Risk factor assessment and adverse outcome prediction of placenta accreta in pregnant women after cesarean section complicated with placenta previa: a national multicenter retrospective study / 中华妇产科杂志

Objective:To study the risk factors of adverse pregnancy outcomes for the diagnosis and treatment of pregnancy after cesarean section complicated with placenta previa.Methods:A national multicenter retrospective study was conducted to select a total of 747 pregnant women with the third trimester singleton pregnancy after cesarean section complicated with placenta previa from 12 tertiary hospitals in January 1st to December 31st, 2018. The risk factors of severe adverse outcomes [hysterectomy, intraoperative blood loss ≥1 000 ml, intraoperative diagnosis of placenta accreta spectrum disorders (PAS)] in pregnant women with second pregnancy complicated with placenta previa after cesarean section were investigated by logistic regression analysis. The roles of prenatal ultrasonography and magnetic resonance imaging (MRI) in the prediction of PAS and severe adverse outcomes were observed. According to whether vascular intervention was performed (uterine artery embolization or abdominal aortic balloon occlusion), the pregnant women were divided into the blocked group and the unblocked group, and the maternal and infant perinatal outcomes between the two groups were compared.Results:(1) General information: the hysterectomy rate of 747 pregnant women with second pregnancy complicated with placenta previa after cesarean section was 10.4% (78/747), the intraoperative blood loss ≥1 000 ml in 55.8% (417/747), and PAS was confirmed in 47.5% (355/747). The incidence of uterine rupture was 0.8% (6/747). (2) Analysis of risk factors for severe adverse outcomes: based on binary unconditioned logistic regression univariate and multivariate analysis, the risk factors for hysterectomy were the mode of vascular embolization and intraoperative blood loss. The probability of hysterectomy with uterine artery embolization was 5.319 times higher than that with abdominal aortic balloon occlusion (95% CI: 1.346-21.018). The risk factors of intraoperative blood loss ≥1 000 ml were the number of cesarean section delivery, ultrasonography indicated PAS and suspected PAS, intraoperative PAS and complete placenta previa. The risk factors for intraoperative PAS were uterine scar thickness, ultrasonography indicated PAS and suspected PAS, MRI indicated PAS and suspected PAS, and complete placenta previa. (3) The roles of ultrasonography and MRI in predicting PAS: the sensitivity and specificity of ultrasonography in predicting PAS were 47.5% and 88.4%; the kappa value was 0.279 ( P<0.001), with fair agreement. The sensitivity and specificity of MRI to predict PAS were 79.2% and 97.8%, respectively. The kappa value was 0.702 ( P<0.001), indicating a good agreement. The intraoperative blood loss and hysterectomy rate of pregnant women with PAS indicated by ultrasonography and MRI were significantly higher than those with PAS only by ultrasonography or MRI. (4) Influence of vascular occlusion on pregnancy outcome: there were no significant differences in intraoperative blood loss and incidence of intraoperative bleeding ≥1 000 ml between the blocked group and the unblocked group (all P>0.05). There was no significant difference in intraoperative blood loss between the pregnant women with abdominal aortic balloon occlusion, uterine artery embolization and those without occlusion ( P=0.409). The hysterectomy rate of pregnant women with uterine artery embolization was significantly higher than those with abdominal aortic balloon occlusion [39.3% (22/56) vs 10.0% (5/50), P=0.001]. Conclusions:In the third trimester of pregnancy with placenta previa after cesarean section, MRI examination has better consistency in predicting PAS than ultrasonography examination. Ultrasonography examination combined with MRI examination could effectively predict the hysterectomy rate and intraoperative blood loss. Vascular occlusion could not reduce the amount of intraoperative blood loss. The hysterectomy rate of pregnant women with uterine artery embolization is higher than those with abdominal aortic balloon occlusion.

Cognition of prevention and control of cervical cancer and influencing factors of HPV vaccination intention among college students in Xiangyang / 公共卫生与预防医学

Objective The knowledge of cervical cancer prevention and control，the cognition of human papillomavirus (HPV) vaccine and the willingness to vaccinate HPV vaccine among college students in Xiangyang were investigated and analyzed to provide a reliable scientific basis for the primary prevention of cervical cancer prevention and control in Xiangyang. Methods By means of stratified sampling method and self-made questionnaire, this paper conducted a questionnaire survey among college students in 3 universities in Xiangyang. Results A total of 8 523 college students participated in the questionnaire survey, and 4 473 of them had sufficient knowledge of cervical cancer prevention and control and HPV vaccine, with the awareness rate of 52.48%. Male students, rural residents and non-medical majors were the influencing factors of insufficient knowledge of cervical cancer prevention and control and HPV vaccine. Among the 6 459 female college students who participated in the survey, 5,993 (92.79%) were willing to be vaccinated, and 859 (13.30%) were already vaccinated. Major, educational background, living expenses and cognitive scores were the influencing factors of HPV vaccination intention. Conclusion College students in Xiangyang City are relatively deficient in the knowledge of cervical cancer prevention and control and HPV vaccine. Targetable science popularization and education can improve college students' correct understanding of cervical cancer prevention and control knowledge, promote the HPV vaccine vaccination plan, and reduce the occurrence of HPV-related diseases and cervical cancer.

Evaluation of the diagnosis and treatment of cesarean scar pregnancy induced in the second trimester: a national multicenter retrospective study / 中华妇产科杂志

Objective:To study the risk factors of adverse pregnancy outcomes for induced abortion of cesarean scar pregnancy in midtrimester.Methods:A national multicenter retrospective study was conducted. A total of 154 singletons pregnant women with cesarean scar pregnancy during the second trimester induced abortion by various reasons in 12 tertiary A hospitals were selected, their pregnant outcomes were observed and the risk factors of serious adverse outcomes were analyzed with univariate and multivariate logstic regression; the role of ultrasound and MRI in predicting placenta accreta and severe adverse outcomes was evaluated, the effectiveness of uterine artery embolization (UAE) in preventing hemorrhage in pregnant women with and without placenta accreta was compared.Results:Among 154 subjects, the rate of placenta accreta was 42.2% (65/154), the rate of postpartum hemorrhage≥1 000 ml was 39.0% (60/154), the rate of hysterectomy was 14.9% (23/154), the rate of uterine rupture was 0.6% (1/154). The risk factor of postpartum hemorrhage≥1 000 ml and hysterectomy was placenta accreta ( P<0.01). For each increase in the number of parity, the risk of placenta accreta increased 2.385 times (95% CI: 1.046-5.439; P=0.039); and the risk of placenta accreta decreased with increasing ultrasound measurement of scar myometrium thickness ( OR=0.033, 95% CI: 0.001-0.762; P=0.033). The amount of postpartum hemorrhage and hysterectomy rate in the group with placenta accreta diagnosed by ultrasound combined with MRI were not significantly different from those in the group with placenta accreta diagnosed by ultrasound only or MRI only (all P>0.05). For pregnant women with placenta accreta, there were no significant difference in the amount of bleeding and hysterectomy rate between the UAE group [median: 1 300 ml; 34% (16/47)] and the non-embolization group (all P>0.05); in pregnant women without placenta accreta, the amount of bleeding in the UAE group was lower than that in the non-embolization group (median: 100 vs 600 ml; P<0.01), but there was no significant difference in hysterectomy rate [2% (1/56) vs 9% (3/33); P>0.05]. Conclusions:(1) Placenta accreta is the only risk factor of postpartum hemorrhage≥1 000 ml with hysterectomy for induced abortion of cesarean scar pregnancy in midtrimester; multi-parity and ultrasound measurement of scar myometrium thickness are risk factors for placenta accreta. (2) The technique of using ultrasound and MRI in predicting placenta accreta of cesarean scar pregnancy needs to be improved. (3) It is necessary to discuss of UAE in preventing postpartum hemorrhage for induced abortion of cesarean scar pregnancy in midtrimester.

Drug analysis based on scalable moving-window similarity and Bayesian method by Raman spectroscopy / 药学实践杂志

Objective To propose scalable moving-window similarity combined with Bayesian for rapid discriminating low active pharmaceutical ingredient(API)signal drugs(LAPIDs).Methods The scalable moving-window similarity method was employed by setting the window size dynamically according to API′s peak width.In each window,the correlation coefficient (CC)of API′s peak spectrum signal with LAPID′s spectrum and LAPID′s spectrum with excipient′s spectrum were calculated respectively.The LAPIDs discrimination model was established by choosing windows with most contribution of the API spec-tral signal to the LAPID spectrum as variables for Bayesian discriminant model.Results The accuracy rate of LAPIDs discrim-ination model for discriminating LAPIDs was 94.7%.The accuracy rate of the model for discriminating testing samples was 95.6%.Conclusion Bayesian discrimination model based on scalable moving-window similarity and Bayesian algorithm can quickly discriminate LAPIDs.

The relationship between follice-stimulating hormone and its receptor in male reproduction / 中国医师杂志

Follicle stimulating hormone (FSH) is the key endocrine hormone regulating the gonadal function of both sexes.FSH stimulates male testicular Sertoli differentiation,promotes testicular development,and mitosis of spermatogonia.FSH maintains adult Sertoli cell metabolism and plays an important role in spermatogenesis,germ cell survival and male fertility.FSH and follicle-stimulating hormone receptor (FSHR) gene mutation or gene polymorphism may affect the role of FSH on target organs.This article reviews the relationship between FSH and FSHR and male reproductive relationship.

Impact of thymalfasin on cellular immune function and lung function of patients with chronic obstructive pulmonary disease / 中国基层医药

Objective To investigate the impact of thymalfasin on cellular immune function and lung function of patients with chronic obstructive pulmonary disease(COPD).Methods 216 patients with COPD in our hospital from March 2011 to August 2014 were randomly selected.According to the digital table,they were divided into the study group (108 cases) and control group (108 cases).The control group was given conventional treatment,while the study group was given thymalfasin on the basis of conventional treatment.Then,the cellular immune function,lung function of each index of the two groups were statistically analyzed.Results The CD3+,CD4+,CD4+/CD8+ of the study group were significantly higher (all P ＜ 0.05),the CD8+ was significantly lower(P ＜ 0.05),the FEV1,FEV1/FVC were significantly higher than the control group (P ＜ 0.05).Conclusion Thymalfasin can effectively improve the cellular immune function and lung function of patients with COPD.

Determination of Ligustrazine in Rat's Plasma,Brain and Liver by HPLC / 中国药房

OBJECTIVE:To establish an HPLC method for the determination of the contents of Ligustrazine in rat's plasma,brain and liver.METHODS:Ligustrazine was separated on Hypersil ODS-C18 column with aspirin as internal standard.The mobile phase consisted of methanol-1.5% glacial acetic acid solution(45∶55,V/V)at a flow rate of 1.0 mL?min-1.The UV detection wavelength was 279 nm.RESULTS:The linear range of ligustrazine in rat's plasma,brain and liver was 0.006 25～7.813 ?g?mL-1,The lowest detectable limits were 0.5 ng?mL-1,1.55 ng?mL-1,and 1.55 ng?mL-1 and the average recoveries were 97.26%,96.44%,and 95.43% respectively with RSD at 3.40%,4.19% and 4.94%,respectively.CONCLUSION:With good linearity,precision and recovery,the method is sensitive and simple,and suitable for pharmacokinetic study and the research of Ligustrazine preparation.

Comparison of color level among Vita,Shofu and Dentsply shade guide / 实用口腔医学杂志

Objective:To compare color level among Vita,Shofu and Dentsply shade guide. Methods:Vita,Shofu and Dentsply shade guide were scanned into a computer and saved as BMP pictures. L *, a * and b * values of the color of the images were measured by Photoshop. Results:There was same trend of variation in color of the shade guides, but the maximum and minimum of L *, a * and b * in those shade guides were different. Conclusion: For matching color accurately, one shade guide can not be used to replace the other one in clinical application.