Clinical and molecular characterization of four patients with NTCP deficiency from two unrelated families harboring the novel SLC10A1 variant c.595A>C (p.Ser199Arg)

Sodium taurocholate cotransporting polypeptide (NTCP), a carrier protein encoded by solute carrier family 10 member 1 (SLC10A1), is expressed in the basolateral membrane of hepatocytes, where it is responsible for the uptake of bile acids from plasma into hepatocytes. The first patient with NTCP deficiency was described in 2015. A limited number of such patients have been reported in the literature and their genotypic and phenotypic features require further investigation. The current study investigated 4 patients with NTCP deficiency from two unrelated families. The patients were subjected to SLC10A1 genetic analysis and it was revealed that all patients were compound heterozygous for the c.800C>T (p.Ser267Phe) and c.595A>C (p.Ser199Arg) SLC10A1 variants. To the best of the authors' knowledge, the latter variant had not been previously reported. Further analysis in 50 healthy individuals did not identify carriers. The c.595A>C (p.Ser199Arg) variant exhibited co-segregation with hypercholanemia and exhibited a relatively conserved amino acid when compared with homologous peptides. Moreover, SWISS-MODEL prediction revealed that the mutation affected the conformation of the NTCP molecule. The 4 patients demonstrated varying degrees of hypercholanemia while a downward trend in the plasma levels of total bile acids (TBA) in 2 pediatric patients and occasionally normal TBA level in an adult case were observed. The results indicated an autosomal recessive trait for NTCP deficiency, supported the primary role of NTCP in the uptake of bile acids from plasma and suggested that hepatic uptake of bile acids may occur by means other than NTCP uptake. Moreover, the novel missense variant c.595A>C(p.Ser199Arg) enriched the SLC10A1 mutation spectrum and may serve as a new genetic marker for the molecular diagnosis and genetic counseling of NTCP deficiency.

Evaluation of the effects of Uncaria rhynchophylla alkaloid extract on LPS-induced preeclampsia symptoms and inflammation in a pregnant rat model

Excessive pro-inflammatory cytokines result in adverse pregnancy outcomes, including preeclampsia-like phenotypes, and fetal growth restriction. Anti-inflammation might be an effective therapy. The aim of this research was to investigate whether Uncaria rhynchophylla alkaloid extract (URE), a highly safe anti-inflammation constituent of the herb, can inhibit inflammation and improve clinical characteristics of preeclampsia in a lipopolysaccharide (LPS)-induced preeclampsia rat model. The rat model was established by daily administration of LPS (1 μg/kg body weight per day) from gestational day (GD) 14 to 19. Different doses of URE (35, 70, and 140 mg/kg body weight per day) were administered from GD 14 to GD 19. The effects of URE on proteinuria, maternal hypertension, pregnancy outcomes, as well as pro-inflammatory cytokines levels in serum and placenta were measured. High-dose URE (HURE) treatment decreased LPS-induced mean 24-h proteinuria and systolic blood pressure, and increased fetal weight, placental weight, and the number of live pups (P<0.05). Moreover, increased serum and placental levels of interleukin (IL)-6, IL-1β, tumor necrosis factor-α, and interferon-γ in the LPS-treated group were obviously inhibited after HURE administration (P<0.01). URE improved preeclampsia symptoms and mitigated inflammatory responses in the LPS-induced preeclampsia rat model, which suggests that the anti-inflammation effect of URE might be an alternative therapy for preeclampsia.

Medical nutrition treatment of women with gestational diabetes mellitus by a telemedicine system based on smartphones

AIM

To explore whether WeChat platform-based treatment of women with gestational diabetes mellitus (GDM) reduces the risk of perinatal complications and explore factors affecting gestational age at delivery.

METHODS

Pregnant women with GDM (n = 107) and normal glucose tolerance (n =50, group C) according to oral glucose tolerance test (OGTT) results during gestational weeks 24-28 were included. Women with GDM were divided into groups A (n =57) and B (n =50) according to informed consent. According to GDM treatment norms, group B was given routine outpatient treatment and health education guidance. In addition to the interventions in group B, group A was given access to both a smartphone-based telemedicine system and articles providing continuous health education. The PBG level in groups A and B was compared, as were differences in maternal and fetal outcomes. Data were analyzed by t-test, analysis of variance (anova), chi-square test and multiple linear regression, with P < 0.05 considered significant.

RESULTS

Fasting blood glucose (FBG) and 2-h postprandial blood glucose (PBG) were significantly lower and premature delivery was significantly less likely in group A than in group B (all P < 0.05). Compared with group B, caesarean section was more likely in group A (P < 0.05). Pregnancy-induced hypertension had a higher incidence in group B than in group C (P < 0.05). Gestational age at delivery was associated with OGTT2h, premature fetal membrane rupture and self-monitoring of blood glucose.

CONCLUSION

GDM treatment based on the WeChat platform effectively reduces FBG and 2-h PBG and may improve pregnancy outcomes. However, 1-h PBG was not affected by treatment. Obstetricians should consider the OGTT2h value to increase gestational age at delivery.

Tracing GFP-labeled WJMSCs in vivo using a chronic salpingitis model: an animal experiment

Background

The present study was conducted to evaluate the distribution of Wharton’s jelly-derived mesenchymal stem cells (WJMSCs) and their repairing function on the oviduct.

Methods

WJMSCs were transfected with the LV3-GFP-PURO lentivirus. Female New Zealand rabbits (n = 24) were divided randomly into control A and B groups and experimental C and D groups to establish inflammation models. Sterile saline solution or WJMSCs were injected into rabbits via ear veins and/or genital tract perfusion once weekly for 3 weeks. All rabbits were humanely sacrificed 1 week after the last perfusion to collect the oviduct, uterus, liver, and bladder for examination. Green fluorescent protein (GFP) and cytokeratin 7 (CK7) were imaged using a Leica Qwin Plus V3 fluorescence confocal microscope and analyzed as mean optical densities in an Image-Pro Plus analysis system.

Results

We found that lentivirus expressing the GFP gene produced an efficient transfection. The mean optical density values of GFP and CK7 in the oviducts were higher in the experimental D group than those in the control A and experimental C groups. No GFP fluorescence deposits occurred in the bladder of the control A group or experimental C group. Colocalization of CK7 and WJMSCs was observed in the oviducts in all groups.

Conclusions

WJMSCs exhibited homing characteristics and migrated to the injured oviduct to promote epithelial cell growth. Additionally, local treatment resulted in higher efficiency.

Treatment evaluation of Wharton's jelly-derived mesenchymal stem cells using a chronic salpingitis model: an animal experiment

Background

The present study was conducted to evaluate new methods to repair the reproductive function of the oviduct, thereby allowing gametes to combine and grow in vivo under natural circumstances.

Methods

Sixty pathogen-free female New Zealand rabbits were divided into three groups: a wild-type group, an untreated control group, and a treatment group. Disposable sterile newborn sputum suction tubes were inserted into the urogenital tract to instill an Escherichia coli suspension into the uterine cavity to establish the chronic salpingitis model. Wharton’s jelly-derived mesenchymal stem cells (WJMSCs) or normal saline were used to treat this infection via different methods. The therapeutic effect was assessed by evaluating morphology, inflammatory factors, proteinology, and pregnancy outcomes.

Results

Oviducts of New Zealand rabbits in the untreated control group showed structural failure and abnormal supermicrostructure of epithelial cells. WJMSCs could partially repair the structure and supermicrostructure of the tubal epithelium. The concentration of tumor necrosis factor (TNF)-α in the untreated control group was significantly higher than that in the wild-type group (P = 0.015). The concentration of TNF-α in the local treatment group was significantly lower than that in the untreated control group (P = 0.011). The expression of oviductal glycoprotein (OVGP) and OVGP mRNA in the wild-type group was significantly higher than those in the untreated control group (P = 0.024 and P = 0.013, respectively). The litter size of the treatment group was 2 ± 2.39 kits, which was higher than that of the untreated control group (P = 0.035).

Conclusion

Chronic inflammation can destroy the structure of the oviduct and the supermicrostructure of epithelial cells as well as leading to infertility. WJMSC transplantation therapy in rabbits with chronic salpingitis partially restored fertility. WJMSCs also repaired the structure of the tubal epithelium subjected to chronic inflammation, decreased the level of inflammatory factors, and partially restored the secretion level of OVGP.

Therapeutic influence of intraperitoneal injection of Wharton's jelly-derived mesenchymal stem cells on oviduct function and fertility in rats with acute and chronic salpingitis

To study the effect of Wharton's jelly-derived mesenchymal stem cells (WJMSCs) on the rat salpingitis model, 50 female Wistar rats were randomly divided into one control and five model groups. Mixed bacteria were injected into the oviducts of model groups. The treated acute and chronic groups received intraperitoneal injections of WJMSCs (1 x 10(6)) once a week for three weeks. Serum inflammation factor, collagen fiber content and oviduct-specific glycoprotein (OVGP) levels were detected in control, chronic, ex-treatment acute and chronic, and treated acute and chronic groups (N = 5 for each group). Pregnancy rate and litter size of control, chronic, treated acute and treated chronic groups were compared. Serum TNF-α and INF-γ levels increased in ex-treatment acute and chronic groups, and restored to normal in the acute treated group but not in the treated chronic group. Oviduct collagen fibers did not increase significantly before or after treatment in the acute group, but it increased in the ex-treatment chronic group and did not improve after treatment. After treatment, OVGP levels restored to normal in the acute group but reduced in the ex-treatment and treated chronic groups and chronic group. The pregnancy rate and litter size of the treated acute group recovered to normal, but in the treated chronic group and chronic model group, they decreased significantly. Thus, intraperitoneal injection of WJMSCs could recover the function of the oviduct in acute salpingitis rats, but its effect on chronic salpingitis was poor. Timely treatment of salpingitis is crucial to preserve reproductive function.

Ultrasonic dissection versus conventional electrocautery during gastrectomy for gastric cancer: a meta-analysis of randomized controlled trials

OBJECTIVE

Use of ultrasonic surgical instrument is gaining popularity for dissection and coagulation in open surgery. However, there is still no consensus on the efficacy and safety of its use compared with conventional surgical technique in open gastrectomy for gastric cancer. The aim of this meta-analysis was to evaluate the role and surgical outcomes of ultrasonic dissection (UD) compared with conventional electrocautery (EC).

METHODS

A systematic literature search was performed to identify all studies comparing UD and EC in gastric cancer surgery. Intraoperative and postoperative outcomes were compared using weighted mean differences (WMDs) and odds ratios (ORs).

RESULTS

Five studies were included in this meta-analysis, comprising 489 patients. Meta-analysis results showed that compared with EC, UD was associated with significantly shorter operation time (P = 0.03), less intraoperative blood loss (P = 0.002), lower morbidity (P = 0.02), and reduced postoperative hospital stay (P = 0.03). However, there was no significant difference between the two surgical techniques with regards to postoperative abdominal drainage (P = 0.17), and total cost in hospital (P = 0.59).

CONCLUSIONS

Compared to EC, the use of UD during open gastrectomy can provide several improved outcomes for operation time, intraoperative blood loss, overall morbidity, and postoperative hospital stay. It appears that UD can be used instead of conventional EC in open gastric cancer surgery, although more larger trials with long follow-up should be performed.

Germline mutation analysis in the CYLD gene in Chinese patients with multiple trichoepitheliomas

Trichoepithelioma is a benign neoplasm that primarily shows follicular germinative differentiation. Classic trichoepithelioma typically presents as a skin-colored papule or nodule on the face or upper trunk; lesions have a predilection for the nose. Trichoepithelioma can be sporadic or familial and solitary or multiple. Most previously reported multiple trichoepithelioma cases are familial, and germline CYLD mutations could be detected in some patients. We performed mutational analysis of the germline CYLD gene in 8 Chinese multiple trichoepitheliomas patients, 6 of which were sporadic cases. A heterozygous missense mutation (c.1112C>A) in the 9th exon of the CYLD gene was detected in some mother-daughter patients. However, the germline CYLD mutation could not be detected in the 6 non-familial cases. The results suggest that the pathogenesis of sporadic multiple trichoepitheliomas may differ from that of familial cases. Our findings also further confirmed the genetic heterogeneity of multiple trichoepitheliomas.

The impact of umbilical blood flow regulation on fetal development differs in diabetic and non-diabetic pregnancy

BACKGROUND/AIMS

Diabetes is well-known to influence endothelial function. Endothelial function and blood flow regulation might be different in diabetic and non-diabetic pregnancy. However, the impact of umbilical blood flow regulation in gestational diabetes on fetal development is unknown so far.

METHODS

In a prospective birth cohort study, we analyzed the association of the umbilical artery Doppler indices (pulsatility index, resistance index and systolic/diastolic ratio) and fetal size measures (biparietal diameter, head circumference, abdominal circumference, femur length and birth weight) in 519 non-gestational diabetes mellitus pregnancies (controls) and 226 gestational diabetes mellitus pregnancies in middle (day 160.32 ±16.29 of gestation) and late (day 268.12 ±13.04 of gestation) pregnancy.

RESULTS

Multiple regression analysis considering confounding factors (gestational day of ultrasound examination, offspring sex, maternal body mess index before pregnancy, maternal age at delivery, maternal body weight at delivery and maternal hypertension) showed that umbilical artery Doppler indices (pulsatility index, resistance index and systolic/diastolic ratio) were associated with fetal head circumference and femur length in middle gestational diabetes mellitus pregnancy but not in non-gestational diabetes mellitus pregnancy. Head circumference, biparietal diameter, abdominal circumference and femur length in mid gestation were smaller in fetus of gestational diabetes mellitus pregnancy versus non-gestational diabetes mellitus pregnancy. In contrast to non-gestational diabetes mellitus pregnancy in late gestation, umbilical artery Doppler indices in gestational diabetes mellitus pregnancy were not associated with ultrasound measures of fetal growth. Birth weight was slightly increased in gestational diabetes mellitus pregnancy as compared to non-gestational diabetes mellitus pregnancy.

CONCLUSIONS

The impact of umbilical blood flow on fetal growth is time dependent in human gestational diabetes mellitus and non-gestational diabetes mellitus pregnancy. In gestational diabetes mellitus pregnancy umbilical blood flow is critical for organ development in much earlier stages of pregnancy as compared to non-gestational diabetes mellitus pregnancy. The physiological and molecular pathways why there is a catch up growth in later times of gestational diabetes mellitus pregnancy resulting in larger gestational diabetes mellitus babies at birth needs to be addressed in further studies.

Individualized management of pregnant women with high hepatitis B virus DNA levels

Hepatitis B is a major health concern in the Asia-Pacific region, and is endemic in China, Southeast Asia, and Africa. Chronic hepatitis B virus (HBV) infection may cause hepatic cirrhosis and liver cancer. It is estimated that there are more than 350 million chronic HBV carriers worldwide, of whom approximately one quarter will die of chronic hepatitis B-related liver diseases. HBV is transmitted horizontally through blood and blood products or by sexual transmission, and vertically from mother to infant. Perinatal infection is the predominant mode of transmission in countries with a high prevalence of hepatitis B surface antigen (HBsAg) carriage, and perinatal transmission leads to high rates of chronic infection. Therefore, it is important to prevent the mother-to-child transmission (MTCT) of HBV. Research has shown that pregnant women with high HBV DNA levels have an increased risk of MTCT. However, most of the obstetrics guidelines do not make a distinction between pregnant women with high HBV DNA levels and those who are HBsAg positive only. This review addresses the management of pregnant women with high levels of HBV viremia, in terms of antiviral therapy, use of hepatitis B immunoglobulin (HBIG), the combined application of hepatitis B vaccine and HBIG, choice of delivery mode and feeding practices.

Telbivudine during the second and third trimester of pregnancy interrupts HBV intrauterine transmission: a systematic review and meta-analysis

BECKGROUND: Evaluate the efficacy and safety of telbivudine during the 2nd and 3rd trimester of pregnancy in intrauterine transmission of hepatitis B virus (HBV). Based on the principle of Cochrane systematic reviews, a database was constructed from Medline, EMBASE, Cochrane Library, the US National Science Digital Library (NSDL), the China Biological Medicine Database (CBM-disc), and contact with Chinese experts in the field from November 2006 to February 2013.

METHODS

The Critical Appraisal Skills Programme (CASP) of Oxford, Cochrane Collaboration's tool, and Review Manager Version 5.0 (Rev-Man 5.0) for assessing the quality of clinical trials, risk of bias, and statistical analysis was used. We analyzed the effects and safety of telbivudine treatment on intrauterine mother-to-child transmission (MTCT) of HBV from HBsAg and HBV-DNA positive mothers. All newborns received an immune prophylaxis schedule consisting of simultaneous hepatitis B virus vaccine and hepatitis B immunoglobulin (HBIG) postpartum. Of 32 studies, 7 studies fulfilled the inclusion criteria in the study.

RESULTS

Either the Mantel-Haenszel or Inverse Variance fixed-effects model or Mantel-Haenszel or Inverse Variance random-effects model was applied for all analyses indicated by odds ratio (OR) and 95% confidence interval (CI). The meta-analysis based on new onset of HBsAg seropositivity of infants at 6-12 months postpartum revealed that the control group had an intrauterine transmission rate of 8.25-42.31%. This rate was reduced to 0-14.29% in the telbivudine treatment group (OR 0.09, 95% CI 0.04-0.22, including seven trials, p < 0.001). The rates of intrauterine transmission based on new onset of HBV DNA seropositivity of infants at 6-12 months postpartum were 8.25-19.23% in the control group and 0 - 3.57% in the treatment group (OR 0.07, 95% CI 0.02-0.22, p < 0.001, including only five trials, since two trials had no data on HBV DNA in infants). With the exception of CK elevations, adverse effect frequencies were similar in both groups.

CONCLUSIONS

Telbivudine is an effective and safe drug for preventing intrauterine transmission of HBV.

Prenatal ultrasonography and Doppler sonography for the clinical investigation of isolated ventricular septal defects in a late second-trimester population

Background

The purpose of this study was to evaluate the efficacy of prenatal ultrasonography and Doppler sonography in detecting isolated ventricular septal defects (VSDs) in a late-second-trimester population.

Methods

Fetal echocardiography, Doppler ultrasound, and biometry were used to evaluate 2,661 singleton fetuses (1,381 male fetuses and 1,280 female fetuses) between 1 August 2006 and 31 May 2010. The efficacy of each fetal biometry, Doppler ultrasound, and nasal bone length (NBL) measurement was evaluated in all of the fetuses. A standard fetal echocardiographic evaluation, including two-dimensional gray-scale imaging and color and Doppler color flow mapping, was performed on all fetuses.

Results

We detected isolated VSDs in 124 of the 2,661 singleton fetuses between 19 and 24 weeks of gestation. The prevalence of isolated VSDs in the study population was 4.66%. A multiple logistic regression analysis indicated that short fetal NBL (odds ratio = 0.691, 95% confidence interval: 0.551 to 0.868) and the pulsatility index (PI) of the umbilical artery (odds ratio = 8.095, 95% confidence interval: 4.309 to 15.207) and of the middle cerebral artery (odds ratio = 0.254, 95% confidence interval: 0.120 to 0.538) are significantly associated with isolated VSDs.

Conclusion

Late-second-trimester fetal NBL, umbilical artery PI, and middle cerebral artery PI are useful parameters for detecting isolated VSDs, and can be used to estimate the a priori risk of VSDs in women at high risk and at low risk of isolated VSDs.

Expression of interferon-γ in decidual natural killer cells from women with hypertensive disorder complicating pregnancy

AIM

Hypertensive disorder complicating pregnancy (HDCP) is one of the most frequent and serious pregnancy-related diseases, which is closely related to disorders of the maternal immune system, especially the local immune microenvironment of the maternal-fetal interface. Uterine decidual natural killer (dNK) cells are the major immune cells in the maternal-fetal interface and they play an important role in establishing and maintaining a normal pregnancy. The aim of this study was to investigate the phenotype and function of dNK cells from women with HDCP.

MATERIAL AND METHODS

Decidual tissues were collected from women with normal pregnancy (normal control group, n = 15 cases) and HDCP (HDCP group, n = 20 cases), respectively. The mononuclear cells were extracted from tissues and flow cytometry (FCM) was utilized to sort out dNK cells. The phenotypes of dNK cells (CD56(bright)CD16⁻CD3⁻ vs CD56(dim)CD16⁺CD3⁻) were detected by FCM. After being co-cultured with Phorbol 12-myristate 13-acetate, ionomycin and monensin, the expression level of interferon (IFN)-γ in the dNK cells was detected by FCM.

RESULTS

The phenotypes of dNK cells from the two groups were dominated by the CD56(bright)CD16⁻CD3⁻ subset, with no significant statistical difference (P < 0.05). The expression level of IFN-γ in the dNK cells from women with HDCP was on a lower trend than those from women with normal pregnancy, having significant statistical difference (P = 0.000 < 0.05).

CONCLUSIONS

Our results indicated that although the phenotype of dNK cells from women with HDCP is of no difference, their functions are abnormal. Impaired cell function leads to a lower expression level of IFN-γ and this may account for one of the pathogeneses of HDCP.

Paternal body mass index (BMI) is associated with offspring intrauterine growth in a gender dependent manner

BACKGROUND

Environmental alternations leading to fetal programming of cardiovascular diseases in later life have been attributed to maternal factors. However, animal studies showed that paternal obesity may program cardio-metabolic diseases in the offspring. In the current study we tested the hypothesis that paternal BMI may be associated with fetal growth.

METHODS AND RESULTS

We analyzed the relationship between paternal body mass index (BMI) and birth weight, ultrasound parameters describing the newborn's body shape as well as parameters describing the newborns endocrine system such as cortisol, aldosterone, renin activity and fetal glycated serum protein in a birth cohort of 899 father/mother/child triplets. Since fetal programming is an offspring sex specific process, male and female offspring were analyzed separately. Multivariable regression analyses considering maternal BMI, paternal and maternal age, hypertension during pregnancy, maternal total glycated serum protein, parity and either gestational age (for birth weight) or time of ultrasound investigation (for ultrasound parameters) as confounding showed that paternal BMI is associated with growth of the male but not female offspring. Paternal BMI correlated with birth parameters of male offspring only: birth weight; biparietal diameter, head circumference; abdominal diameter, abdominal circumference; and pectoral diameter. Cortisol was likewise significantly correlated with paternal BMI in male newborns only.

CONCLUSIONS

Paternal BMI affects growth of the male but not female offspring. Paternal BMI may thus represent a risk factor for cardiovascular diseases of male offspring in later life. It remains to be demonstrated whether this is linked to an offspring sex specific paternal programming of cortisol secretion.

Renin angiotensin aldosterone system and glycemia in pregnancy

BACKGROUND

The renin-angiotensin-aldosterone system (RAAS) is involved in the pathogenesis of insulin resistance and type 2 diabetes in the general population. The RAAS is activated during pregnancy. However, it is unknown whether the RAAS contributes to glycemia in pregnant women.

METHODS

Plasma renin activity (PRA) and plasma aldosterone levels were quantified at delivery in 689 Chinese mothers. An oral glucose tolerance test in fasted women was performed in the second trimester of pregnancy. The diagnosis of gestational diabetes mellitus (GDM) and impaired glucose tolerance during pregnancy were made according to the guidelines of the Chinese Society of Obstetrics.

RESULTS

Plasma aldosterone was significantly higher in pregnant women with GDM as compared to those without impairment of glycemic control (normal pregnancies: 0.27 +/- 0.21 ng/mL, GDM: 0.36 +/- 0.30 ng/mL; p < 0.05). Regression analyses revealed that PRA was negatively correlated with fasting blood glucose (FBG) (R2 = 0.03, p = 0.007), whereas plasma aldosterone and aldosterone/PRA ratio were positively correlated with FBG (R2 = 0.05, p < 0.001 and R = 0.03, p = 0.007, respectively). Multivariable regression analysis models considering relevant confounding factors confirmed these findings.

CONCLUSIONS

This study demonstrated that fasting blood glucose in pregnant women is inversely correlated with the PRA, whereas plasma aldosterone showed a highly significant positive correlation with fasting blood glucose during pregnancy. Moreover, plasma aldosterone is significantly higher in pregnant women with GDM as compared to those women with normal glucose tolerance during pregnancy. Although causality cannot be proven in association studies, these data may indicate that the RAAS during pregnancy contributes to the pathogenesis of insulin resistance/new onset of diabetes during pregnancy.

Association of fetal but not maternal P-glycoprotein C3435T polymorphism with fetal growth and birth weight, a possible risk factor for cardiovascular diseases in later life

BACKGROUND

The multidrug transporter P-glycoprotein (PGP) is expressed in the human placenta. In particular the C3435T ABCB1 polymorphism was associated with altered tissue expression of PGP in the human placenta. However, the potential functional impact of this polymorphism on the offspring is unknown so far.

METHODS

We analyzed the impact of the ABCB1/C3435T polymorphism on fetal growth in 262 mother/child pairs. Fetal growth was assessed by differential ultrasound examination of the fetal body prior to birth and by measuring birth weight.

RESULTS

The maternal ABCB1/C3435T polymorphism showed no trend for an association with birth weight or any ultrasound parameter describing late gestational fetal body shape. Genotyping the newborns, however, demonstrated that newborns carrying two copies of the T allele had a birth weight of 3176.39 g, whereas CT and CC newborns had a birth weight of 3345.04 g (p = 0.022). Adjusting for gestational age at delivery, child's gender, maternal BMI, maternal age and body weight at delivery confirmed this finding (p = 0.009). Considering gestational day of late ultrasound examination, gestational age at delivery, child's gender, maternal BMI, maternal age and maternal body weight at delivery, the fetal ABCB1/C3435T genotype revealed likewise a significant negative correlation with abdominal diameter and abdominal circumference (R2 = 0.538, p = 0.010 and R2 = 0.534, p = 0.005, respectively).

CONCLUSIONS

Low birth weight may be a risk factor for cardiovascular diseases in later life. The fetal ABCB1/C3435T gene polymorphism may contribute to this risk. Since PGP controls transport of various biological agents, we suggest that PGP is involved in the transport of biological agents to the fetus that are important for normal fetal growth.

Late gestational maternal serum cortisol is inversely associated with fetal brain growth

To analyze the association between fetal brain growth and late gestational blood serum cortisol in normal pregnancy.Blood total cortisol was quantified at delivery in 432 Chinese mother/child pairs. Key inclusion criteria of the cohort were: no structural anomalies of the newborn, singleton pregnancy, no alcohol abuse, no drug abuse or history of smoking no hypertensive disorders and no impairment of glucose tolerance and no use of steroid medication during pregnancy. Differential ultrasound examination of the fetal body was done in early (gestational day 89.95 ± 7.31), middle (gestational day 160.17 ± 16.12) and late pregnancy (gestational day 268.89 ± 12.42). Newborn's cortisol was not correlated with any of the ultrasound measurements during pregnancy nor with birth weight. Multivariable regression analysis, considering timing of the ultrasound examination, the child's sex, maternal BMI, maternal age, maternal body weight at delivery, the timing of cortisol measurement and maternal uterine contraction states, revealed that maternal serum total cortisol was significantly negative correlated with ultrasound parameters describing the fetal brain: late biparietal diameter (R²=0.512, p=0.009), late head circumference (R²=0.498, p=0.001), middle biparietal diameter (R²=0.819, p=0.013), middle cerebellum transverse diameter R²=0.76, p=0.014) and early biparietal diameter(R²=0.819, p=0.013). The same analysis revealed that birth weight as well as ultrasound parameters such as abdominal circumference and femur length were not correlated to maternal cortisol levels. In conclusion, our study demonstrates that maternal cortisol secretion within physiological ranges may be inversely correlated to fetal brain growth but not to birth weight. It remains to be demonstrated whether maternal cortisol secretion negatively influencing fetal brain growth translates to adverse neurological outcomes in later life.

Removal of ammonium from rare-earth wastewater using natural brucite as a magnesium source of struvite precipitation

This paper presents a study regarding ammonium removal from rare-earth wastewater by struvite precipitation with natural brucite mineral as a source of magnesium. Experimental results indicated that a pH ranging from 8.5 to 9.5 was the optimum for the removal of ammonium using the soluble form of brucite as a magnesium source. Additionally, when solid brucite was used as a magnesium source as well as an alkali reagent, the initial ammonium concentration of 4,535 mg/L decreased to 239-317 mg/L after an reaction time of 12 h in wastewater treated with the S/L (solid brucite/liquid wastewater) ratios ranging from 31.2 to 63.2 g/L. Furthermore, as some non-reacted brucite still remained in the precipitates obtained at the end of reaction, the precipitates were subjected to reuse. The reuse results demonstrated that the reuse of the precipitates obtained with 63.2 g/L was feasible, and almost half of the brucite dose could be saved.

Flocculation properties of a bioflocculant produced by Bacillus licheniformis

Studies of the flocculation properties of bioflocculant combined with its structure characterization are helpful to develop more effective bioflocculant. This paper reports findings of our research on the flocculation properties of the bioflocculant ZS-7 in the kaolin suspension based on its structure characterization. With the addition of 2 mg/L ZS-7 and 9 mM CaCl(2), the optimum temperature for flocculation performance of ZS-7 in the kaolin suspension is about 30°C, giving the highest flocculating activity 99.2%. Studies of the flocculation properties revealed that it was stable at 60-100°C and pH 4-10. Moreover, it could flocculate a kaolin suspension over a wide range of pH (2-12) and temperatures (4-95°C) in the presence of CaCl(2).

Recycle use of magnesium ammonium phosphate to remove ammonium nitrogen from rare-earth wastewater

This paper presents a recycle MAP process (magnesium ammonium phosphate) to remove NH4-N from a typical rare-earth wastewater. The optimum conditions for the MAP precipitation and recycle use of the MAP with a newly-designed process were investigated in laboratory. The results showed that the pH value and dosages of P (phosphate) and Mg reagents have a significant influence on NH4-N removal, with a maximum removal efficiency of 99.4% at the conditions of pH=9 and Mg:N:P molar ratio=1.2:1:1.2. In the process of recycle use of the MAP, adding some HCl to dissolve MAP decomposition residues could effectively enhance NH4-N removal. The NH4-N removal efficiency reached 99.6% by adding an HCl amount of H+:OH- molar ratio=0.8 into the reused MAP decomposition residues, whereas the NH4-N removal efficiency without addition of HCl was only 96.4%. Moreover, the residual PO4-P from the end of reaction was recovered and the optimum recovery efficiency was achieved at a Mg:P molar ratio=6 and pH=10. Under these optimum conditions, the residual NH4-N and PO4-P concentrations in the treated wastewater, through 6 times of the recycling, were less than 15 mg/L and 1 mg/L, respectively. On the basis of this, an economic evaluation of the recycling MAP was made, and this recycle process could save 48.6% cost used in the chemicals for treating per cubic meter of the rare-earth wastewater, compared to the conventional MAP process.

The effects of hyperbaric oxygen treatment on lipid peroxidation of pregnant rabbits and their fetus during late pregnancy

OBJECTIVE

To measure the effects of hyperbaric oxygen on lipid peroxidation of pregnant and fetal rabbits during late pregnancy.

METHODS

Sixteen pregnant rabbits were randomly and equally divided into two groups. One, the HBO2 group, was exposed to 2-atm oxygen for 60 min a day from the 21st to the 30th day of gestation, and the other group, non-HBO2 group, did not obtain any hyperbaric oxygen treatment.

RESULTS

On the 30th day of pregnant period, the activity of antioxidant enzyme SOD in plasma of the pregnant rabbits of the HBO2 group was significantly higher than that of the non-HBO2 group, but there was no significant difference in the level of oxidative stress marker 8-iso-PG-F2 alpha between the two groups. As for the fetal rabbits, the SOD activity in umbilical plasma, placenta tissue and fetal brain tissue of HBO2 group was significantly higher than that of the non-HBO2 group, while there was no statistical difference between the concentrations of 8-iso-PG-F2 alpha of HBO2 and non-HBO2 group.

CONCLUSION

HBO2 treatment during the late pregnancy up-regulates the activity of antioxidant enzyme in plasma of pregnant rabbits, placenta, umbilical plasma, and fetal brain. This does not have significant effect on the oxidative stress in these tissues.

l-Arginine treatment for asymmetric fetal growth restriction

OBJECTIVES

[corrected] To investigate the effects of L-Arginine in treating asymmetric fetal growth restriction (FGR).

METHODS

A total of 66 pregnant women whose fetuses were diagnosed with asymmetric fetal growth restriction were divided into two groups. Group 1 consisted of 36 women who were given routine therapy alone; group 2 consisted of 30 women who were given L-Arginine and routine therapy; and the control group consisted of 30 more women with a normal pregnancy.

RESULTS

Before treatment, mean maternal serum levels of NO2-/NO3- were significantly lower in groups 1 and 2 than in the control group (P<0.01). After treatment, maternal serum levels of NO2-/NO3- were considerably higher in group 2 than in group 1 (P<0.01). Mean birth weight was significantly higher in group 2 than in group 1 (P<0.05), but still lower in group 2 than in the control group (P<0.01).

CONCLUSIONS

A deficiency in nitric oxide may play an important role in the development of asymmetric fetal growth restriction. L-Arginine can be used to increase maternal NO2-/NO3- levels and newborn birth weight.