Objective To find out the clinical outcomes of twin-twin transfusion syndrome (TTTS) after aminioreduction. Methods Twenty-nine pregnancies with TTTS delivered in Beijing Gynecological and Obstetric Hospital from Nov. 1, 2002 to Sept. 30, 2007 were recruited. The effect of gestational age at the onset, the degree of TTTS and amnioreduction therapy on the fetal outcomes were compared. Results All of the 8 cases with the onset of TTTS before 26 weeks without treat- ment were lost, but 4 out of the 6 with the onset after 26 weeks survived (P=0. 015). Among the 9 cases received amnioreduction, 4 out of the 5 with onset before 26 weeks survived, and significant difference was found compared to those untreated ones (P= 0. 007), but no difference was shown when compared with those developed after 26 weeks(4/4)(P= 1. 000). The average delivery weeks in the untreated ones was earlier than those received treatment E(28.7±4.7)weeks vs (33.2±4.9) weeks, P=0. 001]. Amnioreduction improved the umbilical cord blood flow. For severe TTTS(stage Ⅲ～Ⅳ) with the onset before 26 weeks, the survival rate after amnioreduction was significantly high- er than those untreated ones[4/5 vs 0/5, P=0. 048)]. Conclusions Aminioreduetion is effective in improving the cord blood flow, prolonging the pregnancies, and achieving a higher fetal survival rate.

Objective To investigate the perinatal outcomes of isolated single umbilical artery (ISUA) in full-term birth. Methods We performed a retrospective study of 82 252 pregnant women (aged<35 years;singleton; full-term live birth; no known chromosomal/structural anomalies) who delivered between January 1, 2011 and January 1, 2012 in 39 hospitals in 14 cities in China. There were 273 cases with ISUA as study group and 1 092 cases with a three-vessel cord selected in a 1∶4 ratio as control group. Perinatal outcomes including delivery modes (vaginal delivery or emergency cesarean section for fetal reasons), birth weight and height, placental weight, umbilical cord length, Apgar scores at 1 min, and rate of neonatal asphyxia were analyzed retrospectively. Data were analyzed using the Chi-square test, two independent samples t-test or rank sum test. Results The incidence of ISUA was 0.3%(273/82 252). There was no difference between the two groups with regard to maternal age, parity, gravidity, smoking status, gestational age at birth, or rate of complications during pregnancy (gestational diabetes mellitus or pregnancy-induced hypertension) (all P>0.05). The birth weight in ISUA group and control group was (3 259±463) and (3 344±411) g (t=3.689), birth hight was (48.6±2.7) and (49.7±1.9) cm (t=8.368), placental weight was (508±72) and (543±153) g (t=3.114), umbilical cord length was (52.6±8.1) and (53.7±7.5) cm (t=1.983), and Apgar scores at 1 min were 9.0 (8.0-10.0) and 10.0 (9.0-10.0) (Z=11.831), respectively; the values in the ISUA group were lower than those in control group (all P < 0.05). No significant differences were observed in the rate of vaginal delivery and emergeny cesarean section for fetal reasons between the ISUA group and control group [52.8%(144/273) and 49.9%(545/1 092),χ2=0.704;19.4%(25/273) and 15.7% (86/1 092), χ2=1.162; both P>0.05]. Conclusions ISUA does not increase emergency cesarean delivery rates for the fetal reasons, but the fetal growth and development may fall behind those with a three-vessel umbilical cord. Monitoring during pregnancy and delivery should be intensified for fetuses with ISUA.

Objective:To evaluate the effect of the plasma cyclic nucleotide in patients with pregnancy-in-duced hypertension. Methods :To observe the level of the plasma cAMP by radio competitive protein bind-ing assay and level of the p lasma cGMP by radioimmunoassay (RIA). Results:The contents of the plasmacAMP and cGMP were significantly higher in PIH group than those in the controls. Plasma cAMP showedthe negative correlation to postpartum MAP. Conclusion:cAMP and cGMP had synergy on antagonizingthe contraction evoked by Ca2+. This was an effective compensatory protective mechanism of PIH.

Objective To investigate the influence of gestational weight gain (GWG) on the incidence of macrosomia, and to establish the reference ranges of GWG based on the incidence of macrosomia. Methods A multicenter, cross-sectional study was conducted. Totally, 112485 women were recruited from 39 hospitals in 14 provinces in China. Totally, 61149 cases were eligible with singleton pregnancies and non-premature deliveries. The associations of pre-pregnancy body mass index (BMI), GWG, newborn gender and gestational diabetes with macrosomia were analyzed with logistic regression. The normal GWG ranges were calculated in all maternal BMI subgroups, based on the normal incidence of macrosomia was set as the range of 5.0% to 10.0%. Results In this study, the incidence of macrosomia was 7.46%(4563/611149). The macrosociam was positive related with maternal height, delivery week,pre-pregnancy BMI, GWG, gestational diabetes, primipara, and male babies significantly (P<0.05), based on unadjusted and adjusted logestic regression. The normal range of GWG 20.0-25.0, 10.0-20.0, 0-10.0 and 0-5.0 kg in subgroups of underweight (pre-pregnancy BMI<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2) and obese (≥30.0 kg/m2), respectively. Conclusion The reference range of GWG in China based on the incidence of macrosomia is established.

Objective:To determine levels of insulin and glucose of maternal serum (MS),umbilical venous serum (UVS) and umbilical artery serum (UAS) in normal term pregnancy and intrauterine growth retardation(IUGR).Methods:One hundred and seven cases of normal gestational weeks on induction of labors and spontaneous deliveries and 32 cases of pregnancies complicated with IUGR.Levels of insulin were measured with sensitive radioimmunoassay and levels of glucose were measured by the glucose oxidase-peroxidase method.Results:Level of insulin of maternal serum was not significantly different before 28 gastational weeks and peaked on 28 th gastational week,then it decreased with gestational weeks and peaked again at last term.Levels of insulin increased in UVS and UAS.Levels of glucose in MS,umbilical venous serum and umbilical artery serum were not significantly different.Level of insulin and glucose of MS in IUGR had no change,but it was significantly different in IUGR of UVS and UAS (P<0.01).Conclusion:Our study suggested a decrease of insulin and glucose in UVS and UAS with IUGR.

Objective To establish the methods of isolating and culturing human ovarian endometriosis-derived microvascular endothelial cells (OEMEC).Methods The tissues of human endometriotic cyst of ovary were finely minced with scissors,then digested by collagenase Ⅰ,Ⅱ and trypsinethylene diamine tetraacetic acid (EDTA).The cells were purified by using centrifugation of 2000 r/min speed.OEMEC were identified by light microscope and transmission electron microscope observing CD34,FⅧ-Rag and Weibel-Palade in microvascular endothelial cells.Results The OEMEC grew as confluent monolayer like cobblestones under light microscope.CD34 and FⅧ-Rag were expressed strongly,and the percentages of CD34 and FⅧ-Rag positive cells were 91.4％ and 92.5％.Weibel-Palade bodies could be observed under transmission electron microscope.The time of cell doubling proliferation was 4.5 days.Conclusion The established system of isolating OEMEC would provide lab base for studying the mechanisms of angiogenesis in endometriosis lesions.

Objective To investigate the clinical significance and safety of liquid-based cytology (thinprep cytologic test, TCT ) in pregnant women and cytological characteristics of the smears during pregnancy. Methods TCT were performed in 1951 pregnant women (group A), 3752 gynecological out-patients(group B)and 5069 routine screening women (group C ). The age of the women was ranged from 20 to 39 years. The cytological preparations were analyzed using TCT method following the Bathesda system (TBS) standard. Results (1) The incidence of abnormal epithelial patterns in groups A, B and C was 23.58%(460/1951), 19.22%(721/3752) and 13.40%(679/5069) respectively (P0.05). Conclusions TCT smear screening is necessary, safe and acceptable for routine prenatal tests. There is no difference in the cervical squamous intraepithelial lesions between pregnant and non-pregnant women.

0 05) Conclusion The COMT G1947→A gene polymorphism is not associated with the generation and the severity of PIH The mutation genotype does not increase the risk of PIH

Objective:To estimate the organ doses and effective doses to different-age children during cardiovascular interventional radiological procedures under some specific exposure conditions, and explore the main influencing factors on the doses.Methods:Based on the paediatric reference computational phantoms recommended in the ICRP Publication 143, several specific exposure models of cardiovascular intervention were built, and the Monte Carlocook MCNPX 2.7.0, was used to calculate the organ doses and effective doses for 1-, 5-, 10- and 15-year-old children. To validate the simulation result , an experiment was implemented by putting the thermoluminescent dosimeters in a 5-y old phantom (ATOM 705-D) manufactured by the CIRS Inc. in the USA.Results:Both the height and weight of the reference children for 1-, 5- and 10-year-old provided for by Chinese national standards are nearly in consistency with those recommended by ICRP, and even for the 15-year-old, the maximum relative deviations of the height and weight are only -1.9% and -5.7%, respectively. Under the exposure condition where the focal spot to image receptor distance (SID) was 90 cm, the length of square field of view (FOV) was 30 cm with a dose area product (DAP) of 45 Gy·cm 2, the relative deviations between simulated and measured doses to main organs/tissues within the irradiation filed were within ±6.7%. Under the same exposure conditions, the younger the children, the larger the organ doses and effective doses, and the effective doses could vary by a factor of about 5 among the 4 age groups. The conversion coefficient between the organ dose and the value of DAP was not only closely related to the age of children, but also affected by the FOV. Conclusions:In combination with the paediatric reference computational phantoms and the exposure models of cardiovascular intervention, the Monte Carlo method can be used to calculate the doses to children undergoing cardiovascular interventional radiological procedures. The information on the values of DAP and FOV as well as the directions of projection are needed for more accurate estimation of the exposure doses.

Objective To investigate the expression and function of thymus and activation regulated chemokine (TARC) and its special receptor CCR4 at placenta villous in the first trimester placenta villous.Methods Placenta villous was collected from healthy women undergoing artificial abortion at 6 to 8 weeks of gestation,mRNA levels of TARC,CCR4 were analyzed using semi-quantitative reverse transcription (RT)-PCR methods.Immunohistochemistry assay was used to assess the protein localization and expression of TARC,CCR4.Additionally,extravillous cytotrophoblasts were isolated and cultured.Expression of TARC and CCR4 was measured by immunofluorescence assay.Invasion of cell line HTR8/SVneo was analyzed by transwell assay at concentration of 10,25,50 and 100 ng/ml of TARC matched with RPMI 1640 fetal bovine serum free eulture medium as control group.In the mean time,blocking experiment was also added to detect TARC regulating cell invasion,which were classified into four groups:control,100 ng/ml rhTARC,20 μg/ml anti-TARC + 100 ng/ml rhTARC,100 ng/ml rhTARC + 20 μg/ml IgG.The influence of 100 ng/ml TARC on expression level of integrin-α5 and integrin-β1 were measured by using western-blot assay.Results (1)In vivo assay:expression of TARC and CCR4 mRNA were detectable in first trimester placenta villous,TARC protein was localized in cytotrophoblasts,syncytiotrophoblasts and cell column especially on the distal portion,while CCR4 protein was localized on invading interstitial cytotrophobalsts.(2)In vitro assay:①TARC,CCR4 was also expressed in primary isolated extravillous cytotrophoblasts by immunofluorescence assay; ②Matrigel invasion assay demonstrated that TARC had specific dose dependent stimulatory effects on the cells invading through the matrigel precoated filter,the number of cells migration into the lower chamber were:142 ± 31 at 10 ng/ml group,161 ±46 at 25 ng/ml group,201 ±30 at 50 ng/ml group,312 ±48 at 100 ng/ml group,117 ± 33 at control group,the significant response observed from 25 ng/ml (P ＜ 0.05)and reached a peak effect at 100 ng/ml (P ＜ 0.01); ③Blocking experiment demonstrated that when trophoblast invasion was monitored in response to TARC neutralizing antibody (15 μg/ml) together with rhTARC 100 ng/ml.The stimulatory activity of rhTARC was completely overcome,with the cells invasion into the lower chambers were 100 ng/ml rhTARC,20 μg/ml anti-TARC + 100 ng/ml rhTARC,100 ng/ml rhTARC +20 μg/ml IgG,control:313 ±47,113 ±41,287 ±75 and 128 ±23,respectively;④Western-blot assay demonstrated that if cells were treated with 100 ng/ml rhTARC,the expression of integrin-α5 were significantly increased(P ＜0.01),integrin-β1 level also increased when compared with control(P ＜0.05).Conclusion TARC was expressed specifically at human fetal-maternal interface.Trophoblast invasion and migration mainly was regulated by up-regulation integrin-α5 and integrin-β1,which plays an role in trophoblasts differentiation and placentation.