Objective To evaluate the clinical value of prenatal screening by analyzing the second -trimes-ter maternal serum screening results and prognosis .Methods The second-trimester maternal serum screening in-cluding alpha-fetoprotein (AFP) andβ-human chorionic gonadotrophin (β-HCG) was tested by time-resolu-tion immunofluorescence .2T-Risks software was used to evaluate fetal risk of three kinds of defects , such as trisomy 21, trisomy 18 and neural tube defects (NTD).For those of pregnant women with high -risk screening results, am-niotic fluid, umbilical cord blood karyotype analysis or four -dimensional color Doppler ultrasound scan can be rec-ommended to confirm the diagnosis .Results This research included the analysis of 10 668 cases of pregnant meta-phase prenatal screening results .677 cases were in high-risk, which took up 6.35%.Among those 677 cases, 501 cases had high-risk 21-trisomy Syndrome , and 104 cases had high-risk NTD.72 cases with high-risk 18-tri-somy Syndrome had been found , and the percentage of those cases above were 4.70%, 0.97%and 0.67%, respec-tively.As for the 677 follow-up pregnant women with high risks , the results indicated that during those 356 high-risk women, who had performed prenatal diagnosis , 2 cases of 21-trisomy Syndrome, 3 cases of NTD, and 4 cases of structural abnormalities had been found .In addition , there were 19 cases of spontaneous abortion and stillbirth , as well as 10 cases of other abnormalities .There are 40 abnormal cases in total , which took up an abnormal percentage of 5.91%.In those 9 991 follow-up pregnant women with low risks , there are 57 cases (0.57%) presented abnor-mal, in which had 1 cases with 21-trisomy Syndrome, 2 cases with NTD, 3 cases with deformity, 23 cases of spon-taneous abortion and stillbirth and 28 other abnormal cases .Conclusion The second -trimester maternal serum screening plays an important clinical role in the prediction of abnormal fetus and prevention of birth defects .

Objective To explore the relationship between mathematical characteristics of cardiotocograph in electronic fetal monitoring (EFM) and umbilical blood acidosis,and help to evaluate the clinical significance of indeterminate EFM.Methods A total of 85 vaginal delivery cases (or transfer to caesarean section during labor) hospitalized in Peking University Third Hospital during February 4 to December 5,2011 was enrolled in this retrospective study.EFM monitored 0.5-1 hour before delivery was recorded and the mathematical characteristics as the baseline,deceleration area per unit time (cm2/min),deceleration duration ratio and some other variables of EFM were analyzed.All cases were divided into acidosis (n=12) and non-acidosis group (n=73) based on the umbilical blood gas results.Rank sum test or t-test were used to compare the difference on mathematical characteristics between these two groups.Results The deceleration duration ratio and deceleration area per unit time in acidosis group were 0.56±0.17 and 0.45 cm2/min (0.38-0.79 cm2/min),which were higher than those in non acidosis group [0.42±0.14 and 0.30 cm2/min (0.19-0.40 cm2/min)],the differences were statistically significant (t=2.889,Z=2.587,both P＜0.05).There were no statistically significant differences in the number of mild variable deceleration and severe deceleration per unit time between acidosis group and non acidosis group [(0.44± 0.14)/min vs (0.41±0.13)/min,t=1.318,P＞0.05; 0.033/min (0.016-0.062/min) vs 0.016/min (0.008-0.033/min),Z=-1.596,P＞0.05].Conclusions The deceleration duration ratio and deceleration area per unit time can be used to assist the interpretation of indeterminate EFM.

Objective To investigate the influence of family nursing intervention on daily life ability of senile dementia patients? Methods Eighty senile dementia patients were equally randomized into two groups: the control group and the observation group? The controls received conventional home nursing instruction and health education and those in the latter group were managed with home nursing intervention? The activity of daily living scale(ADL)was used to assess their daily life ability? Result After nursing intervention,the daily life ability of observation group was better than control group(Z = 18?914,P < 0?05)? Conclusions The family nursing intervention is effective in directing the dementia patients with exercises of daily living ability? Thus it may improve their ability in daily life?

Objective:To explore the predictive value of a scoring model based on MRI images for diagnosing invasive placenta accreta and associated adverse clinical outcomes.Methods:This retrospective cohort study involved 260 patients delivered at Peking University Third Hospital from January 2015 to December 2018, who were suspected to be placenta accreta with two or more ultrasound image findings and underwent MRI examination. Placenta accreta was finally diagnosed and classified based on the intraoperative clinical findings or pathological examination. Adverse clinical outcomes were defined as intraoperative bleeding ≥1 500 ml and/or having hysterectomy. Quantitative and qualitative interpretation of five MRI signs were performed, including intraplacental low-intensity band on T2 weighted imaging, abnormal intraplacental vascularization, vascularization of uterovesical interface, uterine bulging and cervical involvement. Chi-square and t test were used for univariate analysis of the five MRI signs and the receiver operating characteristics (ROC) curve of each MRI sign for predicting invasive placenta accreta and adverse clinical outcomes were drawn. The predictive value was assigned as 1 when ≥ the cutoffs that matched to the maximum Yoden index values, and was assigned as 0 when below the cutoffs. A scoring model based on the five MRI signs was established, ROC curves of the model for predicting invasive placenta accreta and adverse clinical outcomes were drawn and the area under the curve (AUC), sensitivity, specificity and Youden index were calculated. Results:(1) Univariate analysis showed that all five MRI signs were significantly associated with invasive placenta accreta and adverse clinical outcomes. Except for cervical involvement, the other four signs had an AUC value of greater than 0.5 in predicting invasive placenta accreta and adverse clinical outcomes. (2) The predictive cut-off values of abnormal intraplacental vascularization image and intraplacental dark band area on T2 weighted imaging were 2.0 cm 2 and 0.6 cm 2, respectively, and were all 1.0 for the other three signs. The AUC value of MRI signs-based scoring model for predicting invasive placenta accreta was 0.863. When the score was ≥ 2 points, the diagnostic sensitivity was 0.836 and the specificity was 0.726. The scoring model predicted adverse clinical outcomes with an AUC of 0.841. When the score was ≥3 points, the predictive sensitivity was 0.707 and the specificity was 0.818. Conclusions:The scoring model based on MRI signs is of good value for the diagnosis of invasive placenta accreta and the prediction of adverse clinical outcomes.

Objective To predict the binding sites of transforming growth factor-βreceptor Ⅱ (TβRⅡ ) ectodomain and the aptamer S58 specifically targeted TβRⅡ ,and to confirm the structure stability of the aptamer S 58 in vitro .Methods We created three-dimensional structure by utilizing ssDNA aptamer sequences ,the crystal structure of the TβRⅡ was searched by protein data bank database .According to the results of the molecular docking experiments on aptamer S 58 and TβRⅡ ectodomain ,we sheared the aptamer sequences ,then verified its affinity respectively by biosensor technology and Western blot .Results Binding sites of aptamers S58 and TRβⅡ ectodomain included site Ⅰ(T4 ,T5 ,G6 ,C7) ,site Ⅱ(G13 ,A14 ,T15 ,C16 ,G17 ,C18 ) ,site Ⅲ (T31 ,G32 , T33 ,C34) and site Ⅳ(G40 ,A41 ,T42 ,T43 ,T44 ,G45 ,G46) .We validated the high affinity between aptamer S58 and TRβⅡ ectodo-main .The expression of α-smooth muscle actin(α-SMA) protein in the human tenon′s capsule fibroblasts was descended obviously after the experiment of the aptamer S58 in comparing with the control of DMEM (P< 0 .05) .But the new ssDNA by shear the aptamer ssDNA S58 according to the results were poor than aptamers S58 .Conclusion The aptamer S58 targeted TβRⅡ was high-ly specific with a certain stability ,any changing of structure will reduce the affinity of TβRⅡ .Computer-aided molecular docking technology has become an important means of an exploratory intermolecular interaction ,and can provides a good theoretical basis on medical research .

Objective To analyze the characteristics of long-range monitoring of fetal heart rate in the third trimester fetuses with atypical non-stress test (NST).Methods Long-range monitoring of fetal heart rate was performed in low-risk pregnant women who received antenatal care between April 2014 and October 2015 in Peking University Third Hospital.All subjects underwent NST from the 36th gestational week,and divided into normal NST (30 cases) and atypical NST (36 cases) groups according to the results of NST.The clinical data,including maternal age,gestational age at delivery,termination of pregnancy,neonatal asphyxia,hospitalization rate and umbilical cord blood peak-systolic/diastolic ratio value were collected.The data of long-range monitoring were analyzed by specially designed computer software.T test and Chi-square test were applied for statistical analysis.Results There were no differences in maternal age,gestational age at delivery,mode of delivery and incidence of neonatal asphyxia between the two groups (all P＞0.05).In atypical NST group,fetal heart rate baseline was higher [(138.05±5.65) vs (135.10±5.39) bpm] (t=-2.170,P＜0.05),and fetal heart rate baseline variability was lower than in normal NST group [(5.19±1.07) vs (6.28±1.15) bpm] (t=3.960,P＜0.001).Compared with normal NSTs,the percentage of mild baseline variability was significantly increased in atypical NST group [(40.79±9.97) vs (51.17± 10.84)％],while that of moderate variability was significantly decreased [(56.57±8.86) vs (46.72± 10.24)％] (t=-4.018 and 4.133,both P ＜ 0.001).In atypical NSTs,the average ratio of time of acceleration/the whole time of monitoring [(37.41 ±4.60)％] and acceleration area per unit time[(1.42±0.48) cm2/20 min] were decreased compared with normal NSTs [(40.78±4.23)％ and (2.03±0.67) cm2/20 min] (t=3.079 and 4.359,both P＜0.05).Conclusions Long-range monitoring of fetal heart rate in the third trimester fetuses with atypical NST is characterized by the declined fetal heart rate baseline variability,increased proportion of mild variability and unit time acceleration area;but these are not associated with pregnancy outcomes and short-term prognosis.

Objective To explore the value of ultrasound scoring system in predicting the type and risk of placenta accreta.Methods Clinical data of 180 placenta accreta patients who delivered in the Peking University Third Hospital between January 2005 and November 2014,were retrospectively analyzed.Prenatal ultrasonographic features were analyzed,including position and thickness of the placenta,disappearance of hypoechoes in posterior placenta,continuousness of bladder line,existence of lacuna,condition of the subplacental vascularity,completeness of cervical morphology,existence of cervical sinus,and history of cesarean section.A score of 0,1 or 2 was given to each item,and a sum-up was calculated for each patient.The cut-off scores of patients with placenta accreta,placenta increta and placenta percreta were calculated by receiver operating characteristic carve,respectively.At the same time,blood loss and hysterectomy rate were compared among the three groups.Variance analysis,rank sum or Chi-square tests were used for statistical analysis.Results Among the 180 cases,there were 115 cases of placenta accreta,38 of planceta increta and 27 of placenta percreta.Placenta increta and percreta were defined as the severe type.Blood loss in placenta accreta was lower than in the severe type [200 (100-4 000) ml vs 3 025 (100-15 000) ml,P＜0.01].There was no difference in blood loss between patients with placenta increta or percreta (P=0.350).No hysterectomy was performed for patients with placenta accreta,the rate being lower than in the severe type [0 vs 29.2％ (19/65),P＜0.01].Among the severe type,18.4％ (7/38) of the placenta increta patients underwent hysterectomy,the rate being lower than in placenta percreta patients [44.4％ (12/27),P＜0.01].The score in placenta accreta was lower than in the severe type [(1.88± 1.45) vs (7.01 ±2.15) scores,P＜0.01].In the severe type,the score in placenta increta was lower than in placenta percreta [(6.08 ± 2.62) vs (8.74 ± 2.75),P＜0.01].The receiver operating characteristic curve showed that the cut-off score of placenta accreta and the severe type was 5 [area under the curve (AUC)=94.3％,the score ≥ 4.5,the sensitivity=81.5％,and the specificity=95.7％],the cut-off score of placenta accreta and increta was 3 (AUC=91.1％,score ≥ 2.5,the sensitivity=92.1％,and the specificity=75.7％),and the cut-off score of placenta increta and percreta was 10 (AUC=74.6％,score ≥ 9.5,the sensitivity=55.6％,and the specificity=89.5％).Conclusions Ultrasound scoring system is effective in assessing types of placenta accreta and predicting its associate risks,and alerting the possibility of hysterectomy.It also facilitates preoperative planning and guides physicians in formulating subsequent treatment plans.Placenta accreta and the severe type (placenta increta and percreta) can be distinguished by cut-offscores ≥ 5,and a score ≥ 10 implies a higher risk of placenta percreta.

Objective To discuss the relationship between repetitive variable deceleration with a short interval (RDSI) in labor and neonatal acidosis.Methods One hundred and seventy-seven electronic fetal heart monitoring (EFM) patterns within one hour preceding delivery in term singleton pregnancies were collected in Peking University Third Hospital between February 2011 to October 2013.Continued EFM were recorded before delivery.Analysis was conducted on general information of both mothers and babies,including pregnant complications,duration of labor,cord and placental factors,nature of amniotic fluid,Apgar score and neonatal cord blood gas.RDSI was defined as that over 50％ intervals between two decelerations (the end of the last deceleration to the beginning of the next one) ≤ 60 s which appeared repetitevly in a period of 20 minutes.Independent sample t test,rank sum test,Chi-square test and Fisher's exact test were applied for statistics and receiver operating characteristic curve was obtained from the information of those with RDSI.Results Twenty-four of the 177 women with RDSI were assigned to the study group (24 cases,13.6％) and the rest 153 cases without RDSI to the control group.Background information of women in the two groups was comparable according to the maternal age,gestational weeks at delivery and duration of labor (all P ＞ 0.05).The occurrence of meconium stained amniotic fluid in the study group was higher than that of the control group [16.7％ (4/24) vs 5.2％ (7/153),x2=5.204,P=0.045],while the pH and base excess value of the neonatal blood gas in the study group were lower [7.20 (7.13-7.28) vs 7.29 (7.25-7.33),Z=-4.490;-6.10 (-4.67 to-9.62) mmol/L vs-3.20 (-4.90 to-1.55) mmol/L,Z=-5.044;P ≤ 0.01] resulting a higher rate of neonatal acidosis [50.0％(12/24) vs 7.8％ (12/153),x2=31.456,P ＜ 0.01].No significant difference was found in the incidence of neonatal asphyxia between the two groups.The area under the curve was 0.774 (95％CI:0.579-0.969).Conclusion RDSI in labor might indicate a high risk of neonatal acidosis.

Independent component analysis (ICA) is a statistic technique which extracts independent components from a set of standard signals. Since Electroencephalogram (EEG) signals are the mixture of several relatively independent sources, ICA has attracted extensive attention in the field of EEG processing. In this paper, a new Constrained ICA (cICA) algorithm is introduced, it would solve the problem of orderless output when FastICA algorithm is used. The experiment results testify that the cICA algorithm can reduce the effect of different individual when the artifacts of EEG are removed manually. The results also show that the cICA algorithm is robust and performs faster convergence.
Algorithms ; Artifacts ; Brain ; physiology ; Electroencephalography ; methods ; Humans ; Principal Component Analysis ; Signal Processing, Computer-Assisted

Objective To evaluate the accuracy of realtime polymerase chain reaction (PCR) assay in the detection of group B Streptococcus (GBS) in pregnant women. Methods Samples were collected from 1 395 women at 35-37 weeks of gestation from March 1 to December 31, 2009 at three hospitals in Beijing. Samples were obtained from the lower one third vaginal wall and perianal area and tested for GBS using standard culture and PCR. Standard culture and gene analysis for GBS were applied as the gold standard, and the sensitivity and specificity of the rapid assay were determined. Results Of the 1 395 women qualified for PCR testing, 40(2.9%) were identified as GBS positive on the basis of the results of specimen culture, compared to 114 (8.2%) on the basis of PCR assay. The culture was negative and the PCR positive in 77 patients. The results which were not in agreement using the two tests were evaluated by the gene analysis for GBS. Among the 77 samples which were GBS positive by PCR, 66 samples were determined as GBS positive by gene analysis. The sensitivity of the PCR assay was 97.2%(103/106) and specificity was 99.1%(1 278/1 289), the maternal GBS colonization was 7.6%(106/1 395). Conclusions Realtime PCR assay allows rapid and reliable detection of GBS in last trimester with high sensitivity and specificity.