Objective To evaluate the role of transvaginal color Doppler ultrasound measurements of endometrial thickness,endometrium and subendometrial blood distribution patterns and flow index in predicting endometrial receptivity and pregnancy outcome of freezing embryo transfer(FET).Methods 468 cycles FET were analysed retrospectively.Endometrial thickness,endometrium and subendometrial blood distribution patterns,pulsatility index (PI),resistance index (RI),systolic /diastolic ratio (S/D) of endometrial and subendometrial blood flows with transvaginal ultrasonography were measured on the day of progesterone initiation.Based on the clinical pregnancy or not,patients were divided into two groups.The comparison of these indicators were carried out between pregnant group and non pregnant group.Results The endometrium and subendometrial blood distribution patterns had statistical difference between the two groups(P ＜0.05),the clinical pregnancy rate of Ⅰ,Ⅱ,Ⅲ blood distribution patterns were 31.0％,62.5％,79.0％ respectively.In the pregnancy group,the S/D,PI,and RI of endometrium were significantly lower than those in the nonpregnant group (P ＜ 0.05),and there was no significant difference between the pregnant group and nonpregnant group in endometrial thickness(P ＞0.05).Conclusions Endometrium and subendometrial blood distribution patterns and flow index measured with transvaginal color Doppler ultrasound could assess endometrial receptivity and guide the time selecting of FET transplantation.

Objective To investigate the pregnancy outcome of frozen-thawed embryos transfer in different endometrial progesterone preparation time.Methods From January to December 2012,pregnant outcome of 1 103 frozen-thawed embryo transfer cycles using artificial periodic endometrial preparation were studied retrospectively in Reproductive Medical Center of Henan Provincial People's Hospital.It was divided into 4 groups:group 3-3 (n =543,3 days after endometrial progesterone preparation and transfer D3 embryo),group 4-3(n =330,4 days after endometrial progesterone preparation and transfer D3 embryo),group 5-5 (n =150,5 days after endometrial progesterone preparation and transfer D5 blastula),group 6-5 (n =80,6 days after endometrial progesterone preparation and transfer D5 blastula).The rate of implantation,pregnancy,ectopic pregnancy,multiple pregnancy,and first trimester abortion were compared among those groups.Results (1) With the different endometrial progesterone preparation methods and transfer D3 embryos,implantation rate [group 3-3:39.9％ (429/1 074) ; group 4-3:44.1％ (286/648)],pregnancy rate [group 3-3:56.0％ (304/543) ; group 4-3:59.4％ (196/330)],ectopic pregnancy rate [group 3-3:3.3％ (10/304) ; group 4-3:2.6％ (5/196)],multiple pregnancy rate [group 3-3:38.5％ (117/304) ; group 4-3:43.4％ (85/196)]and early abortion rate[group 3-3:13.5％ (41/304); group 4-3:13.3％ (26/196)] had no significant differences between group 3-3 and group 4-3 (all P ＞ 0.05).(2) With the different endometrial progesterone preparation methods and transfer D5 blastocysts,implantation rate [group 5-5:64.7％ (191/295) ; group 6-5:69.4％ (100/144)],pregnancy rate [group 5-5:80.7％ (121/150) ; group 6-5:78.8％ (63/80)],ectopic pregnancy rate [group 5-5:2.5％ (3/121) ; group 6-5:0],multiple pregnancy rate[group 5-5:55.4％ (67/121) ; group 6-5:46.3％ (37/80)] and early abortion rate[group 5-5:5.8％ (7/121); group 6-5:7.9％ (5/63)].However,there were no significantly differences between group 5-5 and group 6-5 (all P ＞ 0.05).Conclusions The two different progesterone transformed endometrial methods can obtain satisfactory clinical outcome with D3 embryo or D5 blastocysts transfor.It is convenient to clinical and laboratory work arrangements.

Objective To investigate and analyze the chronic diseases and geriatric syndromes in elderly inpatients.Methods A total of 227 elderly patients undergoing the comprehensive geriatric assessment admitted into geriatric ward of our hospital from June to December in 2018 were retrospectively analyzed in this case-control study.The patients were divided into two groups aged 80-90 years(n=137)and 65-79 years(n=90).The prevalence of chronic diseases and distribution of geriatric syndromes were compared between the two groups.Results Among 227 patients,the top five chronic diseases were primary hypertension (155 cases,68.3 ％),cerebrovascular diseases (108 cases,47.8％),coronary heart disease(103 cases,45.4 ％),osteoarthrosis (9 cases,39.2 ％) and type 2 diabetes mellitus (79 cases,34.8％).The prevalence of chronic diseases and geriatric syndromes showed an increased tendency along with ageing in elderly patients.The incidence rate of malnutrition,nutritional risk,cognitive disorders,poor vision,hearing loss,fecal and urinary incontinence and constipation were higher in the group aged 80-90 years than in the group aged 65-79 years (P＜0.05).The decreases of activities of daily life and instrumental activities of daily life,and fragile were more severe in the group aged 80-90 years than in the group aged 65-79 years(P＞0.05).No significant difference was found between the two groups in the incidences of multidrug use,mood disorder,sleep disorder,chronic pain and falls.The prevalence of chronic diseases was positively correlated with the prevalence of geriatric syndromes(r =0.339,P ＜0.01).Conclusions Along with ageing in elderly inpatients,the number of chronic diseases is increased,geriatric syndromes are more obvious,and the function significantly declines in elderly inpatients.Elderly patients should receive the comprehensive geriatric assessment,in order to timely identify and intervene these geriatric problems.

Objective To explore the value of anti-Müllerian hormone (AMH) and age in predicting outcomes of patients undergoing in vitro fertilization and embryo transfer treatment. Methods In this retrospective study, 6 328 Chinese patients who underwent the first in vitro fertilization or intracytoplasmic sperm injection and embryo transfer treatment in Henan Provincial People′s Hospital between July 2016 and July 2018 were analyzed. All the patients were categorized into two groups according to pregnancy or not. Baseline data and outcomes of two groups were compared. The regression analysis was conducted to identify the independent factors of clinical pregnancy rates. Furthermore, correlation analysis was performed between AMH and other factors. Results (1) The total clinical pregnancy rate was 56.86% (3 547/6 238). Age, AMH, basal FSH, antral follicle number (AFC), starting dose of gonadotropin (Gn), total doses of Gn, duration of Gn, number of oocytes, transferable cleavage embryos and transferred embryos were significantly different (all P<0.01). (2) Correlation analysis showed that AMH had significant passive correlation with age, basal FSH, starting dose of Gn and total doses of Gn (all P<0.01), while showed significant positive correlation with AFC, body mass index, duration of Gn, number of oocytes and transferable cleavage embryos (all P<0.01). Of all the factors, AMH had the strongest correlation with AFC (P<0.01). (3) Multivariate logistic regression analysis suggested that age was the independent influencing factor of clinical pregnancy rate ( OR=0.938, 95%CI : 0.824-0.952, P<0.01), while AMH not ( OR=1.004, 95%CI : 0.984-1.024, P=0.687). In the subgroups according to age, the advanced group (age>35 years old) had lower clinical pregnancy rate and higher cancellation rate for no available embryos. Conclusions AMH has no predictive value of clinical pregnancy outcomes for patients with in vitro fertilization and embryo transfer treatment, while age has certain predictive value of pregnancy outcomes. AMH level may have indictive value for the evaluation of ovarian reserve.

Objective:To explore the clinical outcomes of top-quality blastocysts transfer developed from cleavage embryos with different grading and determine whether the cleavage stage embryo morphology grading should be taken into consideration when transferring the embryo at the blastocyst stage.Methods:A number of 3 059 cycles were included with single top-quality blastocyst transfer dating from January 2017 to May 2021 in Henan Provincial People′s Hospital. According to the number of cleavage sphere and degree of fragmentation, all cleavage stage embryos were divided into three groups: top D3 embryo (8 cells, ≤5% fragments)-TB group, suboptimal D3 embryo (8 cells, 5%0.05); and the early abortion rate were 10.74%, 12.54% and 12.62%, respectively ( P>0.05). After adjusting for confounders, logistic regression showed that no significant associations were found between cleavage stage embryo morphology grading and clinical pregnancy rate (suboptimal D3 embryo-TB group: OR=1.02, 95% CI: 0.76-1.38, P=0.879; normal D3 embryo-TB group: OR=0.84, 95% CI: 0.61-1.14, P=0.262) and early abortion rate (suboptimal D3 embryo-TB group: OR=1.18, 95% CI: 0.77-1.82, P=0.445; normal D3 embryo-TB group: OR=1.26, 95% CI: 0.81-1.98, P=0.309). The results of threshold effect analysis showed that when a single top-quality blastocysts was transferred, the effect of age on the clinical pregnancy rate showed a curve relationship, when the age was≥33 years old, the clinical pregnancy rate decreased significantly with age increased ( OR=0.89, 95% CI: 0.83-0.95, P=0.007); and there was no significant change in early abortion rate ( OR=1.01, 95% CI: 0.97-1.06, P=0.628). Conclusions:Cleavage stage embryo grading is not found to correlate with clinical outcomes in single top-quality blastcyst tranfer. Therefore, when considering blastocyst transfer, its morphology at blastocyst stage is more relevant. The effect of age on pregnancy outcomes of single blastocyst transfer should be considered.

Objective To understand the characteristics of nasal prongs or nasal mask for non-invasive positive pressure ventilation in preterm infants with respiratory distress syndrome ( RDS ) .Methods Ninety-three RDS preterm infants from August 2012 to June 2013 were chosen and divided into the nasal prong group (n=48) or nasal mask group (n=45) according to the random number table .The nasal prong group received the short binasal prongs as the connection interface , and the nasal mask group received the nasal mask .The parameters including fraction of inspiration O 2 ( FiO2 ) were adjusted according to transcutaneous oxygen saturation monitoring or blood gas analysis , and the various parameters and incidence rate of adverse reaction were recorded.Results After 12-24 h of non-invasive positive pressure ventilation, the level of pH, PaCO2, FiO2 , abdominal distension , the average time of non-invasive ventilation and the failure cases of non-invasive ventilation were respectively (7.32 ±0.06), (48.2 ±9.0) mmHg, (0.39 ±0.08), 3 cases, (54.1 ± 16.8) h and 12 cases in the nasal prong group, and were (7.31 ±0.07), (47.2 ±10.2) mmHg, (0.38 ± 0.08), 5 cases, (54.8 ±13.6) h and 9 cases in the nasal mask group, and the differences were not statistically significant (t/χ2 =0.169, 0.484, 0.464, 0.217, -0.226, 0.332, respectively;P>0.05).The total numbers of falling off and leaking gas were respectively 89 and 352 in the nasal prong group , and were lower than 48 and 489 in the nasal mask group, and the differences were statistically significant (χ2 =8.898, 44.644, respectively;P<0.05).No difference was found in the incidence rate of nasal injury between two groups (χ2 =0.009,P>0.05).But the sites of nasal injury between two groups were significant different , and the sites of nasal injury in the nasal prong group were almost around the medial aspect of the nasal septum and the columella, and were around the junction of the nasal septum and philtrum and the glabella in the nasal mask group.Conclusions The nasal prongs fall off more easily than nasal masks , and the nasal mask leaks more easily than nasal prongs , but there are no significant differences in the duration and the failure rate of noninvasive ventilation between the two types of connection interfaces .The incidence rate and degree of nasal injury causes by the nasal prongs or nasal mask are similar , but the sites of nasal injury are different .