Hypoxic Preconditioning Enhances Cellular Viability and Migratory Ability: Role of DANCR/miR-656-3p/HIF-1α Axis in Placental Mesenchymal Stem Cells.

Preeclampsia (PE) is a common complication of pregnancy characterized by new-onset hypertension, albuminuria, or end-stage organ dysfunction, which is seriously harmful to maternal and infant health. Mesenchymal stem cells (MSCs) are pluripotent stem cells derived from extraembryonic mesoderm. They have the potential for self-renewal, multidirectional differentiation, immunomodulation, and tissue regeneration. Several in vivo and in vitro experiments have confirmed that MSCs can delay the pathological progression of PE and improve maternal and fetal outcomes. However, the major limitations in the application of MSCs are their low-survival rates in ischemic and hypoxic disease areas after transplantation and their low rate of successful migration to the diseased regions. Therefore, enhancing cell viability and migration ability of MSCs in both ischemic and anoxic environments is important. This study aimed to investigate the effects of hypoxic preconditioning on the viability and migration ability of placental mesenchymal stem cells (PMSCs) and their underlying mechanisms. In this study, we found that hypoxic preconditioning enhanced the viability and migration ability of PMSCs, increased the expression of DANCR and hypoxia-inducible factor-1α (HIF-1α), and decreased the expression of miR-656-3p in PMSCs. Inhibiting the expression of HIF-1α and DACNR in PMSCs under hypoxia can inhibit the promotive effect of hypoxic preconditioning on viability and migration ability. In addition, RNA pull down and double luciferase assays confirmed that miR-656-3p could directly bind to DANCR and HIF-1α. In conclusion, our study showed that hypoxia could promote the viability and migration ability of PMSCs through the DANCR/miR-656-3p/HIF-1α axis.

Application of uterine lower part breakwater-like suture operation in placenta previa / 中华妇产科杂志

Objective To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods From June 2016 to June 2017,47 patients were diagnosed placenta previa in Union Hospital,Tongji Medical College of Huazhong University of Science and Technology.Posterior wall breakwater-like suture technique was used preferentially,as for cases with poor myometrium layer,lower anterior wall stitch suture was used at the same time.Bilateral descending branches of uterine artery ligation and Cook balloon compression of uterine lower segment was conducted when necessary. The clinic data of the 47 cases were analyzed. Results Thirty cases(63.8, 30/47)were diagnosed placenta inccreta or percreta by ultrasound or MRI preoperatively.Senventeen cases were diagnosed as placenta accreta(36.2%,17/47).Thirty-four cases had the previous history of cesarean section.The average cervical canal length of 47 patients was(2.8±0.9)cm. There were 19 cases(40.4%,19/47)with 1 time posterior wall breakwater-like sutured and 16 cases (34.0%,16/47)with 2 or 3 times posterior wall breakwater-like sutured; 12 cases(25.5%,12/47)were treated with anterior wall stitch suture simultaneously.Ten cases(21.3%, 10/47)underwent uterine artery ligation, 17 cases(36.2%, 17/47)underwent COOK balloon compression on the staxis surface of lower segment. None of them had postpartum hemorrhage or performed internal iliac artery embolization. The median blood loss in the operation was 700 ml,the percentiles 25 was 500 ml,and the percentiles 75 was 1 200 ml.The blood loss≥1 000 ml in 18(38.3%,18/47)patients,and the most serious one was 2 500 ml. The median blood transfusion volume(including allogenetic transfusion and autotransfusion)was 450 ml, the percentiles 25 was 228 ml,and the percentiles 75 was 675 ml.The average vaginal bleeding volume was (150 ± 63)ml first day after operation. The mean hospitalization time was(4.7 ± 1.0)days. The mean gestational weeks of pregnancy termination was(36.1±1.5)weeks,and the mean birth weight of newborns was(2 817±492)g.Apgar score:1-minute 7.8±1.1,5-minute 8.9±0.8.No neonatal death, 16 cases were transferred to neonatal ICU(34.0%, 16/47)mainly for premature delivery and low birth weight. No complication was found in 6 months post-operation. Conclusions Uterine posterior wall breakwater-like suture technique is a simple,safe and effective way in controlling intraoperative bleeding of placental previa. Lower anterior wall stitch suture could effectively stop bleeding and restore the normal uterine shape. Combined application of various methods could significantly reduce the incidence of postpartum hemorrhage and hysterectomy,and improve maternal and fetal prognosis.

Role of axonal guidance factor netrin-1 in human placental vascular growth / 华中科技大学学报（医学）（英德文版）

This study investigated the role of netrin-1 in placental vascular development. In vitro rat aortic ring assay and in vivo Matrigel plug assay were conducted to exmaine the effect of netrin-1 on angiogenesis. Human placental microvascular endothelial cells (HPMECs) were isolated and cultured and their viability, migration and tubular formation were studied, in order to examine the effects of netrin-1. The results showed that netrin-1 potently stimulated neovascularization in a mouse Matrigel plug in vivo and the sprouting of endothelial cells in rat aortic rings in vitro. In addition, netrin-1 enhanced the viability, migration and tube formation of HPMECs. Our study suggested that netrin-1 could significantly promote the formation of blood vessels of human placenta and may be a potential target for developing new therapeutic strategies for placental vasculature-related diseases.

In vivo and in vitro research study of the influence on placenta angiogenesis by gene silencing of netrin-1 / 中华妇产科杂志

Objective To study influence on angiogenesis of placenta by gene silencing of netrin-1.Methods Netrin-1 gene in human umbilical vein endothelial cells(HUVEC)and placenta of pregnant rats were silenced by RNA interference.The following methods were used in this study,including the phenytetrazoliumromide(MTT)for viability,clone formation for proliferation,transwell for migration,and tube formation for angiogenesis in vitro.The change of fetal growth was recorded.Placental microvessel density in pregnant rats was measured by immunohistochemical CD34 staining in vivo.Results (1)HUVEC:viability and proliferation of HUVEC were remarkably inhibited by gene silencing of netrin-1.which number of clone formation,migration cell,tube formation were from(69±6)%,86±17,37±9 decreased to(46±5)%,46±13 and 17±5(P＜0.05)respectively.(2)Placenta of pregnant rats:after netrin-1gene silenced,fetal weight were decreased from(2.39 ±0.17)g to(2.12±0.10)g(P＜0.05).Placental microvessel density was decreased from(258±38)/mm2 to(197±32)/mm2 in vivo(P＜0.05).Conclusions Gene silencing of netrin-1 could inhibit viability,proliferation,migration,tubal formation of HUVEC and angiogcnesis of placenta.Netrin-1 plays an important role in regulating angiogenesis in placenta.

Evaluation of "J"-shaped uterine incision during caesarean section in patients with placenta previa: A retrospective study / 华中科技大学学报（医学）（英德文版）

This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa. A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months. The subjects were divided into two groups with respect to the uterine incision. Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine incision and 31 pregnant women with placenta previa received caesarean section that used the traditional transverse incision. The two groups were compared in terms of operation time, estimated blood loss, infant expulsion time, exhaust time and postoperative recovery. Meanwhile, comparison was also made in neonatal clinical data between the two groups. Compared with the "J"-shaped incision group, the traditional incision group had a lower Apgar scores (P0.05). It is concluded that, with caesarean section for placenta previa patients, the "J"-shaped uterine incision significantly decreases intraoperative blood loss and facilitates the fetal delivery.

Effects of Netrin-1 on angiogenesis in vitro and in vivo / 中国综合临床

Objective To investigate the effects of Netrin-1 on angiogenesis in vitro and in vivo. Methods We performed in vitro rat aortic ring assay and in vivo Matrigel plug assay to determine the effect of Netrin-1 on angiogenesis. Results 10 μg/L, 50 μg/L and 100 μg/L Netrin-1 stimulated microvessel sprouting from the adventitia of aortic rings and the effect reached maximum at 50 μg/L The in vivo Matrigel plug assay showed orange color change if Nestrin-1 was positive; and CD34 immunofluorescent staining showed vascular structures in the Matrigel plug with hemachrome ( 53.4 ± 7. 3 ), which was significantly higher than control ( 5. 8 ± 0. 9 )Conclusions Netrin-1 can induce angiogenesis in vitro and in vivo.

Relationship between variation of phosphatidyl inositol-3 kinase expression and activity and insulin resistance in pregnant women with gestational diabetes mellitus / 中华围产医学杂志

Objective To investigate the variations of the expression and activity of phosphatidyl inositol-3 kinase(PI-3K)in the adipose tissue of pregnant women with gestational diabetes mellitus(GDM)and to explore its relationship with insulin resistance(IR)in these women.Methods The expression of PI-3K p85aprotein and mRNA in adipose tissue were detected by Western blot and Semi quantitative reverse transcription polymerase chain reaction(RT-PCR)in 20 GDM women(GDM group)and 20 normal pregnant women(normal group).The activity of PI-3K was determined by ELISA and IR index was calculated using homeostasis model assessment(HOMA)according to the results of fasting insulin(FINS)and fasting plasma glucose(FPG),which measured by oxidase assay and immunoradioassay,respectively.Results The expressions of PI-3K p85αmRNA and PI-3K p85a protein were markedly increased in the adipose tissue of GDM group than in the normal group(mRNA:0.83±0.03 vs 0.53±0.07,P＜0.01;protein:0.93±0.04 vs 0.71±0.06,P＜0.01).However,the PI-3K activity in the GDM groups was significantly down-regulated compared with the normal group(1.7±0.6 vs 5.2±0.5,P＜0.01).The levels of FPG and FINS (HOMA-IR)in the GDM group were all significantly higher than the normal group[FPG:(5.8±0.2)mmol/L vs(4.7±0.3)mmol/L;FINS:(14.8±0.2)mmol/L vs(11.2±0.3)mmol/L;HOMA-IR:1.3±0.4 vs 0.9±0.3,a11 P＜0.01]. Conclusions The decreased activity of PI-3K in the adipose tissue may be one of the molecular mechanisms for IR in GDM.

Correlation of netrin-1 expression with invasion of extra villous trophoblasts / 中华妇产科杂志

Objective To investigate mechanism of netrin-1 regulating invasion of extra villous trophoblasts. Methods RT-PCR was used to detect six receptors expression including UNC5A, UNC5B, UNC5C, UNC5D, DCC and neogenin in extra villous trophoblast cell line TEV-1. The TEV-1 cells were cultured and devided into seven groups according to the concentration of netrin-1 adding into the medium, which include 10 μg/L, 50 μg/L, 100 μg/L, 500 μg/L, 1000 μg/L, 5000 μg/L and the control(the concentration of netrin-1 was 0 μg/L) groups. The proliferation and invasion of TEV-1 induced by netrin-1 were determined by CCK-8 assay and transwell invasion assay respectively. Results (1) Only neogenin and UNC5B were found to be expressed on TEV-1 by RT-PCR method. (2) In CCK-8 proliferation assay, after 72 hours culture, the proliferation of TEV-1 were 1.55 ±0.29 in 10 μg/L, 1.72±0. 31 in 50 μg/L, 2.15 ±0.35 in 100 μg/L, 1.42 ±0. 25 in 500 μg/L, 1.50±0. 27 in 1000 μg/L, and 1.38±0.23 in 5000 μg/L group, which were all higher than 1.00 ± 0.16 in control group significantly ( P<0.05 ). (3) In matfigel invasion assay, after 6 hours culture, the number of the trans-membrane cells in various netrin-1 group, including 41 ±4 in 10 μg/L, 47 ±5 in 50 μg/L, 55±6 in 100 μg/L, 44 3=5 in 500 μg/L, 43±5 in 1000 μg/L and 42 ±5 in 5000 μg/L group, were all higher than 30 ±4 in control group with statistical significance( P<0.05 ). (4) The fold changes of neogenin were 1.50 ± 0.16 in 10 μg/L, 1.83 ± 0.19 in 50 μg/L, 2.24 ± 0.25 in 100 μg/L, 2.12 ±0.24 in 500 μg/L, 2.12±0.23 in 1000 μg/L and 2.13 ± O. 23 in 5000 μg/L group, which were all higher than 1.00 ±0.11 in control group significantly( P <0.05 ). There were significant difference between group 10 μg/L and 50 μg/L, group 50 μg/L and 100 μg/L (P < 0.05). There were no significant difference between group 100 μg/L and 500 μg/L, group 1000 μg/L and 5000 μg/L (P>0.05). (5) The fold changes of UNC5 B 1.09 ± 0.11 in 10 μg/L, 1.47±0.14 in 50 μg/ L, 1.61 ±0.16 in 100 μg/L, 1.85±0.19 in 500 μg/L, 2.21±0.21 in 1000 μg/L and 2.42±0.23 in 5000 μg/L group, were all higher significantly when compared with 1.00 ± 0.07 in control group (P<0.05 ). There were significant difference between all groups ( P<0.05). Conclusion Netfin-1 can promote the potential of proliferation and invasion of extravillous trophohlasts in vitro through its receptors including neogenin and UNC5 B.

Changes in number and biological function of endothelial progenitor cells in hypertension disorder complicating pregnancy / 华中科技大学学报（医学）（英德文版）

To examine the changes in number and function of endothelial progenitor cells (EPCs) from peripheral blood (PB) in hypertension disorder complicating pregnancy (HDCP), 20 women with HDCP and 20 normal pregnant women at the third trimester were studied. Mononuclear cells (MNCs) from PB were isolated by Ficoll density gradient centrifugation. EPCs were identified by positive expression of both CD34 and CD133 under fluorescence microscope and positive expression of factor VIII as shown by immunocytochemistry. The number of EPCs was flow-cytometrically determined. Proliferation and migration of EPCs were measured by MTT assay and modified Boyden chamber assay, respectively. The adhesion activity of EPCs was detected by counting the number of the adherent cells. The results showed that, compared with normal pregnant women, the number of EPCs was significantly reduced in HDCP (4.29%+/-1.21% vs 15.32%+/-2.00%, P<0.01), the functional activity of EPCs in HDCP, such as proliferation (13.45%+/-1.68% vs 18.45%+/-1.67%), migration (37.25+/-7.28 cells/field vs 67.10+/-9.55 cells/field) and adhesion activity (20.65+/-5.19 cells/field vs 34.40+/-6.72 cells/filed) was impaired (P<0.01). It is concluded that the number and function of EPCs are significantly decreased in HDCP.

Expression and tyrosine phosphorylation of insulin receptor substrate-1 in adipose tissue from patients with gestational diabetes mellitns / 中华内分泌代谢杂志

Objective To investigate the expression and tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1) and in the adipose tissue of patients with gestational diabetes mellitus (GDM), and to explore molecular mechanisms of insulin resistance in GDM. Methods The serum and adipose tissue were sampled from patients with GDM (GDM group, n = 20) and normal pregnant women (control group, n = 20). Fasting plasma glucose was measured by glucose oxidase assay. The expressions of IRS-1 protein and mRNA were determined by Western blot and semi-quantitative RT-PCR. The tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation. Results Compared with control group, in GDM group, the expression of IRS-1 mRNA was markedly decreased (0.61 ±0.06 vs 1.12 ± 0.17, P < 0.01), the expression of IRS-1 protein was significantly decreased (0.57 ±0.08 vs O. 83 ±0.07, P <0.01) and tyrosine phosphorylation was significantly reduced (0.23 ± O. 06 vs O. 62 ±0.04, P < 0.01) in the adipose tissue. Conclusion The decline of protein expression and tyrosine phosphorylation of IRS-1 in the adipose tissue of gestational diabetes appears to be one of the moleculemechanisms of insulin resistance in patients with GDM.

Fetal Nucleated Red Blood Cell in Maternal Peripheral Blood: Frequency and Relationship with Gestational Age / 中华围产医学杂志

Objective To study the frequency and relationship with gestational age of fetal nucleated red blood cell (NRBC) in maternal peripheral blood. Methods Samples of peripheral blood in 44 women of 6~40 gestational weeks were collected to enrich the fetal nucleated red blood cells by discontinuous density gradient centrifugation. The isolated cells were made smears and counted under the microscope. NRBCs were found and retrieved using a micromanipulator under a microscope for PCR amplification of Y chromosome specific DNA to determine fetal sex. Results NRBCs were found in 17 out of 44 maternal samples, distributing from 9 to 26 gestational weeks The highest frequency of NRBC was found in 11~20 gestational age which reached to 76.5%(13/17). The amount of detected NRBCs ranged from 5/7ml to 30/7ml. Y chromosome 149bp was found in 7 cases and not in the other 10, which agreed to the actual fetal sexes. Conclusion The appropriate time to make a prenatal diagnosis using fetal nucleated red blood cells is in 11~20 gestational age.

The value of the soluable intercellular adhesion molecule-1 levels in matermal serum for determination of occult chorioamnionitis in premature rupture of membranes / 华中科技大学学报（医学）（英德文版）

To compare the diagnostic value of soluble intercellular adhesion molecule 1 (sICAM-1) with that of c-reactive protein (CRP) for detecting chorioamnionitis (CAM) in serum of women with premature rupture of membranes (PROM), 55 pregnant women with PROM, including 18 pregnant women with preterm premature rupture of membranes (PPROM) and 20 normal pregnant women at term (TPROM) were studied. Maternal serum were measured by Sandwish enzyme-linked immunoabsorbent assay (ELISA) for sICAM. CAM was histologically confirmed after delivery. The results revealed that (1) maternal serum levels of sICAM-1 and CRP were significantly higher in women with PROM than those without it; (2) maternal serum levels of sICAM-1 and CRP were significantly higher in women with CAM than those without it; (3) serum levels of sICAM-1 in PPROM women were similar to those in TPROM women, whereas serum levels of CRP in PPROM women were significantly higher than those in TPROM women; (4) the sensitivity, specificity, positive predictive value, negative predictive value, Kappa index and area under receiver operating characteristic (ROC) curve of maternal serum sICAM-1 (cutoff 104.7 ng/ml) and CRP (cutoff 1.03 mg/dl) for diagnosing CAM were 100%, 91.2%, 87.5%, 100%, 0.20, 0.995 and 81.0%, 73.5%, 65.4%, 86.2%, 0.13, 0.811, respectively; (5) among the mild histological CAM group, severe histological CAM group and clinical CAM group, the difference in maternal serum levels of sICAM-1 were significantly (P<0.001), with the order of concentration from high level to low level corresponding to the severity of CAM. It is concluded that maternal serum level of ICAM-1 is superior to that of CRP as biomarker for diagnosing intraamniotic infection in pregnant women with PROM.

Number of Fetal Nucleated Red Blood Cell in Maternal Blood and Placenta in Pregnancies with Intrauterine Growth Retardation / 中华围产医学杂志

Objective To examine the number of fetal nucleated red blood cell (NRBC) in maternal blood and placenta tissue in fetal growth restriction(FGR) pregnancies. Methods 20 women of 28-36 weeks' gestation at age of 21~30(including 9 FGR pregnancies)were chosen. Fetal cells were isolated from maternal blood with discontinuous density gradient centrifugation. The isolated cells were made smear and counted under the microscope; After delivery, the placenta tissue were made into sections and also counted under the microscope; To determine the origin of the NRBC , the single NRBC was analysed by primer extension preamplification (PEP) and polymerase chain reaction (PCR). Results The number of NRBC in 9 FGR pregnancy women's peripheral blood ranged from 12/7 ml~40/7 ml,(average 22.6/7 ml). The number of NRBC in the control pregnancies ranged from 0/7 ml~10/7 ml, (average 5.4/7 ml). Significant difference was shown between the two groups; The number of NRBC in 9 FGR pregnancy women's placenta tissue was significantly higher than the median value in the control pregnancies (2.8/20HP compared with 0.6/20HP, P

The Values of the Maternal Intercellular Adhesion Molecule 1 Level for Determination of Subclinical-typed Chorioamnionitis in Premature Rupture of Membranes / 中华围产医学杂志

Objective To compare the diagnostic value of soluble intercellular adhesion molecule 1 (sICAM-1) with c-reactive protein (CRP) in serum of women with premature rupture of membranes (PROM) for detecting chorioamnionitis. Methods 55 pregnant women with term PROM including 18 pregnant women with preterm premature rupture of membranes (PPROM) and 20 normal pregnant women at term were enrolled. Maternal serum sICAM-1, CRP were measured by Sandwish enzyme-linked immunoabsorbent assay (ELISA). Chorioamnionitis was histologically confirmed after delivery. Results (1)Maternal serum levels of sICAM-1 and CRP were statistically significantly higher in women with PROM than that without it;(2)Maternal serum levels of sICAM-1 and CRP were statistically significantly higher in women with chorioamnionitis than those without it;(3)In the complicated chorioamnionitis group and in the uncomplicated with chorioamnionitis group, serum levels of sICAM-1 in PPROM women were similar with those in TPROM women, whereas serum levels of CRP in PPROM women were statistically significantly higher than those in TPROM women;(4)The sensitivity, specificity, postive predictive value, negtive predictive value, Kappa index and area under receiver operating characteristic (ROC) curve of maternal serum sICAM-1(cutoff 104.7 ?g/L) and CRP(cutoff 10.3 mg/L) for diagnosing chorioamnionitis were 100%, 91.2%, 87.5%, 100%, 0.20, 0.995 and 81.0%, 73.5%, 65.4%, 86.2%, 0.13, 0.811, respectively; (5) Maternal serum levels of sICAM-1 compared with one another among mild histologic chorioamnionitis group, severe histologic chorioamnionitis group and clinical chorioamnionitis group, the difference are statistically significantly (P

The role of autoantibodies against angiotensin Ⅱ type 1-receptor in the pathogenesis in preeclampsia / 中华围产医学杂志

Objective To explore the role of the autoantibodies against angiotensinⅡ type 1 receptor (ATR-1) in the pathogenesis of preeclampsia. Methods Forty normotensive and 46 pregnant women with preeclampsia were recruited in this study. Synthesized ATR-1 polypeptide fragment was used as antigens to screen the autoantibodies against ATR-1 by ELISA. The level of angiotensinⅡ was also examined. Results The positive rate of the ATR-1 antibodies and plasma level of angiotensin Ⅱ in patients with preeclampsia [63.0%(29/46) and (92.54?37.22) pmol/L] were significantly higher than those in normotensives [7.5% (3/40) and (25.75?12.33) pmol/L, P

Study on Modification of the Misgav Ladach Method for Cesarean Section / 华中科技大学学报（医学）（英德文版）

172 cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach technique and 56 cases in Pfannenstiel group with Pfannenstiel technique from May to Dec. 1999. The modified points included: transversely incising the fascia 2 to 3 cm, then dividing it bluntly; without opening and dissociating the visceral peritoneum; two layers suturing of low transverse uterine incision; closing the skin by continuous suturing. Results showed the average delivery time in the modification group was (3.6±2.6) min and (5.7±2.9) min in the Misgav Ladach group (P<0.05). Median operating time was (28.3±5.4) min in modification group compared with (27.5±6.5) min in the Misgav Ladach group (P>0.05). Average blood loss was (128±35) ml in modification group compared with (212±147) ml in the Pfannenstiel group (P<0.05). It was concluded that the modified Misgav Ladach technique not only preserved all advantages of Misgav Ladach method, but also had additional advantages, such as faster in delivering the fetus, less damage, easier mastering for obstetricians.

Study on Modification of the Misgav Ladach Method for Cesarean Section / 华中科技大学学报（医学）（英德文版）

172 cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach technique and 56 cases in Pfannenstiel group with Pfannenstiel technique from May to Dec. 1999. The modified points included: transversely incising the fascia 2 to 3 cm, then dividing it bluntly; without opening and dissociating the visceral peritoneum; two layers suturing of low transverse uterine incision; closing the skin by continuous suturing. Results showed the average delivery time in the modification group was (3.6±2.6) min and (5.7±2.9) min in the Misgav Ladach group (P<0.05). Median operating time was (28.3±5.4) min in modification group compared with (27.5±6.5) min in the Misgav Ladach group (P>0.05). Average blood loss was (128±35) ml in modification group compared with (212±147) ml in the Pfannenstiel group (P<0.05). It was concluded that the modified Misgav Ladach technique not only preserved all advantages of Misgav Ladach method, but also had additional advantages, such as faster in delivering the fetus, less damage, easier mastering for obstetricians.

The value of the soluable intercellular adhesion molecule-1 levels in matermal serum for determination of occult chorioamnionitis in premature rupture of membranes / 华中科技大学学报（医学）（英德文版）

To compare the diagnostic value of soluble intercellular adhesion molecule 1 (sICAM-1) with that of c-reactive protein (CRP) for detecting chorioamnionitis (CAM) in serum of women with premature rupture of membranes (PROM), 55 pregnant women with PROM, including 18 pregnant women with preterm premature rupture of membranes (PPROM) and 20 normal pregnant women at term (TPROM) were studied. Maternal serum were measured by Sandwish enzyme-linked immunoabsorbent assay (ELISA) for sICAM. CAM was histologically confirmed after delivery. The results revealed that (1) maternal serum levels of sICAM-1 and CRP were significantly higher in women with PROM than those without it; (2) maternal serum levels of sICAM-1 and CRP were significantly higher in women with CAM than those without it; (3) serum levels of sICAM-1 in PPROM women were similar to those in TPROM women, whereas serum levels of CRP in PPROM women were significantly higher than those in TPROM women; (4) the sensitivity, specificity, positive predictive value, negative predictive value, Kappa index and area under receiver operating characteristic (ROC) curve of maternal serum sICAM-1 (cutoff 104.7 ng/ml) and CRP (cutoff 1.03 mg/dl) for diagnosing CAM were 100%, 91.2%, 87.5%, 100%, 0.20, 0.995 and 81.0%, 73.5%, 65.4%, 86.2%, 0.13, 0.811, respectively; (5) among the mild histological CAM group, severe histological CAM group and clinical CAM group, the difference in maternal serum levels of sICAM-1 were significantly (P<0.001), with the order of concentration from high level to low level corresponding to the severity of CAM. It is concluded that maternal serum level of ICAM-1 is superior to that of CRP as biomarker for diagnosing intraamniotic infection in pregnant women with PROM.

Suramin inhibits the in vitro expression of encephalitis B virus proteins NS3 and E / 华中科技大学学报（医学）（英德文版）

In this study, the mechanism by which Suramin inhibits the replication of epidemic encephalitis B virus was explored to provide a theoretical basis for its further application in clinical practice. After viral infection of HepG2 and IMR-32 cells, different concentrations of Suramin were added to the culture media, and then the cultural supernatants and infected cells were collected 48 h later. For the evaluation of the curative effect, cytopathic effect (CPE), virus titers, the expression of viral protein and viral RNA were determined by Western blot, RT-PCR and in vitro RNA synthesis, respectively. At the concentration of 50 microg/ml of Suramin, HepG2 and IMR-32 infected with epidemic encephalitis B virus decreased by 51.8% and 0.03% respectively, as compared with controls. It was suggested that expression of encephalitis B virus proteins NS3 and E was notably reduced by Suramin. This is especially true of E protein. At RNA level, however, no difference in RNA virus was found between Suramin-treated virus and non-treated cells. Our results suggest that Suramin can inhibit viral replication by blocking the production of viral proteins.

Safety of Breastfeeding in Mothers with SARS-CoV-2 Infection

BackgroundThe outbreak of Coronavirus Disease 2019 (COVID-19) is threatening a surging number of populations worldwide, including women in breastfeeding period. Limited evidence is available concerning breastfeeding in women with COVID-19. MethodsTwenty-three pregnant women and puerperae were enrolled in the study. To evaluate the effect of breastfeeding on SARS-CoV-2 transmission, the presence of SARS-CoV-2, IgG and IgM in breast milk, maternal blood and infant blood were assessed. Feeding patterns were also recorded in follow-up. ResultsNo positive detection for SARS-CoV-2 of neonates was found. All breast milk samples were negative for the detection of SARS-CoV-2. The presence of IgM of SARS-CoV-2 in breast milk was correlated with maternal blood. The results of IgG detection for SARS-CoV-2 were negative in all breast milk samples. All the infants were in healthy condition while six of them were fed with whole or partial breast milk. Eight infants received antibody test for SARS-CoV-2 in one month after birth and the results were all negative. ConclusionFindings from this small number of cases suggest that there is currently no evidence for mother-to-child transmission via breast feeding in women with COVID-19 in the third trimester and puerperium.