Objective To analyze the relationship between pre － pregnancy body mass index ( BMI) ，gestational weight gain ( GWG) and the birth weight of infants，and explore the effect of weight change before and during pregnancy on low birth weight ( LBW) and macrosomia． Methods Women were enrolled by the Chinese Pregnant Women Cohort Study during first trimester． Each respondent＇s weight before and during pregnancy and the birth weight of infant were collected after fellow up． Prepregnancy BMI was divided into underweight，normal and overweight /obesity groups and GWG was divided into suitable， insufficient and excessive groups． Multivariate Logistic regression was adopted to explore the relationship be- tween pre－pregnancy BMI，GWG and newborn＇s birth weight． Ｒesults Women＇s prepregnancy BMI and GWG were associated with neonatal birth weight ( all P＜0. 05) ． Prepregnancy overweight or obesity ( OＲ=2. 339，95% CI: 1. 674－2. 282，P＜0. 001) and excessive GWG ( OＲ= 1. 398，95% CI: 1. 188－1. 978，P= 0. 048) were shown as risk factors for macrosomia． Insufficient GWG increased LBW risk ( OＲ = 1. 479， 95% CI: 1. 461－1. 679，P= 0. 035) while excessive GWG declined LBW risk ( OＲ= 0. 428，95% CI: 0. 225 －0. 817，P= 0. 010) ． Under weight－insufficient GWG was risk factor of LBW ( OＲ= 1. 335，95% CI: 1. 048 －2. 319，P= 0. 048) while normal BMI－excessive GWG ( OＲ= 1. 088，95% CI: 1. 016－1. 675，P= 0. 038) and overweight /obesity－excessive GWG ( OＲ= 1. 498，95% CI: 1. 244－2. 017，P= 0. 046) were associated with higher risk of delivering macrosomia． Conclusions Prepregnancy BMI and GWG were associated with infant＇s birth weight and women were suggested to maintain their weight in recommended range before and during pregnancy．

Objective: To analyze and compare the features and strengths of different methods for calculating the biophysical properties of meridian points, and thus propose corresponding suggestions to fully achieve the research and application value of biophysical properties of meridian points.Methods: We searched and collected the literature on the imbalance of biophysical properties of meridian points between January 1, 2005 and March 1, 2020 in China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP) and PubMed database, and then analyzed, compared, and summarized the applied methods for calculating the imbalance degree of the biophysical properties of meridian points. Results: The current methods for calculating the imbalance degree of the biophysical properties of meridian points are diverse and can be summarized as the following three: direct comparison of the measured values of the left and right namesake points, difference method, and ratio method. The low uniformity of the calculation methods has limited the promotion and application of its research results. Conclusion: In future research on the biophysical properties of meridian points, multidisciplinary cooperation in terms of imbalance degree calculation methods, detection instruments, and health data models is necessary to achieve more widely applicable scientific conclusions and more generalized experimental results.

OBJECTIVETo study the chemical constituents in the active parts of Huoxue Yiqi Tang.

METHODThe silica gel, Sephadex LH-20 were used to isolate the compounds, El, FAB-MS and 1D, 2D-NMR were used to identify the obtained compounds.

RESULT14 compounds were obtained from the prescription.

CONCLUSIONThey were all first time obtained from the prescription. Among them, 7, 3'-dihydroxyl-5'-methoxyisoflavone is new.

Anthraquinones ; chemistry ; isolation & purification ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; Emodin ; chemistry ; isolation & purification ; Isoflavones ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry

OBJECTIVETo evaluate the prognostic effects of neoadjuvant chemotherapy (NAC) in patients with local advanced gastric cancer.

METHODSWe retrospectively analyzed prognosis in 191 patients with advanced gastric cancer, of whom 71 were treated with NAC and 120 received surgery only between February 2007 and July 2013. Postoperative complication rate was recorded. Survival by clinicopathological features, pathological T and N stages, and histopathological tumor regression was retrospectively compared between the two groups.

RESULTSAccording to Response Evaluation Criteria in Solid Tumors, none of the 71 patients in the NAC followed by surgery group showed complete response, 36 showed partial response, 25 had stable disease, and 10 had progressive disease. The chemotherapy response rate was 50.7%; the disease control rate was 85.9%. Grade 3/4 adverse events were seen in less than 20% patients, with acceptable toxicities. No difference was found in the overall postoperative complication rates between the two groups (7 versus 22 cases, P=0.18). Median survival time was significantly different, at 54 months in the NAC combined with surgery group and 25 months in the surgery-only group (P=0.025).

CONCLUSIONIn patients with operable gastric adenocarcinomas, NAC can significantly improve overall survival without increasing surgical complications.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; mortality ; pathology

OBJECTIVE To observe the clinical effect of modified Sheganmahuang Tang plus symbicort in treating the acute attack of asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS).METHODS Forty-two ACOS patients were divided into the experimental group(22 cases)and the control group(20 cases)according to the random number.On the basis of conventional western drug symptomatic treatment including oxygen inhalation,stopping cough and resolving phlegm,bronchus dilation,anti-infection,the control group was given symbicort inhalation,and the experimental group was given She-ganmahuang Tang plus symbicort.The treatment course was 4 weeks.the curative effects of both groups were observed.RE-SULTS In terms of clinical effect,the totally effective rates of the experimental group and the control group were 96.00％and 65.00％,respectively,and the difference between two groups was significant,P<0.05.The FEV1％and FEV1/FVC in-creased significantly compared with the control group,P<0.05.DLCO in the experimental group increased slightly higher than that in the control group,P>0.05;CAT score(16±2)decreased significantly compared with the control group(20± 2);and the ACT score(24±3)increased significantly compared with the control group(16±2),P<0.05.The reoccurrence rate in the experimental group decreased significantly compared with the control group,P<0.05～0.01.Both groups reported no severe adverse event.CONCLUSION Sheganmahuang Tang plus symbicort achieves satisfactory curative effect in the treat-ment of acute attack of ACOS with no severe adverse event,which is worthy of spreading.

Objective To analyze the incidence of gestational diabetes mellitus (GDM) among Chinese pregnant women and the distributions of unhealthy lifestyles. Exploring the association between these behaviors and GDM to provide some suggestions to GDM prevention. Methods Women who were enrolled by the Chinese Pregnant Women Cohort Study and delivered before the 31st December, 2018 were enrolled by this study. The characters of physical activity, sedentary lifestyle, tobacco exposure, alcohol consumption, unhealthy diet and low sleep level were assessed by questionnaire and also the pregnancy complications. Binary Logistic regression model was adopted to analyzed the relationship between the dependent and independent variables. Results A total of 3 162 women were enrolled in this study and 372 of them were diagnosed GDM. Single variable analysis showed that lack of leisure time physical activity (RR=1.015,95% CI=1.005-1.279，P=0.046) and low sleep quality (RR=1.019, 95% CI: 1.004-1.196，P=0.047) were two risk factors of GDM. Compared with women who showed none of these unhealthy lifestyle, those who showed all six unhealthy behaviors had higher risk of GDM (RR=1.530, 95% CI: 1.263-8.880，P=0.036). Conclusions The incidence of GDM among Chinese women was 11.76%. Lack of physical activity and poor sleep quality could increase the risk of GDM and the cluster of unhealthy lifestyles is associated with higher GDM risk. Adequate physical activity, no smoking and drinking, balanced diet and other healthy behaviors are important to GDM prevention.

Objective To explore the associations between cesarean section with different types and intensity of physical activity in the second trimester pregnant women． Methods Six hundred and seventy－two participants from the Chinese pregnant women cohort study ( CPWCS) were analyzed． The pregnancy physical activity questionnaire ( PPAQ) was used to collect the status of physical activities in pregnant women． The participants were followed up and the data of delivery way was collected． Logistic regression model was conducted to analyze the associations． Ｒesults A total of 273 pregnant women ( 40. 63%) were delivered by cesarean section． After adjusting age，pre-pregnancy BMI and history of childbirth，results of Logistic regression model showed that pregnant women with higher levels of exercise had a lower risk of cesarean section than those who did not participate in exercise ( OＲ= 0. 564，95% CI: 0. 338－0. 941) . In terms of physical activity intensity，pregnant women who participated in the higher level of moderate to vigorous physical activity had a lower risk of cesarean section than those who partici- pated in the lower level ( OＲ= 0．642，95% CI: 0．437－0．972) ． Conclusions Exercise and moderate to vigorous physical activity are protective factors for cesarean section． Health education should be further strengthened to encourage pregnant women to carry out appropriate physical activity during pregnancy．

Objective To observe the changes of serum aldosterone(ALD)in children with patent ductus arteriosus(PDA)at before and after interventional therapy,and explore its relationship with cardiac remodeling and its clinical significance.Methods Serum ALD level taken in supine position,left heart chambers sizes and heart f unction in children with PDA were measured and compared before,24 hours part intervention and at 1 month and 3 months after.The relationship between ALD and the left heart chambers sizes and the heart function were analyzed.Results Serum ALD levels were significantly lower 24 hours,1 month and 3 months than the pre-procedure levels [(348.44± 54.27)pmol/L vs.(311.35±50.34)pmol/L vs.(258.14±50.56)pmol/L vs.(199.09±48.12)pmol/L,F=18.98,P＜0.05].The lef t atrial diameter indexes[(42.33±6.44)mm/m2 vs.(36.22±5.33)mm/m2 vs.(35.54±5.36)mm/m2 vs.(34.26±4.32)mm/m2,F=12.18,P ＜ 0.05] and the lef t ventricular end diastolic diameter indexes [(69.34±7.43)mm/m2 vs.(67.43±6.33)mm/m2 vs.(66.35±6.56)mm/m2 vs.(60.54±5.34)mm/m2,F=11.71,P＜0.05] were also lower at 24 hours,1 month and 3 months after intervention than pre-procedure measurements.The left ventricular end systolic diameter indexes measured at 24 hours,1 mouth and 3 mouths after intervention were all lower as compared to pre-procedure condition[(39.43±8.32)mm/m2 vs.(38.47±7.45)mm/m2 vs.(36.85±5.43)mm/m2 vs.(35.63±5.34)mm/m2,F=13.13,P ＜ 0.05].There was relevance between the serum ALD level and the left heart chamber size indexes(P ＜ 0.05).Conclusions Early interventional therapy for PDA can reverse the activation of aldosterone secretion and cardiac remodeling.

BACKGROUND: Studies have shown that dental pulp stem cells have high proliferation and multi-directional differentiation abilities and can differentiate into a variety of cells under certain conditions. At present, the use of dental pulp stem cells to construct tissue-engineered dentin-pulp complex is expected to become a new strategy for human dental defect repair . OBJECTIVE: To observe the effect of dental pulp stem cells on the repair of rat tooth defects by construction of tissue-engineered dentin-pulp complex. METHODS: Twenty-four Sprague-Dawley rats were used to make animal models with dental pulp removal, and then model rats were randomly divided into model group and transplantation group. Rats in the transplantation group were subjected to tissue-engineered dentin-pulp complex transplantation, and those in the model group given no treatment. Tooth samples were collected at 3, 5, 7 weeks post transplantation and observed using hematoxylin-eosin staining and immunofluorescence staining. The dentin thickness of rats was measured by Image Pro Plus 6.0 image software system. RESULTS AND CONCLUSION: (1) Dental pulp cells was mostly spindle/oval-shaped and partially polygonal. The third generation of cells with long spindle shape showed fibrous growth and uniform morphology. Findings from immunohistochemical staining showed spindle-shaped deep-colored cells with oval nuclei stained as dark blue were identified as fibroblast-like cells, and were positire for vimtin. (2) Findings from hematoxylin-eosin staining showed vacuolar degeneration of the cells, and hbdestroyed pulp tissue and debris, irregular cord-like tissue, and a large amount of red blood cells and inflammatory cells in the pulp cavity, accompanied by clearly visible vascular dilation. Seven weeks after transplantation, a bundle of odontoblasts were visible in the matrix-like tissues of the dentin, and there was a distinct boundary between the original dentin and regenerated dentin. (3) Findings from immunofluorescent staining showed that after dentin-pulp complex transplantation, the number of cells in the pulp cavity increased significantly at 3 weeks, and there was also a substantial increase in dental pulp cells at 5 weeks that were distributed on the wall of the pulp cavity. Compared with the model group, the dentin thickness in the transplantation group was significantly higher at each time after transplantation (P < 0.05), and in the transplantation group, there was also a significant difference in the dentin thickness at different time points (P < 0.05). To conclude, the tissue-engineered dentin-pulp complex can promote dentin regeneration and repair.

BACKGROUNDPulmonary embolism (PE) is rare and seldom considered in adolescent patients; however it occurs with a greater frequency than is generally recognized, and it is a potentially fatal condition. The aim of the current study was to understand its epidemiology, clinical features and the cause of delay of its diagnosis in adolescents.

METHODSA retrospective analysis of nine adolescents with acute PE admitted to the Peking University Third Hospital over the past 16-year period was performed. The epidemiology, clinical features and risk factors of the adolescents were described and compared with those of adults and elderly patients. The time to diagnosis and misdiagnosed diseases were analyzed. Pretest probability of PE was assessed retrospectively by the Wells score and revised Geneva score.

RESULTSThe incidence of PE was 43.6 per 100 000 hospitalized adolescents in our hospital. The incidence of PE in adolescents was much lower than that in adults and PE is diagnosed in about 1/50 of elderly people. The clinical features in adolescents were similar to those in adults. But fever and chest pain were more common in adolescents (P < 0.05). The major risk factors included surgery, systemic lupus erythematosus (SLE), thrombocytopenia, long-term oral glucocorticoids and trauma. The mean diagnostic time was (7.8 ± 8.4) days. Six cases had a delayed diagnosis. The mean delay time from symptom onset to diagnosis was (11.0 ± 8.8) days. The time of presentation to diagnosis in patients initially admitted to the emergency department was less than one day, and was much shorter than the time in outpatients, (9.4 ± 7.5) days. Most of the patients were initially misdiagnosed with a respiratory tract infection. Most patients' values of Wells score or revised Geneva score were in the moderate or high clinical probability categories; 88% by Well score vs. 100% by revised Geneva score.

CONCLUSIONSPE was seldom considered in the adolescent patients by physicians, especially outpatient physicians, so the diagnosis was often delayed. If adolescent patients complain of dyspnea or chest pain or syncope with/without fever, and they had risk factors such as surgery, thrombocytopenia and trauma, PE should be considered and included in the differential diagnosis.

Adolescent ; Adult ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Male ; Probability ; Pulmonary Embolism ; diagnosis ; epidemiology ; etiology ; Retrospective Studies ; Risk Factors