autonomous region) from 1989 to 2006. METHODS: The paper was based on data collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey of Chinese residents of 24 h in three consecutive day dietary recall data. The healthy residents aged 18 - 59 years with twenty-four-hour dietary recall data were selected as study subjects. The sample sizes of these seven surveys were 5766, 7296, 7019, 7599, 8143, 7168 and 6827, respectively. The trends of their food consumption in each year were analyzed through Kruskal-wallis method. RESULTS: The intake of cereals decreased significantly from (528.5 ± 192.9) g/d in 1989 to (427.7 ± 173.8) g/d in 2006 (χ(2) = 2833.13, P < 0.01). The minor variation of soybean food intake was observed. The average intake was (22.3 ± 39.4) g/d in 1989 and (18.9 ± 30.5) g/d in 2006 which was still at a low level. The trend of vegetables intake showed a small decrease. It was (374.5 ± 205.9) g/d in males and (346.4 ± 187.6) g/d in females in 2006, respectively. Both quantity and rate of fruits consumption showed an increase trend. Its consumption rate reached at 22.5% (741/3296) in males and 27.7% (1004/3619) in females in 2006, respectively. The average intake increased from (122.4 ± 126.9) g/d in 1989 to (228.5 ± 267.3) g/d in 2006 (χ(2) = 539.66, P < 0.01). At the same time, the daily intake of meat and egg showed a large increase, the average meat intake increased from (97.0 ± 111.5) g/d in males and (80.2 ± 97.0) g/d in females in 1989 to (141.5 ± 125.2) g/d in males and (118.4 ± 111.8) g/d in females in 2006, respectively. The oil consumption showed a significant increase. The average intake increased from (30.4 ± 37.9) g/d in 1989 to (42.8 ± 32.3) g/d in 2006 (χ(2) = 1646.94, P < 0.01). CONCLUSIONS: There have been noticeable changes in the Chinese dietary pattern in the past 17 years. Some changes would be helpful for nutritional improvement in Chinese people, but it also caused some adverse effects on health because of improper food consumption.

Efficacy and Safety of Domperidone and Metoclopramide in Breastfeeding: A Systematic Review and Meta-Analysis.

Objectives: To evaluate the efficacy and safety of domperidone and metoclopramide used by breastfeeding women. Methods: A systematic literature search retrieved citations from PubMed, Embase, The Cochrane Library, Medline, EBSCO, Web of Science, ClinicalTrials.gov (from inception to January, 2021) and bibliographies of known articles. Randomized controlled trials exploring the effects of domperidone and metoclopramide in breastfeeding women with term and preterm infants experiencing adequate or low milk supply were identified. Human milk volume and maternal side effects were presented as mean difference (MD) or relative risks (RR) with 95% confidence intervals (CI). Results: Sixteen trials involving 729 women were included in the qualitative analysis and 14 trials involving 607 women were included in the meta-analysis. In mothers of preterm infants with low milk supply, domperidone demonstrated a significant increase in daily human milk volume (MD = 90.53 mL/day, 95% CI [65.42 to 115.64], I2 = 9%). However, metoclopramide did not show significant difference in daily human milk volume in women with preterm infants (MD = -1.14 mL/day, 95% CI [-31.42 to 29.14], I2 = 0%). No differences in maternal side effects were noted with domperidone (RR = 1.20, 95% CI [0.74 to 1.97], I2 = 0%) or metoclopramide (RR = 1.05, 95% CI [0.52 to 2.11], I2 = 27%) in women with preterm infants. Regarding the women with term infants, there were insufficient data in the current review. Conclusions: Domperidone can be used to treat low milk supply in women with preterm infants without significant side effects based on the current review. More evidence exploring the efficacy and safety of domperidone and metoclopramide are still needed for breastfeeding women in the future.

[The nutrition status of special population living in the areas affected by Wenchuan Earthquake after 3 months].

OBJECTIVE: To investigate and analyze the nutritional status of infants, preschool and primary school students, pregnant and lactating women in Wenchuan earthquake disaster area after 3 months. METHODS: In August 2008, the nutritional and health status information of special population were collected and evaluated using the questionnaires, anthropometric and hemoglobin concentration measurements from four settlements of villages and towns in Mao and Mianzhu Country of Sichuan and Kang Country and Wudu District in Gansu provinces. A total of 236 infants aged below 36 months, 48 preschool children, 368 primary students, 32 pregnant women and 72 lactating women were investigated. Principal investigator indexes included the low body weight, growth retardation, anemia prevalence, two-week prevalence of diarrhea and respiratory disease, food intake and nutrition-related diseases, the percentage of patients morbidity of 36 months infants, preschool and primary school students; the prevalence of anemia, the prevalence of nutrition-related diseases of pregnant and lactating women. RESULTS: The stunting prevalence was 14.6% (34/236) and the anemia prevalence was up to 40.1% (61/236) among infants younger than 36 months. Besides, the percentages of infants and young children suffered from the respiratory-infected disease and diarrhea within recent two weeks were 40.4% (95/236) and 30.2% (71/236) respectively. The percentage of low body weight of preschool children was 14.6% (7/48) and the growth retardation and anemia prevalence was 14.6% (7/48) and 39.6% (19/48), respectively. Among primary students, 6.3% (23/368) showed growth retardation and 12.2% (45/368) were anemia. The prevalence of anemia status of pregnant women and lactating mothers were 53.9% (17/32) and 24.4% (18/72) respectively. The main food composition of 45.8% (33/72) lactating women were grain and vegetables, 29 (40.3%), 32 (44.4%), 28 (38.9%) and 53 (73.6%) lactating women did not have animal originated (including meat, aquatic, livestock and poultry products) food, eggs, beans and their products, milk and dairy products, respectively. CONCLUSION: Special population lived in disaster area have suffered different degree of malnutrition. The main dietary pattern was vegetable food. The consumption of meat, eggs, milk and milk products was relatively insufficient.