Pathogenesis of Brucella ovis in pregnant mice and protection induced by the candidate vaccine strain B. Ovis ΔabcBA

Ovine brucellosis caused by Brucella ovis is a major cause of reproductive failure in sheep. This study aimed to evaluate transplacental infection and pathogenicity of B. ovis wild type strain ATCC 25,840 (WT B. ovis) and the candidate vaccine strain B. ovis ΔabcBA in pregnant mice. A total of 40 BALB/c mice were equally divided into 4 groups: (i) non immunized and uninfected control mice (3/10 mice became pregnant); (ii) non immunized and challenged with WT B. ovis (5/10 pregnant); (iii) inoculated only with B. ovis ΔabcBA (6/10 pregnant); (iv) immunized with B. ovis ΔabcBA and challenged with WT B. ovis (5/10 pregnant). Female mice bred, and five days after visualization of the vaginal plug, they were inoculated intraperitoneally (ip) with 100 µL of sterile PBS, 100 µL of 1 × 10⁶ CFU of B. ovis ΔabcBA, or 100 µL of 1 × 10⁶ CFU of B. ovis WT, according to each group. At the 17th day of gestation, samples of spleen, liver, uterus, placenta, fetus and mammary gland were obtained for bacteriology, histopathology and immunohistochemistry. Non immunized mice challenged with B. ovis WT developed necrotizing placentitis as well as microgranulomas in the liver and spleen. These findings support the notion that B. ovis infection in pregnant mice induces lesions that are similar to those caused by B. abortus in the same animal model. B. ovis ΔabcBA was not recovered from any of the sampled organs, and it did not cause any gross or microscopic lesions, indicating that it is a safe and attenuated strain in this experimental model. In addition, B. ovis ΔabcBA was induced protective immunity as demonstrated by decreased numbers of B. ovis WT in the liver, uterus and fetuses of immunized mice after the challenge with B. ovis WT.     

地中海贫血孕妇ALP、AFU和甲状腺激素变化情况

目的探讨地中海贫血孕妇早期体内碱性磷酸酶(ALP)、α-L-岩藻糖苷酶(AFU)和甲状腺激素变化情况。方法选取2016年2月-2017年3月在该院产科建档并进行产检的地中海贫血早期孕妇281例,同时设置281例正常孕周为3个月孕妇作为对照组。采集空腹静脉血2 ml注入紫色EDTA-K2抗凝管中,完成血液检测;采集空腹静脉血4 ml,静止,分离血清,检测ALP、AFU、血清游离三碘甲状腺原氨酸(FT_3)、血清游离甲状腺激素(FT_4)和促甲状腺激素(TSH),PCR+反向斑点杂交法检测确认地中海贫血。结果对照组孕妇ALP和AFU水平高于地中海贫血孕妇(P<0.05);地中海贫血孕妇TSH高于对照组孕妇(P<0.05);地中海贫血孕妇FT3和FT4低于对照组孕妇(P<0.05)。结论地中海贫血孕妇早期ALP、AFU和甲状腺激素水平受到影响。     

胎盘早剥程度及母儿预后的临床危险因素

目的探讨胎盘早剥程度以及母儿预后的相关临床危险因素,以期改善母儿结局。方法收集2007年1月-2012年12月在该院住院确诊的167例胎盘早剥孕妇的临床资料,采用Logistic回归方法对年龄、产次、外伤、脐带情况、是否催产等影响胎盘早剥程度及母儿预后的高危因素进行单因素和多因素分析。结果 167例胎盘早剥孕妇中,胎盘早剥Ⅰ度91例(轻型组),Ⅱ度38例(中型组),Ⅲ度38例(重型组);单因素回归分析显示,重型组孕妇产次、产时出血量、输血量、子宫胎盘卒中率、新生儿窒息、死胎率与中、轻型组比较,差异有统计学意义(P<0.05)。多因素分析显示,产次、子宫胎盘卒中、休克及死胎是胎盘早剥的独立高危因素(P<0.05)。结论重视发生胎盘早剥的经产妇、休克及死胎孕妇,警惕重度胎盘早剥的发生。     

子宫肌瘤剔除术后妊娠的危险因素及妊娠者生育结局和孕产期相关并发症分析

目的分析探讨子宫肌瘤剔除术后妊娠的危险因素及妊娠者生育结局和孕产期相关并发症。方法选取南通大学附属海安人民医院于2012年3月-2016年6月期间收治的229例有生育要求的子宫肌瘤患者,所有患者均进行子宫肌瘤剔除手术。将其中153例不合并其他影响生育因素的患者划分为甲组,109例妊娠患者划分为乙组,分析影响甲组患者术后妊娠的因素,并研究乙组患者孕产期相关并发症和生育结局。结果影响患者术后妊娠的风险因素主要为患者年龄和术前不孕史(均P<0.05),肌瘤类型以及肌瘤大小、数目和手术方式等并不是影响患者术后妊娠的风险因素(均P>0.05)。术后妊娠患者有109例(47.6%),距离手术首次妊娠间隔时间平均为(21.3±12.9)个月,其中活胎例数为94例(86.2%),流产例数为14例(12.8%),剖宫产例数为1例(0.9%)。足月儿例数为85例(90.4%),早产儿例数9例(9.6%);其中剖宫产例数为75例(79.8%),分娩例数为19例(20.2%)。开腹子宫肌瘤剔除(TAM)、腹腔镜下子宫肌瘤剔除(LM)和宫腔镜下子宫肌瘤剔除(TCRM)3种不同术式患者的孕产期并发症发生率分别为7.0%、13.3%和14.3%,差异无统计学意义(χ~2=2.316,P>0.05)。结论影响子宫肌瘤患者剔除术后妊娠的主要风险因素为年龄和术前不孕史,因此临床上对于合并有不孕症的子宫肌瘤患者应及时进行剔除手术,以提高其妊娠率。     

3099例孕妇的孕期营养知识知晓情况及影响因素分析

目的了解孕妇的营养知识水平及其相关因素,为孕期营养教育提供科学依据。方法采用自行设计的一般情况调查表和孕期营养知识问卷对3 099例产检孕妇进行调查。结果孕期营养知晓率为73.73%。肥胖导致孕期糖尿病、体重指数、正常体重孕妇理想增重范围、早孕反应进食少是否会影响胎儿的生长发育等方面知晓率低,分别为39.98%、33.49%、49.34%、29.85%。本人户籍、本人教育程度、丈夫教育程度、家庭月收入、年龄、分娩史为孕期营养知识知晓率的相关因素。结论要针对不同文化程度、不同地域孕妇开展多种形式的营养知识教育,尤其针对文化程度低及初产妇实施个体化教育,宣传范围应扩展到孕妇的配偶及其他家庭成员,从而全面提高孕妇的孕期营养知识水平,形成正确的行为。     

Molecular epidemiology of invasive and non-invasive group B Streptococcus circulating in Serbia

Streptococcus agalactiae (group B Streptococcus, GBS) remains the leading cause of invasive diseases in neonates and an important cause of infections in the elderly. The aim of this study was to access the prevalence of GBS genito-rectal colonisation of pregnant women and to evaluate the genetic characteristics of invasive and non-invasive GBS isolates recovered throughout Serbia.A total of 432 GBS isolates were tested for antimicrobial susceptibility, capsular polysaccharide (CPS) types and the presence of the hvgA gene. One hundred one randomly selected isolates were further characterized by clustered regularly interspaced short palindromic repeats (CRISPRs) analysis and/or multilocus sequence typing (MLST).The prevalence of GBS colonization in pregnant women was 15%. Overall, six capsular types (Ia, Ib, II to V) were identified, the most common being III (32.2%) and V (25.2%). The hiper-virulent clone type III/ST17 was present in 43.1% and 6.3% (p?<?0.05) of paediatric and adults isolates, respectively. Comparative sequence analysis of the CRISPR1 spacers content indicated that a few clones comprised the vast majority of the tested GBS isolates. Thus, it was estimated that dominant clones recovered from infants were CPS III/ST17 in late-onset infections (19/23; 82.6%), and Ia/ST23 in early-onset disease (44.4%). Conversely, genotype CPS V/ST1 was the most prevalent in adults (4/9; 25.4%). All isolates were susceptible to penicillin. Macrolide resistance (23.1%) was strongly associated with the ermB gene and constitutive resistance to clindamycin (63.9%). The majority of strains was resistant to tetracycline (86.6%), mostly mediated by the tetM gene (87.7%). GBS isolates of CPS V/ST1 and CPS III/ST23 were significantly associated with macrolide and tetracycline resistance, respectively.In conclusion, hyper-virulent CPS III/ST17 and V/ST1 were recognized as dominant GBS clones in this study.     

沿海地区孕妇尿碘检测水平分析

目的调查本地区孕妇人群尿碘水平,指导孕妇合理适度补碘,提高新生儿出生质量。方法采用砷铈催化分光光度法进行尿碘水平的检测。结果在2189例孕妇标本中,调查对象尿碘水平中位数为143.1μg/L;尿碘水平低于适宜水平者1187例,占54.2%,高于适宜水平者313例,占14. 3%。孕早、中、晚期3组的孕妇尿碘中位数分别为141.8、144. 6、131.3μg/L,各孕期孕妇的尿碘水平差异无统计学意义(χ~2=0.941,P>0.05)。结论该地区虽属沿海地区,但近半数及以上的孕妇尿碘水平处于不足状态,孕妇尿碘水平总体偏低。     

2011-2017年孕妇生殖道无乳链球菌检出及其耐药性变化

目的了解某地区孕妇生殖道无乳链球菌的感染及其耐药状况,为临床诊断与治疗提供依据。方法收集2011年1月—2017年12月广东省人民医院产科病区及门诊孕妇送检的生殖道分泌物培养的结果,比较分析各年份无乳链球菌检出情况及耐药率变化趋势。结果共送检31 569份生殖道分泌物标本,检出病原菌1 940株,其中无乳链球菌591株,占30.46%。无乳链球菌在生殖道分泌物标本中的检出率为1.87%;2011—2017年无乳链球菌药敏结果中,未发现对青霉素、氨苄西林、奎奴普丁/达福普汀、利奈唑胺、替考拉宁、万古霉素耐药菌株;对环丙沙星、左氧氟沙星、克林霉素、红霉素的耐药率较高,分别为19.80%～28.97%、19.80%～28.95%、26.73%～39.29%、44.05%～66.34%;对四环素的耐药率最高,为80.37%～94.29%,但有逐年下降的趋势（P＜0.05）。结论无乳链球菌为孕妇生殖道感染的主要病原菌,分析其耐药性,合理、规范的使用抗菌药物,可减少孕妇及新生儿无乳链球菌感染的发生。     

孕期维生素D水平与母儿结局的相关研究进展

维生素D是人体重要的营养素,在妊娠女性中普遍缺乏,孕期维生素D缺乏与妊娠期糖尿病、子痫前期、妊娠丢失、早产、小于胎龄儿等多种不良母儿结局相关,众多研究试图通过补充维生素D来预防相关并发症。但由于研究人群和试验设计的不同,孕期维生素D水平与母儿结局的相关性以及补充维生素D是否可以改善相关结局,目前均无统一结论,本文将对此进行综述。     

孕妇丙型肝炎病毒感染影响因素的病例对照研究

目的了解孕妇人群丙型肝炎病毒(hepatitis C virus,HCV)感染的影响因素,为科学制定预防控制策略提供理论依据。方法采用1∶2配比的病例对照的研究方法,对甘肃省妇幼保健院2008-2018年兰州地区227例抗-HCV阳性的孕妇进行研究。采用条件logistic回归模型进行孕妇HCV感染影响因素的单因素及多因素分析。结果 2008-2018年甘肃省妇幼保健院产科孕妇抗-HCV阳性率为0.33%(227/69 620)。单因素条件logistic回归分析模型结果表明,产次[COR(95%CI)=1.539(1.088~2.177)]、输血史[COR(95%CI)=104.536 (14.458~755.83)]和侵入性器械诊疗[COR(95%CI)=2.222 (0.903~5.469)]是孕妇HCV感染的影响因素。多因素条件logistic回归模型分析结果显示,输血史[OR(95%CI)=98.296(13.578~711.597)]为孕妇感染HCV独有的危险因素。结论孕妇HCV感染的危险因素主要为输血史,应及时采取有效措施做好育龄妇女HCV感染预防控制工作。