[Clinical characteristics of severe pre-eclampsia in a single tertiary referral center of Xiamen City]

Objective: To explore the key points for preventing and reducing severe pre-eclampsia (SPE) and its severe complications in the tertiary medical referral system of a second-tier city by analyzing the clinical characteristics of SPE. Methods: The clinical data of 341 patients with SPE who terminated pregnancy in Women and Children's Hospital, School of Medicine, Xiamen University, from January 1, 2020 to December 31, 2022 were retrospectively analyzed, and the pre-eclampsia (PE) risk factors, clinical characteristics and severe complications of SPE between the patients referred from primary hospitals (referral group) and the patients received regular prenatal care in the tertiary referral center (central group) were compared, as well as the influence of the referral timing on the maternal and perinatal outcomes. Results: Among the 341 cases of SPE, 92 cases were in the referral group and 249 cases were in the central group. (1) Analysis of PE risk factors: there was no statistical difference in the proportion of risk factors of PE between these two groups [75.0% (69/92) vs 71.9% (179/249); χ²=0.328, P=0.567]. (2) Analysis of clinical features: the gestational ages at the PE early warning factors onset, at the PE first symptom onset and at SPE diagnosed, pregnancy terminated and onset of SPE severe complications in the referral group were significantly earlier than those in the central group (all P<0.05), the proportions of terminating pregnancy before 32 weeks of gestation, between 32 and 34 weeks of gestation, intensive care unit (ICU), neonatal ICU hospitalization and fetal growth restriction in single pregnancies were higher than those in the central group, while the live birth rate was lower than that in the central group (all P<0.05). (3) Analysis of SPE severe complications: the rates of SPE severe complications in the referral group was higher than that in the central group [28.3% (26/92) vs 13.7% (34/249); χ²=9.885, P=0.002]. Among them, the rates of placental abruption [7.6% (7/92) vs 2.8% (7/249); χ²=3.927, P=0.048] and still birth [6.5% (6/92) vs 0.4% (1/249); χ²=9.656, P=0.002] in the referral group were significantly higher than those in the central group. (4) Analysis of referral timings: the timings included referral after onset of SPE severe complications (9.8%, 9/92), referral after SPE diagnosed (63.0%, 58/92), referral after detection of SPE early warning signs (20.7%, 19/92) and referral after detection of PE risk factors (6.5%, 6/92). The gestational ages at SPE diagnosed and pregnancy terminated in group of referral after onset of SPE severe complications and group of referral after SPE diagnosed were significantly earlier than those in group of referral after detection of PE early warning signs and group of referral after detection of PE risk factors (P<0.05). The earlier the referral, the higher the live birth rates (P<0.05). Conclusions: The tertiary referral center of the second-tier city plays an important role in reducing the maternal and perinatal damage of PE. The timing of referral in primary medical institutions is the key point of reducing the occurrence of SPE severe complications and maternal, perinatal damage of PE. It is necessary for medical institutions of all levels in all regions to improve the ability of early identification and early intervention for PE, to enhance the awareness of SPE and its severe complications prevention and control. Primary medical institutions should especially pay attention to raise the consciousness of PE risk factors and early warning signs, and to improve the ability of PE risk factors and early warning signs screening.

Is a 'healthy diet' and a 'calcium-rich diet' the same thing? Qualitative study examining perceptions of a calcium-rich diet in individuals who have received bone health education

BACKGROUND

In the present study, we aimed to (i) examine perceptions of achieving calcium and vitamin D recommended dietary allowance (RDA) and (ii) determine how participants talked about food in relation to RDA recommendations.

METHODS

Participants aged ≥50 years who were prescribed osteoporosis medication and received two modes of bone health education were eligible. Relying on a qualitative description design, we interviewed participants 1 month after they had attended an education session and received a self-management booklet. Calcium and vitamin D intakes were estimated by in-depth questions about diet and supplements and compared with perceptions of achieved RDA levels. Interview transcripts were analysed based on an analytic hierarchical process.

RESULTS

Forty-five participants (29 reporting previous fragility fractures) were included. Calcium and vitamin D RDA appeared to be potentially achieved by 64% and 93% of participants, respectively, primarily because of reliance on supplements. Few participants talked about vitamin D in relation to food intake and 49% of participants were unclear about the calcium content of food. Most considered that a healthy diet was equivalent to a calcium-rich diet. We noted no differences in our findings in the subset of individuals with fragility fractures.

CONCLUSIONS

Despite reporting a prescription for osteoporosis medication and receiving bone health education, a substantial number of individuals appeared to have sub-optimal calcium levels. This may be attributed to the challenge of achieving RDA with diet alone and the misconception of a healthy diet as a calcium-rich diet.

Genetic mechanism associated with congenital cytomegalovirus infection and analysis of effects of the infection on pregnancy outcome

We aimed to compare the diagnostic value of various detection methods for cytomegalovirus (CMV) infection, to investigate the genetic mechanism associated with CMV infection in pregnant women, and to analyze the risk of sequelae development in fetuses with CMV infection. A total of 300 participants who had the same immunosuppressive regimen and received preemptive therapy for CMV infection were prospectively enrolled in this study; they included 289 vaccine trial participants. The gB-absorbed CMV IgG assay was performed for each vaccine trial participant. The healthy women were divided into 2 groups, and amniotic fluids were collected from them at 15-18 weeks of gestation to test for CMV seropositivity before conception by using IgM specific antibodies, CMV-DNA, and IgG analysis. In 104 cases, cord blood sera and urine specimens were also collected from the infants and examined. The sensitivity and specificity of immediate-early messenger RNA and pp67 (late) messenger RNA detection by the nucleic acid sequence-based amplification technique was comparable to those of virus isolation and PCR. Furthermore, an association between single nucleotide polymorphisms in the TLR-2 gene and congenital CMV infection was observed and confirmed. Moreover, CMV infection during early pregnancy has been shown to have a much more severe effect on the pregnancy outcome compared to infection during later stages of pregnancy.

Multi-walled carbon nanotube-supported metal-doped ZnO nanoparticles and their photocatalytic property

A simple and versatile approach has been developed to synthesize multi-walled carbon nanotubes/metal-doped ZnO nanohybrid materials (MWNT/M-doped ZnO) by means of the co-deposition method. The experimental results illuminate that MWNTs can be modified by metal-doped ZnO nanoparticles at 450 °C, such as Mn, Mg, and Co elements. Furthermore, the MWNT/Mg-doped ZnO hybrids have been proven to have a high photocatalytic ability for methyl orange (MO), in which the degraded rate for MO reaches 100 % in 60 min. The enhancement in photocatalytic activity is attributed to the excellent electriconal property of MWNTs and Mg-doping. The resultant MWNT/Mg-doped ZnO nanohybrids have potential applications in photocatalysis and environmental protection.

Non-linear analysis of body responses to functional electrical stimulation on hemiplegic subjects

Functional electrical stimulation (FES) is a method of applying low-level electrical currents to restore or improve body functions lost through nervous system impairment. FES is applied to peripheral nerves that control specific muscles or muscle groups. Application of advanced signal computing techniques to the medical field has helped to achieve practical solutions to the health care problems accurately. The physiological signals are essentially non-stationary and may contain indicators of current disease, or even warnings about impending diseases. These indicators may be present at all times or may occur at random on the timescale. However, to study and pinpoint these subtle changes in the voluminous data collected over several hours is tedious. These signals, e.g. walking-related accelerometer signals, are not simply linear and involve non-linear contributions. Hence, non-linear signal-processing methods may be useful to extract the hidden complexities of the signal and to aid physicians in their diagnosis. In this work, a young female subject with major neuromuscular dysfunction of the left lower limb, which resulted in an asymmetric hemiplegic gait, participated in a series of FES-assisted walking experiments. Two three-axis accelerometers were attached to her left and right ankles and their corresponding signals were recorded during FES-assisted walking. The accelerometer signals were studied in three directions using the Hurst exponent H, the fractal dimension (FD), the phase space plot, and recurrence plots (RPs). The results showed that the H and FD values increase with increasing FES, indicating more synchronized variability due to FES for the left leg (paralysed leg). However, the variation in the normal right leg is more chaotic on FES.

Photostability of quantum dots with amphiphilic polymer-based passivation strategies

Quantum dots (QDs) have many appealing properties for biological fluorescence imaging, but exhibit photostabilities that are dependent upon surface passivation to minimize susceptibility to oxygen and light. Here, through spectroscopy and imaging techniques, we compare the photostability of micelle-encapsulated QDs with QDs passivated with either crosslinked amphiphilic polymers or crosslink-free amphiphilic polymers. Both crosslinked and crosslink-free amphiphilic polymer passivation strategies produced QDs with high photoluminescence stability for exposure to light under ambient conditions. In contrast, micelle encapsulation resulted in QDs with photoluminescence emission levels that were highly sensitive to both light exposure and oxygen, exhibiting a reduction of up to 70% in photoluminescence intensity within twenty minutes of exposure. With the addition of reducing agents, the photoluminescence level of the micelle-encapsulated QDs was significantly stabilized. We conclude that amphiphilic polymers provide coatings with considerably higher integrity and stability than micelle encapsulation, reducing the QDs' sensitivities to oxygen and light, both of which are relevant factors in biological imaging applications.

Analysis of SM22alpha-deficient mice reveals unanticipated insights into smooth muscle cell differentiation and function

SM22alpha is a 22-kDa smooth muscle cell (SMC) lineage-restricted protein that physically associates with cytoskeletal actin filament bundles in contractile SMCs. To examine the function of SM22alpha, gene targeting was used to generate SM22alpha-deficient (SM22(-/-LacZ)) mice. The gene targeting strategy employed resulted in insertion of the bacterial lacZ reporter gene at the SM22alpha initiation codon, permitting precise analysis of the temporal and spatial pattern of SM22alpha transcriptional activation in the developing mouse. Northern and Western blot analyses confirmed that the gene targeting strategy resulted in a null mutation. Histological analysis of SM22(+/-LacZ) embryos revealed detectable beta-galactosidase activity in the unturned embryonic day 8.0 embryo in the layer of cells surrounding the paired dorsal aortae concomitant with its expression in the primitive heart tube, cephalic mesenchyme, and yolk sac vasculature. Subsequently, during postnatal development, beta-galactosidase activity was observed exclusively in arterial, venous, and visceral SMCs. SM22alpha-deficient mice are viable and fertile. Their blood pressure and heart rate do not differ significantly from their control SM22alpha(+/-) and SM22alpha(+/+) littermates. The vasculature and SMC-containing tissues of SM22alpha-deficient mice develop normally and appear to be histologically and ultrastructurally similar to those of their control littermates. Taken together, these data demonstrate that SM22alpha is not required for basal homeostatic functions mediated by vascular and visceral SMCs in the developing mouse. These data also suggest that signaling pathways that regulate SMC specification and differentiation from local mesenchyme are activated earlier in the angiogenic program than previously recognized.

Lipid metabolism is altered by nebacitin in rats fed cooked-stored polished rice as the only dietary carbohydrate with or without exogenous cholesterol

Male adult Wistar rats were randomly divided into four groups in a 2 x 2 factorial design and were fed diets containing cooked-stored polished rice (CSPR), with and without 0.7 g/100 g of Nebacitin [bacitracinneomycin sulfate (2:1, wt/wt)] and with and without 1 g cholesterol/100 g diet. The CSPR diet contained 1.87 g resistant starch/100 g. After 4 wk, arterial blood and liver were collected. Feces were collected during the last 7 d. Rats fed the diet with Nebacitin and cholesterol had higher serum total cholesterol than the rats fed diets without cholesterol. Serum triglyceride concentration was greater in rats fed Nebacitin, regardless of dietary cholesterol concentration. Rats fed the diet with Nebacitin and cholesterol had higher serum LDL cholesterol concentration and liver total cholesterol concentration than rats fed the other three diets. Rats fed the CSPR diet with Nebacitin both with and without cholesterol had a higher fecal resistant starch concentration and excretion and lower serum short-chain fatty acid concentration than rats fed the diets without Nabacitin. Hepatic cholesterol concentration was greater in rats fed Nebacitin only when the diet also contained cholesterol. Therefore, dietary Nebacitin alters lipid metabolism in rats, and some effects are most pronounced in those also fed cholesterol.