[Blood eosinophils and clinical features of pneumoconiosis complicated with chronic obstructive pulmonary disease: A cross-sectional study].

Objective: To analyze the correlation between peripheral blood eosinophil (EOS) level and clinical characteristics of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) . Methods: From January 2007 to November 2020, newly diagnosed patients with pneumoconiosis complicated with COPD in Beijing Chaoyang Hospital, were retrospectively analyzed. These patients were stratified into EOS<100 cells/µl group and EOS≥100 cells/µl group, taking 100 cells/µl as the cut-off value. Demographic characteristics, clinical symptoms, lung function and laboratory indexes were compared between the two groups. Results: The median EOS count of patients with pneumoconiosis complicated with COPD was 100 (40, 180) cells/µl. 50.2% (160/319) had blood eosinophil counts ≥100 cells/µl, and 11.0% (35/319) had blood eosinophil counts ≥300 cells/µl. In comparison with EOS<100 cells/µl group, EOS≥100 cells/µl group were older (P=0.035), had higher body mass index (P=0.008), and had lower forced respiratory volume in the first second (P=0.017), had higher the ratio of residual volume to total lung volume (P=0.010), and had lower diffusing capacity of the lung for carbon monoxide (P=0.008). Arterial partial pressure of oxygen was significantly reduced in EOS≥100 cells/µl group (P=0.039). The peripheral blood EOS count was negatively correlated with forced vital capacity, forced breathing volume in the first second, carbon monoxide diffusion, peak expiratory flow, and maximum mid expiratory flow as a percentage of expected values (r(s)=-0.22, -0.18, -0.19, -0.19, -0.19, P=0.000, 0.001, 0.003, 0.008, 0.002), and positively correlated with the ratio of residual air volume to total lung volume (r(s)=0.17, P=0.002) . Conclusion: There was a correlation between blood EOS count and pulmonary function parameters, can proide reference for the diagnosis and treatment of chnoric obstuctive pulmmory disease in clinical practice.

[A systematic review of the epidemiology and clinical characteristics of artificial stone-related silicosis and dust protection].

Objective: To investigate the epidemiology, clinical characteristics, on-site dust monitoring and individual protection of the patients with artificial stone-related silicosis. Methods: In March 2022, the literature on artificial stone-related silicosis published from January 1965 to February 2022 was searched in China Journal Full-text Database, Wanfang Database, VIP Database, EMbase and PubMed. Chinese and English search terms include "silica dust""silica dust""silicosis""artificial stone""pneumoconiosis", etc. References were included according to inclusion and exclusion criteria, and data were extracted. The epidemiological characteristics, natural course of disease, workplace dust concentration and individual protection level of patients with artificial stone-related silicosis were analyzed by systematic review. Results: A total of 30 literatures were included, including 7 cohort studies, 14 cross-sectional studies, 3 case-control studies and 6 case reports. A total of 1358 patients with artificial stone-related silicosis were diagnosed from 1997 to 2020, with an average age of 41.5 years old and an average dust exposure time of 11.3 years. Among them, 36.2% (282/778) had progressive mass fibrosis or accelerated progressive silicosis at first diagnosis. Chest imaging showed diffuse small nodule shadow, pulmonary fibrosis, and silico-alveolar proteinosis. Pulmonary function showed restricted or mixed ventilation disorder with or without decreased diffusion volume. The disease progressed rapidly, with progressive mass fibrosis, respiratory failure, and even death. Patients engaged in artificial quartz stone processing, with high concentration of silica including ultra-fine particles, most of which were dry operation, lack of on-site ventilation measures and no effective personal protection. Conclusion: The artificial stone processing workers suffer from artificial stone-related silicosis due to dry cutting, lack of on-site dust removal facilities and personal protective measures, and the disease progresses rapidly, leading to poor prognosis.

[Effect of pirfenidone on paraquat-induced pulmonary fibrosis in rats].

Objective: To construct paraquat (PQ) poisoning rat model and to explore the effect of pirfenidone (PFD) on PQ-induced pulmonary fibrosis. Methods: In April 2017, male 6-8 week-old Wistar rats were selected, and PQ was administered intraperitoneally at one time. PFD was administered by gavage 2 hours after poisoning. The daily gavage doses were 100, 200 and 300 mg/kg, and the rats were divided into physiological saline group, PQ group, PQ+PFD 100 group, PQ+PFD 200 group, PQ+PFD 300 group, with 10 rats in each group at each observation time point. The pathological changes of lung tissue at different time points (the 1st, 3rd, 7th, 14th, 28th, 42nd and 56th days) after poisoning and the effect of PFD intervention with different dose on PQ-induced pulmonary fibrosis were observed. Pathological evaluation of lung tissue was performed by Ashcroft scale method. The PQ+PFD 200 group was selected to further explore the pathological changes of lung tissue, the contents of hydroxyproline and malondialdehyde in lung tissue were determined.And the tumor necrosis factor (TNF) -α, interleukin (IL) -6, transforming growth factor (TGF) -ß1, fibroblast growth factor (FGF) -B, platelet-derived growth factor (PDGF) -AB, insulin-like growth factor (IGF) -1 and PQ concentrations in serum and lung tissue were determined. Results: On the 1st to 7th day after PQ exposure, rats developed lung inflammation, which was aggravated on the 7th to 14th day, and pulmonary fibrosis appeared on the 14th to 56th day. Compared with PQ group, the Ashcroft scores of lung fibrosis in PQ+PFD 200 group and PQ+PDF 300 group decreased significantly in 7th and 28th day (P<0.05), while the Ashcroft score of lung fibrosis in PQ+PFD 100 group had no significant difference (P>0.05). After PQ exposure, the content of hydroxyproline in lung tissue increased gradually and reached the peak value on the 28th day. Compared with the PQ group, the contents of hydroxyproline in the PQ+PFD 200 group decreased at the 7th, 14th and 28th day, and the contents of malondialdehyde decreased at the 3rd and 7th day, the differences were statistically significant (P<0.05). The levels of TNF-α, IL-6 in rat serum and lung tissue reached the peak value on the 7th day after PQ exposure, and the levels of TGF-ß1, FGF-B and IGF-1 in rat serum and lung tissue reached the peak value on the 14th day after PQ exposure, and the level of PDGF-AB in rat serum and lung tissue reached the peak value on the 28th day after PQ exposure. Compared with PQ group, the level of serum IL-6 in PQ+PFD 200 group decreased significantly on the 7th day, and serum TGF-ß1, FGF-B, PDGF-AB and IGF-1 on the 14th and 28th day were decreased significantly (P<0.05). The levels of TNF-α, IL-6 in lung tissue of rats in PQ+PFD 200 group on the 7th day decreased significantly, and the levels of TGF-ß1, FGF-B and IGF-1 in lung tissue of rats on the 14th day were significantly decreased, and the level of PDGF-AB in lung tissue of rats on the 28th day were significantly decreased (P<0.05) . Conclusion: PFD partially alleviates the PQ-induced lung inflammation and fibrosis by inhibiting oxidative stress, reducing the levels of pro-inflammatory and pro-fibrotic cytokines in serum and lung tissue, but does not affect the concentrations of PQ in serum and lung tissue.

[Bibliometric and hot spot visualization analysis of pneumoconiosis and smoking].

Objective: To analyze the distribution and keywords of Chinese and English literature on pneumoconiosis and smoking, and to explore its characteristics and evolutionary laws. Methods: In November 2020, using PubMed, Web of Science, SinoMed, and CNKI as search databases, literature search was performed using Chinese and English search terms related to pneumoconiosis and smoking. The document management software Note Express 3.5.0 and the bibliometric analysis software VOS viewer 1.6.10 were used to analyze the publication year, number of publications, countries, research institutions and keywords. Results: In the English literature, there were 938 articles about pneumoconiosis and smoking related research, and the literature was first published in 1962. Among them, the United States published the largest number of articles (450 articles), and China published 29 articles, ranking fourth. There were a total of 601 research articles on pneumoconiosis and smoking in Chinese literature. The literature was first published in 1976. The institution that published the most articles was China Medical University (23 articles), followed by Lanzhou University (15 articles). Keyword co-occurrence analysis showed that domestic and foreign literatures were the main research hotspots on occupational exposure, carcinogenicity, risk factors, lung function, and DNA damage of pneumoconiosis and smoking. Conclusion: The research on pneumoconiosis and smoking focuses on carcinogenicity, risk factors, lung function, DNA damage mechanism, etc., providing research hotspots for the prevention and clinical treatment of related diseases.

[Prevalence and risk factors of silicosis complicated with chronic obstructive pulmonary disease].

Objective: To explore the prevalence, clinical characteristics and risk factors of chronic obstructive pulmonary disease (COPD) in silicosis patients. Methods: In May 2021, a cross-sectional study was used to retrospectively include 329 silicosis patients first diagnosed in Beijing Chaoyang Hospital from January 1, 2007 to December 31, 2020. The demographic data, occupational history, chest imaging, pulmonary function and blood routine indicators of silicosis patients with COPD were analyzed, and the risk factors of silicosis with COPD were analyzed by multiple logistic regression. Results: There were 128 patients with silicosis complicated with COPD, and the overall prevalence rate was 38.9% (128/329) . Among them, 73.4% (94/128) were male and 33.6% (43/128) were heavy smokers; 33.6% (43/128) of patients were classified as gold 1, 37.5% (48/128) as gold 2, 25.0% (32/128) as gold 3, and 3.9% (5/128) as gold 4. Diagnostic age (OR=1.04, 95%CI=1.02~1.06, P<0.001) , cumulative smoking (OR=1.03, 95%CI=1.01~1.05, P=0.008) and silicosis stage III (OR=7.06, 95% CI=4.00-12.46, P<0.001) were risk factors for silicosis complicated with COPD. Conclusion: Diagnostic age, cumulative smoking volume and third stage of silicosis are the risk factors of silicosis patients with different degrees of COPD, which should be paid attention to in clinical treatment.

[Correlation of serum lipids levels of Alzheimer's disease patients with sex, age and apolipoprotein E gene polymorphism].

Objective: To explore the correlation of serum lipids levels of Alzheimer's disease (AD) patients with sex, age and apolipoprotein E (Apo E) gene polymorphism. Methods: The retrospective study method was used, and 407 AD patients (142 males and 265 females, aged 52-91 years) were selected from Beijing Tiantan Hospital from January 2015 to August 2021 as the research target, and 894 healthy persons (339 males and 555 females, aged 52-94 years) who did body examination were selected as the control group. The AD patients were divided into four age groups according to the age interval of 10 years, including 85 aged 50-59 years, 163 aged 60-69 years, 119 aged 70-79 years, and 40 aged more than 80 years. The serum lipids levels were detected by biochemical analyzer, including triglycerides (TG), cholesterol (CHO), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoproteinA1(Apo A1) and apolipoprotein B (Apo B). ApoE gene polymorphism were detected by PCR fluorescent probe method. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the serum lipids levels in each group. Results: The levels of serum CHO and LDL-C were 3.30(1.41,4.82) mmol/L and 1.76(1.39,2.78) mmol/L in AD patients, and 4.84(4.24, 5.56) mmol/L and 2.91(2.36, 3.57) mmol/L in control group, and the levels of serum CHO and LDL-C of AD patients were significantly lower than control group (Z=-15.172,Z=-14.583, P<0.001, P<0.001). The levels of serum HDL-C and Apo B were 1.84(1.30, 3.88) mmol/L and 1.17(0.85, 1.57) g/L in AD patients, and 1.39(1.18, 1.64) mmol/L and 0.93(0.81, 1.09) g/L in control group, and the levels of serum HDL-C and Apo-B of AD patients were significantly higher than control group (Z=-12.249, Z=-9.706, P<0.001, P<0.001). There was no significant difference in TG and Apo A1 between 2 groups (Z=-1.577, Z=-0.408, P=0.115, P=0.683). The levels of TG, CHO, LDL-C in female AD patients were significantly higher than male patients (Z=-2.737, Z=-3.963, Z=-4.417, P=0.006, P<0.001, P<0.001). There were significant differences in TG, CHO, HDL-C, LDL-C, Apo A1 and Apo B among AD patients of all age groups (Z=11.263, Z=10.060, Z=40.246, Z=10.451, Z=24.315, Z=19.922, P=0.010, P=0.018, P<0.001, P=0.015, P<0.001, P<0.001). The serum CHO and LDL-C levels were positively correlated with age (rs=0.160, rs=0.174, P=0.001, P<0.001), and HDL-C, Apo A1 and Apo B levels were negatively correlated with age (rs=-0.312, rs=-0.272, rs=-0.146, P<0.001, P<0.001, P=0.003), and there was no correlation between TG level and age in AD patients (rs=0.086, P=0.082). There were 3 cases (3.33%) of E2, 43 cases of E3 (47.78%) and 44 cases of E4 (48.89%) in AD patients, and 22 cases (12.72%) of E2, 117 cases of E3 (67.63%) and 34 cases of E4 (19.65%) in control group. There was significant difference in Apo E genotype distribution between AD patients and control group (χ²=26.381, P<0.001). Apo E4 was the most common genotype in AD patients, and the proportion was 48.89%. Except for Apo A1(Z=7.821, P=0.020), there was no significant difference in TG, CHO, HDL-C, LDL-C and Apo B levels among all patients with different genotypes (Z=3.732, Z=1.677, Z=1.455, Z=1.619, Z=2.202, P=0.155, P=0.432, P=0.483, P=0.445, P=0.333). Conclusion: The levels of CHO and LDL-C decreased while the levels of HDL-C and Apo B increased in AD patients. The dyslipidemia in AD patients might be correlated with age, but not sex and Apo E genotypes.

[Current trends in research on occupational benzene poisoning: a bibliometric and visual analysis].

Objective: To analyze the research trends of benzene poisoning in recent years, to highlight the relevant research hotspots and prospects through bibliometrics. Methods: In August 2020, used "benzene" methylbenzere as key words, publications were retrieved from the PubMed, the Web of Science Core Collection database, SinoMed and CNKI before August 31, 2020. Describing the publication time, the number of the published research, publication countries, research institutions and journals. VOSviewer 1.6.10 were used to evaluate and co-occurrence analyze the keywords of the researches. Results: There were 510 English literatures about benzene poisoning. 43 countries had published relevant literatures. The United States had the largest number of articles (43.92%, 224/510) in this field, and China ranked second (11.57%, 59/510) . Relevant results had been published in 257 English journals. The most widely published journal was Environmental Health Perspectives (4.90%, 25/510) . There were 536 Chinese literatures. 368 research institutions had published relevant literatures. The first one was Shenzhen Occupational Disease Prevention and Control Hospital (3.36%, 18/536) , followed by the Chinese Center for Disease Control and Prevention (3.17%, 17/536) . A total of 170 journals had published relevant research results. The most frequently published journal is Chinese Journal of Industrial Hygiene and Occupational Diseases (12.13%, 65/536) . Key words co-occurrence analysis indicated that the domestic and foreign literatures paid more attention to occupational exposure, blood toxicity, myelosuppression, genetic polymorphism and so on. Conclusion: Domestic and foreign researches on benzene poisoning are mostly in China and the United States. In recent years, the research has gradually focused on the related mechanism of benzene poisoning, such as blood toxicity, carcinogenicity, genotoxicity and immunotoxicity.

[The levels and clinical significance of serum leptin and transforming growth factor beta1 in silicosis patients].

Objective: To investigate the levels and clinical significance of serum leptin and transforming growth beta 1 (TGF-ß1) in silicosis patients. Methods: A total of 52 patients with silicosis (already identified as occupational diseases) were enrolled in the Department of Respiratory and Critical Disease Medicine, the First Hospital of Shanxi Medical University from June 2018 to July 2019. These patients were regarded as silicosis group. They were divided into 25 patients with first stage silicosis, 22 patients with second stage silicosis and 5 patients with third stage silicosis. At the same time, 30 patients with no history of dust exposure in the same period of physical examination were selected as control group. Serum leptin and TGF-ß1 levels were measured by enzyme-linked immunosorbent assay in all investigators. At the same time, the comparison and correlation analysis between groups were carried out, and the diagnostic value was judged by receive operating characteristic (ROC) curve. Results: The serum levels of leptin and TGF-ß1 in silicosis patients were higher than those in the control group, the differences were statistically significant (P<0.05) . The serum levels of leptin in patients with second stage and third stage silicosis were higher than those in the control group and first stage, the differences were statistically significant (P<0.05) . Serum levels of TGF-ß1 in all stage silicosis patients were higher than those in the control group, and third stage silicosis was higher than first stage, the differences were statistically significant (P<0.05) . There was a positive correlation between serum levels of leptin and TGF-ß1 in silicosis group (r(s)=0.400, P<0.05) . The ROC area of leptin and TGF-ß1 combined to predict silicosis was 0.826, with the sensitivity and specificity were 73.10% and 80.00%. Conclusion: The levels of serum leptin and TGF-ß 1 are related to different stages of silicosis, and the combined detection of leptin and TGF-ß 1 can assist the diagnosis of silicosis.

[Outcome of vaginal birth after cesarean section in women with advanced maternal age].

Objective: To explore the perinatal outcome of vaginal birth after cesarean (VBAC) in women with advanced age. Methods: Totally 2 587 women delivered after one or two prior cesarean sections (gestational age≥28 weeks) in the First Affiliated Hospital of Kunming Medical University from July 2013 to February 2017. 909 trial of labor after cesarean(TOLAC) cases of singleton pregnancy with one prior cesarean section were studied retrospectively. According to the age, of the 909 TOLAC cases, 237 were the advanced age group, and 672 cases were the low age group. The maternal and neonatal outcomes between the two groups were compared. Results: The percentage of TOLAC in women with advanced age was 32.4% (237/731), and VBAC rate was 88.2% (209/237). The percentage of TOLAC in younger women was 36.2% (672/1 856), and VBAC rate was 82.4% (554/672). The difference of the TOLAC rate between the two groups was not significant (P>0.05), and the VBAC rate of the advanced age group was higher than the low age group (P<0.05). In the comparison of the two groups, the proportion of bachelor degree or above(55.7%,132/237), the prepregnancy BMI (22.4±3.0) kg/m(2), pregnant interval time (68.5±38.3) months, the proportion of gestational hypertension (8.4%,20/237), the proportion of gestational diabetes(34.6%,82/237) and the rate of the neonatal ICU admission (18.1%,43/237) in the advanced age group were higher than those of the low age group (P<0.05), respectively. And there were no significant differences in the rate of postpartum hemorrhage, the rate of postpartum hemorrhage≥1 500 ml, the rate of postpartum transfusion, puerperal morbidity, neonatal birth weight, neonatal 5 min Apgar score<7 score, umbilical artery blood pH<7.0, neonatal tracheal intubation and respiratory distress syndrome (all P>0.05). In all TOLAC cases, the rate of uterine rupture was 0.11%(1/909) and there was no maternal and neonatal death. Conclusion: VBAC is a safe and feasible way of delivery for singleton pregnancy after one prior cesarean section in women with advanced age.

[The outcome of trial of labor after cesarean section].

Objective: To explore the outcome of trial of labor after cesarean section(TOLAC). Methods: Totally 614 TOLAC were conducted in the First Affiliated Hospital of Kunming Medical University from July 2013 to June 2016. Among them, 586 cases of singleton pregnancy with one prior cesarean section(gestational age≥28 weeks)were studied retrospectively. The maternal and neonatal outcomes among the vaginal birth after cesarean(VBAC)group(481 cases), failed TOLAC group(105 cases)and the elective repeat cesarean section(ERCS)group(1 145 cases)were compared. Multiple logistic regression was used to determine the risk factors of admission to neonatal intensive care unit(NICU). Results: (1)The TOLAC rate was 29.62%(614/2 073)from July 2013 to June 2016, and the VBAC rate was 82.6%(507/614). The cesarean section rate was reduced by VBAC by 3.147%(507/16 112).(2)The comparison of adverse maternal outcomes: in the VBAC group, the postpartum hemorrhage volume was(431±299)ml, the rate of postpartum fever was 6.4%(31/481), the birth weight of the neonates was(3 085± 561)g, and the rate of large for gestational age was 2.9%(14/481). All were significantly lower than those in the failed TOLAC group and the ERCS group(P<0.05). There was no significant difference in other adverse maternal outcomes[the uterine rupture rate(0.2% ,1/481), the bladder injury rate(0), the proportion of postpartum hemorrhage volume≥1 500 ml(1.0%, 5/481), the blood transfusion rate(3.7%, 18/481)]and adverse perinatal outcomes[the rate of neonatal 5-minute Apgar score<7(0.4%, 21/481), the rate of umbilical arterial pH<7.0(0.6% , 3/481), the rate of the NICU admission and the perinatal mortality rate(12.3%, 59/481)]among the 3 groups(P>0.05). Multiple logistic regression showed no association between VBAC and admission to the NICU(OR=0.84, 95%CI: 0.58-1.21). The isolated risk factors for admission to the NICU were preterm birth(OR=16.71, 95% CI: 11.44-24.40), hypertensive disorder complicating pregnamcy(OR=3.89, 95% CI: 2.39-6.35), meconium stained amniotic fluid(OR=2.48, 95% CI: 1.62-3.80), small for gestational age(OR=2.00, 95% CI: 1.19-3.36)and diabetes mellitus(OR=1.69, 95% CI: 1.14-2.50). Conclusions: VBAC reduces cesarean section rate, with good outcomes in both mother and neonate. It is a safe and feasible way of labor in women with only one cesarean section history.

Applicability of first-trimester combined screening for fetal trisomy 21 in a resource-limited setting in mainland China.

OBJECTIVE: To assess the feasibility and performance of the first-trimester combined screening test for trisomy 21 in a resource-limited setting in mainland China. DESIGN: Prospective observational cohort study. SETTING: First Affiliated Hospital of Kunming Medical University, China. POPULATION: Ten thousand four hundred and forty-two pregnant women requesting first-trimester screening. METHODS: The combined screening test was performed from May 2012 to December 2014. Women with a high-risk result (≥1:600) were offered further confirmatory tests after counselling. The threshold for high risk was determined by Monte Carlo simulation to achieve a 5% false-positive rate according to the local age distribution. Pregnancy outcome and screening results were recorded for all women and monthly audits were conducted. MAIN OUTCOME MEASURES: Sensitivity, screen positive rate, cost per case of Down syndrome detected. RESULTS: Six hundred and ten women (5.8% of the total screened) had a high-risk screening test, of whom 274 (44.9%) underwent a diagnostic test and 169 (27.7%) opted for a noninvasive prenatal screening test (NIPT); 160 (26.2%) declined further testing after counselling. The pregnancy outcome was available for 10 174 (97.4%) of the women. The observed incidence of Down syndrome was 0.13% (1/750). All 14 women with a trisomy 21 pregnancy had a high-risk screening test result. The cost per Down syndrome detected was RMB596 686 compared with RMB1.79 million if all had been screened by NIPT. CONCLUSIONS: The combined screening test appears to be a more cost-effective strategy in mainland China. Screening performance in China would be improved by adopting Chinese-specific models, external quality control and assurance, and establishing risk thresholds appropriate for the age distribution of the population. TWEETABLE ABSTRACT: Combined first-trimester Downs screening in China was improved by adopting Chinese-specific models and external QC.

[Lack of progesterone receptor expression predicts poor prognosis in patients with operable ER-positive invasive breast cancer].

OBJECTIVE: To investigate the impact of lack of progesterone receptor (PR) expression on the prognosis of patients with operable ER (estrogen receptor)-positive invasive breast cancer. METHODS: We retrospectively analyzed the clinicopathological features, treatment and survival data of 318 women with ER+ /PR+ and ER+ /PR- invasive breast cancer. RESULTS: Among the 318 patients, there were 219 PR-positive and 99 PR-negative cases. The 5-year overall survival (OS) rate was 92.5%, and the 5-year disease-free survival (DFS) rate was 87.2% in the 318 ER-positive patients. Among them, the 5-year OS rates were significantly different between the PR-positive group (94.6%) and PR-negative group (87.8%, P=0.020), and the 5-year DFS rates were also significantly different from each other (89.8% and 81.6%, respectively, P=0.019). Univariate analysis showed that PR status, tumor size, T stage, axillary lymph node metastasis, and clinical stage were prognostic factors for OS (P<0.05 for all). Multivariate analysis showed that lack of PR expression, T stage ≥2, and positive axillary lymph node metastasis were independent risk factors for poor DFS and OS in ER-positive breast cancer patients (P<0.05 for all). Subgroup analysis showed that lack of PR expression was not significant in predicting poor DFS or OS when patients were in stage Ⅰ or with a small tumor (≤2 cm) (P>0.05 for all), and also showed that premenopausal women with PR-negative disease had poorer DFS and OS than PR-positive patients (P<0.05 for both). CONCLUSIONS: Lack of PR expression is an independent risk factor for poor prognosis in patients with operable ER-positive invasive breast cancer, especially in patients with a large tumor (>2 cm), advanced clinical stage (Stage Ⅱ or Ⅲ) or in premenopausal status.

[Growth patterns of appropriate for gestational age infants of gestational diabetic mothers during the first year].

OBJECTIVE: To explore the growth pattern of appropriate for gestational age (AGA) infants of mother with gestational diabetes mellitus (GDM). METHODS: The objects of this study were offspring of women who delivered in our hospital from January to December 2011. The GDM group included 70 AGA infants (36 male cases and 34 female cases) of mother with GDM. The control group included 154 AGA infants (66 male cases and 88 female cases) of women with normal glucose tolerance. The data of demographic characteristics of mothers of two groups were collected. Body weight and length of infants in two groups were measured at 3, 6 and 12 months age respectively. Body mass index (BMI), weight and height gain during infancy (0-3 months, 3-6 months and 6-12 months) of infants in two groups were also calculated. RESULTS: Body weight, length and BMI of male AGA infants in GDM group were less than that of control group at 3 months and 6 months age, but more than that of control group at 12 months age, however, there were no significant differences between two group(P>0.05). The weight and height gain during infancy (0-3 months, 3-6 months) of male AGA infants in GDM group were lower than that of control group, but the difference was statistically significant only at 3-6 months[(1.1±0.4) vs (1.4±0.4) kg, P=0.040; (4.9±2.3) vs (6.3±1.2) cm, P=0.026]. The weight and height gain during infancy (6-12 months) of male AGA infants of gestational diabetic mothers were higher than that of control group, but the difference was not statistically significant[(2.1±0.5) vs (1.8±0.5) kg, P=0.361; (8.4±1.3) vs (7.8±1.4) cm, P=0.464]. CONCLUSION: Male infants of gestational diabetic mothers grew slowly during their infancy of 0-6 months, and then their growth became increasingly fast, which suggested that the influence of intrauterine hyperglycemia environment of GDM mothers on fetal growth might continue after birth.

Maternal gestational diabetes mellitus and overweight and obesity in offspring: a study in Chinese children.

The purpose of this study was to investigate the effects of maternal gestational diabetes mellitus (GDM) and breast feeding on childhood overweight and obesity in a mainland Chinese population. The incidence of and factors associated with overweight and obesity were compared between children of mothers with (n=1068) and without (n=1756) GDM. The independent roles of the associated factors were examined by multiple logistic regression analysis. The incidence of overweight was higher (16.6 v. 12.6%, P=0.002) in the GDM group, but that of obesity was not different (10.7 v. 12.0%, P=0.315). At age 1-2 and 2-5 years, no difference in overweight (11.0 v. 12.0%, P=0.917, and 15.7 v. 14.6%, P=0.693, respectively) was found, while obesity (8.0 v. 13.6%, P=0.019, and 8.4 v. 13.4%, P=0.014, respectively) was less frequent in the GDM offspring. At age 5-10 years, increased overweight (22.2 v. 12.1%, P<0.001) and obesity (15.9 v. 9.0%, P=0.001) were found in the GDM group, which was associated with maternal obesity, being born large-for-gestational age, male gender and formula feeding. After adjusting for confounding factors, GDM remained an independent determinant of offspring overweight and obesity (aOR 2.28, 95% CI 1.61-3.22), suggesting that the effects of GDM were independent of breast feeding, as well as of maternal obesity and birth size.

Early third trimester maternal response to glucose challenge and pregnancy outcome in Chinese women-relationship between upper distribution level and recommended diagnostic criteria.

BACKGROUND/OBJECTIVES: The objective of this study was to examine the relationship between upper distribution levels of glucose values in the 75-g oral glucose tolerance test (OGTT) and recommended diagnostic criteria for gestational diabetes mellitus (GDM) and adverse pregnancy outcomes. SUBJECTS/METHODS: The distribution of the OGTT 2-h values of 13,501 pregnant women, which were below the World Health Organization (WHO) threshold for overt diabetes mellitus (DM), and managed in one teaching hospital in China, was reviewed and related to maternal characteristics and pregnancy outcomes. RESULTS: For the entire group, the 90th and 95th percentile values of the OGTT 2-h glucose level, respectively, were close to the diagnostic cutoff values of the WHO and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. For adverse maternal outcomes, glucose level above the 90th percentile value was associated with increased hypertensive disorders, whereas no difference was seen with cutoff using the 95th percentile value. For perinatal outcomes, the 90th percentile was associated with increased neonatal intensive care unit admission and hypoglycemia, whereas the 95th percentile showed in addition association with phototherapy for jaundice and 5th-minute Apgar score <7. Although no differences in the incidence of adverse pregnancy outcomes were found using the different cutoffs, the >95th percentile cutoff value would have missed out 33.3-56.7% of the cases of adverse outcomes that would otherwise have been attributed to GDM. CONCLUSIONS: Further studies are warranted to clarify which diagnostic criterion is most appropriate universally to identify adverse pregnancy outcomes attributed to GDM, and which could be mitigated with treatment specific for GDM.

Investigation on maternal physiological and psychological factors of cheilopalatognathus.

OBJECTIVE: Case-control study on mothers of cheilopalatognathus children was conducted, to investigate the maternal physiological and psychological factors for occurrence of cheilopalatognathus. MATERIALS AND METHODS: One hundred ten mothers of cheilopalatognathus children who were scheduled for one-stage surgery were selected as a research group, and 110 mothers of normal children served as a normal control group at the same time. Trait Anxiety Inventory (T-AI), Life Events Scale (LES), Trait Coping Style Questionnaire (TCSQ), Type C Behavior Scale (CBS), adult Eysenck Personality Questionnaire (EPQ), and homemade general questionnaire survey were employed for the investigation. RESULTS: Compared with the control group, the scores for negative event tension value, anxiety, and depressive factors were higher in the study group (p < 0.05); while the scores for positive event tension value, intellect, optimism, and social support factors were lower (p < 0.05). Regression analysis found that physiological factors included were five: education, changes in body weight during pregnancy, the intake amount of milk and beans, and intake of healthcare products, and supplementary folic acid taken or not, while the psychological factors included were four: positive event stimulation, negative event stimulation, the amount of social support, as well as introvert and extrovert personalities. CONCLUSION: The study results suggest that pregnant women's physiological and psychological factors can cause changes in cheilopalatognathus incidence, which is expected to be guidance for healthcare during pregnancy, to prevent the occurrence of cheilopalatognathus.

Ultralow-power complementary metal-oxide-semiconductor inverters constructed on Schottky barrier modified nanowire metal-oxide-semiconductor field-effect-transistors.

We show that the threshold voltages of both n- and p-channel metal-oxide-semiconductor field-effect-transistors (MOSFETs) can be lowered to close to zero by adding extra Schottky contacts on top of nanowires (NWs). Novel complementary metal-oxide-semiconductor (CMOS) inverters are constructed on these Schottky barrier modified n- and p-channel NW MOSFETs. Based on the high performances of the modified n- and p-channel MOSFETs, especially the low threshold voltages, the as-fabricated CMOS inverters have low operating voltage, high voltage gain, and ultra-low static power dissipation.

Effects of sleep deprivation on human postural control, subjective fatigue assessment and psychomotor performance.

This study aimed to investigate the effects of sleep deprivation on postural control, subjective fatigue assessment and psychomotor performance, and to assess the efficiency of an objective posturographic test as an indicator of mental fatigue. Postural sway using static posturography (Romberg's test), subjective fatigue assessment (Stanford Sleepiness Scale) and psychomotor performance (Sternberg dual-task test) were assessed in 12 subjects before and after 24 h of sustained wakefulness. After sustained wakefulness, the Romberg test parameters of circumference area and rectangle area with the eyes-closed, and standard deviation in the anterior-posterior direction with the eyes-open were significantly higher compared with baseline values (before sustained wakefulness). Subjective fatigue assessment scores were also significantly increased, while psychomotor performance was unchanged. Sleep deprivation can arouse a feeling of fatigue and can affect postural stability, hence an objective posturographic test score may be useful as an indicator of mental fatigue.

Schottky junction photovoltaic devices based on CdS single nanobelts.

Schottky junction photovoltaic (PV) devices were fabricated on single CdS nanobelts (NBs). Au was used as the Schottky contact, and In/Au was used as the ohmic contact to CdS NB. Typically, the Schottky junction exhibits a well-defined rectifying behavior in the dark with a rectification ratio greater than 10(3) at +/- 0.3 V; and the PV device exhibits a clear PV behavior with an open circuit photovoltage of about 0.16 V, a short circuit current of about 23.8 pA, a maximum output power of about 1.6 pW, and a fill factor of 42%. Moreover, the output power can be multiplied by connecting two or more of the Schottky junction PV devices, made on a single CdS NB, in parallel or in series. This study demonstrates that the 1D Schottky junction PV devices, which have the merits of low cost, easy fabrication and material universality, can be an important candidate for power sources in nano-optoelectronic systems.

Maternal mean arterial pressure and oral glucose tolerance test results. Relationship in normotensive women.

OBJECTIVE: To examine the relationship between oral glucose tolerance test (OGTT) results and maternal mean arterial pressure (MAP) throughout pregnancy in normotensive women. STUDY DESIGN: A retrospective study was performed on 84 pregnant women with normal and abnormal antenatal OGTT results who delivered in a 12-month period to determine the changes in MAP and its relationships with the OGTT values. RESULTS: MAP was increased from 28 weeks until delivery in gestational diabetics (n = 50) as compared with controls (n = 34). The OGTT fasting glucose value significantly correlated with MAP at 32 and 36 weeks, while the 2-hour glucose value correlated with MAP at 24 weeks and from 32 weeks until predelivery. Only the 2-hour glucose values from 32 weeks until delivery correlated with MAP when body mass index was controlled for. CONCLUSION: Progressive glucose intolerance is associated with an upward shift in blood pressure in the third trimester of pregnancy in normotensive women. Blood pressure changes below the diagnostic threshold for hypertensive disorders of pregnancy may help to identify women at increased risk of gestational diabetes mellitus.