Objective To evaluate the association of fetal total bile acid (TBA) concentration with fetal adrenocortical dysfunction in intrahepatic cholestasis of pregnancy(ICP). Methods The concentration of TBA, cortisol and DHEA-S in the cord blood were measured in 20 fetuses with maternal ICP (ICP group) and 22 fetuses of normogravidas (control group) after elective cesarean section. The cord blood TBA concentration was investigated by enzyme method and the cord concentration of cortisol and DHEA-S by radioimmunoassay. Results The cord TBA concentration in ICP group was significantly higher than that of controls [(8.93?3.16)mmol/L vs (4.33?1.51)mmol/L, P0.05)]. The cord blood level of cortisol,DHEA-S and the ratio of DHEA-S over cortisol were correlated with the cord blood TBA concentration (r 1= 0.87,r 2=-0.88,r 3=-0.84,P

Objective To investigate the relation of changes of fetal bile acid and morphologic ultrastructure of human placental syncytial cells in intrahepatic cholestasis of pregnancy (ICP). Methods(Total bile acid of cord venous blood was measured by cycle enzyme method between intrahepatic cholestasis of pregnancy and control groups after birth. The ultrastructure of human placental syncytial cell was analyzed by morphologic study in two groups. Results (1) The total bile acid of cord venous blood in ICP group was significantly higher than in control group[(8.6?3.2) ?mol/L vs (4.6?1.5)?mol/L ](P0.05). The average volume, surface area density and volume density of mitochondrion in ICP group [respectively (0.0200?0.0020) ?m~3,(0.600?0.010) ?m~2/?m~3,(0.0800?0.0090)?m~3/?m~3] were significantly enlarged than in control group [respectively (0.0100?0.0050)?m~3, (0.500?0.030) ?m~2/?m~3,(0.0500?0.0020) ?m~3/?m~3](P0.05). Conclusion In ICP, high levels of bile acids may impair cellular organelle, resulting in abnormality of physiological function of syncytial cells, and affecting the synthesis and transportation functions of placenta.

0.05). IH scores of 15-PGDH in chorion of placenta and fetal membranes in PL were 1.5?0.6,2.3?0.8, respectively, in TL were 2.6?0.8,3.0?0.7, respectively, and in control group were 4.4?1.1, 4.1?1.2,respectively. IH scores in PL and TL were obviously lower than those in control group(P

Objective To investigate the changes of human leukocyte antigen-G (HLA-G) protein expression and Th1/Th2 type cytokines in intrahepatic cholestasis of pregnancy (ICP) and their relativity to the etiology of ICP. Methods Peripheral blood and placental tissues were obtained from 26 ICP patients (the ICP group) and 22 normal pregnant women (the NP group) in the operation room for Cesarean birth. Immunohistochemistry was used to detect the expression of HLA-G protein in the placental tissues. Meanwhile we tested the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) by enzyme-linked immunosorbent assay (ELISA) in the peripheral blood and checked the levels of TBA in the serum.Results TBA level in the ICP group was (27.05±6.08) μmol/L, significant higher than that in the NP group (4.35±2.68)μmol/L (P＜0.01). The positive expression of HLA-G protein in extravillous trophoblast in the ICP group was significantly lower than that in the NP group (P＜0.01). The mean optical density (MOD) of positive expression of HLA-G protein in the placenta tissues in the ICP group (52.91±7.19) was significantly lower than that in the NP group (69.26±7.72) (P＜0.01). The concentration of TNF-α was significantly higher in the ICP group (101.31±19.30) pg/mL than that in the NP group (54.51±23.72) pg/mL (P＜0.01). The concentration of IL-4 was lower in the ICP group (22.16±6.55) pg/mL than that in the NP group (31.69±8.25) pg/mL (P＜0.01). The ratio of TNF-α/IL-4 was higher in the ICP group (4.52±1.91) than that in the NP group (1.72±0.61) (P＜0.01). There was a negative correlation between the MOD of HLA-G protein and TNF-α (r=-0.98, P＜0.01) in the ICP group. No correlation with IL-4 and TNF-α/IL-4 was seen (P＞0.05). There was a positive correlation between TBA and TNF-α (r=0.99, P＜0.01), and a negative correlation between TBA and the MOD of HLA-G protein (r=-1.00, P＜0.01) in the ICP group. No correlation with IL-4 and TNF-α/IL-4 was seen (P＞0.05). Conclusion There is an imbalance of Th1/Th2 cytokines to the Th1 type in the peripheral blood of ICP patients. The expression of HLA-G protein in the placenta of ICP patients decreases, leading to an increase of Th1 type cytokines that may be one of the reasons for liver destroy in ICP.

Objective To investigate the changes of umbilical cord and the vasoactive substance in umbilical vein in intrahepatic cholestasis of pregnancy.MethodsBy HE staining method we analyzed the pathologic change of umbilical cord of 25 women with intrahepatic cholestasis of pregnancy(ICP)and fetal distress(ICP fetal distress group),25 ICP women without fetal distress group(ICP control group)and 27 normal pregnancies(control group).The nitric oxide synthase(NOS)and endothelin-1(ET-1)were detected in human umbilical vein endothelial cells(HUVEC)by immunohistochemistry method.Umbilical vein total bile acid(TBA)and NOS and ET-1 were measured.Resuits(1)A remarkable high TBA level was found in umbilical vein in ICP,and it was higher in ICP fetal distress group(19.0±2.3)μmol/L than in ICP control group(9.0±1.7)μmol/L(P＜0.05);it was higher in ICP control group than the control group(4.4±1.5)μmol/L(P＜0.05).(2)A significant difference was found in the endotheliocytes of umbilical vein in ICP fetal distress group compared with ICP control group.The ratio of cells with pathological changes in ICP fetal distress group(92％,23/25)was higher than ICP control group(68％,17/25;P＜0.05).The occurrence of the pathological changes was associated with TBA.(3)The expression of eNOS in ICP fetal distress group 0.09±0.06 was lower than in ICP control group 0.21±0.08(P＜0.05),and it was lower in ICP control group than in control group 0.47±0.07(P＜0.05).In contrast.the expression of ET-1 in ICP fetal distress group 0.49±0.08 was higher than in ICP control group 0.32±0.07(P＜0.05),and it was higher in ICP control group than control group 0.14±0.06(P＜0.05).The expression of inducible nitric oxide synthase(iNOS)in ICP fetal distress group 0.20±0.04 and ICP control group 0.21±0.05 was lower than in control group 0.26±0.04(P＜0.05),but no significant difference was found in ICP fetal distress group and ICP control group(P＞0.05).(4)The expression of eNOS,iNOS and ET-1 was correlated with umbilical vein TBA in ICP(r1=-0.88,r2=-0.45,r3=0.79;P＜0.01),respectively.Conclusions High level of TBA in ICP is harmful to the umbilical vein endothelium,which is correlated with the raised expression of ET-1.and the decreased expression of eNOS,and iNOS in human umbilical cord endothelium cells.All these changes of umbilical vein may be associated with the occurrence of fetal distress in ICP.

Objective To investigate the role of RhoA and Rho kinase system in the onset of labor. Methods Forty term pregnant women, who delivered through cesarean section at the Xiangya Second Hospital of Central South University from February 2007 to November 2007, were selected and divided into 2 groups: 20 in labor group and 20 in non-labor group. Another 20 non-pregnant women undergoing hysterectomy due to cervical intraepithelial neoplasia were chosen as the control. Real-time fluorescence quantitative RT-PCR and western blot were applied to detect the expression RhoA and ROCKⅠ mRNA and protein in uterine smooth muscle tissue and the correlation between the mRNA and protein expression of RhoA and ROCKⅠ were analyzed. Results (1) The mRNA expressions of both RhoA and ROCKⅠ were detected in all groups, and higher levels were found in the labor group than in the non-labor group and the control [RhoA mRNA: (3.51±0.56)×10-3 vs. (2.75±0.52)×10-3 and (2.11±0.54)×10-3; ROCKⅠ mRNA: (4.07±0.66)×10-3 vs. (2.71±0.52)×10-3 and(2.01±0.23)×10-3, P<0.01]. (2) RhoA and ROCKⅠ proteins were also identified in all three groups, and the expressions in the labor and non-labor group were higher than those of the control (RhoA protein: 0.72±0.23 and 0.64±0.17 vs. 0.46±0.15; ROCKⅠ protein: 0.56±0.14 and 0.42±0.16 vs. 0.29±0.08, P<0.01). (3) The expression of RhoA mRNA and ROCKⅠ mRNA were positively correlated in each of the three groups (r=0.73,P<0.01), and the same was found in the expression of RhoA protein and ROCKⅠ protein (r=0.37,P<0.01). Conclusion The increased expression of RhoA and Rho kinase may play an important role in the initiation of labor.

We have made an investigation on medica1 college students' thinking about the teaching of human parasitology,and put forward a preliminary tentative plan and suggestion to the teaching goal,teaching content,method and so on to human parasitology teaching.

Objective To explore the effects of maternal hypercholanemia on the myocardium changes in rat fetus. Methods Thirty clean SD female rats were equally randomized to three groups after mating successfully.From the 13th to 20th day of gestation,group A and B were injected injected with sodium chloride(NS) as control.Total bile acid(TBA) and cardiac troponin I(cTnI) were measured in the maternal and fetal serum on the 21st day when all rats were killed.Fetal cardiac muscle cells were also collected for examination with light microscope and electronic microscope.Results (1)TBA in maternal and fetal serum were(22.32±8.12)μmol/L and(28.84±8.06) μmol/L,respectively in group A,(9.77±3.56)/μmol/L and(9.34±3.54) μmol/L in group B,and (3.60±1.78) μmol/L and(3.95±1.19) μmol/L in group C.Significant differences were found among groups(P<0.01).(2)Fetal death rates were significantly different among the three groups (P<0.05),with 30.11%,16.85%,and 7.05%,respectively.(3)Fetal cTnl were also found significant difference among groups(P<0.01),with(19.98±7.75)ng/ml,(11.41±3.64)ng/ml and(4.38±1.19)ng/ml,respectively.(4)The integrated scores of fetal necrosis area were significantly different in three groups(P<0.05),with 1.92±0.43,1.36±0.37 and 0.44±0.12,respectively.(5)Under electronic microscope,the number density of mitochondria in group A was lower than that in group C(P<0.05)while the average volume of mitochondria was larger in group A (P<0.05).The average volume of mitoehondria in group B was larger than that in group C(P<0.05) while no difference was found with regard to the number density between the two groups.The number density and average volume of myofibril in group A were lower than those in group C(P<0.05).The number density of myofibril in group B was higher than that in group C(P<0.05) while no difference was found with the average volume.(6)Positive correlations were found in maternal TBA,fetal TBA,fetal cTnI and the integrate of fetal necrosis area when comparing every two of the above factors. Conclusions Fetal myocardium is impaired obviously in hypercholanemia rats.The serum level of TBA and cTnI in fetal rats are positively correlated with each other.

Objective To explore the relationship between total bile acid(TBA)concentration and fetal pulmonary surfactant in intrahepatic cholestasis of pregnancy(ICP).Methods Fifry five patients with ICP(ICP group)who received cesarean section from April 2008 to February 2010 in Second Xiangya Hospital,Central South University,were recruited.The general conditions of the neonates within 7 days after birth in ICP group were recorded.Those with fetal distress,neonatal asphyxia,or neonatal respiratory distress syndrome were referred as pathological neonates, others were referred as normal neonates. Over the same period, 23 healthy gravidas were recruited as control group. Enzymatic method was used to detect the TBA concentrations in maternal blood, cord blood and amniotic fluid. ELISA was employed to measure the urfactant protein A (SP-A) concentration in cord blood. High performance liquid chromatography system was used to detect the concentrations of phesphatidylcholine (PC),phosphatidylinositol (PI),lysophosphatidylcholine ( LPC), and sphingomyelin(SM) in amniotic fluid. Results ( 1 ) The concentrations of TBA in maternal blood, cord blood and amniotic fluid were ( 30. 1 ± 7.9 ), (9. 3± 3. 3 ) and (4. 4 ± 1.5 ) mmol/L in ICP group, (4. 8 ± 2. 2), (4. 9 ± 0. 9) and ( 1.4 v 1.1 ) mmol/L in control group, respectively. The differences between the two groups were significant ( P ＜ 0. 05 ). ( 2 ) The SP-A concentration in cord blood in ICP group was ( 29. 5 ± 6. 4 ) μg/L, significantly higher than that in control group, which was ( 22. 6 ± 7. 4 )μg/L ( P＜ 0. 05 ). ( 3 ) There were 20 pathological neonates and 35 normal neonates in ICP group. In pathological neonates, the concentrations of TBA and SP-A in cord blood were (10.9 ± 2.2) mmol/L,(37.0 ± 5.9 ) μg/L, respectively; and were ( 8.0 ± 2. 8 ) mmol/L, ( 26. 7 ± 4. 8 ) μg/L in normal neonates. The differences were significant (P＜ 0. 05 ). (4) There was a positive correlation between TBA concentration in cord blood and in maternal blood ( r1 = 0. 706, P＜0. 05 ). The TBA concentration in cord blood was positively correlated with SP-A concentration as well ( r3 = 0. 494,P ＜ 0. 05 ). (5) The PC and PI concentrations in amniotic fluid were (65.4 ± 7.2) mg/L and ( 3. 8 ± 0. 6 ) mg/L in ICP group, ( 69. 7 ±3.7) mg/L and (4. 3 ± 0. 7 ) mg/L in control group, respectively. The differences were significant (P ＜0. 05 ). The concentration of LPC in amniotic fluid in ICP group was (4. 8 ±0. 9) mg/L, significantly higher than that in control group (P＜0. 05), which was (4. 2 ±0. 6) mg/L. The concentration of SM in amniotic fluid was (3.5±0. 8) mg/L in ICP group, (4. 0 ± 0. 5 ) mg/L in control group, with no significant difference ( P＞0. 05 ). (6) The ratio of PC/LPC in ICP group ( 14. 2± 3. 2 ) was significantly lower than that in control group ( 16. 9 ± 2. 5 ) ( P＜ 0. 05 ). ( 7 ) The TBA concentration in cord blood was negatively correlated with PC and PI concentrations (r1 = -0. 561, r2 = -0. 407, P ＜ 0. 05 ), and had no correlation with LPC concentration (r3 = 0. 260, P＞ 0. 05). Conclusions ( 1 ) The fetal TBA concentrations in both cord blood and amniotic fluid of patients with ICP was higher than those of healthy gravidas, they were also positively correlated with maternal TBA concentration. (2) ICP resulted in the change of fetal pulmonary surfactant and this change was associated with TBA concentrations in both cord blood and amniotic fluid.

Objective: To study the relation of bile acid levels and fetal hypoxia and brain injury in Intrahepatic Cholestasis of Pregnancy (ICP). Methods: From May. 2006 to Sep. 2006, we selected 30 cases of ICP as the study group, and randomly selected 30 cases of normal pregnant women for delivery during the same period as the control group in our hospital. Color Doppler ultrasound was used to measure the peak systolic velocity to end-diastolic velocity (S/D) and the resistive index (RI) of fetal middle cerebral artery, and the automatic biochemical analyzer be used to detect the total bile acid (BA) in maternal blood, and BA, pH as well as lactate in umbilical arterial serum; neuron-specific enolase (NSE) in umbilical artery serum was detected by ELISA. The results were analyzed and compared. Results:①The BA concentration in maternal blood and newborn umbilical artery blood of the study group was significantly higher than that of the control group ( P<0.01). In the study group, the BA in maternal and newborn blood were positively correlated ( r=0.937, P< 0.01) ;②Lactate and the NSE Concentration in newborn umbilical artery of the study group was significantly higher than that of the control group ( P< 0.01). The pH value innewbom umbilical artery and The S/D, RI value of fetal middle cerebral artery in the study group was significantly lower than those of control group ( P< 0.01); ③ In the study group, the NSE concentration was positively correlated with BA and lactate concentration in newborn umbilical artery, while negatively correlated with the S/D and RI values of fetal middle cerebral artery and the pH value in newborn umbilical artery ( P<0.01). Conclusions: There is the existence of hypoxia and brain injury in fetus of ICP. By measuring the blood flow changes of fetal cerebral artery with Color Doppler and detecting pH, lactate as well as NSE levels in umbilical arterial blood, we could early predict the fetal hypoxia and diagnose the fetal brain injury in ICP.