Targeting PTGES/PGE2 axis enhances sensitivity of colorectal cancer cells to 5-fluorouracil.

Insensitivity and resistance to 5-fluorouracil (5FU) remain as major hurdles for effective and durable 5FU-based chemotherapy in colorectal cancer (CRC) patients. In this study, we identified prostaglandin E synthase (PTGES)/prostaglandin E2 (PGE2) axis as an important regulator for 5FU sensitivity in CRC cells. We found that PTGES expression and PGE2 production are elevated in CRC cells in comparison to normal colorectal epithelial cells. Depletion of PTGES significantly enhanced the inhibitory effect of 5FU on CRC cell viability that was fully reverted by exogenous supplement of PGE2. Inhibition of PTGES enzymatic function, by either inducing loss-of-function mutant or treatment with selective inhibitors, phenocopied the PTGES depletion in terms of 5FU sensitization. Mechanistically, PTGES/PGE2 axis modulates glycolysis in CRC cells, thereby regulating the 5FU sensitivity. Importantly, high PTGES expression is correlated with poor prognosis in 5FU-treated CRC patients. Thus, our study defines PTGES/PGE2 axis as a novel therapeutic target for enhancing the efficacy of 5FU-based chemotherapy in CRC.

Simple high-performance liquid chromatography-ultraviolet method for simultaneous separation and detection of 14 bisphenol pollutants in building materials.

A high-performance liquid chromatography-ultraviolet method was developed for rapidly and simultaneously analyzing novel and typical bisphenols in building materials, including bisphenol S, diphenolic acid, bisphenol F, bisphenol E, bisphenol A, bisphenol B, bisphenol AF, bisphenol AP, bisphenol C, bisphenol FL, bisphenol Z, bisphenol BP, bisphenol M, and bisphenol P. By using a Kromasil 100-5 C18 column, these bisphenols were completely separated in 40 min via gradually increasing the concentration of methanol in the mobile phase from 45 to 80% during the elution process. In particular, this method achieved the synchronous analysis of bisphenol S, diphenolic acid, bisphenol FL, bisphenol BP, and bisphenol M through HPLC, which were difficult to separate and had to be identified and detected through mass spectrometry. The limits of detection of the method ranged from 0.002 to 0.040 mg/L for these 14 bisphenols, with a precision of less than 4.9% (n = 7, c = 0.05 mg/L). The analytical results for five types of building materials (phenolic, epoxy, polycarbonate, polyester, and polysulfone resins) indicated that the proposed method is appropriated for the rapid measurement of bisphenols in real samples.

Risk of gestational diabetes recurrence and the development of type 2 diabetes among women with a history of gestational diabetes and risk factors: a study among 18 clinical centers in China / 中华医学杂志(英文版)

BACKGROUND@#Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China.@*METHODS@#A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed.@*RESULTS@#In 6204 participants, there are 1002 women (1002/6204,16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P  < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P  = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P  = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P  = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P  = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further.@*CONCLUSIONS@#The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.

The effect of phacoemulsification through corneoscleral incision on cataract patients with type 2 diabetes mellitus / 中国医师杂志

Objective:To explore the effect of phacoemulsification through corneoscleral incision on cataract patients with type 2 diabetes mellitus.Methods:A prospective case-control study was conducted to collect cataract patients with type 2 diabetes who were admitted to the First Hospital of Hebei Medical University from January 2018 to June 2019. All patients were treated with phacoemulsification. They were randomly divided into three groups: 40 cases (68 eyes) of corneoscleral incision, 40 cases (66 eyes) of upper transparent corneal incision and 40 cases (70 eyes) of temporal transparent corneal incision. The dry eye symptom scale score, corneal fluorescein staining (FL) score, tear rupture time (BUT) and Schirmer I test (SIt) were compared in three groups; The levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in aqueous humor were compared among the three groups before and 7 days after operation.Results:⑴ The levels of IL-6 and IL-8 in aqueous humor of the three groups were significantly lower than those before operation, especially in group A ( P<0.05), but there was no significant difference in the levels of IL-6 and IL-8 in aqueous humor of group B and C ( P>0.05); ⑵ The scores of dry eye symptoms in group B were significantly higher than those in group A at 1 and 7 days after operation ( P<0.05); The scores of dry eye symptoms in group C were significantly higher than those in group A and B at 1, 7 and 30 days after operation ( P<0.05); The dry eye symptom score in group A and B decreased to the preoperative level 30 days after operation ( P>0.05), and that in group C decreased to the preoperative level 90 days after operation ( P>0.05); ⑶ The postoperative 1, 7 and 30 d BUT in group A and C were significantly higher than those in group B ( P<0.05), and the level of SIt was significantly lower than that in group B ( P<0.05); At 1 and 7 days after operation, SIt in group A was significantly lower than that in group C ( P<0.05); the FLS score in group A and C was significantly lower than that in group B at 1 and 7 days after operation ( P<0.05). Conclusions:The incision of corneoscleral margin has little effect on tear film stability and ocular surface function of cataract patients with type 2 diabetes mellitus treated by phacoemulsification, which is worthy of clinical recommendation.

Comparison of clinical efficacy of three different cataract incision phacoemulsification for cataract patients with type 2 diabetes mellitus / 中国医师杂志

Objective:To compare and study the clinical efficacy of three different phacoemulsification incisions for cataract patients with type 2 diabetes mellitus.Methods:A retrospective analysis was performed in 120 patients (198 eyes) with type 2 diabetes cataract who underwent cataract extraction and intraocular lens implantation from January 2018 to June 2019 in the First hospital of Hebei Medical University. According to the surgical incision, the patients were divided into three groups: A group (the cornea scleral marginal incision, 40 cases, 72 eyes), B group (the clear corneal incision at the top , 40 cases, 66 eyes), C group (underwent temporal clear corneal incision, 40 cases, 60 eyes). The corneal perception, dry eye symptoms, basic tear secretion test (SIt), tear film rupture time (BUT), corneal fluorescein staining (FL) and complications were compared among the three groups before and after treatment.Results:The corneal perception of B group and C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05); The scores of dry eye symptoms in C group were higher than those in A group and B group on 1 d, 7 d and 30 d after operation ( P<0.05), and the scores of dry eye symptoms in B group were higher than those in A group on 1 d and 7 d after operation ( P<0.05); The SIt value of C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05), and that of B group was lower than that of A group and group C on 1 d, 7 d and 30 d after operation ( P<0.05); The BUT value of C group was lower than that of A group at 1 d and 7 d after operation ( P<0.05), and the BUT value of B group was lower than that of A group and C group at 1 d, 7 d and 30 d after operation ( P<0.05); The FL value between A group and C group at 1 d, 7 d, 30 d and 90 d after treatment was not significant ( P>0.05). The FL value of B group returned to the level before treatment at 30 d after operation, and the FL value of B group was higher than that of A group and C group at 1 d and 7 d after operation ( P<0.05); There was little difference in the incidence of complications among the three groups ( P>0.05). Conclusions:The cornea scleral marginal incision can reduce the tear secretion, maintain the stability of tear film, and is more suitable for cataract patients with type 2 diabetes mellitus. It is worthy of further promotion in clinic.

Effects of interpregnancy interval on pregnancy outcomes of subsequent pregnancy: a multicenter retrospective study / 中华妇产科杂志

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

Influencing factors of macrosomia in second term singleton pregnancy / 中华围产医学杂志

Objective To explore the characteristics of neonatal birth weight (BW) in two consecutive term singleton pregnant women and to investigate the influencing factors of macrosomia in the second birth.Methods In this case-control study,medical records of 1 920 singleton full-term pregnant women who gave birth twice in Peking University First Hospital from January 2005 to December 2017 were reviewed.All subjects were divided into two groups according to neonatal BW at the second birth regardless of the first one:macrosomia group (n=122) and non-macrosomia group (n=l 798).Then,those two groups were further divided into four sub-groups based on the neonatal BW in the first birth:macrosomia at both deliveries (n=27),macrosomia at the second time and non-macrosomia at the first time (n=95),non-macrosomia at the second time and macrosomia at the first time (n=90) and non-macrosomia at both deliveries (n=l 708).The differences of delivery interval,and the maternal age,pre-pregnancy body mass index (BMI),weight gain during pregnancy,area under the curve of oral glucose tolerance test results,weight retention,the incidence of diabetes in pregnancy (including gestational diabetes mellitus and diabetes mellitus complicated with pregnancy),incidence of hypertensive disorders during pregnancy and cesarean section rate at the second pregnancy between the groups and sub-groups were compared with t-test,Chi-square test and logistic regression analysis.Results (1) The total average neonatal BW in the second pregnancy was higher than that in the first [(3 443 ± 378) vs (3 403 ± 396) g,t=-4.119,P＜0.001].However,the proportion of macrosomia in each group was similar [6.4％ (122/ 1 920) vs 6.1％ (117/1 920),x2=3.237,P=0.198].The pre-pregnancy BMI,weight gain during pregnancy and proportion of previous macrosomia in the macrosomia group were significantly higher than those in non-macrosomia group [(23.6±3.4) vs (22.7±3.1) kg/m2,t=-2.882,P=0.004;(13.4±5.0) vs (12.4± 4.1) kg,t=-2.522,P=0.037;22.1％ (27/122) vs 5.0％ (90/1 798),x2=58.554,P＜0.001].Logistic regression analysis showed that previous macrosomia (OR=4.979,95％CI:3.052-8.122,P＜0.001),pre-pregnancy BMI (OR=1.084,95％CI:1.023-1.149,P=0.001) and weight gain during pregnancy (OR=1.077,95％CI:1.031-1.125,P=0.007) were influencing factors for macrosomia in the index delivery.(2) The pre-pregnancy BMI in the subgroup of macrosomia at both deliveries was significantly higher comparing to the subgroup of non-macrosomia at the second time and macrosomia at the first time [(25.8±4.3) vs (23.9±2.9) kg/m2,t=-2.600,P=0.011].Women in the subgroup of macrosomia at the second time and non-macrosomia at the first time had higher weight gain during second pregnancy than the subgroup of non-macrosomia at both deliveries [(13.5 ± 4.2) vs (12.5 ±4.1) kg,t=-2.404,P=0.016].Conclusions For two consecutive term singleton pregnancies,the average neonatal BW in the second time is slightly higher than that in the first,but the incidence of macrosomia is similar.Pre-pregnancy BMI,weight gain during pregnancy and macrosomia in the first birth are influencing factors for macrosomia in the second pregnancy.More attention should be paid to pre-pregnancy BMI reduction in women with history of macrosomia.For women without a history of macrosomia,weight management should be emphasized during the second pregnancy.

Gas-phase alkyl and N-alkylamino cation affinities of anionic alpha-oxygen nucleophiles (H n XO-; X = N, P, As, O, S, Se, F, Cl, Br; n = 0-2): a theoretical G2(+)M study.

In this work, we studied anionic alpha-oxygen nucleophiles in which there was an atom of with one or more unshared lone-pair electrons from groups 15-17 and periods 2-4 of the periodic table positioned adjacent to the negative attacking-oxygen (i.e., H n XO-; X = N, P, As, O, S, Se, F, Cl, Br; n = 0-2); these nucleophiles were termed "alpha-agents." Specifically, we investigated the gas-phase simple alkyl cation affinities (ACAs) and the simple N-alkylamino cation affinities (NAAMCAs) of these alpha-agents theoretically via the modified G2(+)M method. Our calculations indicate that the O-C bond of CH3OXH n is somewhat similar to that of iPrOXH n (n = 0, 1, 2; X = N, P, As, O, S, Se, F, Cl, Br). Also, steric repulsion is an important influence on these cation affinities. It appears that the kinetic gas-phase alpha effect in the SN2 reactions of interest cannot be explained by the thermodynamic proton affinity or the affinity (SuA) of the anionic or neutral nucleophile (Nu) for the substrate cation, as the gas-phase ACA (NAAMCA) was found to be linearly correlated with the PA for the alpha-agents, similar to the previously reported linear correlation of the gas-phase ACA (NAAMCA) with the PA for normal nucleophiles.

Development of a diagnosis model for coronary artery disease.

BACKGROUND: The purpose of this study was to develop a coronary artery disease (CAD) prediction model that optimally estimates the pre-test probability of CAD for patients suspected of CAD. METHODS AND RESULTS: This retrospective, multi-centre study included 7360 consecutive patients (4678 men, 57.87±11.42 years old; 2682 women, 61.60±9.58 years old) who underwent coronary angiography for evaluation of CAD. A prediction model was fitted for diagnosis of CAD with the help of eight significant risk factors including sex, age, smoking status, diabetes, hypertension, dyslipidaemia, serum creatinine and angina. All potential predictors were significantly associated with the presence of CAD. The prevalence of CAD was significantly higher in men than in women. The clinical model gives a relatively accurate prediction of CAD with an area under the curve (AUC) of 0.74 (95% CI, 0.88-0.96; P<0.001). Addition of angina to the prediction model improves the predictive precision of the model. The optimal cut-off for predicting CAD in this model was 0.79 with a sensitivity of 0.658 and a specificity of 0.709. CONCLUSION: A prediction model including age, sex, and cardiovascular risk factors allow for an accurate estimation of the pre-test probability of coronary artery disease in Chinese populations. This algorithm may be useful in making decisions relating to the diagnosis of CAD.

Chondroitinase with adipose-derived mesenchymal stem cell transplantation:a therapeutic strategy for retinal degeneration in rats / 中国组织工程研究

BACKGROUND: Studies have found that chondroitin sulfate proteoglycans degradation with chondroitinase canpromote the migration of Müller cells on the retina, but whether it could promote the migration of adipose-derivedmesenchymal stem cells in retinal degeneration rats is unclear.OBJECTIVE: To investigate the effect of chondroitin sulfate proteoglycans degradation with chondroitinase on adipose-derived mesenchymal stem cell treatment for retinal degeneration in rats.METHODS: Human adipose-derived mesenchymal stem cells were isolated and cultured. A retinal degeneration ratmodel was established followed by administration of adipose-derived mesenchymal stem cells+chondroitinase into thesubretinal space. The migration of adipose-derived mesenchymal stem cells and retinal cell apoptosis in rats aftertransplantation were observed.RESULTS AND CONCLUSION: The human adipose-derived mesenchymal stem cells could be successfully cultured.The labeling rate of BrdU to the human adipose-derived mesenchymal stem cells was more than 90.0%. At 7 days aftermodeling, the outer nuclear layer of the retina was collapsed, and a large amount of photoreceptor cells were dissected.The outer nuclear layer was attached to the Bruch''s membrane, and the retina was arched. The central retina andperipheral retina were damaged. In normal rats, the retinal layers were clear, and the photoreceptor cells arrangedregularly; and the retinal pigment epithelium was complete. The migration rate of adipose-derived mesenchymal stemcells in adipose-derived mesenchymal stem cells+chondroitinase group was higher than that in adipose-derivedmesenchymal stem cells group (P 0.05). These experimental findings show that chondroitin sulfate proteoglycans degradationwith chondroitinase can enhance the migration ability of human adipose-derived mesenchymal stem cells on the retina.

Cesarean Section Rate in Singleton Primiparae and Related Factors in Beijing, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The cesarean section rate (CSR) has been a main concern worldwide. The present study aimed to investigate the CSR in Beijing, China, and to analyze the related factors of CS delivery.</p><p><b>METHODS</b>An observational study was conducted in 15 medical centers in Beijing using a systemic cluster sampling method. In total, 15,194 pregnancies were enrolled in the study between June 20, 2013 and November 30, 2013. Independent t-tests and Pearson's Chi-square test were used to examine differences between two groups, and related factors of the CSR were examined by multivariable logistic regression.</p><p><b>RESULTS</b>The CSR was 41.9% (4471/10,671) in singleton primiparae. Women who were more than 35 years old had a 7.4-fold increased risk of CS delivery compared with women <25 years old (odd ratio [OR] = 7.388, 95% confidence interval [CI] = 5.561-9.816, P < 0.001). Prepregnancy obese women had a 2-fold increased risk of CS delivery compared with prepregnancy normal weight women (OR = 2.058, 95% CI = 1.640-2.584, P < 0.001). The excessive weight gain group had a 1.4-fold increased risk of CS delivery compared with the adequate weight gain group (OR = 1.422, 95% CI = 1.289-1.568, P < 0.001). Gestational diabetes mellitus (GDM) women and DM women had an increased risk of CS delivery (1.2- and 1.7-fold, respectively) compared with normal blood glucose women. Women who were born in rural areas had a lower risk of CS delivery than did those who were born in urban areas (OR = 0.696, 95% CI = 0.625-0.775, P < 0.001). The risk of CS delivery gradually increased with a decreasing education level. Neonates weighing 3000-3499 g had the lowest CSR (36.2%). Neonates weighing <2500 g had a 2-fold increased risk of CS delivery compared with neonates weighing 3000-3499 g (OR = 2.020, 95% CI = 1.537-2.656, P < 0.001). Neonates weighing ≥4500 g had an 8.3-fold increased risk of CS delivery compared with neonates weighing 3000-3499 g (OR = 8.313, 95% CI = 4.436-15.579, P < 0.001).</p><p><b>CONCLUSIONS</b>Maternal age, prepregnancy body mass index, gestational weight gain, blood glucose levels, residence, education level, and singleton fetal birth weight are all factors that might significantly affect the CSR.</p>

[Correlation between cystatin C and properties and features of coronary plague].

OBJECTIVE: To explore the correlation between cystatin C (Cys C) and properties and features of coronary plague using 256-slice coronary computed tomography angiography (CTA). METHODS: From January 2013 to October 2013, a total of 184 patients with suspected coronary artery disease undergoing CTA for coronary artery lesions were enrolled. Based on the results of cystatin C levels, they were divided into normal Cys C concentration group ( ≤ 0.95 mg/L) and high Cys C concentration group (>0.95 mg/L). Based on the results of CTA, they were divided into single-vessel, 2-vessel and 3-vessel groups according to the number of diseased coronary arteries. And they were divided into mild stenosis (<50%), moderate stenosis ( ≥ 50%, <75%) and severe stenosis ( ≥ 75%) groups according to the severity of coronary artery disease. The Hounsfield units were used to determine the soft, fibrous and calcified plaques for assessing the relationship between cystatin C levels and narrow severity score, pathological changes limits, plague properties. RESULTS: There were 95 with normal concentrations of Cys C and 89 with high concentrations of Cys C. A total of 1 112 plaques were detected and those with high concentrations of Cys C showed a higher proportion of non-calcified plaque (13.5% vs 8.8%, P < 0.01) compared with normal group. The proportion of those with 1-vessel disease was lower (22.5% vs 37.9%, P < 0.05) but 3-vessel disease higher (48.3% vs 33.7%, P < 0.05) than in normal group. Multiple Logistic regression analysis revealed that high Cys C was a significant risk factor for multi-vessel disease (OR = 17.483, 95%CI:2.218-143.627; P < 0.01). CONCLUSION: For patients with coronary artery lesions, a high level of Cys C may be associated with severity of coronary atherosclerosis and plaque instability.

Construction of shRNA-Bmi-1 plasmid and its effect on proliferation of ECA109 cells.

OBJECTIVE: To explore the role of Bmi-1 gene in the proliferation of squamous carcinoma cells and whether the silencing Bmi-1 can inhibit the growth of squamous cell carcinomas cells. METHODS: The expressions of Bmi-1 in primary cultured Fibroblasts, karatinocyte cell line Hacat,squamous carcinoma cell line A431, and ECA109 were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis. Recombinant plasmid inserted with Bmi-1 gene short hairpin RNA (shRNA) expression vector PGPU6/GFP/Neo-shBmi-1 was constructed and transfected into ECA109 cells with control set. After transfection for 48 and 72 hours,the mRNA and protein levels of Bmi-1 were examined with RT-PCR and Western blot analysis, respectively. The proliferation of the ECA109 cells was evaluated by MTT method and flow cytometry. RESULTS: Bmi-1 was highly expressed in A431 and ECA109 cells than in Fibroblast cells and Hacat cells. The mRNA and protein expressions of Bmi-1 were significantly silenced in ECA109 cells after recombinant expression vector PGPU6/GFP/Neo-shBmi-1 transfection (P<0.05). Compared with the control groups,the proliferation of ECA109 transfected with PGPU6/GFP/Neo-shBmi-1 was significantly inhibited (P<0.05), and cells in G1 phase increased while in S phase decreased (P<0.05). CONCLUSIONS: Bmi-1 is involved in the proliferation of squamous carcinoma cells. After the silencing of Bmi-1 expression,the proliferation ECA109 cells is suppressed due to the altered cell cycle.

Influence of Cigarette Smoking on Burden and Characteristics of Coronary Artery Plaques in Chinese Men.

BACKGROUND: It is generally well-known that smoking has a substantial impact on general health, and cardiovascular health in particular. The purpose of this study was to analyze the effects of different smoking status on the burden and characteristics of coronary artery plaques in Chinese men. METHODS: Our study enrolled 1920 individuals with suspected coronary artery disease undergoing 256-detector-row computed tomography scan after clinical assessment. These study participants were stratified into three groups: never smoker, current smoker, and former smoker, according to their smoking status. Thereafter, the associations of different smoking status with the coronary artery plaques were assessed using both univariable and multivariable logistic regression. RESULTS: The prevalences of any plaque, significant stenosis and coronary artery calcium score (CACS) ≥ 10 were highest in the current smokers (all p < 0.05). The proportion of calcified plaques was the lowest and the prevalence of non-calcified plaques was the highest in current smokers (p = 0.004). The higher pack-years group had significantly elevated percentages of any plaque, significant stenosis, ≥ 2/LM vessel disease and CACS ≥ 10 than the lower pack-years group (all p < 0.001). The percent of calcified plaques was lower and the percent of non-calcified plaques was higher in the higher (> 20) pack-years group than in the lower pack-years group (≤ 20) (p = 0.024). Current smoking with higher pack-years was the independent risk factor for any plaque, significant stenosis, CACS ≥ 10, non-calcified and mixed plaques (all p < 0.05) after multivariate adjustments. CONCLUSIONS: The current smokers had the most serious burden of coronary artery plaques and the highest percentage of non-calcified plaques. Current smoking with higher pack-years was a significant risk factor for coronary artery plaque burden and non-calcified and mixed plaques. KEY WORDS: Chinese men; Cigarette smoking; Coronary artery calcium score; Coronary artery plaques; Non-calcified plaques.

[Prevalence, severity, characteristics and coronary calcified score of coronary artery plaques are different in women than men with suspected coronary artery disease].

OBJECTIVE: To validate the prevalence, severity, characteristics and coronary calcified score(CACS) of coronary artery plaques in women are different from men. METHODS: A total of 3 752 patients with suspected coronary artery disease in the First Affiliated Hospital of China Medical University were enrolled between September 2011 and December 2013. Patients with suspect CAD underwent 256-detecter coronary computed tomography (CCTA) and CACS measurement were enrolled. The differences of sex-associated coronary artery plaques were assessed. The univariable and multivariable Logistic regression were employ to assess the association female and male with coronary artery plaques. RESULTS: A total of 3 752 patients including 1 832 females and 1 920 males, the average age of the patients was (56 ± 11) years. Women were older and less smoker than men. The prevalences of any plaque, 2-,3-/LM disease and significant/severe stenosis significantly decreased in female than male (all P<0.01). The proportion of non-calcified plaques significantly higher and mixed plaque significantly lower in female than male (all P<0.01). the proportion of women were significantly lower than men in CACS>0 (all P<0.01). The similar tendency also happened in four age-matched female and male subgroups. After adjustment, female was the significant protective factor for significant and severe stenosis, 2- and 3-/LM vessel disease, calcified and mixed plaques, and CACS>100 (all P<0.01); female was the significant protective factor for non-calcified plaques in the univariate analysis (P<0.01). When the age ≥ 65, female became the significant risk factor for coronary artery plaques (all P<0.01). CONCLUSIONS: Women have less prevalence and extensive coronary artery plaques and lower CACS, the plaque characteristics in women is more frequently composed by non-calcified plaques than men, even after matched by age. With age, female change from a protective factor to a risk factor for coronary artery plaques.

A cross-sectional analysis of the relationship between uric acid and coronary atherosclerosis in patients with suspected coronary artery disease in China.

BACKGROUND: Although many studies have examined the relationship between uric acid (UA) and coronary artery disease (CAD), whether UA is an independent risk factor contributing to progression of CAD is still controversial. Whether UA plays a different role in different sexes is also unclear. METHODS: A total of 1116 individuals with suspected CAD were stratified into four groups according to their serum UA quartiles in total (men and women combined), in men, and in women. The association of UA with coronary atherosclerosis was assessed by univariable and multivariable logistic regression. RESULTS: In total and in women, the prevalence of any plaques and significant/severe stenosis was significantly increased with an increase in quartiles of UA (all P < 0.05). The proportion of triple-vessel disease and left main artery lesion was highest in the fourth quartile (both p < 0.05). Increasing quartiles of UA were significantly associated with a coronary artery calcium score (CACS) >10 (all P < 0.01). As UA levels increased in women, the incidence of double-vessel lesions (p = 0.017) and the proportion of mixed plaques (p = 0.022) were significantly increased. The proportion of a CACS of 0 in total, in men and women was highest in the first quartile (all P < 0.01). UA was the strongest predictor of significant stenosis, multivessel disease, and mixed plaques in women (all p < 0.05). UA was the only risk factor for mixed plaques in total (P = 0.046). CONCLUSION: The level of UA was significantly associated with coronary atherosclerosis in women, but not men.