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.

34 weeks. The clinical data were evaluated. The relations between the pattern of end organ damage and maternal outcomes and perinatal mortality and morbidities were analyzed. Results 71. 70% of all 191 S-PE cases were involved in single organ systemic damage, and the rate was higher than those involved in two or more end organ damage. In those women with single end organ damage, placenta (55. 26%) and liver(15. 79%) were the two main organs concerned in early onset group; while in late onset group they were placental(18. 42% , compared with the early onset group P

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.

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 investigate the risk factors for severe and mild preeclampsia (PE) in women with irregular prenatal care,and to identify practical measures to reduce the occurrence of severe PE.Methods A retrospective study of 222 PE patients with irregular prenatal care,who delivered in Peking University Third Hospital from January 2007 to December 2011,was performed.The risk factors for PE and the status of prenatal care were analyzed.The non-parametric test,Chi-square test,Fisher's exact test,trendy Chi-square test and Logistic regression analysis were used for statistical analysis.Results There were 207 (93.2％) cases of severe PE and 15 (6.8％) cases of mild PE.In 207 severe PE patients,there were 95 cases (45.9％) of early-onset PE (diagnosed before 32 gestational weeks) and 112 cases (54.1％) of late-onset PE.In the 15 mild PE patients,there were two early-onset cases and 13 late-onset cases.The percentage of early-onset cases in severe PE patients was higher than that in mild PE patients [45.9％ (95/207) vs 2/15,x2=6.027,P=0.015].After excluding 9 cases without any prenatal care,213 PE patients were analyzed,and it was found that the proportion of severe PE diagnosed in hospitals of grade 3,2 and 1 were significantly different [5/9,94.2％ (131/139) vs 96.9％ (63/65),x2=8.600,P=0.003].Compared with mild PE patients,the prenatal care interval for PE diagnosis in severe PE patients was longer [M(Q),8.0(4.0) vs 4.8(4.4) weeks,Z=2.695,P=0.007];the frequency of prenatal care after 20 gestational weeks was less [1(1) vs 3(3) times,Z=-4.195,P=0.000];the gestational week of PE diagnosis and referral to grade 3 hospitals were earlier [32.4(5.6) vs 35.4(4.3) weeks,Z=-3.075,P=0.002;33.1(5.3) vs 35.4(3.9) weeks,respectively,Z=-2.608,P=0.009];and the interval between PE diagnosis and referral was longer [0.1 (0.7) vs 0.0(0.0) weeks,respectively,Z=2.904,P=0.004].Multivariate logistic regression showed that the frequency of prenatal care after 20 gestational weeks was an independent risk factor for severe PE (OR=0.115,95％CI:0.046-0.285,P=0.000).Conclusion In women without regular prenatal care,the onset of severe PE is related to low-level prenatal hospital care,lack of prenatal care after 20 gestational weeks and longer prenatal care intervals as well as referral to grade 3 hospitals.

Objective To investigate the oxidative stress and inflammation in trophoblast cells stimulated by different chain length fatty acids.MethodsSerum-free trophoblast cells cultured in vitro were divided into five groups,which were incubated with DMEM medium without free fatty acid (F-FFA),short chain fatty acids (SC-FFA),medium chain fatty acids (MC-FFA),long chain fatty acids (LC-FFA),very long chain fatty acids (VLC-FFA).Then cells in each group were stimulated by DMEM medium,reduced form of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase inhibitor (apocynin) and p38 mitogen-activated protein kinases (p38MAPK) inhibitor (SB203580) and were subdivided as each FFA plus-DMEM group, plus-NADPH-Ⅰ and plus-p38MAPK-Ⅰ groups.Expressions of mRNA and protein of p38MAPK and cyclooxygenase 2 (COX-2) in trophoblast cells were detected by real-time PCR and western blot.Results (1) The mRNA expression of p38MAPK in LC-FFA + DMEM,VLC-FFA + DMEM,LC-FFA + NADPH-Ⅰ,LC-FFA + p38MAPK-Ⅰ,VLC-FFA + NADPH-Ⅰ,VLC-FFA + p38MAPK-Ⅰ group were 4.56 ±0.28,22.65 ±2.40,0.87 ±0.06,1.02 ±0.15,19.87 ± 1.93,10.22 ±0.75 separately,and the protein expressions were 0.79 ± 0.02,0.93 ± 0.10,0.43 ± 0.06,0.44 ± 0.19,0.79 ± 0.10,0.81 ±0.14.Compared with other groups,the mRNA and protein expressions of p38MAPK in LC-FFA + DMEM,VLC-FFA + DMEM group were increased ( P ＜ 0.05 ).Compared with LC-FFA + DMEM group,mRNA and protein expressions of p38MAPK in LC-FFA + NADPH-Ⅰ and LC-FFA + p38MAPK-Ⅰ group were significantly decreased (P ＜ 0.05 ).Compared with VLC-FFA + DMEM group,mRNA and protein expressions of p38MAPK had no difference in VLC-FFA + NADPH-Ⅰ group (P ＞ 0.05 ),mRNA expression of p38MAPK in VLC-FFA + p38MAPK-Ⅰ group was significantly decreased (P ＜ 0.05 ),but there was no difference in protein expression ( P ＞ 0.05).(2) The mRNA expression of COX-2 in LC-FFA + DMEM,VLC-FFA +DMEM,LC-FFA + NADPH-Ⅰ,LC-FFA + p38MAPK-Ⅰ,VLC-FFA + NADPH-Ⅰ,VLC-FFA + p38MAPK-Ⅰ group were 3.97 ±0.03,39.08 ±0.63,0.99 ±0.13,0.98 ±0.18,20.93 ±3.70,13.46 ± 2.31 separately,and the protein expressions were 1.32 ± 0.20,1.33 ± 0.25,0.59 ± 0.13,0.58 ± 0.30,0.88 ± 0.18,0.91 ± 0.24.Compared with other groups,mRNA and protein expressions of COX-2 in LC-FFA + DMEM and VLC-FFA + DMEM group were significantly increased ( P ＜ 0.05 ).Compared with LC-FFA + DMEM group,mRNA and protein expressions of COX-2 in LC-FFA + NADPH-Ⅰ and LC-FFA +p38MAPK-Ⅰ group were decreased ( P ＜ 0.05 ).Compared with VLC-FFA + DMEM group,mRNA and protein expressions of COX-2 in VLC-FFA + NADPH-Ⅰ and VLC-FFA + p38MAPK-Ⅰ group were all decreased ( P ＜ 0.05 ).( 3 ) The correlation analysis showed that there were significantly positive correlations between the mRNA and protein expressions of p38MAPK and COX-2 in LC-FFA group ( P ＜ 0.05 ).There were significantly positive correlations in protein expression ( P ＜ 0.05 ),but no conrelation in the mRNA expression between p38MAPK and COX-2 in the F-FFA,SC-FFA,MC-FFA,VLC-FFA groups (P ＞ 0.05).ConclusionsThe oxidative stress and inflammation may exist in trophoblast cells which were stimulated by LC-FFA and VLC-FFA.p38MAPK signal transduction pathway may contributed in this process.

Objective To explore the best serum-free cultural way in neural stem cells from the hippocampus of the newborn rats and observe the characteristics of growth,proliferation,and induced differentiation of neural stem cells.Methods The neonatal rats′ hippocampus tissues were dissociated mechanically.The cells were cultured in the serum-free cultural medium which were added separately basic fibroblast growth factor(bFGF),epithelium growth factor(EGF),bFGF+EGF by suspended cultural way.The neural stem cells were identified by nestin immunofluorescence.After induced differentiation of embryonic cow serum,the differentiated cells were identified.Results The serum-free medium added bFGF and EGF could perfectly induce neural stem cells to proliferate and the differentiated cells expressed the specific antigen of neurons,astrocytes and oligodendrocytes.Conclusion The serum-free medium with bFGF and EGF can be used to culture neural stem cells from hippocampus tissue of rats in vitro.

Objective To investigate the relation of pelvic three-dimensional conformal radiotherapy(3D-CRT) target with rectal dose distribution and irradiation volume in cervical cancer.Methods In 45 patients with cervical cancer(Ⅱa-Ⅲb) treated in our department from September to December 2006,we compared rectal dose distribution in different treatment plans: conventional radiation,4-field box radiation,4-field oblique radiation and 5-field radiation,and studied the relationship between rectal irradiation volume and dose in the target area.Results Compared with that of the other models,the dose distribution of CTV in 3D-CRT was relatively poor although it could satisfy the demand of treatment;dose distribution of D90,D80 and D50 in the radiated rectum differed significantly(P

OBJECTIVETo study the inhibitory effect and mechanism of Ganoderma lipsiense extract (GLE) on the growth of triple-negative breast cancer (TNBC) cell line MDA-MB-231-HM in a mouse model.

METHODSThe mouse model of TNBC was established by subcutaneous injection of 1.5 x 10(6) of MDA-MB-231-HM cells into BALB/c-nu mouse. Twenty successfully modeled mice were divided into the GLE group and the negative control group according to random digit table, 10 in each group. GLE (0.2 mL 100 mg/mL) was peritoneally injected to mice in the GLE group, while equal dose of normal saline was peritoneally injected to mice in the negative control group. The medication was administered once per 3 days and discontinued after 45 days. The CD34 expression was detected using immunohistochemical assay for counting microvessels. Meanwhile, expressions of thrombospondin 1 (TSP-1) and cyclin D1 were detected using immunohistochemical assay.

RESULTSThe average weight was obviously lower in the GLE group than in the negative control group [(0.33 ± 0.16) g vs (0.68 ± 0.37)g, P < 0.05]. The tumor inhibition rate was 51.4% in the GLE group. The volume of transplanted tumor was obviously lesser in the GLE group than in the negative control group (P < 0.05). Results of immunohistochemical staining showed, the microvessel density (MVD) under every field was (20.7 ± 2.1), TSP-1 positive cell count was (66.2 ± 9.2), cyclin D1 positive cell count was (33.8 ± 16.4) in the GLE group, and they were 34.0 ± 2.0, 24.0 ± 6.6, and 168.2 ± 32.6, respectively in the negative control group. There was statistical difference in all indices between the two groups (P < 0.05).

CONCLUSIONGLE could inhibit malignant proliferation of tumor cells by suppressing angiogenesis of blood vessels in tumor tissues and regulating cell cycles, thereby inhibiting TNBC.

Animals ; Biological Products ; pharmacology ; Cell Line, Tumor ; Cyclin D1 ; metabolism ; Disease Models, Animal ; Ganoderma ; chemistry ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Microvessels ; Neoplasm Transplantation ; Neovascularization, Pathologic ; prevention & control ; Random Allocation ; Thrombospondin 1 ; metabolism ; Triple Negative Breast Neoplasms ; drug therapy