Medicine
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Observational Study
Pregnancy outcomes in patients with pulmonary arterial hypertension: A retrospective study.
The mortality of pregnant women with pulmonary arterial hypertension (PAH) remains high. The aim of this study was to evaluate and analyze perinatal and postpartum outcomes in patients with PAH. A total of 79 pregnant patients with PAH who underwent abortion or parturition were reviewed retrospectively. ⋯ Overall, 55 (96.5%) patients delivered by cesarean section and 2 (3.5%) delivered vaginally. There were 7 fetal deaths - 6 in the severe PAH group and one in the mild PAH group (6/24 vs 1/30). Although the mortality rate of this group of women with PAH was lower than that previously reported, patients with PAH should still be advised against pregnancy.
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Epidemiology of type 2 diabetes (T2D) is affected by genetic and environmental factors. Deoxyribonucleic acid (DNA) methylation as a kind of epigenetic mechanism has been reported to affect the pathogenesis of T2D. Both global DNA methylation and candidate genes were observed differentially methylated and identified changes. Peripheral blood biomarkers could have significant clinical utility due to the noninvasive operation and showed efficacy in measuring T2D-related DNA methylation. Moreover, due to the reversible feature of DNA methylation, it can be an effective therapy for T2D. ⋯ This study will be conducted according to the preferred reporting items for systematic review and meta-analysis protocols 2015 statement. The protocol of this systematic review and meta-analysis was registered on international platform of registered systematic review and meta-analysis protocols (No. 202040136). The following electronic bibliographic databases will be searched from inception: EMBASE, MEDLINE, Web of Science, Cochrane Central, China National Knowledge Infrastructure, Wanfang and China Science and Technology Journal Database, and Clinical Trials (ClinicalTrials.gov). A search strategy will be developed using a combination of medical subheadings words and keywords related to T2D, human peripheral blood, and DNA methylation. Two reviewers will screen the literature, and a third reviewer will adjudicate in case of disagreements. All the data will be extracted by 2 independent reviewers. The Cochrane Risk of Bias Assessment Tool will be used to assess the bias of randomized controlled studies, and the Newcastle-Ottawa scale for nonrandomized controlled studies. All the assessment will be investigated by 2 independent reviewers. The overall quality of extracted data will be assessed by using the grading of recommendations, assessment, development, and evaluation assessment tool. Disagreements and conflicts will be resolved by discussing it with a third reviewer. The narrative synthesis and meta-analysis of all evidence will be performed as the main findings analyzed.
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Psoriasis vulgaris (PV) is a refractory and relapsing skin disease that affects the physical and mental health of patients and leads to poor quality of life. Current conventional systemic therapy shows a large side effect, which can not be used for a long time, easy to relapse after drug withdrawal, long-term efficacy is poor. At present, traditional Chinese medicine treatment of psoriasis vulgaris effective, can alleviate symptoms, improve the quality of life, stabilize the condition, prolong the remission period. Whereas, there is no related systematic review and meta-analysis. Thus, we intend to conduct a systematic review and meta-analysis to testify autologous blood or autologous serum acupoint injection therapy for Psoriasis Vulgaris. ⋯ INPLASY202040052.
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Some muscular dystrophies may have a negative impact on fertility. A decreased ovarian reserve is 1 of the factors assumed to be involved in fertility impairment. AMH (anti-Müllerian hormone) is currently considered the best measure of ovarian reserve. ⋯ The MD1 group shows a significant decrease of AMH values (median 0.7 ng/mL; range 0 - 4.9 ng/mL) compared with age-matched healthy controls (P < .01). AMH levels were similar between patients and controls in terms of females with MD2 (P = .98), FSHD (P = .55) and cDMD (P = .60). This study suggests decreased ovarian reserve in women with MD1, but not in MD2, FSHD and cDMD.
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Few studies have paid attention to the performances of non-invasive models in diagnosing stages of liver fibrosis and inflammation, which are critical for early and accurate assessment of prognostication and decisions on antiviral treatment in chronic hepatitis B infection patients with high hepatitis B virus DNA and normal or mildly elevated alanine transaminase levels (≤2 times upper limit of normal (ULN)). This study aimed to investigate the value of routine serum markers in evaluation of liver inflammation and fibrosis in these patients. A total of 370 consecutive chronic hepatitis B virus-infected patients who underwent liver biopsy were retrospectively analyzed. ⋯ To predict severe fibrosis (≥ S3), the AUROC of FIB-4 was higher than that of RPR (0.805 vs 0.750, P = .006) and GP (0.805 vs 0.755, P = .046), comparable to that of APRI (0.805 vs 0.785, P = .550) and GPR (0.805 vs 0.818, P = .694). As for significant liver histological changes (G ≥ 2 or/and S ≥ 2), the performance of APRI was higher than that of RPR (0.717 vs 0.652, P = .006), GP (0.717 vs 0.659, p = .011), equivalent to that of FIB-4 (0.717 vs 0.692, P = .254) and GPR (0.717 vs 0.680, P = .166). We found that APRI, GPR, and FIB-4 were more effective than RPR and GP for diagnosing liver inflammation and fibrosis.