Objective: To explore the relationship between prenatal anxiety and cesarean section (c-section) with non-medical indication.
Methods: Nested case-control study was used to analyze the risk factors for c-section with no medical needs: 433 pregnant women with gestational age longer than 24 weeks were enroled in this study. According to the mode of delivery, we divided them into a vaginal delivery group, a c-section group without medical need and a c-section group with medical need.
Results: The c-section rate was 62.1%, 55.8% of which was c-section without medical need at family request. The score of state anxiety (S-AI) and trait anxiety (T-AI) was 42.53±11.04 and
44.40±10.23 respectively, much higher than that of normal population. After the adjustment of maternal social economic status and other prenatal statuses for this pregnancy, the prenatal anxiety was still associated with c-section with non-medical indication. The adjusted odd ratio for prenatal anxiety state, prenatal trait anxiety state and c-section with non-medical indication was 1.41 (95%CI: 1.06-1.87) and 1.23 (95% CI: 1.08-1.40), respectively.
Conclusion: Prenatal anxiety state is a risk factor for c-section with non-medical indication.

BACKGROUND:Aconitum carmichaeli Debx (ACD) is the tuberous root of Aconium carmicgaekum, used as cardiotonic to restore yang for the treatment of colapse and shock, to warm the kidney and reinforceyang, and to expel cold and promote the flow ofyang-qi. Studies have found that ACD has obviously cardiotonic, antihypertensive, vasodilatory, analgesic, anti-inflammatory and toxic effects. OBJESTIVE: To observe the vasodilatory effects of a water decoction of ACD on rabbit’s aorta rings and its mechanism. METHODS:Rabbits aorta arteries were isolated, pre-contracted with noradrenaline (10-6 mol/L) and their responses to different concentrations of ACD (0.5, 1.0, 2.0, 4.0, 8.0 g/L) were investigated. The effects of removal of vascular endothelium and different signaling pathway inhibitors (Nω-nitro-L-arginine: 1×10-4 mol/L, methylene blue: 1×10-5 mol/L, indomethacin: 1×10-5 mol/L, propranolol: 1×10-5 mol/L) on ACD-induced vasodilation were also assessed. RESULTS AND CONCLUSION:ACD could not change the resting tension of rabbit aortic rings, but ACD treatment resulted in an obvious relaxation in narodrenaline-precontracted aortic rings and the relaxant effect was dose-dependent. The vasodilatory effect of ACD was significantly reduced by removal of endothelium, 1×10-4 mol/L Nω-nitro-L-arginine and 1×10-5 mol/L methylene blue but not reduced by indomethacin and propranolol. In addition, 4 g/L water decoction of ACD did not decrease the dose-response curves of artery rings to narodrenaline or KCl in the absence of endothelial cels. ACD can relax isolated rabbit’s aorta, which may be related to endothelium-released nitric oxide, but has no significant relevance with receptor-operated and voltage-dependent calcium channels.

Objective To investigate the effect of EMG-electrical stimulation on upper extremity function in patients with hemiplegia after stroke.Methods52 stroke patients with hemiplegia were randomly divided into the EMG-electrical stimulation group (27 cases) and control group (25 cases). All patients of two groups were treated with routine therapy and regularly physical therapy and occupational therapy, while those of the EMG-electrical stimulation group were given EMG-electrical stimulation training. The active range of motion (AROM) of wrist dorsiflexion was evaluated and upper extremity function was assessed by Fugl-Meyer Assessment (FMA) pre-treatment and 2 months after treatment.ResultsThe upper extremity function of all patients in two groups improved and the patients of the EMG-electrical stimulation group were superior to those of the control group ( P<0.05). The AROM and FMA scores of the patients in the EMG-electrical stimulation group were significantly superior to that of the patients in the control group ( P<0.05).ConclusionThe EMG-electrical stimulation can improve the upper extremity function of hemiplegic patients after stoke.

Objective:To investigate the expression of long non-coding RNA MALAT1, interleukin 6(IL-6) and apoptosis induced factor(AIF) in peripheral venous blood of premature infants with bronchopulmonary dysplasia (BPD) and its clinical significance.Methods:Preterm infants admitted to the Department of Neonatology, Shanghai Children′s Hospital from January 2015 to December 2016 were enrolled.The selection criteria included gestational age (GA) ≥28 weeks and ≤32 weeks, and birth weight (BW) < 1 500 g. According to the diagnosis, they were divided into BPD group (20 cases) and control group (20 cases). The clinical data of the two groups of premature infants were collected and analyzed, and the levels of MALAT1, IL-6 and AIF in the blood of 40 premature infants were detected by real-time polymerase chain reaction (RT-PCR). T test was used to compare gestational age, birth weight, MALAT1, IL-6 and AIF between the two groups. Results:(1)There was no significant differences in sex ( χ2=1.76), gestational age ( t= 0.17) and birth weight ( t=1.25) of premature infants in BPD group, compared with the control group (all P >0.05). (2)Compared with the control group, the expression of MALAT1 in the peripheral blood of premature infants in BPD group were significantly increased (0.273 4±0.067 3 vs. 0.375 5±0.081 9, P<0.05). (3)Compared with the control group, the expression of IL-6 in the peripheral blood of premature infants in BPD group were obviously decreased (1.448 8±0.191 8 vs.4.444 6±0.165 7, P<0.05). (4)Compared with the control group, the expression of AIF in the peripheral blood of premature infants in BPD group were remarkably decreased(0.006 8±0.002 0 vs.0.004 5±0.001 9, P<0.05). Conclusions:MALAT1 and IL-6 levels of long non-coding RNA in BPD and non-BPD preterm infants are different, which may be related to the incidence of BPD.IL-6 may be a predictor of BPD, and MALAT1 may protect premature infants with BPD.

Objective To investigate the infection of hemorrhagic fever with renal syndrome (HFRS) in host animals and inapparent infection of HFRS in general population in Dongting Lake areas after floods. Methods The night trapping method was used to capture rodents. The immunofluorescence assays were used to detect the hantavirus (HV) antigens and antibodies in rodents lung and in the serum of general population. Nonconditional logistic regression was applied to analyze risk factors for inapparent infection with HV. Results In flood region,draw-near flood region and new migration region,rodent density was 6.95%,6.28%, and 8.67%, respectively, and the virus-carrying rate in rodents was 15.07%,9.25%, and 4.47%, respectively. The virus-carrying rat index was the highest in flood region (0.10). Apodemus agrarius was the dominant species. The standardized positive rate of HV antibody in general population from above mentioned regions was 4.49%, 3.11%, and 3.13%, respectively. There was no significant difference among different age or gender groups. The results of logistic regression analysis indicated that people who were involved in construction of water conservancy facilities in winter or practice of rat extermination at home were the principal factors related to inapparent infection with HV. Conclusion The virus-carrying rate in main host animals of HV in the 3 regions is high, whereas the positive rate of HV antibody is low in general population. Comprehensive measures should be taken to prevent and control HFRS, such as reinforcing surveillance of HFRS, strengthening deratization, and preventive inoculation.

Objective To explore the association between serum vaspin levels and the severity of the lower extremity vascular lesions in type 2 diabetes mellitus (T2DM) patients.Methods According to the lower extremity artery plaque,stenosis and intima-media membrane thickening severity score,92 cases of T2DM patients were divided into three groups:simple diabetes group (DM1 group) (32 cases),mild diabetic lower limb vascular lesion group (DM2 group) (33 cases),and moderately severe diabetic lower limb vascular lesion group (DM3 group) (27 cases).Twenty-six age-and gender-matched apparently healthy controls (control group) were recruited as well.Systolic blood pressure (SBP),ankle-brachial index (ABI),insulin resistance index (HOMA-IR),and other indicators were determined,serum vaspin was measured by enzyme-linked immunosorbent assay.Results After adjustment for age and gender,the DM1 group had a significantly higher serum vaspin level than control group (P ＜0.01),while for the DM2 and DM3 groups,serum vaspin levels were significantly lower than the DM1 group (P ＜ 0.01).Partial correlation analysis showed that serum vaspin was inversely associated with HOMA-IR (r =-0.461,P =0.001)and positively correlated with ABI (r =0.462,P =0.001).Logistic regression analysis demonstrated that SBP,ABI and fasting serum vaspin levels were significantly associated with the presence of the lower extremity vascular lesions in type 2 diabetes.Conclusions Serum vaspin levels were significantly elevated in simple type 2 diabetic patients while the reduction of its level might be associated with the formation of lower extremity vascular lesions in type 2 diabetic patients.

As a metabolic disorder during pregnancy,gestational diabetes mellitus (GDM) has an important effects on fetal development,neonatal health and maternal long-term health,and is one of the pregnancy complications with high incidence.It is of great significance that we have an accurate understanding of the etiology and risk factors of GDM for its prevention and control.GDM is a complex disease with multiple etiologies.Current studies have shown that the occurrence of GDM may be the result of combined effect of heredity and environment,but the exact etiology is still unclear.In this paper,we summarized the possible etiologies and risk factors of GDM,so as to understand the occurrence and development of GDM better and to provide possible references for prevention and further etiological studies of GDM.

Background The risk of HIV sexual transmission is much higher among people unaware of their HIV status than among those aware.Only a few studies have indicated that the incidence of unsafe sex can be reduced when people know their HIV status.This study was to investigate this effect in China.Methods A cohort study consisting of two surveys was conducted at two different times among a group of people living with HIV/AIDS,whose status was newly diagnosed with HIV via sexual contact,in Shanghai,Chongqing,and Kunming.The first survey was conducted among 823 people tested positive for HIV before notifying them of the HIV status.The second survey was conducted among 650 HIV-positive people at six months following the first survey (after notification of HIV status).The scope of survey covered unsafe sex practices,number of unsafe sexual partners,and frequency of unsafe sexual behaviors over the prior six months.Unsafe sex is defined as unprotected anal or vaginal sex with partners who are HIV positive or whose HIV status is unknown.Results The proportion of unsafe sex was reduced by about 85％ after HIV status notification.The risk of HIV sexual transmission was 15 times higher among persons unaware of their HIV status than among those aware.Approximately 95％ of new sexually transmitted HIV infections stemmed from 56％ of the infected persons unaware of their HIV status in China.Conclusion Timely HIV status notification has the potential to significantly reduce unsafe sex among HIV-infected persons and reduce the risk for HIV transmission via unsafe sex.

This study was designed to investigate the effects of some Traditional Chinese Medicine (TCM) agents on bone resorption and morphometric features of osteoclasts as well as their relationships. TCM ShengGuZaiZaoSan and XianLingGuBao, were used to treat the experimental fracture. Thirty 6-month-old Chinchilla rabbits were used for the establishment of animal models each with a 3 mm bone defect in the middle of left radius as well as of right radius. These models were divided randomly into 3 groups : ShengGuZaiZaoSan Group (Group A), XianLingGuBao groups (Group B) and control-group (Group C). Every group was further divided into 2 subgroups: a former sacrificed group (14 days after operation) and a latter sacrificed group (31 days after operation). After the rabbits being killed, the samples of their undecalcified calli were subjected to the morphometry study of bone resorption and osteoclasts. Group A had more bone resorption, compared with Group B and C. Both Groups A and B exhibited some changed morphometric features of osteoclasts as compared with Group C (P < 0.05). Simple correlation analysis indicated that bone resorption is mainly correlated with osteoclast numbers, and that in individual group, bone resorption is correlated with osteoclast form factor, area and mean photodensity (P < 0.05). These allow us to conclude that ShengGuZaiZaoSan can increase bone resorption and accelerate bone remodeling by increasing osteoclast numbers at the former stage and can enhance osteoclast function at the latter stage. These changes are beneficial to fracture healing.
Animals ; Bone Remodeling ; drug effects ; Bone Resorption ; physiopathology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Fracture Healing ; drug effects ; physiology ; Male ; Osteoclasts ; drug effects ; pathology ; Phytotherapy ; Rabbits ; Radius Fractures ; drug therapy ; pathology ; physiopathology ; Random Allocation

OBJECTIVETo understand the risks and associated factors of HIV transmission by sharing syringes among HIV-positive drug users.

METHODThe survey was conducted among HIV-positive injecting drug users (IDUs-HIV+) who received HIV counseling, testing and treatment in Changsha city Infectious Disease Hospital and Hengyang city No.3 People's Hospital from July 2012 to May 2013 to understand their socio-demographic characteristics, HIV prevalence and syringe sharing. A total of 503 IDUs-HIV+ were involved in and provided the contact list of 2 460 drug users who had the syringe sharing experience over one month with IDUs-HIV+. 420 IDUs-HIV+ among 503 were defined as infection sources due to sharing syringe with at least one drug user. Among them, 234 HIV-negative persons were in control group, and 186 HIV-positive were in cased group. A total of 1 220 drug users were followed up among 2 460 and defined as vulnerable population. The HIV transmission rate was calculated based on the HIV prevalence among vulnerable population. Based on the result of HIV transmission to vulnerable population from 420 infection sources, case-control study and the multivariate logistic regression analysis were adopted to explore the associated factors of HIV transmission among IDUs-HIV+.

RESULTSAs the sources of HIV transmission, 420 IDUs-HIV+ had an average duration of (4.5 ± 1.2) years for drug use. As a susceptible population, 1 220 drug users sharing syringes with the 420 IDUs-HIV+ had an average duration of (1.1 ± 0.5) years for drug use. There were 238 HIV-positive persons among 1 220 vulnerable drug users, with a transmission rate of 0.57. In the case-control study, the proportion of male subjects was 87.1% (162/186) in the case group, which was higher than that in the control group (77.8%, 182/234). The proportion of subjects who received support after knowing their HIV infection status was 51.1% (95/186) in the case group, which was lower than that in the control group (79.5%, 186/234). The proportion of subjects sharing syringes every time of using drugs was 47.8% (89/186) in the case group, which was higher than that in the control group (36.8%, 86/234). The proportion of subjects having AIDS awareness was 21.0% (39/186) in the case group, which was lower than that in the control group (64.5%, 151/234); the proportion of subjects having close contact with HIV-positive persons for more than 106 days was 60.2% (112/186) in the case group, which was higher than that in the control group (31.6%, 74/234). The proportion of subjects maintaining the original drug use method after being infected with HIV was 50.5% (94/186) in the case group, which was higher than that in the control group (16.7%, 39/234) (all P values < 0.05). The multivariate logistic regression analysis was carried out to analyse high correlate factors of HIV transmission by sources of transmission, and the AIDS awareness, duration of contact between sources of transmission and vulnerable population, access to support following confirmed HIV infection were protective factors, OR (95% CI) values were 0.155 (0.104-0.262), 0.170 (0.106-0.253), and 0.306 (0.189-0.450), respectively; while the frequency of syringe sharing and continuous drug use after being infected with HIV were risk factors, and the OR (95% CI) values were 3.06 (1.77-5.29), and 3.54 (2.16-5.80), respectively.

CONCLUSIONHIV transmission by IDUs-HIV+ might be contained by raising AIDS awareness, providing comprehensive psychological support, conducting needle exchange and methadone maintenance treatment and reducing syringe sharing.

Aged ; Case-Control Studies ; Drug Users ; HIV Infections ; Humans ; Male ; Methadone ; Needle Sharing ; Prevalence ; Risk Factors ; Substance Abuse, Intravenous