We studied cutinase production from short-chain organic acids by Thermobifida fusca WSH03-11 to evaluate the possibility of converting municipal sludge to high value-added products. The optimum organic acid (8.0 g/L) and nitrogen source (1.5 g/L) concentrations were determined by the single factor experiments with butyric acid, propionic acid and acetic acid as the carbon sources. When lactic acid was used as the carbon source, the optimum organic acid (3.0 g/L) and nitrogen source (1.0 g/L) concentrations were obtained. Cutinase production by T. fusca WSH03-11 was further improved with butyric acid (by 31.0%), propionic acid (by 13.3%), acetic acid (by 43.8%) and lactic acid (by 73.2%) as carbon source, respectively, with the optimized cutin concentrations. Among these four short-chain organic acids, the average specific consumption rate of acetic acid was the highest, higher than that of propionic acid 1.3-folds, butyric acid 2.0-folds and lactic acid 2.2-folds. The highest cutinase activity reached 52.4 u/mL with butyric acid (8 g/L) as the sole carbon source, higher than that of lactic acid (3 g/L) 1.7-folds, acetic acid (8 g/L) 2.5-folds and propionic acid (8 g/L) 3.2-folds. The yield of cutinase activity on lactic acid (12.70 u/mg) higher than that of butyric acid 1.4-folds, propionic acid 3.0-folds and acetic acid 3.8-folds. T. fusca WSH03-11 consumed acetic acid firstly in mixed acids carbon sources, and the consumption of butyric acid was inhibited. Further studies indicated that the consumption rate of butyrate was decreased by 66.7% in the presence of 0.5 g/L acetic acid in the mixed acids. This was the first report concerning the production of cutinase by T. fusca with mixed organic acids as the carbon sources. The results presented here provided a novel and efficient approach to produce high value-add products from municipal sludge, and also established a foundation for the industrial production of cutinase by T. fusca WSH03-11 with cheap carbon sources from the processing of municipal sludge.
Acetates ; metabolism ; Actinomycetales ; growth & development ; metabolism ; Butyric Acid ; metabolism ; Carboxylic Ester Hydrolases ; biosynthesis ; Fermentation ; Organic Chemicals ; metabolism ; Propionates ; metabolism

OBJECTIVETo compare the applicative effect of four diagnostic criteria of metabolic syndrome (MS) among the urban adult population of Zhejiang Province.

METHODSAccording to multi-stage stratified and proportional to size, cluster, random sampling principle, 3 417 adults population at urban areas were extracted by random number method from 320 families of Shangcheng and Jianggan community in Hangzhou,Jiangdong community in Ningbo and Wucheng community in Jinhua in 2009 and 2010 respectively, which excluded pregnant, wet nurse, children, and those who were at least 18 years of age. Height, weight, waist, blood pressure, fasting plasma glucose (FBG) , 2-hour postprandial blood glucose (2h-PBG), TG and HDL-C of all the subjects were measured by standard method. MS was diagnosed and compared according to four diagnostic criteria:Chinese Medical Association Diabetic Society (CDS), Joint Committee for Developing Chinese Guidelines (JCDCG), American National Cholesterol Education Program Adult Treatment PaneI II in 2005 (ATPIII) and International Diabetes Federation (IDF), respectively.

RESULTSThe high prevalence of MS diagnosed by the criteria of ATPIII was 21.6% (737/3 417) , while the lowest prevalence diagnosed by CDS was 9.8% (335/3 417), the result of consistency check demonstrated the MS diagnostic criteria of ATPIII and IDF, ATPIII and JCDCG were in strong and the same accordance with the concordance rate, Kappa value was 0.75, while the consistency of the criteria of ATP III and CDS were in relatively weak agreement, Kappa value was 0.53; the detection result of MS abnormal components showed the highest proportion of having ≥ 3 risk factors was presented by ATPIII among subjects diagnosed as MS (100.0%) , meanwhile, the lowest proportion of having ≥ 3 risk factors was also found by ATPIII among those MS-free (0.8%) .

CONCLUSIONSThe criteria of ATPIII may have more sensitivity when screening MS and its abnormal components.However, it's limited to extrapolate the results from the cross-sectional survey to the total population.

Adult ; Blood Glucose ; Body Weight ; Body Weights and Measures ; Cholesterol ; Cross-Sectional Studies ; Diabetes Mellitus ; Diagnostic Techniques and Procedures ; Humans ; Metabolic Syndrome ; Prevalence ; Risk Factors ; Urban Population

Objective: To invesigate the epidemic status of the metabolic syndrome (MS) among mainland Chinese adolescents aged 10-17 in 2010-2012. Methods: Data were collected from Chinese Nutrition and Health Surveillance in 2010-2012. Multi-stage stratified proportion to the population cluster random sampling method was conducted to determine 16 872 adolescents in 150 counties from 31 provinces in mainland China. The epidemic status of metabolic syndrome was analyzed by China criterion (defined by Chinese Pediatric Society, Chinese Medical Association) and Cook criterion, respectively. The prevalence of MS and 95%CI were calculated through weighted complex sampling processing by population data released by the National Bureau of Statistics in 2009. Results: Based on China criterion, the weighted prevalence of MS was 2.4% (95% CI: 2.1%-2.6%) among Chinese adolescents aged 10-17. Prevalence in urban was higher than in rural (2.8%, 95%CI: 2.4%-3.2% and 1.9%, 95%CI:1.6%-2.3%, respectively). Prevalence in boys and girls were 2.7% (95% CI: 2.3%-3.0%), and 2.0% (95% CI: 1.7%-2.4%), respectively. Based on Cook criterion, the weighted prevalence was 4.3% (95% CI: 4.0%-4.7%) . The highest weighted prevalence of the components of the metabolic syndrome was low high-density lipoprotein cholesterol (26.8%, 95% CI: 26.0%-27.5%), followed by high fasting glucose (11.5%, 95% CI: 11.0%-12.0%), abdominal obesity (11.1%, 95%CI: 10.6%-11.7%) , hypertriglyceridemia (8.8%, 95%CI: 8.4%-9.3%) , and high blood pressure (6.4%, 95% CI: 6.0%-6.8%). Conclusion Among the five indicators of metabolic syndrome, the prevalence of central obesity and hypertriglyceridemia were relative high in Chinese adolescents aged 10-17 years, though the prevalence of metabolic syndrome was not high.

Objective: To analyze the latent category characteristics of lifestyle habits of adolescents aged 12-18 years, and to explore its relationship with obesity. Methods: Data of 3 252 adolescents aged 12-18 years in the established China Nutrition and Health Survey were used for this study. The contents of the survey include basic situation, living habits, and body mass index. Latent category analysis was performed on 11 lifestyle habits on eating and exercise. Chi square test was used to explore the relationship between the potential categories of lifestyle habits and obesity. Results: All the participants were classified into 3 categories:mixed ( n =1 092, 35.58%), passive ( n =765, 23.52%), and healthy ( n =1 395, 42.90%) groups. Body mass index showed significant differences across three categories ( χ 2=19.66, P ＜0.01). In the BMI classification of adolescents, the healthy type has the highest proportion in the light type, overweight type and obesity type(41.61%,47.87%,50.00%). Conclusion The lifestyle habits of adolescents aged 12-18 years show obvious classification characteristics, which have different correlations with obesity. Targeted interventions should be carried out according to the characteristics of lifestyle habits under different body mass index.

Objective To access the prevalence of type 2 diabetes mellitus ( T2DM) and its associated risk factors among adults with obesity in Zhejiang province. Methods The enrolled subjects were selected among local residents aged≥18 years with body mass index≥28 kg/m2 from 15 counties by multi stage stratified cluster random sampling from July to November, 2010. Each participant was required to attend complete questionnaire, physical examination, and testing overnight fasting blood specimen. Results A total of 1 351 residents were enrolled, including 613 males and 738 females. The prevalence of T2DM in adult population with obesity was 15. 03%, being 14. 03% in male, and 15. 85% in female;and that in urban area was 16. 64%, and in rural area was 13. 93%. Data from multivariable logistic regression showed that factors such as ageing (OR=1. 473, 95% CI 1. 243-1. 747), a family history of T2DM(OR=8. 945, 95% CI 5. 481-14. 598), staple food intake (OR=1. 185, 95% CI 1. 017-1. 380), triglyceride(≥1. 7 mmol/L, OR=1. 542, 95%CI 1. 066-2. 232) were risk factors of T2DM;while annual income(OR=0. 695, 95%CI 0. 544-0. 888), and milk intake(OR=0. 750, 95%CI 0. 567-0. 993) were shown as protective factors. Conclusion The prevalence of T2DM in adults with obesity was raised, ageing, a family history of T2DM, staple food intake, and dyslipidemia appeared to be major risk factors for T2DM.

ObjectiveTo study the epidemiological characteristics of diabetes mellitus and awareness rate in Zhejiang adults.MethodA total of 17 437 adults from 15 counties were randomly selected with stratified multi-stage cluster sampling method from July to November,2010.Each participant was required to complete a set of standardized questionnaire,physical examination,and blood specimen collection.ResultsThe overall standardized rate of diabetes mellitus was 5.94％ ( crude prevalence 8.80％ ).It was increased by 96.67％ during past 8 years,as compared with the prevalence 3.02％ in 2002.The standardized rate of diabetes mellitus of the urban and rural area were 7.52％ and 5.19％ ( crude prevalence 11.33％ and 7.09％ ),respectively.The standardized rate of diabetes mellitus in the urban was higher than rural ( u =6.58,P＜0.05 ).The standardized rate of diabetes mellitus of the male and the female were 5.74％ and 6.15％ ( crude prevalence 8.36％ and 9.13％ ),respectively,without significant difference ( u =1.39,P＞0.05 ).The awareness rate of diabetes mellitus was 59.19％ ( 56.66％ in male and 61.23 ％ in female,x2 =3.26,P＞0.05 ).The awareness rate of the urban was higher than the rural (63.47％ vs 54.69％,x2=12.20,P＜0.01 ).ConclusionThe prevalence of diabetes mellitus showed a rapidly rising trend in Zhejiang province.The effective intervention should be taken at its early stage.

This paper systematically summarized the core problems in the field of medical and health services and did the root analysis.It is concluded that the current domestic and international related medical service modes deviated from the essence of health services and led to difficulties in the idea and method,bringing people to new problems and new crises.KY3H health care service model,set innovative ideas,innovative technical methods,innovative products,innovative processes,standards and standards into one,by providing a full range and the whole cycle of people-oriented,self-help,"diagnosis and treatment of security" integration of health careservice,improve people's health status,fundamentally change the traditional passive "seeking medical treatment" service mode,to active "seeking one's own" health service mode,so as to achieve "health status continues to rise,the medical costs continue to decline,"which is the social development aims.The paper systematically analyzes the idea,operational logic,goal,mode structure,characteristics of the model,and its significance to individuals,industries,society,countries and even the international community in order to make a positive contribution to the healthy development strategy in China and provide a Chinese case for global Health.

Objective To estimate the prevalence and distribution of metabolic syndrome (MS) in Chinese adults.Methods Cross-sectional data on 104 098 men and women aged 18 years or above was gathered from 150 monitoring sites from 31 provinces,autonomous regions,and municipalities from the China National Health and Nutrition Surveillance (2010-2012) Project.Data was randomly selected by multi-stage stratified and Probability Proportionate to Size (PPS) cluster random sampling method.Prevalence of MS was defined under the diagnostic criteria of China Diabetes Society (CDS).Complex sampling weighing method was used with demographic data released by the National Bureau of Statistics of China in 2009,when calculating the prevalence and its 95％CI of MS.Results The overall prevalence rate of the MS among adults was 11.0％,more seen in urban than in rural areas,and in men than in women.The prevalence showed a parallel increasing trend with age.As was observed in the comparison between the prevalence of four components of MS,the prevalence rates of dyslipidemia (33.7％) and overweight or obesity (32.3％) showed more serious than in hypertension (22.4％) or hyperglycemia (16.2％).Conclusion The prevalence of MS among adults in China showed an increasing trend which had already become a significant public health problem,in the country.

Objective To study the influence of diet and behavior related factors on the peripheral blood triglyceride levels in adults,through a cross-sectional survey.Methods The current study included 13 434 subjects without histories of major chronic diseases from a population-based cross-sectional survey:the 2010 Metabolic Syndrome Survey in Zhejiang Province.A generalized linear model was used to investigate the influence of diet/behavior-related factors on the peripheral blood triglyceride levels.Results Mean TG of the sample population appeared as (1.36± 1.18) mmol/L.The proportions of elevated TG and marginally elevated TG were 10.3％ and 11.0％ respectively,with statistically significant difference seen between males and females (x2=44.135,P＜0.001).In this sampled population,the daily intake of cooking oil was exceeding the recommendation levels by over 50％ while the intake of fruit,milk,nuts and physical exercise were much below the recommendation.There were statistically significant differences between smoking,alcohol-intake,meat,fruit and water intake in male population from this study.However,in females,the intake of aquatic product and physical exercise showed statistically significant differences.After controlling for other variables,factors as age,drinking,staple food and aquatic products showed positive influence on TG,while milk presented negative influence on TG.Through interaction analysis,fruit and meat intake in males and staple food in females showed positive influence on TG,when compared to the reference group.Conclusion Hyperglyceridemia appeared as one of the major metabolic abnormities in Zhejiang province.Programs on monitoring the alcohol,staple food and meat intake should be priority on intervention,in the communities.

Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.