Serum Ion Concentrations and Antioxidation of Dairy Cows with Retained Fetal Placenta

[ Objective] TO further explore the mechanism of retained fetal membrane （RFM） of dairy cows in Qinghai Province. [ Methed] As many as 15 dairy cows with retained fetal placenta and 15 without retained fetal placenta were selected. The serum concentrations of eight metal ions, namely, potassium, sodium, calcium, magnesium, copper, iron, zinc and manganese at parturition and 12 h post partum were determined by atomic absorption spectrometry. The anti-oxidative indexes at parturition were determined by UV-1601 doub｜e-beam visib｜e spectrophotometer. ~=- sultl In the dairy cows with retained fetal placenta, the concentrations of calcium, magnesium, copper, zinc and manganese were decreased signif- icantly （ P 〈 0.05） ; that of iron was increased significantly （ P 〈 0.01 ） ; those of potassium and sodium did not change greatly; the activities of su- peroxide dismutase and glutathione peroxidase were decreased significantly （ P 〈 0.01 ） ; and the MDA content was increased significantly （ P 〈 0.05）. However, the concentrations of the eight metal ions and anti-oxidative indexes did not change in the dairy cows without retained fetal placen- ta, [ CondusionJ The RFM of dairy cows has some relationships with the serum concentrations of metal ions and antioxidation.

Necrotizing Enterocolitis in Multi Fetal Pregnancies: Can We Find a Key in Placental Abnormalities? A Retrospective Data Analysis

Objective: We aimed to evaluate the relationship between chorionicity, placental abnormalities and necrotizing enterocolitis in multiple pregnancies. We hypothesized that unbalanced interfetal transfusion through vascular anastomoses in monochorionic placentation causes hypoperfusion of the intestinal mucosa, increasing the risk of developing necrotizing enterocolitis. Material and methods: All women with multiple pregnancies who delivered at the University Medical Center Utrecht between January 1995 and December 2015 were retrospectively selected. We compared baseline characteristics and neonatal and maternal outcomes. Secondly, we analyzed ultrasound and placental pathology findings of monochorionic multiples with and without necrotizing enterocolitis. Finally, we compared illness characteristics of necrotizing enterocolitis in monochorionic multiples with necrotizing enterocolitis in dichorionic multiples. Results: We included 2859 dichorionic and 817 monochorionic neonates. Necrotizing enterocolitis occurred significantly more often in monochorionic as compared to dichorionic neonates (3.3% and 1.6% respectively), also after correction for birthweight, gestational age and nulliparity (OR 1.7, 95% CI 1.0 - 2.8). Ultrasound abnormalities were not associated with necrotizing enterocolitis. Histopathology showed that necrotizing enterocolitis was significantly associated with the presence of unbalanced interfetal transfusion (76.9% of monochorionic with necrotizing enterocolitis versus 31.4% of cases without necrotizing enterocolitis, P = 0.001). Conclusion: Necrotizing enterocolitis is more common in monochorionic multiples as compared to dichorionic multiples, at least in part due to the presence of and related to the presence of unbalanced interfetal transfusion through arterial-venous anastomoses in the placenta. Possibly, subtle ischemic damage caused by intra-uterine fetal hypotension or anemia plays a key role in the development of necrotizing enterocolitis in monochorionic twins.

Caesarian Section for Placenta Praevia: Does Booking Status Affect Maternofetal Outcome?

Background: Placenta praevia accounts for significant maternal morbidity and perinatal morbidity and mortality. Despite advances in blood transfusion technique and surgical procedure, abnormal placentation still remains a difficult challenge for obstetricians. Objective: To determine the influence of booking status on the fetal and maternal outcome among parturients with placenta praevia that underwent caesarian delivery. Methodology: This was a comparative and retrospective study between booked and unbooked subjects with significant placenta praevia that were delivered by caesarian section between January 1st 2004 and December 31st 2008 with respect to maternal and fetal outcome. Result: Out of 14,344 deliveries during study period, 123 cases of placenta praevia that underwent caesarian delivery were identified giving a prevalence rate of 0.86%. 49 subjects were booked while 74 were unbooked. There was no statistically significant difference between booked and unbooked cases with respect to risk factors (30.6% of booked and 23% of unbooked), X2(4) = 7.203, P = 0.126 and the mean blood loss at surgery (870.4 ± 486.9 ml in booked versus 779.7 ± 380.96 ml in unbooked), X2(1) = 0.202, P = 0.653. However, antepartum transfusion (12.2% booked versus 34.7% unbooked) and postpartum transfusion (51% booked versus 72% unbooked) showed statistically significant difference, X2(1) = 9.744, P = 0.002. One maternal death occurred amongst the unbooked cases and none among the booked cases. Statistically significant differences were also noted in the apgar score at 1 minute X2(3) = 15.528, P = 0.001 and 5 minutes X2(3) = 12.912, P = 0.005 respectively. More babies died in the unbooked group (19) compared to two (2) in the booked mothers. Conclusion: Unbooked status in placenta previa significantly increases the risk for antepartum and postpartum transfusion, is associated with higher mortality, increased preterm delivery, poorer apgar scores and higher perinatal mortality rate.

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.

Changes in Maternal Lifestyle during Ramadan Altered Placental Development

People born with low birth weight are at a greater risk of developing later life diseases such as hypertension, diabetes and cancer. Recent studies have pinpointed the placenta as a critical factor involved in developmental programming. Changes in maternal lifestyle or dietary habits can alter placental development and increase the risk of developmental programming of adult diseases. Saudi people, including pregnant women, change their lifestyle and eating habits during the holy month of Ramadan. Previous studies found that the exposure to Ramadan lifestyle reduces placental weight;however, effects on other placental aspects remained unknown. We aimed to further examine the effects of exposure to Ramadan lifestyle on full-term placental morphometrics, histology and gene expression of key glucose transporters. To examine this, fresh placentas were collected from 60 healthy Saudi women. Samples were equally classified into two groups;not exposed to Ramadan lifestyle (control) or exposed to Ramadan lifestyle in the first. Placental weight, length and breadth were recorded and placental surface area was calculated. Placental tissue was processed and stained with eosin and hematoxylin for histological examination. Apoptosis was assessed using TUNEL assay. The gene expression of the glucose transporters GLUT1 and GLUT3 was evaluated. The results show that women exposed to Ramadan lifestyle have more elongated placentas with less central cord insertion. Placental weight and surface area were significantly lowered in women exposed to Ramadan lifestyle. Placental length was not affected but the breadth was significantly smaller in than control. Placentas exposed to Ramadan lifestyle had fewer and less-developed syncytial knots and thicker syncytiotrophoblast cells. Apoptosis was detected in placentas exposed to Ramadan lifestyle. GLUT1 mRNA expression was unaltered, but GLUT3 was increased compared to control group. These findings suggest that changes in maternal lifestyle during Ramadan can alter placental structure at morphometric, histological and molecular levels. These structural changes are indication of placental adaptations for a suboptimal maternal environment. Such adaptations have been linked to adult diseases in various populations worldwide. Further studies are required to evaluate the possible link between exposure to Ramadan lifestyle and the risk of developing adulthood chronic diseases in the Saudi population.

Early gestation chorionic villi-derived stromal cells for fetal tissue engineering

AIM: To investigate the potential for early gestation placenta-derived mesenchymal stromal cells(PMSCs) for fetal tissue engineering.METHODS: PMSCs were isolated from early gestation chorionic villus tissue by explant culture. Chorionic villus sampling(CVS)-size tissue samples(mean = 35.93 mg)were used to test the feasibility of obtaining large cell numbers from CVS within a clinically relevant timeframe. We characterized PMSCs isolated from 6 donor placentas by flow cytometry immunophenotyping, multipotency assays, and through immunofluorescent staining. Protein secretion from PMSCs was examined using two cytokine array assays capable of probing for over 70 factors in total. Delivery vehicle compatibility of PMSCs was determined using three common scaffold systems: fibrin glue, collagen hydrogel, and biodegradable nanofibrous scaffolds made from a combination of polylactic acid(PLA) and poly(lactic-co-glycolic acid)(PLGA). Viral transduction of PMSCs was performed using a Luciferase-GFPcontaining lentiviral vector and efficiency of transduction was tested by fluorescent microscopy and flow cytometry analysis.RESULTS: We determined that an average of 2.09 × 106(SD ± 8.59 × 105) PMSCs could be obtained from CVS-size tissue samples within 30 d(mean = 27 d, SD ± 2.28), indicating that therapeutic numbers of cells can be rapidly expanded from very limited masses of tissue. Immunophenotyping by flow cytometry demonstrated that PMSCs were positive for MSC markers CD105, CD90, CD73, CD44, and CD29, and were negative for hematopoietic and endothelial markers CD45, CD34, and CD31. PMSCs displayed trilineage differentiation capability, and were found to express developmental transcription factors Sox10 and Sox17 as well as neuralrelated structural proteins NFM, Nestin, and S100 β. Cytokine arrays revealed a robust and extensive profile of PMSC-secreted cytokines and growth factors, and detected 34 factors with spot density values exceeding 103. Detected factors had widely diverse functions that include modulation of angiogenesis and immune response, cell chemotaxis, cell proliferation, blood vessel maturation and homeostasis, modulation of insulin-like growth factor activity, neuroprotection, extracellular matrix degradation and even blood coagulation. Importantly, PMSCs were also determined to be compatible with bothbiological and synthetic material-based delivery vehicles such as collagen and fibrin hydrogels, and biodegradable nanofiber scaffolds made from a combination of PLA and PLGA. Finally, we demonstrated that PMSCs can be efficiently transduced(> 95%) with a Luciferase-GFPcontaining lentiviral vector for future in vivo cell tracking after transplantation.CONCLUSION: Our findings indicate that PMSCs represent a unique source of cells that can be effectively utilized for in utero cell therapy and tissue engineering.

基于MRI体素内不相干运动成像技术的胎盘胎儿侧与母体侧的功能差别

目的:探讨胎盘胎儿侧与母体侧功能是否存在差异以及这两部分功能变化与孕周的相关性。方法:采用体素内不相干运动成像技术(IVIM),分别采集75例妊娠23~40周胎盘母体侧与胎儿侧的灌注分数f,扩散系数D和伪扩散系数D^(*)的数据。通过Wilcoxon配对符号秩和检验比较胎盘母体侧与胎儿侧IVIM参数的差异,并采用回归方法进行曲线估计及曲线拟合分析胎儿侧和母体侧数据与孕周的相关性。结果:胎盘母体侧与胎儿侧的灌注分数f,扩散系数D之间的差异均具有统计学意义。母体侧灌注分数f-out (y)与孕周(x)具有相关性,呈现二次曲线相关,曲线拟合优度R^(2)为0.121,方程式为y=0.635-0.0155x+0.0001x^(2)。胎儿侧与母体侧灌注分数差值fin-fout(y)与孕周(x)具有相关性,呈二次曲线相关,曲线拟合优度R^(2)为0.295,方程式为y=_(1).318+0.080x-0.001x^(2)。结论:胎盘胎儿侧与母体侧灌注功能存在显著差异,胎盘母体侧灌注分数与孕周具有相关性。

孕中期胎盘功能监测指标的临床研究

目的探讨孕中期胎盘功能监测指标的临床效果。方法选取2021年1月至2023年12月南昌市第一医院诊断为胎儿生长受限(FGR)的60例孕妇设为观察组,正常孕妇60例设为对照组,比较两组胎盘血流学参数[血管指数(VI)、血流指数(FI)和血管血流综合指数(VFI)]、胎盘形态学参数[胎盘体积(PV)]以及外周血胎盘激素[人绒毛膜促性腺激素(hCG)、游离雌三醇(uE3)]等指标差异,分析绘制受试者工作特征(ROC)曲线,分析VI、VFI、FI、PV、hCG、uE3预测FGR价值。结果观察组VI为(15.47±2.39)、VFI为(4.14±0.72)、FI为(21.21±2.31)、PV为(35.51±3.42)cm3,均低于对照组,差异有统计学意义(P<0.05);观察组hCG检测值高于对照组,而uE3检测值低于对照组,差异有统计学意义(P<0.05);VI、VFI、FI、PV、hCG、uE3联合检测预测FGR的曲线下面积(AUC)为0.923,灵敏度为0.917,特异度为0.837,均高于单一检测。结论孕中期胎盘功能监测指标与FGR发生关系密切,各指标联合检测可有效预测FGR发生。

胎盘植入性疾病患者不同终止妊娠时机的母婴结局分析

目的探讨胎盘植入性疾病(PAS)患者不同终止妊娠时机的母婴结局。方法选取2022年2月至2023年10月在我院分娩的PAS患者54例,根据终止妊娠孕周分为34 w≤孕周<35 w(A组)21例、35 w≤孕周<36 w(B组)14例、36 w≤孕周≤37 w(C组)19例。对比3组术中、术后的相关指标;各组新生儿以及产妇预后情况;采用logistic多因素分析影响新生儿以及产妇不良结局的相关因素。结果术中出血量、术后住院时间、急诊手术率:A组<B组<C组,差异有统计学意义(P<0.05);三组产后出血率、子宫切除率、入住ICU率以及失血性休克率比较,差异无统计学意义(P>0.05);Logistic多因素分析显示,术中出血量、剖宫产次数、孕周、胎盘植入、侵入型胎盘植入、完全型胎盘植入是影响产妇不良结局的独立危险因素(P<0.05);三组均无新生儿死亡事件出现,新生儿窒息率、转入NICU率:A组<B组<C组,差异有统计学意义(P<0.05);孕周、出生时体重、胎盘植入、剖宫产次数、侵入型胎盘植入、完全型胎盘植入是影响新生儿不良结局的独立危险因素(P<0.05)。结论PAS患者在妊娠34-35w期间终止妊娠是最适宜的终止妊娠时间,可更好的平衡母婴之间的风险,且母婴结局相对更好。

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。

母胎界面免疫代谢微环境调节胚胎着床的研究进展

胚胎着床诱导母胎界面发生适应性的代谢重编程,形成低氧、低度炎症和弱酸性的微环境,这种微环境通过调节免疫细胞的募集、激活、代谢和极化,有助于子宫内膜容受态建立、蜕膜化、滋养细胞侵袭和母胎免疫耐受。胚胎成功着床需要免疫炎性反应和以糖酵解为主导的代谢重编程适时、适度的启动和结束。由病理因素介导的免疫代谢失调会导致胚胎着床失败或着床后流产等不良妊娠结局。巨噬细胞是种植窗口期子宫内膜数量最多的抗原提呈细胞,凭借极强的免疫可塑性和代谢灵活性,在母胎免疫代谢微环境的调节中发挥关键作用。综述母胎界面微环境中的免疫代谢调控机制,为制定临床干预策略以改善自然妊娠和辅助生殖助孕结局提供参考。

脑-胎盘-子宫比率对预测晚发型胎儿生长受限的作用

目的:探讨超声多普勒测量脑-胎盘-子宫比率(CPUR)在预测晚发型胎儿生长受限(FGR)中的效能。方法:选择2020年5月至2021年5月在香港大学深圳医院接受产前检查的1255例单胎妊娠孕妇,孕35~37^(+6)周进行胎儿生长和超声多普勒测量。新生儿出生体质量<第10百分位数的孕妇为FGR组。分别和联合分析子宫动脉(UtA)、脐动脉(UA)和胎儿大脑中动脉(MCA)的搏动指数(PI),通过ROC曲线分析CPUR、脑-胎盘比率(CPR)、脑-子宫比率(C-UtA)对晚发型胎儿FGR预测价值,评估其预测晚发型FGR的敏感度、阳性和阴性预测值。结果:CPUR、CPR、C-UtA、平均UtA-PI在FGR组的曲线下面积值(AUC)为0.88、0.86、0.84、0.72。在一定的截断值和87%以上特异度下,CPUR、CPR、C-UtA、平均UtA-PI对预测FGR的敏感度分别为43.2%、46.6%、39.8%和23.9%;CPUR、CPR、C-UtA、平均UtA-PI、UA-PI对预测FGR的阳性预测值分别为90.5%、71.9%、83.3%、63.6%、5.2%。结论:CPUR预测晚发型FGR的综合效能较CPR、C-UtA、平均UtA-PI更好,可更有效提高临床FGR的检出率,以降低FGR风险。

乳酸对孕早期小鼠胎盘促血管生成基因表达及胎鼠生长的影响

背景胚胎着床过程中,子宫内膜基质细胞发生蜕膜化,进一步支持妊娠。子宫内膜蜕膜化过程中存在Warburg样糖酵解,产生大量乳酸。目的探讨乳酸对孕早期小鼠胎盘促血管生成基因表达及胎鼠生长的影响。方法选择6~8周龄的CD1雌性小鼠,与雄鼠交配成功后,随机分为抑制剂组和对照组,每组12只。抑制剂组从小鼠孕4.5 d开始连续3 d给予腹腔注射Syrosingopine[乳酸转运体抑制剂,剂量为7.5 mg/(kg·d)];对照组单纯腹腔注射等体积的0.9%氯化钠注射液;于妊娠8.5 d取小鼠孕囊称重,RT-PCR检测小鼠蜕膜组织中促胎儿生长和促血管生成相关基因的表达;于妊娠12.5 d取胎鼠及胎盘称重,RT-PCR检测胎盘促血管生成相关基因的表达,Western blot检测胎盘中CD31蛋白表达的变化。结果与对照组比较:孕8.5 d,抑制剂组小鼠孕囊组织重量降低(P<0.001),蜕膜组织中促胎儿生长/促血管生成相关基因Opn、Ogn、Angpt2、Angpt4、CD31、Hif-1α、Tgf-1β、Tie-2、Vegfr2、Vegfr3的mRNA表达水平降低(P<0.05);孕12.5 d,抑制剂组胎鼠体质量降低(P=0.003),胎盘重量降低(P=0.033),胎盘效率降低(P<0.001),小鼠胎盘促血管生成相关基因Angpt4、CD31、Hif-1α、Tgf-1β、Tie-2、Vegfr2、Vegfr3的mRNA表达水平降低(P<0.05),小鼠胎盘组织的CD31蛋白表达水平降低(P<0.05)。结论抑制蜕膜组织乳酸摄取可降低孕早期小鼠胎盘促血管生成基因表达,可能对胎鼠生长产生影响。

胎儿生长受限孕妇血清与胎盘Gas6、Endoglin、PLAC-1表达水平及其临床意义

目的分析胎儿生长受限(FGR)孕妇血清及胎盘中生长阻滞特异性蛋白6(Gas6)、Endoglin、胎盘特异性蛋白1(PLAC-1)表达水平,并探讨其临床意义。方法选取2022年5月至2024年9月确山县人民医院收治的81例FGR孕妇为FGR组,按照1∶1配对原则,另选取同期81例无FGR孕妇为对照组。比较两组孕妇的基线资料和胎盘相关指标(Gas6 mRNA、Endoglin mRNA、PLAC-1 mRNA、胎盘厚度、胎盘质量),采用Pearson法分析胎盘各指标表达与胎盘厚度、胎盘质量、新生儿体质量的相关性,比较两组孕妇不同孕期的血清各指标水平,采用Pearson法分析孕妇血清与胎盘各指标表达的相关性,采用受试者工作特征曲线(ROC)分析血清各指标对FGR的预测价值。结果FGR组孕妇的新生儿体质量、PLAC-1 mRNA、胎盘厚度、胎盘质量[(2.13±0.32)kg、0.50±0.11、(1.90±0.66)cm、(0.38±0.10)kg]明显低于对照组[(3.23±0.29)kg、1.00±0.06、(2.51±0.57)cm、(0.59±0.08)kg],胎盘Gas6 mRNA、Endoglin mRNA(1.42±0.24、1.38±0.16)明显高于对照组(1.04±0.05、1.06±0.07),差异均有统计学意义(P<0.05);胎盘Gas6 mRNA、Endoglin mRNA与胎盘厚度、胎盘质量、新生儿体质量呈负相关(P<0.05),PLAC-1 mRNA与胎盘厚度、胎盘质量、新生儿体质量呈正相关(P<0.05);FGR组孕妇孕早、中、晚期的血清Gas6、Endoglin明显高于对照组,PLAC-1明显低于对照组,差异均有统计学意义(P<0.05);孕早、中、晚期血清Gas6、Endoglin、PLAC-1表达与对应指标胎盘中表达量均呈正相关(P<0.05);经ROC分析结果显示,孕早、中、晚期血清Gas6、Endoglin、PLAC-1联合预测FGR的曲线下面积(AUC)分别为0.890、0.913、0.936,均优于单一指标,且血清各指标联合预测FGR的AUC随着孕期的推进依次增大,至孕晚期联合预测AUC为0.936,为最大。结论FGR孕妇血清及胎盘组织中Gas6、Endoglin、PLAC-1表达异常,且血清各指标联合检测对FGR具有一定预测价值,可作为临床早期评估FGR的辅助指标。

子痫前期患者胎盘、胎膜组织中水通道蛋白9的表达变化与子痫前期发病的关系

目的:研究子痫前期患者胎盘和胎膜中水通道蛋白9(AQP9)定位、mRNA、蛋白表达水平变化及在子痫前期发病中的作用。方法:选择足月剖宫产轻度和重度子痫前期孕妇各20例为病例组,正常足月妊娠孕妇40例为对照组。采用免疫组织化学增强聚合物法测定AQP9的定位;采用逆转录-聚合酶链反应(RT-PCR)和蛋白印迹技术检测AQP9 mRNA及蛋白表达水平,应用凝胶蛋白定量分析软件测定蛋白灰度值。结果:1AQP9表达定位于合体滋养细胞、绒毛膜滋养细胞及羊膜上皮细胞。2AQP9 mRNA在病例组和对照组胎盘及胎膜中均有表达。3病例组和对照组胎盘AQP9蛋白灰度值为0.53±0.13、0.19±0.01,胎膜中为0.53±0.15、0.16±0.01,病例组高于对照组,差异均有统计学意义(P<0.01);在轻度与重度子痫前期组胎盘中AQP9蛋白灰度值分别为0.41±0.01、0.66±0.02,胎膜中为0.38±0.02、0.67±0.01,重度子痫前期组高于轻度子痫前期组,差异均有统计学意义(P<0.01)。结论:子痫前期患者AQP9蛋白表达水平明显升高,AQP9是子痫前期发病的重要因素。

奶牛胎衣不下血清离子水平和机体抗氧化作用的研究

[目的]进一步探讨青海地区奶牛胎衣不下的发病原因。[方法]选择胎衣不下和胎衣正常排出的奶牛各15头分为两组。通过原子吸收光谱法测量两组奶牛分娩时和分娩后12h血清中8种金属元素K、Na、Ca、Mg、Cu、Fe、Zn和Mn的含量,同时用日产UV-1601双光束紫外可见分光光度计对两组奶牛分娩时血清中的抗氧化指标进行检测。[结果]与正常对照组比较,胎衣不下组血清中Mn、Zn、Cu、Ca和Mg含量显著降低(<0.01),Fe含量显著升高,K和Na含量没有明显变化;胎衣不下组奶牛血清中抗氧化酶总SOD和GSH-Px的活性明显降低(<0.01),而MDA含量显著提高(<0.05)。[结论]奶牛的胎衣不下与其血清中金属离子水平和抗氧化指标间有一定的相关性。

晚发型胎儿生长受限胎盘组织绒毛微循环变化的体视学分析

目的:观察晚发型胎儿生长受限(fetal growth restriction,FGR)患者胎盘绒毛微血管的体视学变化,探讨FGR的发病机制。方法:FGR组和对照组的胎盘组织标本各15例,应用免疫组织化学法抗CD34标记血管内皮细胞显示血管,测试胎盘绒毛内微血管的长度密度和体积密度。结果:抗CD34几乎标记胎盘绒毛所有的血管。两组微血管长度密度的差异无统计学意义(P>0.05),FGR组微血管体积密度小于对照组,差异有统计学意义(P<0.05)。结论:胎盘绒毛微血管管腔缩窄引起胎盘微循环血量减少,可能导致FGR的发生。

水通道蛋白1在人胎盘和胎膜中的表达

目的研究正常妊娠晚期人胎盘和胎膜组织中水通道蛋白1(AQP1)的表达及分布模式。方法收集5例正常足月妊娠剖宫分娩的人胎盘和胎膜组织样本,运用RT-PCR法、western印迹和免疫组织化学方法检测AQP1在胎盘和胎膜组织中的表达。结果RT-PCR显示AQP1mRNA在胎盘和胎膜组织均有表达;AQP1Western印迹检测胎盘和胎膜组织在28KD左右有一特异性条带;免疫组织化学结果显示AQP1强表达于胎盘的血管内皮细胞和合体滋养细胞、羊膜上皮细胞、平滑绒毛膜细胞滋养细胞。结论AQP1在人胎盘和胎膜的表达提示其在母胎液体交换及羊水平衡中可能发挥着重要的作用。

胎盘生长因子于胎儿生长受限时在胎盘及蜕膜组织中的表达

目的研究胎儿生长受限(fetalgrowthrestriction,FGR)时胎盘生长因子(placentagrowthfactor,PLGF)在胎盘及蜕膜组织中的表达。方法采用免疫组织化学和分子原位杂交的方法对正常妊娠和胎儿生长受限的胎盘及蜕膜组织中的PLGF及PLGFmRNA的表达进行检测,并通过计算机软件对组织中表达的情况进行定量分析。结果①胎盘生长因子及其mRNA在正常组与FGR组间表达的部位相同,主要在胎盘的合体滋养细胞中表达,在绒毛间质细胞、内皮细胞及蜕膜细胞中也是有少量表达。②FGR组15例患者的胎盘合体滋养细胞、绒毛间质细胞、内皮细胞及蜕膜组织中PLGF的表达均较正常组明显减少。③FGR组15例患者的上述组织细胞中PLGFmRNA的转录水平也较正常组明显降低。结论胎儿生长受限时,胎盘及蜕膜中PLGF及PLGFmRNA中表达较正常妊娠时明显减少,提示滋养细胞合成及分泌PL-GF的功能下降,这可能是胎儿生长受限发病机制中的一个重要环节。

特发性胎儿生长受限胎盘组织学与体视学分析

目的:评估特发性胎儿生长受限(IFGR)胎盘大体、组织学及终末绒毛体视学特征。方法:对2013年1月至2014年12月在上海交通大学医学院附属国际和平妇幼保健院足月分娩的IFGR40例(IFGR组)及正常妊娠30例(对照组)行回顾性研究,比较二组胎盘组织学及体视学参数差异。结果:与对照组比较,IFGR组大体检查胎盘最长径×最短径减小(分别为17.21 cm×19.00 cm、14.25 cm×16.10 cm)、胎盘质量明显降低(分别为595.68±22.70 g、422.00±18.42 g)(P<0.001),胎盘质量及径线与胎儿体质量间均存在线性相关(r=0.574,r=0.603,P<0.001);但两组胎盘系数无明显差异(P>0.05)。组织学评估发现IFGR组胎盘中绒毛周围大量纤维蛋白沉积、慢性绒毛膜羊膜炎、绒毛发育迟缓、合体结节增多的发生率显著增高(P<0.05)。体视学测量发现IFGR组胎盘终末绒毛在每个镜下参考面积中的总个数明显多于正常对照组,终末绒毛平均面积及血管形成系数明显减低,差异均有统计学意义(P<0.05)。结论:IFGR时胎盘形态学和体视学特征均有改变,IFGR胎盘存在绒毛发育和胎儿-胎盘血管生成异常。