Objectives To investigate the risk profile of preterm birth (PTB) in 2018 in China. Method A prospective multicentre case–control study was conducted in 15 hospitals located in seven provinces throughout three geographical areas (the Eastern, South‐Central and North‐Western regions) in China. A total of 3147 preterm (<37+0 weeks) and 3147 term (37+0 to 41+6 weeks) live‐birth mothers were included. Designed questionnaires were used to investigate maternal and fetal information. We calculated multivariable logistic regression and population attributable risk (PAR). Results Iatrogenic PTB accounted for 48.1% of preterm mothers. Multivariable analysis showed PTB was significantly associated with six categories of maternal and fetal factors, adverse life‐style and psychological conditions (adjusted odds ratio (aOR) 2.063, 95% confidence interval (CI) 1.601–2.657) had the highest PAR% (60.1%). High school and below education level (PAR% = 25.8%), living in town or village (PAR% = 24.4%), low pregnant weight gain (PAR% = 16.8%), hypertensive disorders in pregnancy (aOR: 5.010, 95% CI: 4.039–6.216, PAR% = 15.3%), placental abnormality (aOR: 4.242, 95% CI: 3.454–5.211, PAR% = 14.1%) and multiple pregnancy (aOR: 10.990, 95% CI: 7.743–15.599, PAR% = 11.8%) were significantly associated with PTB with high PAR% value. Conclusion The main risk factors for PTB in China were placental abnormality, hypertensive disorders in pregnancy and multiple pregnancy. Adverse life‐style and psychological conditions and socio‐economic disadvantage had high public health significance.
We present new detrital zircon U–Pb chronological and whole‐rock geochemical data for the newly discovered black rock units in West Kunlun Orogen in an attempt to constrain the provenance variations of the siliciclastic rocks and the tectonic history of NW China. Geochemical data indicate these black rock units could have formed in an active continental margin to continental arc setting during the Late Ordovician and source rocks could have undergone modest chemical weathering under a relatively warm and humid climate during the deposition of the black rock units. U–Pb dating of 170 detrital zircons defines five major age populations at 459–545 Ma, 710–900 Ma, 1,300–900 Ma, 1,814–1,641 Ma, and 2,153–2,845 Ma, demonstrating that the black rock units deposited during the Late Ordovician and the tectonic events that occurred in the West Kunlun Orogen were related to the assembly and breakup of the supercontinents of Columbia and Rodinia. Prevalence of Early Palaeozoic magmatic zircons further indicates the black rock units were derived from a proximal source, most likely from the South Kunlun arc.
Aims Recombinant human brain natriuretic peptide (rh-BNP) is commonly used as a decongestive therapy. This study aimed to investigate the instant effects of rh-BNP on cardiac output and venous return function in post-cardiotomy patients with congestive heart failure (CHF). Methods and resultsTwenty-four post-cardiotomy heart failure patients were enrolled and received a standard loading dose of rh-BNP. Haemodynamic monitoring was performed via a pulmonary artery catheter before and after the administration of rh-BNP. The cardiac output and venous return functions were estimated by depicting Frank-Starling and Guyton curves. After rh-BNP infusion, variables reflecting cardiac congestion and venous return function, such as pulmonary artery wedge pressure, mean systemic filling pressure (Pmsf) and venous return resistance index (VRRI), reduced from 15 ± 3 to 13 ± 3 mmHg, from 32 ± 7 to 28 ± 7 mmHg and from 6.7 ± 2.6 to 5.7 ± 1.8 mmHg min m 2 /L, respectively. Meanwhile, cardiac index, stroke volume index, and the cardiac output function curve remained unchanged per se. The decline in Pmsf [À13% (À22% to À8%)] and VRRI [À12% (À25% to À5%)] was much greater than that in the systemic vascular resistance index [À7% (À14% to 0%)].In the subgroup analysis of reduced ejection fraction (<40%) patients, the aforementioned changes were more significant. Conclusions rh-BNP might ameliorate venous return rather than cardiac output function in post-cardiotomy CHF patients.
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