Influential factors of adverse pregnancy outcome in women with subchorionic hematoma / 中国基层医药

Objective:To investigate the influential factors of adverse pregnancy outcomes in women with subchorionic hematoma.Methods:A total of 101 women with subchorionic hematoma who received treatment in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2017 to June 2020 were included in this study. They were divided into a control group and an adverse pregnancy outcome group according to whether there was an adverse pregnancy outcome. The epidemiological characteristics, hematoma characteristics observed on ultrasound images, and pregnancy outcomes were compared between the two groups.Results:There was no significant difference in the number of women who used assisted reproductive technology between the control and adverse pregnancy outcome groups [6 (8.0%) vs. 8 (30.7%), χ2 = 8.38, P = 0.004]. There was a significant difference in hematoma volume between adverse pregnancy outcome and control groups [(4.12 ± 0.61) mL vs. (6.36 ± 0.87) mL, t = 6.73, P = 0.009]. There was a significant difference in the number of patients who had obstetric complications between control and adverse pregnancy outcome groups [11 (14.7%) vs. 16 (61.5%), χ2 = 21.66, P = 0.001]. There was a significant difference in the number of patients who had hematomas located at the edge of the placenta between the control and adverse pregnancy outcome groups [15 (20.0%) vs. 12 (46.2%), χ2 = -4.81, P = 0.001]. Conclusion:Women who use assisted reproductive technology for pregnancy, have obstetric complications, or have a subchorionic hematoma with hematoma at the edge of the placenta are more likely to experience a miscarriage. Therefore, women of childbearing age should actively treat the primary disease and be alert to the occurrence of placental abruption.

Manejo del embarazo gemelar monocoriónico monoamniótico: revisión de la literatura y reporte de caso

A propósito de la presentación de un caso de embarazo gemelar monocoriónico monoamniótico, se revisó la literatura sobre su diagnóstico y manejo mediante búsqueda electrónica en la base de datos de Medline, OVID, Cochrane y PubMed entre los años 1966 y 2019. Las palabras clave utilizadas en la indagación fueron: embarazo, gemelos, monoamniótico, enredamiento de cordones. Existe un riesgo alto de muerte fetal súbita en gemelos monoamnióticos causado por el enredamiento de los cordones umbilicales, por lo que el diagnóstico oportuno de la corionicidad y amnionicidad en el embarazo gemelar mediante ecografía puede dar la pauta para una vigilancia fetal estrecha y mejorar así el resultado obstétrico.

In view of the presentation of a case of monochorionic monoamniotic twin pregnancy, the literature on its diagnosis and management was reviewed by electronic search in the Medline, OVID, Cochrane, and PubMed databases between 1966 and 2019. The key words used in the inquiry were: pregnancy, twins, monoamniotic, cord entanglement. There is a high risk of sudden fetal death in monoamniotic twins caused by entanglement of the umbilical cords, so timely diagnosis of chorionicity and amnionicity in twin pregnancy by ultrasonography may provide guidance for close fetal surveillance and thus improve obstetric outcome.

Anastomosis placentarias en embarazos gemelares monocoriales: estudio mediante técnicas de inyección vascular y relación con complicaciones fetales / Placental anastomoses in monochorionic twin pregnancies: study using vascular injection techniques and relationship with fetal complications

RESUMEN Introducción. Los embarazos gemelares son clasificados en dos grupos: monocoriónico (MC) y dicoriónico (DC). Los gemelos MC tienen 5 a 6 veces más riesgo de tener un resultado perinatal adverso. Se publica el estudio de un grupo de 22 placentas de pacientes con embarazo gemelar monocoriónico que presentaron complicaciones como síndrome de transfusión feto-fetal (STFF), secuencia de anemia policitemia (TAPS), perfusión arterial reversa (TRAP) y restricción de crecimiento intrauterino selectivo (RCIU-s). Objetivo . Determinar los tipos de anastomosis predominantes en las placentas con síndrome de transfusión feto-fetal, secuencia de anemia policitemia, síndrome de perfusión arterial reversa y restricción de crecimiento selectivo. Metodología . Se aplicó la técnica de inyección vascular placentaria para el reconocimiento de las anastomosis. Resultados . El número medio de anastomosis por placenta en el STFF (que fue la complicación más severa) fue de 8,2 ± 2,2. Las anastomosis AV y VA predominaron en un 83%. Hubo signos de discordancia placentaria en 30% de las placentas, y un 40% de placentas presentaron cordón de inserción velamentosa. Conclusiones. Las anastomosis vasculares no solo están implicadas en la etiología de las principales patologías propias de gestaciones monocoriónicas, sino que también influyen en su manejo. Creemos que un adecuado estudio placentario de cada uno de estos casos mediante la técnica de inyección vascular placentaria sería indispensable en los centros que aspiran a desarrollar manejos diferenciados de terapia fetal para cada una de estas complicaciones.

ABSTRACT Introduction: Twin pregnancies are classified into two groups: monochorionic (MC) and dichorionic (DC). MC twins are 5 to 6 times more likely to have an adverse perinatal outcome. The study of a group of 22 placentas from patients with monochorionic twin pregnancy who presented with complications such as feto-fetal transfusion syndrome (FFTS), twin anemia polycythemia sequence (TAPS), twin reverse arterial perfusion syndrome (TRAP) and selective intrauterine growth restriction (sIUGR) is presented. Objective: To determine the predominant types of anastomoses in placentas with feto-fetal transfusion syndrome, twin anemia polycythemia sequence, reverse arterial perfusion syndrome and selective intrauterine growth restriction. Methodology: The placental injection technique was applied for the recognition of anastomoses. Results: The mean number of anastomoses per placenta in STFF, which was the most severe complication, was 8.2 ± 2.2. The AV and VA anastomoses predominated in 83%. There were signs of placental discordance in 30% of placentas, and 40% of placentas presented velamentous cord insertion. Conclusions: Vascular anastomoses are not only involved in the etiology of the main pathologies of monochorionic gestations, but also influence their management. We believe that an adequate placental study of each of these cases by means of the placental vascular injection technique would be essential in centers that aspire to develop differentiated fetal management for each of these complications.

Neonatal and long-term outcomes of selective fetal growth restricted fetuses / 中华围产医学杂志

Objective:To investigate the short- and long-term outcomes of fetuses with selective fetal growth restriction (sFGR).Methods:A retrospective study was conducted on monochorionic diamniotic (MCDA) twins with sFGR admitted to the Neonatal Intensive Care Unit of Peking University Third Hospital from September 2017 to December 2019. MCDA neonates delivered during the same period without significant complications were selected as the control group. MCDA twins with sFGR were divided into type Ⅰ, Ⅱ, and Ⅲ groups and then further divided into the larger and the smaller fetus subgroups according to the birth weight. These children were followed up by telephone at 2-3 years old. Height-for-age and weight-for-age Z-scores were calculated. Ages and Stages Questionnaire-Third Edition (ASQ-3) was used to determine comprehensive development. Independent sample t-test, one-way analysis of variance, non-parameter test, and Chi-square test (or rank-sum test) were used for statistical analysis. Results:(1) A total of 116 pregnant women with sFGR (232 neonates) were enrolled in this study. There were 43, 40, and 33 mothers and 86, 80, and 66 newborns in type Ⅰ, Ⅱ, and Ⅲ groups, respectively. The control group included 31 pregnant women and 62 neonates. The gestational age at onset of sFGR was younger in the type Ⅱ and Ⅲ groups than in type Ⅰ group [(23.8±4.8) and (24.1±3.1) vs (27.0±6.1) weeks, F=5.19, P<0.05; all P<0.017 during pairwise comparisons]. (2) The incidence of sepsis and treatment abandonment/death in neonates in type Ⅱ and Ⅲ groups were higher than those in type Ⅰ and control groups [neonatal sepsis: 11.3% (9/80) and 6.1% (4/66) vs 2.3% (2/86) and 0.0% (0/62), χ2=6.30, P=0.001; death or treatment abandonment rate:13.8% (11/80) and 10.6% (7/66) vs 3.5% (3/86) and 0.0% (0/62), χ2=4.68, P=0.003; all P<0.017 during pairwise comparisons]. In cases with type Ⅱ or type Ⅲ sFGR, the risk of digestive system diseases was significantly higher in the smaller fetus group than in the larger fetus group [type Ⅱ: 46.2% (37/80) vs 38.7% (31/80), χ2=16.72; type Ⅲ: 47.0% (31/66) vs 34.8% (23/66), χ2=39.69; both P<0.001], while the rate of respiratory system diseases was lower in the smaller fetus group [type Ⅱ: 35.0% (28/80) vs 45.0% (36/80), χ2=36.85; type Ⅲ: 37.9% (25/66) vs 45.4% (30/66), χ2=12.55; both P<0.001]. The incidence of neonatal sepsis in smaller fetuses was higher than that in larger ones in type Ⅱ sFGR [7.5% (6/80) vs 3.7% (3/80), χ2=4.68, P=0.034]. The incidence of neurological complications in larger fetuses was higher than that in smaller ones in type Ⅲ sFGR [15.1% (10/66) vs 4.5% (3/66), χ2=5.72, P<0.001]. (3) In type Ⅱ group, seven neonates died (one case of cerebral hemorrhage, two cases of gastrointestinal perforation, two cases of septic shock, and two cases of necrotizing enterocolitis), and four cases withdrew the treatment. In type Ⅲ group, four neonates died (two cases of necrotizing enterocolitis, one case of gastrointestinal perforation, and one case of cerebral hemorrhage), and three cases withdrew from the treatment. (4) Totally, 71 children in type Ⅰ, 61 in type Ⅱ, and 58 in type Ⅲ group were followed up at the age of 2-3. Children with type Ⅱ or type Ⅲ sFGR lagged behind those in type Ⅰ group and control group in physical growth [ M ( P25- P75), Z-scores:－0.46 (－0.87-0.42),－0.35 (－0.62-0.71), 0.05 (－0.61-0.51), and 0.14 (－0.57-0.75); H=6.20, P=0.001]. In type Ⅱ and Ⅲ groups, the smaller fetuses lagged the larger fetuses in physical growth at 2-3 years of age. ASQ-3 scores in communication, gross motor, fine motor, problem-solving and personal-social areas were all lower in type Ⅱ and Ⅲ groups than in type Ⅰ and control groups. ASQ-3 scores in the five dimensions of the smaller fetuses in the type Ⅱ group were lower than those of the larger fetuses. In the type Ⅲ group, the smaller fetuses had lower ASQ-3 scores in communication and gross motor than the larger ones [communication ability: (42.6±18.8) vs (56.4±9.4) scores, t=19.63, P<0.001; gross motor: (45.5±19.7) vs (54.5±9.7) scores, t=12.64, P=0.003]. Conclusion:The neonatal morbidity is significantly increased in type Ⅱ and Ⅲ sFGR, and babies lagged others in height, weight, and ASQ-3 score at 2-3, which is worthy of early attention.

The morphology of the eggs in the Hermanella complex (Ephemeroptera: Leptophlebiidae)

ABSTRACT The Hermanella complex is a well-established monophyletic group of Hagenulinae mayflies, but the phylogenetic relationships among its members are still being discussed. In order to fill some gaps in the taxonomy of this group we describe, for the first time, the eggs of eight species of this complex (Hermanella amere, Hermanella mazama, Hydromastodon sallesi, Hydrosmilodon gilliesae, Hydrosmilodon plagatus, Leentvaaria palpalis, Paramaka incognita, Paramaka sp.) using scanning electron microscopy, including some important members whose generic allocation have been questioned. The egg morphology in these eight species of Hermanella complex and their similarities with other species of the complex are discussed.

Comparative preclinical assessment of the use of dehydrated human amnion/chorion membrane to repair perforated sinus membranes

PURPOSE: The aim of this study was to evaluate the use of dehydrated human amnion/chorion membrane (dHACM) to repair perforated sinus membranes in rabbits. METHODS: Bilateral surgical windows (7.5-mm diameter) were prepared on the nasal bones of 14 rabbits. Standardized circular perforations (5-mm diameter) were made in the sinus membrane by manipulating implant twist drills. The perforated sinus membranes were repaired using dHACM or a resorbable collagen membrane (CM). The negative control (NC) group did not undergo perforated sinus membrane repair, while the positive control (PC) group underwent sinus augmentation without perforations. The same amount of deproteinized porcine bone mineral was grafted in all 4 groups. After 6 weeks, micro-computed tomography (micro-CT) and histomorphometric evaluations were conducted. RESULTS: The micro-CT analysis revealed that the total augmented volume was not significantly different among the groups. In the dHACM group, newly formed bone filled the augmented area with remaining biomaterials; however, non-ciliated flat epithelium and inflammatory cells were observed on the healed sinus membrane. Histometric analysis showed that the percentage of newly formed bone area in the dHACM group did not differ significantly from that in the CM group. The dHACM group showed a significantly higher percentage of newly formed bone area than the NC group, but there was no significant difference between the dHACM and PC groups. CONCLUSIONS: dHACM could be a feasible solution for repairing sinus membrane perforations that occur during sinus floor augmentation.

Comparative study of clinical features and pregnancy outcomes of intrauterine subchorionic hematoma and retroplacental hematoma / 中国医师进修杂志

Objective@#To explore the clinical features and pregnancy outcomes of intrauterine subchorionic hematoma and retroplacental hematoma.@*Methods@#From May 2016 to May 2018, in the Fourth Hospital of Xi′an City, 110 cases of intrauterine hematoma were selected in the middle of pregnancy, including 52 cases of subchorionic hemaloma (group A) and 58 cases of retroplacental hematoma (group B). The clinical features and pregnancy outcomes of the two groups were compared.@*Results@#The volume of hematoma in group B was significantly smaller than that in group A [(8.8 ± 1.7) cm3 vs. (18.3 ± 2.0) cm3], the gestational weeks of group B was also significantly lower than that of group A [(35.2 ± 2.1) weeks vs. (38.4 ± 1.8) weeks], the full-term pregnancy rate in group B was lower than that in group A[56.9%(33/58) vs. 84.6%(44/52)], miscarriage rate and premature birth rate were higher than those in group A [20.7%(12/58) vs. 5.8%(3/52), 22.4%(13/58) vs. 7.7%(4/52)], and the differences were statistically significant (P < 0.05).The incidence of fetal distress in group B was higher than that in group A [17.4%(8/46) vs. 2.0%(1/49)], the incidence of fetal membrane rupture, placental abnormality, and placental residue was all higher than that in group A[41.3%(19/46) vs.10.2%(5/49), 37.0%(17/46)vs.12.2%(6/49), 28.3%(13/46) vs. 6.1%(3/49)], and the differences were statistically significant (P < 0.05). The neonatal body mass in group B was lower than that in group A [(3 091.7 ± 887.6) g vs. (3 457.6 ± 560.2) g], and the incidence of neonatal diseases was higher than that of group A [15.2%(7/46) vs. 2.0%(1/49)], and the differences were statistically significant (P < 0.05).@*Conclusions@#The volume of hematoma and gestational weeks of intrauterine retroplacental hematoma are lower than those of subchorionic hematoma, and the retroplacental hematoma is more likely to have adverse pregnancy outcomes.

Comparative study of clinical features and pregnancy outcomes of intrauterine subchorionic hematoma and retroplacental hematoma / 中国医师进修杂志

Objective To explore the clinical features and pregnancy outcomes of intrauterine subchorionic hematoma and retroplacental hematoma. Methods From May 2016 to May 2018, in the Fourth Hospital of Xi′an City, 110 cases of intrauterine hematoma were selected in the middle of pregnancy, including 52 cases of subchorionic hemaloma (group A) and 58 cases of retroplacental hematoma (group B). The clinical features and pregnancy outcomes of the two groups were compared. Results The volume of hematoma in group B was significantly smaller than that in group A [(8.8 ± 1.7) cm3 vs. (18.3 ± 2.0) cm3], the gestational weeks of group B was also significantly lower than that of group A [(35.2 ± 2.1) weeks vs. (38.4 ± 1.8) weeks] , the full-term pregnancy rate in group B was lower than that in group A[56.9% (33/58) vs. 84.6% (44/52)], miscarriage rate and premature birth rate were higher than those in group A [20.7%(12/58) vs. 5.8%(3/52), 22.4%(13/58) vs. 7.7%(4/52)], and the differences were statistically significant (P<0.05).The incidence of fetal distress in group B was higher than that in group A [17.4% (8/46) vs. 2.0% (1/49)], the incidence of fetal membrane rupture, placental abnormality, and placental residue was all higher than that in group A[41.3% (19/46) vs.10.2%(5/49), 37.0% (17/46)vs.12.2%(6/49), 28.3% (13/46) vs. 6.1%(3/49)], and the differences were statistically significant (P < 0.05). The neonatal body mass in group B was lower than that in group A [(3 091.7 ± 887.6) g vs. (3 457.6 ± 560.2) g], and the incidence of neonatal diseases was higher than that of group A [15.2% (7/46) vs. 2.0%(1/49)], and the differences were statistically significant (P < 0.05). Conclusions The volume of hematoma and gestational weeks of intrauterine retroplacental hematoma are lower than those of subchorionic hematoma, and the retroplacental hematoma is more likely to have adverse pregnancy outcomes.

Biological characteristics of three kinds of human placenta-derived mesenchymal stem cells / 中国组织工程研究

BACKGROUND: The placental tissue structure is complex, including the amniotic membrane, chorion, and decidua from the mother. Mesenchymal stem cells derived from different tissues of the same placenta have been reported to have similar biological characteristics. To date, there is no study regarding quantitative comparison of differentiation potential and immunomodulatory function of mesenchymal stem cells derived from different tissues of human placenta. OBJECTIVE: To investigate the biological characteristics including differentiation potential and immunomodulatory function of mesenchymal stem cells derived from different tissues of human placenta. METHODS: The amnion-, chorion-, and decidua-derived mesenchymal stem cells were isolated from the placental tissue of a baby boy by enzymatic digestion method. The biological characteristics of these three kinds of mesenchymal stem cells were systematically investigated including cell morphology, immunophenotypes, karyotypeanalysis, adipogenic and osteogenic differentiation potential, and Treg cells proliferation capacity. RESULTS AND CONCLUSION: All three kinds of mesenchymal stem cells showed fibroblast-like morphology and expressed the surface markers of mesenchymal stem cells with high expressions of CD73, CD90 and CD105, as well as low expressions of CD14, CD19, CD34, CD45 and HLA-DR. The karyotypes of the amnion-and chorion-derived mesenchymal stem cells were the same as the fetus, and decidua-derived mesenchymal stem cells had the same karyotype as the mother. There were significant differences in adipogenic differentiation capacity between three kinds of mesenchymal stem cells (amnion-derived mesenchymal stem cells> chorion-derived mesenchymal stem cells> decidua-derived mesenchymal stem cells; P < 0.05). In contrast, the osteogenic differentiation capacity of amnion-derived mesenchymal stem cells was remarkably higher than that of decidua-derived mesenchymal stem cells (P < 0.05). The amnion-and chorion-derived mesenchymal stem cells had the higher potential of Treg cell proliferation induction than decidua-derived mesenchymal stem cells. These findings indicate that three sources of human placenta-derived mesenchymal stem cells have different karyotypes, adipogenic and osteogenic differentiation potential, and immunomodulatory capability, providing a variety of ideal seed cell sources for disease treatment.

Ultrasonic diagnosis and prognosis of chorionic bump in first-trimester pregnancy / 中华超声影像学杂志

Objective To study the value of ultrasonic diagnosis of chorionic bump in early pregnancy and the relationship between the sonographic features and the pregnancy outcome . Methods A retrospective analysis of the ultrasonography of 76432 cases in early pregnancy was designed ,including 137 cases with chorionic bump ,their pregnancy outcomes were counted ,and were compared with the control group of 8139 cases of early pregnancy without chorionic bump . The sonographic features of chorionic bump ,such as the size and number were analyzed . Results There were 55 cases of miscarriage in 137 cases ,the rate happened in early pregnancy was 40 .1％ . The rate of miscarriage between the chorionic bump group and the control group had statistical difference( P =0 .000) . The chorionic bump group was divided into two subgroups according to the different number of chorionic bump ,single and multiple bumps , the rates of abortion were 35 .2％ and 80％ ,respectively . There was significant difference between the two sub groups in the rate of miscarriage( P =0 .001) . In 82 cases of intrauterine live pregnancy ,73 cases were found the disappearance of chorionic bump in the early stage of pregnancy . Conclusions Diagnosis of chorionic bump in early pregnancy has some clinical value ,and the first trimester is the critical period to determine the outcome of pregnancy .

Improving the production of human placental chorionic-derived mesenchymal stem cells by modified primary culture method / 国际生物医学工程杂志

Objective To establish a cultivating method for obtaining a large number of P0 generation human placental chorionic-derived mesenchymal stem cells (hpcMSCs).Methods The hpcMSCs were isolated from human placental chorion.After primary culturing and culturing for seven days,the culture medium,the non-adherent tissue and the douching normal saline of the primary culture were centrifuged and re-cultured twice.Cell morphology was observed by an inverted microscope.CCK-8 was used to measure the cell growth curve.Flow cytometry was used to detect cell surface markers.Adipogenic and osteogenic differentiation kits were used to assess the cell differentiation potential.Results The obtained hpcMSCs were fibroblast-like adherent cells and (25.54±3.38)×106 cells were obtained per placenta.The total yield of the primary culture,secondary culture and tertiary culture were (11.73±2.09)×106,(11.12±1.42)×106 and (2.69±0.71)×106,respectively,and the incubation time were (12.00±0.64) d,(8.87±0.63) d and (12.33±0.80) d.There was significant differences in incubation time between the secondary culture and the primary culture as well as the tertiary culture (all P＜0.05),and there was no significant difference between the primary culture and the tertiary culture.However,the incubation time of the tertiary culture had an increasing trend (P＞0.05).The yield per culture flask of the primary culture,secondary culture and tertiary culture were (1.12±0.15) × 106,(2.10±0.16)×106 and (1.04±0.16)×106,respectively.There was significant differences in the yield per culture flask between the secondary culture and the primary culture as well as the tertiary culture (all P＜0.05),and there was no significant difference between the primary culture and the tertiary culture.However,the yield per culture flask of the tertiary culture had a decreasing trend (P＞0.05).There was no difference among the three cultures in the growth curve and the expression of surface markers,and the osteogenic and adipogenic differentiation were all positive.Conclusions The P0 generation hpcMSCs isolated from a choriocarcinoma sample can be doubled by the three cultures compared with the primary culture,which can provide plenty stem cell source for the regenerative medicine.

Effect of Dll4 at different concentrations on the biological functions of extravillous trophoblasts / 中国组织工程研究

BACKGROUND:Extravil ous trophoblasts exert a crucial effect on early pregnancy. When extravil ous trophoblasts function abnormal y, many pregnancy diseases can develop, such as preeclampsia, fetal growth restriction and placental implantation. OBJECTIVE:To investigate the effect of Dl 4, a ligand of Notch signaling family, on biological functions of extravil ous trophoblasts. METHODS:Human extravil ous trophoblast cel lines, HTR-8/SVneo, were cultured with human recombined protein Dl 4 of different concentrations (0, 0.125, 0.25, 0.5, 1.0 mg/L). Cel viability was tested by cel counting kit-8 assay. Transwel assay was applied to examine the changes in cel migration and invasion ability. RESULTS AND CONCLUSION:Dl 4 could significantly improve migration and invasion abilities of extravil ous trophoblasts, but had no effect on cel viability. In addition, Dl 4 regulated the invasion ability of extravil ous trophoblast in a dose-dependent manner. Above al , Dl 4 can play an important role in normal pregnancy by regulating the biological functions of extravil ous trophoblasts.

Biological characters of mesenchymal stem cells separated from different components of human placenta / 中国组织工程研究

BACKGROUND:Human placenta is a stable source for mesenchymal stem cels, which is becoming a cellsource in the regenerative medicine that attracts widespread attentions. OBJECTIVE: To compare the biological characters of mesenchymal stem cels that separated from different components of human placenta (human chorion and vilous trophoblast). METHODS:The amniotic membrane of placenta surface was detached surgicaly. Human chorion and vilous trophoblast in the fetal side was cut into pieces. After digestion with PBS containing colagenase II, mononuclear cels were separated and cultured in Dulbecco’s modified Eagle’s medium containing 10% fetal bovine serum in 37℃ and 5% CO2, 95% saturated humidity, after 48 hours the ful amount in liquid, dislodge suspension cels. Forty-eight hours later, the medium was changed completed, and non-adherent cels were removed. When cellfusion reached about 90%, trypsin digestion was employed for cellpassage. Biological characters of mesenchymal stem cels separated from different components of human placenta were compared through observation of total number of primary cels, cellmorphology, and surface markers expression (CD90, CD73 and CD105). RESULTS AND CONCLUSION:The flow cytometric analysis revealed that the cels separated from the human chorion and vilous trophoblast were over 90% strongly positive for CD90, CD73, CD105. These two sources of cels showed typical fibroblast morphology, suggesting that the cels have the characteristics of mesenchymal stem cels. Under the same enzyme digestion time, enzyme concentration, and shaking speed, more cels are visible from the chorion, and the subsequent culture is easier to harvest cels.

Gene Expression Pattern of Human Chorion-Derived Mesenchymal Stem Cells during Adipogenic Differentiation

PURPOSE: The aim of this study was to identify the adipocyte-specific gene expression patterns in chorion-derived mesenchymal stem cells during adipogenic differentiation. MATERIALS AND METHODS: Chorionic cells were isolated from the third trimester chorions from human placenta at birth and identified morphologically and by fluorescence-activated cell sorting analysis. After inducing adipogenic differentiation for 28 days, cells at days 3, 10, 21 and 28 were analyzed by Oil red O staining and RNA extraction in order to assess the expression levels of adipocyte marker genes, including CCAAT-enhancer binding protein alpha (C/EBPalpha), peroxisome proliferator-activated receptor gamma (PPARgamma), fatty acid binding protein 4 (FABP4) and Glycerol-3-phosphate dehydrogenase (GPD2). Cells not induced for differentiation were compared with the induced cells as a control group. RESULTS: Chorion-derived cells showed the same pattern as fibroblasts, and expressed CD73, CD105, and CD166 antigens, but not CD45, CD34, and HLA-DR antigens. On day 3 after differentiation, cells began to stain positively upon Oil red O staining, and continuously increased in lipid granules for 4 weeks. The expression level of C/EBPalpha increased 4.6 fold on day 3 after induction, and continued to increase for 4 weeks. PPARgamma was expressed at a maximum of 2.9 fold on day 21. FABP4 and GPD2 were significantly expressed at 4.7- and 3.0-fold, respectively, on day 21, compared to controls, and further increased thereafter. CONCLUSION: Human chorion-derived mesenchymal stem cells exhibited the sequential expression pattern of adipocyte marker genes during differentiation, corresponding to adipogenesis.

Isolation and Characterization of Chorionic Mesenchymal Stromal Cells from Human Full Term Placenta

This study focused on the characterization of mesenchymal stromal cells (MSCs) from the chorion of human full term placenta from 15 donors. Chorionic MSCs revealed homologous fibroblast-like morphology and expressed CD73, CD29, CD105, and CD90. The hematopoietic stem cell markers including HLA DR, CD11b, CD34, CD79a, and CD45 were not expressed. The growth kinetics of their serial passage was steady at the later passages (passage 10). The multilineage capability of chorionic MSCs was demonstrated by successful adipogenic, osteogenic and chondrogenic differentiation and associated gene expression. Chorionic MSCs expressed genes associated with undifferentiated cells (NANOG, OCT4, REX1) and cardiogenic or neurogenic markers such as SOX2, FGF4, NES, MAP2, and NF. TERT was negative in all the samples. These findings suggest that chorionic MSCs undifferentiated stem cells and less likely to be transformed into cancer cells. A low HLA DR expression suggests that chorionic MSCs may serve as a great source of stem cells for transplantation because of their immune-privileged status and their immunosuppressive effect. Based on these unique properties, it is concluded that chorionic MSCs are pluripotent stem cells that are probably less differentiated than BM-MSCs, and they have considerable potential for use in cell-based therapies.

Estabilización interespinosa lumbar dinámica con autoinjerto de piel / Dynamic lumbar interspinal stabilization using skin flaps

INTRODUCCIÓN. El objetivo de esta investigación fue describir los resultados de la estabilización interespinosa lumbar dinámica utilizando un autoinjerto de piel en pacientes con enfermedad degenerativa discal. Este constituye un reporte inicial sobre la aplicación de dicha técnica en Cuba. MÉTODOS. La muestra estuvo integrada por 10 pacientes a los cuales se les realizó estabilización interespinosa dinámica utilizando corion (lonja de piel de la herida quirúrgica), practicada después del procedimiento básico de discoidectomía o recalibraje. RESULTADOS. Se encontró estenosis aislada del canal vertebral en 4 pacientes (40 por ciento), hernia discal aislada en 3 pacientes (30 por ciento), y la combinación de ambos procesos patológicos en el mismo segmento lumbar, en 2 casos (20 por ciento). En un paciente (1 por ciento) se asociaba una espondilolistesis de grado I sintomática en L5-S1 y una hernia discal en L4-L5. La afectación del segmento L4-L5 estuvo presente en 9 de los pacientes seleccionados (90 por ciento) y en L3-L4 en uno (1 por ciento). La ligamentoplastia interespinosa con corion se realizó en los 10 casos (100 por ciento), mientras que la discoidectomía y el recalibraje de Senegas, como procedimiento único o combinado, fueron practicados en el 60 por ciento de los casos, respectivamente. La evaluación de los resultados se realizó por las escalas de discapacidad de Oswestry y visual análoga del dolor (EVA). La media preoperatoria para la escala de Oswestry fue de un 59,2 por ciento y disminuyó al 25,4 por ciento en el posoperatorio, mientras que la EVA preoperatoria fue como promedio de 7,3 y decreció a 2,4 en el posoperatorio, a los 6 meses de la cirugía. Nueve de los pacientes operados (90 por ciento) sentían mejoría y manifestaron estar satisfechos con la cirugía. CONCLUSIONES. La ligamentoplastia interespinosa con autoinjerto de piel después de la discoidectomía o el recalibraje de Senegas es un método de estabilización funcional que...

INTRODUCTION: The aim of present research was to describe the results of dynamic lumbar interspinal stabilization using a skin flap in patient presenting with a degenerative disk disease. Present paper is an initial report on application of such technique in Cuba. METHODS: Sample included 10 patients underwent a dynamic interspinal stabilization using corium (slice of skin from surgical wound), carried out of the basic procedure of disk surgical removal or recalibration. RESULTS: There was a isolated stenosis of vertebral channel in 4 patients (40 percent), isolated disk hernia in 3 patients (30 percent) and a combination of both processes in the same lumbar segment in 2 cases (20 percent). In a patient there was a associated symptomatic I degree spondylolosthesis in L5-S1 and a disk hernia in L4-L5. The involvement of L4-L5 segment was present in 9 of the selected patients (90 percent) and in L3-L4 in one (1 percent). Interspinal ligamentoplasty with corium was carried out in the ten cases (100 percent), whereas the discoidectomy and the Senegas's recalibration as a unique or combined procedure were carried out in the 60 percent of cases, respectively. Results assessment was made by Oswestry inability scale and analogue visual of pain (EVA). Preoperative mean for Oswestry scale was of 59,2 percent and decreased to 25,4 percent during the postoperative period, whereas the preoperative EVA was as average of 7,3 and decrease to 2,4 during the postoperative one at 6 months of surgery. Nine patients operated on (90 percent) improved and expressed satisfaction with surgery. CONCLUSIONS: Interspinal ligamentoplasty with skin graft after discoidectomy or the Senegas's recalibration is a method of functional stabilization relieving the pain after surgery

INTRODUCTION. Le but de cette étude est de décrire les résultats de la stabilisation intervertébrale lombaire dynamique en utilisant une autogreffe de peau chez des patients atteints d'une maladie dégénérative discale. Ceci constitue un rapport initial sur l'application de cette dite technique à Cuba.MÉTHODES. L'échantillon a été composé par 10 patients traités par stabilisation intervertébrale dynamique en utilisant du chorion (pellicule de peau de la blessure chirurgicale), pratiquée après la discoïdectomie ou le recalibrage.RÉSULTATS. Une sténose isolée a été rencontrée chez 4 patients (40 percent), une hernie discale chez 3 patients (30 percent), et une combinaison de tous les deux processus pathologiques au même segment lombaire dans 2 cas (20 percent). Chez un même patient (1 percent) une spondylolisthésis symptomatique à grade I au niveau de la L5-S1 et une hernie discale au niveau de la L4-L5 se sont associées. Les segments L4-L5 et L3-L4 ont été affectés respectivement chez 9 patients (90 percent) et 1 patient (1 percent) . La ligamentoplastie intervertébrale à chorion a été réalisée dans les 10 cas (100 percent), tandis que la discoïdectomie et le recalibrage de Senegas, en tant que procédé unique ou combiné, ont été appliqués par l'échelle d'incapacité d'Oswestry et l'échelle visuelle analogue de la douleur (EVA). La moyenne préopératoire pour l'échelle d'Oswestry a été 59,2 percent, et a diminue à 25,4 percent au postopératoire, tandis que l'EVA préopératoire a été 7,3 en moyenne, et a diminue à 2,4 au postopératoire, 6 mois après la chirurgie. Neuf patients ont subi une amélioration, et ont manifesté leur satisfaction avec la chirurgie.CONCLUSIONS. La ligamentoplastie intervertébrale avec autogreffe de peau après une discoïdectomie ou recalibrage de Senegas est une méthode de stabilisation fonctionnelle soulageant la douleur après la chirurgie

Trombohematoma subcorionico masivo: una patología placentaria emergente / Massive subchorionic thrombohematoma

El trombohematoma subcoriónico es una extravasación de sangre localizada en la placa coriónica, entre amnios y corion. Es muy infrecuente, el diagnóstico no es común, tiene alto riesgo perinatal y no hay casos comunicados en nuestro medio. Se presentan 12 casos de sospecha diagnóstica antenatal, confirmada en el examen histopatológico placentario. Se describe y discute el cuadro clínico, las complicaciones maternas y perinatales, el diagnóstico ultrasónico, el manejo y los resultados obtenidos. En nueve casos se identifcó una fase latente con hematoma de tamaño estable, entre el inicio de los síntomas y el parto, que duró en promedio 7,3 semanas. En ocho casos la fase latente fue seguida por una fase activa con aumento del hematoma asociado al parto prematuro. Tres embarazadas presentaron patología médica compleja con una muerte materna. Seis casos hicieron anemia severa y tres patología miscelánea. Hubo ocho amenazas de parto prematuro con tocolisis, tres rotura prematura de membranas, una colestasis y una preeclampsia. Los partos fueron prematuros, dos de 36 y 33 semanas y diez menores a 32 semanas. Siete prematuros tuvieron peso inferior a 1000 gramos y seis hicieron restricción fetal grave, en percentil <5 de la curva de crecimiento. Hubo complicaciones neonatales relacionadas con prematurez, restricción y bajo peso, manejados con hospitalización prolongada con promedio de 74 días (rango: 6-298 días). Diez neonatos sobrevivieron; hubo un mortinato y un mortineonato. La sobrevida fue 83,3 por ciento y la mortalidad de 16,6 por ciento que se comparan favorablemente con las cifras comunicadas.

Subchorial thrombohaematoma is caused by blood extravasations in the corionic plate, between amnion and chorion. It is a rare pathologic entity, that carries a high perinatal risk, which has not being published in our country up to now. We report 12 cases in which the diagnosis was suspected before birth, and confirmed in the placentary pathological examination. We describe the clinical presentation, fetal and maternal risks, ultrasonographic findings, treatment and clinical outcomes. In 9 patients a latent phase was identified with a stable size hematoma, which had a mean duration of 7.3 weeks. In 8 cases the latent phase was followed by an active phase, with increasing size of the hematoma associated with preterm labour. Three pregnant women had severe complications which caused one maternal death. Six had severe anemia and other three had minor complications. Eight had preterm labor symptoms which required tocolysis. Three had prelabour rupture of membranes, one cholestasis disease and preeclampsia. Preterm labours were at 36, 33 and other ten before 32 weeks of gestation. Seven preterm newborns weight less than 1000 grams and six had severe fetal restriction (p<5). Newborn complications were related with prematurity, requiring prolonged hospitalization (mean 74 days, range 6-298 days). Ten newborns survived. There were 1 still birth and 1 dead newborn. Survival rate was 83.3 percent and 16.6 percent mortality, better rates than previously published.

The effect of TNF-α in medical abortion / 中国医师杂志

Objective To investigate the expression of tumor necrosis factor-alpha (TFN-α) in human villus and deciduas from different abortion. Methods From May 2008 to May 2009, 45 women with early pregnancy( <49days)were divided into three groups, medical abortion completed group ( n = 15),medical abortion uncompleted group( n = 15 )and control group( n = 15, patients with dilatation and curettage ). The villus and deciduas were collected at the third day of medical abortion or at the day of curettage.Immunohistochemical technique was carried out to examine the distribution of TNF-α in villus and deciduas of the three groups. Results The age, gestational age, diameter of gestional sac and levels of serum E2, P and B-HCG before abortion were similar in all three groups. The expression of TNF-o in villus and deciduas of the control group was lowest among three groups[(4. 75 ± 10. 22)% vs (2. 66 ±2. 57)%]. The expression of TNF-α in villus and deciduas of medical abortion completed group was highest among three groups [(26. 67 ± 7.46) % vs ( 18. 44 ± 11. 14) %, P < 0. 05]. Conclusion Appropriate amount of TNF-α exists in the normal pregnancy, mifepristone can increase the expression of TNF-α in human villus and deciduas. and disturb reproductive immunity and effect matenal-fetal interface to induce abortion.

Chorion biopsy in mongrel dogs / Biopsia do cório fetal em cães

With the great development of the gestational studies in all of the species, we noticed the necessity of adaptations of these techniques for prenatal diagnosis in dogs. Based on this, we studied the feasibility of chorion biopsy guided by ultrasound. Our results demonstrated accuracy on the sex determination being 2 males and 12 females, as well as it would be possible to identify chromosome alteration due to the quality of samplings. Sex determination was accomplished with the identification of Y gene chromosomes in PCR technique. After the collection, fragments were prepared for light microscopy studies and revealed fetal chorion tissue, blood colloid and erythrocyte. In the whole material we found hemosiderin impregnations due to the hemolysis and to the residue of blood of the placental marginal hematomes. The submitted female dogs to this technique demonstrated normal puppy births without death.

Com o grande desenvolvimento dos estudos gestacionais em todas as espécies, percebemos a necessidade de adaptarmos técnicas para diagnóstico pré-natal para cães. Assim, buscamos bases nas técnicas já existentes empregadas em humanos, e através destas, conseguimos estabelecer um método para coleta em cães, utilizando PCR para garantirmos a integridade das amostras. O procedimento foi realizado através de punção da cinta placentária com agulha de biopsia guiada por ultra-som. De todas as 14 amostras coletadas, duas apresentaram-se positivas para o cromossomo Y, presente apenas em machos, confirmando assim a viabilidade das amostras demonstrando com isso que através desta técnica podemos coletar material fetal para diagnóstico de alterações gênicas ou cromossômicas presentes nos cães antes mesmo destes virem a termo. A microscopia de material revelou fragmentos de cório fetal, colóide sangüíneo e eritrócitos. Em todo o material encontramos impregnações de hemosiderina devido à hemólise e ao resíduo de sangue dos hematomas marginais placentários. As cadelas submetidas a esta técnica tiveram partos normais sem óbito de nenhum filhote.

Evolução morfométrica dos anexos embrionários e fetais bovinos obtidos por monta natural, com 10 a 70 dias da gestação / Biometrics evolution of the embryonic and fetal annexes in cows obtained by natural mating, at 10 to 70 days of gestation

O período inicial da gestação de bovinos é caracterizado por grandes perdas embrionárias. Considerando a importância deste fator no âmbito da reprodução animal foram estudados os anexos embrionários e fetais bovinos fecundados por monta natural de 15-70 dias de gestação, com o objetivo de estabelecer parâmetros morfométricos da placenta na fase inicial da gestação. Com uso de um paquímetro foram realizadas mensurações do comprimento (crânio caudal), largura (latero lateral) e altura (dorso ventral) das membranas corioalantóide e amniótica. O início da formação dos cotilédones foi observado e quantificado, assim como, o peso placentário. O peso médio do saco gestacional aumentou com o evoluir da idade gestacional, entretanto, o crescimento foi acelerado a partir de 20-30 dias de gestação. O comprimento crânio caudal e dorso ventral da membrana corioalantóide e do âmnio apresentaram crescimento lento e gradual com o evoluir dos períodos gestacionais analisados. Com 30-40 dias de gestação, os primeiro cotilédones já eram visualizados e contatos com facilidade na superfície coriônica. Os períodos de crescimento coincidiram com os maiores índices de perdas gestacionais em bovinos. Os parâmetros aqui analisados poderão servir para futuras investigações dos anexos embrionários de organismos manipulados em laboratório.

The main goal of this morphometrical study was to characterize the development of the extra-embryonic membranes of 15 to 70-day-old bovine embryos obtained by natural mating. With a millimeter paquimeter the cranio-caudal, latero-lateral and dorso-ventral measurements of chorion and amnion were determined. The development of the cotyledons and weight of the gestational sac were observed and quantified. The weight of the gestational sac increased during gestation; however, the growth was faster then 20 to 30 days. The cranial-caudal and dorsal-ventral length of the choriallantois and the amnion developed slowly and gradually with progress of the gestational period, and the cranio-caudal length decreased after 50 to 60 days of gestation, increasing in the next period. After 30 to 40 days of gestation, the first cotyledons were visualized and counted easily in the chorionic surface. The growth periods were the same of the main gestational losses in cattle. The parameters analyzed could be useful for investigations of extra-embryonic membranes in organisms manipulated in the laboratory.