BACKGROUND:The effect of body mass index (BMI) on the outcomes ofin vitrofertilization (IVF) is controversial. Some scholars suggested that the higher BMI, the lower rate of pregnancy, and the higher rate of abortion. However, some others got the different results. To data, the effects of BMI on the pregnancy outcomes in females at different ages are rarely reported.
OBJECTIVE:To explore the effect of BMI on the pregnancy outcomes of IVF for infertile women atdifferent ages.
METHODS:A total of 902 cycles undergoing IVF were divided into two groups according to the age:≤ or> 35 years old groups. The patients in each group were then divided into four subgroups according to BMI: low weight, normal weight, excess weight, and obesity subgroups, respectively.
RESULTS AND CONCLUSION: With increasing BMI, the average dosage of gonadotropins was increased gradualy in two both of age groups (P < 0.05). In the≤ 35 years old, the levels of estrogens on the day of injecting human chorionic gonadotropin was significantly lower in obesity group than the other subgroups (P < 0.05); the rates of empty folicle in excess weight and obesity subgroups were significantly higher than that in normal weight subgroup (P < 0.008 23). The fertilization rate and clinical pregnancy rate of in obesity subgroup were significantly lower than those in the other subgroups (P < 0.05). In the > 35 years old group, the empty folicle rate in obesity subgroup was significantly higher than that in normal weight subgroup (P < 0.008 23). Fertilization rate in excess weight and obesity subgroups was significantly lower than that in the normal weight subgroup (P< 0.008 23). There were no significant differences in cleavage rate, cycle cancelation rate, implantation rate, biochemical pregnancy rate and abortion rate between four subgroups (P> 0.05). These findings suggest that in the females at the younger age, BMI not only affects the quality of folicles and fertilization rate; but with increasing BMI, clinical pregnancy rate is decreased obviously. However in the females at the older age, BMI only affects the folicular quality, embryo quality and fertilization rates; there are no significant differences in the outcomes of pregnancy in the four subgroups. BMI have effects on pregnancy outcomes of IVF, and the effects are much greater in the younger female group.

AlM:To observe clinical effects between the laser in situ keratomileusis ( LASlK ) surgery and the laser subepithelial keratomileusis ( LASEK ) surgery as the second operation after an unsuccessful LASlK surgery.METHODS:Forty-nine patients (98 eyes) with refractive regression after LASlK operation received the second surgery. All patients were divided into two groups:group A and B. Group A (48 eyes of 24 patients) received LASlK surgery and group B ( 50 eyes of 25 patients ) received LASEK surgery. lnspect the main parameters included visual acuity, refraction, corneal curvature, and the total value of high-aberration after 1wk, 1mo and 1a, t-test of groups was used as statistical analysis method.RESULTS: There was statistically significant (P<0. 05) between the two groups in visual acuity after 1wk. There was no statistically significant between the two groups in visual acuity after 1mo, and there was also no statistically significant between the two groups in visual acuity, average spherical equivalent refractive degree, average corneal curvature, and the total value of high-aberration after one year (P>0. 05). There developed one case of epithelium in growth after LASlK surgery, and one case of haze Ⅱ after LASEK surgery.CONCLUSlON: Both LASlK and LASEK surgery can obtain satisfactory therapeutic results after an unsuccessful LASlK surgery.

Objective To measure the renal cortex blood flow leVel in Patients with stage 3-4 chronic kidney disease, and to obserVe the effect of Probucol on renal cortex blood flow and renal function. Methods Twenty Patients with stage 3-4 chronic kidney disease in our hosPital were randomly diVided into treatment grouP ( 10 Patients ) and obserVation grouP ( 10 Patients). Ten healthy subjects were chosen as the control grouP. Dynamic sonograPhic tissue Perfusion measurement (DTPM) was used to eValuate the mean flow intensity (Imix),mean flow Velocity (Vmix) and tissue resistance index (TRI) in the three grouPs. Patients in the obserVation grouP were treated with standard theraPy;the treatment grouP was giVen Probucol 500 mg,twice daily in addition to standard theraPy for 6 months. The renal cortex blood flow leVel after treatment was measured in the treatment grouP and obserVation grouP. The serum BUN,SCr,TC,TG,LDL,HDL,hs_CRP,ox_LDL,PA,ALB before and after treatment were measured and comPared between the treatment grouP and obserVation grouP. Results Imix and Vmix were significantly lower,and TRI was significantly higher in the treatment grouP and obserVation grouP than in the control grouP (P<0. 01). After 6 months of treatment,Imix and Vmix in the treatment grouP were significantly increased and TRI significantly decreased as comPared with the baseline and the control grouP (P<0. 01). After treatment,Imix and Vmix were significantly decreased and TRI was significantly increased in the obserVation grouP (P<0. 05). In the treatment grouP,the serum BUN,SCr,TC,TG,LDL,hs_CRP and ox_LDL decreased and PA,ALB and HDL increased after treatment as comPared with the baseline and the obserVation grouP (P<0. 05 or P<0. 01). Conclusion The renal cortex blood flow leVel is significantly lower in Patients with stage 3-4 chronic kidney disease than in the healthy PeoPle. Probucol can imProVe the renal cortex blood flow leVel significantly,Protect the renal function, and imProVe microinflammatory state,nutrition status and dysliPidemia.

Objective To evaluate the change of cellular immunity and its clinical significance in JRA.Methods 7 lymphocyte swbpopulation was analyzed by immunofluorescein and interleukin 2 (IL-2) produced by peripheral blood mononuclear cells in vitro by MTT colorimetric assay. 29 times of various stage with JRA were examined, including 14 clinically active patients, 8 posttreatment or 7 clinically inactive ones. There are 19 healthy children of similar age in control group.Results In active patients, the number of OKT8, OKT4, the ratio of OKT4/OKT8 and the level of IL-2 decreased significantly compared with normal controls. These changes recovered matkedly in remission patients though they did alter affective treatment for (2～4) weeks.Conclusion Patients with active JRA are characterised by aberration of cellular immunity and the aberration reverses obviously slow in comparision with the clinical manifestetions and the routine laboratory investigation.

Humans ; Hypertension, Pulmonary ; metabolism ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; metabolism

Introduction: Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient’s survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis. Case Presentation: A previously healthy 35-year-old lady was referred from district hospital for hypertensive cardiomyopathy complicated by acute pulmonary oedema. After being admitted to the Intensive Care Unit, the mean arterial pressure on the left arm was noted to be significant higher. On physical examination, both lower limbs were dusky in appearance because of poor perfusion. Investigations: Computed Tomography Angiography showed extensive arch and abdominal aorta dissection extending to the proximal common carotid artery. There was distal abdominal aorta thrombosis with partial left renal infarction. Echocardiogram showed global hypokinesia, presence of intimal flap, aortic regurgitation and mild pericardial effusion. Supine chest X-ray showed apparent cardiomegaly. Treatment: Repair of the ascending aortic dissection and suspension of the aortic valve by the cardiothoracic team on Day 2 of admission. The vascular team did bilateral high above knee amputation on Day 9 of admission. Outcome: Patient passed away on Day 10 of admission. Discussion: With the absence of classical features of aortic dissection, establishing the diagnosis can be challenging and requires both good clinical judgment and prompt radiological imaging, such that early treatment can be initiated. Conclusion: A high index of suspicion and good clinical judgment is needed in cases of significant blood pressure discrepancy between arms.
Blood Pressure

Objective To study the effects of acute coronary comprehensive syndrome with PCI therapy after secondary HIT-Ⅱ give sulphur of liver fondaparinux therapy clinical comprehensive effect.MethodsDecimation in 66 patients with acute coronary syndrome after PCI patients was applied on the basis of drug therapy and postoperative anticoagulation.Study group (33 cases) in the postoperative secondary HIT Ⅱ after being diagnosed with stop heparin and give sulphur of fondaparinux, bleeding in the coagulation indexes, within 30 days event and 6months heart vascular pieces efficacy evaluation.ResultsThe use of heparin before.The index of blood coagulation in study group were normal, confirmed HIT Ⅱ when the index change significantly (P<0.05) and the discontinuation of heparin 24h, 3d, 7d indexes compared at diagnosis were restored (P<0.05) and 14 days of heparin to stop with the use of heparin levels.The patients in the study group, the incidence of bleeding events was 9.1%, compared to 15.2% in the control group no significant difference.The patients in the study group of adverse cardiovascular events occurred rate was 12.1%, compared to 18.2% in the control group no significant difference.ConclusionAcute coronary syndrome after PCI HIT-Ⅱ to grant the sulphur of fondaparinux treatment had no significant effect on blood coagulation function and safety.

Objective To study the effects of granisetron hydrochloride on vasovagal syncope(VVS) in rabbits.Methods Twenty-four healthy New Zealand rabbits were divided stochastically into control group and intervention group,12 in each group. The control group was injected intravenously with normal saline. The intervention group was injected intravenously with granisetron hydrchloiride.Rabbit VVS models were established,each was taken at 4 points in time in the bloodletting process:T1,T2,T3,T4,to compare the bloodletting time,the concentration of 5-hydroxytryptamine(5-HT) in T2,T3,T4 and the total blood volume between the groups,and monitor the heart rate, blood pressure during the entire process.Results 1.The time of intervention group in T2,T3,T4 was longer than the time of control group obviously(P

To investigate the utility of optomap panoramic 200Tx in screening fundus disease among the patients after cataract surgery.
●METHODS: From November 18 th to December 31st , 2013 all 146 post- cataract surgery patients were recruited. All non - mydriatic fundus images were taken with the optomap panoramic 200Tx and were diagnosed by one masked retinal specialist. Non - mydriatic direct ophthalmoscope exam and mydriatic slit-lamp lens exam were also done by other two masked specialists. Comparisons of the three methods were made.
●RESULTS: Among 146 patients ( 161 eyes), 40 eyes (24. 8%) of retinal lesions was detected by non-mydriatic direct ophthalmoscope exam, 59 ( 36. 7%) by non -mydriatic optomap 200Tx exam, and 61 (37. 9%) by slit-lamp lens exam. Nine eyes ( 5. 6%) needed medical intervention immediately. Results of optomap 200Tx exams and slit - lamp lens exams were similar without statistically significant difference ( P > 0. 05), better than direct ophthalmoscope exam ( P < 0. 05) with statistically significant difference.
● CONCLUSlON: Opacification of the refractive medium makes thorough fundus examination impossible. So post-operative fundus examination is highly necessary and should be a routine. Optomap panoramic 200Tx, which shows no statistically difference from mydriatc slit- lamp lens exam, is a convenient and feasible method in discovering fundus pathological changes.