胎儿生长受限胎盘血管模型的构建及其临床意义分析

目的搜集正常妊娠和合并有胎儿生长受限（fetal growth restriction，FGR）孕妇的胎盘，并运用血管铸型技术，构建和检查胎盘血管模型。方法搜集正常妊娠组（normal term pregnancies，NP组）胎盘20例，合并有FGR（FGR组）的胎盘20例，分别向胎盘脐动脉和脐静脉灌注以丙烯酸为主要成份的灌注液来构建胎盘血管网模型。然后检查和比较胎盘血管容量及特征（血管分支数量、直径以及形态）。结果NP组胎盘脐静脉分支为5～7级，末梢动静脉分支比值为1：2～1：3；FGR组脐静脉仅有4—5级分支，血管呈串珠状改变逐渐变细，且末梢血管动静脉分支比值为1：1～2：1。通过比较，我们可以发现两组在胎盘血管容量及脐带动静脉管径方面明显不同。在FGR组胎儿出生体重与胎盘血管容量、静脉管径及某些动脉管径呈显著的正相关。结论胎盘血管模型可以重建，这样的血管模型可以为我们研究健康和疾病提供新的见解并可以提高对胎盘血管系统的认识。

孕期补充叶酸:不仅仅是预防神经管缺陷

叶酸(维生素B9)是DNA复制的必需原料,并且是氨基酸合成、维生素代谢中酶促反应的底物之一。由于孕期胎儿的生长发育也需要叶酸,因此孕期对叶酸需求也相应增加。叶酸缺乏会引起母婴异常,孕妇主要有贫血、周围神经病变,而胎儿则有发生先天性畸形的可能。这篇文章综述了叶酸的代谢、孕期如何合理补充叶酸及其潜在的益处,以及补充左旋甲基叶酸对神经管缺陷以外的孕期相关并发症的预防作用。

Study of concentration of amniotic fluid Alpha-fetal protein in thalassemia fetus

Objective:To test the hypothesis that concentration of amniotic fluid alpha-fetal protein(AFAFP) is increased in thalassemia fetus.Methods:A total of 135 cases of amniocentesis admitted from July 2013 to December 2014 were included in this study.Among them 98 cases of normal fetuses were assigned into control group and 37 cases of thalassemia fetus were included as thalassemia fetus group.Alpha-fetoprotein levels detected by enzyme linked immunosorbent assay and the alpha-fetoprotein concentration were compared between the two groups.There is no significant difference in gestrational age between the two groups.Results:1.AFP concentration in thalassemia fetus group was significantly higher than that of normal control group [(1541.65±734.78) μg/mL vs.(2728.84± 1539.97) μg/mL ],and amniotic fluid AFP concentration was related to fetal thalassemia.2.AFAFP concentration in pureα-thalassemia fetus was higher than that of β thalassemia fetus or mixed αand was not significant.Conclusions:Concentration of a β thalassemia fetus,but the difference mniotic fluid alpha-fetal protein is increased in thalassemia fetus.AFP concentration inα-thalassemia fetus was higher than that of β thalassemia or mixed αand lore β thalassemia fetus but difference was not significance.Further studies are needed to exp the possible correlation between Down syndrome and biochemical markers of Thalassemia.

Acupuncture for hyperlipidaemia in adults： A systematic review and meta-analysis

目的：评价针灸治疗高脂血症有效性和安全性.方法：纳入针灸治疗高脂血症为研究对象的随机对照试验,对每个纳入研究进行偏倚风险和质量评估,统计学分析采用RevMan5.3.3软件.用GRADEprofiler软件和标准评估证据质量.结果：本系统评价纳入17个随机对照试验,共1,408例患者,Meta分析得出针灸治疗在总有效率[OR=1.30,95%CI（1.10,1.55）]优于普伐他汀治疗组,但在辛伐他汀治疗组[OR=1.05,95%Cl（0.95,1.16）]和阿托伐他汀治疗组[OR=0.93,95%Cl（0.78,1.10）]无统计学差异;在升高高密度脂蛋白[MD=-0.11,95%Cl（-0.17,0.06）]、降低甘油三酯[MD=0.30,95%Cl（0.16,0.44）]和低密度脂蛋白[MD=0.43,95%Cl（0.33,0.53）]与普伐他汀治疗组比较无统计学差异;在降低总胆固醇[MD=-0.03,95%Cl（-0.16,0.09）]与他汀治疗组比较无统计学差异.在升高高密度脂蛋白[MD=0.23,95%Cl（0.08,0.37）]、降低低密度脂蛋白[MD=-0.33,95%Cl（-0.63,-0.03]和总胆固醇[MD=-0.85,95%Cl（-1.13,-0.56）]都优于安慰剂组或假针灸治疗组,但在总有效率[OR=0.95,95%Cl（0.72,1.24）]、降低甘油三酯[MD=-0.25,95%Cl（-0.94,0.45）]与安慰剂组或假针灸治疗组比较,无统计学差异.GRADE证据质量评估为低质量证据.针灸治疗高脂血症不良反应少,因此相对安全.结论：针灸治疗高脂血症安全、有效,是最佳级别证据,但证据质量低,仍需高质量研究产生的证据支持.