Clinical risk score for central precocious puberty among girls with precocious pubertal development: a cross sectional study.

BACKGROUND: The gold standard for the diagnosis of central precocious puberty (CPP) is gonadotropin-releasing hormone (GnRH) or GnRH analogs (GnRHa) stimulation test. But the stimulation test is time-consuming and costly. Our objective was to develop a risk score model readily adoptable by clinicians and patients. METHODS: A cross-sectional study based on the electronic medical record system was conducted in the Children's Hospital, Fudan University, Shanghai, China from January 2010 to August 2016. Patients with precocious puberty were randomly split into the training (n = 314) and validation (n = 313) sample. In the training sample, variables associated with CPP (P < 0.2) in univariate analyses were introduced in a multivariable logistic regression model. Prediction model was selected using a forward stepwise analysis. A risk score model was built with the scaled coefficients of the model and tested in the validation sample. RESULTS: CPP was diagnosed in 54.8% (172/314) and 55.0% (172/313) of patients in the training and validation sample, respectively. The CPP risk score model included age at the onset of puberty, basal luteinizing hormone (LH) concentration, largest ovarian volume, and uterine volume. The C-index was 0.85 (95% CI: 0.81-0.89) and 0.86 (95% CI: 0.82-0.90) in the training and the validation sample, respectively. Two cut-off points were selected to delimitate a low- (< 10 points), median- (10-19 points), and high-risk (≥ 20 points) group. CONCLUSIONS: A risk score model for the risk of CPP had a moderate predictive performance, which offers the advantage of helping evaluate the requirement for further diagnostic tests (GnRH or GnRHa stimulation test).

Auricular therapy improves gastrointestinal function in patients with gynecological laparoscopic surgery: A protocol for systematic review and meta analysis.

BACKGROUND: Gynecological laparoscopic surgery is the main method to treat gynecological diseases, but postoperative gastrointestinal reactions are more common in patients. Auricular therapy, as a characteristic therapy of Traditional Chinese Medicine, can improve gastrointestinal symptoms such as nausea and vomiting by stimulating the conduction of acupoints through the nervous system on internal organs, but there are studies questioning the efficacy of auricular therapy. Therefore, the purpose of this study is to prove the efficacy and safety of auricular therapy in promoting gastrointestinal function recovery after gynecological laparoscopic surgery, and to provide reference value for future clinical practice. METHODS: To search English databases (PubMed, Excerpta Medical Database [Embase], Web of Science, the Cochrane Library) and Chinese databases (Chinese National Knowledge Internet [CNKI], WanFang, Viper, Chinese Biomedical Literature Database) by computer, and conduct a randomized controlled trial on the effect of aural point therapy on gastrointestinal function recovery of patients after gynecological laparoscopic surgery from the establishment of the database to October 2020. Two researchers independently evaluate the quality of the included studies and extract the data, and meta-analysis of the included literature is carried out using RevMan5.3 software. RESULTS: In this study, the efficacy and safety of auricular therapy in the recovery of gastrointestinal function after gynecological laparoscopic surgery are evaluated from the aspects of first anal exhaust time, bowel sound recovery time, and incidence of gastrointestinal complications. CONCLUSION: This study will provide reliable evidence-based evidence for auricular therapy in the treatment of gastrointestinal function after gynecologic laparoscopic surgery. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605 / OSF.IO / ZSPGA.

Low Level of Vitamin D is a Risk Factor for the Occurrence of Early and Late Onset Pre-Eclampsia in Pregnant Women.

BACKGROUND: This study was aimed to investigate the relationship between 25-hydroxy vitamin D (25(OH)D) level and the occurrence of pre-eclampsia (PE) and also the risk factors of developing early and late onset PE. METHODS: A total of 370 pregnant women were included between January 2015 and December 2016 at our hospital. PE was defined as the presence of maternal blood pressure > 140/90 mmHg and 24-hour proteinuria levels > 300 mg or 2 + in a random sample of urine after the 20th week of pregnancy. Controls were pregnant women without hypertension and proteinuria. Assessment of 25(OH)D was performed at 16 - 20 weeks of gestation. Univariate and multivariate analyses were used to evaluate the association of vitamin D with PE. RESULTS: There were 201 patients with PE while 169 pregnant women were controls. Patients with PE had older maternal age (p < 0.001), earlier gestation age (p < 0.001), and higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) (p < 0.001). The level of 25(OH)D in the PE group (17.26 ± 13.95 µg/L) was significantly lower than that in controls (22.15 ± 12.65 µg/L, p = 0.019). Moreover, the proportion of 25(OH)D deficiency in patients with PE was significantly higher than that of controls (27.6% vs. 0.9%, p < 0.001). Older age, high SBP, and low level of 25(OH)D were independent risk factors of both early and late onset PE during pregnancy. CONCLUSIONS: Low 25(OH)D level was more likely presented in PE patients and was an independent risk factor of both early and late onset PE.

The effect of surgery on subsequent pregnancy outcomes among patients with cesarean scar diverticulum.

OBJECTIVE: To determine whether surgical treatment of cesarean scar diverticulum (CSD) reduced adverse outcomes during the subsequent pregnancy. METHODS: A retrospective observational study was conducted using the medical records of pregnant women with CSD who attended a single hospital in Hangzhou, China, between January 1, 2014, and December 31, 2016. Baseline characteristics and pregnancy outcomes were compared between the surgery group and the no surgery group. RESULTS: There were 106 patients included in the study, 83 in the surgery group and 23 in the no surgery group. The CSD size was greater in all dimensions for the surgery group versus the no surgery group: length (P<0.001), width (P=0.001), and depth (P=0.030). The remaining myometrium was thinner among women in the surgery group than those in the no surgery group (P=0.011). In all, 76 (91.6%) women in the surgery group were symptomatic. The incidence of live delivery pregnancy was higher (P=0.033) and the incidence of cesarean scar pregnancy was lower (P=0.019) in the surgery group versus the no surgery group. Surgery increased the thickness of the lower uterine segment (P<0.001); however, it did not reduce the risks of placenta previa or placenta accreta (P=0.683) and uterine dehiscence or uterine rupture (P=0.458). CONCLUSION: Surgical intervention reduced the incidence of cesarean scar pregnancy and increased the number of live deliveries.

Rapid Assessment of Adverse Drug Reactions by Statistical Solution of Gene Association Network.

Adverse drug reaction (ADR) is a common clinical problem, sometimes accompanying with high risk of mortality and morbidity. It is also one of the major factors that lead to failure in new drug development. Unfortunately, most of current experimental and computational methods are unable to evaluate clinical safety of drug candidates in early drug discovery stage due to the very limited knowledge of molecular mechanisms underlying ADRs. Therefore, in this study, we proposed a novel na€ive Bayesian model for rapid assessment of clinical ADRs with frequency estimation. This model was constructed on a gene-ADR association network, which covered 611 US FDA approved drugs, 14,251 genes, and 1,254 distinct ADR terms. An average detection rate of 99.86 and 99.73 percent were achieved eventually in identification of known ADRs in internal test data set and external case analyses respectively. Moreover, a comparative analysis between the estimated frequencies of ADRs and their observed frequencies was undertaken. It is observed that these two frequencies have the similar distribution trend. These results suggest that the naive Bayesian model based on gene-ADR association network can serve as an efficient and economic tool in rapid ADRs assessment.

Different miRNA expression profiles between human breast cancer tumors and serum.

A bunch of microRNAs (miRNAs) have been demonstrated to be aberrantly expressed in cancer tumor tissue and serum. The miRNA signatures identified from the serum samples could serve as potential noninvasive diagnostic markers for breast cancer. The role of the miRNAs in cancerigenesis is unclear. In this study, we generated the expression profiles of miRNAs from the paired breast cancer tumors, normal, tissue, and serum samples from eight patients using small RNA-sequencing. Serum samples from eight healthy individuals were used as normal controls. We identified total 174 significantly differentially expressed miRNAs between tumors and the normal tissues, and 109 miRNAs between serum from patients and serum from healthy individuals. There are only 10 common miRNAs. This suggests that only a small portion of tumor miRNAs are released into serum selectively. Interestingly, the expression change pattern of 28 miRNAs is opposite between breast cancer tumors and serum. Functional analysis shows that the differentially expressed miRNAs and their target genes form a complex interaction network affecting many biological processes and involving in many types of cancer such as prostate cancer, basal cell carcinoma, acute myeloid leukemia, and more.

A global characterization and identification of multifunctional enzymes.

Multi-functional enzymes are enzymes that perform multiple physiological functions. Characterization and identification of multi-functional enzymes are critical for communication and cooperation between different functions and pathways within a complex cellular system or between cells. In present study, we collected literature-reported 6,799 multi-functional enzymes and systematically characterized them in structural, functional, and evolutionary aspects. It was found that four physiochemical properties, that is, charge, polarizability, hydrophobicity, and solvent accessibility, are important for characterization of multi-functional enzymes. Accordingly, a combinational model of support vector machine and random forest model was constructed, based on which 6,956 potential novel multi-functional enzymes were successfully identified from the ENZYME database. Moreover, it was observed that multi-functional enzymes are non-evenly distributed in species, and that Bacteria have relatively more multi-functional enzymes than Archaebacteria and Eukaryota. Comparative analysis indicated that the multi-functional enzymes experienced a fluctuation of gene gain and loss during the evolution from S. cerevisiae to H. sapiens. Further pathway analyses indicated that a majority of multi-functional enzymes were well preserved in catalyzing several essential cellular processes, for example, metabolisms of carbohydrates, nucleotides, and amino acids. What's more, a database of known multi-functional enzymes and a server for novel multi-functional enzyme prediction were also constructed for free access at http://bioinf.xmu.edu.cn/databases/MFEs/index.htm.

Follow-up results of children with melamine induced urolithiasis: a prospective observational cohort study.

BACKGROUND: Melamine-contaminated milk powder was the cause of the 2008 outbreak of urolithiasis in young children and infants in China, but the prognosis of these children remains unknown. We hypothesized that urolithiasis induced by melamine-contaminated milk powder may be associated with secondary renal injury. METHODS: A total of 8335 children (≤6 years old) with a history of consuming melamine-contaminated milk powder were screened. Urine analysis and urinary system ultrasonography were performed. For children with urolithiasis, the basic information and the results of examination were recorded, and effective therapy was given. They were followed up for 6 months after the original diagnosis, and urinary microprotein profiles were measured. RESULTS: Of the 8335 children, 105 (1.26%) were diagnosed with melamine-contaminated milk powder-associated urolithiasis. The size of the stone was correlated with the duration of exposure to melamine. Six months later, 69.8% (67) of the children with urolithiasis passed stones (follow-up rate: 91.4%). Of the 67 children, 28 passed stones within 2 months. The higher possibility of passing a stone was correlated with the smaller diameter of the stone (P<0.001). The detection rate of abnormal urinary microprotein excretion (microalbumin, immunoglobulin G, and N-acetyl-ß-D-glucosidase) was 52.4% in children with persistent stones and 38.2% in those who passed their stones. The detection rate was lower in children who passed stones within 2 months (31.8%) than in those who passed stones in 2 to 6 months (50.0%). The levels of microalbumin/creatinine and immunoglobulin G/creatinine were significantly higher in children with persistent stones than in those who passed their stones. CONCLUSIONS: Early passage of a stone may reduce the renal injury induced by melamine-contaminated milk powder-associated urolithiasis.

[Relationship of fetal total bile acid and the change of fetal pancreas endocrine secretion and its impact on fetal growth and development in intrahepatic cholestasis of pregnancy].

OBJECTIVE: To investigate the relationship of fetal total bile acid (TBA) concentration with the change of fetal pancreas endocrine secretion and its impact on fetal growth and development in intrahepatic cholestasis of pregnancy (ICP). METHODS: The concentrations of TBA, insulin, glucagon and glucose in the cord blood were measured in 30 fetuses with maternal ICP (case group) and 30 fetuses of normogravidas (control group) after elective cesarean section during the same period in the Department of Obstetrics of Xiangya Second Hospital of Central South University from March 2007 to February 2008. The cord blood TBA concentration was investigated by enzyme method and the concentrations of insulin and glucagon were investigated by radioimmunoassay. The glucose was measured by oxidase-superoxide method. The neonatal weight, length and the ponderal index (PI) were measured after parturition. RESULTS: (1) The cord blood insulin concentration (9.0 +/- 3.3) mU/L and the ratio of insulin over glucagon 0.048 +/- 0.028 in the case group was significantly lower than that of controls (10.1 +/- 3.7) mU/L, 0.050 +/- 0.020 (P < 0.05). The concentrations of TBA (10.3 +/- 3.8) miromol/L and glucagon (235 +/- 57) ng/L in case group were obviously higher than that in controls (4.1 +/- 1.3) micromol/L, (205 +/-34) ng/L (P < 0.05). But no difference was shown in the glucose concentration in cord blood between the case and control groups [(3.4 +/- 1.1) mmol/L vs. (3.6 +/- 1.2) mmol/L, P > 0.05]. (2) The neonatal weight and length in case group were significantly lower than that of control [(3163 +/- 478) g vs. (3498 +/- 393) g, (46.5 +/- 2.3) cm vs. (49.3 +/- 1.9) cm, P < 0.01]; while the Ponderal index in case group was significantly higher than that of control group (3.13 +/- 0.23 vs. 2.92 +/- 0.29, P < 0.01). (3) The cord blood TBA concentration respectively showed a linear relationship with the cord blood insulin concentration, the cord blood glucagon concentration and the ratio of insulin over glucagon in the case group. With the increase in cord blood TBA concentration, the cord insulin concentration and the ratio of insulin over glucagon decreased; meanwhile the cord blood glucagon concentration rose (P < 0.01). The cord blood insulin concentration and the ratio of insulin over glucagon in case group were respectively positively correlated with the neonatal weight and length, and were negatively correlated with the PI (P < 0.01); while the cord glucagon concentration was respectively negatively correlated with the neonatal weight and length, and positively correlated with the PI (P < 0.01). CONCLUSIONS: In ICP fetus pancreas, there are hypoinsulinism, glucagon oversecretion, and decrease of the ratio of insulin over glucagon, which is closely correlated with fetal TBA concentration. The endocrine function of fetal pancreas affects the fetal growth and development.