Prediction models for children/adolescents with obesity/overweight: A systematic review and meta-analysis.

The incidence of obesity and overweight in children and adolescents is increasing worldwide and becomes a global health concern. This study aims to evaluate the accuracy of available prediction models in early identification of obesity and overweight in general children or adolescents and identify predictive factors for the models, thus provide a reference for subsequent development of risk prediction tools for obesity and overweight in children or adolescents. Related publications were obtained from several databases such as PubMed, Embase, Cochrane Library, and Web of Science from their inception to September 18th, 2022. The novel Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to assess the bias risk of the included studies. R4.2.0 and Stata15.1 softwares were used to conduct meta-analysis. This study involved 45 cross-sectional and/or prospective studies with 126 models. Meta-analyses showed that the overall pooled index of concordance (c-index) of prediction models for children/adolescents with obesity and overweight in the training set was 0.769 (95% CI 0.754-0.785) and 0.835(95% CI 0.792-0.879), respectively. Additionally, a large number of predictors were found to be related to children's lifestyles, such as sleep duration, sleep quality, and eating speed. In conclusions, prediction models can be employed to predict obesity/overweight in children and adolescents. Most predictors are controllable factors and are associated with lifestyle. Therefore, the prediction model serves as an excellent tool to formulate effective strategies for combating obesity/overweight in pediatric patients.

Quantitative determination of chondroitin sulfate with various molecular weights in raw materials by pre-column derivatization with 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate.

A simple and reliable HPLC method was developed for quantification of chondroitin sulfate (CS). The procedure is based on precolumn hydrolysis of CS to liberate galactosamine and subsequent derivatization with 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate. Hydrolysis and derivatization conditions were optimized. A linear correlation coefficient of 0.9999 was calculated within the range of 10-1500 µg/mL from the standard curve. The method produces good precision and good accuracy (100.75 % recovery). An advantage over other common methods is its ability to quantify CS of all molecular weights and structures, as evidenced by the determination of CS fractions with narrow molecular weight distributions obtained through depolymerization by different methods, while enzymatic HPLC was proven to be infeasible. Extraction recoveries of CS from monosaccharide mixed samples were > 93 %. The reliability was also validated by a small difference (-1.95 % to 4.12 %) relative to enzymatic HPLC results in analysing representative CS samples of different animal origins and suppliers.

Molecular weight determination of low molecular weight hyaluronic acid and chondroitin sulfate by gel permeation chromatography.

Low molecular weight (LWM) hyaluronic acid (HA) and chondroitin sulfate (CS) have a wide range of applications. To determine their molecular weight (MW), we developed a gel permeation chromatography (GPC) method, which is calibrated based on serrated peaks in the chromatograms. MW calibrants were obtained from the enzymolysis of HA and CS using hyaluronidase. The identical structure of calibrants and samples ensured the soundness of the method. The highest confidence MWs were up to 14,454 and 14,605 for HA and CS, respectively, and the standard curves showed very high correlation coefficients. Thanks to the changeless relationship between MW and its contribution to the GPC integral, the second calibration curves could be derived via one GPC column, also embodied correlation coefficients of >0.9999. The discrepancies of MW values were minuscule, and the measurement of a sample could be conducted in <30 min. The accuracy of the method was verified using LWM heparins, and the measured Mw values showed a 1.2 %-2.0 % error relative to pharmacopeia results. The MW results obtained for LWM-HA and LWM-CS samples were also consistent with the results obtained by multiangle laser light scattering. The method was also verified be able to measure the very low MWs.

Knockdown of lncRNA MEG3 protects against sepsis-induced acute lung injury in mice through miR-93-5p-dependent inhibition of NF­κB signaling pathway.

Excessive inflammatory response is a prominent pathogenic hallmark of acute lung injury (ALI). Long noncoding RNA (lncRNA) has been recently reported to play a key role in the pathophysiology of many inflammatory disorders, including ALI. Herein, we attempted to explore the role and underlying mechanism of lncRNA MEG3 in the inflammation in ALI. Firstly, an ALI mouse model was generated via intra-tracheal instillation of lipopolysaccharide (LPS), and then, the impact of lncRNA MEG3 on lung tissue damage, pulmonary edema, lung microvascular permeability and pulmonary inflammatory response, as well as the ALI mice survival rate was investigated. LncRNA MEG3 was upregulated in lung tissues, and knockdown of lncRNA MEG3 protected mice from LPS-induced ALI, with significantly reduced lung pathological changes, decreased lung wet/dry (W/D) ratio and lung microvascular permeability, attenuated inflammatory response, along with increased ALI mice survival. Moreover, lncRNA MEG3 could sponge miR-93, negatively regulated its expression, and lncRNA MEG3 overexpression liberated the suppression of TLR4 expression caused by miR-93. Further, functional studies demonstrated that the protective effects of lncRNA MEG3 on excessive inflammatory response may be related to miR-93-mediated modulation of TLR4/MyD88/NF-κB pathway. Collectively, lncRNA MEG3 inhibition blocked TLR4/MyD88/NF-κB pathway to repress the progression of sepsis-induced lung injury via upregulating miR-93, implying that lncRNA MEG3 might be a viable therapeutic target for ALI.

Studies on Flavor Compounds and Free Amino Acid Dynamic Characteristics of Fermented Pork Loin Ham with a Complex Starter.

Staphylococcus simulans and Lactobacillus plantarum screened from Guizhou specialty food were used to prepare fermented pork loin ham. The sensory qualities and flavor profiles of fermented pork loin hams from 0 to 42 days were investigated in order to reveal the dynamics of fermented pork loin ham. The results show that total free amino acids (TFAA) content reached the highest value on the 35th day, and the umami amino acids, including aspartic acid (ASP), glutamic acid (GLU), glycine (GLY), and alanine (ALA), were the main amino acids in all periods. Notably, the RV coefficient (0.875) indicates that free amino acids (FAA) are highly correlated with the sensory score of the E-tongue. In terms of the volatile compounds identified, the esters content gradually increased between 7 and 42 days, and ethyl octanoate was the most abundant compound during all periods. These esters imparted a characteristic aroma component to the fermented pork loin ham. The most important finding was that the increase in the content of esters represented by octanoic acid-ethyl ester might be related to the increase in the content of FAA with the increase in fermentation time. Both the E-nose and E-tongue showed good discrimination ability for fermented tenderloin ham with different fermentation times, which was crucial in cases with large clusters. In addition, the multiple factor analysis (MFA) indicated that the E-nose aroma value might be the key factor in distinguishing fermented pork loin ham with different fermentation times.

Immune thrombocytopenia associated with Hashimoto thyroiditis in a pediatric patient: A case report.

RATIONALE: Immune thrombocytopenia (ITP) is one of the most commonly acquired bleeding diseases in children. Infection and autoimmune disorders are the most common causes of ITP. The pathogenic mechanism of ITP is complex and is not completely understood. Understanding the underlying causes or disorders of ITP will improve the prognosis and make therapy more targeted. PATIENT CONCERNS: An 8-year-old girl with ITP responded poorly to first- and second-line treatment. The patient showed multiple scattered petechiae, ecchymoses, and purpura in the skin and blood clots in the oral mucous membrane. DIAGNOSES: The patient was diagnosed with ITP associated with Hashimoto thyroiditis. INTERVENTIONS: The patient was admitted to our emergency department and received platelet transfusion, IVIG, glucocorticoids and eltrombopag. The patient's thrombocytopenia resolved within 18 days after the administration of levothyroxine treatment. OUTCOMES: The patient was diagnosed with Hashimoto thyroiditis, and the platelet count recovered on the 3rd day of levothyroxine treatment. The platelet count became steadily normal with levothyroxine and prednisone treatment within 2 months of follow-up. LESSONS: Early identification of the underlying reasons and treatment with multiple modalities may be useful in improving the prognosis of ITP. The treatment of thyroid disease and restoration of the euthyroid state impact the clinical outcome of ITP in children.

Retraction Note to: Associations of IL-8 gene polymorphisms and IL-8 levels with predisposition to age-related macular degeneration: a meta-analysis.

The authors have retracted this article.

Green, Simple, and Effective Process for the Comprehensive Utilization of Shrimp Shell Waste.

An environmentally friendly approach for the comprehensive utilization of shrimp shell waste was reported. Instant catapult steam explosion (ICSE) was employed for shrimp shell waste pretreatment. After ICSE, lower crystallinity and greater surface areas of shrimp shells were achieved, which significantly enhanced the extraction of chitin. Compared to the traditional method, weaker organic acid (HCOOH) and much lower dosages of KOH (90% molar less) were used, and chitin with a high demineralization rate (98.2%) and deproteinization rate (97.7%) was obtained. The wastewater was neutralized by simply intermixing, and it was recycled as a potential plant fertilizer because it contained more oligopeptides, calcium, and potassium, but it was less salty and therefore non-toxic to plants. The whole process produced less solid waste and no waste water. The obtained chitin also showed a low degree of acetylation (50.5%), which demonstrates the potential for environmentally friendly preparation of chitosan in dilute alkali through ICSE.

Crystalline reduction, surface area enlargement and pore generation of chitin by instant catapult steam explosion.

In this study, instant catapult steam explosion (ICSE) was employed for chitin treatment, and the effect of ICSE on the chitin structure was systematically investigated by using a series of analytical techniques including scanning electron microscopy, X-ray diffraction and Brunauer-Emmett-Teller analysis. Due to the powerful seepage force of the steam during ICSE, the crystallinity index of chitin decreased 10.2% in the (1 1 0) plane and 13.3% in the (0 2 0) plane. Significantly larger surface areas (up to 2.5 times greater, 12.69 m²/g at 1.6 MPa) with more and larger pores (up to a 3.5 times larger pore volume, 0.0333 cm³/g at 2.0 MPa) were achieved after ICSE, and numerous lacerated-like pore shapes were observed on the porous surface of chitin. Importantly, the molecular structure of chitin remained intact with no substantial damage to chitin's molecular weight, thermostability and acetylation (∼70%), which ensures the possibility and diversity of further chitin derivatization.

[Comparative Analysis of Different Soil Amendment Treatments on Rice Heavy Metal Accumulation and Yield Effect in Pb and Cd Contaminated Farmland].

Using selected sepiolite (SEP) and biochar (BC) as contrasts, we investigated the effects of a new cross-linked modified chitin (CC) on the bioavailability of Pb and Cd in soils, the yield of rice, and the absorption and accumulation of Pb and Cd in different parts of rice plants in a field environment. We hope this study provides the basis for the application of this material to improve soil fertility, and a direction for further soil improvement studies. A field experiment was carried out in 2015-2016 on selected Pb- and Cd-contaminated rice fields in Linghai, Liaoning. The changes in soil pH and available Pb and Cd in the soil were analyzed after the rice was harvested(October 2016). The effects of different treatments on the growth traits and yield of rice, the absorption of Pb and Cd by rice roots, stems and leaves, and grains were compared. The results showed that adding 167-333 kg·hm-2 CC could increase the soil pH value by 0.36-0.45 units, decreasing the contents of available Pb and Cd in the soil by 46.39%-64.01% and 29.73%-43.24% respectively (P<0.05). This treatment significantly reduced the Pb and Cd contents in all parts of rice (P<0.05) compared to conventional fertilization; Pb and Cd contents in different parts of rice were significantly reduced (P<0.05) by 16.09%-38.14% and 21.22%-31.38% in the root, 19.17%-46.92% and 25.66%-45.34% in the stem and leaf, and 29.47%-58.25% and 44.75%-64.02% in the grain, respectively. The treatment of adding 333 kg·hm-2 CC (CC-2) reduced the contents of Pb and Cd in rice grains to 0.2041±0.011 mg·kg-1 and 0.1922±0.021 mg·kg-1, respectively, which were lower than or close to the limit values of Pb and Cd in rice (0.20 mg·kg-1) as per GB 2762-2005. Compared to conventional fertilization, SEP treatment, and BC treatment, without adding any amendments, the yield per mu of rice under CC treatment increased by 33.6-47, 27.6-44, and 8.67-34.77 kg, respectively. The effect of CC-2 treatment on yield was the most obvious; the yield of rice per mu increased by 47 kg, and the yield increase rate was 8.59%. The ability of CC to repair soil contaminated by Pb and Cd and to reduce the contents of Pb and Cd in rice was not weaker than that of SEP and BC. The CC treatment also controlled the migration and redistribution of Pb and Cd in soil-rice systems, and significantly increased the yield of rice. It has good potential to ensure the safe production of rice.

Clinical Manifestations and Genetic Analysis of 17 Patients with Autosomal Dominant Hyper-IgE Syndrome in Mainland China: New Reports and a Literature Review.

PURPOSE: Autosomal dominant hyper-IgE syndrome (AD-HIES) is a rare complicated primary immunodeficiency disease (PID). Signal transducer and activator of transcription 3 (STAT3) gene mutation is found to cause AD-HIES. The distribution of AD-HIES patients with STAT3 deficiency in the Chinese population is not clear. Herein, we retrospectively report 17 AD-HIES patients with STAT3 deficiency and demonstrate their clinical, immunological, and genetic features. METHODS: Patients' clinical data were collected from their medical records. Routine laboratory testing results included lymphocyte subset analysis and immunoglobulin quantification. STAT3 mutations were investigated by sequencing of genomic DNA. RESULTS: Among 575 patients with PID, 28 (4.87%) were clinically diagnosed as HIES. Among them, 17 (2.96%) were confirmed as STAT3 mutant AD-HIES. The ratio of male to female patients was 8:9. All of the 17 patients had NIH scores over 40 points. The mean ages at onset and diagnosis were 1.05 and 10.35 years, respectively. Three patients (17.65%, 3/17) died with a mean age of 13.33 years. Eczema, recurrent skin infection, and respiratory tract infection were the most common clinical symptoms and are present in all of the 17 patients in this study. Six patients (37.5%, 6/16) suffered complication from BCG vaccination. Noninfection symptoms are characteristic facial features in 17 patients (100%, 17/17), retention of primary teeth in 10 patients (90.91%, 10/11), and abnormal bone fractures in 7 patients (41.18%, 7/17). Eleven types of STAT3 mutations were identified in 17 patients, including 1 novel mutation. CONCLUSIONS: We here retrospectively report the largest Chinese cohort of AD-HIES patients with STAT3 mutation. Unique features, when compared to existing literature reports, include (1) later age of diagnosis, (2) significantly higher rate of BCG complications, and (3) lower rate of candidiasis and chronic otitis media.

Variable clinical phenotypes of X-linked lymphoproliferative syndrome in China: Report of five cases with three novel mutations and review of the literature.

BACKGROUND: X-linked lymphoproliferative disease (XLP) is a rare life-threatening syndrome. Rapid recognition and definitive diagnosis are critical to improve the prognosis and survival of patients with XLP. Nowadays, little is known about patients with XLP in China. METHODS: We report the characterization of five Chinese XLP patients with three novel mutations and review the literature related to this syndrome. Male patients with fulminant infectious mononucleosis (FIM), Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (HLH) or persistent EBV viraemia were enrolled in this study. The patients' clinical features were assessed by retrieval of data from medical records. Immunological function included analysis of lymphocyte subsets and the detection of immunoglobulins G, A, M and/or E were evaluated by flow cytometry and nephelometry. Direct sequencing was used to detect SH2D1A/XIAP gene mutations. RESULTS: Twenty-two male patients with FIM, EBV-associated HLH or persistent EBV viraemia were evaluated among 421 PID patients in our centre. Four patients had SH2D1A mutations, and one patient had an XIAP mutation. The onset age of the 5 patients range from 1month to 4years which was earlier than that in the western world. The diagnosis age was between 16months and 9years with a long diagnosis lag (1-97months). Two of them had positive family history. The clinical phenotypes varied in different patients among which two patients with FHLH and hypogammaglobulinaemia, one with hypogammaglobulinaemia, lymphoma and aplastic anaemia (AA) which is the first case with AA in China, one with hypogammaglobulinaemia only and the other one with FHLH. For immunological function, three exhibited reduced CD4/CD8 ratios. Arg55stop mutations as well as splice mutation in intron 1 were most frequently found and exon 2 was the hottest exon in China. Two patients died at the time of diagnosis for severe infection or hepatic coma. Three were alive and waiting for haematopoietic stem cell transplantation (HSCT). CONCLUSION: For patients with severe EBV-associated HLH, hypogammaglobulinaemia, lymphoma and aplastic anaemia, possibility of XLP should be considered and if confirmed, HSCT should be performed as soon as possible.

Controllable targeted system based on pH-dependent thermo-responsive nanoparticles.

In this study, a pH-dependent thermo-responsive polymer (poly (N-isopropyl acrylamide-co-methacrylic acid-co-ethyl methacrylate, P(NIPAAm-co-MAA-co-EMA)), which was used as a masking functional module was designed and prepared. Its LCST was pH-dependent, leading to a sensitive isothermal phase transition between the blood and the extracellular environment of solid tumours. This masking polymer had a LCST of 36.4 °C at pH 6.5, and remained hydrophilic at pH 7.4 even when the temperature was increased to 50 °C. The liver-targeted nanoparticles (NPs) were then obtained by co-grafting the masking functional module and the targeting ligands glycyrrhetinic acid (GA) onto the gold nanoparticles (Au NPs). Their surface properties and targeting ability could be switched based on the expanding or shrinking behaviour of the polymers. The shielding/deshielding effect of GA was confirmed by the bovine serum albumin adsorption and cellular uptake. The results indicated that GA could be shielded by the hydrophilic P(NIPAAm-co-MAA-co-EMA) in the normal physiological environment (pH 7.4, 37 °C) and deshielded in the tumour microenvironment of pH 6.5, 40 °C, leading to an increase in cellular uptake as high as 2.3-fold compared with that observed at pH 7.4, 37 °C. More importantly, the ultrasensitive phase transition of the polymer was reversible, which means that the targeting ability of the deshielded Au NPs could be reshielded if they come back to the blood circulation.

Dehydroxymethylepoxyquinomicin selectively ablates T-CAEBV cells.

Chronic active Epstein-Barr virus infection (CAEBV) represents a new subtype of lymphoproliferative disorders characterized by high morbidity and mortality rates and often leads to malignant transformation of infected cells. Efficient therapeutic strategies are presently unavailable; therefore, the development of therapies to prevent CAEBV-mediated transformation and disease progression is crucial. Here, we used microarray analysis and luciferase reporter assays to reveal the potential role of activated nuclear factor kappa B (NF-kB) in T cell type of-CAEBV infection. Using a series of cellular and molecular experiments, we demonstrated that dehydroxymethylepoxyquinomicin (DHMEQ), a novel NF-kB inhibitor, can selectively induce apoptosis in SNT-16 cells infected with CAEBV. Mechanistic studies suggested that DHMEQ induces SNT-16 cell apoptosis through NF-kB inhibition coupled with oxidative stress generation. Thus, activated NF-kB could be a new target for CAEBV therapeutics. Owing to its selective targeting ability, DHMEQ may be a candidate for a novel therapeutic regimen to control the progression of CAEBV infections.

Shieldable tumor targeting based on pH responsive self-assembly/disassembly of gold nanoparticles.

A new approach to shield/deshield ligands for controllable tumor targeting was reported, which was based on amphiphilic self-assembly and disassembly of gold nanoparticles (Au NPs). Thanks to the excellent pH response of the system, glycyrrhetinic acid (GA) ligands can be buried inside the Au NPs' assembly at normal tissue pH (pH 7.4), while exposed when the nanostructure is disassembled at tumor extracellular pH (pHe 6.8). Hydrophobic GA molecules not only acted as ligands targeting tumor cells but also provided the major interparticle attractive force for Au NPs' assembling. An ordered assembly of Au NPs with regular shape, proper size and ultrasharp pH sensitivity (ΔpH ∼ 0.2) was achieved by fine-tuning of materials modified on Au NPs. Mechanism studies for assembly and disassembly of Au NPs indicated the possibility of a GA shield when the assembly formed, which was further demonstrated by bovine serum albumin absorption and cellular uptake. The assembly/disassembly process was reversible within extrinsic pH changes, which provides a perspective for reversible tumor targeting.

Clinical features and genetic analysis of 20 Chinese patients with X-linked hyper-IgM syndrome.

X-linked hyper-IgM syndrome (XHIGM) is one type of primary immunodeficiency diseases, resulting from defects in the CD40 ligand/CD40 signaling pathways. We retrospectively analyzed the clinical and molecular features of 20 Chinese patients diagnosed and followed up in hospitals affiliated to Shanghai Jiao Tong University School of Medicine from 1999 to 2013. The median onset age of these patients was 8.5 months (range: 20 days-21 months). Half of them had positive family histories, with a shorter diagnosis lag. The most common symptoms were recurrent sinopulmonary infections (18 patients, 90%), neutropenia (14 patients, 70%), oral ulcer (13 patients, 65%), and protracted diarrhea (13 patients, 65%). Six patients had BCGitis. Six patients received hematopoietic stem cell transplantations and four of them had immune reconstructions and clinical remissions. Eighteen unique mutations in CD40L gene were identified in these 20 patients from 19 unrelated families, with 12 novel mutations. We compared with reported mutation results and used bioinformatics software to predict the effects of mutations on the target protein. These mutations reflected the heterogeneity of CD40L gene and expanded our understanding of XHIGM.

Highly efficient enantioselective construction of bispirooxindoles containing three stereocenters through an organocatalytic cascade Michael-cyclization reaction.

Bispirooxindole derivatives containing three stereocenters, including two spiro quaternary centers, were synthesized in a high-yielding, atypically rapid, and stereocontrolled cascade Michael-cyclization reaction between methyleneindolinones and isothiocyanato oxindoles catalyzed by a bi- or multifunctional organocatalyst. Mild conditions were used to construct bispirooxindoles with excellent enantio- and diastereomeric purities within less than 1 min. Catalyst reconfiguration offered access to the opposite enantiomer. This exceptionally highly efficient procedure will allow diversity-oriented syntheses of this intriguing class of compounds with potential biological activities.

Surfactant-controlled morphology and magnetic property of manganese ferrite nanocrystal contrast agent.

MnFe(2)O(4) nanocrystals (NCs) coated with three different surfactants (oleic acid, oleylamine or 1,2-hexadecanediol) and their mixtures, with sizes in range 6-12 nm, were synthesized by high-temperature decomposition of organometallic precursors. The effects of morphology and surface chemistry of MnFe(2)O(4) NCs on the magnetic properties were systematically investigated by comparing their saturation magnetization values and their capability to improve the negative contrast for magnetic resonance imaging (MRI) after converting the hydrophobic NCs to hydrophilic ones by a ligand exchange protocol. An important finding is that the magnetization values and proton relaxivity rates of MnFe(2)O(4) NCs are strongly dependent on the size and surface state of the particles that covalently bonded with different hydrophobic ligands before ligand exchange. In particular, monodisperse cubic MnFe(2)O(4) NCs could be obtained when oleylamine and 1,2-hexadecanediol were used as mixed stabilizers, and showed excellent morphology and magnetic properties. Furthermore, the low cytotoxicity and good cell uptake MR imaging of the dopamine capped MnFe(2)O(4) NCs make them promising candidates for use as bio-imaging probes.