Zinc hexacyanoferrate/g-C3N4 nanocomposites with enhanced photothermal and photodynamic properties for rapid sterilization and wound healing.

Photoactivated therapy has gradually emerged as a promising and rapid method for combating bacteria, aimed at overcoming the emergence of drug-resistant strains resulting from the inappropriate use of antibiotics and the subsequent health risks. In this work, we report the facile fabrication of Zn3[Fe(CN)6]/g-C3N4 nanocomposites (denoted as ZHF/g-C3N4) through the in-situ loading of zinc hexacyanoferrate nanospheres onto two-dimensional g-C3N4 sheets using a simple metal-organic frameworks construction method. The ZHF/g-C3N4 nanocomposite exhibits enhanced antibacterial activity through the synergistic combination of the excellent photothermal properties of ZHF and the photodynamic capabilities of g-C3N4. Under dual-light irradiation (420 nm + 808 nm NIR), the nanocomposites achieve remarkable bactericidal efficacy, eliminating 99.98% of Escherichia coli and 99.87% of Staphylococcus aureus within 10 minutes. Furthermore, in vivo animal experiments have demonstrated the outstanding capacity of the composite in promoting infected wound healing, achieving a remarkable wound closure rate of 99.22% after a 10-day treatment period. This study emphasizes the potential of the ZHF/g-C3N4 nanocomposite in effective antimicrobial applications, expanding the scope of synergistic photothermal/photodynamic therapy strategies.

Immune persistence after different polio sequential immunization schedules in Chinese infants.

Trivalent oral poliovirus vaccine (tOPV) has been withdrawn and instead an inactivated poliovirus vaccine (IPV) and bivalent type 1 and type 3 OPV (bOPV) sequential immunization schedule has been implemented since 2016, but no immune persistence data are available for this polio vaccination strategy. This study aimed to assess immune persistence following different polio sequential immunization schedules. Venous blood was collected at 24, 36, and 48 months of age from participants who had completed sequential schedules of combined IPV and OPV in phase III clinical trials. The serum neutralizing antibody titers against poliovirus were determined, and the poliovirus-specific antibody-positive rates were evaluated. A total of 1104 participants were enrolled in this study. The positive rates of poliovirus type 1- and type 3-specific antibodies among the sequential immunization groups showed no significant difference at 24, 36, or 48 months of age. The positive rates of poliovirus type 2-specific antibody in the IPV-IPV-tOPV group at all time points were nearly 100%, which was significantly higher than the corresponding rates in other immunization groups (IPV-bOPV-bOPV and IPV-IPV-bOPV). Immunization schedules involving one or two doses of IPV followed by bOPV failed to maintain a high positive rate for poliovirus type 2-specific antibody.

Contamination and health risks brought by arsenic, lead and cadmium in a water-soil-plant system nearby a non-ferrous metal mining area.

Heavy metal(loid)s contamination prevails in the water-soil-plant system around non-ferrous metal mining areas. The present study aimed to evaluate the heavy metal(loid)s contamination in Nandan Pb-Zn mining area (Guangxi, China). A total of 36 river water samples, 75 paired paddy soil and rice samples, and 128 paired upland soil and plant samples were collected from this area. The concentrations of arsenic (As), lead (Pb), and cadmium (Cd) in these samples were measured. Results showed that the average water quality indexes (WQIs) at the 12 sampling sites along the main river ranged from 41 to 5008, indicating the water qualities decreasing from "Excellent" to "Undrinkable". The WQIs nearby tailings or industrial park were significantly higher than those at the other sites. 34.0% and 64.5% of soil samples exceeded the risk screening values for As and Cd. The Pb and Cd concentrations in all rice samples exceeded the Chinese food safety limits by 18.7% and 82.7%, respectively. Leafy vegetables had a higher concentration of As, Pb, and Cd than other vegetables, exceeding the maximum permissible limits by 14.1%, 61.2%, and 40.0%, respectively. The biological accumulation coefficient (BAC) of Cd was the highest in rice and lettuce leaves. The hazard quotients (HQs) of As and Cd, indicating non-carcinogenic risks, were 4.15 and 1.76 in adult males, and 3.40 and 1.45 in adult females, all higher than the permitted level (1.0). The carcinogenic probabilities of As and Cd from rice and leafy vegetables consumption were all higher than 1 × 10-4. We conclude that metal(loid)s contamination of the water-soil-plant system has posed great non-carcinogenic and carcinogenic risks to the local population.

Adjacent Mn site boosts photocatalytic hydrogen evolution of MnXCd1-XS solid solution through a dual-metal-site design.

CdS has emerged as a possible candidate for photocatalytic hydrogen generation. However, further improvement in the performance of the Cd metal site is challenging due to limited optimization space. To solve this limitation, in this work, the Mn-Cd dual-metal photocatalyst was synthesized by a one-step solvothermal method, and the effects of different proportions of bimetals on hydrogen production activity were systematically studied. The ingenious design of the bimetallic sites enhances the carrier separation efficiency and the built-in electric field intensity, which leads to significant improvement in the photocatalytic hydrogen production performance of MCS0.19. Density functional theory (DFT) calculations confirm that the introduction of the Mn element can drive electrons through the Fermi level, resulting in enhanced conductivity of the catalyst. Meanwhile, electron channels are built between Mn and S, which speeds up the rate of electron transfer and is conducive to improving hydrogen production activity. This work provides a technical-methodological entrance to improve the photocatalytic hydrogen production performance of dual-metal S solid solutions and also promises to open a novel approach to creating high-efficiency solid solution photocatalysts.

Safety and immunogenicity of a skin- and neuro-attenuated live vaccine for varicella: a randomized, double-blind, controlled, dose-escalation and age de-escalation phase 1 clinical trial.

Background: Despite the success in decreasing varicella-related disease burden, live-attenuated Oka vaccine strain of varicella-zoster virus (vOka) remains neuro-virulence and may establish latency and reactivate, raising safety concerns. Here we aimed to evaluate the safety and immunogenicity of a skin- and neuro-attenuated varicella vaccine candidate (v7D). Methods: This is a randomized, double-blind, placebo-controlled, dose-escalation and age de-escalation phase 1 clinical trial conducted in Liuzhou, China (ChiCTR1900022284). Eligible healthy participants aged 1-49 years, with no history of varicella vaccination and had no history of varicella or herpes zoster were sequentially enrolled and allocated to subcutaneously receive one of the three doses (3.3, 3.9, and 4.2 lg PFU) of v7D, vOka or placebo in a dose-escalation and age de-escalation manner. The primary outcome was safety, assessed by adverse events/reactions within 42 days after vaccination and serious adverse events (SAEs) throughout six months after vaccination. The secondary outcome was immunogenicity, assessed by the VZV IgG antibodies measured with fluorescent antibody to membrane antigen (FAMA) assay. Findings: Between April 2019 and March 2020, totally 224 participants were enrolled. Within 42 days post-vaccination, the incidences of adverse reactions were 37.5%-38.7% in the three doses of v7D groups which were similar to that of the vOka (37.5%) and placebo (34.4%) groups. No SAE has been judged as causally related to vaccination. At 42 days post-vaccination, 100% of children aged 1-12 years in the per-protocol set of immunogenicity cohort of the v7D groups became seropositive. Meanwhile, in the intent-to-treat set of immunogenicity cohort of subjects aged 1-49 years, the geometric mean increases of the three groups of v7D vaccine were 3.8, 5.8 and 3.2, respectively, which were similar to that of the vOka vaccine group (4.4) and significantly higher than that of the placebo group (1.3). Interpretation: The candidate v7D vaccine has been preliminarily shown to be well-tolerated and immunogenic in humans. The data warrant further evaluation of the safety advantage and efficacy of v7D as a varicella vaccine. Funding: The National Natural Science Foundation of China, CAMS Innovation Fund for Medical Sciences, and Beijing Wantai CO., LTD.

Safety and immunogenicity of a bivalent HPV16/18 vaccine in Chinese females.

As global supply is still inadequate to address the worldwide requirements for HPV vaccines, we assessed the safety and immunogenicity of a new bivalent HPV16/18 vaccine. In this randomized, double-blind, placebo-controlled, phase 2 trial, healthy 9-45-year-old Chinese females in three age cohorts (600 aged 9-17 years; 240 aged 18-26 years; 360 aged 27-45 years) were randomized 1:1 to receive three doses (0,2,6 months) of HPV16/18 vaccine or placebo. We measured neutralizing antibodies against HPV 16 and 18 at 7 months and monitored safety to 12 months in all age cohorts; 9-17-year-old girls were monitored for safety and immunogenicity to 48 months. In vaccinees, 99.8% seroconverted for HPV 16 and 18 types at 7 months; respective GMTs of 5827 (95% CI: 5249, 6468) and 4223 (3785, 4713) were significantly (p < .001) higher than controls for all comparisons. GMTs in the 9-17-year-olds, which were significantly higher than in older women at 7 months, gradually declined to 48 months but remained higher than placebo with seropositivity rates maintained at 98.5% and 97.6% against HPV 16 and 18, respectively. Adverse events occurred at similar rates after vaccine and placebo (69.8% vs. 72.5%, p = .308), including solicited local reactions and systemic adverse events which were mainly mild-to-moderate. The bivalent HPV16/18 vaccine was well tolerated and induced high levels of neutralizing antibodies in all age groups which persisted at high levels to 48 months in the 9-17-year-old age group which would be the target for HPV vaccination campaigns.

Electronic and energy level structural engineering of graphitic carbon nitride nanotubes with B and S co-doping for photocatalytic hydrogen evolution.

The ideal photocatalyst used for photocatalytic water splitting requires strong light absorption, fast charge separation/transfer ability and abundant active sites. Heteroatom doping offers a promising and rational approach to optimize the photocatalytic activity. However, achieving high photocatalytic performance remains challenging if just relying on single-element doping. Herein, Boron (B) and sulfur (S) dopants are simultaneously introduced into graphitic carbon nitride (g-C3N4) nanotubes by supramolecular self-assembly strategy. The developed B and S co-doped g-C3N4 nanotubes (B,S-TCN) exhibited an outstanding photocatalytic performance in the conversion of H2O into H2 (9.321 mmol g-1h-1), and the corresponding external quantum efficiency (EQE) reached 5.3% under the irradiation of λ = 420 nm. It is well evidenced by the closely combined experimental and (density functional theory) DFT calculations: (1) the introduction of B dopants can facilitate H2O adsorption and drive interatomic electron transfer, leading to efficient water splitting reaction. (2) S dopants can stretch the VB position to promote the oxidation ability of g-C3N4, which can accelerate the consumption of holes and thus inhibit the recombination with electrons. (3) the simultaneous introduction of B and S can engineer the electronic and energy level structural of g-C3N4 for optimizing interior charge transfer. Finally, the purpose of maximizing photocatalytic performance is achieved.

[Characterization of Ambient Volatile Organic Compounds, Source Apportionment, and the Ozone-NOx-VOC Sensitivities in Liucheng County, Guangxi].

Liucheng county, as a suburb of Liuzhou City in Guangxi province, has a prominent ozone (O3) pollution problem; however, there have been no relevant analyses of the cause of local O3 pollution reported. In order to investigate the causes of O3 pollution, an online observation of 116 VOCs with a time resolution of 1 h was carried out in Liucheng county from October 1st to 15th, and the sensitivity of ozone to the relative changes in the NOx and VOCs was analyzed. The results showed that the average value of φï¼»total volatile organic compounds (TVOCs)ï¼½ during the observation period was 27.52×10-9, and the average value of φ(TVOCs) during the polluting process (October 1st to 6th) was 32.15×10-9, which was 32.79% higher than that of the non-pollution process (October 8th to 15th). In terms of species concentration, oxygenated volatile organic compounds (OVOCs) contributed the highest, accounting for 43.70%, followed by alkanes (23.00%), aromatics (11.75%), and halocarbons (7.35%). In terms of ozone formation potential (OFP), OVOCs contributed the highest (41.96%) to OFP, followed by aromatics (32.60%) and alkenes (17.92%). During the observation period, VOCs mainly came from motor vehicle emissions (32.44%), biomass combustion sources (29.31%), solvent use sources (16.43%), plant sources (11.34%), and chemical industry emissions (10.49%). The contribution ratios of solvent use sources and plant sources in the pollution process increased by 28.58% and 28.53%, respectively. The EKMA curve shows that, during the observation period, Liucheng county was in a synergistic control area for VOCs and nitric oxide (NOx). Therefore, in the high ozone-occurrence autumn of Liucheng county, the key will be to reduce both VOCs and NOx emissions.

Engineering surface bromination in carbon nitride for efficient CO2 photoconversion to CH4.

The direct conversion of CO2 into reusable CH4 fuel by solar energy can effectively solve the problems of energy crisis and carbon emissions. However, the challenge of photocatalytic CO2 reduction to produce CH4 is still low conversion efficiency and poor selectivity. Here, surface brominated carbon nitride (named CNBr) is fabricated for stable and efficient photocatalytic CO2 reduction to produce CH4 with a rate of 16.68 µmol h-1 g-1 (70.27 % selectivity). Br atom in CNBr can substitute the N atom in the tri-s-triazine unites, which promotes local charge separation, narrows band gap and deepens the conduction band of CNBr. Benefiting from Br as active sites, CO2 can be enriched on the catalyst surface, and localized photogenerated electrons can activate the adsorbed CO2 to form CH4 through subsequent hydrogenation. Density functional theory results suggest that Br doping can effectively reduce the energy barrier of the rate-limiting step, accelerate the reaction, and induce the formation of *CHO, thereby improving the selectivity of CH4. This work reveals that surface modification can simultaneously increase the activation site of CO2 adsorption activation, enhance light absorption and accelerate charge, laying a solid foundation for the future design of carbon nitride based photocatalyst with high performance.

MicroRNA-139-5p mediates BMSCs impairment in diabetes by targeting HOXA9/c-Fos.

The properties and functions of BMSCs were altered by the diabetic microenvironment, and its mechanism was not very clear. In recent years, the regulation of the function of BMSCs by microRNA has become a research hotspot, meanwhile, HOX genes also have been focused on and involved in multiple functions of stem cells. In this study, we investigated the role of miR-139-5p in diabetes-induced BMSC impairment. Since HOXA9 may be a target gene of miR-139-5p, we speculated that miR-139-5p/HOXA9 might be involved in regulating the biological characteristics and the function of BMSCs in diabetes. We demonstrated that the miR-139-5p expression was increased in BMSCs derived from STZ-induced diabetic rats. MiR-139-5p mimics were able to inhibit cell proliferation, and migration and promoted senescence and apoptosis in vitro. MiR-139-5p induced the down-regulated expression of HOXA9 and c-Fos in BMSCs derived from normal rats. Moreover, miR-139-5p inhibitors reversed the tendency in diabetic-derived BMSCs. Further, gain-and-loss function experiments indicated that miR-139-5p regulated the functions of BMSCs by targeting HOXA9 and c-Fos. In vivo wound model experiments showed that the downregulation of miR-139-5p further promoted the epithelialization and angiogenesis of diabetic BMSC-mediated skin. In conclusion, induction of miR-139-5p upregulation mediated the impairment of BMSCs through the HOXA9/c-Fos pathway in diabetic rats. Therefore, miR-139-5p/HOXA9 might be an important therapeutic target in treating diabetic BMSCs and diabetic complications in the future.

Safety and immunogenicity of an Escherichia coli-produced bivalent human papillomavirus type 6/11 vaccine: A dose-escalation, randomized, double-blind, placebo-controlled phase 1 trial.

A dose-escalation, randomized, double-blind, placebo-controlled phase 1 clinical trial enrolled 145 eligible participants aged 18-55 years in March 2015 in Liuzhou, China. Stratified by age and sex, the participants were randomly assigned to receive either 30, 60, or 90 µg of the HPV-6/11 vaccine (n = 41/40/40) or the parallel placebo vaccine (n = 8/8/8) with a 0/1/6-month dose-escalation schedule. Participants were actively followed-up to record local and systemic AEs occurring within 30 days after each vaccination, and SAEs occurred in 7 months. Blood and urine samples of each participant were collected before and 2 days after the first and third vaccination to determine changes in routine blood, serum biochemical, and urine indexes. Serum HPV-6/11-specific IgG and neutralizing antibody levels at month 7 were analyzed. A total of 79 adverse events were reported, and no SAEs occurred. The incidences of total adverse reactions in the 30 µg, 60 µg, and 90 µg HPV vaccine groups and the control group were 31.7%, 50.0%, 42.5%, and 62.5%, respectively. All but one of the adverse reactions was mild or moderate with grade 1 or 2. No vaccine-related changes with clinical significance were found in paired blood and urine indexes before and after vaccinations. All the participants in the per-protocol set seroconverted at month 7 for both IgG and neutralizing antibodies. The candidate novel Escherichia-coli-produced bivalent HPV-6/11 vaccine has been preliminarily proven to be well tolerated and with robust immunogenicity in a phase 1 clinical study, supporting further trials with larger sample size. The study has been registered at ClinicalTrials.gov (NCT02405520).

Enhanced photoelectrochemical aptasensing triggered by nitrogen deficiency and cyano group simultaneously engineered 2D carbon nitride for sensitively monitoring atrazine.

Determination of atrazine (ATZ) residues in aquatic environment has important theoretical and practical significance for protecting the ecological environment and ensuring human health. A photoelectrochemical (PEC) aptasensing based on nitrogen deficiency and cyano group simultaneously engineered two-dimensional (2D) carbon nitride (named as DCN) has been proposed for sensitively detecting ATZ. The introduction of nitrogen deficiency can narrow band gap of DCN, leading to positive position of intermediate electronic state, and improving the absorption of visible light. The intermediate electronic state can function as an electron trap to promote the separation and migration of photogenerated carriers. Cyano groups can trap photoinduced electrons and suppress charge recombination. Gas produced by thermal decomposition has a tailoring effect, endowing DCN with 2D ultra-thin structure, which shortens transmission path of carriers. The synergistic effect of the above enhances PEC performance of DCN. The PEC aptasensing exhibited a wide linear range of 1.0 × 10-4 to 1.0 × 103 pM and a low detection limit of 3.33 × 10-5 pM with excellent selectivity, stability, and satisfactory accuracy during detecting real samples. The proposed design of carbon nitride-based materials may provide a better understanding of the relationship between kind of photoactive materials and PEC performance.

Crystal phase engineering boosted photo-electrochemical kinetics of CoSe2 for oxygen evolution catalysis.

Crystal phase is an important parameter that can determine the electronic structure and catalytic properties of catalysts. In this work, we report the crystal phase dependent photo- and electrocatalytic oxygen evolution reaction (OER) performance of CoSe2. In electrocatalytic reaction, we firstly found that CoSe2 with orthorhombic phase (o-CoSe2) showed a higher OER performance than that of CoSe2 with cubic phase (c-CoSe2). In the further exploration of photocatalytic application using Fe2O3 as light harvester and CoSe2 as cocatalysts, o-CoSe2/Fe2O3 can realize the qualitative changes of photocatalytic oxygen evolution performance from "0″ to "1". As contrast, c-CoSe2/Fe2O3 cannot work in photocatalytic oxygen evolution process under the same condition. Experimental and theoretical analysis uncover that, the key factor leading to the crystal phase-dependent performance is the decreased activation barrier of H2O on o-CoSe2 surface. This work opens up an opportunity of correlating the CoSe2 crystal phase with performance in OER.

Ultrathin structure of oxygen doped carbon nitride for efficient CO2photocatalytic reduction.

Photocatalytic conversion of carbon dioxide into fuels and valuable chemicals is a promising method for carbon neutralization and solving environmental problems. Through a simple thermal-oxidative exfoliation method, the O element was doped while exfoliated bulk g-C3N4into ultrathin structure g-C3N4. Benefitting from the ultrathin structure of g-C3N4, the larger surface area and shorter electrons migration distance effectively improve the CO2reduction efficiency. In addition, density functional thory computation proves that O element doping introduces new impurity energy levels, which making electrons easier to be excited. The prepared photocatalyst reduction of CO2to CO (116µmol g-1h-1) and CH4(47µmol g-1h-1).

Changes in Bone Mineral Density Following Conventional Oral Phosphonate Treatment of Hypophosphatemic Osteomalacia: A Non-Randomized Controlled Study.

PURPOSE: There are limited clinical studies aimed at solving the problem of the efficiency of conventional treatment with oral phosphate and calcitriol in adults with hypophosphatemic osteomalacia (HO). In addition, there still had no good non-hazardous markers to evaluate the severity of bone loss of osteomalacia before and after treatment. Therefore, the purpose of this study was to assess the efficacy of conventional treatment with a self-blended phosphate supplementation and calcitriol on patients with HO and whether bone mineral density (BMD) can be helpful for monitoring the efficacy. PATIENTS AND METHODS: A total of 21 HO patients and 105 healthy controls were enrolled. All patients were tested for serum biomarkers and BMD of the lumbar spine (L1-L4), femoral neck, and total left hip. After three years of treatment, 11 of 21 HO patients were recalled for BMD measurement. According to the administration of drugs, HO patients with calcium and calcitriol were divided into three phosphate treatment groups: patients in group A (n = 3) received continuous phosphate supplementation, patients in group B (n = 5) received intermittent phosphate supplementation and patients in group C (n = 3) received no phosphate supplementation. RESULTS: The diagnoses of 21 HO patients were 5 cases of hereditary hypophosphatemic rickets, 4 cases of Fanconi syndrome with the features of renal tubular acidosis and vitamin D deficiency, and 12 cases of hereditary vitamin D abnormality. The average initial serum phosphorus level of the patient group was approximately 50% lower than that of the control group. Lower BMD was significantly observed in the HO group than the control group at the lumbar spine and total hip. Continuous treatment with the phosphate supplement could increase BMD in the lumbar spine and total hip by 33.4-52.3% and in the femoral neck increased by 43.2-79.3% compared with baseline, and the effect appears to be continued once treatment is discontinued. CONCLUSION: These findings suggest that conventional therapy can improve bone mineral defects in patients with HO, especially in the femoral neck. Detection of BMD in HO patients is a good tool to assess the extent of bone defects and the therapeutic effect. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-OOC-16010095. Registered 7 December 2016. Retrospectively registered.

Association of lead and cadmium exposure with kidney stone incidence: A study on the non-occupational population in Nandan of China.

BACKGROUND: Environmental lead (Pb) and cadmium (Cd) pollution has been considered a risk factor in the etiology of kidney stones. However, the association between Pb and Cd exposure and kidney stone incidence has yet to be determined. OBJECTIVES: This study aimed to determine a possible the association between kidney stones with Pb and Cd exposure (alone or combined) in a non-occupational population. METHODS: Pb and Cd contaminations in soil-plant system were determined by flame atomic absorption spectrophotometry. Health risk assessment of dietary Pb or Cd intake from rice and vegetables were calculated. Kidney stones were diagnosed with urinary tract ultrasonography. Urinary cadmium (UCd) and blood lead (BPb) levels were determined by graphite-furnace atomic absorption spectrometry. Multivariate logistic regression models were constructed. RESULTS: The hazard indexes (HI) of Pb and Cd were 7.91 and 7.31. The odds ratio (OR) was 2.83 (95 %CI:1.38-5.77) in males with high BPb (BPb ≥ 100 µg/L), compared with those with low BPb (BPb＜100 µg/L). Compared to those with low BPb and low UCd (BPb＜100 µg/L and UCd＜2 µg/g creatinine), the ORs were 2.58 (95 % CI:1.17-5.70) and 3.43 (95 % CI:1.21-9.16) in females and males with high BPb and high UCd (BPb ≥100 µg/L and UCd ≥2 µg/g creatinine), respectively. The OR was 3.16 (95 % CI:1.26-7.88) in males with high BPb and low UCd (BPb ≥ 100 µg/L and UCd ＜2 µg/g creatinine), compared to those with low BPb and low UCd. CONCLUSIONS: Kidney stones incidence was increased by high Pb exposure in males, and by Pb and Cd co-exposure in males and females.

Unique Dual-Sites Boosting Overall CO2 Photoconversion by Hierarchical Electron Harvesters.

Low selectivity and poor activity of photocatalytic CO2 reduction process are usually limiting factors for its applicability. Herein, a hierarchical electron harvesting system is designed on CoNiP hollow nano-millefeuille (CoNiP NH), which enables the charge enrichment on CoNi dual active sites and selective conversion of CO2 to CH4 . The CoNiP serves as an electron harvester and photonic "black hole" accelerating the kinetics for CO2 -catalyzed reactions. Moreover, the dual sites form from highly stable CoONiC intermediates, which thermodynamically not only lower the reaction energy barrier but also transform the reaction pathways, thus enabling the highly selective generation of CH4 from CO2 . As an outcome, the CoNiP NH/black phosphorus with dual sites leads to a tremendously improved photocatalytic CH4 generation with a selectivity of 86.6% and an impressive activity of 38.7 µmol g-1  h-1 .

Burden and etiology of moderate and severe diarrhea in children less than 5 years of age living in north and south of China: Prospective, population-based surveillance.

BACKGROUND: Diarrhea remains the leading cause of childhood illness in China. Better understanding of burden and etiology of diarrheal diseases is important for development of effective prevention measures. METHODS: Population-based diarrhea surveillance was conducted in Sanjiang (southern China) year-round and Zhengding (northern China) in autumn/winter. Stool specimens were collected from children < 5 years of age experiencing diarrhea. The TaqMan Array Card (TAC), based on multiplex real-time PCR, was applied to detect multiple enteric microbial agents simultaneously. Results using these methods were compared to those derived from conventional PCR assays. RESULTS: During the study period, 6,380 children in Zhengding and 3,581 children in Sanjiang < 5 years of age participated. Three hundred and forty (31.2%) and 279 (22.9%) diarrhea episodes were identified as moderate-to-severe in the two counties, with incidence of 60.4 and 88.3 cases per 1,000 child-years in Zhengding and Sanjiang, respectively. The five most frequently detected bacterial and viral agents in Sanjiang were adenovirus, enterovirus, enteroaggregative Escherichia coli (EAEC), rotavirus, and sapovirus all the year round, while the most common viral agents in Zhengding were rotavirus, followed by astrovirus and adenovirus during the cool season. Compared to conventional PCR assay, the average incremental detection via the TAC method was twofold. CONCLUSION: Our study demonstrated high diversity and prevalence of multiple major bacterial and viral agents, including rotavirus and calicivirus, among children in China. Further studies are needed to define the public health significance of neglected but frequently detected pathogens such as EAEC, enterotoxigenic E. coli, Campylobacter, adenovirus, and enterovirus.

[Clinical Characteristics and Genetic Analysis of Klippel-Feil Syndrome].

Objective To summarize clinical characteristics and investigate possible pathogenic gene of Klippel-Feil syndrome(KFS)by the self-designed multigene panel sequencing,so as to decipher the molecular basis for early diagnosis and targeted therapy.Methods From January 2015 to December 2018,we consecutively recruited 25 patients who were diagnosed with KFS in Peking Union Medical College Hospital.The demographic information,clinical manifestations,physical examination and radiological assessments were analyzed.Multigene panel sequencing was performed after DNA extraction from peripheral blood.The possible pathogenic mutations of KFS were explored on the basis of bioinformatics analysis.Results The KFS cohort consisted of 25 patients,including 15 males and 10 females,with a mean age of(12.9±7.3)years.Limited cervical range of motion was the most common clinical feature(12 cases,48%).Based on the Samartzis classification,the proportion of patients suffered from short neck(P=0.031)and limited cervical range of motion(P=0.026)in type Ⅲ KFS was significantly higher than that in type Ⅱ and type Ⅰ KFS.Panel sequencing detected a total of 11 pathogenic missense mutations in eight patients,including COL6A1,COL6A2,CDAN1,GLI3,FLNB,CHRNG,MYH3,POR,and TNXB.There was no pathogenic mutation found in five reported pathogenic genes(GDF6,MEOX1,GDF3,MYO18B and RIPPLY2)associated with KFS.Conclusions Our study has shown that patients with multiple contiguous cervical fusions are more likely to manifest short neck,limited cervical range of motion,and clinical triad.Therefore,these patients need additional attention and follow-up.Our analysis highlights novel KFS-related genetic variants,such as COL6A and CDAN1,extending the spectrum of known mutations contributing to this syndrome and providing a basis for elucidating the pathogenesis of KFS.

Clinical Characteristics and Genetic Analysis of Klippel-Feil Syndrome / 中国医学科学院学报

Objective To summarize clinical characteristics and investigate possible pathogenic gene of Klippel-Feil syndrome(KFS)by the self-designed multigene panel sequencing,so as to decipher the molecular basis for early diagnosis and targeted therapy.Methods From January 2015 to December 2018,we consecutively recruited 25 patients who were diagnosed with KFS in Peking Union Medical College Hospital.The demographic information,clinical manifestations,physical examination and radiological assessments were analyzed.Multigene panel sequencing was performed after DNA extraction from peripheral blood.The possible pathogenic mutations of KFS were explored on the basis of bioinformatics analysis.Results The KFS cohort consisted of 25 patients,including 15 males and 10 females,with a mean age of(12.9±7.3)years.Limited cervical range of motion was the most common clinical feature(12 cases,48%).Based on the Samartzis classification,the proportion of patients suffered from short neck(P=0.031)and limited cervical range of motion(P=0.026)in type Ⅲ KFS was significantly higher than that in type Ⅱ and type Ⅰ KFS.Panel sequencing detected a total of 11 pathogenic missense mutations in eight patients,including COL6A1,COL6A2,CDAN1,GLI3,FLNB,CHRNG,MYH3,POR,and TNXB.There was no pathogenic mutation found in five reported pathogenic genes(GDF6,MEOX1,GDF3,MYO18B and RIPPLY2)associated with KFS.Conclusions Our study has shown that patients with multiple contiguous cervical fusions are more likely to manifest short neck,limited cervical range of motion,and clinical triad.Therefore,these patients need additional attention and follow-up.Our analysis highlights novel KFS-related genetic variants,such as COL6A and CDAN1,extending the spectrum of known mutations contributing to this syndrome and providing a basis for elucidating the pathogenesis of KFS.