Objective:To figure out the clinical factors contributing to the oocytes utility rate (OUR) of high responders in in vitro fertilization (IVF)-embryo transfer treatment.Methods:OUR was defined by the number of usable embryos for transfer and (or) cryopreservation divided by the number of oocytes retrieved in a freeze-all cycle. The cycles with ≥15 eggs were included from January 2013 to December 2019. Those with OUR at the top 10% (Group A) and the bottom 10% (Group B) were picked and compared for patients′ characteristics, parameters relating to ovary stimulation and pregnant outcomes. Multifactorial logistic regression was applied to reveal the risk factors affecting OUR in them.Results:A total of 43 patients were included in Group A (OUR: 77.4%, 601/776) and 47 for Group B (OUR: 11.9%, 104/874). Previous IVF/intracytoplasmic sperm injection (ICSI; OR=0.10, 95% CI: 0.01-0.81) and endometriosis ( OR=0.16, 95% CI: 0.03-0.84) were negative factors for OUR ( P<0.05); dual suppression protocol ( OR=3.74, 95% CI: 1.06-26.86) and longer days of stimulation ( OR=3.24, 95% CI: 1.25-8.42) were protective factors in terms of ovarian stimulation ( P<0.05), on contrary to that, any decline of estradiol during the stimulation led to poorer OUR ( OR=0.16, 95% CI: 0.04-0.64). Although two groups had similar quantities of eggs and metaphase of meiosis Ⅱ (MⅡ) oocytes, distinguished cumulative clinical pregnancy rate and cumulative live birth rate were seen in Group A and group B respectively [95.3% (41/43) vs 40.4% (19/47) and 90.7% (39/43) vs 31.9% (15/47), all P<0.01]. Conclusions:High responders with attempted IVF/ICSI and endometriosis should be considered as risk factors for OUR. Over ovarian stimulation, dual suppression and a slightly longer stimulating duration could be tried; besides, estradiol decline should be prevented for a better OUR.

Adult ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Spondylitis, Ankylosing ; diagnosis ; drug therapy ; Tripterygium ; chemistry

Objective To evaluate the therapeutic responses to transsphenoidal surgery and medical therapy in terms of normalization of prolactin(PRL),mortality,morbidity and the cost-effectiveness of PRL normalization in order to establish an individualized therapeutic protocol for the patients with prolactinoma.Methods A retrospective study was undertaken of a consecutive series of patients with prolactinoma who were followed for at least 1 year after transsphenoidal surgery or medical treatment.The clinical characteristics and the long-term outcomes(normalization of PRL,morbidity or mortality)were assessed.Utilizing the principle of medical economics and data from the two types of treatment,we worked out a Markov chain and calculated the lowest cost of two kinds of therapeutic protocols.Results(1)The success rate of normalizing serum PRL through surgical treatment in microadenoma was 85%(22/26),and that of medical treatment was 95%(19/20).There was no statistical difference between the two therapies(P＞0.05).The success rate of normalizing serum PRL through surgical treatment in macroadenoma was45%(19/42),and that of medical treatment was 5/5.There was a statistical difierence between the two therapies(P＜0.05).(2)According to the Markov model,it would cost a microprolactinoma patient 25 129.25 yuan to normalize serum PRL by surgical treatment.This is comparable to the cost of medical treatment which would be 24 943.99 yuan.Whereas for a macroprolactinoma patient surgery would cost 35 208.20 yuan and medical treatment would cost 25 344.38 yuan.Conclusions Medical therapy is superior to surgical treatment in regard to complication rate and cost-effectiveness for macro-and extra big prolactinomas.Transsphenoidal surgery remains an option for patients with microadenomas.Markov model is an effective way to predict the treatment cost for patients with hyperprolactinoma at different ages and with different canses

OBJECTIVE To realize the situation of nosocomial infection and usage of antibiotic in order to prevent and control nosocomial infection effectively. METHODS According to the request of countrywide nosocomial infection net,using the method of clinic investigation and case history investigation,we have investigated the infection complexion about all patients in 19 May 2006 and 24 May 2007,including the duration,transferring department and dead case.Then to analyze the comparison between two results. RESULTS 3489 cases were investigated,including 186 infection cases.The prevalence rate of nosocomial infection was 5.33%.Five departments had the high prevalence rate of nosocomial infection.They were hematology department,ICU,pediatrics department,neonatal unit and cadre ward.The highest rate was 31.30%.The lowest was 0.The infection site focused on lower respiratory tract.The antibiotic utilizing rate was high. CONCLUSIONS Enhanceing the management of nosocomial infection in key departments,regulating the antibiotic utilizing,to reduce the prevalence rate of nosocomial infection.

OBJECTIVETo observe the therapeutic efficacy and safety of gonadotropin-releasing hormone agonist (GnRHa) combined Wenshen Xiaozheng Decoction (WXD) in auxiliary treating endometriosis after laparoscopy.

METHODSOne hundred and thirty-four endometriosis patients with confirmative pathological diagnosis were assigned to three groups depending on whether they would receive adjuvant therapy or Chinese medicine treatment, i.e., the control group, the observation 1 group, and the observation 2 group. The 22 patients in the control group received no adjuvant therapy after laparoscopy. The 42 patients in the observation 1 group were treated with GnRHa 3.6 mg by subcutaneous injection starting from the 1st day to the 5th day of menstruation, once per 28 days. The 70 patients in the observation 2 group were treated with GnRHa 3.6 mg by subcutaneous injection in combination with WXD starting from the 1st day to the 5th day of menstruation, once per 28 days. They also took WXD for 7 doses, one cycle per every 28 days. The treatment lasted for three to six months. Serum levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and cancer antigen 125 (CA125), as well as clinical efficacy, and adverse drug reactions were observed before and after treatment.

RESULTSThere was statistical difference in serum levels of E2, FSH, or LH between the control group and the observation 1 and 2 groups (P < 0.05). There was no statistical difference in serum levels of E2, FSH, or LH between the observation 1 group and the observation 2 group (P > 0.05). There was statistical difference in the clinical efficiency among the 3 groups (P < 0.05). There was statistical difference in the pre-post difference of CA125 levels among the three groups (P < 0.01). Compared with the control group, there was no statistical difference in the pre-post difference of CA125 levels between the observation 1 group and the observation 2 group (P > 0.05). No obvious adverse reaction occurred during the treatment.

CONCLUSIONSGnRHa combined WXD showed confirmative clinical efficacy in treating endometriosis after laparoscopy. It also could lower serum levels of E2, FSH, and LH levels. So it was an ideal solution for treatment of endometriosis.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; surgery ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Laparoscopy ; Treatment Outcome

With low molecular weight chitosan and poloxamer 188 as the joint carriers, ginsenoside Rg3 solid dispersions were prepared by using the solvent evaporation method for an in vitro dissolution test. Subsequently, differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and X-ray diffraction (X-RD) were adopted for a phase analysis. The results showed that the 60 min in vitro cumulative dissolution rate of ginsenoside Rg3 solid dispersions prepared with low molecular weight chitosan and poloxamer 188 at the ratio of 2:1 exceeded 90%, and the drug was dispersed in carriers in an amorphous state. Therefore, ginsenoside Rg3 solid dispersions prepared with low molecular weight chitosan and poloxamer 188 could help significantly improve the drug dissolution, with a practical application value.
Chitosan ; chemistry ; Drug Compounding ; methods ; Ginsenosides ; chemistry ; Molecular Weight ; Poloxamer ; chemistry ; Solvents ; chemistry

The ideal treatment and recovery of osteoarticular injury remain to be resolved. Small intestinal submucosa (SIS), a naturally-occurring decellularized extracellular matrix, has been recognized as an ideal scaffold for tissue engineering and widely used in repairing various tissues and organs. Nowadays its application has also been gradually increased in the field of orthopedics. We reviewed laboratorial studies and clinical trails about the application of SIS in bone and joint repair, aiming to evaluate its effects on the repair of bone, cartilage, meniscus, ligament and tendon. SIS has showed promising results in repairing bone, meniscus, ligament or tendon. However, additional studies will be required to further evaluate its effects on articular cartilage and tendon-bone healing. How to optimize SIS material,is also a focused problem concerned with making SIS a potential therapeutic option with high value for orthopedic tissue repair.
Animals ; Cell- and Tissue-Based Therapy ; Humans ; Intestinal Mucosa ; cytology ; Intestine, Small ; cytology ; Joint Diseases ; physiopathology ; surgery ; therapy ; Tissue Engineering ; instrumentation ; methods ; Tissue Scaffolds ; chemistry

Objective To investigate the changes of serum soluble factor-related apoptosis (sFas) and soluble Fas ligand (sFasL) and their relations with cognition disorders in the patients with vascular dementia (VaD). Methods Serum concentrations of sFas and sFasl were detected by enzyme-linked immunosorbent assay (ELISA) and compared between 70 patients with VaD aged (72.5± 7.5)years and 50 healthy elderly people aged(72.5 ± 7.5)years.The VaD patient's cognitive functions were evaluated by activity of daily living scale (ADL),mini mental state examination (MMSE) and hachinski ischemia score (Hachinski). Results The serum levels of sFas and sFasL in VaD patients were (228.0±60.7)μg/L and (146.8±30.1)μg/L,and in the healthy elderly were (62.4±22.6)μg/L and (82.3 ± 18.7)μg/L,respectively.The serum levels of apoptosis factors in VaD patients were significantly higher than in the healthy controls (t=20.883,14.453,P＜0.01).sFas level was negatively correlated with age,the scores of ADL and Hachiuski while positively with the scores of MMSE (r=-0.956,-0.943,-0.950 and 0.904,all P＜0.01). sFasL level was negatively correlated with the scores of MMSE while positively with age,the scores of ADL and Hachinski (r=-0.899,0.963,0.948 and 0.939,a11 P＜0.01). Conclusions Apoptosis may be involved in the pathological change during VaD and the serum levels of sFas and sFasL might be related with cognition disorders.

Objective To study the hepatocyte cells infected by hepatitis C virus (HCV) positive serum. Methods Human hepatocyte 7701 was incubated with HCV RNA-positive and HCV antibody(Ab) negative sera BP52. Then, the expression of HCV antigen and the presence of HCV-RNA in cell and supernatant were assayed by RT-PCR, sequence analysis, immunofluorescent staining, Western blot, confocal laser microscopy. The ultrastructural changes of infected cells were observed by electro-microscopy. Results Plus-strand RNA and minus-strand RNA were intermittently detected in cell and/or supernatant on day 7-45 after infection. Sequence analysis demonstrated that the positive DNA nucleic acids were identified with HCV 5′-non-coding region(NCR) sequence. HCV core and NS3 protein were expressed in cytoplasm of infected cells. After 2 or 3 weeks, obvious intracellular ultrastructural changes and virus-like particles were observed. Conclusion human hepatocyte 7701 could support replication of HCV in vitro, which could be a useful tool for setting up cell model of HCV infection and studying the mechanism of HCV infection.

Objective To construct the recombinant plasmid pYES6-S and express and purify spike protein of severe acute respiratory syndrome(SANS)coronavirus in Saccharomyces cerevisiae. Methods DNA fragments of SANS coronavirus were obtained by reverse transeription.Four over- lapped fragments of spike protein genes were amplified by polymerase chain reaction(PCR)and ligated into an integral spike protein gene by restriction enzyme digestion.The spike protein gene recombined with pYES6 and cloned into E.coll.The recombinant plasmid pYES6-S was induced and expressed in Saccharomyces cerevisiae(INVScl)by galactose.Results The recombinant plasmid pYES6-S was confirmed that inserted fragment was right in length,direction and base matching by restriction enzyme digestion and sequencing.The purified protein encoded by the whole spike protein gene was about Mr 110?10~3 identified by electrophoresis.Conclusion The whole spike protein gene of SARS coronavirus is cloned into E.coli and the protein is expressed in Saccharomyces cerevisiae successful ly.which can be helpful in SARS vaccine research.