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BACKGROUND: Ferroptosis plays an important role in acute kidney injury (AKI), but the specific regulatory mechanism of ferroptosis in AKI remains unclear. This study is expected to analyze ferroptosis-related genes (FRGs) in AKI and explore their underlying mechanisms. RESULTS: A total of 479 differentially expressed genes (DEGs), including 196 up-regulated genes and 283 down-regulated genes were identified in the AKI chip GSE30718. 341 FRGs were obtained from the Genecard, OMIM and NCBI database. Totally 11 ferroptosis-related DEGs in AKI were found, in which 7 genes (CD44, TIGAR, RB1, LCN2, JUN, ARNTL, ACSL4) were up-regulated and 4 genes (FZD7, EP300, FOXC1, DLST) were down-regulated. Three core genes (FZD7, JUN, EP300) were obtained by PPI and KEGG analysis, among which the function of FZD7 in AKI is unclear. The WGCNA analysis found that FZD7 belongs to a module that was negatively correlated with AKI. Further basic experiments confirmed that FZD7 is down-regulated in mouse model of ischemia-reperfusion-AKI and cellular model of hypoxia-reoxygenation(H/R). In addition, knockdown of FZD7 could further aggravate the down-regulation of cell viability induced by H/R and Erastin, while overexpression of FZD7 can rescue its down-regulation to some extent. Furthermore, we verified that knockdown of FZD7 decreased the expression of GPX4 and overexpression of FZD7 increased the expression of GPX4, suggesting that FZD7 may inhibit ferroptosis by regulating the expression of GPX4 and plays a vital role in the onset and development of AKI. CONCLUSIONS: This article revealed the anti-ferroptosis effect of FZD7 in acute kidney injury through bioinformatics analysis and experimental validation, suggesting that FZD7 is a promising target for AKI and provided more evidence about the vital role of ferroptosis in AKI.
Assuntos
Injúria Renal Aguda , Ferroptose , Animais , Camundongos , Injúria Renal Aguda/genética , Proteínas Reguladoras de Apoptose , Sobrevivência Celular , Biologia Computacional , Bases de Dados Factuais , Ferroptose/genética , Monoéster Fosfórico HidrolasesRESUMO
Short-term monocular deprivation (MD) shifts sensory eye balance in favour of the previously deprived eye. The effect of MD on eye balance is significant but brief in adult humans. Recently, researchers and clinicians have attempted to implement MD in clinical settings for adults with impaired binocular vision. Although the effect of MD has been studied in detail in single-session protocols, what is not known is whether the effect of MD on eye balance deteriorates after repeated periods of MD (termed 'perceptual deterioration'). An answer to this question is relevant for two reasons. Firstly, the effect of MD (i.e., dose-response) should not decrease with repeated use if MD is to be used therapeutically (e.g., daily for weeks). Second, it bears upon the question of whether the neural basis of the effects of MD and contrast adaptation, a closely related phenomenon, is the same. The sensory change from contrast adaptation depends on recent experience. If the observer has recently experienced the same adaptation multiple times for consecutive days, then the adaptation effect will be smaller because contrast adaptation exhibits perceptual deterioration, so it is of interest to know if the effects of MD follow suit. This study measured the effect of 2-h MD for seven consecutive days on binocular balance of 15 normally sighted adults. We found that the shift in eye balance from MD stayed consistent, showing no signs of deterioration after subjects experienced multiple periods of MD. This finding shows no loss of effectiveness of repeated daily doses of MD if used therapeutically to rebalance binocular vision in otherwise normal individuals. Furthermore, ocular dominance plasticity, which is the basis of the effects of short-term MD, does not seem to share the property of 'perceptual deterioration' with contrast adaptation, suggesting different neural bases for these two related phenomena.
Assuntos
Córtex Visual , Adulto , Humanos , Córtex Visual/fisiologia , Privação Sensorial/fisiologia , Visão Ocular , Visão Binocular/fisiologia , Dominância Ocular , Visão Monocular/fisiologiaRESUMO
OBJECTIVE: This study set out to investigate a novel ultrasound parameter using cervical elastosonography for improving the prediction of spontaneous preterm birth (sPTB) in twin pregnancies. STUDY DESIGN: The study was comprised of 106 twin pregnancies from October 2020 to January 2022 in Beijing Obstetrics and Gynecology Hospital. They were divided into two groups according to gestational age (GA) at delivery (delivery < 35 weeks and delivery ≥ 35 weeks). There were five elastographic parameters: Elasticity Contrast Index (ECI), Cervical Hardness Ratio (CHR), Closed Internal cervical ostium Strain rate (CIS); External cervical ostium strain rate (ES), CIS/ES ratio and Cervical Length (CL). All of the clinical and ultrasonic indicators with P < 0.1 were considered candidate indicators via univariate logistic regression. Based on the extracted unified combination of clinical indicators, the combinations of permutation with the candidate ultrasound indicators were performed step by step in multivariable logistic regression. The best ultrasound indicator with the lowest Akaike Information Criterion (AIC) and the highest Areas Under the receiver operating characteristic Curve (AUC) was chosen for establishing the prediction score. RESULTS: Over 30% (36/106) of those who delivered before 35 weeks gestation. There were distinct differences in the clinical characteristics and cervical elastography parameters between the two groups. Seven major clinical variables were identified as a unified clinical indicator. CISmin as the best ultrasound elastography predictor indicated the lowest AIC and the highest AUC and outperformed alternative indicators significantly in the prediction of delivery before 35 weeks of gestation. Unfortunately, CLmin which was commonly used in clinical practice ranked far from all of the cervical elastography parameters and presented the highest AIC and the lowest AUC. A preliminary scoring rule was established and the ability to predict the risk of sPTB in twin pregnancies was improved (Accuracy: 0.896 vs 0.877; AIC: 81.494 vs 91.698; AUC: 0.923 vs 0.906). CONCLUSIONS: The cervical elastosonography predictor such as CISmin might be a more useful indicator applied for enhancing the ability in predicting twin pregnancies preterm birth than CL. Furthermore, there would be more benefits for advancing clinical decision-making in actual clinical practice by using cervical elastosonography in the near future.
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BACKGROUND: A bicornuate uterus often results in infertility. While reconstructive procedures may facilitate pregnancy, spontaneous abortion or serious pregnancy complications may occur. We present a case of a bicornuate uterus with spontaneous conception after Strassman metroplasty; however, life-threatening complications during pregnancy occurred. CASE PRESENTATION: A 38-year-old woman with a history of infertility presented for prenatal care at 6 weeks of gestation. She had conceived spontaneously after four failed in vitro fertilization and embryo transfer (IVF-ET) procedures, Strassman metroplasty for a complete bicornuate uterus, and two postoperative IVF-ET pregnancies that ended in embryo arrest. This pregnancy was uneventful until the patient presented with massive vaginal bleeding at 28 weeks of gestation and was diagnosed with placenta previa and placenta percreta. Bleeding was controlled after emergency Caesarean section and delivery of a healthy neonate. However, severe adhesions were noted as well as a rupture along the metroplasty scar. Two days later, on removal of the intrauterine gauze packing, severe hemorrhage resumed, and the uterus did not respond to oxytocin, hemabate, or carbetocin. Emergency hysterectomy was required. CONCLUSIONS: Reconstructive surgical procedures for complete bicornuate uterus may allow patients to achieve spontaneous pregnancies. However, potential intrapartum complications include placenta implantation and postpartum hemorrhage, and the latter may be exacerbated as the uterus does not contract or respond to oxytocin or prostaglandin drugs. Patients should be counseled on the risks associated with pregnancy after Strassman metroplasty, and clinicians must be aware of potential severe complications.
Assuntos
Placenta Acreta/cirurgia , Complicações na Gravidez/cirurgia , Anormalidades Urogenitais/cirurgia , Hemorragia Uterina/diagnóstico , Útero/anormalidades , Útero/cirurgia , Aborto Espontâneo/etiologia , Adulto , Cesárea/efeitos adversos , Feminino , Idade Gestacional , Humanos , Histerectomia , Recém-Nascido , Placenta Prévia/cirurgia , Gravidez , Resultado da Gravidez , Segundo Trimestre da Gravidez , Procedimentos de Cirurgia Plástica/efeitos adversos , Hemorragia Uterina/etiologia , Hemorragia Uterina/cirurgiaRESUMO
Accumulating evidence has appreciated long non-coding RNAs (lncRNAs) as novel prognostic markers and therapeutic targets in malignant carcinomas. Here, we aim to investigate the value of a novel cancer-related lncRNA, LOXL1-AS1, in cholangiocarcinoma (CCA). LOXL1-AS1 was found overexpressed in CCA tissues screened by high-throughput sequencing technology. Upregulation of LOXL1-AS1 was identified by TCGA database and qRT-PCR analysis. Additionally, upregulation of LOXL1-AS1 was associated with lymph node invasion, advanced TNM stages and unfavorable prognosis. Loss-of-function and gain-of-function experiments were conducted and validated that LOXL1-AS1 could facilitate cell proliferation, migration and invasion and attenuate cell apoptosis. Moreover, luciferase reporter and rescue assays indicated that LOXL1-AS1 functioned as a ceRNA to elevate ATP-binding cassette transporter A1 (ABCA1) level by sponging miR-324-3p and exhibited the malignant phenotypes of CCA cells, thereby playing an oncogenic role in CCA. Taken together, this study reveals that LOXL1-AS1 might act as a potential biomarker and therapeutic target for CCA clinical application.
Assuntos
Transportador 1 de Cassete de Ligação de ATP/metabolismo , Aminoácido Oxirredutases/genética , Colangiocarcinoma/patologia , MicroRNAs/metabolismo , RNA Longo não Codificante/fisiologia , Aminoácido Oxirredutases/metabolismo , Apoptose/genética , Movimento Celular/genética , Proliferação de Células/genética , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/genética , Progressão da Doença , Humanos , Prognóstico , Regulação para CimaRESUMO
BACKGROUND: The prevalence of CGG repeat expansion mutation in FMR1 gene varies among different populations. In this study, we investigated the prevalence of this mutation in women of reproductive age from northern China. METHODS: A total of 11,891 pre-conceptional or pregnant women, including 5037 pregnant women and 7357 women with the history of spontaneous abortion or induced abortion due to delayed growth of the embryos, were recruited. The number of CGG repeats in FMR1 was measured by the TRP-PCR method. We also offered genetic counseling and prenatal diagnosis to the women carrying pre-mutation or full mutation alleles. RESULTS: The prevalence of pre-mutation in reproductive women in northern China was 1/410, higher than that in southern China and Korea but lower than that in western countries. We also found that the prevalence of pre-mutation was relatively high (1/320) in women with abortion history. CONCLUSION: Screening for CGG repeat expansion mutation in FMR1 should be recommended to the women with the history of spontaneous abortion or induced abortion due to delayed growth of the embryos.
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Proteína do X Frágil da Deficiência Intelectual/genética , Mutação , Reprodução , Repetições de Trinucleotídeos , Adolescente , China , Estudos de Coortes , Feminino , Humanos , Gravidez , Resultado da Gravidez , Adulto JovemRESUMO
Breast milk (BM) hormones have been hypothesised as a nutritional link between maternal and infant metabolic health. This study aimed to evaluate hormone concentrations in BM of women with and without gestational diabetes mellitus (GDM), and the relationship between maternal factors, BM hormones and infant growth. We studied ninety-six nulliparous women with (n 48) and without GDM and their exclusively breastfed term singletons. Women with GDM received dietary therapy or insulin injection for euglycaemia during pregnancy. Hormone concentrations in BM, maternal BMI and infant growth were longitudinally evaluated on postnatal days 3, 42 and 90. Mothers with GDM had decreased concentrations of adiponectin (P colostrum<0·001; P mature-milk=0·009) and ghrelin (P colostrum=0·011; P mature-milk<0·001) and increased concentration of insulin in BM (P colostrum=0·047; P mature-milk=0·021). Maternal BMI was positively associated with adiponectin (ß=0·06; 95 % CI 0·02, 0·1; P=0·001), leptin (ß=0·16; 95 % CI 0·12, 0·2; P<0·001) and insulin concentrations (ß=0·06; 95 % CI 0·02, 0·1; P<0·001), and inversely associated with ghrelin concentration in BM (ß=-0·08; 95 % CI -0·1, -0·06; P<0·001). Among the four hormones, adiponectin was inversely associated with infant growth in both the GDM (ß weight-for-height=-2·49; 95 % CI -3·83, -1·15; P<0·001; ß head-circumference=-0·39; 95 % CI -0·65, -0·13; P=0·003) and healthy groups (ß weight-for-height=-1·42; 95 % CI -2·38, -0·46; P=0·003; ß head-circumference=-0·15; 95 % CI -0·27, -0·03; P=0·007). Maternal BMI and GDM are important determinants of BM hormone concentrations. Milk-borne adiponectin is determined by maternal metabolic status and plays an independent down-regulating role in early infant growth.
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Adiponectina/metabolismo , Grelina/metabolismo , Insulina/metabolismo , Leptina/metabolismo , Leite Humano/metabolismo , Antropometria , Glicemia/análise , Índice de Massa Corporal , Peso Corporal , Aleitamento Materno , Colostro/metabolismo , Diabetes Gestacional/metabolismo , Regulação para Baixo , Feminino , Teste de Tolerância a Glucose , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Mães , Ciências da Nutrição , Obesidade Infantil , GravidezRESUMO
BACKGROUND: The caesarean section rate has risen rapidly in China. The purpose of this retrospective study was to estimate caesarean section rates and indications by hospital facility level in Mainland China to investigate reasons contributing to the high rate. METHODS: This cross-sectional hospital-based study collected data from 39 hospitals in three geographical regions in China, covering 14 different provinces, municipalities, and autonomous regions, including 20 tertiary health hospitals and 19 secondary hospitals. Data from all women who gave birth at these hospitals during 2011 were included. RESULTS: A total of 112,138 women who gave birth after 24 weeks of gestation were surveyed. Of these pregnancies, 54.5% (61,084 cases) resulted in caesarean section, non-indicated caesarean section accounted for 38.4% of caesarean sections. Overall caesarean section rates were higher at the tertiary level hospitals (55.9%) compared to the secondary level hospitals (50.9%). The secondary level hospitals had higher rates of non-indicated caesarean section (48.9% of caesarean sections) compared to tertiary level hospitals (34.5% of caesarean sections). The rate of caesarean section on maternal request was higher in the secondary hospitals (16.6%) than in the tertiary hospitals (10%) (P < 0.001), as well as the caesarean section rate for CPD prior to labour. Operative vaginal deliveries were overall rare (1.2%) with 90.9% (1200/1320 cases) performed in the tertiary hospitals. CONCLUSIONS: Caesarean section on maternal request accounts for a large portion of China's high caesarean section rate, especially in the secondary hospitals. The first step to reduced caesarean section rates is to decrease the number of non-indicated caesarean sections.
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Cesárea/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Adulto , China , Estudos Transversais , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Procedimentos Desnecessários/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVES: To investigate the delivery mode and perinatal outcomes of low birth weight infants in mainland China, and to explore the appropriate delivery mode and timing of delivery. METHODS: Clinical data of 103 678 babies delivered from Jan 1(st) to Dec 31(th), 2011 in 39 hospitals in mainland China were analyzed retrospectively. The 39 hospitals located in 7 administrative regions, including Northeast, Northwest, North, Central, East, South and Southwest China. RESULT: (1) The average birth weight of the newborns was (3 263 ± 540) g. Among them, 7 474 cases were diagnosed low birth weight infants, with the incidence of 7.209% (7 474/103 678). There were 2.328% (2 214/95 116) full-term low birth weight infants and 61.434% (5 260/8 562) preterm low birth weight infants. (2) From week 28 to week 36, the cesarean section rate of low birth weight infants increased with the increasing of gestational weeks. The cesarean section rate of full-term low birth weight infants were 61.14% (1 139/1 863), which was higher than that of normal birth weight infants (52.947%, 45 108/85 195). The differences were statistically significant (P < 0.01). (3) The constitution of the indication of cesarean section showed that social factor and maternal factor were 10.73% (443/4 128) and 48.91% (2 019/4 128) for low birth weight infants, respectively. While for the normal birth weight infants, they were 27.70% (12 495/45 108) and 38.60% (17 412/45 108), respectively. There was statistically significant difference (P < 0.01). (4) The emergency cesarean section rate of full-term low birth weight infants was 41.09% (468/1 139), which was higher than that of normal birth weight infants (31.09%, 14 024/45 108). The difference was statistically significant (P < 0.01). (5) The rates of stillbirth, neonatal asphyxia and the mortality of full-term low birth weight infants were 2.36% (44/1 863), 6.12% (114/1 863), and 3.17% (59/1 863), respectively. Those of normal birth weight infants were 0.11% (94/85 195), 1.41% (1 201/85 195), and 0.14% (119/85 195), respectively. The differences were statistically significant (P < 0.01). (6) The stillbirth rate and mortality of low birth weight infants born by cesarean delivery were significantly lower than those born by vaginal delivery. The rate of neonatal asphyxia (17.95%) and other morbidity (3.61%) among low birth weight infants born by cesarean section in week 28 to week 33(+6) were significantly lower than those born by vaginal delivery (30.09%, 6.62%, respectively). (7) With the increase of gestational age, the incidence of neonatal asphyxia and stillbirth decreased. The incidence of neonatal asphyxia (39.22%) and stillbirth (23.28%) was most seen in 28 to 29 gestational weeks, which decreased to 9.08% and 2.88% in 34 gestation weeks. CONCLUSIONS: Low birth weight is one of the leading causes of adverse perinatal outcomes and cesarean section. To decrease the incidence of low birth weight, individualized management should be performed according to the gestational age and fetal condition. Extending the gestational age to at least 34 weeks may avoid iatrogenic preterm labor and improve the neonatal survival rate.
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Cesárea/estatística & dados numéricos , Parto Obstétrico/métodos , Recém-Nascido de Baixo Peso , Trabalho de Parto/fisiologia , Asfixia Neonatal/epidemiologia , Asfixia Neonatal/etiologia , Peso ao Nascer , China/epidemiologia , Feminino , Idade Gestacional , Humanos , Incidência , Lactente , Recém-Nascido , Trabalho de Parto Prematuro , Gravidez , Estudos Retrospectivos , Fatores de TempoRESUMO
BACKGROUND: Macrosomia, defined as a birthweight at least 4000 g, is a public health problem because of its adverse influences on maternal and neonatal outcomes. Studies show that there is an increasing prevalence of macrosomia births in developing countries. However, information on the epidemiology of macrosomia is limited in China. This study aimed to determine the prevalence and geographic variability of macrosomia in China and risk factors that can be targeted for intervention. METHODS: A hospital-based, cross-sectional survey was conducted in 14 provinces in China, covering a wide range of geographic areas. The medical records of 101,723 singleton term infants born in 39 hospitals during 2011 were reviewed. Multiple logistic regression analysis was used to examine the associations between demographic characteristics and the risk of macrosomia. RESULTS: The total prevalence of macrosomia was 7.3%. The prevalence varied between provinces, ranging from 4.1% to 13.4%. The prevalence of macrosomia in northern China (8.5%) was significantly higher than that in southern China (5.6%). Logistic regression analyses showed that risk of macrosomia was positively associated with maternal age, pre-pregnant body mass index (BMI), gravidity, parity, maternal height, gestational weight gain (GWG), gestational diabetes mellitus (GDM), and male fetal sex. Maternal BMI, gestational week, and GWG were the three risk factors most strongly associated with macrosomia. CONCLUSIONS: The prevalence of macrosomia varied dramatically between different areas of China. High pre-pregnancy BMI and GWG represent main modifiable risk factors for macrosomia and need more attention from health care providers.
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Peso ao Nascer , Macrossomia Fetal/epidemiologia , Paridade , Adulto , Índice de Massa Corporal , Distribuição de Qui-Quadrado , China/epidemiologia , Estudos Transversais , Feminino , Macrossomia Fetal/etiologia , Número de Gestações , Humanos , Recém-Nascido , Modelos Logísticos , Masculino , Idade Materna , Gravidez , Prevalência , Fatores de Risco , Centros de Cuidados de Saúde Secundários , Fatores Sexuais , Centros de Atenção TerciáriaRESUMO
BACKGROUND: The association between fetal gender and pregnancy outcomes has been thoroughly demonstrated in western populations. However, this association has not been thoroughly documented in China. The primary objective of the present study is to determine whether the association of adverse pregnancy and labour outcomes with male fetuses applies to the Chinese population. METHODS: This cross-sectional hospital-based retrospective survey collected data from thirty-nine hospitals in 2011 in mainland China. A total of 109,722 women with singleton pregnancy who delivered after 28 weeks of gestation were included. RESULTS: Of these pregnancies, the male-to-female sex ratio was 1.2. The rates of preterm birth (7.3% for males, 6.5% for females) and fetal macrosomia (8.3% for males, 5.1% for females) were higher for male newborns, whereas fetal growth restriction (8.0% for females, 5.4% for males) and malpresentation (4.3% for females, 3.6% for males) were more frequent among female-bearing mothers. A male fetus was associated with an increased incidence of operative vaginal delivery (1.3% for males, 1.1% for females), caesarean delivery (55.0% for males, 52.9% for females), and cephalopelvic disproportion/failure to progress (10.0% for males, 9.2% for female). Male gender was also significantly associated with lower Apgar scores (<7 at 5 min, adjusted odds ratio 1.3, 95% CI 1.0-1.6), as well as a neonatal intensive care unit admission and neonatal death, even after adjustments for confounders (adjusted odds ratio 1.3, 95% CI 1.1-1.5, adjusted odds ratio 1.4, 95% CI 1.1-1.8). CONCLUSION: We confirm the existence of obvious neonatal gender bias and adverse outcomes for male fetuses during pregnancy and labour in our population. Further research is required to understand the mechanisms and clinical implications of this phenomenon.
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Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Fatores Sexuais , Adulto , Índice de Apgar , Desproporção Cefalopélvica/epidemiologia , Cesárea/estatística & dados numéricos , China/epidemiologia , Estudos Transversais , Extração Obstétrica/estatística & dados numéricos , Feminino , Retardo do Crescimento Fetal/epidemiologia , Macrossomia Fetal/epidemiologia , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Apresentação no Trabalho de Parto , Masculino , Admissão do Paciente/estatística & dados numéricos , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Inércia Uterina/epidemiologia , Adulto JovemRESUMO
BACKGROUND: In recent decades we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. However, the real reasons for this phenomenon are uncertain. Notably, the number of women requesting elective CS without accepted valid medical indication has also increased, generating a nationwide debate because several studies have shown that this may be the underlying cause of the increase in CS rates observed recently. Therefore, we carried out a multicentre, large-sample, cross-sectional study to describe the CS rate and indications for CS in mainland China during 2011. METHODS: This was a multicentre, large-sample, cross-sectional study of women who delivered infants in 39 hospitals in 14 provinces in China during 2011. We selected 111, 315 deliveries that occurred during 2011, excluding miscarriages or termination of pregnancy before 28 gestational weeks. RESULTS: The overall rate of CS in mainland China was 54.90%. The most common indication for CS was caesarean delivery on maternal request (CDMR; 28.43%), followed by cephalo-pelvic disproportion (14.08%), fetal distress (12.46%), previous CS (10.25%), malpresentation and breech presentation (6.56%), macrosomia (6.10%) and other indications (22.12%). CDMR accounted for 15.53% of all the deliveries and 28.43% of all CS deliveries in mainland China. CONCLUSIONS: CDMR appears to be a considerable driver behind the increasing CS rate in mainland China. The relaxation of China's "one-child policy" may translate into a greater number of CS because of previous CS delivery. To decrease the CS rate, we should first decrease the rate of CS on maternal request. Appropriate policies and guidelines should be considered to accomplish the goal.
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Apresentação Pélvica/cirurgia , Cesárea/estatística & dados numéricos , Sofrimento Fetal/cirurgia , Preferência do Paciente/estatística & dados numéricos , Gravidez de Alto Risco , Adolescente , Adulto , Apresentação Pélvica/diagnóstico por imagem , Cesárea/métodos , Distribuição de Qui-Quadrado , China , Estudos Transversais , Parto Obstétrico/métodos , Parto Obstétrico/estatística & dados numéricos , Feminino , Sofrimento Fetal/diagnóstico , Humanos , Incidência , Recém-Nascido , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/cirurgia , Resultado da Gravidez , Medição de Risco , Estatísticas não Paramétricas , Ultrassonografia , Adulto JovemRESUMO
OBJECTIVE: To determine the pregnancy outcomes related with maternal age in China. METHODS: A total of 110 450 cases were selected and divided into 6 age groups at intervals of 5 years. The clinical data were collected from 39 hospitals in mainland China. All deliveries were after 28 weeks of completed gestation in 2011. The unadjusted binary-logistic regression was employed for statistics. RESULTS: The mean age of all pregnant women was 28 ± 5 at the time of delivery. The advanced age groups (35-39 yr and ≥ 40 yr) had higher risks than the 25-29 age group for pregestational diabetes [odds ratio (OR), 2.2 and 3.8], chronic hypertension (OR, 4.6 and 6.5), leiomyoma (OR, 4.2 and 5.8), gestational diabetes (OR, 2.6 and 3.5), preeclampsia (OR, 2.5 and 3.6), postpartum hemorrhage (OR, 1.5 and 1.7), premature delivery (OR, 1.8 and 2.4), placenta previa (OR, 2.7 and 4.0), placental abruption (OR, 1.4 and 2.5), cesarean delivery (OR, 2.1 and 2.5), macrosomia (OR, 1.2 and 1.2), low birth weight neonates (OR, 1.6 and 2.3) and perinatal mortality (OR, 1.6 and 3.7). The adolescent group had higher risks than the 25-29 age group for anemia (OR, 1.4), preeclampsia (OR, 1.6), preterm birth (OR, 2.1), low birth weight neonates (OR, 2.3) and perinatal mortality (OR, 3.6). CONCLUSION: Maternal and neonatal risks are higher during both the adolescent and advanced maternal ages. And the age group of 20-30 years has the lowest risk for pregnancy and delivery.
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Idade Materna , Adolescente , Adulto , Peso ao Nascer , Cesárea , China , Estudos de Coortes , Diabetes Gestacional , Feminino , Humanos , Recém-Nascido , Modelos Logísticos , Razão de Chances , Placenta Prévia , Pré-Eclâmpsia , Gravidez , Complicações na Gravidez , Resultado da Gravidez , Nascimento Prematuro , Estudos RetrospectivosRESUMO
OBJECTIVE: To estimate cesarean delivery rates and indications by region in mainland China. METHODS: A cross sectional survey of all deliveries in 39 hospitals in 14 provinces of mainland China from January 1 to December 31, 2011 was evaluated for mode of delivery, cesarean delivery rates and indications for delivery. RESULTS: (1) A survey of a total of 112 138 women at delivery with gestations greater than 24 weeks was analyzed. 79 631 and 32 507 deliveries were obtained from the tertiary and secondary hospitals respectively. 90 971 were primipara, 21 167 were multipara. Of these pregnancies, 61 084, 49 734 and 1 320 cases resulted in cesarean delivery, vaginal delivery and operative vaginal delivery respectively, the cesarean delivery rate was 54.472% (61 084/112 138). Among 61 084 women who had cesarean delivery, 14 998 cases of the cesarean deliveries were performed without medical indications, 46 086 cases of the cesarean deliveries had medical indications. The cesarean delivery rate of the tertiary hospitals was 55.927% (44 535/79 631), and was significant higher than that in the secondary hospitals (50.909%, 16 549/32 507; P < 0.01). (2) Overall 24.553 % (14 998/61 084) of cesarean deliveries were performed without medical indications. 19.744% (8 793/44 535) of the cesarean deliveries without medical indications were performed in the tertiary hospitals, and was significant lower than in the secondary hospitals (37.495%, 6 205/16 549;P < 0.01). (3) Maternal request was the most common indication (24.553% of all cesarean deliveries), followed by fetal distress (12.507% , 7 640/61 084), cephalopelvic disproportion (11.787%, 7 200/61 084), previous uterine surgery (10.374%, 6 337/61 084), malpresentation (5.815%, 3 552/61 084), failure to progress (5.710%, 3 488/61 084) and suspected macrosomia (5.594%, 3 417/61 084). CONCLUSIONS: The increasing caesarean section rate in mainland China is explained mainly by the high non-indicated caesarean section rate. The main medical indications of the cesarean deliveries included fetal distress, cephalopelvic disproportion, previous uterine surgery, malpresentation and failure to progress.
Assuntos
Cesárea/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Adulto , Peso ao Nascer , Desproporção Cefalopélvica/epidemiologia , Cesárea/tendências , China , Estudos Transversais , Feminino , Sofrimento Fetal/epidemiologia , Macrossomia Fetal , Idade Gestacional , Humanos , Paridade , Gravidez , Complicações na Gravidez/epidemiologia , Gravidez de Alto Risco , Adulto JovemRESUMO
Purpose: This study aimed to evaluate the effects of monocular flicker stimulation on binocular imbalance in both amblyopic and nonamblyopic adults. Methods: Seven amblyopic patients (28.3 ± 3.3 years; four females) and seven normally sighted participants (27.3 ± 4.1 years; five females) participated in the study. We used liquid crystal spectacles to create externally-generated monocular flicker (4, 7, 10, 15, or 20 Hz) and used the metric of log balance point (logBP) to determine whether imposed flicker could change the eyes' equilibrium interocular contrast ratio. Flicker was applied to either the fellow eye vs. the amblyopic eye or dominant eye (DE) vs. non-DE (non-DE) of amblyopic and nonamblyopic participants, respectively. We defined a logBP of 0 to indicate complete binocular balance and an increase in logBP relative to baseline to indicate a relative strengthening of the non-DE or amblyopic eye. Results: Monocular flicker applied to the DE or fellow eye increased logBP, whereas when applied to the non-DE or amblyopic eye, reduced the logBP. These effects were more pronounced at low temporal frequencies than that at high temporal frequencies. The interaction between eye and temporal frequency was significant in both normals, F(4, 24) = 58.082, P < 0.001, η2 = 0.906, and amblyopes, F(1.923, 11.538) = 60.555, P < 0.001, η2 = 0.91. Conclusions: Monocular flicker diminishes the contribution of the flickered eye in binocular combination, resulting in a relative dominance of the nonflickered eye in interocular interactions. Furthermore, a more pronounced temporally modulated effect was observed at lower temporal frequencies.
Assuntos
Ambliopia , Adulto , Feminino , Animais , Humanos , AvesRESUMO
BACKGROUND: Low birth weight (LBW) is one of the leading causes of adverse perinatal outcomes and is closely related to neonatal disease and death. The incidence of LBW has been increasing. The aim of this study was to investigate the current incidence rate and factors affecting low birth weight infants and perinatal outcomes of full-term low birth weight infants in mainland China. METHODS: This paper describes a retrospective analysis of children born in 39 hospitals of different types in 14 different provinces, municipalities, and autonomous regions in seven districts within China throughout 2011. The data were first collected in hardcopy format and then entered into computer network databases. Data covering a total of 112,441 cases were collected. Cases were excluded if data were incomplete and in the case of miscarriage before 24 weeks of gestation, multiple pregnancies, or induction of labor due to fetal malformation, intrauterine death, and other reasons, leaving a total of 101,163 cases. SPSS 18.0 and SAS 9.2 statistical packages were used to analyze the collected data. RESULTS: According to this research, the incidence of LBW in mainland China was 6.1%, which is higher than the 5.87% reported in 2000, and it varied across different areas. The incidence of LBW was significantly higher in tertiary care hospitals than in secondary care hospitals. LBW was found to be associated with maternal age of less than 20 years, low level of maternal education, previous histories of adverse pregnancies, and with pregnancy comorbidities and complications, such as hypertensive disorders during pregnancy, anemia, oligohydramnios, premature rupture of membranes, and gestational diabetes. The rates of stillbirths, severe neonatal asphyxia, and deaths among full-term LBW infants were 2.42%, 0.83%, and 3.49%, respectively. The rates of stillbirths and neonatal deaths among full-term LBW infants born by caesarean section were 0.5% and 1.0%, respectively, which was lower than vaginal delivery. CONCLUSIONS: The incidence of LBW has increased in China. LBW is a leading cause of adverse pregnancy outcomes. Health care during pregnancy and management of high-risk factors for LBW may reduce the incidence of LWB and the death rate of LBW infants.
Assuntos
Peso ao Nascer , Recém-Nascido de Baixo Peso , Complicações na Gravidez/epidemiologia , História Reprodutiva , Adulto , Anemia/epidemiologia , Asfixia Neonatal/epidemiologia , Cesárea/estatística & dados numéricos , China/epidemiologia , Diabetes Gestacional/epidemiologia , Escolaridade , Feminino , Ruptura Prematura de Membranas Fetais/epidemiologia , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Incidência , Mortalidade Infantil , Recém-Nascido , Idade Materna , Oligo-Hidrâmnio/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Centros de Cuidados de Saúde Secundários/estatística & dados numéricos , Natimorto/epidemiologia , Nascimento a Termo , Centros de Atenção Terciária/estatística & dados numéricos , Adulto JovemRESUMO
Diet-induced obesity in mice and humans is commonly associated with an imbalance between energy intake and expenditure. Reportedly, creatine can enhance energy expenditure in brown adipose tissue and reduce hepatic triglycerides accumulation; however, the molecular mechanism underlying the role of exogenous creatine supplementation in regulating lipid droplet mobilization remains elusive. Herein, we employed a high-fat diet (HFD)- induced mouse model to investigate the role of creatine in regulating lipolysis and lipophagy in brown adipose tissue and the liver. Exogenous creatine supplementation ameliorated HFD-induced obesity, increased insulin sensitivity and improved glucose homeostasis. Creatine supplementation enhanced the expression of uncoupling protein 1 (UCP1), cell death-inducing DNA fragmentation factor alpha-like effector A (CIDEA), and other brown adipose tissue-specific thermogenic genes Cpt1a, Gyk, and Pgc1ß in brown adipose tissue. Furthermore, creatine inhibited the expression of CIDEA, which promotes hepatic lipid accumulation. Creatine stimulated the expression of triglyceride lipase adipose triglyceride lipase, and phospho-hormone-sensitive lipase (HSL) induced increased lipolysis in brown adipose tissue and the liver. Meanwhile, reduced LC3B expression was accompanied by an increased level of p62 in HFD-fed mice, indicating diminished basal autophagy in brown adipose tissue and the liver; however, creatine enhanced P62/LC3B induced lipophagy in brown adipose tissue and the liver. Collectively, our results suggest that creatine may function as a brown adipose tissue activator to increase whole-body energy metabolism via coordinated lipolysis and lipophagy in brown adipose tissue and the liver.
Assuntos
Tecido Adiposo Marrom , Lipólise , Humanos , Camundongos , Animais , Tecido Adiposo Marrom/metabolismo , Creatina/metabolismo , Dieta Hiperlipídica/efeitos adversos , Tecido Adiposo Branco/metabolismo , Obesidade/metabolismo , Fígado/metabolismo , Metabolismo Energético/fisiologia , Autofagia , Lipase/metabolismo , Tecido Adiposo/metabolismoRESUMO
Purpose: The current understanding of binocular processing is primarily derived from static spatial visual perception: this leaves the role of temporal information unclear. In this study, we addressed this gap by testing the effect of alternating flicker on binocular information processing in adults with abnormal binocular vision. Our goal was to determine which temporal frequency optimally balanced input from both eyes. Methods: We took measurements in four groups of human adults: 10 normal adults with the individual's nondominant eye covered by a 2% neutral density filter (aged 25.60 ± 1.43 years, experiment 1), 9 nonamblyopic anisometropes (aged 24.33 ± 1.66 years, experiment 2), 7 amblyopes (aged 26.5 ± 1.64 years, experiment 3), and 7 treated amblyopes (aged 24 ± 3.21 years, experiment 4). The balance point (BP), where participants' two eyes are equally effective, was measured using a binocular orientation combination task at four spatial frequencies (SFs; 0.5-4 c/d) and five temporal frequencies (TFs; baseline and 4, 7, 10, and 15 Hz). Its log transformation |logBP| was taken into further analysis. Results: We observed clear U-shaped temporal tuning of the |logBP| for the entire range of TFs (that we measured: trough occurred at 7 Hz). This pattern occurred and was significant in all four groups (P < 0.001). In addition, the effect of SFs on |logBP| was significant in normal, amblyopic, and treated amblyopic groups (all P < 0.001) and was marginally significant in the nonamblyopic anisometropic group (P = 0.086). Conclusions: Alternating flicker around 7 Hz may be the optimal temporal frequency for balancing eyes in human adults with binocular imbalance.
Assuntos
Ambliopia , Visão Binocular , Humanos , Adulto , Percepção Visual , Visão OcularRESUMO
Aim: Preeclampsia (PE) belongs to hypertensive disorders of pregnancy (HDP), which can cause maternal death worldwide. This study aimed to identify the miRNA-mRNA-associated ceRNA network and to find new treatment schedules for PE. Methods: 4 microarray datasets were downloaded from the Gene Expression Omnibus database. We obtained 1737 differentially expressed mRNAs (865 upregulated and 872 downregulated) and 148 differentially expressed miRNAs (76 upregulated and 72 downregulated) from the placenta tissues of PE, respectively. Functional enrichment analyses of DEmRNAs were performed. The regulatory relationship between DEmiRNAs and DEmRNA was predicted via related databases. An miRNA-mRNA regulatory network was constructed. Results: hsa-let-7c and IGF1R were identified as potential regulators for PE, and function enrichment analysis showed that the PI3K-Akt signaling pathway was closely related. Therefore, ceRNAs might regulate the PI3K-Akt signaling pathway via the upregulation of IGF1R by binding to hsa-let-7c, affecting invasion of trophoblast, angiogenesis, and proinflammation in PE. Further study demonstrated that anticancer drugs including the PI3K inhibitor, AKT inhibitor, and IGF-1 inhibitor might be a potential solution for PE treatment. Conclusions: The hsa-let-7c/IGF1R axis might affect the PI3K-Akt signaling pathway which is involved in the pathogenesis of PE, and inhibitors targeting this pathway might be used for PE treatment.
RESUMO
BACKGROUND: Prevention strategies can reduce the incidence of early-onset group B Streptococcus (GBS) neonatal sepsis (EOGBS). Rates of GBS colonization and infection vary among regions within China. China has not adopted a unified prevention strategy. METHODS: To assess strategies to reduce EOGBS in China, models were developed to quantify residual EOGBS rates with intrapartum antibiotic prophylaxis in infants ≥ 35 weeks' gestation in risk factor-based and antepartum screening-based strategies. Maternal GBS colonization rates and EOGBS incidence in 3 regions of China (A: Xiamen of Fujian province, B: Shanghai and C: Liuzhou of Guangxi province) were estimated from published data. RESULTS: Estimates for GBS colonization and attack rates were 21.6%, 11.7% and 6.1% and 1.79, 1.79 and 0.58 per 1000 live births for regions A, B and C, respectively. Modeling predicted that strategies including screening cultures beginning at 36 weeks' gestation and intrapartum antibiotic prophylaxis in 90% of eligible parturients could reduce EOGBS incidence to 0.44, 0.50 and 0.16 per 1000 live births in these regions. In region C, the expected EOGBS rate could be reduced to 0.28 per 1000 using a risk factor-based strategy. CONCLUSIONS: Different strategies for preventing EOGBS may be needed in different regions of mainland China. Screening strategies may be most appropriate in regions with higher attack rates, even with moderate levels of maternal GBS colonization. In areas with low attack rates, risk factor strategies that reduce morbidity by at least one-third may suffice.