Mechanism of Radix Paeoniae Alba in the treatment of liver fibrosis based on network pharmacology / 药学实践杂志

Objective To explore the possible mechanism of Radix Paeoniae Alba on hepatic fibrosis based on network pharmacology. Methods Tcmsp database was used to screen the active components of Paeonia alba. With the help of PubChem and Swiss target prediction database, the potential action targets of the effective components of Paeonia Alba were predicted. GeneCards and OMIM databases were used to screen the corresponding targets of liver fibrosis, and venn2.1.0 was used to obtain the common targets of white peony and liver fibrosis. Cytoscape 3.9.0 software was used to build the network diagram of “white peony - active ingredients - intersection target - liver fibrosis” and to predict the main active sites. String database was used to draw the PPI network. Go analysis of effective targets and enrichment analysis of KEGG in pathway were performed by David database. Results Six effective components, 213 targets of Paeonia Alba and 155 hepatic fibrosis targets were screened. There were 49 targets of Radix Paeoniae Alba in the treatment of liver fibrosis. The main active ingredients are kaempferol, paeoniflorin, mairin and β-Sitosterol. Go enrichment analysis showed 269 biological processes, 30 cell compositions, 64 molecular functions, and 67 pathways in KEGG pathway enrichment analysis. Conclusion The mechanism of anti-hepatic fibrosis of Radix Paeoniae Alba has been preliminarily studied through network pharmacology, which shows that Radix Paeoniae Alba has multi-component, multi-target, and multi-channel effects, and provides reference for further experimental research.

Early myocardial strain characteristics in type 2 diabetic mellitus mice evaluated by 7.0 T cardiac MR / 中华放射学杂志

Objective:To investigate the characteristics of early myocardial mechanics changes in diabetic cardiomyopathy (DCM).Method:Sixty healthy 4-week-old male C57BL/6J mice were randomly divided into the T2DM group ( n=30) and the control group ( n=30). The T2DM group was fed with high-fat diet for 4 weeks, and accepted injection of a single high-dose of streptozotocin (STZ) intraperitoneally. Finally, the model was established successfully in 23 mice. The control group was fed with a normal diet and treated with citrate buffer liquid at an equal dose as T2DM group. Then, nine mice were randomly selected from each of the two groups every 4 weeks until the end of the 24th week. Six of the nine mice were randomly selected to perform 7.0 T MR scanning after measuring blood glucose and body weight. Cine images were acquired through cardiovascular MR feature tracking (CMR-FT). The obtained parameters included the left ventricle global peak circumferential strain (LV-GPCS), left ventricle global peak radial strain(GPRS) and the ejection fraction (EF), etc. The rest three mice were sacrificed for observation of the changes of interstitial fibers and micro-vessels in myocardial tissue with Sirius red staining. One-way analysis of variance (ANOVA) and t test were used for comparison. Results:There were significant differences in blood glucose levels between the two groups during the observation period ( P<0.05). In the 4 th-24 th week, the value of GPCS in T2DM group showed a downward trend, and the difference was statistically significant ( F = 8.23, P<0.001). Compared with the control group, the value of GPCS in T2DM group was statistically significant at the 20 th and 24 th week (the 20 th week: -11.4%±2.1% in the T2DM group vs. -14.3%±1.9% in the control group, t=2.54, P=0.029;the 24 th week: -12.3%±1.7% in the T2DM group vs. -14.6%±1.8% in the control group, t=2.35 , P=0.040), while the EF value was different at the 24 th week (51%±5% in the T2DM group vs. 62%±6% in the control group, t=3.38, P=0.007). There was no significant difference in the GPRS of the T2DM mice group over time or compared with the controls ( P>0.05). Moreover, the pathological results showed that the myocardial interstitial fibers in the T2DM group had remarkably increased since the 12 th week. Conclusions:The alterations in myocardial interstitial fibers and myocardial contractility appeared early in T2DM mice. Especially, the left ventricle global peak circumferential strain value is superior to the EF value in reflecting the early changes in DCM.

Willingness and associated factors of novel coronavirus vaccination among parents of primary and middle school students in Tongzhou District of Beijing / 中国学校卫生

Objective@#To understand the willingness and associated factors with novel coronavirus vaccination (‘COVID-19 vaccination’) among parents of primary and middle school students in Tongzhou District of Beijing, and to provide reference for studying the feasibility of COVID-19 vaccination among students.@*Methods@#Multistage stratified cluster random sampling method was conducted to select 3 026 parents of students in Tongzhou District. An online questionnaire survey was conducted to compare the willingness of COVID-19 vaccination by different characteristics. Multivariate Logistic regression model was conducted to analyze associated factors of COVID-19 vaccination.@*Results@#About 65.40% of parents were willing to vaccinate their children. Multivariate Logistic regression analysis showed that parets from rural areas, who had daughters, children in good health, who direct participated in the prevention and control, and those whose child had received vaccines at their own cost are more positive with COVID-19 vaccination of children(OR=1.17, 1.33, 0.64, 1.32, 1.47, P<0.05).@*Conclusion@#Parents of primary and secondary schools in Tongzhou District have a low willingness to vaccinate their children with COVID-19 vaccine. The propaganda of the government authorities and the official media should be strengthened, and the vaccination rate should be improved through the recommendation of medical personnel.

Application of antenatal corticosteroid in different pregnant populations / 中华围产医学杂志

We review the safety and efficacy of antenatal corticosteroid (ACS) in different pregnant populations at risk of preterm birth. According to the current evidence, attention should be paid to the following aspects: Pregnant women with fetal growth restriction exposuring to ACS are more likely to deliver a low birth weight infant, repeated administration without indications is not recommended; Though ACS is beneficial to pregnant women with premature rupture of membranes complicated by chorionic amniotic inflammation, it is not recommended to use uterine inhibitors for completing the treatment of ACS. For those with acute chorionic amniotic inflammation, pregnancy should be terminated as soon as possible; For twin/multiple pregnancies, the ACS therapy is the same as for singletons, but the efficacy is controversial.

Improving college students sub-threshold depression by music neurofeedback / 生物医学工程学杂志

Sub-threshold depression refers to a psychological sub-health state that fails to meet the diagnostic criteria for depression. Appropriate intervention can improve the state and reduce the risks of disease development. In this paper, we focus on music neurofeedback stimulation improving emotional state of sub-threshold depression college students.Twenty-four college students with sub-threshold depression participated in the experiment, 16 of whom were members of the experimental group. Decompression music based on spectrum classification was applied to 16 experimental group participants for 10 min/d music neural feedback stimulation with a period of 14 days, and no stimulation was applied to 8 control group participants. Three feature parameters of electroencephalogram (EEG) relative power, sample entropy and complexity were extracted for analysis. The results showed that the relative power of α、β and θ rhythm increased, while δ rhythm decreased after the stimulation of musical nerofeedback in the experimental group. The sample entropy and complexity were significantly increased after the stimulation, and the differences of these parameters pre and post stimulation were statistically significant ( < 0.05), while the differences of all feature parameters in the control group were not statistically significant. In the experimental group, the scores of self-rating depression scale(SDS) decreased after the stimulation of musical nerofeedback, indicating that the depression was improved. The result of this study showed that music neurofeedback stimulation can improve sub-threshold depression and may provides an effective new way for college students to self-regulation of emotion.

Weighted multiple multiscale entropy and its application in electroencephalography analysis of autism assessment / 生物医学工程学杂志

In this paper, a feature extraction algorithm of weighted multiple multiscale entropy is proposed to solve the problem of information loss which is caused in the multiscale process of traditional multiscale entropy. Algorithm constructs the multiple data sequences from large to small on each scale. Then, considering the different contribution degrees of multiple data sequences to the entropy of the scale, the proportion of each sequence in the scale sequence is calculated by combining the correlation between the data sequences, so as to reconstruct the sample entropy of each scale. Compared with the traditional multiscale entropy the feature extraction algorithm based on weighted multiple multiscale entropy not only overcomes the problem of information loss, but also fully considers the correlation of sequences and the contribution to total entropy. It reduces the fluctuation between scales, and digs out the details of electroencephalography (EEG). Based on this algorithm, the EEG characteristics of autism spectrum disorder (ASD) children are analyzed, and the classification accuracy of the algorithm is increased by 23.0%, 10.4% and 6.4% as compared with the EEG extraction algorithm of sample entropy, traditional multiscale entropy and multiple multiscale entropy based on the delay value method, respectively. Based on this algorithm, the 19 channel EEG signals of ASD children and healthy children were analyzed. The results showed that the entropy of healthy children was slightly higher than that of the ASD children except the FP2 channel, and the numerical differences of F3, F7, F8, C3 and P3 channels were statistically significant ( <0.05). By classifying the weighted multiple multiscale entropy of each brain region, we found that the accuracy of the anterior temporal lobe (F7, F8) was the highest. It indicated that the anterior temporal lobe can be used as a sensitive brain area for assessing the brain function of ASD children.

Study on the improvement of brain cognitive function status by mind-control game training / 生物医学工程学杂志

This study uses mind-control game training to intervene in patients with mild cognitive impairment to improve their cognitive function. In this study, electroencephalogram (EEG) data of 40 participants were collected before and after two training sessions. The continuous complexity of EEG signals was analyzed to assess the status of cognitive function and explore the effect of mind-control game training on the improvement of cognitive function. The results showed that after two training sessions, the continuous complexity of EEG signal of the subject increased (0.012 44 ± 0.000 29, < 0.05) and amplitude of curve fluctuation decreased gradually, indicating that with increase of training times, the continuous complexity increased significantly, the cognitive function of brain improved significantly and state was stable. The results of this paper may show that mind-control game training can improve the status of the brain cognitive function, which may provide support and help for the future intervention of cognitive dysfunction.

Research on electroencephalogram emotion recognition based on the feature fusion algorithm of auto regressive model and wavelet packet entropy / 生物医学工程学杂志

Focused on the world-wide issue of improving the accuracy of emotion recognition, this paper proposes an electroencephalogram (EEG) signal feature extraction algorithm based on wavelet packet energy entropy and auto-regressive (AR) model. The auto-regressive process can be approached to EEG signal as much as possible, and provide a wealth of spectral information with few parameters. The wavelet packet entropy reflects the spectral energy distribution of the signal in each frequency band. Combination of them gives a better reflect of the energy characteristics of EEG signals. Feature extraction and fusion are implemented based on kernel principal component analysis. Six emotional states from a public multimodal database for emotion analysis using physiological signals (DEAP) are recognized. The results show that the recognition accuracy of the proposed algorithm is more than 90%, and the highest recognition accuracy is 99.33%. It indicates that this algorithm can extract the feature of EEG emotion well, and it is a kind of effective emotion feature extraction algorithm, providing support to emotion recognition.

Tracer-based MRI evaluation on transportation and clearance in extracellular space of rats / 中国医学影像技术

Objective To explore the rule of transportation in extracellular space (ECS) and the changes induced by the external stimulation with tracer-based MRI.Methods Thirty two mature Sprague Dawley rats were randomly divided into four groups,i.e.caudate nucleus-control (Cc) group,thalamus-control (Tc) group,caudate nucleus-moving (Cm) group and thalamus pain stimulation (Tp) group.The rats were anesthetized and a series of MR scanning were performed before and after the injection of Gd-DTPA in ECS of caudate nucleus and thalamus until the intensity of Gd-DTPA was invisible.Half-life of Gd-DTPA in ECS was calculated and analyzed with t-test.Results Gd DTPA in caudate nucleus was transported to the ipsilateral cortices away from the injection points,which only distributed on site in the thalamus.The transportation between the two partitions was not observed.The half-life of Tc group ([49.93±2.11] min) was significantly shorter than that of Cc group ([104.30±54.12];t=2.839,P＜0.05),no difference was observed between the Cm group ([113.42±47.32]min) and Cc group (t=0.359,P＞0.05),while half-life of Tp group ([109.40±10.33]min) was significantly longer than that of Tc group (t=15.954,P＜0.05).Conclusion Tracer-based MRI can be used to investigate the rule of transportation in ECS,and the transportation and clearance of substances into the ECS can be influenced by a selective external stimulation.

Clinical charateristcs and high risk factors of intractable postpartum hemorrhage requiring hysterectomy:analysis of 152 patients / 中华围产医学杂志

Objective To explore the clinical characteristics and etiology of intractable postpartum hemorrhage requiring hysterectomy. Methods We retrospectively collected 152 patients with intractable postpartum hemorrhage between January 2005 and March 2016 in Department of Obstetrics and Gynecology of Peking University First Hospital. Analysis was conducted to identify the general status, etiology, high risk factors, complications and outcome of patients with or without hysterectomy (hysterectomy group and conservative group). T-test, Rank sum test, and Logistic regression analysis were applied in the statistical analysis. Results (1) Totally 152 patients were identified, accounting for 0.3% of total deliveries during the study period (152/48 694). Among them, 111 cases (73.0%) received routine prenatal care in our hospital; and 41 cases (27.0%) were transferred from other hospitals for high-risk pregnancy. The median blood loss within 24 h after delivery was 1 807(1 027-10 000) ml and 6 (2-42) U of red blood cells was transfused. Totally, uterus was removed in 29 cases (19.1%), with a hysterectomy rate of 0.060% (29/48 694) among all deliveries. (2) The proportion of women with previous cesarean sections [62.1%(18/29) vs 9.8%(12/123), χ2=40.541], the total amount of blood loss within 24 h postpartum [5 145(2 061-10 000) vs 1 586 (1 027-7 350) ml, Z= － 7.671] and of transfused red blood cells [24(6-42) vs 6(2-40) U, Z= － 7.485] were all significantly higher in the hysterectomy group than those of the conservative group. (3) The main causes for intractable postpartum hemorrhage were uterine atony (66/152, 43.4%), placental factors (58/152, 38.2%), soft birth canal injury (21/152, 13.8%) and coagulation dysfunction (7/152, 4.6%). The proportions of placenta factors and coagulation dysfunction in hysterectomy group were higher than those of the conservative group [69.0%(20/29) vs 30.9%(38/123), OR(95% CI): 4.971(2.071-11.912); 20.7%(6/29) vs 0.8%(1/123), OR (95% CI): 31.826(3.654-276.132)], while the proportion of uterine atony was lower [3.4%(1/29) and 52.8%(65/123), OR(95%CI):0.032(0.001-0.241)] (all P<0.01). No statistical difference was shown in the proportion of soft birth canal injury between the two groups. (4) Among the 152 cases, 17.8%(27/152) were admitted into the intensive care unit (ICU) and 15.8%(24/152) experienced severe complications. More postpartum women developed severe complications or being transferred to the ICU in the hysterectomy group than in the conservative group [65.5%(19/29) vs 4.1% (5/123), χ2=72.423; 72.4%(21/29) vs 4.9%(6/123), χ2=73.273; all P<0.001]. Conclusions For women with intractable postpartum hemorrhage cases requiring hysterectomy, previous cesarean section complicating with placenta accreta, is the major reason, while those complicated with coagulation dysfunction carries the highest risk. Meanwhile, those caused by uterine rupture should not be ignored. Although uterine atony remains the leading cause, uterus may be preserved through conservative surgery in most cases in hospitals with adequate medical resources and techniques.

Clinical phenotypes of hepatocyte nuclear factor 1 homeobox b-associated disease / 中华儿科杂志

Objective@#Hepatocyte nuclear factor 1 homeobox b (HNF1B) -associated disease is an autosomal dominant inherited disorder with a variable, multi-systemic phenotype. In China, five adult probands and one child proband with HNF1B-associated disease had been reported, whereas few fetuses are described. The aims of this retrospective study were to understand about the clinical manifestations of HNF1B-associated disease and to further improve the recognition of this disorder.@*Method@#Four patients (3 males, 1 female) and three fetuses with HNF1B mutations were included in this study. They were admitted to our hospital from January 2013 to March 2017. HNF1B mutations were detected using targeted next generation sequencing and quantitative real-time PCR or Sanger sequencing. HNF1B heterozygous deletion of exons 1-9 was found in 4 patients and 2 fetuses, and HNF1B heterozygous missense mutation in 1 fetus. These two mutations had been reported. Two patients and 1 fetus had de novo mutations. Results of renal ultrasonography with or without magnetic resonance imaging, biochemical investigations, urine routine examination and other necessary investigations in 7 cases were analyzed.@*Result@#Three patients were Han Chinese ethnicity, and one patient was Mongolian. In patients 1 and 4, abnormal fetal kidneys were discovered by routine ultrasonography, and the age at first feature identified in Patients 2 and 3 were 13 years and 28 years. Patient 3 had normal renal function and the remainder had reduced glomerular filtration rate. In addition, patient 4 presented with nephrotic syndrome and glycosuria, patient 2 with early onset hyperparathyroidism and renal osteodystrophy, and patient 3 with diabetes mellitus. All the 4 patients had renal structural abnormalities including bilateral multiple renal cysts, dysplasia and hyperechogenic kidneys. Only patient 3 had a positive family history of renal diseases, the remainder had a negative family history of renal diseases. In 3 fetuses, prenatal ultrasound anomalies were detected during the second trimester. These 3 fetuses had hyperechogenic kidneys with or without renal cysts. Polyhydramnios was detected in only one of the 3 fetuses. Two of the 3 fetuses had a positive family history of renal diseases.@*Conclusion@#Clinical phenotypes of HNF1B-related disease are heterogeneous, renal malformations clearly appear to be the most common manifestation, multiple renal cysts are characteristic, and patients can progress to impaired kidney function during childhood; HNF1B mutation is a differential diagnosis of fetal hyperechogenic kidneys or multiple renal cysts.

Prenatal diagnosis and prognosis of fetal hyperechogenic kidney: a study of 65 cases / 中华围产医学杂志

Objective To investigate prenatal diagnosis and prognosis of fetus with hyperechogenic kidney.Methods Clinical data of 65 cases prenatally diagnosed with fetal hyperechogenic kidney in Peking University First Hospital between July,2009 and May,2015 were retrospectively analyzed.Results of fetal ultrasound screening and pregnancy outcomes were analyzed and Growth and development status of those babies were followed up until December,2015.Independent-sample-t,Chi-square or Fisher's exact test was applied for statistical analysis.Results Among the 65 cases,including 48(73.8％) bilateral and 17 (26.2％) unilateral,34 cases (52.3％) were diagnosed as non-isolated and 31 cases (47.7％) as isolated fetal hyperechogenic kidney.The primary associated malformations with non-isolated fetal hyperechogenic kidney included cardiac abnormality (14 cases,41.2％),urinary system abnormality (12 cases,35.2％),skeletal system abnormality (nine cases,26.5％),central nervous system abnormality (eight cases,23.5％) and Meckel-Gruber sydrome (one case,2.9％).Amniotic volume,the size and numbers of affected kidney between non-isolated and isolated groups showed no significant differences (all P＞0.05).Twenty out of the 65 cases (30.8％) received fetal karyotyping and one received non-invasive prenatal testing,and no abnormality was detected.Three cases received cord blood array comparative genomic hybridization with negative results.Pathogenic genes were found in two cases who received targeted exome capture with high throughput sequencing,including a TTC21B mutation in cord blood in one case and a HNF1β deletion mutation in peripheral blood after birth in the other.There were 23 (35.4％) terminations of pregnancy and 42 (64.6％) live births among which three died after birth.The rate of live birth was significantly higher in the isolated group than in the non-isolated group[87.1％(27/31) vs 44.1％(15/34),x2=13.101,P＜0.01].Of the fifteen live births in the non-isolated group,there were fourteen survived symptomfree except that one lost to follow-up.Of the 27 live births in the isolated group,follow up study revealed 23 symptom-free survivors,one lost,two neonatal deaths (one died of volvulus neonatorum,and the other due to unknown causes) and one death of renal and liver function failures at the age of two-and-a-half.ConclusionsFetal hyperechogenic kidney is an important prenatal ultrasound marker for congenital renal anomalies,and the prognosis of non-isolated fetal hyperechogenic kidney is poor.The current rate of abnormal karyotype in fetus with hyperechogenic kidney is very low.However,the rate of prenatal genes screening should be encouraged.

Development of the fiscal input model for public hospitals and calculation of subsidy standard / 中华医院管理杂志

Objective To explore a scientific and reasonable fiscal input mechanism for public hospitals, in order to fully leverage the policy guidance and efficiency of such funding.Methods With literature review, expert consultation and demonstration, a basic subsidy model for public hospitals was established.According to the past operation data of 4 public hospitals in Baoshan district of Shanghai, the study figured out specific subsidy standards.Results The basic subsidy for public hospitals should be determined according to the number of approved beds, the number of outpatients and emergency visits, hospital bed days, surgeries, key services, and the quality and efficiency of work.In Baoshan district, the standard reference value of subsidy for each approved bed, each outpatient and emergency visit, each bed-day, each surgical operation is 42 096 yuan, 27.9 yuan, 104.9 yuan and 244 yuan respectively.The standard value of subsidy is 100 yuan per bed for critically ill inpatients.For patients under clinical pathway management, the subsidy is 300 yuan per case, and for hospital maternal care, it is 150 yuan per person.Conclusions The basic subsidy model for public hospitals has overcome the shortcomings of fiscal input based on hospital scale or hospital workload, and established an incentive mechanism to promote the implementation of key services.These measures can improve the operation mechanism of public hospitals and encourage them to play their role of public welfare as designed.

Analysis of the characteristics of multi-drug resistant acinetobacter baumannii infection in elderly patients with severe respiratory / 中华老年医学杂志

Objective To investigate the clinical characteristics of multiple drug resistant Acinetobacter baumannii infection in respiratory elderly patients.Methods A total of 102 elderly patients infected with multidrug-resistant Acinetobacter baumannii were enrolled in our hospital from January 2014 to December 2015.At the same time,no multiple drug-resistant Acinetobacter baumannii infection elderly patients was selected as a control group.The gender,age,antimicrobial use,white blood cell count,mechanical ventilation time and other differences between the two groups of elderly patients were compared.Results There were significant differences in the days of hospitalization [(18.7±7.5) d vs.(10.0±2.7)d],the time of application of invasive ventilator[(24.6±10.3) d vs.(11.6±6.9)d] and the time of application of antimicrobial agents[(26.2±13.1) d vs.(8.0±2.6)d] (t=19.463、15.436、26.905,all P＜ 0.05).There was no significant difference in immunosuppressant use,white blood cell count,serum protein level and APACHEⅡ score (all P＞0.05).Conclusions Reasonable scientific application of antimicrobial agents,reducing invasive mechanical ventilation time and improving patient immunity can help to reduce the risk of respiratory infection in elderly patients with multiple drug resistance to Acinetobacter baumannii.

Analysis of incidence and risk factors of preterm birth in 15 urban hospitals in China / 中华围产医学杂志

Objective To investigate the incidence and major risk factors of preterm birth in urban hospitals in China so as to provide evidence for effective interventions to reduce preterm birth.Methods Postpartum women delivered between 22 and 37 weeks of gestation were selected from 15 urban hospitals in Beijing,and Guangdong,Hu'nan,Hubei,Sichuan and Shaan'xi Province.Between April 2012 and March 2013,data of 10 days were collected every 3 months.Questionnaire was obtained under informed consent from 9 143 cases,including 958 cases of preterm birth and 8 185 cases of term birth.Demographics,history of pregnancy,prenatal care,and incidences of complication and/or comorbidities,lifestyle and dietary habit during pregnancy were included in the questionnaire.Chi-square test for univariate analysis and logistic regression multivariate analysis were used for statistics.Results The incidence ofpreterm birth was 9.9％(10 986/111 095) in the 15 hospitals.Among the 958 preterm birth cases,2.3％(22/958) were in gestational weeks ＜28,22.7％(217/958) in ≥ 28-＜34 gestational weeks,and 75.1％(719/958) in ≥ 34-＜37 gestational weeks.Univariate analysis showed that the influencing factors related to preterm birth included(preterm birth groups vs term birth group):maternal age ＞40 years or ＜18 years[1.6％(15/958) vs 1.2％(100/8 185),0.6％(6/958) vs 0.1％(7/8 185),22=18.515,P=0.000],ethnic Han [97.7％(919/941) vs 96.3％(7 811/8 115),22=4.819,P=0.028],less educated (lower than junior middle school) [27.1％(257/950) vs 14.9％(1 215/8 132),22=91.879,P=0.000],unmarried status[2.8％(27/955) vs 1.3％(110/8 154),22=12.609,P=0.000],family income ＜5 000 yuan(RMB)/ month [40.5％(380/939) vs 30.8％(2 479/8 060),22=40.457,P=0.000],being preterm born [14.2％(134/942) vs 2.6％(211/8 099),22=349.801,P=0.000],adverse obstetric history [12.9％(72/958) vs 8.5％(346/8 185),22=12.009,P=0.001],previous preterm delivery [50.0％(36/72) vs 17.1％(59/346),x2=36.840,P=0.000],fetal malformation history[4.2％(3/72) vs 18.8％(65/346),22=9.351,P=0.002],reproductive technology assisted conception [7.7％(72/930) vs 2.1％(172/8 037),x22=98.816,P=0.000],antenatal visits ＜5 times [21.0％(195/930) vs 12.0％(966/8 037),22=68.634,P=0.000],second hand smoking [24.5％(235/958) vs 19.6％(1 603/8 185),x2=13.573,P=0.000],unpleasant events during pregnancy [27.6％(264/958) vs 22.0％(1 802/8 185),x2=15.213,P=0.000],folic acid supplementation before and during pregnancy [before pregnancy:39.1％(375/958) vs 49.0％(4 007/8 185);during pregnancy:61.2％(586/958) vs 67.0％(5 485/8 185),x2=31.842,11.667,P=0.000,0.001],multivitamin supplementation during pregnancy [43.4％(416/958) vs 48.1％(3 937/8 185),x2=7.393,P=0.007],and pregnant complications,including anemia,premature rupture of membranes,intrauterine infection,pregnancy complication heart diseases,oligohydramnios,placental abruption,placental previa,fetal distress,multiple gestation,etc [59.9％(574/958) vs 38.9％(3 184/8 185),x2=156.47l,P=0.000].Logistic regression multivariate analysis showed that the following factors were significantly associated with preterm birth:antenatal visits ＜5 times (OR=1.916,95％CI:1.060-3.462),intrauterine infection (OR=5.441,95％CI:1.723-17.176),severe preeclampsia during pregnancy (OR=11.220,95％CI:1.041-2.149),premature rupture of membranes (OR=3.188,95％CI:1.916-5.305) and placenta previa (OR=6.607,95％CI:2.919-14.801).Conclusions There are multiple factors for preterm birth in urban hospitals in east-northern part of China,and quality of antenatal care should be improved and pregnant complications should be closely monitored and managed timely.

Analysis of clinical effect of McDonald cervical cerclage and the related risk factors / 中华妇产科杂志

Objective To investigate the clinical effect of McDonald cervical cerclage and the affecting factors. Methods Between January 2002 to December 2013 in Peking University First Hospital we performed McDonald cervical cerclage for 116 single pregnant women. They were defined as the successful group who deliveried the live babies after 28 weeks after the cerclage and the failure group who deliveried in the second trimester. According to the surgical indications they were divided into preventive cerclage group and therapeutic cerclage group. Then we analyzed the curative effect and the affecting factors in the groups. Results (1) In the 116 cases, 12 cases (10.3%) failed, and 104 cases (89.7%) succeeded. In the successful group, 37 cases (35.6%,37/104) deliveried pretermly and 67 cases (64.4%) deliveried termly. And there were 56 cases of vaginal delivery (53.8%), and 48 cases (46.2%) of cesarean section. (2) Among the 116 cases, 48 cases (41.4%) were included in prophylactic cerclage group, the gestational age was (16.3± 2.2) weeks, 68 (58.6%) cases were included in therapeutic group, the gestational age was (24.0±2.2) weeks. The operation time was (22±9) minutes in preventive group and (24±13) minutes in therapeutic group,there was no statistical difference between the two groups (P>0.05). Live-birth rate between preventive cerclage group and therapeutic cerclage group was no statistically significant difference (P>0.05). The term birth rate (72.9%, 35/48) in preventive group was higher than that in therapeutic group (47.1%, 32/68), the difference was statistically significant (P0.05). (4) There were 68 cases in the therapeutic group, 7 cases failed, and 61 cases succeeded;the preoperative cervical os in failure group [ (21 ± 20) mm] was wider than that in successful group [(14±5) mm], the difference was statistically significant (P0.05). Conclusions The McDonald cervical cerclage for cervical incompetence is a simple, safe and high successful rate of intervention measures. The term labor rate of prophylactic cervical cerclage was higher than that of the therapeutic cerclage. Older maternal age and preoperative invasive procedure may be the risk factors for cerclage. The infection may play an important factor leading to the failure of McDonald cervical cerclage.

Efficiency of ring butterfly sewing in lower uterine segment aided with tourniquet in treating pernicious ;placenta previa combined with placenta percreta / 中华围产医学杂志

Objective To investigate the efficiency of ring butterfly sewing in lower uterine segment aided with tourniquet in treating pernicious placenta previa combined with placenta percreta. Methods Twelve pregnant women diagnosed with pernicious placenta previa combined with placenta percreta by prenatal ultrasound in Peking University First Hospital from April 1, 2012 to November 30, 2014, were enrolled. All of them received elective cesarean delivery using ring butterfly sewing in lower uterine segment aided with tourniquet. The efficiency of this novel technique, in term of blood loss and vital signs during operation, blood transfusion, and postoperative recovery, was analyzed. Results Twelve cases were diagnosed with placenta percreta during operation, with placenta invading the perimetrium in seven cases and urinary bladder being involved in one case. Ring butterfly sewing in lower uterine segment aided with tourniquet during elective cesarean delivery was all successful in the 12 cases. The median amount of blood loss was 1 000(400-2 000) ml during operation and the amount of blood loss was lower than 1 000 ml in three cases. Two cases received no blood transfusion, and the median blood transfusion in the other 10 cases were 400(400-1 200) ml. The mean operation time was (75±22) min (43-131) min. Eleven cases had normal lochia and temperature after operation and the other one had placenta invading urinary bladder and partial placenta in situ, and developed fever at day 3 after operation, but recovered after antibiotic treatment, and no placenta tissue was seen by ultrasound at day 59 after operation. Conclusions The ring butterfly sewing in lower uterine segment aided with tourniquet is highly effective for the pernicious placenta previa combined with placenta percreta, and it is a simple, fast and fertility sparing technique with low blood loss and without usage of special equipment.

Histological chorioamnionitis in placenta and preterm birth / 中华围产医学杂志

Objective To investigate the causes and mechanism of preterm birth through analysis of the relationship between histological chorioamnionitis (HCA) in placental tissue and preterm birth.Methods Totally,327 preterm birth cases with report of placental pathologic examination were retrospectively collected from those women who delivered from December 1,2009 to December 1,2012 in Peking University First Hospital.According to the etiology of preterm birth,three groups were assigned:iatrogenic group (n=106),spontaneous contraction group (n=56) and premature rupture of membranes (PROM) group (n=165).According to the gestational age at delivery,three subgroups were further divided:early-preterm group (≥ 28-＜ 32 weeks),mid-preterm group(≥ 32-＜ 34 weeks) and late-preterm group (≥ 34-＜ 37 weeks).HCA was confirmed when ≥ 5 neutrophil infiltration identified on the chorionic plate and amniotic membrane under high power light microscope after HE staining.The relationship between HCA and the different types of preterm birth and the different delivery gestational age were analyzed.Besides,the consistency between clinical chorioamnionitis and HCA was also analyzed.Chi-square test was applied for statistics.Results The incidence of HCA in the spontaneous contraction group was significantly higher than in the iatrogenic group and PROM group [66.1％ (37/56) vs 25.5％ (27/106) and 33.3％ (55/165),x2=25.27 and 18.44,both P ＜ 0.01],but no significant difference was found between the latter two groups (P ＞ 0.05).Among the three subgroups,the early-,midand late-preterm subgroup,the incidence of HCA in the iatrogenic group was 24.0％ (6/25),33.3％ (8/24) and 22.8％ (13/57) (P ＞ 0.05),and 13/17,5/7 and 59.4％ (19/32) in the spontaneous contraction group (P ＞ 0.05).However,significantly higher incidence of HCA was shown in the early-preterm subgroup than in the mid-and late-preterm subgroup [70.0％ (20/29) vs 41.2％ (14/34) and 20.6％ (21/102),X2=4.87 and 24.58,both P ＜ 0.05] in the PROM group.Among the subjects in PROM group,those with the latency ≥ 72 h after the rupture of membranes had a higher incidence of HCA than those with the latency less than 72 h [68.6％ (24/35) vs 23.8％ (31/130),x2=24.82,P ＜ 0.01].For all 327 cases in this study,the incidence of clinical chorioamnionitis was 15.9％ (52/327),among which 31 cases [59.6％ (31/52)] were diagnosed as HCA.Conclusions The occurrence of HCA is closely associated with spontaneous contraction preterm.Some iatrogenic preterm birth might cause HCA.The earlier the preterm birth and the longer the latency after PROM,the higher the incidence of HCA.Differential diagnosis is necessary as the inconsistency between clinical chorioamnionitis and HCA.

MR Tracer Diffusion in Cerebral Interstitial Fluid of Elderly SD Rats / 中国医学影像学杂志

Purpose With the progression of brain tissue aging, the transport and drainage characteristics of metabolites and secretory products for neurons in extracellular space occurs irreversible change. This paper aims to investigate and quantify MR tracer diffusion characteristics in cerebral interstitial fluid of elderly SD rats. Materials and Methods MR contrast agent Gd-DTPA was injected into the caudate nucleus of two groups of rats including 8 in experimental group (15-17 month old) and 15 in control group (7-10 month old). MR scan was performed at 0.25 h, 0.5 h, 1 h, 2 h, 3 h and 4 h to observe the dynamic distribution in the caudate and measure the diffusion and clearance rate. Results There was no statistically significant difference in diffusion rate and D* between control group with (3.32±0.70)×10-4 mm2/s and experimental group with (3.25±0.46)×10-4 mm2/s (t=1.739, P>0.05). The clearance rate k' was significantly different between control group (0.62±0.12)×10-4/s and experimental group (0.29±0.08)×10-4/s (t=11.602, P<0.05). Conclusion The degeneration of aging brain tissue changes the composition of extracellular space resulting in decreased speed of ISF clearance. This may cause accumulation of metabolites which eventually triggers a variety of age-related diseases.

Construction and identification of interference plasmid targeting on TNFAIP8 / 中国免疫学杂志

Objective:To construct and screen the high efficiency interference plasmid of TFAIP8-shRNA-pSIREN-RetroQ.Methods:Selected and synthesized three Target Sequence of TNFAIP8 shRNA1,TNFAIP8 shRNA2,TNFAIP8 shRNA3,and construct the TNFAIP8 interference plasmid.Transfection TNFAIP8-shRNA-pSIREN-RetroQ interference plasmid to A549 cells.Filter out the highest interference efficiency plasmid by detecting the mRNA and protein levels using RT-PCR and Western blot methods.Results:We successfully design and built three TNFAIP8-shRNA-pSIREN-RetroQ interference plasmids,and screen out the highest efficiency interference plasmid.Conclusion: Three interference plasmids targeting the TNFAIP8 gene have been constructed successfully and provide a useful tool for studying the function of TNFAIP8.