ABSTRACT
OBJECTIVES@#To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia.@*METHODS@#A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively.@*RESULTS@#Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia.@*CONCLUSIONS@#The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Subject(s)
Infant, Newborn , Humans , Male , Pregnancy , Female , Nomograms , Retrospective Studies , Cesarean Section , Risk Factors , Asphyxia Neonatorum/etiologyABSTRACT
Objective To investigate the incidence and possible influencing factors of secondary relative hypoparathyroidism (SRHOP) in the patients with maintenance hemodialysis (MHD). Methods Totally 182stable chronic renal failure patients with MHD for more than 3 months were selected from the Blood Purification Center ofShanghai 7th People's Hospital from January 2012 to December 2012. The status of plasma intact parathyroid hormone (iPTH) was analyzed according to the KDIGO (Kidney Disease: Improving Global Outcomes) guidelines. The patients were divided into two groups according to plasma iPTH concentrations: SRHOP group (iPTH < 150 pg/mL, n=73) and non-SRHOP group (iPTH ≥ 150 pg/mL, n = 109). The influencing factors for the SRHOP of MHD patients were investigated by Spearman correlation analysis and Logistic regressionanalysis. Results The average concentration of plasma iPTH of 182 MHD patients was (173. 5 ± 114.3) pg/mL, and the concentration decreased gradually with age. According to KDIGO guidelines, the concentrations of plasma iPTH reached the standard in 83 cases (45. 6%), lower than the standard in 73 cases (40. 1%), and higher than the standard in 26 cases (14. 3%). The concentrations of plasma iPTH were not significantly different between the genders. The age, incidence of diabetes, and plasma corrected calcium concentration of the SRHOP patients were significantly higher, while the plasma phosphorus, albumin and normalized protein equivalent of nitrogen appearance (nPNA) levels were significantly lower than those of the non-SRHOP patients (P < 0. 05). There were no significant differences in gender composition, duration of dialysis, blood pressure, plasma urea nitrogen, plasma creatinine, urea clearance index (Kt/V), numbers of patients with oral calcium or vitamin D, and hemoglobin between the two groups. Spearman analysis showed that age, diabetes, plasma corrected calcium, and phosphorus and albumin levels were associated with SRHOP, and Logistic regression analysis indicated that the age and plasma phosphorus level of MHD patients were independent risk factors for SRHOP. Conclusion SRHOP, rather than secondary hyperparathyroidism, often occurs in MHD patients. The patient age and plasma phosphorus level are the independent risk factors for SRHOP.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of hypoxia during the prenatal period and its later repercussions on sexual behavior and the sex hormone secretion of male rats.</p><p><b>METHODS</b>Experimental animals were divided into three groups randomly: control group, which was kept at normal atmospheric pressure, and two stress groups exposed to a simulated altitude equivalent to 3000 m and 5000 m, respectively. Stress groups were exposed to hypoxic circumstance at their final week of gestation in animal decompression chamber.</p><p><b>RESULTS</b>Adulthood, males exposed to hypoxic stress during the prenatal period were able to mate with normal females, but these treated males exhibited decreased male sexual behavior. Decreased anogenital distances were observed in male offspring, and presented reductions of plasma testosterone levels, increase of plasma corticosterone levels, but no notable alteration in the organ index.</p><p><b>CONCLUSION</b>These results indicate that exposure to hypoxia in the later stages of pregnancy may have a long-term effect on the fertility and sexual behavior of male offspring.</p>