Acute pancreatitis in pregnancy (APIP) is rare and the reasons for APIP are biliary disease and congenital or acquired hypertriglyceridemia, which could occur during any trimester but more than 50% cases happened during the third trimester. In this report, one case of a young pregnant woman, a HBV carrier in her 37th week+5 d of gestation, was admitted to Emergency Department due to acute abdominal pain, vomiting and diarrhea. The patient was in antiretroviral treatment with telbivudine from 28 weeks of gestation to prevent mother-to-child transmission of HBV. Laboratory tests demonstrated hypertriglyceridemia, abdominal computed tomography scan revealed peripancreatic edema. Hyperlipidemic pancreatitits was primary diagnosed and the patient was admitted to the intensive care unit. Considering the possible role in the pathogenesis of pancreatitis, telbivudine was interrupted after birth giving. After supportive treatment, her condition gradually improved. Since it is the ifrst description of APIP during treatment with telbivudine, the association between pregnancy, hyperlipidemia, telbivudine and acute pancreatitis has been well investigated.

Changes in neurotransmitter levels in the brain play an important role in epilepsy-like attacks after pregnancy-induced preeclampsia-eclampsia. Metabotropic glutamate receptor 1 participates in the onset of lipid metabolism disorder-induced preeclampsia. Pregnant rats were fed with a high-fat diet for 20 days. Thus, these pregnant rats experienced preeclampsia-like syndromes such as tension and proteinuria. Simultaneously, metabotropic glutamate receptor 1 mRNA and protein ex-pressions were upregulated in the rat hippocampus. These findings indicate that increased sion of metabotropic glutamate receptor 1 promotes the occurrence of high-fat diet-induced preec-lampsia in pregnant rats.

Progestogens and early pregnancy:prevention and treatment

吉林省不同孕期妇女尿碘水平与甲状腺功能关系的调查

目的 为掌握全民食盐加碘后吉林省孕妇在不同孕期碘营养和甲状腺功能状况,为今后实施孕妇甲状腺功能监测的必要性和可能性提供依据.方法 以省为单位,按“人口比例概率抽样方法”(PPS)抽取30个抽样单位(县).用单纯随机抽样法从上述抽到的每个抽样单位中抽取3个乡(镇、街道办事处),每个乡(镇、街道办事处)抽取孕妇8人,每县(市、区、旗)孕妇24人.收集被调查对象尿样、血样及家中的食用盐、饮用水.采用化学发光法检测甲状腺功能(包括甲状腺抗体)指标,砷铈催化分光光度法检测尿、水碘含量,直接滴定法检测食盐碘含量.结果 孕早、中、晚期妇女的尿碘中位数分别为188.6μg/L、201.9μg/L、175.7μg/L且不同孕期尿碘中位数及频数分布无显著性差异.孕早、中期妇女甲状腺功能异常主要为低FT4血症和亚临床甲状腺功能减退.孕晚期除低FT4血症和亚临床甲状腺功能减退外还有一定比例4.2％ (10/240)甲状腺功能亢进(亚临床甲状腺功能亢进)存在.孕晚期妇女与孕早、中期相比甲状腺功能异常比率明显增加,孕妇抗体阳性率为10.2％ (77/755).抗体阳性者发生亚甲减3例占3.8％(3/77),低FT4血症1例占1.3％(1/77),甲亢(亚甲亢)3例占3.8％(3/77).结论 吉林省孕妇的碘营养处于适宜水平；建议在孕早期开展尿碘监测和甲功筛查.

This case?controlled study was designed to evaluate the association between various baseline parental factors and the risk of hypospadias in China. Patients were selected from tertiary referral hospitals in Anhui, a province in mid?eastern China. Aquestionnaire was given to the parents of each patient. The ifnal database included 193cases and 835 controls. The incidence of additional coexistent anomalies was 13.0%, primarily cryptorchidism(9.8%). Ten patients(5.1%) were from families with genital anomaly, including ifve families(2.6%) with hypospadias. The risks of hypospadias was higher for children of mothers>35 (odds ratio[OR] =1.47) and<18(OR=2.95) years of age, and in mothers who had consumed alcohol(OR=2.67), used drugs(OR=1.53) and had an infection(OR=1.87) during pregnancy. The risk of hypospadias was also higher when mothers(OR=1.68) and fathers(OR=1.74) were engaged in agriculture. Other factors assessed were not associated with the risk of hypospadias.

The potential role of progesterone during pregnancy as an induction of infantile hemangioma

Infantile hemangioma (IH) is one of the most common benign tumors in infants characterized by occurrence within a few weeks after birth,rapid growth during the first year and spontaneous involution over a period of several years.Despite the high incidence rate of 5％-10％ in infants of mixed European descent,detailed pathogenesis of IH remains elusive.Recent studies have indicated multipotential stem cells derived from hemangioma tissue (HemSCs) could recapitulate human infantile hemangioma in immunodeficient mice.Considering the effect of progesterone on regulation of cytokines and growth factors in endometrium as well as the inhibition of immune response,using progesterone during pregnancy might help the HemSCs escape from the immune response and reside in the tissue of embryo by the aid of increased MMPs and decreased TIMPs,then proliferation was stimulated by increased growth factors like VEGF and bFGF.Thus,IH is potentially produced.Supported by National Natural Science Foundation of China (81070846).

Objectives:To detect the concentration of serum vascular endothelial growth factor (VEGF) in patients with pregnancy induced hypertension (PIH) as well as to explore the role of VEGF in the pathogenesis of PIH.Methods:Serum VEGF concentrations in 23 healthy nonpregnant women (normal group),30 normal pregnant women (control group) and 37 women with PIH (PIH group) were measured by sandwich enzyme-linked immunoadsorbent assay (ELISA).Results:Serum concentrations of VEGF in control group were significantly higher (149.39±27.15ng/L) than those in normal group (11.98±3.99ng/L) (P＜0.001),peaking in the second trimester of pregnancy (183.84±49.02ng/L) and decreasing in the third trimester (118.37±34.29ng/L).Serum VEGF concentrations (64.45±24.33ng/L) in PIH group were significantly lower than those in normal late pregnancy women of control group (118.37±34.29ng/L) (P＜0.01).There was a trend that serum VEGF concentrations in PIH group decreased with the severity of PIH (P＜0.05).Conclusion:The serum VEGF concentration in PIH women are significantly decreased,which suggests that VEGF may play an important role in the pathogenic mechanism of PIH.

Here two cases of renal failure occurring in pregnancy were reported, with biopsy-proven pauci-immune crescentic glomerulonephritis at postpartum. It is most rare that pauci-immune crescentic glomerulonephritis as the cause of renal failure in pregnancy. Their renal function could remain stable for some time due to timely and appropriate treatment. Therefore, the pregnant and maternal who have the performance of renal impairment should be closely tracked their blood pressure, urinary protein and renal function, if necessary, execute renal biopsy, for a clear and accurate pathological diagnosis is of great significance to grasp the opportunity of treatment. But the long-term prognosis is still poor.