Implementation of STRONGkids for identifying nutritional risk in outpatients of child health care clinics: Results of a multicentre study.

AIM: To investigate nutritional risk across children in their first 2 years at child health care clinics in Jiangsu, China, and to highlight the importance of nutritional risk screening in outpatient clinics. METHODS: A multi-centre, cross-sectional, observational study was conducted among outpatients in child health care clinics. Nutritional risk screening using the STRONGkids tool and anthropometric assessments were performed on children under 2 years old at outpatient initial visits in ten hospitals from March 2021 to March 2022. RESULTS: There were 11,454 children enrolled. The percentages of children with high, moderate and low nutritional risk were 2.0% (228), 28.2% (3229) and 69.8% (7997), respectively. The occurrence rate of high nutritional risk was higher in female children than in male children (p < 0.05). The incidence of moderate nutritional risk in infants was significantly higher than in children aged ≥12 months (p < 0.01). Children with moderate or high nutritional risk more frequently answered 'yes' to the STRONGkids item 'high risk disease or major surgery planned'. The top three diagnoses related to nutritional risk were prematurity (50.5%), food allergy (14.3%) and recurrent respiratory disease (10.7%). In addition, the incidence of chronic undernutrition in children with moderate (14.0%) or high nutritional risk (36.4%) was significantly higher than acute undernutrition (p < 0.01). CONCLUSION: Among children up to 2 years of age seen in child health clinics, nutritional risk associated with prematurity and potential disease requires special attention. Nutritional risk screening should be part of child health care, and STRONGkids is a useful screening tool.

Evaluation of microRNAs as potential biomarkers in circulating HPV-DNA-positive non-small cell lung cancer patients.

The aim of the present study was to identify the potential risk of circulating-HPV-DNA in non-small cell lung cancer (NSCLC) and to analyze abnormally expressed miRNAs in circulating HPV-DNA-positive NSCLC. HPV universal primers were used to detect the presence of HPV-DNA in the peripheral blood of 100 patients with NSCLC. The relationship between circulating-HPV-DNA and NSCLC patients characteristics was analyzed. Then, eight differentially expressed miRNAs in NSCLC were screened based on the TCGA database. The levels of miRNAs in circulating HPV-DNA-positive NSCLC patients were detected by real-time quantitative PCR. ROC curves were generated to evaluate the diagnostic performance. Circulating-HPV-DNA was found in 16 patients. The proportion of HPV-DNA-positive patients with poorly differentiated NSCLC, advanced lung cancer and lymph node metastasis was higher than that of HPV-DNA-negative patients. The levels of miR-183, miR-210 and miR-182 were significantly higher and miR-144 was significantly lower in HPV-DNA-positive NSCLC than those in HPV-DNA-negative NSCLC patients. When using a single miRNA to identify circulating HPV-DNA-positive NSCLC patients, miR-210 had a higher area under the ROC curve (AUC) than other miRNAs, and its sensitivity and specificity were also higher. In addition, the combination of two miRNAs was more effective than a single miRNA. Among them, miR-210+ miR-144 had the highest AUC value and showed the best prediction performance. Circulating-HPV-DNA may serve as a risk factor in NSCLC. Plasma miR-183, miR-210, miR-182 and miR-144 can be used as reliable biomarkers to identify circulating HPV-DNA-positive NSCLC.

[Mycoplasma pneumoniae toxin of community-acquired respiratory distress syndrome (CARDS) promotes autophagy of THP-1 cells and activates NLRP3 inflammasomes].

Objective To study the mechanism of community-acquired respiratory distress syndrome (CARDS) toxin of Mycoplasma pneumoniae (Mp) inducing THP-1 cell autophagy and the activation of pyrin domain containing the nucleotide-binding oligomerization domain-like receptor family 3 (NLRP3). Methods The recombinant CARDS (rCARDS) Mp toxin was obtained by Escherichia coli expression system, and THP-1 cells were treated with the toxin at the concentrations of 5 and 10 µg/mL for 20, 40 minutes, 1, 2 and 3 hours. The expression of autophagy-related proteins beclin-1, LC3II and P62 of THP-1 cells were determined by Western blot; the gene expression of NLRP3, caspase-1 and interleukin 1ß (IL-1ß) were detected by real-time quantitative PCR; and the level of reactive oxygen species (ROS) of THP-1 cells was tested by DCFH-DA staining. Results Compared with the control group, when treated with rCARDS toxin for 1 hour, the expression of beclin-1, LC3 and P62 significant increased. When treated with rCARDS toxin for 2 and 3 hours, the expression of beclin-1, LC3 and P62 significant decreased. When treated with rCARDS toxin for 20 and 40 minutes, the NLRP3 gene expression had no significant difference between the groups treated with the concentration of 5 and 10 µg/mL rCARDS toxin. NLRP3 gene expression in the groups treated with rCARDS toxin was higher than that in the control group in the whole experiment. When treated with rCARDS toxin for 1 hour and 2 hours, the NLRP3 gene expression of the 10 µg/mL group was significant higher than that in the 5 µg/mL group. When treated with rCARDS toxin for 3 hours, the NLRP3 gene expression of the 10 µg/mL group and 5 µg/mL group was lower than that in the groups treated for 2 hours. When treated with rCARDS toxin for 40 minutes, 1 hour and 2 hours, the caspase-1 mRNA expression of rCARDS toxin groups was higher than that in the control group. When treated for 40 minutes, 1, 2 and 3 hours, the caspase-1 gene expression of the 10 µg/mL group was significantly higher than that in the 5 µg/mL group. Compared to the control group, when treated with rCARDS toxin for 20 and 40 minutes, IL-1ß gene expression had no significant difference. When the time prolonged to 1 hour and 3 hours, the levels of IL-1ß mRNA expression and ROS had a significant increase in a dose-dependent manner in all groups. Conclusion CARDS Mp toxin can activate NLRP3 inflammasomes and induce cell autophagy in THP-1 cells.