Objective To compare perinatal outcomes of the singleton and twin pregnancies , and explore risk factors associated with twin pregnancies. Methods The data of 1 026 patients in single and twin pregnancies treated with IVF/ICSI between January 2014 to March 2015 were retrospectively analyzed. Results The early miscarriage rate and early pregnancy loss rate in the singleton group was significantly higher than the twin group (16% vs 5.41%; 16% vs 6.98%) and the late abortion rate in the singleton group was significantly lower than the twin group (1.93% vs 7.12%), but the total pregnancy loss rate was not significantly different between the groups. The premature delivery rate in the twin group was significantly increased (9.19% vs 41.89%), the term taking-baby-home rate was significantly lower (56% vs 37.89%), but the total taking-baby-home rate was significantly higher in the twin group than the singleton group. The low weight delivery rate in the twin group was significantly increased (1.2% vs 14.8%), but the rate of birth defects was no significantly different between the groups. There were significant differences in age and number of embryo transfer between the two groups. Conclusions Twin pregnancies may increase the risk of late abortion and premature delivery and low weight delivery significantly. Age and number of embryo transfer may be the risk factors for twin pregnancies.

OBJECTIVE:To provide reference for the rational utilization of narcotic drugs in cancer pain patients. METH-ODS:In retrospective survey,2275 prescriptions of narcotic drugs for cancer pain patients in outpatient and emergency depart-ment of our hospital during 2014-2016 were analyzed statistically in respects of general information,drug amount,consumption sum and DDDs,etc. RESULTS:The proportion of male patients and female patients with cancer pain in our hospital were 65.63%and 34.37% within 3 years,mainly aged 21-90. The consumption amount and sum of narcotic drugs in our hospital increased year by year. Dosage forms were mainly tablet. The consumption amount,sum and DDDs of Morphine hydrochloride sustained-release tablets took up the first places among narcotic drugs. And those of Pethidine hydrochloride injection were the lowest. CONCLU-SIONS:The utilization of narcotic drugs is rational in outpatient and emergency department of our hospital on the whole. Morphine preparations are the predominant analgesic drugs for patients with cancer pain.

Objective To study the effects of parthenolide on osteoclast differentiation of RAW264. 7 cell induced by receptor activator of nuclear factor κB ligand (RANKL). Methods The mouse macrophage RAW264.7 cells induced by RANKL was used alone as the control group, different concentrations of par-thenolide (0.5, 1, 2 μmol/L) were added to culture the RAW264.7 cells. On the third, fifth and seventh day, the tartrate resistant acid phosphatase (TRAP) staining method was used to detect osteodast-like cells and the cell number was count;the contents of tartrate resistant acid phosphatase (TRAP5b) in the Culture supernatant of each groups were detected by enzyme linked immunosorbent assay (ELISA) and the expression of osteodast marker gene alcitonin receptor (CTR) and matrix metalloproteinase (MMP)-9 in each groups were detected by realtime-polymerase chain reaction (PCR) on the seventh day. We use Chi-square test and t test to test the differences between groups by SPSS 17.0. Results In different culture conditions, RANKL could always induce the RAW264.7 cell differentiate into mature osteoclasts. Compared with the control group at the same time control group, on the third, fifth and seventh day, he number of mature osteoclasts induced were obviously decreased in groups adding different concentration of PAR; the number of induced osteoclasts decreased along with the increase of parthenolide concentration, on the seventh day in 0.5, 1, 2 μmol/L concentration PAR groups, the number of mature osteoclasts compared with the control group were descended 36.3%, 40.8%, 49.3%(t=7.758, 8.742, 10.56;P<0.05);the contents of TRAP5b in the culture supernatant were consistent with the cell counting results on the seventh day (P<0.05). The expression of CTR and MMP-9 by TRAP positive osteoclasts decreased along with the increase of parthenolide concentration, and the 2 μmol/L group was the lowest. Compared with the control group, there were statistically significant differences with the different PAR concentration groups 0.5, 1, 2 μmol/L (P<0.05). Conclusion Parthenolide can inhibit RANKL induced RAW264.7 differentiation into osteoclast cells, and the inhibition is dose dependent.

Objective To analyze the clinical effect through 20 adult atrial septal defect repair cases with totally thoracoscopic and summarize the experience of totally thoracoscopic cardiac surgeries.Methods From March 2014 to August 2016, 20 adult atrial septal defect cases repaired by totally thoracoscopic were enrolled in the study. Extracorporeal circulation was established by inserting artery pump tubes into the right femoral artery and vein tubes in to the right femoral vein, cold blood cardioplegia was perfused ante gradely through the aortic root in order to protect the myocardium, then atrial septal defect repair cardiac surgeries were implemented by perforating 3 holes through the right chest wall. Analyze the operation time, aortic cross clamping time, CPB time, amount of drainage, hospital stay, postoperative complications and so on.Results The operation time was 3.5~5.0 h, and the average level was (3.8 ± 0.5) h. The blocking duration of the ascending aorta ranged from 28 to 46 min, and the average level was (29.8 ± 8.2) min. The duration of extracorporeal circulation ranged from 86 to 108 min, and the average level was (80.6 ± 11.5) min. Ventilation time ranged from 5 to 8h, and the average level was (6.0 ± 0.8) h. The amount of thoracic drainage ranged from 100 to 260 ml, and the average level was (150.0 ± 35.0) ml. Hospital stay ranged from 6 to 9 days, and the average level was (6.5 ± 1.2) days. All the operations were completed successfully. There were no in-hospital death or serious post-operative complications. UCG performed 3~5 days after the operation revealed surgical results were satisfactory. Follow up to 1~28 months were available in all cases. During the period, the heart function was conifrmed asⅠ level.Conclusion Adult atrial septal defect repair surgeries with totally thoracoscope is safe and reliable and have advantages of less injury, rapid discovery, light pain, and less postoperative drainage.

In this study, we compared the three-point bending test of the metaphyseal tibia versus the three-point bending test of the diaphysial tibia in rats. Twenty 6-month-old female Sprague-Dawley rats were randomly divided into the ovariectomized (OVX) group and the sham-operated (Sham) group. All rats were housed in standard environmental conditions. Five months after operation, all rats were sacrificed by depletion method. All left tibia were removed for the three-point bending test. The changes of mechanical parameters were examined by the three-point bending test of the metaphyseal tibia and by that of the diaphysial tibia. Elastic, Maximum Load, Maximum Stress, Failure Load, and Failure Stress of the metaphyseal tibia were much lower in OVX rats than in Sham rats. However, there was no statistically significant difference in all of the mechanical parameters of the diaphysial tibia between the OVX group and the Sham group. The new three-point bending test of the metaphyseal tibia is much more sensitive and useful as compared with the test of the diaphysial tibia in evaluating the changes of mechanical properties of tibia in osteoporotic rats.
Animals ; Biomechanical Phenomena ; Bone Density ; physiology ; Female ; Osteoporosis ; pathology ; physiopathology ; Ovariectomy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tibia ; physiology

This study was aimed at observing the effects of ovariectomy and estradiol on the microarchitecture of cancellous bone and exploring the influence of microarchitectural change on the biomechanical properties. Thirty 6-month-old unmated female SD rats were randomly divided into 3 groups (10 rat each): sham-operated control group (Sham), ovariectomized group (OVX)and Estradiol Benzoate treated group (EBT). All rats were housed in standard environmental conditions. Five months after operation, the rats were sacrificed. The biomechanical properties of the third lumbar vertebras (L3) were measured with compression testing in vitro. Micro-CT scanning was performed on the fourth lumbar vertebras (L4) in vitro. In comparison with the corresponding variables of Sham, the bone volume fraction (BV/TV) and the trabecular number (Tb. N) of OVX were reduced remarkably, and the trabecular separation (Tb. Sp) and the structural model index (SMI) of OVX were enhanced obviously. These facts implicated that the bone trabecular plate-like structure of OVX were decreased. BV/TV, Tb. N and the trabecular thickness (Tb. Th) of EBT were greater than those of OVX. Tb. Sp and SMI of EBT were much smaller than those of OVX. The results of mechanical test showed that the maximum forioe (Fmax), the maximum stress (sigmamax) and the elastic modeulus (E) of the lumbar vertebral cancellous bone of OVX were declined sharply, while the aforesaid biomechanical index of EBT was improved distinctly. The performance of three-dimensional micro-CT and the mechanical testing to assess microarchitecture of cancellous bone are useful for evaluating the state of osteoporosis and the antiosteoporotic effect of agents.
Animals ; Biomechanical Phenomena ; Estradiol ; pharmacology ; Female ; Imaging, Three-Dimensional ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; Osteoporosis ; pathology ; Ovariectomy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tomography, X-Ray Computed

Objective To systematically evaluate the efficacy and safety of immune checkpoint inhibitors in the treatment of advanced gastric cancer or gastroesophageal junction cancer (GC/GEJC). Methods CNKI, Wanfang, PubMed, EMBASE, ClinicalTrials, Cochrane Library and other databases were searched to collect the clinical trials of immune checkpoint inhibitors in the treatment of advanced GC/GEJC. The retrieval time was from the inception to Nov. 2019. Outcome measures mainly included ORR, DCR, PFS, OS and toxicities. The adoption rate difference and hazard ratio were effect measures. Meta-analysis was performed using RevMan 5.3 software. Results We included seven literatures with a total of 1949 patients. Meta-analysis showed that for the patients with advanced GC/GEJC, the second-line or later immune checkpoint inhibitor therapy improved the overall survival rate at 12 and 18 months; the OS of the patients was prolonged, compared with chemotherapy/placebo therapy (all P < 0.05). The incidence of adverse reactions of any grade or ≥grade 3 caused by immune checkpoint inhibitor therapy was lower than that caused by chemotherapy/placebo. Conclusion Immune checkpoint inhibitor treatment could improve survival endpoints in some patients with advanced GC/GEJC, and the incidence of common adverse reactions is low.

Objective:To investigate the protective effect of hyperbaric oxygen therapy(HBOT)on myocardial fibrosis and oxidative stress induced by D-galactose(D-gal)in senescent model mice and its possible mechanism.Methods:Three-month-old male Kunming mice(n=27)were randomized into control, D-gal, and D-gal + HBOT groups.The control group received subcutaneous sterilized saline(5 ml · kg -1· d -1)for 8 weeks; the remaining 2 groups received subcutaneous D-gal(200 mg · kg -1· d -1)for 8 weeks. The D-gal + HBOT group underwent HBOT intervention at week 7~8.At the end of the experiment, the histopathological changes were analyzed by hematoxylin-eosin(HE)staining, and the fibrosis changes were analyzed by Masson staining and Sirius red staining.Oxidative stress kit was used to detect catalase(CAT), total superoxide dismutase(T-SOD)activity and malon-di-aldehyde(MDA)content in serum of mice.Western blotting was used to detect the expression levels of the aging-related proteins p53 and p16 in mouse heart tissue, the heart-function-related proteins atrial natriuretic peptide(ANP)and brain natriuretic peptide(BNP), and the oxidative stress-related protein superoxide dismutase 1(SOD1), superoxide dismutase 2(SOD2)and catalase(CAT). Results:Cardiac morphologic staining indicated that as compared with the control group, mice of D-gal group exhibited features of senescence and the increased fibrosis area, and senescence and fibrosis were obviously improved after HBOT intervention as compared with the D-gal group.The findings of the oxidative stress kit measurement indicated that as compared with the control group, the D-gal group had markedly decreased activities of CAT and T-SOD, significantly increased MDA content in the serum.After HBOT treatment, as compared with d-gal group, serum CAT and T-SOD activities were increased, while MDA content was decreased( F=126.85, 32.89, 157.50, all P<0.05).Furthermore, as compared with the control group, the D-gal group had obviously increased contents of p53, p16, ANP and BNP, while the content of CAT, SOD1 and SOD2 were obviously decreased.After HBOT intervention, as compared with the D-gal group, the contents of p53, p16, ANP、BNP were reduced, while the content of CAT, SOD1 and SOD2 were increased( F=36.37, 14.81, 23.28, 58.41, 12.79, 80.08, 6.63, all P<0.05). Conclusions:HBOT intervention could protects against cardiac injury in aging mice, which may be related to attenuating myocardial fibrosis, inducing the expression of antioxidant enzymes, and reducing oxidative stress.

Objective To investigate the clinical diagnostic value of serum procalcitonin(PCT),D-dimer (DD),C-reactive protein(CRP)in acute-on-chronic liver failure(ACLF). Methods 124 ACLF patients, 63 chronic hepatitis B patients,32 chronic hepatitis C patients,24 chronic hepatitis E patients and 60 healthy controls from the second affiliated hospital of Nanchang University were enrolled in this study.PCT was detected by a sandwish immunodetection method. D-dimer was detected by Latex Turbidimetry. CRP was detected by rate nephenometry. The detection results were used for analyzing the clinical diagnostic value of ACLF with infection. Results(1)The level of PCT,DD and CRP in ACLF group were significantly higher than non-ACLF group and healthy controls(P<0.05).The levels of PCT,DD and CRP in the infection group were significantly higher than non-infection group(P<0.05).(2)The positive rates of PCT,DD and CRP in the infection group were 93.24%, 78.38%,89.19%,which were significantly higher than the non-infection group and healthy controls respectively (P < 0.05).(3)The sensitivity(93.24%)and specificity(90.00%)of PCT were the highest among all indexes. (4)The area under the ROC curve of PCT,DD,CRP were 0.892,0.715,0.755,respectively.PCT had the highest diagnostic value. Conclusion The levels of serum PCT,DD and CRP have a significant clinical value for the early diagnosis of ACLF with infection.

OBJECTIVE：To eval uate the effect of pharmacists intervention on opioid treatment and management in outpatients with cancer pain under multidisciplinary team （MDT）mode. METHODS ：Totally 120 outpatients with cancer pain were selected from outpatient department of our hospital from Jan. 2016 to Dec. 2018，and divided into observation group and control group according to random number table method ，with 60 cases in each group. After 1 month follow-up ，patients in the control group were given opioid analgesics and routine intervention according to pain degree ，while patients in the observation group were given same treatment as control group and pharmacist intervention based on MDT. The pain condition ，medication compliance condition ， quality of life （QOL）score，the incidence of ADR and satisfaction degree were observed in 2 groups before and after intervention . RESULTS：Follow-up were completed in 2 groups. After intervention ，NRS scores of 2 groups were significantly lower than before intervention；the observation group was significantly lower than the control group ；medication compliance scores and QOL scores of 2 groups were significantly higher than before intervention ，the observation group was significantly higher than the control group at the same time . With the prolongation of treatment time ，the number of patients with mild pain and general medication compliance in 2 groups increased gradually ，and the observation group were significantly higher than the control group at the same time；the number of patients with moderate , severe pain and low medication compliance were significantly decreased gradually ， and the observation group was significantly lower than the control group at the same time. The number of patients with good medication compliance in the observation group was significantly higher than that in the same group before intervention and the control group at the same time （P＜0.05 or P＜0.01）. There was no significant difference in the incidence of ADR between 2 groups（P＞0.05）. The satisfaction of pain control results ，doctors’treatment and pharmacists follow-up in the observation group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Under MDT mode ，pharmacists participating in the management of opioid treatment for cancer pain outpatients can effectively relieve the pain ，and improve the medication compliance and quality of life .