BACKGROUND: Diseases and maternal poor habits before conception and during pregnancy have been considered as the definite risk factors for premature delivery and one of the results with better repeatability in the studies on the pathogenesis, whether parental socioeconomic status is related to the occurrence of premature birth?OBJECTIVE: To investigate the association of parental socioeconomic status with premature birth.DESIGN: A case-control study with the parents who has premature infants or normal infants as subjects.SETTING: Department of Preventive Medicine, Medical College of Qingdao University;Woman's Department of Traditional Chinese Medicine, Qingdao Municipal Haici Medicine Group; Department of Obstetric and Gynecology, Qingdao Municipal Eighth People's Hospital PARTICIPANTS: A cohort of premature infants (n=227) were recruited from Qingdao Municipal Maternity and Children Health Institute and the Eighth People's Hospital, Qingdao, premature birth were confirmed according to the diagnostic standards; the control infants (n=750) were also recruited from the same place, they were delivered at pregnancy of from 38 to 42 weeks with birth mass of 3 000-4 000 g. Two groups were matched in sexual constitution and the birthday of within the same week.METHODS: Parents of two groups were asked to fill the self-made questionnaire. Maternal obstetric factors were referring to the perinatal booklet and infant birth record; meanwhile parental socio-economic status, daily-life behaviours and sociodemographic character were also investigated. Multivariate non-conditioned logistic regression analysis was used to assess the relationship of correlative factors.MAIN OUTCOME MEASURES: Parental school education, occupation, the annual family income, as well as bad living and behavioral habits.RESULTS: According to the real state, data of 227 premature infants and 750 normal control infants were analyzed finally. Maternal delivery age of ＞ 35 years old (≤ 25 years old in normal control group), working as a teacher or unemployment (worker in control group), smoking and drinking during pregnancy, father's occupation as peasant (worker in control group), with a long smoking history, lower parental education (not lower than junior college education in control group) and family income less than 35 thousand Yuan (more than 35 thousand Yuan in control group) were proved to be the significant risk factors for premature birth (OR =1.629-15.701).CONCLUSION: Maternal employment as a teacher with father as a peasant, together with lower family income and lower parental education are connected with premature delivery.

AIM: To investigate the mechanism of renal damage in chronic intermittent hypoxia (CIH) rat model.METHODS:The Sprague-Dawley rats were randomly divided into 2-week CIH group (2IH), 2-week simulated air control group (2C), 4-week CIH group (4IH) and 4-week simulated air control group (4C).HE staining, PAS staining and Masson staining were used for histological evaluation .Blood was collected for the measurement of superoxide dismutase (SOD).The mRNA expression of hypoxia-inducible factor-1α(HIF-1α), manganese superoxide dismutase (MnSOD), copper/zinc superoxide dismutase ( Cu/ZnSOD ) was detected by real-time PCR.RESULTS: ( 1 ) No significance difference of renal weight , body weight , and the ratio of renal weight to body weight was observed , while IH caused mor-phologic kidney damage , especially in 4IH group.Hypertrophy of epithelial cells in the kidney tubles and dilation in the glomeruli were observed under light microscope with HE and PAS staining , especially in 4IH group.Masson staining showed no significant fibrotic response in the kidney of the rats exposed to IH .(2) The SOD levels in the serum and kid-ney were decreased after CIH .Compared with the corresponding control groups , the levels of serum SOD were significantly lower in CIH groups, especially in 4IH group.The mRNA expression of Cu/ZnSOD and MnSOD in CIH groups decreased significantly as compared with control groups .The mRNA levels of HIF-1αwere significantly higher in CIH groups than those in the corresponding control groups .CONCLUSION: CIH induces abnormalities of glomeruli and convoluted tu-bules, while 4-week IH exposure has not led to fibrotic response .CIH participates in the process of renal oxidative stress damage by upregulating HIF-1αtranscription and downregulating Cu/ZnSOD and MnSOD transcription .

[ ABSTRACT] AIM: To investigate the effect of chronic intermittent hypoxia on AMP-activated protein kinase ( AMPK) pathway in the brain of young rats.METHODS:Part one:SD mice (3~4 weeks old) were randomly divided into 4 groups (n=8): simulated air control group for 2 weeks (2AC), chronic intermittent hypoxia group for 2 weeks (2IH), simulated air control group for 4 weeks (4AC) and chronic intermittent hypoxia group for 4 weeks (4IH).Part two:SD mice (3~4 weeks old) were randomly divided into 2 groups (n=8): chronic intermittent hypoxia group for 4 weeks (4IH) and chronic intermittent hypoxia group treated with AMPK inhibitor for 4 weeks (4IHI).After modeling, the eight-arm maze test was performed.TUNEL method was used to detect the neuronal apoptosis in the hippocampal and pre-frontal cortical tissues.The mRNA expression of adenosine A2a receptor was examined by RT-qPCR, and the protein levels of phosphorylated AMPK (p-AMPK) and mammalian target of rapamycin (p-mTOR) were determined by Western blot.
RESULTS:Compared with control group, the numbers of reference memory error ( RME) , working memory error ( WME) and total error (TE) in 2IH group and 4IH group significantly increased (P<0.01).Compared with 2IH group, the num-bers of errors in 4IH group also increased significantly (P<0.01).Compared with 4IH group, the values in 4IHI group significantly decreased.Compared with control group, the neuronal apoptosis of hippocampus and prefrontal cortex in 2IH group and 4IH group increased, and that in 4IH group was more evident (P<0.05).In 4IHI group, the neuronal apopto-sis decreased.The mRNA expression of adenosine A2a receptor in the hippocampal and cortical tissues in 2IH group and 4IH group was higher than that in control group.The protein level of p-AMPK was higher, and p-mTOR was lower in 2IH group and 4IH group, and those in 4IH group were more evident (P<0.05).Compared with 4IH group, the protein level of p-AMPK was lower, and p-mTOR was higher in 4IHI group.CONCLUSION: Chronic intermittent hypoxia induces neuronal apoptosis, resulting in impairment of learning and memory in a time-dependent manner by upregulating adenosine A2a receptor, activating AMPK activity, and inhibiting mTOR phosphorylation in rats.

Objective To study the relationship between the change of T lymphocyte subsets and NK cells in esophageal cancer patients and radiotherapy effect.Methods The levels of T lymphocyte subsets and NK cells were detected by flow cytometry in 56 cases with histologically confirmed esophageal cancer treated with radiotherapy and contrasted to the healthy people.Results In patients with esophageal cancer,peripheral blood T cells,Th cells,Th / Ts were decreased significantly compared with the control group [(58.3±5.2) ％ vs (65.8±7.2) ％,(28.7±5.0) ％ vs (38.1±7.7) ％,(1.0±0.3) vs (1.6+2.7),all P ＜ 0.05],while the Ts cells were significantly increased [(28.8±5.3) ％ vs (25.4±5.7) ％,P ＜ 0.05].There was no significant difference between peripheral blood T lymphocyte subsets,Th/Ts ratio change and patient age,sex,tumor staging,histological differentiation and pathological lesions.After radiotherapy,the levels of peripheral blood T cells,Th cells,Th/Ts cell ratio and NK cells in esophageal cancer patients were increased [(66.9±4.5) ％ vs (59.4±4.9) ％,(40.6±5.6) ％ vs (29.1±4.2) ％,(1.6+0.5) ％ vs (1.0±0.4) ％,(16.2±3.9) ％ vs (14.6±3.2) ％,all P ＜ 0.05],while the Ts cells decreased [ (25.4±3.6) ％ vs (28.4±5.7) ％,P ＜ 0.05].The increasing degree of peripheral blood T cells,Th cells were closely related to the lesion progress,the difference was significant (both P ＜ 0.05).Conclusion Cellular immune function in patients with esophageal cancer is low.Detection of T lymphocyte subsets,NK cells can be used for immune monitoring of patients with esophageal cancer.

ObjectiveTo investigate the relationship of lymphotoxin β receptor (LTβR) and classical nuclear factor-κB (NF-κB) activation pathway in the pathogenesis and progress of cystitis and bladder cancer.MethodsThe LTβR and P65 mRNA expression were detected by Real-time quantitative PCR in 108 cases of fresh bladder tissue specimens (75 cases of bladder cancer,10 cases of inflammation and 23 normal bladder mucosa cases grouped by the tissue classification ),and protein expression were analyzed by immunohistochemistry assay in 118 cases of paraffin-embedded biopsy specimens (73 cases of bladder cancer,30 cases of cysitis and 15 normal bladder mucosa cases).The correlation analysis between the expressions of LTβR and P65 with clinical pathological data was then performed.Differences between LTβR and P65 mRNA and protein expression level were compared in different groups of bladder tissues using Kruskal-Wallis H test and the Chi-square test.Results( 1 )The mRNA expressions of LTβR and NF-κB/P65were higher in bladder cancer than those in normal group ( LTβR:29.4 ( 14.2 - 46.7 ) × 10 - 3/1.2 ( 0.3 -7.0) ×10-3,Z=-5.508; P65:9.7 (2.7 -21.1) ×10-3/1.0(0.8 ～1.8) ×10-3,Z=-5.030,P＜0.05 ).There were significantly differences between bladder cancer with different histological grades ( LTβR:18.2(2.1-31.3) × 10-3/ 28.4(16.6-36.2) × 10-3/47.9(34.3 -70.5) ×10-3,x2K-W=20.378;P65:4.9(1.3 - 12.0) × 10-3/7.4(3.0-21.9) × 10-3/17.0(10.0 ～28.3)× 10-3 ,x2K-W2 =15.219,P all ＜0.05) and lymph node metastasis (LTβR:27.2(9.7-40.1) ×10-3/39.4(26.7 -52.6) ×10-3,Z=-2.552; P65:7.4(2.3-15.6) ×10-3/13.4(6.7-23.3) ×10-3,Z=-2.026,P＜0.05).(2)The positive rates of LTβR and phosphorylated P65 ( p-P65 ) protein in cancer were higber than those of normal group (LTβR:69.8％/13.3％,x2 =16.600 ; p-P65:56.2％/6.7％,x2 =12.220,P ＜ 0.05 ).Upregulation of LTβR and p-P65 were associated with the histological grade (LTβR:56.3％/70.0％/90.4％,x2 =7.055; p-P65:40.6％ /60.0％/76.2％,x2 =6.679,P ＜0.05) and with lymph node metastasis (LTβR:58.3％/92.0％,x2 =8.849; p-P65:52.1％/64.0％,x2 =5.088,P ＜0.05).(3)There was a positive correlation between LTβR and P65 expression ( mRNA:r =0.654,P ＜ 0.05,protein:r =0.399,P ＜ 0.05 )in the bladder cancer and cystitis (r =0.521,P＜0.05).ConclusionsThe activation of LTβR and P65 was associated with progression and metastasis of bladder cancer.The activation of classical NF-κB pathway by LTβR may be achieved by P65.

Objective? To explore the status quo of nursing masters' core competence and to analyze its influencing factors. Methods? Totally 350 full-time schooling nursing masters from 7 universities from Shandong Province, Guangxi Zhuang Automatous Region, Jilin Province, Yunnan Province, Xinjiang Uygur Automatous Region, Tianjin Municipality and Liaoning Province and 140 nursing teachers from 5 teaching hospitals for nursing masters were selected by convenient sampling between March and October 2018. Nursing masters were investigated with the Core Competence Self-rating Scale for Nursing Masters (CCSRS-NM), while nursing teachers were investigated with the Nurse Master-administered Rating Scale (NMARS). A total of 350 questionnaires were distributed to the master of nursing, 332 valid questionnaires were obtained, 140 questionnaires were distributed to the teachers, and 128 valid questionnaires were obtained. SPSS 17.0 was used for statistical analyses. Multivariate linear regression analysis was employed to explore the influencing factors. Results? The CCSRS-NM score of 332 nursing masters totaled (174.67±23.45); the total NMARS score of 128 nursing teachers was (203.10±26.85). Univariate analysis showed that there were statistical differences in CCSRS-NM scores between nursing masters with different sex, grade, frequent presence at seminars, type of training, time of theoretical learning, published papers or not, attitude to nursing and guidance of supervisors (F/t=2.024, 7.306, 2.375, 2.534, -4.780, 3.792, 11.983, 7.454; P＜0.05); there were statistical differences in NMARS scores between nursing teachers with different age, length of service, professional title, educational background and qualified as supervisors or not (F/t=4.305, 4.696, 6.307, 2.330, -2.226;P＜0.05). According to multivariate analysis, nursing masters' attitude to nursing, time of theoretical learning, guidance of supervisors, sex, published papers or not and grade were the factors influencing nursing masters' core competence (P＜ 0.05); Length of service, professional title and qualified as supervisors or not were the influencing factors to nursing teachers' NMARS scores (P＜ 0.01). Conclusions? The core competence of nursing masters stands at an intermediate level, and nursing teachers' evaluation is higher than nursing masters' self-evaluation. Nursing masters' core competence may be enhanced by strengthening professional attitude education, increasing time of theoretical learning, intensifying supervisors' guidance, encouraging male candidates to study as a nursing major and encouraging nursing masters to publish papers, and reinforcing the communication and exchange between students at different grades. Evaluation of nursing masters' core competence should involve teachers and supervisors with different length of service and professional title.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.