1353名学龄前儿童血液中部分矿物质含量调查分析

目的：调查金坛市学龄前儿童血中铁、铜、锌、钙和镁的含量，为进一步探讨矿物质含量与学龄前儿童智力和行为的关系提供基础资料。方法：调查城区、城郊结合部、乡镇3家幼儿园共1353名学龄前儿童，用原子吸收光谱仪进行全血铁、铜、锌、钙和镁的检测。结果：1353名学龄前儿童缺锌、缺钙和缺铁的比例较高，缺乏率分别为38．14％、34．29％和24．32％，铜和镁的缺乏率分别为0．67％和0．61％。结论：金坛市学龄前儿童矿物质缺乏的现象比较普遍，营养状况有待于进一步改善，矿物质与智力及行为的关系值得进一步研究。     

糖尿病母亲和新生儿血清瘦素水平及胎盘瘦素表达的研究

目的：比较正常和糖尿病母儿血瘦素水平及胎盘瘦素的表达。方法：采用放射免疫法测定21例糖尿病母儿和32例正常母儿血瘦素及胰岛素水平,应用逆转录多聚酶链反应（RT－PCR）技术检测胎盘瘦素mRNA表达。结果：糖尿病组母亲血清瘦素和胰岛素水平与正常对照组。糖尿病母亲胎盘瘦素mRNA表达显著高于正常对照组（P＜0．001）。结论：糖尿病母亲所生新生儿有较高的脐血瘦素水平,且糖尿病母亲胎盘瘦素表达水平高于正常对照,提示糖尿病母胎胎盘瘦素表达上调可能与巨大儿有关。     

孕妇体重预测巨大儿发生的临床价值

目的:分析孕妇体重预测巨大儿发生的临床价值。方法:选取2008年1~10月在常州市妇幼保健院进行产前检查并分娩巨大儿的260例孕妇和分娩正常体重儿的270例孕妇分别为研究组和对照组,对比并分析两组孕妇不同妊娠时期体重,建立预测巨大儿的ROC曲线,根据ROC曲线下面积比较孕妇不同妊娠时期体重预测巨大儿的能力。结果:不同妊娠时期孕妇体重的ROC曲线下面积及截断值分别为:孕前体重0.679,截断值55.0 kg;孕27周末体重0.720,截断值65.5 kg;分娩前体重0.730,截断值72.0 kg;孕中期增重0.611,截断值10.5 kg;孕晚期增重0.567,截断值6.5 kg;孕期总增重0.639,截断值17.5 kg。以孕27周末体重作为预测指标,当截断值取≥65.5 kg时,敏感度和特异度分别为66.15%和67.04%;以孕前体重作为预测指标,当取截断值为55.0 kg时,灵敏度和特异度分别为65.77%和65.56%。经多因素Logistic回归分析,控制混杂因素后,孕前体重≥55.0 kg的孕妇发生巨大儿的风险是孕前体重<55.0 kg孕妇的3.306倍(OR=3.306,95%CI:2.207~4.952);孕27周末体重≥65.5 kg的孕妇发生巨大儿的风险是孕27周末体重<65.5 kg孕妇的2.818倍(OR=2.818,95%CI:1.834~4.329)。结论:孕27周末体重可能是一个临床价值较好的预测指标,孕前体重也有一定的预测价值。为提高预测价值,可以结合孕前体重和孕27周末体重两个指标分两个阶段进行巨大儿预测。     

Maternal risk factors for low birth weight for term births in a developed region in China:a hospital-based study of 55,633 pregnancies

Low birth weight (LBW) is an important risk factor for neonatal and infant mortality and morbidity in adults..However,no large scale study on the prevalence of LBW and related maternal risk factors in China has been published.To explore the effects of maternal factors on LBW for term birth in China,we conducted a hospital-based retrospective study of 55,633 Chinese pregnancy cases between 2001 and 2008.Maternal sociodemographic data,history of infertility and contraceptive use were obtained.Their medical status and diseases during pre-pregnancy were examined by physical examination at the first antenatal care visit.Maternal medical status before childbirth and pregnancy outcomes,including body weight,infant gender,multiple pregnancy and congenital anomalies,were recorded.Univariate and multivariate logistic regression,and linear regression were used to investigate the relationship between maternal factors and term LBW.The general incidence of term LBW was 1.70% in the developed area of China.After preliminary analysis using the univariate model,low primary education,anemia,hypertensive disorders,placental previa,oligohydramnios and premature rupture of membrane were predicted as independent factors of term LBW in the multivariate model.Furthermore,the decrease in annual frquencies of these risk factors were major causes of gradual decline in the incidence of LBW (from 2.43% in 2001 to 1.21% in 2008).The study demonstrated that among maternal factors,primary education,anemia and hypertensive disorders could contribute to LBW for term birth even in the most developed area of China.     

Low-pass whole-genome sequencing in clinical cytogenetics: a validated approach

PurposeChromosomal microarray analysis is the gold standard for copy-number variant (CNV) detection in prenatal and postnatal diagnosis. We aimed to determine whether next-generation sequencing (NGS) technology could be an alternative method for CNV detection in routine clinical application.MethodsGenome-wide CNV analysis (>50 kb) was performed on a multicenter group of 570 patients using a low-coverage whole-genome sequencing pipeline. These samples were referred for chromosomal analysis; CNVs (i.e., pathogenic CNVs, pCNVs) were classified according to the American College of Medical Genetics and Genomics guidelines.ResultsOverall, a total of 198 abortuses, 37 stillbirths, 149 prenatal, and 186 postnatal samples were tested. Our approach yielded results in 549 samples (96.3%). In addition to 119 subjects with aneuploidies, 103 pCNVs (74 losses and 29 gains) were identified in 82 samples, giving diagnostic yields of 53.2% (95% confidence interval: 45.8, 60.5), 14.7% (5.0, 31.1), 28.5% (21.1, 36.6), and 30.1% (23.6, 37.3) in each group, respectively. Mosaicism was observed at a level as low as 25%.ConclusionsPatients with chromosomal diseases or microdeletion/microduplication syndromes were diagnosed using a high-resolution genome-wide method. Our study revealed the potential of NGS to facilitate genetic diagnoses that were not evident in the prenatal and postnatal groups.Genet Med 18 9, 940–948.     

What is the effect of regular group exercise on maternal psychological outcomes and common pregnancy complaints? An assessor blinded RCT

Objectiveto examine the effects of supervised group exercise on maternal psychological outcomes and commonly reported pregnancy complaints.Designan observer-blinded randomized controlled trial.SettingNorwegian School of Sport Sciences, Oslo, Norway.Participants105 sedentary, nulliparous pregnant women, mean age 30.7(±4.0) years, pre-pregnancy BMI 23.8 (±4.3), were assigned to either exercise (n=52) or control group (n= 53) at mean gestation week 17.7 (±4.2).Interventionthe exercise intervention followed ACOG guidelines and included a 60 minutes general fitness class, with 40 minutes of endurance training/aerobic and 20 minutes of strength training and stretching/relaxation, performed at least twice per week for a minimum of 12 weeks.Measurementsoutcome measures were assessed through standardized interviews pre- and post-intervention (gestation week 36.6, ±0.9), and included psychological variables related to quality of life, well-being, body image and pregnancy depression, as well as assessment of 13 commonly reported pregnancy complaints.Findingspost-intervention, using intention to treat (ITT) analysis, women randomized to exercise rated their health significantly better compared to women in the control group (p=0.02) and reported less fatigue related to everyday activities (p=0.04). Women with complete exercise adherence (≥24 sessions) had significantly better scores on measurements of feelings related to sadness, hopelessness and anxiety (p<0.01), compared to the control group. Contradictory, the control group reported higher life enjoyment (p<0.01). There were no significant group differences in body-image or pregnancy depression. With respect to analysing pregnancy complaints according to ITT, no differences between the groups were found. A comparison of the women who attended ≥19 (80%, n=21) or ≥24 (100%, n=14) exercise sessions with the control-participants, showed that fewer women in the exercise group reported nausea/vomiting and numbness/poor circulation in legs.Key conclusion and implication for practiseparticipation in regular group exercise during pregnancy contributed to improvements in some variables related to maternal well-being and quality of life. Women with high exercise adherence had significantly better results on several health variables reaping the highest benefits. A qualitative study exploring the barriers of women in achieving recommended amount of activity may be necessary to understand this population and developing better clinical practice educational tools.     

美国极低出生体质量儿坏死性小肠结肠炎管理指南

坏死性小肠结肠炎是引起新生儿尤其是早产儿死亡的重要疾病之一,存活者多留有后遗症。《极低出生体重儿坏死性小肠结肠炎管理指南》由美国新生儿坏死性小肠结肠炎工作小组于2005年7月制定,2010年10月重新修订完成。该指南以循证医学为基础,制定了极低出生体质量儿坏死性小肠结肠炎的预防、诊断及治疗规范,并提出了今后的研究方向。该指南对我国今后制定新生坏死性小肠结肠炎诊治常规有一定的参考作用。     

Application of ultra pulse CO2 lattice laser in the treatment of female urinary incontinence

BackgroundThis study aimed to explore the application of CO₂ lattice laser in the treatment of mild and moderate urinary incontinence in female patients.MethodsWe analyzed the clinical data of 33 female patients with mild to moderate urinary incontinence from a prospective cohort study, who were treated with FemiLift CO₂ lattice laser instrument (Alma Laser Ltd, Caesarea, Israel) at our hospital from January 2018 to December 2018. All the female patients were married and fertile, with a mean age of (43.15±6.49) years old (35–62 years old). There were 18 participants with mild urinary incontinence and 15 with moderate urinary incontinence. All participants received laser treatment 3 times, with an interval of 30 days. The International Consultation of Incontinence Questionnaire- Short Form (ICIQ-SF) survey was conducted before the treatment, 3 months after, and 6 months after the treatment. A 1-hour urine pad test was used to quantify the leakage of urine. Residual urine and urine routine examination were performed to exclude other combined diseases.ResultsAfter 3 times of treatment with FemiLift CO₂ laser, 13 cases were cured in 3 months, and 16 cases were cured in 6 months. 10 cases and 15 cases were significantly improved in 3 or 6 months, respectively. 2 patients had no significant changes, and no adverse reactions were recorded. The pad test showed that the symptom of all 33 patients were significantly improved, and the average scores of ICIQ-SF were significantly decreased (P<0.05) from 12.36 (Grade I) and 15.67 (Grade II) (5-21) before treatment to 3.73(Grade I) and 5.49 (Grade II) (1-12) after 6 months of therapy.ConclusionsThe CO₂ lattice laser is safe and effective in the treatment of mild and moderate urinary incontinences in female patients, which can effectively improve the symptom of urinary leakage without obvious adverse reactions.     

人源抗TROP2全分子抗体IgG的真核表达及对胰腺癌细胞增殖的抑制作用

目的:以人源抗TROP2抗体Fab基因为模板,构建人源抗TROP2全分子抗体IgG真核表达系统,观察人源抗TROP2全分子抗体IgG对胰腺癌细胞增殖的抑制作用?方法:分别扩增抗TROP2抗体的重链和轻链基因,构建人源抗TROP2全分子抗体IgG的重组表达载体pWS-anti-TROP2,转染CHO dhfr-细胞,加MTX筛选抗体表达量高的单克隆株,Protein G 亲和柱纯化,获得人源抗TROP2全分子抗体IgG?SDS-PAGE?Western blot?ELISA?免疫荧光和流式细胞术等方法鉴定人源抗TROP2全分子抗体IgG并分析其免疫学活性?MTT法分析人源抗TROP2全分子抗体IgG对胰腺癌细胞BxPC-3的增殖抑制作用?结果:成功构建了人源抗TROP2全分子抗体IgG的真核表达系统,表达并纯化人源抗TROP2全分子抗体IgG?经鉴定,抗体的轻链与重链大小与预期一致,可与TROP2蛋白特异性结合,效价可达1∶6 400?MTT检测结果表明,人源抗TROP2全分子抗体IgG对胰腺癌BxPC3细胞的增殖有明显的抑制作用,且呈时效?量效依赖关系?结论:本研究成功构建了人源抗TROP2全分子抗体IgG的真核表达系统,并证明此抗体可特异性识别胰腺癌细胞表面的TROP2蛋白,且对胰腺癌细胞的增殖有明显的抑制作用?