合体滋养层细胞微粒对子痫前期重度病情进展的影响

目的探讨合体滋养层细胞微粒（syncytiotrophoblast microparticles,STBM）在子痫前期重度病情进展中的作用。方法收集子痫前期重度33例,按照子痫前期重度临床发病特点和病情进展时间（从发病至发展为子痫前期重度是否大于48h）分为突发型（11例）和渐进型（22例）,并随机选取同期正常健康剖宫产孕妇20例作为正常对照组,采用酶联免疫分析法（ELISA）测定母体外周血血浆中STBM浓度。结果突发型及渐进型子痫前期重度外周血血浆STBM浓度均明显高于对照组,差异有统计学意义（P〈0.05）。突发型STBM浓度高于渐进型,差异有统计学意义（P〈0.05）。结论 STBM脱落进入血液循环增多可能与子痫前期重度病情进展有关。     

低水平铅暴露人胎盘组织诱导型和内皮型一氧化氮合酶的表达及意义

目的探讨孕期低水平铅暴露对胎盘组织诱导型和内皮型一氧化氮合酶的表达及其与铅水平的关系。方法2005年2月至2006年12月孕期外周血铅水平大于30μg/l的67例孕妇,根据铅水平分组,血铅水平30μg/l-60μg/l的孕妇35例为A组;血铅水平在60μg/l-100μg/l的孕妇32例为B组。检测胎盘中一氧化氮合酶系统表达。结果低水平铅暴露下诱导型和内皮型一氧化氮合酶在各组胎盘中的表达均分布在合体滋养细胞、细胞滋养细胞、微小血管内皮细胞、蜕膜细胞、绒毛间纤维细胞(villus fibrocyte)的胞浆,定位显示无显著差异;高血铅组的表达水平与强度显著高于低铅水平组(P<0.05)。结论金属铅可诱导发育中胎盘组织诱导型和内皮型一氧化氮合酶产生,胎盘NOS酶活性上升,能够改善子宫-胎盘血循环障碍,抵御铅毒性,维持正常妊娠的进行。     

粒单核系和粒细胞集落刺激因子在人胎盘细胞的确定

粒单核系和粒细胞集落刺激因子在人胎盘细胞的确定刘桂兰孙敏张莹虞有智回允中一、材料和方法１材料来源和制备：胎盘标本来源于我院产科妊娠３７～４０周，健康孕妇，足月顺产分娩的正常胎盘组织１０份。胎盘娩出后，立即送病理科冰冻。将标本在低温恒冷切片机中做成１...     

髓过氧化物酶(MPO)在妊高征发病中的作用

目的本文旨在探讨髓过氧化物酶在妊高征发病中的作用。方法采用分光光度计比色法检测胎盘组织中中性粒细胞髓过氧化物酶(MPO)活性。结果重度妊高征组胎盘组织MPO含量显著高于中度妊高征组(P<0.05);重度妊高征组胎盘组织MPO含量显著高于正常组(P<0.05);中度妊高征组胎盘组织MPO含量与正常组相比较没有显著性差异(P>0.05)。结论重度妊高征妇女胎盘组织髓过氧化物酶含量较正常孕妇相比增高,差异有显著性,支持妊高征发病的中性粒细胞活化导致的内皮细胞损伤学说。     

孕产妇孕期锌缺乏对胎盘碱性磷酸酶的影响

目的探讨孕产妇孕期锌缺乏对胎盘碱性磷酸酶影响的组化特征.方法选择17例锌缺乏的孕妇与57名血清锌正常的孕妇做为对照,AKP的组化染色采用钙-钴显示法,血清锌用血浆蛋白-原子吸收分光度法,来检测锌及AKP的活性.结果锌缺乏(<90μg/dl)的孕妇分娩后胎盘碱性磷酸酶含量明显低于对照组.结论孕产妇孕期锌缺乏导致胎盘碱性磷酸酶的活性降低,从而影响胎盘的正常代谢.     

不同孕期D-二聚体浓度分析

目的 :探讨产前孕妇血浆D 二聚体水平。方法 :排除D 二聚体增高的相关性疾病 ,将孕妇分成早、中、晚孕三组 ,并设非孕育龄妇女对照组 ,用免疫比浊法对检测对象进行D 二聚体水平分析。结果 :对照组D 二聚体为 0 .2 3 μg/ml± 0 .0 8μg/ml;早、中、晚孕组分别为0 .3 3 μg/ml± 0 .0 9μg/ml、0 .76μg/ml± 0 .2 4μg/ml、1.5 1μg/ml± 1.0 7μg/ml。孕妇各组比较差异显著 (P <0 .0 1) ,与对照组比较 ,D 二聚体均有明显增高 (P <0 .0 1)。结论 :产前孕妇D 二聚体水平普遍高于健康妇女 3～ 4倍。在进行DIC或静脉血栓临床诊断时 ,不能套用健康人正常参考范围 ,否则会造成临床诊断的错误。必须注意对纤维蛋白原 >5 g/L ,D 二聚体正常或略高于正常 ,或显著高于正常的产前孕妇进行动态观察 ,防止DIC发生     

胎盘合体滋养细胞的免疫抑制活性

<正> 选用正常足月妊娠新鲜胎盘,经酶消化合并机械分离法分离胎盘合体滋养细胞。所获得的合体滋养细胞的纯度达90～95％以上,细胞活力大于90％。经培养4小时的合体滋养细胞的上清液,对母亲与胎儿的淋巴细胞转化试验和向混合淋巴细胞培养均有明显的抑制。提示可能通过局部抑制母体免疫     

IL-17在子痫前期患者胎盘组织的表达

目的探讨白细胞介素-17(IL-17)与子痫前期发病的关系。方法选取2010年10月至2011年12月在广州医学院第二附属医院和广州医学院第三附属医院产科住院的子痫前期患者30例,其中足月妊娠9例,未足月妊娠21例;选取同期住院分娩的正常足月妊娠孕妇30例为对照组。30例正常晚期妊娠孕妇为对照组。采用免疫组化方法检测两组胎盘组织IL-17表达水平。结果子痫前期组胎盘IL-17表达量较对照组升高(P<0.05)。结论IL-17可能介导了子痫前期的发生。     

子痫前期患者外周及胎盘血循环中瘦素水平的比较

目的探讨妊娠期高血压疾病子痫前期患者血中瘦素水平的变化,及胎盘在这一变化中的作用.方法行剖宫产时,取孕妇肘前静脉及胎盘附着部位子宫静脉血.其中妊娠期高血压疾病子痫前期患者(研究组)15例,正常妊娠妇女(对照组)20例.应用放射免疫分析法测定血清瘦素水平.结果研究组外周血瘦素水平为23.29±3.32μg/L,对照组为13.87±1.24μg/L,两组比较差异有极显著性(P<0.01).研究组子宫静脉血瘦素水平为16.44±2.23μg/L,对照组为11.2±0.94μg/L,两组比较有显著性(P<0.05).研究组外周血和子宫静脉血比较有极显著性(P<0.01).对照组外周血和子宫静脉血比较有极显著性(P<0.01).结论妊娠期高血压疾病子痫前期患者外周血瘦素水平高于正常妊娠,提示瘦素可能参与妊娠期高血压疾病的发病.妊娠期高血压疾病子痫前期患者子宫静脉血瘦素水平高于正常妊娠,提示妊娠期高血压疾病患者胎盘中瘦素的合成增加.妊娠期高血压疾病子痫前期患者及正常妊娠孕妇外周血瘦素水平均高于子宫静脉血,提示胎盘只是正常妊娠孕妇及妊娠期高血压疾病患者血中瘦素增加来源之一.     

孕妇使用庆大霉素对胎儿脐血中庆大霉素浓度的影响

本文报告了40例健康孕妇临产前使用庆大霉素后监测产时孕妇血液中及胎儿脐血中庆大霉素含量的结果。孕妇末次肌注庆大霉素8万~μ后约30～100min内分娩,产时孕妇血液中庆大霉素浓度为3.69±SD0.98μg/ml,胎儿脐血中庆大霉素浓度为1.05±SD0.47μg/ml,母体血浓为胎儿脐带血浓的3.5倍。末次注射后45min内分娩的17例,孕妇血浓3.38±SD1.16μg/ml,胎儿     

子宫颈上皮内瘤变患者行宫颈环切术对妊娠结局的影响

目的探讨对宫颈上皮内瘤变患者行宫颈环切术对妊娠结局的影响。方法回顾性分析2001年5月～2010年4月对宫颈上皮内瘤变患者行宫颈环切术27例患者的妊娠结局。结果占同期宫颈环切术宫颈环切术手术的13.3%(27/203),患者年龄为23～40岁,中位年龄为30.3岁。27例中,10例因计划生育行人工流产术、1例异位妊娠、2例6～8周自然流产。14例足月分娩,其中阴道分娩9例,剖宫产5例。所有分娩孕妇的分娩孕周均大于38周,新生儿体重2905～4000g。新生儿1minApgar评分:9分2例;10分12例。无新生儿窒息。结论宫颈环切术是治疗宫颈上皮内瘤变的安全有效的方法。只要掌握手术指征和手术切除范围,对其后的妊娠生育是安全的。     

Gene expression profile in labouring and non-labouring human placenta near term

The duration of pregnancy and initiation of labour are thought to be controlled by fetal, maternal and placental factors. The aim of this study was to investigate whether labour influences gene expression in placenta near term. Placental samples were obtained from 27 women after vaginal delivery (labouring) and 17 women after elective Caesarean section (non-labouring). All women were Caucasian and had uncomplicated pregnancies. For global gene expression analysis, 17 human oligo-arrays were used, representing 24 650 genes each. An empirical Bayes analysis was applied in order to find differentially expressed genes. About 8000 genes that were represented on the arrays met our quality criteria. Ninety two genes were down-regulated and 94 genes were up-regulated in labouring placentas compared to non-labouring placentas. However, none of these was differentially expressed at a significant level (>2.5-fold change and a P-value of <0.01). We conclude that gene expression in near term human placenta is not significantly altered by labour.     

Is meconium from healthy newborns actually sterile?

In a previous study, bacteria were able to be isolated from umbilical cord blood of healthy neonates and from murine amniotic fluid obtained by caesarean section. This suggested that term fetuses are not completely sterile and that a prenatal mother-to-child efflux of commensal bacteria may exist. Therefore, the presence of such bacteria in meconium of 21 healthy neonates was investigated. The identified isolates belonged predominantly to the genuses Enterococcus and Staphylococcus. Later, a group of pregnant mice were orally inoculated with a genetically labelled E. fecium strain previously isolated from breast milk of a healthy woman. The labelled strain could be isolated and PCR-detected from meconium of the inoculated animals obtained by caesarean section one day before the predicted date of labor. In contrast, it could not be detected in samples obtained from a non-inoculated control group.     

Increased T-cell activation in decidua parietalis compared to decidua basalis in uncomplicated human term pregnancy

PROBLEM: The aim of this study was to quantify and compare activated T cells in term decidua basalis and parietalis using flow cytometry. METHOD OF STUDY: Term decidua basalis and parietalis samples were obtained from 20 placentas collected after elective caesarean section. Percentages of leukocyte subclasses within the CD45+ cell fraction and activated T cells were determined by flow cytometry. RESULTS: There was no significant difference in CD45+, CD14+, CD19+, and CD3+ cell percentages. However, within the CD3+ population, there were significantly more T-cell receptor-gamma(delta)+ (TCR-gamma(delta)-) and CD8+ cells in decidua parietalis compared with decidua basalis. More importantly, percentages of T cells expressing CD25, human leukocyte antigen (HLA)-DR, CD45RO, and CD69 markers were significantly increased in decidua parietalis. CONCLUSION: These findings suggest that there are more activated T cells in decidua parietalis than in decidua basalis. Further investigation into differences between the two decidual sites may expand our understanding of the immunology of the maternal-fetal interface.     

Caspase-3 mRNA在子痫前期患者胎盘中的表达及其意义

目的检测半胱天冬氨酸蛋白酶-3（Caspase-3）mRNA在子痫前期患者胎盘中的表达,以探求Caspase-3在子痫前期发病机制中的意义。方法用半定量逆转录聚合酶链反应（RT-PCR）技术检测正常妊娠（10例）,子痫前期（22例）剖宫产后胎盘中Caspase-3基因在转录水平的表达。结果子痫前期组胎盘中Caspase-3 mRNA表达量较正常妊娠组显著升高（P〈0.01）。结论Caspase-3在子痫前期的发病中起着重要作用,可能与Caspase-3表达的增加有关。     

Audit of thromboprophylaxis following caesarean section

Venous thromboembolism is the most common cause of death in pregnant women and delivery by caesarean section increases the risk of developing venous thromboembolism. In 1995 the Royal College of Obstetricians and Gynaecologists (RCOG) issued guidelines for thromboprophylaxis following caesarean section. We have performed an audit of compliance with these guidelines in our unit. Of 240 women who were delivered by caesarean section over a six month period, 62.9% and 20.4% fell into moderate and high risk groups for venous thromboembolism according to RCOG guidelines. Overall, 34 (17%) of 200 eligible women received thromboprophylaxis. Women undergoing an emergency caesarean section were just over twice aslikely to have had no thromboprophylaxis compared with those undergoing an elective caesarean section (OR 2.6 (95% CI 1.2 - 5.9).     

Calpain10基因在脂肪及胎盘组织中的表达与妊娠糖尿病的相关研究

目的检测钙蛋白酶10(Calpain10)mRNA在妊娠糖尿病患者脂肪及胎盘组织中的表达,以探求Calpain10在妊娠糖尿病发病机制中的意义。方法用半定量逆转录聚合酶链反应(RT-PCR)技术检测正常妊娠(60例),妊娠糖尿病患者(60例)剖宫产后脂肪及胎盘中Calpain10基因在转录水平的表达。结果妊娠糖尿病组脂肪组织中Calpain10mRNA表达量较正常妊娠组显著下降(P0.01),并与妊娠糖尿病胰岛素抵抗指标相关(P0.01);而胎盘组织中Calpain10mRNA表达则无差异。结论脂肪组织Calpain10表达的减少可能是GDM患者胰岛素抵抗的重要原因。胎盘Calpain10的表达与GDM及其胰岛素抵抗的关系不明显。     

Placental Cellular Immune Response in Women Infected with Human Parvovirus B19 during Pregnancy

Human parvovirus B19 can cause congenital infection with variable morbidity and mortality in the fetus and neonate. Although much information exists on the B19-specific antibody response in pregnant women, little information is available describing the cell-mediated immune (CMI) response at the maternal-fetal interface. The focus of this study was to characterize the CMI response within placentas from women who seroconverted to B19 during their pregnancies and compare it to controls. Immunohistochemical techniques were used to identify the various immune cells and the inflammatory cytokine present within placental tissue sections. Group 1 consisted of placentas from 25 women whose pregnancies were complicated by B19 infection; 6 women with good outcome (near-term or term delivery), and 19 with poor outcome (spontaneous abortion, nonimmune hydrops fetalis, or fetal death). Group 2 consisted of placentas from 20 women whose pregnancies were complicated with nonimmune hydrops fetalis of known, noninfectious etiology. Group 3 consisted of placentas from eight women whose pregnancies ended in either term delivery or elective abortion. The results of the study revealed a statistically significant increase in the number of CD3-positive T cells present within placentas from group 1 compared to group 2 or 3 (13.3 versus 2 and 1, respectively) (P < 0.001). In addition, the inflammatory cytokine interleukin 2 was detected in every placenta within group 1 but was absent from all placentas evaluated from groups 2 and 3. Together, these findings demonstrate evidence for an inflammation-mediated cellular immune response within placentas from women whose pregnancies are complicated with B19 infection.     

HBV感染胎盘乳腺癌耐药蛋白的表达及意义

目的探讨乳腺癌耐药蛋白在HBV感染胎盘组织中的表达及其意义。方法选取HBV感染足月胎盘20例;选择无HBV感染足月胎盘20例作为正常对照组。实时荧光定量RT-PCR分别检测两组胎盘中ABCG2mRNA的表达。蛋白免疫印迹法分别检测两组胎盘中乳腺癌耐药蛋白的表达。结果各组荧光定量PCR检测ABCG2 mRNA的相对表达量为乙肝组(0.424±0.358),正常组(0.144±0.116),两组相比,差异有显著性(P0.005)。蛋白免疫印迹法检测乳腺癌耐药蛋白表达量为乙肝组(0.4250±0.3106),正常组(0.1129±0.1045),两组相比,差异有显著性(P0.001)。结论乳腺癌耐药蛋白在HBV感染胎盘组织中表达的升高,可能与乙型肝炎病毒感染有关。     

Placental cellular immune response in women infected with human parvovirus B19 during pregnancy

Human parvovirus B19 can cause congenital infection with variable morbidity and mortality in the fetus and neonate. Although much information exists on the B19-specific antibody response in pregnant women, little information is available describing the cell-mediated immune (CMI) response at the maternal-fetal interface. The focus of this study was to characterize the CMI response within placentas from women who seroconverted to B19 during their pregnancies and compare it to controls. Immunohistochemical techniques were used to identify the various immune cells and the inflammatory cytokine present within placental tissue sections. Group 1 consisted of placentas from 25 women whose pregnancies were complicated by B19 infection; 6 women with good outcome (near-term or term delivery), and 19 with poor outcome (spontaneous abortion, nonimmune hydrops fetalis, or fetal death). Group 2 consisted of placentas from 20 women whose pregnancies were complicated with nonimmune hydrops fetalis of known, noninfectious etiology. Group 3 consisted of placentas from eight women whose pregnancies ended in either term delivery or elective abortion. The results of the study revealed a statistically significant increase in the number of CD3-positive T cells present within placentas from group 1 compared to group 2 or 3 (13.3 versus 2 and 1, respectively) (P < 0.001). In addition, the inflammatory cytokine interleukin 2 was detected in every placenta within group 1 but was absent from all placentas evaluated from groups 2 and 3. Together, these findings demonstrate evidence for an inflammation-mediated cellular immune response within placentas from women whose pregnancies are complicated with B19 infection.