[Relationship of S100B protein expression and the pathogenesis of early-onset and late-onset preeclampsia].

OBJECTIVE: To investigate the relationship of S100B protein expression and the pathogenesis of early-onset and late-onset preeclampsia. METHODS: Sixty patients with preeclampsia who received caesarean section at Qingdao Municipal Hospital from October 2010 to September 2011 were enrolled in this study. Thirty cases were early-onset preeclampsia (referred as early-onset preeclampsia group, < 34 weeks), and the other 30 cases were late-onset preeclampsia (referred as late-onset preeclampsia group, ≥ 34 weeks). Thirty women who received caesarean section because of pelvic structural deformities, breech presentation, macrosomia and social factors were included as the control group. The expression of S100B mRNA in the placenta was detected by reverse transcription (RT)-PCR. The expression of S100B protein in the placenta was detected by immunohistochemistry. RESULTS: (1) S100B mRNA was expressed in the trophoblasts of preeclampsia and control groups. The expression of S100B mRNA in early-onset preeclampsia group (0.73 ± 0.11) was significantly higher than the control group (0.58 ± 0.08) and late-onset preeclampsia group (0.64 ± 0.10, P < 0.05). There was no significant difference between late-onset preeclampsia group and the control group (P > 0.05). (2) S100B protein was expressed in the plasma membrane and cytoplasm of the trophoblasts, correlated positively with the brownish yellow and brown particles inside the cells. It was expressed in all the three groups. Immunohistochemistry revealed that the expression of S100B protein in the placenta of early-onset preeclampsia group was 100% (30/30), significantly higher than those of late-onset preeclampsia group and the control group, in which the positive rate were 70% (21/30) and 63% (19/30) respectively (P < 0.05). There was no difference between late-onset preeclampsia group and the control group (P > 0.05). CONCLUSION: Early-onset and late-onset preeclampsia may have different etiology and pathogenesis. S100B may be a factor in the pathogenesis of early-onset preeclampsia.

[Effects of transient receptor potential V6 silence on proliferation and apoptosis of trophoblasts].

OBJECTIVE: To investigate the effects of the transient receptor potential V6 (TRPV6) gene silencing on the proliferation and apoptosis of trophoblasts HTR-8/SVneo cells. METHODS: siRNA sequences targeting the TRPV6 gene were constructed and then transfected into HTR-8/SVneo cells mediated by liposome. The cells were divided three groups, including blank control (add the reagent of transfenction), negative control groups (transfecting nonspecific siRNA) and experimental groups (transfecting TRPV6-siRNA). Those cells in every group were collected at 24, 48, 72 hours after transfecting. The expression levels of TRPV6 mRNA were detected by reverse transcription (RT) PCR at different times after transfecting. The effects of siRNA on the proliferation and apoptosis of the cells were assayed by methyl thiagolyl tetragolium (MTT) and flow cytometry at different times after transfecting. RESULTS: siRNA TRPV6 transfection could inhibit the expression of TRPV6 mRNA in the HTR-8/SVneo cells. The expression was decreased with the extension of time, by 0.72 ± 0.02, 0.54 ± 0.02 and 0.29 ± 0.01 after 12, 48 and 72 hours of siRNA transfection as compared with the blank control and the negative control groups (P < 0.01). The rates of proliferation inhibition were (19.29 ± 1.23)%, (32.12 ± 1.35)% and (46.51 ± 1.42)% at 24, 48 and 72 hours respectively when compared with the blank control (2.12 ± 0.03)%, (2.42 ± 0.02)%, (3.13 ± 0.04)% and the negative control groups (2.37 ± 0.01)%, (2.61 ± 0.05)%, (2.93 ± 0.03)% (P < 0.01). The apoptosis rates of HTR-8/SVneo cells was 16.21% at 48 hours after transfected with siRNA TRPV6, which were significantly higher than 3.27% in the blank control and 5.34% in the negative control groups (P < 0.05). CONCLUSION: Silenceing of TRPV6 genen could inhibit the proliferation and increase the apoptosis of extravillous trophoblas of human placenta.

[Efficacy and delivery outcomes of women underwent double-catheter epidural block during labor].

OBJECTIVE: To investigate the efficacy and pregnancy outcomes of women receiving double-catheter epidural block in labor analgesia, and compare the results with single-catheter epidural block. METHODS: A double-blind clinical trial was conducted on 206 full-term singleton primiparas, aged 25 - 35 and at the 37 - 42 weeks of gestation who delivered at the Department of Obstetrics, Qingdao Municipal Hospital from August 2006 to December 2008, which were randomly divided into two groups: double-catheter epidural block (group D, n = 103) and single-catheter epidural-block (group S, n = 103). Women in group D were given mixture of 0.1% repivacaine hydrochloride and 0.5 mg/L sufentinil 4 - 6 ml as initial dose. Patient control epidural analgesia pump (PCEA) was connected with the upper catheter after 45 minutes. A bolus dose of 4 - 6 ml analgesia mixture was infused according to the condition through the lower catheter. Women in group S received analgesia mixture 10 - 15 ml as initial dose and PCEA pump was connected after 45 minutes. Oxytocin was infused in both groups according to uterine contraction after 30 minutes. The following indexes was observed: (1) visual analogue scales (VAS); (2)modified Bromage Scores; (3) the total dose of analgesia mixture, the percentage of oxytocin infusion, duration of labor and duration of the second stage of labor; (4) fetal birth weight and Apgar scores (1, 5 minutes); (5) mode of delivery; (6) the concentration of plasma cortisol and angiotension II at the beginning of regular uterine contraction and at the time when cervical dilated to 4 cm and 10 cm and fetal disengagement; (7) anesthesia-related complications. RESULTS: (1) The neonatal birth weight and Apgar scores (1, 5 minutes) of group D were (3456 ± 468) g, 9.8 ± 0.6 and 9.9 ± 0.7, respectively, while (3399 ± 569) g, 9.8 ± 0.5 and 9.9 ± 0.7 in group S (P > 0.05). No motor function block was reported in any group and the modified Bromage score was zero. (2) The total dose of analgesia mixture in group D was similar to that in group S [(57 ± 9) ml vs. (58 ± 11) ml, P > 0.05]. However, the percentage of women received oxytocin in group D was smaller [59.2% (61/103) vs. 81.6% (84/103), P < 0.01], and the total time of labor and the duration of second stage of labor in group D were shorter [(532 ± 140) minutes vs. (608 ± 150) minutes; (46 ± 31) minutes vs. (60 ± 34) minutes, P < 0.05]. (3) There were no significant differences in VAS at 30 minutes after initial dose and in the first stage of labor between group D and S (1.2 ± 1.1 vs 1.2 ± 1.1, 1.1 ± 1.1 vs. 1.2 ± 1.0, P > 0.05). VAS at the second stage of labor stage was lower in group D than in group S (1.2 ± 1.1 vs. 4.5 ± 2.2, P < 0.01). (4) The rate of cesarean section, instrumental delivery and episiotomy in group D were lower than in group S (7.8% vs. 17.5%, 7.8% vs. 15.5%, 10.7% vs. 18.4%, P < 0.05). The incidence of fetal distress and meconium-stained amniotic fluid as the indication of cesarean section were similar between the two groups (P > 0.05). Lower incidence of fetal malpresentation and arrested second stage of labor were shown in group D than in group S (2.9% vs. 9.7%, 1.0% vs. 5.8%, P < 0.05). (5) The concentration of plasma cortisol and angiotension II were lower in group D than in group S [(86 ± 25) ng/L vs. (100 ± 20) ng/L, (278 ± 53) nmol/L vs. (311 ± 53) nmol/L, P < 0.05] only at the end of second stage of labor, but not at any other times (P > 0.05). (6) No serious anesthesia-related complications were reported in any groups. Some light backache around the puncture point were complained by 29.1% (30/103) of the women in group D and 31.1% (32/103) in group S (P > 0.05). CONCLUSION: Double-catheter epidural block can provide better analgesia effect during labor than single-catheter epidural block, without any adverse influence on delivery outcomes.

[Study on the relation between concentration of circulating non-host fetal DNA in pregnant women and pre-eclampsia].

OBJECTIVE: To explore the diagnostic value of plasma fetal DNA level in preeclampsia. METHODS: Thirty cases of pregnant women with preeclampsia (at 33 weeks and 3 days) and 30 cases of normal pregnant women (at 34 weeks and 3 days) were selected. All the pregnant women carried a male fetus by B-ultrasound, and were sampled at gestational 20 weeks, third trimester and at 1 hour, 3 hours, 6 hours after delivery. SRY levels in maternal blood were quantitated by polymerase chain reaction (QF-PCR). The endotheliotoxin (ET) level was measured with RIA. RESULTS: (1) Mean fetal DNA level of patients with preeclampsia at 20 weeks of gestation was (316 +/- 61) copy/ml. They were (266 +/- 79) copy/ml, (396 +/- 91) copy/ml, (165 +/- 43) copy/ml for light and severe preeclampsia women and normal pregnant women, respectively. Maternal blood fetal DNA levels in pregnant women with preeclampsia at 20-weeks of gestation were significantly higher than those normal pregnant women (P < 0.01). (2) Mean fetal DNA level of patients with preeclampsia in third trimester was (970 +/- 413) copy/ml. They were (758 +/- 357) copy/ml, (1285 +/- 573) copy/ml, (319 +/- 99) copy/ml for light and severe preeclampsia and normal pregnant women, respectively. Maternal blood fetal DNA levels in pregnant women with preeclampsia in third trimester were significantly higher than those normal pregnant women (P < 0.01). (3) Maternal blood mean fetal DNA level of patients with preeclampsia were (139 +/- 45) copy/ml, (76 +/- 31) copy/ml, (44 +/- 13) copy/ml at 1 hour, 3 hours, and 6 hours after delivery, respectively. Mean fetal DNA level was (102 +/- 42) copy/ml, (57 +/- 25) copy/ml, (36 +/- 12) copy/ml for patients with light preeclampsia, (209 +/- 51) copy/ml, (97 +/- 40) copy/ml, (52 +/- 17) copy/ml for patients with severe preeclampsia, and (33 +/- 13) copy/ml, (9 +/- 5) copy/ml, 0 copy/ml for normal pregnant women. Significant difference was found between preeclampsia and control groups (P < 0.01). (4) The mean endotheliotoxin level for preeclampsia women was (80 +/- 18) ng/L. For light preeclampsia, severe preeclampsia and normal pregnant women ET levels were (74 +/- 14) ng/L, (89 +/- 32) ng/L, (50 +/- 11) ng/L, respectively. ET levels in pregnant women with preeclampsia were significantly higher than those normal pregnant women (P < 0.01). (5) A positive correlation was found between fetal DNA levels and ET levels in preeclampsia group (r = 0.748, P < 0.01). CONCLUSION: The fetal DNA determination may help diagnose preeclampsia.

[Study on the time selection of pregnancy and delivery in women with systemic lupus erythematosus].

OBJECTIVE: To analyze the appropriate time selection of pregnancy and delivery in women with systemic lupus erythematosus (SLE). METHODS: Twenty-nine pregnancies in women with SLE in our hospital from 1998 to 2003 were retrospectively analyzed regarding the selection of appropriate time of pregnancy and delivery. RESULTS: All patients did not take any cytotoxic medicine for at least 6 months before pregnancy. Twenty-three conceptions occurred when SLE was inactive for at least 1 year. Two conceptions occurred when SLE was active without doctors' agreement. SLE was diagnosed during pregnancy in the remaining 4 cases. The condition of all patients fluctuated and the gestational time at delivery ranged from 30 to 38 weeks after we modified the doses of glucocorticoid (prednisone). Among totally 29 living neonates, eight were premature neonates, three were FGR and one had serious congenital heart disease. Two neonates died of complications in early stage of neonatal period. None of the 29 neonates from all patients had neonatal lupus. CONCLUSION: Pregnancy safety will be improved obviously if the condition of SLE is controlled and the patients are given reasonable doses of glucocorticoid and intensive monitoring. If pharmacotherapy does not work well and the condition threatens the safety of mother and fetus, or the fetus has matured, termination of pregnancy should be done on time, which reduces maternal complications and improves the perinatal mortality rate. The gestational time should be 34 to 38 weeks.