ABSTRACT
Background Preterm birth-related complications are the leading cause of death in newborns and children under the age of 5 years. Maternal heat exposure has been associated with both sleep status during pregnancy and the increased risk of preterm birth. However, whether sleep status could mediate the association between heat exposure and preterm birth remains unclear. Objective To evaluate the association between maternal heat exposure in early pregnancy and preterm birth, and to further explore potential mediation effect of sleep status on the association between heat exposure and preterm birth. Methods A birth cohort was established in Guangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital) from 2017 until now. Pregnant women (with gestational age between 8 and 13 weeks) were included in this study when they presented to the hospital for their first prenatal care visit and signed an informed consent. Then they were followed up until delivery. A total of 3 268 pregnant women were included for the final analysis. Questionnaires were distributed to collect the demographic characteristics, lifestyles, and sleep status of pregnant women. Daily meteorological data during the study period were collected from meteorological monitoring stations in Guangzhou and the average ambient mean temperature of four weeks before the survey was calculated and assigned for each pregnancy. The 75th, 80th, 85th, 90th, and 95th percentiles (P75, P80, P85, P90, and P95) of the average ambient temperature of all pregnant women were used as the thresholds to define heat exposure. Logistic regression was used to evaluate the effects of heat exposure in different definitions on preterm birth and sleep status (sleep duration, night sleep timing, and wake up timing). The mediation effects of sleep status on the relationship between heat exposure and preterm birth were also analyzed. Results Among all the included participants, 165 newborns were preterm births with an incidence rate of 5.0%. Heat exposures with thresholds of P90 and P95 increased the risk of preterm birth, with ORs (95%CIs) of 1.66 (1.04-2.57) and 1.90 (1.03-3.33), respectively (P<0.05). Heat exposures with thresholds of P75, P80, P85, P90, and P95 decreased the sleep duration (<9 h vs. ≥9 h, control group: ≥9 h), and the ORs (95%CIs) were 1.51 (1.25-1.83), 1.44 (1.17-1.77), 1.35 (1.08-1.70), 1.43 (1.09-1.87), and 1.45 (1.00-2.13), respectively. Heat exposures with P75 and P80 thresholds resulted in earlier wake up timing (<8: 00 vs. ≥8: 00, control group: <8: 00), with ORs (95%CIs) of 0.77 (0.63-0.93) and 0.76(0.61-0.93), respectively. No significant association was observed between heat exposure and night sleep timing. The mediation analyses showed that under heat exposure with P90 threshold, a statistically significant mediation effect was observed for sleep duration, and the proportion mediated was 6.07% (95%CI: 0.17%-25.00%) (P<0.05). No significant mediation effect was observed for night sleep timing and wake up timing. Conclusion An elevated risk of preterm birth after heat exposure in early pregnancy may be partly mediated through reducing sleep duration.
ABSTRACT
Objective:To explore the application value of the family-centered nursing model and home care platform in PICC nursing of elderly tumor patients, in order to provide reference for PICC nursing of elderly tumor patients.Methods:A total of 122 elderly tumor patients admitted to Boao Hengda International Hospital, Hainan Province from October 2017 to October 2019 were selected and divided into control group (61 cases) and observation group (61 cases) according to the random number table method. The control group received routine care. The observation group combined family-centered care with home care platform for nursing intervention. Before and 3 months after intervention, the self-management ability, quality of life and mental resilience of the two groups were evaluated by Cancer Patients PICC Self-Management scale(CPPMS), 36-item Short Form Health Survey(SF-36) and Connor-Davidson Resilience Scale(CD-RISC). The incidence of complications during the observation period and service volume was recorded.Results:There was no significant difference in the score of CPPMS,SF-36, CD-RISC before intervention between the two groups( P>0.05). The CPPSM scores of the observation group and the control group after intervention were (144.21±8.93) points and (125.85±10.52) points, the difference was statistically significant ( t value was 10.392, P<0.05). The scores of social function, life vitality, physical pain, physical function, physical role limitation, emotional role limitation, mental health and overall health were (70.34±5.96),(68.27±5.01),(63.46±4.57),(58.53±5.78),(59.74±6.49),(60.32±5.69),(59.83±6.72),(66.58±6.76) points in the observation group, and (65.32±6.04), (65.33±6.57), (58.35±4.92), (54.51±4.82), (55.64±6.12), (54.59±6.42), (55.67±5.06), (62.14±4.77) points in the control group, the differences were statistically significant ( t values were 2.779-5.943, P<0.05). The CD-RISC scores of the observation group and the control group after intervention were (82.41±8.79) points and (73.39±7.64) points, the difference was statistically significant ( t value was 6.049, P<0.05). There was no significant difference in the complication rate between the two groups ( P>0.05). The number of calls, consultations, and door-to-door services were (6.77±1.27), (6.34±1.92), (2.58±0.52) times/person in the observation group, and (4.52± 1.48), (4.06±1.41), (2.03±0.19) times/person in the control group, the difference was statistically significant( t values were 9.011, 7.475, 7.759, P<0.05). Conclusions:Compared with conventional care, the family-centered care model and home care platform have higher application value in elderly patients with PICC oncology, which can effectively improve the PICC management ability and quality of life of patients, and further improve the psychological flexibility. It is worthy of promotion and application.
ABSTRACT
Mineralized tissue regeneration is an important and challenging part of the field of tissue engineering and regeneration. At present, autograft harvest procedures may cause secondary trauma to patients, while bone scaffold materials lack osteogenic activity, resulting in a limited application. Loaded with osteogenic induction growth factor can improve the osteoinductive performance of bone graft, but the explosive release of growth factor may also cause side effects. In this study, we innovatively used platelet-rich fibrin (PRF)-modified bone scaffolds (Bio-Oss
Subject(s)
Humans , Autografts , Bone Regeneration , Cell Differentiation , Mesenchymal Stem Cells , Osteogenesis , Tissue Engineering , Tissue ScaffoldsABSTRACT
Objective:To investigate the expression level of serum ficolin-3 (FCN3) in breast cancer patients and its relationship with prognosis.Methods:A total of 145 patients with breast cancer (the breast cancer group) who were treated in Boao Evergrande International Hospital from February 2014 to February 2016 and 148 healthy women during the same period (the healthy control group) were selected. The level of FCN3 was detected by using enzyme-linked immunosorbent assay (ELISA); the serum carbohydrate antigen 153 (CA153) level of the two groups was detected by using automatic electrochemiluminescence immunoassay; the diagnostic value of serum FCN3 for breast cancer was evaluated by using receiver operating characteristic curve (ROC). The relationship between the level of serum FCN3 and the clinicopathological characteristics of breast cancer patients was analyzed. Kaplan-Meier method was used to analyze and compare the 3-year overall survival rate of breast cancer patients with different serum FCN3 levels.Results:Serum FCN3 level in breast cancer group was (14.1±3.4) μg/ml, which was higher than that in the healthy control group [(9.1±3.0) μg/ml], and the difference was statistically significant ( t = 13.644, P < 0.01). The serum CA153 level in breast cancer group was (36.3±15.2) U/ml, which was higher than that in the healthy control group [(16.8±6.9) U/ml], and the difference was statistically significant ( t = 14.397, P < 0.01). The area under the curve (AUC) of serum FCN3 and CA153 for the diagnosis of breast cancer was 0.894 and 0.720, respectively. The AUC of combined detection of serum FCN3 and CA153 for the diagnosis of breast cancer was 0.909, which was higher than that of CA153 alone ( Z = 2.050, P = 0.040), but compared with FCN3 alone, the difference was not statistically significant ( Z = 0.157, P = 0.875). Serum FCN3 level in stage Ⅲ breast cancer patients was higher than that in stage Ⅰ and Ⅱ patients, and serum FCN3 level in stage Ⅱ patients was higher than that in stage Ⅰ patients (all P < 0.05). The breast cancer patients with lymph node metastasis had higher serum FCN3 level compared with those patients without lymph node metastasis ( P < 0.05). The 3-year overall survival rate of breast cancer patients in the low-level FCN3 group (≤12.07 μg/ml) was higher than that in the high-level group (>12.07 μg/ml) ( P = 0.033). Conclusion:Serum FCN3 is up-regulated in breast cancer patients, which is expected to be a potential index for diagnosis and prognosis evaluation of breast cancer.
ABSTRACT
Objective To evaluate the application of M-mode echocardiography and Doppler echocardiography in diagnosing complete atrioventricular block (CAVB) in fetus. Methods M-mode and Doppler echocardiography were used to screen the fetuses and bradycadia was established as CAVB in 10 cases. Atrial and ventricular rhythm was measured by M-mode echocardiography. Flow of mitral valve, left ventricular in-flow and out-flow tract, venous duct was measured by Doppler echocardiography. The characteristics and prognoses of CAVB fetus were compared and analyzed. Results CAVB was established as independence in rhythm of atrium and ventricle. The rhythm of atrium could be in normal range, while the rhythm of ventricle should be slower than normal. Enlarged chambers were observed in 6 cases, cardiac dysfunction in 5 cases, and pericardial effusion in 7 cases. Tricuspid regurgitation and mitral regurgitation existed in 5 and 1 case, respectively. All of the CAVB fetus in this study underwent abortions. Conclusions Fetal echocardiography is proven to be a useful tool to diagnose CAVB, which greatly influenced the cardiac function in fetuses. Clear diagnosis as early as possible is crucial to the treatment of CAVB fetus.
ABSTRACT
Objective To identify the risk factors for early postoperative cognitive dysfunction (POCD) in the elderly patients undergoing spinal surgery.Methods One hundred and fifty ASA Ⅱ or Ⅲ patients,aged ≥65 yr,undergoing elective spinal surgery under general anesthesia,were studied.Venous blood samples were taken at 1 day before operation and 7 days after operation to determine the concentration of serum S-100B protein.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 7 days after operation.The patients were diagnosed as having POCD if MMSEpre-MMSEpost ≥ 3.The patients were divided into POCD group and non-POCD group.Age,body weight,sex,education,type of operations,complications,preoperative TCM syndrome type,MMSE score at 1 day before operation and 7 days after operation,duration of operation,emergence time,and intraoperative blood loss,cardiovascular events,and amount of fluid infused per hour were recorded.The risk factors for POCD were analyzed using multivariate logistic regression analysis.Results Thirty-eight patients developed early POCD (25.3％).The resuhs of logistic regression analysis showed that age ≥ 70 yr,elementary education or below,duration of operation ≥5 b,and the number of hypotension occurred during operation≥3 were the risk factors for early POCD.Conclusion Age≥70 yr,elementary education or below,duration of operation ≥ 5 h,and the number of hypotension occurred during operation ≥ 3 are the risk factors for early POCD in the elderly patients undergoing spinal surgery.