To find out the bacterial species in the vagina of postpartum women and the possible influencing factors on colonization.From Jun. 2007 to Oct. 2007, 560 postpartum women from 7 hospitals in China were enrolled. Questionnaire survey, gynecological examination and Nugent score of vaginal smear and microbial spectrum study of the vaginal flora were completed.(1) According to the Nugent score, 48 out of the 560 women were normal (8.6%), 337 at the borderline (60.2%) and 175 (31.2%) were complicated with bacterial vaginosis (BV). Among the 560 women, Bacterium lacticum were identified in 74 cases (13.2%), but not in the rest 486 cases (86.8%). Gardnerella and bacteroids were detected in 322 women (57.5%) and small flectobacillus in 214 women (38.2%) out of the 560 subjects. (2) Influencing factors on vaginal microflora: among the 266 women who had normal vaginal delivery, 25 (9.4%) showed normal vaginal microflora, 148 (55.6%) at borderline and BV was diagnosed in 93 women (35.0%). The corresponding figures among the 294 women who underwent cesarean section were 23 (7.8%), 189 (64.3%) and 82 (27.9%), respectively. However, the incidence of BV had no statistical difference between these two groups (P = 0.204). In the 233 women who received episiotomy, 22 (9.4%) showed normal vaginal microflora, 135 (57.9%) at borderline and 76 presented with BV (32.6%), the corresponding figures among the 327 women without episiotomy were 26 (8.0%), 202 (61.8%) and 99 (30.2%), respectively. The incidence of BV did not show any statistical difference between the above two groups (P = 0.790). (3) Prenatal vaginitis were reported in 46 women, among which 5 (10.9%) with normal vaginal flora, 26 (56.5%) at borderline and 15 (32.6%) with BV, and again in the 514 women without prenatal vaginits, the above figures changed to 43 (8.4%), 311 (60.5%) and 160 (31.1%). No significant difference was found in the incidence of BV between the two groups (P = 0.962). The rate of BV in women without sex, with sex occasionally and with sex frequently during pregnancy was 27.5% (78/284), 35.6% (96/270) and 1/6, respectively (P = 0.185), and the numbers in women who had breast-feeding, bottle feeding and mixed feeding were 31.0% (67/216), 39.3% (35/89) and 28.6% (73/255), respectively (P = 0.573).The amount of Lactobacillus in vagina of postpartum women is greatly reduced leading to dysbacteria. The incidence of BV is not affected by vaginal delivery, episiotomy, vaginitis, prenatal intercourse and the way of feeding, but is higher in postpartum women.
The Patient-Reported Outcomes Measurement Information System 29-item Profile (PROMIS-29) has been widely used to measure health outcomes from the patient's perspective. It has not been validated in adults with aortic disease. The aim of this study was to explore the reliability and validity of the Chinese PROMIS-29 among patients undergoing surgery for aortic dissection (AD).A cross-sectional design was applied. Eligible patients completed a questionnaire that contained the PROMIS-29 and legacy measures, including the Short Form-12 Health Survey (SF-12), 8-item Somatic Symptom Scale (SSS-8), Generalized Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire-2 (PHQ-2). The structural validity of the PROMIS-29 was evaluated using confirmatory factor analysis (CFA). Reliability was evaluated with Cronbach's α. Construct validity was assessed by calculating Spearman's rank correlations and comparing known-group differences.In total, a sample of 327 AD patients was included in the final analysis. Most of them were male (89%) with a mean age of 52.7 (± 10.3). CFA revealed good model fit of the seven-factor structure within PROMIS-29, as well as most domains in single-factor analysis. Reliability was confirmed with Cronbach's α > 0.90. Correlations between comparable domains of the PROMIS-29 and those of legacy questionnaires and most know-group comparisons were observed as hypothesized.This study found evidence for acceptable structural validity, construct validity and internal consistency of the PROMIS-29 in a sample of AD patients. It can be applied to AD survivors by researchers or clinicians, measuring outcomes after surgery and identifying those with worse health status.
The aim of this study was to compare the effectiveness and safety of intramuscular phloroglucinol and oral misoprostol for cervix pretreatment before diagnostic hysteroscopy. Several modalities for cervical priming and pain reduction have been adopted to reduce the complications related to cervical dilatation before hysteroscopy. Among them, the prostaglandin analog misoprostol is the most frequently used agent. Phloroglucinol, a spasmolytic, has also been showed to have an effect in inducing cervical dilatation but is rarely used before hysteroscopy. One hundred twenty outpatients undergoing anesthesia-free diagnostic hysteroscopy were randomly assigned to receive 80 mg intramuscular phloroglucinol and 400 mg oral misoprostol before diagnostic hysteroscopy. The main outcome measures were preoperative cervical width, visual analog scales (VAS) for pain, cervical passage time, and adverse reactions. Intramuscular phloroglucinol resulted in a significantly wider cervical width, lower VAS pain score, shorter cervical passage time, and a lower adverse effects rate compared with oral misoprostol. Intramuscular phloroglucinol is more effective and safer than oral misoprostol in inducing proper cervical priming and may be the optimal choice for cervical pretreatment before diagnostic hysteroscopy.
In Brief OBJECTIVE: To evaluate whether sustained transabdominal uterine massage can reduce blood loss after vaginal delivery. METHODS: In this multicenter randomized controlled trial, eligible women who had delivered vaginally were randomly assigned to receive 10 units oxytocin intramuscularly immediately after delivery of the shoulder plus 30 minutes of sustained transabdominal uterine massage after delivery of the placenta or to 10 units oxytocin intramuscularly alone. The primary outcome was blood loss of 400 mL or more in the 2 hours after delivery of the neonate. Secondary outcomes included blood loss of 1,000 mL or more, blood loss in the 2 hours after delivery, use of therapeutic uterotonics or other hemostatic procedures, hemoglobin of lower than 80 g/L before discharge, and need for blood transfusion. Analysis was by intent to treat. With a one-sided α of 0.05 and a power of 0.8, a sample size of 1,061 women per group was calculated to detect a 3% absolute decrease in the primary outcome. RESULTS: Of 2,340 eligible women, 1,170 were randomized to oxytocin plus uterine massage and 1,170 to the oxytocin-only group. Baseline characteristics were similar in both groups. The incidence of blood loss of 400 mL or more in the 2 hours after delivery was not significantly different between the two groups (143/1,170 [12.2%] compared with 144/1,170 [12.3%]; relative risk 0.99, 95% confidence interval 0.88–1.13) according to intent-to-treat analysis with a power of more than 0.8. No significant differences were found in the secondary outcomes. CONCLUSION: In patients delivered vaginally, transabdominal uterine massage after delivery of the placenta in addition to oxytocin does not reduce blood loss when compared with administration of oxytocin alone. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry, www.chictr.org, ChiCTR-TRC-11001763. LEVEL OF EVIDENCE: I Routine uterine massage after vaginal delivery is not necessary when oxytocin is administered.
To evaluate the associations between periodontal conditions, serum level of interleukin-1beta (IL-1beta) and delivery outcomes in pregnant women with a diagnosis of threatened premature labor(TPL).Eighty systemically healthy pregnant women were enrolled in the study. The case group was composed of 40 pregnant women hospitalized with the diagnosis of TPL (TPL group) and the control group was composed of 40 normal pregnant women (Non-TPL group). Periodontal examinations included assessments of plaque index (PLI), clinical attachment loss (CAL), probing depth (PD), bleeding index (BI) and the percent of periodontitis sites (PD >3 mm, CAL > or =2 mm). The serum level of IL-1beta was determined using commercially available enzyme-linked immunoassays.(1) Fourteen of forty subjects of TPL group delivered premature labor infants (TPL-TB group), and twenty-six subjects delivered natural labor infants (TPL-PB group). No infants were delivered as premature labor infants in non-TPL group. There were significant differences in gestational age at delivery, birth weight, PLI, percentage of periodontitis sites and IL-1beta levels between the non-TPL group and TPL group or between the TPL-TB group and TPL-PB group (P < 0.05). (Significant negative correlation were observed between the gestational age at delivery and percentage of periodontitis sites as well as serum IL-1beta levels (P < 0.05). And significant positive correlation were observed between percentage of periodontitis site and serum IL-1beta levels (P < 0.05).Periodontal inflammation might be one of the pathogenesis of preterm birth.
Phase change memory (PCM) is an important element in the development and realization of new forms of brain-like computing. In this article, a three-dimensional finite element method simulation is carried out to study the temperature profiles within PCM cells for a better understanding of switching operations. On the basis of a finite difference method, the simulation consists of phase transition kinetics, electrical, thermal, percolation effect, as well as thermoelectric effects, using temperature-dependent material parameters. The Thomson effect within the phase-change material and the Peltier effect at the electrode contact are respectively considered for a detailed analysis of the impact on the temperature profiles and the programming current for switching processes. The simulation results show that switching operations are primarily implemented by the melting and quenching of the phase-change material close to the contact between the bottom electrode and phase change material, and its final phase distribution is determined by the cooling rate. With positive current polarity, thermoelectric effects improve heating efficiency and then reduce the programming current. Because of the different occurrence region, the Peltier effect significantly changes the temperature profile, which is more influential in switching operations. Additionally, the contribution of thermoelectric effects decreases with the cell size scaling because of the weakening of the Peltier effect. This paper aims at providing a more precise description of the thermoelectric phenomena taking place in switching operations for future PCM design.
MicroRNA (miRNA) is a kind of non-coding RNA that regulates gene expression and is involved in tumor development. MiRNA-125 is reportedly aberrantly expressed in colorectal cancer tissue; however, its potential function and underlying mechanism remain unclear. The present study aimed to investigate the expression level and potential role of the miRNA-125 family in the invasion and migration of colorectal cancer.To further understand the role of the miRNA-125 family in metastatic colorectal cancer, we overexpressed miRNA-125 in the SW480 cell line by transfection with the miRNA-125 family mimics or a sponge. Methyl thiazolyl tetrazolium (MTT) assay was performed to identify the effect of the miRNA-125 family on cell proliferation, and a Transwell filter assay was used to detect the role of the miRNA-125 family in migration and invasion. A luciferase assay was carried out to confirm the binding site of miRNA-125 and the target gene, damage specific DNA binding protein 2 (DDB2). Western blot was applied to detect the expression levels of DDB2 and the markers of epithelial-to-mesenchymal transition (EMT) in colorectal cancer cells.The real-time polymerase chain reaction (PCR) results showed that miR-125a-5p and miR-125b-1-5p were up-regulated in metastatic colorectal cancer tissues. The Transwell filter assay results appeared that miR-125a-5p and miR-125b-1-5p could promote the invasion and migration of colorectal cancer cells. The luciferase assay data confirmed the binding site of miR-125a-5p and miR-125b-1-5p on the 3' untranslated region (3'UTR) of DDB2 messenger RNA (mRNA). The real-time PCR and Western blot results indicated that miR-125a-5p and miR-125b-1-5p could regulate the expression levels of DDB2 and EMT markers, and lower DDB2 expression was observed in metastatic tissues.Our findings illustrated that miRNA125a-5p and miRNA125b-1-5p could reduce the expression of DDB2 by binding to the 3'UTR region, and then regulate the expression levels of EMT markers, leading to the enhanced invasion and metastasis of colorectal cancer cells. Thus, miRNA125a-5p and miRNA125b-1-5p might be novel markers of colorectal cancer migration and potential therapeutic targets to treat metastatic colorectal cancer patients.
This paper describes the mechanism of the placenta circulatory disturbance of thrombophilia in pregnancy, and investigates the pathologic patterns of placentas through both sides of the maternal blood circulation disorders and uterine blood circulation disorders. This paper attempt to add deeper understanding of thrombophilia and recognize the pathological mechanism of relevant perinatal outcomes.
Key words:
Thrombophilia; Pregnancy complications; Placenta; Pathologic processes
How cancer cells evade the therapeutic effects of immune checkpoint blockade is largely unknown. Here, we report that fibrinogen-like protein 1 (FGL1), a newly identified immune checkpoint ligand, was modified by acetylation at Lys 98 in hepatocellular carcinoma (HCC), which targeted it for proteasomal degradation. Sirtuin 2 (SIRT2) deacetylated and stabilized FGL1, thus promoting immune evasion. Notably, the SIRT2 inhibitor 2-Cyano-3-[5-(2,5-dichlorophenyl)-2-furanyl]-N-5-quinolinyl-2-propenamide (AGK2) enhanced acetylation of FGL1 and reduced FGL1 protein levels in vitro. The combination of AGK2 and programmed death ligand 1 (PD-L1) blockade effectively suppressed tumor growth and improved overall survival of mice. Furthermore, aspirin, an old drug, could directly acetylate FGL1 at Lys 98 and promote its degradation in vitro. Aspirin enhanced the immunotherapeutic efficacy, induced tumor regression, and extended the lifespan of tumor-bearing mice. Furthermore, the SIRT2/FGL1 axis was expressed in HCC specimens. Collectively, these findings unveil an acetylation-mediated regulation of FGL1, identify a potential target for HCC immunotherapy, and provide therapeutic strategies for the clinical treatment of HCC.
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