Effects of responsive breastfeeding intervention on breastfeeding and infant growth in China: A randomised controlled trial.

Responsive feeding serves as an important protective factor for infant growth and overall health development. This study based on self-determination theory (SDT) aimed to assess the effects of a responsive breastfeeding (RBF) intervention programme on maternal breastfeeding and infant growth and development. A total of 110 mother-infant pairs were recruited and randomly divided into an intervention group (n = 55) and a control group (n = 55). The primary outcomes were breastfeeding motivation score, breastfeeding self-efficacy (BSE) and exclusive breastfeeding rate; the secondary outcomes were infant physical development at 6 weeks and 3 months. A repeated measures ANOVA indicated that the intervention group had significantly higher Enjoyment scores compared to the control group at three time points: at discharge (MD: 5.28; 95% CI: 3.68 to 6.89; p < 0.001), 6 weeks post-partum (MD: 5.06; 95% CI: 3.80 to 6.31; p < 0.001) and 3 months post-partum (MD: 5.24; 95% CI: 4.12 to 6.35; p < 0.001). Similarly, the intervention group reported significantly higher connection and mother's self-perception scores at discharge (MD: 4.31; 95% CI: 3.07 to 5.56; p < 0.001), 6 weeks post-partum (MD: 4.69; 95% CI: 3.71 to 5.68; p < 0.001) and 3 months post-partum (MD: 4.93; 95% CI: 4.14 to 5.72; p < 0.001), compared to the control group. In contrast, the pressure from significant others scores were higher in the control group relative to the intervention group at discharge (MD: -2.09; 95% CI: -2.88 to -1.31; p < 0.001), 6 weeks post-partum (MD: -4.35; 95% CI: -5.20 to -3.49; p < 0.001) and 3 months (MD: -4.89; 95% CI: -5.70 to -4.08; p < 0.001). Finally, the intervention group also reported higher Instrumental Needs scores at all three time points: at discharge (MD: 1.96; 95% CI: 1.35 to 2.58; p < 0.001), 6 weeks post-partum (MD: 3.58; 95% CI: 3.05 to 4.11; p < 0.001) and 3 months post-partum (MD: 1.18; 95% CI: 0.68 to 1.69; p < 0.001). BSE scores were significantly higher in the intervention group compared to the control group at discharge (MD: 14.29; 95% CI: 10.38 to 18.21; p < 0.001), 6 weeks post-partum (MD: 14.04; 95% CI: 11.05 to 17.02; p < 0.001) and 3 months post-partum (MD: 6.80; 95% CI: 4.66 to 8.94; p < 0.001). The rates of exclusive breastfeeding were higher in the intervention group than in the control group at each stage of the intervention (p < 0.01). At 6 weeks post-partum, the intervention group's infants showed slower weight (t = -0.90, p = 0.371) and length (t = -0.69, p = 0.495) growth compared to the control group, though not significantly. By 3 months post-partum, there was a significant difference in both weight (t = -3.46, p = 0.001) and length (t = -2.95, p = 0.004) between the groups. The findings in this study suggest that the RBF intervention programme based on SDT may be effective in improving mothers' motivation to breastfeed, building breastfeeding self-confidence and increasing the rate of exclusive breastfeeding. The effects of the intervention on infant physical development will need to be verified with longer follow-up in future research.

Laparoscopic vs. open procedure for intermediate­ and high­risk endometrial cancer: a minimum 4-year follow-up analysis.

BACKGROUND: The long-term oncologic outcomes after laparoscopic and open procedures for patients with intermediate­ and high­risk endometrial cancer (EC) remain unclear. Accordingly, laparoscopy cannot still be recommended as the standard choice for intermediate­ and high­risk EC. This retrospective study aimed to assess the perioperative and long-term oncologic outcomes of laparoscopy and open surgery in patients with intermediate- and high­risk ECs within a minimum 4-year follow-up. METHODS: We included 201 patients who underwent laparoscopic or open procedures for intermediate­ and high­risk EC between 2010 and 2017. Between-procedure comparisons of perioperative and oncological outcomes were performed using the independent t-test or Pearson's chi-squared test and the Kaplan-Meier method, respectively. RESULTS: Finally, there were 136 intermediate­ and 65 high­risk endometrial tumors in the laparoscopic and open groups, respectively. There were no between-group differences in all baseline characteristics. Compared with the open group, the laparoscopic group had a significantly longer mean operating time (p = 0.005) and a lower mean estimated blood loss (EBL) (p = 0.031). There was a higher possibility of postoperative complication in the open group than in the laparoscopic group (p = 0.048). There were no significant between-group differences in pathological outcomes as well as the recurrence-free survival and overall survival rates (p = 0.626 and p = 0.148, respectively). CONCLUSIONS: Among patients with intermediate­ and high­risk EC, laparoscopic surgery has an advantage over the open surgery in reducing EBL and the rate of postoperative complications without weakening the oncological control. There were no between-procedure differences in the recurrence-free and overall survival rates.

Secretomes of human pluripotent stem cell-derived smooth muscle cell progenitors upregulate extracellular matrix metabolism in the lower urinary tract and vagina.

BACKGROUND: Adult mesenchymal stem cells (MSCs) have been studied extensively for regenerative medicine; however, they have limited proliferation in vitro, and the long culture time induces cell senescence. MSCs also contribute to tissue repair through their paracrine function. In this study, we sought to examine the paracrine effects of human smooth muscle cell progenitors (pSMC) on the urethra and adjacent vagina of stress urinary incontinence rodents. We use human pluripotent stem cell (PSC) lines to derive pSMCs to overcome the issue of decreased proliferation in tissue culture and to obtain a homogenous cell population. METHOD: Three human PSC lines were differentiated into pSMCs. The conditioned medium (CM) from pSMC culture, which contain pSMC secretomes, was harvested. To examine the effect of the CM on the extracellular matrix of the lower urinary tract, human bladder smooth muscle cells (bSMCs) and vaginal fibroblasts were treated with pSMC-CM in vitro. Stress urinary incontinence (SUI) was induced in rats by surgical injury of the urethra and adjacent vagina. SUI rats were treated with pSMC-CM and monitored for 5 weeks. Urethral pressure testing was performed prior to euthanasia, and tissues were harvested for PCR, Western blot, and histological staining. Kruskal-Wallis one-way ANOVA test and Student t test were used for statistical comparisons. RESULTS: pSMC-CM upregulated MMP-2, TIMP-2, collagen, and elastin gene expression, and MMP-9 activity in the human bladder and vaginal cells consistent with elastin metabolism modulation. pSMC-CM treatment in the SUI rat improved urethral pressure (increase in leak point pressure compared to intact controls, p < 0.05) and increased collagen and elastin expression in the urethra and the adjacent vagina. CONCLUSION: Conditioned media from smooth muscle cell progenitors derived from human pluripotent stem cells improved urethral leak point pressure and collagen and elastin content in the SUI rat. These findings suggest a novel therapeutic potential for PSC-based treatments for SUI and pelvic floor disorders where tissues are affected by collagen, elastin, and smooth muscle loss.

LINC00441 promotes cervical cancer progression by modulating miR-450b-5p/RAB10 axis.

BACKGROUND: As one of the most common gynaecological malignant tumors, cervical cancer (CC) has become an important public health issue. Emerging evidence has revealed long non-coding RNAs (lncRNAs) are crucial regulators of biological functions in cancers, including CC. And the oncogenic role of LINC00441 has been verified in hepatocellular carcinoma (HCC). But the molecular mechanism and biological functions of LINC00441 in CC remain unknown. METHODS: qRT-PCR analysis detected the expression of genes in CC tissues or cells. CCK-8, colony formation, flow cytometry, transwell, western blot assays as well as animal studies were conducted to analyze the function of LINC00441 in CC. Luciferase reporter, RIP and RNA pull down assays were applied to verify the binding relations among the indicated genes. RESULTS: LINC00441 was upregulated in CC tissues and cells. Further, LINC00441 depletion repressed cell proliferation and motility in vitro as well as tumor growth in vivo. LINC00441 could sponge miR-450b-5p to upregulate RAB10 expression. Finally, miR-450b-5p inhibitor or RAB10 upregulation counteracted LINC00441 knockdown-mediated function on the development of CC. CONCLUSIONS: LINC00441 drives CC progression by targeting miR-450b-5p/RAB10 axis, which might provide new idea for researching CC-related molecular mechanism.

Prevalence and risk factors of urinary incontinence among perimenopausal women in Wuhan.

This study investigated the prevalence and risk factors of urinary incontinence (UI) among perimenopausal women in Wuhan. A cross-sectional survey was performed on 1067 women aged 40-65 years sampled in Wuhan urban area from April to October 2014. Information about demographic characteristics, menstruation, parity and UI symptoms was collected using a questionnaire. The data were evaluated by Chi-square test and multiple Logistic regression analysis. The prevalence rate of UI was 37.2%, with stress UI (32.2%) being more prevalent than urgency UI (21.6%) and mixed UI (16.6%). 31.2% women with UI stated that UI had negative impact on their life. Risk factors for UI included menstrual disorder, menopause, overweight, perineal laceration, atrophic vaginitis, constipation and pelvic organ prolapse. Appropriate investigation apropos the factors associated with UI should be performed to diminish its impact on women's life.

Structure-Based Design of a Br Halogen Bond at the Complex Interface of the Human Placental HtrA1 PDZ Domain with Its Heptapeptide Ligand.

The shock-induced serine protease HtrA1 is a potential regulator of human placenta development during pregnancy. The protein contains a functional PDZ domain that has been solved in complex with a phage display-derived heptapeptide: Asp-6 Ser-5 Arg-4 Ile-3 Trp-2 Trp-1 Val0 . In this study, a rationally designed halogen bond was introduced to the domain-peptide complex based on its NMR structure in solution. We computationally compared the stabilization energies and hindrance effects due to the presence of different halogens X (X = F, Cl, Br, or I), using a hybrid quantum mechanics/molecular mechanics (QM/MM) approach, and found that the Br atom could considerably promote the peptide binding free energy (ΔΔG = -5.2 kcal/mol). Fluorescence assays confirmed that the peptide affinity to the HtrA1 PDZ domain was improved by approximately sevenfold upon bromination. Structural analysis identified a geometrically perfect halogen bond between the Br atom of the peptide Trp-1 residue and the carbonyl O atom of the HtrA1 Ile385 residue, with a bond length and an interaction energy of d = 3.20 Å and ΔE = -3.7 kcal/mol, respectively.

Structure-based lead discovery for protein kinase C zeta inhibitor design by exploiting kinase-inhibitor complex crystal structure data and potential therapeutics for preterm labour.

The protein kinase C (PKC) is a family of serine/threonine kinases with a broad range of cellular targets. Members of the PKC family participate at the diverse biological events involved in cellular proliferation, differentiation and survival. The PKC isoform zeta (PKCζ) is an atypical member that has recently been found to play an essential role in promoting human uterine contractility and thus been raised as a new target for treating preterm labour and other tocolytic diseases. In this study, an integrative protocol was described to graft hundreds of inhibitor ligands from their complex crystal structures with cognate kinases into the active pocket of PKCζ and, based on the modeled structures, to evaluate the binding strength of these inhibitors to the non-cognate PKCζ receptor by using a consensus scoring strategy. A total of 32 inhibitors with top score were compiled, and eight out of them were tested for inhibitory potency against PKCζ. Consequently, five compounds, i.e. CDK6 inhibitor fisetin, PIM1 inhibitor myricetin, CDK9 inhibitor flavopiridol and PknB inhibitor mitoxantrone as well as the promiscuous kinase inhibitor staurosporine showed high or moderate inhibitory activity on PKCζ, with IC50 values of 58 ± 9, 1.7 ± 0.4, 108 ± 17, 280 ± 47 and 0.019 ± 0.004 µM, respectively, while other three compounds, including two marketed drugs dasatinib and sunitinib as well as the Rho inhibitor fasudil, have not been detected to possess observable activity. Next, based on the modeled structure data we modified three flavonoid kinase inhibitors, i.e. fisetin, myricetin and flavopiridol, to generate a number of more potential molecular entities, two of which were found to have a moderately improved activity as compared to their parent compounds.

[Adaptability of abnormal tadpole (Rana chensinensis) to water pH, salinity and alkalinity in Changbai Mountain of China].

Under field condition with 16-18 degree C water temperature, single-factor acute toxicity test was used to study the toxicity effects of water pH, salinity and carbonate-alkalinity on abnormal tadpole (R. chensinensis). The results showed that when the water salinity was 0.18 g x L(-1), carbonate-alkalinity was 1.41 mmol x L(-1), and water pH was 4.3-9.7, the survival rate of abnormal tadpole within 96 hours was not affected. The upper limit of LC50 for the pH within 24, 48, 72 and 96 hours was 10.33, 10.18, 10.08 and 10.02, and the prescribed minimum was 3.92, 4.07, 4.11 and 4.16, respectively. The upper limit of LC0 was 9.95, 9.80, 9.70 and 9.70, and the prescribed minimum was 4.23, 4.45, 4.30 and 4.30, and that of LC100 was 10.70, 10.55, 10.45 and 10.33, and the prescribed minimum was 3.55, 3.70, 3.92 and 4.03, respectively. The survival rate of abnormal tadpole within 96 hours was not affected in the water salinity between 2.0-3.0 g x L(-1). When water pH was 7.0-8.5 and carbonate-alkalinity was 1.41 mmol x L(-1), the LC50 of the salinity within 24, 48, 72 and 96 hours was 8.21, 7.25, 5.17 and 3.70 g x L(-1), the LC0 was 7.14, 6.00, 2.67 and 2.20 g x L(-1), and the LC100 was 9.98, 9.00, 7.67 and 5.20 g x L(-1), respectively, while the SC was 1.70 g x L(-1). Under the same water pH and when the water salinity was 0.18 g x L(-1), the LC50 of carbonate-alkalinity within 24, 48, 72 and 96 hours was 14.36, 11.83, 10.35, and 7.68 mmol x L(-1), the LC0 was 8.76, 8.51, 4.65 and 3.88 mmol x L(-1), and the LC100 was 19.96, 15.14, 16.05 and 11.48 mmol x L(-1), respectively, while the SC was 1.70 mmol x L(-1). The survival rate of abnormal tadpole (R. chensinensis) was decreased with increasing water pH, salinity and carbonate-alkalinity. The optimum water salinity and carbonate-alkalinity to the survival and the growth of abnormal tadpole (R. chensinensis) were below 2.0 g x L(-1) and 3.0 mmol x L(-1), respectively, and water pH was between 6.0 and 9.0.