Generation of gene-modified cynomolgus monkey via Cas9/RNA-mediated gene targeting in one-cell embryos.

Monkeys serve as important model species for studying human diseases and developing therapeutic strategies, yet the application of monkeys in biomedical researches has been significantly hindered by the difficulties in producing animals genetically modified at the desired target sites. Here, we first applied the CRISPR/Cas9 system, a versatile tool for editing the genes of different organisms, to target monkey genomes. By coinjection of Cas9 mRNA and sgRNAs into one-cell-stage embryos, we successfully achieve precise gene targeting in cynomolgus monkeys. We also show that this system enables simultaneous disruption of two target genes (Ppar-γ and Rag1) in one step, and no off-target mutagenesis was detected by comprehensive analysis. Thus, coinjection of one-cell-stage embryos with Cas9 mRNA and sgRNAs is an efficient and reliable approach for gene-modified cynomolgus monkey generation.

sc2MeNetDrug: A computational tool to uncover inter-cell signaling targets and identify relevant drugs based on single cell RNA-seq data.

Single-cell RNA sequencing (scRNA-seq) is a powerful technology to investigate the transcriptional programs in stromal, immune, and disease cells, like tumor cells or neurons within the Alzheimer's Disease (AD) brain or tumor microenvironment (ME) or niche. Cell-cell communications within ME play important roles in disease progression and immunotherapy response and are novel and critical therapeutic targets. Though many tools of scRNA-seq analysis have been developed to investigate the heterogeneity and sub-populations of cells, few were designed for uncovering cell-cell communications of ME and predicting the potentially effective drugs to inhibit the communications. Moreover, the data analysis processes of discovering signaling communication networks and effective drugs using scRNA-seq data are complex and involve a set of critical analysis processes and external supportive data resources, which are difficult for researchers who have no strong computational background and training in scRNA-seq data analysis. To address these challenges, in this study, we developed a novel open-source computational tool, sc2MeNetDrug (https://fuhaililab.github.io/sc2MeNetDrug/). It was specifically designed using scRNA-seq data to identify cell types within disease MEs, uncover the dysfunctional signaling pathways within individual cell types and interactions among different cell types, and predict effective drugs that can potentially disrupt cell-cell signaling communications. sc2MeNetDrug provided a user-friendly graphical user interface to encapsulate the data analysis modules, which can facilitate the scRNA-seq data-based discovery of novel inter-cell signaling communications and novel therapeutic regimens.

Proteins in Tumor-Derived Plasma Extracellular Vesicles Indicate Tumor Origin.

Cancer-derived extracellular vesicles (EVs) promote tumorigenesis, premetastatic niche formation, and metastasis via their protein cargo. However, the proteins packaged by patient tumors into EVs cannot be determined in vivo because of the presence of EVs derived from other tissues. We therefore developed a cross-species proteomic method to quantify the human tumor-derived proteome of plasma EVs produced by patient-derived xenografts of four cancer types. Proteomic profiling revealed individualized packaging of novel protein cargo, and machine learning accurately classified the type of the underlying tumor.

Analysis of Patient-Reported Outcomes After Breast Reconstruction: A Retrospective Study.

OBJECTIVE: This study aimed to investigate the effects of surgical timing, procedure, and age, on complication rates, health-related quality of life, and postoperative satisfaction, in patients who underwent breast reconstruction. METHODS: The data of 80 patients who underwent breast reconstruction surgery between August 2004 and June 2018 were reviewed. Patients were grouped according to surgical timing, procedure, and age. The evaluation indicators included complications and BREAST-Q scores. The statistical methods used included the Mann-Whitney U test and analyses of variance and covariance. RESULTS: The incidence of complications was 15.0% (12/80). The complication rates were similar in each group ( P > 0.05). The postsurgical scores of patient satisfaction with breast, psychosocial well-being, and sexual well-being were higher than the presurgical scores ( P < 0.05). The postoperative psychosocial and sexual well-being scores of patients in the immediate group were higher than those in the delayed group ( P < 0.05). The satisfaction with the outcome in the abdominal flap group was higher than that in the other group, whereas the sexual well-being score of the abdominal flap group was lower than that of the other group ( P < 0.05). The scores of the postoperative physical well-being of the chest and abdomen in the younger group were higher than that in the older group ( P < 0.05). CONCLUSIONS: Breast reconstruction can significantly improve patients' health-related quality of life and satisfaction. Immediate breast reconstruction can reduce the adverse psychological and physical effects that breast loss exerts on patients, leading to better postoperative satisfaction. Patients who underwent breast reconstruction with abdominal flaps had higher postoperative satisfaction. Breast reconstruction in elderly patients was associated with considerable postoperative satisfaction.

[Status of infant and young child feeding in China in 2016-2017].

OBJECTIVE: To describe the feeding status and related factors of infant and young child aged 6-23 months in China. METHODS: Data was from the China Nutrition and Health Surveillance among 0-17 Years Old Children and Lactating Women in 2016-2017, and 20 423 children aged 6-23 months were involved in 275 surveillance sites from 31 provinces(autonomous regions and municipalities). The introduction of solid, semi-solid or soft foods, minimum dietary diversity, minimum meal frequency were analyzed with WHO and UNICEF 2021 updated infant and young child feeding indicators. Data analyses were conducted using the complex weight based on national census from National Bureau of Statistics in 2010. Rao-Scott Chi-square was used test for statistical difference. RESULTS: The percentage of infants 6-8 months of age who consumed solid, semi-solid or soft foods was 83.2%(95%CI 80.5%-85.9%) in 2016-2017. No significant difference were observed between boys and girls; there was significant difference in different areas(Rao-Scott χ~2=30.85, P<0.01), it was 90.3% in medium and small cities, and reached 75.0% even in poor rural areas. The proportions of children aged 6-23 months meeting minimum dietary diversity(MDD) was 60.6%(95%CI 58.1%-63.1%). It was 71.1% in medium and small cities, and 50.5% in poor rural areas. Except for breast milk, the percentage of eggs(34.4%) and legumes(19.0%) consumption was low, the percentage of grains, vitamin A-rich fruits or vegetables consumption was 89.7%(95%CI 88.4%-91.1%). The percentage of consuming egg and/or flesh food was 76.4%(95%CI 74.2%-78.7%). The percentage of zero vegetables or fruits consumption was 9.1%(95%CI 7.8%-10.4%). The proportions of children aged 6-23 months meeting minimum meal frequency(MMF) was 72.4%(95%CI 70.1%-74.7%). It was over 70% in large cities, medium and small cities, general rural areas; and 60.2% in poor rural areas. The proportions of children aged 6-23 months meeting minimum acceptable diet was 43.4%(95%CI 40.7%-46.1%), it was over 50% in urban areas, and less than 40% in rural areas, 30.1% in poor rural areas. No consistent differences were observed between boys and girls for all 3 indicators(MDD, MMF and MAD), and there was significant difference in different areas and various months of age(P<0.01). CONCLUSION: There was no gender difference in the feeding status of children aged 6-23 months in China, the complementary feeding was relatively timely, and the minimum dietary diversity and meal frequency of children were relatively ideal, but the minimum acceptable diet of children in poor rural areas was poor.

[Breast milk intake of Chinese infants aged 0-5 months in 2019-2021].

OBJECTIVE: To describe the breast milk intake of infants aged 0-5 months in China and its trends, and to analyze the effects of feeding mode, gender and regions on breast milk intake. METHODS: Data were extracted from Ministry of Science and Technology's basic resource survey project "China's 0-18-year-old children's nutrition and health system survey and application" project. Caregivers were face to face interviewed to collect the basic information of infants. Weighing method was used to measure 24 hourly breast milk intake of infants aged 0-5 months in China. The rank sum test was used to compare the differences in breast milk intake between groups, the Spearman rank sum test was used to analyze the trend of breast milk intake with increasing age, and the general linear regression model was used to analyze the effects of gender and region on breast milk intake. RESULTS: The mean breast milk intake of exclusively breastfed infants aged 0-5 months was 800.1 g/d, ranging from 696.4 to 937.7 g/d. Breast milk intake increased with age and remained stable at 5 months(ß=29.6, P=0.009). There was a statistically significant difference in breast milk intake among infants in different month age groups(χ~2=17.96, P=0.003). Infants aged 0-5 months who are exclusively breastfed were fed 8 times in 24 hours, the breast milk intake per each time is 103.4-152.5 g, the duration of each feeding is 20.4-24.6 min, and the breast milk intake per minute is 4.4-7.0 g. Except for 5 months of age, there was no gender difference in the 24-hour breast milk intake of exclusively breastfed infants aged 0 to 4 months(P>0.05). Except for 4-month-old exclusively breastfed infants, there was no regional differences in the breast milk intake of others(t=-4.25, P<0.001). In the mixed feeding group, breast milk + complementary feeding group and breast milk + formula powder + complementary feeding group, the breast milk intake of infants aged 0-5 months were 341.1-496.7 g, 239.1-742.7 g and 90.0-508.0 g, respectively. CONCLUSION: In 2019-2021, infants aged 0-5 months in China Breast milk intake increased with age, and remained stable at 5 months. The breast milk intake of infants aged 0-5 months in different regions or genders is similar except for individual months. The introduction of formula or complementary food directly affects the intake of breast milk in infants.

Dual-Loaded Liposomes Tagged with Hyaluronic Acid Have Synergistic Effects in Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) is the most lethal subtypes of breast cancer. Although chemotherapy is considered the most effective strategy for TNBC, most chemotherapeutics in current use are cytotoxic, meaning they target antiproliferative activity but do not inhibit tumor cell metastasis. Here, a TNBC-specific targeted liposomal formulation of epalrestat (EPS) and doxorubicin (DOX) with synergistic effects on both tumor cell proliferation and metastasis is described. These liposomes are biocompatible and effectively target tumor cells owing to hyaluronic acid (HA) modification on their surface. This active targeting, mediated by CD44-HA interaction, allows DOX and EPS to be delivered simultaneously to tumor cells in vivo, where they suppress not only TNBC tumor growth and the epithelial-mesenchymal transition, but also cancer stem cells, which collectively suppress tumor growth and metastasis of TNBC and may also act to prevent relapse of TNBC.

Human milk cholesterol is associated with lactation stage and maternal plasma cholesterol in Chinese populations.

BACKGROUND: Milk cholesterol concentrations throughout lactation were analyzed, and the relationship between maternal plasma cholesterol and milk cholesterol in various Chinese populations was examined. METHODS: A sub-sample of 1138 lactating women was randomly selected from a large cross-sectional study in China (n = 6481). Milk cholesterol concentrations were determined by HPLC, and concentrations of maternal plasma lipids were determined by an automated biochemical analyzer. RESULTS: The mean cholesterol concentrations were 200, 171, and 126 mg/L for colostrum, transitional milk, and mature milk, respectively. Cholesterol concentrations differed significantly between stages of lactation (colostrum vs. transitional milk, colostrum vs. mature milk, transitional milk vs. mature milk, all p < 0.001). Concentrations of maternal plasma total cholesterol (TC) (p = 0.02) and low-density lipoprotein cholesterol (LDL-C) (p = 0.03) were significantly associated with milk cholesterol. Milk cholesterol concentrations varied among different ethnicities (Tibetan vs. Hui: 164 vs. 131 mg/L, p = 0.027) but not among different geographic regions. CONCLUSIONS: The concentration of cholesterol in human milk changes dynamically throughout lactation. Milk cholesterol concentrations are significantly associated with maternal plasma concentrations of TC and LDL-C, and milk cholesterol concentrations vary across ethnicities in China. IMPACT: Concentrations of milk cholesterol were measured in various Chinese populations. Cholesterol concentrations differ significantly between stages of lactation. Maternal plasma total cholesterol and low-density lipoprotein cholesterol are associated with milk cholesterol. Milk cholesterol concentrations vary across ethnicities in China.

Recent Advances of LncRNA H19 in Diabetes LncRNA H19 in Diabetes.

Diabetes mellitus (DM) causes damage to major organs, including the heart, liver, brain, kidneys, eyes, and blood vessels, threatening the health of the individuals. Emerging evidence has demonstrated that lncRNAs has important functions in the pathogenesis of human diseases, such as cancers, neurodegenerative diseases, cardiac fibroblast phenotypes, hypertension, heart failure, atherosclerosis and diabetes. Recently, H19, a lncRNA, has been reported to shown to participate in the regulatory process of muscle differentiation, glucose metabolism, and tumor metastasis, as well as endometrial development. However, the roles of H19 in DM were still not completely understood. This review was conducted to summarize the functions of H19 in diabetes and discuss the challenges and possible strategies of H19 in DM.

Does the Presence of Pathological Change in the Schneiderian Membrane Increase the Risk of Membrane Perforation During Sinus Floor Elevation? A Systemic Review.

A Schneiderian membrane (SM) thickness of >2 mm is regarded as a pathological mucosal change. The current study aimed to determine whether sinus floor elevation (SFE) in the presence of SM pathology increases the risk of membrane perforation and implant failure rate. MEDLINE, Embase, Cochrane Library, and CNKI, Wanfang, and VIP databases were systemically searched for studies published until February 2020. Randomized and nonrandomized studies reporting the incidence of SM perforation in patients with SM pathology (antral pseudocyst or mucosal thickening) during SFE were included. The outcome measures were the incidence of SM perforation and implant survival rate. The pooled odds ratio (OR) and 95% confidence intervals (CIs) were calculated using fixed-effects model. A P value ≤.05 was considered to be statistically significant. Eighteen studies with a total of 1542 patients and 1797 SFE were included. A nonsignificant difference in the incidence of SM perforation was observed between the normal-appearing sinus and thickened sinus mucosa (fixed effects; OR, 0.896; 95% CI, 0.504-1.59; P = .707, I2 = 32%). The rates of SM perforation in the normal sinus, mucosal thickening, and antral pseudocysts were 14%, 6%, and 6% respectively. The implant survival rate was 98% in the normal sinus and 100% in antral pseudocyst and mucosal thickening. SM thickening or antral pseudocysts did not increase the risk of membrane perforation or rate of implant failure. Additional randomized controlled trials are needed to evaluate the effect of pathological changes in the SM on the failure of bone augmentation and dental implants.

What are the determinants of low exclusive breastfeeding prevalence in China? A cross-sectional study.

Exclusive breastfeeding (EBF) status is far from the national target in China. To identify the modifiable factors associated with EBF of infants aged under 6 months in China. A cross-sectional study was conducted in 12 provinces/municipalities across China in 2017-2018. We used multistage stratified cluster sampling and collected data through face-to-face interviews with mothers using an electronic questionnaire. Totally, 5287 pairs of mother-infant aged <6 months were investigated. The EBF prevalence was 29.2% (1544/5287). Mothers with correct knowledge of colostrum (adjusted odds ratio [AOR]:1.32, 95% confidence interval [CI]: 1.07, 1.62), EBF (AOR: 1.39, 95% CI: 1.06, 1.81) and the highest scores of perceptions for breastfeeding benefits (AOR: 1.36, 95% CI: 1.14, 1.61) were more likely to exclusively breastfeed. However, mothers with more frequent unwillingness of breastfeeding during the first month postpartum were less likely to practice EBF (AOR: 0.68, 95% CI: 0.52, 0.90). Infants having their first breast milk within 24 h of birth increased the odds of EBF (AOR: 2.41, 95% CI: 1.86, 3.13). Infants were less likely to be exclusively breastfed in the families in which the main caregiver was the grandmothers. Mothers without receiving infant formula feeding suggestions via the health facilities, media, or the Internet (AOR: 1.57, 95% CI: 1.33, 1.85) or without the experience of infant formula feeding in public (AOR: 1.45, 95% CI: 1.23, 1.72) might more likely to practice EBF. To acquire comprehensively correct knowledge and keep a positive attitude of breastfeeding for the mothers are crucial for improving the EBF prevalence. Family supports are potential interventions worth focusing on. Infant formula promotion remains a great barrier for EBF in China.

[Gestational weight gain and associated factors of Chinese women in the second and third trimester of pregnancy in 2015].

OBJECTIVE: To describe gestational weight gain status of pregnant women in China, and to explore potential factors related to gestational weight gain of pregnant women in the 2 nd and 3 rd trimester in 2015. METHODS: Participants were from Chinese National Nutrition and Health Surveillance in 2012 and in 2015. Using a multi-stage stratified cluster random sampling method, a total of 8512 pregnant women were recruited in 2015. A standard questionnaire was used to collect general information and pre-pregnancy weight. Body weight and height of pregnant women were measured using a unified weighing scale and stadiometer. RESULTS: In 2015, the prevalences of underweight, normal weight, overweight and obesity in pre-pregnancy were 16.0%, 66.0%, 14.9%, 3.1% according to Chinese BMI standard, respectively. In the 2 nd trimester, the prevalences of inadequate gestational weight gain, appropriate gestational weight gain and excess gestational weight gain were 14.6%, 27.2% and 58.2% based on IOM gestational weight gain standard, respectively. In the 3 rd trimester, the prevalences of inadequate gestational weight gain, appropriate gestational weight gain and excess gestational weight gain were 12.7%, 31.5%, 55.8% based on IOM gestational weight gain standard, respectively. The odds of excess gestational weight gain was 1.53(95%CI 1.19-1.99) in the second trimester, and 2.05(95% CI 1.59-2.63) in the third trimester for overweight women, compared to normal weight women during pre-pregnancy. The prevalence of excess gestational weight gain showed an increasing trend in both urban and rural areas, which was not related to pregnant women's age and education. Second parity might be a protective factor for appropriate weight gain in late pregnancy. CONCLUSION: Compared to 2012, the prevalence of underweight before pregnancy and inadequate gestaional weight gain decreased in 2015. By contrast, the prevalence of overweight, obesity and excess gestational weight gain showed an upward trend.

[Concentration of osteopontin in human milk and associated factors in Chinese populations from 2011 to 2013].

OBJECTIVE: To analyze content of human milk osteopontin(OPN) and to explore associated factors in Chinese populations. METHODS: The samples and data were extracted from the database for human milk composition in China between 2011 and 2013. A sub-sample of 459 mothers was randomly selected after stratification according to lactation stage, and human milk OPN concentrations were determined by ultra performance liquid chromatography-tandem mass spectrometer(UPLC/MS). RESULTS: The average OPN concentration(M(P25, P75)) in breast milk was 44.0(30.1-72.0) mg/L within 0-330 days postpartum. OPN concentrations were independent of lactation stage, which were 45.6(31.8, 80.7) mg/L in colostrum, 41.3(29.2, 70.0) mg/L in transitional milk and 46.9(30.2, 71.9) mg/L in mature milk, corresponding to 0.40%、0.42% and 0.65% of the total milk protein content(OPN/protein%). The percentage of OPN to total protein in milk showed an increasing trend with lactation progression(r=0.21, P<0.001). Multivariate analysis showed that sleep quality of mothers within one week prior to milk collection was correlated with the breast milk OPN level(P=0.04). The OPN level in breast milk from mothers with good sleep quality was significantly higher than that from mothers with poor sleep quality(46.5 mg/L vs.34.7 mg/L). The median level of milk OPN concentration in mothers from Yunnan was higher than mothers from Beijing(50.5 mg/L vs.36.1 mg/L, P=0.03). Maternal age, mode of delivery, prepregnancy body mass index, weight gain during pregnancy, passive smoking and outdoor activities 24 hours prior to milk collection were not correlated with milk OPN concentration. OPN concentration in breast milk was not related to preterm birth. Also, milk OPN concentration did not correlate with diarrhoea, respiratory disease, or allergic disease in infants during two weeks before milk collection. CONCLUSION: The concentration of OPN in breast milk of Chinese woman may be similar among different lactation stages. Geographic region and sleep quality of mothers may be related to the milk OPN concentration.

[Prevalence and risk factors for anemia of Chinese lactating women in 2013].

OBJECTIVE: To investigate the prevalence of anemia and its risk factors for lactating women in China. METHODS: Data was extracted from Chinese National Nutrition and Health Surveillance-Mothers for children under 2 years of age(2013). Totally, 11 178 mothers of children under 2 years old were selected from 55 counties of 30 provinces in China by using the multi-stage stratified cluster randomization sampling method. Among these women 7129 are lactating. The basic information of lactating women was collected through the questionnaire survey. Hemoglobin concentration was measured by photometric determination of haemiglobincyanide(HiCN) method. Participants without blood sample and basic information were excluded. Finally, 6255 lactating women were included in the analysis. Complex sampling method with weighted analysis was used. RESULTS: Totally, with a complex sampling method with weighted analysis, the prevalence of anemia for lactating women was 9.3%. The mean hemoglobin level was(136.1±0.9) g/L. The mild and moderate anemia accounted for 98.8% of all anemic cases. Compared with those lactating time<6 months, lactating time between 6 to 12 months had a lower risk of anemia(OR=0.74, 95%CI 0.61-0.90). Compared with those living in large cities, the maternal living in poor rural areas had a higher risk of anemia(OR=1.69, 95%CI 1.29-2.20). CONCLUSION: In 2013, the prevalence of anemia was mild for the lactating women in China. Lactating women in poor rural areas, within 6 months after deliveryhad the higher risk for anemia.

[Nutritional status of vitamin B_(12) and its influence factors in Chinese lactating women in 2013].

OBJECTIVE: To examine the vitamin B_(12) status of lactating women in China and to analyze the factors affecting the level of serum vitamin B_(12) in these subjects. METHODS: Participants were from the Chinese National Nutrition and Health Surveillance in 2013. By multi-stage stratified cluster randomly sampling method, 10 331 lactating women were selected from 55 counties of 30 provinces in China. Questionnaire was conducted to collect the basic information of lactating women and the dietary intake of them in the past one month was collected by food frequency questionnaire. A total of 20% of the total number of lactating women(a total of 1976) were randomly selected to analyze serum vitamin B_(12) by electro-chemiluminescence immunoassay method. Serum vitamin B_(12) deficiency was defined as a serum vitamin B_(12) level<200 pg/mL. The distribution of serum vitamin B_(12 )was lognormal, a generalized linear model was used to analyze the factors affecting the serum vitamin B_(12) level after logarithm transformation of it. RESULTS: The median of serum vitamin B_(12)(P25, P75) in lactating women was 469. 0(349. 0, 633. 5)pg/mL, the prevalence of vitaminB_(12) deficiency was 2. 7%(53/1976)and marginal deficiency rate was 12. 8%. With the increase of the education level of the lactating women the rate of vitamin B_(12) deficiency decreased gradually. The rate of vitamin B_(12 )deficiency of the lactating women presented regional differences and varied significantly among different regionals, education levels and the mothers who were breastfeeding or not. The value of serum vitamin B_(12 )was analyzed by generalized linear regression model showed that the levels of serum vitamin B_(12) in general rural counties and medium-sized or small cities were 1. 07 and 1. 13 times higher than those in poor rural areas, respectively. The serum vitamin B_(12) level of non-lactating women was 1. 08 times higher than that of lactating women. The serum vitamin B_(12 )level of the lactating women with junior high school level or below was significantly lower than that of the lactating women with college education and university education level, 88. 3% and 85. 0% of the lactating women with college education and university education, respectively. Serum vitamin B_(12) levels were positively correlated with intake of livestock meat, fish and seafood. CONCLUSION: The status of vitamin B_(12) in lactating women in China is good. Our findings suggest that some regionals, education levels, breastfeeding or not and livestock meat, fish meat and seafood supplement may be associated with serum vitamin B_(12 )in lactating women.

[Relationship between household safe drinking water, hygienic toilet and prevalence of stunting for Chinese children aged 0 to 5 years old in 2013].

OBJECTIVE: To investigate the relationship between household drinking water, toilet status and the prevalence of stunting for Chinese children aged 0 to 5 years old in 2013. METHODS: Data was extracted from the Chinese National Nutrition and Health Surveillance in 2013. A total of 32 861 children aged 0 to 5 years old were selected from 165 townships(streets) of 55 counties(cities/districts) in 30 provinces. Caregivers were face to face interviewed to collect data, including demographic characteristics of children, mothers and household, main source of household drinking water and main type of household toilet. Height/Length of children was measured using a standard procedure. Height(Length) for age Z score(HAZ(LAZ)) was calculated using WHO Anthro Survey Analyser software(online version), and stunting was defined as HAZ(LAZ)<-2. SAS 9. 4 was used to analyze. SURVEYFREQ procedure was used to calculate the coverage rate of safe drinking water, hygienic toilet, and the prevalence of stunting. SURVEYLOGISTIC procedure was used to analyze the relationship between household safe drinking water, hygienic toilet and prevalence of stunting for Chinese children aged 0 to 5 years old in 2013. RESULTS: A total of 32 861 children completed the study. The coverage rate of safe drinking water was 86. 9%. The proportion of water piped into household, a public tab and water from a protected spring or well was 49. 4%, 15. 9% and 15. 6%, respectively. The coverage rate of hygienic toilet was 56. 8%. The proportion of pour-flush toilet and pit latrine were 52. 1% and 4. 7%. The prevalence of stunting for 0 to 5 years old children was 8. 1% in China. The prevalence of stunting were 8. 1% for children aged 0-5 years old with safe household drinking water and 7. 8% for those without safe household drinking water. The difference was not significant(P=0. 882). The prevalence of stunting was 6. 6% for children aged 0-5 years old with hygienic household toilet and 10. 0% for those without hygienic household toilet. The difference was not significant(P=0. 069). There was no significant relationship between household sanitary condition and stunting for children aged 0 to 5 years old. CONCLUSION: Household sanitary conditions, including main source of household drinking water and the main type of household toilet may not be associated with the prevalence of stunting for children aged 0 to 5 years old in this settings.

A Liposomal Formulation for Improving Solubility and Oral Bioavailability of Nifedipine.

Proliposomes were used to improve the solubility and oral bioavailability of nifedipine. Nifedipine proliposomes were prepared by methanol injection-spray drying method. The response surface method was used to optimize formulation to enhance the encapsulation efficiency (EE%) of nifedipine. The particle size of nifedipine proliposomes after rehydration was 114 nm. Surface morphology of nifedipine proliposomes was observed by a scanning electron microscope (SEM) and interaction of formulation ingredients was assessed by differential scanning calorimetry (DSC). The solubility of nifedipine is improved 24.8 times after forming proliposomes. In vitro release experiment, nifedipine proliposomes had a control release effect, especially in simulated gastric fluid. In vivo, nifedipine proliposomes significantly improved the bioavailability of nifedipine. The area under the concentration-time curve (AUC0-∞) of nifedipine proliposomes was about 10 times than nifedipine after oral administration. The elimination half-life (T1/2ß) of nifedipine was increased from 1.6 h to 6.6 h. In conclusion, proliposomes was a promising system to deliver nifedipine through oral route and warranted further investigation.

Visualization of Higher-Order Topological Insulating Phases in Two-Dimensional Dielectric Photonic Crystals.

The studies of topological phases of matter have been developed from condensed matter physics to photonic systems, resulting in fascinating designs of robust photonic devices. Recently, higher-order topological insulators have been investigated as a novel topological phase of matter beyond the conventional bulk-boundary correspondence. Previous studies of higher-order topological insulators have been mainly focused on the topological multipole systems with negative coupling between lattice sites. Here we experimentally demonstrate that second-order topological insulating phases without negative coupling can be realized in two-dimensional dielectric photonic crystals. We visualize both one-dimensional topological edge states and zero-dimensional topological corner states by using the near-field scanning technique. Our findings open new research frontiers for photonic topological phases and provide a new mechanism for light manipulating in a hierarchical way.

The association between pancreas steatosis and metabolic syndrome: A systematic review and meta-analysis.

OBJECTIVES: Pancreas steatosis is the description of fat accumulation in the pancreatic gland. The prevalence and development mechanisms of pancreatic steatosis in patients with metabolic disorders still remain unclear. The aim of this study is to systematically review the association between pancreatic steatosis and metabolic co-morbidities. METHODS: We performed a systematic search strategy using three electronic databases (MEDLINE, Scopus, and Embase) for relevant studies concerning the associations of pancreatic steatosis with metabolic syndrome (MetS) and its clinical relevance from inception until 30 September 2018. RESULTS: One thousand three hundred fifty one references were identified in the initial search, and a total of 13 studies involving 49 329 subjects were included. This analyses elucidated the presence of non-alcoholic fatty pancreas disease (NAFPD) and was associated with a significant increased risk of metabolic syndrome (RR = 2.25; 95% CI, 2.00-2.53; P < 0.0001; I2  = 42.8%; eight studies included), hypertension (RR = 1.43; 95% CI, 1.08-1.90; P = 0.013; I2  = 94.7%; nine studies included), non-alcoholic fatty liver disease (NAFLD) (RR = 2.49; 95% CI, 2.06-3.02; P < 0.0001; I2  = 96.9%; nine studies included), diabetes mellitus (RR = 1.99; 95% CI, 1.18-3.35; P = 0.01; I2  = 97.6%; 10 studies included), and central obesity (RR = 1.91; 95% CI, 1.67-2.19; P < 0.0001; I2  = 95.9%; six studies included). The association between NAFPD and hyperlipidaemia was not statistically significant (RR = 1.33; 95% CI, 0.82-2.17; P = 0.249; I2  = 97%; five studies included). CONCLUSIONS: The existing evidence indicates that NAFPD is significantly associated with an increased risk of metabolic syndrome and its components. Well-designed prospective cohort studies between pancreatic steatosis and MetS are needed to elaborate the causality in the future.

A Single-center Retrospective Cohort Study on Cesarean Section under General Anesthesia.

Objective Neuraxial block is the most common anesthesia method for cesarean section (CS). However, for some urgent and high-risk cesarean delivery, general anesthesia (GA) also plays a very important role. We aimed to find out the reasons of choosing GA for CS in our center and the factors that may be related to the maternal and fetal outcomes.Methods We retrospectively selected parturients who had CS procedures under GA in Peking Union Medical College Hospital from January 1, 2014 to December 31, 2016. Clinical data (baseline maternal status, preoperative status, perioperative information, maternal and fetal outcomes) of parturients and neonates were collected and analyzed. We summarized the common reasons for applying general anesthesia, and compared the back-to-ICU ratio and hospital stay time between parturients with different maternal American Society of Anesthesiologists (ASA) grade, gestational weeks and intraoperative blood loss, as well as the fetal one-minute Apgar score between different maternal ASA grade and gestational weeks.Results There were 98 cases of CS under GA enrolled in the study. Among the maternal and fetal factors, pregnancy with internal or surgical diseases is the most common reason (59 cases, 60.2%) for choosing GA, followed by the placenta and fetal membrane abnormalities (38 cases, 38.8%) and the pregnancy-specific disorders (36 cases, 36.7%). ASA grade Ⅲ-Ⅳ of parturients (χ 2=44.3, P<0.05), gestation period < 37 weeks (χ 2=23.4, P<0.05), and blood loss > 800 ml (χ 2=5.5, P<0.05) were related to the higher postoperative intensive care unit (ICU) rate in parturients. ASA grade Ⅲ-Ⅳ of parturients (t=-2.99, P<0.05), gestation period < 37 weeks (t=2.47, P<0.05) were related to the longer hospital stay. ASA grade Ⅲ-Ⅳ of parturients (t=2.21, P=0.01) and gestation period < 37 weeks (t=-3.21, P=0.002) were related to the lower one-minute Apgar score of neonates. Conclusion Pregnancy with internal or surgical diseases is the most common reason for choosing GA for CS. High ASA grade and short gestation period were the related factors of high postoperative ICU ratio for parturients and low one-minute Apgar score for neonates.