New Devitalized Freeze-Dried Human Umbilical Cord Amniotic Membrane as an Innovative Treatment of Ocular Surface Defects: Preclinical Results.

A preclinical study was performed to investigate the efficacy and safety of a new viral inactivated, devitalized, freeze-dried and gamma-sterilized human umbilical cord amniotic membrane (lhUC-AM) for the treatment of deep scleral and corneal defects with or without perforation. Firstly, lhUC-AM was investigated on experimental deep sclerectomy in rabbit eyes (n = 12) and compared to autograft (n = 4) on cross section histology. Secondly, lhUC-AM was studied on a selected series of uncontrolled cases of corneal defects (n = 18) with or without perforation, in dogs and cats. lhUC-AM tolerance, reconstruction of the deep corneal lesion and recovery of the structural aspect of the tissue were followed post-surgery. In experimental deep sclerectomy, histology showed that the lhUC-AM was well tolerated and degraded completely in 45 days while allowing an overall quality and kinetic of scleral regeneration, similar to autograft. In the clinical situations, lhUC-AM was well tolerated, with ocular inflammatory signs quickly decreasing after surgery. Mean follow-up was 16.40 ± 11.43 months. In 15 out of 18 cases, lhUC-AM allowed ocular surface wound healing. The ocular surface was fully reconstructed three months after surgery. This study suggests a good safety and efficacy profile of lhUC-AM in the treatment of deep corneal or scleral defect in animals. This new tissue should now facilitate the treatment of severe ocular surface diseases in humans.

Correlation of placental MR imaging signs and pathologic diagnosis of placenta accreta spectrum: Retrospective single center case series.

INTRODUCTION: Alongside initial screening obstetric US, use of placental MRI has been increasing in the last few decades to aid with antenatal diagnosis and delivery planning in Placenta Accreta Spectrum (PAS). The aim of this study was to determine if the MRI pathophysiological sign subcategories described in the current literature can predict the severity of pathologic diagnosis. METHODS: Institutional imaging records were reviewed for placental MRIs performed for suspicion of PAS in the last decade. Electronic health records were searched for patient history and pathology. The 59 MRI studies were reviewed using the 11 MRI signs described by the SAR and ESUR joint consensus statement. Further breakdown of the signs was divided by underlying pathophysiologic subcategories including gross morphologic, interface and tissue architecture signs. RESULTS: Pathologic diagnosis yielded 34 cases: accreta 4/34, incerta 14/34, percreta 10/34 and normal 6/34. Of the accreta cases all of them demonstrated at least two interface and half of the cases had tissue architecture signs, 13/14 increta cases demonstrated interface signs and 12/14 demonstrated tissue architecture signs, 9/10 percreta cases had two interface and at least six demonstrated three tissue architecture signs. Statistical analysis showed significant difference between pathologic diagnosis and the number of positive interface signs with p = 0.02. DISCUSSION: Interface signs were the most objective and sensitive MRI subcategory. Statistical analysis determined there was a significant difference between PAS diagnosis and number of interface signs present. This subcategory has the most overlap with classic US signs which are traditionally used before MRI referral.

Association between metal cobalt exposure and the risk of congenital heart defect occurrence in offspring: a multi-hospital case-control study.

BACKGROUND: Many studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between cobalt exposure and CHD occurrence in offspring. The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring. MATERIALS AND METHODS: In order to explore the association between cobalt exposure and occurrence of congenital heart defect (CHD), a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of cobalt in hair of pregnant woman and fetal placental tissue were measured and processed by a logistic regression analysis to explore the relationship between cobalt exposure and risk of CHDs. RESULTS: The median concentration of hair cobalt in the control and case group was 0.023 ng/mg and 0.033 ng/mg (aOR, 1.837; 95% CI, 1.468-2.299; P < 0.001), respectively. And the median (5-95% range) fetal placental cobalt concentrations were 19.350 ng/g and 42.500 ng/g (aOR, 2.924; 95% CI, 2.211-3.868; P < 0.001) in the control and case groups, respectively. Significant differences in the middle level of cobalt in hair were found in the different CHD subtypes, including septal defects, conotruncal defects, right ventricular outflow tract obstruction, and left ventricular outflow tract obstruction (P < 0.001). Dramatically, different cobalt concentrations in fetal placental tissue were found in all subtypes of cases with CHDs (P < 0.01). CONCLUSIONS: The finding suggested that the occurrence of CHDs may be associated with cobalt exposure.

Association between metal cobalt exposure and the risk of congenital heart defect occurrence in offspring: a multi-hospital case-control study

BACKGROUND@#Many studies have investigated heavy metal exposure could increase the occurrence of congenital heart defects (CHDs). However, there are limited data regarding the relationship between cobalt exposure and CHD occurrence in offspring. The aim of this study was to analyze the association between cobalt exposure in mothers and the risk of CHDs in offspring.@*MATERIALS AND METHODS@#In order to explore the association between cobalt exposure and occurrence of congenital heart defect (CHD), a case-control study with 490 controls and 399 cases with CHDs in China were developed. The concentrations of cobalt in hair of pregnant woman and fetal placental tissue were measured and processed by a logistic regression analysis to explore the relationship between cobalt exposure and risk of CHDs.@*RESULTS@#The median concentration of hair cobalt in the control and case group was 0.023 ng/mg and 0.033 ng/mg (aOR, 1.837; 95% CI, 1.468-2.299; P < 0.001), respectively. And the median (5-95% range) fetal placental cobalt concentrations were 19.350 ng/g and 42.500 ng/g (aOR, 2.924; 95% CI, 2.211-3.868; P < 0.001) in the control and case groups, respectively. Significant differences in the middle level of cobalt in hair were found in the different CHD subtypes, including septal defects, conotruncal defects, right ventricular outflow tract obstruction, and left ventricular outflow tract obstruction (P < 0.001). Dramatically, different cobalt concentrations in fetal placental tissue were found in all subtypes of cases with CHDs (P < 0.01).@*CONCLUSIONS@#The finding suggested that the occurrence of CHDs may be associated with cobalt exposure.

Expressions of HIF-1α and HSP70 in placenta tissue of patients with pregnancy-induced hypertension syndrome and their significances / 吉林大学学报(医学版)

Objective: To investigate the expressions of hypoxia-inducible factor-la (HIF-la) and heat shock protein 70 (HSP70) in the placenta tissue of the patients with pregnancy-induced hypertension syndrome (PIH), and to elucidate the clinical significances of their expressions in the placenta tissue of the patients with PIH. Methods: Twenty-two cases of placenta tissue of the PIH patients (PIH group) and eighteen cases of placenta tissue of the normal pregnant women (control group) were selected. The expressions of HIF-la and HSP70 were detected by immunohistochemical method. The differences of potive expressions rates of HIF-la and HSP70 in placenta tissue of the PIH patients and the normal pregnant women and their relationships in placenta tissue of the PIH patients were analyzed. Results: The positive expression rate of HIF-1α in placenta tissue of the patients in PIH group (81.8%) was higher than that of the normal pregnant women in control group (38.9%) (χ2=7.785, P= 0.005), and the positive expression rate of HSP70 in placenta tissue of the patients in PIH group 90.9%) was higher than that of the normal pregnant women in control group 55.6%) (χ2=6.599, P=0.010). Eighteen cases of placenta tissue with HIF-la positive expression in the PIH patients had HSP70 positive expression (100.0%); among four cases of placenta tissue with HIF-la negative expression, two cases had HSP70 negative expression 50.0%); their expressions in placenta tissue of the PIH patients had positive correlation (r=0.671, P=0.001). Conclusion: The expressions of HIF-la and HSP70 in placenta tissue of the PIH patients are higher, and they have positive correlation.

Expressions of HIF-1α and HSP70 in placenta tissue of patients with pregnancy-induced hypertension syndrome and their significances / 吉林大学学报(医学版)

Objective:To investigate the expressions of hypoxia-inducible factor-1α(HIF-1α)and heat shock protein 70(HSP70)in the placenta tissue of the patients with pregnancy-induced hypertension syndrome(PIH), and to elucidate the clinical significances of their expressions in the placenta tissue of the patients with PIH. Methods:Twenty-two cases of placenta tissue of the PIH patients(PIH group)and eighteen cases of placenta tissue of the normal pregnant women(control group)were selected.The expressions of HIF-1αand HSP70 were detected by immunohistochemical method.The differences of potive expressions rates of HIF-1α and HSP70 in placenta tissue of the PIH patients and the normal pregnant women and their relationships in placenta tissue of the PIH patients were analyzed.Results:The positive expression rate of HIF-1α in placenta tissue of the patients in PIH group(81.8%)was higher than that of the normal pregnant women in control group(38.9%)(χ2=7.785,P=0.005),and the positive expression rate of HSP70 in placenta tissue of the patients in PIH group(90.9%)was higher than that of the normal pregnant women in control group(55.6%)(χ2=6.599,P=0.010).Eighteen cases of placenta tissue with HIF-1α positive expression in the PIH patients had HSP70 positive expression(100.0%);among four cases of placenta tissue with HIF-1α negative expression,two cases had HSP70 negative expression (50.0%);their expressions in placenta tissue of the PIH patients had positive correlation(r=0.671,P=0.001). Conclusion:The expressions of HIF-1αand HSP70 in placenta tissue of the PIH patients are higher,and they have positive correlation.

[Expression of macrophage migration inhibitory factor gene in placenta tissue and its correlation with gestational diabetes mellitus].

Objective: To investigate the relationship between the expression of macrophage migration inhibitory factor (MIF) gene and the incidence of gestational diabetes mellitus (GDM) in Chinese Han population in northern China. Method: This study was consisted of 126 GDM women and 150 cases of healthy subjects who came from the obstetrics department of Maternity Hospital of Qingdao University and Maternity and Child Care Hospital of Donggang District of Rizhao. The protein expression of MIF in placenta tissue was detected by Western blot method. The blood glucose, insulin levels and other clinical physicochemical index were tested. The differences of MIF, fasting blood-glucose (FBG), fasting insulin (FIN) and the homeostasis model assessment of insulin resistance (HOMA-IR) were compared between the two groups of pregnant women. Result: The level of MIF protein in GDM group (0.85±0.10) was higher than that in healthy pregnant group (0.12±0.09), with significant difference (P<0.001). Insulin resistance index in GDM group were higher than that in healthy pregnant group, with significant difference (P<0.001). Conclusion: The expression of MIF in placental tissues of GDM women was increased and correlated with insulin resistance in GDM patients, suggesting that MIF may play an important role in the occurrence and development of GDM.

Proteomics analysis of human placenta reveals glutathione metabolism dysfunction as the underlying pathogenesis for preeclampsia.

Hypertensive disorder in pregnancy (HDP) refers to a series of diseases that cause the hypertension during pregnancy, including HDP, preeclampsia (PE) and eclampsia. This study screens differentially expressed proteins of placenta tissues in PE cases using 2D LC-MS/MS quantitative proteomics strategy. A total of 2281 proteins are quantified, of these, 145 altering expression proteins are successfully screened between PE and control cases (p<0.05). Bioinformatics analysis suggests that these proteins are mainly involved in many biological processes, such as oxidation reduction, mitochondrion organization, and acute inflammatory response. Especially, the glutamine metabolic process related molecules, GPX1, GPX3, SMS, GGCT, GSTK1, NFκB, GSTT2, SOD1 and GCLM, are involved in the switching process from oxidized glutathione (GSSG) conversion to the reduced glutathione (GSH) by glutathione, mercapturic acid and arginine metabolism process. Results of this study revealed that glutathione metabolism disorder of placenta tissues may contribute to the occurrence of PE disease.

Assessment of parabens and ultraviolet filters in human placenta tissue by ultrasound-assisted extraction and ultra-high performance liquid chromatography-tandem mass spectrometry.

Increasing concerns have been raised over recent decades about human exposure to Endocrine Disrupting Chemicals (EDCs), especially about their possible effects on embryo, foetus, newborn, and child. Parabens (PBs) and ultraviolet filters (UV-filters) are prevalent EDCs widely used as additives in cosmetics and personal care products (PCPs). The objective of this study was to determine the presence of four PBs and ten UV-filters in placental tissue samples using a novel analytical method based on ultrasound-assisted extraction (UAE) and ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Multivariate optimization strategies were used to accurately optimize extraction and clean-up parameters. Limits of quantification ranged from 0.15 to 0.5µgkg-1, and inter-day variability (evaluated as relative standard deviation) ranged from 3.6% to 14%. The method was validated using matrix-matched standard calibration followed by a recovery assay with spiked samples. Recovery percents ranged from 94.5% to 112%. The method was satisfactorily applied for the determination of the target compounds in human placental tissue samples collected at delivery from 15 randomly selected women. This new analytical procedure can provide information on foetal exposure to compounds, which has been little studied.

[Acupoint injection of human placenta tissue fluid combined with oral administration of metformin hydrochloride enteric-coated tablets treating type 2 diabetes:a randomized controlled trial].

OBJECTIVE: To observe the difference for type 2 diabetes between acupoint injection of human placenta tissue fluid combined with oral administration of metformin and simple metformin. METHODS: Sixty patients with type 2 diabetes were randomly assigned into a medication group and an injection group,30 cases in each one. In the oral medication group,metformin hydrochloride enteric-coated tablets was applied orally for continuous eight weeks,0.25 g a time,twice a day. In the injection group,based on the same oral administration,human placenta tissue fluid was injected into Diji(SP 8) and Yishu(EX-B 5) for two courses(four weeks as one course),once every other day and three times a week. Fast blood glucose(FBG),postprandial blood glucose(PBG),glycosylated hemoglobin(HbAlc) and clinical effect were observed in the two groups before and after treatment. RESULTS: Compared with those before treatment,FBG,PBG and HbAlc were decreased in the two groups after treatment (all P<0.05),with more apparent change in the injection group(all P<0.05). The total effective rate of the injection group was 90.0%(27/30),which was obviously better than 63.3%(19/30) of the medication group (P<0.05). CONCLUSIONS: Acupoint injection of human placenta tissue fluid combined with metformin hydrochloride enteric-coated tablets for type 2 diabetes can better lower blood glucose than simple metformin hydrochloride enteric-coated tablets.

Acupoint injection of human placenta tissue fluid combined with oral administration of metformin hydrochloride enteric-coated tablets treating type 2 diabetes:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the difference for type 2 diabetes between acupoint injection of human placenta tissue fluid combined with oral administration of metformin and simple metformin.</p><p><b>METHODS</b>Sixty patients with type 2 diabetes were randomly assigned into a medication group and an injection group,30 cases in each one. In the oral medication group,metformin hydrochloride enteric-coated tablets was applied orally for continuous eight weeks,0.25 g a time,twice a day. In the injection group,based on the same oral administration,human placenta tissue fluid was injected into Diji(SP 8) and Yishu(EX-B 5) for two courses(four weeks as one course),once every other day and three times a week. Fast blood glucose(FBG),postprandial blood glucose(PBG),glycosylated hemoglobin(HbAlc) and clinical effect were observed in the two groups before and after treatment.</p><p><b>RESULTS</b>Compared with those before treatment,FBG,PBG and HbAlc were decreased in the two groups after treatment (all<0.05),with more apparent change in the injection group(all<0.05). The total effective rate of the injection group was 90.0%(27/30),which was obviously better than 63.3%(19/30) of the medication group (<0.05).</p><p><b>CONCLUSIONS</b>Acupoint injection of human placenta tissue fluid combined with metformin hydrochloride enteric-coated tablets for type 2 diabetes can better lower blood glucose than simple metformin hydrochloride enteric-coated tablets.</p>

Effects of Sevoflurane for maternal HSP70 in general anesthesia in caesarean operation / 实用医学杂志

Objective Using Sevoflurane in general anesthesia in cesarean operation , to evaluate change of stress response by monitoring maternal plasma concentrations of HSP70 and the expression of HSP70 in the placenta tissue and provide an ideal and basis of safty and effectiveness in obstetric general anesthesia. Methods Sixty caesarean operation puerperas undergoing general anesthesia in women and children′s hospital of Guangdong province were selected and randomly divided into the sevoflurane group (S group) and the propofol group (P group) through random number table, each group had 30 cases. We tested materal blood concentration and expression of HSP70 in placenta tissue. Results HSP70 concentration (when) in the P group was significantly higher than that before surgery (P < 0.05); Comparing with the group S at the same time point, the difference was statistically significant (P < 0.05); In expression of HSP70 in placental tissue, P group was obviously higher than the S group (P < 0.05), Conclusion Sevoflurane used in general anesthesia for cesarean operation is safe and effective , which can reduce the concentration of HSP70 in maternal blood and expression of HSP70 in placental tissue.