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Anthocyanin biosynthesis requires the MYB-bHLH-WD40 protein complex to activate the late biosynthetic genes. LcMYB1 was thought to act as key regulator in anthocyanin biosynthesis of litchi. However, basic helix-loop-helix proteins (bHLHs) as partners have not been identified yet. The present study describes the functional characterization of three litchi bHLH candidate anthocyanin regulators, LcbHLH1, LcbHLH2, and LcbHLH3. Although these three litchi bHLHs phylogenetically clustered with bHLH proteins involved in anthcoyanin biosynthesis in other plant, only LcbHLH1 and LcbHLH3 were found to localize in the nucleus and physically interact with LcMYB1. The transcription levels of all these bHLHs were not coordinated with anthocyanin accumulation in different tissues and during development. However, when co-infiltrated with LcMYB1, both LcbHLH1 and LcbHLH3 enhanced anthocyanin accumulation in tobacco leaves with LcbHLH3 being the best inducer. Significant accumulation of anthocyanins in leaves transformed with the combination of LcMYB1 and LcbHLH3 were noticed, and this was associated with the up-regulation of two tobacco endogenous bHLH regulators, NtAn1a and NtAn1b, and late structural genes, like NtDFR and NtANS. Significant activity of the ANS promoter was observed in transient expression assays either with LcMYB1-LcbHLH1 or LcMYB1-LcbHLH3, while only minute activity was detected after transformation with only LcMYB1. In contrast, no activity was measured after induction with the combination of LcbHLH2 and LcMYB1. Higher DFR expression was also oberseved in paralleling with higher anthocyanins in co-transformed lines. LcbHLH1 and LcbHLH3 are essential partner of LcMYB1 in regulating the anthocyanin production in tobacco and probably also in litchi. The LcMYB1-LcbHLH complex enhanced anthocyanin accumulation may associate with activating the transcription of DFR and ANS.

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Objective  Maternal mortality ratio (MMR) in Shanghai residents has been declining in the past two decades and has reached levels comparable to developed countries. The MMR in migrating population in Shanghai remains high, however. The objectives of this study were to compare the trends of MMR between residents and migrating population in Shanghai from 1996 to 2005 and to explore the reasons for the dramatic differences in MMR between the two groups living in the same city. Design  Retrospective cohort study. Setting  Shanghai, China. Population  A total of 902 807 pregnancies with live births in Shanghai in the period of 1996–2005. Methods  We first compared the overall MMR between migrating population and permanent residents in Shanghai and examined temporal trends of MMR in the two subpopulations. We then compared the causes and maternal characteristics of maternal deaths between the two subpopulations. Main outcome measures  Maternal mortality and cause of death. Results  A total of 902 807 live births and 243 maternal deaths were recorded in Shanghai in the period of 1996 to 2005, with an average MMR of 26.66 per 100 000 live births. The MMR in Shanghai residents declined dramatically from 22.47 per 100 000 in 1996 to 1.64 per 100 000 live births in 2005 (P < 0.01), while the MMR in migrating population was reduced only moderately from 54.68 per 100 000 live births to 48.46 per 100 000 (P > 0.05). The main causes of maternal deaths in migrating population were postpartum haemorrhage (39.9%), pregnancy‐induced hypertension (9.8%), and puerperal infection (9.3%), whereas the main causes of maternal death of Shanghai residents were chronic heart and liver diseases (20.0%), postpartum haemorrhage (12.9%), and amniotic fluid embolism (12.9%). Among the maternal death cases in migrating women, 60% had elementary education or less, 22% were unemployed, 65% had no prenatal visit, 44% gave a birth at home, and 12% of the deaths occurred at home. Conclusion  Lack of access to quality maternity care, especially for the effective management of postpartum haemorrhage, is the main reason for the high MMR in migrating population in Shanghai.

There has been a resurgence of congenital syphilis in Shanghai, China, especially in the migrating population and other populations with a lower socioeconomic status.

The aim of the study was to specify prevalence and severity of menopausal symptoms among middle-aged women and to understand the factors associated with women’s perimenopausal healthcare-seeking behavior in Shanghai, China. A community-based cross-sectional study was carried out involving 3147 participants aged 40–60 years. A combination of stratified sampling and quota sampling was used. Out of the total 16 districts in Shanghai, 7 were purposefully selected in consideration of covering both central and suburban areas, population distribution, and willingness to participate. Two communities were randomly selected in each of six districts. Four communities were randomly selected in the 7th district considering the relatively low coverage of central population in the sampling frame. Eligible women were recruited continuously according to the house number and invited to participate in the study until 200 participants were recruited in each community. A structured questionnaire was designed to collect information including sociodemographic data, menopausal symptoms, and experiences in seeking perimenopausal healthcare. The severity of menopausal symptoms was assessed with the modified Kupperman menopausal index (mKMI). The mean age of all the participants was 51 years. 33.13% of the participants were premenopausal, 14.52% were perimenopausal, and 52.35% were postmenopausal. The total prevalence of menopausal symptoms was 73.8%, while among the perimenopausal women, the symptoms were the most common (81.70%). The top three reported symptoms were fatigue (38.08%), hot flushes and sweating (33.65%), and joint ache (28.81%). Perimenopausal and postmenopausal participants had a higher score of the mKMI than premenopausal women (p < 0.01). Of the women who had symptoms, 25.97% had sought healthcare. A logistic regression model revealed that employment, menstruation status, and the mKMI were significantly associated with healthcare-seeking behaviors (p < 0.01). We concluded that prevalence of menopausal symptoms was relatively high among middle-aged women, with perimenopausal women showing the highest level. However, only a small percentage of the participants sought healthcare. Carrying out health education may be a measure to improve the healthcare-seeking behavior.

BackgroundIncreasing evidence shows that antibiotic use in pregnancy may increase the risk of childhood asthma but epidemiologic studies are still limited and findings are inconsistent. Meanwhile, exclusive and prolonged breastfeeding may prevent children from allergic diseases. We aimed to assess the association between prenatal antibiotic use and the risk of childhood asthma, and explore whether breastfeeding modifies the risk.MethodsWe conducted a case-control study in Shanghai, China, from June 2015 to January 2016. A total of 634 asthma cases and 864 controls aged 3–12 years were included. Multiple logistic regressions were used to estimate crude and adjusted odds ratios (aOR).ResultsThe prevalence of antibiotic use in pregnancy in the cases and controls was 7.1 and 3.5%, respectively. A significant association between prenatal antibiotic use and childhood asthma was observed (aOR: 1.7, 95% CI: 1.0–2.9), particularly in boys (aOR: 2.2, 95% CI: 1.1–4.4) and children with family history of allergic disorders (aOR: 3.1, 95% CI: 1.2–8.4). However, this association existed only in children who were not breastfed exclusively in the first six months of life (aOR 2.6, 95% CI 1.3–5.1) but not in children who were exclusively breastfed (aOR 0.9, 95% CI 0.4–2.1). Likewise, exclusive breastfeeding also decreased the association between antibiotic use in pregnancy and asthma in boys and in children with family histories of allergic diseases.ConclusionsAntibiotic use in pregnancy was a risk factor for childhood asthma. However, this risk may be attenuated by exclusive breastfeeding in the first six months of life, especially among high-risk children.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1936-5) contains supplementary material, which is available to authorized users.