Artificial intelligence (AI) could automatedly detect abnormalities in digital cytological images, however, the effect in cervical cancer screening is inconclusive. We aim to evaluate the performance ...of AI-assisted cytology for the detection of histologically cervical intraepithelial lesions (CIN) or cancer.
We trained a supervised deep learning algorithm based on 188,542 digital cytological images. Between Mar 13, 2017, and Oct 20, 2018, 2145 referral women from organized screening were enrolled in a multicenter, clinical-based, observational study. Cervical specimen was sampled to generate two liquid-based slides: one random slide was allocated to AI-assisted reading, and the other to manual reading conducted by skilled cytologists from senior hospital and cytology doctors from primary hospitals. HPV testing and colposcopy-directed biopsy was performed, and histological result was regarded as reference. We calculated the relative sensitivity and relative specificity of AI-assisted reading compared to manual reading for CIN2+. This trial was registered, number ChiCTR2000034131.
In the referral population, AI-assisted reading detected 92.6% of CIN 2 and 96.1% of CIN 3+, significantly higher than or similar to manual reading. AI-assisted reading had equivalent sensitivity (relative sensitivity 1.01, 95%CI, 0.97–1.05) and higher specificity (relative specificity 1.26, 1.20–1.32) compared to skilled cytologists; whereas higher sensitivity (1.12, 1.05–1.20) and specificity (1.36, 1.25–1.48) compared to cytology doctors. In HPV-positive women, AI-assisted reading improved specificity for CIN1 or less at no expense of reduction of sensitivity compared to manual reading.
AI-assisted cytology may contribute to the primary cytology screening or triage. Further studies are needed in general population.
•AI based on deep learning could generated severity scores of abnomal cytology associating with histological lesions.•AI-assisted cytology show comparable performance for the detection of CIN2+ relative to skilled cytologist in referral women.•AI-assisted cytology would improve specificity at no expense of sensitivity in HPV-positive triage.•AI-assisted cytology may contribute to the primary cytology screening or HPV-positive triage.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract Objective To explore the risk factors for maternal near-miss (MNM) using the WHO near-miss approach. Methods Data were obtained from the Maternal Near-Miss Surveillance System in Hunan ...Province, China, 2012–2022. Multivariate logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for MNM. Results Our study included 780,359 women with 731,185 live births, a total of 2461 (0.32%) MNMs, 777,846 (99.68%) non-MNMs, and 52 (0.006%) maternal deaths were identified. The MNM ratio was 3.37‰ (95%CI: 3.23–3.50). Coagulation/hematological dysfunction was the most common cause of MNM (75.66%). Results of multivariate logistic regression analysis showed risk factors for MNM: maternal age > = 30 years old (aOR > 1, P < 0.05), unmarried women (aOR = 2.21, 95%CI: 1.71–2.85), number of pregnancies > = 2 (aOR > 1, P < 0.05), nulliparity (aOR = 1.51, 95%CI: 1.32–1.72) or parity > = 3 (aOR = 1.95, 95%CI: 1.50–2.55), prenatal examinations < 5 times (aOR = 1.13, 95%CI: 1.01–1.27), and number of cesarean sections was 1 (aOR = 1.83, 95%CI: 1.64–2.04) or > = 2 (aOR = 2.48, 95%CI: 1.99–3.09). Conclusion The MNM ratio was relatively low in Hunan Province. Advanced maternal age, unmarried status, a high number of pregnancies, nulliparity or high parity, a low number of prenatal examinations, and cesarean sections were risk factors for MNM. Our study is essential for improving the quality of maternal health care and preventing MNM.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Pregnant women infected with HCV should be given attention due to their special physiological stage and the effect on offspring health. To examine the prevalence of HCV infection among pregnant women ...in part of China and explore relevant factors during pregnancy, a cross-sectional study was conducted in four maternal and children health care institutions (MCHC) in Guangdong, Hunan and Chongqing. Pregnant women who were delivered, induced or spontaneous abortion were included and relevant information was collected through the Hospital Information System. Results showed that the prevalence of HCV among pregnant women in four MCHCs was 0.11% (95% CI 0.09-0.13%). Age, occupations, regions, syphilis-infection, intrahepatic cholestasis of pregnancy (ICP), and placenta previa were significant factors (all P < 0.05). Age and syphilis-infection were positively correlated with HCV infection (Z = 3.41, P = 0.0006; OR = 18.16, 95% CI 9.34-35.29). HCV and HBV infection were risk factors of ICP (OR = 4.18, 95% CI 2.18-8.04; OR = 2.59, 95% CI 2.31-2.89). Our study indicates that the prevalence of HCV among pregnant women in the three provinces(city) was low compared with the general population in China. Older age and syphilis-infection increased the risk of HCV infection during pregnancy. HCV infection was a risk factor of ICP. Generally, we need keep a watchful eye on HCV infection and relevant factors mentioned above during pregnancy in clinic, especially those also infected with syphilis. HCV testing based on risk factors is recommended in antenatal care and obstetrics.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Ovarian aging is a significant challenge in gynecology, and there is currently no effective treatment for it. However, the medicinal agent Qingxin Zishen decoction (QZD) has shown potential in the ...treatment of ovarian dysfunction. The present study aimed to evaluate the mitochondrial apoptotic mechanism of delayed ovarian aging in QZD in aging rats. The healthy female Sprague-Dawley (SD) rats (n = 40, 350 ± 20 g) were randomly assigned to different dosage groups and 4-month-old SD rats (n = 10) were assigned to the control group. QZD groups were treated with QZD for four weeks, and ovarian tissues were extracted for mRNA and protein assays to examine the role of the apoptotic pathway in QZD. The results showed that QZD treatment for four weeks significantly increased the mRNA and protein expressions of the anti-apoptotic gene B-cell lymphoma 2 (Bcl-2) and Bcl-2/Bax ratio, as well as downregulated the pro-apoptotic genes Bax, caspase-3, and caspase-9. Moreover, QZD treatment effectively reduced the expression of cytochrome C (cyto-C) and apoptotic protease-activating factor 1 (Apaf-1), both of which are components of the intrinsic apoptotic pathway. These changes exhibited a dose-response manner. The findings suggest that QZD might have therapeutic potential in delaying ovarian mitochondrial function decline and in preventing and treating ovarian aging-related diseases by downregulating and upregulating the pro-apoptotic (Bax, caspase-3, caspase-9, cyto-C, Apaf-1) and anti-apoptotic (Bcl-2 and Bcl-2/Bax ratio) genes, respectively.
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•Pro-apoptotic markers were downregulated in the ovaries of rats treated with Qingxin Zishen decoction (QZD).•BCL-2 and Bcl-2/Bax ratio were upregulated in the ovaries of aged rats following QZD administration.•QZD could potentially delay ovarian mitochondrial function decline and be used to treat ovarian aging-related diseases.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Insulin resistance plays an important role in the pathogenesis of polycystic ovarian syndrome (PCOS).
Calpain10
(
CAPN10
) gene was the first identified susceptibility gene for type 2 diabetes ...mellitus and closely related to insulin sensitivity. A lot of research attention has been attracted on the relationship between
CAPN10
polymorphisms and PCOS risk, but they didn’t reach a consistent conclusion. We therefore performed this systematic review and meta-analysis to assess the association of
CAPN10
common variants with PCOS susceptibility. A total of 21 studies were eligible for inclusion. Meta-analyses were done for 5 variants that had at least two data sources: UCSNP-19, -43, −44, −56 and −63. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under five genetic models. Subgroup analyses by ethnicity, PCOS diagnostic criteria, and source of controls were conducted. Moreover, false-positive report probability (FPRP) test and trial sequential analysis (TSA) were performed to assess the significant associations. The results showed a possible negative association between UCSNP-19 and PCOS risk (ins/ins vs. del/del + del/ins: OR = 0.84, 95% CI: 0.72–0.98). In subgroup analyses, FPRP test indicated that noteworthy associations were observed in mixed ethnicities for UCSNP-43 (A vs. G: OR = 1.81, 95% CI: 1.17-2.79; AA + AG vs. GG: OR = 2.14, 95% CI: 1.20-3.80) and in Asians for UCSNP-44 (CC vs. TT: OR = 2.07, 95% CI: 1.21-3.51; CC vs. CT + TT: OR = 2.19, 95% CI: 1.31-3.69), but TSA plots showed that the accumulated sample sizes of these associations were insufficient to draw firm conclusions. In summary, our study suggested that UCSNP-19, UCSNP-43, and UCSNP-44 in
CAPN10
gene may be involved in PCOS susceptibility. These findings warrant further studies.
To investigate the adverse pregnancy outcomes and associated risk factors among pregnant women with syphilis.
Pregnant women with syphilis in the registry for the prevention of mother-to-child ...transmission of AIDS, syphilis and hepatitis B in Hunan Province, China, from January 1, 2013 to December 31, 2018 were included in the study.
Among the 14,219 pregnant women with syphilis, 11,346 had definite pregnancy outcomes and were in singleton pregnancy. The risk factors related to adverse pregnancy outcomes include the age of pregnant women with syphilis <20 years old (aOR = 1.274, 95% CI: 1.088-1.493) or ≥ 35 years old (aOR = 1.402, 95% CI: 1.167-1.686), not married (aOR = 1.855, 95% CI: 1.453-2.367), initial syphilis detection in the late pregnancy (aOR = 1.266, 95% CI: 1.032-1.555), diagnosis of syphilis in the late pregnancy (aOR = 5.806, 95% CI: 1.796-18.770), diagnosis of syphilis during labor (aOR = 4.102, 95% CI: 1.263-13.330), husband/sexual partner infected with syphilis (aOR = 1.222, 95% CI: 1.068-1.398), untreated (aOR = 6.756, 95% CI: 5.586-8.197), and nonstandard medication (aOR = 3.300, 95% CI: 2.841-3.846).
The prevalence of adverse pregnancy outcomes among pregnant women with syphilis in Hunan Province, China from 2013 to 2018 was relatively high. The adverse pregnancy outcomes associated with syphilis could be reduced by early detection and standard treatment of syphilis for pregnant women and their husbands/sexual partners.
Silver complexes with proteinogenic amino acid ligands are of interest for biomedical and antimicrobial applications. In this work, we obtained ...{Ag7(l-his)4(NO3)3·3H2O}0.2{Ag8(l-his)4(H2O)2(NO3)4·3H2O}0.8 (1) and {Ag7(d-his)4(NO3)3·3H2O}0.2{Ag8(d-his)4(H2O)2(NO3)4·3H2O}0.8 (2), which represent the first example of any Ag-exclusive complex featuring a cluster-type core motif and with only proteinogenic amino acid ligands. Upon immersion into acetonitrile, an interesting single-crystal-to-single-crystal transformation occurred to produce a new cluster complex of the formula Ag8(l-his)4(NO3)(H2O)(NO3)3 (3). Using a racemic mixture of histidine, the reaction under otherwise identical conditions led to the production of the second example of a three-dimensional (3D) network structured Ag-exclusive complex with only a proteinogenic amino acid ligand. Compared with other Ag–histidine complexes in the literature, the significance of reaction conditions, particularly the Ag/histidine ratio and pH of the reaction mixture, is revealed. Temperature-dependent emission of 1 and 2 at 440 nm characteristic of silver–philophilic interactions was also observed.
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IJS, KILJ, NUK, PNG, UL, UM, UPUK
The control of maternal deaths continues to be a significant public health issue and commands an enormous amount of attention, especially under the future family planning policy. Here, we describe ...the epidemiology and trends of maternal deaths in Hunan province, and give several policy implications.
Maternal deaths in Hunan province between 2009 and 2014 were retrospectively reviewed and analyzed. Cochran-Armitage trend test was used to assess the time trends of maternal mortality rates. Binary logistic regression analyses were undertaken to identify the factors that were associated with unavoidable maternal deaths.
In total, there were 987 maternal deaths, with the overall MMR declining by 45.24%. The most common causes of maternal death during this period were pregnancy complications (28.37%), obstetric hemorrhage (25.33%), and amniotic fluid embolism (15.70%). Obstetric hemorrhage (28.14%) was higher in rural areas, while pregnancy complications were higher (29.27%) in urban areas. In all, 627 (63.5%) deaths were avoidable. The risk factors associated with unavoidable maternal deaths was above 35 years (aOR = 1.80 95%CI: 1.27-2.55), without prenatal examination (aOR = 8.97 95%CI: 1.11-7.78), low household incomes (aOR = 1.15 95%CI: 1.02-1.29), without adopting the new way to deliver (aOR = 5.15 95%CI: 3.20-8.31), and death location (aOR = 1.09 95%CI: 1.02-1.18). The most frequent and important factors associated with avoidable deaths was improper knowledge and skills of the county medical institutions.
Moderate progress was made in reducing the MMR in Hunan province. The government should aim to improve the basic midwifery skills in rural areas and the obstetric emergency rescue service for critically ill pregnant women in urban areas, and strengthen training to improve knowledge and skills in medical institutions in counties.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Hunan provincial government has implemented a free breast cancer screening program for rural women aged 35 to 64 years from 2016, under a 2015 policy aimed at of poverty eradication and improving ...women's health in China. However, there has been no population study of the breast cancer screening program in China to date, especially considering exploring differences related to the area's poverty status. We explored differences in risk factors, clinical examination results, and clinicopathological features among breast cancer patients in poor compared with non-poor counties in rural areas of Hunan province from 2016 to 2018 using χ and Fisher's exact test, and multivariate logistic regression analysis. A total of 3,151,679 women from rural areas participated in the screening program, and the breast cancer prevalence was 37.09/10. Breast cancer prevalence was lower in poor (29.68/10) than in non-poor counties (43.13/10). There were differences between breast cancers in poor and non-poor counties in terms of cysts, margins, internal echo, blood flow in solid masses in the right breast on ultrasound examination, lump structure in mammograms, and clinicopathological staging and grading in pathological examinations. Breast cancer in poor counties was more likely to be diagnosed at later stages as determined by ultrasound, mammography, and pathological examinations. Furthermore, indexes of the breast screening program including early detection, prevalence, pathological examination, and mammography examination were lower in poor compared with non-poor counties. Multivariate logistic regression analysis showed that education, ethnicity, reproductive history and the year 2017 were associated with an increased risk of breast cancer in poor counties (odds ratio >1, P < .05). In conclusion, women in poor areas were more likely to be diagnosed with breast cancer at a later stage compared with women in non-poor areas. Women in poor areas of Hunan province should therefore have better access to diagnostic and clinical services to help rectify this situation.
Lanthanide hydroxide cluster complexes with acetylacetonate were synthesized by the hydrolysis of the corresponding hydrated lanthanide acetylacetonates in methanol in the presence of triethylamine. ...Polymeric lanthanide hydroxide complexes based on diamond-shaped dinuclear repeating units of Ln(2)(CH(3)CO(3))(2)(4+) (Ln = La, Pr) and discrete complexes featuring a tetranuclear distorted cubane core of Ln(4)(μ(3)-OH)(2)(μ(3)-OCH(3))(2)(8+) (Ln = Nd, Sm) and a nonanuclear core of Ln(9)(μ(4)-O)(μ(4)-OH)(μ(3)-OH)(8)(16+) (Ln = Eu-Dy, Er, Yb) were obtained. The dependence of the cluster nuclearity on the identity of the lanthanide ion is rationalized in terms of the influences of a metal ion's Lewis acidity and the sterics about the Ln-OH unit on the kinetics of the assembly process that leads to a particular cluster.
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