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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 Department of Obstetrics and Gynecology Third Affiliated Hospital of Guangzhou Medical University Guangzhou 510150 China Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 Union Hospital Wuhan 430022 Zhongnan Hospital of Wuhan University Wuhan 430071

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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未足月胎膜早破的管理:争议与挑战

中华围产医学杂志 2023年第10期26卷 797-802页

作者：漆洪波重庆医科大学附属妇女儿童医院妇产科重庆401147

未足月胎膜早破(preterm premature rupture of membranes,PPROM)因发病率不低,且与早产、母儿感染、新生儿呼吸疾病等并发症有关,一直是产科临床研究的热点问题。虽然近年来PPROM管理在不断更新和完善,但一些争议和挑战仍然存在。如PP... 详细信息

未足月胎膜早破(preterm premature rupture of membranes,PPROM)因发病率不低,且与早产、母儿感染、新生儿呼吸疾病等并发症有关,一直是产科临床研究的热点问题。虽然近年来PPROM管理在不断更新和完善,但一些争议和挑战仍然存在。如PPROM诊断后,是否需要卧床休息?是终止妊娠还是期待治疗?如何使用各种治疗药物才能起到最佳的治疗效果?本文将根据近年来的最新证据对目前存在的争议与挑战进行详细阐述。

关键词：胎膜早破妊娠中期临床方案

The metabolic role of LncZBTB39-1:2 in the trophoblast mobility of preeclampsia

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Genes & Diseases 2018年第3期5卷 235-244页

作者： Yamin Liu Ting-Li Han Xiaofang Luo Yuxiang Bai Xuehai Chen Wei Peng Xi Xiong Philip N.Baker Chao Tong hongbo qi Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine Chongqing Medical UniversityChongqing400016China Department of Obstetrics and Gynaecology The First Affiliated Hospital of Chongqing Medical UniversityChina Liggins Institute The University of AucklandAucklandNew Zealand College of Medicine Biological Sciences and PsychologyUniversity of LeicesterUK

Preeclampsia is characterized by new onset of hypertension and proteinuria after 20 weeks’gestation and is a leading cause of maternal and neonatal morbidity and *** pathogenesis of preeclampsia is often associated with aberrant trophoblast function that leads to shallow placental ***,the exact underlying mechanisms remain *** LncZBTB39-1:2 expression level was investigated in 20 healthy placentae and 20 placentae with preeclampsia using qRT-PCR,and the metabolic profile of trophoblasts overexpressing LncZBTB39-1:2 in vitro was analysed using gas chromatography-mass spectrometry(GCeMS).In this study,we found that the expression of LncZBTB39-1:2 was significantly higher in preeclamptic placentae than in healthy *** metabolomics results have shown that tricarboxylic acid cycle intermediates and metabolites related to carbohydrate metabolism were decreased with the overexpression of LncZBTB39-1:2 in HTR8/SVneo *** findings were validated by detecting a lower level of intracellular ATP in HTR8/Vneo ***,the migration of HTR8/SVneo cells was compromised when cells were transfected with a plasmid encompassing LncZBTB39-1:2 *** these results,we conclude that abnormal levels of LncZBTB39-1:2 expression might lead to aberrant conditions in HTR-8/SVneo trophoblast *** conditions might be associated with dysregulated trophoblast migration and subsequent failure of uterine spiral artery remodelling,a pathogenesis recognised as a contributing factor in the aetiology of preeclampsia.

关键词： Complications GCeMS Long noncoding RNA Metabolomics Preeclampsia

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全球胎儿生长受限指南:求同存异

中华围产医学杂志 2024年第9期27卷 710-721页

作者：王昊漆洪波重庆医科大学附属妇女儿童医院、重庆市妇幼保健院产科重庆401147

由于诊断标准不一致,“胎儿生长受限(fetal growth restriction,FGR)”常与“小于胎龄儿(small for gestational age,SGA)”混用。但SGA新生儿通常仅表现为体形偏小,而FGR胎儿发生近、远期并发症的风险则相对较高。近年来超声技术、多... 详细信息

由于诊断标准不一致,“胎儿生长受限(fetal growth restriction,FGR)”常与“小于胎龄儿(small for gestational age,SGA)”混用。但SGA新生儿通常仅表现为体形偏小,而FGR胎儿发生近、远期并发症的风险则相对较高。近年来超声技术、多组学联用和人工智能等领域的发展有助于揭示FGR的诊断及病因机制,但FGR仍面临检出率低、诊断标准不统一和防治手段欠缺等挑战。本文对比各主要学术组织对FGR的定义、风险分级、早期筛查与诊断、遗传咨询和产前诊断、产前监测、终止妊娠及预防等方面的观点,并进行适度评价,以有助于推进现有的诊断与孕期管理,并有望为未来的研究提供方向,实现对FGR的早期识别和精准诊断。

关键词：胎儿生长受限诊疗指南产前诊断胎儿发育

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未足月胎膜早破时宫缩抑制剂的应用

中国实用妇科与产科杂志 2006年第6期22卷 413-415页

作者：漆洪波重庆医科大学附属第一医院妇产科重庆400016

由于未足月胎膜早破（PPROM）发生后早产常不可避免，通常要考虑使用宫缩抑制剂来适当延长孕周，同时给予糖皮质激素治疗，以提高新生儿成活率，减少新生儿病率。因此，宫缩抑制剂、糖皮质激素以及抗生素的应用是处理未足月胎膜早破的3... 详细信息

由于未足月胎膜早破（PPROM）发生后早产常不可避免，通常要考虑使用宫缩抑制剂来适当延长孕周，同时给予糖皮质激素治疗，以提高新生儿成活率，减少新生儿病率。因此，宫缩抑制剂、糖皮质激素以及抗生素的应用是处理未足月胎膜早破的3大措施。

关键词：未足月胎膜早破宫缩抑制剂糖皮质激素治疗抗生素的应用新生儿成活率

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胎儿生长受限:进步与困顿的交织

中华围产医学杂志 2023年第11期26卷 893-897页

作者：漆洪波王昊重庆医科大学附属妇女儿童医院(重庆市妇幼保健院)产科重庆400013

胎儿生长受限(fetal growth restriction,FGR)是围产儿死亡的第二大风险因素,且可导致新生儿期及远期多种并发症,然而目前对FGR的认识充满了困惑与挑战。本文从FGR概念的形成和演变入手,阐述了FGR病因机制、动物模型、预防与干预、早期... 详细信息

胎儿生长受限(fetal growth restriction,FGR)是围产儿死亡的第二大风险因素,且可导致新生儿期及远期多种并发症,然而目前对FGR的认识充满了困惑与挑战。本文从FGR概念的形成和演变入手,阐述了FGR病因机制、动物模型、预防与干预、早期筛查和诊断的研究现状及进展,以及目前对FGR研究的困惑与思考。

关键词：胎儿生长迟缓早期诊断早期医疗干预

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二甲双胍在妊娠期的应用及思考

中华围产医学杂志 2024年第1期27卷 13-18页

作者：廖玖江漆洪波重庆医科大学附属妇女儿童医院妇产科重庆401147

二甲双胍降低血糖的同时增加胰岛素敏感性, 现已成为2型糖尿病一线口服用药。虽然二甲双胍能自由穿过胎盘导致胎儿药物暴露, 但是长期的临床使用中并未观察到明显的不良后果, 现已应用于妊娠合并肥胖、多囊卵巢综合征、2型糖尿病以及妊... 详细信息

二甲双胍降低血糖的同时增加胰岛素敏感性, 现已成为2型糖尿病一线口服用药。虽然二甲双胍能自由穿过胎盘导致胎儿药物暴露, 但是长期的临床使用中并未观察到明显的不良后果, 现已应用于妊娠合并肥胖、多囊卵巢综合征、2型糖尿病以及妊娠期糖尿病患者。本文就现有的研究证据进行总结:妊娠期使用二甲双胍可帮助控制血糖及孕期增重, 不显著增加母胎近期风险, 但通常需要联合使用胰岛素以实现血糖控制, 并且二甲双胍妊娠期暴露对后代长期健康的影响存在一定争议, 还需更长时间的随访研究以提供更多的临床证据。因此, 妊娠期使用二甲双胍需谨慎控制其适应证, 不推荐将二甲双胍作为妊娠期血糖控制的一线用药, 胰岛素抵抗严重患者可考虑作为辅助用药, 对于胰岛素获取困难的资源匮乏地区可考虑限制性使用。

关键词：二甲双胍妊娠结局远期影响合理应用

Predicting the Risk of Preterm Birth Throughout Pregnancy Based on a Novel Transcriptomic Signature

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Maternal-Fetal Medicine 2023年第4期5卷 213-222页

作者： Yuxin Ran Dongni Huang Nanlin Yin Yanqing Wen Yan Jiang Yamin Liu hongbo qi Women and Children's Hospital of Chongqing Medical University(Chongqing Health Center for Women and Children) Chongqing 401120China Chongqing Key Laboratory of Maternal and Fetal Medicine Chongqing Medical UniversityChongqing 401120China Center for Reproductive Medicine The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

Objective::This study focused on the prediction of preterm birth(PTB).It aimed to identify the transcriptomic signature essential for the occurrence of PTB and evaluate its predictive value in early,mid,and late pregnancy and in women with threatened preterm labor(TPTL).Methods::Blood transcriptome data of pregnant women were obtained from the Gene Expression Omnibus *** activity of biological signatures was assessed using gene set enrichment analysis and single-sample gene set enrichment *** correlation among molecules in the interleukin 6(IL6)signature and between IL6 signaling activity and the gestational week of delivery and latent period were evaluated by Pearson correlation *** effects of molecules associated with the IL6 signature were fitted using logistic regression analysis;the predictive value of both the IL6 signature and IL6 alone were evaluated using receiver operating characteristic curves and pregnancy maintenance probability was assessed using Kaplan-Meier *** analysis was performed using the DEseq2 and limma ***::Circulatory IL6 signaling activity increased significantly in cases with preterm labor than in those with term pregnancies(normalized enrichment score(NES)=1.857,P=0.001).The IL6 signature(on which IL6 signaling is based)was subsequently considered as the candidate biomarker for *** area under the curve(AUC)values for PTB prediction(using the IL6 signature)in early,mid,and late pregnancy were 0.810,0.695,and 0.779,respectively;these values were considerably higher than those for IL6 *** addition,the pregnancy curves of women with abnormal IL6 signature differed significantly from those with normal *** pregnant women who eventually had preterm deliveries,circulatory IL6 signaling activity was lower in early pregnancy(NES=-1.420,P=0.031)and higher than normal in mid(NES=1.671,P=0.002)and late pregnancy(NES=2.350,P<0.001).In women with TPTL,the AUC values for PTB pr

关键词： Premature birth IL6 signature Transcriptome Clinical prediction

基于改进Faster R-CNN与迁移学习的农田杂草识别算法

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中国农机化学报 2022年第10期43卷 176-182页

作者：尚文卿齐红波石家庄工程职业学院信息工程系石家庄市050024

杂草是导致农作物减产不保量的重要因素,针对田间自然环境下杂草识别精度低和识别范围局限的问题,提出一种基于改进Faster R-CNN与迁移学习的农田杂草识别算法。首先,采集多场景下不同时段不同角度的杂草图片,通过旋转、裁剪和调节色彩... 详细信息

杂草是导致农作物减产不保量的重要因素,针对田间自然环境下杂草识别精度低和识别范围局限的问题,提出一种基于改进Faster R-CNN与迁移学习的农田杂草识别算法。首先,采集多场景下不同时段不同角度的杂草图片,通过旋转、裁剪和调节色彩等方式扩充数据集;然后,在原始Faster R-CNN网络的基础上利用改进的双阈值非极大抑制算法(Non-Maximum Suppression,NMS)查找置信度较高的边界框;最后,将AlexNet、GoogleNet、VGG16和ResNet50等作为模型的区域建议网络,并将其最优模型参数迁移至农田杂草识别任务中。通过在多样本数据集和少量物种样本数据集上进行测试验证,试验结果表明,算法可以实现96.58%的精确率、94.82%的召回率和95.06%的F_(1)-score,相比当前主流算法在保持识别精度较高的基础上,具有更广的识别范围。

关键词：杂草识别 Faster R-CNN 迁移学习双阈值非极大抑制算法