Lamellar Bodies Count (LBC) as a Predictor of Fetal Lung Maturity in Preterm Premature Rupture of Membranes Compared to Neonatal Assessment

Background: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality, affecting approximately 1% of all live births and 10% of all preterm infants. Lamellar bodies represent a storage form of pulmonary surfactant within Type II pneumocytes, secretion of which increases with advancing gestational age, thus enabling prediction of the degree of FLM. Preterm premature rupture of membranes (PPROM) complicates approximately 1/3 of all preterm births. Birth within 1 week is the most likely outcome for any patient with PPROM in the absence of adjunctive treatments. Respiratory distress has been reported to be the most common complication of preterm birth. Sepsis, intraventricular haemorrhage, and necrotizing enterocolitis also are associated with prematurity, but these are less common near to term. Objective: To assess the efficacy of the amniotic fluid lamellar body counting from a vaginal pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Methods: This study was conducted at Ain Shams University Maternity Hospital in the emergency ward from January 2019 to September 2019. It included 106 women with singleton pregnancies, gestational age from 28 - 36 weeks with preterm premature rupture of membranes. This study is designed to assess the efficacy of the amniotic fluid lamellar body counting (LBC) from a vaginal pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Results: The current study revealed a highly significant increase in the lamellar body count in cases giving birth to neonates without RDS compared to that cases giving birth to neonates with RDS. Also, no statistically significant difference between LBC and age, parity and number of previous miscarriages in the mother was found. Gestational age at delivery was significantly lower among cases with respiratory distress. Steroid administration was significantly less frequent among cases with respiratory distress. However, lamellar bodies had high diagnostic performance in the prediction of respiratory distress. Conclusion: Lamellar body count (LBC) is an effective, safe, easy, and cost-effective method to assess fetal lung maturity (FLM). It does not need a highly equipped laboratory or specially trained personnel, it just needs the conventional blood count analyzer. Measurement of LBC is now replacing the conventional Lecithin/Sphyngomyelin L/S ratio. LBC cut-off value of ≤42.5 × 103/μL can be used safely to decide fetal lung maturity with sensitivity of 95.7% and specificity of 97.6%.

Treatment of Retained Fetal Membranes: Comparison of the Postpartum Period after Routine Treatment or Routine Treatment Including an Additional Phytotherapeutic Substance in Dairy Cattle in Switzerland

Background: The therapy of retained fetal membranes (RFM) is a controversial subject. In Switzerland, intrauterine antibiotics are routinely administered although their effect on fertility parameters is questionable. The objective of this study was to compare the post-partal period after a routine treatment of RFM in 2 groups: one group received a placebo additionally (A), whereas the other group received a phytotherapeutic substance (lime bark) (B) additionally. The routine treatment of RFM included an attempt to manually remove the fetal membranes (for a maximum of 5 min), intramuscular administration of oxytetracycline and intrauterine treatment with tetracycline. In case of an elevated rectal temperature (>39.0°C), an additional non-steroidal inflam-matory drug was allowed. Methods: Cows undergoing caesarean section, suffering from prolapse of the uterus, deep cervical or vaginal injuries, hypocalcaemia, and illnesses during the last 14 days before calving were excluded. Cows had to be more than 265 days pregnant. Only cows that were artificially inseminated after RFM were included. Group stratification was done according to the last number on the ear tag (even/uneven) with (n = 50) cows in group A and (n = 55) cows in group B. Results: The number of treatments after the initial treatment of RFM was not significantly different between groups. The median interval from calving to the first insemination was 77 days in group A compared to 82 days in group B (p = 0.72). The number of AI’s until conception was not significantly different between groups. The median number of days open was 89 days in group A compared to 96 days in group B (p = 0.57). The culling rate was not significantly different between groups. Conclusion: There was neither a difference between the groups concerning therapies within the first 50 days after RFM nor concerning the subsequent fertility variables.

EFFECTS OF SALVIA MILTIORRHIZA BUNGE(SMB)ON LIPID PEROXIDATION AND PLASMA MEMBRANE FLUIDITY OF CULTURED HUMAN FETAL HEPATOCYTES INJURED BY CARBON TETRACHLORIDE

In order to investigate the effect of salvia miltiorrhiza hunge(SMB)on the plasma membrane fluidity and the relationship between the lipid peroxidation and the Plasma membrane fluidityin cultured human fetdal hepatocytes,the plasma membrane fluidity,using 1,6-dipheny-1,3,5-hexatriene(DPH)as a fluorescence probe, malondialdehyde(MDA)production as well as alanine aminotransferase(ALT)release of human fetal hepatocytes cultured in Presence of carbon tetrachloride(CCl4)or SMB puls CCl4 were estimated. In the cultured hepatocytes injured by CCl4,significant increments of the MDA production and the ALT release,and significant decrease in the plasma membrane fluidity were observed.when the culture medium was supplied with SMB prior to the additionof CCl4,the CCl4 induced increments in MDA production and ALT release was suppressed signifi cantly and a concomitant raise of plasma membrane fluidity towards normal occurred.The resultssuggested that SMB could suppress the lipid peroxidation in bepatocytes,thereby normal membranefluidity might be retained.

Maternal and fetal outcomes in term premature rupture of membrane

BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia.METHODS: A retrospective cross sectional study was conducted using data available at MizanAman General Hospital during a period of 3 years(January 2011 to December 2013). We examined records of 4 525 women who gave birth in the hospital; out of these women, 185 were diagnosed with term PROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books. The data were analyzed using SPSS version 20.0 statistical package. The association between independent and dependent variables was assessed by bivariate and multiple logistic regression analyses. 95%CI and P value less than 0.05 were considered statistically signifi cant.RESULTS: Of the 4 525 women who gave birth in the hospital, 202 were complicated by term PROM. About 22.2% of the women showed unfavorable maternal outcomes. The most common cause of maternal morbidity and mortality was puerperal sepsis. About 33.5% of neonates experienced unfavorable outcomes. The duration of PROM >12 hours(AOR=5.6, 95%CI 1.3–24.1) latency >24 hours(AOR=2.8, 95%CI 1.7–11.8), residing in rural areas(AOR=4.2, 95%CI 3.96–29.4) and birth weight less than 2 500 g were associated with unfavorable outcomes.CONCLUSION: Women residing in rural areas, long latency, and neonates with birth weight less 2 500 g may have unfavorable outcomes. Therefore, optimum obstetric and medical care is essential for the reduction of the devastating complications related to disorders.

Tb(III) Transport in Dispersion Supported Liquid Membrane System with D2EHPA as Carrier in Kerosene

The transport of Tb（III） in dispersion supported liquid membrane（DSLM） with polyvinylidene fluoride membrane（PVDF） as the support and dispersion solution including HCl solution as the stripping solution and di（2-ethylhexyl） phosphoric acid（D2EHPA） dissolved in kerosene as the membrane solution, has been studied. The effects of pH value, initial concentration of Tb（III） and different ionic strength in the feed phase, volume ratio of membrane solution to stripping solution, concentration of HCl solution, concentration of carrier, different stripping agents in the dispersion phase on the transport of Tb（III） have also been investigated, respectively. As a result, the optimum transport conditions of Tb（III） were obtained, i.e., the concentration of HCl solution was 4.0 mol/L, the concentration of D2EHPA was 0.16 mol/L, the volume ratio of membrane solution to stripping solution was 30：30 in the dispersion phase and pH value was 4.5 in the feed phase. Ionic strength had no obvious effect on the transport of Tb（III）. Under the optimum conditions, the transport percentage of Tb（III） was up to 96.1% in a transport time of 35 min when the initial concentration of Tb（IIl） was 1.0× 10 -4 mol/L. The diffusion coefficient of Tb（III） in the membrane and the thickness of diffusion layer between feed phase and membrane phase were obtained and the values were 1.82×10 -8 m2/s and 5.61 um, respectively. The calculated results were in good agreement with the literature data.

Using bipolar membrane electrodialysis to synthesize di-quaternary ammonium hydroxide and optimization design by response surface methodology

Bipolar membrane electrodialysis(BMED) has already been described for the preparation of quaternary ammonium hydroxide. However, compared to quaternary ammonium hydroxide, di-quaternary ammonium hydroxide has raised great interest due to its high thermal stability and good oriented performance.In order to synthesize N,N-hexamethylenebis(trimethyl ammonium hydroxide)(HM(OH)_2) by EDBM,experiments designed by response surface methodology were carried out on the basis of single-factor experiments. The factors include current density, feed concentration and flow ratio of each compartment(feed compartment: base compartment: acid compartment: buffer compartment). The relationship between current efficiency and the above-mentioned three factors was quantitatively described by a multivariate regression model. According to the results, the feed concentration was the most significant factor and the optimum conditions were as follows: the current efficiency was up to 76.2%(the hydroxide conversion was over 98.6%), with a current density of 13.15 m A·cm^(-2), a feed concentration of 0.27 mol·L^(-1) and a flow ratio of 20 L·h^(-1):26 L·h^(-1):20 L·h^(-1):20 L·h^(-1) for feed compartment, base compartment, acid compartment, and intermediate compartment, respectively. This study demonstrates the optimized parameters of manufacturing HM(OH)_2 by direct splitting its halide for industrial application.

胎衣不下奶牛miRNA-185靶向调控血管内皮生长因子A表达的研究

【目的】通过体内和体外试验检测miRNA-185及血管内皮生长因子A(vascular endothelial growth factor A,VEGFA)在胎衣正常排出和胎衣不下(RFM)奶牛胎盘组织中的差异表达情况及VEGFA在奶牛母体胎盘组织中表达分布,验证及明确miRNA-185和VEGFA与奶牛胎衣不下发生密切相关并存在靶向调节关系,为深入研究miRNA-185在奶牛胎衣不下发生过程中的作用提供理论依据和试验基础。【方法】采用实时荧光定量PCR法检测胎衣正常排出及胎衣不下奶牛母体胎盘组织中miRNA-185及VEGFA基因表达情况,采用荧光原位杂交技术(FISH)检测VEGFA在母体胎盘组织的表达分布及mRNA的差异表达情况;采用双荧光素酶明确miRNA-185与VEGFA的靶向调节关系,采用实时荧光定量PCR及Western blotting检测体外转染miRNA185 mimics、miRNA-185 inhibitor及miRNA-185 NC后VEGFA mRNA及蛋白的差异表达情况。【结果】实时荧光定量PCR结果显示,与胎衣正常排出奶牛相比,胎衣不下奶牛体内miRNA-185及VEGFA的表达水平均极显著下调(P<0.01);荧光原位杂交结果显示,VEGFA mRNA主要在奶牛子宫内膜上皮细胞中表达。VEGFA是miRNA-185的靶向调节蛋白。与阴性对照组相比,转染miRNA-185 mimics后VEGFA的mRNA及蛋白表达水平均极显著下调(P<0.01),转染miRNA-185 inhibitor后VEGFA的mRNA及蛋白表达水平均极显著上调(P<0.01)。【结论】胎衣不下奶牛母体胎盘组织内miRNA-185及VEGFA表达显著降低,VRGFA主要在子宫内膜上皮细胞中表达,miRNA-185可通过靶向调控VEGFA的表达参与奶牛胎衣不下的发生发展。

细胞焦亡相关蛋白在胎膜早破孕妇胎膜组织中的表达及其与妊娠结局的关系

目的:探究细胞焦亡相关蛋白半胱氨酸天冬氨酸特异性蛋白酶-1(cysteinyl aspartate specific proteinase,Caspase-1)和核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)在胎膜早破孕妇胎膜组织中的表达及其与妊娠结局的关系。方法:选择2020年1月至2023年1月于常熟市中医院妇产科就诊并分娩的胎膜早破孕妇135例作为观察组,另选择同期产检并分娩的健康孕妇135例作为对照组,比较两组孕妇胎膜组织中NLRP3 mRNA和Caspase-1 mRNA表达。依据妊娠结局将135例胎膜早破孕妇分为妊娠不良组(n=50)和妊娠良好组(n=85),通过单因素和多因素Logistic分析胎膜早破孕妇妊娠不良的独立危险因素;应用Logistic回归模型结合限制性立方样条(restricted cubic splines,RCS)分析胎膜早破孕妇胎膜组织中细胞焦亡相关蛋白表达量与妊娠不良的剂量反应关系;依据独立因素构建列线图预测模型,并对模型进行验证。结果:观察组胎膜组织中NLRP3 mRNA和Caspase-1 mRNA表达显著高于对照组(P<0.001)。就诊时间≥2 h、生殖道感染、NLRP3 mRNA和Caspase-1 mRNA高表达是胎膜早破孕妇妊娠结局不良的独立危险因素(P<0.05);RCS结果显示,胎膜早破孕妇胎膜组织中NLRP3 mRNA、Caspase-1 mRNA表达量与妊娠结局不良呈非线性剂量反应关系,在NLRP3 mRNA表达量为1.20(OR=1.818,95%CI:1.673~1.932)和Caspase-1 mRNA表达量为1.25(OR=2.735,95%CI:1.132~3.821)处发生妊娠结局不良的风险最大;构建的列线图预测模型具有良好的区分度、准确性和临床适用性。结论:NLRP3 mRNA和Caspase-1 mRNA在胎膜早破孕妇胎膜组织中呈高表达,二者是胎膜早破孕妇妊娠结局不良的独立危险因素,随着表达量升高,胎膜早破孕妇妊娠不良的危险性也随之升高。

保留胎膜剖宫产在早产孕妇中的应用效果分析

目的:分析保留胎膜剖宫产在早产孕妇中的应用效果。方法:选取2022年1月—2023年8月于东莞市长安医院行剖宫产的早产孕妇80例作为研究对象,随机分为观察组和对照组,各40例。对照组实施常规剖宫产,观察组实施保留胎膜剖宫产。比较两组治疗效果。结果:观察组术中出血量、产后24 h出血量少于对照组,差异有统计学意义(P<0.001)。术前,两组红细胞计数、血细胞比容、血红蛋白水平比较,差异无统计学意义(P>0.05);术后3 d,两组红细胞计数、血细胞比容、血红蛋白水平低于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。观察组脐动脉pH、脐静脉血红蛋白水平高于对照组,肿瘤坏死因子-α水平低于对照组,差异有统计学意义(P<0.05)。观察组新生儿出生后1、5 min阿普加评分高于对照组,差异有统计学意义(P<0.05)。结论:保留胎膜剖宫产在早产孕妇中的应用效果显著,可减少孕妇术中及产后24 h出血量,减轻早产儿机体损伤。

胎膜早破的危险因素及其对新生儿结局影响的临床分析

目的分析胎膜早破的危险因素及其对新生儿结局的影响,为胎膜早破新生儿是否需要提前干预提供临床依据。方法采用便利抽样法选取2019年1月1日至12月31日北京市通州区妇幼保健院产科住院分娩的2066例单胎产妇及其分娩的新生儿临床资料进行横断面研究,统计胎膜早破的发生率,分析胎膜早破的危险因素,分析胎膜早破对新生儿结局的影响,并进一步分析胎膜早破的时间和产前应用抗生素对新生儿结局的影响。结果(1)2019年北京市通州区妇幼保健院产科单胎胎膜早破的发生率为28.94%(598/2066)。(2)多因素Logistic回归分析结果显示:孕周(足月)、剖宫产病史、漏斗骨盆、贫血、孕次、急性绒毛膜羊膜炎及巨大儿是胎膜早破的危险因素(P<0.05)。(3)根据胎膜在临产前是否发生自发性破裂分为胎膜早破组(n=598)和非胎膜早破组(n=1468)。胎膜早破组在早产和新生儿72 h内转新生儿科住院率分别为10.03%、10.20%,均高于非胎膜早破组(2.86%、7.29%),差异均有统计学意义(P<0.05);胎膜早破组与非胎膜早破组的胎儿宫内窘迫、新生儿窒息和新生儿早期感染发生率比较,差异均无统计学意义(P>0.05)。(4)胎膜早破时间对新生儿出生后72 h内新生儿科住院预测的受试者工作特征(ROC)曲线中的切点为胎膜早破时间>21 h,其预测新生儿出生后72 h内转新生儿科住院的曲线下面积为0.601,特异度为77.9%,灵敏度为37.7%。(5)胎膜早破>21 h新生儿早期感染发生率、新生儿科住院发生率和产前抗生素使用率分别为7.04%、16.20%、94.37%,均高于胎膜早破≤21 h新生儿(2.63%、8.33%、35.96%),差异均有统计学意义(P<0.05)。结论2019年北京市通州区妇幼保健院产科单胎胎膜早破的发生率为28.94%;剖宫产病史、漏斗骨盆、贫血、急性绒毛膜羊膜炎、孕次和巨大儿是胎膜早破的危险因素;胎膜早破增加了早产和新生儿科住院率,产前应用抗生素可降低新生儿早期感染发生率。

miRNA-424-5p靶向VEGFA对胎衣不下奶牛胎盘胶原蛋白降解的影响

【目的】通过探究miRNA-424-5p对奶牛母体胎盘组织胶原蛋白降解的影响,进而明确miRNA-424-5p对奶牛胎衣不下(retained fetal membranes,RFM)发生的调控作用及机制。【方法】检测胎衣正常排出与胎衣不下奶牛母体胎盘组织miRNA-424-5p表达水平,采用qRT-PCR和Western blot方法进行胎衣正常排出与胎衣不下奶牛的母体胎盘组织VEGFA、MMP-2、MMP-9、COL-IV的表达水平检测。应用生物信息学分析对miRNA-424-5p进行靶基因预测,并通过双荧光素酶试验验证miRNA-424-5p与VEGFA的靶向关系。在奶牛子宫内膜上皮细胞中转染miRNA-424-5p mimics和miRNA-424-5p inhibitor进行过表达和沉默miRNA-424-5p。采用免疫荧光技术观察VEGFA在奶牛子宫内膜上皮细胞的表达变化,qRT-PCR和Western blot检测VEGFA、MMP-2、MMP-9、COL-IV的mRNA与蛋白表达水平的变化。【结果】与健康组相比,RFM组母体胎盘组织中的miRNA-424-5p mRNA表达水平显著升高(P<0.01),VEGFA、MMP-2、MMP-9 mRNA与蛋白表达水平极显著降低(P<0.01),COL-IV mRNA与蛋白表达水平极显著升高(P<0.01)。miRNA-424-5p的潜在靶基因共有152个,并经双荧光素酶试验结果证实VEGFA是miRNA-424-5p的靶基因。过表达和沉默miRNA-424-5p后,免疫荧光结果显示,与对照组相比miRNA-424-5p mimics组VEGFA的表达较低,而miRNA-424-5p inhibitor组VEGFA表达较高;qRT-PCR和Western blot结果显示,过表达miRNA-424-5p,靶基因VEGFA mRNA与蛋白表达水平极显著降低,基质金属蛋白酶MMP-2、MMP-9 mRNA与蛋白表达水平极显著降低(P<0.01),胶原蛋白COL-IV mRNA与蛋白表达水平极显著升高(P<0.01),而沉默miRNA-424-5p时VEGFA、MMP-2、MMP-9 mRNA与蛋白表达显著升高(P<0.01),COL-IV mRNA与蛋白表达水平极显著降低。【结论】miRNA-424-5p可靶向VEGFA调控MMPs表达、胶原蛋白的分解从而引起细胞外胶原降解障碍,是引起胎衣不下发生的重要因素。

围产期孕妇GBS感染情况及与不良妊娠结局及新生儿结局的相关性

目的:分析围产期孕妇B族链球菌(GBS)感染情况及其与不良妊娠结局及新生儿结局的相关性。方法:选取2021年11月—2023年3月在郑州市妇幼保健院就诊的1590例孕36~42周的孕妇作为研究对象,检测并统计围产期孕妇的GBS感染状况,并根据GBS感染情况,将孕妇进行分组。采用logistic回归分析围产期孕妇感染GBS的影响因素,比较两组孕妇的不良妊娠结局,对比两组的新生儿结局。结果:本研究的1590例围产期孕妇中,共有84例(5.28%)GBS为阳性,1506例(94.72%)GBS为阴性。阳性组及阴性组孕妇的平均年龄、平均孕周、平均产次等资料相比,差异无统计学意义(P>0.05);而两组孕妇的孕早期体质指数(BMI)、存在阴道炎、妊娠期糖耐量异常等资料相比,差异有统计学意义(t/χ^(2)=9.373、35.860、22.236,P<0.05)。logistic多因素回归分析结果显示,孕早期BMI、存在阴道炎、妊娠期糖耐量异常为影响围产期孕妇感染GBS的独立危险因素(P<0.05)。阳性组孕妇发生胎膜早破、宫内感染、产褥感染、产后出血等的概率均明显高于阴性组,差异有统计学意义(χ^(2)=6.939、24.067、27.741、35.902,P<0.05)。阳性组发生胎儿宫内窘迫、早产、新生儿肺炎、脑膜炎、败血症、病理性黄疸等的概率均明显高于阴性组,差异有统计学意义(χ^(2)=5.434、52.989、9.394、17.940、17.940、7.354,P<0.05)。结论:围产期孕妇出现GBS感染可明显增加不良妊娠结局的发生风险,因此,应对围产期孕妇开展GBS常规筛查,以保障母婴安全。若孕妇感染GBS,应尽早干预,以改善不良妊娠结局。

妊娠34 周前胎膜早破的治疗进展

未足月胎膜早破(preterm premature rupture of the membranes,PPROM)特别是孕龄<34周的胎膜早破是临床上处理比较困难的问题,期待治疗增加了母体感染、产后出血等并发症的发生风险;胎儿也可能存在宫内感染,胎膜早破所致羊水过少;期待时间过长可导致胎儿骨骼发育异常、胎儿肢体粘连、胎肺发育不全等不良后果。在无继续妊娠禁忌证情况下,期待治疗能明显降低新生儿发病率和病死率。因此,在制订诊疗方案时需结合多方面因素进行考虑,得出最佳治疗方案,以期减少母儿并发症发生。本文通过对PPROM的治疗进展进行综述,为临床工作者提供帮助。

三氯生对牙髓干细胞生物学特性的影响

目的探讨环境污染物三氯生(triclosan,TCS)对牙髓干细胞(dental pulp stem cells,DPSCs)的多种生物学特性是否有消极影响,以及TCS在大鼠体内牙髓组织的分布情况和危害,为DPSCs的临床应用和TCS的安全性提供依据。方法获得武汉科技大学附属天佑医院医学伦理委员会批准,收集离体牙,分离、培养并鉴定人来源的DPSCs,在DPSCs体外培养液中加入0~0.08 mmol/L的TCS,通过CCK-8检测DPSCs的增殖能力,划痕实验检测DPSCs的迁移能力,诱导三系分化检测DPSCs的分化能力,检测肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)、诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)、转化生长因子-β(transforming growth fac-tor-β,TGF-β)的基因或蛋白表达,荧光染色分析DPSCs生成活性氧(reactive oxygen species,ROS)的水平,荧光探针检测DPSCs线粒体膜电位的改变,以及检测DPSCs的PI3K/Akt/mTOR、p38和JNK通路活性。获得武汉科技大学实验动物伦理委员会批准,建立50 mg/kg/d的TCS短期灌胃暴露2个月的大鼠模型,收集并通过液相色谱-质谱联用法检测大鼠肝脏、大脑和牙髓组织中的TCS浓度。结果0.02 mmol/L、0.04 mmol/L和0.08 mmol/L的TCS在与人来源DPSCs接触的第5天和第7天显著抑制了其增殖能力;0.04 mmol/L和0.08 mmol/L的TCS在接触第3天显著抑制了DPSCs的迁移能力和三系分化能力,诱导了促炎因子TNF-α、IL-1β、IL-6、iNOS以及TGF-β的基因或蛋白表达,抑制了抗炎因子IL-10的蛋白表达;0.04 mmol/L和0.08 mmol/L的TCS在接触第1天诱导了DPSCs的ROS产生,降低了DPSCs的线粒体膜电位,并在第3天抑制了DPSCs的PI3K/Akt/mTOR通路活性,增强了p38通路活性,不影响JNK通路活性;大鼠短期TCS灌胃暴露后,在肝脏(430ng/mL)和大脑(41.4ng/mL)组织中检测到TCS存在,牙髓中未检测到,TCS分布浓度最高的肝脏未出现明显组织病理学变化。结论TCS对DPSCs的多种生物学特性具有抑制作用,对生物体具有潜在风险;短期TCS暴露大鼠的牙髓组织中没有TCS,大鼠健康未受到损害。

胎膜早破合并早产产妇进行规范化院前急救的效果分析

目的研究规范化院前急救对胎膜早破合并早产孕产妇的干预效果。方法选取2020年10月至2023年10月厦门市妇幼保健院收治的76例胎膜早破合并早产的孕妇,按院前急救方案的不同分为观察组(规范化院前急救,n=38)和对照组(常规院前急救,n=38)。比较两组产妇的宫缩抑制时间和治疗时间,保胎成功率,新生儿Apgar评分和不良事件发生率。结果观察组产妇宫缩抑制时间和治疗时间均显著短于对照组产妇(P<0.001);接受急救后,观察组产妇保胎成功率显著高于对照组产妇(P<0.05);出生5 min后,观察组新生儿心率、皮肤颜色、呼吸、肌张力及弹足底反应的Apgar评分均高于对照组新生儿(P<0.001);观察组新生儿不良事件发生率为5.26%(2/38),显著低于对照组新生儿不良事件发生率[23.68%(9/38)](P<0.05)。结论规范化院前急救对胎膜早破合并早产孕产妇可快速抑制宫缩,提高保胎成功率,降低不良事件发生率,保障母婴的生命安全。

TIMP-1、PCT、CRP、sTREM-1及G-CSF联合检测对胎膜早破并发HCA的诊断价值分析

目的 探讨TIMP-1、PCT、CRP、sTREM-1及G-CSF联合检测对胎膜早破并发HCA的诊断价值。方法 选取2020年7月-2022年7月南阳医学高等专科学校第一附属医院收治的83例胎膜早破并发HCA患者作为观察组,另选同期83例胎膜早破患者作为对照组。比较2组血清各指标差异;绘制ROC曲线分析血清TIMP-1、PCT、CRP、sTREM-1、G-CSF及联合检测诊断胎膜早破并发HCA的临床价值。结果 观察组血清TIMP-1水平低于对照组,PCT、CRP、sTREM-1、G-CSF水平高于对照组(P<0.05);绘制ROC曲线显示,联合检测价值最高。结论 血清TIMP-1、PCT、CRP、sTREM-1及G-CSF联合检测可提高胎膜早破并发HCA诊断效能,且可评估HCA严重程度,有助于临床开展针对性治疗。

保留胎膜囊剖宫产术对胎膜未破早产儿围生期结局的影响

目的分析胎膜未破早产儿采用保留胎膜囊剖宫产术对其围生期结局的影响。方法选取42例早产需行剖宫产术的患者,根据随机数字表法分为对照组与研究组,各21例。对照组采用常规剖宫产术治疗,研究组采用保留胎膜囊剖宫产术治疗,比较两组临床效果。结果研究组新生儿窒息发生率低于对照组(P<0.05)。研究组产妇手术成功率为100%,略高于对照组的95.24%,但差异无统计学意义(P>0.05)。研究组胎儿娩出时间长于对照组(P<0.05)。两组产妇羊水量、新生儿出生体重比较,差异无统计学意义(P>0.05)。研究组脐血p H、出生后1 min和5 min的Apgar评分均高于对照组(P<0.05)。结论对于胎膜未破早产儿采用保留胎膜囊剖宫产术治疗,有助于预防新生儿窒息,改善围生期结局,值得临床推广。

宫腔镜IBS刨削系统用于宫腔残留组织物治疗中的效果观察

目的 探讨宫腔镜IBS刨削系统用于宫腔残留组织物治疗中的效果。方法 选取2021年7月—2023年2月收治的流产后宫腔残留组织物患者80例作为研究对象,采用随机数字表法分为对照组与观察组,每组40例。对照组采用可视清宫术治疗,观察组采用宫腔镜IBS刨削系统治疗,比较两组治疗效果。结果 观察组总有效率明显较对照组更高(P<0.05);观察组月经恢复时间、月经量、HCG恢复正常时间与对照组比较有明显差异(P<0.05)。观察组术后宫腔粘连发生率、术后妊娠率与对照组比较有明显差异(P<0.05)。术前两组子宫内膜厚度、HIF-1α、FGF、VEGF水平无显著差异(P>0.05);术后观察组各指标低于对照组(P<0.05)。结论宫腔镜IBS刨削系统用于宫腔残留组织物治疗中的效果令人满意,可促进快速恢复,也能减少宫腔粘连发生,提高术后妊娠率,值得推广。

Placental-derived stem cells:Culture, differentiation and challenges

Stem cell therapy is a promising approach to clinical healing in several diseases. A great variety of tissues(bone marrow, adipose tissue, and placenta) arepotentially sources of stem cells. Placenta-derived stem cells(p-SCs) are in between embryonic and mesenchymal stem cells, sharing characteristics with both, such as non-carcinogenic status and property to differentiate in all embryonic germ layers. Moreover, their use is not ethically restricted as fetal membranes are considered medical waste after birth. In this context, the present review will be focused on the biological properties, culture and potential cell therapy uses of placental-derived stem cells. Immunophenotype characterization, mainly for surface marker expression, and basic principles of p-SC isolation and culture(mechanical separation or enzymatic digestion of the tissues, the most used culture media, cell plating conditions) will be presented. In addition, some preclinical studies that were performed in different medical areas will be cited, focusing on neurological, liver, pancreatic, heart, muscle, pulmonary, and bone diseases and also in tissue engineering field. Finally, some challenges for stem cell therapy applications will be highlighted. The understanding of the mechanisms involved in the p-SCs differentiation and the achievement of pure cell populations(after differentiation) are key points that must be clarified before bringing the preclinical studies, performed at the bench, to the medical practice.

Comparison of Two Different Protocols for Induction of Parturition in Heifers with or without Estradiol Benzoate

Objectives of this study were to investigate the efficacy of dexamethasone in combination with estradiol benzoate in controlled induction of parturition in heifers, especially in the subjects of retained fetal membranes and dystocia caused by fetal oversize. A total number of 100 Holstein-Friesian heifers aged 24-25 months, mean weight 450 kg and body condition score of 3-4 from a dairy herd located in the suburb of Tabriz with similar nutrition and management systems were allocated at random into two groups. Group A （Control, n = 50） heifers, after passing the minimum 270 d of pregnancy were injected with 30 mg dexamethasone IM. Group B （Treatment, n = 50） heifers with the same period of pregnancy received 30 mg dexamethasone plus 20 mg estradiol benzoate IM on the same days of pregnancy. The overall durations of initial treatments to induction of parturition were （41.50 ~ 2.65） h in group A and （37.50 ：i： 1.27） h in group B. In group A, more dystocia cases were observed than in group B. After parturition, group A showed a higher percentage of retention of fetal membranes as well as the calf mortality and dystocia compared to group B. The differences between two groups were statistically significant （P 〈 0.05）. In conclusion, our results indicate that induction of parturition by estradiol benzoate and dexamethasone together will be more effective than dexamethasone alone because of the less retention of fetal membranes, easy calving and shorter time from induction to parturition.