1.Triple serum tests screening for Down's syndrome in women at second trimester: a meta analysis
Long LI ; Jianfeng HE ; Baosheng ZHU
Chinese Journal of Perinatal Medicine 2016;19(2):119-127
Objective To explore the value of maternal serum triple markers screening,consisted of AFP (α-fetal protein),β-human chorionic gonadotropin (β-hCG) and free estriol (uE3),for Down's syndrome,in second trimester.Methods We searched published literatures from PubMed,MEDLINE,China National Knowledge Internet (CNKI) and Wanfang Database from January 1990 to August 2014 and articles met the following criteria were collected:(1) The report was of a screening test;(2) The research purpose was to study the efficiency ofAFP,hCG and uE3 (triple markers) screening for Down's syndrome;(3) The research subjects were pregnant women in second trimester;(4) All of the studied cases were confirmed by amniocentesis and chromosome karyotyping;(5) The pregnant outcomes must be available;(6) Each report should have at least one case of Down's syndrome identified;(7) The literature could be retrieved by Science Citation Index or Chinese core periodicals;(8) When assessed by QUADAS (quality assessment of studies of diagnostic accuracy included in systematic reviews) Quality Assessment Scale,the score should be ≥ 8.Information were extracted,including name of the first author,publication time,sample size,sensitivity,specificity,maternal age,gestational age,cutoff value,β-hCG type and others.MetaDiSc 1.4 software was applied for meta-analysis.I2 was used for heterogeneity,and the fixed or random effects model for calculation of the combined sensitivity,specificity,diagnostic odds ratio (DOR) and the 95%CI.The summary receiver operating characteristic (SROC) curve was drawn.Deek's test in Stata Software was used to validate publication bias.Results A total of 49 literatures were recruited in this study with a total sample size of 960 245.Deck's funnel plot analysis showed that the correlation coefficient and the standard error of bias were-1.067 and 3.64 (t=-0.290,P=0.771).The correlation coefficient and the standard error of the slope were 3.578 and 0.26 (t=13.740,P=0.000).The random effects model showed the pooled sensitivity of the 49 literatures was 0.72 (95%CI:0.70 0.74),the pooled specificity was 0.92 (95%CI:0.92-0.93),and DOR was 33.80 (95%CI:25.03-45.65).The area under the SROC was 0.900 7.DOR of younger age group (including three literatures) was 14.38 (95%CI:3.67-56.42) and 26.64 (95%CI:19.49-36.41) for the older age group (two literatures).For two literatures determining the gestational age based on ultrasonography,the DOR was 50.22 (95%CI:26.91-93.71),and DOR was 33.09 (95%CI:17.33-63.19) for those based on last menstrual period in these two literatures.For eight literatures applied the cutoff value of 1:270,12 applied 1:250 and four applied mixed cutoff value,the DOR was 10.94 (95%CI:3.04-39.38),54.34 (95%CI:42.19-70.01) and 36.37 (95%CI:31.19-42.40),respectively.DOR of total β-hCG group (12 literatures) was 22.06 (95%CI:16.46-29.58) and that of free β-hCG group (ten literatures) was 37.15 (95%CI:30.00-46.02).Conclusions Triple regimen of second trimester maternal serum screening for Down's syndrome is much more efficient.The detection rate could be further improved by determination of the gestational age with ultrasound,and application of 1:250 as the risk cutoff value and free β hCG as a screening marker.
2.Maternal and neonatal perinatal outcomes in pregnancies after in vitro fertilization and natural pregnancy: a systematic: a meta analysis
Ling LONG ; Liren HE ; Chuan YE ; Yuyan LI ; Wei HE
Chongqing Medicine 2017;46(16):2228-2232
Objective To systematically evaluate maternal perinatal complications and neonatal outcomes after in vitro fertili zation and embryo transplantation(IVF-ET).Methods The computer retrieval was performed on the databases of PubMed,Cochrane library,EMbase,CNKI,Wanfang and Chinese biomedical literature database.The articles on the comparison between IVF and natural pregnancy were included.The RevMan5.3 software was adopted to conduct the meta analysis.Results Twenty-three articles conforming to the requirements were included,including 1 312 651 cases,among them 113 044 cases were IVF and 1 199 607 cases were naturalpregnancy.IVF mother's age was larger than that of natural pregnancy,while the gestational weeks were smaller than those of natural pregnancy,the newborn birth weight was lighter than that of natural pregnancy(P<0.05);the probability of pregnancy-induced hypertension (PIH),placenta previa,postpartum hemorrhage and gestational diabetes mellitus (GDM) occurrence in IVF mother were higher than that of natural pregnancy (P<0.05);the rate of multiple and cesarean section in IVF mothers were higher than that of natural pregnancy (P<0.05);the occurrence rates of small for gestational age(SGA),low birth weight infants,stillbirth and premature in IVF were higher than those of natural pregnancy (P<0.05).Conclusion The maternal perinatal complications in IVF are higher than those of natural pregnancy,and the birth outcomes in IVF are worse than those of natural pregnancy.
3.Relationships among posttraumatic growth, social support, and coping style in women with infertility
Yongju YU ; Li PENG ; Long CHEN ; Ling LONG ; Wei HE ; Jing LI ; Min LI
Chinese Journal of Behavioral Medicine and Brain Science 2013;22(8):707-709
Objective To explore the relationships among posttraumatic growth (PTG),social support,and coping style in women with infertility.Methods 182 women with infertility were recruited in one public hospital department of assisted reproduction technology.Measures included Posttraumatic Growth Inventory (PTGI),Perceived Social Support Scale (PSSS),and Simplified Coping Style Questionnaire (SCQ).Results ① The PTG score of women with infertility was 42.55 ± 16.83,lower than the average level.② Compared with the lower PTG group,the higher PTG group scored significantly higher in social support,positive coping,and negative coping (t =3.867,P< 0.01 ; t =8.452,P< 0.01 ; t =2.817,P< 0.01).③ There were significantly positive correlations among PTG,social support and positive coping (r =0.295-0.515,P < 0.01).④ Positive coping served as a total mediator in the relationship between social support and PTG.Conclusion There are closely correlations among PTG,social support,and positive coping style.Positive coping style significantly mediate the relationship between social support and PTG.
4.Application of classification-partition-distribution emergency nursing management for severe trauma patients
Jinjiao LI ; Xiangmei LONG ; Huiping HE ; Lijuan ZHONG ; Chunchang LI
Modern Clinical Nursing 2017;16(5):18-20
Objective To study the effects of classification-partition-distribution emergency nursing management for severe trauma patients. Method A total of 60 patients from June 2014 to May 2015 were set as control group receiving common nursing and other 62 patients from June 2015 to June 2016 as observation group treated with emergency hierarchical partition and triage nursing. Result The treatment success rate in the observation group were both significantly higher than that of the control group (P<0.05). Conclusion Classification-partition-distribution emergency nursing management for severe trauma patients can increase treatment success rate .
5.Concurrent reversible posterior leukoencephalopathy syndrome during peri-operative period of renal transplantation in one case
Jianzhong LI ; Lianhui FAN ; Long LIU ; Hongwei YANG ; Xin LI ; Zhiqiang CAO ; Long HE
Chinese Journal of Tissue Engineering Research 2014;(5):748-753
BACKGROUND:Reversible posterior leukoencephalopathy syndrome is rarely reported, especial y concurrent during perioperative period of renal transplantation. Due to its clinical manifestations similar to uremia, transplant doctors are easy to ignore or not timely diagnosis reversible posterior leukoencephalopathy syndrome, thus impacting its treatment.
OBJECTIVE:To discuss the clinical manifestations, imaging features, treatment experience and prognosis of patients with reversible posterior leukoencephalopathy syndrome concurrent during perioperative period of renal transplantation, in order to improve the diagnostic rate and therapeutic effect.
METHODS:We reviewed clinical data of one case of concurrent reversible posterior leukoencephalopathy syndrome during perioperative period of renal transplantation admitted at the General Hospital of Shenyang Military Region.
RESULTS AND CONCLUSION:From the 3rd day postoperatively, the patient gradual y experienced abnormal blood pressure, blurred vision, headache, seizures, disturbance of consciousness and mental and behavioral abnormalities. Early head CT showed low density in the left frontal lobe and corona radiate;and further MRI re-examination showed flake-shaped T1 and long T2 signals in the bilateral frontal lobe, hippocampus, parietal occipital cortex, and brainstem, as wel as high signals on FLARI images at the corresponding parts. After active treatment, the clinical manifestations were improved. Retrospective analysis of clinical data of this case and review of relevant literature wil provide clinical data for the diagnosis and treatment of concurrent reversible posterior leukoencephalopathy syndrome during perioperative period of renal transplantation.
6.Development and characterization of TPGS modified proniosomes of docetaxel.
He-long LIU ; Kai-li HU ; Jian-fang FENG
China Journal of Chinese Materia Medica 2015;40(19):3775-3779
A novel oral delivery system that TPGS modified docetaxel proniosomes, DTX-TPGS-PN, was developed and the characterization after hydration was observed. Firstly, Doce-TPGS-PN was optimized by investing the factors, including the type of surfactant, methods of adding TPGS, content of TPGS and the molar ratio of span40/cholesterol, which may affecting the particle size, encapsulation efficiency and instantaneous release of drug in the formulation. Then, the morphology, particle size, Zeta potential, encapsulation efficiency and in vitro release of the formulation were evaluated. The result showed that hydrated nanoparticles of DTX-TPGS-PNs were (93 ± 6.5) nm in size,(-83.95 ± 3.69) mV in zeta potential, (97.31 ± 0.60)% in encapsulation efficiency, exhibiting spherical morphology and biphasic release process that a low burst effect within the first 0.5 hour and a relative-sustained release for the next several hours in PBS. These results indicate the oral delivery system of DTX-TPGS-PN was successfully built with good properties.
Chemistry, Pharmaceutical
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methods
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Particle Size
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Polyethylene Glycols
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chemistry
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Taxoids
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chemistry
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pharmacology
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Vitamin E
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analogs & derivatives
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chemistry
8.Effects of hydrogen-rich saline on expression of phosphor-p38MAPK during cerebral ischemia-reperfusion in rats
Da LI ; Yanqiu AI ; Feng JIN ; Long HE ; Wei ZHANG
Chinese Journal of Anesthesiology 2015;35(3):370-372
Objective To evaluate the effect of hydrogen-rich saline on the expression of phosphor-p38 mitogen-activated protein kinase (p-p38MAPK) during cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two adult male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 3 groups (n =20 each) using a random number table:sham operation group (group S),I/R group and hydrogen-rich saline group (group I/RH).Cerebral ischemia was induced in chloral hydrate-anesthetized rats by 2 h middle cerebral artery occlusion in I/R and I/RH groups.The artery was only exposed but not occluded in group S.At 3 days before operation and immediately after onset of reperfusion,hydrogen-rich saline (0.6 mmol/L) 10 ml/kg was intraperitoneally injected in group I/RH,while the equal volume of normal saline was given in S and I/R groups.Neurological deficits were blindly assessed and scored at the end of 24 h reperfusion.The animals were then sacrificed,and brains were removed for microscopic examination and for determination of the cerebral infarct size (by TTC),brain water content,cell apoptosis (by TUNEL),and expression of p38MAPk and phosphor-p38MAPK (p-p38MAPK) (by immunohistochemistry and Western blot).Apoptosis index was calculated.Results Compared with group S,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly increased,and the expression of p38MAPK and p-p38MAPK was up-regulated in I/R and I/RH groups.Compared with group I/R,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly decreased,and the expression of p38MAPK and p-p38MAPK was down-regulated in group I/RH.The pathological changes of cerebral tissues were significantly attenuated in group I/RH as compared with group I/R.Conclusion Hydrogen-rich saline can reduce cell apoptosis through inhibiting p-p38MAPK expression,thus attenuating cerebral I/R injury in rats.
9.Effects of total saponins on calcium content and lipid peroxidation in injured spinal cord of rats
Fengchi HE ; Zaiyun LONG ; Li ZHOU ; Yingbing |LIU
Journal of Third Military Medical University 1988;0(05):-
Four hours after the spinal cord of rats was injured,the contents of malondi-aldehyde(MDA)and free fatty acid(FFA)were significantly increased,the activity of xan-thine oxidase(XOD)elevated,the activity of superoxide dismutase(SOD)reduced,and the calcium content significantly increased in the tissues of the injured cord.These facts suggest that there is the generation of calcium-mediated free radicals and lipid peroxidation in the membrane.Intravenous injection of saponins of Panax notoginseng(PNS)in the dosage of 30,90,and 270mg/kg could all inhibit the production of MDA; 270mg/kg could inhibit the release of FFA and the activity of XOD;90mg/kg could significantly decrease the calcium content.These findings indicate that the inhibition of PNS on the calcium influx might be one of the mechanisms of anti-lipid peroxidation in spinal cord injury in rats.
10.Changes of Intracerebral Amino Acid Transmitters in Periventricular Leukomalacia of Newborn Rats Observed with Microdicalysis Technology
long, ZHANG ; li, JIANG ; ting, WANG ; nong-yue, HE
Journal of Applied Clinical Pediatrics 2006;0(20):-
Objective To observe the changes of intracerebral amino acid transmitters in the periventricular leukomalacia (PVL) of newborn rats with microdialysis and so as to explore the role of excitotoxicity in PVL.Methods Replicated the model for PVL at the age of postnatal day 5 (P5) by intracerebral injection of 3-nitropropionic acid (3-NPA).Before injection of 3-NPA,and 15 min,30 min,45 min,60 min,75 min,90 min after injection of 3-NPA,collected the sample of extracellular fluid (ECF) at the corpus callosum above the left ventricle through microdialysis,respectively.After microdialysis,the experimental rats were allowed to survive to P6-P14,and then they were killed and the brains were prepared for HE stain.The amino accids of dialysate were quantified through high performance liquid chromatography(HPLC),and then the excitotoxic index (EI) was calculated.Results Fifteen min to 45 min after injection of 3-NPA,the concentrations of glumate (Glu) and aspartic acid (Asp) of ECF elevated significantly,and then returned to the normal levels.Fifteen min to 75 min and 15 min to 30 min after injection of 3-NPA,the concentrations of glycine (Gly) and GABA significantly elevated,respectively,and returned to normal levels at 90 min and 45 min after injection of 3-NPA,respectively.But the EI,which indicated the balance of excitatory amino acids(EAAs) and inhibitory amno aciols(IAAs),significantly elevated 15 min to 75 min after injection of 3-NPA,then retured to normal level after 90 min.Sub-cortical and periventricular white matter rarefaction and significant lateral ventricle enlargement were observed in HE staining.Conclusions Changes of intracerebral amino acid transmitters in the PVL of newborn rats show regularity:EAAs,IAAs of ECF and EI elavate in the early stage,and then return to the normal level quickly.It indicates that excitotoxicity play a great role in PVL,especially at the early stage.Therefore,the preventions of PVL must be executed at the early stage.