Application of cell-free transcription and translation system in CRISPR technologies and the associated biosensors / 生物工程学报

Cell-free transcription and translation (TXTL) system is a cell extract-based system for rapid in vitro protein expression. The system bypasses routine laboratory processes such as bacterial transformation, clonal screening and cell lysis, which allows more precise and convenient control of reaction substrates, reduces the impact of bacteria on protein production, and provides a high degree of versatility and flexibility. In recent years, TXTL has been widely used as an emerging platform in clusterd regularly interspaced short palindromic repeat (CRISPR) technologies, enabling more rapid and convenient characterization of CRISPR/Cas systems, including screening highly specific gRNAs as well as anti-CRISPR proteins. Furthermore, TXTL-based CRISPR biosensors combined with biological materials and gene circuits are able to detect pathogens through validation of related antibiotics and nucleic acid-based markers, respectively. The reagents can be freeze-dried to improve portability and achieve point-of-care testing with high sensitivity. In addition, combinations of the sensor with programmable circuit elements and other technologies provide a non-biological alternative to whole-cell biosensors, which can improve biosafety and accelerate its application for approval. Here, this review discusses the TXTL-based characterization of CRISPR and their applications in biosensors, to facilitate the development of TXTL-based CRISPR/Cas systems in biosensors.

Mahuang Shengmatang Based on Five Depression Syndromes in Huangdi Neijing / 中国实验方剂学杂志

Mahuang Shengmatang was first recorded in the chapter "Reverting Yin Diseases" in the Treatise on Cold Damage （《伤寒论》）. Whether it is a classic prescription created by ZHANG Zhong-jing is controversial among scholars and physicians due to its distinctiveness in contexts and drug composition. In fact， its proven efficacy in a number of clinical cases cannot be denied， and it is rather biased to judge that Mahuang Shengmatang is a fallacy of later generations. The present study pointed out that Mahuang Shengmatang was a representative in the Treatise on Cold Damage in the treatment of diseases with complicated syndromes. In this formula， although the compatibility of drugs effective in dispersion， astringing， nourishing Yin， assisting Yang， clearing heat， dissipating cold， ascending， floating， sinking， and descending seems complex， it follows certain therapeutic principles. Five depression syndromes in the Huangdi Neijing （《黄帝内经》） highly reflect the Five Elements losing the nature， and embody multiple characteristics of the five elements， such as the movement forms， functions， and disease nature. Furthermore， the corresponding treatment methods were pointed out in the Plain Questions · Major Discussion on the Progress of the Six Climatic Changes of Huangdi′s Internal Classic， including "stagnation of wood should be treated by smoothing， stagnation of fire by dispersing， stagnation of earth by attacking， stagnation of metal by dredging， and stagnation of water by inhibiting"， aiming to restore the physiological conditions of the five elements. The indicated syndromes of Mahuang Shengmatang are complex in superior-inferior， asthenia-sthenia， and cold-heat. The five depression syndromes and their treatment methods recorded in the Huangdi's Internal Classic can reflect the key syndrome pathogenesis and therapeutic principles， which are conducive to analyzing the syndrome differentiation and formulating principles of Mahuang Shengmatang. In the disease progression， impaired Yang Qi in greater Yin and inward invasion of cold pathogens in reverting Yin happen in the initial stage of indicated syndromes of Mahuang Shengmatang， with characteristics of water stagnation， earth stagnation， and wood stagnation. Furthermore， mental stagnation and fire stagnation triggered by Yang Qi accumulation in greater Yang and Yang brightness are the secondary consequences. The compatibility of five types of drugs in Mahuang Shengmatang can act on five depression syndromes in a targeted manner. Based on the five-depression theory in the Huangdi′s Internal Classic and available literature， the present study summarized syndrome pathogenesis and medication characteristics of Mahuang Shengmatang， clarified the correlation between formula and syndrome， and reviewed clinical reports in recent years， which is expected to provide references for the clinical application of Mahuang Shengmatang.

Distribution and haplotype polymorphism of HLA-A、-B、-C、-DRB1、-DQB1 alleles in Anhui Han population / 中国输血杂志

【Objective】 To study the distribution and haplotype polymorphism of HLA-A, -B, -C, -DRB1, -DQB1 alleles in Anhui Han population. 【Methods】 The HLA-A, -B, -C, -DRB1 and -DQB1 genotyping of 3 169 random unrelated stem cell donors was performed by PCR-SBT. The allele frequency, haplotype frequency and linkage imbalance parameters were calculated by counting method, maximum expectation algorithm and PyPop software. 【Results】 A total of 411 HLA alleles were detected in the population, of which 67, 143, 65, 75 and 64 alleles were detected for HLA-A, -B, -C, -DRB1 and -DQB1, respectively. The alleles with frequency >0.1 were HLA-A*11∶01, A*11∶01, A*24∶02, A*02∶01, C*01∶02, C*07∶02, C*06∶02, DRB1*09∶01, DRB1*15∶01, DRB1*07∶01, DQB1* 03∶01, DQB1* 03∶03, and DQB1*02∶01. 1426 HLA-A~HLA-B, 1 772 HLA-B~HLA-DRB1, 798 HLA-B~HLA-C, and 446 HLA-DRB1~HLA-DQB1 haplotypes were detected. The haplotypes showed linkage imbalance, and 19 of them showed strong linkage imbalance (RLD>0.80). 【Conclusion】 The frequency and haplotype distribution of HLA-A, -B, -C, -DRB1 and -DQB1 alleles in Anhui Han population were obtained. The distribution of those alleles and haplotypes have their own characteristics.

Key performance indexes of two HBsAg ELISA reagents: A retrospectively comparative analysis / 中国输血杂志

【Objective】 To retrospectively analyze the key performance indicators of two hepatitis B surface antigen (HBsAg) ELISA reagents used in blood stations, so as to provide basis for reagent selection from the perspective of laboratory performance. 【Methods】 The test results, reactive rate of initial/repeat test, concordance rate of initial and repeat test, and the NAT-yield implicated in ELISA-reactive samples with one assay from 2016 to 2019 were analyzed to compare the detection performance of two ELISA reagents. 【Results】 The total ELISA reactive rate of HBsAg was 0.39%(1 863/480 741), with 0.31% and 0.29% in two reagents, respectively. The initial reactive rate were 0.44% and 0.39%, concordance rate of initial and repeat test was 70.21% and 74.55%, respectively. 43 NAT-yield samples were implicated in ELISA-reactive samples with one assay. 【Conclusion】 There are differences underlying in the detection performance of the two reagents. In order to avoid blood waste and ensure blood safety, the key performance indexes and test results should be taken into consideration when selecting reagents.

Incidence of unintended pregnancy within 2 years after delivery and its influencing factors in China / 中华妇产科杂志

Objective:To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China.Methods:Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women′s socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis.Results:A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95% CI: 4.5%－6.1%) and 13.1% (95% CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions:In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.

The mediating effect of self-esteem between childhood trauma and aggressive behavior in patients with major depressive disorder / 中华行为医学与脑科学杂志

Objective:To explore the relationship between childhood trauma and aggressive behavior in patients with major depressive disorder(MDD), and the mediating role of self-esteem in childhood trauma and aggression.Methods:A total of 241 MDD patients with childhood trauma were investigated by Chinese version of the Buss & Perry aggression questionnaire(AQ-CV) and self-esteem scale (SES). Data were analyzed by SPSS 23.0 and AMOS 24.0.Pearson correlation analysis was used to assess the correlation of childhood trauma, aggressive behavior and self-esteem.The Bootstrap method was applied to test the mediating effect of self-esteem between childhood trauma and aggressive behavior.Results:The total score of attack questionnaire, self-esteem and childhood trauma were (48.81±18.81), (24.91±5.29)and(53.87±10.43), respectively. Self-esteem of MDD patients was negatively correlated with aggressive behavior and childhood trauma ( r=-0.45, -0.24, P<0.01). Childhood trauma was positively correlated with aggressive behavior ( r=0.42, P<0.01). The direct effect of childhood trauma on aggressive behavior was 0.438(95% CI: 0.305, 0.579). Self-esteem played a partly mediating effect between childhood trauma and aggressive behavior, and the mediating effect value was 0.161 (95% CI: 0.080, 0.256), accounted for 26.9% of the total effect. Conclusion:Self-esteem plays a partly mediating role between childhood trauma and aggressive behavior.Childhood trauma can directly and through the part of mediating role of self-esteem affect aggressive behavior.

Screening and confirmation of TP antibody and analysis of syphilis infection status among 12 295 blood donors in Huainan area / 中国基层医药

Objective:To understand the current situation of syphilis infection among 12 295 blood donors in Huainan area, so as to provide reference for the management of public health.Methods:The Treponema pallidum(TP) antibody of the blood donors was screened by enzyme-linked immunosorbent assay, and the unqualified blood donors for TP antibody were confirmed by Treponema pallidum particle agglutination(TPPA).Results:There were 48 blood donors TPPA positive among 12 295 blood donors in Huainan area, and the TPPA positive rate was 3.90‰(48/12 295). There was no statistically significant difference in the TPPA positive rate of the different gender blood donors[male 3.12‰(22/7 048) vs.female 4.96‰(26/5 247)] in Huainan area( u=1.61, P>0.05). There was statistically significant difference in the TPPA positive rate of the different marriage blood donors[married 5.33‰(42/7 884) vs.unmarried 2.01‰(6/2 989)] in Huainan area( u=2.33, P<0.05). There was statistically significant difference in the TPPA positive rate of the blood donors among different education level in Huainan area(χ 2=29.94, P<0.05). There was no statistically significant difference in the TPPA positive rate of the blood donors among ABO blood groups in Huainan area(χ 2=2.24, P>0.05). Conclusion:There are significant differences in the TPPA positive rates of the blood donors among marital status and education level in Huainan area.

Advance of diagnosis and medical treatment for neonatal necrotizing enterocolitis / 中华实用儿科临床杂志

Necrotizing enterocolitis (NEC) is one of the acquired intestinal inflammatory disease in neonate, with a high mortality rate.The morbidity and mortality rate of NEC remain at high level although recognition for NEC has been improved in last decades.Understanding of this disease has been furthered in latest years.The research advance of NEC is reviewed in present which is focus on the diagnosis and medical treatment to provide new evidence for further study.

Study on Improvement Effect and Mechanism of Shuangshen Yin on Liver Fibrosis Model Rats / 中国药房

OBJECTIVE： To study improvement effect and mechanism of Shuangshen yin on liver function and the degree of liver fibrosis in liver fibrosis model rats. METHODS： Healthy SD rats were collected and given 40％ CCl4 olive oil solution intraperitoneally for consecutive 7 weeks to induce liver fibrosis model. 47 model rats were randomly divided into model group， positive control group and Shuangshen yin low-dose， medium-dose and high-dose groups， with 9， 9， 9， 10， 10 rats respectively； another 10 healthy SD rats were included in normal group. From the next week after model induction， model group and normal group were given water intragastrically； positive control group [colchicines 0.2 mg/（kg·d）] and Shuangshenyin groups [Shuangshen yin water decoction 3， 6， 12 g/（kg·d）， by crude drug] were given corresponding medicines respectively for consecutive 28 d. The serum levels of liver function indicators （ALT， AST， TBIL， ALB， GLB） were determined by Rye’s analysis method. The serum levels of liver fibrosis indexes （HA， LN， Ⅲ-PC， Ⅳ-C） were determined by ELISA. The pathological changes of liver tissues were observed by HE staining and VG staining. The levels of SOD， MDA and HYP in liver tissues were determined by spectrophotometry. The expression of α-SMA was detected by immunohistochemistry. RESULTS： Compared with normal group， the serum levels of ALT， AST， TBIL， HA， LN， PC-Ⅲ and Ⅳ-C in model group were increased significantly， and the level of ALB was decreased significantly （P＜0.05）. There were some pathological phenomena such as vacuolar degeneration and fibrous tissue proliferation in rat liver. The levels of SOD in liver tissue were decreased significantly， while the levels of MDA and HYP were increased significantly （P＜0.05）. A large number of positive staining granules of α-SMA protein were observed in liver tissue， and the expression level of α-SMA protein was significantly increased （P＜0.05）. Comparison of model group， the serum levels of ALT， AST and liver fibrosis indexes were significantly decreased and ALB level was significantly increased in Shuangshen yin groups， while the TBIL levels in Shuangshen yin medium-dose， high-dose groups were significantly decreased （P＜0.05）； the phenomena of hepatocyte degeneration and fibrosis tissue proliferation were significantly improved； the levels of SOD in liver tissue were significantly increased， and the levels of MDA and HYP were significantly decreased （P＜0.05）； the positive staining of α-SMA protein decreased significantly， and the expression level of α-SMA protein was decreased significantly （P＜0.05）. CONCLUSIONS： Shuangshen yin has protective and anti-fibrotic effects on liver in rats with hepatic fibrosis， the mechanism of which may be associated with enhancing antioxidant capacity， down-regulating the expression of α-SMA， inhibiting the activation of hepatic stellate cells， reducing extracellular matrix synthesis so as to reverse liver fibrosis.

TMEM43-S358L mutation enhances NF-κB-TGFβ signal cascade in arrhythmogenic right ventricular dysplasia/cardiomyopathy

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a genetic cardiac muscle disease that accounts for approximately 30% sudden cardiac death in young adults. The Ser358Leu mutation of transmembrane protein 43 (TMEM43) was commonly identified in the patients of highly lethal and fully penetrant ARVD subtype, ARVD5. Here, we generated TMEM43 S358L mouse to explore the underlying mechanism. This mouse strain showed the classic pathologies of ARVD patients, including structural abnormalities and cardiac fibrofatty. TMEM43 S358L mutation led to hyper-activated nuclear factor κB (NF-κB) activation in heart tissues and primary cardiomyocyte cells. Importantly, this hyper activation of NF-κB directly drove the expression of pro-fibrotic gene, transforming growth factor beta (TGFβ1), and enhanced downstream signal, indicating that TMEM43 S358L mutation up-regulates NF-κB-TGFβ signal cascade during ARVD cardiac fibrosis. Our study partially reveals the regulatory mechanism of ARVD development.

Regulation of gene expression via control of transcription elongation during immune responses / 中国免疫学杂志

Transcription is a multi-stage process that coordinates several steps during the transcription cycle including pre-initiation,initiation and elongation.Recent advances by genome-wide study suggest that control of transcription elongation is a critical step for precise regulation of gene expression across species from Drosophila to mammals.Here we review the molecular mechanisms of how transcription elongation of RNA polymeraseⅡ(PolⅡ) is modulated by the major pausing factors-NELF,DSIF and the positive elongation factor P-TEFb,which is the key player in pause release.We also discuss the potential implications of regulation of transcription elongation in pathogenesis of cancer,inflammation and virus infection.

RBP-J is required for M2 macrophage polarization in response to chitin and mediates expression of a subset of M2 genes

Development of alternatively activated (M2) macrophage phenotypes is a complex process that is coordinately regulated by a plethora of pathways and factors. Here, we report that RBP-J, a DNA-binding protein that integrates signals from multiple pathways including the Notch pathway, is critically involved in polarization of M2 macrophages. Mice deficient in RBP-J in the myeloid compartment exhibited impaired M2 phenotypes in vivo in a chitin-induced model of M2 polarization. Consistent with the in vivo findings, M2 polarization was partially compromised in vitro in Rbpj-deficient macrophages as demonstrated by reduced expression of a subset of M2 effector molecules including arginase 1. Functionally, myeloid Rbpj deficiency impaired M2 effector functions including recruitment of eosinophils and suppression of T cell proliferation. Collectively, we have identified RBP-J as an essential regulator of differentiation and function of alternatively activated macrophages.

Role of Notch signaling in regulating innate immunity and inflammation in health and disease

The Notch signaling pathway is conserved from Drosophila to mammals and is critically involved in developmental processes. In the immune system, it has been established that Notch signaling regulates multiple steps of T and B cell development in both central and peripheral lymphoid organs. Relative to the well documented role of Notch signaling in lymphocyte development, less is known about its role in regulating myeloid lineage development and function, especially in the context of acute and chronic inflammation. In this review article, we will describe the evidence accumulated during the recent years to support a key regulatory role of the Notch pathway in innate immune and inflammatory responses and discuss the potential implications of such regulation for pathogenesis and therapy of inflammatory disorders.

Comparison of human and Drosophila atlastin GTPases

Formation of the endoplasmic reticulum (ER) network requires homotypic membrane fusion, which involves a class of atlastin (ATL) GTPases. Purified Drosophila ATL is capable of mediating vesicle fusion in vitro, but such activity has not been reported for any other ATLs. Here, we determined the preliminary crystal structure of the cytosolic segment of Drosophila ATL in a GDP-bound state. The structure reveals a GTPase domain dimer with the subsequent three-helix bundles associating with their own GTPase domains and pointing in opposite directions. This conformation is similar to that of human ATL1, to which GDP and high concentrations of inorganic phosphate, but not GDP only, were included. Drosophila ATL restored ER morphology defects in mammalian cells lacking ATLs, and measurements of nucleotide-dependent dimerization and GTPase activity were comparable for Drosophila ATL and human ATL1. However, purified and reconstituted human ATL1 exhibited no in vitro fusion activity. When the cytosolic segment of human ATL1 was connected to the transmembrane (TM) region and C-terminal tail (CT) of Drosophila ATL, the chimera still exhibited no fusion activity, though its GTPase activity was normal. These results suggest that GDP-bound ATLs may adopt multiple conformations and the in vitro fusion activity of ATL cannot be achieved by a simple collection of functional domains.

Analysis of the clinical risk factors of type 2 diabetes complicated with cerebral infarction / 国际检验医学杂志

Objective To analyze the clinical risk factors of type 2 diabetes complicated with cerebral infarction .Methods 508 patients with type 2 diabetes were selected and divided into two groups :group A (complicated with cerebral infarction ,n=240) and group B (without cerebral infarction ,n=268) .The basic clinical information of two groups were recorded .The coagulation indica‐tors and biochemical indicators (including blood glucose ,blood lipid ,HbA1c ,blood β2 microglobulin ,urineβ2 microglobulin ,urine microalbuminuria ,fasting insulin ,fasting C peptide etc) were detected respectively .Results There were significant differences in age ,age at onset of diabetes ,duration of hypertension and systolic blood pressure between group A and group B (P<0 .05) .The in‐cidence of hypertension and coronary heart disease in group A were higher than group B (P<0 .05) .Comparing with group B ,the levels of HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,blood β2 microglobulin ,urineβ2 microglobulin ,and urine microalbuminuria of group A were significantly different (P<0 .05) .The ATⅢ level of group A was significantly lower than that of group B (P<0 .05) .Conclusion The risk factors of type 2 diabetes complicated with cerebral infarction include age ,hyper‐tension ,HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,etc make diabetics be more prone to cerebral infarc‐tion ect .

Maternal serum markers for Down syndrome screening in second-trimester and its relations with adverse pregnant outcomes / 中华围产医学杂志

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.

Relationship of adverse pregnancy outcomes and a high risk serum screen for Down syndrome in the second trimester / 中华妇产科杂志

Objective To investigate the the relationship of a high risk serum screen for Down syndrome in second trimester and adverse pregnancy outcomes,and to evaluate the predictive value for adverse pregnancy outcomes.Methods The tri-marker second trimester maternal serum screening for Down syndrome (alpha-fetoprotein,free beta-hCG and unconjugated estriol)was performed on the pregnant women at Peking Union Medical Hospital from January 2009 to January 2011.The cutoff valvue was 1/270.Pregnancy outcomes were followed up.The general condition and pregnancy complications of the pregnant women with high risk (high-risk group) were compared to that of the pregnant women with low risk (low-risk group); and with 35 years old as a demarcation,the incidences of adverse pregnancy outcomes were calculated in the two groups.Results ( 1 ) A total of 1935 cases were collected.And 1784 cases were with low risk,and 151 cases were with high risk.The difference of weight and gestational age betweem the two groups was not statistically significant ( P ＞ 0.05 ) ; the difference of age between the two groups was statistically significant ( P ＜ 0.01 ).(2) Pregnancy complications were found in 791 cases.In high-risk group,the incidences of gestational diaetes mellitus (GDM,13.9％),neonatal asphyxia (4.0％ ) and small for gestational age infant ( SGA,4.6％ ) were higher than that in low-risk group ( 8.4％,1.0％,1.6％ ),the difference was statistically significant ( P ＜ 0.05 ).The incidences of gestational hypertension disease,premature labor,oligohydrammios,placenta previa,placenta abruption,fetal macrosomia in the two groups was not statistically different (P ＞0.05).(3) In 1705 cases aged less than 35 years,129 cases (7.6％) were GDM,43 cases ( 2.5％ ) were gestational hypertension disease,61 cases ( 3.9％ ) were premature labor; in 230 cases aged 35 years or more,41 cases (17.8％ ) were GDM,12 cases (5.2％) were gestational hypertension disease,15 cases (6.5％ ) were premature labor,and the difference between the two groups was statistically significant ( P ＜ 0.05 ).In ＜ 35 years old group,the incidences of GDM,neonatal asphyxia and SGA (12.3％,4.4％,5.3％ ) were higher in the high-risk group than that (7.2％,0.9％,1.6％ ) in the low-risk group,and the difference was statistically significant ( P ＜ 0,05 ).In ≥35 years old group,the incidences of GDM,neonatal asphyxia and SGA ( 18.9％,2.7％,2.7％ ) were slightly higher in the high-risk group than that (17.6％,1.6％,1.6％ ) in the low-risk group,the difference between the two groups was not statistically significant (P ＞ 0.05 ).Conclusions The present study revealed apparertt increase in the adverse pregnancy outcomes in women with a high risk of Down syndrome screening test.Advanced age is the most important risk factor for a high risk of Down syndrome screening test and adverse pregnancy outcomes.More attention should be attached to the patients whose age were ＜35 years old and with a high risk of Down syndrome screening test.

Pregnancy outcomes of eight pregnant women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency / 中华妇产科杂志

ObjectiveTo investigate the clinical features and pregnant outcomes of the pregnant women with congenital adrenal hyperplasia (CAH) 21-hydroxylase deficiency (21-OHD).MethodsThe clinical features,therapies,pregnant outcomes of the pregnant women with 21-OHD were retrospectively reviewed in Peking Union Medical College Hospital,from January 2005 to April 2011.ResultsThere were 8 pregnant womenwith 21-OHD including 5siinplevirilizing patientsand 3nonclassical 21-OHD women.Eightpatientswereacceptedprogestationalandprenatalcontinuallowerglucocorticoid treatment.During the gestational period,the dosage of glucocorticoid was adjusted in one pregnancy.The serum level of 17-alpha hydroxyprogesterone (17-OHP) were elevated after pregnancy [ (70 ± 38 ) versus (24 ±23) nmol/L,P ＜ 0.05].The fertility and offspring rate of 8 patients was 8/12,the fertility and offspring rate of patients who started treatment at preadolescence was significantly increased (4/5 versus 4/7).Four patients were accepted genital reconstructive surgery ( clitorectomy,clitoroplasty,vulvoplasty) before pregnancy.The incidence of GDM was 1/8.All patients selected caesarean at from 37 +6 gestation weeks to 39+6 gestation weeks.The average newborn birth weight was (3210 ± 447 ) g,and height was (48 ±2) cm of 8 neonates,none of them was CAH.Conclusions Medical and surgical therapy provides satisfactory fertility and pregnancy outcomes for women with 21-OHD.It is safe to pregnant women with 21-OHD and their fetus in continual lower glucocorticoid treatment.The dosage of glucocorticoid should be carefully adjusted during the pregnancy individually according to serum level of 17-OHP.

A prospective cohort study on the influence of high doses of herbs for clearing heat and resolving stasis on survival rates in patients with hepatitis B-related acute-on-chronic liver failure / 中西医结合学报

Hepatitis B-related acute-on-chronic liver failure (ACLF) is a severe clinical syndrome characterized by jaundice, coagulopathy, ascites and hepatic encephalopathy and with a high mortality rate of 65% to 93%. It involves significant ethical issues when a randomized, double-blinded, placebo-controlled clinical study is conducted to such a serious disease. Therefore, a prospective cohort study design was utilized to explore a new treatment modality of applying integrated traditional Chinese and Western medicine.

Clinical analysis of 16 cases of venous thromboembolism in pregnancy and puerperium / 中华围产医学杂志

ObjectiveTo investigate the high risk factors,etiology,diagnosis,treatment and precaution of venous thromboembolism (VTE) in pregnancy and puerperium. MethodsData of 16 cases of VTE admitted in Department of Obstetrics and Gynecology,Peking Union Medical College Hospital from January 1992 to April 2011 were analyzed retrospectively.The differences of blood routine test and coagulation function between VTE patients (study group) and normal pregnant women (control group) were compared by paired t test in this case-control study.Results All patients were diagnosed by color Doppler ultrasound or CT pulmonary artery angiography.Five cases (31.2 ％) occurred before delivery and 11 (68.8 ％) occurred during postpartum.Two cases (12.5 ％)complicated by pulmonary thromboembolism,and one of them died.Six cases (37.5％) were older than or equal to 35 years old,and 12 cases (75.0％) had gestational complications.The hematocrit in study group were lower than that in control group (0.29±0.06 vs 0.39±0.02,t=4.56,P=0.01).There was no statistical difference between the coagulation function of the two groups.After anticoagulant therapy or surgery,15 cases recovered.One pulmonary thromboembolism patients complicated with rheumatic cardiac disease remained shock after anti-coagulants was administered,then died of hemorrhage of respiratory tract after inferior vena cava filter placement. Conclusions VTE is likcly to happen in puerperium than in pregnancy.There are no good screening indicators for thromboembolism during pregnancy and puerperium.Anticoagulation is recommended to be the first line therapy.For women with high risk of thromboembolism,it is suggested to prevent actively and treat early to decrease the complications and long-term sequelea.