ObjectiveTo discuss the value of diffusion weighted imaging (DWI) in the diagnosis of placenta increta. MethodsThe clinical data of 42 patients with placenta increta admitted to Sichuan Provincial Hospital for Women and Children between May 2012 and January 2014 were retrospectively analyzed. All the patients were examined by prenatal magnetic resonance scans and DWI scans for subsequent comparison between ADC of the local convex placental region and ADC of the normal placental region and between the results of the two imaging methods. ResultsADC of the implantation area was significantly different from that of the normal placenta, so it could be used as a quantitative index. DWI had a higher sensitivity of diagnosis than conventional MRI. ConclusionCompared with conventional magnetic resonance imaging, DWI is more valuable in the clinical diagnosis of placenta increta, which provides a reliable basis for clinical treatment.
目的 建立测定胎盘灌流液中格列苯脲浓度的高效液相色谱（HPLC）检测方法。方法 采用的色谱柱为Symmetry Shield RP C18（150 mm×4.6 mm，5 μm），柱温40℃，流动相为NaH2PO4缓冲盐（25 mmol/L，pH值5.2）︰乙腈=1︰1；内标为格列齐特，流速1.0 mL/min，检测波长228 nm，采用液-液萃取预处理方法测定胎盘灌流液中格列苯脲的浓度。 结果 格列苯脲浓度线性范围为2.0～25.0 μg/mL，线性方程为：y=0.226x+0.002，r=0.999 9 （n=6），日内相对标准偏差（RSD）＜3.1%，日间RSD＜9.5%，方法学回收率为95.32%～103.35%。 结论 HPLC检测方法灵敏、简便，可用于胎盘灌流液中格列苯脲浓度的检测。
Objective To explore a method to isolate, culture and multiplicate the placentaderived mesenchymal stem cells (PMSCs) and the bone marrow-derived mesenchymal stem cells (BMSCs) of rabbit，and to compare their biological characteristics. Methods PMSCs were isolated from placenta of 1fetation rabbitby Percoll density gradient centrifuge and cultured in vitro. BMSCs were isolated from hindlimb bone marrow blood of 1 new born rabbit by direct plates culturemethod. The 3rd passage PMSCs and BMSCs were observed by inverted phase contrast microscope. The stem cell marker (CD44, CD105, CD34 and CD40L) were examined by immunohistochemistry. The 2nd passage PMSCs and BMSCs were co-cultured with biomaterials，(1.0-1.5)×106 cells in one biomaterial， and then observed by aematoxylinstaining after 5 days,and by SEM after 3 days and 8 days. Results PMSCs and BMSCs were both uniformly spondle-shaped in appearance and showed active proliferative capacity. The proliferative ability of PMSCs were quite b and declined with passages. After cultured 10 passages in vitro, its growthslowed. Both PMSCs and BMSCs expressed CD44 and CD105,but did not express CD34 and CD40L immunoreactivity. PMSCs and BMSCs poliferated and adhered to the surface of biomaterials, and cell formed clumps and network; the cells proliferation and the matrix were seen in the pore after 5 days of culture. The observation ofSEM showed that many cells adhered to the biomaterials with spindle-shape and polygon after 3 days; and that PMSCs and BMSCs grew,arranged in layers andsecreted many matrices; the reticular collagen formed arround cells after 8 days. Conclusion PMSCs and BMSCs have similar biological characteristics and PMSCs can be served as excellent seedingcells for tissue engineering.
ObjectiveTo systematically evaluate the changes in placental protein expressions in gestational diabetes mellitus (GDM) and their correlations with maternal insulin resistance (IR). Methods PubMed, Cochrane Library, Scopus, Web of Science, Embase, China National Knowledge Infrastructure, VIP database, Wanfang Database and CBMdisc were searched for case-control studies published from January 2009 to November 2021, which reported the placental protein expressions in GDM and their correlations with IR. Two researchers independently reviewed the literature, extracted data and evaluated the literature quality. RevMan 5.4 software was used for meta-analysis, and descriptive analysis was performed on data that cannot be combined. ResultsA total of 19 studies were included, comprising 2 012 patients. The results of meta-analysis showed that: the expression level of retinol binding protein 4 (RBP4) [standard mean difference=2.11, 95% confidence interval (CI) (1.64, 2.58), P<0.000 01] and the positive rate of protein tyrosine phosphatase-1B (PTP1B) [relative risk (RR)=1.56, 95%CI (1.29, 1.88), P<0.000 01] were up-regulated, and the positive rate of insulin receptor substrate 1 (IRS-1) [RR=0.69, 95%CI (0.60, 0.78), P<0.000 01] was down-regulated. The protein expression levels of RBP4 (P<0.000 01) and PTP1B (P<0.000 01) were positively correlated with homeostasis model assessment of insulin resistance (HOMA-IR), while the protein expression levels of IRS-1 (P<0.000 01) and APN (P=0.002) were negatively correlated with HOMA-IR, and glucose transporter 4 (GLUT 4) was not correlated with HOMA-IR (P=0.79). Descriptive analysis found that the expression levels or positive rates of adipocytokines (leptin, resistin), oxidative stress markers (xanthione oxidase, malondialdehyde, 8-isoprostaglandin),inflammatory factors (tumor necrosis factor α, Toll-like receptor 4, Galectin-3, Galectin-2, migration inhibitory factor),fetuin-A, forkhead box transcription factor 1, forkhead box transcription factor 3a and estrogen receptor α in GDM placenta were up-regulated and all were positively correlated with HOMA-IR. The expression levels or positive rates of insulin signaling pathway proteins [phosphoinositide 3-kinase (PI3K), protein kinases B (AKT), phospho-protein kinases B (p-AKT), GLUT 4] were down-regulated, PI3K and AKT were negatively correlatedwith HOMA-IR, while p-Akt had no correlation with HOMA-IR. ConclusionsThe dysregulation of placental protein expressions may mediate maternal IR exacerbation, thus promote the occurrence and development of GDM and other pregnancy complications. The causal relationship and regulatory mechanism are still unclear, which need to be further studied.
【摘要】目的探讨骨桥蛋白(OPN)及其受体整合素ανβ3在子痫前期(preeclampsia,PE)患者胎盘组织中的表达及其意义。方法2008年11月2009年9月,采用免疫组织化学方法检测20例PE患者(轻度及重度PE各10例)和14例正常足月孕妇(对照组)胎盘组织中OPN及ανβ3蛋白表达水平。采用RTPCR检测各组孕妇胎盘组织中的OPN、αν和β3的mRNA的表达水平。结果PE组孕妇胎盘组织中OPN及ανβ3蛋白表达低下,与对照组相比,差异有统计学意义(Plt;0.05);重度PE组OPN及ανβ3蛋白表达水平更低,与轻度PE组比较,差异有统计学意义(Plt;0.05)。PE组孕妇胎盘组织中OPN mRNA水平明显低于对照组,两组差异有统计学意义(Plt;0.05);重度PE组OPN mRNA水平显著降低,与轻度PE组比较,两组差异有统计学意义(Plt;0.05);但αν和β3 mRNA的表达水平三组间比较差异无统计学意义。结论OPN及其受体整合素ανβ3在PE胎盘组织中的低表达可能在子痫前期的发病过程中起重要作用。
ObjectiveTo explore the related factors for the influences and outcomes of mothers and infants, and further provide a basic reference for reducing maternal and prenatal mortality caused by central placenta previa, through the analysis of its clinical characteristics. MethodsWe retrospectively analyzed the clinical data of 89 patients with central placenta previa treated from January to August 2012. ResultsThere were 89 patients with central placenta previa, and the average age of these patients was (29.6±11.4) years, and the average number of pregnancy among the patients was 3.17. Nine patients had scar uterus; 8 had pernicious placenta previa (9%); 34 had prenatal anemia symptoms; 44 had prenatal vaginal bleeding with the bleeding volume ranged from 2 to 500 mL; 40 were treated before delivery. The average gestational age was 36 weeks ±4.2 days, and 28 of them were readmitted. The intraoperative bleeding in such patients as had placenta located in the anterior wall, placenta adhesion or implantation, history of uterine cavity operation or multipara was more than other patients. The postpartum hemorrhage of patients with the gestational age of 36 weeks or more was more than that of patients with the gestational age shorter than 36 weeks. The incidence of fetal distress in patients with the gestational age of 36 weeks or more is lower and the neonatal 1-minute Apgar score was higher than that in patients with the gestational age shorter than 36 weeks (P<0.05). ConclusionThe treatment of central type of placenta previa should be more active to prolong the gestational week. Patients with placenta adhesion or implantation, caesarean, multipara and placenta in the anterior wall are susceptible to intraoperative bleeding during the termination of pregnancy. Termination of pregnancy in these patients with central placenta previa should be carried out by cesarean section when gestation is more than 36 weeks to reduce postpartum hemorrhage and complications.
摘要:目的: 分析凶险型前置胎盘的临床特点, 预防产后出血和子宫切除的发生。 方法 :对11例凶险型前置胎盘与75例普通型前置胎盘的病例进行回顾性分析。 结果 :凶险型组与普通型组发生产前出血的量差异无统计学意义(Pgt;0.05);在发生胎盘植入、产后出血的量差异有统计学意义(Plt;0.05);子宫切除的发生率差异有统计学意义(Plt;0.05)。 结论 :凶险型前置胎盘对孕产妇有极大的威胁,应努力做好凶险型前置胎盘产后出血的抢救,减少子宫切除的发生。Abstract: Objective: To assess the clinical feature of dangerous placenta praevia in order to prevent postpartum hemorrhage and intrapartal hysterectomy. Methods : Retrospective analysis was done between the 11 cases of dangerous placenta praevia and ordinary placenta praevia . Results : There were no significant difference in blood volume antepartum (Pgt;0.05); There was significant difference in placenta increta and postpartum hemorrhage (Plt;0.05). Conclusion : Dangerous placenta praevia have great threat to gravid and puerperant, we should try our best to rescue postpartum hemorrhage about dangerous placenta praevia and reduce the incidence of intrapartal hysterectomy.
ObjectiveTo investigate the relationship between placental growth factor (PlGF) and the gastric cancer. MethodsThe cancer tissues (cancer tissue group) and para-cancer tissues (para-cancer tissue group) of 88 patients with gastric cancer who underwent surgery in Sichuan Mianyang 404 Hospital from Mar. 2013 to Dec. 2014 were collected retrospectively, to determine the expressions of PlGF mRNA and its protein by polymerase chain reaction (PCR) and immunohistochemistry method. In addition, blood samples of 30 normal persons (normal person group) who got examina-tion in Sichuan Mianyang 404 Hospital in Sep. 2014 and 88 patients with gastric cancer (gastric cancer group) were collected to detect the concentration of serum PlGF, by using enzyme linked immunosorbent assay (ELISA). Comparison of the expressions of PlGF mRNA and its protein between cancer tissue group and para-cancer tissue group, concentration of PlGF between cancer tissue group and normal person group were performed, as well as the relationship between expressions of serum PlGF mRNA/PlGF in gastric cancer tissues and clinicopathological features of patients with gastric cancer, and relationship between concentration of PlGF in blood and clinicopathological features of patients with gastric cancer was explored by univariate analysis. ResultsThe expression level of PlGF mRNA (0.569±0.166 vs. 0.037±0.020, t=-29.948, P=0.000) and positive-expression rate of PlGF[80.7% (71/88) vs. 5.7% (5/88), χ2=100.867, P=0.000] were significantly higher in cancer tissue group than those of para-cancer tissue group. And the concentration of PlGF in blood of patients in gastric cancer group was higher than that of normal person group[(57.247±9.800) ng/L vs. (10.351±1.715) ng/L, t=43.000, P=0.000]. The expressions of PlGF mRNA and its protein were both correlated with diameter of tumor, pT staging, pN staging, differentiation, and Borrmann type (P<0.050). The expression levels of PlGF mRNA and its protein in that patients with diameter of tumor greater than 4 cm, pT3-4 staging, pN3 staging, low differentiation, and Borrmann Ⅲ-Ⅳ staging were higher. While there were no significant correlation between expressions of PlGF mRNA/protein and age, gender, pM staging, and gastrointestinal type (P>0.050). Concentration of serum PlGF of gastric cancer patient wasn't significantly correlated with age, gender, diameter of tumor, pT staging, pN staging, pM staging, differentiation, Borrmann type, and gastrointestinal type (P>0.050). ConclusionThe abnormal expression of PlGF at gastric cancer tissues may play an important role in pathogenesis of gastric cancer.
ObjectiveTo investigate the effects of human placental mesenchymal stem cells (hPMSCs) transplantation on pulmonary vascular endothelial permeability and lung injury repair in mice with lipopolysaccharide (LPS)-induced acute lung injury (ALI).MethodsThe hPMSCs were isolated from the human placental tissue by enzyme digestion and passaged. The cell phenotype of the 3rd generation hPMSCs was detected by flow cytometry. Twenty-four 6-week-old healthy male C57BL/6 mice were randomly divided into 3 groups (n=8). The mice were instilled with LPS in the airway to prepare an ALI model in the ALI model group and the hPMSCs treatment group, and with saline in the control group. At 12 hours after LPS infusion, the mice were injected with 3rd generation hPMSCs via the tail vein in hPMSCs treatment group and with saline in the ALI model group and the control group. At 24 hours after injection, the lung tissues of all mice were taken. The pathological changes were observed by HE staining. The wet/dry mass ratio (W/D) of lung tissue was measured. The Evans blue leak test was used to detect the pulmonary vascular endothelial permea bility in mice. The expression of lung tissue permeability-related protein (VE-cadherin) was detected by Western blot.ResultsFlow cytometry examination showed that the isolated cells had typical MSCs phenotypic characteristics. Mice in each group survived. The alveolar structure of the ALI model group significantly collapsed, a large number of inflammatory cells infiltrated, and local alveolar hemorrhage occurred; while the alveolar structure collapse of the hPMSCs treatment group significantly improved, inflammatory cells infiltration significantly reduced, and a few red blood cells were in the interstitial lung. W/D and exudation volume of Evans blue stain were significantly higher in the ALI model group than in the control group and the hPMSCs treatment group (P<0.05), in the hPMSCs treatment group than in the control group (P<0.05). The relative protein expression of VE-cadherin was significantly lower in the ALI model group than in the control group and the hPMSCs treatment group (P<0.05), and in the hPMSCs treatment group than in the control group (P<0.05).ConclusionIntravenous injection of hPMSCs can effectively reduce the increased pulmonary vascular endothelial permeability mediated by LPS, relieve the degree of lung tissue damage, and play a therapeutic role in ALI mice.