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OBJECTIVES: Nausea and vomiting in pregnancy (NVP) is a common condition that reduces the quality of life by negatively affecting work and family life, physical and mental health, and economic well-being. However, its risk factors remain unclear. This study aimed to explore the association between NVP and verbal rating scale (VRS)-measured dysmenorrhea and to explore potential protective factors. METHODS: This retrospective cohort study was conducted from June 2018 to December 2020 at Tongji Hospital in Wuhan. Information on baseline characteristics, pregnancy-related history, periconceptional micronutrient supplementation, and obstetric outcomes were collected. The severity of dysmenorrhea was assessed using VRS. RESULTS: A total of 443 pregnant women were recruited and divided into the NVP group (n = 76) and the control group (n = 367). A significant association was observed between NVP and VRS-measured dysmenorrhea (c2=10.038, P = 0.007). After adjusting for covariates, the association between moderate/severe dysmenorrhea and NVP remained significant (OR 2.384; 95% CI 1.104-5.148, P = 0.004). First-trimester docosahexaenoic acid supplement (OR 0.443; 95% CI 0.205-0.960, P = 0.039) may be beneficial in reducing the risk of NVP. CONCLUSIONS: Women with moderate to severe dysmenorrhea have a higher risk of experiencing NVP during the first trimester. Periconceptional docosahexaenoic acid supplementation may play a protective role.
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Dismenorrea , Humanos , Femenino , Embarazo , Estudios Retrospectivos , Adulto , Náusea , Náuseas Matinales , Estudios de Cohortes , Complicaciones del Embarazo , China , Índice de Severidad de la Enfermedad , VómitosRESUMEN
OBJECTIVE: To explore the genetic basis for a child with optic atrophy and global developmental delay. METHODS: A child who had presented at the Guangzhou Women and Children's Medical Center in January 2022 was selected as the study subject. Clinical data were collected. Whole exome sequencing (WES) was carried out for the child. Candidate variant was validated by Sanger sequencing and bioinformatic analysis. RESULTS: The child, a nine-month-old female, had manifested dysopia and global developmental delay. Genetic testing revealed that she has harbored a de novo c.425G>C (p.Arg142Pro) variant of the NR2F1 gene, which has been associated with Bosch-Boonstra-Schaaf syndrome. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as pathogenic (PS2+PM1+PM2_Supporting+PM5+PP3+PP4). CONCLUSION: The c.425G>C (p.Arg142Pro) variant of the NR2F1 gene probably underlay the pathogenesis in this child. Above finding has enriched the genotypic and phenotypic spectrum of the NR2F1 gene.
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Atrofia Óptica , Femenino , Humanos , Lactante , Biología Computacional , Factor de Transcripción COUP I/genética , Pruebas Genéticas , Genómica , Genotipo , Atrofia Óptica/genéticaRESUMEN
An Fe-based catalyst was prepared by oxidising waste Fe shavings directly in a solution. In engineering applications, Fe shavings were compressed and modified to form Fe-based monolithic catalyst packing. Both of which exhibited excellent catalytic activity in catalytic ozonation industrial wastewater after biochemical treatment. Fe-based monolithic catalyst packing has irregular channels, large porosity, small pore diameter, and the effective specific surface area (SSA) up to 3500 m2/m3, these characteristics are conducive to mass transfer, and promote the effective utilisation of â¢OH in the catalyst "action zone". A tower reactor (<3000 m3/d) and reinforced concrete construction reactor (>5000 m3/d) were designed according to the wastewater flow. Regression analysis showed that hydraulic residence time (HRT) and O3/CODin are important parameters in engineering design and operation. In addition, strategies for the application of Fe-based monolithic catalyst packing to wastewater with high salinity and high inorganic carbon concentration have been proposed. Fe-based monolithic catalyst packing catalytic ozonation is a relatively cost-effective and eco-friendly process with extremely broad application prospects in the advanced treatment of industrial wastewater.
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Ozono , Contaminantes Químicos del Agua , Purificación del Agua , Aguas Residuales , Hierro/análisis , Contaminantes Químicos del Agua/análisis , CatálisisRESUMEN
Japanese encephalitis virus (JEV), an important neurotropic pathogen, belongs to the genus Flavivirus of the family Flaviviridae and has caused huge threat to public health. It is still obscure regarding the functions of stem-loop (SL) and dumbbell (DB) domains of JEV 3' UTR in viral replication and virulence. In the current study, using the infectious clone of JEV SA14 strain as a backbone, we constructed a series of deletion mutants of 3' UTR to investigate their effects on virus replication. The results showed that partial deletions within SL or DB domain had no apparent effects on virus replication in both mammalian (BHK-21) and mosquito (C6/36) cells, suggesting that they were not involved in viral host-specific replication. However, the entire SL domain deletion (ΔVR) significantly reduced virus replication in both cell lines, indicating the important role of the complete SL domain in virus replication. The revertant of ΔVR mutant virus was obtained by serial passage in BHK-21 cells that acquired a duplication of DB domain (DB-dup) in the 3' UTR, which greatly restored virus replication as well as the capability to produce the subgenomic flavivirus RNAs (sfRNAs). Interestingly, the DB-dup mutant virus was highly attenuated in C57BL/6 mice despite replicating similar to WT JEV. These findings demonstrate the significant roles of the duplicated structures in 3' UTR in JEV replication and provide a novel strategy for the design of live-attenuated vaccines.
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Regiones no Traducidas 3' , Virus de la Encefalitis Japonesa (Especie)/genética , Virus de la Encefalitis Japonesa (Especie)/fisiología , Encefalitis Japonesa/virología , Replicación Viral/genética , Animales , Línea Celular , Virus de la Encefalitis Japonesa (Especie)/patogenicidad , Ratones , Ratones Endogámicos C57BL , Mutación , Conformación de Ácido Nucleico , ARN Viral/química , ARN Viral/genética , Virulencia/genéticaRESUMEN
IMPORTANCE: The clinical characteristics of infectious mononucleosis (IM) in Chinese children have not been evaluated in multicenter studies, and the effectiveness of antiviral treatment are controversial. OBJECTIVE: To investigate the clinical characteristics of Chinese children with IM and current status of antiviral therapy for affected patients. METHODS: Hospitalized patients with IM were enrolled between 2018 and 2020 in five children's hospitals in China. The clinical characteristics were compared among four age groups: <3 years, 3-<6 years, 6-<10 years, and ≥10 years. The clinical characteristics of IM and effectiveness of antiviral therapy were compared among patients receiving acyclovir (ACV), ganciclovir (GCV), and no antiviral therapy (i.e., non-antiviral group). RESULTS: In total, 499 patients were analyzed; most patients were 3-<6 years of age. The most common symptoms and signs included fever (100%), lymphadenopathy (98.6%), pharyngitis (86.4%), eyelid edema (76.8%), and snoring (72.9%). There were significant differences in rash, hepatomegaly, and liver dysfunction among the four age groups. Patients aged < 3 years had a lower incidence of liver dysfunction and a higher incidence of rash. Among the 499 patients, 50.1% were treated with GCV, 26.3% were treated with ACV, and 23.6% received no antiviral therapy. Compared with the non-antiviral group, patients in the ACV and GCV groups had longer durations of fever (P < 0.001). There were no significant differences in the incidences of complications among the three treatment groups. INTERPRETATION: The incidence of IM in Chinese children peaked at 3-<6 years of age. Clinical features of IM varied according to age. Patients receiving antiviral therapy exhibited more serious clinical manifestations than did patients without antiviral therapy. The effectiveness of antiviral therapy for IM requires further analysis.
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Rationale: Children usually develop less severe symptoms responding to Coronavirus Disease 2019 (COVID-19) than adults. However, little is known about the molecular alterations and pathogenesis of COVID-19 in children. Methods: We conducted plasma proteomic and metabolomic profilings of the blood samples of a cohort containing 18 COVID-19-children with mild symptoms and 12 healthy children, which were enrolled from hospital admissions and outpatients, respectively. Statistical analyses were performed to identify molecules specifically altered in COVID-19-children. We also developed a machine learning-based pipeline named inference of biomolecular combinations with minimal bias (iBM) to prioritize proteins and metabolites strongly altered in COVID-19-children, and experimentally validated the predictions. Results: By comparing to the multi-omic data in adults, we identified 44 proteins and 249 metabolites differentially altered in COVID-19-children against healthy children or COVID-19-adults. Further analyses demonstrated that both deteriorative immune response/inflammation processes and protective antioxidant or anti-inflammatory processes were markedly induced in COVID-19-children. Using iBM, we prioritized two combinations that contained 5 proteins and 5 metabolites, respectively, each exhibiting a total area under curve (AUC) value of 100% to accurately distinguish COVID-19-children from healthy children or COVID-19-adults. Further experiments validated that all the 5 proteins were up-regulated upon coronavirus infection. Interestingly, we found that the prioritized metabolites inhibited the expression of pro-inflammatory factors, and two of them, methylmalonic acid (MMA) and mannitol, also suppressed coronaviral replication, implying a protective role of these metabolites in COVID-19-children. Conclusion: The finding of a strong antagonism of deteriorative and protective effects provided new insights on the mechanism and pathogenesis of COVID-19 in children that mostly underwent mild symptoms. The identified metabolites strongly altered in COVID-19-children could serve as potential therapeutic agents of COVID-19.
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COVID-19/sangre , COVID-19/virología , Adulto , COVID-19/epidemiología , COVID-19/inmunología , Niño , Preescolar , China/epidemiología , Femenino , Hospitalización , Humanos , Masculino , Metabolómica/métodos , Persona de Mediana Edad , Proteómica/métodos , SARS-CoV-2/aislamiento & purificaciónRESUMEN
OBJECTIVE: Mild encephalopathy with reversible splenial lesion (MERS) is associated with a variety of infections and anti-epileptic drug withdrawal. Here we report the clinical characteristics of H1N1 influenza A-associated MERS based on our experience of four pediatric cases. METHODS: A detailed retrospective analysis of four patients with H1N1 influenza A-associated MERS was performed at Guangzhou Women and Children's Medical Center. RESULTS: All patients exhibited mild influenza-like illness and seizures. Three patients presented with a new-onset seizure with fever after 5 years of age. 75% patients had altered mental status. For all four patients, influenza A (H1N1) viral RNA was detected in throat swab specimens at least twice. Brain magnetic resonance images revealed similar ovoid lesions in the corpus callosum, mainly in the splenium and for one patient in the splenium and genu of the corpus callosum. Only one patient had an abnormal electroencephalogram tracing. Cells and protein in the cerebrospinal fluid were normal in all patients. All patients received oseltamivir and one patient received intravenous immunoglobulin. As a result, all patients fully recovered after 2 months and showed no neurologic sequelae at discharge. CONCLUSION: This case series provides insight towards clinical features of H1N1 influenza A-associated MERS.
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Encefalopatías/diagnóstico , Encéfalo/diagnóstico por imagen , Cuerpo Calloso/diagnóstico por imagen , Subtipo H1N1 del Virus de la Influenza A/patogenicidad , Encéfalo/fisiopatología , Encefalopatías/diagnóstico por imagen , Encefalopatías/fisiopatología , Encefalopatías/virología , Niño , Preescolar , Cuerpo Calloso/fisiopatología , Femenino , Humanos , Gripe Humana/complicaciones , Gripe Humana/diagnóstico , Gripe Humana/fisiopatología , Gripe Humana/virología , Imagen por Resonancia Magnética , MasculinoRESUMEN
BACKGROUND: Many medical image processing problems can be translated into solving the optimization models. In reality, there are lots of nonconvex optimization problems in medical image processing. OBJECTIVE: In this paper, we focus on a special class of robust nonconvex optimization, namely, robust optimization where given the parameters, the objective function can be expressed as the difference of convex functions. METHODS: We present the necessary condition for optimality under general assumptions. To solve this problem, a sequential robust convex optimization algorithm is proposed. RESULTS: We show that the new algorithm is globally convergent to a stationary point of the original problem under the general assumption about the uncertain set. The application of medical image enhancement is conducted and the numerical result shows its efficiency.
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Algoritmos , Procesamiento de Imagen Asistido por Computador , Humanos , Aumento de la ImagenRESUMEN
AIMS: We aimed to establish the basal reference levels of liver stiffness and accumulated fat in healthy Chinese children. METHODS: To obtain the liver stiffness measurement (LSM) and the fat attenuation parameter (FAP) levels, the transient elastography (FibroTouch) was used in pediatric patients aged 0 to 18 years. The patients were divided into groups as follows: newborns/infants (0-2 years), preschool children (3-5 years), elementary school children (6-11 years), and adolescents/teenagers (12-18 years). The weight, height and fasting liver function tests were performed. FibroTouch and abdominal ultrasonography were performed. RESULTS: The livers of 521 out of 1362 children (329 male; median age, 4.6 years; age range 0.2-17.6 years) were examined with the FibroTouch. The LSM reference range was 1.5-5.9 kPa, and the FAP reference range was 159.6-217.1 dB/m in healthy children from 0 to 18 years of age. The median LSM value was higher in males than that in females (3.5 vs. 3.2 kPa, respectively; P = 0.01). CONCLUSION: For healthy children from 0 to 18 years in southern China, the LSM reference range was 1.5-5.9 kPa, and the FAP reference range was 159.6-217.1 dB/m. The LSM values were age-dependent in children from 3 to 18 years old, and the FAP values were age-independent in children from 0 to18 years old.
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Diagnóstico por Imagen de Elasticidad , Adolescente , Niño , Preescolar , China , Femenino , Humanos , Lactante , Recién Nacido , Hígado/diagnóstico por imagen , Hígado/patología , Cirrosis Hepática/patología , Masculino , Valores de ReferenciaAsunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/genética , Infecciones por Coronavirus/virología , Proteínas de la Nucleocápside/genética , Neumonía Viral/genética , Neumonía Viral/virología , Interferencia de ARN , Betacoronavirus/patogenicidad , Betacoronavirus/fisiología , COVID-19 , Proteínas de la Nucleocápside de Coronavirus , ARN Helicasas DEAD-box/metabolismo , Proteínas Fluorescentes Verdes/antagonistas & inhibidores , Proteínas Fluorescentes Verdes/genética , Células HEK293 , Humanos , Proteínas de la Nucleocápside/fisiología , Pandemias , Fosfoproteínas , ARN Mensajero/genética , ARN Mensajero/metabolismo , ARN Interferente Pequeño/genética , Proteínas de Unión al ARN/genética , Proteínas de Unión al ARN/fisiología , Ribonucleasa III/metabolismo , SARS-CoV-2 , TransfecciónRESUMEN
We report epidemiological and clinical investigations on ten pediatric SARS-CoV-2 infection cases confirmed by real-time reverse transcription PCR assay of SARS-CoV-2 RNA. Symptoms in these cases were nonspecific and no children required respiratory support or intensive care. Chest X-rays lacked definite signs of pneumonia, a defining feature of the infection in adult cases. Notably, eight children persistently tested positive on rectal swabs even after nasopharyngeal testing was negative, raising the possibility of fecal-oral transmission.
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Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Heces/virología , Neumonía Viral/virología , Esparcimiento de Virus , Betacoronavirus/genética , COVID-19 , Prueba de COVID-19 , Niño , Preescolar , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Femenino , Humanos , Lactante , Masculino , Nasofaringe/virología , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Radiografía Torácica , Reacción en Cadena en Tiempo Real de la Polimerasa , Recto/virología , SARS-CoV-2RESUMEN
In response to the current coronavirus disease 2019 (COVID-19) pandemic, it is crucial to understand the origin, transmission, and evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which relies on close surveillance of genomic diversity in clinical samples. Although the mutation at the population level had been extensively investigated, how the mutations evolve at the individual level is largely unknown. Eighteen time-series fecal samples were collected from nine patients with COVID-19 during the convalescent phase. The nucleic acids of SARS-CoV-2 were enriched by the hybrid capture method. First, we demonstrated the outstanding performance of the hybrid capture method in detecting intra-host variants. We identified 229 intra-host variants at 182 sites in 18 fecal samples. Among them, nineteen variants presented frequency changes > 0.3 within 1-5 days, reflecting highly dynamic intra-host viral populations. Moreover, the evolution of the viral genome demonstrated that the virus was probably viable in the gastrointestinal tract during the convalescent period. Meanwhile, we also found that the same mutation showed a distinct pattern of frequency changes in different individuals, indicating a strong random drift. In summary, dramatic changes of the SARS-CoV-2 genome were detected in fecal samples during the convalescent period; whether the viral load in feces is sufficient to establish an infection warranted further investigation.
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COVID-19/prevención & control , Heces/virología , Genoma Viral/genética , SARS-CoV-2/genética , COVID-19/epidemiología , COVID-19/virología , Convalecencia , Perfilación de la Expresión Génica/métodos , Genómica/métodos , Haplotipos , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Humanos , Mutación , Pandemias , Polimorfismo de Nucleótido Simple , SARS-CoV-2/fisiología , Factores de TiempoRESUMEN
The massive amount of sludge generated by the classic Fenton process, which has often been hypothesized to consist of ferric hydroxide, remains a major obstacle to its large-scale application. Therefore, reutilization of Fenton sludge has recently gained more attention. Understanding the formation, transformation, and properties of Fenton sludge combined with the stages of the Fenton reaction is pivotal, but not well illustrated yet. In this study, SEM-EDS, FT-IR, XRD, and XPS were applied to study the morphology, crystallinity, elemental composition, and valence state of Fenton sludge. The authors report that schwertmannite and 2-line ferrihydrite were generated and transformed in the oxidation phase and the neutralization phase of the Fenton process. SO42- in the solution decreased by 8.7%-26.0% at different molar ratios of Fe(II) to H2O2; meanwhile, iron ion precipitated completely at pHâ¯3.70 with the formation of schwertmannite containing sulfate groups in the Fenton sludge. The structural sulfate (Fe-SO4) in schwertmannite was released from the precipitate with the addition of OH-, and the production of Fenton sludge decreased with increasing pH when pHâ¯>â¯3.70. Goethite was found to form when the final pH was adjusted to 12 or at a reaction temperature of 80°C. Moreover, the possible thermal transformation to goethite and hematite indicated that Fenton sludge can be reused as a raw material for synthesizing more stable iron (hydro)oxides. The results provide useful insights into the formation and transformation of Fenton sludge, with implications for regulating the crystal type of Fenton sludge for further reuse.
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Compuestos de Hierro/química , Modelos Químicos , Peróxido de Hidrógeno/química , Concentración de Iones de Hidrógeno , Hierro/química , Oxidación-Reducción , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
INTRODUCTION: Hand-foot-and-mouth disease (HFMD) is a paediatric infectious disease that is particularly prevalent in China. Severe HFMDs characterised by neurological involvement are fatal and survivors who have apparently fully recovered might still be afflicted later in life with neurocognitive impairments. Only when a well-designed, prospective cohort study is in place can we develop clinical tools for early warning of neurological involvement and can we obtain epidemiological evidence regarding the lingering effects of the sequelea. METHODS AND ANALYSIS: A prospective, hospital-based cohort study is underway in Guangzhou, China. Clinical data and biosamples from hospitalised children (<14 years of age) with an admission diagnosis of HFMD will be collected to determine risk factors for subsequent neurological involvement. Clinical tools for early detection of severe HFMDs will be developed by integrating clinical and biological information. Questionnaire surveys and neurocognitive assessments will be conducted at discharge and each year in the first 2 years of follow-up and every 2 years afterwards until study participants turn 16 years of age or show no evidence of neurocognitive deficits. The association between childhood enterovirus infection and neurocognitive impairment later in life will be examined. ETHICS AND DISSEMINATION: A written informed consent from parents/guardians is a prerequisite for study entry. The protocol of this study has been approved by the hospital's ethics committee. Data usage follows the rules of the hospital's data oversight committee. Findings of this study will be disseminated through publications in international peer-reviewed journals and will be presented in academic conferences. TRIAL REGISTRATION NUMBER: ChiCTR-EOC-17013293; Pre-results.
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Enfermedad de Boca, Mano y Pie/complicaciones , Trastornos Neurocognitivos/epidemiología , Adolescente , Animales , Niño , Preescolar , China/epidemiología , Progresión de la Enfermedad , Femenino , Humanos , Lactante , Masculino , Prevalencia , Estudios Prospectivos , Proyectos de Investigación , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
An Fe-based catalyst was used as a heterogeneous catalyst for the ozonation of industrial wastewater, and key operational parameters (pH and catalyst dosage) were studied. The results indicated that the Fe-based catalyst significantly improved the mineralization of organic pollutants in wastewater. TOC (total organic carbon) removal was high, at 78.7%, with a catalyst concentration of 200â¯g/L, but only 31.6% with ozonation alone. The Fe-based catalyst significantly promoted ozone decomposition by 70% in aqueous solution. Hydroxyl radicals (·OH) were confirmed to be existed directly via EPR (electron paramagnetic resonance) experiments, and ·OH were verified to account for about 34.4% of TOC removal with NaHCO3 as a radical scavenger. Through characterization by SEM-EDS (field emission scanning electron microscope with energy-dispersive spectrometer), XRD (X-ray powder diffraction) and XPS (X-ray photoelectron spectroscopy), it was deduced that FeOOH on the surface of the catalyst was the dominant contributor to the catalytic efficiency. The catalyst was certified as having good stability and excellent reusability based on 50 successive operations and could be used as a filler simultaneously. Thereby, it is a promising catalyst for practical industrial wastewater advanced treatment.
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Catálisis , Residuos Industriales , Hierro/química , Ozono/química , Aguas Residuales/química , Purificación del Agua/métodos , Carbono/aislamiento & purificación , Radical Hidroxilo/química , Contaminantes Químicos del Agua/químicaRESUMEN
OBJECTIVE: To investigate the incidence of late-onset sepsis (LOS) in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU) and the risk factors for LOS. METHODS: A retrospective analysis was performed for the clinical data of all VLBW and ELBW infants who were hospitalized in the NICU between January 2011 and December 2013. According to the presence or absence of LOS, these infants were divided into LOS group and non-LOS group. The incidence and mortality rates of LOS, common pathogenic bacteria, and risk factors for LOS were analyzed. RESULTS: Of the 226 VLBW and ELBW infants, 117 (51.8%) developed LOS, among whom 45 had a confirmed diagnosis of LOS and 72 had a clinical diagnosis of LOS. The LOS group had a significantly higher mortality rate than the non-LOS group [13.7% (16/117) vs 4.6% (5/109); P<0.05]. Bacterial culture found 51 strains of pathogenic bacteria, among which 32 (63%) were Gram-negative bacteria, 16 (31%) were Gram-positive bacteria, and 3 (6%) were fungi. The multivariate logistic regression analysis showed that gestational age, small for gestational age (SGA), duration of parenteral nutrition, peripherally inserted central catheter (PICC) placement, and mechanical ventilation were independent risk factors for LOS in VLBW and ELBW infants (OR=0.84, 1.59, 1.34, 3.11, and 4.55 respectively; P<0.05). CONCLUSIONS: LOS has high incidence and mortality rates in VLBW and ELBW infants. Common pathogenic bacteria of LOS are Gram-negative bacteria. Low gestational age, long duration of parenteral nutrition, SGA, PICC placement, and mechanical ventilation may increase the risk of LOS in VLBW and ELBW infants.
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Recien Nacido con Peso al Nacer Extremadamente Bajo , Recién Nacido de muy Bajo Peso , Sepsis/epidemiología , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Sepsis/etiología , Sepsis/mortalidadRESUMEN
Hyperbilirubinemia is a common cause for irreversible neuronal influence in the brain of term newborns, while the feature of neurological symptoms associated with hyperbilirubinemia has not been well characterized yet. In the present study, we examined a total of 203 neonates suffering from hyperbilirubinemia with a bedside amplitude-integrated Electroencephalography (aEEG) device, in order to determine whether there is any special change in sleep-wake cycles (SWCs). Among these patients, 14 cases showed no recognizable SWCs with the total serum bilirubin (TSB) level at 483.9-996.2 µmol/L; 75 cases exhibited reduced SWCs with the TSB level at 311.2-688.5 µmol/L; and the rest cases had the normal SWCs. The number of the normal SWCs occurrence had a significant negative correlation with the increased TSB level in a non-linear manner (r = -0.689, p <0.001). In addition, the increased TSB reshaped the structure of SWC by narrowing down the broadband and broadening the narrowband. Spearman's correlation analysis indicated a significant negative correlation between the TSB level and the ratio of broadband (r = -0.618, p < 0.001), a significant positive correlation between the TSB level and the narrowband ratio (r = 0.618, p < 0.001), respectively. Furthermore, the change of SWC seemed like a continuous phenomenon, and the hyperbilirubinemia caused SWC changes was fit into a loess model in this paper. In summary, the hyperbilirubinemia influenced SWC of term newborns significantly at a non-linear manner, and these results revealed the feature of the neurological sequela that is associated with TSB.
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Ritmo Circadiano , Hiperbilirrubinemia/fisiopatología , Recién Nacido/sangre , Trastornos del Sueño-Vigilia/sangre , Bilirrubina/sangre , Estudios de Casos y Controles , Electroencefalografía , Femenino , Humanos , Hiperbilirrubinemia/sangre , Hiperbilirrubinemia/complicaciones , Recién Nacido/fisiología , Masculino , Sueño , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/fisiopatología , VigiliaRESUMEN
To treat respiratory distress syndrome, surfactant is currently delivered via less invasive surfactant administration (LISA) or INtubation SURfactant Extubation (INSURE). The aim of this study was to compare the effect of the two delivery methods of surfactant on cerebral autoregulation. Near infrared spectroscopy monitoring was carried out to detect cerebral oxygen saturation (ScO2), and the mean arterial blood pressure (MABP) was simultaneously recorded. Of 44 preterm infants included, the surfactant was administrated to 22 via LISA and 22 via INSURE. The clinical characteristics, treatments and outcomes of the infants showed no significant differences between the two groups. The correlation coefficient of ScO2 and MABP (r ScO2-MABP) 5 min before administration was similar in the two groups. During surfactant administration, r ScO2-MABP increased in both groups (0.44±0.10 to 0.54±0.12 in LISA, 0.45±0.11 to 0.69±0.09 in INSURE). In the first and second 5 min after instillation, r ScO2-MABP was not significantly different from baseline in the LISA group, but increased in the first 5 min after instillation (0.59±0.13, P=0.000 compared with the baseline in the same group) and recovered in the second 5 min after instillation (0.48±0.10, P=0.321) in the INSURE group. There were significant differences in the change rates of r ScO2-MABP between the two groups during and after surfactant administration. Our results suggest that cerebral autoregulation may be affected transiently by surfactant administration. The effect duration of LISA is shorter than that of INSURE (<5 min in LISA vs. 5-10 min in INSURE).
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Administración Intranasal/efectos adversos , Encéfalo/metabolismo , Homeostasis , Recien Nacido Prematuro , Intubación/efectos adversos , Surfactantes Pulmonares/administración & dosificación , Síndrome de Dificultad Respiratoria del Recién Nacido/tratamiento farmacológico , Femenino , Humanos , Recién Nacido , Masculino , Consumo de Oxígeno , Surfactantes Pulmonares/uso terapéutico , Síndrome de Dificultad Respiratoria del Recién Nacido/terapiaRESUMEN
In mammalian cells, DNA methylation critically regulates gene expression and thus has pivotal roles in myriad of physiological and pathological processes. Here we report a novel method for targeted DNA demethylation using the widely used clustered regularly interspaced short palindromic repeat (CRISPR)-Cas system. Initially, modified single guide RNAs (sgRNAs) (sgRNA2.0) were constructed by inserting two copies of bacteriophage MS2 RNA elements into the conventional sgRNAs, which would facilitate the tethering of the Tet1 catalytic domain (Tet-CD), in fusion with dCas9 or MS2 coat proteins, to the targeted gene loci. Subsequently, such system was shown to significantly upregulate transcription of the target genes, including RANKL, MAGEB2 or MMP2, which was in close correlation to DNA demethylation of their neighboring CpGs in the promoters. In addition, the dCas9/sgRNA2.0-directed demethylation system appeared to afford efficient demethylation of the target genes with tenuous off-target effects. Applications of this system would not only help us understand mechanistically how DNA methylation might regulate gene expression in specific contexts, but also enable control of gene expression and functionality with potential clinical benefits.
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BACKGROUND: To observe the development of neonatal sleep among healthy infants of different conceptional age (CA) by analyzing the amplitude-integrated electroencephalography (aEEG) of their sleep-wake cycles (SWC). METHODS: Bedside aEEG monitoring was carried out for healthy newborns from 32 to 46 weeks CA between September 1, 2011 and August 30, 2012. For each aEEG tracing, mean duration of every complete SWC, number of SWC repetition within 12 hours, mean duration of each narrow and broadband of SWC, mean voltage of the upper edge and lower edge of SWC, mean bandwidth of SWC were counted and calculated. Analysis of the correlations between voltages or bandwidth of SWC and CA was performed to assess the developmental changes of central nervous system of newborns with different CA. RESULTS: The SWC of different CA on aEEG showed clearly identifiable trend after 32 weeks of CA. The occurrence of SWC gradually increases from preterm to post-term infants; term infants had longer SWC duration. The voltage of upper edge of the broadband decreased at 39 weeks, while the lower edge voltage increases and the bandwidth of broadband declined along with the growing CA. The upper edge of the narrowband dropped while the lower edge rised gradually, especially in preterm stage. The width of the narrowband narrowed down while CA increased. CONCLUSIONS: The SWC on aEEG of 32-46 weeks infants showed a continuous, dynamic and developmental progress. The appearance of SWC and the narrowing bandwidth of narrowband is the main indicator to identify the CA-dependent SWC from the preterm to the late preterm period. The lower edge of the broadband identifies the term to post-term period.