6746例孕妇血清生化二联标记物筛查唐氏综合征分析

目的探讨孕妇血清标志物甲胎蛋白(AFP)和游离绒毛膜促性腺激素(Free-βhCG)对孕中期妇女进行胎儿唐氏综合征(Down's syndrome,DS)为主的先天缺陷筛查的作用.方法对孕15w～19w妇女进行上述二项血清标志物检测,结合孕妇年龄、孕周、体重等因素,经过软件计算风险率,对高风险孕妇进行羊水细胞染色体检查及三维彩超进行确诊.结果6746例孕妇中,发现DS 2例,18-三体综合征2例,其它胎儿异常24例.结论孕中期血清AFP、Free-βhCG二项血清标志物联合检测,可作为孕中期唐氏综合征筛查优选项目;在孕中期用AFP、Free-βhCG检测还可以筛查神经管缺陷(NTD),18-三体综合征等其它胎儿异常.     

无锡地区21568例孕妇孕中期产前筛查结果分析

目的探讨孕中期孕妇血清标志物甲胎蛋白(AFP)和游离人绒毛促性腺激素β亚单位(Free-βhCG)和雌三醇(uE3)检测在产前筛查中的作用。方法应用时间分辨荧光免疫分析系统对21 568例孕中期(14～20+6周)妇女进行血清AFP、uE3和Free-βhCG的检测及分析,风险率≥1∶270为唐氏综合征筛查高风险,追踪胎儿和孕妇的情况,产前诊断及新生儿检查以确认。结果 21 568例筛查孕妇中,唐氏综合征筛查高风险1392例,检出6例21三体,18-三体3例,其他异常染色体36例。胎儿异常检出率为2.59%。结论孕中期产前筛查是预测异常胎儿和不良妊娠结局的有效方法,再结合产前诊断对防止先天缺陷有实用性价值。     

无锡地区15241例孕中期产前筛查结果分析

目的探讨孕中期孕妇血清标志物甲胎蛋白（AFP）和游离人绒毛促性腺激素β亚单位（Free-βhCG）和雌三醇（uE3）检测在产前筛查中的作用。方法应用时间分辨荧光免疫分析系统对15241例孕中期（14～20＋6周）妇女进行血清AFP、uE3和Free-βhCG的检测及分析,风险率≥1∶270为唐氏综合征筛查高风险,追踪胎儿和孕妇的情况,产前诊断及新生儿检查以确认。结果15241例筛查孕妇中,唐氏综合征筛查高风险876例,检出36例21三体,18-三体6例,其他异常染色体170例。NTD高风险的孕妇中,B超检查发现胎儿畸形,宫内发育迟缓,死胎等异常共59例。胎儿异常检出率为30.9%。结论孕中期产前筛查是预测异常胎儿和不良妊娠结局的有效方法,再结合产前诊断对防止先天缺陷有实用性价值。     

Down''''s综合征的孕中期筛查

目的检测孕妇血清标物甲胎蛋白(AFP)、游离-β-绒毛膜促性腺激素(Free-β-HCG)进行孕中期胎儿唐氏综合征无创伤性产前筛查.方法采用金标定量系统对孕中期(14～22w)妇女进行AFP、Free-β-HCG检测,并配有唐氏综合征产前筛查专用软件进行分析校正,对筛查出的先天性缺陷胎儿,在孕妇知情的情况下,选择适宜的产前诊断.结果接受筛查的358名孕妇中,唐氏综合征高风险孕妇为32例,筛查阳性率为8.94%,其中12例接受羊水细胞培养染色体检查,占高危孕妇的37.5%,检出染色体异常核型4例,占高危孕妇羊水细胞培养染色体检查的33.3%.结论利用孕妇血清AFP、Free-β-HCG进行孕中期胎儿唐氏综合征无创伤性产前筛查,对减少病残儿的出生,具有重要意义.     

孕中期先天缺陷产前筛查4426例分析

目的探讨孕妇血清标志物甲胎蛋白(AFP)和游离绒毛膜促性腺激素(Free-βhCG)对孕中期妇女进行胎儿唐氏综合征(Down's syndrome,DS)为主的先天缺陷筛查的作用.方法对孕14～20w妇女进行上述2项血清标志物检测,结合母龄、孕周、体重等因素,经过软件计算风险率,对高风险孕妇进行羊水细胞染色体检查及B超进行确诊.每例受检孕妇追踪到出生.结果 4426例孕妇中,发现DS 1例,18三体综合征2例,其它胎儿异常14例.结论孕中期血清AFP、Free-βhCG 2项血清标志物联合检测,作为筛查胎儿先天缺陷可行,能降低先天缺陷患儿出生率3.61‰.     

产前筛查及数据微机分析的临床意义

目的应用孕妇血清妊娠蛋白检测产前筛查胎儿质量。方法通过ELISA方法检测8790例、孕龄为14-20周的中国人群孕妇血清AFP、βhCG浓度,结合孕妇年龄、孕周等关键参数,计算唐氏综合征的风险系数,并建立了适合本中心的孕中期MoM值。结果在14～20孕周的AFP血清浓度为（28.13～72.50）IU/ml、Free-βhCG血清浓度为9.22mIU/ml-47.09mIU/ml,且呈正态分布,各孕周中位数值与本中心使用的贝喜唐氏综合征产前筛查系统的中位数值较一致,但与以往报道的白种人、黑种人数据有明显的差异。用贝喜唐氏综合征产前筛查系统计算,临床筛查假阳性率约为5.95%;对高危人群中的459人次进行了羊水诊断,其中有唐氏综合征患儿1例,神经管缺损10例。结论在中国人群AFP和βhCG数据库基础上建立的唐氏综合征筛查系统,对于年均有2000万新生儿的中国有着更重要的价值。     

唐氏综合征孕中期产前筛查与产前诊断结果分析

目的检测孕妇血清甲胎蛋白（AFP）,游离-β-绒毛膜促性腺激素（Free-β-HCG）,进行孕中期胎儿唐氏综合征的无创伤性筛查。方法采用金标定量系统对孕中期（14-22w）妇女进行AFP、Free-β-HCG检测,结合母龄、孕周、体重等因素,经专用软件进行分析校正,计算风险率,对高风险孕妇在知情的情况下,自愿选择羊膜腔穿刺,进行羊水细胞染色体核型分析。结果接受筛查的1568名孕妇中筛查出唐氏综合征高风险104例,占筛查总数的6.63%。其中62例接受羊水细胞染色体检查,占高危孕妇的59.62%。检出染色体异常核型14例,占高危孕妇接受羊水细胞培养染色体检查的22.58%。结论利用孕妇血清AFP、Free-β-HCG进行孕中期胎儿无创伤性产前筛查,结合产前诊断,对减少出生缺陷儿的出生,具有重要意义。     

孕中期母血产前筛查回顾性分析

目的 对柳州地区3299例孕中期妇女产前筛查结果进行回顾性分析,建立适合本实验室的血清AFP中位数值,探讨进行筛查的最佳孕周.方法 用酶联免疫法(ELISA)对孕妇血清AFP和Free-βhCG进行检测,并结合孕妇年龄、孕周、体重、有无糖尿病等,采用配套软件估算风险概率.应用EXCEL计算本地区孕妇AFP中位数,比较标化前后检测结果,并对各孕周筛查风险概率进行比较.结果 在3299例孕中期妇女中,DS和神经管缺陷筛查阳性率分别为8.73%和3.30%,检出先天缺陷10例.柳州地区孕中期妇女AFP中位数比内嵌软件中位数平均高9.43%.校正后NTD筛查敏感度提高10.08%;孕14、15、19周筛查阳性率分别为9.26%、8.09%、7.74%,高于其它各孕周筛查阳性率.结论 血清AFP、HCG联合检测,可作为柳州地区孕中期产前筛查优选项目,建立适合本地区的中位数值可提高筛查的准确度,建议以孕16、17、18周为最佳筛查孕周.     

孕中期产前筛查产前诊断在减少出生缺陷中的作用

目的 探讨孕妇血清标记物甲胎蛋白(AFP)和游离绒毛膜促性腺激素(Free-β hCG)对孕中期妇女进行胎儿唐氏综合征(Dewn's syndrome,DS)产前筛查,进而对高风险孕妇进行羊水、B超的产前诊断在减少出生缺陷中的作用.方法 对孕14～20w妇女进行血清AFP及Free-β hCG检测,结合孕妇年龄、孕周及体重等因素,经过计算机软件测算风险率.对高风险孕妇进行一对一遗传咨询,在知情同意的情况下选择羊水染色体或B超检查以明确诊断并追踪随访至出生.结果 在10343例参筛孕妇中共筛出唐氏征高风险604例,占筛查总数的5.84%,其中384例进行羊水染色体检查,检出21三体6例,47,XXY 1 例;B超诊断胎儿发育异常4例;另外自然流产3例,胎死宫内2例.漏筛2例.结论 孕中期产前筛查产前诊断能减少缺陷儿的出生,方法有效可行.如能通过妇幼保健网推广筛查工作,扩大筛查覆盖范围,选择性地产前诊断,适时终止妊娠,才能真正有效地预防和减少出生缺陷.     

8345例孕中期妇女唐氏综合征产前筛查结果分析

目的评价孕中期妇女血清学产前筛查唐氏综合征（DS）的临床应用价值。方法采用时间分辨荧光免疫法对孕中期（15～20周）妇女进行血清标记物AFP/Free-β-hCG的二联产前筛查,筛查结果应用Multicalc和Risks2T分析软件计算唐氏综合征风险。DS和开放性神经管缺陷（ONTD）的风险切割值为1：270,18-三体综合征的风险切割值为1：350,筛查结果为DS高风险的孕妇,结合B超、羊水或脐血进行产前诊断排除胎儿异常。结果产前筛查8345例孕妇,共筛查出高危孕妇276例,阳性率为3.10%,其中DS高风险202例、ONTD高风险37例、18-三体综合征高风险24例、年龄〉35岁的14例,其高风险检出率分别为2.42%、0.44%、0.29%、0.17%。在239例DS、18-三体综合征高风险孕妇中有124例接受了羊水穿刺,6例接受脐血穿刺产前诊断,发现胎儿染色体异常3例、死胎3例、先天性心脏病1例,异常检出率2.93%。结论孕中期妇女血清hAFP和Free-β-hCG标记物是DS产前筛查异常胎儿的有效指标,再结合羊水或脐血、三维B超等产前诊断技术对防止先天缺陷有实用性价值。     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.     

Seasonal variations in acute toxoplasmosis in pregnant women in Slovenia

Between December 1999 and December 2004, 40 081 pregnant women were examined for toxoplasmosis with Toxo-IgG, Toxo-IgM enzyme immunoassay. Women with positive results were then retested with the Toxo-IgG avidity assay for recent toxoplasmosis. Recent acute toxoplasmosis in pregnant women was found to be significantly more frequent (p < 0.01) during winter than summer. The incidence of acute toxoplasmosis during winter-spring was also significantly more frequent (p < 0.025) than summer-autumn. This phenomenon should be taken into account when formulating preventive measures for toxoplasmosis, especially for pregnant women.     

Age-related changes in polyamines in memory-associated brain structures in rats

Polyamines putrescine, spermidine and spermine are positively charged aliphatic amines and have important roles in maintaining normal cellular function, regulating neurotransmitter receptors and modulating learning and memory. Recent evidence suggests a role of putrescine in hippocampal neurogenesis, that is significantly impaired during aging. The present study measured the polyamine levels in memory-related brain structures in 24- (aged), 12- (middle-aged) and 4- (young) month-old rats using liquid chromatography/mass spectrometry and high performance liquid chromatography. In the hippocampus, the putrescine levels were significantly decreased in the CA1 and dentate gyrus, and increased in the CA2/3 with age. Significant age-related increases in the spermidine levels were found in the CA1 and CA2/3. There was no difference between groups in spermine in any sub-regions examined. In the parahippocampal region, increased putrescine level with age was observed in the entorhinal cortex, and age did not alter the spermidine levels. The spermine level was significantly decreased in the perirhinal cortex and increased in the postrhinal cortex with age. In the prefrontal cortex, there was age-related decrease in putrescine, and the spermidine and spermine levels were significantly increased with age. This study, for the first time, demonstrates age-related region-specific changes in polyamines in memory-associated structures, suggesting that polyamine system dysfunction may potentially contribute to aged-related impairments in hippocampal neurogenesis and learning and memory.     

休克过程中肾上腺髓质素变化的研究进展

Adrenomedullin (AM) is a new peptidergic regulator of vascular function. AM serves as a hormone, which has many biological properties, plays an important role in the many pathophysiological processes, especially shock. This review will highlight the structure, biological properties of AM and the relationship between AM and shock.     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Uteroglobin in the developing rabbit conceptus in vivo and in vitro

Summary Uteroglobin (UGL) was measured in day- 4 to day-10 rabbit conceptuses by a competitive ELISA. Levels in blastocyst fluid, tissues, coverings and in the early fetus were determined separately. The total amount of UGL increased from 18.4 ng to 6.8 g per conceptus. The UGL content of individual day-6 blastocysts was studied in vitro. Culturing was carried out up to 60 h in Ham's F10 medium with polyvinylpyrrolidone as macromolecular component, with and without progesterone, and with progesterone plus estradiol. UGL was determined in the blastocyst fluids, tissues with coverings and in the culture media. After labelling with [³⁵S]-methionine, protein patterns of total blastocysts and of culture media were analysed by two-dimensional gel electrophoresis and fluorography. The morphology of cultured blastocysts was examined by electron microscopy. During 60 h of culture, the blastocysts expanded in diameter by 84%, and released 19% of their initial UGL content into the medium, independent of the hormonal substitution. Neither de novo synthesis, nor degradation of UGL was found: the protein remained unlabelled in fluorography, and its total quantity was not significantly different from that of non-cultured controls. Trophoblast, endoderm and embryoblast cells showed well preserved cell organelles and intercellular junctions, while the morphological differentiation of the germ layer was inhibited.