Objective To investigate factors and neonatal outcomes associated with histologic chorioamnionitis (HCA) in preterm premature rupture of membranes (PPROM).MethodsFrom Jan.2008 to Jun.2011,230 women with PPROM at 28 -33 +6 weeks of gestation undergoing deliveries in the Second Affiliated Hospital of Wenzhou Medical College were studied retrospectively.According to placental histopathologic findings,those patients were categorized into two groups,including 138 cases in histologic chorioamnionitis (HCA group ) and 65 cases in non-chorioamnionitis (control)group.Age,parity,gestational age of PPROM and delivery,latency period,oligohydramnios,white blood cell (WBC) count and serum C-reactive protein (CRP) level at admission and before delivery,the incidence of neonatal respiratory distress syndrome (NRDS),neonatal pneumonia,bronchopulmonary dysplasia,necrotizing enterocolitis,early-onset neonatal sepsis,abnormal brain sonography findings and mortality were compared between two groups.Results( 1 ) The incidence of HCA was 68.0.％ ( 138/203 ) in all 203 cases with PPROM.(2) The occurring ruptured membrane gestation in HCA group was ( 31.1 ± 1.5 ) weeks,which were significantly earlier than (32.0 ± 1.3 ) weeks in control group ( P ＜ 0.05 ).The level of CRP of (8.2 ± 14.9) mg/L before delivery in HCA group was significantly higher than (5.5 ±7.2) mg/L in control group (P ＜ 0.05).The rate of oligohydramnios and cesearean sections were 55.1％ (76/138) and 45.7％ (63/138) in HCA group,which were significantly higher than 30.8％ (20/65) and 29.2％ (19/65) in control group (P ＜0.05).There were no significant difference in patient's age,parity,WBC count and CRP at admission between two groups (P ＞ 0.05 ).The latency period did not show significant difference between (140± 116) hours in HCA group and (129 ± 125) hours in control group (P ＞ 0.05).(3) Using multivariable logistic regression models,oligohydramnios ( OR =2.937 ),gestational age of PPROM ＜ 32 weeks ( OR =2.352),serum CRP level ＞ 8 mg/L before delivery ( OR =4.923 ) and latency period ＞ 48 -168 hours (OR =4.439) were significantly associated with HCA (P ＜0.05).(4) The gestational age of delivery and birth weight of HCA group were significantly lower than those of control group [ ( 32.0 ± 1.5 ) weeks vs.( 32.7 ± 1.5 ) weeks,( 1680 ± 379) g vs.(2017 ± 333) g,respectively,P ＜ 0.05 ].The incidence of Apgar ＜7,abnormal brain sonograhy findings, neonatal pneumonia,bronchopulmonary dysplasia,early-onset neonatal sepsis and mortality in HCA group were significantly higher than those in control group [20.3％ (28/138) vs.7.7％ (5/65),14.5％ (20/138) vs.4.6％ (3/65),12.3％ (17/138) vs.3.1％(2/65),5.8％ (8/138) vs.0,6.5％ (9/138) vs.0,12.3％ (17/138) vs.3.1％ (2/65),respectively,P ＜ 0.05 ].The incidence of necrotizing enterocolitis ( 1.5％,2/138 ) in HCA group was higher than that of controlgroup(0) and the incidence of NRDS ( 18.8％,26/138) in HCA group did not show statistical difference with 21.4％ ( 14/65 ) in control group ( P ＞ 0.05 ).ConclusionsIt was found that HCA was significantly correlated with lower gestational age of PPROM,higher serum CRP level before delivery,prolonged latency period and oligohydramnios in PPROM.HCA could increase the neonatal morbidity and mortality.

Objective To investigate the pathogenesis role of aquaporin 3 and aquaporin 9 in idiopathic polyhydramnios by detecting their expression and distribution in fetal membranes and placenta.Methods Twenty-one of term pregnancy women with idiopathic polyhydramnios were enrolled as patient group matched with 30 women with normal term pregnancy as control group.The expression and localization of aquaporin 3 and aquaporin 9 in fetal membranes and placenta were detected by real-time polymerase chain reaction and streptavidin peroxidase immunohistochemiscal staining.Results (1)The mRNA expressions of aquaporin 3 and aquaporin 9 were detected in amnion,chorion and placental tissue in both patient group and control group.Both aquaporin 3 and aquaporin 9 were demonstrated positive staining in the amnion epithelia,chorion cytotrophoblasts and placental trophoblast.(2)The ratio of aquaporin 3 and aquaporin 9 mRNA expressions in amnion in patient group comparing to those in control group were 5.00 and 3.25,while in chorion they were 2.03 and 2.08.When compared with those in amnion and chorion of control group,there was a significant difference(P<0.01).However,the relative change fold of aquaporin 3 and aquaporin 9 in placental trophoblast in patient group were decreased in comparison of those in control group,which also showed statistical difference(P<0.01).(3)The expression of aquaporin 3 and aquaporin 9 protein in anmion were 7.5 ±2. 0 and 11.1 ± 1.8 in patient group, while they were 5.3 ± 1. 6 and 5.6 ± 2. 3 in control group. In chorion, the expression of aquaporin 3 and aquaporin 9 protein was 7.5±2. 0 and 10. 0 ±1.6 in patient group, respectively, while in control group, they were 5.4 ±2.2 and 5.6±2. 1. When compared with those proteins in control group, it exhibited statistical difference (P<0.05). However, in placental trophoblast of patient greup,the expression of aquaporin 3 and aquaporin 9 protein were 3.5±1.4and 4. 0±2. 5, respectively, which were significantly decreased than 5.6±1. 3 and 7. 1±2. 9 in control group(P< 0. 05). Conclusions The alterations of aquaporin 3 and aquaporin 9 expressions in fetal membrane and placenta might be an adaptive response to idiopathic polyhydramnios. Further investigation should be needed to clarify the regulatory mechanism of aquaporin 3 and aquaporin 9 expressions.

Objective To investigate the influence of pertussis toxin(PTX)on G protein-coupled estrogen receptor(GPER)-mediated activation of phosphatidylinositol 3-kinase(PI3K)/protein kinase B (Akt)signaling activated by 17 β-estradiol(17β-E2)in endometrial carcinoma cells.Methods Expressions of GPER protein were detected by immunohistochemical SP method in Ishikawa and HEC-1A cells.Changes of levels of GPER,ERα and ERβ protein and the activation of Akt protein were observed by western blot in the two cells after they were treated by PTX for 30 minutes at different concentrations(0,0.1,0.5,1.0 μg/ml),and then co-stimulated with with 1 × 10-6 mol/L 17β-E2 respectively at different time (Ishikawa 30 minutes,HEC-1A 15 minutes).Results(1)Immunohistochemical SP method showed that GPER was positive stained in cell cytoplasm of Ishikawa and HEC-1A cell.(2)After co-treated with PTX at different concentrations(0,O.1,0.5,1.0 μg/ml)and 10-6 mol/L 17β-E2,in Ishikawa cell,the ratio of pAkt/Akt was 0.74 ±0.54,0.34 ±0.06,0.18 ±0.03,0.07 ±0.15,the gray values of GPER was 0.872 ± 0.490,0.395 ± 0.054,0.145 ± 0.014,0.034 ± 0.008,and with increasing concentration of PTX,the ratio of p-Akt/Akt and the expression of GPER decreased gradually(P ＜ 0.05),which was most obviously when the concentration was 1.0 μg/ml(F =63.729,P =0.0001;F =160.284,P =0.0001);ERα and ERβ protein had no significant change among different groups(P ＞0.05).In HEC-1A cell,the ratio of pAkt/Akt was 0.73 ±0.09,0.26 ±0.14,0.11 ±0.03,0,the Gray values of GPER is 0.927 ±0.134,0.485 ± 0.022,0.194 ± 0.004,0,and with increasing concentration of PTX,the ratio of p-Akt/Akt and the expression of GPER decreased gradually(P ＜ 0.05),which were also completely inhibited when the concentration was 1 μg/ml(F =1039.321,P =0.0001;F =109.646,P =0.0001),ERα protein had no significant differences(P ＞ 0.05)among different groups.ERβ was negatively expressed.Conclusion The results proposed that the activation of PI3K/Akt signaling in Ishikawa and HEC-1A cells could be inhibited after blocking the role of GPER by PTX.

OBJECTIVE To investigate the effects of obstructive sleep apnea hypopnea syndrome on the quality of life of the patients. METHODS The quality of life was assessed with the Medical Outcomes Study SF-36 Health Survey in 145 patients with OSAHS and 17 snorers without OSAHS. Excessive Daytime Sleepiness was assessed with Epworth Sleepiness Scale. Pearson linear correlation and stepwise multiple regression analysis were used to study the association between each domain score of SF-36 and patients information,PSG parameters,EDS scores. RESULTS Three domains of SF-36 correlated negatively with Body Mass Index. Four domains correlated negatively with EDS. Three domains and total score correlated significantly with the lowest oxygen saturation. Two domains correlated negatively with the longest time of apnea. AHI and the lowest oxygen saturation have a mild side effect on the quality of life. BMI and EDS score have significantly side effect on the quality of the life. CONCLUSION Comparing to the mild OSAHS patients and snorers without OSAHS,the severe OSAHS patients have worse quality of life. EDS score and BMI have a significantly side effect on the severe OSAHS patients. OSAHS has a side effect on the quality of life of the patients.

Objective To evaluate the expressions and prognostic significance of phosphorylation of protein kinase B1 (pAkt1) and human telomere reverse transcriptase (hTERT) in epithelial ovarian carcinoma.Methods The expressions of pAkt1 and hTERT were examined by immunohistochemical SP method in 72 cases of epithelial ovarian carcinoma and 10 normal endometrial tissues to analyze the correlation between pAkt1 and hTERT and their relationships with clinic-pathological features and prognosis.Results The positive expression rate of pAkt1 in epithelial ovarian carcinoma was 73.6％,and the positive expression rate of hTERT was 56.9％,compared with normal ovarian tissues,with statistical significance (x2 =20.814,P ＜ 0.001;x2 =11.3g9,P ＜ 0.001).The expression of pAkt1 was not associated with hTERT expression (r =0.075,P =0.532) in epithelial ovarian carcinoma.The expressions of pAkt1 and hTERT in epithelial ovarian carcinoma were correlated with tumor differentiation status (x2=6.475,P =0.011;x2 =1.370,P =0.001).The disease-free survival of patients with pAkt1 and hTERT positive coexpression was significantly shorter than others (8.585 months vs.11.227 months,x2 =4.361,P =0.037),but there was no significant difference in overall survival (11.107 months:11.695 months,x2 =0.394,P =0.530).Conclusion pAkt1 and hTERT are highly expressed in epithelial ovarian carcinoma,and high coexpression of pAkt1 and hTERT indicates poor prognosis in epithelial ovarian carcinoma.

Objective:To investigate the diagnostic value of metagenomic next-generation sequencing (mNGS) in AIDS patients complicated with Pneumocystis jirovecii ( P. jirovecii) infection. Methods:This is a retrospective study. From January 2019 to June 2021, the respiratory tract and other body fluid samples of 236 cases of AIDS co-infected patients diagnosed in the AIDS Department of Changsha First Hospital were collected, along with corresponding medical histories. Traditional etiological hexamine silver staining and serum 1,3-β-D glucan (BDG) were performed simultaneously with mNGS detection, and Fisher′s exact test was used to analyze the results and compare the diagnostic performances of mNGS with those of hexamine silver staining and serum G test.Results:A total of 236 cases of AIDS patients with pulmonary infection were collected and tested. Seventy-seven cases were clinically diagnosed with Pneumocystis jiroveci pneumonia and 159 cases with non- Pneumocystis jiroveci pneumonia. Among the 236 AIDS patients with pulmonary infection, mNGS detected 77 [32.63%(77/236)] positive cases of Pneumocystis jiroveci, while hexamine silver staining detected 10[4.24%(10/236)] and serum BDG detected 146 [61.86% (146/236). Based on these clinical diagnostic results, the sensitivity of mNGS detection was 100% (77/77) for the 77 patients with Pneumocystis pneumoniae, significantly higher than that of silver hexamine staining [12.99% (10/77), P=0.046] and serum BDG [58.44% (45/77), P=0.038]. The mNGS showed good specificity, which was the same as that of hexamine silver staining [100% (159/159)] and significantly higher than that of serum BDG [36.48% (58/159), P=0.026]. With therapeutic clinical diagnosis as the reference method, the accuracy of mNGS detection was 100% (236/236). Conclusions:This study evaluated the diagnostic value of mNGS detection in AIDS patients with Pneumocystis jirovecii infection. The results showed that the sensitivity and specificity of mNGS detection were high, and it had exceptional clinical application value in the pathogenic detection of infectious diseases.

Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Humans ; Lymphoma, Follicular ; drug therapy ; Rituximab

ObjectiveTo analyze and sum up the medication rule and the core prescription of Professor LIU Minru in the treatment of polycystic ovary syndrome （intracellular lipid membrane congestion syndrome）and explore the effect mechanism underlying the medication. MethodTwo platforms were used to carry out data mining to analyze the characteristics and rules of Professor LIU's prescriptions for the treatment of this disease. Network pharmacology was used to further clarify active ingredients in the core prescription，and a traditional Chinese medicine-active ingredient-target network was constructed，with the potential mechanism of action analyzed. ResultA total of 321 prescriptions were included in the medical records，involving 178 Chinese medicinals and 28 kinds of formula granules.The Chinese medicinals mainly act on the liver and kidney meridians， whose main tastes were sweetness，pungency，and bitterness and properties were mainly warm，mild，and slightly cold.Commonly used medicine pairs include Dioscoreae Rhizoma-Rehmanniae Radix Praeparata，Chuanxiong Rhizoma-Angelicae Sinensis Radix，Bupleuri Radix-Aurantii Fructus，and Gleditsiae Spina-Curcumae Rhizoma.The commonly used formulas are Xuefu Zhuyutang，Siwugang，Yangjing Zhongyutang，etc. The core prescription is composed of 12 Chinese medicinals such as angelica，white peony，saponaria thorn，and epimedium，containing 74 active ingredients，including quercetin，luteolin，kaempferol，fisetin，and β-sitosterol.A total of 37 key targets were found，involving phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt），mitogen-activated protein kinase （MAPK），Janus protein tyrosine kinase （JAK）/signal transduction and activator of transcription （STAT），and other signaling pathways. ConclusionThe pathogenesis of this disease is complex.Professor LIU adheres to the pathogenesis of "kidney deficiency as the root cause，and phlegm retention as the symptom". Under the guidance of the academic ideology of "kidney Qi as the root，and protecting Yin as the foundation" and "nurturing Yin to support Yang"，she takes into account Yin and Yang in kidney tonic，replenishes and consolidates the essence and blood，and relieves manifestations by dissipating mass， activating blood， and regulating Qi. She has a rigorous thinking in formulating prescriptions. The core prescription has the characteristics of comprehensive regulation by multiple components at multiple targets in multiple pathways.

ObjectiveTo understand the visual environment sanitation in primary and secondary school classrooms in Minhang District， Shanghai， and to investigate the factors affecting the decline in students’ visual acuity. MethodsIn 2020， among all the primary and secondary schools in Minhang District， according to different types of classroom structures， levels， orientations， unilateral lighting， and bilateral lighting， a total of 20 231 students from 674 classrooms in primary and secondary schools were selected through stratified cluster sampling. Each monitored classroom was regarded as a research unit， and the naked eye vision of students was tested using a standard logarithmic vision chart during the 2020 and 2021 academic years. The change in average visual acuity between the two measurements was taken as the dependent variable， and the visual environment indices were considered as independent variables. The relationship between classroom visual environment indices and the decline in students’ naked eye vision was analyzed. ResultsThe qualification rates for per capita classroom area， window to floor area ratio， average illuminance of the blackboard， uniformity of blackboard illuminance， average illuminance of the desks， uniformity of desk illuminance， lighting coefficient of classroom， blackboard reflection ratio， back wall reflection ratio， and distance between lamps and desks were 79.53%， 88.58%， 46.74%， 70.33%，64.69%， 80.86%， 71.81%， 20.30%， 1.63%， and 97.53%， respectively. The average naked eye vision of primary and secondary school students in the 2020 academic year was 4.75±0.37 （right eye） and 4.76±0.37 （left eye）， while in the 2021 academic year， it was 4.70±0.39 （right eye） and 4.71±0.38 （left eye）. There was a significant decrease in the naked eye vision of primary and secondary school students in the 2021 academic year compared to that of 2020 （P<0.05）. Univariate linear regression analysis showed a significant correlation between grade， average illuminance of the blackboard， average illuminance of the desks， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks， and the decline of students’ naked eye vision within one academic year （P<0.05）. After adjusting for grade， multiple linear regression analysis revealed a significant correlation between the average illuminance of the blackboard， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks， and the decline of students’ naked eye vision within one academic year （P<0.05）. Higher average illuminance of the blackboard， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks were protective factors for naked eye vision. ConclusionThe visual environment of primary and secondary school classrooms in Minhang District is a matter of concern. Average illuminance of the blackboard， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks are related to the degree of visual impairment in students over a year.

OBJECTIVE To explore the therapeutic effect of modified Yupingfeng powder combined with Yougui pill on patients with chronic obstructive pulmonary disease （COPD）with deficiency of lung and kidney in remission period . METHODS Ninety-two patients ，who were in remission of COPD and whose traditional Chinese medical syndromes belonged to deficiency of lung and kidney from Fuzhou Hospital of Traditional Chinese Medicine in Jiangxi province during May 2018-January 2020，were divided into control group and observation group according to random number table method ，with 46 patients in each group . Control group was treated with conventional western medicine （given Tiotropium bromide powder spray ，18 μg/inhalation，one dose per day ）；observation group was additionally treated with modified Yupingfeng powder decoction combined with Yougui pill （decocting one dose per day ，filtering 300 mL per time ，150 mL in the morning and afternoon ）on the basis of control group . After 8 weeks of treatment ，the clinical efficacy ，serum inflammatory factors and fibrosis indexes ，T cell subsets and lung function indexes，and the occurrence of adverse drug reactions were compared between 2 groups. RESULTS After treatment ，the total clinical effective rate of treatment （91.30%）in observation group was significantly higher than that of the control group （71.74%）； the levels of serum chemokine C -X3-C motif ligand 1，transforming growth factor β1，interleukin-6，matrix metalloproteinase -2 and tissue inhibitor of metalloproteinase -2 in observation group were significantly lower than control group ；there was statistical significance in CD 4+，CD3+，CD4+/CD8+，forced vital capacity ，the ratio of forced expiratory volume in the one second to forced vital capital （FEV1/FVC%）（P＜0.05）. The adverse drug reactions of the two groups were mainly gastrointestinal reactions and rashes. The incidence of adverse drug reactions in the observation group was 13.04%，and there was no statistical difference compared with control group （10.86%） （P＞0.05）. CONCLUSIONS Modified Yupingfeng powder combined with Yougui pill can reduce airway inflammation ， improve immunity and improve lung function of COPD patients with deficiency of lung and kidney in remission period ，and have good safety .