Anomalía de Ebstein: a propósito de un caso

La anomalía de Ebstein es una cardiopatía congénita rara y poco frecuente caracterizada por el adosamiento de los velos valvulares tricuspídeos; en la etapa prenatal se estima que su incidencia corresponde a un 3% de todas las cardiopatías diagnosticadas. Se presenta el caso de un feto con diagnóstico de anomalía de Ebstein a quien se le realizó un diagnóstico prenatal adecuado, lo que permitió planificar el nacimiento neonatal con un equipo multidisciplinario integral. Debido a la rareza del diagnóstico prenatal de esta entidad, se describe el caso clínico y los hallazgos imagenológicos representativos.

Ebsteins anomaly is a rare and infrequent congenital heart disease characterized by the attachment of the tricuspid valve leaflets; in the prenatal stage it is estimated that its incidence corresponds to 3% of all diagnosed heart diseases. We present the case of a fetus diagnosed with Ebsteins anomaly who underwent an adequate prenatal diagnosis, which made it possible to plan the neonatal birth with a comprehensive multidisciplinary team. Due to the rarity of the prenatal diagnosis of this entity, the clinical case and the representative imaging findings are described.

Meta-analysis of the efficacy and safety of Saccharomyces boulardii versus Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea / 中国药房

OBJECTIVE To compare the efficacy and safety of Saccharomyces boulardii and Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CBM， Wanfang data， CNKI and VIP， randomized controlled trials （RCTs） about S. boulardii （S. boulardii group） versus Bifidobacterium triple liver bacteria （Bifidobacterium group） were collected. After screening the literature， extracting data and evaluating the quality， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 9 RCTs were included， involving 898 patients. Results of meta-analysis showed there was no statistical significance in total response rate [OR＝1.69， 95%CI （0.93， 3.09）， P＝0.09]， duration of diarrhea [MD＝－1.39， 95%CI （－3.35， 0.57）， P＝0.16]， the time of abdominal pain disappearance [MD＝0.09， 95%CI（－0.87， 1.05），P＝0.86] or the incidence of adverse reactions [OR＝0.65， 95%CI （0.05， 8.03）， P＝0.74]. The number of stools in S. boulardii group was significantly less than Bifidobacterium group [MD＝－0.91， 95%CI （－1.80， －0.02）， P＝0.04]. The results of subgroup analysis showed that the duration of diarrhea in children with antibiotic-associated diarrhea in S. boulardii group was significantly shorter than Bifidobacterium group （P＜0.05）. CONCLUSIONS The efficacy and safety of S. boulardii are similar to those of Bifidobacterium in the treatment of diarrhea， but S. boulardii is better than Bifidobacterium in terms of stool number， the duration of diarrhea in children with antibiotic-associated diarrhea.

Low BMI is Associated with Poor OI-IUI Outcomes in Patients with Unexplained Primary Infertility / 中山大学学报(医学科学版)

ObjectiveTo evaluate the effect of women's body mass index （BMI） on pregnancy outcomes of ovulation induction intrauterine insemination （OI-IUI） in patients with unexplained primary infertility. MethodsThe study included 764 OI-IUI cycles from January 2016 to December 2022 in reproductive center of Sun Yat-sen Memorial Hospital. According to BMI，patients were divided into three groups：low BMI （BMI<18.5 kg/m2）， normal BMI （18.5 kg/m2 ≤BMI＜23.0 kg/m2）， and high BMI （BMI≥23.0 kg/m2）. Comparison of clinical data and pregnancy outcomes was performed between the groups. Logistic regression was used to analyze the association between BMI and live birth rate. ResultsFrom the low BMI group to the high BMI group， the HCG positive rate （7.08%，9.74%， 13.19%）， clinical pregnancy rate（5.51%， 7.91%， 13.19%）， and live birth rate （4.72%， 6.90%， 12.50%） increased. Among them， the live birth rate of the high BMI group was significantly higher than that of the low BMI group and the normal BMI group， with a statistically significant difference （P=0.034）. While the early miscarriage rate （14.28%， 10.26%， 5.26%） decreased from the low BMI group to the high BMI group. The binary logistic regression analysis revealed that BMI was an independent factor in live birth， and high BMI resulted in a better live birth rate than low BMI （OR=3.15，95%CI=1.191-8.329，P=0.021）. ConclusionLow BMI is associated with poor OI-IUI outcomes in patients with unexplained primary infertility. These patients are encouraged to gain weight in a healthy manner.

A comparison of pre- and post-operative outcomes in living donors undergoing transperitoneal laparoscopic nephrectomy and open nephrectomy: a retrospective single-center study

ABSTRACT BACKGROUND: Kidney transplantation is often regarded as the preferred therapy for end-stage renal disease. Several surgical procedures have been developed to reduce postoperative donor complications, while maintaining kidney quality. OBJECTIVE: This study aimed to compare the preoperative and postoperative outcomes of living kidney donors who underwent either transperitoneal laparoscopic nephrectomy or open nephrectomy. DESIGN AND SETTING: Retrospective study conducted in Istanbul, Turkey. METHODS: Fifty-five living-related kidney donors underwent nephrectomy and were retrospectively divided into two groups: 21 donors who underwent open nephrectomy (Group 1) and 34 donors who underwent transperitoneal laparoscopic nephrectomy (Group 2). RESULTS: In comparison to the donors who underwent open nephrectomy, those who underwent transperitoneal laparoscopic nephrectomy had significantly shorter postoperative hospital stays (2.3 ± 0.2 versus 3.8 ± 0.8 days, P = 0.003), duration of urinary catheterization (1.2 ± 0.8 days versus 2.0 ± 0.7 days, P = 0.0001), operating times (210 ± 27 minutes versus 185 ± 24 minutes, P = 0.02), and less blood loss (86 ml versus 142 ml, P = 0.048). There was no statistically significant difference between the two groups with regard to the estimated blood transfusion and warm ischemia time. The preoperative week, first postoperative week, and 1-month postoperative serum creatinine levels were comparable between the groups. CONCLUSIONS: Laparoscopic donor nephrectomy can be safely performed at centers with expertise in laparoscopic surgery. Laparoscopic donor nephrectomy has better outcomes than open donor nephrectomy in terms of length of hospital stay, duration of urinary catheterization, operating time, and blood loss.

Evaluación de la calidad de las estadísticas vitales de niños menores de cinco años. Colombia, 2000-2018

Introducción: Las estadísticas vitales son fundamentales para conocer las condiciones de salud de la población y diseñar intervenciones. De su calidad depende la precisión y validez de las métricas derivadas y la relevancia de las decisiones de política pública. Objetivo: Evaluar la calidad de las estadísticas vitales de niños menores de cinco años en Colombia, entre 2000 y 2018. Métodos: Estudio descriptivo y exploratorio. Se analizó la calidad de los registros de nacidos vivos y defunciones publicados por el DANE, utilizando los criterios recomendados por las Naciones Unidas: exactitud (precisión), cobertura (compleción) y oportunidad. Resultados: Se encontraron registros de nacimientos y defunciones con datos perdidos en categorías que indican gradiente social. El 8,2 % de los registros de defunción tenían como causa básica de muerte códigos poco útiles para la toma de decisiones en salud pública. El 97,8 % de los nacidos vivos fueron registrados durante el mismo año de ocurrencia. El subregistro de la mortalidad infantil se estimó en un 28,9 %, con diferencias entre territorios. Conclusiones: La calidad de las estadísticas vitales en niños menores de cinco años de Colombia mejoró en los 19 años evaluados, en particular en exactitud y oportunidad. Sin embargo, persisten problemas en la asignación de la causa básica de muerte y en el subregistro, con diferencias importantes entre territorios. Mejorar la calidad del sistema de estadísticas vitales debe ser un imperativo ético, en especial para comprender las poblaciones de áreas geográficas históricamente invisibilizadas en el país.

Introduction: Vital statistics are essential to identify the health conditions of a population and design interventions. Vital statistics are essential to understand population health and design public health interventions. The accuracy and validity of the derived metrics and the relevance of public policy decisions depend on its quality. Objetive: To evaluate the quality of the vital statistics of children under five years of age in Colombia, between 2000 and 2018. Methods: A descriptive and exploratory study was carried out and the quality of records of live births and deaths published by DANE was analyzed using the criteria suggested by the United Nations: accuracy (precision), opportunity, and coverage (completeness). Results: Of the death records, 8.2% show codes useless for public health purposes as underlying cause of death. Of the live births, 97.8% were registered during the same year of occurrence. We estimated the underregistration of infant mortality at 28.9%, with differences between territories. Conclusions: The quality of vital statistics of children under five years of age has improved in Colombia in the 19 years analyzed, particularly in accuracy and opportunity. However, problems persist in assigning the underlying cause of death and in underregistration, with significant differences between territories. Improving the quality of the vital statistics system must be an ethical imperative, especially to understand the populations of geographic areas historically invisible in the country.

Tendência temporal de nascidos prematuros no estado de Santa Catarina entre 2011 e 2021 / Temporal trend of premature birth in the state of Santa Catarina between 2011 and 2021

Objetivo: Analisar a tendência temporal de nascimentos prematuros no estado de Santa Catarina entre 2011 e 2021. Métodos: Estudo observacional ecológico de tendência temporal realizado com informações do banco de dados do Sistema de Informação sobre Nascidos Vivos do estado de Santa Catarina (2011-2021), disponibilizado pela Diretoria de Vigilância Epidemiológica. Foram analisados todos os nascidos vivos prematuros segundo o ano de processamento e o local de residência em Santa Catarina (110.422). Foram incluídos os nascidos vivos de gestação com menos de 37 semanas completas. As taxas de nascimentos prematuros foram calculadas proporcionalmente à totalidade de nascimentos e calculadas segundo macrorregião, idade materna, número de consultas do pré-natal, instrução materna e cor de pele. Para o cálculo da tendência temporal, foi utilizada a regressão linear simples, com intervalo de confiança de 95% (p ≤ 0,05). Resultados: A taxa média de nascimentos prematuros no estado de Santa Catarina foi de 10,57%, com tendência estável (p < 0,001). Maiores taxas específicas foram encontradas nas macrorregiões Meio Oeste e Serra e Planalto Norte e Nordeste (11,46%), extremos de idade (10-14 anos e 45-64 anos) e menor escolaridade. Maior número de consultas de pré-natal apresentou taxa de prematuridade menor (7,69%). Tendências crescentes das taxas foram apenas encontradas na macrorregião Grande Oeste, faixa etária materna entre 40-44 anos e entre 4-6 consultas de pré-natal. Conclusão: A tendência da taxa de prematuridade manteve-se estável em Santa Catarina. Baixo número de consultas de pré-natal, extremos de idades e baixa escolaridade mostraram taxas maiores de prematuridade. (AU)

Objective: Analyzing the temporal trend of premature births in the state of Santa Catarina between 2011 and 2021. Methods: Observational ecological temporal trend study carried out with information from the database of the Information System on Live Births in the state of Santa Catarina (2011-2021), made available by the Epidemiological Surveillance Directorate. All premature live births were analyzed according to the year of processing and place of residence in Santa Catarina (110,422). Live births of less than 37 completed weeks were included. The rates of premature births were calculated in proportion to the total number of births and calculated according to macro-region, maternal age, number of prenatal consultations, maternal education and skin color. Simple linear regression was used to calculate the temporal trend, with a confidence interval of 95% (p ≤ 0.05). Results: The average rate of premature births in the state of Santa Catarina was 10.57%, with a stable trend (p < 0.001). Higher specific rates were found in the Midwest and Serra, North Plateau and Northeast macro-regions (11.46%), age extremes (10-14 years and 45-64 years) and lower schooling. A greater number of prenatal consultations had a lower prematurity rate (7.69%). Increasing trends in rates were only found in the Grande Oeste macro-region, maternal age group between 40-44 years and between 4-6 prenatal consultations. Conclusion: The prematurity rate trend remained stable in Santa Catarina. Low number of prenatal consultations, extremes of age and low education showed higher rates of prematurity. (AU)

Vaccination in children with immune-mediated disorders

Abstract Objective: To present an updated review of recommendations for the vaccination of children with immune-mediated diseases, with an emphasis on rheumatic and inflammatory diseases. Source of data: Studies published in the PubMed and Scielo databases between 2002 and 2022, Guidelines of Brazilian Scientific Societies, Manuals and Technical Notes of the Ministry of Health of Brazil, on current immunization schedules for special populations. Data synthesis: Immunosuppressive drugs and biological agents reduce the immunogenicity of vaccines and favor susceptibility to infections. The safety and efficacy of immunogens are important points for vaccination in children with immune-mediated diseases. The safety threshold of a vaccine applied to immunocompromised individuals can be reduced when compared to healthy individuals. Very often, the recommendations for the immunization of children with immunemediated diseases follow the recommendations for immunocompromised patients. Vaccination against COVID-19, on the other hand, should ideally occur when the disease is stabilized and in the absence of a low degree of immunosuppression. The patients should be informed about the possibility that the immunization may fail during treatment with immunosuppressants. Specific vaccination schedules should be considered to ensure better protection. Conclusions: Recent studies have allowed updating the recommendations on the safety and immunogenicity of vaccination in children with immune-mediated diseases, especially for live attenuated vaccines. There is a scarcity of data on the safety and efficacy of COVID-19 vaccines in patients, particularly pediatric patients, with rheumatic diseases. The completion of ongoing studies is expected to help guide recommendations on COVID-19 vaccines in this group of patients.

Anticancer potential of Solanum lycopersicum L. extract in human lung epithelial cancer cells A549

The study aimed to reveal the phytochemical profile, free radical scavenging potential, and anticancer activity of Solanum lycopersicum L. leaf extract (SLLE). According to the study, SLLE contains plant secondary metabolites that are beneficial for health, like phenolics, flavonoids, ascorbic acid, alkaloids, and terpenoids. The SLLE has shown potential free radical scavenging potential in DPPH and ABTS free radical scavenging analysis and its EC50 values (concentration required to inhibit 50% of free radicals) were determined as 481.29 ± 33.82 and 527.56 ± 20.34 µg/mL, respectively. The SLLE has the ability to scavenge free radicals and could be used to treat illnesses brought on by oxidative stress. The anticancer activity of SLLE was assessed by MTT, LDH, micro-morphological, live/dead dual staining, and caspase-3 analysis. In the MTT assay, the IC50 value (concentration required to inhibit 50% of cell viability) of SLLE was determined as 190.41 ± 4.77 µg/mL. Furthermore, SLLE has shown potential anticancer activity by adversely affecting the plasma membrane integrity and escalating the caspase-3 levels. In the biomedical field, SLLE could be highly useful to treat cancer.

Doppler de la arteria oftálmica: un modelo para predicción de preeclampsia / Ophthalmic artery Doppler: a model for the prediction of preeclampsia

Resumen ANTECEDENTES: En México, la preeclampsia sigue siendo un problema de salud pública; en la actualidad es la principal causa de muerte materna. Su incidencia es de 47.3 casos por cada 1000 nacimientos. La preeclampsia trae consigo repercusiones en la madre y el feto; de ahí la necesidad de la validación de modelos de tamizaje efectivos que permitan su diagnóstico oportuno. La evaluación Doppler de la arteria oftálmica sigue siendo motivo de diversas investigaciones porque aporta información valiosa de los cambios hemodinámicos intracraneales que suceden, incluso, antes del curso sintomático de la enfermedad. OBJETIVO: Analizar las recomendaciones emitidas por diferentes autores que han evaluado la utilización del Doppler de la arteria oftálmica como modelo de tamizaje para la predicción y diagnóstico tempranos de preeclampsia. METODOLOGÍA: Estudio retrospectivo basado en la búsqueda exhaustiva en diferentes bases de datos de metanálisis y estudios clínicos aleatorizados que describieran, detalladamente, la población estudiada y los parámetros de la arteria oftálmica evaluados. RESULTADOS: Se identificaron 22 publicaciones y en el cribado se excluyeron 8 artículos que estaban duplicados, 2 por no cumplir con los criterios de inclusión y 1 por encontrarse en otro idioma diferente al inglés; al final se revisaron 11 títulos y para complementar el tema de estudio se revisaron otros 60 artículos. CONCLUSIONES: La evaluación mediante Doppler de la arteria oftálmica es un examen simple, rápido, reproducible, seguro y no invasivo que puede incorporarse a la predicción y diagnóstico temprano de pacientes con alto riesgo de preeclampsia.

Abstract BACKGROUND: Preeclampsia remains a public health problem in Mexico and is currently the leading cause of maternal death. Its incidence is 47.3 cases per 1000 live births. Pre-eclampsia has consequences for the mother and the fetus, so there is a need to validate effective screening models for early diagnosis. Doppler assessment of the ophthalmic artery continues to be studied because it provides valuable information on intracranial hemodynamic changes that occur before the symptomatic course of the disease. OBJECTIVE: To analyze the recommendations of different authors who have evaluated the use of ophthalmic artery Doppler as a screening model in the prediction and early diagnosis of pre-eclampsia. METHODOLOGY: Retrospective study based on the search exhaustive search of different databases of meta-analyses and randomized clinical trials describing in detail the population studied and the ophthalmic artery parameters evaluated. RESULTS: Twenty-two publications were identified and after screening, 8 articles were excluded as duplicates, 2 for not meeting the inclusion criteria and 1 for being in a language other than English; finally, 11 titles were reviewed, and another 60 articles were reviewed to complement the study topic. CONCLUSIONS: Doppler evaluation of the ophthalmic artery is a simple, rapid, reproducible, safe, and noninvasive test that can be used to evaluate the ophthalmic artery.

The effect of sperm DNA fragmentation on in vitro fertilization outcomes of unexplained infertility

Abstract Background Infertility is caused by heterogeneous risks, but most of them are unexplained. The sperm DNA Fragmentation Index (DFI) was increasingly acknowledged as a parameter for the evaluation of male infertility. This study aimed to investigate the association between sperm DFI and laboratory and clinical outcomes in a population with unexplained infertility. Methods The clinical data of an infertile population was collected for the selection of reproductive patients with unexplained infertility. The authors classified the patients with normal sperm parameters in a control group (DFI < 25%) and an observation group (DFI ≥ 25%) and compared the difference in basal characteristics, laboratory, and clinical outcomes between the two groups. The authors conducted a correlation analysis to examine the relationship between DFI and the number of D3 good-quality embryos, as well as the clinical pregnancy rate and live birth rate. A total of 176 cases were enrolled in the retrospective study. Results The observation group (n = 88) showed advanced male age, lower sperm concentration, progressive motility, and morphology assessment than the control group. In addition, lower No. of D3 good-quality embryos, clinical pregnancy rate, and the live birth rate were shown in the observation group. A negative correlation between the DFI and No. of D3 good-quality embryos (rs = -0.347, p < 0.001) or live birth rate (rs = -0.185, p = 0.028) was shown. Conclusions Sperm DFI was a good indicator for the prediction of D3 good-quality embryos in unexplained infertility couples, but it did not provide sufficient information regarding clinical pregnancy outcome but live pregnancy outcome.

Procedimiento clínico-quirúrgico en una paciente embarazada con una derivación urológica compleja. Reporte de un caso / Clinical-surgical approach in a pregnant patient with complex urological diversion. A case report

Resumen ANTECEDENTES: El mielomeningocele es el defecto del tubo neural más frecuente; se registra un caso por cada 1000 nacidos vivos. Es más frecuente en mujeres, que resultan con secuelas discapacitantes, entre ellas las urológicas. Pueden subsanarse con diferentes técnicas quirúrgicas y derivaciones urológicas complejas que las predispone a infecciones de vías urinarias de repetición y, cuando hay embarazo, complicaciones materno-fetales y dificultad para el acceso quirúrgico, en caso de cesárea. CASO CLÍNICO: Paciente con 14 semanas de embarazo, 27 años de edad, con diagnóstico de mielomeningocele y vesicoplastia, con múltiples infecciones urinarias y ruptura de membranas pretérmino. Finalización del embarazo por cesárea a las 33 semanas, por indicación de las condiciones fetales. La técnica de la cesárea se modificó para no dañar la cistoplastia y evitar complicaciones con las adherencias en la pelvis. CONCLUSIONES: El mejor pronóstico materno-fetal en pacientes con derivación urológica compleja se consigue con la búsqueda intencionada de infecciones urinarias y tratamiento oportuno y adecuado, además de una planificación multidisciplinaria al momento de la finalización del embarazo.

Abstract BACKGROUND: Myelomeningocele is the most common neural tube defect; one case per 1000 live births is reported. It is more frequent in females, resulting in disabling sequelae, including urological sequelae. They can be corrected with different surgical techniques and complex urological derivations that predispose them to repeated urinary tract infections and, when there is pregnancy, maternal-fetal complications and difficulty for surgical access, in case of cesarean section. CLINICAL CASE: Patient 14 weeks pregnant, 27 years old, diagnosed with myelomeningocele and vesicoplasty, with multiple urinary tract infections and preterm rupture of membranes. Termination of pregnancy by cesarean section at 33 weeks, due to fetal conditions. The cesarean section technique was modified so as not to damage the cystoplasty and to avoid complications with adhesions in the pelvis. CONCLUSIONS: The best maternal-fetal prognosis in patients with complex urologic diversion is achieved with the intentional search for urinary tract infections and timely and adequate treatment, in addition to multidisciplinary planning at the time of termination of pregnancy.

Avaliação da completude dos dados do sistema de informação sobre nascidos vivos de imigrantes e brasileiros no estado do Paraná, 2014-2019 / Evaluation of the completeness of data in the information system on live births of immigrants and brazilians in the state of Paraná, 2014-2019 / Evaluación de la completitud de los datos del sistema de información sobre nacidos vivos de inmigrantes y brasileños en el estado de Paraná, 2014-2019

Avaliar a completude dos dados no SINASC do Paraná, entre 2014 a 2019, de imigrantes e brasileiros. Método: Estudo transversal, retrospectivo, de análise de completude dos dados de nascimento do ano de 2014 a 2019 no estado do Paraná. Foram critérios de análise: excelente (menos de 5% de incompletude); bom (5% a 10%); regular (10% a 20%); ruim (20% a 50%); e muito ruim (acima de 50%). Resultados: Foram registrados no Brasil 948.316 nascidos vivos, dos quais 935.629 eram de mães brasileiras e 12.867 de mães imigrantes de diversas nacionalidades. Dentre as variáveis, os campos incompletos de mães brasileiras somaram 50.243 (5,37%) e de imigrantes 696 (5,41%), demonstrando um bom preenchimento do banco. Conclusão: Foi possível verificar que o banco de dados SINASC mostrou-se confiável e com baixas incompletudes entre os anos de 2014 a 2019 no estado do Paraná, independente da naturalidade da mãe. Porém, dados incompletos referentes às imigrantes ainda são maiores comparados aos de mulheres brasileiras, podendo ser resultado de uma falta de capacitação dos profissionais da saúde para a comunicação com as mães imigrantes que não falam a língua nativa, não coletando os dados de forma adequada e completa.

To evaluate the completeness of data in the SINASC of Paraná, from 2014 to 2019, of immigrants and Brazilians. Method: Cross-sectional, retrospective study, of analysis of completeness of birth data from the year 2014 to 2019 in the state of Paraná. Analysis criteria were: excellent (less than 5% incompleteness); good (5% to 10%); fair (10% to 20%); bad (20% to 50%); and very bad (above 50%). Results: In Brazil, 948,316 live births were registered, of which 935,629 were from Brazilian mothers and 12,867 from immigrant mothers of various nationalities. Among the variables, the incomplete fields of Brazilian mothers totaled 50,243 (5.37%) and of immigrants 696 (5.41%), de- monstrating a good completion of the bank. Conclusion: It was possible to verify that the SINASC database proved to be reliable and with low incompleteness between the years 2014 to 2019 in the state of Paraná, regardless of the mother's naturality. However, in- complete data referring to immigrants are still higher compared to those of Brazilian wo- men, which may be the result of a lack of training of health professionals for communi- cation with immigrant mothers who do not speak the native language, not collecting the data properly and completely.

Evaluar la completitud de datos en el SINASC de Paraná, de 2014 a 2019, de inmigrantes y brasileños. Método: Estudio transversal, retrospectivo, de análisis de completitud de datos de nacimiento del año 2014 a 2019 en el estado de Paraná. Los criterios de análisis fueron: excelente (menos de 5% de incompletitud); bueno (5% a 10%); regular (10% a 20%); malo (20% a 50%); y muy malo (más de 50%). Resultados: En Brasil se registraron 948.316 nacidos vivos, de los cuales 935.629 eran de madres brasileñas y 12.867 de madres inmigrantes de diversas nacionalidades. Dentre as variá- veis, os campos incompletos de mães brasileiras somaram 50.243 (5,37%) e de imigrantes 696 (5,41%), demonstrando um bom preenchimento do banco. Conclusão: Foi possível verificar que o banco de dados SINASC mostrou-se confiável e com baixa incompletudes entre os anos de 2014 a 2019 no estado do Paraná, independentemente da naturalidade da mãe. Sin embargo, los datos incompletos referidos a las inmigrantes siguen siendo más altos en comparación con los de las mujeres brasileñas, lo que puede ser el resultado de la falta de formación de los profesionales de la salud para la comunicación con las madres inmigrantes que no hablan el idioma nativo, no recogiendo los datos de forma adecuada y completa.

Adaptação e validação de Índice de Qualidade de Vida para gestantes brasileiras / Adaptation and validity of the Quality of Life Index for Brazilian pregnant women / Adaptation and validity of the Quality of Life Index for Brazilian pregnant women / Adaptación y validación del Índice de Calidad de Vida para mujeres embarazadas brasileñas

Resumo Objetivo Adaptar e validar o Índice de Qualidade de Vida de Ferrans & Powers para gestantes brasileiras. Métodos Estudo metodológico. A versão brasileira Índice de Qualidade de Vida de Ferrans & Powers para gestantes tem 36 itens e quatro domínios. A validação de conteúdo foi realizada por comitê de juízes. Na etapa de validação foi testada a consistência interna, a validade de constructo convergente e discriminante e a dimensionalidade. Nível de significância 5%. Resultados Cinco juízes participaram do comitê. O índice de validade de conteúdo foi de 0,94 e a maioria dos itens apresentou coeficiente de validade de conteúdo por item acima de 0,80. Participaram da etapa de validação 280 gestantes.O alfa de Cronbach foi de 0,94 para o escore total com variação de 0,78 a 0,89 entre os domínios A correlação de Pearson entre o Índice de Qualidade de Vida de Ferrans e o WHOQOL-Bref foi positiva e forte (0,79; p<0,001). A validade de constructo discriminante não revelou diferenças estatisticamente significante. A análise fatorial confirmatória revelou que o modelo de quatro domínios se ajusta ao modelo. Conclusão A versão adaptada do Índice de Qualidade de Vida de Ferrans mostrou-se confiável e válida para aplicação em gestantes, mostrando-se uma ferramenta promissora para profissionais de saúde e pesquisadores na identificação da Qualidade de vida de gestantes.

Resumen Objetivo Adaptar y validar el Índice de Calidad de Vida de Ferrans & Powers para mujeres embarazadas brasileñas. Métodos Estudio metodológico. La versión brasileña del Índice de Calidad de Vida de Ferrans & Powers para mujeres embarazadas tiene 36 ítems y cuatro dominios. La validación de contenido fue realizada por un comité de jueces. En la etapa de validación se probó la consistencia interna, la validez de constructo convergente y discriminante y la dimensionalidad. Nivel de significación del 5 %. Resultados Cinco jueces participaron del comité. El índice de validez de contenido fue de 0,94 y la mayoría de los ítems presentó un coeficiente de validez de contenido por ítem superior a 0,80. En la etapa de validación participaron 280 mujeres embarazadas. El alfa de Cronbach fue de 0,94 para el puntaje total con variación de 0,78 a 0,89 entre los dominios. La correlación de Pearson entre el Índice de Calidad de Vida de Ferrans y el WHOQOL-Bref fue positiva y fuerte (0,79; p<0,001). La validez del constructo discriminante no reveló diferencias estadísticamente significativas. El análisis factorial confirmatorio reveló que el modelo de cuatro dominios se ajusta al modelo. Conclusión La versión adaptada del Índice de Calidad de Vida de Ferrans demostró ser confiable y válida para su uso en mujeres embarazadas y demostró ser una herramienta promisora para profesionales de la salud y para investigadores en la identificación de calidad de vida de mujeres embarazadas.

Abstract Objective To adapt and validate the Ferrans and Powers Quality of Life Index for Brazilian pregnant women. Methods This is a methodological study. The Ferrans and Powers Quality of Life Index for pregnant women, Brazilian version, has 36 items and four domains. Content validity was performed by a committee of judges. In the validity stage, internal consistency, convergent and discriminant construct validity and dimensionality were tested. Significance level 5%. Results Five judges participated in a committee. The Content Validity Index was 0.94 and most items had a content validity coefficient per item above 0.80. A total of 280 pregnant women participated in the validity stage. Cronbach's alpha was 0.94 for the total score, ranging from 0.78 to 0.89 between the domains. Pearson's correlation between the Ferrans and Powers Quality of Life Index and the WHOQOL-Bref was positive and strong (0.79; p<0.001). Discriminant construct validity did not reveal statistically significant differences. Confirmatory factor analysis revealed that the four-domain model fits the model. Conclusion The Ferrans and Powers Quality of Life Index, adapted version, proved to be reliable and valid for use in pregnant women, proving to be a promising tool for health professionals and researchers to identify pregnant women's quality of life.

Reflection on the regulatory path for online sales of Chinese medicinal materials in the context of live streaming / 中国药房

OBJECTIVE To provide feasible regulatory paths for the online sales supervision of Chinese medicinal materials from the perspective of the characteristics of new online sales and the characteristics of Chinese medicinal materials. METHODS Through the investigation of the sales form of Chinese medicinal materials on the e-commerce platform and the search of Chinese medicinal materials online dispute cases， the difficulties and existing problems in the supervision of Chinese medicinal materials under the new online sales model were analyzed， and corresponding countermeasures were proposed. RESULTS & CONCLUSIONS Clarifying the conceptual boundary between Chinese medicinal materials and their decoction pieces， agricultural products and food is the key to standardizing the online sale of Chinese medicinal materials. The regulatory criteria， which determine whether Chinese medicinal materials belong to drug management based on whether they had been included in medicinal channels， didn’t consider the diversity of online sales channels for Chinese medicinal materials， their safety and the disguised sales of Chinese herbal decoction pieces. It is necessary to establish the concept of hierarchical management of Chinese medicinal materials， strictly restrict the behavior of claiming the efficacy of Chinese medicinal materials and selling Chinese herbal decoction pieces in live streaming， improve the defining path of false propaganda of Chinese medicinal materials， implement the responsibilities and obligations of live streaming marketing subjects and platforms， and safeguard the legitimate rights of consumers.

Safety analysis of children of different ages vaccinated with measles, mumps and rubella combined attenuated live vaccine/measles and rubella combined attenuated live vaccine in Jilin Province from 2015 to 2022 / 中国生物制品学杂志

@#Objective To analyze the safety of children of different ages vaccinated with measles,mumps and rubella combined attenuated live vaccine(MMR in brief)/measles and rubella combined attenuated live vaccine(MR in brief)in Jilin Province from 2015 to 2022.Methods The actual vaccination data of MMR and MR from January 1,2015 to December 31,2022 were collected through the Jilin information management system for immunization programming,and all AEFI case information reported after vaccination with MMR and MR in this period was collected through the national adverse event following immunization(AEFI) monitoring and reporting system.The incidence rates of AEFI reports were compared among8-month-old children vaccinated with the first dose of MMR(MMR 8 group) and MR(MR8 group),18-month-old children vaccinated with the first dose of MMR(vaccinated with MR at 8 months old,MMR18-1 group) and the second dose of MMR(vaccinated with the first dose of MMR at 8 months old,MMR18-2 group) to preliminarily evaluate the safety of children vaccinated with MMR and MR at different ages.Results The reported incidence of AEFI in MMR8,MR8,MMR18-1 and MMR18-2 groups were 374.41/100 000,350.81/100 000,101.70/100 000 and 104.91/100 000,respectively,with significant difference among the four groups(χ~2=1 145.47,P=0.00);There was no significant difference between MMR8 and MR8,as well as MMR18-1 and MMR18-2 groups(χ~2=3.780 and 0.194,respectively,each P> 0.05);There were significant differences between MMR8 and MMR18-1,MMR8 and MMR18-2,as well as MR8 and MMR18-1groups(χ~2=920.440,412.110 and 1 021.120,respectively,each P=0.00).Most of the adverse reactions were general reactions,mainly fever,local redness and induration;A few were abnormal reactions,which were mainly allergic reactions(rash,papules,urticaria,etc.).Only one case of coincidence was reported in MMR8 group,and no psychogenic reaction,vaccine quality accident and vaccination accident occurred.All AEFI turned out to be improved or cured.Conclusion The differences of AEFI reported incidence of 8-month-old children vaccinated with MMR and MR were all small,and the difference of AEFI reported incidence of 18-month-old children vaccinated with the second dose of MMR was small regardless of the initial vaccination with MMR or MR.It is safe to use MMR instead of MR for the first vaccination in8-month-old children.

Screening and safety evaluation of heat-resistant protective agents for live classic swine fever vaccine / 中国生物制品学杂志

@#Objective To screen the formulation of heat-resistant protective agent for live classic swine fever(CSF) vaccine in order to prolong the preservation time of vaccine under harsh conditions.Methods The heat-resistant protective agent prepared based on the formula containing gelatin,D-sorbitol,trehalose,D casein hydrolysate of different contents was mixed with the live virus antigen of CSF and then lyophilized.The finished products with qualified appearance were screened for routine detection and aging resistance test,and the over-dose(10 and 30 portions) of the products qualified in the aging resistance test were used to immunize piglets via subauricular neck,5 for each to evaluate the safety of the vaccines.Results Among the 6 batches of lyophilized live CSF vaccine,3 batches(20200301,20200302 and 20200303) met the requirements of the current Chinese Veterinary Pharmacopoeia.The lyophilized loss was within 0.04～0.33 titers,and the moisture contents were all less than 2%;20200301 and 20200302 batches of finished products passed the aging resistance test.No adverse clinical symptoms were observed in all piglets 30 min after vaccination;The body temperatures of piglets vaccinated with 10 and 30 doses of vaccine were normal for 14 d after vaccination.Conclusion The two formulations of heatresistant protective agent selected might be used for freeze-dried preparations of live CSF vaccine with good effect of aging resistance and safety to piglets.

Effects of methyl methanesulfonate and UV sensitive gene clone 81 on hepatocellular carcinoma cells / 中华肝胆外科杂志

Objective:To detect the expression of methyl methanesulfonate and UV sensitive gene clone 81 (Mus81) in hepatocellular carcinoma(HCC) and to observe the effects of Mus81 on the migration, invasion and metastatic ability of human HCC cells.Methods:Thirty-two tissue specimens were selected from HCC tissues and corresponding paraneoplastic tissues of patients with HCC who underwent surgical resection in Guangzhou Red Cross Hospital Affiliated to Jinan University from January 2020 to June 2021. The expression levels of Mus81 in 32 HCC specimens, 374 HCC samples from the cancer genome atlas database, human normal liver cell line HL-7702 and human HCC cell lines JHH-7, Huh-7 and Hep3B were analyzed. Mus81 knockdown in JHH-7, Huh-7 and overexpressed in Hep3B HCC cell lines were constructed, and the effects of Mus81 on HCC cells were observed by scratch assay, Transwell migration and invasion assay and tail vein injection transfer assay in nude mice.Results:The expression of Mus81 was higher in HCC tissues or cell lines than which in paraneoplastic tissues or normal hepatocyte lines (all P<0.05). The migration rate, metastatic and invasive cell numbers of Mus81-knockdown Huh-7 HCC cells were 22.24%±2.16%, 49.04±5.62, 3.81±1.08, the negative control group were 26.89%±1.15%, 86.81±4.79, 19.78±3.30, and the differences between the two groups were statistically significant ( t=4.24, 26.59, 23.92, all P<0.01). The migration rate, metastatic and invasive cell numbers of Mus81-overexpressed Hep3B HCC cells were 80.57%±5.12%, 18.74±8.07, 33.81±8.44, which were significantly higher than those of the empty vector group 64.17%±7.20%, 10.96±5.32, 3.04±1.13, and the differences were statistically significant ( t=4.15, 4.18, 18.78, all P<0.01). Tail vein transfer experiments in nude mice showed that the total fluorescence expression, weight of metastatic tumors, and the metastatic rates in kidney, vertebral column, neck, axilla and subcutis in nude mice injected with Mus81-knockdown JHH-7 cells were significantly lower than those in the control group (all P<0.05). Conclusion:Mus81 gene expression is upregulated in HCC and promotes the migration, invasion and metastatic ability of HCC cells, suggesting that Mus81 may be a potential therapeutic target for HCC.

Research on the online teaching practice of Chinese traditional medicine based on the model of "Chaoxing learning platform + live broadcasting" / 中华医学教育探索杂志

Taking the course of Chinese traditional medicine as an example, this paper discusses the construction and implementation effect of online teaching mode from the following four aspects: online teaching curriculum design, teaching implementation, teaching effect evaluation, and teaching reflection, with a view to providing beneficial reference for the follow-up hybrid teaching and promoting the construction of hybrid first-class courses by summarizing the experience of online teaching.

Effects of paternal age on pregnancy outcomes in frozen-thaw embryo transfer cycles / 现代泌尿外科杂志

【Objective】 To observe the effects of paternal age on the pregnancy outcomes in frozen embryo transfer (FET) cycles. 【Methods】 The clinical data of two groups after propensity score matching (PSM) were retrospectively analyzed, including 738 cycles in the 0.05). The clinical pregnancy rate (52.2%vs. 67.2%) and live birth rate (41.1% vs. 57.2%) decreased in the 40-60 year group compared with those in the 0.05). 【Conclusion】 Advanced paternal age decreases clinical pregnancy rate and live birth rate.

Effects of live attenuated measles vaccine Hu191 strain on epithelial mesenchymal transition,proliferation and migration of 4T1 breast cancer cells / 中国生物制品学杂志

@#Objective To investigate the effects of live attenuated measles vaccine Hu191 strain(MV-Hu191)on epithelial mesenchymal transition(EMT),proliferation and migration of 4T1 breast cancer cells.MethodsCCK-8 and clone formation assay were used to analyze the effect of MV-Hu191 on the proliferation of 4T1 cells;The effect of MV-Hu191 on 4T1cell migration was analyzed by cell scratch test;The expression of EMT pathway proteins(MMP-2,MMP-9,E-cadherin)in4T1 cells was detected by Western blot;4T1 tumor-bearing mouse model was established in female BALB/c mice. The model mice were divided into control group(PBS),MV-Hu191(1 × 106TCID50)group and paclitaxel group(15 mg/kg),with 10 mice in each group,and injected into tumor at the dosage of 100 μL every 2 d for 5 times. At 28 d after administration,the effects of MV-Hu191 on survival time,tumorigenicity and metastasis in vivo were observed;The pathological characteristics of lung tissue and tumor tissue were observed by HE staining under microscope;The expression of EMT pathway proteins(MMP-2,MMP-9 and E-cadherin)in tumor tissue was detected by immunohistochemical staining.Results The results of in vitro experiment showed that,compared with the control group,MV-Hu191 inhibited the proliferation and migration of 4T1 cells(F = 2. 811 and 13. 535,P = 0. 001 and 0. 002,respectively),down regulated the expression of MMP-2 and MMP-9(F = 45. 433 and 9. 744,P = 0. 011 and 0. 038,respectively),and up regulated the expression of Ecadherin(F = 7. 001,P = 0. 032);The results of in vivo experiment showed that MV-Hu191 significantly prolonged the survival time of tumor-bearing mice,and decreased the tumor quality(F = 8. 301,P = 0. 003)and the number of pulmonary nodules metastasis compared with the control group(F = 33. 792,P = 0. 000);MV-Hu191 treated tumor tissue gap was small,the cells were round,and the alveolar contour was clearly visible;The expression of MMP-2 and MMP-9 in MVHu191 treated tumor tissue decreased significantly(F = 6. 705 and 9. 047,P = 0. 028 and 0. 023,respectively),while the expression of E-cadherin increased significantly(F = 3. 468,P = 0. 039).ConclusionMV-Hu191 signi-ficantly inhibits the proliferation and migration of 4T1 breast cancer cells,antagonizes the tumorigenicity and lung meta-stasis of 4T1 tumorbearing mice,and prolongs the survival time of mice. The possible mechanism of MV-Hu191 against breast cancer is closely related to the regulation of EMT pathway protein expression.