APA scoring system: a novel predictive model based on risk factors of pregnancy loss for recurrent spontaneous abortion patients.

The aim of this study was to analyse the risk factors of pregnancy loss of patients with recurrent spontaneous abortion (RSA) and develop a scoring system to predict RSA. Clinical data of 242 cases, with RSA who were treated at Fujian Provincial Maternity and Children's Hospital, were selected. The factors of pregnancy loss for RSA patients were evaluated by univariate and multivariate analyses. There were 242 RSA patients, of whom 34 (14.0%) developed pregnancy loss. A multivariate analysis showed the following adverse risk factors for RSA: antinuclear antibody spectrum, protein s deficiency and antiphospholipid antibodies. The pregnancy loss rates of antinuclear antibody spectrum group, protein S deficiency group and antiphospholipid antibodies group were 25.0%, 22.5% and 19.4%, respectively. Each of these factors contributed 1 point to the risk score. The pregnancy loss rates were 6.3%, 24.6%, 50% for the low-, intermediate- and high-risk categories, respectively (p < .001). The area under the receiver operating characteristic curve for the score of RSA was .733. Our findings suggest that this validated and simple scoring system could accurately predict the risk of pregnancy loss of RSA patients. The score might be helpful in the selection of risk-adapted interventions to decrease the incidence. Impact StatementWhat is already known on this subject? The live birth rate increases to 80%-90% after anticoagulant and/or immunosuppressive treatment in patients with RSA. However, there is still a high rate of re-abortion even after active treatment.What do the results of this study add? Antinuclear antibody spectrum, protein s deficiency and antiphospholipid antibodies were independent risk factors for pregnancy loss. A novel predictive model based on these factors was then established and validated.What are the implications of these findings for clinical practice and/or further research? The newly developed score might be helpful in the selection of risk-adapted interventions to decrease the incidence. For patients in the intermediate-risk and high-risk groups, we should conduct more targeted studies and formulate corresponding therapies to improve the success rate of treatment.

Reliability and Validity of Disability Identity Scale in Chinese Version / 中国康复理论与实践

Objective:To investigate the applicability of Disability Identity Scale in Chinese context. Methods:A total of 291 questionnaires about Disability Identity Scale were collected with multi-stage sampling in May, 2018. The preliminary structure of the Disability Identity Scale was analyzed with exploratory factor analysis, and the structural validity of the scale was discussed with confirmatory factor analysis. Results:The Cronbach's α coefficient of the total scale was 0.865, and the internal consistency of each dimension of the scale was 0.742 to 0.838. The total test-retest reliability was 0.776, and the internal consistency of each dimension was 0.640 to 0.893. Five factors were extracted, named Positive Disability and Stigma/Shame in the dimension of personal identity, Social Acceptance, Social Exclusion-Personal Attribution, Social Exclusion-Social Attribution in the dimension of social identity. Conclusions:Disability Identity Scale is reliable and stable that can be used in the study of disability identity in China after modification.

Management of silicosis patients complicated with respiratory failure by mechanical ventilation with lung dilation and sputum suction / 中国职业医学

OBJECTIVE: To explore the curative effect of mechanical ventilation combined with lung dilation and sputum suction in silicosis patients complicated with respiratory failure. METHODS: By a random number table method,76 silicosis patients complicated with respiratory failure from 2013 to 2016 were selected as study subjects. They were divided into control group( 38 cases) and observation group( 38 cases). The control group was treated with routine sputum suction and artificial airway nursing; the observation group was treated with lung dilation and sputum suction based on the control group'nursing. After 1 week of treatment,airway resistance,oxygen partial pressure( PaO_2),blood oxygen saturation( SaO_2),incidence and mortality of ventilator associated pneumonia( VAP),and the incidence of atelectasis were compared between the two groups. RESULTS: There was no statistical significant difference found in airway resistance,PaO_2 and SaO_2 between the two groups of patients before treatment( P > 0. 05). The two groups of patients after treatment were compared with the same group before treatment,airway resistance decreased( P < 0. 01),PaO_2 and SaO_2 were increased( P < 0. 01). After treatment,the airway resistance of patients in observation group was lower than that of the control group( P < 0. 01),while PaO_2 and SaO_2 were higher than that in control group( P < 0. 01). Compared with control group,the incidence,mortality and pulmonary atelectasis rate of VAP in observation group were lower than that of control group( P < 0. 05). CONCLUSION: Treatment of patients with silicosis and respiratory failure by mechanical ventilation with lung dilation and sputum suction is helpful to reduce the incidence and mortality of VAP and improve treatment outcomes.

Role of store-operated Ca2+ channels in ethanol-induced intracellular Ca2+ increase in HepG2 cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of ethanol-induced calcium overload in hepatocytes and the related role of store-operated calcium channels (SOCs).</p><p><b>METHODS</b>HepG2 cells were treated an ethanol concentration gradient with or without intervention treatment with the extracellular calcium chelator EGTA or the SOCs inhibitor 2-aminoethoxydiphenyl borate (2-APB). Effects on cell viability were assessed by the CCK8 assay. Effects on leakage of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined by automatic biochemical analyzer measurements of the culture supernatants. Effects on cytoplasmic free Ca2+ concentration ([Ca2+]i) were accessed by detecting fluorescence intensity of the calcium indicator Fluo-3/AM with a flow cytometer. Effects on mRNA and protein expression levels of SOCs, stromal interacting factor 1 (STIM1), and calcium release-activated calcium channel protein 1 (Orai1) were evaluated by qPCR and western blotting.</p><p><b>RESULTS</b>The ethanol treatment produced dose-dependent reduction in cell viability (r = -0.985, P less than 0.01) and increases in leakage of ALT (F = 15.286, P less than 0.01) and AST (F = 39.674, P less than 0.01). Compared to untreated controls, the ethanol treatments of 25, 50, 100, 200 and 400 mM induced significant increases in [Ca2+]i level (1.25+/-0.36, 1.31+/-0.15, 1.41+/-0.18, 2.29+/-0.25, 2.58+/-0.19; F = 15.286, P less than 0.01). Both intervention treatments, EGTA and 2-APB, significantly reduced the 200 mM ethanol treatment-induced [Ca2+]i increase (2.32+/-0.08 reduced to 1.79+/-0.15 (t = 7.201, P less than 0.01) and 1.86+/-0.09 (t = 8.183, P less than 0.01) respectively). EGTA and 2-APB also increased the ethanol-treated cells' viability and reduced the ALT and AST leakage. The 200 mM ethanol treatment stimulated both gene and protein expression of STIM1 and Orai1, and the up-regulation effect lasted at least 72 h after treatment.</p><p><b>CONCLUSION</b>Ethanol-induced dysregulation of SOCs may be an important molecular mechanism of ethanol-induced [Ca2+]i rise in hepatocytes and the related liver cell injury.</p>

Thinking about acupuncture for treatment of simple obesity / 中国针灸

In the viewpoint of traditional Chinese medicine (TCM), the authors consider that simple obesity is not a disease, which does not fit to be treated according to the models of diagnosis and treatment in TCM. Considering its cause, pathogenesis, syndrome differentiation, principles and methods of treatment, as well as experimental study, etc. , the authors point out that the true effects of acupuncture on weight-loss should be investigated alone and avoid the influence of diet and exercise. Until now, what we have done on the acupuncture for treatment of simple obesity is not sufficient to verify the direct effects of acupuncture for weight-loss. The correct way for weight-loss is health care including dietary regime and regular life schedule. Comparatively, the treatment as the main choice for weight-loss is not recommended.