Objective To explore the effect of a shared care applied to pregnancy care among pregnant women with hypertensive disorder of pregnancy(HDP).Methods A total of 88 pregnant women with HDP who received ob-stetric check-ups in a tertiary A-level matemity hospital in Nanjing City from January to October 2023 were conve-niently selected as the research subjects.According to the order of obstetric examinations,44 pregnant women with HDP from June to October 2023 were selected as an experimental group,and 44 pregnant women with HDP from January to May 2023 were selected as a control group.The experimental group received the shared care clinic management model,and the control group received the routine management.The scores of the rate of blood pres-sure attainment,the incidence of disease progression,the questionnaire on knowledge of HDP,the Hypertension Self-Management Scale,the Pregnancy-Related Anxiety Scale,and the Patient Satisfaction Questionnaire were compared between the 2 groups.Results 41 patients in the experimental group and 39 patients in the control group com-pleted the study.After the intervention,the blood pressure compliance rate of pregnant women with HDP in the experimental group was 95.12％,higher than 79.49％in the control group.The incidence of disease progression was 7.32％,lower than 25.64％in the control group.HDP Knowledge Questionnaire score(25.24±4.07),Hypertension Self-Management Scale score(114.39±14.89),and Patient Satisfaction Questionnaire score(19.56±1.14)were higher than that of the control group.The score of Pregnancy-Related Anxiety Scale was(18.02±2.15),lower than(23.18±9.58)in the control group.The score of Patient Satisfaction Questionnaire was(19.56±1.14),higher than that(17.26±2.25)in the control group.The differences were statistically significant(P＜0.001).Conclusion The shared care clinic model can improve HDP pregnant women's blood pressure control compliance,HDP knowledge,and self-management,reduce the incidence of disease progression,pregnancy-related anxiety,and improve satisfaction,which provides a reference for optimising the HDP management model.

Objective To explore the effect of a shared care applied to pregnancy care among pregnant women with hypertensive disorder of pregnancy(HDP).Methods A total of 88 pregnant women with HDP who received ob-stetric check-ups in a tertiary A-level matemity hospital in Nanjing City from January to October 2023 were conve-niently selected as the research subjects.According to the order of obstetric examinations,44 pregnant women with HDP from June to October 2023 were selected as an experimental group,and 44 pregnant women with HDP from January to May 2023 were selected as a control group.The experimental group received the shared care clinic management model,and the control group received the routine management.The scores of the rate of blood pres-sure attainment,the incidence of disease progression,the questionnaire on knowledge of HDP,the Hypertension Self-Management Scale,the Pregnancy-Related Anxiety Scale,and the Patient Satisfaction Questionnaire were compared between the 2 groups.Results 41 patients in the experimental group and 39 patients in the control group com-pleted the study.After the intervention,the blood pressure compliance rate of pregnant women with HDP in the experimental group was 95.12％,higher than 79.49％in the control group.The incidence of disease progression was 7.32％,lower than 25.64％in the control group.HDP Knowledge Questionnaire score(25.24±4.07),Hypertension Self-Management Scale score(114.39±14.89),and Patient Satisfaction Questionnaire score(19.56±1.14)were higher than that of the control group.The score of Pregnancy-Related Anxiety Scale was(18.02±2.15),lower than(23.18±9.58)in the control group.The score of Patient Satisfaction Questionnaire was(19.56±1.14),higher than that(17.26±2.25)in the control group.The differences were statistically significant(P＜0.001).Conclusion The shared care clinic model can improve HDP pregnant women's blood pressure control compliance,HDP knowledge,and self-management,reduce the incidence of disease progression,pregnancy-related anxiety,and improve satisfaction,which provides a reference for optimising the HDP management model.

Objective To study the efficacy and safety of apolipoprotein E(ApoE)gene and solute carrier organic anion transporter family 1B1(SLCO1B1)gene guided rosuvastatin in regulating lipid.Methods According to ApoE genotype,patients with dyslipidemia were divided into E2 group(ε2/ε2,ε2/ε3),E3 group(ε3/ε3,ε2/ε4)and E4 group(ε3/s4,ε4/ε4).According to SLCO1B1 genotype,they were divided into TT group(*1a/*1a,*la/*1b,*lb/*lb),TC group(*la/*5,*1a/*15,*lb/*15)and CC group(*15/*15).All patients were given rosuvastatin calcium tablets 10 mg each time,once a night,orally for 6 months.The levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)in three groups of ApoE genotype patients were compared.The levels of alanine aminotransferase(GPT),glutamic-oxalacetic aminotransferase(GOT),creatine kinase(CK),creatinine(Cr),fasting blood glucose(FBG)and glycated hemoglobin(HbA1C)in SLCO1B1 genotype patients in 3 groups;the occurrence of myalgia during the study period was observed.Results A total of 1 693 patients were included,including 204 patients in E2 group,1 226 patients in E3 group and 263 patients in E4 group.Among them,there were 1 340 cases in TT group,334 cases in TC group and 19 cases in CC group.After rosuvastatin treatment,the TG levels of E2,E3 and E4 groups were(1.34±1.17),(1.20±0.43)and(1.34±0.55)mmol·L-1;the LDL-C levels were(1.84±0.52),(2.09±0.66)and(2.25±0.51)mmol·L-1;the HDL-C levels were(1.20±0.26),(1.13±0.27)and(1.01±0.21)mmol·L-1.Compared with the E3 and E4 groups,the levels of TG and LDL-C in E2 group were significantly decreased;the HDL-C levels in E2 and E3 groups were significantly higher than that in E4 group(all P＜0.05).After rosuvastatin treatment,the CK levels in CC group were significantly higher than that in TT and TC groups(113 vs 96,94 U·L-1,all P＜0.05).The incidences of myalgia in TT,TC and CC groups were 3.13％,5.99％and 10.53％(P＜0.05).Conclusion After rosuvastatin treatment,ε2 allele and E2/E3 genotype were more effective in reducing TG and LDL-C levels in patients with dyslipidemia.SLCO1B1 521T＞C:CC genotype is more prone to myalgia,521T＞C genotypes did not lead to diabetes.

Objective To study the efficacy and safety of apolipoprotein E(ApoE)gene and solute carrier organic anion transporter family 1B1(SLCO1B1)gene guided rosuvastatin in regulating lipid.Methods According to ApoE genotype,patients with dyslipidemia were divided into E2 group(ε2/ε2,ε2/ε3),E3 group(ε3/ε3,ε2/ε4)and E4 group(ε3/s4,ε4/ε4).According to SLCO1B1 genotype,they were divided into TT group(*1a/*1a,*la/*1b,*lb/*lb),TC group(*la/*5,*1a/*15,*lb/*15)and CC group(*15/*15).All patients were given rosuvastatin calcium tablets 10 mg each time,once a night,orally for 6 months.The levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)in three groups of ApoE genotype patients were compared.The levels of alanine aminotransferase(GPT),glutamic-oxalacetic aminotransferase(GOT),creatine kinase(CK),creatinine(Cr),fasting blood glucose(FBG)and glycated hemoglobin(HbA1C)in SLCO1B1 genotype patients in 3 groups;the occurrence of myalgia during the study period was observed.Results A total of 1 693 patients were included,including 204 patients in E2 group,1 226 patients in E3 group and 263 patients in E4 group.Among them,there were 1 340 cases in TT group,334 cases in TC group and 19 cases in CC group.After rosuvastatin treatment,the TG levels of E2,E3 and E4 groups were(1.34±1.17),(1.20±0.43)and(1.34±0.55)mmol·L-1;the LDL-C levels were(1.84±0.52),(2.09±0.66)and(2.25±0.51)mmol·L-1;the HDL-C levels were(1.20±0.26),(1.13±0.27)and(1.01±0.21)mmol·L-1.Compared with the E3 and E4 groups,the levels of TG and LDL-C in E2 group were significantly decreased;the HDL-C levels in E2 and E3 groups were significantly higher than that in E4 group(all P＜0.05).After rosuvastatin treatment,the CK levels in CC group were significantly higher than that in TT and TC groups(113 vs 96,94 U·L-1,all P＜0.05).The incidences of myalgia in TT,TC and CC groups were 3.13％,5.99％and 10.53％(P＜0.05).Conclusion After rosuvastatin treatment,ε2 allele and E2/E3 genotype were more effective in reducing TG and LDL-C levels in patients with dyslipidemia.SLCO1B1 521T＞C:CC genotype is more prone to myalgia,521T＞C genotypes did not lead to diabetes.

A retrospective case review was conducted of 3 cases with umbilical venous catheterization(UVC) related pericardial effusions in the Neonatal Intensive Care Unit of Zhongnan Hospital of Wuhan University from December 2020 to April 2022.All 3 cases were preterm infants with gestational ages of 33 + 4, 31 and 27 + 6 weeks, respectively.UVC was inserted routinely in 24 hours after birth.Three neonates developed tachycardia or bradycardia, dyspnea, decreased oxygen saturation and muffled heart sound at the 1 st to 4 th day after catheterization.Echocardiography indicated pericardial effusion, so the 3 neonates underwent pericardiocentesis and drainage.Among the 3 neonates, 2 cases improved and have good prognosis, 1 case died.UVC can cause pericardial effusion, which occurs mostly in the early stage after catheterization.Pericardial effusion and tamponade should be considered when patients show unexplained sudden clinical deterioration after catheterization, such as dyspnea, cyanosis, tachycardia or bradycardia, etc.Once diagnosed, umbilical vein catheter should be removed in time and pericardiocentesis and drainage should be performed for decompression.Early diagnosis and intervention can effectively improve the prognosis.

OBJECTIVES: To study the influence of umbilical cord milking versus delayed cord clamping on the early prognosis of preterm infants with a gestational age of <34 weeks. METHODS: PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, Weipu Database, and SinoMed were searched for randomized controlled trials on umbilical cord milking versus delayed cord clamping in preterm infants with a gestational age of <34 weeks published up to November 2021. According to the inclusion and exclusion criteria, two researchers independently performed literature screening, quality evaluation, and data extraction. Review Manger 5.4 was used for Meta analysis. RESULTS: A total of 11 articles were included in the analysis, with 1 621 preterm infants in total, among whom there were 809 infants in the umbilical cord milking group and 812 in the delayed cord clamping group. The Meta analysis showed that compared with delayed cord clamping, umbilical cord milking increased the mean blood pressure after birth (weighted mean difference=3.61, 95%CI: 0.73-6.50, P=0.01), but it also increased the incidence rate of severe intraventricular hemorrhage (RR=1.83, 95%CI: 1.08-3.09, P=0.02). There were no significant differences between the two groups in hemoglobin, hematocrit, blood transfusion rate, proportion of infants undergoing phototherapy, bilirubin peak, and incidence rates of complications such as periventricular leukomalacia and necrotizing enterocolitis (P>0.05). CONCLUSIONS Compared with delayed cord clamping, umbilical cord milking may increase the risk of severe intraventricular hemorrhage in preterm infants with a gestational age of <34 weeks; however, more high-quality large-sample randomized controlled trials are needed for further confirmation.
Cerebral Hemorrhage ; Constriction ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Pregnancy ; Prognosis ; Umbilical Cord/physiology* ; Umbilical Cord Clamping

Background: Our previous studies have shown that regulatory factor X5 (RFX5), a classical transcription regulator of MHCII genes, was obviously overexpressed in hepatocellular carcinoma (HCC) tumors. However, the role of RFX5 in the carcinogenesis and progress of HCC remains unknown. This study aimed to reveal its biological significance and the underlying mechanism in HCC. Methods: RFX5 mRNA expression level and copy number variation in HCC tumors and cell lines were determined by analyzing deposited data sets in the Cancer Genome Atlas and Gene Expression Omnibus database. The biological significance of RFX5 in HCC was investigated by monitoring the colony formation and subcutaneous tumor growth capacity when RFX5 was silenced with lentiviral short hairpin RNA and CRISPR/Cas9 system in HCC cell lines. The downstream gene transcriptionally activated by RFX5 in HCC cells was determined by chromatin immunoprecipitation and luciferase reporter assay. The involvement of tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein theta (YWHAQ) in HCC development was further determined by performing colony formation rescue assay and subcutaneous tumor growth rescue experiment. The association of YWHAQ with recurrence-free survival of patients with HCC was assessed by Kaplan-Meier analysis. Moreover, apoptosis level and the protein level of p53 pathway were determined to reveal the mechanism of RFX5 in driving HCC development. Results: RFX5 was amplified and highly overexpressed in HCC tumor tissues compared with the corresponding non-tumor tissues. The mRNA expression level of RFX5 was significantly correlated with its DNA copy number (r = 0.4, P < 0.001). Functional study demonstrated that RFX5 was required for both clonogenic forming in vitro and subcutaneous tumor growth in vivo of HCC cells. Further study identified YWHAQ, namely 14-3-3 tau, as a key downstream transcriptional target gene of RFX5, which was tightly regulated by RFX5 in HCC. Moreover, overexpression of YWHAQ largely rescued the clonogenic growth of HCC cells that was suppressed by RFX5 knockdown. In addition, overexpression of YWHAQ in primary tumor was linked to poor prognosis of patients with HCC. These results demonstrated that YWHAQ was a downstream effector of RFX5 in HCC. Notably, RFX5-YWHAQ pathway could protect cells from apoptosis by suppressing the p53 and Bax in HCC. Conclusion RFX5 is a putative HCC driver gene that plays an important role in the development and progression of HCC by transactivating YWHAQ and suppressing apoptosis.

According to different toxicities of various aqueous extracts of Polygonum multiflorum on hepatocyte, the impacts of chemical composition on the safety of P. multiforum was studied. In this study, 8 main chemical compositions in aqueous extracts of P. multiflorum were determined by the established HPLC method; at the same time, the inhibition ratios of different aqueous extracts of P. multiflorum on L02 cell were determined. Afterwards, the potential compounds related to the toxicity of P. multiforum were tentatively found through a multiple correlation analysis. The results showed that P. multiforum with different chemical compositions exhibited great differences in dissolution. The hepatocyte toxicity of P. multiflorum powder was much greater than P. multiflorum lumps. In addition, three constituents closely related to toxicity of P. multiflorum were found by multiple correlation analysis. The study revealed that chemical composition of P. multiflorum is closely related to the hepatotoxicity, and the hepatotoxicity of P. multiflorum powder is greater than that of other dosage forms. This study indicates that P. multiflorum with different chemical compositions show varying toxicity, which therefore shall be given high attention.

Objective To investigate a reasonable and effective internal fixation method for posterolateral fracture of the tibial plateau. Methods Specimens of the tibial plateau with posterolateral fracture made from 12 adult male cadavers were randomly and evenly divided into 3 groups, and fixed by anterior 6.5 mm lag screw, lateral 4.5 mm L-shape plate, posterior 3.5 mm T-shape plate, respectively. All the specimens were loaded in turn by stress of 250, 500, 750, 1 000 N, and the corresponding axial displacement and stress were measured. Results Under the same stress, the Y-axial displacement of the anterior lag screw group was the smallest, showing a significant difference with the lateral plate group and the posterior plate group, while there was no significant difference between the lateral plate group and the posterior plate group in the Y-axial displacement. The stresses on marked points in the anterior lag screw group were evenly distributed. Conclusions For fixation of isolated posterolateral fractures of the tibial plateau, the anterior 6.5 mm lag screw can effectively increase the axial stability and balance the stress distribution around the fracture block, indicating it is an effective method for mechanical fixation. The lateral plate has certain advantage in lateral stability control, while the posterior plate has certain value to reduction of the posterior tibia plateau fracture.