[Objective]To evaluate the role of mature cumulus cells from oocyte-cumulus complex(OCC)in in-vitro maturation(IVM)and establish a new culture technique which is convenient to carry out.[Methods]The cumulus cells of OCC were cut off and dispersed by 1 mL syringe.The cumulus cells were co-cultured with the immature oocytes retrieved from the COH cycles after they adherent to the bottom of the dish.The immature oocytes were experienced IVM procedures in different culture media.They were divided into 3 groups(the oocytes at germinal vesicle stage from one woman were allotted to the same group randomly).Group 1(solution A):basic culture medium+human follicular fluid(hFF);Group 2(solution B):solution A+ cumulus cells(OCC);Group 3(solution C):solution A+ OCC+ follicle stimulating hormone(FSH)+ epidermal growth factor (EGF).Then,the maturation rate,fertilization rate and formation rate of available embryo were observed.[Results]In 113 treatment cycles,298 immature oocytes were performed IVM with solution A,B,and C.The difference for 24 hour maturation rates among 3 groups wag statistically significant(A:45.2%,B:61.7%,C:78.2%,P＜0.05).There was no statistical difference for 25～48 hour maturation rates and normal fertilization rates of mature oocytes.The differences of cleavage rates and rescued embryo rates between group 1 and 2,group 1 and 3 were statistically significant(P＜0.05).The formation rates of available embryo showed an increasing trend from group 1,2,to 3.[Conclusion]After being dispersed by simply beat upon with syringe and adherent culture,the mature cumulus eells from mature OCCs in COH cycles,together with growth factors in the follicular fluid or extraneously supplemented,could promote the IVM of immature oocyte.

Bilateral medial medullary infarction(MMI)was a rare subtype of stroke.The clinical manifestations of bilateral MMI were complicated,which leaded to misdiagnosis.Patients with bilateral MMI could progress rapidly,and were easy to progress to respiratory failure and even death.Patients with this type of cerebral infarction did not respond well to medication.One case data of a patient with bilateral MMI was reviewed and analyzed.The weakness on the right side of the body was presented,accompanied by slurred speech,and was finally diagnosed with atherosclerosis of the large arteries through cranial MR examination.The patient had occlusion of the left posterior inferior cerebellar artery distal to the left vertebral artery V4 segment on the left side.The patient was treated with stent thrombectomy and balloon angioplasty,and the follow-up phone call at 3 months after discharge was showed good prognosis.Through a review of the literature,combined with the clinical and imaging features of this case,a preliminary analysis suggested that atherosclerosis of the large arteries may be the most common cause of bilateral MMI.Cranial MR imaging is an important method for diagnosing this condition.For patients with bilateral MMI accompanied by occlusion of the vertebral artery V4 segment,endovascular intervention may be attempted.