3.Risk factors of late preterm birth and perinatal complications among late preterm infant
Ying ZHANG ; Yingdong HE ; Qian CHEN
Chinese Journal of Perinatal Medicine 2014;(6):379-383
To analyze maternal and neonatal complications among late preterm birth cases and to investigate risk factors of late preterm birth. Methods This was a retrospective analysis of 258 late preterm cases (late preterm group) born in Peking University First Hospital from January 1, 2009 to December 31, 2010. Maternal comorbidity and complications, delivery modes, and neonatal complications of these 258 late preterm infants were compared with 308 term cases (term group) during the same period. Statistical analysis was performed usingχ2 test, Fisher's exact probability test, t test and logistic regression. Results In Peking University First Hospital, late preterm births accounted for 3.9%(258/6 695) of live births and 60.1%(258/429) of preterm births. The incidence of the following maternal complications among the late preterm group was higher than that among term group(all P<0.05): severe pre-eclampsia [7.4%(19/258) vs 1.0%(3/308), χ2=15.35]; preterm rupture of membrane [42.6%(110/258) vs 15.3%(47/308), χ2=52.49];cervical insufficiency [1.9%(5/258) vs 0.0%(0/308), Fisher's exact test];placenta previa[3.5%(9/258) vs 0.6%(2/308), Fisher's exact test] and placental abruption [2.7%(7/258) vs 0.3%(1/308), Fisher's exact test]. Severe pre-eclampsia was the major risk factor leading to late preterm birth. The incidence of the following neonatal complications among the late preterm group was higher than that among term group (all P<0.05):respiratory distress syndrome (NRDS) [11.6%(30/258) vs 1.6%(5/308), χ2=24.22]; hyperbilirubinemia [64.3%(166/258) vs 39.6%(122/308),χ2=34.36];electrolyte disturbance [12.8%(33/258) vs 1.6(95/308),χ2=27.96];hypothermia [7.0%(18/258) vs 2.9%(9/308),χ2=5.08];infectious pneumonia[13.6%(35/258) vs 3.2%(10/308), χ2=20.43]; leukoencephalopathy [3.1%(8/258) vs 0.3%(1/308), χ2=5.25]; low body temperature [18.6%(48/258) vs 3.6%(11/308),χ2=33.98] and neonatal asphyxia [6.2%(16/258) vs 1.0%(3/308),χ2=11.86]. The incidence of the following neonatal complications among late preterm infants born at<35 weeks gestation was higher than that among late preterm infants born at≥35 weeks gestation (all P<0.05):NRDS [30.4%(14/46) vs 7.5%(16/212) ,χ2=19.26];hyperbilirubinemia [91.3%(42/46) vs 58.5%(124/212), χ2=17.74]; electrolyte disturbance [21.7%(10/46) vs 10.8%(23/212), χ2=4.02]; intracranial hemorrhage [8.7%(4/46) vs 1.9%(4/212),χ2=3.88];leukoencephalopathy [10.9%(5/46) vs 1.4%(3/212),χ2=8.32] and neonatal asphyxia [15.2%(7/46) vs 4.2%(9/212), χ2=6.05]. Conclusions Severe pre-eclampsia is the major risk factor leading to late preterm birth. The incidence of complications among late preterm infants is higher than that among term infants. If a pregnancy has to be terminated because of maternal disorders, the pregnancy period should be extended to 35 weeks if it permits.
4.Management on national major program based on the theory of PDCA cycle
Wencai QIAN ; Ying CHEN ; Huanping ZHANG
Chinese Journal of Medical Science Research Management 2014;27(1):48-50
Apply PDCA cycle theory to the progress management of the national 863 program aimed at the problem of paying more attention to program application and achievement awards,but ignoring progress management.It indicated that the quality of research has been improved.So,scientific research administrators should renew their management knowledge,to improve the ability of scientific research management.
7.Identification of plasmid-mediated AmpC ?-lactamase in Escherichia coli
Ying YE ; Qian WANG ; Yan CHEN ; Jia-Bin LI ;
Chinese Journal of Laboratory Medicine 2000;0(06):-
Objective To investigate genotypes and antibiotic resistance of Escherichia coli producing plasmid-mediated AmpC ?-lactamase in Anhui province.Methods A total of 407 clinical isolates of nonrepeated Escherichia coli were collected from different cities in Anhui province.AmpC ?-lactamase producing isolates were identified by cefoxitin three-dimensional test and antibiotic susceptibility was identified by agar dilution test.Plasmid extraction,PCR amplication of corresponding group was performed, followed by sequencing.Results The positive rate of cefoxitin three-dimensional test was 8.1% (33/407), and the prevalence of plasmid-mediated AmpC ?-lactamase was 3.0% (12/407).bla_(CMY-2) gene,bla_(DHA-1) gene and bla_(ACT-2) gene were identified by PCR amplification and confirmed by sequencing in 5 strains,4 strains and 2 strains,respectively.A new CMY genotype was identified,with its sequence revealed 97% identity to the deduced amino acid sequence with previous CMY-2.This is also the first report on ACT-2 genotype in China.The susceptibility test showed that all strains were resistant to cephamycins and piperacillin,and susceptible to imipenem.Two strains of Escherichia coli producing DHA-1 were resistant to fourth-generation cephalosporin.Conclusions CMY-2,DHA-1 and ACT-2 are the most common genotypes in plasmid-mediated AmpC ?-lactamase produced by clinical Escherichia coli isolates in Anhui province. Carbapenems could be the first choice for the treatment of infection caused by AmpC ?-lactamase producers.
8.Monitoring of Serum Phenytoin Concentration in 130 Cases and Analysis of the Cases of Intoxication
Wenjing QIAN ; Shaogang SONG ; Jianlong WU ; Ying HE ; Xiaoyan CHEN ;
China Pharmacy 2001;0(09):-
OBJECTIVE: To study the relationship among the dosage, serum concentration and clinical effect of phenytoin(PHT) in treating epileptic patients .METHODS: 130 steady -- state serum concentrations of PHT were determined by fluores-cence polarization immunoassay(FPIA) in 70 patients with or without other drugs used in combination .RESULTS: The indi-vidual difference among the patients who received routine dosage of PHT was very significant. Intoxication occurred ex-tremely often in patients whose PHT serum concentrations were over 30?g/ml .CONCLUSION: It is necessary to perform TDM(Therapeutic Drug Monitoring) and individualize the use of PHT,so that the safe and effective use of drug can be ensured.
9.Affection of Zidan decoction containing serum on endometrial receptivity in uterine immunity environment
Qian CHEN ; Zhe JIN ; Qiudan LU ; Ying CAO ; Nan LI
International Journal of Traditional Chinese Medicine 2012;34(3):220-223
Objective To investigate the effect of Zidan decoction containing serum on endometrial receptivity in uterine immunity environment,and then to discuss if it's effect on endometrial receptivity through its controlling the expression of cell factors which related to endometrial receptivity.Methods Mice's endometrium tissue samples and uterine Natural Killer (UNK) cells were obtained from pregnant mice on gd 4.5 days and gd 12.5 days.After endometrial glandular epithelial cells,endometrial stromal cells and UNK cells were separated through primary culture,epithelial cells and endometrial stromal cells at rate of 1 ∶ 1 a certain concentration UNK were mixed together and highly purified-cultured.Different concentrations of Zidan decoction was acted on the culture solution.FBS,black and aspirin control group were setup for contrast.The expression of LIF and VEGF which influenced by Zidan decoction in the immunity environment was assayed by Realtime-PCR.Results The expression of LIF and VEGF was significantly increased in the immunity environment of uterine (in 10% Zidan decoction group,10% aspirin group and 10% blank control group:LIF was 2.10±0.20,1.98±0.14,0.90±0.05 separately,and VEGF was 3.17±0.31,2.52±0.09,0.92±0.06respectively,P<0.05).Conclusion Zidan decoction could improve endometrial receptivity by increasing the expression of cell factor which related to endometrial receptivity with the help ofUNK paracrine.
10.Antagonism of vecuronium-induced residual neuromuscular blockade with neostigmine
jia-qian, ZHOU ; xi-ming, CHEN ; ying-wei, WANG
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(02):-
0.05). Conclusion When TOFR recovers to 0.55,antagonism of residual neuromuscular blockade is still necessary.Different doses of neostigmine may antagonize vecuronium-induced residual neuromuscular blockade,and lower dose of neostigmine(10-20 ?g/kg) is recommended.