A pre-conception cohort study of fertility and its related factors among couples with the intention of conception / 中华预防医学杂志

Objective: To describe fertility and explore factors associated with it among pre-conception couples of childbearing age. Methods: Based on the pre-conceptional offspring trajectory study of the School of Public Health of Fudan University, couples of childbearing age who participated in the pre-conception physical examination in Shanghai Jiading District from 2016 to 2021 were recruited and followed up. Couples' time to pregnancy (TTP) was analyzed and Cox proportional hazards regression model was used to explore the factors associated with TTP. Kaplan-Meier was used to calculate each menstrual cycle's cumulative pregnancy rate. Results: A total of 1 095 preconception couples were included in the analysis, the M(Q1,Q3)of TTP was 4.33 (2.41, 9.78) menstrual cycles. Age of women (FR=0.90, 95%CI: 0.85-0.95, P<0.001), women who were overweight or obese before pregnancy (FR=0.36, 95%CI: 0.24-0.55, P<0.001), women who were exposed to second-hand smoking (FR=0.63, 95%CI: 0.44-0.92, P=0.016), women whose home or office had been renovated in the past 2 years and had a particular smell (FR=0.46, 95%CI: 0.26-0.81, P=0.008) were risk factors for impaired fertility. Regular menstrual cycles (FR=1.64, 95%CI: 1.16-2.31, P=0.005), females who often drank tea/coffee (FR=1.55, 95%CI: 1.11-2.17, P=0.011) and males who took folic acid before conception (FR=2.35, 95%CI: 1.38-4.23, P=0.002) were associated with better fertility. The cumulative pregnancy rate of 3, 6, and 12 menstrual cycles was 37.6%, 64.4%, and 78.4%, respectively. Conclusion: Older couples, overweight or obesity before pregnancy, irregular menstruation, exposure to secondhand smoke and decoration pollutants in females are associated with impaired fertility. Frequent tea/coffee drinking before pregnancy in females and taking folic acid before pregnancy in males are associated with shortened conception time.

Increased risk of cerebrovascular mortality in head and neck cancer survivors aged ≥ 65 years treated with definitive radiotherapy: a population-based cohort study.

BACKGROUND: To investigate the relationship between radiotherapy (RT) and the risk of cerebrovascular mortality (CVM) in head and neck cancer (HNC) survivors aged ≥ 65 years. METHODS: Patients with HNC survivors aged ≥ 65 years diagnosed between 2000 and 2012 were included from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier analysis, Log-rank tests, and Cox proportional-hazards regression models were performed for statistical analyses. RESULTS: We included 16,923 patients in this study. Of these patients, 7110 (42.0%) patients received surgery alone, 5041 (29.8%) patients underwent RT alone, and 4772 (28.2%) patients were treated with surgery and RT. With a median follow-up time of 87 months, 1005 patients died with cerebrovascular disease. The 10-years CVM were 13.3%, 10.8%, and 11.2% in those treated with RT alone, surgery alone, and surgery plus RT, respectively (P < 0.001). The mean time for CVM was shorter in RT alone compared to surgery alone and surgery plus RT (52 months vs. 56-60 months). After adjusting for covariates, patients receiving RT alone had a significantly higher risk of developing CVM compared to those receiving surgery alone (hazard ratio [HR] 1.703, 95% confidence interval [CI] 1.398-2.075, P < 0.001), while a comparable risk of CVM was found between those treated with surgery alone and surgery plus RT (HR 1.106, 95% CI 0.923-1.325, P = 0.274). Similar trends were found after stratification age at diagnosis, gender, tumor location, and marital status. CONCLUSIONS: Definitive RT but not postoperative RT can increase the risk of CVM among older HNC survivors. Long-term follow-up and regular screening for CVD are required for HNC patients who received definitive RT to decrease the risk of CVM.

Relationship between breastfeeding knowledge， self-efficacy and exclusive breastfeeding behavior among postpartum mothers / 上海预防医学

Objective:To explore the relationship between breastfeeding knowledge， self-efficacy and exclusive breastfeeding behavior among mothers of one-month old babies. Methods:Random sampling method was conducted for choosing 5 out of 13 community service health centers in Jiading district of Shanghai. A cross-sectional online survey was conducted among the mothers. Results:A total of 456 valid questionnaires were received， the full score of breastfeeding knowledge was set at 60， with an average of 47.17±5.65， ranging from 12 to 60. The full score of self-efficacy was set at 70， with an average of 47.70±14.48， ranging from 14 to 70. The exclusive breastfeeding rate of one-month old infants was 55.3%（252/456）. Multivariate logistic analysis showed that mothers with higher scores of breastfeeding knowledge had significantly higher rate of exclusive breastfeeding （OR=1.717， 95%CI 1.034-2.851， P=0.037）. Those with higher scores of breastfeeding self-efficacy also had significantly higher rate of exclusive breastfeeding （OR=5.736， 95%CI 3.455-9.522， P=0.001）. Conclusions:The breastfeeding knowledge and self-efficacy of mothers of one-month old babies were significantly associated with the rate of exclusive breastfeeding. Medical staff should strengthen the delivery and cultivation of breastfeeding knowledge and skills for mothers to improve breastfeeding self-efficacy， and ultimately promote the rate of exclusive breastfeeding.

Mechanisms of electroacupuncture effects on acute cerebral ischemia/reperfusion injury: possible association with upregulation of transforming growth factor beta 1.

Electroacupuncture at the head acupoints Baihui (GV20) and Shuigou (GV26) improves recovery of neurological function following ischemic cerebrovascular events, but its mechanism remains incompletely understood. We hypothesized that the action of electroacupuncture at these acupoints is associated with elevated serum levels of transforming growth factor beta 1 (TGF-ß1). To test this, we established a rat model of cerebral ischemia by middle cerebral artery occlusion. Electroacupuncture was performed at Baihui and Shuigou with a "disperse-dense" wave at an alternating frequency of 2 and 150 Hz, and at a constant intensity of 3 mA. Each electroacupuncture session lasted 30 minutes and was performed every 12 hours for 3 days. Neurological severity scores were lower in injured rats after acupuncture than in those not subjected to treatment. Furthermore, serum level of TGF-ß1 was greater after electroacupuncture than after no treatment. Our results indicate that electroacupuncture at Baihui and Shuigou increases the serum level of TGF-ß1 in rats with acute cerebral ischemia/reperfusion injury, and exerts neuroprotective effects.

Fabrication and characteristics of a multilayered ionic polymer metal composite based on Nafion/tetraethyl orthosilicate and Nafion/MCNT nanocomposites.

Nafion/multi-walled carbon nanotubes (Nafion/MCNT) and Nafion/tetraethyl orthosilicate (Nafion/TEOS) nanocomposites were prepared and used as starting materials in the fabrication of an ionic polymer metal composite (IPMC). Experimental data show that the Nafion/MCNT-based IPMC exhibited a blocking force that is two times higher than that of bare Nafion-based IPMC. This higher blocking force is due to the stable homogeneous dispersions of multiwalled carbon nanotubes as well as to their improved conductivity. Meanwhile, the Nafion/TEOS-based IPMC generated a blocking force that is more than two times higher than that of bare Nafion-based IPMC because of the induced channels and increased water content. In this paper, a novel Nafion membrane containing a primary Nafion/TEOS layer sandwiched between two outer Nafion/MCNT nanocomposite layers was prepared by consecutive casting of liquid solutions. By using the multilayered Nafion membrane, IPMC was carefully fabricated by electroless plating. In addition, the blocking force, displacement, and electric current of the IPMC were measured on the test apparatus. The multilayered IPMC exhibited a significantly improved blocking force of 6.5 gf as well as a long effective air-operating life time. Finally, this multilayered IPMC was successfully used to actuate the robotic fish.

[Efficacy observation on acupuncture prescription of regulating yin-yang and five viscera for intractable insomnia].

OBJECTIVE: To explore a more optimal therapy for intractable insomnia. METHODS: Seven hundred cases of intractable insomnia that were in accordance with the criteria were randomly divided into an observation group (368 cases) and a control group (332 cases). The acupuncture prescription of regulating yin-yang and five viscera was applied in the observation group, where Dazhui (GV 14), Shenmai (BL 62), Guanyuan (CV 4), Zhaohai (KI 6), Geshu (BL 17), etc. were selected. The acupuncture prescription of tranquilizing mind was applied in the control group, where Baihui (GV 20), Sishencong (EX-HN 1), Anmian (Extra), Shenmen (HT 7), Sanyin jiao (SP 6) were selected. The treatment was given once a day, ten times of which made a session. After the treatment for 4 sessions, the clinical efficacy and Pittsburgh sleep quality index (PSQI) were compared between two groups. RESULTS: The total effective rate was 92.6% (338/365) in the observation group, which was superior to 73.1% (242/331) in the control group (P < 0.05). The PSQI score was obviously decreased in two groups after the treatment (both P < 0.05), in which the decreasing in the observation group was superior to that in the control group (P < 0.05). CONCLUSION: The acupuncture prescription of regulating yin-yang and five viscera has better effect for intractable insomnia, which could be considered as a more optimal therapy.

[Surgical treatment of subluxated lens with cataract].

OBJECTIVE: To study the surgical treatment of the subluxated lens with cataract caused by broken suspensory ligament of the lens. METHODS: Phacoemulsification combined with intraocular lens implantation was performed in 21 eyes. Extracapsular cataract extraction with small-incision was performed in 6 eyes. The visual acuity, the position of IOL, and the postoperative complications were observed and analyzed. RESULTS: Postoperative vision was increased in all patients. Vision 3 days after the operation was 0.1 - 0.4 in 6 eyes and 0.5 - 0.8 in 21 eyes. Vision 1 month after the operation was 0.1 - 0.4 in 7 eyes and 0.5 - 0.8 in 20 eyes. The up-edge of IOL could be observed at normal pupil in only one eye. IOL positions were found to be diverged after dilation of the pupil in 2 eyes; no diplopia was experienced. There were no serious complications during or after the operation. CONCLUSION: If the operator has perfect skill and chooses the optimal method, a good result can be obtained in surgical treatment of the subluxated lens.