Dysregulated miRNAs contribute to altered placental glucose metabolism in patients with gestational diabetes via targeting GLUT1 and HK2.

INTRODUCTION: Dysregulated genes in glucose transport and metabolize pathways have been found in patients with Gestational diabetes (GDM), but the underlying mechanisms were still unclear. MATERIALS AND METHODS: Placental villous samples were collected from 31 patients with GDM and 20 healthy controls. The expression of GLUT1, GLUT4, GLUT9 and HK2 was examined by immunoblotting and qRT-PCR. The miRNAs have the potential targeting GLUT1 and HK2 were predicted using online bioinformatics tool: TargetScan. The interaction between miRNAs and target genes were confirmed by dual luciferase assay and immunoblotting. The function of miR-9 and miR-22 on glucose metabolism was examined by glucose uptake assay and lactate secretion assay. RESULTS: GLUT1 and HK2 proteins level was found upregulated in patients with GDM, but the mRNA level was not significantly changed. Predicted by using bioinformatics tools and confirmed by dual luciferase assay and immunoblotting, GLUT1 was identified as a target of miR-9 and miR-22, whereas HK2 was identified as a target of miR-9. MiR-9 and miR-22 level was found reduced in the placenta villous and negatively correlated with the expression of GLUT1 and HK2. Functional studies indicated that miR-9 and miR-22 inhibitors upregulated the expression of GLUT1 and HK2, and then increased the glucose uptake, lactate secretion, cell viability and repressed apoptosis in primary syncytiotrophoblasts (STBs) and HTR8/SVneo cells. DISCUSSION: The upregulation of GLUT1 and HK2 in the placenta, which is induced by miR-9 and miR-22 reduction, contributes to the disordered glucose metabolism in patients with GDM.

[Prevalence and major risk factors of peripartum thromboembolic disease in different regions of Guangdong province].

OBJECTIVE: To investigate the prevalence and major risk factors of peripartum thromboembolic disease in different regions of Guangdong province. METHODS: Data from 169 218 pregnant women in different regions of Guangdong province from January 2005 to June 2010 were analyzed retrospectively. The prevalence and epidemiological characteristics of thromboembolic disease during pregnancy or puerperium were investigated. RESULTS: Of the studied population, (1) 201 cases (1.3‰) suffered from thromboembolic disease during pregnancy or puerperium including 128 cases of deep vein thrombosis (DVT), 68 cases of cerebral venous thrombosis (CVT) and 5 pulmonary embolism, the prevalence rates were 0.8‰, 0.4‰, and 0.02‰ respectively. (2) Risk factors in different regions showed that, in the Pearl River Delta area, the major risk factors for DVT would include previous or family history of thrombosis, pregnancy complications, with medically involved diseases, prolonged bed rest and pregnancy weight gain>15 kg etc. While in eastern, western, northern parts of Guangdong, the major risk factors for DVT would include pregnancy weight gain>15 kg, prolonged bed rest, preeclampsia, cesarean section and complications during pregnancy. In Pearl River Delta region, the major risk factors for CVT would include eclampsia, preeclampsia, pregnancy complications, prolonged bed rest>3 days, past history or family history of thrombosis. While eclampsia, preeclampsia, advanced age or younger age, pregnancy weight gain>15 kg, complications during pregnancy were the major risk factors for CVT in the eastern, western or northern parts of Guangdong. CONCLUSION: Prevalence and major risk factors of peripartum thromboembolic disease in different regions of Guangdong were different. It was crucial to take effective measures in pregnant women with different epidemiological characteristics and risk factors to prevent and reduce the incidence of peripartum thromboembolic disease.

[Expression of ZNF217 in human ovarian cystadenocarcinoma and its clinical significance].

OBJECTIVE: To explore the correlation of ZNF217 expression to the carcinogenesis and progression of human ovarian cancer. METHODS: Immunohistochemistry and real-time RT-PCR were used to detect ZNF217 expression in human ovarian cystadenocarcinoma, ovarian cystadenoma and normal ovary tissues. RESULTS: The expression levels of ZNF217 protein and mRNA in ovarian cystadenocarcinoma was significantly higher than those in matched ovarian cystadenoma and normal tissues (P<0.05). No significant difference was found in the expression between ovarian cystadenoma and normal ovarian tissues (P>0.05). The mRNA expression in the specimens was consistent with the protein expression of ZNF217 (P<0.05). CONCLUSION: ZNF217 gene expression is closely correlated to the occurrence and clinical stages of ovarian carcinomas, suggesting that ZNF217 can be an important candidate gene responsible for the occurrence and progression of ovarian carcinomas.

[Ultrasonic study of deep-vein diameter and blood flow spectrum changes in full-term pregnant women].

OBJECTIVE: To explore the changes in lower limb deep vein diameters, blood flow velocity and blood biochemistry in full-term pregnant women for early diagnosis and treatment of prothrombotic state. METHODS: One hundred and twenty-eight full-term pregnant women at high risk of thrombosis (Group A), 61 healthy full-term pregnant women (Group B), and 42 healthy non-pregnant women (Group C) underwent high-resolution color Doppler ultrasound (CDU) for examining the deep veins of the lower limbs. The hematological indexes such as D-D, PLT, HGB, HCT, TT, APTT, PT, and FbgC were also observed in these 3 groups. RESULTS: Compared to Group B, the women in group A showed significantly increased diameters of the common femoral veins (CFV) and left superficial femoral vein (SFV), HCT and DD, but with significantly decreased peak blood flow in the bilateral popliteal veins (POPV) (P<0.01) and increased left POPV diameter (P=0.034). Compared to those in group C, the diameters of the bilateral CFVs, SFVs, POPV, and posterior tibial veins (PTVs) were significantly increased, but the peak blood flow in the bilateral CFVs and POPVs were significantly reduced in groups A and B; the PLT, HGB, HCT, DD, TT, APTT, PT, and FbgC also showed significant changes in groups A and B (P<0.01). CONCLUSION: The full-term pregnant women are at higher risk of prothrombotic state than non-pregnant women, and the full-term pregnant women with the high risk factors for thrombosis are more likely to have prothrombotic state than healthy full-term pregnant women. CDU examination of the lower limb deep veins can be of value in the diagnosis of prothrombotic state.

[Hysterectomy after cardiopulmonary resuscitation in patients with obstetric hemorrhagic shock].

OBJECTIVE: To explore the indication of hysterectomy after successful resuscitation of cardiac arrest due to obstetric hemorrhagic shock. METHODS: A retrospective analysis was conducted in 13 patients with cardiac arrest due to obstetric hemorrhagic shock in 7 hospitals of Guangzhou, including 12 patients undergoing hysterectomy and 1 undergoing uterine artery embolization. RESULTS: s After successful cardiopulmonary resuscitation, only 4 of the 13 patients undergoing hysterectomy or uterine artery embolization for continuing uterus hemorrhage survived. CONCLUSION: Detailed plans and emergency measures should be formulated in the management of high-risk pregnancies. Early diagnosis and active treatment of obstetric hemorrhagic shock with hysterectomy or uterine artery embolization are critical in preventing cardiac arrest and improving the survival of the patients.

[Clinical study of Osaka formula and improved multiparameter ultrasonic measurement for fetal weight estimation].

OBJECTIVE: To analyze the factors affecting the accuracy of Osaka formula multiparameter ultrasound-based fetal mass estimation, thereby establishing new formulas to improve the accuracy of the estimation. METHODS: A retrospective review was conducted among 519 healthy women with singleton pregnancy. Three days before the delivery (between 37 and 42 weeks' gestation), ultrasonic measurement of the fetal weight and other indices of the fetus was routinely performed. Correlation and multiple linear stepwise regression analysis were used to correct the 3 equations, which, along with Osaka University formula, were used to predict another 219 fetuses' birth weight. The coincidence rate of the predicted value and with the actual birth weight, and the absolute error and relative error were compared between the equations. RESULTS: The fetal abdominal area (AA) and abdominal circumference (AC) showed the most conspicuous influence on the estimated fetal birth weight, and fetal humerus length (HL) was more sensitive than femur length (FL) for the estimation. Three new regression equations were established, among which the equation 2 (fetal birth weight=1082.859+4.116xAAxHL) showed the best accuracy in clinical prediction. CONCLUSION: AA,AC and HL are more sensitive indices for estimation of the fetal birth weight, and the equation 2 established in this study still awaits further verification for its clinical value.

[Changes in serum endothelin and in pregnant rabbits with pulmonary embolism].

OBJECTIVE: To study change of serum endothelin (ET) and in serum endothelin and in pregnant rabbit with acute pulmonary embolism. METHODS: In 17 pregnant rabbits, autologous blood clots were administered into the right atrium via the femoral vein to establish the animal models of acute pulmonary embolism, and another 10 pregnant rabbits received injection with saline to serve as the control group. Serum levels of ET and CGRP were measured before, 0, 2, 4, 6 and 8 h after the injection. RESULTS: Acute pulmonary embolism was induced in all the rabbits receiving the injection of autologous blood clots with a success rate of 100%. In these rabbit models of pulmonary embolism, serum ET increased 0 h after the embolism and kept rising till 6 h, whereas CGRP level underwent immediate decrease after the embolism followed then by increase during the period from 4 to 8 h, showing significant difference from the levels of the control group. CONCLUSION: Significant difference in serum ET and CGRP levels occur in the event of acute pulmonary embolism in pregnant rabbits.