Sleep quality and sleep disturbances in Chinese pregnant women: a multicenter cross-sectional study / 中华耳鼻咽喉头颈外科杂志

Objective: This study aims to investigate the sleep quality of pregnant women in Xuhui District, Shanghai, and the related factors of sleep disturbances during pregnancy. Methods: From February 2019 to February 2021, we used online integrated sleep questionnaire (including PSQI, BQ, ESS, AIS) in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, The International Peace Maternity and Child Health Hospitals of China Welfare Institution, and Shanghai Eighth People's Hospital, to investigate the sleep quality across pregnancy. We also collected maternal physical examination results, childbearing history, sociodemographic, and other clinical data. The prevalences and related factors of various sleep disturbances in pregnant women were analyzed, including insufficient/excessive nighttime sleep, low sleep efficiency, difficulty falling asleep, poor sleep quality, insomnia, daytime sleepiness, and high risk of sleep-disordered breathing (SDB). Results: This study includes 1 898 cases in the first trimester (T1), 3 099 cases in the second trimester (T2), and 1 539 cases in the third trimester (T3). Poor sleep quality (38.6%), daytime sleepiness (mild 41.9%, moderate 17.7%, severe 2.1%), and suspicious insomnia (32.3%) are most prevalent among women in T1 (P<0.01). In comparison, short sleep time (2.7%), long sleep time (8.6%), difficulty falling asleep (12.2%), poor sleep efficiency (35.4%), very poor sleep quality (6.7%), clinical insomnia (21.8%), and high-risk SDB (6.4%) are most prevalent among women in T3 (P<0.05). During pregnancy, late gestation (OR=1.016, 95%CI: 1.006-1.025) and multiple induced/drug abortions (OR=1.329, 95%CI: 1.043-1.692) are risk factors for poor sleep quality (PSQI>5), while multiple full-term deliveries (OR=0.800, 95%CI: 0.675-0.949) is its protective factor. Advanced maternal age (OR=0.976, 95%CI: 0.956-0.997), multiple full-term deliveries (OR=0.808, 95%CI: 0.680-0.959), late gestation (OR=0.983, 95%CI: 0.974-0.992) and hypertension (OR=0.572, 95%CI: 0.401-0.814) are protective factors for daytime sleepiness (ESS>6). The high-risk pregnancy category (OR=9.312, 95%CI: 1.156-74.978) is a risk factor for insomnia (AIS≥4), while multiple full-term deliveries (OR=0.815, 95%CI: 0.691-0.961) is its protective factor. High BMI (OR=1.334, 95%CI: 1.270-1.402) and hypertension (OR=4.427, 95%CI: 2.539-7.719) are risk factors for high-risk SDB in pregnant women. Conclusions: The prevalences of various sleep disturbances are high throughout pregnancy. Noticeably, symptoms of maternal SDB develop along with pregnancy. Different types of sleep disturbances are associated with different factors. Women of high-risk pregnancy category, in late gestation, with high BMI, hypertension, a history of induced/drug abortion, or without a history of full-term delivery can be at high risk of sleep disturbances during pregnancy.

Cloning, expression, and characterization of three ribosomal protein S13 genes in Sophora flavescens / Clonagem, expressão e caracterização de três proteínas ribossômicas S13 genes em Sophora flavescens

To characterize the structure and function of ribosomal protein S13 (RPS13), we identified fulllength open reading frames (ORFs) of three RPS13 genes (RPS13-1, RPS13-2, and RPS13-3) of the Chinese medicinal plant, Sophora flavescens. The target genes were amplified by reverse transcription-olymerase chain reaction (RT-PCR), ligated into the pET22b(+) vector, and then transformed into Escherichia coli BL21 competent cells for protein expression. The physicochemical properties, protein motif, evolution, and structural organization of the three RPS13 genes were analyzed using bioinformatics tools. The full-length ORFs (453 bp) of the three RPS13 genes of S. flavescens were cloned, and each encodes a protein of 151 amino acids in length, and their expression was detected by Western blotting. Bioinformatics analysis showed that RPS13s are stable proteins that are closely related to the 40S RPS13s of Vigna radiate var. radiate. Their three-dimensional structures included three -helices at the C-terminal and four -helices at the N-terminal, and the two clusters of helices were connected by a long random coil, which may help maintain the dynamic bridging interactions between the large and small subunits of the ribosome. The full-length ORFs of three RPS13 genes of S. flavescens were successfully cloned and expressed in vitro. The study of the physicochemical properties, evolution, and secondary and three-dimensional structures of the three proteins will provide the theoretical basis for further studies on the function of RPS13s in plants.

Objetivo: Para caracterizar a estrutura e a função da proteína ribossomal S13 (RPS13), identificamos fases de leitura abertas (ORFs) completas de três genes RPS13 (RPS13-1, RPS13-2 e RPS13-3) da planta medicinal chinesa, Sophora flavescens. Métodos: Os genes alvo foram amplificados por reação em cadeia da polimerase por transcrição reversa (RT-PCR), ligados ao vetor pET22b(+), e então transformados em células competentes de Escherichia coli BL21 para expressão protéica. As propriedades físico-químicas, o motivo protéico, a evolução e a organização estrutural dos três genes RPS13 foram analisados utilizando ferramentas de bioinformática. Resultados: ORFs completos (453 pb) dos três genes RPS13 de S. flavescens foram clonados, e cada um codifica uma proteína de 151 aminoácidos de comprimento, e sua expressão foi detectada por western blotting. A análise de bioinformática mostrou que as RPS13s são proteínas estáveis que estão intimamente relacionadas com as 40S RPS13s de Vigna radiata var. radiate. Suas estruturas tridimensionais incluíam três -hélices no C-terminal e quatro -hélices no N-terminal, e os dois aglomerados de hélices eram conectados por uma longa bobina aleatória, o que pode ajudar a manter as interações de ponte dinâmicas entre o subunidades grandes e pequenas do ribossomo. Conclusões: As ORFs completas de três genes RPS13 de S. flavescens foram clonadas e expressas com sucesso in vitro. O estudo das propriedades físico-químicas, evolução e estruturas secundárias e tridimensionais das três proteínas fornecerão a base teórica para estudos adicionais sobre a função das RPS13s em plantas.

Extensive cranioplasty for sagittal synostosis in young children by preserving multiple cranial bone flaps adhered to the dura mater: experience with 63 cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>This study aimed to evaluate the effort of applying frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater in the treatment of sagittal synostosis.</p><p><b>METHODS</b>From April 2008 to June 2013, sixty-three children with sagittal synostosis, aged 5 months to 3 years, were included in the study. The frontal bone flap was removed using an air drill. The occipital and bilateral temporal bone flaps were cut open but not detached from the dura mater or fixed to produce floating bone flaps. The skull bone was cut into palisade-like structures. Brain compression from both sides and the base of the skull was released and the brain expanded bilaterally through the enlarged space. Only a long strip-shaped bone bridge remained in the central parietal bone. Subsequently, the frontal bone flaps and occipital bone flap were pushed towards the midline and fixed with the parietal bone bridge to shorten the anteroposterior diameter of the cranial cavity and allow the brain to expand bilaterally to correct scaphocephaly. The CT images showed that both sides of the parietal bone of artificial sagittal groove gradually merged postoperative 1 year, and skull almost completely normal healing after operation 2 or 3 years, without deformity recurrence within 5 years. Among them all, 61 children's intelligence is normal and 2 children's lagged behind normal level, no further improvement.</p><p><b>RESULTS</b>Patients were followed up 1 - 5 years (an average of 43 months). Skull growth was excellent in all patients, the anteroposterior diameter was shortened by 14.6 mm averagely, the transverse diameter was increased by 12.3 mm averagely, the prominent forehead was corrected, and scaphocephaly improved significantly. There were no complications such as death and skull necrosis.</p><p><b>CONCLUSIONS</b>The application of frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater can be used in the treatment of sagittal synostosis. Surgery without removing bone flaps is less traumatic and results in no massive bleeding. It can effectively relieve brain compression and promotes transversal expansion of the brain during surgery and subsequent normal brain development.</p>

A study on the effect of different family tobacco control patterns on cotinine level and acute respiratory infections among infants / 预防医学

Objective To explore the effect of different family tobacco control patterns on cotinine level and acute respiratory infections among infants.Methods A total of 300 infants were included,and were divided into 3 groups based on the tobacco control patterns:strictly tobacco -controlled group (97 cases),partly tobacco -controlled group (88 cases)and tobacco -uncontrolled group (1 1 5 cases).Urinary cotinine was measured in all participants.All participants were prospectively followed -up for 1 year,and the incidence of acute respiratory infections was recorded during the follow-up.Results The cotinine level of strictly tobacco -controlled group [0.45 ±0.21 (μg/L)]was significantly lower than the other two groups [1 .01 ±0.49(μg/L),1 .1 6 ±0.48(μg/L),P <0.05],and no significant differences were detected between the partly tobacco -controlled group and tobacco -uncontrolled group.The incidence of lower respiratory tract infection,not the upper respiratory tract infections,was significant different among the 3 groups (strictly tobacco -controlled group:1 8.75%;partly tobacco -controlled group:32.1 8%;tobacco -uncontrolled group:37.72%)(P <0.05).The number of upper respiratory tract infections and lower respiratory tract infections was significantly different among the three groups.The difference was significant between strictly tobacco -controlled group and partly tobacco -controlled group and between strictly tobacco -controlled group and tobacco -uncontrolled group (P <0.05).Conclusion Strict tobacco control could reduce the prevalence of passive smoking and the incidence of respiratory infections among infants.

A system review: comparison of doxorubicin and epirubicin containing regimens for metastatic breast cancer / 中国药学杂志

OBJECTIVE: To compare the efficacy and safety of doxorubicin with epirubicin in patients with metastatic breast cancer (MBC) by systematic review and Meta-analysis to provide reference for clinicians. METHODS: Randomized controlled trials (RCTs) that compared the efficacy, safety, or both, of doxorubicin with epirubicin in treatment of metastatic breast cancer were collected from the Cochrane library, PubMed, Embase, CNKI, CBM and Wanfang database using the following terms: doxorubicin, epirubicin, breast cancer, randomized controlled trials. In addition, the reference lists of relevant trials or reviews were screened. Trials that provided sufficient data on objective response rate (ORR) and/or overall survival (OS) were considered eligible for inclusion. Studies were assessed for quality. A fixed-effect model was used for Meta-analysis unless there was significant between-study heterogeneity. Meta-analysis was performed by Revman 5.3 software, with results expressed as odds ratio (OR), 95% confidence interval (CI) and P value. The other parameters were summarized by descriptive analysis. RESULTS: A total of 1221 patients from six RCTs were included for final analysis, with 614 patients in the doxorubicin group and 607 patients in the epirubicin group. The median OS was 549 d for the doxorubicin group and 480 d for the epirubicin group. The pooled risk ratio (RR) suggested that there was not statistically significant difference in the ORRs between the doxorubicin (general type and liposomal type) group and the epirubicin group for the treatment of MBC [for doxorubicin vs epirubicin, RR=1.12, 95% CI (0.99, 1.26), P=0.07; for liposomal doxorubicin vs epirubicin, RR=1.24, 95% CI (0.94, 1.62), P=0.12]; and for general doxorubicin vs epirubicin RR=1.09, 95% CI (0.96, 1.24), P=0.12); Descriptive analysis of safety showed that doxorubicin had similar incidences of hematologic toxicity and alopecia to epirubicin but was superior to epirubicin in aspect of cardiac toxicity. There was no significant heterogeneity among the included studies in most of the Meta-analyses. CONCLUSION: Epirubicin and doxorubicin are equally effective and the safety profile of the former is at least not worse than the latter in the first-line treatment of patients with metastatic breast cancer. But compared to doxorubicin, epirubicin might be a better choice for MBC patients especially those with cardiac diseases.

Establishment and maintenance of the way of enteral nutrition support / 中华胃肠外科杂志

Enteral nutrition is the preferred way of clinical nutrition support, especially in critical ill patients. Establishment and maintenance of an appropriate way should be considered to ensure the safety and effectiveness of enteral nutrition support.

Effectiveness of intervention services provided by social workers in methadone maintenance treatment clinics / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effectiveness of psychosocial services provided by social workers in reducing dropout rate and increasing treatment dosage in methadone maintenance treatment (MMT) users.</p><p><b>METHODS</b>From May in 2009 to April in 2010, 300 MMT users were recruited from three MMT clinics in Guangzhou, and were randomly allocated into the intervention group and the control groups. The control group (152 cases) received standard MMT services while the intervention group (148 cases) received additional services provided by social workers. Methadone dosage, dropout rate, perceptions toward MMT etc. were compared between the two groups.</p><p><b>RESULTS</b>The 1-month dropout rate of the control and intervention groups were 19.7% (30/152) and 6.8% (10/148) (P < 0.05) respectively; the 6-month dropout rate of the control and intervention groups were 75.5% (115/152) and 50.7% (75/148) (P < 0.05) respectively. The intervention group had higher average treatment dosage than the control group ((56.0 ± 21.2) vs (64.4 ± 23.1) ml/d, (58.0 ± 24.0) vs (66.1 ± 26.6) ml/d, P < 0.05). At 1-month and 6-month, the intervention group had higher scores of MMT-related perception ((1.26 ± 0.68) vs (1.84 ± 0.95), (1.55 ± 0.83) vs (2.44 ± 1.23), P < 0.05), self-efficacy of maintenance ((3.68 ± 1.33) vs (4.20 ± 1.05), (3.80 ± 1.38) vs (4.43 ± 0.79), P < 0.05) and satisfaction toward MMT((4.08 ± 0.54) vs (4.15 ± 0.60), (4.01 ± 0.67) vs (4.31 ± 0.64), P < 0.05) as compared to the control group. The reverse was true for the score of negative experiences ((1.05 ± 0.86) vs (0.96 ± 0.92), (1.46 ± 0.87) vs (1.11 ± 1.07), P < 0.05).</p><p><b>CONCLUSION</b>The psychosocial interventions provided by social workers were effective in reducing dropout rate, increasing treatment dosage and improving cognitions of MMT users.</p>

Development of a real-time PCR method for the detection of bacterial colonization in rat models of severe acute pancreatitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Techniques for the fast and accurate detection of bacterial infection are critical for early diagnosis, prevention and treatment of bacterial translocation in clinical severe acute pancreatitis (SAP). In this study, the availability of a real-time PCR method in detection of bacterial colonization in SAP rat models was investigated.</p><p><b>METHODS</b>Samples of blood, mesenteric lymph nodes (MLN), pancreas and liver from 24 specific pathogen-free rats (8 in a control group, 16 in a SAP group) were detected for bacterial infection rates both by agar plate culture and a real-time PCR method, and the results were made contrast.</p><p><b>RESULTS</b>Bacterial infection rates of the blood, MLN, pancreas and liver in the SAP group and the control group by the two different methods were almost the same, which were 5/16, 12/16, 15/16, 12/16 in the SAP group compared with 0/8, 1/8, 0/8, 0/8 in the control group by agar plate culture, while 5/16, 10/16, 13/16, 12/16 and 0/8, 1/8, 0/8, 0/8 respectively by a real-time PCR method. Bacterial number was estimated by real-time PCR, which showed that in the same mass of tissues, the pancreas contained more bacteria than the other three kinds of organs in SAP rats (P < 0.01), that may be due to the edema, necrosis and hemorrhage existing in the pancreas, making it easier for bacteria to invade and breed.</p><p><b>CONCLUSION</b>Fast and accurate detection of bacterial translocation in SAP rat models could be carried out by a real-time PCR procedure.</p>

The mutation spectrum of phenylalanine hydroxylase gene in patients with phenylketonuria in Henan province / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of the phenylalanine hydroxylase (PAH) gene mutations in patients with phenylketonuria (PKU) in Henan province, China, in order for providing basic information for clinical genetic counseling and prenatal diagnosis.</p><p><b>METHODS</b>All the exons and partial flanking introns of the PAH gene were detected by polymerase chain reaction (PCR) and bi-directional sequencing in 34 patients with PKU from Henan province.</p><p><b>RESULTS</b>A total of 23 different disease-causing mutations were identified which corresponded to 92.65% (63/68) of the PAH alleles, including 12 missense mutations, 4 nonsense mutations, 4 splicing junction mutations, and 3 deletion mutations. Among them, A156P and P69_S70delinsP(delCTT) were novel mutations; IVS2+ 5G to C, G332E, IVS10-14C to G and L367 to Wfs were reported in Chinese population for the first time according to the PAH database (www.pahdb.mcgill.ca). Among all the 13 exons, exon 7 harbored the most type of mutations, exon 11 and exon 5 the second. The most common mutations included R243Q (17.65%, 12/68), V399V (11.76%, 8/68), IVS4-1G to A (8.82%, 6/68), R400T(7.35%, 5/68), Y166X(5.88%,4/68) and G247R(5.88%, 4/68). In addition, 9 other gene variations were found in this study.</p><p><b>CONCLUSION</b>The mutation spectrum and frequency of the PAH gene of patients with phenylketonuria in Henan province were slightly different from those from other parts of China.</p>