ABSTRACT
Objective:To investigate the maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) during pregnancy at advanced maternal age for their second child at advanced maternal age, and to explore the relationship with neonatal outcomes.Methods:This study involved 1 965 women of advanced maternal age who delivered the second child in the Northwest Women's and Children's Hospital from July 1 to December 31, 2017. Clinical data of these women and their newborns were collected through the electronic medical record information system. According to pre-pregnancy BMI, all subjects were divided into four groups: underweight group (<18.5 kg/m 2, n=139), normal weight group (18.5-23.9 kg/m 2, n=1 342), overweight group (24.0-27.9 kg/m 2, n=404) and obese group (≥28.0 kg/m 2, n=80). According to the GWG standard recommended by the American Institute of Medicine (IOM) in 2009, they were also divided into three groups: inadequate GWG group ( n=478), normal GWG group ( n=884) and excessive GWG group ( n=603). Mann-Whitey U test, Chi-square test or Fisher's exact test were used as statistical methods. Effects of pre-pregnancy BMI and GWG on gestational age and birth weight of the newborns were analyzed by binary and multi-class logistic regression models. Results:The median pre-pregnancy BMI of the 1 965 women was 22.1 (20.3-23.9) kg/m 2 and patients with abnormal pre-pregnancy BMI accounted for 31.7% (623/1 965). Their median GWG was 13.0 (10.0-16.0) kg and 55.0% (1 081/1 965) of them were abnormal. Compared with normal pre-pregnant weight women, overweight and obesity subjects were associated with increased risks of preterm birth ( OR=2.100, 95% CI: 1.398-3.156), low birth weight infants (LBWI) ( OR=3.187, 95% CI: 1.892-5.367) and macrosomia ( OR=1.758, 95% CI: 1.182-2.614); pre-pregnancy underweight reduced the incidence of large for gestational age (LGA) infants ( OR=0.476, 95% CI: 0.236-0.960). Compared with the normal GWG group, the inadequate GWG group had increased risks of preterm birth ( OR=2.316, 95% CI: 1.530-3.505) and LBWI ( OR=1.850, 95% CI: 1.103-3.104), while the excessive GWG group showed increased risks of macrosomia ( OR=1.828, 95% CI: 1.225-2.726) and LGA infants ( OR=1.955, 95% CI: 1.448-2.640), but a reduced risk of LBWI ( OR=0.359, 95% CI: 0.193-0.667) and small for gestational age infants ( OR=0.452, 95% CI: 0.240-0.852). Conclusions:Both abnormal pre-pregnancy BMI (underweight, overweight and obese) and GWG (inadequate and excessive) have adverse effects on neonatal outcomes in women of advanced age in pregnancy for their second baby. Weight management should be addressed during the whole pregnancy, including both adjusting the pre-pregnancy BMI to normal range and maintaining reasonable GWG, so as to reduce potential adverse outcomes in newborns.
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Objective To study the expression of LI-cadherin in gastric cancer, gastric stromal tumor, chronic gastritis and intestinal metaplasia. Methods Two hundred and forty four specimens were collected, including normal epithelia (n=28), chronic superficial gastritis (n=30), chronic atrophic gastritis(n=42), intestinal metaplasia (n=58), gastric adenocarcinoma (n=46), paracancerous gastric tissues (n=30), gastric stromal tumor (n=10). The expression of LI-cadherin was detected by S-P immunohischemistry with purified goat polyclonal antibody. Results The expression of LI-cadherin in normal epithelia and chronic gastritis are all negative, the positive rates of LI-cadherin expression in intestinal metaplasia and gastric adenocarcinoma is 83% (48/58) and 65% (30/46) respectively. By Laurien classification, the positive rate of LI-cadherin expression in intestinal type was higher(78% ) than those in the diffuse type (35%) (P<0.05). LI-cadherin was in positive correlation with lymph node metastasis and staging. Paracancerous tissues and gastric stromal tumor did not express LI-cadherin. Conclusions The abnormal expression of LI-cadherin was correlated with intestinal metaplasia and gastric adenocarcinoma. GCs with high LI-cadherin index have more lymph node metastasis. High expression rate of LI-cadherin in gastric cancer tissues may predict poor prognosis.
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Objective To investigate patients'cognition of social status of physicians and nurses,and find out the influence factors of it. Methods 286 patients were asked to finish serf-designed scale of social status of physicians and nurses. Results Most patients thought social status of nurses was above the middle level in our country.The majority of patients considered doctors " social status was higher than nurses'(approval rate 75.5% ).The nurses'economic treatment was lower than doctors' (approval rate 62.2% );About 14 items among 15 items on the occupational reputation,doctors" occupation cognition rate was higher than the nurses,the nurses' occupation cognition rate was higher than the doctors' occupation only on the item of labor intensity.The influence factors of the social status differences between physicians and nurses were economic treatment,the important degree of occupation,the professional authority,the requirement of specialized skills for workers. Conclusions To study the influence factors of the social status difference of physicians and nurses is beneficial for us to study the strategy of improving the nurses' social status in order to fulfil the viewpoint of science development,keep nurse troops developing continuously and set up the harmonious physician-nurse relationship.