The combined effect of ultrasonic exposure and protein restriction on maternal and fetal mice

This investigation was undertaken to assess the combined effects of protein restriction and ultrasonic energy exposure during pregnancy on the maternal and fetal mouse. Pregnant female mice were fed diets containing either 18% casein (control diet) or 6% casein (restricted protein diet) during gestation. All animals were subjected to the ultrasonic exposure procedure (actual: 2.5 W/cm² spatial peak; sham: 0 W/cm²; continuous wave for 20 sec at a frequency of 1 MHz) on day 8 of gestation. On day 18 of gestation, the animals were sacrificed. Products of conception were examined, and chemical analysis were performed on maternal liver, placenta and fetus.Our results suggest that there are possible influences of ultrasonic energy exposure to the mouse fetus and placenta, as indicated by the tendency toward decreases of fetal weight, placental weight, and DNA and RNA contents of both fetus and placenta, especially with restricted protein in the maternal diet during gestation.Protein restriction during pregnancy had an adverse influence on both the maternal organism and her products of conception. The nutritional needs for the fetus were not met at the expense of the maternal organism. Parameters of fetal cellular growth were reduced by gestational protein restriction indicating that there is competition for available nutrients between the fetus under time of stress. Results also show that the trends of fetal and placental growth are in the same general direction suggesting the possible usefulness of human placental tissue as a maker for fetal growth in subsequent population studies.     

BMP signaling mediates astrocyte differentiation of oligodendrocyte progenitor cells

Oligodendrocyte precursor cells (OPCs) can differentiate into oligodendrocytes or astrocytes, depending on cellular microenvironments. OPCs, cultured in medium supplemented with 10% (v/v) fetal bovine serum (FBS), give rise to type II astrocytes that express glial fibrillary acidic protein and a cell surface ganglioside that is recognized by A2B5 monoclonal antibody. However, the factors in FBS that direct the astrocyte differentiation are not determined. Moreover, bone morphogenetic proteins (BMPs) have been reported to be involved in astrocyte differentiation of neural progenitor cells. We therefore examined whether BMPs are responsible for the serum-mediated astrocyte differentiation from OPCs. OPCs were isolated from the spinal cords of Wistar rat embryos (at day 14) using the A2B5 antibody. We measured the concentrations of BMP-2 and BMP-4 in FBS and rat and human sera and the expression of mRNAs for three types of BMP receptors (BMPRIa, Ib and II) in OPCs by RT-PCR. The serum samples of the three species contained BMP-2 and BMP-4, as judged by ELISA with each monoclonal antibody, and the BMP receptor mRNAs are expressed in OPCs. When OPCs were cultured in the medium containing 10% FBS, cells (more than 95%) differentiated into type II astrocytes. However, when OPCs were pretreated with noggin, a soluble antagonist of BMP action, the degree of astrocyte differentiation was markedly decreased from 95.39 to 38.36%. Taken together, these results suggest that BMP signaling may be responsible for the serum-mediated astrocyte differentiation of OPCs. Our findings provide new insights into the molecular basis of differentiation of OPCs.     

Experimental congenital toxoplasmosis. II. Transmission of toxoplasmosis to the placenta and fetus following vaginal infection in the pregnant mouse

Pregnant mice infected with Toxoplasma by the vaginal route have been found to transmit toxoplasmosis to the placentas and fetuses in utero. The microorganism entered the blood stream of the mother from primary foci of infection in the vaginal wall and produced disseminated lesions in the labyrinth of the allantoic placenta at the same time as other peripheral maternal tissues were involved. Placental lesions were observed in mice infected with Toxoplasma by vagina between the 3rd and the 9th day of pregnancy. They consisted of microscopic foci of degeneration, without inflammation, in the syncytial trophoblast, and parasites undergoing multiplication were readily identified in them. Here Toxoplasma gained access to the fetal circulation. Following the vaginal instillation of Toxoplasma on the 8th day of pregnancy, subinoculation of test animals revealed the parasites in the maternal peripheral and placental blood on the 13th day and later, while the first histopathologic changes in the placenta were found on the 17th day. Toxoplasma could be demonstrated in suspensions of fetal tissues on and after the 17th day by the injection of normal test animals. However, no lesions of toxoplasmosis, or Toxoplasma, were found in histologic sections of fetuses 11 to 21 days old removed at autopsy from vaginally infected mothers. It is concluded that before birth the parasites were confined to the fetal blood. The experiments provide the first direct histological demonstration of placental toxoplasmosis. The possible bearing of the experimental disease on human placental and fetal toxoplasmosis is briefly considered. It is probable that a maternal parasitemia during the latter part of pregnancy, whatever the portal of entry may be, is an essential factor in the pathogenesis of human congenital toxoplasmosis and that this occurs shortly after exposure to Toxoplasma rather than in a later chronic stage of the infection. The suggestion is offered that some instances of spontaneous abortion or fetal death in man, as in the mouse, may be due to inapparent toxoplasmosis.     

妊娠期高血压病患者终止妊娠时机及分娩方式临床观察

目的探讨妊娠期高血压疾病患者的终止妊娠时机及分娩方式对妊娠结局的影响。方法选取本院产科于2011年11月-2013年10月收治的妊娠期高血压疾病孕妇156例,根据终止妊娠时机分为3组：A组（〈34周,22例）、B组（34-36周,41例）、C组（〉36周,93例）;根据分娩方式分为2组：经阴道分娩组（38例）和剖宫产组（118例）。分别对比不同妊娠时机、不同分娩方式新生儿出生体质量、新生儿窒息发生率、新生儿死亡率以及产妇并发症发生率。结果A组新生儿出生体质量显著低于B、C组（P〈0．01）,B组显著低于C组（P〈0．01）;A组新生儿窒息发生率及新生儿死亡率显著高于B、C组（P〈0．01或P〈0．05）,B组显著高于C组（P〈0．05）。不同终止妊娠时机产妇并发症发生率比较差异无统计学意义（P〉0．05）。经阴道分娩组新生儿出生体质量显著低于剖宫产组（P〈0．01）;而经阴道分娩组新生儿窒息发生率、死亡率以及产妇并发症发生率均显著高于剖宫产组（P〈0．01）。结论孕周较小的妊娠期高血压疾病患者应给予合理的治疗以适当延长妊娠时间,于妊娠36周左右时终止妊娠,并应尽可能选择剖宫产,从而降低经阴道分娩对产妇及胎儿造成的伤害,降低新生儿及产妇围生期并发症发生率。     

围产期发生胎膜早破的多因素分析

目的探讨围产期发生胎膜早破的多种相关影响因素的分析。方法依照病例定义选择2012年6月～2013年5月陕西省人民医院产科的正常孕产妇112例和胎膜早破的孕产妇108例,记录孕产妇的年龄、婚龄、初潮时间、初始性生活、周性交频次、安全套使用、不洁性交、吸烟、流产次数、生育胎次、第一胎产时间、孕周、胎位、羊水量、缺乏维生素C／微量元素铜／微量元素锌、孕后期咳嗽、孕后期性生活、便秘、妊娠期高血压及胎儿的体重和性别共21项因素;同时采集孕妇的阴道分泌物用定量PCR进行支原体、衣原体、念珠茵、B族链球茵的检测及阴道微生态的检测,综合分析以上27项相关因素对胎膜早破的影响及其导致的产后母婴感染。统计学方法：分类资料用卡方检验,计量资料用方差分析,支原体的感染采用对数转换后进行计量统计。结果对两组产妇研究的27项变量进行单因素分析得到：孕周、支原体感染在两组间的差异有统计学意义（t=2．435～6．093,P=0．005～0．027）;流产次数、吸烟、胎位、缺乏维生素C＼微量元素铜＼微量元素锌、孕后期咳嗽、阴道微生态失调、B族链球菌感染、衣原体感染在两组间的差异有统计学意义（x2=2．769～20．517,P=0．000～O．046）。同时胎膜早破组发生早产、新生儿肺炎、胎儿窘迫、产褥感染、羊膜炎感染比正常孕妇组高,两组间的差异有统计学差异（x2=4．96～36．5,P=0．000～0．035）。结论围产期发生胎膜早破是多因素影响的结果,而且可导致产后不良结局,建议临床应对胎膜早破进行早期的评估和治疗,避免因胎膜早破而引起的母婴感染。     

罗哌卡因用于腰硬联合阻滞麻醉分娩镇痛效果及对母婴安全的影响

目的：探讨罗哌卡因用于腰硬联合阻滞麻醉分娩镇痛效果及对母儿安全的影响。方法抽选该院自愿要求实施无痛阴道分娩的足月妊娠、无椎管内麻醉手术禁忌证、单胎头位产妇100例为观察组,予以1 m g/m L罗哌卡因复合0．5μg/m L舒芬太尼腰硬联合阻滞麻醉分娩镇痛,同时选择条件相似未行任何镇痛措施的产妇100例作为对照组,比较两组患者镇痛效果、产程、产妇下肢肌力、分娩结局。结果观察组麻醉10 min后直至宫口全开时产妇疼痛视觉模拟评分法（VAS）评分均明显低于对照组,差异有统计学意义（P＜0．05）;两组产妇产程、产后出血及新生儿窒息率、新生儿Apgar评分、缩宫素使用率、产妇下肢肌力等比较差异无统计学意义（P＞0．05）;观察组剖宫产率明显低于对照组,差异有统计学意义（P＜0．05）;观察组麻醉镇痛后产妇生命体征以及血氧饱和度均相较于镇痛前比较差异无统计学意义（P＞0．05）。结论罗哌卡因用于腰硬联合阻滞麻醉对阴道分娩产妇的镇痛效果显著,显著降低及剖宫产率,并且不增加母婴安全隐患,值得临床推广。     

双胎妊娠经阴道分娩的母婴结局分析与对策*

目的：探讨双胎妊娠经阴道分娩的母婴安全性,为双胎妊娠分娩方式的选择提供更多参考。方法：收集双胎妊娠选择经阴道试产的孕产妇63例,对母婴结局进行回顾性分析。结果：63例双胎妊娠阴道试产产妇中,成功阴道分娩者55例,阴道分娩成功率87.3%,其中9例经产妇,阴道试产均成功。55例阴道分娩产妇中,孕28～33 +6周39例,34～36+6周11例,37周以上5例,孕周越小,阴道分娩成功率越大;55例成功经阴道分娩产妇中,胎方位为头/头位32例。头/臀位23例。产后出血率9例。阴道分娩新生儿110例,发生窒息16例,新生儿窒息率14.5%。孕周<34周新生儿窒息率13.6%（15/110）,孕周≥34周新生儿窒息率0.9%（1/110）,孕周<34周的新生儿窒息发生率高于≥34周的新生儿（P<0.05）;第1新生儿窒息发生率3.6%（2/55）,第2窒息发生率25.5%（14/55）,第2新生儿窒息发生率高于第1新生儿（P<0.01）。结论：双胎妊娠绝非阴道试产的禁忌,分娩方式应根据孕周、胎方位、孕妇的孕产次情况等综合判断,制定个性化的分娩计划,阴道试产过程中加强评估与监护,提高双胎妊娠经阴道分娩的母婴安全。     

胎盘早剥48例临床分析

目的:提高胎盘早剥的早期诊断和及时治疗,降低母儿并发症.方法:回顾性分析我院2006年1月~2011年6月诊治的48例胎盘早剥的临床资料.结果:胎膜早破、妊娠期高血压疾病、胎儿生长受限为胎盘早剥的重要高危因素.主要临床表现为腹痛、子宫张力大、阴道流血、子宫压痛、胎心异常、死胎、血性羊水等.剖宫产30例,阴道产18例,产妇发生产后出血9例,DIC 2例,行次全子宫切除术1例,无孕产妇死亡.新生儿轻度窒息11例,重度窒息5例,死胎3例.结论:胎盘早剥病因多,临床表现个体差异大,及早识别和处理是降低风险,提高母婴结局的关键.     

超高龄孕妇终止妊娠时机探讨

目的探讨超高龄孕妇终止妊娠时机对母婴结局的影响。 方法回顾性分析佛山市第一人民医院产科2016年2月至2019年1月160例超高龄孕妇分娩的资料,依据产妇分娩时妊娠周数分为超预产期妊娠组（40~41周,共33例）和正常足月妊娠组（37~39^＋6周,共127例）。对两组患者的年龄、距离前次妊娠时间、分娩前血红蛋白水平、产时体质量指数（BMI）等指标的组间比较采用t检验,对两组患者直接剖宫产、阴道试产失败后转剖宫产、阴道助产、顺产、产后出血、新生儿转儿科、羊水过少、羊水混浊、急性胎儿窘迫、胎膜早破、巨大儿的发生率的组间比较采用χ²检验。 结果超预产期妊娠组与正常足月妊娠组在年龄、距离前次妊娠时间、分娩前血红蛋白水平、产时BMI、直接剖宫产率、阴道试产失败后转剖宫产率、阴道助产率、顺产率、产后出血发生率、新生儿转儿科发生率、胎膜早破发生率、巨大儿发生率等方面差异无统计学意义（P均>0.05）。超预产期妊娠组与正常足月妊娠组比较,羊水过少发生率（15.15% vs 3.15%,χ²=5.026,P=0.025）、羊水混浊发生率（33.33% vs 3.15%,χ²=24.648,P<0.001）、急性胎儿窘迫发生率（12.12% vs 1.57%,χ²=5.414,P=0.020）均明显增高,差异有统计学意义。 结论超高龄孕妇应选择足月后预产期前终止妊娠,降低发生围产儿不良结局的概率。     

高龄产妇并发子痫前期的母胎血流动力学及临床分析

目的探讨高龄产妇并发子痫前期对母儿预后的影响。方法对210例子痫前期患者的临床资料进行回顾性分析,按年龄分为3组,Ⅰ组为观察1组:年龄≥40岁,共36例;Ⅱ组为观察2组:35岁年龄≤40岁,共60例;Ⅲ组为对照组:年龄35岁,共114例;应用彩色多普勒超声对孕妇进行血液动力学有关参数测定(包括UA-S/D、UA-PI、UtA-S/D、UtA-PI),并结合其预后进行统计分析。结果随着孕龄的增长,各组UA、UtA的S/D值及PI值均呈下降的趋势,三组比较,观察1组的UtA-PI、UA-S/D、UA-PI在各妊娠周均显著高于对照组,P0.05;轻、重度子痫前期的构成比及子痫的发生率上,观察组与对照组比较无显著性差异(P0.05);观察1组剖宫产率显著高于对照组,差异有统计学意义(P0.05);观察组胎盘早剥、心衰、肝损害、肾损害、产后出血、HELLP综合征等严重并发症的发生率高于对照组,三组比较,均无显著性差异(P0.05);观察组在胎儿宫内窘迫、新生儿窒息、围产儿死亡的发生方面与对照组无显著性差异(P0.05)。在胎儿生长受限及早产的发生率上,观察1组显著高于对照组,两组比较有统计学差异(P0.05)。结论高龄产妇(特别是年龄大于40岁);并发重度子痫前期时对母儿危害大;应加强产前监护;适时剖宫产终止妊娠;以改善母儿预后     

Effectiveness of spiramycin for treatment of congenital Toxoplasma gondii infection in rhesus monkeys.

The effectiveness of spiramycin for the treatment of rhesus monkey fetuses congenitally infected with Toxoplasma gondii was studied. Eight monkeys were infected at day 90 of pregnancy. This is comparable to the second trimester of organogenetic development in humans. Transmission of infection was found prenatally in five of the eight monkeys by detection of the parasite in the amniotic fluid. Treatment with spiramycin (20 mg/kg/day in two intermittent doses given intravenously) was started as soon as fetal infection was proven and was continued until birth. Nine to 14 days after initiation of treatment, the parasite was still detectable in amniotic fluid samples from four of these five cases. However, the parasite was detected only by PCR and not by mouse inoculation. T. gondii was also detected only by PCR in the placenta of one monkey that delivered prematurely. This monkey received spiramycin treatment for only 2 weeks. In the four monkeys that received treatment for about 7 weeks, the parasite was not present at birth in the placenta nor in amniotic fluid or neonatal organs. Spiramycin accumulates mainly in maternal tissues. Although concentrations in neonatal tissue were found to be 5 to 28 times higher than the corresponding concentrations in neonatal serum, the concentrations in neonatal tissue were still 11 to 16 times lower than those found in the mothers. However, no spiramycin was found in the fetal brains. Early treatment with spiramycin may prevent transmission of infection to the fetus but most probably cannot interrupt an existing brain infection, which is the most severe outcome of congenital toxoplasmosis in humans.     

妊娠期糖尿病孕期干预对妊娠结局的影响

目的：探讨妊娠期糖尿病的孕期干预对妊娠结局的影响。方法回顾性分析妊娠糖尿病（GDM）患者120例,将孕期通过干预后血糖控制良好的76例孕妇为干预实验组,将未予孕期干预、血糖控制不佳者44例为干预对照组,同时,随机抽取110例血糖正常的分娩孕妇为正常对照组,比较三组孕妇妊娠结局及围生儿结局。结果干预实验组早产、羊水过多、巨大儿、FGR、糖尿病酮症、新生儿低血糖、新生儿窒息及高胆红素血症的发生率及剖宫产率均低于干预对照组,差异有统计学意义（P〈0.05）,而其与正常对照组比较差异无统计学意义（P〉0.05）。结论妊娠期糖尿病孕期有效干预可明显降低母婴并发症的发生率,改善母婴结局,甚至达到正常孕妇水平。     

Customized fetal weight limits for antenatal detection of fetal growth restriction.

OBJECTIVE: To define cut-off limits for individually adjustable fetal weight standards for the detection of intrauterine growth restriction. DESIGN: Retrospective study, with the outcome measures small-for-gestational age (SGA) birth weight, operative delivery for fetal distress, umbilical artery pH < 7.15, and admission to the neonatal intensive care unit. SUBJECTS AND METHODS: Two hundred and fifteen women considered to be at increased risk of uteroplacental insufficiency were recruited to a study of serial ultrasound scans. Fetal weights were derived using standard formulae and, retrospectively, weight percentiles were calculated after individual adjustment for maternal height, weight in early pregnancy, ethnic group, parity and fetal sex. INTRODUCTION: One or more antenatal scans indicative of fetal weight below the 10th customized percentile were predictive for a SGA neonate at birth (P < 0.001), operative delivery for fetal distress (P < 0.01) and admission to neonatal intensive care (P < 0.01) but not for a low umbilical artery pH (P = 0.6). Receiver-operator curves showed the optimal customized fetal weight percentile limit for predicting an SGA neonate to be the 18th percentile (sensitivity 83%, specificity 79%, positive predictive value 63% and negative predictive value 92%). For the prediction of operative delivery for fetal distress and admission to neonatal intensive care, the optional customized cut-off value was the 8th percentile. CONCLUSIONS: The assessment of fetal weight using ultrasound and an individually-adjusted standard is predictive of growth restriction and perinatal events associated with hypoxia or diminished reserve. The optimal cut-off value for predicting operative delivery for fetal distress or admission to the neonatal intensive care unit suggests that the 10th customized percentile is a good limit for clinical use.     

近足月头位胎儿生长受限的分娩方式

目的探讨近足月头位胎儿生长受限（FGR）的适宜分娩方式。方法采用回顾性分析方法,收集2010年1月~2015年9月分娩孕周≥36周、单胎、头位分娩的FGR病例且符合入选标准与排除标准的孕妇146例,按其分娩方式分为研究组（阴道分娩）和对照组（剖宫产分娩）,并对两组资料进行比较分析。结果研究组的孕妇与对照组相比,妊娠合并症发生率无显著差异,分娩时间较对照组延迟5 d（t=3.941,P < 0.001）,住院时间缩短3 d（t=-3.870,P < 0.001）;而研究组的羊水混浊和新生儿窒息率与对照组比较无显著性差异（χ2=1.490,P=0.222;χ2=0.216,P=0.642）,入住新生儿重症监护病房或病婴室的概率明显下降（59.1% vs 85.3%,χ2=12.280,P < 0.001）,住院时间缩短3 d（t=-3.230,P=0.002）。结论妊娠36周后的FGR病例,采取阴道分娩不增加其围产儿不良结局,并可减少母儿住院时间。      

新生大鼠全大脑组织分离诱导分化神经干细胞的体外实验

背景：神经干细胞的供体一股以胎鼠和成年鼠为主，利用细胞培养技术分离步骤较繁琐。目的：以新生大鼠为神经干细胞供体，拟建立一种较为简便、细胞获得率较高的分离培养方法。设计、时间及地点：以细胞为对象观察性实验，于2006—10／2007—03在重庆医科大学完成。材料：新生1～3d的Wistar大鼠全大脑。方法：以胰蛋白酶消化、无血清、悬浮培养原代细胞，并加含体积分数为0．10胎牛血清的DMEM／F12培养液诱导其分化。主要观察指标：应用相差显微镜观察神经干细胞的生长特点及分化后的细胞形态学变化。应用间接免疫细胞化学染色法鉴定神经千细胞及其分化后神经元和胶质细胞标志蛋白的表达。以BrdU标记神经干细胞，观察其增殖情况。结果：新生大鼠脑组织分离的细胞具有连续传代和增殖的能力，能稳定表达神经干细胞特异性巢蛋白。诱导分化后的细胞能表达神经元细胞、旱形胶质细胞、少突胶质细胞的特异性蛋白。结论：从新生大鼠脑组织分离培养出的神经干细胞获得率高，保持了干细胞的未分化属性，具有自我更新和多项分化潜能。     

Maternal molecular hydrogen administration on lipopolysaccharide-induced mouse fetal brain injury

Fetal brain injury is often related to prenatal inflammation; however, there is a lack of effective therapy. Recently, molecular hydrogen (H₂), a specific antioxidant to hydroxyl radical and peroxynitrite, has been reported to have anti-inflammatory properties. The aim of this study was to investigate whether maternal H₂ administration could protect the fetal brain against inflammation. Pregnant C3H/HeN mice received an intraperitoneal injection of lipopolysaccharide (LPS) on gestational day 15.5 and were provided with H₂ water for 24 h prior to LPS injection. Pup brain samples were collected on gestational day 16.5, and the levels of apoptosis and oxidative damage were evaluated using immunohistochemistry. Interleukin-6 (IL-6) levels were examined using real-time PCR. The levels of apoptosis and oxidative damage, as well as the levels of IL-6 mRNA, increased significantly when the mother was injected with LPS than that in the control group. However, these levels were significantly reduced when H₂ was administered prior to the LPS-injection. Our results suggest that LPS-induced apoptosis, oxidative damage and inflammation in the fetal brain were ameliorated by maternal H₂ administration. Antenatal H₂ administration might protect the premature brain against maternal inflammation.     

Fetal toxic effects of angiotensin II receptor antagonists: case report and follow-up after birth

OBJECTIVE: To report a child born with renal impairment following severe anhydramnios due to maternal exposure to an angiotensin II receptor type 1 (AT1) antagonist, valsartan, and hydrochlorothiazide during the first 28 weeks of pregnancy. CASE SUMMARY: A hypertensive woman treated with valsartan 80 mg/day, hydrochlorothiazide 12.5 mg/day, prazosin 10 mg/day, lysine acetylsalicylate 100 mg/day, and levothyroxine 250 microg/day became pregnant. At 28 weeks' gestational age, severe anhydramnios associated with high beta2-microglobulin levels in the fetal blood cord was observed. Upon discontinuation of valsartan, fetal renal prognosis improved. In this case, using the Naranjo probability scale, the renal insufficiency of the child was probably related to valsartan. At the age of 2.5 years, the child presented with only mild chronic renal insufficiency. Growth parameters were within the normal range, and there was no evidence of developmental delay. DISCUSSION: Exposure to AT1 antagonists during the second part of pregnancy can lead to abnormalities similar to those observed after exposure to angiotensin-converting enzyme inhibitors, that is, reduced fetal kidney perfusion that may result in oligoamnios and neonatal renal insufficiency. Fourteen previous reports of maternal exposure to AT1 antagonists during this period have been published. In 6 cases, fetal or neonatal death occurred; in 2 cases, pregnancy was terminated because of complete anhydramnios or fetal abnormalities; in 1 case, renal insufficiency persisted at 8 months of age; in 2 cases, kidney function was fairly normal at birth; and in 4 cases, including the one described here, neonatal renal failure improved in the first year of life. CONCLUSIONS: AT1 antagonists should be avoided throughout pregnancy. If these agents are prescribed accidentally to a pregnant woman, monitoring of amniotic fluid volume and beta2-microglobulin fetal blood levels after discontinuation of the AT1 antagonist can provide critical data for advising parents on pregnancy and fetal outcome.     

CO中毒迟发性脑病大鼠脑内星形胶质细胞和少突胶质细胞的表达及高压氧治疗对其表达的影响

目的探讨CO中毒迟发性脑病（DNS）大鼠脑内星形胶质细胞和少突胶质细胞的表达情况及高压氧（HBO）治疗对上述两种胶质细胞表达的影响，分析迟发性脑病的发病机制。方法建立DNS大鼠模型，用HE染色观察大鼠脑组织病理学变化，用免疫组织化学方法，采用小鼠抗大鼠神经胶质原纤维酸性蛋白（GFAP）单克隆抗体、小鼠抗大鼠RIP单克隆抗体检测大鼠脑内星形胶质细胞和少突胶质细胞的表达。结果HE染色标本上，正常对照组大鼠脑内细胞形态正常，DNS大鼠脑皮质出现大片疏松区，海马锥体细胞层稀疏，可见点片状坏死；HBO组坏死程度相对较轻。免疫组化结果显示，与对照组比较，DNS组GFAP表达明显增多（P〈0．05），且阳性细胞形态发生改变；RIP表达随损伤时间的推移逐渐减少（P〈0．05）；HBO组GFAP较7d组表达减少（P〈0．05），RIP较7d组表达增多（P〈0．05）。结论星形胶质细胞和少突胶质细胞在DNS的发病过程中起重要作用，高压氧治疗可针对胶质细胞改善患者脑组织损伤程度。     

Fetal and neonatal allo-immune response

The components of the immune system may be present in early stages of embryonic and then fetal, then they reach maturity at different stages of pregnancy. Just as the growth and development of the components of the embryonic and then fetal immune system progressively mature, functions are acquired sequentially during the course of pregnancy, both the ability to mount a cell-mediated or antibody-mediated immune response and the tolerance towards a certain group of antigens. The fetus is immunocompetent because during this development, it acquires the ability to generate an immune response. As development takes place, the fetus also generates specific tolerance as it is exposed to genetically foreign and non-inherited maternal antigens. Nonetheless, the fetal immune system does not attack nor harm maternal tissues. At birth, the immune system, although developed, is not mature enough yet. Furthermore, passive transfer of maternal antibodies creates a unique scenario of compatibility that cannot be seen in children or adults. Recent advances in knowledge of fetal and neonatal immunology make it possible to recognize the risks associated with transfusion and how to resolve them.