Objective To analyze monitoring data on congenital heart disease (CHD) in Shenzhen city from 2009 to 2013.Methods This study described epidemiological characteristics of perinatal CHD.Patients with CHD were divided into isolated CHD group and complex CHD group (the patients were found with malformations of other systems).The prognosis,social and demographic characteristics,and complications of pregnancy were analyzed.Results The average incidence rate of CHD was 7.25‰,of which 94.36％ were diagnosed by ultrasound,of which 33.20％ were diagnosed before delivery.The top three cardiovascular abnormalities were patent ductus arteriosus,patent foramen ovale,and ventricular septal defect.There were about 14.11％ of CHD with other system malformations,mainly including musculoskeletal system,facial features,and nervous system.Compared isolated cardiac malformations and complex cardiacmalformations,significant differences were found in the age stratification,culture degree,prognosis,diagnosis time,incidence rate of complication of pregnancy,and childbirth complications rate (P ＜0.01).Conclusions Most CHDs were diagnosed by ultrasound.Simple cardiovascular malformation was common,especially CHD with two or more types of cardiovascular malformations.The incidence rate of CHD in 30 to 40-year-old women,stillbirth rate,incidence of prenatal diagnostic rate were significantly higher than the simple CHD group.

AIM:To investigate the clinical significance of microRNA-26a-5p (miR-26a-5p)-regulated mye-loid cell leukemia-1 (MCL-1) expression in the development of maternal preeclampsia.METHODS:Plasma and placen-tal tissues were collected from 21 cases of normal pregnancy, 13 cases of maternal gestational hypertension, 15 cases of mild preeclampsia and 26 cases of severe preeclampsia.The levels of plasma and placental miR-26a-5p and placental MCL-1 mRNA were detected by real-time PCR.Western blotting analysis was used to determine the protein expression of placen-tal MCL-1.The clinical significance of the above parameters was also analyzed.RESULTS:miR-26a-5p expression gradu-ally increased(P<0.01) in the 4 groups of maternal plasma and placentas with the disease development, and the mRNA expression of MCL-1 was significantly reduced in the placentas (P<0.01), both showing a significant negative correlation (P<0.01).Meanwhile, the expression of miR-26a-5p and MCL-1 protein in the placental tissues was negatively correla-ted (P<0.01).The miR-26a-5p up-regulation in maternal plasma and placental tissues was negatively correlated with ges-tational age, maternal plasma albumin levels and fetal weight, while it was positively correlated with maternal blood pres-sure and urinary protein level (P<0.01), which was in contrary to the down-regulation of placental MCL-1.CONCLU-SION:Up-regulation of miR-26a-5p is involved in the occurrence and development of preeclampsia by down-regulation of MCL-1.

Objective To study the COX regression model of 28-day mortality in ARDS patients.Methods Four hundred and fifty-two ARDS patients from 2003 to 2005 was prospectively analyzed in a multi-center and random way. Results In the ARDS pathogeny,sepsis accounted for 41%,severe trauma and operation accounted for 36.3%,severe pancreatitis for 8.8%,and other for 13.9%.The 28-day mortality was 62.2%.Compared with the survived group,the number of dysfunction organs,age,APACHEII,PaCO_2,FiO_2,and A-aDO_2 were higher in the succumbed group,while PaO_2,PaO_2/FiO_2,and pH were lower.Conclusion The 28-day mortality was related with the number of dysfunction organs,age,GLASGOW score,and shock.

Objective To investigate the correlation between peroxisome proliferator-activated re-ceptor-gamma ( PPAR-γ) gene polymorphism and preeclampsia ( PE) . Methods 110 PE patients and 110 normal pregnants who delivered in our hospital from May 2016 to October 2018 were selected as the study subjects. Detection of two loci of PPAR-γ gene by SNaPshot technique: rs10865710 and rs4684847. Re-sults ⑴ rs10865710:The genotype frequencies of CC, CG and GG in the control group were 44. 55％, 42. 73％ and 12. 73％, respectively, and those in the PE group were 31. 82％, 44. 55％ and 23. 64％, re-spectively. There was a critical difference in the distribution of genotype frequencies between the two groups (x2 =5. 975, P=0. 050); The frequencies of C and G alleles were 65. 91％ and 34. 09％ in the control group, 54. 09％ and 45. 91％ in the PE group, respectively. There was significant difference in the fre-quency distribution of C and G alleles between the two groups (x2 =6. 402, P=0. 015). ⑵ rs4684847:the genotype frequencies of CC, CT and TT in control group were 94. 55％, 5. 45％, 0, and those in PE group were 84. 55％, 15. 45％ and 0, respectively,with significant difference in the distribution of genotype frequencies between the two groups (x2 =5. 875, P =0. 015). The frequencies of C and T alleles in control group were 97. 27%, 2. 73% and those in PE group were 92. 27% and 7. 73%, respectively,with significant difference in allele frequency distribution between the two groups (x2 = 5. 551, P = 0. 030). ⑶ The frequency of GG genotype and G allele at rs10865710 locus in PE group was significantly higher than that in control group [OR (95% CI) =2. 600 (1. 190 - 5. 679), P = 0. 021; OR (95% CI) = 1. 64 (1. 117 -2. 411), P =0. 015]. The frequencies of CT genotype and T allele at rs4684847 locus in PE group were significantly higher than those in control group [OR (95% CI) =3. 168 (1. 199 -8. 374), P =0. 026; OR (95% CI) =2. 987 (1. 155 -7. 726), P =0. 030]. Conclusions The single nucleotide polymorphisms of PPAR-γ gene rs10865710 and rs4684847 may be related to the susceptibility to preeclampsia in Chinese population.

Cardiac arrest in pregnancy is the emergency sereve case in clinic,which can threaten life and health of the fetus and pregnant women.Pregnancy cardiac arrest once happened,providing health care providers should start high quality chest compressions immediately,open the airway and commence ventilation,activate an emergency call system in which all providers in the maternal/neonatal resuscitation teams.We read from several aspects of 2014 the United States society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy in order to improve the cardiopulmonary resuscitation quality of pregnant women after cardiac arrest and optimize maternal and neonatal outcomes.