Objective: To under the prevalence of malnutrition and its associated factors in school aged children with cerebral palsy, so as to provide a basis for relevant departments to formulate targeted policies. Methods: From July to August 2023, the researchers selected 333 children with cerebral palsy and 960 children with other diseases aged 6-18 years who were residents of a social welfare institution in Guangzhou, China. Their height and weight were measured and a nutritional status analysis was carried out using a cluster sampling method. Multivariate Logistic analysis was performed to analyze the relative factors and malnutrition status of school aged children with cerebral palsy. Results: The prevalence of growth retardation among school aged children with cerebral palsy was 74.5%, with rates of stunting, normal nutrition status, and overweight/obesity being 17.7%, 7.2%, and 0.6%, respectively. The results of the univariate analysis revealed statistically significant differences in the detection rate of malnutrition among school aged children with cerebral palsy based on gender, gross motor function classification system (GMFCS) grading, and the presence of swallowing disorders ( χ 2=6.02, 15.23, 32.16, P <0.05). The results of the multivariate Logistic regression analysis showed that gender ( OR=0.37, 95%CI =0.15-0.91), dysphagia (OR=4.10, 95%CI =1.39-12.12), and GMFCS classification ( OR=1.45, 95%CI =1.04-3.01) were influencing factors of malnutrition ( P <0.05). Conclusions The detection rate of malnutrition among children and adolescents with cerebral palsy in welfare institutions was found to be relatively high, and influenced by various factors. Corresponding nutritional interventions should be developed and implemented based on the risk factors of malnutrition in school aged children with cerebral palsy to improve their nutritional status.

Alcoholic steatohepatitis (ASH) is a liver disease characterized by steatosis, inflammation, and necrosis of the liver tissue as a result of excessive alcohol consumption. Pregnane X receptor (PXR) is a xenobiotic nuclear receptor best known for its function in the transcriptional regulation of drug metabolism and disposition. Clinical reports suggested that the antibiotic rifampicin, a potent human PXR activator, is a contraindication in alcoholics, but the mechanism was unclear. In this study, we showed that the hepatic expression of fatty acid binding protein 4 (FABP4) was uniquely elevated in ASH patients and a mouse model of ASH. Pharmacological inhibiting FABP4 attenuated ASH in mice. Furthermore, treatment of mice with the mouse PXR agonist pregnenolon-16α-carbonitrile (PCN) induced the hepatic and circulating levels of FABP4 and exacerbated ASH in a PXR-dependent manner. Our mechanism study established FABP4 as a transcriptional target of PXR. Treatment with andrographolide, a natural compound and dual inhibitor of PXR and FABP4, alleviated mice from ASH. In summary, our results showed that the PXR-FABP4 gene regulatory axis plays an important role in the progression of ASH, which may have accounted for the contraindication of rifampicin in patients of alcoholic liver disease. Pharmacological inhibition of PXR and/or FABP4 may have its promise in the clinical management of ASH.

Objective: To explore the association between maternal pre pregnancy and pre delivery overweight with overweight and obesity among offspring during adolescence in Guangzhou, and to provide evidence for child obesity prevention. Methods: Based on the routine physical examination of primary and secondary school students in Guangzhou, random sampling was used to 6 middle schools and questionnaire survey was conducted among 3 384 students and their parents. Students with overweight and obesity were included in the case group, and the other students were included in the control group. Propensity Score Matching (PSM) was adopted to reduce selection bias. Logistic regression model and χ 2 test were used to analyze the data before and after PSM. Results: The result of univariate analysis showed that there were statistically significant differences between overweight/obese group and the control group by gender, schooling stage (middle and high schools), picky eater, family history of obesity, family monthly income, delivery mode, high birthweight, and gestational weight gain before PSM( χ 2=42.38, 10.64, 14.47, 26.85, 10.58, 13.59 , 15.53, 20.64, P <0.05). After PSM, results showed that there were no statistically significant differences between overweight/obese group and the control group in middle and high schools, and mother delivery mode( P >0.05). Logistic regression analysis showed that the risk of overweight and obesity of maternal pre pregnancy on adolescent offspring was 1.54 times higher than control group (95% CI =1.01-2.36) before PSM, and the overweight and obesity of maternal predelivery also increased the risk of overweight and obesity of adolescent offspring( OR=2.35, 95%CI =1.67-3.31). After PSM, maternal overweight and obesity pre pregnancy ( OR=2.17, 95%CI =1.41-3.34) and maternal overweight and obesity pre delivery( OR=2.99, 95%CI =2.08-4.31) significantly increased the risk of overweight and obesity in adolescent offspring. Conclusion Maternal overweight and obesity pre pregnancy and pre delivery are associated with increased risk of overweight and obesity in adolescent offspring.

Previous studies suggest that the reduction of SMAD3 (mothers against decapentaplegic homolog 3) has a great impact on tumor development, but its exact pathological function remains unclear. In this study, we found that the protein level of SMAD3 was greatly reduced in human-grade IV glioblastoma tissues, in which LAMP2A (lysosome-associated membrane protein type 2A) was significantly up-regulated. LAMP2A is a key rate-limiting protein of chaperone-mediated autophagy (CMA), a lysosome pathway of protein degradation that is activated in glioma. We carefully analyzed the amino-acid sequence of SMAD3 and found that it contained a pentapeptide motif biochemically related to KFERQ, which has been proposed to be a targeting sequence for CMA. In vitro, we confirmed that SMAD3 was degraded in either serum-free or KFERQ motif deleted condition, which was regulated by LAMP2A and interacted with HSC70 (heat shock cognate 71 kDa protein). Using isolated lysosomes, amino-acid residues 75 and 128 of SMAD3 were found to be of importance for this process, which affected the CMA pathway in which SMAD3 was involved. Similarly, down-regulating SMAD3 or up-regulating LAMP2A in cultured glioma cells enhanced their proliferation and invasion. Taken together, these results suggest that excessive activation of CMA regulates glioma cell growth by promoting the degradation of SMAD3. Therefore, targeting the SMAD3-LAMP2A-mediated CMA-lysosome pathway may be a promising approach in anti-cancer therapy.

Objective: To investigate the incidence of adolescent depressive symptoms in primary and secondary schools in Guangzhou and the effect of gestational complications on adolescent depression, so to provide scientific basis for depression prevention among adolescent. Methods: Stratified cluster random sampling method was used to select 808 primary and secondary schools in 11 districts of Guangzhou. A total of 96 756 parents of adolescents aged 10-20 were surveyed for adolescents depressive symptoms and maternal gestational complications. Results: The parental reported rates of mild, moderate and major depressive symptoms of adolescents were 5.5%, 3.5%, and 0.5%, respectively. Univariate analysis showed that the severity of adolescent depression symptoms had statistical significance with maternal gestational hypertension, gestational diabetes mellitus, cholestasis, hypothyroidism, hyperthyroidism, gestational anemia and viral hepatitis ( χ 2=12.42~158.91， P <0.01). Multivariate Logistic regression showed that maternal gestational diabetes mellitus ( OR =1.41, 95% CI =1.18- 1.68 ), hypothyroidism during pregnancy ( OR =1.61, 95% CI = 1.15-2.26), and hyperthyroidism during pregnancy ( OR =1.40, 95% CI =1.03-1.91), anemia during pregnancy ( OR = 1.46 , 95% CI =1.35-1.59), and viral hepatitis during pregnancy ( OR =1.67, 95% CI =1.38-2.02) were positively correlated with the severity of adolescent depression symptoms reported by parents( P <0.05). Conclusion Gestational diabetes mellitus, gestational hypothyroidism, gestational hyperthyroidism, gestational anemia and gestational viral hepatitis are associated with adolescent depressive symptom.

Background::Parkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s dementia. Mitochondrial dysfunction is involved in the pathology of PD. Coiled-coil-helix-coiled-coil-helix domain-containing 2 (CHCHD2) was identified as associated with autosomal dominant PD. However, the mechanism of CHCHD2 in PD remains unclear.Methods::Short hairpin RNA (ShRNA)-mediated CHCHD2 knockdown or lentivirus-mediated CHCHD2 overexpression was performed to investigate the impact of CHCHD2 on mitochondrial morphology and function in neuronal tumor cell lines represented with human neuroblastoma (SHSY5Y) and HeLa cells. Blue-native polyacrylamide gel electrophoresis (PAGE) and two-dimensional sodium dodecyl sulfate-PAGE analysis were used to illustrate the role of CHCHD2 in mitochondrial contact site and cristae organizing system (MICOS). Co-immunoprecipitation and immunoblotting were used to address the interaction between CHCHD2 and Mic10. Serotype injection of adeno-associated vector-mediated CHCHD2 and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) administration were used to examine the influence of CHCHD2 in vivo.Results::We found that the overexpression of CHCHD2 can protect against methyl-4-phenylpyridinium (MPP+)-induced mitochondrial dysfunction and inhibit the loss of dopaminergic neurons in the MPTP-induced mouse model. Furthermore, we identified that CHCHD2 interacted with Mic10, and overexpression of CHCHD2 can protect against MPP +-induced MICOS impairment, while knockdown of CHCHD2 impaired the stability of MICOS. Conclusion::This study indicated that CHCHD2 could interact with Mic10 and maintain the stability of the MICOS complex, which contributes to protecting mitochondrial function in PD.

Objective:To investigate early cardiac rehabilitation program on short term and long term effect of patients with acute myocardial infarction after percutaneous coronary intervention.Methods:A total of 98 acute myocardial infarction patients who undergo percutaneous coronary intervention were randomly assiged to the study group ( n=49) and the control group ( n=49). Participants in the control group received exercise training, while the study group carried out early cardiac rehabilitation program. The cardiac function, activity of daily living and exercise endurance were compared in both groups before and 1 week after intervention, in addition, the patient`s quality of life and the incidence of adverse cardiac events were also compared before and 6 months after intervention. Results:After 1 week of intervention, the value of LVEF, LVDD, scores of activity of daily living and 6MWT were (56.74 ± 8.92)%, (49.29 ± 5.09)mm, (76.00 ± 5.95) and (378.12 ± 48.54)m in the study group, those index were (52.10 ± 7.44)%, (48.47 ± 4.04)mm, (72.93 ± 6.51), (355.69 ± 46.36)m in the control group, the LVEF, scores of activity of daily living and 6MWT were significantly increased in the study group compared to the control group ( t=0.878-2.792, P<0.05). After 6 months of intervention, the scores physical function, role-physical, bodily pain, general health, vitality, social function, role-emotional, mental health were [(75.14 ± 12.15), (56.38 ± 7.65), (68.79 ± 6.65), (68.48 ± 10.91), (80.82 ± 7.12), (66.44 ± 9.61), (77.75 ± 13.05), (77.07 ± 8.46)] and [(72.70 ± 10.97), (52.05 ± 5.61), (62.07 ± 5.51), (65.76 ± 8.45), (78.33 ± 8.71), (65.20 ± 6.84), (72.53 ± 9.66), (75.49 ± 5.76)] in the study group and control group, respectively. The scores of role-physical, bodily pain, role-emotional were significantly increased in the study group compared to the control group ( t=2.248-3.448, P<0.05). The study group showed lower incidence of angina and arrhythmia compared to the control group (4.08% and 6.12% vs 16.33% and 20.41%), the differences had statistical significance ( χ2=4.009 and 4.346, P<0.05). Conclusion:Early cardiac rehabilitation program improve the cardiac function and exercise endurance in patients with acute myocardial infarction after percutaneous coronary intervention, reduce the the incidence of adverse cardiac events and improved patients` quality of life.

Objective:To investigate the characteristics of senile neurodegenerative diseases (NDDs) inpatients in south China, especially in Guangdong province, and explore the influencing factors for their medical expenses.Methods:The medical records of 7231 patients with NDDs≥65 years were collected in the electronic health database of our hospital from January 2010 to December 2019, including gender, age, admission ways, chief complaints, length of hospital stays and medical expenses. On the basis of median of the medical expenses (21 345 yuan) of these patients, they were divided into low cost (<21 345 yuan) group and high cost (≥21 345 yuan) group. Univariate Logistic analysis and multivariate Logistic regression analysis were conducted to screen the influencing factors for medical expenses and the independent influencing factors.Results:(1) The main age group of geriatric inpatients with NDDs were 70-79 years (40.96%); the admission source was mainly outpatient (56.70%), and length of hospital stays of a large percent of patients (44.50%) were 8-14 d. (2) From 2010 to 2019, the number of hospitalized geriatric patients with NDDs showed an increasing trend year by year, the overall trend of length of hospital stays was shortened, and the medical expenses showed gradual increase; the causes of hospitalization, percentages of patients caused by infection, abnormal blood pressure and water-electrolyte metabolism disturbances showed decreased trend, percentages of patients caused by heart diseases, cerebrovascular accidents and mental-psychological diseases showed increased trend, and the proportions of patients caused by fracture/trauma/wound injuries were generally stable. The proportion of patients returning home and mortality rate after hospital discharge were declined, and the proportion of patients returning to other medical or community institutions was increased. (3) Living in ICU, length of hospital stays, diabetes, nosocomial infection, chronic kidney disease, urinary tract infection, tumble, body mass index, and anticholinergic drugs were independent risk factors influencing the medical expenses ( P<0.05). Conclusions:An aging trend is noted in patients with NDDs; the number of hospitalized patients and medical expenses increase year by year, and the length of hospital stays gradually decreases. In view of the many factors that influence the medical expenses of this disease, it is suggested to develop the corresponding standardized treatment plan for the main influencing factors in clinical practice.