A comprehensive understanding of the nutritional composition and active components of human milk are important for promoting infant health. However, in the design and implementation of scientific research on human milk, the lack of standardized research and implementation methods have led to the collection, storage, and testing processes of human milk samples being largely based on reference literature and practical experience. This has resulted in variability in the representativeness of human milk samples and differences in the comparability of research results between different studies. This article summarizes the principles and guidelines for the " Specification for collection and storage of human milk samples for research", published by the Chinese Nutrition Society on December 30, 2022, and discusses the feasibility and importance of standardized management in the process of scientific research on human milk.

Objective:To investigate the safety and risk factors of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic lesions.Methods:Five thousand one hundred and sixty patients who underwent EUS-FNA in the Department of Endoscopy, Fudan University Shanghai Cancer Center from January 2012 to December 2022 were retrospectively reviewed. The incidence of adverse events was calculated, and independent risk factors were analyzed by univariate and logistic regression.Results:The incidences of postoperative pancreatitis, intraoperative bleeding and postoperative bleeding were 1.38% (68/4 930), 0.82% (42/5 143) and 0.78% (40/5 143) respectively. No perforation or death occurred. Age >60 years ( OR=0.581, 95% CI: 0.356-0.946, P=0.029), tumor located in the neck, body and tail ( OR=0.355, 95% CI: 0.194-0.652, P=0.001), lesion diameter of >20-40 mm ( OR=0.450, 95% CI: 0.227-0.893, P=0.023), and lesion diameter >40 mm ( OR=0.382, 95% CI: 0.168-0.869, P=0.022) were independent protective factors for postoperative pancreatitis. Transduodenal puncture ( OR=2.435, 95% CI: 1.319-4.496, P=0.005) was an independent risk factor for postoperative pancreatitis. Puncture for 3-4 pass ( OR=0.439,95% CI: 0.235-0.821, P=0.010), lesion diameter of >20-40 mm ( OR=0.154, 95% CI: 0.069-0.341, P<0.001), and lesion diameter >40 mm ( OR=0.326, 95% CI: 0.143-0.743, P=0.008) were independent protective factors for intraoperative bleeding. Fine-needle biopsy (FNB) needle ( OR=2.314, 95% CI: 1.189-4.502, P=0.014) was an independent risk factor for postoperative bleeding. Conclusion:EUS-FNA is a safe procedure with low incidence of adverse events. The occurrence of postoperative pancreatitis and intraoperative bleeding is mainly related to clinical characteristics of the lesion, while postoperative bleeding is related to the type of puncture needle.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

Tripartite motif-containing protein 28 is a kind of macromolecular protein with E3 ubiquitin ligase, which belongs to an important member of the TRIM protein family. As a new molecular biomarker, it has attracted wide attention. TRIM28 is highly expressed in many kinds of malignant tumors, which is closely related to clinicopathological features, and is also involved in biological behaviors such as proliferation, apoptosis, migration and invasion of tumor cells. TRIM28 may be a potential marker and therapeutic target for clinical diagnosis and prognosis of tumors. This study reviews the structure and biological function of TRIM28, its relationship with malignant tumors and the molecular mechanism of signal transduction pathway.

Objective:To analyze effects of parity on women′s nutrition and health status.Methods:This study was based on the data bank of "Chinese Nutrition and Health Surveillance of Children and Adolescents Aged 0-17 years old and Lactating Mothers from 2016 to 2017". Using a multi-stage stratified random sampling method, 17 771 women at 0 to 24 months postpartum from 31 provinces in Mainland China were included in this study. Questionnaires were used to collect data on women′s general demographic characteristics, parity, mode of delivery, pre-pregnancy weight, pre-delivery weight, diseases before and during pregnancy, postpartum hemorrhage. Current body height, body weight, waist circumference, and blood pressure were measured. Blood hemoglobin, blood glucose and blood lipids were detected. Pre-pregnancy BMI, gestational weight gain, postpartum weight retention, postpartum BMI, the rates of anemia, hypertension, diabetes, and dyslipidemia were calculated. Survey sample weights were calculated according to the sampling design and number of children under 2 years old from the sixth population census data of China. Effects of parity on the observational indicators after adjusting for confounding factors were analyzed by multivariate linear regression and multivariate logistic regression.Results:The age of 17 771 women was (29.5±5.0) years old, 12.2% (2 172) were over 35 but less than 40 years old, and 3.2% (563) were over 40 years old; the women with one parity, two parities, and three parities accounted for 47.3% (8 413), 48.5% (8 620) and 4.2% (738), respectively; urban women accounted for 49.9% (8 875), and rural women accounted for 50.1% (8 896). The results from multivariate linear regression showed that the pre-pregnancy BMI of women with two and three parities was 0.55 kg/m 2 and 0.76 kg/m 2 higher than women with one parity, respectively; the results of multivariate logistic regression showed that the OR(95% CI) of pre-pregnancy anemia was 1.45(1.04-2.02) for women with three parities compared with women with one parity, and the OR(95% CI) of anemia during pregnancy for women with two parities was 1.20(1.06-1.35) compared with women with one parity. Conclusion:Parity is associated with pre-pregnancy BMI and risk of anemia before and during pregnancy in women of reproductive age.

Objective:To analyze effects of parity on women′s nutrition and health status.Methods:This study was based on the data bank of "Chinese Nutrition and Health Surveillance of Children and Adolescents Aged 0-17 years old and Lactating Mothers from 2016 to 2017". Using a multi-stage stratified random sampling method, 17 771 women at 0 to 24 months postpartum from 31 provinces in Mainland China were included in this study. Questionnaires were used to collect data on women′s general demographic characteristics, parity, mode of delivery, pre-pregnancy weight, pre-delivery weight, diseases before and during pregnancy, postpartum hemorrhage. Current body height, body weight, waist circumference, and blood pressure were measured. Blood hemoglobin, blood glucose and blood lipids were detected. Pre-pregnancy BMI, gestational weight gain, postpartum weight retention, postpartum BMI, the rates of anemia, hypertension, diabetes, and dyslipidemia were calculated. Survey sample weights were calculated according to the sampling design and number of children under 2 years old from the sixth population census data of China. Effects of parity on the observational indicators after adjusting for confounding factors were analyzed by multivariate linear regression and multivariate logistic regression.Results:The age of 17 771 women was (29.5±5.0) years old, 12.2% (2 172) were over 35 but less than 40 years old, and 3.2% (563) were over 40 years old; the women with one parity, two parities, and three parities accounted for 47.3% (8 413), 48.5% (8 620) and 4.2% (738), respectively; urban women accounted for 49.9% (8 875), and rural women accounted for 50.1% (8 896). The results from multivariate linear regression showed that the pre-pregnancy BMI of women with two and three parities was 0.55 kg/m 2 and 0.76 kg/m 2 higher than women with one parity, respectively; the results of multivariate logistic regression showed that the OR(95% CI) of pre-pregnancy anemia was 1.45(1.04-2.02) for women with three parities compared with women with one parity, and the OR(95% CI) of anemia during pregnancy for women with two parities was 1.20(1.06-1.35) compared with women with one parity. Conclusion:Parity is associated with pre-pregnancy BMI and risk of anemia before and during pregnancy in women of reproductive age.

Exploring the genetic basis of human infertility is currently under intensive investigation.However,only a handful of genes have been validated in animal models as disease-causing genes in infertile men.Thus,to better understand the genetic basis of human spermatogenesis and bridge the knowledge gap between humans and other animal species,we construct the FertilityOnline,a data-base integrating the literature-curated functional genes during spermatogenesis into an existing sper-matogenic database,SpermatogenesisOnline 1.0.Additional features,including the functional annotation and genetic variants of human genes,are also incorporated into FertilityOnline.By searching this database,users can browse the functional genes involved in spermatogenesis and instantly narrow down the number of candidates of genetic mutations underlying male infertility in a user-friendly web interface.Clinical application of this database was exampled by the identifi-cation of novel causative mutations in synaptonemal complex central element protein 1(SYCE1)and stromal antigen 3(STAG3)in azoospermic men.In conclusion,FertilityOnline is not only an integrated resource for spermatogenic genes but also a useful tool facilitating the exploration of the genetic basis of male infertility.

Objective:To evaluate CT and or MRI imaging in the diagnosis of lateral lymph node metastasis in patients of middle and low rectal cancer.Methods:In this study, 112 lateral lymph nodes were harvested in 79 patients with middle and low rectal cancer. The relationship between the preoperative imaging features of the lateral lymph nodes and the postoperative pathology was evaluated.Result:Thirty-eight cases (48%) were pathologically confirmed to have lateral lymph node metastasis. The diameter of metastasis-positive lateral lymph nodes was significantly larger than that of metastasis-negative lateral lymph nodes ( P<0.01). Multivariate analysis of clinical features and imaging features found that, tumors poorly differentiated, mucinous adenocarcinoma, signet ring cell carcinoma ( P=0.006), and the largest short diameter of the lateral lymph node ≥7 mm ( P=0.024), uneven density or signal ( P=0.022) were independent risk factors for lateral lymph node metastasis. Conclusion:Poor tumor differentiation, lateral lymph node maximum short diameter ≥7 mm, density or signal unevenness are independent risk factors for lateral lymph node metastasis in middle and low rectal carcinoma.

OBJECTIVE: To detect variants of IVD gene among 4 neonates with suspected isovalerate acidemia in order to provide a guidance for clinical treatment. METHODS: 111 986 newborns and 7461 hospitalized children with suspected metabolic disorders were screened for acyl carnitine by tandem mass spectrometry. Those showing a significant increase in serum isovaleryl carnitine (C5) were analyzed for urinary organic acid and variants of the IVD gene. RESULTS: Four cases of isovalerate acidemia were detected, which included 2 asymptomatic newborns (0.018‰, 2/111 986) and 2 children suspected for metabolic genetic diseases (0.268‰, 2/7461). The formers had no obvious clinical symptoms. Analysis of acyl carnitine has suggested a significant increase in C5, and urinary organic acid analysis has shown an increase in isovaleryl glycine and 3-hydroxyisovalerate. Laboratory tests of the two hospitalized children revealed high blood ammonia, hyperglycemia, decreased red blood cells, white blood cells, platelets and metabolic acidosis. The main clinical manifestations have included sweaty foot-like odor, feeding difficulty, confusion, drowsiness, and coma. Eight variants (5 types) were detected, which included c.158G>A (p.Arg53His), c.214G>A (p.Asp72Asn), c.548C>T (p.Ala183Val), c.757A>G (p.Thr253Ala) and 1208A>G (p.Tyr403Cys). Among these, c.548C>T and c.757A>G were unreported previously. None of the variants was detected by next generation sequencing of 2095 healthy newborns, and all variants were predicted to be likely pathogenic based on the guidelines from the American College of Medical Genetics and Genomics. CONCLUSION The incidence of isovalerate acidemia in Liuzhou area is quite high. Screening of metabolic genetic diseases is therefore recommended for newborns with abnormal metabolism. The discovery of novel variants has enriched the mutational spectrum of the IVD gene.
Infant, Newborn ; Child ; Humans ; Acidosis ; Carnitine ; Erythrocytes ; High-Throughput Nucleotide Sequencing