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BACKGROUND: Umbilical cord blood (UCB) is a new and convenient source of stem cells reported to be safe and effective in preventing and treating preterm complications. The initial processing step for this therapy involves cord blood collection and isolation of the mononuclear cell (MNC) layer. However, there is limited information regarding the feasibility and safety of cord blood collection in preterm infants, and whether cord blood cell quality and quantity are adequate for treating complications in preterm infants. UCB units from preterm infants are currently discarded due to safety concerns regarding collection and owing to the harvesting of inadequate volumes for banking. This study aimed to investigate the feasibility and safety of UCB collection following delayed cord clamping (DCC) for preventing and treating complications in preterm infants. METHODS AND MATERIALS: Singleton preterm infants below 35 weeks gestation were assigned to two cohorts: cord blood collection and non-cord blood collection groups. Mortality and preterm complications in the two groups were compared to evaluate the safety of cord blood collection in preterm infants. The characteristics of the cord blood cells in preterm infants were investigated by comparing the cord blood parameters before and after processing with those of term infants born during the same period. RESULTS: There were 90 preterm infants and 120 term neonates enrolled in this study. Compared to those of the term group, the preterm neonates had significantly less cord blood volume and fewer cell numbers. Nevertheless, the MNC number in the preterm group was 1.92±1.35×108 per kg, which fulfilled the previously reported targeted cell dose (5×107 cells/kg) suitable for application to improve preterm complications. There was no significant difference regarding complications in the preterm neonates with or without cord blood collection. CONCLUSIONS: The collection of UCB after DCC in preterm infants is feasible and safe. The cell numbers and quality fulfill the criteria for use in improving preterm complications. Cord blood MNCs from preterm neonates should be reconsidered as an ideal source for use in stem cell therapy for preterm complications.
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Acute abdomen in pregnancy is not rare and clinical management usually is a dilemma. Acute abdominal pain in pregnancy can occur due to obstetric factors as well for reasons that are unrelated to pregnancy. The diagnostic approach of acute abdomen during pregnancy can be tricky owing to the altered clinical presentations brought about by the anatomical and physiological changes of gestation along with the reluctance to use certain radiological investigations for fear of harming the fetus. Delay in diagnosis and treatment can lead to adverse outcomes for both the mother and fetus. In this article, we attempt to review and discuss the various etiologies, the current concepts of diagnosis, and treatment, with a view to developing a strategy for timely diagnosis and management of pregnant women presenting with acute abdominal pain.
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Objectives To assess the relationship between amniotic fluid erythropoietin(EPO)and neona-tal adverse outcome in fetal growth restriction(FGR)pregnancy labored during 28-36 gestational weeks.To explore the clinical application in timing of delivery. Methods The retrospective research had recruited 87 patients with single pregnancy complicated FGR,of which the gestational weeks range from 28 weeks to 36 weeks. All subjects were collected from amniotic fluid at cesarean section or within a week of cesarean section. Amniotic fluid EPO were detected according to the classical definition. We categorized EPO < 27 IU/L as an normal state,whereasE-PO≥27 IU/L as an abnormal state.The relationship between amniotic fluid EPO with biophysical profile,the flow velocity waveform/blood gas parameters of the umbilical artery,and the neonatal adverse outcome were observed. Results For FGR pregnant women who chose 28-36 weeks for delivery,the incidence of neonatal adverse out-comes was significantly higher in the amniotic fluid EPO increased group than that in normal concentration group (χ2= 9.49,P = 0.002). Pearson analysis showed that amniotic fluid EPO concentration was negatively correlated with umbilical artery pH(P<0.001,r=-0.908)and base excess(P<0.001,r=-0.624).However,it was pos-itively correlated with PCO2(P<0.001,r=0.631),whereas there was no significant correlation between amniotic fluid EPO concentration and PO2(P=0.068,r=-0.197).In addition,neither biophysical profile nor flow velocity waveform has difference in amniotic fluid EPO concentration. Conclusions The abnormal increased amniotic fluid EPO in FGR pregnant women who delivered before 36 gestational weeks were closely related to the adverse out-come of the newborn.The amniotic fluid EPO is expected to be an additional indicator of fetal hypoxia,which can help determine the time of birth.
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Objective To observe the clinical efficacy of Yaoyi-Shenhuojiu combined with synthetic rehabilitation therapy on shoulder-hand syndrome after stroke (SHSAS). Methods 100 SHSAS patients were randomly divided into an observation group and a control group, with 50 patients in each group. Patients in the observation group were treated with Yaoyi-Shenhuojiu on the basis of comprehensive rehabilitation training of the control group. After treated for 2 consecutive weeks, the pain, motor function, activities of daily living in patients of both groups were compared and improvement of the constitution according to VAS, FMA, MBI was also compared. Results After treatment, the decrease of VAS score in the observation group (3.43 ± 1.76 vs. 5.21 ± 2.15, t=4.530) and the increase of FMA score (55.66 ± 4.33 vs. 40.45 ± 3.75, t=18.776) was significantly better than the control group (P<0.01); Physiological function in SF-36 health survey questionnaire (95.78 ± 7.68 vs. 87.88 ± 7.21, Z=5.042), physiological functions of (50.78 ± 21.44 vs. 36.89 ± 18.42, Z=7.241), body pain (83.22 ± 13.45 vs. 75.52 ± 13.23, Z=4.055), overall health (50.25 ± 18.45 vs. 39.01 ± 18.63, Z=8.043), vigor (79.28 ± 11.92 vs. 70.22 ± 10.69, Z=3.216), social function (85.78 ± 20.12 vs. 74.71 ± 19.22, Z=4.128), emotional function (36.66 ± 23.79 vs. 28.11 ± 18.21, Z=6.052) and mental health (81.17 ± 9.72 vs. 74.61 ± 11.25, Z=5.367) eight dimensions of higher score in the observation group were also significantly better than the control group (P<0.05). The total effective rate (94.0% vs. 76.0%) in the observation group was significantly better than the control group (χ2=5.020, P=5.020). Conclusion Yaoyi-Shenhuojiu combined with comprehensive rehabilitation therapy can effectively improve limb movement function in patients with SHSAS, besides its improving the life self-care ability and life quality.
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Objectives To investigate gestational multiple metabolic abnormalities aggregation and diagnostic criteria for gestational metabolic syndrome(GMS),and to analyze the risk factors of GMS.Methods A cohort study recruiting 309 pregnant women with preeclampsia,627 pregnant women with gestational diabetes mellitus(GDM)and 1245 normal pregnant women was performed from January 2008 to December 2011 in Guangdong Women and Children's Hospital.Information regarding age,gestational weeks,basic blood pressure,admission blood pressure,height and body mass index(BMI)before pregnancy was recorded.Biochemical indicators including fasting plasma glucose(FPG),fasting insulin (FINS),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),free fatty acids(FFA)were tested.GMS was diagnosed with three or all of the following conditions:(1)overweight and/or obesity before pregnancy(BMI ≥ 25 kg/m2);(2)hypertension with blood pressure ≥ 140/90 mm Hg(1 mm Hg =0.133 kPa);(3)hyperglycemia:diagnosed as GDM;(4)dyslipidemia with TG≥3.23 mmol/L The incidence of GMS of the three groups were calculated and the risk factors were analyzed.Results(1)The age,gestational weeks,basic blood pressure,admission blood pressure,BMI before pregnancy of women with preeclampsia and women with GDM were significantly different compared to normal women,respectively(P ＜ 0.01).(2)Biochemical indicators of women with preeclampsia were as following:FPG(4.6 ± 1.0)mmol/L,FINS(10.1 ± 5.6)mU/L,TC(6.3 ±1.6)mmol/L,TG(3.9 ± 1.8)mmol/L,HDL-C(1.4 ±0.4)mmol/L,LDL-C(3.0 ± 1.0)mmol/L,FFA (0.8 ±0.4)mmol/L.And those in women with GDM were:FPG(4.7 ± 0.9)mmoL/L,FINS(10.2 ± 5.8)mU/L,TC(5.7 ± 1.3)mmol/L,TG(3.2 ± 1.1)mmol/L,HDL-C(1.4 ± 0.4)mmol/L,LDL-C (2.7 ± 0.9)mmol/L,FFA(0.6 ± 0.3)mmol/L In normal pregnant women they were:FPG(4.3 ±0.5)mmol/L,FINS(9.0±4.4)mU/L,TC(5.7 ±1.1)mmol/L,TG(2.8 ±1.1)mmol/L,HDL-C (1.5 ± 0.4)mmol/L,LDL-C(2.9 ± 0.8)mmol/L,FFA(0.6 ± 0.2)mmol/L Statistic differences were found in preeclampsia and GDM women compared to normal women respectively(P ＜ 0.01).(3)The prevalence of GMS in preeclampsia group and in GDM group was 26.2％(81/309)and 13.6％(85/627),statistically different from that of the control group(0)(P ＜0.01).(4)Compared to normal women,women with preeclampsia had higher risk of developing GMS(OR =1.62,95 ％ CI 1.31-2.00,P ＜ 0.01).The risk factors were BMI(OR =1.29,95％ CI 1.13-1.47)and TG(OR =2.49,95％ CI 1.87-3.31).Also,women with GDM had higher risk of developing GMS than normal women(OR =1.27,95％ CI 1.09-1.49,P ＜ 0.01),and the risk factors were BMI(OR =1.13,95 ％ CI 1.04-1.23)and TG(OR =1.16,95 ％ CI 1.02-1.33).TG was the independent risk factor in both preeclampsia women and GDM women(P ＜ 0.01,P ＜ 0.05).HDL-C seemed to have less importance in identifying GMS(P ＞ 0.05).Conclusions According to the GMS diagnostic criteria used in this study,some preeclampsia patients and some GDM women had aggregation of multiple metabolic abnormalities including pre-pregnancy overweight/obesity,hyperglycemia,high blood pressure and dyslipidemia.TG was the independent risk factor for GMS.HDL-C seemed to have less importance in identifying GMS.
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Objective To investigate the correlations between the hippocampal acetylcholine (ACh) content and neuronal apoptosis in the hippocampal CA1 region as well as the spatial memory impairment in a rat model of vascular dementia (VaD).Methods Forty male healthy Sprague-Dawley rats were randomly divided into either a VaD group or a sham operation group (n =20 in each group).A VaD model was induced by intermittently clipping common carotid artery.Microdialysis was used to collect dialysis solutions in rat hippocampus.High-performance liquid chromatographic analysis was used to detect the ACh content in the dialysis fluid.Morris water maze test was used to test their learning and memory abilities.TUNEL staining was used to detect neuronal apoptosis in the hippocampal CA1 region.Results Microdialysis analysis showed that the ACh content in the hippocampus in the VaD group was significantly lower than that in the sham operation group (0.442 ± 0.028 μmmol/L vs.1.560 ± 0.092 μ mmol/L; t =51.697,P =0.000).TUNEL staining showed that the apoptosis rate in the hippocampal CA1 region in the VaD group was significantly higher than that in the sham operation group (55.652％ ±2.051％ vs.6.530％ ± 1.872％ ; t =79.114,P=0.000).The escape latencies at different detection time points were prolonged significantly (At day 3:49.713 ± 18.161 s vs.13.322 ± 2.454 s; t =-8.881,P =0.000; at day 4:34.368 ± 7.424 s vs.10.503±1.415 s; t=-14.121,P=0.000; at day 5:30.676± 6.669s vs.7.311± 1.534 s; t=-15.270,P =0.000),and the numbers of cross platform were reduced significantly (3.768 ± 1.072 vs.10.218 ± 1.165; t =18.224,P=0.000).Pearson correlation analysis showed that the ACh contents in the VaD group were negatively correlated with the escape latencies (at day 3:r =-0.476,P =0.034; at day 4:r=-0.700,P=0.001; at day 5:r=-0.693,P=0.001).They were positively correlated with the numbers of cross platform (r =0.689,P =0.001),and negatively correlated with the neuronal apoptosis rates in the hippocampal CA1 region (r =-0.271,P =0.031).Conclusions The decreased ACh content,the increased neuronal apoptosis rate in the rat hippocampal CA1 region in the VaD model may be one of the mechanisms of cognitive impairment in VaD rats.
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ObjectiveTo explore the expression of hemopoietin(EPO) mRNA on cerebral ischemia-reperfusion injury in rats brain tissue and the effect of Tongxinluo on it.Methods The model of rat (MCAO) were perfused with Tongxinluo,the changes of neural stem cell proliferation and differentiation related cell factors of EPO mRNA were detected after ischemia-reperfusion injury 3、5、7、14 d by means of reverse transcriptase polymerase chain reaction(RT-PCR).ResultsEPO mRNA of ischemia-reperfusion models showed expression in different period,the expression enhanced in the third day,reached the highest in the fifth day; the ischemia side EPO mRNA expression enhanced in the third day after give Tongxinluo,in the 5,7 and 14 day,PCR expression gray values were higher than the model group.ConclusionEPO mRNA expression enhanced after cerebral ischemia,this expression can be strengthened by Tongxinluo,and may further induce neural stem cell proliferation and differentiation.
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Objective To investigate the correlationship of second-trimester serum human chorionic gonadotropin (hCG) level and preeclampsia, premature rupture of membranes and preterm delivery. Methods 200 cases of second-trimester gestational serum hCG level was determined by radioimmunoassay,and the pregnancy outcome was followed up. Results The maternal serum hCG level in every gestative week has no significant differences;hCG level of pregnancies with preeclampsia,premature rupture membranes and preterm delivery was significantly higher than normal pregnancies. The rate of developing preeclampsia,premature rupture of membranes and preterm delivery in those hCG ≥2MOM patients (30.9%、35.8% and 14.8% respectively)was significantly higher than those MshCG
