De novo 7q deletion with a positive maternal serum triple test screening

A 32-year-old woman at 17 weeks of gestation had a high possibility (1:82) of having a child with Down syndrome. Fetal chromosome according to amniocentesis revealed 46,XX,del(7)(q11.23q21.2). The fetus' chromosomal defect was not inherent because the chromosome analysis of the parents did not have any abnormal findings. We were regularly monitoring the pregnant woman by routine prenatal schedule and she had a normal spontaneous delivery. The baby showed a typical facial malformation, epicanthal fold, decreased muscle tone, and cardiac abnormalities. This is the first patient prenatally diagnosed with de novo 7q deletion by positive triple marker screening test. We consider the triple test, which is the most popular examination used to clarify the risk of chromosome abnormality in obstetrics, will be used not only for trisomy 21 and 18, but also for any other chromosome abnormalities.     

Arsenic trioxide (As2O3) reduces the invasive and metastatic properties of cervical cancer cells in vitro and in vivo

OBJECTIVES: Arsenic trioxide (As(2)O(3)) was found to induce apoptosis in certain types of cancer cells including acute promyelocytic leukemia, and recently in solid tumors. We have previously demonstrated that As(2)O(3) has a therapeutic effect on cervical cancer by apoptosis promotion in vitro and in vivo. Here we further our study on the role of arsenic trioxide in regulating invasive activity of cervical cancer cells in vitro and in vivo. METHODS: The effects of As(2)O(3) on human cervical cancer cell lines (HeLa, SiHa, Caski) adhesion, migration and invasion were observed by means of cell adhesion test, cell migration test and cell invasion test. The effects of As(2)O(3) on p-IkappaB, MMP-2, E-cadherin, caveolin-1 and beta-catenin protein expressions of tumor cells were determined by Western blot. In addition, the effects of As(2)O(3) on NF-kappaB activity of tumor cells were analyzed by immunoblot in whole lysates, cytosol and nucleus, respectively. In animal experiments, cervical cancer cells TC-1 were injected into tail veins of C57BL/6 mice and then the mice were treated by intraperitoneal injection of different doses As(2)O(3). Lung weights and the foci on the surface of lungs were measured. RESULTS: As(2)O(3) inhibited attachment of tumor cells to Fibronectin and Matrigel, reduced cell motility and inhibited tumor invasion potential. As(2)O(3) treatment also resulted in a positive regulation of caveolin-1, upregulation of E-cadherin and decreased activity of beta-catenin, NF-kappaB and NF-kappaB-regulated gene MMP-2. In animal experiments, lung weights in PBS group (0.31+/-0.07 g) were significantly elevated compared with those in As(2)O(3)-treated groups (0.21+/-0.03 g and 0.17+/-0.03 g) also As(2)O(3) reduced number of metastatic lesions of lungs (15.4+/-3.5 vs. 8.3+/-2.0 and 6.3+/-2.3) in a dose-dependent manner. CONCLUSIONS: This study is the first to report the effectiveness of As(2)O(3) as an inhibitor of cervical cancer invasion both in vitro and in vivo, suggesting a potential clinical application of As(2)O(3) in cervical cancer therapies combining apoptosis induction and metastasis inhibition.     

High glucose alters proteoglycan expression and the glycosaminoglycan composition in placentas of women with gestational diabetes mellitus and in cultured trophoblasts

Impaired glucose metabolism with diabetes may alter the expressions of proteoglycans (PGs), which may impair the biological functions of placenta. In this study, we investigated the expression of PGs and their conjugated glycosaminoglycan (GAG) composition in the placentas of mothers with gestational diabetes mellitus (GDM) and trophoblasts cultured in a high-glucose condition. The PGs by guanidine/HCl extraction and DEAE Sepharose fractionation followed by GAG degradation enzyme digestion analyses showed that the expression of chondroitin sulfate and/or dermatan sulfate (CS/DS) PGs was increased whereas the heparan sulfate (HS) PG was decreased in GDM placentas compared to controls. Western blot analyses demonstrated that the increased CS/DS PGs in GDM placentas were predominantly the small leucine-rich proteoglycans (SLRPs), decorin and biglycan. Increased mRNA expression level was consistently shown by quantitative real-time PCR. Immunohistochemistry indicated intensive staining of decorin and biglycan in the diabetic placenta with different localizations. Additionally, the basement membrane HSPG, perlecan was found to contain both CS/DS and HS in GDM placentas and plain HS in controls. Similar findings of PG alterations induced by hyperglycemia were observed in cultured trophoblast in a high-glucose condition. This study demonstrated that hyperglycemia induced not only the gene expressions of PGs but also alterations in the carried GAG type and composition.     

Adequacy of prenatal care and neonatal mortality in infants born to mothers with and without antenatal high-risk conditions

BACKGROUND: Previous studies have found that inadequate prenatal care was associated with increased neonatal mortality in the general pregnant women. AIMS: To examine the association between adequacy of prenatal care and neonatal mortality in the presence and absence of antenatal high-risk conditions. METHODS: We conducted a retrospective cohort study of infants based on 1995-2000 vital statistics data in the USA. The relative risk for neonatal death associated with adequacy of prenatal care was estimated by multivariate logistic regressions with adjustment of confounding factors. RESULTS: Inadequate prenatal care was associated with increased neonatal mortality when pregnancies were complicated by anaemia, cardiac disease, lung disease, chronic hypertension, diabetes, renal disease, pregnancy-induced hypertension, and previous preterm/small-for-gestational-age birth. The observed association also existed in the absence of these antenatal high-risk conditions. Overutilisation of prenatal care was associated with increased risk of neonatal deaths in both the presence and the absence of antenatal high-risk conditions. When gestational age at delivery and birthweight were further adjusted, the observed association between inadequate prenatal care and neonatal mortality was not significant in pregnancies with various high-risk conditions. CONCLUSIONS: Inadequate prenatal care is associated with increased neonatal death in both the presence and the absence of antenatal high-risk conditions. The observed association between inadequate prenatal care and neonatal mortality may be mediated by increased risk of preterm delivery and low birthweight in these pregnancies. Overutilisation of prenatal care is associated with potential risks for fetal and neonatal development, leading to increased neonatal mortality.     

聚焦超声治疗外阴上皮内非瘤样病变的近远期疗效及其影响因素

目的 探讨聚焦超声治疗外阴上皮内非瘤样病变的近远期疗效及并发症,并初步分析其预后影响因素。方法 选择经病理检查证实为外阴上皮内非瘤样病变患者共76例,采用聚焦超声进行治疗。术后定期随访局部瘙痒症状的改善情况,采用阴道镜检查方法观察体征的变化。结果 聚焦超声治疗后平均随访28．3个月（24～60个月）,有39例患者治愈（27例为鳞状上皮增生型,12例为硬化性苔癣型）,总治愈率为51％（39／76）,总有效率达95％（72／76）,累计复发率为36％（26／72）。对复发病例在间隔一段时间后进行再次聚焦超声治疗,同样可以获得显著的临床治疗效果,18例复发后再治疗患者中,6例完全恢复正常,12例症状明显减轻或缓解。76例患者中,4例（2例鳞状上皮增生型,2例硬化性苔癣型）于治疗后2～4h出现治疗区皮肤少量水疱,经抗炎、对症治疗后均痊愈。另有2例（1例鳞状上皮增生型,1例硬化性苔癣型）在治疗后2周出现治疗区局部皮肤浅表溃疡,经抗炎、对症及促表皮生长等治疗3周后痊愈。76例患者经24～60个月的临床观察未发现有远期并发症。不同的麻醉方式及不同的病理类型对聚焦超声治疗效果的影响比较,差异无统计学意义（P〉0．05）,但病程越短、年龄越小,聚焦超声治疗的临床效果越好。结论 聚焦超声用于治疗外阴上皮内非瘤样病变安全有效,无远期并发症发生。