OBJECTIVE: To investigate the relationship of group B (GBS) colonization in late pregnancy with perinatal outcome. METHODS: Pregnant women who underwent antenatal check-up at General Hospital of PLA Eastern Theater Command and the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were enrolled in the study. The vaginal and rectal swab samples were collected for GBS culture at 35-37 weeks of pregnancy. The perinatal outcomes of positive and negative GBS groups were compared. The GBS-positive group samples were tested for antibiotic susceptibility. In GBS positive group the maternal and child perinatal outcomes were compared between pregnant women with antibiotics treatment and those without antibiotics. RESULTS: A total of 13 000 pregnant women were enrolled, and the overall colonization rate of GBS was 3.65%(475/13 000). The colonization rate of GBS in the vagina was 2.33%(303/13 000), and the colonization rate in the rectum was 1.75%(227/13 000). Through the collection and detection of rectal specimens, the positive rate of GBS increased by 56.77%(172/303). The monthly colonization rate of GBS showed significant fluctuations with the highest in March and October (all < 0.05). The sensitivity of 475 GBS-positive specimens to ceftriaxone, vancomycin and linezolid were 100%, and the sensitivity to ampicillin and penicillin were 97.26%and 93.47%, respectively. The resistance rates of the strains to levofloxacin, clindamycin, erythromycin and tetracycline were 30.11%, 48.00%, 52.21%and 88.63%. The incidence of premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal pneumonia and sepsis in GBS positive group were significantly higher than those in GBS negative group (all < 0.01). In pregnant women with positive GBS, the incidence of puerperal infection, neonatal infection and admission to the NICU in the antibiotic group were significantly lower than those in the non-antibiotic group ( < 0.05 or < 0.01). CONCLUSIONS The total colonization rate of GBS is low. The detection of GBS can be significantly improved by supplementing rectal examination. Ceftriaxone, ampicillin and penicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases. GBS infection can increase the incidence of maternal and child complications. The use of antibiotics during labor can improve the outcome of mothers and infants.
Anti-Bacterial Agents ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Outcome ; Streptococcal Infections ; Streptococcus agalactiae ; Vagina

Objective The incidence rate of acute pancreatitis in pregnancy (APIP) is on the rise, and yet there is no effec-tive method for its prevention and treatment .This study aimed to investigate the high risk factors of APIP and its prognostic evaluation index. Methods We retrospectively analyzed the clinical data of 35 cases of APIP ( group A) and another 35 cases of acute pancre-atitis in non-pregnancy as controls (group B).We compared the etiologic factors of acute pancreatitis , changes of laboratory indexes after onset of the disease , and clinical outcomes between the two groups . Results No statistically significant differences were found in the risk factors between the two groups (χ2 =0.233, P>0.05).Serum cholesterol and triglyceride levels were remarkably higher in group A ([15.69 ±7.71] and [15.54 ±7.82] mol) than in B ([5.07 ±2.95] and [3.82 ±2.58] mol) (P<0.05).There were significant differences between groups A and B in WBC count ([19.00 ±5.31] vs [14.98 ±9.77] 109/L), Hb ([82.77 ±11.77] vs [101.77 ±1.50] g/L), and serum Glu ([8.77 ±2.76] vs [6.23 ±1.99] mol/L)(P<0.05).Multivariate logistic regression a-nalysis showed the predictive value of cholesterol and triglyceride levels for APIP and a correlation of WBC and Hb with the clinical out -comes of the patients.The in-hospital mortality rate was significantly higher in group A than in B (χ2 =3.968, P=0.046), and so was the incidence rate of severe acute pancreatitis (χ2 =5.510, P=0.019). Conclusion Biliary diseases are the main high risk factors of APIP, followed by hyperlipidemia .Triglyceride and cholesterol levels have the predictive value for APIP .The WBC count and Hb level can be used to assess the patients′condition and predict the clinical outcomes .

Objective To explore the impact of throughout patient-controlled epidural analgesia(PCEA) on labor progress and delivery mode. Methods We enrolled 120 nulliparous women with term cephalic singleton preg-nancies. They were divided into two groups ,throughout analgesia group(n=60):when they are in labor,we started an-algesia and continued to the end of second stage of labor. While 60 nulliparous were selected to non-analgesia group as the control group. Data were collected about duration of the first, second stage of labor, oxytocin dosage, postpartum hemorrhage,outcome of delivery, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis and the effect of epidural analgesia, etc. Results There wsa is significant difference in the duration of the first stage delivery, the utilization rates of oxytocin, delivery mode (P<0.05) ;and there was no remarkable differences in the second stage of labor process, postpartum hemorrhage, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis (P>0.05) Conclusion The throughout patient-controlled epidural analgesia can shorten labor progress, cut down uterine-incision delivery and reach satisfying analgesis effect, without commidng any impact on the outcome of delivery.

OBJECTIVETo report a true hermaphroditism due to a teragametic chimerism and to discuss the pathogenesis of tetragametic chimerism.

METHODSChromosomal analysis and fluorescence in situ hybridization(FISH) were carried out on the lymphocytes from the blood and on the fibroblasts from the cultured skin and on fibroblasts from two different kinds of gonadal tissues of the patient with ambiguous genitalia respectively. Blood groups, human leukocyte antigen (HLA) haplotyping and 77 short tandem repeat (STR) microsatellite markers were tested. The two kinds of tissues in the gonad were detected by histopathological examination. Blood groups, HLA haplotying and 77 STR microsatellite markers parents of the patient's were also analyzed.

RESULTSEither 46,XX or 46,XY karyotype was found in the lymphocytes of the blood and in the fibroblasts of the cultured skin and of the two different kinds of gonadal tissues. Two X chromosome-specific signals or one X and one Y signal were detected in each interphase nucleus by FISH from the lymphocytes of the blood and the fibroblasts of three different tissue cultures. The karyotype of the 46,XY cell line predominated in all cultures except the cultured-fibroblasts from yellow gonadal tissues. STR marker analysis, ABO grouping and HLA study from the patient were identified a single haplotype in the patient from the mother and two different haplotypes from the father. Two kinds of tissues in the gonad were observed by histopathological examination. The yellow tissue was ovary and the white one was testis.

CONCLUSIONSHistopathological examination and chromosomal analysis combined with FISH are very useful methods for the diagnosis of true hermaphroditism. Blood typing, HLA and short tandem repeat microsatellite markers afford strong evidence for confirming tetragametic chimerism. The mechanism of tetragametic chimerism in true hermaphroditism can be explained by a parthenogenetic division of a haploid nucleu into two identical gametes, followed by fertilization with both X and Y spermatozoa and then developed into an organism.

ABO Blood-Group System ; Chimera ; Disorders of Sex Development ; blood ; genetics ; pathology ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Sex Chromosomes

Objective DNA methylation in the pathogenesis of endometriosis is drawing more and more attention from the medical world.This study aimed to evaluate the methylation status of the Homeobox-A10 (HOXA10) gene promoter region and the expression of the HOXA10 protein in endometriosis,and to explore the relationship of endometriosis with the aberrant methylation and expression of HOXA10 and its clinical significance.Methods The methylation-specific PCR(MSP) and the immunohistochemical SP methods were employed to detect both the methylation status of the HOXA10 promoter and its expression in the eutopic and ectopic endometrial tissues from 36 endometriosis patients,with normal endometrial tissue samples from 12 healthy women as controls.Results Hypermethylation of the HOXA10 promoter region was present in 38.9% (14/36) of the ectopic endometrial tissue samples and 25.0% (9/36) of the eutopic endometrial tissue samples,all in endometriosis of stages Ⅲ and Ⅳ,but no hypermethylation was found in the endometrial tissues of the normal controls,with significant differences between the two groups (P

Objective: To analyze the clinical characteristics of non-diabetic fetal macrosomia and their mothers.Methods: A retrospective case control study design was used to analyze 149 cases of non-diabetic fetal macrosomia and their mothers with the normal oral glucose tolerance test(OGTT) by comparison with 166 randomly included newborns of normal birth weight.Results: More cases of non-diabetic fetal macrosomia were found in the male neonates.The body weight,height,FL and BPD averaged significantly higher in the macrosomia group than in the control,and so did the body weight,height,uterus height,abdominal circumference and gestational age of the mothers.The rates of cesarean section and other obstetric complications were also higher in the macrosomia group.Conclusion: Different from the diabetic macrosomic fetus,the non-diabetic macrosomic fetus is a normal one,the incidence of which is associated with mothers'excessiver pregnancy nutrition as well as with genetic factors.

Objective: All-trans retinoic acid(ATRA) is a classic drug that can induce tumor differentiation,and its influence on the aberrant methylation of cancer cells has been studied insufficiently.The objective of this study was to observe the influence of ATRA on the methylation of the RARa gene promoter in ovarian cancer cell line COC2 and its relationship with the RARa expression.Methods: The ovarian cancer cell line COC2 was treated with different concentrations of ATRA for different times.Methylation specific PCR(MSP) and bisulfate sequencing methods were used to detect the changes in the methylation of the RARa promoter after ATRA treatment.RT-PCR was employed to observe the changes in the expression level of RARa mRNA.Results: Aberrant methylation of the RARa gene promoter was found in the ovarian cancer cell line COC2.ATRA treatment decreased the number of RARa promoter methylation sites in COC2 within a certain scope in a concentrationand time-dependent manner,and increased the expression of RARa mRNA.Conclusion: Aberrantly high methylation of the RARa promoter exists in the ovarian cancer cell line COC2;ATRA can partially reverse the methylation and increase the RARa mRNA expression.

0.05),while the difference of dynamic HCO3-,BE in the umbilical blood gas analysis was significant statistically in the three groups(P

Objective:(i)to compare plasma ghrelin levels between women with PCOS and women presented only with hyperandrogenaemia;(ii)to investigate the relationship between circulating ghrelin and BMI、insulin level,insulin resistance,and Androgen levels in PCOS.Methods:Blood samples from sixty women with PCOS,15 women with only hyperandrogenaemia and 40 controls were collected,the basal levels of gonadotrophin,androgens,prolactin,sex hormone-binding globulin,glucose,insulin and ghrelin were measured.Results:(1)Comparing with PCOS and Controls,women with only hyperandrogenaemia had the lowest ghrelin levels;women with PCOS had lower ghrelin levels comparing with controls,but they were not significant.(2)Ghrelin levels were negatively correlated with BMI、WHR、Insulin levels and Insulin Resistance,positively correlated with sex hormone-binding globulin levels.Conclusion:In PCOS,circulating ghrelin and BMI、Insulin Resistance、SHBG levels were inversely related,indicating that Ghrelin might be associated with energy balance,obesity,and Insulin Resistance.However,further investigation was needed to clarify whether low ghrelin was a cause or the consequence of obesity and Insulin Resistance awaits.

Objectives: Hypertensive disorders complicating pregnancy(HDCP) has a long-term deleterious effect.This study aimed to investigate the changes of cognitive function in women with HDCP and explore their possible mechanism.Methods: Fifty-three patients with HDCP and 22 normal pregnant women were included in this study,their cognitive functions assessed 60-80 days after delivery by word learning and delayed recall test,symbol digit substitution test,animal category fluency test,block design,trail making test(Part A) and digit span test.The results of the cognitive tests were compared between the HDCP and normal control groups.Results: Cognitive performances of the severe preeclampsia patients differed significantly from those of the normal individuals on the tests of word learning(P