Association of maternal isolated thyroid peroxidase antibody positive in the first trimester with fetal growth / 北京大学学报(医学版)

OBJECTIVE@#To investigate the association of isolated thyroid peroxidase antibody (TPOAb) positive in the first trimester with fetal growth.@*METHODS@#A total of 16 446 pregnant women were included in the birth cohort study, whose last menstrual period was between May 2016 and April 2019 and with singleton pregnancy. Maternal serum samples were collected when they firstly came for prenatal care in the first trimester. The pregnant women were consecutively seen and followed in the hospital and the information of pregnant women was extracted from the electronic medical information system. The pregnant women were divided into isolated TPOAb positive group (n=1 654) and euthyroid group (n=14 792). Three fetal ultrasound examinations were scheduled during the routine prenatal visits at the hospital and were performed by trained sonographers. All fetal growth indicators were quantified as gestational age- and gender- adjusted standard deviation score (Z-score) using the generalized additive models for location, scale and shape (GAMLSS). Fetal growth indicators included estimated fetal weight (EFW), abdominal circumference (AC), biparietal diameter (BPD), femur length (FL) and head circumference (HC). Fetal growth restriction (FGR) was defined as AC or EFW Z-score＜3rd centile based on clinical consensus. Generalized estimating equation (GEE) analysis was applied to assess the association of maternal isolated TPOAb positive with fetal growth. The generalized linear model was further used to analyze the association between isolated TPOAb positive and fetal growth indicator at different gestational ages when the fetal growth indicator was significantly associated with isolated TPOAb positive in the GEE mo-del.@*RESULTS@#The median gestational age at three ultrasound measurements was 23.6 (23.3, 24.1), 30.3 (29.7, 30.9), 37.3 (37.0, 37.7) weeks, respectively. The BPD Z-score was higher in isolated TPOAb positive women, compared with the euthyroid pregnant women after adjustment (β=0.057, 95%CI: 0.014-0.100, P=0.009). The generalized linear model showed the BPD Z-score was higher in the isolated TPOAb positive women at the end of 21-25 weeks (β=0.052, 95%CI: 0.001-0.103, P=0.044), 29-32 weeks (β=0.055, 95%CI: 0.004-0.107, P=0.035) and 36-40 weeks (β=0.068, 95%CI: 0.011-0.125, P=0.020), compared with the euthyroid pregnant women. There was no difference in other fetal growth indicators (EFW, AC, FL and HC) and FGR between the isolated TPOAb positive and euthyroid pregnant women.@*CONCLUSION@#The BPD Z-score was slightly increased in the isolated TPOAb positive pregnant women in the first trimester, while other fetal growth indicators were not changed. The reproducibility and practical significance of this result need to be confirmed.

The Effect of PCDH15 Gene Variations on the Risk of Noise-induced Hearing Loss in a Chinese Population / 生物医学与环境科学（英文）

Noise-induced hearing loss (NIHL) is a complex disease caused by interactions between environmental and genetic factors. This study investigated whether genetic variability in protocadherin related 15 (PCDH15) underlies an increased susceptibility to the development of NIHL in a Chinese population. The results showed that compared with the TT genotype of rs11004085, CT/CC genotypes were associated with an increased risk of NIHL [adjusted odds ratio (OR) = 2.64; 95% confidence interval (CI): 1.14-6.11, P = 0.024]. Additionally, significant interactions between the rs11004085 and rs978842 genetic variations and noise exposure were observed in the high-level exposure groups (P < 0.05). Furthermore, the risk haplotype TAGCC was observed when combined with higher levels of noise exposure (P < 0.05). Thus, our study confirms that genetic variations in PCDH15 modify the susceptibility to NIHL development in humans.

Diagnostic value of high-frequency ultrasonography in testing carpal canal structure in patients with occupational hand-arm vibration disease / 中国职业医学

OBJECTIVE: To evaluate the clinical value of high-frequency ultrasonagraphy in testing carpal canal structure in the diagnosis of patients with occupational hand-arm vibration disease( HAVD). METHODS: Eighteen patients with occupational mild HAVD( 36 wrists) were selected as the case group and 20 healthy volunteers( 40 wrists) were enrolled as the control group by using convenience sampling method. The color doppler ultrasound was used to measure the crosssectional areas( CSA) of median nerve at the level of pisiform bone,the thickness of transverse carpal ligament,and the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook of the 2 groups. Fisher discriminant analysis and receiver operating characteristic( ROC) curve were performed to assess the effect of diagnosing HAVD with the CSA of median nerve at the level of pisiform bone in patients with HAVD. RESULTS: The CSA of median nerve at the level of pisiform bone in both hands was smaller than that of the control group( P < 0. 01). However,there was no statistical significance in the thickness of transverse carpal ligament of both hands,the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook in the case and control groups( P > 0. 05). Through the Fisher discriminant analysis which was carried on and the distinction equation which was established meanwhile by using the CSA of median nerve at the level of pisiform bone in both hands as HAVD diagnostic criterion,the HAVD predictive accuracy rate was 78. 9%. The ROC curve was underway with the discriminant score as an indicator for distinguishing HAVD,and the result showed that the area under the curve was 0. 842,with sensitivity of 75. 00% and specificity of 88. 90%. CONCLUSION: High-frequency ultrasonography can be used to observe and quantify the imaging changes of carpal canal structure in patients with HAVD,which can provide objective and scientific diagnostic basis for the diagnosis of HAVD.

The effects of extremely low frequency electromagnetic field exposure on the pH of the adult male semen and the motoricity parameters of spermatozoa in vitro / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the effects of 50-Hz extremely low frequency electromagnetic field (ELF-EMF) exposure on the pH of the adult male semen and the motoricity and motoricity parameters of spermatozoa.</p><p><b>METHODS</b>Healthy adult male fresh semen was exposed to a 50-Hz EMF at 0.4 mT for 15, 30 and 60 min, respectively. The pH value of the semen, the motoricity and motoricity parameter of spermatozoa were detected and recorded in real time using the WLJY-9000 pattern chromatic color spermatozoa quality detection system.</p><p><b>RESULTS</b>Compared with parallel control group, the exposure of adult male fresh semen to a 50-Hz EMF at 0.4 mT for 15 min or 60 min could decrease significantly the motoricity (spermatozoa with a + b lever) and the activity ratio (spermatozoa with a + b + c lever)(P < 0.01). However, there were no significant differences of motoricity and the activity ratio between exposure group and control group (P > 0.05), and after exposure to a 50-Hz. EMF for 30 min the motoricity and the activity ratio of exposure group were inhibited, as compared with control group (P < 0.01 or P < 0.05). The pH value of the semen was not obvious changed (P > 0.05) when semen was exposed to a 50-Hz EMF of 0.4 mT for 15, 30 and 60 min.</p><p><b>CONCLUSION</b>In present experiment, it is suggested that the exposure of adult male fresh semen to a 50-Hz EMF in vitro could inhibit the motoricity and the activity ratio, but not affect the pH value of the semen within 60 min.</p>

Clinical observation of bushen er'xian decoction in treating premature ovarian failure / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect and immune regulatory mechanism of Bushen Er'xian Decoction (BED) on patients with premature ovarian failure (POF).</p><p><b>METHODS</b>Sixty patients with POF were randomly assigned to two groups in the ratio of 2:1, the 40 in the treatment group were treated with BED and the 20 in the control group were treated with artificial menstrual cycle therapy. The clinical efficacy was observed and the changes of serum reproductive hormone and T lymphocytes before and after treatment were observed.</p><p><b>RESULTS</b>The total effective rate in the treatment group was 72.5% (29/40 cases), which was higher than that in the control group, 45.0% (9/20 cases, P < 0.05). Serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) decreased and estradiol (E2) increased in both groups after treatment (P <0.05), but the level of FSH was lower in the treatment group than in the control group (22.57 +/- 12.49 IU/L vs 31.10 +/- 14.50 IU/L, P <0.05). CD4 and CD4/CD8 increased, CD8 decreased in the treatment group after treatment, showing significant difference as compared with those before treatment and with those in the control group after treatment (P <0.01).</p><p><b>CONCLUSION</b>BED is favourable for improving POF, being a good remedy with better clinical efficacy.</p>

Clinical observation on treatment of infertile patients with severe endometriosis by Kangyi Zhongyu Decoction combined with gonadotropin releasing hormone-a / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Kangyi Zhongyu Decoction (KZD) combined with gonadotropin releasing hormone-a (GnRH-a) on infertile patients with severe endometriosis.</p><p><b>METHODS</b>Seventy-five infertile patients with the diagnosis of endometriosis confirmed by laparoscope who were scheduled to receive in vitro fertilization and embryo transfer (IVF-ET) were randomly assigned to three groups, they were treated respectively with KZD (A), GnRH-a (B) alone and combined of both (C), and IVF-ET were applied in the patients after 3 months of treatment. The clinical efficacy and adverse reactions in the three groups were observed and the changes of serum cancer antigen 125 (CA125) and endometrial antibody (EMAb) levels before and after treatment were tested.</p><p><b>RESULTS</b>Score of dyspareunia in Group A and C was obvioushy lower than that in Group B after treatment (P <0.01). Pregnancy rate in Group C was higher than that in Group A and B (P <0.05), with the adverse reactions less than in Group B (P <0.01). The positive rate of plasma EMAb was reduced obviously after treatment in Group C with the level lower than that in the other two groups (P<0.05).</p><p><b>CONCLUSION</b>The combined use of KZD and GnRH-a is a new method in treating infertile patients with severe endometriosis with ideal effectiveness and fewer adverse reactions, and it could advance the successful rate of reproductive assistant technique.</p>