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Clinical data of 3 pregnant women with primary hyperparathyroidism admitted in Jinan Maternal and Child Health Hospital from 2013 to 2021 were retrospectively reviewed. Hyperparathyroidism was diagnosed during pregnancy in all 3 cases. The clinical manifestations were non-specific, such as nausea, vomiting, anorexia, and fatigue. Patients also had gallbladder stones (1 case), gallbladder polyps (1 case), and renal parenchyma changes (2 cases). The hypercalcemia crisis occurred in all 3 cases, the blood Ca 2+ levels were 4.11 mmol/L, 2.92-3.82 mmol/L and 3.49-4.10 mmol/L, respectively; and preeclampsia developed in 2 cases. Sudden death occurred in case 1 who did not receive effective treatment during pregnancy; blood calcium was well controlled during pregnancy in case 2, and her neonate had hypocalcemia with good prognosis; case 3 underwent surgical treatment in early pregnancy, and then had missed abortion. Pathological examination revealed parathyroid tumors in all 3 cases.
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Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.
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Objective To analyze the clinical characteristics of streptococcal toxic shock syndrome (STSS) caused by Streptococcus pyogenes (S.pyogenes) in the third trimester to improve clinical awareness of this disease.Methods A retrospective study was conducted to analyze the clinical data of two patients with STSS caused by S.pyogenes in Jinan Maternal and Child Health Care Hospital and nine reported cases of healthy pregnant women infected with S.pyogenes at 28-42 gestational weeks with detailed data retrieved from Chinese National Knowledge Infrastructure and PubMed database from January 1997 to December 2018.Results The two cases admitted to our hospital were both multiparas,with onset in winter and no specific symptoms in early stage.Disseminated intravascular coagulation (DIC) was developed in both cases on admission.In one case,the fetal heart rate was reduced and disappeared soon after admission.The other patient was diagnosed as stillbirth on admission.Both patients died and blood culture revealed infection of group A streptococcus.Nine previous cases were reported in one Chinese and five English articles.No high-risk pregnancy or premature rupture of membranes was reported in these 11 cases.Among the 11 cases,ten were positive for S.pyogenes indicated by blood or tissue culture and one was positive for streptococcal toxin.Ten cases had high fever and three presented with respiratory symptoms in early stage.Abdominal pain and watery diarrhea were common symptoms and all patients developed multiple organ dysfunction and DIC.Cases occurred in winter or spring were more common.Nine women died within 36 h after the onset of fulminant symptoms.Only two survived and hospitalized for 90 d and 25 d,respectively,after emergent cesarean section indicated by reduced fetal heart rate.Unfortunately,both neonates died after birth.For the babies,there were seven intrauterine fetal deaths,one stillbirth and three live births,but only one survived (whose mother developed respiratory cardiac arrest 90 min after delivery).Conclusions STSS caused by S.pyogenes in pregnant women exacerbates rapidly with a high mortality.Early identification of clinical manifestations and rapid progress of the disease are crucial for early diagnosis and treatment,which may help improve maternal and fetal outcomes.
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Objective@#To analyze the clinical characteristics of streptococcal toxic shock syndrome (STSS) caused by Streptococcus pyogenes (S. pyogenes) in the third trimester to improve clinical awareness of this disease.@*Methods@#A retrospective study was conducted to analyze the clinical data of two patients with STSS caused by S. pyogenes in Jinan Maternal and Child Health Care Hospital and nine reported cases of healthy pregnant women infected with S. pyogenes at 28-42 gestational weeks with detailed data retrieved from Chinese National Knowledge Infrastructure and PubMed database from January 1997 to December 2018.@*Results@#The two cases admitted to our hospital were both multiparas, with onset in winter and no specific symptoms in early stage. Disseminated intravascular coagulation (DIC) was developed in both cases on admission. In one case, the fetal heart rate was reduced and disappeared soon after admission. The other patient was diagnosed as stillbirth on admission. Both patients died and blood culture revealed infection of group A streptococcus. Nine previous cases were reported in one Chinese and five English articles. No high-risk pregnancy or premature rupture of membranes was reported in these 11 cases. Among the 11 cases, ten were positive for S. pyogenes indicated by blood or tissue culture and one was positive for streptococcal toxin. Ten cases had high fever and three presented with respiratory symptoms in early stage. Abdominal pain and watery diarrhea were common symptoms and all patients developed multiple organ dysfunction and DIC. Cases occurred in winter or spring were more common. Nine women died within 36 h after the onset of fulminant symptoms. Only two survived and hospitalized for 90 d and 25 d, respectively, after emergent cesarean section indicated by reduced fetal heart rate. Unfortunately, both neonates died after birth. For the babies, there were seven intrauterine fetal deaths, one stillbirth and three live births, but only one survived (whose mother developed respiratory cardiac arrest 90 min after delivery).@*Conclusions@#STSS caused by S. pyogenes in pregnant women exacerbates rapidly with a high mortality. Early identification of clinical manifestations and rapid progress of the disease are crucial for early diagnosis and treatment, which may help improve maternal and fetal outcomes.
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@#Objective To explore the effect of surface electromyography biofeedback combined with the routine comprehensive rehabilitation treatment on walking ability of stroke patients with hemiplegia. Methods 80 stroke patients with hemiplegia were randomly divided into control group (n=40) and treatment group (n=40). All the patients received routine comprehensive rehabilitation treatment. The treatment group received electromyography biofeedback electrostimulation in addition. Fugl-Meyer Assessment was used to assess motor and balance function; active range of movement of ankle joint, the integrated electromyogram (iEMG) of isometric contraction of anterior tibialis muscle under maximum ankle dorsiflexion and Holden walking function were determined before and 8 weeks after treatment. Results 8 weeks after treatment, the scores of motor and balance function, the active range of movement of ankle, the iEMG, and Holden walking function significantly improved in both groups (P<0.001), and improved more in the treatment group than in the control group (P<0.05).Conclusion The electromyography biofeedback combined with routine comprehensive rehabilitation treatment can improve ankle motion control ability and walking ability of stroke patients with hemiplegia.
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@#Objective To investigate the effect of neuromuscular activation on patients with low back pain after lumbar vertebra fracture operation. Methods 60 low back pain patients who received lumbar vertebra fracture operation were divided into treatment group (n=30)and control group (n=30). Both groups received 20 times of frequency treatments for 4 weeks. While the treatment group received the lumbar stability treatment with neuromuscular activation, and the control group received back muscle strengthen treatment. They were assessed with visual analogue scale (VAS) for pain and Short Form of Health Survey (SF-36) before, 4 weeks and 6 months after treatment. Results The scores of VAS and SF-36 was not significantly different between 2 groups (P>0.05) before treatment, and was significantly different (P<0.05) 4 weeks after treatment and later. Both the scores of VAS and SF-36 improved in both groups after treatment (P<0.05). Conclusion Neuromuscular activation can relieve low back pain after lumbar vertebra fracture operation and improve the quality of life.
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Background: A DNA vaccine encoding the whole segment of the Derp2 allergen could prevent allergic airway inflammation in a Derp2 allergen-induced allergic airway inflammation mouse model. Objective: This study investigated the effect of DNA vaccine encoding Derp2-mutant gene in which an IgE epitope was deleted on airway inflammation and the role of TLR9 in the asthmatic mouse model. Methods: A Derp2-mutant DNA vaccine was constructed. Mice were immunized, sensitized and challenged. Airway inflammation, airway hyper reactivity (AHR) and serum antibody were tested. The expression of Toll like receptor9 (TLR9) was detected with western-blot and immunehistochemistry. Results: We demonstrated that the Derp2-mutant-DNA induced IgG2a and inhibited IgE production, inhibited airway allergenic inflammation and AHR. Derp2-mutant-DNA vaccine induce TLR9 expression in lung tissue. Conclusions: The data indicate that allergen DNA vaccine deleted IgE epitope could prevent allergenic airway inflammation, AHR, and upregulate lung TLR9 express.
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@#ObjectiveTo evaluate the effect of the comprehensive rehabilitation training, including multi-joint isokinetic muscle strength, balance, and weight-support training, on the senile patients after total hip arthroplasty. Methods50 patients after total hip arthroplasty were divided into group A (n=25) and group B (n=25). The group A received the comprehensive rehabilitation training combined with the 3 systems, while the group B received the routine rehabilitation training. They were assessed with the Harris scale and the life satisfaction before and 4, 8 and 12 weeks after rehabilitation. ResultsCompared with that before rehabilitation, the Harris score of all the patients improved 8 weeks after rehabilitation (P<0.05), while it improved more in the group A than in the group B (P<0.05). The incidence of hip joint recovery was more in the group A than in the group B as well (P<0.05). The life satisfaction improved in both groups 4 weeks after rehabilitation (P<0.01), and it was more in the group A than in the group B 12 weeks after training (P<0.05). ConclusionThe rehabilitation combined with isokinetic, balance, weight-support training can promote the functional recovery after total hip arthroplasty
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Objective To observe the effect of ageand menstrual statuson body composition in healthy Beijing women.Methods We measured body composition with dual-energy X-ray(GE Lunar Prodigy)in 316 healthy Beijing females aged 20 to 74 years(5-7 cases per age).Parameters provided by the software were as following:total body bone mineral content,lean mass,fat mass and fat percentage(% fat).Local regions measured included arm,leg,trunk,android region and gynoid region.Body mass index (BMI),fat mass index(FMI),free fat mass index(FFMI)and A/G were calculated.Volunteers were assigned to 6 groups according age by every ten years a group.Results BMC peaked during the 4th decade,LM peaked during the 5th decade,with a decline of 18.1%and 5.2%respectively at age 74 years.Total body fat mass and % fat showed a general increase with aging throughout the studied age range.Total body fat mass increased from 16±5 kg at age 20-29 years to 24±6 kg at age 70-74 years,while % fat increased from 31.3%to 39.5%.All local region % fat increased with aging at different extents.Android region % fat showed the largest raise extent(32.2%).BMI increased gradually from 21.1 kg/m2 at age 20-29 years to 26.1 kg/m2 at age 70-74 years.FMI changed more obviously than FFMI.A/G increased from 0.85 at age 20-29years to 1.02 at age 70-74 years.Different menstrual status in women of 40-59 vears had obvious eflfect on A/G and BMC(P＜0.05),while it had no significant effect on BMI.body weight and waist circumference(P＞0.05). Conclusions Aging and menstrual status have evident effect on body composition distribution in healthy Beijing women.
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Objective: To determine the content of paeoniflorin extracted from Shaogan Granules by D 101 macro resin. Methods: The determination was performed by RP HPLC using C 18 column methanol∶K 2HPO 4∶acetate∶isopropanol (188∶300∶5∶4) as mobile phase, the column temperature at 30 ?C and wavelenthgh at 230nm. Results: The average recovery was 99.4%. RSD was 1.0%. Conclusion: This method is accurate and highly reproducible. It can be a method for quality control of Shaogan granules.