Effect of labor on postpartum clearance of cell-free fetal DNA from the maternal circulation

OBJECTIVE

The aim of this study was to compare the effect of mode of delivery on the postpartum clearance of cell-free fetal (cff) DNA.

METHODS

Women who gave birth to a single-term male infant by any mode of delivery had blood collected on three occasions: within 3 h of birth, on day 1-2 postpartum and at 2 weeks postpartum. The SRY sequence was used as a marker of cff DNA, and was detected using conventional PCR.

RESULTS

Eighty-seven women were included in the study. There were 28 women in the elective caesarean section group and 59 in the labor group. Cell-free fetal DNA was detected in 38/87 (44%) of women within 3 h of birth. There was a significant difference between the group that labored and the group that did not (54 vs 21%, p = 0.003). Twelve percent of women who labored had persistent cff DNA on day 1-2 postpartum, compared with none of the women who delivered without labor. No woman had DNA that persisted up to 2 weeks postpartum.

CONCLUSION

The presence of labor increases the rate of detectable DNA in women within 3 h of birth and on day 1-2 postpartum. Postpartum clearance was completed by 2 weeks in all women tested regardless of mode of delivery.

Antagonistic control of cell fates by JNK and p38-MAPK signaling

During the development and organogenesis of all multicellular organisms, cell fate decisions determine whether cells undergo proliferation, differentiation, or aging. Two independent stress kinase signaling pathways, p38-MAPK, and JNKs, have evolved that relay developmental and environmental cues to determine cell responses. Although multiple stimuli can activate these two stress kinase pathways, the functional interactions and molecular cross-talks between these common second signaling cascades are poorly elucidated. Here we report that JNK and p38-MAPK pathways antagonistically control cellular senescence, oncogenic transformation, and proliferation in primary mouse embryonic fibroblasts (MEFs). Similarly, genetic inactivation of the JNK pathway results in impaired proliferation of fetal hepatoblasts in vitro and defective adult liver regeneration in vivo, which is rescued by inhibition of the p38-MAPK pathway. Thus, the balance between the two stress-signaling pathways, MKK7-JNK and MKK3/6-p38-MAPK, determines cell fate and links environmental and developmental stress to cell cycle arrest, senescence, oncogenic transformation, and adult tissue regeneration.

The molecular basis of "curlicue": a sperm motility abnormality linked to the sterility of t haplotype homozygous male mice

The t complex, a variant region of chromatin occupying approximately 40-million base pairs of proximal chromosome 17, exists in natural populations of wild mice of the Mus musculus species as a family of homologues called t haplotypes (t). Relative to wild-type (+) homologues, all t haplotypes share four large non-overlapping inversions, spanning 95% of the region, leading to intra-inversion recombination suppression in +/t heterozygotes. Non-lethal t homozygous males or complementing recessive lethal t doubly heterozygous males (hereafter both abbreviated "t/t males") are invariably and completely sterile, due to expression of several sperm function abnormalities. One of these traits, "curlicue", describes a condition in which spermatozoa from t/t males fail to reach the site of fertilization in vivo because they exhibit a severe loss of vigorous forward motility due to the chronic negative curvature of their flagella. Current data indicate that "curlicue" is the complex phenotypic reflection of the expression of three or more mutations clustered in the distal one-third of the largest and most-distal t complex inversion, In(17)4. From proximal to distal, candidates include Dnahc8, Tsga2 and Tctex5. Interestingly, new results from high-resolution intra-inversion genetic mapping and protein localization studies suggest that the products of the distal two candidates, Tsga2 and Tctex5, might play synergic roles in the expression of both the "curlicue" motility abnormality and the "stop" sperm-egg interaction aberration, regarded as functionally unrelated traits.

Analysis of HLA-DQB1 gene polymorphisms in asymptomatic HBV carriers and chronic hepatitis B patients in the Chinese Han population

Host genetic factors and environment factors including hepatitis B virus (HBV) genotype are widely viewed as common basis of the different outcomes of HBV infection. Human leucocyte antigen (HLA) plays an important role in immunological reaction to HBV infection. The study aimed to explore whether the HLA-DQB1 allele polymorphisms are associated with the outcomes of HBV infection in the Chinese Han population. One hundred and thirty-four asymptomatic HBV carriers and 139 chronic hepatitis B patients were recruited in this case-control study in Beijing, China. Sequence-specific primers-polymerase chain reaction was used to detect 13 alleles of HLA-DQB1 gene. The frequency distributions of alleles in two groups were analysed using sas 9.1.2 software. After adjustment of confounders the frequencies of HLA-DQB1*0503 allele and *0303 allele in chronic hepatitis B group were statistically significant lower than those in asymptomatic HBV carrier group (P = 0.04; P = 0.05), and the frequency of exposure to alcohol consumption in patients with chronic hepatitis B was clearly higher than that in asymptomatic HBV carrier group (P = 0.004). HLA-DQB1*0503 allele and *0303 allele are independently resistant genetic factors to chronic hepatitis B, and alcohol consumption is the risk factor of chronic hepatitis B.

Mutant p53 in MDA-MB-231 breast cancer cells is stabilized by elevated phospholipase D activity and contributes to survival signals generated by phospholipase D

p53 is the most commonly mutated gene in human cancer. Although the loss of tumor suppressor functions for p53 in tumorigenesis is well characterized, gain-of-function p53 mutations observed in most cancers are not as widely appreciated. The human breast cancer cell line MDA-MB-231, which has high levels of a mutant p53, has high levels of phospholipase D (PLD) activity, which provides a survival signal in these cells when deprived of serum growth factors. We report here that the mutant p53 in MDA-MB-231 cells is stabilized by the elevated PLD activity in these cells. Surprisingly, the survival of MDA-MB-231 cells deprived of serum was dependent on the mutant p53. These data indicate that a mutant p53, stabilized by elevated PLD activity, can contribute to the suppression of apoptosis in a human breast cancer cell line and suggest a rationale for the selection of p53 mutations early in tumorigenesis to suppress apoptosis in an emerging tumor.

Assessment of left ventricular function long term after arterial switch operation for transposition of the great arteries by dobutamine stress echocardiography

OBJECTIVES

To use dobutamine stress echocardiography to determine left ventricular (LV) function and wall motion of children long term after arterial switch operation (ASO) for transposition of the great arteries.

DESIGN AND PATIENTS

31 patients (24 boys) with ASO performed at a mean (SD) of 15.5 (4.3) days of life were studied at an age of 9.4 (2.0) years. All had normal coronary angiographic findings. LV echocardiographic indexes, including fractional shortening, ejection fraction, rate corrected velocity of circumferential fibre shortening (VCFc), and wall stress, as well as LV wall motion abnormalities were determined at rest and under dobutamine stress. The results were compared with those of 20 healthy age matched control participants.

SETTING

Tertiary paediatric cardiac centre.

RESULTS

Fractional shortening, ejection fraction, and VCFc were significantly lower in patients than in controls at rest (all with p < 0.001). Stress-velocity index detected impaired LV contractility in 19 (61%) patients at rest. An older age at operation (p = 0.01), longer bypass (p = 0.01) and circulatory arrest times (p = 0.045), and an unusual coronary artery pattern (p = 0.059) were associated with impaired resting LV contractility. Dobutamine stress echocardiography unmasked wall motion abnormalities in 23 (74%) patients. Exercise myocardial perfusion scan, performed in 22 patients, showed reversible myocardial perfusion defects in 17. These defects corresponded to segments of hypokinesia as detected by dobutamine stress echocardiography.

CONCLUSION

A significant proportion of children, albeit asymptomatic, had impaired baseline LV contractility and reversible myocardial perfusion defects and mild wall motion abnormalities on stress after ASO.

[The clinical characteristics of adhesive type cholesteatoma]

OBJECTIVE

To study the clinical characteristics of adhesive type cholesteatoma.

METHODS

Fifty-two cases (52 ears) of adhesive type cholesteatomas were reviewed. Of the 52 cases there were 30 males and 22 females; 24 left ears and 28 right ears. The age of the patients ranged from 8 to 70 years. All of the patients were treated by tympanoplasty, and the open and close methods were performed in 37 ears and 10 ears, respectively. Other methods were employed in the remaining 5 cases. Nine ears underwent tympanoplasty type "O" without ossicular re-construction for an increase in the threshold of the bone conduction. Types I, III and IV tympanoplasties were performed in 1, 16 and 26 ears, respectively.

RESULTS

The structures of the upper parts of the stapes had disappeared in 25 ears, which was significantly higher in this series than that in the attic type cholesteatoma. The over-all recovery rate of hearing was 69.8%, while 75.9% and 55.6% in the open and closed tympanoplasties, respectively. Postoperative complications of perforations and re-adhesions of the tense part of the tympanic membrane were observed in 3 and 4 ears, respectively.

CONCLUSIONS

Adhesive type cholesteatoma is not uncommon. The cause of this disease may be the functional defects in the pharynotympanic tube. A thorough and effective treatment for the secretory otitis media is crucial for the prevention of adhesive type cholesteatomas. The open method tympanoplasty was considered as the first choice for adhesive type cholesteatoma while the closed method must be great careful.

Evaluation of physiological work demands and low back neuromuscular fatigue on nurses working in geriatric wards

This study evaluated the physiological demands and low back neuromuscular fatigue patterns following a daytime work shift of 21 female nurses working in geriatric wards. Subjects' heart rate (HR) at work was monitored for 8 h and surface electromyogram (EMG) of their back muscle was recorded during a 1-minute horizontal trunk holding test before and after work. Results showed that the nurses had heart rates exceeding 90 beats/min in 57% and 110 beats/min in 19% of their working hours. The EMG revealed a significant drop in initial median frequency (MF) (p = 0.04) and increase in negative slope of the MF/time plot (p<0.001) of the back muscle after work. These suggest that the muscles were fatigued after work. The nurses rated patient lifting, transfer and turning as most physically demanding, and these corresponded to the highest heart rates recorded. The physiological and neuromuscular strain on the nurses indicated that extreme care should be exercised at work, particularly towards the end of a work shift when the muscles have become fatigued.

Relationship between hyperventilation and intracranial pressure in patients with severe head injury

With high fatality rate and disability rate, the pathophysiologic changes of severe head injury are complicated. But the method of lowering intracranial pressure (ICP) through artificial hyperventilation is called in question recently. To understand the related changes of the partial pressure of carbon dioxide in artery (PaCO(2)) and the ICP at the acute period of severe head injury, a total of 64 patients with severe head injury were monitored and analyzed on the 3rd day after injury.

[Phacoemulsification of the subluxated lens with cataract]

OBJECTIVE

To study the efficiency of phacoemulsification in the treatment of subluxated lens with cataract.

METHOD

Phacoemulsification combined with intraocular lens implantation was performed on 19 eyes of 18 patients.

RESULT

The visual acuity in 18 eyes was improved to different degrees. The visual acuity in one eye was not improved due to the preoperative macular contusion.

CONCLUSION

Phacoemulsification for treatment of subluxated lens with cataract may decrease many complications occurring in the past procedure.

Epidemiological survey of Trichinella infection in some areas of Henan province

During 1996-1998 epidemiological survey of domestic Trichinella spiralis infection and serological survey on human beings were carried out in Yanling, Xuchang counties and Luohe city. By the artificial digestion method, the positive rates of pork in market and mutton were 1.6% and 0.6% respectively. Meat samples of pigs from pig-farms, cats and dogs were all negative for Trichinella larvae. Trichinellosis infection levels in rats captured in peasant households and places around abattoirs were 0.5% and 4.1% respectively (P < 0.05). By ELISA (double-antibody) with excretion-secretion (ES) antigens of Trichinella larvae, the positive rates of antibodies against Trichinella in sera of peasants and professional drivers were 2.2% and 7.8% (P < 0.05). The positive rates of antibodies in pigs from pig-farms and from peasant households were 1% and 7% respectively (P < 0.05). The levels of anti-Trichinella antibodies in rats captured in peasant households and places close to abattoirs were 0% and 11.1% respectively. Trichinella spiralis larvae were found in the washing meat slop in abattoirs.

Unitarity bounds and the cuspy halo problem

Conventional cold dark matter cosmological models predict cuspy halos which are in apparent conflict with observations. We show that unitarity arguments imply interesting constraints on two proposals to address this problem: collisional dark matter and strongly annihilating dark matter. Efficient scattering in both implies m less, similar to 12 GeV and m less, similar to 25 GeV, respectively. We also show that the strong annihilation in the second scenario implies the presence of elastic scattering. Recent evidence suggests a collisional scenario where the cross section scales inversely with velocity--we argue superelastic processes are likely involved. Exceptions and implications for searches are discussed.

Expression profiling suggested a regulatory role of liver-enriched transcription factors in human hepatocellular carcinoma

By using a cDNA array representing 14,000 cDNA clusters, we studied the expression profiles in paired clinical hepatocellular carcinoma (HCC) samples and the distal nontumorous liver tissues from the same patients. Despite the significant heterogeneity among the clinical samples, 72 genes (including 30 novel genes) were down-regulated and 84 genes (including 48 novel genes) were up-regulated in >50% of the cancer samples that were identified. The alterations in gene expression levels were confirmed by Northern blot and reverse-transcription PCR in all of 4 randomly selected genes. It was conspicuous that 21 of 38 hepatocarcinoma (HCC) down-regulated genes studied previously were reportedly regulated by a group of liver-enriched transcription factors (LETFs), and 12 of 36 HCC up-regulated genes studied previously were involved in protein translation. Reexamination of the cDNA array data further revealed that most of the genes known to be regulated by LETFs were down-regulated in at least a portion of the HCC samples. Among the LETFs, the expression level of CCAAT/enhancer-binding protein (C/EBP) alpha was down-regulated in cancer, whereas hepatocyte nuclear factor 1 (HNF-1), HNF-3beta, HNF-4alpha, and HNF-4gamma were up-regulated. The expression profiling thus suggested multiple regulatory pathways involved in HCC, especially that related to LETFs.

Preliminary study of associations between objective parameters of facial electromyography and subjective estimates of taste palatability

20 subjects' palatability reports and facial electromyographic (EMG) activities at the zygomaticus major, corrugator supercilli, and levator labii (superioris/alaeque nasi) regions were recorded while they were tasting water or pickle juice. The results showed that subjects reported significantly higher ratings of palatability to water than to pickle juice. The EMG activities at the levator labii region generated significantly higher power than those at the corrugator supercilli region while tasting water. The EMG activities at the levator labii region generated significantly higher power than those at the corrugator supercilli region and those at the zygomaticus major region while tasting pickle juice. It was concluded that the facial EMG activity at the levator labii region was the most sensitive indicator of palatability.

Emphysematous pyelonephritis

Emphysematous pyelonephritis is a rare, severe, necrotizing form of renal infection characterized by the presence of gas within the renal parenchyma or perinephric space. In patients suspected of emphysematous pyelonephritis, computed tomography scan should be done promptly. Based on the available data and this case, surgical intervention appears to be the preferred treatment.

[The study of facial neurapraxia]

OBJECTIVE

To study the clinical characteristics and mechanism of facial neurapraxia.

METHOD

Patients were tested with nerve excitability method and judged the degree of facial paralysis. Animal mode of neurapraxia was made and threshold of evoked electromyographic potential was tested. The fibers of facial nerve were observed under transmission electromicroscope.

RESULT

Average restoration time of evoked electromyographic potential was 52.5 min. The lamellar separation of myelin sheath of facial nerve was found under electromicroscope. Patients with facial neurapraxia was judged as denervation negative and residual function of facial muscles was above 65%.

CONCLUSION

Facial neurapraxia is mild reversible facial paralysis and relevant to the lamellar separation.

Dexamethasone use in adult meningococcal meningitis

The use of dexamethasone in the management of bacterial meningitis in adults remains controversial. This report illustrates the case of a 27-year-old male with severe meningococcal meningitis and meningococcemia who completely recovered after receiving antibiotics and dexamethasone. In adults with suspected bacterial meningitis, especially in high risk cases, the adjunctive use of dexamethasone may be beneficial.

[Male contraception of triptonide and its function mechanism]

OBJECTIVE

The male contraceptive mechanism in rats of triptonide, isolated from Multiglycosides of Tripterygium wilfordii (GTW), was investigated.

METHODS

The dosage of triptonide was 200 micrograms/(kg.d), fed for 8 weeks via gastric intubation. Sperm counts, sperm motility, and sperm silver staining were used to test the antispermatogenic effect of triptonide; the study of morphology was learned from paraffin sections of testis and visceras of triptonide-treated rats; protamine was abstracted from testis by electrophoresis; using antisense mRNA of cyclin D1 and Cdk4 as prodes, we examined the expression of cyclin D1 and Cdk4 through hybridization in situ.

RESULTS

Sperm counts (26.43 +/- 3.90) x 10(6)/g and sperm motility(66.0 +/- 6.8)% of triptonide-treated rats were substantially different from those of control, (41.15 +/- 5.51) x 10(6)/g (P < 0.01) and (88.0 +/- 2.0)% (P < 0.001). Paraffin sections of testis of triptonide-treated rats stained by PAS showed that the number of spermatids per 100 sertoli cells (9.15 +/- 0.33) was remarkably decreased compared with control's (10.73 +/- 0.38) (P < 0.001). At the same time, delaying sperm-released process was observed, which affects the nature course of sperm. And the extended vacuoles of vary sizes, the segregation of cells in lumens were also found in the cross-section of testis of rats treated with triptonide. In addition, the contents of protamine (4.6 +/- 2.2)% was extremely decreased, compared with the control's (40.6 +/- 7.2)% (P < 0.001). By using antisense mRNA of cyclin D1 and Cdk4 as prodes, we detected that the expression of the genes was notably increased in spermatids.

CONCLUSIONS

The results suggest the antispermatogenic effect of triptonide is very well and it mainly plays its role on spermatids by increasing the expression of cyclin D1 and Cdk4, meanwhile, decreasing the biosynthesis of protamine. The appropriate target region of triptonide makes itself most potency to be a suitable male antifertility drug.