Adult ; Female ; Follow-Up Studies ; Humans ; Influenza A Virus, H1N1 Subtype ; pathogenicity ; Influenza, Human ; diagnosis ; Pregnancy ; Respiratory Distress Syndrome, Adult ; diagnosis ; virology

OBJECTIVETo study the application value of normal sperm morphology on the outcomes of classic in vitro fertilization and embryo transfer (IVF-ET).

METHODSThis study included 659 infertile couples admitted to our center for IVF-ET. Based on the percentage of morphologically normal sperm (MNS), we divided the patients into groups A (n = 112, MNS < 2%), B (n = 180, MNS > or = 2 - < 4%), C (n = 74, MNS > or = 4 - < 5%), and D (n = 293, MNS > or = 5%), and compared the rates of fertilization, normal fertilization, embryos obtained, biochemical pregnancy, clinical pregnancy, implantation, and live birth among different groups.

RESULTSThe mean fertilization rate was significantly higher in groups C (71.90%) and D (72.89%) than in A (57.97%) and B (63.29%) (P < 0.05), with no remarkable differences either between A and B (P > 0.05) or between C and D (P > 0.05). The normal fertilization rate was also significantly higher in group D (57.16%) than in A (46.52%) and B (50.89%) (both P < 0.05) as well as in C (54.67%) than in A (P < 0.05). The rate of embryos obtained, too, was markedly higher in group D (55.62%) than in B (45.75%) (P < 0.05), but none with remarkable difference from other groups (all P > 0.05). There were no statistically significant differences among the four groups in the rates of biochemical pregnancy, clinical pregnancy, implantation, abortion, and live birth (all P > 0.05).

CONCLUSIONThe rate of MNS had some influence on IVF-ET, and 5% MNS exhibited a higher value than 4% MNS in predicting the outcomes of IVF.

Adult ; Embryo Implantation ; Female ; Fertilization in Vitro ; Humans ; Male ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Spermatozoa ; cytology

OBJECTIVETo investigate the association between CTLA-4 gene polymorphism and Henoch-Schönlein purpura (HSP) in children.

METHODSSixty children who were diagnosed with HSP were enrolled as the case group, consisting of 33 males and 27 females. Thirty healthy children were enrolled as the control group. The patients were further divided into HSP nephritis (HSPN) and non-HSPN groups (n=30 each) according to the presence or absence of nephritis. Polymerase chain reaction-restriction fragment length polymorphism was used to analyze the genotype and allele frequencies at +49 and -1722 loci.

RESULTSAA, AG, and GG genotypes were detected at +49; neither genotype nor allele frequencies showed significant differences between the case and control groups, between the HSPN and non-HSPN groups, and between male and female patients (P>0.05). TT, TC, and CC genotypes were detected at -1722; neither genotype nor allele frequencies showed significant differences between the case and control groups and between male and female patients (P>0.05). There were significant differences in CC genotype frequency and T and C allele frequencies between the HSPN and non-HSPN groups (P<0.05). Combinational analysis of +49 A/G and -1722 T/C showed no significant differences in the genotype frequency between the case and control groups and between male and female patients (P>0.05). GG-CC combination showed a significant difference between the HSPN and non-HSPN groups (P<0.05).

CONCLUSIONSCTLA-4 +49 A/G polymorphism is not associated with HSP. CC genotype and C allele of CTLA-4 -1722 and the combination of GG at +49 A/G and CC at -1722 T/C may be risk factors for HSPN.

CTLA-4 Antigen ; genetics ; Child ; Child, Preschool ; Female ; Genotype ; Humans ; Male ; Polymorphism, Genetic ; Purpura, Schoenlein-Henoch ; genetics

Objective To evaluate the modified foruix-based technique with Guyton hook as an approach for the treatment of children with horizontal strabismus.Methods The clinical data of 128 patients (170 eyes) who underwent horizontal strabismus surgery between January 2014 and June 2017 were retrospectively reviewed,including 60 males and 68 females.The mean age was 1.5-17.0 (6.5 ± 1.6) years.All procedures under general anesthesia were performed using the modified fornix-based conjunctival incision with Guyton hook,and the follow-up period was 6 to 12 months.The clinical and cosmetic outcomes of strabismus surgery,the complications and interventions related to the incision were assessed.Results At 3 months after surgery,orthophoria with excellent cosmetics was achieved in 119 patients (93％) with the deviation ≤ ± 10△.Together 102 eyes (60％) had no intraoperative suture.Moreover,the incision was sutured with one stitch in 45 eye (26.5％),in 20 (11.8％) with 2 stitches,and in 3 (1.8％) with 3 stitches.During the follow up period,there was no severe intraoperative or postoperative complications.The swelling and redness of conjunctiva recovered quickly.Patients' discomfort was alleviated in a few days after the surgery.No oblivious scarring was found along the incision lines.Conclusion The modified fornix-based approach with Guyton hook is an effective and safe method for minimal incision surgery in children with horizontal strabis.

Objective To analyze the distribution of pathogens in the genital tract of infertile female,and comparing traditional methods with simultaneous amplification and testing (SAT) in the detection of UU,CT,NG and MG.Methods 467 female infertility patients were selected from the reproductive center of Suzhou Hospital Affiliated to Nanjing Medical University between June and September 2016 to analyze the distribution of UU,CT,MG and NG.The age was between 20 to 48 years old (mean 31.52±6.83 years old).352 cases of female patients with assisted reproductive technology were selected,aged from 21 to 46 years old (mean 30.67±6.67 years old).The swabs were tested by traditional methods or SAT.The sensitivity and specificity of the methods in detecting the pathogens were evaluated according to the experimental results.Results Among the 467 infertile women,the number of UU positive cases was the highest,the positive rate was 62.53％ (292/467),the positive rate of CT was 1.93％ (9/467) and the positive rate of NG was 0.21％ (1/467),and the positive rate of MG was 1.71％ (8/467).UU infection rate was higher in infertile women than normal control group 23.81％ (25/105) (x2 =52.01,P＜0.01).352 cases of female patients with assisted reproductive technology were selected for further analysis.For UU detection,the positive rate of swab samples detected by liquid culture was 48.9％,while the positive rate detected by SAT was 63.9％.Obviously the positive rate of SAT was higher than that of liquid culture.Swab culture and SAT results were analyzed by paired x2 test (x2 =41.93,P＜0.01).The positive rate of CT SAT was 1.71％,and the positive rate of CT-latex method was 0.28 ％.There was significant difference between CT latex method and SAT (Fisher exact probabilistic method statistical analysis,P＜0.005),which indicated that SAT method had a higher sensitivity.The positive rate (1.7 ％) and sensitivity (100％) of SAT were also higher than that of traditional method.Conclusion UU was the most common pathogen in female reproductive tract pathogens,followed by CT and MG.The SAT method has higher sensitivity than the conventional method in detecting of UU and CT.

Different cytokines are needed in the course of culturing cells to do adoptive immunotherapy. This study was aimed to investigate the differentiation directions of lymphocytes and related gene expression characteristics after combined stimulation of lymphocytes by different cytokines or EBV antigen peptide combined with cytokines. The experiment was divided into 4 groups. The levels of total T lymphocytes (CD3(+)), T helper lymphocytes (CD3(+)CD4(+)), cytotoxic T-lymphocyte (CD3(+)CD8(+)), memory T cells (CD3(+)CD8(+)CD45RO(+)), naive T cells (CD3(+)CD8(+)CD45RA(+)), Th2 cells (CD3(+)CD30(+)), B cells (CD19(+)), NK cells (CD56(+)), naive T regulatory cells (CD4(+)CD25(+)), precise T regulatory cells (CD4(+)CD25(+)FOXP3(+)) were detected by flow cytometry. The expression levels of house-keeping gene (mad1, pten), T helper cells transcriptional regulatory gene t-bet (Th1), gata3 (Th2), cytokine IFN-γ(Th1), IL-4(Th2) were detected by using RT-PCR. The results showed that CTL in EBV polypeptide group were dominant cells with certain clinical effects. Comparison of result of EBV polypeptide group with other 3 different cytokine stimulating groups demonstrated that EBV antigen peptide had much more effects on stimulating CTL generation. The expression of IFN-γ gene was significantly increased; the T helper differentiation-related gene t-bet, gata3 also increased evidently, while expression change of house-keeping gene mad1 and pten were not evident. Addition of different cytokines and antigen peptides in culture may be much more effective on stimulating CTL generation. It is concluded that specific CTL can be obtained by using the lymphocytes co-cultured with EBV and cytokines, and the different cytokines play different roles in cell differentiation.
Cells, Cultured ; Cytokines ; immunology ; metabolism ; Epstein-Barr Virus Nuclear Antigens ; genetics ; Flow Cytometry ; Humans ; Immunotherapy, Adoptive ; Lymphocyte Count ; Lymphoma, Extranodal NK-T-Cell ; genetics ; immunology ; T-Lymphocytes, Cytotoxic ; immunology

Objective To observe the retinal microstructure changes in patients with rhegmatogenous retinal detachment following vitrectomy procedures and its correlation with the best corrected visual acuity (BCVA).Methods Patients who were diagnosed with rhegmatogenous retinal detachment and underwent vitrectomy were recruited in this study.BCVA and optical coherence tomography (OCT) examination were performed at 1 week,1 month,3 months and 6 months after operation for recording the neurosensory retinal thickness and outer nuclear layer thickness as well as observing the occurrence of ellipsoid zone,external limiting membrane rupture,macuiar edema,macular epiretinal membrane.Results A total of 32 eyes from 31 patients were followed up,and the BCVA became better as the follow-up prolonged.Both neurosensory retinal thickness and outer nuclear layer thickness thickened from 1 week [(122.75 ± 111.84) μm and (79.06 ±76.67) μm] to 3 months [(163.28 ± 133.10) μm and (108.66 ± 120.40)μm],and slightly thinned at 6 months [(159.50 ± 99.26) μm and (99.22 ± 74.89) μm].AS follow-up went by,the occurrence rate of ellipsoid zone and external limiting membrane rupture were 68.8％ and 53.1％,65.6％ and 46.9％,56.3％ and 40.6％,50.0％ and 37.5％ at 1 week,1 month,3 months,6 months,respectively,and both variables were significantly correlation with the patients' BCVA.Conclusion The neurosensory retinal thickness and outer nuclear layer thickness in patients with rhegmatogenous retinal detachment became gradually thicker and the vision became better during follow-up.Meanwhile,the ellipsoid zone and external limiting membrane rupture are the key factors for patients' BCVA.

Objective To describe the features of clinical,imaging and cerebral spinal fluid (CSF) of listerial rhombencephalitis to improve the understanding of this disease in clinical practice.Methods All the clinical data of three cases of listerial rhombencephalitis from April to August 2017 in Qilu Hospital were collected and analyzed retrospectively.Results All the three cases were healthy adult women before,with a rapidly progressive course,beginning with fever (38.2-40 ℃),headache accompanied by nausea and vomiting,followed by cranial paralysis,dysphagia and paralysis of the limbs on the 2nd to 5th day of onset,and developed to acute respiratory failure and unconsciousness on the 5th to 8th day of onset.All the three patients were diagnosed with CSF culture positive for Listera monocytogenes on the 3rd to 5th day after admission.The initial CSF lactic acid increased significantly,representing 12.3,12.0 and 10.0 mmol/L respectively;CSF white blood cells were 416× 106/L,760× 106/L and 793× 106/L,respectively,and the protein levels were 0.76 g/L,0.57 g/L and 1.47 g/L,respectively.Brain images showed brain stem was involved in all the three patients,therein cases 1 and 3 with cerebellar hemisphere involved,case 2 with upper cervical spinal cord involved,and case 1 with supratentorial hydrocephalus involved.After treatment with sensitive antibiotics,case 1 recovered,case 2 died,and case 3 lived with dysphagia.Conclusions Listerial rhombencephalitis should be suspected when a patient started with fever and headache,rapidly progressed to cranial nerve paralysis,brainstem symptoms,and acute respiratory failure,especially when the brain imaging suggested brainstem involved with increased white blood cells and apparently elevated lactic acid level of CSF.The earlier the sensitive antibiotics initiated,the better the patients' prognosis.

Hypertension is the leading risk factor for death resulted from cardiovascular diseases.According to the statistics,the number of patients with hypertension in China is 270 million.At present,15 classes and 69 drugs have been approved for the treatment of hypertension,however,the treatment rate and the control rate remain low.Therefore,the research tocusing on new antihypertensive drugs are how to effectively reduce the blood pressure in patients with refractory hypertension,reduce the target organ damage in patients with complications,and reduce adverse drug reactions.This paper summarized the recent research progress of anti-hypertensive drugs on the market or in development,so as to provide references for development and application of antihypertensive drugs.

Acute Coronary Syndrome ; drug therapy ; Angioplasty, Balloon, Coronary ; Aspirin ; administration & dosage ; Humans ; Platelet Aggregation Inhibitors ; administration & dosage ; Thrombelastography ; Ticlopidine ; administration & dosage ; analogs & derivatives ; Tyrosine ; administration & dosage ; analogs & derivatives