1.Prognostic value of 18F-NaF PET/CT coronary plaque imaging in patients with coronary heart disease
Xue YU ; Li LI ; Chunrong JIN ; Yu HONG ; Jialin SONG ; Bo WANG ; Huifeng WANG ; Xincheng SI ; Xiaoli SHI ; Zhifang WU ; Sijin LI
Chinese Journal of Nuclear Medicine and Molecular Imaging 2025;45(2):65-70
Objective:To investigate the clinical value of 18F-NaF PET/CT coronary plague imaging in evaluating the long-term prognosis of patients with coronary artery disease (CAD). Methods:A retrospective cohort study was conducted among 54 patients (37 males and 17 females, aged (57.2±9.8) years) diagnosed with CAD from a multicenter study between September 2015 and October 2022. All patients underwent 18F-NaF PET/CT and coronary angiography (CAG) within 1 week, and the PET/CT imaging was performed at the First Hospital of Shanxi Medical University. Major adverse cardiovascular events (MACE) were followed up. ROC curves were established to obtain the optimal thresholds of SUV max and accumulated SUV max of all lesions of main coronary artery branches (S-SUV max) for predicting MACE. Cox proportional risk model and Kaplan-Meier method (log-rank test) were used to analyze the predictive value of PET parameters for MACE. Differences in metabolic parameters between 2 groups were compared by Mann-Whitney U test. Results:The median follow-up time of the 54 patients was 6.0(1.8, 6.6) years, and 13(24.1%) patients developed MACE, including 7 deaths, 5 myocardial infarction and 1 severe arrhythmia. S-SUV max in MACE group was significantly higher than that in the non-MACE group (2.64(2.08, 4.49) vs 1.83(0.95, 2.90); Z=-2.04, P=0.041). ROC curve showed that the optimal threshold of S-SUV max for MACE prediction was 2.05 (AUC=0.690). Multivariate Cox analysis showed that S-SUV max was a strong predictor of MACE (hazard ratio ( HR)=2.434(95% CI: 1.547-3.828), P<0.001). ROC curve showed that the optimal threshold of SUV max to predict MACE was 0.55 (AUC=0.659), and univariate Cox analysis showed that SUV max was a factor to predict MACE ( HR=10.192 (95% CI: 2.667-38.953), P=0.001). In 25 patients with incomplete revascularization (ICR), Kaplan-Meier analysis showed that the incidence of MACE in patients with positive 18F-NaF uptake (single medium stenosis (40%-70%) with SUV max≥0.55) was significantly higher than that in patients with negative 18F-NaF uptake (5/14 vs 0/11; χ2=6.07, P=0.014). Conclusions:18F-NaF PET/CT can be used as an independent predictor of MACE in patients with CAD and can quantitatively assess the long-term progression of moderate coronary artery stenosis. In the future, it is expected to be a new non-invasive way to guide the revascularization treatment decision of multi-vessel CAD.
2.Association between postpartum blood loss volume and maternal adverse clinical outcomes
Shuangyi LIANG ; Jiangxue QU ; Huifeng SHI ; Yangyu ZHAO
Chinese Journal of Obstetrics and Gynecology 2025;60(6):422-429
Objective:To investigate the relationship between postpartum hemorrhage (PPH) volume and the risk of adverse clinical outcomes in pregnant women.Methods:This was a retrospective cohort study of 41 494 deliveries at Peking University Third Hospital from 2012 to 2020. With PPH volume as the main exposure, the outcome indicators included: (1) Severe adverse outcomes: shock or embolism, abnormal coagulation function, abnormal liver function, and kidney injury; (2) General adverse outcomes: moderate to severe anemia, hypoalbuminemia, postpartum blood transfusion. Robust Poisson regression was employed to calculate the risk of each outcome index in pregnant women with different PPH volumes under the condition of controlling confounding factors, and to analyze the risk trends of each outcome index with the change of PPH volumes.Results:A total of 41 494 pregnant women were included in the study, including 9 959 cases (24.00%, 9 959/41 494), 23 974 cases (57.78%, 23 974/41 494), 5 235 cases (12.62%, 5 235/41 494), 1 144 cases (2.76%, 1 144/41 494), 508 cases (1.22%, 508/41 494), 208 cases (0.50%, 208/41 494), 207 cases (0.50%, 207/41 494) and 259 cases (0.62%, 259/41 494) pregnant women with PPH volume <250, 250-499, 500-749, 750-999, 1 000-1 249, 1 250-1 499, 1 500-1 999 and ≥2 000 ml, respectively. The risk of any serious adverse outcome, such as shock or embolism, abnormal coagulation function, abnormal liver function and kidney injury, showed a "J-shaped" relationship with PPH volume: risks remained stable (0.26%-0.59%) below 1 500 ml but increased significantly to 3.38% ( RR=3.43, 95% CI: 1.14-10.35) at 1 500-1 999 ml and 5.02% ( RR=4.53, 95% CI: 1.49-13.75) at ≥2 000 ml (all P<0.05). Moderate-to-severe anemia showed threshold effects at 750 ml ( RR ranging from 7.21 to 8.53) and hypoalbuminemia at 1 250 ml ( RR ranging from 3.24 to 3.83), with risks plateauing beyond these thresholds (all P<0.05). Conclusion:It is suggested that 750 ml, 1 250 ml and 1 500 ml should be used as the key intervention thresholds, corresponding to the initiation thresholds of anemia, hypoalbuminemia management and multidisciplinary intensive care, respectively, so as to provide a new reference for optimizing the clinical diagnosis and treatment strategy of PPH.
3.Epidemiological characteristics and trends of preterm births in China from 2017 to 2022
Tianchen WU ; Yixin LI ; Huifeng SHI ; Lian CHEN ; Xiaoxia WANG ; Jie QIAO ; Yangyu ZHAO ; Yuan WEI
Chinese Journal of Perinatal Medicine 2025;28(2):126-133
Objective:To analyze the epidemiological characteristics and trends of preterm births in China using medical institution survey data, thereby providing epidemiological data support for perinatal care.Methods:Based on a nationwide sampling survey on healthcare quality data from 2017 to 2022, this study included 3 547, 4 436, 4 513, 4 535, 5 068, and 5 790 medical institutions, with 7 039 107, 8 926 441, 9 006 420, 7 051 984, 7 311 862, and 7 354 062 parturient women, respectively. The overall rates of preterm birth (live births at 28 to 36 +6 weeks of gestation/overall live births) and early preterm birth (live births at 28 to <34 weeks of gestation/overall live births) were calculated at the national level, across diverse provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps, and for various levels of medical institutions. Generalized estimating equations were used to analyze the influence of maternal characteristics and medical institution characteristics on the rates of preterm birth and early preterm birth. Results:From 2017 to 2022, both the preterm birth rate and the early preterm birth rate in China showed a continuous increase. The preterm birth rate rose from 5.13% (363 036/7 079 454) in 2017 to 6.56% (487 150/7 424 734) in 2022, and the early preterm birth rate increased from 1.32% (118 021/8 971 870) in 2018 to 1.43% (106 157/7 424 734) in 2022. These rates showed an overall increasing trend in private, secondary public specialty, and general hospitals. In tertiary public specialty hospitals, these rates fluctuated around 8.0% and 2.0% from the year 2018, respectively, while in tertiary public general hospitals, these rates peaked in 2020 at 8.63% (205 570/2 381 523) and 2.19% (52 197/2 381 523), respectively. Compared with 2017, by 2022, the preterm birth rate had increased to varying degrees in all provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps, except for Henan Province [preterm birth rate in 2017 was 6.22% (27 173/437 187); preterm birth rate in 2022 was 5.83% (37 604/645 104)]. As for the early preterm birth rate, it showed a decline in Fujian, Guangdong, Guangxi, Hainan, Henan, Jiangsu, Shanghai, Xinjiang, Yunnan, and Zhejiang, but had increased to varying degrees in all other provinces , autonomous regions, municipalities and Xinjiang Production and Construction Corps across the country. The grade and location of medical institutions both had a significant impact on the preterm birth rate and early preterm birth rate (both P<0.05). For every 1% increase in the proportions of multiparous women, women of advanced maternal age, or twin pregnancies, the preterm birth rate increased by 0.014%, 0.042%, and 0.763%, and the early preterm birth rate increased by 0.004%, 0.013%, and 0.239%, respectively (all P<0.05). Conclusion:From 2017 to 2022, the preterm birth rate and early preterm birth rate in China have continued to rise, reflecting the dual challenges of changing characteristics in the childbearing population and the uneven distribution of medical and health resources faced by maternal and child healthcare in China.
4.Impact of DNMT3A,FAT1,IL-7R Gene Mutations on the Prognosis of Allo-HSCT in MDS Patients with Normal Karyotype
Journal of Modern Laboratory Medicine 2025;40(5):82-87
Objective Study on the effect of DNA methyltransferase 3A(DNMT3A),fat atypical cadherin 1(FAT1),and interleukin-7 receptor(IL-7R)gene mutations on the prognosis of patients with myelodysplastic syndrome(MDS)undergoing allogeneic hematopoietic stem cell transplantation(allo-HSCT)treatment with normal karyotype.Methods A single-center retrospective cohort method was used to analyze the clinical data of 380 patients with MDS with normal karyotype who received allo-HSCT to the Department of Hematology,Handan First Hospital from January 2021 to December 2023.Next-generation sequencing(NGS)was used to analyze the gene mutation profile of patients.According to the gene sequencing results,patients with any gene mutation in DNMT3A,FAT1 and IL-7R were classified as mutant group(n=61),and the remaining patients without the above mutation were included in the wild type group(n=319).The clinical characteristics of mutant and wild type patients were analyzed.Kaplan-Meier method was used to analyze the cumulative survival of mutant and wild-type patients,and Log Rank test was used to compare the differences between groups.According to the follow-up outcome,the patients were divided into death group(n=130)and survival group(n=250).Univariate and multivariate COX regression analysis of the factors affecting the overall survival time of MDS patients after allo-HSCT treatment.Results Among 380 patients with normal MDS,16.05%(61/380)were mutant.Compared with the wild type,the mutant's age years old,mean platelet volume(MPA)and IL-6 levels were significantly increased,and the differences were statistically significant(t=7.320,23.774,17.838,all P<0.05).There was no significant difference in overall survival(OS)rate between mutant group and wild-type group patients(59.02%vs 67.08%),and the difference was statistically significant(Log rank χ2=1.610,P>0.05).Age,sex,IL-6,DIF gene mutation,MPV,and bone marrow original cell ratio were the factors influencing the overall survival time of MDS patients after allo-HSCT treatment(t/χ2=5.286~42.498,all P<0.05).COX regression analysis showed that bone marrow original cell ratio≥50%was an independent risk factor for overall survival of MDS patients after allo-HSCT treatment(95%CI:1.046~2.829,HR=1.734,P=0.026).Conclusion DNMT3A,FAT1 and IL-7R gene mutations have no significant effect on the overall survival of MDS patients with normal karyotype treated with allo-HSCT,and the proportion of bone marrow original cells is higher than 50%as an independent risk factor.
5.Association between postpartum blood loss volume and maternal adverse clinical outcomes
Shuangyi LIANG ; Jiangxue QU ; Huifeng SHI ; Yangyu ZHAO
Chinese Journal of Obstetrics and Gynecology 2025;60(6):422-429
Objective:To investigate the relationship between postpartum hemorrhage (PPH) volume and the risk of adverse clinical outcomes in pregnant women.Methods:This was a retrospective cohort study of 41 494 deliveries at Peking University Third Hospital from 2012 to 2020. With PPH volume as the main exposure, the outcome indicators included: (1) Severe adverse outcomes: shock or embolism, abnormal coagulation function, abnormal liver function, and kidney injury; (2) General adverse outcomes: moderate to severe anemia, hypoalbuminemia, postpartum blood transfusion. Robust Poisson regression was employed to calculate the risk of each outcome index in pregnant women with different PPH volumes under the condition of controlling confounding factors, and to analyze the risk trends of each outcome index with the change of PPH volumes.Results:A total of 41 494 pregnant women were included in the study, including 9 959 cases (24.00%, 9 959/41 494), 23 974 cases (57.78%, 23 974/41 494), 5 235 cases (12.62%, 5 235/41 494), 1 144 cases (2.76%, 1 144/41 494), 508 cases (1.22%, 508/41 494), 208 cases (0.50%, 208/41 494), 207 cases (0.50%, 207/41 494) and 259 cases (0.62%, 259/41 494) pregnant women with PPH volume <250, 250-499, 500-749, 750-999, 1 000-1 249, 1 250-1 499, 1 500-1 999 and ≥2 000 ml, respectively. The risk of any serious adverse outcome, such as shock or embolism, abnormal coagulation function, abnormal liver function and kidney injury, showed a "J-shaped" relationship with PPH volume: risks remained stable (0.26%-0.59%) below 1 500 ml but increased significantly to 3.38% ( RR=3.43, 95% CI: 1.14-10.35) at 1 500-1 999 ml and 5.02% ( RR=4.53, 95% CI: 1.49-13.75) at ≥2 000 ml (all P<0.05). Moderate-to-severe anemia showed threshold effects at 750 ml ( RR ranging from 7.21 to 8.53) and hypoalbuminemia at 1 250 ml ( RR ranging from 3.24 to 3.83), with risks plateauing beyond these thresholds (all P<0.05). Conclusion:It is suggested that 750 ml, 1 250 ml and 1 500 ml should be used as the key intervention thresholds, corresponding to the initiation thresholds of anemia, hypoalbuminemia management and multidisciplinary intensive care, respectively, so as to provide a new reference for optimizing the clinical diagnosis and treatment strategy of PPH.
6.Epidemiological characteristics and trends of preterm births in China from 2017 to 2022
Tianchen WU ; Yixin LI ; Huifeng SHI ; Lian CHEN ; Xiaoxia WANG ; Jie QIAO ; Yangyu ZHAO ; Yuan WEI
Chinese Journal of Perinatal Medicine 2025;28(2):126-133
Objective:To analyze the epidemiological characteristics and trends of preterm births in China using medical institution survey data, thereby providing epidemiological data support for perinatal care.Methods:Based on a nationwide sampling survey on healthcare quality data from 2017 to 2022, this study included 3 547, 4 436, 4 513, 4 535, 5 068, and 5 790 medical institutions, with 7 039 107, 8 926 441, 9 006 420, 7 051 984, 7 311 862, and 7 354 062 parturient women, respectively. The overall rates of preterm birth (live births at 28 to 36 +6 weeks of gestation/overall live births) and early preterm birth (live births at 28 to <34 weeks of gestation/overall live births) were calculated at the national level, across diverse provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps, and for various levels of medical institutions. Generalized estimating equations were used to analyze the influence of maternal characteristics and medical institution characteristics on the rates of preterm birth and early preterm birth. Results:From 2017 to 2022, both the preterm birth rate and the early preterm birth rate in China showed a continuous increase. The preterm birth rate rose from 5.13% (363 036/7 079 454) in 2017 to 6.56% (487 150/7 424 734) in 2022, and the early preterm birth rate increased from 1.32% (118 021/8 971 870) in 2018 to 1.43% (106 157/7 424 734) in 2022. These rates showed an overall increasing trend in private, secondary public specialty, and general hospitals. In tertiary public specialty hospitals, these rates fluctuated around 8.0% and 2.0% from the year 2018, respectively, while in tertiary public general hospitals, these rates peaked in 2020 at 8.63% (205 570/2 381 523) and 2.19% (52 197/2 381 523), respectively. Compared with 2017, by 2022, the preterm birth rate had increased to varying degrees in all provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps, except for Henan Province [preterm birth rate in 2017 was 6.22% (27 173/437 187); preterm birth rate in 2022 was 5.83% (37 604/645 104)]. As for the early preterm birth rate, it showed a decline in Fujian, Guangdong, Guangxi, Hainan, Henan, Jiangsu, Shanghai, Xinjiang, Yunnan, and Zhejiang, but had increased to varying degrees in all other provinces , autonomous regions, municipalities and Xinjiang Production and Construction Corps across the country. The grade and location of medical institutions both had a significant impact on the preterm birth rate and early preterm birth rate (both P<0.05). For every 1% increase in the proportions of multiparous women, women of advanced maternal age, or twin pregnancies, the preterm birth rate increased by 0.014%, 0.042%, and 0.763%, and the early preterm birth rate increased by 0.004%, 0.013%, and 0.239%, respectively (all P<0.05). Conclusion:From 2017 to 2022, the preterm birth rate and early preterm birth rate in China have continued to rise, reflecting the dual challenges of changing characteristics in the childbearing population and the uneven distribution of medical and health resources faced by maternal and child healthcare in China.
7.Impact of DNMT3A,FAT1,IL-7R Gene Mutations on the Prognosis of Allo-HSCT in MDS Patients with Normal Karyotype
Journal of Modern Laboratory Medicine 2025;40(5):82-87
Objective Study on the effect of DNA methyltransferase 3A(DNMT3A),fat atypical cadherin 1(FAT1),and interleukin-7 receptor(IL-7R)gene mutations on the prognosis of patients with myelodysplastic syndrome(MDS)undergoing allogeneic hematopoietic stem cell transplantation(allo-HSCT)treatment with normal karyotype.Methods A single-center retrospective cohort method was used to analyze the clinical data of 380 patients with MDS with normal karyotype who received allo-HSCT to the Department of Hematology,Handan First Hospital from January 2021 to December 2023.Next-generation sequencing(NGS)was used to analyze the gene mutation profile of patients.According to the gene sequencing results,patients with any gene mutation in DNMT3A,FAT1 and IL-7R were classified as mutant group(n=61),and the remaining patients without the above mutation were included in the wild type group(n=319).The clinical characteristics of mutant and wild type patients were analyzed.Kaplan-Meier method was used to analyze the cumulative survival of mutant and wild-type patients,and Log Rank test was used to compare the differences between groups.According to the follow-up outcome,the patients were divided into death group(n=130)and survival group(n=250).Univariate and multivariate COX regression analysis of the factors affecting the overall survival time of MDS patients after allo-HSCT treatment.Results Among 380 patients with normal MDS,16.05%(61/380)were mutant.Compared with the wild type,the mutant's age years old,mean platelet volume(MPA)and IL-6 levels were significantly increased,and the differences were statistically significant(t=7.320,23.774,17.838,all P<0.05).There was no significant difference in overall survival(OS)rate between mutant group and wild-type group patients(59.02%vs 67.08%),and the difference was statistically significant(Log rank χ2=1.610,P>0.05).Age,sex,IL-6,DIF gene mutation,MPV,and bone marrow original cell ratio were the factors influencing the overall survival time of MDS patients after allo-HSCT treatment(t/χ2=5.286~42.498,all P<0.05).COX regression analysis showed that bone marrow original cell ratio≥50%was an independent risk factor for overall survival of MDS patients after allo-HSCT treatment(95%CI:1.046~2.829,HR=1.734,P=0.026).Conclusion DNMT3A,FAT1 and IL-7R gene mutations have no significant effect on the overall survival of MDS patients with normal karyotype treated with allo-HSCT,and the proportion of bone marrow original cells is higher than 50%as an independent risk factor.
8.Prognostic value of 18F-NaF PET/CT coronary plaque imaging in patients with coronary heart disease
Xue YU ; Li LI ; Chunrong JIN ; Yu HONG ; Jialin SONG ; Bo WANG ; Huifeng WANG ; Xincheng SI ; Xiaoli SHI ; Zhifang WU ; Sijin LI
Chinese Journal of Nuclear Medicine and Molecular Imaging 2025;45(2):65-70
Objective:To investigate the clinical value of 18F-NaF PET/CT coronary plague imaging in evaluating the long-term prognosis of patients with coronary artery disease (CAD). Methods:A retrospective cohort study was conducted among 54 patients (37 males and 17 females, aged (57.2±9.8) years) diagnosed with CAD from a multicenter study between September 2015 and October 2022. All patients underwent 18F-NaF PET/CT and coronary angiography (CAG) within 1 week, and the PET/CT imaging was performed at the First Hospital of Shanxi Medical University. Major adverse cardiovascular events (MACE) were followed up. ROC curves were established to obtain the optimal thresholds of SUV max and accumulated SUV max of all lesions of main coronary artery branches (S-SUV max) for predicting MACE. Cox proportional risk model and Kaplan-Meier method (log-rank test) were used to analyze the predictive value of PET parameters for MACE. Differences in metabolic parameters between 2 groups were compared by Mann-Whitney U test. Results:The median follow-up time of the 54 patients was 6.0(1.8, 6.6) years, and 13(24.1%) patients developed MACE, including 7 deaths, 5 myocardial infarction and 1 severe arrhythmia. S-SUV max in MACE group was significantly higher than that in the non-MACE group (2.64(2.08, 4.49) vs 1.83(0.95, 2.90); Z=-2.04, P=0.041). ROC curve showed that the optimal threshold of S-SUV max for MACE prediction was 2.05 (AUC=0.690). Multivariate Cox analysis showed that S-SUV max was a strong predictor of MACE (hazard ratio ( HR)=2.434(95% CI: 1.547-3.828), P<0.001). ROC curve showed that the optimal threshold of SUV max to predict MACE was 0.55 (AUC=0.659), and univariate Cox analysis showed that SUV max was a factor to predict MACE ( HR=10.192 (95% CI: 2.667-38.953), P=0.001). In 25 patients with incomplete revascularization (ICR), Kaplan-Meier analysis showed that the incidence of MACE in patients with positive 18F-NaF uptake (single medium stenosis (40%-70%) with SUV max≥0.55) was significantly higher than that in patients with negative 18F-NaF uptake (5/14 vs 0/11; χ2=6.07, P=0.014). Conclusions:18F-NaF PET/CT can be used as an independent predictor of MACE in patients with CAD and can quantitatively assess the long-term progression of moderate coronary artery stenosis. In the future, it is expected to be a new non-invasive way to guide the revascularization treatment decision of multi-vessel CAD.
9.Effectiveness and safety of low-dose oral misoprostol solution for cervical ripening in the third trimester
Yike YANG ; Zhiheng YU ; Xunke GU ; Linlin CAO ; Huifeng SHI ; Yan WANG ; Yangyu ZHAO
Chinese Journal of Perinatal Medicine 2024;27(1):24-32
Objective:To investigate the effectiveness and safety of low-dose oral misoprostol solution for cervical ripening in late gestation.Methods:This was a prospective cohort study including 396 primiparas with singleton pregnancy who received low-dose oral misoprostol solution for cervical ripening (oral group) in Peking University Third Hospital from March to October 2022. They were further allocated to receive oral misoprostol alone (OA group, n=167) or oral misoprostol in combination with oxytocin/amniotomy (OC group, n=229). Moreover, 218 cases who received vaginal misoprostol for cervical ripening (vaginal group) during the same period in 2021 were reviewed (a retrospective cohort). Among them, 77 were given vaginal misoprostol alone (VA group) and 141 received vaginal misoprostol in combination with oxytocin/amniotomy (VC group). The OA group and VA group (72 and 73 cases) as well as the OC group and VC group (108 and 103 cases) were matched using propensity scores. Basic clinical information, hospital stay, duration of labor induction, uterine hyperstimulation, rate of labor initiation, vaginal delivery rate, rate of delivery within 24 h, duration of labor, neonatal condition, adverse pregnancy outcomes, and other information were compared between different groups. All data were statistically analyzed using independent sample t test, analysis of variance, nonparametric test, Chi-square test, or Fisher's exact probability test. Logistic regression model was used to analyze the factors affecting the labor initiation and the failure of labor induction. Results:The average hospital stay, the duration from medication to labor initiation and the duration from medication to vaginal delivery were significantly shorter in the oral group than those in the vaginal group [(5.4±2.4) vs. (6.5±2.6) d, (34.2±24.1) vs. (38.9±25.7) h, (45.8±25.8) vs. (53.4±27.8) h; t=5.24, 2.10 and 3.39; all P<0.05]. The total labor initiation rate and vaginal delivery rate in the oral group were significantly higher than those in the vaginal group [92.9% (368/396) vs. 83.5% (182/218), 72.2% (286/396) vs. 60.1% (131/218); χ 2=13.43 and 9.50; both P<0.05]. The incidence of failed induction of labor, uterine hyperstimulation, fetal distress, and intrauterine infection in the oral group were lower than those in the vaginal group [2.0% (8/396) vs. 6.9% (15/218), 4.3% (17/396) vs. 17.9% (39/218), 8.8% (35/396) vs. 14.7% (32/218), 1.3% (5/396) vs. 3.7% (8/218); χ 2=9.21, 31.36, 4.93 and 3.93; all P<0.05]. The duration from medication to labor initiation and to vaginal delivery in the OA group were higher than those in the VA group [(25.8±17.0) vs. (17.4±10.8) h, (37.2±18.8) vs. (29.7±13.5) h; t=3.49 and 2.74; both P<0.05]. There were no significant differences in the labor initiation rate, vaginal delivery rate, rate of delivery within 24 h or the incidence of failed induction of labor between the OA and VA groups (all P>0.05). Women in the VA group were more likely to develop uterine hyperstimulation than those in the OA group [19.2% (14/73) vs. 4.2% (3/72), χ2=7.89, P=0.005]. There were no significant differences in the duration from medication to labor initiation or to vaginal delivery between the VC and OC groups (both P>0.05), but the duration were significantly longer than those in the corresponding medication alone group (VC vs. VA groups: (49.7±24.6) vs. (17.4±10.8) h and (61.6±25.7) vs. (29.7±13.5) h, t=5.31 and 5.13, both P<0.05; OC vs. OA groups: (45.3±26.6) vs. (25.8±17.0) h and (56.1±27.2) vs. (37.2±18.8) h, t=10.35 and 9.78, both P<0.05]. The labor initiation rate, vaginal delivery rate and rate of delivery within 24 h in the OC group were higher than those in the VC group [88.9% (96/108) vs. 77% (87/113), 63.0% (68/108) vs. 47.8% (54/113), 10.3% (7/108) vs. 0.0% (0/113); χ 2=5.49, 5.14 and 7.56; all P<0.05]. The incidence of uterine hyperstimulation in the OC group was 4.6% (5/108), which was lower than that in the VC group [18.6% (21/113), χ 2=10.37, P=0.001]. Logistic regression analysis showed that oral misoprostol and gestational age were positively correlated with labor initiation [ OR (95% CI): 2.18 (1.24-3.90) and 1.43 (1.14-1.79)], while maternal age was negatively correlated with labor initiation [ OR (95% CI): 0.90 (0.82-0.98)]. Moreover, failed induction of labor was negatively correlated with oral misoprostol [ OR (95% CI): 0.37 (0.14-0.91)], but positively correlated with maternal age [ OR (95% CI): 1.21 (1.05-1.40)]. Conclusions:Oral administration of low-dose misoprostol solution is as effective as vaginal misoprostol in promoting cervical ripening. Besides, it can shorten the average hospital stay and reduce the incidence of uterine hyperstimulation, suggesting that low-dose oral misoprostol solution is relatively safer and can be used to promote cervical ripening in late gestation.
10.Role of innate immune cells in the immune and inflammatory mechanisms of abdominal aortic aneurysm:a research progress review
Xianlu MA ; Tianming WANG ; Peixi ZHANG ; Yongjie ZHAO ; Huifeng SHI
Chinese Journal of General Surgery 2024;33(12):2083-2090
Abdominal aortic aneurysm (AAA) is a life-threatening large-vessel disease closely associated with immune and inflammation-related mechanisms. During the development of AAA,innate immune cells play a pivotal role in the immune-mediated inflammatory infiltration and destruction of the aortic wall. These cells include neutrophils,monocytes,macrophages,dendritic cells,mast cells,natural killer cells,innate lymphoid cells,and invariant natural killer T cells. Although various immune cells have been progressively identified in the study of AAA,their activation mechanisms and functions remain to be further elucidated. This article summarizes the roles of innate immune cells in the progression of AAA and discusses the regulatory mechanisms of their activation in this disease,providing a theoretical basis for research on AAA progression.

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