宫内发育迟缓新生大鼠胰腺中MafA的表达

目的 观察宫内发育迟缓(intrauterine growth restriction,IUGR)新生大鼠胰腺中MafA的表达。方法 清洁级Wister大鼠,雌雄鼠5∶1合笼,孕鼠按受孕顺序随机分为两组(低蛋白组和对照组),低蛋白组自妊娠第1天至分娩给予低蛋白饲料,对照组妊娠全程给予标准饲料。测量IUGR组和对照组新生大鼠空腹血糖及糖负荷后的血糖,摘取胰腺组织,称重,采用HE染色,光镜观察胰腺形态学变化,应用免疫组织化学法检测新生大鼠胰腺组织中MafA的表达。结果 IUGR组新生大鼠空腹血糖低于对照组,给予糖负荷后,IUGR组血糖下降较慢,至120 min仍明显高于对照组(P<0.05);胰重显著低于对照组(P<0.05)。与对照组相比,IUGR组胰腺表现为组织松散,胰岛数量及面积减少,胰腺中MafA的表达明显低于对照组(P<0.05)。 结论 宫内蛋白营养不良可致大鼠发生IUGR,IUGR新生大鼠胰腺中MafA的表达下降,这可能是影响新生大鼠胰腺发育和功能完善的机制之一。     

A Comparative Study of Gravidogram and Ultrasound in Detection of IUGR

Objectives

The present study was conducted to compare the gravidogram and ultrasound in the detection of intrauterine growth restriction.

Methods

This study was conducted in the Department of Obstetrics and Gynecology, Voluntary Health Services, Chennai (TN) from August 2007–May 2009. The study included 321 women with singleton pregnancy in a longitudinal lie. These women underwent serial symphysio-fundal height measurements and ultrasound. Birth weights of the newborns were noted at the time of delivery. Gravidogram and ultrasound findings were correlated with the birth weights.

Results

The sensitivity of the ultrasound in the detection of IUGR was higher (85.2 vs 74.1 %) than the gravidogram, but the specificity was almost the same (96.6 and 95.9 %).

Conclusions

The gravidogram is a simple and inexpensive screening tool and as useful as an ultrasound in detection of intrauterine growth restriction. Both gravidogram and ultrasound, when used together, have higher detection rates.     

Restriction of placental vasculature in a non-human primate: a unique model to study placental plasticity

The limits of placental plasticity, i.e., the ability of the placenta to adapt and alter its growth trajectory in response to altered fetal requirements, are not known. We report fetal and placental hemodynamic adaptations in a novel non-human primate model in which the fetal inter-placental bridging vessels were surgically ligated. Doppler ultrasound studies showed that the rhesus placenta compensates for an approximate 40% reduction in functional capacity by increased growth and maintenance of umbilical volume blood flow. This unique experimental animal model has applications for mechanistic studies of placental plasticity and the impact on fetal development.     

Evaluation of the adequacy of Hadlock’s reference chart for identification of fetuses with growth restriction

Objective: This study aimed to verify whether Hadlock’s reference values for fetal weight identify fetuses below the 10th percentile in our population correctly.

Methods: The fitness of the Hadlock reference range to our study population was tested by assessment of Z scores. We evaluated differences between the reference weight ranges proposed in our study and those recommended by Hadlock.

Results: Z scores for Hadlock reference values were non-normally distributed. The difference between the 50th percentile fetal weight proposed by our study model and that proposed by Hadlock was ≤1% at GAs ≥22 weeks and 2–3% at 19–21 weeks. For the 90th percentile level, the maximum difference at GAs ≥17 weeks was 1.5%. For the 10th percentile level, the differences were 2–4% in the third trimester, reaching 8% in week 20 and 13% at a GA of 14 weeks.

Conclusions: The weight reference ranges of this study virtually overlap with the Hadlock ranges. We believe that only at lower gestational ages in the second trimester might some FGR diagnoses be missed in the population study with Hadlock’s reference.     

Screening for adverse perinatal outcomes: uterine artery Doppler,cerebroplacental ratio and estimated fetal weight in low-risk women at term

Objective: To stratify apparently low-risk pregnant women into those who are at risk of adverse perinatal outcomes. Appropriate stratification would allow targeted prenatal and intrapartum management.

Methods: This prospective, observational study included normotensive women with appropriately grown, non-anomalous, singleton pregnancies. Participants underwent fortnightly ultrasounds from 36 weeks’ gestation and intrapartum and neonatal outcomes were recorded. The association between uterine artery pulsatility index (UtA-PI), the cerebroplacental ratio (CPR) and estimated fetal weight (EFW) were explored along with their screening performance for CS-IFC and CNM.

Results: The final cohort included 429 women. As continuous variables, UtA-PI and the CPR were not correlated (rho?=??0.05, p?=?.33). UtA-PI >95^th centile and the CPR <10^th centile were predictive of CS-IFC and CNM, with the highest sensitivity achieved by their combination (33.3%, 95% CI 11.6–55.1) for a false positive rate (FPR) of 15.8% (12.3–19.3). For CNM, the highest sensitivity (28.4%, 95% CI 18.6–38.2) and corresponding FPR (17.0%, 95% CI 13.0–20.9) was achieved by combining UtA-PI 95^th centile, the CPR 10^th centile and EFW 10^th centile. EFW was the weakest of the three predictors.

Conclusion: In this population, UtA-PI 95^th centile and the CPR 10^th centile have modest screening performance for CS-IFC and CNM.     

维生素D受体基因起始密码子多态性与体力活动对青春期女童骨量增长的交互作用

目的 探讨维生素D受体(VDR)基因起始密码子(Fok I位点)多态性与体力活动对青春期女童骨量增长的交互作用.方法 选择228名9～11.5岁未月经初潮的健康女童进行2年追踪,应用双能X线骨密度仪检测对象追踪前后全身、左侧近端股骨(包括股骨颈、大转子、粗隆间和华氏三角区)和L1～L4腰椎骨密度,应用PCR-RFLP技术检测VDR基因Fok I位点多态性.结果 本次研究的有效观察人数为176名.Fok I位点多态性与骨密度(BMD)2年增长率没有关联.在低体力活动水平(<1197 kJ/d)时,FF基因型女童左侧近端股骨骨密度(THBMD)和股骨颈骨密度(FNBMD)增长率低于Ff+ff基因型女童,差异有统计学意义;体力活动与THBMD和FNBMD增长率有关联,但仅限于FF基因型女童.结论 VDR基因Fok I多态性与体力活动水平对青春期女童骨量增长存在交互作用,低体力活动水平的FF基因型女童可能是骨量增长较低的危险人群,体力活动能促进FF基因型女童骨量增长.     

孕鼠补充牛磺酸对生长受限胎鼠脑组织IL-6、IL-8、TNF-α和IL-1β水平的影响及临床意义探讨

目的 了解宫内生长受限(IUGR)胎鼠脑组织IL-6、IL-8、TNF-α和IL-1β表达水平,探讨孕鼠补充牛磺酸对其表达水平的影响及临床意义。方法 采用妊娠期全程饥饿法建立IUGR胎鼠模型,将15只孕鼠随机分为3组正常对照组、IUGR组、IUGR＋补充牛磺酸组[300 mg/(kg·d)](牛磺酸组)。采用酶联免疫吸附法测定三组胎鼠脑组织IL-6、IL-8、TNF-α和IL-1β的含量。结果 对照组、IUGR组、牛磺酸组胎鼠脑组织IL-6含量分别为(81.070±5.286)pmol/L、(148.362±18.733)pmol/L和(107.361±11.184)pmol/L,差异有统计学意义(H=43.760,P=0.00);三组胎鼠脑组织IL-8含量分别为(90.573±7.344)pmol/L、(165.596±8.635)pmol/L和(126.309±11.008)pmol/L,差异有统计学意义(H=45.910,P=0.00);三组胎鼠脑组织TNF-α含量分别为(8.231±0.607)pmol/L、(14.881±0.703)pmol/L和(11.709±0.936)pmol/L,差异有统计学意义(H=45.929,P=0.00);三组胎鼠脑组织IL-1β含量分别为(46.693±4.122)pmol/L、(84.799±4.315)pmol/L和(62.407±4.631)pmol/L,差异有统计学意义(H=46.064,P=0.00)。结论 孕鼠补充牛磺酸可减少IUGR胎鼠脑组织IL-6、IL-8、TNF-α和IL-1β的表达。     

Longitudinal course of lung function in myotonic dystrophy type 1

Introduction: Quality of life and prognosis among patients with myotonic dystrophy type 1 (DM1) depend on the degree of respiratory impairment. However, the changes over time in pulmonary function in DM1 have not been clearly described. Methods: We retrospectively reviewed pulmonary function tests of 80 DM1 patients followed for at least 5 years. Results: During 9.02 ± 3.4 years of follow‐up, the average annual changes were: forced vital capacity (FVC) –0.034 ± 0.06 L (–0.72 ± 1.7% predicted); forced expiratory volume in 1 second (FEV₁) –0.043 ± 0.05 L (–1.07 ± 1.7% predicted); and total lung capacity (TLC) –0.047 ± 0.1 L (–1.15 ± 1.7% predicted). Conclusions: These results suggest that, compared with other neuromuscular disorders, DM1 is, overall, associated with slowly progressive impairment of lung function. Muscle Nerve 56 : 816–818, 2017