蛋白质组学在妊娠期高血压疾病中的研究进展

蛋白质组学的兴起能快速筛选并鉴定疾病的特异性生物标志物,有助于研究妊娠期高血压疾病的病因、发生机制,通过特异性生物标志物进行早期诊断,从而改善母儿结局,降低母儿严重发病率和死亡率。本文综述近年来与妊娠期高血压疾病相关的蛋白质研究及其在妊娠期高血压疾病患者血液、脑脊液、尿液、羊水、滋养细胞中差异蛋白质谱的分析,为进一步研究提供思路。     

同型半胱氨酸与超敏c反应蛋白在妊娠期高血压疾病中的研究进展

妊娠期高血压疾病是妊娠期特有的疾病,早期诊断对预后至关重要。妊娠期高血压疾病发病机制之一为血管内皮损伤,血浆中Hcy浓度升高会导致血管内皮损伤,血管内皮细胞功能失调常刺激超敏C反应蛋白（hs—cRP）的产生,而升高的hs—CRP可能导致血压上升。因此高血压和慢性炎症相互促进从而导致和加重了高血压。近年来血浆同型半胱氨酸（Hcy）、超敏C反应蛋白（hs—cRP）水平的升高与妊娠期高血压疾病的关系成为新的研究热点。本文将同型半胱氨酸、超敏C反应蛋白与妊娠期高血压疾病中的关系综述如下。     

Evidence for interplay between genes and maternal stress in utero: monoamine oxidase A polymorphism moderates effects of life events during pregnancy on infant negative emotionality at 5 weeks

The low activity variant of the monoamine oxidase A (MAOA) functional promoter polymorphism, MAOA‐LPR, in interaction with adverse environments (G × E) is associated with child and adult antisocial behaviour disorders. MAOA is expressed during foetal development so in utero G × E may influence early neurodevelopment. We tested the hypothesis that MAOA G × E during pregnancy predicts infant negative emotionality soon after birth. In an epidemiological longitudinal study starting in pregnancy, using a two stage stratified design, we ascertained MAOA‐LPR status (low vs. high activity variants) from the saliva of 209 infants (104 boys and 105 girls), and examined predictions to observed infant negative emotionality at 5 weeks post‐partum from life events during pregnancy. In analyses weighted to provide estimates for the general population, and including possible confounders for life events, there was an MAOA status by life events interaction (P = 0.017). There was also an interaction between MAOA status and neighbourhood deprivation (P = 0.028). Both interactions arose from a greater effect of increasing life events on negative emotionality in the MAOA‐LPR low activity, compared with MAOA‐LPR high activity infants. The study provides the first evidence of moderation by MAOA‐LPR of the effect of the social environment in pregnancy on negative emotionality in infancy, an early risk for the development of child and adult antisocial behaviour disorders .     

重度妊娠期肝内胆汁淤积症对母婴结局影响的临床分析

目的：分析重度妊娠期肝内胆汁淤积症（intrahepatic cholestasis of pregnancy,ICP）对母婴结局的影响,以提高对ICP的认识与治疗水平。方法：选择ICP产妇58例,根据ICP分度标准分为轻度组（n=26例）和重度组（n=32例）,比较两组产妇的母婴结局。结果：与轻度组相比,重度组产妇剖宫产率、产后出血与平均产后出血量显著升高或增加,阴道分娩率显著降低,组间比较差异均具有统计学意义（P〈0.05）;重度组新生儿早产、胎儿窘迫、羊水污染和新生儿窒息的发生率均显著上升,新生儿平均出生体重显著降低,组间比较差异均具有统计学意义（P〈0.05）。结论：ICP对产妇及新生儿均有不良影响,对ICP严重程度进行划分,有利于临床处理。对于重度ICP产妇,应尽早采取剖宫产分娩的方式终止妊娠。     

Vitamin D and maternal and child health: Overview and implications for dietary requirements

The essentiality of vitamin D for normal growth and development has been recognized for over 80 years, and vitamin D fortification programs have been in place in the United States for more than 70 years. Despite the above, vitamin D deficiency continues to be a common finding in certain population groups. Vitamin D deficiency has been suggested as a potential risk factor for the development of preeclampsia, and vitamin D deficiency during infancy and early childhood is associated with an increased risk for numerous skeletal disorders, as well as immunological and vascular abnormalities. Vitamin D deficiency can occur through multiple mechanisms including the consumption of diets low in this vitamin and inadequate exposure to environmental ultraviolet B rays. The potential value of vitamin D supplementation in high‐risk pregnancies and during infancy and early childhood is discussed. Currently, there is vigorous debate concerning what constitutes appropriate vitamin D intakes during early development as exemplified by differing recommendations from the Institute of Medicine Dietary Reference Intake report and recent recommendations by the Endocrine Society. As is discussed, a major issue that needs to be resolved is what key biological endpoint should be used when making vitamin D recommendations for the pregnant woman and her offspring. Birth Defects Research (Part C) 99:24–44, 2013. © 2013 Wiley Periodicals, Inc.     

剖宫产术后切口妊娠介入治疗与保守治疗效果的临床研究

目的:研究子宫动脉介入化疗栓塞术在临床上对剖宫产切口妊娠的治疗效果.方法:回顾性分析我院2007年1月至2012年12月的收治的切口妊娠患者53例.并将53例患者随机分为介入治疗组28例、保守治疗组25例,介入治疗组患者采用双侧子宫动脉栓塞术后进行刮宫术的治疗,保守治疗组患者采用口服米非司酮以及肌内注射MTX后进行刮宫术的治疗.对两组患者的临床资料包括出血量,住院时间,降血HCG时间等进行统计学分析.结果:介入治疗组患者的出血量,住院时间,降血HCG时间明显低于保守治疗组患者的情况,差异具有显著性(P＜0.05).介入治疗组和保守治疗组间的不良反应差异无统计学意义(P＞0.05).结论:对患者采用子宫动脉介入对剖宫产切口妊娠进行治疗的方式,可以对切口妊娠大出血进行有效的控制,同时也可以对妊娠物进行有效的杀死.     

Reproductive biology of the viviparous scorpion,Liocheles australasiae (Fabricius) (Arachnida,Scorpiones, Ischnuridae) III. Structural types and functional phases of the adult ovary

Summary

Five structural types of the adult ovary were distinguished in a parthenogenetic viviparous scorpion Liocheles australasiae based on the presence or absence of swollen ovarian diverticula (SD) containing embryos and/or empty ones (ED) as remnants of past pregnancies. These structural types seem to correspond to the following ovarian functional phases: the ovary (1) with SD and without ED corresponds to the first pregnancy; (2) without SD and with ED to after the first parturition; (3) with SD and ED to the second pregnancy; (4) without SD and with old and new ED to after the second parturition; and (5) with SD and old and new ED to the third pregnancy. Such correspondence indicates that a female can repeat pregnancies at least three times. Some possible cases in which the present structural types correspond to other functional phases were also discussed.     

Behavioural cues of reproductive status in seahorses Hippocampus abdominalis

A method is described to assess the reproductive status of male Hippocampus abdominalis on the basis of behavioural traits. The non‐invasive nature of this technique minimizes handling stress and reduces sampling requirements for experimental work. It represents a useful tool to assist researchers in sample collection for studies of reproduction and development in viviparous syngnathids, which are emerging as important model species.     

妇科针对性护理对保守治疗、开腹手术治疗、腹腔镜微创手术治疗宫外孕患者机体恢复的影响

目的:目前宫外孕的发病率日趋增多,发病年龄也趋向年轻化,为减轻患者痛苦,促进其早日康复,本文旨在回顾性分析妇科护理工作在三种方式治疗宫外孕治疗中的作用.方法:选取2010年10月至2011年9月间,于我院妇科进行宫外孕手术的患者172例,针对172例患者所采取的保守治疗、开腹手术治疗、腹腔镜微创手术三种不同治疗方法,根据不同情况,实施多种妇科针对性护理措施,并对结果进行回顾性分析和总结.结果:172例宫外孕患者经腹腔镜微创手术治疗治愈126例,经过针对性妇科护理,平均住院6.56天;开腹手术治愈26例,经过针对性妇科护理,平均住院9.85天;保守治疗20例,保守治疗失败转为手术治疗3例,平均住院17.87天.经过对所有患者采取有效的针对性精心护理,护理效果较为满意,预后情况良好.结论:腹腔镜微创手术治疗因其创伤小、恢复快,且兼具明确诊断和治疗的作用,是目前临床治疗宫外孕的主要方法;对选择不同治疗方式的患者采取有效的针对性护理,可以提高护理质量和治疗效果,减轻患者痛苦、减少并发症的发生,确保患者早日康复出院.