Attach great importance to the significance of serum anti-müllerian hormone and androgen in the evaluation of polycystic ovary syndrome / 中华预防医学杂志

Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of childbearing age, which seriously affects women's reproductive health. In recent years, more and more studies have found that serum anti-Müllerian hormone (AMH) has certain significance in the diagnosis and treatment evaluation of PCOS. In addition, with the improvement of detection methods, more attention has been paid to the significance of female androgens and AMH in the evaluation of PCOS. This article reviews the recent research progress of serum AMH and androgens in the evaluation of PCOS.

Effects of Transcutaneous Electrical Acupoint Stimulation on Ovarian Responses and Pregnancy Outcomes in Patients Undergoing IVF-ET: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the influence of different transcutaneous electrical acupoint stimulation (TEAS) modes on ovarian responses and pregnancy outcomes in patients with infertility undergoing in vitro fertilization and embryo transfer (IVF-ET).@*METHODS@#Two hundred infertility patients undergoing IVF-ET were divided randomly into experimental groups (TEAS groups: E-I, E-II, E-III, and E-IV, 40 cases each group) and a control group (mock TEAS group, 40 patients) using the random number method. The patients in the experimental groups received TEAS treatment of 20, 30, 40 and 50 mA for the E-I, E-II, E-III and E-IV groups, respectively. The control group received a treatment of 5 mA. TEAS was applied at acupoints of Guanyuan (RN 4), Zhongji (RN 3), Sanyinjiao (SP 6), Zigong (EX-CA 1), and Taixi (KI 13), once a day for 30 min each time for a treatment period of 10-13 d. Treatment effect was assessed using the following indicators: endometrial thickness on the 6th day of gonadotropin treatment (GN6 day), endometrial thickness on the day on chorionic gonadotropin administration (HCG day), number of ovarian follicles on HCG day, number of ova captured, amount of estrogen required for each harvested ova, number of mature ova divided by the total number of ova, percentage of high-quality embryos, and clinical pregnancy.@*RESULTS@#Endometrial thickness in the experimental groups on the HCG day was significantly better than that of the control group after TEAS stimulation (P=0.01). TEAS exhibited a greater impact on the number of ova captured (P=0.003). However, the effect of TEAS stimulation on the high-quality embryo rate and clinical pregnancy in patients was not statistically significant (P>0.05).@*CONCLUSIONS@#TEAS is an effective method in improving the ovarian state. When the stimulus intensity was at 40 mA and above, it could be helpful to improve the patient's endometrial condition and endometrial receptivity and to retrieve more oocytes. (Trial registration No. ChiCTR-TRC-11001780).

Perinatal complications and live-birth outcomes following assisted reproductive technology: a retrospective cohort study / 中华医学杂志(英文版)

BACKGROUND@#With the development of assisted reproductive technology (ART) and its increasing success rate in the mainland of China, more attention has been paid to the safety of ART. In this study, we explored the associations between conception by ART and pregnancy/perinatal complications, and neonatal outcomes compared with similar outcomes following spontaneous conception.@*METHODS@#This retrospective cohort study of pregnancies over a 3-year period (2013-2015) was performed at Beijing Obstetrics and Gynecology Hospital, Beijing, China. Subjects were divided into two groups: conception by ART (n = 2256) or spontaneous conception (n = 6768). According to different fertilization modes, the ART group was divided into in vitro fertilization (IVF, n = 1873) and intracytoplasmic sperm injection (ICSI, n = 383) subgroups. The ART group was also divided into two different embryo transfer methods; fresh embryo transfer (ET, n = 1583) and frozen embryo transfer (FET, n = 673) subgroups. Pregnancy complications, perinatal complications, and neonatal outcomes of the enrolled subjects were investigated and analyzed by univariate analysis and multivariate logistic regression.@*RESULTS@#After adjustment for maternal age, gravidity, parity, maternal education, smoking, alcohol consumption, and body mass index (BMI), pregnancies conceived by ART were associated with a significantly increased incidence of gestational diabetes mellitus (GDM; OR 1.88, 95% CI 1.56-2.27), gestational hypertension (OR 2.18, 95% CI 1.83-2.60), and intrahepatic cholestasis of pregnancy (ICP) (OR 2.79, 95% CI 2.15-3.64), compared with spontaneous conception. These associations were similar for the singleton group. In the twin group, only the incidence of ICP was significantly higher than in controls. We found that pregnancies conceived by ART were associated with perinatal complications, including placental abruption (OR 2.14, 95% CI 1.33-3.45), premature rupture of membranes (PROM; OR 1.24, 95% CI 1.06-1.45), postpartum hemorrhage (OR 2.89, 95% CI 2.33-3.59) and polyhydramnios (OR 2.01, 95% CI 1.29-3.16). The singleton group had a similar result with placental abruption, but not with fetal membranes ruptures before labor and polyhydramnios. There were no significant differences in the incidence of these perinatal complications in the twin group. Some neonatal outcomes, including preterm labor (OR 4.29, 95% CI 3.84-4.80) and low birth weight (OR 1.72, 95% CI 1.42-2.08), were more likely to occur with singleton births after ART. However, there were no significant differences for these outcomes from twin pregnancies. Perinatal complications and neonatal outcomes were consistent between the IVF and ICSI subgroups. The FET and ET subgroups showed a similar increase in complications, except for the incidence of placental abruption. After taking into account the effects of parity, birth plurality and maternal age, the ART group still exhibited increased maternal and neonatal complications, although some differences narrowed or disappeared.@*CONCLUSIONS@#This retrospective cohort study demonstrated that patients who underwent ART were at increased risk of several adverse pregnancy outcomes compared with women who conceived spontaneously. These complications may be attributed in part to the relatively high multiple pregnancy rate after ART. Elective single embryo transfer should be promoted in China to reduce the obstetrical risks of ART pregnancy. Singletons of ART pregnancy exhibited increased maternal and neonatal complications as well, suggesting that underlying infertility or other maternal or parental factors may contribute to the adverse outcomes.

Perinatal complications and live-birth outcomes following assisted reproductive technology: a retrospective cohort study / 中华医学杂志(英文版)

Background@#With the development of assisted reproductive technology (ART) and its increasing success rate in the mainland of China, more attention has been paid to the safety of ART. In this study, we explored the associations between conception by ART and pregnancy/perinatal complications, and neonatal outcomes compared with similar outcomes following spontaneous conception.@*Methods@#This retrospective cohort study of pregnancies over a 3-year period (2013-2015) was performed at Beijing Obstetrics and Gynecology Hospital, Beijing, China. Subjects were divided into two groups: conception by ART (n = 2256) or spontaneous conception (n = 6768). According to different fertilization modes, the ART group was divided into in vitro fertilization (IVF, n = 1873) and intracytoplasmic sperm injection (ICSI, n = 383) subgroups. The ART group was also divided into two different embryo transfer methods; fresh embryo transfer (ET, n = 1583) and frozen embryo transfer (FET, n = 673) subgroups. Pregnancy complications, perinatal complications, and neonatal outcomes of the enrolled subjects were investigated and analyzed by univariate analysis and multivariate logistic regression.@*Results@#After adjustment for maternal age, gravidity, parity, maternal education, smoking, alcohol consumption, and body mass index (BMI), pregnancies conceived by ART were associated with a significantly increased incidence of gestational diabetes mellitus (GDM; OR 1.88, 95% CI 1.56-2.27), gestational hypertension (OR 2.18, 95% CI 1.83-2.60), and intrahepatic cholestasis of pregnancy (ICP) (OR 2.79, 95% CI 2.15-3.64), compared with spontaneous conception. These associations were similar for the singleton group. In the twin group, only the incidence of ICP was significantly higher than in controls. We found that pregnancies conceived by ART were associated with perinatal complications, including placental abruption (OR 2.14, 95% CI 1.33-3.45), premature rupture of membranes (PROM; OR 1.24, 95% CI 1.06-1.45), postpartum hemorrhage (OR 2.89, 95% CI 2.33-3.59) and polyhydramnios (OR 2.01, 95% CI 1.29-3.16). The singleton group had a similar result with placental abruption, but not with fetal membranes ruptures before labor and polyhydramnios. There were no significant differences in the incidence of these perinatal complications in the twin group. Some neonatal outcomes, including preterm labor (OR 4.29, 95% CI 3.84-4.80) and low birth weight (OR 1.72, 95% CI 1.42-2.08), were more likely to occur with singleton births after ART. However, there were no significant differences for these outcomes from twin pregnancies. Perinatal complications and neonatal outcomes were consistent between the IVF and ICSI subgroups. The FET and ET subgroups showed a similar increase in complications, except for the incidence of placental abruption. After taking into account the effects of parity, birth plurality and maternal age, the ART group still exhibited increased maternal and neonatal complications, although some differences narrowed or disappeared.@*Conclusions@#This retrospective cohort study demonstrated that patients who underwent ART were at increased risk of several adverse pregnancy outcomes compared with women who conceived spontaneously. These complications may be attributed in part to the relatively high multiple pregnancy rate after ART. Elective single embryo transfer should be promoted in China to reduce the obstetrical risks of ART pregnancy. Singletons of ART pregnancy exhibited increased maternal and neonatal complications as well, suggesting that underlying infertility or other maternal or parental factors may contribute to the adverse outcomes.

Effect of Dandelion Extracts on the Proliferation of Ovarian Granulosa Cells and Expression of Hormone Receptors / 中华医学杂志(英文版)

<p><b>Background</b>In the current society, infertility related to age has become a social problem. The in vitro fertilization (IVF) success rate in women with poor ovarian response (POR) is very low. Dandelion extract T-1 (DE-T1) is an effective component of the extract from the leaves and stems of Taraxacum officinale, which is one of the medicines used in some patients with POR, but its molecular mechanism remains unclear.</p><p><b>Methods</b>Following IVF, ovarian granulosa cells (GCs) of sixty patients were extracted and divided into normal ovarian response (NOR) and POR groups. GCs were cultured in a dose-dependent and time-dependent manner with DE-T1, proliferation of GCs was determined by Cell Counting Kit-8 assay, and mRNA levels of insulin-like growth factor 1 receptor (IGF-1R), luteotropic hormone receptor (LHR), follicle-stimulating hormone receptor (FSHR), LHR, and CYP19A1 (aromatase) were determined by quantitative polymerase chain reaction. Progesterone and estradiol (E2) concentrations were determined by enzyme-linked immunosorbent assay.</p><p><b>Results</b>The cell viability gradually increased with the progressive increase in the DE-T1 concentration. Compared with the control group (without DE-T1), the mRNA expressions of FSHR, LHR, IGF-1R, and CYP19A1 were upregulated after the addition of DE-T1, especially in the 2.5% DE-T1 group (P < 0.01). The expression of IGF-1R was upregulated approximately 25 times (24.97 ± 4.02 times) in the POR group with 2.5% DE-T1. E2 and progesterone levels increased with the increasing DE-T1 concentration. There were highly significant differences in the E2 and progesterone secretion between the NOR and POR groups (P < 0.01).</p><p><b>Conclusion</b>DE-T1 may promote steroid hormone synthesis by promoting GC proliferation and upregulating GC receptor expression, thereby improving ovarian endocrine function.</p>

Epidemiological investigation of risk factors of the pregnant women with early spontaneous abortion in Beijing / 中国结合医学杂志

<p><b>OBJECTIVE</b>To determine the risk factors of the pregnant women with early spontaneous abortion in Beijing.</p><p><b>METHODS</b>A total of 34,417 cases of pregnant women were participated in the survey from January 2000 to December 2013. A questionnaire was informed to each woman. The content of questionnaire includes four parts: general condition, obstetrical history, past history and family history, and living environment and habits. The mental condition was evaluated with Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS).</p><p><b>RESULTS</b>A total of 32,296 questionnaires were collected. The spontaneous abortion rate in the total sample was 3.0%. There was no significant difference between the normal pregnancy group and spontaneous abortion group in terms of general condition, obstetrical and past history (P>0.05). Significant differences between the two groups were found in terms of decoration during pregnancy, keeping pets, near mobile communication base station within 100 m around the residence, drinking during pregnancy, having a cold during pregnancy and SAS (P<0.05). Having a cold during pregnancy, decoration during pregnancy, near mobile communication base station within 100 m around the residence, keeping pets and high SAS were determined the independent risk factors of spontaneous abortion by Logistic regression analysis.</p><p><b>CONCLUSIONS</b>Having a cold during pregnancy, decoration, keeping pets, near mobile communication base station within 100 m around the residence and high SAS are the independent risk factors of spontaneous abortion in Beijing.</p>

Epidemiological Survey and Risk Factor Analysis of Recurrent Spontaneous Miscarriages in Infertile Women at Large Infertility Centers / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A higher frequency of spontaneous miscarriage has been observed in infertile couples, and there is a higher prevalence of infertility among patients with a history of recurrent spontaneous miscarriages (RSMs; ≥2 miscarriages). This study aimed to determine the proportion of infertile patients with RSM and examine risk factors associated in patients with RSM being treated with assisted reproductive technologies.</p><p><b>METHODS</b>This cross-sectional observational study was conducted at six reproductive medicine centers in three cities of China. Data of 751 patients with at least one spontaneous miscarriage were analyzed. Demographic data and etiological factors associated with infertility were compiled and compared between patients with a single spontaneous miscarriage (SSM) and those with RSM.</p><p><b>RESULTS</b>Two hundred (26.6%, 95% confidence interval [CI]: 23.50-29.95%) patients experienced RSMs and 551 (73.4%) had a single miscarriage. The odds of RSM increased with increasing age (odds ratio [OR] = 1.06), uterine disorders (OR = 2.09), endocrine disorders (OR = 2.48), and immune disorders (OR = 2.98). Higher education level, masters or above, and a pelvic cavity disorder were associated with lower risk of RSM (OR = 0.27 and 0.46, respectively). Late spontaneous miscarriages were more frequent in patients with RSM than in those with a SSM (31.5% vs. 14.2%, respectively, P< 0.001) and were associated with a history of uterine cavity procedures (OR = 2.095) and cervical factors related to infertility (OR = 4.136, 95% CI: 1.012-16.90).</p><p><b>CONCLUSIONS</b>Compared to patients with only a SSM, the conditions of patients with RSM are more complicated. To increase the success rate of assisted reproductive technology, factors including uterus cavity adhesion, cervical relaxation, endocrine disorders, and immune disorders should be treated before assisted reproduction is initiated. These data may provide treatment guidance for infertile patients with a history of RSM.</p>

Hydrogen-rich Water Exerting a Protective Effect on Ovarian Reserve Function in a Mouse Model of Immune Premature Ovarian Failure Induced by Zona Pellucida 3 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Premature ovarian failure (POF) is a disease that affects female fertility but has few effective treatments. Ovarian reserve function plays an important role in female fertility. Recent studies have reported that hydrogen can protect male fertility. Therefore, we explored the potential protective effect of hydrogen-rich water on ovarian reserve function through a mouse immune POF model.</p><p><b>METHODS</b>To set up immune POF model, fifty female BALB/c mice were randomly divided into four groups: Control (mice consumed normal water, n = 10), hydrogen (mice consumed hydrogen-rich water, n = 10), model (mice were immunized with zona pellucida glycoprotein 3 [ZP3] and consumed normal water, n = 15), and model-hydrogen (mice were immunized with ZP3 and consumed hydrogen-rich water, n = 15) groups. After 5 weeks, mice were sacrificed. Serum anti-Müllerian hormone (AMH) levels, granulosa cell (GC) apoptotic index (AI), B-cell leukemia/lymphoma 2 (Bcl-2), and BCL2-associated X protein (Bax) expression were examined. Analyses were performed using SPSS 17.0 (SPSS Inc., Chicago, IL, USA) software.</p><p><b>RESULTS</b>Immune POF model, model group exhibited markedly reduced serum AMH levels compared with those of the control group (5.41 ± 0.91 ng/ml vs. 16.23 ± 1.97 ng/ml, P = 0.033) and the hydrogen group (19.65 ± 7.82 ng/ml, P = 0.006). The model-hydrogen group displayed significantly higher AMH concentrations compared with that of the model group (15.03 ± 2.75 ng/ml vs. 5.41 ± 0.91 ng/ml, P = 0.021). The GC AI was significantly higher in the model group (21.30 ± 1.74%) than those in the control (7.06 ± 0.27%), hydrogen (5.17 ± 0.41%), and model-hydrogen groups (11.24 ± 0.58%) (all P < 0.001). The GC AI was significantly higher in the model-hydrogen group compared with that of the hydrogen group (11.24 ± 0.58% vs. 5.17 ± 0.41%, P = 0.021). Compared with those of the model group, ovarian tissue Bcl-2 levels increased (2.18 ± 0.30 vs. 3.01 ± 0.33, P = 0.045) and the Bax/Bcl-2 ratio decreased in the model-hydrogen group.</p><p><b>CONCLUSIONS</b>Hydrogen-rich water may improve serum AMH levels and reduce ovarian GC apoptosis in a mouse immune POF model induced by ZP3.</p>

Aneuploidy in Early Miscarriage and its Related Factors / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Genetic factors are the main cause of early miscarriage. This study aimed to investigate aneuploidy in spontaneous abortion by fluorescence in situ hybridization (FISH) using probes for 13, 16, 18, 21, 22, X and Y chromosomes.</p><p><b>METHODS</b>A total of 840 chorionic samples from spontaneous abortion were collected and examined by FISH. We analyzed the incidence and type of abnormal cases and sex ratio in the samples. We also analyzed the relationship between the rate of aneuploidy and parental age, the rate of aneuploidy between recurrent abortion and sporadic abortion, the difference in incidence of aneuploidy between samples from previous artificial abortion and those from no previous induced abortion.</p><p><b>RESULTS</b>A total of 832 samples were finally analyzed. 368 (44.23%) were abnormal, in which 84.24% (310/368) were aneuploidies and 15.76% (58/368) were polyploidies. The first was trisomy 16 (121/310), followed by trisomy 22, and X monosomy. There was no significant difference in the rate of aneuploidy in the advanced maternal age group (≥ 35 years old) and young maternal age group (<35 years old). However, the rate of trisomy 22 and the total rate of trisomies 21, 13, and 18 (the number of trisomy 21 plus trisomy 13 and trisomy 18 together) showed significantly different in two groups. We found no skewed sex ratio. There was no significant difference in the rate of aneuploidy between recurrent miscarriage and sporadic abortion or between the samples from previous artificial abortion and those from no previous artificial abortion.</p><p><b>CONCLUSIONS</b>Aneuploidy is a principal factor of miscarriage and total parental age is a risk factor. There is no skewed sex ratio in spontaneous abortion. There is also no difference in the rate of aneuploidy between recurrent abortion and sporadic abortion or between previous artificial abortion and no previous induced abortion.</p>

Association between left ventricular twist/untwist and diastolic dysfunction of high cardiovascular risk population in the community / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the association between left ventricular (LV) twist and untwist with the severity of diastolic dysfunction of high cardiovascular risk population in the community.</p><p><b>METHODS</b>This cross-sectional survey was performed in high cardiovascular risk people with normal left ventricular (LV) ejection fraction in an urban community of Beijing (n = 620). Normal LV diastolic function was defined in 305 subjects, mild diastolic dysfunction in 266 subjects and moderate/severe diastolic dysfunction in 49 subjects. Peak LV twist, peak twist velocity, peak untwist velocity and untwist rate were measured in apical and basal short-axis images using speckle tracking echocardiography.</p><p><b>RESULTS</b>Peak LV twist was similar among subjects with normal diastolic function, mild diastolic dysfunction and moderate/severe diastolic dysfunction. Peak twist velocity [(129.3 ± 45.3)°/s vs. (118.0 ± 36.2)°/s] and untwist velocity [(-132.9 ± 50.4) °/s vs. (-121.2 ± 41.4)°/s] were significantly higher in mild diastolic dysfunction group than in normal diastolic function group (all P < 0.01) and similar between normal diastolic function and moderate/severe diastolic dysfunction group (P > 0.05). Untwist rate of moderate/severe diastolic dysfunction decreased significantly than that of normal diastolic function [(41.9 ± 32.9)°/s vs. (57.7 ± 36.2) °/s, P < 0.01] and mild diastolic dysfunction group [(41.9 ± 32.9)°/s vs. (60.9 ± 39.9) °/s, P < 0.01].</p><p><b>CONCLUSIONS</b>Twist and untwist parameters are increased/preserved in population with normal systolic function and mild diastolic dysfunction and "normalized" or reduced in those with advanced diastolic dysfunction. The maintaining (if not increasing) of LV twist in early diastolic dysfunction might serve as a compensatory mechanism in case of reduced myocardial relaxation in these subjects.</p>

Gain of human telomerase RNA gene is associated with progression of cervical intraepithelial neoplasia grade I or II / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The 3q26 chromosome region, where the human telomerase RNA gene (hTERC) is located, is a biomarker for cervical cancer and precancerous lesions. The aim of this study was to confirm the value of measuring hTERC gene gain in predicting the progression of cervical intraepithelial neoplasia grade I or II (CIN-I and -II, respectively) to CIN-III and cervical cancer.</p><p><b>METHODS</b>Liquid-based cytological samples from 54 patients with CIN-I or CIN-II lesions were enrolled in this study. Follow-up was performed with colposcopy and biopsy within 24 months after the diagnosis of CIN-I or CIN-II. Copy numbers of the hTERC gene were measured by fluorescence in situ hybridization with a dual-color probe mix containing the hTERC gene probe (labeled red) and the control, the chromosome 3 centromere-specific probe (labeled green).</p><p><b>RESULTS</b>All patients whose lesions progressed from CIN-I or CIN-II to CIN-III displayed a gain of the hTERC gene, whereas patients where the hTERC gene was not amplified did not subsequently progress to CIN-III or cervical cancer. The signal ratio pattern per cell was recorded as N:N (green:red). The numbers of cells with the signal ratio pattern of 4:4 or N:≥5 in patients whose lesions progressed to CIN-III were significantly higher than those whose lesions did not progress. Significantly, none of the patients with a 4:4 signal ratio pattern regressed spontaneously.</p><p><b>CONCLUSIONS</b>In conclusion, measurement of hTERC gene gain in CIN-I or CIN-II patients using liquid-based cytological samples could be a useful biomarker to predict the progression of such cervical lesions. In addition, a 4:4 or N:≥5 signal ratio pattern may indicate the unlikeness of spontaneous regression of CIN-I or CIN-II lesions.</p>

Association between serum uric acid and brachial ankle pulse wave velocity in Beijing community residents / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the relationship between serum uric acid and brachial ankle pulse wave velocity (ba-PWV) in Beijing community individuals.</p><p><b>METHODS</b>This epidemiological survey was performed in residents of two communities from Shijingshan District in Beijing from 2007 to 2008. Cardiovascular risk factors and ba-PWV were measured. Two thousand five hundred and forty three individuals with both ba-PWV and serum uric acid measurements were included. Ba-PWV ≥ 1400 cm/s was defined as abnormal. The individuals were divided into four groups (Q1, Q2, Q3 and Q4 group) according to the gender-specific quartiles of serum uric acid. Univariate logistic regression was used to evaluate the relation between various cardiovascular risk factors and ba-PWV abnormality. Multivariate logistic regression was used to evaluate the relation between serum uric acid and ba-PWV abnormality after adjusting for other cardiovascular risk factors.</p><p><b>RESULTS</b>Body mass index, triglyeride and prevalence of hypertension increased with increasing levels of serum uric acid (all P < 0.01). Univariate logistic regression analysis showed that age, gender, smoking, hypertension, systolic blood pressure, diastolic blood pressure, diabetes, body mass index, total cholesterol, triglyeride and estimated glomerular filtration rate were related with ba-PWV abnormality (all P < 0.01). Compared with Q1 group, ba-PWV abnormality OR value of Q4 group was 1.73 (95%CI: 1.34 - 2.22, P < 0.01). Multivariate logistic regression revealed that ba-PWV abnormality OR value of Q4 group was 1.66 (95%CI: 1.16 - 2.37, P < 0.01 ) after adjusting for age, gender, smoking, hypertension, systolic blood pressure, diastolic blood pressure, diabetes, body mass index, total cholesterol, triglyeride and estimated glomerular filtration rate when compared with Q1 group and OR values were 1.55 (95%CI: 0.88 - 2.74, P > 0.05) and 1.65 (95%CI: 1.04 - 2.64, P < 0.05) in male and female respectively.</p><p><b>CONCLUSION</b>Increased serum uric acid was independently associated with ba-PWV abnormality in Beijing community residents.</p>

Relation between aortic root dimension and cardiovascular disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the relation among aortic root dimension (ARD) measured by echocardiography, cardiovascular disease risk factors and cardiovascular disease in adult Beijing community population.</p><p><b>METHODS</b>Echocardiography was performed in 1041 individuals in a suburban community of Beijing from 2004 to 2005. ARD and other echocardiographic parameters including left atria dimension, left ventricular mass, septal and posterior wall thickness and dimension were analyzed. Histories of cardiovascular disease as well as risk factors were obtained. Spearman correlation was used to determine the relation between ARD and other cardiovascular risk factors. Multifactorial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of ARD and cardiovascular disease.</p><p><b>RESULTS</b>Ascending aortic dimension (AAD) and mean root dimension (MRD) were positively associated with age, weight, BMI, systolic and diastolic blood pressure, left atria dimension, left ventricular mass, left ventricular septal and posterior wall thickness, and left ventricular dimension. With the lowest quintile of AAD and MRD as the reference, ORs for the highest quintile of AAD for specific cardiovascular diseases in female were as follows: stroke (OR = 2.20, 95%CI: 1.03 - 4.72, P = 0.04), chronic heart failure (OR = 2.62, 95%CI: 1.49 - 4.61, P = 0.001), total cardiovascular disease (OR = 2.52, 95%CI: 1.51 - 4.21, P < 0.001). ORs of MRD were as follows: chronic heart failure (OR = 2.19, 95%CI: 1.26 - 3.80, P = 0.01), total cardiovascular disease (OR = 2.20, 95%CI: 1.32 - 3.68, P = 0.002). After adjustment for age, BMI, smoking status, TC, hypertension, diabetes mellitus, the ORs were not statistically significant (P > 0.05).</p><p><b>CONCLUSION</b>ARD was positively associated with several CHD risk factors, but was not independent risk factor for cardiovascular disease. ARD may act as an intermediate risk factor for cardiovascular disease. Combined ARD and traditional cardiovascular disease risk factors might enhance the predict power for cardiovascular disease.</p>

Relationship between the Akt-regulated direct p53 mitochondrial translocation and the resistance to cisplatin of ovarian cancer cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore Akt-regulated direct p53 mitochondrial translocation in cisplatin-induced apoptosis in ovarian cancer cells and the relationship between this and chemoresistance in ovarian cancer.</p><p><b>METHODS</b>Chemosensitive ovarian cancer cell lines (OV2008 and A2780s) and chemoresistant cells (C13(*) and A2780cp) were treated with cisplatin and whole cell and mitochondrial p53 contents were determined by Western blot. The p53 accumulation in mitochondria was determined in purified mitochondrial fractions in cisplatin-sensitive and -resistant ovarian cancer cells. Akt1/2 siRNA were transfected into C13(*) cells. Cisplatin-induced apoptosis was measured by Hoechst staining and p53 translocation was determined by Western blot.</p><p><b>RESULTS</b>Cisplatin induced mitochondrial p53 accumulation and apoptosis in chemosensitive cells (P < 0.05), but not in resistant cells (P > 0.05). Over-expression of active Akt2 inhibited p53 directly translocate to mitochondria, and downregulation of Akt by Akt1/2 siRNA increased p53 mitochondrial accumulation and sensitize C13(*) cells to cisplatin treatment.</p><p><b>CONCLUSIONS</b>Cisplatin induces direct p53 mitochondrial accumulation in chemosensitive cells, and Akt confers resistance in ovarian cancer cells, in part, by regulating the direct action of p53 in mitochondrial death pathway.</p>

Fluorescence in situ hybridization in uncultured amniocytes for detection of aneuploidy in 4210 prenatal cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Almost all reported fluorescence in situ hybridization (FISH) kits for prenatal diagnosis use probes from foreign (non-Chinese) countries. The aim of this study was to analyze the reliability of domestic (Chinese) FISH probe sets to detect aneuploidies of chromosomes 13, 18, 21, X, and Y related to prenatal diagnosis in 4210 cases.</p><p><b>METHODS</b>Cytogenetic karyotyping was carried out as a standard prenatal diagnostic test, and amniotic fluid cell interphase FISH analysis was performed using two sets of probes (centromeric probes for chromosomes 18, X, and Y, and locus-specific probes for chromosomes 13 and 21) provided by GP Medical Technologies, Beijing, China. Then we compared the two results and found the performance characteristics for informative FISH results of aneuploidies by the domestic kit probes.</p><p><b>RESULTS</b>In 4210 cases, 4126 cases generated karyotype results and 133 abnormal karyotypes (including 97 aneuploidies) were found. The FISH results of 98 cases (among them, 31 cases gave normal cytogenetic results) were uninformative. The rate of abnormal cases was 3.2% (133/4126). For the abnormal karyotypes, the rate of aneuploidy was 72.9% (97/133). Among the 97 aneuploidies, there were 58 cases of trisomy 21 (58/97, 59.8%), four cases of trisomy 13, 23 cases of trisomy 18, and 12 cases of sex chromosomal aneuploidies. The total concordance of the two methods was 97.9% (95/97; two cases were mosaics that had a low percentage of abnormal cells), and the concordance of trisomy 21, 13, and 18 by the two methods was 100%.</p><p><b>CONCLUSIONS</b>The two sets of the domestic FISH kit probes are reliable for prenatal diagnosis. The results demonstrate that FISH is a rapid and accurate clinical method for prenatal identification of chromosome aneuploidies.</p>

Association between chronic kidney disease and cardiovascular events in middle-to-old-aged Chinese population / 中华流行病学杂志

Objective This study aimed to determine the relationships between estimated glomerular filtration rate (eGFR) and cardiovascular events. Methods 2500 residents aged more than 40 years old were selected from Shougang community, Shijingshan district, in Beijing. 2315 of them took part in the survey. First morning urinary sample was collected for all the participants.Albumin and creatinine were measured and eGFR was calculated using simplified MDAD formula.Cardiovascular risk factors were also investigated. The participants were followed up for 4 years, and all-cause mortality and cardiovascular events were collected. The subjects were divided into three groups according to eGFR[ml/(min·1.73 m2)]: ＜60, 60-90,＞90.Cox regression model was used to analyze the relationships between eGFR, all events, and cardiovascular events after adjusting for confounders. Results The prevalence of eGFR ＜60 was 3.3%. The incidence rates of cardiovascular events were 43.9, 21.8 and 11.5/1000 person-years among three groups, and the incidence rates of all events (all-cause mortality and cardiovascular events) were 53.7, 28.8 and 14.6/1000 person-years,respectively. After adjusting for age, gender, smoking, body mass index, serum lipids, diabetes mellitus, cardiovascular disease, the hazard risk (HR) for cardiovascular events was 1.29 (95%CI:0.85-1.96) in eGFR＜60 group and 2.14 (95% CI: 1.02-4.50) in 60≤eGFR＜90 group, when compared with the eGFR＞90 group; the HR for all events were 1.25 (95%CI: 0.86-1.81 ) and 1.95(95% CI: 1.00-3.80) , respectively. Conclusion In the population studied, eGFR＜60 seemed an independent predictor for cardiovascular events and all-cause events.

Characteristics of abnormal menstrual cycle and polycystic ovary syndrome in community and hospital populations / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Polycystic ovary syndrome (PCOS) is considered to be the most common endocrine disorder in women of reproductive age. The involvement of an abnormal menstrual cycle in the etiology of PCOS remains unclear. We aimed to analyze the characteristics of abnormal menstrual cycles and their association with PCOS in community and hospital patient populations.</p><p><b>METHODS</b>Women with PCOS identified from 2111 permanent female residents in the community of Beijing and 506 outpatients obtained from the reproductive clinic of Peking University Third Hospital were recruited for this study, comprising the PCOS community group and the PCOS hospital group, respectively. Each group was further divided into four subgroups according to the length of menstrual cycles: <21 days; 21-34 days; 35-60 days; and >60 days. Women in each group were interviewed using a questionnaire to assess factors including age, age of menarche, menstrual cycle history, related family history, and modified Ferriman-Gallwey (mF-G) score. All women received transvaginal ultrasound scan and had fasting blood samples taken for endocrine evaluation. A two-tailed P value of <0.05 was considered significant.</p><p><b>RESULTS</b>In the community population, the prevalence of abnormal menstrual cycle was 27.19% (574/2111). The prevalence of PCOS in the community was 6.11% (129/2111) according to Rotterdam criteria. In the community group, the most common menstrual cycle length was 35-60 days, whereas for the hospital group, it was >60 days. In both the community and hospital groups, the most common phenotype of PCOS was that of Oligo/amenorrhea+PCO+ hyperandrogenism (HA) (O+P+H) (P=0.000). With increasing cycle length of 35-60 days to >60 days, the percentages of Oligo/amenorrhea+PCO (O+P) and O+P+H were found to significantly decrease in the community group and significantly increase in the hospital group (P=0.000 for each). In the hospital group, as the menstrual cycle length increased from 35-60 days to >60 days, the rate of spontaneous abortion increased significantly (P=0.000), meanwhile the rate of poorly-secreted endometrium and abnormal endometrial hyperplasia increased significantly (P=0.000).</p><p><b>CONCLUSIONS</b>The prevalence of PCOS in the Beijing community of women was 6.11%. Oligo/amenorrhea was the most common type of abnormal menstrual cycle and may be an indicator for PCOS and endometrial lesions. Gynecologists should seek relevant medical information from women in the community to promptly diagnose PCOS and then follow up patients for potential development of subsequent complications.</p>

Inhibition of mitochondrial Smac release by Akt in chemoresistant ovarian cancer cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the relationship between Akt and second mitochondria-derived activator of caspases (Smac) in cisplatin (CDDP)-induced apoptosis in human ovarian cancer cells and the role of Akt in the molecular mechanism of chemoresistance in ovarian cancer.</p><p><b>METHODS</b>Chemosensitive (OV2008 and A2780s) and chemoresistant (C13* and A2780cp) ovarian cancer cell lines were treated with CDDP and subcellular Smac contents were determined by Western blot. Smac siRNA and Smac N7 peptide were transfected into OV2008 and C13* cells, respectively. CDDP-induced apoptosis was measured by flow cytometry. A2780s cells stably transfected with Akt2 (A2780s-AAkt2) and C13* cells transfected with Aktl/2 siRNA were treated with CDDP, and Smac content and apoptosis in the cells were determined to detect the changes of their chemoresistance to CDDP.</p><p><b>RESULTS</b>CDDP induced mitochondrial Smac release and apoptosis in chemosensitive cells (P < 0.05), but not resistant cells (P > 0.05). Downregulation of Smac by Smac siRNA confer resistance in OV2008 cells and Smac N7 peptide sensitized C13* cells to CDDP treatment. Overexpression of Akt2 inhibited mitochondrial Smac release and downregulation of Akt by siRNA sensitized C13* cells to CDDP treatment.</p><p><b>CONCLUSION</b>Smac is required in CDDP-induced apoptosis in ovarian cancer cells and overexpression of Akt inhibits mitochondrial Smac release. Akt is closely related to the chemoresistance of ovarian cancer.</p>

Comparison Between Two Criteria for Diagnosing Metabolic Syndrome in Hypertension Patients / 中华高血压杂志

Objective To compare the prevalence rate of metabolic syndrome(MS)using the criteria of Chi- nese Diabetes Society(CDS)or International Diabetes Federation(IDF)in hypertension patients in China.Methods The prevalence of MS in hypertension patients(n=17861)in China and its relations with age,gender and levels of blood pressure were studied.Results 1)the prevalence of MS in hypertension patients was 42.2 % or 46.3 %,ac- cording to the definition of CDS or of IDF.The diagnostic rate of the definition of IDF was higher(P80 years group,the diagnostic rate by IDF definition was slightly but significantly higher in all ages groups(P0.05),on contrary,the female prevalence was increased while the male prevalence decreased by IDF. The prevalence of MS increased with levels of blood pressure by both definition.4)The prevalence rate was in- creased with the elevation of BP,compare with CDS criteria the diagnostic rate of MS was slightly higher by IDF cri- teria in all levels of BP.Conclusion Compared with the definition of CDS,the diagnostic rate of MS by the defini- tion of IDF was higher in hypertension patients,addressing more aggressively control global risk factors.

An evaluation on effectiveness of worksite-based intervention for cardiovascular disease during 1974 - 1998 in capital iron and steel company of Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the feasibility and effectiveness of worksite-based cardiovascular disease (CVD) prevention and control program in urban population of China.</p><p><b>METHODS</b>Worksite-based intervention program was implemented 110 000 employees at Capital Iron and Steel Company of Beijing (CISC) focusing on primary prevention for CVD and control of hypertension. Intervention components comprised of infrastructure setting-up, health education and health promotion, professional training, detection and management of hypertensive patients, and reasonably readjusting their diet structure focusing on salt intake reduction, reducing their overweight, quitting smoking, and restricting alcohol consumption in high-risk population. Changes in level of risk factors, incidence and mortality of stroke and coronary events and their trend were evaluated between the intervention group at CISC and eight simultaneously parallel reference groups in other provinces outside Beijing with population surveillance data.</p><p><b>RESULTS</b>Major risk factors for CVD, including blood pressure, body mass index and serum cholesterol level, decreased relatively in intervention population at CISC during 1974 to 1998, while those in majority of eight parallel reference groups at different provinces of China significantly increased at the same time. Systolic blood pressure (SBP) decreased by 0.8 mm Hg and 4 mm Hg in average for men and women, respectively, and their diastolic blood pressure (DBP) remained the same as baseline for both men and women at CISC, while SBP increased by (2 - 11) mm Hg and (6 - 8) mm Hg in average for men and women, respectively in reference groups, and DBP increased by (2 - 6) mm Hg in average for men in five of eight reference groups, and by (3 - 6) mm Hg for women in four of eight reference groups. Serum level of cholesterol decreased by 0.26 mmol/L in women and slightly increased for men at CISC, and increased by (0.35 - 0.97) mmol/L for men and (0.29 - 1.05) mmol/L for women in all reference groups. Prevalence of overweight increased by 58.7% for men and 11.3% for women at CISC and increased by one to 22 folds in eight reference groups. Awareness of health knowledge improved significantly with an average net reduction of SBP/DBP of (2.5/2.2) mm Hg in the enforced intervention group at CISC than that in general intervention groups. Incidence and mortality rates of stroke decreased by 54.7% and 74.3%, respectively in intervention group at CSIC, but those of coronary events slowly increased with fluctuation.</p><p><b>CONCLUSION</b>Worksite-based comprehensive intervention for CVD prevention and control was feasible and cost-effective in decreasing risk factors for CVD, incidence and mortality rate of stroke in population of urban areas of China.</p>