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Risk factors for postpartum posttraumatic stress disorder after emergency admission

World Journal of Emergency Medicine 2024年第2期15卷 121-125页

作者： Fengxia Du Jun Zha Yan Li Lichao Fang Shuyu Xia youjia yu Department of Obstetrics Suzhou Xiangcheng People’s HospitalSuzhou 215131China Department of Anesthesiology the Second Affiliated Hospital of Wannan Medical CollegeWuhu 241000China Department of Anesthesiology Suzhou Xiangcheng People’s HospitalSuzhou 215131China Department of Emergency and Intensive Care Unit Suzhou Xiangcheng People’s HospitalSuzhou 215131China

BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.

关键词： Risk factors Posttraumatic stress disorder Emergency Delivery

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Exosome Biomarkers in Cardiovascular Diseases and their Prospective Forensic Application in the Identification of Sudden Cardiac Death

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Journal of Forensic Science and Medicine 2022年第4期8卷 170-178页

作者： Ye Wang Jie Wang Li Hu Shuainan Huang yue Cao youjia yu Feng Chen Department of Forensic Medicine Nanjing Medical UniversityNanjingChina Key Laboratory of Targeted Intervention of Cardiovascular Disease Collaborative Innovation Center for Cardiovascular Disease Translational MedicineNanjing Medical UniversityNanjingChina

Sudden cardiac death(SCD)is a common cause of death due to the high prevalence and mortality of cardiovascular disease(CVD).Currently,the forensic identification of SCD relies on traditional histomorphological examination,lacking stable biomarkers with high specificity and sensitivity.Previous studies have shown that exosomes(Exos)are ideal vectors and the application of Exos provides novel insight as the diagnostic biomarkers and treatment of CVD,and is hot research filed in biomedicine.This review briefly describes the biology of Exos,including the biogenesis of Exos and the mechanisms of action.The research progresses on Exos multi‑omics,i.e.,genomics,proteomics and metabolomics,and their roles in the diagnosis of different types of CVD,especially coronary heart disease and cardiomyopathy,are summarized.In addition,the current difficulties of applications of Exos in forensic identification of SCD and the prospective forensic applications in the future are highlighted.The aim of this review is to summarize the current advances of Exos in CVD in a disease‑oriented manner,and to provide a reference for future forensic pathological identification of SCD,as well as the early diagnosis of SCD in clinic.

关键词： Cardiovascular disease cause of death exosomes forensic pathology sudden cardiac death

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Sudden Cardiac Death Due to Long QT Syndrome

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Journal of Forensic Science and Medicine 2022年第4期8卷 190-193页

作者： Jiayi Wu Wei Tang Kai Zhang Kai Li Jianwen Wang youjia yu Feng Chen Department of Forensic Medicine Nanjing Medical UniversityNanjingChina Department of Forensic Medicine Forensic Expertise Institute of Nanjing Medical UniversityNanjingChina Key Laboratory of Targeted Intervention of Cardiovascular Disease Collaborative Innovation Center for Cardiovascular Disease Translational MedicineNanjing Medical UniversityNanjingChina

Identification of sudden cardiac death(SCD)with a structurally normal heart remains an important challenge in forensic pathology.Long QT syndrome(LQTS)is known as an inherited or acquired channelopathy,which is characterized with prolonged QT interval,and is likely to cause SCD in young adults.In this circumstance,no specific pathological change in the heart can be found anatomically or histologically in the LQTS victims.Thus,postmortem LQTS diagnosis is mainly based on clinical manifestations and genetic testing.Here,we reported a 26‑year‑old woman who was found dead at home with a history of unexplained syncope.Her clinical records and an electrocardiograph(ECG)obtained 3 months before her death showed a QTc interval of 539 ms which implicates the diagnosis of LQTS.Although the autopsy and pathological examination findings lacked specificity,we noticed enhanced lipofuscin accumulation in cardiomyocytes,which might be related to LQTS.After excluding potential diseases and injuries,we made the postmortem diagnosis as LQTS according to ECG,clinical history,and forensic postmortem findings.In conclusion,we provided clinical and pathological features of an SCD case due to LQTS,which might enrich the understanding of forensic postmortem SCD diagnosis with nonstructural cardiac diseases.

关键词： Electrocardiograph long QT syndrome QT interval sudden cardiac death

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The histopathological features of the explanted lungs from an end-stage COVID-19 patient

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Forensic Sciences Research 2020年第4期5卷 348-350页

作者： Kai Li youjia yu Ding Li Changxing Luan Li Hu Jie Wang Jingjing Ding Yanfang yu Hang Yang Jingyu Chen Feng Chen Chuan Su Department of Forensic Medicine Nanjing Medical UniversityNanjingChina Wuxi Lung Transplantation Center Wuxi People's Hospital Affiliated with Nanjing Medical UniversityWuxiChina Key Laboratory of Targeted Intervention of Cardiovascular Disease Collaborative Innovation Center for Cardiovascular Disease Translational MedicineNanjing Medical UniversityNanjingChina Department of Pathogen Biology and Immunology Jiangsu Key Laboratory of Pathogen BiologyNanjing Medical UniversityNanjingChina

Although the pathological findings of coronavirus disease 2019(COVID-19)associated with acute respiratory distress syndrome(ARDS)have been reported in previous studies,the data of histopatho-logical features of end-stage COVID-19 lungs are still lacking.We have previously reported the clini-cal features and managements of three COVID-19 patients with irreversible deterioration of pulmonary function who received lung transplantation(LT)after being supported by extracorporeal membrane oxygenation(ECMO)[1].

关键词： distress acute respiratory

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带状疱疹后神经痛患者介入治疗预后不良的危险因素和预测模型构建

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中华麻醉学杂志 2024年第4期44卷 442-446页

作者：俞又佳袁俊鹏徐慧婵李艳宋绍永金晓红苏州大学附属第四医院疼痛科苏州215125 苏州市相城人民医院麻醉疼痛科苏州215131 苏州大学附属第一医院疼痛科苏州215006 苏州大学医学中心苏州215125

目的筛选带状疱疹后神经痛(PHN)患者介入治疗预后不良的危险因素并构建预测模型。方法回顾性收集2020年3月至2023年8月在苏州大学附属第一医院行介入治疗的PHN患者的病历资料,包括患者基本信息、既往病史和手术史、症状、药物治疗情况... 详细信息

目的筛选带状疱疹后神经痛(PHN)患者介入治疗预后不良的危险因素并构建预测模型。方法回顾性收集2020年3月至2023年8月在苏州大学附属第一医院行介入治疗的PHN患者的病历资料,包括患者基本信息、既往病史和手术史、症状、药物治疗情况、临床疼痛评分、介入治疗前中性粒细胞/淋巴细胞比值(NLR)和介入治疗方法等。采用logistic回归分析筛选PHN患者介入治疗预后不良的危险因素,构建预后不良的列线图预测模型。采用C指数和Hosmer-Lemeshow检验评价列线图预测模型的区分度和校准度。绘制校准曲线和临床决策曲线进一步验证预测模型的准确性。结果多因素logistic回归分析结果显示:年龄增长、病程延长、NLR增高、使用免疫抑制剂和脉冲射频治疗是PHN患者介入治疗预后不良的独立危险因素(P<0.05)。基于此构建的PHN介入治疗预后不良列线图预测模型C指数为0.844;校准曲线显示:预测预后不良概率与实际预后不良发生率的一致性较好;临床决策曲线显示:在该预测模型中,准确性和净获益较好。结论年龄增长、病程延长、NLR增高、使用免疫抑制剂和脉冲射频治疗是PHN患者介入治疗预后不良的独立危险因素,基于此构建的列线图预测模型可有效预测PHN患者介入治疗预后不良的发生。

关键词：神经痛,带状疱疹后预后危险因素预测介入治疗

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A novel long-term intravenous combined with local treatment with human amnion-derived mesenchymal stem cells for a multidisciplinary rescued uremic calciphylaxis patient and the underlying mechanism

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Journal of Molecular Cell Biology 2022年第2期14卷 56-71页

作者： Lianju Qin Jing Zhang yujie Xiao Kang Liu yugui Cui Fangyan Xu Wenkai Ren Yanggang yuan Chunyan Jiang Song Ning Xiaoxue Ye Ming Zeng Hanyang Qian Anning Bian Fan Li Guang Yang Shaowen Tang Zhihong Zhang Juncheng Dai Jing Guo Qiang Wang Bin Sun Yifei Ge Chun Ouyang Xueqiang Xu Jing Wang Yaoyu Huang Hongqing Cui Jing Zhou Meilian Wang Zhonglan Su Yan Lu Di Wu Jingping Shi Wei Liu Li Dong Yinbing Pan Baiqiao Zhao Ying Cui Xueyan Gao Zhanhui Gao Xiang Ma Aiqin Chen Jie Wang Meng Cao Qian Cui Li Chen Feng Chen youjia yu Qiang Ji Zhiwei Zhang Mufeng Gu Xiaojun Zhuang Xiaolin Lv Hui Wang Yanyan Pan Ling Wang Xianrong Xu Jing Zhao Xiuqin Wang Cuiping Liu Ningxia Liang Changying Xing Jiayin Liu Ningning Wang State Key Laboratory of Reproductive Medicine Center of Clinical Reproductive MedicineThe First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Nephrology The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Epidemiology and Biostatistics School of Public HealthNanjing Medical UniversityNanjing 211166China Department of Pathology The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Cardiology The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Rheumatology The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Obstetrics The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Dermatology The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Burn and Plastic Surgery The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Nuclear Medicine The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Infection The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Anesthesiology and Pain Management The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Nephrology The First People’s Hospital of LianyungangLianyungang 222061China Department of Nephrology Northern Jiangsu People’s HospitalYangzhou 225001China Department of General Medicine Geriatric Hospital of Nanjing Medical UniversityNanjing 210024China Department of Nephrology BenQ Medical CenterThe Affiliated BenQ Hospital of Nanjing Medical Uni

Calciphylaxis is a rare disease characterized histologically by microvessel calcification and microthrombosis,with high mortality and no proven therapy.Here,we reported a severe uremic calciphylaxis patient with progressive skin ischemia,large areas of painful malodorous ulcers,and mummified legs.Because of the worsening symptoms and signs refractory to conventional therapies,treatment with human amnion-derived mesenchymal stem cells(hAMSCs)was approved.Preclinical release inspections of hAMSCs,efficacy,and safety assessment,including cytokine secretory ability,immunocompetence,tumorigenicity,and genetics analysis in vitro,were introduced.We further performed acute and long-term hAMSC toxicity evaluations in C57BL/6 mice and rats,abnormal immune response tests in C57BL/6 mice,and tumorigenicity tests in neonatal Balbc-nu nude mice.After the preclinical research,the patient was treated with hAMSCs by intravenous and local intramuscular injection and external supernatant application to the ulcers.When followed up to 15 months,the blood-based markers of bone and mineral metabolism improved,with skin soft tissue regeneration and a more favorable profile of peripheral blood mononuclear cells.Skin biopsy after 1-month treatment showed vascular regeneration with mature noncalcified vessels within the dermis,and 20 months later,the re-epithelialization restored the integrity of the damaged site.No infusion or local treatment-related adverse events occurred.Thus,this novel long-term intravenous combined with local treatment with hAMSCs warrants further investigation as a potential regenerative treatment for uremic calciphylaxis due to effects of inhibiting vascular calcification,stimulating angiogenesis and myogenesis,anti-inflammatory and immune modulation,multidifferentiation,re-epithelialization,and restoration of integrity.

关键词： calciphylaxis chronic kidney disease vascular calcification multidisciplinary rescue human amnion-derived mesenchymal stem cells preclinical research regenerative medicine

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Co_2O_3-doping Effect on the Formation of 3CaO 3Al_2O_3 CaSO_4

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Journal of Wuhan University of Technology(Materials Science) 2013年第2期28卷 347-351页

作者：郭惠玲谢峻林 TAN Chang yu youjia RAO Chengcheng Department of Pharmacy College of Bioengineering Hubei University of Technology Key Laboratory for Silicate Materials Science and Engineering of Ministry of Education Wuhan University of Technology

The Co2O3-doping effect on the formation of 3CaO · 3A12O3· CaSO from CaCO3-A12O3-CaSO4, 2H20 mixtures was investigated by means of SO2 emission behavior, chemical analysis, X-ray diffraction, differential thermal analysis and scanning electron microscopy. The experimental results show that CO2O3 addition increases the reactivity of the CaCO3-A12O3-CaSO4·2H2O system significantly, by reducing SO2 emissions in combustion andf-CaO contents in the clinkers, promoting the nucleation and growth of 3CaO·3A12O3-CaSO4, and intensifying the formation of 3CaO·3A12O3·CaSO4. Moreover, CO2O3 addition lowers the formation temperature of 3CaO·3A12O3·CaSO4 by 18 ℃, and similarly increases the thermal stability of it at a wider temperature range.

关键词： 3CaO · 3A12O3· CaSO Co2O3 SO2 emission thermal analysis

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术前血浆氧化三甲胺浓度与老年患者术后谵妄的关系

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中华麻醉学杂志 2023年第8期43卷 942-945页

作者：薄惠龙查俊顾琴俞又佳李艳苏州市相城人民医院麻醉科苏州215131 皖南医学院第二附属医院麻醉科芜湖241000

目的:评价术前血浆氧化三甲胺(TMAO)浓度与老年患者术后谵妄(POD)的关系。方法:选取择期髋关节置换术患者180例,年龄≥65岁,ASA分级Ⅱ或Ⅲ级,BMI 17~30 kg/m^(2)。术前1 d采集静脉血样,采用高通量液相色谱-串联质谱法检测血浆TMAO浓度,... 详细信息

目的:评价术前血浆氧化三甲胺(TMAO)浓度与老年患者术后谵妄(POD)的关系。方法:选取择期髋关节置换术患者180例,年龄≥65岁,ASA分级Ⅱ或Ⅲ级,BMI 17~30 kg/m^(2)。术前1 d采集静脉血样,采用高通量液相色谱-串联质谱法检测血浆TMAO浓度,根据血浆TMAO浓度水平按三分位数分为3组:低水平组(L组,≤1.2μmol/L)、中水平组(M组,1.3~1.9μmol/L)、高水平组(H组,≥2.0μmol/L)。均采用腹股沟上髂筋膜间隙阻滞联合静脉全身麻醉。于术后1、2、3和7 d时采用中文版意识模糊评估量表诊断POD,根据患者是否发生POD,分为POD组和非POD组。采用二元logistic回归分析评价不同血浆TMAO浓度与POD的关系。采用受试者工作特征(ROC)曲线评价血浆TMAO浓度对POD发生的预测效能。结果:L组60例,M组67例,H组53例,POD发生率分别为12%、22%和32%。H组POD发生率高于L组(P<0.05)。POD组血浆TMAO浓度高于非POD组(P<0.05)。logistic回归分析显示,H组POD发生风险是L组的3.91倍(P<0.05)。术前血浆TMAO浓度预测POD的ROC曲线下面积为0.754(95%CI 0.671~0.838,P<0.05),约登指数为0.426时,血浆TMAO浓度最佳截断值为1.625μmol/L,特异度和灵敏度分别为0.795和0.631。结论:术前血浆TMAO浓度增高的老年患者POD的发生风险升高,且其对POD具有较好的预测价值。

关键词：老年人谵妄手术后并发症氧化三甲胺

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右美托咪定对丙泊酚增强创伤后应激障碍大鼠恐惧记忆效应的影响

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中华麻醉学杂志 2022年第2期42卷 231-234页

作者：俞又佳王鑫怡姚瑞朱杨子苏州市相城人民医院麻醉科苏州215131 徐州市第一人民医院麻醉科徐州221002 徐州市中心医院麻醉科徐州221009

目的:评价右美托咪定对丙泊酚增强创伤后应激障碍(PTSD)大鼠恐惧记忆效应的影响。方法:清洁级健康雄性SD大鼠220只,体重300~400 g,12~16周龄,行条件性恐惧记忆训练,建立PTSD模型。取120只大鼠,采用随机数字表法分为6组(n=20):对照组(C组... 详细信息

目的:评价右美托咪定对丙泊酚增强创伤后应激障碍(PTSD)大鼠恐惧记忆效应的影响。方法:清洁级健康雄性SD大鼠220只,体重300~400 g,12~16周龄,行条件性恐惧记忆训练,建立PTSD模型。取120只大鼠,采用随机数字表法分为6组(n=20):对照组(C组)、PTSD组、丙泊酚组(P1组)、丙泊酚+右美托咪定不同给药剂量组(P1+DEX10组、P1+DEX20组和P1+DEX40组)。C组大鼠条件性恐惧记忆训练时仅播放声音,不予以电击;训练结束后,PTSD组腹腔注射芝麻油1 ml/kg,P1组腹腔注射丙泊酚1 ml/kg,P1+DEX10组、P1+DEX20组和P1+DEX40组分别腹腔注射右美托咪定10、20及40μg/kg。给药结束后行条件性恐惧记忆检测,记录大鼠90 s内僵立行为时间,计算僵立行为时间百分比。记录给药期间SpO_(2)0.05)。与P2组比较,P2+DEX T0和P2+DEX_(T30)组僵立行为时间百分比降低(P0.05)。结论:右美托咪定可减轻丙泊酚增强PTSD大鼠恐惧记忆的效应,中等剂量(20μg/kg)早期给药(给予丙泊酚后30 min内)的效果最佳。

关键词：右美托咪啶二异丙酚应激障碍创伤后恐惧记忆巩固

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Quantum Spin Exchange Interactions to Accelerate the Redox Kinetics in Li–S Batteries

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Nano-Micro Letters 2024年第5期16卷 370-383页

作者： yu Du Weijie Chen yu Wang yue yu Kai Guo Gan Qu Jianan Zhang Key Laboratory of Advanced Energy Catalytic and Functional Materials Preparation of Zhengzhou City College of Materials Science and EngineeringZhengzhou UniversityZhengzhou 450001People’s Republic of China

Spin-engineering with electrocatalysts have been exploited to suppress the“shuttle effect”in Li–S batteries.Spin selec-tion,spin-dependent electron mobility and spin potentials in activation barriers can be optimized as quantum spin exchange interactions lead-ing to a significant reduction of the electronic repulsions in the orbitals of catalysts.Herein,we anchor the MgPc molecules on fluorinated carbon nanotubes(MgPc@FCNT),which exhibits the single active Mg sites with axial displacement.According to the density functional theory calculations,the electronic spin polarization in MgPc@FCNT not only increases the adsorption energy toward LiPSs intermediates but also facilitates the tunneling process of electron in Li–S batter-ies.As a result,the MgPc@FCNT provides an initial capacity of 6.1 mAh cm^(-2) even when the high sulfur loading is 4.5 mg cm^(-2),and still maintains 5.1 mAh cm^(-2) after 100 cycles.This work provides a new perspective to extend the main group single-atom catalysts enabling high-performance Li–S batteries.

关键词： Metal phthalocyanines Spin polarization Electrocatalysis Li–S batteries

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