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.

A comparative clinical study of postoperative intensity-modulated radiotherapy combined with concurrent and sequential chemotherapy for high-risk early-stage cervical cancer / 中华放射肿瘤学杂志

Objective To evaluate the efficacy and acute toxieities of postoperative intensity-modulated radiotherapy (IMRT) combined with concurrent (C-IMRCT) or sequential chemotherapy (S-IMRCT) in the treatment of high-risk early-stage cervical cancer.Methods A retrospective study was performed on the clinical data of 105 patients with high-risk early-stage (Ⅰ B1-Ⅱ A2) cervical cancer from 2009 to 2017.Those patients were divided into C-IMRCT group (n=73) and S-IMRCT group (n=32).The 5-year disease-free survival (DFS) and overall survival (OS) rates,recurrence rate,metastasis rate,and acute toxicities were compared between the two groups.The survival rates were calculated by the Kaplan-Meier method and analyzed by the log-rank test.Univariate prognostic analysis was performed by the log-rank test.Recurrence,metastasis,and adverse reactions were compared using continuous correction chi-square test.Results The median follow-up time was 20 and 23 months in the C-IMRCT group and the S-IMRCT group,respectively (P=0.813).There were no significant differences in the 5-year DFS and OS rates between the two groups (72.6％ vs.72.5％,P=0.918;82.8％ vs.78.5％,P=0.504).There were no significant differences in the recurrence and metastasis rates between the two groups (P=0.598;P=1.000).The univariate prognostic analysis showed that no pathological factor affected prognosis.There were no significant differences in the incidence rates of grade 1-2 hematological toxicity,diarrhea,and urinary tract infection between the two groups (46.6％ vs.41.9％,P=0.884;P=0.854;P=0.271).Conclusions Further clinical studies are needed in terms of the survival rate in patients with high-risk early-stage cervical cancer receiving C-IMRCT.

Correlation between the overexpression of epidermal growth factor receptor and mesenchymal makers in endometrial carcinoma / 부인종양

OBJECTIVE: The objective of this study was to evaluate the effect of overexpression of epidermal growth factor receptor (EGFR) on the expression of epithelial cell markers (E-cadherin and alpha-catenin) and mesenchymal cell markers (N-cadherin and vimentin) in endometrial carcinoma. METHODS: The expression of all 4 markers was evaluated in EGFR overexpressing Ishikawa cells, control Ishikawa cells, and KLE cells using reverse transcription polymerase chain reaction (RT-PCR) and Western blotting. The expression of these 4 markers was also determined in cancerous tissues of patients with endometrial carcinoma using immunohistochemical staining. RESULTS: Ishikawa cells transfected with EGFR showed decreased expression of E-cadherin and alpha-catenin and increased expression of N-cadherin and vimentin compared with control Ishikawa cells (p<0.01 for all). The expression of N-cadherin and vimentin was higher and the expression of E-cadherin and alpha-catenin was lower in stage II-III than stage I and in grade II-III than grade I endometrial carcinoma tissue (p<0.01 for all). CONCLUSION: Decreased expression of epithelial markers (E-cadherin and alpha-catenin) and increased expression of mesenchymal markers (N-cadherin and vimentin) were observed in human endometrial carcinoma tissue. These findings correlate with high EGFR expression in cultured endometrial carcinoma cells.

Effects of surgery-induced menopause on neuropsychological symptoms in women with perimenopause / 上海第二医科大学学报

Objective To investigate the effects of surgery-induced menopause on neuropsychological symptoms in women with perimenopause. Methods Sixty-eight women with perimenopause who underwent bilateral oophorectomy for benign indications were evaluated by the modified Kupperman index on the perimenopause syndrome pre-and post-surgery,including the score in neuropsychological symptoms.Patients were further requested to remake a decision on the acceptance of surgery,and were divided into "accept the surgery" group(n=30) and "postpone the surgery" group(n=38).The neuropsychological symptoms were reevaluated and comparison was made between these two groups. Results The prevalence of perimenopause syndrome pre-surgery was 67.65%(22/68),and that of moderate and severe symptoms was 30.88%.The prevalence of perimenopause syndrome post-surery(97.06%)(66/68)was significantly increased,as well as that of moderate and severe symptoms(70.59%)(P