Objective To evaluate the effect of the pathological changes of the pelvic cavity and fallopian tube on the outcome of in vitro fertilization and embryo transfer(IVF-ET).Method One thousand and thirty-two patients who underwent IVF-ET were divided into tubal and pelvic infertile group(605 cases)and non-tubal and pelvic infertile group(427 cases).The tubal and pelvic infertile group was also divided into salpingemphraxis group(243 cases),tubal resection group(104 cases),fallostomy group(149 cases),tubal dropsy group(109 cages)according to the tubal lesion regions,and combined with pelvic group(194 cases),combined without pelvic group(411 cases).The data of clinical pregnancy,ectopic pregnancy,and abortion was analyzed respectively.Results The ectopic pregnancy and abortion rates in tubal and pelvic infertile group[10.63%(27/254)and 9.06%(23/254)]were higher than those in non-tubal and pelvic infertile group [3.27%(5/153)and 4.58%(7/153)](P<0.01 or<0.05).The ectopic pregnancy rate was the lowest in tubal resection group[2.17%(1/46)],the highest in fallostomy group[22.41%(13/58)],there was significant difference among the groups(P<0.01).The abortion rate in fallostomy group and tubal dropsy group[10.34%(6/58)and 15.00%(6/40)]was higher than that in salpingemphraxis group and tubal resection group [7.27%(8/110)and 6.52%(3/46)],there was significant difference among the groups(P<0.05).The abortion rate in combined with pelvic group[11.54%(9/78)]was higher than that in combined without pelvic group[7.95%(14/176)](P<0.05).Conclusions The pathological changes of the pelvic cavity and fallopian tube are higher risk factors of ectopic pregnancy and abortion occurrence.The assessment and treatment of pelvic cavity and fallopian tube before assisted reproductive treatment cycles should be enhanced.

Child, Preschool ; Female ; Humans ; Infant ; Male ; Methionine ; blood ; Tyrosine ; blood ; Tyrosine Transaminase ; deficiency ; Tyrosinemias ; blood ; diagnosis ; enzymology ; pathology ; therapy

Objective To investigate the efficacy of neoadjuvant chemotherapy combined with radical resection of cervical cancer in the treatment of stage IB2-ⅡB cervical cancer.Methods According to the treatment plan from October 2012 to October 2016 in the People′s Hospital of Luohu District of Shenzhen in 80 cases of stage IB2-II B cervical cancer patients were divided into observation group(n=43) and control group(n=37),the observation group was treated with neoadjuvant chemotherapy combined with radical surgery for cervical cancer,patients in the control group directly treated for radical resection of cervical cancer.Chemotherapy effect,operation time,intraoperative blood loss,postoperative pathological risk factor differences of two groups of patients were compared.Results (1)Evaluated the curative effect of neoadjuvant chemotherapy,squamous cell carcinoma group complete remission(CR) 4 cases,partial remission(PR) 22 cases,stable disease(SD),6 cases of disease progression(PD) in 0 cases,in adenocarcinoma group CR 1 cases,PR 3 cases,SD 5 cases,PD 2 cases of squamous cell carcinoma group adjuvant chemotherapy was significantly better than that of adenocarcinoma group,the difference was statistically significant(z=2.4968,P=0.0063).(2)The operation time((215±57) min) and intraoperative blood loss((682±145) ml) in the observation group were significantly lower than those in the control group(((259±62) min,(758±193) ml)),the difference was statistically significant(t=3.8780,2.2528,P=0.0002,0.0263).(3)The two groups of patients with ureteral fistula(P=0.5039),vesicovaginal fistula(P=0.3639),wound healing(P=0.5182),lower extremity deep venous thrombosis(P=0.4818) complications had no significant difference.(4)The positive rate of the observation group of lymph nodes(χ2=8.2005,P=0.0000),parametrial infiltration rate(χ2=8.1553,P=0.0000) was significantly lower than the control group,the difference was statistically significant.Two groups of patients with deep myometrial invasion rate(χ2=0.0991,P=0.7516),the incidence of cancer embolus(χ2=0.0130,P=0.9176) compared to no statistical significance.Conclusion The effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma is better than that of adenocarcinoma.Compared with the direct for radical resection of cervical cancer,neoadjuvant chemotherapy combined with radical resection of cervical cancer patients for the treatment of stage IB2-ⅡB cervical cancer,operation time and blood loss are lower,node positive and parametrial invasion and postoperative pathologic risk factors in lymph node also can get better effect.

Objective To investigate the dynamic alterations of parameters of platelet in newborns with pulmonary hemorrhage(PHN).Methods One hundred and forty-eight cases were selected into research group,within 48 hours after admission,every 3 hours at the time of pulmonary bleeding,peripheral arterial blood were collected and tint deal blood samples were examined with full-automatic blood cell analyzer in order to monitor dynamically changes of platelet and its parameters.Results The blood platelet count(BPC),thronbocytocrit and PDW were greatly changed at 6 hours before occuring pulmonary hemorrhage(all P

Objective To study the influence of carboxymethyl-chitosan(CM-chitosan)on chondro- cyte apoptosis induced by recombinant human interleukin-1?(rhIL-1?)and explore its mechanism.Methods Rabbit chondrocytes were isolated and cultured.Chondrocytes were pretreated with different concentrations of CM-chitosan for 1 h,then 10 ng/ml IL-1?were added into the culture medium.After 24 h,the apoptotic rates of chondrocytes were measured by flow cytometry with AnnexinⅤ-FITC and PI staining.The morphology of nuclei was observed by fluorescent microscopy with Hoechst 33342 staining.The mitochondrial membrane po- tentials were tested by confocal laser scanning microsocopy with Rhodamine-123 and ATP contents were mea- sured by luciferase reaction.Results CM-chitosan could inhibit chondrocyte apoptosis and restore the func- tion of mitochondria induced by IL-113 in a dose-dependent manner.Conclusion CM-ehitosan can inhibit chondrocyte apoptosis by protecting mitochondrial function.

Background Human limbal allograft transplantation or limbal autograft transplantation are the primary approaches to the severe corneal-blindness,but their application in clinic were limited because of the defects of donor material.With the development of tissue engineering technology,transplantation of in vitro cultured limbal epithelial stem cells is being an advanced management.Objective The aim of this work was to expand human limbal epithelial stem cells ex vivo under the guidance of confocal microscope and to lay the foundation for fabricating ex vivo cultured cell sheets.Methods Ten eyes of ten patients were examined with the Heidelberg Retina Tomography Ⅲ Rostock Cornea Module(HRT3-RCM)to elucidate the structure of the human corneoscleral limbus and to correlate limbal epithelial dimensions.According to the analysis of the images of limbal epithelia,the limbal tissues provided by Eye Bank of Henan Eye Institute were cut into suitable explants.Then,this study was conducted to expand limbal epithelial stem cells ex vivo on denuded amniotic membrane.The phenotypes of primary cultured cells were evaluated by morphology and immunofluorescent staining with antibodies for limbal epithelial stem cell markers (p63,cytokeratinl9)and differentiation markers(keratin 3,involucrin).This experimental procedure was approved by the Ethic Committee of Henan Provincial People's Hospital.The written informed consent was obtained from subjects before initiation of any examination.Results The palisade morphology of human limbus was imaged clearly on the laser scanning in vivo confocal microscopy and many hyperreflective cells were observed in palisade basal cells.The cell-island phenomenon was seen in the basement membrane under the laser scanning in vivo confocal microscopy.The oblique sections of limbus showed many papilla-like epithelial columns below the superficial limbal epithelia.Throughout the experiment duration,the epithelial cells grew well with the migration rates from limbal tissue (68.62± 16.94)％ and the migration time(5.83 ±2.04)days,which depended on the tissue freshness.Compared with the second and forth batch of tissue,the migration rates of the third and sixth batch of tissues were significantly higher(P＜0.05),and the migration time was evidently longer in the forth and sixth batch of tissue compared with the first,second,third and fifth batch(P＜0.05).The positively expressing rates in the cultured corneal stem cells were 4.05％ and 36.52％ for p63,26.07％ and 40.55％ for CK19,57.88％ and 40.81％ for K3,64.66％ and 59.19％ for involucrin.Conclusion Human limbal epithelial stem cells can be successfully and purposefully obtained from the limbal tissue based on the guidance confocal miscroscope.The cultured corneal stem cells can grow well on the denuded amniotic membrane

Objective To evaluate the safety and efficacy of Enterprise stent in the treatment of severe symptomatic basilar artery atherosclerosis stenosis.Methods All patients who underwent Enterprise stent for the treatment of symptomatic basilar artery atherosclerotic stenosis in our center from Nov.2011 to Nov.2014 were enrolled in the study.Preoperative and postoperative dual antiplatelet drugs and intensive lipid-lowering therapy were given to all the patients.Multi-modality imaging guiding for stent angioplasty was performed in all the patients, including head MRI or CT, CT or MRI perfusion, high resolution MRI for plaque analysis and angiography.Angiography after 6 months was recommended.The main outcome parameters were any stroke or death within 30 days, stroke recurrence in the basilar artery blood supply area during the follow-up period and in-stent restenosis.Results A total of 35 cases were enrolled in the study with operation technical success rate of 100％.The average preoperative and postoperative stenosis rate was (83.0-10.1)％ and (28.1 ±8.9)％.The main perioperative complication and mortality rate was 0.The average follow-up period was (10.6 ±7.9) months.During follow-up period, only 2 cases (5.7％) of TIA related to the stented artery were observed.In patients with follow-up period more than 6 months, 17 cases (56.7％) underwent cerebral angiography.Restenosis rate was 17.6％.One patient with in-stent restenosis suffered from transient cerebral ischemia and received another Enterprise stenting successfully.Conclusion Long term follow-up results show that Enterprise stent for the treatment of symptomatic basilar artery severe stenosis is safe and recurrence of stroke can be prevented effectively.

Objective To evaluate the relationship between sternum protection and bone marrow suppression in postoperative radiotherapy for esophageal carcinoma. Methods Total of 98 postoperative patients with thoracic esophageal carcinoma were randomly divided into experimental group (52 cases) and control group (46 cases). All patients were given intensity-modulated radiotherapy (IMRT), with the dose of 50-50.4 Gy. The patients in experimental group were irradiated by 6 fields (4-fields in front, 2-fields behind) which were crossed to avoid direct exposure to the sternum. The patients in control group were irradiated by 5 fields (3-fields in front, 2-fields behind) with front-middle of the field passing through the sternum. Concurrently all patients received 2 cycles of cisplatin chemotherapy. Results Dmean, V20 and V30 of the sternum in the experimental group were (20.21 ±3.60) Gy, (40.78 ±7.19) % and (33.78 ±9.44) %, which were lower than those in the control group [(30.91±5.21) Gy, (81.01±4.81) %, (51.60±6.84) %], respectively (P<0.05). However, the volume and dose distribution of lung, spinal cord and heart were similar between the two groups (P> 0.05). Both the incidence rates of bone marrow suppression at 14th day and 35th day after radiotherapy were significantly higher in the control group (52.2%, 73.9%) than those in the experimental group (28.8 %, 50.0 %) (P< 0.05), and the incidence rate of bone marrow suppression at 7th day after radiotherapy was similar between the two groups. Conclusion Protecting and sketching for sternum in postoperative radiotherapy for esophageal carcinoma can reduce the incidence of bone marrow suppression effectively, which would not increase the radiation dose in the lung, heart and spinal cord.

Objective To evaluate the protective effect of astragaloside Ⅳ against ultraviolet B (UVB)-induced photodamage to human HaCaT keratinocytes,and to investigate its mechanisms.Methods Culturedimmortalized human HaCaT keratinocytes were divided into four groups:blank control group receiving untreated,UVB group irradiated with 50 mJ/cm2 UVB,astragaloside Ⅳ group treated with astragaloside Ⅳ,UVB + astragalosideⅣ group treated with astragaloside Ⅳ for 24 hours before and after 50 mJ/cm2 of UVB radiation.The concentration ofastragaloside Ⅳ ranged from 10 to 200 mg/L in cell proliferation assay,and according to the results of proliferationassay,20 mg/L was determined as the optimal concentration in the other assays.At 24 hours after UVB radiation,cellcounting kit-8 (CCK8) assay was performed to evaluate cellular proliferative activity,flow cytometry to determineintracellular reactive oxygen species (ROS) levels,and Western blot to measure the expression levels of p53,p38,matrix metalloproteinase-9 (MMP-9) and high mobility group Al (HMGA-1) protein in HaCaT cells.ResultsCompared with the control group,astragaloside Ⅳ at 10 and 20 mg/L had no inhibitory effect (F =1.32,P ＞ 0.05),while astragaloside Ⅳ at 50,100 and 200 mg/L showed significantly inhibitory effect (F =20.20,P ＜ 0.05),on theproliferation of HaCaT cells.In addition,cellular proliferative activity in the UVB group was significantly lower thanthat in the control group (F =99.00,P ＜ 0.01).Compared with the UVB group,cellular proliferative activityincreased to different degrees in HaCaT cells treated with both UVB and astragaloside Ⅳ of 10-200 mg/L (F =19.08,P ＜ 0.01),with the strongest increase observed in those treated with UVB and astragaloside Ⅳ of 20 mg/L.Further experiments revealed reduced intracellular ROS levels in the UVB + astragaloside Ⅳ (20 mg/L) groupcompared with the UVB group (t =21.12,P ＜ 0.01).Western blot assay showed that the expression levels of p53,p38,MMP-9 and HMGA-1 protein were significantly higher in the UVB group than in the control group (all P ＜0.01),but significantly lower in the UVB + astragaloside Ⅳ (20 mg/L) group than in the UVB group (all P ＜ 0.01).Conclusion Astragaloside Ⅳ can effectively protect keratinocytes from UVB-induced photodamage.

Objective To discuss the relationship of congenital choledochus cyst(CCC)with occurrence of pancreatitis in adults and methods of surgical treatment.Methods The clinical data of 17 adult patients with congenital choledochus cyst who underwent surgical treatment from 1997-2005 were analyzed retrospectively.Results Clinical diagnosis was made mainly by B-ultrasound,MRCP,intraoperative cholangiography,ERCP and CT scans.Among 17 cases,10 cases were congenital choledochus cyst typeⅠ,4 cases type Ⅱ,1 case type Ⅲ,1 case type Ⅳ and 1 case type Ⅴ;and associated with cholelithiasis in 14 cases(bile pigment stone in 11cases,cholesterol calculus 3cases),chronic cholecytitis 5 cases,polypoid lesions of gallbladder 1 case,anomalous pancreaticobiliary junction(APBJ)10 cases,and pancreatitis 10 cases.Resection of extrahepatic cyst with Roux-y hepaticojejunostimy was performed in 15 cases,preserving pylorus pancreatoduodinectomy in 1 case,and cholecystectomy and T tube drainage in 1 case.Excellent and good results were achieved on follow-up in 14 out of the 17 CCC cases undergoing surgical treatment,while pancreatitis occurred in 2 cases and unexpected death in 1 case.Conclusions Pancreatitis is apt to occurr in CCC with APBJ and bile pigment stone in choledochus.The incidence of pancreatitis in CCC and APBJ(P-B)can be decreased by resection of extrahepatic cyst and Roux-en-Y hepaticojejunostimy and cholecystectomy.