Objectives To determine the predictive effect of the transvaginal ultrasonographic cervical measurement in induction of labor among the nulliparous. Methods This prospective observational study recruited women with singleton gestation scheduled for induction of labor at ≥37 weeks. All the pregnancy women were nulliparous. Transvaginal ultrasonographic cervical measurement was performed and Bishop score was detemined, each by operators masked to the other measurement. Data were collected on parity, gestational age, mode of delivery, induction agent, induction onset of labor interval, Bishop score and cervical measurement. Results A total 121 women were included. A stepwise regression model identified cervical length was the best linear predictor of induction to onset of labor interval. ( r=0.67, P

Objective To investigate the impact of the gestational diabetes mellitus and abnormal glucose challenge test (GCT) on macrosomia. Methods Clinical data of 8656 pregnant women who had antenatal care and delivered in the Department of Obstetrics and Gynecology of the First Hospital of Peking University from Jan 1995 to Mar 2001 were retrospectively analyzed. All of them underwent 50 g GCT. Results The incidence of macrosomia was 8.1% (700/8656). The incidence of macrosomia in GDM or IGT women was 12.5%(69/552), which was significantly higher than that of other women with normal glucose level 7.8%(631/8104, P

Objective To observe the changes of cervix in women between 16 and 35 weeks of gestation using transvaginal ultrasound and to determine the value of the cervix length in predicting preterm delivery among the women with threatened preterm labor Methods Transvaginal sonography were performed in 154 normal single nulliparous pregnant women between 16 and 35 weeks of gestation and 58 women with threatened preterm labor but without premature rupture of membrane Results (1) There is no definitely change in either cervical length or internal diameter of cervix among the pregnant women over the studied period There was also no funneling to be observed The mean cervical length is (36?5) mm,and the mean cervical internal diameter is (4?1) mm (2) Eleven preterm deliveries occured among the 58 pregnancy women with threatened preterm labor The cervical length by sonography of 11 preterm deliveries was (18?6) mm,and was significant shorter than the women without preterm deliveries whose mean cervical length was (32?6) mm ( P

OBJECTIVE:To systematically evaluate the efficacy and safety of simvastatin vs. pravastatin in the treatment of hy-perlipidemia,and provide evidence-based reference for the clinical treatment. METHODS:PubMed,Medline,EMBase,Cochrane Library and CJFD were retrieved to collect the randomized controlled trial(RCT)of efficacy and safety of simvastatin(test group) and pravastatin (control group) in the treatment of hyperlipidemia. The methodological quality of included studies was evaluated. The Rev Man 5.2 software was chosen for data analysis. RESULTS:14 RCT involving 1 019 patients were included. Meta-analysis showed that simvastatin had more significant effect in the decreasing of TC [MD=-0.34,95%CI(-0.52,-0.16),P<0.001] and LDL-C[MD=-0.31,95%CI(-0.45,-0.17),P<0.001] than pravastatin;and simvastatin and pravastatin had the similar effect in TG[MD=-0.06,95%CI(-0.18,0.05),P=0.28)] and HDL-C[MD=0.00,95%CI(-0.04,0.04),P=0.85]. Adverse drug reaction rate results showed they were similar[OR=0.70,95%CI(0.36,1.39),P=0.31]. CONCLUSIONS:Simvastatin is more effective in lipid-lowering than pravastatin with similar safety. Due to the limited number and low quality of included studies,it remains to be further verified with more reasonably designed,multi-center and large-sample studies.

ObjectiveTo investigate the imaging features of anterior cruciate ligament(ACL) graft insufficiency.Methods X-Ray and MR imaging examinations in 24 consecutive patients who had ACL reconstructive graft insufficiency were retrospectively evaluated for tunnel position,osteoarthrosis and its related complications.Follow-up arthroscopy showed 16 graft tears and 8 graft laxities.Fisher exact test was used to compare tunnel malpositions,the proportion of graft tear on MRI and osteoarthrosis between graft tear group and graft laxity group.ResultsTwo malpositions of tibial tunnel and 3 malpositions of femoral tunnel were seen in graft tear group.Three-malpositions of tibial tunnel and 4 malpositions of femoral tunnel were seen in graft laxity group.The proportion of tibial or femoral malposition showed no significant difference between the two groups(P =0.289,P =0.167).In graft tear group,15 complete graft tears were diagnosed correctly,1 partial tear was misdiagnosed as normal on MRI.In graft laxity group,4 grafts were diagnosed as normal and 4 were considered as graft tear on MRI.A significant difference was seen between the two groups (P = 0.028) in the proportion of graft tear diagnosed on MRI.Fourteen osteoarthrosis were seen in graft tear group and 5 in graft laxity group.No significant difference was seen between the two groups ( P =0.289) in the proportion of esteoarthrosis.Conclusion The proportions of tunnel malposition and osteoarthrosis showed no significant difference between the graft tear group and graft laxity group.Most graft tears can be diagnosed accurately on MRI,but some cases of graft laxity may be misdiagnosed for graft tear.

Objective To investigate the association between Helicobacter pylori(H. pylori) infection and Autoimmune thyroid diseases (ATDs). Methods The literatures on the association of H. pylori with ATDs were retrieved by searching databases from the inception of each da?tabase to October 2015. Data extraction and quality assessment were completed by two authors. Meta analysis was performed using RevMan 5.3 software,calculating the odds ratio and 95%confidence interval. Results Twelve papers were included for the meta?analysis. The total sample size was 1 615,with 918 cases and 697 controls,respectively. Compared with the controls,H.pyloriinfection significantly increased the risk of auto?immune thyroid diseases development with a pooled of[OR=1.86,95%CI(1.18,2.94)]. H.Pylori?CagA infection significantly increased the risk of autoimmune thyroid diseases development with a pooled of[OR=2.66,95%CI(1.61,4.41)]. H. pylori infection is associated with Graves dis?ease[OR=3.37,95%CI(1.90?5.97)]and Hashimoto′s thyroiditis[OR=1.83,95%CI(1.22,2.76)]. The results of publication bias and sensitivi?ty analysis confirmed the reliability and stability of this meta analysis. Conclusion H. pylori infection may be associated with an increased risk of developing the autoimmune thyroid diseases.

Objective:To investigate the risk factors of rotator cuff tears combined with long head of bicep tendon (LHBT) lesion and its effects on preoperative function.Methods:From January 2016 to January 2020, there were 680 patients with rotator cuff tears, including 260 males and 420 females, were included. The average age was 56.1±8.7 (range 27-74 years). There were 250 cases on the left side and 430 cases on the right side. There were 436 cases on the main side, while 274 cases had definite trauma before operation. The following were the Post rotator cuff tears classification, 133 cases in partial injury, 473 cases in small and medium size of rotator cuff tears, 74 cases in large and massive size of rotator cuff tears. The Habermayer-Walch classification of LHBT lesions was as following, 302 cases in type 0 (normal), 216 cases in type 1 (tendonitis), 29 cases in type 2 (dislocation and subluxation), 104 cases in type 3 (partial tear), 20 cases in type 4 (complete tear) and 9 cases in type 5 (SLAP injury above type II). The patient with rotator cuff tears were divided into partial tears group, medium and small tears group, large and massive tears group according to the classification of Post. The visual analogue scale (VAS), simple shoulder test (SST), Constant-Murley function score and the score of the University of California Los Angeles (UCLA) were recorded. The differences in age, sex, main side, trauma and LHBT lesion in patients with three types of rotator cuff tears were analyzed. The preoperative pain and function scores of patients with or without LHBT lesions in various rotator cuff tears were compared among the groups by t-test. The age, sex, main side, with trauma or not, and the classification of rotator cuff tears were analyzed by Logistic regression to investigate the risk factors of patients with rotator cuff tears with LHBT lesions. Results:There were 378 cases (55.6%) with LHBT lesions in 680 patients with rotator cuff tears, including 216 cases of tendinitis (57.1%), 104 cases of partial tear (27.5%), 29 cases of dislocation and subluxation (7.7%), 20 cases of complete tear (5.3%) and 9 cases of SLAP injury (2.4%). The incidence of partial injury, small and medium injury, large and massive rotator cuff injury combined with LHBT lesions were 35.3% (47/133), 57.5% (272/473) and 79.7% (59/74) respectively. The preoperative VAS score, UCLA score, Constant-Murley score and SST score were 5.20±1.52, 14.81±4.12, 41.45±4.93 and 4.56±1.96 respectively in rotator cuff tears group and 5.29±1.65, 14.34±4.01, 41.60±5.88, 4.47±1.97 in LHBT group ( P>0.05). In the partial rotator cuff tears group, the VAS score was 5.16±1.41 in patients with simple rotator cuff tears and 5.68±1.46 in patients with LHBT lesion ( t=2.004, P=0.047). Regression analysis showed that age ≥60 years and rotator cuff tears degree were the risk factors for rotator cuff tears with LHBT ( P<0.001). Conclusion:It is common for patients to have rotator cuff tears with LHBT lesions. The more severe the rotator cuff tears are, the higher the incidence of LHBT lesions will be. Patients with rotator cuff tears aged 60 and above are more likely to have LHBT lesions. However, the complications of LHBT could not affect the preoperative pain and functional scores of patients with rotator cuff tears.

Objective To detect the expressions of human telomerase tranacriptase (hTERT) and MMP-7 mRNA in the peripheral blood of patients with cardia cancer.Methods Total RNA was extracted with TRIzol and was transcribed reversely into cDNA.RT-PCR was used to detect mRNA expression of MMP-7 and hTERT in the peripheral blood of 157 patients with cardia cancer.81 patients without metastasis were followed up for 12 months.Results Of 157 patients,73 cases (46.0 ％) and 61 cases (38.8 ％) had the positive expressions of hTERT,MMP-7,respectively.There were significant correlations between the blood micro-metastases MMP-7 and hTERT expressions and TNM staging (x2 =10.624,14.530),tumor metastasis (x2 =7.294,12.824),and differentiation degree (x2 =12.003,6.482),but no significant correlations were seen in sex (x2 =2.597,0.199) and age (x2 =4.314,0.073).There was statistically significant in the occurrence rate of tumor metastasis between 6-month and 12-month follow-up.The occurrence rate of metastasis in patients with micro-metastases was 6.12-fold compared with patients without micro-metastases after 12-month follow-up.Conclusion Detection of MMP-7 and hTERT expressions can be used as reliable markers to predict peripheral blood micro-metastasis in patients with cardia carcinoma.

Objective To investigate the risk of hepatitis B virus (HBV) infection in the children born to HBV‐infected parent (s) after in vitro fertilization (IVF) .Methods From January 2008 to December 2013 , in the reproductive medicine center of the Third Affiliated Hospital of Zhengzhou University ,the medical history of 221 mothers by IVF were collected .Inclusion criteria were at least one of the parents was positive for hepatitis B surface antigen (HBsAg) ,and HBV DNA<1 × 104copies/mL . Hepatitis B vaccination status and HBV infection status of children were followed by telephone .Results One hundred and seventy‐two cases were followed up successfully ,and 49cases were lost .Two hundred and twenty‐four cases of children were HBsAg negative ,but one of them showed hepatitis B virus e antibody and hepatitis B virus core antibody positive .Conclusions The vertical transmission risk of HBV infection of children born to HBV‐positive patent(s) by IVF did not increase .

Objective To compare the clinical outcomes of two D3 embryo and single blastocyst transfer in patients retrieving different oocytes, so as to provide data support for selecting a clinical transfer strategy. Methods We made a retrospective analysis of patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)between January and December 2014 in the Reproductive Medicine Center,the Third Affiliated Hospital of Zhengzhou University.The patients were divided into three groups according to the number of oocytes received:Group A (5-9 oocytes),Group B (10 - 14 oocytes)and Group C (≥ 1 5 oocytes).Patients in each group all received four different transfer methods as follows:transfer of two fresh D3 embryos (a ),transfer of one fresh blastocyst (b ),transfer of two D3 frozen embryos (c ),and transfer of one frozen blastocyst (d ).We compared the 2PN fertilization rate of oocytes,rate of available embryos and rate of good embryos among the three groups.We also compared the embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate, multiplets rate and abortion rate among the four transfer methods in each group.Results ① There were 667, 573,and 479 transfer cycles in Group A,Group B and Group C,respectively.The 2PN fertilization rate of IVF and available embryos rate was significantly higher in Group A than in Group B and Group C (P =0.003/P <0.001).② There was no significant difference in biochemical pregnancy rate,clinical pregnancy rate or abortion rate with the four transfer methods in Group A (P >0.05),but the implantation rate of c was significantly lower than that of a and d (P =0.027/0.020),d had a higher implantation rate than a and c in Group B (P =0.005/0.001).In Group C,the biochemical pregnancy rate and clinical pregnancy rate of d were significantly higher than those of a (P =0.048/0.027)and c (P =0.003/0.001).Patients in Group C also had a higher implantation rate than D3 embryos (P <0.05).③ The multiple pregnancy rate of single blastocyst transfer decreased compared with D3 embryos transfer in the three groups (P <0.05).Conclusion Single blastocyst transfer has both higher implantation rate and lower multiple pregnancy rate in high response patients (1 5 or more oocytes received).For patients who received 5-9 and 10-14 oocytes,D3 embryos have a similar clinical pregnancy rate with that of single blastocyst but a higher multiple pregnancy rate.Single vitrified-warmed blastocyst transfer has a higher clinical pregnancy rate.It is the best transfer method for patients who received more than 10 oocytes.