Résumé
Objective:To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China.Methods:Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women′s socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis.Results:A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95% CI: 4.5%－6.1%) and 13.1% (95% CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions:In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.
Résumé
Objective To investigate the effect of Astragalus membranaceus on the antioxidant capacity and liver and kidney function in patients with chronic schizophrenia and metabolic syndrome.Methods 110 cases of patients with chronic schizophrenia and metabolic syndrome were selected as subjects.They were randomly divided into the control group and the observation group by random number table method.Both groups were treated with routine antipsychotic drugs, and the observation group were additionally treated with Astragalus injection, once per day.10~14 d as a course of treatment, they were treated for a total of 6 courses.The antioxidant capacity and the liver and kidney function were compared between the two groups.The mental symptoms was evaluated with the positive and negative symptoms scale(PANSS).Results After treatment, the antioxidant capacity of the two groups was significantly increased while MDA was significantly decreased, and the changes were more obvious in observation group than the control group.After treatment, indexes of liver and kidney function were significantly increased.Except BUN and SUA, the other indicators were better in the observation group than the control group(P<0.05).After treatment, PANSS score (61.4±7.8)in the control group was significantly higher than that of the observation group(54.5±8.2)(P<0.05).Conclusion Astragalus membranaceus can be used as an assisted drug for treating chronic schizophrenia and metabolic syndrome.It can effectively improve the antioxidant capacity, reduce the damage to liver and kidney function and improve symptoms of mental illness, so as to improve the quality of life.
Résumé
Objective In vitro model with three dimensional cell culture provides the appealing biomimetic platform to probe the biological characteristics of multiple stem cells,which serves as an important in vitro tools to investigate regulating factors controlling the proliferation and differentiation of neural stem cells (NSCs).The present study aims to reconstruct an integrated poly-peptide hydrogel made extracellular matrix (ECM) enhanced with cyclo-RGD molecular [c(RGDfK)] for the exploration of NSCs bio-characteristics.Methods Spinal cords from one-d-old SD rats were collected and spinal-derived NSCs were induced in the complete medium; immunofluorescence staining was employed to observe the NSCs morphology and identify NSCs.Three hydrogel including type Ⅰ collagen,self-assembly poly-peptide nanofiber hydrogel (SAPNH) of RADA16 and RADA16-c(RGDfK) were employed to serve as culturing ECM of spinal-derived NSCs to mimic the ex vivo 3-D culturing.With the theological analysis,cyto-morphological observation was performed,NSCs proliferation was observed by MTT assay,and cell immunochemistty and confocal microscopy were employed to detect the NSCs differentiation.Results SAPNH born appropriate elastic module conducive to the cellular adhesion and proliferation of neural cells (RADA16 and RADA16-c (RGDfK)=(0.42±0.07) kPa and (0.47 ±0.09) kPa,without significant difference (P＞0.05); however,the elastic module in the type Ⅰ collagen group was (0.87±0.12) kPa,which was significantly stronger than the two groups (P＜0.05).Uniform distribution of neuron-shape cells was noted in the extracellular matrix ofRADA16-c (RGDfK) cells,with almost the diameter of cell sphere (200-300 μm); cells in the RADA16 and RADA16-c (RGDfK) had better growth characteristics than the other two groups; RADA16-c(RGDfK) had significantly better cellular adhesion and proliferation of neural cells as compared with RADA16 and collagen groups (P＜0.05).A large number of neural precursor cells differentiated into neurogliocytes was noted in the RADA16 group and RADA16-c (RGDfK) group,with low proportion of neuronal differentiation (17.6％ ±3.1％ and 19.0％±3.6％,respectively); this proportion of neuronal differentiation was significantly higher than that in the type Ⅰ collagen group (10.6％±2.3％,P＜0.05).Conclusions The functionalized SAPNH enhanced with c(RGDfK) presents the excellent biocompatibility and promotes the adhesion and proliferation of spinal NSCs.Serving as the engineered cellular vector,functionalized SAPNH has laid a solid foundation for the studies of neural regeneration and repair with novel neuro-engineering techniques in the subsequent researches.
Résumé
Objective To investigate the surgical strategy for degenerative lumbar scoliosis (DIS)and evaluate the clinical results of the posterior correction and fusion technique. Methods From May 2003 to May 2009,27 patients with DIS were treated posterior operation. All the patients were performed posterior laminectomy,spinal fusion and correction with pedicle screws system. Among the patients, 18 cases with posterolateral bone grafting,9 cases complicated spondylolishesis with PLIF intervertebral combined with posterolateral fusion. Results All the cases were followed up for a minimum of 12 months and 88.9% (24/27) of them had excellent or good outcome, Oswestry score was(21.54 ± 1.95 )%;22 cases were followed up for 24 months and showed a rate for excellent or good results of 86.4%( 19/22),and Oswestry score was (24.26 ± 2.32)%. Oswestry scores of the postoperative 12,24 months were lower than that before operation (57.83 ± 2.71 )%. There was statistical difference in the cases preoperation and postoperation. Correction of scoliosis of the coronal plane was 47.2%. Preoperative lumbar lordosis was augmented from 23.6°± 8.3° to 43.8°± 9.1°. One case complicated with wound infection during perioperation period, and 2 eases with heart diseases. The screw of 1 case was loosening at 3 months postoperation. Conclusion Decompressing thoroughly and improving lumbar lordosis, the operation of posterior correction and bone graft fusion shows good results for degenerative lumbar scoliosis.