Objective:To compare and analyze the perioperative characteristics and the differences in maternal and neonatal outcomes of parturients transferring to Caesarean section with different durations in the second stage of labor.Methods:A total of 109 parturients who underwent natural delivery and transitioned to Caesarean section during the second stage of labor at the General Hospital of Northern War Zone from January 2022 to June 2024 were selected. Among them, 51 parturients with a duration of the second stage of labor <2 h were selected as group A, and 58 parturients with a duration of the second stage of labor ≥2 h were selected as group B. The general data of preoperative maternal and neonatal conditions, surgical indications, maternal surgical status, perioperative complications, neonatal characteristics, and adverse outcomes were compared between the two groups .Normally distributed measurement data were described by xˉ±s, and independent sample t test was used on comparison between groups.Counting data were described by composition ratio or rate, and χ2 test was used on comparison between groups. P<0.05 indicated a statistically significant difference. Results:The incidence of intrapartum fever in group A was 17.6% (9/51), and the type Ⅱ and Ⅲ fetal heart rate monitoring was 43.1% (22/51), which were significantly higher than those in group B [5.2%(3/58),13.8%(8/58)] ( χ2=4.31, 11.71, P=0.038, <0.001).The proportion of fetal distress in the surgical indications of group A was 37.3% (19/51), which was significantly higher than that of group B[8.6%(5/58)]( χ2=12.96, P<0.001). The proportion of fetal head descent arrest and relative cephalo-pelvic disproportion in group A were 13.7% (7/51) and 62.7% (32/51), respectively, which were significantly lower than those in group B[50.0%(29/58),94.8%(55/58)] ( χ2=16.14,17.34, P<0.001).The incidence of puerperal morbidity in group A was 35.3% (18/51), which was significantly higher than that in group B[13.8%(8/58)] ( χ2=6.91, P=0.009).The incidence of neonatal hyperbilirubinemia in group A was 15.7% (8/51), and the proportion of newborns transferred to the neonatal intensive care unit due to neonatal hyperbilirubinemia within 7 days after birth was 11.8% (6/51), which were significantly lower than those in group B[32.8%(19/58),29.3%(17/58)]( χ2=4.24,5.02, P=0.039,0.025). Conclusions:Transferring to Caesarean section within 2 hours of the second stage of labor for natural childbirth parturients increases the risk of puerperal morbidity. At the same time, attention should be paid to the presence or absence of prenatal fever and the monitoring of fetal heart rate should be strengthened in the early stage of the second labor. Transfer cesarean section after 2 hours of the second stage of labor requires enhance monitoring of neonatal bilirubin levels.

Objective To investigate the dynamic changes of N-terminal pro-brain natriuretic peptide(NT-proBNP)and high-sensitivity cardiac troponin T(hs-cTnT)during gestation period in women with heart disease,and to evaluate their predictive value for adverse pregnancy outcomes.Methods A total of 221 pregnant women with heart disease undergoing peripartum management were enrolled and divided into adverse outcome group(n=68)and favorable outcome group(n=153)based on pregnancy outcomes.General clinical data and pregnancy outcomes were compared between two groups.Levels of NT-proBNP and hs-cTnT were measured during early pregnancy,mid-pregnan-cy as well as late pregnancy and within 24 hours postpartum.The predictive value of NT-proBNP and hs-cTnT for adverse pregnancy outcomes was evaluated using receiver operating characteristic(ROC)curve analysis.Multivariate Logistic regression analysis was used to screen independent risk factors for adverse pregnancy outcomes.Results There was a statistically significant difference in the New York Heart Association(NYHA)cardiac function classification,left ventricular ejection fraction(LVEF)and pulmonary artery systolic pressure(PASP)between two groups(P＜0.001).In the early stage of pregnancy,the second stage of pregnancy,the third stage of pregnancy and at 24 hours after delivery,the levels of NT-proBNP and hs-cTnT in the adverse outcome group were higher than those in the favorable outcome group,and the differences were statistically significant(P＜0.001).The incidence of maternal complications in the adverse outcome group was higher than that in the favorable outcome group,and the difference was statistically significant(P＜0.01 or P＜0.001).The rates of preterm birth,low birth weight and neonatal asphyxia in the adverse outcome group were higher than those in the favorable outcome group,and the differences were statistically significant(P＜0.01 or P＜0.001).The ROC curve analysis showed that the area under the curve(AUC)of NT-proBNP was 0.892(95％CI,0.845 to 0.939),the AUC of hs-cTnT was 0.857(95％CI,0.802 to 0.912),and the AUC of the combined detection of the two was 0.924(95％CI,0.885 to0.963).The NT-proBNP＞986.5 pg/mL(OR=6.85,95％CI,3.24 to 14.46)and hs-cTnT＞15.8 ng/L(OR=5.62,95％CI,3.24 to 14.46)in the third trimester 2.86 to 11.05)and NYHA class Ⅲ to Ⅳ(OR=4.28,95％CI,1.96 to 9.35)were independent risk factors for adverse pregnancy outcomes.Conclusion The levels of NT-proBNP and hs-cTnT during the perina-tal period in patients with pregnancy complicated with heart disease show dynamic changes.Monito-ring two indicators has important clinical value for predicting adverse pregnancy outcomes.

Objective:To compare and analyze the perioperative characteristics and the differences in maternal and neonatal outcomes of parturients transferring to Caesarean section with different durations in the second stage of labor.Methods:A total of 109 parturients who underwent natural delivery and transitioned to Caesarean section during the second stage of labor at the General Hospital of Northern War Zone from January 2022 to June 2024 were selected. Among them, 51 parturients with a duration of the second stage of labor <2 h were selected as group A, and 58 parturients with a duration of the second stage of labor ≥2 h were selected as group B. The general data of preoperative maternal and neonatal conditions, surgical indications, maternal surgical status, perioperative complications, neonatal characteristics, and adverse outcomes were compared between the two groups .Normally distributed measurement data were described by xˉ±s, and independent sample t test was used on comparison between groups.Counting data were described by composition ratio or rate, and χ2 test was used on comparison between groups. P<0.05 indicated a statistically significant difference. Results:The incidence of intrapartum fever in group A was 17.6% (9/51), and the type Ⅱ and Ⅲ fetal heart rate monitoring was 43.1% (22/51), which were significantly higher than those in group B [5.2%(3/58),13.8%(8/58)] ( χ2=4.31, 11.71, P=0.038, <0.001).The proportion of fetal distress in the surgical indications of group A was 37.3% (19/51), which was significantly higher than that of group B[8.6%(5/58)]( χ2=12.96, P<0.001). The proportion of fetal head descent arrest and relative cephalo-pelvic disproportion in group A were 13.7% (7/51) and 62.7% (32/51), respectively, which were significantly lower than those in group B[50.0%(29/58),94.8%(55/58)] ( χ2=16.14,17.34, P<0.001).The incidence of puerperal morbidity in group A was 35.3% (18/51), which was significantly higher than that in group B[13.8%(8/58)] ( χ2=6.91, P=0.009).The incidence of neonatal hyperbilirubinemia in group A was 15.7% (8/51), and the proportion of newborns transferred to the neonatal intensive care unit due to neonatal hyperbilirubinemia within 7 days after birth was 11.8% (6/51), which were significantly lower than those in group B[32.8%(19/58),29.3%(17/58)]( χ2=4.24,5.02, P=0.039,0.025). Conclusions:Transferring to Caesarean section within 2 hours of the second stage of labor for natural childbirth parturients increases the risk of puerperal morbidity. At the same time, attention should be paid to the presence or absence of prenatal fever and the monitoring of fetal heart rate should be strengthened in the early stage of the second labor. Transfer cesarean section after 2 hours of the second stage of labor requires enhance monitoring of neonatal bilirubin levels.

Objective:To investigate the placenta tissue expression levels of monocyte chemotactic protein-1 (MCP-1), nuclear factor-κBp65 (NF-κBp65) and proliferating cell nuclear antigen (PCNA) in pregnant women with gestational diabetes mellitus (GDM), and to analyze their correlation with pregnancy outcomes.Methods:The clinical data of 124 pregnant women with GDM from May 2020 to December 2021 in PLA Northern Theater General Hospital were retrospectively analyzed. Among them, 62 pregnant women were willing to receive treatment (treatment group), while 62 pregnant women were unwilling to receive treatment (untreated group). In addition, 80 healthy pregnant women in the same period were selected as the healthy control group. The natural birth rate, neonatal Apgar score and the incidences of macrosomia, neonatal hypoglycemia, neonatal hyperbilirubinemia were record. The placenta tissue expression levels of MCP-1, NF-κBp65 and PCNA were detected by immunohistochemical.Results:The natural birth rate in untreated group was significantly lower than that in treatment group and healthy control group: 24.19% (15/62) vs. 75.81% (47/62) and 88.75% (71/80), the natural birth rate in treatment group was significantly lower than that in healthy control group, and there was statistical difference ( P<0.05). The Apgar score in untreated group was significantly lower than that in treatment group and healthy control group: (8.45 ± 2.02) scores vs. (9.46 ± 2.59) and (9.71 ± 3.21) scores, the incidences of macrosomia, neonatal hypoglycemia and neonatal hyperbilirubinemia were significantly higher than those in treatment group and healthy control group: 35.48% (22/62) vs. 11.29% (7/62) and 3.75% (3/80), 29.03% (18/62) vs. 8.06% (5/62) and 2.50% (2/80), 24.19% (15/62) vs. 9.68% (6/62) and 2.50% (2/80), and there were statistical differences ( P<0.05); there were no statistical difference in the indexes treatment group and healthy control group ( P>0.05). The positive expression rates of MCP-1, NF-κBp65 and PCNA in untreated group were significantly higher than those in treatment group and healthy control group: 72.58% (45/62) vs. 25.81% (16/62) and 12.50% (10/80), 69.35% (43/62) vs. 27.43% (17/62) and 13.75% (11/80), 69.35% (43/62) vs. 24.19% (15/62) and 11.25% (9/80), the indexes in treatment group were significantly higher than those in healthy control group, and there were statistical differences ( P<0.05). Conclusions:The placenta tissue expression levels of MCP-1, NF-κBp65 and PCNA in pregnant women with GDM are associated with adverse pregnancy outcomes. After active treatment, the positive rates of the three indexes in pregnant women with GDM significantly decrease, and the prognosis got improved.

OBJECTIVETo explore the role of platelet-activating factor receptor (PAFR) in adhesion and invasion of phospho- rylcholine (PC)-positive Aggregatibacter actinomycetemcomitans in cultured human umbilical vein endothelial cells (HUVEC).

METHDOSCultured HUVECs were pretreated with the PAFR antagonist CV3988 or anti-human PAFR monoclonal antibody for 30 min before infection with PC-positive or -negative A. actinomycetemcomitans strains. The bacterial adhesion and invasion and cytotoxicity in the cells were examined using MTT assay.

RESULTSPretreatment with PAFR antagonists at 100, 200 and 500 nmol/L significantly reduced the adhesion rate (36.29∓3.52)%, (19.04∓3.35)% and (7.69∓3.19%), respectively] and invasion rate [(12.12∓1.58)%, (7.08∓0.29)% and (2.60∓2.26)%, respectively] of PC-positive A.actinomycetemcomitans in HUVECs. Similarly, pretreatment with anti-PAFR antibody also significantly reduced A.actinomycetemcomitans adhesion and invasion in HUVECs [(50.05∓5.28)% and (39.09∓6.50)%, respectively]. Pretreatment with PAFR antagonist (200 and 500 nmol/L) and anti-PAFR antibody (25 µg/mL) significantly increased the viability of HUVECs incubated with PC-positive A.actinomycetemcomitans from (25.39∓9.33)% to (91.12∓3.14)%, (94.12∓2.15)% and (65.5∓1.87)%, respectively, but such pretreatments did not increase the viability of cells incubated with PC-negative A.actinomycetemcomitans.

CONCLUSIONSPAFR plays an important role in the adhesion, invasion, and cytotoxicity of PC-positive A.actinomycetemcomitans in cultured HUVECs.

Aggregatibacter actinomycetemcomitans ; pathogenicity ; Bacterial Adhesion ; Cells, Cultured ; Human Umbilical Vein Endothelial Cells ; microbiology ; Humans ; Platelet Membrane Glycoproteins ; metabolism ; Receptors, G-Protein-Coupled ; metabolism

BACKGROUNDSporadic fundic gland polyps (FGPs) are common gastric polyps. Some studies reported that FGPs dramatically increased due to proton pump inhibitors (PPIs) use and a decreased prevalence of Helicobacter pylori (H. pylori) infection in Western countries. However, data are still controversial. This study aimed to identify the relationships between these two factors and FGPs in China.

METHODSConsecutive patients with FGPs detected were retrospectively analyzed. Data including patients' age, sex, symptoms, H. pylori infection, history of PPIs use, and the polyps were documented. Each patient was compared with two randomly selected age- and sex-matched controls with similar symptoms in the same period.

RESULTSDuring the period from March 2011 to March 2012, a total of 328 patients were diagnosed as FGPs in 23 047 patients who underwent routine esophagogastroduodenoscopy and 656 patients without FGPs as controls. The mean age was (55.12±12.61) years, and 75.91% were women. The prevalence of H. pylori in patients with FGPs was significantly lower than in those without FGPs (22.30% (64/287) vs. 42.26% (224/530), P < 0.001, OR 0.392, 95% CI 0.283-0.544). Overall, a total of 54 patients with FGPs (54/328, 16.46%) and 136 patients without FGPs (136/656, 20.73%) received PPIs therapy (P = 0.110). According to the different duration of PPIs use, no significant differences of PPIs use were found between the cases and controls among all subgroups. Moreover, the PPIs use was also similar, regardless of age, sex, H. pylori infection, and the number of polyps.

CONCLUSIONSporadic FGPs may not be induced by PPIs therapy but negatively correlate with H. pylori infection in China, which is not the same with the data in Western countries.

Adenomatous Polyps ; epidemiology ; Adult ; Aged ; China ; epidemiology ; Endoscopy, Digestive System ; Female ; Gastric Fundus ; drug effects ; pathology ; Helicobacter Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Proton Pump Inhibitors ; adverse effects ; Retrospective Studies ; Stomach Neoplasms ; epidemiology

Objective To explore the clinical characteristics,management and pregnancy outcome in patients with ovarian tumor and ovarian tumor like condition complicated with pregnancy.Methods The clinical data of 248 patients with ovarian tumor and ovarian tumor like condition eomplicated with pregnancy who treated,operated and pathology conducted from January 2003 to December 2009 was analyzed retrospectively.Results Among of 248 patients,8 patients were found by pelrioscopy,184 patients were found by sonography.The rate of ovarian tumor and ovarian tumor like condition during pregnancy was 0.49％ (248/50 652),about 52.82％(131/248)were diagnosed as benign tumor,most of them were ovarian mature teratoma(22.18％,55/248).About 45.56％(113/248)were diagnosed as ovarian tumor like condition,most of them were ovarian chocolatecyst(23.79％,59/248).Four patients(1.61％,4/248)were ovarian malignant tumor.Two hundred and sixteen received operation,term birth was in 164 patients,premature birth was in 19 patients,miscarriage was in 33 patients.Conclusions Pelvioscopy and sonogaraphy are principally important in the diagnosis and detection of ovarian tumor during pregnancy.Pregnancy complicated with ovarian tumor or ovarian tumor like condition should be treated by tumor resection.Suitable surgery intervention during second trimester is safe.

Objective To study the expression and clinical significance of transforming growth factor-beta1(TGF?1) and its receptors(TGF?RⅠ and TGF?RⅡ) in placentas of pregnancy-induced hypertension(PIH). Methods Immunohistochemistry (SABC) was used to determine the distribution and intensity of TGF?1,TGF?RⅠ,TGF?RⅡ staining in placentas of 64 cases of PIH patients (21, 20 and 23 of mild, moderate and severe cases, respectively) and 20 cases of normal gravidas. Results The expression of TGF?1,TGF?RⅠ and TGF?RⅡ in placental trophoblasts and decidual cells was significantly increased in PIH group compared with the normal group (TGF?1:70.31% vs 35.00%,P