Effectiveness and safety of low-dose oral misoprostol solution for cervical ripening in the third trimester / 中华围产医学杂志

Objective:To investigate the effectiveness and safety of low-dose oral misoprostol solution for cervical ripening in late gestation.Methods:This was a prospective cohort study including 396 primiparas with singleton pregnancy who received low-dose oral misoprostol solution for cervical ripening (oral group) in Peking University Third Hospital from March to October 2022. They were further allocated to receive oral misoprostol alone (OA group, n=167) or oral misoprostol in combination with oxytocin/amniotomy (OC group, n=229). Moreover, 218 cases who received vaginal misoprostol for cervical ripening (vaginal group) during the same period in 2021 were reviewed (a retrospective cohort). Among them, 77 were given vaginal misoprostol alone (VA group) and 141 received vaginal misoprostol in combination with oxytocin/amniotomy (VC group). The OA group and VA group (72 and 73 cases) as well as the OC group and VC group (108 and 103 cases) were matched using propensity scores. Basic clinical information, hospital stay, duration of labor induction, uterine hyperstimulation, rate of labor initiation, vaginal delivery rate, rate of delivery within 24 h, duration of labor, neonatal condition, adverse pregnancy outcomes, and other information were compared between different groups. All data were statistically analyzed using independent sample t test, analysis of variance, nonparametric test, Chi-square test, or Fisher's exact probability test. Logistic regression model was used to analyze the factors affecting the labor initiation and the failure of labor induction. Results:The average hospital stay, the duration from medication to labor initiation and the duration from medication to vaginal delivery were significantly shorter in the oral group than those in the vaginal group [(5.4±2.4) vs. (6.5±2.6) d, (34.2±24.1) vs. (38.9±25.7) h, (45.8±25.8) vs. (53.4±27.8) h; t=5.24, 2.10 and 3.39; all P<0.05]. The total labor initiation rate and vaginal delivery rate in the oral group were significantly higher than those in the vaginal group [92.9% (368/396) vs. 83.5% (182/218), 72.2% (286/396) vs. 60.1% (131/218); χ 2=13.43 and 9.50; both P<0.05]. The incidence of failed induction of labor, uterine hyperstimulation, fetal distress, and intrauterine infection in the oral group were lower than those in the vaginal group [2.0% (8/396) vs. 6.9% (15/218), 4.3% (17/396) vs. 17.9% (39/218), 8.8% (35/396) vs. 14.7% (32/218), 1.3% (5/396) vs. 3.7% (8/218); χ 2=9.21, 31.36, 4.93 and 3.93; all P<0.05]. The duration from medication to labor initiation and to vaginal delivery in the OA group were higher than those in the VA group [(25.8±17.0) vs. (17.4±10.8) h, (37.2±18.8) vs. (29.7±13.5) h; t=3.49 and 2.74; both P<0.05]. There were no significant differences in the labor initiation rate, vaginal delivery rate, rate of delivery within 24 h or the incidence of failed induction of labor between the OA and VA groups (all P>0.05). Women in the VA group were more likely to develop uterine hyperstimulation than those in the OA group [19.2% (14/73) vs. 4.2% (3/72), χ2=7.89, P=0.005]. There were no significant differences in the duration from medication to labor initiation or to vaginal delivery between the VC and OC groups (both P>0.05), but the duration were significantly longer than those in the corresponding medication alone group (VC vs. VA groups: (49.7±24.6) vs. (17.4±10.8) h and (61.6±25.7) vs. (29.7±13.5) h, t=5.31 and 5.13, both P<0.05; OC vs. OA groups: (45.3±26.6) vs. (25.8±17.0) h and (56.1±27.2) vs. (37.2±18.8) h, t=10.35 and 9.78, both P<0.05]. The labor initiation rate, vaginal delivery rate and rate of delivery within 24 h in the OC group were higher than those in the VC group [88.9% (96/108) vs. 77% (87/113), 63.0% (68/108) vs. 47.8% (54/113), 10.3% (7/108) vs. 0.0% (0/113); χ 2=5.49, 5.14 and 7.56; all P<0.05]. The incidence of uterine hyperstimulation in the OC group was 4.6% (5/108), which was lower than that in the VC group [18.6% (21/113), χ 2=10.37, P=0.001]. Logistic regression analysis showed that oral misoprostol and gestational age were positively correlated with labor initiation [ OR (95% CI): 2.18 (1.24-3.90) and 1.43 (1.14-1.79)], while maternal age was negatively correlated with labor initiation [ OR (95% CI): 0.90 (0.82-0.98)]. Moreover, failed induction of labor was negatively correlated with oral misoprostol [ OR (95% CI): 0.37 (0.14-0.91)], but positively correlated with maternal age [ OR (95% CI): 1.21 (1.05-1.40)]. Conclusions:Oral administration of low-dose misoprostol solution is as effective as vaginal misoprostol in promoting cervical ripening. Besides, it can shorten the average hospital stay and reduce the incidence of uterine hyperstimulation, suggesting that low-dose oral misoprostol solution is relatively safer and can be used to promote cervical ripening in late gestation.

Calcium carbide-ripened plantain induced alterations in plasma electrolytes concentration and kidney function in rats / Alterações induzidas por plátano maturado com carbureto de cálcio na concentração plasmática de eletrólitos e na função renal em ratos

Abstract Introduction: Artificial fruit ripening agents such as ethanol, ethylene, ethephon, and calcium carbide (CaC2) is usually employed in stimulating the fruit ripening process. Currently, there is a paucity of information regarding the effects of various artificial fruits ripening methods on the health status of consumers. In this study, the physiological effects and possible health hazards associated with the consumption of plantain ripened by CaC2 and other non-chemical methods on the kidneys were investigated. Methods: Artificially ripened plantain was mixed with rat feed and fed to Wistar albino rats for four weeks, and the levels of plasma electrolytes (Na+, HCO3−, K+, and Cl−), urea, creatinine, as well as histological changes in the kidneys were determined. Results: Results indicated that rats fed with carbide-ripened plantain had a significantly high level of plasma bicarbonate (HCO3−) compared to control rats., but there was no difference in the level of plasma sodium (Na+). However, the levels of plasma potassium (K+) and chloride (Cl−) were significantly low in rats fed with CaC2-ripened plantain as compared to the control rats. Furthermore, the levels of urea and creatinine were significantly high in rats fed with CaC2-ripened plantain compared to the control animals. Histological analyses showed glomeruli atrophy and tubular necrosis in kidneys of rats fed with CaC2-ripened plantain, thereby further indicating toxicity to the kidneys. Conclusions: Histological evidence and alterations in the level of the plasma electrolytes, urea, and creatinine suggest that consumption of fruits ripened with calcium carbide may be harmful to the kidneys.

Resumo Introdução: Agentes de maturação artificial como etanol, etileno, etefon e carbureto de cálcio (CaC2) são comumente empregados para estimular o amadurecimento de frutas. Atualmente, há uma escassez de informações a respeito dos efeitos de diversos métodos artificiais de maturação de frutas no estado de saúde dos consumidores. Neste estudo, investigaram-se os efeitos fisiológicos e possíveis riscos à saúde associados ao consumo de plátano maturado por CaC2 e outros métodos não químicos nos rins. Métodos: O plátano artificialmente amadurecido foi misturado com ração de rato e fornecido a ratos albinos Wistar por quatro semanas, e determinaram-se os níveis de eletrólitos plasmáticos (Na+, HCO3−, K+, e Cl−), ureia, creatinina, bem como alterações histológicas nos rins. Resultados: Ratos alimentados com plátano amadurecido com carbureto apresentaram um nível significativamente maior de bicarbonato plasmático (HCO3−) em comparação com ratos controle, mas não houve diferença no nível plasmático de sódio (Na+). Entretanto, os níveis plasmáticos de potássio (K+) e cloreto (Cl−) foram significativamente baixos em ratos alimentados com plátano maturado com CaC2 comparados com ratos controle. Além disso, os níveis de ureia e creatinina foram significativamente mais elevados em ratos alimentados com plátano amadurecido com CaC2, em comparação com os animais controle. Análises histológicas mostraram atrofia glomerular e necrose tubular em rins de ratos alimentados com plátano amadurecido com CaC2, indicando assim ainda mais toxicidade aos rins. Conclusões: Evidências histológicas e alterações nos eletrólitos plasmáticos, ureia e creatinina sugerem que o consumo de frutas amadurecidas com carbureto de cálcio pode ser prejudicial aos rins.

Calidad de frutos de pitahaya (Selenicereus mega/anthus Haw.) sometidos a diferentes recubrimientos durante el almacenamiento

R E S U M E N La pitahaya amarilla es susceptible a los daños mecánicos durante la vida en anaquel, lo que genera pérdidas económicas considerables, las cuales se pueden mitigar a través de la aplicación de ceras. Por lo anterior se evaluó el efecto de recubrimientos comestibles en la calidad poscosecha de frutos de pitahaya amarilla con el fin de mantener la calidad por más tiempo. Se empleó un diseño de tres tratamientos completamente aleatorizados (cerabrix, cera natural y testigo sin aplicación). Las aplicaciones de ceras en los frutos de pitahaya disminuyeron la pérdida de masa (PM) en promedio en un 21% durante el almacenamiento, especialmente el recubrimiento con cerabrix. La firmeza de los frutos disminuyó drásticamente a partir de los seis días después de cosecha (ddc), al pasar de 5I,2 a 7,3 N. Durante la poscosecha, los frutos de pitahaya mostraron un aumento en la intensidad respiratoria (IR) al pasar de 10,48 a 26,35 mg.kg-I.hI de CO2, además, el pH aumentó de 4,I3 a 5,I7, mientras que los los sólidos solubles totales (SST), la acidez total titulable (ATT) y la relación de madurez (RM) disminuyeron, no obstante, la aplicación de cerabrix mantuvo los valores más bajos de sólidos solubles totales (SST). Los frutos con aplicación de recubrimiento comestible presentaron al final del almacenamiento menores valores de luminosidad (L* = 62,6) con una tonalidad más oscura que los frutos sin aplicación (L*= 66,4), los cuales mantuvieron el color amarillo característico de la pitahaya. La aplicación de recubrimientos comestibles no afectó las características organolépticas de los frutos de pitahaya.

Yellow pitahaya is very susceptible to mechanical damage during shelf life, which generates considerable economic losses, which can be mitigated through the application of coats. Therefore, the effect of edible coatings on the postharvest quality of yellow pitahaya fruits was evaluated in order to maintain quality for longer. A completely randomized three-treatment design was used (cerabrix, natural wax and control without application) was used. Wax applications in pitahaya fruits decreased PM by an average of 2I% during storage, especially the cerabrix coating. The firmness of the fruits decreased drastically from six days after harvest, when going from 5I.2 to 7.3 N. During the postharvest, the pitahaya fruits showed an increase in IR when going from I0.48 to 26.35 mg.kg-I.hI of CO2, in addition, the pH increased from 4.I3 to 5.I7, while the TSS, TTA and MI decreased, however, the application of cerabrix maintained the lowest values of TSS. Fruits with edible coating application showed lower luminosity values at the end of storage (L* = 62.6) with a darker hue than fruits without application (L*= 66.4), which maintained the characteristic yellow color of the pitahaya. The application of edible coatings did not affect the organoleptic characteristics of pitahaya fruits.

A pitaia amarela é muito suscetível a danos mecânicos durante a vida de prateleira, o que gera perdas econômicas consideráveis, que podem ser mitigadas com a aplicação de demãos. Portanto, avaliou-se o efeito de revestimentos comestíveis na qualidade pós-colheita de frutos de pitaia amarela, a fim de manter a qualidade por mais tempo. Um desenho de três tratamentos completamente randomizado foi usado. (cerabrix, cera natural e controle sem aplicação). A aplicação de cera em frutos de pitaia reduziu o PM em média 21% durante o armazenamento, principalmente o revestimento de cerabrix. A firmeza dos frutos diminuiu drasticamente após seis dias após a colheita, ao passar de 5I,2 para 7,3 N. Durante a pós-colheita, os frutos de pitaia apresentaram aumento da IR ao passar de I0,48 para 26,35 mg.kg-I.hI de CO2, além disso, o pH aumentou de 4,I3 para 5,I7, enquanto o TSS, TTA e MI diminuíram, porém, a aplicação de cerabrix manteve os menores valores de TSS. Frutos com aplicação de revestimento comestível apresentaram menores valores de luminosidade ao final do armazenamento (L* = 62,6) com tonalidade mais escura do que frutos sem aplicação (L*= 66,4), que mantiveram a coloração amarela característica da pitaia. A aplicação de coberturas comestíveis não afetou as características organolépticas dos frutos de pitaiaia.

Randomized and controlled trial to determine safety and efficacy of Foley’s catheter and PGE2 gel for induction of labor

Background: The goal of obstetrics is a pregnancy that results in a healthy infant and a healthy mother. During medical or obstetrics complications of pregnancy, cervical ripening and induction of labor are often required. Different methods are available for that. Aims and Objectives: Randomized and control trial has been conducted to determine safety and efficacy of Foley’s catheter and prostaglandin E2 (PGE2) gel for induction of labor. Materials and Methods: Randomized and controlled trial has been conducted on 200 study participant who fullfield inclusion criteria in Department of Obstetrics and Gynaecology, GMERS Medical College, Sola during the period of July 2017–July 2019. Statistical analysis was done by descriptive statistics and qualitative method. Results: Both groups cerviprim and Foley’s catheter are comparable for cervical ripening for induction of labor in terms of safety and efficacy as there was no statistically significant observation for obstetric and perinatal outcome. Conclusion: Foley’s catheter is equally dependable method for cervical ripening for induction of labor as cerviprim gel as it is cost effective and easily available.

Cervical ripening and induction of labor: Interpretation of 2023 Society of Obstetricians and Gynaecologists of Canada clinical practice guideline / 中华围产医学杂志

In January 2023, the Society of Obstetricians and Gynaecologists of Canada (SOGC) released the guidelines "Cervical Ripening and Induction of Labour" based on the latest research results and evidence-based evidence, which are divided into three parts: General, Cervical Ripening and Induction of Labour, detailing the indications and methods of cervical ripening and induction of labor. This article highlights the main update points in the guideline. The SOGC Induction Guideline emphasizes the individualization of induction and the importance of respecting patients' choices and providing humane care. The guideline also recommends to confirm gestational age according to the ultrasound examination at 8-12 weeks and inducing labor for pregnant women aged 40 and above at or after 39 weeks. In terms of cervical ripening, both balloon catheters and prostaglandin preparations are effective, with balloon catheters being suitable for women with scarred uterus who require vaginal delivery. Balloon catheters and prostaglandin E 2 suppositories can be used for outpatient cervical ripening. Misoprostol and prostaglandin E 2 preparations can be used for both cervical ripening and labor induction. Low-dose oral misoprostol is safe and effective, while misoprostol solution is easier to administer accurately.If cervical ripening is prolonged, the process of cervical ripening can be interrupted if the mother and fetus are safe.

VIGS Silencing SlWRKY53b Gene Inhibits Tomato Fruit Ripening / 中国生物化学与分子生物学报

Tomato (Solarium lycopersicum) is one of the most popular vegetables worldwide and is a classic model plant for studying fruit development and ripening due to its short growth cycle, clear genetic background and ease of molecular manipulation. This paper used virus-induced gene silencing (VIGS) to construct SlWRKY53b gene-silenced tomato fruits and analyzed the effect of SIWRKY531) gene silencing in the tomato fruit ripening process. We found that transient silencing of SIWRKY531) resulted indelayed in-broken color, higher chlorophyll contents (P<0.05) and reduced carotenoid contents (P<0.05) in tomato fruits, and color difference results indicated that the differences in L *, a * and b * values were consistent with fruit color changes. Further studies showed that genes significantly down-regulated (P<0.01) in SIWRKY531) gene-silenced tomato fruits include the chlorophyll degradation-related genes (AFCl, PAO, PPH, SGR1), carotenoid synthesis-related genes (PSYl, PDS, ZDS), ethylene synthesis pathway-related genes (ACOl, ACS2, NOR, AC03, EA, RIN), and cell wall degradation-related genes (PG, EXP, CELT.). Correlation analysis showed that the expression of SlWRKY53b was negatively correlated with chlorophyll contents and positively correlated with carotenoid contents and the expression of maturation-related genes. These results suggest that inhibition of SIWRKY531) expression at the transcrip-tional level can achieve the effect of delaying tomato fruit ripening, indicating that S1WRKY531) plays arole as a facilitator in the tomato fruit ripening process.

A Critical Review on Physiological Changes during Growth Maturation and Ripening of Citrus Fruits

Citrus is one of the major fruit crops in the world and widely recognized by their nutritional, organoleptic and health-related benefits of fresh fruit. The genetic diversity among the genus and independent changes in peel and pulp, make the definition of standard maturity indexes of fruit quality. Commercial maturity indexes in the citrus industry are usually based on peel coloration, soluble solids, pH but their relevance may differ among varieties and the specific requirements of the markets. Citrus fruits are excellent source of many phytochemical, including ascorbic acid, antioxidant, tannin, etc., which greatly contribute to the health-related benefits of citrus fruits. Criteria and definition of the main maturity indexes for citrus fruit worldwide are described, as well as changes during fruit maturation in key components affecting organoleptic and nutritional properties. Citrus fruits were analyzed at different maturity stages. This review is aimed to characterize the physiological maturity of the fruit across the different developmental stage which has not been well reported in literature till now.

Effects of Calcium Carbide Used as a Fruit-Ripening Agent on Fruit Toxicity

Aims: To provide a comprehensive summary of what has been published about the effects of calcium carbide (CaC2) as a fruit-ripening agent and to determine the necessity or not to develop awareness among government agencies, policymakers, farmers, vendors, and scientists in order to best address different aspects of artificial fruit ripening issues and to provide more profitable solutions for global health preservation. Methodology: Scientific information about the effects of CaC2 published elsewhere was reviewed. Online databases of scientific journals which include Wiley Online Library, Science Direct, PubMed, CAS, CABI, AJOL and Google Scholar were used to select valuable studies. Results: Most studies have reported the hazardous potential of CaC2 as a ripening agent. Among other potential effects that were discovered through laboratory investigations are the adulteration of nutritional values of ripened fruits and direct or indirect toxicity in studied living systems such as genotoxicity and cytotoxicity to dividing cells, increase of the cellular oxidative stress, disturbance of the redox balance of the cell, estrogenic disruptions, increase of the white blood cells and Lymphocytes, alteration of hematopoiesis, alteration of sperm cells, a decrease of the fertility rate, weakness of the immune system, etc.). Conclusion: Overall, this review provides comprehensive information on what is known about the effects of CaC2 and showed the necessity to discourage its application as an artificial fruit ripening agent through the establishment of laws and regulations for better control of its use in most developing countries.

A Comparison of Misoprostol and Dinoprostone Gel for Induction and Cervical Ripening

Introduction: Labour induction at term is a universal conventional obstetric interference with an objective to stimulate uterine contractions artificially to attain a spontaneous vaginal delivery. The current study was aimed to compare the efficacy and safety profile of low dose vaginal Misoprostol with Dinoprostone gel for induction of labour in term pregnancies with unfavorable cervix and intact membranes. Methodology: This Randomized Controlled Trial was conducted among pregnant women with term pregnancy with obstetrical or medical indication for induction of labour after institutional ethical committee approval. A detailed history, complete physical examination and investigations were done for all patients. Result: Misoprostol and Dinoprostone gel are equally effective inducing agents. Both are equally effective in Primigravida and Multigravida. Failure of induction rate for Misoprostol and Dinoprostone was statistically not significant. The need of Oxytocin augmentation, maternal complication rate, NICU admission rate, caesarean section rate and occurrence of meconium-stained liquor are statistically not significant in both the study groups. Our study was unable to demonstrate superiority of any single drug compared to other. Only the difference is cost, induction with Conclusion: considering the easy to preserve and administer, we recommend use of Misoprostol as a safe, effective, cheaper, and more convenient drug for induction of labour.

Bioactive compounds and physical-chemical characteristics of two genotypes of peach trees submitted to nitrogen fertilization

Nitrogen, which is the primary nutrient peach trees need, may affect their fruit quality. Thus, this study aimed at evaluating the effect of nitrogen fertilization on two genotypes of peach trees, regarding their fruit quality, in three consecutive crops. The experiment was carried out in the experimental area that belongs to the Embrapa Clima Temperado, located in Pelotas, Rio Grande do Sul (RS), Brazil, from 2016, 2016, 2017 and 2018. Four doses of nitrogen (0, 60, 120 and 180 Kg ha-1) and two peach tree genotypes ('Cascata 1513' and 'Cascata 1067') were used. For the fruit, we evaluated epidermis color, pulp firmness, epidermis firmness, soluble solids concentration, titratable acidity, concentration of total phenolic compounds, anthocyanins and antioxidant activity. Fruit underwent physical, chemical and bioactive compound analyses. Results showed that the highest dose of nitrogen (180 Kg ha-1) applied to the soil retards fruit ripening, while no application of nitrogen fertilization brings fruit maturation forward. Nitrogen fertilization via soil does not favor anthocyanins in fruit. Doses of 60 and 120 Kg ha-1 of nitrogen are recommended because they lead to improvement in peach color, epidermis firmness and acidity. Peach tree genotypes influence soluble solids, juice pH, phenolic compounds and antioxidant activity of their fruit.