Development of risk prediction nomogram for neonatal sepsis in Group B Streptococcus-colonized mothers: a retrospective study.

Neonatal clinical sepsis is recognized as a significant health problem, This study sought to identify a predictive model of risk factors for clinical neonatal sepsis. A retrospective study was conducted from 1 October 2018 to 31 March 2023 in a large tertiary hospital in China. Neonates were divided into patients and controls based on the occurrence of neonatal sepsis. A multivariable model was used to determine risk factors and construct models.The utilization and assessment of model presentation were conducted using Norman charts and web calculators, with a focus on model differentiation, calibration, and clinical applicability (DCA). Furthermore, the hospital's data from 1 April 2023 to 1 January 2024 was utilized for internal validation. In the modelling dataset, a total of 339 pairs of mothers and their newborns were included in the study and divided into two groups: patients (n = 84, 24.78%) and controls (n = 255, 75.22%). Logistic regression analysis was performed to examine the relationship between various factors and outcome. The results showed that maternal age < 26 years (odds ratio [OR] = 2.16, 95% confidence interval [CI] 1.06-4.42, p = 0.034), maternal gestational diabetes (OR = 2.17, 95% CI 1.11-4.27, p = 0.024), forceps assisted delivery (OR = 3.76, 95% CI 1.72-5.21, p = 0.032), umbilical cord winding (OR = 1.75, 95% CI 1.32-2.67, p = 0.041) and male neonatal sex (OR = 1.59, 95% CI 1.00-2.62, p = 0.050) were identified as independent factors influencing the outcome of neonatal clinical sepsis. A main effects model was developed incorporating these five significant factors, resulting in an area under the curve (AUC) value of 0.713 (95% CI 0.635-0.773) for predicting the occurrence of neonatal clinical sepsis. In the internal validation cohort, the AUC value of the model was 0.711, with a 95% CI of 0.592-0.808. A main effects model incorporating the five significant factors was constructed to help healthcare professionals make informed decisions and improve clinical outcomes.

Astragaloside IV attenuates cardiac hypertrophy in rats born from mothers with intrauterine hypoxia through the PKCßII/Egr­1 pathway.

Astragaloside IV (AS-IV) is a naturally occurring agent that confers several wide-ranging reported pharmacological effects, such as cardioprotective, antioxidative and pro-angiogenic activities. Although it was previously reported that AS-IV could attenuate neonatal rat myocardial ischemia-reperfusion injury, the possible effects of AS-IV on the development of cardiac hypertrophy associated with intrauterine hypoxia (IUH) remain unclear. The present study established a model of IHU by placing the pregnant rats in a plexiglass chamber with an oxygen supply of 10% before neonatal rat delivery. To investigate the in vivo effect of AS-IV on cardiac hypertrophy, neonatal rats with hypertension were randomly grouped to receive AS-IV (20 mg/kg), AS-IV (40 mg/kg), AS-IV (80 mg/kg) or vehicle for 12 weeks, followed by left ventricular (LV) hemodynamics and heart tissue histological analysis. Rats born from mothers with IHU displayed pathological features of cardiac hypertrophy. However, AS-IV 40 and 80 mg/kg significantly decreased the heart/body weight (BW), LV mass (LVM)/BW, heart mass/tibia length (TL) and LVM/TL ratios. H&E staining showed that 40 and 80 mg/kg AS-IV prevented the morphometric changes induced by IHU. According to data from LV hemodynamics measurements, AS-IV 80 mg/kg reversed the increased systolic blood pressure, diastolic blood pressure, LV systolic pressure, LV end-diastolic pressure, dP/dt maximum and heart rate induced by IHU. Mechanistically, ERK1/2 activation and early growth response 1 (Egr-1) protein expression were both upregulated by IHU induction, which was reversed by AS-IV treatment. In conclusion, these data suggested that AS-IV could attenuate cardiac hypertrophy in neonatal rats born from mothers with IHU through the protein kinase C ß type isoform 2/Egr-1 pathway, but the underlying mechanism requires further investigation.

[Occurrence Relationship Between Microplastics and Heavy Metals Pollutants in the Estuarine Sediments of Poyang Lake and the Yangtze River].

Heavy metals are typical pollutants in the environment and microplastics are relatively newly recognized environmental pollutants, with their coexistence potentially compounding pollution and ecological risks. In this study, we investigate the contents and morphological characteristics of microplastics and heavy metals (Cu, Cd, Pb, Zn, and Cr) in the estuarine sediments of Poyang Lake and the Yangtze River as a means of exploring the relationship between them. The results showed that the abundance of microplastics ranged from 356 n·kg-1 to 1452 n·kg-1, with an average abundance of 982.33 n·kg-1 in the dry sediments. Microplastics were identified as being of three main types:fragments, fibers, and films, whereby fragments were the most dominant type found and accounted for 48.23% of the total microplastics in the sediments. The main color of microplastics in the sediments was chromatic, and the particle size of most microplastics was<1 mm. The major polymer components were polyethylene (PE), low density polyethylene (LDPE), and polyethylene (PP). Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDS) results indicated that the surfaces of microplastics were rough, porous, cracked, and torn, and that the five heavy metals were found on the surfaces of different microplastics. These heavy metals accumulated to different degrees in the estuarine sediments, and redundancy analysis indicated that environmental factors[including the total organic carbon (TOC), pH, electrical conductivity (EC), and sediment particle size] and the occurrence of microplastics all had significant (P<0.05) effects on the distribution of heavy metal concentrations in sediments. Variation partitioning analysis (VPA) showed that the contribution rates of environmental factors and microplastics to the bioavailability of heavy metals were 37.70% and 0.70% respectively, but the combined effect was 49.60%. We conclude that microplastics in sediments may act as carriers of heavy metals and activate their bioavailability, hence posing a potential threat to the ecological security of estuaries and wetlands.

Factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation: a retrospective case study in Southeast China.

OBJECTIVE: The aim of this study was to evaluate factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation (CCM). DESIGN: A 3-year retrospective study was undertaken between January 2013 and December 2015 in four centres in China. SETTING: This involved a retrospective chart review of paediatric patients with CCM in four large hospitals in Southeast China. PARTICIPANTS: Sixty-five paediatric patients with CCM were included in this study. We derived all available information on patient demographics, clinical characteristics, preoperative complications and surgical methods from the charts of all these patients. INTERVENTIONS: Univariate and multivariate logistic regression analyses were used to evaluate factors significantly affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM. RESULTS: Twenty-three of the 65 case surgeries were performed using laparoscopic technique, and 42 surgeries were performed by conventional open surgery. The median operating time was 215 min (range 120-430 min). The morphological subtype of CCM and the presence of cholecystitis or cholangitis were the only factors found to affect the operating time (p<0.05). Logistic regression analysis confirmed cholangitis as an independent risk factor. CONCLUSIONS: The morphological subtype of CMM and the presence of cholecystitis or cholangitis are factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM, whereas cholangitis is an independent risk factor.