Analysis of Down syndrome failed to be diagnosed after prenatal screening: A multicenter study.

To analyze the characters of Down syndrome (DS) who failed to be diagnosed after prenatal screening and hope to be able to improve the programs of prenatal screening and reduce the missed diagnosis of DS. In this multicenter study, we collected the missed cases from 3 prenatal diagnosis centers and analyzed their characters. A total of 126 DS babies failed to be diagnosed after prenatal screening. Their mothers accepted the prenatal screening in second trimester. We collected the mothers' blood and detected the levels of alpha-fetoprotein (AFP) and the free beta subunit of human chorionic gonadotropin (fβhCG) by time-resolved fluoroimmunoassay. The values were also presented as multiples of the median (MoM) and determined the risk of carrying a fetus with DS by Wallace LifeCycle Elipse analysis software. Compared with normal control group, the level of fβhCG and hCG MoM were dramatically increased, while AFP and AFP MoM were decreased. The area under the receiver-operating-characteristic curve of trisomy 21 was 0.8387 for hCG-MoM and AFP-MoM testing. The sensitivity, specificity, positive predictive value, and negative predictive value were 84.6%, 74.8%, 75.4%, and 83.6%, respectively. Meanwhile, the prediction mode was "0.39957 + 1.90897HCG-MOM -3.32713AFP-MOM". It was worthwhile noting that the risk of 65.9% DS missed diagnosis group were higher than 1/1000, 92.9% higher than 1/3000. However, 72.5% cases in normal control group were lower than 1/3000. Only 9.2% mothers would be higher than the value of risk in 1/1000. The prediction mode of hCG MoM and AFP MoM might be able to help us reduce the missed diagnosis. It is also necessary to adjust more reasonable range of noninvasive prenatal testing with further clinical researches

Luttinger-volume violating Fermi liquid in the pseudogap phase of the cuprate superconductors

Based on the NMR measurements on Bi$_2$Sr$_{2-x}$La$_x$CuO$_{6+\delta}$ (La-Bi2201) in strong magnetic fields, we identify the non-superconducting pseudogap phase in the cuprates as a Luttinger-volume violating Fermi liquid (LvvFL). This state is a zero temperature quantum liquid that does not break translational symmetry, and yet, the Fermi surface encloses a volume smaller than the large one given by the Luttinger theorem. The particle number enclosed by the small Fermi surface in the LvvFL equals the doping level $p$, not the total electron number $n_e=1-p$. Both the phase string theory and the dopon theory are introduced to describe the LvvFL. For the dopon theory, we can obtain a semi-quantitative agreement with the NMR experiments.Comment: The final version in PR

Note On Certain Inequalities for Neuman Means

In this paper, we give the explicit formulas for the Neuman means $N_{AH}$, $N_{HA}$, $N_{AC}$ and $N_{CA}$, and present the best possible upper and lower bounds for theses means in terms of the combinations of harmonic mean $H$, arithmetic mean $A$ and contraharmonic mean $C$.Comment: 9 page

Anti-TNF-α Therapies in Systemic Lupus Erythematosus

Tumor necrosis factor (TNF)-α is not just a proinflammatory cytokine. It has also been proposed to be an immunoregulatory molecule that can alter the balance of T regulatory cells. Anti-TNF-α therapies have been provided clinical benefit to many patients and introduced for treating moderate to severe rheumatoid arthritis, Crohn's disease, and other chronic inflammatory disorders. However, their use also is accompanied by new or aggravated forms of autoimmunity, such as formation of autoantibodies, including antinuclear antibodies (ANAs), antidouble-stranded DNA (dsDNA) antibodies, and anticardiolipin antibodies (ACL). Systemic lupus erythematosus (SLE) is a disease with autoimmune disturbance and inflammatory damage. The role of TNF-α in human SLE is controversial. Here we review the role of TNF-α in the pathophysiological processes of SLE and the likely effects of blocking TNF-α in treatment of SLE