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1.
Curr Med Sci ; 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34729680

RESUMO

OBJECTIVE: The goal of this work is to analyze the incidence, etiology, clinical characteristics, maternal and neonatal outcomes of complete uterine rupture during pregnancy. METHODS: The information of complete uterine rupture between June 2010 and May 2020 was investigated retrospectively at a tertiary center, and included demographic data, delivery characteristics, intraoperative findings, and maternal and neonatal outcomes. The prevalence rate of uterine rupture in the early group (hospitalized from June 2010 to May 2015) and late group (June 2015 to May 2020) was compared and analyzed. RESULTS: There were 37 (0.056%) cases of complete uterine rupture in 66 092 births, including 27 (0.041%) of scar uterus and 10 (0.015%) of non-scarred uterus. High-risk factors for scarred uterine rupture included: previous cesarean section (13, 48.1%), myomectomy (8, 29.6%), corneal pregnancy resection (6, 22.2%), history of uterine rupture (1, 3.7%), and uterus perforation during abortion (1, 3.7%). Compared to the early group, the number of uterine ruptures caused by previous cesarean section was significantly reduced in the late group. Of the 10 patients with non-scarred uterine rupture, 3 (30%) occurred during delivery and 7 (70%) were spontaneous. Among the 37 complete rupture patients, 3 (8.1%) died of uterine scar rupture, 19 (51.3%) cases were reported with fetal/newborn deaths, 5 (13.5%) cases underwent hysterectomy and the rest were treated with uterine repair. CONCLUSION: Complete uterine rupture often has catastrophic effect on pregnancy outcomes. Obstetrics doctors should be vigilant to identify the risk factors and clinical presentations of uterine rupture during pregnancy. Strict prenatal management is beneficial to improve pregnancy outcomes.

2.
Cancer Chemother Pharmacol ; 88(6): 953-960, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34477945

RESUMO

BACKGROUND: Inhibitors of arachidonate lipoxygenase 5 (ALOX5) exhibit anticancer activity. Zileuton is an FDA-approved drug for treating asthma and an ALOX5 inhibitor. This study evaluated the efficacy of zileuton in cervical cancer, determined the molecular mechanism of action, and assessed ALOX5 expression in cervical cancer patients. METHODS: The effects of zileuton were evaluated using cervical cancer cell lines and xenograft mouse models. Loss-of-function analysis of ALOX5 was performed using siRNA. The levels of ALOX5 and 5-HETE were determined using immunohistochemistry and ELISA. RESULTS: Zileuton resulted in cell proliferation inhibition and apoptosis induction in a dose-dependent manner, regardless of cellular origin or HPV infection. In two independent cervical cancer xenograft mouse models, zileuton at nontoxic doses significantly prevented tumor formation and decreased tumor growth. Zileuton acts on cervical cancer cells by inhibiting the ALOX5-5-HETE axis. Of note, ALOX5-5-HETE was significantly upregulated in cervical cancer compared with normal tissue. Inhibition of ALOX5 via the siRNA approach mimics the inhibitory effects of zileuton and confirms the roles of ALOX5 in cervical cancer. CONCLUSIONS: Our work demonstrates that the ALOX5-5-HETE axis is activated in cervical cancer, with important roles in growth and survival, and this can be therapeutically targeted by zileuton. Our findings also provide preclinical evidence to assess the efficacy of zileuton in cervical cancer in clinical settings.

3.
Anim Sci J ; 92(1): e13624, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34459072

RESUMO

The COVID-19 epidemic and government intervention measures may have adverse effects on people's mental health. To explore the influence of pets on the intervention of people's psychological problems during the COVID-19 epidemic, an online survey was carried out between April 9 and April 29, 2020. A total of 756 participants replied to this questionnaire. Mental health variables were assessed, and the comparison of behavior changes among pet owners and pets on positive mental well-being during COVID-19 epidemic. Comparative analysis was performed; compared with individuals without pets (n = 575), pet owners (n = 181) had a higher prevalence of insomnia (p = 0.006). Living in Wuhan city was a risk factor for people with psychological stress (p < 0.05). Dog owners exhibited lower than average scores of insomnia and uncertainty of infection than cat owners (p = 0.004). People with more than one pet exhibited lower than average scores of depression than having one pet (p = 0.040). For analysis of psychological effects of pets on people, the role of pets in subjective feeling and positive psychological changes of pet owner was significantly different. Pet owners relieve that psychological pressure through behavioral changes towards their pets in early stage. Pets provided positive subjective well-being and psychological effects for their owners.


Assuntos
COVID-19 , Epidemias , Vínculo Humano-Animal , Propriedade , Animais de Estimação , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Gatos , Criança , China/epidemiologia , Estudos Transversais , Cães , Emoções , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Propriedade/estatística & dados numéricos , Prevalência , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
4.
Sci Rep ; 11(1): 8434, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-33875708

RESUMO

To determine the factors predicting the probability of severe postpartum hemorrhage (SPPH) in women undergoing repeat cesarean delivery (RCD). This multicenter, retrospective cohort study involved women who underwent RCD from January 2017 to December 2017, in 11 public tertiary hospitals within 7 provinces of China. The all-variables model and the multivariable logistic regression model (pre-operative, operative and simple model) were developed to estimate the probability of SPPH in development data and external validated in validation data. Discrimination and calibration were evaluated and clinical impact was determined by decision curve analysis. The study consisted of 11,074 women undergoing RCD. 278 (2.5%) women experienced SPPH. The pre-operative simple model including 9 pre-operative features, the operative simple model including 4 pre-operative and 2 intraoperative features and simple model including only 4 closely related pre-operative features showed AUC 0.888, 0.864 and 0.858 in development data and 0.921, 0.928 and 0.925 in validation data, respectively. Nomograms were developed based on predictive models for SPPH. Predictive tools based on clinical characteristics can be used to estimate the probability of SPPH in patients undergoing RCD and help to allow better preparation and management of these patients by using a multidisciplinary approach of cesarean delivery for obstetrician.


Assuntos
Cesárea , Hemorragia Pós-Parto , Adulto , China , Feminino , Humanos , Modelos Estatísticos , Nomogramas , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/patologia , Período Pós-Parto , Gravidez , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
5.
Artigo em Inglês | MEDLINE | ID: mdl-33715162

RESUMO

OBJECTIVE: To explore the ability of albumin concentration to predict calf venous thromboembolism (cVTE) in gynecologic diseases. METHODS: We analyzed data from 761 patients from the gynecology department. We screened the serum albumin concentration as an important indicator for predicting cVTE through logistic analysis. The data were divided into albumin below 35 and 35 g/L or more. Receiver operating characteristics analysis was used to compare the predictive ability of albumin, D-dimer, and a combination of these parameters as indicators for cVTE risk in different groups and subgroups. RESULTS: In gynecologic diseases, the albumin concentrations were lower in the surgery and malignancy group than in the chemotherapy and benign disease group. Albumin concentration had a predictive ability for cVTE risk. In ovarian cancer patients with albumin concentrations less than 35 g/L, albumin was better than D-dimer at predicting cVTE (area under the curve [AUC] 0.79, 95% confidence interval [CI] 0.70-0.87, P < 0.001 versus AUC 0.65, 95% CI 0.54-0.77, P = 0.016). CONCLUSION: The albumin concentration was a candidate indicator for predicting cVTE in surgical patients in the gynecology department, especially in ovarian cancer patients with albumin concentrations less than 35 g/L. A combination of the albumin and D-dimer parameters may improve the predictive ability for cVTE.

6.
Curr Med Sci ; 41(1): 77-83, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33582909

RESUMO

The Coronavirus disease 2019 (COVID-19) outbreak has been brought under control through a nationwide effort, and now it has become a global pandemic and the situation seems grim. We summarized the measures taken in Wuhan and analyzed the effects to comprehensively describe the factors involved in controlling the COVID-19 in China. In China, several measures such as the lockdown of Wuhan, restriction of traffic and communities, increasing hospital beds, nationwide support from medical staff, epidemic prevention equipment and supplies, and establishment of makeshift shelter hospitals have been taken. The lockdown of Wuhan reduced the propagation of cases to other cities in Hubei province and throughout China, traffic and community restrictions reduced the flow of population and the spread of disease, increasing wards and beds and medical personnel reduced the incidence of severe cases and mortality, the establishment of the Fangcang shelter hospitals provided a good isolation and monitoring environment, and further reduced the spread and fatality of the disease. The fact that China was able to control the spread of COVID-19 within three months without a specific drug or vaccine suggests that these measures are more adequate and effective.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Pandemias/prevenção & controle , COVID-19/transmissão , China , Controle de Doenças Transmissíveis/instrumentação , Feminino , Humanos , Masculino
7.
Cell Biosci ; 11(1): 33, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33557944

RESUMO

BACKGROUND: Interleukin-15 (IL-15), a member of the 'four α-helix bundle' cytokine family, has been associated with many inflammatory and metabolic diseases. Abnormal expression of IL-15 has been linked to the occurrence and development of obesity and diabetes. However, there is a paucity of research on the involvement of IL-15 in Gestational Diabetes Mellitus (GDM). This study aims at investigating the role of IL-15 in the pathogenesis of GDM. RESULTS: IL-15 was consistently expressed in the placenta throughout pregnancy and dynamically changed with pregnancy progress. Trophoblasts have been identified as the major source of IL-15 in the placenta. Expression of IL-15 was significantly increased in the placenta of GDM and in the trophoblasts cultured with high glucose (HG). In our study, expression of IL-15 in the placenta was positively correlated with blood glucose concentration of 75 g Oral Glucose Tolerance Test (OGTT), and was inversely correlated with weight of newborns. Further investigations in vitro showed that exogenous addition of IL-15 promoted trophoblasts proliferation, improved invasion and tube formation ability by activating the JAK/STAT signaling pathway, which be blocked by JAK inhibitors. CONCLUSION: Our results demonstrated that IL-15 expression in the placenta was dynamically changing during pregnancy, and it was upregulated in the placenta of GDM patients. Furthermore, IL-15 altered the biological behavior of trophoblasts through JAK/STAT signaling pathway in vitro, and may contributed to the placental pathology of GDM. Our findings provide a new direction for studying the pathophysiological changes of placenta in GDM.

8.
BMC Pregnancy Childbirth ; 21(1): 126, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579220

RESUMO

BACKGROUND: To determine the effects of maternal age at first cesarean on maternal complications and adverse outcomes of pregnancy with the second cesarean. METHODS: This was a multicenter, historical, cross-sectional cohort study involving singleton pregnancies ≥28 gestational weeks, with a history of 1 cesarean delivery, and who underwent a second cesarean between January and December 2017 at 11 public tertiary hospitals in 7 provinces of China. We analyzed the effects of maternal age at first cesarean on adverse outcomes of pregnancy in the second cesarean using multivariate logistic regression analysis. RESULTS: The study consisted of 10,206 singleton pregnancies. Women were at first cesarean between 18 and 24, 25-29, 30-34, and ≥ 35 years of age; and numbered 2711, 5524, 1751, and 220 cases, respectively. Maternal age between 18 and 24 years at first cesarean increased the risk of placenta accreta spectrum (aOR, 1.499; 95% CI, 1.12-2.01), placenta previa (aOR, 1.349; 95% CI, 1.07-1.70), intrahepatic cholestasis of pregnancy (aOR, 1.947; 95% CI, 1.24-3.07), postpartum hemorrhage (aOR, 1.505; 95% CI, 1.05-2.16), and blood transfusion (aOR, 1.517; 95% CI, 1.21-1.91) in the second cesarean compared with the reference group (aged 25-29 years). In addition, maternal age ≥ 35 years at first cesarean was a risk factor for premature rupture of membranes (aOR, 1.556; 95% CI, 1.08-2.24), placental abruption (aOR, 6.464, 95% CI, 1.33-31.51), uterine rupture (aOR, 7.952; 95% CI, 1.43-44.10), puerperal infection (aOR, 6.864; 95% CI, 1.95-24.22), neonatal mild asphyxia (aOR, 4.339; 95% CI, 1.53-12.32), severe asphyxia (aOR, 18.439; 95% CI, 1.54-220.95), and admission to a neonatal intensive care unit (aOR, 2.825; 95% CI, 1.54-5.17) compared with the reference group (aged 25-29 years). CONCLUSIONS: Maternal age between 18 and 24 years or advanced maternal age at first cesarean was an independent risk factor for adverse maternal outcomes with the second cesarean. Advanced maternal age at the first cesarean specifically increased adverse neonatal outcomes with the second. Therefore, decisions as to whether to perform a first cesarean at a young or advanced maternal age must be critically evaluated.


Assuntos
Cesárea/efeitos adversos , Idade Materna , Placenta Acreta/epidemiologia , Placenta Prévia/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Nascimento Prematuro/epidemiologia , Adolescente , Adulto , Fatores Etários , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Recém-Nascido , Placenta Acreta/etiologia , Placenta Prévia/etiologia , Hemorragia Pós-Parto/etiologia , Gravidez , Resultado da Gravidez , Nascimento Prematuro/etiologia , Risco , Adulto Jovem
9.
Arch Gynecol Obstet ; 304(1): 65-72, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33386958

RESUMO

PURPOSE: Through this study, we aimed to evaluate the effects of different types of placenta previa (PP) on maternal and neonatal outcomes. METHODS: This study was conducted in The Third Affiliated Hospital of Guangzhou Medical University and Tongji Hospital between January 2009 and 2019. PP was traditionally classified into four types, namely low-lying placenta, marginal, partial, and complete PP. Previous studies have classified PP into two types, namely low-lying placenta and PP. Based on our clinical experience, we proposed the classification of PP into three types, for the first time, which included low-lying placenta, "marpartial" (marginal and partial) PP, and complete PP. Multivariate logistic regression analysis was performed to determine the effects of different types of PP on maternal and neonatal outcomes. RESULTS: In total, 4490 singleton pregnancies were complicated with PP. In the four-classification method, compared with women with low-lying placenta, women with complete PP had a risk of placenta accrete spectrum disorders, postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, NICU admission, and low birth weight. There was no difference in maternal and neonatal outcomes between marginal and partial PP, except for increased chances of preterm labor and low birth weight in partial PP. In the two-classification method, PP was the risk factor for most of the adverse maternal and neonatal outcomes, compared with low-lying placenta. CONCLUSION: Complete PP and low-lying placenta were associated with the highest and lowest risks of adverse pregnancy outcomes, respectively, whereas clinically similar outcomes were observed between marginal and partial PP. The three-classification of PP may be practical from the clinical perspective.


Assuntos
Placenta Prévia/classificação , Resultado da Gravidez/epidemiologia , Adulto , Feminino , Humanos , Recém-Nascido , Placenta Acreta , Placenta Prévia/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/etiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Natimorto
10.
Med Sci Monit ; 26: e927681, 2020 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-33270607

RESUMO

BACKGROUND The rate of delivery by cesarean section is rising in China, where vaginal birth after cesarean (VBAC) is in its early stages. There are no validated screening tools to predict VBAC success in China. The objective of this study was to identify the variables predicting the likelihood of successful VBAC to create a predictive model. MATERIAL AND METHODS This multicenter, retrospective study included 1013 women at ≥28 gestational weeks with a vertex singleton gestation and 1 prior low-transverse cesarean from January 2017 to December 2017 in 11 public tertiary hospitals within 7 provinces of China. Two multivariable logistic regression models were developed: (1) at a first-trimester visit and (2) at the pre-labor admission to hospital. The models were evaluated with the area under the receiver operating characteristic curve (AUC) and internally validated using k-fold cross-validation. The pre-labor model was calibrated and a graphic nomogram and clinical impact curve were created. RESULTS A total of 87.3% (884/1013) of women had successful VBAC, and 12.7% (129/1013) underwent unplanned cesarean delivery after a failed trial of labor. The AUC of the first-trimester model was 0.661 (95% confidence interval [CI]: 0.61-0.712), which increased to 0.758 (95% CI: 0.715-0.801) in the pre-labor model. The pre-labor model showed good internal validity, with AUC 0.743 (95% CI: 0.694-0.785), and was well calibrated. CONCLUSIONS VBAC provides women the chance to experience a vaginal delivery. Using a pre-labor model to predict successful VBAC is feasible and may help choose mode of birth and contribute to a reduction in cesarean delivery rate.


Assuntos
Modelos Biológicos , Nascimento Vaginal Após Cesárea , Adulto , Calibragem , China , Feminino , Humanos , Trabalho de Parto , Nomogramas , Gravidez , Curva ROC , Reprodutibilidade dos Testes
11.
Medicine (Baltimore) ; 99(42): e22533, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080687

RESUMO

RATIONALE: Split-hand/split-foot malformation (SHFM), also known as ectrodactyly, is a congenital limb malformation affecting the central rays of the autopod extending to syndactyly, median clefts of the hands and feet, aplasia/hypoplasia of phalanges, metacarpals and metatarsals. Duplication of this 10q24 region is associated with SHFM3. While the clinical and genetic heterogeneity of SHFM makes the prenatal diagnosis and genetic counseling more challenging and difficult. PATIENT CONCERNS: A physically normal pregnant woman had a systemic ultrasound at the second trimester, only identified the deformity of both hands and feet on the fetus. DIAGNOSES: The fetus was diagnosed as sporadic SHFM3. INTERVENTIONS: After seeking advice from genetic counseling, she decided to terminate the pregnancy. The induction of infant was done after appearance of bipedal clefts, lobster-claw appearance and partial loss of phalanges and metacarpals, leaving behind 2nd finger in the left hand and the 5th in the right hand. Furthermore, collection of umbilical cord is recommended to this fetus for genome-wide detection. OUTCOMES: An outcome of the gene detection from abortion shows that there is variation in copy number in genome of chromosome 1 and chromosome 10. LESSONS: This case study confirms an association between SHFM3 and chromosomal micro-duplication on 10q24.3, and the extension of clinical spectrum of SHFM3. It also proposes some prenatal diagnosis and genetic counseling to help in planning and management in affected pregnancy. This will reduce the congenital and development abnormalities in birth rate, as well as relive the economic, psychological, and physical burden to the affected families.


Assuntos
Aconselhamento Genético , Deformidades Congênitas dos Membros/diagnóstico , Deformidades Congênitas dos Membros/genética , Diagnóstico Pré-Natal , Aborto Induzido , Duplicação Cromossômica , Feminino , Humanos , Gravidez
12.
J Med Internet Res ; 22(8): e19642, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32750000

RESUMO

BACKGROUND: Since December 2019, an outbreak of the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly in Wuhan and worldwide. However, previous studies on pregnant patients were limited. OBJECTIVE: The aim of this study is to evaluate the clinical characteristics and outcomes of pregnant and nonpregnant women with COVID-19. METHODS: This study retrospectively collected epidemiological, clinical, laboratory, imaging, management, and outcome data of 43 childbearing-age women patients (including 17 pregnant and 26 nonpregnant patients) who presented with laboratory-confirmed COVID-19 in Tongji Hospital, Wuhan, China from January 19 to March 2, 2020. Clinical outcomes were followed up to March 28, 2020. RESULTS: Of the 43 childbearing-age women in this study, none developed a severe adverse illness or died. The median ages of pregnant and nonpregnant women were 33.0 and 33.5 years, respectively. Pregnant women had a markedly higher proportion of history exposure to hospitals within 2 weeks before onset compared to nonpregnant women (9/17, 53% vs 5/26, 19%, P=.02) and a lower proportion of other family members affected (4/17, 24% vs 19/26, 73%, P=.004). Fever (8/17, 47% vs 18/26, 69%) and cough (9/17, 53% vs 12/26, 46%) were common onsets of symptoms for the two groups. Abdominal pain (n=4, 24%), vaginal bleeding (n=1, 6%), reduced fetal movement (n=1, 6%), and increased fetal movement (n=2, 13%) were observed at onset in the 17 pregnant patients. Higher neutrophil and lower lymphocyte percent were observed in the pregnant group compared to the nonpregnant group (79% vs 56%, P<.001; 15% vs 33%, P<.001, respectively). In both groups, we observed an elevated concentration of high-sensitivity C-reactive protein, erythrocyte sedimentation rate, aminotransferase, and lactate dehydrogenase. Concentrations of alkaline phosphatase and D-dimer in the pregnant group were significantly higher than those of the nonpregnant group (119.0 vs 48.0 U/L, P<.001; 2.1 vs 0.3µg/mL, P<.001, respectively). Both pregnant (4/10, 40%) and nonpregnant (8/15, 53%) women tested positive for influenza A virus. A majority of pregnant and nonpregnant groups received antiviral (13/17, 76% vs 25/26, 96%) and antibiotic (13/17, 76% vs 23/26, 88%) therapy. Additionally, both pregnant (2/11, 18%) and nonpregnant (2/19, 11%) recovered women redetected positive for SARS-CoV-2 after discharge. CONCLUSIONS: The epidemiology and clinical and laboratory features of pregnant women with COVID-19 were diverse and atypical, which increased the difficulty of diagnosis. Most pregnant women with COVID-19 were mild and moderate, and rarely developed severe pneumonia or severe adverse outcomes.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/fisiopatologia , Adulto , COVID-19 , China , Surtos de Doenças , Feminino , Humanos , Pandemias , Gravidez , Estudos Retrospectivos , SARS-CoV-2 , Resultado do Tratamento
13.
Soc Sci Med ; 260: 113186, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32683160

RESUMO

Accessibility to delivery care is crucial for improving maternal health, which is an important policy goal to ensure healthy lives and promote well-being in China and worldwide, especially with the change of the family planning policy in China in 2016. This study develops a set of methods to project the population of women of child-bearing age and birth population and assess the accessibility to delivery care services in Hubei Province. The Cohort-Component projection method with various scenarios was applied to project the population of women of children-bearing age in 2030. A Gravity-based Variable Two-Step Floating Catchment Area (GV2SFCA) method is developed, which takes into account the heterogeneous catchment areas and distance decay effects for different regions and various levels of delivery care services. The parameters are calibrated by using medical records with patients' addresses. The traditional Supply-Demand Ratio method is also applied. The results demonstrate an overall decreasing trend of birth population in Hubei in all scenarios, but with significant disparities across regions. In 2016, 28% of districts fail to reach the policy goal with 17 beds per thousand births. In 2030, accessibility to delivery care is projected to increase in 98% of districts, while there are still 22% of districts that fail to reach the policy goal. The accessibility scores are further combined with the densities of birth population to identify shortage areas of delivery care. 7% and 6% of districts are classified as Major Shortage Areas in 2016 and 2030, respectively. The findings shed lights on the distributions and future changes of accessibility to and shortage areas of delivery care in Hubei, which can provide evidence-based recommendations for planning and policymaking. It also provides innovative methods for more accurately assessing accessibility to delivery care.


Assuntos
Acesso aos Serviços de Saúde , Área Programática de Saúde , Criança , China , Feminino , Humanos
14.
Int J Health Geogr ; 19(1): 23, 2020 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-32563251

RESUMO

BACKGROUND: Some studies have reported that air pollution exposure can have adverse effects on pregnancy outcomes. However, the disparity between urban and rural areas in the risk of preterm birth (PTB) has yet to be elucidated. Considering geographic contexts as homogeneous or ignoring urban-rural differences cannot accurately reveal the disparities in the health effects of air pollution under different geographic contexts. The aims of this study were to examine the disparities in the risks of PTB in three different regions and five urban-rural types and to investigate the extent to which fine particulate matter (PM2.5) exposure during the entire pregnancy can explain the variations. METHODS: We collected data on 429,865 singleton newborns born in 2014 in Hubei Province, China, and divided Hubei Province into three regions. Spatial correlation methods were employed to measure the associations between the rate of PTB and air pollution using average annual indexes for the entire province and regions. A series of multilevel logistic models were conducted to examine disparities in the risks of PTB with decreases in urbanity and the effects of air pollution exposure on the occurrence of preterm births. RESULTS: The PM2.5 concentration was significantly different across the regions. The eastern region had the most wide-ranged and serious level of pollution, whereas the levels in the middle and western regions weakened. The odds of PTB and air pollution exhibited a positive spatial correlation for the entire province and in the east (BiMoran's I = 0.106 and 0.697, respectively). Significant urban-rural disparities in the risks of PTB were noted in the east and middle regions, and the mean PM2.5 exposure during the entire pregnancy was positively associated with PTB risk. However, in the west, the results showed weak differences in the risks of PTB among the five urban-rural types and an insignificant effect of PM2.5 exposure. The direction of the effect of district/county-level income on PTB varied by region. CONCLUSIONS: This study finds that air pollution exposure and PTB have significant and positive spatial relationships in areas with a serious air pollution burden. The risks of PTB in three regions of Hubei Province follow the same W-shaped pattern as urbanity decreases and rurality increases. High levels of air pollution exposure may be an important disadvantage for urban pregnant women in this setting.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Nascimento Prematuro , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Criança , China/epidemiologia , Feminino , Humanos , Recém-Nascido , Exposição Materna/efeitos adversos , Material Particulado/efeitos adversos , Material Particulado/análise , Gravidez , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologia
16.
EMBO Rep ; 21(6): e50164, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32250038

RESUMO

Potassium (K) is essential for plant growth and development. Here, we show that the KUP/HAK/KT K+ transporter KUP9 controls primary root growth in Arabidopsis thaliana. Under low-K+ conditions, kup9 mutants displayed a short-root phenotype that resulted from reduced numbers of root cells. KUP9 was highly expressed in roots and specifically expressed in quiescent center (QC) cells in root tips. The QC acts to maintain root meristem activity, and low-K+ conditions induced QC cell division in kup9 mutants, resulting in impaired root meristem activity. The short-root phenotype and enhanced QC cell division in kup9 mutants could be rescued by exogenous auxin treatment or by specifically increasing auxin levels in QC cells, suggesting that KUP9 affects auxin homeostasis in QC cells. Further studies showed that KUP9 mainly localized to the endoplasmic reticulum (ER), where it mediated K+ and auxin efflux from the ER lumen to the cytoplasm in QC cells under low-K+ conditions. These results demonstrate that KUP9 maintains Arabidopsis root meristem activity and root growth by regulating K+ and auxin homeostasis in response to low-K+ stress.


Assuntos
Proteínas de Arabidopsis , Arabidopsis , Ácidos Indolacéticos , Meristema/crescimento & desenvolvimento , Raízes de Plantas/crescimento & desenvolvimento , Potássio , Arabidopsis/genética , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Regulação da Expressão Gênica de Plantas , Homeostase
17.
Clin Infect Dis ; 71(15): 853-857, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32161941

RESUMO

In December 2019, the coronavirus disease (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and now has spread in many countries. Pregnant women are a population susceptible to COVID-19 and are more likely to have complications and even progress to severe illness. We report a case of neonatal COVID-19 in China with pharyngeal swabs testing positive by real-time reverse-transcription polymerase chain reaction assay 36 hours after birth. However, whether the case is a vertical transmission from mother to child remains to be confirmed.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Complicações Infecciosas na Gravidez/virologia , Adulto , Betacoronavirus/patogenicidade , COVID-19 , China , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/virologia , Transmissão Vertical de Doenças Infecciosas , Pandemias , Gravidez , SARS-CoV-2
18.
Curr Med Sci ; 40(2): 285-289, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32219626

RESUMO

Based on the New Diagnosis and Treatment Scheme for Novel Coronavirus Infected Pneumonia (Trial Edition 5), combined with our current clinical treatment experience, we recently proposed a revision of the first edition of "Guidance for maternal and fetal management during pneumonia epidemics of novel coronavirus infection in the Wuhan Tongji Hospital". This article focused on the issues of greatest concern of pregnant women including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnostic criteria, inspection precautions, drug treatment options, indications and methods of termination of pregnancy, postpartum fever, breastfeeding considerations, mode of mother-to-child transmission, neonatal isolation and advice on neonatal nursing, to provide valuable experience for better management of SARS-CoV-2 infection in pregnant women and newborns.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Pandemias/prevenção & controle , Isolamento de Pacientes , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/terapia , SARS-CoV-2
19.
Lancet Infect Dis ; 20(5): 559-564, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32220284

RESUMO

BACKGROUND: In December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19. METHODS: In this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed. FINDINGS: Seven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29-34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of follow-up was Feb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth. INTERPRETATION: The maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature. FUNDING: National Natural Science Foundation of China, Hubei Provincial Natural Science Foundation of China.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez , Resultado da Gravidez , Adulto , COVID-19 , China , Infecções por Coronavirus/diagnóstico por imagem , Feminino , Humanos , Pandemias , Pneumonia Viral/diagnóstico por imagem , Gravidez , SARS-CoV-2 , Tomografia Computadorizada por Raios X
20.
Placenta ; 90: 18-26, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-32056547

RESUMO

INTRODUCTION: Studies have reported that villous cytotrophoblasts (CTBs) undergo a partial epithelial to mesenchymal transition (EMT) when differentiating into extravillous cytotrophoblasts (EVTs). Epithelial splicing-regulatory protein 1 (ESRP1), an alternative splicing regulator, has been demonstrated to play important roles in the EMT process. Nevertheless, the roles of ESRP1 in the placentation remain undefined. METHODS: ESRP1 expression in placental tissues throughout pregnancy was determined by immunohistochemistry and western blotting. The effect of ESRP1 knockdown by using small-interfering RNAs (siRNAs) on the phenotype of trophoblast cell line (HTR-8/SVneo) and villous explants was evaluated. RESULTS: ESRP1 was localized within the CTBs, trophoblast columns, and EVTs located in the decidua. ESRP1 expression was changed during pregnancy, with the highest expression level in term placentae. ESRP1 knockdown significantly increased the migration and invasion of HTR-8/SVneo cells, as well as the outgrowth of EVTs from villous explants, without affecting cell proliferation. This enhanced effect was associated with the increased expression of N-cadherin, vimentin and CD44. DISCUSSION: Our results suggested an important role for ESRP1 in regulating trophoblast migration and invasion during placentation.


Assuntos
Movimento Celular/fisiologia , Endométrio/metabolismo , Placenta/metabolismo , Proteínas de Ligação a RNA/metabolismo , Trofoblastos/metabolismo , Proliferação de Células/fisiologia , Feminino , Humanos , Gravidez , RNA Interferente Pequeno , Proteínas de Ligação a RNA/genética
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