Objective To investigate the application value of two kinds of endometrial preparation in patients with thin endometrium of frozen thawed embryo transfer cycle.Methods A retrospective analysis of the clinical data of 82 cycle of 76 patients was carried out.According to the difference of the endometrial preparation,the two groups were divided into two groups.One group was progynova group (42 cycles),and the other group was femonston group (40 cycles).Baseline information,endometrial status and pregnancy outcome were compared between the two groups.Results There was no significant difference in baseline data (age,years of infertility,body mass index,basal hormone level) between the two groups.There was no significant difference in endometrial thickness[progynova group (5.52 ± 0.74) mm,femonston group (5.33 ± 0.66) mm,t =1.290,P =0.203],endometrial volume (progynova grouP ＜ 2mL and ≥ 2mL 38 patients and 4 patients,that of femonston group 36 cases and 4 cases,x2 =0.005,P =0.942),endometrial type (progynova group A,B,C type 35 cases,7 cases,0 case,those of emonston group 34 cases,6 cases,0 case,x2 =0.043,P =0.836) and blood flow (progynova group Ⅰ + Ⅱ and Ⅲ 34 cases and 8 cases,those of femonston group 35 cases and 5 cases,x2 =0.658,.P =0.417) between the two groups before treatment.After administration,endometrial thickness [progynova group (6.90 ± 0.62) mm,femonston group (7.60 ± 0.63) mm,t =5.04,P =0.000],neointimal growth [progynova group (1.67 ± 0.48) mm,femonston group (3.20 ± 0.61) mm,t =12.74,P =0.000],ratio of endometrial volume more than or equal to 2 mL [progynova group 52.38 ％ (22/42),femonston group 80.00％ (32/40),x2 =6.95,P =0.008],and ratio of endometrial blood flow type Ⅲ [progynova group 38.10％ (16/42),femonston group 70.00％ (28/40),x2 =8.387,P =0.004] of femonston group were higher than those of progynova group.The dosage[progynova group (112.43 ± 16.39)mg,femonston group (78.85 ± 10.17)mg,t =11.08,P =0.000] was lower than that of progynova group,and the difference was statistically significant.There was no significant difference in the two groups in endometrial type (progynova group A,B,C 30 cases,12 cases and 0 case,those of femonston group 28,12 and 0,x2 =0.020,P =0.887) after the treatment.There was no significant difference in the number of transplanted embryos (progynova group 1.78 ± 0.47,femonston group 1.77 ± 0.42,t =0.108,P =0.914),high quality embryo rate [progynova group 74.67 ％ (56/75),femonston group 73.24 ％ (52/71),x2 =0.039,P =0.844],implantation rate [progynova group 14.67 ％ (11/75),femonston group 16.90％ (12/71),x2 =0.137,P =0.711],biochemical pregnancy rate[progynova group 38.10％ (16/42),femonston group 40.00％ (16/40),x2 =0.031,P =0.860] and clinical pregnancy rate [progynova group 28.57 ％ (12/42),femonston group 32.50％ (13/40),x2 =0.149,P =0.699] between the two groups.Conclusion Femonston with less dosage,better improvement of the endometrial thickness,endometrial volume,endometrial blood flow of patients with thin endometrium of patients can obtain similar pregnancy outcomes compared with progynova.

Objective To investigate the effects of somatostatin (SST) on levels of IL-6,IL-8 and TNF-αduring CPB in pigs. Methods Twenty four healthy pigs were randomly divided into control group (SS00) and 3 experimental groups, SS05, SS10 and SS20. All pigs were performed by CPB for cardiac arrest in 45 min. the levels of IL-6, IL-10 and TNF-αwere tested and compared. Results The TNF-α, IL-6 and IL-10 levels were higher than T0 among all groups after CPB(P<0.05);The levels of TNF-αand IL-6 after CPB in SS10, SS20 groups were lower than SS00 group(P<0.05), and the IL-10 level was higher(P<0.05). Conclusion Infusing with a certain dose of SST before CPB could down-regulate acute inflammatory response;SST has no impact on the operative safety.

Objective To analyze the medical service capacity of primary healthcare in Zhejiang province since the ongoing healthcare reform and put forward suggestions. Methods Key indicators of healthcare resources and medical service utilization from 2009 to 2015 reflecting the primary healthcare were identified,for a quantitative analysis in terms of the structure-process-outcome dimensions. Results In terms of structural service capacity,the average headcount growth rate of primary healthcare′s technical personnel was 5. 7% per year; the personnel competence structure kept improving; the hospital beds at primary institutions and their ratio among all were slightly decreased,with better devices and informatization. In terms of procedural service capacity,the proportion of primary institutions with contract-based services amounted to 89. 9%,with the standard contract signing rate up to 18. 8%. In terms of consequential service capacity,the average growth rate of the number of outpatient visits at primary institutions was 6. 3%. The amount and proportion of inpatients were slightly decreased,while the hospital bed utilization ratio was increased slightly. Conclusions It is necessary to further strengthen the training and introduction of primary healthcare professionals. The functional orientation of hospitals at various levels should be clarified, encouraging contract-signing of general practitioners, promote the medical insurance payment reform featuring the capitation payment at primary level,and improve the income distribution and incentive mechanism.

Objective To observe the efficacy and acute inflammatory reactionof Qingjin Huazhuo Prescription combined with Western medicine therapy for treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Totally 60 hospitalized patients with AECOPD (Grade Ⅱ) and acute exacerbation course≤1 week were enrolled in this study. The patients were randomly divided into two groups, with 30 cases in each group. The control group was treated with conventional Western medicine. The observation group was treated with conventional Western medicine and oral administration of Qingjin Huazhuo Prescription for 10 days, once a day. TCM syndrome and dyspnea grading (mMRC score), white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT) and partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), were measured before and after the treatment. Results The total scores of TCM syndromes and cough, expectoration, wheezing, fever, and cyanosis in the two groups decreased significantly (P<0.05). The improving degrees of cough and expectoration were better in the observation group than in the control group (P<0.05). The scores of mMRC in the two groups were better than before treatment (P<0.05). The levels of WBC, CRP and PaCO2 in the two groups were lower than those before treatment (P<0.05). The decreased degrees of CRP and PaCO2 in the observation group were better than those in the control group (P<0.05, P<0.01). Conclusion Qingjin Huazhuo Prescription combined with Western medicine therapy can relieve clinical symptoms, reduce the acute inflammatory reaction of AECOPD patients and improve respiration.

Objective To evaluate the consistency of psoriasis-involved body surface area (BSA) measurement among raters from different clinical centers after training in a new standard operating procedure (SOP) for involved BSA measurement,so as to provide a method for the evaluation of psoriasis with high accuracy and operability.Methods Firstly,two raters from Guangdong Provincial Hospital of Chinese Medicine (GPHCM) independently and alternately assessed the disease severity in 40 patients with psoriasis after systematic training in the BSA-SOP.Then,one of the raters from GPHCM and 11 raters from 11 subcenters separately assessed the disease severity in 209 patients with psoriasis by using the BSA-SOP,and the consistency was evaluated by using intraclass correlation coefficient (ICC).Results There was a very high degree of consistency in involved BSA values between the 2 raters from GPHCM (ICC =0.989,95％ confidence interval:0.979-0.994).The consistency of involved BSA values for the assessment of psoriasis severity was also high among the rater from GPHCM and the raters from 11 subcenters (ICC ranging from 0.849 to 0.998).Conclusion The raters from different centers showed high consistency of involved BSA measurement for the assessment of psoriasis severity after training in the new BSA-SOP,so the BSA-SOP can serve as a reliable reference for multicenter clinical studies.

Objective To investigate the effect of the Qingjin-Huazhuo prescription on the fractional exhaled nitric oxide (FeNO) in the patients with phlegm heat accumulation of lung syndrome in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 72 patients with phlegm heat accumulation of lung syndrome in AECOPD who met the criteria were included were randomly divided into two groups,36 in each group.The control group received the conventional western medicine treatment,and the observation group received the additional Qingjin-Huazhuo prescription on the basis of the western medicine treatment.The duration of treatment was 10 days.The changes of TCM syndromes,FeNO and pulmonary function (FEV 1％,FVC％,FEV 1/FVC) on both two groups before and after treatment were recorded and compared.Results The improvement of cough,phlegm,wheeze and total score of TCM syndrome in the observation group were significantly better than the control group (t=3.091,2.303,3.063,2.412,P＜0.05).The improvement of FeNO in the observation group was significantly better than the control group (9.81 ± 12.10 ppb vs.3.42 ± 14.78 ppb,t=2.007) (P＜0.05).As for the pulmonary function,the improvement of FEV1％,FVC％,FEV1/FVC in the observation group were better than the control group (t=1.295,1.187,0.829,P=-0.200,0.240,0.411),but the differences were not significantly.Conclusions The Qingjin-Huazhuo prescription on the basis of conventional western medicine treatment for patientswith phlegm heat accumulation of lung syndrome in AECOPD,showed the improvement of symptoms,inhibit the inflammation in the respiratory tract and improve the ventilation function.

Objective To explore the feasibility of differential diagnosis of Gleason score (GS)(3+4)and (4+3)in prostate cancer (PCa) based on texture parameters of T2 WI and ADC maps.Methods A total of 77 patients with GS 7 points in PCa confirmed by pathology were enrolled in this retrospective study,including 45 GS(3+4)cases and 32 GS(4+3)cases.ROI was manually drew on the largest section of tumor on the axial T2 WI and ADC maps,and five texture parameters were extracted,namely,angular second moment (ASM),contrast, correlation,inverse difference moment and entropy,and the texture parameters between groups were analyzed statistically,then ROC curve was used to evaluate the diagnostic efficiency of texture parameters with statistical differences.Results There was no significant difference in age and prostate specific antigen (PSA)between GS (3 + 4)and GS (4 + 3)groups (P＞0.05).There were significant differences in ASM and entropy between T2 WI and ADC (P＜0.05),but there was no statistical difference in contrast,correlation and inverse difference moment (P＞0.05).Except for the AUC of T2 WIASM,there were statistical differences among T2 WIentropy ,ADCASM and ADCentropy.The AUC of ADCASM and ADCentropy were larger than that of T2 WIASM and T2 WIentropy.The AUC of ADCentropy had the largest AUC (0.732),the cut off value was 5.71 ,with the sensitivity was 97.6% and specificity was 5 9.5%.Conclusion MRI texture analysis can be used to differentiate GS (3 + 4)from GS (4 + 3)in PCa,and the ADCentropy have the best diagnostic efficacy.

Objective: This study aimed to systematically evaluate potential causal relationships between nine cathepsins and female infertility using Mendelian randomization (MR) methods. Methods: A bidirectional MR analysis was conducted utilizing single nucleotide polymorphisms as instrumental variables to investigate the potential causal effects between nine cathepsins and female infertility. Genetic data on female infertility were sourced from the FinnGen study, and cathepsin-related data were obtained from genome-wide association studies datasets of European ancestry. Results: Elevated levels of cathepsin E were significantly and inversely associated with the risk of female infertility, suggesting a potential protective role. This finding was further supported by multivariable MR analysis. However, no significant associations were observed between the other eight cathepsins and female infertility. Conclusion This study represents the first systematic MR analysis to identify a potential protective effect of cathepsin E on female infertility.

Objective: This study aimed to systematically evaluate potential causal relationships between nine cathepsins and female infertility using Mendelian randomization (MR) methods. Methods: A bidirectional MR analysis was conducted utilizing single nucleotide polymorphisms as instrumental variables to investigate the potential causal effects between nine cathepsins and female infertility. Genetic data on female infertility were sourced from the FinnGen study, and cathepsin-related data were obtained from genome-wide association studies datasets of European ancestry. Results: Elevated levels of cathepsin E were significantly and inversely associated with the risk of female infertility, suggesting a potential protective role. This finding was further supported by multivariable MR analysis. However, no significant associations were observed between the other eight cathepsins and female infertility. Conclusion This study represents the first systematic MR analysis to identify a potential protective effect of cathepsin E on female infertility.

Objective: This study aimed to systematically evaluate potential causal relationships between nine cathepsins and female infertility using Mendelian randomization (MR) methods. Methods: A bidirectional MR analysis was conducted utilizing single nucleotide polymorphisms as instrumental variables to investigate the potential causal effects between nine cathepsins and female infertility. Genetic data on female infertility were sourced from the FinnGen study, and cathepsin-related data were obtained from genome-wide association studies datasets of European ancestry. Results: Elevated levels of cathepsin E were significantly and inversely associated with the risk of female infertility, suggesting a potential protective role. This finding was further supported by multivariable MR analysis. However, no significant associations were observed between the other eight cathepsins and female infertility. Conclusion This study represents the first systematic MR analysis to identify a potential protective effect of cathepsin E on female infertility.