Novel Nucleic Acid-Assisted Ion-Responsive ECL Biosensor Based on Hollow AuAg Nanoboxes with Excellent SPR and Effective Coreaction Acceleration.

Novel hollow AuAg nanoboxes (AuAg NBs) were designed for an innovative electrochemiluminescence (ECL) sensor to ultrasensitively detect Pb2+ and Hg2+ with the aid of DNAzyme and "thymine-Hg2+-thymine" ("T-Hg2+-T") structure. AuAg NBs are employed as an excellent surface plasma resonance (SPR) source, as well as an effective coreaction accelerator for the CoNi NFs/S2O82- system to greatly improve ECL performance. To detect Pb2+, the DNAzyme catalyzes the cleavage of ribonucleic acid targets into numerous small nucleic acid fragments, leading to an ECL signal. When Hg2+ is added, the thymine-thymine (T-T) mismatches of the Hg2+ aptamer bind Hg2+ to form the "T-Hg2+-T" structure, which not only inhibits the SPR process but also produces a large steric hindrance, thus quenching the ECL signal and allowing quantification of Hg2+. The novel ECL sensor quantifies Pb2+ in the range of 0.1 fM to 0.1 µM with a limit of detection of 0.07 fM and Hg2+ in the range of 10 pM to 1 µM with a LOD of 4.07 pM.

PdPt@SnS2 Nanosheets for a Novel Ultrasensitive Electrochemiluminescence Biosensor for miRNA-21 Assay.

PdPt nanosheets decorated on SnS2 nanosheets (i.e., PdPt@SnS2 NSs) were fabricated for a novel electrochemiluminescence (ECL) biosensor for ultrasensitive detection of miRNA-21 based on catalytic hairpin assembly (CHA) cycles. The PdPt@SnS2 NSs serve as both the main luminophore and a highly effective coreaction accelerator in the ECL biosensor. In the CHA cycles, more miRNA-21 is captured, and the performance of the ECL biosensor is improved. When miRNA-21 is present, the hairpin chain DNA1 (i.e., H1) is opened, and the ferrocene (Fc)-modified hairpin chain DNA2 (i.e., Fc-H2) hybridizes with as-opened H1 by replacing miRNA-21 to stimulate CHA cycles of miRNA-21. During the CHA cycles, Fc-H2 quenches the ECL signal to monitor miRNA-21. As a result, the ECL biosensor shows ultrasensitive and highly selective detection of miRNA-21 from 1 aM to 1 nM with a detection limit (LOD) of 0.02 aM. In addition, the ECL biosensor exhibits excellent practicality for miRNA-21 detection in human serum samples.

Self-Powered Biosensor for a Highly Efficient and Ultrasensitive Dual-Biomarker Assay.

A dual-biomarker, self-powered biosensor was fabricated for the ultrasensitive detection of microRNA-21 (miRNA-21) and miRNA-155 based on enzymatic biofuel cells (EBFCs), catalytic hairpin assembly (CHA), and DNA hybridization chain reaction (HCR), with a capacitor and digital multimeter (DMM). In the presence of miRNA-21, the CHA and HCR are triggered and lead to the generation of a double-helix chain, which stimulates [Ru(NH3)6]3+ to move to the biocathode surface due to electrostatic interaction. Subsequently, the biocathode obtains electrons from the bioanode and reduces [Ru(NH3)6]3+ to [Ru(NH3)6]2+, which significantly increases the open-circuit voltage (E1OCV). When miRNA-155 is present, CHA and HCR cannot be completed, resulting in a low E2OCV. The self-powered biosensor allows for the simultaneous ultrasensitive detection of miRNA-21 and miRNA-155 with detection limits of 0.15 and 0.66 fM, respectively. Moreover, this self-powered biosensor exhibits the highly sensitive detection for miRNA-21 and miRNA-155 assay in human serum samples.

AuPt Nanodonuts as a Novel Coreaction Accelerator and Luminophore for a Label-free Electrochemiluminescence Aptasensor.

Novel and effective coreaction accelerators are of great importance in electrochemiluminescence (ECL) systems. In this work, novel AuPt nanodonuts, i.e., SnS2 quantum dots (QDs)/Cys-AuPt heterogeneous nanorings (NRs), serve as both a highly effective coreaction accelerator and the luminophore in a label-free ECL aptasensor. The novel AuPt nanodonuts were formed by decorating SnS2 QDs onto AuPt NR surfaces, which would promote the production of more coreactant intermediate in the SnS2 QDs/K2S2O8 system. As a result, the ECL performance was greatly improved. Meanwhile, l-cysteine (l-Cys) played an important role in the combination between AuPt NRs and SnS2 QDs, and the nanodonuts served as the matrix to load numerous lincomycin (Lin) aptamers. Under optimal conditions, the ECL aptasensor exhibited ultrasensitive detection of Lin from 1 fg/mL to 0.1 pg/mL with a limit of detection (LOD) of 0.7 fg/mL (1.72 fM).

Self-Powered Biosensing System with Multivariate Signal Amplification for Real-Time Amplified Detection of PDGF-BB.

A self-powered biosensing system with multivariate signal amplification is designed for the ultrasensitive, highly efficient, rapid-response, and real-time detection of platelet-derived growth factor-BB (PDGF-BB). The biosensing system is composed of enzymatic biofuel cells (EBFCs), a capacitor, a digital multimeter (DMM), and a computer. Using the hybridization chain reaction (HCR), a few single DNA chains are transformed into abundant double-helix chains, which stimulates the reduction of [Ru(NH3)6]3+ to [Ru(NH3)6]2+ by electrostatic interaction, corresponding to the "on" state for HCR. As a result, the open-circuit voltage (EOCV) is significantly increased in this self-powered biosensing system. When PDGF-BB is present, a binding interaction between the target and the aptamer, i.e., PDGF-BB/Apt, corresponding to the "off" state for HCR, results in a decrease of EOCV. The PDGF-BB concentration is inversely proportional to EOCV, allowing readable, effective, and precise real-time detection of PDGF-BB. The detection limit of the biosensing system is 0.031 pg/mL (S/N = 3). This strategy provides a promising and powerful tool for the early clinical diagnosis of related colorectal cancer markers.

Novel Ultralow-Potential Electrochemiluminescence Aptasensor for the Highly Sensitive Detection of Zearalenone Using a Resonance Energy Transfer System.

An ultralow-potential electrochemiluminescence (ECL) aptasensor has been designed for zearalenone (ZEN) assay based on a resonance energy transfer (RET) system with SnS2 QDs/g-C3N4 as a novel luminophore and CuO/NH2-UiO-66 as a dual-quencher. SnS2 QDs were loaded onto g-C3N4 nanosheets and enhanced the ECL luminescence via strong synergistic effects under an ultralow potential. The UV-vis absorption spectrum of CuO/NH2-UiO-66 exhibits considerable overlap with the ECL emission spectrum of SnS2 QDs/g-C3N4, an important consideration for the RET process. In order to stimulate RET, the ZEN aptamer and complementary DNA are introduced for conjugation between the donor and the acceptor. With the binding interaction between ZEN by its aptamer, CuO/NH2-UiO-66 is removed from the electrode surface, resulting in the inhibition of the RET system and an increase in the ECL signal. Under optimal conditions, the as-prepared aptasensor quantified ZEN from 0.5 µg·mL-1 to 0.1 fg·mL-1 with a low limit of detection of 0.085 fg·mL-1, and it exhibited good stability, excellent specificity, high reproducibility, and desirable practicality. The sensing strategy provides a method for mycotoxins assay to monitor food safety.

Self-Powered Biosensor Based on DNA Walkers for Ultrasensitive MicroRNA Detection.

A novel self-powered biosensor is fabricated for ultrasensitive microRNA-21 (miRNA-21) detection, which includes an enzymatic biofuel cell (EBFC), DNA walkers, a digital multimeter (DMM), and a capacitor. As a novel strategy for signal amplification, DNA walkers are designed in the cathode, while the capacitor stores electrochemical energy from the EBFC to further boost the instantaneous current displayed by the DMM. When miRNA-21 is present, the DNA walkers are provoked to walk from as-opened hairpin structures to other hairpin structures, generating double-strand DNA structures, which stimulate [Ru(NH3)6]3+ to be adsorbed on the cathode surface by electrostatic interaction. Afterward, [Ru(NH3)6]3+ is reduced to [Ru(NH3)6]2+, and the open circuit voltage (EOCV) is significantly increased. Depending on the approach of signal amplification from DNA walkers, this biosensor displays an ultrasensitive assay toward miRNA-21 in the range of 0.5 to 104 fM, with a detection limit of 0.15 fM. In addition, this self-powered biosensor displays high selectivity for miRNA-21 assay in human serum samples.

Comprehensive transcriptomics and metabolomics analyses reveal that hyperhomocysteinemia is a high risk factor for coronary artery disease in a chinese obese population aged 40-65: a prospective cross-sectional study.

BACKGROUND: Clinical observations suggest a complex relationship between obesity and coronary artery disease (CAD). This study aimed to characterize the intermediate metabolism phenotypes among obese patients with CAD and without CAD. METHODS: Sixty-two participants who consecutively underwent coronary angiography were enrolled in the discovery cohort. Transcriptional and untargeted metabolomics analyses were carried out to screen for key molecular changes between obese patients with CAD (CAD obese), without CAD (Non-CAD obese), and Non-CAD leans. A targeted GC-MS metabolomics approach was used to further identify differentially expressed metabolites in the validation cohorts. Regression and receiver operator curve analysis were performed to validate the risk model. RESULTS: We found common aberrantly expressed pathways both at the transcriptional and metabolomics levels. These pathways included cysteine and methionine metabolism and arginine and proline metabolism. Untargeted metabolomics revealed that S-adenosylhomocysteine (SAH), 3-hydroxybenzoic acid, 2-hydroxyhippuric acid, nicotinuric acid, and 2-arachidonoyl glycerol were significantly elevated in the CAD obese group compared to the other two groups. In the validation study, targeted cysteine and methionine metabolomics analyses showed that homocysteine (Hcy), SAH, and choline were significantly increased in the CAD obese group compared with the Non-CAD obese group, while betaine, 5-methylpropanedioic acid, S-adenosylmethionine, 4-PA, and vitamin B2 (VB2) showed no significant differences. Multivariate analyses showed that Hcy was an independent predictor of obesity with CAD (hazard ratio 1.7; 95%CI 1.2-2.6). The area under the curve based on the Hcy metabolomic (HCY-Mtb) index was 0.819, and up to 0.877 for the HCY-Mtb.index plus clinical variables. CONCLUSION: This is the first study to propose that obesity with hyperhomocysteinemia is a useful intermediate metabolism phenotype that could be used to identify obese patients at high risk for developing CAD.

Proteins and signaling pathways response to Wenjingtongluo drug-contained serum in IHUVECs: an explorative proteomic study.

Angiogenesis is a dynamic and complex process leading to the development of new vessels from pre-existing vessels, which played a major role in pathological processes in many diseases. The present study aimed to investigate the effect of drug-contained serum of Traditional Chinese medicine (TCM) Wenjingtongluo decoction (WJLTD) on antiangiogenesis in Immortalized Human Umbilical Vascular Endothelial cells (IHUVECs), and elucidate the possible mechanisms based on proteomic analysis. Cells were treated with the drug-contained serum of the Drug-contained Serum (DS) of WJLTD and the blank serum (BS). The antiangiogenesis capacity of DS was evaluated using wound healing assay, Transwell, and tube formation assay. We performed three biological replicates to compare large-scale differential protein expression between two groups by tandem mass tag (TMT) labeling technology based on liquid chromatography-mass spectrometry analysis (LC-MS/MS). Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed for the general characterization of overall enriched proteins. For validation of the results of TMT, the candidate proteins were verified by parallel reaction monitoring (PRM) analysis. The results showed that 4% DS could inhibit the migration process of IHUVECs according to wound healing assay and Transwell. And tube formation ability was also dramatically inhibited (p<0.001). TMT analysis revealed 148 differentially expressed proteins between two groups that were identified and quantified. The further validation results of the two candidate proteins, Ferritin heavy chain (FTH1) and Ferritin light chain (FTL) from the Ferroptosis pathway, which played an important role in DS treatment, were consistent with those of LC-MS/MS. In conclusion, this is the first proteomics-based study to report the mechanism underlying DS treatment for angiogenesis. Further functional verification of the potential signaling pathways and the enriched proteins is warranted.

Electrochemical skin conductance and heart rate variability in patients with non-dialysis chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) is very common now and associates with high overall and cardiovascular mortality. Numerous studies have reported that Heart rate variability (HRV) could also be used to detect cardiovascular autonomic dysfunction (CAD). We investigated the association of electrochemical skin conductance (ESC) of EZSCAN results with HRV in non-dialysis CKD patients. METHODS: In a cross-sectional study, we enrolled 248 prevalent non-dialysis CKD patients. Patients underwent a 24-h Holter (CB-2302-A, Bio Instrument, China). A time domain analysis of HRV was performed, and the following parameters were obtained: SDNN, SDANN, rMSSD, pNN50. EZSCAN device (Impeto Medical, Paris, France) measures ESC values of each participants. Mean global skin conductance computed as 0.5 * (reflecting (right + left hand)/2 + (right and left foot)/2). Log transforms data into a normal distribution for statistical analysis. RESULTS: There were 142 males and 106 females included in the present study. Patients' age was 56.6±17.08 years. Logarithm(Log) (global ESC) was independently predicted by age (P<0.01), hypertension history, estimated Glomerular filtration rate (eGFR) and log SDNN (P<0.05). While log SDANN, rMSSD and pNN50 were not independent predictors for log (global ESC). CONCLUSION: Increased global ESC significantly associated with elevated HRV, specifically SDNN in non-dialysis CKD patients. This suggested that global ESC may appear to be an important predictor of CAD, and even could be used as a cardiovascular risk factor in non-dialysis CKD patients.

A Novel ECL Sensing System for Ultrahigh Sensitivity miRNA-21 Detection Based on Catalytic Hairpin Assembly Cascade Nonmetallic SPR Effect.

A novel electrochemical luminescence (ECL) sensing system is designed based on the catalytic hairpin assembly (CHA) cascade nonmetallic surface plasmon resonance (SPR) effect for ultrasensitive and selective miRNA-21 detection. In the CHA cycles, much more target miRNA-21 is captured to amplify the detection signal and enhance sensitivity. Meanwhile, the specific recognition between streptavidin (SA) and biotin, together with the SPR effect of SnS2 nanoplates on perylene tetracarboxylic acid, further amplifies the ECL signal. Together, miRNA-21 can be quantified with a limit of detection of 0.6 aM in the novel ECL system with ultrahigh sensitivity and selectivity. The ECL biosensor exhibits excellent stability and reproducibility as well as good practicality for miRNA-21 detection in real human serum.

Novel Dual-Signal Electrochemiluminescence Aptasensor Involving the Resonance Energy Transform System for Kanamycin Detection.

Based on luminol-capped Pt-tipped Au bimetallic nanorods (NRs) (L-Au-Pt NRs) as the anode emitter and SnS2 quantum dots (QDs) hybrid Eu metal organic frameworks (MOFs) (SnS2 QDs@Eu MOFs) as the cathode emitter, a dual-signal electrochemiluminescence (ECL) platform was designed for the ultrasensitive and highly selective detection of kanamycin (KAN). Using a dual-signal output mode, the ratiometric ECL aptasensor largely eliminates false-positives or false-negatives by self-calibration in the KAN assay process. To stimulate the resonance energy transform (RET) system, the KAN aptamer and complementary DNA are introduced for conjugation between the donor and acceptor. With the specific recognition of target KAN by its aptamer, L-Au-Pt NRs-apt partially peels off from the electrode surface. Eventually, the RET system is removed, leading to an increasing cathode signal and a decreasing anode signal. In view of this phenomenon, the ratiometric aptasensor can quantify KAN from 1 pM to 10 nM with a low detection limit of 0.32 pM. This dual-signal ECL aptasensor exhibits great practical potential in environmental monitoring and food safety.

A Dual-Function Sensor for Highly Sensitive Detection of Flame and Humidity.

Early warning sensors rapidly monitor critical temperatures, humidity, and fires, which are crucial to reduce or avoid natural disasters in complex environments, such as fire or water disasters. Here, a highly sensitive, readable, and dual-functional sensor is designed for a fast-response fire alarm and rapid humidity detection based on sustainable biological films (named MSCG films). The MSCG films are composed of grafted sisal nanofibers (MgC), silk nanofibers, graphene, and citric acid (CA). After crosslinking with CA, MSCG films exhibit good wet strength (i.e., 128.8 MPa) after soaking in 100 °C water, thus confirming that the films would be applicable to a broad temperature range in humid environments. After flame ignition, the MSCG films are rapidly carbonized to activate an alarm sound and a light in the circuit with a fire response time as short as 1 s. It exhibits ultrafast temperature response/recovery time (i.e., 0.1 s/0.3 s) and rapid humidity response time (i.e., 0.9 s). The dual-functional sensor is further assembled into a versatile sensor system for real-time monitoring of fire accidents and environmental humidity, which can be integrated into consumer electronics, such as portable laptops and mobile phones.

Long non-coding RNA screening and identification of potential biomarkers for type 2 diabetes.

BACKGROUND: To investigate new lncRNAs as molecular markers of T2D. METHODS: We used microarrays to identify differentially expressed lncRNAs and mRNAs from five patients with T2D and paired controls. Through bioinformatics analysis, qRT-PCR validation, ELISA, and receiver operating characteristic (ROC) curve analysis of 100 patients with T2D and 100 controls to evaluate the correlation between lncRNAs and T2D, and whether lncRNAs could be used in the diagnosis of T2D patients. RESULTS: We identified 68 and 74 differentially expressed lncRNAs and mRNAs, respectively. The top five upregulated lncRNAs are ENST00000381108.3, ENST00000515544.1, ENST00000539543.1, ENST00000508174.1, and ENST00000564527.1, and the top five downregulated lncRNAs are TCONS_00017539, ENST00000430816.1, ENST00000533203.1, ENST00000609522.1, and ENST00000417079.1. The top five upregulated mRNAs are Q59H50, CYP27A1, DNASE1L3, GRIP2, and lnc-TMEM18-12, and the top five downregulated mRNAs are GSTM4, PODN, GLYATL2, ZNF772, and CLTC. Examination of lncRNA-mRNA interaction pairs indicated that the target gene of lncRNA XR_108954.2 is E2F2. Multiple linear regression analysis showed that XR_108954.2 (r = 0.387, p < 0.01) and E2F2 (r = 0.368, p < 0.01) expression levels were positively correlated with glucose metabolism indicators. Moreover, E2F2 was positively correlated with lipid metabolism indicators (r = 0.333, p < 0.05). The area under the ROC curve was 0.704 (95% CI: 0.578-0.830, p = 0.05) for lncRNA XR_108954.2 and 0.653 (95% CI: 0.516-0.790, p = 0.035) for E2F2. CONCLUSIONS: This transcriptome analysis explored the aberrantly expressed lncRNAs and identified E2F2 and lncRNA XR_108954.2 as potential biomarkers for patients with T2D.

Cell-free DNA from plasma as a promising alternative for detection of gene mutations in patients with Maffucci syndrome.

Maffucci syndrome (MS, OMIM 166000) is an extremely unusual, nonhereditary, multisystemic disorder that is characterized with multiple enchondromas and vascular lesions, most of which are spindle cell hemangiomas. Complications of MS, such as bone deformities and dysfunction caused by enchondromas, usually increase during childhood and adolescence. Malignant transformation of enchondromas and other malignancies are the most severe complications. MS is caused by somatic mosaic IDH1/2 mutations, 65% of which are the IDH1 p.Arg132Cys variant. Due to its rarity, there is no international consensus for the most appropriate treatment option of MS.Here, we report a case of a female patient presenting with multiple enchondromas and spindle cell hemangiomas (SCHs) on bilateral hand and feet diagnosed as MS. A detailed clinical, pathological and genetic diagnosis of MS was rendered. Integrative Genomics Viewer (IGV) visualization of next-generation sequencing (NGS) data revealed the consistent detection of the low-frequency somatic IDH1 p.Arg132Cys mutation between SCH tissue and cystic blood-derived cfDNA. This is the first successful molecular diagnosis of MS complicated with SCH utilizing minimally invasive cfDNA techniques. We suggest that cfDNA sequencing could potentially be used as an alternative, reliable and sensitive method to identify molecular information for genetic diagnosis and for future targeted therapies of MS.

Complex vascular anomalies and tissue overgrowth of limbs associated with increased skin temperature and peripheral venous dilatation: parks weber syndrome or PROS?

PIK3CA-related overgrowth spectrum (PROS) is a series of congenital, sporadic disorders that are associated with segmental overgrowth phenotypes and postzygotic, somatic gene mutations in the PIK3CA-ATK-mTOR pathway. The variability and overlapping phenotypes between PROS and other complex vascular malformations make the differential diagnosis confusing and challenging. PROS should be considered for the differential diagnosis with other complex vascular malformations and syndromes with a tissue overgrowth phenotype, such as Parkes-Weber syndrome (PWS).Herein, we diagnosed one unique clinically challenging case manifested as capillary malformation (CM), limb overgrowth, as well as increased skin temperature and peripheral venous dilatation of lower limb that indicated a potential fast-flow lesion. The patient was initially diagnosed with PWS. Contrary to the previous diagnosis, based on further MR imaging and digital subtraction angiography (DSA), which ruled out the existence of AVMs and AVFs, and molecular analysis with targeted next-generation sequencing (NGS) revealing a somatic PIK3CA mutation, we ultimately diagnosed that the patient had a unique form of PROS simulating PWS phenotypes. We suggest that it is important to propose the differential diagnosis of PWS and PROS, two diseases that share a common overgrowth phenotype. We recommended radiological diagnosis such as MRI, CT and DSA as well as further molecular diagnosis to provide more information for the assessment of vascular lesions and to further guide clinical treatment strategies.

Network Traffic Prediction Incorporating Prior Knowledge for an Intelligent Network.

Network traffic prediction is an important tool for the management and control of IoT, and timely and accurate traffic prediction models play a crucial role in improving the IoT service quality. The degree of burstiness in intelligent network traffic is high, which creates problems for prediction. To address the problem faced by traditional statistical models, which cannot effectively extract traffic features when dealing with inadequate sample data, in addition to the poor interpretability of deep models, this paper proposes a prediction model (fusion prior knowledge network) that incorporates prior knowledge into the neural network training process. The model takes the self-similarity of network traffic as a priori knowledge, incorporates it into the gating mechanism of the long short-term memory neural network, and combines a one-dimensional convolutional neural network with an attention mechanism to extract the temporal features of the traffic sequence. The experiments show that the model can better recover the characteristics of the original data. Compared with the traditional prediction model, the proposed model can better describe the trend of network traffic. In addition, the model produces an interpretable prediction result with an absolute correction factor of 76.4%, which is at least 10% better than the traditional statistical model.

A High-Wet-Strength Biofilm for Readable and Highly Sensitive Humidity Sensors.

Low-cost and flexible biofilm humidity sensors with good wet strength are crucial for humidity detection. However, it remains a great challenge to integrate good reversibility, rapid humidity response, and robust humid mechanical strength in one sensor. In this respect, we report a facile method to prepare a sustainable biofilm (named MC film) from sisal cellulose microcrystals (MSF-g-COOH) and citric acid (CA). After cross-linking with CA, the MC film exhibits excellent wet strength and rapid humidity response. More importantly, MC film can be used over a wide temperature range with excellent durability and reversibility for humidity detection. A highly sensitive humidity sensor fabricated from the MC film exhibits high reversibility and excellent water resistance and can be applied in humidity and personalized breath health monitoring. Our work fills the gap between biomaterial design and high-performance sensing devices.

A Hydrophobic Sisal Cellulose Microcrystal Film for Fire Alarm Sensors.

At present, environmentally friendly biobased flexible films are of particular interest as next-generation fireproof packaging and sensor materials. To reduce the moisture uptake and fire risks induced by hygroscopic and flammable biobased films, we report a simple and green approach to develop a hydrophobic, flame-retardant composite film with synergetic benefit from soy protein isolate (SPI), sisal cellulose microcrystals (MSF-g-COOH), graphene nanosheets (GN), and citric acid (CA). Compared with SPI/MSF-g-COOH composite films, the as-prepared SPI/MSF-g-COOH/CA/GN composite films have significantly improved water resistance and can maintain excellent physical structure and good electrical conductivity in an ethanol flame. This work opens a pathway for the development of novel fire-retardant fire alarm biosensors.

[Analysis of IVD gene variants in four children with isovalerate acidemia].

OBJECTIVE: To detect variants of IVD gene among 4 neonates with suspected isovalerate acidemia in order to provide a guidance for clinical treatment. METHODS: 111 986 newborns and 7461 hospitalized children with suspected metabolic disorders were screened for acyl carnitine by tandem mass spectrometry. Those showing a significant increase in serum isovaleryl carnitine (C5) were analyzed for urinary organic acid and variants of the IVD gene. RESULTS: Four cases of isovalerate acidemia were detected, which included 2 asymptomatic newborns (0.018‰, 2/111 986) and 2 children suspected for metabolic genetic diseases (0.268‰, 2/7461). The formers had no obvious clinical symptoms. Analysis of acyl carnitine has suggested a significant increase in C5, and urinary organic acid analysis has shown an increase in isovaleryl glycine and 3-hydroxyisovalerate. Laboratory tests of the two hospitalized children revealed high blood ammonia, hyperglycemia, decreased red blood cells, white blood cells, platelets and metabolic acidosis. The main clinical manifestations have included sweaty foot-like odor, feeding difficulty, confusion, drowsiness, and coma. Eight variants (5 types) were detected, which included c.158G>A (p.Arg53His), c.214G>A (p.Asp72Asn), c.548C>T (p.Ala183Val), c.757A>G (p.Thr253Ala) and 1208A>G (p.Tyr403Cys). Among these, c.548C>T and c.757A>G were unreported previously. None of the variants was detected by next generation sequencing of 2095 healthy newborns, and all variants were predicted to be likely pathogenic based on the guidelines from the American College of Medical Genetics and Genomics. CONCLUSION: The incidence of isovalerate acidemia in Liuzhou area is quite high. Screening of metabolic genetic diseases is therefore recommended for newborns with abnormal metabolism. The discovery of novel variants has enriched the mutational spectrum of the IVD gene.