Overweight prevalence among Chinese preschool children in Beijing is comparable to some European countries. Prevention strategies should include identified lifestyle risk factors.

Exosomes, the nano-vesicles released from living cells, were the important mediator for cell-to-cell communication. In order to clarify whether the exosomes derived from obesity adipose tissue mediate insulin resistance of hepatocytes, we extract the exosomes from the adipose tissue of different mice models. Exosomes derived from ob/ob mice (Ob-exosomes), B6 mice fed with a high-fat diet (HFD-exosomes) and normal B6 mice (WT-exosomes) displayed similar size and molecular makers, but their effect on the insulin sensitivity of hepatocytes were obviously different or opposite. Abundant exosomal miRNAs in Ob-, HFD- and WT-exosomes were detected by the Next Generation Sequencing. The levels of miR-141-3p in Ob- and HFD-exosomes were significantly lower than WT-exosomes. MiR-141-3p can be effectively delivered into AML12 cells accompanied by the absorption of exosomes, but the absorption of miR-141-3p into AML12 cells could be blocked by GW4869, an inhibitor of exosome biogenesis and release. Importantly, the Ob-exosomes or miR-141-3p knockdown in WT--exosomes obviously inhibited the insulin response and glucose uptake of AML12 cells, however, the inhibitory effects on insulin function disappeared after the overexpression of miR-141-3p in Ob-exosomes or AML12 cells. The effects of miR-141-3p on insulin function could be achieved by improving the level of phosphorylation of AKT and enhancing insulin signal transduction. Therefore, the absorption of hepatocytes for exosomes released from obesity adipose tissue containing less miR-141-3p than healthy adipose tissue can significantly inhibit the insulin sensitivity and glucose uptake. Our study may certify a novel mechanism that the secretion of “harmful” exosomes from obesity adipose tissues cause insulin resistance.

The high infectivity of COVID-19 has led to a rapid increase in new cases and outbreaks since December 2019 (1, 2). A part of patients showed adverse outcomes from treatment, such as severe pneumonia, pulmonary edema, acute respiratory distress syndrome (ARDS) or even multiple organ failure. Recent studies have basically identified the correlation between the poor prognosis and outcome of COVID-19 patients with their own status (3). Based on the relationship between nutritional status and prognosis, the present study fully considered the nutritional status of patients in the acute phase of admission, and chose total cholesterol, total lymphocyte and serum protein count as CONUT score to reflect their nutritional status and immunological characteristics. Since the number of studies about the epidemiological characteristics of COVID-19 is scarce, the present study aims to analyze the correlation between the nutritional status and prognosis of COVID-19 patients, and their epidemiological characteristics with different nutritional status. Methods and materials The present study used a single-center, retrospective analysis method. 489 patients who were diagnosed positive for COVID-19 in Hubei Provincial Hospital of Traditional Chinese Medicine from December 2019 to March 2020 were recruited. However, 60 patients were excluded due to their missing score of CONUT, and 429 patients were finally included in the study. The diagnostic criteria was based on Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) (4). The study was approved by the Ethics Committee of Hubei Provincial Hospital of Traditional Chinese Medicine, and the data was from the cases in our hospital during hospitalization. The average age of the included 429 patients was 58.29 ± 15.89 (The oldest: 92; the youngest: 19). The number of male patients was 212 (49.42%), and the number of female patients was 217 (50.58%). Evaluation index The demographics, medical history, signs, symptoms and inpatient lab examinations of COVID-19 patients were collected. The major indicator of adverse outcomes was the all-cause death of COVID-19 patients. Secondary indicators of adverse outcomes included transferring to ICU due to aggravation, acute heart failure or acute respiratory failure (5). The CONUT score (the highest score: 12; the lowest score: 0) of each patient was evaluated based on his/her serum albumin, peripheral blood lymphocyte count, and cholesterol concentration (6-9). CONUT score 4 was set as the critical

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