Transabdominal villus sampling in early second trimester: A safe sampling method for women of advanced age

Transabdominal chorionic villus sampling (TA-CVS) was performed in 707 viable singleton pregnancies to exclude chromosomal abnormalities. Maternal age ranged between 36 and 49 years (mean 37·9 years); gestational age varied between 10·2 and 18·3 weeks (mean 13·3 weeks). In 639 women (90·4 per cent), a sufficient amount of chorionic tissue (⩾ 10 mg) was obtained after one needle insertion; in 66 women (9·3 per cent) two insertions were needed. An abnormal chromosome pattern was established in 19 cases (2·9 per cent). Vaginal bleeding or spotting within 28 days after TA-CVS occurred in 11 cases (1·5 per cent). The completed follow-up of 678 chromosomally normal pregnancies showed an overall fetal loss rate of 2·6 per cent before 28 weeks. The overall perinatal mortality was 0·9 per cent. When relating fetal loss to gestational age at TA-CVS, this was 6·6 per cent in women sampled before 12 weeks against only 1·8 per cent after 12 weeks. At the same time, the percentage of fetal loss occurring within 2 weeks following the procedure was 75 and 30 per cent, respectively. It is suggested that these data reflect the decline in spontaneous abortion rate during this particular period of pregnancy. It is concluded that TA-CVS is an effective procedure which, when performed after the natural decrease of fetal loss, appears to be a safe option for women of advanced maternal age.     

Detection and delineation of critical areas using echelons and spatial scan statistics with synoptic cellular data

Geographical surveillance for hotspot detection and delineation has become an important area of investigation both in geospatial ecosystem health and in geospatial public health. In order to find critical areas based on synoptic cellular data, geospatial ecosystem health investigations apply recently discovered echelon tools. In order to find elevated rate areas based on synoptic cellular data, geospatial public health investigations apply recently discovered spatial scan statistic tools. The purpose of this paper is to conceptualize a joint role for these together in the spirit of a cross-disciplinary cross-fertilization to accomplish more effective and efficient geographical surveillance for hotspot detection and delineation, and early warning system.     

Genetic diagnosis by chorionic villus sampling before 8 gestational weeks: Efficiency,reliability, and risks on 317 completed pregnancies

Transabdominal chorionic villus sampling (TA-CVS) was attempted in 328 high-risk pregnancies at 6–7 weeks of gestation. Sampling was feasible in 97.7 per cent of cases; chorionic tissue specimens of more than 10 mg were obtained in 94.4 per cent ofcases at the first needle insertion and in 100 per cent after a second attempt. Fetal karyotyping succeeded in 99.4 per cent of cases, while no diagnostic failures were reported in enzymatic and DNA analyses. Fetal loss rate in the first 4 weeks after CVS was significantly higher than in the later CVS series (7.2 vs. 2.5 per cent), but 50 per cent of losses were observed within 2 weeks in cases of inviable aneuploidies. A high incidence of severe limb abnormalities (1.6 per cent) was detected in pregnancies intended to continue, confirming the aetiological role of early CVS. Unclear visualization of the placental limits and poor control of the needle path are thought to be the main reasons for the vascular disruption of the chorionic plate, and thereby hypoxic embryo tissue damage. A better selection of cases, together with high-resolution vaginal ultrasound visualization, and analytical techniques requiring a minimal amount of tissue should avoid any teratogenic effect of early CVS.     

Uterine cavity lavage: Adding fish to conventional cytogenetics for embryonic sexing and diagnosing common chromosomal aberrations

This study was undertaken to examine the efficacy for early prenatal diagnosis of uterine cavity lavage at the level of the internal os and to assess the rate of maternal contamination. In phase I, uterine cavity lavage was performed in 38 women scheduled for pregnancy termination between 6 and 12 weeks. In addition to short- and long-term cultures, one-colour FISH (fluorescence in situ hybridization) with Y and X probes was used for fetal sexing. Two-colour FISH was used in all known male fetuses for the assessment of maternal contamination. In phase II, lavage was performed on 16 women. Fetal sex was diagnosed with direct labelled X and Y probes and common numerical chromosomal aberration was attempted with 18 and 21 direct labelled probes. Fetal sexing was successful in all cases in phases I and II. Out of 34 patients in which tissue was obtained, only FISH was done in six. Long-term cell cultures were successful in the other 28 cases, but complete karyotyping in 19 (56 per cent). No chromosomal aberration was found with the direct labelled probes 18 and 21 in FISH. Maternal contamination was assessed to be 5–10 per cent. This simple and easy-to-master technique is very effective in obtaining fetal cells early in pregnancy for genetic diagnosis, especially by FISH. However, the safety of the procedure must be tested in ongoing pregnancies.     

Risk assessment of amniocentesis between 11 and 15 weeks: Comparison to later amniocentesis controls

We studied 693 consecutive early amniocenteses (prior to 15 weeks) and found a spontaneous abortion rate to 28 weeks' gestation of 1·5 per cent. A control group of women having standard amniocentesis (15–20 weeks) experienced a 0·6 per cent fetal loss in the same period. There were no other apparent differences between the two groups. Early amniocentesis results are generally available 4–6 weeks before standard amniocentesis and 1–3 weeks after chorionic villus sampling (CVS). Alpha-fetoprotein (AFP) can be accurately assayed in 11- to 15-week amniotic fluid samples but additional studies are necessary to determine the accuracy of neural tube defect (NTD) detection. Including the present study, over 5800 early amniocenteses have been reported and the results suggest that this is a relatively safe prenatal diagnostic test and an alternative to CVS and later amniocentesis.     

民国初年灾荒史研究综述

自民国迄今,一些政治家、思想家及学者分别从自然科学角度和社会历史角度对民国初年灾荒史予以诠释,依时间而言主要集中于20世纪80年代以后,依内容而言又呈现出一种多元化的态势。其间,虽然取得了一定的成就,诸如积累了一些资料、研究内容多样化等,但仍存在着一些不足。     

Prenatal diagnosis of anatomical connections in conjoined twins by use of contrast magnetic resonance imaging

Omphalopagus conjoined twins were diagnosed by ultrasonography in a pregnant woman at 21 weeks' gestation. In order to clarify the anatomical connections, magnetic resonance imaging (MRI) was performed, having achieved fetal paralysis by intravascular injection of 100 mg of pancuronium into each twin. Prior to MRI, 2 ml of a 0.0001 mmol/ml solution of gadolinium DTPA was also injected into the stomach of one twin. The contrast agent opacified the bowel loops of both twins, indicating bowel to bowel anastomosis. Following pregnancy termination, autopsy confirmed the prenatal diagnosis.     

基于可拓云模型的区域生态安全预警模型及应用——以祁连山冰川与水源涵养生态功能区张掖段为例

针对区域生态安全预警中的不确定性问题,考虑生态安全等级边界信息的随机性、模糊性及动态性,利用可拓学中兼具定性和定量分析及动态性的物元理论和具有不确定推理特性的云模型,提出了基于可拓云模型的区域生态安全预警模型;运用该模型对祁连山冰川与水源涵养生态功能区张掖段2005—2015年生态安全进行了定量评估,并对2017年生态安全环境进行动态预警。结果表明:祁连山生态功能区张掖段2005—2015年的生态安全整体水平均处于"理想"以下,其变化趋势为"较差"到"一般"再到"良好";2017年祁连山冰川与水源涵养生态功能区张掖段生态安全为"蓝色"预警,但有向"黄色"转变的趋势,其中工业三废、环保投入强度、森林覆盖率及人均水资源量是影响祁连山冰川与水源涵养生态功能区张掖段生态安全的主要因素。     

基于BP神经网络和SVR的Fund?o尾矿坝排水数据预测对比研究

针对尾矿库运行过程中安全预警问题,选取2015年巴西Samarco铁矿溃坝事故案例,研究BP神经网络和SVR方法在排水数据预测的适用性。综合分析了排水数据的复杂且非线性的特点,以库水位、降雨量和干滩长度为输入特征,采用上述2个模型对尾矿坝排水数据进行预测。研究结果表明:基于BP神经网络预测结果的最大相对误差不高于4.35%;基于SVR算法的最大相对误差不高于9.21%;Fundo坝的排水预测结果是可行的,BP神经网络的预测精度更高,而SVR模型的运算速度更快。研究结果可为矿山安全工作的快速响应和溃坝预警提供信息支撑和参考依据。