Objective To evaluate the values of maternal serum levels of lipid and uric acid at second trimester in predicting preeclampsia,gestational diabetes mellitus and macrosomia. Methods Concentrations of selected metabolic markers including total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,apolipoprotein AI,apolipoprotein B and uric acid were examined in 1000 healthy singleton primiparous who accepted regular prenatal healthcare in Naniing Drum Tower Hospital,at 20 weeks of gestation from June 2009 to January 2010.All the pregnant women were followed up to their deliveries.Pregnancy complications,such as preeclampsia and gestational diabetes mellitus (GDM),the data of maternal and neonatal outcomes such as gestational age at delivery,neonatal birthweight were recorded.Relationship between adverse outcome and blood lipid,uric acid levels was analyzed by Logistic regression,and the risk factors were confirmed; predictive values of those sensitivity and specificity were calculated by receiver operating characteristic curve. Results Among the 1000 pregnant women, 61 (6.1％) developed preeclampsia and 100 (10.0％) developed GDM.The mean gestational age of delivery was (39.3±1.2) weeks,and the incidence of preterm delivery was 1.5％ (15/1000).The mean birthweight was (3389.6±4 422.8) g,and the prevalence of macrosomia was 8.9％ (89/1000).Women who had elevated triglyceride levels had a 3.42-fold increased risk of preeclampsia (95 ％ CI:1.88-6.22,P =0.000) and 2.12-fold increased risk of GDM (95％ CI:1.38-3.35,P =0.001).Hyperuricemic women experienced a 2.09-fold increased risk of preeclampsia (95％CI:1.24-3.53,P=0.005) and 2.22-fold increased risk of GDM (95％CI:1.32-3.43,P=0.002).Women who had decreased high density lipoprotein-cholesterol level experienced a 2.34-fold increased risk of preeclampsia (95 ％ CI:1.20-4.55,P =0.011),2.03-fold increased risk of GDM (95 ％ CIr:1.33-3.11,P =0.001 ) and 1.67-fold increased risk of macrosomia (95％CI:1.06-2.64,P=0.026).The area under receiver operating characteristic curve of these metabolic markers was 0.56-0.65, the sensitivity was 28％-82％ and the specificity was 34％-85％. Conclusions Hypertriglycemia,hyperuricemia,and hypo high density lipoprotein-cholesterolcmia at 20 weeks of gestation might relate to preeclampsia,GDM and macrosomia,but the predictive values of them are limited.

We used SDS-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting of monoclonal antibody (McAb) J28 and peanutagglutinin (PNA) for detecting fetoacinar pancreatic protein (FAP) in extracts of 20 cases of fetal pancreas, 5 of pancreatic cancer and 4 of normal pancreas. The result showed that fetal pancreas and pancreatic cancer had a same level band about 110000 in Commassie blue stain, but absent in normal pancreas. The band could react with both McAb J28 and PNA PNA also could react with smaller glycoprotein in pencreatic cancer. It is suggested that McAb J28 and PNA combine with different sites of FAP.

This histochemical binding of horseradish peroxidase labeled peanut agglutinin (HRP?PNA) to paraffin sections of 18 cases of pancreatic cancer was investigated with 5 case of normal pancreas and 8 pancreatitis as the control. The PAN receptor was not found in the normal pancreas, but it appeared in 15 cases of pancreatic cancer (82%). Three cases of pancreatitis presented positive stainings of PNA binding (37%). There were 3 kinds of PNA binding forms: (1) linear distribution along the gland of carcinoma cells; (2) round staining with the ductal epithelium; and (3) diffuse scattering with an increased dot staining. There was a good relationship between the staining degree and cell differentiation. The positive staining increased when the cell was transformed from inflammation to carcinogenesis, and decreased from well differentiation to poorly differentiation.

Objective To investigate whether maternal antibody to hepatitis B surface antigen (anti-HBs)in infants may interfere with the antibody response to hepatitis B vaccine. Methods Infants from singleton pregnant mothers,who delivered at full term at the Affiliated Drum Tower Hospital of Nanjing University Medical School from October 2006 to January 2007,were divided into two groups based on their mothers'status of anti-HBs(43 positive and 29 negative).All infants were vaccinated with hepatitis B vaccine at birth and one month thereafter.Serum anti-HBs were quantitatively determined for the mothers before delivery and for infants in cord blood at delivery and in serum at the age of 1 and 3.5 months. Results Anti-HBs of all 43 newborns in the positive group were positive in cord blood with the coefficiency of 0.98 to the maternal serum anti-HBs level(t=39.05,P<0.01).Forty-two out of the 43 infants remained anti-HBs positive at the age of 1 month.Anti-HBs was negative both at birth and 1 month old in infants of the negative group.However,all infants in both groups were anti-HBs positive at 3.5 months of age,while the average concentration of anti-HBs in infants of the negative group was significantly higher than that of the positive group [(466.9±86.7)mIU/ml vs(151.2±23.1)mIU/ml,t=2.72,P=0.011].Among the 5 infants whose maternal anti-HBs level>1000 mIU/ml,3 did not produce active antibodies against two doses of hepatitis B vaccination. Conclusions Passively acquired maternal anti-HBs in infants can inhibit the active antibody response to hepatitis B vaccine,and the extent of this effect is associated with maternal anti-HBs level.

Objective Trachoma is a preventable infective eye disease worldwide. The incidence rate of active trachoma in children can reflect the epidemical degree of trachoma in the location. This study tried to assess the prevalence and risk factors of trachoma in students at primary school in Wuqiang County, China. Methods An epidemiological survey was carried out in Wuqiang County in 2006. The investigators were from Wuqiang County Hospital and Beijing Tongren Eye Center and received special training. Primary school children aged 6- to 16-years-old were selected by a cluster sampling with the class shift as the sampling unit. Trachoma was clinically examined under the slim lamp and assessed based on the simplified classification for trachoma proposed by the World Health Organization (WHO). The C. Trachomatis inclusion body was detected from conjunctival swab of patients with trachoma using enzyme immunoassay and polymerase chain reaction (PCR). The questionnaire was performed in the examinees and parents. The survey followed the Declaration of Helsinki and written informed consent was obtained from the examinees. Results A total 379 cases with trachoma were determined in 1622 primary school examinees with the prevalence 23. 4% (95% CI:25. 5% -21. 3%) .including follicular trachoma in 81% and intense trachoma in 19% . The overall prevalence of trachoma was higher in female students than male ones (25. 8% versus 20. 9%, P = 0. 020). No inclusion body of the conjunctiva was observed. Sixty-four cases (38. 1%) presented the positive response for C. Trachomatis antigen by enzyme immunoassay, and 109 cases (64. 9%) were positive response by PCR. The multiple factors logistic regression analysis showed the risk factors for active trachoma included living location, suburbs and female and age(0R =0.763, 1.299, 1. 147 respectively). Conclusion Trachoma showes a disseminating procedure among primary school children in Wuqiang County. The prevention strategy should be made for related risk factors.

To investigate the impact of maternal hepatitis B virus (HBV) carrier state on twin pregnancy outcomes. Methods From January 2004 to December 2012, 569 women with twin pregnancy were hospitalized in Nanjing Drum Tower Hospital. Thirty-two women positive for hepatitis B surface antigen (HBsAg)(negative for hepatitis B e antigen, with normal liver function before conception)were included in the HBsAg-positive group and the other 537 women were included in the HBsAg-negative group. The pregnancy outcomes of the two groups were compared by t test and Chi-square test. The risk factors for neonatal birth weight were analyzed by multivariate regression analysis. Results Compared with the HBsAg-negative group, the HBsAg-positive women had a higher incidence of abnormal liver function (alanine aminotransferase≥50 U/L) [18.8% (6/32) vs 5.8% (31/537), χ2=6.367, P=0.012]. The incidence of gestational diabetes mellitus was 21.9% (7/32) in the HBsAg-positive group, which was higher than in the HBsAg-negative group [11.6% (62/537)], although the difference was not significant (χ2=2.132, P=0.144). The incidences of intrahepatic cholestasis of pregnancy,hypertensive disorders complicating pregnancy, premature rupture of membranes, placenta previa, fetal distress, postpartum hemorrhage, preterm birth, caesarean section, umbilical cord around the neck, meconium-staining amniotic fluid and neonatal asphyxia were no statistical difference between two groups (all P<0.05, respectively). Multivariate regression analysis showed that gestational diabetes mellitus (β=67.869, 95%CI: 0.494-135.244, P=0.048), maternal age (β=6.592, 95%CI: 2.020-11.880, P=0.006) and gestational age (β=164.069, 95%CI:154.426-173.712, P<0.01) were risk factors for neonatal birth weight, but not the maternal HBsAg-positive status (β=78.864, 95%CI: -16.950-174.678, P=0.107). Conclusion Twin pregnancy and HBV carrier state increase the risk of abnormal liver function, but not other adverse pregnancy outcomes and newborn diseases.

Objective To assess the protective effect of vaccination in routine application on hepatitis B virus (HBV) exposed infants and to clarify whether hepatitis B immunoglobulin (HBIG) administration of pregnant women may reduce the risk of maternal-fetal transmission of HBV. Methods Serum samples of 6398 pregnant women at gestation of 15-20 weeks from 6 urban and 8 rural areas across Jiangsu province were previously tested for serologic markers of HBV by ELISA from July 2002 to August 2004. In this study, infants born to 419 HBV carrier mothers were taken as the study group, while infants born to 453 non-carrier mothers were taken as the control group by stratified random sampling. They were followed-up and screened for HBV markers during October 2009 to March 2010. Information including HBIG administration during pregnancy, HBV vaccination and HBIG administration of the infants were collected. χ2 test or Fisher′s exact method were used to compare the rates and the comparison of the means was by t test. Results The follow-up rates of the study group and control group were 71.12% (298/419) and 72.41% (328/453), respectively. Of the 298 infants born to HBV carrier mothers, 11 (3.7%) were positive for HBsAg, while none of the 328 infants born to non-carrier mothers was HBsAg positive (χ2=12.32, P<0.01). All of the 11 children were born to mothers with both HBsAg and HBeAg positive, and nine of the 11 children were not injected HBIG or not immunized with hepatitis B vaccine within 24 hours after birth, with only one received regular vaccination and detailed information was unknown in one case. The positive rates of anti-HBs in the study group and the control group were 69.46% and 69.21% respectively (χ2=0.01, P=0.95). HBsAg positive rate of the children born to pregnant women treated with HBIG during late pregnancy (n=92) was 2.17% (n=2), whereas that in the children born to women not treated with HBIG (n=197) was 4.57% (χ2=0.98, P=0.51). Conclusions The protective effect of immunoprophylaxis in routine application against perinatal HBV infection in Jiangsu province is good. Efforts are required to emphasize the importance of HBIG administration in infants born to HBV carrier mothers, especially in HBeAg positive mothers within 24 hours after delivery. Treatment of HBsAg positive pregnant women with HBIG in third trimester would not decrease the risk of maternal-fetal transmission of HBV.

Objective To investigate the different expression of microRNA-155 (miR-155) and cysteine-rich 61 (CYR61) in human placentas between severe preeclamptic and normal pregnancies.Methods Placentas were obtained from severe preeclamptic and healthy control pregnant women (n=18 for each group) at 36～40 gestational weeks. The expressions of miR-155 and CYR61 mRNA were assessed by real-time quantitative reverse transcription-polymerase chain reaction, and the levels of CYR61 protein were tested by Western blot. Results Compared with the control group, the miR-155 expression was increased in placentas from severe preeclampsia groups ( 165. 7 ± 16. 4 vs 527.9±49.1,t=7.00, P＜0.01), and the CYR61 mRNA expression (31.7±2.7 vs 16.4±1.2,t=5.10,P＜0. 01), as well as the CYR61 protein expression (36.4±1.5 vs 19.7±1.2,t=36.26, P＜0.01 ) were decreased. There was a significantly negative correlation between the expression of miR-155 and CYR61 mRNA within both groups (preeclamptic group: r=-0.52, P＜0.05;control:r=-0.57, P＜0.05). Conclusions Up-regulation of placental miR-155 in severe preeclampsia may be related to the decreased expression of CYR61. Both miR-155 and CYR61 may contribute to the disorders of placental angiogenesis in severe preeclampsia in human.

Objective To evaluate the effect of domestic wire-reinforced epidural catheter on the occurrence of adverse events during epidural block.Methods Three hundred ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 41-78 kg,scheduled for elective operations under combined spinal-epidural anesthesia,were randomly divided into 3 groups (n =100 each):polyvinyl chloride epidural catheter group (group A),imported wire-reinforced epidural catheter group (group B) and domestic wire-reinforced epidural catheter group (group C).Combined spinal-epidural anesthesia was performed routinely.The corresponding epidural catheter was inserted in each group.The catheterization without difficulty,paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,intravascular catheter insertion,injection obstruction,easiness during removal of the catheter,bleeding after removal,postoperative paresthesia and epidural hematoma within 1 week after operation were recorded.Results Compared with A group,the incidences of paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,injection obstruction and postoperative paresthesia were significantly decreased (P ＜ 0.05),and no significant change was found in the other parameters in B and C groups (P ＞ 0.05).There was no significant difference in all the parameters between B group and C group (P ＞ 0.05).Conclusion Domestic wire-reinforced epidural catheter can decrease the occurrence of catheterization-induced damage to the nerve and blood vessels and the efficacy is comparable with that of imported wire-reinforced epidural catheter.

Objective To investigate the incremental value of 99Tcm-MIBI SPECT/CT imaging in the preoperative diagnosis of PHPT.Methods Forty-one patients (13 males,28 females,age range:14-82 (50.0± 13.2) years)with PHPT were retrospectively enrolled.99Tcm-MIBI dual-phase planar scan,SPECT/CT imaging,CT and neck ultrasound were performed before surgery.All patients had pathological results.McNemarx2 test was used to compare the detection rates of the four imaging methods.ROI method was applied to calculate the uptake ratio (T/NT) and Pearson correlation analysis was used to evaluate correlation between T/NT and serum intact PTH,Ca,the lesion volume measured after parathyroidectomy.Results A total of 42 parathyroid lesions were confirmed by pathology.There were 39 patients with parathyroid adenoma (2 with double adenomas,and 37 with single adenoma containing 2 ectopic adenomas) and 1 patient with parathyroid carcinoma.The detection rate of planar scan,SPECT/CT imaging,CT and neck ultrasound were 78.0％ (32/41),92.7％ (38/41),73.2％ (30/41) and 70.7％ (29/41) respectively.Detection rate of SPECT/CT imaging was significantly higher than that of planar scan,CT or ultrasonography (x2 =4.17,4.90,5.82,all P＜0.01).However there were no remarkable differences between the detection rate of planar scan and that of CT or ultrasonography (x2=0.08,0.36,both P＞0.05).Detection rates of CT and ultrasonography were not significantly different either (x2 =1.90,P＞0.05).T/NT in delayed planar imaging were significantly correlated with PTH,Ca and the lesion volume measured after parathyroidectomy (r =0.56,0.54,0.56,all P＜0.01).Conclusions Compared with 99Tcm-MIBI dual-phase planar scan,CT and ultrasonography,SPECT/CT imaging could be of important clinical value for preoperative localization of PHPT because of its higher detection rate and accurate anatomical localization ability.