Analysis of risk factors for postpartum depression after cesarean section in women with early-onset preeclampsia

BACKGROUND Early-onset preeclampsia significantly increases maternal and fetal morbidity and mortality.Many pregnant women with early onset preeclampsia choose cesarean section as their delivery method.Although extensive research has explored the association between postpartum depression(PPD)and cesarean section,few studies have investigated the risk factors after cesarean section in women with early-onset preeclampsia.AIM To examine these risk factors through a retrospective,observational analysis of 287 women who underwent a cesarean section for early preeclampsia between June 2014 and March 2024.METHODS Participants were assessed in person during the 32nd week of pregnancy,2 days post-cesarean,and 6 weeks postpartum.According to the Edinburgh Postnatal Depression Scale(EPDS),participants who underwent cesarean section were divided into PPD(n=60)and non-PPD groups(n=227).Furthermore,PPD was diagnosed at 6 weeks postpartum according to depressive symptoms(EPDS score≥11).The demographic and clinical features of PPD were screened.Multivariate logistic regression analysis was used to identify PPD risk factors.RESULTS The prevalence of PPD was 20.9%(60/287)among the 287 women who underwent cesarean section for early-onset preeclampsia.Multivariate logistic regression analyses revealed that advanced age(age>40 years)[odds ratio(OR)=1.93,95%CI:1.31-2.82],previous preeclampsia(OR=7.15,95%CI:5.81-8.85),pre-pregnancy obesity(OR=2.42,95%CI:1.62-3.63),gestational diabetes mellitus(OR=3.52,95%CI:2.51-4.92),preexisting hypertension(OR=1.35,95%CI:1.03-1.89),PPD symptoms(EPDS≥11)at 2 days postpartum(OR=6.15,95%CI:1.32-28.35),high prenatal self-rating anxiety scale score(OR=1.13,95%CI:1.06-1.18),and pain at 6 weeks postpartum(OR=2.16,95%CI:1.28-3.66)were independently associated with PPD.CONCLUSION Risk factors for PPD after cesarean section in women with early-onset preeclampsia include advanced age(age>40 years),pre-pregnancy obesity,previous preeclampsia,gestational diabetes mellitus,preexisting hypertension,PPD symptoms(EPDS≥11)at 2 days postpartum,prenatal anxiety,and pain at 6 weeks postpartum.The early identi-fication of these factors and interventions can mitigate the risk of PPD.

Effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage

Objective: To study the effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage. Methods: The patients with hypertensive intracerebral hemorrhage received surgical treatment in our hospital during February 2015 - December 2017 were selected and divided into two groups by random number table. The observation group received ulinastatin combined surgery and the control group received conventional medicine combined with surgery. Before treatment and 1 weeks after treatment, serum levels of nerve damage markers, neurotrophic indexes, oxygen free radicals production indexes and inflammatory cytokines were measured. Results: After treatment, the contents of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of two groups were all decreased, the contents of BDNF, NGF, VEGF, IGF-I were all increased and the decreasing trend of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of observation group was more obvious than that of the control group, the increasing trend of BDNF, NGF, VEGF, IGF-I content was more obvious than that of the control group. Conclusion: The use of ulinastatin combined with surgery in the treatment of hypertensive intracerebral hemorrhage can significantly reduce the damage of nerve function and reduce the production of oxygen free radicals and inflammatory factors.

Value of preoperative erythrocyte sedimentation rate, CRP and D-D levels in evaluating the prognosis of elderly patients after hip replacement

Objective: To analyze the clinical value of blood sedimentation rate, C-reactive protein (CRP) and D-dimer (D-D) expression levels in elderly patients before hip replacement for judging the prognosis after operation. Methods 88 patients who needed hip replacement in orthopaedic surgery of our hospital from January 2014 to December 2017 were selected as the research object. According to the prognosis of patients, they were divided into two groups. 42 patients with good prognosis were treated as observation group and 46 patients with poor prognosis were treated as control group. The ESR and CRP of the two groups were recorded and analyzed before and after operation. The expression level of D-D, perioperative changes, and the prognostic value of the area under the curve (AUC) were compared by drawing the patient's working characteristic curve (ROC curve). Results The expression levels of ESR, CRP and D-D in the observation group were significantly higher than those in the control group (P < 0.05). The expression levels of CRP in the observation group were significantly higher than those in the control group (P < 0.05). The expression levels of ESR and CRP in the observation group before discharge were significantly higher than those in the control group (P < 0.05). There was significant difference between the two groups (P < 0.05);the level of ESR expression before and 2 days after operation was significantly lower than that before discharge (P < 0.05);the level of ESR expression before operation was significantly lower than that 2 days after operation (P < 0.05);and the CRP and D-D table before operation were compared between the two groups (P < 0.05). The level of CRP and D-D expression in two groups was significantly higher than that before discharge (P < 0.05). In this study, two groups of patients were infected. The incidence of thrombosis in the observation group was higher than that in the control group, but the difference was not statistically significant (P > 0.05). The Harris score of the observation group was significantly higher than that of the control group (P < 0.05). Conclusion There are abnormal levels of ESR, CRP and D-D expression in elderly patients with hip replacement before operation, and they have certain clinical value in evaluating the prognosis of elderly patients after hip replacement.

Risk factors for cognitive impairment in patients with chronic kidney disease

BACKGROUND Chronic kidney disease(CKD)patients have been found to be at risk of concurrent cognitive dysfunction in previous studies,which has now become an important public health issue of widespread concern.AIM To investigate the risk factors for concurrent cognitive dysfunction in patients with CKD.METHODS This is a prospective cohort study conducted among patients with CKD between October 2021 and March 2023.A questionnaire was formulated by literature review and expert consultation and included questions about age,sex,education level,per capita monthly household income,marital status,living condition,payment method,and hypertension.RESULTS Logistic regression analysis showed that patients aged 60-79 years[odds ratio(OR)=1.561,P=0.015]and≥80 years(OR=1.760,P=0.013),participants with middle to high school education(OR=0.820,P=0.027),divorced or widowed individuals(OR=1.37,P=0.032),self-funded patients(OR=2.368,P=0.008),and patients with hypertension(OR=2.011,P=0.041)had a higher risk of cognitive impairment.The risk of cognitive impairment was lower for those with a college degree(OR=0.435,P=0.034)and married individuals.CONCLUSION The risk factors affecting cognitive dysfunction are age,60-79 years and≥80 years;education,primary school education or less;marital status,divorced or widowed;payment method,selffunded;hypertension;and CKD.

Combined lumbar muscle block and perioperative comprehensive patient-controlled intravenous analgesia with butorphanol in gynecological endoscopic surgery

BACKGROUND Laparoscopic surgery has become a common surgical approach for the clinical treatment of intra-abdominal lesions in recent years.We hypothesized that lumbar block with postoperative patient-controlled intravenous analgesia(PCIA)by butorphanol after gynecological surgery under general anesthesia would be more effective than PCIA by butorphanol alone.AIM To investigate the effect of lumbar block with PCIA by butorphanol after gynecological surgery under general anesthesia.METHODS This study assessed 120 women scheduled for laparoscopic surgery at our hospital between May 2017 and May 2020.They were divided using a random number table into a research group(those who received quadratus lumborum block combined with PCIA analgesia by butorphanol)and a control group(those who received only PCIA analgesia by butorphanol),with 60 patients in each group.Demographic factors,visual analog scale scores for pain,serum inflammatory markers,PCIA compressions,Ramsay scores,and adverse events were compared between groups using a t-test,analysis of variance,orχ2 test,as appropriate.RESULTS There were no significant differences in demographic factors between groups(all P>0.05).The visual analog scale scores of the research group in the resting state 12 h and 24 h postoperatively were significantly lower than those of the control group(P<0.05).Two hours after surgery,there were no significant differences in the levels of serum tumor necrosis factor-α,interleukin(IL)-6,or IL-8 between groups(P>0.05).The serum tumor necrosis factor-αlevels of the research group 24 h postoperatively were significantly lower than those of the control group(P<0.05).The levels of serum IL-6 and IL-8 in the study group 24 h and 48 h postoperatively were significantly lower than those in the control group(P<0.05).CONCLUSION Lumbar block with PCIA with butorphanol after gynecological surgery under general anesthesia significantly improves the analgesic effect and reduces the degree of inflammation,instances of PCIA compression,and adverse reactions.

Effects on newborns of applying bupivacaine combined with different doses of fentanyl for cesarean section

BACKGROUND The choice of anesthesia for cesarean section is very important.AIM To compare the effects of applying bupivacaine combined with different doses of fentanyl on newborns after cesarean section.METHODS We randomly divided one hundred and twenty patients undergoing cesarean section into the following 4 groups:group B(bupivacaine group),group BF10(bupivacaine combined with 10μg fentanyl),group BF30(bupivacaine combined with 30μg fentanyl)and group BF50(bupivacaine combined with 50μg fentanyl).The heart rate,mean arterial pressure,block plane fixation time and sensory block time were recorded.Umbilical artery blood was then collected immediately after fetal delivery for blood gas analysis and qualitative detection of fentanyl.Additionally,data on the neonatal 1-min and 5-min Apgar scores,results of umbilical artery blood gas analysis and qualitative detection of fentanyl in umbilical artery blood were recorded.RESULTS Although the mean arterial pressure decreased in all four groups at 3 min after anesthesia,the percentage of the decrease was less than 20%of the baseline.In addition,there were no significant differences in the 1-min or 5-min Apgar scores or the umbilical artery blood gas analysis among the four groups(P>0.05).Moreover,the concentration of fentanyl in umbilical artery blood was qualitatively detected using an ELISA kit,and the results in the four groups were negative.CONCLUSION Bupivacaine combined with fentanyl spinal anesthesia is effective in cesarean section.

Effect of preoperative Brucea javanica oil emulsion + conventional chemotherapeutic drugs intraperitoneal chemotherapy on the expression of oncogene in advanced gastric cancer after surgical resection

Objective: To study the effect of preoperative Brucea javanica oil emulsion + conventional chemotherapeutic drugs intraperitoneal chemotherapy on the expression of oncogene in advanced gastric cancer after surgical resection. Methods: The patients who were diagnosed with advanced gastric cancer in our hospital during the period of March 2015 to October 2017 were randomly divided into the combined group received preoperative Brucea javanica oil emulsion + conventional chemotherapeutic drugs intraperitoneal chemotherapy, control group received conventional chemotherapeutic drugs intraperitoneal chemotherapy. The tumor markers in serum were measured before and after chemotherapy, and the expression of oncogenes in the lesion was measured after operation. Results: After chemotherapy, the levels of CEA, CA199, G17 and TK1 in the serum of the two groups were significantly decreased and the decreasing trend of CEA, CA199, G17 and TK1 in the serum of the combined group was more significant than that of the control group. The mRNA expression of CyclinD1, FRA-1, Bmi-1, c-Met, HER-2, CAT-D, MMP2, MMP7 in gastric cancer of combined group were significantly lower than the control group, and the mRNA expression of PTEN, p16, KISS-1, Caspase-3, TSPYL-5, TIMP1, RECK were significantly higher than that of the control group. Conclusion: Preoperative Brucea javanica oil emulsion + conventional chemotherapeutic drugs intraperitoneal chemotherapy can more significantly regulate the expression of oncogene in gastric cancer than conventional chemotherapy drugs.

Pachymic Acid Ameliorates Pulmonary Hypertension by Regulating Nrf2-Keap1-ARE Pathway

Objective:Pulmonary hypertension(PH)is a severe pulmonary vascular disease that eventually leads to right ventricular failure and death.The purpose of this study was to investigate the mechanism by which pachymic acid(PA)pretreatment affects PH and pulmonary vascular remodeling in rats.Methods:PH was induced via hypoxia exposure and administration of PA(5 mg/kg per day)in male Sprague-Dawley rats.Hemodynamic parameters were measured using a right ventricular floating catheter and pulmonary vascular morphometry was measured by hematoxylin-eosin(HE),a-SMA and Masson staining.MTT assays and EdU staining were used to detect cell proliferation,and apoptosis was analyzed by TUNEL staining.Western blotting and immunohistochemistry were used to detect the expression of proteins related to the Nrf2-Keapl-ARE pathway.

Effect of mild moxibustion on cancer-related fatigue,serum ghrelin and adiponectin in patients undergoing chemotherapy after colorectal cancer surgery

Objective To observe the effect of mild moxibustion on cancer-related fatigue,serum ghrelin and adiponectin in patients undergoing chemotherapy after colorectal cancer surgery.Methods Seventy patients were divided into a control group and an observation group according to the random number table method,with 35 cases in each group.Patients in both groups were treated with conventional FOLFOX4 chemotherapy regimen.Patients in the control group also received routine treatments such as symptomatic treatment of complications,health education,nutritional support,and exercise intervention.Patients in the observation group received mild moxibustion on the basis of interventions used in the control group.The Piper fatigue scale-revision(PFS-R),Karnofsky performance status(KPS)and spleen and kidney yang deficiency syndrome were scored,and serum ghrelin and adiponectin levels were measured before and after treatment.Results After treatment,total score of PFS-R in the control group did not change significantly(P>0.05),while in the observation group it was significantly reduced(P<0.05)and lower than that in the control group(P<0.05);KPS scores in both groups were increased(both P<0.05),and it was significantly higher in the observation group than in the control group(P<0.05);total score of spleen and kidney yang deficiency syndrome in the control group did not change significantly(P>0.05),while it was significantly reduced in the observation group(P<0.05)and lower than that in the control group(P<0.05);serum ghrelin and adiponectin levels in the control group had no significant changes(both P>0.05),but the levels were significantly increased in the observation group(both P<0.05)and higher than those in the control group(both P<0.05).Conclusion Based on the routine treatments,mild moxibustion can relieve fatigue,improve quality of life,and improve the symptoms of spleen and kidney yang deficiency in patients undergoing chemotherapy after colorectal cancer surgery,which may be related to the regulation of serum ghrelin and adiponectin levels.

Pedigree analysis of a POLD1 germline mutation in urothelial carcinoma shows a close association between different mutation burdens and overall survival

Bladder cancer(BCa)is the ninth most frequently diagnosed tumor worldwide,and smoking remains a major risk faaor.BCa is divided into nonmuscle invasive bladder cancer(NMIBC)and muscle invasive bladder cancer(MIBC).1 NMIBC accounts for 70-80% of all BCa cases,its recurrence rate is high,and 20-30% of NMIBC patients progress to MIBC.

VIS Atlas:A Database of Virus Integration Sites in Human Genome from NGS Data to Explore Integration Patterns

Integration of oncogenic DNA viruses into the human genome is a key step in most virusinduced carcinogenesis.Here,we constructed a virus integration site(VIS)Atlas database,an extensive collection of integration breakpoints for three most prevalent oncoviruses,human papillomavirus,hepatitis B virus,and Epstein-Barr virus based on the next-generation sequencing(NGS)data,literature,and experimental data.There are 63,179 breakpoints and 47,411 junctional sequences with full annotations deposited in the VIS Atlas database,comprising 47 virus genotypes and 17 disease types.The VIS Atlas database provides(1)a genome browser for NGS breakpoint quality check,visualization of VISs,and the local genomic context;(2)a novel platform to discover integration patterns;and(3)a statistics interface for a comprehensive investigation of genotypespecific integration features.Data collected in the VIS Atlas aid to provide insights into virus pathogenic mechanisms and the development of novel antitumor drugs.