Prevalence of hepatitis B virus infection among women at reproductive age at a German university hospital

BACKGROUND: Mother to infant transmission of hepatitis B virus (HBV) represents a major factor in maintaining chronic infection and depends on the degree of maternal infectivity status. OBJECTIVES: To examine the seroprevalence of hepatitis B virus surface antigen (HBsAg) in women at reproductive age admitted to the Department of Gynaecology at a German university hospital. STUDY DESIGN: The seroprevalence of hepatitis B surface antigen (HBsAg) in 5518 women at reproductive age was examined, HBsAg-positive samples were tested for additional HBV markers to verify the infection status. RESULTS: Out of 5518 samples from women at reproductive age, 88 women (1.59%) were positive for HBsAg and 7 of these HBV-positive women (7.95%) were additionally positive for HBeAg. The majority of the study population were German citizens, however most HBV infected persons originated from countries with a high HBV prevalence. The HBV seroprevalence in our study group is about two times higher compared to the average seroprevalence in the German citizen adult population, thus probably resulting in an underestimation of the infection rate in a multinational setting. CONCLUSIONS: Screening for HBsAg during pregnancy is still necessary and important for reduction of perinatal HBV transmission even in countries with low HBV prevalence.     

eNOS基因和MTHFR基因多态性与妊娠高血压综合征发病的相关性研究进展

〔摘要〕 妊娠高血压综合征（妊高征）产科常见的并发症，是引起孕产妇和围产儿死亡的主要原因之一，对其发病原因和机理尚不清楚。一般认为是由环境因素和遗传因素共同作用造成的，目前的研究热点是易感基因与妊高征的关系。本文对内皮型一氧化氮合酶（eNOS）基因和亚甲基四氢叶酸还原酶(MTHFR)基因多态性与妊高征发病的相关性进行了综述。     

胎盘生长因子在妊娠期高血压疾病胎盘组织中的定位及定量分析

目的探讨胎盘生长因子(placental growth factor,PLGF)在妊娠期高血压疾病胎盘中定位及定量表达。方法选择妊娠期高血压疾病患者46例,其中子痫前期重度23例,子痫1例;慢性高血压并发子痫前期1例,选择同期正常妊娠妇女20例作为对照组。采用免疫组织化学染色法和免疫印迹(Western blot)方法检测两组患者胎盘PLC蛋白定位及定量表达。结果 (1)免疫组织化学染色发现PLGF蛋白在妊娠期高血压疾病组及正常妊娠组胎盘中分布范围基本一致, 主要分布在绒毛合体滋养细胞和间质细胞的胞浆,部分血管合体膜上也有PLGF阳性染色。(2)Western blot方法检测妊娠期高血压疾病组子痫前期轻、重度胎盘绒毛PLGF蛋白表达低于正常妊娠组(0.3±0.4 vs 0．6±0．4、0．2±0．5 vs 0．6± 0．4),差异有统计学意义(P<0．01);妊娠期高血压患者胎盘中PLGF蛋白的表迭为0．5±0．6,与对照组比较,差异无显著性(P>0．05)。结论胎盘PLGF蛋白表达异常在妊娠期高血压疾病发病中可能具有重要的作用。     

Use of antidepressants by pregnant women: Evaluation of perception of risk, efficacy of evidence based counseling and determinants of decision making

Summary Background: The World Health Organization predicts that by 2012, depression will be the number one disease in the world. Thus, many women who become pregnant will require treatment with antidepressants. We are aware that women and their health care providers remain hesitant to prescribe and take these drugs during pregnancy, despite evidence of the relative safety. Objectives: 1) To determine perception of risk of antidepressant drugs by pregnant women with depression, 2) to determine the efficacy of evidence-based counseling, and 3) to identify determinants that influence women in their decision making regarding the continuation/discontinuation of antidepressants during pregnancy. Methods: Women who called The Motherisk Program requesting information about the safety of an antidepressant during pregnancy were compared with two other groups: 1) Women who called about antibiotic use (i.e., non-teratogenic drugs used short-term) and 2) women who called about gastric medications (i.e., non-teratogenic drugs used long-term). Their perception of risk was measured before and after evidenced-based information was given and determinants of decision making was also evaluated. Results: We recruited 100 women taking antidepressants during pregnancy and 100 in each comparison group. Despite receiving evidence-based reassuring information, 15% of antidepressant users, compared to 4% using gastric drugs and 1% using antibiotics, chose to discontinue their medication. The main determinants of decision making were based on: information received prior to calling Motherisk, family and friends advice, the internet, sequence of advice given and if a women was undecided at the time of call. Conclusions: Women continue to fear taking antidepressants during pregnancy, more so than non psychiatric drugs, however, evidence based counseling can lower this fear, although not totally. Deciding whether to continue to take a medication or not during pregnancy, is a complex decision for women and their healthcare providers to make.     

妊娠期血清微量元素的变化

目的探讨妊娠期血清微量元素的变化规律。方法以原子吸收分光光度法分别测定421例孕妇和128例正常对照妇女血清铜(Cu)、锌(Zn)、铁(Fe)等微量元素浓度和血清镁(Mg)、钙(Ca)浓度。结果血清铜(Cu)在整个孕期内无显著性变化,P>0.05;血清锌(Zn)、铁(Fe)、镁(Mg)、钙(Ca)随孕期的增加而降低,P均<0.05。结论孕妇在妊娠期内应根据不同孕期,合理补充微量元素。     

Concentrations of serum total protein and protein fractions during diestrus and pregnancy in Makuii ewes

The aim of this study was to determine the blood protein changes during different stages of pregnancy and to compare with prepregnancy diestrus in ewes. A total of 90 blood samples were taken from ten Makuii ewes (the native sheep breed in Iran) at diestrus and on days 8, 14, 28, 45, 60, 90, 125, and 145 of pregnancy. Serum protein electrophoresis of samples exhibited four fractions: albumin, α, β, and γ fractions in Makuii ewes, which in α- and γ-globulin bands were divided to α1 and α2; and γ1 and γ2, respectively. The mean concentrations (in gram per deciliter) of total serum proteins, albumin, α1-, α2-, β-, γ1-, and γ2-globulin at diestrus period were 7.03, 3.77, 0.18, 0.74, 0.41, 1.56, and 0.41, respectively. Those values fluctuated nonsignificantly throughout gestation until the 125th day of pregnancy. Thereafter, a significant decrease (p < 0.01) in serum protein levels occurred at the 145th day of pregnancy compared to prepregnancy and other gestational time points. It was concluded that blood protein levels declined sharply during late gestation when the nutrient demands of the fetus were maximal.     

Long-term treatment of acromegalic patients with repeatable parenteral depot-bromocriptine

Summary We studied the efficacy and tolerability of a repeatable long-acting parenteral depot-bromocriptine preparation (Parlodel LAR) in 14 acromegalic patients, 10 of whom had received oral bromocriptine therapy previously, 2 of them showing intolerance to oral bromocriptine. Patients received i.m. injections of 50–100 mg depot-bromocriptine at 4-week intervals for 3–24 months (median 6). Growth hormone profiles were assessed by four daily samples at 4-week intervals. Main daily growth hormone levels decreased from 52.1 ±12.3 g/l (mean ± SEM) to 19.4 ± 4.7 g/l on the day of injection. In 6 patients, growth hormone values were lowered by more than 50%, whereas IGF-I levels decreased only slightly and growth hormone values during the oral glucose tolerance test remained non-suppressible. Tumour sizes were not affected. Two women became pregnant and were delivered of healthy babies. Side-effects typical of bromocriptine occurred frequently on the days of injection and diminished in most patients after 2 months of therapy despite increasing dosage. Compared with previous oral bromocriptine therapy, 9 of 10 patients preferred the depot preparation, whereas the reduction of growth hormone levels was similar during both treatments. In conclusion, depot-bromocriptine should be considered for acromegalic patients intolerant to oral bromocriptine.Abbreviations br Bromocriptine - oral br. oral bromocriptine - depot-br. depot-bromocriptine - GH growth hormone - oGTT oral glucose tolerance test - GnRH gonadotropin-releasing hormone - TRH thyrotropin-releasing hormone     

The pregnancy-associated α2-glycoprotein (α2-PAG) A tumour marker?

Summary Long-term studies of 2-PAG in sera of patients with breast cancer, bronchial carcinoma, gynaecological carcinoma, melanoma and laryngeal carcinoma have proved that 2-PAG is a possible laboratory parameter for the assessment of recurrence of tumour and metastasis. The results published for trophoblastic tumour and gastrointestinal carcinoma are still divergent. Because of the large individual range of 2-PAG concentrations and the widely differing 2-PAG levels in men and women single determinations of this protein are without value. A detailed classification of the pathological mechanisms to which these proteins are submitted is still missing and consequently we have no fundamental knowledge of diseases that apart from pregnancy and neoplasia lead to changes in the physiological 2-PAG serum concentration.Dedicated to Prof. Dr. E. Schmiedt to his 60th birthday (20th of November 1980)     

孕血清中早孕因子（EPF）的活性及其对T淋巴细胞亚群影响的研究

本文分别用抗人E受体、抗T_H、Ts细胞单抗的Ea花结抑制试验检测孕血清中EPF活性并对其进行了动态观察,同时检测了EPF活性与HCG-β、AFP、孕酮的关系以及对T淋巴细胞亚群的影响。结果说明:孕血清中EPF活性明显高于对照组(P<0.001)。孕血清中EPF活性主要通过对T_H细胞的作用实现。在孕早期EPF活性较高,随孕期延长活性逐渐下降,至孕6个月活性渐趋消失,分娩前10周基本消失。EPF活性与血中HCG-β、AFP浓度无关,与孕酮呈负相关。EPF不能直接抑制淋巴细胞的花结形成,但能显著地增强ATS、anti-CCT_3、anti-CD_4的花结抑制效应。     

宫腔内人工授精97个周期临床分析

目的 选择84对患者97个周期的宫腔内人工授精(IUI)进行临床疗效分析。方法 按自然周期、克罗米芬(CC) 补佳乐 HCG、克罗米芬(CC) HMG HCG分为三组进行围排卵期IUI技术比较。结果 84对患者进行97含属期IUI，自然周期11个，有1例妊娠，妊娠率0．09％；克罗米芬(CC) 补佳乐 HCG组57个周期，有8例妊娠，妊娠率14．04％：克罗米芬(CC) HMG HCG组29个周期，有6例妊娠，妊娠率20．69％。结论 使用促排卵药物，尤其克罗米芬(CC) HMG HCG组，诱发排卵数目多，子宫内膜厚。妊娠率高。