Along with the development of screening, diagnostic and therapeutic technologies, the spectrum of fetal abnormalities has been constantly expanded. This brings increasing challenges to the clinical diagnosis and treatment, including but not limited to optimizing multidisciplinary cooperation, options of prenatal genetic testing methods, the uncertainty in the transition period of new technology implementation, and the comprehensiveness of genetic counseling before and after testing. We discuss the above issues aiming to meet the dilemma and achieve the leap of fetal medicine to the advanced level through multidisciplinary collaboration resulting in the improvement of diagnosis and treatment efficiency.

Objective To investigate the expression of glucose transporters(GLUTs)in placentas of pregnant women with abnormal glyeometabolism,and to explore its effect on glucose transport between mother and fetus and its relation with the birth weight.Methods Placentas of 41 pregnant women with abnormal glycometabolism(7 cases of DM,10 GDM A1,10 GIGT and 14 GDMA2)and 15 normal pregnant women as control were selected.The expression of GLUT1 and GLUT3was detected by immunohistochemistry.The birth weight was measured at delivery.Results GLUT1 was expressed in the syncytiotrophoblasts and cytotrophoblasts,whereas GLUT3 in some endothelial cells.The expressions of GLUT1 and GLUT3 were significantly different among the five groups(P＜0.01).Positive correlation was shown between the GLUT1 expression and the birth weight(rs=0.532,P＜0.01),but not in GLUT3 expression.Conclusions The expression of GLUT1 and GLUT3 in placentas of pregnancy with abnormal glycometabolism is enhanced,and GLUT1 may play a predominant role in the fetal glucose uptake.

Objective To observe the changes of serum bilirubin(BIL) and high-sensitivity C-reactive protein(hs-CRP) after percutaneous coronary intervention(PCI) in acute myocardial infarction(AMI) patients.Methods The TBiI,IBil,DBil and hs-CRP levels in serum were detected in 60 AMI patients within 6 hours after attack with immunoturbidimetry before PCI,at the point of operation,6h,12h,24h,72h and 7d afer PCI.30 healthy persons were chosen as normal control.The two groups were compared.Results The hs-CRP level was increased gradually with time in AMI patients after PCI.The peak value was at 72h after PCI and it was significantly higher than those in the normal group( P ＜ 0.05 ).The TBil,IBil,DBil levels at pre-PCI point were significantly lower than the normal group (P ＜ 0.05).These index were gradually recovered to the normal group and no significancet differences between them (P ＞ 0.05 ).The coefficient correlation of hs-CRP and TBil,IBil,DBil were 0.44 ( P ＞ 0.05 ).Conclusion The TBil,IBil,DBil and hs-CRP levels in short time after attack of AMI with PCI presented a dynamic changing and recovered to the normal level.No associativity was observed between them,but as the follow-up index,it was significant for the disease turnover.

Objective To explore the diagnostic value of cystatin C(CysC) on early kidney damage in primary hypertension. Method To detect the CysC, BUN, Scr, UA in Ⅰ (31), Ⅱ (31), Ⅲ (31) stage of primary hypertension patients and 40 control cases ,then compared these results with normal control. Results The level of CysC in serum of Ⅰ , Ⅱ, Ⅲ stage of primary hypertension was(0. 81 ± 0. 16), (0. 94 ± 0. 23), (1.19 ± 0. 46) mmg/L, all of them were higher than normal control (0. 75 ± 0. 10) mg/L. The difference of CysC between Ⅱ、Ⅲ stage of primary hypertension and normal control was significant (t = 4. 195, t = 4. 446, P ＜ 0.01). The level of CysC in Ⅲ stage of primary hypertension was higher than in Ⅰ , Ⅱ stage(t = 4. 382 ,t = 4. 250,P ＜ 0.01). Significant positive correlation was observed between CysC and Scr(r = 0. 713,P＜0.01) ,CysC and UA(r=0. 45,P ＜0.01). Conclusion Serum CysC was a sensitive and reliable indicator on early kidney function damage in primary hypertension.

Objective To explore the metabolic phenotype of the adult offspring rats with maternal severe hyperglycemia during pregnancy and overfeeding in early life. Methods The adult Wistar rats were administered intraperitoneally with 20% Streptozotocin (STZ, 50 mg/kg) on day 5 of pregnancy to induce severely gestational diabetes mellitus (SDM) model (blood glucose ≥20 mmol/L). Early postnatal overfeeding models were established through reduction of the number of newborn rats fed by one mother rat. Offsprings were divided into 3 groups according to maternal blood glucose level during the pregnancy and feeding patterns during the lactation period (1) control pups (CP) :maternal euglycemia was achieved during pregnancy and eight pups fed by one mother rat; (2)SDM-normal feeding group: SDM mothers and 8 pups fed by one mother rat;(3)SDM-overfeeding group:SDM mother and 4 pups fed by one mother rat. All pups were fed by standard laboratory chow adlibitum after weaning at 3 weeks of age. The body weight of all pups were measured weekly after weaning. At the age of 26 weeks, the systolic blood pressure (SBP), diastolic blood pressure (DBP) ,heart rate (HR) and metabolic markers, including fasting plasma glucose (FPG), fasting insulin (FINS), total triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholestrol (LDL-C)and high density lipoprotein-cholestrol (HDL-C) were measured in all 3 groups. ANOVA and LSD test were applied in statistical analysis. Results The average plasma glucose level was significantly higher in the SDM mothers than in the controls [(28.34±5.14) mmol/L va (6.25±1.41) mmol/L,P＜0.05]. After weaning at 3 weeks, the weight of SDM-overfeeding group and SDM-normal feeding group was lighter than that of CP group [(43.63±4.83) g, (31.45±10.21) g vs (55.75±8.41) g,P＜0. 05], meanwhile, that of the SDM-overfeeding group were heavier than that of the SDM-normal feeding group (P＜0. 05). Pups in SDM-overfeeding group exhibited catch-up growth during the lactation period, and those in SDM-normal group showed catch-up growth at both lactation period and childhood. At 26 weeks of age, the systolic blood pressure and TG level of pups in SDM-normal feeding and overfeeding group were (153.31 ± 13.91) mm Hg and (147.21 ± 12.29) mm Hg, and (0. 73±0. 22) mmol/L and (0. 71±0.49) mmol/L, respectively, which were higher than those of the CP group [( 132.21 ± 11.26) mm Hg, and (0. 37 ± 0. 08) mmol/L, P＜0.05], but no significant difference was found between the two SDM groups (P＞0.05). There was no difference in FPG levels among the three groups, but the FINS level and HOMA-IR in the SDM-overfeeding group were higher than in the SDM normal feeding and CP group [( 12. 552 ± 3.260) mU/L vs (9.067 ± 1.782) mU/L and (8.590± 0.806) mU/L, 2.400± 0.624 vs 1.797 ± 0.508 and 1.729 ± 0.246; P＜0.05].Conclusions Fetal exposure to maternal severe hyperglycemia during pregnancy may lead to low birth weight infant who will exhibit postnatal catch-up growth. This may lead to the increased risk of metabolic syndrome in the offspings when they grow up, and this process would be accelerated by early overfeeding.

Objective To analyze the immunological feature of the multiple myeloma. Methods The serum of 117 cases were detected by serum protein electrophoresis and immunofixation electrophoresis;and analyzed quantitatively immune globulin(IgG、IgA、IgM) ,total protein and albumin. Results Monoclone protein peak was found in 67 patients out of 117 patients tested(57.3%) ,it located mainly at γ border. Immunoglobulin G was found in 62 patients out of 117 patients tested(53.0%). Immunoglobulin A was 19 cases(16.3%) ,Immunoglobulin M was 12 cases(10. 1%) ,DL was 2 cases(1.7%) ,free light chain was 22 cases(18.8%). Homotypic immunoglobulin level increased notably and non-correspond constituent was low in immunoglobulin test. The protein quantified displayed that total protein increased and albumin decreased in different level. Conclusion The seroimmunological index played a crucial role in diagnois,clinical stage and prognosis of MM.

Objective To evaluate the expression and distribution of Toll-like receptor 4 (TLR4) in term placentas of women with gestational diabetes mellitus (GDM). Methods Placental samples were collected from 36 normal full-term singleton pregnant women (control group) and 33 full-term singleton pregnant women with GDM who had elective cesarean section in Peking University First Hospital between November 2014 and June 2015. Immunohistochemical assay was used to detect the expression and distribution of TLR4 in placental tissues. T test was used to compare the expression of TLR4 in various cell types of placenta by semi-quantitative analysis. Results (1) TLR4 was expressed in the cell membrane, cytoplasm or nuclei of trophoblast, decidual cells, vascular endothelial cells and amniotic epithelial cells of term placentas. (2) Compared with the control group, the expression of TLR4 was significantly enhanced in trophoblast and decidual cells of GDM women (0.38±0.01 vs 0.31±0.01, 0.39±0.01 vs 0.34±0.01, t=5.218 and 4.525, all P<0.01). Moreover, the change of TLR4 average optical density was most significant in trophoblast. (3) There was no difference in the expression of TLR4 in vascular endothelial cells and amniotic epithelial cells in term placentas of GDM women compared with the control group (all P>0.05). Conclusions The expression of TLR4 is different in various cell types of GDM term placentas.

Karyotype analysis has been considered as the key tool for prenatal diagnosis .Although it is cost-effective, it has great challenge to meet the growing demand of efficiency and quality in clinical settings.To improve the effeiciency and detection quality , cytogenomic microarray analysis ( CMA ) is developed, with high detection rate.However, traditional karyotype analysis at different resolution should also be used as the reference for CMA .

Objective:To develop a Subject Interest Inventory (SII) for senior high school students.Methods:The SII was structured by incorporating rational-theoretical and empirical techniques. The item functionality, scale reliability and validity were established.Results:Final version was a 90-item scale measuring student's 9 subject interests. The internal consistency and test-retest reliability were acceptable. The structure of SII was confirmed by intercorrelations among the subscales and by exploratory factor analysis. Evidence of concurrent validity was supported by: (a) the correlations between the interests and the scholastic achievements; (b) the gender differences in subject interest and in the correlations between the interests and the achievements; and (c) the different interests scores between the art students and the science students.Conclusion: These results suggest that the structure of SII is acceptable, and that its reliability and validity indexes are sound.

Objective To investigate whether oral propofol has any inhibitory effects and dose-response relationship on the pain inducing tissue injury in mice. Methods The effect of propofol on pain was observed in formalin test and acetic acid writhing test in mice. Formalin was injected subcutaneously into the plantar surface of one hind paw. Spontaneous nocuous responses were immediately scored by counting the number of flinches of the injected hindpaw at every 5-minute interval during a 60-minute period. The number of writhing caused by intraperitoneal injection of 0.6% acetic acid was also observed in mice. Results Oral propofol in a dose of 100mg/kg did not significantly inhibit nocuous stimulation. With higher doses, propofol inhibited both the phases 1 and 2 of persistent spontaneous pain induced by subcutaneous formalin injection. Orally taken propofol also inhibited the number of writhing after intraperitoneal acetic acid injection in a dose dependent manner. Conclusion Oral propofol is effective in inhibiting pain induced by formalin and acetic acid.