Preeclampsia (PE), characterized by new-onset hypertension and proteinuria after 20 weeks of gestation, presents substantial risks to both mother and fetus. Cuproptosis represents a newly identified form of regulated cell death; its potential association with PE pathogenesis remains unclear. We retrieved the GSE60438 dataset from the GEO database and identified 557 differentially expressed genes (DEGs) associated with PE. Weighted gene co-expression network analysis (WGCNA) was performed, and by intersecting the DEGs with WGCNA module genes, we obtained 198 candidate PE-related genes. KEGG and GO enrichment analyses revealed their potential biological functions, with significant enrichment in lipoic acid metabolism, the tricarboxylic acid (TCA) cycle, and components of the mitochondrial matrix. By further intersecting the DEGs, WGCNA module genes, and cuproptosis-related genes, we identified DLD as the hub cuproptosis-related gene in PE. GSEA further revealed its involvement in key metabolic pathways. The expression of DLD in PE and normal placental tissues was detected by qRT-PCR and immunohistochemical staining. Loss or gain-of-function tests were performed to assess the effects of DLD on the proliferation, migration, and invasion of HTR-8/SVneo cells. Concurrently, pyruvate and citrate levels were quantified with commercial kits, and intracellular ultrastructure was examined by transmission electron microscopy. Herein, we detected increased DLD in the PE placental tissues. In vitro studies showed that knockdown of DLD promoted trophoblast proliferation, migration, and invasion; conversely, overexpression of DLD showed the opposite effect. Concurrently, DLD overexpression induced metabolic dysregulation in tricarboxylic acid (TCA) cycle intermediates as well as distinct mitochondrial ultrastructural alterations. Our study demonstrated that DLD, a cuproptosis-related gene, is significantly upregulated in PE and functionally impairs trophoblast activity, suggesting its pathogenic role may be mediated through cuproptosis.

Cervical insufficiency is a significant cause of mid-trimester miscarriage and preterm birth, for which cervical cerclage is the standard treatment. However, some patients experience extreme preterm delivery even after undergoing a repeat cerclage following initial cerclage failure. This study aimed to investigate the optimal timing for repeat cerclage and to identify independent predictors of its failure. The sociodemographic characteristics and clinical data of 47 singleton pregnancies who underwent a repeat cerclage at Fujian Maternity and Child Health Hospital from October 2018 to May 2025 were retrospectively analyzed. Participants were divided into a failure group (delivery < 28 weeks, n = 17) and a success group (delivery ≥ 28 weeks, n = 30). Univariate and multivariate logistic regression analyses were used to identify independent risk factors. Receiver operating characteristic (ROC) curves were employed to determine optimal cut-off values for key continuous variables. Moreover, the BP neural network was used to perform a secondary validation of the independent risk factors. Multivariate analysis using Firth’s penalized logistic regression identified that cervical dilation before repeat cerclage (aOR = 3.098, 95

The association of inflammatory markers, including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR), with pregnancy outcomes in twin pregnancies following cervical cerclage remains unclear. This study aimed to evaluate the predictive value of these markers for spontaneous preterm birth before 28 weeks of gestation in this high-risk population. This retrospective study included 111 twin pregnancies undergoing transvaginal cervical cerclage for cervical shortening or dilation. Inflammatory markers (SII, SIRI, NLR, and PLR) were calculated from maternal peripheral blood collected before the procedure. The primary outcome was cerclage failure, defined as spontaneous preterm birth before 28 weeks of gestation. The area under the receiver operating characteristic curve (AUC) was used to assess predictive performance, and modified Poisson regression was applied to evaluate the association between these markers and cerclage failure. Cerclage failure occurred in 13 pregnancies (11.7

To investigate the impact mechanisms of vitamin D on inflammatory factors and neutrophil activity in preterm pregnant rats. 24 pregnant rats were selected as the research objects and randomly divided into control group, LPS group and LPS + VD group, with 8 rats in each group. On the second day of pregnancy, the LPS + VD group was injected intraperitoneally with 50 mg/L vitamin D30.2 mL, and the LPS group and the control group were injected with the same amount of 0.9

This study aimed to study the correlation between preeclampsia (PE) and lncRNA nuclear paraspeckle assembly transcript 1 (NEAT1), and to examine the molecular mechanisms behind the development of PE. 30 PE and 30 normal pregnant women placental samples were assessed the levels of NEAT1 and miR-217 by quantitative real-time PCR (qRT-PCR). The trophoblast cell line HTR8/SVneo was used for silencing NEAT1 or miR-217 inhibitor in the absence or presence of an inhibitor and H2O2. Cell counting Kit 8 (CCK-8), flow cytometry, and Transwell were used to detect cell proliferation, apoptosis, migration, and invasion. Luciferase reporter gene assay was utilized to verify the binding between miR-217 and Wnt family member 3 (Wnt3), and between the miR-217 and NEAT1. Proteins related to the Wnt/β-catenin signaling pathway were detected using western blotting. The PE group exhibited a significantly downregulated expression of miR-217 and a significantly upregulated expression of NEAT1. NEAT1 targeted miR-217, and Wnt is a miR-217 target gene. siRNA-NEAT1 inhibited the apoptosis of trophoblast cells, but promoted their invasion, migration, and proliferation. MiR-217 inhibitor could partially reverse the effects of siRNA-NEAT1. The expression of the Wnt/β-catenin signaling pathway-related proteins, WNT signaling pathway inhibitor 1 (DKK1), cyclin-D1 and β-catenin, was significantly increased after siRNA-NEAT1. NEAT1 could reduce trophoblast cell invasion and migration by suppressing miR-217/Wnt signaling pathway, leading to PE.

目的 探讨McDonald子宫颈环扎术的临床疗效及其影响因素.方法 回顾性分析2019年1月至2022年3月在我院行McDonald子宫颈环扎术的宫颈机能不全孕妇资料,并分别使用多因素logistic回归、神经网络模型以分析宫颈环扎失败的影响因素.结果 共纳入226例孕妇,其中30例(13.3％)孕妇于孕28周之前流产.多因素logistic回归分析结果:绒毛膜羊膜炎(OR=5.2;95％CI2.013,13.428;P=0.001)、血小板淋巴细胞比(PLR)(OR=1.013;95％CI 1.005,1.021;P=0.02)和臀先露(OR=6.372;95％CI 2.017,13.428;P=0.001)是宫颈环扎失败的影响因素.神经网络模型结果:宫口扩张、绒毛膜羊膜炎、PLR、胎膜膨出、臀先露是环扎失败的影响因素.结论 McDonald宫颈环扎术是宫颈机能不全的有效治疗措施.宫口扩张、绒毛膜羊膜炎、PLR、胎膜膨出、臀先露是环扎失败的影响因素.

Purpose: To determine the predictive value of maternal White Blood Cells (WBC), neutrophils, and C-Reactive Protein (CRP) for diagnosing Histological Chorioamnionitis (HCA) among women with Preterm Premature Rupture of Membranes (PPROM) who underwent cervical cerclage.Methods: A total of 55 eligible women were included in the final analysis, including 36 (65.45%) cases with HCA and 19 (34.55%) without HCA. Women with HCA had higher WBC count (12.31 +/- 2.80) x 10(9)/L and neutrophil count (9.67 +/- 2.90)x10(9)/L than those without HCA (10.35 +/- 2.53) x 10(9)/L and (7.82 +/- 2.82) x 10(9)/L, respectively) (both p < 0.05). The cut-off value of WBC count at 10.15x10(9)/L was found to be the most effective in identifying HCA, with an Area Under Curve (AUC) of 0.707 (95% CI: 0.56-0.86; p = 0.012), sensitivity of 86.11%, specificity of 57.90%, Positive Predictive Value (PPV) of 79.49%, Negative Predictive Value (NPV) of 68.75%, and Youden index of 0.44. The combination of WBC + neutrophil had a slightly higher AUC value 0.711 (95% CI: 0.57-0.86; p = 0.011), specificity (68.42%), and PPV (81.25%), but lower sensitivity (72.22%), than the WBC count alone. A cut-off value of neutrophil at 7.46 x 10(9)/L was effective in identifying HCA, with an AUC of 0.689 (95% CI: 0.53-0.84; p = 0.022).Discussion: Combination use of WBC+neutrophil was found to be the most accurate predictor of HCA among women with PPROM after surgery of cervical cerclage.

目的 探讨救援性宫颈环扎术前中性粒细胞/淋巴细胞比值(NLR)对潜在组织绒毛膜羊膜炎(HCA)的预测价值.方法 回顾性分析2016年1月至2020年12月福建省妇幼保健院98例行救援性宫颈环扎术早产孕妇的临床资料,根据分娩后胎盘的病理结果分为早产伴HCA组(63例)和早产不伴HCA组(35例).比较两组术前外周血相关炎症标志物及宫颈分泌物培养阳性率.对NLR进行ROC曲线分析,分析其对HCA的预测价值.结果 早产伴HCA组的胎膜早破孕龄、分娩孕龄低于早产不伴HCA组,妊娠延长天数短于早产不伴HCA组,剖宫产率、新生儿体重低于早产不伴HCA组,差异有统计学意义(P＜0.05).早产伴HCA组的外周血NLR、宫颈微生物培养阳性率高于早产不伴HCA组,差异有统计学意义(P＜0.05).ROC曲线分析显示,NLR的AUC为0.726(P＜0.05),最佳截断值为5.61,预测HCA的灵敏度、特异度、阳性预测值、阴性预测值分别为69.84％,57.78％,83.02％和42.22％.按照NLR的截断值分组,Kaplan-Meier生存分析显示,NLR≥5.61组宫颈环扎术后妊娠延长天数中位数为53 d,NLR＜5.61组的宫颈环扎术后妊娠延长天数中位数为63 d,差异有统计学意义(P＜0.05).结论 外周血NLR可成为预测急性宫颈机能不全孕妇合并HCA的炎症标志物,并与救援性宫颈环扎术后孕周的延长有关.

The purpose of this study was to develop a dynamic model to predict the risk of spontaneous preterm birth at < 32 weeks in twin pregnancy. A retrospective clinical study of consecutively asymptomatic women with twin pregnancies from January 2017 to December 2019 in two tertiary medical centres was performed. Data from one centre were used to construct the model, and data from the other were used to evaluate the model. Data on maternal demographic characteristics, transvaginal cervical length and funnelling during 20–24 weeks were extracted. The prediction model was constructed with independent variables determined by multivariate logistic regression analyses. After applying specified exclusion criteria, an algorithm with maternal and biophysical factors was developed based on 88 twin pregnancies with a preterm birth < 32 weeks and 639 twin pregnancies with a delivery ≥ 32 weeks. It was then evaluated among 34 pregnancies with a preterm birth < 32 weeks and 252 pregnancies with a delivery ≥ 32 weeks in a second tertiary centre without specific training. The model reached a sensitivity of 80.00%, specificity of 88.17%, positive predictive value of 50.33% and negative predictive value of 96.71%; ROC characteristics proved that the model was superior to any single parameter with an AUC of 0.848 (all P < 0.005). We developed and validated a dynamic nomogram model to predict the individual probability of early preterm birth to better represent the complex aetiology of twin pregnancies and hopefully improve the prediction and indication of interventions.

Objective: The purpose of this study was to develop a dynamic nomogram model to predict the risk of spontaneous preterm birth at <32 weeks in twin pregnancy. Design: A retrospective analysis and multicentre validation study Setting and Population: Women with twin pregnancies followed up in two tertiary medical centres from January 2017 to March 2019. Methods: Data on maternal demographic characteristics, transvaginal cervical length and funneling were extracted. The prediction model was constructed with independent variables determined by logistic regression analyses. The risk score was calculated according to the dynamic nomogram model. Main outcome measures: The risk of spontaneous preterm birth at <32 weeks in twin pregnancy. Results: In total, 1065 twin pregnancies were eligible for the study, of which the data of 764 cases (92 twin preterm cases (<32 weeks) and 672 control cases) were obtained from a tertiary medical centre as the training group and those of 301 cases (36 twin preterm cases (<32 weeks) and 265 control cases) from the other tertiary medical centre as the external validation group. Based on logistic regression analyses, we built a dynamic nomogram model with satisfactory discrimination in both the training group(C-index: 0.856, 95% CI: 0.813-0.899) and external validation group(C-index: 0.808, 95% CI: 0.751-0.865). The restricted cubic splines and ROC curve supported the performance of the prediction model. Conclusions: We developed and validated a dynamic nomogram model to predict the individual probability of preterm birth in twin pregnancy at <32 weeks.

This study aimed to evaluate the efficacy of physical examination–indicated cerclage in twin pregnancies and compare it with those that received conservative management. We used a retrospective cohort study design of asymptomatic twin pregnancies identified with physical examination indications at 14–26 weeks from 2015 through 2019 at Fujian Maternity and Child Health Hospital. The primary outcomes were gestational age (GA) at delivery and the incidence of spontaneous preterm birth (SPTB) at < 34 weeks, < 32 weeks, < 28 weeks, and < 24 weeks. The main secondary outcomes were latency period from diagnosis to delivery, composite neonatal adverse outcome and neonatal survival at discharge. Thirty–one women with twin pregnancies were managed with physical examination-indicated cerclage, and another 31 received expectant management. The demographic characteristics of the two groups were not significantly different. GA at delivery was significantly later in the cerclage group than in the controls: 32.53 ± 4.78 vs. 27.53 ± 4.15 weeks, with a mean difference of 5.00 weeks [95% confidence interval (CI), 2.73–7.28]. There were significant decreases in the incidence of spontaneous preterm birth (SPTB) at < 34 weeks, < 32 weeks, < 28 weeks, and < 24 weeks in the cerclage group. The interval from diagnosis to delivery was increased with cerclage by a mean difference of 4.37 weeks (95% CI, 1.96–7.06). Regarding neonatal outcome, the perinatal mortality rate in the cerclage group was significantly reduced compared to that in the control group [8/62 (12.9%) vs. 26/62 (41.9%); P < 0001]. Likewise, the neonatal intensive care unit (NICU) admissions, length of stay in the NICU, and composite adverse neonatal outcome in the cerclage group were significantly reduced. Physical examination–indicated cerclage was associated with significantly later GA at delivery, longer latency period from diagnosis to delivery, decreased incidence of SPTB at any given GA, and improved perinatal outcome compared with the corresponding measures in controls treated conservatively.

目的:研究Ib～IIb期宫颈癌盆腔淋巴结转移相关因素,建立风险预测模型,为指导临床实践提供参考.方法:回顾分析福建省妇幼保健院收治的194例Ib～IIb期宫颈癌病例的临床病理资料.Logistic逐步回归法筛选盆腔淋巴结转移相关因素并建立风险预测模型.结果:Ib～IIb期宫颈癌病例中,盆腔淋巴结转移率为21.13％(41/194).盆腔淋巴结转移率与临床分期、治疗前血清鳞状细胞癌抗原(SCC-Ag)水平、肿瘤直径、脉管癌栓、肌层浸润深度、宫旁浸润、切缘阳性及肿瘤分化显著相关(P均<0.05),这8个因素间存在多重共线性.盆腔淋巴结转移率与宫旁浸润、切缘阳性、肿瘤分化均存在较强关联(OR均>5.0).Ib～IIb期宫颈癌病例中,宫旁浸润、切缘阳性、肿瘤分化G3者占比较低,分别为4.12％(8/194)、3.61％(7/194)和5.67％(11/194).经Logistic回归法筛选,最终纳入预测模型的因素为临床分期、肿瘤直径及脉管癌栓,该模型对训练样本预测的正确率为74.5％,模型的拟合优度良好.结论:对于Ib～IIb期宫颈癌病例,临床分期、肿瘤直径及脉管癌栓情况是用于构建预测其盆腔淋巴结转移风险模型的相对最优因素,由此构建的模型具有良好的拟合优度和实用性,可为临床实践提供参考.

目的 研究高发性孕期疾病的并发症、治疗方法、发病影响因素、发病机理间的关联,为临床研究提供一个新的研究方法,为未来研究提供借鉴.方法 利用知识图谱这项新兴数据挖掘和可视化技术,对高发性孕期疾病的大量相关论文和临床研究进行分析,通过对生成的知识图谱的处理,展现文献中目的疾病的相关研究点之间的潜在关联.结果 在妊娠期有高血压疾病是导致子痫前期的重要因素或与之互为并发症,治疗子痫前期的手段有剖宫产和终止妊娠;胎儿生长受限、妊娠并发症、胎盘早剥、子痫前期都会影响妊娠结局;母体有胰岛素类疾病有可能导致小于胎龄儿,小于胎龄儿极有可能导致极低出生体重儿.结论 利用已有医学文献,通过知识图谱解析和数据挖掘等方式,结果能够很好地吻合现代临床医学所得出的结论,同时也得到一些新的结论以供临床参考,很好地辅助临床医学研究.

目的 通过部分特征数据,利用人工神经网络技术,判断患者是否存在胎盘植入高危因素和患有胎盘植入,从而得到一个临床预测辅助诊断模型.方法 利用人工神经网络技术,设计一个三层BP神经网络模型,将14个特征值作为神经网络的输入数据,将是否为胎盘植入作为输出数据.结果 共收集266条孕产妇检测数据(其中226条为训练样本,40条为测试样本),抽取出14个有可能影响胎盘植入并发症的特征指标如血清白蛋白、宫颈长度、胎盘位置、流产次数等.训练好的神经网络经测试组测试判断正确率为85％.结论 可以利用训练好的神经网络作为胎盘植入的临床预测辅助诊断模型.

Due to inconspicuous clinical characteristics of placenta accreta, there is no prenatal diagnosis methods with high sensitivity and specificity in clinical medicine. In this paper, feature selection method is introduced into the prenatal diagnosis of placenta accreta. From the view of feature correlation, a multi-objective feature optimization problem is formulated to extract features with effective medical meaning for the prenatal diagnosis of placenta accreta, and then an improved non-dominated sorting genetic algorithm II ( NSGA-II) is described to solve this problem. The computational result based on real clinical data for placenta accreta shows that the proposed method can extract placenta accreta features with effective medical meaning from complex clinical data of placenta accreta. The analysis based on receiver operating characteristic ( ROC ) curve shows that medical meaning of the extracted features has high diagnostic values, and it can be an effective decision tool for obstetricians to study the pathogenesis of placenta accreta and to make a timely prenatal diagnosis. The study reveals that some biochemistry characteristics in real diagnosis are very important and it can provide a reliable criterion for the prenatal diagnosis of placenta accreta.