胎儿期暴露于高糖宫内环境增加成年后糖尿病患病风险

妊娠期糖尿病（GDM）是指妊娠期首次发生的葡萄糖耐量异常,占妊娠合并糖尿病的80％～90％。生活方式的不断西化,肥胖人群的逐年增加,     

产前诊断胎儿单基因病及微缺失/微重复综合征的挑战

随着生物医学科学技术的进步,胎儿疾病谱不断扩展,临床诊疗过程中以下问题尤为突出：多学科协作模式的必要性、产前选取遗传学检测方法的复杂性、新技术转化应用中的不确定性、检测前后遗传咨询的全面性和客观性等。本文就上述问题进行论述,希望相关学科共同合理应对挑战,不断提高诊疗效率,迎接胎儿医学的飞跃发展。     

阴道分泌物胎儿纤维连接蛋白与宫颈长度联合预测早产的多中心前瞻性研究

Objective To discuss the clinical value of fetal fibronectin (fFN) and cervical length in predicting preterm birth. Methods Totally, 511 pregnant women at 22-35 weeks of gestations were enrolled from Dec. 2006 to Dec. 2007 at 4 tertiary hospitals in Beijing, and all with either symptoms or high risk factors of preterm birth, but without preterm premature rupture of membrane or vaginal bleeding. Cervical fFN were determined and cervical length of each subjects were measured by ultrasound. The pregnancy outcomes were compared. Results The sensitivity, specificity and negative predictive value (NPV) of fFN in predicting preterm birth within 7 d were 77.4%, 69.4% and 97. 9%, respectively; and 70.5%, 70.0% and 96.2% for deliveries within 34 weeks. The above figures changed to 54.8%, 66.3%, 95.8% for deliveries within 7 d and 59.1%, 67.2%, 94.6% for those within 34 weeks, respectively, when cervical length ≤3 cm was applied to predict preterm birth. When fFN and cervical length were combined, the sensitivity, specificity and NPV were 51.6%, 87.1%, 96.5% for deliveries within 7 d, and 45.5%, 87.60/00, 94.5% for those within 34 weeks, respectively. Conclusions FFN has higher NPV and specificity than cervical length in predicting preterm birth within 7 d and 34 weeks, and the positive predictive value and specificity can be improved when combined with cervical length.     

妊娠期合并生殖道沙眼衣原体感染

沙眼衣原体（Chlamydi trachomatis,CT）是女性泌尿生殖道最常见的感染性疾病,在25岁及以下有性生活的女性中发病率最高。女性CT感染后可引发许多严重的并发症,如盆腔炎、宫外孕和不孕。一些患者宫颈感染CT后,虽无临床症状,但可导致“亚临床”的上生殖道感染。妊娠期CT感染不但会引起不良妊娠结局，同时还可导致新生儿CT的感染。美国孕妇宫颈CT的感染率达2％～37％，每年约10万以上的新生儿感染有CT。孕妇CT感染对妊娠结局的影响，介绍如下。     

女性生殖道支原体及其他病原体在急性盆腔炎中的检出率

目的:根据急性盆腔炎妇女与正常妇女的解脲支原体(Ureaplasma Urealylium,Uu)、人型支原体(Mycoplas-ma Hominis,Mh)、生殖支原体(Mycoplasmag enitalium,Mg)检出情况,结合急性盆腔炎妇女衣原体(Chlamydi trachomatis,Ct)及需氧菌的检出率,探讨支原体与急性盆腔炎的相关性。方法:取30例患急性盆腔炎的育龄期妇女的阴道后穹窿分泌物与子宫内膜分别进行解脲支原体(Uu)、人型支原体(Mh)的培养,生殖支原体(Mg)的PCR方法检测并以30例正常妇女为对照组,以及盆腔炎组取子宫内膜作衣原体(Ct)的PCR检测、细菌培养、内膜病理检验。结果:急性盆腔炎妇女阴道后穹窿分泌物解脲支原体(60%)、生殖支原体(33.3%)检出率明显高于正常妇女(30%、6.7%),两者差异有统计学意义(P0.05);急性盆腔炎妇女子宫内膜解脲支原体(40%)、生殖支原体(33.3%)检出率明显高于正常妇女(6.7%、6.7%),两者差异有统计学意义(P0.05);急性盆腔炎妇女阴道后穹窿、子宫内膜人型支原体(23.3%、23.3%)检出率与正常妇女(10%、6.7%)两者差异无统计学意义(P0.05),可能与例数较少有关;盆腔炎组阴道后穹窿分泌物与子宫内膜Uu(60%vs40%)、Mh(23.3%vs23.3%)、Mg(33.3%vs33.3%)的检出率差异无统计学意义(P0.05),正常对照组阴道后穹窿分泌物与子宫内膜Uu的检出率(30%vs6.7%)差异具有统计学意义,Mh(10%vs6.7%)、Mg(6.7%vs6.7%)的检出率差异无统计学意义(P0.05);30例送检标本中子宫内膜的5种病原体的检测结果显示,盆腔炎组子宫内膜Uu检测出12例阳性(40%),Mh检测出7例阳性(23.3%),Mg检测出10例阳性(33.3%),Ct检测出9例阳性(30%),需氧菌检测出9例阳性(30%),两种混合感染检测出17例阳性(56.6%),三种混合感染检测出3例阳性(10%)。结论:①解脲支原体、生殖支原体与盆腔炎关系密切;②盆腔炎中解脲支原体的检出率最高,衣原体与细菌也是盆腔炎的重要病原体;③Uu的检测推荐首选子宫内膜检测;④盆腔炎为多种病原体混合感染。     

阴道分泌物胎儿纤维连接蛋白与宫颈长度联合预测早产的多中心前瞻性研究

Objective To discuss the clinical value of fetal fibronectin (fFN) and cervical length in predicting preterm birth. Methods Totally, 511 pregnant women at 22-35 weeks of gestations were enrolled from Dec. 2006 to Dec. 2007 at 4 tertiary hospitals in Beijing, and all with either symptoms or high risk factors of preterm birth, but without preterm premature rupture of membrane or vaginal bleeding. Cervical fFN were determined and cervical length of each subjects were measured by ultrasound. The pregnancy outcomes were compared. Results The sensitivity, specificity and negative predictive value (NPV) of fFN in predicting preterm birth within 7 d were 77.4%, 69.4% and 97. 9%, respectively; and 70.5%, 70.0% and 96.2% for deliveries within 34 weeks. The above figures changed to 54.8%, 66.3%, 95.8% for deliveries within 7 d and 59.1%, 67.2%, 94.6% for those within 34 weeks, respectively, when cervical length ≤3 cm was applied to predict preterm birth. When fFN and cervical length were combined, the sensitivity, specificity and NPV were 51.6%, 87.1%, 96.5% for deliveries within 7 d, and 45.5%, 87.60/00, 94.5% for those within 34 weeks, respectively. Conclusions FFN has higher NPV and specificity than cervical length in predicting preterm birth within 7 d and 34 weeks, and the positive predictive value and specificity can be improved when combined with cervical length.     

女性生殖道沙眼衣原体的免疫研究

沙眼衣原体是严重威胁妇女健康的性传播疾病,由于其致病型较为复杂,不同个体预后不同,加之耐药菌株的增加而日益受到关注.对沙眼衣原体病原本身和感染时机体对其免疫反应的基础研究进行综述,其中包括近年研究热点如沙眼衣原体逃逸机体免疫反应的机制、机体非特异免疫中Toll样受体、人类防御素(human defensins)等与沙眼衣原体感染的关系等.对沙眼衣原体感染时的机体免疫反应的研究,进而预测那些发生严重并发症的患者,在感染早期干预和预防并发症的发生.认识特定沙眼衣原体成分的致病作用,可能用于未来沙眼衣原体疫苗的研究.