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Objective To analyze the effect of different stress levels noninvasive mask BiPAP ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with type Ⅱ respiratory failure.Methods From January 2015 to June 2017,120 patients of AECOPD with type Ⅱ respiratory failure in Jincheng People's Hospital were randomly divided into three groups by the random number table,with 40 cases in each group.The suction pressure of A group was set to 10-14cmH2O.The suction pressure of B group was set to 15-19cmH2O,while the suction pressure of C group was set to 20-25cmH2O.The clinical curative effect of three groups was compared.Results The PaO2 level of three time points among the three groups were compared by repeated measurements of variance.The results showed that after treatment for 24h,the PaO2 levels of A group,B group and C group were (57.15 ± 5.03) mmHg,(60.28:±:5.21) mmHg and (58.38 ± 6.06) mmHg,respectively.After treatment for 72h,the PaO2 levels of A group,B group and C group were (63.02 ± 6.08) mmHg,(80.16 ± 5.28) mmHg and (70.07 ± 5.23)mmHg,respectively.After treatment for 168h,the PaO2 levels of A group,B group and C group were (70.11 ±60.28)mmHg,(86.35 ± 5.01) mmHg,(79.26 ±5.16) mmHg,respectively.The results showed that the difference in PaO2 of different groups was statistically significant (F =8.514,P ＜0.001),and there was significant difference in PaO2 at different time points (F =13.681,P ＜ 0.001),and there was interaction between groups (different processing formulas) and time points (F =9.872,P ＜ 0.001).There was an interaction between PaCO2 and PaO2/FiO2 in the groups and time points (P ＜ 0.001).The rank sum test was used to compare the curative effect among the three groups.The Z value was 17.512 (P ＜0.001),and the comparison with the cutting probability method showed that the effective rate of B group was significantly higher than that of A group and C group (P ＜ 0.012).Conclusion 15-19cmH2O inhalation pressure can significantly improve the effect of non invasive mask BiPAP treatment for AECOPD with type Ⅱ respiratory failure,and the improvement of blood gas index is better with time.
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Objective@#To analyze the effect of different stress levels noninvasive mask BiPAP ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with type Ⅱ respiratory failure.@*Methods@#From January 2015 to June 2017, 120 patients of AECOPD with typeⅡrespiratory failure in Jincheng People's Hospital were randomly divided into three groups by the random number table, with 40 cases in each group.The suction pressure of A group was set to 10-14cmH2O.The suction pressure of B group was set to 15-19cmH2O, while the suction pressure of C group was set to 20-25cmH2O.The clinical curative effect of three groups was compared.@*Results@#The PaO2 level of three time points among the three groups were compared by repeated measurements of variance.The results showed that after treatment for 24h, the PaO2 levels of A group, B group and C group were (57.15±5.03)mmHg, (60.28±5.21)mmHg and (58.38±6.06)mmHg, respectively.After treatment for 72h, the PaO2 levels of A group, B group and C group were (63.02±6.08)mmHg, (80.16±5.28)mmHg and (70.07±5.23)mmHg, respectively.After treatment for 168h, the PaO2 levels of A group, B group and C group were (70.11±60.28)mmHg, (86.35±5.01)mmHg, (79.26±5.16)mmHg, respectively.The results showed that the difference in PaO2 of different groups was statistically significant (F=8.514, P<0.001), and there was significant difference in PaO2 at different time points (F=13.681, P<0.001), and there was interaction between groups (different processing formulas) and time points (F=9.872, P<0.001). There was an interaction between PaCO2 and PaO2/FiO2 in the groups and time points (P<0.001). The rank sum test was used to compare the curative effect among the three groups.The Z value was 17.512 (P<0.001), and the comparison with the cutting probability method showed that the effective rate of B group was significantly higher than that of A group and C group (P<0.012).@*Conclusion@#15-19cmH2O inhalation pressure can significantly improve the effect of non invasive mask BiPAP treatment for AECOPD with type II respiratory failure, and the improvement of blood gas index is better with time.
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Objective To analyze gene mutations and the etiology of six fetuses with osteogenesis imperfecta detected by prenatal ultrasonography.Methods From March 2016 to May 2017,six gravidas of singleton pregnancy and their fetuses that were diagnosed with osteogenesis imperfecta by prenatal ultrasonography were enrolled in this study.Gravida 1 came to the Center of Prenatal Diagnosis of the First Affiliated Hospital of Zhengzhou University for prenatal diagnosis,while the other five were referred to that center after termination to identify genetic defects with their fetal tissues.Next-generation sequencing technology was carried out for exome sequencing in the genomes of six fetuses.Suspected mutations were confirmed by polymerase chain reaction and Sanger sequencing.Two hundred unrelated healthy individuals were analyzed with Sanger sequencing for validation of novel mutations.Results Fetus 1 carried a heterozygous mutation in collagen,type Ⅰ,alpha-1 (COL1A1) gene,c.724G＞C(p.Gly242Arg),which was found in the mother and brother but not in the father.Fetus 2 carried a known heterozygous mutation in COL1A 1 gene,c.2461G＞A(p.Gly821Ser),which was found in the mother but not in the father.Four heterozygous mutations,c.2282G＞A(p.Gly761Asp),c.1002+5G＞A in COL1A1 gene,c.1774G＞A(p.Gly592Ser) and c.3277G＞T(p.Gly1093Cys) in collagen,type Ⅰ,alpha-2 (COL1A2) gene,were respectively carried by fetuses 3 to 6,but not by their parents.Mutations of c.724G＞C(p.Gly242Arg),c.2282G＞A (p.Gly761Asp) and c.1002+5G＞A in COL1A1 gene and c.3277G＞T (p.Gly1093Cys) in COL1A2 gene were four novel mutations,which were not found in the 200 unrelated healthy individuals.The mother of fetus 1 who was highly suspected with osteogenesis imperfecta selected to continue the pregnancy because the family members had mild symptoms.After delivery,cord blood was collected for genetic test and the result was consistent with that of prenatal genetic diagnosis.Fetus 1 had no fractures during a six-month follow-up after birth.Conclusions Mutations in the COL1A1 and COL1A2 genes may be the etiology of osteogenesis imperfecta in these six fetuses.Results of this study could enrich the data on COL1A1 and COL1A2 mutations relating to osteogenesis imperfecta,and provide a basis for genetic counseling.
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Objective To observe the regulation of microRNA (miRNA,miR)-758-3p on the expression of murine double microsomal gene 2 (MDM2) and its effect on invasion and proliferation of gastric cancer cell line MGC803.Methods The bioinformatics software was used to predict MDM2 as target gene of miR-758-3p.The wild type MDM2 gene 3'untranslated region luciferase reporter gene vector and miR-758-3p target sequence mutated vector and the corresponding miRNA were transfected into gastric cancer cells MGC803 by lipofectamine.Dual luciferase reporter system detects luciferase activity.The miR-758-3p mimics were transfected into gastric cancer cell MGC803 by lipofectamine.Real-time PCR was used to detect the transfection efficiency.Real-time PCR and Western blot were used to detect miR-MDM2 expression level in cells after transfection.Transwell assay and CCK-8 assay were used to detect cell invasion and proliferation.SPSS 20.0 was used to conduct the statistical analysis.Results Dual luciferase reporter assay confirmed that miR-758-3p could target MDM2 gene(P ＜ 0.05).The expression level of miR-758-3p in MGC803 cells transfected with miR-758-3p mimics was significantly higher than that in miR-NC cells [(6.68 ±0.53) vs (0.84 t0.12),P ＜0.01].Compared with miR-NC group,MDM2 expression was down-regulated in MGC803 cells transfected with miR-758-3p mimics (P ＜ 0.05).The number of invasive cells in miR-NC group and miR-758-3p group were (136.00 ± 16.62) and (79.49 ± 6.42).After knockdown MDM2,the invasiveness of cells was significantly decreased (P ＜ 0.05).The results of CCK-8 showed that the proliferation of MGC803 cells transfected with miR-758-3p group was significantly lower than that of miR-NC group (P ＜ 0.01).Conclusion miR-758-3p can reduce the invasion and proliferation of MGC803 cells by targeting MDM2.
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Objective To investigate the accuracy of the new trauma scoring method:Glasgow coma score (GCS),age and systolic pressure score (GAP),in diagnosing patients' traumatic condition and predicting fatality rate in department of emergency.Methods The chnical data of 27 706 traumatic patients in department of emergency were collected.The observation was categorized into three kinds:death within 24 h after reaching department of emergency (24 h death);death from 24 h after reaching department of emergency to 7 d (death after 24 h);survival.On the basis of the trauma mechanism,GCS,age and systolic pressure score (MGAP),the GAP method was used for judging traumatic condition and predicting fatality rate of traumatic patients in department of emergency.The accuracy of GAP in predicting fatality rate was compared with revised trauma score (RTS),trauma and injury severity score (TRISS) and MGAP.The C-statistics method was used to calculate the accuracy in predicted the fatality rate.Results The C values (0.936 and 0.961) of GAP in predicting fatality rate after 24 h and in 24 h were higher than RTS (0.917 and 0.958) and MGAP (0.920 and 0.950),but slightly lower than TRISS (0.950 and 0.970).The traumatic condition in GAP was defined in this way:severity 3-10 scores,moderation 11-18 scores,and slightness 19-24 scores.Conclusions The GAP is simple,practical and accurate in diagnosing patients' traumatic condition and predicting their fatality rate.It is helpful in physicians' decision of a proper treatment plan.
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The connection between male infertility and abnormal methylation of imprinted genes has attracted much attention. Some imprinted genes, e.g., H19, MEG3, MEST and SNRPN, are known to be related with male infertility. Abnormal imprinted information may influence sperm concentration, motility and morphology, but the mechanism is still unclear. Sperm genomic imprinting reconstruction and erase respectively occur at the time of spermatogenesis and before embryo transfer. Many studies have shown that the probability of imprinting disorder syndrome of offspring born through assisted reproductive technology (ART) was significantly higher, leading to the worry about the safety of ART and speculation that the operation and in vitro environment may affect sperm imprinted information, which in turn may lead to imprinting diseases in the offspring. However, above connection still lacks convincing evidence. This paper has conducted a literature review of recent literature and explored the impact of abnormal methylation of imprinted genes on male fertility and the offspring.
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Humans , Male , Genomic Imprinting , Infertility, Male , Genetics , Proteins , Genetics , RNA, Long Noncoding , Genetics , Reproductive Techniques, AssistedABSTRACT
Wide range of disorders ranging from genetic disorders to coital difficulties can influence male fertility. In this regard, genetic factors are highlighted as the most frequent, contributed to 10-15%, of male infertility causes. To investigate the influence of genetic abnormalities on semen quality and reproductive hormone levels of infertile men from Northeast China. 2034 infertile men including 691 patients with abnormal sperm parameters were investigated retrospectively. Semen analysis was performed according to the World Health Organization guidelines. Y chromosome micro deletions were detected by polymerase chain reaction assays. Chromosome analysis was performed using G-banding. The incidence of abnormal chromosomal karyotype in the patients with abnormal sperm parameters was 12.01% [83/691]. The most frequent cause was Klinefelter's syndrome 37.35% [31/83]. As the same as chromosomal abnormalities group, the volumes of testes [p=0.000 and 0.000, respectively] and the levels of testosterone [T] [p=0.000], and testosterone/ luteinizing hormone [T/LH] [p=0.000] of patients with Y chromosome micro deletions were significantly lower than those of fertile group. In addition, the levels of follicle-stimulating hormone [FSH] [p=0.000], and luteinizing hormone [LH] [p=0.000] were significantly higher in patients with Y chromosome micro deletions than those in the fertile group. Translocation abnormalities displayed slight effect on sperm motility. Y chromosome micro deletions and sex chromosome disorders particularly Klinefelter's [47, XXY], have severe adverse influence on normal hormone levels, testicular volume and sperm count, whereas translocation abnormalities may inversely correlate with sperm motility
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Objective To investigate the predictive value of abnormal multiples of the median (MoM) of second trimester maternal serum triple screening (STMSTS) markers for adverse pregnancy outcomes.Methods 16 000 singleton pregnancies at 15+0 to 20+6 weeks' gestation who underwent STMSTS between July 2010 and January 2013 in the First Hospital of Jilin University were recruited.Maternal serum AFP,free β-hCG (F-β-hCG) and unconjugated estriol (uE3) levels were measured using time-resolved fluoroimmunoassay,and then convened to MoM.LifeCycle 3.2 software was used to calculate risk,and a risk value greater than 1 in 270 or 1 in 350 was considered as high risk for trisomy 21 syndrome (Down syndrome,DS) and trisomy 18 syndrome (Edwards syndrome,ES),respectively.MoM of AFP more than 2.5was considered high risk for open neural tube defect (ONTD).Amniocentesis and karyotyping,ultrasound screening were advised for high risk women.AFP,F-β-hCG higher than 2.0 MoM or uE3 lower than 0.5MoM was considered as abnormal,respectively.The MoM of STMSTS marker between women with adverse pregnancy outcome and with normal outcome was compared.Results (1) The median MoM of AFP,F-β-hCG and uE3 was 0.91 MoM,0.94 MoM and 1.05 MoM,respectively.Of the 16 000 pregnant women,there was no statistical difference in the median MoM of triple screening marker at different weeks of gestation (P＞0.05).The positive rate of DS,ES and ONTD in women ≤35 years old (n=14 972) was 4.03％ (603/14 972),0.36％(54/14 972) and 0.29％(44/14 972) respectively.And in women＞35 years old(n=1 028),the positive rate was 24.51％ (252/1 028),1.95％ (20/1 028) and 0.78％ (8/1 028),respectively.There was a statistically significant difference of positive rate between the two groups(P＜0.05).(2) 9 cases of DS,1 case of ES and 1 ease of ONTD were found in the high risk group,and 2 cases of DS in the low risk group.The detection rate of DS,ES and ONTD was 9/11,1/1 and 1/1 respectively; and the positive predictive value was 1.05％(9/855),1.35％(1/74) and 1.92％(1/52),respectively.(3)The incidence of adverse outcome (group 1) was 1.49 ％(239/16 000).7 760 pregnant women in this study were healthy during pregnancy,so were their fetuses (group 2).There were significant differences in the age at delivery,body weight and markers' MoM of STMSTS between the two groups(P＜0.01).(4) In group 1,the rate of abnormal MoM of AFP or F-β-hCG was 7.95％(19/239) and 23.85％ (57/239),and the abnormal rate of MoM of uE3 was 4.18％(10/239).The rate of two abnormal MoM of markers was 5.02％(12/239); the rate that all three MoM were abnormal was 0.84％(2/ 239).However,in group 2,the rate of two abnormal MoM of markers was 0.14 ％(11/7 760); and the rate that all three MoM were abnormal was 0.There was a significant difference of abnormal MoM of maternal serum marker between the two groups (P＜0.01).Conclusions There is a relationship between abnormal marker of STMSTS and adverse outcomes.STMSTS show a high value in the detection of DS,ES and ONTD.
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Objective To study the relationship between Y chromosome abnormalities and AZF microdeletions in males with reproductive failure.Methods A case-control study was conducted in 2694 reproductive failure men with age ranges from 23 to 49 years old from the Institute of Reproductive Medicine of Jilin Province.Patients were divided into three groups:spermatogenic failure group (n =1332),disadvantage pregnancy outcomes group (n =994) and adverse birth outcomes group.All patients underwent chromosomal karyotype analysis (G-banding).AZF microdeletions were further investigated in patients with Y chromosomal abnormalities by PCR.The Chi-square test was used to compare the frequency of Y chromosome abnormalities in three groups.Results Of the 51 cases of Y chromosome abnormalities (1.89％,51/2694),32 were (2.40％,32/1332) in the spermatogenic failure group,15 were (1.51％,15/994) in disadvantage pregnancy outcomes group and 4 were (1.09％,4/368) in adverse birth outcomes group.There was no significant difference in Y chromosome abnormalities among different groups (x2 =3.895,P ＞0.05).AZF microdeletions were detected in 10 cases (19.61％,10/51) of Y chromosome abnormalities patients with spermatogenic failure.Conclusions The incidence of Y chromosomal abnormalities in three reproductive failure groups is similar.Chromosome karyotype analysis and AZF microdeletions examination could identify the genetics etiology in males with reproductive failure.
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Objective To describe different types of chromosomal abnormalities on male infertility.Methods From May 2006 to May 2012,2034 infertile males with genetic counseling underwent chromosome karyotype analysis,semen routine examination and reproductive hormones levels detection.The data from them were analyzed.Results 267 cases of chromosomal abnormalities were detected in 2034 cases (13.13％).258 cases underwent semen routine examination in 267 cases with chromosomal abnormalities,of which 190 cases of azoospermia,58 cases of oligozoospermia,10 cases of semen normal.In 267 cases of chromosomal abnormalities,including 169 cases (63.30％) of number abnormalities,mainly with azoospermia,157 cases of Klinefelter syndrome (KS) (58.80％),7 cases of 47,XYY (2.62％),4 cases of Turner syndrome (1.50％),1 case of marker chromosome (0.37％) ; 49 cases (18.35％) of structural abnormalities mainly with oligozoospermia,including 32 cases of chromosomal translocations (11.99％),17 cases of inversion (6.37％) ; 4 cases of sex reversal (1.50％) with azoospermia; 45 cases of chromosome polymorphism (16.85％) mainly with oligozoospermia.Non-mosaicism KS patients' age,testicular volume,semen volume,and serum reproductive hormones levels were compared between different groups of semen results,and there were no significant difference except age.Conclusions Chromosome abnormalities were the most important genetic causes of abnormal semen quality and male infertility.It is necessary to be performed chromosome karyotype analysis for infertile males.