Vertical distribution rules and factors influencing phytoplankton in front of a drinking water reservoir outlet.

The phenomenon of algal blooms caused by the excessive proliferation of phytoplankton in drinking water reservoirs is becoming increasingly frequent, seriously endangering water quality, ecosystems, water safety, and people's health. Thus, there is urgent need to conduct research on the distribution rules and factors influencing phytoplankton in drinking water reservoirs. Given that the outflows from reservoirs usually come from the middle and lower layers of the water column and the current studies on phytoplankton in drinking water reservoirs are usually carried out on the surface, an 8-month monitoring of vertical phytoplankton and the corresponding influencing factors in front of the outlet in a drinking water reservoir was conducted. Based on the monitoring results, the distribution rules of phytoplankton and the associated factors were analyzed. The results showed that phytoplankton biomass significantly decreased with increasing water depth, but the biomass near the outlet (40 m depth) still reached the WHO level 2 warning threshold for algal blooms multiple times. During the monitoring period, Cyanophyta, Chlorophyta and Bacillariophyta dominated. The selected multisource environmental factors explained 60.5 % of the spatiotemporal changes in phytoplankton, with thermal intensity (water temperature and thermal stratification intensity) being the driving factor. Meanwhile, excessive TN and TP provided necessary conditions for the growth of phytoplankton. Based on influencing factors, reducing upstream nutrient inflows and thermal stratification intensity are recommended as measures to prevent and control algal blooms. This study provides insights into the vertical distribution rules and factors influencing phytoplankton in a drinking water reservoir, which can provide a reference for the management of drinking water reservoirs and the prevention and control of algal blooms.

Melatonin Engineering M2 Macrophage-Derived Exosomes Mediate Endoplasmic Reticulum Stress and Immune Reprogramming for Periodontitis Therapy.

Periodontitis is a chronic infectious disease caused by bacterial irritation. As an essential component of the host immunity, macrophages are highly plastic and play a crucial role in inflammatory response. An appropriate and timely transition from proinflammatory (M1) to anti-inflammatory (M2) macrophages is indispensable for treating periodontitis. As M2 macrophage-derived exosomes (M2-exos) can actively target inflammatory sites and modulate immune microenvironments, M2-exos can effectively treat periodontitis. Excessive endoplasmic reticulum stress (ER stress) and unfolded protein response (UPR) are highly destructive pathological characteristics during inflammatory periodontal bone loss. Although melatonin has antioxidant and anti-inflammatory effects, studies focusing on melatonin ER stress modulation remain limited. This study fabricates engineered M2-exos loading with melatonin (Mel@M2-exos) for treating periodontitis. As a result, M2-exos drive an appropriate and timely macrophage reprogramming from M1 to M2 type, which resolves chronic inflammation and accelerated periodontal healing. Melatonin released from Mel@M2-exos rescues the osteogenic and cementogenic differentiation capacity in inflammatory human periodontal ligament cells (hPDLCs) by reducing excessive ER stress and UPR. Injectable gelatin methacryloyl (GelMA) hydrogels with sustained-release Mel@M2-exos accelerate periodontal bone regeneration in rats with ligation-induced periodontitis. Taken together, melatonin engineering M2 macrophage-derived exosomes are promising candidates for inflammatory periodontal tissue regeneration.

Molecular insight of p53/Sp1/MUC5AC axis in the tumorigenesis and progression of lung adenocarcinoma.

The aberrant expression of secretory mucin MUC5AC has been documented during the tumourigenesis and progression of various cancers. However, little is currently known on the function of MUC5AC in lung adenocarcinoma. The present study focused on the tumour-promoting role of MUC5AC and its regulatory mechanisms in lung adenocarcinoma. Firstly, MUC5AC expression was evaluated in NSCLC tissue microarrays by immunohistochemistry. Kaplan-Meier analysis were used to clarify the prognostic value of MUC5AC. Subsequently, small interfering RNA and small hairpin RNA were used to knockdown MUC5AC in lung ADC cell lines to elucidate its role in tumorigenesis and progression of lung adenocarcinoma via in vitro functional assays and xenograft mouse models. Finally, the regulatory mechanisms underlying p53/Sp1/MUC5AC axis were identified through dual-luciferase report. We found that MUC5AC was upregulated in lung ADC tissues and cell lines, especially in KRAS-mutant cases and correlated with poor prognosis. MUC5AC gene silencing resulted in reduced cell proliferation, invasion and migration. Furthermore, knockdown of MUC5AC led to reversion of the epithelial-mesenchymal transition. Additionally, downregulation of MUC5AC reduced tumourigenesis in mouse models. Finally, we found an antagonistic role between Sp1 and p53 in the regulation of MUC5AC gene expression. Our findings suggest that high MUC5AC expression promotes tumourigenesis and progression of lung ADC. Both p53 gene inactivation and Sp1 overexpression in lung ADC may enhance MUC5AC expression, especially in KRAS-mutated cases. Given the paucity of efficient drug-targeted approaches of KRAS-driven lung ADCs, therapies directed at downstream effectors such as MUC5AC could have huge prospects.

[Current status of oral health literacy and its influencing factors among adult orthodontic patients].

PURPOSE: To investigate the current status of oral health literacy among adult orthodontic patients and analyze its influencing factors. METHODS: Totally 163 adult orthodontic patients were recruited by convenience sampling method from November 2021 to February 2022 at the Department of Oral and Craniomaxillofacial Surgery, Center of Craniofacial Orthodontics in Shanghai Ninth People's Hospital. General information questionnaire, Chinese version of Health Literacy in Dentistry (HeLD-14), Chinese version of Self-Efficacy Scale for Self-care (SESS) and Social Support Rating Scale (SSRS) were applied. SPSS 21.0 software package was used for data analysis. RESULTS: The mean score of oral health literacy in adult orthodontic patients was (48.74±5.54), and the lowest score were obtained in concern (6.80±1.19) and support (6.40±1.59) dimensions. Multiple stepwise regression analysis showed that adult orthodontic patients' consultation self-efficacy, social support utilization, family or friends' orthodontic history and objective support were the influencing factors of oral health literacy. CONCLUSIONS: The oral health literacy in adult orthodontic patients is at a middle to high level, but concern and support literacy need to be improved. Strengthening consultation self-efficacy, objective support and utilization of social support can improve adult orthodontic patients' oral health literacy. Attention should be paid to patients who have no relatives or friends with history of orthodontic treatment.

Study of the Reliability of Field Test Methods for Physical Fitness in Children Aged 2-3 Years.

Physical fitness measures overall physical health. It is the ability of the body to work effectively and stay healthy during leisure and emergencies. Given the progressive integration of 2-3-year-olds into preschool, physical fitness testing of these children has become increasingly important. We aimed to develop and test the reliability of an appropriate field test method for physical fitness in 2-3-year-olds children. One hundred and three children (44 boys and 59 girls) volunteered for this study. Their height and weight were tested, and the same tester conducted the test twice for handgrip strength, 3 m balance walking, stair climbing, 5 m run, and kicking a ball at one-minute intervals. Pearson correlation coefficient and intraclass correlation coefficient (ICC) were used for reliability testing. The reliability of this field test method for physical fitness was high in the repetitive tests of Chinese 2-3-year-olds for the four items of handgrip strength, 3 m balance walking, stair climbing and 5 m run, and the reliability was moderate for the kicking the ball item. This study indicates that these field-based physical fitness test methods have good reliability and are simple, feasible, safe, and easy to be accepted and understood by 2-3-year-old children; thus, it may be used as a reference for professionals in China and abroad.

Combined Surgical-Orthodontic Treatment of Patients With Severe Parry-Romberg Syndrome.

ABSTRACT: Parry-Romberg syndrome (PRS) refers to a relatively rare dysfunction disease that is characterized by chronic progressive maxillofacial atrophy, especially one side of facial skin, subcutaneous tissue, muscle, and bone. According to the atrophy degree of skin, subcutaneous tissue, and skeleton in the area innervated by the trigeminal nerve, PRS can be classified into mild, moderate, and severe. In general, cases with different severity have specific treatment regimens. For mild and moderate cases, soft tissue augmentation techniques are the optimal strategy for aesthetic reconstruction. In this study, the authors report a 19-year-old female with severe PRS. Considering the severity of the case, a combined surgical and orthodontic treatment was performed, which was involved in alveolar bone augmentation, preoperative and postoperative orthodontic treatment in combination with orthognathic surgery, medpor filling of zygomatic and maxillary complex, free fat grafting, as well as angulus oris and lip trimming. Comprehensive treatment is recommended for severe cases with extensive atrophy of soft tissue and craniofacial bone, obvious deviation of the chin and occlusal plane.

[Analysis of information needs of patients with dentofacial deformities at different stages of treatment].

PURPOSE: To investigate the treatment experience and information needs of patients with dentofacial deformities in the process of surgical program design, surgical treatment and postoperative rehabilitation. METHODS: Thirty-six patients with dentofacial deformities at different treatment stages from March to July 2019 were selected for semi-structured interview. Colaizzi content analysis method and QSR NVivo 12.0 software were used to analyze and code the data, as well as extract the theme and genus. RESULTS: Three themes and eight categories were extracted, including① information needs in different treatment stages, mainly specific content of information needs at pre-operative preparation stage, orthognathic perioperative stage and post-operative rehabilitation stage; ② information support methods, i.e., diversified information support methods and patients' recognition of internet information;③ patients' cognition difference,namely the difference between patients' psychological expectation and the results of operation. CONCLUSIONS: Due to the treatment characteristics of orthognathic surgery and individual cognitive differences of patients, there is a large demand for information support at different stages of treatment. However, the current information support mode is limited, so it is necessary to further improve and provide scientific, professional and targeted information support for patients with dentofacial deformities.

Rapid BMI Increases and Persistent Obesity in Small-for-Gestational-Age Infants.

Purpose: In order to compensate for the early intrauterine growth restriction, small-for-gestational age (SGA) infants have "catch-up growth" after birth. Increased caloric intake has been suggested for SGA infants conventionally. It is important to determine if the early growth rate of body mass index (BMI) is associated with risk of persistent obesity later in life. In this longitudinal cohort study, we assessed the BMI of a large cohort of children who were SGA at birth to determine their risk of persistent obesity at school age (6-7 years) due to excessive weight gain in the first 3 years of life. Methods: We collected the height and weight data of 23,871 SGA babies. A polynomial function was used to fit the BMI-for-age z-score (BAZ) values of 0-6 years old SGA children and interpolate their growth trajectory. In addition, we screened out 6,959 children from 23,871 children to further evaluate the dynamic changes of early childhood BMI. We divided the school-age children into groups as non-obese (BAZ < 2) and obese (BAZ > 2), and determined the association between changes in BMI and school-age obesity. Results: From the perspective of BMI distribution, the interpolated growth trajectory indicated that SGA children reaching overweight status or developing obesity by 3 years of age, continued to have obesity until school age (R2, 0.65; R2, 0.21). The retrospective analysis showed that children who were overweight and had obesity during school age had a high BMI from early age. By analyzing the changes in early BMI, we found that the fastest growth of SGA children occurred in the early infancy before 6 months and they continued to grow rapidly for a period of time. Interestingly, former SGA children who maintained a near overweight (1 < BAZ < 2) status before the age of 2 maintained an appropriate growth rate and usually did not develop obesity. Conclusions: A rapid increase in BMI during early infancy in former SGA newborns leads to a persistent risk of obesity. The energy intake of SGA infants should appropriately meet the infants' growth needs and early BMI changes should be closely monitored for an optimal integrated management.

Eating Habits and Their Association with Weight Status in Chinese School-Age Children: A Cross-Sectional Study.

BACKGROUND: Poor eating habits increase children's risk of chronic diseases such as overweight and obesity, adult diabetes, and cardiovascular and cerebrovascular diseases. Therefore, this study aimed to examine the eating habits of school-age children and their impact on children's body mass index. METHODS: Multistage cluster sampling was used to sample 2224 students in grades 4 to 6 from 16 primary schools in Changsha. A self-designed questionnaire was used to collect general demographic, eating habit, and snack consumption data from school-age children. Height and weight were measured so that the body mass index Z-score could be calculated and evaluated according to the 2007 World Health Organization's Body Mass Index (BMI) reference standard. RESULTS: The prevalence rates of overweight and obesity in school-age children were 17.0% and 8.3%, respectively. Boys had higher rates of overweight and obesity than girls (19.9% vs. 13.6%, 12.9% vs. 3.0%, respectively, p < 0.05). Among the total population of children, 71.6% reported picky eating habits, and 55.1% had late-night snacks. Children who skipped breakfast (OR 1.507 and 95% CI 1.116~2.035) and ate puffed food (OR 1.571 and 95% CI 1.170~2.110) were more likely to be overweight/obese. CONCLUSIONS: The eating habits of school-age children are closely related to their weight status. Poor eating habits can be risk factors for overweight and obesity. The dietary management of children should be strengthened so that they develop good eating habits and the incidence of overweight and obesity in school-age children decreases.

[Qualitative study on the decision-making of orthognathic surgery in adult patients with malocclusion].

PURPOSE: The main purpose of this study was to explore the experience associated with patient's decision to have or not have orthognathic treatment. METHODS: Phenomenological methodology was used in this study. Ten patients were collected from January 2018 to March 2018, who were consulted in the Department of Oral and Craniomaxillofacial Surgery, Center of Craniofacial Orthodontics in Shanghai Ninth People's Hospital. They were interviewed by semi-structured, face to face in-depth interviews. Data were organized and analyzed by Colaizzi methods. RESULTS: By reading, analysis and extraction, two topics, i.e, motivation and interference factor were obtained. CONCLUSIONS: The treatment information service was limited. Further research is needed to improve the information services that support the treatment decision of malocclusion patients and help them to make the best choice.

Catalytic Role of Conserved Asparagine, Glutamine, Serine, and Tyrosine Residues in Isoprenoid Biosynthesis Enzymes.

We report the results of an investigation into the catalytic role of highly conserved amide (asparagine, glutamine) and OH-containing (serine, tyrosine) residues in several prenyltransferases. We first obtained the X-ray structure of cyclolavandulyl diphosphate synthase containing two molecules of the substrate analog dimethylallyl (S)-thiolodiphosphate (DMASPP). The two molecules have similar diphosphate group orientations to those seen in other ζ-fold (cis- head-to-tail and head-to-middle) prenyltransferases with one diphosphate moiety forming a bidentate chelate with Mg2+ in the so-called S1 site (which is typically the allylic binding site in ζ-fold proteins) while the second diphosphate binds to Mg2+ in the so-called S2 site (which is typically the homoallylic binding site in ζ-fold proteins) via a single P1O1 oxygen. The latter interaction can facilitate direct phosphate-mediated proton abstraction via P1O2, or more likely by an indirect mechanism in which P1O2 stabilizes a basic asparagine species that removes H+, which is then eliminated via an Asn-Ser shuttle. The universal occurrence of Asn-Ser pairs in ζ-fold proteins leads to the idea that the highly conserved amide (Asn, Gln) and OH-containing (Tyr) residues seen in many "head-to-head" prenyltransferases such as squalene and dehydrosqualene synthase might play similar roles, in H+ elimination. Structural, bioinformatics and mutagenesis investigations indeed indicate an important role of these residues in catalysis, with the results of density functional theory calculations showing that Asn bound to Mg2+ can act as a general (imine-like) base, while Gln, Tyr and H2O form a proton channel that is adjacent to the conventional (Asp-rich) "active site". Taken together, our results lead to mechanisms of proton-elimination from carbocations in numerous prenyltransferases in which neutral species (Asn, Gln, Ser, Tyr, H2O) act as proton shuttles, complementing the more familiar roles of acidic groups (in Asp and Glu) that bind to Mg2+, and basic groups (primarily Arg) that bind to diphosphates, in isoprenoid biosynthesis.

Insights into infancy weight gain patterns for term small-for-gestational-age babies.

BACKGROUND: Too fast or slow weight gain in infancy is bad for health in later life. In this study, we aim to investigate the optimal weight gain pattern during the first 2 y of life for term small-for-gestational-age (SGA) infants. METHOD: We employed data from a longitudinal, community-based cohort study on the growth and development of SGAs collected between 2004 and 2010 in Shanghai, China. Latent class growth analysis (LCGA) was applied to identify weight gain patterns among 3004 SGAs. BMI curves for each latent class from 1 mo to 5 y were produced through mixed-effects regression analysis. Multivariable regression was performed to examine the association between various classes and adverse outcomes (overweight/obesity/ malnutrition) during 2-5 y. RESULT: Five weight gain patterns aged 0-2 y of 3004 term SGAs were identified and labeled as follows--class 1: excessively rapid catch-up growth (10.7%); class 2: rapid catch-up growth (19.7%); class 3: appropriate catch-up growth (55.7%); class 4: slow catch-up growth (10.2%); class 5: almost no catch-up growth (3.7%). A decreasing age at adiposity rebound (AR) and an increasing BMI value were observed from class 5 to 1. Class 1 and 2 showed an early appearance of AR (< 4 y). SGAs in class 1 and 2 had a higher BMI in 2-5 y of life. After adjustment for potential confounding variables, class 1 and 2 were found to have an increased risk of being overweight/ obese. At the same time, we found the risk of malnutrition was especially prominent among SGAs in classes 4 and 5. CONCLUSION: Our results suggest that for term SGA infants, catch-up growth that crossing two centile levels, that is, from < 10th to the interval between 25th and 50th (ΔWAZ> 1.28) in the first several months, along with on track growth and maintenance at a median level by age 2 may be the optimal catch-up growth trajectory, minimizing risk of childhood adverse health outcomes.

The Crystal Structure of a Class of Cyclases that Catalyze the Cope Rearrangement.

Found recently in stignomatales, the Stig cyclases catalyze the Cope rearrangement and intramolecular cyclization to produce complex indole alkaloids. Five crystal structures were solved of subfamily 1 and 2 Stig cyclases, which adopt a ß-sandwich fold like the non-catalytic carbohydrate-binding motif. Several complex structures were also determined of indole-based compounds, which are bound to the hydrophobic terminal cavity, where a conserved Asp residue makes an H-bond to the indole N and triggers the acid-catalyzed Cope rearrangement. Through analyzing the enzyme-ligand interactions and mutagenesis experiments, several aromatic residues were found important in catalysis. Apart from a common substrate binding mode and catalytic mechanism, potential subfamily variations that may attribute to the different product specificity are implicated. These results shall expand our scope of enzymology, in particular for further investigation of the biosynthetic Cope rearrangement.

Growth of infants and young children born small for gestational age: growth restriction accompanied by overweight.

Objectives To compare growth profiles of children born small for gestational age (SGA) with those born the appropriate size for gestational age (AGA), and examine expected growth patterns for SGA in early childhood. Methods A survey on 23,871 SGA children was conducted in Shanghai. Data were collected at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, and 60 months of age (+30 days). A check-up included assessments of weight, height, and head circumference. Results At 5 years old, weight, height, and head circumference were lower in SGA children compared with AGA children. The proportions of overweight and obesity of SGA children at 4 to 18 months after birth were significantly higher than those in AGA children, with higher proportions in boys than in girls. There was no correlation between overweight at 5 years old and overweight before 2 years old in SGA children. Conclusions Children born SGA remain shorter and lighter, with a smaller head circumference at 5 years old compared with AGA children. At 4 to 18 months after birth, there is a high incidence of overweight and obesity in SGA children. Overweight and obesity in SGA boys are more serious than those in SGA girls.

"Head-to-Middle" and "Head-to-Tail" cis-Prenyl Transferases: Structure of Isosesquilavandulyl Diphosphate Synthase.

We report the first X-ray crystallographic structure of the "head-to-middle" prenyltransferase, isosesquilavandulyl diphosphate synthase, involved in biosynthesis of the merochlorin class of antibiotics. The protein adopts the ζ or cis-prenyl transferase fold but remarkably, unlike tuberculosinol adenosine synthase and other cis-prenyl transferases (e.g. cis-farnesyl, decaprenyl, undecaprenyl diphosphate synthases), the large, hydrophobic side chain does not occupy a central hydrophobic tunnel. Instead, it occupies a surface pocket oriented at 90° to the hydrophobic tunnel. Product chain-length control is achieved by squeezing out the ligand from the conventional allylic S1 binding site, with proton abstraction being achieved using a diphosphate-Asn-Ser relay. The structures revise and unify our thinking as to the mechanism of action of many other prenyl transferases and may also be of use in engineering new merochlorin-class antibiotics.

Structural insight into a novel indole prenyltransferase in hapalindole-type alkaloid biosynthesis.

FamD1 is a novel CloQ/NphB-family indole prenyltransferase which involves in hapalindole-type alkaloid biosynthesis. Here the native FamD1 structure and three protein-ligand complexes are analyzed to investigate the molecular basis of substrate binding and catalysis. FamD1 adopts a typical ABBA architecture of aromatic prenyltransferase, in which the substrate-binding chamber is found in the central ß-barrel. The indole-containing acceptor substrate is bound adjacent to the prenyl donor. Based on the complex structures, a catalytic mechanism of FamD1 is proposed. Functional implications on the sister enzyme FamD2 are also discussed.

Influencing factors of the neurodevelopment of high-risk infants.

BACKGROUND: High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life. AIMS: To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of high-risk infants. METHODS: High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up. The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment (0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted. RESULTS: 484 high-risk infants (male 51%, female 49%) with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was 2.1 (0.8) months, and the developmental quotient (DQ) scores of full-term high-risk infants in motor (t=3.542, p=0.001), cognitive (t=3.125, p=0.002), language (t=3.189, p=0.002) and social (t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor (χ2 =9.452, p=0.002), cognitive (χ 2 =6.258, p=0.012), language (χ 2 =12.319, p =0.001) and social (χ 2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%. CONCLUSION: The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment. Monitoring and early interventions help to improve high-risk infants' neurodevelopment.

Characterization and crystal structure of a novel zearalenone hydrolase from Cladophialophora bantiana.

Zearalenone (ZEN) is a mycotoxin which causes huge economic losses in the food and animal feed industries. The lactonase ZHD101 from Clonostachys rosea, which catalyzes the hydrolytic degradation of ZEN, is the only known ZEN-detoxifying enzyme. Here, a protein homologous to ZHD101, denoted CbZHD, from Cladophialophora batiana was expressed and characterized. Sequence alignment indicates that CbZHD possesses the same catalytic triad and ZEN-interacting residues as found in ZHD101. CbZHD exhibits optimal enzyme activity at 35°C and pH 8, and is sensitive to heat treatment. The crystal structure of apo CbZHD was determined to 1.75 Šresolution. The active-site compositions of CbZHD and ZHD101 were analyzed.

A Village-Based Intervention: Promoting Folic Acid Use among Rural Chinese Women.

BACKGROUND: Folic acid supplementation is effective in reducing the risk of neural tube defects (NTDs). However, the use of folic acid is low among rural women in China. Nutrition education can provide information about folic acid and encourage its use. The primary objective of this study was to test the effectiveness of a village-based nutrition intervention on folic acid use among rural women. METHODS: Sixty villages were randomly selected using multiple-stage sampling and were divided into control and intervention groups. The intervention included nutritional education at village clinics, written materials, and text messages (SMS). Folic acid use knowledge and behavior was assessed at baseline and after the intervention. RESULTS: Self-reported compliance with folic acid supplement use increased from 17.0%-29.2% at baseline to 41.7%-59.2% one year post-intervention. During the same period, the folic acid knowledge score in the intervention group increased from 3.07 to 3.65, significantly higher than the control group (3.11 to 3.35). Multivariate binary logistic regression showed that the women who received folic acid education and SMS intervention were more likely to comply with folic acid supplement recommendations. CONCLUSIONS: The results indicated that an integrated village-based folic acid education intervention may be an effective way of promoting folic acid use for the prevention of NTDs in rural women.

[Growth follow-up of infants born macrosomia at their life of 0 to 18 months].

OBJECTIVE: To study the growth of macrosomic infants, the incidence of overweight and the factors related to overweight at 18 months old. METHODS: Eighty-four macrosomic infants without underlying diseases were enrolled in this study. Their growth was followed up regularly. Factors related to overweight at 18 months old were investigated. RESULTS: Twenty infants (24%) showed as overweight at 18 months old. More male infants were overweight than female infants (30% vs 11%; P<0.05). The overweight infants at 18 months old had a higher proportion of overweight at 6 months (80% vs 22%; P<0.01) and at 12 months old (80% vs 13%; P<0.01) than non-overweight infants at 18 months. The spearman correlation analysis demonstrated that weight-for-length Z score at 18 months old was positively correlated with birth weight and weight gain between 0 to 6 months, 7 to 12 months and 13 to 18 months (P<0.05). The strongest correlation was observed between weight gain form 0 to 6 months and weight-for-length Z score at 18 months old (r=0.597, P<0.01). CONCLUSIONS: More attention should be given to the aspect of rapid weight gain in the first 6 months of life in macrosomic infants, especially males, to prevent obesity in early childhood.