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.

Objective To explore the clinical manifestations,antimicrobial therapy,and risk factors of mortality in patients with Acinetobacter baumannii bloodstream infection.Methods Clinical data of 153 patients with Acinetobacter baumannii bloodstream infection hospitalized in First Affiliated Hospital of Zhejiang University from January 2013 to September 2014 were analyzed retrospectively.According to the 28-day survival after diagnosis,the patients were divided into death group (n =76) and survival group (n =77).Data related to demographic and clinical characteristics,underlying diseases,treatment,invasive procedures,bacterial resistance to antibiotics,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)scores at onset,and antimicrobial therapy were collected.The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis.Results This study included 153 patients with Acinetobacter baumannii bloodstream infection.The 28-day mortality was 49.7％.The independent risk factors of mortality were APACHE Ⅱ score ≥22 at onset (OR =15.7,95％ CI 5.1-48.1,P ＜ 0.001),septic shock (OR =6.3,95 ％ CI 1.9-21.3,P =0.003),and administration of steroids (OR =3.6,95％ CI 1.0-12.3,P =0.043).Compared with subjects treated with non-cefoperazone-sulbactam-based regimen,those treated with cefoperazone-sulbactam for multidrug-resistant Acinetobacter baumannii (MDR-AB) had significantly lower mortality on day7,day14 and day28 (8.9％ vs 59.2％,31.1％ vs 65.8％,44.4％ vs 72.4％ respectively).Conclusions The patients with Acinetobacter baumannii bloodstream infection have high mortality within one month.Administration of steroids and septic shock are associated with poor prognosis.APACHE Ⅱ score ≥ 22 at onset predicts adverse outcome.Cefoperazone-sulbactam-based antimicrobial therapy improves patients' survival.

To study the influence of hypercholesterolemia with caveolin-1 on the plasmalemma of vascular endothelium, we used the methods of immunohistochemistry to detect the dynamic changes of caveolin-1 in cultured ECV-304 cells which were stimulated high cholesterol serum and the arterial endothelium of hypercholesterolemia rats. It is resulted that high cholesteorol level can upregulate the expression of caveolin-1 both in vitro and in vivo. In the initial stage of hypercholesterolemia model, the expression of caveolin-1 increased as the time of high cholesterol level added, but in the later period it was decreased slightly.
Animals ; Aorta ; pathology ; Caveolin 1 ; Caveolins ; biosynthesis ; genetics ; Cells, Cultured ; Cholesterol ; blood ; Endothelium, Vascular ; cytology ; metabolism ; Female ; Humans ; Hypercholesterolemia ; metabolism ; Male ; Rabbits ; Rats ; Rats, Sprague-Dawley ; Umbilical Veins ; cytology

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.