[NKX2.5 and TBX5 gene mutations in in vitro fertilization children with congenital heart disease].

OBJECTIVE: To explore the differences of NKX2.5 and TBX5 gene mutations between in vitro fertilization (IVF) children with congenital heart disease (CHD) and naturally conceived children with CHD. METHODS: Blood samples from 68 IVF children with CHD and 98 naturally conceived children with CHD were collected. The mutations in coding regions 1 and 2 of the NKX2.5 gene, and coding regions 4, 5, and 8 of the TBX5 gene were examined by polymerase chain reaction (PCR) and DNA sequencing. RESULTS: An A-to-G mutation at nucleotide 63 (c.63A>G) in coding region 1 of the NKX2.5 gene was found in both IVF and naturally conceived children with CHD. There were no significant differences in genotype and allele frequencies at c.63A>G locus of the NKX2.5 gene between the two groups. No mutations were detected in coding region 2 of the NKX2.5 gene and coding regions 4, 5 and 8 of the TBX5 gene. CONCLUSIONS: There is no difference in NKX2.5 and TBX5 gene mutations between IVF and naturally conceived children with CHD. Therefore, it is presumed that assisted reproductive technology may not lead to mutations in the NKX2.5 and TBX5 genes.

[Effect of advanced maternal age on birth defects and postnatal complications of neonates].

OBJECTIVE: To investigate the effect of advanced maternal age on birth defects and postnatal complications of neonates. METHODS: Among the 1 109 neonates who were born at The First People's Hospital of Yunnan Province between January 2014 and December 2015, 536 neonates whose mothers were aged ≥35 years were enrolled as advanced age group and 573 neonates whose mothers were aged <35 years were enrolled as appropriate-age group. The incidences of the comorbidities in pregnancy, fetal intrauterine distress, neonatal birth defects, and postnatal complications were compared between the two groups. A univariate logistic regression analysis was performed to analyze the effect of advanced maternal age on neonatal comorbidities during perinatal period. RESULTS: Compared with the appropriate-age group, the advanced age group had significantly higher rate of caesarean section and incidence rates of multiple birth, gestational diabetes, pregnancy-induced hypertension, in vitro fertilization, and fetal intrauterine distress (P<0.01). The neonates in the advanced age group had a significantly higher incidence rate of cleft lip and palate and a significantly lower rate of skeletal dysplasia than in the appropriate-age group (P<0.05). Advanced maternal age was the risk factor for fetal intrauterine distress (OR=2.27, 95%CI: 1.33-3.88, P=0.003), neonatal resuscitation (OR=1.66, 95%CI: 1.19-2.31, P=0.003), and intracranial hemorrhage (OR=2.70, 95%CI: 1.21-6.04, P=0.02). CONCLUSIONS: The women of maternal advanced age have higher incidence rates of pregnancy comorbidities than those of appropriate age, and the neonates born to the mothers of advanced maternal age have a higher incidence rate of cleft lip and palate. Advanced maternal age may increase the risks of fetal intrauterine distress, neonatal resuscitation, and intracranial hemorrhage.

[Value of combined measurement of intestinal fatty acid-binding protein and fecal calprotectin in diagnosis of necrotizing enterocolitis in full-term neonates].

OBJECTIVE: To study the value of combined measurement of intestinal fatty acid-binding protein (I-FABP) and fecal calprotectin (FC) in the diagnosis of necrotizing enterocolitis (NEC) in full-term neonates. METHODS: A total of 36 full-term neonates with NEC (case group) and 39 neonates without digestive system diseases (control group) were enrolled as study subjects. ELISA was used to measure the serum I-FABP level and fecal FC level, and the clinical value of I-FABP combined with FC in the diagnosis of NEC was evaluated. RESULTS: The case group had significantly higher I-FABP and FC levels than the control group (P<0.05). In the case group, serum I-FABP level was positively correlated with fecal FC level (r=0.71, P<0.05). In the diagnosis of NEC, I-FABP alone, FC alone, and I-FABP/FC combination had sensitivities of 83.3%, 81.5%, and 79.5%, specificities of 72.5%, 75.8%, and 86.3%, and areas under the ROC curve (AUCs) of 0.82, 0.81, and 0.88. The combined measurement showed significantly higher specificity and AUC than single measurement (P<0.05). CONCLUSIONS: Children with NEC have significant increases in I-FABP and FC levels, and there is a correlation between them. Combined measurement of I-FABP and FC can increase the specificity of the diagnosis of NEC.

[Neonatal complications and birth defects in infants conceived by in vitro fertilization].

OBJECTIVE: To investigate the survival quality of infants conceived by in vitro fertilization (IVF) and to identify the factors that cause birth defects and neonatal complications in IVF infants. METHODS: The study included 150 IVF infants (IVF group) and 200 naturally conceived infants (control group). Indicators such as birth situation, gestational disease, birth defects, and neonatal complications were compared between groups. The influencing factors for birth defects and neonatal complications were analyzed by non-conditional logistic regression analysis. RESULTS: Compared with the control group, the IVF group had increased incidences of twin pregnancy and low birth weight (P<0.01) but decreased average birth weight (P<0.05). In the IVF group, the mother's age was elder, with higher incidence of cesarean section, premature rupture of membranes, and pregnancy complications, as compared with the control group (P<0.05). There was no significant difference in the incidence of birth defects between the two groups (P>0.05). The IVF group had higher incidence rates of low birth weight and neonatal scleroderma (P<0.05), with a longer hospital stay (P<0.01), as compared with the control group. The non-conditional logistic regression analysis indicated that IVF, prematurity, twin pregnancy, and pregnancy complications were risk factors for low birth weight (P<0.05). CONCLUSIONS: There is no significant difference in the incidence of birth defects between IVF and naturally conceived infants. However, IVF infants have higher incidences of twin pregnancy and low birth weight, with a longer hospital stay, as compared with naturally conceived infants. Natural conceiving, avoiding prematurity, twin pregnancy, and pregnancy complications will reduce the incidence of low birth weight.

[The proliferation-promoting effects of calcitonin gene-related peptide on type II alveolar epithelial cell exposed to hyperoxia mediated by protein kinase C alpha pathway].

OBJECTIVE: To explore the effects of calcitonin gene-related peptide (CGRP) on type II alveolar epithelial cell (AECII) exposed to hyperoxia, and to determine whether the mechanism is mediated by protein kinase C alpha/nuclear factor-KappaB (PKC alpha/NF-KappaB) signal pathway. METHODS: AECII were isolated from the lung of 21 days fetal rat and cultured for 15 hours to coalesce. Then AECII were randomly assigned into four groups: air, hyperoxia, O(2)/CGRP, and O(2)/CGRP8-37 (a receptor antagonist against CGRP). AECII were exposed to FiO(2) 21% (air) or 85% (hyperoxia) for 24 hours respectively. In O(2)/CGRP and O(2)/CGRP8-37 groups CGRP or both CGRP and CGRP8-37 were added into cultural fluid before placing the plate into 85% oxygen. Cell proliferation ability was determined by methyl thiazolyl tetrazolium (MTT) assay and cell cycles by flow cytometry. Western blotting was employed to detect the fraction of PKC alpha in membrane and cytosol, and translocation of NF-KappaB was observed under laser confocal microscopy. RESULTS: AECII in hyperoxia group showed a decreased viability of AECII [(68.752+/-5.766)% vs. (100.000+/-6.682)%] and had an enhanced percentage of G0/G1 phase [(80.652+/-6.253)% vs. (45.825+/-2.899)%] with a corresponding decline in percentage of S phase [(14.198+/-4.785)% vs. (27.470+/-2.775)%] and G2/M phases [(5.148+/-1.688)% vs. (26.708+/-1.863)%] compared with AECII in air (all P<0.01). Addition with CGRP before hyperoxia exposure promoted AECII proliferation [(94.813+/-6.102)%] and enhanced the cell proportions in S and G2/M phases [(30.547+/-9.861)% and (17.668+/-9.509)%, all P<0.01]. The ratio of membrane to cytoplasm fraction of PKC alpha declined (0.63+/-0.10 vs. 1.00+/-0.09) and the fluorescence of NF-KappaB in nucleus enhanced (22.98+/-2.20 vs. 14.54+/-2.35) in hyperoxia compared with that in air, while both the ratio of PKC alpha and intensity of NF-KappaB were increased in O(2)/CGRP group (1.41+/-0.23, 35.38+/-3.37) compared with those in hyperoxia (0.63+/-0.10, 22.98+/-2.20) and O(2)/CGRP8-37 groups (0.74+/-0.10, 24.88+/-1.81, all P<0.01). CONCLUSION: CGRP could promote proliferation of AECII when exposed to high oxygen tension. PKC alpha participates in the signal transduction process and NF-KappaB is a downstream molecular of PKC alpha, executing in part the function of PKC alpha signal.