Replacement therapy with plasma derived or recombinant F Ⅷ (rFⅧ) concentrates is only effective way to treat hemophilia A.Currently,the first,second and third generation rFⅧ are commercially available.Of the three products,the third generation rFⅧ products are best,because of no additional human or animal plasma proteins at any period.The use of rFⅧ concentrates has greatly improved the safety of replacement therapy in hemophilia A and reduced the risk of blood-borne pathogen transmission.In this article we review the current knowledge about the three rF Ⅷ concentrates,analyzing their main characteristic and their clinical hemostatic efficacy and safety.

A series of innovations in EMP teaching have been carried out in the 7-year-program clinical medicine from such aspects as curriculum design,teaching methodology and strategies,form of examination and establishment of an open teaching system.This paper is to compare the 5 language skills before and after the innovation.

OBJECTIVETo search for an optimal protocol and freezing conditions for the cryopreservation of microamount round spermatids of the mouse.

METHODSWe compared the survival rates of frozen-thawed microamount round spermatids of the mouse achieved by vitrification or standard slow freezing with different concentrations of glycerol (5, 7, or 9%) and different lengths of equilibrium time (0, 15, 30, 45, or 60 min).

RESULTSUnder the conditions of 7% glycerol and 30 min equilibrium, both vitrification and standard slow freezing achieved high survival rates of spermatids, and the former obtained an even higher rate than the latter ([72.9 ± 15.4]% vs [58.2 ± 17.7]%, P < 0.05).

CONCLUSIONA high rate of frozen-thawed microamount round spermatids of the mouse can be achieved by vitrification under the conditions of 7% glycerol and 30 min equilibrium.

Animals ; Cell Survival ; Cryopreservation ; methods ; Cryoprotective Agents ; administration & dosage ; pharmacology ; Glycerol ; administration & dosage ; pharmacology ; Male ; Mice ; Spermatids ; Time Factors ; Vitrification ; drug effects

Objective To study the changes of cerebral haemodynamics in neonates with hypoxic-ischemic encephalopathy(HIE) treated with Shengmai injection compared with citicoline,and explore the clinical interventions of Shengmai injection on HIE.Methods Fifty patients with HIE were randomized into 2 groups: shengmai group treated with Shengmai injection(n=30),and citicoline group treated with citicoline(n=20).The haemodynamic parameters included peak systolic flow velocity(PSFV),end-diastolic flow velocity(EDFV),pulsation index(PI) and resistance index(RI) of anterior and middle cerebral artery were detected by color Doppler ultrasound before treatment and on 7~(th) day after treatment respectively.Control group(n=50) compared with the two groups.Results PSFV,PDFV and RI of HIE patients were significantly lower than those of control group(P

Objective To study the relationship among insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3(IGFBP-3) and birth weight, length and placental weight and to discuss the endocrine factors which affected fetal growth by assaying levels of IGF-1、IGFBP-3 in umbilical cord serum.Methods The neonates were divided into appropriate for gestational age infant(AGA) and small for gestational age infant(SGA) according to birth weight and gestation. The birth weight, length and placental weight of neonates were measured and at meantime the levels of IGF-1 and IGFBP-3 were assayed by immunoradiometric assay.Results 1.There were 105 neonates, including 79 AGA and 26 SGA. There were significantly statistical differences in birth weight, length and placental weight (all, P

Objective To study the clinical significance of dynamic determination of serum CRP,IL-6 and fibrinogen(Fib) levels in unstable angina pectoris (UAP) patients.Methods 162 UAP patients were selected as UAP group(including 52 cases of low risk group,53 cases in medium risk group and 57 cases in high risk group),58 healthy people were selected as control group.The CRP,IL-6 and Fib contents were observed in UAP patients after cardiac events.Results At discharge,CRP,IL-6,Fib in UAP low risk group were (3.47 ±0.55)mg/L,(10.38 ± 1.57) ng/L,(1.64 ± 0.65) g/L,which were significantly lower than the admission contents [(6.50 ±0.87) mg/L,(14.35 ± 1.22) ng/L,(3.01 ± 0.28) g/L] (t =2.761,2.945,2.118,P =0.028,0.003,0.031).CRP,IL-6,Fib levels in the medium risk group were (6.87±0.75) mg/L,(14.35 ± 1.02) ng/L,(2.26 ± 0.33) g/L,which were significantly lower than the admission contents [(9.21±1.03) mg/L,(19.24±1.58) ng/L,(4.15 ±0.47) g/L] (t =2.985,3.157,3.548,P =0.003,0.001,0.000).CRP,IL-6,Fib levels in the high risk group were (8.71 ±0.84) mg/L,(17.37 ± 1.26) ng/L,(4.67 ±0.85) g/L,which were significantly lower than the admission contents [(12.48 ± 1.24) mg/L,(25.13 ± 1.84) ng/L,(7.28 ± 0.64) g/L] (t =3.472,4.018,5.097,P =0.000,0.000,0.000).Six months after hospital discharge,in CRP,IL-6,Fib elevated groups,the incidence rates of cardiac event were 40.20％,40.35％ and 47.50％,which were significantly higher than those in normal group (5.0％,4.17％,14.29％,x2 =23.655,2.211,14.442,P=0.000,0.000,0.000).Conclusion CRP,IL-6 and Fib levels in UAP patients were significantly higher than those in healthy people,and with remission,contents would be lower,which was the index to reflect the severity of UAP,but its specificity is bad,need to use caution.

Objective To analyze the outcomes of frozen-thawed blastocyst and cleavage embryo transfer after whole embryos cryopreservation. Methods The data of 489 IVF-ET cycles in reproductive medicine center of our hospital from September 2012 to August 2013 were analyzed retrospectively. Whole embryos cryopreservation in 214 patients were carried out with vitrification method and served as group A , 275 cycles performed fresh embryo transfer were served as group B. Then group A and group B were subdivided into group A1 (83 cycles),group A2 (131 cycles), group B1 (120 cycles)and group B2 (155 cycles)according to blastocyst transfer or cleavage-stage embryo transfer. The clinical outcomes of all groups were compared each other. Results The pregnancy rate and embryo implantation rate in group A1 were significantly higher(71.1% ,53.0%)than those in group A2, B1 and B2 (A2 group: 57.3%, 34.0%, B1group: 55.0%,42.1%, B2 group: 52.9%, 32.7%,respectively)(P<0.05). The embryo implantation rate in group B1 were higher than those in group B2 (P < 0.05). Conclusion F-ET after whole embryos freezing could significantly improve the embryo utilization rate and clinical pregnancy rate. Frozen-thawed blastocyst transfer could get better clinical outcomes than frozen-thawed cleavage-stage embryo transfer.

Objective To evaluate the clinical value of frozen-thawed blastocyst transfer and the blastocyst derived from frozen-thawed cleavage stage embryo transfer.Methods The data of 5 1 8 cycles in reproductive medicine center of the hospital from Sep-tember 2012 to August 2013 were analyzed retrospectively.According to the frozen-embryos type,all patients were divided into three groups,group A:frozen-thawed blastocyst transfer,129 cycles;group B:blastocysts derived from frozen-thawed cleavage stage embryos transfer,123 cycles;group C:frozen-thawed cleavage embryos transfer,266 cycles.The clinical outcomes of all groups were compared with each other,and the rates of blastocyst formation and cancellation were compared between group A and group B.Re-sults The rates of biochemical pregnancy,clinical pregnancy and embryo implantation in group A(70.5%,61.2%,42.3%)and group B(67.5%,58.2%,40.2%)were significantly higher than group C(53.0%,42.5%,23.1%)(P<0.05);there were no signif-icant differences in the rates of early abortion,ectopic pregnancy,multiple pregnancy among three groups(P>0.05);there were no significant differences in the blastocyst formation rates of the high quality cleavage embryos at D3 in fresh cycles and the frozen-thawed cleavage embryos(62.5%vs.57.7%)(P>0.05)and those two groups were both significantly higher than the poor quality cleavage embryos at D3 in fresh cycles(20.3%)(P<0.05).Conclusion Blastocyst transfer in vitrified-thawed cycles could get rel-atively satisfactory clinical outcomes.There are higher blastocyst formation rate and better clinical outcomes of transfer blastocyst derived from frozen-thawed cleavage embryo.

Objective To evaluate improvement of visual acuity for advanced proliferative diabetic retinopathy eyes with different complications after vitrectomy. Methods Four groups of advanced proliferative diabetic retinopathy (APDR) in 314 eyes with diabetes type Ⅱ and type Ⅰ were analyzed retrospectively: vitreous hemorrhage with limited traction retinal detachment (VH), extensive fibrovascular membranes with traction retinal detachment (TD), combined rhegmatogenous and traction retinal detachment (CRT) and cataract with vitreous hemorrhage or and traction retinal detachment (CHD). Results 0.1 or better postoperative visual acuity was achieved in 59.5% of type Ⅱ and 66.7% of type Ⅰ in the VH group; 39.4% of type Ⅱ and 52.6% of type Ⅰ in the extensive TD group; 31.6% of the CRT group; 62.5% of the CHD group. The major intraoperative complication is iatrogenic retinal breaks. The causes of postoperative visual loss in present study included neovascular glaucoma (2.8% of type Ⅰ and 0.4% of type Ⅱ in aphakia, 25% of type Ⅱ in aphakia and 4.2% in pseudophakia), retinal detachment and CRAO. Conclusion The majority of APDR eyes obtained better visual improvement after vitrectomy and photocoagulation.

Objective To evaluate the success rate and the risk of impairing vision for epimacular surgery. Methods A retrospective analysis of 57 eyes with epimacular membrane after surgery was made, and the changes in visual acuity and near visual acuity, in different etiology, improvement in distortion, as well as intraoperative and postoperative complications were compared. Results The eyes of 78 8% achieved a visual improvement of more than 2 lines. The visual improvement after surgery of epimacular membranes was the most in buckling group, then in macular hole with epimacular membrane and idiopathic eyes, the change was very limited in macular traction syndrome. The improvement of near visual acuity is usually better than distant visual acuity. The improvement rate of distortion is of 65 0%. The main intraoperative complication was reopen of the primary hole(4 eyes) and the formation of new hole(5 eyes). Conclusion Surgical peeling for epimacular membranes can improve the visual acuity and distorted vision,particularly in epimacular membrane after buckling surgeries, with macular hole and idiopathic eyes. possible risks might be present in surgical manipulation.