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营养包信息传播对农村地区不同代际婴幼儿看护人营养包喂服行为的影响

姚秀春, 孙畅, 叶睿雪, 吴玉菊, 郑莉, 周欢

姚秀春, 孙畅, 叶睿雪, 等. 营养包信息传播对农村地区不同代际婴幼儿看护人营养包喂服行为的影响[J]. 四川大学学报(医学版), 2022, 53(6): 1061-1067. DOI: 10.12182/20221160206
引用本文: 姚秀春, 孙畅, 叶睿雪, 等. 营养包信息传播对农村地区不同代际婴幼儿看护人营养包喂服行为的影响[J]. 四川大学学报(医学版), 2022, 53(6): 1061-1067. DOI: 10.12182/20221160206
YAO Xiu-chun, SUN Chang, YE Rui-xue, et al. Effect of Information Communication on Micronutrient Powders (or Yingyangbao) Feeding Behaviors of Different Generations of Baby Caregivers in Rural Areas[J]. Journal of Sichuan University (Medical Sciences), 2022, 53(6): 1061-1067. DOI: 10.12182/20221160206
Citation: YAO Xiu-chun, SUN Chang, YE Rui-xue, et al. Effect of Information Communication on Micronutrient Powders (or Yingyangbao) Feeding Behaviors of Different Generations of Baby Caregivers in Rural Areas[J]. Journal of Sichuan University (Medical Sciences), 2022, 53(6): 1061-1067. DOI: 10.12182/20221160206

营养包信息传播对农村地区不同代际婴幼儿看护人营养包喂服行为的影响

基金项目: 国家自然科学基金(No. 71874114)、四川省卫生健康委员会卫生健康科研课题(No. 19PJ072)和四川省科技厅科普培训项目(No. 2021JDKP0042)资助
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    周欢: E-mail:zhouhuan@scu.edu.cn

Effect of Information Communication on Micronutrient Powders (or Yingyangbao) Feeding Behaviors of Different Generations of Baby Caregivers in Rural Areas

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  • 摘要:
      目的   了解西南地区某省儿童营养改善项目地区营养包信息传播现状,探究信息传播途径和传播内容对不同代际婴幼儿看护人营养包喂服行为的影响。
      方法   2019年10月,采用多阶段随机整群抽样抽取西南地区某省6个县(2个汉族县、2个藏族县、2个彝族县)的36个乡的108个村,整群纳入6~24月龄婴幼儿的看护人进行面对面问卷访谈,共纳入816对婴幼儿及其看护人。问卷内容包括婴幼儿及看护人社会人口学特征、营养包信息传播途径和传播内容、看护人营养包喂服情况。采用多因素logistic回归分析营养包信息传播对不同代际看护人营养包有效喂服行为的影响。
      结果   看护人营养包信息获取途径有医生(85.66%)、周围人群(15.81%)、纸质材料和大众媒体(4.78%),获取的信息内容包括营养包是免费的(37.50%)、使用方法(49.26%)、好处(57.84%)。看护人营养包知晓率为89.95%、营养包益处知晓率为69.73%、领取率为84.07%、正确使用率为68.26%、营养包总体有效喂服率为49.14%。祖辈看护人营养包有效喂服率(59.07%)高于父辈看护人(45.08%)(P<0.05)。多因素logistic回归分析显示,对于父辈看护人,营养包信息传播途径为医生〔比值比 (OR)=2.20,95%可信区间(CI):1.13~4.31)〕,信息传播内容为营养包使用方法(OR=1.80,95%CI:1.19~2.73)、营养包好处(OR=2.40,95%CI:1.61~3.57)是营养包有效喂服的促进因素,而营养包免费(OR=0.58,95%CI:0.38~0.87)是营养包有效喂服的不利因素。对于祖辈看护人,营养包信息传播途径为医生(OR=2.95,95%CI:1.12~7.76),信息传播内容为营养包使用方法(OR=2.86,95%CI:1.34~6.09)是营养包有效喂服的促进因素。
      结论   本研究地区看护人接受的营养包信息传播渠道以医生面对面讲解为主,信息传播内容主要涉及“营养包免费”“营养包使用方法”“营养包好处”三方面。营养包信息传播渠道和传播内容对父辈和祖辈看护人喂服行为的影响存在差异。未来研究可针对不同代际人群特点制定针对性的干预策略,以改善看护人营养包的喂服行为。

     

    Abstract:
      Objective   To evaluate the status of information communication concerning micronutrient powders (MNP), or yingyangbao in Pinyin, the Chinese Romanization system, in areas covered by the Child Nutrition Improvement Project in a province in southwest China, and to investigate the effect of different communication channels and message communicated on the feeding behaviors of different generations of caregivers.
      Methods  In October 2019, 6 counties, including two counties with predominantly Han population, two counties with substantial Tibetan population, and two counties with substantial Yi population, were selected from a province in southwest China through multistage random cluster sampling. A total of 816 pairs of babies and their caregivers from 108 villages in 36 townships were enrolled for the study. The age of the babies ranged between 6 months to 24 months. A structured questionnaire concerning the demographic data of the babies and their caregivers, the communication channel of information on MNP and the message communicated, and the caregivers’ MNP feeding behaviors was designed to collect data through face-to-face interviews. Logistic regression was done to analyze the effect of MNP information communication on the feeding behaviors of caregivers from different generations.
      Results  Caregivers acquired information on MNP from village and township physicians (85.66%), surrounding populations (15.81%), and brochures and mass media (4.78%). The messages they received included the free availability of MNP (37.50%), feeding methods (49.26%), and the benefits of giving babies MNP (57.84%). Among the caregivers, 89.95% knew about the availability of MNP, 69.73% were aware of the benefits, and 84.07% actually received MNP. The correct feeding rate was 68.26% and the total effective feeding rate was 49.14%. The effective feeding rate of caregivers of the grandparents' generation (59.07%) was higher than that of the caregivers of the parents' generation (45.08%) (P<0.05). Logistic regression analysis suggested that, for caregivers of the parents' generation, information communication channel of village and township physicians (odds ratio [OR]=2.20, 95% confidence interval [CI]: 1.13-4.31) and communication messages on feeding methods (OR=1.80, 95% CI: 1.19-2.73) and benefits of MNP (OR=2.40, 95% CI: 1.61-3.57) facilitated their effective feeding behavior, while communication message concerning the free availability of MNP (OR=0.58, 95% CI: 0.38-0.87) inhibited their effective feeding behavior. For caregivers of the grandparents' generation, information communication channel of village and township physicians (OR=2.95, 95% CI: 1.12-7.76) and communication messages on the feeding methods (OR=2.86, 95% CI: 1.34-6.09) were facilitating factors of their effective feeding behaviors.
      Conclusion  The main channel of MNP information delivered to caregivers from the areas covered by the study was face-to-face explanation by doctors. The message communicated mainly involved three aspects--the administration method, the benefits and free availability of MNP. The channel and message of MNP information communnication had different effects on the feeding behaviors of caregivers of the parents' and grandparents' generations. Future research should focus on developing targeted information communication strategies according to the characteristics of populations from different generations, so as to improve the caregivers' feeding behavior.

     

  • 心肌纤维化是导致心肌梗死和心脏功能恶化的重要病理基础,同时心肌梗死往往会造成心脏重塑。在重塑过程中,肌成纤维细胞引起梗死区的心肌纤维化,之后会出现一系列的不良反应如组织结构紊乱,僵硬程度增高,细胞外基质大范围的沉积,最终形成不可逆的修复瘢痕[1-2]。虽然瘢痕可以防止心肌梗死后的心脏破裂,但它也会导致血流动力学功能障碍和心律失常,从而导致心力衰竭。在心肌梗死诱导的心肌纤维化中,其纤维化水平与心血管疾病患者致死率和不良事件频发率相关[3]。心脏组织结构纤维化的基本是转变成纤维细胞状态,在心脏损伤后首先被激活,随即高度增殖活化为肌成纤维细胞的状态,进而产生瘢痕[4]。由此得知,探究肌成纤维细胞被激活的因素至关重要。

    目前发现一些神经体液介质、细胞因子等在肌成纤维细胞激活过程中发挥重要的作用,例如:血管紧张素Ⅱ[5-6]、转化生长因子-β(transforming growth factor-β, TGF-β)[7-8]等。已有研究证明盲肌样蛋白家族(musclebind-like protein, MBNL)在心肌梗死后通过调控Sox9影响心肌成纤维细胞增殖,以及参与维持成纤维细胞向肌成纤维细胞转变[4]。溴结构域和外结构域蛋白可以联合致活转录,当注射全身性溴结构域和外结构域抑制剂时可以减轻小鼠的心力衰竭[9]。溴结构域和外结构域抑制剂通过成纤维细胞中转录因子MEOX1(mesenchyme homeobox 1, MEOX1)介导心肌纤维化和心力衰竭,且其依赖性的转录开关在心力衰竭中促进成纤维细胞活化为肌成纤维细胞[10]。同源盒转录因子家族(iroquois homeobox protein, IRX)在血管紧张素Ⅱ刺激时通过作用早期生长反应因子1通路促进病理性心脏纤维化的发展[11]。19号染色体(C19orf10)编码的骨髓源性生长因子(myeloid-derived growth factor, Mydgf)又被命名为SF20或白细胞介素25,是由骨髓源性单核细胞以及巨噬细胞分泌的蛋白质[12]。前期实验发现[13]Mydgf基因敲除成年小鼠心肌梗死后表现出更大的纤维化瘢痕组织以及更严重的心脏收缩功能障碍,提示Mydgf可能与心肌纤维化相关。本研究拟探索Mydgf缺失在心肌梗死后是否促进心脏成纤维细胞活化完成纤维化修复。

    成年(6~8周)龄野生型雄性C57BL/6J小鼠(24~26 g)(以下简称为WT小鼠),来自北京维通利华动物公司,并且其执行号SCXK(京)2021-0011。Mydgf-flox小鼠与EIIa-Cre小鼠交配产生的后代,与WT小鼠繁育后得到Mydgf-KO小鼠(敲除Mydgf基因的1、2、3号外显子)。成年SPF级Mydgf-KO雄性小鼠(6~8周龄,24~26 g)由上海南方模式实验室赠予,其后代由本实验室繁育。动物操作过程已得到北京协和医学院心血管疾病国家重点实验室实验动物管理和使用委员会的批准,批准号FW-2022-0053。

    Masson试剂盒(Sigma,美国);免疫荧光抗体(Invitrogen,美国);兔抗Mydgf抗体(爱必信,上海);兔抗α-平滑肌肌动蛋白(α-SMA)抗体(Abcam,美国公司);DAPI细胞核染液(中杉金桥,北京);凝胶成像仪(UVP,英国);烤片机、石蜡切片机(徕卡,德国);激光共聚焦显微镜、光学体视显微镜(Zeiss,德国);iBlot 2干转印系统、−20 ℃医用低温冷冻冰箱(Thermo Fisher,美国);−80 ℃医用深低温冷冻冰箱、4 ℃低温冰箱(海尔,中国)。

    选取成年Mydgf-KO小鼠10只,进行基因型鉴定:裂解鼠尾提取DNA,PCR电泳区别WT(87 bp)与Mydgf-KO(355 bp)的电泳条带。选取成年WT小鼠与Mydgf-KO小鼠,每组3只,实时定量PCR(quantitative real-time PCR, qRT-PCR)检测Mydgf的mRNA水平,Western blot检测Mydgf的蛋白表达量。qRT-PCR和Western blot检测方法具体见1.3.7和1.3.8小节。

    各选取上述Mydgf-KO成年小鼠繁育的小鼠及其对照WT同窝小鼠20只,每组留3只做术前对照,每组另外17只建立心肌梗死模型:腹腔注射三溴乙醇麻醉,气管插管,碘伏消毒后,剪开左侧第3、4肋之间的皮肤,钝性破开小鼠的肋间隙,挤出心脏,将其左心耳右下缘穿入7-0缝合线,结扎冠状动脉后见线结以下心肌组织缺血发绀发白,即为建模成功。缝合肋间隙及皮肤,待其苏醒后拔出气管插管后放回笼位。造模后各组死亡1只,故每组有19只纳入后续检测。

    将小鼠异氟烷麻醉后,固定在操作台上。在未手术以及心肌梗死造模术后第2、7、14、21、28天,取Mydgf-KO成年小鼠及其对照WT同窝小鼠(n=10),采用Vevo 2100超声仪(VisualSonics,加拿大)取左心室长轴横切面,利用软件计算小鼠左室射血分数(left ventricular ejection fraction, LVEF)和左室短轴缩短率(left ventricular fractional shortening, LVFS)。

    将19只WT小鼠与19只Mydgf-KO小鼠分别在未手术(n=3)以及心肌梗死后第7天(n=3)、第14天(n=3)、第28天(n=10)脱颈处死,采用眼科剪打开胸腔,摘取心脏,固定、脱水以及包埋。调整切片厚度为5 μm,以每层200 μm的间隔从心梗部位到心尖连续切片,每个心脏收集5~7个层面。

    心肌梗死后第28天,各取10只WT与Mydgf-KO小鼠心脏组织拷片、脱蜡及水化;然后将切片放置在2.5%重铬酸钾溶液中浸泡持续12~18 h;染色后脱水:依次将切片放进体积分数70%、80%、90%三种无水乙醇溶液浸泡;再将切片浸泡在二甲苯溶液中;使用中性树胶封片。蔡司扫片机进行图像采集,利用Image J软件分析染成蓝色的心脏梗死面积占染成红色的心脏组织面积的百分比。

    心肌梗死后第7天,各取3只Mydgf-KO成年小鼠及其对照WT同窝小鼠的心脏组织,免疫荧光染色验证成纤维细胞状态转变情况。烤片、脱蜡、水化、EDTA修复及封闭;将一抗DAPI(1∶1000)、α-SMA(1∶250)、Vimentin(1∶250)稀释液滴到组织表面,4 ℃过夜孵育;加入二抗避光室温孵育1 h;避光清洗后保存,进行图像采集。

    各取未手术以及心肌梗死后第7、14天的Mydgf-KO成年小鼠及其对照WT同窝小鼠(每组、每时点3只)的心脏组织,Western blot验证成纤维细胞状态转变情况。先提取组织蛋白,采用蛋白裂解试剂提取,加热变性,电泳、转膜、封闭、孵育兔抗Mydgf(1∶1000)、兔抗α-SMA(1∶1000)、内参GAPDH(1∶5000),最终配置显影液显影。Image J软件分析每个条带的灰度值,以目的条带与内参条带灰度值的比值,为目的条带的相对表达量。

    取未手术以及心肌梗死后第7天的Mydgf-KO成年小鼠及其对照WT同窝小鼠(每组、每时点3只)的心脏组织,qRT-PCR验证成纤维细胞状态转变情况。采用Trizol法提RNA。RNA反转录cDNA,PCR反应程序为95 ℃ 10 min,95 ℃ 10 s、60 ℃ 30 s,循环40次,使用2−ΔΔCt计算各mRNA的相对表达水平。基因引物序列见表1

    表  1  实时荧光定量PCR特异性引物及序列
    Table  1.  Specific primers and sequences for real-time PCR
    Gene Sequence Amplified product
    length/bp
    GAPDH F: 5′-CGTCCCGTAGACAAAATGGT-3′ 110
    R: 5′-TTGATGGCAACAATCTCCAC-3′
    Mydgf F: 5′-TCGTGCATTCGTTCTCCC-3′ 87
    R: 5′-GCTCGTTGGTCCCTCCTT-3′
    α-SMA F: 5′-GTCCCAGACATCAGGGAGTAA-3′ 102
    R: 5′-TCGGATACTTCAGCGTCAGGA-3′
    postn F: 5′-CCTGCCCTTATATGCTCTGCT-3′ 297
    R: 5′-ACATGGTCAATAGGCATCACT-3′
    ctgf F: 5′-GGGCCTCTTCTGCGATTTC-3′ 149
    R: 5′-CCAGGCAAGTGCATTGGTA-3′
    col8al F: 5′-ACTCTGTCAGACTCATTCAGGC-3′ 131
    R: 5′-CAAAGGCATGTGAGGGACTTG-3′
     GAPDH: glyceraldehyde-3-phosphate dehydrogenase; Mydgf: myeloid-derived growth factor; α-SMA: α-smooth muscle actin; postn: periostin; ctgf: connective tissue growth factor; col8al: type Ⅷ collagen.
    下载: 导出CSV 
    | 显示表格

    使用GraphPad Prism(8.0版,GraphPad软件)进行统计。每组实验均重复3次以上,各组间的数据表述为均值±标准误,以单因素方差分析(one-way ANOVA)比较多组间差异,选用独立样本t检验来比较两组间差异,P<0.05为差异有统计学意义。

    图1显示,PCR鉴定结果显示10只Mydgf-KO小鼠组条带均在355 bp处显影(图1A)。与WT同窝小鼠相比,Mydgf-KO小鼠的Mydgf的mRNA与蛋白水平均下降(P均<0.05)(图1B~1C)。这表明引进的Mydgf-KO成年小鼠的Mydgf基因确定已被敲除,实验中均用该Mydgf-KO成年小鼠繁育的小鼠。

    图  1  PCR、qRT-PCR及Western blot验证Mydgf敲除效率
    Figure  1.  PCR, qRT-PCR, and Western blot were performed to verify the Mydgf knockdown efficiency.
    A, The bands of – and + are tail samples of WT mice (87 bp) and Mydgf-KO mice (355 bp) respectively, and bands 1-10 are tail samples of unknown mice (Marker: DL2000); B, the expression level of Mydgf mRNA in WT mice and Mydgf-KO adult mice ; C, protein expression level of Mydgf in WT and Mydgf-KO adult mice under physiological conditions. WT: wild type (C57BL/6J mice); Mydgf-KO: mice with Mydgf systemic gene knockout. n=3. * P<0.05, **** P<0.0001, vs. WT group .

    图2显示,超声检测心肌梗死术前小鼠的心功能,WT小鼠的LVEF为(74.724±2.304)%,LVFS为(43.645±3.706)%;Mydgf-KO小鼠的LVEF为(64.407±2.103)%,LVFS为(37.326±2.770)%,两组间LVEF、LVFS值差异均无统计学意义(P均>0.05),表明Mydgf缺失不影响小鼠的心功能(图2A)。心肌梗死术前,与WT同窝小鼠相比,Mydgf-KO成年小鼠肌成纤维细胞标志物α-SMA和骨膜蛋白(postn) mRNA水平升高(P均<0.05)(表2),α-SMA蛋白水平增高(P<0.05)(图2B表2)。这表明Mydgf缺失促进成纤维细胞转变为肌成纤维细胞。

    图  2  Mydgf缺失促进成纤维细胞活化
    Figure  2.  Loss of Mydgf promotes fibroblast activation
    A, Cardiac function in adult mice examined by ultrasound; B, protein expression level of α-SMA in WT and Mydgf-KO adult mice under physiological conditions. The samples were all collected before MI modeling.
    表  2  Mydgf敲除促进成纤维细胞转变为肌成纤维细胞
    Table  2.  Mydgf knockdown promotes the transformation of fibroblasts into myofibroblasts
    Index n WT group Mydgf-KO group
    Mydgf mRNA 3 1.0010±0.0383 0.0442±0.0008#
    α-SMA mRNA
    3 1.0080±0.0890 1.8620±0.2108*
    postn mRNA 3 1.0020±0.0482
    1.3770±0.1301*
    α-SMA protein 3 1.0000±0.1655 1.8470±0.2418*
      * P<0.05, # P<0.000 1, vs. WT group. The samples were all collected before MI modeling.
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    图3,在术后第2、7、14、21、28天对小鼠进行了超声检测,观察小鼠心功能。与WT小鼠组相比,MI后Mydgf-KO小鼠在第21和28天LVEF和LVFS均降低(P均<0.05)(图3A)。Masson结果显示,术后第28天的WT小鼠组梗死面积占心脏组织总面积为(15.01±0.74)%,Mydgf-KO小鼠组的梗死面积占(26.57±2.04)%,与WT小鼠组相比,Mydgf-KO小鼠梗死面积显著增大(P<0.001)(图3B)。以上结果提示,缺失Mydgf促使心肌梗死后的心功能恶化及梗死面积增大。

    图  3  缺失Mydgf加重心肌梗死后的心肌纤维化
    Figure  3.  Loss of Mydgf aggravates myocardial fibrosis after MI
    A, LVEF and LVFS of WT and Mydgf-KO adult mice; B, Masson plot of WT and Mydgf-KO adult mice after MI. The angular black line marks the size of the infarcted area. The blue-purple color represents the infarcted area after Masson staining. The five graphs arranged from bottom to top are serial sections from the infarction site to the apex of the heart at 200 μm intervals per layer. n=10. * P<0.05, ** P<0.01, vs. Mydgf-KO group.

    图4,与WT小鼠组相比,Mydgf-KO小鼠在心肌梗死第7天,肌成纤维细胞标志物α-SMA、Ⅷ型胶原(col8al)、postn和结缔组织生长因子(ctgf)mRNA水平增高及Mydgf mRNA水平下降(P均<0.05)(图4A、4B);在心肌梗死第7、14天,Mydgf-KO小鼠α-SMA蛋白表达水平增高(P<0.05)(图4C);免疫荧光染色结果显示在心肌梗死第7天,WT小鼠组α-SMA与Vimentin共定位占心脏组织总面积为(9.79±0.83)%,Mydgf-KO小鼠组则为(18.49±1.32)%,与WT小鼠组相比,Mydgf-KO小鼠α-SMA阳性的成纤维细胞增多(P<0.01)(图4D)。以上结果提示,缺失Mydgf在心肌梗死后促进成纤维细胞活化成肌成纤维细胞。

    图  4  Mydgf缺失促进心肌梗死后成纤维细胞转变为肌成纤维细胞
    Figure  4.  Mydgf deletion promotes the transformation of fibroblasts into myofibroblasts after MI
    A, The expression levels of α-SMA, postn, col8al, and ctgf mRNA in WT and Mydgf-KO adult mice 7 days after the MI; B, the mRNA expression level of Mydgf in WT and Mydgf-KO adult mice 7 days after MI; C, the protein expression levels of α-SMA in WT and Mydgf-KO adult mice 7 and 14 days after MI; D, multiplex immunofluorescence staining of α-SMA (green), Vimentin (red), and DAPI (blue) was performed for the heart tissues from the WT and the Mydgf-KO groups 7 days after MI (Scale bar: 20 μm). n=3. * P<0.05, ** P<0.01, *** P<0.001, vs. WT group.

    2020年我国城乡居民的疾病致死率中,其中心血管疾病占首位,分别占乡村、城市死亡率的48.00%和45.86%;我国心血管病主要死因是缺血性心脏病、出血性和缺血性脑卒中[14]。而心肌纤维化是心肌梗死、心力衰竭和心律失常等多种心血管疾病中常见的病理进程,与患者的不良预后密切相关。在心脏重塑过程中,激活的成纤维细胞(肌成纤维细胞)导致心肌梗死区的心脏纤维化,以支持心脏结构[15-17]。因此,阐明心脏纤维化治疗过程中,成纤维细胞被激活这一步骤至关重要,抑制该过程的发生是治疗心肌纤维化的关键靶点。

    既往研究表明,心肌梗死后Mydgf对心脏心肌细胞凋亡起负向作用、对心脏内皮细胞增殖起正向作用,来达到修补梗死心脏的目的[12]。Mydgf也可通过保护心肌细胞中肌/内质网钙泵的表达来预防压力超负荷诱导的心力衰竭[18]。由本实验室既往结果得知[13],Mydgf可通过对心肌细胞增殖起正向作用来实现新生小鼠心脏再生;与野生型小鼠相比,心肌梗死后成年和新生小鼠的Mydgf基因敲除后,瘢痕心肌组织会变得更大,心脏收缩功能障碍也会更为严重。

    为探究Mydgf缺失在心肌梗死后心肌成纤维细胞激活过程中的潜在作用,本研究利用Mydgf-KO小鼠,结合心肌梗死模型[19],检测纤维化过程中成纤维细胞状态转变。通过M型超声和Masson染色检验小鼠心功能和瘢痕面积,结果发现,与WT组相比,Mydgf-KO鼠心肌梗死第21天LVEF和LVFS下降,表现出更明显的收缩功能障碍;Mydgf-KO小鼠出现了更大的瘢痕面积。鉴于Mydgf在心肌纤维化中的关键作用[13],本研究收集Mydgf-KO成年小鼠及其对照WT同窝小鼠的心脏组织,通过Western blot和qRT-PCR验证成纤维细胞状态转变情况。进一步发现Mydgf-KO小鼠心肌梗死后,心肌组织中肌成纤维细胞标志物α-SMA、postn表达水平增高,提示缺失Mydgf促进心脏成纤维细胞转变成肌成纤维细胞。虽然生理情况下Mydgf-KO小鼠心功能没有恶化,但是α-SMA、postn表达水平依然升高,猜测在生理情况下Mydgf缺失生成的肌成纤维细胞活化的数目不足以生成富含胶原的瘢痕,从而影响心功能的变化。与WT鼠相比,Mydgf-KO小鼠心肌梗死后的心肌组织中肌成纤维细胞标志物col8alctgf mRNA表达水平增高,提示缺失Mydgf心肌梗死后促进心脏成纤维细胞转变成肌成纤维细胞。通过本实验室质谱数据发现与对照WT同窝小鼠相比,Mydgf-KO小鼠心肌梗死后成纤维细胞生长因子1(fibroblast growth factor 1, FGF1)的表达水平下降(数据待发表)。并且已有研究证明FGF1亚家族(FGF1、FGF2)可以促进心肌细胞存活,并减少心肌梗死时的梗死面积,并且也能减弱主动脉弓缩窄模型(transverse aortic constriction, TAC)和血管紧张素Ⅱ(angiotensin Ⅱ, Ang Ⅱ)诱导的病理性心脏重构[20]。由此提示Mydgf可能通过分泌FGF1抑制成纤维细胞活化。本研究将继续探讨Mydgf缺失可能加剧心肌纤维化的分子生物学机制。

    综上,本实验结果显示缺失Mydgf能够促进成纤维细胞转变为肌成纤维细胞,促使心肌梗死后心肌纤维化加剧。但本研究缺乏Mydgf特异性过表达对心脏成纤维细胞的影响,课题组将继续探索Mydgf是否特异性作用心脏成纤维细胞,进一步将其转变为肌成纤维细胞;以及Mydgf缺失加剧心肌纤维化作用机制是否与FGF1的表达有关,或是否存在其他相关机制仍需后续实验进行深入探究。应用药物学等手段来抑制肌成纤维细胞活性,可以很大程度上防止心脏及其邻近组织损失后的组织重构,是解决过度纤维化的问题的潜在方向。

    *    *    *

    作者贡献声明 韩国玲负责论文构思、正式分析、调查研究、研究方法、验证、可视化和初稿写作,郝琰琰负责数据审编、研究方法和审读与编辑写作,李若朴负责研究项目管理、软件和监督指导,刘维静负责研究方法和监督指导,刘俊负责正式分析和监督指导,聂宇负责经费获取和提供资源,白丽娜负责研究项目管理、监督指导、可视化和审读与编辑写作,王玉瑶负责研究项目管理、提供资源、监督指导和审读与编辑写作。所有作者已经同意将文章提交给本刊,且对将要发表的版本进行最终定稿,并同意对工作的所有方面负责。

    Author Contribution  HAN Guoling is responsible for conceptualization, formal analysis, investigation, methodology, validation, visualization, and writing--original draft. HAO Yanyan is responsible for data curation, methodology, and writing--review and editing. LI Ruopu is responsible for project administration, software, and supervision. LIU Weijing is responsible for methodology and supervision. LIU jun is responsible for formal analysis and supervision. NIE Yu is responsible for funding acquisition and resources. BAI Lina is responsible for project administration, supervision, visualization, and writing--review and editing. WANG Yuyao is responsible for project administration, resources, supervision, and writing--review and editing. All authors consented to the submission of the article to the Journal. All authors approved the final version to be published and agreed to take responsibility for all aspects of the work.

    利益冲突 上海南方模式实验室赠送了SPF级Mydgf-KO雄性小鼠。除此之外,所有作者均声明不存在利益冲突。

    Declaration of Conflicting Interests The Shanghai Southern Model Laboratory donated male mice with SPF grade Mydgf-KO. Other than this, all authors declare no competing interests.

  • 表  1   研究对象基本信息(n=816)

    Table  1   Demographic data of the research subjects (n=816)

    VariableCase (%)
    Infant gender
     Male 432 (52.94)
     Female 384 (47.06)
    Caregiver
     Parental generation 579 (70.96)
     Grandparent generation 237 (29.04)
    Ethnicity
     Han 305 (37.38)
     Tibetans 252 (30.88)
     Yi 259 (31.74)
    Caregiver occupation
     Farmer 293 (35.91)
     Babycarer 373 (45.71)
     Others1 150 (18.38)
    Caregiver education
     Illiteracy 364 (44.61)
     Primary school 198 (24.26)
     Middle school 152 (18.63)
     High school and above 102 (12.50)
    Family economic status2
     Low 202 (24.75)
     Lower middle 187 (22.92)
     Higer middle 237 (29.04)
     High 190 (23.28)
     1: Others include professional and technical staff, grassroots staff, bussinessman; 2: Principal component analysis was used to examine the family economic status by appraising household fixed assets, including refrigerators, TV, washing machines, water heaters, computers, access to Internet, motorcycles, and automobiles.
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    表  2   营养包信息传播途径和传播内容

    Table  2   Information communication channels and message concerning micronutrient powders (MNP)

    Information communicationTotal (n=816) Parental generation (n=579) Grandparent generation (n=237)χ2P
    Case (%)Case (%)Case (%)
    Channel
     Doctors1 699 (85.66) 503 (86.87) 196 (82.70) 3.33 0.068
     Surrounding populations 129 (15.81) 97 (16.75) 32 (13.50) 0.54 0.463
     Brochures and mass media 39 (4.78) 33 (5.70) 6 (2.53) 5.34 0.021
    Message communicated
     Free availability 306 (37.50) 222 (38.34) 84 (35.44) 0.26 0.612
     Feeding method 402 (49.26) 296 (51.12) 106 (44.73) 0.56 0.453
     Benefits 472 (57.84) 341 (58.89) 131 (55.27) 0.12 0.726
     Storage 146 (17.89) 102 (17.62) 44 (18.57) 0.41 0.520
     Abnormal reaction response2 74 (9.07) 54 (9.33) 20 (8.44) 0.00 0.995
     1: The doctors include township physicians and village physicians; 2: This includes information on how to deal with black poop after feeding MNP.
    下载: 导出CSV

    表  3   不同代际婴幼儿看护人营养包有效喂服的单因素分析

    Table  3   Univariate analysis of effective feeding behaviors of caregivers of different generations

    VariableEffective feeding rate
    Parental generation (n=261)Grandparental generation (n=140)
    Case (%) or $ \bar x \pm s $χ2 or tPCase (%) or $ \bar x \pm s $χ2 or tP
    Infant gender 0.263 0.608 0.414 0.520
     Male 141 (54.02) 72 (51.43)
     Female 120 (45.98) 68 (48.57)
    Infant age/month 16.63±4.41 −1.159 0.247 17.41±4.40 1.447 0.149
    Caregiver age/yr. 29.59±5.95 −3.263 0.001 53.97±7.02 −0.452 0.652
    Ethnicity 14.615 0.001 5.305 0.070
     Han 105 (40.23) 76 (54.29)
     Tibetans 57 (21.84) 47 (33.57)
     Yi 99 (37.93) 17 (12.14)
    Caregiver occupation 8.310 0.016 8.99 0.011
     Farmer 123 (47.13) 83 (59.29)
     Babycarer 97 (37.16) 42 (30.00)
     Others 41 (15.71) 15 (10.71)
    Caregiver education 3.268 0.352 0.655 0.884
     Illiteracy 107 (41.00) 69 (49.29)
     Primary school 46 (17.62) 54 (38.57)
     Middle school 65 (24.90) 15 (10.71)
     High school and above 43 (16.48) 2 (1.43)
    Family economic status 8.045 0.045 4.23 0.238
     Low 78 (29.89) 16 (11.43)
     Lower middle 48 (18.39) 27 (19.29)
     Higer middle 67 (25.67) 59 (42.14)
     High 68 (26.05) 38 (27.14)
    Communication channel
     Doctor 16.173 <0.001 8.241 0.004
      Yes 243 (93.10) 124 (88.57)
      No 18 (6.90) 16 (11.43)
     Surrounding populations 0.914 0.339 1.433 0.231
      Yes 48 (18.39) 22 (15.71)
      No 213 (81.61) 118 (84.29)
     Brochures and mass media 4.868 0.027 0.147 0.702
      Yes 21 (8.05) 4 (2.86)
      No 240 (91.95) 136 (97.14)
    Message communicated
     Free availability 0.110 0.741 1.463 0.226
      Yes 102 (39.08) 54 (38.57)
      No 159 (60.92) 86 (61.43)
     Feeding method 22.788 <0.001 21.334 <0.001
      Yes 162 (62.07) 80 (57.14)
      No 99 (37.93) 60 (42.86)
     Benefits 35.877 <0.001 4.095 0.043
      Yes 189 (72.41) 85 (60.71)
      No 72 (27.59) 55 (39.29)
     Storage 4.827 0.028 5.670 0.017
      Yes 56 (21.46) 33 (23.57)
      No 205 (78.54) 107 (76.43)
     Abnormal reaction response 11.21 0.001 0.318 0.573
      Yes 36 (13.79) 13 (9.29)
      No 225 (86.21) 127 (90.71)
    下载: 导出CSV

    表  4   父辈婴幼儿看护人营养包有效喂服的多因素logistic分析

    Table  4   Logistic regression of effective feeding behaviors of caregivers of the parents' generation

    VariableβSEWald χ2POR (95% CI)
    Communication channel
     Doctor (No)1 (Ref)
     Yes0.790.755.320.0212.20 (1.13-4.31)
    Message communicated
     Free availability (No)1 (Ref)
     Yes−0.550.126.980.0080.58 (0.38-0.87)
     Feeding method (No)1 (Ref)
     Yes0.590.387.710.0051.80 (1.19-2.73)
     Benefits (No)1 (Ref)
     Yes0.870.4918.46<0.0012.40 (1.61-3.57)
     β: Partial regression coefficient; SE: Standard error; OR: Odds ratio; CI: Confidence interval.
    下载: 导出CSV

    表  5   祖辈婴幼儿看护人营养包有效喂服的多因素logistic分析

    Table  5   Logistic regression of effective feeding behaviors of caregivers of the grandparents' generation

    VariableβSEWald χ2POR (95% CI)
    Communication channel
     Doctor (No)1 (Ref)
     Yes1.081.464.800.0292.95 (1.12-7.76)
    Communication message
     Feeding method (No)1 (Ref)
     Yes1.051.107.390.0072.86 (1.34-6.09)
     β: Partial regression coefficient; SE: Standard error; OR: Odds ratio; CI: Confidence interval.
    下载: 导出CSV
  • [1] 徐娇, 霍军生, 孙静, 等. 国内外贫困地区6~24月龄婴幼儿营养状况研究. 中国食品卫生杂志,2017,29(4): 427–433. DOI: 10.13590/j.cjfh.2017.04.008
    [2]

    LI Z H, LI X Y, SUDFELD C R, et al. The effect of the Yingyangbao complementary food supplement on the nutritional status of Infants and Children: A systematic review and meta-analysis. Nutrients, 2019, 11(10): 10.3390/nu11102404 [2021-11-01]. https://www.mdpi.com/2072-6643/11/10/2404. doi: 10.3390/nu11102404.

    [3] 黄永玲, 张唯敏, 方亮. 安徽贫困地区6~24月龄婴幼儿营养干预效果评价. 中国公共卫生,2020,36(11): 1582–1585. DOI: 10.11847/zgggws1120879
    [4]

    ZHOU H, SUN S, LUO R F, et al. Impact of text message reminders on caregivers' adherence to a home fortification program against child anemia in rural Western China: A cluster-randomized controlled trial. Am J Public Health,2016,106(7): 1256–1262. DOI: 10.2105/AJPH.2016.303140

    [5] 李甫云, 方响, 刘旭栋, 等. 甘肃省贫困地区儿童营养改善项目营养包服用影响因素分析. 中国妇幼保健,2019,34(21): 4851–4855.
    [6] 周旭, 方俊群, 罗家有, 等. 湖南省贫困农村地区6~24月龄婴幼儿营养包有效服用相关因素. 卫生研究,2017,46(2): 256–261. DOI: 10.19813/j.cnki.weishengyanjiu.2017.02.016
    [7] 李晓强, 姜涛, 刘媛, 等. 宁夏贫困地区婴幼儿营养包服用情况及影响因素. 中国儿童保健杂志,2019,27(3): 320–322.
    [8]

    WU Q, ZHANG Y F, CHANG S Y, et al. Monitoring and evaluating the adherence to a complementary food supplement (Ying Yang Bao) among young children in rural Qinghai, China: A mixed methods evaluation study. J Glob Health, 2017, 7(1): 011101[2021-11-01]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502707/. doi: 10.7189/jogh.07.011101.

    [9]

    ZHAO X Q. Relationships between sources of health information and diabetes knowledge in the U. S. Hispanic population. Health Commun,2014,29(6): 574–585. DOI: 10.1080/10410236.2013.784937

    [10]

    JU I, PARK T, OHS J E. Consumer engagement with prescription medicine decisions: Influences of health beliefs and health communication sources. Health Commun,2020,35(2): 135–147. DOI: 10.1080/10410236.2018.1545336

    [11]

    ZHANG L S, YANG X D. Linking risk perception to breast cancer examination intention in China: Examining an adapted cognitive mediation model. Health Commun,2021,36(14): 1813–1824. DOI: 10.1080/10410236.2020.1796283

    [12]

    FRANCIS D B, ZELAYA C M, FORTUNE D A, et al. Black college women's interpersonal communication in response to a sexual health intervention: A mixed methods study. Health Commun,2021,36(2): 217–225. DOI: 10.1080/10410236.2019.1673949

    [13] 杜艳, 叶睿雪, 赵梓玲, 等. 西部贫困农村地区健康信息传播对婴幼儿母亲科学喂养认知的促进. 现代预防医学,2020,47(21): 3841–3845.
    [14]

    CREED-KANASHIRO H, BARTOLINI R, ABAD M, et al. Promoting multi-micronutrient powders (MNP) in Peru: Acceptance by caregivers and role of health personnel. Matern Child Nutr,2016,12(1): 152–163. DOI: 10.1111/mcn.12217

    [15]

    SARMA H, MBUYA M N, TARIQUJJAMAN M, et al. Role of home visits by volunteer community health workers: To improve the coverage of micronutrient powders in rural Bangladesh. Public Health Nutr,2021,24(S1): s48–s58. DOI: 10.1017/S1368980020000038

    [16] 牛贺, 王燕, 唐鹤, 等. 贵州、云南和山西省贫困农村儿童营养包食用依从性及影响因素. 卫生研究,2017,46(2): 262–265. DOI: 10.19813/j.cnki.weishengyanjiu.2017.02.017
    [17]

    ROSCHNIK N, DIARRA H, DICKO Y, et al. Adherence and acceptability of community-based distribution of micronutrient powders in Southern Mali. Matern Child Nutr, 2019, 15(S5): e12831[2021-11-02]. https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12831. doi: 10.1111/mcn.12831.

    [18]

    ANGDEMBE M R, CHOUDHURY N, HAQUE M R, et al. Adherence to multiple micronutrient powder among young children in rural Bangladesh: a cross-sectional study. BMC Public Health, 2015, 15: 440[2021-11-02]. https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-015-1752-z.pdf. doi: 10.1186/s12889-015-1752-z.

    [19] 中华人民共和国国家卫生健康委员会. 国家卫生健康委员会2018年12月22日新闻发布会散发材料之八: 《中国流动人口发展报告2018》内容概要. (2018-12-22)[2021-11-10]. http://www.nhc.gov.cn/wjw/xwdt/201812/a32a43b225a740c4bff8f2168b0e9688.shtml.
    [20]

    YE J Z, LU P. Differentiated childhoods: Impacts of rural labor migration on left-behind children in China. J Peasant Stud,2011,38(2): 355–77. DOI: 10.1080/03066150.2011.559012

    [21] 国家卫生计生委办公厅, 全国妇联办公厅. 2014年贫困农村地区儿童营养改善项目技术方案. (2014-11-24)[2021-11-03]. https://wenku.baidu.com/view/2264aa46bdeb19e8b8f67c1cfad6195f302be822.html.
    [22]

    D'AGOSTINO A, SSEBIRYO F, MURPHY H, et al. Facility- and community-based delivery of micronutrient powders in Uganda: Opening the black box of implementation using mixed methods. Matern Child Nutr, 2019, 15(S5): e12798[2021-11-02]. https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12798. doi: 10.1111/mcn.12798.

    [23]

    ZAIDI S, DAS J K, KHAN G N, et al. Food supplements to reduce stunting in Pakistan: A process evaluation of community dynamics shaping uptake. BMC Public Health,2020,20(1): 1046. DOI: 10.1186/s12889-020-09103-8

    [24]

    KORENROMP E L, ADEOSUN O, ADEGOKE F, et al. Micronutrient powder distribution through Maternal, Neonatal and Child Health Weeks in Nigeria: process evaluation of feasibility and use. Public Health Nutr,2016,19(10): 1882–1892. DOI: 10.1017/S1368980015002499

    [25]

    LOCKS L M, DAHAL P, POKHAREL R, et al. Predictors of micronutrient powder (MNP) knowledge, coverage, and consumption during the scale-up of an integrated infant and young child feeding (IYCF-MNP) programme in Nepal. Matern Child Nutr, 2019, 15(S5): e12712[2021-11-02]. https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12712. doi: 10.1111/mcn.12712.

    [26]

    REERINK I, NAMASTE S M, POONAWAL A A, et al. Experiences and lessons learned for delivery of micronutrient powders interventions. Matern Child Nutr, 2017, 13(S1):e12495[2021-11-02]. https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12495. doi: 10.1111/mcn.12495.

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出版历程
  • 收稿日期:  2021-11-29
  • 修回日期:  2022-09-13
  • 网络出版日期:  2022-11-28
  • 发布日期:  2022-11-19

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