BACKGROUND Persistent left superior vena cava(PLSVC)is the most common venous system variant.The clinical characteristics and amniotic fluid cytogenetics of fetuses with PLSVC remain to be further explored.AIM To deve...BACKGROUND Persistent left superior vena cava(PLSVC)is the most common venous system variant.The clinical characteristics and amniotic fluid cytogenetics of fetuses with PLSVC remain to be further explored.AIM To develop reliable prenatal diagnostic recommendations through integrated analysis of the clinical characteristics of fetuses with PLSVC.METHODS Cases of PLSVC diagnosed using prenatal ultrasonography between September 2019 and November 2022 were retrospectively studied.The clinical characteristics of the pregnant women,ultrasonic imaging information,gestational age at diagnosis,pregnancy outcomes,and amniocentesis results were summarized and analyzed using categorical statistics and the chi-square test or Fisher’s exact test.RESULTS Of the 97 cases diagnosed by prenatal ultrasound,49(50.5%)had isolated PLSVC and 48(49.5%)had other structural abnormalities.The differences in pregnancy outcomes and amniocentesis conditions between the two groups were statistically significant(P<0.05).No significant differences were identified between the two groups in terms of advanced maternal age and gestational age(P>0.05).According to the results of the classification statistics,the most common intrac-ardiac abnormality was a ventricular septal defect and the most common extrac-ardiac abnormality was a single umbilical artery.In the subgroup analysis,the concurrent combination of intra-and extracardiac structural abnormalities was a risk factor for adverse pregnancy outcomes(odds ratio>1,P<0.05).Additional-ly,all abnormal cytogenetic findings on amniocentesis were observed in the comorbidity group.One case was diagnosed with 21-trisomy and six cases was diagnosed with chromosome segment duplication.CONCLUSION Examination for other structural abnormalities is strongly recommended when PLSVC is diagnosed.Poorer pregnancy outcomes and increased amniocentesis were observed in PLSVC cases with other structural abnor-malities.Amniotic fluid cytogenetics of fetuses is recommended for PLSVC with other structural abnormalities.展开更多
Background: Amniotic fluid turbidity increases with fetal lung maturation due to vernix and lung surfactant micelles suspended in the amniotic fluid. This study focused on this phenomenon and evaluated the presence or...Background: Amniotic fluid turbidity increases with fetal lung maturation due to vernix and lung surfactant micelles suspended in the amniotic fluid. This study focused on this phenomenon and evaluated the presence or absence of respiratory distress syndrome (RDS)/transient tachypnea of the newborn (TTN) by quantitatively assessing the brightness of the amniotic fluid turbidity using a noninvasive ultrasound histogram measurement function. Methods: We included cases of singleton pregnancies managed at the Niigata University Medical and Dental Hospital between November 2020 and March 2022. Histograms of amniotic fluid turbidity were measured at the center of the amniotic fluid depth, avoiding the fetus, placenta, and umbilical cord, with the gain setting set to 0, and the average value was obtained after three measurements. Histograms of fetal urine in the bladder were measured similarly. The value obtained by subtracting the fetal bladder brightness value from the amniotic brightness value based on histogram measurements was used as the final amniotic fluid brightness value. Results: We included 118 cases (16 of RDS/TTN and 102 of control). The gestational age of delivery weeks was correlated with amniotic fluid brightness (Spearman’s rank correlation coefficient was 0.344;p = 0.00014). Amniotic fluid brightness values were significantly lower in the RDS/TTN group than in the control group (RDS/TTN: 16.2 ± 13.5, control: 26.3 ± 16.3;p = 0.020). The optimal cutoff value of amniotic fluid brightness to predict RDS/TTN was 20.3. For predicting RDS/TTN, the sensitivity, specificity, positive predictive value, and negative predictive value were 91.7%, 69.6%, 26.2%, and 94.1%, respectively. Conclusions: The quantitative value of the amniotic fluid brightness by histogram measurements may provide an easy and objective index for evaluating the presence or absence of RDS/TTN.展开更多
Objective:To test the hypothesis that concentration of amniotic fluid alpha-fetal protein(AFAFP) is increased in thalassemia fetus.Methods:A total of 135 cases of amniocentesis admitted from July 2013 to December 2014...Objective:To test the hypothesis that concentration of amniotic fluid alpha-fetal protein(AFAFP) is increased in thalassemia fetus.Methods:A total of 135 cases of amniocentesis admitted from July 2013 to December 2014 were included in this study.Among them 98 cases of normal fetuses were assigned into control group and 37 cases of thalassemia fetus were included as thalassemia fetus group.Alpha-fetoprotein levels detected by enzyme linked immunosorbent assay and the alpha-fetoprotein concentration were compared between the two groups.There is no significant difference in gestrational age between the two groups.Results:1.AFP concentration in thalassemia fetus group was significantly higher than that of normal control group [(1541.65±734.78) μg/mL vs.(2728.84± 1539.97) μg/mL ],and amniotic fluid AFP concentration was related to fetal thalassemia.2.AFAFP concentration in pureα-thalassemia fetus was higher than that of β thalassemia fetus or mixed αand was not significant.Conclusions:Concentration of a β thalassemia fetus,but the difference mniotic fluid alpha-fetal protein is increased in thalassemia fetus.AFP concentration inα-thalassemia fetus was higher than that of β thalassemia or mixed αand lore β thalassemia fetus but difference was not significance.Further studies are needed to exp the possible correlation between Down syndrome and biochemical markers of Thalassemia.展开更多
BACKGROUND Diabetes mellitus(DM)is a serious and growing global health burden.It is estimated that 80%of diabetic patients have micturition problems such as poor emptying,urinary incontinence,urgency,and urgency incon...BACKGROUND Diabetes mellitus(DM)is a serious and growing global health burden.It is estimated that 80%of diabetic patients have micturition problems such as poor emptying,urinary incontinence,urgency,and urgency incontinence.Patients with diabetic bladder dysfunction are often resistant to currently available therapies.It is necessary to develop new and effective treatment methods.AIM To examine the therapeutic effect of human amniotic fluid stem cells(hAFSCs)therapy on bladder dysfunction in a type 2 diabetic rat model.METHODS Sixty female Sprague-Dawley rats were divided into five groups:Group 1,normal-diet control(control);group 2,high-fat diet(HFD);group 3,HFD plus streptozotocin-induced DM(DM);group 4,DM plus insulin treatment(DM+insulin);group 5,DM plus hAFSCs injection via tail vein(DM+hAFSCs).Conscious cystometric studies were done at 4 and 12 wk after insulin or hAFSCs treatment to measure peak voiding pressure,voided volume,intercontraction interval,bladder capacity,and residual volume.Immunoreactivities and/or mRNA expression of muscarinic receptors,nerve growth factor(NGF),and sensory nerve markers in the bladder and insulin,MafA,and pancreatic-duodenal homeobox-1(PDX-1)in pancreatic beta cells were studied.RESULTS Compared with DM rats,insulin but not hAFSCs treatment could reduce the bladder weight and improve the voided volume,intercontraction interval,bladder capacity,and residual volume(P<0.05).However,both insulin and hAFSCs treatment could help to regain the blood glucose and bladder functions to the levels near controls(P>0.05).The immunoreactivities and mRNA expression of M2-and M3-muscarinic receptors(M2 and M3)were increased mainly at 4 wk(P<0.05),while the number of beta cells in islets and the immunoreactivities and/or mRNA of NGF,calcitonin gene-related peptide(CGRP),substance P,insulin,MafA,and PDX-1 were decreased in DM rats(P<0.05).However,insulin and hAFSCs treatment could help to regain the expression of M2,M3,NGF,CGRP,substance P,MafA,and PDX-1 to near the levels of controls at 4 and/or 12 wk(P>0.05).CONCLUSION Insulin but not hAFSCs therapy can recover the bladder dysfunction caused by DM;however,hAFSCs and insulin therapy can help to regain bladder function to near the levels of control.展开更多
Aim: The objective of this study is to review all the reported outcomes of heparin application in amniotic fluid embolism (AFE) so far and to find out why, when and how heparin or other anticoagulants should be used i...Aim: The objective of this study is to review all the reported outcomes of heparin application in amniotic fluid embolism (AFE) so far and to find out why, when and how heparin or other anticoagulants should be used in AFE. Material and methods: We searched Medline (from 1969 to 2011), using two key words: 1) amniotic fluid embolism;2) amniotic fluid embolism and heparin. The search for the former produced 1127 replies, of which 208 were case reports of AFE. In response to the other key word, there were 94 articles. We looked through all the articles, selecting those relevant for our study. Results: In the years 1969-2011, 208 AFE cases were reported. Heparin (unfractionated heparin) or low molecular weight heparin (LMWH) was applied in 20 cases (9.6%), being the main drug in 11 cases (5.3%) and in 6 cases as a component of spectacular treatment of AFE (surgical treatment and extracorporal membrane oxygenation). In one of these cases anithrombin (AT) with LMWH was used. In one patient heparin therapy was considered to be unsuccessful and hence recombinant plasminogen activator (rt-PA) was instituted. All the patients survived. Conclusions: 1) The attempts to use heparin in AFE could be defined as promising, although the number of treated patients is too small for conclusion;2) The postulate to use heparin at the very onset of AFE (a bolus of 10,000 U followed by monitored intravenous infusion) has serious justification: one of the pathways of AFE is the target for heparin (coagulation pathway).展开更多
Background/Aim: Recently, a comparative study on the incidence of AFE has highlighted rather confusing results, showing that the complication is more than three times higher in North America than that in some European...Background/Aim: Recently, a comparative study on the incidence of AFE has highlighted rather confusing results, showing that the complication is more than three times higher in North America than that in some European countries. In this paper, we put forward the hypothesis that this discrepancy is due to inaccurate diagnosis of non-classical form of AFE (atypical AFE). We also provide an outline of symptoms that characterize this type of AFE based on the analysis of all available case reports. Material and Methods: We searched Medline from 1969 (its inception) to 2011, using the key words “amniotic fluid embolism”. The search produced 1127 articles, including 208 case reports of AFE and other publications identified as eligible for our study (11 review articles and 6 population-based studies of the last few years). Moreover, we looked through the articles from the period before “inception of Medline” to find 178 earlier case reports. Full texts were analyzed. Results and Conclusions: (i) Worldwide, 447 cases of AFE have been reported, including 70 cases of atypical AFE (15.7%). (ii) Typical AFE is characterized by three clinical phases (cardiopulmonary collapse, clotting disorders and hemorrhages, multiorgan disturbances), whereas the atypical one shows lack of cardiopulmonary collapse as the initial presentation—the first to appear is obstetric hemorrhage and/or pulmonary and renal dysfunction. (iii) Four subclasses of atypical AFE were distinguished on the basis of case reports: uterine hemorrhage-type of AFE, ARDS as the only presentation of atypical AFE, paradoxical AFE, and cesarean section-related atypical AFEs.展开更多
Introduction: Oligohydramnios is an important sign of fetal jeopardy and amniotic fluid index (AFI) and single deepest vertical pocket (SDVP) have been used to detect it. Objective: To compare AFI vs. SDVP at term as ...Introduction: Oligohydramnios is an important sign of fetal jeopardy and amniotic fluid index (AFI) and single deepest vertical pocket (SDVP) have been used to detect it. Objective: To compare AFI vs. SDVP at term as a predictor of adverse perinatal outcomes. Methods: A prospective observational study was conducted in Teaching Hospital Kandy, Sri Lanka for eight months from July 2015 to March 2016. 448 Singleton pregnancies admitted after 37 completed weeks were included. AFI ≤ 5 cm and SDVP < 2 cm were the exposure variables, which were related to outcome variables. Results: Mean AFI was 11.35 cm (SD = 5.15) and Mean SDVP was 4.07 cm (SD = 1.88). AFI and SDVP values showed a significant positive correlation (r = 0.954;p < 0.001). A significant percentage with low AFI needed induction of labour (RR 2.14, 95% CI 1.85 - 2.49). Low AFI was also a significant risk factor for not having an uneventful birth outcome (RR 2.682, 95% CI 1.082 - 6.642). Low SDVP was a significant risk factor for induction of labour (RR 1.83, 95% CI 1.434 - 2.334), operative delivery (RR 1.714, 95% CI 1.292 - 2.280), meconium-stained liquor (RR 2.67, 95% CI 1.342 - 5.308), and Apgar < 7 (RR 17.74, 95% CI 7.96 - 40.924). SDVP had better predictability than AFI for adverse perinatal outcomes. Conclusion: AFI better predicted oligohydramnios and subsequent labour induction than SDVP. Low SDVP was a risk factor for adverse perinatal outcomes (such as induction of labour, meconium-stained liquor, operative delivery, 5-minute Apgar less < 7, admission to special care baby units or perinatal deaths). In predicting adverse perinatal events, a higher potential was noted in SDVP method than AFI method. To determine the most predictive cut-off values of SDVP and AFI for each perinatal outcome, an in-depth experimental analysis is required in future research.展开更多
Literature concerning procoagulant activity of the amniotic fluid and pathomechanism of amniotic fluid embolism (AFE) was surveyed and a new concept of its pathogenesis, called the integrated concept of AFE, was prese...Literature concerning procoagulant activity of the amniotic fluid and pathomechanism of amniotic fluid embolism (AFE) was surveyed and a new concept of its pathogenesis, called the integrated concept of AFE, was presented. According to this concept, two components of the amniotic fluid are involved: (i) apoptosis-affected amniotic cells showing a special role in the initiation of disseminated intravascular coagulation (DIC) and (ii) leukotrienes (formerly called slow-reacting substances), inducing bronchial and pulmonary vascular smooth muscle contraction. Although each of these components initiates a different pathogenic pathway, they both lead to the formation of a mechanical barrier on blood flow through the lungs (amniotic debris + microemboli) and/or functional barrier (pulmonary vasoconstriction). An old dilemma, concerning indications for heparin therapy in AFE was recalled in the light of the new concept.展开更多
Background and purpose The prenatal diagnosis of cleft palate is an important component of sequential therapy,but the relevant diagnostic methods are still limited.We aimed here,to explore the possibility of an early ...Background and purpose The prenatal diagnosis of cleft palate is an important component of sequential therapy,but the relevant diagnostic methods are still limited.We aimed here,to explore the possibility of an early prenatal diagnosis of cleft palate by assessing metabolites in pregnant mice.Methods Twenty-four inseminated females were randomly divided into retinoic acid(RA)-treated(treated with retinoic acid at 10.5 gestation days)and control groups.The metabolites of the embryonic palatal tissue,maternal amniotic fluid,and serum were characterized using 9.4T magnetic resonance spectroscopy in vitro.Then,a predictive model was established through the principal component analysis(PCA),and the correlations between the metabolites of amniotic fluid and palatal tissue were explored using orthogonal-2 partial least squares(O2-PLS).Results The incidences of cleft palate were 100%and 0%in the RA-treated and control groups,respectively.A predictive PCA model with a high specificity and sensitivity was established for the early prenatal diagnosis of isolated cleft palate using amniotic fluid metabolic data.Between RA-treated and control mice,we found that two metabolites in the amniotic fluid and palatal tissue were correlated.Creatinine showed the same trend in the palatal tissue and amniotic fluid,while choline showed opposite trends in the two tissues.However,the data for serum metabolites could not be used to establish a prediction model.Conclusion This study indicates that assessing the metabolites of amniotic fluid is a potential approach for the prenatal diagnosis of isolated cleft palate.展开更多
Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:Thi...Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:This retrospective cohort study,conducted at Peking University Third Hospital from August 2011 to December 2020,used data from 375 women aged 20 to 45 years who had dichorionic twin pregnancies that were confirmed through first-trimester ultrasound.After exclusions,reference curves were developed using 318 women with 3,299 DVP scans,and the data analyzed included maternal demographics,pregnancy outcomes,ultrasound measurements,and neonatal information.DVPs were assessed via ultrasound at regular intervals and grouped by gestational age(GA)for analyses.Linear mixed models were used to create amniotic fluid reference curves.Associations between abnormalities and adverse perinatal outcomes were examined using Chi-squared or Fisher's exact tests.Logistic regression provided both crude and adjusted odds ratios,adjusting for pre-pregnancy weight,age,ethnicity,parity,and conception mode.Significance was set at P<0.05 with 95%confidence intervals(CI),and the analyses were conducted using SPSS ver.26.0(IBM Corp.,Armonk,NY)and SAS ver.9.4(SAS Institute Inc.,Cary,NC,USA)software.Results:DVP increased from the first trimester to a maximum at 26 weeks(95%confidence interval(CI),2.7–8.3 cm for twin 1 and 2.8–7.9 cm for twin 2)and then decreased gradually toward term.Differences between twins 1 and 2 were significant after 26 weeks(95%CI for twin 1:5.3,5.5;95%CI for twin 2:4.4,4.5;P<0.010).Polyhydramnios of twin 1 increased the risk of large for GA.Oligohydramnios of twin 1 increased the risk of small for GA.Polyhydramnios of twin 2 increased the risk of small for GA,premature birth,and neonatal complications.Oligohydramnios of twin 2 increased the risk of preeclampsia,hypertensive disorder complicating pregnancy,and premature rupture of membranes.Conclusion:Reference curves for twin amniotic fluid volumes vary by GA and differ between twins,with potential implications for pregnancy outcomes.展开更多
Background Making decisions regarding the mode of delivery in the cases of meconium amniotic fluid(MAF)presents a challenge for healthcare providers.We aimed to compare the neonatal outcome of MAF cases delivered via ...Background Making decisions regarding the mode of delivery in the cases of meconium amniotic fluid(MAF)presents a challenge for healthcare providers.We aimed to compare the neonatal outcome of MAF cases delivered via cesarean section(CS)versus those delivered vaginally to determine if CS is a protective factor against the adverse neonatal outcomes.Methods In this retrospective study,we assessed singleton pregnant mothers diagnosed with MAF who gave birth at a tertiary hospital in Bandar Abbas,Iran,between January 2020-2022.Mothers with certain adverse pregnancy conditions were excluded from the study.These conditions included:abnormal fetal heart rate and pattern,bloody amniotic fluid,malpresentation,abnormal placentation,chorioamnionitis,intrauterine growth restriction,intrauterine fetal death,obstructed labor,and maternal comorbidities.The MAF mothers were divided into two groups based on the method of delivery:those who had CS and those who had a normal vaginal delivery(NVD).Demographic factors,obstetrical factors,and neonatal outcomes were compared between the two groups.Results Out of 746 MAF mothers,213(28.5%)underwent CS,while 533(71.4%)had NVD.There were no significant differences between the groups in terms of demographic characteristics.Among MAF mothers who had CS,66.2%were primiparous,and 33.8%were multiparous.For those who had NVD,35.1%were primiparous,and 64.9%were multiparous.The first and 5-min Apgar values,rates of asphyxia,neonatal intensive care unit(NICU)admission,and neonatal death were not statistically different between the two delivery modes.The rate of newborns who breastfed within the first hour did not differ depending on the mode of delivery.Although initial resuscitation steps were required more frequently in MAF mothers with NVD than in those with CS(11.1%vs.2.3%),no correlation was found between the mode of delivery and the need for resuscitation using logistic regression.Conclusions Our research findings suggest that there were no superior neonatal outcomes in terms of CS compared to NVD in MAF mothers.Further studies are needed to provide more substantial evidence to support this conclusion.展开更多
Micro RNAs(mi RNAs) are dynamically regulated during neurodevelopment,yet few reports have examined their role in spina bifida.In this study,we used an established fetal rat model of spina bifida induced by intragastr...Micro RNAs(mi RNAs) are dynamically regulated during neurodevelopment,yet few reports have examined their role in spina bifida.In this study,we used an established fetal rat model of spina bifida induced by intragastrically administering olive oil-containing all-trans retinoic acid to dams on day 10 of pregnancy.Dams that received intragastric administration of all-trans retinoic acid-free olive oil served as controls.The mi RNA expression profile in the amniotic fluid of rats at 20 days of pregnancy was analyzed using an mi RNA microarray assay.Compared with that in control fetuses,the expression of mi RNA-9,mi RNA-124 a,and mi RNA-138 was significantly decreased(> 2-fold),whereas the expression of mi RNA-134 was significantly increased(> 4-fold) in the amniotic fluid of rats with fetuses modeling spina bifida.These results were validated using real-time quantitative reverse-transcription polymerase chain reaction.Hierarchical clustering analysis of the microarray data showed that these differentially expressed mi RNAs could distinguish fetuses modeling spina bifida from control fetuses.Our bioinformatics analysis suggested that these differentially expressed mi RNAs were associated with many cytological pathways,including a nervous system development signaling pathway.These findings indicate that further studies are warranted examining the role of mi RNAs through their regulation of a variety of cell functional pathways in the pathogenesis of spina bifida.Such studies may provide novel targets for the early diagnosis and treatment of spina bifida.展开更多
Complete wound regeneration preserves skin structure and physiological functions,including sensation and perception of stimuli,whereas incomplete wound regeneration results in fibrosis and scarring.Amniotic fluid stem...Complete wound regeneration preserves skin structure and physiological functions,including sensation and perception of stimuli,whereas incomplete wound regeneration results in fibrosis and scarring.Amniotic fluid stem cells(AFSCs)would be a kind of cell population with self-renewing and non-immunogenic ability that have a considerable role in wound generation.They are easy to harvest,culture,and store;moreover,they are non-tumorigenic and not subject to ethical restrictions.They can differentiate into different kinds of cells that replenish the skin,subcutaneous tissues,and accessory organs.Additionally,AFSCs independently produce paracrine effectors and secrete them in exosomes,thereby modulating local immune cell activity.They demonstrate anti-inflammatory and immunomodulatory properties,regulate the physicochemical microenvironment of the wound,and promote full wound regeneration.Thus,AFSCs are potential resources in stem cell therapy,especially in scar-free wound healing.This review describes the biological characteristics and clinical applications of AFSCs in treating wounds and provide new ideas for the treatment of wound healing.展开更多
BACKGROUND Obstetric hemorrhage is the leading cause of maternal mortality globally,especially in China.The key to a successful rescue is immediate and rapid blood transfusion.Autotransfusion has become an integral pa...BACKGROUND Obstetric hemorrhage is the leading cause of maternal mortality globally,especially in China.The key to a successful rescue is immediate and rapid blood transfusion.Autotransfusion has become an integral part of clinical blood transfusion,with intraoperative cell salvage(IOCS)being the most widely used.AIM To investigate the application of IOCS in cesarean section.METHODS A total of 87 patients who underwent cesarean section and blood transfusion in our hospital from March 2015 to June 2020 were included in this prospective controlled study.They were divided into the observation(43 cases)and control(44 cases)groups using the random number table method.The patients in both groups underwent lower-segment cesarean section.The patients in the control group were treated with traditional allogeneic blood transfusion,whereas those in the observation group were treated with IOCS.Hemorheology[Red blood cell count,platelet volume,and fibrinogen(FIB)]and coagulation function(partial prothrombin time,prothrombin time(PT),platelet count,and activated coagulation time)were measured before and 24 h after transfusion.In the two groups,adverse reactions,such as choking and dyspnea,within 2 h after cesarean section were observed.RESULTS Before and after transfusion,no significant differences in hemorheology and coagulation function indices between the two groups were observed(P>0.05).About 24 h after transfusion,the erythrocyte count,platelet ratio,and FIB value significantly decreased in the two groups(P<0.05);the PLT value significantly decreased in the two groups;the activated partial thromboplastin time,PT,and activated clotting time significantly increased in the two groups(P<0.05);and no statistical differences were observed in hemorheology and coagulation function indices between the two groups(P>0.05).Furthermore,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION In patients undergoing cesarean section,intraoperative cell salvage has a minimum effect on hemorheology and coagulation function and does not increase the risk of amniotic fluid embolism.展开更多
Inflammatory,proliferative and remodeling phases constitute a cutaneous wound healing program.Therapeutic applications and medication are available;however,they commonly are comprised of fortified preservatives that m...Inflammatory,proliferative and remodeling phases constitute a cutaneous wound healing program.Therapeutic applications and medication are available;however,they commonly are comprised of fortified preservatives that might prolong the healing process.Chick early amniotic fluids(ceAF)contain native therapeutic factors with balanced chemokines,cytokines and growth-related factors;their origins in principle dictate no existence of harmful agents that would otherwise hamper embryo development.Instead,they possess a spectrum of molecules driving expeditious mitotic divisions and possibly exerting other functions.Employing both in vitro and in vivo models,we examined ceAF's therapeutic potentials in wound healing and found intriguing involvement of transient senescence,known to be intimately intermingled with Senescence Associated Secretory Phenotypes(SASP)that function in addition to or in conjunction with ceAF to facilitate wound healing.In our cutaneous wound healing models,a low dose of ceAF exhibited the best efficacies;however,higher doses attenuated the wound healing presumably by inducing p16 expression over a threshold.Our studies thus link an INK4/ARF locus-mediated signaling cascade to cutaneous wound healing,suggesting therapeutic potentials of ceAF exerting functions likely by driving transient senescence,expediting cellular proliferation,migration,and describing a homeostatic and balanced dosage strategy in medical intervention.展开更多
Myocardial regeneration has been considered a promising option for the treatment of adult myocardial injuries.Previously,a chick early amniotic fluid(ceAF)preparation was shown to contain growth-related factors that p...Myocardial regeneration has been considered a promising option for the treatment of adult myocardial injuries.Previously,a chick early amniotic fluid(ceAF)preparation was shown to contain growth-related factors that pro-moted embryonic growth and cellular proliferation,though the nature of the components within ceAF were not fully defined.Here we tested whether this ceAF preparation is similarly effective in the promotion of myocardial regen-eration,which could provide an alternative therapeutic for intervening myocardial injury.In this study,a myocardial ischemic injury model was established in adult mice and pigs by multiple research entities,and we were able to show that ceAF can efficiently rescue damaged cardiac tissues and markedly improve cardiac function in both experimental models through intravenous administration.ceAF administration increased cell proliferation and improved angio-genesis,likely via down-regulation of Hippo-YAP signaling.Our data suggest that ceAF administration can effectively rescue ischemic heart injury,providing the key functional information for the further development of ceAF for use in attenuating myocardial injury.展开更多
<strong>Objectives:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Although an asymptomatic short cervix is a risk fact...<strong>Objectives:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Although an asymptomatic short cervix is a risk factor for spontaneous preterm birth (SPTB), the risk factors for SPTB among those with short cervix remain unknown. We herein investigated risk factors for preterm delivery (PTD) at <34 weeks of gestation in pregnant women with a short cervix. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study. Seventy-three asymptomatic pregnant women with a sonographic short cervix (excluding visible bulging fetal membranes) were selected, and the relationship between clinical or biochemical risk factors and preterm delivery (PTD) at <34 weeks was examined.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Thirteen cases (17.8%) had PTD at <34 weeks. A univariate analysis showed that a history of SPTD, gestational weeks on admission, cervical length, cervical mucus interleukin (CM-IL)-8 and amniotic fluid interleukin (AF-IL)-8 in PTD at <34 weeks significantly differed from those in delivery at </span><span style="font-family:Verdana;">≥34 weeks (p < 0.05, respectively). A multiple logistic regression analysis i</span><span style="font-family:Verdana;">dentified CM-IL-8 ≥ 803.5 ng/mL [21.3 (3.0 - 260), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.002] and cervical length ≤15 mm [17.1 (1.9 - 517), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.008] as independent risk factors for PTD at <34 weeks.</span><b><span style="font-family:Verdana;"> Conclusions:</span></b><span style="font-family:Verdana;"> Evaluation for cervical inflammation may be necessary for appropriate treatment strategies in asymptomatic pregnant women with a short cervix. Cervical inflammation warrants further study.</span></span></span></span>展开更多
A 39-year-old 34-week-pregnant woman was referred to our hospital for preterm labor and fetal dysfunction. Fetal middle cerebral artery systolic maximum blood flow velocity was high, so fetal anemia was suspected. Blo...A 39-year-old 34-week-pregnant woman was referred to our hospital for preterm labor and fetal dysfunction. Fetal middle cerebral artery systolic maximum blood flow velocity was high, so fetal anemia was suspected. Blood type was O-type Rh (+) and fetal hemoglobin was 0.4%;tests for irregular antibody and human parvovirus B19 IgM were negative. A high brightness echoic mass was observed in fetal stomach bubble, and amniotic fluid appeared bright. Labor suppression was disabled, and emergency cesarean section was performed. Amniotic fluid turbidity was observed, and on suctioning the stomach content of the infant, turbid amniotic fluid containing blood was obtained. On placental pathological examination, the cause of bloody amniotic fluid was not identified. The infant’s hemoglobin level was low at 8.7 g/dL, so the infant received red cell concentrate, with improvement of general condition.展开更多
Pregnancy is a state of immunological balance during which the mother and the developing fetus must tolerate each other while maintaining sufficient immunocompetence to ward off potential threats.The site of closest c...Pregnancy is a state of immunological balance during which the mother and the developing fetus must tolerate each other while maintaining sufficient immunocompetence to ward off potential threats.The site of closest contact between the mother and fetus is the decidua,which represents the maternal–fetal interface.Many of the immune cell subsets present at the maternal–fetal interface have been well described;however,the importance of the maternal T cells in this compartment during late gestation and its complications,such as preterm labor and birth,has only recently been established.Moreover,pioneer and recent studies have indicated that fetal T cells are activated in different subsets of preterm labor and may elicit distinct inflammatory responses in the amniotic cavity,leading to preterm birth.In this review,we describe the established and proposed roles for maternal T cells at the maternal–fetal interface in normal term parturition,as well as the demonstrated contributions of such cells to the pathological process of preterm labor and birth.We also summarize the current knowledge of and proposed roles for fetal T cells in the pathophysiology of the preterm labor syndrome.It is our hope that this review provides a solid conceptual framework highlighting the importance of maternal and fetal T cells in late gestation and catalyzes new research questions that can further scientific understanding of these cells and their role in preterm labor and birth,the leading cause of neonatal mortality and morbidity worldwide.展开更多
文摘BACKGROUND Persistent left superior vena cava(PLSVC)is the most common venous system variant.The clinical characteristics and amniotic fluid cytogenetics of fetuses with PLSVC remain to be further explored.AIM To develop reliable prenatal diagnostic recommendations through integrated analysis of the clinical characteristics of fetuses with PLSVC.METHODS Cases of PLSVC diagnosed using prenatal ultrasonography between September 2019 and November 2022 were retrospectively studied.The clinical characteristics of the pregnant women,ultrasonic imaging information,gestational age at diagnosis,pregnancy outcomes,and amniocentesis results were summarized and analyzed using categorical statistics and the chi-square test or Fisher’s exact test.RESULTS Of the 97 cases diagnosed by prenatal ultrasound,49(50.5%)had isolated PLSVC and 48(49.5%)had other structural abnormalities.The differences in pregnancy outcomes and amniocentesis conditions between the two groups were statistically significant(P<0.05).No significant differences were identified between the two groups in terms of advanced maternal age and gestational age(P>0.05).According to the results of the classification statistics,the most common intrac-ardiac abnormality was a ventricular septal defect and the most common extrac-ardiac abnormality was a single umbilical artery.In the subgroup analysis,the concurrent combination of intra-and extracardiac structural abnormalities was a risk factor for adverse pregnancy outcomes(odds ratio>1,P<0.05).Additional-ly,all abnormal cytogenetic findings on amniocentesis were observed in the comorbidity group.One case was diagnosed with 21-trisomy and six cases was diagnosed with chromosome segment duplication.CONCLUSION Examination for other structural abnormalities is strongly recommended when PLSVC is diagnosed.Poorer pregnancy outcomes and increased amniocentesis were observed in PLSVC cases with other structural abnor-malities.Amniotic fluid cytogenetics of fetuses is recommended for PLSVC with other structural abnormalities.
文摘Background: Amniotic fluid turbidity increases with fetal lung maturation due to vernix and lung surfactant micelles suspended in the amniotic fluid. This study focused on this phenomenon and evaluated the presence or absence of respiratory distress syndrome (RDS)/transient tachypnea of the newborn (TTN) by quantitatively assessing the brightness of the amniotic fluid turbidity using a noninvasive ultrasound histogram measurement function. Methods: We included cases of singleton pregnancies managed at the Niigata University Medical and Dental Hospital between November 2020 and March 2022. Histograms of amniotic fluid turbidity were measured at the center of the amniotic fluid depth, avoiding the fetus, placenta, and umbilical cord, with the gain setting set to 0, and the average value was obtained after three measurements. Histograms of fetal urine in the bladder were measured similarly. The value obtained by subtracting the fetal bladder brightness value from the amniotic brightness value based on histogram measurements was used as the final amniotic fluid brightness value. Results: We included 118 cases (16 of RDS/TTN and 102 of control). The gestational age of delivery weeks was correlated with amniotic fluid brightness (Spearman’s rank correlation coefficient was 0.344;p = 0.00014). Amniotic fluid brightness values were significantly lower in the RDS/TTN group than in the control group (RDS/TTN: 16.2 ± 13.5, control: 26.3 ± 16.3;p = 0.020). The optimal cutoff value of amniotic fluid brightness to predict RDS/TTN was 20.3. For predicting RDS/TTN, the sensitivity, specificity, positive predictive value, and negative predictive value were 91.7%, 69.6%, 26.2%, and 94.1%, respectively. Conclusions: The quantitative value of the amniotic fluid brightness by histogram measurements may provide an easy and objective index for evaluating the presence or absence of RDS/TTN.
基金supported by the National Key Developing Project for Basic Research 2012CB966502Hainan Provencial Research Project(10086)+1 种基金Hainan Provencial Key Research Project(ZDXM 20130063)National University Student’s Independent Innovative Project(201411810048)
文摘Objective:To test the hypothesis that concentration of amniotic fluid alpha-fetal protein(AFAFP) is increased in thalassemia fetus.Methods:A total of 135 cases of amniocentesis admitted from July 2013 to December 2014 were included in this study.Among them 98 cases of normal fetuses were assigned into control group and 37 cases of thalassemia fetus were included as thalassemia fetus group.Alpha-fetoprotein levels detected by enzyme linked immunosorbent assay and the alpha-fetoprotein concentration were compared between the two groups.There is no significant difference in gestrational age between the two groups.Results:1.AFP concentration in thalassemia fetus group was significantly higher than that of normal control group [(1541.65±734.78) μg/mL vs.(2728.84± 1539.97) μg/mL ],and amniotic fluid AFP concentration was related to fetal thalassemia.2.AFAFP concentration in pureα-thalassemia fetus was higher than that of β thalassemia fetus or mixed αand was not significant.Conclusions:Concentration of a β thalassemia fetus,but the difference mniotic fluid alpha-fetal protein is increased in thalassemia fetus.AFP concentration inα-thalassemia fetus was higher than that of β thalassemia or mixed αand lore β thalassemia fetus but difference was not significance.Further studies are needed to exp the possible correlation between Down syndrome and biochemical markers of Thalassemia.
基金Supported by the Linkou Chang Gung Memorial Hospital grants,No. CMRPG3J0951 and No. CMRPG3H1041-2Ministry of Science and Technology Taiwan grants,No. MOST 107-2314-B-182A-101 and No. MOST 109-2314-B-182A-084
文摘BACKGROUND Diabetes mellitus(DM)is a serious and growing global health burden.It is estimated that 80%of diabetic patients have micturition problems such as poor emptying,urinary incontinence,urgency,and urgency incontinence.Patients with diabetic bladder dysfunction are often resistant to currently available therapies.It is necessary to develop new and effective treatment methods.AIM To examine the therapeutic effect of human amniotic fluid stem cells(hAFSCs)therapy on bladder dysfunction in a type 2 diabetic rat model.METHODS Sixty female Sprague-Dawley rats were divided into five groups:Group 1,normal-diet control(control);group 2,high-fat diet(HFD);group 3,HFD plus streptozotocin-induced DM(DM);group 4,DM plus insulin treatment(DM+insulin);group 5,DM plus hAFSCs injection via tail vein(DM+hAFSCs).Conscious cystometric studies were done at 4 and 12 wk after insulin or hAFSCs treatment to measure peak voiding pressure,voided volume,intercontraction interval,bladder capacity,and residual volume.Immunoreactivities and/or mRNA expression of muscarinic receptors,nerve growth factor(NGF),and sensory nerve markers in the bladder and insulin,MafA,and pancreatic-duodenal homeobox-1(PDX-1)in pancreatic beta cells were studied.RESULTS Compared with DM rats,insulin but not hAFSCs treatment could reduce the bladder weight and improve the voided volume,intercontraction interval,bladder capacity,and residual volume(P<0.05).However,both insulin and hAFSCs treatment could help to regain the blood glucose and bladder functions to the levels near controls(P>0.05).The immunoreactivities and mRNA expression of M2-and M3-muscarinic receptors(M2 and M3)were increased mainly at 4 wk(P<0.05),while the number of beta cells in islets and the immunoreactivities and/or mRNA of NGF,calcitonin gene-related peptide(CGRP),substance P,insulin,MafA,and PDX-1 were decreased in DM rats(P<0.05).However,insulin and hAFSCs treatment could help to regain the expression of M2,M3,NGF,CGRP,substance P,MafA,and PDX-1 to near the levels of controls at 4 and/or 12 wk(P>0.05).CONCLUSION Insulin but not hAFSCs therapy can recover the bladder dysfunction caused by DM;however,hAFSCs and insulin therapy can help to regain bladder function to near the levels of control.
文摘Aim: The objective of this study is to review all the reported outcomes of heparin application in amniotic fluid embolism (AFE) so far and to find out why, when and how heparin or other anticoagulants should be used in AFE. Material and methods: We searched Medline (from 1969 to 2011), using two key words: 1) amniotic fluid embolism;2) amniotic fluid embolism and heparin. The search for the former produced 1127 replies, of which 208 were case reports of AFE. In response to the other key word, there were 94 articles. We looked through all the articles, selecting those relevant for our study. Results: In the years 1969-2011, 208 AFE cases were reported. Heparin (unfractionated heparin) or low molecular weight heparin (LMWH) was applied in 20 cases (9.6%), being the main drug in 11 cases (5.3%) and in 6 cases as a component of spectacular treatment of AFE (surgical treatment and extracorporal membrane oxygenation). In one of these cases anithrombin (AT) with LMWH was used. In one patient heparin therapy was considered to be unsuccessful and hence recombinant plasminogen activator (rt-PA) was instituted. All the patients survived. Conclusions: 1) The attempts to use heparin in AFE could be defined as promising, although the number of treated patients is too small for conclusion;2) The postulate to use heparin at the very onset of AFE (a bolus of 10,000 U followed by monitored intravenous infusion) has serious justification: one of the pathways of AFE is the target for heparin (coagulation pathway).
文摘Background/Aim: Recently, a comparative study on the incidence of AFE has highlighted rather confusing results, showing that the complication is more than three times higher in North America than that in some European countries. In this paper, we put forward the hypothesis that this discrepancy is due to inaccurate diagnosis of non-classical form of AFE (atypical AFE). We also provide an outline of symptoms that characterize this type of AFE based on the analysis of all available case reports. Material and Methods: We searched Medline from 1969 (its inception) to 2011, using the key words “amniotic fluid embolism”. The search produced 1127 articles, including 208 case reports of AFE and other publications identified as eligible for our study (11 review articles and 6 population-based studies of the last few years). Moreover, we looked through the articles from the period before “inception of Medline” to find 178 earlier case reports. Full texts were analyzed. Results and Conclusions: (i) Worldwide, 447 cases of AFE have been reported, including 70 cases of atypical AFE (15.7%). (ii) Typical AFE is characterized by three clinical phases (cardiopulmonary collapse, clotting disorders and hemorrhages, multiorgan disturbances), whereas the atypical one shows lack of cardiopulmonary collapse as the initial presentation—the first to appear is obstetric hemorrhage and/or pulmonary and renal dysfunction. (iii) Four subclasses of atypical AFE were distinguished on the basis of case reports: uterine hemorrhage-type of AFE, ARDS as the only presentation of atypical AFE, paradoxical AFE, and cesarean section-related atypical AFEs.
文摘Introduction: Oligohydramnios is an important sign of fetal jeopardy and amniotic fluid index (AFI) and single deepest vertical pocket (SDVP) have been used to detect it. Objective: To compare AFI vs. SDVP at term as a predictor of adverse perinatal outcomes. Methods: A prospective observational study was conducted in Teaching Hospital Kandy, Sri Lanka for eight months from July 2015 to March 2016. 448 Singleton pregnancies admitted after 37 completed weeks were included. AFI ≤ 5 cm and SDVP < 2 cm were the exposure variables, which were related to outcome variables. Results: Mean AFI was 11.35 cm (SD = 5.15) and Mean SDVP was 4.07 cm (SD = 1.88). AFI and SDVP values showed a significant positive correlation (r = 0.954;p < 0.001). A significant percentage with low AFI needed induction of labour (RR 2.14, 95% CI 1.85 - 2.49). Low AFI was also a significant risk factor for not having an uneventful birth outcome (RR 2.682, 95% CI 1.082 - 6.642). Low SDVP was a significant risk factor for induction of labour (RR 1.83, 95% CI 1.434 - 2.334), operative delivery (RR 1.714, 95% CI 1.292 - 2.280), meconium-stained liquor (RR 2.67, 95% CI 1.342 - 5.308), and Apgar < 7 (RR 17.74, 95% CI 7.96 - 40.924). SDVP had better predictability than AFI for adverse perinatal outcomes. Conclusion: AFI better predicted oligohydramnios and subsequent labour induction than SDVP. Low SDVP was a risk factor for adverse perinatal outcomes (such as induction of labour, meconium-stained liquor, operative delivery, 5-minute Apgar less < 7, admission to special care baby units or perinatal deaths). In predicting adverse perinatal events, a higher potential was noted in SDVP method than AFI method. To determine the most predictive cut-off values of SDVP and AFI for each perinatal outcome, an in-depth experimental analysis is required in future research.
文摘Literature concerning procoagulant activity of the amniotic fluid and pathomechanism of amniotic fluid embolism (AFE) was surveyed and a new concept of its pathogenesis, called the integrated concept of AFE, was presented. According to this concept, two components of the amniotic fluid are involved: (i) apoptosis-affected amniotic cells showing a special role in the initiation of disseminated intravascular coagulation (DIC) and (ii) leukotrienes (formerly called slow-reacting substances), inducing bronchial and pulmonary vascular smooth muscle contraction. Although each of these components initiates a different pathogenic pathway, they both lead to the formation of a mechanical barrier on blood flow through the lungs (amniotic debris + microemboli) and/or functional barrier (pulmonary vasoconstriction). An old dilemma, concerning indications for heparin therapy in AFE was recalled in the light of the new concept.
基金This study was funded by the Guangdong Basic and Applied Basic Research Foundation(2019A1515011857)the Guangdong Medical Research Foundation Project(A2019108,A2020099,A2020538)+4 种基金the Guangdong Science and Technology Innovation Strategy Special Fund(Vertical Collaborative Management Direction)Project([2018]157-45)the Guangdong Higher Education Teaching Reform Project(No.246),the Shantou University Chuangqiang Provincial Special Fund Construction Project(925-38230120)the Shantou University Special Support for In-school Research of the School of Arts(STURCS201813)and the Shantou Science and Technology Project([2019]10602)It was also supported by the Department of Education of Guangdong Province under the Top-tier University Development Scheme for Research and Control of Infectious Diseases and the grant for Key Disciplinary Project of Clinical Medicine under the Guangdong Highlevel University Development Program,and supported by 2020 Li Ka Shing Foundation Cross-Disciplinary Research Grant(2020LKSFG18B,2020LKSFG02E).
文摘Background and purpose The prenatal diagnosis of cleft palate is an important component of sequential therapy,but the relevant diagnostic methods are still limited.We aimed here,to explore the possibility of an early prenatal diagnosis of cleft palate by assessing metabolites in pregnant mice.Methods Twenty-four inseminated females were randomly divided into retinoic acid(RA)-treated(treated with retinoic acid at 10.5 gestation days)and control groups.The metabolites of the embryonic palatal tissue,maternal amniotic fluid,and serum were characterized using 9.4T magnetic resonance spectroscopy in vitro.Then,a predictive model was established through the principal component analysis(PCA),and the correlations between the metabolites of amniotic fluid and palatal tissue were explored using orthogonal-2 partial least squares(O2-PLS).Results The incidences of cleft palate were 100%and 0%in the RA-treated and control groups,respectively.A predictive PCA model with a high specificity and sensitivity was established for the early prenatal diagnosis of isolated cleft palate using amniotic fluid metabolic data.Between RA-treated and control mice,we found that two metabolites in the amniotic fluid and palatal tissue were correlated.Creatinine showed the same trend in the palatal tissue and amniotic fluid,while choline showed opposite trends in the two tissues.However,the data for serum metabolites could not be used to establish a prediction model.Conclusion This study indicates that assessing the metabolites of amniotic fluid is a potential approach for the prenatal diagnosis of isolated cleft palate.
基金supported by Beijing Municipal Science&Technology Commission (Z201100005520074)Peking University Third Hospital (BYSYDL2021004)National Clinical Research Center for Obstetrics and Gynecology (BYSYSZKF2021003).
文摘Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:This retrospective cohort study,conducted at Peking University Third Hospital from August 2011 to December 2020,used data from 375 women aged 20 to 45 years who had dichorionic twin pregnancies that were confirmed through first-trimester ultrasound.After exclusions,reference curves were developed using 318 women with 3,299 DVP scans,and the data analyzed included maternal demographics,pregnancy outcomes,ultrasound measurements,and neonatal information.DVPs were assessed via ultrasound at regular intervals and grouped by gestational age(GA)for analyses.Linear mixed models were used to create amniotic fluid reference curves.Associations between abnormalities and adverse perinatal outcomes were examined using Chi-squared or Fisher's exact tests.Logistic regression provided both crude and adjusted odds ratios,adjusting for pre-pregnancy weight,age,ethnicity,parity,and conception mode.Significance was set at P<0.05 with 95%confidence intervals(CI),and the analyses were conducted using SPSS ver.26.0(IBM Corp.,Armonk,NY)and SAS ver.9.4(SAS Institute Inc.,Cary,NC,USA)software.Results:DVP increased from the first trimester to a maximum at 26 weeks(95%confidence interval(CI),2.7–8.3 cm for twin 1 and 2.8–7.9 cm for twin 2)and then decreased gradually toward term.Differences between twins 1 and 2 were significant after 26 weeks(95%CI for twin 1:5.3,5.5;95%CI for twin 2:4.4,4.5;P<0.010).Polyhydramnios of twin 1 increased the risk of large for GA.Oligohydramnios of twin 1 increased the risk of small for GA.Polyhydramnios of twin 2 increased the risk of small for GA,premature birth,and neonatal complications.Oligohydramnios of twin 2 increased the risk of preeclampsia,hypertensive disorder complicating pregnancy,and premature rupture of membranes.Conclusion:Reference curves for twin amniotic fluid volumes vary by GA and differ between twins,with potential implications for pregnancy outcomes.
文摘Background Making decisions regarding the mode of delivery in the cases of meconium amniotic fluid(MAF)presents a challenge for healthcare providers.We aimed to compare the neonatal outcome of MAF cases delivered via cesarean section(CS)versus those delivered vaginally to determine if CS is a protective factor against the adverse neonatal outcomes.Methods In this retrospective study,we assessed singleton pregnant mothers diagnosed with MAF who gave birth at a tertiary hospital in Bandar Abbas,Iran,between January 2020-2022.Mothers with certain adverse pregnancy conditions were excluded from the study.These conditions included:abnormal fetal heart rate and pattern,bloody amniotic fluid,malpresentation,abnormal placentation,chorioamnionitis,intrauterine growth restriction,intrauterine fetal death,obstructed labor,and maternal comorbidities.The MAF mothers were divided into two groups based on the method of delivery:those who had CS and those who had a normal vaginal delivery(NVD).Demographic factors,obstetrical factors,and neonatal outcomes were compared between the two groups.Results Out of 746 MAF mothers,213(28.5%)underwent CS,while 533(71.4%)had NVD.There were no significant differences between the groups in terms of demographic characteristics.Among MAF mothers who had CS,66.2%were primiparous,and 33.8%were multiparous.For those who had NVD,35.1%were primiparous,and 64.9%were multiparous.The first and 5-min Apgar values,rates of asphyxia,neonatal intensive care unit(NICU)admission,and neonatal death were not statistically different between the two delivery modes.The rate of newborns who breastfed within the first hour did not differ depending on the mode of delivery.Although initial resuscitation steps were required more frequently in MAF mothers with NVD than in those with CS(11.1%vs.2.3%),no correlation was found between the mode of delivery and the need for resuscitation using logistic regression.Conclusions Our research findings suggest that there were no superior neonatal outcomes in terms of CS compared to NVD in MAF mothers.Further studies are needed to provide more substantial evidence to support this conclusion.
文摘Micro RNAs(mi RNAs) are dynamically regulated during neurodevelopment,yet few reports have examined their role in spina bifida.In this study,we used an established fetal rat model of spina bifida induced by intragastrically administering olive oil-containing all-trans retinoic acid to dams on day 10 of pregnancy.Dams that received intragastric administration of all-trans retinoic acid-free olive oil served as controls.The mi RNA expression profile in the amniotic fluid of rats at 20 days of pregnancy was analyzed using an mi RNA microarray assay.Compared with that in control fetuses,the expression of mi RNA-9,mi RNA-124 a,and mi RNA-138 was significantly decreased(> 2-fold),whereas the expression of mi RNA-134 was significantly increased(> 4-fold) in the amniotic fluid of rats with fetuses modeling spina bifida.These results were validated using real-time quantitative reverse-transcription polymerase chain reaction.Hierarchical clustering analysis of the microarray data showed that these differentially expressed mi RNAs could distinguish fetuses modeling spina bifida from control fetuses.Our bioinformatics analysis suggested that these differentially expressed mi RNAs were associated with many cytological pathways,including a nervous system development signaling pathway.These findings indicate that further studies are warranted examining the role of mi RNAs through their regulation of a variety of cell functional pathways in the pathogenesis of spina bifida.Such studies may provide novel targets for the early diagnosis and treatment of spina bifida.
基金National Natural Science Foundation of China(Approval numbers 81871570 and 82072195)Science and Technology Plan of Guizhou Province(No.20204Y148 and No.20162910)Collaborative Innovation of 2011 for Tissue Injury Repair and Regenerative Medicine of Guizhou Province(No.201507)。
文摘Complete wound regeneration preserves skin structure and physiological functions,including sensation and perception of stimuli,whereas incomplete wound regeneration results in fibrosis and scarring.Amniotic fluid stem cells(AFSCs)would be a kind of cell population with self-renewing and non-immunogenic ability that have a considerable role in wound generation.They are easy to harvest,culture,and store;moreover,they are non-tumorigenic and not subject to ethical restrictions.They can differentiate into different kinds of cells that replenish the skin,subcutaneous tissues,and accessory organs.Additionally,AFSCs independently produce paracrine effectors and secrete them in exosomes,thereby modulating local immune cell activity.They demonstrate anti-inflammatory and immunomodulatory properties,regulate the physicochemical microenvironment of the wound,and promote full wound regeneration.Thus,AFSCs are potential resources in stem cell therapy,especially in scar-free wound healing.This review describes the biological characteristics and clinical applications of AFSCs in treating wounds and provide new ideas for the treatment of wound healing.
文摘BACKGROUND Obstetric hemorrhage is the leading cause of maternal mortality globally,especially in China.The key to a successful rescue is immediate and rapid blood transfusion.Autotransfusion has become an integral part of clinical blood transfusion,with intraoperative cell salvage(IOCS)being the most widely used.AIM To investigate the application of IOCS in cesarean section.METHODS A total of 87 patients who underwent cesarean section and blood transfusion in our hospital from March 2015 to June 2020 were included in this prospective controlled study.They were divided into the observation(43 cases)and control(44 cases)groups using the random number table method.The patients in both groups underwent lower-segment cesarean section.The patients in the control group were treated with traditional allogeneic blood transfusion,whereas those in the observation group were treated with IOCS.Hemorheology[Red blood cell count,platelet volume,and fibrinogen(FIB)]and coagulation function(partial prothrombin time,prothrombin time(PT),platelet count,and activated coagulation time)were measured before and 24 h after transfusion.In the two groups,adverse reactions,such as choking and dyspnea,within 2 h after cesarean section were observed.RESULTS Before and after transfusion,no significant differences in hemorheology and coagulation function indices between the two groups were observed(P>0.05).About 24 h after transfusion,the erythrocyte count,platelet ratio,and FIB value significantly decreased in the two groups(P<0.05);the PLT value significantly decreased in the two groups;the activated partial thromboplastin time,PT,and activated clotting time significantly increased in the two groups(P<0.05);and no statistical differences were observed in hemorheology and coagulation function indices between the two groups(P>0.05).Furthermore,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION In patients undergoing cesarean section,intraoperative cell salvage has a minimum effect on hemorheology and coagulation function and does not increase the risk of amniotic fluid embolism.
文摘Inflammatory,proliferative and remodeling phases constitute a cutaneous wound healing program.Therapeutic applications and medication are available;however,they commonly are comprised of fortified preservatives that might prolong the healing process.Chick early amniotic fluids(ceAF)contain native therapeutic factors with balanced chemokines,cytokines and growth-related factors;their origins in principle dictate no existence of harmful agents that would otherwise hamper embryo development.Instead,they possess a spectrum of molecules driving expeditious mitotic divisions and possibly exerting other functions.Employing both in vitro and in vivo models,we examined ceAF's therapeutic potentials in wound healing and found intriguing involvement of transient senescence,known to be intimately intermingled with Senescence Associated Secretory Phenotypes(SASP)that function in addition to or in conjunction with ceAF to facilitate wound healing.In our cutaneous wound healing models,a low dose of ceAF exhibited the best efficacies;however,higher doses attenuated the wound healing presumably by inducing p16 expression over a threshold.Our studies thus link an INK4/ARF locus-mediated signaling cascade to cutaneous wound healing,suggesting therapeutic potentials of ceAF exerting functions likely by driving transient senescence,expediting cellular proliferation,migration,and describing a homeostatic and balanced dosage strategy in medical intervention.
基金This work was supported by ZheJiang HygeianCells Biomedical Co.Ltd.,Hangzhou,Zhejiang,310019,China.
文摘Myocardial regeneration has been considered a promising option for the treatment of adult myocardial injuries.Previously,a chick early amniotic fluid(ceAF)preparation was shown to contain growth-related factors that pro-moted embryonic growth and cellular proliferation,though the nature of the components within ceAF were not fully defined.Here we tested whether this ceAF preparation is similarly effective in the promotion of myocardial regen-eration,which could provide an alternative therapeutic for intervening myocardial injury.In this study,a myocardial ischemic injury model was established in adult mice and pigs by multiple research entities,and we were able to show that ceAF can efficiently rescue damaged cardiac tissues and markedly improve cardiac function in both experimental models through intravenous administration.ceAF administration increased cell proliferation and improved angio-genesis,likely via down-regulation of Hippo-YAP signaling.Our data suggest that ceAF administration can effectively rescue ischemic heart injury,providing the key functional information for the further development of ceAF for use in attenuating myocardial injury.
文摘<strong>Objectives:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">Although an asymptomatic short cervix is a risk factor for spontaneous preterm birth (SPTB), the risk factors for SPTB among those with short cervix remain unknown. We herein investigated risk factors for preterm delivery (PTD) at <34 weeks of gestation in pregnant women with a short cervix. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study. Seventy-three asymptomatic pregnant women with a sonographic short cervix (excluding visible bulging fetal membranes) were selected, and the relationship between clinical or biochemical risk factors and preterm delivery (PTD) at <34 weeks was examined.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Thirteen cases (17.8%) had PTD at <34 weeks. A univariate analysis showed that a history of SPTD, gestational weeks on admission, cervical length, cervical mucus interleukin (CM-IL)-8 and amniotic fluid interleukin (AF-IL)-8 in PTD at <34 weeks significantly differed from those in delivery at </span><span style="font-family:Verdana;">≥34 weeks (p < 0.05, respectively). A multiple logistic regression analysis i</span><span style="font-family:Verdana;">dentified CM-IL-8 ≥ 803.5 ng/mL [21.3 (3.0 - 260), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.002] and cervical length ≤15 mm [17.1 (1.9 - 517), </span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.008] as independent risk factors for PTD at <34 weeks.</span><b><span style="font-family:Verdana;"> Conclusions:</span></b><span style="font-family:Verdana;"> Evaluation for cervical inflammation may be necessary for appropriate treatment strategies in asymptomatic pregnant women with a short cervix. Cervical inflammation warrants further study.</span></span></span></span>
文摘A 39-year-old 34-week-pregnant woman was referred to our hospital for preterm labor and fetal dysfunction. Fetal middle cerebral artery systolic maximum blood flow velocity was high, so fetal anemia was suspected. Blood type was O-type Rh (+) and fetal hemoglobin was 0.4%;tests for irregular antibody and human parvovirus B19 IgM were negative. A high brightness echoic mass was observed in fetal stomach bubble, and amniotic fluid appeared bright. Labor suppression was disabled, and emergency cesarean section was performed. Amniotic fluid turbidity was observed, and on suctioning the stomach content of the infant, turbid amniotic fluid containing blood was obtained. On placental pathological examination, the cause of bloody amniotic fluid was not identified. The infant’s hemoglobin level was low at 8.7 g/dL, so the infant received red cell concentrate, with improvement of general condition.
基金This research was supported by the Wayne State University Perinatal Initiative in Maternal,Perinatal and Child Health and the Perinatology Research Branch,Division of Obstetrics and Maternal–Fetal Medicine,Division of Intramural Research,Eunice Kennedy Shriver National Institute of Child Health and Human Development,National Institutes of Health,U.S.Department of Health and Human Services(NICHD/NIH/DHHS)in part,with federal funds from NICHD/NIH/DHHS under Contract no.HHSN275201300006C.Dr.Romero has contributed to this work as part of his official duties as an employee of the United States Federal Government.
文摘Pregnancy is a state of immunological balance during which the mother and the developing fetus must tolerate each other while maintaining sufficient immunocompetence to ward off potential threats.The site of closest contact between the mother and fetus is the decidua,which represents the maternal–fetal interface.Many of the immune cell subsets present at the maternal–fetal interface have been well described;however,the importance of the maternal T cells in this compartment during late gestation and its complications,such as preterm labor and birth,has only recently been established.Moreover,pioneer and recent studies have indicated that fetal T cells are activated in different subsets of preterm labor and may elicit distinct inflammatory responses in the amniotic cavity,leading to preterm birth.In this review,we describe the established and proposed roles for maternal T cells at the maternal–fetal interface in normal term parturition,as well as the demonstrated contributions of such cells to the pathological process of preterm labor and birth.We also summarize the current knowledge of and proposed roles for fetal T cells in the pathophysiology of the preterm labor syndrome.It is our hope that this review provides a solid conceptual framework highlighting the importance of maternal and fetal T cells in late gestation and catalyzes new research questions that can further scientific understanding of these cells and their role in preterm labor and birth,the leading cause of neonatal mortality and morbidity worldwide.
