Objective To evaluate the efficacy and safety of transvaginal hydrolaparoscopic ovarian drilling for treatment of the polycystic ovary syndrome(PCOS)in clomiphene citrate-resistant infertile women.Methods Between February 2008 and November 2008,11 clomiphene citrate-resistant anovulatory women with PCOS mean age:(29.3?3.7)years,mean body mass index:(24.3?8.3)kg/m2] were enrolled in this study.Transvaginal hydrolaparoscopy using a F5 bipolar needle was performed on the patients to create 5-15 holes with a free length of 0.8 cm and a diameter of 0.2 mm in each ovary(electrocoagulation time 10-15 sec).Results A mean of(17?6)holes were made in both the ovaries in the patients.No surgical complications occurred.The levels of LH,FSH,and androstenedione dropped from(14.7?4.5)IU/L,(7.1?6.4)IU/L,and(12.2?4.4)nmol/L to(10.5?3.7)IU/L,(6.4?1.7)IU/L,and(8.9?3.0)nmol/L(t=2.389,P=0.027;t=1.007,P=0.326;and t=2.104,P=0.048)respectively after the operation.The patients were followed up for 2 to 9 months,during the period 6(54.5%)patients recovered spontaneous menstruation,among which 3 recovered ovulatory cycles(27.3%)and 2(18.2%)had spontaneous pregnancy.In the other 8 patients who didn't recover spontaneous menstruation,5 cases received CC or FSH(one of them was pregnant after the treatment);1 case was not pregnant though received IVF;and 2 are still in follow-up.Conclusions Transvaginal hydrolaparoscopic ovarian drilling is safe and effective for clomiphene citrate-resistant infertile women.

Objective To investigate the clinical pregnancy outcomes of laparoscopic treatment for different degrees of tubal adhesion and tubal distal occlusion.Methods Clinical information of 41 infertile patients from April 2001 to December 2005 was reviewed.According to the extent of tubal and pelvic lesion,the patients were classified as stage Ⅰ in 10 patients,stage Ⅱ in 10,stage Ⅲ in 17,and stage Ⅳ in 6.After a diagnosis was made by hysterosalpinggography(HSG),all the patients received a salpingostomy and adhesionlysis under laparoscope.Results No abnormal findings were detected by hysteroscopy and bilateral tubes were patent after operation in all the 41 patients.The 10 patients at stage Ⅰ were followed up for 12~21 months.Four of them got pregnant in six months and 1 got pregnant in 1 year because of intermittent separation,all the 5 patients being intrauterine pregnancy.The 8 patients at stage Ⅱ were followed up for 12~26 months.Three patients got pregnant,including intrauterine pregnancy in 1 and ectopic pregnancy in 2.The pregnancy occurred at 15,16,and 26 months after operation,respectively.The 17 patients at stage Ⅲ were followed up for 3~48 months.Four had pregnancy,at 3,4,12,and 14 months after operation,respectively,including intrauterine pregnancy in 1 and ectopic pregnancy in 3.The 6 patients at stage Ⅳ were followed up for 12~36 months and no pregnancy was observed.Among the 12 patients with pregnancy,8 got pregnant within 12 months and 3 at 13~18 months after operation,the pregnancy rate within 18 months being 91.7%(11/12). Conclusions Clinical pregnancy outcomes are related with the degree of tubal lesion and adnexal adhesion.Patients at stage Ⅰ~Ⅱ have better pregnancy outcomes than patients at stage Ⅲ~Ⅳ.

Objective To investigate the effects of laparoscopic management of hydrosalpinx on outcomes of in vitro fertilization and embryo transfer(IVF-ET).Methods A total of 53 patients with hydrosalpinx undergoing IVF-ET from 2002 to 2005 were divided into three groups: ①Untreated Group included 17 patients who were given no interventions for hydrosalpinx prior to IVF-ET;②Preoperative Group included 17 patients undergoing laparoscopic treatment of hydrosalpinx prior to IVF-ET;③Postoperative Group had 19 patients who had experienced a history of unsuccessful IVF-ET treatment cycles and received laparoscopic management of hydrosalpinx prior to subsequent IVF-ET cycles.Results The pregnancy rates in fresh IVF cycles,the pregnancy rates in frozen cycles,the mean pregnancy rates per transfer,and the accumulative rate of live fetuses were 15.8%(3/19),10.5%(2/19),13.2%(5/38),and 17.6%(3/17) in the Untreated Group,36.8%(7/19),23.1%(3/13),30.3%(10/32),and 41.7%(8/17) in the Preoperative Group,and 16.7%(2/12),58.3%(14/24),44.4%(16/36),and 73.7%(14/19) in the Postoperative Group,respectively.The pregnancy rates in frozen cycles,the mean pregnancy rates per transfer,and the accumulative rate of live fetuses were all significantly higher in the Postoperative Group than in the Untreated Group(?~2=10.374,P=0.001;?~2=8.903,P=0.003;?~2=11.305,P=0.001,respectively).The mean pregnancy rates per transfer and the accumulative rate of live fetuses in the Preoperative Group tended to higher than those in the Untreated Group(?~2=3.377,P=0.066;?~2=3.360,P=0.067).Conclusions Hydrosalpinx is associated with poor IVF-ET outcomes.Laparoscopic management for hydrosalpinx prior to IVF-ET improves the pregnancy rate of IVF-ET.

Objective This study aims to explore the social support,coping style on depressive mood of infertile patients.Methods 165 infertility patients were collected as the research object,and they were investigated with the self-rating depression scale,social support scale and coping style questionnaire.Results 34.55％,48.48％ of the patients with education background of junior middle school,high school appeared depression.Subjective support and positive coping had significant positive correlation.The availability of support and positive coping had significant positive correlation.Positive coping and depression had significant negative correlation,negative coping and depression had significant positive correlation.Educational level and depression demonstrated inverted U shape relationship; coping style had direct effect and indirect effect on infertile female patients with depression.Conclusions Use of active coping without negative coping can reduce depressive mood,improve patients' social support in order to reduce mental stress level.

Objective To explore the value of real time contrast-enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant adrenal lesions.Methods Totally,57 adrenal lesions (26malignant and 31 benign) underwent conventional ultrasound and real-time CEUS.The enhancement patterns including types of time-intensity curve,centripetal fill-in,homogeneity and intensity of enhancement were analyzed.Results The enhancement pattern of normal adrenal gland was homogeneous,centrifugal and rapid perfusion from the medulla to the cortex.Four enhancement patterns were significantly different between benign and malignant adrenal lesions (P ＜0.05).If enhancement in the early arterial phase and rapid washout was suggestive of malignancy,the sensitivity and specificity of CEUS were 96.2％ and 77.4％,respectively.If peripheral to central filling was suggestive of malignancy,the sensitivity and specificity of CEUS were 76.9 ％ and 80.7 ％,respectively.Conclusions The patterns of real-time CEUS are helpful in differential diagnosis of malignant and benign adrenal lesions.

ObjectiveTo evaluate the diagnosis and surgical management of non-palpable breast cancer (NPBC). MethodsDiagnosis, preoperative localization and surgical management of 26 cases of NPBC were analyzed retrospectively.ResultsAll the 26 lesions were found by ultrasound or mammography.Local-extensive excision was performed under preoperative ultrasound-guided or radio-guided wire localization.Of the 26 lesions, 14 were ductal carcinoma in situ (DCIS), 9 were DCIS with micro-invasion and 3 were invasive ductal carcinoma.ConclusionsCombination of ultrasound and mammography improves the discovery rate of NPBC.Local-extensive excision under preoperative ultrasound-guided or radio-guided wire localization of NPBC shortens the duration of surgical procedure, avoids excessive resection of breast tissues and maintains the apperance of the breast.

Objective To investigate the influence of acupuncture therapy on neural stem cell (NCS) proliferation and differentiation in the hippocampus of the senescence-accelerated prone-8 (SAP8) mouse. Methods Twenty-four SAP8 mice were randomly and equally divided into a model group and an acupuncture group. Twelve senescence-accelerated resistant ( SAR1 ) mice served as the control group. Acupuncture was administered at the Baihui (DU20) point to mice in the acupuncture group once daily for 21 consecutive days. Bromodeoxyuridine (BrdU) was used to detect the proliferation and differentiation of NCSs in the hippocampus through double-labeled immunofluoresSAR1 group, the positive cells in the SAP8 group were significantly fewer Compared to the SAP8 group, positive cells markers of neuron or glia cell positive cells appeared. Compared to the SAR1 group, the expression of BrdU/GFAP increased in the SAP8 group, and decreased after acupuncture but not significantly. BrdU/S-100 β cells decreased significantly in the SAP8 group, and increased after acupuncture, but again not significantly. Compared to the SAR1 group BrdU/GalC positive cells increased significantly in the SAP8 group and decreased significantly after acupuncture.Conclusions After acupuncture treatment for 21 days, the differentiation of hippocampal NSCs into oligodendrocytes was inhibited, but there was little effect on their differentiating into neurons and immature astrocytes.

Objective To analyze the clinical outcomes of patients treated with in vitro fertilization and embryo transfer (IVF-ET) and influence factors of pregnancy rate. Methods We retrospectively analyzed the clinical data of 12 491 cycles, including 6832 fresh IVF/intracytoplast single sperm injection (ICSI) cycles and 5659 frozen embryo transfer (FET) cycles from 2005 to 2007. Results The clinical pregnancy rate per cycle was 32. 99% (2254/6832)in fresh embryo transfer program, and the live birth rate was 25.75% (1394/5413); the early pregnant loss rate was 9. 36% (211/2254), and the prenatal defect rate was 1.45% (25/1722). Through analysis of these patients' basic data, we found that the patients' age, causes for infertility, egg retrieval and cycle number affected the pregnancy rate. Using logistic regression method, we found that patients′ age was the most important factor affecting pregnancy outcome. In FET cycles, the clinical pregnancy rate was 38.08% (2155/5659), significantly higher than fresh embryo transfer cycles. Conclusions IVF-ET treatment is a safe and effective method for infertility couples. However, the female age and poor ovarian response are the main factors affecting pregnancy rate. Thawed embryo transfer can increase the accumulated pregnancy rate effectively.

Objective To investigate the role of FTY720, an agonist of the sphingosine 1-phos-phate (S1P) receptor, in acute graft-versus-host disease (aGVHD) caused by allogeneic hematopoietic stem cell transplantation and to further elucidate its possible mechanism .Methods BALB/c ( H2 d ) recipient mice were given whole body lethal irradiation (750 cGy) for 4 hours.A mouse model of aGVHD was estab-lished by intravenously injecting recipient mice with 1×107 C57BL/6 (H2b) mice derived bone marrow cells (BMCs) and 5×106 whole splenic cells.FTY720 (3 mg/kg) was intraperitoneally injected into recipient mice from the day before allogeneic bone marrow transplantation ( allo-BMT) to day 4 thereafter to monitor the survival rate .The mice in control group were perfused with equal volume of control reagent .Fluores-cence-activated cell sorting ( FACS) was used to analyze the phenotypes of immune cells in spleen , liver, lung as well as intestines of mice on the fourth day of allo-BMT with or without FTY720 treatment. Results FTY720 significantly prolonged overall survival in mice with allo-BMT induced aGVHD .FACS analysis showed that FTY720 significantly inhibited the distribution of matured dendritic cells ( DCs) in lung and small intestines .Conclusion FTY720 could significantly alleviate the symptom of aGVHD in mice re-ceived allogeneic hematopoietic stem cell transplantation .The possible mechanism might be associated with the inhibited distribution of matured DCs in lung and intestines .

Objective To build the relationship model of childhood aubuse, personality, insecurity and dissociative trait in medical students. Methods Through stratified sampling,262 medical students were investiga?ted by the Personal Report of Childhood Abuse( PRCA) ,Dissociative Trait Scale( DTS) ,Self?Rating Feeling of In?security Scale( SRFIS) ,Revised NEO Five?Factor Inventory( NEO?FFI?R) . A path analysis was applied by AMOS (Analysis of Moment Structures) version 7.0. Results ①Childhood abuse was positively related to insecurity, dissociative trait and neuroticism( r=0.248~0.361, P<0.01) ,but was passively related to extraversion,agreeable?ness and conscientiousness( r=-0.168~-0.250, P<0.01). Insecurity was positively related to dissociative trait and neuroticism( r=0.479~0.522, P<0.01) ,but was passively related to extraversion,agreeableness and conscien?tiousness( r=-0.234~-0.324, P<0.01). Dissociative trait was positively related to neuroticism( r=0.597, P<0.01) ,but was passively related to openness, extraversion, agreeableness and conscientiousness ( r=-0. 133~-0.453, P<0.05). ②The path analysis showed that childhood abuse was directly related to insecurity(B=0.339, P<0.01)and personality(B=-0.226, P<0.01)of medical students. Personality was directly related to insecurity and dissociative( B=-0.609~-0.363, P<0.01) . Insecurity was directly related to dissociative trait( B=0.448, P<0.01) . Personality and insecurity mediated entirely the relationship between childhood abuse and dissociative trait of medical students. The model fit indexes were χ2/ df =1.151<3.000, P=O.080>0.05,RMSEA=0.024<0.050, GFI=0.935,AGFI=0.909,NFI=0.923,RFI=0.902,IFI=0.989,TLI=0.986 and CFI=0.989. Conclusion Per?sonality and insecurity as mediated variable mediate the relationship between childhood abuse and dissociative trait of medical students. Childhood abuse has no direct effect on dissociative trait of medical students.