Objective To investigate the clinical outcome of patients who underwent whole embryo vitrification freezing and thawed frozen embryo transplantation, and to compare it with the patients at the same period in the fresh cycle to explore the value of vitrification technology in the whole embryo freezing combined with recovery transplantation. Methods The whole embryo freezing group included 40 untransplanted cases of in-vitro fertilization (IVF), while another 300 patients in the fresh cycle with in vitro fertilization and embryo transfer (IVF-ET) at the same period served as the fresh cycle group. The average number of transferred embryos, high-quality embryos, endometrial thickness, estradiol (E2) level, and clinical pregnancy rate were compared.Results The average number of transferred embryos, high-quality embryos, difference in endometrial thickness were not significant between the 2 groups (P>0.05); the E2 level of the fresh cylcle group was significantly higher than that of the whole embryo freezing group (P<0.05), and the clinical pregnancy rate in the fresh cylcle group was significantly lower than that of the whole embryo freezing group (P<0.05). Conclusion Vitrification technology is a simple, reliable, and efficient embryo freezing technology. For patients who meet the requirements, whole embryo vitrfication freezing and thawed frozen embryo transplantation is feasible. It is worth for further clinical research.

leptin-induced VSMCs proliferation as well as expression of PCNA and OB-R at both mRNA and protein levels. The maximum effect was at 100 μmol/L(P<0.01).

OBJECTIVE:To improve rational drug use and reduce potentially inappropriate medication (PIM). METHODS:PIM of 700 elderly inpatients in internal medicine department of our hospital was evaluated by Beers criteria(2012 edition)and STOPP/START criteria. RESULTS:700 inpatients whose mean ages were (76.3 ± 7.2) years old took (12.1 ± 4.9) kinds of drugs per patient. 144 cases involved PIM(20.6%). The number of PIM was 220 in total,among which there were 117 cases/times relat-ed to drugs and 22 cases/times related to disease in according to Beers criteria,9 cases/times of STOPP and 72 cases/times of START. Drug with most frequency of PIM in accordance with Beers was benzodiazepines and most frequency in STOPP was thia-zides that used by patients with gout histonry. The most omission frequency of START prescription were absence of metformin thera-py for type 2 diabetes and absence of antiplatelet therapy for diabetes complicated with cardiovascular risk. CONCLUSIONS:A high prevalence of PIM in elderly inpatients in our hospital requires various measures to prevent its occurrence.

Objective To investigate the effect of different doses of dexmedetomidine combined with intercostal nerve block in regional adenomammectomy.Methods 112 patients receiving regional adenomammectomy and meeting criterions were selected from Oct.2013 to Oct.2016.And they were divided into control group and low,medium,and high dose group according to table of random number,with 28 cases in each group.Patients of the control group only received intercostal nerve block.Patients of low dose group received low dose of dexmedetomidine (0.7 μg/kg load dose and 0.25μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of medium dose group received medium dose of dexmedetomidine (0.7 μg/kg load dose and 0.5 μg·kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of high dose group received high dose of dexmedetomidine (0.7 μg/kg load dose and 1 μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Mean arterial pressure,heart rate,VAS score and sedation score of the four groups were detected and compared at T0,T1,T2,T3 and T4.Results The mean arterial pressure and heart rate of medium and high dose group were lower than those of the control group and low dose group at T1,T2,T3 (P＜0.05).The mean arterial pressure and heart rate of high dose group were lower than those in medium dose group at T1,T2,T3 (P＜0.05).VAS score of medium and high dose group were lower than those of the control group and low dose group (P＜0.05),while the difference was not statistically significant between medium and high dose group(P＞0.05).The sedation scores of low,medium and high dose groups were higher than those of the control group at T1,T2,T3 and T4 (P＜0.05),while the sedation score of high dose group were higher than those of low and medium dose groups at T1,T2,T3 and T4 (P＜0.05).Conclusion Medium and high dose of dexmedetomidine combined intercostal nerve block can effectively relieve pain for patients undergoing regional adenomammectomy,while high dose of dexmedetomidine is likely to cause bradycardia,hypotension and excessive sedation.Appropriate dosage should be chosen in clinical practice.

Objective To study the effectiveness and safety of lipo-PGE1 on proteinuria in patients with diabetic nephropathy. MethodsForty-eight cases suffering from diabetic nephropathy with proteinuria exceeding 0.5 g/d and stage Ⅱ-Ⅳ of chronic kidney disease were divided into two groups.The basic treatment scheme for all the patients includes insulin and/or oral antidiabetic drugs and anti-hypertension drugs.The patients in the control group were given dipyridamole,and those in the lipo-PGE1-treatment group were managed with lipo-PGE1(alprostadil injection),10 ?g,qd?14 d.Results After the treatment,a decrease in proteinuria and increase in serum albumin were observed in the lipo-PGE1-treatment group,which was superior to the control group(P

Objective In order to investigate the relationship between hearing loss and diabetic peripheral neuropathy( DPN ) via comparing the pure tone thresholds and vibration perception threshold(VPT) in type 2 diabetic patients and control person without diabetes. Methods 173 subjects including 138 type 2 diabetic patients(DM)and 35 non-diabetes controls were examined for VPT and hearing threshold. Nerve conducting velocity ( NCV )including sensory nerve conducting velocity( SCV )and motorial nerve conducting velocity( MCV )of diabetic patients were determined. The participants were divided into three groups: control group (n = 35 ), DM group without peripheral neuropathy( non-PN group, n = 74 ), and DM group complicated with peripheral neuropathy (PN group,n = 64 ). The clinical characteristics, biochemical parameters , the incidence of sensorineural hearing loss ( SNHL),pure tone threshold, and VPT were compared among three groups. At last, the relationship between hearing thresholds and NCV were analyzed. Results The incidence of hearing impairment of sensorineural type was 29.69% in PN group, which was significantly higher than that of non-PN group( 17.57% )and control group( 17. 14% ). There was significant differences in age, duration of diabetes, glycolated hemoglobin (HbA1c), glycolated serum albumin ( GA), Fasting blood glucose( FPG), 2h postprandial blood glucose( PPG), VPT, and hearing threshold among the three groups( all P＜0. 05 ). The value of hearing threshold increased significantly( all P＜0. 05 ) in 3 VPT subgroups with VPT≤ 15 V, VPT 16-25 V, and VPT ＞25 V. The Spearman correlation analysis showed median NCV was negatively correlated with hearing threshold on 1.00, 2.00, 4. 00, and 8. 00 kHz ( All P ＜ 0. 05 ). The logistic regression analysis indicated that the age( regression coefficient =0. 088, P＜0. 01 ) was the independent risk factor of SNHL, median nerve MCV ( regression coefficient = -0. 135, P = 0. 046 ) was the important influencing factor of SNHL. Conclusion Diabetic patients are more likely to suffer from impaired middle-frequency and high-frequency hearing, DPN in patients is often complicated with hearing impairment. Age and median nerve MCV were major risk factors of SNHL in diabetic patients.

ObjectiveTo investigate the clinical value of serum complement C3 and C4 levels for predicting the severity of hepatic fibrosis in patients with chronic hepatitis B.MethodsHistopathological diagnosis was confirmed in 442 patients with chronic hepatitis B.Serum complement C3 and C4 levels were determined by Beckman-Coulter Immage 800 immunochemistry system.ROC curve was used to analyze the value of serum complement C3 and C4 levels in predicting the severity of hepatic fibrosis.ResultsThe areas under ROC curve of complement C3 and C4 for predicting significant fibrosis ( ≥ S2),severe fibrosis ( ≥ S3) and cirrhosis (S4) were all significantly larger than the area under diagonal reference line ( P =0.009,0.000,0.000 and P =0.005,0.000,0.000,respectively).According to ROC curves,the optimal cut-offs of serum complement G3 for predicting severe fibrosis and cirrhosis were ≤0.74 g/L and ≤0.64 g/L,and the corresponding sensitivity,specificity,positive predictive value,negative predictive value,accuracy were 0.585,0.681,0.617,0.650,0.636 and 0.509,0.775,0.423,0.830,0.710,respectively.The optimal cut-offs of serum complement C4 for predicting severe fibrosis and cirrhosis were ≤0.14 g/L and ≤0.12 g/L,and the corresponding sensitivity,specificity,positive predictive value,negative predictive value,accuracy were 0.565,0.634,0.576,0.623,0.602 and 0.463,0.781,0.407,0.818,0.704,respectively.ConclusionSerum complement C3 and C4 may be used for predicting severe fibrosis and cirrhosis in patients with chronic hepatitis B,but its stability and reliability need to be improved.

Objective To evaluate the safety and effectiveness of the treatment by selective β 1 receptor blockers on patients with chronic obstructive pulmonary disease (COPD).Methods Eighty cases of COPD Ⅲ (stable period) inpatient with or without coronary heart disease were collected in The Second People's Hospital of Shanghai from September 2012 to November 2013.The patients were randomly divided into testing group (Metoprolol treatment group) and control group (regular treatment group) with 40 cases for each group.Metoprolol group therapy based on the use of conventional metoprolol tablets,an initial dose of metoprolol 12.5 mg/d,titrated to the appropriate dose based on heart rate and tolerance of the morning resting heart rate of 55 to 60 times/min that reached the target dose of metoprolol continuous medication for 12 months.Blood gas analysis were recorded before and after treatment,pulmonary function,and 6 min walk test (6MWT) and were chronic lung disease Assessment Test (CAT) Rating.The control group was administrated regular treatment while the testing group added small dose of Metoprolol with titration to an appropriate dose on this basis.12 months in a row,and assessed the end stage.Results (1) After the application of selective β receptor blockers on testing group,no statistically significant difference (P＞0.05) in the values of FEV1 in anticipation value％ (testing group:(45.45 ± 4.68) ％ vs.(43.32 ± 4.84) ％;control group:(44.23 ± 4.68) ％ vs.(42.58 ±4.24)％),PaO2(testing group:(75.92± 10.78) mmHg vs.(74.86± 11.21) mmHg;control group:(70.23 ±6.45) mmHg vs.(72.36±7.28) mmHg) and PaCO2(testing group:(46.28±8.28) mmHg vs.(47.46±10.22) mmHg);control group:(44.54 ± 8.89) mmHg vs.(42.36 ± 7.45) mmHg) before and after treatment.But the 6MWD (testing group:(287 ± 23) m vs.(384± 34) m;control group:(284 ± 25) m vs.(295 ±21) m) and COPD appraisal test(CAT) (testing group:(21±7) score vs.(17±6) score);control group:(22 ±5) score vs.(20± 6) score) had improved significantly compared with that before treatment,with significant difference(t=4.903,4.784;P＜0.05).Conclusion Selective β receptor blockers have no effect on the airway resistance of COPD patients and reduction on pulmonary function.It can also increase the exercise tolerance and enhance the living quality for improving clinical prognosis.

Objective:To conduct a systematic review on the implementation effects of National Essential Medi-cine System ( NEMS) since the new health care reform and provide some suggestions to further improve the NEMS. Methods:Databases and relevant international organization reports were searched to collect studies related to the im-plementation of NEMS in China. The database search occurred from January 2009 to December 2014. Results:A to-tal of 1 292 studies were finally included, encompassing 1,277 Chinese papers, 12 English papers, and 3 WHO/HAI reports. A lot of researches have been done on NEMS, but the techniques of NEMS evaluation are not perfect. The sample representativeness is poor, and the longitudinal follow-up studies of the microscopic view is insufficient. . Evi-dence-based evaluation research using big data has just started. Conclusions: The research on NEMS should be strengthened. The NEMS evaluation should not only be based on national conditions, but it should also be in combi-nation with an international, multidimensional evaluation framework in terms of availability, affordability and rational drug use, so as to provide evidences to perfect the NEMS.

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