AIM: To explore the relationship between human cytomegalovirus(HCMV) gene activity and cytopathogenesis in HCMV infection. METHODS: HCMV echelin-infected cell model was set up in vitro by coincubating passage cultured HEL and HCMV with different titers (group A: 10-5; group B: 10-3; and group C: 10-1). FQ-PCR was performed to evaluate the number of HCMV DNA copies. MCP mRNA was measured by RT-PCR. Meanwhile the development of cytopathologic effects (CPE) was observed under microscope and ultrastructural changes determined by TEM.RESULTS: Compared with group B and C in high HCMV titer, group A with low viral titer showed low HCMV DNA load (P

Objective To determine whether therapy of Salvia miltiorrhiza,Ligustrazine and magnesium sulfate has effect on concentrations of SOD, MDA,NO,ET,TXA 2, PGI 2 in blood and outcomes of women with pregnancy-induced hypertension(PIH). Methods Two hundred and twenty-five women with moderate PIH were studied while treated with Salvia miltiorrhiza, Ligustrazine and magnesium sulfate in group A, B, and C(n=75 respectively). Concentrations of SOD, MDA, NO, ET, TXA 2, PGI 2 in blood, blood pressure, postpartum hemorrhage, fetal distress, and neonatal asphyxia were monitored. Results In maternal blood the concentrations of SOD in the three groups before and after treatment were 178.3?4.1 vs 219.5?4.1、190.4?2.4 vs 208.4? 2.4、176.1?3.4 vs 221.1?2.2、MDA 11.4?1.3 vs 7.2?1.2、13.0?2.7 vs 8.6?2.0、10.3?1.5 vs 7.1?1.1、NO 747?202 vs 940?232、798?159 vs 907?142、776?212 vs 862?189、ET 78.3?4.5 vs 62.3?3.8、78.3?4.3 vs 58.3?4.4、76.9?3.9 vs 60.2?2.9、TXA 2 560?28 vs 486?27、537?27 vs 502?20、558?25 vs 472?21、PGI 2 162?13 vs 217?14、167?17 vs 227?16、169?13 vs 213?11 respectively,there were significant differences between betore and after treatment (P0.05). Conclusions It is showed that Salvia miltiorrhiza ,Ligustrazine and magnesium sulfate can well balance circulating levels of SOD, MDA, NO, ET, TXA 2, and PGI 2 in women with PIH. Magnesium sulfate may interfere the results of the monitoring on the fetal heart rate.

Objective To investigate the influence of pregnancy on the production of reactive oxygen species (ROS) from mouse peripheral blood neutrophils (PMN),the levels of NO and cytokines from serum,the activation of T lymphocytes,and initially find the immune regulation effects of pregnancy on the mouse peripheral blood lymphocytes.Methods Take the BALB/c mice which were at the mid trimester of pregnancy (day 14) as the object,full blood staining using ROS probe 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) combing with flow cytometry was used to test the levels of ROS from PMN.The production of NO from peripheral blood serum were analyzed by Griess kit while the soluble cytokines interleukin (IL) 6,IL-10,monocyte chemotactic protein 1 (MCP-1),interferon γ (IFN-γ),tumor necrosis factor α (TNF-α) and IL-12 were detected by liquid protein quantitative technology cytometric bead array (CBA) using flow cytometry.The activation of peripheral blood lymphocytes at early,middle and later phases which marked with CD69,CD25 and CD71 respectively were tested by flow cytometry and two-color fluorescent staining.Results Comparing to the normal non-pregnant mouse,pregnancy obviously promoted the production of ROS from PMN (101.1 ± 2.2 versus 134.5 ± 10.3,P ＜ 0.05).Comparing to the normal non-pregnant mouse,pregnancy obviously promoted the secretion of NO [(22.7 ± 0.7) versus (36.3 ±1.2) μmol/L,P ＜0.01].In normal non-pregnant mouse,the serum levels of IL-6,IL-10,MCP-1,IFN-γ,TNF-αandlL-12were (9.3±0.5),(26.7±0.9),(21.2±1.6),(14.5 ±1.8),(22.6±1.6) and (8.4 ± 1.2) pg/ml,while in pregnancy group the levels were (26.5 ± 1.0),(40.4 ± 2.5),(25.1 ±0.7),(457.4 ± 17.9),(93.2 ± 4.3) and (7.5 ± 0.9) pg/ml correspondingly ; the levels of IL-6,IFN-γ,TNF-α from peripheral blood serum (P ＜ 0.01),while had no effects on the production of IL-10 and MCP-1 (P ＞ 0.05).About the CD3+ T lymphocytes activation,in normal non-pregnant mouse,the CD69,CD25 and CD71 expression rate were (0.43 ±0.15)％,(5.13 ±0.25)％ and (0.37 ±0.11)％,while in pregnancy group the CD69,CD25 and CD71 expression rate were (0.40 ±0.10)％,(6.17 ±0.40)％ and (6.10 ±0.31)％.The levels of middle and later phases markers as CD25 and CD71 were highly up-regulated (P ＜ 0.05),while the early phase action CD69 had no obvious variation (P ＞ 0.05).Conclusion The mid trimester of pregnancy promoted the production of ROS from PMN,the levels of NO,IL-6,IFN-γ,TNF-αfrom peripheral blood serum,and the middle-and later-phase activation of T lymphocytes.

Objective To assess the clinical efficacy and safety of testa triticum tricum purif (trade name: fiberform) in treating constipation during pregnancy. Methods With multicenter,prospective and self-controlled study method, in four domestic hospitals 140 pregnant ladies with constipation were enrolled according to recruiting criteria. The patients were treated by orally taking Festa Triticum Tricum Purif 3. 5 g every time, twice a day. Before and after taking medicine,constipation symptoms and the characters of feces were observed and quantized with score to identity its efficacy and side effects. Results After Testa Triticum Tricum treatment, dyporsia was relieved and the characters of the feces were improved significantly. Taking Testa Triticum Tricum for 7 days and 14 days, the effective rate was 90.0% and 93.6% respectively. Before and after taking medicine,the difference in constipation symptoms was statistical significant. No side effects were observed during Testa Triticum Tricum Purif treatment. Conclusions Fiberform is effective and safe for functional constipation treatment.

Objective To analyze the cause and clinical characteristics of maternal cardiac arrest.Methods The data of all cases of maternal cardiac arrest from January 2005 to December 2009 in Third Affiliated Hospital of Guangzhou Medical College was retrospectively studied.Results ( 1 ) A total of 41 maternal cardiac arrests (6 in prenatal period,2 in the first stage of labor,7 in the third stage of labor,26 in postpartum period ) were included.All patients regained spontaneous circulation after basic life support.Twelve (29％) mothers survived.Twelve cardiac arrests occurred in the hospital,and the totaldelivery number from January 2005 to December 2009 was 17101,with occurrence rate of 1:1425.(2) Thecauses of arrest were hemorrhagic shock (12,29％),amniotic fluid embolism (7,17％),severepreeclampsia/eclampsia (7,17％),septic shock (6,15％),cardiac disease (2,5％),unidentified cause (2,5％ ) and other occasional causes.(3) Thirty-seven (90％) in-hospital maternal cardiac arrest occurred in operation room (16,39％ ),ICU (7,17％ ),maternity wards (6,15％ ),delivery room (5,12％ ) and the emergency room (3,7％ ).Three (7％) arrest occurred out of hospital and one in the ambulance.Matemal survival rate was 2/3 in the emergency room,8/16 in the operation room,1/5 in the maternity wards,and 1/6 in the delivery room.No mother survived in ICU,ambulance or out of hospital.(4) Five of the 12 survived women showed ischemic encephalopathy after cardiac arrest and one of them developed cerebral infarction in the right corona radiate.(5) In 4 of the 8 cases of cardiac arrest in pregnancy,perimortem caesarean section (PMCS) was performed.In the four PMCS,2 mothers and 2 children survived.In the 4 cases that PMCS was not carried out,no infant survived.Conclusions Hemorrhagic shock,severe preeclampsia and eclampsia,amniotic fluid embolism are the major obstetric causes of maternal cardiac arrest.Septic shock and cardiac diseases are the major non-obstetric causes.Cardiac arrests occurred in emergency room and operation room has a higher maternal survival rate than those occurred in the delivery room and maternity wards.Timely PMCS may ensure the optimal outcome for mothers and fetuses.

Objective To investigate the role of dimethylarginine dimethylaminohydrolase-2 (DDAH-2)/asymmetric dimethylarginine(ADMA)in pathophiology of preeclampsia by detecting expression of DDAH-2 in placenta and serum plasma ADMA.Methods From Jan.2004 to Jan.2005,30 preeclampsia patients(PE group)were chosen in the Third Affiliated Hospital.Guangzhou Medical College matched with 10 normal third trimester women as control(control group).The placental DDAH-2 mRNA expression was detected by fluorescence quantitative polymerase chain reaction(FQ-PCR)and the plasma concentration of ADMA WSB determined by high performance liquid chromatography(HPLC).Results(1)The level of ADMA in PE group was significantly higher that than of control group[(18.0±7.2)mg/L vs.(10.3±1.7)mg/L,P<0.01].The expression level of ADMA in preeclampsia occurring before 34 gestatinal weeks WaS significantly higher than that of preeclampsia occurring after 34 gestational weeks[(22.0±7.0)ms/L vs.(12.7±2.8)mg/L,P<0.01].(2)The Placental DDAH-2 mRNA expression in preeclampsia patients was remarkably lower than that of control group[1×10(5.23±0.45)copy/μlvs.1×10(5.65±0.08)copy/μl,P<0.01].The Placental DDAH-2 mRNA in preeclampsia occurring before 34 gestatinal weeks was significantly lower than that of preeclampsia occurring after 34 gestational weeks [1×10(5.02±0.46)copy/μl vs.1×10(5.61±0.19)copy/μl,P<0.01].Conclusion Our results suggested that low expression of DDAH-2 in placenta and increased serum ADMA level might confer the susceptibility to preeclampsia.

Objective The purpose was to describe the outcomes and characteristics of the obstetric patients with concurrent eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP) syndrome. Methods We retrospectively collected the materials between December 1999 and December 2008 in Obstetric Critical Care Center of Guangzhou. There were 76 patients in rolled then they were divided into two groups according to with or without HELLP syndrome. All the patients were injected Magnesium Sulfate to control seizure and to prevent the recurring of seizure. We analyzed the characteristics (such as age, gestational weeks, blood pressure after seizure), complications, biochemistry markers, the rate for intensive care unit (ICU) admittion, the need for mechanical ventilation, the Glasgow coma score (GCS) when admitted into ICU, computed tomography scan (CT) or magnetic resonance imaging (MRI),death rate of maternal and others, then compared between the two groups. Results ( 1 ) General data:There were 17 patients admitted with both eclampsia and HELLP syndrome, and 59 patients admitted eclampsia without HELLP syndrome. The incidence of eclampsia with HELLP syndrome was 22% (17/76).In eclampsia with HELLP syndrome group, the systolic blood pressure was higher and the rate of preterm also was higher [ (182 ± 20) mm Hg (1 mm Hg=0. 133 kPa)vs. (159± 21 ) mm Hg, P ＜ 0. 05 ]. But in regard to the age, gestational weeks, the rate of regular prenatal care and diastolic blood pressure, there were no differences between the two groups. (2) Biochemistry markers: the aspartate transaminase (AST), lanine transaminase (ALT), blood urea nitrogen and creatinine were significantly increased in eclampsia with HELLP syndrome group than eclampsia without HELLP syndrome group [ (879 ± 337) U/L vs. (90 ± 27)U/L, (344 ±83) U/Lvs. (43 ±11)U/L, (2245 ±294) U/L vs. (485 ±61)U/L, (14 ±9) mmol/L vs.(7 ± 3) mmol/L, ( 140 ± 92) μmol/L vs. (83 ± 28 ) μmol/L, P ＜ 0. 01, P ＜ 0. 05 ], and the platelet was lower in eclampsia with HELLP syndrome group [ (38 ± 13) × 109/L vs ( 172 ±46) × 109/L, P ＜0. 01 ].(3) Clinical outcomes: The maternal death rate was 35% (6/17) in eclampsia with HELLP syndrome patients, and significantly higher than the rate in eclampsia without HELLP syndrome group (3%, 2/59)(P ＜ 0. 05 ). There were more patients admitted to ICU and more patients who need mechanical ventilation in eclampsia with HELLP syndrome (13/17 vs. 34%, 9/17 vs. 24/, P ＜0. 05), also more patients with GCS ≤8 in eclampsia with HELLP syndrome when admitted to ICU ( 8/17 vs. 7/59, P ＜ 0. 05 ), compared to the eclampsia without HELLP syndrome group. There were more patients complicated with cerebral venous thrombosis and cerebral hemorrhage in eclampsia with HELLP syndrome group than other group (8/17 vs.7%, P ＜ 0. 05 ). Five of six patients died of cerebral hemorrhage in eclampsia with HELLP syndrome group,while other two missing cases in eclampsia without HELLP syndrome group all died of cerebral hemorrhage.The all missing cases were performed CT or MRI and seven (7/8) of them showed cerebral hemorrhage.Conclusion The incidence of concurrent eclampsia and HELLP syndrome was not rare, it happened seriously and with more mortalities, such as cerebral hemorrhage, and also the maternal mortality rate was significantly higher. It should be warning that the obstetrician should take great attention for these women,and consider life support treatment for them.

Objective To evaluate the value of whole genome amplification (WGA) combined with array comparative genomic hybridization (aCGH) in prenatal diagnosis. Methods Array CGH were performed by the DNA of 18 prenatal specimens , which were amplified by WGA because of the low DNA yield. Result 3 of the 18 fetuses were 45, X0 and 9 of 15 fetuses with normal aCGH results showed healthy outcome. Conclusion It’ s feasible for prenatal diagnosis using WGA combined with aCGH which not only can shorten the reporting time but also keep the sensitivity and accuracy of detection.

Objective To investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pre-eclampsia or eclampsia gravida. Methods This study was conducted in the Third Affiliated Hospital of Guangzhou Medical University between January 2013 and March 2016. A total of 100 patients who had no severe neurological diseases and were diagnosed pre-eclampsia or eclampsia, and underwent brain MRI were collected retrospectively. They were divided into 2 groups according to the MRI results, the RPLS group (n=49) and the non-RPLS group (n=51). The medical history, clinical symptoms and the results of laboratory examination were analyzed by the logistic regression, in order to explore the risk factors.Results In single factor analysis, HELLP syndrome, pregnancy associated with other diseases, poor prenatal care, grade 3 hypertension, elevated systolic blood pressure or diastolic blood pressure, elevated WBC, aspartate transaminase (AST), alanine aminotransferase (ALT), uric acid (UA) and lactate dehydrogenase (LDH), decreased platelet (PLT), headache, visual changes, seizures and conscious disturbance were more frequent in the RPLS group than those in the non-RPLS group (all P<0.05). According to the multivariate logistic regression analysis, the elevated WBC (OR=1.291, 95%CI:1.058-1.575, P=0.012), UA (OR=1.008,95%CI:1.001-1.016,P=0.032) and headache (OR=18.260, 95%CI:3.562- 93.607, P=0.000) were the independent risk factors.Conclusions Maternal history, clinical symptoms and some laboratory examinations might help in the early diagnosis of RPLS in pre-eclampsia or eclampsia gravida. Headache, the elevation of WBC and UA were the most significant factors.

Objective To discuss the diagnosis and management options of fetal nuchal cystic hygroma(NCH). Methods Ten cases of fetal nuchal cystic hygroma from Mar 1996 to Mar 2003 were retrospectively analyzed. The sonographic images, fetal karyotype examination after amniocentesis, TORCH results and pathology were reviewed. Results The sonogram detected a large cystic mass around the posterior of the neck. The smallest one was 5.3 cm?4.8 cm?4.0 cm in size and the biggest 12.6 cm?6.6 cm?4.0 cm. The nuchal ligament could be seen inside the mass. Four cases complicated with pleural effusions and 4 with pleural effusions, ascites and skin edema. One case was deliveried in full term and the other 9 cases were induced (including 4 fetal death). Seven cases were examined for TORCH of amniotic fluid among which only one TOX PCR positive. The karyotype examination was performed in 6 cases. The results were 45XO(3 cases), 45XO/46XX (60:40) and 45XX,-21,-22,+t(21;22). The only alive baby is 46XX. Conclusions Ultrasound and invasive amniocentesis to detect the fetal karyotype have an important role in early diagnosis and management of nuchal cystic hygroma. Nuchal cystic hygromas are associated with Turner’s syndrome and other chromosomal abnormalities.