Search

Background: Studies focused on pregnant women with congenital heart disease (CHD)–associated pulmonary hypertension (PH) are scarce and limited by small sample sizes and single-center design. This study sought to describe the pregnancy outcomes in women with CHD with and without PH. Methods: Outcomes for pregnant women with CHD were evaluated retrospectively from 1993 to 2016 and prospectively from 2017 to 2019 from 7 tertiary hospitals. PH was diagnosed on the basis of echocardiogram or catheterization. The incidence of maternal death, cardiac complications, and obstetric and offspring complications was compared for women with CHD and no PH, mild, and moderate-to-severe PH. Results: A total of 2220 pregnant women with CHD had completed pregnancies. PH associated with CHD was identified in 729 women, including 398 with mild PH (right ventricle to right atrium gradient 30–50 mm Hg) and 331 with moderate-to-severe PH (right ventricle to right atrium gradient >50 mm Hg). Maternal mortality occurred in 1 (0.1%), 0, and 19 (5.7%) women with CHD and no, mild, or moderate-to-severe PH, respectively. Of the 729 patients with PH, 619 (85%) had CHD-associated pulmonary arterial hypertension, and 110 (15%) had other forms of PH. Overall, patients with mild PH had better maternal outcomes than those with moderate-to-severe PH, including the incidence of maternal mortality or heart failure (7.8% versus 39.6%; P P P 100 ng/L (odds ratio, 1.9 [95% CI, 1.0–3.4], P =0.04) and New York Heart Association class III to IV (odds ratio, 2.9 [95% CI, 1.6–5.3], P P P =0.001) were protective. Conclusions: Women with CHD-associated mild PH appear to have better outcomes compared with women with CHD-associated moderate-to-severe PH, and with event rates similar for most outcomes with women with CHD and no PH. Multimodality risk assessment, including PH severity, brain natriuretic peptide level, and New York Heart Association class, may be useful in risk stratification in pregnancy with PH. Follow-up with a multidisciplinary team and strict antenatal supervision during pregnancy may also help to mitigate the risk of adverse maternal cardiac events.

Objective This study aimed to investigate the relationship between the characteristics and diameters of residual anastomoses and the occurrence of twin anemia-polycythemia sequence (TAPS) in twin-to-twin transfusion syndrome (TTTS) patients with placental vascular injection after fetoscopic laser surgery (FLS). Methods A total of 90 cases of pregnant women who underwent FLS owing to TTTS were collected in the university hospital from May 2018 to December 2020. Therein, 40 cases received placental injection and were divided into the TAPS group and non-TAPS group according to the postoperative complications. The number of residual superficial anastomoses was counted and the diameter was measured. Results Among the placentae of nine patients in the TAPS group, two cases had no superficial anastomoses, and seven cases had 16 superficial anastomoses, including eight arterio-venous (AV) anastomoses, two veno-arterial (VA) anastomoses, three arterio-arterial (AA) anastomoses and three veno-venous (VV) anastomoses. Among the placentae of 31 patients in the non-TAPS group, 19 cases had no superficial anastomoses, and 12 cases had 18 superficial anastomoses, including two AV anastomoses, five VA anastomoses, seven AA anastomoses, and four VV anastomoses; and both the two cases of AV anastomoses were accompanied by AA anastomoses. The number of AV anastomoses in the placentae of the TAPS group was significantly elevated compared with that in the non-TAPS group (p0.05). Through analyzing the diameters of 34 superficial anastomoses in the two groups, it was shown that the diameters of AA anastomoses in the non-TAPS group were significantly larger than those in the TAPS group (Z=1.97, p0.05), VA anastomoses (Z=0.98, p>0.05), and VV anastomoses (Z=0.36, p>0.05). The differences of the birth weight and inter-twin hemoglobin difference were statistically significant (p0.05). Conclusion The increase in the number of AV anastomoses could obviously elevate the incidence of TAPS. The probability of TAPS occurrence is reduced following the increased diameters of AA anastomoses, demonstrating that AA anastomosis has a protective effect on TTTS patients.

Waardenburg syndrome (WS) is a rare genetic disorder characterized by varying combinations of sensorineural hearing loss and abnormal pigmentation involving the hair, skin and iris. WS is classified into 4 subtypes (WS1–WS4) based on additional symptoms. WS2 is characterized by the absence of additional symptoms and is mainly attributed to variants in the microphthalmia-associated transcription factor (MITF) gene. We detected a novel frameshift variant c.1025_1032delGGAACAAG (NM_198159) of MITF in 5 patients with WS2 from the same Chinese family by using targeted next-generation sequencing and Sanger sequencing. Phenotypic and genotypic analyses of the family members suggested that this novel variants was pathogenic. Our finding expands the spectrum of MITF variants.

Objective: Through metabolomics method, the objective of the paper is to differentially screen serum metabolites of GDM patients and healthy pregnant women, to explore potential biomarkers of GDM and analyze related pathways, and to explain the potential mechanism and biological significance of GDM. Methods: The serum samples from 30 GDM patients and 30 healthy pregnant women were selected to conduct non-targeted metabolomics study by liquid chromatography-mass spectrometry. The differential metabolites between the two groups were searched and the metabolic pathway was analyzed by KEGG database. Results: Multivariate statistical analysis found that serum metabolism in GDM patients was different significantly from healthy pregnant women, 36 differential metabolites and corresponding metabolic pathways were identified in serum, which involved several metabolic ways like, fatty acid metabolism, butyric acid metabolism, bile secretion, and amino acid metabolism. Conclusion: The discovery of these biomarkers provided a new theoretical basis and experimental basis for further study of the early diagnosis and pathogenesis of GDM. At the same time, LC-MS-based serum metabolomics methods also showed great application values in disease diagnosis and mechanism research. Keywords: Gestational diabetes mellitus, Metabolomics, Serum, Liquid chromatography-mass spectrometry, Metabolic pathway analysis

Objective Fetoscopic laser surgery (FLS) is currently the standard treatment for twin to twin transfusion syndrome (TTTS). This study aims to improve the perinatal outcomes of TTTS patients by analyzing the risk factors associated with preterm delivery after FLS for TTTS. Methods A prospective cohort study was conducted in 97 cases of patients with TTTS who underwent FLS at the Third Affiliated Hospital of Zhengzhou University from May 2018 to December 2020. A multivariate logistic regression model was used to determine the risk factors associated with preterm delivery. Finally, ROC curve was utilized to analyze the diagnostic value of related risk factors. Results A total of 90 TTTS patients were included in the study. There were 37 cases in group A and 53 cases in group B. Through multivariate logistic regression model analysis, three risk factors related to the gestational age of childbirth P P=0.024), placental abruption (OR, 17.6; P=0.018). ROC curve analysis suggested that the AUC of the combined diagnosis of the three factors was 0.799 (P

Background Long noncoding RNAs (lncRNAs) have been reported to be associated with the proliferation of several cancer cells. The aim of this study was to investigate the role of FLVCR1-AS1 in ovarian serous cancer (OSC). Methods FLVCR1-AS1 expression was determined in human OSC tissues, serums and cell lines. The role of FLVCR1-AS1 knockdown or overexpression on OSC cell growth, migration, invasion, apoptosis and epithelial to mesenchymal transition (EMT) were evaluated in vitro using CCK8, colony formation assay, wound healing assay, transwell assay and western blot assay. Besides, luciferase reporter assays were performed to identify interactions among FLVCR1-AS1 and its target genes. Moreover, the in vivo effects were investigated using immunocompromised NSG female mice. Results In this study, FLVCR1-AS1 expression was upregulated in OSC tissues, serums, and cells. Knockdown FLVCR1-AS1 decreased cell growth, migration, invasion, and EMT, as well as increased apoptosis in OSC cells, whereas, overexpression of FLVCR1-AS1 increased cell proliferation, migration, invasion, and EMT, and decreased apoptosis of OSC cells. Besides, FLVCR1-AS1 directly bound to miR-513 and downregulated its expression. Moreover, FLVCR1-AS1 reversed the effect of miR-513 on the OSC cell growth, which might be associated with the role of YAP1. Furthermore, in terms of mechanism, FLVCR1-AS1 promoted EMT in OSC cells. Finally, mice models further confirmed that knockdown FLVCR1-AS1 distinctly suppressed cell growth and EMT in vivo. Conclusion Taken together, FLVCR1-AS1 mediated miR-513/YAP1 signaling to promote cell progression, migration, invasion and EMT process in OSC cells.

To compare the effects of metformin with insulin on maternal and neonatal outcomes in gestational diabetes mellitus (GDM). A literature search in PUBMED, EMBASE, Science Direct, Springer link, and Cochrane library was conducted using the following search terms: “Gestational Diabetes” or “GDM”, and “insulin” and “metformin”. Quality assessment of included studies was determined with Quality Assessment of Diagnostic Accuracy Studies. Review Manger 5.2 was used to analyze mean difference (MD)/risk ratio (RR) and 95 % confidence interval (CI) in random-effects model or fixed-effects model depending on the level of heterogeneity. A total of 11 studies were identified. There was no significant difference of the effect on maternal outcomes between the two treatments in glycohemoglobin A1c levels (P = 0.37), fasting blood glucose (P = 0.66), and the incidence of preeclampsia (P = 0.26); whereas, significantly reduced results were found in the metformin group in pregnancy-induced hypertension (PIH) rate (RR = 0.53, 95 % CI 0.31–0.90, P = 0.02), average weight gains after enrollment (MD = −1.28, 95 % CI −1.54 to −1.01, P

Genxia Li,1,* Na Yang,2,* Mingkun Xie,1 Yajuan Xu,1 Ning Han,1 Qi Chen,3 Hezhou Li,4 Yueli Wu,5 Chunhua Cheng,1 Yuhong Wang,1 Man Zhou,6 Bo Xia,6 Shuhua Guo,1 Shihong Cui11Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 2Department of Obstetrics and Gynecology, The First People’s Hospital in Guangzhou, Guangzhou, 3Department of Pediatric Surgery, 4Department of Ultrasound, 5Department of Genetics Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China; 6Department of Genetics and Biochemistry, Clemson University, Clemson, SC, USA*These authors contributed equally to this workSynopsis: The establishment of a multidisciplinary consultation system is necessary for the diagnosis of complicated fetal anomalies.Purpose: We aimed to investigate the incidences of different types of fetal anomalies and the influence of multidisciplinary consultation on fetal prognosis.Patients and methods: Multidisciplinary specialists include obstetricians, pediatricians, pediatric surgeons, and experts of ultrasound department and genetic counseling. Consultation was done if the fetal ultrasound examinations showed abnormality. Follow-up, assistance, and guidance for the fetus were achieved by phone calls.Results: Ultrasound screening showed that the incidences of central nervous system anomaly and genitourinary anomaly were 25.80% (275/1,066) and 22.05% (235/1,066), respectively. The detection rates of fetal anomalies were 5.07% (54/1,066), 36.12% (385/1,066), and 58.82% (627/1,066) in pregnant women with gestational age of 28 weeks, respectively. In addition, the fetal cerebral ventriculomegaly accounted for 40.73% of central nervous system malformation, while 71.43% cases with fetal cerebral ventriculomegaly were alleviated during the follow-up period. The proportion of hydronephrosis in genitourinary anomalies was 50.64%, and the remission rate of hydronephrosis was 67.23% during the follow-up period.Conclusion: The establishment of a multidisciplinary consultation system is necessary for the diagnosis of complicated fetal anomalies. The central nervous system anomaly and genitourinary anomaly are the most common fetal anomalies. In addition, the remission rates of cerebral ventriculomegaly and fetal hydronephrosis are high during the follow-up period. Keywords: multidisciplinary consultation, fetal anomalies, pregnancy outcome

Progestins, particularly medroxyprogesterone acetate (MPA), have for a long time been used as conservative treatment for young patients with clinical stage I, grade I endometrial carcinoma. However, more than 30% of patients with endometrial adenocarcinoma display resistance to endocrine therapies at the time of presentation and most cancer patients that initially respond to progestin treatment will at some point develop resistance, resulting in tumor progression. The cellular mechanisms underlying acquired resistance to progestin are poorly understood. In order to investigate the molecular mechanisms whereby human endometrial adenocarcinoma develops resistance to progestin therapy, we have undertaken to develop human endometrial adenocarcinoma cell lines that are resistant to the growth-inhibitory effects of progestins in vitro. A progestin-resistant subcell line of Ishikawa cells was developed from Ishikawa human endometrial adenocarcinoma cells by stepwise selection in increasing concentrations of the synthetic progestin, MPA, over ten months. The doubling time of the progestin-resistant cells (34.18±3.15 h) grown routinely in the medium containing 10 μM MPA was not significantly different from the doubling time of the parent Ishikawa cells (35.14±2.68 h) grown in the absence of MPA (t=−0.331, P=0.762). Moreover, the effect of treatment with MPA shifted from suppression of growth and invasiveness, as observed in the parent Ishikawa cells, to stimulation of growth and invasiveness in the progestin-resistant Ishikawa cells. The positive rates of estrogen receptor a (ERα) and progesterone receptor B (PRB) of the progestin-resistant Ishikawa cells were significantly reduced, whilst the positive rate of ERβ was significantly enhanced compared to the parent Ishikawa cells. These differences were statistically significant (P