Effect of lipoxin A4 on interleukin-1β production of human monocytes from severe preeclamptic women and its relationship with cytoplasm free calcium concentration-an in vitro study

Objective To investigate the effect of lipoxin A4(LXA4) on interleukin-1β(IL-1β)production of monocytes in maternal peripheral blood from severe preeelampsia women and its relationship with cytosolic free calcium([Ca2+]i)concentration. Methods Peripheral venous blood was drawn from 15 women with severe preeelampsia(SPE group)and 20 normal pregnant women (control group)who were admitted to the First Affiliated Hospital of Wenzhou Medical College from October 2008 to May 2009.Monoeytes were obtained from peripheral blood with Ficolt density gradient centrifugation and then were suspended in RPMI-1640 culture supplemented with LXA4 at the final concentrations of 0,10 and 100 nmol/L,respectively.IL-1β levels in monocytes supernatant were detected by enzyme-linked immunosorbent assay.The cytoplasma[Ca2+]i of cultured monocytes and its variations affected by LXA4 were measured by laser scanning confocal microscope. Results (1) After incubation with different concentrations of LXA4(0,10,100 nmol/L)for 24 h,the levels of IL-1β in SPE group were(63.16±8.20)pg/L,(53.71±8.08)pg/L and(43.16±6.89)pg/L,respectively, indicating a significant inhibition effect on IL-1β level in a dose-dependent manner (P<0. 05). The IL-1β levels in the control group were (19.22±7.43) pg/L, (16.99±6.32) pg/L and (15. 18±5.24) pg/L, correspondingly (P>0.05). (2) Without LXA4, the [Ca2+ ]i concentrations of monocytes in the SPE group were higher than that of the control (1028.09 ± 160. 52 vs 323.61 ±87.86, P<0. 05). After treatment with 100 nmol/L LXA4, the [Ca2+ ]i concentration of monocytes significantly decreased in the SPE group (409.67± 116.73, P<0. 05). Conclusions In vitro LXA4 may inhibit the IL-1β production in monoeytes of SPE patients through decrease of the cytoplama [Ca2+ ]i concentration.     

Expression and significance of interleukin-18.12 and tumor necrosis factor-α in intrahepatic cholestasis of pregnancy

Objective To investigate the effect of Interleukin(IL)-18,IL-12 and tumor necrosis factor-α(TNF-α)in hepatic injury in intrahepatic cholestasis of pregnancy(ICP).Methods Sixty-two cases of ICP patients(ICP group),30 cases of normal pregnant women(control group)and 30 cases of hepatitis B(HBV) women (hepatitis group) were recruited. Serum IL-18, IL-12 and TNF-α were examined by ELISA. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were examined by automatic biochemical analysis instrument. Results ( 1 ) In hepatitis group, serum concentrations of IL-18,IL-12 and TNF-α were (256±51 ) ng/L, ( 122±96) ng/L and (207±3) ng/L; serum levels of ALT and AST were(363±174) U/L and (359 ±237) U/L, respectively. In ICP group, serum concentrations of IL18, IL-12 and TNF-α were (72±32) ng/L, (42 ±28) ng/L and (48±14) ng/L; serum levels of ALT and AST were (201 ±128) U/L and ( 132±87) U/L, respectively. While in control group, serum concentrations of IL-18, IL-12 and TNF-α were (43 ± 13) ng/L, ( 10±3) ng/L and (33±9) ng/L; serum levels of ALT and AST were (13 ~ 4) U/L and (15 ± 3) U/L, respectively. Serum IL-18, IL-12, TNF-α, ALT and AST levels in hepatitis group were significantly higher than those in ICP group and control group ( P ＜0. 05 ).Serum IL-18, IL-12, TNF-α, ALT and AST levels in ICP group were significantly higher than those in control group(P ＜ 0. 05 ). (2) In severe ICP subgroup, serum concentrations of IL-18, IL-12 and TNF-α were (81 ±32) ng/L, (50 ±25) ng/L and(50 ± 14) ng/L; serum levels of ALT and AST were (269 ± 111 ) U/L and (181±73) U/L In mild ICP subgroup, serum concentrations of IL-18, IL-12 and TNF-α were (48 ±18 ) ng/L, (17 ± 4 ) ng/L and (40 ± 10 ) ng/L; serum levels of ALT and AST were (87±46) U/L and (50 ±21 ) U/L, respectively. Serum IL-18, IL-12, TNF-α, ALT and AST levels in severe ICP subgroup were significantly higher than those in mild ICP subgroup and control group (P ＜ 0. 05). And serum ALT and AST levels in mild ICP subgroup were significantly higher than those in control group(P ＜0. 05). (3) There were 16 cases with preterm birth (50%, 16/32 ) and 10 cases with meconium-stained amniotic fluid( 31%, 10/32 ) in severe ICP subgroup, significantly higher than those in mild ICP subgroup ( P＜ 0. 05 ), which contained 2 preterm births ( 7%, 2/30) and 1 meconium-stained amniotic fluid (3%, 1/30). While in control group, the numbers were 1(3%, 1/30)and 1(3%, 1/30),respectively. As for the cases of neonates whose 1 minute Apgar score were not more than 7, there were 2 cases, 1 case and 1 case in severe ICP subgroup, mild ICP subgroup and control group, respectively,which showed no significant difference(P＞ 0. 05). Conclusion Serum IL-18, IL-12 and TNF-α may be involved in the process of hepatic injury of ICP.     

Expression and significance of interleukin-18.12 and tumor necrosis factor-α in intrahepatic cholestasis of pregnancy

Objective To investigate the effect of Interleukin(IL)-18,IL-12 and tumor necrosis factor-α(TNF-α)in hepatic injury in intrahepatic cholestasis of pregnancy(ICP).Methods Sixty-two cases of ICP patients(ICP group),30 cases of normal pregnant women(control group)and 30 cases of hepatitis B(HBV) women (hepatitis group) were recruited. Serum IL-18, IL-12 and TNF-α were examined by ELISA. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were examined by automatic biochemical analysis instrument. Results ( 1 ) In hepatitis group, serum concentrations of IL-18,IL-12 and TNF-α were (256±51 ) ng/L, ( 122±96) ng/L and (207±3) ng/L; serum levels of ALT and AST were(363±174) U/L and (359 ±237) U/L, respectively. In ICP group, serum concentrations of IL18, IL-12 and TNF-α were (72±32) ng/L, (42 ±28) ng/L and (48±14) ng/L; serum levels of ALT and AST were (201 ±128) U/L and ( 132±87) U/L, respectively. While in control group, serum concentrations of IL-18, IL-12 and TNF-α were (43 ± 13) ng/L, ( 10±3) ng/L and (33±9) ng/L; serum levels of ALT and AST were (13 ~ 4) U/L and (15 ± 3) U/L, respectively. Serum IL-18, IL-12, TNF-α, ALT and AST levels in hepatitis group were significantly higher than those in ICP group and control group ( P ＜0. 05 ).Serum IL-18, IL-12, TNF-α, ALT and AST levels in ICP group were significantly higher than those in control group(P ＜ 0. 05 ). (2) In severe ICP subgroup, serum concentrations of IL-18, IL-12 and TNF-α were (81 ±32) ng/L, (50 ±25) ng/L and(50 ± 14) ng/L; serum levels of ALT and AST were (269 ± 111 ) U/L and (181±73) U/L In mild ICP subgroup, serum concentrations of IL-18, IL-12 and TNF-α were (48 ±18 ) ng/L, (17 ± 4 ) ng/L and (40 ± 10 ) ng/L; serum levels of ALT and AST were (87±46) U/L and (50 ±21 ) U/L, respectively. Serum IL-18, IL-12, TNF-α, ALT and AST levels in severe ICP subgroup were significantly higher than those in mild ICP subgroup and control group (P ＜ 0. 05). And serum ALT and AST levels in mild ICP subgroup were significantly higher than those in control group(P ＜0. 05). (3) There were 16 cases with preterm birth (50%, 16/32 ) and 10 cases with meconium-stained amniotic fluid( 31%, 10/32 ) in severe ICP subgroup, significantly higher than those in mild ICP subgroup ( P＜ 0. 05 ), which contained 2 preterm births ( 7%, 2/30) and 1 meconium-stained amniotic fluid (3%, 1/30). While in control group, the numbers were 1(3%, 1/30)and 1(3%, 1/30),respectively. As for the cases of neonates whose 1 minute Apgar score were not more than 7, there were 2 cases, 1 case and 1 case in severe ICP subgroup, mild ICP subgroup and control group, respectively,which showed no significant difference(P＞ 0. 05). Conclusion Serum IL-18, IL-12 and TNF-α may be involved in the process of hepatic injury of ICP.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

重度子痫前期患者临床发病前预警信息分析

Objective To identify the early warning signs of severe preeclampsia (SPE). Methods A case-control (1: 2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. Results (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27±4.31)kg/m2 vs (21.52±3.09)kg/m2, P>0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60±2.17)kg/m2 vs (4.85±1.52)kg/m2, P<0.05] and the increase of BMI per week was also higher [(0.74±0.41)kg/(m2*w)-1 vs (0.23±0.18)kg/(m2*w)-1, P<0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m2*w)-1, respectively, and 79% and 91% at 0.41 kg/(m2*w)-1 correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93±0.70)kg vs (0.63±0.20)kg, P<0.01]. Significant difference was also found in the net weight gain between the two groups (P<0.01), but not in the percentage of women with excessive weight gain (>0.50 kg/w) [60%(25/42) in the study group vs 63%(53/84) in the control group, P>0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17%(8/47) vs 5%(5/94), P<0.01]. (5) In the study group, 53%(25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls(P<0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6±1.6)g/L and(38.4±2.1)g/L(P<0.01), respectively. (7) Proteinuria was reported in 10 cases (21%)in the study group and 4(4%) in the controls (P<0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR=6.16,95%CI:2.29-16.57),pre-hypertension (OR=6.21,95%CI:1.56-24.77),proteinuria (OR=9.68,95%CI:1.86-50.30), and weight gain >0.85 kg/w during the third trimester (OR=11.60,95%CI:3.54-37.97). Conclusions Edema, excessive weight gain,pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.     

细胞因子信号传导负调控因子3在妊娠期肝内胆汁淤积症孕妇胎盘组织中的表达及其意义

Objective To detect the expression and significance of suppressor of cytokine signaling 3(SOCS3) in the placentas of pregnant women with intrahepatic cholestasis of pregnancy (ICP). Methods Totally, 44 ICP gravidas, including 21 severe ICP and 23 mild ICP who delvered through cesarean section at the Second Xiangya Hospital of Central South University from April 2008 to January 2009, were selected as the ICP group, and another 25 healthy pregnant women were chosen as control. Placentas of the above gravidas were collected and the expression and localization of SOCS3 were determined by immunohistochemical peroxidase streptomyces-avidin link (SP) method (indicated by the percentage ofpositive cells and average gray scale) and the levels of interleukin-10 (IL-10) and interferon-γ (IFN-γ)from placenta homogenation were measured by enzyme linked immunoadsorbent assay (ELISA). Results(1) SOCS3 were expressed in placentas of both groups mainly in the intracytoplasma of trophocyte.However, weakly positive, positive, and strongly positive expressions were found in the severe ICP, mild ICP and the control group, respectively. Almost no expression was detected in membrane and nucleus of the trophoblasts. (2) The percentage of SOCS3 positive cells in the severe ICP group was significantly lower than in the control and the mild ICP group, respectively [ (0.15±0.08)% vs (0.69±0.12)% and (0.42±0.09) % , P < 0.01 ]. The average gay SOCS3 in placental tissue in the severe ICP group was significantly higher than that in control and mild ICP group, respectively (204 ±7 vs 81 ±7 and 147 ± 7, P <0.01 ).(3) Significant lower level of IL-10 in placenta homogenation was found in the severe ICP group than in the control and mild ICP group [ ( 1.16 ± 0.68) μg/L, vs ( 1.39 ± 0.08) μg/L and ( 1.22 ± 0.75 ) μg/L,P < 0.01 ]. (4) The opposite results were found in the level of IFN-γin trophoblasts and the ratio of IFN-γ/IL-10 [ severe ICP group: ( 16.8 ± 0.7 ) μg/L and 16.02 ± 2.79; control group: ( 10.5 ± 0.3 ) μg/L and8.56 ±0.14; mild ICP group: ( 13.4 ±0.5) μg/L and 8.56 ±0.14, P <0.01]. (5) Negative correlation was shown between the percentage of SOCS3 positive cells in trophoblasts and the ratio of IFN-γ/IL-10 ( r =-0.685 and -0.702, P < 0.01 ), and the average gay SOCS3 was positively correlated with the ratio of IFN-γ/IL-10 (r=0.621 and 0.891, P<0.01) in both mild and severe ICP group. Conclousions SOCS3 may participate in the pathogenesis of ICP and its expression may affected by the severity of ICP, and SOCS3may also play a role in the immunological regulation in ICP patients.     

细胞因子信号传导负调控因子3在妊娠期肝内胆汁淤积症孕妇胎盘组织中的表达及其意义

Objective To detect the expression and significance of suppressor of cytokine signaling 3(SOCS3) in the placentas of pregnant women with intrahepatic cholestasis of pregnancy (ICP). Methods Totally, 44 ICP gravidas, including 21 severe ICP and 23 mild ICP who delvered through cesarean section at the Second Xiangya Hospital of Central South University from April 2008 to January 2009, were selected as the ICP group, and another 25 healthy pregnant women were chosen as control. Placentas of the above gravidas were collected and the expression and localization of SOCS3 were determined by immunohistochemical peroxidase streptomyces-avidin link (SP) method (indicated by the percentage ofpositive cells and average gray scale) and the levels of interleukin-10 (IL-10) and interferon-γ (IFN-γ)from placenta homogenation were measured by enzyme linked immunoadsorbent assay (ELISA). Results(1) SOCS3 were expressed in placentas of both groups mainly in the intracytoplasma of trophocyte.However, weakly positive, positive, and strongly positive expressions were found in the severe ICP, mild ICP and the control group, respectively. Almost no expression was detected in membrane and nucleus of the trophoblasts. (2) The percentage of SOCS3 positive cells in the severe ICP group was significantly lower than in the control and the mild ICP group, respectively [ (0.15±0.08)% vs (0.69±0.12)% and (0.42±0.09) % , P < 0.01 ]. The average gay SOCS3 in placental tissue in the severe ICP group was significantly higher than that in control and mild ICP group, respectively (204 ±7 vs 81 ±7 and 147 ± 7, P <0.01 ).(3) Significant lower level of IL-10 in placenta homogenation was found in the severe ICP group than in the control and mild ICP group [ ( 1.16 ± 0.68) μg/L, vs ( 1.39 ± 0.08) μg/L and ( 1.22 ± 0.75 ) μg/L,P < 0.01 ]. (4) The opposite results were found in the level of IFN-γin trophoblasts and the ratio of IFN-γ/IL-10 [ severe ICP group: ( 16.8 ± 0.7 ) μg/L and 16.02 ± 2.79; control group: ( 10.5 ± 0.3 ) μg/L and8.56 ±0.14; mild ICP group: ( 13.4 ±0.5) μg/L and 8.56 ±0.14, P <0.01]. (5) Negative correlation was shown between the percentage of SOCS3 positive cells in trophoblasts and the ratio of IFN-γ/IL-10 ( r =-0.685 and -0.702, P < 0.01 ), and the average gay SOCS3 was positively correlated with the ratio of IFN-γ/IL-10 (r=0.621 and 0.891, P<0.01) in both mild and severe ICP group. Conclousions SOCS3 may participate in the pathogenesis of ICP and its expression may affected by the severity of ICP, and SOCS3may also play a role in the immunological regulation in ICP patients.     

Maternal plasma adenosine and endothelin-1 levels in twin gestation complicated by preeclampsia

The aim of this study was to evaluate the relationship between the vascular resistance in uterine arteries and the maternal release of adenosine and endothelin-1 in twin gestations with and without preeclampsia. Uterine artery Doppler velocimetry and maternal arterial blood sampling were performed in 14 women with normal singleton gestation, nine women with singleton gestation with preeclampsia, eight women with dichorionic twin gestation without preeclampsia and six women with dichorionic twin gestation with preeclampsia at 28–34 weeks’ gestation. In normal singleton gestations, the average maternal uterine arteries pulsatility index (PI), plasma adenosine and endothelin-1 levels were 0.64±0.07, 0.34±0.11 μmol/l and 1.29±0.31 pg/ml, respectively. In preeclamptic singleton gestations, increased vascular resistance in the uterine arteries (PI: 0.85±0.14, P<0.05) and the elevation of maternal arterial plasma adenosine (0.48±0.14 μmol/l, P<0.05) and endothelin-1 levels (1.91±0.55 pg/ml, P<0.05) were observed. In the normal twin gestation group, the average maternal vascular resistance of the uterine arteries (PI: 0.55±0.09) was lower than that in the normal singleton gestation group, while the average plasma adenosine levels (0.47±0.12 μmol/l) were higher than that in normal singleton gestation. On the other hand, significant increased plasma endothelin-1 concentrations (1.87±0.42 pg/ml) were observed in the preeclamptic twin gestation groups without changes in plasma adenosine levels or vascular resistance of uterine arteries. Our results indicate the presence of different mechanisms for the pathogenesis of preeclampsia between twin and singleton gestations. Received: 5 October 2001 / Accepted: 3 December 2001 Correspondence to S. Suzuki     

Interaction among peroxisome proliferators-activated receptor alpha, cytochrome P450 oxysterol 7α-hydroxylase and estrogen receptor and its association with intrahepatic cholestasis in pregnant rats

Objective To investigate the relationship between interaction of peroxisome proliferators-activated receptor alpha (PPARα), cytochrome P450 oxysterol 7α-hydroxylase (CYP7B1) and estrogen receptor (ER) and intrahepatic cholestasis in pregnant rats. Methods Eighty clean SD pregnant rats were selected and divided into four groups randomly with 20 in each. Since the 13th day of pregnancy,rats in the control group was injected subcutaneously with refined vegetable oil 2.0 ml · kg-1 · d -1 , those in the low-dose, moderate-dose and high-dose groups received 17-α-ethynylestradiol (EE) 1.0 mg · kg-1 · d-1,1.25 mg · kg-1 · d-1 and 1.5 mg · kg-1 · d-1, respectively. All rats were sacrificed at the 21at day of pregnancy and maternal hepatic tissues were collected. The serum levels of alanine aminotransferase(ALT), aspartate transaminase (AST), total bile acid (TBA) and bilirubin (BIL) were determined by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of PPARα, CYP7B1, Erα and Erβ in maternal rat livers were examined by real-time PCR. Results (1) Biochemical indicators: the serum levels of ALT,AST, TBA and BIL were significantly lower in the control group than in the rest 3 groups,respectively [ control group: (41.1 ± 2.8 ) U/L, (44.4 ± 3.6) U/L, (26.4 ± 5.6 ) μmol/L and( 2.8 ± 0.2)U/L;low-dose group: (48.2 ±3.4) U/L,(47.9 ±3.7) U/L,(36.4 ±4.2) μmol/L and (4.2 ±0.2) U/L;moderate-dose group: (70.4 ± 5.3 ) U/L, (68.4 ± 5.6) U/L, (64.3 ± 3.8 ) μmol/L and ( 6.2 ± 1.2)U/L; high-dose group: (72.4 ±7.6) U/L, (70.2 ±3.8) U/L, (72.4 ±7.8) μmol/L and (8.2 ±2.2)U/L, P<0.05], and those in the moderate or high-dose groups were higher than in the low-dose group (P<0.05). (2) mRNA expression of Erα and Erβ: the mRNA expression of Erα in pregnant rat livers increased in a dose-dependent manner, which were all significantly higher than that in the control group,respectively ( low-dose group: 0.76 ± 0.02 ); moderate -dose group: ( 0.99 ± 0.04; high-dose group:1.21 ±0.01 ;control group:0.65 ±0.01, P <0.05), but no difference was found among the 4 groups in the mRNA expression of Erβ ( P > 0.05 ). (3) mRNA expression of CYP7B1 and PPARα: the mRNA expression of CYP7B1 in pregnant rat livers increased from the low-dose group to the high-dose group, and were all higher than that of the control group ( low-dose group: 0.93 ± 0.01; moderate-dose group: 0.99 ±0.06; high-dose group: 1.22 ± 0.04; control group: 0.75 ± 0.02, P < 0.05 ). However, the mRNA expression of PPARα decreased from the low-dose group to the high-dose group, and were all lower than that of the control group (low-dose group: 0.83 ± 0.05; moderate-dose group: 0.71 ± 0.02; high-dose group:0.64 ± 0.03; control group: 1.35 ± 0. 05; P < 0.05 ) . Conclusions The down regulated mRNA expression of PPARα, caused by higher dose of estrogen, may increase the expression of CYP7B1 due to the ineffectiveness of the inhibition of PPARα on CYP7B1, which may further stimulate the Erα activity and then induce intrahepatic cholestasis. Abnormal expression of PPARα, CYP7B1 and ER may play a role in the pathogenesis of estrogen-induced intrahepatic cholestasis.     

Interaction among peroxisome proliferators-activated receptor alpha, cytochrome P450 oxysterol 7α-hydroxylase and estrogen receptor and its association with intrahepatic cholestasis in pregnant rats

Objective To investigate the relationship between interaction of peroxisome proliferators-activated receptor alpha (PPARα), cytochrome P450 oxysterol 7α-hydroxylase (CYP7B1) and estrogen receptor (ER) and intrahepatic cholestasis in pregnant rats. Methods Eighty clean SD pregnant rats were selected and divided into four groups randomly with 20 in each. Since the 13th day of pregnancy,rats in the control group was injected subcutaneously with refined vegetable oil 2.0 ml · kg-1 · d -1 , those in the low-dose, moderate-dose and high-dose groups received 17-α-ethynylestradiol (EE) 1.0 mg · kg-1 · d-1,1.25 mg · kg-1 · d-1 and 1.5 mg · kg-1 · d-1, respectively. All rats were sacrificed at the 21at day of pregnancy and maternal hepatic tissues were collected. The serum levels of alanine aminotransferase(ALT), aspartate transaminase (AST), total bile acid (TBA) and bilirubin (BIL) were determined by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of PPARα, CYP7B1, Erα and Erβ in maternal rat livers were examined by real-time PCR. Results (1) Biochemical indicators: the serum levels of ALT,AST, TBA and BIL were significantly lower in the control group than in the rest 3 groups,respectively [ control group: (41.1 ± 2.8 ) U/L, (44.4 ± 3.6) U/L, (26.4 ± 5.6 ) μmol/L and( 2.8 ± 0.2)U/L;low-dose group: (48.2 ±3.4) U/L,(47.9 ±3.7) U/L,(36.4 ±4.2) μmol/L and (4.2 ±0.2) U/L;moderate-dose group: (70.4 ± 5.3 ) U/L, (68.4 ± 5.6) U/L, (64.3 ± 3.8 ) μmol/L and ( 6.2 ± 1.2)U/L; high-dose group: (72.4 ±7.6) U/L, (70.2 ±3.8) U/L, (72.4 ±7.8) μmol/L and (8.2 ±2.2)U/L, P<0.05], and those in the moderate or high-dose groups were higher than in the low-dose group (P<0.05). (2) mRNA expression of Erα and Erβ: the mRNA expression of Erα in pregnant rat livers increased in a dose-dependent manner, which were all significantly higher than that in the control group,respectively ( low-dose group: 0.76 ± 0.02 ); moderate -dose group: ( 0.99 ± 0.04; high-dose group:1.21 ±0.01 ;control group:0.65 ±0.01, P <0.05), but no difference was found among the 4 groups in the mRNA expression of Erβ ( P > 0.05 ). (3) mRNA expression of CYP7B1 and PPARα: the mRNA expression of CYP7B1 in pregnant rat livers increased from the low-dose group to the high-dose group, and were all higher than that of the control group ( low-dose group: 0.93 ± 0.01; moderate-dose group: 0.99 ±0.06; high-dose group: 1.22 ± 0.04; control group: 0.75 ± 0.02, P < 0.05 ). However, the mRNA expression of PPARα decreased from the low-dose group to the high-dose group, and were all lower than that of the control group (low-dose group: 0.83 ± 0.05; moderate-dose group: 0.71 ± 0.02; high-dose group:0.64 ± 0.03; control group: 1.35 ± 0. 05; P < 0.05 ) . Conclusions The down regulated mRNA expression of PPARα, caused by higher dose of estrogen, may increase the expression of CYP7B1 due to the ineffectiveness of the inhibition of PPARα on CYP7B1, which may further stimulate the Erα activity and then induce intrahepatic cholestasis. Abnormal expression of PPARα, CYP7B1 and ER may play a role in the pathogenesis of estrogen-induced intrahepatic cholestasis.     

水通道蛋白1和水通道蛋白3在羊水过少孕妇胎盘和胎膜的表达及其意义

Objective To study the expression of aquaporin 1 (AQP1) and aquaporin 3 (AQP3) in fetal membranes and placenta in pregnant women with oligohydramnios and to explore their function in the balance of amniotic fluid. Methods Thirty cases of term pregnancy with oligohydramnios were selected as the experimental group and 30 healthy term pregnant women with normal amniotic fluid volume were served as control. The expressions of mRNA and protein of AQP1 and AQP3 in fetal membranes and placenta were examined by real-time polymerase chain reaction and streptavidi peroxidase immunohistochemiscal staining. Results The expression of AQP1 mRNA in the amnion of the experimental group was 0.31 relative to that of the control group. The expression of AQP1 protein in the amnion of the experimental group was 0.14±0.02, which showed significant decrease when compared with the control (0.25±0.03) (P<0.05), while no significant difference in the chorion and placenta was found between the two groups(P>0.05). The amount of AQP3 mRNA expressions in amnion and chorion in the experimental group were 0.31 and 0.37 relative to those of the control group, respectively, while 7.36 in the placenta. The expression of the AQP3 protein in the amnion and chorion in the experimental group were 0.18±0.05 and 0.18±0.04, respectively, which showed significant decrease when compared with those in the control group (0. 26±0.03 vs 0.29± 0.06, P<0.05). But the expression of AQP3 protein in the placenta of experimental group was significantly higher than that of the control (0.47±0.09 vs 0.28±0.01, P<0.05). Conclusions The alterations of AQP1 and AQP3 expressions in fetal membrane and placenta in oligohydramniotic women are adaptive response to oligohydramnios.     

血清可溶性髓样细胞触发受体-1在足月新生儿细菌感染中的表达及意义

Objective To observe the changes of serum soluble form of triggering receptors expressed on myeloid cell-1 (sTREM-1) level in full-term newborns with infection and to investigate the relationship between serum sTREM-1 and neonatal bacterial infection.Methods Eighty-five full-term newborns admitted to the neonatal ward of Shanghai Children s Hospital of Shanghai Jiaotong University were selected into this study.According to the locations and severity of infection,patients were divided into 3 groups: severe infection group (n = 27),mild infection group (n = 28),non-infection group (n = 30).The samples of infection groups were collected before using antibiotics and within 48 h after infection symptom occurred; others were collected during hospitalization.For the neonates with organ dysfunction in the severe infection group,samples were also collected at the third and seventh day of infection.Serum sTREM-1 was measured by enzyme-linked immunosorbent assay.Analysis of variance was used to compare the difference between groups.Receiver operating characteristic (ROC) curve was used to calculate the sensitivity,specificity,positive and negative predictive value and Youden index.Results (1) Serum sTREM-1 level of severe infection group[(91.2±47.3) pg/ml] was significantly higher than that of mild infection group[(68.8 + 30.4) pg/ml] and non-infection group[(35.5±17.6) pg/ml],respectively (P＜0.05).(2) Serum sTREM-1 level of the survival newborns (n= 17) in the severe infection group was lower than that of dead ones[(73.1±34.9) pg/ml vs (121.6±49.3) pg/ml,t= - 2.995,P = 0.006].(3) For the survival patients,the serum sTREM-1 level decreased in the first week of infection,while that of dead patients increased,the cut-off value was 100.6 pg/ml.(4) Based on the ROC analysis,43.8 pg/ml was selected as the the cut-off value,area under the curve was 0.868,and sensitivity was 85.5%,specificity 80.0%,positive predictive value 0.887,negative predictive value 0.750,Youden index 0.655.Conclusions Serum sTREM-1 level increases in neonatal infection.The change of serum sTREM-1 level in patients with severe infection is correlated to the prognosis.