Myotonic dystrophy type 1 during pregnancy: a case report / 中华围产医学杂志

This paper reports the diagnosis and treatment of a pregnant woman complicated with myotonic dystrophy (DM) type 1(DM1). The pregnant woman complained of occasional dull pain in the precardiac region accompanied by night sweats in the first trimester and a mild increase in myocardial enzymes was observed. Symptoms were improved after oral medication followed by no regular reexamination. While in the third trimester, abnormal myocardial enzyme, liver enzyme, and urinary protein were found and echocardiography and abdomen ultrasound suggested multiple organic lesions involving the heart and spleen. A girl was born through cesarean section at 36 +5 weeks of gestation due to maternal heart failure, with Apgar scores of 10 at 1 and 5 minutes. The patient developed acute respiratory failure, ventricular bigeminy, and diarrhea after surgery. Neurology consultation found incomplete buried eyelids in both eyes, weak bulging cheeks, and weak upper extremity muscle strength. Muscle biopsy confirmed the diagnosis of DM and genetic testing showed abnormal amplification of non-coding region [CTG] n in myotonic dystrophy protein kinase gene in chromosome 19q13.3, which indicated DM1. The mother recovered well at nine months postpartum. Further genetic analysis of pedigree and offspring is recommended.

Intra-abdominal aortic balloon occlusion in the management of placenta percreta / 中华医学杂志(英文版)

BACKGROUND@#Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients.@*METHODS@#We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed.@*RESULTS@#One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2 = 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2 = 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P = 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t = -0.638, P = 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups.@*CONCLUSIONS@#IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.

Effects of interpregnancy interval on pregnancy outcomes of subsequent pregnancy: a multicenter retrospective study / 中华妇产科杂志

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

Risk factors and sonographic findings associated with the type of placenta accreta spectrum disorders / 中华妇产科杂志

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.

The clinic significance of TIP30 and VEGF-C protein expressions in small cell lung cancer / 实用肿瘤学杂志

Objective To investigate the correlation between TIP 30 and VEGF-C expression and clini-cophathological characteristics in resected small cell lung cancer ( SCLC) patients and to identify patients with in-creased risk of cancer recurrence and to provide a theoretical basis for the further clinical prevention of SCLC . Methods Sixty eight resected SCLC patients were included in this study .Paraffin-embedded specimens of pa-tients were used for the evaluation of TIP 30 and VEGF-C expression by immunohistochemistry .Results The expression of VEGF-C had positive correlation with lymph node metastasis .TIP30 expression was positively cor-related with VEGF-C expression.Patients with low TIP30 expression had shorter Overall survival (OS)and Dis-ease-Free survival(DFS)than those with high TIP30 expression.OS and DFS of the patients with VEGF -C-positive tumors were significantly lower than that of the patients with VEGF -C negative tumors .The multivariate Cox regression analysis showed that low TIP 30 and high VEGF-C expression were independent markers of poor OS(P<0.01)in operable SCLC patients.Conclusion The expression of VEGF -C shows positive correlation with lymph node metastasis .Low TIP30 and high VEGF -C expression are independent prognostic markers of poor overall survival in resected SCLC patients .

Expression of Gas6 in placenta and decidua tissues and its relationship with the pathogenesis of preeclampsia / 中华妇产科杂志

Objective To investigate the expression of growth arrest-specific protein 6 (Gas6) in the placenta and decidua tissues and its relationship with the pathogenesis of preeclampsia. Methods All the patients were recruited in Qilu Hospital of Shangdong University from October 2013 to June 2014. Among them, thirty-two women with early-onset severe preeclampsia who received cesarean section were assigned to the preeclampsia group, and thirty healthy pregnant women who received cesarean section were defined as the control group. Blood glucose, blood lipids, platelet count, D-dimer levels and other clinical indicators of the two groups were detected. Immunohistochemistry of SP was conducted to identify the localization of Gas6 protein in the placenta and decidua tissues. And reverse transcription (RT)-PCR was performed for quantitative analysis of Gas6 RNA expression in placentas. The correlations between placental Gas6 mRNA levels with clinical indicators were analyzed. Results (1) The gestational age at delivery, blood pressure, serum albumin, platelet count and birth weight of fetuses showed statistically significant differences between the two groups(P<0.05). (2) The Gas6 protein expressed in the cytoplasm and nucleus of the syncytiotrophoblasts and decidual cells in the placenta and decidual tissues of the two groups. (3) The Gas6 mRNA expression elevated significantly in the placenta of preeclampsia group (0.60 ± 0.38) when compared to that of the control group (0.34±0.22;P<0.05). (4) The expression of Gas6 mRNA was positively related with body mass index, diastolic blood pressure, systolic blood pressure, free fatty acids and creatinine (P<0.05), while it was negatively associated with serum albumin(P<0.05). Conclusion The high expression of Gas6 in the placenta and decidua tissues may be related to the pathogenesis of severe preeclampsia.

Expression of interleukin-37 in placenta and its relationship with the pathogenesis of severe preeclampsia / 中华妇产科杂志

Objective To investigate the expression of interleukin-37 (IL-37) in placenta tissue and its relationship with the pathogenesis of severe preeclampsia. Methods All the patients were recruited in Qilu Hospital of Shangdong University from November 2012 to November 2013. Among them, thirty patients with severe preeclampsia were assigned to the preeclampsia group, and thirty-one healthy pregnant women were assigned to the control group. Immunohistochemistry of SP was used to detect the IL-37 protein expression in placenta tissue of the two groups. The expression level of IL-37 in placenta tissue of the two groups was detected by western blot. Besides, reverse transcription(RT)-PCR was used to detect the expression of IL-37 mRNA. The correlation between the expression of IL-37 mRNA and the delivery gestational age, body mass index(BMI)was analyzed. Results (1) IL-37 were detected in the placenta of both the preeclampsia group and the control group, and the expression site mainly located in the syncytiotrophoblast, with a small amount in cytotrophoblast.(2)The expression levels of IL-37 protein in the preeclampsia group and the control group were 0.59 ± 0.39 and 0.88 ± 0.22, respectively. The IL-37 mRNA levels in the preeclampsia group and the control group were 0.55 ± 0.17 and 1.11 ± 0.21, respectively. Both decreased significantly when compared to the control group (P0.05) was seen neither in the preeclampsia group nor in the control group(r=-0.053, P>0.05). In the severe preeclampsia group, the pregnant women′s BMI had no significant correlation with IL-37 mRNA expression of placenta tissue(r=0.102, P>0.05), neither did the control group(r=-0.115, P>0.05). Conclusion IL-37 expression is significantly lower in severe preeclampsia placenta tissue than that in the normal pregnant women, which may play a protective role in the course of severe preeclampsia.

The expression and prognostic significance of tumor suppressor gene ING1 in colorectal cancer / 实用肿瘤学杂志

Objective Inhibitor of growth 1 ( ING1 ) gene has been identified as a novel candidate of tumor suppressor gene .Over-expression of ING1 plays well-established roles in numerous cell processes ,inclu-ding DNA repair and cell apoptosis .Our study is to investigate the clinical significances of expression of ING 1 in colorectal cancer ( CRC) .Methods The mRNA level of ING1 in 82 matched samples comprising primary CRC and paired non-cancerous mucosa were detected and compared by quantitative RT -PCR.Then the correlations of mRNA level of ING1 with the clinicopathological characteristics and prognosis of patients with CRC were ana -lyzed.Results (1)In the same matched tissues,the expression level of ING1 was significantly higher in normal tissues than that in cancer tissues.(2)mRNA expression of ING1 was associated with certain clinical -pathologic variables such as tumor infiltrating level ,lymphatic metastasis,distant metastasis and advancing TNM stage .(3) We obtained the expression levels ratio of cancer tissue and normal tissue and found the lower ratio has a lower Disease-Free Survival(DFS)(P<0.0001).(4)ING1,as a candidate of tumor suppressor gene ,remained a sta-tistically-significant prognostic marker in the Cox regression analysis .Conclusion Down-regulation of ING1 may be correlated tightly with the occurrence and progression of sporadic colorectal cancer .Its expression level can be used to predict prognosis of CRC .

Multi-center study of motherwort injection to prevent postpartum hemorrhage after caesarian section / 中华妇产科杂志

Objective To evaluate the efficacy and safety of motherwort (herbs leonuri/leonurus heterophyllus sweet) injection for preventing postpartum hemorrhage after caesarian section. Methods The prospective study was designed as a randomized and single blind multi-center research matched with positive agent as controls from Apt 2007 to Aug 2007. 440 women underwent caesarian section (CS) indicated by obstetric factors were enrolled from 15 teaching hospitals in China and assigned into three groups: group of motherwort: 147 cases were administered by motherwort 40 rag uterine injection during CS and 20 mg intramuscular injection per 12 hours 3 times after CS; group of motherwort + oxytocin : 144 cases were administered by motherwort 40 mg and oxytocin 10 U uterine injection during CS and motherwort 20 mg intramuscular injection per 12 hours 3 times after CS and group of oxytocin: 149 cases were administered by oxytocin 10 U uterine injection and oxytocin 10 U + 5% glucose 500 nd intravenously injection during operation and oxytocin 10 U intramuscular injection per 12 hours 3 times after CS. The following clinical parameter were collected and analyzed: (1) The amount of blood loss during operation, at 2, 6, 12, 24, 48 hours after operation. (2) The total amount of blood loss in 24 hours after CS and the incidence of postpartum hemorrhage. (3) The change of level of hemoglobin (Hb) and counting of red blood cell ( RBC ) from prepartum to postpartum. (4) Adverse reaction. Results (1) The mean amount of blood loss during operation were (368±258) ml in group of motherwort, (255±114) mi in group of motherwort + oxytocinand (269±141 ) ml in group of oxytocin, which exhibited significant difference among three groups ( P<0.01 ). Meanwhile, no statistical different amount of blood loss among three groups were observed at 2,6,12, 24, 48 hours after CS. (2)The amount of blood loss of postpartum at 24 hours were (480±276)ml ingroup of motherwort, (361±179) ml in group of motherwort + oxytocin, (381±179) nd in group of oxytocin, which showed significant difference among 3 groups(P <0.01 ). (3) The incidence of postpartum hemorrhage were 32.0% (47/147) in group of motherwort, 11.1% (16/144) in group of motherwort + oxytocin, and 18.8% in (28/149) in group of oxytocin. When comparing the lowest rate of postpartum blood loss in group of motherwort + oxytocin and the highest rate in group of motherwort, it displayed statistical difference (P<0.01). (4) The decreased level of RBC and Hb were shown that RBC(0.3±0.5)×10<'12<‘/L and Hb(9±13)g/L in group of motherwort, RBC (0.2±0.4)×10<'12/L and Hb ( 6±10) g/Lin group of motherwort + oxytocin and RBC (0.2±0.4)×10<'12/L and Hb(7±30) g/L in group of oxytocinrespectively. However, the comparison of different value of RBC and lib in group of oxytocin and motherwort +oxytocin showed significant difference (P<0.05 ). (5) Two cases with allery reaction was observed.Conclusion It is safe and efficacious that combined use of motherwort injection and oxytocin was to preventpostpartum hemorrhage during or after caesarian section.

Molecular imaging of human breast cancer xenografts in nude mice by epidermal growth factor labelled by near infrared fluorescent dye / 中华放射学杂志

can specifically combined with EGFR, which may be applied to noninvasive NIRF imaging of tumors highly expressed EGFR in vivo.

Effect of nano-sized-Fe3O4-lipoteichoic acid from Bifidobacterium on cytokine expression in human gastric cancer in nude mice / 中华微生物学和免疫学杂志

Objective To investigate the effect of lipoteichoic acid from Bifidobacterium loaded with magnetic particle nano-sized-Fe3O4(nano-sized-Fe3O4-BLTA)on several cytokines in vivo expression in beterologous graft model for human gastric cancer in nude mice.and to analyze the inhibition mechanism of nano-sized-Fe3 O4-BLTA on BGC-823 human gastric carcinoma transplanted tumor.Methods Forty male nude mice(BALB/e.nu/nu)were used for in vivo transplant tumor model.the experimental animals were randomly divided into five groups to administrated by several dosages of Hano-sized-Fe3 O4-BLTA,and were executed after 12 d.The tumors were collected and photographed.and the tumor tissues were used for differ-ent assays for measuring tumor inhibition.The peritoneal fluid was extracted to isolate the macrophages for cytokines assays.Using irmnunohistochemical staining for vascular endothelial growth factor(VEGF)and CD3 l in tumor to investigate the tumor inhibition rate.Double antibody sandwich ELISA was used to detect the level of cytokine change.Results The mice treated with low dosage(10 μg/d)of nano-sized-Fe3O4-BLTA.the growth inhibifion rate of tumor was 49%,and the levels of VEGF(0.0224±0.0763)and CD31 (57.000 4±6.790)were lower than other treated groups(P<0.01).The high dosage(100μg/d)and me-dium dosage(50μg/d)of nano-sized-Fe3 O4-BLTA groups were significant difference(P<0.01)on the content of cytokines excreted by macrophages.The level of TNF-α(39.4040 ±-1.5590)induced by the low dosage group was higher relatively(P<0.01).Conclusion Nano-sized-Fe3O4-BLTA exerts an inhibiting effect on the growth of human gastric cancer in nude mice.Using nano-sited-Fe3 O4-BLTA,LTA can get more permeability and improve the therapy effect.which will be a new drug on the stomach cancer targeted therapy.

Association between rheumatoid arthritis and shared epitope of HLA-DRB1 gene in Shandong population / 中华风湿病学杂志

Objective To investigate the association between rheumatoid arthritis (RA) and the presence of the shared epitope (SE) of HLA DRB1 gene in Han nationality of Shandong population.Methods The method of DNA amplification with sequence specific primers (PCR SSP) was used to determine 17 alleles of HLA DRB101,04,10 genotypes in 132 RA patients and 130 healthy controls from the Han nationality population in Shandong.Results The frequencies of SE were significantly increased in RA patients compared with controls (50 0% vs 22 3%, P

Effects of human immunodeficiency virus infection on pregnancy outcome / 中华妇产科杂志

Objective To investigate the effects of human immunodeficiency virus (HIV) infection on the pregnancy outcome and the incidence of vertical transmission in HIV positive pregnant women Method 86 cases of HIV positive pregnant women and their infants were evaluated retrospectively, and HIV antibody in peripherial blood was detected using enzyme linked immunosorbent assay (ELISA) Results Compared with normal control group, the incidences of abortion, preterm birth, low birth weight and small for gestational age babies were 9 3%, 14 0%, 16 3% and 10 5%, respectively ( P

Study on prenatal diagnosis using fluorescence quantitative polymerase chain reaction for congenital toxoplasmosis / 中华妇产科杂志

Objective To investigate prenatal diagnosis and treatment of toxoplasmosis in fetuses with fluorescence quantitative polymerase chain reaction (FQ PCR) technique Methods Of the 70 pregnant women with toxoplasma(TOX) DNA positive , TOX DNA in amniotic fluid and/or fetal umbilical cord blood was detected with FQ PCR technique to diagnose fetal infection 48 ones were given routine treatment with spiramycin for 2 therapy periods Ultrasound examination were undertaken in all of pregnant women to monitor fetal growth Results Of the 70 cases with TOX DNA positive, TOX DNA was detected in 21 fetuses TOX DNA positive rates were similar in amniotic fluid and umbilical cord blood The higher the TOX DNA, the higher fetal infectious rate Fetal infectious rate was lower in treatment group(21%) than that in control group (50%), there was a statistically difference between two groups Conclusions Maternal TOX infection may cause fetal damage Detection of TOX DNA in amniotic fluid with FQ PCR technique can diagnose fetal toxoplasmosis exactly Treatment in pregnant period may decrease intrauterine infection rate

Study on breast-feeding in hepatitis B virus carrier women / 中华围产医学杂志

Objective To explore the possibility of breast feeding in chronic asymptomatic hepatitis B virus (HBV) carriers after immuno prophylaxis of the infants. Methods The infants with asymptomatic HBV carriers mothers were selected by the obstetric department of Qilu Hospital of Shangdong University, Jinan Maternity and Infant Health Institute of Shangdong from Sept 2001 to Oct 2003 prospectively. Umbilical blood HBV deoxyribonucleic acid (HBV DNA) was detected at birth. All infants received 200 IU HBV specific immunoglobin(HBIG)within 12 hours and on 14 days after birth. The hepatitis B recombinant vaccine was given within 24 hours after birth and at 1 and 6 months of age. The way of feeding was chosen by the mothers as they liked. There were 55 infants in breast feeding group and 36 in bottle feeding group. Infants were then followed up at 7 and 12 months of age and tested for hepatitis B surface antigen(HBsAg), hepatitis B surface antibody (anti HBs), hepatitis B e antigen(HBeAg), hepatitis B e antibody(anti HBe) and hepatitis B core antibody(anti HBc) and HBV DNA. Uninfected infants with negative anti HBs were given repeated dose of vaccinations. Results At 7 and 12 months of age, the positive rates of HBV DNA were 9.09%(5/55)and 9.09%(5/55), anti HBs were 85.45%(47/55)and 90.90%(50/55)in breast feeding group respectively;while the positive rates of HBV DNA were 8.33%(3/36)and 8.33%(3/36), anti HBs were 86.11%(31/36)and 91.67%(33/36)in bottle feeding group respectively. No significant differences was shown in positive rates of HBV DNA and anti HBs between these two groups. Conclusions With appropriate immunoprophylaxis, including hepatitis B immune globulin and hepatitis B vaccine, HBV carriers can breast feed their babies.