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.     

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.     

Flow cytometric method to measure urea-resistant alkaline phosphatase from blood neutrophils for use in the prenatal screening of Down's syndrome

The histochemical measurement of urea-resistant alkaline phosphatase from maternal blood neutrophils is known to have a high detection rate for the prenatal detection of Down's syndrome pregnancies. However, because the histochemical method is laborious and subjective to use, it has not gained widespread acceptance in prenatal screening programmes. We present a simple and objective method for the measurement of urea-resistant alkaline phosphatase by flow cytometry. The method should allow the design of larger studies aimed at evaluating the role of neutrophil urea-resistant alkaline phosphatase in the prenatal screening for Down's syndrome.     

Expanding multiple marker screening for Down's syndrome to include Edward'S syndrome

Information on maternal age and maternal serum alpha-fetoprotein, unconjugated oestriol (uE₃), and human chorionic gonadotrophin (hCG) levels was used to investigate retrospectively the effect of estimating Edward's syndrome risk in women having multi-marker screening for Down's syndrome. The screened population comprised 15 pregnancies affected by Edward's syndrome, 15 with Down's syndrome and 5472 unaffected pregnancies. The use of all three markers to estimate Edward's syndrome risk would have led to the detection of 10–12 (67–80 per cent) cases with a false-positive rate of 0.3–0.6 per cent depending on the risk cut-off. A further case would have been detected as a result of screening for Down's syndrome alone. Similar results were obtained when the Edward's syndrome risk was based on uE₃ and hCG only. These data suggest that extending Down's syndrome screening to include Edward's syndrome risk will yield a high detection rate with only a small increase in the false-positive rate.     

Serum PAPP-A measurements in first-trimester screening for Down syndrome

Serum PAPP-A measurements taken from 254 women in the first trimester are reported. Eleven chromosomal abnormalities were detected. The mean serum PAPP-A levels in cases of Down syndrome were 0.44 MOM at 9 weeks gestation, 0.15 MOM at 10 weeks, and 0.29 MOM at 11 weeks. The PAPP-A level at 10 weeks was below those of pregnancies which aborted spontaneously. At 11 weeks, the pregnancies with Down syndrome recorded the lowest PAPP-A levels at that gestation. On this small sample, offering chorionic villus sampling to women with singleton pregnancies and a PAPP-A level below 0.3 MOM (approximately 6.5 per cent of this at-risk group) would have detected all the Down syndrome fetuses at 10 weeks and 50 per cent at 11 weeks without selecting those cases destined to abort. This suggests that serum PAPP-A should continue to be investigated as a potential first-trimester screening test for Down syndrome.     

布袋式除尘在大型煤炭筛分系统中的成功应用

煤炭筛分系统在工作时产生的大量煤尘对环境造成污染，为解决这一问题，我们设计安装了两套煤炭筛分除尘系统，通过布袋式除尘器，把煤尘用布袋收集起来，解决了煤炭粉尘污染问题，通过三年的使用观察，效果非常明显。     

普通车床工件工具飞出伤人事故树分析

针对普通车床常见、多发的工件、工具飞出伤人事故,采用事故树分析事故原因,并提出安全对策措施.     

Pesticide Impact Rating Index – A Pesticide Risk Indicator for Water Quality

Pesticide users, natural resource managers, regulators, government agencies and many others are concerned about the off-site impact of pesticides on the environment. Systematic methods of the assessment of potential risk of pesticides to environmental components can serve as valuable tools in decision making and policy formulation. Simple risk indicators have been developed which cover a range of scenarios such as toxicity to organisms, health of farm workers, consumer health, and residues in harvested produce. The authors have developed a software package named Pesticide Impact Rating Index (PIRI) that outputs an improved pesticide risk indicator for water quality. PIRI is a standalone, user-friendly, platform-independent program. It can be used to (i) rank pesticides in terms of their relative pollution potential to groundwater or surface water, and (ii) to compare different land uses in a catchment or at a regional scale in terms of their relative impact on water quality. It is based on pesticides use; the pathway through which the pesticides are released to the water resources (drift, runoff, erosion, leaching) and the value of the water resources threatened. Each component is quantified using pesticide characteristics (including toxicity to organisms at different trophic levels, i.e. fish, daphnia, algae, etc.), environmental and site conditions (e.g. organic carbon content of soil, water input, slope of land, soil loss, recharge rate, depth of water table, etc.). This paper describes two case studies of the application of PIRI in Australia. The comparison of the risk assessment by PIRI on these revealed that PIRI correctly estimated the pollution potential of pesticides in greater than 80% of cases. A GIS version of PIRI is described in a companion paper in this volume. An erratum to this article is available at .     

小城镇产业集群主要污染源筛查与影响分析

以郫县安德镇川菜产业园为研究对象,采用等标污染负荷法对污染影响进行了标准化评价。结果发现:川菜产业园主要的工业污染行业为豆制品加工行业,排污量为2 919.94 t/a,占总排污量的96.46%,等标污染负荷为9.83,占总污染负荷的92.83%,其中有6家企业为主要控制对象。对比分析发现,环境污染受企业规模、末端处理方式、废水排放量等多方面因素共同影响。所有污染因子中,BOD对环境的实质污染影响较大。该研究成果将为优化小城镇产业集群的规划、管理和污染物总量控制提供有价值的参考。