Association between depression and dysmenorrhea among adolescent girls: multiple mediating effects of binge eating and sleep quality.

BACKGROUND: Dysmenorrhea has a significant negative impact on teenagers' quality of life, and its prevalence is increasing annually. Although studies have explored the factors affecting dysmenorrhea, it remains unclear how these factors interact with one another. This study aimed to explore the mediating role of binge eating and sleep quality between depression and dysmenorrhea. METHODS: This cross-sectional study recruited adolescent girls from the Health Status Survey of adolescents in Jinan, Shandong Province, and used multistage stratified cluster random sampling. Data was collected using an electronic questionnaire between March 9, 2022, and June 20, 2022. The Numerical Rating Scale and Cox Menstrual Symptom Scale were used to assess dysmenorrhea and the Patient Health Questionnaire-9 to assess depression. The mediation model was tested by Mplus 8.0, and the mediating effect was analyzed using the Product of Coefficients approach and the Bootstrap method. RESULTS: Among the total of 7818 adolescent girls included in this study, the prevalence of dysmenorrhea is 60.5%. A significant positive association was found between dysmenorrhea and depression. Binge eating and sleep quality seemingly mediate this association. The mediating effect of sleep quality (21.31%) was greater than that of binge eating (6.18%). CONCLUSIONS: The findings of this study point in the right direction for preventing and treating dysmenorrhea in adolescents. For adolescent dysmenorrhea, mental health should be considered and proactive steps taken for educating adolescents on healthy lifestyles to reduce negative consequences of dysmenorrhea. Longitudinal studies on the causal link and influence mechanisms between depression and dysmenorrhea should be conducted in the future.

Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection.

BACKGROUND: The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis. METHODS: A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly. RESULTS: The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397 ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR < 154. CONCLUSIONS: Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.

Hyperuricemia is associated with impaired intestinal permeability in mice.

Hyperuricemia is associated with many metabolic diseases. However, the underlying mechanism remains unknown. The gut microbiota has been demonstrated to play significant roles in the immunity and metabolism of the host. In the present study, we constructed a hyperuricemic mouse model to investigate whether the metabolic disorder caused by hyperuricemia is related to intestinal dysbiosis. A significantly increased intestinal permeability was detected in hyperuricemic mice. The difference in microflora between wild-type and hyperuricemic mice accompanies the translocation of gut microbiota to the extraintestinal tissues. Such a process is followed by an increase in innate immune system activation. We observed increased LPS and TNF-α levels in the hyperuricemic mice, indicating that hyperuricemic mice were in a state of low-grade systemic inflammation. In addition, hyperuricemic mice presented early injury of parenteral tissue and disordered lipid metabolism. These findings suggest that intestinal dysbiosis due to an impaired intestinal barrier may be the key cause of metabolic disorders in hyperuricemic mice. Our findings should aid in paving a new way of preventing and treating hyperuricemia and its complications.NEW & NOTEWORTHY Hyperuricemia is associated with many metabolic diseases. However, the underlying mechanism remains unknown. We constructed a hyperuricemic mouse model to explore the relationship between intestinal dysbiosis and metabolic disorder caused by hyperuricemia.

Effect of Baogong Zhixue Granules Combined with Tranexamic Acid Injection on the Hemodynamics and Reproductive System in Patients with Postpartum Hemorrhage after Cesarean Section.

Objective: To investigate the effect of Baogong Zhixue granules combined with tranexamic acid injection on the hemodynamics and reproductive system in patients with postpartum hemorrhage (PPH) after cesarean section. Methods: The data of 90 puerperae undergoing cesarean section in our hospital from January 2019 to January 2020 were retrospectively analyzed. According to the order of admission, they were equally divided into the control group (CG) and experimental group (EG). CG was treated with tranexamic acid injection combined with oxytocin, while EG was treated with Baogong Zhixue granules combined with tranexamic acid injection to compare the clinical observation indexes between the two groups. Results: Compared with CG, EG achieved remarkably less amount of bleeding at 2 h and 24 h after delivery (P < 0.001), lower postpartum APTT, PT, HR, and MAP (P < 0.001), shorter maintenance time of uterine contraction and lochia (P < 0.001), and lower postpartum FSH and LH (P < 0.001). After delivery, EG had higher postpartum Fib and descending speed of uterine fundus and E 2 compared with CG (P < 0.001). Conclusion: Baogong Zhixue granules combined with tranexamic acid injection have little effect on the reproductive system of PPH patients after cesarean section, stabilize the hemodynamics, and improve the coagulation function. Therefore, further research on the combined treatment can provide better hemostatic schemes for such patients.

[Association between plasma levels of soluble leukocyte differentiation antigens CD40/CD40 ligand and kidney damage in preeclamptic patients].

OBJECTIVE: To investigate the variance levels of plasma soluble leukocyte differentiation antigens CD40 (sCD40) and soluble CD40 ligand (sCD40 L) in preeclamptic patients with renal damage and its relationship. METHODS: A total of 63 pregnant women attended the Department of Obstetrics, Affiliated Hospital of Qingdao University Medical College between August 2008 and June 2010. In the present study included 28 pregnant women with mild preeclampsia and 35 patients with severe preeclampsia. Thirty matched normotensive pregnant women were enrolled in the study as the control group. Expression of sCD40 and sCD40 L were determined by ELISA. At the same time, the blood routine, C reaction protein (CRP), urine routine, 24 hours urine protein excretion, and serum uric acid (UA), creatinine (Cr), blood urea nitrogen (BUN) were measured. The correlation analysis was performed between the sCD40/sCD40 L and the blood biochemical indexes in 3 groups. RESULTS: (1) The median levels of CRP in severe preeclampsia (10.8 mg/L) and mild preeclampsia group (7.1 mg/L) are significantly higher than that of control group (3.3 mg/L, P < 0.05); The level of CRP in severe preeclampsia group was also higher than that of mild preeclampsia group (P < 0.05). The median gestational age at delivery in severe preeclampsia (32.5 weeks) was significantly less than that of mild preeclampsia group (37.2 weeks) and normal group (38.6 weeks, P < 0.05). However no significant differences were observed between mild preeclampsia group and normal group (P > 0.05). The platelet count in severe preeclampsia (132 × 109/L) was significantly less than those of mild preeclampsia group (212 × 109/L) and normal group (216 × 109L, P < 0.01), but no significant differences were observed in blood platelet amount between mild preeclampsia group and normal group (P > 0.05). There was no significant difference in hemoglobin level and white blood cell in three groups (P > 0.05). (2) The sCD40 plasma concentration in severe, mild preeclampsia and normal group was 133.6, 126.5 and 90.7 ng/L, respectively. The sCD40 L plasma concentrations were 12.5, 10.4 and 4.4 ng/L respectively in the 3 groups. 24 hours urinary protein quantitative was 4.5 g/d, 0.8 g/d and 0 in the 3 groups respectively. And the UA level was 486 µmol/L, 289 µmol/L and 162 µmol/L. In the above three groups, the monitoring indicators were significantly higher in women with severe preeclampsia group compared with mild preeclampsia and control groups (P < 0.01), and there were also higher in mild preeclampsia group than that in control groups (P < 0.01). The level of plasma Cr (89 µmol/L) and BUN (5.32 mmol/L) in severe preeclampsia group were higher than those of mild preeclampsia group (66 µmol/L and 4.49 mmol/L) and control group (57 µmol/L and 3.32 mmol/L, P < 0.05). There was no significant difference between mild preeclampsia group and normal group (P > 0.05). (3) The correlation analysis indicated that the level of sCD40 has a positive correlation with 24 hours urinary protein quantitative (r = 0.434, P < 0.05), also significant positive correlation (r = 0.536, 0.528, P < 0.01) between the level of sCD40 and UA or CRP in women with preeclampsia. There was no significant correlation between the level of sCD40 and systolic blood pressure, diastolic blood pressure, delivery gestational age, Cr, BUN, and platelet count (r = 0.135, 0.183, -0.133, 0.190, 0.167, -0.221, all P > 0.05). There were positive correlation between the level of sCD40 L and 24 hours urine protein excretion, either UA or CRP (r = 0.591, 0.445, 0.539, all P < 0.01). No significant correlation was found between sCD40 L and systolic blood pressure, diastolic blood pressure, delivery gestational age, Cr, BUN, and platelet count (r = 0.178, 0.212, -0.292, 0.144, 0.135, -0.273, all P > 0.05). There was significant positive correlation between plasma sCD40 and sCD40 L (r = 0.707, P < 0.01). There was no relationship between the level of sCD40, sCD40 L and the blood biochemical indexes in normotensive pregnant women (P > 0.05). CONCLUSIONS: The plasma concentrations of sCD40 and sCD40 L are significantly higher in pregnant women with preeclampsia compared with the control, which may be involved in the development of preeclampsia and contribute to the kidney damage. The variance levels of sCD40 and sCD40 L may be also related to the severity of preeclampsia.

Differences in epidemiology of patients with preeclampsia between China and the US (Review).

Preeclampsia (PE) is a complex complication that occurs during pregnancy. Studies indicated that morbidity from PE exhibits marked variations among geographical areas. Disparities in the incidence of PE between China and the US may be due to differences in ethnicity and genetic susceptibility, maternal age, sexual culture, body mass index, diet, exercise, multiple pregnancies and educational background. These epidemiological differences may give rise to differences between the two countries in terms of diagnostic and therapeutic criteria for PE. PE may be largely attributed to susceptibility genes and lifestyles, such as diet, body mass index and cultural norms regarding sexual relationships. The epidemiologic differences of patients with PE between the two countries indicated that appropriate prevention plans for PE require to be developed according to local conditions.

Association of Hyperuricemia With Immune Disorders and Intestinal Barrier Dysfunction.

BACKGROUND: More than 30-40% of uric acid is excreted via the intestine, and the dysfunction of intestinal epithelium disrupts uric acid excretion. The involvement of gut microbiota in hyperuricemia has been reported in previous studies, but the changes and mechanisms of intestinal immunity in hyperuricemia are still unknown. METHODS: This study developed a urate oxidase (Uox)-knockout (Uox-/-) mouse model for hyperuricemia using CRISPR/Cas9 technology. The lipometabolism was assessed by measuring changes in biochemical indicators. Furthermore, 4-kDa fluorescein isothiocyanate-labeled dextran was used to assess gut barrier function. Also, 16S rRNA sequencing was performed to examine the changes in gut microbiota in mouse feces. RNA sequencing, Western blot, Q-PCR, ELISA, and immunohistochemical analysis were used for measuring gene transcription, the number of immune cells, and the levels of cytokines in intestinal tissues, serum, kidney, liver, pancreas, and vascellum. RESULTS: This study showed that the abundance of inflammation-related microbiota increased in hyperuricemic mice. The microbial pattern recognition-associated Toll-like receptor pathway and inflammation-associated TNF and NF-kappa B signaling pathways were significantly enriched. The increased abundance of inflammation-related microbiota resulted in immune disorders and intestinal barrier dysfunction by upregulating TLR2/4/5 and promoting the release of IL-1ß and TNF-α. The levels of epithelial tight junction proteins occludin and claudin-1 decreased. The expression of the pro-apoptotic gene Bax increased. The levels of LPS and TNF-α in systemic circulation increased in hyperuricemic mice. A positive correlation was observed between the increase in intestinal permeability and serum levels of uric acid. CONCLUSION: Hyperuricemia was characterized by dysregulated intestinal immunity, compromised intestinal barrier, and systemic inflammation. These findings might serve as a basis for future novel therapeutic interventions for hyperuricemia.

Effects of forkhead box protein M1 on trophoblast invasion and its role in preeclampsia development.

The present study aimed to investigate the expression of the forkhead box protein M1 (FOXM1) in the placenta of patients with preeclampsia, and its effect on trophoblasts. A total of 28 patients with preeclampsia and 30 patients without preeclampsia (controls) who underwent cesarean section and were admitted to the Affiliated Hospital of Qingdao University between June 2013 and September 2016 were enrolled in the present study. The expression of FOXM1 in placental tissues was examined by reverse transcription-quantitative polymerase chain reaction, western blotting and immunohistochemistry. HTR8/SVneo cells were used to measure the in vitro expression of the vascular endothelial growth factor (VEGF). The results demonstrated that FOXM1 expression was downregulated in the placental tissues of patient with preeclampsia (P<0.05). Following the silencing of FOXM1 expression, the proliferation of HTR8/SVneo cells was suppressed. The results of flow cytometry demonstrated that proportion of HTR8/SVneo cells in the G0/G1 phase and the proportion of apoptotic cells increased. The expression of the apoptosis regulator BCL-2, as well as the expression of VEGF mRNA and protein expression were also downregulated following FOXM1 silencing. FOXM1 may therefore promote the development of preeclampsia via the VEGF signaling pathway.