Objective To investigate the clinical characteristics and research progress of the patients with pregnancy complicating paroxysmal nocturnal hemoglobinuria(PNH).Methods The clinical data of 10 case-times of pregnancy complicating PNH admitted and treated in the Third Affiliated Hospital of Guang-zhou Medical University from September 2009 to January 2023 were retrospectively analyzed."Paroxysmal nocturnal hemoglobinuria"and"pregnancy"served as the English keywords,the literatures included in PubMed were retrieved."paroxysmal nocturnal hemoglobinuria"and"pregnancy"served as the Chinese key-words,the literatures included in CNKI and Wan Fang Databases from January 1986 to December 2022 were retrieved.The clinical characteristics,pregnancy diagnosis and treatment,and pregnancy outcome of together 43 case-times pregnancies complicating with PNH in 10 case-times by retrospective analysis and 33 case-times by retrieval report were analyzed by descriptive statistic method.Results Among 43 case-times of pregnancy,the common clinical symptoms had 29 case-times of anemia(67.44％),17 case-times of thrombocytopenia(39.53％),15 case-times of soy sauce color urine(34.88％),6 case-times of fatigue(13.95％),5 case-times of abdominal pain(11.63％),8 case-times of thrombosis(18.60％)during pregnancy and childbirth and 10 cases of complicating preeclampsia(23.25％).There were 31 case-times(72.09％)of red blood cell transfusions and 11 case-times(30.23％)of platelet transfusions;19 case-times(48.83％)of glucocorticoids use and 25 case-times(46.51％)of low molecular weight heparin(LMWH)use.There were 11 case-times(25.58％)of fetal growth restriction,17 case-times of premature delivery(39.53％),in which 6 case-times(28-33+6 weeks)of early stage premature delivery,the early premature delivery rate was 13.95％,there were 11 case-times of late premature delivery(34-36+6 weeks),the rate of late premature delivery was 25.58％.There were 3 case-times(6.97％)of stillbirth.Conclusion The incidence rate of mother and infant complications and adverse outcomes in the patients with pregnancy complicating PNH is high,which should be jointly man-aged by the doctors in hematology department and obstetric doctors with the experience for treating high risk pregnancy in general hospitals.

Objective:To investigate the impacts of astragaloside Ⅳ (AS-Ⅳ) on in- vitro proliferation and angioblastic differentiation of human umbilical cord blood-derived mesenchymal stem cells (hUCBMSCs), providing a basis for further research about the effects of AS-Ⅳ on mesenchymal stem cells (MSCs)-mediated angiogenesis. Methods:The hUCBMSCs were extracted from umbilical cord blood of normal full-term infants and subcultured. Osteoblasts, chondroblasts, and lipoblasts were induced, differentiated and identified. At the same time, the surface antigens CD44, CD73, and CD105 on hUCBMSCs were determined by flow cytometry. The successfully identified hUCBMSCs were cultured and treated with a series concentrations of AS-Ⅳ (0, 50, 100, 200, 300, and 400 mg/L). The optimum concentration of AS-Ⅳ for cell proliferation in hUCBMSCs was confirmed. In another experiment, hUCBMSCs were randomly divided into the experimental group and the control group. The cells in the experiment group were treated with the optimum concentration of AS-Ⅳ, and those in the control group were treated with equal volume of PBS. The impact of AS-Ⅳ on the proliferation of hUCBMSCs was detected using the cell counting kit (CCK-8). Besides, the impact of AS-Ⅳ on the angioblastic differentiation of hUCBMSCs was examined using the matrigel in- vitro tube formation assay. CD31 and von willebrand factor (vWF) expressions were determined using immunofluorescence after hUCBMSCs differentiated towards endothelial cells. Results:Under the light microscope, hUCBMSCs had clear edges and arranged orderly, showing a typical long fusiform structure. Flow cytometry confirmed that hUCBMSCs had surface markers of mesenchymal stem cells. The optimum concentration of AS-Ⅳ for the proliferation of MSCs was 300 mg/L. The OD values of the control and experimental groups were (0.51±0.01) and (0.98±0.05), respectively, with statistical significance ( t=15.96, P<0.05), indicating that the proliferation ability of the experimental group was enhanced. Compared with the control group, the tube density and the length of the tube network in vitro in the experimental group were higher, with statistically significant difference [(629.80±52.94)mm vs (110.36±13.19)mm, P<0.05]. Compared with the control group, the expression of CD31 and vWF increased in the experimental group after AS-Ⅳ induced hUCBMSCs differentiation ( t=13.64, 13.18, P<0.05). Conclusions:AS-Ⅳ has no toxicity to human umbilical cord blood mesenchymal stem cells, and can improve their proliferation function, and induce hUCBMSCs to differentiate into endothelial cells.