Metabolic changes in bile acids with pregnancy progression and their correlation with perinatal complications in intrahepatic cholestasis of pregnant patients.

Intrahepatic cholestasis of pregnancy (ICP) is a rare liver disease occurring during pregnancy that is characterized by disordered bile acid (BA) metabolism. It is related to adverse clinical outcomes in both the mother and fetus. Our aim was to evaluate the BA metabolism profiles in different types of ICP and investigate the association between specific BAs and perinatal complications in ICP patients. We consecutively evaluated 95 patients with ICP, in which 53 patients were diagnosed with early-onset ICP (EICP) and 42 patients were diagnosed with late-onset ICP (LICP). Concentrations of 15 BA components were detected using high-performance liquid chromatography tandem mass spectrometry. Clinical information was abstracted from the medical records. The percentage of conjugated bile acids increased in ICP patients. Specifically, taurocholic acid (TCA) accumulated in LICP patients, and glycocholic acid (GCA) predominated in EICP patients. A higher preterm birth incidence was observed among ICP patients. Albumin, total bile acids, total bilirubin and GCA percentage values at ICP diagnosis predicts 83.5% of preterm birth in EICP, and the percentage of TCA in total bile acids at ICP diagnosis predicts 93.2% of preterm birth in LICP. This analysis showed that the BA metabolism profiles of EICP and LICP were distinct. Increased hepatic load was positively correlated with preterm birth in EICP. An elevated TCA percentage in total bile acids provides a biomarker to predict preterm birth in LICP.

Coagulation and Fibrinolysis Biomarkers as Potential Indicators for the Diagnosis and Classification of Ovarian Hyperstimulation Syndrome.

Background: Accurate diagnosis and classification of ovarian hyperstimulation syndrome (OHSS) is important for its management. We employed a new high-sensitivity chemiluminescence immunoassay to detect the thrombin-antithrombin complex (TAT), plasmin alpha2-plasmin inhibitor complex (PIC), soluble thrombomodulin (sTM), and tissue plasminogen activator-inhibitor complex (TPAI-C), and evaluated their diagnostic and classification performance for OHSS. Methods: A total of 106 women were enrolled, including 51 patients with OHSS (25 mild or moderate OHSS, 26 severe OHSS), and 55 without OHSS (control group). TAT, PIC, sTM, and TPAI-C levels were measured using the Sysmex HISCL5000 automated analyzer. Results: Compared to the control group, TAT, PIC, and TPAI-C levels were significantly higher (P < 0.001, P < 0.001, P < 0.001, respectively), whereas the sTM level was significantly lower (P < 0.001) in the patients with OHSS. The receiver operating characteristic was used to evaluate the diagnostic efficiency. For the diagnosis of OHSS, the area under the curves (AUCs) for TAT, PIC, sTM, and TPAI-C were 0.991, 0.973, 0.809, and 0.722, respectively. In particular, the sensitivity, specificity, positive predictive value, and negative predictive value for TAT and PIC were all above 90%. For the differential diagnosis of mild-moderate and severe OHSS, the AUCs for TAT, PIC, and TPAI-C were 0.736, 0.735, and 0.818, respectively. The cutoff values of TAT, PIC, and TPAI-C for the differential diagnosis of mild-moderate and severe OHSS were 11.5 ng/mL, 2.4 µg/mL, and 5.8 ng/mL, respectively. Based on these cutoff values, eight cases of mild-moderate OHSS exceeded the cutoff values, two of which developed to severe OHSS in the following days. However, of the remaining 17 cases of mild-moderate OHSS patients with negative biomarkers, none subsequently developed severe OHSS. Conclusions: TAT, PIC, sTM, and TPAI-C can be used as sensitive biomarkers in the diagnosis of OHSS. Meanwhile, TAT, PIC, and TPAI-C also displayed remarkable potential in the classification of OHSS. In addition, the levels of TAT, PIC, and TPAI-C above the cutoff values in patients with mild-moderate OHSS might predict a high risk of developing severe OHSS.

Diagnostic performance of HE4 and ROMA among Chinese women.

OBJECTIVE: Human epididymis protein 4 (HE4) has been suggested as a new biomarker for the detection of ovarian cancer. Because there are few reports on HE4 in terms of ovarian cancer diagnosis in the Chinese population, we evaluated the diagnostic performances of HE4 and the ROMA in Chinese women with pelvic masses. METHODS: The serum concentrations of CA 125 and HE4 in 318 Chinese women with pelvic masses (39 of which were ovarian cancers) were determined. RESULTS: For the discrimination of benign gynecological diseases from ovarian cancer, the sensitivity and specificity values were 87.2% and 75.8% for the ROMA and 51.3% and 97.3% for HE4. The ROMA also showed higher sensitivity than HE4 in both the early and advanced stages. In the ROC curve analysis, the AUC values for ROMA, HE4 and CA 125 were 0.927, 0.907 and 0.785, respectively. CONCLUSIONS: As a new tumor marker, HE4 shows high specificity and efficacy in the Chinese population, while the ROMA that combines HE4 and CA 125 shows high sensitivity and a high Youden's index. These markers should be extended to China since they have good diagnostic performances.

Whole-exome sequencing reveals genetic variants in ERC1 and KCNG4 associated with complete hydatidiform mole in Chinese Han women.

Complete hydatidiform mole (CHM) is a rare pregnancy-related disease with invasive potential. The genetics underlying the sporadic form of CHM have not been addressed previously, but maternal genetic variants may be involved in biparental CHM. We performed whole-exome sequencing of 51 patients with CHM and 47 healthy women to identify genetic variants associated with CHM. In addition, candidate variants were analyzed using single base extension and Matrix Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry in 199 CHM patients and 400 healthy controls. We validated candidate variants using Sanger sequencing in 250 cases and 652 controls, including 205 new controls. Two single nucleotide polymorphisms, c.G48C(p.Q16H) inERC1 and c.G1114A(p.G372S) in KCNG4, were associated with an increased risk of CHM (p<0.05). These variants may contribute to the pathogenesis of CHM and could be used to screen pregnant women for this genetic abnormality.

Performance of ROMA based on Architect CA 125 II and HE4 values in Chinese women presenting with a pelvic mass: A multicenter prospective study.

BACKGROUND: We evaluated the performance of human epididymis protein 4 (HE4), cancer antigen 125(CA 125) and Risk of Ovarian Malignancy Algorithm (ROMA) in distinguishing between benign and malignant pelvic masses in Chinese women. METHOD: From April to December 2012, women with a pelvic mass scheduled to have surgery were enrolled in a prospective, multi-center study conducted in 5 different regions in China. Preoperative serum concentrations of HE4 and CA 125 were examined and ROMA was calculated. RESULTS: A total of 684 women with a pelvic mass were included, of which 482 were diagnosed with benign conditions and 202 were diagnosed with malignant ovarian tumors. At cutoffs of 7.4% and 25.3% for ROMA, the sensitivities and specificities were 85.6% and 81.7% for all patients, 85.7% and 81.5% for premenopausal women, and 85.6% and 83.9% for postmenopausal women, respectively. The ROC-AUC of ROMA was significantly better than that of HE4 (P=0.0003) or CA 125 (P<0.0001) for all malignant diseases (including EOC, Non-EOC, LMP, metastases and other pelvic malignancy with no involvement of the ovaries) compared with benign diseases for all patients. CONCLUSIONS: We demonstrated the efficiency of ROMA in the distinction of ovarian cancers from benign disease in a multiple-regions Chinese population, especially in premenopausal women.

Telomeric repeat-containing RNA (TERRA) related to polycystic ovary syndrome (PCOS).

CONTEXT: Telomeric repeat-containing RNA (TERRA) participates in the regulation of telomere length, and leucocyte telomere length (LTL) plays an important role in the pathophysiology of polycystic ovary syndrome (PCOS), but little is known about the role of TERRA in PCOS. OBJECTIVE: To evaluate the role of TERRA and peripheral blood LTL in PCOS. DESIGN AND PARTICIPANTS: Forty women with PCOS and 35 healthy women without PCOS were recruited. A prospective case-control study was performed. MEASUREMENTS: RNA fluorescence in situ hybridization (FISH) was used to detect TERRA expression in peripheral blood leucocyte. Quantitative PCR was used to measure TERRA expression and the mean LTL in the PCOS and control groups. We analysed the association between related clinical parameters and the age-adjusted ratio of the telomere repeat length (T/S ratio) or TERRA. RESULTS: Telomeric repeat-containing RNA was expressed in human peripheral blood leucocytes, and the signal was abolished after culture with RNase A. The age-adjusted LTLs were significantly longer in the PCOS group than in the control group (P < 0·01). The age-adjusted TERRA level was significantly lower in the PCOS group than in the control group (P < 0·01). Testosterone (TTE) was related positively to LTL and negatively to TERRA in the PCOS group (r = 0·532, P = 0·002; r = -0·477, P = 0·017). CONCLUSION: We found TERRA expression in human peripheral blood leucocytes, and LTLs were positively associated with PCOS. TERRA and testosterone play an important role in the LTL regulation in PCOS.

A multicenter study of fetal chromosomal abnormalities in Chinese women of advanced maternal age.

OBJECTIVE: This study aimed to determine the rates of different fetal chromosomal abnormalities among women of advanced maternal age in China and to discuss the possible misdiagnosis risks of newer molecular techniques, for selection of appropriate prenatal screening and diagnostic technologies. MATERIALS AND METHODS: Second trimester amniocentesis and fetal karyotype results of 46,258 women were retrospectively reviewed. All women were ≥ 35 years old with singleton pregnancies. The rates of clinically significant chromosomal abnormalities (CSCAs), incidence of chromosomal abnormalities, and correlations with age were determined. RESULTS: From 2001 to 2010, the proportion of women of advanced maternal age undergoing prenatal diagnosis increased from 20% to 46%. The mean age was 37.4 years (range, 35-46 years). A total of 708 cases of CSCAs, with a rate of 1.53% were found. Trisomy 21 was the most common single chromosome abnormality and accounted for 55.9% of all CSCAs with an incidence of 0.86%. Trisomy 13, trisomy 18, and trisomy 21, the most common chromosome autosomal aneuploidies, accounted for 73.6% of all CSCAs, with a rate of 1.13%. As a group, the most common chromosomal aneuploidies (13/18/21/X/Y) accounted for 93.9% of all abnormalities, with a rate of 1.44%. The incidence of trisomy 21, trisomy 13/18/21 as a group, and 13/18/21/X/Y as a group was significantly greater in women aged 39 years and older (p < 0.001), but was not different between women aged 35 years, 36 years, 37 years, and 38 years. CONCLUSION: These findings may assist in genetic counseling of advanced maternal age pregnant women, and provide a basis for the selection of prenatal screening and diagnostic technologies.

Hyper Expression of Mucin 5ac Indicates Poor Cancer Prognoses: A Meta-Analysis.

The aim of the study was to explore the association between mucin 5ac expression and cancer prognosis. A systematically comprehensive search was performed through PubMed, the Web of Science, and the China National Knowledge Infrastructure (CNKI). The prognostic value of mucin 5ac expression in cancer patients was evaluated. The overexpression of mucin 5ac was found to be significantly associated with a poor prognosis in cancer patients (pooled HR: 1.53, 95%CI: 1.158-2.028, P = 0.003). This association was also detected in a biliary subgroup (pooled HR: 1.83, 95%CI: 1.269-2.639, P = 0.001) and a gastrointestinal subgroup (pooled HR: 1.44, 95%CI: 1.069-1.949 P = 0.017). In the geography subgroup analysis, a statistical association was found in the Asian subgroup (pooled HR: 1.69, 95%CI: 1.200-2.384, P = 0.003). In the clinical characteristics analysis, a statistical association was found between the hyper expression of mucin 5ac and lymphatic metastasis. We indicated that mucin 5ac is a promising prognostic predictor for cancer, especially for biliary and gastrointestinal cancer, and is more suitable for predicting cancer prognoses in Asians.

Clinicopathological and prognostic significance of MUC4 expression in cancers: evidence from meta-analysis.

Mucin4 (MUC4) is a secreted glycoprotein. Numerous studies had indicated that MUC4 was an attractive prognostic tumor biomarker. However, the results of different studies have been inconsistent. So we conducted this meta-analysis to explore the association between MUC4 expression and cancer prognosis. A systematically comprehensive search was performed through PubMed, EMBASE and CNKI (Chinese National Knowledge Infrastructure). Prognostic value of MUC4 expression in malignancy patients was evaluated by pooled hazard ratios (HRs) and their 95% confidence intervals (CIs). Meanwhile, pooled odds ratio (OR) with 95% CI was appropriate for the association between MUC4 expression and clinicopathological parameters. Eighteen studies including 1,933 patients were enrolled in this meta-analysis. Significant association was found between elevated MUC4 expression and poorer overall survival (OS) with pooled hazard ratio (HR) of 1.87 [95% confidence interval (CI): 1.58-2.23, P<0.001]. Significant associations were also detected in biliary tract carcinoma (HR: 2.41, 95% CI: 1.69-3.42, P<0.001), pancreatic cancer (HR: 2.01, 95% CI: 1.42-2.86, P<0.001) and colorectal cancer (HR: 1.73, 95% CI: 1.17-2.54, P=0.006). Moreover, combined odds ratio (OR) of MUC4 indicated that MUC4 overexpression was associated with tumor stage, tumor invasion and lymph node metastasis. Our results demonstrated that MUC4 may be exploited as a novel prognostic biomarker for cancer patients.

Role of TERRA in the regulation of telomere length.

Telomere dysfunction is closely associated with human diseases such as cancer and ageing. Inappropriate changes in telomere length and/or structure result in telomere dysfunction. Telomeres have been considered to be transcriptionally silent, but it was recently demonstrated that mammalian telomeres are transcribed into telomeric repeat-containing RNA (TERRA). TERRA, a long non-coding RNA, participates in the regulation of telomere length, telomerase activity and heterochromatinization. The correct regulation of telomere length may be crucial to telomeric homeostasis and functions. Here, we summarize recent advances in our understanding of the crucial role of TERRA in the maintenance of telomere length, with focus on the variety of mechanisms by which TERRA is involved in the regulation of telomere length. This review aims to enable further understanding of how TERRA-targeted drugs can target telomere-related diseases.

Gestational thyroid reference intervals in antibody-negative Chinese women.

OBJECTIVES: The aim of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function assays in pregnant Chinese women with ARCHITECT and compare them to other GRI studies. DESIGN AND METHOD: Thyroid antibody negative pregnant Chinese women were enrolled and followed to establish GRIs for thyroid function by use of the Abbott ARCHITECT i2000SR analyzer (N=1409). Samples from 360 non-pregnant Chinese women served as controls. RESULTS: GRIs of thyroid-stimulating hormone, free thyroxine and free triiodothyronine for first trimester pregnancies were 0.16-3.78mIU/L, 10.9-17.7pmol/L and 2.9-5.0pmol/L, respectively. GRIs for second trimester pregnancies were 0.34-3.51mIU/L, 9.3-15.2pmol/L and 2.9-4.6pmol/L. GRIs for third trimester pregnancies were 0.34-4.32mIU/L, 7.9-14.1pmol/L and 2.9-4.5pmol/L. CONCLUSIONS: Our thyroid GRIs were different from those in other Chinese studies generated on other analyzers, but were similar to a Swiss study using the same analyzer. These data should prove useful for the interpretation of thyroid function assays among pregnant women measured on the Abbott analyzer.

The resistance analysis of Ureaplasma urealyticum and Mycoplasma hominis in female reproductive tract specimens.

The aim of this study was to analyze the drug resistance of Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) in female reproductive track from 2007 to 2011 in Hangzhou. Antibiotics sensitivity test in Mycoplasma, which was isolated in clinics from 2007 to 2011 were analyzed retrospectively. The detection of Mycoplasma during 2007-2011 was 20,146 (54.37 %), of which the single infection rate of Uu was 42.08 %, of Mh 1.26 %, and of Uu+Mh was 11.02 %. The drug resistance rate of Uu was increased significantly in ofloxacin in 2007 (41.80 %), 2008 (45.94 %), 2009 (46.07 %), 2010 (50.36 %), and 2011 (53.22 %) (P < 0.05). The resistance rate to ciprofloxacin was significantly increased in 2007 (67.15 %), 2008 (67.44 %), 2009 (73.00 %), 2010 (75.28 %), and 2011 (75.28 %) (P < 0.05). Exceptionally, the resistance rates of the other antibiotics were low. The drug resistance rate of Uu was significantly increased with quinolones at increasing tendency. It is necessary to monitor the local drug resistance rate of Uu regularly to provide reasonable guidelines in clinics.

Reference intervals of D-dimer during the pregnancy and puerperium period on the STA-R evolution coagulation analyzer.

BACKGROUND: Pregnant women are at a hyper-coagulable state with a higher risk of deep venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC), which could be life threatening. We established gestational age-specific reference intervals for D-dimer, and estimate the role of D-dimer test in ruling out VTE and DIC in pregnant women. METHODS: We followed 1343 healthy pregnant women and 1042 uncomplicated postpartum women to establish gestational age-specific reference intervals of D-dimer during normal pregnancy. Eighty uncomplicated non-pregnant women were chosen as control group. D-dimer testing was also performed among the patients with pregnancy-related complications. RESULTS: D-dimer concentration increased progressively during the pregnancy and peaked at the first postpartum day, and then it began to decrease steadily and reach to non-pregnant concentrations on the 42nd postpartum day. The results of several cases that had clinical suspicion of VTE were compared with those of the reference group. CONCLUSIONS: The study provides reference intervals of D-dimer during the pregnancy and postpartum period for women of Chinese Han ethnicity using latex-based immunoturbidimetry on the STA-R evolution coagulation analyzer. Further studies are needed to validate these reference ranges and assess the clinical utility of the reference intervals for D-dimer.

Serum insulin-like, growth factor binding protein-related protein 1 (IGFBP-rP1) and endometrial cancer risk in Chinese women.

Hyperinsulinemia and the metabolic syndrome confer increased risks of endometrial carcinoma. The roles of insulin, and, insulin-like growth factor-binding proteins (IGFBPs) in the etiology of endometrial carcinoma, remain unclear. We recruited 206 patients with endometrial carcinoma and 350 healthy women to a case-control study of fasting insulin and IGFBP-related protein 1 (IGFBP-rP1) in a Chinese tertiary centre. Patients with endometrial carcinoma had higher insulin concentrations (14.8 ± 16.7 vs. 8.1 ± 9.4 µU/mL; p < 0.001) and lower IGFBP-rP1 levels (17.5 ± 17.2 vs. 22.4 ± 22.8 µg/L; p = 0.018) than controls. High insulin and IGFBP-rP1 levels were both positively and negatively associated with endometrial cancer (odds ratio for the highest tertile versus the lowest tertile: insulin: 4.11; 95% CI = 2.61-6.47; IGFBP-rP1: 0.38; 95% CI = 0.24-0.60). Logistic regression analysis confirmed the associations between endometrial carcinoma and fasting insulin or IGFBP-rP1 after adjustments for age, BMI, serum glucose, cholesterol, triglycerides and high-density lipoprotein cholesterol (odds ratio for the highest tertile versus the lowest tertile: insulin: 2.13; 95% CI = 1.30-3.49; IGFBP-rP1: 0.57; 95% CI = 0.34-0.94). Hyperinsulinemia and high IGFBP-rP1 levels confer altered risks for endometrial carcinoma.

Premature infants born after preterm premature rupture of membranes with 24-34 weeks of gestation: a study of factors influencing length of neonatal intensive care unit stay.

OBJECTIVES: To determine the factors influencing length of neonatal intensive care unit (NICU) stay among premature infants born after preterm premature rupture of membranes (PPROM) with 24-34 weeks of gestation. METHODS: Characteristic parameters of the pregnant women with PPROM and their premature infants were analyzed retrospectively using univariate and multivariate analysis. RESULTS: The overall rate of PPROM was 1.3% (323/24,173), of which 19.2% (62/323) were premature infants with sepsis. Overall, the median NICU stay of the premature infants was 11 days. Multiple factor regression analysis identified factors influencing length of stay in premature infants: gestational age (ß = -0.172, P = 0.000), parturition modes (ß = -0.115, P = 0.000), infant's birth weight (ß =  -0.728, P = 0.000), infant's discharge weight (ß = 0.443, P = 0.000), bacterial culture of cord blood (ß = -0.100, P = 0.011) and sepsis (ß = 0.192, P = 0.000). Additionally, latency period of sepsis diagnosis in neonatal sepsis between negative and positive cord blood culture was significantly discrepant, and 98.1% specificity and 84.4% positive predictive value for cord blood culture. CONCLUSION: We have identified several predictive factors for length of stay in cases of premature infants after PPROM, of which cord blood culture can be used as an additional diagnostic test to detect newborns at risk of infections, and be valuable in clinical application and generalization among neonate sepsis.

ADAM12 is an effective marker in the second trimester of pregnancy for prenatal screening of Down syndrome.

OBJECTIVE: To estimate the use of maternal serum ADAM12 as a second-trimester Down syndrome serum marker. METHODS: Samples from a total of 46 Down syndrome pregnancies and 184 unaffected singleton pregnancies matched for gestational age and maternal weight were retrieved from storage and measured for ADAM12; 35 false-positive pregnancies were included among the controls to assess reductions in false-positive rates by inclusion of ADAM12 in the risk calculation of an algorithm that used alpha-fetoprotein (AFP) and human chorionic gonadotrophin (hCG) (double screen). RESULTS: ADAM12 was measured and expressed as multiple of the gestation-specific median (MoM) and corrected for maternal weight. The median ADAM12 level in the affected pregnancies was 1.26 MoM compared with 1.0 MoM in the unaffected control pregnancies (p < 0.05). In unaffected pregnancies, there was a significant correlation between ADAM12 and AFP (r = 0.314) but not hCG (r = 0.018). Statistical modeling predicted that ADAM12 as a second serum marker could increase the detection rate from 48 to 85%, while reducing the false-negative and false-positive rates. CONCLUSION: ADAM12 can be used as an effective second-trimester serum marker for prenatal screening of Down syndrome.

The association between metabolic abnormality and endometrial cancer: a large case-control study in China.

OBJECTIVES: To investigate the association between insulin-resistance-related conditions (comprising the metabolic syndrome) and endometrial cancer risk in Chinese women. METHODS: We conducted a large case-control study including 942 endometrial cancers and 1721 controls on a Chinese population. The relative endometrial cancer risks from various factors were calculated by the x(2) test. Menopausal status and BMI were applied as potential confounders to analyze the joint effects with other factors. RESULTS: We found that overweight/obesity, hypertension, diabetes mellitus and glucose metabolic disturbance were all associated with endometrial cancer risk. Effective medication on diabetes can significantly decrease cancer risk (uncontrolled diabetes: RR=5.563, 95% CI=2.406-12.859, p<0.001; controlled diabetes: RR=1.331, 95% CI=0.529-3.352, p>0.05) as compared with normal controls. Serum lipids were also found to be linked to endometrial cancer risk: positive correlations were present with total serum cholesterol, triglycerides, low-density lipoprotein cholesterol and dyslipidaemia, while a negative correlation was found with high-density lipoprotein cholesterol. We also observed an elevated risk for type I endometrial cancer (OR=1.839, 95% CI=1.539-2.197, p<0.001) in women with BMI>or=24.58 versus those with BMI<24.58, but not for type II cancer (OR=1.092, 95% CI=0.969-1.231, p>0.05). CONCLUSIONS: Our findings support the hypothesis that metabolic abnormalities or insulin resistance may promote the initiation and progression of endometrial cancer. The effective treatment of type 2 diabetes might contribute to endometrial cancer prevention.

Contingent triple-screening for Down syndrome in the second trimester: a feasibility study in Mainland Chinese population.

OBJECTIVES: To explore the efficacy of contingent triple-screening for Down syndrome (DS), that is, performing triple-screening in pregnant women with DS risks between 1/270 and 1/1000 at routine double-screening, in a Mainland Chinese population. METHODS: Maternal serum concentrations of alpha fetoprotein (AFP), free-beta human chorionic gonadotropin (free beta-hCG), and unconjugated estriol (uE3) were measured by time-resolved fluoroimmunoassay in 24 double-screening false-negative (DSFN) and 322 double-screening true-negative (DSTN) pregnancies with DS risks between 1/270 and 1/1000 at routine double-screening performed at 15-20 weeks' gestation. DS risk of each pregnancy was calculated by computer software. The detection rate (DR), false-positive rate (FPR), and costs of contingent triple-screening were calculated and compared with routine double-screening methods. RESULTS: Six of 24 DSFN and 3 of 322 DSTN were contingent triple-screening positive. Compared with routine double-screening, DR of contingent triple-screening increased by 10% (from 50% to 60%) without a significant increase of FPR (p > 0.05). When compared with routine triple-screening, uE3 costs in contingent triple-screening were reduced by more than 84.3%. CONCLUSIONS: Second-trimester maternal serum contingent triple-screening could be effective and suitable for prenatal care in Mainland China. Governments and Health Agencies of other developing countries may also find this strategy cost-effective.

Genetic analysis of 15 STR loci in the population of Zhejiang Province (Southeast China).

Fifteen autosomal STR loci were analyzed from a population sample of 598 unrelated individuals residing in Zhejiang Province. We report allele frequencies distribution and statistical parameters for all 15 STR loci, D8S1179, D21S11, D7S820, CSF1PO, D3S1358, THO1, D13S317, D16S539, D2S1338, D19S433, VWA, TPOX, D18S51, D5S818 and FGA. Allele frequencies, the observed heterozygosity (Ho), the polymorphic information content (PIC), and the probability of paternity exclusion (PE) were calculated. All loci were in accordance with Hardy-Weinberg equilibrium (P>0.05). Our studied population data were compared with the previously published population data of other ethnic groups or areas in China. Our results of present study were valuable for human identification and paternity tests in Zhejiang Province.