Physical activity status of early stage pregnant women and its influential factors / 中华健康管理学杂志

Objective To understand the physical activity of early stage pregnant women and explore its influential factors. Methods From June 2015 to June 2016, 2122 pregnant women with early pregnancy card in Ma An Shan Maternal and Child Health Hospital were selected and surveyed with a questionnaire. The Physical Activity Questionnaire was used to understand the physical activity of pregnant women in their early pregnancy. Analysis of variance and t-test were used to describe the distribution of energy expenditures of physical activity of pregnant women with different demographic characteristics, and multiple linear regression analysis was used to analyze the factors influencing the energy expenditure of their physical activity. Result The duration of activities of sleep and sitting type was (16.56 ± 3.54) h, accounting for 83.38％of total activity time;the energy consumption value was (17.17±5.59) METs·h;mild physical activity time was (2.62±1.86) h, accounting for total time. 13.19％and the energy consumption value was (6.06±4.43) METs·h;the average time of moderate to severe physical activity was (0.68±0.93) h, accounting for 3.42％of total physical activity time, and the energy consumption value was (3.22±4.58) METs·h. In the univariate analysis, the energy expenditures of physical activity between the different groups (t=-3.551), education level (F=1.347), and occupation type (F=1.485) were different, and the difference was statistically significant (P<0.05). In multiple linear regression analysis, different occupational types and education were the energy expenditure levels of physical activity during early pregnancy. Influencing factors (P<0.05). Conclusion Pregnant women have longer periods of sleep and meditation during the first trimester, and shorter duration of physical activity than mild and above;the energy expenditure of physical activity during the first trimester of pregnancy is affected by the occupational type and educational level of the pregnant woman.

Application of early continuous renal replacement therapy in the bundle treatment of severe pneumonia / 中华危重病急救医学

Objective To explore the role of early continuous renal replacement therapy (CRRT) in bundle treatment of severe pneumonia. Methods Seventy severe pneumonia patients admitted to respiratory intensive care unit (RICU) of Second Affiliated Hospital of Xuzhou Medical University from January 2013 to June 2017 were enrolled. The patients were randomly divided into routine treatment group and CRRT treatment group, with 35 patients in each group. All patients were treated with bundle therapy, and those in CRRT treatment group was treated with CRRT daily on the basis of conventional bundle therapy. The mode was continuous veno-venous hemofiltration (CVVH), lasting 8-24 hours at a time. On the day of admission and the treatment of 1, 3, 5, 7 days, the fasting venous blood was collected. Inflammatory stress and immune parameters including procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and CD4+cells were determined by enzyme linked immunosorbent assay (ELISA) or flow cytometer. The incidence of acute respiratory distress syndrome (ARDS) and mortality within 7 days were observed in the two groups. Results Seventy patients with severe pneumonia were enrolled. There was no significant difference in the serum PCT, IL-6, TNF-α or CD4+before treatment between the two groups. With the prolongation of treatment time, the PCT, IL-6 and TNF-α levels were gradually decreased, and the CD4+was gradually increased. Compared with routine treatment group, PCT and TNF-α in CRRT treatment group were significantly decreased since the 3rd day [PCT (μg/L): 3.11±1.28 vs. 3.76±1.42, TNF-α (ng/L): 98.61±11.58 vs. 119.47±12.38], and CD4+was significantly increased (0.39±0.03 vs. 0.35±0.03, all P < 0.05). The changes in IL-6 of CRRT treatment group was delayed, the statistical significance was found since the 5th day as compared with routine treatment group (ng/L: 35.43±12.39 vs. 52.86±10.78, P < 0.05). Compared with routine treatment group, the incidence of ARDS [11.43% (4/35) vs. 31.43% (11/35)] and mortality [0% (0/35) vs. 11.43% (4/35)] within 7 days in CRRT treatment group were significantly lowered (both P < 0.05). Conclusions CRRT in the early stage of bundle therapy for severe pneumonia is not only suggested to remove inflammatory mediators and improve immune function, but an opportunity and effective way to reduce complications and delay rapid progression of severe pneumonia. It provides the opportunity and condition for comprehensive treatment.

Analysis on the correlation between serum 25(OH)D deficiency and pregnancy-related anxiety in early pregnancy / 中华健康管理学杂志

Objective To explore the correlation between pregnancy-related anxiety and serum 25 (OH)D level during early pregnancy. Methods A radioimmunoassay was used to determine the serum 25 (OH)D levels of 2 122 early pregnant women in Maanshan Maternal and Child Health Care Hospital, from June 2015 to 2016. Data were collected using a questionnaire. Results The mean serum 25(OH)D level was(29.71±32.27)nmol/L.About 15.2% of the subjects had adequate,22.6% had insufficient,45.1% had deficient,and 17.1% had severely deficient serum 25(OH)D levels.The type of housing and testing seasons were significantly associated with the serum 25(OH)D level.Single factor logistic regression analysis results show that pregnancy-related anxiety incidence in the group deficient in 25(OH)D was higher than that in the adequate group, which has a statistically significant difference (P<0.05). After adjusting for the maternal age,BMI,and educational level,multivariate logistic regression analysis results showed that the difference was statistically significant. Conclusion The serum 25(OH)D level in early pregnant women was inadequate. Furthermore, lack of serum 25(OH)D in early pregnancy and pregnancy-related anxiety were negatively correlated.

Effect and mechanism of etanercept on pulmonary fibrosis in mice induced by bleomycin / 中国免疫学杂志

Objective:To observe the effect of etanercept on bleomycin-induced pulmonary fibrosis in mice and its possible mechanisms.Methods:Thirty male SPF Kun ming mice were randomly assigned to control group ( intratracheal saline injection ) or model group ( intratracheal injection of bleomycin 5 mg/kg ) or intervention group ( intratracheal bleomycin injection followed by etanercept 3 mg/kg intraperitoneal administration twice a week )(n=10 group).Lung tissue were taken after the sacrifice of the mice with 28 days of molding.The content of hydroxyproline of the right lung samples was measured by alkaline hydrolysis method ,while the left lungs were fixed in 4%paraformaldehyde and embedded in paraffin with the sections stained with hematoxylin -eosin or Masson′s trichrome for pathological examination .Total tissue protein was extracted from lung homogenates to detect the expression of NF -κB and phosphorylation of NF-κB( P-NF-κB) by Western blot.Results:The content of hydroxyproline in lung tissue of mice of intervention arm was decreased significantly compared with the model arm ( P<0.01 ).The alveolar structure of the intervention arm maintained integrity with alveolar septum slightly thickened.The inflammation and fibrosis scores were decreased significantly with noticeable greater improvement of pulmonary fibrosis than the model arm (P<0.01).In addition,the protein phosphorylation of NF-κB in the lung tissues was remarkably decreased in the intervention arm ( P<0.01 ).Conclusion: Etanercept can inhibit the phosphorylation of NF-κB and reduce lung inflammation and fibrosis caused by bleomycin in mice ,which may be useful in the treatment of pulmonary fibrosis.

The significance of multi-criteria decision analysis for the bundle treatment of severe pneumonia / 中华危重病急救医学

ObjectiveTo determine the effect of multi-criteria decision analysis (MCDA) on the effect of bundle treatment for severe pneumonia.Methods A prospective historical control observation was conducted. Seventy-five patients with severe pneumonia having received MCDA (from January 2013 to August 2014) were assigned as intervention group. MCDA group was set up by the medical staff. Bundled treatment plan was composed of the MCDA evaluation results, anti-infection, phlegm and other conventional treatment measures which was adjust on time until the patient was transferred out of the respiratory intensive care unit (RICU) or died. Seventy patients with severe pneumonia before receiving MCDA (from August 2010 to December 2012) were set as historical control group. Comparison of general condition before treatment and the incidence of hospital infection, average hospitalization cost, duration of RICU stay and mortality between these two groups were performed.Results There were no statistically significant differences in gender, age, past history, and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score at admission between two groups. Compared with control group, the incidence of hospital infection [1.33% (1/75) vs. 11.43% (8/70),χ2 = 4.723,P = 0.030], mean hospitalization cost in RICU (10 thousand Yuan: 3.44±0.79 vs. 3.76±0.91,t = 2.265, P = 0.025), length of RICU stay (days: 15.01±4.22 vs. 16.92±4.79,t = 2.552,P = 0.012) and mortality in RICU [8.0% (6/75) vs. 21.4% (15/70),χ2 = 5.272,P = 0.032] in intervention group was significantly decreased. Conclusions Application of MCDA in the bundle treatment of severe pneumonia could elevate the scientificalness of decision, and reduce the medical cost. Additionally, MCDA is worth to be generalized because the implementation of guidelines can improve the clinical outcome and prognosis of the patients.