Implementing a novel capture and ligation probe-PCR method in mass screen and treatment to support malaria elimination efforts in the China-Myanmar border region.

BACKGROUND: Mass screening and treatment (MSAT) for malaria elimination lacks an ideal diagnostic tool to allow sensitive and affordable test of the target population in the field. This study evaluated whether Capture and Ligation Probe-PCR (CLIP-PCR) could be used in a field MSAT in Laiza City, Myanmar. METHODS: On day 0, two dried blood spots were collected from each participant. On day 1, all samples were screened for Plasmodium in a 20 m2 laboratory with workbench, a biosafety cabinet, a refrigerator, a benchtop shaking incubator and a qPCR machine, by four technicians using CLIP-PCR with sample pooling, at a health clinic of the Chinese bordering town of Nabang. On day 2, all positives were followed up and treated. RESULTS: Of 15,038 persons (65% of the total population) screened, 204 (1.36%) were CLIP-PCR positives. Among them, 188, 14, and 2 were infected with Plasmodium vivax, Plasmodium falciparum, and P. vivax/P. falciparum mix, respectively. The testing capacity was 538 persons/day, with a cost of US$0.92 /person. The proportion of submicroscopic infection was 64.7%. All positive individuals received treatment within 72 h after blood collection. CONCLUSION: Using CLIP-PCR in MSAT in low transmission settings can support the malaria elimination efforts in the China-Myanmar border region.

Pan-cancer analysis of oncogenic TNFAIP2 identifying its prognostic value and immunological function in acute myeloid leukemia.

BACKGROUND: Tumor necrosis factor alpha-induced protein 2 (TNFAIP2), a TNFα-inducible gene, appears to participate in inflammation, immune response, hematopoiesis, and carcinogenesis. However, the potential role of TNFAIP2 in the development of acute myeloid leukemia (AML) remains unknow yet. Therefore, we aimed to study the biological role of TNFAIP2 in leukemogenesis. METHODS: TNFAIP2 mRNA level, prognostic value, co-expressed genes, differentially expressed genes, DNA methylation, and functional enrichment analysis in AML patients were explored via multiple public databases, including UALCAN, GTEx portal, Timer 2.0, LinkedOmics, SMART, MethSurv, Metascape, GSEA and String databases. Data from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO) and Beat AML database were used to determine the associations between TNFAIP2 expression and various clinical or genetic parameters of AML patients. Moreover, the biological functions of TNFAIP2 in AML were investigated through in vitro experiments. RESULTS: By large-scale data mining, our study indicated that TNFAIP2 was differentially expressed across different normal and tumor tissues. TNFAIP2 expression was significantly increased in AML, particularly in French-American-British (FAB) classification M4/M5 patients, compared with corresponding control tissues. Overexpression of TNFAIP2 was an independent poor prognostic factor of overall survival (OS) and was associated with unfavorable cytogenetic risk and gene mutations in AML patients. DNA hypermethylation of TNFAIP2 at gene body linked to upregulation of TNFAIP2 and inferior OS in AML. Functional enrichment analysis indicated immunomodulation function and inflammation response of TNFAIP2 in leukemogenesis. Finally, the suppression of TNFAIP resulted in inhibition of proliferation by altering cell-cycle progression and increase of cell death by promoting early and late apoptosis in THP-1 and U937AML cells. CONCLUSION: Collectively, the oncogenic TNFAIP2 can function as a novel biomarker and prognostic factor in AML patients. The immunoregulation function of TNFAIP2 warrants further validation in AML.

Analysis of the Therapeutic Effect of Multimode Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke.

OBJECTIVE: We sought to observe the effectiveness and safety of multimode mechanical thrombectomy in the treatment of acute ischemic stroke. METHODS: The data from patients with acute intracranial artery occlusion treated with multimode mechanical thrombectomy between November 2018 and December 2019 were collected, and the clinical features, imaging data, treatment, and clinical follow-up results 90 days after the operation were analyzed. Postoperative recanalization and the 90-day modified Rankin Scale score were used as clinically effective endpoints. The incidence of symptomatic intracranial hemorrhage within 72 hours and postoperative 90-day mortality were used to evaluate safety. RESULTS: A total of 70 patients were enrolled, including 18 cases with bridging treatment, 11 cases with stent implantation, and 10 cases with balloon dilatation. During the 90 days of follow-up after surgery, 35.7% of (25/70) patients had a good prognosis (modified Rankin Scale score of 0-2). The incidence of postoperative symptomatic intracranial hemorrhage was 11.4% (8/70), and postoperative mortality was 34.3% (24/70). The onset-to-puncture time in the good-prognosis group and the poor-prognosis group was 270 (225-345) versus 330 (270-420) minutes, respectively, and the onset-to-recanalization time in the 2 groups was 350 (295-405) versus 410 (340-470) minutes, respectively. Successful recanalization in the good-prognosis group and the poor-prognosis group was 96.0% versus 57.8%, respectively, and the incidence of symptomatic intracranial hemorrhage in the 2 groups was 0% versus 17.8%, respectively. The difference between the 2 groups was statistically significant (P < 0.05). CONCLUSIONS: Multimode mechanical thrombectomy is a safe and effective therapy for the intracranial occlusion of large vessels in patients with acute ischemic stroke.

Historical review of malaria control and elimination in the border areas of China: A case study of Yunnan Province.

To understand how malaria could be eliminated in the original hyperendmic area for malaria along international borders in Yunnan Province, malaria situation and control were described on the basis of seven phases. At last the experiences and lessons of the program that reduced border malaria from hyperendmicity to malaria-free status were summarized. Malaria control and elimination area were particularly difficult in the Yunnan border. The achievement can be attributed to high political commitment, strategic and technical innovations based on the actual locality, effective collaboration and communication with neighbouring countries to carry out cross border interventions. Other border areas might perform their own pilot interventions based on their local context, including malaria burden, governing system, health service structure contextualized based on their socioeconomic development and ecology, and then a local decision could be made according to their own trial results.

Effectiveness of joint 3 + 1 malaria strategy along China-Myanmar cross border areas.

BACKGROUND: Cross-border malaria in Laiza City of Myanmar seriously affected Yingjiang County of China and compromised reaching the goal of malaria elimination by 2020. Since 2017, a pilot project on 3 + 1 strategy of joint cross-border malaria prevention and control was carried out for building a malaria buffer in these border areas. Here, 3 were the three preventive lines in China where different focalized approaches of malaria elimination were applied and + 1 was a defined border area in Myanmar where the integrated measures of malaria control were adopted. METHODS: A 5-year retrospective analysis (2015 to 2019) was conducted that included case detection, parasite prevalence and vector surveillance. Descriptive statistics was used and the incidence or rates were compared. The annual parasite incidence and the parasite prevalence rate in + 1 area of Myanmar, the annual importation rate in Yingjiang County of China and the density of An. minimus were statistically significant indictors to assess the effectiveness of the 3 + 1 strategy. RESULTS: In + 1 area of Myanmar from 2015 to 2019, the averaged annual parasite incidence was (59.11 ± 40.73)/1000 and Plasmodium vivax accounted for 96.27% of the total confirmed cases. After the pilot project, the annual parasite incidence dropped 89% from 104.77/1000 in 2016 to 12.18/1000 in 2019, the microscopic parasite prevalence rate dropped 100% from 0.34% in 2017 to zero in 2019 and the averaged density of An. Minimus per trap-night dropped 93% from 1.92 in June to 0.13 in September. The submicroscopic parasite prevalence rate increased from 1.15% in 2017 to 1.66% in 2019 without significant difference between the two surveys (P = 0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The averaged annual importation rate from 2015 to 2019 was (0.47 ± 0.15)/1000. After the pilot project, the annual importation rate dropped from 0.59/1000 in 2016 to 0.28/1000 in 2019 with an overall reduction of 53% in the whole county. The reduction was 67% (57.63/1000 to 18.01/1000) in the first preventive line, 52% (0.20/1000 to 0.10/1000) in the second preventive line and 36% (0.32/1000 to 0.22/1000) in the third preventive line. The averaged density of An. Minimus per trap-night in the first preventive line dropped 94% from 2.55 in June to 0.14 in September, without significant difference from that of + 1 area of Myanmar (Z value = - 1.18, P value = 0.24). CONCLUSION: The pilot project on 3 + 1 strategy has been significantly effective in the study areas and a buffer zone of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China.

Long-term outcomes of busulfan plus melphalan-based versus melphalan 200 mg/m2 conditioning regimens for autologous hematopoietic stem cell transplantation in patients with multiple myeloma: a systematic review and meta-analysis.

BACKGROUND: High-dose melphalan (HDMEL, 200 mg/m2) is considered as the standard conditioning regimen for autologous hematopoietic stem cell transplantation (auto-HSCT) in multiple myeloma (MM). However, whether the combination of melphalan with busulfan (BUMEL) conditioning outperforms HDMEL remains controversy. Accordingly, a systematic review and meta-analysis was carried out to compare the outcomes of HDMEL and BUMEL-based conditioning regimens in newly diagnosed MM patients having undergone auto-HSCT. METHODS: A systematic literature search was conducted in PubMed, Embase and Cochrane Library database until July 31, 2021, to identify all eligible studies comparing progression-free survival (PFS), overall survival (OS), optimal treatment response after auto-HSCT, duration of stem cell engraftment and incidence of toxic events between patients undergoing BUMEL-based and HDMEL conditioning regimens. Hazard ratio (HR), mean difference (MD) or odds ratio (OR) corresponding to 95% confidence interval (CI) were determined to estimate outcomes applying RevMan 5.4 software. Publication biases were assessed by performing Egger's test and Begg's test by Stata 15 software. RESULTS: Ten studies with a total of 2855 MM patients were covered in the current meta-analysis. The results of this study demonstrated that patients having received BUMEL-based regimen was correlated with longer PFS (HR 0.77; 95% CI 0.67~0.89, P = 0.0002) but similar OS (HR 1.08; 95% CI 0.92~1.26, P = 0.35) compared with those having received HDMEL. The differences of best treatment response after auto-HSCT and duration of neutrophil or platelet engraftment did not have statistical significance between the two groups of patients. With respect to adverse effects, the patients in BUMEL-based group were less frequently subject to gastrointestinal toxicity while the patients in HDMEL group less often experienced mucositis and infection. No significant difference was observed in hepatic toxicity between the two groups of patients. CONCLUSIONS: In the present study, BUMEL-based conditioning was identified as a favorable regimen for a better PFS and equivalent OS as compared with HDMEL, which should be balanced against higher incidences of mucositis and infection. BUMEL-based conditioning is likely to act as an alternative strategy to more effectively improve auto-HSCT outcomes in MM.

Intensive surveillance, rapid response and border collaboration for malaria elimination: China Yunnan's ''3 + 1''strategy.

BACKGROUND: Eliminating malaria and preventing re-establishment of malaria transmission in border areas requires universal coverage of malaria surveillance and a rapid response to any threats (i.e. malaria cues) of re-establishing transmission. MAIN TEXT: Strategy 1: Intensive interventions within 2.5 km-wide perimeter along the border to prevent border-spill malaria. The area within 2.5 km along the international border is the travel radius of anopheline mosquitoes. Comprehensive interventions should include: (1) proactive and passive case detection, (2) intensive vector surveillance, (3) evidence-based vector control, and (4) evidence-based preventative treatment with anti-malarial drugs. Strategy 2: Community-based malaria detection and screening of migrants and travellers in frontier townships. Un-permitted travellers cross borders frequently and present in frontier townships. Maintenance of intensified malaria surveillance should include: (1) passive malaria detection in the township hospitals, (2) seek assistance from villager leaders and health workers to monitor cross border travellers, and refer febrile patients to the township hospitals and (3) the county's Centre for Disease Control and Prevention maintain regular proactive case detection. Strategy 3: Universal coverage of malaria surveillance to detect malaria cues. Passive detection should be consolidated into the normal health service. Health services personnel should remain vigilant to ensure universal coverage of malaria detection and react promptly to any malaria cues. Strategy + 1: Strong collaborative support with neighbouring countries. Based on the agreement between the two countries, integrated control strategies should be carried out to reduce malaria burden for both countries. There should be a clear focus on the border areas between neighbouring countries. CONCLUSION: The 3 + 1 strategy is an experience summary of border malaria control and elimination, and then contributed to malaria elimination in Yunnan's border areas, China. Nevertheless, Yunnan still has remaining challenges of re-establishment of malaria transmission in the border areas, and the 3 + 1 strategy should still be carried out.

Malaria: elimination tale from Yunnan Province of China and new challenges for reintroduction.

BACKGROUND: Eradication of infectious disease is the sanctified public health and sustainable development goal around the world. MAIN BODY: Three antimalarial barriers were developed to control imported malarial cases, and an effective surveillance strategy known as the "1-3-7 approach" was developed to eliminate malaria from the Chinese population. From 2011 to 2019, 5254 confirmed malaria cases were reported and treated in Yunnan Province, China. Among them, 4566 cases were imported from other countries, and 688 cases were indigenous from 2011 to 2016. Since 2017, no new local malarial case has been reported in China. Thus, malaria has been completely eliminated in Yunnan Province. However, malaria is detected in overseas travellers on a regular basis, such as visitors from neighbouring Myanmar. CONCLUSION: Hence, the strategies should be further strengthened to maintain a robust public health infrastructure for disease surveillance and vector control programs in border areas. Such programs should be supported technically and financially by the government to avert the possibility of a malarial resurgence in Yunnan Province.

[Research progress of effect of Rhei Radix et Rhizoma and its anthraquinone in treatment of autoimmune diseases].

Rhei Radix et Rhizoma was first recorded in Shennong Ben Cao Jing, with a wide range of pharmacological activities. Autoimmune disease is a kind of disease that damages the tissue structure and function of immune cells and their components due to the impairment of immune tolerance function, including atherosclerosis, multiple sclerosis, gout, rheumatoid arthritis, autoimmune thyroiditis, ulcerative colitis, type 1 diabetes and IgA nephropathy. In recent years, clinical and experimental studies show that Rhei Radix et Rhizoma has potential therapeutic effects on autoimmune diseases. Under the guidance of the theory of traditional Chinese medicine, this paper reviews therapeutic and intervening effects of Rhei Radix et Rhizoma and its main active ingredient anthraquinone on autoimmune diseases. It also puts forward new study directions in view of the existing problems in studies of rhubarb and its anthraquinone, with the aim to provide reference for clinical treatment and scientific studies of effect of Rhei Radix et Rhizomaon autoimmune diseases.

Prevalence and dissemination risk of antimicrobial-resistant Enterobacteriaceae from shared bikes in Beijing, China.

Bike-sharing as a common public transportation has been booming in China in recent years. Previous studies showed that the surfaces of public transport can act as reservoirs of antimicrobial-resistant (AR) bacteria, but AR bacterial contamination of shared bikes has not been investigated. Otherwise, the AR-Enterobacteriaceae is considered as a global health threat for humans. Herein, we aimed to investigate the prevalence of AR Enterobacteriaceae on shared bikes and examine correlations between AR Enterobacteriaceae from shared bikes and public buildings around Metro stations in Beijing. We collected 2117 samples from shared bikes at 240 Metro stations in Beijing. A total of 444 non-duplicate Enterobacteriaceae were isolated from 418 samples at 166 stations. The isolates exhibited low rates of resistance (0.5%-6.3%) to all antimicrobial agents except sulfamethoxazole-trimethoprim (31.5%). Three ceftazidime-resistant E. coli isolates were positive for blaCTX-M-199 and two of them were positive for carbapenemase-producing gene blaNDM-5. Multivariable logistic regression model revealed that variable "secondary/tertiary non-profit hospital nearby" was significantly (p < 0.05) associated with isolation of AR Enterobacteriaceae from the shared bikes around the Metro stations. Low AR rates of Enterobacteriaceae observed in this study suggested the risk of dissemination of AR-Enterobacteriaceae via shared bikes is limited. However, we identified hospitals as a risk factor for the dissemination of AR Enterobacteriaceae among shared bike users. More attention should be paid to both comprehensive hygiene managements in the surrounding environment of hospitals and the increasing of public awareness on the personal hygienic habits.

Effect of midwife-led care on birth outcomes of primiparas.

BACKGROUND: The high caesarean section rate is a prominent public health problem in China. AIM: This study aimed to determine the effects of midwife-led care during labour on birth outcomes for healthy primiparas. DESIGN: Randomized controlled trial. SETTING: The Obstetrics Department of Fujian Provincial Maternity and Child Health Hospital. METHODS: A total of 666 primiparas in labour were randomly divided into an intervention and control group (333 in each group). The intervention group received a midwife-led model of care during labour. RESULTS: Data from 648 cases (331 intervention group and 317 control group) were analysed. The intervention group was less likely to experience caesarean section, postpartum haemorrhage, opiate analgesia, vaginal examinations, neonatal asphyxia, and neonatal hospitalization and was more likely to experience shorter length of labour and vaginal birth than the control group (all, P < 0.05). No differences were found in the number of artificial rupture of membranes and oxytocin use (P > 0.05). CONCLUSIONS: Midwife-led care can reduce the caesarean section rate, promote normal birth, improve birth outcomes, and promote maternal and child health.

[Optimization ofPig-aGene Mutation in Rats and Assessment of Time-dependent and Dose-response Relationship of N-ethyl-N-nitrosourea].

OBJECTIVES: To optimize the method of Pig-a mutation assay, and to explore the time-dependent and dose-response relationship of N-ethyl-N-nitrosourea (ENU). METHODS: Thirty rats were randomly assigned to 5 groups: treated with PBS (control group)or different doses of ENU (10, 20, 40 and 80 mg/kg) for 3 d by oral gavage. Blood samples were collected at 0 d, 15 d, 30 d, 45 d, 60 d, 75 d and 90 d. After enrichment, erythrocytes were incubated with Anti-CD59-APC and SYTO 13 nucleic acid dye solution. Mutant phenotype erythrocytes (RBCCD59-) and mutant phenotype reticulocytes (RETCD59-) were measured by flow cytometry to analyze mutant frequencies, and the RET percentage was determined as well. RESULTS: The RBCCD59- mutation frequency in 4 ENU groups were significantly increased in a dose- and time-dependent manner. The RETCD59- mutation frequency increased to a stable high level with a slight fluctuation, and decreased at 45 d , with the peak values observed at 30 d. The RETCD59- mutation frequency showed a dose-dependent trend in 4 ENU groups. The RET percentage in all 5 groups declined at 30 d, to a stable low level thereafter, but the trends showed no significant differences by time or group. CONCLUSIONS: The optimized in vivo Pig-a mutation assay could detecte the mutagen, such as ENU, induces mutation in RBC in a time- and dose-dependent manner.

[Study on the risk factors related vertical transmission of HBV positive couples to their infant].

OBJECTIVE: To explore the risk factors and the rate of HBV vertical transmission from HBsAg-positive couple to their infant. METHODS: 46 families who had antenatal examination at Fujian Provincial Maternal and Child Health Hospital during August 2010 and November 2011 were chosen as research object. Cord blood was sampled after delivery for HBVM and HBV-DNA quantification. Those with HBV-DNA load ≥ 5 × 10(2) copies/ml were involved in the case group while those having < 5 × 10(2) copies/ml were chosen as controls. RESULTS: The average positive rate of neonatal cord blood HBV-DNA was 45.7% (21/46), while the positive rates of cord blood HBsAg and HBeAg were 34.8% (16/46) and 23.9% (11/46) respectively. The positive rates of maternal serum HBV-DNA and paternal serum HBV-DNA were 52.2% (24/46) and 69.6% (32/46) respectively, with the positive rate of couple serum HBeAg as 39.1% (18/46) and 32.6% (15/46) respectively. Results from univariate analysis showed that hepatitis B surface markers, serum HBeAg-positive, serum HBV-DNA positive, and serum HBV-DNA load of the couples were risk factors to the HBV vertical transmission (χ(2) = 8.731, 8.414, 8.932, 9.663, 10.823, 3.962, 13.638, 36.501; P < 0.05). Data from the multivariate analysis showed that maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors to the HBV vertical transmission[OR = 17.6 (1.3 - 238.4) ; OR = 3.5 (1.6-7.6)]. Serum HBV-DNA loads of the couples were positively correlated with the cord blood HBV-DNA load, while the load levels of the couple's serum HBV-DNA were higher than cord blood HBV-DNA. There appeared dose-response relationship between couple's serum HBV-DNA load level and the cord blood HBV-DNA load level. RESULTS: from the analysis of ROC curve showed that both maternal serum HBV-DNA load level (10(3) copies/ml) and paternal serum HBV-DNA load level (10(4) copies/ml) were demarcation points to better forecast the occurrence of vertical transmission of HBV, because there showed higher sensitivity and specificity for the forecasting process. Neonatal outcomes showed no significant difference between the case group and the control group. The negative conversion rate became 15.0% (3/20) when the HBV-DNA positive infants were followed up for 7 months. CONCLUSION: Both maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors of HBV vertical transmission. When the maternal serum HBV-DNA load appeared > 10(3) copies/ml and paternal serum HBV-DNA load > 10(4) copies/ml, the rate of HBV vertical transmission would increase.

[A correlation analysis between the rate of vertical transmission of HBV and HBsAg-positive father to infant and the rate of neonatal cord blood HBV-DNA].

OBJECTIVE: To study the influence of HBV-DNA with different load levels of HBsAg-positive among fathers on the rate of neonatal cord blood HBV-DNA. METHODS: Using HBsAg and HBV-DNA as screening indicators for pregnant women and their husbands from an obstetric clinic. 161 pregnant women whose HBsAg and HBV-DNA were negative, but HBsAg was positive among their husbands and their newborns, were selected. Blood samples from those pregnant women, their husbands and their newborns were collected to detect the related indicators. Using ELISA to detect hepatitis B virus markers (HBVM), and FQ-PCR to detect the levels of HBV-DNA load. According to neonatal cord blood HBV-DNA detection guideline, newborns with cord blood HBV-DNA positive were selected as cases, others as controls. RESULTS: (1) Result of the study showed that there was a dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive rates in newborns (trend χ(2) = 64.117, P = 0.000). The rate of vertical transmission of HBV from HBsAg-positive father to infant in the paternal serum HBV-DNA ≥ 1.0 × 10(7) copies/ml group was significantly higher than HBV-DNA < 1.0 × 10(7) copies/ml group (χ(2) = 71.539, P = 0.000). (2) There was a positive rank correlation between semen positive HBeAg and vertical transmission of HBV from HBsAg-positive father to infant (χ(2) = 6.892, P = 0.009). CONCLUSION: There was a dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive in newborns. Paternal serum HBV-DNA ≥ 1.0 × 10(7) copies/ml and with HBeAg positive status were risk factors of vertical transmission of HBV from HBsAg-positive father to infant.

[Risk factors for paternal vertical transmission of hepatitis B virus.].

OBJECTIVE: To explore the risk factors of and the influence of different hepatitis B virus (HBV) DNA load on paternal vertical transmission of HBV. METHODS: Totally, 161 HBsAg negative women, whose husband was HBsAg positive, attended the antenatal clinics of the Provincial Maternity and Child Health Hospital of Fujian from September 2007 to December 2008 and their newborns were selected, and the epidemiologic information, the duration of being a HBV carrier, the first class HBV family history of the fathers, HBV markers, HBV DNA load, HBsAb of the gravidas, the outcomes of the newborns were all collected. Cord blood was sampled after delivery for HBV DNA quantification and those with HBV DNA load >/= 1.0 x 10(3) copy/ml were chosen as the case group and those < 1.0 x 10(3) copy/ml as control. RESULTS: (1) Among the 161 newborns, 36 HBV DNA positive cord blood samples were detected, giving a rate of 22.4% (36/161) for paternal vertical transmission of HBV. The HBV DNA positive rate in cord blood was 32.0% (23/72) in HBeAg-positive fathers and 14.6% (13/89) in HBeAg-negative fathers. (2) Univariate analysis showed that HBeAg-positive, HBV DNA positive, first class family history of HBV and the duration of being a HBV carrier of the fathers were risk factors of paternal HBV vertical transmission [chi(2) = 6.892, 29.916, 29.499 and 23.821, OR = 2.7, 5.2, 8.3 and 1.4 (P < 0.01)]. (3) Multivariate analysis found that paternal serum HBV DNA positive and the first class family history of HBV of the father side were risk factors of paternal vertical transmission of HBV (OR = 11.1, 95%CI: 4.6 - 27.1; OR = 17.1, 95%CI: 3.5 - 82.6). (4) According to the different serum HBV DNA load of the HBsAg-positive father, 7 groups were divided. A dose dependent effect was found that the HBV DNA positive rate of the cord blood increased with the rising of HBV DNA load. No HBV DNA positive cord blood was detected when paternal HBV DNA load was < 1.0 x 10(4) copy/ml, while 100% of the cord blood were positive when paternal HBV DNA load >/= 1.0 x 10(8) copy/ml. (5) The average birth weight of the newborns in the two groups was the same (3.3 +/- 0.4) kg. And the delivery mode, gestational age at delivery, height and Apgar score of the newborns at 1 minute, neonatal pathological jaundice and other complications had no significant difference between the two groups (P > 0.05). No relationship was found between the neonatal outcomes and the paternal HBV vertical transmission (P > 0.05). CONCLUSIONS: HBV DNA load in the serum of HBsAg-positive father, and the paternal first class family history of HBV are risk factors of paternal HBV vertical transmission. When the serum HBV DNA load in HBsAg-positive father is >/= 1.0 x 10(7) copy/ml, the possibility of paternal vertical transmission of HBV would increase.

[Study on the influence of maternal physiology, mentality and prenatal health care on children born with low birth weight].

OBJECTIVE: To explore the role of maternal physiology, mentality and prenatal health care on low birth weight (LBW). METHODS: A LBW-small for gestation age (SGA)-control group retrospective study was conducted based upon a population of infants born from November 2004 to June 2006. 896 cases involved in this study were entirely under voluntary participation and subject could withdraw their consent at any point. All subject recruitment and enrollment took place at Fujian Provincial Maternal and Children Hospital at the time of delivery. Using chi2 test for single factor analysis and logistic regression for multiple analyses. RESULTS: There were 15 out of 22 single factors having statistical significances, including 2 maternal psychological, 4 physiological, 6 pathological and 3 prenatal health care factors respectively. When multi-factorial stepwise regression analyses was performed, there were 9 factors for main relative factors of LBW, including women's height, number of prenatal examination, in-normal non-stress test, umbilical cord around the neck, retardation of the umbilical blood flow, week of gestation when the first examination was performed, premature rupture of membrane, preference on the sex of the infant, abnormal family history etc. were influencing the existence of LBW. Awareness on health information appeared to be a protective factor, suggesting that LBW could be prevented during the pregnant period. CONCLUSION: Multiple factors seemed to be contributing to the incidence of low birth weight.

[Epidemiological study on 38 418 syphilis cases during pregnancy].

OBJECTIVE: To explore the prevalence of syphilis and risk factors on pregnant women in Fujian province. METHODS: From July 1st, 2004 to June 30th, 2006, epidemiologic methods as questionnaires to fill in and rapid plasma reagent testing (RPR) were performed. Pregnant women with positive RPR test and then were confirmed by treponema pallidum test (TP). Intervention was provided to the pregnant women who were followed up to the postpartum periods. Results were compared during the peri-neonatal stage between syphilis-infected and non-infected women. Factors which were relative to syphilis infection were analyzed by simple and then further logistic regression analysis. RESULTS: There were 38 418 pregnant women under study, of whom 772 were confirmed including 60 who were still pregnant. The prevalence of syphilis during pregnancy was 1.85% (712/38 418), with mostly underlying syphilis which played an important role during the neonatal stage. Main risk factors to have been found as: women's occupation, cultural background, place of living, husband's occupation, family income, having sexually transmitted disease(STD) infection. The prognosis of peri-neonatal stage was worse if the mother was having blood RPR test positive. Mortality of peri-neonatal, preterm birth rate and low-birth weight rate were found also higher among mothers when RPR was positive (P < 0.01). CONCLUSION: The prevalence of syphilis in Fujian province was going up yearly. 8 factors including women's occupation, cultural background, place of living, received poor health education, having multiple sexual partners, husband's occupation, family income and having STD were main risk factors in the province, the mother's status of syphilis infection would strongly relate to the peri-neonatal stage of pregnancy.

[Study on interventional methods and the pattern of maternal-fetal transmission of syphilis during pregnancy].

OBJECTIVE: To explore the maternal-fetal transmission patterns and interventional methods of syphilis during pregnancy. METHODS: A total of 847 cases of syphilis in pregnancy confirmed by rapid plasma reagin test (RPR) and treponema pallidum hemoagglutination test (TPHA) were treated with procaine benzylpenicillin intramuscular injection, and with erythrocin oral medication if hypersensitive to benzylpenicillin. Eight hundred forty seven cases of syphilis during pregnancy were followed up for pregnancy outcomes. And their newborn babies were tested using the RPR. The newborns with positive results were given intervention and followed up until 24 months after birth. RESULTS: (1) A total of 733 cases among the total 847 have given birth to living-babies, in which 626 cases were tested using RPR, and the positive rate was 55.1% (345/626). (2) The RPR positive rate, neonatal mortality, preterm birth rate and low birth rate in the newborn of mothers with an RPR titer higher than or at 1:8 were higher than those of mothers with an RPR titer lower than 1:8 (P < 0.01). (3) The neonatal RPR positive rate was related to the timing of the treatment of the women. (1) The neonatal RPR positive rate was 22.4% (15/67) for treatment compared with 49.6% (330/666) for non-treatment before pregnancy (P < 0.01). (2) The positive RPR rate of neonates between treatment before pregnancy and treatment during pregnancy was different, being 22.4% (15/67) and 40.3% (240/595) respectively (P < 0.05) (3) In comparison between treatment both in the early pregnancy and in late pregnancy with only treatment in the late pregnancy, the positive RPR rate of neonates was 28.5% (45/158) and 56.9% (95/167) respectively (P < 0.01). In comparison between treatment both in the mid-term pregnancy and in late pregnancy and treatment in only one period in the terminal, the positive RPR rate of neonates was 37.0% (100/270) and 56.9% (95/167) respectively (P < 0.01). CONCLUSIONS: The maternal-fetal transmission rate and perinatal prognosis are related to maternal RPR titer and the timing of maternal treatment. Inborn syphilis can be prevented and cured in fetal time. For neonates with anti-syphilis treatment in protestation, RPR positive rate is significantly lower than that without treatment in protestation. Treatment prior to pregnancy is a powerful measure to prevent the maternal-fetal transmission of syphilis.

[An intervention study on preventing maternal-fetal transmission of syphilis during pregnancy].

OBJECTIVE: To study the prevalence and principal rules of women with syphilis during pregnancy and to develop relative methods to prevent maternal-fetal transmission. METHODS: A nested case control study on epidemiologic research was used based on review and preview methods on prevention and cure. Targeting pregnant women with syphilis diagnosed during premarital or pregnancy stages and were identified through rapid plasma reagin test (RPR) but confirmed by treponema pallidum test (TP),a total number of 339 women receiving treatment, intervention and being followed throughout the pregnant and neonatal periods. RESULTS: The prevalence of syphilis in pregnancy was 2.33%, and the positive rate in neonatal cord blood was closely associated with the opportunity of getting maternal treatment. The lowest RPR positive rate was among these women who got pregnant after receiving the treatment. The RPR positive rate of neonatal cord blood was positively relative to the mother's RPR titer. The higher was the mother's blood RPR titer, the worse the prenatal prognosis would turn to. CONCLUSION: Mother's blood RPR titer and the opportunity of getting treatment were strongly associated with the positive rate in neonatal cord blood. Pregnancy after receiving the treatment was a powerful measure to prevent the maternal-fetal transmission of syphilis.