Optimized cutoff maternal age for adverse obstetrical outcomes: a multicenter retrospective cohort study in Urban China during 2011 to 2012 / 中华医学杂志(英文版)

BACKGROUND@#China's two-child policy has led to a trend of aging in pregnancy which was associated with adverse outcomes. This study aimed to identify the clinically cutoff maternal age for adverse obstetric outcomes in China.@*METHODS@#This secondary analysis of a multicenter retrospective cohort study included data of childbearing women from 39 hospitals collected in urban China during 2011 to 2012. Logistic regression was used to assess the adjusted odds ratios (aOR) of adverse outcomes in different age groups in comparison to women aged 20 to 24 years. The adjustments included the location of the hospital, educational level, and residence status. Clinically cutoff age was defined as the age above which the aOR continuously become both statistically (P  2) significant.@*RESULTS@#Overall, 108,059 women were recruited. In primiparae, clinically cutoff maternal ages for gestational diabetes (aOR: 2.136, 95% confidence interval [CI]: 1.856-2.458, P < 0.001), placenta previa (aOR: 2.400, 95% CI: 1.863-3.090, P < 0.001), cesarean section (aOR: 2.511, 95% CI: 2.341-2.694, P < 0.001), hypertensive disorder (aOR: 2.122, 95% CI: 1.753-2.569, P < 0.001), post-partum hemorrhage (aOR: 2.129, 95% CI: 1.334-3.397, P < 0.001), and low birth weight (aOR: 2.174, 95% CI: 1.615-2.927, P < 0.001) were 27, 31, 33, 37, 41, and 41 years, respectively. In multiparae, clinically cutoff ages for gestational diabetes (aOR: 2.977, 95%CI: 1.808-4.904, P < 0.001), hypertensive disorder (aOR: 2.555, 95% CI: 1.836-3.554, P < 0.001), cesarean section (aOR: 2.224, 95% CI: 1.952-2.534, P < 0.001), post-partum hemorrhage (aOR: 2.140, 95% CI: 1.472-3.110, P < 0.001), placenta previa (aOR: 2.272, 95% CI: 1.375-3.756, P < 0.001), macrosomia (aOR: 2.215, 95% CI: 1.552-3.161, P < 0.001), and neonatal asphyxia (aOR: 2.132, 95% CI: 1.461-3.110, P < 0.001) were 29, 31, 33, 35, 35, 41, and 41 years, respectively.@*CONCLUSIONS@#Early cutoff ages for gestational diabetes and cesarean section highlight a reasonable childbearing age in urban China. The various optimized cutoff ages for different adverse pregnancy outcomes should be carefully considered in childbearing women.

Effects of MD2 gene silencing on high glucose-induced proliferation inhibition, apoptosis and inflammation in rat cardiomyocytes / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of myeloid differentiation-2 (MD2) gene silencing on high glucose-induced proliferation inhibition, apoptosis and inflammation in rat cardiomyocytes.@*METHODS@#The immortalized rat cardiomyocyte cell line H9C2 were transfected with MD2 small interfering RNA (si-MD2) and negative control for 24 h, then stimulated with high glucose (HG) for 48 h. RT-qPCR was performed to detect the mRNA levels of MD2 and inflammatory factors TNF-α, IL-1β and IL-6. MTS and flow cytometry were used to evaluate cell proliferation, cell cycle and apoptosis rate. Western blot was used to detect protein expression levels and phosphorylation levels.@*RESULTS@#The mRNA and protein levels of MD2 in H9C2 cells were dramatically decreased after transfected with si-MD2 (P＜0.01). After stimulation of high glucose, the mRNA levels of inflammatory factors, the cells in G0/G1 phase , the cell apoptosis rate and the protein level of cleaved Caspase-3 were significantly increased, while the cell proliferation ability was decreased (P＜0.01). MD2 gene silencing antagonized the effects of high glucose on cell proliferation, cell cycle, cell apoptosis and the mRNA levels of TNF-α, IL-1β , IL-6(P＜0.05). Western blot analysis showed that the phosphorylation levels of extracellular signal-regulated kinase(ERK1/2), P38 mitogen-activated protein kinase(P38 MAPK) and C-Jun N-terminal kinase(JNK) protein were increased significantly in H9C2 cells treated with high glucose, which could be reversed by silencing of MD2 (P＜0.01).@*CONCLUSION@#This study demonstrates that MD2 gene silencing reverses high glucose-induced myocardial inflammation, apoptosis and proliferation inhibition via the mechanisms involving suppression of ERK, P38 MAPK, JNK signaling pathway.

Determination of Six Active Ingredients in Gualoupi Injection by Quantitative Analysis of Multi-components by Single Marker / 中国药师

Objective: To develop a method of quantitative analysis of multi-components by single marker (QAMS) for six active ingredients in Gualoupi injection. Methods: An HPLC method was used with a Waters Sunfire ODS C18column (250 mm×4. 6mm, 2. 5 μm), the mobile phase was methanol(A)-0. 2% glacial acetic acid solution(B) with gradient elution, the flow rate was 1. 0 ml· min-1,the detection wavelength was 254 nm,the column temperature was 30℃ and the injection volume was 20 μl. Using 3, 29-dibenzoyl rarounitriol as a reference, the relative correction factors among karounidiol, vanillic acid, adenosine, quercitrin and cynaro-side were detected by QAMS and their contents were calculated, and the results were compared with those of the external standard method. Results: The differences were not statistically significant between the calculated values of karounidiol, vanillic acid, adeno-sine, quercitrin and cynaroside and those measured by the external standard method (P>0. 05). Conclusion: QAMS can be used for the determination of 6 effective components in Gualoupi injection, and the result is accurate, simple and effective.

Impact of Rehabilitation on Exercise Capacity, Cardiopulmonary Function and Quality of Life in Chronic Heart Failure Patients / 中国循环杂志

Objective: To evaluate the impact of rehabilitation on exercise capacity, cardiopulmonary function and quality of life (QoL) in patients with chronic heart failure (CHF). Methods: A total of 96 CHF patients with NYHA Ⅱ-Ⅲ and left ventricular ejection fraction (LVEF)<40% were enrolled. Based on routine drug therapy, the patients were randomly assigned into 2 groups: Control group, n=50 and Rehabilitation group, n=46, the patients performed treadmill exercise, the training intensity was tailored by (50-80) % of peak oxygen uptake (peak VO2) of baseline cardiopulmonary exercise test (CPET) at (25-40) min/session, 3 sessions/week for 12 weeks. The peak VO2, VE/VCO2 slop, anaerobic threshold (VO2 AT), maximum workload and maximum exercise time were measured by CPET; left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD), cardiac index (CI) and LVEF were examined by echocardiography; 6 min walking distance (6MWD) and plasma NT-proBNP level were recorded; QoL was assessed by Minnesota living with heart failure questionnaire (MLWHFQ). The above indexes were compared within Rehabilitation group and between 2 groups. Results: In Rehabilitation group, compared to baseline condition, the following indexes were increased by 12 weeks training: peak VO2 (19.8±2.7) ml/min?kg vs (17.4±2.1) ml/min?kg, VO2 AT (11.6±2.5) ml/min?kg vs (9.5±1.8) ml/min?kg, maximum workload (120±20) w vs (102±21) w, maximum exercise time (8.2±1.7) min vs (6.4±1.5) min, CI (2.2±0.5) L/(min?m2) vs (1.9±0.4) L/(min?m2), LVEF (42±5) % vs (35±4) % and 6MWD (406±58) m vs (345±79) m, all P<0.05; while the following parameters were decreased: VE/VCO2 slop (31.7±4.6) vs (34.2±5.8), LAD (38.6±5.5) mm vs (41.5±3.6) mm, LVEDD (58.4±6.3) mm vs (62.9±5.4) mm, NT-proBNP (235±69) ng/ml vs (387±57) ng/ml and MLWHFQ (30.8±12.0) vs (42.3±8.5), all P<0.05. The above indexes were different between Control group and Rehabilitation group, all P<0.05. Conclusion: Rehabilitation may safely and effectively improve cardiopulmonary function and quality of life in CHF patients.

Diagnostic value of high-frequency ultrasonography in testing carpal canal structure in patients with occupational hand-arm vibration disease / 中国职业医学

OBJECTIVE: To evaluate the clinical value of high-frequency ultrasonagraphy in testing carpal canal structure in the diagnosis of patients with occupational hand-arm vibration disease( HAVD). METHODS: Eighteen patients with occupational mild HAVD( 36 wrists) were selected as the case group and 20 healthy volunteers( 40 wrists) were enrolled as the control group by using convenience sampling method. The color doppler ultrasound was used to measure the crosssectional areas( CSA) of median nerve at the level of pisiform bone,the thickness of transverse carpal ligament,and the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook of the 2 groups. Fisher discriminant analysis and receiver operating characteristic( ROC) curve were performed to assess the effect of diagnosing HAVD with the CSA of median nerve at the level of pisiform bone in patients with HAVD. RESULTS: The CSA of median nerve at the level of pisiform bone in both hands was smaller than that of the control group( P < 0. 01). However,there was no statistical significance in the thickness of transverse carpal ligament of both hands,the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook in the case and control groups( P > 0. 05). Through the Fisher discriminant analysis which was carried on and the distinction equation which was established meanwhile by using the CSA of median nerve at the level of pisiform bone in both hands as HAVD diagnostic criterion,the HAVD predictive accuracy rate was 78. 9%. The ROC curve was underway with the discriminant score as an indicator for distinguishing HAVD,and the result showed that the area under the curve was 0. 842,with sensitivity of 75. 00% and specificity of 88. 90%. CONCLUSION: High-frequency ultrasonography can be used to observe and quantify the imaging changes of carpal canal structure in patients with HAVD,which can provide objective and scientific diagnostic basis for the diagnosis of HAVD.

Cytotoxicity evaluation of three kinds of perforation repair materials on human periodontal ligament fibroblasts in vitro / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To select three kinds of perforation repair materials, mineral trioxide aggregate (MTA), Z350, amalgam. And to evaluate the cytotoxicity of three kinds of perforation repair materials on human periodontal ligament fibroblasts (HPDLF) in vitro.</p><p><b>METHODS</b>The proliferation of HPDLF to three perforation repair materials were examined by methyl thiazolyl tetrazolium (MTT) assay at 1, 3 and 5 days. The mRNA expression levels of bone-associated alkaline phosphatase (ALP) and osteocalcin (OC) were determined using a real-time quantitative polymerase chain reaction (PCR).</p><p><b>RESULTS</b>MTA shew almost no inhibition to HPDLF, the expression of ALP mRNA and OC mRNA in the HPDLF cultured on MTA were higher. Z350 induced a slight inhibition to HPDLF, and the expression of ALP mRNA but there was no difference in the expression of OC mRNA. Cell proliferation was significantly impaired by amalgam with grade 3, and the expression of ALP mRNA and OC mRNA were significantly reduced.</p><p><b>CONCLUSION</b>MTA have minimum cytotoxicity on HPDLF and can promote cell differentiation and regenerate of periodontal tissue. Z350 have lower cytotoxicity on HPDLF. Amalgam show highest cytotoxicity on HPDLF in the three materials and inhibit cells differentiation.</p>

Morphology and microleakage study of repairing subpulpal wall perforation with resinous inlay / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The purpose of this study is to study the sealing ability and the furcal appearance of repairing subpulpal wall perforation with resinous inlay.</p><p><b>METHODS</b>Fifty newly extracted human molars were randomly divided into three experiment groups (group A, group B, group C, 15 teeth each) and one control group (5 teeth). In experiment groups, perforations were made perpendicularly to the center of the pulp chamber floor. Perforations of group A and B were repaired with resinous inlay and sealed by AH Plus sealer and luting glass-ionomer, respectively. Perforations of group C were directly repaired using light-cure composite resin. Perforations were not made in five teeth of control group. The furcal appearances were evaluated under stereomicroscope after repairing. Microleakage was measured by glucose oxidase detection.</p><p><b>RESULTS</b>The fineness rate of furcal appearances with resinous inlay repairing were 83.3%, while the fineness rate of furcal appearances with light-cure composite resin directly repairing were 46.7%. There were statistics difference between resinous inlay repairing and light-cure composite resin directly repairing (P<0.05). There were statistics difference among the daily microleakage of three experiment groups, group A<group B<group C (P<0.05).</p><p><b>CONCLUSION</b>Using resinous inlay to repair the subpulpal wall perforation can improve the sealing effect and avoid material overextension. AH Plus can be used as perforation sealant because of its better sealing ability.</p>

The Protective Effect of Sodium Hyaluronate on the Cartilage of Rabbit Osteoarthritis by Inhibiting Peroxisome Proliferator-Activated Receptor-Gamma Messenger RNA Expression

PURPOSE: The purpose of this study was to study the protective effect and influence of sodium hyaluronate (Na-HA) on mRNA expression of peroxisome proliferators-activated receptor gamma (PPAR-gamma) in cartilage of rabbit osteoarthritis (OA) model. MATERIALS AND METHODS: Forty eight white rabbits were randomly divided into A, B, and C groups. Group A was normal control group, B and C groups underwent unilateral anterior cruciate ligament transection (ACLT). The rabbits in group B were injected normal saline after ACLT; and Group C received intraarticular1% sodium hyaluronate (HA) injection 5 weeks after surgery, 0.3 mL once a week. At 11th week after surgery, all the rabbits were sacrificed. The cartilage changes on the medial femoral condyles were graded separately. Cartilage sections were stained with safranin-O and HE, and messenger RNA (mRNA) expression of PPAR-gamma was detected by using real time polymerase chain reaction (Real Time-PCR). RESULTS: Cartilage degeneration in group B was significantly more severe than in A and C injection group. The grey value of Safranin-O of B group was higher than A and C groups. Expression of PPAR-gamma mRNA in group B was higher than group A and C. CONCLUSION: This study shows that Na-HA has a protective effect on articular cartilage degeneration, and the inhibitory effect on the PPAR-gamma mRNA expression may be one of therapeutic mechanism of Na-HA.

Altered surfactant protein A gene expression and protein homeostasis in rats with emphysematous changes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The decrease of surfactant protein (SP) secreted by the alveolar type II cell is one of the important causes of limiting air of pulmonary emphysema. However, the SP-A gene and protein changes in this disease are rarely studied. This study was undertaken to investigate alterations in SP-A gene activity and protein, and to explore their roles in the pathogenesis of emphysematous changes.</p><p><b>METHODS</b>Twenty Wistar rats were divided randomly into a normal control group (n = 10) and a cigarette smoking (CS) + lipopolysaccharide (LPS) group (n = 10). Ultra-structural changes were observed under an electron microscope. The number of cells positive for SP-A was measured by immunohistochemistry. The mRNA expression and protein level of SP-A in the lung tissues were determined by quantitative polymerase chain reaction (qPCR) and Western blot separately. The protein level of SP-A in lavage fluid was determined by Western blot.</p><p><b>RESULTS</b>The number of cells positive for SP-A of the CS + LPS group (0.35 +/- 0.03) was lower than that of the blank control group (0.72 +/- 0.06, P < 0.05). The level of SP-A in the lung tissues of rats in the CS + LPS group (0.2765 +/- 0.0890) was lower than that in the blank control group (0.6875 +/- 0.1578, P < 0.05). The level of SP-A in the lavage fluid of rats in the CS + LPS group (0.8567 +/- 0.1458) was lower than that in the blank control group (1.3541 +/- 0.2475, P < 0.05). The lung tissues of rats in the CS + LPS group showed an approximate increase (0.4-fold) in SP-A mRNA levels relative to beta-actin mRNA (P < 0.05).</p><p><b>CONCLUSIONS</b>The changes of SP-A may be related to emphysematous changes in the lung. And cigarette smoke and LPS alter lung SP-A gene activity and protein homeostasis.</p>