Objective To observe and analyze the clinical values of ultrasonic and electromyography exami-nation in lumbosacral nerve root lesions and peripheral neuropathy of lower extremity.Methods The prospective clinical study was performed.A total of 32 cases of suspected lumbosacral nerve root disease were recruited.All patients underwent ultrasound and electromyography examination to eliminate peripheral neuropathy;a total of 15 cases of suspected peripheral neuropathy patients were recruited to eliminate lumbosacral nerve root lesions.Results Among 32 cases of lumbosacral nerve root lesions,neuromuscular electrical diagram screening found 4 cases of periph-eral neuropathy(12.5%),and ultrasound screening found 5 cases of peripheral neuropathy(15.6%).There was no significant difference between the two groups(P >0.05).Among 15 cases of peripheral neuropathy,neuromuscular electrical diagram screening found 3 cases of lumbosacral nerve root lesions(20.0%),and ultrasound screening found 0 case of lumbosacral nerve root lesions.There was no significant difference between the two groups(χ2 =6.47,P <0.05).Conclusion Neuromuscular electrical diagram inspection and ultrasonic inspection in the lumbosacral nerve root lesions in the differential diagnosis of lower limb peripheral neuropathy has certain clinical values.Detection rate regarding lower limb peripheral neuropathy has no significant difference between the two methods.

Objective To explore the differences of nerve conduction of lower limbs in general population with different nationalities in Xining region.Methods Physical examination and healthy volunteers in No.1 People's Hospital of Xining were collected.Two hundred and forty Hui people of them was Hui group.Two hundred and forty people with other ethnic minorities including Tibetan,Tu and Mongolian of them was mixed group.Two hundred and forty Han people of them was Han group.The nerve conduction of lower limbs in all the people were detected.And the differences were compared.Results The differences of nerve conduction of posterior tibial nerve among all the groups were not statistical significant (all P>0.05).The latent period of common peroneal nerve in Hui group was significantly longer than mixed group and Han group,the motor conduction velocity of which was significantly slower,the motor nerve action potential of which was significantly reduced (all P<0.05).The latent period of superficial peroneal nerve in Hui group was significantly longer than mixed group and Han group,the sensory conduction velocity of which was significantly slower,the sensory nerve action potential of which was significantly reduced (all P<0.05).The differences of nerve conduction of sural nerve among all the groups were not statistical significant (all P>0.05).The differences of nerve conduction of each group among different age periods were statistical significant(all P<0.05).Conclusions The nerve conduction of lower limbs in general Hui people in Xining region must be different with other general people.It must be noticed in clinical examination.

Objective To predict the genes that affect endometrial receptivity through the differential expression of microRNA (miRNA) in eutopic endometrial tissues during implantation window in patients with endometriosis infertility. Methods Among infertile patients that received treatments at the Center for Reproductive Medicine,Peking University Third Hospital between May and December 2013, patients with endometriosis infertility were selected as endometriosis group (among the selected 17 cases, there were 6 cases with follicular phase endometrium and 11 cases with implantation window phase endometrium), and patients with tubal factor infertility were selected as control group (among the selected 19 cases, there were 7 cases with follicular phase endometrium and 12 cases with implantation window phase endometrium). (1)Implantation window phase endometrium was selected from 3 cases in each group. Using miRNA and mRNA joint gene sequencing and database for forecast results, as well as using the negative regulatory relationship between miRNA and mRNA, the intersection of target gene that negatively correlates with miRNA expression were obtained. The co-expression network of miRNA-mRNA wae constructed. Combined with the genes associated with endometrial receptivity found through bioinformatics method, the miRNA with core regulatory functionwas found. (2) Expand sample size to 14 cases for endometriosis group and 16 cases for control group.Reverse transcription (RT)-PCR technique was utilized to detect the expression of miR-142-5p, miR-146a-5p and miR-543 in endometrial tissues, and verify miRNA microarray results. Results (1) miRNA and mRNA microarray screening results showed that, among the endometrial tissues of patients with endometriosis infertility and with implantation window phase, 6 differentially expressed miRNA were indentified, among which miR-142-5p, miR-146a-5p, miR-1281, miR-940, miR-4634 showed significantly enhanced expression and miR-543 showed significantly inhibited expression. Sixty-three differentially expressed mRNA were indentified, among which 58 mRNA such as CADM1, IL-10RA, ITGAL and LPAR5 had significantly enhanced expression. Five mRNA such as HLA-DRB1,3,4,5 and SOHLH2 showed significantly inhibited expression. Thirty-six taget genes were found in consideration of negatively correlated miRNA expression with the genes, miRNA-mRNA co-expression network were constructed. The miR-543 was found at the core of the network. Targetscan and other database predicted that miR-142-5p, miR-146a-5p and miR-543 could act on various types of endometrial receptivity molecular corresponding marker genes such as HOX10, ITGAV, ITGB3, OPN, LIF, ESR, PGR, CDH1 and MMP. (2) RT-PCR test showed that the average levels of expression of miR-142-5p and miR-146a-5p in implantation window phase endometrium in endometriosis group were 8.3 ± 10.6 and 1.9 ± 0.8 respectively;the average levels of that in control group were 1.1±0.6 and 0.9±0.4, respectively. The difference was statistically significant (P=0.027, P=0.015), and was consistent with results from miRNA microarray test. The expression of miR-543 in tissues of follicular phase endometrium in endometriosis group (2.3±1.0) was significantly higher than that in control group (1.0 ± 0.4), and the difference was statistically significant (P=0.008). However, when comparing the expression of miR-543 implantation window phase endometrium in endometriosis group (1.2±0.6) with that in control group (1.5 ± 1.0), the difference was not statistical significant (P=0.890). Conclusions There are multiple differential expressions of miRNA in the implantation window phase endometrium tissues of endometriosis infertility patients, among which miR-142-5p and miR-146a-5p show significantly enhanced expression and may affect embryo implantation by acting on a variety of endometrial receptivity marker molecules. The expression of miR-543 in implantation window phase endometrium of endometriosis infertility patients is lower than that in the follicular phase, forewarned changes in the pattern of cyclic variation of miR-543, and may be the reason for affecting endometrial receptivity.

Objective To investigate the effects of laparoscopic management of hydrosalpinx on outcomes of in vitro fertilization and embryo transfer(IVF-ET).Methods A total of 53 patients with hydrosalpinx undergoing IVF-ET from 2002 to 2005 were divided into three groups: ①Untreated Group included 17 patients who were given no interventions for hydrosalpinx prior to IVF-ET;②Preoperative Group included 17 patients undergoing laparoscopic treatment of hydrosalpinx prior to IVF-ET;③Postoperative Group had 19 patients who had experienced a history of unsuccessful IVF-ET treatment cycles and received laparoscopic management of hydrosalpinx prior to subsequent IVF-ET cycles.Results The pregnancy rates in fresh IVF cycles,the pregnancy rates in frozen cycles,the mean pregnancy rates per transfer,and the accumulative rate of live fetuses were 15.8%(3/19),10.5%(2/19),13.2%(5/38),and 17.6%(3/17) in the Untreated Group,36.8%(7/19),23.1%(3/13),30.3%(10/32),and 41.7%(8/17) in the Preoperative Group,and 16.7%(2/12),58.3%(14/24),44.4%(16/36),and 73.7%(14/19) in the Postoperative Group,respectively.The pregnancy rates in frozen cycles,the mean pregnancy rates per transfer,and the accumulative rate of live fetuses were all significantly higher in the Postoperative Group than in the Untreated Group(?~2=10.374,P=0.001;?~2=8.903,P=0.003;?~2=11.305,P=0.001,respectively).The mean pregnancy rates per transfer and the accumulative rate of live fetuses in the Preoperative Group tended to higher than those in the Untreated Group(?~2=3.377,P=0.066;?~2=3.360,P=0.067).Conclusions Hydrosalpinx is associated with poor IVF-ET outcomes.Laparoscopic management for hydrosalpinx prior to IVF-ET improves the pregnancy rate of IVF-ET.

0.05).The pregnancy rate was 41.5%(17/41) in the(Non-cystectomy) Group,33.3%(23/69) in the Laparoscopic Group,and 25.5%(14/55) in the Open Group,respectively,without significant differences(?~2=2.754,P=0.252).A total of 86 patients(90 cycles) were given a unilateral cystectomy,including 37 cycles in the Open Group and 53 cycles in the Laparoscopic Group.In the 37 cycles of the Open Group,the number of dominant follicles was less in affected ovary(4.41?4.02) than in contralateral one(6.14?4.37)(t=-2.364,P=0.024),whereas in the 53 cycles of the Laparoscopic Group,the number of dominant follicles was significantly less in affected ovary(3.33?3.50) than in contralateral ovary(6.40?3.61)(t=-5.358,P=0.000).Conclusions Both laparoscopic and open cystectomy of ovarian endometrioma may cause damage to ovarian response of COH.

Objective To compare clinical effects among three techniques of multifetal pregnancy reduction(MFPR) guided by transvaginal ultrasonography through vaginal approach.Methods Under the guidance of transvaginal B-ultrasonography,99 cases of multiple pregnancy following assisted reproductive technique underwent three different methods of embryo reduction: drug injection directly to the pregnancy sac(Drug Group),simple embryonic bud aspiration(Aspiration Group),and combined use of drug and aspiration(Combination Group).Results The gestational age at the procedure ranged 41~88 days(mean,58.9?8.7 days).The success rate of the procedure on one session was 100%(99/99).Short-term outcomes included 3 cases of abortion(3.0%).On continuing follow-up observations in 73 cases,the incidences of abortion and premature delivery were 11%(8/73) and 12%((9/73)),respectively.No statistical differences were seen among the three groups in rates of abortion,premature delivery,and full-term delivery(?~2=1.131,P=0.889).In the Aspiration Group,however,the exposure time to B-ultrasound and the operative time were significantly shorter than those in the other two groups.The gestational age at the procedure was 61.7?8.2 days in the Drug Group,48.8?2.7 days in the Aspiration Group,and 56.7?7.2 days in the Combination Group,respectively,with significant differences between the Aspiration Group and other two groups(F=19.36,P=0.000).The number of embryos reduced was associated with pregnancy outcomes: the abortion rate was remarkably higher in patients receiving the reduction of more than two embryos than only one embryo(?~2=6.415,P=0.040).Conclusions Ultrasound-guided multifetal pregnancy reduction is a safe,effective and microinvasive procedure.It is recommended that simple embryonic bud aspiration be used for multifetal pregnancy before 7 gestational weeks,combined use of drug injection and aspiration for multifetal pregnancy at 7~9 gestational weeks,and drug injection to the pregnancy sac for multifetal pregnancy after 9 weeks.

Objective To investigate the clinical pregnancy outcomes of laparoscopic treatment for different degrees of tubal adhesion and tubal distal occlusion.Methods Clinical information of 41 infertile patients from April 2001 to December 2005 was reviewed.According to the extent of tubal and pelvic lesion,the patients were classified as stage Ⅰ in 10 patients,stage Ⅱ in 10,stage Ⅲ in 17,and stage Ⅳ in 6.After a diagnosis was made by hysterosalpinggography(HSG),all the patients received a salpingostomy and adhesionlysis under laparoscope.Results No abnormal findings were detected by hysteroscopy and bilateral tubes were patent after operation in all the 41 patients.The 10 patients at stage Ⅰ were followed up for 12~21 months.Four of them got pregnant in six months and 1 got pregnant in 1 year because of intermittent separation,all the 5 patients being intrauterine pregnancy.The 8 patients at stage Ⅱ were followed up for 12~26 months.Three patients got pregnant,including intrauterine pregnancy in 1 and ectopic pregnancy in 2.The pregnancy occurred at 15,16,and 26 months after operation,respectively.The 17 patients at stage Ⅲ were followed up for 3~48 months.Four had pregnancy,at 3,4,12,and 14 months after operation,respectively,including intrauterine pregnancy in 1 and ectopic pregnancy in 3.The 6 patients at stage Ⅳ were followed up for 12~36 months and no pregnancy was observed.Among the 12 patients with pregnancy,8 got pregnant within 12 months and 3 at 13~18 months after operation,the pregnancy rate within 18 months being 91.7%(11/12). Conclusions Clinical pregnancy outcomes are related with the degree of tubal lesion and adnexal adhesion.Patients at stage Ⅰ~Ⅱ have better pregnancy outcomes than patients at stage Ⅲ~Ⅳ.

Objective To study the value of laparoscopic operation in the management of ectopic pregnancy. Methods The management of 509 cases of ectopic pregnancy reviewed retrospectively in our hospital from January 1999 to December 2001.Selected 60 cases treated by laparoscopy in 2001 were compared with 58 cases treated by laparotomy without hypovolemia shock.Operating time, postoperative hospital stay, time returning to normal temperature,total cost were compared. Results Laparoscopic surgery was performed in three cases in 1999,twenty three cases in 2000 and sixty cases in 2001. Comparison between laparoscopic and laparotomy group showed the operating time (66.3?25.3) min vs (75.9?22.0)min( t =-2.02, P =0.03);postoperative hospital stay (3.3?1.9)days vs (5.1?1.7)days( t =-5.42, P =0.00); total cost (7318.4?1440.1) RMB vs (5567.8?1567.8) RMB ( t =6.32, P =0.00). Conclutions Laparoscopic surgery is superior to laparotomy in the management of ectopic pregnancy.

Objective To compare the costs of laparoscopy and laparotomy in the operative treatment of ovarian cysts. Methods Patients with ovarian cysts who were operated on by laparoscopy (83) or by laparotomy (65) in the Peking University Third Hospital from June 2000 to August 2001 were retrospectively analyed.Patients' hospital stay,time taken for the patients to return to work,hospital charges,costs because of inability to work and total costs (including the direct medical costs,direct non-medical costs and indirect costs) were compared between the two groups. Results The mean hospital stay and the mean time taken for the patients to return to work were statistically shorter in the laparoscopy group than those in the laparotomy group.The mean hospital charges were significantly higher and the mean costs of without work were significantly lower in the laparoscopy group.The total costs in the two groups were similar (no significant difference). Conclusions According to the mean income of the people in Beijing,the costs of laparoscopy in the operative of the ovarian cysts are not higher than that of lapatomy.

Objective To evaluate the efficacy and safety of transvaginal hydrolaparoscopic ovarian drilling for treatment of the polycystic ovary syndrome(PCOS)in clomiphene citrate-resistant infertile women.Methods Between February 2008 and November 2008,11 clomiphene citrate-resistant anovulatory women with PCOS mean age:(29.3?3.7)years,mean body mass index:(24.3?8.3)kg/m2] were enrolled in this study.Transvaginal hydrolaparoscopy using a F5 bipolar needle was performed on the patients to create 5-15 holes with a free length of 0.8 cm and a diameter of 0.2 mm in each ovary(electrocoagulation time 10-15 sec).Results A mean of(17?6)holes were made in both the ovaries in the patients.No surgical complications occurred.The levels of LH,FSH,and androstenedione dropped from(14.7?4.5)IU/L,(7.1?6.4)IU/L,and(12.2?4.4)nmol/L to(10.5?3.7)IU/L,(6.4?1.7)IU/L,and(8.9?3.0)nmol/L(t=2.389,P=0.027;t=1.007,P=0.326;and t=2.104,P=0.048)respectively after the operation.The patients were followed up for 2 to 9 months,during the period 6(54.5%)patients recovered spontaneous menstruation,among which 3 recovered ovulatory cycles(27.3%)and 2(18.2%)had spontaneous pregnancy.In the other 8 patients who didn't recover spontaneous menstruation,5 cases received CC or FSH(one of them was pregnant after the treatment);1 case was not pregnant though received IVF;and 2 are still in follow-up.Conclusions Transvaginal hydrolaparoscopic ovarian drilling is safe and effective for clomiphene citrate-resistant infertile women.