血管紧张素Ⅱ及血管紧张素Ⅱ1型受体反义寡核苷酸对心肌细胞bax、bcl-2基因表达

目的　探讨血管紧张素 (AngⅡ )及血管紧张素Ⅱ 1型受体 (AT1R)反义寡核苷酸 (AS ODN)对心肌细胞凋亡调节蛋白bax、bcl 2的影响。方法　将培养的乳鼠心肌细胞分为正常组、AngⅡ组、AT1R AS ODN组 :AngⅡ组用 10 - 6 mol/LAngⅡ刺激 2 4小时 ;AT1R AS ODN组在转染反义寡核苷酸后也用 10 - 6 mol/LAngⅡ刺激 2 4小时 ;正常组不予任何刺激。刺激 2 4小时后用免疫细胞化学方法观察AngⅡ及AT1R AS ODN对心肌细胞凋亡调节蛋白bcl 2、bax表达的影响。结果　与正常组相比 ,AngⅡ组心肌细胞bcl 2蛋白光密度值下降显著 (0 0 72 5± 0 0 0 65vs 0 0 975± 0 0 0 83 ,P <0 0 5) ,bax蛋白光密度值增加 (0 0 941± 0 0 0 42vs 0 0 82 3± 0 0 0 2 4,P <0 0 5) ;与AngⅡ组相比 ,AT1R AS ODN组bcl 2蛋白光密度值增加 (0 0 90 0± 0 0 0 16vs 0 0 72 5± 0 0 0 65,P <0 0 5) ,bax蛋白光密度值降低 (0 0 863± 0 0 0 19vs 0 0 941±0 0 0 42 ,P <0 0 5)。结论　AngⅡ可以诱导心肌细胞发生凋亡 ,而AT1R AS ODN可以逆转AngⅡ诱导的心肌细胞凋亡。     

波动性高糖对人脐静脉血管内皮细胞的损伤及其机制的研究

目的 观察波动性高糖在体外诱导人脐静脉血管内皮细胞(human umbilical vein endothelial cell,HUVEC)的损伤作用,并探讨其机制.方法 以HUVEC为研究对象,体外培养至第三代,实验分为:A组为正常组(正常培养的细胞),B组给予恒定加入5.5mmol/L 葡萄糖(Glu),C组给予恒定加入7.8mmol/L Glu,D组给予每24h轮换加入5.5mmol/L/7.8mmol/L Glu,E组给予恒定加入14.5mmol/L Glu,F组给予每24h轮换加入5.5mmol/L/14.5mmol/L Glu,G组给予恒定加入20mmol/L Glu,H组给予每24h轮换加入5.5mmol/L/20mmol/L Glu各组分别与HUVEC孵育5d,测定各组细胞液中的细胞活力(MTT)指标.测定正常对照组、恒定性高糖组(E组和G组)及波动性高糖组(F组和H组)细胞上清液中丙二醛(MDA)的含量、超氧化物歧化酶活力(SOD)、一氧化氮(NO)的含量、细胞间黏附分子-1(ICAM-1)含量及细胞凋亡率,并在显微镜下观察细胞形态变化.结果 培养液中SOD、NO的含量在波动性高糖组与恒定性高糖组均与对照组比较,差异有统计学意义(P＜0.05);培养液中MDA及ICAM-1的含量在波动性高糖组与恒定性高糖组均与对照组比较,差异有统计学意义(P＜0.05).波动性高糖与恒定性高糖均可导致HUVECs出现凋亡的形态学变化,波动性高糖组的凋亡率与恒定性高糖组比较,差异有统计学意义(P＜0.05).结论 (1)波动性高糖和恒定性高糖对人脐静脉血管内皮细胞均有损伤,且波动性高糖对其损伤更大.(2)波动性高糖体外诱导人脐静脉血管内皮细胞损伤的机制可能与其氧化应激水平更高,炎症反应加重及细胞凋亡率增加有关.     

氟美松对嗜酸粒细胞凋亡的作用及其机制

目的　探讨氟美松对体外嗜酸粒细胞凋亡的作用及其机制。方法　在不同浓度白细胞介素 (IL) 5和氟美松的条件下体外培养嗜酸粒细胞 ,锥虫蓝拒染法和原位凋亡检测法观察嗜酸粒细胞凋亡的变化及嗜酸粒细胞凋亡抑制基因bcl 2表达的变化。结果　IL 5显著抑制嗜酸粒细胞凋亡 ,氟美松呈浓度和时间依赖性抑制IL 5介导的嗜酸粒细胞存活 ,10 -6mol/L氟美松显著抑制 1× 10 4 U/LIL 5介导的嗜酸粒细胞存活 ,培养 3d嗜酸粒细胞存活率为 (7± 3) % (P <0 .0 1) ,抑制率达 (90± 4) %。IL 5使嗜酸粒细胞bcl 2表达增强 ,氟美松对此具有抑制作用。但高浓度的IL 5 (1× 10 6U/L)可抑制氟美松的凋亡诱导作用。结论　氟美松具有诱导嗜酸粒细胞凋亡的作用 ,其机制可能与抑制嗜酸粒细胞bcl 2表达有关。     

卡维地洛对大鼠缺血再灌注心肌细胞凋亡及基因表达的影响

目的 :研究卡维地洛对缺血再灌注心肌细胞凋亡及bcl 2、bax基因表达的影响 ,探讨卡维地洛抑制缺血再灌注心肌细胞凋亡的可能分子机制。方法 :结扎Wistar大鼠左冠状动脉前降支 (LAD) ,建立大鼠缺血再灌注动物模型。 30只大鼠分 3组 (每组 10只 ) :卡维地洛组 (卡维地洛治疗 )、缺血再灌注组和假手术组。用Tunnel法检测心肌细胞凋亡 ,并用光学显微镜进行细胞计数 ,免疫组化和原位杂交法检测bcl 2、bax基因表达 ,并利用图像分析系统检测二者的平均光密度值 (A值 ) ,进行定量分析。结果 :心肌细胞凋亡数在缺血再灌注组、假手术组和卡维地洛组分别为 36 .8± 9.0、0 .2± 0 .1和 9.5± 3.0 ,各组间差异有统计学意义 (P <0 .0 1)。缺血再灌注组、假手术组和卡维地洛组的bcl 2mRNAA值分别为 0 .0 6± 0 .0 1、0 .0 8± 0 .0 1和 0 .0 9± 0 .0 1,bcl 2蛋白平均A值分别为0 .0 8± 0 .0 2、0 .14± 0 .0 1和 0 .15± 0 .0 3,卡维地洛组与缺血再灌注组相比差异无统计学意义 (P >0 .0 5 ) ;缺血再灌注组bax蛋白的平均A值为 0 .13± 0 .0 2 ,假手术组为 0 .0 7± 0 .0 1,卡维地洛组为 0 .0 6± 0 .0 1,卡维地洛组与缺血再灌注组相比差异有统计学意义 (P <0 .0 5 ) ,bcl 2 /bax蛋白比值在缺血再灌注组、假手术组和卡     

神经肽Y诱导血管平滑肌细胞凋亡相关基因表达与细胞内液pH变化的关系

为探讨细胞内液pH在神经肽Y诱导血管平滑肌细胞凋亡过程中的变化 ,以体外培养血管平滑肌细胞模型为研究对象 ,运用激光共聚焦显微镜和免疫荧光组织化学技术 ,定量和动态观察研究神经肽Y诱导血管平滑肌细胞凋亡相关基因bcl 2和bax表达与细胞内液pH变化之间的关系。结果发现 ,在神经肽Y作用下 ,体外培养的血管平滑肌细胞凋亡相关基因bcl 2和bax表达的平均荧光值分别为 134 9.6 7± 10 8.2 8和 1397.5 0± 10 4.43,与对照组的 986 .6 4± 91.2 2和 10 6 0 .44± 10 7.5 4相比 ,差异明显 (P <0 .0 1) ,bax与bcl 2两者平均荧光值之比为 1.0 4;神经肽Y还可降低血管平滑肌细胞内液pH的平均荧光值 ,使细胞浆酸化。此结果提示 ,神经肽Y诱导血管平滑肌细胞凋亡相关基因的表达与神经肽Y降低细胞内液酸碱度、细胞浆酸化有关。     

吲哚美辛诱导胃癌细胞凋亡的机制研究

目的 :研究非甾体类抗炎药吲哚美辛诱导人胃癌细胞系SGC 790 1的凋亡作用及对COX 2mRNA表达及c myc、bcl 2、cas pase 3凋亡基因蛋白的表达 ,以探索其凋亡机制。方法 :胃癌细胞的凋亡用电子显微镜、AnnexinV FITC染色流式细胞仪技术测定。COX 2基因表达用RT PCR法测定。c myc、bcl 2和caspase 3蛋白表达用免疫细胞化学技术测定。结果 :吲哚美辛在浓度为 50 μmol/L时作用48、72h和浓度为 1 0 0和 2 0 0 μmol/L时作用 2 4、48、72h均可诱导胃癌细胞凋亡 ,凋亡率分别为 6 .48%、8.2 0 % ;9.1 4 %、1 2 .2 7%、1 5 .1 1 %和 9.95 %、1 4 .70 %、1 9.81 % ,呈浓度和时间依赖性。吲哚美辛可降低COX 2mRNA表达和bcl 2蛋白表达 ,增加c myc和caspase 3蛋白表达。 2 0 0 μmol/L吲哚美辛作用 72h ,bcl 2、c myc和caspase 3蛋白表达阳性率分别为 2 2 .8± 6 .5 %、42 .5± 1 3 .1 %和 31 8± 1 2 .7% ;对照组为 44 .6± 1 0 .1 %、2 4 .74± 9.5 %和 1 4 .8± 6 .4%。两者比较 ,差异有显著性 (P <0 .0 1 )。结论 :吲哚美辛可诱导胃癌细胞SGC 790 1凋亡 ,其机制涉及bcl 2表达下调、c myc表达上调及caspase 3激活。说明多基因调控参与其中     

别嘌呤醇对高糖诱导损伤的人脐静脉血管内皮细胞的保护作用

目的探讨别嘌呤醇对高糖损伤后的人脐静脉血管内皮细胞（HUVEC）的保护作用及其机制。方法以HUVEC为研究对象,体外培养至第三代,分为：①20mmol／L高糖损伤对照组;②别嘌呤醇保护组（浓度分别为0．1mmol／L、0．2mmol／L、0．3mmol／L）;③维生素C阳性对照组（浓度为100mg／L）。不同浓度别嘌呤醇及维生素C先与HUVEC孵育24h,再加入20mmol／L高糖诱导损伤48h,测定各组细胞上清液中一氧化氮（NO）、丙二醛（MDA）、超氧化物歧化酶（SOD）、细胞间黏附分子-1（ICAM-1）含量及细胞凋亡率。结果别嘌呤醇（0．1mmol／L、0．2mmol／L、0．3mmol／L）药物保护组的细胞凋亡率低于20mmol／L高糖组,其中以0．3mmol／L更为明显（P〈0．01）;细胞培养液中SOD、NO的量均较20mmol／L高糖组增高,其中以0．3mmd／L别嘌呤醇组更为明显（P〈0．01）。药物保护组细胞培养液中合成MDA、ICAM-1较波动性高糖组降低,且在一定浓度范围内（0．05-49．30mmol／L）呈浓度依赖性（P〈0．05）。结论①别嘌呤醇对高糖体外诱导的HUVEC损伤有保护作用,呈浓度依赖性。②别嘌呤醇对高糖体外诱导HUVEC损伤保护作用的机制包括抑制氧化应激、炎症反应及细胞凋亡。     

非甾体抗炎药对胃癌细胞凋亡的诱导及相关基因表达的调控

目的明确非甾体抗炎药(NSAID)对胃癌细胞凋亡的影响及凋亡相关基因表达的调控。方法应用MTT比色法检测NSAID对胃癌细胞生长活力的影响;吖啶橙/溴化乙锭(AO/EB)双染色、AnnexinV/PI双染色、共聚焦显微镜、流式细胞术检测细胞凋亡;RTPCR、Westernblot法检测凋亡相关基因bcl2、bax表达水平的改变。结果吲哚美辛(Indo)和阿司匹林(Asp)对胃癌细胞株AGS均有生长抑制作用,且呈时间/浓度依赖性;在药物作用6～24h生长抑制率改变最为明显;NSAID使AGS细胞发生细胞凋亡的形态学改变,Indo800μmol/L作用24h凋亡率为9.34%±1.99%,48h为38.97%±3.36%;Asp8mmol/L48h凋亡率为17.60%±3.30%,Indo的凋亡诱导作用更为明显;随着药物作用时间的延长,bcl2mRNA表达逐渐减弱,bax基因及蛋白表达逐渐增强,在药物作用6～24h改变最为明显,Bcl2蛋白未检测到。结论NSAID可诱导胃癌细胞凋亡,为NSAID的抗肿瘤应用提供了理论依据;NSAID可能通过调控bcl2、bax的基因及蛋白水平而诱导凋亡。     

三氧化二砷体外对人卵巢上皮癌细胞3AO增殖及凋亡的影响

目的　探讨三氧化二砷 (As2 O3 )体外对人卵巢上皮癌细胞株 3AO增殖和凋亡的影响及其作用机制。方法　将人卵巢上皮癌细胞株 3AO与不同浓度的As2 O3 进行体外培养 ,采用四甲基偶氮唑蓝(MTT)测定不同浓度As2 O3 对 3AO细胞的生长抑制率 ,采用流式细胞技术检测细胞凋亡率、细胞周期时相及其Fas、FasL、P53 和bcl 2蛋白的表达。结果　 0 2 5～ 8 0 μmol /L浓度的As2 O3 均显著抑制3AO细胞的增殖 ,且随浓度升高及作用时间的延长 ,抑制率上升 ,As2 O3 与 3AO细胞联合培养 4 8小时的半数致死量 (IC50 )为 (3 90± 0 2 0 ) μmol /L。 0 2 5～ 4 0 μmol /L浓度的As2 O3 均诱导 3AO细胞凋亡 ,随浓度升高 ,凋亡率上升。As2 O3 阻滞 3AO细胞停滞于S期 ,并诱导细胞凋亡。As2 O3 (2 μmol/L )培养3AO细胞 4 8小时 ,Fas蛋白表达率为 (4 6 76± 4 5 0 ) % ,明显高于对照组的 (6 36± 0 82 ) % ,差异有显著性(P <0 0 5 ) ,FasL、P53 和bcl 2蛋白表达无明显变化 (P >0 0 5 )。结论　As2 O3 以剂量 时间依赖性方式抑制人卵巢上皮癌细胞 3AO增殖并诱导其凋亡 ,其作用机制与上调Fas基因表达有关。     

瑞格列奈和拜糖平对2型糖尿病降糖作用的比较

目的　比较瑞格列奈和拜糖平治疗 2型糖尿病时的降糖作用。方法　将 5 6例 2型糖尿病患者分为瑞格列奈组 3 2例和拜糖平组 2 4例 ,观察治疗 8周。定期检测患者的空腹及餐后血糖、HbA1c、C肽和体重。结果　瑞格列奈组的空腹血糖从 (11.0 1± 1.63 )mmol/L降至 (6.73±1.47)mmol/L(P <0 .0 1) ,平均下降了 3 .47mmol/L ;拜糖平组空腹血糖从 (10 .43± 0 .5 3 )mmol/L降到 (7.0 5± 1.2 1)mmol/L (P <0 .0 1) ,平均下降了 2 .84mmol/L。瑞格列奈组的餐后血糖从(13 .98± 2 .5 6)mmol/L降至 (8.67± 2 .5 9)mmol/L(P <0 .0 1) ,拜糖平组的餐后血糖从 (14 .17±3 .71)mmol/L降至 (8.80± 2 .14 )mmol/L(P <0 .0 1)。瑞格列奈和拜糖平都能明显降低HbA1c(P <0 .0 1) ,分别降低 1.16%和 0 .91%。两药对C肽和体重均无明显影响。结论　瑞格列奈和拜糖平均有明显的降低空腹和餐后血糖以及HbA1c的作用。瑞格列奈降空腹血糖的作用优于拜糖平 ,两种药物对餐后血糖和HbA1c的降低程度相似。     

Anti-malarial efficacy of pyronaridine and artesunate in combination in vitro and in vivo

Pyronaridine is a Mannich base anti-malarial with demonstrated efficacy against drug resistant Plasmodium falciparum, P. vivax, P. ovale and P. malariae. However, resistance to pyronaridine can develop quickly when it is used alone but can be considerably delayed when it is administered with artesunate in rodent malaria models. The aim of this study was to evaluate the efficacy of pyronaridine in combination with artesunate against P. falciparum in vitro and in rodent malaria models in vivo to support its clinical application. Pyronaridine showed consistently high levels of in vitro activity against a panel of six P. falciparum drug-sensitive and resistant strains (Geometric Mean IC50=2.24 nM, 95% CI=1.20-3.27). In vitro interactions between pyronaridine and artesunate showed a slight antagonistic trend, but in vivo compared to pyronaridine and artesunate administered alone, the 3:1 ratio of the combination, reduced the ED90 of artesunate by approximately 15.6-fold in a pyronaridine-resistant P. berghei line and by approximately 200-fold in an artesunate-resistant line of P. berghei. Complete cure rates were achieved with doses of the combination above or equal to 8 mg/kg per day against P. chabaudi AS. These results indicate that the combination had an enhanced effect over monotherapy and lower daily doses of artesunate could be used to obtain a curative effect. The data suggest that the combination of pyronaridine and artesunate should have potential in areas of multi-drug resistant malaria.     

Parameters of anorectal and colonic motility in health and in severe constipation

Anorectal function and colonic transit was assessed in 17 severely constipated patients and 15 age-matched controls. The constipated patients were divided into those who had immobile perineum (perineal descent 1.0 cm during attempted defecation) and those who had a normal descent (>1.0 cm) of the perineum. When constipation was accompanied by an immobile perineum, patients had impaired balloon expulsion, impaired and delayed artificial stool expulsion, decreased straightening of the anorectal angle, decreased descent of the pelvic floor with defecation, and prolonged rectosigmoid colon transit compared with the patients with constipation who had a mobile perineum and with normal controls. The mobile-perineum group differed from controls only in colon transit times, having prolonged total colon transit. Anal sphincter resting pressures, immediate artificial stool expulsion, resting anorectal angles, and electromyography of the external anal sphincter and puborectalis did not differentiate the constipated patients from the controls. We concluded that descent of the perineum of <1 cm was associated with impaired expulsion, an adynamic anorectal angle, and slowed distal colon transit. This simple sign of pelvic floor function distinguished constipated patients with disordered expulsion from constipated patients with normal pelvic floor function. These patients may respond poorly to surgery and conventional management and would therefore be candidates instead for pelvic floor retraining. Accurate characterization and appreciation of pelvic floor dysfunction in patients with severe chronic constipation may improve the selection for and results of surgical and nonsurgical intervention.Supported in part by Research Grants DK37990, RR585, and DK34988 from the National Institutes of Health and by the Mayo Foundation, Rochester, Minnesota.     

Effects of dietary phytoestrogens in vivo and in vitro in rainbow trout and Siberian sturgeon: interests and limits of the in vitro studies of interspecies differences

A study of the effects of dietary genistein on trout and sturgeon in vivo showed that sturgeon was sensitive to 20 ppm of genistein, whereas trout was not. To analyze the origin of this interspecies difference in sensitivity, a cell culture technique was developed with hepatocytes from sturgeon and compared to results obtained with hepatocytes from trout in the same system. The hepatocyte culture proved to be useful as bioassay for estrogenicity. Vitellogenin (VTG), assayed by a specific enzyme-linked immunosorbent assay, was used as a biomarker of the estrogenic activity. 17 beta-Estradiol, its glucuronide and sulfate derivatives, and estradiol analogues (ethynylestradiol and diethylstilbestrol) were tested. Nonestrogenic compounds such as androgens, progesterone, and cortisol were tested as negative controls. VTG production was monitored at doses ranging from 1 nM to 10 microM estradiol. Phytoestrogens, from the isoflavone family, were tested individually at increasing doses exhibiting dose response curves for concentrations from 500 nM to 10 microM. With tamoxifen, an antagonist of estrogen receptors, the estrogenic effect was partially reduced. The effect was the same with ICI182,780 in sturgeon, whereas the effect was the opposite in trout. The estrogenic potency of the isoflavones ranged differently between the two species in the following order: biochanin A < daidzein = formononetin < genistein < equol in trout and biochanin A < genistein < daidzein < formononetin < equol in sturgeon. Further, in sturgeon, formononetin was the most potent phytoestrogen in vitro, whereas its activity was weakest in vivo. These data suggest that one must reconsider the relevance of heterologous estrogenic tests and of homologous in vitro tests for estrogenic potency of chemicals.     

The role of alcohol and drugs in homicides in England and Wales

BACKGROUND: The annual number of homicide convictions in England and Wales is increasing. Previous studies have highlighted the aetiological role of alcohol and drugs in homicide. AIMS: To examine rates of alcohol and drug misuse and dependence in people convicted of homicide; the role of alcohol and drugs in the offence; the social and clinical characteristics of alcohol- and drug-related homicides; and the social and clinical characteristics of patients with dual diagnosis who commit homicide. METHODS: A national clinical survey based on a 3-year (1996-9) consecutive sample of people convicted of homicide in England and Wales. Information on rates of alcohol and drug misuse/dependence, the role of alcohol and drugs in the offence and social and clinical characteristics of perpetrators were collected from psychiatric reports prepared for the court in homicide convictions. Detailed clinical information was gathered from questionnaires completed by mental health teams for those in contact with mental health services. RESULTS: Of the 1594 homicide perpetrators, more than one-third (42%) occurred in people with a history of alcohol misuse or dependence and 40% in people with a history of drug misuse or dependence. Alcohol or drug misuse played a contributory role in two-fifths of homicides. Alcohol played a major role in 52 (6%) and a minor role in 364 (39%) homicides. Drugs played a major role in six (1%) and a minor role in 138 (14%) homicides. Forty-two homicides (17%) were committed by patients with severe mental illness and substance misuse. Alcohol- and drug-related homicides were generally associated with male perpetrators who had a history of violence, personality disorders, mental health service contact and with stranger victims. CONCLUSIONS: Substance misuse contributes to the majority of homicides in England and Wales. A public health approach to homicide would highlight alcohol and drugs before severe mental illness.     

Trends in COPD mortality and hospitalizations in countries and regions of Asia-Pacific

Background and objective: The growing burden of COPD in the Asia‐Pacific region supports the need for more intensive research and analysis of the epidemiology of COPD to raise awareness of the disease and its causes, to ensure the development of effective national health policies and to facilitate equitable deployment of finite health‐care resources in the prevention and management of COPD. This study estimated and compared COPD mortality and hospital morbidity rates and trends in these rates over time across countries and regions of Asia‐Pacific. Methods: Data consistent with standard definitions of COPD (ICD‐9/ICD‐10) for the period 1991–2004 were obtained from national health statistics agencies. For countries/regions with complete national mortality and hospitalization data (Australia, Pacific Canada (British Columbia, Hong Kong, South Korea and Taiwan), annual age‐standardized mortality and hospitalization rates were calculated for men and women aged ≥ 40 years. Negative binomial regression modelling was used to estimate rate ratios for country/region, gender and age differences and general trends over time. Results: Mortality rates per 10 000 population ranged 6.4–9.2 in men, 2.1–3.5 in women and 3.7–5.3 overall in 2003. Corresponding ranges for morbidity were 32.6–334.7, 21.2–129 and 28.1–207.3 per 10 000. Trend analysis of data since 1997 produced annual percentage changes in mortality versus hospitalization of ?4.4% versus ?0.7% in Australia, ?3.6% versus 7.5% in Pacific Canada (British Columbia), ?7.15% versus ?5.6% in Hong Kong and ?2.9% versus ?4.2% in Taiwan. Conclusions: In Asia‐Pacific, overall mortality and morbidity rates are high and trends in mortality and morbidity vary between countries/regions. Differences in rates and trends for men and women most likely reflect the different trends in historical and prevalent smoking profiles for COPD in the different countries and regions.     

Morbidity and maternal and infant outcomes of hypertensive disorder in pregnancy in China in 2018

Hypertensive disorder in pregnancy is a disease that occurs during pregnancy. We aimed to analyze the morbidity and maternal and infant outcomes with respect to the hypertensive disorder in pregnancy in China in 2018. Clinical data of 38 590 cases from 161 hospitals were retrospectively collected. The differences in morbidity and maternal and infant mortality among the major regions and provinces were compared. The overall national average morbidity was 4.74%, and the ratios of gestational hypertension, preeclampsia, eclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia were 29.17%, 55.02%, 0.66%, 6.53%, and 8.62%, respectively. The overall maternal mortality was 0.61/100 000, and the case fatality was 0.13%. Morbidity associated with hypertensive disorder in pregnancy was 7.74% in North China, 6.62% in Northwest China, 6.40% in Central China, 5.83% in Northeast China, 4.28% in East China, 3.85% in South China, and 2.88% in Southwest China. The morbidity in each province was 1.62‐11.28%. The overall perinatal mortality was 3.59% (81.09% for stillbirths; 18.91% for neonatal deaths). Perinatal mortality decreased with increasing gestational weeks from 24 to 37 + 6 weeks. Perinatal mortality for delivery at 32 weeks of gestation in all regions of the country was <10%. Morbidity varied across regions in China, with the lowest in Southwest and the highest in North China. The low maternal mortality is related to the large‐scale development of standardized maternal health care in China. For severe hypertensive disorder patients, gestation should be prolonged to 32 weeks as often as possible for better neonatal survival rates.     

Qualitative and quantitative changes of melatonin levels in physiological and pathological aging and in centenarians

Melatonin secretion is an endogenous synchronizer, and it may possess some anti-aging properties. Thus we examined melatonin levels in physiological aging, in extreme senescence and in senile dementia. In healthy old (age 66-94 yr) and young subjects (age 23-39 yr) and in demented patients (age 68-91 yr) plasma melatonin was measured by radioimmunoassay in eight serial blood samples. In centenarians (age 100-107 yr) melatonin levels were estimated by assaying urinary 6-hydroxymelatonin sulfate (aMT6s) in two different urine samples collected from 08:00 to 20:00 hours and from 20:00 to 08:00 hours. These data were compared with the aMT6s excretion of old and young controls. Elderly subjects, demented or not, exhibited a flattened circadian profile of plasma melatonin, because of the suppression of the nocturnal peak. An age-related decline of the circadian amplitude of the melatonin rhythm occurred in old subjects, especially in demented individuals. Furthermore, the melatonin nocturnal peak was significantly correlated with the severity of the cognitive impairment. aMT6s urinary excretion also declined with age. However, as in young controls, in centenarians the aMT6s excretion was significantly higher at night than during the day. In conclusion, pineal melatonin secretion is affected by age and by the degree of cognitive impairment. In centenarians the maintenance of the circadian organization of melatonin secretion may suggest that the amplitude of the nocturnal peak and/or the persistence of a prevalent nocturnal secretion may be an important marker of biological age and of health status.