2015年 · 第95卷第01期

Years go away, clouds scatter easily, time rushes. In 2015, we will celebrate the 100th anniversary of the Chinese Medical Association, and at the same time, we will commemorate the 100th anniversary of the founding of the Chinese Medical Journal as its journal. Turning over the century-old history of Chinese Medical Journal, many medical classics are worth remembering, and countless medical sages are worth remembering. Chinese Medical Journal is the first medical journal in the true sense of modern China. After a hundred years, it has witnessed the development of modern medicine in China and recorded countless wonderful chapters in the development of modern medicine in China. On the occasion of the 100th anniversary of the publication of Chinese Medical Journal, the first thing we should remember is Dr. Wu Liande, the founder and first editor-in-chief of this journal. More than 100 years ago, China was "full of sores, everyone lamented", and tuberculosis and plague were epidemic^[1]。 In response to the government's call, Mr Ng Liande, a Malaysian overseas Chinese and a Ph.D. from Cambridge University in the United Kingdom, devoted himself to the cause of medicine and epidemic prevention with enthusiasm for his motherland. He is the earliest advocate, organizer and practitioner of health and epidemic prevention in China. He initiated the establishment of the Chinese Medical Association and served as the first secretary and president. In November 1915, shortly after the establishment of the Chinese Medical Association, the Chinese Medical Journal was officially founded in Shanghai, and he personally served as the editor-in-chief. In his founding speech, he sent a message: "When we observe the rise and fall of a country, we should always measure it by magazines. When magazines are developed, the country will be strong."^[2]。 Since its founding 100 years ago, Chinese Medical Journal has always adhered to the purpose of serving readers, authors and medical and health scientific and technological personnel, promoting domestic and foreign medical academic exchanges and the development of medical science, keeping up with the world medical progress trend, and promoting the progress and development of Chinese medical science and technology as its own responsibility. Promoting new knowledge, new technology, new achievements and exchanging experiences have played an important role in improving the theoretical and professional level of Chinese medical staff and promoting the development and improvement of Chinese medical science.

In September 2014, the journal Lancet published a longitudinal study of fetal growth and development^[1]It is an update and supplement to the International Growing Child Standards issued by the World Health Organization (WHO) in 2006, which makes the growth of fetuses have an international standard. Human beings experience unfavorable factors during the fetal period, such as malnutrition, overnutrition, uteroplacental dysfunction, etc. Permanent or procedural changes in the structure and function of tissues and organs will affect the occurrence and development of chronic non-communicable diseases such as diabetes mellitus, metabolic syndrome, cardiovascular diseases, mental behavior abnormalities, asthma, tumors, osteoporosis, neurological diseases, etc^[2,3]However, the focus of obstetrics has always been on maternal safety. With the development of fetal medicine, people are more and more aware of the importance of paying attention to fetal growth and development.

At present, there is no dispute that hypertensive disorders during pregnancy are a group of hypertensive disorders that appear during pregnancy. However, for preeclampsia-eclampsia (PE-E) in this group of diseases, whether PE-E is only an idiopathic disease with idiopathic manifestations of pregnancy or a group of diseases with "syndrome" manifestations is a controversial topic that is being continuously discussed in depth. Whether it is from the change of disease terms to the constant change of diagnostic classification and diagnostic criteria, it can be said that the understanding of PE-E is constantly deepening. With the advancement of clinical research and basic research on different etiologies and pathogenesis of early-onset and late-onset preeclampsia, multiple factors and heterogeneity affecting the pathogenesis of PE-E and multiple pathways of pathogenesis are continuously revealed and discovered. From "pregnancy-induced hypertension syndrome" many years ago to "preeclampsia-eclampsia syndrome" today, the intrinsic meanings of the syndrome are very different. It is not only the parallel connection of PE and E, but the thinking of the cause of PE disease. This understanding helps us to have a deeper understanding of this disease that has been explored by researchers for centuries.

Hepatitis B virus (HBV) infected pregnant women transmit the virus to their children, that is, mother-to-child transmission, which is the main cause of chronic HBV infection in China. Vaccination against hepatitis B is the most effective measure to prevent HBV infection. With the attention of governments at all levels and the efforts of medical staff and the whole society, the timely vaccination rate of the first vaccine of most newborns in China is>90%^[1]Great achievements have been made in controlling HBV infection, but there are still challenges in how to further reduce mother-to-child transmission of HBV.

Over the last 20 years, over-diagnosis of dystocia has been widespread not only in China, but all over the world. Including the diagnosis of prolonged incubation period latent phase, arrested active phase, and protracted second stage, all contributed to the increase in cesarean section rates. 2000 Gifford et al.^[1]It is reported that 25% of women in the United States who undergo cesarean section every year because of slow labor progress have been diagnosed with "protraction disorders" when the cervical dilation is only 0-3 cm. For a long time, we have been too demanding on the maternal delivery process, and always hope that the cervix will expand rapidly in the early stage of labor. In fact, the cervix will expand slowly in the early stage of labor, which will easily lead to over-diagnosis of dystocia. Moreover, the guiding role of partogram, which was widely recommended before this, for obstetricians and midwives needs to be considered. Most of the time, partogram is drawn retrospectively, rather than truly recorded and drawn, because the time of labor is difficult to determine. Therefore, how to judge that the parturient has really entered the active phase, how to determine the turning point of cervical dilatation during labor, and whether it is necessary to re-formulate a new labor chart or a new labor standard, these are all questions worth our consideration.

Preeclampsia is a unique disease of pregnancy, with an incidence rate of 7% ~10%. The number of maternal deaths directly caused by pregnancy is about 6.8/100,000 every year^[1]； It is often complicated by fetal growth restriction, iatrogenic preterm delivery, chronic fetal hypoxia and abnormal learning and memory ability of offspring. However, there is still a lack of effective early diagnosis and intervention measures for preeclampsia, and its etiology and pathogenesis are still unclear. According to the available data, maternal-fetal conflict may be the key link in the occurrence of preeclampsia.

single fiber electromyography (SFEMG) selectively records the action potential of individual muscle fibers by using a special needle electrode with a very small recording area. Domestic Cui Liying et al^[1]The value of SFEMG in amyotrophic lateral sclerosis, myasthenia gravis (MG) and inflammatory myopathy were studied^[2,3,4]。 The two most clinically valuable parameters in SFEMG examination are fiber density (FD) and neuromuscular junction jitter values; FD can reflect the redistribution of muscle fibers in motor units, and jitter value is the most sensitive index to evaluate the function of neuromuscular junction at present. Because single fiber needle (SFN) is expensive, it is often reused after sterilization and sterilization. In recent years, the application of invasive medical devices may bring about iatrogenic infection, which has attracted widespread attention. For example, routine disinfection cannot eliminate the potential prion infection risk during repeated use of SFN. Therefore, the clinical application of SFN is limited. In 2000, it was reported abroad that the jitter value of neuromuscular junction was recorded by concentric needle electrode (CNE)^[5]。 Subsequently, the literature reported that CNE-recorded neuromuscular junction jitter values, called CNE-recorded single-fiber electromyography^[6,7,8]。 However, because the action potentials recorded by CNE are not real in the sense of individual muscle fibers, recently Stålberg et al^[9,10]This is referred to as jitter recording with CNE (CNE-jitter).

Neonatal lupus erythematosus (NLE) is a rare neonatal disease associated with maternal autoantibodies entering the fetus through the placenta^[1]。 NLE was originally reported by dermatologists Mccuistion and Schoch in 1954^[2]。 1980 Weston et al.^[3]It is suggested that maternal anti-Sjogren's syndrome A (SSA) and anti-Sjogren's syndrome B (SSB) antibodies may be associated with the pathogenesis of NLE. Subsequently, it was found that other autoantibodies, such as anti-U1 ribonucleoprotein (U1RNP) antibody, anti-calreticulin antibody, and anti-fodrin antibody, were associated with the pathogenesis of NLE. The main clinical manifestations of NLE are skin lesions and congenital heart block (CHB), which can also involve the liver and blood system, but simultaneous involvement of more than two systems is rare. This article will summarize the research progress of neonatal lupus in epidemiology, pathogenesis, clinical manifestation, treatment and prognosis.