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Fetal Head Compression: Its Possible Role in Neurologic Injury

Open Journal of Obstetrics and Gynecology 2024年第1期14卷 124-143页

作者： Barry S. Schifrin Brian J. Koos Wayne R. Cohen Department of Obstetrics and Gynecology The Western University of Health Sciences Pomona USA The David Geffen School of Medicine at UCLA Los Angeles USA The University of Arizona College of Medicine Tucson USA

It is widely assumed that fetal ischemic brain injury during labor derives almost exclusively from severe, systemic hypoxemia with marked neonatal depression and acidemia. Severe asphyxia, however, is one of several causes of perinatal neurological injury and may not be the most common;most neonates diagnosed with hypoxic-ischemic encephalopathy do not have evidence of severe asphyxia. Sepsis, direct brain trauma, and drug or toxin exposure account for some cases, while mechanical forces of labor and delivery that increase fetal intracranial pressure sufficiently to impair brain perfusion may also contribute. Because of bony compliance and mobile suture lines, the fetal skull changes shape and redistributes cerebrospinal fluid during labor according to constraints imposed by contractions, and bony and soft tissue elements of the birth canal as the head descends. These accommodations, including the increase in intracranial pressure, are adaptive and necessary for efficient descent of the head while safeguarding cerebral blood flow. Autonomic reflexes mediated through central receptors normally provide ample protection of the brain from the considerable pressure exerted on the skull. On occasion, those forces, which are transmitted intracranially, may overcome the various adaptive anatomical, cardiovascular, metabolic, and neurological mechanisms that maintain cerebral perfusion and oxygen availability, resulting in ischemic brain injury. Accepting the notion of a potentially adverse impact of fetal head compression suggests that avoidance of excessive uterine activity and of relentless pushing without steady progress in descent may offer protection for the fetal brain during parturition. Excessive head compression should be considered in the differential diagnosis of ischemic encephalopathy.

关键词： Fetal Brain Injury Fetal Head Compression ischemic encephalopathy Neonatal encephalopathy

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Earthworm proteases multiply function in protein fibrils degradation involving several diseases including Hepatitis B

Earthworm proteases multiply function in protein fibrils deg...

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中国生物化学与分子生物学会第十二届全国会员代表大会暨2018年全国学术会议

作者： Xiumei Wang Shichao Fan Rongqiao He Institute of Biophysics Chinese Academy of Sciences

Eisenia fetida proteases(Ef Ps) and Lumbricus rubellus proteases(LrPs) have been used to treat human important diseases including cardiovascular diseases,ischemic encephalopathy,diabetic encephalopathy diabetic kidney disease,as well as hepatitis *** the treatment of all those diseases,the general mechanisms of Ef Ps and LrPs are linked with degradation and decrement of protein fibrils on specific *** described by our previous work,Ef Ps as a complex drug markedly cleave fibrinogen and decrease fibrogenesis to prevent clotting formation and clotting *** Ps showed high activity on fibrinogen-chain,moderate activity on-chain and low activity *** other words,the activity of Ef Ps prefers decrease fibrinogen to proteolysis of *** found that fibronectin an important molecule participates in hepatitis B infection and liver *** purified the component of Ef Ps,which had highest proteolytic activity on fibronectin,and verified to use in HBV infection treatment in HepG2.2.15 *** observed that Ef Ps contained eight isozymes including ***,we demonstrated that Ef Ps had a definite effect on HBV infection in animal model not only through proteolysis of fibronectin,but also degradation of *** data provide valuable information to understand the therapeutic role and potential therapeutic mechanism of Ef Ps as effective antiviral medicine in treating chronic hepatitis B.

关键词： Earthworm protease Fibronectin HBeAgase Isozyme ischemic encephalopathy Chronic Hepatitis B

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