Abstract Background Maternal rectovaginal colonization with group B Streptococcus (GBS) or Streptococcus agalactiae is the most common pathway for this disease during the perinatal period. This meta-analysis aimed to summarize existing data regarding maternal colonization, serotype profiles, and antibiotic resistance in China. Methods Systematic literature reviews were conducted after searching 6 databases. Meta-analysis was applied to analyze colonization rate, serotype, and antimicrobial susceptibility of GBS clinical isolates in different regions of China. Summary estimates are presented using tables, funnel plots, forest plots, histograms, violin plots, and line plots. Results The dataset regarding colonization included 52 articles and 195 303 pregnant women. Our estimate for maternal GBS colonization in China was 8.1% (95% confidence interval [CI] 7.2%–8.9%). Serotypes Ia, Ib, III, and V account for 95.9% of identified isolates. Serotype III, which is frequently associated with the hypervirulent clonal complex, accounts for 46.4%. Among the maternal GBS isolates using multilocus sequence typing (MLST), ST19 (25.7%, 289/1126) and ST10 (25.1%, 283/1126) were most common, followed by ST12 (12.4%, 140/1126), ST17 (4.8%, 54/1126), and ST651 (3.7%, 42/1126). GBS was highly resistant to tetracycline (75.1% [95% CI 74.0–76.3%]) and erythromycin (65.4% [95% CI 64.5–66.3%]) and generally susceptible to penicillin, ampicillin, vancomycin, ceftriaxone, and linezolid. Resistance rates of GBS to clindamycin and levofloxacin varied greatly (1.0–99.2% and 10.3–72.9%, respectively). A summary analysis of the bacterial drug resistance reports released by the China Antimicrobial Resistance Surveillance System (CARSS) in the past 5 years showed that the drug resistance rate of GBS to erythromycin, clindamycin, and levofloxacin decreased slowly from 2018 to 2020. However, the resistance rates of GBS to all 3 antibiotics increased slightly in 2021. Conclusions The overall colonization rate in China was much lower than the global colonization rate (17.4%). Consistent with many original and review reports in other parts of the world, GBS was highly resistant to tetracycline. However, the resistance of GBS isolates in China to erythromycin and clindamycin was greater than in other countries. This paper provides important epidemiological information, to assist with prevention and treatment of GBS colonization in these women.

Background Placenta accreta spectrum (PAS) is mainly characterized by excessive invasion of the uterine muscle layer accompanied by a large number of foreign blood vessels, leading to severe bleeding during and after delivery. However, the mechanism of excessive invasion of nutrient cells in placenta accreta is currently unclear. Methods We performed RNA sequencing of 6 PAS patients and 4 control donors, coupled with Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The mRNA and protein expression of C-X-C motif ligand 8 (CXCL8) in the placental tissue was measured by qRT‒PCR, immunohistochemical staining and Western blotting. HTR-8/SVneo human villous trophoblast Neo cells were used for in vitro investigation of cell migration and invasion as well as the expression level of CXCL8. Results A total of 1120 differentially expressed mRNAs were identified in PAS patients. Moreover, GO and KEGG analyses indicated that the differentially expressed mRNAs were most closely associated with immune system processes, biological adhesion and Wnt signaling pathway. The CXCL8 mRNA and protein levels in PAS tissue were significantly higher than those in normal placental tissue. Forced overexpression of CXCL8 significantly increased the migration and invasion of HTR-8/SVneo cells, accompanied by the upregulation of matrix metalloproteinase-2 and matrix metalloproteinase-9 and the downregulation of E-cadherin, which was reversed by knockdown of CXCL8. Conclusions CXCL8 was highly expressed in PAS, and knockdown of CXCL8 suppressed the migration and invasion of HTR-8/SVneo cells, suggesting its potential as a diagnostic and therapeutic target for PAS.

目的 探讨妊娠期肝内胆汁淤积症(ICP)血清甘胆酸水平对妊娠结局的影响.方法 采用回顾性研究方法,选取无锡妇幼保健院2020年1月至12月就诊的73例ICP患者为ICP组,以同期73例正常孕妇作为对照组.采用电化学发光法检测血清甘胆酸水平,并分析血清甘胆酸与妊娠结局的关系.结果 ICP患者血清甘胆酸水平为(15.50±9.01)μg/ml,显著高于对照组的(1.15±0.64)μg/ml(P＜0.05).ICP组围生结局发生率如产后出血(10.96％)、胎儿宫内窘迫(16.44％)、新生儿窒息(10.96％)、早产(26.03％)、羊水污染(24.66％)明显高于对照组(1.37％,4.11％,1.37％,6.85％,5.48％),差异均有统计学意义(P＜0.05,P＜0.01);ICP 组新生儿 Apgar评分明显低于对照组(7.95±1.52 vs 9.02±1.45,P＜0.01).将ICP组孕妇按血清甘胆酸水平分为低(≤10 μg/ml)、中(＞10～15 μg/ml)、高(≥15 μg/ml)三组,随着孕妇血清甘胆酸水平的升高,胎儿宫内窘迫发生率随之升高(P＜0.05),而新生儿Apgar评分伴随降低(P＜0.01).结论 ICP对妊娠结局影响显著,血清甘胆酸的升高对妊娠结局有一定预警作用,监测血清甘胆酸有利于尽早实施临床治疗,降低不良结局的发生率.

Long noncoding RNAs (lncRNAs) are a class of important regulators participating in various pathological processes. Until now, the role of lncRNAs in the occurrence and development of intrahepatic cholestasis of pregnancy (ICP) has rarely been investigated. The data from microarray screening revealed 58 upregulated and 85 downregulated lncRNAs and 47 upregulated and 71 downregulated mRNAs in ICP patients compared to healthy controls. Bioinformatics analysis revealed biological processes focused on lipid metabolism, apoptosis, cell cycle, cell differentiation, and oxidative stress. Furthermore, the expressions of three lncRNAs (ENST00000505175.1, ASO3480, and ENST00000449605.1) chosen for verification were significantly decreased and showed the diagnostic and prognostic value for ICP based on ROC analysis. This is the first study to report the specific role of lncRNAs in ICP, which may be helpful for the diagnosis and prognosis of ICP clinically.

目的:探讨血清载脂蛋白A1 (apolipoproteinA1,APOA1)、胆碱酯酶(cholinesterase,CHE)在妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)诊断及程度判定中的应用价值.方法:采用回顾性病例对照研究,选取100例ICP患者和100例正常妊娠女性为研究对象.分析比较两组血清APOA1、CHE水平,采用受试者工作特征(receiver operating charac-teristic,ROC)曲线分析两者对ICP诊断和疾病程度判定的价值.结果:ICP组APOA1、CHE含量与正常对照组相比显著降低(P＜0.05),其与总胆汁酸具有显著负相关性.APOA1与CHE诊断ICP疾病的ROC曲线下面积(area under the curve,AUC)分别为0.871、0.782,APOA1与CHE对ICP疾病程度判定的AUC分别为0.843、0.773.两种标志物联合诊断ICP的AUC为0.909,两种标志物联合检测对ICP疾病程度判定的AUC为0.891.结论:APOA1和CHE联合检测可以作为诊断ICP疾病和程度判定的新型标志物,提高ICP疾病的诊断率.

We used data-independent acquisition (DIA) proteomics technology followed by ELISAs and automated biochemical analyses to identify and validate protein expression levels in Intrahepatic Cholestasis of Pregnancy (ICP) and healthy pregnant controls. We employed bioinformatics to identify metabolic processes associated with differentially expressed proteins.The expression levels of two proteins (S100-A9 and the L-lactate dehydrogenase A chain) were significantly higher in ICP patients than in controls; the areas under the receiver operating characteristic (ROC) curves (AUCs) were 0.774 and 0.828, respectively. The expression levels of two other proteins (apolipoprotein A-I and cholinesterase) were significantly lower in patients, with values of 0.900 and 0.842, respectively. Multiple logistic regression showed that a combination of the levels of the four proteins optimized the AUC (0.962), thus more reliably diagnosing ICP. The levels of all four proteins were positively associated with that of total bile acids. Bioinformatics analyses indicated that the four proteins principally affected neutrophil activation involved in the immune response, cell adhesion, lipoprotein metabolism, and the PPAR signaling pathway. SIGNIFICANCE: This preliminary work improves our understanding of changes in serum levels of protein in pregnant women with ICP. The four proteins may serve as novel noninvasive biomarkers for ICP.

BackgroundIntrahepatic cholestasis of pregnancy (ICP) usually occurs in the third trimester and is associated with increased risks in fetal complications. Currently, the exact mechanism of this disease is unknown. The purpose of this study was to develop potential biomarkers for the diagnosis and prediction of ICP.MethodsWe enrolled 40 pregnant women diagnosed with ICP and 40 healthy pregnant controls. The number of placental samples and serum samples between the two groups was 10 and 40 respectively. Ultra-performance liquid chromatography tandem high-resolution mass spectrometry was used to analyze placental metabolomics. Then, we verified the differentially expressed proteins and metabolites, both placental and blood serum, in the first, second, and third trimesters.ResultsMetabolomic analysis of placental tissue revealed that fatty acid metabolism and primary bile acid biosynthesis were enriched. In the integrated proteomic and metabolomic analysis of placental tissue, peroxisomal acyl-CoA oxidase 1 (ACOX1), L-palmitoylcarnitine, and glycocholic acid were found to be three potential biomarkers. In a follow–up analysis, expression levels of both placental and serum ACOX1, L-palmitoylcarnitine, and glycocholic acid in both placenta and serum were found to be significantly higher in third-trimester ICP patients; the areas under the ROC curves were 0.823, 0.896, and 0.985, respectively. Expression levels of serum ACOX1, L-palmitoylcarnitine, and glycocholic acid were also significantly higher in first- and second-trimester ICP patients; the areas under the ROC curves were 0.726, 0.657, and 0.686 in the first trimester and 0.718, 0.727, and 0.670 in the second trimester, respectively. Together, levels of the three aforementioned biomarkers increased the value for diagnosing and predicting ICP (AUC: 0.993 for the third, 0.891 for the second, and 0.932 for the first trimesters).ConclusionsL-palmitoylcarnitine, ACOX1, and glycocholic acid levels taken together may serve as a new biomarker set for the diagnosis and prediction of ICP.

目的 探讨血清miR-3614-5p在妊娠期肝内胆汁淤积症(ICP)诊断中的应用.方法 采用临床对照回顾性研究方法.选取南京医科大学附属无锡妇幼保健院2017年11至2018年10月就诊的79例ICP病人,同时按随机数字表法选取同期79例正常孕妇作为健康对照.采用实时荧光定量PCR(qPCR)法检测血清miR-3614-5p水平,并分析miR-3614-5p与临床资料的关系,进行相关性及受试者工作特征曲线(ROC)分析,评价miR-3614-5p在ICP诊断中的临床应用价值.结果 ICP病人血清miR-3614-5p相对表达量[ΔCT:9.893(8.635,10.166)]明显高于对照组[ΔCT:10.841(10.256,11.987)],差异有统计学意义(P<0.05).ICP组中miR-3614-5p和TBA水平呈显著正相关(r=0.311,P<0.001),血清miR-3614-5p在ICP组中的ROC曲线下面积(AUC)、灵敏度和特异度分别为0.864、79.0％和83.0％.结论 血清miR-3614-5p可能成为ICP诊断的新型分子靶标.

Surface antigen one (Sao) protein is a bacterial surface protein identified in the important zoonotic pathogen Streptococcus suis serotype 2 (S. suis 2) during an extensive search for functional proteins. The Sao protein is anchored to the bacterial cell wall by the LPVTG motif and is widely distributed in many S. suis serotypes. In this paper, we present the immunodominant epitope peptide of the Sao protein that is recognized by BALB/c antibodies against the Sao protein: 355SEKQMPSVVNENAVTPEKQMTNKENDNIET384 (location Sao355−384). To determine the core epitope recognized by antibodies, we prepared truncation peptide libraries. Analyses of the immunoreactivity of truncation peptides with anti-Sao355−384 serum revealed that the most immunoreactive sequence was 355SEKQMPSVVNENAVTPEK372 (location Sao355−372). Moreover, we observed that this core epitope also showed good specificity based on the ratio of reactivity with serum from S. suis–positive patients compared to serum from S. suis–negative patients. Our results point to the potential of using the Sao355−372 peptide in diagnostic assays to determine S. suis infection in humans.

目的 研究多排CT(MDCT)、冠状动脉造影(CAG)对不稳定型心绞痛(UAP)患者冠状病变诊断的价值.方法 将我院2017牟3月-2018年3月年间收治的31例UAP患者纳为研究对象,其均在CAG检查前一周内行MDCT检查,且具备完善影像学资料,通过分析UAP患者影像学资料,评估MDCT在诊断UAP冠状病变中的应用价值.结果 以CAG检查结果为金标准,MDCT在诊断UAP患者冠状动脉病变节段中的灵敏度、特异度及准确度分别89.89％、97.89％、95.34％;两种检查方法在评估血管狭窄程度中无显著性差异(P＞0.05);MDCT共检出2 5块斑块,其中软斑块3个(12.00％)、纤维斑块7个(28.00％)、硬斑块13个(52.00％)、混合斑块2个(8.00％);MDCT与CAG在判断斑块性质中无显著性差异(P＞0.05).结论 MDCT与CAG在诊断UAP患者冠状动脉病变中的效果相似,且MDCT检查具有无创性,其检查参数CT值在辨别斑块性质,筛查易损斑块中具有很好的参考性.

Dysfunction of trophoblast metastasis into the endometrium is the main cause of pre-eclampsia (PE); however, the factors affecting this process are still unclear. In this study, we found that endoplasmic reticulum protein 29 (ERp29), one molecular chaperone of the endoplasmic reticulum, was aberrantly upregulated in the placenta of pre-eclamptic patients compared with healthy controls. Then, an in vitro study using human extravillous trophoblast HTR-8/SVneo cells showed that ERp29 upregulation could inhibit the migratory and invasive ability of HTR-8/SVneo cells, while ERp29 downregulation had the opposite effect. Mechanical experiments confirmed that ERp29 blocked trophoblast metastasis via inhibiting the process of epithelial-mesenchymal transition and affecting the Wnt/beta-catenin signaling pathway. In conclusion, this study revealed the important role of ERp29 in trophoblast metastasis and improved the mechanical understanding of PE occurrence.

Objective To establish a method for detecting drug resistant gene blaKPC-2 of carbapenem resistant Klebsiella pneumoniae by visual loop-mediated isothermal amplification (LAMP). Methods A total of 3 pairs of specific LAMP primers were designed, and the LAMP detection system of 25 μL was established and optimized. The specificity and sensitivity were compared with those of polymerase chain reaction (PCR). Results A method for detecting drug resistant gene blaKPC-2 of carbapenem resistant Klebsiella pneumoniae by visual LAMP was established, which was used in the rapid detection of blaKPC-2 at 63 ℃ for 40 min. The specificity was close to that of PCR, and the sensitivity was higher than that of PCR for 10 times. There were 12 isolates detected with blaKPC-2 by LAMP among 25 imipenem, meropenem or ertapenem resistant isolates, and there were 5 isolates detected with blaKPC-2 by LAMP among 31 imipenem, meropenem and ertapenem resistant isolates (P=0.009 9). Conclusions The established LAMP could be used as a method to detect blaKPC-2, but it could not replace drug susceptibility test in vitro.

Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder occurred in pregnant women, and the mechanism for such disease is still unclear. The bioinformatics analysis of our previous study has revealed the abnormal expression of endoplasmic reticulum protein 29 (ERp29) in placental tissue of ICP patients. In this study, the function of ERp29 was further explored using in vitro model of ICP. The results showed that up-regulation of ERp29 occurred in TCA (taurocholic acid)-treated human trophoblast HTR-8/SVeno cells, and ERp29 inhibition reversed TCA toxicity via attenuating G2/M arrest and cell apoptosis. Mechanical study revealed ERp29 inhibition suppressed phosphorylation and kinase activity of p38, thus subsequently affecting expression and phosphorylation of p53 (ser18) as well as the transcriptional activity of p53. The conduction of this study might confirm the important role of ERp29 in ICP and which would be helpful for the development of target therapeutic method for ICP.

Triple negative breast cancer (TNBC), an aggressive form of breast cancer, has high rate of metastasis and which is the main cause of poor outcomes for such disease. The acquisition of invasive properties such as epithelial mesenchymal transition (EMT) and anoikis resistance is estimated to be the critical step in TNBC metastasis. Therefore, targeting these metastatic processes may contribute to the control of TNBC metastasis. In this study, investigations were conducted into the effect and mechanism of Ziyuglycoside II (Ziyu II), the main compound extracted from Sanguisorba Officinails L, on EMT, anoikis resistance as well as cell migration and invasion in human triple negative breast carcinoma MDA-MB-231 cells. The results showed that the treatment of Ziyu II could inhibit EMT, reverse anoikis resistance and subsequently suppress cell migration and invasion in MDA-MB-231 cells, which was associated with the inactivation of Src/EGFR-dependent ITGB4/FAK signaling and subsequent Akt and p38MAPK signaling pathways. These findings provide the new evidence of the anti-metastatic activity of Ziyu II and suggest the possibility of using this compound for the control of TNBC metastasis.

目的:探讨炎症标志物在妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)程度判定中的应用价值.方法:采用回顾性病例对照研究,选取110例ICP患者和188例正常妊娠女性为研究对象.ICP患者根据总胆汁酸水平(to-tal bile acid,TBA)分为轻度ICP组(＜40 μmol/L)和重度ICP组(≥40 μmol/L),分析比较两组炎症标志物白细胞(white blood cell,WBC)、血小板(platelet,PLT)、中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte-ratio,NLR)、血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)、血小板平均体积(mean platelet volume,MPV)、红细胞平均分布宽度(red blood cell distributionwidth,RDW)的平均水平.结果:重度ICP组患者WBC、MPV、NLR含量与轻度ICP组、正常对照组相比显著增加(P＜0.05),且总胆汁酸(total bile acid,TBA)水平与WBC、MPV、NLR呈显著正相关(P＜0.05).结论:WBC、MPV、NLR可以作为评价ICP严重程度的炎症标志物,具有潜在的临床应用价值.

Background/Aims: Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific disease that significantly increases the risk of fetal complications. Here, we measured serum miRNA levels in ICP patients to identify candidate biomarkers for ICP. Methods: We used the Agilent miRNA array followed by reverse transcription-polymerase chain reaction assays to identify and validate the serum miRNA profiles of 40 pregnant women with ICP and 40 healthy pregnant controls. We used bioinformatics to identify metabolic processes related to differentially expressed miRNAs. Results: The expression levels of three miRNAs (miR-371a- 5p, miR-6865-5p, and miR-1182) were significantly increased in ICP patients compared to controls; the areas under the receiver operating characteristic (ROC) curves (AUCs) were 0.771, 0.811, and 0.798, respectively. Multiple logistic regression analysis showed that a combination of the levels of the three miRNAs afforded a greater AUC (0.845), thus more reliably diagnosing ICP. The levels of all three miRNAs were positively associated with that of total bile acids. Furthermore, bioinformatics analysis indicated that the three miRNAs principally affected lipid phosphorylation, apoptosis, and the MAPK signaling pathway. Conclusion: This preliminary work improves our understanding of serum miRNA changes in pregnant women with ICP. The three miRNAs may serve as novel noninvasive biomarkers of ICP.

Objective To explore the prevalence of vaginitis in perimenopausal women in local area and the related factors.Methods 439 cases of gynecological examination in our hospital from July 2016 to June 2017 were studied retrospectively.The results of vaginal secretions examination and personal information were analyzed.Results Among the 439 patients,99 (22.6％) had vaginitis.The infection rate of vaginitis was different in patients with different educational levels,which was up to 26％ in women with primary education and lower than primary education levels.There was no significant difference between groups (P =0.49).The result of secretion detection showed that 29 cases (29.3 ％) were Mycoplasma and Chlamydia positive,13 cases (13.1％) were Trichomonas positive,22 cases (22.2％) were Gardnerella positive,while 35 cases (35.4％) were Candida positive.Conclusion The proportion of vaginitis in perimenopausal women in the local area is related to educational level.Candida is the most common causative agent,followed by Mycoplasma and Chlamydia (including Ureaplasma urealyticum,Mycoplasma hominis and Mycoplasma hyopneumoniae).Since vaginitis is very likely to recur,doctors should pay attention to bacterial culture during the examination,and patients should accept regular re-examination.

Objective To explore the value of low-dose multi-slice spiral computed tomography (MSCT) multi-stage scan and three-dimensional reconstruction in diagnosis of patients with gastric carcinoma.Methods A total of 40 patients with gastric carcinoma were selected.All the patients were conducted with low-dose MSCT scan,dynamic contrast scanning and three-dimensional reconstruction scan,and then were processed by multi-planar reconstruction,volume reconstruction and CT virtual endoscopy.Primary lesions in gastric cancer,peripheral infiltration and distant metastasis were observed.Results All the patients were satisfied with the low dose MSCT images,and all of them found primary gastric lesions and had satisfactory diagnosis rates of gastric peripheral infiltration,lymph node metastasis and distant metastasis.Conclusion Low-dose MSCT multi-stage scan and three-dimensional reconstruction can reduce the radiation dose and reveal the primary gastric lesions,gastric peripheral infiltration and distant metastasis.

Our previous studies have demonstrated overexpression of Mcl-1 in cervical cancer tumorigenesis. However, the molecular mechanism of its overexpression remains not elucidated. MiR-320 has been reported to be down-regulated in various types of cancer, and bioinformatics prediction indicated that it may regulate the expression of Mcl-1. The aim of this study is to investigate the role of miR-320 and its target gene Mcl-1 in cervical cancer progression and to assess their clinical significance. miR-320 and Mcl-1 expressions in human cervical cancer tissues were investigated by qRT-PCR, in situ hybridization, and immunohistochemical staining, respectively. The clinicopathological implications of these molecules were analyzed. Bioinformatic prediction and luciferase assays were employed to identify the predicted microRNA (miRNA) which regulates Mcl-1. The apoptosis, proliferation, migration, and invasion assays were performed to investigate the effect of miR-320 on the cervical cancer cells. MiR-320 expression is significantly down-regulated versus Mcl-1 expression is up-regulated in cervical cancer tissues compared with normal controls with a negative correlation between them. Luciferase assay showed that miR-320 negatively regulates Mcl-1 expression. In addition, miR-320 induces apoptosis via down-regulation of Mcl-1 and activation of caspase-3 but inhibits cell proliferation, migration, invasion, and tumorigenesis in cervical cancer cells. Our studies show that miR-320 expression is decreased in cervical cancer, and its expression is negatively correlated with Mcl-1 expression in cervical cancer. In addition, miR-320 inhibits cervical cancer progression by down-regulation of Mcl-1. These results indicate that miR-320 may be an important biomarker and target for diagnosis and treatment of cervical cancer patient.

目的 分析苏南地区育龄妇女微小病毒B19感染的状况,为本区妇幼保健提供基础数据.方法 采用酶联免疫检测法(ELISA)检测2012-2014年苏南地区育龄妇女血清中特异性的IgM抗体.结果 8927例育龄妇女的微小病毒B19 IgM抗体阳性率为13.83％,近三年差异无统计学意义(x2=0.35,P＞0.05);不良妊娠结局组、正常妊娠组和婚检组感染率分别为16.37％、12.59％和13.39％,差异有统计学意义(x2=16.76,P＜0.05);感染组与非感染组不良妊娠结局发生率差异有统计学意义(x2=38.71,P＜0.05).结论 妊娠期HPV B19感染可引起不良妊娠结局.2012-2014年苏南地区育龄妇女感染率并不低,相关的妇幼保健单位应加强微小病毒B19的感染监测,开展全面检查,提高人口素质.