A longitudinal and cross-sectional study of placental circulation between normal and placental insufficiency pregnancies.

INTRODUCTION: To longitudinally and cross-sectionally study the differences in the uterine artery pulsatility index (UTPI), umbilical artery pulsatility index (UAPI) and placental vascularization indices (PVIs, derived from 3-dimensional power Doppler) between normal and placental insufficiency pregnancies throughout gestation. METHODS: UTPI, UAPI and PVI were measured 6 times at 4- to 5- week intervals from 11 to 13+6 weeks-36 weeks. Preeclampsia (PE) and fetal growth restriction (FGR) were defined as placental insufficiency. Comparisons of UTPI, UAPI and PVI between normal and insufficiency groups were performed by one-way repeated measures analysis of variance. RESULTS: A total of 125 women were included: monitored regularly from the first trimester to 36 weeks of gestation: 109 with normal pregnancies and 16 with placental insufficiency. Longitudinal study of the normal pregnancy group showed that UTPI and UAPI decreased significantly every 4 weeks, while PVIs increased significantly every 8 weeks until term. In the placental insufficiency group however, this decrease occurred slower at 8 weeks intervals and UTPI stabilized after 24 weeks. No significant difference was noted in PVIs throughout pregnancy. Cross-sectional study from different stages of gestation showed that UTPI was higher in the insufficiency group from 15 weeks onward and PVIs were lower after 32 weeks. DISCUSSION: Compared to high-risk pregnancies with normal outcome, UTPI and UAPI needed a longer time to reach a significant change in those with clinical confirmation of placental insufficiency pregnancies and no significant change was found in PVI throughout gestation. UTPI was the earliest factor in detecting adverse outcome pregnancies.

[Analysis of curative effects of chemoembolization with drug-loaded microspheres of different particle sizes for the treatment of hepatocellular carcinoma].

Objective: To compare and analyze the clinical curative effect and safety of chemoembolization with drug-loaded microspheres of different particle sizes (D-TACE) for the treatment of hepatocellular carcinoma. Methods: Clinical data of 281 cases with hepatocellular carcinoma treated with drug-loaded microspheres-transarterial chemoembolization (TACE) were retrospectively analyzed. According to the different particle sizes of drug-loaded microspheres, they were divided into 100~300 µm (small particle size) and 300~500 µm (large particle size) group. Tumor response rate and complication conditions at 1, 3, and 6 months after chemoembolization were compared. The overall survival time of the two groups were analyzed. Quantitative data conformed to normal distribution and homogeneity of variance were compared using t-test, while other with Wilcoxon signed rank-sum test. Qualitative data were compared using χ2 test. Kaplan-Meier method was used for survival analysis, and the differences in survival were analyzed using Log-rank test. P＜0.05 was considered as statistically significant. Survival curves and histograms were drawn using GraphPad Prism9.1 software. Results: The complete remission rates at 1, 3 and 6 months after surgery in the small and large particle size groups were 31.25%, 30.15%, and 42.45% and 18.25%, 15.79% and 24.74%, respectively, and the differences were statistically significant between groups (P1 month=0.012, P3 month=0.009, P6 month=0.008, P＜0.05). The objective remission rates at 1, 3 and 6 months after surgery in the small and large particle size groups were 88.19%, 76.99%, and 70.75% and 81.02%, 72.81% and 53.60%, respectively. Six months after surgery, the small particle size group (objective response rate = 70.75%) was significantly higher than the large particle size group (objective response rate=53.6%, P=0.012). The disease control rates of the small particle size group were 95.14%, 83.33%, and 74.53%, while large particle size group were 91.24%, 81.58%, and 64.95%, respectively, with no statistically significant difference between the two groups. However, the incidence of postoperative biliary tumors (6.20%) was significantly higher in the small-size than large-size group (0.70%), and the difference was statistically significant (P＜0.05, P=0.03). There were no statistically significant differences between other adverse events such as post-embolization syndrome, liver abscess, and myelosuppression. The median survival time of the small and large particle size groups was 31.8 months and 20.5 months, respectively, but the difference was not statistically significant (P=0.182). Conclusions: In the treatment of hepatocellular carcinoma with D-TACE, the short-term curative effect of the small particle size group was better than large particle size group, but the incidence of biliary tumors was high, and D-TACE of different particle sizes had no significant effect on long-term survival.

The value of placental vascularization indices for predicting preeclampsia and fetal growth restriction in different stages of gestation: A prospective and longitudinal study.

INTRODUCTION: To assess value of placental vascularization indices (PVIs) for predicting preeclampsia (PE) and fetal growth restriction (FGR) in different stages of pregnancy in high-risk women. METHOD: PVIs derived from 3-dimensional power doppler(3DPD) imaging were measured at seven stages of pregnancy: 11-13+6w, 15-19+6w, 20-23+6w, 24-27+6w, 28-31+6w, 32-36+6w, and ≥37w. PE and FGR were used as outcomes in logistic regression models. Area under the receiver operating characteristic (ROC) curve (AUC) of each PVI was calculated, cut-off points were determined to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Finally, AUCs combined with baseline characteristics, uterine artery pulsatility index (UTPI) and PVIs were used to determine whether PVIs could increase the predictive value. RESULTS: Adverse outcomes occurred in 10.9% of pregnancies. Statistical differences appeared in 32-36+6w only. AUCs of vascularization index (VI) and vascularization flow index (VFI) for 32-36+6w were 0.79 (0.70-0.87, p: 0.000), and 0.78 (0.69-0.88, p: 0.000). Sensitivity, specificity, PPV, NPV, PLR, and NLR for VI were 0.91, 0.63, 20%, 98%, 2.39, and 0.15, and those for VFI were 0.62, 0.84, 29%, 95%, 3.75, and 0.45. AUC increased from 0.79 to 0.85 by adding PVIs to baseline characteristics and UTPI model. No statistical significance was found before 32w. DISCUSSION: VI and VFI were valuable for predicting PE and FGR at the 32-36+6w stage, while their values before 32w were poor.

Estrogen/ERR-α signaling axis is associated with fiber-type conversion of upper airway muscles in patients with obstructive sleep apnea hypopnea syndrome.

Estrogen is related with the low morbidity associated with obstructive sleep apnea hypopnea syndrome (OSAS) in women, but the underlying mechanisms remain largely unknown. In this study, we examined the relationship between OSAS and estrogen related receptor-α (ERR-α). We found that the expression levels of ERR-α and Myh7 were both downregulated in palatopharyngeal tissues from OSAS patients. In addition, we report that ERR-α is dynamically expressed during differentiation of C2C12 myoblasts. Knockdown of ERR-α via instant siRNA resulted in reduced expression of Myh7, but not Myh4. Furthermore, differentiation of C2C12 cells under 3% chronic intermittent hypoxia, a model resembling human OSAS, was impaired and accompanied by a obvious reduction in Myh7 expression levels. Moreover, activation of ERR-α with 17ß-estradiol (E2) increased the expression of Myh7, whereas pretreatment with the ERR-α antagonist XCT790 reversed the E2-induced slow fiber-type switch. A rat ovariectomy model also demonstrated the switch to fast fiber type. Collectively, our findings suggest that ERR-α is involved in estrogen-mediated OSAS by regulating Myhc-slow expression. The present study illustrates an important role of the estrogen/ERR-α axis in the pathogenesis of OSAS, and may represent an attractive therapeutic target, especially in postmenopausal women.

Cholesterol imbalance in adipocytes: a possible mechanism of adipocytes dysfunction in obesity.

Studies of the past decade have increased our understanding of the role of adipose tissue dysfunction in obesity and obesity-related insulin resistance and type 2 diabetes. Although adipose tissue is the body's largest pool of free cholesterol, adipocytes have limited activity in cholesterol synthetic pathway. Thus, the majority of adipocyte cholesterol originates from circulating lipoproteins. To maintain cholesterol homeostasis, adipocytes have developed multiple pathways for cholesterol efflux. Several transcriptional factors, such as sterol regulatory element-binding proteins and liver X receptors may be responsible for the regulation of cholesterol homeostasis in adipocytes. Most notably, because altering cholesterol balance profoundly modifies adipocyte metabolism in a way resembling that seen in hypertrophied adipocytes, cholesterol imbalance is recognized as a characteristic for enlarged adipocytes per se in the obese state. In addition, plasma membrane cholesterol normalization by chromium picolinate can fully restore insulin-stimulated glucose transport, further supporting the role of the adipocyte cholesterol imbalance in obesity and insulin resistance.

[Evolution study of wheat (Tritium aestivum L.) A, B and D genome based on DNA sequence similarity].

Tritium aestivum L., and its four potential origin species T. urartu T., T. monococcum L., Ae. squarrosa L. and T. dicoccum S., were amplified with MWG913, a STS marker located in 1H chromosome of barley. Those products are cloned and sequenced. By the discrepancies of these sequences, we have obtained some evidences about the origin of wheat A, B, D genomes at molecular level. The results showed that the studied sequence in A genomes of Tritium aestivum L. was identical with that of T. urartu T., T. monococcum L. and T. dicoccum S.; that in D genome of Tritium aestivum L. was as same as that of Ae. squarrosa L.; that in B genome of Tritium aestivum L. differed from that of T. dicoccum S. in 0.61%. The results also suggested that A, B and D genome have the different evolution speed.

[The creation of 1H chromosome-specific CAPs and ASA markers of barley].

Sequence-Tagged Site(STS) marker is a kind of important marker for identifying heterogeneous chromosome on account of its simplicity, speediness and specificity. There are many STS markers in use, which changed from the RFLP and RAPD markers. But some of those from RFLP markers cannot directly be used for identifying the specific chromosomes, such as MWG913. Amplified wheat genome by MWG913, a STS marker of barley's 1H chromosome, then cloned the products. These clones were classified by restricted enzyme Taq I and then sequenced. On the basis of the results of these sequences compared with barley's (obtained from the GenBank)., two restricted enzyme specifying on 1H chromosome, EcoR I and Pvu I, were chosen to digest the PCR products of T. aestivum, Secale cereale, Hordeum vulgare, Agropyron intermedium, Haynaldia villosa, Thinopyrum elongatum and identified their specilization to Hordeum vulgare genome. Furthermore, according to the difference of Pvu I recognition site, the second PCR primers were designed and identified its specificity to Hordeum vulgare genome by PCR. Thus 1H chromosomespecific CAPs and ASA markers of barley were obtained.

[The chromosome-specific PCR marker's screening and identification of barley 6H chromosome].

Two barley 6H chromosome specific RAPD markers were obtained by screening DNA of barley Hordeum vulgare (Betzes) and wheat-barley 6H addition line with 200 primers, then the RAPD markers were changed into specific PCR markers. Checking different plant materials by the PCR markers, it revealed that there was a specific band in those materials containing 6H chromosome such as Betzes, Igri, CS6H, and there was no specific band if the material did not contain 6H chromosome, such as Triticum aestivum, Secale cereale, Agropyron intermedium, Haynaldia villosa, Thinopyrum elongatum. Therefore, those PCR markers specific to chromosome 6H of barley are established. Southern hybridization indicated that the two cloned DNA fragments belong to barley genomic specific high-copy repeat sequence and low-copy sequence in wheat and barley genomes respectively.

[Effects of low concentration carbon monoxide on the neurobehavior function in mice].

OBJECTIVE: To study the effect of low concentration CO on neurobehaviour function and the maximal allowable concentration (MAC) in limited time. METHOD: 40 KM (kunming) male mice were randomly divided into groups A, B, C and D. They were exposed to normal air, 30 mg/m3 CO, 300 mg/m3 CO and 600 mg/m3 CO respectively. The changes in neurobehaviour function of the mice before, during and after 72 h exposure in 0.5 m3 static chambers were observed. Four indices were measured: response time (RT) and error rate (ER) in the water maze test, enter check frequency (ECF) and urine or excrement frequency (UEF) in open field test. RESULT: The set upright frequency in group D was smaller than those in groups A, B and C during exposure. RT and ER values went in a direction contrary to pre-exposure the four groups in the second 3 days (6 d) after or out of exposure, while ER values showed that group D > group C > group A > group B in the third 3 days (9 d). RT value was not different among the 4 groups, but its order of numerical value was similar to the ER order. The order of ECF values was that group C > group A and group D in 3 d after or out of exposure and not different among the 4 groups in 6 d and group D < group A and group B in 9 d. UEF values were not different among the 4 groups in 3 d and 9 d, but group D > group A and group B in 6 d after or out of exposure. Comparison with every group itself, showed statistically significance increase in ER values in 9 d out of exposure than before exposure in group D. ECF values showed the statistics significant increase in 9 d in group A and B. CONCLUSION: Low concentration CO may interfere with the learning and memory of mice in the water maze and impede the development of the motor nervous function and disturb the steadiness of emotion of mice in the open field. In addition, low concentration of CO may be of tardy toxicity.

Laparoscopic management of a gastric perforation after snare removal of a gastric leiomyoma.

A 67-year-old man with a history of myocardial infarction, who had been suffering intermittent epigastric pain and tarry stool for nine months, was referred to our hospital with a suspected gastric tumor. The panendoscopy showed a round, hard submucosal tumor at the greater curvature of the upper gastric body, near the fundus. An ulcer scar was observed on the surface of the tumor. Polypectomy using snare cauterization was carried out. However, severe abdominal pain and abdominal distension developed. A chest radiograph revealed bilateral subphrenic free air. Due to the high risk in this patient, laparoscopic repair of the gastric perforation was carried out using an Endo-GIA instrument. The postoperative course was uneventful. Feeding started on the third postoperative day, and the patient was discharged on the eighth day. A follow-up panendoscopy two months later showed a well-healed scar.