Current concepts of Down syndrome screening tests in assisted reproduction twin pregnancies: another double trouble

Assisted reproductive technologies (ART) have increased both the number of pregnancies in women beyond the age of 35 and the incidence of multiple pregnancies. Various methods of screening for Down syndrome (DS) were introduced in clinical practice during the last two decades, and specific problems were encountered when they were applied for twin pregnancies. The current review aims to explore the problematic issue of prenatal DS screening in ART twins. Overall, more women with twin pregnancies (mainly those who conceived via assisted reproduction) are found to be false positive for DS. This is because mid-trimester maternal serum screening is associated with a higher false-positive rate secondary to changes in the feto-placental endocrinologic metabolism, reflected mainly in high human chorionic gonadotrophin (hCG) levels in the ART pregnancies. First-trimester nuchal translucency (NT) measurement in twin pregnancies is not affected by the problems encountered in serum screening. This sonographic screening approach enables a fetus-specific identification of those fetuses at high risk of DS and is associated with a lower false-positive rate than mid-trimester serum screening. DS screening in ART twins presents several challenges in determining the most appropriate screening test modality. Whether there is any significant benefit of adding first-trimester biochemistry or nasal bone scanning in screening ART-conceived twins awaits further investigation. Copyright © 2005 John Wiley & Sons, Ltd.     

最小割集在系统安全分析方法中的应用

利用事故树分析法对矿井火灾进行分析 ,结合平煤六矿建立了矿井火灾事故树。阐述了最小割集理论及其在事故分析中的作用 ,着重提出了对事故树底部事件进行排序分级的加权结构重要度分析法。该方法新颖、简洁而实用 ,为系统安全分析提供了新的方法和途径。     

大连地区唐氏筛查孕中期妇女羊水中甲状腺激素水平与PBDEs内暴露关系初探

多溴联苯醚(polybrominated diphenyl ethers,PBDEs)是一类常用的溴代阻燃剂,由于使用广泛,已成为普遍存在的环境污染物。研究表明,PBDEs具有内分泌干扰作用,影响甲状腺功能,对胚胎发育、婴幼儿及儿童的健康存在潜在的危害。本研究采集了100例具羊水穿刺指征的孕妇的孕中期羊水样本,采用罗氏全自动电化学发光免疫分析仪测定羊水中促甲状腺激素(TSH)、三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)、甲状腺素(TT4)、游离甲状腺素(FT4)、抗甲状腺过氧化酶抗体(TPOA)和抗甲状腺球蛋白抗体(TGA)的含量,用气相色谱-负化学源-质谱法测定羊水样品中16种PBDEs同系物含量。结果显示,羊水中TSH、TT3、FT3、TT4、FT4中位数分别为0.342μIU·m L-1、0.949 nmol·L-1、1.52 pmol·L-1、11.02 nmol·L-1和3.91pmol·L-1,95%参考区间值分别为0.174~0.872μIU·m L-1、0.835~1.01 nmol·L-1、1.26~2.72 pmol·L-1、9.42~20.68 nmol·L-1和2.16~6.35 pmol·L-1。具有唐氏筛查高风险和甲状腺激素水平低下的羊水样品中共检出6种BDEs(BDE-47、BDE-71、BDE-138、BDE-183、BDE-190、BDE-209),其中BDE-71、183和190在被检羊水样品中均被检出,并且,TSH水平低下的羊水中BDE-190和209负荷水平显著高于正常组。这些结果提示,大连地区孕中期妇女羊水存在PBEDs内暴露,并且PBDEs内暴露可能与羊水的甲状腺激素水平低下、尤其TSH水平升高有关,提示PBDEs暴露可能与胎儿中枢神经系统损伤产生的下丘脑-垂体-甲状腺(HPT)轴功能失调有关。因此,羊水PBDEs内暴露对新生儿出生结局的影响值得进一步关注。     

In-stand scenic beauty of variable retention harvests and mature forests in the U.S. Pacific Northwest: The effects of basal area, density, retention pattern and down wood

Tensions between amenity- and timber-based economies in the U.S. and Canadian Pacific Northwest motivated a study of scenic beauty inside mature forests and timber harvests. A diverse sample of regional forests, measures of forest structure, and large, representative samples of photographs and public judges were employed to measure scenic beauty inside un-harvested mature and old-growth forests, and timber harvests. The latter varied systematically in down wood levels and retention level and pattern. Scenic beauty tended to be optimized at a basal area of 110–155 m³/ha and/or 700–900 trees/ha. Older forests and those with larger trees were perceived to be more beautiful. In harvests, greater retention levels, less down wood, and dispersed rather than aggregated retention patterns contributed to aesthetic improvements. Green-tree retention harvests offer considerable potential gains in perceived scenic beauty compared to perceived very ugly clearcuts, particularly at higher retention levels. These gains are more reliable from dispersed retention patterns. The silvicultural parameters studied change strength in affecting scenic beauty with changes in retention level. These interactions are explored in relation to a range of scenic quality objectives as an aid to planners, visual impact analysts, and silviculturists.