MATERNAL SERUM ALPHA-FETOPROTEIN SCREENING FOR OPEN NEURAL TUBE DEFECTS IN TWIN PREGNANCIES

Data on maternal serum alpha-fetoprotein (AFP) levels at 13–24 weeks' gestation in 46 twin pregnancies with open neural tube defects (22 with anencephaly, 24 with open spina bifida) and 169 unaffected twins were used to estimate the detection and false-positive rates associated with different cut-off levels. Using the conventional cut-off level of 2·5 multiples of the median (MoM) for unaffected singleton pregnancies of the same gestation and laboratory, the detection rate in twins was 99 per cent for anencephaly and 89 per cent for open spina bifida, with a false-positive rate of 30 per cent. Using a 5·0 MoM cut-off level to maintain a similar false-positive rate to that found among singleton pregnancies at 16–18 weeks' gestation (about 3 per cent), the detection rate was 83 per cent for anencephaly and 39 per cent for open spina bifida. Estimates are provided of the odds of having an affected twin pregnancy given a positive AFP result as well as the odds for individual women with a raised AFP level.     

Iniencephaly is not uniformly fatal

Iniencephaly is an uncommon, but not rare, lesion involving a fusion between the posterior occipital bone and the cervical spine. Many cases are associated with other cranio-cervical abnormalities and anencephaly, and most are associated with other structural abnormalities. The prognosis is thought to be dismal. We describe a male infant, one of twins, who was diagnosed prenatally as having iniencephaly. The child was born without complication and has grown and thrived. This is the fourth patient with long-term survival with iniencephaly. We recommend that non-directive counselling be applied when presenting the findings of iniencephaly to parents.     

Effects of mid-trimester induced abortion on the subsequent pregnancy

The outcome of the pregnancy following (a) a mid-trimester termination of pregnancy (TOP) for fetal neural tube defect (NTD) (77 women=group 1); (b) mid-trimester TOP for fetal Down's syndrome (13 women=group 2); (c) delivery of a baby with NTD (119 women=group 3) was studied. The prenatal fetal loss was relatively high in all groups. In group 1 it was similar to that found in other studies after first trimester TOP, in group 2 it was associated with advanced maternal age and the unexpected finding in group 3 was not attributable to advanced maternal age. It is suggested that a previous NTD per se might increase the risk of fetal loss in the next pregnancy. A previous mid-trimester TOP for NTD was not associated with an increase in premature labour, small for dates babies or congenital abnormality in the next pregnancy, but there was a slight increase in the number of babies weighing less than 2500 g.     

Is maternal alpha-fetoprotein screening still of value in a low-risk area for neural tube defects?

Estimation of maternal serum alpha-fetoprotein (AFP) was used as a screening method for the detection of neural tube defects (NTDs) in 6344 women over three years. Of 88 (1.4 per cent) who had one or more serum AFP levels equal to, or greater than, 2.5 multiples of the median (MoM) for the relevant gestational age, 43 (0.68 per cent) underwent amniocentesis. There were eight NTDs. Four of these were screened by serum AFP, and all cases of spina bifida had serum AFP levels greater than 3.0 MoM, including one small open defect which was not seen on ultrasound. The other four cases of NTD, which were not screened, were identified by ultrasound. Of 64 singleton pregnancies 32 (50 per cent) had serum AFP levels between 2.5 and 3.0 MoM, and low birthweight (⪕2500 g) occurred in 29 per cent. Because of improvements in ultrasound techniques and the apparent falling incidence of NTD, the role of serum AFP as the primary screening procedure should be regularly reviewed. Effective screening is dependent on mothers booking early.     

Recurrence risk of neural tube defects following a miscarriage

Data from 280 sibships in three published series were used to see if the increased risk of neural tube defect (NTD) associated with having had a miscarriage in the immediately preceding pregnancy was also found in women with a previous affected pregnancy. A statistically significant relative risk of 4.0 (2-tail P=0.0111, Fisher exact test) was found among such women, and this could not be accounted for by the effect of parity or of a history of miscarriage in general. The finding may be useful when counselling patients.     

气相连通罐组群罐燃爆风险定量评估技术研究

炼化企业气相连通罐组存在群罐重大火灾风险,需要采取系统评估、层层设防的思路进行防控。采用HALOPA技术,结合中国石化风险矩阵标准,建立基于风险的气相连通罐组重大燃爆风险控制准则、不同罐容的事故后果等级划分标准、各类保护措施的风险消减因子和燃爆事件可能性评估方法以及相关重要设计要求。案例分析表明,VOCs气相连通罐组群罐燃爆风险定量评估方法可对群罐火灾风险进行快速量化评估,可用于气相连通罐组的风险评估和工程安全设计。     

黄磷尾气的综合利用及净化途径探讨

对黄磷尾气综合利用的途径和生产的技术进行了探讨,应用变温吸附和变压吸附分离技术处理黄磷尾气,净化效果较好,再生容易,各种杂质脱除率高.     

生物过滤法处理挥发性有机物气体研究进展

生物过滤法是一种高效、廉价的废气处理技术。介绍了近年来生物过滤法处理挥发性有机物(VOCs)气体的研究进展。重点讨论了生物过滤法处理VOCs气体的性能、影响因素和运行模拟等内容。     

生物滴滤塔处理正丁醇废气的研究

实验分别采用清水吸收法和生物滴滤法处理模拟正丁醇废气,结果表明,在实验工况条件下,清水吸收的净化效率随进口浓度的增加而增加,净化效率可达99%,最佳液气比为2.1L/m3;生物滴滤塔的净化效率随着进气流量、液体流量和进气浓度的增加而降低,当进气流量<1.0m3/h时,其对降解效率的影响较小。     

兰州城市主要大气污染治理方案和环境效益

根据兰州市经济技术条件，提出多种大气污染治理工程方案。用数值模式计算分析了这些单项方案和综合方案可减少的大气污染物排放量和空气质量改善程度，推荐了当前可行的投资低、环境效益好的优化综合方案，该综合方案可使兰州市区空气中SO2浓度下降24.6%-75.4%，TSP降10.4%-45.4%；降少数网格点外，SO2浓度都不出现超标。