Female ; Pregnancy ; Humans ; Pre-Eclampsia/diagnosis*

Objective To investigate the risk factors with placental abruption in patients with preeclampsia.Methods Retrospective analysis on medical documents of 219 patients treated in Peking University Third Hospital from Jan.1994 to Dec.2008.Patients were divided into 3 groups, including 52 cases with severe preeclampsia terminated following placental abruption, 130 cases only with severe preeclampsia and 37 cases with unexplained placental abruption without preeclampsia.One hundred and multivariate regression analysis were used to identify the risk factors for placental abruption in patients with preeclampsia.Results (1) When compared with those in control group, univariate analysis showed that gravidity, parity, history of preeclampsia, second and third trimester pregnancy loss, history of autoimmune disease, chronic hypertension disease, lack of regular antenatal care, fetal growth restriction (FGR) and raises of umbilical artery Doppler resistance were risk factors associated with placental abruption.Logistic regression analysis showed that lack of a regular antenatal care ( OR = 45.348, 95% CI: 17.096 - 120.288,P = 0.000 ), FGR ( OR = 27.087, 95% CI: 5.585 - 131.363, P = 0.000 ) and second/third trimester pregnancy loss( OR = 16.068, 95% CI: 1.698 - 152.029, P = 0.015 ) were independent risk factors with placental abruption.(2) When compared with those in preeclampsia patients without placental abruption,the history of preeclampsia ( OR = 3.715,95% CI: 1.096 - 12.596, P = 0.035 ) and lack of a regular antenatal care( OR = 2.509,95% CI:1.173 -5.370,P =0.018) were risk factors for placental abruption in preeclampsia.Conclusion Lack of regular antenatal care, FGR, history of preeclampsia and second/third trimester pregnancy loss were risk factors associated with placental abruption in patients with preeclampsia.

Mitochondrial fatty acids ?-oxidation is a repetitive process of four steps which provides the major source of energy for heart, liver and skeletal muscle. Several enzymes are involved in this spiral cycle. The medium-chain acyl-CoA dehydrogenase ( MCAD) , the short-chain acyl-CoA dehydrogenase (SCAD) , the long-chain 3-hydroxy acyl-CoA dehydrogenase (LCHAD) and the carnitine-palmitoyl-CoA transferase Ⅱ ( CPT Ⅱ ) deficiency have been recognized as the most common inborn errors of metabolism and frequently reported in their association with sudden infant death ( SID) . The prevalent mutations in these genes need further investigation in different populations.

AIM:To study the efficacy and safety of Toric implantable contact lens (TICL) implantation in the treatment of patients with high myopia and astigmatism.METHODS: Totally 90 patients (178 eyes) diagnosed as this disease were selected in our hospital during September 2012 to September 2016 by the method of random.The UCVA, BCVA, refraction, astigmatism coefficient, corneal endothelial cell, intraocular pressure, manifest refraction examination were accessed and compared before and after 3 and 9mo of surgery.RESULTS: After 3 and 9mo of the surgery, the UCVA and BCVA were much higher than those before treatment, which the difference was statistically significant (P<0.05).We compared the refraction at 3mo (-0.52±0.23D) and 9mo (-0.54±0.16D), the astigmatism coefficient at 3mo (-0.39±0.23D) and 9mo (-0.33±0.56D) after treatment, and we found that the differences were not statistically significant (P>0.05).The corneal endothelial cells at 3 and 9mo after operation were compared with those of before treatment, and we found that the differences were statistically significant (P<0.05).The intraocular pressure of 3 and 9mo after operation was compared with that before operation, and we found that the differences were not statistically significant (P>0.05).CONCLUSION: TICL implantation in the treatment of patients with high myopia and myopic astigmatism has a more obvious clinical efficacy and safety and reliability.

Female ; Humans ; Polycystic Ovary Syndrome/therapy* ; Infertility, Female/therapy*

Objective To investigate the effect of clinical risk factors including maternal underlying medical conditions on the development of preeclampsia (PE) in order to improve and strengthen the early assessment of high clinical risk population of PE.Methods Clinical.observational data of patients with PE in Peking University Third Hospital from November 2008 to January 2011 were analyzed.Comparative analysis was made among medical conditions with PE (M-PE) sub-group and isolated PE (I-PE) sub-group and non-PE pregnancy with or without medical conditions (control group).Results Totally 159 cases,43.09％ (159/369) of total cases of PE had high clinical risk factors (multiple pregnancy and medical conditions) and 32.3％ (97/300) of singleton PE accompanied with medical conditions.The incidence of PE in singleton pregnancies with medical conditions was significantly higher than those without medical conditions [ 15.0％ (97/646) versus 4.45％ (210/4719),P ＜ 0.05 ].In M-PE sub-group,the average age [ ( 31.7 ± 4.5 ) versus ( 29.3 ± 5.2) year-old] and body mass index (BMI) in first trimester [ (26.0 ±5.6) versus (23.3 ± 3.7) kg/m2],the proportion with previous preeclampsia [ 11％ (11/97) versus 4.9％ (10/203) ] and pregnancy loss in third trimester [ 11％ ( 11/97 ) versus 3.0％ ( 6/203 ) ],were higher than those of I-PE sub-group ( all P ＜ 0.05 ).The onset of preeclampsia in M-PE sub-group was earlier than I-PE ( 32.9 versus 34.4 gestation weeks,P ＜ 0.05 ).The proportion serious cases of PE occurring before 32 gestational weeks were higher in M-PE than that of I-PE sub-group [ 45％ (44/97)versus 34.0％ (69/203),P ＜0.05].Multivariate regression analysis showed that previous history of late pregnancy loss and irregular prenatal care were clinical risk factors for early-onset PE whether early-onset was defined as ＜ 34 or ＜ 32 gestational weeks respectively (all P ＜ 0.05) ; medical conditions were risk factors for PE if early-onset was defined as ＜ 32 gestational weeks ( OR =1.718,95％ CI:1.005 - 2.937,P =0.048).Conclusions Multiple pregnancies and pregnancies with medical conditions exceed one-third of total subjects of PE.The onset of PE in subjects with maternal underlying medical conditions was earlier which is the subgroup should not be ignored.The difference of early pregnancy BMI may show the maternal heterogeneity in early onset and late onset of preeclampsia.Assessment of clinical risk factors including the underlying medical disorders for preeclampsia in early trimester should be strengthened.

Objective To investigate the relationship between potential maternal risk factors between potential maternal risk factors in different level hospitals as well as different prenatal care patterns and characteristics of preeclampsia. Methods A retrospective study of 300 preeclamptic singleton patients delivered in Peking University Third Hospital was performed.Patients were divided into three groups:regular prenatal care in tertiary hospitals (n =100),regular prenatal care in primary hospitals (n=81) and without prenatal care (n=119). The onset of preeclampsia and incidence of severe preeclampsia of different groups were analyzed. Non-parametric and Chi-square test were adopted for continuous and categorical variables respectively. Results (1) In total cases of preeclampsia subgroup (I-PE subgroup) and with chronic hypertension (CH subgroup),the diagnosis of preeclampsia was later in patient with regular prenatal care in tertiary hospital (patient-TH)[100,64 and 14 cases,37.1 (4.1),37.3 (1.7) and 36.3 (2.5) weeks respectively] than those with regular prenatal care in primary hospital (patient-PH) [81,54 and 9 cases,32.9 (6.7),33.8 (6.1)and 27.9(6.3) weeks respectively] (Z=72.29,51.30 and 14.58 respectively,P＜0.05) or the patient without regular prenatal care (patient-NP) [119,85 and 19 cases,31.6(6.6),31.9(6.7) and 30.3(4.7) weeks respectively] (Z=86.69,58.83 and 11.33 respectively,P＜0.05).The proportion of severe preeclampsia occurred earlier than 32 weeks [13.0％ (13/100) vs 55.5％ (66/119),9.4％(6/64) vs 50.6％(43/85),and 35.7％(5/14) vs 89.5％(17/19); x2=43.95,29.42 and 10.17respectively,P＜0.05] or earlier than 34 weeks [17.0％ (17/100) vs 65.5％ (78/119),14.1％(9/64) vs 61.2％(52/85) and 42.9％(6/14) vs 94.7％(18/19); x2 =47.71,31.18 and 10.61 respectively,P＜0.05] were lower in patient-TH than in patient-NP.(2) In patient-NP and patientPH,onset of preeclampsia was earlier in CH subgroup compared with I-PE subgroup (Z=26.61 and 22.82,P＜ 0.05). In patient-NP,the proportion of severe preeclampsia occurred earlier than 32 weeks (x2 =9.11,P＜0.05) or earlier than 34 weeks (x2 =7.95,P＜0.05) was higher in CH subgroup than in I-PE subgroup. Conclusions Regular prenatal care in tertiary hospital might effectively delay the onset of preeclampsia or severe preeclampsia,especially in patients with risk factors for preeclampsia. Assessment of risk factors for preeclampsia in early trimester should be strengthened and individualized prenatal care plan should be established.

Objective To study the location and level of relaxin receptor in placenta tissues of preeclampsia and normal pregnancy,and the relationship of relaxin receptor with pre-eclampsia.Methods Twenty-six placenta tissue samples from pregnant women with severe preeclampsia(study group),and 20samples from normal pregnancies(control group)were obtained.We detected the expression of relaxin receptor by immunohistochemistry and the expression of relaxin receptor mRNA by RT-PCR.Results In the placenta of control and preeclampsia groups,the leucine-rich repeat-containing G protein-coupled receptor(LGR7)was positively expressed.Relaxin receptor was located in the membrane of trophoblast cells.There were both strong signals on cytotrophoblastic cells and syneytiotrophoblast.The level of relaxin receptor in the control group was 0.912 ±0.003.and 0.625±0.037 in the preeclampsia group.Thedifference between the two groups was obvious(P＜0.01).In the control group,the level of relaxin receptor mRNA was 0.776±0.021;in the preeclampsia group,it was 0.393±0.075.The difference was obvious(P＜0.01).Conclusion Decrease in the expression of relaxin receptor at placenta is related with the occurrence and development of preeclampsia.

Bone Neoplasms ; Female ; Humans ; Middle Aged ; Waldenstrom Macroglobulinemia

Decision Making, Organizational ; Disasters ; Earthquakes ; Humans ; Public Health Practice ; Stress Disorders, Post-Traumatic