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子宫瘢痕妊娠;个体化治疗;保留生育功能;子宫动脉栓塞 1

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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    

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    

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

null

《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    

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    

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    

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    

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    

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    

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    

Detection of maternal serum thromboxane B2 in different durations of pregnancy and prediction of preeclampsia

Geqing XIA MD, Zehua WANG MD, Li ZOU MD, Chaoying WU MS, Yu HU MD,

《医学前沿(英文)》 2010年 第4卷 第2期   页码 235-240 doi: 10.1007/s11684-010-0002-0

摘要: This study was aimed to detect maternal serum levels of thromboxane B2 (TXB2) in different durations of pregnancy and explore the predictive value of TXB2 for preeclampsia. By employing a prospective and double-blind study method, 180 pregnant women with previously normal blood pressures during their progestation were included in the study. Peripheral venous blood samples were obtained during 10–14 (period I), 20–24 (period II) and 30–34 (period III) weeks of gestation. Maternal serum levels of TXB2 were measured by enzyme-linked immunoassay. The pathogenetic condition and pregnancy outcomes of these cases were observed. (1) Among the 180 previously normotensive women, ten developed preeclampsia (case group; four severe and six mild preeclampsia). One hundred and seventy remained normal till the end of pregnancy (control group). (2) With development of pregnancy, the levels of maternal serum TXB2 in the 180 cases gradually ascended as seen through the Wilcoxon Signed Ranks Test. There was a statistical significance in maternal TXB2 levels between two different gestational stages (<0.01). (3) The levels of maternal serum TXB2 were slightly higher in the case group than in the control group during period I of gestation, but the difference was not statistically significant (>0.05); the levels of TXB2 were significantly higher in the case group than in the control group during periods II and III of gestation (both <0.05). (3) The best cutoff points of maternal TXB2 were 3750 and 4400ng/mL during periods II and III of gestation by receiver operator characteristic (ROC) curve; and the sensitivity, specificity, positive predictive value, negative predictive value and odds radio of TXB2 in predicting preeclampsia were 80%, 69.5%, 13.3%, 98.33%, 9.11 and 90%, 68.82%, 13.84%, 99.13, 19.86, respectively. Higher levels of maternal serum TXB2 were detected a long time before clinical symptoms appeared. The maternal serum TXB2 after 20 weeks of gestation had predictive value, and the index after 30 weeks was superior to that prior to 30 weeks .

关键词: thromboxane B2     preeclampsia    

CSP保留生育功能治疗的探讨——附46例病例分析

管睿,刘玉环,徐明娟,张俊洁,惠宁,崔英

《中国工程科学》 2015年 第17卷 第6期   页码 45-49

摘要:

探讨剖宫产子宫瘢痕妊娠(CSP)的保留生育功能治疗方法的选择。对2000—2014年第二军医大学附属长海医院收治的46例CSP患者临床资料进行回顾性分析。孕早期45例,孕中期1例,13例(28.9 %)早孕患者早期误诊而行负压吸引术或药流+清宫术。其余32例,根据CSP临床分型标准,Ⅰ型19例,Ⅱ型13例,全部病例均成功保留子宫,63.1 %Ⅰ型CSP采用B超监护下清宫,21.0 %Ⅰ型CSP采用子宫动脉栓塞(UAE)+B超监护下清宫;84.6 %Ⅱ型CSP采用病灶切除+疤痕修补。1例中孕16+周外院引产发生产后大出血,UAE 30天后下肢血栓坏死转我院治疗,期间再次阴道大出血,手术探查证实为CSP,行病灶切除+瘢痕修补术。CSP治疗原则是早期诊断,及早处理,根据CSP临床分型、β-HCG等情况,选择个体化治疗是关键。临床上对CSP要保持高度警惕,尽早诊断,保留生育功能治疗是完全可行的。此外,UAE后仍存在一定风险,选择UAE要谨慎。

关键词: 子宫瘢痕妊娠;个体化治疗;保留生育功能;子宫动脉栓塞    

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    

Current recommendations of managing HBV infection in preconception or pregnancy

null

《医学前沿(英文)》 2014年 第8卷 第2期   页码 158-165 doi: 10.1007/s11684-014-0340-4

摘要:

Hepatitis B remains a leading cause of cirrhosis, hepatocellular carcinoma and liver transplantation worldwide. Management of chronic hepatitis B during pregnancy is challenging. Transmission of hepatitis B to infants still occurs perinatally although immunoprophylaxis is widely available for infants born to mothers with chronic hepatitis B infection. The emerging data suggest that initiation of antiviral therapy in the beginning of the third trimester in highly viremic mothers can prevent immunoprophylaxis failure in their infants. The available drug safety data show that lamivudine, telbivudine and tenofovir are generally safe to be used during the pregnancy. In order to minimize the fetal exposure to the antiviral medication, antiviral therapy during the pregnancy should be limited to a selected group of patients with cirrhosis, high hepatitis B viral load, or prior history immunoprophylaxis failure. An elective Caesarean section may reduce the risk of perinatal transmission. For those females planning for pregnancy or in early stage of pregnancy, communication and follow-up among obstetrician, gastroenterologist, and primary care physician are important. In this article, we will review the features of hepatitis B infection before, during and after the pregnancy; the risk factors that increase mother-to-child transmission; safety data on antiviral drug use during pregnancy; and the potential role of Caesarean section in selected cases.

关键词: antiviral therapy     Caesarean section     cirrhosis     hepatitis B     immunoprophylaxis     mother-to-child transmission     pregnancy     prevention    

Expression of inducible nitric oxide synthase in trophoblasts and deciduas in early medical abortion

Geqing XIA, Chaoying WU

《医学前沿(英文)》 2009年 第3卷 第2期   页码 216-219 doi: 10.1007/s11684-009-0028-3

摘要: The purpose of this study was to investigate the expression of inducible nitric oxide synthase in trophoblasts and deciduas in early medical abortion, and study the relationship of medical abortion through mifepristone and inducible nitric oxide synthase (iNOS) in early pregnancy. Expression of iNOS in trophoblasts and deciduas was detected by both hybridization and immunohistochemical assay in 40 patients (experimental group); the positive expression of iNOS was represented by number density (N/S) and positive unit (Pu) using computer color magic image analysis system (CMIAS). All results were compared with that obtained from vacuum aspiration. In the experimental group, N/S and Pu in trophoblasts were 0.120 ± 0.010 and 15.3 ± 2.6, respectively, while in the control group, they were 0.021 ± 0.003 and 3.1 ± 0.5, respectively, and there were significant differences between the two groups. By immunohistochemical assay, N/S and Pu were 0.090 ± 0.010, 10.24 ± 1.55 0.016 ± 0.002, 1.26 ± 0.33 in the trophoblasts of the two groups; there were also significant differences between the two groups. There were lower iNOS expressions in deciduas by in situ hybridization and immunohistochemical assay, and the difference between the two groups was not significant.It was concluded that mifepristone induced medical abortion through the expression of iNOS in trophoblasts but not in deciduas.

关键词: mifepristone     inducible nitric oxide synthase     early pregnancy     placental immunity    

连云港市病残儿童资料分析及孕前优生干预其父母再生育效果研究

赵玉凤,谢炜,裴丹,王其军,张立华,段玉秋,李 琴,刘艳丽,王 英

《中国工程科学》 2015年 第17卷 第6期   页码 36-40

摘要:

目的:分析连云港市病残儿童资料,通过孕前优生健康检查干预其近五年病残儿父母再生育,预防病残儿的发生风险。方法:对连云港市2008―2012年经过医学鉴定的病残儿的资料进行分析,比较其五年间数量、地区、性别分布、疾病顺位变化等,发放调查问卷了解其在生育病残儿之前的基本情况;再次怀孕后有无优生指导、超生排畸、唐筛、妊娠结局、分娩方式等调查,分析干预效果。结果:近五年通过医学鉴定符合病残儿童标准的1 046例五年间无明显变化;城区较农村多;男性较女性多;疾病顺位排序先天性心脏病位于第一位。通过干预,收回问卷中先天性心脏病父母再生育72例均为正常儿,其次脑瘫患儿父母再生育35例均为正常儿。结论:病残儿鉴定父母通过孕前优生健康检查,完成整个孕前保健、风险评估到个性化咨询指导一系列干预后再生育均为正常儿,干预效果明显,减少了不良妊娠结局的发生,对预防和降低再次生育病残儿的发生非常重要。

关键词: 病残儿;出生缺陷;孕前优生健康指导;再生育干预    

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