Search

Preeclampsia is a severe pregnancy-related disorder, and patients usually present with high circulating inflammatory factor levels and excessive activation of the nuclear factor-κB (NF-κB) pathway. Administration of aspirin (ASP) is effective for preventing preeclampsia, and thus, we propose that ASP might affect placental function by regulating the NF-κB pathway. Systemic lipopolysaccharide (LPS) (20 μg/kg) was used to induce preeclampsia-like pregnant mouse model, and low-dose ASP (15.2 mg/kg) was administrated. Here, we report significantly increased circulatory expression levels of the proinflammatory cytokines tumor necrosis factor-alpha, interleukin-6, and soluble Fms-related tyrosine kinase-1 in LPS-treated pregnant mice, accompanied by kidney and placental dysfunction. Low-dose ASP treatment significantly reversed the preeclampsia-like phenotype, lowering hypertension, decreasing proteinuria, and ameliorating fetal growth retardation. Moreover, the excessive activation of NF-κB signaling in mice placentae induced by LPS was significantly reduced by ASP. In JEG-3 cells, LPS activated the NF-κB signaling pathway by upregulating the expression of cyclooxygenase-2 (COX-2) and related inflammatory factors, whereas the invasion ability of JEG-3 cells was weakened. However, ASP administration impeded NF-κB signaling activation, downregulated COX-2 and inflammatory factor expression, and rescued trophoblast invasion. This study provides new evidence that low-dose ASP is beneficial for preeclampsia prevention by inhibiting NF-κB and its downstream signaling pathways in trophoblast cells.

Background: This study aimed to assess the diagnostic accuracy of a real-time optoelectronic device (TruScreen) for uterine cervical cancer screening., Methods: On the basis of Preferred Reporting Items for Systematic Reviews and Meta-analyses (the PRISMA statement) we performed this systematic review and meta-analysis. We searched PubMed, EMBASE, the Cochrane Library, CNKI, CBM, and WanFang Data using medical subject headings (MeSH) and text words. Title/abstract screening, full text check, data extraction, and methodological quality assessment (with the QUADAS-2 tool) were performed by 2 reviewers independently. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), the summary receiver operator characteristic curve, and the area under the curve (AUC) were analyzed with Meta-DiSc software. Statistical heterogeneity was evaluated by Cochran's Q test and I, meta-regression was conducted based on patient type, and the possibility of publication bias was evaluated using Deeks funnel plot in Stata software., Results: Of 293 publications, nine met our inclusion criteria. These studies included a total of 2730 patients and 567 cervical intraepithelial neoplasias. The pooled test characteristics for the TruScreen were as follows: sensitivity 76% (95% CI, 73-80%), specificity 69% (95% CI, 67%-71%), PLR 2.30 (95% CI, 1.59-3.33), and NLR 0.34 (95% CI, 0.23-0.51). The corresponding pooled DOR was 7.03 (95% CI, 3.40-14.55). The AUC was 0.7859 (Q = 0.7236)., Conclusion: The diagnostic accuracy of the TruScreen device is moderately good. The study findings are based on Chinese studies only and could not be generalized to other populations.

Introduction: Fetal macrosomia has confirmed be related to multiple labor complications and metabolism syndromes later in life. However, the mechanism of fetal macrosomia in normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM) pregnant women is still obscure. This study aimed to investigate the mechanism of Rho guanine nucleotide exchange factor 11 (ARHGEF11) and the insulin signaling pathway in placenta affecting fetal overgrowth in NGT and GDM pregnant women., Methods: Eighty-nine pregnant women with paired antepartum BMI were recruited and divided into four groups: NGT with normal birth weight (NGT-N, n = 30) or macrosomia (NGT-M, n = 22) and GDM with normal birth weight (GDM-N, n = 22) or macrosomia (GDM-M, n = 15). Placenta tissue was collected to examine the expression of ARHGEF11, ROCK1, the phosphorylation of Tyr612 IRS-1 (p-Y612), Ser307 IRS-1 (p-S307), PI3K, AKT, pAKT, GLUT4 and S6K., Results: Gene expression of ARHGEF11, ROCK1, p-S307 and S6K in placenta was significantly increased in the NGT-M group (p < .05). The protein density of ARHGEF11 and ROCK1 was positively correlated with birth weight (p < .001) in the NGT groups. p-Y612, PI3K, pAKT and GLUT4 were significantly decreased in NGT-M, GDM-N and GDM-M group (p < .05). But there was no statistical difference between the two GDM groups., Discussion: ARHGRF11 inhibited the insulin signaling pathway in placenta may participated in fetal macrosomia in NGT pregnant women. The insulin signaling pathway was suppressed in GDM placenta, but was not closely related to fetal macrosomia, indicated different mechanism in fetal overgrowth in NGT and GDM pregnant women., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: Fatty acid-binding protein 4 (FABP4) has been proposed to be a potential predictive factor of gestational hypertension or preeclampsia (GH/PE) because of its integrating metabolic and inflammatory responses. Women with gestational diabetes mellitus (GDM) are more likely to develop both GH/PE, than the normal population. The aim of our study was to examine the relationship between plasma FABP4 in the second trimester of pregnancy and the risk of GH/PE in women with GDM., Methods: This was a nested case-control study conducted within a large on-going prospective cohort study conducted at Peking University First Hospital. A total of 1344 women, who were diagnosed with GDM, according to a 75 g oral glucose tolerance test, participated in the GDM One-Day Clinic at Peking University First Hospital from February 24, 2016 to February 9, 2017. Of the 748 GDM women who agreed to the blood sample collection, 637 were followed until their delivery. The cases included GDM patients who developed gestational hypertension or preeclampsia (GDM-GH/PE group, n = 41). Another 41 matched GDM women without major complications were selected as the control group (GDM group)., Results: The incidence of GH/PE was 6.44% and 3.30% for preeclampsia. The level of the second trimester plasma FABP4 in the GDM-GH/PE group was significantly higher than the GDM group (17.53±11.35 vs. 12.79±6.04 ng/ml, P = 0.020). The AUC ROC for the second trimester plasma FABP4 predicted GH/PE in the GDM patients alone was 0.647 (95%CI 0.529-0.766). Multivariate analysis showed that the elevated second trimester FABP4 level was independently associated with GH/PE in the GDM patients (OR 1.136 [95% CI 1.003-1.286], P = 0.045)., Conclusions: Increased second trimester plasma FABP4 independently predicted GH/PE in GDM patients.

Lipases are the most widely employed enzymes in commercial industries. The catalytic mechanism of most lipases involves a step called "interfacial activation". As interfacial activation can lead to a significant increase in catalytic activity, it is of profound importance in developing lipase immobilization methods. To obtain a potential biocatalyst for industrial biodiesel production, an effective strategy for enhancement of catalytic activity and stability of immobilized lipase was developed. This was performed through the combination of interfacial activation with hybrid magnetic cross-linked lipase aggregates. This biocatalyst was investigated for the immobilization of lipase from Rhizomucor miehei (RML). Under the optimal conditions, the activity recovery of the surfactant-activated magnetic RML cross-linked enzyme aggregates (CLEAs) was as high as 2058%, with a 20-fold improvement over the free RML. Moreover, the immobilized RML showed excellent catalytic performance for the biodiesel reaction at a yield of 93%, and more importantly, could be easily separated from the reaction mixture by simple magnetic decantation, and retained more than 84% of its initial activities after five instances of reuse. This study provides a new and versatile approach for designing and fabricating immobilized lipase with high activation and stability., Competing Interests: The authors declare no conflict of interest.

Although progress has been made in determining the structure and understanding the function of photosystem I (PSI), the PSI assembly process remains poorly understood. PsaC is an essential subunit of PSI and participates in the transfer of electrons to ferredoxin. However, how PsaC is assembled during accumulation of the PSI complex is unknown. In the present study, we showed that Pyg7 localized to the stromal thylakoid and associated with the PSI complex. We also showed that Pyg7 interacted with PsaC. Furthermore, we found that the PSI assembly process was blocked following formation of the PsaAB heterodimer in the pyg7 mutant. In addition, the analyses of PSI stability in Pyg7RNAi plants showed that Pyg7 is involved in maintaining the assembled PSI complex under excess-light conditions. Moreover, we demonstrated that decreased Pyg7 content resulted in decreased efficiency of PSI assembly in Pyg7RNAi plants. These findings suggest that the role of Pyg7 in PSI biogenesis has evolved as an essential assembly factor by interacting with PsaC in Arabidopsis, in addition to being a stability factor for PSI as seen in Synechocystis., (© 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.)

Prevention of obesity in women of reproductive age is widely recognised to be important both for their health and for that of their offspring. Weight-control interventions, including drug treatment, in pregnant women who are obese or overweight have not had sufficient impact on pregnancy and birth outcomes, which suggests that the focus for intervention should include preconception or post-partum periods. Further research is needed into the long-term effects of nutritional and lifestyle interventions before conception. To improve preconception health, an integrated approach, including pregnancy prevention, planning, and preparation is needed, involving more than the primary health-care sector and adopting an ecological approach to risk reduction that addresses personal, societal, and cultural influences. Raising awareness of the importance of good health in the period before pregnancy will require a new social movement: combining bottom-up mobilisation of individuals and communities with a top-down approach from policy initiatives. Interventions to reduce or prevent obesity before conception and during pregnancy could contribute substantially to achievement of the global Sustainable Development Goals, in terms of health, wellbeing, productivity, and equity in current and future generations., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: To establish the gestational age-specific reference ranges for thyroid-related indicators of pregnant women in our hospital, especially for serum thyroid stimulating hormone (TSH) in the first trimester., Methods: A total of 548 pregnant women in the first trimester were collected in Peking University First Hospital from June 2013 to April 2014. Among them, 254 pregnant women with single fetus who conformed to the National Academy of Clinical Biochemistry criteria, without adverse pregnancy outcomes and obstetric complications, were enrolled in the current study. To establish their own self-sequential longitudinal reference intervals, serum TSH, total thyroxine (TT4) and free thyroxine (FT4) levels were measured using Siemens detection kits during three different trimesters. Urine iodine (UI) was measured using digestion instrument in some of the pregnant women., Results: The gestational age-specific reference ranges for thyroid-related indicators of pregnant women in our hospital were as follows: in the first trimester: TSH 0.23-4.08 mU/L, TT4 92.59-186.25 nmol/L, FT4 13.36-20.81 pmol/L; in the second trimester: TSH 0.78-4.25 mU/L, TT4 103.20-180.95 nmol/L, FT4 11.57-16.62 pmol/L; in the third trimester: TSH 0.65-4.52 mU/L, TT4 78.20-174.70 nmol/L, FT4 10.01-20.57 pmol/L. The median level of TSH during 7 to 12 weeks of gestational age was lower than that of 4 to 6 weeks, but with no significant statistical difference (P=0.063). The medians of UI during three trimesters of pregnancy were 211.60 μg/L, 195.55 μg/L and 198.65 μg/L, respectively, which were all classified as adequate iodine status., Conclusions: The gestational age-specific reference ranges for thyroid-related indicators are different from the kits' reference ranges, which are also different among the three trimesters. It may be more reasonable to establish different reference ranges for thyroid-related indicators at 4 to 6 weeks and 7 to 12 weeks in the first trimester separately.

Objective: To investigate the values and characteristics of 75 g oral glucose tolerance test (OGTT) in women with different pre-pregnancy body mass index (BMI) and to evaluate the risk of gestational diabetes mellitus (GDM)., Methods: Medical records of 9803 pregnant women attending the Peking University First Hospital and delivered between July 1, 2011 and December 31, 2013 were retrospectively analyzed. The frequency of adverse pregnancy outcomes across different degrees pre-pregnancy BMI was calculated. We divided participants into 4 groups based on pre-pregnancy BMI, underweight: BMI<18.5 kg/m(2) (1221 cases), normal weight: 18.5-23.9 kg/m(2) (6594 cases), overweight: 24-27.9 kg/m(2) (1549 cases), obesity: ≥28.0 kg/m(2) (439 cases). The diagnosis of GDM was made when any one of the values was met or exceeded in 75 g OGTT. The characteristics of 75 g OGTT and the incidence of GDM were analyzed., Results: (1) The average age, pre-pregnancy weight, height and pre-pregnancy BMI of the participants was (30.5±3.7) years, (57.7±9.0) kg, (162.8±4.9) cm and (21.8±3.2) kg/m(2), respectively. All the values of 75 g OGTT were presented normal distribution. (2) There was statistical difference in the glucose levels among women with different pre-pregnancy BMI. The fasting, 1-hour, 2-hour glucose were (4.55±0.34), (7.31±1.54), (6.38±1.23) mmol/L in underweight women, (4.65±0.38), (7.70±1.59), (6.70±1.27) mmol/L in normal weight women, (4.82±0.47), (8.29±1.67), (7.04±1.29) mmol/L in overweight women and (4.94±0.48), (8.56±1.64), (7.10±1.35) mmol/L in obesity women (P<0.01). (3) The incidence of GDM was 21.76% (2133/9803) in our study. There were 1374 cases (64.42%, 1374/2133) with only one abnormal OGTT value while 759 cases (35.58%, 759/2133) with two or more abnormal values. The incidence of GDM in women with underweight, normal weight, overweight and obesity was 12.53% (153/1221), 19.71% (1300/6594), 32.73% (507/1549) and 39.41% (173/439), respectively (P<0.05). Meanwhile, the incidence of women with two and more abnormal OGTT value in GDM was increased as the pre-pregnancy increasing., Conclusion: The risk of GDM is increased as pre-pregnancy BMI increasing, and the risk of GDM increases significantly in women with pre-pregnancy overweight or obesity.

Objective: To investigate whether area under the curve (AUC) of oral glucose tolerance test (OGTT) could work as a predictor of outcomes of gestational diabetes mellitus (GDM) on condition that blood glucose is controlled., Methods: A total of 1 796 women who had a standard antenatal care in Peking University First Hospital and gave single live births from July 1, 2011 to December 31, 2 013 were included. They should be diagnosed of GDM by the diagnosis criteria of gestational diabetes published by the Ministry of Health of PRC and diabetes pre-pregnancy excluded. Data were analyzed with SPSS 17.0, grouping by AUC., Results: (1) Women with higher AUC had a rising trend of age and a downward trend of gestational weight gain, however, not statistically significant [specifically, in the four group of less than 15.00 mmol · L⁻¹ · h⁻¹, 15.00 to 16.79 mmol · L⁻¹ · h⁻¹, 16.80 to 17.99 mmol · L⁻¹ · h⁻¹ and 18.00 mmol · L⁻¹ · h⁻¹ or more, gestational weight gain was (15.3 ± 5.2), (14.1 ± 4.8), (13.5 ± 4.7) and (13.1 ± 4.8) kg]. The prevalence of macrosomia raised while AUC increased. Those with an AUC of lower than 15.00 (mmol · L⁻¹ · h⁻¹) had a lower risk of macrosomia (P = 0.04). But those with an AUC of 18.00 (mmol · L⁻¹ · h⁻¹) or more had a higher risk of macrosomia (P = 0.02). There was a rising trend in premature birth and preeclampsia with AUC increasing but not significant (the prevalence of premature birth was 4.38%, 5.36%, 7.71% and 7.94% while that of preeclampsia was 2.85%, 4.69%, 4.67% and 5.08% in these four groups). (2) The prevalence of macrosomia was 12.76% (54/423) when overweight pre-pregnancy, significantly higher compared with 5.87% (65/1 107) in normal group. The prevalence of preeclampsia was 5.91% (25/423) and 3.34% (37/1 107) in those two groups, which was also significantly different. The obese group had a statistically highest prevalence of preeclampsia of 9.23% (12/130). (3) AUC (P < 0.05, OR = 1.113, 95% CI: 1.008-1.218), as well as gestational weight gain (P < 0.05, OR = 1.520, 95% CI: 1.279-1.806) and pre-pregnancy BMI (P < 0.05, OR = 1.183, 95% CI: 1.125-1.243) made a difference in the prevalence of macrosomia. Meanwhile, pre-pregnancy BMI made sense in the prevalence of premature labor (P < 0.05, OR = 1.059, 95% CI: 1.003-1.119) and preeclampsia (P < 0.01, OR = 1.202, 95% CI: 1.123-1.286)., Conclusions: AUC, as well as pre-pregnancy BMI and gestational weight gain have a significant impact on outcomes of GDM, macrosomia especially, though blood glucose is controlled. Meanwhile, AUC might be considered as a predictor of macrosomia.

Objective: To evaluate the application of non-invasive prenatal testing (NIPT) in high-risk pregnancies before invasive prenatal diagnosis., Methods: This prospective study involved all pregnancies participating in the clinical trial of NIPT validation. The indication, age and gestational week were recorded. And the results of karyotype and NIPT risk were compared., Results: A total of 2 439 high-risk pregnancies were enrolled from 18 prenatal diagnosis clinics in China. After excluding 48 cases (36 missing clinical information, 9 karyotype failures and 3 NIPT failures), 2 391 cases were analyzed. Their gestational ages were 10 to 31 weeks. And 56.3% (1 345/2 691) were at a high risk for mid-trimester screening, following by advanced maternal age (26.0%, 621/2 391). Forty-six aneuploidies (trisomy 21, n = 38; trisomy 18, n = 7; trisomy 13, n = 1) were diagnosed by karyotyping. And it was consistent with the NIPT results of high-risk distribution., Conclusion: NIPT may be used to reduce unnecessary invasive prenatal diagnosis by improving the efficacy of current mid-trimester screening strategy, particularly for trisomy 21.

Objective: To investigate the varaiation of the incidence of macrosomia and its influencing factors., Methods: A population-based study of 25 944 pregnant women, who delivered in Peking University First Hospital in term birth, with singleton, between Jan. 1, 2006 and Dec. 31, 2013 and accepted the gestational diabetes mellitus (GDM) screening and diagnosis, was performed. The women are grouped according to the different clinical interventions at different period. Women delivered between Jan.1, 2006 and Dec. 31, 2006 was defined as Group 2006, and they were diagnosed with glucose metabolism disorder [gestational impaired glucose tolerance (GIGT) and GDM] and intervened only when meeting National diabetes data group (NDDG) criteria. Women delivered between Jan. 1, 2007 and Apr. 30, 2011 were defined as Group post 2007, and NDDG criteria was also applied in this period. Women delivered between May. 1, 2011 and Dec. 31, 2013 were defined as Group post 2011, and Ministry of Health (MOH) of China was used for GDM diagnosis in this group. All pregnant women in Group post 2007 accepted the preliminary pregnancy nutrition advice and weight management. All participants met MOH criteria were diagnosed as glucose metabolism disorder in this study, in which women diagnosed and intervened in pregnancy were defined as Group diagnosis and those not being identified during pregnancy were defined as Group missed diagnosis. It was analyzed retrospectively for the incidence of macrosomia and the influencing factor., Results: (1) The prevalence of macrosomia and cesarean section was decreased every year from Jan. 2006 to Dec. 2013. The incidence of macrosomia was 9.14% in 2006, reduced to 8.02% in 2007-2011 and 6.79% in 2011-2013. The incidence of cesarean section was 55.22%, reduced to 51.04% in 2007-2011 and 44.15% in 2011-2013. However, there was not remarkable change in the prevalence of small for gestational age (P > 0.05). (2) Compared with Group 2006, the incidence of cesarean section was lower in Group post 2007 [51.04% (6 504/12 744) vs 55.22% (1 371/2 483)], and the difference is significantly (P < 0.05). Meanwhile, the incidence of cesarean section (44.15%, 4 732/10 717) and macrosomia (6.79%,728/10 717) in Group post 2011 was lower significantly than Group 2006 and Group post 2007 (P < 0.05). (3) The incidence of macrosomia was 7.41% (1 129/15 227) and 6.61% (1 006/15 227) respectively in Group diagnosis and Group missed diagnosis before May 2011, combined 14.02% (2 135/15 227) in total. It was increased significantly in the incidence of GDM 21.41% (2 294/10 717) after May 2011 compared with that before (P < 0.05). The incidence of macrosomia was decreased significantly using MOH criteria in GDM women since 2011. It was the downtrend in the incidence of macrosomia since 2007 in non GDM women. However, there was no difference in SGA in different period. (4) In glucose metabolism disorder women, compared with Group 2006 and Group post 2007, the incidence of macrosomia and cesarean section was lower in Group post 2011, and the difference is significantly (P < 0.05). However, there was no significant difference in the incidence of macrosomia and cesarean section between Group 2006 and Group post 2007, and there was no difference in SGA in the 3 groups ( P > 0.05). In non GDM women, the incidence of macrosomia and cesarean section was lower in Group post 2011 than Group 2006 (P < 0.05); meanwhile, it was the downtrend in the incidence of macrosomia in Group post 2007 compared to Group 2006, and the difference of the incidence of cesarean section was significant (P < 0.05)., Conclusion: The prevalence of macrosomia and cesarean section might be reduced by application of suitable criteria for diagnosis of GDM and education on nutrition during pregnancy.

Objective: To compare the clinical use of continuous glucose monitoring system (CGMS) and self-monitoring blood glucose (SMBG) when monitoring blood glucose level of patients with gestational diabetes mellitus (GDM) or type 2 diabetes mellitus (DM) complicated with pregnancy., Methods: A total of 99 patients with GDM (n = 70) and type 2 DM complicated with pregnancy (n = 29) that whether hospitalized or in clinical of Peking University First Hospital were recruited from Aug 2012 to Apr 2013. The CGMS was used to monitor their blood glucose level during the 72-hour time period, while the SMBG was also taken seven times daily. The correlation between these blood glucose levels and their glycosylated hemoglobin (HbA1c) levels were analyzed by comparing the average value, the maximum and the minimum value of blood glucose, and the appeared time of these extremum values in these two monitoring methods, and the amount of insulin usage was recorded as well., Results: (1) The maximum, minimum and the average blood glucose value in the GDM group were (8.7 ± 1.2), (4.5 ± 0.6)and (6.3 ± 0.6)mmol/L of SMBG vs. (10.1 ± 1.7), (3.1 ± 0.7), (6.0 ± 0.6) mmol/L of CGMS. These values in DM group were(10.1 ± 2.2), (4.5 ± 1.0), (6.9 ± 1.1)mmol/L of SMBG vs.(12.2 ± 2.6), (2.8 ± 0.8), (6.6 ± 1.1) mmol/L of CGMS. By using the two methods, the maximum and the average value of the two groups showed significant differences (P < 0.01) while the minimum value showed no significant differences (P > 0.05). (2) In the GDM group, the average blood glucose values of CGMS and SMBG were significantly correlated (r = 0.864, P < 0.01). The maximum values presented the same result (r = 0.734, P < 0.01). Correlation was not found in the minimum values of CGMS and SMBG (r = 0.138, P > 0.05). In the DM group, the average valves of two methods were significantly correlated (r = 0.962, P < 0.01), the maximum values showed the same result (r = 0.831, P < 0.01).It can also be observed in the minimum values (r = 0.460, P < 0.05). (3) There was significant correlation between the average value of CGMS and HbA1c level (r = 0.400, P < 0.01), and the average value of SMBG and HbA1c level were correlated (r = 0.031, P < 0.05) in the GDM group; the average values of CGMS (r = 0.695, P < 0.01) and SMBG (r = 0.673, P < 0.01) were both significantly correlated with the HbA1c level in the DM group. (4) In the GDM group, 37% (26/70) of the minimum values of SMBG appeared 30 minutes before breakfast, while 34% (24/70) of them appeared 30 minutes before lunch; 86% (60/70) of the maximum values of SMBG were evenly distributed 2 hours after each of the three meals. In the DM group, 41% (12/29) of the minimum values of SMBG presented 30 minutes before lunch, while 21% (6/29) and 14% (4/29) of them were showed 30 minutes before breakfast and dinner respectively; about 30% of the maximum values of SMBG appeared 2 hours after each of the three meals. (5) In the GDM group, 23% (16/70) of the minimum values of CGMS occurred between 0:00-2:59 am., and most of the other minimum values of CGMS were evenly distributed in the rest of the day, except for 3% (2/70) of them were found during 18:00- 20:59 pm. 43% (30/70) of the maximum values of CGMS appeared during 6:00-8:59 am., only 1% (1/70) and 3% (2/70) of them presented during 0:00-2:59 am. and 21:00-23:59 pm., and the rest were evenly distributed for the other times of the day. In the DM group, 34% (10/29) of the minimum values of CGMS were found during 0:00-2:59 am., 14% (4/29) of them appeared during 9:00-11:59 am. and 15:00-17:59 pm., 45% (13/29) of the maximum values of the CGMS presented during 6:00-8:59 am., none was found during 21:00-23:59 pm.,0:00-2:59 am. and 3:00-5:59 am., and the rest were evenly distributed for the other times of the day. (6) 64% (45/70) of the patients in the GDM group did not require for insulin treatment, while 36% (25/70) of them did. For those patients who received insulin treatment, after CGMS, 64% (16/25) of them adjusted the insulin dosage according to their blood glucose levels. In the DM group, 14% (4/29) of them did not receive insulin treatment, while for the others who did (86%, 25/29); 60% (15/25) of them adjusted the insulin dosage according to their blood glucose levels after CGMS., Conclusions: Both CGMS and SMBG could correctly reflect patients' blood glucose levels. It was more difficult to control the blood glucose levels in patients with type 2 DM complicated with pregnancy than the GDM patients. Compared with SMBG, CGMS could detect postprandial hyperglycemia and nocturnal hypoglycemia more effectively.

Background: Gestational diabetes mellitus (GDM) is a common complication during pregnancy, and gestational weight gain is one of the major and modifiable risk factors. This study aims to estimate the relationship between the rate of gestational weight gain before diagnosis of GDM and the subsequent risk of GDM., Methods: A case-control study was conducted with 90 GDM cases and 165 women in the control group from May 2012 to August 2012 at Peking University First Affiliated Hospital. GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011. The plasma glucose levels, weights, and covariate data of the women were obtained based on medical records. Univariate analysis and unconditional Logistic regression model were used to estimate the associations., Results: After adjusting for age at delivery, parity, and pre-pregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lower rate of gestational weight gain (less than 0.28 kg per week), a rate of weight gain of 0.28 kg per week or more was associated with increased risk of GDM (odds ratio: 2.03; 95% confidence interval: 1.15 to 3.59). The association between the rate of gestational weight gain and GDM was primarily attributed to the increased weight gain in the first trimester., Conclusion: High rates of gestational weight gain, particular during early pregnancy, may increase a woman's risk of GDM.

Background: The International Association of Diabetes and Pregnancy Study Group (IADPSG) recommended new diagnostic criteria for gestational diabetes mellitus (GDM) after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China., Methods: A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group (NDDG) or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed., Results: According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% (P < 0.01) respectively, and the prevalence of cesarean section (52.5% vs. 46.0%, P < 0.01), macrosomia (7.5% vs. 6.3%, P < 0.05), neonatal hypoglycemia (1.6% vs. 1.0%, P < 0.01), and perinatal death (0.5% vs. 0.2%, P < 0.01); the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section (62.3%) and macrosomia (14.8%) was the highest in untreated mild GDM patients., Conclusions: Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.

Objectives: To investigate the incidence and risk factors for pre-eclampsia in pregnant Chinese women with abnormal glucose metabolism., Methods: A retrospective cohort study was performed on 1499 pregnant women with abnormal glucose metabolism at Peking University First Hospital from January 1995 to December 2004., Results: The overall prevalence of pre-eclampsia in women with abnormal glucose metabolism was 9.4% (141/1499). The prevalence of pre-eclampsia in women diagnosed with diabetes mellitus prior to pregnancy was higher than that of gestational diabetes mellitus and gestational impaired glucose tolerance patients (29.1% vs 8.7% and 7.8%, P<0.01). Pre-pregnancy body mass index was significantly higher in women with pre-eclampsia than in those without. A higher rate of pre-eclampsia was found in women with chronic hypertension and those with poor glucose control. The independent risk factors for pre-eclampsia were chronic hypertension and elevated pre-pregnancy body mass index., Conclusions: The type of diabetes, chronic hypertension, and elevated pre-pregnancy body mass index are high risk factors for pre-eclampsia in pregnant women with abnormal glucose metabolism.

Background: The mucosal lymphocyte population is the largest in the body, and the gastrointestinal compartment has been well characterized in HIV infection. Much less is known about the effects of HIV on the genital tract., Objective: : To examine the T-lymphocyte phenotype and receptor repertoire as well as total and virus-specific immunoglobulin concentrations in the endocervix of HIV-infected women at different stages of infection as compared with uninfected women., Patients and Methods: Participants were 12 seronegative women, 10 HIV-infected "slow progressors" not taking antiretroviral therapy, and 9 HIV-infected women whose antiretroviral therapy was failing. We used multiparameter flow cytometry to enumerate T-cell populations on cytobrush-obtained cervical specimens, the immunoscope technique to determine the T-cell receptor (TCR) repertoire, and quantitative enzyme-linked immunosorbent assays for antibody determinations on cervical secretions absorbed onto ophthalmic sponges. Nonparametric statistical analyses were performed., Results: We found marked depletion of leukocytes and CD4 T lymphocytes in the endocervix of HIV-infected women as compared with uninfected women; this was significant at more advanced disease stages. Naive T cells were rare in the endocervix of all groups. Activation marker expression was higher in endocervical T lymphocytes than in peripheral blood among control and slow-progressing HIV-infected women but not in women failing therapy. Endocervical T lymphocytes showed highly restricted utilization of Vbeta TCR families. Unlike other mucosal sites, the cervix contained IgG as the predominant immunoglobulin isotype. HIV-IgG was detected in the cervix of most HIV-infected women and in blood of all infected women., Conclusions: HIV infection induces substantial changes in the immune profile of the female genital tract. Further study of the implications of these findings for HIV acquisition and transmission is needed.