ABSTRACT
Objective To explore the relationship between the obstetric factors defined by Robson Ten-Group Classification System (RTGCS) and cesarean section rate (CSR),and to evaluate the validity of predictive models established based on the RTGCS for cesarean section.Methods Clinical data of 41 295 cases delivered in Shanghai First Maternity and Infant Hospital from January 1,2012 to September 30,2014 were retrospectively collected.CSR of different groups categorized by the RTGCS was analyzed by descriptive epidemiological methods by three models.Model 1 was obstetrics factors (parity,history of cesarean section,number of fetus,mode of labor,fetal presentation and gestational age);model 2 was obstetrics factors (model 1) + demographic characteristics and severity (maternal age and with/without treatment in intensive care unit);model 3 was defined as model 2+ complications (placenta previa,placental abruption,chronic or gestational hypertension,preeclampsia,renal disease,or human immunodeficiency virus infection).The relationship between obstetrics factors classified by the RTGCS and CSR was analyzed by the logistic regression model (the potential confounders were controlled).The validity of predictive models was evaluated by analyzing the area under the receiver operative characteristic (ROC) curve.Results (1) There were statistical differences in total CSR and CSR before labor among those cases respectively grouped by age,medical insurance,parity,signal/multiple pregnancy,fetal presentation and gestational age (all P＜0.05).(2) The recruited cases were categorized into ten groups according to the RTGCS and among them,the second group (single,cephalic presentation,nulliparous,≥ 37 gestational weeks,induced labor or cesarean section before labor) accounted for most of the cesarean section cases (61.2％,11 217/18 322),followed by the fourth group (single,cephalic presentation,multiparous,no previous cesarean section,≥ 37 gestational weeks,induced labor or cesarean section before labor),which were 11.2％ (2 061/18 322).(3) Obstetrical parameters,including parity,number of fetus,mode of delivery,history of cesarean section,fetal presentation and gestational weeks at delivery were related to CSR,even after adjustment for maternal age and medical insurance,or obstetrical complications,or both above factors (all P＜0.05).(4) Areas under the ROC curves and the 95％ confidence intervals of model 1,2 and 3 were 0.867 (0.863-0.870),0.875 (0.872-0.878) and 0.881 (0.878-0.885),respectively (all P＜0.01).Conclusion Related variables of RTGCS highly correlate with CSR and could be used as promising indicators for prediction of cesarean section.The RTGCS is of great application value to those research subjects.
ABSTRACT
Objective To evaluate the effect of child obesity intervention comprehensive program on the improvement of overweight,obese control and knowledge-attitude-practice.Methods The study design was under cluster-randomized controlled trial,with 965 children in the intervention and 895 children in the control groups.Repeated measurement data on child obesity was analyzed through Generalized Estimating Equation models.Results The risk of becoming overweight or obesity in the intervention group was 0.824 times more than children in the control group,showing a reduction of 17.6％ the risk of being overweight or obese (P=0.031).In addition,the possibility of increasing one unit of correct rate on obesity related knowledge,children in the intervention group children was 1.044 times (P=0.001) than in the control group.On the mean obesity related correct attitude rate,it was 1.023 times (P=0.001) in the intervention group of the control group.Regarding the possibility of increasing one unit om the mean obesity related behavior score,children in the intervention group was 1.522 times (P=0.001) than those in the control group (P=0.046).Conclusion The comprehensive child obesity intervention program could effectively reduce the risk of developing overweight or obeseity and improving the obesity related knowledge,attitude and behavior in children.
ABSTRACT
A robust, selective and highly sensitive chemiluminescent （CL） platform for protein assay was presented in this paper. This novel CL approach utilized rolling circle amplification （RCA） as a signal enhancement technique and the 96-well plate as the immobilization and separation carrier. Typically, the antibody immobilized on the surface of 96-well plate was sandwiched with the protein target and the aptamer-primer sequence. This aptamer-primer sequence was then employed as the primer of RCA. Based on this design, a number of the biotinylated probes and streptavidin-horseradish peroxidase （SA-HRP） were captured on the plate, and the CL signal was amplified. In summary, our results demonstrated a robust biosensor with a detection limit of 10 fM that is easy to be established and utilized, and devoid of light source. Therefore, this new technique .will broaden the perspective for future development of DNA-based biosensors for the detection of other protein biomarkers related to clinical diseases, by taking advantages of high sensitivity and selectivity.
ABSTRACT
A robust,selective and highly sensitive chemiluminescent (CL) platform for protein assay was presented in this paper.This novel CL approach utilized rolling circle amplification (RCA) as a signal enhancement technique and the 96-well plate as the immobilization and separation carrier.Typically,the antibody immobilized on the surface of 96-well plate was sandwiched with the protein target and the aptamer-primer sequence.This aptamer-primer sequence was then employed as the primer of RCA.Based on this design,a number of the biotinylated probes and streptavidin-horseradish peroxidase (SA-HRP) were captured on the plate,and the CL signal was amplified.In summary,our results demonstrated a robust biosensor with a detection limit of 10 fM that is easy to be established and utilized,and devoid of light source.Therefore,this new technique will broaden the perspective for future development of DNA-based biosensors for the detection of other protein biomarkers related to clinical diseases,by taking advantages of high sensitivity and selectivity.
ABSTRACT
Objective To study the effects of preconditioning treadmill exercise on excitatory amino vacid changes in rats after the cerebral infarction and the protective effects against cerebral isehemia brain injury. Methods Thirty Sprague-Dawley rats were used in this study. Twenty-five rats were subject to an operation to establish the animal model of middle cerebral artery occlusion and divided into a isehemia group, an 1-week ex- ercise group (trained in the 4th week) , a 2-week exercise group (trained in the 3rd and 4th weeks) and a 4- week exercise group (trained for 4 weeks) , while the remaining 5 rats were subject to sham operation, and served as the controls. After 4 weeks of experiment, all the the rats were fixed on stereotactie apparatus for the brain microdialysis of the striatum. Then the focal middle cerebral artery ischemia and reperfusion were made with thread oeclussion in rats and microdialysis technique was used to collect extraeellular fluid in each period of pre-ischemia, ischemia (40, 80 and 120 min), and reperfusion (40, 80, 120, 160, 200 and 240 min) to detect the changes of the excitatory amino acid. At the same time the infarction volume was also measured at 24 hours after ischemia-reperfusion of the brain. Results The difference between any two groups was significant with regard to the volume of cerebral infarction (P < 0.05). Two weeks and four weeks of the preconditioning treadmill exercise couled significantly reduce concentration of Glu excessively released due to the ischemia (P < 0.01). Conclusion At least two weeks of preconditioning treadmill exercise can inhibit the excessive release of the important excitatory amino acid neurotransmitter glutamate, to some extent, in the process of the subse- quent ischemic brain injury and during reperfusion, which might be one of the protective mechanisms of move- ment against the early isehemie brain injury.