1.Advances in cohort study concerning the effect of gestational weight gain on preterm birth
Yihui WU ; Shuqi ZHU ; Zhaoxia LIANG
Chinese Journal of Perinatal Medicine 2024;27(12):1097-1100
Gestational weight gain reflects maternal body adaptability and fetal development. Inappropriate gestational weight gain is causally associated with various adverse pregnancy outcomes, including preterm birth. Preterm birth is a major cause of increasing neonatal mortality and long-term morbidity globally. As an effective method for analytical research, a cohort study possesses the advantages of having clear causality, high authenticity, effectiveness, and evidence strength, rendering it broadly applicable for investigating the origins of disease and evaluating the outcomes of prevention and treatment. This article reviews cohort studies on the impact of gestational weight gain on preterm delivery in recent years, pointing out the correlation between unjustifiable gestational weight gain and the occurrence of preterm delivery. Additionally, it is identified that the relationship between gestational weight gain and preterm delivery is affected by the level of environmental toxin exposure, race, and dietary patterns.
2.Intratumoral and peritumoral magnetic resonance imaging radiomics combined with clinical characteristics to predict lymphovascular space invasion in cervical cancer
Baojin LIN ; Zhaoxia WU ; Shi WANG ; Xianfeng LONG ; Lili LIANG ; Disheng LI ; Chaohua ZHU
Chinese Journal of Medical Physics 2024;41(7):851-857
Objective To investigate the value of a nomogram model constructed from intratumoral and peritumoral magnetic resonance imaging radiomics combined with clinical characteristics in predicting the status of lymphovascular space invasion(LVSI)in cervical cancer.Methods A retrospective analysis was conducted on 178 cervical cancer patients confirmed by postoperative pathology,with 70 cases of LVSI(+)and 108 cases of LVSI(-).The patients were divided into a training set[142 cases,including 54 cases of LVSI(+)and 88 cases of LVSI(-)]and a test set[36 cases,including 16 cases of LVSI(+)and 20 cases of LVSI(-)]at a ratio of 8:2.All underwent magnetic resonance imaging before surgery,and regions of interest were manually delineated layer by layer on the T2WI sequence,with the peritumoral region being uniformly expanded outward.Univariate logistic analysis was performed on clinical factors to select independent factors for cervical cancer LVSI(+).Radiomic features were extracted separately from the intratumoral region,the peritumoral region,and the intratumoral-peritumoral region to construct radiomics models,and the differences between the peritumoral and the intratumoral-peritumoral models were compared.A combined model was established based on the radiomics scores of the optimal intratumoral-peritumoral model and clinical independent predictive factors,and a nomogram was plotted.Receiver operating characteristic curves were used to evaluate the diagnostic performance of each model,and decision curve analysis was used to assess the clinical value of the models.Results The combined model demonstrated the best performance among the various models,with AUC of 0.970 in the training set and 0.803 in the test set.Conclusion Intratumoral and peritumoral magnetic resonance imaging radiomics combined with clinical characteristics can effectively predict LVSI in cervical cancer.
3.Research progress on immune-related pathogenesis of gestational diabetes mellitus
Luyao HU ; Yibo TANG ; Zhaoxia LIANG
Chinese Journal of Preventive Medicine 2024;58(3):394-399
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, which seriously endangers the health of mothers and infants. Its incidence is gradually increasing worldwide. Research has found that, in addition to insulin resistance and pancreatic β-cell dysfunction, immune disorders play an important role in the pathogenesis of GDM. This study reviews the recent research on the involvement of common immune cells in the pathophysiological process of GDM to explore the functional changes of immune cells related to the occurrence and development of GDM and provides a reference for the prevention and treatment of GDM.
4.Research progress on immune-related pathogenesis of gestational diabetes mellitus
Luyao HU ; Yibo TANG ; Zhaoxia LIANG
Chinese Journal of Preventive Medicine 2024;58(3):394-399
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, which seriously endangers the health of mothers and infants. Its incidence is gradually increasing worldwide. Research has found that, in addition to insulin resistance and pancreatic β-cell dysfunction, immune disorders play an important role in the pathogenesis of GDM. This study reviews the recent research on the involvement of common immune cells in the pathophysiological process of GDM to explore the functional changes of immune cells related to the occurrence and development of GDM and provides a reference for the prevention and treatment of GDM.
5.Optimization and Evaluation of Conditions for Orthotopic Nude Mouse Models of Human Liver Tumor Cells
Yu MENG ; Dongli LIANG ; Linlin ZHENG ; Yuanyuan ZHOU ; Zhaoxia WANG
Laboratory Animal and Comparative Medicine 2024;44(5):511-522
Objective The study aims to optimize the conditions for constructing orthotopic nude mouse models of liver cancer by injecting human liver tumor cell lines and to explore appropriate timings for drug administration. Methods Human hepatocellular carcinoma Hep3B and hepatoblastoma HepG2 cell lines, which stably expressing the luciferase reporter gene (LUC), were selected. The linear correlation between the luciferase luminescence intensity and the number of liver tumor cells was analyzed using a Small Animal In Vivo Imaging system to verify the luminescent efficiency of the human liver tumor cells. Different concentrations (8×106, 2.4×107, 7.2×107 cells/mL) and resuspension media (PBS, Matrigel) of human liver tumor cell suspensions HepG2-LUC and Hep3B-LUC were orthotopically inoculated into the liver lobes of 5-week-old female BALB/c nude mice (12 groups, 7 mice each) to construct human liver tumor nude mouse orthotopic cancer models. Every 7 days, the weights of mice were recorded, and the growth of orthotopic tumors was monitored using the Small Animal In Vivo Imaging system. On day 35 post-cell inoculation, mouse livers were dissected, and pathological slices were prepared for HE staining to observe histopathological changes in liver tissues. Results The luminescence intensity of human liver tumor cell lines was positively correlated with the number of cells (R2=0.983 1, R2=0.970 5), indicating their suitability for orthotopic model construction. Successful modeling was achieved in the high-concentration groups of HepG2-LUC, the low-, medium-, and high-concentration groups of HepG2-LUC+Matrigel, the medium- and high-concentration groups of Hep3B-LUC, and the low-, medium-, and high-concentration groups of Hep3B-LUC+Matrigel. For both HepG2-LUC+Matrigel and Hep3B-LUC+Matrigel groups, mice in the high-concentration groups exhibited significantly reduced body weight compared to the low- and medium-concentration groups (both with P<0.05). The luminescence intensity of successfully modeled mice increased exponentially over time (R2>0.950 0), and reached a minimum of 1.0×107 p/(s·cm²·sr) by day 14 post-transplantation. Mice in the low- and medium-concentration groups of HepG2-LUC and the low-concentration group of Hep3B-LUC showed no significant pathological changes, while the other groups exhibited evident liver tumors and hepatocyte lesions. Conclusion For the HepG2-LUC cell line, the recommended injection volume is 50 µL with a cell density of 2.4×107 cells/mL, resuspended with Matrigel, followed by drug administration or prognostic measures on day 7 post-modeling. For the Hep3B-LUC cell line, the recommended injection volume is 50 µL with a cell density of 7.2×107 cells/mL, not resuspended with Matrigel, with administration or prognostic measures on day 14 post-modeling.
6.Advances in cohort study concerning the effect of gestational weight gain on preterm birth
Yihui WU ; Shuqi ZHU ; Zhaoxia LIANG
Chinese Journal of Perinatal Medicine 2024;27(12):1097-1100
Gestational weight gain reflects maternal body adaptability and fetal development. Inappropriate gestational weight gain is causally associated with various adverse pregnancy outcomes, including preterm birth. Preterm birth is a major cause of increasing neonatal mortality and long-term morbidity globally. As an effective method for analytical research, a cohort study possesses the advantages of having clear causality, high authenticity, effectiveness, and evidence strength, rendering it broadly applicable for investigating the origins of disease and evaluating the outcomes of prevention and treatment. This article reviews cohort studies on the impact of gestational weight gain on preterm delivery in recent years, pointing out the correlation between unjustifiable gestational weight gain and the occurrence of preterm delivery. Additionally, it is identified that the relationship between gestational weight gain and preterm delivery is affected by the level of environmental toxin exposure, race, and dietary patterns.
7.Comparison of the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter in term nulliparous women with borderline oligohydramnios.
Yongqing ZHANG ; Luping CHEN ; Guohui YAN ; Menglin ZHOU ; Zhengyun CHEN ; Zhaoxia LIANG ; Danqing CHEN
Chinese Medical Journal 2022;135(6):681-690
BACKGROUNDS:
At present, there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter (SBC) in term nulliparous women with borderline oligohydramnios.
METHODS:
We conducted a retrospective cohort study from January 2016 to November 2018. During the study period, a total of 244 cases were enrolled. Of these, 103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC. The pregnancy outcomes between the two groups were compared. Primary outcomes were successful vaginal delivery rates. Secondary outcomes were maternal and neonatal adverse events. Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups.
RESULTS:
The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group (64.1% [66/103] vs. 59.6%, [84/141] P = 0.475), even after adjustment for potential confounding factors (adjusted odds ratio [aOR]: 1.07, 95% confidence interval [CI]: 0.57-2.00, P = 0.835). The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group (1.9% [2/103] vs. 7.8%, [11/141] P < 0.001), but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group (12.6% [13/103] vs. 0.7%, [1/141] P < 0.001). Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone (aOR: 6.71, 95% CI: 1.96-22.95). There were three factors related to vaginal delivery failure after induction with SBC, namely gestational age (aOR: 1.51, 95% CI: 1.07-2.14), body mass index (BMI) >30 kg/m2 (aOR: 2.98, 95% CI: 1.10-8.02), and fetal weight >3500 g (aOR: 2.49, 95% CI: 1.12-5.50).
CONCLUSIONS
Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC, with their advantages and disadvantages. In women with nuchal cord, the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor. BMI >30 kg/m2, large gestational age, and estimated fetal weight >3500 g are risk factors for vaginal delivery failure after induction with SBC.
Administration, Intravaginal
;
Catheters
;
Dinoprostone/therapeutic use*
;
Female
;
Fetal Weight
;
Humans
;
Infant, Newborn
;
Labor, Induced/methods*
;
Nuchal Cord
;
Oligohydramnios
;
Oxytocics
;
Pregnancy
;
Pregnancy Outcome
;
Retrospective Studies
8.Relationship of abnormal mid-term oral glucose tolerance test and maternal weight gain with adverse pregnancy outcomes in women with gestational diabetes mellitus.
Yunyan CHEN ; Qi WU ; Lixia ZHANG ; Danqing CHEN ; Zhaoxia LIANG
Journal of Zhejiang University. Medical sciences 2021;50(3):313-319
To explore the correlation of mid-term oral glucose tolerance test (OGTT) and maternal weight gain with adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM). A total of 2611 pregnant women with GDM who were examined and delivered in Women's Hospital, Zhejiang University School of Medicine from July 1st 2017 to 30th June 2018 were enrolled in this study. According to the number of abnormal items of mid-term OGTT results or maternal gestational weight gain (GWG), patients were classified. The incidence of adverse perinatal outcomes in each group and its relation with OGTT results and GWG were analyzed. The incidence of gestational hypertension, premature delivery, macrosomia and large for gestational age infant (LGA) in three abnormal items GDM patients were significantly higher than those in one or two abnormal items GDM patients (all <0.017). The incidence of gestational hypertension and premature delivery in two abnormal items GDM patients were higher than those in one abnormal item GDM patients (all <0.017). The incidence of gestational hypertension and macrosomia in excessive GWG patients were significantly higher than those in inadequate and appropriate GWG patients (all <0.017), and the incidence of LGA were higher than that in inadequate GWG patients (all <0.017). The incidence of premature delivery and low birth weight infants in appropriate GWG patients were significantly lower than those in inadequate and excessive GWG patients, and the incidence of small for gestational age infant (SGA) were significantly lower than that in inadequate GWG patients (all <0.017). In one abnormal item GDM patients, inadequate GWG was a risk factor for premature delivery and SGA (=1.66, 95%: 1.10-2.52; =2.20, 95%: 1.07-4.53), and protective factor for LGA (=0.40, 95%: 0.27-0.59). And excessive GWG was a risk factor for gestational hypertension, premature delivery and low birth weight infants (=2.15, 95%: 1.35-3.41; =1.80, 95%: 1.20-2.72; =2.18, 95%: 1.10-4.30).In two abnormal items GDM patients, inadequate GWG was a protective factor for macrosomia and LGA (=0.24, 95%: 0.09-0.67; =0.54, 95%: 0.34-0.86), while excessive GWG was risk factor for premature delivery (=1.98, 95%: 1.23-3.18).In three abnormal items GDM patients, there was no significant relationship between GWG and adverse pregnancy outcomes. For GDM women with one or two items of elevated blood glucose in OGTT, reasonable weight management during pregnancy can reduce the occurrence of adverse pregnancy outcomes. For those with three items of elevated blood glucose in OGTT, more strict blood glucose monitoring and active intervention measures should be taken in addition to weight management during pregnancy.
Blood Glucose
;
Blood Glucose Self-Monitoring
;
Body Mass Index
;
Diabetes, Gestational/epidemiology*
;
Female
;
Gestational Weight Gain
;
Glucose Tolerance Test
;
Humans
;
Pregnancy
;
Pregnancy Outcome
9.Impact of pre-pregnancy body mass index, weight gain and blood lipid level during pregnancy on pregnancy outcome in patients with gestational diabetes mellitus.
Heng XU ; Yan MA ; Lixia ZHANG ; Zhaoxia LIANG ; Danqing CHEN
Journal of Zhejiang University. Medical sciences 2021;50(3):320-328
To explore the effects of pre-pregnancy body mass index (BMI), weight gain and blood lipid level during pregnancy on pregnancy outcome in patients with and without gestational diabetes mellitus(GDM). A total of 12 650 singleton pregnant women without history of hypertension and diabetes who were admitted at Women's Hospital, Zhejiang University School of Medicine for delivery from January 2018 to April 2019 were enrolled in the study. There were 2381 cases complicated with gestational diabetes (GDM group) and 10 269 cases without GDM (non-GDM group). The pre-pregnancy BMI and weight gain during pregnancy were documented in two groups. The factors related to perinatal outcome were analyzed. In both GDM and non-GDM pregnant women, pre-pregnancy overweight and excessive weight gain during pregnancy were independent factors of large for gestational age infant (LGA), small for gestational age infant (SGA) and first cesarean section (<0.01 or <0.05). Excessive weight gain during pregnancy was also an independent risk factor of preeclampsia (<0.05). Triglyceride levels in the second trimester were independently associated with multiple adverse pregnancy outcomes, such as LGA, preeclampsia, initial cesarean delivery, premature delivery. Controlling excessive or insufficient weight gain during pregnancy can significantly reduce the incidence of LGA and SGA. And controlling BMI before pregnancy can effectively reduce the incidence of LGA, preeclampsia and the first cesarean section. For non-GDM pregnant women, abnormal blood lipid levels in the second trimester may be closely related to multiple adverse pregnancy outcomes, and active dietary guidance or treatment is also required.
Body Mass Index
;
Cesarean Section
;
Diabetes, Gestational/epidemiology*
;
Female
;
Humans
;
Lipids
;
Pregnancy
;
Pregnancy Outcome
;
Weight Gain
10.Frequency-Dependent Effects on Bladder Reflex by Saphenous Nerve Stimulation and a Possible Action Mechanism of Tibial Nerve Stimulation in Cats
Xing LI ; Xiaoping WAN ; Zhaoxia WANG ; Yanan LIANG ; Zhuo JIA ; Xu ZHANG ; Limin LIAO
International Neurourology Journal 2021;25(2):128-136
Purpose:
The present study determined the effects of saphenous nerve stimulation (SNS) at different stimulation frequencies on bladder reflex and explored a possible action mechanism of tibial nerve stimulation (TNS) on bladder activity in cats.
Methods:
Two bipolar nerve cuff electrodes were implanted on the saphenous nerve and the contralateral tibial nerve in 13 cats, respectively. Multiple cystometrograms were obtained to determine the effects of single SNS at different frequencies and that of combined SNS and TNS on the micturition reflex by infusing normal saline.
Results:
SNS at 1 Hz significantly reduced the bladder capacity (BC) to 59.8%±7.7% and 59.3%±5.8% of the control level at the intensity threshold (T) and 2T, respectively (P<0.05), while that at 20 Hz significantly increased the BC to 130.6%±4.2% of the control level at 6T (P<0.05). The TNS and SNS at 20 Hz did not significantly change the BCs at 1T (P>0.05), while combined stimulation at 1T significantly increased the BC to 122.7%±1.9% of the control level and induced an inhibitory effect which was similar to that TNS at 2T.
Conclusions
The current study revealed that SNS reduced and increased BC depending on different stimulation frequencies. The combined SNS and TNS maximized the clinical efficacy at a low intensity. Also, SNS may be a potential therapeutic mechanism of TNS.

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