early lithagogue rate.

Objective To explore the clinical application of endometrial scratching in patients with repeated implantation failure(RIF).Methods A total of 189 women with RIF who planned to undergo in vitro fertilization and embryo transfer(IVF‐ET)once again at the Reproductive Medicine Center of Tongji Hospital ,Huazhong University of Science and Technology ,be‐tween October 2013 and August 2014 ,were prospectively examined.These women were infertile due to tubal factors ,with their male partners having normal semen measurements.According to the case numbers ,the 189 patients were randomly divided into experimental group(n=96)and control group(n=93).In the experimental group ,endometrial scratching was conducted within 6 h of one menstrual cycle one month before oocyte retrieval ,while in control group ,no endometrial scratching was performed at that time.The outcomes of pregnancy were compared between the two groups after embryo transplantation.Results There was no statistical difference between the two groups in the patient age ,infertility duration ,body mass index(BMI) ,basal levels of follicle‐stimulating hormone(FSH) ,luteinizing hormone(LH) ,and progesterone(P) ,gonadotropin‐releasing hormone(Gn‐RH) injection days and doses ,the number of retrieved oocytes ,the number of transferred embryos ,the endometrial thickness and lev‐els of estradiol(E2 )and P on the day of HCG injection(P>0.05).The embryo implantation rate ,the clinical pregnancy rate and the ongoing pregnancy rate in the experimental group were much higher than those in the control group ,with statistically signif‐icant difference noted(P<0.01).Conclusion The endometrial scratching can improve the endometrial receptivity and enhance the clinical pregnancy rate of RIF patients.

Objective To compare the effects of point contact-dynamic compression plates (PC-DCP) and dynamic compression plates (DCP) on cortical bone blood flow in an intact sheep tibia model. Methods Fifteen mature goats were used in this experiment. After the bilateral tibia of goats were fixed with DCP and PC-DCP respectively, the regional cortical bone blood flow was measured at four time intervals (1 day, 2, 6 and 12 weeks after operation) using radiolabelled microsphere technique. Results After operation, the cortical bone blood flow was acutely decreased at the first day, kept lower than normal level until six weeks and recovered at the 12th week. The blood supply under PC-DCP recovered to normal, even over normal level two weeks after operation and remained at a high level until 12 weeks. Conclusions PC-DCP can markedly protect cortical bone blood flow.

Objective To compare the effects of point contact-dynamic compression plates (PC-DCP) and dynamic compression plates (DCP) on bone structure and mechanical properties of the plated bone in the intact goat tibia model. Methods Ten matured goats were used. The bilateral intact tibia of goats were fixed with DCP and PC-DCP respectively. The goats were sacrificed at 12 and 24 weeks after operation, and the tibiae were harvested. The structure of bone under plate was studied both by CT scan and histomorphology. The mechanical properties of the plated bone were examined by torsional test. Results At 12 weeks after internal fixation, there was obvious osteoporosis in the cortical bone underneath the plate in the DCP group compared with that of the PC-DCP group. Both of the cortical bone thickness underneath the plate and the torsion strength of the plated tibiae were significantly higher in the PC-DCP group than that in DCP group (P0.05). Conclusion The underlying bone resorption after rigid plate fixation is induced by both the disturbance of the bone blood supply and stress shielding. However, the former is the main cause in the early stage of fixation. PC-DCP is able to prevent bone resorption in the early stage of fixation.

Objective To study the mechanism of anti-keratin autoantibodies (AK auto Ab) inhibiting the keratinocytes proliferation. Methods Keratinocytes from normal human skin and squamous cell carcinoma were cultured, then treated with AK auto Ab in different doses. MTT and immunohistochemical technologies were applied to test the proteins related to proliferation and apoptosis. Results AK could inhibit the proliferation of these two kinds of cells with a dose related effect. AK auto Ab could promote the expression of p53,c-myc, and inhibited the expression of PCNA. Conclusions The results indicate that AK auto Ab plays an important role in the proliferation of keratinocytes both from normal skin and from SCC.

To investigate changes in density of platelet glycoprotein (GP)Ⅱb/Ⅲa receptor during the perioperative period of hepatectomy in rats with myocardial infarction. 26 adult SD rats were randomly divided into 2 groups: the control group(1)( n =13) and the infarction group(2)( n =13). Myocardial infarction was produced by celiac injection (1 time/d) of isoproterenol (30mg/kg) for 3 days. All rats underwent hepatectomy after 3 weeks. Platelet surface density of GPⅡb/Ⅲ receptors was determined by flow cytometric analysis before and 6, 12, 24, 48, 72 hours after the operation. 12 hours after the operation, the density of GPⅡb/Ⅲa was transiently increased compared with preoperative period in control group ( P

Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

Objective To investigate the diagnostic value of intraductal ultrasonography (IDUS) for bile duct stones by comparing between magnetic resonance cholangiopancreatography ( MRCP), endoscopic retrograde cholangiography (ERC) and IDUS. Methods ERC was performed in 30 patients with suspected extrahepatic cholelithiotic after MRCP. IDUS was applied through guide wire after ERC, and stones were removed if necessary. Results MRCP detected bile duct stones in 22 cases, misdiagnosed bile duct floc as stones in 2 and missed stones in 2 others. The accuracy, sensitivity and specificity of MRCP in diagnosis of bile duct stone were 86. 7% (26/30), 91. 7% (22/24), and 66. 7% (4/6), respectively. ERC detected bile duct stones in 23 cases, misdiagnosed bile duct air bubble as stones in 2 and missed stones in 1. The accuracy , sensitivity and specificity of MRCP in diagnosis of bile duct stone were 90% (27/30), 92% (23/25) and 66.7% (4/6) , respectively. IDUS detected 24 cases of bile duct stones, 4 bile duct floc and 2 air bubble without any misdiagnosis. The accuracy, sensitivity and specificity of IDUS in diagnosis of bile duct stone were 100%. Conclusion IDUS, safe and reliable, is superior to ERC and MRCP in diagnosis of bile duct stone.

Objective To explore the risk factors of lower limb deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT. Methods A total of 1 068 patients with traumatic fractures were involved in the study to analyze the incidence of DVT under 43 risk factors including general state, injury type, fracture condition and operation and screen significant factors for multiple factor analysis. Results The total incidence rate of DVT in 1 068 patients was 12.0%. The univariate analysis showed that male patients at age ＞60 years, with BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension, coronary artery disease and cerebrovascular disease had higher incidence rate of DVT. In different injury types, the fall injury caused the highest incidence rate of DVT (45.6%). There were different DVT rates for different fracture position,with the highest incidence rate of DVT for femur shaft fracture (20.5%). The incidence rate of DVT was 51.7% for fractures of more than three parts, 14.2% for fractures of two parts and only 3.7% for sole part. The incidence rate of DVT for comminuted fractures was higher than the overall rate. The operation duration, massive transfusion during operation and epidural anesthesia were related with the increase of incidence of DVT. Multivariate analysis found nine independent risk factors and showed that the more risk factors were, the higher incidence of DVT was. Conclusions The risk factors of DVT for traumatic fractures include age ＞60 years, BMI≥25 kg/m2, history of smoking, fall injury, more than three parts of fractures, comminuted fractures, operation duration ＞ 2 hours, massive transfusion during operation and epidural anesthesia.

Objective To analyze the clinical characteristics of children tsutsugamushi infection in order to strengthen understanding,reduce the misdiagnosis rate,reduce the complications and improve the level of diagnosis and treatment.Methods To analyze retrospectively the clinical data and treatment outcome of 22 cases of children tsutsugamushi disease,including symptoms,physical signs and laboratory examination.Results All the cases with fever onset,high fever (＞ 39 ℃) was 72.7％ (16/22),all cases were typical eschars and ulcers,while 8 cases (36.4％,8/22)had lymphadenectasis.Merger multiple organ damage in 14 cases (63.6％,14/22),anemia in 11 cases (50.0％,11/22)and liver function abnormal in 4 cases (18.2％,4/22).All of 22 cases were treated with azithromycin.All cases after treatment with azithromycin heal,no recurrence.Conclusions The manifestation of tsutsugamushi disease is diversity,much complications,among which hematology and liver are the most common cases.Physical examination roundly might reduce missed diagnosis and misdiagnosis as greatly as possible.Azithromycin has good therapeutic effects on children tsutsgamushi disease.