Associations of Plasma and Fecal Metabolites with Body Mass Index and Body Fat Distribution in Children.

CONTEXT: Childhood obesity continues to be a critical public health concern with far-reaching implications for the well-being. OBJECTIVE: This study aimed to investigate the association between metabolites in plasma and feces and indicators including body mass index (BMI), BMI for age Z score (BMIZ), and body fat distribution among children aged 6-9 years in China. METHODS: This cross-sectional study enrolled 424 healthy children, including 186 girls and 238 boys. Dual-energy X-ray absorptiometry (DXA) was used to determine the body fat content and regional fat distribution. Plasma and fecal metabolites were analyzed using targeted metabolomic technologies. RESULTS: A total of 200 plasma metabolites and 212 fecal metabolites were accurately quantified via ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS). By using Orthogonal Projections to Latent Structures Discriminant Analysis (OPLS-DA) and random forest model, we discovered that 9 plasma metabolites and 11 fecal metabolites were associated with different weight statuses. After adjusting for potential covariates and false discovery rate (FDR) correction, multiple linear regression analyses revealed that plasma metabolites (fumaric acid, glycine, l-glutamine, methylmalonic acid, and succinic acid) and fecal metabolites (protocatechuic acid) were negatively associated (ß: -1.373--0.016, pFDR: <0.001-0.031; ß: -1.008--0.071, pFDR: 0.005-0.033), while plasma metabolites (isovaleric acid, isovalerylcarnitine, l-glutamic acid, and pyroglutamic acid) and fecal metabolites (3-aminoisobutanoic acid, butyric acid, N-acetylneuraminic acid, octanoylcarnitine, oleoylcarnitine, palmitoylcarnitine, stearoylcarnitine, taurochenodesoxycholic acid, and taurodeoxycholic acid) exhibited positive associations with BMI, BMIZ, and body fat distribution (ß: 0.023-2.396, pFDR: <0.001; ß: 0.014-1.736, pFDR: <0.001-0.049). CONCLUSION: Plasma and fecal metabolites such as glutamine may serve as a potential therapeutic target for the development of obesity.

Mucosal vaccines for viral diseases: Status and prospects.

Virus-associated infectious diseases are highly detrimental to human health and animal husbandry. Among all countermeasures against infectious diseases, prophylactic vaccines, which developed through traditional or novel approaches, offer potential benefits. More recently, mucosal vaccines attract attention for their extraordinary characteristics compared to conventional parenteral vaccines, particularly for mucosal-related pathogens. Representatively, coronavirus disease 2019 (COVID-19), a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), further accelerated the research and development efforts for mucosal vaccines by thoroughly investigating existing strategies or involving novel techniques. While several vaccine candidates achieved positive progresses, thus far, part of the current COVID-19 mucosal vaccines have shown poor performance, which underline the need for next-generation mucosal vaccines and corresponding platforms. In this review, we summarized the typical mucosal vaccines approved for humans or animals and sought to elucidate the underlying mechanisms of these successful cases. In addition, mucosal vaccines against COVID-19 that are in human clinical trials were reviewed in detail since this public health event mobilized all advanced technologies for possible solutions. Finally, the gaps in developing mucosal vaccines, potential solutions and prospects were discussed. Overall, rational application of mucosal vaccines would facilitate the establishing of mucosal immunity and block the transmission of viral diseases.

Response of dissolved carbon dioxide and methane concentration to warming in shallow lakes.

Shallow lake ecosystems are highly sensitive to temperature fluctuation because of their high water surface-to-volume ratios. Shallow lakes have been increasingly identified as a hotspot of CO2 and CH4 emissions, but their response to temperature variation remains unclear. Here, we report from a 5-month outdoor mesocosm experiment where we investigated the impacts of a projected 3.5 °C future warming and monthly temperature changes on lake CO2 and CH4, as well as the key drivers affecting the lake carbon cycling. Our results show that CO2 and CH4 concentrations had a significantly positive correlation with monthly temperatures. CH4 concentration was primarily regulated by monthly temperature, while nutrients effects on CO2 concentration overrode climate warming and temporal temperature changes. These findings imply the varied roles that temperature and nutrient levels can play on CO2 and CH4 dynamics in shallow lake systems. The relationship between temperature and CO2 concentration was nonlinear, showing a threshold of approximately 9 °C, at which CO2 concentration could be strongly modified by nutrient level in the lake systems. Understanding this complex relationship between temperature with CO2 and CH4 concentrations in shallow lakes is crucial for effective lake management and efficient control of greenhouse gases (GHGs) emissions.

Diel variability of carbon dioxide concentrations and emissions in a largest urban lake, Central China: Insights from continuous measurements.

Accurately quantifying the carbon dioxide (CO2) emissions from lakes, especially in urban areas, remains challenging due to constrained temporal resolution in field monitoring. Current lake CO2 flux estimates primarily rely on daylight measurements, yet nighttime emissions is normally overlooked. In this study, a non-dispersive infrared CO2 sensor was applied to measure dissolved CO2 concentrations over a 24-h period in a largest urban lake (Tangxun Lake) in Wuhan City, Central China, yielding extensive data on diel variability of CO2 concentrations and emissions. We showed the practicality and efficiency of the sensor for real-time continuous measurements in lakes. Our findings revealed distinct diurnal variations in CO2 concentrations (Day: 38.58 ± 23.8 µmol L-1; Night: 42.01 ± 20.2 µmol L-1) and fluxes (Day: 7.68 ± 10.34 mmol m-2 d-1; Night: 9.68 ± 9.19 mmol m-2 d-1) in the Tangxun Lake. The balance of photosynthesis and respiration is of utmost importance in modulating diurnal CO2 dynamics and can be influenced by nutrient loadings and temperature. A diel variability correction factor of 1.14 was proposed, suggesting that daytime-only measurements could underestimate CO2 emissions in urban lakes. Our data suggested that samplings between 11:00 and 12:00 could better represent the average diel CO2 fluxes. This study offered valuable insights on the diel variability of CO2 fluxes, emphasizing the importance of in situ continuous measurements to accurately quantify CO2 emissions, facilitating selections of sampling strategies and formulation of management strategies for urban lakes.

Robust and Flame-Retardant Zylon Aerogel Fibers for Wearable Thermal Insulation and Sensing in Harsh Environment.

The exceptional lightweight, highly porous, and insulating properties of aerogel fibers make them ideal for thermal insulation. However, current aerogel fibers face limitations due to their low resistance to harsh environments and a lack of intelligent responses. Herein, a universal strategy for creating polymer aerogel fibers using crosslinked nanofiber building blocks is proposed. This approach combines controlled proton absorption gelation spinning with a heat-induced crosslinking process. As a proof-of-concept, Zylon aerogel fibers that exhibited robust thermal stability (up to 650 °C), high flame retardancy (limiting oxygen index of 54.2%), and extreme chemical resistance are designed and synthesized. These fibers possess high porosity (98.6%), high breaking strength (8.6 MPa), and low thermal conductivity (0.036 W m-1 K-1 ). These aerogel fibers can be knotted or woven into textiles, utilized in harsh environments (-196-400 °C), and demonstrate sensitive self-powered sensing capabilities. This method of developing aerogel fibers expands the applications of high-performance polymer fibers and holds great potential for future applications in wearable smart protective fabrics.

The analgesic effects and neural oscillatory mechanisms of virtual reality scenes based on distraction and mindfulness strategies in human volunteers.

BACKGROUND: Virtual reality (VR) has been widely used as a non-pharmacological adjunct to pain management. However, there is no consensus on what type of VR content is the best for pain alleviation and by what means VR modulates pain perception. We used three experiments to explore the analgesic effect of VR scenes in healthy adult volunteers. METHODS: We first compared the effect of immersive VR on pain perception with active (i.e. non-immersive, two-dimensional video) and passive (i.e. no VR or audiovisual input) controls at both subjective perceptual (Experiment 1) and electrophysiological (electroencephalography) levels (Experiment 2), and then explored possible analgesic mechanisms responsible for VR scenes conveying different strategies (e.g. exploration or mindfulness; Experiment 3). RESULTS: The multisensory experience of the VR environment lowered pain intensity and unpleasantness induced by contact heat stimuli when compared with two control conditions (P=0.001 and P<0.001, respectively). The reduced pain intensity rating correlated with decreased P2 amplitude (r=0.433, P<0.001) and increased pre-stimulus spontaneous gamma oscillations (r=-0.339, P=0.004) by 32-channel electroencephalography. A VR exploration scene induced a strong sense of immersion that was associated with increased pre-stimulus gamma oscillations (r=0.529, P<0.001), whereas a VR mindfulness meditation scene had a minor effect on immersive feelings but induced strong pre-stimulus alpha oscillations (r=-0.550, P<0.001), which led to a comparable analgesic effect. CONCLUSIONS: Distinct neural mechanisms are responsible for VR-induced analgesia, deepening our understanding of the analgesic benefits of VR and its neural electrophysiological correlates. These findings support further development of digital healthcare.

Intense methane diffusive emissions in eutrophic urban lakes, Central China.

Urban lakes are hotspots of methane (CH4) emissions. Yet, actual field measurements of CH4 in these lakes are rather limited and our understanding of CH4 response to urban lake eutrophication is still incomplete. In this study, we measured dissolved CH4 concentrations and quantified CH4 diffusion from four urban lakes in subtropical China during wet and dry seasons. We found that these lakes were constantly CH4-saturated, contributing the greenhouse gas (GHG) to the atmosphere. Nutrient enrichment significantly increased CH4 concentrations and diffusive fluxes. Average CH4 flux rate in the highly-eutrophic lake zones (4.18 ± 7.68 mmol m-2 d-1) was significantly higher than those in the mesotrophic (0.19 ± 0.18 mmol m-2 d-1) and lightly/moderately-eutrophic zones (0.72 ± 2.22 mmol m-2 d-1). Seasonally, CH4 concentrations and fluxes were significantly higher in the wet season than in the dry season in the mesotrophic and the lightly/moderately-eutrophic lake zones, but an inverse pattern existed in the highly-eutrophic lake zones. CH4 concentrations and fluxes increased with elevated levels of nitrogen, phosphorus and dissolved organic carbon (DOC). The accumulation of nutrients provided autochthonous substrate for methanogenesis, indicated by a negative correlation between CH4 and the C:N ratio. Ammonium-nitrogen (NH4+-N) was the best predictor for spatial fluctuation of CH4 concentrations and diffusive fluxes in the mesotrophic and the lightly/moderately-eutrophic lake zones, while total nitrogen (TN) and total phosphorus (TP) levels showed the highest predictability in the highly-eutrophic lake zones. Based on the findings, we conclude that nutrient enrichment in urban lakes can largely increase CH4 diffusion, and that urban sewage inflow is a key concern for eutrophication boosting CH4 production and diffusive emission. Furthermore, our study reveals that small urban lakes may be an important missing source of GHG emissions in the global C accounting, and that the ratio of littoral-to-pelagic zones can be important for predicting lake-scale estimation of CH4 emission.

Association of gut microbiota, plasma and fecal metabolite profiles with intellectual development in school-age children.

Background: Little is known about how the gut microbiota and metabolic profiles are related to cognitive outcomes in young children until now. It was hypothesized that the gut microbiota, the plasma and fecal metabolites significantly correlated with intelligence quotient (IQ) in school-age children in current study. Methods: This cross-sectional study enrolled 452 children aged 6-9 years old. IQ was measured using the Wechsler Intelligence Scale for Children-Fourth Edition. Fecal microbiota, plasma and fecal metabolites were analyzed using 16S rRNA amplicon sequencing and targeted metabolomic technologies, respectively. Results: Restricted maximum likelihood (REML) analyses showed that microbiota composition and fecal metabolites were associated with neither subscale nor full-scale IQ (P: 0.059-0.500). However, plasma metabolites were significantly correlated with the processing speed (P=0.008). In multiple regression analysis after adjusting for confounders and multiple test correction, benzoic acid, azelaic acid, adipic acid, suberic acid and malonic acid selected by the multivariate methods with unbiased variable selection were positively associated with processing speed index (PSI) [Pfalse discovery rate (FDR): 0.006-0.024], whereas pyruvic acid was negatively associated with the PSI and full-scale IQ (PFDR: 0.014-0.030). Conclusions: In normal school-age children, certain plasma metabolites concentrations but not the gut microbiota composition nor fecal metabolites are correlated with intelligence.

Translocator protein alleviates allodynia and improves Schwann cell function against diabetic peripheral neuropathy via activation of the Nrf2-dependent antioxidant system and promoting autophagy.

AIMS: In diabetes, autophagy and the nuclear factor erythroid-derived-2-like 2 (Nrf2)-dependent antioxidant system are impaired. Translocator protein (TSPO) agonist Ro5-4864 alleviates neuropathic pain, including diabetic peripheral neuropathy (DPN). However, the precise mechanisms remain unclear. Thus, we investigated the effects of Ro5-4864 on autophagy and the Nrf2-dependent antioxidant system in the sciatic nerves of DPN rats. METHODS: All rats were randomly assigned to Sham or DPN group. After type 2 diabetes modelling (established by high-fat diet and streptozotocin injection) followed by behavioural tests, established DPN rats were randomly assigned to the DPN group, the Ro (TSPO agonist Ro5-4864) group, the Ro + 3-MA (autophagy inhibitor) group and the Ro + ML385 (Nrf2 inhibitor) group. Behavioural assessments were performed at baseline, on days 3, 7, 14, 21 and 28. Sciatic nerves were collected on day 28 for immunofluorescence, morphological and western blot analyses. RESULTS: Ro5-4864 alleviated allodynia and increased myelin sheath thickness and myelin protein expression after DPN. Beclin-1 (p < 0.01) and LC3-II/LC3-I ratio (p < 0.01) decreased and p62 (p < 0.01) accumulated in the DPN rats. Ro5-4864 administration increased the Beclin-1 and LC3-II/LC3-I ratio and decreased p62 accumulation. Furthermore, nuclear Nrf2 contents (p < 0.01) and cytoplasmic HO-1 (p < 0.01) and NQO1 (p < 0.01) expressions were significantly inhibited in the DPN rat, which was also improved by Ro5-4864. All the beneficial effects were abrogated by 3-MA or ML385. CONCLUSION: TSPO exhibited a potent analgesic effect and improved Schwann cell function and regeneration against DPN by activating the Nrf2-dependent antioxidant system and promoting autophagy.

Erratum: [Corrigendum] Interpretation of HbA1c lies at the intersection of analytical methodology, clinical biochemistry and hematology (Review).

[This corrects the article DOI: 10.3892/etm.2022.11643.].

Determination of ß2-Agonist Residues in Fermented Ham Using UHPLC-MS/MS after Enzymatic Digestion and Sulfonic Resin Solid Phase Purification.

ß2-agonists are a class of synthetic sympathomimetic drugs with acute poisoning effects if consumed as residues in foods. To improve the efficiency of sample preparation and to overcome matrix-dependent signal suppression in the quantitative analysis of four ß2-agonists (clenbuterol, ractopamine, salbutamol, and terbutaline) residues in fermented ham, an enzyme digestion coupled cation exchange purification method for sample preparation was established using ultra-high performance liquid chromatography and tandem mass spectrometry (UHPLC-MS/MS). Enzymatic digests were subject to cleanup treatment on three different solid phase extraction (SPE) columns and a polymer-based strong cation resin (SCR) cartridge containing sulfonic resin was found to be optimal compared with silica-based sulfonic acid and polymer sulfonic acid resins based SPEs. The analytes were investigated over the linear range of 0.5 to 10.0 µg/kg with recovery rates of 76.0-102.0%, and a relative standard deviation of 1.8-13.3% (n = 6). The limit of detection (LOD) and the limit of quantification (LOQ) were 0.1 µg/kg and 0.3 µg/kg, respectively. This newly developed method was applied to the detection of ß2-agonist residues in 50 commercial ham products and only one sample was found to contain ß2-agonist residues (clenbuterol at 15.2 µg/kg).

Passive Daytime Radiative Cooling of Silica Aerogels.

Silica aerogels are one of the most widely used aerogels, exhibiting excellent thermal insulation performance and ultralow density. However, owing to their plenitude of Si-O-Si bonds, they possess high infrared emissivity in the range of 8-13 µm and are potentially robust passive radiative cooling (PRC) materials. In this study, the PRC behavior of traditional silica aerogels prepared from methyltrimethoxysilane (MTMS) and dimethyldimethoxysilane (DMDMS) in outdoor environments was investigated. The silica aerogels possessed low thermal conductivity of 0.035 W/m·K and showed excellent thermal insulation performance in room environments. However, sub-ambient cooling of 12 °C was observed on a clear night and sub-ambient cooling of up to 7.5 °C was achieved in the daytime, which indicated that in these cases the silica aerogel became a robust cooling material rather than a thermal insulator owing to its high IR emissivity of 0.932 and high solar reflectance of 0.924. In summary, this study shows the PRC performance of silica aerogels, and the findings guide the utilization of silica aerogels by considering their application environments for achieving optimal thermal management behavior.

CaCl2 promotes the cross adaptation of Reaumuria trigyna to salt and drought by regulating Na+, ROS accumulation and programmed cell death.

Reaumuria trigyna, a salt-secreting xerophytic shrub endemic to arid desert regions of northwest China, is extremely adaptable to salt and aridity. In this study, we used PEG to simulates drought stress and investigated the effect of NaCl and CaCl2 on R. trigyna seedlings exposed to drought stress. Exogenous application moderate NaCl and CaCl2 were found to stimulate the growth and alleviate drought stress in R. trigyna seedlings. Moderate NaCl and CaCl2 combined treatment increased fresh weight and decreased electrolyte leakage, and malondialdehyde (MDA) content in R. trigyna seedlings under drought stress. Simultaneously, leaf senescence and root damage induced by drought stress were alleviated, with programmed cell death (PCD) related genes expression down-regulated. Among them, the application of CaCl2 under drought and salt treatment is the most effective way to increase osmotic regulators content, antioxidant enzymes activities, and related genes expressions of plants under drought stress, which scavenged excess reactive oxygen species (ROS) and alleviated oxidative damage caused by drought stress. Meanwhile, CaCl2 can reduce the content of Na+and the ratio of Na+/K+ by promoting the outflow of Na+ and inflow of Ca2+, as well as the expression of ion transporter gene, and reduce the ionic toxicity caused by drought and salt cross adaptation. The principal component analysis (PCA) showed that the relevant beneficial indicators were positively correlated with the combined treatment. These results indicated that moderate NaCl can positively regulates defense response to drought stress in R. trigyna, while CaCl2 can significantly promote this process.

Oral application of magnesium-L-threonate enhances analgesia and reduces the dosage of opioids needed in advanced cancer patients-A randomized, double-blind, placebo-controlled trial.

PURPOSE: To investigate the effects of oral administration of magnesium-L-threonate, a novel magnesium compound, on the analgesic effect of opioids in patients with advanced cancer. METHODS: We performed a prospective, randomized, double-blind trial at a tertiary hospital in Shanghai, China. Eligible cancer patients who took opioids orally were assigned randomly to receive L-TAMS capsules (1.5 g or 2.0 g according to weight) or a placebo (starch capsules). The primary outcome was the increase in the daily oral dose of morphine in each of the two groups, measured at 7, 14, 21, 30, 60, and 90 days during this trial. RESULTS: A total of 116 patients from the oncology and pain departments, including inpatients and outpatients, were screened; 83 were enrolled. The increases in daily morphine doses began to differ from day 30 (L-TAMS group 9.85 mg/d vs. Placebo group 20.49 mg/d, p < 0.05); the differences persisted on day 60 (L-TAMS group 15.96 mg/d vs. Placebo group 29.06 mg/d, p < 0.05) and on day 90 (L-TAMS group 21.20 mg/d vs. Placebo group 40.44 mg/d, p < 0.01). CONCLUSIONS: L-TAMS outperforms a placebo in enhancing the analgesic effect of opioids and reducing the necessary opioid dosage. Moreover, L-TAMS can significantly relieve opioid-induced constipation. These advantages may be beneficial to patients with advanced cancer.

Structure Characterization and Anti-Inflammatory Activity of Polysaccharides from Lingzhi or Reishi Medicinal Mushroom Ganoderma lucidum (Agaricomycetes) by Microwave-Assisted Freeze-Thaw Extraction.

A water-soluble polysaccharide (GLP-2) was isolated and purified from Ganoderma lucidum by the microwave-assisted freeze-thaw method. Microwave-assisted rapid thawing treatment can greatly improve the extraction yield of polysaccharides. The chemical structure of GLP-2 was analyzed with FT-IR, HPLC, GC-MS, and NMR spectrometry. It was proved that GLP-2 is mainly composed of ß-1,3-glucose and ß-1,6-glucose. The chain conformation of GLP-2 was analyzed by SEC-MALLS-RI, indicating that GLP-2 adopts semi-rigid chain conformation. Its molecular weight is 16.7 × 104, and its molecular size is about 61.2 nm. MTT assay indicated that GLP-2 was non-toxic to RAW 264.7 cells in vitro. The results of anti-inflammatory studies showed that GLP-2 can inhibit the production of NO, TNF-α, IL-1ß, and IL-6 in RAW 264.7 macrophage stimulated by lipopolysaccharide (LPS). The above data showed that the extraction method used in this study can obtain a high-yield polysaccharide with anti-inflammatory activity.

Interpretation of HbA1c lies at the intersection of analytical methodology, clinical biochemistry and hematology (Review).

Over past few decades, diabetes has become widespread on a global scale. Hemoglobin A1c (HbA1c) assessment is crucial for diabetes care, since it allows for the monitoring of an individual's level of glycemic control over the course of 2 to 3 months and risk assessment to determine any possible complications. Numerous methods, including cation-exchange chromatography, electrophoresis, immunoassays and affinity chromatography, can be used to determine the HbA1c level. Each method has its limitations, however. The amount of HbA1c in patient samples is not only dependent on blood glucose levels, but is also strongly influenced by changes in red blood cell lifespan and globin chain structure. Consequently, hematological, clinical biochemistry and analytical methods all intertwine when interpreting HbA1c. There are numerous reports on the interactions of HbA1c with inherited and acquired diseases. Some of these impacts are inconsistent and difficult to explain. The present review article aimed to summarize and classify these effects and evaluate their clinical relevance. The findings discussed herein may serve as a reminder that clinical HbA1c values need to be analyzed with caution.

Biomimetic Core-Shell-Structured Nanofiber Membranes for Rapid and Portable Water Purification.

Rapid and portable water purification (RPWP) technologies, helping travelers survive in the wild, have attracted increasing interest due to increasing activities, such as exploration, field hiking, and excursion. Field water is usually pathogenic because of various soluble and insoluble contaminants. In this study, fish-gill-like biomimetic core-shell-structured nanofiber membranes are designed and synthesized by an in situ oxidation polymerization coating process. A polyimide nanofiber membrane and a polypyrrole (PPy) coating layer are employed as a core and shell, respectively. The biomimetic membranes exhibit dual-functional capacities: a rapid removal of insoluble contaminants owing to the highly porous network and broad-spectrum adsorption of soluble contaminants enabled by the PPy shell. Model studies confirm the excellent ability of the membranes to purify Cr(VI)-contaminated water to drinkable water with a safe capacity of ∼1415 L m-2. Actual application tests show that the membrane can efficiently remove coliform and suspended solids in a muddy water sample taken from a river in Suzhou, China. This study provides a promising route for the design of a single-layer membrane with dual functions for highly efficient RPWP.

Patient-Controlled Intravenous Analgesia with or without Ultrasound-Guided Bilateral Intercostal Nerve Blocks in Children Undergoing the Nuss Procedure: A Randomized, Double-Blinded, Controlled Trial.

Background: Two analgesic strategies have been described for pain treatment after the pectus excavatum surgery: the patient-controlled intravenous analgesia (PCIA) and ultrasound-guided intercostal nerve block. In this prospective, randomized and double-blinded trial and the short and long-term outcomes were compared in patients after surgery. Methods: The children were randomized to either the intercostal or control group. Ultrasound-guided intercostal nerve block was with 0.25% ropivacaine and 5 mg dexamethasone in the intercostal group, while the control group was with 0.9% normal saline. The block was performed in the intercostal space corresponding to the lowest depression of the sternum and repeated bilaterally in the spaces above and below. Postoperatively, the children in the two-groups received PCIA with fentanyl for 48 hours. The primary outcome was a pain score on the postoperative day 1, as measured by the Visual Analogue Scale (VAS). Results: Sixty children undergoing the Nuss procedure were enrolled in the trial. The mean differences in VAS scores between the two groups were 3.2 in the PACU (p < 0.001), 1.7 on postoperative day 1 (p < 0.001) and 0.7 on postoperative day 2 (p=0.015). The opioid consumption was significantly lower in the intercostal group during the postoperative 48 hours (p < 0.05). The anxiety and QOL scores in the intercostal group were significantly improved on some points of time (p < 0.05). The incidence of adverse events was markedly lower in the intercostal group during the postoperative 48 hours (p < 0.05). Conclusions: Our results suggest ultrasound-guided intercostal nerve block with PCIA may be more effective than PCIA alone in children who underwent the Nuss procedure.

Identification of a rare compound heterozygous hemoglobin variant ß0-thal [ß17(A14) Lys>Stop, HBB: c.52A>T] and Hb J-Lome [ß59(E3) Lys>Asn, HBB: c.180G>C].

BACKGROUND: HbA1c is the validated biomarker for glycemic management in diabetic individuals. Here, we report a compound heterozygote for ß0-thal and Hb J-Lomeand evaluate its effect on HbA1c measurements. METHODS: A 51-year-old female was suspected of harboring a hemoglobin variant following no value of HbA1c levelby Arkray HA-8180 V (48s HbA1c mode), abnormal hematological data, and abnormalhemoglobin analysison capillary electrophoresis (Capillarys 2 Flex Piercing, Hb program). Sanger sequencing of the α and ß genes was subsequently performed on the proband.HbA1c was reanalyzed using D10 (Bio-Rad), Capillarys 2 Flex Piercing (Sebia), and Roche Cobas c501 (Roche Diagnostics). RESULTS: Sanger sequencing identified a compound heterozygote for ß0-thal [ß17(A14) Lys > Stop, HBB: c.52A > T] and Hb J-Lome [ß59(E3) Lys > Asn, HBB: c.180G > C].HbA1c values ⁣⁣determinedby D10, Capillarys 2 Flex Piercing (HbA1c program), and Roche Cobas c501were 2.3%, no HbA1c value, and 5.1 (32 mmol/mol), respectively. During pedigree analysis, the son of the proband was found to have normal blood glucose (5.55 mmol/L), decreased HbA1c (3.6%, 16 mmol/mol)by Arkray HA-8180 V (48s HbA1c mode), an abnormal band on the electrophoretogram of Capillarys2 (Hb program), and the Hb J-Lome mutation in the ß globin gene.Subsequently, HbA1c values ⁣⁣determinedby D10, Capillarys 2 Flex Piercing (HbA1c program), and Roche Cobas c501 were4.0% (20 mmol/mol), no HbA1c value, and 5.0 (31 mmol/mol), respectively. CONCLUSION: Atypically low HbA1c levels or a discrepancy between blood glucose and HbA1c levels should raise concerns about hemoglobin variations.

Translocator Protein (TSPO) Alleviates Neuropathic Pain by Activating Spinal Autophagy and Nuclear SIRT1/PGC-1α Signaling in a Rat L5 SNL Model.

Purpose: Recent studies showed promotion of astrocyte autophagy in the spinal cord would provide analgesic effects. Silent information regulator T1 (SIRT1) and α subunit of peroxisome proliferator-activated receptor-γ coactivator-1 (PGC-1α) are two master regulators of endogenous antioxidant defense and mitochondrial biogenesis. They play vital roles in both autophagy and neuropathic pain (NP). Our previous study showed that TSPO agonist Ro5-4864 elicited potent analgesic effects against NP, but the mechanisms remain unclear. This study aims to investigate the effects of TSPO agonist Ro5-4864 on autophagy and nuclear SIRT1/PGC-1α signaling in spinal dorsal horn. Methods: A rat model of L5 spinal nerve ligation (SNL) was adopted. Rats were randomly assigned to the Sham group, the SNL group, the Ro (TSPO agonist Ro5-4864) group and the Ro+3-MA group. The behavior assessments were conducted at baseline, on Day 1, 3, 7 and 14 after SNL. The autophagy-related proteins (ATG7, Beclin1, LC3, and P62) in spinal dorsal horn were assayed and the nuclear SIRT1/PGC-1α and downstream factors were analyzed. Results: Ro5-4864 alleviated the mechanical allodynia induced by SNL (P < 0.01 vs the SNL group), which could be totally abrogated by autophagy inhibitor 3-MA (P < 0.01 vs the Ro group). SNL induced elevated ATG7 (P < 0.01), Beclin1 (P < 0.01) and LC3-II/LC3-I (P < 0.01) contents and P62 accumulation (P < 0.01) on Day 7 and Day 14, which suggested an autophagy flux impairment. Ro5-4864 augmented ATG7 (P < 0.01), Beclin1 (P < 0.01) and LC3-II/LC3-I (P < 0.05) with decreased P62 (P < 0.01), which indicated a more fluent autophagic process. These effects were also totally abrogated by 3-MA (P < 0.01). Furthermore, Ro5-4864 activated the spinal nuclear SIRT1/PGC-1α signaling pathway. Conclusion: TSPO improved both autophagy impairment and mitochondrial biogenesis, which may provide a new strategy for the treatment of NP.