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Early diagnosis of gastric cancer can improve the prognosis of patients, especially for those with early gastric cancer (EGC), but only 15% of patients, or less, are diagnosed with EGC and precancerous lesions. Magnifying endoscopy with narrow-band imaging (ME-NBI) can improve diagnostic accuracy. We assess the efficacy of ME-NBI in diagnosing ECG and precancerous lesions, especially some characteristics under NBI+ME. This was a retrospective analysis of 131 patients with EGC or gastric intraepithelial neoplasia (IN) who had undergone endoscopic submucosal dissection and were pathologically diagnosed with EGC or IN according to 2019 WHO criteria for gastrointestinal tract tumors. We studied the characteristics of lesions under ME-NBI ,compared the diagnostic efficacy of ME-NBI and white light endoscopy (WLI) plus biopsy, and investigated the effect of Helicobacter pylori infection on microvascular and microsurface pattern. The diagnostic accuracy of ME-NBI for EGC, high-grade IN (HGIN), and low-grade IN (LGIN) was 76.06%, 77.96%, and 77.06%, respectively. The accuracy of WLI plus biopsy in diagnosing the above lesions was 69.7%, 57.5%, and 60.53%, respectively. The rate of gyrus-like tubular pattern was highest in LGIN (60.46%), whereas the highest rate of papillary pattern was 57.14% in HGIN and villous tubular pattern was 52% in EGC. Demarcation lines have better sensitivity for differentiating EGC from IN (92.06%). The ME-NBI has higher diagnostic accuracy for EGC than WLI plus biopsy. Demarcation lines and villous and papillary-like microsurface patterns are more specific as EGC and HGIN characteristics. The cerebral gyrus-like microsurface pattern is more specific for LGIN.
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Carcinoma in Situ , Detecção Precoce de Câncer , Gastroscopia , Imagem de Banda Estreita , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Imagem de Banda Estreita/métodos , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Detecção Precoce de Câncer/métodos , Gastroscopia/métodos , Carcinoma in Situ/diagnóstico por imagem , Carcinoma in Situ/patologia , Adulto , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/diagnóstico , Infecções por Helicobacter/diagnóstico , Biópsia/métodos , Helicobacter pylori , Mucosa Gástrica/patologia , Mucosa Gástrica/diagnóstico por imagem , Ressecção Endoscópica de Mucosa/métodosRESUMO
OBJECTIVE: Percutaneous repair is an alternative to open surgical repair of the Achilles tendon with comparable, functional results and low re-rupture and infection rates; however, sural nerve injury is a known complication. The purpose of this study is to design a new surgical procedure, the minimally invasive peritendinous submembrane access technique (MIS-PSAT). It offers optimal results, with excellent functional outcomes, and with minimal soft tissue complications and sural nerve injury. METHODS: This retrospective study included 249 patients with acute closed Achilles tendon ruptures treated at our institution between 2009 and 2019. All patients underwent MIS-PSAT at our institution and were followed up for 8-48 months. Functional evaluation was based on the Achilles tendon total rupture score (ATRS) and the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS), associated with local complications and isokinetic tests. RESULTS: None of the patients had infection, necrosis, or sural nerve injury. Re-rupture occurred in two cases. The average times to return to work and sports was 10.4 and 31.6 weeks, respectively. The average ATRS and AOFAS-AHS scores were 90.2 and 95.7, respectively, with an excellent rate of 99.5%. Isokinetic tests showed that ankle function on the affected side was comparable with that on the healthy side (p > 0.05). CONCLUSION: The MIS-PSAT for acute Achilles tendon rupture is easy to perform with few complications. Importantly, the surgical technique reduces the risk of sural nerve injuries. Patients have high postoperative satisfaction, low re-rupture rates, and muscle strength, and endurance can be restored to levels similar to those on the healthy side.
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Tendão do Calcâneo , Procedimentos Cirúrgicos Minimamente Invasivos , Traumatismos dos Tendões , Humanos , Tendão do Calcâneo/lesões , Tendão do Calcâneo/cirurgia , Estudos Retrospectivos , Ruptura/cirurgia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Traumatismos dos Tendões/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Adulto Jovem , IdosoRESUMO
The rising sea levels due to climate change are a significant concern, particularly for vulnerable, low-lying coastal regions like the Gulf of Guinea (GoG). To effectively address this issue, it is crucial to gain a comprehensive understanding of historical sea level variability, and the influencing factors, and develop a reliable modeling system for future projections. This knowledge is essential for informed planning and mitigation strategies aimed at protecting coastal communities and ecosystems. This study presents a comprehensive analysis of mean sea level anomaly (MSLA) trends in the GoG between 1993 and 2020, covering three distinct periods (1993-2002, 2003-2012, and 2013-2020). It investigates the connections between interannual sea level variability and large-scale oceanic and atmospheric forcings. Furthermore, the study evaluates the performance of supervised machine learning techniques to optimize sea level modeling. The findings reveal a consistent rise in MSLA linear trends across the basin, particularly pronounced in the northern region, with a total linear trend of 88 mm over the entire period. The highest decadal trend (38.7 mm) emerged during 2013-2020, with the most substantial percentage increment (100%) occurring in 2003-2012. Spatial variation in decadal sea-level trends was influenced by subbasin physical forcings. Strong interannual signals in the spatial sea level distribution were identified, linked to large-scale oceanic and atmospheric phenomena. Seasonal variations in sea level trends are attributed to seasonal changes in the forcing factors. The evaluation of supervised learning modeling methods indicates that Random Forest Regression and Gradient Boosting Machines are the most accurate, reproducing interannual sea level patterns in the GoG with 97% and 96% accuracy. These models could be used to derive regional sea level projections via downscaling of climate models. These findings provide essential insights for effective coastal management and climate adaptation strategies in the GoG.
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The efficient infection of plants by the bacteria Xanthomonas campestris pv. campestris (Xcc) depends on its type III effectors (T3Es). Although the functions of AvrE family T3Es have been reported in some bacteria, the member XopAM in Xcc has not been studied. As XopAM has low sequence similarity to reported AvrE-T3Es and different reports have shown that these T3Es have different targets in hosts, we investigated the functions of XopAM in the Xcc-plant interaction. Deletion of xopAM from Xcc reduced its virulence in cruciferous crops but increased virulence in Arabidopsis (Arabidopsis thaliana) Col-0, indicating that XopAM may perform opposite functions depending on the host species. We further found that XopAM is a lipase that may target the cytomembrane and that this activity might be enhanced by its membrane-targeted protein XOPAM-ACTIVATED RESISTANCE 1 (AMAR1) in Arabidopsis Col-0. The binding of XopAM to AMAR1 induced an intense hypersensitive response that restricted Xcc proliferation. Our results showed that the roles of XopAM in Xcc infection are not the same as those of other AvrE-T3Es, indicating that the functions of this type of T3E have differentiated during long-term bacteriumâhost interactions.
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Arabidopsis , Xanthomonas campestris , Arabidopsis/metabolismo , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Proteínas de Membrana/metabolismo , Virulência , Fatores de Virulência/metabolismo , Doenças das Plantas/microbiologiaRESUMO
OBJECTIVE: To analyze the causes, management and prevention of complications after micro-incision percutaneous repair of acute Achilles tendon rupture. METHODS: A retrospective study indentyfied 279 patients with acute Achilles tendon rupture who underwent a mini-invasive procedure using the micro-incision percutaneous Achilles tendon suture system(MIPAS) from August 2008 to November 2019, including 269 males and 10 female;96 cases on the right side and 183 cases on the left side;aged from 18 to 64 years old with an average of (36.9±11.4 )years old. Surgery was performed 0.5 to 7 days with an average of(2.7±0.9 )days after injury. The incision-related complications, re-rupture, sural nerve injury, deep vein thrombosis, Achilles tendon adhesion, local pain, and ankle stiffness within 18 months after surgery were recorded, as well as the corresponding management and outcome, the causes and prevention measures were analyzed. RESULTS: No superficial or deep infection was found in all patients, symptomatic Achilles tendon adhesion and ankle stiffness were not observed, delayed suture foreign-body reactions occurred in 2 cases (0.7%), re-rupture in 5 cases (1.8%), sural nerve injury in 3 cases (1.1%), 21 cases(7.5%) with skin invagination at puncture site, 2 cases (0.7%) with symptomatic vein thrombosis, and 45 cases (16.1%) of transient posterior medial malleolus pain. After individualized treatment, the function was good. American Orthopeadic Foot & Ankle Sciety(AOFAS) score was 93 to 100 with an average of(98.9±5.4) scores. CONCLUSION: Despite the occurrence of unique complications with MIPAS, it shows low functionally-related complications rates, such as incision-related complications, re-rupture, sural nerve injury, deep vein thrombosis and ankle stiffness.
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Tendão do Calcâneo , Traumatismos dos Tendões , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Tendão do Calcâneo/cirurgia , Tendão do Calcâneo/lesões , Estudos Retrospectivos , Resultado do Tratamento , Traumatismos dos Tendões/cirurgia , Ruptura/cirurgia , Suturas , Doença Aguda , Técnicas de SuturaRESUMO
BACKGROUND AND AIMS: The effect of linked color imaging (LCI) compared with white light imaging (WLI) is conflicting. The aim of this meta-analysis is to compare the efficacy of LCI versus WLI for the adenoma detection. METHODS: PubMed, Embase, Google Scholar and Cochrane Library were searched up to the end of Aug 18, 2021. All randomized controlled trials (RCTs) comparing LCI with WLI were included. Dichotomous data were pooled to obtain the relative risk (RR) with a 95% confidence interval (CI), whereas continuous data were pooled using a mean difference (MD) with 95%CI. RESULTS: A total of 10 RCTs involving 5,510 patients were included. The use of LCI was associated with a statistically significant improvement in adenoma detection rate (ADR), polyp detection rate (PDR), mean adenomas per patient (MAP) and mean polyp per patient (MPP) when compared to WLI (ADR: RR=1.15, 95%CI: 1.07-1.23, p=0.0001, PDR: RR=1.15, 95%CI: 1.08-1.22, p<0.0001; MAP: MD=0.18, 95%CI: 0.09- 0.28, p=0.0002; MPP: MD=0.13, 95%CI: 0.01, 0.25, p=0.03). When stratified by size, LCI group had a higher detection rate of small adenomas (<10 mm) than the WLI group. Besides, LCI showed a significant decrease in adenoma miss rate (AMR) when compared to WLI. There were no statistically significant differences between the two groups in advanced ADR (AADR), sessile serrated lesion detection rate (SDR), cecal intubation rate, insertion time, and withdrawal time. CONCLUSIONS: The pooled evidence suggests that LCI can significantly improve the detection of ADR, especially for small adenomas (<10 mm). Moreover, the AMR were significantly lower using LCI compared with WLI.
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Adenoma , Pólipos do Colo , Neoplasias Colorretais , Adenoma/diagnóstico por imagem , Adenoma/patologia , Ceco , Pólipos do Colo/diagnóstico por imagem , Pólipos do Colo/patologia , Colonoscopia/métodos , Neoplasias Colorretais/patologia , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Asphaltene deposition around the wellbore is a major cause of formation damage, especially in heavy oil reservoirs Ultrasonic stimulation, rather than chemical injection, is thought to be a more cost-effective and environmentally friendly means of removing asphaltene deposition. However, it seems to be unclear how crucial features like reservoir pore geometries and ultrasonic parameters affect this ultrasound treatment. In this work, five two-dimensional glass micromodels with different pore geometries were designed to assess the impact of pore geometries on the ultrasonic removal of asphaltene deposition. Experiments were undertaken in an ultrasound bath at a set frequency (20 kHz) and adjustable powers (100-1000 W). Direct image analysis before, during and after sonication was used to assess the impact of pore geometry and a change in ultrasonic parameter on the removal of asphaltene deposition. The effectiveness of ultrasound treatment at various sonication periods were found to be reliant on the pore geometries of the individual micromodels. For micromodels with throat sizes 300 µm and pore shapes as circle, square and triangle, an increase in ultrasonic power from 400 to 1000 W resulted in an increase in the percentage of removed asphaltene deposition after 2 h from 12.6 to 14.7, 11.5 to 14.63, and 5.8 to 7.1 percent, respectively.
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OBJECTIVE: To investigate the morphological, histological and ultrastructural changes of acute closed rupture of Achilles tendon, in order to clarify the pathological basis of the injury and to explore the significance. METHODS: From January 2015 to January 2019, 35 patients with acute Achilles tendon rupture who underwent the minimally invasive Achilles tendon suture technique were retrospectively analyzed. Among these patients, 12 cases in acute open Achilles tendon rupture group included 10 males and 2 females, with an average age of (35.1±9.7) years old ranging from 19 to 50, and the time from injury to operation was 2 to 8 hours with an average of(5.6±1.8);23 cases in acute closed Achilles tendon rupture group included 21 males and 2 females, with an average age of (35.5±6.6) years old ranging from 18 to 50, and the time from injury to operation was 3 to 15 hours with an average of (7.5±3.1). The gross appearance and imaging findings of the broken end of Achilles tendon tissue in the two groups were compared by naked eye observation and foot and ankle MRI at 4 to 6 hours before operation. HE staining, scanning and fluoroscopic electron microscopy, immunohistochemistry(Sirius red staining) were performed on the intraoperative Achilles tendon tissue specimens at 1 to 2 days after operation, the collagen fiber degeneration and local fat infiltration, collagen fiber shape, cell morphology and function, and the distribution of typeâ and type â ¢ collagen fibers in Achilles tendon were compared between the two groups. RESULTS: Compared with the acute open Achilles tendon rupture group, the acute closed Achilles tendon rupture group had poor elasticity, hard texture, moderate edema, irregular shape of Achilles tendon broken end, horsetail shape, and more calcification around the broken end. HE staining results:the collagen fibers in the Achilles tendon of the acute open Achilles tendon rupture group were arranged irregularly, with hyaline degeneration and fat infiltration;The results of electron microscopy showed that collagen arranged disorderly and fibroblasts atrophied in the acute closed Achilles tendon rupture group. Immunohistochemical(Sirius staining) results:the proportion of collagenâ in the acute open Achilles tendon rupture group and the acute closed Achilles tendon rupture group was(91.12±4.34)% and(54.71±17.78)% respectively, and the proportion of collagen â ¢ was (8.88±4.34)% and (45.29±17.78)% respectively. The content of collagenâ in the acute closed Achilles tendon rupture group was lower than that in the acute open Achilles tendon rupture group, and the content of collagen â ¢ in the acute closed Achilles tendon rupture group was higher than that in the acute open Achilles tendon rupture group(P<0.05). CONCLUSION: The morphology, histology and ultrastructure of the acute closed ruptured Achilles tendon are significantly altered compared with the normal Achilles tendon. The original fine and orderly spatial structure cannot be maintained, part of collagen â is replaced by collagen â ¢, and the toughness and strength of the tendon tissue decreased, which may be the feature of degeneration of the Achilles tendon and an important pathological basis for closed Achilles tendon rupture.
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Tendão do Calcâneo , Traumatismos dos Tendões , Tendão do Calcâneo/cirurgia , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Ruptura/cirurgia , Técnicas de Sutura , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/cirurgia , Resultado do TratamentoRESUMO
Xanthomonas campestris pv. campestris (Xcc) can cause black rot in cruciferous plants worldwide. Two-component systems (TCSs) are key for bacterial adaptation to various environments, including hosts. VemR is a TCS response regulator and crucial for Xcc motility and virulence. Here, we report that RavA is the cognate histidine kinase (HK) of VemR and elucidate the signalling pathway by which VemR regulates Xcc motility and virulence. Genetic analysis showed that VemR is epistatic to RavA. Using bacterial two-hybrid experiments and pull-down and phosphorylation assays, we found that RavA can interact with and phosphorylate VemR, suggesting that RavA is the cognate HK of VemR. In addition, we found that RpoN2 and FleQ are epistatic to VemR in regulating bacterial motility and virulence. In vivo and in vitro experiments demonstrated that VemR interacts with FleQ but not with RpoN2. RavA/VemR regulates the expression of the flagellin-encoding gene fliC by activating the transcription of the rpoN2-vemR-fleQ and flhF-fleN-fliA operons. In summary, our data show that the RavA/VemR TCS regulates FleQ activity and thus influences the expression of motility-related genes, thereby affecting Xcc motility and virulence. The identification of this novel signalling pathway will deepen our understanding of Xcc-plant interactions.
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Xanthomonas campestris , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Regulação Bacteriana da Expressão Gênica , Histidina Quinase/genética , Histidina Quinase/metabolismo , Fosforilação , Virulência/genéticaRESUMO
OBJECTIVE: To summarize the research progress of osteonecrosis of femoral head (ONFH) following femoral intertrochanteric fractures in adults. METHODS: Relevant literature at home and abroad was extensively reviewed to summarize the pathogenesis, high-risk factors, and treatment of ONFH after femoral intertrochanteric fracture in adults. RESULTS: ONFH after femoral intertrochanteric fracture mostly occurs within 2 years after operation, with a lower incidence. At present, it is believed that comminuted and large displacement fractures caused by high-energy injuries, fracture line close to the base of neck, excessive external rotation deformity, improper intramedullary nail entry points, and rough intraoperative manipulating may injury the deep branch of the medial circumflex femoral artery, causing ONFH. Hip replacement is the main treatment for necrosis, which can achieve good results. CONCLUSION: Addressing the above risks, excessive external rotation, overstretching, and rough manipulating should be avoided. Anatomical reduction should be performed during the operation, the nail entry point should be accurate and avoid repeated drilling and thermally bone necrosis.
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Fraturas do Fêmur , Fixação Intramedular de Fraturas , Fraturas do Quadril , Pinos Ortopédicos , Cabeça do Fêmur/cirurgia , Fraturas do Quadril/cirurgia , Humanos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Inspired by the porous scale of the bright white beetle Cyphochilus, a polymerization-induced phase separation method is proposed to fabricate bioinspired high-scattering polymer films with porous structures. With an optimized formulation, the porous films with a mean pore size of â¼200nm feature a broadband reflectance of â¼71% at a thickness of 16 µm and are measured to have a transport mean free path of â¼3µm. The porous films with high reflectivity enable the application on light-emitting diodes and have great potential in other similar optoelectronic fields.
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Following publication of the original article [1], we have been notified that there was a spelling mistake in the author affiliations. In this Correction, correct and incorrect versions are shown.
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In survival trials with fixed trial length, the patient accrual rate has a significant impact on the sample size estimation or equivalently, on the power of trials. A larger sample size is required for the staggered patient entry. During enrollment, the patient accrual rate changes with the recruitment publicity effect, disease incidence and many other factors and fluctuations of the accrual rate occur frequently. However, the existing accrual models are either over-simplified for the constant rate assumption or complicated in calculation for the subdivision of the accrual period. A more flexible accrual model is required to represent the fluctuant patient accrual rate for accurate sample size estimation. In this paper, inspired by the flexibility of the Gaussian mixture distribution in approximating continuous densities, we propose the truncated Gaussian mixture distribution accrual model to represent different variations of accrual rate by different parameter configurations. The sample size calculation formula and the parameter setting of the proposed accrual model are discussed further.
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Modelos Estatísticos , Humanos , Distribuição Normal , Seleção de Pacientes , Tamanho da AmostraRESUMO
BACKGROUND: The management of old bony mallet fingers is complicated. The aim of the study is to present a new method of open reduction and compression with double Kirschner wires (K-wires) in treating old bony mallet fingers. METHODS: This was a retrospective analysis of patients with old closed bony mallet fingers treated between June 2013 and December 2016. Complications were observed. The range of motion (ROM) of the DIP joints was measured using a protractor. At the last follow-up, anteroposterior and lateral X-ray of the affected finger was performed, the flatness of the articular surface was scored, and the results were graded using Crawford's criteria. RESULTS: Seventeen patients were followed up for 8 (6-19) months. The width of the avulsion fracture block accounted for 25-62% of the articular surface of the distal phalanx. Twelve (70.6%) patients had anterior dislocation of the interphalangeal joint. All patients reported healing at the fracture sites. Healing time was 7.6 ± 2.1(5-13) weeks. All patients had incision healing of I/Class A. Lateral X-ray showed 13 and four patients had excellent and good articular surface flatness, respectively. At the last follow-up, no traumatic arthritis was present. Only one patient developed mild pain after surgery (VAS score of 3). Postoperative ROM was 76.5 ± 10.6° (P = 0.0625 vs. healthy side). At the last follow-up, the angle of loss of dorsiflexion was 0-10° (P < 0.0001 vs. baseline). The flexion angle was 50-90° (P = 0.0625 vs. healthy side). CONCLUSIONS: Open reduction and compression with double K-wires is feasible in treating old bony mallet finger.
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Fios Ortopédicos , Falanges dos Dedos da Mão/lesões , Falanges dos Dedos da Mão/cirurgia , Fixação de Fratura/métodos , Fraturas Ósseas/cirurgia , Adolescente , Adulto , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Redução Aberta , Estudos Retrospectivos , Fatores de Tempo , Adulto JovemRESUMO
With the deepening of the research on intertrochanteric fracture, the importance of "lateral wall" of femur is gradually recognized. The integrity of the lateral wall can affect the stability of intertrochanteric fractures, the choice of surgical methods and internal fixation, and the outcome of patients after surgery, which has become a research hotspot. However, there is no unified understanding on the definition of lateral wall, the judgement of injury status and the treatment of lateral wall fracture. This article reviews the literature, and combines with the clinical understanding of the role of the lateral femoral wall, in order to provide reference for orthopaedic surgeons and relevant researchers.
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Fraturas do Quadril , Fêmur , Fixação Interna de Fraturas , Humanos , Resultado do TratamentoRESUMO
Analytical similarity assessment of critical quality attributes (CQAs) serves as a foundation for the development of biosimilar products and facilitates an abbreviated subsequent clinical evaluation. In this study, we establish a statistical evaluation roadmap with statistical approaches for some selected CQAs from Tier 1, because they are most relevant to clinical outcomes and require the most rigorous statistical methods. In the roadmap, we incorporate 3 methods-ranking and tier assignment of quality attributes, the equivalence test, and the Mann-Whitney test for equivalence-that are important to determine analytical similarity between the reference and biosimilar products. For the equivalence test, we develop a power calculation formula based on the two one-sided tests procedure. Exact sample sizes can be numerically calculated. Then, we propose a flexible idea for selecting the number of reference lots (nR) and the number of biosimilar lots (nT) to adjust for serious unbalanced sample sizes. From results of extensive simulations under various parameter settings, we obtain a workable strategy to determine the optimum sample size combination (nT, nR) for the equivalence test of CQAs from Tier 1. R codes are provided to facilitate implementation of the roadmap and corresponding methods in practice.
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Medicamentos Biossimilares , Interpretação Estatística de Dados , Humanos , Estados Unidos , United States Food and Drug AdministrationRESUMO
The aim of the present study was to comprehensively evaluate the changes in the metabolite profile of breast milk over lactation stages and their relationship with dietary intake in Chinese women by HPLC-QTOFMS based metabolomic analysis. The colostrum, transitional milk and mature milk of thirty healthy lactating women were collected for analysis. Eighty-four differential metabolites over lactation stages were identified, including 12 fatty acyls, 15 glycerolipids, 23 glycerophospholipids, 7 sphingolipids, 7 vitamins, 5 nucleotides-related metabolites, 2 amino acids, 1 amino acid derivate, 9 dipeptides, 1 steroid hormone, 1 energy-related metabolite and 1 amine. Partial least-squares regression analysis indicated that the metabolite profiles of the colostrum, transitional milk and mature milk have a strong relationship with dietary intake (R2 values were 0.92, 0.87 and 0.74, respectively). However, among the 84 differential metabolites over lactation stages, only two showed a strong relationship with dietary intake: 1,24,25-(OH)3 vitamin D3 was positively correlated with the dietary intake of meat and eggs, protein and fat; 11ß-hydroxyprogesterone was negatively correlated with the dietary intake of fruit and carbohydrate. After adjusting for dietary intake, the variation trend of all the 84 differential metabolites over lactation stages remained unchanged. In conclusion, 84 differential metabolites in the breast milk of Chinese women over lactation stages were identified, and their variation trend was independent of dietary intake. These metabolites were partially different from those identified in previous metabolomic studies in the Western population. The present study is quite meaningful for understanding the variation of nutritional requirements in Chinese infants at different developmental stages and manufacturing optimal infant formulas for them.
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Lactação , Leite Humano/química , Adulto , Aminoácidos/química , Aminoácidos/metabolismo , Cromatografia Líquida de Alta Pressão , Colostro/química , Colostro/metabolismo , Dieta , Ácidos Graxos/química , Ácidos Graxos/metabolismo , Feminino , Glicerídeos/química , Glicerídeos/metabolismo , Humanos , Espectrometria de Massas , Metabolômica , Leite Humano/metabolismo , Gravidez , Vitaminas/química , Vitaminas/metabolismoRESUMO
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
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Hemorrhagic fever with renal syndrome (HFRS) is a major rodent-borne zoonosis. Each year worldwide, 60,000-100,000 HFRS human cases are reported in more than seventy countries with almost 90% these cases occurring in China. Shaanxi Province in China has been among the most seriously affected areas since 1955. During 2009-2013, Shaanxi reported 11,400 human cases, the most of all provinces in China. Furthermore, the epidemiological features of HFRS have changed over time. Using long-term data of HFRS from 2005 to 2016, we carried out this retrospective epidemiological study combining ecological assessment models in Shaanxi. We found the majority of HFRS cases were male farmers who acquired infection in Guanzhong Plain, but the geographic extent of the epidemic has slowly spread northward. The highest age-specific attack rate since 2011 was among people aged 60-74 years, and the percentage of HFRS cases among the elderly increased from 12% in 2005 to 25% in 2016. We highly recommend expanding HFRS vaccination to people older than 60 years to better protect against the disease. Multivariate analysis revealed artificial area, cropland, pig and population density, GDP, and climate conditions (relative humidity, precipitation, and wind speed) as significant risk factors in the distribution of HFRS.
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Febre Hemorrágica com Síndrome Renal/epidemiologia , Zoonoses/epidemiologia , Fatores Etários , Animais , China/epidemiologia , Fazendeiros , Humanos , Exposição Ocupacional , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Topografia MédicaRESUMO
Epidermal growth factor (EGF) and transforming growth factor-α (TGF-α) are important growth-promoting factors in human milk and play an important role in a newborn's gastrointestinal function. The aim of the present study was to compare EGF and TGF-α contents in breast milk from different lactation periods and different regions and further analyze the effect of maternal diet on the concentration of EGF and TGF-α in breast milk. Breast milk samples and 24-hour food records were obtained from lactating mothers on day 1 (colostrum), day 14 (transitional milk) and day 42 (mature milk) from Hangzhou (n = 76), Lanzhou (n = 76) and Beijing (n = 76), China. EGF and TGF-α levels were determined by enzyme-linked immunosorbent assay (ELISA). The concentration of EGF in breast milk decreased over lactation periods (p < 0.001) while the TGF-α content in breast milk increased over lactation periods (p < 0.001). During all of the three lactation periods, the EGF content in the breast milk from Lanzhou participants was significantly higher than Beijing and Hangzhou participants (p < 0.001), while the TGF-α content in the breast milk from Beijing was significantly higher than that from Lanzhou and Hangzhou (p < 0.001). The concentration of EGF in breast milk decreased with the increasing intake of proteins (p = 0.042), total energy (p = 0.031), vegetables (p = 0.002), fruits (p < 0.001), soy products (p = 0.001) and dairy foods (p < 0.001), while the TGF-α content in breast milk increased with the increasing intake of carbohydrates (p = 0.023) and dairy products (p = 0.011) and decreased with the increasing intake of proteins (p = 0.008) and meat (p = 0.016). The EGF and TGF-α contents in breast milk were greatly influenced by regions and lactation periods and there was also a strong relationship with maternal diet.