Objective To investigate the pregnancy outcomes of in vitro fertilization (IVF) and embryo transfer (ET) in infertile women with polycystic ovarian syndrome (PCOS).Methods From August 2005 to June 2011,200 IVF-ET cycles performed in women with polycystic ovarian syndrome in Shengjing Hospital and Shenyang 204 Hospital were enrolled in this retrospective study,matched with 400 IVF-ET cycles in infertile women with fallopian tube factors as control group.The incidence of abortion,gestational diabetes mellitus (GDM),hypertensive disorders in pregnancy,preterm birth,small for gestational age infant(SGA),large for gestational age infant (LGA),neonatal asphyxia,neonatal death and deformity was compared between two groups.Results The incidence of spontaneous abortion was 26.0％ (52/200) in PCOS group,which was significantly higher than 10.2％ (41/400) in control group (P ＜ 0.05).The incidence of GDM,hypertensive disorders in pregnancy,preterm birth,cesarean section in PCOS group was 23.6％ (35/148),16.2％ (24/148),17.6％ (26/148),83.1％ (123/148),which were significantly higher than 4.2％ (15/359),6.1％ (22/359),7.8％ (28/359),73.8％ (265/359) in control group (P ＜0.05).The incidence of SGA,LGA,neonatal asphyxia,neonatal death and deformity did not show remarkable difference between two groups,which were 2.7％ (4/148),4.7％ (7/148),5.4％ (8/148),0 in PCOS group and 1.4％ (5/359),2.2％ (8/359),2.8％ (10/359),0 in control group (P ＞0.05).Conclusion IVF-ET is an effective treatment for infertile women with PCOS,however,the incidence of spontaneous aborcion,GDM,hypertensive disorders in pregnancy,preterm birth,cesarean section in PCOS patients was increased.

Objective To systematically evaluate the effectiveness of intermittent nasogastric feeding on enteral nutrition of critical patients. Methods The relevant randomized controlled trials were searched in the Cochrane Library, PubMed, EMbase, Web of Science, JBI Library and the databases of China National Knowledge Infrastructure (CNKI), China Scientific Journal Database by VIP (VIP), Wanfang Database. The studies were selected according to the inclusion and exclusion criteria by two reviewers. Meta- analysis was conducted by using RevMan 5.2. Results Nine RCTs were included involving 558 patients. The results of meta- analysis showed that intermittent nasogastric feeding was greater than continuous pump feeding in the incidence of constipation, OR=0.32, 95%CI 0.14~0.71, P<0.05, the difference was significant. However, they were alike in the incidences of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and effects of nutrition, there was no statistical difference (P>0.05). Conclusions Intermittent nasogastric feeding and continuous pump feeding did not affect the incidence of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and the effects of nutrition. However, the incidence of constipation was significantly less in patients receiving intermittent nasogastric feeding.

To review the scientific evidence of system management for lung cancer patients with cancer- related fatigue by the method of literature review and evaluate researchers on authenticity, importance and applicability, in order to improve the nursing quality and the quality of life of them. Interventions of lung cancer patients with cancer- related fatigue mainly includes: non- drug intervention, drug intervention and self- management. The use of intervention measures should be combined with the situation of the patients. however, many of the effectiveness of the intervention measures not sure, need large sample randomized controlled trial verifies the results .

Objective: To denvolop HPLC an method for the determination of the content of three saponins in Zhixiao suppositories. Methods: Analysis carriedout was performed on a Kromasil C18 column (4.6 mm×250 mm., 5μm)at 23℃. The mobile phases were methanol and 0.2% phosphoricacid solution in a gradient elution. The flow rate was set at 1.0 mL·min-1 and the ultraviolet detector was operated at 203 nm. Results: The linear ranges of notoginsenoside R1, ginsenoside Rg1 and ginsenoside Rb1 were 0.368～2.76μg,0.676～5.07 μg and 0.812～6.09μg,respectively. The average recoveries of the three saponins were 98.53%, 99.20% and 99.35%, respectively. The RSD (n=5) were 2.11%, 1.88% and 2.38%, respectively. Conclusion: The separation is a good and the results are accurate and reproducible. It can be used for the quality control of Zhixiao suppositories.

The purpose of this study was to clarify the strains of E .granulosus from sheep of Xiwuqi and people of Xil-inhot in Inner Mongolia region and its genotypes .CO1 and ND1 of mitochondria gene were cloned and sequenced ,and then they were analyzed by MegAlign of DNAStar5 .0 .Results showed that the length of CO1 and ND1 gene of E .granulosus ,which were from sheep of Xiwuqi or people of Xilinhot ,were 936 bp and 895 bp ,respectively .The homology of CO1 gene sequences of E .granulosus strains from Xiwuqi and Xinjiang was 99 .3% ,while the homology of the corresponding gene sequences of E .granulosus from man of Xilinhot City and Xinjiang were 98 .6% .ND1 gene of E .granulosus of sheep from Xiwuqi and hu-man from Xilinhot were identical to ND1 gene of G1 type .All these indicated that the homology of E .granulosus from the two regions were high and the genotype were G1 type ,which provided an important basis for the determination of strains ,and it al-so had a great significance to prevent and control the disease .

Objective To evaluate the efficacy and safety of domestic human recombinant FSH (rhFSH) in women with anovulation of WHO groupⅡ. Methods A randomized, blind, parallel-controlled, non-inferiority and multicenter study was performed. A total of 534 admitted to 13 hospitals from May 2008 to August 2009. There were 531 women with ovulatory disorder was included in the statistical analysis, were randomly divided into test group (domestic rhFSH, n=352) and control group (imported rhFSH, n=179). Percentage of cycle with mature follicle, ovulation rate, clinical pregnancy rate, multiple pregnancy rate, ovarian hyperstimulation syndrome (OHSS) and adverse events were observed. Results No statistical significant differences (P>0.05) were observed between the two groups in terms of the efficiency on mature follicle [91.8%(323/352) versus 88.8%(159/179)], ovulation rate [91.3%(295/323) verus 90.6%(144/159)], clinical pregnancy rate [19.2%(62/323) verus 18.2%(29/159)], the number of the follicles<14 mm, the level of serum LH and progesterone, the thickness of endometrium on the day of hCG administration. The number of follicle≥18 mm and 14 mm≤follicle<18 mm and the level of serum estradiol on the day of hCG in the test group were significantly higher than those in the control group (P<0.05). The number of days of rhFSH administration in the test group was significantly less than that in the control group [(9.8±2.2) versus (11.4± 0.6) days, P<0.05], the dosage of rhFSH was significantly lower than that in the control group [(879 ± 419) versus (1 043 ± 663) U, P<0.05]. The multiple pregnancy rate in the test group was significantly higher than that in the control group [21% (13/62) versu 10% (3/29), P<0.05]. The incidence of OHSS and adverse events were similar between the two groups (P>0.05), and no other adverse events were observed in test group during treatment. Conclusion Ovarian stimulation with domestic rhFSH is effective, safe and economical in women with anovulation of WHO groupⅡ.

We constructed bicistronic expression system containing AH6 promoter, 5' UTR and its fore 38 bp sequence from Corynebacterium glutamicum, followed by a conserved Shine-Dalgarno (SD) sequence for xylanase expression. The two major secretory pathways signal peptide in C. glutamicum, Tat (CgR0949) and Sec (CspB) dependent signal peptide were added before xylanase for its secretion. Fed-batch cultivation was done in a 5 L jar for high-level xylanase secretion. The enzyme properties of the purified xylanase were then studied, including the effect of temperature and pH on its activity. The xylanase could be secreted into the culture supernatant when the Sec-dependent signal peptide CspB was used, but none was detected when CgR0949 was used. The secretory production level of xylanase in a flask was 486.2 U/mL and become 1 648.7 U/mL when in a 5 L jar, which was 3.4 fold as in the flask. The optimal pH and temperature of xylanase were pH 4.5 and 45 ℃, respectively. Its activity was 80% of initial activity after pretreatment at 4 ℃ for 24 h at pH 4-11, 95% after incubation below 50 ℃ for 15 min, and 20% when the temperature above 60 ℃. The xylanase could be efficiently secreted into the culture medium by C. glutamicum using its own genetic elements, and the secretion level could be improved through large-scale fed-batch cultivation. This bicistronic expression system can provide a useful tool for heterologous proteins secretion in C. glutamicum. In addition, the catalyze activity of xylanase could be further improved by enzyme properties study.
Corynebacterium glutamicum ; Promoter Regions, Genetic ; Protein Sorting Signals ; Protein Transport

Objective: To systematically review the barriers and facilitators affecting the implementation of clinical pathways for the clinical pathways. Methods: PubMed, Embase, CNKI, CBM, Wanfang, Cvip databases were searched to collect articles about clinical pathways implementation barriers and facilitators from inception to January 4th, 2019. The tool of confidence in the evidence from reviews of qualitative research(CERQual)was used to grade the confidence of each study. Results: A total of 43 articles from 12 countries were included.There were 8 main categories and 31 subcategories of the barriers about clinical pathways, including content of the clinical pathways, negative outcomes of clinical pathways, physicians knowledge, physicians attitude, resource availability, implementation of activities, patients factors and social factors. The first three barriers of high confidence were lacking of time, capital, equipment, staff and other resources(15 articles, 34.9%), increasing workload(14 articles, 32.6%), unrecognizing pathways(12 articles, 27.9%). There were 6 main categories and 28 subcategories of the facilitators about clinical pathways, including pathways content related, physician related, resource factor and implementation activity. The first three facilitators of high confidence were communication, education and training(25 articles, 58.1%), supporting from managers and colleagues(21 articles, 48.8%)and establishing a clinical pathway facilitation committee(17 articles, 39.5%). Conclusions The successful implementation of clinical pathways connects with its development process, aftereffect evaluation and feedback. It will be implemented effectively only by the completely and environmentally acceptable pathways design, adequate resources, effective organizational activities, continuous audit, evaluation and feedback and physicians active cooperation.

ObjectiveTo investigate the safety and efficacy of endoscopic ultrasound-guided tissue adhesive injection with the assistance of metal clips in the treatment of cirrhotic patients with gastric varices and gastric-renal shunt （GRS）. MethodsThe patients who attended Beijing Ditan Hospital， Capital Medical University， due to liver cirrhosis and gastric varices from February to June 2023 were enrolled， and all patients were confirmed to have GRS and received endoscopic ultrasound-guided tissue adhesive injection with the assistance of metal clips. The primary evaluation index was alleviation or disappearance of varicose veins after surgery， and the secondary evaluation indices were surgical completion and complications. ResultsA total of 11 patients were enrolled in this study， among whom there were 7 male patients and 4 female patients， with a median age of 55 years. Of all patients， 1 had Child class A liver function， 7 had Child class B liver function， and 3 had Child class C liver function. The maximum （median） diameter of the shunt was 8 mm， and the minimum （median） diameter of the shunt was 4 mm. The median blood flow velocity of the target vessel was 11 cm/s before treatment and 5 cm/s after occlusion with metal clips. The median amount of tissue adhesive injected was 2 mL， and the amount of lauromacrogol used was 1 mL. Disappearance of blood flow signals was observed in all patients after surgery （100%）， and the success rate of surgery was 100%. No patient experienced rebleeding after follow-up for 6 weeks. Gastroscopy at 1 month after surgery showed that gastric varices were eradicated or almost disappeared in 9 patients and were alleviated in 2 patients. ConclusionEndoscopic ultrasound-guided tissue adhesive injection with the assistance of metal clips is a feasible， safe， and effective treatment method for cirrhotic patients with gastric varices and GRS.