Adolescent ; Adult ; Child ; Decision Trees ; Female ; HIV Infections ; economics ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; economics ; prevention & control ; Kenya ; Middle Aged ; Mothers ; South Africa ; Vietnam ; Young Adult

OBJECTIVE: To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China. METHODS: A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia. RESULTS: Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05). CONCLUSIONS The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.
Asphyxia Neonatorum ; epidemiology ; China ; Humans ; Incidence ; Infant, Newborn ; Retrospective Studies

Bupleurum polysaccharides (BPs) is isolated from Bupleurum smithii var. parvifolium, a key traditional Chinese medicine. The study was to investigate the effects of BPs on diabetic kidney injury. After two intraperitoneal injections of streptozotozin (STZ) 100 mg·kg, renal injury in diabetic mice was induced and BPs was orally administrated at dosages of 30 and 60 mg·kg·d. The STZ injected mice developed renal function damage, renal inflammation and fibrosis known as diabetic kidney disease (DKD). BPs significantly reduced serum creatinine level and urinary albumin excretion rate, with the attenuated swelling of kidneys. BPs treatment obviously alleviated the pathological damage of renal tissue. The progression of renal injury in BPs treated mice was inhibited with less expression of type IV collagen (Col IV), fibronectin (FN) and α-smooth muscle actin (α-SMA). The inhibition of inflammation in kidney was associated with the reduced level of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). BPs administration suppressed the over-expression of toll like receptor 4 (TLR4) and high-mobility group box 1 (HMGB1) with lowered activity of nuclear factor kappa B (NF-κB) in renal tissue of diabetic mice. Oral administration of BPs effectively prevented the development ofrenal injury in diabetic mice. This study suggested that the protection provided by BPs might affect through the interruption of HMGB1-TLR4 pathway, leading to the inhibition of renal inflammation and fibrotic process.

Objective:To explore the effect of celastrol in inhibiting the lipid metabolism disorder in hepatic L02 cells and its possible mechanism on endoplasmic reticulum stress (ERS) of non-alcoholic fatty liver cells by intervening non-alcoholic fatty liver disease(NAFLD) cell model with celastrol. Method:Hepatic L02 cells were divided into control group, model group, low-dose celastrol treatment group (Cel 0.5 mg·L^-1), high-dose celastrol treatment group (Cel 1 mg·L^-1) and simvastatin group (SIM 6 mg·L^-1) for cultivation. The contents of total cholesterol (TC) and total triglyceride (TG) in hepatic L02 cells were detected, and the oil red staining was used to detected the lipid accumulation in hepatic L02 cells. Reverse transcription polymerase chain reaction (RT-PCR) and Western blot were used to detect the mRNA and protein expression levels of endoplasmic reticulum stress (ERS)-related signal molecules activating transcription factor 6 (ATF6), glucose regulated protein 78 (GRP78), inositol-requiring enzyme 1 (IRE1), sterol regulatory element-binding protein cleavage-activating protein (SCAP), sterol regulatory element-binding protein-1c (SREBP-1c) and sterol regulatory element-binding protein-2 (SREBP-2) in hepatic L02 cell model respectively. Result:The contents of TC and TG in hepatic L02 cells of NAFLD group were significantly higher than those in control group (P<0.05). The TC and TG contents in hepatic L02 cells of Cel 0.5 mg·L^-1 group, Cel 1 mg·L^-1 group and SIM 6 mg·L^-1 group were significantly lower than those in NAFLD group (P<0.05). Oil red O staining showed that a large amount of red-stained lipid particles were deposited in the hepatic L02 cells of the NAFLD group, while the red-stained lipid particles in the Cel 0.5 mg·L^-1 group, the Cel 1 mg·L^-1 group, and the SIM 6 mg·L^-1 group were lower than the NAFLD group to different degrees. According to the results of RT-PCR and Western blot, the mRNA transcription and protein expression levels of ERS-related signaling molecules ATF6, GRP78, IRE1, SCAP, SREBP-1c and SREBP-2 in hepatic L02 cells of NAFLD group were higher than those of control group (P<0.05). The mRNA transcription and protein expression levels of ERS-related signaling molecules ATF6, GRP78, IRE1, SCAP, SREBP-1c and SREBP-2 in hepatic L02 cells of Cel 0.5 mg·L^-1 group, Cel 1 mg·L^-1 group and SIM 6 mg·L^-1 group were lower than those of NAFLD group (P<0.05). There was no significant difference in the mRNA transcription and protein expression levels of ATF6, GRP78, IRE1, SCAP, SREBP-1c and SREBP-2 between the Cel 1 mg·L^-1 group and the SIM 6 mg·L^-1 group. Conclusion:Celastrol can reduce the lipid metabolism disorder in hepatic L02 cells by down-regulating the expressions of ERS-related signaling molecules ATF6, GRP78, IRE1, SCAP, SREBP-1c and SREBP-2 in hepatic L02 cells, so as to improve NAFLD.

AIM:To investigate the effects of exercise training on the progression from prehypertension to hy -pertension,blood pressure regulation and the angiotensin-converting enzyme 2(ACE2)-angiotensin(Ang)(1-7)-MAS axis activation in cardiovascular centers ,and to elucidate the central mechanisms of exercise training postponing hyperten -sion progression.METHODS:The male spontaneously hypertensive rats(SHR;n=20,5 weeks old)and normotensive Wistar Kyoto(WKY)rats(n=20)were randomly assigned to sedentary(Sed)group and exercise training(ExT)group. The trained rats run on a treadmill in moderate-intensity for 20 weeks.Systolic blood pressure(SBP)was measured by tail-cuff method.The baroreflex sensitivity(BRS)was assessed by intravenous injection of phenylephrine.The expression of ACE2 and MAS receptor at mRNA and protein levels in baroreflex centers were determined by real-time PCR and Western blot,respectively.Alterations of BRS were evaluated before and after intracerebroventricular injection of MAS receptor ago -nist Ang(1-7)and its antagonist A779,respectively.RESULTS:Compared with SHR +Sed group,exercise training since prehypertension significantly postponed the development of hypertension ,delayed the hypertension progression ,and decreased SBP in both SHR and WKY rats(P<0.05).Exercise training enhanced blood pressure regulation and improved the BRS in SHR(P<0.01).The expression of ACE2 and MAS receptor at mRNA and protein levels in the baroreflex cen-ters(rostral ventrolateral medulla ,nucleus tract solitarius and paraventricular nucleus )were up-regulated in SHR +ExT group(P<0.05).Central administration of A779 abolished the benefits of exercise-induced improvement of BRS in SHR +ExT group(P<0.01).In contrast,Ang(1-7)improved the BRS in both SHR +Sed group and SHR +ExT group(P<0.05).CONCLUSION:Exercise training postpones hypertension progression and improves blood pressure regula -tion,which may be associated with the activation of central ACE 2-Ang(1-7)-Mas axis.

Objective To evaluate the efficacy of infection prevention and control measures on the management of rational use of antimicrobial agents.Methods Patients who were admitted in a hospital from 2011 to 2015 were as the research object,a series of infection prevention and control intervention measure were taken,efficacy of intervention measures were evaluated.Results After the implementation of comprehensive intervention measures,compliance rate of hand hygiene increased year by year,from 38.17 ％ in 2011 to 87.16 ％ in 2015,difference was statistically significant (x2 =48.50,P＜0.05).Incidence of healthcare-associated infection dropped from 1.45％ to 1.06％,difference was statistically significant (x2 =42.50,P＜0.05);antimicrobial use density in 2011-2015 were 63.1,44.4,40.0,40.8,and 40.5 respectively,which showed a decreasing tendency.Conclusion Effective infection prevention and control measures have obvious effect on promoting management of rational use of antimicrobial agents,it is helpful for reducing the clinical use density of antimicrobial agents.

Objective To investigate the effects of bone marrow mesenchymal stem cells (BMSC) on the expression of inflammatory factors in rats with multiple organ dysfunction syndrome (MODS). Methods BMSC extracted from the 4-week-old Sprague-Dawley (SD) rats was cultivated and identified in vitro, then the 4th passage of which was used in the experimental study. Sixty SD rats were randomly(random number) divided into three groups (n=20 in each group): Sham group (SG), MODS group (MG) and BMSC group (BG). Rats in the MG was injected by 1 mg/kg lipopolysaccaride (LPS) via great saphenous vein, rats in the SG injected with the same volume sterile phosphate buffer saline and rats in the BG infused by 1×106/cells BMSCs through the tail vein at 2 h after LPS injection. The survival rate, tissue pathological changes of the lung, liver and heart by hematoxylin and eosin (HE) staining, organ dysfunction measurement by blood gas analysis and biochemical indicators as well as the related inflammatory factors by protein microarray and enzyme linked immunosorbent assay (ELISA), were detected 72 h post operation. Multi-group quantitative data was analyzed by one way ANOVA, paired-comparisons by LSD-t test and the comparisons of survival curves in the three groups by Log-rank test. The value of P<0.05 was considered statistically significant. Results The survival rate in SG, MG and BG was 100％, 60％ and 80％, respectively. The survival curves showed that the survival rate of SG was higher than the MG and BG (SG vs. MG, χ2=9.798, P=0.0017; SG vs. BG, χ2=4.333, P=0.0374), but there was no significant difference comparing the BG to the MG (χ2=2.408, P=0.1207). The tissue congestion and edema, and inflammatory cells infiltration in the lung, liver, and heart of the MG were observed by HE staining, while these changes reduced in the BG. Compared with the SG, the levels of pH and PaCO2 and lactic acid (Lac) increased significantly (all P<0.01), the level of total bilirubin (TB) significantly increased [(0.801±0.501)U/L vs. (2.533±0.382)U/L, P=0.003], while the albumin(ALB) level decreased significantly[(35.471±4.015)U/L vs. (23.202±4.872)U/L, P<0.01], and creatine kinase (CK) level increased significantly in MG [(315.670±41.402) vs. (708.250±219.201), P=0.042]. After BMSC treatment, the organ function improved significantly (all P<0.05). Gamma interferon (IFN-γ) and monocyte chemotactic protein 1 (MCP-1) were the differential expression factors in protein chips. The results of ELISA were similar to the protein chips: compared with the SG, IFN-γ and MCP-1 expressions in the MG increased significantly (P<0.01). Compared with MG, the expressions of IFN-γ and MCP-1 decreased significantly in the BG (P<0.01). Conclusion BMSC administration could modulate the inflammatory response of MODS rats by inhibiting the levels of IFN-γ and MCP-1, and improve the organ function and the survival rate.

Objective To explore the current status of the prenatal care quality and the influencing factors in Hangzhou City. Methods We used sociodemographic characteristics questionnaire and the Chinese version of QPCQ to investigate 383 pregnancy women who were at 36 weeks' gestation or greater by convenient sampling method from September to December in 2016. Results A total of 350 questionnaires were valid. The average age of 350 samples was (29.71±3.67) years old. There were 231 primiparas which accounted for 66.00％. Among them, 196 (56.00％) were satisfied with the prenatal care they received, and 153 (43.70％) think general, and only 1 (0.30％) felt unsatisfied. The score of the Chinese version of QPCQ was 3.61±0.50. The item "My prenatal care professional (s) always answered my questions honestly" had the highest scores of 4.10±0.62, while "My prenatal care professional (s) did things hastily" had the lowest scores of 2.44±0.96 . By multiple linear regression analysis, those people who had more visiting time (β' = 0.21, P<0.01), less waiting time (β' = -0.18, P<0.01) and the cognition of the essentiality of pregnancy school (β' = 0.12, P=0.02) were more likely to give higher regards for the quality of prenatal care. Conclusion Sufficient time scored relative lower in the whole questionnaire. So, hospitals could take efforts to shorten the waiting time by promoting the hospital process optimization, making good use of this period time and other strategies, so as to improve the quality of prenatal care.

Objective To analyze the premature death rate and life expectancy caused by cancer, cardiovascular disease, chronic respiratory disease and diabetes and to provide the basis for the government to formulate residents' health promotion measures. Methods The data of deaths of permanent residents in Tongxiang in 2016 were derived from"Zhejiang Chronic Disease Surveillance Information System" . The mortality, premature death rate, years of potential life loss and life expectancy of four chronic diseases were descriptively analyzed. Results In 2016, a total of 5104 deaths were reported in Tongxiang, with a crude death rate of 738.77 / 100, 000 and a standardized mortality rate of 480.40 / 100, 000, 23.59％ were premature deaths. The mortality rate of the four types of chronic diseases was 8.44％ , malignant tumors, cardiovascular and cerebrovascular diseases, chronic respiratory diseases, diabetes were 5.68％, 2.06％, 0.65％ and 0.24％. Residents' life expectancy was 81.40 years, removal of cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes, the life expectancy increased 3.69, 2.78, 1.43 and 0.16 years, respectively. The four types of chronic diseases had a potential life-loss loss of 15, 239 person-years, with an average life-saving year of 4.25 years and a life-saving rate of 22.06 ‰. Mortality rate, premature death rate, years of potential loss of life, average life expectancy and longevity rate were higher in males than in females. Conclusion The probability of premature death of four types of chronic diseases in Tongxiang was 8.44％, and male residents were more likely to be affected.

Objective To investigate the underlying mechanism of bone marrow mesenchymal stem cells (BMSC) modulating the inflammatory response during the multiple organ dysfunction syndrome (MODS), especially the expression of inflammatory cytokines, which will provide new theoretical and experimental basis of MODS in clinic. Methods BMSC of Sprague-Dawley (SD) rat (female, 4 weeks) was extracted and cultivated, and the 4th passage were used in experimental study. According to the random number table, 60 female SD rats were divided into three groups (n = 20 per group): sham group, MODS group, BMSC group. MODS model in rats was induced by lipopolysaccaride (LPS, 1 mg/kg) via femoral vein injection. Sham group was injected with the sterile phosphate buffer saline (PBS) in the same volume. BMSC group, in which BMSC infusion was started at 2 hours after 0.5 mL LPS stimulation (1×106/cells) through the tail vein. The survival rate was observed after 72 hours in each group. Abdominal aortic blood was collected for routine blood and biochemical examination at 72 hours after operation. Protein microarray was used to detect the related 34 inflammatory cytokines. Signal ratio was defined as the differentially expressed factors when it was more than 2.0 or less than 0.5. And enzyme linked immunosorbent assay (ELISA) was be applied to validate the significant inflammation factor. Meanwhile, the heart, kidney, intestine tissue was harvested, then their pathological changes were observed by hematoxylin eosin (HE) staining.Results 20, 12, 16 rats lived in sham group, MODS group and BMSC group respectively at 72 hours after operation. Compared with the sham group, the indicators (routine blood, liver and kidney function, myocardial enzyme) were apparently unusual, and the heart, kidney, intestine tissue were injured obviously in the MODS group. After BMSC administration, the organ function was improved and tissue damaged was alleviated significantly. Protein microarray showed that interleukin-4 (IL-4) and receptor for advanced glycation end products (RAGE) were significantly different in 34 goal cytokines. The signal ratio change of IL-4 was 0.397, 1.124, 2.826 respectively, and the signal ratio of RAGE was 6.197, 1.552, 0.250, respectively in MODS/sham group, BMSC/sham group, BMSC/MODS group. ELISA validated the result that the expression level of IL-4 decreased significantly (ng/L:3.59±1.21 vs. 29.10±5.78) and the expression level of RAGE increased significantly (ng/L: 1.09±0.04 vs. 0.11±0.03) in MODS group as compared with sham group (bothP < 0.05). Compared with the MODS group, the level of IL-4 was obviously higher than that in BMSC group (ng/L: 9.59±2.21 vs. 3.59±1.21,P < 0.01), and RAGE decreased significantly (ng/L: 0.29±0.07 vs. 1.09±0.04,P < 0.05).Conclusions BMSC administration can regulate the expression of IL-4 and RAGE in the rats subjected to MODS. Moreover, BMSC can promote the restoration of tissue and organ function, thus improve the survival rate. BMSC may be the target in cell therapy for the inflammatory disease.