Objective To explore the value of predicting ovarian response using the antral follicle count in in vitro fertilization(IVF) cycle. Methods 54 patients in our infertility treatment center were observed, in which 6 patients had poor ovarian response and the other 48 patients had good ovarian response. The clinical data, duration and efficacy of treatment were compared between the two groups. Results The mean number of antral follicles and retrieved oocytes in the third day of menstruation in good ovarian response group was significantly higher than that in poor ovarian response group. The clinical pregnancy rate of the good ovarian response group was better than that of the poor one. Conclusions Monitoring the antral follicle count in both ovaries using vaginal ultrasound may predict ovarian response in IVF in the third day of menstruation.

Objective To analyse the effects of anastomat to the resection surgery in 1800 esophageal and gastric cardiac carcinoma patients. Methods The Esophagus-gaster and Esophagus-intestine were stapled by anastomat in the cervical region in 182 cases、 intrathoracically in 1296 cases and intraperitoneal in 322cases. The occurrence of complications caused by anastomat, including anastomotic fistula,anastomotic stricture,anastomotic bleeding and mechanical failure,were observed. Results Anastomotic fistula occurred in 15 cases ( 15/1800,0.83% ,ten cases took Shanghai-made GF-I anastomat ,five cases took YH-W single disposable single anastomat ), among which 6 cases had the cervical anastomosis; Anastomotic stricture occurred in 41 cases ( 41 /1800,3.11%, fifteen cases took Shanghai-made GF-I anastomat, twenty-six took YH-W single disposable single anastomat) ,but all of them recovered after dilatation; Anastomotic bleeding occurred in 21 cases (21/18001.16%, thirteen cases took Shanghai-made GF-I anastomat, eight took YH-W single disposable single anastomat) ;Anastomat mechanical failure in operation occurred in 14 cases( 14/1800,0. 78% ,ten cases took Shanghai-made GF-I anastomat, four took YH-W single disposable single anastomat). Conclusion Anastomat is an effective method in reducing the postoperational complications of esophageal and gastric cardiac carcinoma resection. Disposable single anastomat has higher clinical value.

Acute Kidney Injury ; chemically induced ; Child ; Humans ; Male ; Methotrexate ; administration & dosage ; adverse effects ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Animals ; Arrhythmias, Cardiac ; chemically induced ; prevention & control ; Cats ; Endothelin-1 ; adverse effects ; Medulla Oblongata ; drug effects ; Metoprolol ; pharmacology ; gamma-Aminobutyric Acid ; pharmacology

Objective To compare the applicability of the 7th and 6th editions of the UICC-AJCC esophageal cancer TNM staging systems for adenocarcinoma of esophagogastric junction (EGJ).Methods During June 2007 through December 2010,199 patients with EGJ adenocarcinoma(Siewert type Ⅱ) underwent R0-intent resection in our hospital.Their clinicopatholigical and survival data were retrospectively analyzed with Kaplan-Meier and Cox regression models.They were restaged according to the 7th and 6th UICC/AJCC TNM staging systems for esophageal cancer,respectively.Then the Akaike information criterion(AIC) was used for measuring goodness of fit of both staging systems.Results Among 199 patients,there were 162 males and 37 females.Univariate analysis indicated that age(P =0.009),surgical approach(P =0.002),cell differentiation (P =0.030),preoperative co-morbidity (P =0.026),depth of tumor invasion (P ＜ 0.000) and number of metastatic lymph nodes(P ＜ 0.000) were significant influencing factors on overall survival.Multivariate analysis demonstrated that the independent prognostic factors for EGJ adenocarcinoma were age,T stage,N stage and preoperative co-morbidity according to the 6th edition of esophageal cancer TNM staging system,and only T stage,N stage and preoperative co-morbidity according to the 7th edition of esophageal cancer TNM staging system.The AIC value was 961.4 for the 7th edition of esophageal cancer staging system and 972.4 for the 6th edition.Conclusion The 7th edition of UICC/AJCC esophageal cancer TNM classification is su perior to its 6th edition of esophageal cancer staging system for EGJ adenocarcinoma.

ObjectiveTo explore the clinical presentation, diagnosis, treatment, and outcome of the Barth syndrome (BTHS).MethodsClinical data were collected and analyzed from 3 patients with conifrmed genetic diagnosis of BTHS from June 2013 to October 2014.ResultsAll of the 3 patients were males and two of them were twins. The main clinical manifes-tations of the 3 patients were cardiomyopathy and heart failure, accompanied by different degrees of trabeculations of the left ventricle. Two of them were diagnosed of left ventricular noncompaction (LVNC). All of the 3 patients presented with motor retardation, muscle weakness, growth delay and signiifcantly increased urinary excretion of 3-methylglutaconic acid (3-MGC). One patient was found to have neutropenia. All 3 patients hadTAZ gene mutations which included a novel missense mutation (c.527A>G, p.H176R) detected in the twins and a known nonsense mutation (c.367C>T, p.R123X) identiifed in the other patient. All of the mutations were inherited from their mothers. During the follow-up, the twins died at 7 months old and 7.5 months old respectively. The other patient was still alive.ConclusionBTHS is one of the causes of cardiomyopathy in children. In the male patients who presented with muscle weakness, neutropenia, and increased urinary excretion of 3-MGC, especially in those com-bined with LVNC, BTHS should be screened.

Objective To observe the influencing factors of recurrence and metastasis for postoperative breast cancer high-risk population, and TCM regimen of syndrome differentiation and treatment was used to validate its significance for the prevention of recurrence and metastasis. Methods The influencing factors of recurrence and metastasis of 178 postoperative breast cancer high-risk cases with positive hormone receptor were studied. The recurrence and metastasis, disease-free survival and accumulative points of TCM symptoms of integrated group (with TCM syndrome differentiation and endocrine therapy) and western medicine group (with endocrine therapy) were compared. Results Lymph node metastasis, cancer staging and TCM therapy had influence on the disease-free survival rate of postoperative breast cancer high-risk patients. TCM therapy was the independent prognostic factor for disease-free survival. 3-year recurrence and metastasis rate was lower in integrated group than that in western medicine group, with statistical difference (P=0.03). The total accumulative points of TCM symptoms in both two groups decreased after treated for 3 and 6 months, integrated group showed greater significance. TCM therapy was better for the treatment of irritability, hot flash and perspiration, good for spontaneous perspiration and insomnia, but poor in dry mouth, bitter taste in mouth and fatigue. Conclusion Lymph node metastasis, cancer staging and TCM therapy are main influencing factors for recurrence and metastasis. TCM therapy with regimen of syndrome differentiation and treatment can reduce 3-year recurrence and metastasis rate, improve TCM symptoms, especially is significant for the improvement of irritability, hot flash and perspiration.

Objective To discuss the treatment strategy of knee dislocation and to evaluate its outcome.Methods Thirty-six patients with unilateral knee dislocation treated with individualized protocol were studied retrospectively,including 22 males and 14 females with an average age of 35 years (range,19-72 years).There were 30 acute and 6 chronic knee dislocations.According to the modified Schenck's classification of knee dislocation,there were 7 KD- Ⅰ and 23 KD-Ⅲ cases in the acute category,and all 6 chronic cases were KD-Ⅲ.Seven acute KD- Ⅰ and 6 chronic KD-Ⅲ cases underwent one-stage arthroscopic surgery.In 23 acute KD-Ⅲ cases,2 were treated conservatively with splint or brace due to advanced age,18 with staged surgery,3 with one-stage surgery due to concomitant vascular and nerve injury.Functional and clinical evaluation was conducted at final follow-up.Results All 36 patients were followed up for an average of 27 months (range,18-36 months).The Lysholm score (82.0±11.4),Tegner score (5.5±1.3),and knee range of motion (118.3°±19.2°) at final follow-up showed a statistically significant improvement compared with preoperative results (P＜O.O1).Eight (23.5％) patients had residual knee instability:posterior drawer test and Sag sign were positive (++ or +++) in 8 knees,valgus instability (++) in 1 and varus instability (+++) in 1.The remaining 28 knees were stable.Conclusion Special attention should be paid to rotational knee dislocation with single cruciate ligament rupture.Properly individualized treatment plan is the key to optimal outcome.Arthroscopic surgery can lead to successful outcome.Early one-stage arthroscopic surgery is recommended for acute KD-Ⅰ and chronic KD-Ⅲ dislocation,staged arthroscopic surgery for acute KD-Ⅲ dislocation.

AIM:To analyze the cause of hip prosthesis dislocation,so as to prevent the dislocation following total hip arthroplasty(THA).METHODS:Between January 2002 and June 2007,a total of 348 cases(406 hips) received THA in the Department of Orthopaedics,the Second Affiliated Hospital of Fujian Medical University,and 15 patients(15 hips) occurred dislocation(3.7%),including 6 males and 9 females.Their age ranged 35-76 years,with a mean of 58 years.Primary affections consisted of femoral neck fracture in 3 cases(one with dislocation rebuilding after THA),femoral necrosis in 5 cases,hip arthodysplasia in 5 cases,and osteoarthritis in 2 cases.THA was carried out through lateral approach in 8 patients,and posterior lateral approach in 7 patients.The first dislocation occurred in 2 patients within 2 weeks,3 patients during 2-4 weeks,6 patients during 4-6 weeks,3 patients during 6-12 weeks,and 1 patient 12 weeks later.The movement of dislocation occurrence includes moving the patients in 2,turning over in 2,turning around in 4,trying to stand from sitting in 3,sock wearing in 3,and picking up in 2.It was revealed in the clinical analysis and operational incision that anterior dislocation was found in 6 cases,while posterior dislocation in 9 cases;proper placement of prosthesis in 5 cases,while incorrect placement in 10 cases.Close reduction was conducted in short time after dislocation,achieving success in 11 cases.There were 4 cases treated with open reduction after failure of close reduction,and hip joints were restricted.Seven patients were found dislocation again.And four patients prolonged external fixation and 3 patients were performed revision.RESULTS:The follow-up period ranged from 10 to 60 months.Eight cases succeeded the first reduction,with good joint stability and without relapse.Redislocation occurred in 4 cases,and was cured by prolonging fixation.No cases following revision were found dislocation.The average score was(85?5) according to Harris scoring system.There was no biocompatibility between the materials and the host.CONCLUSION:We should emphasize prevention of dislocation in the early THA and enough fixation time after reduction.

Objective:To explore the pathogenesis of multiple organ dysfunction syndrome(MODS)with respect to the bal- ance of Th1/Th2.Methods:Eighteen healthy male minipigs,weighing 22-30 kg,were randomly divided into two groups: MODS group and control group.Double-hit method including hemorrhagic shock and endotoxiemia was used to establish the porcine MODS model.The peripheral vein blood samples were collected at different time-points(before bloodletting,before en- dotoxin injection,1 h,24 h,48 h and 72 h after endotoxin injection)in the two groups.The spleen samples were collected after death of the animals.Plasma levels of IFN-?and IL-4 were detected by enzyme-linked immunosorbent assay(ELISA).Real- time PCR was used to detect the expression of IFN-?,IL-4,T-bet and GATA-3 mRNA(The latter 2 were the key transcription factors associated with Th1/Th2 response)in the spleen samples.Results:The plasma levels of IFN-?and IL-4 quickly reached the peak values 1 h after the endotoxin injection,then the level of IFN-?decreased quickly.The ratio of IFN-?/IL-4 was signifi- cantly lower than the baseline value 72 h after endotoxin injection(P=0.000).The ratio of IFN-?/IL-4 mRNA in MODS group was obviously lower than that in the control group(P=0.020);the ratio of T-bet/GATA-3 was also lower in MODS group (P=0.038).Conclusion:The shift from Th1 to Th2 occurs in the progress of MODS.