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OBJECTIVE: To develop a WeChat-mini-program-based Online breastfeeding education and support program and explore its impacts on promoting mothers of preterm infants' breastfeeding knowledge, attitudes, self-efficacy, and rates. DESIGN, SETTING, AND PARTICIPANTS: This was a quasi-experimentation with two-group comparisons. The eligible preterm mother-infant pairs were recruited from the NICU within seven days postpartum. The first 25 mothers admitted to the NICU during the study period were included in the control group, and the following 25 mothers were in the intervention group according to the admission order of their preterm infants. A generalized linear mixed model was used to detect the effects of the online intervention program and the interaction effects of group and time. INTERVENTIONS: The participants received a 3-month online breastfeeding intervention from a WeChat mini program for the intervention group. MEASUREMENTS: Mothers of preterm infants' breastfeeding knowledge, attitudes, self-efficacy, and breastfeeding rates of different patterns were respectively evaluated by the Breastfeeding Knowledge Questionnaire (BKQ), Iowa Infant Feeding Attitude Scale (IIFAS), and Breastfeeding Self-Efficacy Scale (BSES) at three different points of times including before intervention (T0), at one month postpartum (T1) and three months postpartum (T2). FINDINGS: The breastfeeding knowledge significantly differed between the two groups but without differences between different time points and in the grouping*time interaction. Within the intervention group, significant improvements were observed from T0 to T2 and T1 to T2. No significant differences in breastfeeding attitudes, self-efficacy, and breastfeeding rates were found between and within groups. KEY CONCLUSIONS: The WeChat-mini-program-based online breastfeeding intervention may improve the breastfeeding knowledge level of mothers of preterm infants but has no significant impact on mothers' breastfeeding attitudes, breastfeeding self-efficacy, and breastfeeding rates. IMPLICATIONS FOR PRACTICE: The WeChat mini program can be used to improve the breastfeeding knowledge level of mothers of preterm infants. Future interventions need to target both mothers of preterm infants and their family members by combing online and offline approaches.

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BACKGROUND: Breast cancer is the leading causes of cancer-associated mortality among women, and triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer. Long non-coding RNAs (LncRNAs) have recently been studied to predict the prognosis of various cancers, but whether it is an effective marker in TNBC is inconclusive. METHODS: We used RNA-sequencing analysis to identify differentially expressed exosomal LncRNAs, and qRT-PCR assay was performed to verify dysregulated LncRNAs in multicenter validation cohorts. A signature, which was composed of LINC00989, CEA, and CA153, was then utilized to predict the progression and recurrence of TNBC. Kaplan-Meier analysis was applied to evaluate the prognostic values of the signature. RESULTS: On the basis of RNA-sequencing analysis, we found that serum exosomal LncRNA LINC00989 was significantly up-regulated in metastatic patients of TNBC. Then LINC00989, together with clinic marker CEA and CA125, were selected to construct a prognostic signature. In both training and validation cohort, higher levels of this signature were significantly related with shorter overall and progression-free survival time. Univariate and multivariate analysis shown that the signature was the independent prognosis factor of TNBC patients. CONCLUSIONS: Our results suggested that this prognostic signature might potentially predict prognosis and recurrence of TNBC, and was worth validation in future clinical trials.

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BACKGROUND: Although developmental supportive care is an effective approach to improve the long-term psychomotor and/or neurobehavioral function of preterm infants, very limited studies have focused on the impact of after-discharge developmental support. The underlying epigenetic changes are unclear. PURPOSE: This study aimed to explore the preliminary effect of an evidence-based Postdischarge Developmental Support Program (PDSP) on preterm infant neurodevelopment and underlying epigenetic changes, including brain-derived neurotrophic factor (BDNF) gene-related DNA methylation and expression. METHODS: In this randomized controlled pilot trial, the preterm infant-parent dyads were randomized into either the intervention group/PDSP group (n = 22) or the control group/usual care group (n = 22). The neurodevelopmental outcomes of preterm infants were measured by Ages & Stages Questionnaires. Urine BDNF concentration level was tested by the enzyme-linked immunosorbent assay. Infant saliva specimens were collected to analyze the methylation level of BDNF gene promoter I at pre- and postintervention test. RESULTS: After PDSP intervention, the total neurodevelopmental and the 5 domain scores of the PDSP group were all significantly higher than those of the control group ( P < .05). The BDNF levels decreased significantly only within control group ( P = .01). The difference in BDNF concentration and methylation levels between groups was not statistically significant. IMPLICATIONS FOR PRACTICE AND RESEARCH: Postdischarge Developmental Support Program may promote the neurodevelopment of preterm infants but has no effect on BDNF's expression and gene methylation level at 3 months of corrected age. The epigenetic mechanism of PDSP needs further study using a larger sample and longer follow-up.

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AgI/g-C3N4 S-scheme heterojunction with a unique electron transfer pathway was developed as a catalyst for H2 evolution. We discussed the behavior of chemisorption and photoexcited charge carriers in photocatalytic reduction on the S-scheme AgI/g-C3N4 heterojunction. It was demonstrated that the path of charge transfer mediated by S-scheme AgI/g-C3N4 heterojunction was favorable for the improvement of electron utilization in photocatalysis. The advantage of S-scheme heterojunction was that the holes in the valence band (VB) of g-C3N4 could recombine with the electrons in the conduction band (CB) of AgI due to the built-in electric field. Electrons on the CB of g-C3N4 and holes on the VB of AgI were preserved for further photocatalytic reaction. Therefore, a distinctive electron transfer pathway was introduced in the S-scheme heterojunction. In addition, the lifetime of charge carriers was prolonged, and the reduced ability of electrons was increased as compared to reference g-C3N4. It not only decreased the energy required for electron excitation, but also reduced the energy consumption for the charge transfer. This paper provided a new strategy to improve the utilization of photogenerated electrons and chemisorption of water for photocatalytic H2O splitting.

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Background: Due to the limitation of blood culture diagnosis, this study sought to evaluate the cerebral hemodynamic changes by Doppler ultrasound for timely and objective diagnosis techniques in preterm infants with early onset-neonatal sepsis. Methods: In this retrospective study, 86 preterm infants treated at the Department of Neonatology, Renmin Hospital of Wuhan University from January 1, 2019 to March 31, 2021, were divided into the following 2 groups: (I) the early onset neonatal sepsis (EONS) group (G1, n=41); (II) the normal control group (G2, n=45). The cerebral hemodynamic changes were examined by transcranial ultrasound. Stata15.0 and SPSS26.0 software were used for the data analysis. The pair-wise comparisons of the receiver operating characteristic (ROC) curves were on the MedCalc18.2.1 software. For all the statistical analyses, P value <0.05 was considered significant. Results: Sex, birth weight, and gestational age did not differ significantly between the groups (P>0.05); the peak systolic velocity (PSV), mean velocity (MV), end diastolic velocity (EDV) (cm/s), resistivity index (RI), pulsatility index (PI) of the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) differed significantly between 2 groups (P<0.05). In relation to the diagnostic sensitivity, the area under the receiver operating characteristic (AUROC) analyses showed that compared to IL-6 (0.95, 1.00), EDV of the ACA, and PSV, EDV and MV of the MCA and PCA had a higher sensitivity than the others (AUROC: 1, all 95% CI: 1.00, 1.00). The diagnostic points of the EDV and MV of the ACA were 9.8 and 17.3 cm/s, respectively, the PSV, EDV, and MV of the MCA were 55.9, 10.9, and 20.4 cm/s, respectively, and the PSV, EDV, and MV of the PCA were 27.5, 7.5, and 9.8 cm/s, respectively. Conclusions: The study showed that PI increases and RI decreases, MV increases, and cerebral blood flow increases in EONS. Further, the EDV and MV of the ACA and the PSV, EDV, and MV of the MCA and PCA showed higher sensitivity than IL-6.

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BACKGROUND: Lung cancer is the leading cause of cancer-related deaths in the world. Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancer cases. For lack of conveniently sensitive and specific biomarkers, the majority of patients are in the late stage at initial diagnosis. Long non-coding RNAs (LncRNAs), a novel type of non-coding RNA, have recently been recognized as critical factors in tumor initiation and progression, but the role of exosomal LncRNAs has not been thoroughly excavated in NSCLC yet. METHODS: We isolated exosomes from the serum of patients with NSCLC and healthy controls. Exosome RNA deep sequencing was subsequently performed to detect differentially expressed exosomal LncRNAs. qRT-PCR assay was then utilized to validate dysregulated LncRNAs in both testing and multicentric validation cohort. Receiver operating characteristic (ROC) curve was used to detect the diagnostic capability of exosomal biomarkers. Furthermore, Kaplan-Meier analysis was applied to evaluate the prognostic values of these molecules. RESULTS: On the basis of analysis, we found that novel exosomal LncRNA RP5-977B1 exhibited higher levels in NSCLC than that in the healthy controls. The area under the curve (AUC) value of exosomal RP5-977B1 was 0.8899 and superior to conventional biomarkers CEA and CYFRA21-1 both in testing and multicentric validation cohort. Interestingly, the diagnostic capability of exosomal RP5-977B1 was also validated in early-stage patients with NSCLC. Furthermore, high expression of exosomal RP5-977B1was closely related with worse prognosis in NSCLC (P = 0.036). CONCLUSIONS: Our results suggested that exosomal RP5-977B1 might serve as a novel "liquid biopsy" diagnostic and prognostic biomarker to monitor NSCLC and improve possible therapy.

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BACKGROUND: Choledocholithiasis is a severe disorder that affects a significant portion of the world's population. Treatment using endoscopic sphincterotomy (EST) has become widespread; however, recurrence post-EST is relatively common. The bile microbiome has a profound influence on the recurrence of choledocholithiasis in patients after EST; however, the key pathogens and their functions in the biliary tract remain unclear. AIM: To investigate the biliary microbial characteristics of patients with recurrent choledocholithiasis post-EST, using next-generation sequencing. METHODS: This cohort study included 43 patients, who presented with choledocholithiasis at the Guangdong Second Provincial General Hospital between May and June 2020. The patients had undergone EST or endoscopic papillary balloon dilation and were followed up for over a year. They were divided into either the stable or recurrent groups. We collected bile samples and extracted microbial DNA for analysis through next-generation sequencing. Resulting sequences were analyzed for core microbiome and statistical differences between the diagnosis groups; they were examined using the Kyoto Encyclopedia of Genes and Genomes pathway hierarchy level using analysis of variance. Correlation between the key genera and metabolic pathways in bile, were analyzed using Pearson's correlation test. RESULTS: The results revealed distinct clustering of biliary microbiota in recurrent choledocholithiasis. Higher relative abundances (RAs) of Fusobacterium and Neisseria (56.61% ± 14.81% vs 3.47% ± 1.10%, 8.95% ± 3.42% vs 0.69% ± 0.32%, respectively) and the absence of Lactobacillus were observed in the bile of patients with recurrent disease, compared to that in stable patients. Construction of a microbiological co-occurrence network revealed a mutual relationship among Fusobacterium, Neisseria, and Leptotrichia, and an antagonistic relationship among Lactobacillales, Fusobacteriales, and Clostridiales. Functional prediction of biliary microbiome revealed that the loss of transcription and metabolic abilities may lead to recurrent choledocholithiasis. Furthermore, the prediction model based on the RA of Lactobacillales in the bile was effective in identifying the risk of recurrent choledocholithiasis (P = 0.03). CONCLUSION: We demonstrated differences in the bile microbiome of patients with recurrent choledocholithiasis compared to that in patients with stable disease, thereby adding to the current knowledge on its microbiologic etiology.

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Although noroviruses are the causative agents of most non-bacterial foodborne disease outbreaks, effective antivirals are currently unavailable. Certain probiotic strains have been reported as active antivirals for norovirus infections, but their mechanisms have not been fully elucidated. Herein, we examined the antiviral potential of 122 lactic acid bacteria isolates against murine norovirus (MNV), a human norovirus surrogate. A centenarian gut-derived strain, Limosilactobacillus fermentum PV22, exhibited the strongest MNV antagonism and reduced the viral titer by 2.23 ± 0.38 (log-value) in 5 min with stable activity at 25°C (P < 0.01). Genome mining revealed that its antiviral activity can be attributed to the synthesis of γ-aminobutyric acid, and this finding was experimentally verified. Furthermore, we demonstrated the safety of the isolate and its high intestinal colonization ability. In conclusion, we discovered a centenarian gut-derived L. fermentum strain with strong anti-norovirus activity and identified its antiviral metabolite. Our results will offer new solutions for the prevention and treatment of food-related norovirus infections.

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BACKGROUND: Although antimicrobial resistance (AMR) in Helicobacter pylori is a global threat to human health and the underlying molecular mechanisms have been explored previously, only a few of them are fully elucidated. MATERIALS AND METHODS: In the present study, we isolated 54 Helicobacter pylori strains from Southern China and assessed their susceptibility to five antibiotics using the agar dilution assay. Whole-genome sequencing was performed to screen the AMR genotypes of the Helicobacter pylori isolates. RESULTS: Our study revealed a high prevalence of resistance to clarithromycin (CLR), levofloxacin (LVX), and metronidazole (MTZ) in the Chinese isolates, 55.56% of which showed multidrug-resistant phenotypes. We screened for the 94 types of previously reported AMR mutations in 12 genes, but only a few of them were related to the AMR phenotype. Furthermore, we discovered four new mutations in the 23S rRNA gene and one mutation in infB related to CLR resistance. Another three mutations in gyrA and one in gyrB were closely correlated with the AMR pattern against LVX. We also demonstrated that the mutations R16C/H in rdxA, V56I in rpsU, and D54A in sodB might contribute to resistance to MTZ, which were previously reported in laboratory experiments but not found in clinical strains. We examined the concordance between the genotype and phenotype of AMR and identified several potential molecular biomarkers for predicting CLR and LVX resistance. CONCLUSIONS: Our study explored the molecular mechanisms underlying the antibiotic resistance of Helicobacter pylori isolates from Southern China. We propose further epidemiologic investigations in China.

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BACKGROUND: Emerging evidence suggests that circular RNAs (circRNAs) were aberrantly expressed in the patients of non-small cell lung cancer (NSCLC). This study aims to evaluate the diagnostic value of potential serum biomarker in circRNAs. METHODS: Serum circRNAs were extracted and purified by RNA isolated kit and identified by quantitative real time-polymerase chain reaction (qRT-PCR) assay. We then performed a receiver operating characteristic (ROC) curve to estimate the diagnostic efficacy. The relationship between circRNA and clinic characteristics of patients was analyzed by SPSS 25.0. Univariate and multivariate analyses were also used to evaluate its diagnostic capability. The mechanism of circFOXP1 was further excavated by bioinformatics analysis. RESULTS: By performing qRT-PCR assay, we identified that circFOXP1 (hsa_circ_0008234) and conventional tumor markers (carcinoembryonic antigen (CEA) and cytokeratin fragment 21-1 (CYFRA21-1)) were all significantly overexpressed in the serum of patients with NSCLC when compared with healthy controls (P < 0.05). While the ROC curves analysis demonstrated that area under the curve of circFOXP1 was obviously superior to CEA and CYFRA21-1, which exerted more diagnostic advantage. Univariate and multivariate analyses revealed that serum circFOXP1 was an independent diagnostic molecule, and was significantly correlated with T stage and lymphatic metastasis in NSCLC (P < 0.05). Mechanistically, circFOXP1 might target hsa-miR-370-3p and hsa-miR-18a-5p, and be involved in vascular endothelial growth factor signaling pathways to regulate proliferative and metastasis processes. CONCLUSION: Our results highlight the preferable diagnostic potential of serum circFOXP1 in NSCLC.

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The commensal microbiome influences skin immunity, but its function in toenail health remains unclear. Paronychia is one of the most common inflammatory toenail diseases, but antibiotic treatment is seldom effective in clinical cases. In this study, we performed 16S rRNA sequencing to investigate the characteristics of microbes associated with paronychia in order to identify the key microorganisms involved in inflammation. Seventy dermic samples were collected from patients with paronychia and the differences in dermic microbiota were analyzed in patients with different inflammation severities. Distinct clustering of dermal microbiota was observed in the dermis with different inflammation severities. A higher relative abundance of anaerobic microorganisms such as Parvimona, Prevotella, and Peptoniphilus was observed in severe paronychia, whereas Lactobacillus disappeared with disease progression. Co-occurring network analysis suggested that the disturbance of the dermic microbiome and attenuation of antagonism by Lactobacillus against anaerobic pathogens may aggravate inflammation in paronychia. Functional analysis showed that dermic microbiome disturbance may worsen microbial metabolism and tissue repair in the skin. In conclusion, we revealed that an increased abundance of anaerobic microorganisms and loss of Lactobacillus in the dermis may promote paronychia progression and microbiological imbalance may aggravate inflammation in patients with paronychia.

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BACKGROUND TRIAL DESIGN: The incidence rate of gestational diabetes is high. In the long run, it harms the health of both the mother and child. In order to understand the distribution of hematological cells with gestational diabetes mellitus (GDM), a longitudinal cohort study was conducted from 2012 to 2018. METHODS: A longitudinal case control study of 1860 pregnant women was conducted between 2012 and 2018. Data of hematological parameters at 11 time points of gestational stage were obtained from a laboratory database. Repeated measures analysis and independent t-test were used to analyze the effect of the hematological parameters on GDM. RESULTS: The trend of blood cells fluctuated with gestational age in normal controls but was more remarkable in GDM. Compared with the controls, blood neutrophils, lymphocytes, and monocytes augmented in the second trimester but decreased in the third trimester; platelet (PLT) and thrombocytocrit increased throughout the three trimesters, and red blood cell (RBC) was abundant in the last 2 trimesters in GDM. CONCLUSIONS: Peripheral blood leukocytes, platelets, and erythrocytes were significantly different during gestation between GDM and normal controls. Inflammation may also be involved in GMD.

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BACKGROUND: To investigate the clinical values of the common biomarkers including blood routine (B-Rt), C-reactive protein (CRP), serum amyloid A (SAA) and procalcitonin (PCT) for efficacy monitoring of antibiotics in early-onset neonatal sepsis (EONS). METHODS: The clinical and laboratory data of 78 neonates with confirmed EONS in the neonatal intensive care unit (NICU) of our center from July 1, 2019 to June 30, 2020 were retrospectively analyzed. All the subjects were treated with cefotiam (50 mg/kg q12h) and augmentin (30 mg/kg q12h) within 12 hours after birth. Blood samples were collected 0-12 hours after birth for blood culture, measurements of B-Rt, CRP and SAA. Subsequently, blood sampling was performed at intervals of 12-24, 24-48, 48-96, and 96-144 hours for measurements of B-Rt, CRP, SAA and PCT. Statistical analyses were performed in the SPSS 20.0 software package. P value of <0.05 was considered statistically significant. RESULTS: WBC count showed no significant change among different intervals (12-24, 24-48, 48-96, and 96-144 hours); in contrast, NEU%, CRP, SAA and PCT significantly differed across all intervals. SAA had sensitivities of 75.86%, 93.1%, 44.83%, and 3.45%, respectively; specificities of 100% across all intervals; and AUCs of 0.879 (P<0.0001), 0.966 (P<0.0001), 0.724 (P<0.0001), and 0.500, respectively (P=1). PCT had sensitivities of 100%, 100%, 79.31%, and 51.72%, respectively; specificities of 100% across all intervals; and AUCs of 1 (P<0.0001), 1 (P<0.0001), 0.793 (P<0.0001), and 0.517 (P>0.8551), respectively. CONCLUSIONS: WBC count, NEU% and CRP showed no clinical significance for any intervals for efficacy monitoring of antibiotic treatment. SAA and PCT had similar monitoring values at 12-24 and 24-48 hours. SAA is thus more valuable than PCT for efficacy monitoring of antibiotics at the 48-96 and even at the 96-144 hours intervals in EONS.

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A novel 2D ultrathin Ag/AgI-δ-Bi2O3 photocatalyst was constructed by a facile hydrothermal and in situ photodeposition method, which presented a uniform nanosheet structure with an average height of 6 nm. Its composition, morphology and light-harvesting properties were characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), transmission electron microscopy (TEM), UV-vis spectrophotometer (UV-vis) and photoluminescence (PL) measurements in detail. The Ag/AgI-δ-Bi2O3 nanocomposites showed an excellent photocatalytic nitrogen fixation performance of 420 µmol L-1 g-1 h-1 in water without any sacrificial agent. The introduction of Ag/AgI nanoparticles caused the morphology modification of δ-Bi2O3, a higher concentration of oxygen vacancy, and the construction of a plasmon sensitized heterojunction, resulting in enhanced light absorption, improved separation efficiency of charge carriers and strong N2 absorption and activation ability, which are responsible for the superior photocatalytic performance of Ag/AgI-δ-Bi2O3.

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Photocatalytic nitrogen fixation provides an attractive approach to produce reactive nitrogen compounds at benign conditions. Herein, Ag decorated δ-Bi2O3 photocatalyst, which has the features of multilayer ultrathin structure, suitable absorption edge and many exposed surface sites, is prepared by a hydrothermal and photoreduction process. Under visible light illustration, the obtained Ag-δ-Bi2O3 photocatalyst exhibits efficient photocatalytic activity for NH4+ generation at room temperature and atmospheric pressure in aqueous solution. The multilayer ultrathin sheets in the structure of Ag-δ-Bi2O3 favors the effective separation of photogenerated electron-hole pairs and fast interfacial charge transfer. Due to the Ag surface plasmonic resonance, obvious trap is formed in the ultrathin Ag-δ-Bi2O3 sheets, which not only inhibites the recombination of electron hole pairs but also produces light-induced oxygen vacancies under irradiation. Those factors significantly improve the photocatalytic ability of as-prepared Ag-δ-Bi2O3. The results provide insights into rational design of enhanced active photocatlysts with Ag surface plasmonic resonance and ultrafast charge carrier transfer for photocatalytic nitrogen fixation.

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Metabolic profiles of broiler chickens were examined after the ingestion of green tea, tea polyphenols, and (-)-epigallocatechin-3-gallate (EGCG). Solid-phase extraction of serum and litters yielded free catechins and their metabolites, which were then identified and quantified by liquid chromatography-tandem mass spectrometry. In plasma samples, (-)-gallocatechin, (+)-catechin, and EGCG were detected in the green tea group; pyrogallol acid, (epi)catechin-O-sulfate, 4'-O-methyl-(epi)gallocatechin-O-glucuronide, and (epi)catechin-3'-O-glucuronide were detected in the tea polyphenols group; and EGCG, (-)-gallocatechin gallate (GCG), and 4'-O-methyl-(epi)gallocatechin-O-glucuronides were detected in the EGCG group. In litters, gallic acid, EGCG, GCG, and ECG were detected in the green tea and tea polyphenols groups; EGCG and ECG were detected in the EGCG group. The conjugated metabolites, 4'-O-methyl-(epi)gallocatechin-O-glucuronide, (epi)catechin-3'-glucuronide, and 4'-O-methyl-(epi)catechin-O-sulfate, were identified in the green tea group; 4'-O-methyl-(epi)catechin-O-sulfate and 4'-O-methyl-(epi)gallocatechin-O-sulfate were identified in the tea polyphenols group; only 4'-O-methyl-(epi)gallocatechin-O-sulfate was detected in the EGCG group. The excretion of tea catechins was 95.8, 87.7, and 97.7% for the green tea, tea polyphenols, and EGCG groups, respectively.

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HW-02 is a new organophosphates herbicide which is discovered and developed in China. The kinetics and mechanism of HW-02 photodegradation in the organic solvents were studied at 25 degrees C under the irradiation of ultraviolet light. The results showed that photochemical reaction of HW-02 in organic solvents such as n-hexane, methanol, dimethyl benzene and acetone under UV light could be well described by the first kinetic equation, and the photodegradation efficiency decreased with a order of n-hexane > methanol > xylene > acetone. The photodegradation efficiency constant of HW-02 in n-hexane, methanol, xylene and acetone were 4.951 x 10(-2), 3.253 x 10(-2), 2.377 x 10(-2) and 1.628 x 10-2 min(-1), and the corresponding half-lives were 13.99, 21.20, 29.15 and 42.56 min, respectively. By separation and identification of photoproducts using GC-MS, it could be concluded that HW-02 was photolyzed through ester cleavage, photo-dechlorination and photoisomerization of the molecule itself.

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