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OBJECTIVE@#To explore the factors for the failure of non-invasive prenatal testing (NIPT) through multifactorial unconditional Logistic regression analysis.@*METHODS@#A total of 3 410 pregnant women who had visited Dalian Women and Children Medical Group from July 2019 to June 2020 were selected as the study subjects and divided into first success NIPT group (n = 3 350) and first failed group (n = 60). Clinical data including age, weight, body mass index (BMI), gestational week, type of pregnancy (singleton/twin), history of delivery, heparin treatment, and conception method [natural conception/assisted reproductive technology (ART)] were collected. Independent sample t-test and Chi-square test were carried out for comparing the two groups, and multi-factorial unconditional Logistic regression analysis was carried out to explore the factors for the failure of NIPT, and receiver operating characteristic curve (ROC) analysis was used to evaluate the diagnosis and predictive effects.@*RESULTS@#Among the 3 410 pregnant women, 3 350 were assigned to the first success NIPT group, and 60 were assigned to the first failed group, and the first-time failure rate was 1.76% (60/3 410). No significant difference was found in age, weight, BMI and method of conception between the two groups (P > 0.05). Compared with first success group, first failed group had lower sampling gestational weeks, lower proportion of women with previous history of delivery, and higher proportion of twin pregnancies and heparin treatment (P < 0.05). Multi-factorial unconditional Logistic regression analysis indicated that sampling gestational week (OR = 0.931, 95%CI: 0.845 ~ 1.026, P < 0.001) and history of heparin use (OR = 8.771, 95%CI: 2.708 ~ 28.409, P < 0.001) are independent factors for first failed NIPT. One-way unconditional Logistic regression analysis for sampling gestational weeks indicated that the regression equation for NIPT screening failure was Logit (P) = -9.867 + 0.319 × sampling gestational week, with the area under the ROC curve being 0.742, a Jordan index of 0.427, and a cutoff value of 16.36 weeks.@*CONCLUSION@#Gestational week and heparin treatment are independent factors for the first failed NIPT. A regression equation has been established and determined the optimal sampling gestational week to be 16.36 weeks, which may provide a reference for the timing of NIPT screening.
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Criança , Gravidez , Feminino , Humanos , Modelos Logísticos , Diagnóstico Pré-Natal/métodos , Gravidez de Gêmeos , Técnicas de Reprodução AssistidaRESUMO
21-hydroxylase deficiency(21-OHD) is mainly characterized by cortisol deficiency with or without aldosterone deficiency and hyperandrogenemia.The disease requires lifelong exogenous glucocorticoid/salt supplementation.Excessive doses of exogenous glucocorticoids are often needed to control hyperandrogenemia, but the effect is not satisfactory.Corticotropin releasing factor (CRF) type 1 receptor antagonist can directly block the production of adrenocorticotropin, inhibit the generation of adrenogenic androgen, reduce the dose of glucocorticoid therapy, and thus lower the incidence of adverse reactions.In this article, the current research progress on 21-OHD therapy and CRF1 receptor antagonist was reviewed.
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Ribosomal proteins (RP) are important components of ribosomes and play key roles in ribosome biogenesis and protein translation. In addition, ribosomal proteins also possess many extra-ribosomal functions, such as regulation of gene expression, cell proliferation, differentiation, apoptosis, DNA repair, and many other cellular processes. The dysfunction of RP is closely related to the occurrence and development of various diseases including blood, metabolism, cardiovascular diseases and tumors, and RP might become potential therapeutic targets for a variety of diseases. The research progress on RP, including the basic functions of RP, extra-ribosomal properties, and the connections with human diseases were reviewed and their potential as biomarkers and therapeutic targets in diseases were discussed in this paper.
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Under the background that the family doctor teams undertake the evaluation function of long-term care insurance for the elderlies living at home, it is imperative to further improve the efficiency of its integrated aging-medical care by strengthening the management. The Huacao community health service center and Hongqiao community health service center in Minhang District of Shanghai explored the construction of a family doctor′s home-based aging care management path, a practice launched since February 2021. This path was mainly designed with the entry criteria, management requirements for various services and evaluation indicators, with a service path form formulated on such basis. The form covered three stages: that before the on-site service, that on the day of the on-site service and that after the on-site service. Each stage was subdivided into three dimensions: the work content of the main aging-medical care, the key works of family doctors and the key works of assistant nurses. The implementation of this management path can enable such teams to provide further refined, standardized and procedural aging-medical care services, avoid service delays, improve service quality and management efficiency, and improve the utilization efficiency of health resources.
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Objective:To investigate the risk factors and establish a risk scoring system for bronchopulmonary dysplasia (BPD) in very and extremely preterm infants.Methods:From December 2013 to December 2018, 254 very and extremely preterm infants with less than 32 weeks of gestation hospitalized for 28 d and above in the Third Staff Hospital of Baotou Steel Group were retrospectively enrolled. According to the diagnostic criteria of BPD, they were divided into the BPD group ( n=129) or the non-BPD group ( n=125). Clinical data and the risk factors for BPD were analyzed with univariate t-test, Chi-square test, rank-sum test, and multivariate logistic regression analysis. Based on the results, the risk scoring system was evaluated by receiver operating characteristic (ROC) curve, sensitivity, and specificity. Results:Logistic regression analysis showed that gestational age, neonatal respiratory distress syndrome (NRDS), ventilator-associated pneumonia (VAP), and duration of ventilation >7 d were the risk factors for BPD (all P<0.05). When the area under the ROC curve was 0.868 (95% CI: 0.823-0.913, P<0.001) and the maximum Youden index was 0.644, the sensitivity of the scoring systems for BPD was 0.884 (95% CI: 0.812-0.931), and the specificity was 0.760 (95% CI: 0.674-0.830). Conclusions:Gestational age, NRDS, VAP, and prolonged duration of ventilation were the risk factors for BPD. The risk scoring system established has the prediction value on BPD in very and extremely preterm infants.
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Objective:To investigate the clinical effects of glycated hemoglobin, fasting blood glucose and serum C-peptide combined screening for gestational diabetes screening and its clinical significance.Methods:A total of 40 pregnant women with gestational diabetes mellitus (observation group) and 40 pregnant women (control group) in Peking University Medical Lu Zhong Hospital from January 2016 to September 2019 were enrolled. The changes of glycated hemoglobin, fasting blood glucose, and serum C-peptide were compared between the two groups, and the efficacy of combined screening for gestational diabetes was evaluated.Results:The glycated hemoglobin of the pregnant women in the observation group was significantly higher than that in the control group [(8.12 ± 1.14)% vs. (5.23 ± 0.15)%], the serum C-peptide of the pregnant women in the observation group was lower than that in the control group [(1.19 ± 0.28) nmol/L vs. (1.61 ± 0.22) nmol/L], and there were significant differences ( P<0.05). There was no significant difference in fasting blood glucose between the two groups ( P>0.05). When glycosylated hemoglobin, fasting blood glucose and serum C-peptide index was screened combinedly, the sensitivity, specificity, positive predictive value, negative predictive value and the areas under the receiver operation characteristic (ROC) curve were 98.65%, 86.50%, 88.42%, 95.45%, and 0.943, respectively. Compared with all other individual indicators, the difference was statistically significant ( P<0.05). Conclusions:The combined detection of glycosylated hemoglobin, fasting blood glucose and serum C-peptide can more accurately diagnose gestational diabetes mellitus at an early stage.
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OBJECTIVE： To study the effects of glycyrrhizic acid on the pharmacokinetics of nifedipine in rats. METHODS： Rats were randomly divided into experimental group and control group， with 10 rats in each group. Experimental group was given glycyrrhizic acid 5 mg/kg and control group was given 0.5％ CMC-Na （sodium carboxymethylcellulose） solution， once a day， for 14 consecutive days. On 14th day after 30 min of intragastric administration， both groups were given nifedipine 3 mg/kg intragastrically. Blood samples 0.5 mL were collected from intraocular vein plexus before and at 0.25， 0.5， 0.75， 1， 1.5， 2， 3， 4， 6， 8， 12 and 24 h after intragastric administration. The concentration of nifedipine was determined by HPLC using diazepam as internal standard. The determination was performed on ODS-C18 column with mobile phase consisted of methanol-water （62 ∶ 38， V/V，pH adjusted to 4.5 with acetic acid） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃. The detection wavelength was set at 238 nm， and sample size was 20 μL. The pharmacokinetic parameters were calculated with Winonlin 6.0 software， and statistical analysis was performed by t-test. RESULTS： The main pharmacokinetic parameters of the experimental group and the control group were as follows as tmax was （1.40±0.15）， （1.50±0.01） h； cmax was （0.15±0.03）， （0.29±0.09） mg/L； t1/2 was （4.70±1.17）， （5.20±1.38） h； AUC0-24 h were （1.00±0.10）， （1.89±0.37） mg·h/L； AUC0-∞ was （1.00±0.16）， （1.98±0.32） mg·h/L； MRT was （6.76±0.64）， （6.60±1.36） h， respectively. Compared with control group， cmax， AUC0-24 h and AUC0-∞ of nifedipine were decreased significantly in experimental group， with statistical significance （P＜0.05）. CONCLUSIONS： Glycyrrhizic acid can reduce the bioavailability of nifedipine in rats. It is suggested that the dosage of nifedipine should be increased in order to achieve effective blood concentration.
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A mathematical model of competition-type lateral flow immunoassay (LFIA) was developed to describe the dynamic process of LFIA.The competition-type LFIA was divided into two categories: TwA-competition-type LFIA and TnA-competition-type LFIA.On the basis of the developed model, the COMSOL software was exploited to simulate the dynamic process of LFIA.The simulation result demonstrated the relationships between the concentrations of substances on the test and control lines and the influence factors.In particular, the influence factors in the TwA-competition-type LFIA included the concentrations of target analyte A (0-20 mol/L) and reporter particle P (0.01-100 mol/L), and the position of the test line (5-20 mm).On the other hand, the influence factors in the TnA-competition-type LFIA included the concentrations of target analyte A (0-20 mol/L) and reporter particle P (0.01-100 mol/L), and the porosity.Experiment result showed that the developed model could be used to explore the influence of the parameters on the test results, and optimize the performance of LFIA.
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Objective To investigate the gene expression change of TNF-α,IL-6 and IL-1β at different time points in brain tissues of rats with cerebral ischemia reperfusion injury.Methods A total of 24 adult male SD rats were randomly divided into four groups:sham group and 3 groups with brain ischemia reperfusion of 3h,6h and 12h.Real-Time PCR was used to analyze the gene expression ofTNF-α,IL-6 and IL-1 β at 3h,6h,and 12h after reperfusion.Results In the sham group,the mRNA expression levels of TNF-α,IL-6 and IL-1 β in were low,but increased immediately after brain ischemia injury and decreased gradually thereafter.The gene expression of TNF-α mRNA at 3h after reperfusion was significantly increased and reached the peak (P ＜0.01) then significantly decreased at 12h after reperfusion.The gene expression of IL-6 mRNA was notably increased at 3h after reperfusion and peaked at 6h (P＜0.01),and significantly decreased at 12h compared with 6h (P＜0.01).The gene expression of IL-1 β mRNA at 3h after reperfusion was significantly increased,peaked at 6h (P＜0.01) and significantly decreased at 12h (P ＜0.01).Conclusion The gene expression levels of TNF-α,IL-6 and IL-1β mRNA increased significantly in the early stage of reperfusion and decreased gradually after reaching the peak,which suggested that the gene expression change of TNF-α,IL-6 and IL-1β was involved in the mechanism of cerebral ischemia reperfusion injury.
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Objective To evaluate the diffuse characteristics of two types of botulinum toxin type A (BOTOX and CBTX A) in the forehead and the effect of intradermal (ID) and subcutanous (SC) infections on their diffusion.Methods Healthy volunteers (n =20) were recruited to receive a 0.05 ml (2 U) injection of botulinum toxin type A at four forehead sites [both sides of medial forehead (SC) and temporal forehead (ID)],one side for BOTOX and another for CBTX-A.On day 14,the Minors' iodine starch test was performed and photographs were taken for calculating the area and dimensions of anhydrotic area.Results The areas of anhidrosis ID were significantly greater with CBTX-A (180±15) mm2 than that of BOTOX (144±14) mm2.The same conditions occurred in vertical dimensions (14.4±1.1) mm vs.(15.8±1.0) mm and horizontal dimensions (10.8±0.6) mm vs.(12.5±0.7) mm.There was significant variation between the both for diffuseness in the two anhidrotic halos observed after ID injection (P＜0.05).The areas of anhidrosis by SC were significantly greater with CBTX-A (207±17) mm2 than that in BOTOX (183±18) mm2.The mean horizontal dimension was greater with CBTX-A by SC (13.2±0.6) mm than that of BOTOX by SC (12.2±0.7) mm,but not statistically significant (P =0.06).The mean horizontal dimension in BOTOX was significantly greater with SC than that with ID (P＜0.05).There was no statistically significant difference between SC and ID administration of CBTX-A.Conclusions BOTOX diffuses less than CBTX-A.ID injection technique may result in less diffusion than SC.
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Objetive To explore bacteriological changes and susceptible factor of nosocomial infection in neonatal intensive care unit (NICU). Methods The clinical data from 5543 hospitalized neonates during January 2010 to December 2015 were retrospectively analyzed. Results Nosocomial infection rate during the study period was 8 . 75 %. The most common pathogen of nosocomial infection was Staphylococcus epidermidis, followed by Escherichia coli and Klebsiella pneumoniae. Respiratory infection accounted for 37.73% and blood infection 37.53%. 36.74% blood samples were tested to be positive, and 32.67% sputum were positive. In the first three years, the main pathogens of nosocomial infection were Candida albicans, Klebsiella pneumonia, and Staphylococcus aureus; in the last three years, the main pathogens were Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. The susceptible factors of nosocomial infection in NICU were gestational age?
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ObjectiveTo investigate the effect of follow-ups on medical compliance behaviors and quality of life of patients with gastroesophageal reflux disease (GERD).Methods One hundred GERD patients who were hospitalized in our department from June 2012 to June 2013 were divided into intervention group (n=50) and control group (n=50) according to the random number table. Both groups received the same drug treatment and conventional nursing during hospitalization.The control group received periodically outpatient follow-ups,while the intervention group received professional follow-ups by trained nurses after discharge from hospital. The compliance behaviors and quality of life in these patients were assessed and statistically analyzed after 6 months nursing intervention or outpatient follow-up.Results With the implement of follow-up in patients with GERD,the intervention group was better than the control group in compliance behaviors,including the decrement of smoking and drinking,strong tea,coffee,having midnight snack and spicy food (P<0.05),but there was no difference in the behavior of staying-up between the two groups.Concerning the quality of life,the intervention group was significantly better than the control group in the 6 items excluding the physical and physiological functions (P<0.05).Conclusion Professional follow-ups can improve compliance behavior and quality of life of GERD patients.
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Objective To analyze the changes of serum total bilirubin (TBil) and gamma glutamyltransferase (GGT) in patients with type 2 diabetes newly diagnosed without complications and explore their relationship with vascular complications of type 2 diabetes.Methods The levels of serum TBil and GGT were determined by automatic biochemical analyzer in 42 healthy person (control group),64patients with type 2 diabetes without complications (diabetes without complications group) and 81 patients with type 2 diabetes with vascular complications (diabetes with complications group).Results The levels of serum TBil and GGT were (7.89 ± 4.81) μ mol/L and (29.81 ± 14.97) U/L in diabetes with complications group.The level of serum TBil was (10.42 ± 3.55) μ mol/L in control group.The levels of serum TBil and GGT were (11.30 ± 4.16) μ mol/L and (47.00 ± 38.57) U/L in diabetes without complications group.The level of serum TBil in diabetes with complications group was lower than that in control group and diabetes without complications group (P ＜ 0.05).The level of serum GGT in diabetes with complications group was lower than that in diabetes without complications group (P ＜ 0.05).Pearson correlation analysis showed that 24-hour urinary protein excretion,urinary albumin creatinine ratio had negative correlation with serum TBil (P ＜0.05).Logistic regression analysis showed that GGT was the protective factor of diabetic vascular complications (OR =0.965).Conclusion The levels of serum TBil and GGT may be associated with the occurrence and development of vascular lesions in patients with type 2 diabetes.
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Objective To study the relationship between low birth weight and hemangioma, as well as the efficacy of dye laser alone and in combination with intralesional drugs in the treatment of cutaneous vascular anomalies. Methods A questionaire was designed and delivered to assess the health status of 209 children with hemangioma and 100 normal control children, as well as the situation of their mothers during pregnancy.Pulsed dye laser was utilized to treat capillary hemangioma, venular malformation, spider angioma and pyogenic granuloma, and pulsed dye laser plus intralesional drugs to manage mixed hemangioma, followed by evaluation of therapeutic efficacy. Results Low birth weight babies amounted to 33.49% in 209 children with hemangioma and 9% in normal controls (u = 4.621, P ＜ 0.05). The effective rate of pulsed dye laser was 83.69% for capillary hemangioma, 92.59% for venular malformation, 100% for spider angioma and 50% for pyogenic granuloma. An effective rate of 95.59% was observed for pulsed dye laser plus intralesional drugs in the treatment of mixed hemangioma. Conclusions Low birth weight has a close relationship with the development of hemangioma. A favorable efficacy has been observed for pulsed dye laser in the treatment of capillary hemangioma, venular malformation and spider angioma, and for pulsed dye laser plus intralesional drugs in the treatment of mixed hemangioma.
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Objective To study the effects of perinatal and postnatal cytomegalovirus(CMV) infection on infantile physical development and nerves mental growth. Methods We observed forty-eight cases of perinatal and postnatal CMV infection infants and twenty-two cases of non-CMV infected infants. We compared the physical development between two groups at birth ,3 months and 1 year of age, and evaluated development quotient (DQ) at 1 year of age. Results There were no significant differences of baby length,weight, head circumference between two groups at birth and 3 months (P > 0.05). The averages of baby length,weight,and head circumference were all in the normal range,which showed no significant differences between two groups(P > 0. 05). There were no significant differences in DQ of rough movement,accurate movement, adaptability, language and sociality ability between two groups at 1 year of age (P > 0.05). The averages of total DQ were in the normal range, which showed no significant difference between two groups as well (P > 0. 05). According to the evaluation hierarchies, DQ values of two groups were mostly in normal level range, and there also was no significant difference(x2 = 1. 026, P > 0. 05). Conclusion The perinatal and postnatal cytomegalovirus(CMV) infection has no significant adverse effects on infantile physical development and neuro-psychological development.
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Objective To explore the association between HLA-A and B alleles and alopecia areata.Methods HLA-A and-B alleles were studied by LABTypeTM SSO in 44 patients with alopecia areata and 200 healthy controls.Results The frequencies of HLA-A＊11（χ2=6.08,P 〈 0.05）,HLA-B＊13（χ2=29.80,P 〈 0.01）,HLA-B＊40（χ2=8.04,P 〈 0.01）,HLA-B＊46（χ2=5.86,P 〈 0.05）and HLA-B＊51（χ2=8.82,P 〈 0.01）alleles were significantly increased in alopecia areata patients compared with the control.Conclusion HLA-A＊11,HLA-B＊13,HLA-B＊40,HLA-B＊46 and HLA-B＊51 might be the susceptible alleles of the patients with alopecia areata.
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The effects of all-trans-retinoic acid (ATRA) administration on the concentration of retinoids (RA and vitamin A) in liver, oxidative stress and the hepatic injury in a rat model of com-mon bile duct ligation (CBDL)-induced liver injury were investigated. Female rats were subjected to a sham (n=5) or CBDL (n=48). Two weeks after operation, rats undergoing CBDL were randomized to receive treatment with either ATRA at three different doses (0.1, 1.5, 7.5 mg/kg) dissolved in bean oil or only bean oil every day over a 4-week experimental period. Rats were killed and blood samples were collected from the heart for determination of the serum transaminase. The contents of retinoids in rat liver were detected by using HPLC. Malondialdehyde (MDA), glutathione (GSH) and superox-ide dismutase (SOD) levels in liver were determined by a spectrophotometric method according to the instruction of the kits. Liver pathologic changes were observed under the light microscopy and electron microscopy. The results showed that compared with sham-operated group, the levels of reti-noids in the liver tissue were significantly decreased in the CBDL group (P<0.01). ATRA (0.1 mg/kg) administration in CBDL rats partially restored the contents of retinoids (P<0.05). Liver RA and vita-min A contents in CBDL group were significantly increased after ATRA (1.5 and 7.5 mg/kg) sup-plementation as compared with sham-operated group (P<0.05). However, in ATRA-treated CBDL group, hepatic GSH level and SOD activity, depressed by CBDL, and hepatic MDA level, increased by CBDL were returned to those in sham-operated group (P<0.05). The histologic observation of liver tissues indicated that ATRA treatment notably alleviated hepatocellular swelling, steatosis, the swelling of mitochondria and proliferation of smooth endoplasmic reticulum (SER). Treatment with ATRA could reduce levels of serum transaminase as compared with sham-operated group, more greatly in 1.5 and 7.5 mg/kg ATRA-treated groups than in 0.1 mg/kg ATRA-treated group. It was concluded that ATRA treatment can recover MDA and GSH levels and SOD activity in CBDL rat liver through restoring RA and vitamin A contents, and eventually ameliorate liver injury.
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OBJECTIVE: To study the lactagogue effect of Rutong granule on rat with postpartum hypogalactia. METHODS: Female rats which had kittening behavior within 24 h were selected to induce rat model by perfusing bromocriptinum. Meanwhile, model rats were given Rutong granule via i.g. gtt. Milk yield of female rats and body weight of young rats were determined everyday from the second day. Rats were sacrificed on the 8th day. The level of PRL and histological change of breast were observed. RESULTS: Rutong granule can increase the serum PRL level gradually to promote the increase of acinar number and dilatation of gland ducts. Rutong granules can also increase the milk yield of female rats and weight of young rats. CONCLUSION: Rutong granule can promote secretion of milk by means of increase of PRL level and expediting of secretion channels.
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Purpose:To evaluate the results of combination chemotherapy with MxFL[mitoxantrone(MIT),Fluaroracil (5 FU),Leucovorin (CF)]in the treatment of metastatic breast cancer.Methods:From 1993 through 1998,41 patients with metastatic breast cancer were enrolled in this study, Twenty six patients had no prior chemotherapy and 15 were had prior chemotherapy in nineteen patients estrogen receptor (ER) was positive. MIT 12 mg/m 2 by was given intravenous titrate the first day; continuous 5 FU 320 mg/m 2 by intravenous titrate the first day;continuous 5 FU 320 mg/m 2 by intravenous titrate was given for one hundred and twenty hours during the first day to the fifth day; at the same time, CF 50 mg/m 2 by intravenous titrate, once every twelve hours for five days. Repeated every three weeks. Results:Complete response was observed in 11 patients and partial response was observed in 19 patients with an overall response rate of 73.2%. The median response duration was 17 months and the median survival period was 23 months. The dose limiting toxicity was neutropenia which was seen in 85.4% of the treated cases (19.5% in grades Ⅲ and Ⅳ). Stomatitis was observed in 9.8% of the patients and local venous toxicity was observed in 12.2% of the patients. Conclusions:A high response rate is obtained in metastatic breast cancer treated by MxFL. Such treatment may be used as first line chemotherapy for metastatic breast cancer.
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Object To investigate the effects of different processed on content of matrine in the root of Sophora tonkinensis Gapnep. Methods The determination of matrine was carried out by double wavelength TLC scanning for different processed products. Results There were obviously differences between the crude and kinds of different processed products of matrine in the root of S. tonkinensis. Conclusion The different processing methods and adjuvant materials can make the contents of matrine in the root of S. tonkinensis change before and after processing.