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1.
World Neurosurg ; 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-34062300

RESUMO

OBJECTIVE: Previous studies have shown that deep brain stimulation can improve the levels of consciousness of comatose patients with traumatic brain injuries (TBIs). However, the most suitable targets for deep brain stimulation are unknown, and the mechanisms underlying recovery remain to be determined. The aim of the present study was to assess the effects of lateral hypothalamic area deep brain stimulation (LHA-DBS) in comatose rats with TBIs. METHODS: A total of 55 Sprague-Dawley rats were randomly assigned to 5groups: Control group, TBI group, stimulated (TBI+LHA-DBS) group, antagonist (TBI+SB334867+LHA-DBS) group, and an antagonist control group (TBI+ Saline+ LHA-DBS). Comas were induced using a free fall drop method. Rats with a TBI in the stimulated group received bilateral lateral hypothalamic area stimulation (frequency, 200 Hz; voltage, 2-4 V; pulse width, 0.1 ms) that lasted for 1 h, with 5 min intervals between subsequent stimulations, which were applied alternately to the left and right sides of the lateral hypothalamus. Comatose rats in the antagonist group were intracerebroventricularly injected with an orexins receptor type 1 (OX1R) antagonist(SB334867), and then received LHA-DBS.A I-VI consciousness scale and electroencephalography (EEG) were used to assess the levels of consciousness in each group of rats after LHA-DBS. Western blotting and immunofluorescence were used to detect the levels of OX1R expression in the lateral hypothalamic area and the levels of α1-adrenoceptor subtype (α1-AR) and gama-aminobutyric acid b receptor (GABAbR) expression in the prefrontal cortex. RESULTS: The results of the present study showed that 5 out of 11 rats were awakened in the TBI group, 10 of 11 were awakened in the stimulated group, 6 of 11 rats were awakened in the antagonist group, and 9 of 11 rats were awakened in the antagonist control group. EEG readings indicated that the percent of δ waves were lower in the stimulated group compared with the TBI and antagonist groups (P<0.05). Additionally, western blotting and immunofluorescence analysis showed that OX1R expression was higher in the stimulated group compared with the TBI group (P<0.05). α1-AR was more highly expressed in the stimulated group compared with the TBI and antagonist groups (P<0.05). In contrast, GABAbR levels in the stimulated group were lower compared with the TBI group and antagonist group (P<0.05). There was a significant difference between the antagonist group and antagonist control group. CONCLUSIONS: Taken together, the results suggest that LHA-DBS promotes the recovery of consciousness in comatose rats with TBIs. An upregulation of α1-AR expression and downregulation of GABAbR expression in the prefrontal cortex via the orexins/OX1R pathways maybe involved in the wakefulness-promoting effects of LHA-DBS.

2.
Vaccine ; 2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-33992437

RESUMO

BACKGROUND AND AIMS: ROTAVAC® (frozen formulation stored at -20 °C) and ROTAVAC 5D® (liquid formulation stable at 2-8 °C) are rotavirus vaccines derived from the 116E human neonatal rotavirus strain, developed and licensed in India. This study evaluated and compared the safety and immunogenicity of these vaccines in an infant population in Zambia. METHODS: We conducted a phase 2b, open-label, randomized, controlled trial wherein 450 infants 6 to 8 weeks of age were randomized equally to receive three doses of ROTAVAC or ROTAVAC 5D, or two doses of ROTARIX®. Study vaccines were administered concomitantly with routine immunizations. Blood samples were collected pre-vaccination and 28 days after the last dose. Serum anti-rotavirus IgA antibodies were measured by ELISA, with WC3 and 89-12 rotavirus strains as viral lysates in the assays. The primary analysis was to assess non-inferiority of ROTAVAC 5D to ROTAVAC in terms of the geometric mean concentration (GMC) of serum IgA (WC3) antibodies. Seroresponse and seropositivity were also determined. Safety was evaluated as occurrence of immediate, solicited, unsolicited, and serious adverse events after each dose. RESULTS: The study evaluated 388 infants in the per-protocol population. All three vaccines were well tolerated and immunogenic. The post-vaccination GMCs were 14.0 U/mL (95% CI: 10.4, 18.8) and 18.1 U/mL (95% CI: 13.7, 24.0) for the ROTAVAC and ROTAVAC 5D groups, respectively, yielding a ratio of 1.3 (95% CI: 0.9, 1.9), thus meeting the pre-set non-inferiority criteria. Solicited and unsolicited adverse events were similar across all study arms. No death or intussusception case was reported during study period. CONCLUSIONS: Among Zambian infants, both ROTAVAC and ROTAVAC 5D were well tolerated and the immunogenicity of ROTAVAC 5D was non-inferior to that of ROTAVAC. These results are consistent with those observed in licensure trials in India and support use of these vaccines across wider geographical areas.

4.
Artigo em Chinês | MEDLINE | ID: mdl-33910285

RESUMO

Objective: To analyze the effects of noise exposure on the hearing at different frequencies in workers from the automobile manufacturing industry. Methods: A total of 4723 noise workers in a large automobile manufacturing company in Guangzhou were chosen as the research object by using judgment sampling method between April and July, 2018, and carried out 0.5, 1.0, 2.0, 3.0, 4.0 and 6.0 kHz pure tone audiometry threshold to analyze the characteristics of the status of hearing loss at different frequencies and its relationship with the noise exposure time. Results: The detection rate of hearing loss in noise-exposed workers was 29.8% (1406/4723) . Among them, the binaural hearing loss was 21.2% (999/4723) , and single unilateral hearing loss accounted for 8.6% (407/4723) . The hearing loss detection rate of right ear was higher than that of the left ear (P<0.05) , especially in the 6.0 kHz (P<0.001) . The detection rate of increased speech frequency hearing threshold was 1.9% (90/4723) , and the detection rate of increased high-frequency hearing threshold was 28.9% (1366/4723) . The detection rate of increased threshold in both the left and the right ear increased with the increase of frequency (P<0.001) , the increased hearing threshold was the highest at the frequency of 6.0 kHz. The auditory threshold of left ear in 0.5 kHz were higher than that of right ear at the same frequency (P<0.05) . The detection rate of hearing loss increased with the increase of noise exposure time (P<0.001) , and the increased threshold of 3.0, 4.0 and 6.0 kHz from workers increased with the increase of noise exposure time (P<0.001) . Conclusion: There is a significant increased threshold in workers exposed to noise frequency of 6.0 kHz, right ear is more easily damaged than left ear, there is a dose-response relationship for the noise exposure time and high-frequency hearing loss.


Assuntos
Perda Auditiva Provocada por Ruído , Ruído Ocupacional , Exposição Ocupacional , Audiometria de Tons Puros , Limiar Auditivo , Automóveis , Perda Auditiva Provocada por Ruído/epidemiologia , Humanos , Indústria Manufatureira , Ruído Ocupacional/efeitos adversos
5.
Zhonghua Yi Xue Za Zhi ; 101(9): 654-660, 2021 Mar 09.
Artigo em Chinês | MEDLINE | ID: mdl-33685048

RESUMO

Objective: To investigate the molecular mechanism of nest metastasis in blood vessels encapsulated by tumor clusters (VETC) positive hepatocellular carcinoma (HCC). Methods: A total of 72 paraffin embedded HCC tissue samples were collected. Immunohistochemistry staining with CD34 (vascular endothelial cell marker protein) was used to observe the morphological manifestations of VETC cancer nests in primary tumors, bile duct cancerous thrombi and portal vein cancerous thrombi, and to study the characteristics of hematogenous metastasis of VETC cancer nests. Bioinformatics was used to predict the key proteins closely related to VETC cancer nest formation. Immunohistochemistry was used to detect the expression of angiogenin-2 (Ang-2), integrin α5, Integrin ß1, and cyclooxygenase-2 (COX-2) proteins in HCC. Transwell cell migration assay was used to detect the effect of Ang-2/integrin α5ß1 protein on the migration ability of endothelial cells and HCC cells. Western blotting was used to detect the effect of Ang-2/integrin α5ß1 protein on the activity of focal adhesion kinase (FAK) protein. Results: Of the collected HCC specimens, 27 cases (27/72) were VETC (+), including 3 cases with biliary duct cancerous thrombus, 5 cases with portal vein cancerous thrombus, and 3 cases with both biliary duct cancerous thrombus and portal vein cancerous thrombus. VETC (+) HCC could metastasize to portal vein, bile duct, and liver in the form of cancer nest, and the nests retain their intact structure. Ang-2, integrin α5 and integrin ß1 were overexpressed in tumor cells and endothelial cells of VETC (+) HCC nests, while COX-2 was only overexpressed in tumor cells of VETC (+) HCC nest. Ang-2 could promote the migration of HCC cell [(121±12) vs (186±11), P<0.01] and endothelial cells [(81±7) vs (163±14), P<0.01]. Integrin α5ß1 activation antagonist ATN-161 could significantly block the ability of Ang-2 to promote the migration of HCC cells [(185±10) vs (135±9), P<0.05] and endothelial cells [(156±14) vs (103±6), P<0.05]. ATN-161 could significantly block the phosphorylation of FAK in HCC and endothelial cells induced by Ang-2. Conclusions: VETC (+) HCC could metastasize as a whole in a nested form, and possesses a specific regulatory protein. Ang-2/α5ß1/FAK might be potential protein targets in the treatment of VETC (+) HCC nest-type metastasis.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Angiopoietina-2 , Células Endoteliais , Humanos , Integrina alfa5beta1
6.
Clin Transl Oncol ; 2021 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-33616859

RESUMO

BACKGROUND: Aerobic glycolysis has a pivotal role in the carcinogenic process. The current understanding of the functional role and mechanism of UCHL3-related aerobic glycolysis in pancreatic cancer is far from comprehensive, therefore requires an in-depth analysis on this aspect. METHODS: In the present research, the expressions of ubiquitin carboxyl-terminal hydrolase L3 (UCHL3), lactate dehydrogenase A (LDHA) and Forkhead box protein M1 (FOXM1) were detected by qRT-PCR, Western blot and immunohistochemistry. The effects of UCHL3 knockdown or overexpression on pancreatic cancer cells were examined by determining cell viability and colony formation. Aerobic glycolysis was assessed according to glucose uptake, lactic acid production, and lactate dehydrogenase (LDH) activity. Dual-luciferase reporter assay was performed to detect LDHA promoter activity. RESULTS: The results showed that UCHL3 expression was significantly increased in the pancreatic cancer tissues and cells, and that knocking down UCHL3 noticeably inhibited cell viability and aerobic glycolysis. Further investigations revealed that LDHA expression was promoted by UCHL3 and could be reduced by shFOXM1, and that low-expressed LDHA partly reversed the inhibition of aerobic glycolysis induced by overexpressed UCHL3. CONCLUSIONS: To conclude, this study demonstrates that UCHL3 plays a carcinogenic role by promoting aerobic glycolysis in pancreatic cancer, suggesting that UCHL3 may be a potential diagnostic and therapeutic target for the treatment of cancer.

7.
Zhonghua Zhong Liu Za Zhi ; 43(2): 218-223, 2021 Feb 23.
Artigo em Chinês | MEDLINE | ID: mdl-33601488

RESUMO

Objective: To explore the latest progress of oncology drug clinical trials in China under COVID-19, as well as to provide decision-making evidence for related stakeholders. Research progress of oncology drug trials and approved cancer drugs in China in 2020 were systematically summarized and compared with 2019. Methods: Information Disclosure Platform for Drug Clinical Studies and China Food and Drug Administration Query System for Domestic and Imported Drug were searched for registered clinical trials and approved oncology drugs, respectively. The trial scope, stage, drug type, effect and mechanism of domestic and global pharmaceutical enterprises were compared between 2019 and 2020. Results: A total of 722 cancer drug trials registered in China in 2020, with an annual growth rate of 52.3%, accounting for 28.3% of all registered trials. Among them, 603 (83.5%) trials were initiated by domestic pharmaceutical enterprises, and 105 (14.5%) were international multicenter trials, phase I trials accounted for 44.5%. For all those trials, there were 458 cancer drug varieties, with an annual growth rate of 36.7%, and 361 (85.8%) were developed by domestic enterprises. Most of the investigational products were therapeutic innovative drugs (77.1%), major in tumor treatment (92.8%). In terms of mechanism, targeted drugs were the most popular, accounting for 76.6%, and programmed cell death-1 (PD-1) and epithelial growth factor receptor (EGFR) were the most common targets. In addition, there were 19 anticancer drugs from 17 companies approved in China in 2019, with 10 drugs from domestic companies. Lung cancer and breast cancer are the most common indications for both registered trials and marketed drugs. No statistically significant differences were found between 2020 and 2019 in terms of the distribution of trial sponsor, scope and stage, as well as the distribution of drug type, effect and mechanism (P>0.05). Conclusions: During the Covid-19 epidemic period, clinical trials of oncology drugs in China progress smoothly and maintain a high growth rate. Series of innovative products obtained by domestic enterprises in 2020 is the main driving force of development of oncology drug clinical trials in China.


Assuntos
Antineoplásicos , Neoplasias , Antineoplásicos/uso terapêutico , China , Ensaios Clínicos como Assunto , Humanos , Oncologia , Neoplasias/tratamento farmacológico , Estados Unidos
9.
Bratisl Lek Listy ; 122(2): 145-151, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33502884

RESUMO

AIM: Platycodin D (PD), an oleanane kind of triterpenoid saponin, possesses various pharmacological activities. We aimed to investigate the effects of PD in pulmonary fibrosis. METHOD: MRC-5 cells were induced by transforming growth factor-beta1 (TGF-ß1) to simulate the pulmonary fibrosis in vitro. Cell viability was determined using a CCK-8 kit in the absence or presence of PD. Then, the expression of proliferation-related proteins was detected using immunofluorescence assay or western blot analysis. Moreover, the levels of inflammatory factors were examined. Subsequently, the ability of cell migration was evaluated using wound healing assay. Additionally, western blot analysis was employed to determine migration- and extracellular matrix accumulation (ECM)-related proteins expression. RESULTS: Results indicated that PD exposure significantly dose-dependently inhibited TGF-ß1 induced proliferation in MRC-5 cells. Additionally, the contents of inflammatory factors were notably inhibited with PD treatment. Furthermore, significant decrease in migration of TGF-ß1-stimulated MRC-5 cells was observed after PD intervention. Afterwards, PD remarkably suppressed the expression of alpha smooth muscle actin (α-SMA), collagen I (Col I), collagen III (Col III) and E-cadherin (E-cad). CONCLUSIONS: PD attenuated proliferation and ECM accumulation in TGF-ß1 induced lung fibroblasts, providing experimental support for the clinical application of PD in the treatment of pulmonary fibrosis (Fig. 6, Ref. 33).


Assuntos
Fibrose Pulmonar , Actinas , Proliferação de Células , Matriz Extracelular , Fibroblastos , Pulmão , Saponinas/farmacologia , Fator de Crescimento Transformador beta1 , Triterpenos
11.
Public Health ; 191: 33-38, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33482625

RESUMO

OBJECTIVE: The aim of the study was to estimate the gout burden and risk factors in China from 1990 to 2017. STUDY DESIGN: The Global Burden of Disease (GBD) Study uses various analytical tools and a diverse set of data sources to generate comparable estimates of deaths and mortality rates broken down by age, sex, cause, year, and geography. METHODS: We used the results from the GBD Study 2017 to compare disability-adjusted life years (DALYs), prevalence, incidence, and risk factors of gout in China. The median of the percentage change and 95% uncertainty intervals were determined for the period between 1990 and 2017. RESULTS: The age-standardized DALY rate, prevalence, and incidence increased 6.92%, 6.88%, and 6.16%, respectively, in China from 1990 to 2017. Although the rates of gout both globally and in China were increasing, the range of change for males in China was larger than that of the global level. All risk factors combined accounted for 30.04% of gout DALYs in 2017. The leading risk factors for gout DALYs were high body mass index and impaired kidney function, and the proportion of high body mass index increased significantly from 10.67% to 24.31%, whereas the proportion of impaired kidney function remained basically unchanged. CONCLUSIONS: The age-standardized DALY rate, prevalence, and incidence in China have increased progressively since 1990. Increasing attention on body weight management should be prioritized for controlling the rising prevalence of gout in the young and middle-aged population.


Assuntos
Carga Global da Doença/estatística & dados numéricos , Gota/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , China , Pessoas com Deficiência , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco
12.
Clin Exp Dermatol ; 46(1): 74-81, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32668051

RESUMO

BACKGROUND: Atopic dermatitis (AD) is a common, chronic, severely pruritic, eczematous skin disease that seriously deteriorates the quality of life of patients. Scratching is a cardinal symptom of AD. Although the vicious itch-scratch cycle continues and aggravates skin barrier dysfunction in AD, how scratching induces skin barrier dysfunction through tight junctions remains unclear. AIM: To study the effect of scratching on tight junctions in the itch-scratch cycle. METHODS: Scratching behaviour and skin barrier dysfunction on the neck and back in an AD mouse model were assessed. The expression of tight junction proteins was compared between the neck and back mice, and the mechanisms underlying the involvement of Akt/CLDN1 pathways in this process were explored. RESULTS: We used oxazolone to induce AD on the neck or back of mice. There was significantly more scratching behaviour and more pronounced skin barrier dysfunction with the neck than with the back. Downregulation of claudin-1 (CLDN1) and upregulation of Akt phosphorylation in skin were well correlated with scratching behaviour in this AD model. Furthermore, SC79, an agonist of Akt phosphorylation, could downregulate CLDN1 expression in HaCaT cells. An antagonist of Akt phosphorylation (LY294002) was used to treat the AD mice; this treatment rescued CLDN1 expression through inhibiting Akt phosphorylation in skin, and importantly, also inhibited the scratching behaviour induced by AD. CONCLUSION: The results reveal the underlying mechanism of tight junction damage promoted by scratching in the itch-scratch cycle of AD, and opens a new avenue to pruritus management in AD, through Akt antagonists.

13.
15.
HIV Med ; 21(11): 739-746, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33369033

RESUMO

OBJECTIVES: Tuberculosis (TB) is the most common and fatal opportunistic co-infection among HIV-infected individuals. While TB-associated mortality predominantly occurs in the first 90 days after admission, such a correlation remains unclear in HIV/TB co-infected patients. Thus, we aimed to investigate the 90-day mortality and associated risk factors among HIV/TB co-infected patients in China. METHODS: Adult patients with HIV and a newly confirmed TB diagnosis admitted to the Shanghai Public Health Clinical Center between September 2009 and August 2017 were enrolled. Clinical and laboratory characteristics, key treatments and outcomes were collected retrospectively. The associations between different factors and early mortality were analysed. RESULTS: Of the 485 laboratory-confirmed HIV/TB patients [median (range) age = 39 (19-79) years], 413 (85.15%) were male. Diagnosis was confirmed by culture, pathology and acid-fast bacilli smear alone in 362 (74.6%), 6 (1.2%) and 117 (24.1%) patients, respectively. Multiple drug-/rifampin-resistant TB was detected in 21 (5.8%) of the 367 patients with a positive culture. Rifampin or rifabutin was administered to 402 (82.9%) patients. Additionally, 66 (13.6%) and 86 (17.7%) died within 90 days and 1 year of admission, respectively. Of the 64 TB-related deaths, 59 (92.2%) occurred within 90 days of admission. In Cox regression, central nervous system (CNS) TB [odds ratio (OR) = 2.49, 95% confidence interval (CI): 1.46-4.23, P < 0.001], no antiretroviral therapy (ART) within 3 months after admission (OR = 11, 95% CI: 6.4-18.9, P < 0.001), and plasma albumin level < 25 g/L (OR = 1.91, 95% CI: 1.07-3.40, P = 0.021) were associated with early death. CONCLUSIONS: Tuberculosis co-infection was prevalent and fatal in HIV-infected patients, with most deaths occurring within 90 days of admission. Early mortality was associated with CNS-TB, no ART, and serum albumin level < 25 g/L.

16.
Zhonghua Xue Ye Xue Za Zhi ; 41(10): 836-842, 2020 Oct 14.
Artigo em Chinês | MEDLINE | ID: mdl-33190441

RESUMO

Objective: Endoplasmic reticulum stress(ERS)was used as the research emphasis to further investigate the mechanisms of apoptosis of FLT3-ITD-mutated leukemia cells and decreased expression of FLT3-ITD mutated protein induced by all-trans retinoic acid(ATRA). Methods: FLT3-ITD-mutated leukemia cell lines(MV4-11 and MOLM13)were treated with ATRA. Flow cytometry was conducted to assess cell apoptosis. Real-time fluorescent quantitative PCR(RT-qPCR)and Western blot were used to detect the expression of ERS-related and autophagy-related genes and protein, respectively. Results: A low-dose ATRA further increased FLT3-ITD cells and ERS levels. ATRA acted on the ERS-related PERK/eif2ɑ signaling pathway and continued to increase the ERS of FLT3-ITD cells, resulting in an upregulation of apoptotic gene CHOP expression. After the treatment with ATRA, FLT3-ITD protein in FLT3-ITD cells was decreased. Of the two main ERS-related protein degradation pathways, ER-associated degradation(ERAD)and ER-activated autophagy(ERAA), the expression of ERAD-related protein ATF6 in FLT3-ITD cells was not significantly changed on ATRA, whereas the expression of ERAA-related proteins Atg7 and Atg5 were significantly increased. Conclusions: ATRA further raises the ERS level of FLT3-ITD cells continuously by activating the ERS-related PERK/eif2ɑ signal pathway and induces FLT3-ITD protein autophagy degradation through ERAA pathway, which induces apoptosis of FLT3-ITD-mutated leukemia cells. These results provide preliminary evidence on the use of ATRA in the treatment of refractory leukemia with FLT3-ITD.

17.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(5): 483-488, 2020 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-33185059

RESUMO

OBJECTIVE: To investigate the epidemiological characteristics of malaria and implementation of the "1-3-7" approach in malaria elimination in Yunnan Province, so as to provide the data support for the development of post-elimination surveillance interventions. METHODS: All data pertaining to malaria cases in Yunnan Province from 2014 to 2019 were captured from the Notifiable Disease Reporting System of Chinese Center for Disease Control and Prevention, and the changes in the epidemic situation of malaria were analyzed during the 5-year period. In addition, the core indexes regarding the "1-3-7" approach in malaria elimination of Yunnan Province from 2014 to 2019 were retrieved from the Malaria Control System in the Parasitic Disease Information Reporting System, and all changes in the indexes were descriptively analyzed. RESULTS: During the period from 2014 to 2019, a total of 2 283 malaria cases were reported in Yunnan Province, including 1 927 cases with vivax malaria, 326 cases with plasmodium malaria, 29 cases with other species of malaria, and one case with unidentified species. There were 64 local cases, 2 219 overseas imported cases. Among the 2 283 malaria cases, the male/female ratio was 4.58∶1, and 80.25% of the cases were aged from 15 to 50 years. Farmer (70.00%) was the predominant occupation, and 76.70% (1 751/2 283) of the cases were identified in 25 border counties (districts). Malaria cases were reported in each month during the 5-year period, and the number of malaria cases increased from April, peaked on May to July, and started to decline on August. From 2014 to 2019, the reporting rate of malaria cases within 24 hours upon diagnosis was 100%, and the detection of malaria cases was 99.69% (2 276/ 2 283) in the laboratory, with a 99.65% (2 275/2 283) rate of definite diagnosis. In addition, the percentage of individual epidemiological investigations within 3 days was 100.00% (2 283/2 283), and the number of epidemic foci survey and treatment within 7 days was 576 during the 3-year period from 2017 to 2019. The goal of malaria elimination was achieved in Yunnan Province on June, 2020. CONCLUSIONS: Malaria has been eliminated in Yunnan Province, and management of overseas imported malaria is the primary challenge to consolidate the malaria elimination achievements in the future. However, the approach in malaria elimination remains to be maintained, and the role of the Yunnan Provincial Malaria Diagnostic Reference Laboratory requires to be strengthened.

19.
BJOG ; 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33145901

RESUMO

OBJECTIVE: To elucidate the association between sleep disturbances and blood pressure as well as uterine artery Doppler during pregnancy in women with no pre-existing hypertension. DESIGN: Prospective cohort study. SETTING: Outpatient specialist clinics at KK Women's and Children's Hospital, Singapore. POPULATION: Women with viable singleton pregnancies confirmed by ultrasonography at less than 14 weeks of amenorrhoea at first visit. METHODS: In all, 926 subjects were recruited for this study in the outpatient specialist clinics at KK Women's and Children's Hospital, Singapore, between 1 September 2010 and 31 August 2014. They were followed up throughout pregnancy with sleep quality, blood pressure and uterine artery Doppler assessed at each visit. MAIN OUTCOME MEASURES: Sleep quality, blood pressure and uterine artery Doppler. RESULTS: Sleep progressively worsened as pregnancy advanced. Shorter sleep duration and poorer sleep efficiency were associated with higher blood pressure, especially in the first trimester. Mixed model analysis demonstrated an overall positive association between sleep quality represented by Pittsburgh Sleep Quality Index (PSQI) score and diastolic blood pressure (DBP) (P < 0.001) and mean arterial pressure (MAP) (P = 0.005) during pregnancy after considering all trimesters. Sleep duration was found to be negatively associated with both systolic blood pressure (SBP) (P = 0.029) and DBP (P = 0.002), whereas sleep efficiency was negatively correlated with DBP (P = 0.002) only. Overall poor sleep during pregnancy was also found to be associated with a higher uterine artery pulsatility index. CONCLUSION: Our prospective study demonstrated that poor sleep quality is significantly associated with higher blood pressure and uterine artery pulsatility index during pregnancy. TWEETABLE ABSTRACT: Poor sleep quality is significantly associated with higher blood pressure and higher uterine artery pulsatility index during pregnancy.

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