Analysis of factors related to postpartum depression in pregnancyinduced hypertension syndrome patients and construction and evaluation of nomograms

BACKGROUND It is positive to integrate and evaluate the risk factors for postpartum depression in patients with pregnancy-induced hypertension syndrome and to detect highrisk patients as early as possible,which has application value for the clinical development of personalized prevention programs and prognosis of patients.AIM To analyze factors related to postpartum depression in patients with pregnancyinduced hypertension and construct and evaluate a nomogram model.METHODS The clinical data of 276 patients with pregnancy-induced hypertension admitted to Huzhou Maternity and Child Health Care Hospital between January 2017 and April 2022 were retrospectively analyzed.We evaluated the depression incidence at 6 wk postpartum.The depression group included patients with postpartum depression,and the remainder were in the non-depression group.Multivariate logistic regression analysis and the LASSO regression model were applied to analyze the factors related to postpartum depression in patients with pregnancyinduced hypertension.After that,a risk prediction model nomogram was constructed and evaluated.RESULTS Multivariate logistic regression analysis showed that vitamin A deficiency(VAD)during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,eicosapentaenoic acid(EPA),and docosahexaenoic acid(DHA)were independent risk factors for postpartum depression in patients with pregnancy-induced hypertension(P<0.05).We constructed the nomogram model based on these five risk factors.The area under the curve,specificity,and sensitivity of the model in predicting postpartum depression in patients with pregnancy-induced hypertension was 0.867(95%confidence interval:0.828–0.935),0.676,and 0.889,respectively.The average absolute error was 0.037(Hosmer-Lemeshow testχ2=10.739,P=0.217).CONCLUSION VAD during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,EPA,and DHA affect postpartum depression in patients with pregnancy-induced hypertension.

Intracranial Hypertension Syndrome in Systemic Lupus Erythematosus: Clinical Analysis and Review of the Literature

In order to better understand the clinical manifestation of systemic lupus erythematosus （SLE） with intracranial hypertension syndrome （IHS）, we analyzed the clinical features and treatment of a typical SLE patient with IHS. SLE is one of the most unpredictable autoimmune diseases involving multiple organ systems that is defined clinically and associated with antibodies directed against cell nuclei. IHS is an uncommon manifestation of neuropsychiatric SLE （NPSLE） and is characterized by an elevated intracranial pressure, papilledema, and headache with occasional abducens nerve paresis, absence of a space-occupying lesion or ventricular enlargement, and normal cerebrospinal fluid chemical and hematological constituents. IHS has been reported in a few sporadic cases in patients with SLE worldwide, but rarely has been reported in China. In this study, a 34-year-old female SLE patient with IHS was. reported and pertinent literature reviewed. The clinical presentation, image logical features, and investigatory findings were discussed.

Obesity, hypertension and the metabolic syndrome

The prevalence of obesity in both developed and developing countries has increased dramatically in recent years.1Many people who are obese develop metabolic changes that increase the risk of diabetes mellitus and adverse cardiovascular outcomes. Obesity leads to the development of insulin resistance, lipid abnormalities and increased blood pressure.……

Metabolic syndrome risk factors and dry eye syndrome:a Meta-analysis

AIM：To explore the relationship between metabolic risk factors and dry eye syndrome（DES）.METHODS：Retrieved studies on the association of metabolic syndrome risk factors（hypertension,hyperglycemia,obesity,and hyperlipidemia） and DES were collected from PubMed,Web of Science,and the Cochrane Library in December 2015.Odds ratio（OR） with 95% confidence interval（Cl） were pooled to evaluate the final relationship.Subgroup analyses were conducted according to diagnostic criteria of DES.RESULTS：Nine cross-sectional studies and three case-control studies were included in this Meta-analysis.The pooled results showed that people with hypertension,hyperglycemia,and hyperlipidemia had a higher risk of suffering from DES（P〈0.05）,especially the typical DES symptoms.On the other hand,obesity did not increase the risk of DES.CONCLUSION：The present Meta-analysis suggests that all metabolic risk factors except obesity were risk factors for DES.

Increased apoptosis in third - trimester placental tissue from gestations complicat-ed by PIH

Objective: To investigate a possible role of apoptosis in the pathophysiologic mechanisms of PIH (pregnancy-induced hypertension syndrome).Methods: In this study, placental samples were obtained from 16 uncomplicated third-trimester pregnancies and from 16 cases of PIH.We used light microscopy, electron microscopy to identify apoptosis.Light microscopy was used to quantify their incidence of apoptosis.Electron microscopy was used to confirm the occurrence of apoptosis.Results: Apoptosis has been conclusively demonstrated within human third-trimester placental tissue.Medians and interquartile ranges of normal placenta (n=16) was 0.12% (0.08%-0.19%); Medians and interquartile ranges of PIH group (n=16) was 0.37% (0.15%-0.49%).Compared to normal placentas, the incidence of apoptosis was higher in placentas from gestations complicated by PIH (P<0.05, T'-test).Conclusion: Placental apoptosis increases significantly in PIH, and it may play a role in the pathophysiologic mechanisms of this syndrome.

Constructing protein-protein interaction network of hypertension with blood stasis syndrome via digital gene expression sequencing and database mining

OBJECTIVE： To construct a protein-protein interaction（PPI） network in hypertension patients with blood-stasis syndrome（BSS） by using digital gene expression（DGE） sequencing and database mining techniques.METHODS： DGE analysis based on the Solexa Genome Analyzer platform was performed on vascular endothelial cells incubated with serum of hypertension patients with BSS. The differentially expressed genes were f iltered by comparing the expression levels between the different experimental groups. Then functional categories and e nriched pathways of the unique genes for BSS were analyzed using Database for Annotation, Visualization and Integrated Discovery（DAVID） to select those in the enrichment pathways. I nterologous Interaction Database（I2D） was used to construct PPI networks with the selected genes for hypertension patients with BSS. The potential candidate genes related to BSS were identif ied by comparing the number of relationships among genes. Confi rmed by quantitative reverse transcription-polymerase chain reaction（q RTPCR）, gene ontology（GO） analysis was used to infer the functional annotations of the potential candidate genes for BSS.RESULTS： With gene enrichment analysis using DAVID, a list of 58 genes was chosen from the unique genes. The selected 58 genes were analyzed using I2 D, and a PPI network was constructed. Based on the network analysis results, candidate genes for BSS were identifi ed：DDIT3, JUN, HSPA8, NFIL3, HSPA5, HIST2H2 BE, H3F3 B, CEBPB, SAT1 and GADD45 A. Verif ied through qRT-PCR and analyzed by GO, the functional annotations of the potential candidate genes were explored.CONCLUSION： Compared with previous methodologies reported in the literature, the present DGE analysis and data mining method have shown a great improvement in analyzing BSS.

Traditional Chinese medicine wrist pulse-taking is associated with pulse waveform analysis and hemodynamics in hypertension

BACKGROUND： Pulse wave analysis（PWA） quantifies the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis（PIA） is a subjective examination in traditional Chinese medicine. OBJECTIVE： This study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This observational, cross-sectional study enrolled 45 patients（26 men,（55.2± 10.3） years, systolic blood pressure（155± 28） mm Hg, diastolic blood pressure（93± 17） mm Hg） for assessment of clinical and laboratorial data. MAIN OUTCOME MEASURES： Primary outcomes comprised： pattern differentiation based on an automated method; PIA at the radial artery using the ‘simultaneous pressing＇ method for identification of factors such as strength（strong/weak）, depth（superficial/deep）, and speed（fast/moderate/slow）; and PWA at the same artery using a noninvasive system. RESULTS： Significant multivariate main effects were observed for depth（l=0.648, F_（5,29）=3.149, P=0.022, h^2 =0.352）, strength（l=0.608, F_（5,29） =3.736, P=0.010, h^2 =0.392）, and speed（l=0.535, F_（5,29） =5.302, P=0.002, h^2 =0.465）. General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mm Hg and systolic blood pressure ≥ 149.5 mm Hg, whereas a superficial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s. CONCLUSION： Associations were explained by La Place＇s law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.

Carvedilol therapy for patients with Eisenmenger syndrome

Background： Eisenmenger syndrome is characterized by the development of pulmonary arterial hypertension with resultant intracardiac right-to-left shunt and hypoxemia in patients with congenital heart defects. In clinical practice, we found that these patients might benefit from carvedilol therapy. Thus, we designed this prospective, open label, observational study to evaluate the efficacy of carvedilol for patients with Eisenmenger syndrome. Methods Twenty patients（17.5 ± 4.8 years） with Eisenmenger syndrome were treated with carvedilol for 6 weeks. The efficacy of carvedilol on 6-minute walking distance, World Health Organization（WHO） functional class, arterial oxygen saturation and right ventricle systolic pressure were assessed.Results At the end of observation, change from baseline in 6-minute walking distance increased 36.35 meters（95% confidence intervals [CI] 25.43 to 47.27 m, P 〈 0.01）. WHO functional class was also significantly improved（P 〈 0.05）. Change from baseline in right ventricular systolic pressure assessed by echo was reduced by 8.11 mm Hg（95% confidence intervals [CI],-10.78 to-5.44 mm Hg, P 〈 0.05）. However, arterial oxygen saturation remained unchanged（87.5 ± 3.02 % at baseline versus 87.80 ± 7.29 % at the end of observation）. Conclusions Carvedilol can improve clinical function, symptoms as well as exercise capacity in patients with Eisenmenger syndrome. These findings need to be confirmed in further randomized clinical trials.

Effect of retension sutures on abdominal pressure after abdominal surgery

To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients. Methods： This prospective cohort study included patients who were admitted to Daping Hospital from May 15, 2014 to October 11, 2014. A total of 57 patients were enrolled, including 18 patients in the ＂U＂ type retention suture group, 17 patients in the intermittent retention suture group, and 22 patients in non-retention suture group. The demographic data, clinical data and risk factors for abdominal wound dehiscence were recorded. The bladder pressure （IVP） was monitored preoperatively, intraoperatively, and four days postoperatively. Additionally, the incidence of abdominal wound dehiscence and infection 14 days after the operation was recorded. Results： During the operation, the IVP decreased and then increased; it was at its lowest I h after the start of the operation （5.3 mmHg _＋ 3.2 mmHg） and peaked after tension-reducing （8.8 mmHg _＋ 4.0 mmHg）. The IVP values in the ＂U＂ type retention suture group and intermittent retention suture group were higher than in the non-retention suture group 4 days after operation （p 〈 0.005）. The Visual Analogue Scale （VAS） pain scores were 3.9 ~ 2.2, 3.8 ~ 2.0, and 3.0 _＋ 1,0 in the retention suture group, intermittent retention suture group and non-retention suture group, respectively. The VAS pain scores in the ＂U＂ type tension-reducing group and intermittent tension-reducing group were higher than in the non-tension-reducing group （p 〈 0,005）. Conclusion： Although retention sutures may reduce the incidence of postoperative wound dehiscence in abdominal surgery patients, they can increase the IVP and postoperative pain.