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Wang C.Y.,Fujian Provincial Maternity and Child Health Hospital
Zhonghua er ke za zhi. Chinese journal of pediatrics | Year: 2012

Inflammation and coagulation occur concomitantly in severe pneumonia. The term non-overt disseminated intravascular coagulation (DIC) (pre-DIC state) refers to a state prevalent before the occurrence of overt DIC. It is suggested that initiation of treatment in non-overt DIC leads to better outcome than in overt DIC. The present study aimed at evaluating potential use of soluble P-selectin in diagnosis of pre-DIC state of children with severe pneumonia. The laboratory findings (including soluble P-selectin, D-Dimer, platelet count, activated partial prothrombin time, prothrombin time and fibrinogen) of 226 children with severe pneumonia from Jan. 2010 to Jul. 2011 in pediatric intensive care unit (PICU), were analyzed in this prospective cohort study, and the ROC curve was plotted to evaluate the potential role of soluble P-selectin in diagnosis of pre-DIC state. A total of 226 patients with severe pneumonia comprised of 75 positive and 151 negative pre-DIC state cases were enrolled. The mean value of soluble P-selectin, D-Dimer, and platelet count were 124.8 (26.9 - 608.3) μg/L, 1.3(0.7 - 16.0) mg/L and 91 (56 - 196)×10(9) for the positive cases, and 63.3 (2.8 - 302.1) μg/L, 0.5 (0.2 - 1.0) mg/L and 231 (120 - 680)×10(9) for the negative cases, respectively. There was a significant difference between the two groups. Coagulatory function in the positive cases, including activated partial prothrombin time, prothrombin time and fibrinogen which were (39.1 ± 3.5) sec, (14.8 ± 2.1) sec and (3.8 ± 0.5) g/L, respectively, were significantly higher than those in the negative cases [(37.2 ± 2.4) sec, (13.0 ± 0.5) sec and (3.3 ± 0.2) g/L] (P < 0.001). The area under ROC curve showed that D-dimer, soluble P-selectin for pre-DIC state had higher diagnostic value. The Optimal Operating Point of soluble P-selectin was determined and interpreted at 94.0 μg/L with a sensitivity of 0.824, a specificity of 0.887, and the Optimal Operating Point of D-dimer was determined and interpreted at 0.7 mg/L with a sensitivity of 0.905, a specificity of 0.867, systematic test of soluble P-selectin and D-dimer had a higher specificity of 0.920, determined at the same time. To improve the outcome of patients with DIC, there is a need to establish more useful and easily operative diagnostic criteria for pre-DIC state. Plasma levels of soluble P-selectin will be helpful in this respect. Systematic test of soluble P-selectin and D-dimer may be helpful in reducing misdiagnosis rate.

Yongping Z.,Peking UniversityPeoples Hospital Reproductive Medical Center | Dianliang L.,Fujian Provincial Maternity and Child Health Hospital | Huan S.,Peking UniversityPeoples Hospital Reproductive Medical Center | Ningning S.,Peking UniversityPeoples Hospital Reproductive Medical Center | Qian Y.,Peking UniversityPeoples Hospital Reproductive Medical Center
Chinese Journal of Andrology | Year: 2012

Objective To investigate the effect of oral Imatinib Mesylate on the quality of the semen of male patients with chronic myelogenous leukemia and explore its reproductive toxicity. Methods Thirty-seven semen samples were collected, of which 23 were from healthy men, averagely aged 30.78±5.98 (normal control group) and 14 from male patients, averagely aged 34.00±11.40 with chronic myelogenous leukemia treated with oral Imatinib Mesylate, 400mg/d (experimental group) for three months. Semen routine analysis was performed according to the WHO semen analysis manual. A Spermetoza was first labeled with cysteine proteinase 3 (Caspase-3), and then sperm apoptosis rate was analyzed by a flow cytometer. The data was statistically analyzed. Results The average sperm density, motility, motility a+b%, abnormal sperm rate, sperm apoptosis rate of the experimental group before and after treatment were (113.47±37.40)106/ml VS (34.32±21.46)106/ml (P<0.01), 72.21±16.52% VS 41.21±18.96%, 3.40±16.67 VS 34.22±19.10(P<0.01),70.64±9.35% VS 80.93±9.87%(P<0.01), 0.19±0.09% VS 2.52±0.38%(P<0. 01), respectively and showed significant difference. In comparison with the control group, same result was shown (P <0.01). The sperm apoptosis was significantly correlated with the sperm parameters (P<0.01). Conclusion Oral-taking of Imatinib Mesylate for three months might lower the semen quality in male patients with chronic myelogenous leukemia and induce sperm apoptosis. Sperm analysis and cryopreservation should be performed before the treatment with Imatinib Mesylate to avoid male infertility.

Zhang R.L.,Fujian Provincial Maternity and Child Health Hospital
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi | Year: 2012

To explore the risk factors and the rate of HBV vertical transmission from HBsAg-positive couple to their infant. 46 families who had antenatal examination at Fujian Provincial Maternal and Child Health Hospital during August 2010 and November 2011 were chosen as research object. Cord blood was sampled after delivery for HBVM and HBV-DNA quantification. Those with HBV-DNA load ≥ 5 × 10(2) copies/ml were involved in the case group while those having < 5 × 10(2) copies/ml were chosen as controls. The average positive rate of neonatal cord blood HBV-DNA was 45.7% (21/46), while the positive rates of cord blood HBsAg and HBeAg were 34.8% (16/46) and 23.9% (11/46) respectively. The positive rates of maternal serum HBV-DNA and paternal serum HBV-DNA were 52.2% (24/46) and 69.6% (32/46) respectively, with the positive rate of couple serum HBeAg as 39.1% (18/46) and 32.6% (15/46) respectively. Results from univariate analysis showed that hepatitis B surface markers, serum HBeAg-positive, serum HBV-DNA positive, and serum HBV-DNA load of the couples were risk factors to the HBV vertical transmission (χ(2) = 8.731, 8.414, 8.932, 9.663, 10.823, 3.962, 13.638, 36.501; P < 0.05). Data from the multivariate analysis showed that maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors to the HBV vertical transmission[OR = 17.6 (1.3 - 238.4) ; OR = 3.5 (1.6-7.6)]. Serum HBV-DNA loads of the couples were positively correlated with the cord blood HBV-DNA load, while the load levels of the couple's serum HBV-DNA were higher than cord blood HBV-DNA. There appeared dose-response relationship between couple's serum HBV-DNA load level and the cord blood HBV-DNA load level. from the analysis of ROC curve showed that both maternal serum HBV-DNA load level (10(3) copies/ml) and paternal serum HBV-DNA load level (10(4) copies/ml) were demarcation points to better forecast the occurrence of vertical transmission of HBV, because there showed higher sensitivity and specificity for the forecasting process. Neonatal outcomes showed no significant difference between the case group and the control group. The negative conversion rate became 15.0% (3/20) when the HBV-DNA positive infants were followed up for 7 months. Both maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors of HBV vertical transmission. When the maternal serum HBV-DNA load appeared > 10(3) copies/ml and paternal serum HBV-DNA load > 10(4) copies/ml, the rate of HBV vertical transmission would increase.

Zhang J.,Peking University | Zhang X.,Guangdong Womens and Children Hospital | Qiu L.,Zhejiang University | Zhang R.,Fujian Provincial Maternity and Child Health Hospital | And 5 more authors.
BMC Public Health | Year: 2014

Background: Disparity in maternal mortality exists between rural-urban migrant and urban resident women in China, but little research has provided evidence for related policy development. The objective of this study was to identify associations with and risks for maternal death among rural-urban migrant women in order to improve health services for migrant women and reduce maternal mortality in China. Methods. We conducted a prospective case-control study in urban areas of Guangdong, Zhejiang and Fujian provinces and Beijing municipality. In each, migrant women who died between July 1, 2010 and October 1, 2011 were identified through reports from China's Maternal and Child Mortality Surveillance System. For each, four matched controls were selected from migrant women who delivered in local hospitals during the same period. We compared socio-demographic characteristics, health status and health service variables between cases and controls, and used bivariate and multivariate conditional logistic regression analyses to determine associations with and risk factors for maternal death. Results: 109 cases and 436 controls were assessed. Family income <2000 yuan per month (OR = 4.5; 95% CI 1.7-11.7) and lack of health insurance (OR = 1.3; 95% CI 1.1-1.6) were more common amongst women who died, as were lack of antenatal care (ANC) (OR = 22.3; 95% CI 4.3-116.0) and attending ANC only 1-4 times (OR = 5.0; 95% CI 1.6-15.5). Knowledge of danger signs during delivery was less common in this group (OR = 0.3; 95% CI 0.1-0.8). Conclusion: Differences existed between migrant women who died in pregnancy and surviving controls. The identified risk factors suggest strategies for health sector and community action on reducing maternal mortality among migrant women in China. A systematic approach to maternity care for rural-urban migrant women is recommended. © 2014 Zhang et al.; licensee BioMed Central Ltd.

Chen X.J.,Fujian Provincial Maternity and Child Health Hospital
Zhonghua fu chan ke za zhi | Year: 2010

To study the effect of urodynamic factors on the urinary retention of the patients with cervical cancer received radical hysterectomy. Seventy-two patients with cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage Ib1 to IIa hospitalized in Fujian Provincial Maternity and Child Health Hospital between June 2006 and August 2009, who were not found any abnormal representation of urodynamics before the operation, were divided into the group with urinary retention and the group without urinary retention based on whether urinary retention after the operation. All patients were detected by urodynamic examination following radical hysterectomy. Data obtained from urodynamic examination were analysed by logistic regression to evaluate the influence of urodynamic factors on the urinary retention postoperation. Twenty-one patients out of all were found with urinary retention after the operation, the incidence rate of urinary retention was 29%. The first sensation after operation in both groups were increased significantly than those before operation [(171 ± 61) ml vs. (126 ± 28) ml, (134 ± 39) ml vs. (119 ± 17) ml, all P < 0.05], while the maximum volume [(337 ± 66) and (300 ± 66) ml, respectively], the compliance [(31 ± 25) and (29 ± 18) ml/cm H2O (1 cm H2O = 0.098 kPa), respectively], the maximum flow rate [(10 ± 4) and (12 ± 5) ml/s, respectively] and the pressure at the maximum flow rate [(27 ± 9) and (32 ± 8) cm H2O, respectively] were decreased obviously after radical hysterectomy in both the group with urinary retention and the group without urinary retention (all P < 0.05), compared with the corresponding value before the operation. The urodynamic changes in urinary retention group was much more severe than those in group without urinary retention (P < 0.05). The single factor analysis results showed that bladder destusor dysfunction (OR = 8.20, 95%CI: 2.62-25.66, P < 0.01) and lack of sensation (OR = 6.90, 95%CI: 1.95-24.43, P < 0.01) were relevant to the urinary retention post-operation. While there were not relationship was found between low compliance bladder (OR = 1.99, 95%CI: 0.70-5.63, P = 0.195), detrusor overactivity (OR = 2.51, 95%CI: 0.73-8.67, P = 0.144), bladder outlet obstruction (OR = 3.77, 95%CI: 0.76-18.57, P = 0.104) or dyssynergia of urethral external sphincter (OR = 2.67, 95%CI: 0.49-14.45, P = 0.255) and urinary retention following the operation. There were an antagonistic effects (OR = 7.60, 95%CI: 1.43-40.39, P = 0.017) of detrusor overactivity and bladder destrusor dysfunction on urinary retention. The multiple factors analysis results revealed that bladder destusor dysfunction (OR = 7.01, P < 0.01) and lack of sensation (OR = 5.45, P = 0.018)were the independent risk factors influencing on the urinary retention post-operation. There are obvious urodynamic change in cervical cancer patients following radical hysterectomy. Bladder destrusor dysfunction and lack of sensation are the independent urodynamic risk factors influencing on urinary retention following radical hysterectomy, while detrusor over activity may be a protective effect on bladder destrusor dysfunction post-operation in some degree. Urodynamic test is important for analysis and treatment of urinary retention following radical hysterectomy.

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