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免费孕前优生健康检查对象潜在危险因素接触和妊娠结局分析

车焱,周公望,王彩琴,张焕玲,张建娥,闫立新,陆珍,陆梅,沈洁,朱昊平

《中国工程科学》 2014年第16卷第5期页码 56-59

摘要：

分析并报告上海市静安区免费孕前优生健康检查后待孕夫妇不良妊娠结局潜在影响因素接触情况以及妊娠率和妊娠结局，为免费孕前健康检查政府实施项目效果的评估提供基础数据。对2011 年8 月—2012 年11 月在静安区参加免费孕前优生健康检查的所有对象在其检查结束后的3 个月、6 个月、12 个月进行随访，重点关注不良妊娠结局潜在危险因素接触情况以及妊娠时间和妊娠结局。统计方法为χ2检验、寿命表、Logistic 回归分析。在目标时段内共有1 480 对夫妇参加了免费孕前优生健康检查，其中1 249 对服务对象接受了随访，随访率为84.4 %。截至2013 年4 月，48.7 %的随访对象已经受孕，孕前检查后3 个月调查累积妊娠率为23.9 %，6 个月调查累积妊娠率为45.0 %。365 人完成妊娠结局的随访，结果显示，早产率为3.0 %，低出生体重率为4.3 %，巨大儿发生率为3.3 %。自然流产率为6.3 %。另外，发现出生缺陷1 人，占妊娠妇女数的0.16 %，占有妊娠结局妇女数的0.27 %。烟酒等不良生活习惯丈夫的比例（18 %～20 %）高于妻子（1 %～3 %），77 %的丈夫和妻子接受潜在电磁辐射的时间超过8 h。9 %的夫妇自述生活和工作中接触重金属以及农药、化肥等潜在致畸物。超过10 %的妻子在怀孕以后接触了潜在致畸物。初步分析未发现上述因素与不良妊娠结局的关系。静安区孕前健康检查后半年内妇女妊娠率不到50 %，有必要在上海乃至全国开展免费孕前健康检查的成本效益评估。

关键词：孕前优生健康检查妊娠率累积妊娠率不良妊娠结局危险因素

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Propensity score-matched study and meta-analysis of cumulative outcomes of day 2/3 versus day 5/6 embryo transfers

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《医学前沿（英文）》 2017年第11卷第4期页码 563-569 doi: 10.1007/s11684-017-0535-6

摘要：

The superiority of the cumulative outcomes of day 5/6 embryo transfer to those of day 2/3 embryo transfer in infertile couples has been debated. This retrospective study included data collected from 1051 patients from July 2011 to June 2014. Multiple maternal baseline covariates were subjected to propensity score matching analysis, and each day 5/6 group woman was matched to one day 2/3 group woman. A systematic meta-analysis was conducted to validate the results. After matching was completed, 217 patients on the day 2/3 group were matched with those on the day 5/6 group, and no significant differences in the baseline characteristics were observed between the two groups. The cumulative pregnancy rate (57.14% vs. 53.46%, OR 1.16, 95% CI 0.79–1.70) and cumulative live birth rate (53.00% vs. 49.77%, OR 1.14, 95% CI 0.78–1.66) of day 5/6 embryo transfers were higher than those of day 2/3 embryo transfers, but this difference was not significant. The mean cycles per live birth and mean days per live birth in the day 5/6 group were significantly lower than those in the day 2/3 group. This study demonstrated that day 5/6 embryo transfer is a more cost-effective and time-efficient policy than day 2/3 embryo transfer to produce a live baby.

关键词： blastocyst embryo transfer cumulative pregnancy rate cumulative live birth rate IVF

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HCG注射日血清雌孕激素对试管婴儿妊娠结局的影响

周丹妮,杨菁,吴庚香,李赛姣,余楠,赵萌,文妍琪

《中国工程科学》 2014年第16卷第5期页码 79-84

摘要：

探究体外受精—胚胎移植/单精子卵泡浆内注射-胚胎移植（IVF/ICSI）患者注射人绒毛膜促性腺激素（HCG）日血清雌孕激素水平对妊娠结局的影响。回顾分析武汉大学人民医院生殖医学中心2011 年9 月—2012 年9 月符合相关条件行IVF的新鲜周期患者1 270 例，按血清孕酮值将其分为两组进行比较，低孕酮组HCG日血清孕酮值<2.0 pg/mL，高孕酮组HCG日血清孕酮值≥2.0 pg/mL；再按照孕酮与雌二醇比值（P/E2）分为两组，以0.6 作为P/E2切点。比较两组间的女方年龄、不孕年限、基础卵泡刺激素（FSH）值、促性腺激素（Gn）天数、Gn用量、获卵数、MII 卵数、受精数、卵裂数、优胚数、移植数、E2值、临床妊娠率、胚胎着床率。高孕酮组Gn天数、Gn用量、获卵数、MII数、卵裂数、E2值增加，但临床妊娠率、胚胎着床率减少；高P/E2比值组女方年龄、基础FSH、Gn 天数、Gn 用量、获卵数、受精数、优胚数、P 值均增加，妊娠结局无明显差异。HCG注射日血清孕酮水平过高会降低临床妊娠率及胚胎着床率。

关键词：孕酮值 HCG日 IVF/ICSI 新鲜周期临床妊娠率

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广州市2 046例孕前育龄妇女TORCH检查状况分析

余志衡

《中国工程科学》 2014年第16卷第5期页码 63-66

摘要：

采用酶联免疫吸附试验(ELISA) 对2013 年1 月—2013 年12 月进行孕前筛查和孕早期普查的2 046 例妇女进行TORCH 特异性IgM 和IgG 抗体检测，主要检测RV-IgG、TOXO-IgG、TOXO-IgM、CMVIgG、CMV-IgM 五项。在调查的2 046 例妇女中，TORCH-IgM 总阳性率为0. 88 %，其中以巨细胞病毒(CMV)感染率居高，为0.68%，弓形虫（TOXO）为0. 20%。TORCH－IgG 阳性率以CMV最高，达97.65 %，其次为RV-IgG、TOXO-IgG，分别为85.58 %和4.89 %。广州市孕前和孕早期妇女TORCH感染率较高，应该积极进行监测和宣传，早发现，早干预，提高出生人口素质，减少出生缺陷与残疾发生。

关键词： TORCH 感染率酶联免疫吸附试验出生缺陷孕前检查

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Control of lupus activity during pregnancy via the engagement of IgG sialylation: novel crosstalk between

《医学前沿（英文）》 2023年第17卷第3期页码 549-561 doi: 10.1007/s11684-022-0965-7

摘要： Immunoglobulin (IgG) glycosylation affects the effector functions of IgG in a myriad of biological processes and has been closely associated with numerous autoimmune diseases, including systemic lupus erythematosus (SLE), thus underlining the pathogenic role of glycosylation aberration in autoimmunity. This study aims to explore the relationship between IgG sialylation patterns and lupus pregnancy. Relative to that in serum samples from the control cohort, IgG sialylation level was aberrantly downregulated in serum samples from the SLE cohort at four stages (from preconception to the third trimester of pregnancy) and was significantly associated with lupus activity and fetal loss during lupus pregnancy. The type I interferon signature of pregnant patients with SLE was negatively correlated with the level of IgG sialylation. The lack of sialylation dampened the ability of IgG to suppress the functions of plasmacytoid dendritic cells (pDCs). RNA-seq analysis further revealed that the expression of genes associated with the spleen tyrosine kinase (SYK) signaling pathway significantly differed between IgG- and deSia-IgG-treated pDCs. This finding was confirmed by the attenuation of the ability to phosphorylate SYK and BLNK in deSia-IgG. Finally, the coculture of pDCs isolated from pregnant patients with SLE with IgG/deSia-IgG demonstrated the sialylation-dependent anti-inflammatory function of IgG. Our findings suggested that IgG influences lupus activity through regulating pDCs function via the modulation of the SYK pathway in a sialic acid-dependent manner.

关键词： pregnancy IgG glycome type I interferon systemic lupus erythematosus

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Effect of antitubercular treatment on the pregnancy outcomes and prognoses of patients with genital tuberculosis

Jing Yue, Bo Zhang, Mingyue Wang, Junning Yao, Yifan Zhou, Ding Ma, Lei Jin

《医学前沿（英文）》 2019年第13卷第1期页码 121-125 doi: 10.1007/s11684-018-0615-2

摘要： This retrospective study aims to demonstrate the effect of antitubercular treatment (ATT) on the pregnancy outcomes and prognoses of patients with genital tuberculosis (GTB) who had received laparoscopy and/or hysteroscopy. This study included 78 patients with infertility and who were diagnosed with GTB through laparoscopy and/or hysteroscopy over the period of November 2005 to October 2015. The recruited patients were divided into ATT and nonATT groups on the basis of ATT duration. The GTB recurrence rates, menstrual patterns, and pregnancy outcomes of the patients were determined at follow-up. Among the 78 patients, 46 received ATT and 32 did not receive ATT. The menstrual volumes of patients in the ATT group significantly decreased relative to those of patients in the nonATT group. GTB did not recur among all patients regardless of treatment. A total of 11 pregnancies (36.7%) in the ATT group and 19 pregnancies (63.3%) in the nonATT group were observed. Pregnancy rates significantly differed ( = 0.002) between the two groups. ATT may decrease the menstrual volume and pregnancy rates of patients who were diagnosed with GTB through laparoscopy and/or hysteroscopy. In addition, ATT did not improve the prognosis of patients with chronic GTB.

关键词： antitubercular treatment pregnancy prognosis genital tuberculosis

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Cushing’s syndrome during pregnancy caused by adrenal cortical adenoma: a case report and literature

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《医学前沿（英文）》 2015年第9卷第3期页码 380-383 doi: 10.1007/s11684-015-0407-x

摘要：

Cushing’s syndrome (CS) during pregnancy is a rare condition with significant maternal and fetal complications. A case of CS during the third trimester of pregnancy secondary to adrenocortical adenoma was reported. Literature review revealed the disadvantages of different treatments in this period. Besides the conservative treatment, surgery is recommended for CS during the third trimester of pregnancy secondary to adrenal adenoma, if an experienced surgeon is available.

关键词： Cushing’s syndrome pregnancy adrenocortical adenoma

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一项关于药物和补充剂对改善男性不育症患者的自然妊娠和精液参数影响的系统综述和网状荟萃分析 Article

李建, 吴奇, Ernest Hung Yu Ng, Ben Willem J. Mol, 吴效科, Chi Chiu Wang

《工程（英文）》 2022年第16卷第9期页码 198-209 doi: 10.1016/j.eng.2021.07.009

摘要：

本研究采用网状荟萃分析对药物和补充剂治疗特发性男性不育症的疗效进行比较，以获得最佳治疗方法。对Medline、EMBASE、OVID和CNKI等数据库中发表于1990年1月至2021年6月的文献进行检索，检索关键词包括“男性不育”“药物疗法”“补充/营养疗法”及其相关术语等。将研究药物[主要包括促卵泡激素（FSH）、雄激素、克罗米芬/他莫昔芬（SERM）]或补充剂[主要是锌、硒、维生素C/E、卡尼丁、辅酶Q₁₀（CoQ₁₀）或联合治疗]治疗特发性不育男性的随机对照试验（RCT）纳入meta分析。按PRISMA声明中的报告规范提取数据，并使用偏倚风险工具和适用于网状meta分析的GRADE系统评估证据质量。研究的主要结局是活产率和自然妊娠率（SPR），次要结局是精子参数（包括精子浓度、前向运动百分比和形态）和不良反应。65项RCT被纳入分析，共包括7541名精子参数异常但激素水平正常的育龄男性。36项研究报道SPR，但仅三项研究报道活产率。纳入研究的质量评价为中、高级。与安慰剂或未治疗相比，卡尼汀联合维生素治疗显著增加SPR（RR = 3.7, 95% CI为1.6 ~ 8.5），脂肪酸补充剂显著增加精子浓度（MD = 12.5 × 10⁶ mL^–1, 95% CI为3.1 × 10⁶ ~ 22.0 × 10⁶）。SERM联合辅酶Q₁₀显著提升前向活力精子（MD = 11.0%, 95% CI为0.1% ~ 21.9%）和正常形态精子（MD = 11.0%, 95% CI为4.6% ~ 17.4%）。对改善SPR和精子浓度的最佳治疗方案分别是卡尼汀联合维生素和脂肪酸补充剂，即便排除具有高偏倚风险的研究，结果仍保持一致。对于少弱精子症男性，与安慰剂或未治疗相比，FSH（RR = 4.9, 95% CI为1.1 ~ 21.3）显著增加SPR，而SERM联合激肽酶可显著增加精子浓度（MD = 16.5 × 10⁶ mL^–1, 95% CI为1.6 × 10⁶ ~ 31.4 × 10⁶)，SERM联合辅酶Q₁₀则显著改善前向活力精子（MD = 11.3%, 95% CI为7.3% ~ 15.4%）和正常形态精子（MD = 11.2%, 95% CI为 5.4% ~ 16.9%）。在不良反应方面，脂肪酸补充剂和己酮可可碱分别与口臭或味觉差（RR = 8.1, 95% CI为1.0 ~ 63.5）和呕吐（RR = 8.0, 95% CI为1.0 ~ 63.0）相关。综上所述，对于改善不育男性配偶活产率的最佳治疗方案仍然不清楚。对于所有不孕夫妇和男性少弱精症不孕夫妇，卡尼汀联合维生素和FSH方案在成功实现自然妊娠方面分别优于其他方案。其他治疗方法对妊娠结局的疗效仍需要进一步验证。

关键词：男性不育症药物补充剂自然妊娠率精子参数

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The relationship between progesterone and Th-related cytokines in plasma during early pregnancy in cows

Lei CHENG,Youdong XIN,Xiaohua LIU,Xiuzhong HU,Min XIANG,Dingfa WANG,Shuhong ZHAO

《农业科学与工程前沿（英文）》 2016年第3卷第2期页码 147-152 doi: 10.15302/J-FASE-2016099

摘要： In cows, progesterone (P4) is essential for the maintenance of pregnancy and successful embryo development is dependent on the maternal immunomodulation of Th-related cytokines. However, investigation of the relationship between P4 and Th immunity in cattle remains incomplete. Therefore, we evaluated plasma P4 concentrations and expressions of three Th-related cytokines, interleukins IL-1β, IL-4 and IL-6, in 15 pregnant and 11 non-pregnant cows 0, 14, 18, 21, and 28 d post artificial insemination. Pregnant cows had significantly higher plasma P4 levels and pregnant cows with higher P4 on 14 d tended to have higher P4 in the subsequent period of pregnancy. There was no difference in IL-4 and IL-6 expression between pregnant cows and non-pregnant cows, whereas plasma IL-1β was temporally upregulated on 21 d. The cytokines measured were not affected in either the high-P4 group (>11.1 ng·mL ) or the low-P4 group (<11.1 ng·mL ) in pregnant cows. A weak negative correlation between IL-1β and IL-6 was observed, but none of the cytokines was associated with a change in plasma P4. In conclusion, there was no clear relationship between P4 and Th immunity in maternal plasma in the pregnant cows, which differs from what occurs in humans and mice during early pregnancy.

关键词： dairy cow progesterone pregnancy cytokine

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继发性中晚期腹腔妊娠诊断和治疗 ——附一例病例报道

申颖,戴姝艳

《中国工程科学》 2015年第17卷第6期页码 61-64

摘要：

目的：探讨继发性中晚期腹腔妊娠的诊断以及治疗方案。方法：回顾性地分析和总结我院收治的1例继发性中晚期腹腔妊娠的诊断及治疗方案。结果：该病例经磁共振成像（MRI）检查明确诊断，同时成功予以手术治疗。结论：继发性中晚期腹腔妊娠非常罕见，临床症状不典型，早期诊断较困难，MRI是一种有效的诊断方法，手术是最重要的治疗方式。

关键词：腹腔妊娠诊断治疗磁共振成像

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育龄妇女非意愿妊娠原因分析与对策研究

王代权,刘长艳,向琼,马代慈

《中国工程科学》 2014年第16卷第5期页码 11-15

摘要：

采取整群抽样调查方法，对2011 年1 月—2013 年5 月在秭归县、夷陵区计划生育服务站因非意愿妊娠而实行人工终止妊娠对象，通过查阅病历资料和调查问卷，了解非意愿性妊娠原因及相关因素。1 360例非意愿妊娠中，未婚为21.62 %，已婚为78.38 %；人群分布在20～39 年龄段（73.82 %）；孕次分布主要在孕2～孕3 的对象为57.87 %；非意愿妊娠中避孕措施失败者为44.34 %，无措施者为55.66 %。避孕措施因素宫内节育器为10.51 %，避孕套为10.51 %，避孕药为8.24 %，外用为6.62 %，其他为8.46 %。存在侥幸心理和取出宫内节育器（IUD）后续措施没能跟进是无措施者导致非意愿妊娠的主要原因。避孕知识知晓率为98.90 %，对紧急避孕的知晓率仅为15.37 %，知道哺乳期需避孕者为18.38 %。医务人员、计生干部、宣传资料是已婚人群获取避孕知识的主要途径，农民及农民工对象获取免费服务高于城镇居民、国家工作人员、商业服务人员及外来流入人员。

关键词：育龄妇女非意愿妊娠人工流产影响因素

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2010—2013年新疆HIV感染孕产妇妊娠结局分析

沙吾力·艾力卡,艾比拜·买买提明,王晓军

《中国工程科学》 2015年第17卷第6期页码 50-52

摘要：

旨在了解新疆HIV感染孕产妇妊娠结局。利用2010—2013年间在预防艾滋病母婴传播管理信息网络直报系统中报告的HIV感染孕产妇个案卡资料进行分析。2 256例HIV感染孕产妇平均年龄29.1岁，以维吾尔族为主，占90.65 %，初中及以下文化程度者占72.07 %，无业和农民占82.36 %（其中无业者占47.30 %），初婚占56.12 %，再婚占37.19 %。2次及以上妊娠者占69.68 %，有316例HIV感染孕产妇在知道自己的感染状况后仍然选择妊娠，占总数的14.01 %；再次妊娠的HIV感染孕产妇中人工终止妊娠的比例明显高于第一次接受服务的HIV感染孕产妇，两者有统计学差异（χ2=141.14，P=0.000）。新疆HIV感染孕产妇知道自身感染情况后仍有选择再次妊娠者，再次妊娠者中选择人工终止妊娠的比例明显高于第一次妊娠者，提示意外妊娠的存在，建议加强HIV感染妇女预防艾滋病母婴传播咨询服务和避孕指导，减少意外妊娠的发生，使HIV感染女性能够了解相关知识从而能够做出正确的生育或妊娠选择。

关键词： HIV感染孕产妇非意愿性妊娠生殖健康

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Factors influencing the somatic cell nuclear transfer efficiency in pigs

Yong JIN, Manling ZHANG, Xinrong JU, Shuang LIANG, Qiang XIONG, Lihua ZHAO, Xiaowei NIE, Daorong HOU, Qiang LIU, Junzheng WANG, Chenyu WANG, Xiaokang LI, Lining ZHANG, Xiaorui LIU, Ying WANG, Haiyuan YANG, Yifan DAI, Rongfeng LI

《农业科学与工程前沿（英文）》 2019年第6卷第1期页码 73-80 doi: 10.15302/J-FASE-2018220

摘要：

Using a data set from our laboratory, we assessed the effects of several factors on pig cloning efficiency. The results demonstrated that cells at high confluence (>90%) used as donor cell resulted in higher pregnancy rate, delivery rate and overall cloning efficiency (number of live offspring born per reconstructed embryo transferred to recipients) compared with the cells at 60% to 79% confluence and 80% to 89% confluence. Cells with four, five and six passages compromised the pregnancy and delivery rates compared with first passage cells. The number of blastocysts transferred by somatic cell nuclear transfer (SCNT) did not significantly affect the cloning efficiency, but transfer of blastocyst derived from culture 5 d after SCNT achieved a significantly higher pregnancy rate compared with one to two cell SCNT embryos from overnight culture. The highest pregnancy rate, delivery rate and the largest litter size were obtained when Bama Miniature pig fibroblasts were used as donor cells and Landrace/Yorkshire hybrid gilts were used as recipients. Recipients treated with chemicals for estrus synchronization had higher pregnancy rates compared with untreated recipients. Our data might be helpful for improving SCNT efficiency in pigs.

关键词： blastocyst donor cell estrus synchronization pregnancy rate pig cloning somatic cell nuclear transfer

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不同类型阴道斜隔综合征妊娠3例报告

陈秀娟,熊秀梅,林元

《中国工程科学》 2014年第16卷第5期页码 90-95

摘要：

阴道斜隔综合征发病率低，Burgis 等曾报道发病率为0.1 %～3.8 %，其临床上有3 种分型，不同类型的斜隔综合征临床表现各不同，阴道斜隔综合征合并妊娠常因复杂的生殖道畸形造成人工流产困难。本文通过报告3 种类型的斜隔综合征患者终止非意愿性妊娠各一例，说明阴道斜隔综合征合并妊娠在诊断和处理上有一定的难度，存在误诊和漏诊，因此需要临床医师、超声医师共同提高对该病的认识，提高诊断准确性，从而指导临床治疗。

关键词：阴道斜隔综合征妊娠超声治疗