1.Efficacy analysis of uterine suture with tourniquet binding for placenta previa with placenta accreta spectrum grades 2-3a
Shanduo MA ; Ting QI ; Haowen ZHENG ; Haoyan DONG ; Weijun WANG
Chinese Journal of Perinatal Medicine 2025;28(11):962-968
Objective:To evaluate the clinical feasibility and safety of uterine suture with tourniquet binding during cesarean delivery for placenta previa with placenta accreta spectrum (PAS) grades 2-3a.Methods:This retrospective cohort study included 62 patients with placenta previa and PAS grades 2-3a who underwent cesarean section at the First Affiliated Hospital of Kangda College of Nanjing Medical University (the First People's Hospital of Lianyungang) from June 2018 to June 2023. Participants were divided into two groups according to vascular occlusion method: 31 patients receiving uterine suture with aortic balloon and/or uterine artery embolization comprised the intervention group, while 31 patients undergoing uterine suture with rubber tourniquet binding constituted the tourniquet group. Clinical characteristics and outcomes were compared, including operative duration, 24-hour postoperative blood loss, postoperative hospitalization, costs (hospitalization and 24-hour transfusion), early complications (late postpartum hemorrhage, fever, disseminated intravascular coagulation, organ injury), and late complications (menstrual changes, pelvic pain, urinary tract infections within 6-12 months). Statistical analyses employed two independent t-tests, Mann-Whitney U tests, and Chi square tests. Results:(1) Baseline characteristics, including maternal age, gestational weeks at delivery, gravidity and parity, number of previous cesarean deliveries, hemoglobin levels within 24 hours before surgery, neonatal birth weight, or proportion of emergency surgeries, showed no significant differences between the two groups (all P>0.05). (2) The tourniquet group demonstrated shorter operative duration [(118.3±38.2) vs. (180.7±66.6) min, t=3.87, P<0.001] and postoperative hospitalization [(5.9±1.7) vs. (7.6±2.2) d, t=3.04, P=0.002], with lower hospitalization costs [20 000 (15 000-23 000) vs. 44 000 (34 000-52 000) CNY, Z=5.92, P<0.001] and 24-hour transfusion costs [1 300.0 (1 207.5-2 400.0) vs. 2 828.0 (1 634.5-5 657.7) CNY, Z=2.90, P=0.004]. Early complication rates were significantly reduced [6.5% (2/31) vs. 35.5% (11/31), χ2=7.88, P=0.005], while 24-hour blood loss [1 574.2 (900.0-2 000.0) vs. 1 990.3 (1 000.0-2 500.0) ml, Z=1.37, P=0.172] and late complication rates [25.8% (8/31) vs. 32.3% (10/31), χ2=0.48, P=0.399] showed no significant differences. Conclusion:For placenta previa with PAS grades 2-3a, tourniquet-binding uterine suture effectively controls hemorrhage, reduces operative time, hospitalization duration, and costs, representing a safe and efficient surgical approach.
2.Protective effects of p53/GLUT4 regulation on cardiomyocyte injury induced by high glucose combined with hypoxia/reoxygenation
Aheniyazi ALIYANMU ; Fen LIU ; Haoyan JIANG ; Yunze WANG ; Rong ZHANG ; Yajing QIU ; Runxuan HU ; Yining YANG
International Journal of Biomedical Engineering 2025;48(2):124-136
Objective:To investigate the protective effects of p53/glucose transporter 4 (GLUT4) regulation on cardiomyocyte injury induced by high glucose combined with hypoxia/reoxygenation.Methods:Human myocardial AC16 cells were treated with 33 mmol/L glucose and a hypoxic chamber to establish an in vitro model of high glucose combined with hypoxia/reoxygenation. Based on the glucose concentration in the medium and hypoxia/reoxygenation conditions, AC16 cells were divided into control group, high glucose group, hypoxia/reoxygenation group and high glucose combined with hypoxia/reoxygenation group. On the basis of high glucose combined with hypoxia/reoxygenation group, cells were transfected with empty vector, p53 small interfering RNA (siRNA), and co-transfected with p53 and GLUT4 siRNA to establish negative control group, sip53 transfection group, and sip53+siGLUT4 transfection group, respectively. Western blotting was used to detect the levels of hypoxia-inducible factor-1α (HIF-1α), p53, GLUT4, dynamin-related protein 1 (Drp1), mitofusin 2 (Mfn2), B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax) and cysteine aspartic acid specific protease-3 (Caspase-3). The levels of reactive oxygen species were detected using the 2′,7′-dichlorodihydrofluorescein diacetate fluorescent probe. Mitochondria were labeled with the Mito-Tracker Deep Red FM fluorescent probe to assess mitochondrial morphology and their related parameters. Mitochondrial membrance potential was meausred using the JC-1 detection kit. Adenosine triphosphate (ATP) content was determined using an ATP assay kit. Glucose uptake ability was evaluated by measuring the fluorescence intensity of 2-[ N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) amino]-2-deoxy- D-glucose (2-NBDG) using a multifunctional microplate reader. Apoptosis was assessed by TUNEL assay. Results:The relative expression of HIF-1α protein in the high glucose combined with hypoxia/reoxygenation group was 1.189±0.185, higher than that in the control group (0.086±0.071) ( P<0.05). The relative expression of p53 protein in the high glucose combined with hypoxia/reoxygenation group was 1.248±0.194, higher than those in the control group (0.730±0.184), high glucose group (0.932±0.161) and hypoxia/reoxygenation group (1.109±0.151) (all P<0.05). The relative expression of GLUT4 protein in the high glucose combined with hypoxia/reoxygenation group was 0.407±0.140, lower than those in the control group (1.061±0.060) and hypoxia/reoxygenation group (0.781±0.092) (both P<0.05). The fluorescence intensity of reactive oxygen species in the high glucose combined with hypoxia/reoxygenation group was 38.31±1.66, higher than that in the control group (11.59±1.02) ( P<0.05). The number of mitochondria in the high glucose combined with hypoxia/reoxygenation group was (62.00±15.26), lower than those in the control group (136.20±23.55) and high glucose group (96.55±13.72) (both P<0.05). The average mitochondrial area in the high glucose combined with hypoxia/reoxygenation group was (7.02±1.38) μm 2, lower than those in the control group [(13.74±0.67) μm 2], high glucose group [(9.27±1.99) μm 2] and hypoxia/reoxygenation group [(9.64±2.36) μm 2] (all P<0.05). The average perimeter of mitochondria in the high glucose combined with hypoxia/reoxygenation group was (9.10±1.14) μm, lower than those in the control group [(13.35±0.69) μm] and the hypoxia/reoxygenation group [(10.83±1.58) μm] (all P<0.05). The number of mitochondrial branches was 53.73±9.49, lower than those in the control group (147.10±25.99), high glucose group (97.08±13.65) and hypoxia/reoxygenation group (104.80±24.92) (all P<0.05). The average branch length of mitochondria in the high glucose combined with hypoxia/reoxygenation group was (1.45±0.26) μm, lower than that in the control group [(2.29±0.52) μm] ( P<0.05). The red-green fluorescence intensity ratio in the high glucose combined with hypoxia/reoxygenation group was 0.580±0.133, lower than those in the control group (2.379±0.242), high glucose group (1.200±0.112) and hypoxia/reoxygenation group (0.883±0.076) (all P<0.05). The ATP content of the high glucose combined with hypoxia/ reoxygenation group was (0.025±0.003) μmol/10 5 cells, lower than those of the control group [(0.137±0.012) μmol/10 5 cells], high glucose group [(0.078±0.003) μmol/10 5 cells] and hypoxia/reoxygenation group [(0.073±0.010) μmol/10 5 cells] (all P<0.05). The fluorescence intensity of 2-NBDG in the high glucose combined with hypoxia/reoxygenation group was 257 315±7 951, lower than those in the control group (339 597±10 165), high glucose group (317 293±8 876) and hypoxia/reoxygenation group (314 611±12 228) (all P<0.05). The relative expression of Drp1 protein in high glucose combined with hypoxia/reoxygenation group was 1.203±0.090, higher than those in the control group (0.705±0.170), high glucose group (0.910±0.106) and hypoxia/reoxygenation group (1.002±0.112) (all P<0.05). The relative expression of Mfn2 protein in the high glucose combined with hypoxia/reoxygenation group was 0.706±0.285, lower than those in the control group (1.988±0.139), high glucose group (1.305±0.076) and hypoxia/reoxygenation group (1.131±0.236) (all P<0.05). The relative expression levels of Bax/Bcl-2 and Caspase-3 proteins in the high glucose combined with hypoxia/reoxygenation group were 2.318±0.216 and 1.076±0.076, respectively, higher than those in the control group (0.281±0.046 and 0.442±0.084), high glucose group (0.673±0.043 and 0.662±0.159) and hypoxia/reoxygenation group (0.807±0.293 and 0.835±0.058), respectively (all P<0.05). The TUNEL fluorescence intensity of the high glucose combined with hypoxia/reoxygenation group was 70.55±7.22, higher than those of the control group (14.10±5.93), high glucose group (36.59±2.56) and hypoxia/reoxygenation group (39.04±6.016) (all P<0.05). The relative expression levels of p53 protein in the sip53 transfection group and sip53+siGLUT4 transfection group were 0.322±0.147 and 0.391±0.149, respectively, lower than that in the high glucose combined with negative control group (1.002±0.035) (both P<0.05). The relative expression of GLUT4 protein in the sip53 transfection group was 1.871±0.123, higher than that in the negative control group (1.281±0.232) ( P<0.05). The relative expression of GLUT4 protein in the sip53+siGLUT4 transfection group (0.951±0.193) was lower than that in the sip53 transfection group ( P<0.05). The fluorescence intensity of reactive oxygen species in the sip53 transfection group (27.73±0.74) was lower than that in the negative control group (38.83±0.83) ( P<0.05). The fluorescence intensity of reactive oxygen species in the sip53+siGLUT4 transfection group (43.12±5.08) was higher than that in the sip53 transfection group ( P<0.05). The number of mitochondria, the average area of mitochondria, the average perimeter of mitochondria, the number of mitochondrial branches and the average branch length of mitochondria in the sip53 transfection group were (92.27±10.10), (9.25±0.42) μm 2, (10.86±0.58) μm, (83.27±13.57), and (1.81±0.21) μm, respectively. They were higher than (52.36±16.87), (7.44±1.49) μm 2, (9.22±1.11) μm, (52.36±16.87), and (1.22±0.26) μm in the negative control group (all P<0.05). The number of mitochondria, the average area of mitochondria, the average perimeter of mitochondria, the number of mitochondrial branches and the average branch length of mitochondria in the sip53+siGLUT4 transfection group were (53.73±9.49), (6.89±0.61) μm 2, (8.88±0.47) μm, (53.73±9.49), and (1.22±0.17) μm, respectively, lower than those in the sip53 transfection group (all P<0.05). The red-green fluorescence intensity ratio, ATP content, 2-NBDG fluorescence intensity and relative expression of Mfn2 protein in the sip53 transfection group were 1.27±0.23, (0.048±0.021) μmol/10 5 cells, 275 923±10 447 and 2.608±0.581, respectively, higher than those in the negative control group [0.53±0.21, (0.020±0.007) μmol/10 5 cells, 254 875±8 078, and 0.687±0.146, respectively] (all P<0.05). The red-green fluorescence intensity ratio, ATP content, 2-NBDG fluorescence intensity and relative expression of Mfn2 protein in the sip53+siGLUT4 transfection group were 0.40±0.08, (0.011±0.012) μmol/10 5 cells, 199 511±6 855, and 0.649±0.070, respectively, lower than those in the sip53 transfection group (all P<0.05). The relative expression levels of Drp1, Bax/Bcl-2, Caspase-3 proteins and TUNEL fluorescence intensity in the sip53 transfection group were 0.759±0.063, 0.446±0.161, 1.048±0.300, and 48.93±1.48 respectively, lower than those (1.065±0.149, 1.197±0.133, 1.847±0.201, and 67.61±9.99) in the negative control group (all P<0.05). The relative expression levels of Drp1, Bax/Bcl-2, Caspase-3 proteins and TUNEL fluorescence intensity in the sip53+siGLUT4 transfection group were 0.958±0.166, 2.660±0.135, 1.587±0.220, and 63.39±12.84, respectively, higher than those in the sip53 transfection group (all P<0.05). Conclusions:Under the condition of high glucose combined with hypoxia/reoxygenation, p53 induces cardiomyocyte injury by down-regulating GLUT4. Inhibition of p53 can increase the expression of GLUT4, thereby reducing cardiomyocyte injury induced by high glucose combined with hypoxia/reoxygenation.
3.Effect of regional crosstalk between sympathetic nerves and sensory nerves on temporomandibular joint osteoarthritic pain.
Zhangyu MA ; Qianqian WAN ; Wenpin QIN ; Wen QIN ; Janfei YAN ; Yina ZHU ; Yuzhu WANG ; Yuxuan MA ; Meichen WAN ; Xiaoxiao HAN ; Haoyan ZHAO ; Yuxuan HOU ; Franklin R TAY ; Lina NIU ; Kai JIAO
International Journal of Oral Science 2025;17(1):3-3
Temporomandibular joint osteoarthritis (TMJ-OA) is a common disease often accompanied by pain, seriously affecting physical and mental health of patients. Abnormal innervation at the osteochondral junction has been considered as a predominant origin of arthralgia, while the specific mechanism mediating pain remains unclear. To investigate the underlying mechanism of TMJ-OA pain, an abnormal joint loading model was used to induce TMJ-OA pain. We found that during the development of TMJ-OA, the increased innervation of sympathetic nerve of subchondral bone precedes that of sensory nerves. Furthermore, these two types of nerves are spatially closely associated. Additionally, it was discovered that activation of sympathetic neural signals promotes osteoarthritic pain in mice, whereas blocking these signals effectively alleviates pain. In vitro experiments also confirmed that norepinephrine released by sympathetic neurons promotes the activation and axonal growth of sensory neurons. Moreover, we also discovered that through releasing norepinephrine, regional sympathetic nerves of subchondral bone were found to regulate growth and activation of local sensory nerves synergistically with other pain regulators. This study identified the role of regional sympathetic nerves in mediating pain in TMJ-OA. It sheds light on a new mechanism of abnormal innervation at the osteochondral junction and the regional crosstalk between peripheral nerves, providing a potential target for treating TMJ-OA pain.
Animals
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Osteoarthritis/physiopathology*
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Mice
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Sympathetic Nervous System/physiopathology*
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Temporomandibular Joint Disorders/physiopathology*
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Arthralgia
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Sensory Receptor Cells
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Disease Models, Animal
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Norepinephrine
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Male
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Temporomandibular Joint/physiopathology*
;
Pain Measurement
4.Research progress on high-quality development of dietary nutrition and chronic disease big data
Jianqiang LAI ; Zhenyu YANG ; Ye WANG ; Haoyan GUO
Chinese Journal of Preventive Medicine 2025;59(10):1624-1631
This article delves into the importance and urgency of improving the quality of big data on dietary nutrition and chronic diseases within the disease control system. With the continuous rise in the incidence of chronic diseases, enhancing the quality of relevant data has become crucial in addressing public health challenges. The article proposes a series of concrete measures to improve the accuracy, completeness, and usability of the data, drawing on theoretical and technical support. By strengthening data collection, management, analysis, and application, the goal is to establish a high-quality big data system for dietary nutrition and chronic diseases. This will provide solid data support and scientific evidence for formulating targeted prevention and control strategies, supporting policy development, promoting scientific research innovation, and improving public health standards.
5.Development status of maternal and child health care institutions in China from 2012 to 2022
Ting HUANG ; Bing WANG ; Wenqiang YIN ; Yifei CAO ; Haoyan DENG ; Jinwei HU ; Zhongming CHEN ; Dongping MA ; Kui SUN ; Hongwei GUO
Chinese Journal of Hospital Administration 2025;41(2):96-103
Objective:To understand the development status of maternal and child health care institutions in China from 2012 to 2022, identify the challenges they face, and provide references for further promoting the high-quality development of these institutions.Methods:Data from the China Health Statistics Yearbook (2013—2015), China Health and Family Planning Statistics Yearbook (2016—2017), and China Health and Wellness Statistics Yearbook (2018—2023) were used. Descriptive analysis was conducted on the data related to resource allocation and utilization efficiency, service provision, income and expenditure structure, and operational status of maternal and child health care institutions in China from 2012 to 2022, using methods such as fixed-base growth rate, year-on-year growth rate, and average annual growth rate. Results:From 2012 to 2022, the number of maternal and child health care institutions in China decreased from 3 044 to 3 031. In terms of resource allocation, the average annual growth rates of bed numbers and business-use floor area were 5.404% and 10.923%, respectively, while the average annual growth rate of health professionals was 7.183%. Regarding service provision, the average annual growth rates of outpatient visits and inpatient admissions were 3.954% and 1.572%, respectively. In terms of service efficiency, the bed occupancy rate decreased from 76.9% to 53.9%, and the average number of patients seen per physician per day decreased from 8.85 to 7.30. In terms of income and expenditure and operations, the income-expenditure surplus rate decreased from 9.16% to 5.41%, and the debt-to-asset ratio increased from 27.88% to 33.60%. During the same period, the average annual growth rates of bed numbers and business-use floor area in grassroots maternal and child health care institutions were 4.545% and 10.091%, respectively, lower than the national average. The number of outpatient visits increased from 89.03 million to 126.93 million, with an average annual growth rate of 3.610%, while the number of inpatient admissions decreased from 4.19 million to 3.91 million, with an average annual decline of 0.689%. The income-expenditure surplus rate of grassroots institutions decreased from 7.76% to 4.05%, 1.36 percentage points lower than the national level, and the debt-to-asset ratio increased from 27.53% to 36.37%, higher than the overall level.Conclusions:From 2012 to 2022, maternal and child health care institutions in China achieved certain developments in resource allocation and service scale. However, several challenges remain, including unbalanced resource allocation, decreased utilization efficiency, slowed growth in medical service volume, imbalanced income and expenditure structure, increased asset operation risks, and restricted development of grassroots institutions. It is recommended that relevant management departments and maternal and child health care institutions optimize resource allocation, plan for service transformation and upgrading, expand income sources, strengthen internal financial control, and reinforce the construction of high-quality and efficient maternal and child health care systems to promote the high-quality development of maternal and child health care institutions in China.
6.tert-Butyl hydroperoxide can induce ferroptosis in nucleus pulposus cells
Chao CHEN ; Yaoquan HU ; Zhengpin LYU ; Qicong HE ; Zijiu YANGYANG ; Haoyan LUO ; Guishuai WU ; Qianlin ZUO ; Xuenan WANG ; Fan ZHANG
Chinese Journal of Tissue Engineering Research 2025;29(32):6858-6865
BACKGROUND:Degeneration of nucleus pulposus cells is a key component of intervertebral disc degeneration.Ferroptosis,a novel form of programmed cell death,is closely associated with the onset and progression of intervertebral disc degeneration;however,its precise mechanisms remain unclear.OBJECTIVE:To establish an oxidative stress model in vitro by inducing ferroptosis in nucleus pulposus cells using tert-butyl hydroperoxide and to investigate the mechanisms of tert-butyl hydroperoxide-induced ferroptosis in nucleus pulposus cells,thereby elucidating the role of ferroptosis in the pathogenesis of intervertebral disc degeneration.METHODS:Nucleus pulposus cells were treated with varying concentrations of tert-butyl hydroperoxide(0,25,50,100,and 200 μmol/L),and cell morphology and viability were assessed using fluorescence microscopy and the cell counting kit-8 assay.Interventions with 100 μmol/L tert-butyl hydroperoxide,10 μmol/L RSL3,or dimethylsulfoxide were applied to nucleus pulposus cells,and cell proliferation was evaluated using the EdU assay.The expression levels of ferroptosis-related proteins(glutathione peroxidase 4,ferritin heavy chain 1,PTGS2,and ACSL4)and intervertebral disc degeneration marker proteins(matrix metalloproteinase 13 and Col2A)were analyzed via western blot and immunofluorescence.Additionally,reactive oxygen species and lipid peroxidation levels were quantified using the reactive oxygen species detection kit and C11-BODIPY probe.Mitochondrial morphological changes were observed under transmission electron microscopy.RESULTS AND CONCLUSION:(1)tert-Butyl hydroperoxide treatment significantly reduced the viability and proliferation of nucleus pulposus cells.(2)tert-Butyl hydroperoxide induced typical ferroptosis-related morphological changes in nucleus pulposus cells.(3)tert-Butyl hydroperoxide exposure led to a decrease in the expression of ferroptosis-suppressing proteins glutathione peroxidase 4 and ferritin heavy chain 1,while increasing the expression of ferroptosis-promoting factors ACSL4 and PTGS2.(4)tert-Butyl hydroperoxide elevated intracellular reactive oxygen species production and lipid peroxidation levels in nucleus pulposus cells.(5)Transmission electron microscopy revealed ferroptosis-specific mitochondrial changes in nucleus pulposus cells treated with tert-butyl hydroperoxide,including contraction,reduced cristae,and increased membrane density.(6)tert-Butyl hydroperoxide treatment also resulted in the increased expression of matrix metalloproteinase 13 and decreased expression of Col2A in nucleus pulposus cells.In conclusion,tert-butyl hydroperoxide induces ferroptosis in nucleus pulposus cells,contributing to the development of intervertebral disc degeneration.This process may represent a key pathological mechanism in intervertebral disc degeneration and offers potential targets for developing novel therapeutic strategies.
7.Development status of maternal and child health care institutions in China from 2012 to 2022
Ting HUANG ; Bing WANG ; Wenqiang YIN ; Yifei CAO ; Haoyan DENG ; Jinwei HU ; Zhongming CHEN ; Dongping MA ; Kui SUN ; Hongwei GUO
Chinese Journal of Hospital Administration 2025;41(2):96-103
Objective:To understand the development status of maternal and child health care institutions in China from 2012 to 2022, identify the challenges they face, and provide references for further promoting the high-quality development of these institutions.Methods:Data from the China Health Statistics Yearbook (2013—2015), China Health and Family Planning Statistics Yearbook (2016—2017), and China Health and Wellness Statistics Yearbook (2018—2023) were used. Descriptive analysis was conducted on the data related to resource allocation and utilization efficiency, service provision, income and expenditure structure, and operational status of maternal and child health care institutions in China from 2012 to 2022, using methods such as fixed-base growth rate, year-on-year growth rate, and average annual growth rate. Results:From 2012 to 2022, the number of maternal and child health care institutions in China decreased from 3 044 to 3 031. In terms of resource allocation, the average annual growth rates of bed numbers and business-use floor area were 5.404% and 10.923%, respectively, while the average annual growth rate of health professionals was 7.183%. Regarding service provision, the average annual growth rates of outpatient visits and inpatient admissions were 3.954% and 1.572%, respectively. In terms of service efficiency, the bed occupancy rate decreased from 76.9% to 53.9%, and the average number of patients seen per physician per day decreased from 8.85 to 7.30. In terms of income and expenditure and operations, the income-expenditure surplus rate decreased from 9.16% to 5.41%, and the debt-to-asset ratio increased from 27.88% to 33.60%. During the same period, the average annual growth rates of bed numbers and business-use floor area in grassroots maternal and child health care institutions were 4.545% and 10.091%, respectively, lower than the national average. The number of outpatient visits increased from 89.03 million to 126.93 million, with an average annual growth rate of 3.610%, while the number of inpatient admissions decreased from 4.19 million to 3.91 million, with an average annual decline of 0.689%. The income-expenditure surplus rate of grassroots institutions decreased from 7.76% to 4.05%, 1.36 percentage points lower than the national level, and the debt-to-asset ratio increased from 27.53% to 36.37%, higher than the overall level.Conclusions:From 2012 to 2022, maternal and child health care institutions in China achieved certain developments in resource allocation and service scale. However, several challenges remain, including unbalanced resource allocation, decreased utilization efficiency, slowed growth in medical service volume, imbalanced income and expenditure structure, increased asset operation risks, and restricted development of grassroots institutions. It is recommended that relevant management departments and maternal and child health care institutions optimize resource allocation, plan for service transformation and upgrading, expand income sources, strengthen internal financial control, and reinforce the construction of high-quality and efficient maternal and child health care systems to promote the high-quality development of maternal and child health care institutions in China.
8.tert-Butyl hydroperoxide can induce ferroptosis in nucleus pulposus cells
Chao CHEN ; Yaoquan HU ; Zhengpin LYU ; Qicong HE ; Zijiu YANGYANG ; Haoyan LUO ; Guishuai WU ; Qianlin ZUO ; Xuenan WANG ; Fan ZHANG
Chinese Journal of Tissue Engineering Research 2025;29(32):6858-6865
BACKGROUND:Degeneration of nucleus pulposus cells is a key component of intervertebral disc degeneration.Ferroptosis,a novel form of programmed cell death,is closely associated with the onset and progression of intervertebral disc degeneration;however,its precise mechanisms remain unclear.OBJECTIVE:To establish an oxidative stress model in vitro by inducing ferroptosis in nucleus pulposus cells using tert-butyl hydroperoxide and to investigate the mechanisms of tert-butyl hydroperoxide-induced ferroptosis in nucleus pulposus cells,thereby elucidating the role of ferroptosis in the pathogenesis of intervertebral disc degeneration.METHODS:Nucleus pulposus cells were treated with varying concentrations of tert-butyl hydroperoxide(0,25,50,100,and 200 μmol/L),and cell morphology and viability were assessed using fluorescence microscopy and the cell counting kit-8 assay.Interventions with 100 μmol/L tert-butyl hydroperoxide,10 μmol/L RSL3,or dimethylsulfoxide were applied to nucleus pulposus cells,and cell proliferation was evaluated using the EdU assay.The expression levels of ferroptosis-related proteins(glutathione peroxidase 4,ferritin heavy chain 1,PTGS2,and ACSL4)and intervertebral disc degeneration marker proteins(matrix metalloproteinase 13 and Col2A)were analyzed via western blot and immunofluorescence.Additionally,reactive oxygen species and lipid peroxidation levels were quantified using the reactive oxygen species detection kit and C11-BODIPY probe.Mitochondrial morphological changes were observed under transmission electron microscopy.RESULTS AND CONCLUSION:(1)tert-Butyl hydroperoxide treatment significantly reduced the viability and proliferation of nucleus pulposus cells.(2)tert-Butyl hydroperoxide induced typical ferroptosis-related morphological changes in nucleus pulposus cells.(3)tert-Butyl hydroperoxide exposure led to a decrease in the expression of ferroptosis-suppressing proteins glutathione peroxidase 4 and ferritin heavy chain 1,while increasing the expression of ferroptosis-promoting factors ACSL4 and PTGS2.(4)tert-Butyl hydroperoxide elevated intracellular reactive oxygen species production and lipid peroxidation levels in nucleus pulposus cells.(5)Transmission electron microscopy revealed ferroptosis-specific mitochondrial changes in nucleus pulposus cells treated with tert-butyl hydroperoxide,including contraction,reduced cristae,and increased membrane density.(6)tert-Butyl hydroperoxide treatment also resulted in the increased expression of matrix metalloproteinase 13 and decreased expression of Col2A in nucleus pulposus cells.In conclusion,tert-butyl hydroperoxide induces ferroptosis in nucleus pulposus cells,contributing to the development of intervertebral disc degeneration.This process may represent a key pathological mechanism in intervertebral disc degeneration and offers potential targets for developing novel therapeutic strategies.
9.Efficacy analysis of uterine suture with tourniquet binding for placenta previa with placenta accreta spectrum grades 2-3a
Shanduo MA ; Ting QI ; Haowen ZHENG ; Haoyan DONG ; Weijun WANG
Chinese Journal of Perinatal Medicine 2025;28(11):962-968
Objective:To evaluate the clinical feasibility and safety of uterine suture with tourniquet binding during cesarean delivery for placenta previa with placenta accreta spectrum (PAS) grades 2-3a.Methods:This retrospective cohort study included 62 patients with placenta previa and PAS grades 2-3a who underwent cesarean section at the First Affiliated Hospital of Kangda College of Nanjing Medical University (the First People's Hospital of Lianyungang) from June 2018 to June 2023. Participants were divided into two groups according to vascular occlusion method: 31 patients receiving uterine suture with aortic balloon and/or uterine artery embolization comprised the intervention group, while 31 patients undergoing uterine suture with rubber tourniquet binding constituted the tourniquet group. Clinical characteristics and outcomes were compared, including operative duration, 24-hour postoperative blood loss, postoperative hospitalization, costs (hospitalization and 24-hour transfusion), early complications (late postpartum hemorrhage, fever, disseminated intravascular coagulation, organ injury), and late complications (menstrual changes, pelvic pain, urinary tract infections within 6-12 months). Statistical analyses employed two independent t-tests, Mann-Whitney U tests, and Chi square tests. Results:(1) Baseline characteristics, including maternal age, gestational weeks at delivery, gravidity and parity, number of previous cesarean deliveries, hemoglobin levels within 24 hours before surgery, neonatal birth weight, or proportion of emergency surgeries, showed no significant differences between the two groups (all P>0.05). (2) The tourniquet group demonstrated shorter operative duration [(118.3±38.2) vs. (180.7±66.6) min, t=3.87, P<0.001] and postoperative hospitalization [(5.9±1.7) vs. (7.6±2.2) d, t=3.04, P=0.002], with lower hospitalization costs [20 000 (15 000-23 000) vs. 44 000 (34 000-52 000) CNY, Z=5.92, P<0.001] and 24-hour transfusion costs [1 300.0 (1 207.5-2 400.0) vs. 2 828.0 (1 634.5-5 657.7) CNY, Z=2.90, P=0.004]. Early complication rates were significantly reduced [6.5% (2/31) vs. 35.5% (11/31), χ2=7.88, P=0.005], while 24-hour blood loss [1 574.2 (900.0-2 000.0) vs. 1 990.3 (1 000.0-2 500.0) ml, Z=1.37, P=0.172] and late complication rates [25.8% (8/31) vs. 32.3% (10/31), χ2=0.48, P=0.399] showed no significant differences. Conclusion:For placenta previa with PAS grades 2-3a, tourniquet-binding uterine suture effectively controls hemorrhage, reduces operative time, hospitalization duration, and costs, representing a safe and efficient surgical approach.
10.Research progress on high-quality development of dietary nutrition and chronic disease big data
Jianqiang LAI ; Zhenyu YANG ; Ye WANG ; Haoyan GUO
Chinese Journal of Preventive Medicine 2025;59(10):1624-1631
This article delves into the importance and urgency of improving the quality of big data on dietary nutrition and chronic diseases within the disease control system. With the continuous rise in the incidence of chronic diseases, enhancing the quality of relevant data has become crucial in addressing public health challenges. The article proposes a series of concrete measures to improve the accuracy, completeness, and usability of the data, drawing on theoretical and technical support. By strengthening data collection, management, analysis, and application, the goal is to establish a high-quality big data system for dietary nutrition and chronic diseases. This will provide solid data support and scientific evidence for formulating targeted prevention and control strategies, supporting policy development, promoting scientific research innovation, and improving public health standards.

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