Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

Objective: To understand the iodine nutritional status of residents in the newly identified high iodine and non-high iodine areas in Puyang, and to provide evidence for relevant departments to adjust the iodine supplementation policy. Methods: According to the survey results of drinking water iodine content in 2017, in 2018 stratified and systematic sampling methods were used to extract 25 villages in the newly identified high iodine areas and non-high iodine areas in Puyang City. Each village surveyed 40 children and 20 pregnant women, the urinary iodine content of the subjects and the salt iodine content at their home were measured, and the thyroid volume of children in 10 villages in high iodine and non-high iodine areas was measured. Results: In high iodine areas and non-high iodine areas, the household salt samples collected were 1 357 and 1 544, respectively, the iodized salt coverage rate was 87.91% (1 193/1 357) and 85.62% (1 322/1 544), respectively, and the difference was not statistically significant (χ² = 3.291, P > 0.05). A total of 1 028 children and 329 pregnant women in high iodine areas were investigated, their median urinary iodine content was 337.0 and 289.0 μg/L, respectively; a total of 1 041 children and 503 pregnant women in non-high iodine areas were investigated, their median urinary iodine content were 310.0 and 265.0 μg/L, the differences of the urinary iodine content between high iodine and non-high iodine areas were statistically significant (Z = -3.825, -2.795, P < 0.05). Thyroid volume was measured in 407 children in high iodine areas and 423 children in non-high iodine areas. The thyroid enlargement rate was 8.85% (36/407) and 3.78% (16/423), respectively, and the difference was statistically significant (χ² = 9.053, P < 0.05). Conclusions The iodine nutrition levels of children and pregnant women in high iodine areas are higher than those in non-high iodine areas. Iodized salt should be stopped supplying in high iodine areas as soon as possible. In non-high iodine areas, the feasibility of reducing the iodine concentration of iodized salt should be investigated to ensure the iodine nutrition level of local residents.

Objective To analyze the clinical significance of patients self -intervention on self -efficacy and lipid levels in patients with cerebral infarction.Methods 300 patients with cerebral infarction in our hospital were selected from May 2014 to May 2015,and they were randomly divided into two groups by digital table method:the observation group(n =1 50)and the control group(n =1 50),the two groups of patients had no significant differences in the general data.The observation group treated according to the conventional rehabilitation treatments for rehabilitation nursing,in view of the self -management group.After three months,the two groups of patients'self -efficacy and lipid levels were recorded before and after the intervention and the patients'self management abilities were measured. Comparisons between before and after the intervention of the indicators and between the different groups were analyzed,and the relationship of self -management ability and lipid levels of patients was analyzed by Pearson correlation analysis.Results Before the intervention,there was no difference between the two groups in the self -efficacy scale(P >0.05).After the treatment,the self -efficacy scale of the observation group was (29.85 ±5.34), which of the control group was (22.74 ±4.73),the difference between the two groups was statistically significant(t =1 2.207,P <0.001 ).For the lipid levels after treatment,the TC,TG,LDL -C,HDL -C in the observation group were (4.06 ±0.58)mmol/L,(1 .26 ±0.56)mmol/L,(2.27 ±0.49)mmol/L,(1 .42 ±0.54)mmol/L,which in the control group were (4.86 ±1 .05)mmol/L,(1 .54 ±0.48)mmol/L,(3.1 5 ±0.29)mmol/L,(1 .23 ±0.37)mmol/L, the differences between the two groups were statistically significant (t =8.1 68,4.649,1 8.929,3.555,all P <0.001 ).The correlation analysis of self -management ability and the blood lipid improvement of the two groups showed that the observation group presented positive correlation.The patients'self -management ability was stronger, its lipid improve ability was better.Conclusion From the self -efficacy and the blood lipid level analysis,cerebral infarction patients'self -intervention can promote physical and mental health and improve the symptoms of cerebral infarction.In summary,it is helpful for recovery and has positive clinical effect on cerebral infarction.

OBJECTIVE To investigate theradiosensitization of combined inhibition of signal transducer and activator of transcription 3(STAT3) and hypoxia-inducible factor-1α(HIF-1α)on laryngeal squamous carcinoma of xenograft mice and its underlying mechanisms.METHODS Xenograft mice were divided into 5 groups randomly: control group(A), irradiation group(B), irradiation and AG490 group(C), irradiation and PX478 group(D), irradiation combined AG490 and PX478 group(E). The size of xenograft tumor was measured and calculated. The expression of Ki67 and HIF-1α was detected by immunohistochemical method. Western blot was used to detect the expression of PARP1.RESULTS The size of xenograft tumor in group E was smaller compared with that in group C and group D. There were significantly difference between them respectively (t=12.367,11.598,P=0.000). The expression of HIF-1α in group E was lower than that in group C and group D respectively, and there were significantly difference respectively(t=5.422, 3.000,P<0.05). Ki67 index in group E was lower compared with that in group C and group D respectively and there were significantly difference respectively (t=4.479, 4.352,P<0.05). The level of cleaved PARP-1 in group E was higher than that in group C and group D respectively and there were significantly difference respectively (t=5.507, 7.102,P<0.05). CONCLUSION Combined inhibition of STAT3 and HIF-1α can increase the radiosensitivity of human laryngeal squamous carcinoma in the xenograft mice.

The article reviewed the situation of warming kidney and strengthen spleen treatment for ulcerative colitis (UC) in recent 15 years from three aspects: Yang deficiency in spleen and kidney syndrome is one of the most important syndromes in UC; common prescriptions, medicine and efficacy of warming kidney and strengthening spleen treatment for treating UC; the mechanism of the treatment for UC is related to immunity enhancement, inhibition of gastrointestinal smooth muscle, promoting gastrointestinal function, antibiosis, improving plant nerve function, and release of enzymes. It also proposed the problems about warming kidney and strengthening spleen treatment for UC, and prospect for relevant problems.

Objective To study effects ofXiangsha Liujunzi Decoction (XSLJZ) on gastric emptying function, pepsin activity and expression of HIF-1α gene and protein of gastric mucosa in chronic atrophic gastritis (CAG) of rats with deficiency of spleen and stomach.Methods Rats were randomly divided into normal group and model group. The models of CAG rats with deficiency of spleen and stomach type were induced by synthetic methods. After the modeling, models rats were divided into model group, positive control group and XSLJZ high-, medium-, and low-dose groups. Normal group and model group were given 10 mL/kg distilled water every day for gavage; XSLJZ high-, medium-, and low-dose groups were given 24, 12, and 6 g/kg XSLJZ Decoction for gavage; positive control group was given 0.30 g/kg Vatacoenayme for gavage, for successive 120 d. Gastric emptying function and pepsin activity were detected, and HIF-1α gene and protein expression in gastric mucosa were detected by RT-qPCR and IHC. Results Compared with the normal group, the gastric emptying function and pepsin activity in the model group were much lower (P<0.01); expressions of HIF-1α gene and protein in gastric tissues was much higher (P<0.01). Compared with model group, XSLJZ could increase the gastric emptying function and pepsin activity significantly (P<0.05), and decrease expressions of HIF-1α gene and protein (P<0.05).Conclusion XSLJZ has functions of improving the gastric emptying function, promoting pepsin activity, and reducing expressions of HIF-1α gene and protein.

Objective To observe the effects ofXiangsha Liujunzi Decoction (XSLJZ) on levels and mRNA of IL-6, IL-10 and protein expression of HSP70 of gastric mucosa in chronic atrophic gastritis (CAG) rats with spleen-stomach deficiency; To discuss its mechanism.Methods Rats were divided into 2 groups through random number table: normal group and model group. The model of CAG rat with spleen-stomach deficiency type was induced by synthetic methods. After successful modeling, rats were divided into model group, positive control group, XSLJZ high-, medium-, low-dose group. Rats in normal and model group received distilled water 10 mL/(kg?d) for gavage; XSLJZ high-, medium-, low-dose group received XSLJZ 24, 12, 6 g/(kg?d), respectively; positive control group received mycin 0.30 g/(kg?d) for gavage for 120 consecutive days. Generally living conditions, levels and mRNA of IL-6, IL-10 and protein expression of HSP70 in gastric mucosa tissue were detected by protein immunoblotting.Results Compared with the normal group, generally living conditions of rats in the model group were poor; mRNA and the content of IL-6 increased significantly, and mRNA and the content of IL-10 decreased significantly (P<0.05,P<0.01); mRNA and protein expression of HSP70 in gastric tissues was much lower than that of normal group (P<0.05,P<0.01). Compared with model group, generally living conditions of rats in the XSLJZ high-dose groups were improved significantly; mRNA and the content of IL-6 decreased significantly, and mRNA and the content of IL-10 increased significantly (P<0.05); XSLJZ high-, medium-dose groups mRNA and protein expression of HSP70 in gastric tissues increased significantly(P<0.05).Conclusion XSLJZ has protective effects on gastric mucosa of CAG rats with spleen-stomach deficiency.

Objective To observe the dynamic changes of ghrelin of spleen-qi-deficiency rats and the intervention effects ofSijunzi Decoction.Methods Experimental rats were randomly divided into normal control group, model group andSijunzi Decoction group. Except for normal control group, spleen-qi-deficiency model was copied through the two-factor methods of breaking qi by bitter cold and swimming exhausted. Meanwhile,Sijunzi Decoction group was given 20 g/(kg?d)Sijunzi Decoction intervention. The activities of GAS, MTL, SS and VIP at different time points (14, 21, 28 d) in intestine and serum were detected by ELISA and RIA. At the same time the intervention effect of Sijunzi Decoction was studied.Results Compared with normal control group, GAS and MTL in intestine and serum of model rats decreased, while SS and VIP increased (P<0.05,P<0.01). Compared with model group, GAS and MTL in intestine and serum of rats in theSijunzi Decoction group increased, while SS and VIP decreased (P<0.05,P<0.01).Conclusion Ghrelin in intestine and serum of spleen-qi-deficiency rats shows dynamic coincidental changes.Sijunzi Decoction can treat spleen qi deficiency by regulating the activities of rat ghrelin.

OBJECTIVE: To study the expression of Cyclin D1 in nasopharyngeal carcinoma cells processed by epigallocatechin gallate(EGCG) and it's significance, and revealed the anti-tumor mechanism of EGCG against nasopharyngeal carcinoma. METHOD: CNE-2 cells were treated by EGCG at different concentrations, the morphological changes of CNE-2 cells were observed by inverted microscope; the inhibition ratio of cell proliferation was detected by MTT colorimetric method, flow cytometry was used to analyze the changes of cell cycle. The expression of Cyclin D1 mRNA was detected by RT-PCR. RESULT: After treated by EGCG, the CNE2 cells decreased in amount and density, some of which became roll and small; Floating and dead cells can be seen in the inverted microscopy; cell proliferation was significantly inhibited in a time and dose dependent (P < 0.05). CNE-2 cells were arrested at G1/G0 phase. The expression of Cyclin D1 mRNA was down-regulated by EGCG with concentration and action time dependent (P < 0.05). CONCLUSION EGCG resisted nasopharyngeal carcinoma by inhibiting the cell proliferation, The down regulation of Cyclin D1 mRNA expression in a time and dose dependent may be the possible mechanisms.
Carcinoma ; Catechin ; analogs & derivatives ; pharmacology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cyclin D1 ; metabolism ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology