Objective： This retrospective study examined risk factors for cytomegalovirus （CMV） infection after umbilical cord blood transplantation （UCBT） and the impact of CMV infection on patient survival. Methods： In al...Objective： This retrospective study examined risk factors for cytomegalovirus （CMV） infection after umbilical cord blood transplantation （UCBT） and the impact of CMV infection on patient survival. Methods： In all 176 patients, plasma CMV DNA was negative prior to the transplantation, and examined twice a week for 100 d, and then once weekly for additional 300 d. Preemptive antiviral therapy （ganciclovir or foscarnet） was started in patients with 〉 1,000/mL copies of CMV DNA but no full-blown CMV disease, and was discontinued upon two consecutive negative reports of blood CMV DNA test. The survival and risk factors for CMV infection or disease were examined using logistic regression. Results： CMV infection developed in 71% （125/176） of the patients, with a median onset of 32 d. Four patients （2.3%） developed CMV disease. Neither the 5-year overall survival （OS） nor event-free survival （EFS） differed significantly in infected patients vs. those with no infection （59.4% vs. 64.8%, P=0.194; 53.4% vs. 59.1%, P=0.226）. A stepwise multivariate analysis indicated an association of CMV infection with age, high-dose glucocorticoids, the number of transplanted CD34^＋ cells, and the number of platelet transfusion, but not with gender, the conditioning regimen, and the day of neutrophil recovery and chronic graft-versus- host disease （cGVHD）. Conclusions： CMV infection is very common after UCBT, but does not seem to affect long-term survival with preemptive antiviral treatment.展开更多
Mercury （Hg） is a well-known neurotoxicant. Hg exposure at high levels can harm individuals of all ages. Even low level exposure to Hg can damage the brain of fetuses and young children, and affect their central ner...Mercury （Hg） is a well-known neurotoxicant. Hg exposure at high levels can harm individuals of all ages. Even low level exposure to Hg can damage the brain of fetuses and young children, and affect their central nervous system and cognitive development. The aims of our study were to measure total Hg levels in infant umbilical cord blood and to investigate the risk factors associated with total Hg cord blood levels in various cities in China. Our goal was to provide clues for the prevention of Hg exposure in utero. The results indicated that the average cord blood mercury levels （CBMLs） were （1.81 ± 1.93） μg/L, which were lower than those found in most previous studies. The concentrations also differed according to geographic region. The CBMLs were not only associated with family economic and living conditions, but also with diet in pregnant women, especially the intake of marine fish, shellfish, poultry, formula milk and fruits.展开更多
Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gyneco...Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.展开更多
基金supported by the National Natural Science Fund of China(81250001)the Twelfth Five-year Science and Technology Project in Anhui Province(11010402164)+1 种基金Anhui Province Science and Technology Leader of Scientific Research FundAnhui Provincial‘115’Industrial Innovation Program[2009]
文摘Objective： This retrospective study examined risk factors for cytomegalovirus （CMV） infection after umbilical cord blood transplantation （UCBT） and the impact of CMV infection on patient survival. Methods： In all 176 patients, plasma CMV DNA was negative prior to the transplantation, and examined twice a week for 100 d, and then once weekly for additional 300 d. Preemptive antiviral therapy （ganciclovir or foscarnet） was started in patients with 〉 1,000/mL copies of CMV DNA but no full-blown CMV disease, and was discontinued upon two consecutive negative reports of blood CMV DNA test. The survival and risk factors for CMV infection or disease were examined using logistic regression. Results： CMV infection developed in 71% （125/176） of the patients, with a median onset of 32 d. Four patients （2.3%） developed CMV disease. Neither the 5-year overall survival （OS） nor event-free survival （EFS） differed significantly in infected patients vs. those with no infection （59.4% vs. 64.8%, P=0.194; 53.4% vs. 59.1%, P=0.226）. A stepwise multivariate analysis indicated an association of CMV infection with age, high-dose glucocorticoids, the number of transplanted CD34^＋ cells, and the number of platelet transfusion, but not with gender, the conditioning regimen, and the day of neutrophil recovery and chronic graft-versus- host disease （cGVHD）. Conclusions： CMV infection is very common after UCBT, but does not seem to affect long-term survival with preemptive antiviral treatment.
基金supported by the Ministry of Health of the People’s Republic of China (No.201002001, 201002006)the Science and Technology Commission of Shanghai Municipality (No.09DZ2200900, 10DZ2272200)+1 种基金the International and Comparative Education Research Institute,Joint School of Medical Education and Social Science Research Papers Prize (No.YX09003)the Xinhua Hospital Scientific Research Fund
文摘Mercury （Hg） is a well-known neurotoxicant. Hg exposure at high levels can harm individuals of all ages. Even low level exposure to Hg can damage the brain of fetuses and young children, and affect their central nervous system and cognitive development. The aims of our study were to measure total Hg levels in infant umbilical cord blood and to investigate the risk factors associated with total Hg cord blood levels in various cities in China. Our goal was to provide clues for the prevention of Hg exposure in utero. The results indicated that the average cord blood mercury levels （CBMLs） were （1.81 ± 1.93） μg/L, which were lower than those found in most previous studies. The concentrations also differed according to geographic region. The CBMLs were not only associated with family economic and living conditions, but also with diet in pregnant women, especially the intake of marine fish, shellfish, poultry, formula milk and fruits.
基金the National Key Research&Development Program of China(2016YFC1000400,2018YFC1002903).
文摘Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.
