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Objective:To investigate the clinical characteristics, management and outcome of aortic dissection (AD) in pregnant women with pre-eclampsia.Methods:Clinical characteristics, management, and prognosis of nine patients with pre-eclampsia complicated by AD who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to April 2021 were retrospectively summarized using descriptive statistical analysis.Results:(1) Clinical features: The incidence of pre-eclampsia complicated by AD among the total deliveries and pre-eclampsia deliveries were 18/100 000 (9/49 166) and 182/100 000 (9/4 943), respectively. All the nine cases of pre-eclampsia complicated by AD, with an average age of (36.6±4.2) years, presented clinical symptoms in the second or the third trimester that were mainly manifested as chest and back pain (8/9) and the average gestational week at onset was (31.0±4.7) weeks. Seven cases were confirmed by transthoracic echocardiography (TTE) and computed tomography angiography (CTA), one by TTE and magnetic resonance angiography, and one by TTE+MRI+CTA. The main classification of AD was Stanford B (8/9). In the grading of blood pressure during pregnancy, except for one case without data, eight cases were severe. (2) Management: Four women did not receive any antihypertensive treatment. However, blood pressure remained uncontrolled in the other five cases despite antihypertensive managment. Except for one death before operation due to rapid deterioration, the other eight cases all received initial treatment and thoracic endovascular aortic repair (TEVAR). Four cases underwent TEVAR prior to the termination of pregnancy. Two cases were delivered by cesarean section first, and TEVAR was performed 5 and 6 days after delivery, respectively. The other two cases undenwent cesarean section and TEVAR at the same time. Lung infection ( n=6) was the main postoperative complication. (3) Delivery: Among the nine patients, one patient died, and the average termination time of the eight patients (six underwent cesarean section, including two cases with fetal death, two underwent vaginal delivery following fetal death) was (32.9±3.6) weeks and none of them had postpartum hemorrhage. (4) Maternal-infant outcomes: Follow-up of the eight surviving women showed that one had numbness in one side of the limbs, one with occasional heart palpitations, and the rest had good outcomes. There were four live births, including two with low birth weight and one with neonatal asphyxia, and five stillbirths. During the 7-83 months of follow-up, all four children grew well. Conclusions:Pregnant women with pre-eclampsia should actively control blood pressure to avoid AD. Once symptoms such as chest and back pain occur, the possibility of AD should be considered. Active treatment after diagnosis of AD can improve maternal and fetal survival rate.
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Objective:To explore the effects of pregnancy complicated with Takayasu arteritis (TA) on maternal and fetal outcomes.Methods:The clinical data of 17 TA patients with pregnancy and finally terminated admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were collected and the maternal and infant outcomes were retrospectively analyzed.Results:Among the 24 pregnancies in 17 TA patients in our hispital, 11 patients in our hospital were primiparous (46%, 11/24) and 13 patients were multiparous (54%, 13/24); 4 cases of chronic hypertension before pregnancy (17%, 4/24), and 20 cases of non-hypertension (83%, 20/24) were abserved. Apart from the thoracoabdominal artery type, 15 cases (63%, 15/24) of brachiocephalic type, 8 cases (33%, 8/24) of extensive type, and 1 case of pulmonary artery type (4%, 1/24) were included in TA classification; the renal artery was damaged in 7 cases (7/8) of the extensive type. Among the 24 pregnancies of 17 TA patients, 8 cases of pregnancy complications occurred, including 4 cases (17%, 4/24) of preeclampsia, one case of (4%, 1/24) new-onset hypertension during pregnancy, exacerbation of existing hypertension, thrombocytopenia and ischemic stroke respectively; 3 cases of induced abortion, 1 case of induced labor, and 20 cases of final delivery were found. Of the 20 final deliveries, 3 cases (15%, 3/20) were delivered through the vagina; 17 cases (85%, 17/20) were delivered by cesarean section; 3 cases (15%, 3/20) of fetal growth restriction and 6 cases of oligohydramnios (30%, 6/20) were occurred. The median gestational age of pregnancy termination of 17 full-term neonates (85%, 17/20) and 3 premature neonates (15%, 3/20) was 38.4 weeks (range:29.6-40.9 weeks). All premature women were complicated with pre-eclampsia or severe pre-eclampsia, which lead to premature birth; the birth weight of the neonates was (2 791±783) g. Neonatal asphyxia occurred in 3 cases (15%, 3/20), and 6 cases (30%, 6/20) were admitted to the neonatal intensive care unit. None of the newborns died. The patients were followed up for 3 months to 7 years. Except for one case who underwent surgical treatment 3 years after delivery and died of intraoperative hemorrhage, the other 16 patients were in stable condition; all the newborns grew and developed well. The incidences of maternal and infant adverse events were higher in those with chronic hypertension, renal artery involvement, and no use of hormones and aspirin during pregnancy, but the differences were not statistically significant (all P>0.05). Conclusions:Pregnancy with TA has adverse effects on maternal and infant outcomes. To reduce the occurrence of maternal and child adverse events, the condition of TA patients should be fully assessed before pregnancy, multidisciplinary cooperation, regular treatment, strengthened monitoring of the condition, timely treatment of complications, selection of appropriate delivery methods after pregnancy, and vigilance of postpartum complications should be properly carried out.
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Fatigue not only affects people′s lives and work, but also causes diseases .Numerous studies have shown that some phytochemicals can promote body energy metabolism and regeneration , improve physical condition , resist fatigue growth and accelerate fatigue alleviation .This paper reviewed the recent research progress , domestic and overseas , in the anti-fatigue effect of phytochemicals .
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Objective To assess the differences in nutrient composition by chemical analysis method and weighing method,A corps of armed police forces daily dietary nutrient intakes were investigated in Tianjin,to understand the status of the actual intakes of dietary nutrient.Methods A dietary survey was performed using the weighing method and with ref-erence to China food composition database in 2002.The intake of each nutrient was calculated through chemical analysis;Nutritional analysis was used in the collection of duplicate food portions during the dietary survey.Results For most of the main dietary nutrients(protein,fat and carbohydrates),minerals (Na,K,Mg,Ca,Zn,Cu and Se)and vitamins (β-car-otene,vitamin E,thiamine,riboflavin,vitamin C,niacin,and vitamin A),the calculated values of intakes were found to exceed those obtained via chemical analysis.Conclusion Differences of the two methods of dietary survey were ultimately due to the analysed values were below the calculated ones.So it is necessary to improve methods of food storage and trans-portation in order to obtain adequate nutrition and to improve the health of troops.
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ObjectiveTo evaluate the long-term therapeutic efficacy of muscle-region alignment needling plus dermalneedle therapy in treating post-stroke upper-limb spasticity.MethodTotally 488 patients with post-stroke upper-limb spasticity were randomized into a treatment group and a control group, 244 in each group. Besides theessentialrehabilitation treatment, the treatment group was intervened by muscle-region alignment needling plus dermal needle therapy, while the control group was given regular Western medication.Thetwo groups were intervened for 3 weeks and were followed up for 6 months. The neurologic function, Functional Comprehensive Assessment (FCA), and Stroke Speciality-Quality of Life (SS-QOL) were observed for the follow-up study.ResultThe total effective rate was 93.4% in the treatment group versus 61.5% in the control group, and the difference was statistically significant (P<0.05); the neurologic function, FCA score, and SS-QOL score in the treatment group were significantly superior to that in the control group at the end of the follow-up study (P<0.05).ConclusionMuscle-region alignment needling plus dermal needle therapycan produce a content long-term therapeutic efficacy in treating post-stroke upper-limb spasticity.
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Objective To investigate the effects of oxidative stress on homocysteine and related amino acids metabolism in methionine-loading BRL rat hepatocytes.Methods Cultured BRL rat hepatocytes were divided into control and oxidatively stressed group(100 μmol/L H2O2 was added in culture medium for 2 hours),methionine group(50 mmol/L methionine was added in culture medium for 1 hour),and oxidatively stressed + methionine group(100 μmol/L H2O2 was added in culture medium for 2 hours + 50 mmol/L methionine was added in culture medium for 1 hour).At the end of the experiment,culture fluid was collected.Homocysteine,cysteine,and glutathione were measured by high-performance liquid chromatography,and amino acids were assayed by amino acids analyzer.Results Compared with the control group,the contents of homocysteine[(3.76 ± 0.22)vs.(1.54±0.05)μmol/L,P=0.000]and cysteine[(199.80 ±8.75)vs.(99.11 ±2.47)μmol/L,P=0.000]significantly increased in methionine group,and the contents of homocysteine[(3.84 ± 0.34)vs.(1.54 ±0.05)μmol/L,P=0.000]and cysteine[(200.66±8.60)vs.(99.11 ±2.47)μ mol/L,P=0.000]also increased in oxidatively stressed + methionine group.Compared with oxidatively stressed group,the concentrations of homocysteine[(3.76 ± 0.22)vs.(1.67 ± 0.13)μmol/L,P =0.000],cysteine[(199.80 ± 8.75)vs.(82.64±15.88)μmol/L,P=0.000],and glutathione[(1.50 ±0.14)vs.(1.00 ±0.11)μ mol/L,P=0.011)]significantly increased in methionine group,and the concentrations of homocysteine[(3.84 ± 0.34)vs.(1.67±0.13)μmol/L,P=0.000],cysteine[(200.66±8.60)vs.(82.64±15.88)μmol/L,P=0.000]and glutathione[(1.40 ± 0.30)vs.(1.00 ± 0.11)μmol/L,P =0.028]significantly increased in oxidatively stressed + methionine groups.Compared with the control group,the contents of serine[(12.41 ± 1.51)vs.(24.00 ±2.54)mg/L,P =0.000],glutamate[(33.31 ±0.17)vs.(43.10 ±0.52)mg/L,P =0.000]and glycine[(6.23 ± 0.18)vs.(24.66 ± 10.87)mg/L,P =0.000]significantly decreased,while taurine [(7.99 ±0.16)vs.(6.17 ±0.15)mg/L,P =0.000]increased significantly in oxidatively stressed group.Compared with the oxidatively stressed group,the concentrations of serine[(16.98 ± 0.39)vs.(12.41 ± 1.51)mg/L,P=0.006)]and glutamate[(35.44 ±0.82)vs.(33.31 ±0.17)mg/L,P =0.002]in methionine group significantly increased,while taurine[(3.77 ±0.16)vs.(7.99 ±0.16)mg/L,P =0.000]significantly decreased in methionine group.Compared with the methionine group,the contents of serine[(12.59 ± 0.66)vs.(16.98±0.39)mg/L,P=0.008],glutamate[(30.87±0.60)vs.(35.44±0.82)mg/L,P=0.000]significantly decreased while taurine[(4.37 ± 0.12)vs.(3.77 ± 0.16)mg/L,P =0.001]in oxidatively stressed + methionine group significantly increased.Conclusion Oxidative stress can somehow promote homocysteine production in methionine loading BRL rat hepatocytes,but it is not the main effects.