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Objective:To develop and validate a predictive model for adverse outcomes in women with hypertensive disorders of pregnancy (HDP).Methods:We retrospectively analyzed the clinical data of patients diagnosed with HDP and delivered at the First Affiliated Hospital of Soochow University or Sichuan Provincial Maternity and Child Health Care Hospital between May 1, 2011, and April 30, 2019. These patients were categorized as the adverse outcome group or the control group with adverse outcomes within 48 h after admission. Univariate analysis, least absolute shrinkage, selection operator (LASSO), and multivariable logistic regression were employed to analyze factors influencing the adverse outcomes and develop a predictive model. The receiver operating characteristic (ROC) curve and calibration plot was used to assess the predictive performance. Bootstrapping was used for the internal validation and the retrospective dataset of patients with HDP from the First Affiliated Hospital of Soochow University from May 1, 2019, to April 30, 2020, for the external validation. A graphic nomogram was created through R software based on the model.Results:(1) Of the 2 978 HDP patients who were included in the development set, 356 were in the adverse outcome group, accounting for 12.0%; of the 233 patients who were included in the external validation set, 40 presented with adverse outcomes within 48 h after admission, accounting for 17.2%. (2) Nine optimal predictors were identified based on the LASSO regression analysis and multivariable logistic regression, consisting of gestational age on admission, routine prenatal care, number of symptoms, mean arterial pressure, platelet count, fibrinogen, albumin, serum urea, and serum creatinine, based on which the logistic predictive model was established. (3) The ROC curve for this predictive model achieved an area under the curve (AUC) of 0.878 (95% CI: 0.858-0.897), and the ideal cut-off value for predicted probability was 0.136, with a sensitivity of 0.778 (95% CI: 0.731-0.820) and specificity of 0.848(95% CI: 0.834-0.862). The model was well-calibrated as the Hosmer-Lemeshow test showed that P>0.05. The calibration plot of the model had a slope of 1 and an intercept of 0. (4) The model showed good consistency in the internal validation and had an AUC of 0.872 (95% CI: 0.807-0.937) in the external validation. The Hosmer-Lemeshow test showed that the P value was >0.05, and the calibration slope was 1.001. (5) A nomogram was constructed for convenient clinical use. Conclusion:A relatively accurate prediction model for adverse outcomes in HDP patients was established, which could be used as a valuable quantitative tool for assessing HDP-related complications.
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Objective@#Cisplatin resistance is a huge problem encountered in ovarian cancer treatment. Our study probed the roles and the underlying mechanisms of lncRNA MCF2L-AS1 in ovarian cancer cisplatin-resistance. @*Methods@#SKOV3 and IGROV-1 cells were subjected to gradually increasing concentrations of cisplatin to construct ovarian cancer cisplatin-resistance cells. Cell proliferation was evaluated by cell counting kit-8 and colony formation assays. Cell apoptosis was assessed using Annexin V and PI staining. The relationships between SP1, MCF2L-AS1 and insulin-like growth factor-2 mRNA binding protein 1 (IGF2BP1) were verified by RNA pull-down, RIP, ChIP and dual-luciferase reporter gene assay, respectively. Tumor xenograft experiment was employed to evaluate the effects of MCF2L-AS1 silencing on ovarian cancer cisplatin-resistance in vivo. TUNEL staining and immunohistochemistry were performed in tumor tissue. @*Results@#MCF2L-AS1 and IGF2BP1 were upregulated in cisplatin-resistant cells. MCF2L-AS1 silencing suppressed cell proliferation of cisplatin-resistant cells, while promoted the apoptosis, suggesting that MCF2L-AS1 knockdown suppressed ovarian cancer cells cisplatin-resistance. Meanwhile, MCF2L-AS1 silencing enhanced cisplatin sensitivity in ovarian cancer parental cells and IGF2BP1 overexpression impaired cisplatin sensitivity of parental cells. MCF2L-AS1 activated IGF2/MEK/ERK pathway through interacting with IGF2BP1. Transcription factor SP1 activated MCF2L-AS1 expression. MCF2L-AS1 knockdown inhibited ovarian cancer cisplatin-resistance in vivo. @*Conclusion@#SP1-induced MCF2L-AS1 promoted ovarian cancer cisplatin-resistance through activation of IGF2/MEK/ERK pathway via interacting with IGF2BP1.
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ObjectiveTo compare the clinical efficacies of double-point acupuncture and moxibustion versus conventional acupuncture and moxibustion in treating thoracolumbar compression fracture secondary to primary osteoporosis.MethodOne hundred volunteerss were randomly allocated to treatment and control groups.The treatment group received double-point acupuncture and moxibustion and the control group, conventional acupuncture and moxibustion. Treatment was given once daily. The therapeutic effects were evaluated in the two groups after 20 treatments.ResultThe marked efficacy and cure rate was 94.0%in the treatment group and 50.0% in the control group; there was a statistically significant difference between the two groups (P<0.05).ConclusionDouble-point acupuncture and moxibustion has a better therapeutic effect than conventional acupuncture and moxibustion in treating thoracolumbar compression fracture secondary to primary osteoporosis.
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Objective: To observe the clinical effect of treating lumbar intervertebral disc protrusion by needling the points on both sides of the impaired lumbar vertebrae. Methods: One hundred and eighty cases of lumbar intervertebral disc protrusion were randomly divided into three groups, treatment group, control group of acupuncture and control group of western medicine, with 60 cases in each group. The therapeutic effects were compared after 20-day treatments. Result: The effective rate was 96.7% in the treatment group, 80.0% in the acupuncture group, and 81.7% in the Western medicine group. There was a statistically significant difference between the treatment group and two control groups (P<0.05). Conclusion: It is an effective therapy to treat lumbar intervertebral disc protrusion by puncturing the acupuncture points on both sides of the impaired lumbar vertebrae.
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Objective To explore the differences in the expression of inhibin(INH)receptors and activin (ACT)receptors in the follicular/luteinic phase in normal human ovaries and their relationship with female endocrine hormone levels.Methods Real time PCR and immunohistochemistry were used to determine the expression of inhibin receptors(INHR)genes,activin receptors(ACTR)genes.Serum estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),INHB,ACTA levels were determined by a solid quantitative sandwich enzyme immunoassay technique(Sandwich ELISA)in 21 women during follicular phase and another 21 women during luteinic phase,the correlations between each gene and each hormone were analyzed.Results(1)ACT type Ⅰ and Ⅱ receptors genes(ACTR Ⅰ A,ACTR Ⅰ B,ACTRⅡA,ACTR Ⅱ B)and INH receptor β-glycan genes were expressed higher in the follicular phase than in the luteinic phase:ACTR Ⅰ A(0.50±0.17 vs 0.36±0.18;P＜0.05),ACTR Ⅰ B(0.050±0.019 vs0.036±0.020;P＜0.05),ACTRⅡ A(0.10±0.04 vs 0.07±0.04;P＜0.05),ACTR Ⅱ B(0.28±0.10vs 0.19±0.11;P＜0.05),β-glycan(0.26±0.10 vs 0.17±0.09;P＜0.01).(2)The intensities of ACTR I A,ACTR Ⅱ A,β-glycan immunostaining in human normal ovaries in the follicular phase were significantly stronger compared to those in luteinic phase.In the follicular phase β-glycan expression was positively correlated with serum E2,FSH,LH,INHB levels.The correlation coefficient was 0.53(P＜0.05).0.74(P＜0.01),0.85(P＜0.01)and 0.76(P＜0.01)respectively.Conclusion In normal human ovary in the follicular phase INH and ACT bind their receptors and down-regulate or up-regulate FSH,thus influencing the follicular development.