Reduced CD200 and CD200R1 expression in human chorionic villi contributes to early spontaneous abortion.

OBJECTIVE: To examine the expression of CD200 and its receptor (CD200R) in human chorionic villi during the first trimester of normal pregnancy and early spontaneous abortion (ESA). DESIGN: Prospective study. METHODS: Expression of CD200 and CD200R in the chorionic villi was determined using streptavidin-peroxidase immunohistochemistry, confocal laser scanning microscopy and real-time polymerase chain reaction. POPULATION: Thirty-five women diagnosed with ESA and 30 women experiencing a healthy pregnancy in a medical university hospital in China were enrolled in this study between 2011 and 2013. MAIN OUTCOME MEASURES: CD200 and CD200R expression. RESULTS: The expression of CD200 in syncytiotrophoblast cells was significantly higher during normal pregnancy than in ESA (0.51 ± 0.05 vs. 0.35 ± 0.05). In contrast, expression of CD200 in cytotrophoblast cells and CD200R in stromal cells was significantly lower during normal pregnancy when compared with ESA (CD200: 0.16 ± 0.02 vs. 0.32 ± 0.03; CD200R: 0.19 ± 0.03 vs. 0.22 ± 0.02). In villi, the expression of both CD200 protein and CD200R transcripts were significantly higher in healthy first-trimester pregnancy than in ESA (CD200: 156.89 ± 105.65 vs. 37.51 ± 17.62). CONCLUSIONS: There is an increase in inhibitory properties of human chorionic villi during normal pregnancy. The mechanism underlying ESA might be associated with enhanced expression of CD200 and CD200R in the trophoblast, leading to an upregulation of the immune response during the first trimester of pregnancy.

Status of human papillomavirus infection in the rural female population in Northwestern China: an observational study.

OBJECTIVE: The purpose of the present study was to investigate human papillomavirus (HPV) infection and evaluate the risk factors for occurrence of HPV infection in the prevention of HPV-related cancers in Northwestern China. MATERIALS AND METHODS: In a cross-sectional study, 402 rural women, ages 20 to 60 years in the rural areas of Shiquan County in the Shaanxi Province of China between August 2009 and July 2010 were interviewed and examined, and specimens were collected to identify the HPV type using the polymerase chain reaction. RESULTS: The prevalence rate of HPV was 12.6% (47/373). Coinfections with more types of HPV were detected in 38.3% (18/47) of HPV-positive subjects. There was an age-dependent prevalence, showing the highest prevalence among women in the study between ages 20 and 29 years (18.2%, 8/44). Human papillomavirus 35 was the most common type of infection found, occurring in 5.1% (19/373) of the HPV-positive samples, followed by HPV-16 (4.6%, 17/373), HPV-58 E7 (4.0%, 15/373), HPV-18 (1.6%, 6/373), HPV-31 (0.5%, 2/373), and HPV-33 (0.3%, 1/373). More than 1 previous abortion and women with vaginitis were associated with the increased risk of HPV infection (χ = 4.71, p < .05; χ = 9.703, p < .01). CONCLUSION: The prevalence rate of HPV among women in the study was 12.6%, and HPV-35 was the most common type of HPV infection in the study in Shaanxi Province. Women with more than 1 previous abortion and vaginitis had more HPV prevalence, and HPV infection could coincide with pregnancy.

Efficacy of scleral-fixated 3-looped haptics intraocular lens implantation for surgical management of microspherophakia.

AIM: To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens (IOL) implantation for surgical management of microspherophakia. METHODS: A retrospective case series include 10 microspherophakic patients (15 eyes) who underwent lens removal plus a modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation. The primary outcomes involved visual acuity, intraocular pressure (IOP). Secondary outcomes were spherical equivalent (SE), anterior chamber depth (ACD), corneal endothelial cell density and postoperative complications. RESULTS: After a postoperative follow-up of 17.60±15.44mo, improved visual outcomes can be observed. The uncorrected distance visual acuity (UCVA) logMAR improved from 1.54±0.59 preoperatively to 0.51±0.35 postoperatively (P=0.001), and best corrected visual acuity (BCVA) logMAR improved from 0.97±0.91 preoperatively to 0.24±0.23 postoperatively (P=0.003). Moreover, the SE decreased from -9.58±7.47D preoperatively to -0.65±2.21 D postoperatively (P<0.001). In terms of safety profile, the average IOP decreased from 21.10±12.94 mm Hg preoperatively to 14.03±3.57 mm Hg postoperatively (P=0.044), and the previously elevated IOP of three eyes decreased to the normal range. The ACD increased from 2.25±1.45 mm preoperatively to 3.35±0.39 mm postoperatively (P=0.017). The density of corneal endothelial cells did not change significantly after surgery (P=0.140). The posterior chamber IOLs were well centered and no severe complications were found. CONCLUSION: Lens removal plus the modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation can help in improvement of visual acuity, which can be regarded as a relative safe method for the surgical management of microspherophakia.

[Quantitative evaluation for diagnostic efficacy of computed tomography and magnetic resonance imaging in patients with lumbar disc herniation].

OBJECTIVE: To evaluate the diagnostic performances of CT and MRI in patients with lumbar intervertebral disc herniation through the Meta analytical method. METHOD: The relevant English and Chinese articles published between 1980 and 2010 were searched in PubMed, Medline, Ovid database, Cochrane library and Chinese Periodical Web. According to the criteria for diagnostic researches published by Cochrane Method Group on Screening and Diagnostic Tests, each article was critically appraised and screened with regards to the absolute numbers of true-positive, false-negative, true-negative and false-positive. Statistical analysis was performed by the Meta-Disc version 1.4, SPSS 13.0 and Comprehensive Meta-analysis version II. Heterogeneity was tested and publication bias analyzed. And the pooled weighted sensitivity and specificity and the corresponding 95%CI were calculated. The summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) calculated to summarize and evaluate the diagnostic efficiency of CT and MRI in lumbar intervertebral disc herniation. Finally a sensitivity analysis was performed. RESULTS: According to the criteria of internalization, 9 articles were included. Among them, the themes were CT (n = 3), MRI (n = 3) and CT & MRI (n = 3). Eight was prospectively studied and one retrospectively. At the diagnosis of lumbar intervertebral disc herniation, the pooled weighted sensibility and specificity and 95% confidence interval and area under SROC curve for CT to the lumbar intervertebral disc herniation was 0.73 (0.68 - 0.77), 0.78 (0.72 - 0.82) and 83.5% respectively. The MRI was 0.88 (0.83 - 0.91), 0.79 (0.71 - 0.87) and 88.8% respectively. There was statistically significant difference in the pooled weighted sensibility (P < 0.05); No statistically significant difference was found in the pooled weighted specificity (P > 0.05); And there was statistically significant difference in the AUC curve (P < 0.05). CONCLUSION: After a meta-analysis of the diagnostic value of CT and MRI for the lumbar intervertebral disc herniation, MRI is more accurate than CT in the diagnosis of lumbar intervertebral disc herniation.

[Quantitative evaluations of ischemic stroke based on meta-analysis].

OBJECTIVE: To perform a meta-analysis to explore the evolutions of apparent diffusion coefficient during different stages of ischemic stroke. METHODS: The relevant English and Chinese articles published from 2001 to 2010 were retrieved from the databases of Cochrane Library, Pubmed, Elsevier and Chinese Knowledge Resource Integrated Database (CNKI). According to the criteria of diagnostic researches published by the Cochrane Method Group on Screening & Diagnostic Tests, each article was critically appraised. We tested their heterogeneity, selected the corresponding effect model and calculated pooled weighted effect size and corresponding 95% CI. RESULTS: By the established inclusion criteria, we retrieved 34 studies with 20 English and 14 Chinese articles. The pooled apparent diffusion coefficient (ADC) values of diffusion weighted imaging-magnetic resonance imaging (DWI-MRI) and 95%CI of hyper-acute, acute, sub-acute, chronic stroke were 0.53 (0.45 - 0.60), 0.50 (0.47 - 0.53), 0.66 (0.62 - 0.70), 1.20 (1.01 - 1.38) while those of penumbra and control were 0.70 (0.68 - 0.89) and 0.87 (0.84 - 0.91) respectively. The ADC values of hyper-acute and acute stroke were obviously lower than that of penumbra and it had statistical significance (both P < 0.05). The ADC values of hyper-acute, acute, sub-acute and chronic stroke were obviously different from that of control and it had statistical significance [0.53 (0.45 - 0.60) × 10(-3) s/mm, 0.50 (0.47 - 0.53) × 10(-3)s/mm, 0.66 (0.62 - 0.70) × 10(-3)s/mm, 1.20 (1.01 - 1.38) × 10(-3)s/mm vs 0.87 (0.84 - 0.91) × 10(-3)s/mm, all P < 0.05]. CONCLUSIONS: As indicated by our meta-analysis, the ADC values can quantitatively evaluate different stages of stroke and guide the choices of treatment methods.

[Coronary artery disease diagnosis with 64-slice spiral CT coronary artery angiography in China and abroad: a meta analysis].

OBJECTIVE: This meta-analysis evaluated the accuracy of diagnosing coronary artery disease using 64-section spiral computed tomography, and compared the difference between Chinese studies and abroad studies. METHODS: Relevant English and Chinese articles published from 1998 to 2009 were searched in Cochrane library, Medline, Embase database, OVID database and CNKI. Heterogeneity was tested, pooled weighted sensitivity and specificity and the corresponding 95%CI were calculated. Summary receiver operating characteristic (SROC) curve was drawn and the area under the curve was calculated, differences between studies from China and abroad were compared. RESULTS: A total of 433 articles were searched and 108 articles were included (46 English articles and 62 Chinese articles) after excluding articles of research purposes or design does not match. Because of no gold standard, no blind, can not be calculated literature data, 7 and 20 (P > 0.05), 44 and 6 (P < 0.05), 3 and 1 (P < 0.05) Chinese studies and English articles respectively were excluded. Twenty-seven articles fulfilled all inclusion criteria (8 Chinese and 19 foreign studies) In 8 Chinese studies the pooled weighted sensitivity and specificity and area under SROC curve was 0.892 (95%CI: 0.868 - 0.913), 0.972 (95%CI: 0.966 - 0.977) and 0.983 (95%CI: 0.966 - 1.000) at segment-based analysis. In 19 foreign studies, the pooled weighted sensitivity and specificity and area under SROC curve was 0.971(95%CI: 0.957 - 0.982), 0.878 (95%CI: 0.852 - 0.902) and 0.973 (95%CI: 0.958 - 0.989) at patient-based analysis, 0.917 (95%CI: 0.895 - 0.936), 0.919 (95%CI: 0.909 - 0.928) and 0.974 (95%CI: 0.964 - 0.984) at vessel-based analysis, 0.882 (95%CI: 0.868 - 0.895), 0.959 (95%CI: 0.956 - 0.962) and 0.985 (95%CI: 0.978 - 0.992) at segment-based analysis. Pooled weighted pecificity of 64-section spiral CT angiography at segment-based analysis has significant different between home and abroad (P < 0.05). CONCLUSIONS: Meta-analysis showed that noninvasive 64-section spiral computed tomography could correctly diagnose coronary artery disease with high sensitivity and specificity. Quality of related studies performed in abroad is significantly higher than those performed in China.

Nuclear translocation of nuclear factor Kappa B in first trimester deciduas and chorionic villi in early spontaneous miscarriage women.

The nuclear factor kappa B is widely expressed in the distinct subpopulations of chorionic villi and deciduas of first-trimester pregnancies. We examined the cellular distribution and expression of nuclear factor kappa B in the human first-trimester chorionic villi and deciduas of women with early spontaneous miscarriage and viable pregnancy by confocal laser scanning microscope and immunohistochemistry. There is a greater nuclear translocation of nuclear factor kappa B is restricted to villous stromal cells, decidual stromal cells, glandular epithelial cells and vessel endothelial cells in early spontaneous miscarriage than in viable pregnancies. Collectively these observations suggest that over-activation of nuclear factor kappa B has a relationship with early spontaneous miscarriages.

Decreased expression of CD200 and CD200R1 by human decidual tissues in spontaneous early abortion.

Objective: To examine the cellular distribution and the expression of CD200 and its receptor 1 (CD200R1) in human deciduas in first-trimester pregnant women with spontaneous early abortion (SEA) and normal pregnancy, and to explore their role in the etiology of SEA.Subjects and methods: Thirty-five women at 6-10-week gestation with SA and 30 women of similar gestational age with a healthy pregnancy were recruited. Expression of CD200 and CD200R1 in the deciduas was determined using immunohistochemistry, confocal laser scanning microscope, Western blot, and real-time PCR (RT-PCR).Results: The decidual stromal cells, glandular epithelial cells, and vessel endothelial cells during the first trimester of pregnancy express both CD200 and CD200R1 proteins. During this period, the expression of CD200 in glandular epithelial cells and vessel endothelial cells is significantly higher in normal pregnancy than that in women with SEA (0.3079 ± 0.0674 versus 0.2735 ± 0.0515; 0.4077 ± 0.1366 versus 0.3249 ± 0.0993); the expression of CD200R1 in stromal cells, decidual stromal cells, glandular epithelial cells is significantly higher during normal pregnancy than SEA (0.2574 ± 0.0588 versus 0.2292 ± 0.0415; 0.3617 ± 0.1046 versus 0.2804 ± 0.0640). Western blot analysis showed an approximately 44% decrease in CD200R1expression in decidua in the SEA versus the controls. Finally, in decidua, the expression of both CD200 protein and CD200R1 transcript are significantly higher in healthy first-trimester pregnancy than in SEA (CD200: 2.2089 ± 1.2754 versus 0.7241 ± 0.2143; CD200R1: 15.7843 ± 10.7085 versus 7.3381 ± 5.8529).Conclusions: Women with SEA have a lower level of CD200 and CD200R1 expression in deciduas compared with normal pregnant women suggesting that under physiological conditions, CD200 and CD200R1 expression by deciduas is important to prevent fetal loss ensure a successful pregnancy.

Soluble tumor necrosis factor receptor mediates cell proliferation on lipopolysaccharide-stimulated cultured human decidual stromal cells.

The tumor necrosis factor-alpha (TNF-alpha) cytokine receptor system modulates apoptosis in many cell types, so we have investigated the role of sTNFR1 in bacterial lipopolysaccharide (LPS)-induced cell death in cultured human decidual stromal cells, hypothesizing that sTNFR1 might play a central role in this action. In this work we characterized in vitro decidual stromal cell viability with LPS treatment and LPS and sTNFR1 co-treatment. We found that LPS treatment induced decidual stromal cell death in a dose-dependent manner and that sTNFR1 blocked the effect of the LPS treatment. There was a significant proliferation among cells co-incubated with LPS at 10 microg/mL and sTNFR1 at 0.1 microg/mL compared with LPS and sTNFR1 at 0.01, 0.05, 0.2 and 0.5 microg/mL (p < 0.01). This study demonstrated that LPS led to decidual stromal cell death in vitro but sTNFR1 down-regulates the cell death due to LPS under the same conditions. Taken together, these results suggested that sTNFR1 could participate in a protective mechanism against endotoxin.

Trace elements and cytokine profile in cytomegalovirus-infected pregnancies: a controlled study.

OBJECTIVE: Qinba Mountain area of Shanxi Province, China, is one of the poorest, culturally backward regions in China with a high incidence of mental retardation. To investigate whether cytomegalovirus (CMV) plays a role in the high incidence of mental retardation in this region, we studied the incidence of CMV infection during pregnancy and possible risk factors associated with CMV infection. METHODS: 386 consecutive pregnant women in Qinba Mountain area were monitored for the level of a CMV-specific IgM antibody. Polymerase chain reaction was used to detect CMV in breast milk obtained within 2 weeks postpartum and urine samples of newborn infants born to actively CMV-infected mothers. Serum levels of TNF-alpha, IL-6, zinc, copper, iron and selenium were analyzed in CMV-infected pregnant women. RESULTS: The incidence of CMV-active infection during pregnancy, intrauterine transmission and excretion in breast milk were 15.03, 33.33, and 39.58%, respectively. Active CMV infection during pregnancy was correlated with maternal age, education and economic status, parity, and history of obstetric complications. Those women who had active CMV infection, intrauterine transmission, or CMV excretion in milk showed higher values of TNF-alpha and IL-6, lower values of zinc as compared with health age-matched controls (p < 0.05). No differences were identified between studied cases and controls in the level of copper, iron, and selenium (p > 0.05). CONCLUSION: The incidence of CMV-active infection during pregnancy was high in Qinba Mountain area of Shanxi Province. Zinc deficiency may be a risk factor for the development of CMV infection. TNF-alpha and IL-6 may be involved in the pathophysiologic process.