Metabolic characteristics and management of polycystic ovary syndrome during pregnancy / 中国实用妇科与产科杂志

Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disorders in women of childbearing age,which may have adverse effects on both pregnant and non-pregnant women.In recent years,it has been found that PCOS appears to increase risks of developing adverse outcomes,which may be related to insulin resistance,obesity,glucose and lipid metabolic disorders and hyperandrogenism.Proper management of PCOS in prepregnancy,preg⁃nancy and postpartum might play important roles in the prevention of short-term and long-term complications.The metabolic characteristics and management of PCOS are reviewed in this article.

Progress in pathogenesis of adverse pregnancy outcomes induced by group B Streptococcus / 中华微生物学和免疫学杂志

Group B Streptococcus ( GBS) is a leading infectious cause of adverse pregnancy out-comes such as preterm birth. GBS colonizes the vagina during pregnancy and can ascend into the uterus and then infect the fetus. It encodes a series of virulence factors such as adhesion and invasion factors, hemolytic pigments and hyaluronidase, which are important to vaginal colonization and immune evasion. Immune re-sponses to GBS cause the release of a multiple of inflammatory mediators, leading to the premature rupture of membranes, preterm birth and fetal injury. This paper reviews the pathogenesis of GBS vaginal colonization and ascending infection causing adverse pregnancy outcomes.

Chemical constituents from stems of Cipadessa cinerascens / 中草药

To study the chemical constituents from the stems of Cipadessa cinerascens. The constituents were separated by column chromatography and their structures were elucidated by spectral data analyses. Seventeen chemical constituents were isolated from the EtOAc extract in the stems of C. cinerascens and their structures were identified as lanost-7-en-3-one-22, 25-epoxy-23, 24-acetone acetal (1), chisopanin M (2), 3β-hydroxy-5-en-stigmast (3), 7α-hydroxy-4-en-3-one-stigmast (4), 3β-hydroxy-5-en-7-one-stigmast (5), 7α-hydroxysitosterol (6), 22E-7α-methoxy-5α, 6α-epoxy-8 (14), 22-dien-3β-hydroxy-ergosta (7), 7β-hydroxy-4-en-3-one-cholest (8), 3β-acetyloxy-2β, 4β-dihydroxy-16-one-pregnan (9), 17α, 20R-dihydroxy-3, 16-dione-pregnan (10), 2β, 3β-dihydroxy-16-one-pregnan (11), 3β, 7α-dihydroxy-20-one-pregnan (12), 2α, 3β-dihydroxy-5-en-20-one-pregnan (13), 1, 4-dien-3, 16-dione-2-hydroxyandrosta (14), 5-en-17-one-3β, 16β-dihydroxyandrost (15), apegenin (16), and annuionone D (17). Conclusion All the compounds except 14 and 17 are obtained from this plant for the first time.

Controle do ganho de peso materno na gestação: revisão sistematizada / Control of the maternal weight gain during pregnancy: systematic review

O objetivo deste trabalho foi avaliar as técnicas utilizadas para o controle do ganho de peso na gestação. Foram selecionados estudos randomizados, publicados entre 2001 e 2011, em língua portuguesa e inglesa, nas bases eletrônicas de dados PubMed, MEDLINE, SciELO e Cochrane. As palavras-chave foram: “ganho de peso”, “dieta”, “gestantes”, “gestação”, “comportamento alimentar” ou “nutrição materna” e suas equivalências na língua inglesa. Os filtros foram humanos, mulheres e ensaios clínicos. Foram excluídos estudos em que as gestantes iniciavam a pesquisa com algum tipo de doença (diabetes, câncer, HIV, hipertensão) ou que apresentavam gestação de gemelares. As principais técnicas aplicadas pelos autores foram a prescrição dietética individualizada, orientações alimentares gerais, consultas frequentes com nutricionista ou médico e a prática de atividade física. Entre os onze artigos selecionados, dez (90,9%) estudos associaram duas ou mais técnicas no Grupo Intervenção, sendo que as mais utilizadas foram as consultas frequentes com os profissionais de saúde e o estímulo à prática de atividade física. Seis (54,5%) estudos foram eficazes no controle do ganho de peso com a associação de duas ou mais técnicas. A associação entre diferentes técnicas e o início precoce das intervenções conseguiu controlar adequadamente o ganho de peso na maioria dos estudos.

The objective of this study was to evaluate the techniques for control of the weight gain during pregnancy. The randomized trials published between 2001 and 2011, in Portuguese or English languages, in electronic databases PubMed, MEDLINE, SciELO and Cochrane were selected. The keywords were: “weight gain”, “diet”, “pregnant women”, “pregnancy”, “maternal nutrition” or “feeding behavior” and their equivalents for the Portuguese language. The filters were human, women and clinical trials. We excluded all studies in pregnant women who had began the research with some type of illness (diabetes, cancer, HIV, hypertension) or who had gemelar pregnancies. The main techniques applied by the authors were individualized dietary prescription, general dietary guidelines, frequent consultations with a nutritionist or doctor, and physical activity. Among the eleven selected articles, ten (90.0%) studies have linked two or more techniques in the Intervention Group and the most frequently used were consultations with health professionals and encouragement for physical activity. Six (54.5%) studies were effective in controlling weight gain with the combination of two or more techniques. The association between different techniques and early interventions could properly control the weight gain in most of the studies.

Toxoplasmose e gestação: resultados perinatais e associação do teste de avidez de IgG com infecção congênita em gestantes com IgM anti-Toxoplasma gondii reagente / Toxoplasmosis and pregnancy: perinatal results and association of the IgG avidity test with congenital infection in pregnant women with positive anti-Toxoplasma gondii IgM

Objetivos: verificar os desfechos perinatais em gestantes com toxoplasmose aguda e se houve associação entre os resultados dos testes de avidez para anticorpos IgG anti-Toxoplasma gondii e a presença ou ausência de infecção fetal/neonatal. Métodos: um estudo transversal incluiu gestantes com diagnóstico sorológico de toxoplasmose apresentando IgM específica reagente, atendidas no Ambulatório de Gestação de Alto Risco da Faculdade de Medicina da Universidade Federal de Mato Grosso do Sul, no período de novembro de 2002 a novembro de 2007. Resultados do teste de avidez de IgG demonstrando índices superiores a 30% foram considerados alta avidez, enquanto valores inferiores a 30% foram considerados baixa avidez. Definiram-se como sendo de infecção fetal e/ou neonatal os casos com resultado positivo para a reação em cadeia da polimerase no líquido amniótico ou com IgM específica para toxoplasmose reagente no sangue do recém-nascido. Resultados: considerando-se todas as gestantes referidas para o ambulatório de gestação de alto risco no período estudado, a frequência de gestantes com IgM anti-Toxoplasma gondii reagente foi de 10,8% (176/1.634). A taxa de infecção congênita nessas pacientes foi de 4% (7/176). O teste de avidez de IgG foi realizado em 162 gestantes (92%), encontrando-se avidez alta em 144 (88,9%). Houve associação (p=0,003) entre avidez alta e ausência de toxoplasmose fetal/neonatal na amostra estudada, com razão de prevalência de 13,4 (intervalo de confiança [IC] 95% 2,2-86,6). O Valor preditivo positivo do teste de avidez (probabilidade de infecção congênita com avidez baixa) foi de 22% (IC 95% 6%-47%), enquanto o valor preditivo negativo (probabilidade de ausência da infecção congênita com avidez alta) foi de 98% (IC 95% 94%-99%).

Aims: To verify the perinatal outcomes in pregnant women with acute toxoplasmosis, and to determine if there was association between the results of Toxoplasma gondii-specific IgG avidity test and the presence or absence of fetal/neonatal infection. Methods: A cross-sectional study included pregnant women with serological diagnosis of acute toxoplasmosis (presenting a positive Toxoplasma gondii-specific IgM test) attended at the outpatient unit for high-risk pregnancy of the Faculty of Medicine, Federal University of Mato Grosso do Sul, Brazil, in the period from November 2002 to November 2007. Test results demonstrating IgG avidity index above 30% were considered high avidity, while values below 30% were considered low avidity. Fetal and/or neonatal infection was defined by positive result for the polymerase chain reaction in amniotic fluid, or by a positive Toxoplasma gondii-specific IgM test in the newborn?s serum. Results: Considering all pregnant women referred to the outpatient unit for high-risk pregnancy in the period of study, frequency of pregnant women with positive Toxoplasma gondii-specific IgM was 10.8% (176/1.634). The rate of congenital infection in these patients was 4% (7/176). The IgG avidity test was performed in 162 patients (92% of the 176 pregnant women with positive IgM), and the avidity was high in 144 (88.9%). There was an association (p=0.003) between high avidity and no fetal/neonatal toxoplasmosis in our sample, with a prevalence ratio of 13.4 (confidence interval [CI] 95% 2.2-86.6). The positive predictive value of the avidity test (probability of congenital infection with a low avidity) was 22% (95% 6%-47%), while the negative predictive value (probability of absence of congenital infection with a high avidity) was 98% (95% CI 94% -99%).

Some progress on the chemistry of natural bioactive terpenoids form Chinese medicinal plants

(1) Pseudolaric acids - Novel diterpenes, Pseudolaric acid A, B, C and D were isolated from Pseudolarix kaempferi Gorden (pinaceae). Their structures were assigned by spectroscopic data and chemical correlations. In the contineous studies, the absolute configurations, the conformations in the solutions, the framentation mechanisms of MS and assigments of all NMR spectral signals were also reported. They showed the antifungal and cytotoxic activities. (2) Daphnane diterpenes - In the further studies on the plants of Thymelaeaceae, besides 10 known diterpenes, 16 new daphnane diterpenes were isolated from Daphne genkwa, D. tangutica, D. giraldii, Wikstroemie chamaedaphne. They showed the antifertilities activities. (3) Tripterygium diterpenes 14 new diterpenes were isolated from Triperygium wilfordii, T. regeli and T. hypoglaucum. Some of them showed the antitumor activities. The CD spectra showed that A/B ring of all compoundshave trans configuration as same as tripdiolide and triptolide determined by X-ray diffraction (4) Pregnane glycosides from Marsdenia koi - Two new pregnane glycosides marsdenikoiside A and marsdenikoiside B which can terminate the early pregnancy were isolated from Marsdeia koi. Their structures were elucidated by hydrolysis and spectroscopic methods.