The potential threshold for dietary energy intake (DEI) that might prevent protein-energy wasting (PEW) in chronic kidney disease (CKD) is uncertain. The subjects were non-dialysis CKD patients aged ≥ 14 years who were hospitalised from September 2019 to July 2022. PEW was measured by subjective global assessment. DEI and dietary protein intake (DPI) were obtained by 3-d diet recalls. Patients were divided into adequate DEI group and inadequate DEI group according to DEI ≥ 30 or < 30 kcal/kg/d. Logistic regression analysis and restricted cubic spline were used in this study. We enrolled 409 patients, with 53·8 % had hypertension and 18·6 % had diabetes. The DEI and DPI were 27·63 (sd 5·79) kcal/kg/d and 1·00 (0·90, 1·20) g/kg/d, respectively. 69·2 % of participants are in the inadequate DEI group. Malnutrition occurred in 18·6 % of patients. Comparing with patients in the adequate DEI group, those in the inadequate DEI group had significantly lower total lymphocyte count, serum cholesterol and LDL-cholesterol and a higher prevalence of PEW. For every 1 kcal/kg/d increase in DEI, the incidence of PEW was reduced by 12·0 % (OR: 0·880, 95 % CI: 0·830, 0·933, P < 0·001). There was a nonlinear curve relationship between DEI and PEW (overall P < 0·001), and DEI ≥ 27·6 kcal/kg/d may have a preventive effect on PEW in CKD. Low DPI was also significantly associated with malnutrition, but not when DEI was adequate. Decreased energy intake may be a more important factor of PEW in CKD than protein intake.

The aim of this study was to determine the pregnancy loss rate of amniocentesis with double-needle insertions in twin pregnancies. This was a retrospective study of twin pregnancies who underwent amniocentesis with double-needle insertion between 2010 and 2019 at a single center. The pregnancy loss rates were recorded as single or double fetal loss before 24 weeks’ gestation and within 4 weeks after the procedure. Risk factors for pregnancy loss after amniocentesis were also assessed. A total of 678 twin pregnancies with amniocentesis were finally included. The pregnancy loss rates before 24 weeks’ gestation and within 4 weeks after the procedure were 0.9% and 1.9%, respectively. Only one fetal loss was presumed to be a direct result of the procedure. All other cases were complicated by structural or chromosomal anomalies. Twin pregnancies with abnormal ultrasound findings had a significantly higher rate of pregnancy loss with a relative risk of 4.81 (95% CI [1.03, 22.2]). Our study showed a low pregnancy loss rate after amniocentesis in twin pregnancies with double-needle insertions technique of sampling, which can help decision making in prenatal screening and diagnosis for twin pregnancies.

In mainland China, the clinical, epidemiological and genetic features of non-O1/non-O139 Vibrio cholerae (NOVC) bacteraemia have been scarcely investigated. Herein, we describe a patient with NOVC bacteraemia diagnosed in our hospital and present a retrospective analysis of literature reports of 32 other cases in China, detailing the clinical epidemiology, antibiotic resistance and molecular characteristics of isolates. Most patients were male (84.8%; median age, 53 years) and had predisposing factors, such as cirrhosis, malignant tumours, blood diseases and diabetes. In addition to fever, gastroenteritis was the most frequent presenting symptom. The mortality rate during hospitalisation was 12.1%. NOVC bacteraemia cases were more common in June–August, with the majority in coastal provinces and the Yangtze River basin. Only 42.4% of cases were attributed to consumption of marine (aquatic) products. Tetracycline, third-generation cephalosporins, and fluoroquinolones were the most effective antimicrobial agents, and the highest frequencies of resistance were recorded for ampicillin/sulbactam (37.5%), amoxicillin/clavulanic acid (33.3%), ampicillin (29.2%) and sulfamethoxazole (20%). Multi-drug resistant isolates were not detected. Limited data indicate that ctxAB and tcpA genes were absent in all NOVC isolates but other putative virulence genes (hlyA, toxR, hap and rtxA) were common. Ten multilocus sequence types were identified with marked genetic heterogeneity between different isolates. As clinical manifestations of NOVC bacteraemia may vary widely, and isolates exhibit genetic diversity, clinicians and public health experts should be alerted to the possibility of infection with this pathogen because of the high prevalence of liver disease in China.

We sought to examine the potential modifiers in the association between long-term low-dose folic acid supplementation and the reduction of serum total homocysteine (tHcy) among hypertensive patients, using data from the China Stroke Primary Prevention Trial (CSPPT). This analysis included 16 867 participants who had complete data on tHcy measurements at both the baseline and exit visit. After a median treatment period of 4·5 years, folic acid treatment significantly reduced the tHcy levels by 1·6 μmol/l (95 % CI 1·4, 1·8). More importantly, after adjustment for baseline tHcy and other important covariates, a greater degree of tHcy reduction was observed in certain subgroups: males, the methylenetetrahydrofolate reductase (MTHFR) 677TT genotype, higher baseline tHcy levels (≥12·5 (median) v. <12·5 μmol/l), lower folate levels (<8·0 (median) v. ≥8·0 ng/ml), estimated glomerular filtration rate (eGFR) <60 ml/min per 1·73 m2 (v. 60–<90 and ≥90 ml/min per 1·73 m2), ever smokers and concomitant use of diuretics (P for all interactions <0·05). The degree of tHcy reduction associated with long-term folic acid supplementation can be significantly affected by sex, MTHFR C677T genotypes, baseline folate, tHcy, eGFR levels and smoking status.

Garnets, omphacite and the minerals of a clinopyroxene/amphibole/plagioclase symplectite in UHP eclogites from Yingshan, Dabieshan have been investigated by TEM and Micro-FTIR. TEM reveals that the predominant microstructures in eclogites and symplectite-forming minerals are chain multiplicity faults (CMFs), dislocation substructures, clusters of water molecules up to ∼50 nm in diameter and recrystallized grains ∼1.75 μm in diameter. This indicates dynamic recrystallization of omphacite, probably during an eclogite-facies metamorphic episode. The deformation structures in symplectite-forming minerals were produced by plastic deformation related to an amphibolite-facies retrograde metamorphic event. CMFs described in the present work demonstrate the existence of an infrequent ½<011> (010) slip system for P2/n omphacite from an UHP eclogite sample from Dabieshan. The frequent occurrence of CMFs in omphacite suggests that they indicate an important deformation mechanism in omphacite and shows that this slip system plays a significant role in the deformation and recovery of eclogite. The hydrous components of deformed minerals may cause plastic deformation of the rocks by dislocation movement and accelerate retrograde metamorphism. Micro-FTIR results show that all the garnets and omphacites contain structural water occurring as hydroxyl groups (OH) or water (H2O). The structural water contents in omphacite range from 110—710 ppm and in garnet from 0—180 ppm. Water released during decompression might supply an early-stage retrograde metamorphic fluid.

Genetic and environmental influences on predictors of decline in daily functioning, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), handgrip, and five-times-sit-to-stand test (FTSST), have not been addressed in the aging Chinese population. We performed classical twin modeling on FEV1, FVC, handgrip, and FTSST in 379 twin pairs (240 MZ and 139 DZ) with median age of 50 years (40–80 years). Data were analyzed by fitting univariate and bivariate twin models to estimate the genetic and environmental influences on these measures of physical function. Heritability was moderate for FEV1, handgrip, and FTSST (55–60%) but insignificant for FVC. Only FVC showed moderate control, with shared environmental factors accounting for about 50% of the total variance. In contrast, all measures of pulmonary function and muscle strength showed modest influences from the unique environment (40–50%). Bivariate analysis showed highly positive genetic correlations between FEV1 and FVC (rG = 1.00), and moderately negative genetic correlations between FTSST and FEV1 (rG = −0.33) and FVC (rG = −0.42). FEV1 and FVC, as well as FEV1 and handgrip, displayed high common environmental correlations (rC = 1.00), and there were moderate correlations between FVC and handgrip (rC = 0.44). FEV1 and FVC showed high unique environmental correlations (rE = 0.76) and low correlations between handgrip and FEV1 (rE = 0.17), FVC (rE = 0.14), and FTSST (rE = −0.13) with positive or negative direction. We conclude that genetic factors contribute significantly to the individual differences in common indicators of daily functioning (FEV1, handgrip, and FTSST). FEV1 and FVC were genetically and environmentally correlated. Pulmonary function and FTSST may share similar sets of genes but in the negative direction. Pulmonary function and muscle strength may have a shared environmental background.

Early-onset familial Alzheimer's disease (EOFAD) is a condition characterized by early onset dementia (age at onset < 65 years) and a positive family history for dementia. To date, 230 mutations in presenilin (PS1, PS2) and amyloid precursor protein (APP) genes have been identified in EOFAD. The mutations within these three genes (PS1/PS2/APP) affect a common pathogenic pathway in APP synthesis and proteolysis, which lead to excessive production of amyloid β. Compared with sporadic Alzheimer's disease (AD), EOFAD has some distinctive features including early age at onset, positive familial history, a variety of non-cognitive neurological symptoms and signs, and a more aggressive course. There is marked phenotypic heterogeneity among different mutations of EOFAD. Studies in presymptomatic mutation carriers reveal biomarkers abnormalities. EOFAD diagnosis is based on clinical and family history, neurological symptoms and examination, biomarker features, as well as genotyping in some cases. New therapeutic agents targeting amyloid formation may benefit EOFAD individuals.

We consider a class of uncertain non-linear systems preceded by unknown backlash-like hysteresis, which is modelled by a differential equation. We propose a new state feedback robust adaptive control scheme using a backstepping technique and properties of the differential equation. In this control scheme, we construct a new continuous function to design an estimator to estimate the unknown constant parameters and the unknown bound of a ‘disturbance-like’ term. The transient performance of the output tracking error can be guaranteed by the introduction of pre-estimates of the unknown parameters in our controller together with update laws. We do not require bounds on the ‘disturbance-like’ term or unknown system parameters in this scheme. The global stability of the closed-loop system can be proved.

The current work describes the simple solution process of ball-chain polycrystalline Fe nanofibers with aspect ratios (λ) and diameters (D) of over 1−65 and 30−95 nm. Static magnetic and microwave electromagnetic property studies demonstrated that such properties strongly depend on the λ and D of the Fe nanofibers. As the λ and D increase, the U-shape of the saturation magnetization (Ms) reaches a maximum of 180.0 emu·g−1, owing to the cooperative action of nanoeffects and magnetic interactions, whereas the coercivity (Hc) gradually increases due to aspect ratio variations. In contrast, the change in trends of the permittivity (ε′, ε″) and the dielectric loss (tgδE) are represented as an inverted U-shape; the permeability (μ′, μ″) and magnetic loss (tgδM) increase at low-frequency ranges and decrease at high frequency ranges. Stronger absorption and broader bandwidths of Fe nanofibers compared with Fe nanoparticles are ascribed to higher dielectric losses. The prepared Fe nanofibers have high potential in light-weight and broad bandwidth microwave absorbing applications.

Metal-based silicides on silicon substrates are a widely used material system for infrared detection. PtSi/p-Si infrared Schottky barrier detectors (IRSBD) have become one of the most successful photoemisive infrared detectors. Till now, most of the efforts have been focused on the design of two dimensional PtSi-SBD arrays for the infrared (IR) camera. In this paper, we discussed the formation conditions of PtSi. Qualities are compared for PtSi films prepared at different conditions including different annealing sequences, annealing time, film thickness, and annealing ambient using pulsed laser deposition on various temperature substrates. Film structures and compositions, phase's formation using different processes are analyzed. By studying the kinetics of PtSi formation during various annealing processing, preferable preparing conditions are proposed to form the continuous PtSi ultra-thin film on Si substrate by PLD.