Placental diseases may affect the outcome of pregnancy and long-term health of the mother and fetus. Fetal fraction is a key indicator for the success of non-invasive prenatal testing, and has been associated with gestational age, body mass index and fetal chromosomal aneuploidies. Many studies have found that fetal fraction is also related to placenta-derived diseases and may become a new predictor for such diseases. This article has summarized the association between the two, with an aim to provide new ideas for the prediction of placental diseases.

BACKGROUND: Endocrine therapy (ET) and ET-based regimens are the preferred first-line treatment options for hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (HR+/HER2- MBC), while chemotherapy (CT) is commonly used in clinical practice. The aim of this study was to investigate the efficacy and clinical outcome of ET and CT as first-line treatment in Chinese patients with HR+/HER2- MBC. METHODS: Patients diagnosed with HR+/HER2-MBC between January 1st, 1996 and September 30th, 2018 were screened from the Chinese Society of Clinical Oncology Breast Cancer database. The initial and maintenance first-line treatment, progression-free survival (PFS), and overall survival (OS) were analyzed. RESULTS: Among the 1877 included patients, 1215 (64.7%) received CT and 662 (35.3%) received ET as initial first-line treatment. There were no statistically significant differences in PFS and OS between patients receiving ET and CT as initial first-line treatment in the total population (PFS: 12.0 vs. 11.0 months, P = 0.22; OS: 54.0 vs . 49.0 months, P =0.09) and propensity score matched population. For patients without disease progression after at least 3 months of initial therapy, maintenance ET following initial CT (CT-ET cohort, n = 449) and continuous schedule of ET (ET cohort, n = 527) had longer PFS than continuous schedule of CT (CT cohort, n = 406) in the total population (CT-ET cohort vs. CT cohort: 17.0 vs . 8.5 months; P <0.01; ET cohort vs . CT cohort: 14.0 vs . 8.5 months; P <0.01) and propensity score matched population. OS in the three cohorts yielded the same results as PFS. CONCLUSIONS ET was associated with similar clinical outcome to CT as initial first-line treatment. For patients without disease progression after initial CT, switching to maintenance ET showed superiority in clinical outcome over continuous schedule of CT.
Humans ; Female ; Breast Neoplasms/metabolism* ; Receptor, ErbB-2/metabolism* ; Progression-Free Survival ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Disease Progression ; Treatment Outcome

This article reported a survived case of amniotic band syndrome (ABS) following fetal reduction by radiofrequency ablation. The woman conceived monochorionic diamniotic twin pregnancy spontaneously. Prenatal ultrasound at 24 weeks of gestation indicated twin-twin transfusion syndrome (stage Ⅲ), and radiofrequency ablation for fetal reduction was successfully performed after formal consent. At 28 +6 weeks, ultrasound reexamination revealed significant edema in the left foot of the fetus, with banding around the ankle, as well as the strangulation mark and narrowing rings. Fetal ABS (ⅡB stage) was diagnosed after multidisciplinary consultation. An immediate emergency cesarean section was performed and a live male baby was born. A thin amniotic band could be seen wrapping around the left ankle of the newborn for several rounds, with obvious strangulation marks about 1 cm deep into the skin, and significant edema on the dorsum and sole of the foot, and the submalleolus area. The amniotic band was released at once, and the edema faded gradually after surgery. After a follow-up of 28 days, the lower limbs of the newborn became normal.

Objective:To explore the feasibility and preliminary effectiveness of case-based learning (CBL) teaching based on network resources in standardized residency training for nuclear medicine.Methods:Open network resources of CBL curriculum (13 sessions in total) were used to perform the collective teaching of 21 residents who received training in our professional base, with a total of 61 person-times. The residents received the test on objective questions before class, immediately after class, and at 1 week after class (7-10 days) to assess the learning effect of residents at these time points, and an evaluation form of teaching effectiveness was used after each class to assess the teaching effect. SPSS 23.0 was used to perform a one-way analysis of variance.Results:As for the test score of objective questions, there were 61 valid scores before class, 61 valid scores immediately after class, and 51 valid scores at 1 week after class (7-10 days), with a mean score of (49.43±13.37), (84.43±14.44), and (80.88±10.04), respectively (with 100 points as the total score), which showed a significant difference ( F=105.80, P<0.01). As for the evaluation of teaching effectiveness, a total of 61 valid forms were received, and the results of "very satisfied, satisfied, fairly good, and dissatisfied" accounted for 34.4% (21/61), 52.5% (32/61), 9.84% (6/61), and 3.28% (2/61), respectively, with an overall satisfaction rate (very satisfied+satisfied) of 86.9% (53/61). Conclusion:It is feasible and effective to make full use of network resources to carry out CBL teaching in standardized residency training for nuclear medicine, which has achieved a good preliminary effect.

OBJECTIVE: To compare the performance of high-throughput sequencing technology in prenatal thalassemia screening in Zhuhai area through comparison with traditional methods. METHODS: A total of 1463 pregnant women were randomly selected. Following DNA extraction, high-throughput sequencing and conventional three-step thalassemia screening were carried out for each sample. Inconsistent results samples were validated by quantitative fluorescence PCR (QF-PCR) or Sanger sequencing. The results by the two methods were compared. RESULTS: Among the 1463 cases, 318 (21.74%) were detected by conventional method, which included 210 (14.35%) with α-thalassemia, 97 (6.63%) with β-thalassemia, 11 (0.75%) with composite α- and β-thalassemia. Meanwhile, 379 cases (25.91%) of thalassemia were detected by high-throughput sequencing, which included 260 (17.77%) with α-thalassemia, 107 (7.31%) with β-thalassemia, 12 (0.82%) with composite α- and β-thalassemia. Six one cases were missed by the conventional method, which yielded a missed diagnosis rate of 16.09%, including 50 cases of α- thalassemia,10 cases of β-thalassemia, and 1 case of α-compound β-thalassemia. No cases of thalassemia were missed by high-throughput sequencing, and 10 rare thalassemia genotypes were detected. CONCLUSION High-throughput sequencing technology can improve the detection rate of thalassemia and reduce the missed diagnosis rate. It has a high application value in prenatal thalassemia screening in Zhuhai area and can more effectively prevent the birth of patients with severe thalassemia.
China ; Female ; Genotype ; High-Throughput Nucleotide Sequencing ; Humans ; Mutation ; Pregnancy ; Prenatal Diagnosis/methods* ; Technology ; alpha-Thalassemia/genetics* ; beta-Thalassemia/genetics*

ObjectiveTo investigate the protective effect of Danggui Shaoyaosan （DSS）-contained serum on β-amyloid （Aβ）_1-40-injured rat adrenal pheochromocytoma PC12 cells and its mechanism in regulating ubiquitin-proteasome pathway （UPP）. MethodAβ_1-40 was used to intervene PC12 cells to prepare the cell models of Alzheimer's disease （AD）， and the experiment was divided into the blank， model， and DSS-contained serum high， medium， and low-dose groups （10%， 5%， and 2.5%）. Cell viability and apoptosis were detected using cell counting kit-8 （CCK-8） method and flow cytometry， respectively. The content of Aβ and p-Tau protein was determined by enzyme-linked immunosorbent assay （ELISA）. The ubiquitin （Ub）， ubiquitin ligase E3 （E3）， 26S proteasome， ubiquitin carboxyl terminal hydrolase1 （UCHL1）， and UCHL3 protein expressions of UPP were displayed using immunofluorescence cytochemistry （ICC）， and the mRNA and protein expression levels of Ub， E3-parkin， 26S， UCHL1， and UCHL3 were determined by real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultThe data of the CCK8 experiment verified that 5 μmol·L^-1 and 48 hours were the optimal conditions for modeling Aβ_1-40-injured PC12 cells. As compared with the blank group， the cell viability rate in the model group decreased （P<0.05） with an increased apoptosis rate （P<0.05）， the content of Aβ and p-Tau contents was elevated （P<0.05）， the mRNA and protein expression levels of Ub increased， and the mRNA and protein expression levels of 26S， E3， and UCHL1+3 decreased （P<0.05）. As compared with the model group， the cell viability rate in the DSS-contained medium-dose group increased （P<0.05）， whereas the apoptosis rate in each DSS-contained group decreased （P<0.05）. The content of Aβ in each DDS-contained group decreased （P<0.05）， and the content of p-Tau in the DDS-contained high and medium-dose groups decreased （P<0.05）. The mRNA expression level of Ub decreased， and that of 26S increased in each DDS-contained group （P<0.05）. The mRNA expression level of UCHL1 in the DDS-contained medium-dose group increased （P<0.05）， and the mRNA expression levels of E3 and UCHL 3 in the DDS-contained high and medium-dose groups increased （P<0.05）. The protein expression level of Ub in each DDS-contained group decreased， and the protein expression levels of 26S， E3， and UCHL1+3 in the DDS high and medium-dose groups increased. The DSS-contained serum medium-dose group exerted the optimal effect. ConclusionDSS-contained serum can increase cell viability rate， reduce cell apoptosis rate， eliminate Aβ and p-Tau protein deposits， and exert protective effects on Aβ_1-40-injured PC12 cells. Its mechanism may involve UPP via decreasing the expression of Ub and increasing that of 26S， E3， UCHL1， and UCHL3.

Objective:To analyze the significance of HBV DNA below the lower detection limit of HBV RNA levels after long-term nucleos(t)ide analogues (NAs) antiviral therapy in patients with hepatitis B virus cirrhosis.Methods:97 cases with hepatitis B virus cirrhosis treated with NAs antiviral therapy for at least 3 years between May 2018 to July 2019 were selected. High-sensitivity HBV DNA (<20 IU/ml), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), HBsAg, HBeAg and HBV RNA at least twice every 6 months were detected. According to Child-Pugh classification, HBeAg, HBsAg level, and HBV RNA level intergroup comparison was performed. Rank sum test, χ2 test and linear regression analysis were performed on the data. Results:Compared with the HBV RNA level of child-Pugh class A patients, the HBV RNA level of Child-Pugh class B+C patients were significantly higher [4.1 (0,4.9) log 10 copies/ml and 2.0 (0,3.5) log 10 copies/ml], and the difference was statistically significant ( Z=2.370, P<0.05). According to different HBeAg levels, they were divided into HBeAg positive and negative group, and the quantitative comparison of HBV RNA levels between the two groups were 2.0 (0, 4.5) log 10 copies/ml and 1.0 (1.0, 2.0) log 10 copies/ml, respectively, and the difference was statistically significant ( Z=3.233, P<0.05). According to different HBsAg levels, they were divided into three groups: HBsAg≤100 IU/ml, 100

Microplastics refer to plastic fibers, particles, or films with a particle size less than 5 mm, and microplastics pollution has become one of the major global environmental problems. Microplastics can be exposed to the human body through ingestion, inhalation and skin contact, affecting maternal and fetal health through mechanisms such as cytotoxicity and signal transduction, energy homeostasis and metabolic disorders, immune dysfunction, and as carriers of microorganisms or toxic chemicals. The purpose of this paper is to review the physical and chemical properties of microplastics, human exposure pathways, maternal-fetal effects, and its mechanisms.

Due to the advantages of being unaffected by fetal gender, ease of detection, and good stability, circulating cell-free fetal RNA (cffRNA) is a potential biomarker in obstetric practice. Current evidence has shown that placenta is the main source of circulating cffRNA. In view of the abnormal expression levels in women with preeclampsia and intrauterine growth restriction, circulating cffRNA is proposed as a potential tool to predict or diagnose these diseases. A summary of the molecular characteristics and the applications in preeclampsia of circulating cffRNA is reviewed, in order to evaluate the hypothesis for the prediction of preeclampsia by cffRNA.

Objective:To understand the possible detected mosaicism chromosome karyotyping using uncultured chorionic villus samples.Methods:This study retrospectively analyzed the clinical data of singleton pregnant women who underwent fetal chromosome karyotyping of uncultured chorionic villus samples at the Prenatal Diagnosis Center of Tianjin Central Hospital of Gynecology and Obstetrics from January 2016 to January 2019. Prenatal diagnosis indicators, fetal karyotypes, the incidence of chromosomal mosaicism and subsequent diagnosis, and perinatal outcomes were analyzed. Amniocentesis was performed when chromosomal mosaicism was identified. Descriptive statistical analysis was used for data analysis.Results:(1) A total of 438 pregnant women with available follow-up data were enrolled. Increased nuchal translucency (56.6%, 248/438) was the major indication for prenatal diagnosis. The karyotype analysis indicated that 79.5% (348/438) were normal, and 2.7% (12/428) were mosaicism. (2) Of the 438 cases, 336 cases (76.7%) were delivered at term, of which 327 cases were uncomplicated. There was one case of premature rupture of membranes within one week after amniocentesis and eight cases of abortion/fetal death between one week after the amniocentesis and 28 weeks of gestation. Of these nine cases, four had chromosomal abnormalities, and five had normal karyotypes. Termination of pregnancy was selected in 65 cases (14.8%) and 28 cases (6.4%) delivered before term. (3) Among the 12 (2.7%) cases of chromosomal mosaicism verified by fetal karyotyping through amniocentesis, four were confined placental mosaicism; six were abnormal chromosomal karyotypes in chorionic villous and amniotic fluid; one was true fetal mosaicism; one was a false positive. Among the 12 cases, three continued to term, one was preterm delivered, and eight selected labor induction, including three cases each of trisomy-21 and ultrasonographic structure abnormalities, and one case each of fetal growth restriction and labor induction based on patient preference.Conclusions:Karyotype analysis of uncultured chorionic villus samples may detect a certain proportion of mosaicism. Therefore, combining fluorescence in situ hybridization to achieve an accurate diagnosis and a detailed and systematic ultrasonic scan are recommended.