Koyanagi A.,Hatsuishi Hospital |
Zhang J.,Xinhua Hospital |
Dagvadorj A.,University of Tokyo |
Hirayama F.,Kyushu University |
Shibuya K.,University of Tokyo
The Lancet | Year: 2013
Background: Macrosomia is a risk factor for adverse delivery outcomes. We investigated the prevalence, risk factors, and delivery outcomes of babies with macrosomia in 23 developing countries in Africa, Asia, and Latin America. Methods: We analysed data from WHO's Global Survey on Maternal and Perinatal Health, which was a facility-based cross-sectional study that obtained data for women giving birth in 373 health facilities in 24 countries in Africa and Latin America in 2004-05, and in Asia in 2007-08. Facilities were selected by stratified multistage cluster sampling and women were recruited at admission for delivery. We extracted data from the medical records with a standardised questionnaire. We used logistic regression with random effects to assess the risk factors for macrosomia and the risks for caesarean section and adverse maternal and perinatal outcomes (assessed by a composite score) in babies with the disorder. Findings: Of 290 610 deliveries, we analysed data for 276 436 singleton livebirths or fresh stillbirths. Higher maternal age (20-34 years), height, parity, body-mass index, and presence of diabetes, post-term pregnancy, and male fetal sex were associated with a significantly increased risk of macrosomia. Macrosomia was associated with an increased risk of caesarean section because of obstructed labour and post-term pregnancy in all regions. Additionally, macrosomia was associated with an increased risk of adverse maternal birth outcomes in all regions, and of adverse perinatal outcomes only in Africa. Interpretation: Increasing prevalence of diabetes and obesity in women of reproductive age in developing countries could be associated with a parallel increase in macrosomic births. The effect and feasibility of control of diabetes and preconception weight on macrosomia should be investigated in these settings. Furthermore, increased institutional delivery in countries where rates are low could be crucial to reduce macrosomia-associated morbidity and mortality. Funding: None. © 2013 Elsevier Ltd.
Shen C.,Xinhua Hospital |
Jiang S.-D.,Xinhua Hospital |
Jiang L.-S.,Xinhua Hospital |
Dai L.-Y.,Xinhua Hospital |
Dai L.-Y.,Shanghai JiaoTong University
Arthroscopy - Journal of Arthroscopic and Related Surgery | Year: 2010
Purpose: The aim of the study was to investigate the outcomes between bioabsorbable and metallic screw fixation in anterior cruciate ligament (ACL) reconstruction. Methods: Randomized controlled trials (RCTs) comparing bioabsorbable versus metallic screw fixation in single-bundle ACL reconstruction were identified systematically, and the outcomes were analyzed in terms of infection rate, knee joint effusion, Lysholm score, International Knee Documentation Committee final score, pivot-shift test, and KT-1000/-2000 arthrometer (MEDmetric, San Diego, CA) measurements. The type of grafts was ignored in the meta-analysis. Standard mean difference (SMD) or risk ratio (RR) with 95% confidence interval (CI) was calculated by a fixed-effects or random-effects model. Heterogeneity across the studies was also assessed. Results: We included 10 studies comprising 790 patients who were treated by bioabsorbable versus metallic screw fixation for single-bundle ACL reconstruction. The meta-analyzed results of these studies showed that there was no statistically significant difference between bioabsorbable and metallic screw fixation in infection rate (RR, 0.91; P = .87; 320 patients in 5 studies), KT-1000/2000 arthrometer testing (SMD, -0.01; P = .95; 438 patients in 7 studies), pivot-shift testing (RR, 1.06; P = .82; 260 patients in 4 studies), International Knee Documentation Committee final score (RR, 0.87; P = .63; 300 patients in 5 studies), and Lysholm score (SMD, 0.03; P = .89; 204 patients in 4 studies). The incidence of knee effusion was higher in the bioabsorbable screw group (RR, 2.57; P = .04; 421 patients in 4 studies). Conclusions: There was no significant difference in measurement results of knee joint stability or knee joint function outcome between bioabsorbable and metallic interference screws. Knee joint effusion is more common after ACL reconstruction with bioabsorbable interference screw fixation than with metallic interference screw fixation. More high-methodologic quality randomized controlled trials would be helpful in further meta-analysis. Level of Evidence: Level I, meta-analysis. © 2010 Arthroscopy Association of North America.
Guan X.-J.,Xinhua Hospital |
Song L.,Xinhua Hospital |
Han F.-F.,Xinhua Hospital |
Cui Z.-L.,Xinhua Hospital |
And 3 more authors.
Journal of Cellular Biochemistry | Year: 2013
Progressive pulmonary inflammation and emphysema have been implicated in the progression of chronic obstructive pulmonary disease (COPD), while current pharmacological treatments are not effective. Transplantation of bone marrow mesenchymal stem cells (MSCs) has been identified as one such possible strategy for treatment of lung diseases including acute lung injury (ALI) and pulmonary fibrosis. However, their role in COPD still requires further investigation. The aim of this study is to test the effect of administration of rat MSCs (rMSCs) on emphysema and pulmonary function. To accomplish this study, the rats were exposed to cigarette smoke (CS) for 11 weeks, followed by administration of rMSCs into the lungs. Here we show that rMSCs infusion mediates a down-regulation of pro-inflammatory mediators (TNF-α, IL-1β, MCP-1, and IL-6) and proteases (MMP9 and MMP12) in lung, an up-regulation of vascular endothelial growth factor (VEGF), VEGF receptor 2, and transforming growth factor (TGFβ-1), while reducing pulmonary cell apoptosis. More importantly, rMSCs administration improves emphysema and destructive pulmonary function induced by CS exposure. In vitro co-culture system study of human umbilical endothelial vein cells (EA.hy926) and human MSCs (hMSCs) provides the evidence that hMSCs mediates an anti-apoptosis effect, which partly depends on an up-regulation of VEGF. These findings suggest that MSCs have a therapeutic potential in emphysematous rats by suppressing the inflammatory response, excessive protease expression, and cell apoptosis, as well as up-regulating VEGF, VEGF receptor 2, and TGFβ-1. © 2012 Wiley Periodicals, Inc.
Shen C.,Xinhua Hospital |
Peng J.-P.,Xinhua Hospital |
Chen X.-D.,Xinhua Hospital
Archives of Orthopaedic and Trauma Surgery | Year: 2013
Background: Morel-Lavallee lesion (MLL) of the peri-pelvic region is less common and various treatments have been introduced to manage the lesion. No standard treatment is recommended. We performed a systematic review of literature to (1) identify the classification of peri-pelvic MLL; (2) review the treatments of the lesion and their complications; (3) define the optimal treatment of peri-pelvic MLL. Methods: A systematic search was performed via PubMed, ISI Web of Knowledge, and Embase for English abstract articles from 1966 to 2012. We identified 21 articles detailing 153 patients with peri-pelvic MLL, most of which were level IV studies. The treatments and clinical results were reviewed. Results: For peri-pelvic MLL patients, surgical intervention was better than conservative therapy. Sclerhodesis method is attended with good outcome in the symptomatic MLL patients without fractures. Patients with peri-pelvic fractures could be managed with local suction drainage or open debridement with dead space closure technique during fracture fixation. The delayed-diagnosis cases might be treated with mass resection when fibrosis capsule was obtained in magnetic resonance imaging. Conclusions: Peri-pelvic MLL can be treated with various surgical methods depending on the formation of fibrosis capsule and associated injuries. Dead space closure technique is emphasized in the treatment of MLL. Higher quality of literature is required to prove this result in future research. © 2013 Springer-Verlag Berlin Heidelberg.
Luo Z.-C.,Xinhua Hospital |
Luo Z.-C.,University of Montréal |
Ouyang F.,Xinhua Hospital |
Zhang J.,Xinhua Hospital |
Klebanoff M.,Ohio State University
American Journal of Obstetrics and Gynecology | Year: 2014
Objective Second-born twins on average weigh less than first-born twins and have been reported at an elevated risk of perinatal mortality. Whether the risk differences depend on their relative birth size is unknown. The present study aimed to evaluate the association of birth order with perinatal mortality by birth order-specific weight difference in twin pregnancies. Study Design In a retrospective cohort study of 258,800 twin pregnancies without reported congenital anomalies using the US matched multiple birth data 1995-2000 (the available largest multiple birth dataset), conditional logistic regression was applied to estimate the odds ratio (OR) of perinatal death adjusted for fetus-specific characteristics (sex, presentation, and birthweight for gestational age). Results Comparing second vs first twins, the risks of perinatal death were similar if they had similar birthweights (within 5%) and were increasingly higher if second twins weighed progressively less (adjusted ORs were 1.37, 1.90, and 3.94 if weighed 5.0-14.9%, 15.0-24.9%, and 25.0% less, respectively), and progressively lower if they weighed increasingly more (adjusted ORs were 0.67, 0.63, and 0.36 if weighed 5.0-14.9%, 15.0-24.9%, and 25.0% more, respectively) (all P <.001). The perinatal mortality rates were not significantly different in cesarean deliveries or preterm (<37 weeks) vaginal deliveries but were significantly higher in second twins in term vaginal deliveries (3.1 vs 1.8 per 1000; adjusted OR, 2.15; P <.001). Conclusion Perinatal mortality risk differences in second vs first twins depend on their relative birth size. Vaginal delivery at term is associated with a substantially greater risk of perinatal mortality in second twins. © 2014 Mosby, Inc. All rights reserved.
Shen C.,Xinhua Hospital |
Yan J.,Xinhua Hospital |
Jiang L.-S.,Xinhua Hospital |
Dai L.-Y.,Xinhua Hospital
Arthritis Research and Therapy | Year: 2011
Introduction: Programmed cell death of intervertebral disc (IVD) cells plays an important role in IVD degeneration, but the role of autophagy, a closely related cell death event, in IVD cells has not been documented. The current study was designed to investigate the effect of interleukin (IL)-1β on the occurrence of autophagy of rat annulus fibrosus (AF) cells and the interrelationship between autophagy and apoptosis.Methods: Rat AF cells were isolated and exposed, in tissue cultures with or without serum, to IL-1β in different concentrations for 24 hours. Ultrastructural analysis, flow cytometry and lysosomal activity assessment were performed after the in vitro treatment to determine the presence and levels of autophagy. The mRNA expression of autophagy-related proteins (Beclin-1, Bcl-2 and microtubule associated protein 1 light chain 3 (LC3)) were evaluated using real-time PCR. 3-methyladenine (3-MA), a PI3K inhibitor, was used to determine the interaction between autophagy and apoptosis via the suppression of autophagy.Results: Autophagy was detected in rat AF cells under serum starvation condition by transmission electron microscopy. PCR and flow cytometry results showed that IL-1β enhanced the autophagy-induction effect of serum deprivation in a dose-dependent manner. However, IL-1β alone failed to induce autophagy in AF cells cultured without serum starvation. When autophagy was suppressed by 3-MA, the apoptosis incidence was increased. Serum supplement also partly reversed the autophagy incidence without affecting the apoptosis incidence in the same cells.Conclusions: IL-1β up-regulates serum deprivation-induced autophagy of AF cells in a dose-dependent manner. Autophagy may represent a protective mechanism against apoptosis in AF cells and IVD degeneration. © 2011 Shen et al.; licensee BioMed Central Ltd.
Gao X.,Fudan University |
Fan J.-G.,Xinhua Hospital
Journal of Diabetes | Year: 2013
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries, affecting 20%-33% of the general population. Large population-based surveys in China indicate a prevalence of approximately 15%-30%. Worldwide, including in China, the prevalence of NAFLD has increased rapidly in parallel with regional trends of obesity, type2 diabetes and metabolic syndrome. In addition, NAFLD has contributed significantly to increased overall, as well as cardiovascular and liver-related, mortality in the general population. In view of rapid advances in research into NAFLD in recent years, this consensus statement provides a brief update on the progress in the field and suggests preferred approaches for the comprehensive management of NAFLD and its related metabolic diseases. © 2013 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.
Xiaoping L.,Xinhua Hospital |
Leizhen Z.,Xinhua Hospital
International Journal of Hyperthermia | Year: 2013
High intensity focused ultrasound (HIFU) is a novel therapeutic modality. Several preclinical and clinical studies have investigated the safety and efficacy of HIFU for treating solid tumours, including pancreatic cancer. Preliminary studies suggest that HIFU may be useful for the palliative therapy of cancer-related pain in patients with unresectable pancreatic cancer. This review provides a brief overview of HIFU, describes current clinical applications of HIFU for pancreatic cancer, and discusses future applications and challenges. © 2013 Informa UK Ltd.
Chen F.,Zhejiang University |
Wu J.-L.,Xinhua Hospital |
Fu G.-S.,Zhejiang University |
Mou Y.,Zhejiang University |
Hu S.-J.,Zhejiang University
Journal of Cardiovascular Pharmacology and Therapeutics | Year: 2015
Qiliqiangxin (QL), a traditional Chinese medicine, has been shown to be beneficial for chronic heart failure. However, whether QL can also improve endothelial cell function in diabetic rats remains unknown. Here, we investigated the effect of QL treatment on endothelial dysfunction by comparing the effect of QL to that of benazepril (Ben) in diabetic Sprague-Dawley rats for 8 weeks. Cardiac function was evaluated by echocardiography and catheterization. Assays for acetylcholine-induced, endothelium-dependent relaxation (EDR), sodium nitroprusside-induced endothelium-independent relaxation, serum nitric oxide (NO), and nitric oxide synthase (NOS) as well as histological analyses were performed to assess endothelial function. Diabetic rats showed significantly inhibited cardiac function and EDR, decreased expression of serum NO and phosphorylation at Ser1177 on endothelial NOS (eNOS), and impaired endothelial integrity after 8 weeks. Chronic treatment for 8 weeks with either QL or Ben prevented the inhibition of cardiac function and EDR and the decrease in serum NO and eNOS phosphorylation caused by diabetes. Moreover, either QL or Ben suppressed inducible NOS (iNOS) protein levels as well as endothelial necrosis compared with the diabetic rats. Additionally, QL prevented the increase in angiotensin-converting enzyme 1 and angiotensin II receptor type 1 in diabetes. Thus, chronic administration of QL improved serum NO production, EDR, and endothelial integrity in diabetic rat aortas, possibly through balancing eNOS and iNOS activity and decreasing renin-angiotensin system expression. © The Author(s) 2014.
Wang S.,Xinhua Hospital |
Peng Q.,Xinhua Hospital |
Zhao P.,Xinhua Hospital
Optometry and Vision Science | Year: 2012
PURPOSE.: To study the features of posterior retinoschisis in high myopia before and after vitrectomy and its correlation with the visual outcome by spectral-domain optical coherence tomography (SD-OCT). METHODS.: In this retrospective case series, 11 highly myopic eyes which underwent vitrectomy with internal limiting membrane peeling and gas tamponade for retinoschisis during June 2008 to December 2009 were followed up for 6 months. Visual acuity and SD-OCT (Topcon 3D OCT-1000) examination were performed before surgery and 1, 3, and 6 months after surgery. RESULTS.: Retinoschisis within the outer, middle, and inner layers was noted in six eyes, and foveal detachment was found in six eyes by SD-OCT preoperatively. The inner and outer segment junctions of the photoreceptor layer showed defects in all eyes. At 6 months postoperatively, the retina had reattached and schisis resolved in 10 eyes. Two parafoveal holes were noted in one eye after surgery. The best-corrected visual acuity increased from 0.15 to 0.8 in one eye, slightly improved in two eyes, and remained unchanged in eight eyes. The continuity of inner segment-outer segment layer almost completely recovered in the eye with best-corrected visual acuity of 0.8 while still showing defects in the other 10 eyes. CONCLUSIONS.: SD-OCT can clearly demonstrate the morphological changes of retinoschisis. It provides important evidence as to the advantage of vitrectomy with internal limiting membrane peeling and helps to explain the visual outcome by documenting the recovery of the inner segment-outer segment layer after surgery. An SD-OCT examination should be considered in patients with high myopia and decreasing vision, with no obvious fundoscopic findings. Copyright © 2012 American Academy of Optometry.