OBJECTIVE: To investigate the relationship of group B (GBS) colonization in late pregnancy with perinatal outcome. METHODS: Pregnant women who underwent antenatal check-up at General Hospital of PLA Eastern Theater Command and the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were enrolled in the study. The vaginal and rectal swab samples were collected for GBS culture at 35-37 weeks of pregnancy. The perinatal outcomes of positive and negative GBS groups were compared. The GBS-positive group samples were tested for antibiotic susceptibility. In GBS positive group the maternal and child perinatal outcomes were compared between pregnant women with antibiotics treatment and those without antibiotics. RESULTS: A total of 13 000 pregnant women were enrolled, and the overall colonization rate of GBS was 3.65%(475/13 000). The colonization rate of GBS in the vagina was 2.33%(303/13 000), and the colonization rate in the rectum was 1.75%(227/13 000). Through the collection and detection of rectal specimens, the positive rate of GBS increased by 56.77%(172/303). The monthly colonization rate of GBS showed significant fluctuations with the highest in March and October (all < 0.05). The sensitivity of 475 GBS-positive specimens to ceftriaxone, vancomycin and linezolid were 100%, and the sensitivity to ampicillin and penicillin were 97.26%and 93.47%, respectively. The resistance rates of the strains to levofloxacin, clindamycin, erythromycin and tetracycline were 30.11%, 48.00%, 52.21%and 88.63%. The incidence of premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal pneumonia and sepsis in GBS positive group were significantly higher than those in GBS negative group (all < 0.01). In pregnant women with positive GBS, the incidence of puerperal infection, neonatal infection and admission to the NICU in the antibiotic group were significantly lower than those in the non-antibiotic group ( < 0.05 or < 0.01). CONCLUSIONS The total colonization rate of GBS is low. The detection of GBS can be significantly improved by supplementing rectal examination. Ceftriaxone, ampicillin and penicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases. GBS infection can increase the incidence of maternal and child complications. The use of antibiotics during labor can improve the outcome of mothers and infants.
Anti-Bacterial Agents ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Outcome ; Streptococcal Infections ; Streptococcus agalactiae ; Vagina

Objective The incidence rate of acute pancreatitis in pregnancy (APIP) is on the rise, and yet there is no effec-tive method for its prevention and treatment .This study aimed to investigate the high risk factors of APIP and its prognostic evaluation index. Methods We retrospectively analyzed the clinical data of 35 cases of APIP ( group A) and another 35 cases of acute pancre-atitis in non-pregnancy as controls (group B).We compared the etiologic factors of acute pancreatitis , changes of laboratory indexes after onset of the disease , and clinical outcomes between the two groups . Results No statistically significant differences were found in the risk factors between the two groups (χ2 =0.233, P>0.05).Serum cholesterol and triglyceride levels were remarkably higher in group A ([15.69 ±7.71] and [15.54 ±7.82] mol) than in B ([5.07 ±2.95] and [3.82 ±2.58] mol) (P<0.05).There were significant differences between groups A and B in WBC count ([19.00 ±5.31] vs [14.98 ±9.77] 109/L), Hb ([82.77 ±11.77] vs [101.77 ±1.50] g/L), and serum Glu ([8.77 ±2.76] vs [6.23 ±1.99] mol/L)(P<0.05).Multivariate logistic regression a-nalysis showed the predictive value of cholesterol and triglyceride levels for APIP and a correlation of WBC and Hb with the clinical out -comes of the patients.The in-hospital mortality rate was significantly higher in group A than in B (χ2 =3.968, P=0.046), and so was the incidence rate of severe acute pancreatitis (χ2 =5.510, P=0.019). Conclusion Biliary diseases are the main high risk factors of APIP, followed by hyperlipidemia .Triglyceride and cholesterol levels have the predictive value for APIP .The WBC count and Hb level can be used to assess the patients′condition and predict the clinical outcomes .

Objective To explore the impact of throughout patient-controlled epidural analgesia(PCEA) on labor progress and delivery mode. Methods We enrolled 120 nulliparous women with term cephalic singleton preg-nancies. They were divided into two groups ,throughout analgesia group(n=60):when they are in labor,we started an-algesia and continued to the end of second stage of labor. While 60 nulliparous were selected to non-analgesia group as the control group. Data were collected about duration of the first, second stage of labor, oxytocin dosage, postpartum hemorrhage,outcome of delivery, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis and the effect of epidural analgesia, etc. Results There wsa is significant difference in the duration of the first stage delivery, the utilization rates of oxytocin, delivery mode (P<0.05) ;and there was no remarkable differences in the second stage of labor process, postpartum hemorrhage, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis (P>0.05) Conclusion The throughout patient-controlled epidural analgesia can shorten labor progress, cut down uterine-incision delivery and reach satisfying analgesis effect, without commidng any impact on the outcome of delivery.

OBJECTIVETo report a true hermaphroditism due to a teragametic chimerism and to discuss the pathogenesis of tetragametic chimerism.

METHODSChromosomal analysis and fluorescence in situ hybridization(FISH) were carried out on the lymphocytes from the blood and on the fibroblasts from the cultured skin and on fibroblasts from two different kinds of gonadal tissues of the patient with ambiguous genitalia respectively. Blood groups, human leukocyte antigen (HLA) haplotyping and 77 short tandem repeat (STR) microsatellite markers were tested. The two kinds of tissues in the gonad were detected by histopathological examination. Blood groups, HLA haplotying and 77 STR microsatellite markers parents of the patient's were also analyzed.

RESULTSEither 46,XX or 46,XY karyotype was found in the lymphocytes of the blood and in the fibroblasts of the cultured skin and of the two different kinds of gonadal tissues. Two X chromosome-specific signals or one X and one Y signal were detected in each interphase nucleus by FISH from the lymphocytes of the blood and the fibroblasts of three different tissue cultures. The karyotype of the 46,XY cell line predominated in all cultures except the cultured-fibroblasts from yellow gonadal tissues. STR marker analysis, ABO grouping and HLA study from the patient were identified a single haplotype in the patient from the mother and two different haplotypes from the father. Two kinds of tissues in the gonad were observed by histopathological examination. The yellow tissue was ovary and the white one was testis.

CONCLUSIONSHistopathological examination and chromosomal analysis combined with FISH are very useful methods for the diagnosis of true hermaphroditism. Blood typing, HLA and short tandem repeat microsatellite markers afford strong evidence for confirming tetragametic chimerism. The mechanism of tetragametic chimerism in true hermaphroditism can be explained by a parthenogenetic division of a haploid nucleu into two identical gametes, followed by fertilization with both X and Y spermatozoa and then developed into an organism.

ABO Blood-Group System ; Chimera ; Disorders of Sex Development ; blood ; genetics ; pathology ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Sex Chromosomes

Objective DNA methylation in the pathogenesis of endometriosis is drawing more and more attention from the medical world.This study aimed to evaluate the methylation status of the Homeobox-A10 (HOXA10) gene promoter region and the expression of the HOXA10 protein in endometriosis,and to explore the relationship of endometriosis with the aberrant methylation and expression of HOXA10 and its clinical significance.Methods The methylation-specific PCR(MSP) and the immunohistochemical SP methods were employed to detect both the methylation status of the HOXA10 promoter and its expression in the eutopic and ectopic endometrial tissues from 36 endometriosis patients,with normal endometrial tissue samples from 12 healthy women as controls.Results Hypermethylation of the HOXA10 promoter region was present in 38.9% (14/36) of the ectopic endometrial tissue samples and 25.0% (9/36) of the eutopic endometrial tissue samples,all in endometriosis of stages Ⅲ and Ⅳ,but no hypermethylation was found in the endometrial tissues of the normal controls,with significant differences between the two groups (P

Objective: To analyze the clinical characteristics of non-diabetic fetal macrosomia and their mothers.Methods: A retrospective case control study design was used to analyze 149 cases of non-diabetic fetal macrosomia and their mothers with the normal oral glucose tolerance test(OGTT) by comparison with 166 randomly included newborns of normal birth weight.Results: More cases of non-diabetic fetal macrosomia were found in the male neonates.The body weight,height,FL and BPD averaged significantly higher in the macrosomia group than in the control,and so did the body weight,height,uterus height,abdominal circumference and gestational age of the mothers.The rates of cesarean section and other obstetric complications were also higher in the macrosomia group.Conclusion: Different from the diabetic macrosomic fetus,the non-diabetic macrosomic fetus is a normal one,the incidence of which is associated with mothers'excessiver pregnancy nutrition as well as with genetic factors.

Objective: To analyze the incidence, etiological factors, clinical characteristic, diagnosis, treatment method and the prevention measures of recurrent ectopic pregnancies in our hospital from January 2001 to June 2004. Methods:19 cases of recurrent ectopic pregnancy were analyzed retrospectively. Results: There were 19 recurrences in 353 cases of ectopic pregnancy with a incidence rate of 1∶ 18.6( 19/353). The average age was 31.7 years old. 17 were operated with lesions involving the contralateral oviduct in 16 cases and the homolateral oviduct in 1 case. Pathological examination revealed additional chronic salpingitis in 13 cases. The shortest interval between the recurrent ectopic pregnancies were 2 months to 6 years,with an average of 33 months. Among them, 10 patients recurred within 36 months. There was one patients suffering from 3 times of ectopic pregnancies. The misdiagnosis rate was 5.26%. And the disease of misdiagnosis was miscarriage of early pregnancy. Surgical treatment can be the first choice of treatment of recurrent ectopic pregnancy. Conclusion: Pelvic adhensions, inflamed salpinx and conservative treatment are risk factors of recurrent ectopic pregnancy. Effective treatment of pelvic inflammation and avoiding of the first heterotopic pregnancy are the important measures for prevention of recurrent ectopic pregnancy.

Objectives:To investigate the level of soluble intracellular adhesion molecule 1 (sICAM 1) concentrations in the serum and peritoneal fluid from the patients with or without endometriosis.To discuss the relationship within sICAM 1 and pelvic endometriosis. Methods:35 serum and 30 peritoneal fluid of patients with endometriosis (test group) and 26 serum and 4 peritoneal fluid without endometriosis (control group) were studied.Soluble intracellular adhesion molecule 1 levels were detected by an enzyme linked immunoassay(ELISA).The results were analysed by T test. Results: The serum concentration of sICAM 1 was significantly higher in test group than controll group. However,There was no significant difference in between two groups. Conclusions: These results suggest that sICAM 1 could play some role in the persistence of endometriotic lesions.

Objective: To analyze the pathogenesis,diagnosis,treatment and prognosis of severe hypertensive disorder complicating pregnancy(HDCP) and hypoproteinaemia(HP).Methods: We reviewed 25 cases of HDCP and HP treated in our hospital and compared and analyzed the perinatal and maternal outcomes,including pregnancy edema,serum albumin,delivery methods and the weight of newborns.Results: Severe HP was the main cause of pregnancy complications in severe PIH.Prompt correction of HP benefited both the neonate and the mother.Conclusion: Severe HDCP is usually complicated with severe HP.Prenatal correction and treatment of HP will be helpful for both severe HDCP mothers and the newborns.

Objective: To observe the influence of all-trans retinoic acid(ATRA) on the expressions of E-cadherin,heparanase and VEGF in epithelial ovarian carcinoma cell line COC2,and to investigate the anti-metastatic potential and possible action mechanism of ATRA.Methods: We used flow cytometry to examine the expressions of E-cadherin,heparanase and VEGF proteins in the epithelial ovarian carcinoma cell line COC2 treated with different concentrations of ATRA.Results: ATRA significantly increased the expression of E-cadherin and decrease that of VEGF and hepareanse in a dose-dependent manner.Conclusion: ATRA can inhibit cell proliferation,improve cell-cell adhesion and downregulate the expressions of VEGF and heparanse proteins,suggestive of an anti-angiogenic and anti-metastatic potential.