Applying mitochondrial replacement technique to human assisted reproduction could benefit the fam-ilies with mitochondrial diseases and improve clinical outcomes of assisted reproduction in elderly patients. But it may also lead to a series of medical ethics issues such as the standardization and security of this technology, the conflict with the traditional ethical concepts, the determination of informed consent and confidentiality principles, the health development issues of the offspring, and commercial donation of eggs and so on. As for this, the relevant institutions should strictly control the indications when apply this technology, the government should formulate rele-vant laws and regulations. Simultaneously, it is important to strengthen supervision and management of social eth-ics, improve professional ethics of assisted reproductive personnel, and emphasize the correct guiding role of public opinion.

Objective To compare the advantages of three-dimensional(3D) and two-dimensional(2D) ultrasound in embryo transfer. Methods A total of 319 patients accepted embryo transfter were included in this study. 2D and 3D ultrasound were used to investigate the uterine cavity and transfer distance from the fundus (TDF),respectivly. They were divided into four groups according to TDF difference(D-TDF) between 2D and 3D ultrasound(group of DTDF<3mm,group of DTDF3～5mm,group of 6～9 mm,group of DTDF≥10 mm. Pregnancy outcomes among the four groups were compared. Results Of the 319 patients, 41 were observed to have abnormal uterine cavity. For 140 patients, the TDF measured by 2D ultrasound were different from that measured by 3D ultrasound. Clinical pregnancy rate and implantation rate were found lowest in group of TDF≥10 mm mm (7.7% vs 34.1%,38.1% ,40.0% and 3.6% vs 18.2% ,21.2% ,20.0%, P <0.05). Conclusions 2D ultrasound is limit and deficient for embryo transfer, especially for the visualization of uterine cavity and location of catheter tip, however, it may be better achieved with 3D ultrasound. It is helpful to use the 3D ultrasound to place the catheter tip accurately and improve the pregnancy rate of embryo transfer.

Objective To assess the usefulness of left ventricular contrast echocardiography in diagnosis of left ventricular myocardium noncompaction.Methods Contrast echocardiography was done in ten patients who were diagnosed or suspected with left ventricular noncompaction by common transthoracic echocardiography,for further study of the trabecular muscles extent,the continuity of the endocardium,the compact myocardium thickness,and the contrast agent in the trabecula recessus.Results By contrast echocardiography,noncompaction myocardium thickness can be perspicuously observed,the turgor of the contrast agent was vividly detected in the trabecular recessus.Especially for the measurement of compaction myocardium,the contrast echocardiography was more accurate than in the condition of the common echocardiography.Conclusions Left ventricular contrast echocardiography can be used in the diagnosis of left ventricular noncompaction,it was a good added method of conventional echocardiography.

0.05), but LA patients had less postoperative pain,less time to ambulation after operation, less time to food intake after operation, less average length of hospital stay,less rate of incision infection and less intestinal adhesion than OA did(all P

Objective To explore the effect of experimental design in the experimental teaching of fundamental nursing. Methods 168 and 199 baccalaureate nursing students were in the control and experimental group respectively, the control group received traditional experimental teaching method, and the experimental group must complete the experimental design before entering the lab. The teaching effect between the two groups were compared. Results The mean operation score of the experimental group was significantly higher than the control group, the proportion of those students who reflected their teaching method could enhance creative ability, problem-solving ability and practical ability was higher in the experimental group, 100% teachers reflected experimental design could improve operation level, strengthen theoretical knowledge, animate teaching atmosphere. Conclusions Experimental design could arouse students' enthusiasm and initiative to study, advocate them to think and ask.

Objective To investigate the influencing factors for left atrial appendage (LAA) spontaneous echo contrast (SEC) or thrombosis in patients with non-valvular atrial fibrillation(NVAF) and normal left ventricular ejection fraction(LVEF).Methods This study prospectively enrolled 255 patients with NVAF [paroxysmal atrial fibrillation(PaAF) 196 cases and persistent atrial fibrillation(PeAF) 59 cases].Patients were divided into two groups according to the findings on transesophageal echocardiography (TEE):positive group with the presence of the LAA SEC or thrombosis (group Ⅰ) and negative group (group Ⅱ) without this two presences.The clinical and echocardiographic data were compared between the two groups.The multivariate logistic regression analysis was used to explore the independent risk factors for development of LAA SEC or thrombosis.Receiver operating characteristic (ROC) curve was performed to determine the predictive value of the factors.Results A total of 255 patients were enrolled.There were 26 cases(10.2％) in group Ⅰ,and 229 cases (89.8％) in group Ⅱ.The age,NT-proBNP,occurrence rate of PeAF,left atrial volume index(LAVI),and LAA orifice long diameter and depth were higher in group Ⅰ than those in group Ⅱ (all P ＜0.01).The left atrial appendage emptying velocity(LAAV),global left atrial longitudinal strain(GLALS) and LVEF were lower in group Ⅰ compared with those in group Ⅱ (all P ＜ 0.01).Multivariate logistic regression analysis and ROC curve showed that GLALS＜12.2％ and LAAV＜ 31.2 cm/s were independent risk factors of LAA SEC or thrombosis in patients with NVAF and perserved LVEF.Conclusions The impairment of left atrial and LAA function are potential risk factors for cardiogenic embolism.GLALS and LAAV can be used as useful referenced parameters for prediction of stroke in patients with NVAF.

[Objective] To evaluate the effect of hydromorphone for postoperative analgesia on residual carbon dioxide during recovery after laparoscopic colorectal surgery.[Methods] A total of 100 patients performed with elective laparoscopic colorectal surgery were randomly allocated into two groups according to different patient controlled intravenous analgesia (PCIA) formula:Group H contained hydromorphone 8 mg and Group M contained morphine 40 mg.Total PCIA volume was 100 mL saline with loading volume 2 mL,background volume 2 mL/h,and lockout time was set on 15 min.Analgesia infusion pump was used in the two groups half an hour before the end of surgery.Surgery time,pneumoperitoneum time,anesthesia time,extubation time,recovery time and retention time in postanesthesia care unit (PACU) were rccordcd,rcspcctively.PaCO2,the pain Visual Analogue Scale (VAS) score,Ramsay sedation score,at 30 min (T0) after pneumoperitoneum,extubation time (T1),30 min (T2),1 h (T3),2 h (T4),and 24 h (T5) after extubation,the times of PCA compressions were recorded.Anesthesia complications during waking-up period such as postoperative nausea and vomiting (PONV),shoulder pain,hypersomnia,pruritus and satisfaction degree after surgery were also recorded.[Results] Compared with group H,PaCO2 was higher at T2 ～ T4 (P ＜ 0.05);Recovery time,extubation time and the retention time in PACU were longer after surgery (P ＜ 0.05);The incidence of postoperative nausea and vomiting,shoulder pain were higher in group M (P ＜ 0.05).Compared with group M,VAS score at T1 ～ T3,and Ramsay sedation score T1 ～ T4 were decreased in group H (P ＜ 0.05).[Conclusion] Compared with morphine,hydromorphone can increase fewer residual carbon dioxide during recovery and fewer side effects for the patients caused by that after laparoscopic colorectal surgery.Hydromorphone was a safer and more effective analgesic for postoperative analgesia than morphine.

Objective To explore the application range and preponderance of different therapeutic methods of traditional medicines in overseas countries with retrospective studies on bibliographies of overseas traditional medicines. Methods All bibliographies were articles written in August 1964 to September 2009 and came from MEDLINE data base through searching 17 inferior words of"replacement therapy" in MeSH subject headings. Results We got altogether 10103 articles in 1633 kinds of periodicals concerned with replacement therapy, and summed up to 9841 effective articles in the end. Conclusion More and more attentions have been paid to traditional medicine in overseas countries; Such kinds of articles were mostly published in American and British medical periodicals; articles with advanced technologies and high reliability have more chances to be adopted by medical periodicals; traditional Chinese medicine plays a leading role in the fields of traditional medicines in the whole world; replacement therapy were increasingly adopted to deal with disease protection and health care.

Objective To evaluate the ability of high resolution pleuropulmonary ultrasonography and bedside chest X-ray in identifying different pathologic abnormalities in patients with dyspnea,using thoracic computed tomography (CT) as a gold standard.Methods Bedside pleuropulmonary ultrasonography was performed in 350 dyspneic patients in the emergency department and ICU,111 patients were enrolled in the study with pleuropulmonary ultrasonography,chest X-ray and chest CT examination performed within 24 hours.Pathologic entities were evaluated:pleural effusion,consolidation,atelectasis,pneumothorax,pulmonary interstitial fibrosis,and pulmonary edema.The sensitivity,specificity,negative and positive prediction value of pleuropulmonary ultrasonography and chest X-ray were compared with the corresponding CT scan results.Results Pleuropulmonary ultrasonography was highly concordant with chest X-ray.Overall ultrasonography exhibited higher sensitivity than chest X-ray and CT for pleural effusion.For atelectasis and pulmonary edema,the sensitivity of ultrasonography was up to 100%.In the diagnosis of pulmonary interstitial fibrosis,the sensitivity of pleuropulmonary ultrasonography was higher than that of chest X-ray,but the specificity was slightly lower.The sensitivity of pleuropulmonary ultrasonography was slightly higher than that of chest X-ray in pneumothorax,and the specificity was coincident with chest X-ray.Although the sensitivity of ultrasonography was slightly lower for consolidation,it was still higher than chest X-ray.The ability of chest X-ray for differentiating pleural effusion from atelectasis or consolidation was worse than that of ultrasonography.Conclusions Our study demonstrates a high concordance between ultrasonography with radiography.The diagnostic performance of bedside pleuropulmonary ultrasonography is better than that of chest X-ray.

Objective To evaluate the lung protection of remote limb ischemic preconditioning during one-lung ventilation (OLV) in the patients undergoing esophageal cancer resection.Methods Seventyone patients of both sexes,aged 30-64 yr,with body mass index of 15-28 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective esophageal cancer resection,were randomly divided into control group (group C,n =34) and remote limb ischemic preconditioning group (group RLIP,n =37) using a random number table.Patients in group RLIP received three cycles of 5-min ischemia/5-min reperfusion induced by a blood pressure cuff placed on one upper arm before OLV.Before OLV (T0),at 1 and 2 h of OLV (T1,2),at 20 min after re-expansion of the collapsed lung (T3),and at 2 h after operation (T4),blood samples were drawn from the radial artery for blood gas analysis,oxygenation index (PaO2/FiO2) and alveolar-arterial oxygen gradient (A-aDO2) were calculated.At T0,T2,T3 and T4,blood samples were collected from the radial artery for determination of plasma tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6),and IL-10 concentrations.Results Compared with group C,PaO2/FiO2 was significantly increased,and A-aDO2was decreased at T1,2,the plasma TNF-α concentrations were decreased at T2-4 (P＜0.05),and no significant change was found in the plasma IL-6 and IL-10 concentrations and rate of abnormal pulmonary function at T1-4 in group RLIP (P＞O.05).Conclusion Although remote limb ischemic preconditioning can produce lung protection during OLV in the patients undergoing esophageal cancer resection,it provides no clinical significance.