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Background: The incidence of inborn errors of metabolism (IEM) varies across countries and areas. Currently, there are no studies on IEM using newborn screening (NBS) in eastern coastal areas of China. We aimed to estimate the incidence and genetic variants of IEM and understand the spectrum of diseases caused by IEM and variants among them in this area. Methods: The NBS performed by tandem mass spectrometry (MS/MS) from 2016 to 2021 was retrospectively reviewed. Heel blood was collected from all newborns 72 h after birth. Targeted massively parallel sequencing was performed for genetic analysis. Results: Among 245,194 newborns, 95 were diagnosed with IEM, the overall incidence observed was—IEM: 1/2581; amino acid metabolism disorder: 1/4715; organic acid metabolism disorder: 1/11676; and fatty acid metabolism disorder: 1/11145. The incidence of different IEM was in the range of 1/245194 to 1/6452. Phenylketonuria (PKU, 1/7211) was the most common IEM, followed by methylmalonic acidemia (MMA, 1/27244), short‐chain acyl‐CoA dehydrogenase deficiency (SCADD, 1/30649), and citrin deficiency (CD, 1/35028). For genetic variants, the common hotspot variants found were—PAH gene for PKU: c.728G > A, c.442‐1G > A, c.611A > G, c.721C > T; PTS gene for non‐classical PKU: c.259C > T; MMACHC gene for MMA: c.658_660delAAG, c.609G > A; MMUT gene for MMA: c.1663G > A; ACADS gene for SCADD: c.1031A > G and c.1130C > T; and SLC25A13 gene for CD: c.1638_1660dup, c.852_855del. Conclusion: This study displayed the diseases and varied spectrum of IEM in eastern coastal areas of China. Implementing NBS for IEM by MS/MS combined with massively parallel sequencing can offer an improved plan for NBS to detect IEM. [ABSTRACT FROM AUTHOR]

In the development of education, each new technology applied to the teaching process provides a new dimension of development in line with human needs. In national education, intelligent network teaching plays a role in promoting education informatization, education reform, and the smooth implementation of new curriculum standards, and the quality of education technology is an essential part of the quality structure of teachers and helps to optimize teaching and training innovative talents. Genetic algorithms play an important role in the design of intelligent network teaching systems, so the application of genetic algorithms is of great importance to the development of national education in China. The purpose of the design is to cultivate children's interest and enthusiasm in computer technology from an early age and to form a preliminary understanding of computer technology. In recent years, with the popularity of computers and smart phones, the wave of information technology has accelerated in China. Early childhood IT teaching should be combined with the characteristics of the subject and the special understanding characteristics of the elementary school student group, to help students develop their abilities through technological innovation. This thesis starts from the characteristics of multimedia technology. Combined with the process of teaching design, several thoughts are given on how the teaching design based on multimedia technology can be more scientific and reasonable, hoping to be helpful to the pedagogues. [ABSTRACT FROM AUTHOR]

China can effectively promote urban-rural integration and economic and social modernization through new urbanization, which also serves as a strong driver and supporter of the growth of rural tourism. This paper examines the new urbanization and the growth of the rural tourism industry based on the rural revitalization strategy. It does so by using the techniques of literature research, field investigation, information technology retrieval, and excavation. We list the accomplishments of the rural tourism sector at its current stage of development and identify the issues and factors that will affect the sector's future growth. In addition, a coordinated development evaluation index system is built based on a theoretical analysis of rural revitalization strategies and new urbanization, and the corresponding comprehensive score is obtained using the entropy method for research. The index weight of the subsystem for rural revitalization in province A is computed using the entropy weight method. According to the findings, the wealth of life has the smallest weight (0.1117), followed by the prosperity of industry (0.2618), which is the largest on a criterion level. The effective weight of governance is the largest, at 0.2801. This study can serve as a useful resource for fostering rural tourism and advancing rural business. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate in vitro activities of β-lactam antibiotics alone and in combination with sulbactam at different ratios against Acinetobacter baumannii clinical strains from China. Methods: A total of 300 clinical isolates of A. baumannii were collected from 29 hospitals across China in 2018. Susceptibility to common antibiotics was assessed, and β-lactamase genes were detected. In vitro activity of ampicillin, cefoperazone and imipenem was tested alone and in combination with sulbactam at the ratios of 2:1, 1:1, 1:1.5, 1:2, 1:2.5 and 1:3. Results: High resistant rates for common antibiotics were observed except tigecycline and polymyxin B. Among carbapenem-resistant A. baumannii, 97.3% isolates harbored blaOXA-23. MIC50 and MIC90 values for sulbactam were 32 mg/L and 64 mg/L, respectively. High resistant rates for ampicillin, cefoperazone and imipenem were observed (92.3%, 93% and 85.3%, respectively). A stepwise increase in the ratio of sulbactam to partner β-lactam antibiotics led to a stepwise decrease in the MICs and a stepwise increase in the susceptible rates. The susceptible rates for imipenem-sulbactam 1:3, ampicillin-sulbactam 1:3 and cefoperazone-sulbactam 1:3 reached 16.3%, 58.3% and 91%, respectively. Conclusion: The increasing proportion of sulbactam could enhance antimicrobial activities of imipenem-sulbactam, ampicillin-sulbactam and cefoperazone-sulbactam combinations against A. baumannii clinical strains in China, with cefoperazone-sulbactam as the most potent compound. [ABSTRACT FROM AUTHOR]

Freshwater influenced wetlands (FIW), wetlands impacted by both freshwater flooding and underground seawater (MIW) and seawater influenced wetlands (SIW) were chosen as sampling sites to investigate the variations in the soil organic carbon content and stock in wetlands with different hydrologic conditions in the Yellow River Delta, China. The results showed that a salinity gradient developed as the hydrologic conditions ranged from freshwater to seawater. In 0–50 cm soils, the mean values of soil organic carbon (SOC), microbial biomass carbon (MBC) and readily oxidized organic carbon (ROOC) were higher in FIW and SIW than those in MIW, while the dissolved organic carbon (DOC) showed a higher mean value in MIW. Along the 0–50 cm soil profile, SOC, MBC, ROOC and DOC decreased as the soil depth increased in FIW and SIW. However, in MIW, soil carbon initially decreased and then increased later. The annual mean values of SOC in 0–50 cm soils were 6.87 g/kg in FIW, 4.92 g/kg in MIW and 5.42 g/kg in SIW, respectively. The soil organic carbon density (SOCD) values for FIW, MIW and SIW were 4.55, 3.26 and 3.84 kg C/m2, respectively. Correlation analysis revealed that SOC, ROOC and DOC were significantly negatively correlated with soil pH, bulk density (BD), sand content, and the C/N ratio, and positively related with water content (WC), silt content, and TN (p < 0.05). However, MBC showed a significantly negative relationship with EC, salt ions content, pH, BD and the C/N ratio, and a significantly positive correlation with TN (p < 0.05). [ABSTRACT FROM AUTHOR]

• A novel method by heterogeneous condensation to reduce CPM emission was proposed. • Essential supersaturated environment can be established by heat exchanger. • CPM reduction rate of 25–35% could be achieved by this novel method. • Influence of original temperature and temperature drop of flue gas are studied. • Flue gas temperature drop is key influence factor and optimum value is 4–6 °C. With ultra-low emissions being implemented in China, the proportion of condensable particulate matter (CPM) increased gradually in total particulate matter (TPM). To reduce the CPM emission, a novel method based on heterogeneous vapor condensation via heat exchanger was proposed. The phase of gaseous CPM would be changed to solid or liquid phase by temperature drop of desulfurized flue gas and then the particle CPM might be enlarged by heterogeneous vapor condensation. With the effect of inertia force, thermophoretic force, and diffusiophoresis force, the enlarged CPM particles would be captured by liquid film, which was formed on the surface of fluoroplastic capillaries. The experimental results indicated that reduction rate for filterable particulate matter (FPM) and CPM would be 26.67% and 30.84% by heterogeneous vapor condensation under typical conditions, and the SO 4 2− and NH 4 + were main ions in water-soluble ions for FPM/CPM. The influences of temperature drop and original temperature of desulfurized flue gas were also investigated. The higher temperature drop of desulfurized flue gas was beneficial for reduction of CPM emission and the effect of original desulfurized flue gas temperature was limited for CPM emission reduction. The results also manifested that the optimum temperature drop is 4–6 °C for different desulfurized flue gas temperatures. [Display omitted] [ABSTRACT FROM AUTHOR]

• We identified mcr-1 gene in fifteen clinical isolates of Enterobacteriaceae. • The mcr-1 -harboring plasmids belonged to different incompatibility group (IncI2, IncX4 and IncP1). • One mcr-1- bearing isolate EC09 was susceptible to colistin with MIC of 0.5 mg/L. • EC09 demonstrated lowest transcription level of mcr-1 gene. Colistin resistance mediated by plasmids for their rapid dissemination in Enterobacteriaceae is alarming. We aimed to characterize the genetic features of mcr-1 gene as well as the role of promoters in gene expression and levels of colistin resistance among clinical isolates of Enterobacteriaceae. Methods: Clinical isolates of Enterobacteriaceae were collected in thirteen cities in China and screened for mcr-1 gene using polymerase chain reaction (PCR) amplification and sequencing. Antimicrobial susceptibility testing, transformation assay and plasmid sequencing, quantitative real-time PCR were performed for mcr -1-positive isolates. Promoter-probe vector pKK232-8 was utilized to assess the activity of the mcr-1 promoters. This study identified the mcr-1 gene in 15 clinical isolates of Enterobacteriaceae, among which 14 were resistant to colistin, with MICs of 4–8 mg/L, while one mcr-1- bearing isolate EC09 was susceptible to colistin, with an MIC of 0.5 mg/L. Moreover, mcr-1 -harbouring plasmids from 10 clinical isolates were transferrable via transformation and belonged to different incompatibility groups (IncI2 and IncX4). Plasmid pEC09 failed to transform and belonged to IncP1. A genetic structure containing the mcr-1-pap2 element was detected in these plasmids. EC09 demonstrated the lowest transcription level of mcr-1 gene, as determined by quantitative real-time PCR, which was in accordance with its susceptibility to colistin. Furthermore, the promoter activity of mcr-1 in pEC09 was the lowest, as determined by promoter-probe vector pKK232-8. Promoter variations were associated with expression of the mcr-1 gene and ultimately the levels of colistin resistance. [ABSTRACT FROM AUTHOR]

Objectives: Imipenem-relebactam (IMR), a novel β-lactam/β-lactamase inhibitor combination, is recommended for infections caused by difficult-to-treat Pseudomonas aeruginosa. This study aimed to investigate the evolution trajectory of IMR resistance under the selection of levofloxacin in P. aeruginosa., Methods: Antimicrobial susceptibility testing, complete genome sequencing and gene manipulation experiments were performed. Quantitative reverse transcription PCR for specific genes and porin levels were detected. Evolution trajectory was simulated in vitro by induction assay., Results: P. aeruginosa HS347 and HS355 were isolated from abdominal drainage of two neighbouring patients (S and Z) undergoing surgery of colon carcinoma in Shanghai, China, with the latter patient having received levofloxacin. They were closely related ST16 strains, and both carried bla KPC-2 plasmids highly similar to those of P. aeruginosa endemic clones from Zhejiang province, where patient Z had received enteroscopy before this admission. Acquisition of resistance was observed for both IMR and fluoroquinolones in HS355, likely prompted by treatment with levofloxacin. The T274I substitution in MexS (putative oxidoreductase), upregulated efflux pump operon mexEF-oprN and decreased production of porin OprD leading to cross-resistance to fluoroquinolones and IMR, which was also verified by in vitro mutant selection under levofloxacin selection., Conclusions: The emergence of a rare bla KPC-2 -plasmid-bearing ST16 clone implies the horizonal spread and inter-regional dissemination of a high-risk plasmid-clone combination, representing a public health challenge. Levofloxacin exposure can select for mexS inactivating mutation, which in turn leads to IMR resistance phenotype, implicating the role of an unrelated, widely used antimicrobial agent in insidiously triggering the development of cross resistance to a latest β-lactam/β-lactamase inhibitor combination., (Copyright © 2024 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.)

Objectives: To evaluate in vitro activities of sitafloxacin and comparators against the clinical isolates of less common nonfermenting Gram-negative bacteria (NFGNB)., Methods: The isolates of less common NFGNB were collected during a long period spanning five years from 2016 to 2020 in Huashan Hospital, Fudan University in Shanghai. A broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of sitafloxacin and comparators., Results: In terms of MIC 50/90 values, sitafloxacin was highly active against Stenotrophomonas maltophilia (0.25/1 mg/L), Burkholderia cepacia complex (0.25/2 mg/L), Achromobacter xylosoxidans (0.25/1 mg/L), and Chryseobacterium gleum (1/2 mg/L), but less active for Elizabethkingia (1/8 mg/L) and Chryseobacterium indologenes (16/32 mg/L). Sitafloxacin was more active than other fluoroquinolones against these NFGNB except Chryseobacterium., Conclusion: The results are helpful for clinicians to be aware of the role of sitafloxacin in managing the infections caused by these NFGNB., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

IMP-45, a variant of IMP-9, is one of the dominant metallo-β-lactamases (MBLs) in clinical carbapenem-resistant Pseudomonas aeruginosa (CRPA) isolates in China. The aim of this study was to investigate the distribution and mechanism of dissemination of bla IMP-45 . MBL genes were detected by PCR in 173 non-duplicate CRPA isolates collected from Hospital HS in Shanghai and 605 P. aeruginosa in China. In total, 17 IMP-45-producers (14 from Hospital HS and 3 from other hospitals) were identified. Molecular typing identified an outbreak of 11 IMP-45-producing ST508 CRPA in the ICU of Hospital HS. Conjugation assays and whole genome sequencing were conducted among IMP-45-producers. Genomic comparison revealed that 16 bla IMP-45 in China. In total, 17 IMP-45-producers (14 from Hospital HS and 3 from other hospitals) were identified. Molecular typing identified an outbreak of 11 IMP-45-producing ST508 CRPA in the ICU of Hospital HS. Conjugation assays and whole genome sequencing were conducted among IMP-45-producers. Genomic comparison revealed that 16 bla IMP-45 -carrying plasmids (9 from this study and 7 from GenBank) shared a similar backbone with IncP-2 bla IMP-9 -carrying plasmid pOZ176 but lacked repA - oriV - parAB region. repA2 gene was presented in pOZ176, bla IMP-45 -carrying plasmids (17 from this study and 7 from GenBank) and 15 megaplasmids from GenBank. Phylogenetic analysis of repA2 showed that most bla IMP-45 -carrying plasmids were clustered into a sublineage separate from the one containing pOZ176. This IncP-2 plasmid sublineage contributed to the dissemination of bla IMP-45 among genetically diverse P. aeruginosa and recruited multiple resistance genes during its evolution.

Background: Postoperative nausea and vomiting (PONV) is a common complication from general anesthesia that impacts on postoperative recovery., Objective: To evaluate prophylactic rewarming following general anesthesia, so as to decrease the incidence of PONV among patients undergoing laparoscopic hysterectomy., Design and Setting: Prospective randomized clinical study at a hospital in China., Methods: Sixty-two patients were randomly assigned into two groups. The forced air warming (FAW) group received pre-warmed Ringer's solution with FAW until the end of surgery. The control group received Ringer's solution without FAW. The pre-warmed Ringer's solution was stored in a cabinet set at 40 °C. The FAW tube was placed beside the patient's shoulder with a temperature of 43 °C., Results: Sixty patients completed the study. The FAW group showed significant differences versus the controls regarding temperature. At 6, 24 and 48 hours postoperatively, the incidences of PONV were 53.3%, 6.7% and 3.3% in the FAW group versus 63.3%, 30% and 3.3% in the controls. VAS scores were significantly lower in the FAW group than in the controls at 24 hours (P= 0.035). Forty-item questionnaire total scores in the FAW group were significantly higher than in the controls. The physical independence and pain scores at 24 hours and emotional support and pain scores at 48 hours in the FAW group were higher than in the controls (P < 0.05). There was no difference in hemodynamics or demographics between the two groups (P > 0.05)., Conclusions: Prophylactic rewarming relieved PONV and improved the quality of postoperative recovery., Chinese Clinical Trial Register (chictr): ChiCTR-IOR-17012901.

Objective To evaluate whether 3-methylcrotonyl-CoA carboxylase deficiency (3-MCCD) should be routinely screened in newborns. Methods Dried blood spots (DBS) were collected and analyzed by tandem mass spectrometry (TMS). Blood samples were collected from infants with positive 3-MCCD results. Targeted sequencing was performed using the extended panel for inherited metabolic diseases to detect 306 genes. The sequencing libraries were quantified and used for massively parallel sequencing on the Illumina HiSeq 2500 platform. Results A total of 536,008 infants underwent newborn screening (NBS) and 14 cases of 3-MCCD were diagnosed. The incidence of 3-MCCD in Jiangsu province was 1:38,286. During the last 3 years of follow-up, none of the subjects with 3-MCCD exhibited obvious clinical symptoms. Only two children had mild feeding difficulties and vomiting. Eleven patients had complex variants of the MCCC1 gene, and three patients had mutations in MCCC2. In total, 17 types of MCCC1 or MCCC2 variants were found, and c.639 + 2t > a was the most common mutation. Conclusions As far as the current results are concerned, 3-MCCD may be benign in Jiangsu province. However, additional investigations and a longer follow-up period are necessary to decide whether NBS of 3-MCCD is necessary or not.

Objective: To determine the frequencies of deafness gene mutations among patients with non-syndromic hearing loss (NSHL) from northern Jiangsu province., Methods: A total of 117 patients with NSHL were enrolled. The coding region of GJB2 gene, IVS7-2A>G and 2168A>G mutations of SLC26A4 gene, and 1555A>G and 1494C>T mutations of mitochondrial DNA 12S rRNA were subjected to Sanger sequencing. Patients in whom no mutation was detected were further tested by targeted gene capture and high-throughput sequencing., Results: Among the 117 patients, 86 (73.50%) were found to carry mutations. GJB2 gene mutations were found in 61 patients (52.14%), including 22 (18.80%) with homozygous mutations and 39 (33.33%) with heterozygous mutations. SLC26A4 gene mutations were found in 19 patients (16.24%), including 4 (3.42%) with homozygous mutations and 15 with heterozygous mutations (14.53%). Mitochondrial 12S rRNA gene mutation was found in 6 patients (5.13%). Targeted gene capture and high-throughput sequencing of 8 patients identified 4 further cases, including 1 with RDX gene 129&#95;130del and 76&#95;79del compound heterozygous mutations, 1 with OTOF gene 1274G>C homozygous mutation, 1 with SLC26A4 gene 919-2A>G and IVS16-6G>A compound heterozygous mutation, and 1 with SLC26A4 gene 919-2A>G and A1673T compound heterozygous mutation., Conclusion: The frequency of mutation among patients with NSHL from north Jiangsu was 73.50%, and GJB2 gene was most commonly mutated.