Machine Learning ; Image Processing, Computer-Assisted/methods*

Objective:To investigate the predictive value of cerebroplacental ratio (CPR) for adverse perinatal outcomes of induction of labor in prolonged pregnancy.Methods:This retrospective study recruited 315 singleton pregnant women who had induced labor due to prolonged pregnancy (≥41 gestational weeks) in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019 to April 30, 2020. Based on the occurrence of adverse perinatal outcomes (emergency delivery due to persistent abnormal fetal heart rate monitoring, umbilical artery blood pH at birth <7.2, 5 min Apgar scores<7, transferring to neonatal intensive care unit after birth, chorioamnionitis and vaginal delivery converted to cesarean section), they were divided into two groups: case group ( n=76) and normal group ( n=239). Clinical features and umbilical artery blood flow, middle cerebral artery (MCA) flow and CPR measured in the last ultrasound scan before induction were compared between the two groups using student's t-test, Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve was used to analyze the predictive values of umbilical artery blood flow, MCA flow and CPR for the adverse perinatal outcomes. Multivariate logistic regression analysis was used to screen the meaningful predictors. Results:Compared with the normal group, the umbilical artery pulsatility index (PI) (0.9±0.1 vs 0.8±0.1, t=-5.458, P<0.001) and the percentage of abnormal CPR (<1.0) increased significantly [21.1%(16/76) vs 6.3%(15/239), χ2=14.190, P<0.001] in the case group, while the MCA-PI and CPR decreased significantly (1.1±0.2 vs 1.3±0.3, t=5.658, P<0.001; 1.2±0.3 vs 1.6±0.5, t=8.940, P<0.001). The areas under the ROC curves of umbilical artery PI, MCA-PI and CPR for predicting adverse perinatal outcomes were 0.71, 0.71 and 0.77, respectively. CPR had the highest sensitivity (0.74) compared with umbilical artery PI (0.68) and MCA-PI (0.71), but the specificity of them were similar (0.67, 0.66 and 0.66). Multivariate logistic regression analysis showed that only CPR was the independent risk factor for adverse perinatal outcomes ( OR=0.028, 95% CI: 0.010-0.080, P<0.001). Conclusions:As an indicator for early prediction of adverse perinatal outcomes of induction of labor in prolonged pregnancy, CPR was more sensitive but less specific.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

OBJECTIVETo evaluate whether intraoperative autologous donation (IAD) can reduce perioperative blood transfusion for patients underwent mitral valve replacement (MVR).

METHODSA total of 318 patients received implementation of IAD from January 2011 to December 2013 were analyzed retrospectively, and compared with 517 patients of the previous 36-month period (from January 2008 to December 2012). The method of small-volume retrograde autologous priming, strict blood transfusion standard along with IAD together constituted a progressive blood-saving strategy. Statistical methods including Students' t-test, Pearson's χ(2) test, Kruskal-Wallis analysis and multivariate Logistic regression model were used for comparisons of the data.

RESULTSThere were no significant difference between IAD group and non-IAD group considering preoperative patient demographics, characteristics and preoperative comorbidities. However, IAD group significantly reduced number of patients transfused with intra/post-operative packed red-blood cell (PRBC) (55(17.0%) vs. 215 (42.1%), χ(2)=53.0, P=0.000), and had significantly reduced postoperative chest tube output (150(380) ml vs. 700(660) ml, H=195.648, P=0.000), length of stay ((16±6) d vs. (20±8)d, t=9.60, P=0.000). But hematocrit were lower in IAD group (30%±5% vs.33%±4% at end of operation, t=7.76, P=0.000; 30%±4% vs. 32%±5% at discharge, P=0.000, t=3.86). Multivariate logistic aggression analysis revealed that age, IAD and smoking history were factors influencing the probability of intra or postoperative blood transfusion.

CONCLUSIONImplementation of blood conservation strategies based on intraoperative autologous donation in mitral valve replacement surgery can significantly reduce intra/postoperative blood transfusion as well as postoperative complications.

Blood Transfusion, Autologous ; Bloodless Medical and Surgical Procedures ; Cardiac Surgical Procedures ; methods ; Hematocrit ; Humans ; Logistic Models ; Mitral Valve ; surgery ; Postoperative Complications ; Retrospective Studies

Objective:To collect the imaging data and related materials of the patients with in-stent restenosis (ISR)after coronary artery stent operation with intravascular ultrasound (IVUS),and to analyze the risk factors of ISR,and to propose the reasonable intervention strategies.Methods:Fifty patients with ISR were divided into ISR ≤ 50% drug group (n = 14 )and ISR > 50% drug group (n = 36),including drug-coated balloon therapy group (n=16)and stent treatment group (n=20);IVUS virtual organization technology was used to compare the plaque area,location,tissue composition,thrombus and other factors of the patients in various groups after treatment;the data changes after 6 months of follow-up were analyzed.Results:The IVUS results showed the plaque areas and plaque loads of the ISR patients treated with intervention were significantly reduced compared with before operation (P <0.05);the plaque compression degree of the patients in drug-coated balloon therapy group was lower than that in stent treatment group (P <0.05),but the differences were not found between drug-coated balloon therapy group and stent treatment group in fibrous tissue components and calcified tissue proportion (P >0.05).Conclusion:The ISR rate is higher in the patients with high degree of fiber components,plaque composition heterogeneity and distribution of diffuse tortuous and calcified lesions.ISR has no significant correlation with the plaque wall thickness and lipid content and plaque instability and necrotic tissue proportion.

OBJECTIVETo observe the differential ability of dental pulp stem cell (DPSC) and ectoblast mesenchyme stem cell (EMSC) that were cultured with tooth germ cell (TGC) as the tooth germ microenvironment.

METHODSThe TGC of 4-day old rat was used as the tooth germ microenvironment. The BrdU marked and determined DPSC and EMSC were cultured with the TGC respectively. The expression of cell surface antigen dentin sialoprotein (DSP) and alkaline phosphatase (ALP) activity were determined with double marker immunofluorescence. The differential ability of DPSC and EMSC were determined by the immunohistochemistry and image analysis in the tooth germ microenvironment.

RESULTSThe transformation efficiency of DSP positive cell in the EMSC co-culture group was higher than that in the DPSC co-culture group (P < 0.05). The transformation efficiency in the co-culture groups was higher than that in the non co-culture group after 7 days by the image analysis of immunohistochemistry (P < 0.05). The ALP activity in the co-culture groups increased after 3 and 7 days. The ALP activity in the EMSC co-culture group was higher than that in the DPSC co-culture group.

CONCLUSIONDPSC and EMSC cultured with TGC as the tooth germ microenvironment can be induced to differentiate into odontoblast. The ability of EMSC is higher than that of DPSC.

Animals ; Cell Differentiation ; Coculture Techniques ; Dental Pulp ; Epithelial Cells ; Extracellular Matrix Proteins ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Mesoderm ; Phosphoproteins ; Rats ; Sialoglycoproteins ; Stem Cells ; Tooth ; Tooth Germ

BACKGROUND: It remains unclear whether ectomesenchymal cells also derived from neural crest stem cell in mammals.OBJECTIVE: To understand the specific markers and differentiation directions of maxillofacial and mandibular processes progenitor cells,and to explore the source and differentiation phenotype of ectomesenchymal stem cells.METHODS: The expression and changes of expression profiles of rat ectomesenchymal cells at E9.5,E10.5,E11.5,and E12.5days were observed by immunohistochemistry and flow cytometry.RESULTS AND CONCLUSION: The progenitors expressed multi-lineage markers,including neural system and several rnesenchymal tissue types,importantly the facts that molecule profiles were changed with time prolonged,suggesting these progenitors were in active differentiating stage,so they were stem like cells or contain stem like cells.Moreover,small populations(2%-3%)of CD57 and P75 phenotypes were detected by flow cytornetry,suggesting that ectomesenchymal stem cells were derived from neural crest,which maintained a quantitative stabilization though it is gradually differentiate after localization.

OBJECTIVETo observe the temporal and spatial expression of Smad7 during human tooth germ development and evaluate the effect of Smad7 on tooth germ development.

METHODSThe expression of Smad7 and its changes at different stages of human tooth germ were detected by using immunohistochemical staining.

RESULTSSmad7 was expressed at all stages of tooth germ, but the distribution patterns at various stages were different. It indicated that temporal and spatial expressing mode of Smad7 during human tooth germ development was specific, which was similar to that of TGF-beta its signal transducer Smad2/3.

CONCLUSIONSmad7 might play an important role in TGF-beta intracellular signaling for modulating the differentiation of ameloblasts and odontoblasts.

Ameloblasts ; cytology ; Cell Differentiation ; DNA-Binding Proteins ; genetics ; metabolism ; physiology ; Fetus ; Humans ; Immunohistochemistry ; Odontoblasts ; cytology ; Odontogenesis ; Signal Transduction ; Smad7 Protein ; Tooth ; growth & development ; Tooth Germ ; embryology ; Trans-Activators ; genetics ; metabolism ; physiology ; Transforming Growth Factor beta ; genetics ; metabolism ; physiology

OBJECTIVEScreening for special genes of matrix proteins of dentin and enamel of mouse dental germ.

METHODSA cDNA library of dental germ of mouse was screened by differential display. The interesting clones were sequenced.

RESULTSSix positive clones were isolated from the cDNA library. The sequence of one of the six positive clones was homologous with the ameloblastin sequence of rat. There are 497 homologous base pairs between the 526 base pairs sequenced by pTriplEX 3' primer of this clone and the 32-580 sequence of the rat ameloblastin gene; and there are 533 homologous base pairs between the 567 base pairs sequenced by pTriplEX 5' primer of this clone and the 1285-1854 sequence of the rat ameloblastin gene.

CONCLUSIONSThe full length cDNA sequence of the mouse ameloblastin was cloned.

Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; DNA, Complementary ; Gene Library ; Mice ; Molecular Sequence Data

OBJECTIVETo determine the clinical effects of preventing dental fear (DF) by pre-operation-education or local anesthesia method during the process of tooth filling.

METHODS150 school children, aged 7 to 12, participated present study. All of them suffered from occlusal caries on their mandibular first permanent molars. They were divided into 3 equal groups, and each had 50, 25 boys and 25 girls. Group1 (pre-operation-education): taking about 1 hour to show them science and educational video tape on caries, then, clinic environment, including machine and instruments, and answering their questions; Group2 (local anesthesia): about 15 minutes before treatment, injecting 1.8 ml of 2% lidocaine for local anesthesia; Group3 (blank): without any measurements for DF. After that, all subjects accepted same filling treatment as usual. DF of each case was evaluated by 3 evaluators blindly based on venham's clinical ratings of anxiety and cooperative.

RESULTSSignificant difference was found between groups (0.57 +/- 0.59, 0.83 +/- 0.66, 1.05 +/- 0.68, H = 18.646, P = 0.0001), also in DF rate (10%, 18% and 42%, chi(2) = 15.5031, P = 0.0004). But not between groups 1 and 2.

CONCLUSIONDuring decayed tooth filling treatment, pre-operation-education is better than that of local anesthesia method, in DF prevention.

Anesthetics, Local ; administration & dosage ; therapeutic use ; Child ; Dental Anxiety ; prevention & control ; Dental Caries ; psychology ; therapy ; Dental Restoration, Permanent ; methods ; psychology ; Education, Dental ; methods ; Female ; Humans ; Lidocaine ; administration & dosage ; therapeutic use ; Male ; Molar ; Treatment Outcome