蛋白指纹图谱技术诊断胎儿神经管缺陷的初步研究

目的:探讨表面增强激光解吸离子化飞行时间质谱(SELDI-TOF-MS)技术在胎儿神经管缺陷(NTD)产前诊断中的应用。方法:取神经管缺陷胎儿的孕妇羊水8例作为NTD组,取正常胎儿的孕妇羊水16例作为对照组,分别进行蛋白质谱分析,确定两组间蛋白峰值的差异。结果:24份羊水检测质谱图,共有96个蛋白质峰,通过统计分析,发现有5个不同质荷比蛋白质在两组的相对含量有明显差异。质荷分别为3484、8126、15112、16139和30891。结论:神经管缺陷胎儿孕妇的羊水中存在差异蛋白质的变化,这一组蛋白质谱图的特征变化具有疾病提示意义,可用于胎儿产前诊断。     

母亲解偶联蛋白(UCP2)基因多态性与后代神经管畸形的关系

目的:探索山西省母亲解偶联蛋白(UCP2)基因多态性与后代神经管畸形发生的关系。方法:采用1:1配对病例对照研究方法,对山西省116例曾孕育过NTDs患儿的母亲和116例配对的未孕育过任何畸形患儿的母亲采血并进行UCP2基因的多态性分析。结果:病例组母亲3’末端缺失纯合子基因型D/D显著高于对照组母亲(P0.01),而A55V基因多态性与NTDs无相关(P0.05)。结论:母亲UCP2基因第8外显子45bpD/I多态性可能是后代发生神经管畸形的遗传危险因素。     

Phthalates and perfluorooctanesulfonic acid in human amniotic fluid: temporal trends and timing of amniocentesis in pregnancy

Background: Measures of prenatal environmental exposures are important, and amniotic fluid levels may directly reflect fetal exposures during hypothesized windows of vulnerability.Objectives: We aimed to detect various phthalate metabolites and perfluorooctanesulfonic acid (PFOS) in human amniotic fluid, to study temporal exposure trends, and to estimate potential associations with gestational week of amniocentesis and maternal age and parity at amniocentesis.Methods: We studied 300 randomly selected second-trimester amniotic fluid samples from a Danish pregnancy-screening biobank covering 1980 through 1996. We used only samples from male offspring pregnancies. We assayed the environmental pollutants by liquid chromatography/triple quadrupole mass spectrometry and analyzed data using generalized linear regression models.Results: We detected the di(2-ethylhexyl) phthalate (DEHP) metabolite mono(2-ethyl-5-carboxypentyl) phthalate (5cx-MEPP) at a median concentration of 0.27 ng/mL [interquartile range (IQR): 0.20–0.37 ng/mL], the diisononyl phthalate (DiNP) metabolite mono(4-methyl-7-carboxyheptyl) phthalate (7cx-MMeHP) at 0.07 ng/mL (IQR: 0.05–0.11 ng/mL), and PFOS at 1.1 ng/mL (IQR: 0.66–1.60 ng/mL). An increase of 1 calendar year was associated with 3.5% lower [95% confidence interval (CI): –4.8%, –2.1%] 5cx-MEPP levels and with 7.1% higher (95% CI: 5.3%, 9.0%) 7cx-MMeHP levels. For each later gestational week of amniocentesis, 5cx-MEPP was 9.9% higher (95% CI: 4.8%, 15.2%), 7cx-MMeHP was 8.6% higher (95: CI: 2.7%, 14.9%), and PFOS was 9.4% higher (95: CI: 3.3%, 15.9%). We observed no associations with maternal age or parity.Conclusions: Measured metabolite levels appeared to parallel decreasing DEHP exposure and increasing DiNP exposure during the study period. The environmental pollutant levels were positively associated with later gestational age at amniocentesis during pregnancy weeks 12–22.     

孕中期血清标志物在筛查唐氏综合征中的意义

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'ssyndrome, DS) 为主的先天缺陷筛查的作用。方法: 对孕14 ~20周妇女进行上述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: 2 776例孕妇中, 发现DS1例, 18-三体综合征2例, 其它胎儿异常12例。结论: 孕中期血清AFP、Free-βhCG2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5. 40‰。     

Estimating an individual''s risk of having a fetus with open spina bifida and the value of repeat alpha-fetoprotein testing: FOURTH REPORT OF THE UK COLLABORATIVE STUDY ON ALPHA-FETOPROTEIN IN RELATION TO NEURAL TUBE DEFECTS

Data from the United Kingdom Collaborative Alpha-fetoprotein (AFP) Study were used to estimate an individual woman's risk of having a fetus with an open neural tube defect based on her particular maternal serum or amniotic fluid AFP concentration, and also to indicate the value of obtaining fresh specimens for repeat AFP testing. This was done by first showing that the AFP distribution adequately fitted a log Gaussian distribution and then estimating the mean and standard deviation of those distributions as well as the components of variance due to assay imprecision and within-person AFP fluctuations. In the United Kingdom as a whole the odds of having a fetus with open spina bifida among women with maternal serum AFP concentrations of 2·0, 3·0, and 4·0 multiples of the normal median (MoM) at 16-18 weeks' gestation are roughly 1:400, 1:59, and 1:13 respectively. Among women who have a single serum AFP concentration ≥2·5 MoM at 16-18 weeks' gestation which remained raised after the revision of gestational age by ultrasound and who proceed to amniocentesis, the odds are 1:84, 1:1, and 24:1 for women who have amniotic fluid AFP values of 2·0, 3·0, and 4·0 MoM respectively at 16-18 weeks' gestation. If the amniotic fluid sample is blood-stained these odds are lower, if it is not they are higher— for example, 1:4 and 5:1 respectively at 3·0 MoM. If an amniotic fluid AFP result is borderline there is practical value in obtaining a fresh amniotic fluid sample and performing a repeat AFP test, but if a maternal serum AFP result is borderline or high there is little value in testing a second maternal serum sample. Centres in which women with raised serum AFP concentrations routinely have a repeat test may therefore wish to reconsider this policy.     

母血、羊水、脐血中白细胞介素-6，-8和血管细胞黏附分子-1联合检测评估胎膜早破及新生儿预后的临床价值

目的探讨母血、羊水、脐血中三种细胞因子白细胞介素-6,-8（interleukin-6,-8,IL-6,-8）和血管细胞黏附分子-1（vascular cell adhesion molecule,VCAM-1）对胎膜早破（premature rupture of membrance,PROM）、绒毛膜羊膜炎和新生儿预后判断的临床意义。方法采用双抗体夹心酶联免疫吸附法,检测58例胎膜早破（PROM组,n=58）及38例正常孕妇（对照组,n=38）母血、羊水、脐血中白细胞介素-6,-8和血管细胞黏附分子-1水平的动态变化,并进行胎膜病理学检查。同时,PROM组按破膜时间分为三组。AI组（n=29）破膜时间为16h,A2组（n=19）破膜时间为（16～24）h,A3组（n=10）破膜时间为〉24h。另外,PROM组与对照组孕妇按病理学检查结果,分为绒毛膜羊膜炎组（n=15）,非绒毛膜羊膜炎组（n=81）。按照PROM组孕妇所产新生儿的Apgar评分,将PROM组分为B1组（n=7,Apgar评分≤7分）和B2组（n=51,Apgar评分≥8分）（分组遵循程序符合扬州大学临床医学院负责人体试验委员会所制定的伦理学标准,并得到该委员会批准,分组征得受试对象的知情同意）。所有个体均无母体疾病、其他产科并发症及胎儿、胎位异常。结果PROM组母血、羊水、脐血中白细胞介素-6,-8和血管细胞黏附分子-1的含量均高于对照组,且含量随破膜时间的延长而升高,尤其破膜时间超过24h（A3组）时,升高更为明显。绒毛膜羊膜炎组患者母血、羊水、脐血中自细胞介素-6,-8和血管细胞黏附分子-1水平明显高于非绒毛膜羊膜炎组患者,两组比较,差异有显著意义（P〈0．05,P〈0．01）。PROM组产妇所生新生儿的Apgar评分≤7分组,其母血、羊水、脐血中自细胞介素-6,-8和血管细胞黏附分子-1含量显著高于Apgar≥8分组（P〈0．05,P〈0．01）。结论白细胞介素-6,-8和血管细胞黏附分子-1三种细胞因子联合检测,可用于对胎膜早破、绒毛膜羊膜炎进行早期诊断,对新生儿预后判断也具有一定的临床价值。     

Amniotic fluid composition responds to changes in maternal dietary carbohydrate and is related to metabolic status in term fetal rats.

The objective of this study was twofold: 1) to determine whether amniotic fluid composition responded to differences in the level or source (glucose vs. fructose) of maternal dietary carbohydrate, and 2) to establish whether any dietary-induced changes in amniotic fluid composition correlated with maternal or fetal metabolic status at term. Pregnant rat dams were fed graded levels (0, 4, 12 and 60%) of glucose or fructose in a triglyceride-based diet (Experiment 1) or isoenergetic low carbohydrate diets having 4% glucose equivalents as glucose, fructose, or lipid-glycerol (Experiment 2) throughout pregnancy. Amniotic fluid and maternal and fetal samples were collected at term (d21). Results demonstrated a significant increase in amniotic fluid glucose and a significant decrease in amniotic fluid uric acid as the level of carbohydrate increased in the maternal diet. Pearson correlation coefficients showed amniotic fluid glucose to be positively associated with maternal and fetal liver glycogen and fetal weight; amniotic fluid uric acid and urea nitrogen were negatively correlated with these same measures. Regression analysis indicated that amniotic fluid glucose was predictive of fetal body weight and fetal liver glycogen at term. The findings show that amniotic fluid can be modified by maternal diet and suggest that composition of amniotic fluid might be used as an accessible nutritional indicator of carbohydrate status in the developing fetus.     

羊水中兴奋性氨基酸的临床意义研究

目的:探讨羊水中兴奋性氨基酸(EAAs):天门冬氨酸(Asp)、谷氨酸(Glu)与胎儿畸形及围产儿缺氧的关系。方法:采用高效液相法对201例孕产妇进行羊水中EAAs:Asp、Glu检测。将其分为正常妊娠组137例,胎儿宫内缺氧组48例,胎儿畸形组16例。结果:①羊水中EAAs:Asp、Glu水平在正常妊娠组孕14～27+6周时分别为8 .66±3 .56μg/ml、2 .25±1 .48μg/ml,至妊娠晚期(37～41+6周)时分别为14. 81±8 .54μg/ml、12 .26±4 .08μg/ml,随孕周增加呈上升趋势(P<0. 05);②正常妊娠组羊水中EAAs:Asp、Glu水平分别为13. 45±5. 74μg/ml、8 .31±2 .09μg/ml,胎儿宫内缺氧组分别为58 .83±11 .21μg/ml、16. 75±4 .08μg/ml,胎儿畸形组分别为97 .40±13 .68μg/ml、22 .88±10 .01μg/ml,胎儿宫内缺氧组与胎儿畸形组羊水EAAs水平明显高于正常妊娠组(P<0 .01),胎儿畸形组亦明显高于胎儿宫内缺氧组(P<0 .05)。结论:正常妊娠羊水中存在EAAs:Asp、Glu,且随妊娠进展而增加;胎儿畸形、胎儿宫内缺氧时羊水中EAAs:Asp、Glu水平升高,提示羊水中EAAs:Asp、Glu检测可望成为判断胎儿畸形、胎儿宫内缺氧状况的一项敏感而简单的生化指标。     

常、微量元素与胎儿宫内发育迟缓关系的研究

目的 探讨常、微量元素与胎儿宫内发育迟缓(IUGR)间的关系.方法 孕晚期测定71名孕妇母血、脐血、羊水中微量元素水平,其中IUGR组21例,对照组35例,巨大儿组15例.结果 IUGR组母血清Zn,Se,Mn,Fe,Mg,Cr明显低于对照组(P＜0.05);Cd,Pb,Ni水平明显高于对照组;巨大儿组母血清Fe含量亦明显低于对照组(P＜0.05);三组间Ca,Ti,Co,Li无明显差别.IUGR组脐血清Se,Mn,Cd,Fe,Cu,Mg明显低于对照组;Pb,Ni明显高于对照组;三组间Zn,Ca,Ti,Co,Li无明显差别.IUGR组羊水Zn,Se,Mn,Fe明显低于对照组,三组间Ca,Co无明显差别.结论 常、微量元素与胎儿发育关系密切,Zn,Se,Mn,Fe,Mg,Cu,Cr缺乏可致胎儿宫内发育迟缓,Cd,Pb,Ni升高可致低体重儿.     

2007 - 2016年河南省神经管缺陷发生率变化趋势分析

目的 分析2007 - 2016年河南省神经管缺陷（NTDs）的发生率变化,为制定神经管缺陷防控措施提供依据。方法 按照中国出生缺陷医院监测方案对2007 - 2016年河南省75家监测医院出生（包括引产）的围产儿进行出生缺陷监测,并对监测所得的神经管缺陷资料进行回顾性分析。结果 2007 - 2016年河南省75所监测医院共监测围产儿2 285 027人,NTDs 2 145例,NTDs总发生率9.39/万,其中无脑畸形、脊柱裂、脑膨出的总发生率分别为2.70/万、5.27/万和1.41/万。NTDs年度发生率从2007年的15.60/万下降到2016年的6.98/万,降幅达55.26%（χ2 = 12.513, P＜0.001）。NTDs在孕28周前检出的比例由2007年的30.08%上升到2016年的78.87%（χ2 = 14.038, P＜0.001）。NTDs总发生率女性（9.27/万）高于男性（8.16/万）（χ2 = 8.047,P = 0.005）,乡村（9.80/万）高于城镇（8.65/万）（χ2 = 7.343,P = 0.007）,产妇年龄＜20岁组NTDs总发生率最高,其次为≥35岁组,25～29岁组最低,呈“U”形分布。结论 河南省神经管缺陷年度发生率呈下降趋势,但仍处于较高水平,脊柱裂是最主要的神经管缺陷类型。     

妊娠高血压综合征患者胎儿生长发育与白细胞介素-6的关系

目的:了解妊高征患者胎儿生长发育与白细胞介素-6(IL-6)水平的关系。方法:对2002年9月2004年9月50例妊娠高血压综合征患者(妊高征组)及30例正常孕妇(对照组)胎儿生长情况进行评价。采用酶联免疫吸附试验(ELISA法)检测两组母血清及羊水中IL-6的含量。结果:①中、重度妊高征患者低体重儿发生率显著高于正常妊娠组(P<0.01);②妊高征组母血清IL-6含量随病情加重呈升高趋势,中、重度妊高征组母血清IL-6含量显著高于正常妊娠组(P<0.01),羊水IL-6含量随妊高征病情加重呈下降趋势,中、重度妊高征组羊水IL-6含量显著低于正常妊娠组(P<0.01),母血清IL-6与羊水IL-6无显著相关关系(r=-0.21,r=-0.29,P>0.05);③妊高征组中24例新生儿出生体重低于2 500 g,其羊水IL-6含量显著低于新生儿出生体重达到2 500 g以上者,羊水IL-6水平与新生儿体重在妊高征组未发现明显相关性(r=0.232,P>0.05)。结论:妊高征患者的免疫活性细胞释放过多的IL-6,参与了妊高征的免疫损伤过程;妊高征患者胎盘产生并转运IL-6至羊水的能力下降,致羊水IL-6含量下降,对妊高征发病及其胎儿生长发育可能有重要影响。     

分娩期GBS阳性产妇羊水、胎盘及脐带血与母婴感染的关联性分析

目的探讨妊娠期生殖道B族溶血性链球菌与围生期母婴感染的关联性。方法回顾性分析2017年1月-2018年6月在医院门诊常规孕检并自然分娩的妇女B族溶血性链球菌(GBS)检测及GBS感染情况。妊娠早期(8~12周)和37周取阴道下三分之一分泌物采用胶体金免疫层析法GBS鉴定卡进行GBS检测;临产后对GBS阳性孕妇预防性静滴抗生素1~2次,分娩时取羊水、胎儿脐带血及胎盘(母体面取拭子)做GBS检测,并纪录母亲产后发热、产褥感染、产后出血、新生儿带菌及新生儿感染发生率。结果共检测2 100例孕妇,早孕期GBS带菌率6. 13%;至妊娠37周时筛查1 848例(去除流产及早产病例252例),GBS阳性率6. 89%;分娩时127例GBS阳性孕妇羊水、胎盘及脐带血GBS阳性率分别为3. 94%、3. 94%及2. 36%,1721例GBS阴性孕妇的羊水、胎盘和脐带血GBS均为阴性。GBS阳性母亲产后发热、产褥感染及产后出血率与阴性者相比差异无统计学意义(P>0. 05),胎盘病理检查绒毛膜羊膜炎的发生率69. 29%明显高于阴性者的18. 94%。GBS阳性母亲的新生儿带菌率为3. 94%,感染率为2. 36%;GBS阴性母亲的新生儿GBS均阴性。结论妊娠期产道GBS阳性母亲,羊水、胎盘及脐带血的阳性率高于阴性者。羊水、胎盘及脐带血阳性者新生儿有一定的带菌率和感染率,应引起产科医师重视。     

新生儿缺血缺氧性脑病发生的相关危险因素研究

目的 探究与分析新生儿缺血缺氧性脑病(HIE)发生的相关危险因素.方法 回顾性分析重庆市铜梁区人民医院自2014年6月至2016年6月收治的186例新生儿的临床资料,按照是否发生缺血缺氧性脑病分为对照组(n=106)与观察组(n=80),对照组为健康新生儿,观察组为新生儿缺血缺氧性脑病,采用自拟问卷调查量表对两组新生儿资料进行统计,分析新生儿缺血缺氧性脑病发生相关因素.结果 与对照组相比较,观察组的脐带异常率(x2=6.89)、母亲贫血率(x2=7.05)、胎盘异常率(x2=6.39)、妊娠高血压疾病或子痫发生率(x2=6.30)、新生儿体重异常率(x2=7.19)、羊水污染率(x2=5.45)、产程异常发生率(x2=8.23)、母亲高龄率(x2=5.64)、母亲低龄率(x2=6.35)、肾功能不全率较高(x2 =5.77)、自然分娩率(x2=6.37)及按时产检率(x2=5.83)则明显较低,组间差异具有统计学意义(均P＜0.05).行多因素Logistic回归分析可见,羊水污染、妊娠期高血压疾病或子痫、胎盘异常、脐带异常、母体贫血、产程异常、母亲高龄及是否按时产检等均为新生儿缺氧缺血性脑病的影响因素(P＜0.05).结论 新生儿缺血缺氧性脑病影响因素较多,有关部门需加强产前检查并给予积极有效的处理对策,以达到降低新生儿缺血缺氧性脑病发生率的目的.     

胎膜早破残余羊水量对妊娠结局的影响

目的探讨胎膜早破不同残余羊水量对妊娠结局的影响。方法对148例足月胎膜早破孕妇资料进行回顾性分析。其中羊水量正常者53例(羊水量正常组),羊水量偏少63例(羊水量偏少组),羊水量过少32例(羊水量过少组)。结果羊水过少组剖宫产率63.13%,明显高于羊水正常组24.53%及羊水偏少组38.10%,羊水过少组与羊水正常组比较存在显著性差异(2=7.15,p<0.05);阴道自然分娩率羊水正常组为69.81%,羊水偏少组为46.03%,羊水过少组为28.13%,羊水偏少组、羊水过少组与羊水正常组之间比较存在显著性差异(2=6.64,2=13.96,p<0.05);宫内感染发生率羊水正常组0.00%,羊水偏少组3.18%,羊水过少组12.50%,在三组之间比较存在显著性差异(2=8.23,p<0.05);胎儿宫内窘迫发生率羊水正常组11.32%,羊水偏少组20.64%,羊水过少组为37.50%,羊水过少组与羊水正常组之间比较存在显著性差异(2=8.19,p<0.05);新生儿窒息发生率羊水正常组5.66%,羊水偏少组19.05%,羊水过少组为37.50%,羊水偏少组、羊水过少组与羊水正常组之间比较存在显著性差异(2=4.58,2=5.58,p<0.05)。结论胎膜早破时残余羊水量的多少与妊娠结局密切相关,羊水残余量越少胎儿的预后相对越会受到影响,并且剖宫产率会明显增加。     

胎心监护仪对孕产妇分娩方式及妊娠结局的影响

目的:探讨分析胎心监护仪对孕产妇分娩方式及妊娠结局的影响。方法:选取2017年1月~2019年1月在本院进行分娩的240例产妇作为研究对象,按照奇偶顺序将其平均分为两组,对照组产妇120例采用常规检测,试验组产妇120例采用胎心监护仪。观察两组产妇的分娩方式和妊娠结局。结果:对照组产妇顺产率为76.67%(92/120),明显高于试验组产妇的61.67%(74/120),差异具有统计学意义(P<0.05)。试验组产妇羊水污染0例,新生儿肺炎1例、脐带异常1例;对照组产妇羊水污染4例,新生儿肺炎6例,脐带异常7例,两组产妇的妊娠结局差异具有统计学意义(P<0.05)。结论:对于孕产妇采用胎心监护仪有助于对产妇以及胎儿的情况进行准确评估,降低不良事件的发生率,改善妊娠结局。     

孕中期母血产前筛查36947例先天缺陷的研究

目的:探讨血清标志物甲胎蛋白(AFP)和游离绒毛膜促性腺激素(Free-βhCG)在胎儿先天缺陷筛查中的作用。方法:对孕15～20周妇女进行上述两项血清标志物检测,结合孕妇年龄、孕周、体重、既往妊娠史、有无糖尿病、吸烟等因素,通过产前筛查软件计算风险率;对高风险孕妇进行羊水细胞染色体检查及B超检查;每例受检孕妇追踪到新生儿出生。结果:36947例孕妇中,发现唐氏综合征13例,18-三体综合征6例,染色体其他核型异常3例。结论:孕中期血清AFP、Free-βhCG两项血清标志物联合检测作为筛查胎儿先天缺陷安全可行,能有效降低先天缺陷患儿出生率。     

Maternal-fetal transfer of domoic acid in rats at two gestational time points

BACKGROUND AND OBJECTIVES: Prenatal exposure to asymptomatic doses of domoic acid (DA) causes learning and memory deficits later in life; therefore, we sought to measure distribution of DA in maternal plasma and brain, prenatal brain, and amniotic fluid 1 hr after exposure, a time frame that normally encompasses acute seizure behavior. METHODS: Pregnant rats were given a single intravenous dose of DA (0.6 or 1.6 mg/kg body weight) at either gestational day (GD) 13 or GD20, which correspond to the beginning of rat embryo neurogenesis and the last day of gestation, respectively. Using a direct ELISA, dose-dependent levels of DA were detected in each sample matrix tested. RESULTS: An average of 6.6 and 14 ng DA/g brain tissue was found in GD13 and GD20 prenatal rats, respectively. Brain concentrations of DA in the GD13 prenates were identical to amniotic fluid levels, consistent with no restriction for DA to enter the GD13 prenatal brain. At GD20 the prenatal brain contained half the concentration of DA in the amniotic fluid, and was approximately half that found in the brain of the dams. After 1 hr, fetal brain and amniotic fluid contained between 1 and 5% of DA found in the maternal circulation. The amniotic fluid levels of DA in this study were also within the same range measured in stranded California sea lions that showed reproductive failure. CONCLUSIONS: DA crosses the placenta, enters brain tissue of prenates, and accumulates in the amniotic fluid. Amniotic fluid appears to be a useful fluid to monitor DA exposure.     

山西省神经管畸形影响因素的病例对照研究

目的 探索山西省神经管畸形(NTDs)患儿发生的影响因素.方法 采用1:1匹配的病例对照研究设计,对医院收集的病例组和对照组孕妇进行问卷调查,采集肘静脉血标本2 ml,检测亚甲基四氢叶酸还原酶(MTHFR)基因多态性.使用条件logistic回归模型,对MTHFR基因及其他因素进行单因素及多因素分析,筛选山西省NTDs患儿发生的影响因素.结果 MTHFR基因677位点有3种基因型,即野生型CC、杂合突变型CT和纯合突变型TT,3种基因型在病例组和对照组间分布差异有统计学意义(χ=2=14.61,P=0.001),病例组T等位基因频率(60.6%)高于对照组(41.4%),差异有统计学意义(χ=2=14.59,P<0.001).经单因素条件logistic回归分析有统计学意义的变量15项引入多因素条件logistic回归,最终进入模型的变量有4项,分别为既往孕次(OR=2.87,95%CI:1.28～6.44)、孕早期接触化肥(OR=16.18,95%CI:1.18～221.59)和经常食用发芽土豆(OR=4.66,95%CI:1.78～12.17)以及MTHFR基因677位点突变(OR=2.13,95%CI:1.08～4.21).结论 孕次、孕早期接触化肥、食用发芽土豆和MTHFR基因677位点突变是山西省NTDS患儿发生的主要危险因素.     

Differential effects of fish oil and folic acid supplementation during pregnancy in rats on cognitive performance and serum glucose in their offspring

OBJECTIVE: We studied the effect of folic acid and polyunsaturated fatty acid supplementation during pregnancy in Wistar albino rats on cognitive performance and serum glucose concentrations in their pups. METHODS: Pregnant female rats from four groups (n = 6/group) were fed casein diets with 18% protein and 2 mg of folic acid/kg of diet (group I), 12% protein and no folic acid (group II), 12% protein and 8 mg of folic acid/kg of diet (group III), or 12% protein and 70 g of cod liver oil/kg of diet (group IV). All pups were weaned on standard control diet with 18% protein. Cognitive performance, brain fatty acid profile, and serum glucose concentrations were studied in offspring at age 6 mo. RESULTS: There was no significant difference in length of gestation or litter size, but the litter weight for group IV was lower (P = 0.047) than that for group I. After weaning, males in group II had lower (P < 0.05) body weights, but those in group III had weights comparable to those in group I for both sexes. In group IV, body weights were lower beyond 15 wk (P < 0.05). Relative brain weight and cognitive performance were significantly higher (P < 0.05) in group IV males and showed higher levels of brain gamma-linolenic acid. Further, these animals had serum glucose levels comparable to those of control animals at age 6 mo, whereas serum glucose levels were higher in males from groups II (P = 0.01) and III (P = 0.01). CONCLUSION: Fish oil supplementation during pregnancy improved cognitive performance and maintained glucose levels into adulthood, unlike folic acid supplementation, which supported only fetal growth and did not maintain glucose levels.     

Effect of administered human growth hormone on protein metabolism in septic rats

The effect of administered human growth hormone (hGH) on protein metabolism in septic rats was investigated. Fifty-three male Wistar rates with SVC cannulation were divided into four groups. Group I (n = 10) underwent sham-operation. Sepsis was induced by cecal ligation in group II (n = 19), group III (n = 10), and group IV (n = 14). Isocaloric, isonitrogenous glucose/amino acids were infused for 4 days. hGH was administered in group III (100 mU/day) and group IV (200 mU/day) every day. Cumulative nitrogen balance (mg/kg) in group IV was significantly higher than in group II (p less than 0.01): group I, 1264 +/- 355; group II, 117 +/- 693; group III, 92 +/- 735; group IV, 1001 +/- 279. Cumulative urinary excretion of 3-methylhistidine (3-MH, mg/kg) did not differ between group II and group IV: group I, 6.2 +/- 0.9; group II, 12.0 +/- 2.2; group III, 13.4 +/- 2.9; group IV, 10.5 +/- 2.3. Serum albumin level in group IV (1.8 +/- 0.2 g/dl) was significantly higher than in group II (1.5 +/- 0.2 g/dl) (p less than 0.01). Blood urea nitrogen level in group IV (12.6 +/- 2.3 mg/dl) was significantly lower than in group II (18.8 +/- 7.4 mg/dl) (p less than 0.05). Although serum levels of glucose, insulin, triglyceride, and phospholipid were higher in sepsis groups than in sham-operated group, those levels did not differ among sepsis groups. Administration of hGH, 200 mU/day, resulted in marked nitrogen retention and had little effect on 3-MH excretion.(ABSTRACT TRUNCATED AT 250 WORDS)