胎儿纤连蛋白与早产和绒毛膜羊膜炎的关系

目的　探讨胎儿纤连蛋白 (FFN)与早产和绒毛膜羊炎膜之间的关系 ,为诊断早产和绒毛膜羊膜炎及判定预后提供新方法。方法　采用ELIAS(酶联免疫吸附法 )对 4 2例先兆早产孕妇 (实验组 )和同孕龄健康孕妇 4 8例 (对照组 )进行宫颈阴道分泌物FFN检测。结果　实验组FFN阳性率 4 5 .2 % (19/42 ) ,对照组FFN阳性率 4 .8% (2 /48) ,两组之间有显著性差异 ;实验组中FFN阳性者发生早产及绒毛膜羊膜炎者分别为 68.4 % (13/19)、73.6% (14/19) ,与FFN阴性者比较有显著性差异。结论　FFN对诊断早产和绒毛膜羊膜炎有重要参考价值 ,可为围产期保健提供重要监测手段     

Testicular sperm retrieval: What should we expect from the fresh and subsequent cryopreserved sperm injection?

We sought to compare ICSI outcomes of cycle using fresh versus thawed TESE spermatozoa obtained during the previous fresh TESE. All consecutive couples undergoing ICSI cycles using fresh TESE spermatozoa, followed by ICSI cycle using cryopreserved sperm remaining from the previous fresh TESE procedure were included. Ovarian stimulation (OS)/laboratory variables and cycle outcome were assessed and compared between those utilising fresh versus thawed TESE spermatozoa. Seventy-five couples were evaluated, with no in-between groups differences in OS nor embryological variables. While implantation and LBR per embryo transfer were nonsignificantly higher in the frozen as compared to the fresh TESE, there was a trend towards higher LBRs per patient in the frozen TESE group. The cumulative miscarriage rate (4% versus 14.7%, p < .022 respectively) was significantly lower and the cumulative LBR (34.7% versus 16%, p < .007 respectively) was significantly higher using frozen TESE spermatozoa. Moreover, significantly higher proportion of frozen TESE sperm samples used pentoxifylline to enhance sperm motility. In conclusion, the results of ICSI cycles using frozen TESE spermatozoa are as good, or even better than using fresh TESE spermatozoa. Further studies are required to explore the factors responsible for the improved ICSI outcome, while using frozen versus fresh TESE sperm samples.     

OHSS高风险全胚冷冻后FET时机对妊娠结局的影响

目的探讨OHSS高风险患者全胚冷冻后冻融胚胎移植(FET)的时机。方法回顾性分析2014年6月至2018年12月于西北妇女儿童医院生殖中心接受IVF/ICSI-ET治疗,因OHSS高风险而全胚冷冻的患者共2060例。根据取卵日距第1次FET日的时间长短分为两组:时间间隔≤40 d为立即FET组,共196例;时间间隔>40 d为延迟FET组,共1864例。对比分析两组间的妊娠结局及新生儿体重。结果两组间女方年龄、BMI、不孕类型及不孕年限、Gn总量、优质胚胎数、扳机日雌激素水平等基线资料的差异均无统计学意义(P>0.05);两组间胚胎种植率、临床妊娠率、流产率、活产率、早产率、单胎及双胎新生儿出生体重、异常出生体重发生率等指标差异均无统计学意义(P>0.05);Logistic回归分析显示,延迟FET对活产率、胚胎种植率、临床妊娠率、流产率无显著性影响(P>0.05)。调整影响妊娠结局的混杂因素,包括女方年龄、女方BMI、移植胚胎个数及移植胚胎类型后,延迟FET对活产率[OR=1.104,95%CI(0.813,1.502),P=0.536]、胚胎种植率[OR=0.907,95%CI(0.641,1.283),P=0.569]、临床妊娠率[OR=0.892,95%CI(0.634,1.275),P=0.529]、流产率[OR=0.924,95%CI(0.575,1.496),P=0.750]的影响仍不显著。两组新生儿出生体重及异常体重新生儿的发生率间差异无统计学意义(P>0.05)。结论因OHSS高风险而全胚冷冻患者,取卵术后首次月经来潮即可开始准备内膜进行FET,延迟FET并不能改善妊娠结局。     

Construction and evaluation of a pertactin-deficient live attenuated pertussis vaccine candidate BPZE1 derivative

Pertussis, mainly caused by Bordetella pertussis, is a severe respiratory disease that can be fatal, especially in young infants. Vaccines, massively implemented since the middle of the last century, have substantially reduced the pertussis incidence, but have not been able to fully control the disease. One of the shortcomings of current pertussis vaccines is their inability to prevent infection by and transmission of B. pertussis, in contrast to immunity following natural infection. We have developed the live attenuated nasal vaccine BPZE1 and have shown that it prevents both disease and B. pertussis infection in preclinical models. This vaccine is now in clinical development. However, the initial clinical studies have suggested that vaccine take is hampered by pre-existing antibodies to pertactin. Here, we have constructed a pertactin-deficient BPZE1 derivative called BPZE1P in order to overcome this limitation. BPZE1P colonized the murine respiratory tract as efficiently as BPZE1 and induced antibodies at levels similar to those elicited by BPZE1. In the presence of pre-existing antibodies induced by acellular pertussis vaccination, BPZE1P colonized the mouse respiratory tract more efficiently than BPZE1. Both vaccines protected equally well the murine lungs and noses from challenge with laboratory and clinical strains of B. pertussis, including pertactin-deficient strains, against which current acellular pertussis vaccines are less efficient. BPZE1P may thus be an interesting alternative to BPZE1 to overcome vaccine take limitations due to pre-existing antibodies to pertactin.     

云南省农村地区早产及其影响因素研究

目的 基于云南省国家免费孕前优生健康检查项目大数据,探索云南省农村地区早产发生情况及影响因素,为早产防治提供科学依据。方法 对2010—2019年十年间云南省参加免费孕前优生健康检查且随访结局为活产的278 760对夫妇进行早产率分布及影响因素logistic回归分析。结果 云南省农村地区早产率为4.49%,年龄越大、文化程度越低、经济水平越差的早产率越高并呈现逐年增高趋势,高龄妊娠、小学及以下文化、少数民族、深度贫困、厌食蔬菜、饮酒、贫血、高血压、风疹病毒IgG阴性、偏瘦、肥胖均是早产危险因素,服用叶酸是保护因素。结论 强化贫困地区、少数民族地区健康教育,孕前控制血压、治疗贫血,孕期合理膳食控制体重、增补叶酸、戒烟戒酒改变不良生活方式可以有效预防早产发生。     

新生儿体重与优生─附13140例分析

回顾性分析了１２年来１３１４０例新生儿体重及相关因素。新生儿初生体重由１９８２年的３０５０±５７６ｇ上升至１９９３年的３３１７±４２９ｇ。低体重儿发生率由６．４％降至２．９％。大胎儿的发生率由１７．８％升至３１．８％。大胎儿剖宫产率、产后出血、新生儿窒息及第二产程延长的发生率均明显高于正常体重儿。提出预防低体重儿和大胎儿并重的原则。     

Do children with autism have March birthdays?

One hundred people with autistic disorder (DSM-III-R) without a known cause who comprised a total population of children with autism were compared with "autistic-like" children, Asperger syndrome and age-matched comparison children from the general population and were examined with regard to month of birth. There was an excess of March birth in the group of children with autism. The possible reasons for this finding are discussed.     

神经移植端侧缝合颈5/7神经根与上干桥接治疗产瘫

目的：探讨一种不影响残存神经自行恢复的产瘫臂丛神经修复新方法。方法：将上干损伤部位行松解,不切除神经瘤,将其近端的颈5或颈7神经根和神经瘤远端的臂丛上干的神经束膜切开窗口,取颈丛皮支或前臂外侧皮神经前成多段（一般每段长约2．0－2．5cm）,两端分别与颈5神经根和上干的神经束膜行端侧缝合,结果：8例患儿经术后1－11年（平均3年）的随访,4例的三角肌和肱二头肌骨力达4级和4^-级,4例达3例。3例后期进行了肩关节松解和旋前圆肌肌腱切断,结论：该方法既提供了可使损伤近端颈5神经根的新生纤维生长至上干的神经通道,又未阻断神经瘤内残存神经纤维的自行恢复,是治疗产瘫特别是Tassin2型的新术式。