Objective: To investigate the current status of syphilis treatment and its influencing factors among pregnant and lying-in women in Zhejiang Province, so as to promote the standardized treatment for pregnant and lying-in women with syphilis. Methods : The sociodemographic characteristics ( age, educational level, ethnicity, marital status, occupation ), fertility ( gravidity, parity, number of children, and adverse pregnancy history ), gestational week at the first antenatal care visit and syphilis treatment ( treatment or not, standardized treatment or not, and antibody titer ) were collected from the pregnant and lying-in women with syphilis infections delivered in Zhejiang Province in 2018, based on the Zhejiang Provincial Information Management System for Prevention of Mother-to-Child Transmission of AIDS, Syphilis and Hepatitis B. Factors affecting the treatment of syphilis infections were identified using a structural-equation model. Results: A total of 2 061 pregnant and lying-in women with syphilis infections were included, with a median age of 29 years and a mean gestational week at the first antenatal care visit of ( 14.33±11.85 ) weeks, and there were 844 women ( 40.95% ) diagnosed in early pregnancy ( <13 weeks of gestational age ). There were 1 978 cases ( 95.97% ) receiving syphilis treatment, and 1 616 cases ( 78.41% ) received standardized treatment. The structural-equation modeling analysis showed that the gestational age at the first antenatal care visit and fertility had direct impacts on the treatment of syphilis infections among pregnant and lying-in women, with standardized path coefficients of -0.187 and -0.157 (both P<0.05 ), respectively, and the sociodemographic characteristics affected the treatment of syphilis through the mediating role of fertility, with a standardized path coefficient of 0.070 ( P<0.05 ). Conclusions The proportion of syphilis treatment is more than 95% among pregnant and lying-in women in Zhejiang Province, which achieves the required process criteria for validation of elimination of mother-to-child transmission of HIV and syphilis. Gestational week at the first antenatal care visit, fertility status, and sociodemographic characteristics are factors affecting the treatment syphilis infections during pregnancy.

Objective: To establish a comprehensive health evaluation index system for HIV-infected pregnant women in floating populations, so as to support the elimination of mother-to-child transmission of HIV. Methods: The preliminary framework of the comprehensive health evaluation indicators was constructed based on literature review and focus group discussion. Experts from maternal and child healthcare, clinical medicine and public health were invited to participate in two-round Delphi consultations. The indicators were scored and weighed according to the importance, priority and measurability, and determined according to means and coefficients of variation of scores. The effectiveness of the consultation was evaluated by positive coefficient, authority coefficient and coordination coefficient. Results: Twenty-six experts participated in this study, including 19 women. There were 5 experts aged 30-40 years, 14 experts aged 41-50 years, and 7 experts aged 51 years and over. There were 17 experts with a master degree and above. All experts had vice senior professional titles and above. The positive coefficients in the two rounds of consultations were 96.30% and 100.00%, the authority coefficients were 0.84 and 0.89, respectively. Finally, 4 primary indicators (individuals and families, disease factors, social environment, health service utilization) and 50 secondary indicators were identified, with the coefficients of variation ranging from 0.084 to 0.236 and the coordination coefficients ranging from 0.282 to 0.405 (all P<0.001). Among the secondary indicators, getting antiviral drugs at the place of residence was restricted to floating populations or not (0.780), HIV viral load during pregnancy (0.750), the registration of maternal and childbirth care manuals at the place of residence was restricted to floating populations or not (0.749), and first-trimester registration or not (0.738) had a high weight. Conclusion This index system can provide the reference for evaluating the health equity of HIV-infected pregnant and lying-in women in floating populations.

AIM:To explore whether down-regulation of peroxisome proliferator-activated receptor γ coactivator (PGC)-1α induces podocyte apoptosis and its mechanism.METHODS:The podocytes were cultured under high glucose (HG) condition and the cell apoptosis was analyzed by flow cytometry.The methods of real-time PCR and Western blot were used to analyze the mRNA and protein expression of related molecules in the control, HG-treated or siRNA-treated podocytes.RESULTS:The expression PGC-1α at mRNA and protein levels was significantly decreased in HG-injured podocytes.Down-regulation of PGC-1α expression in vitro by siRNA resulted in podocyte apoptosis.The nuclear protein expression of nuclear factor of activated T-cells (NFAT) was significantly increased in HG injured podocytes, indicating the NFAT activation.Down-regulation of PGC-1α expression also decreased the nuclear protein expression of NFAT.Moreover, silencing of NFAT expression by siRNA significantly abolished PGC-1α deficiency-induced podocyte apoptosis.CONCLUSION: Down-regulation of PGC-1α induces podocyte apoptosis.NFAT mediates PGC-1α deficiency-induced podocyte apoptosis.

Objective:To analyze the correlation between ambulatory blood pressure variability and the progression of subjective cognitive decline (SCD).Methods:In this prospective observational study, the overall sampling method was used to continuously select 100 patients with SCD in the Department of Neurology, Changshu First People′s Hospital and Changshu Xinzhuang People′s Hospital from January 1 2016 to June 30 2017. The baseline demographic characteristics of the patients were collected. The Chinese version of SCD-Q9 questionnaire was used to self-evaluate SCD, and the Montreal Cognitive Assessment Scale (MoCA) was used to evaluate objective cognitive impairment. All patients received 24 h ambulatory blood pressure monitoring, and 24 h systolic coefficient of variation (SCV) and diastolic coefficient of variation (DCV) were calculated. The follow-up period was 4 years after the first visit, and the MoCA scale was evaluated once a year. Finally, 83 patients completed the follow-up and were included in this study. According to the MoCA score at the end of follow-up (<26 or ≥26), the patients were divided into progression group (39 cases) and non-progression group (44 cases). The difference of MoCA score between baseline and last follow-up was calculated in the progression group. The difference in demographic characteristics between the two groups was compared with χ2 test. The difference of 24 h SCV and 24 h DCV between the two groups were compared by rank sum test. The correlation between 24 h SCV and MoCA score difference or SCD-Q9 score in the progression group were tested by multiple linear regression analysis. Results:The 4-year progression rate of SCD patients was 46.99% (39/83). There was no significant differences in baseline age, gender, education level, medical history, smoking history, SCD-Q9 score and MoCA score between the progressive group and the non-progressive group (all P>0.05). The 24 h SCV in the progressive group was significantly higher than that in the non-progressive group [13.4% (9.9%, 15.6%) vs 10.9% (9.7%, 12.7%), U=594.50, P=0.016]. There was no significant difference in 24 h DCV between the two groups ( P>0.05). In progressive group, the 24 h SCV was negatively correlated with MoCA score difference ( r=-0.368, P=0.021). Conclusion:There is a correlation between ambulatory blood pressure variability and SCD progression, high 24 h SCV may be one of the factors of SCD progression and has certain predictive value.

Objective:To investigate the diagnostic value of microRNA-29b(miR-29b)for left ventricular hypertrophy(LVH)in elderly patients with coronary heart disease(CHD).Methods:From January 2015 to December 2018, 140 elderly patients with CHD admitted in our hospital were enrolled, including 70 CHD patients without LVH(the NLVH group)and 70 CHD patients with LVH(the LVH group). Seventy healthy elderly adults without CHD who underwent heart examination at our hospital during the same period were included as the control group.The interventricular septum thickness(IVSD), left ventricular posterior wall thickness(LVPWD) and the relative expression level of microRNA-29b were detected and compared among the three groups.The correlation of microRNA-29b with IVSD and LVPWD was analyzed, and the diagnostic value of microRNA-29b for LVH in elderly CHD patients was analyzed.Results:There were significant differences in IVSD, LVPWD and the relative expression level of microRNA-29b among the three groups( F=22.838, 22.147 and 114.096, all P=0.000). The IVSD, LVPWD and the relative expression level of microRNA-29b were higher in the LVH group than in the NLVH group( t=3.479, 3.206 and 9.852, all P=0.000)and than in the control group( t=3.904, 3.553 and 10.792, all P=0.000). The relative expression level of microRNA-29b was higher in the NLVH group than in the control group( t=2.306, P=0.420). The receiver-operating characteristics(ROC)curve analysis of microRNA-29b for the diagnosis of LVH in elderly CHD patients showed that the maximum entry point of Youden index was 0.80, the optimal critical value was 3.52, the sensitivity and specificity for the diagnosis of LVH was 91.73% and 88.27%.Pearson correlation analysis showed that the expression level of microRNA-29b was positively correlated with IVSD and LVPWD( r=0.63 and 0.61, P=0.000). Conclusions:The expression level of microRNA-29b is significantly increased in elderly CHD patients with LVH, and positively correlated with IVSD and LVPWD.The expression level of microRNA-29b has high sensitivity and specificity in the diagnosis of LVH in elderly CHD patients.

Purpose: Cavernous nerve injury induced erectile dysfunction (ED) is a refractory complication with high incidence in person under radical prostatectomy. Studies have shown that relaxin-2 (RLX-2) plays a vital role of endothelial protection, vasodilation, anti-fibrosis and neuroprotection in a variety of diseases. However, whether penile cavernous erection can benefit from RLX-2 remains unknown. The purpose of the experiment was to explore the effects of RLX-2 on ED in the rat suffering with bilateral cavernous nerve injury (BCNI). Materials and Methods: The rats were divided into three groups: Sham group was underwent sham operation, BCNI+RLX group or BCNI group was underwent bilateral cavernous nerve crush and then randomly treated with RLX-2 (0.4 mg/kg/d) or saline by continuous administration using a subcutaneously implanted micro pump for 4 weeks respectively. Then, erectile function was evaluated by electrical stimulation of cavernous nerves. Cavernous nerves and penile tissues and were collected for histological evaluation. Results: Erectile function of rats with BCNI was partially improved after RLX-2 treatment. The BCNI group had lower expression of relaxin family peptide receptor (RXFP) 1, p-AKT/AKT, p-eNOS/eNOS ratios than sham operation rats, but RLX-2 could partially reversed these changes. Histologically, the BCNI+RLX group had a significant effect on preservation of neurofilament, neuronal glial antigen 2 of penile tissue and nNOS of cavernous nerves when compared with BCNI group. RLX-2 could inhibited the lever of BCNI induced corporal fibrosis and apoptosis via regulating TGFβ1-Smad2/3-CTGF pathway and the expression of Bax/Bcl-2 ratio, caspase3. Conclusions RLX-2 could improve erectile function of BCNI rats by protecting cavernous nerve and endothelial function and suppressing corporal fibrosis and apoptosis via RXFP1 and AKT/eNOS pathway. Our findings may provide a promising treatment for refractory BCNI induced ED.