1253例孕妇和新生儿TORCH检测结果分析

目的 了解TORCH感染情况,为妇幼保健提供参考依据.方法 采用捕获ELISA方法对1 253例孕妇和新生儿的血清进行TORCH-IgM抗体检测.结果 689例孕妇CMV、TOX、RV及HSVⅡ特异性IgM抗体阳性率分别为1.89％、0.87％、0.44％和0.73％;564例新生儿CMV-IgM、TOX-IgM、RV-IgM和HSVⅡ-IgM阳性率分别为6.91％、0.18％、0和0.35％.结论 检测TORCH特异性抗体对优生优育有重要关系.     

乙肝孕妇肝功能指标变化与早产相关性的临床分析

目的:探讨乙型肝炎病毒感染伴肝功能异常肝功能指标变化对孕妇早产发生的影响.方法:选择2007年1月-2008年12月间在我院产检及住院分娩的156例孕28周至37周存在肝功异常的乙肝孕妇进行了回顾性分析.结果:晚期妊娠合并病毒性乙型肝炎患者早产组与非早产组血清转氨酶水平比较,差异有统计学意义(P＜0.05);两组总胆红素、总胆汁酸水平比较,差异显著(P＜0.01).孕晚期ALT轻度、中度以上异常,旱产发生率分别32%、90%,OR分别为2.7、51;AST轻度、中度以上异常,早产发生率分别35%、87%,OR分别为3.1、37.9;总胆汁酸轻度、中度以上异常,早产发生率分别39%、91%,OR分别为3.6、57.2;总胆红素轻度、中度以上异常,早产发生率分别49%、88%,OR分别为5.4、41.6;早产组与非早产组比较,羊水粪染及胎儿宫内窘迫差异有统计学意义(P＜0.01),剖宫产率、产后出血、新生儿窒息两组间差异无显著性(P＞0.05).结论:乙肝孕妇晚期妊娠血清ALT和AST、TBA、TBI1水平均与早产发生有关.     

青岛地区孕妇产前传染性标志物检测结果分析

目的：了解青岛地区的孕妇在2001年-2009年间感传染性疾病的情况。方法：乙型肝炎表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人免疫缺陷病毒抗体（抗-HIV）的检测采用酶联免疫吸附实验（ELISA）,梅毒测定采用快速血浆反应素（RPR）环状卡片实验,对青岛地区2001年-2009年门诊收治的39369名孕妇的血液进行HbsAg、抗-HCV、抗-HIV、梅毒的检测,并对检测结果进行统计与分析。结果：2001年-2009年间青岛地区的孕妇产前感染以HBsAg多见,其次是梅毒感染和丙型肝炎病毒感染,阳性率分别为3.94%,0.18%和0.15%,抗-HIV暂未检出。各年间各种传染性疾病感染率无显著性差异（P〉0.05）。结论：通过对孕妇产前进行传染性标志物的检测,为临床预防及控制母婴垂直传播传染性疾病的发生提供了依据。     

青岛地区孕妇产前传染性标志物检测结果分析

目的:了解青岛地区的孕妇在2001年-2009年间感传染性疾病的情况。方法:乙型肝炎表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)、人免疫缺陷病毒抗体(抗-HIV)的检测采用酶联免疫吸附实验(ELISA),梅毒测定采用快速血浆反应素(RPR)环状卡片实验,对青岛地区2001年-2009年门诊收治的39369名孕妇的血液进行HbsAg、抗-HCV、抗-HIV、梅毒的检测,并对检测结果进行统计与分析。结果:2001年-2009年间青岛地区的孕妇产前感染以HBsAg多见,其次是梅毒感染和丙型肝炎病毒感染,阳性率分别为3.94%,0.18%和0.15%,抗-HIV暂未检出。各年间各种传染性疾病感染率无显著性差异(P>0.05)。结论:通过对孕妇产前进行传染性标志物的检测,为临床预防及控制母婴垂直传播传染性疾病的发生提供了依据。     

中国人群肝功能检测指标全基因组关联分析研究

肝功能检测(liver function test, LFTs)指标是受遗传和环境影响的复杂性状,具有个体差异性。为系统性研究中国人群全基因组范围内单核苷酸多态性(single nucleotide polymorphism, SNP)与肝功能指标之间的联系,本研究利用英国生物银行(UK Biobank)中1653名中国人的基因分型数据和表型数据为研究对象,利用PLINK软件进行全关联分析研究(genome-wide association study, GWAS),发现229个SNP与中国人群血液中的总胆红素(total bilirubin, TB)相关,27个SNP与中国人群血液中碱性磷酸酶(alkaline phosphatase, ALP)相关,36个SNP与中国人群血液中的γ-谷氨酰转肽酶(γ-glutamyl transpeptidase, GGT)相关,1个SNP与中国人群血液中的门冬氨酸氨基转移酶(aspartate transaminase, AST)相关,最显著的位点中有11个位点是新的LFTs关联位点。通过功能基因组分析,发现这些位点的临床意义(如吉尔伯特综合征)...     

妊娠期合并肝功能异常133例分析

目的分析妊娠期合并肝功能异常的病因构成及临床特征,提高对其临床表现的认识。方法收集133例妊娠期合并肝功能异常病例的临床资料,分析其临床特征、常见并发症对产程及胎儿的影响,并随访6个月后病情转归情况。结果 (1)妊娠相关并发症包括妊娠期合并肝内胆汁淤积症(29例),妊娠期急性脂肪肝(1例),妊娠剧吐(8例)和子痫前期肝功能损害(20例),除妊娠剧吐多出现在孕早期,其余均多发生于孕中晚期;非妊娠的因素包括急性病毒性肝炎(含重症肝炎)(41例),肝硬化(2例),药物性肝损害(1例),也多见于中晚孕期;还有一部分为原因不明(31例)。(2)妊娠合并肝功能异常的常见并发症包括胎儿宫内窘迫、早产、剖宫产、产后出血及围产儿死亡,其发生率与同期对照组比较,差异均有统计学意义。其中产后出血发生率比较,P0.05;其余并发症发生率比较,均P0.01。(3)6个月随访69例,其中妊娠相关肝功能异常好转率为81.5%(22/27),非妊娠相关肝功能异常好转率为20%(5/25),二者均有统计学意义(P0.01)。结论妊娠相关性肝病及妊娠合并病毒性肝炎是妊娠期肝功能异常的主要原因,正确认识并及时发现异常对降低母婴死亡率及改善预后具有重要意义。     

大连地区孕前期及孕早期妇女TORCH检测结果分析

目的 通过化学发光分析法对大连市妇幼保健院就诊的2 293例孕前和孕早期妇女TORCH检测结果进行分析,统计得出其感染的阳性率,为本地区育龄期妇女保健提供参考依据,加强TORCH对孕产妇影响的认识,并指导做好预防工作。方法 采用化学发光免疫分析法（CLIA)对2 293例孕前期及孕早期妇女进行巨细胞病毒（CMV）、单纯疱疹（HSV）、风疹（RV）、弓形虫（TOX）的IgG以及IgM进行检测。结果 IgG抗体检测结果：TOX阳性率为1.25%,CMV阳性率为95.04%,RV阳性率为84.78%,HSV阳性率为94.31%。IgM抗体检测结果：TOX阳性率为1.39%,CMV阳性率为1.48%,RV阳性率为2.28%,HSV阳性率为10.50%。结论 大连地区孕前期及孕早期妇女TORCH的阳性率偏高,TORCH的感染影响人口的质量,与优生优育有着重要的关系,要积极做好检测和预防,及早的干预和治疗。     

高龄孕妇孕早期心律失常及转归分析

目的：观察高龄孕妇孕早期ECG异常及心律失常发生特点,记录孕早期房性及室性心律失常的后期转归情况。方法：290例孕妇按照年龄分为35岁以下组,35~39岁组和40~45岁组。行心电图检查,系统分析心电图波形,采集记录异常心电图变化,包括ST段改变、各型心律失常等,记录房性、室性心律失常的好转率及加重率。结果：35~39岁组和40~45岁组心律失常发生率显著高于35岁以下组（P<0.05）;35~39岁组和40~45岁组ST段异常发生率显著高于35岁以下组（P<0.05）;40~45岁组QRS波增宽发生率高于35岁以下组（P<0.05）。35~39岁组和40~45岁组的窦性心动过速、窦性心律不齐和房性早搏发生率显著低于35岁以下组（P<0.05）;40~45岁组阵发性室上速发生率显著高于35岁以下组（P<0.05）,35~39岁组和40~45岁组室性早搏和房颤发生率均显著高于35岁以下组（P<0.05）。40~45岁组的房性心律失常恢复率显著低于35岁以下组（P<0.05）;40~45岁组的房性和室性心律失常加重率显著高于35岁以下组（P<0.05）。35~39岁组的ECG异常组、40~45岁ECG异常组发生率显著高于35岁以下组和35~39岁组的ECG正常组（P<0.05）;35~39岁组及40~45岁的ECG异常组胎儿窘迫发生率显著高于35岁以下组（P<0.05）。结论：高龄与孕早期心律失常发生有正相关,并且高龄因素降低孕期心律失常自行恢复率而升高心律失常恶化发生率,高龄孕妇伴有心电图异常对围生儿状况有不良影响。     

黄渤海典型海岛的石莼属绿藻形态学观察及分子系统发育分析

对黄渤海典型海岛的石莼属绿藻进行了调查和采集, 共采集到110 株石莼属样品。对所采集样品进行形态学观察, 就ITS、rbcL、tufA、LSU 序列进行分子系统发育分析。结果表明, 受海流条件影响较为相近的南隍城岛与獐子岛上石莼属绿藻种类组成较为相似, 都分布着孔石莼(Ulva pertusa)、缘管浒苔(Ulva linza)、浒苔(Ulva prilifera)、扁浒苔(Ulva compressa)、肠浒苔(Ulva intestinalis)、石莼(Ulva lactuca)六种石莼属绿藻; 而受海流条件影响差异较大的刘公岛上主要分布着孔石莼(Ulva pertusa)、缘管浒苔(Ulva linza)、浒苔(Ulva prilifera)、肠浒苔(Ulva intestinalis)、裂叶石莼(Ulva fasciata)五种石莼属绿藻。综合分析实地采样时观察到的石莼属形态及生境的区别, 探讨受海流条件影响不同的3 个海岛上石莼属的差异, 为石莼属绿藻生物地理学研究提供基础资料。     

新生儿凝血指标及部分生化指标检测参考区间调查

目的:调查分析新生儿凝血指标及部分生化指标检测参考区间。方法:以十所三甲医院2012年1月~2014年6月收治的新生儿2683例为研究对象,其中足月儿1700例,早产儿983例,选择同期十所医院职工健康体检1000例为对照组,通过全自动血凝仪、全自动生化分析仪测定所有对象凝血指标及12项生化指标,并建立相关指标参考区间。结果:足月新生儿PT、TT、APTT凝血指标较对照组延长,Fib较对照组降低,差异均有统计学意义(P=0.000);早产儿PT、TT、APTT较足月儿延长(P=0.000),Fib(P=0.001)降低;足月新生儿Glc水平较对照组低(P=0.000),早产儿Glc水平较足月新生儿更低(P=0.000);足月新生儿血钙水平低于对照组,血清TC、Cr、BUN、ALT含量均在对照组之下(P=0.000),早产儿相对更低(P均0.05);足月新生儿LDH、CK酶活性及K+水平均高于对照组(P均0.05),早产儿水平更高(P0.05);足月儿血清Alb、TP及Na+水平低于对照组(P0.05),早产儿更低(P均0.05)。结论:新生儿凝血表达与成人不同,凝血及部分生化指标参考区间的变化与年龄有联系,有必要为新生儿建立与年龄相关的凝血、生化指标参考区间。     

孕晚期妇女阴道微生态流行病学调查分析

目的 探讨孕晚期妇女阴道微生态状况,为进一步施行干预措施提供实验依据。方法 采用病例对照研究,采集研究对象下阴道2/3的白带样本进行阴道微生态检测,判定研究对象的阴道微生态状况。结果 共纳入4 852名孕晚期妇女及2 500名正常体检妇女进行阴道微生态的基本情况分析,孕晚期妇女的阴道微生态失衡状况高于非孕妇女。影响孕晚期妇女的阴道微生态失衡因素为H2O2阴性（OR=0.84,P=0.012）、唾液酸苷酶阳性（OR=2.25,P<0.001）、乳杆菌比例少（OR=2.73,P<0.001）、AV评分较高（OR=1.12,P=0.039）、酵母样真菌感染/定植（OR=2.22,P<0.001）、酵母样真菌与加德纳/普雷沃菌混合感染（OR=1.82,P=0.032）、Nugent评分较高（OR=1.41,P<0.001）及阴道Ⅲ~Ⅳ级的清洁度人数较多（OR=1.28,P=0.028）。结论 本地区孕晚期妇女阴道微生态存在失衡状况,下一步需提出合理干预措施,减少妊娠不良结局的风险。     

Maternal thyroid function in early and late pregnancy.

Thyroid function was investigated during and after pregnancy in 12 healthy euthyroid women. During pregnancy, serum total T4 (TT4) levels were significantly elevated and nearly stable, while thyroxine-binding globulin (TBG) levels progressively increased till the 7th month. A slight elevation, though not significant, of free T4 (fT4) was recorded in early pregnancy. In the following months, fT4, free T3 (fT3) and the T4/TBG ratio progressively diminished, reaching a plateau at the 7th month. Serum TSH levels, measured by an ultrasensitive immunofluorometric assay, were comparable to postpartum values during the first trimester and showed a moderate upward trend with the progression of pregnancy. The evaluation of 24-hour TSH profiles was performed in 5 women during the first trimester of pregnancy. In all women, the circadian rhythm of TSH was present with a normal nocturnal surge, though anticipated in 1 case. In summary (1) during the first trimester of pregnancy, the increased thyroid activity does not seem to be only sustained by pituitary TSH which remains unmodified; the negative correlation between TSH and hCG levels might suggest that hCG also stimulates the gland to increase thyroid hormone output, and the presence of a normal TSH circadian rhythm indicates that the central mechanism of neuroregulation of the pituitary-thyroid axis is preserved in early pregnancy, and (2) in late pregnancy, a marked decrease in free thyroid hormone fractions is accompanied by serum TSH levels still in the normal range, indicating a modification of thyroid homeostasis which might recognize various etiological factors.     

Decrease in serum prolactin during bromocriptine-induced pregnancy and subsequent restoration of reproductive function in some hyperprolactinemic women

Twenty-two women with hyperprolactinemia and amenorrhea were followed up for at least 18 months after 22 bromocriptine-induced full term pregnancies. Return of menstruation occurred in 9 of the 22 patients after pregnancy. Five of them conceived subsequently without any treatment. The prolactin (PRL) concentration before or during bromocriptine treatment was not significantly different between the patients who conceived spontaneously and those who did not. However, the PRL concentration after weaning was significantly lower in the patients who conceived spontaneously than in those who did not. Serum PRL levels were normal or only slightly elevated in the patients who conceived spontaneously. In 11 of the 22 patients, PRL levels were serially determined during bromocriptine-induced pregnancies. In 7 of the 11 patients, serum PRL levels fell during the second or third trimester. Spontaneous pregnancy occurred in 3 of the 7 patients who showed a decrease in PRL values during pregnancy, but in none of the 4 patients who did not. Furthermore, PRL levels after weaning correlated with PRL levels during the third trimester in these 11 women. Consequently, a decrease in PRL values during pregnancy may result in a fall in PRL levels after pregnancy, which in turn leads to the restoration of reproductive function in some subjects.     

Requirement of vasculogenesis and blood circulation in late stages of liver growth in zebrafish

Background

In the vascular system, Notch receptors and ligands are expressed mainly on arteries, with Delta-like 4 (Dll4) being the only ligand known to be expressed early during the development of arterial endothelial cells and capillaries. Dll4 null embryos die very early in development with severely reduced arterial calibre and lumen and loss of arterial cell identity.

Results

The current detailed analysis of these mutants shows that the arterial defect precedes the initiation of blood flow and that the arterial Dll4 ^-/- endothelial cells proliferate and migrate more actively. Dll4 ^-/- mutants reveal a defective basement membrane around the forming aorta and increased endothelial cell migration from the dorsal aorta to peripheral regions, which constitute the main causes of arterial lumen reduction in these embryos. The increased proliferation and migration of Dll4 ^-/- endothelial cells was found to coincide with increased expression of the receptors VEGFR-2 and Robo4 and with downregulation of the TGF-β accessory receptor Endoglin.

Conclusion

Together, these results strongly suggest that Notch signalling can increase arterial stability and calibre by decreasing the response of arterial endothelial cells to local gradients of pro-angiogenic factors like VEGF.     

孕晚期妇女无乳链球菌感染与耐药性情况及对新生儿的影响

目的探讨孕晚期妇女无乳链球菌感染与耐药性情况及对新生儿的影响。方法选择在金华市妇幼保健院就诊的孕晚期妇女共1 000例,采集孕妇泌尿生殖道标本并进行无乳链球菌培养及药敏试验,探讨孕晚期妇女无乳链球菌的感染情况及耐药性,并根据培养结果分为观察组与对照组,其中观察组为无乳链球菌培养阳性,对照组为无乳链球菌培养阴性,随访并比较两组新生儿无乳链球菌感染情况。结果 1 000例孕晚期妇女共检测出118例感染无乳链球菌,感染率11.80%;无乳链球菌耐药性较高的三种抗生素为四环素86.44%、红霉素73.73%、阿奇霉素56.78%,对头孢曲松、头孢呋辛、青霉素G、亚胺培南、利奈唑胺、万古霉素六种抗生素未发现耐药;观察组新生儿无乳链球菌感染率明显高于对照组(P0.05)。结论孕晚期妇女无乳链球菌感染率较高,容易通过母婴垂直传播感染新生儿,应早期选择合适抗生素治疗,实验室药敏结果能为临床合理使用抗菌药物提供重要的依据。     

Topographical specialization of prostaglandin function in late pregnancy and at parturition in the baboon

Prostaglandins play key central roles in both the maintenance of pregnancy and parturition. Extensive data exist from studies in human pregnancy but the needs of clinical management and the inability to conduct carefully controlled perturbation studies in human pregnancy make it necessary to obtain information from nonhuman primate models. We have used the pregnant baboon to evaluate production, metabolism and receptor mediated actions of prostaglandins in late gestation to demonstrate that expression of key genes is tightly controlled in enzyme-specific, gestation age-specific, tissue-specific and uterine region-specific fashion.