Relationship between body mass index and sexual development in Chinese children / 中华儿科杂志

Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.

Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China / 中华医学杂志(英文版)

BACKGROUND@#Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.@*METHODS@#The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD.@*RESULTS@#A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05).@*CONCLUSION@#Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.

Effects of clinical features of neonates and mothers on the screening of congenital hypothyroidism / 天津医药

@# Objective Toinvestigatetheclinicalfeaturesofneonatesandmothersonthescreeningofcongenital hypothyroidism(CH),andtoprovideabasisforavoidingthemisseddiagnosisofCH.Methods Atotalof206neonateswith positive thyroid stimulating hormone (TSH) screening were collected from January 2016 to November 2017, and 206 neonateswithnegativeTSHwererandomlyselectedoverthesameperiodasnormalcontrolgroupaccordingto1∶1ratio.The impactofneonatalsex,gestationalage,bodyweightandmaternalcomorbidityonCHscreeninganddiagnosiswasanalyzed inthetwogroups.Results ThebodyweightofneonateswithpositiveTSHscreeningwaslowerthanthatofnormalnewborn infants(P＜0.05),whiletherewerenosignificantdifferencesinsex,gestationalage,theproportionofpreterm,matureand post-termdeliverybetweentwogroups.ComparedwithnormalTSHscreening,theproportionofmotherwithhypothyroidism andTSHlevelwassignificantlyhigherinscreeningpositivegroup,butFT3andFT4levelswerelower(P＜0.05).Therewere no significant differences in the ratio of gestational diabetes mellitus, anemia, subclinical hypothyroidism and hyperthyroidism,hemoglobinandfastingglucosebetweenthetwogroupsofmothers.Comparedwithconfirmednormalgroup (n=198),thebodyweightwaslowerinconfirmedCHgroup(n=8),andtheproportionofmotherwithhypothyroidismandTSH levelwassignificantlyhigherinconfirmedCHgroup,FT3andFT4levelswerelower(P＜0.05).Therewerenosignificant differences in sex, gestational age, the ratio of subclinical hypothyroidism and hyperthyroidism between CH group and confirmed normal group. Conclusion Neonatal low body weight and maternal hypothyroidism significantly affect the screening and diagnosis of CH. Special attention should be paid to clinical screening of CH in order to avoid missed diagnosis.

Effect of Vascular Cell Adhesion Molecule -1 Overexpression on Adipogenic Differentiation of Murine Mesenchymal Stem Cells and Its Mechanism / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of vascular cell adhesion molecule-1 (VCAM-1) gene overexpression on adipogenic differentiation of mouse mesenchymal stem cells(MSC) and explore its molecular mechanism.</p><p><b>METHODS</b>VCAM-1 overexpression MSC (MIGR1-VCAM-1/MSC) and the empty plasmid transfection MSC (MIGR1/MSC) were induced to adipogenic differentiation, oil-red-O staining and real-time PCR were used to detect the adipogenic differentiation ability and the mRNA expression level of key transcription factors C/EBP α and PPAR γ. The activation of P38, ERK and JNK pathways were analyzed by Western blot. Furthermore, the specific chemical inhibitors of MAPK pathway (SB203580, PD98059 and JNK inhibitor II) were added to the induced culture system and the alteration of the MSC adipogenic differentiation ability were evaluated.</p><p><b>RESULTS</b>no matter in self or induced differentiation groups, the lipid droplets in MIGR1-VCAM-1/MSC became larger, the amount of adipocyte increased than that in MIGR1/MSC (P<0.01), the mRNA expression level of C/EBPα and PPARγ were upregulated, and JNK pathway were down-regulated while the P38 and ERK pathway were significantly up-regulated. The inhibition of JNK pathway of MIGR1-VCAM-1/MSC could lead to increased mRNA expression level of C/EBP α and PPAR γ, the amount of adipocytes increased (P<0.01), however, the inhibition of the P38 and ERK pathway of MIGR1-VCAM-1/MSC could lead to decreased mRNA expression level of C/EBP α and PPAR γ, and the lipid droplets and the number of adipocytes became smaller and less.</p><p><b>CONCLUSION</b>The overexpression of VCAM-1 may promote MSC to differentiate into adipocytes through inhibiting JNK signaling pathway, activating P38 and ERK pathways.</p>

Effect of Knockdown of Vascular Cell Adhesion Molecule-1 on the Immunologic Regulation Capacity of Murine Mesenchymal Stem Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To establish the stably lower expression of vascular cell adhesion molecule-1 (VCAM-1) in MSC cell line (C3H10T1/2) by siRNA technology, and explore the effect of knockdown of VCAM-1 on the immunologic regulation capacity of murine MSC.</p><p><b>METHODS</b>The mouse GV118-VCAM-1-RNAi retrovirus vector was constructed by gene recombination technology. The recombinant plasmid was identified by restriction analysis and sequencing, and then the recombinant plasmid GV118-VCAM-1-RNAi was transfected into 293 cells by Lipofectamine, and the supernatant was collected to transfect C3H10T1/2. Moreover, the VCAM-1 lower expression on MSC was evaluated by flow cytometry and fluorescent microscopy. The knockdown VCAM-1 MSC was sorted by flow cytometry. Furthermore, the inhibitory effect of the knockdown VCAM-1 MSC on lymphocyte proliferation was tested by lymphoblast transformation assay (LTT) and mixed lymphocyte reaction assay(MLR).</p><p><b>RESULTS</b>The recombinant retroviral vector of knockdown VCAM-1 (GV118-VCAM-1-RNAi) was successfully constructed and transfected into mouse MSC cell line C3H10T1/2. The knockdown VCAM-1/MSC was obtained by flow cytometric sorting. The LTT and MLR assay showed that the immunosuppressive effect of MSC lower-expressing VCAM-1 dramatically decreased (P<0.05).</p><p><b>CONCLUSION</b>Knockdown VCAM-1 in MSC can significantly down-regulate the inhibitory capability of MSC on the proliferation of T-cells. The data of this study laid an experimental foundation for studying effect of VCAM-1 transfecting into MSC on immune function.</p>

Association of plasma glucose, insulin, and cardiovascular risk factors in overweight and obese children

To investigate the association between fasting plasma glucose [FPG], 2-hour post challenge plasma glucose [2hPG], fasting plasma insulin [FINS], 2-hour post challenge plasma insulin [2hINS], and cardiovascular risk factors in obese and overweight children. This is a cross-sectional study of 452 obese and overweight children [male: 312, female: 140, aged 6-16 years]. This study was conducted in the Department of Pediatrics, General Hospital of Tianjin Medical University, Tianjin, China between June 2008 and November 2012. Anthropometries and blood analysis were carried out. Pearson correlation analysis and multiple stepwise linear regression analysis were used to investigate the association among FPG, 2hPG, FINS, 2hINS and cardiovascular risk factors. Body mass index, waist circumference, waist to hip ratio, systolic blood pressure, diastolic blood pressure, and triglyceride were highly correlated with FINS. Fasting plasma insulin influenced greater variance in most cardiovascular risk factors than 2hPG and 2hINS. Fasting plasma insulin was closely associated with most cardiovascular risk factors compared with FPG, 2hPG and 2hINS

Correlation between vaspin concentration and insulin sensitivity in the visceral adipose tissue of young obese rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the correlation between visceral adipose tissue-derived serine protease inhibitor (vaspin) concentration and insulin sensitivity in the visceral adipose tissue of young obese Sprague-Dawley (SD) rats.</p><p><b>METHODS</b>Twenty-four SD rats which had been weaned 3 weeks before were randomly divided into two groups (n=12 each) to receive a high-fat and normal diet. The weight and abdominal circumference (AC) of each rat were measured, the fasting plasma glucose (FPG) and fasting insulin (FINS) in blood from the angular vein were measured after 12 hours of fasting and blood glucose (BG) and insulin (INS) levels in blood from the angular vein were measured at 60 and 120 minutes after intraperitoneal injection of 50% glucose (2 g/kg). The rats were sacrificed, and their liver and visceral adipose tissue were weighed. The vaspin concentration of the visceral adipose tissue in each rat was measured using ELISA. Correlation analysis was performed on the vaspin concentration and other indices.</p><p><b>RESULTS</b>Compared with the normal diet group, the high-fat diet group showed significantly higher weight, AC, weight of visceral adipose tissue, FPG, FINS, 120 minute INS level, vaspin concentration, homeostasis model assessment for insulin resistance (HOMA-IR) and homeostasis model assessment of β cell function (HOMA-β) (P<0.05) Insulin sensitivity index (ISI) was significantly lower (P<0.01). Vaspin concentration was positively correlated with visceral adipose tissue and liver weight, AC, 120 minute INS level, FPG, FINS, HOMA-IR and HOMA-β (P<0.05), and negatively correlated with ISI (P<0.05).</p><p><b>CONCLUSIONS</b>High expression of vaspin is associated with insulin resistance in young obese SD rats. Vaspin is presumably an adipocytokine that can increase insulin sensitivity, promote insulin secretion by islet β-cells and improve glucose tolerance, and it may be involved in insulin resistance and the disturbance of carbohydrate metabolism.</p>

Effects of ICAM-1 gene transfection on the adipogenic differentiation of MSCs / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the effects of ICAM-1 gene transfection on the differentiation of MSCs to adipocytes.</p><p><b>METHODS</b>The recombinant retroviral expression plasmid MIGR1-ICAM-1 containing full length of mouse ICAM-1 gene was constructed. The constructed plasmid MIGR1-ICAM-1, empty plasmid MIGR1 and packaging plasmid ECOS were transfected into T293 cell lines and then the supernatant generated from T293 cells were used to infect mouse MSCs cell line C3H10T 1/2. The transfective efficiency was determined by inverted fluorescence microscope, real-time PCR and flow cytometry. Furthermore, ICAM-1 overexpressing MSCs (C3H10T 1/2-ICAM-1) and empty vector transfection MSCs (C3H10T 1/2-MIGR1) were cultured in medium with or without induction reagents, Oil-red-O staining was used to detect the lipid accumulation, and the expression of transcriptional factors C/EBPα and PPARγ, which were key factors in the differentiation of MSCs to adipocytes, were tested by real-time-PCR.</p><p><b>RESULTS</b>The recombinant retrovirus vector containing mouse ICAM-1 gene was successful constructed. After transfection into MSCs cell line C3H10T 1/2, the overexpression ICAM-1 MSCs cell line (C3H10T 1/2-ICAM-1) and control cell line (C3H10T 1/2-MIGR1) were obtained. Furthermore, these two cell lines were treated without or with adipocytic induction reagents, C3H10T 1/2-ICAM-1 showed significantly lower mRNA expression level for C/EBPα [(1.2 ± 0.7), (2.9 ± 0.9)] and PPARγ [(1557.6 ± 70.2), (7547.0 ± 442.2)] when compared with C3H10T 1/2-MIGR1 [(5.8 ± 0.5), (23.0 ± 2.3) and (2453.0 ± 215.6), (9856.3 ± 542.2)](P < 0.05). Moreover, little lipid droplet and decreased quantity of adipocytes were detected in C3H10T 1/2-ICAM-1 [(3.2 ± 0.5)/well, (12.2 ± 3.8)/well] than that in C3H10T 1/2-MIGR1 [(11.2 ± 0.4)/well, (51.3 ± 2.8)/well] (P < 0.05).</p><p><b>CONCLUSION</b>Overexpression of ICAM-1 in MSCs can inhibit its adipocytic differentiation.</p>

Ret rearrangement mutation in patients with papillary thyroid carcinoma / 中华内分泌代谢杂志

Objective To investigate the association of ret gene rearrangement mutation with the pathogenesis of papillary thyroid carcinoma (PTC). Methods Twenty-seven cases of PTC were analysed for expression of ret gene rearrangement (ret/PTCs) by multiplex-PCR at first, and then ret/PTC1-3 were identified by identification-PCR (ID-PCR). Finally, the specific ret/PTC was affirmed by automated direct sequencing. Ten specimens of malignant thyroid tissues of other histological types, 33 benign thyroid lesions and 30 normal thyroid specimens beside tumor (as the control) were also included. Results (1) Fifteen samples showed positive ret/PTCs, 11 of which harboured ret/PTC1,3 were positive for ret/PTC3, and 1 for ret/PTC2. All the rearrangements were clearly identified by automated direct sequencing of ID-PCR products. (2) All the 15 ret/PTC-positive tissue samples were histologically confirmed to be PTC. The prevalence of the tumor-specific ret rearrangements in 27 patients with PTC is 55.6% (15/27). (3) No significant difference was found regarding the gender and age of the patients, tumor size and metastasis of neck lymph node. 33.3% (2/6) of the PTC with invasion of extrathyroidal soft tissue were ret/PTC-positive, as compared with 66.7%(4/6) for ret/PTC-negative group (P