A total of 130 anvolatory infertile outpatients were divided randomly into 4 groups of LE1 (letrozole 2.5 mg,n =45),LE2 (letrozole 5 mg,n =30),CC1 (clomiphene citrate 50 mg,n =35) and CC2 (clomiphene citrate 100 mg,n =20).The treatments started at day 5 of menstruation and lasted for 5 days.The size and number of ovarian follicles and thickness of endometrium of all 4 groups were measured starting from day 10 of menstruation.8 000-10 000 units of human chorionic gonadotropin (hCG) was injected when ovary follicles were mature.And blood estradiol (E2) was measured at the same day.Ovulation,pregnancy and adverse reaction were also monitored.The pregnancy rate was 33％ (n =15) in group LE1 and 14％ (n =5) in group CC1 with significant statistical difference (x2 =4.00,P ＜ 0.05).And there were 43 successful ovulation periods in 55 periods with an ovulation rate of 78％ in group LE1;28 successful ovulation periods in 52 periods with an ovulation rate of 54％ in group CC with significant statistical difference (X2 =4.60,P ＜0.05).E2 level (pmol/L) in the day of hCG injection in group LE1 was (774.2 ± 126.0) pmol/L and in group CC1 (963.7 ± 108.3) pmol/L,t =3.98 with significant difference (P ＜ 0.01).The number of follicle in group LE1 was 1.20 ± 0.38;CC1 2.28 ± 0.88,t =4.76 with significant difference (P ＜0.01).The thickness of endometrium in the day of hCG in LE1 was (9.6 ± 1.3) mm;CC1 (5.9 ± 1.1) mm,t =6.20 with significant difference (P ＜ 0.01).No significant statistical differences existed between LE1 and LE2,CC1 and CC2 in pregnancy rate,successful ovulation,number of mature follicles,E2 level and thickness of endometrium at the day of hCG injection.The outcomes of 36 pregnancies were 32 full-term deliveries with neonatal health,2 early abortions and 2 prematures.Mild ovarian hyperstimulation syndrome (OHSS) had a low occurrence rate.

Circadian rhythms are endogenous 24 h variations found in virtually all physiological processes and behaviors, which are controlled by the transcriptional translational oscillator that consists of a series of core clock genes (bmal1, clock, cry and per) and clock controlled genes (rev-erbα, rorα, dbp, tef and hlf).Clock genes exist in immune organs, tissues and cells, leading to the immune cell function (migration and chemotaxis, phagocytosis, cytotoxicity and so on) and a variety of immune parameters (factor level of circulating immune cells and subsets of the relative and absolute number of cells) showing circadian rhythm changes, and playing an important role in maintaining immune homeostasis.In addition, some immune related diseases are closely correlated with circadian rhythms abnormalities.This paper will focus on the effect of circadian rhythms on immune functions and their roles in some immune related diseases.

Immune checkpoint blockade can promote the tumor?specific cytotoxic T?lymphocyte ( CTL) response. However, only a small proportion of patients have good response to immune checkpoint blockade. It has been reported that radiotherapy combined with immune checkpoint blockade can promote antigen presentation, which further enhances the tumor?specific CTL response;moreover, the combined therapy achieves better treatment outcomes than radiotherapy alone or immune checkpoint blockade alone. The latest study has shown that radiotherapy combined with dual immune checkpoint blockade has better efficacy than radiotherapy combined with CTLA?4 blockade in patients with melanoma. Therefore, radiotherapy combined with immune checkpoint blockade will become a new approach for treating tumor. This paper reviews the research advances in the combined therapy.

Objective To evaluate the feasibility and efficacy of the ultrasonic technology,digital subtraction angiography(DSA) combined guide line of liver abscess drainage tube.Methods 70 patients with liver abscess received ultrasonic technology,DSA joint drainage tube after treatment.Using ultrasound technology and DSA of complementary advantages,enhancement in the operation was good,especially the liver abscess of abdominal pneumatosis was more and more room,enhancement effect was better than that of pure guided by ultrasound.Results 70 patients were all successful puncture and catheter,development was good,all 70 cases cured,without any serious complication.Conclusion Ultrasound technology,DSA joint guided puncture catheter drainage is a safe,minimally invasive treatment,has significant efficacy and important clinical value.

OBJECTIVE To develop a rapid, sensitive and specific real-time PCR assay for the detection of WU polyomavirus.METHODS The VP2 gene of WU polyomavirus was selected as target gene.The specific primers and TaqMan probes according to the principle of the TaqMan real-time PCR were designed and synthesized,we optimized the PCR reaction,and detected 394 clinical samples.The sensitivity,specificity,reproducibility and dynamic range of the methods were determined.RESULTS The real-time PCR was established and applied successfully to detect the WU polyomavirus.The real-time PCR assay showed excellent linearity between the log of target input and CT value,demonstrating that the assay had a dynamic range of at least 8 logs between 1.0?100 and 1.0?107 copies;the coefficient of variation of intra-assay and inter-assay was less than 5%.Among these 394 specimens,3(0.76%) were positive for WU polyomavirus.CONCLUSIONS The real-time TaqMan PCR is a rapid,specific and sensitive method to detect WU polyomavirus.It can be used in screening large numbers of samples at the same time and establish the solid technological base for clinical diagnosis and epidemiology study.

Objective This study was to investigate the diagnostic value of CT-guided percutaneous needle lung biopsy ( PN-LB) in different types of lung cancer and compare the pathological results of CT-guided PNLB and surgical specimens. Methods We performed a retrospective analysis of 324 cases of lung cancer, all confirmed by CT-guided PNLB after imaging manifestation of lung-occupying lesion and treated by surgical resection.We compared the pathological results of CT-guided PNLB and surgical speci-mens. Results The total coincidence rate of the pathological result from CT-guided PNLB with that from surgical specimens was 85.8% (278/324), with even a higher coincidence rate (96.4%) in adenocarcinoma, followed by squamous cell carcinoma (86.1%), and small cell lung cancer (45.5%).Large cell lung cancer and adenosquamous carcinoma were liable to be diagnosed as adenocarcinoma by CT-guided PNLB ( 7/10 and 6/10 ) .McNemar-Bowker test revealed no significant differences in the coincidence rate in adenocarcinoma, squamous cell carcinoma, and small cell lung cancer (κ=0.837, P=0.215). Conclusion CT-guided PNLB has a high coincidence rate with surgical specimens in the pathological diagnosis of lung cancer, but the coincidence rate varies with different pathological types of the tumor.

Objective To explore whether antibiotic prophylaxis is beneficial in tension-free in-guinal hernia repair Method A perspectiverandomized controlled study was conducted which included 1 28 patients who underwent tension-free inguinal hernia repair from July 201 1 to August 201 3.In the anti-biotic prophylaxis group,antibiotic was intravenously administrated within 30 minutes before surgery.In the control group,no preoperative antibiotic wasadministrated.The incidence of incision infection was com-pared between groups.Result Incision infectiondeveloped in onepatient of the antibiotic prophylaxis group and two patientsin the placebo group,indicating no significant difference between the groups(P >0.05).Conclusion Before tension-free repair,there is no real need to apply prophylactic antibiotics reg-ularlyfor inguinal hernia without high risk factors.

Purpose:To explore the rational operative approach in patients with carcinoma of the middle third of the esophagus by T and N status as determined by preoperative CT scan. Methods:87 cases with carcinoma of the middle third of the esophagus chosen for the operative approach by CT findings entered the observational group, 118 cases with carcinoma of the middle third of the esophagus who were not scanned by CT were put into the control group. The observational group adopted different operative approaches by the relationship between the primary tumour and the aorta,and the relationship between the primary tumour and the azygos vein,and by the metastasis of regional lymph nodes. The operative approaches were chosen as follows:if the aorta was not involved, the operative approaches were chosen by the metastastatic status of the regional lymph nodes; left thoracoabdominal approaches were chosen,if the aorta was involved,and Ivor-Lewis operation was involved if the azygos vein was involved.The control group adopted the Ivor-Lewis operation. The rate of resection between two groups and the difference in positivity rates of the resected regional lymph node were analysed by chi-square test and T test. Results:Sensitivity of N staging by CT scan was 74.7%(65/87), and specificity of N staging was 60%(39/65). Sensitivity of diagnosis of the aorta involved by tumour by CT scan was 21.8%(19/87), and specificity was (26.3%)(5/19). The rate of resection in the observational group was 92%, and the rate of resection in the control group was'81.4%. Both were markedly different,P

Objective To compare the induction of and emergence from anesthesia with target-controlled infusion (TCI) of propofol-remifentanil/fentanyl and isoflurane inhalation. Methods Sixty ASA Ⅰ -Ⅱ patients (26 male, 34 female) aged

Objective To study the effects of allopurinol in different dose on the cardiac function of chronic heart failure rats induced by adrimycin. To explore dose-dependency of allopurinol in improving blood vessel endothe-lium function and cardiac ventricle remodeling of the rats heart, as to supply evidence and new sight in clinical treat-ment of congestive heart failure. Methods 40 Sprague-Dawley male rats were randomly divided into four groups: normal control group (group A)、model control group (group B)、low-dose allopurinol group (group C)、high-dose allopurinol group (group D). The heart failure model was made by administering adriamycin to rats. After the model myocardial pathological changes were detected. Results Compared with the normal control group, the weight and heart weight of rats in model control group and allopurinol groups were obviously lessen (group A=(300.10± 9.85)g,group B=(200.67±9.91)g, group C=(233.14±9.42)g,group D=(248.25±13.34) g;group A= (828.30±50.97) nag, group B=(681.50±16.97) mg, group C=(743.00±17.20) nag, group D=(784.88± 36.83) mg,P<0.05). Heart weight indexes were all incerased ( group A=(2.76±0.15) mg/g, group B=(3.41± 0.17) mg/g, group C=(3.26±0.76) mg/g, group D=(3.11±0.65) mg/g, P<0.05). The hemedynamics resuh showed that myocardial contractile force were enhanced in drug groups. The level of NO, SOD were increased in the allopurinol groups compared with the model control group (group B: NO=(41.55±6.28) μmol/L, group C: NO= (52.47±5.59) μmoL/L,group D:NO=(61.04±4.26) μmoL/L; group B:SOD=(63.83±6.40) U/ml,group C: SOD=(76.29±7.99) U/ml, group D: SOD=(100.13±7.43) U/ml, P<0.05) and MDA levels were obviously decreased (group B: MDA=(9.70±1.08) μmol/L, group C: MDA=(6.64±0.34) μmol/L, group D: MDA= (5.72±0.71)p.moVL,P<0.05). The level of NO, SOD were obviously increased in the allopurinol of high-dose group compared with low-dose allopurinol group(P<0.05). MDA levels were obviously decreased(P<0.05). The myocardial pathological changes were relieved obviously in the allopufinol groups. Conclusion Allopurinol improves blood vessel endothelium function dose-dependently. High-dese allopurinol obviously decreases MDA, improve NO, SOD, thereby can improve the cardiac function of heart failure.