Association of interpregnancy interval and risk of adverse pregnancy outcomes in woman by different previous gestational ages / 中华医学杂志(英文版)

BACKGROUND@#With an increasing proportion of multiparas, proper interpregnancy intervals (IPIs) are urgently needed. However, the association between IPIs and adverse perinatal outcomes has always been debated. This study aimed to explore the association between IPIs and adverse outcomes in different fertility policy periods and for different previous gestational ages.@*METHODS@#We used individual data from China's National Maternal Near Miss Surveillance System between 2014 and 2019. Multivariable Poisson models with restricted cubic splines were used. Each adverse outcome was analyzed separately in the overall model and stratified models. The stratified models included different categories of fertility policy periods (2014-2015, 2016-2017, and 2018-2019) and infant gestational age in previous pregnancy (<28 weeks, 28-36 weeks, and ≥37 weeks).@*RESULTS@#There were 781,731 pregnancies enrolled in this study. A short IPI (≤6 months) was associated with an increased risk of preterm birth (OR [95% CI]: 1.63 [1.55, 1.71] for vaginal delivery [VD] and 1.10 [1.03, 1.19] for cesarean section [CS]), low Apgar scores and small for gestational age (SGA), and a decreased risk of diabetes mellitus in pregnancy, preeclampsia or eclampsia, and gestational hypertension. A long IPI (≥60 months) was associated with an increased risk of preterm birth (OR [95% CI]: 1.18 [1.11, 1.26] for VD and 1.39 [1.32, 1.47] for CS), placenta previa, postpartum hemorrhage, diabetes mellitus in pregnancy, preeclampsia or eclampsia, and gestational hypertension. Fertility policy changes had little effect on the association of IPIs and adverse maternal and neonatal outcomes. The estimated risk of preterm birth, low Apgar scores, SGA, diabetes mellitus in pregnancy, and gestational hypertension was more profound among women with previous term births than among those with preterm births or pregnancy loss.@*CONCLUSION@#For pregnant women with shorter or longer IPIs, more targeted health care measures during pregnancy should be formulated according to infant gestational age in previous pregnancy.

Analysis of hypertension in the Chinese elderly population with hypertension / 中华老年医学杂志

Objective:To assess the prevalences of hypertension, rates of medication recommendations and failure rates of blood pressure(BP)control in Chinese elderly patients(≥65 years old).Methods:We used data from the 2011 China Health and Nutrition Survey(CHNS). A total of 2, 391 Chinese adults aged≥65 years with complete information comprising BP measurements repeated three times and antihypertensive medication use were included for analysis.Results:The mean age of subjects was 72.6±6.2 years, and females accounted for 53.1%.The numbers of patients with hypertension were 1784(74.6%)and 1221(51.1%)according to the definitions from 2017 ACC/AHA guideline and the 2010 Chinese guideline, respectively.There was a significant difference in the prevalence of hypertension in the subgroup with a cardiovascular disease(CVD)history according to the definitions from the two guidelines( χ2=23.70, P<0.01). The BP thresholds for drug therapy recommendations were the same as those set in the diagnostic criteria of hypertension based on the two guidelines.Therefore, the rates for medication recommendations were 74.6% and 51.1%, respectively.The numbers of patients with BP above the target levels were 622(88.2%)and 346(49.1%), respectively, according to the definitions from the two guidelines.There was no significant difference in failure rate of BP control due to age( χ2=5.36, P>0.05), gender( χ2=0.12, P>0.05)or a CVD history( χ2=0.07, P>0.05)according to analyses using the definitions from the two guidelines. Conclusions:Compared with the 2010 Chinese hypertension guideline, the prevalence of hypertension and rate of medication recommendations are higher in the Chinese elderly population when the 2017 ACC/AHA hypertension guideline is used.Hypertension management and antihypertensive drug treatment should be reinforced to improve the control rate of hypertension.

Biological characteristics and dopaminergic neural-like cell differentiation potential of human amniotic membrane-derived mesenchymal stem cells / 中国组织工程研究

BACKGROUND:Human amniotic membrane-derived mesenchymal stem cells (AMSCs) are considered to be one kind of adult stem cells that can be easily obtained in large quantities without using an invasive method. Because of their low immunogenicity, anti-inflammatory properties, multipotency of differentiation and without ethical issue, human amniotic membrane-derived mesenchymal stem cells have been proposed as a good candidate to be used in celltherapy and regenerative medicine. However, the biological properties and the differentiation capacity of human amniotic membrane-derived mesenchymal stem cells are stil poorly characterized. OBJECTIVE:To establish a practical method for isolation and purification of human amniotic membrane-derived mesenchymal stem cells, and to study the biological characteristics and dopaminergic neural-like celldifferentiation potential of the human amniotic membrane-derived mesenchymal stem cells. METHODS:Human amniotic membrane-derived mesenchymal stem cells were disassociated and isolated from the amniotic membrane by trypsin and col agenase based enzymic digestion, and purified by percol mediated density gradient centrifugation. Expressions of surface antigens and transcription factors of the human amniotic membrane-derived mesenchymal stem cells were determined by flow cytometry and western blot assays. Based on the osteogenic and adipogenic induction, the multipotent differentiation capability of human amniotic membrane-derived mesenchymal stem cells was determined. Induction of neural celldifferentiation of human amniotic membrane-derived mesenchymal stem cells was conducted in Neurabasal conditioning medium with ATRA supplement. Neural cellassociated bio-markers were determined by immunofluoresence staining and confocal microscope. RESULTS AND CONCLUSION:In this study, we performed a practical method to isolate and purify human amniotic membrane-derived mesenchymal stem cells and amniotic epithelial cells simultaneously, with high cells yield. We demonstrated a group of constitutive expressions of neural antigens and embryonic associated transcription factor proteins (OCT-4, SOX-2 and KLF4) in fresh isolated human amniotic membrane-derived mesenchymal stem cells as wel as in human amniotic membrane-derived mesenchymal stem cells after in vitro passage, which suggested that the human amniotic membrane-derived mesenchymal stem cells not only possessed intrinsic tendency to neural celldifferentiation, but also maintained their stem cellcharacteristics after in vitro passage. We stimulated the human amniotic membrane-derived mesenchymal stem cells in the neurobasal-A and B27 based conditioning medium to induce neural celldifferentiation. The induced human amniotic membrane-derived mesenchymal stem cells displayed an up-regulation of expression in panel of neural and dopaminergic associate molecules (β-tubulin III, neuron-specific nuclear protein, tyrosine hydroxylase, glial fibril ary acidic protein, myelin basic protein and nestin) by flow cytometry and immunofluorescence staining, which demonstrated the multipotent differentiation capability and dopaminergic neuron-like differentiation potential of the human amniotic membrane-derived mesenchymal stem cells.

Intratumoral relative perfusion rate and the relation between MVD and expression of VEGF assessed with power Doppler imaging: in bladder carcinoma / 中国医学影像技术

Objective To evaluate the relationship between relative perfusion rate assessed with power Doppler imaging (PDI) and microvessel density (MVD), as well as expression of vascular endothelial growth factor (VEGF) in bladder carcinoma. Methods The transrectal ultrasound (TRUS) blood flow signal of bladder carcinoma was preoperatively detected with color Doppler imaging in 45 patients, and the relative perfusion rates were obtained for analysis. MVD and the expression of VEGF of excised tumor were assessed immunohistochemically. Results There were correlation between relative perfusion rate and MVD, the expression of VEGF. MVD and the expression of VEGF were related to pathologic grade and the invasiveness of tumor tissues. The expression of VEGF in bladder carcinoma was positively correlated to the tumor interstitial vascular density. Conclusion Combination of PDI and immunohistochemical parameters is useful for evaluating the angiogensis of bladder carcinoma from a different point of view.

AN OBSERVATION OF THE THERAPEUTIC EFFECTS ON 126 CASES OF DUODENAL BULBAR ULCER BY COMBINED TREATMENT WITH OMEPRAZOLE AMOXIL AND EPIDERMAL GROWTH FACTOR / 中华消化内镜杂志

Observe under endoscope the effect s of raising effective rate on the treatment of duodenal bulbar ulcers by the addition of epidermal growth factor. The control group , 1 08 cases , was randomized from 234 cases of active duodenal bulbar ulcer. Oral omeprazole , 20 mg , in the murning , and amoxil , 0. 5g , t. i. d. were administered for 4 weeks. The treatment group , 1 26 cases , in addition to the above mentioned 2 drugs , epidermal growth factor , 20 ml ( 40?g) , was added orally each morning for 4 weeks , followed by en- doscopy. The therapeutic effect of treatment group was better than that of the control with very significant difference. The effective rate of control group was 84 . 26% , and that of the treatment group , 96. 03% , X~2 = 9. 82 ,P