Meconium-Stained Amniotic Fluid: Impact on Prognosis of Neonatal Bacterial Meningitis.

OBJECTIVES: Clinical data with respect to the impact of meconium on the prognosis of neonatal bacterial meningitis are scarce. Therefore, in this study, we aimed to determine whether meconium-stained amniotic fluid (MSAF) represents a risk factor for poor prognosis of neonatal bacterial meningitis in a confirmed case population. METHODS: This was a retrospective cohort study of 256 neonates diagnosed with bacterial meningitis hospitalized at one of three hospitals in Shantou, China, between October 2013 and September 2018. Clinical manifestation, laboratory test results and treatment were compared between the two groups, with outcomes dichotomized into 'good' or 'poor' prognosis. Multivariate analysis and follow-up logistic regression analysis were used to identify predictive factors of a poor outcome. RESULTS: Of the 256 neonates with BM, 95 (37.1%) had a good prognosis at discharge and 161 (62.9%) had a poor prognosis. In the poor prognosis group, 131/161 (79.4%) neonates had a permanent neurological sequelae and 19 (11.8%) had ≥2 sequelae. Of note, 11 neonates died. The rate of poor prognosis of BM was significantly higher among neonates with than without MSAF (26.1% vs. 12.6%, respectively; p < 0.05). A logistic multivariate analysis to evaluate the prognostic effect of MSAF to BM showed that neonatal with MSAF is more likely to have a worse prognosis of BM [unadjusted odds ratio (OR), 2.44, 95% confidence interval (CI), 1.24-5.10; adjusted OR, 2.31; 95% CI, 1.09-5.17]. CONCLUSION: MSAF is significantly associated with poor prognosis of neonatal bacterial meningitis. Therefore, in case of MSAF, more attention should be paid to neonatal bacterial meningitis.

Genetic polymorphisms in pri-let-7a-2 are associated with ischemic stroke risk in a Chinese Han population from Liaoning, China: a case-control study.

Ischemic stroke is a complicated disease, and its pathogenesis has been attributed to the occurrence of genetic polymorphisms. Evidence has suggested that the microRNA let-7a is involved in the pathogenesis of ischemic stroke. Pri-miRNA is the primary transcript, which undergoes several processing steps to generate pre-miRNA and, later, mature miRNAs. In this case-control study, we analyzed the distribution of pri-let-7a-2 variants in patients at a high risk for ischemic stroke and the interactions of pri-let-7a-2 variants and environmental factors. Blood samples and clinical information were collected from 1086 patients with ischemic stroke and 836 healthy controls between December 2013 and December 2015 at the First Affiliated Hospital of China Medical University. We found that the rs1143770 CC genotype and the C allele were associated with a decreased risk of ischemic stroke, whereas the rs629367 CC genotype was associated with an increased risk for ischemic stroke. Moreover, these two single-nucleotide polymorphisms were in linkage disequilibrium in this study sample. We analyzed gene-environment interactions and found that rs1143770 exerted a combined effect on the pathogenesis of ischemic stroke, together with alcohol use, smoking, and a history of hypertension. Therefore, the detection of pri-let-7a-2 polymorphisms may increase the awareness of ischemic stroke risk. This study was approved by the Institutional Ethics Committee of the First Affiliated Hospital of China Medical University, China (approval No. 2012-38-1) on February 20, 2012, and was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR-COC-17013559) on December 27, 2017.

Association between PPARG genetic polymorphisms and ischemic stroke risk in a northern Chinese Han population: a case-control study.

Two common polymorphisms of the peroxisome proliferator-activated receptor gamma (PPARG) gene, rs1801282 and rs3856806, may be important candidate gene loci affecting the susceptibility to ischemic stroke. This case-control study sought to identify the relationship between these two single-nucleotide polymorphisms and ischemic stroke risk in a northern Chinese Han population. A total of 910 ischemic stroke participants were recruited from the First Hospital of China Medical University, Shenyang, China as a case group, of whom 895 completed the study. The 883 healthy controls were recruited from the Health Check Center of the First Hospital of China Medical University, Shenyang, China. All participants or family members provided informed consent. The study protocol was approved by the Ethics Committee of the First Hospital of China Medical University, China on February 20, 2012 (approval No. 2012-38-1). The protocol was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR-COC-17013559). Plasma genomic DNA was extracted from all participants and analyzed for rs1801282 and rs3856806 single nucleotide polymorphisms using a SNaPshot Multiplex sequencing assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression to estimate the association between ischemic stroke and a particular genotype. Results demonstrated that the G allele frequency of the PPARG gene rs1801282 locus was significantly higher in the case group than in the control group (P < 0.001). Individuals carrying the G allele had a 1.844 fold increased risk of ischemic stroke (OR = 1.844, 95% CI: 1.286-2.645, P < 0.001). Individuals carrying the rs3856806 T allele had a 1.366 fold increased risk of ischemic stroke (OR = 1.366, 95% CI: 1.077-1.733, P = 0.010). The distribution frequencies of the PPARG gene haplotypes rs1801282-rs3856806 in the control and case groups were determined. The frequency of distribution in the G-T haplotype case group was significantly higher than that in the control group. The risk of ischemic stroke increased to 2.953 times in individuals carrying the G-T haplotype (OR = 2.953, 95% CI: 2.082-4.190, P < 0.001). The rs1801282 G allele and rs3856806 T allele had a multiplicative interaction (OR = 3.404, 95% CI: 1.631-7.102, P < 0.001) and additive interaction (RERI = 41.705, 95% CI: 14.586-68.824, AP = 0.860; 95% CI: 0.779-0.940; S = 8.170, 95% CI: 3.772-17.697) on ischemic stroke risk, showing a synergistic effect. Of all ischemic stroke cases, 86% were attributed to the interaction of the G allele of rs1801282 and the T allele of rs3856806. The effect of the PPARG rs1801282 G allele on ischemic stroke risk was enhanced in the presence of the rs3856806 T allele (OR = 8.001 vs. 1.844). The effect of the rs3856806 T allele on ischemic stroke risk was also enhanced in the presence of the rs1801282 G allele (OR = 2.546 vs. 1.366). Our results confirmed that the G allele of the PPARG gene rs1801282 locus and the T allele of the rs3856806 locus may be independent risk factors for ischemic stroke in the Han population of northern China, with a synergistic effect between the two alleles.

Association of PLA2G7 gene polymorphisms with ischemic stroke in northern Chinese Han population.

OBJECTIVE: Human lipoprotein-associated phospholipase A2 (Lp-PLA2), encoded by the PLA2G7 gene, plays an important role in the pathophysiology of inflammation. This study is aimed at evaluating the potential association of V279F and A379V in PLA2G7 gene with ischemic stroke where inflammatory process is involved. DESIGN AND METHODS: A total of 386 patients with ischemic stroke and 386 healthy controls were included in the study. The single nucleotide polymorphisms, V279F and A379V, were analyzed by the polymerase chain reaction-ligation detection reaction method. RESULTS: The frequencies of VV+AV genotype, AV genotype and V allele of A379V in the patients with ischemic stroke were significantly higher than those in the controls (P=0.02, P=0.03, P=0.02, respectively). These correlations still remained after adjusting for confounding risk factors of stroke. Furthermore, subgroup analysis showed that a significant association with A379V was found in large-artery atherosclerotic stroke subgroup. In addition, no significant association was observed between V279F and ischemic stroke. CONCLUSION: The study indicated that the A379V variant in PLA2G7 gene might contribute to ischemic stroke susceptibility in northern Chinese Han population.

[Data analysis of the objective observation parameters of benign prostatic hyperplasia patients accepting different treatment regimens].

OBJECTIVE: To observe different objective observation parameters of the benign prostatic hyperplasia (BPH) patients accepting different treatment strategies, and to further analyze the relationship of these factors with the treatment option. METHODS: Three hundred and twenty-nine BPH patients, aged 50-80, were assigned into 3 groups jointly decided by the physicians and patients based on the individual conditions and the patients' willingness: watchful waiting group (n=61), aged (63 +/- 8), drug treatment group (n=179), aged (68 +/- 7), and operation group (n=89), aged (71 +/- 6). The data of prostate volume, prostate specific antigen (PSA), maximum flow rate (Qmax), average flow rate, urinating volume, and residual urine volume before treatment were recorded. RESULTS: The prostate volume of the watchful waiting group was 33.0 ml, significantly smaller then those of the drug treatment and operation groups (40.1 and 65.5 ml respectively, both P < 0.01); the Qmax of the watchful waiting group was 17.1 ml/s, significantly higher than those of the drug treatment and operation groups (12.4 and 9.1 ml/s respectively, both P < 0.01), and the urinating volume of the watchful waiting group was 332 ml, significantly more than those of the drug treatment and operation groups (247 and 188 ml respectively, both P < 0.01). The serum PSA of the operation group was 5.44 ng/ml, significantly higher than those of the watchful waiting and drug treatment groups (1.53 and 1.99 ng/ml respectively, both P < 0.01); and the residual urine volume of the operation group was 208 ml, significantly higher than those of the watchful waiting and drug treatment groups (21 and 45 ml respectively, both P < 0.01). There were no significant differences in the serum PSA and residual urine volume between the drug treatment and watchful waiting groups. CONCLUSIONS: Prostate volume, PSA, Qmax, average flow rate, urinating volume, and residual urine volume are important influential factors influencing the treatment option of BPH. Data analysis of the objective observation parameters will be helpful in clinical decision making.

[Tadalafil for erectile dysfunction: outstanding efficacy for 36 hours].

Phosphodiesterase type 5 (PDE5) inhibitors are first-line oral medication for erectile dysfunction (ED). Compared with the other two PDE inhibitors (sildenafil and vardenafil), tadalafil is characterized by rapid onset, convenient dosing, excellent efficacy, especially the 36-hour duration of effectiveness deriving from long elimination half-life, allowing for more flexibility to scheduled medication. Higher satisfaction of patients and their partners with tadalafil is mainly due to such psychosocial benefits as decreased time concerns. Tadalafil is well-tolerated, consistent with the principle of safely, effectiveness and convenient dosing and is becoming the favorite choice of ED patients and their partners.

[Advances in the studies on the safety of tadalafil in treating erectile dysfunction].

Erectile dysfunction(ED) is a common ailment in middle-aged and old men. Since tadalafil was introduced into the treatment of ED in October, 2002, more and more ED patients have chosen tadalafil due to its efficacy and safety. The action mechanism, pharmacokinetics, efficacy and safety of tadalafil have been reported in many basic and clinical research documents. This review is to address the safety of tadalafil in treating ED, and provide further guidance for clinicians' choice and safer use of the drug.

[Homologous dermal acellular matrix graft for urethral reconstruction in man (report of 16 cases)].

OBJECTIVE: To investigated the value of homologous dermal acellular matrix graft (AMG) for urethral reconstruction in man, and found an ideal replacement material to simplify the urethroplastic surgery. METHODS: 16 male patients, aged 18-46 (mean 26.5), with urethral diseases were treated with allograft of tissue engineering material AMG. The causes of urethroplasty were complex urethral stricture followed by pelvic fracture (13 cases), anterior urethral stricture (2 cases), hypospadia (1 case). During the operation, AMG was sutured to a tubular graft and replaced the defect urethra. A 18-22 Fr silicone catheter was inserted in the reconstructed urethra for 4-6 weeks. RESULTS: All 16 patients were voiding well after removing the catheter, urethrography reveal excellent caliber of the reconstructed urethra. Urethroscopic examination showed the graft urethra was covered by epithelial tissue and grew into the native tissue. But stenosis was developed in 3 patients postoperatively, 1 patients received transurethral incision, another 2 needed urethral sounding. The patients were followed-up for 12-72 months (mean 45.6), no rejection was observed, all patients voided normally except 4 cases needed urethral dilatation periodically. CONCLUSION: The homologous dermal acellular matrix graft may serve as an ideal replacement material for complex urethral stricture or defect, without concern of rejection.