Objective To investigate clinical characteristics of moderate and severe ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technique .Methods The clinical data of 179 cases with moderate and severe OHSS receiving in vitro fertili‐zation‐embryo transfer (including ICSI) in the hospital from June 2012 to April 2013 were analyzed retrospectively .According to the clinical characteristic ,the OHSS was classified as as the moderate type and severe type ,and the late type and early type . Results It was no statistics difference between moderate type and severe type in the patients age ,number of retrieved oocytes ,ad‐mission transaminase ,proportion of fibrinogen normal numbers(P> 0 .05) .But it was a statistics difference between moderate type and severe type in the occurring time days of hospitalization ,hematocrit on admission ,albumin value ,transaminase maximum ,albu‐min dosage used ,proportion of paracentesis number ,pregnancy rate(P < 0 .05) .It was no statistics difference between early type and late type in the patients age ,admission transaminase ,proportion of fibrinogen normal numbers(P> 0 .05) .But it was a statistics difference between early type and late type in the number of retrieved oocytes ,the proportion of moderate OHSS patients ,days of hospitalization ,hematocrit on admission ,albumin value ,transaminase maximum ,albumin dosage used ,proportion of paracentesis number ,pregnancy rate(P< 0 .05) .Conclusion Synthesizing OHSS patients′ blood indexes ,we can evaluated patients′ pathogenet‐ic condition ,the treatment of disease ,and took appropriate preventive measures as soon as possible .Patients with late type may be have more severe pathogenetic condition than patients with early type .

ObjectiveTo investigate the depression and anxiety state of heart transplantation patients. MethodsFifty-weight heart transplantation outpatients were assessed by Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) in Zhongshan Hospital during October 2010 to April 2011.Those diagnosed with depression disorder should meet the criteria of depression in Chinese Classification of Mental Disorder-3nd version (CCMD-3) and the score of HAMD≥14,and those diagnosed with anxiety disorder should meet the criteria of anxiety disorder CCMD-3 and the score of HAMA≥ 14.The diagnoses of concurrent depression and anxiety were made.Results The prevalence of depression disorder and anxiety disorder was respectively 15.5％ (9/58) and 22.5％ (13/58).The prevalence of depression disorder and anxiety disorder within 12 months was respectively 16.7％ (2/12) and 33.3％ (4/12).The score of HAMD was positively related to HAMA score (P＜0.01 ).ConclusionThe prevalence of depression disorder and anxiety disorder is very high and the co-existence of depression and anxiety is very common.

Objective: To observe the effects of Jinqi Jiangtang Tablet, a compound Chinese herbal medicine, on serum matrix metalloproteinase-9 (MMP-9) level and MMP-9 expression in peripheral blood monocytes of rats with streptozocin-induced diabetes. Methods: Thirty Wistar rats were randomly divided into 3 groups: control group, untreated group and Jinqi Jiangtang Tablet group. Diabetes in rats was induced by a single intraperitoneal injection of streptozocin (70mg/kg body weight). After model building, rats in the Jinqi Jiangtang Tablet group were administered with Jinqi Jiangtang tablets at a dose of 0.8 g/(kg·d) for 6 weeks and rats in the control group and the untreated group were treated with normal saline. After treatment, level of fasting serum glucose was detected by hexokinas method; serum MMP-9 level was tested by enzyme-linked immunosorbent assay; MMP-9 expression in peripheral blood monocytes was measured by reverse transcription-polymerase chain reaction and Western blot method. Results: After treatment, fasting serum glucose level in the Jinqi Jiangtang Tablet group was less than that in the untreated group (P<0.05). After modeling, the serum MMP-9 level of rats in the untreated group was (9.11±3.55) μg/L and that in Jinqi Jiangtang Tablet group was (8.97±3.07) μg/L, which were higher than that in the control group ((4.39±1.44) μg/L) (P<0.01). After gavage, the level of serum MMP-9 was lower in Jinqi Jiangtang Tablet group than in the untreated group (P<0.05). The expression of MMP-9 in peripheral blood monocytes in the untreated group was higher than that in the control group (P<0.05). The MMP-9 expression in peripheral blood monocytes of rats with diabetes was down-regulated by Jinqi Jiangtang Tablet (P<0.05). Conclusion: Jinqi Jiangtang Tablet can decrease the level of serum MMP-9 and down-regulate the MMP-9 expression in peripheral blood monocytes at both mRNA and protein levels in rats with diabetes.

Objective To investigate the relationship between the genetic polymorphisms of glutathione S-Transferase M1,T1 and the susceptibility to sporadic colorectal adenocarcinoma(SCRAC) and smoking and alcohol consumption in Chinese Hans.Methods Multiplex polymerase chain reaction (M-PCR) was used in the study of genetic polymorphisms of GSTM 1,T1 gene.Logistic analysis was performed to elucidate the roles of GSTM1,GST1,smoking and alcohol.Results The null GSTM1,T1 genotypes could increase the susceptibility to SCRAC(OR=1.711,95% CI:1.043～2.805;OR=1.734,95% CI:1.057～2.843),but smoking and alcohol consumption made no significant effect on SCRAC(OR=0.584,95% CI:0.356～0.958;OR=0.378.95% CI:0.217～0.657).Further stratification of the SCRAC patients by chnical features showed that there were no relationship between the GST M1,T1 genotype and the age of the SCRAC patients.But the frequency of null GSTM1 genotype was significantly associated with distal colon adenocarcinoma (P=0.021),colorectal adenocarcinoma of Dukes C classification (P=0.003) and poor difierentiation (P=0.020),respectively.The frequency of null GSTF1 genotype was only higher in colorectal adenocarcinoma of Dukes C classification(P=0.041).No relationship was found between the location,the degree of differentiation and the frequency of null GSTF1 genotype(P＞0.05).Furthermore,the frequencies of homozygous deletion in GSTM1,T1 genes were found to be significantly increased in SCRAC patients than those in healthy controls(38.9%VS25.7%.P=0.023).Conclusion The GST genotype is strongly correlated with SCRAC incidence in Chinese Hans.The null GSTM1,T1 genotypes can enhance the genetic susceptibility to SCRAC.while smoking and alcohol consumption have no significant effect on the susceptibility to SCRAC.

Objective To explore the association of genetic polymorphism of fucosyltransferase (FUT) 2 and FUT3 and expression of Lewis antigen with ulcerative colitis (UC) in Chinese Zhejiang Han population.Methods We genotyped FUT2 (rs281377, rs1047781 and rs601338) and FUT3 (rs28362459, rs3745635 and rs3894326) in 485 UC patients and 580 healthy controls using SNaPshot. By immunohistochemistry method, we also evaluated expression of Lewis a and b antigens in the sigmoid colon of 10 UC patients and 10 patients with benign colonic polyps.Results The frequencies of mutant allele (A) and genotype (GA+AA) in FUT3 rs3745635 were higher in UC patients than in controls (P=0.016, 95%CI 1.339-1.699;P=0.038, 95%CI 1.330-1.742, respectively). Stratified analyses revealed that the frequencies of mutant allele (G) and genotype (TG+GG) of FUT3 rs28362459 were significantly lower in patients with extensive colitis than in those with distal colitis (P=0.001, 95%CI 0.567-0.786;P<0.001, 95%CI 0.503-0.742, respectively). Similar conclusions were drawn for the mutant allele (A) and genotype (GA+AA) of FUT3 rs3745635 in patients with extensive colitis compared to those with distal colitis (P=0.011, 95%CI 0.621-0.900;P=0.006, 95%CI 0.553-0.845, respectively). Although expression of Lewis b antigen in the sigmoid colon did not differ between UC patients and controls, Lewis a antigen expression was higher in the crypt epithelium of both inflammatory and non-inflammatory sigmoid colon of UC patients than in controls (P=0.028).Conclusion Polymorphisms of FUT3 and expression level of Lewis a antigen might be associated with UC.

OBJECTIVETo investigate the clinical effects of close reduction and minimally invasive percutaneous plate osteosynthesis in treating proximal humerus fractures in the aged.

METHODSFrom February 2012 to December 2013,39 patients with proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis (MIPPO group, 21 cases) and open reduction internal fixation (ORIF group, 18 cases). Including 17 males and 22 females in the study, and aged from 67 to 88 years old with an average of (71.8 ± 5.2) years old. In MIPPO group, there were 11 males and 10 females with an average age of (70.0 ± 5.3) years old;and in ORIF group, there were 10 males and 8 females with an average age of (72.0 ± 4.2) years old. Operation time, blood loss during operation, fracture healing time and postoperative complications were recorded. The functions of the shoulder joints were assessed according to Constant-Murley score at final follow-up.

RESULTSAll the patients were followed up from 11 to 27 months with an average of 18.1 months. The mean blood loss of the MIPPO group was (176.0 ± 57.4) ml,while the ORIF group was (356.0 ± 66.9) ml (t = 7.22,P = 0.01). The operation time of the MIPPO group was (47.4 ± 14.9) min, while the ORIF group was (92.7 ± 15.8) min (t = 0.79, P = 0.03). Fracture healing time in the MIPPO group and ORIF group was (17.6 ± 5.8), ( 21.7 ± 4.9) weeks, respectively (P < 0.05). The mean Constant-Murley score at final follow-up was 89.7 ± 14.5 in MIPPO group, and 81.8 ± 13.2 in ORIF group (P < 0.05).

CONCLUSIONMIPPO has advantages of little trauma, less blood loss, rapid recovery, less vascular damage and so on and can effectively treat the proximal humerus fracture in the aged.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Shoulder Fractures ; surgery

Objective:To search for a method for radical resection of pancreatic and duodenal malignancy involving the mesentery root and for the long post-operation survival of patients.Methods:From Jan.2004 to Aug.2006,a total of 26(16 male and 10 female. aged 27-70)patients with pancreatic and duodenal malignancy involving the mesentery root were treated in our department.The patients included 3 with duodenal malignancy and 23 with pancreatic malignancy.Curative resection was performed by the extended pancreaticoduodenetomy(Whipple procedure)combined with mesentery root resection(MRR)for all patients.The outcomes,safety and the post-operation survival rate were analyzed retrospectively.Results:Thirteen patients were treated with Whipple procedures combined with MRR,9 were treated with partial portal vein/superior mesenteric vein(PV/SMV)and reconstruction of the vessel,and 4 patients received pre-shunt between PV and SMV with artificial vessel graft before the extended Whipple and MRR procedures.The operation time was 2.5 to 7(4.4?1.1)hour,and blood loss was 300 to 5 000(1892?1414)ml with the blood transfusion of 0 to 5 600(2 100?1 586)ml.There was no death in our group and 7(27%)had post-operation complication.The post-operation hospital stay was 10 to 30 days.The pathologic examination showed negative surgical margins for all specimens.The tumor size was 4 to 10 (6.17?2.03)cm.After a follow-up of 9 to 38 months,the pain was relieved in all patients.One of the 3 patients with duodenal adenocarcinoma had liver metastasis at 10 months after operation,and the other 2 survived 10 months and 27 months without evidence of tumor reccurence.The patient with pancreatic micro-adenocarcinoma died of local reccurence 9 months after operation.The patient with neuroendocrine carcinoma died of organ failure 24 months after operation.The patient with lymphoma have survived for 24 months after operation.The 1-year and 2-year accumulated survival rates in the 20 cases with pancreatic ductal cancer were 86.6% and 45.6%. respectively.Conclusion:The extended Whipple procedure with MRR is safe and effective.It can obtain R0 resection in patients with malignant tumors(over 5 cm in diameter)in the head,neck and uncinate process of the pancreas and duodenal.

Objective To investigate the techniques and influence factors for the respiratory navigator echo triggered whole-heart coronary MR angiography(WH-CMRA)and evaluate its application in visualizing coronary arteries and the image quality.Methods Ninety two volunteers were acquired with WH-CMRA at 3 T MR scanner using respiratory navigator-echo gated TFE sequence.Imaging quality was visually graded as 0—Ⅳ grade according to the visual inspection,average length,diameter and sharpness of coronary arteries.The correlation between the imaging quality and respiratory pattern,heart rate and navigator efficiency was analyzed.Results The imaging quality in 92 cases was that 28 were graded as Ⅳ, 53 were graded as Ⅲ,9 were graded as Ⅱ and 2 were graded as Ⅰ.The successful rate of scan was 88% (81/92).The imaging quality is mainly graded as Ⅳ when the heart rate was less than 75 beats per minute (bpm)and the sharpness of vessel was(48?11)%.When heart rate was more than 75 bpm,the image quality was mostly graded as Ⅲ and the sharpness was(33?15)%.The correlation between heart rate and imaging quality score was negative(r=-0.726,P0.05).Conclusion 3 T WH-CMRA technique could facilitated the visualization of whole coronary arteries at free breathing but having indications on heart rate.

Objective To study effectiveness and effect on the internal environment of exchange transfusion using peripheral arteries and veins.Methods Exchange transfusion were performed through the peripheral arteries and veins on 22 cases of newborn infants with severe hyperbilirubinemia.Blood electrolyte,blood routine,blood bio- chemistry were measured before and after change blood.Vital signs were monitored electronically recorded.Results Total bilirubin was(595.28?134.44)?mol/L before exchange transfusion and(275.17?74.05)?mol/L after ex- change transfusion(P