[Progress in research of association of adverse childhood experiences with prevalence of common chronic diseases in adulthood]

The effects of adverse childhood experiences on adult health has aroused increasing concern in the world in recent years, but limited studies have been conducted in China. This study synthesized the measurement of adverse childhood experiences, the association between adverse childhood experiences and the prevalence common chronic diseases in adulthood and possible mechanisms. It was found that though measurement range of adverse childhood experiences might be different among studies, current used measurement scales basically met the requirement of disease prevention. Most categories of adverse childhood experiences were positively related to risk of common chronic diseases, and the relationship was influenced by social economic status, sex and age. However, people with exposure to famine in childhood had lower prevalence of hypertension compared with those without the exposure. The possible mechanisms might be that the occurrence of adverse childhood experiences might damage physiological functions or increase the adoption of poor healthy behaviors and lifestyles, and finally increased the risk of chronic diseases directly or indirectly. While premature death due to adverse childhood experiences might reverse the association because of nonrandom selection. It is necessary for us to select appropriate indexes of adverse childhood experiences and conduct more studies to prove the association between adverse childhood experiences and prevalence of common chronic diseases in adulthood and explore the related mechanism for the better prevention of chronic diseases in China.

[Ultrasound measurement of fetal posterior fossa at 11 to 13⁺⁶ gestational weeks for screening open spina bifida]

OBJECTIVE

To establish the normal reference ranges of transabdominal ultrasound measurements of the posterior fossa structure in fetuses at 11 to 13⁺⁶ gestational weeks and explore their clinical value in screening open spina bifida (OSB).

METHODS

Between January, 2013 and September, 541 randomly selected normal fetuses underwent nuchal translucency at the gestational age 11 to 13⁺⁶ weeks. The parameters of the posterior fossa were measured in mid-sagittal view of the fetal face and the axial view of the transverse cerebellum insonated through the anterior fontanel by transabdominal ultrasound to establish the normal reference ranges. The measurements were obtained from 3 fetuses with OSB for comparison with the reference ranges.

RESULTS

In normal fetuses, the parameters of the posterior fossa measured in the two views showed no significant differences (P>0.05). Two high echogenic lines were observed in normal fetuses, as compared with one in fetuses with OSB representing the posterior border of the brain stem and the anterior border of the fourth ventricle. The line between the posterior border of the fourth ventricle and the anterior border of the cisterna magna was not displayed in fetuses with OSB. The anteroposterior diameters of the brain stem, the fourth ventricle, and cisterna magna all increased in positive correlation with the crown-lump length in normal fetuses. In the 3 OSB fetuses, the anteroposterior diameter of the brain stem exceeded the 95th percentile and the anteroposterior diameter of fourth ventrical-cisterner magena was below the 5th percentile of the reference range for CRL; the brain stem to fourth ventrical-cisterner magena anteroposterior diameter ratio was increased to above 1.

CONCLUSION

The established normal reference ranges of the parameters of fetal posterior fossa may provide assistance in early OSB detection. The absence of the posterior border of the fourth ventricle and the anterior border of the cisterna magna and a brainstem to fourth ventrical-cisterner magena anteroposterior diameter ratio greater than 1 can be indicative of OSB at 11 to 13⁺⁶ gestational weeks.

Effects of dopexamine on heart function of isolated hypoxic rabbit heart and in comparison with fenoldopam and procaterol

AIM

To study the effects of dopexamine hydrochloride (Dop) on heart functions and coronary flow (CF) of normal and hypoxic isolated perfusing heart and compare the effects of Dop with those of fenoldopam hydrochloride (Fen) and procaterol hydrochloride (Pro).

METHODS

The isolated rabbit normal and hypoxic hearts were perfused with Krebs-Henseleit (K-H) solution via aorta at 37 +/- 0.5 degree C. The drug were added into the K-H solution.

RESULTS

Dop increased the CF, left ventricular contractile function (+ dp/dtmax etc) and heart rate (HR) in normal heart; Fen increased the heart function more potently, but increased the CF to a lesser degree than Dop did, whereas the effects of Pro was the least. In simple hypoxic group, at 30 min of perfusion, the + dp/dtmax and CF decreased by 66 +/- 4% and 48.1 +/- 1.0%, respectively. Dop remarkably attenuated the decreases in both CF and heart function during hypoxia as it decreased the + dp/dtmax by 32.0 +/- 2.4% and CF by 28 +/- 3%. Fen was less potent than Dop in attenuating the diminution of CF, while Pro was the least effective.

CONCLUSION

Dop has a better prospect in the treatment of ischemic heart disease in view of its dual action of increasing CF and inotropism.

[Effects of dopexamine on the electrophysiologic changes during myocardial ischemia and comparison with fenoldopam and procaterol]

The effects of dopexamine (DPX), a new dopamine receptor agonist, on transmembrane potential and effective refractory period (ERP) of isolated guinea pig ventricular muscle superfused either with hypoxia or mimic ischemia perfusates were investigated by using intracellular microelectrode technique and compared with fenoldopam (FODA) and procaterol. DPX (3 x 10(-6) mol.L-1) was found to significantly reduce both the extent of decrease of resting potential, action potential amplitude and maximal upstroke velocity and the degree of shortening of action potential duration caused by hypoxia or ischemia. These effects of DPX were significantly greater than those of FODA and procaterol albeit the latter showed effects similar to DPX. DPX could not only lengthen the abbreviated ERP resulting from hypoxia, but also shorten the prolonged ERP caused by ischemia. This action of DPX was more evident than that of FODA and procaterol. The results reveal the potential advantages of DPX over other dopaminergic agonists in the antiarrhythmic activity during myocardial ischemia.

Comparison of the effects of dopamine1- and dopamine2-receptor agonists on the cAMP generating system in canine coronary and renal arteries

To further evaluate the functional significance of dopamine (DA) receptors in different vasculature, in this study we compared the effects of D1- and D2-receptor agonists on canine coronary and renal arteries by measuring adenylate cyclase (AC) activity as a biomedical index of DA receptor function. It was found that both the selective D1-receptor agonist, fenoldopam, and the D2-receptor agonist, propyl-butyl-dopamine (PBDA), induced a dose-related increases in cAMP formation in coronary and renal arteries; however, the magnitude of increase in the renal artery was remarkably greater than that in the coronary artery. The stimulatory effect on AC activity of fenoldopam was significantly more potent than that of PBDA. The selective D1-receptor antagonist, SCH23390, blocked fenoldopam- and PBDA-induced cAMP production, while the selective D2-receptor antagonist, domperidone, was without effect on the increase of cAMP elicited by PBDA. After beta-adrenergic blockade with propranolol, fenoldopam still increased the cAMP level significantly but to a much lesser degree. The existence of postsynaptic D2-receptor associated with inhibition of cAMP formation could not be demonstrated in this study. These data suggest the presence of D1-receptors associated with stimulation of AC activity in both renal and coronary arteries. However, there are much fewer receptor sites in the coronary artery than in the renal artery, suggesting less physiological importance of such receptors in the coronary artery than in the renal artery.

Comparison of dopexamine hydrochloride, fenoldopam, and procaterol on myocardial nutritional flow in rats

Myocardial nutritional flow (MNF) was determined using 99mTechnetium-methoxy-isobutyl-isonitrile (99mTc-MIBI) in rats. At 25 nmol.kg-1, dopexamine hydrochloride (DH), fenoldopam, and procaterol increased the uptake rate of 99mTc-MIBI/g myocardium by 80.8 +/- 10.2% (P < 0.01), 44.9 +/- 6.3% (P < 0.05), and 30.2 +/- 5.4% (P < 0.05) respectively. These findings suggested the potential advantages of DH over other dopaminergic agonists in the treatment of coronary disease.