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Using the Delphi Technique to Achieve Consensus on Prevention and Treatment of Preterm Single Birth in China

Maternal-Fetal Medicine 2023年第4期5卷 206-212页

作者： Taishun Li Zhe Liu huixia yang Yali Hu Medical Statistics and Analysis Center Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008China Department of Obstetrics and Gynecology Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008China Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China.

Objective::This study aimed to reach a consensus among obstetric experts on the prevention and treatment of preterm single births in ***::Based on the scoping literature review and the 2014 edition of preterm birth of Clinical Diagnosis and Treatment guidelines,we generated the Delphi survey statements with five evaluation dimensions,including the definition of preterm birth,exclusion of risk factors for preterm birth,prevention,and prediction of preterm birth,treatment of preterm birth,and evaluation of intervention outcomes of preterm *** experts from the Obstetrics and Gynecology Branch of the Chinese Medical Association formed the expert group for this *** the obstetric experts participated two-round modified Delphi survey via an anonymous online survey and an online *** scores,rank sum,full score ratio,and the lowest score ratio were calculated to reflect the concentration of expert *** coefficient of variation and Kendall W coefficient were used to reflect the expert opinion coordination degree of the survey ***::The expert response rate for both rounds of surveys was 100%(41/41).Experts reached an agreement on 36 statements in five dimensions of preterm birth prevention and treatment in the first round of the survey and reached a consensus on the remaining 13 statements in the second round.A total of 49 statements(mean scores≥3,full score ratio≥20%,coefficient of variation≤0.3)were explicitly included in this guideline to form recommendations,while the remaining three clinical issues that did not reach a consensus require further determination based on evidence *** Kendall W coefficient in the two rounds of the Delphi survey were 0.20(P<0.001)and 0.29(P<0.001).Conclusion::The five dimensions and 49 statements,agreed upon through a two-round Delphi study,determined the recommended statements to be included in the updated guidelines for the prevention and treatment of preterm birth in ***

关键词： Premature birth Delphi technique Consensus Guidelines

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Low-dose aspirin in the prevention of pre-eclampsia in China: postpartum hemorrhage in subgroups of women according to their characteristics and potential bleeding risk

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Chinese Medical Journal 2023年第5期136卷 550-555页

作者： Jiahui Chen Jing Huai Li Lin Boya Li Yuchun Zhu huixia yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus Beijing 100034China.

Background:The APPEC study is a large-population randomized controlled trial in China evaluating the role of low-dose aspirin prophylactic treatment for *** was no statistically significant difference in postpartum hemorrhage(PPH)incidence between the aspirin and control *** study aimed to evaluate the potential bleeding risk of 100 mg aspirin in high-risk pregnant women and the difference in the incidence of PPH according to maternal ***:This is a secondary data analysis of the APPEC *** counts and coagulation test results were collected at five follow-up *** defined by maternal age(<35 years and≥35 years),pre-pregnancy body mass index(pre-BMI,<28 kg/m 2 and≥28 kg/m 2),parity,gestational age at enrollment,and medical history,including pre-eclampsia,chronic hypertension,and diabetes mellitus,were *** regression analysis was used to determine the statistical significance of the difference in the incidence of PPH after aspirin administration in pregnant women in each *** using multiple logistic regression models followed these *** logistic regression was used to determine the relationship between pre-BMI and ***:There was no significant difference between the aspirin and control groups in bleeding risk(3.4%[16/464]vs.3.0%[13/434],T=0.147,P=0.701).No significant difference was found in the incidence of PPH in total(relative risk=1.220,95%confidence interval[CI]=0.720–2.067,P=0.459;aspirin group *** group,6.5%[30/464]vs.5.3%[23/434],P=0.459)or in subgroup analysis.A significant correlation between pre-BMI and PPH was found in the aspirin group,while in the control group there was no significant correlation(aspirin group,odds ratio[OR]=1.086,95%CI=1.004–1.175,P=0.040;control group,OR=1.060,95%CI=0.968–1.161,P=0.209).Conclusions:A dosage of 100 mg of aspirin per day,initiated from 12 to 20 gestational weeks until 34 weeks of gestation,did not increa

关键词： APPEC study Aspirin Postpartum hemorrhage Body mass index Pre-eclampsia

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Reproductive advance of fertility preservation in patients with early endometrial carcinoma or endometrial atypical hyperplasia

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Gynecology and Obstetrics Clinical Medicine 2022年第4期2卷 186-190页

作者： Jiao Yu yangyang Zhang huixia yang yang Xu Department of Obstetrics and Gynecology Peking University First HospitalBeijing100034China

Endometrial cancer(EC)is the fourth common cancer in women worldwide with its incidence rising each year.10%–15%young patients are diagnosed of *** patients of childbearing age with early endometrial cancer or atypical hyperplasia,it is necessary to consider surgical removal of uterus after they have given *** is a big challenge for reproductive doctors and oncologists to help such patients get pregnant safely as soon as *** this article,we will review the latest progress in conservative treatment and candidates for fertility preservation,application of molecular detection,the fertility outcome and follow-up treatment which aims to stimulate more thinking.

关键词： Endometrial cancer Atypical endometrial hyperplasia Fertility preservation Molecular detection

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缺氧后处理通过piRNA-005854调控衰老心肌细胞自噬发挥保护心肌作用

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中国组织工程研究 2024年第13期28卷 2054-2060页

作者：迟宏扬杨慧霞郝银菊杨安宁白志刚焦运熊建团马胜超姜怡邓宁夏医科大学临床医学院宁夏回族自治区银川市750004 宁夏医科大学国家卫生健康委代谢性心血管疾病研究重点实验室宁夏回族自治区银川市750004 宁夏医科大学药学院宁夏回族自治区银川市750004 宁夏医科大学基础医学院宁夏回族自治区银川市750004 宁夏回族自治区人民医院宁夏回族自治区银川市750004 宁夏医科大学总医院感染科宁夏回族自治区银川市750004

背景:缺血后处理是减轻缺血再灌注损伤的有效方式之一,近年来被越来越广泛地应用于临床实践,但其具体分子机制还有待研究。目的:探讨piRNA-005854在衰老心肌细胞缺氧后处理中的作用及机制。方法:体外给予心肌细胞8 mg/mL D-半乳糖9 d诱... 详细信息

背景:缺血后处理是减轻缺血再灌注损伤的有效方式之一,近年来被越来越广泛地应用于临床实践,但其具体分子机制还有待研究。目的:探讨piRNA-005854在衰老心肌细胞缺氧后处理中的作用及机制。方法:体外给予心肌细胞8 mg/mL D-半乳糖9 d诱导其衰老,β-半乳糖苷酶染色观察心肌细胞的衰老情况;衰老后细胞给予缺氧/复氧处理和缺氧后处理,ELISA检测心肌损伤标志物肌酸激酶同工酶MB以及乳酸脱氢酶水平;Western blot检测衰老心肌细胞中自噬相关蛋白LC3Ⅱ、p62和ULK1及其磷酸化ULK1的表达;qRT-PCR检测piRNA-005854的表达水平;进一步用piRNA-005854 inhibitor及piRNA-005854 mimics转染衰老心肌细胞并进行缺氧后处理,Western blot检测LC3Ⅱ、p62和ULK1及其磷酸化ULK1的表达。结果与结论:①D-半乳糖诱导9 d后心肌细胞出现明显衰老;②与正常氧组比较,缺氧/复氧组肌酸激酶同工酶MB以及乳酸脱氢酶水平增加(P<0.01);LC3Ⅱ/Ⅰ表达升高、p62表达降低、ULK1磷酸化水平升高、piRNA-005854表达升高(P<0.01);③与缺氧/复氧组比较,缺氧后处理组肌酸激酶同工酶MB以及乳酸脱氢酶水平明显减少(P<0.01);LC3Ⅱ/Ⅰ表达明显降低(P<0.05)、p62表达升高(P<0.01)、ULK1磷酸化水平降低(P<0.05)、piRNA-005854表达降低(P<0.01);④转染piRNA-005854 inhibitor后,LC3Ⅱ/Ⅰ表达降低(P<0.01),p62表达明显升高(P<0.05),ULK1磷酸化水平明显降低(P<0.01);转染piRNA-005854 mimics后,LC3Ⅱ/Ⅰ表达显著升高,p62表达降低,ULK1磷酸化水平明显增加(P<0.01);⑤结果表明,piRNA-005854介导的ULK1依赖性自噬水平降低是衰老心肌细胞缺氧后处理发挥保护作用的可能机制。

关键词： piRNA 自噬衰老心肌细胞缺血再灌注损伤缺氧/复氧缺氧后处理

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基于GM-BP组合监测的市政道路工程水稳层施工质量控制研究

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北方建筑 2024年第4期9卷 20-25页

作者：侯兵张辉王生彦许振振姜健杨晖霞中建七局安装工程有限公司河南郑州450000

为提高水稳层施工质量并延长市政道路工程的使用寿命,以某市政道路工程项目为例,提出基于GM-BP组合监测的水稳层施工质量智能控制方法。根据工程需求,选择等级在32.5以上的普通硅酸盐水泥作为主要原材料;将混合料摊铺在作业面上,进行混... 详细信息

为提高水稳层施工质量并延长市政道路工程的使用寿命,以某市政道路工程项目为例,提出基于GM-BP组合监测的水稳层施工质量智能控制方法。根据工程需求,选择等级在32.5以上的普通硅酸盐水泥作为主要原材料;将混合料摊铺在作业面上,进行混合料摊铺厚度调整与摊铺速度控制;碾压施工按初、复、终三个阶段进行,根据工程需求设计市政道路工程水稳层碾压施工;在此基础上,采用灰色神经网络(Grey Model with Back Propagation,GM-BP)监测施工关键参数,实时进行施工调整,对道路工程进行接缝处理,之后对其进行养护,由此完成施工质量智能控制。分析结果表明:设计的施工质量智能控制方法应用效果良好,可以确保道路工程压实度、平整度、纵段高程、横坡等指标通过质量验收,使施工后的道路实际强度满足施工强度代表值要求。

关键词：市政道路工程摊铺碾压控制方法施工质量水稳层

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Exploring the Optimal Diagnostic Thresholds of Hyperglycemia During Pregnancy

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Maternal-Fetal Medicine 2023年第1期5卷 1-3页

作者： Xinyu Shu Juan Juan huixia yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus Beijing 100034China

Gestational diabetes mellitus(GDM)is a specific disease during pregnancy that is characterized by the onset of abnormal maternal glucose tolerance,1 which was first discovered by O’Sullivan and Mahan2 in *** then,the gradual understanding of the impact of GDM on the long-term risk of maternal diabetes and other metabolic diseases has led to modifications in the diagnostic criteria of GDM by different associations and organizations.

关键词： pregnancy diseases Sullivan

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Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2:Current Evidence and Perspectives

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Maternal-Fetal Medicine 2023年第2期5卷 65-68页

作者： Chong Shou Chen Wang huixia yang Department of Medicine Melrose Wakefield HospitalMelrose 02176MAUSA Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China.

With the widespread transmission of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the medical community has organized efforts to determine a series of clinical questions about the *** questions have also arisen in the field of maternal-fetal medicine and have received increasing attention,as physiological and immunologic changes in pregnancy might potentially increase the susceptibility to SARS-CoV-2 infection and complications of the virus.1 Many early reports indicated that pregnant women with SARS-CoV-2 infection were not prone to experiencing severe disease.

关键词： acute respiratory Vertical

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Intra-abdominal aortic balloon occlusion in the management of placenta percreta

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Chinese Medical Journal 2022年第4期135卷 441-446页

作者： Weiran Zheng Ruochong Dou Jie Yan Xinrui yang Xianlan Zhao Dunjin Chen Yuyan Ma Weishe Zhang Yiling Ding Ling Fan huixia yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing Key Laboratory of Maternal-Fetal Medicine of Gestational Diabetes MellitusXicheng DistrictBeijing 100034China Department of Obstetrics and Gynecology First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Department of Obstetrics and Gynecology Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510260China Department of Obstetrics and Gynecology Qilu Hospital of Shandong UniversityJinanShandong 250012China Department of Obstetrics and Gynecology Xiangya Hospital Central South UniversityChangshaHunan 410008China Department of Obstetrics and Gynecology Second Xiangya Hospital of Central South UniversityChangshaHunan 410008China Department of Obstetrics and Gynecology Beijing Obstetrics and Gynecology HospitalBeijing 100026China

Background:Massive bleeding is the main concern for the management of placenta percreta(PP).Intra-abdominal aortic balloon occlusion(IABO)is one method for pelvic devascularization,but the efficacy of IABO is *** study aims to investigate the outcomes of IABO in PP ***:We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December *** cases with/without the use of IABO were *** score matching analysis was performed to reduce the effect of selection *** hemorrhage(PPH)and the rate of hysterectomy,as well as neonatal outcomes,were ***:One hundred and thirty-two matched pairs of patients were included in the final *** with the control group,maternal outcomes,including PPH(68.9%vs.87.9%,χ^(2)=13.984,P<0.001),hysterectomy(8.3%vs.65.2%,χ^(2)=91.672,P<0.001),and repeated surgery(1.5%vs.12.1%,χ^(2)=11.686,P=0.001)were significantly reduced in the IABO *** neonatal outcomes,Apgar scores at 1 minute(8.67±1.79vs.8.53±1.68,t=-0.638,P=0.947)and 5 minutes(9.43±1.55vs.9.53±1.26,t=0.566,P=0.293)were not significantly different between the two ***:IABO can significantly reduce blood loss,hysterectomies,and repeated *** procedure has not shown harmful effects on neonatal outcomes.

关键词： Placenta accreta spectrum disorders Placenta percreta Conservative management Intra-abdominal aortic balloon occlusion Propensity score matching

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病例02(2024):冠状动脉夹层致妊娠期急性ST段抬高型心肌梗死1例

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中华围产医学杂志 2024年第3期27卷 226-232页

作者：孔令英贺鹏康李建平王东信洪涛孙瑜陈倩魏玉梅张鸿杨慧霞北京大学第一医院妇产生殖医学中心北京100034 北京大学第一医院心血管内科北京100034 北京大学第一医院麻醉科北京100034

本文报道1例冠状动脉夹层导致孕妇急性ST段抬高型心肌梗死的病例。孕妇41岁,1岁时曾行心脏瓣膜手术,无高血压、糖尿病、吸烟、饮酒及冠状动脉性心脏病家族史等危险因素。2021年6月1日孕31周^(+1)突发胸痛4 h,急诊转至北京大学第一医院... 详细信息

本文报道1例冠状动脉夹层导致孕妇急性ST段抬高型心肌梗死的病例。孕妇41岁,1岁时曾行心脏瓣膜手术,无高血压、糖尿病、吸烟、饮酒及冠状动脉性心脏病家族史等危险因素。2021年6月1日孕31周^(+1)突发胸痛4 h,急诊转至北京大学第一医院。心电图提示Ⅰ、aVL、V_(2)~V_(6)导联ST段抬高;血生化检查示高敏心肌肌钙蛋白I、肌酸激酶-MB升高;超声心动图提示节段性室壁运动不良(心尖部),左心室功能减低,诊断为急性前壁ST段抬高型心肌梗死。急诊行冠状动脉造影和经皮冠状动脉介入术,确诊冠状动脉夹层,术后予抗血小板、抗凝及支持治疗。孕34周+3急性前壁ST段抬高型心肌梗死病情相对稳定,行剖宫产顺利分娩。产后定期心内科随诊,出院2年随访心功能基本正常。

关键词：冠状动脉夹层急性ST段抬高型心肌梗死妊娠孕晚期

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Maternal-Fetal Medicine:The Journey Thus Far and Way Forward

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Maternal-Fetal Medicine 2022年第1期4卷 1-2页

作者： yang Pan huixia yang Editorial Office of Maternal-Fetal Medicine Chinese Medical Association Publishing HouseBeijing 100052China Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus Beijing 100034China

As we shortly welcome the New Year,we are very pleased to share with you that Maternal-Fetal Medicine(MFM)has had another productive year and has reached another milestone with over 70,000 readings and downloads since its inauguration in July *** addition to its inclusion into the DOAJ in 2020,MFM has also been accepted by three other major medical databases,including EMBASE,SCOPUS,and ESCI.

关键词： DOAJ Medicine Forward

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