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Wei C.-N.,Jiaxing Maternity and Child Health Care Hospital | Zhang Y.-F.,Jiaxing Maternity and Child Health Care Hospital | Xia F.,Jiaxing Maternity and Child Health Care Hospital | Wang L.-Z.,Jiaxing Maternity and Child Health Care Hospital | Zhou Q.-H.,Jiaxing University
International Journal of Obstetric Anesthesia | Year: 2017

Background: We aimed to test whether abdominal girth and vertebral column length were predictors of spinal hyperbaric bupivacaine spread in term parturients. Methods: A total of 128 parturients having elective caesarean section under spinal anaesthesia were enrolled. Combined spinal-epidural anaesthesia was performed at the L3/4 interspace, confirmed by ultrasonography. Two millilitres of 0.5% hyperbaric bupivacaine was injected intrathecally and spinal spread assessed at three minute intervals. If loss of discrimination of pinprick sensation at the T6 level was not obtained within 15. min after injection, 5. mL of 2% lidocaine was administered epidurally. Correlation and multiple linear regression were used to analyse the relationship between patient variables, including age, height, weight, abdominal girth, vertebral column length and neonatal biparietal diameter, and the spread of spinal anaesthesia. Results: Two parturients were excluded. Significant univariate correlation with spinal spread existed for height, weight, abdominal girth and vertebral column length (r=-0.446, 0.201, 0.372, P <0.711, respectively, all P <0.05). Multiple linear regression analysis showed that parturient's abdominal girth and vertebral column length were the key determinants of spinal spread (both P <0.0001). The adjusted R2 was 0.742 for the regression equation between abdominal girth, vertebral column length and height of block. Conclusion: Parturient abdominal girth and vertebral column length have significant predictive value in determining the cephalad spread of spinal anaesthesia with hyperbaric bupivacaine in term parturients. © 2017 Elsevier Ltd.


PubMed | Jiaxing Maternity and Child Health Care Hospital and Nanchang University
Type: | Journal: BioMed research international | Year: 2016

CSCC is a systemic disease involving polygenic alteration and multiple steps, and HIF and VEGF are closely associated with tumorigenesis. Specimens surgically resected from 64 cases of CSCC and 22 cases of normal cervical tissue were selected randomly to detect the expression of HIF-2 and VEGF in CSCC for exploring their clinical significance; information regarding the age, lymph node metastasis, and FIGO staging were collected as well; expression of HIF-2 and VEGF was detected by qPCR and immunohistochemistry. We found that the expression of HIF-2 and VEGF mRNA in CSCC was significantly higher than that of normal cervical tissues and showed a positive correlation between them. The positive rates of HIF-2 and VEGF protein expression in CSCC and normal cervical tissues were 93.8% and 18.2%, respectively, with correlation between them. The expression of both HIF-2 and VEGF mRNA did not relate closely to age but the FIGO staging and lymph node metastasis. Compared with the counterpart control group, CSCC tissues with high FIGO staging and lymph node metastasis had a higher level of HIF-2 and VEGF mRNA expression. So, HIF-2 and VEGF were overexpressed in CSCC, which has a great clinical significance for its diagnosis.


Sun S.,Zhejiang University | Sun S.,Jiaxing Maternity and Child Health Care Hospital | Qiu X.,Zhejiang University | Zhou J.,Zhejiang University
Journal of Obstetrics and Gynaecology Research | Year: 2014

Aim We investigated thyroid function and the impact of gestational transient thyrotoxicosis (GTT) on pregnancy outcome in patients with hyperemesis gravidarum (HG; n = 143) who were hospitalized for rehydration. Methods Serum thyroid-stimulating hormone (TSH), free T3 (FT3), free T4 (FT4), thyroid globulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and hCG were measured after admission. Results The total prevalence of thyrotoxicosis in HG was 48.3%; GTT was the main form (45.5%). The total incidence of GTT increased significantly if serum hCG was more than 80 000 IU/L, subclinical GTT if serum hCG was 80 000-140 000 IU/L and clinical GTT if serum hCG was more than 180 000 IU/L. GTT did not require antithyroid therapy. The course of TSH, FT3 and FT4 were followed in 34 cases of GTT; thyroid function normalized by the second trimester. Of 65 patients with GTT, two underwent abortions due to unplanned pregnancies, two delivered prematurely and two infants had macrosomia. There were no other complications. All newborns (n = 63) of mothers with GTT had normal TSH levels. Conclusion GTT is common in HG. The severity of GTT is related to serum hCG levels. In patients with HG and GTT, thyroid function normalized by the second trimester without antithyroid treatment. GTT did not affect pregnancy outcomes. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.


Zheng J.-S.,Zhejiang University | Liu H.,Jiaxing Maternity and Child Health Care Hospital | Li J.,Jiaxing Maternity and Child Health Care Hospital | Chen Y.,Jiaxing Maternity and Child Health Care Hospital | And 7 more authors.
Journal of Nutrition | Year: 2014

The association between breastfeeding status and childhood overweight is inconclusive. The aim of the present study was to investigate the relation between exclusive breastfeeding and childhood overweight risk in children 4-5 y of age in Southeast China. Among 97,424 children enrolled between 1999 and 2009 in the Jiaxing Birth Cohort, 42,550 of them were included in the final analysis with complete records on breastfeeding status and anthropometric measurements at 4-5 y of age (48-60 mo). Overweight and being at risk of overweight were identified as a body mass index (BMI)-for-age Z-score ≥ 2 and between 1 and 2, respectively. After 4-5 y of follow-up, 4845 (11.4%) children were identified as being at risk of overweight, and 1343 (3.16%) children were overweight. Adjusting for important child and maternal characteristics, longer duration of breastfeeding was associated with lower risk of childhood overweight (P-trend = 0.009) and being at risk of overweight (P-trend < 0.001). Children exclusively breastfed for 3-5 mo and ≥6 mo had 13% (RR = 0.87; 95% CI: 0.77, 0.99) and 27% (RR = 0.73; 95% CI: 0.56, 0.95) lower risk of becoming overweight compared with children exclusively breastfed for <1 mo, respectively. In boys, there were inverse associations of 3-5 mo (RR = 0.83; 95% CI: 0.71, 0.98) or ≥6 mo (RR = 0.65; 95% CI: 0.47, 0.91) of exclusive breastfeeding against becoming overweight, but there were no significant associations in girls (3-5 mo: RR = 0.96, 95% CI: 0.76, 1.22; ≥6 mo: RR = 0.92, 95% CI: 0.60, 1.41). In conclusion, the present findings suggest that longer duration of exclusive breastfeeding is associated with lower risk of becoming overweight in Chinese children. © 2014 American Society for Nutrition.


Wang L.-Z.,Jiaxing Maternity and Child Health Care Hospital | Hu X.-X.,Jiaxing Maternity and Child Health Care Hospital | Liu X.,Jiaxing Maternity and Child Health Care Hospital | Qian P.,Jiaxing Maternity and Child Health Care Hospital | And 2 more authors.
International Journal of Gynecology and Obstetrics | Year: 2011

Objective: To evaluate the effects of epidural dexamethasone on maternal temperature and serum cytokine levels after labor epidural analgesia. Methods: Sixty healthy term nulliparas in spontaneous labor were randomized to receive epidural analgesia alone using bupivacaine 0.125% and fentanyl 1 μg/mL (group I) or epidural analgesia combined with dexamethasone 0.2 mg/mL (group II) (n = 30 per group). Maternal tympanic temperature was measured before epidural analgesia and hourly thereafter until delivery. Maternal and cord venous blood were sampled for analysis of interleukin-6 (IL-6), tumor necrosis factor-α, and interleukin-10 levels. Results: There was no difference in the incidence of intrapartum fever (38 °C or more) between the 2 groups (3/30 versus 1/30, P = 0.612). The mean maternal temperature increased with time in group I, with the elevation reaching statistical significance at 4 hours post analgesia and at delivery compared with baseline (P = 0.012 and P = 0.043, respectively). A similar trend was observed with maternal serum IL-6 levels in group I. In group II, maternal temperature and IL-6 levels did not differ from baseline at any time point during labor. Conclusion: Epidural dexamethasone alleviates maternal temperature elevation after epidural analgesia. This effect can be attributed to the decrease in IL-6 levels. © 2011 International Federation of Gynecology and Obstetrics.


Ji X.-Y.,Jiaxing Maternity and Child Health Care Hospital | Wu M.,Jiaxing Maternity and Child Health Care Hospital
Chinese Journal of Contemporary Pediatrics | Year: 2016

Objective To investigate the mRNA expression of dopamine receptor D2 (DRD2) and dopamine transporter (DAT) in peripheral blood lymphocytes before and after treatment in children with tic disorder (TD). Methods RT-PCR was used to measure the mRNA expression of DRD2 and DAT in peripheral blood lymphocytes before and after treatment in 60 children with TD. The correlations between mRNA expression of DRD2 and DAT and the severity of TD were analyzed. Sixty healthy children served as the control group. Results Before treatment, the children with TD had a significant increase in the mRNA expression of DRD2 and DAT compared with the control group (P<0.05). After 3 months of treatment with oral aripiprazole, the mRNA expression of DRD2 decreased significantly (P<0.05), while that of DAT showed no significant changes in children with TD. In the children with moderate or severe TD, the mRNA expression of DRD2 was positively correlated with Yale Global Tic Severity Scale (YGTSS) score (P<0.05). In the children with moderate TD, the mRNA expression of DAT was positively correlated with YGTSS score (P<0.05). Conclusions In children with TD, the mRNA expression of DRD2 in peripheral blood lymphocytes can be used as one of the indicators for diagnosing TD, assessing the severity of TD, and evaluating clinical outcomes.


Wang L.Z.,Jiaxing Maternity and Child Health Care Hospital | Zhang Y.F.,Jiaxing Maternity and Child Health Care Hospital | Hu X.X.,Jiaxing Maternity and Child Health Care Hospital | Chang X.Y.,Jiaxing Maternity and Child Health Care Hospital
International Journal of Obstetric Anesthesia | Year: 2014

Background Previous studies using low-dose spinal anesthesia for cesarean delivery have focused on hypotension and efficacy. This study evaluated whether, using a combined spinal-epidural technique, there was a difference in onset of anesthesia for cesarean delivery between low-dose spinal with an immediate epidural local anesthetic bolus, and conventional-dose spinal anesthesia. Methods Forty healthy term nulliparous women undergoing elective cesarean delivery with a combined spinal-epidural technique were enrolled into this prospective, randomized, double-blind study. Patients were randomly allocated to the low-dose (Group L) or conventional-dose group (Group C). Patients in Group L received intrathecal isobaric bupivacaine 5 mg with sufentanil 2.5 μg followed by epidural 2% lidocaine 5 mL; patients in Group C received intrathecal isobaric bupivacaine 10 mg with sufentanil 2.5 μg followed by epidural saline 5 mL. The onset of anesthesia (defined as the time from spinal injection to a block to T6), incidence of hypotension, maximal sensory block, epidural supplementation and side effects were recorded. Results All blocks reached T6 within 11 min except for one patient in Group L. There were no differences in onset of anesthesia (9.9 ± 3.2 min in Group L vs. 8.5 ± 1.2 min in Group C, P = 0.08), maximal block level and the number of patients who required epidural supplementation in both groups. Hypotension occurred in 8 patients (40%) in Group L and 15 patients (75%) in Group C (P = 0.02). Conclusions Intrathecal bupivacaine 5 mg with immediate 2% epidural lidocaine 5 mL provided comparable onset and efficacy of anesthesia as bupivacaine 10 mg with immediate epidural normal saline 5 mL for cesarean delivery. © 2013 Elsevier Ltd. All rights reserved.


Zhang W.P.,Jiaxing Maternity and Child Health Care Hospital | Zhu S.M.,Jiaxing Maternity and Child Health Care Hospital
Acta Anaesthesiologica Taiwanica | Year: 2016

Background: High peak airway pressure (Ppeak) and high end-tidal carbon dioxide tension (PETCO2) are the common problems encountered in the obese patients undergoing gynecological laparoscopy with conventional volume-controlled ventilation. This study was designed to investigate whether volume-controlled inverse ratio ventilation (IRV) with inspiratory to expiratory (I:E) ratio of 2:1 could reduce Ppeak or the plateau pressure (Pplat), improve oxygenation, and alleviate lung injury in patients with normal lungs. Methods: Sixty obese patients undergoing gynecological laparoscopy were enrolled in this study. After tracheal intubation, the patients were randomly divided into the IRV group (n = 30) and control group (n = 30). They were ventilated with an actual tidal volume of 8 mL/kg, respiratory rate of 12 breaths/min, zero positive end-expiratory pressure and I:E of 1:2 or 2:1. Arterial blood samples, hemodynamic parameters, and respiratory mechanics were recorded before and during pneumoperitoneum. The concentrations of tumor necrosis factor-α, and interleukins 6 and 8 in bronchoalveolar lavage fluid were measured immediately before and 60 minutes after onset of CO2 pneumoperitoneum. Results: IRV significantly increased arterial partial pressure of oxygen, mean airway pressure, and dynamic compliance of respiratory system with concomitant significant decreases in Ppeak and Pplat compared to conventional ventilation with I:E of 1:2 (p < 0.05). Additionally, the levels of tumor necrosis factor-α, and interleukins 6 and 8 were significantly lower than those in control group (p < 0.05). Conclusion: Volume-controlled IRV not only reduces Ppeak, Pplat, and the release of inflammatory cytokines, but also increases mean airway pressure, and improves oxygenation and dynamic compliance of respiratory system in obese patients undergoing gynecologic laparoscopy without adverse respiratory and hemodynamic effects. It is superior to conventional ratio ventilation in terms of oxygenation, respiratory mechanics and inflammatory cytokine in obese patients undergoing gynecologic laparoscopy. Copyright © 2015, Taiwan Society of Anesthesiologists. Published by Elsevier Taiwan LLC.


PubMed | Jiaxing Maternity and Child Health Care Hospital
Type: Journal Article | Journal: Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists | Year: 2016

High peak airway pressure (Ppeak) and high end-tidal carbon dioxide tension (PETCO2) are the common problems encountered in the obese patients undergoing gynecological laparoscopy with conventional volume-controlled ventilation. This study was designed to investigate whether volume-controlled inverse ratio ventilation (IRV) with inspiratory to expiratory (I:E) ratio of 2:1 could reduce Ppeak or the plateau pressure (Pplat), improve oxygenation, and alleviate lung injury in patients with normal lungs.Sixty obese patients undergoing gynecological laparoscopy were enrolled in this study. After tracheal intubation, the patients were randomly divided into the IRV group (n = 30) and control group (n = 30). They were ventilated with an actual tidal volume of 8 mL/kg, respiratory rate of 12 breaths/min, zero positive end-expiratory pressure and I:E of 1:2 or 2:1. Arterial blood samples, hemodynamic parameters, and respiratory mechanics were recorded before and during pneumoperitoneum. The concentrations of tumor necrosis factor-, and interleukins 6 and 8 in bronchoalveolar lavage fluid were measured immediately before and 60 minutes after onset of CO2 pneumoperitoneum.IRV significantly increased arterial partial pressure of oxygen, mean airway pressure, and dynamic compliance of respiratory system with concomitant significant decreases in Ppeak and Pplat compared to conventional ventilation with I:E of 1:2 (p < 0.05). Additionally, the levels of tumor necrosis factor-, and interleukins 6 and 8 were significantly lower than those in control group (p < 0.05).Volume-controlled IRV not only reduces Ppeak, Pplat, and the release of inflammatory cytokines, but also increases mean airway pressure, and improves oxygenation and dynamic compliance of respiratory system in obese patients undergoing gynecologic laparoscopy without adverse respiratory and hemodynamic effects. It is superior to conventional ratio ventilation in terms of oxygenation, respiratory mechanics and inflammatory cytokine in obese patients undergoing gynecologic laparoscopy.


PubMed | Jiaxing Maternity and Child Health Care Hospital
Type: Journal Article | Journal: Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics | Year: 2016

To investigate the mRNA expression of dopamine receptor D2 (DRD2) and dopamine transporter (DAT) in peripheral blood lymphocytes before and after treatment in children with tic disorder (TD).RT-PCR was used to measure the mRNA expression of DRD2 and DAT in peripheral blood lymphocytes before and after treatment in 60 children with TD. The correlations between mRNA expression of DRD2 and DAT and the severity of TD were analyzed. Sixty healthy children served as the control group.Before treatment, the children with TD had a significant increase in the mRNA expression of DRD2 and DAT compared with the control group (P<0.05). After 3 months of treatment with oral aripiprazole, the mRNA expression of DRD2 decreased significantly (P<0.05), while that of DAT showed no significant changes in children with TD. In the children with moderate or severe TD, the mRNA expression of DRD2 was positively correlated with Yale Global Tic Severity Scale (YGTSS) score (P<0.05). In the children with moderate TD, the mRNA expression of DAT was positively correlated with YGTSS score (P<0.05).In children with TD, the mRNA expression of DRD2 in peripheral blood lymphocytes can be used as one of the indicators for diagnosing TD, assessing the severity of TD, and evaluating clinical outcomes.

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