Objective To investigate the occurrence law of autophagy in trophoblast cells from preeclampsia and its underlying mechanisms.Methods Twenty cases of placenta tissues were collected from women suffered from preeclampsia and normal pregnant women respectively.Autophagosome of trophoblast cells were observed by transmission electron microscope.The expressions of LC3-Ⅱ/Ⅰ and Atg4B in placenta tissues were detected by western blot and real-time PCR.Results Compared with the control group,typical autophagosomes of trophoblast cells were observed by transmission electron microscope.The ratio of LC3-Ⅱ / Ⅰ in placenta of PE patients was increased (1.43 ± 0.23) compared with control group (0.59 ±0.12),and the expression of Atg4B was up-regulated in both mRNA [(1.73 ±0.16) folds] and protein levels (0.71 ± 0.13) compared with control group (P ＜ 0.05).Conclusions Autophagy was significantly up-regulated in trophoblast cells from patients suffered from preeclampsia.Thus,all the data suggest that autophagy might be involved in the generation of preeclampsia.

Objective To investigate the difference and the correlation of the vowel's phonation threshold pressure and nasalance in normal subjects .Methods The Aeroview (GLOTTAL Enterprises)with the materials /pa/,/pi/,/pu/ was used to obtain phonation threshold pressure values and The NasalviewTM (Tiger Electronics Inc .,Seattle ,Shanghai) with the materials /a/,/i/,/u/was used to obtain nasalance values .A total of 30 subjects (15 males ,15 females ,and aged 19~30) years old received the tests .The results of the vowel's phonation threshold pressure and nasalance gender score difference were compared .Results The PTP gender scores of /a/,/i/,/u/in maleswere4.53±0.70cm,5.21±0.80cm,5.87±1.45cm,andinfemaleswere4.09±0.30cm,4.47±0.30cm, and 4 .77 ± 0 .32 cm ,respectively .There were significant differences between males and females in PTP values (P<0 .05) .The PTP gender score differences showed that males were greater than that of females .There were signifi‐cant differences in different vowels (P<0 .05) .The nasalance gender scores of /a/,/i/,/u/in males were 30 .2 ± 5 . 75% ,38 .8 ± 8 .54% ,26 .5 ± 6 .03% ,and in females w ere32 .4 ± 7 .14% ,40 .5 ± 11 .8% ,and 30 .1 ± 4 .83% ,respec‐tively .There were no significant differences between males and females in nasalance values (P> 0 .05) .The na‐salance gender score differences showed that females were greater than males .There were significant differences in different vowels(P<0 .05) .This study found a weak correlation between PTP and nasalance .Conclusion The relationship between oral pressure and nasal flow cannot be accurately measured by measuring PTP ,and /pa/is a relatively suit‐able material for testing oral pressure .

Objective To study the validity of a new material, to verify the influence of gender and age differences on normal school children, and give advice to establishing the norms of mean nasalance for normal school children.Methods The mean nasalance of 190 school children in Shanghai was obtained by reading the new, old material and the vowel /a/,/o/,/e/,/i/,/u/, and /ü/, the mean nasalance was analyzed for the standard deviations.The gender and age score differences were compared.Results The new material was more stable than the old.In the test of /i/ and/ü/and the nasal material, the girls'' MNS was higher than the boys''.In testing the vowels /a/,/o/,/e/,/i/,/u/, and /ü/and the new material, there were differences in different ages.Conclusion The validity of new material is more stable than the old.The MNS of the normal children in Shanghai show that it is higher for the girls than the boys, and also higher for the older children than for the younger.

Objective To analyze the characteristics of the speech fluency of preschool hearing-impaired children with hearing devices ,and to explore influence of different hearing devices, age, ender and intervention time on their speech fluency.Methods A total of 109 subjects of normal children and hearing-impaired children were induded in this study.They were divided into 3 groups, 30 of normal children , 28 of hearing-impaired children with hearing aids , 26 of hearing-impaired children with cochlear implants, 25 of hearing-impaired children with Cochlear implant and hearing aids.Their speech speed,pause,repetition,and prolongation in spontaneous language tasks by exploring the influence of factors such as hearing devices'' types,age, gender and intervention time difference to their speech fluency were studied.Results (1) The speed in normal children was significantly higher than those of in the other three groups(P<0.05), while the normal children had less pauses than the hearing-impaired children with cochlear implants(P=0.001) and hearing-impaired children with cochlear implants and hearing aids(P=0.032).The normal children have less prolongation than the hearing-impaired children with hearing aids (P=0.001) and hearing-impaired children with cochlear implants and hearing aids(P=0.001) but noticeably greater prolongation than the hearing-impaired children with cochlear implants (P<0.001).(2) Hearing-impaired children''s speech speed,pause,repetition,and prolongation had no significant differences in gender(P>0.05).The speech speed of children with hearing aids was higher than children with cochlear implants(P=0.045).Children with cochlear implant had more pauses than children with hearing aids(P=0.028).The speech speed of hearing-impaired children in 3.5~5 years old was lower than hearing-impaired children in 5.1~6.5 years old(P=0.042).The speech speed of hearing-impaired children who receive intervention less than 2.5 years, was higher than the children who receive intervention more than 2.5 years(P=0.002),while children who receive intervention less than 2.5 years had more pauses(P=0.047) and prolongations(P=0.002).Conclusion (1)Preschool hearing-impaired children''s speed is lower than the normal, and the times of pause and prolongation is more than the normal.(2) Different hearing devices and intervention time influence preschool hearing-impaired children''s verbal fluency, while gender have no effects.

Objective To analysis the clinical high risk factors for fetal chromosomal abnormalities.Methods Amniocentesis,chromosomal karyotype analysis and other related methods were performed on 4829 pregnant women,who presented sole indication of prenatal diagnosis such as advanced age,high risk factors and fetal ultrasound abnormalities,for analyzing the correlations of those women to the incidence of fetal chromosomal abnormalities.Results The detection rates of abnormal karyotype were 5.0％ (57/1143),1.7％ (40/2367) and 4.3％ (57/1319) in the older women group (age＞35),abnormal maternal serological screening group and abnormal fetal ultrasound finding group,respectively.The detection rats of karyotype abnormality were 6.9％ (23/333) in women with fetal congenital heart diseases,8.5％ (20/234) in those with abnormal amniotic fluid,1.1％ (1/89) in those with fetal ventriculomegaly,1.1％ (10/898) in those with fetal intracardiac hyperechogenicity,5.9％ (2/34) in those with fetal choroid cyst and 5.6％ (1/18) in those with fetal renal pelvis broadening.Conclusion The pregnant women with age＞35,fetal sonographic structural anomalies or two or more soft marker abnormalities should be prenatally diagnosed and doing the genetic counseling combined with the family history.

Objective To explore the correlation between speech fluency and diadochokinetic rate in children aged 7～11 years with cochlear implant.Methods Speech samples were collected from 62 children aged 7～11 years with cochlear implant using language retelling task and diadochokinetic rate test task.Their speech rate,articulation rate,syllable duration and pause duration were analyzed.The data were input into ICF converter to obtain the im-pairment limit of each parameter and analyze the speech fluency and diadochokinetic rate characteristics.Partial cor-relation analysis was performed for speech rate,articulation rate,syllable duration and pause duration by two tasks.Results ① For children with cochlear implant,the mean ICF impairment limit of diadochokinetic rate was 1.3± 0.1,the mean ICF impairment limit of fluency in retelling was 1.0±0.3,with various degree of impairment in both tasks.② There was a moderate or low correlation between speech rate,articulation rate,syllable duration in retell-ing task and those in diadochokinetic rate task(0.3＜|r |≤0.8).There was a low correlation between pause dura-tion in retelling task and speech rate and pause duration in diadochokinetic rate task(0.3＜|r |≤0.5).Conclusion The speech fluency and diadochokinetic rate of children aged 7～11 years with cochlear implant is underdeveloped,and the poor articulation movement ability limits their development of speech fluency.

OBJECTIVETo optimize the methods for genetic detection and prenatal diagnosis of Duchenne muscular dystrophy (DMD).

METHODSDenaturing high-performance liquid chromatography (DHPLC), multiplex PCR (mPCR), sequencing and other molecular techniques were used in combination for molecular diagnosis of 8 cases diagnosed as DMD.

RESULTSAmong the 8 cases, 4 have carried large deletions, 3 have point mutations, among which 6 were of de novo type. Prenatal diagnosis were offered for 5 families, the results showed that none of the fetuses had carried large deletions or point mutations. The pregnancies had continued and healthy babies were born.

CONCLUSIONCombined use of short tandem repeat, DHPLC, mPCR and sequencing can improve the detection of DMD gene mutations. By establishing and optimizing genetic and prenatal diagnostic methods, accurate genetic counseling can be provided for families affected with DMD.

Adult ; Base Sequence ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genetic Testing ; Humans ; Molecular Sequence Data ; Muscular Dystrophy, Duchenne ; diagnosis ; embryology ; genetics ; Pedigree ; Point Mutation ; Pregnancy ; Prenatal Diagnosis ; Sequence Deletion ; Young Adult

ObjectiveTo compare the development status of health facilities in different regions （non-agricultural and agricultural districts）and different types across four dimensions： organizational management， health environment， health activities， and health outcomes， to explore factors that may affect the current development status and summarize effective experiences， and to provide a foundation for the subsequent comprehensive， standardized， and effective promotion of health facility development and tiered and classified management. MethodsInvestigators conducted a health status survey based on the four dimensions for 50 health facilities in 16 districts of Shanghai， representing three types （including government agencies， enterprises， and communities）. Evaluation forms were filled out through on-site observation and document reviews， which were developed in accordance with the Shanghai Health Settings Evaluation Standards （for trial implementation in 2019）. ResultsThe average total score of health facilities in Shanghai was （88.42±11.93） points， with an overall excellence rate of 86.0%. The excellence rate of each dimension， from highest to lowest， were healthy environment （84.0%）， organizational management （82.0%）， health activities （78.0%）， and health outcomes （44.0%）. Health facilities in agricultural districts scored higher in both total score and average score on the organizational management dimension compared to non-agricultural districts. The excellence rate for the organizational management dimension was also higher in agricultural districts than in non-agricultural districts. There was no statistical significance in the total score， the score of each dimension， the overall excellence rate， and the excellence rate of each dimension among different types of health facilities （P>0.05）. ConclusionThe development of health facilities among government agencies， enterprises， and communities in Shanghai has begun to yield positive results. Health facilities in non-agricultural districts should actively draw on the experience of those in agricultural districts， particularly in organizational management， adjust development ideas and planning based on their own realities， so as to continuously improve the levels of development.

Objective To investigate the acoustic characteristics of monophthong vowels and compound vow-els articulation movement in patients with dysarthria.Methods A total of 24 patients aged 40～81 years old with dysarthria from hospitals,and 24 healthy adults aged 40～80 years old from communities in Shanghai were recrui-ted.The first and second formants(F1,F2)of monophthong vowels/a/,/i/,/u/were extracted from the speech samples,and mandibular distance,tongue distance,vowel space area(VSA)and vowel articulation index(VAI)were calculated.The slope of the second formant of compound vowels/ai/,/ua/,/uai/was extracted and calculat-ed.The acoustic parameters of two groups of subjects were compared under different tasks.Results Under the monophthong vowels task,F1 of/a/,F2 of/i/,mandibular distance,tongue distance,VSA and VAI in the pa-tients were significantly lower than those in the control group(P＜0.01).F2 of/u/was significantly higher than that in the control group(P＜0.01).F2 slope of/ai/,/ua/,/uai/was significantly lower than that of the control group(P＜0.05).Conclusion The space of monophthong vowels articulation movement was reduced in the pa-tients with dysarthria,presenting a state of aggregation.The speed of compound vowels articulation movement was decreased.