Multi-omics reveals that green pea (Pisum sativum L.) hull supplementation ameliorates non-alcoholic fatty liver disease via the SHMT2/glycine/mTOR/PPAR-γ signaling pathway.

Diets rich in various active ingredients may be an effective intervention strategy for non-alcoholic fatty liver disease (NAFLD). The green pea hull (GPH) is a processing by-product of green peas rich in dietary fiber and polyphenols. Here, a mouse model of NAFLD induced by DSS + high-fat diet (HFD) was established to explore the intervention effect of the GPH. The results showed that dietary supplements with the GPH can inhibit obesity and reduce lipid accumulation in the mouse liver to prevent liver fibrosis. GPH intervention can improve liver antioxidant capacity, reduce blood lipid deposition and maintain glucose homeostasis. DSS-induced disruption of the intestinal barrier aggravates NAFLD, which may be caused by the influx of large amounts of LPS. A multi-omics approach combining metabolomics and transcriptomic analysis indicated that glycine was the key target and its content was decreased in the liver after GPH intervention, and that dietary supplements with the GPH can relieve NAFLD via the SHMT2/glycine/mTOR/PPAR-γ signaling pathway, which was further supported by liver-associated protein expression. In conclusion, our study demonstrated that dietary GPH can significantly ameliorate NAFLD, and the future development of related food products can enhance the economic value of the GPH.

Fabricating pectin and chitosan double layer coated liposomes to improve physicochemical stability of beta-carotene and alter its gastrointestinal fate.

To improve storage stability and gastrointestinal (GI) stability of liposomes, pectin and chitosan double layer coated liposome (P-C-L) was proposed and optimized using electrostatic deposition technique. The physical-chemical properties and GI fate of the carrier were then investigated in comparison to that of chitosan coated liposomes (C-L) and un-coated liposomes (L). The results showed P-C-L was successfully prepared at 0.2 % chitosan and 0.06 % pectin. It was hydrogen bonds between the amino groups in chitosan and liposomal interfacial region, and the interaction between the carboxyl groups in pectin layer and amino groups in chitosan layer maintained the structure of P-C-L after absorption by electrostatic interaction. The double layer coatings could improve chemical stability of the encapsulated ß-carotene (ßC), as well as the thermal stability of liposomes. What's more, the permeability of liposomal bilayers and ßC release mechanism in simulated GI fluids was changed by the polymer coating. P-C-L exhibited better controlled release for ßC than C-L and L, and displayer beneficial effect on delivering bioactive agents passing through intensity tract. This may assistant developing more efficient delivery system for bioactive agent.

Tetrastigma hemsleyanum leaf extracts ameliorate NAFLD in mice with low-grade colitis via the gut-liver axis.

Nonalcoholic fatty liver disease (NAFLD) is a complex metabolic disorder, manifested as oxidative stress, lipid accumulation, and inflammation of the liver. Tetrastigma hemsleyanum leaves (THL), which are rich in flavonoids and phenolic acids, have good anti-inflammatory, antioxidant, and hepatoprotective effects. However, it is unknown whether THL extracts can improve NAFLD and the underlying mechanisms are unknown. Hence, this study was designed to investigate the effects of THL extracts on NAFLD and perform a preliminary inquiry into the underlying mechanism based on the gut-liver axis. The results showed that THL extracts could reverse NAFLD-related oxidative stress, lipid accumulation, and inflammation. Additionally, the protective effect of THL extracts on the gut includes the maintenance of the intestinal barrier and the regulation of gut microbiota, which may be one of the mechanisms by which THL improves NAFLD. To be specific, in our study, THL extracts alleviated hepatic lipid accumulation and oxidative stress by regulating the expression of lipid synthesis/catabolism and the oxidative stress genes (SREBP-1c/ACC-1/PPAR-α/PPAR-γ/Keap1/Nrf2). In addition, THL extracts reduced damage to the intestinal barrier (ZO-1/Mucin2/occludin) and increased the relative abundance of Lactobacillales, Ruminococcaceae, and Bifidobacteriales in NAFLD mice. In short, THL extracts alleviated NAFLD-related oxidative stress, lipid accumulation, and inflammation in NAFLD mice which may be via the gut-liver axis (gut barrier integrity and gut microbiota).

Rice Protein Peptides Alleviate Dextran Sulfate Sodium-Induced Colitis via the Keap1-Nrf2 Signaling Pathway and Regulating Gut Microbiota.

Inflammatory bowel disease (IBD), with increasing incidence, causes a range of gastrointestinal symptoms and brings distress and impact on the health and lives of patients. The aim of this study was to explore the protective effects of industrially produced rice protein peptides (RPP) on dextran sulfate sodium (DSS)-induced acute colitis in mice and the potential mechanisms. The results showed that RPP treatment alleviated the symptoms of colitis in mice, including weight loss, colon shortening, and injury, decreased the level of disease activity index (DAI), regulated the balance of inflammatory factors and oxidation, activated Kelch-like ECH-associating protein 1 (Keap1)-nuclear factor E2-related factor 2 (Nrf2) signaling pathway, regulated the expression of related antioxidant proteases, and promoted the expression of intestinal tight junction proteins. In addition, RPP maintained intestinal mucosal barrier function and alleviated acute colitis caused by DSS treatment in mice by increasing the value of F/B, increasing the relative abundance of beneficial bacteria such as Akkermansia, and regulating the level of short-chain fatty acids. In conclusion, RPP alleviated colitis symptoms through the Keap1-Nrf2 signaling pathway and regulating gut microbiota, which had the potential as dietary supplements or functional foods.

Bioactives and their metabolites from Tetrastigma hemsleyanum leaves ameliorate DSS-induced colitis via protecting the intestinal barrier, mitigating oxidative stress and regulating the gut microbiota.

Tetrastigma hemsleyanum, a precious edible and medicinal plant in China, has attracted extensive research attention in recent years due to its high traditional value for the treatment of various diseases. In vitro digestion and colonic fermentation models were established to evaluate the stability of Tetrastigma hemsleyanum leaves (THL) phenolics by the HPLC-QqQ-MS/MS method. The total phenolic and flavonoid contents were degraded during digestion and fermentation. 3-caffeoylquinic acid, 5-caffeoylquinic acid, orientin and (iso)vitexin were metabolized by digestive enzymes and the gut microbiota, and absorbed in the form of glycosides and smaller phenolic acids for hepatic metabolism. The protective effects of THL on dextran sodium sulfate (DSS)-induced colitis in mice and potential mechanisms were explored. The results showed that THL supplementation increased the body weight and colon length, and the expression levels of tight junction proteins including occludin, claudin-1 and ZO-1 were up-regulated by THL. The secretions of pro-inflammatory cytokines containing IL-1ß, IL-6 and TNF-α were significantly suppressed, whereas the content of anti-inflammatory cytokine IL-10 was promoted in the THL treated group. In addition, THL treatment activated the nuclear transfer of Nrf2, improved the expression of SOD, CAT, HO-1, NQO1 and GCLC, and decreased the content of MPO and MDA. It is worth noting that THL treatment significantly increased the content of short-chain fatty acids (SCFAs), increased the abundance of Ruminococcaceae, and decreased the abundance of Verrucomicrobia which is positively correlated with pro-inflammatory cytokines. These results indicated that THL effectively inhibited DSS-induced colitis by maintaining the intestinal epithelial barrier, mitigated oxidative stress through regulating the Keap1/Nrf2 signaling pathway and regulated the imbalance of the intestinal flora structure.

Peanut selenium distribution, concentration, speciation, and effects on proteins after exogenous selenium biofortification.

Fortification of Se is vital importance for both nutritional demand and prevention of Se-deficiency-related diseases. To better understand t selenium distribution, concentration, speciation, its effects on proteins, and cytotoxic activity, the biofortification of exogenous Se in peanut was conducted in this study. Our data have shown that foliar spraying of Se-riched fertilizer was more efficient for biotransformation of inorganic Se to organic Se by peanut plant. Besides, the Se content in peanut was increased in a dose-dependent manner. Our present study also confirmed that SeCys2, MeSeCys, and SeMet were the main Se speciation within peanut proteins. Moreover, the secondary structure and thermostability of peanut protein were altered as a result of the Se treatments, and these alterations could be attributed to the replacements of cysteine and methionine by selenocysteine and selenomethionine, respectively. The Se-enriched peanut protein could significantly inhibit the growth of Caco-2 and HepG2 in a concentration-dependent manner.

Akebia trifoliata pericarp extract ameliorates inflammation through NF-κB/MAPK signaling pathways and modifies gut microbiota.

Akebia trifoliata fruits, a kind of popular edible berry in Asia, are widely consumed as daily fruits or functional foods. Our previous study found several bioactives from Akebia trifoliata pericarp extract (APE), and preliminarily investigated their anti-inflammatory activity. However, the underlying mechanism of APE for the observed anti-inflammatory effects is still unknown. Thus, the bioactive profiles and anti-inflammatory mechanism of APE were investigated by a combination of chemical assays: UPLC-LTQ-Orbitrap/MS technique, lipopolysaccharide (LPS)-induced RAW264.7 cells and DSS-induced mouse model. The results indicated that the phenolic acids and terpenoids are major bioactives of APE, which could inhibit the production of nitric oxide (NO) and prostaglandin E2 (PGE2) by blocking the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in RAW264.7 cells as well as reduce the expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1ß (IL-1ß), and suppress the phosphorylation of p-65, IκBα and mitogen-activated protein kinase (MAPKs including p38, ERKs, JNKs) proteins both in vitro and in vivo. Furthermore, APE treatment could regulate gut microbiota by increasing the richness of Rikenellaceae and Lactobacillaceae and reducing that of Lachnospiraceae and Ruminococcaceae. In summary, these findings clearly demonstrated that APE mitigates inflammation by restraining the production of cytokines through nuclear factor-κB (NF-κB) and MAPK signaling pathways, and altering gut microbiota, and therefore, this could be a potential functional food for the treatment and prevention of inflammatory bowel diseases.

Effects of Chemical Composition and Microstructure in Human Milk and Infant Formulas on Lipid Digestion.

Infant formula (IF) is an important substitute for infants when human milk (HM) is unavailable; however, it was often observed with "insufficient fat" and showed different metabolic phenotypes, which may affect the growth and brain development of the infant. Considering that the milk fat digestion rate may affect the fat absorption and metabolism and further influence the metabolic phenotype, it is valuable to study the fat digestive behaviors of IF and HM. In the current study, we investigated the in vitro fat digestive properties of HM in comparison to four formulas (IF1, 2, 3, 4) including IFs enriched in OPO lipids (IF1 and IF3) and IFs with common mixed plant oils (IF2 and IF4). Results showed that the extent of eventual lipid hydrolysis of HM (98.9 ± 2.70%) was higher than those of IF1 and IF3 (90.4 ± 3.39 and 91.1 ± 1.67%, respectively) (p < 0.05) and IF2 and IF4 (81.9 ± 1.64 and 79.9 ± 1.05% respectively) (p < 0.01). Native fat globules and protein aggregation were observed at the end of HM gastric digestion, and the aggregates became smaller and then resolved from 60 to 120 min in intestinal digestion, while a large number of aggregates were observed in IF, which may slow the lipid digestion. The absorption differences between HM and IFs in lipid digestion need further study to elucidate the nutritional relevance to infant development and growth.

Integrative analysis of DNA methylation and gene expression reveals distinct hepatocellular carcinoma subtypes with therapeutic implications.

We aimed to develop an HCC classification model based on the integrated gene expression and methylation data of methylation-driven genes. Genome, methylome, transcriptome, proteomics and clinical data of 369 HCC patients from The Cancer Genome Atlas Network were retrieved and analyzed. Consensus clustering of the integrated gene expression and methylation data from methylation-driven genes identified 4 HCC subclasses with significant prognosis difference. HS1 was well differentiated with a favorable prognosis. HS2 had high serum α-fetoprotein level that was correlated with its poor outcome. High percentage of CTNNB1 mutations corresponded with its activation in WNT signaling pathway. HS3 was well differentiated with low serum α-fetoprotein level and enriched in metabolism signatures, but was barely involved in immune signatures. HS3 also had high percentage of CTNNB1 mutations and therefore enriched in WNT activation signature. HS4 was poorly differentiated with the worst prognosis and enriched in immune-related signatures, but was barely involved in metabolism signatures. Subsequently, a prediction model was developed. The prediction model had high sensitivity and specificity in distributing potential HCC samples into groups identical with the training cohort. In conclusion, this work sheds light on HCC patient prognostication and prediction of response to targeted therapy.

Phenolics of Green Pea (Pisum sativum L.) Hulls, Their Plasma and Urinary Metabolites, Bioavailability, and in Vivo Antioxidant Activities in a Rat Model.

Increased processing of pulses generates large volumes of hulls, which are known as an excellent source of phenolic antioxidants. However, the bioavailability and in vivo activity of these phenolics are rarely reported. This research was therefore carried out to study the absorption, metabolism, and in vivo antioxidant activities of green pea hull (GPH) phenolics using ultrahigh-pressure liquid chromatography with a linear ion trap-high-resolution Orbitrap mass spectrometry and an oxidative stress rat model. A total of 31 phenolics, including 4 phenolic acids, 24 flavonoids, and 3 other phenolics, were tentatively identified. Ten of these phenolics and 49 metabolites were found in the plasma and urine of rats, which helped to explain the favorable changes by GPH phenolics in key antioxidant enzymes (superoxide dismutase, glutathione peroxidase, and glutathione) and indicators (total antioxidant capacity, malondialdehyde) in the plasma and different tissues of rats. This is the first comprehensive report on dry pea hull phenolics and their bioavailability, metabolic profiles, and mechanisms of in vivo antioxidant activities.

New pectin-induced green fabrication of Ag@AgCl/ZnO nanocomposites for visible-light triggered antibacterial activity.

The pectin (CEP) was used as matrix material to prepare Ag@AgCl/ZnO nanocomposites with a green method for photocatalytic antibacterial activity in visible-light. Briefly, Ag@AgCl plasmonic hybrids were prepared in the CEP macromolecule matrix with size control, which was attributed to the stability of carboxyl and hydroxyl groups on the CEP. Subsequently, an effective and green two-steps approach was explored for the fabrication of CEP-Ag@AgCl/ZnO nanocomposites with resource saving and environment friendly. Interestingly, more Ag+ was converted into metallic Ag in the CEP-Ag@AgCl/ZnO than that in the CEP-Ag@AgCl. This phenomenon was attributed that the reducibility of free hemiacetal hydroxyl groups on CEP was realized with the help of NaOH in the preparation of CEP-ZnO. In addition, the CEP chains were not obviously destroyed except for the change in the crystallinity after the preparation of the CEP-Ag@AgCl/ZnO nanocomposites, indicating that the method was non-destructive. Moreover, the pH triggered release of Zn2+ and low release of Ag+ in CEP-Ag@AgCl/ZnO nanocomposites with excellent photocatalytic antibacterial activity were confirmed in this work. The proposed green process provides a new idea for the large-scale production of antibacterial pectin-based nanocomposites in industry with a low-cost.

The profiling of bioactives in Akebia trifoliata pericarp and metabolites, bioavailability and in vivo anti-inflammatory activities in DSS-induced colitis mice.

The fruit of Akebia trifoliata is popular in Asia, but researches concerning the phytochemicals of A. trifoliate pericarp extract (APE) and their metabolites, bioavailability, metabolism and anti-inflammatory activity in vivo are less known. In the present study, the chemical constituents of APE and their metabolites of rats after oral administration were identified using UPLC-LTQ-Orbitrap-MS/MS. A total of 18 compounds were tentatively characterized in APE, while 8 original compounds and 8 metabolites were observed in plasma, and 10 original compounds and 39 metabolites were detected in urine. Deglycosylation, glucuronidation, methylation and sulfation were the reactions that mainly occurred in the metabolism in vivo. Meanwhile, APE supplementation decreased dextran sulphate sodium (DSS)-induced colitis in mice, ameliorating epithelial barrier disruption, suppressing the proliferation and infiltration of immune cells, modulating the secretion of nitric oxide (NO) and prostaglandin E2 (PGE2), decreasing the expression of nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) as well as regulating oxidative stress in vivo. The results suggested that APE triterpenoids and their metabolites as major contributors to anti-inflammatory activities, providing a scientific basis for the use of APE as a functional food to ameliorate colon health in humans.

Development of antibacterial pectin from Akebia trifoliata var. australis waste for accelerated wound healing.

The fruit of Akebia trifoliata var. australis can be consumed as food. However, the peel of this fruit is typically regarded as waste. The application of such waste can create opportunities to produce new and valuable by-products. Herein, we have shown that citric acid extracted pectin (CEP) from Akebia trifoliata var. australis peel has good water solubility and high galacturonic units, which helps reduce AgNO3 into Ag nanoparticles (CEP-AgNPs) through a one-step, eco-friendly process. The resulting CEP-AgNPs showed sustained release of Ag+ and remarkable antibacterial activity. Subsequently, the CEP-AgNPs were processed into a CEP-Ag sponge with excellent water absorption and prolonged water retention properties. The CEP-Ag sponge could support the cell adhesion and proliferation. Most importantly, the sponge effectively facilitated a moist environment with bacterial disinfection capability which accelerated the healing of infected wounds. Thus, CEP-Ag sponge, a sustainable and high value by-product, was obtained from food waste.

Distribution and effects of natural selenium in soybean proteins and its protective role in soybean ß-conglycinin (7S globulins) under AAPH-induced oxidative stress.

The effects of selenium (Se) on the protein content, amino acid profile, secondary structure and subunit composition of soy proteins and its distribution were evaluated, as was the effect of peroxyl radicals produced by thermal decomposition of AAPH on the conformational changes of Se-enriched ß-conglycinin (S-7S). The Se biofortification ability of soy was very strong, 7S had strongest ability to incorporate Se, and lower amounts of inorganic Se existed in Se-enriched beans. Se could promote protein synthesis and thus improve the protein content, increase the total amino acid content with a decrease in cysteine, combine into low-molecular-weight proteins, and influence the secondary structure of soybean proteins. Se was involved in the relevant protein changes in surface hydrophobicity, intrinsic fluorescence, infrared absorption and solubility and played an antioxidant role as an effectual "protector" to reduce the influence of peroxyl radical oxidation on S-7S, thereby maintaining the structural rearrangement between aggregation and protein unfolding.

Development of Oral Delivery Systems with Enhanced Antioxidant and Anticancer Activity: Coix Seed Oil and ß-Carotene Coloaded Liposomes.

Fortifying food and beverage products with combinations of bioactive agents is a major initiative within the food industry because of their potentially additive or even synergistic benefits for human health. Coix seed oil (CSO) has been reported to possess anticancer activity, whereas ß-carotene (ßC) is a natural antioxidant that may also exhibit anticancer activity. However, both of these bioactives are insoluble in water and have poor oral bioavailability. The aim of this study was to overcome these obstacles by encapsulating both ßC and CSO into liposomes (L-ßC-CSO). The effect of different combinations of these two bioactive agents on the physiochemical properties, stability, release, antioxidant activity, and anticancer activity of the liposomes was then determined. Increasing the CSO level decreased the ßC entrapment efficiency, increased the particle size, reduced the polydispersity, and raised the magnitude of the surface potential of the bioactive-loaded liposomes. Moreover, the ßC and CSO levels affected their orientation within the lipid bilayer, which also influences the physiochemical properties, stability, and in vitro release behavior of the system. Compared to liposomes containing single bioactive types, the combined systems exhibited higher bioavailability and increased anticancer and antioxidant activity. These results suggest that the combined bioactive-loaded liposomes could be an efficient formulation for potential applications in functional foods and supplements.

Speciation of Selenium in Brown Rice Fertilized with Selenite and Effects of Selenium Fertilization on Rice Proteins.

Foliar Selenium (Se) fertilizer has been widely used to accumulate Se in rice to a level that meets the adequate intake level. The Se content in brown rice (Oryza sativa L.) was increased in a dose-dependent manner by the foliar application of sodium selenite as a fertilizer at concentrations of 25, 50, 75, and 100 g Se/ha. Selenite was mainly transformed to organic Se, that is, selenomethionine in rice. Beyond the metabolic capacity of Se in rice, inorganic Se also appeared. In addition, four extractable protein fractions in brown rice were analyzed for Se concentration. The Se concentrations in the glutelin and albumin fractions saturated with increasing Se concentration in the fertilizer compared with those in the globulin and prolamin fractions. The structural analyses by fluorescence spectroscopy, Fourier transform infrared spectrometry, and differential scanning calorimetry suggest that the secondary structure and thermostability of glutelin were altered by the Se treatments. These alterations could be due to the replacements of cysteine and methionine to selenocysteine and selenomethionine, respectively. These findings indicate that foliar fertilization of Se was effective in not only transforming inorganic Se to low-molecular-weight selenometabolites such as selenoamino acids, but also incorporating Se into general rice proteins, such as albumin, globulin glutelin, and prolamin, as selenocysteine and selenomethionine in place of cysteine and methionine, respectively.

A novel antibacterial agent based on AgNPs and Fe3O4 loaded chitin microspheres with peroxidase-like activity for synergistic antibacterial activity and wound-healing.

In this study, a novel antibacterial agent was developed based on chitin nanofibrous microspheres loaded with AgNPs and Fe3O4 nanoparticles (Ag-Fe3O4-NMs) for synergistic antibacterial activity and wound healing. Ag-Fe3O4-NMs was prepared via an in situ synthetic method which showed an excellent porosity and wettability. Moreover, Ag-Fe3O4-NMs were capable of sustained release of Ag+ and catalysed the decomposition of low H2O2 concentrations to generate hydroxyl radical (OH). The OH and Ag+ showed higher antibacterial activity and inhibited the toxicity with high dose of AgNPs and H2O2. In vitro biocompatibility results suggested that Ag-Fe3O4-NMs have low toxicity and low hemolysis. Thus, a novel antibacterial agent with enhanced synergistic antibacterial activity was obtained by combination of Ag-Fe3O4-NMs and H2O2 at a low and biologlically safe dosage, which could facilitate fibroblast growth, accelerate epithelialization, and promote the healing rate of infected wounds.

Lactobacillus plantarum ZDY04 exhibits a strain-specific property of lowering TMAO via the modulation of gut microbiota in mice.

Trimethylamine N-oxide (TMAO), which is oxidized from trimethylamine (TMA) by hepatic flavin-containing monooxygenases (FMOs), promotes the development of atherosclerosis and is a new target for the prevention and treatment of cardiovascular disease from the perspective of intestinal flora. TMA is transformed by intestinal flora from TMA-containing nutrients, such as choline. Some small molecular agents lower serum TMAO and/or cecal TMA levels. However, probiotics that can effectively reduce serum TMAO levels are currently lacking. In this work, five potentially probiotic strains were administered to mice supplemented with 1.3% choline. Only Lactobacillus plantarum ZDY04 significantly reduced serum TMAO and cecal TMA levels by modulating the relative abundance of the families Lachnospiraceae, Erysipelotrichaceae and Bacteroidaceae and the genus Mucispirillum in mice and not by influencing the expression levels of hepatic FMO3 and metabolizing choline, TMA, and TMAO. In addition, L. plantarum ZDY04 can significantly inhibit the development of TMAO-induced atherosclerosis in ApoE-/- 1.3% choline-fed mice as compared with the untreated PBS group. In conclusion, the use of L. plantarum ZDY04 may be an alternative approach to reduce serum TMAO levels and TMAO-induced atherosclerosis in mice.

Impact of family integrated care on infants' clinical outcomes in two children's hospitals in China: a pre-post intervention study.

BACKGROUND: Most Neonatal Intensive Care Units (NICUs) in China have restricted visiting policies for parents. This also implicates that parents are not involved in the care of their infant. Family Integrated Care (FIC), empowering parents in direct care delivery and decisions, is becoming the standard in NICUs in many countries and can improve quality-of-life and health outcomes of preterm infants. The aim of this study was to evaluate the impact of a FIC intervention on the clinical outcomes of preterm infants with Bronchopulmonary Dysplasia (BPD). METHODS: A pre-post intervention study was conducted at NICUs in two Chinese children's hospitals. Infants with BPD were included: pre-intervention group (n = 134) from December 2015 to September 2016, post-intervention (FIC) group (n = 115) and their parents from October 2016 to June 2017. NICU nurses were trained between July and September 2016 to deliver the FIC intervention, including parent education and support. Parents had to be present and care for their infant minimal three hours a day. The infants' outcome measures were length-of-stay, breastfeeding, weight gain, respiratory and oxygen support, and parent hospital expenses. RESULTS: Compared with control group (n = 134), the FIC group (n = 115) had significantly increased breastfeeding rates (83% versus 71%, p = 0.030), breastfeeding time (31 days versus 19 days, p < 0.001), enteral nutrition time (50 days versus 34 days, p < 0.001), weight gain (29 g/day versus 23 g/day, p = 0.002), and significantly lower respiratory support time (16 days versus 25 days, p < 0.001). Oxygen Exposure Time decreased but not significant (39 days versus 41 days p = 0.393). Parents hospital expenses in local Chinese RMB currency was not significant (84 K versus 88 K, p = 0.391). CONCLUSION: The results of our study suggests that FIC is feasible in two Chinese NICUs and might improve clinical outcomes of preterm infants with BPD. Further research is needed to include all infants admitted to NICUs and should include parent reported outcome measures. Our study may help other NICUs with limited parental access to implement FIC to enhance parental empowerment and involvement in the care of their infant.

Enterobacter aerogenes ZDY01 Attenuates Choline-Induced Trimethylamine N-Oxide Levels by Remodeling Gut Microbiota in Mice.

Trimethylamine N-oxide (TMAO), which is transformed from trimethylamine (TMA) through hepatic flavin-containing monooxygenases, can promote atherosclerosis. TMA is produced from dietary carnitine, phosphatidylcholine, and choline via the gut microbes. Previous works have shown that some small molecules, such as allicin, resveratrol, and 3,3-dimethyl-1-butanol, are used to reduce circulating TMAO levels. However, the use of bacteria as an effective therapy to reduce TMAO levels has not been reported. In the present study, 82 isolates were screened from healthy Chinese fecal samples on a basal salt medium supplemented with TMA as the sole carbon source. The isolates belonged to the family Enterobacteriaceae, particularly to genera Klebsiella, Escherichia, Cronobacter, and Enterobacter. Serum TMAO and cecal TMA levels were significantly decreased in choline-fed mice treated with Enterobacter aerogenes ZDY01 compared with those in choline-fed mice treated with phosphate-buffered saline. The proportions of Bacteroidales family S24-7 were significantly increased, whereas the proportions of Helicobacteraceae and Prevotellaceae were significantly decreased through the administration of E. aerogenes ZDY01. Results indicated that the use of probiotics to act directly on the TMA in the gut might be an alternative approach to reduce serum TMAO levels and to prevent the development of atherosclerosis and "fish odor syndrome" through the effect of TMA on the gut microbiota.