OBJECTIVE:This study aimed to examine the associations between trimester-specific bisphenol exposure and preterm birth (PTB) and explore potential underlying mechanisms. METHODS:Within the Tongji Precision Birth Cohort (TPBC), concentrations of ten bisphenols were quantified using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Multivariable logistic regression models were employed to examine associations between trimester-specific urinary bisphenol exposure and spontaneous PTB (sPTB). Placental expressions of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were evaluated by immunohistochemistry. Median urinary concentrations of Bisphenol A (BPA) and BPF were used to guide in vitro assays. HTR8 and BeWo trophoblast cell lines were exposed to gradient BPA and BPF. RT-qPCR was used to measure mRNA levels of NF-κB pathway-related genes. RESULTS:Among the bisphenols analyzed, BPF emerged as the most common alternative to BPA. Placental BPA and urinary BPF showed associations with sPTB risk. Each standard deviation increase in placental BPA concentration was associated with a 38.1% increased risk of spontaneous preterm birth (95% CI: 1.023-1.866, p = 0.035). Placental expression of IL-6 and TNF-α was increased in sPTB. In trophoblast cells, low to middle concentrations of BPA and BPF might upregulate NF-κB pathway-related genes and selected inflammatory markers. CONCLUSIONS:Bisphenol exposure during pregnancy, particular BPA and BPF, may be associated with increased risk of sPTB. The findings further suggest the involvement of NF-κB pathway-related placental inflammatory signaling.

Evidence on maintenance tocolysis after preterm premature rupture of membranes (PPROM) in twin pregnancies is limited. This study evaluated the association between maintenance tocolysis and pregnancy prolongation and neonatal outcomes in this high-risk population. This retrospective cohort study included twin pregnancies with PPROM between 24 and 34 weeks at Tongji Hospital from January 2012 to December 2022, comparing maintenance tocolysis with non-maintenance tocolysis (no tocolysis or short-term tocolysis). Primary outcomes were latency and gestational age (GA) at delivery. Secondary outcomes included perinatal mortality and morbidity. Multivariate regression was fitted, and generalized estimating equations (GEE) analyses were applied to account for within-twin clustering. In the main cohort, pregnancies receiving maintenance tocolysis had longer median latency (10.44 vs. 0.61 days; p < 0.001) despite earlier GA at PPROM. In the sub-cohort (delivery > 48 h), maintenance tocolysis remained associated with longer latency (adjusted β 5.21 days, 95

OBJECTIVE:Great obstetrical syndrome (GOS) represents a group of pregnancy-related diseases that result in inadequate placentation. Most GOS cases end in preterm, either spontaneously or indicatively, and the use of antenatal corticosteroids (ACS) is inevitably discussed. The placenta is an important, transient fetal-derived organ and is the embodiment of maternal or fetal well-being. However, few studies provide histological evidence of the placenta in GOS. This study aims to address these issues. METHODS:A total of 831 pregnant women were prospectively recruited. Placenta tissue was collected immediately and fixed with 4% paraformaldehyde solution for future H&E analysis. A novel checklist was devised to evaluate maternal vascular malperfusion sections on the basis of the commonly accepted Amsterdam placental workshop group consensus statement. RESULTS:A total of 131 patients were classified as having GOS. Comparisons between those with and without GOS revealed significant differences, including higher levels of distal villous hypoplasia, increased syncytial knots, accelerated villous maturation, and higher total scores in GOS. We found significant negative associations between GOS and neonatal weight, neonatal height, head circumference, placental surface area, placental volume, and placenta gross examination score. GOS neonates were 1.25 times more likely to have hyperbilirubinemia. Regarding the effect of ACS, a significant reduction in birthweight, height, and head circumference was observed, along with an increased risk of hyperbilirubinemia. CONCLUSION:This study provides histological evidence of the GOS that supports the defective deep placentation hypothesis. Our research also contributes to benefit-risk consultation in the GOS, such as in cases of PE and FGR, where a balance between fetal lung maturation and short-term neonatal outcomes is crucial.

Introduction Preterm birth (PTB) presents significant risks to neonatal health, highlighting a deeper understanding of the mechanisms underlying labor initiation. Maternal-fetal interface inflammation and heightened endoplasmic reticulum stress (ERS) are associated with the onset of PTB, while the molecular mechanism remains unclear. This study investigates ERS levels in placental tissues from term and preterm pregnancies and examines the role of ERS and cylindromatosis (CYLD) in trophoblast pyroptosis to reveal the mechanisms underlying PTB. Methods A total of 60 pregnant women were recruited and categorized into four groups: term labor (TL), term not in labor (TNL), preterm labor (PTL), and preterm not in labor (PTNL). Protein expressions of ERS and pyroptosis-related molecules, including CYLD, were assessed using Western blotting, immunohistochemistry, and immunofluorescence. IL-1β and IL-18 mRNA levels were quantified via real-time PCR. An in vitro inflammatory trophoblast model was established using LPS and ATP co-treatment. ERS modulation was achieved with Thapsigargin (TG) and Tauroursodeoxycholate (TUDCA). Results Elevated ERS and pyroptosis-related protein levels were observed in PTB-associated groups and the inflammatory trophoblast model. TG increased CYLD expression and induced cell pyroptosis, while TUDCA mitigated these effects. CYLD silencing reduced trophoblast pyroptosis, whereas overexpression negated TUDCA's inhibitory impact. Discussion Our findings indicate that ERS-mediated trophoblast pyroptosis via CYLD under inflammatory conditions sheds light on PTB mechanisms, providing a potential target for modulating labor onset.

OBJECTIVE:Sleep is fundamental to the physical and mental health of both the general population and pregnant women. Most studies have focused on the impact of certain trimester sleep behaviors on gestational complications and birth outcomes. This study aimed to explore the association between maternal sleep duration and fetal growth development from as early as 23 gestational weeks to birth. METHODS:A total of 803 pregnant women were prospectively enrolled. The self-reported maternal nocturnal sleep duration during all 3 trimesters was recorded. The outcome measures were reference-population-based Z-scores of fetal biometric measurements obtained through routine ultrasonographic examination. RESULTS:Using multiple linear regression, a marginally significant negative association was observed between second-trimester sleep duration and second-trimester fetal head circumference (HC) and third-trimester fetal biparietal diameter (BPD). Then the associations of long sleep duration in each trimester with fetal biometry extreme values were evaluated. A significant impact of second-trimester long sleep duration on the second-trimester BPD below the 10th percentile of the reference population was observed. Longitudinal analysis reported similar results for BPD and HC. CONCLUSIONS:Overall, a negative association between sleep duration and fetal biometric measurements was observed. Long sleep durations in the second trimester might negatively impact fetal growth, particularly brain parameters, including BPD and HC.

Objectives: Nausea and vomiting in pregnancy (NVP) is a common condition that reduces the quality of life by negatively affecting work and family life, physical and mental health, and economic wellbeing. However, its risk factors remain unclear. This study aimed to explore the association between NVP and verbal rating scale (VRS)-measured dysmenorrhea and to explore potential protective factors. Methods: This retrospective cohort study was conducted from June 2018 to December 2020 at Tongji Hospital in Wuhan. Information on baseline characteristics, pregnancy-related history, periconceptional micronutrient supplementation, and obstetric outcomes were collected. The severity of dysmenorrhea was assessed using VRS. Results: A total of 443 pregnant women were recruited and divided into the NVP group (n = 76) and the control group (n = 367). A significant association was observed between NVP and VRSmeasured dysmenorrhea (c2=10.038, P = 0.007). After adjusting for covariates, the association between moderate/severe dysmenorrhea and NVP remained significant (OR 2.384; 95% CI 1.104-5.148, P = 0.004). First-trimester docosahexaenoic acid supplement (OR 0.443; 95% CI 0.205-0.960, P = 0.039) may be beneficial in reducing the risk of NVP. Conclusions: Women with moderate to severe dysmenorrhea have a higher risk of experiencing NVP during the first trimester. Periconceptional docosahexaenoic acid supplementation may play a protective role.

在过去数十年中,由于孕妇生育年龄推迟及广泛应用辅助生殖技术(assisted reproductive technology, ART),全球双胎出生率显著上升,在加拿大,该比率从1991 年的 2%升至 2009 年的 3. 14%. 近年来,这一趋势已趋于稳定,到2018 年为3. 12%,约占所有活产婴儿3% [1]. 双胎妊娠和多胎妊娠是加拿大早产发生率增加的主要原因之一,双胎妊娠发生多种不良妊娠结局的风险较单胎妊娠明显增加,包括流产、早产、胎儿先天性异常、胎儿生长受限(fetal growth re-striction,FGR)、妊娠期糖尿病、妊娠期高血压疾病、手术分娩和产后出血等. 这不仅影响母婴的生活质量,而且消耗大量公共卫生资源. 2022 年,加拿大妇产科医师协会(SOGC)针对双绒毛膜双胎妊娠(简称双绒双胎)的管理,发布了第428 号临床实践指南[2] ,以替代2000 年发布的第91 号指南和第 92 号指南. 该指南结合了最新的循证医学证据,旨在为临床管理双绒双胎提供实践依据,以降低双绒双胎相关风险并改善围产结局. 本文对该指南要点进行如下解读.

ObjectiveTo explore the interactions between cervical length (CL) and placenta accreta spectrum (PAS) on severe postpartum hemorrhage (SPPH) in patients with placenta previa. MethodsA retrospective case-control study was conducted at four medical centers in China, and 588 patients with placenta previa were included. The logistic regression analysis and restricted cubic splines (RCS) were used to evaluate the association between CL and SPPH. Furthermore, the joint effect of CL and PAS on SPPH was assessed, and the additive and multiplicative interactions were calculated. ResultsAfter adjusting for potential confounders, the negative linear dose-response relationship was confirmed by RCS, and the change of odds ratio (OR) was more significant when CL was 2.5 cm or less. The risk of SPPH was significantly higher when CL of 2.5 cm or less co-existed with placenta increta/percreta than when CL of 2.5 cm less, or placenta increta/percreta existed alone (adjusted OR [aOR](CL <= 2.5cm&placenta accreta/non-PAS) 3.40, 95% confidence interval [CI] 1.37-8.45; aOR(placenta increta/percreta&CL >2.5cm) 4.75, 95% CI 3.03-7.47; aOR(CL <= 2.5cm&placenta increta/percreta) 14.51, 95% CI 6.08-34.64), and there might be additive interaction between CL and placenta increta/percreta on SPPH (attributable proportion due to interaction 50.7%, 95% CI 6.1%-95.3%). ConclusionIf CL was routinely performed during PAS evaluation, the increased OR of short CL and PAS could allow better patient preparation through counseling.

Extracellular vesicles (EVs) play an important role in human and bovine milk composition. According to excellent published studies, it also exerts various functions in the gut, bone, or immune system. However, the effects of milk-derived EVs on skeletal muscle growth and performance have yet to be fully explored. Firstly, the current study examined the amino acids profile in human milk EVs (HME) and bovine milk EVs (BME) using targeted metabolomics. Secondly, HME and BME were injected in the quadriceps of mice for four weeks (1 time/3 days). Then, related muscle performance, muscle growth markers/pathways, and amino acids profile were detected or measured by grip strength analysis, rotarod performance testing, Jenner-Giemsa/H&E staining, Western blotting, and targeted metabolomics, respectively. Finally, HME and BME were co-cultured with C2C12 cells to detect the above-related indexes and further testify relative phenomena. Our findings mainly demonstrated that HME and BME significantly increase the diameter of C2C12 myotubes. HME treatment demonstrates higher exercise performance and muscle fiber densities than BME treatment. Besides, after KEGG and correlation analyses with biological function after HME and BME treatment, results showed L-Ornithine acts as a "notable marker" after HME treatment to affect mouse skeletal muscle growth or functions. Otherwise, L-Ornithine also significantly positively correlates with the activation of the AKT/mTOR pathway and myogenic regulatory factors (MRFs) and can also be observed in muscle and C2C12 cells after HME treatment. Overall, our study not only provides a novel result for the amino acid composition of HME and BME, but the current study also indicates the advantage of human milk on skeletal muscle growth and performance.

羊水栓塞(amniotic fluid embolism,AFE)是一种罕见但灾难性的事件,发生在分娩期间或产后,由于缺乏诊断的金标准,全球报道的AFE发病率和死亡率差异很大,发生率为(1.9 ～ 7.7)/10 万,死亡率为19% ～86% [1]. AFE典型的临床表现包括呼吸短促、胎儿窘迫、心肺功能衰竭、弥散性血管内凝血(dissem-ninated intravascular coagulation,DIC)、精神状态改变和产妇死亡. 产妇发生AFE后存活归功于早期识别,适当管理,积极的复苏和治疗. 一旦怀疑AFE,在充分评估和监测的同时应积极组织多学科参与抢救,治疗原则是对症支持治疗,包括维持血氧饱和度、心输出量和血压,矫正凝血功能障碍,心肺复苏等.

1 病历摘要 患者,32 岁,因孕39 周,阴道流液2 小时,于2021年11 月7 日5 时入华中科技大学同济医学院附属同济医院就诊. 39 周前(2021 年2 月26 日),患者因继发性不孕和双侧输卵管梗阻,在华中科技大学同济医学院附属同济医院生殖中心行囊胚移植后受孕. 孕期规律产检,早孕期甲状腺功能正常、地中海贫血基因筛查阴性、胎儿颈项透明层(nuchal translucency, NT)1. 1 mm、无创产前检查(non-invasive prenatal tes-ting,NIPT)低风险、胎儿系统超声检查未发现明显异常;75 g口服葡萄糖耐量试验(OGTT)空腹及服糖后1小时、2 小时的血糖值为4. 31 mmol/L、10. 35 mmol/L、8. 93 mmol/L; B 族链球菌( GBS)阴性.2 小时前(2021 年11 月7 日3 时),患者无诱因突发阴道流液,急诊就诊后入院治疗. 患者否认内科和外科疾病史、手术外伤史、药物食物过敏史. G2 P1,2012 年 3 月经阴道分娩一男婴,新生儿发育正常.

To assess the efficacy of copy number variation sequencing (CNV-seq) and karyotyping for prenatal detection of chromosomal abnormalities in fetuses with increased nuchal translucency. Amniotic fluid samples were extracted from 205 fetuses with increased nuchal translucency (NT ≥ 2.5 mm), diagnosed by ultrasound between gestational ages of 11 and 13 + 6 weeks. Karyotyping and CNV-seq were performed for detecting chromosomal abnormalities. There are 40 fetuses (19.51%) showing increased NT detected with chromosomal abnormalities in karyotyping, and trisomy 21 was found to be the most common abnormalities. There are 50 fetuses (24.39%) identified with chromosomal abnormalities by CNV-seq. The detection of the applied techniques indicated that CNV-seq revealed higher chromosomal aberrations. The risk of chromosomal abnormalities was significantly increased with NT thickening, from 13.64% in the NT group of 2.5–3.4 mm, 38.64% in the NT group of 3.5–4.4 mm, and to 51.72% in the NT group of over 4.5 mm (P < 0.05). The investigated cases with increased NT with presence of soft markers in ultrasound or high risk in non-invasive prenatal testing presented chromosomal abnormalities in higher rates, comparing with those with isolated NT or low risk (P < 0.05). The results indicated that the risk of chromosomal abnormalities was associated with the NT thickness, detected by karyotype or CNV-seq. The combination application of two analysis was efficient to reveal the possible genetic defects in prenatal diagnosis. The finding suggested that the detection should be considered with ultrasonographic soft markers, and the NT thickness of 2.5–3.4 mm could be a critical value for detecting chromosomal abnormalities to prevent the occurrence of missed diagnosis.

Objective The global aim to lower preterm birth rates has been hampered by the insufficient and incomplete understanding of its etiology, classification, and diagnosis. This study was designed to evaluate the association of phenotypically classified preterm syndromes with neonatal outcomes; to what extent would these outcomes be modified after the obstetric interventions, including use of glucocorticoid, magnesium sulfate, and progesterone. Methods This was a retrospective cohort study conducted at Tongji Hospital (composed of Main Branch, Optical Valley Branch and Sino-French New City Branch) in Wuhan. A total of 900 pregnant women and 1064 neonates were retrospectively enrolled. The outcomes were the distribution of different phenotypes among parturition signs and pathway to delivery, the association of phenotypically classified clusters with short-term unfavorable neonatal outcomes, and to what extent these outcomes could be modified by obstetric interventions. Results Eight clusters were identified using two-step cluster analysis, including premature rupture of fetal membranes (PPROM) phenotype, abnormal amniotic fluid (AF) phenotype, placenta previa phenotype, mixed condition phenotype, fetal distress phenotype, preeclampsia-eclampsia & hemolysis, elevated liver enzymes, and low platelets syndrome (PE-E&HELLP) phenotype, multiple fetus phenotype, and no main condition phenotype. Except for no main condition phenotype, the other phenotypes were associated with one or more complications, which conforms to the clinical practice. Compared with no main condition phenotype, some phenotypes were significantly associated with short-term adverse neonatal outcomes. Abnormal AF phenotype, mixed condition phenotype, PE-E&HELLP phenotype, and multiple fetus phenotype were risk factors for neonatal small-for gestation age (SGA); placenta previa phenotype was not associated with adverse outcomes except low APGAR score being 0–7 at one min; mixed condition phenotype was associated with low APGAR scores, SGA, mechanical ventilation, and grade HI-W intraventricular hemorrhage (IVH); fetal distress phenotype was frequently associated with neonatal SGA and mechanical ventilation; PE-E&HELLP phenotype was correlated with low APGAR score being 0–7 at one min, SGA and neonatal intensive care unit (NICU) admission; multiple fetus phenotype was not a risk factor for the outcomes included except for SGA. Not all neonates benefited from obstetric interventions included in this study. Conclusion Our research disclosed the independent risk of different preterm phenotypes for adverse pregnancy outcomes. This study is devoted to putting forward the paradigm of classifying preterm birth phenotypically, with the ultimate purpose of defining preterm phenotypes based on multi-center studies and diving into the underlying mechanisms.

Abstract Background Prevention and treatment in preterm birth are still under intensive investigation. A gap exists between evidence-based recommendations and clinical practice. A deeper understanding of the prevalence of medication use is an essential step toward improving the care of pregnant women. This study aimed to address this issue.Methods A retrospective cohort was conducted between December 2018 and November 2019 in Tongji Hospital (Wuhan). In total, 878 pregnant women were enrolled. Information on maternal characteristics, medication prescription, maternal outcomes (including post-partum hemorrhage), and neonatal outcomes (including APGAR score, birthweight, neonatal intensive care unit (NICU) admission, cardiopulmonary and neurological diseases) in the linking system were retrieved.Results The overall coverage of the common medications, including antenatal corticosteroids (ACS), magnesium sulfate, tocolytics, and progesterone, was 84.5%, 52.8%, 24.9%, and 13.3%, respectively. The treatment plan varied widely regarding the regimen, dosing, duration, and combination of these drugs. Specifically, tocolytic maintenance, which means the administration duration of more than 48 hours in this study, increased the risk of post-partum hemorrhage; it also significantly increased birthweight, but was not a risk factor of large-for-gestational-age (LGA).Conclusions This retrospective study in a single tertiary center disclosed that obstetric medications for preterm labor are highly individualized and do not strictly conform to current guidelines. This phenomenon is not uncommon in other countries. Clinical practice and evidence-based recommendations need to be carefully balanced; more studies are warranted to provide high-quality evidence to aid clinical decisions.

INTRODUCTION:Preeclampsia (PE) is a multisystemic disorder attributed to the excessive presentation of placenta-derived immunoinflammatory factors. PTEN-induced putative kinase 1 (PINK1)-mediated mitophagy participates in the development and persistence of the inflammation. We hypothesized that dysregulated mitophagy might be involved in the pathogenesis of PE by promoting the activation of trophoblast pyroptosis that augment inflammation. METHODS:The morphology of mitochondrial in placenta were observed by transmission electron microscopy. The localization of PINK1 in the placenta was determined by immunohistochemistry. The expression levels of PINK1, PARKIN, LC3B, and SQSTM1 and pyroptosis-related molecules were compared between normal pregnancies and PE. We used hypoxia/reoxygenation (H/R) to stimulate the trophoblast hypoxia environment. HTR-8/SVneo cells were transfected with PINK1 plasmid and si-PINK1, respectively, and then were treated with H/R, to determine whether PINK1 regulated ROS and HTR-8/Svneo pyroptosis. Finally, ROS production was inhibited by MitoTEMPO to observe whether the pro-pyroptosis effect of PINK1 knockdown is alleviated. RESULTS:Swollen mitochondrial were accumulated in the PE placentae. PINK1 is localized on villus trophoblast (VTs) and extravillous trophoblast (EVTs). PINK1-mediated mitophagy was abolished in the PE placenta, while the levels of pyroptosis were induced. H/R stimulation aggravated the downregulation of mitophagy and the up-regulation of pyroptosis. Overexpression of PINK1 mitigated H/R-induced upregulation of ROS and pyroptosis while silencing PINK1 did the opposite. Reducing ROS production can effectively resist the pro-pyroptosis effect of PINK1 knockdown. DISCUSSION:This study demonstrated that PINK1-mediated mitophagy might played a protective role in PE by reducing ROS and trophoblast pyroptosis.

This study introduced whole-exome sequencing (WES) in prenatal diagnosis of fetal bowel dilatation to improve the detection outcome when karyotype analysis and copy number variation sequencing (CNV-seq) were uninformative in detecting pathogenic variants. The work reviewed 28 cases diagnosed with fetal bowel dilatation and analyzed the results of karyotype analysis, CNV-seq, and WES. Among the 28 cases, the detection rate in cases with low risk of aneuploidy was 11.54% (3/26), which is lower than 100% (2/2) in cases with high risk of aneuploidy. Ten low-risk aneuploidy cases with isolated fetal bowel dilatation had normal genetic testing results, while the remaining 16 cases with other ultrasound abnormalities were detected for genetic variants at a rate of 18.75% (3/16). The detection rate of gene variation was 3.85% (1/26) by CNV-seq and 7.69% (2/26) by WES. This study suggested that WES could reveal more genetic risk in prenatal diagnosis of fetal bowel dilatation and has value in prenatal diagnosis to reduce birth defects.

目的 探讨基因组拷贝数变异检测（CNV-seq）联合染色体核型分析在评估胎儿心室强光点超声软指标中的临床应用价值。方法 收集2017年6月至2020年12月于华中科技大学同济医学院附属同济医院妇产科胎儿系统超声诊断为心室强光点（EIF）的143例孕妇，羊膜腔穿刺术抽取羊水，羊水标本行染色体核型分析和拷贝数变异检测。结果 143例心室强光点胎儿羊水标本中，核型分析共检出8例异常结果，异常率为5.59%;CNV-seq共检出8例致病性拷贝数变异（pCNV），异常率5.59%，联合检测共发现9例异常结果，异常率6.29%。心室强光点合并其他单个和多个超声软指标组，染色体异常率分别为8.70%和25.00%，明显高于孤立性心室强光点组（0.00%），差异有统计学意义。心室强光点合并非整倍体筛查高风险时，染色体异常率25.00%，明显高于筛查低风险组（4.58%）。结论 孤立性心室强光点不会增加胎儿染色体异常的风险，心室强光点合并其他超声软指标异常或非整倍体筛查高风险时，染色体畸变的风险显著增加。此外，在核型分析的基础上应用CNV-seq能够检测出额外的染色体异常，减少漏诊和出生缺陷的发生。

Background: It is challenging to make an accurate prenatal diagnosis for congenital anomalies of the kidney and urinary tract (CAKUT) because of its pathologic diversity. This study aims to evaluate the performance of whole-exome sequencing (WES) combined with karyotype analysis and copy number variations (CNVs) in diagnosing high-risk fetal CAKUT.Methods: We conducted a retrospective study on prenatal diagnoses of CAKUT in our hospital from January 2020 to April 2021. The research studied 24 high-risk fetuses with CAKUT who were scanned by ultrasonography at the prenatal diagnosis center of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. The likely pathogenic gene variants were screened for the patients and their parents by multiple approaches, including karyotype analysis, CNVs and WES, and further verified with Sanger sequencing.Results: ①We detected abnormal CNVs in 20.8% (5/24) of the fetuses but only 8.3% (2/24) fetuses had abnormal karyotypes. ②Of the 15 CAKUT fetuses, positive findings (40%) were detected by WES. Of the 9 high-risk fetuses with CAKUT (negative findings in ultrasound scan but with family history), we found abnormal variants (77.8%) through WES.Conclusion: The application of CNVs and WES showed advance in prenatal diagnosis of CAKUT and the pathogenic gene variants were detectable especially for high-risk fetuses with negative ultrasound findings on CAKUT in the preliminary study. The applied strategy could be used to improve the accuracy of prenatal diagnosis for CAKUT in the future.

细胞焦亡(又称细胞炎性坏死),是一种依赖Gasdermin蛋白家族的细胞程序性死亡.其参与调节宿主防御病原体和免疫炎性过程,在维持机体免疫炎症平衡中至关重要.炎性小体激活可介导Gasdermin形成剪切体,参与细胞焦亡.近年来越来越多的证据提示,细胞焦亡和炎性小体在妊娠生理过程和多种妊娠疾病发生发展中扮演重要角色.本文就细胞焦亡和炎性小体在妊娠相关疾病中的研究进展进行综述,旨在为认识和防治妊娠相关疾病提供新方向.

The pandemic caused by severe acute respiratory syndrome coronavirus 2 is sweeping the world, threatening millions of lives and drastically altering our ways of living. According to current studies, failure to either activate or eliminate inflammatory responses timely and properly at certain stages could result in the progression of the disease. In other words, robust immune responses to coronavirus disease 2019 (COVID-19) are critical. However, they do not theoretically present in some special groups of people, including the young, the aged, patients with autoimmunity or cancer. Differences also do occur between men and women. Our immune system evolves to ensure delicate coordination at different stages of life. The innate immune cells mainly consisted of myeloid lineage cells, including neutrophils, basophils, eosinophils, dendritic cells and mast cells; they possess phagocytic capacity to different degrees at different stages of life. They are firstly recruited upon infection and may activate the adaptive immunity when needed. The adaptive immune cells, on the other way, are comprised mainly of lymphoid lineages. As one grows up, the adaptive immunity matures and expands its memory repertoire, accompanied by an adjustment in quantity and quality. In this review, we would summarise and analyse the immunological characteristics of these groups from the perspective of the immune system 'evolution' as well as 'revolution' that has been studied and speculated so far, which would aid the comprehensive understanding of COVID-19 and personalised-treatment strategy.