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This study aims to investigate the fetal outcomes and associated factors of adverse pregnancy outcomes (APOs) in pregnant women with systemic lupus erythematosus (SLE). Clinical data from 251 SLE patients with 263 pregnancies from 2001 to 2015 were analyzed retrospectively. APOs occurred in 70.0% of pregnancies, in which pregnancy loss occurred in 28.5%; preterm delivery occurred in 21.3%; intrauterine growth retardation occurred in 12.2%; and fetal distress occurred in 8.0%. Over time, the rate of APOs decreased from 82.8% during 2001~2005 to 59.6% during 2011~2015. In multivariate analysis, predictors of APOs included positive antiphospholipid antibodies (OR 8.4, 95% CI 1.7~40.8, P = 0.008), lower complement (OR 3.6, 95% CI 1.3~9.9, P = 0.01), hypoalbuminemia (OR 3.2, 95% CI 1.2~8.3, P = 0.02), and hypertension (OR 14.6, 95% CI 1.5~141.6, P = 0.02). The use of antimalarial medications was associated with lower risk for APOs (OR 0.3, 95% CI 0.1~0.7, P = 0.01). In total, 109 patients underwent fetal umbilical artery Doppler in the third trimester. The The adjusted systole/diastole (S/D) ratio, pulsatility index (PI) and resistance index (RI) of SLE patients with APOs were higher than that of patients without APOs (2.9±0.9 vs. 2.4±0.5, P = 0.001). Lupus pregnancy was still at high risk of APOs in terms of pregnancy loss and preterm delivery. Umbilical artery Doppler was a good monitor method for APOs in the third trimester.

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Objective To investigate the fetal and maternal outcomes as well as predictors of APOs in women with SLE who conceived when the disease was stable, the so-called “planned pregnancy.” Methods. A retrospective multicenter study of 243 patients with SLE who underwent a planned pregnancy was performed. APOs in fetus and mothers were recorded. Results The average age at conception was 28.9 ± 3.9 years. Duration of SLE prior to pregnancy was 4.4 ± 4.3 years. Fetal APOs occurred in 86 (86/243, 35.4%) patients. Preterm births, intrauterine growth retardation (IUGR), fetal distress, and fetal loss accounted for 22.2%, 14.8%, 11.1%, and 4.9%, respectively. Forty-two preterm infants (42/54, 77.8%) were delivered after the 34th week of gestation. All the preterm infants were viable. Fifty-two patients (52/243, 21.4%) had disease flares, among which 45 cases (45/52, 86.5%) were mild, 6 (6/52, 11.5%) were moderate, and 1 (1/52, 1.9%) was severe. Disease flares were mainly presented as active lupus nephritis (41/52, 78.8%), thrombocytopenia (10/52, 19.2%), and skin/mucosa lesions (9/52, 17.3%). Pregnancy-induced hypertension (PIH) occurred in 29 patients, among which 3 were gestational hypertension and 26 were preeclampsia. Multiple analysis showed that disease flares (OR, 8.1; CI, 3.8–17.2) and anticardiolipin antibody positivity (OR, 7.4; CI, 2.5–21.8) were associated with composite fetal APOs. Conclusion Planned pregnancy improved fetal and maternal outcomes, presenting as a lower rate of fetal loss, more favorable outcomes for preterm infants, and less severe disease flares during pregnancy.

Pulmonary tuberculosis (PTB) is a high burden infectious disease in China. The immune function is damaged in patients with diabetes mellitus (DM) who are easy to infect with Mycobacterium tuberculosis (Mtb). The growth of Mtb has been shown to be restrained following the administration of vitamin D and antimicrobial peptide cathelicidin (LL-37); however, the effect in patients with DM and PTB remains unclear. Vitamin D can regulate the immune system through Vitamin D receptors expressed in T helper (Th) cells. The aim of the present study was to analyze the status and correlations of vitamin D, LL-37 and Th-associated cytokines in patients with PTB or PTB with DM (DMPTB). Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were measured by liquid chromatography-tandem mass spectrometry, while plasma LL-37 levels were analyzed using a solid-phase enzyme-linked immunosorbent assay. Flow cytometry was used to analyze the levels of Th cytokines, including Th1-associated IFN-γ, Th2-associated IL-4 and Th17-associated IL-17. The results revealed that patients with PTB and DMPTB were vitamin D deficient or had insufficient vitamin D levels. Furthermore, the levels of LL-37, IFN-γ, IL-4 and IL-17 were higher in the PTB and DMPTB groups when compared with the normal controls. These results indicated that vitamin D supplementation is necessary for PTB and DMPTB patients. In addition, LL-37, IFN-γ and IL-17 may be diagnostic indexes that become elevated in the compensatory response caused by Mtb infection. Vitamin D can regulate the immune status in patients suffering from PTB.

ADSC, adipose-derived stem cell; MV, micro vesicle; HUVECs, human umbilical vein endothelial cells; RUNX3, Runtrelatedtranscription factor-3.

Numerous RFID authentication protocols proposed often have some security vulnerabilities, since they lack systematic theory support. We had proposed a series of rules called R-RAPSE (RFID Authentication Protocol Security Enhanced Rules) for RFID authentication protocol design and verification. By three examples, this paper justifies why the protocols do not offer sufficient security and privacy protection, and thereafter, proposes relevant solutions to fix the security holes based on R-RAPSE, which demonstrates how R-RAPSE can be used to verify and improve RFID authentication protocols.

BackgroundLeft ventricular diastolic function is impaired during pregnancy. However, changes in left atrial (LA) function remain unclear. We aimed to evaluate changes in LA function during pregnancy using two-dimensional speckle tracking echocardiography (2DSTE).Methods and Results50 pregnant and 50 healthy nulliparous (control group) women were enrolled in this study. All pregnant women were followed up postpartum in sixth-month. The LA maximum volume, LA minimal volume and LA preatrial contraction volume were obtained using biplane modified Simpson’s method. LA filling volume, LA expansion index, LA ejection fraction, passive volume, passive emptying index, active volume, and active emptying index were calculated. LA longitudinal systolic strain (SS), systolic strain rate (s-SR), early diastolic strain rate (e-SR), and late diastolic strain rate (a-SR) were obtained by 2DSTE. Compared to the control group, the reservoir function was increased in pregnant patients (P<0.05); conduit function was decreased in pregnant patients (P<0.05); booster pump function was increased in pregnant patients (P<0.05). There was no statistically significant difference between the control group and postpartum group.ConclusionsLA reservoir and booster pump function were increased, while conduit function was decreased during pregnancy using 2DSTE. The changes were reversible. 2DSTE can easily assess LA function during pregnancy with good repeatability.