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Cellular and Molecular Atlas of Peripheral Blood Mononuclear Cells from a Pregnant Woman After Recovery from COVID-19

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Maternal-Fetal Medicine 2023年第2期5卷 88-96页

作者： Lili Du Yingyu Liang Xiaoyi Wang Lijun Huang Xingfei Pan Jingsi chen Dunjin Chen Department of Obstetrics and Gynecology Guangdong Provincial Clinical Research Center for Obstetrics and GynecologyGuangdong Engineering and Technology Research Center of Maternal-Fetal MedicineGuangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal MedicineGuangdong Provincial Key Laboratory of Major Obstetric DiseasesThe Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510150China Department of Infectious Diseases Guangdong Provincial Key Laboratory of Major Obstetric DiseasesThe Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510150China.

Objective:This study aimed to investigate the immune response of a pregnant woman who recovered from the coronavirus disease 2019(COVID_(R)S)by using single-cell transcriptomic profiling of peripheral blood mononuclear cells(PBMCs)and to analyze the properties of different immune cell subsets.Methods:PBMCs were collected from the COVID_(R)S patient at 28 weeks of gestation,before a cesarean section.The PBMCs were then analyzed using single-cell RNA sequencing.The transcriptional profiles of myeloid,T,and natural killer(NK)cell subsets were systematically analyzed and compared with those of healthy pregnant controls from a published single-cell RNA sequencing data set.Results:We identified major cell types such as T cells,B cells,NK cells,and myeloid cells in the PBMCs of our COVID_(R)S patient.The increase of myeloid and B cells and decrease of T cells and NK cells in the PBMCs in this patient were quite distinct compared with that in the control subjects.After reclustering and Augur analysis,we found that CD16 monocytes and mucosal-associated invariant T(MAIT)cells were mostly affected within different myeloid,T,and NK cell subtypes in our COVID_(R)S patient.The proportion of CD16 monocytes in the total myeloid population was increased,and the frequency of MAIT cells in the total T and NK cells was significantly decreased in the COVID-RS patient.We also observed significant enrichment of gene sets related to antigen processing and presentation,T-cell activation,T-cell differentiation,and tumor necrosis factor superfamily cytokine production in CD16 monocytes,and enrichment of gene sets related to antigen processing and presentation,response to type II interferon,and response to virus in MAIT cells.Conclusion:Our study provides a single-cell resolution atlas of the immune gene expression patterns in PBMCs from a COVID_(R)S patient.Our findings suggest that CD16-positive monocytes and MAIT cells likely play crucial roles in the maternal immune response against severe acute respiratory syndrome coronavirus 2 infect

关键词： Transcriptome Single-cell analysis Pregnancy Peripheral blood mononuclear cells Recovery COVID-19

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Exploring Experiences with "321" Model Management for High-Risk Pregnancy: A Qualitative Study

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Maternal-Fetal Medicine 2023年第1期5卷 51-53页

作者： Wen Sun Peili Du Lin Yu Xiaoyi Wang Fang He Jingsi chen Chunhong Su Dunjin Chen Department of Obstetrics and Gynecology Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou Medical Centre for Critical Pregnant WomenGuangdong Provincial Key Laboratory of Major Obstetric DiseasesGuangzhou 510150Chin

To editor:In recent years,obstetricians have needed to managemore complex pregnancies involving acute and chronicmedical disorders,and a greater number of pregnancieseach year are now delivered by critical care services.1Datafrom the United States show that poorly controlled maternal medical conditions can have an adverse impact on preg-nancy outcomes.

关键词： Pregnancy high-risk Prenatal care Qualitative research Patient satisfaction

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中国产科重症医学:回顾、思考与展望

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中华围产医学杂志 2023年第11期26卷 910-913页

作者：陈敦金广州医科大学附属第三医院妇产科(广州重症孕产妇救治中心) 广州510150

我国提出至2030年将孕产妇死亡率降至12/10万以下,为实现这一目标,需要促进产科重症医学的发展。本文回顾了我国产科重症医学的发展历史,指出建立重症孕产妇救治中心及产科重症监护病房的必要性与紧迫性,并展望了未来发展,即重视产科危... 详细信息

我国提出至2030年将孕产妇死亡率降至12/10万以下,为实现这一目标,需要促进产科重症医学的发展。本文回顾了我国产科重症医学的发展历史,指出建立重症孕产妇救治中心及产科重症监护病房的必要性与紧迫性,并展望了未来发展,即重视产科危重症患者的个性化救治,并发展产科专科化重症监护病房。

关键词：产科学危重病人医疗危重症护理重症监护病房

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Expert Opinion on Placenta Accreta Spectrum Disorders in China

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Maternal-Fetal Medicine 2021年第4期3卷 235-237页

作者： Jie Yan Dunjin Chen Huixia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China Department of Obstetrics and Gynecology Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510150China

Introduction In March 2018,the International Federation of Gynecology and Obstetrics(FIGO)proposed an inclusive standardized terminology of placenta accreta spectrum(PAS)disorders.1 This grading separates PAS into three categories:placenta adherenta or creta(PC),placenta increta(PI)and placenta percreta(PP).2 The aim of this expert opinion was to share the current knowledge on the diagnosed management of PAS in China.

关键词： China. terminology Expert

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Intra-abdominal aortic balloon occlusion in the management of placenta percreta

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Chinese Medical Journal 2022年第4期135卷 441-446页

作者： Weiran Zheng Ruochong Dou Jie Yan Xinrui Yang Xianlan Zhao Dunjin Chen Yuyan Ma Weishe Zhang Yiling Ding Ling Fan Huixia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing Key Laboratory of Maternal-Fetal Medicine of Gestational Diabetes MellitusXicheng DistrictBeijing 100034China Department of Obstetrics and Gynecology First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Department of Obstetrics and Gynecology Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510260China Department of Obstetrics and Gynecology Qilu Hospital of Shandong UniversityJinanShandong 250012China Department of Obstetrics and Gynecology Xiangya Hospital Central South UniversityChangshaHunan 410008China Department of Obstetrics and Gynecology Second Xiangya Hospital of Central South UniversityChangshaHunan 410008China Department of Obstetrics and Gynecology Beijing Obstetrics and Gynecology HospitalBeijing 100026China

Background:Massive bleeding is the main concern for the management of placenta percreta(PP).Intra-abdominal aortic balloon occlusion(IABO)is one method for pelvic devascularization,but the efficacy of IABO is uncertain.This study aims to investigate the outcomes of IABO in PP patients.Methods:We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015.PP cases with/without the use of IABO were analyzed.Propensity score matching analysis was performed to reduce the effect of selection bias.Postpartum hemorrhage(PPH)and the rate of hysterectomy,as well as neonatal outcomes,were analyzed.Results:One hundred and thirty-two matched pairs of patients were included in the final analysis.Compared with the control group,maternal outcomes,including PPH(68.9%vs.87.9%,χ^(2)=13.984,P<0.001),hysterectomy(8.3%vs.65.2%,χ^(2)=91.672,P<0.001),and repeated surgery(1.5%vs.12.1%,χ^(2)=11.686,P=0.001)were significantly reduced in the IABO group.For neonatal outcomes,Apgar scores at 1 minute(8.67±1.79vs.8.53±1.68,t=-0.638,P=0.947)and 5 minutes(9.43±1.55vs.9.53±1.26,t=0.566,P=0.293)were not significantly different between the two groups.Conclusions:IABO can significantly reduce blood loss,hysterectomies,and repeated surgeries.This procedure has not shown harmful effects on neonatal outcomes.

关键词： Placenta accreta spectrum disorders Placenta percreta Conservative management Intra-abdominal aortic balloon occlusion Propensity score matching

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Maternal high salt-diet increases offspring's blood pressure with dysfunction of NO/PKGI signaling pathway in heart tissue

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Gynecology and Obstetrics Clinical Medicine 2022年第2期2卷 69-75页

作者： Minshan Huang Xiuying Li Luwen Ren Lin Huang Jiahong Pan Jinlin Yao Lili Du Dunjin Chen Jingsi chen Department of Obstetrics and Gynecology The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou510150China Department of Fetal Medicine and Prenatal Diagnosis The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou510150China Obstetrics&Gynecology Institute of Guangzhou Guangzhou510150China Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes Guangzhou510150China Key Laboratories for Major Obstetric Diseases of Guangdong Province Guangzhou510150China Department of Obstetrics The First People's Hospital of FoshanFoshan528000China

Background:High salt-diets have become significant threats to human health,resulting in hypertension and cardiovascular diseases.Hypertensive disorders during pregnancy are complicated,since the maternal cardiovascular system undergoes extensive physiological changes during pregnancy.High-salt diets during pregnancy can disturb the intrauterine environment and negatively affect fetal development.Therefore,we explored how high-salt diets during pregnancy could affect the offspring.Methods:Rats were divided into three groups and fed with low,normal,and high salt diets.The offspring were separated into three groups after weaning based on dietary salt concentration.The blood pressure and urine protein content of both dams and offspring were measured.To evaluate cardiac function,we used Masson staining and immunodetection to confirm the fibrosis status.Finally,we extracted protein from cardiac tissue to test the expression levels of the Nitric Oxide(NO)/cGMP-dependent protein kinase I(PKGI)pathway and the angiotensin receptor.Results:High-salt diets increased blood pressure,and offspring previously exposed to high-salt environments were predisposed to hypertension.High-salt diets were also found to induce cardiac fibrosis and exacerbate fibrosis in offspring and alter the epithelial-mesenchymal transition(EMT).Under these conditions,the NO/PKGI pathway was activated in cardiac tissue and the type-1angiotensin II receptor(AT1R)was upregulated,though the type-2 angiotensin II receptor(AT2R)had the opposite effect.Conclusion:High-salt diets induce high blood pressure and increase predisposition to hypertension in offspring.They are accompanied by cardiac fibrosis,which could be caused by the activation of NO/PKGI and upregulation of AT1R.

关键词： High salt Hypertension Cardiac fibrosis Nitric oxide cGMP-dependent protein kinase I Fetal origins of adult disease

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Highly efficient and precise base editing in discarded human tripronuclear embryos

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Protein & Cell 2017年第10期8卷 776-779页

作者： Guanglei Li Yajing Liu Yanting Zeng Jianan Li Lijie Wang Guang Yang Dunjin Chen Xiaoyun Shang Jia chen Xingxu Huang Jianqiao Liu Department of Reproductive Medicine Third Affiliated Hospital ( Guangzhou Medical University Guangzhou 510150 China School of Life Science and Technology ShanghaiTech University Shanghai 201210 China Institute of Immunology PLA Third Military Medical University Chongqing 400038 China Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes Key Laboratory for Major Obstetric Diseases of Guangdong Province Third Affiliated Hospital of Guangzhou Medical University Guangzhou 510150 China

CRISPR/Cas9 is a powerful tool for genome editing （Komor et al., 2017）. Recently, it has been employed in several attempts to edit the human embryos （Liang et al., 2015; Kang et al., 2016; Tang et al., 2017）.

关键词： GENOME NUCLEASES CLEAVAGE ZYGOTES

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Precautions in delivery of pregnant women infected with COVID-19

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中华妇产科杂志 2020年第2期 73-74页

作者： Qi Hongbo chen dunjin Feng Ling Zou Li Li Jiafu ChinaDepartment of Obstetrics and Gynecology Department of Obstetrics and Gynecology Guangzhou 510150 Huazhong University of Science and Technology Third Affiliated Hospital of Guangzhou Medical University Tongji Hospital Tongji Medical College Union Hospital Wuhan 430022 Wuhan 430030 Wuhan 430071 Zhongnan Hospital of Wuhan University

Once maternal infection of COVID-19 is suspected or confirmed, childbirth becomes complicated and challenging. Precautions in determining the timing of delivery, the indications of caesarean section, preparation of the delivery room to prevent infection during delivering, choosing the type of anesthesia, and newborn management, which are the primary concern of obstetricians, should be taken. COVID-19 infection is not the indication for terminating pregnancy, but the termination of pregnancy should be evaluated case by case. Maternal disease progression, gestational age and fetal intrauterine status are primary concerns. On condition that maternal safety is assured, the timing of delivery should be considered based on gestational age. The selection of delivery method should be based on obstetric indications. Negative pressure isolation ward is proffered for delivery and strict infection protection is required for all medical staff. Most doctors prefer to use epidural anesthesia for pregnant women infected with COVID-19. For confirmed infected mothers, their newborns should be quarantined for at least 14 days.

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Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection

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Maternal-Fetal Medicine 2023年第2期5卷 74-79页

作者： Dunjin Chen Yue Dai Xinghui Liu Hongbo Qi chen Wang Lan Wang Yuan Wei Xiaochao Xu Chuan Zhang Lingli Zhang Yuquan Zhang Ruihua Zhao Yangyu Zhao Borong Zhou Ai-Ling Wang Huixia Yang Li Song Department of Obstetrics and Gynecology The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510150China National Health Commission of the People’s Republic of China Beijing 100044China Department of Obstetrics and Gynecology West China Second University HospitalSichuan UniversityChengdu 610041China Administration Office Chongqing Health Center for Women and ChildrenChongqing 401120China Department of Obstetrics and Gynecology Peking University First HospitalBeijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes MellitusBeijing 100034China Department of Obstetrics and Gynecology Peking University Third HospitalBeijing 100083China Department of Obstetrics and Gynecology Affiliated Hospital of Nantong UniversityNantong 226001China Department of Obstetrics and Gynecology Guang’anmen HospitalChina Academy of Chinese Medical SciencesBeijing 100053China National Center for Women and Children’s Health Chinese Center for Disease Control and PreventionBeijing 100081China.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human’s health.With the passing of time,the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumulates.To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China,the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission.This recommendations includes the epidemiology,diagnosis,management,maternal care,medication treatment,care of birth and newborns,and psychological support associated with maternal SARS-CoV-2 infection.It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.

关键词： COVID-19 Diagnosis SARS-CoV-2 Newborns Pregnancy Recommendation Treatment

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多学科协同,推动我国胎盘植入性疾病规范化诊治体系的建设

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中华产科急救电子杂志 2023年第3期12卷 129-132页

作者：陈敦金广州医科大学附属第三医院妇产科、广州重症孕产妇救治中心、广东省产科重大疾病重点实验室 510150

胎盘植入性疾病(placenta accrete spectrum disorders,PAS)是指胎盘绒毛异常侵入子宫肌层的一组疾病,依据绒毛侵入程度分成粘连性胎盘植入(placenta creta,PC)、植入性胎盘植入(placenta increta,PI)和穿透性胎盘植入(placentapercreta,PP)。PAS发生率为1/350~1/500,近年来呈上升趋势,是导致妊娠期子宫破裂、严重产科出血、子宫切除、脏器损伤,甚至孕产妇死亡的重要原因^([1-2])。

关键词：胎盘植入植入性胎盘孕产妇死亡子宫肌层脏器损伤妊娠期子宫破裂规范化诊治胎盘绒毛

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