Preeclampsia is a serious threat to maternal and fetal health and safety, and is an important cause of maternal death. At present, there is no effective treatment except termination of pregnancy. It is an important measure to identify high-risk groups for standardized management and early prevention to reduce the incidence of preeclampsia and maternal and fetal mortality. Chronic patients are at high risk of preeclampsia, and their morbidity and mortality have increased significantly. It is of great significance for chronic patients to regulate preconception guidance and formulate preconception management strategies to reduce the incidence of preeclampsia and improve maternal and infant outcomes.

Since the two-child policy has been fully liberalized, the number of elderly women has increased, and the widespread application of assisted reproductive technology has increased the proportion of high-risk pregnancy year by year, which adds new challenges to obstetric work. High-risk pregnancy not only increases the risk of pregnancy complications, but also threatens the health of mother and child. Prenatal screening and pregnancy care for high-risk pregnant women are essential to ensure their safety through pregnancy and delivery. In recent years, with the continuous improvement of prenatal screening and hierarchical medical system, high-risk pregnant women have received more intensive monitoring and active intervention. At the same time, the promotion of Internet + hospitals has also achieved initial results in the field of obstetrics, which has increased the convenience of perinatal health care services. However, there are still differences in maternal health status between urban and rural areas and among different regions, and the supply capacity of maternal and child health services needs to be improved. In terms of reducing maternal and perinatal mortality, obstetric workers and maternal women still need to work together to improve the management of high-risk pregnancies, prevent adverse pregnancy outcomes, and ensure the safety of mothers and infants.

Hypertensive disorders complicating pregnancy is a disease which threatened maternal and children health worldwide.Nutrients are closely related to the occurrence and development of hypertensive disorders complicating pregnancy.Excessive weight gain or obesity during pregnancy will greatly increase the risk of pregnancy complications.Balanced diet structure,proper intake of energy,and control of weight gain can effectively reduce the incidence of hypertensive disorders complicating pregnancy.Folic acid supplementation is expected to be an effective way to prevent preeclampsia.Vitamin D supplementation during pregnancy helps to control blood pressure,blood sugar,and blood lipids.Calcium,iron,zinc,selenium and other trace elements may be related to the incidence of hypertensive disorders complicating pregnancy.Nutrients supplements during pregnancy may be helpful to prevent the occurrence of hypertensive disorders in pregnancy.

Objective To observe the effects of pioglitazone on secretion of E2 and expressions of P450 aromatase (P450arom), insulin-receptor substrate-1 (IRS-1), and insulin-receptor substrate-2 (IRS-2) mRNA in polycystic ovary syndrome (PCOS) ovarian granulosa cells.Methods In this study, granulosa cells that were fertilization-embryo transferred from 27 PCOS patients were primary cultured in vitro with different concentrations of pioglitazone (0, 10, 102, 103 and 104nmol/L) (Group A), different concentrations of pioglitazone+FSH (50ng/L, Group B) and different concentrations of pioglitazone+insulin-like growth factor I (IGF-I, 50ng/L, Group C).Estradiol concentrations in the culture supernatant were detected by radioimmunoassay;P450arom, IRS-1 and IRS-2 mRNA expressions on granulosa cells were detected by Real-time PCR.Results The levels of E2 secreted by granulosa cells and the expression of P450arom mRNA on granulosa cells of PCOS for 48 hours were different among Groups A, B and C (P<0.05).With increase in pioglitazone concentration, the level of E2 and the expression of P450arom mRNA declined, some of which correlated negatively with the concentration of pioglitazone.Among these groups, the level of E2 secretion and the expression of P450arom mRNA were higher in Group C than in Group B (P<0.01) and Group A (P<0.01) at the same concentration of pioglitazone.The level of E2 secretion and the expression of P450arom mRNA were higher in Group B than in Group A (P<0.05) at the same concentration of pioglitazone.The expressions of IRS-1 and IRS-2 mRNA on granulosa cells of PCOS under pioglitazone stimulation for 48 hour were different among the groups of different pioglitazone concentrations (P<0.05).With increase inpioglitazone concentration, the expression of IRS-1 mRNA on granulosa cells of PCOS was decreased, but the expression of IRS-2 mRNA on granulosa cells of PCOS was increased.Conclusion Pioglitazone may decrease estrogen production by inhibiting p450 aromatase and adjusting the expressions of IRS-1 and IRS-2 on granulosa cells of PCOS to play a role in ovulation induction and ameliorate insulin resistance in ovary of PCOS.Pioglitazone can inhibit IGF-I and FSH in inducing E2 secretion by ovarian granulosa cells.

AIM:To investigate the clinical significance of microRNA-26a-5p (miR-26a-5p)-regulated mye-loid cell leukemia-1 (MCL-1) expression in the development of maternal preeclampsia.METHODS:Plasma and placen-tal tissues were collected from 21 cases of normal pregnancy, 13 cases of maternal gestational hypertension, 15 cases of mild preeclampsia and 26 cases of severe preeclampsia.The levels of plasma and placental miR-26a-5p and placental MCL-1 mRNA were detected by real-time PCR.Western blotting analysis was used to determine the protein expression of placen-tal MCL-1.The clinical significance of the above parameters was also analyzed.RESULTS:miR-26a-5p expression gradu-ally increased(P<0.01) in the 4 groups of maternal plasma and placentas with the disease development, and the mRNA expression of MCL-1 was significantly reduced in the placentas (P<0.01), both showing a significant negative correlation (P<0.01).Meanwhile, the expression of miR-26a-5p and MCL-1 protein in the placental tissues was negatively correla-ted (P<0.01).The miR-26a-5p up-regulation in maternal plasma and placental tissues was negatively correlated with ges-tational age, maternal plasma albumin levels and fetal weight, while it was positively correlated with maternal blood pres-sure and urinary protein level (P<0.01), which was in contrary to the down-regulation of placental MCL-1.CONCLU-SION:Up-regulation of miR-26a-5p is involved in the occurrence and development of preeclampsia by down-regulation of MCL-1.

Objective To construct the plasmid pSilencer4.1/HtrA1 and stably transfect human trophoblastic cell line HPT-8.Methods We detected the expression of HtrA1 in cell line HPT-8 with immunohistochemical SABC,constructed the plasmid pSilencer4.1/HtrA1,transfected human trophoblastic cell line HPT-8 with plasmid pSilencer4.1/HtrA1 and negative plasmid pSilencer4.1, and observed the cell expression after transfection. Results About 90% of cellular cytoplasm of HPT-8 was dyed brown while the nucleus was negatively stained. Selective concentration of G418 was 200 μg/mL for HPT-8 to be transfected pSilencer4.1/HtrA1.With RT-PCR and Western blot methods,the expression of HPT-8 transfected plasmid Psilence4.1/HtrA1 was significantly downregulated compared with that of cells with negative plasmid and normal cells (P < 0.05 ).There was no significant difference in absorbance value between blank plasmid group and HPT-8 group (P >0.05).Conclusion We successfully constructed stable trophoblastic cell line HPT-8/ pSilencer4.1-HtrA1 with silenced expression of HtrA1,which lays foundation for further research.

Objective To investigate the effects of pioglitazone on serum adipocytokines (leptin, resistin and adiponectin) in polycystic ovary syndrome (PCOS) patients with insulin resistance (IR). Methods Thirty-five PCOS patients with IR were treated with pioglitazone 15mg/d for 12 weeks. The results of ovulation induction were observed. The changes of fasting plasma glucose (FPG), fasting serum insulin (FINS), serum levels of leptin, resistin and adiponectin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), and blood fat were examined at the baseline and after the therapy by enzyme-linked immunosorbentassay (ELISA) and radioimmunoassay (RIA). Results After 12 weeks' treatment, menstruation and rate of ovulation per cycle were improved in 35 (88.5%) PCOS patients with IR. Waist/hip ratio and F-G score were significantly decreased (P<0.05), and BMI declined with no significant difference (P>0.05). The levels of LH, T, FINS, HOMA-IR, total cholesterol, triglyceride and low density lipoprotein-cholesterol were significantly decreased (P<0.01, P<0.05) after treatment; high density lipoprotein-cholesterol level was significantly increased (P<0.01) after treatment. However, there were no significant differences in FSH and FPG (P>0.05). The levels of serum leptin and resistin were decrease than before (P<0.05), and the level of serum adiponectin was increased (P<0.05). Conclusion Pioglitazone can effectively improve clinical syndromes, insulin sensitivity, glucose and lipid metabolism of PCOS patients with IR. Adipocytokines (leptin, adiponectin and resistin) as regulators of insulin metabolism are involved in the pathogenesis of insulin resistance in PCOS. Pioglitazone treatment can decrease plasma glucose level and improve insulin sensitivity at least partly through improving the profiles of adipocytokines.

Objective To explore the expression of matrix metalloproteinase-3 (MMP-3) and matrix metalloproteinase-10 (MMP-10) in normal endometrium, atypical hyperplasia and endometrial adenocarcinoma. We aimed to study the relationship of MMP-3 and MMP-10 expressions with infiltration depth, histologic grade and clinical phase in order to explore the role of MMP-3 and MMP-10 in the occurrence, infiltration and metastasis of endometrial adenocarcinoma. Methods The expressions of MMP-3 and MMP-10 were measured by immunohistochemistry in 12 cases of normal endometrium, 12 cases of atypical hyperplasia and 42 cases of endometrial adenocarcinoma. Results The expression of MMP-3 was 73.8% (31/42), 25.0% (3/12) and 8.3% (1/12) in endometrial adenocarcinoma, atypical hyperplasia and normal endometrium, respectively, whereas the expression of MMP-10 was 76.2% (32/42), 33.3% (4/12) and 0(0/12), respectively. Both MMP-3 and MMP-10 expressions exhibited a pattern of decreased intensity in endometrial carcinoma, atypical hyperplasia and normal endometrium. Furthermore, the statistical analysis showed that the expression of both proteins was significantly greater in endometrial carcinoma than in atypical hyperplasia and normal tissue (P<0.01). Expressions of MMP-3 and MMP-10 had a significant correlation with such clinical parameters as histologic grade, depth of myometrial infiltration and clinical stage (P<0.01). Conclusion MMP-3 and MMP-10 can be used as tumor markers of endometrial carcinoma, and the combined detection of them can increase the detection rate of endometrial carcinoma.

Objective To study the inhibitory action of docetaxel (DOC) on the proliferation of HeLa and SiHa cells. Methods Cell morphological changes were observed with inverted phase contrast microscope. MTT was adopted to test and calculate the cell inhibition ratio. Flow cytometry was used to detect cell cycle. Results DOC had an obvious concentration-dependent inhibitory effect on the proliferation of both HeLa and SiHa cells. The inhibition ratio of DOC on SiHa was significantly higher than that on HeLa (P<0.05). DOC blocked HeLa at G2/M phase. Under the effect of DOC, the cell cycle of SiHa was not changed much. Conclusion DOC has an obvious inhibitory action on both HeLa and SiHa cells, which shows a promising prospect of DOC in clinical treatment of cervical cancer.

Objective To quantitatively analyze the fetal lung echo and right lung volume in the third trimester by real-time three-dimensional ultrasound (3-D US) and evaluate the feasibility of fetal lung maturity. Methods A total of 732 women with normal singleton pregnancies between 28 and 42 weeks of gestation underwent ultrasound examination. The 3-D US equipment with a 3.5-5MHz transabdominal transducer was used for the fetal biometric measurement. The echogenicity ratio between fetal lung and liver was compared. The fetal lung volume was calculated by the rotational multiplanar technique for volume measurement (VOCAL). Results The right fetal lung volume increased with the increase of gestational age with a linear positive correlation (r=0.884, P<0.01). After 34 weeks, the echogenicity ratio of fetal lung to liver was more than 1.1. Conclusion The echogenicity of lung/liver and fetal lung volume could be used as normal fetal predictable indicators for fetal lung maturity.