OBJECTIVETo investigate the values of the sperm deformity index (SDI), acrosome abnormity rate (AAR), and DNA fragmentation index (DFI) of optimized sperm in the prediction of fertilization failure (fertilization rate < 25%) in conventional in vitro fertilization (IVF).

METHODSWe selected 695 cycles of conventional IVF for pure oviductal infertility in this study, including 603 cycles of normal fertilization and 92 cycles of fertilization failure. On the day of oocyte retrieval, we examined sperm morphology, acrosome morphology, and DNA fragmentation using the Diff-Quik, PSA-FITC and SCD methods. We established the joint predictor (JP) by logistic equation and analyzed the values of different parameters in predicting fertilization failure with the receiver operating characteristic (ROC) curve.

RESULTSThe fertilization rate was negatively correlated with SDI (r = - 0.07; P = 0.03), AAR (r = -0.49; P < 0.01), and DFI (r = -0. 21; P < 0.01). The SDI, AAR, and DFI in the normal fertilization group were 1.24 ± 0.20, (7.75 ± 2.28)%, and (7.87 ± 3.15)%, and those in the fertilization failure group were 1.42 ± 0.15, (12.02 ± 3.06)%, and (13.32 ± 4.13)%, respectively, all with statistically significant differences between the two groups (P < 0.05). SDI, AAR, and DFI were all risk factors of fertilization failure ( OR = 2.68, 14.11, and 3.85; P = 0.01, < 0.01, and < 0.01). The areas under the ROC curves for SDI, AAR, DFI, and JP were 0.651 ± 0.033, 0.895 ± 0.019, 0.789 ± 0.022, and 0.915 ± 0.017, respectively. According to the Youden index, the optimal cut-off values of SDI, AAR, and DFI obtained for the prediction of fertilization failure were approximately 1.45, 10%, and 12%.

CONCLUSIONThe SDI, AAR and DFI of optimized sperm are closely associated with the fertilization rate, and all have the value for predicting fertilization failure in IVF. The AAR is more valuable than the other single predictors, but JP is more effective than the AAR.

Acrosome ; Area Under Curve ; DNA Fragmentation ; Fertilization ; Fertilization in Vitro ; methods ; statistics & numerical data ; Humans ; Male ; ROC Curve ; Risk Factors ; Spermatozoa ; abnormalities ; ultrastructure

Adult ; Aminosalicylic Acid ; therapeutic use ; Female ; Humans ; Manganese Poisoning ; drug therapy

Natural orifice tranluminal endoscopic surgery,NOTES is a noval surgical method whose major ad vantage is the diminishing of surgieal scar,thus is benefical to a subgroup of special patients.The key issues related to the development of NOTES are the invention of instrument satisfing the clinical demand,the setting up of safe method of closing the transluminal acce88 and the training of doctors.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Wounds and Injuries ; epidemiology ; Young Adult

OBJECTIVETo investigate the influence of the DNA integrity of optimized sperm on the embryonic development and clinical outcomes of in vitro fertilization and embryo transfer (IVF-ET).

METHODSThis study included 605 cycles of conventional IVF-ET for pure oviductal infertility performed from January 1, 2013 to December 31, 2014. On the day of retrieval, we examined the DNA integrity of the sperm using the sperm chromatin dispersion method. According to the ROC curve and Youden index, we grouped the cycles based on the sperm DNA fragmentation index (DFI) threshold value for predicting implantation failure, early miscarriage, and fertilization failure, followed by analysis of the correlation between DFI and the outcomes of IVF-ET.

RESULTSAccording to the DFI threshold values obtained, the 605 cycles fell into four groups (DFI value < 5%, 5-10%, 10-15%, and ≥ 15%). Statistically significant differences were observed among the four groups in the rates of fertilization, cleavage, high-quality embryo, implantation, clinical pregnancy, early miscarriage, and live birth (P < 0.05), but not in the rates of multiple pregnancy, premature birth, and low birth weight (P > 0.05). DFI was found to be correlated negatively with the rates of fertilization (r = -0.32, P < 0.01), cleavage (r = -0.19, P < 0.01), high-quality embryo (r = -0.40, P < 0.01), clinical pregnancy (r = -0.20, P < 0.01), and live birth (r = -0.09 P = 0.04), positively with the rate of early miscarriage (r = 0.23, P < 0.01), but not with the rates of multiple pregnancy (r = -0.01, P = 0.83), premature birth (r = 0.04, P = 0.54), and low birth weight (r = 0.03, P = 0.62).

CONCLUSIONThe DNA integrity of optimized sperm influences fertilization, embryonic development, early miscarriage, and live birth of IVF-ET, but its correlation with premature birth and low birth weight has to be further studied.

Abortion, Spontaneous ; Chromatin ; ultrastructure ; DNA Fragmentation ; Embryo Implantation ; Embryo Transfer ; Embryonic Development ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility, Female ; Male ; Pregnancy ; Pregnancy Outcome ; ROC Curve ; Spermatozoa ; cytology

Objective To discuss causes and corresponding prevention for groin pain occurred early after total hip arthroplasty(THA).Methods A retrospective study was done on 189 cases(193 hips)treated with THA including unilateral procedures in 185 hips and bilateral procedures in eight hips to analyze common causes for early groin pain.Results Groin pain was found in 9.3% hips(18/ 193)during hospital stay,including 1.6%(3 cases)with deep infection,1.6%(3 cases)with incision infection,1%(2 cases)with posterior dislocation,4.1%(8 cases)with leg lengthening and 1%(2 cases)with hematoma.Conclusions Despite of the numerous diagnostic alternatives available to the orthopedic surgeon,detailed history,careful physical examination,necessary laboratory and imaging stud- ies can contribute to a correct determination of causes for groin pain.Meanwhile,appropriate indication, accurate preoperative radiographic measurement,intraoperative standardized surgical procedures and per- fect rehabilitation are necessary to avoid complications.

Objective To evaluate DSA and MRI in diagnosing focal nodular hyperplasia(FNH) of the liver.Methods DSA and MRI findings in seven patients with pathologically-proved FNH were retrospectively analyzed.Selective hepatic arteriography with DSA,and both plain and dynamic contrastenhanced MR scans were performed in all patients.The imaging findings were retrospectively evaluated and analyzed.Results On DSA examination,all FNH lesions were hyper-vascular,which were characterized by thickened and tortuous feeding arteries.And the feeding arteries,after entering the lesions,branched off peripherally in a radiation pattern and the lesions were evenly dyed with sharp borders.In venous phase,hepatic vein drainage was demonstrated in 6 cases.On dynamic contrast-enhanced MRI,marked enhancement of the lesions was observed,which lasted until to delayed phase when the lesions still showed hyper-intensity or iso-intensity signals.Scar signal in the lesion's center was seen in three cases,which started to enhance at portal vein phase and maintained to delayed phase.Conclusion On DSA imaging,FNH lesions are characterized by thickened and tortuous feeding arteries that branch off peripherally in a radiation pattern after entering the lesions.And the hepatic vein drainage is also a common finding in venous phase.Dynamic contrast-enhanced MRI can well display the abnormal signal of the central scar of FNH.The combination use of DSA and MRI can effectively improve the diagnostic accuracy for FNH.

Objective:To study the effect of midnight-noon ebb-flow acupoint selection on rheumatoid arthritis. Methods:120 cases of patients with rheumatoid arthritis were randomly divided into three groups:midnight-noon ebb-flow acupoint selection group,acupuncture by differentiation of symptoms and signs group,integrative group of midnight-noon ebb-flow acupoint selection and acupuncture by differentiation of symptoms and signs group. Results:In the midday-midnight flowing of qi-blood acupuncture group of 40 cases,11 cases were improved obviously,11cases were improved,9cases were improved slightly,9 cases were ineffective,the total effective rate was 77.5%. In the acupuncture by differentiation of symptoms and signs group of 40 patients,10 cases were improved significantly,11 cases were improved,11 cases were improved moderate,8 cases were ineffective,the total effective rate was 80.0%. In integrated group of midnight-noon ebb-flow acupoint selection and acupuncture by differentiation of symptoms and signs group of 40 patients,15 cases were improved significantly,13 cases were improved,10 cases were improved moderate,2 cases were ineffective,the total effective rate was 95.0%. Curative effect of the integrative group was better than that of other two groups(P

Objective:To investigate the effect of Yiqi Huoxue Jiedu on diabetic peripheral neuropathy.Methods: 60 patients were randomly divided into treatment group receiving Yiqi Huoxue Jiedu treatment,control group receiving vitamin B and routine treatment to improve neural microcirculation.The conduction velocity of all patients’sensory and motor nerves and the scores of the symptoms had been observed.Results: Symptoms and nerve conduction velocity of treatment group and control group had been improved respectively,and the treatment group was superior to control group in clinic symptoms,clinical obvious effective rate and total effective rate.Conclusion: Yiqi Huoxue Jiedu method can improve conduction velocity of sensory and motor nerves,symptoms of anesthesia and pain of limbs of patients with diabetes peripheral neuropathy,and have good effect on diabetes peripheral neuropathy.

Objective To investigate the infection situation of HIV in patents in hospital ,and to provide basis for the prevention of AIDS in the hospital .Methods Three kinds of enzyme‐linked immunosorbent assay(ELISA)kits(Beijing wantai ,Beijing kewei , French BIO‐RAD)were used for screening HIV antibody and antigen in 240 781 samples from Jan .2011 to Dec .2013 .All HIV re‐peated positive screening samples were confirmed by western blotting in Chongqing shapingba Center for Disease Control and Pre‐vention .Results Among 240 781 samples from 2011 to 2013 ,593 samples(0 .246% ) were HIV positive at the first screening ,558 samples(0 .231% ) were HIV positive in at the repeated screening ,29 samples(0 .012% ) were HIV indeterminate ,6 samples(0 . 002% ) were HIV negative.Male and female ratio was 3 .39:1 .Conclusion Screening in hospital patients could be an important way to discover cases with HIV infection .It is nesscessary to strengthen the promotion and propaganda of HIV detection ,and new technology of HIV detection could be used to strengthen the inspection of HIV .Moreover ,the consciousness of self protection should be promoted in the treatment of HIV patients .