1.Astragalin Regulates Autophagy and Apoptosis of Astrocytes in L4-5 Spinal Dorsal Horn of Mouse Inflammatory Pain Model
Weishan ZHANG ; Jiahong LIN ; Can WANG ; Runheng ZHANG ; Junhua YANG ; Jing LIU ; Guoying LI ; Yuxin MA
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(2):186-196
ObjectiveTo explore the effects of astragalin (AST) on autophagy and apoptosis of astrocytes in the L4-5 dorsal horn of the spinal cord in mice with inflammatory pain induced by complete Freund's adjuvant (CFA). MethodsTwenty-four male C57BL/6 mice, aged six months, were randomly assigned to four groups: control group, saline group, CFA model group, and CFA+AST group, six mice in each group. The inflammatory pain model was established by injection of 10 µL CFA into the right lateral malleolus fossa. The saline group were injected with an equal amount of normal saline at the same site. The inflammatory pain mice in CFA+AST group were further treated with AST (60 mg/kg) intraperitoneally once a day for 21 consecutive days. Multiplex immunofluorescence staining was used to detect the coexpression of autophagy-related factors including ATG 12 and Beclin-1, apoptosis-related factors including Cleaved-Caspase3 and Caspase9, and the astrocyte marker such as GFAP in the L4-5 spinal dorsal horn of the mice in each group. Western blot was used to examine the protein expression levels of autophagy-related proteins(ATG12, Beclin-1) and apoptosis-related proteins(Caspase 3, Caspase 9) in the L4-5 spinal dorsal horn of mice. ResultsImmunofluorescent staining showed that in the L4-5 dorsal horn of the spinal cord, the fluorescence intensity of ATG12 (P<0.000 1) and Beclin-1 (P<0.000 1) was significantly increased, while that of Cleaved-Caspase 3 (P<0.001) and Caspase 9 (P<0.000 1) was decreased in the CFA+AST group when compared to the CFA model group. Furthermore, AST could inhibit the activation of astrocytes. Western blot further confirmed that AST significantly upregulated the expression of ATG12 (P<0.000 1) and Beclin-1 (P<0.000 1) in the L4-5 spinal cord of CFA mice, and downregulated the expression of Caspase 3 (P<0.01) and Caspase 9 (P<0.001). ConclusionsAST promotes autophagy of astrocytes and inhibits their apoptosis in the L4-5 spinal dorsal horn of CFA mice.
2.Ecological factors impacting genetic characteristics and metabolite accumulations of Gastrodia elata.
Zhaoyu ZHANG ; Xiaodong LI ; Yuchi ZHANG ; Niegui YIN ; Guoying WU ; Guangfei WEI ; Yuxin ZHOU ; Shilin CHEN ; Linlin DONG
Chinese Herbal Medicines 2025;17(3):562-574
OBJECTIVE:
The investigation of the correlation between ecological factors and the genetic characteristics or metabolites of plants offers valuable insights into the regional causes of genetic and metabolic diversity. Here, Gastrodia elata, a medicinal plant, is employed as a model to explore the environmental factors that influence its genetic characteristics and metabolic accumulations.
METHODS:
A total of 23 G. elata populations from six cultispecies and 11 cultivated regions were selected based on the predictions of the global geographic information system. The genetic characteristics of these populations were evaluated using highly polymorphic simple sequence repeat markers. Additionally, the metabolic accumulations and antioxidant capacity of mature tubers were measured employing colorimetry and high performance liquid chromatography (HPLC). Ecological data of each region were obtained from the WorldClim-global climate database and harmonized world soil database. To assess the influence of ecological factors on the genetic characteristics and metabolic profiles of G. elata, Pearson's correlation analysis was conducted.
RESULTS:
Genetic variation among G. elata populations exceeded that within populations. Genetic diverisity, distance and structure manifested regional and species-specific patterns. Metabolic profiling and antioxidant capacity exhibited regional variations. Notably, the Lueyang region demonstrated that a content range of total polysaccharide, total protein, and phenolic glycosides was 9.34%-189.67% higher than the average. Similarly, in the Hubei region, total phenolic content, p-hydroxybenzyl alcohol content, and antioxidant indicators were observed to be higher than the average levels, by 106.57%, 136.47% and 12.50%-91.14%, respectively. Furthermore, ecological factors had a significant comprehensive impact on G. elata genetic characteristics (r > 0.256 and P < 0.05). Multivariate metabolite accumulations in G. elata were influenced by dominant ecological factors. Temperature notably impacted the accumulation of total protein (|r| > 0.528 and P < 0.05). Moisture, encompassing precipitation and soil content, significantly affected the production of phenolic glycosides (|r| > 0.503 and P < 0.05).
CONCLUSION
The genetic characteristics of G. elata manifested regional and species-specific patterns, with the metabolic accumulations and antioxidant capacity of mature tubers exhibited regional variations. Specifically, multivariate ecological factors comprehensively influenced genetic characteristics. Temperature and moisture played pivotal roles in regulating the accumulations of proteins and phenolic glycosides, respectively. These findings underscore the significant impact of ecological factors on the shaping of G. elata, highlighting their crucial role in enhancing the quality of Chinese medicinal materials.
3.Detection of Free T4 in Cerebrospinal Fluid Predicts Autism-like Behaviors in Offspring Rats Induced by Hypothyroidism during Pregnancy
Lifang LI ; Jiaqi ZHANG ; Junhua YANG ; Yuxin MA ; Guoying LI
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(6):1029-1040
ObjectiveTo investigate the potential value of thyroid hormones in cerebrospinal fluid in predicting autism-like behaviors induced by hypothyroidism in pregnant rats. MethodsTwelve pregnant Wistar rats were randomly divided into a control group and a hypothyroidism group (hypothyroidism model group). Offspring from both groups had serum and cerebrospinal fluid levels of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), and free thyroxine (FT4) levels in serum and cerebrospinal fluid. Ultrasonic vocalization tests were conducted on postnatal day 2 (P2), day 7 (P7), and day 14 (P14), while behavioral tests using the three-box social interaction test were performed on day 21(P21). ResultsCompared with the control group, free T4 (FT4) levels in the cerebrospinal fluid of the hypothyroidism group were significantly reduced during the developmental period (P0-P21; P2: P<0.05; P7: P<0.05; P14: P<0.01; P21: P<0.01), with no statistical difference between the two groups only at P0 (P>0.05). In the ultrasonic vocalization (USV) tests, the number and duration of USVs in offsprings from the hypothyroidism group were significantly reduced compared with those of the control group on P2, P7 and P14: for USV counts (P2: P<0.05; P7: P<0.001; P14: P<0.01); for USV duration (P2: P<0.05; P7: P<0.001; P14: P<0.001). In the three-box social tests, offsprings of the hypothyroidism group showed significantly reduced sniffing time with unfamiliar rats at P21 compared to the control group (all P<0.001). The FT4 levels in cerebrospinal fluid had a significantly positive correlation with USV counts (P7: r=0.883, P<0.05; P14: r=0.902, P<0.05) and sniffing time with unfamiliar rats (r=0.814, P<0.01). ConclusionMeasuring free T4 in cerebrospinal fluid can predict autism-like behaviors in offsprings of rats induced by hypothyroidism during pregnancy.
4.Professor XIE Jingri's Experience in Treating Bile Reflux Gastritis from the Perspective of "Disease of both Wood and Earth"
Xianjun RAO ; Xidan ZHANG ; Guangye LIANG ; Tianjiao QU ; Guoying LIANG ;
Journal of Traditional Chinese Medicine 2024;65(17):1757-1761
This paper summarized the clinical experience of Professor XIE Jingri in treating bile reflux gastritis from the perspective of “disease of both wood and earth”. It is believed that the pathogenesis of bile reflux gastritis is the disharmony of liver and spleen, gallbladder and stomach, which belongs to the disease of both wood and earth. The treatment principle of harmonizing wood and earth is advocated. Clinically, bile reflux gastritis is divided into five patterns including liver constraint and spleen deficiency, liver fire harassing stomach, gallbladder and stomach obstruction, damp-heat in the gallbladder, and stomach yin depletion, for which Shugan Lipi Decoction (疏肝理脾汤) can be used to soothe the liver and move qi, fortify the spleen and activate spleen, Lianyu Qinggan Decoction (连萸清肝汤) to clear the liver and drain fire, harmonize stomach and stanch bleeding, Tongfu Paishi Decoction (通腑排石汤) to unblock and discharge gallbladder, harmonize stomach and direct counterflow qi downward, Qingdan Huazhuo Decoction (清胆化浊汤) to clear and drain damp-heat, promote gallbladder function and stanch bleeding, and Yiwei Decoction (益胃汤) to enrich and nourish stomach yin, clear and discharge deficiency-fire. When the clinical pattern is complex, multiple patterns occur simultaneously, or the disease involves multiple zang fu (脏腑) organs, the liver and the spleen should be regulated simultaneously, and the gallbladder and the stomach treated together, with self-designed Shumu Tiaotu Decoction (疏木调土汤) recommended as a basic prescription with flexibl modification based on the symptoms.
5.Awareness of air pollution protection knowledge among primary school students in Shennongjia Forest District
LI Xiang ; ZHANG Xiuqin ; LI Guoying ; WANG Qiong ; XIE Shuguang ; FAN Chuangang
Journal of Preventive Medicine 2024;36(2):173-176
Objective:
To investigate the awareness of air pollution protection knowledge and its influencing factors among primary school students in Shennongjia Forest District, Hubei Province, so as to provide insights into targeting implementation of health education on air pollution protection knowledge.
Methods:
Students in Grade 3 to 5 in Shennongjia Shiyan primary school were enrolled by stratified cluster sampling method, and students' demographic features and awareness of air pollution protection knowledge were investigated using the Investigation on the Effects of Air Pollution Health Protection of Pupils (Volume A). Factors affecting the awareness of air pollution protection knowledge among primary school students were identified using a multivariable logistic regression model.
Results:
A total of 897 questionnaires were allocated, and 877 valid questionnaires were recovered, with an effective rate of 97.77%. The respondents included 446 men (50.86%) and 431 women (49.14%), 301 third grade students (34.32%), 284 fourth grade students (32.38%), and 292 fifth grade students (33.30%), and had a mean age of (10.32±0.93) years. The overall awareness of air pollution protection was 55.76%, and the awareness rates of basic concepts, basic knowledge, and basic behaviors and skills were 42.99%, 53.48% and 57.24%, respectively. Multivariable logistic regression analysis identified age (OR=1.453, 95%CI: 1.053-2.005), living with parents (OR=2.638, 95%CI: 1.571-4.429), mother's educational level (below primary school, OR=0.270, 95%CI: 0.084-0.862; primary school, OR=0.169, 95%CI: 0.069-0.416; junior high school, OR=0.309, 95%CI: 0.138-0.691; high school, OR=0.352, 95%CI: 0.160-0.773) and average annual family income (50 000 to 100 000 Yuan, OR=1.629, 95%CI: 1.162-2.282; 100 000 to 150 000 Yuan, OR=1.802, 95%CI: 1.101-2.948; ≥150 000 Yuan, OR=1.939, 95%CI: 1.065-3.529) as factors affecting the awareness of air pollution protection knowledge among primary school students.
Conclusion
The awareness of air pollution protection knowledge is 55.76% among primary school students in Shennongjia Forest District, and is affected by age, mother's educational level, average annual family income and living with parents.
6.Allele frequency polymorphism of Duffy, Kidd, Diego blood group system: a study in Dongxiang ethnic group in Gansu Province
Jun CUI ; Weiping ZHANG ; Xia HUI ; Xiaoping ZHANG ; Guoying LI ; Haiyan YANG
Chinese Journal of Blood Transfusion 2024;37(1):68-72
【Objective】 To investigate the allele frequencies polymorphic distribution of Duffy, Kidd and Diego blood group systems in Dongxiang ethnic group in Gansu Province. 【Methods】 Blood samples of 100 unrelated blood donors were randomly selected from Dongxiang ethnic group in Gansu from January to December 2017. Allelic typing of Duffy, Kidd and Diego blood groups was performed by fluorescence PCR. 【Results】 The allele frequencies of Duffy, Kidd, and Diego blood group systems of Dongxiang ethnic group were 0.835 for Fy*01, 0.165 for Fy*02, 0.570 for Jk*01, 0.430 for Jk*02, 0.020 for DI*01, 0.980 for DI*02, respectively. No Fy(a-b-), Jk(a-b-), Di(a+b-) rare phenotypes were found. The antigen incompatibility rates of Fya/Fyb, Jka/Jkb, Dia/Dib of Duffy, Kidd, and Diego blood group systems were 23.76%, 37.01% and 3.84%, respectively. 【Conclusion】 The allele frequencies distribution of Duffy, Kidd and Diego blood group systems in Dongxiang ethnic group in Gansu were polymorphic and has unique ethnic distribution characteristics.
7.Effect of storage temperature and time on coagulation factor after cryoprecipitated antihemophilic factor melting
Yuan WANG ; Guoying LIU ; Dawei KONG ; Jianbin LI ; Xinli JIN ; Yuhong ZHANG ; Wenchao GE ; Lin CHENG ; Jiaxuan LIU ; Yuzhen LIU
Chinese Journal of Blood Transfusion 2024;37(4):425-430
【Objective】 To study and compare the effects of different storage temperature and time on coagulation factor after cryoprecipitated antihemophilic factor(CAF) melting, and to provide reference for the establishment of industry standards. 【Methods】 From June 2021 to May 2023, a total of 96 bags of CAF were sampled in 4 bags per month, and timely detected in the same month. After the CAF was melted in a 37℃ water bath, the mild to moderate lipemic blood was labeled. Each bag of CAF and two 50 mL transfer bags were divided into two bags and two groups of 20 mL each using a sterile adapter. One group was placed in a 4℃ refrigerator and the other in a 22℃ water bath for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h. Then 2 mL of aseptic sample was taken separately and put into the test tube, and 1mL of sample and 3 mL of buffer were added into the other test tube with the sampling gun and mixed on the machine for testing. The experimental data of 60 bags without mild to moderate lipemic blood cryoprecipitation and coagulation factor were randomly selected and statistically analyzed by SPSS21.0. 【Results】 After melting, CAF was stored for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h to detect the average content and growth rate of coagulation factor in the two groups: 1) Storage at 4℃, factor Ⅷ content was 118.62, 111.57(-5.95%), 105.51(-11.05%), 103.30(-12.92%), 94.35(-20.46%) and 83.25(-29.82%) IU/ bag, respectively; Storage at 22℃, the factor Ⅷ content was 118.62, 112.69(-5.00%), 111.41(-6.08%), 109.01(-8.10%), 101.55(-14.39%) and 92.75(-21.81%) IU/ bag, and the storage results of the two groups were compared. At 24 h at 4℃ and 48 h at 22℃, the content of factor Ⅷ had significant statistical significance(P<0.01), and when stored at 22℃, the decay rate of factor Ⅷ was slower; 2) When stored at 4℃, the content of factor V was 41.19, 41.31(0.29%), 40.52(-1.64%), 40.27(-2.23%), 39.05(-5.19%) and 36.99(-10.21%) IU/ bag, respectively; Stored at 22℃, the factor V content was 41.19, 41.71(1.25%), 42.54(3.28%), 41.94(1.80%), 39.21(-4.80%) and 35.64(-13.48%) IU/ bag, respectively. Comparison of storage results between the two groups showed that the content of factor V was statistically significant(P<0.05) and significantly significant(P<0.01) at 4℃48 h and 22℃48 h, respectively, and the decay rate of factor V was faster when stored at 22℃; 3) When stored at 4℃, the Fbg content was 268.86, 268.17(-0.26%), 262.46(-2.38%), 270.50(0.61%), 267.52(-0.50%) and 261.92(-2.58%) mg/ bag, respectively; Stored at 22℃, the Fbg content was 268.86, 265.86(-1.12%), 264.12(-1.77%), 265.89(-1.11%), 266.04(-1.05%) and 261.04(-2.91%) mg/ bag, respectively. There was no statistical significance between the 2 groups and the original 0 h content in each time period(P>0.05). 【Conclusion】 After CAF melting, coagulation factor decreased with the extension of storage time, especially the decrease of factor Ⅷ, followed by factor V, while Fbg basically unchanged. Comparison between the two groups showed that, factor Ⅷ decay rate is slower, factor V decay rate is faster of storage at 22℃. CAF should be transfused as soon as possible after melting. If the delay is unavoidable, for the delay time less than 12 h, storage at 4℃ is recommended, fot the delay time more than 12 h and less than 24 h, storage at 22℃ is recommended.
8.Screening of new biomarkers for esophageal cancer and preliminary verification for peripheral blood mRNA
Bai XUE ; Ping CHEN ; Yuling ZHANG ; Qixiang SHAO ; Guoying XU ; Huihui HAO ; Hongchun LI ; Weili CAI
Chinese Journal of Clinical Laboratory Science 2024;42(5):337-342
Objective To screen and verify the genes that play key role in the occurrence and development of esophageal cancer by u-sing bioinformatics and real-time fluorescence quantitative PCR(qRT-PCR)methods to find new markers for diagnosis of esophageal cancer(ESCA).Methods Using the TCGA database and Wayne plot analysis,the cross genes between the differentially expressed genes of ESCA and the genes which have the most significant impacts on disease-free survival(DFS)rate in esophageal cancer patients were preliminarily identified.Following conducting protein-protein interaction(PPI)network analysis on the overlapping genes,GO and KEGG functional analysis was performed to screen the potential key genes as the diagnostic markers of esophageal cancer.qRT-PCR was used to quantitatively analyze the expression of mRNA of the key gene in peripheral blood.Statistical analysis was con-ducted based on the clinico-pathological characteristics of the patients to determine its potential value as a new diagnostic marker for e-sophageal cancer.Results After overlapping of differentially expressed genes of ESCA and disease-free survival genes in the TCGA database,39 upregulated genes and 20 downregulated genes were found to be differentially expressed,all of which affected disease-free survival rate.After conducting PPI network analysis,15 upregulated genes with core interactions were identified,and the downregulat-ed genes did not form any interaction network.Further enrichment analysis of these 15 core interacting genes through GO and KEGG,revealed that fibronectin 1(FN1)may be a potential biomarker for ESCA diagnosis.The qRT-PCR results showed that compared with the healthy control group,the mRNA expression level of FN1 in the peripheral blood of esophageal cancer patients was significantly ele-vated.After analyzing the clinical characteristics of patients,it was found that the patients with poor differentiation and high clinico-pathological staging had significantly increased peripheral blood FN1 mRNA levels.The model with FN1 mRNA expression levels can distinguish esophageal cancer patients from healthy individuals.Conclusion FN1 mRNA may be a potential non-invasive diagnostic biomarker for esophageal cancer.
9.Analysis of Mycoplasma pneumoniae infection in children in a tertiary hospital of Nanjing before and after the COVID-19 out-break
Fang HE ; Xiaoyang ZHANG ; Weiping XU ; Yidi GUO ; Guoying ZHANG
Chinese Journal of Clinical Laboratory Science 2024;42(11):873-876
Objective To investigate the epidemiological characteristics of Mycoplasma pneumoniae(MP)infection in children in Nanjing Integrated Traditional Chinese and Western Medicine Hospital before and after the COVID-19 outbreak,and provide an experi-mental basis for the prevention and treatment of MP infection.Methods The clinical data of 17 976 children visited Nanjing Integrated Traditional Chinese and Western Medicine Hospital from January 2019 to November 2023 due to respiratory tract infections were retro-spectively analyzed.The levels of serum specific MP-IgM in the children were detected by the direct luminescence immunoassay,and the detection rates of MP-IgM in different genders,seasons,and ages before and after the COVID-19 epidemic were analyzed using the chi square test to explore the epidemiological characteristics of MP infection.Results The total detection rate of serum MP-IgM in 17 976 children with respiratory tract infections was 28.45%(5 114/17 976).Among them,the total detection rate of serum MP-IgM in female children(31.69%,2 672/8 432)was significantly higher than that in male children(25.59%,2 442/9 544,χ2=81.89,P<0.001).The detection rate of serum MP-IgM was highest in 2019(34.35%,1 415/4 119),followed by in 2023(30.11%,2 409/8 001)and in 2020-2022(22.03%,1 290/5 856),with statistically significant difference(χ2=19.95,P<0.001).The detection rate of serum MP-IgM was highest in autumn(33.16%,1 683/5 075),followed by in summer(28.61%,1 053/3 681),winter(27.65%,1 826/6 604),and spring(21.10%,552/2 616),with statistically significant difference(χ2=126.90,P<0.001).Among different age groups,the detection rate of serum MP-IgM was highest in the age group of 7-9 years old(35.83%,1 190/3 321),fol-lowed by 4-6 years old(28.06%,1 882/6 707),1-3 years old(26.55%,1 493/5 623),10-18 years old(23.64%,486/2 056),and<1 year old(23.42%,63/269),with statistically significant difference(χ2=126.11,P<0.001).Conclusion MP is a common pathogen of respiratory tract infections in children,especially in the age range of 7-9 years old,with female children having a higher in-cidence than male children,and the peak incidence in autumn.The effective prevention and control measures during the COVID-19 ep-idemic have reduced the detection rate of MP-IgM,which may provide certain experimental basis for the control and prevention of MP infection transmission and other respiratory diseases.
10.Periconceptional maternal homocysteine and birth weight outcomes in offspring: a prospective cohort study
Yi ZHANG ; Xiaotian CHEN ; Qinyu YAO ; Hongyan CHEN ; Mengru LI ; Dingmei WANG ; Yalan DOU ; Yuanzhou PENG ; Xiaoyan GU ; Weili YAN ; Guoying HUANG
Chinese Journal of Pediatrics 2024;62(2):120-128
Objective:To quantify the associations between periconceptional maternal homocysteine (HCY) and offspring′s birth weight and risk of small for gestational age (SGA) infant.Methods:The 19 984 mother-child pairs in this prospective cohort study were recruited from the Shanghai preconception cohort; the infants were delivered from 1 st September 2016 to 11 th November 2022. A standardized questionnaire was used to collect the mothers′ demographic information, medical history, dietary supplement use, and maternal complications during pregnancy, and their serum samples were collected. Serum HCY, folate, and vitamin B 12 were measured using chemiluminescent microparticle immunoassay based on serum sample drawn at enrollment. Birth weight data were obtained from medical records. Multiple imputation methods were applied to handle missing data in key variables. Multivariable linear regression and Poisson regression models were used to analyze the relationship between maternal HCY concentration during the periconceptional period and the birth weight and SGA risk of the offspring. Results:A total of 9 452 pairs were enrolled preconceptionally and the remaining 10 532 pairs were enrolled in early pregnancy. The proportion of mothers whose pregnancy age was greater than 35 years was 9.2% (1 832/19 984), the proportion of primiparous women was 76.5% (15 283/19 984), the proportion of pre-pregnancy overweight and obesity was 14.0% (2 804/19 984), the proportion of using folic acid supplements before pregnancy was 21.4% (4 272/19 984), and the proportion of those who supplemented with folic acid during early pregnancy was 85.2% (8 976/10 532); gestational diabetes mellitus was in 6.2% (1 245/19 984), gestational hypertensive syndrome in 3.6% (711/19 984). The birth weight of the offspring was (3 297±468) g, and there were 1 962 SGA children (9.8%). The HCY concentration in the overall population in appropriate for gestational age during the periconceptional period was (7.9±3.2) μmol/L, with (8.3±3.7) μmol/L in the preconception subgroup and (7.3±2.4) μmol/L in the early pregnancy subgroup. After adjustment for the covariates of perinatal demographic information, adverse pregnancy outcomes, serum folate and vitamin B 12, increased maternal periconceptional HCY was significantly associated with lower offspring birth weight ( β=-2.30, 95% CI -4.43--0.16, P=0.035). Only the early pregnancy subgroup was significantly associated with lower offspring birth weight ( β=-7.39, 95% CI-11.50--3.21, P<0.001). No association was found between peripregnancy HCY and offspring SGA risk. However, elevated HCY in early pregnancy was associated with an increased risk of SGA in the offspring ( RR=1.05, 95% CI 1.01-1.08, P=0.002). Periconceptional vitamin B 12 was a mediator of the association between HCY and offspring birth weight, accounting for 16.5%, 41.2% and 5.4% of its total effect in the overall periconceptional population, the pre-pregnancy subgroup and the early pregnancy subgroup, respectively. Conclusions:Maternal periconceptional HCY level is associated with lower birth weight in offspring, but not with the risk of SGA. Elevated maternal HCY in early pregnancy subgroup may be associated with increased risk of SGA in offspring.


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