Maternal and fetal/neonatal outcomes of pregnancies complicated by pulmonary hypertension: a retrospective study of 154 patients

Abstract Objectives: To determine the main clinical and demographic outcomes related to Pulmonary Hypertension (PH) and adverse obstetric and fetal/neonatal outcomes. Methods: This study retrospectively analyzed the medical record data of 154 patients with PH who were admitted to the Third Affiliated Hospital of Guangzhou Medical University between January 2011 and December 2020. Results: According to the severity of elevated Pulmonary Artery Systolic Pressure (PASP), 82 women (53.2%) were included in the mild PH group, 34 (22.1%) were included in the moderate PH group, and 38 (24.7%) were included in the severe PH group. There were significant differences in the incidence of heart failure, premature delivery, Very-Low-Birth-Weight (VLBW) infants, and Small-for-Gestational-Age (SGA) infants among the three PH groups (p < 0.05). Five (3.2%) women died within 7-days after delivery, 7 (4.5%) fetuses died in utero, and 3 (1.9%) neonates died. The authors found that PASP was an independent risk factor for maternal mortality. After adjustment for age, gestational weeks, systolic blood pressure, Body Mass Index (BMI), mode of delivery, and anesthesia, the risk of maternal mortality in the severe PH group was 20.21 times higher than that in the mildmoderate PH group (OR = 21.21 [95% CI 1.7~264.17]), p < 0.05. All 131 (85.1%) patients were followed up for 12 months postpartum. Conclusions: The authors found that the risk of maternal mortality in the severe PH group was significantly higher than that in the mild-moderate group, highlighting the importance of pulmonary artery pressure screening before pregnancy, early advice on contraception, and multidisciplinary care.

A comparative study on the construction of medical teams in public primary and secondary schools after multi-channel distribution mode in Guangzhou / 中国学校卫生

Objective@#To understand the situation of school medical staff in Guangzhou after adopting multichannel medical model, and to provide reference for school medical team construction.@*Methods@#A total of 1 099 primary and secondary schools in Guangzhou participated in this study through questionnaire survey regarding school medical personnel, basic situation of school medical personnel and work situation.@*Results@#Among the 1 099 primary and secondary schools surveyed, 638(58.05%) of them consisted of 707 full-time school doctors, the eligible rate was 28.20%. The recruitment of school doctors was still based on independent recruitment(55.87%), and 44.13% of the purchase service modes (community deployment, hospital purchase services, and school clinic custody) were deployed. Most of school medical professionals majored in nursing(56.86%), followed by clinical medicine (26.03%) and preventive medicine (9.76%); In terms of professional titles, junior, intermediate and senior certificates accounted for 52.47%, 37.34%, and 1.27%, respectively; More than 68.74% of school doctors worked for less than 5 years; On average, 68.60% of training were provided every six months. About 33.95% of the school doctor were satisfied with salary, 20.79% were not satisfied. Compared with the year 2016, no significant changes were noticed in academic qualifications, professional titles, and working conditions of school medical team, however, increased proportion of staffs with nursing certificate instead of clinical medicine certificate increased, workload and satisfaction towards salary decreased(P<0.01).@*Conclusion@#After adopting the multi-channel deployment model, the construction of school health workforce in Guangzhou has made breakthrough progress. It is proposed to improve the guidelines for the standardization of school doctors, to strengthen the professional skills training of school doctors, and to better improve the overall level of school health work in the city.

Non-invasive Prenatal Diagnosis of Trisomy 21 by Dosage Ratio of Fetal Chromosome-specific Epigenetic Markers in Maternal Plasma / 华中科技大学学报（医学）（英德文版）

This study examined the methylation difference in AIRE and RASSF1A between maternal and placental DNA,and the implication of this difference in the identification of free fetal DNA in maternal plasma and in prenatal diagnosis of trisomy 21.Matemal plasma samples were collected from 388 singleton pregnancies,and placental or chorionic villus tissues from 112 of them.Methylation-specific PCR (MSP) and methylation-sensitive restriction enzyme digestion followed by fluorescent quantitative PCR (MSRE + PCR) were employed to detect the maternal-fetal methylation difference in AIRE and RASSF1A.Diagnosis of trisomy 21 was established according to the ratio of fetal-specific AIRE to RASSF1A in matemal plasma.Both methods confirmed that AIRE and RASSF1A were hypomethylated in maternal blood cells but hypermethylated in placental or chorionic villus tissues.Moreover,the differential methylation for each locus could be seen during the whole pregnant period.The positive rates of fetal AIRE and RASSF1A in maternal plasma were found to be 78.1％ and 82.1％ by MSP and 94.8％ and 96.9％ by MSRE + PCR.MSRE + PCR was superior to MSP in the identification of fetal-specific hypermethylated sequences (P＜0.05).Based on the data from 266 euploidy pregnancies,the 95％ reference interval of the fetal AIRE/RASSF1A ratio in maternal plasma was 0.33-1.77,which was taken as the reference value for determining the numbers of fetal chromosome 21 in 102 pregnancies.The accuracy rate in 98 euploidy pregnancies was 96.9％ (95/98).Three of the four trisomy 21 pregnancies were confirmed with this method.It was concluded that hypermethylated AIRE and,RASSF1A may serve as fetal-specific markers for the identification of fetal DNA in maternal plasma and may be used for noninvasive prenatal diagnosis of trisomy 21.

A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan

OBJECTIVE: The aim of this retrospective analysis was to determine the age, gender, frequency and distribution of trauma-associated hard tissue and soft tissue lesions of the oral and maxillofacial region in a population from southern Taiwan. PATIENTS AND METHODS: Approximately 10 percent of the 27,995 biopsy records of patients with history of trauma resulting in lesions who were treated at our institution between 1991 and 2006 were examined for this study. RESULTS: In the included records, there were 2,762 soft tissue and 26 hard tissue lesions. Mucocele was the most frequent trauma-associated soft tissue lesion (955 cases). The youngest patients were those who presented with mucocele (mean age = 27.3 years), while the oldest patients were those with peripheral giant cell granuloma (58 years). The lower lip was the most frequent site of occurrence of mucocele (676, 64.5 percent) and was also the predominant site of occurrence of all soft tissue lesions (815, 29.5 percent), followed by the buccal mucosa (654, 23.4 percent) and the tongue (392, 14.2 percent). Trauma-associated hard tissue lesions included only osteoradionecrosis (24 cases) and traumatic bone cysts (2 cases). CONCLUSION: As little data of this nature have been reported from populations of Asian developing countries, the findings of this retrospective analysis is valuable for epidemiological documentation of type of traumatic oral lesions as well as for informing the professionals and the layman about the importance of this category of oral lesions.