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Objective:To search for circulating complement-related proteins that predict hypertensive disorders of pregnancy (HDP) based on reports of the development of gestational hypertension and proteinuria and to investigate the role of the complement system in the development of HDP.Methods:A nested case-control study was used, the serum samples of pregnant women who had been given birth or cesarean section in Guangzhou Women and Children′s Medical Center from November 2014 to March 2017 were collected. A total of 60 HDP and 60 normal pregnant women were included and matched 1∶1 by age and gestational week. Unlabeled mass spectrometry was used to screen the differential expression of complement factors in serum samples of 12 pairs of HDP patients and normal pregnancy collected before 20 weeks of pregnancy, and another 48 pairs of serum samples of HDP patients and normal pregnant women were used for preliminary verification. It was selected when the fold change (FC) of complement factor expression was>1.2 or <0.8 and P<0.05. ROC curve was used to evaluate the diagnostic value of corresponding factors. Results:FC of serum C1s, C8 beta chain (C8β) and C1 inhibitor (C1-INH) of HDP patients were 1.19, 1.23, 0.73 ( t=2.07, 2.06, -3.40; P<0.05), respectively. FC of serum C1s, C8 β, C1-INH, factor H-related protein 5 (CFHR5), clusterin (CLU), and C-reactive protein (CRP) of PE patients were 1.39, 1.50, 0.72, 2.49,4.38, and 1.82 respectively ( t=4.36, 5.61, -3.70, 6.82, 8.70, 7.27; P<0.05).The AUC of combining C1s, C8 β and C1-INH was 0.89 in HDP. The AUC of CFHR5, CLU, and CRP in preeclampsia was 0.88, 0.92, and 0.91. Conclusions:Before HDP, the activation and regulation of classic complement pathway and alternative pathway were disordered in pregnant women. The combined detection of complement C1s, C8 β and C1-INH is expected to be used in the prediction of HDP, and CFHR5, CLU, and CRP are expected to be used in the prediction of preeclampsia.
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Preeclampsia (PE) is a pregnancy-specific systemic multi-organ syndrome. Immune tolerance is very important for the establishment and maintenance of normal pregnancy. More and more studies have proved that the disorder of the complement system is related to the occurrence and development of PE. Complement molecules may be potential markers for PE screening and diagnosis. This review briefly summarized the role and research progress of the complement system in PE, to provide references for the complement molecules as clinical diagnostic markers and prevention target of PE.
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Objective Find abnormal changes of plasma lipid metabolism-related proteins before 20 weeks of gestation in patients with hypertensive disorder of pregnancy(HDP), and preliminarily investigate the role of plasma apolipoprotein C4 elevation in HDP. Methods A nested case-control study was used. The plasma were collected from pregnant women who underwent routine prenatal examination in Guangzhou Women and Children's Medical Center from November 2014 to March 2017. Label-free mass spectrometry was used to detect the differences in plasma lipid metabolism-related proteins before 20 weeks of gestation between 12 pairs of HDP patients and normal controls, and different 48 pairs of samples were used for verification. The protein with the most significant difference multiples was screened to study its effects on monolayer permeability and nitric oxide secretion of endothelial cells. One-way ANOVA was used for comparison between groups, and P<0.05 was considered as statistically significant difference. Results Compared with the control, the lipid metabolism-related proteins, APOC4, Fatty acid-binding protein 4 (FABP4), Apolipoprotein E (APOE), Apolipoprotein C3 (APOC3) and Beta-2-glycoprotein 1(APOH) raised to 1.94, 1.82, 1.59, 1.55 and 1.38 times, phospholipid transfer protein (PLTP) decreased to 0.78 times in plasma before 20 weeks of pregnancy of patients with HDP (t value were 2.499, 2.497, 2.081, 2.098, 2.426 and 2.564, respectively, P<0.05). Cell experiments results showed that 50 ng / ml APOC4 significantly increased 20％ HUVEC single layer cell permeability to FITC-labeled dextran (F=455.4, P<0.01), and significantly decreased the level of nitric oxide in the supernatant of HUVEC culture by 25％ (F=61.92, P<0.01). Conclusions Before diagnosis, plasma protein levels involved in lipid metabolism in HDP patients have been changed, resulting in abnormal lipid metabolism. APOC4 can increase the permeability of vascular endothelial cells, inhibit endothelial source of NO secretion, cause endothelial dysfunction.
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Objective To investigate the expression of circular RNA (circRNA) in peripheral blood of gravidas with gestational diabetes mellitus (GDM) using gene chip technology, and to provide evidence for studying pathogenesis of GDM. Methods A prospective cohort-based nested case-control study was used to select 1 018 pregnant women who were examined and delivered in Guangzhou Women and Children's Medical Center from September 2014 to April 2016. The information of prenatal examination was recorded and the outcome of delivery was followed up. Six pregnant women diagnosed as GDM were selected as the GDM group. Six normal pregnant women who were collected blood samples by 1 ∶ 1 were selected as the control group. The difference of gestational week was less than 7 days, the number of previous pregnancies was less than 2 times, and the difference of previous delivery times as same as the control group. The expression of circRNA in maternal peripheral blood was analyzed by chromosome microarray technique, and the function and the regulation network forecast were analyzed by GO (http://www.geneontology.org/), KEGG PATHWAY (http://www.genome.jp/kegg/pathway.html) and CircNet(http://circnet.mbc.nctu.edu.tw/). t-test was used for data analysis. ResuLts Compared to the normal pregnant women, 2 678 circRNAs were identified to be differentially expressed >2.0 times in GDM women, among which 1 532 were up-regulated and 1 146 were down-regulated. Functional analysis showed that the up-regulated circRNA was enriched in the biological processes of insulin response, gene silencing regulation, glucagon response and cell senescence. Signal pathway analysis showed that circRNA involved in insulin pathway. Taking has_circ_0042852 and has_circ_0004001 as center, the possible GDM-related regulatory networks were predicted. ConcLusions The peripheral blood of GDM women is rich in circRNAs, which might involve in many biological processes, insulin signaling pathway and possibly induding GDM-related regulatory networks.
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Objective@#To analyze the influencing factors and mechanism for unprotected sexual behavior of men who have sex with men (MSM) in China.@*Methods@#MSM who are more than 16 years old and have had homosexual sexual behaviors in recent years were recruited from five cities (Tianjin, Harbin, Nanjing, Chongqing and Xi'an) with active MSM population during 2013-2014 through network, site recruitment and peer recommendation using convenient sampling method. 3 519 subjects were included in this study. The sexual behavior related information of MSM in five cities was investigated using questionnaires. The confirmatory factor analysis was used to construct the measurement model by using the robust estimation method based on the weighted least square method to estimate parameters, and the final model was determined through evaluation and modification.@*Results@#A total of 3 519 subjects were (29.9±8.76) years old, with a clear sexual orientation of 3 223 (91.6%), and 2 287 (65.0%) were aware of free HIV/AIDS treatment policies. The proportion of using condom last time was 77.2% (n=2 718), and the proportion of using condom every time was 36.9% (n=1 299) and 43.2% (n=1 521) respectively for the past six months with fixed and temporary partners. Structural equation model provided a good fit, the root mean square error of approximation, comparative fit index and non-normed fit index was 0.07, 0.97, 0.95, respectively. Knowing AIDS knowledge, educational level and sexual orientation had direct effects on unprotected sexual behavior, and the path coefficients were 0.179,-0.049 and -0.159, respectively. While the role of interventions was indirect, the path coefficient was 0.147.@*Conclusion@#Lower education and unclear sexual orientation are disadvantages for reducing unprotected sexual behavior. Interventions mainly affect the unprotected sexual behavior by improving the level of HIV/AIDS knowledge. Increasing the comprehensive knowledge of MSM through intervention should be highly valued.
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Objective To explore the relationship between the red cell volume distribution width (RDW)in patients with ges-tational diabetes and insulin resistance(IR).Methods A total number of 160 pregnancies performed in Guangzhou Women and Children’s Medical Center from January to October 2016.Matching 80 patients with gestational diabetes (the GDM Group)with 80 healthy pregnancies according to their age,gestational weeks and times.Their inflammatory parameters (hs-CRP,neutrophil-to-lymphocyte ratio,RDW)were respectively examined.HOMA-IR was calculated by testing the level of FBG and FIns.The association of the red cell volume distribution width with insulin resistance was analyzed.Results The level of four inflammatory parameters (hs-CRP,WBC,neutrophil-to-lymphocyte ratio,RDW)were significantly higher than that the control group (t=5.695,5.232,3.337,7.814,all P<0.01).Pearson correlated analysis suggested that RDW had positive correlation with HOMA-IR (r=0.58,P<0.01).Conclusion The RDW level were elevated in the GDM patients and had positive correlation with HOMA-IR,which indicated that IR was associated with inflammation and provided proof to research mechanism of GDM.
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Objective To investigate the diagnostic value of cyclophilin A(CyPA)for chronic heart failure (CHF).Methods Eighty pateints,made a definite diagnosis as CHF,were classified 30 cases as A phase,29 cases as C phase,21 cases as D phase of them.30 healthy subjects were enrolled in this study.Serum CyP A was detcted by ELISA.NT-proBNP was detec-ted with Roche Cobas 6 000 automatic electrochemilu-minescence immunoassay system.Results The amounts of serum CyP A(x-±s,ng/ml)in healthy subjects and each group with CHF were 110.10±49.73,327.85±82.67,331.70±69.34 and 342.46±92.55.Using Oneway Anova,CyP A concentration of CHF was significantly higher than healthy controls (F=58.45,P0.05).Results of ROC curves showed the AUC (CyP A)was 0.97.The best cutoff value was 198.39 (ng/ml).The sensitivity was 91.30%,the specificity was 93.30%.The correlation analysis showed that CyP A and NT-proBNP were correlated (r=0.30,P<0.01). CyP A and NT-proBNP combined detections showed the sensitivity was 93.80% and the specificity was 100%.Conclusion The Cyp A levels in CHF group are significantly higher than the control group,suggesting that Cyp A may be a factor for CHF appearance.These results indicate that combined detections may helpful to early diagnosis of CHF.
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Objective To explore the clinical application value of serum amyloid protein(SAA) and C reactive protein(CRP)in early diagnosis of hand‐foot‐mouth disease(HFMD)in children .Methods The serum/plasma levels of CRP and SAA in 81 children with HFMD(HFMD group)and 125 healthy children(healthy control group)were detected by using dot immunogold filtration as‐say .Data including white blood cell (WBC) count ,levels of CRP and SAA were obtained and analyzed .And diagnostic efficacies of these indicators were evaluated by using receiver operating characteristic (ROC) curve .Results The serum levels of SAA and CRP and WBC count in HFMD group were significantly higher than those in healthy control group ,and all had statistically significant differences(P<0 .05) .The area under the ROC curve(AUC) of SAA(0 .921) was higher than that of CRP(0 .728) ,SAA/CRP ra‐tio(0 .846) and WBC count(0 .721) for diagnosing HFMD ,there were statistically significant differences(P<0 .05) .Compared with CRP ,WBC count and SAA/CRP ratio ,SAA had better diagnostic efficacy .Conclusion As a new biomarker of infections ,SAA can effectively diagnose HFMD early and provide more sensitive reference to clinicians for early diagnosis ,which might be worthy of clinical application widely .
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Objective To assess the relationship between maternal plasma tumor necrosis factor-related apoptosis-inducing ligand ( TRAIL ) before 20 weeks′gestation and hypertensive disorder complicating pregnancy (HDCP);and to evaluate the predictive value of plasma TRAIL for HDCP.Methods A 2-phase screening/validation study was designed.In the screening phase , a nested, case-controlled study was performed , the plasma samples collected before 20 weeks′gestation from 20 women who later developed HDCP and 20 age-and gestation week-matched controls were tested in prospective screening test for protein expression profiling during pregnancy and HDCP.Plasma samples were analyzed by a human protein microarray technology designed to detect 507 proteins simultaneously.Differently expressed proteins′functional annotation and clustering were performed by using of Database for Annotation , Visualization and Integrated Discovery ( DAVID) and Gene Ontology ( GO) database.The TRAIL level of plasma samples obtained before 20 weeks′gestation from 53 women who later developed HDCP and 106 similarly matched controls were further validated by ELISA and 62 clinical risk factors were investigated.Logistic regression and ROC analysis were used to evaluate the relationship between TRAIL and HDCP and its predictive value for HDCP.Results In protein microarray analysis , 23 proteins expressed differently before 20 weeks′gestation between the two groups.Further validation results showed that TRAIL levels in HDCP patients were lower significantly (45.7 ±13.1) pg/ml than those in healthy pregnant controls (51.2 ±14.7)pg/ml, P=0.021.Multiple factor logistic regression analysis of 159 pregnancies showed that three features were finally entering the logistic model, they were:anemia (OR=4.87, 95% CI 1.05-24.26), pre-pregnancy BMI (OR=1.72, 95% CI 1.35 -2.19) and TRAIL (OR=0.96, 95% CI 0.92 -0.99).The predictive accuracy of logistic model was 81.8%.The model significantly increases the predictive value (AUC=0.81, 95%CI 0.73-0.87) compared to TRAIL as independent predictor (AUC=0.59, 95%CI 0.51-0.67).Conclusions Totally 23 proteins were expressed differentially before 20 weeks′gestation in plasma of women who later developed HDCP , confirming that HDCP is a heterogeneous disease with different biological changes.The data suggests that plasma TRAIL levels relate with the development of HDCP and its combination with pre-pregnancy BMI and anemia have a high predictive value for HDCP before 20 weeks′gestation.
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Objective To investigate the significance of Ang-Ⅱ in diagnosis of chronic heart failure.Methods Eighty patients with chronic heart failure were divided into 3 groups:A phase with 30 cases,as C phase with 29 cases and D phase with 21 cases.30 healthy subjects were enrolled in this study.Serum Ang-Ⅱ was detected by ELISA.NT-proBNP was detected with Roche Co-bas6000 automatic electrochemiluminescence immunoassay system.Results Using Oneway Anova,the Ang-Ⅱconcentration of pa-tients with chronic heart failure was significantly higher than that of the healthy subjects (F =38.35,P <0.01).Further using Post Hoc Tests-Multiple Comparisons,the Ang-Ⅱ concentration of each group with chronic heart failure was significantly higher than that of the healthy control group.Results of ROC curves showed the aera under the curve of Ang-Ⅱwas 0.92.The best cutoff value was 552.25 (ng/mL).The sensitivity was 90.00%,and the specificity was93.30%.The correlation analysis showed that Ang-Ⅱwere correlated with NT-proBNP(r=0.23,P <0.05).The sensitivity and the specificity of combined detection of Ang-Ⅱand NT-proBNP were 98.80% and 100%,respectively.Conclusion The Ang-Ⅱlevels in chronic heart failure groups are significantly high-er than that in the control group,which indicates that combined detection may be helpful to the early diagnosis of chronic heart fail-ure.
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Objective The purpose of this study was to assess the analysis capabilities of the dot immunogold filtration method on detecting serum amyloid A ( SAA ) protein in blood.It also aimed to research the clinical value of SAA in diagnosing the infectious diseases of children .Methods ( 1 ) The performance evaluation including the accuracy , within-run precision, inter assay variations , the linear and the distraction-analysis of SAA-SPOT was estimated following the EP file; From March to July in 2014, children from five 3A Grade hospitals in Guangdong Province were enrolled into this observational study.Data including white blood WBC count , CRP and SAA were obtained.(2) From March to July in 2014, children from five 3A Grade hospitals in Guangdong Province were enrolled randomly into this observational study.This study used a cross-sectional survey research method , and 386 children with bacterial infection and 219 children with virus infection were as the research object.The general , clinical diagnosis , treatment information as well as the data of blood SAA , C-reactive protein ( CRP ) and white blood cell ( WBC ) of children were collected.Data were analyzed by variance , independent t test, ROC curve analysis and stepwise regression statistics method.Results ( 1 ) The average recovery rate is 103.74 %.Coefficient of variation (CV) for 10 mg/L,100 mg/L within-run assays were 8.77%, 3.61% and between-run assays were 9.01%, 3.74%;the inter-day CV were 9.07%, 4.03%respectively;the linear range was 5 mg/L-200 mg/L, hemoglobin(5 g/L),serum bilirubin(800 μmol/L),triglyceride(TG, 22 mmol/L), and had no interference in SAA detection.When compared to the BNPRO quantitate system of SIEMENS , the coefficient of association of detection of SAA by SAA-SPOT was R2 =0.96.( 2 ) Compared with control group , the serum SAA of infection group ( bacterial infection group , t =13.05, P=0.001;virus infection group t =7.68, P=0.001) and SAA/CRP ratio (bacterial infection group t=2.29, P=0.023;virus infection group t=3.32, P=0.01) were significantly increased.(3) The serum CRP and SAA rose similarly in bacterial infection, while in viral infection, only SAA increased significantly , CRP had no apparent change.In combination with CRP and WBC , SAA had the better diagnostic efficiency apparently.Conclusions As a POCT detection project , analysis capabilities of the SAA assayed by domestic SAA-SPOT can meet the requirements of clinical test.Combined with CRP , WBC and SAA can improve the efficiency in the diagnosing of infectious disease especially in the virus infection.As a new biomarker of infections , SAA is useful for the early auxiliary diagnosis and differential diagnosis of childhood infection.
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Objective To analyze the common respiratory tract infection pathogens distribution and their drug resistance in pedi-atric cardiac intensive care unit(CICU),so as to provide reference for clinical rational use of antibiotics.Methods 1 350 cases of sputum specimens from lower respiratory tract infection patients of pediatric CICU in the medical center between January 2011 and December 2012 were cultivated and drug susceptibilities were tested.The results were retrospectively analyzed.Results 490 patho-genic strains were isolated from 1 350 cases of sputum specimens and identified,including Gram negative bacilli 288 strains (58.78%),Gram positive coccus 140 strains(28.57%),fungi 62 strains(12.65%,mainly Candida albicans ).Gram negative bacilli was given priority to with Klebsiella pneumoniae (62 strains,12.65%),followed by Branhamella catarhalis ,Pseudomonas aerugi-nosa and Escherichia coli .The rates of extended-spectrum beta-lactamases(ESBLs)-producing strains among Escherichia coli and Klebsiella pneumoniae were 73.33% and 66.13%,respectively.Gram positive coccus was given priority to with Staphylococcus aureus (65 strains,13.27%),followed by Streptococcus pneumoniae .Methicillin-resistant Staphylococcus aureus (MRSA)accounted for 24.62%.Conclusion Staphylococcus aureus ,Streptococcus pneumoniae and Klebsiella pneumoniae are main pathogens of re-spiratory tract infection in pediatric CICU.And there is multiple drug-resistant bacteria infection.Rational applicattion of antibiot-ics according to the test results of isolation and drug susceptibility is an effective way to control the infection of critical children and reduce the emergence of resistant strains.
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With the development of detection technology,point of care testing POCT) presents a tendency of diversity.However,the blood glucose meter and blood gas analyzer are still the major types of POCT in most hospitals.How to manage them effectively has become everyone's concern.The decrease in detection quality is caused by personnel,equipment,reagents,quality control and result reports.According to the baseline survey of POCT carried out in Guangzhou Women and Children's Medical Center,6 key points to improve the quality management were found.Meanwhile,the application of plan-do-check-action (PDCA) may allow access to an effective POCT management program.
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Objective To silence the expression of tissue factor(TF) gene of human umbilical vein endothelial cell(HUVECs) of the newborns with placental abruption(PA) and normal newborns.Methods There were two groups in the experiment,normal group and PA group.Three different treatments were established in each group:(1) the blank; (2) the false-intervention ; (3) the TF gene silencing.There were three samples in each treatments.After these treatments,the changes of mRNA expression of the HUVECs were observed before and aftcr thc gene silencing and the changes of the immunofluorescence of the TF protein level.Results After amplificated,plasmid DNA were sequenced to show that the pENTRTM/U6-TF-shRNA was the positive clone.After the transfected,the levels of the mRNA of TF decreased from 0.657 ± 0.097 to 0.220 ± 0.030 and 1.323 ± 0.323 to 0.207 ± 0.150 in the normal and PA group respectively.Compared with the normal group,there were significant differences for the levels of TF mRNA in PA group with the blank,(1.323 ± 0.323 vs 0.657 ± 0.097,P =0.023) and the same result for the second management (1.057 ±0.178 vs 0.540 ± 0.079,P =0.01).But there was no significant difference between the normal and PA group after RNA interference gene silencing (0.220 ± 0.030 vs 0.207 ± 0.150,P ＞ 0.05).Meanwhile,there were significant differences among the three managements in the themselves groups of normal and pathological ones(F =19.30,P =0.002 ;F =27.66,P =0.001).Conclusion The vectors are transfected into HUVECs and play the biological function.And they silence the expression of TF mRNA.PENTRTM/U6-TF-shRNA could inhibit the expression of TF mRNA of HUVECs in the PA newborn.