Effect of glucocorticoid treatment on insulin like growth factor-Ⅰ and its binding proteins in children with nephrotic syndrome

Objective To identify the changes in serum insulin like growth factor-Ⅰ (IGF-Ⅰ) and IGF binding proteins (IGFBPs) in children with nephrotic syndrome (NS) and the effect of glucocorticoid on serum IGF-Ⅰ and IGFBPs. Methods We measured serum IGF-Ⅰ and IGFBPs levels by radioimmune assay and immune radiomagnetic assay in 36 children with NS, consisting of an active stage group (ANS, n=12), a remission stage group (RE, n=12), an active stage group with glucocorticoid treatment (GNS, n=12), and a normal control group (NC, n=10). Results 1) Compared to NC, serum levels of IGF-Ⅰ and IGFBP-3 were decreased (P<0.01); serum levels of IGFBP-1 and IGFBP-2 were increased (P<0.01) in the ANS group. 2) Serum levels of IGF-Ⅰ and IGFBP-3 were higher and IGFBP-1 and IGFBP-2 were lower in the RE Group than in theANS Group (P<0.01). 3) Compared to the ANS group, serum levels of IGF-Ⅰ and IGFBP-3 were increased (P<0.01) and serum levels of IGFBP-1 and IGFBP-2 were decreased (P<0.01) in the GNS group. 4) A correlation was found between serum levels of IGFBP-3 and albumin in the active stage group (r=0.76 P<0.01). There was also a correlation between serum levels of IGF-Ⅰ and IGFBP-3 and an inverse correlation between the serum level of IGF-Ⅰ and serum levels of IGFBP-1 and IGFBP-2 in the ANS group. No other correlations were observed.Conclusions The serum levels of IGF-Ⅰ and IGFBPs are altered in children in the active stage of NS, but return to normal in the remission stage. GC treatment may influence serum IGF-Ⅰ and IGFBPs in children with NS. Changes in IGF-Ⅰ and IGFBPs levels may play a role in the growth retardation of NS children.     

Comparison of second-trimester maternal serum free-p-human chorionic gonadotropin and a-fetoprotein between normal singleton and twin pregnancies： a population-based study

Background The second-trimester maternal serum screening in twin pregnancy is still controversial, as the serum marker levels in twins are not as clear as those in singletons. This study aimed to evaluate the relationship between the levels of the second-trimester maternal serum free β-human chorionic gonadotropin （free β-HCG） and a-fetoprotein （AFP） in normal twin and singleton pregnancies and to estimate feasible analysis methods for utilizing these markers in second trimester screening for twin pregnancy. Methods On the basis of a prospective population-based study of second-trimester maternal serum screening, the concentrations of maternal serum AFP and free β-HCG of 195 normal twin pregnancy and 26 512 singleton controls at gestational weeks 15 to 20 were measured by time-resolved fluoroimmunoassay in one laboratory. The levels of markers were compared between the twins and singletons using weight-correction and gestational age-specific model. Results According to the research protocol, 95 communities were randomly sampled, which covered the whole Jiangsu province, the east of China. A total of 26 803 pregnant women （98%）, from the target population accepted prenatal screening for maternal serum AFP, β-HCG detection, and all babies were followed up for at least six months. There were 197 （0.73%） twin pregnancies, of which one case had fetal trisomy 18, and one case with fetal anencephaly. The others were normal twin pregnancy. From a total enrollment of 26 803 women participants, 26 512 women with normal singleton pregnancies were selected as the model controls. The other 291 pregnancies, including trisomy 21, neural tube defect （NTD）, trisomy 18, and other fetal abnormalities, were excluded. No significant differences were found in the medians of gestational age-specific maternal serum free β-hCG and AFP in normal twin pregnancy comparing with twice those in model controls with the exception of the medians for free β-hCG during the 16th gestational week （P=0.012）. Conclusion The weight-correction and gestational age-specific levels of Chinese Han population maternal serum free β-hCG and AFP in normal twins were twice the levels as those in the singleton controls during the 17-19 gestational weeks.     

Effect of Bushen Yiqi Huoxue recipe on placental vasculature in pregnant rats with fetal growth restriction induced by passive smoking

Interactions of vascular endothelial growth factor (VEGF) with receptors VEGFR1/Flt1 and VEGFR2/Flk1, and those of angiopoietins (Ang-1, Ang-2) with receptor Tie2 play important roles in placental angiogenesis. This study investigated vascular morphology and expression of these angiogenic factors in rat placenta on the day 15, 18, 21 of gestation (D15, D18 and D21). The rats were randomly assigned into 3 groups: normal group, model group [fetal growth restriction (FGR) model], and Bushen Yiqi Huoxue (BYHR) recipe treatment group (BYHR group, the pregnant rats with FGR were treated with BYHR recipe). Morphological analysis indicated that during initial villous formation, fetal nucleated erythrocytes (FNEs) appeared in maternal blood sinus (MBS). Subsequently, FNEs were surrounded by endothelial cells to form fetal capillary (FC) and then by trophoblast cells to form villi. As pregnancy proceeded, FC density increased progressively with increasing endothelial identification staining (EIS) in normal and BYHR groups. Whereas, villous formation was suppressed, normal increase in FC density was impaired and EIS was weakened in model group. Quantitative PCR analysis showed that VEGF and Flk1 mRNA increased over gestation in all groups, indicating that VEGF might play a pivotal role in FC growth during late gestation. VEGF mRNA was increased on D15, while decreased on D21 in model group as compared with normal group and BYHR group. Immunohistochemically, Ang-2 protein was highly expressed in FNEs, gradually disappeared as villi matured, and decreased over gestation in all groups, indicating that Ang-2 might play a pivotal role in villous formation, which was further supported by decreased Ang-2 mRNA and protein expression in model group on D15. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio increased from D15 to D18 in all groups as placenta matured. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio were decreased on D18 in model group as compared with normal and BYHR groups, indicating delayed maturity of FGR placenta. Alterations in angiogenic factors may result in altered placental vasculature and cause placental insufficiency. BYHR recipe could balance the angiogenic factors to promote the formation and maturation of FGR placental vasculature.     

Comparison of second-trimester maternal serum free-β-human chorionic gonadotropin and α-fetoprotein between normal singleton and twin pregnancies: a population-based study

Background  The second-trimester maternal serum screening in twin pregnancy is still controversial, as the serum marker levels in twins are not as clear as those in singletons. This study aimed to evaluate the relationship between the levels of the second-trimester maternal serum free β-human chorionic gonadotropin (free β-HCG) and α-fetoprotein (AFP) in normal twin and singleton pregnancies and to estimate feasible analysis methods for utilizing these markers in second trimester screening for twin pregnancy.
Methods  On the basis of a prospective population-based study of second-trimester maternal serum screening, the concentrations of maternal serum AFP and free β-HCG of 195 normal twin pregnancy and 26 512 singleton controls at gestational weeks 15 to 20 were measured by time-resolved fluoroimmunoassay in one laboratory. The levels of markers were compared between the twins and singletons using weight-correction and gestational age-specific model.
Results  According to the research protocol, 95 communities were randomly sampled, which covered the whole Jiangsu province, the east of China. A total of 26 803 pregnant women (98%), from the target population accepted prenatal screening for maternal serum AFP, β-HCG detection, and all babies were followed up for at least six months. There were 197 (0.73%) twin pregnancies, of which one case had fetal trisomy 18, and one case with fetal anencephaly. The others were normal twin pregnancy. From a total enrollment of 26 803 women participants, 26 512 women with normal singleton pregnancies were selected as the model controls. The other 291 pregnancies, including trisomy 21, neural tube defect (NTD), trisomy 18, and other fetal abnormalities, were excluded. No significant differences were found in the medians of gestational age-specific maternal serum free β-hCG and AFP in normal twin pregnancy comparing with twice those in model controls with the exception of the medians for free β-hCG during the 16th gestational week (P=0.012).
Conclusion  The weight-correction and gestational age-specific levels of Chinese Han population maternal serum free β-hCG and AFP in normal twins were twice the levels as those in the singleton controls during the 17–19 gestational weeks.

     

An epidemiological survey on neonatal jaundice in China

Objective　To provide epidemiological data for revising the diagnostic criteria of neonatal hyperbilirubinemia in China. Methods　A survey was performed among full-term infants in multiple centers throughout the country. From less than 24 hours after birth, the infants’ bilirubin levels were measured every day until the peak level fell to less than 68.4 μmol/L. Auditory brainstem responses were assessed in 56 infants randomly chosen from those with serum bilirubin levels of higher than 220.5 μmol/L. Results　Jaundice in most infants was detected at 2-3 days after birth. The bilirubin level usually reached a peak level of 204±54.69 μmol/L at 5 days after birth and then fell. Among the 875 infants, the serum bilirubin levels in 34.4% of neonates were higher than 220.5 μmol/L. The mean serum bilirubin level of the infants during the first week after birth varied with geography (P<0.001) and season (P<0.001). The serum bilirubin level was significantly associated with gestation age (P<0.01), delivery method (P<0.01), weight loss (P<0.001), and PCV elevation (P<0.001) during the first three days after birth. Conclusions　The start time of neonatal jaundice was similar to that reported elsewhere, but the mean peak level in our study was higher than the reported. It is suggested that the diagnostic criteria for neonatal hyperbilirubinemia in China should be strict.     

Relationship between serum antisperm antibodies and anticardiolipin antibodies and clinical pregnancy outcome in an in vitro fertilization and embryo transfer program

Objective　To study the influence of maternal immunological factors on clinical pregnancy outcome in an in vitro fertilization and embryo transfer (IVF-ET) program. Methods　One hundred and fifty IVF-ET treatment cycles from November 1995 to November 1996 were studied. The indication for IVF-ET treatment was bilateral blocked tubes. Serum antisperm antibodies and anticardiolipin antibodies were measured using enzyme-linked immunosorbent assay (ELISA). Cleavage rate and successful pregnancy rate in relation to antibody status of infertile women after IVF-ET treatment were assessed. Results　Lower cleavage rate (64.2%±32.1%) was found in 44 cycles of antisperm antibody seropositive women, compared with 84.8%±18.7% in 106 cycles of seronegative women (P<0.05). The clinical pregnancy rate was 31.8% in antisperm antibody-positive cycles and 20.8% in negative cycles (P>0.05). The abortion rates of the two groups were similar (P>0.05). Lower pregnancy rate (9.5%) was found in 21 cycles of serum anticardiolipin antibody-positive group, compared with 26.3% in 129 cycles of seronegative women (P<0.05). Of patients with bio-chemical pregnancy and no pregnancy, 20.0% and 16.2%, respectively, had seropositive anticardiolipin antibody, compared with 5.6% of patients with clinical pregnancy (P<0.05). Conclusion　Serum immunological factors may play a part in clinical pregnancy outcome in IVF-ET.     

Expression of Lung Surfactant Proteins SP-B and SP-C and Their Modulating Factors in Fetal Lung of FGR Rats

This study investigated the expression of lung surfactant proteins SP-B and SP-C, and their modulating factors TTF-1 and PLAGL2 in the fetal lung of rats with fetal growth restriction(FGR). The rat FGR model was established by prenatal hypoxia in the first stage of pregnancy, 180 rats for experiment served as hypoxia group, and 197 healthy rats served as normal control group. The FGR incidence in hypoxia was compared with that in normal control group. The histological changes in the fetal lung were observed under the light microscope and electronic microscope in two groups. The SP-B, SP-C, TTF-1 and PLAGL2 proteins were determined in the fetal lung of two groups immunohistochemically. The expression levels of SP-B, SP-C, TTF-1 and PLAGL2 protein and m RNA in the fetal lung of two groups were detected by using Western blotting and RT-PCR respectively. The FGR rat model was successfully established by using hypoxia. Pathologically the fetal lung developed slowly, and the expression levels of SP-B, SP-C, TTF-1 and PLAGL2 protein and mR NA in the fetal lung were significantly reduced in hypoxia group as compared with those in normal control group. It was suggested that maternal hypoxia in the first stage of pregnancy could induce FGR, and reduce the expression of SP-B and SP-C, resulting in the disorder of fetal lung development and maturation.     

A study on the serum pregnancy zone protein levels in pregnant women and patients with gynecological tumors.

In this study, the serum levels of the pregnancy zone protein (PZP) were determined by PZP-single radial immunodiffusion in 708 cases of normal pregnancy, 207 with abormal pregnancy and 188 with gynecological tumors. The results indicated that serum PZP levels in the normal pregnancy was detectable 5 weeks after gestation. It increased with the advance of gestational weeks, and reached a peak level in week 40. The serum PZP levels in 81.7% of patients with threatened abortion but not aborted were within the normal range, and also mostly in those with pregnancy-nduced hypertension, intrauterine growth retardation (IUGR), anencepbalus and ectopic pregnancy; the serum PZP levels in 51.6% of patients with invasive moles and 80.0% with choriocarcinoma, respectively, were lower than in normal controls. In gynaecological tumors, the serum PZP levels were significantly higher in patients with ovarian carcinomas than in those with other ovarian tumors (P<0.01), and in those with endometrial or cervical carcinoma     

Effect of zinc intake on fetal and infant growth among Chinese pregnant and lactating women

The relationship between maternal nutrient intake and fetal size or infant growth was studied in 1956 pregnant women,599 Parturients and 1043 lactating women,318 non-pregnant women included as controls,The study was conducted in eight regions that were representative of all geograthical areas of China,The diet was comprised primarily of cereal products with 70% to 85% of the zinc intake derived from plant sources.Women in the third trimester of pregnancy,parturients and lactating women consumed more food than non-pregnant women or women in the first two trimesters of pregnancy.Total energy,protein and iron intakes met the recommended allowances for each stage of reproduction,Calcium and zinc intakes,howerver,were 50% and 47% of the amount recommended.respectively.Only 7.2% of the women exceeded two-thirds of the recommended zinc intake.The mean intake of zinc was 6.5mg to 9.0mg each day among all the subjects.Correlation and stepwise regression analysis shoed that maternal zine intake was a predictor factor for fetal dimensions and birthweight.The results of this study show that fetal growth and birthweight are directly related to maternal zine intake among Chinese women,and that there is no relationship between maternal zinc intake during lactation and infant height,Weight,or weight gain from birth.     

生长激素-胰岛素样生长因子-Ⅰ轴在正常妊娠中的作用

目的　探讨生长激素、胰岛素样生长因子 Ⅰ在正常妊娠中的作用。方法　采用酶联免疫吸附法和放免法测定 116例正常孕期不同孕周孕妇母血中IGF Ⅰ和GH水平 ,同期 2 0例正常非孕妇女作为对照。结果　GH水平随孕周增加而逐渐升高 ,至孕 2 5周后达高峰 ,并持续在较高水平 (χ2 =4 0 4 5 8,P <0 0 0 0 1) ,早孕(5周～ )组较非孕组GH水平增高 ,分别为 3 4 5 μg/L和 1 61μg/L ,差异有显著性(P <0 0 5 ) ;IGF Ⅰ水平自孕 2 9周后随孕周迅速上升 ,至足月达高峰为 188 86μg/L(χ2 =5 0 2 2 4 ,P <0 0 0 0 1)。结论　母体GH水平随孕周而增加 ,正是符合胎儿生长的规律 ,母体GH可能在调节母体、胎盘和胎儿间的营养供应及胎盘对营养物质的转运中起着重要作用 ,母体IGF Ⅰ水平在孕晚期随孕周增加而升高 ,推测孕晚期母体高水平的IGF Ⅰ可能参与促进胎儿生长和胎盘成熟的过程。     

Insulin-like growth factors-I and -II and insulin-like growth factor binding protein-1 during normal pregnancy: pattern of secretion and correlation with other placental hormones

OBJECTIVES: To describe pattern of secretion of insulin-like growth factor (IGF)-I, IGF-II, IGF binding protein (IGFBP)-1 and their correlation with each other and major placental hormones during normal pregnancy. DESIGN: Longitudinal study. SETTING: Academic Institutions and a Tertiary Care Maternity Hospital. PARTICIPANTS: Healthy women with singleton uncomplicated pregnancies (N = 35). MEASUREMENTS: Serum levels of IGF-I, IGF-II, IGFBP-1, chorionic gonadotrophin (HCG), placental lactogen (HPL), prolactin, oestradiol and progesterone were studied thrice during the antenatal period and within 24 h of delivery. RESULTS: IGF-I, IGFBP-1, HPL, prolactin, oestradiol and progesterone increased and HCG decreased significantly with advancing gestation (Repeated measures ANOVA: P < 0.01 to 0.0001). IGF-II levels were not significantly affected by period of gestation. Significant negative correlations (multiple regression analysis) were seen between IGFBP-1 and prolactin at 28 +/- 2 (P = 0.0226) and 36 +/- 2 (P = 0.0417) weeks of amenorrhoea (WOA) and between oestradiol and IGF-II at 36 +/- 2 WOA (P = 0.037). Prolactin and IGF-I at 14 +/- 2 WOA (P = 0.0225) and progesterone and IGFBP-1 at 28 +/- 2 WOA (P = 0.0216) correlated positively. CONCLUSIONS: Maternal IGF-I and IGFBP-1 but not IGF-II significantly increase as pregnancy advances. Components of the IGF system regulate or are affected by some of the placental hormones and the effects vary with the period of gestation.     

胰岛素样生长因子—I及胰岛素样生长因子结合蛋白—3与 …

目的 检测孕妇静脉血、脐血中胰岛素样生长因子－Ｉ（ＩＧＦ－Ｉ）及胰岛素样生长因子结合蛋白－３（ＩＧＦＢＰ－３）水平,探讨ＩＧＦ－Ｉ、ＩＧＦＢＰ－３与胎儿宫内发育的关系。方法 采用美国ＤＳＬ公司试剂盒。总计８１例孕妇,其中正常孕妇３８例,妊娠糖尿病孕妇２０例,正常妊娠分娩巨大儿孕妇２３例,采用放射免疫方法测定。结果 正常组及巨大儿组孕妇静脉血ＩＧＦ－Ｉ与新生儿体重呈正相关（ｒ＝０．６５３,ｒ＝０．６     

母血、羊水中胰岛素样生长因子测定及羊膜腔内给药早期诊治胎儿生长

目的探讨胰岛素样生长网子（IGFs）与胎儿生长受限（FGR）的关系以及眙儿生长受限早期治疗的方法。方法挑选FGR孕妇44例和正常孕妇36例，抽取中、晚期母血及羊膜腔穿刺术抽取羊水检测IGF—Ⅰ、IGF-Ⅱ水平。同时将44名FGR孕妇随机分为治疗组和对照组，FGR治疗组行羊膜腔内输注小儿氨基酸治疗，而FGR对照组采用孕妇静脉滴注复方氨基酸治疗．并运用多参数B超比较其疗效。结果（1）FGR孕妇母血中IGF—Ⅰ水平、羊水中IGF—Ⅰ、IGF-Ⅱ水平显著低于同期正常孕妇（P〈0．01），而两组孕妇母血中IGF-Ⅱ水平无显著性差异（P〉0．05）。（2）经治疗后，FGR治疗组羊水中IGF—Ⅰ、IGF-Ⅱ水平显著升高（P〈0．01），母血IGF—Ⅰ水平也明显升高（P〈0．01）；而FGR对照组IGF水平无明显改变（P〉0．05）。（3）FGR治疗组羊水中IGF—Ⅰ、IGF-Ⅱ水平，母血IGF-Ⅰ水平较FGR对照组显著升高（P〈0．01）；FGR治疗组孕妇宫高、腹围，胎儿双顶径．股骨长度净增长值及新生儿出生体重均显著高于对照组（P〈0．01），且治疗组胎儿出生体重接近正常水平。结论检测母血IGF—Ⅰ及羊水中IGF—Ⅰ、IGF-Ⅱ水平可早期诊断FGR及监测胎儿宫内生长。羊膜腔内输注小儿氨基酸是治疗FGR的有效方法。     

胰岛素样生长因子与胎儿宫内生长受限的相关性研究

目的探讨胰岛素样生长因子（IGF）与胎儿生长发育的关系。方法抽取20例分娩宫内生长受限（IUGR）胎儿（IUGR组）及25例分娩正常儿（对照组）产妇肘静脉血、新生儿脐静脉血及羊水和胎盘组织,采用放射免疫法及免疫放射法分别测定其IGF-Ⅰ、IGF-Ⅱ水平和RT-PCR法检测胎盘组织中mRNA含量。结果IU-GR组产妇血清IGF-Ⅰ水平低于对照组,IGF-Ⅱ水平差异无统计学意义;IUGR组脐血及羊水中IGF-Ⅰ、IGF-Ⅱ水平较对照组显著降低;IGF-Ⅰ、IGF-Ⅱ的mRNA水平较正常对照组低。结论检测母血及羊水中IGF-Ⅰ、IGF-Ⅱ水平可监测胎儿生长发育,早期诊断IUGR,IGF与IUGR的发病密切相关。     

Maternal and cord blood levels of insulin-like growth factors--I and--II and insulin-like growth factor binding protein-1: correlation with birth weight and maternal anthropometric indices

OBJECTIVES: To study the correlation of maternal and cord blood insulin like growth factor (IGF)-I and -II and IGF binding protein (IGFBP)-1 levels with birth weight and maternal anthropometric indices. DESIGN: Longitudinal prospective study. SETTING: Academic Institutions and a Tertiary Care Maternity Hospital. PARTICIPANTS: Women with uncomplicated singleton pregnancy (N = 35) and their newborns. MEASUREMENTS: Maternal weight, height, symphysiofundal height and serum levels of IGF-I, IGF-II, IGFBP-1 were measured thrice during the antenatal period, within 24 h of delivery and at 6 weeks and 6 months postpartum. Newborn anthropometric indices were recorded at birth, and at 6 weeks and 6 months of age. Cord blood levels of IGF-1, IGF-II, IGFBP-1, paternal height and weight, and placental weight measured. RESULTS: Maternal and cord blood IGF-I levels were lower than values reported for Caucasians. All newborns showed adequate growth at birth, and up to 6 months of age. Cord blood IGF-1 positively correlated with chest circumference (r = 0.4532, P = 0.0262), IGFBP-1, negatively with birth weight (r = -0.4024, P = 0.0461) and IGF-II had no effect. Cord blood IGF-I positively correlated with maternal levels at 28 +/- 2 (r = 0.4571, P = 0.0247) and 36 +/- 2 (r = 0.4291, P = 0.0364) weeks of amenorrhoea, whereas IGF-II and IGFBP-1 did not correlate with maternal values. Maternal IGF-I, IGF-II and IGFBP-1 did not correlate with newborn or maternal anthropometric indices. Placental weight correlated significantly with birth weight (r = 0.5299, P = 0.0348) and head circumference (r = 0.5031, P = 0.0470). CONCLUSIONS: Cord blood IGFBP-1 and placental weight appear to be determinants of birth weight variation even among appropriately grown for gestational age newborns.     

妊娠晚期母鼠脱水对胎鼠及成年子代肾素血管紧张素系统功能的影响及其“印迹”效应

目的研究妊娠晚期母鼠脱水对胎鼠及成年子代大鼠体内肾素血管紧张素系统（RAS）功能的影响及其＂印迹＂效应。方法妊娠母鼠分成对照组及脱水组,脱水组于妊娠晚期脱水3d,分别称量两组胎鼠心脏、肾脏、胎盘及胎体的干、湿质量,并测量胎鼠体长及尾长等形态学指标;放射免疫法检测两组胎鼠、成年子代血液中血管紧张素Ⅱ（AngⅡ）浓度;实时PCR方法检测胎鼠、成年子代鼠肝脏中血管紧张素原（ATG）mRNA水平及成年子代大鼠心血管系统对AngⅡ的应答。结果妊娠晚期母鼠脱水3d后,胎鼠心脏、肾脏及胎体的干、湿质量与对照组相比均明显降低（P〈0.05）,且心脏与胎体、肾脏与胎体的干质量比也明显减少（P〈0.05）;胎鼠体长及尾长明显减少（P〈0.05）,但胎盘干、湿质量与对照组比较无明显差异（P〉0.05）;脱水组胎鼠血液中AngⅡ的浓度明显增加,胎鼠及成年子代肝脏中ATGmRNA水平明显升高,其雄性成年子代大鼠对AngⅡ反应明显增强,与对照组比较均差异明显（均P〈0.05）。结论妊娠晚期脱水可影响胎鼠的心、肾及胎鼠的生长发育,并可引起其成年子代RAS系统的改变,可能与胎源性疾病的＂印迹＂效应有关。     

阻塞性黄疸患者生长激素/胰岛素样生长因子-Ⅰ轴变化的研究

目的　探讨阻塞性黄疸患者生长激素/胰岛素样生长因子-Ⅰ轴的变化及其临床意义。方法　对60例男性阻塞性黄疸患者（阻黄组）围手术期血浆生长激素、生长激素结合蛋白、胰岛素样生长因子,内毒素、肝功能及前白蛋白水平进行观察,并与40例男性单纯性胆囊结石患者（对照组）进行比较。结果　生长激素、生长激素结合蛋白、胰岛素样生长因子-Ⅰ在阻黄组分别为7.4μg/L±3.6μg/L、9.1±2.3B/T*100、49.8mg/L±6.6mg/L,较对照组（13.9μg/L±5.7μg/L、13.3±1.6B/T*100、61.4mg/L±6.5mg/L显著降低,差异有显著意义(P<0.01),并与黄疸程度,前白蛋白、内毒素水平相关(P<0.01)。结论　阻塞性黄疸患者生长激素/胰岛素样生长因子-Ⅰ轴存在明显下调。其原因可能与营养障碍、内毒素血症引起的生长激素受体表达受抑有关,并可进一步加重营养障碍和内毒素血症,是介导阻塞性黄疸病理生理改变的重要因素。     

围生期宫内生长迟缓胎鼠的发育及其肝胰岛素信号转导蛋白的表达

目的:研究大鼠妊娠期营养不良对围生期胎鼠肝胰岛素信号转导蛋白表达的影响.方法:饥饿组雌性大鼠受孕后第1天控制进食鼍为对照组的50%至分娩,从而建立宫内生长迟缓(intrauterine growth retardation,IUGR)大鼠模型.于雌性大鼠妊娠第15、17、19、21天(E15、E17、E19、E21)取胎,称量胎鼠体重,胎盘、胎鼠肝、脑的重量,计算胎盘重/体重(placenta weight/body weight ratio,PWR)、肝重/体重(liver weight/body weight ratio,LWR),脑重/体重(brain weight/body weight ratio,BWR)的比值;RT-PCR检测E15,E17,E19,E21及生后第1天(P1)新生大鼠肝胰岛素受体(insulin receptor,IR)、胰岛素受体底物-1(insulin receptor substrate-1,IRS-1)、胰岛素受体底物-2(insulin receptor substrate-2,IRS-2)、磷脂酰肌醇3激酶(phosphatidyl inositol 3-kinase,PI3K)mRNA的表达.结果:(1)IUGR胎鼠E15时PWR低于对照组,E17后PWR逐渐增加(P<0.05);IUGR组E15胎鼠的LWR值与对照组相比,差异无统计学意义,E17～E21则明显下降(P<0.05);IUGR胎鼠平均BWR水平高于对照组(P<0.05);(2)IUGR胎鼠肝IRS-1 mRNA的表达在E15、E17与对照相似,E19则下降(P<0.05),并持续低表达至P1(P<0.05);E15 IUGR胎鼠肝IRS-2 mRNA的表达已显著减少,并持续到P1(P<0.05);围生期IUGR胎鼠肝IR mRNA,PI3KmRNA的表达与对照组相近(P0.05).结论:(1)雌性大鼠妊娠期饥饿致胎盘、胎鼠体重、肝、脑组织重量下降,以体重和肝为著,使肝重与体重比值下降而脑重与体重的比值增加,即"脑保护效应";(2)雌性大鼠妊娠期营养不良仔大鼠围生期肝胰岛素信号转导蛋白IR mRNA、PI3K mRNA的表达尚未明显受损;但IRS-1 mRNA和IRS-2mRNA呈低水平表达,可能与其生长迟缓及成年期胰岛素抵抗有关.     

胎盘生长因子及可溶性血管内皮生长因子受体1的水平变化与子痫前期发病的关系

目的:检测正常妊娠与子痫前期患者不同孕周的血清胎盘生长因子(placenta growth factor,PLGF)以及可溶性血管内皮生长因子受体1(soluble fms-like tyrosine kinase-1,sFlt-1)的水平,探讨二者在子痫前期发病中的作用?方法:检测并比较31例轻度子痫前期患者?26例重度子痫前期患者及200例正常妊娠妇女血清PLGF和sFlt-1水平?结果:在孕12~16周?孕20~24周?孕28~32周?孕37~41周,轻度与重度组PLGF水平均显著低于正常妊娠组水平(P < 0.01);除孕12~16周,各组sFlt-1水平差异无显著性意义(P > 0.05),其余各期轻度与重度组均高于正常妊娠组水平(P < 0.01);轻?重度子痫前期组,各阶段sFlt-1/PLGF的比值均显著高于正常妊娠组(P < 0.01)?结论:孕妇血清中PLGF和sFlt-1水平变化与子痫前期发病及病情发展有关?