Objective To investigate the induction factors of hypotension during cesarean sec-tion for perilous placenta previa under combined spinal-epidural anesthesia(CSEA)and to construct a nomogram prediction model.Methods A total of 130 parturients who underwent cesarean section for perilous placenta previa under CSEA from January 2020 to December 2023 in Yulin Maternity and Child Healthcare Hospital were selected as study subjects.A self-designed general information ques-tionnaire was used to investigate the basic information and the occurrence of hypotension of the sub-jects.According to the occurrence of intraoperative hypotension,the patients were divided into hypo-tension group(47 cases)and non-hypotension group(83 cases).Univariate analysis was performed on the general information of the two groups,and multivariate Logistic regression analysis was used to explore the induction factors of intraoperative hypotension.Results Univariate analysis showed that there were statistically significant differences in body mass index,anesthesia level,presence of multiple pregnancy,preoperative systolic blood pressure,operative time,and the occurrence of Bezold-Ja-risch reflex between the two groups(P＜0.05).Multivariate Logistic regression analysis revealed that body mass index ≥ 24 kg/m2,anesthesia level was in the eighth thoracic vertebra(T8)or a-bove,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the occurrence of Bezold-Jarisch reflex were independent risk factors for hypotension during ce-sarean section for perilous placenta previa under CSEA(P＜0.05).A regression equation for the induction factors of hypotension during cesarean section for perilous placenta previa under CSEA was constructed:Logit(P)=-23.211+1.079 ×(body mass index≥24 kg/m2)+1.101 × anesthesia level(≥T8)+3.193 x multiple pregnancy+2.214 x preoperative systolic blood pressure(＜90 mmHg)+4.606 × operative time(＞1.5 h)+2.011 × occurrence of Bezold-Jarisch reflex.The nomogram showed high discrimination and accuracy for patients with preoperative systolic blood pres-sure＜90 mmHg.After 1,000 times of Bootstrap resampling for the nomogram model,a calibration curve was obtained,and the consistency index was calculated as 0.850,indicating good calibration of the nomogram model.The receiver operating characteristic(ROC)curve was plotted,with an ar-ea under the curve of 0.896 and 95％confidence interval of 0.802 to 0.956,suggesting good pre-dictive performance.Conclusion Body mass index ≥24 kg/m2,anesthesia level ≥ T8,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the oc-currence of Bezold-Jarisch reflex are induction factors for hypotension during cesarean section for perilous placenta previa under CSEA.

Objective To investigate the induction factors of hypotension during cesarean sec-tion for perilous placenta previa under combined spinal-epidural anesthesia(CSEA)and to construct a nomogram prediction model.Methods A total of 130 parturients who underwent cesarean section for perilous placenta previa under CSEA from January 2020 to December 2023 in Yulin Maternity and Child Healthcare Hospital were selected as study subjects.A self-designed general information ques-tionnaire was used to investigate the basic information and the occurrence of hypotension of the sub-jects.According to the occurrence of intraoperative hypotension,the patients were divided into hypo-tension group(47 cases)and non-hypotension group(83 cases).Univariate analysis was performed on the general information of the two groups,and multivariate Logistic regression analysis was used to explore the induction factors of intraoperative hypotension.Results Univariate analysis showed that there were statistically significant differences in body mass index,anesthesia level,presence of multiple pregnancy,preoperative systolic blood pressure,operative time,and the occurrence of Bezold-Ja-risch reflex between the two groups(P＜0.05).Multivariate Logistic regression analysis revealed that body mass index ≥ 24 kg/m2,anesthesia level was in the eighth thoracic vertebra(T8)or a-bove,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the occurrence of Bezold-Jarisch reflex were independent risk factors for hypotension during ce-sarean section for perilous placenta previa under CSEA(P＜0.05).A regression equation for the induction factors of hypotension during cesarean section for perilous placenta previa under CSEA was constructed:Logit(P)=-23.211+1.079 ×(body mass index≥24 kg/m2)+1.101 × anesthesia level(≥T8)+3.193 x multiple pregnancy+2.214 x preoperative systolic blood pressure(＜90 mmHg)+4.606 × operative time(＞1.5 h)+2.011 × occurrence of Bezold-Jarisch reflex.The nomogram showed high discrimination and accuracy for patients with preoperative systolic blood pres-sure＜90 mmHg.After 1,000 times of Bootstrap resampling for the nomogram model,a calibration curve was obtained,and the consistency index was calculated as 0.850,indicating good calibration of the nomogram model.The receiver operating characteristic(ROC)curve was plotted,with an ar-ea under the curve of 0.896 and 95％confidence interval of 0.802 to 0.956,suggesting good pre-dictive performance.Conclusion Body mass index ≥24 kg/m2,anesthesia level ≥ T8,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the oc-currence of Bezold-Jarisch reflex are induction factors for hypotension during cesarean section for perilous placenta previa under CSEA.

This study compared the effects on bone metabolism and morphology of pathological obesity induced by excessive fat intake in a non-hibernator (mice) versus healthy obesity due to pre-hibernation fattening in a hibernator (ground squirrels). Kunming mice were fed a high-fat diet to provide a model of pathological obesity (OB group). Daurian ground squirrels fattened naturally in their pre-hibernation season (PRE group) were used as a healthy obesity model. Micro-computed tomography (micro-CT) and three-point bending tests were used to determine the microstructure and mechanical properties of bone. Western blots were used to analyze protein expression levels related to bone metabolism (Runt-related transcription factor 2 (RunX2), osteocalcin (OCN), alkaline phosphatase (ALP), osteoprotegerin (OPG), receptor activator of nuclear factor-‍κB ligand (RANKL), cathepsin K, matrix metallopeptidase 9 (MMP9), patched protein homolog 1 (Ptch1), phosphorylated β‍-‍catenin (P‍-‍β‍-‍catenin), and glycogen synthase kinase-3β (GSK-3β)). Compared with controls, there was no obvious bone loss in the OB mice, and the stiffness of the femur was increased significantly. Compared with summer active squirrels, bone formation was enhanced but the mechanical properties did not change in the PRE group squirrels. In OB mice, western blots showed significantly increased expression levels of all proteins except RunX2, OPG, and Ptch1. PRE ground squirrels showed significantly increased expression of most proteins except OCN and Ptch1, which decreased significantly, and P‍-‍β‍-‍catenin and OPG, which did not change. In conclusion, for non-hibernating mice, moderate obesity had a certain protective effect on bones, demonstrating two-way regulation, increasing both bone loss and bone formation. For pre-hibernating ground squirrels, the healthy obesity acquired before hibernation had a positive effect on the microstructure of bones, and also enhanced the expression levels of proteins related to bone formation, bone resorption, and Wnt signaling.
Mice ; Animals ; Hibernation ; Core Binding Factor Alpha 1 Subunit/metabolism* ; Glycogen Synthase Kinase 3 beta/metabolism* ; Diet, High-Fat ; X-Ray Microtomography ; Sciuridae/metabolism* ; Obesity

【Objective】 To analyze the metagenomics and microbiology of voluntary blood donors in China, so as to assess the potential threats of emerging infectious diseases to the safety of blood transfusion. 【Methods】 12 300 plasma samples (10 mL each) collected by central blood stations in Chongqing, Liuzhou, Urumqi, Mianyang, Wuhan, Nanjing, Mudanjiang, and Dehong Prefecture area from 2012 to 2018 were subjected to total DNA extraction after ultracentrifugation (32 000 rpm/min, centrifugal radius 91.9 mm) in minipools of 160 donations. The metagenomic library was constructed, and deep sequencing was conducted by Illumina Hiseq 4 500. By comparing with reference sequences of bacteria, fungi, parasites and viruses, metagenomic data were analyzed, classification of microbes were identified, and potentially harmful pathogens were evaluated. 【Results】 A total of 632 GB clean data were obtained by deep sequencing, and the top three pathogens were Pseudomonas(0.561 1%), Burkholderia(0.468 7%) and Serratia(4.242 0%). Pathogens with potential threat which could be transmitted by blood transfusion or blood products were found, such as human parvovirus B19(0.126 6%), Leishmania spp(1.348 5%) and Toxoplasma gondii(0.615 8%). 【Conclusion】 Our study analyzed metagenomics of voluntary blood donors in parts of China and revealed pathogens that may cause potential harm to blood safety, which were helpful for targeted prevention and control of emerging infectious diseases.