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Objective:To investigate the influencing factors of the survival in infants with congenital diaphragmatic hernia (CDH) and to develop a prediction model for CDH.Methods:Clinical data of 252 infants with a prenatal diagnosis of CDH in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2010 to December 2018 were retrospectively analyzed. Adverse outcomes were defined as neonatal death on discharge. Chi-square and t test were used for univariate analysis of 16 perinatal and five postnatal risk factors. Regression analysis was used to determine the independent predictors of survival. The receiver operating characteristics (ROC) curves of the risk factors for predicting the survival of CDH were drawn. A prediction model based on the combination of risk factors for predicting adverse outcomes of CDH was established using the cut-off value. ROC curves of the model were drawn and the area under curve (AUC), sensitivity, and specificity were calculated. Results:Out of the 252 patients, 173(68.7%) survived on discharge. Univariate analysis showed that lung-to-head ratio (LHR), polyhydramnios, right diaphragmatic hernia, liver herniation, intrathoracic stomach, premature birth, low birth weight, 5 min Apgar score <7, and amniotic fluid index (AFI) were significantly associated with the survival of CDH. Regression analysis showed that polyhydramnios ( OR=11.19,95% CI:2.83-45.33), liver herniation ( OR=2.81,95% CI:1.32-11.92), intrathoracic stomach ( OR=5.02, 95% CI:1.29-17.13), low birth weight ( OR=8.58,95% CI:1.59-45.01) and AFI ( OR=3.68, 95% CI:1.37-14.72) were independent risk factors for survival at discharge in children with CDH, while LHR ( OR=0.36, 95% CI:0.01-0.69) were protective factors. The predictive cut-off values of LHR, polyhydramnios, liver herniation, intrathoracic stomach, low birth weight, and AFI were 1.6, 1.0, 1.0, 1.0, 1.0, and 232.5 mm, respectively. The model based on the combination of the above indicators for predicting CDH adverse outcomes was shown with an AUC value of 0.904, predictive sensitivity of 0.747, and specificity of 0.896. Conclusions:In this study, LHR, liver herniation, intrathoracic stomach, polyhydramnios, low birth weight, and AFI are independent risk factors for CDH survival. The combination of prenatal and postnatal indicators is noted for a higher accuracy for predicting CDH survival.
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Objective To search for novel potent 3-ester derivatives of arenobufagin and test their antitumor activities in vitro. Methods Target compounds were synthesized by esterification of arenobufagin with acids. CellTiter method was used to assay the in vitro antitumor activities. Results 3-Ester derivatives exhibited excellent antitumor activities against all the cancer cells. Conclusion Among the 3-ester derivatives, compound 2a had the best activities with the IC50 of 4.0−91.7 nmol/L and appeared to be a valuable candidate for further study.
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We reported a women with omithine carbamoyltransferase deficiency who delivered a healthy boy after two pregnancies with adverse outcome with the help of a multidiscipline team.The woman was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine with an acute prenatal hyperammonemic episode at 28 gestational weeks of her first pregnancy in 2013 and was diagnosed with ornithine transcarbamylase deficiency.Her hyperammonemic complications were controlled under a well-planned multidisciplinary management including a low-protein diet and appropriate medications assisting nitrogen removal.A boy was delivered by cesarean section at 32 weeks of gestation but died three days later.Mutation analysis revealed a hemizygous c.583G＞A (G195R) mutation in the neonatal omithine carbamyltransferase gene and his mother was a heterozygous carrier with the same mutation.Two years later in 2015,the patient was pregnant spontaneously.However,she received an induced abortion at 21 weeks of gestation because amniocentesis and DNA analysis showed that the male fetus had the same omithine transcarbamylase gene mutation.The index pregnancy was assisted by in vitro fertilization-embryo transfer and preimplantation genetic diagnosis in 2017 and the woman delivered a healthy boy with the management ofa multidisciplinary team.
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Objective@#To explore the prevalence of occupational musculoskeletal disorders (OMD) and its influencing factors among rural migrant workers in Tianjin, with the aim of developing strategies to improve the health condition of this specific population.@*Methods@#Questionnaire survey was conducted among 415 rural migrant workers working in Tianjin about their fundamental state and occupational musculoskeletal disorders (OMD) during January 2015 to January 2016. Statistical methods were utilized to analyze the influencing factor.@*Results@#A total of 415 rural migrant workers were investigated, in which young Young adults and low education level were in the majority of rural migrant workers. The prevalence of OMD for whole population, male and female were 28.92% (120/415), 33.06% (81/245) and 22.94% (39/170), respectively. Prevalence showed significant differences njin and workplace hygiene. Multivariate logistic regression analysis showed that the risks of OMD increased with age group, and decreased with higher education level. The risk of OMD among rural migrant workers with monthly income between 3000 to 5000 yuan was 2.26 times (95%CI: 1.37-3.75) higher than that of low-income workers (<3000 yuan per month). Workers engaged in housekeeping service had 2.28 times higher risk of OMD than those in manufacturing industry (95%CI: 1.06-4.89) .@*Conclusion@#Prevalence of OMD among rural migrant workers is higher than that of general people. Age, education, monthly income, occupation are the independent influencing factors for OMD among rural migrant workers.
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Objective:To compare the mental health between the urban mothers and rural mothers of children with cleft lip and pal-ate.Methods:1 68 mothers(including 1 24 rural and 44 urban)of the children with cleft lip and palate were included in the trial group and 82 mothers of normal children were included in the control group.The subjects were tested by the self-assessment symptom lists of SCL-90 for the evaluation and comparison of mental health.Results:The scores of nine dimensions of trial group in somatization, forcing symptoms,depression,anxiety,etc were significantly higher than those of the control group(P <0.05).The scores of nine di-mensions of rural group in somatization,forcing symptoms,depression,anxiety,etc were higher than those of the urban group,the ri-val,psychotic and total scores showed significant differences(P <0.05);Conclusion:The mental health status of mothers of children with cleft lip and palate is poorer than that of those of normal children.That of the rural mothers is poorer than that of the urban ones. Special attention should be paid to the mental health status of the parents of children with cleft lip and palate.
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Objective To study the hemostasis activity of iodine complex with carboxymethyl chitosan .Methods The polymers were prepared with azodiisobutyronitrile as the initiating agent and sodium acrylate ,N‐vinylpyrrolidone ,carboxym‐ethyl chitosan and N ,N′‐methylene diacrylamide as the raw materials .It was then complexed with iodine to generate iodine complex with carboxymethyl chitosan ,and the hemostasis activity was tested at the same time .Results The polymers could absorb water with the value of 103g/g and showed potent hemostasis activity for auricular veins and femoral veins .Conclusion The results showed that hemostatic effect of polymers was better than that of hemostatic sponge and Quikclot .