Timing of gestational diabetes diagnosis, gestational weight gains and offspring growth trajectory: a prospective birth cohort study.

BACKGROUND: The evidence on the associations of the timing of maternal gestational diabetes mellitus (GDM) with the comprehensive growth trajectory from perinatal to early childhood in offspring is limited. The potential mechanism remains elusive. Our aim is to estimate the associations of the timing of GDM diagnosis and gestational weight gains (GWG) with the growth trajectory of children from perinatal to early childhood. METHODS: A total of 7609 participants are included from the Maternal & Infants Health in Hefei cohort study. Primary predictors were the timing of maternal GDM diagnosis and GWG during pregnancy. The main outcomes included fetal ultrasonic measurements, birth size as well as BMI peak indicators during infancy within 48 months. RESULTS: GDM diagnosed before 26 weeks was associated with increased risks of overgrowth for fetal abdominal circumference (OR 1.19, 95% CI 1.04-1.36) and birth weight (OR 1.51, 95% CI 1.19-1.91) when compared with unexposed. GDM diagnosis < 26 weeks was related to the higher BMI peak (ß 0.16, 95%CI 0.03-0.28) within 48 months. The significantly additive impacts of maternal early GDM diagnosis and excessive gestational weight gains (EGWG) on offspring overgrowth were observed. Women in GDM < 26 weeks with early EGWG group had higher levels of hsCRP compared with GDM > 26 weeks (P < 0.001). CONCLUSIONS: Exposure to maternal GDM diagnosed before 26 weeks with early EGWG could lead to shifts and/or disruptions from the typical growth trajectory from perinatal to early childhood in offspring.

Maternal 25(OH)D attenuates the relationship between ambient air pollution during pregnancy and fetal hyperinsulinism.

Inflammatory responses have been demonstrated to link air pollution with insulin resistance and type 2 diabetes in adults. However, few studies have focused on the relationship between prenatal air pollution and fetal ß-cell function and the mediating effect of systematic inflammation remains elusive. Whether the anti-inflammatory effect of vitamin D could attenuate the ß-cell dysfunction in early life warrants further investigations. We aimed to determine whether maternal blood 25(OH)D attenuates the associations of ambient air pollution during pregnancy with fetal hyperinsulinism mediated by maternal inflammatory response. A total of 8250 mother-newborn pairs were included between 2015 and 2021 in the Maternal & Infants Health in Hefei study. Weekly mean air pollution exposure to fine particles (PM2.5 and PM10), SO2, and CO was estimated across pregnancy. Maternal serum samples in the third trimester were used to measure the high-sensitivity c-reactive protein (hs-CRP) and 25(OH)D. Cord blood samples at delivery were collected for the measurement of C-peptide. Fetal hyperinsulinism was based on cord C-peptide >90th centile. An increased fetal hyperinsulinism risk was associated with per 10 µg/m3 increase in PM2.5 [odds ratios (OR): 1.45 (95% confidence interval (CI):1.32, 1.59)], per 10 µg/m3 increase in PM10 [OR = 1.49 (95% CI:1.37, 1.63)], per 5 µg/m3 increase in SO2 [OR = 1.91 (95% CI: 1.70, 2.15)], and per 0.1 mg/m3 increase in CO [OR = 1.48 (95% CI:1.37, 1.61)] across pregnancy. Mediation analysis showed a 16.3% contribution of maternal hsCRP to the relationship between air pollution throughout pregnancy and fetal hyperinsulinism. Air pollution-associated higher levels of hsCRP and risk of fetal hyperinsulinism could be attenuated by higher maternal 25(OH)D levels. Prenatal ambient air pollution exposures were associated with an increased fetal hyperinsulinism risk mediated by maternal serum hsCRP. Higher antenatal 25(OH)D levels could attenuate air pollution-induced inflammatory responses and hyperinsulinism risk.

Comparison of the effectiveness of two pulmonary surfactant administration methods among premature infants with respiratory distress syndrome / 预防医学

Objective@#To compare the effectiveness of less invasive surfactant administration (LISA) and intubate surfactant extubation (INSURE) on respiratory distress syndrome (RDS) among premature infant, so as to provide insights into improving treatment effects and reducing complications of RDS among premature infants.@*Methods@#A total of 71 premature infants with RDS in Anhui Provincial Maternity and Child Health Hospital were randomly assigned into the LISA and INSURE group, and pulmonary surfactant (PS) administration was carried out by LISA and INSURE with basic support therapy and respiratory support therapy. The general information, arterial blood gas analysis before and after treatment, respiratory support time and incidence of complications were collected and compared between the two groups.@*Results@#There were 31 cases in the LISA group, with a gestational age of (29.81±0.99) weeks and 22 male cases, and 40 cases in the INSURE group, with a gestational age of (30.02±1.13) weeks and 26 male cases. There were no significant differences in basic characteristics (including gestational age, birth weight, gender, etc.) between the two groups (all P>0.05). After administration, the level of PaO2 was lower in the LISA group than in the INSURE group [(78.35±6.55) mmHg vs. (87.68±8.21) mmHg, P<0.05], the level of PaCO2 was higher in the LISA group than in the INSURE group [(43.03±6.34) mmHg vs. (38.68±9.69) mmHg, P<0.05], and the incidence of bronchopulmonary dysplasia was lower in the LISA group than in the INSURE group (48.39% vs. 72.50%, P<0.05). Linear regression analysis showed that with the duration of LISA administration increase (2-7 min), the minimum heart rate of premature infants increased linearly (β=13, P<0.05). @*Conclusions@#Compared with INSURE, LISA administration could slowly improve ventilation oxygenation, reduce hyperventilation and incidence of bronchopulmonary dysplasia among premature infants with RDS. The incidence of slow heart rate may be reduced by appropriately prolonging the administration duration.

Electrosynthesis of Vertically Aligned Zinc Oxide Nanoflakes on 3D Porous Cu Foam Enables Dendrite-Free Li-Metal Anode.

Three dimensional (3D) hosts have been recognized as effective current collectors for Li metal anodes because of their physical suppression of the lithium dendrites growth. A lithiophilic surface layer on them could increase the Li metal nucleation sites, further regulating the genuine plating of Li metal. The current strategies to construct this lithiophilic layer on 3D structure is complex and not suitable for the scalable fabrication of Li metal anode. In this work, we developed a facile method to grow vertically aligned ZnO nanoflakes on the surface of 3D Cu foam through an electrochemical synthetic process, which physically suppressed the Li dendrites growth due to the unique structure during the Li plating/stripping process. Moreover, these lithiophilic flakes effectively increase the specific surface area of the anode and Li metal nucleation sites number, which reduces the local current densities, leading to the formation of a robust SEI and further suppressing the Li dendrites growth. Consequently, the performances of the symmetric Li plated Cu foam/Li cell and the Li plated Cu foam/LiFePO4 full cell have been greatly enhanced after the growth of vertically aligned ZnO nanoflakes on the Cu foam surface, including capacity, cycling stability, overpotential, and rate capability.

Association of maternal prenatal depression and anxiety with toddler sleep: the China-Anhui Birth Cohort study.

Maternal prenatal depression is associated with child sleep. We investigated whether maternal depression comorbid with anxiety worsens toddler's sleep problems in a prospective cohort study. A total of 1583 mother-infant pairs from the China-Anhui Birth Cohort study were examined. The participants completed the Center for Epidemiologic Studies Depression Scale (CES-D) and Self-Rating Anxiety Scale (SAS) at 30-34 weeks of gestation, and the Edinburgh Postnatal Depression Scale (EPDS) at 3-month postpartum. Toddler's sleep was assessed by the Brief Infant Sleep Questionnaire (BISQ) at 30 months old. Logistic regression models were used to investigate the associations between prenatal depression and anxiety and toddler's sleep, while adjusting for maternal gestational age, education, family income, alcohol use, premature birth, fetal growth restriction, mode of delivery, postnatal depression, and 3-month breastfeeding. In total, 9.0% of participants reported prenatal depression comorbid with anxiety symptoms, and the prevalence of depression, anxiety was 6.7% and 7.3%, respectively. Compared with mothers without depression and anxiety, maternal depression combined with anxiety were significantly associated with shorter total sleep duration (11.16 ± 1.06 h), longer settling time (29.25 ± 23.57 min), and higher risk of toddlers' sleep problems assessed by BISQ (OR = 2.09, 95% CI: 1.22-3.57) or parental report (OR = 1.84, 95% CI: 1.22-2.77). However, there was no significant association between maternal postnatal depression and toddler sleep behaviors. Maternal prenatal depression comorbid with anxiety significantly associated with poorer toddler's sleep. Strategies to regulate prenatal mood status should be considered during prenatal health care to improve children's sleep development.

Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants.

BACKGROUND AND AIM: Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. METHODS: This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1-24 mL/(kg · day), 25-49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables. RESULTS: Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1-24 ml/(kg · day), 139 (14.4%) received 25-49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). CONCLUSIONS: A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03453502 . Registration date: March 5, 2018. This study was retrospectively registered.

Simultaneously Homogenized Electric Field and Ionic Flux for Reversible Ultrahigh-Areal-Capacity Li Deposition.

High areal capacity and stable Coulombic efficiency (CE) in lithium metal anodes (LMAs) play pivotal roles in developing high-energy-density rechargeable batteries. However, few reported LMAs delivering high and stable CE (>50 cycles) under ultrahigh areal capacity (>10 mA h cm-2). We demonstrated that the simultaneous homogenization of electric field and Li ion flux by using self-supported and surface-oxidized 3D hollow porous copper fibers (3D-HPCFs) can greatly increase both the areal capacity and reversibility of Li deposition. Li can be easily confined inside the hollow porous fibers and within the interspaces among fibers without uncontrollable Li dendrites. The 3D-HPCF-based anode can be deeply cycled at high capacity of 15 mA h cm-2 with average CE of 98.87% for 53 cycles, enabling a practical cell to realize high capacity retentions at a surplus Li of 10%. This work provides a novel Li deposition-regulation technology in LMAs targeting for next generation high-energy-density batteries.

Clinical observation of umbilical cord mesenchymal stem cell treatment of severe idiopathic pulmonary fibrosis: A case report.

Idiopathic pulmonary fibrosis (IPF) is a degenerative disease characterized by fibrosis. Cell therapy has been considered within the therapeutic options for IPF. In this study, we explored the potential benefits of human umbilical cord-derived mesenchymal stem cell (HUC-MSC) intravenous infusion in the management of IPF. We describe a case of a 56-year-old man with IPF who was receiving long-term oxygen therapy (LTOT). The patient underwent HUC-MSC intravenous infusion and was followed up for 12 months. Clinical and motor tests, as well as questionnaires assessing quality of life, were performed prior to and following the transplantation. At the end of 12 months, a relevant reduction of LTOT requirement was registered; improvements in terms of physical performance, quality of life, and respiratory parameters were observed in our patient. In conclusion, a program of HUC-MSC intravenous infusion appears to be beneficial to patients with IPF and may be considered as an additional therapeutic option.

Intravenous infusion umbilical cord-derived mesenchymal stem cell in primary immune thrombocytopenia: A two-year follow-up.

Four patients with chronic refractory immune thrombocytopenic purpura (ITP) received human umbilical cord-derived mesenchymal stem cells (hUC-MSCs). The hUC-MSC dose was 5×107 to 1×108. Complete remission (CR) was achieved in three patients in 12 months and one patient in 24 months. Three patients received the second hUC-MSC transplantation with the same dose. The median time between hUC-MSC transplantation and response was 12.5 days (range, 7-16). There were no severe adverse events during and post hUC-MSC transplantation. During follow-up (median, 17 months; range, 13-24) no other immunosuppressive drugs were used post-first hUC-MSCs transplantation. In conclusion, hUC-MSC transplantation is a reasonable salvage treatment in chronic refractory ITP. Prospective randomized large-scale clinical trials are needed to further elucidate the efficacy of hUC-MSCs transplantation therapy on ITP.

Functional characterization of human umbilical cord-derived mesenchymal stem cells for treatment of systolic heart failure.

Congestive heart failure (HF) is a leading cause of morbidity and mortality worldwide. Although advances in medical therapy, mechanical support and heart transplantation have been made, almost half of all patients with HF succumb to the disease within five years of the initial diagnosis. Therefore, treatment methods need to be identified to restore the structure and function of cardiac muscle. Three patients with HF caused by ischemic cardiomyopathy received human umbilical cord-derived mesenchymal stem cell (HUC-MSC) intravenous infusion were included in the present study. Two patients demonstrated a 65.1% increase in left ventricular ejection fraction (LVEF) at the end of 3 months, which was maintained increasing 47.8% at the end of 12 months post-HUC-MSC intravenous infusion. LVEF of patient 1 decreased slowly in the observation period. This LVEF improvement was associated with significant improvements in the clinical parameters of the New York Heart Association class, and six-minute walk test in the coupled time. The third patient showed significant improvement in the six-minute walk test at the end of 12 months, while the other parameters did not change obviously. There were no severe adverse events during and post-HUC-MSC transplantation. During follow-up, no other immunosuppressive drugs were used. In conclusion, HUC-MSC therapy is a reasonable salvage treatment in HF. Future large-scale randomized clinical trials are likely to be designed to elucidate the efficacy of the HUC-MSC transplantation therapy on HF.

Efficacy of umbilical cord-derived mesenchymal stem cell-based therapy for osteonecrosis of the femoral head: A three-year follow-up study.

This is a retrospective analysis of the clinical effects of transplant of mesenchymal stem cells (MSCs) derived from human umbilical cord-derived MSCs (hUC­MSCs) for the treatment of osteonecrosis of the femoral head (ONFH). The biological characteristics of hUC-MSCs were assessed using flow cytometry. Nine eligible patients were enrolled in the study as they adhered to the Association Research Circulation Osseous (ARCO) classification of stage â…¡­â…¢a, and hUC­MSCs were grafted by intra­arterial infusion. Organize effective perfusion was assessed using the oxygen delivery index (ODI). The results showed that the ODI was increased at three days post­operation. The MRI results revealed that at 12 and 24 months after treatment, the necrotic volume of the femoral heads was significantly reduced. No obvious abnormalities were observed. Taken together, these data indicate that intra­arterially infused hUC­MSCs migrate into the necrotic field of femoral heads and differentiate into osteoblasts, thus improving the necrosis of femoral heads. This finding suggested that intra­arterial infusion of hUC­MSCs MSCs is a feasible and relatively safe method for the treatment of femoral head necrosis.

Simultaneous determination of two-component isotherm parameters and lumped mass transfer coefficients in RPLC with the 0-1 model-inverse method.

The 0-1 model-inverse method of nonequilibrium nonlinear chromatography was developed to simultaneously determine the isotherm parameters and the lumped mass transfer coefficients of the two-component systems in RPLC. By comparing the simulated elution curves with experimental curves with regard to profiles and areas, the suitable isotherm parameters and the lumped mass transfer coefficients were obtained with the 0-1 model-inverse method. With a solute cell unit width of 1×10(-3) cm, the average errors of the peak areas were 0.178% for one component and -0.40% for two components, and the numerical diffusions of the 0-1 model for the contribution to band broadening may be negligible. In addition, the results showed that the lumped mass transfer coefficients decrease as the solute concentration increases. The 0-1 model-inverse method has not only the advantages of high calculation speed (less than 10 min for one-component systems or approximately 3 h for two-component systems using an ordinary computer) and high accuracy in simultaneously obtaining thermodynamic parameters and kinetic parameters of two-component systems, but this method also possesses the potential to optimally design and control the time-variant preparative chromatographic system due to the thermodynamic state recursion and the Lagrangian-Eulerian presentation of the 0-1 model.

Synthesis of highly stable dihydrolipoic acid capped water-soluble CdTe nanocrystals.

To prevent the dissociation of organic ligands from the inorganic core and accordingly enhance colloidal stability, is the prerequisite for the further application of nanocrystals in different areas. Dihydrolipoic acid (DHLA) appears very promising for the stabilization and the further functionalization of CdTe nanocrystals because DHLA is characterized by a carboxylic acid group and two thiol functions, through which simultaneous anchorage onto a nanoparticle's surface is possible. For the first time, we synthesized highly luminescent CdTe nanocrystals (maximum quantum yield of 42%) in aqueous solution by the reaction of Cd(2+) and NaHTe using DHLA as capping reagent. The influence of various experimental variables, including reaction temperature, ligand-to-Cd ratio and pH value as well as Te-to-Cd ratio, on the growth rate and optical properties of the obtained CdTe nanocrystals have been systematically investigated. Furthermore, the stability of the dithiol DHLA capped CdTe nanocrystals was compared with the monothiol ligands thioglycolicacid (TGA) and mercaptopropionic acid (MPA) capped nanocrystals. Experimental results indicate that the DHLA capped nanoparticles show better chemical and thermal stability than those capped by TGA or MPA. The mechanism for the high-quality optical properties and the good stability of the resulting CdTe nanocrystals is also primarily elucidated.