Objective To evaluate the value of serum E2 levels during COH in predicting IVF-ET outcome. Method Data from 311 IVF-ET cycles received long protocol were collected and analyzed according to E 2 levels 5 days after stimulation:Group A (E2≤500 pmol/L), Group B (500 2 000 pmol/L). Results In groups with E2>1 000 pmol/L, the conditions of oocyte and embryo are higher than E2<1 000 pmol/L. With the increase of E2 levels, period cancellation rate increases. When E2> 2 000 pmol/L, the pregnancy rate become lowest. Conclusion E2 levels among 1 000~1 500 pmol/L during early COH predicts a better pregnancy outcome.

The process of diagnosis and nursing of a case with human granulocytic anaplasmosis who was confirmed by etiological diagnosis and molecular biology analysis was analyzed.The matters needing attention in nursing and nosocomial infection control were discussed and analyzed.To avoid misdiagnosis and mistreatment,cross infection,reduce pain and economic burden of the patients,to provide references for future diagnosis and treatment of human granulocytic anaplasmosis.

Objective To compare the effect on intraoperative cerebral metabolism between the propofol combined with remifentanil infusion in total intravenous anesthesia and the desflurane combined with remifentanil intravenous inhalation anesthesia in patients in neurosurgery.Methods Thirty-four patients were randomly divided into the propofol combined with remifentanil group (group A,n=16) and the desflurane combined with remifentanil group (group B,n =18).The B-ultrasound under the guide of retrograde catheterization through right internal jugular vein and artery was prepared after the patients entered the operation room.Atropine,propofol,fentanyl,rocuronium were used in the induction of anesthesia.The mechanical ventilation was applied after conventional trachea cannula.Once patients were anesthetized steadily,jugular bulb venous oxygen saturation (SjvO2),jugular bulb venous oxygen partial pressure (PjvO2),Jugular Bulb venous hemoglogin (Hbv),jugular bulb venous lactate (Ljv),jugular bulb venous gluxose (Gv),arterial oxygen saturation (SaO2),arterial oxygen pressure (PaO2),arterin (Hba),arterial blood lactate (La),arterial blood gluxose (Ga),arterial blood oxygen content (CaO2),jugular bulb venous oxygen content (CjvO2),arteriovenous oxygen difference (AVDO2),cerebral extraction of oxygen (CEO2),cerebral lactate production rate (CLP) and cerebral glucose uptake rate (CGU) at different time [before anesthesia induction (T1),1 hours after the start of the operation (T2),2 hours after the start of the operation (T3),half an hour after the operation]were collected.Results (1) The value of SjvO2,PjvO2,CjvO2 and CaO2 in group B was significantly higher than that in group A (P＜0.001);The value of AVDO2 and CEO2 in group B was lower than that in group A (P＜0.05);(2) The value of Gv and Ga in group B was higher than that in group A (P＜0.05);There were no significant differences about CGU in two groups (P＞0.05);(3) The value of CLP in group B was lower than that in group A (P＜0.05);there were no significant differences about Ljv and La in two groups (P＞0.05);(4) Compared with the value at moment of T1 between group A and group B,the value ofPaO2,SaO2,PjvO2 and SjvO2 were increased with time (P＜0.05),the value of CaO2,CjvO2,AVDO2 and CEO2 showed a downward trend (P ＜0.05).Conclusion (1) Both total intravenous anesthesia and intravenous inhalation anesthesia can reduce the cerebral oxygen metabolism;(2) For the cerebral protection of neurosurgery operation,it seems that the effect of intravenous inhalation anesthesia is more stronger than total intravenous anesthesia.

Objective:To explore a method of constructing universal 3-dimensional (3D)colorized digital dental model which can be displayed and edited in common 3 D software (such as Geomagic se-ries),in order to improve the visual effect of digital dental model in 3D software.Methods:The mor-phological data of teeth and gingivae were obtained by intra-oral scanning system (3Shape TRIOS),con-structing 3D digital dental models.The 3D digital dental models were exported as STL files.Meanwhile, referring to the accredited photography guide of American Academy of Cosmetic Dentistry (AACD),five selected digital photographs of patients’teeth and gingivae were taken by digital single lens reflex camera (DSLR) with the same exposure parameters (except occlusal views ) to capture the color data.In Geomagic Studio 201 3,after STL file of 3D digital dental model being imported,digital photographs were projected on 3D digital dental model with corresponding position and angle.The junctions of different photos were carefully trimmed to get continuous and natural color transitions.Then the 3 D colorized digital dental model was constructed,which was exported as OBJ file or WRP file which was a special file for software of Geomagic series.For the purpose of evaluating the visual effect of the 3 D colorized digital model,a rating scale on color simulation effect in views of patients’evaluation was used.Sixteen patients were recruited and their scores on colored and non-colored digital dental models were recorded.The data were analyzed using McNemar-Bowker test in SPSS 20.Results:Universal 3D colorized digital dental model with better color simulation was constructed based on intra-oral scanning and digital photography. For clinical application,the 3D colorized digital dental models,combined with 3D face images,were in-troduced into 3D smile design of aesthetic rehabilitation,which could improve the patients’cognition for the esthetic digital design and virtual prosthetic effect.Conclusion:Universal 3 D colorized digital dental model with better color simulation can be constructed assisted by 3 D dental scanning system and digital photography.In clinical practice,the communication between dentist and patients could be improved as-sisted by the better visual perception since the colorized 3 D digital dental models with better color simula-tion effect.

ObjectiveTo identify mutations ofGATA4 andGATA6 genes in children with isolated congenital atrial septal defect (ASD).Methods From November 2012 to November 2013, 101 patients with ASD (99 unrelated patients and one twin) who were submitted to catheter-based intervention and 100 ethnicity-matched children without congenital heart disease, blood disorders and chromosomal abnormalities were enrolled. The blood was collected. The coding regions and lfanking regions of theGATA4 andGATA6 genes were ampliifed by polymerase chain reaction and sequenced using the dideoxvnucleotide chain termination technique, and then compared with the normal sequence in the Genbank.Results Two novel heterozygous missense GATA6mutations, c. G145A and c. G151A, were identiifed in 2 unrelated ASD patients, which were not present in the controls. These two mutations predicted the conversion of glycine into serine at amino acid residue 49 (G49S) and glutamate into lysine at amino acid residue 52 (K52E). A heterozygous missenseGATA6 mutation c.43 G>C, which caused a conversion from glycine to arginine, was found in 9 ASD patients and 7 controls. A single nucleotide polymorphism c.99G>T, which did not cause amino acid conversion inGATA4 gene, was found.ConclusionsGATA6 gene is an important transcription factor in heart development. The mutation ofGATA6 gene may cause the change of its transcriptional activity, and lead to ASD.

GATA6 transcription factor belongs to the GATA family and contains 2 conserved zinc ifnger DNA binding domains. GATA6 not only presents in embryonic tissues but also found in heart, lung and pancreas and is essential for the maintenance of their function.The present review focuses on the critical roles of GATA6 in heart development and atrial septal defect to provide theoretical basis for diagnosis and treatment of atrial septal defect.

Objective: To analyze the clinical efficacy and pregnancy outcomes of fertility- preserving re-treatment in patients with recurrent atypical endometrial hyperplasia (AEH) and early stage endometrial carcinoma (EEC) after achieved complete remission (CR) of primary fertility-preserving therapy. Methods: There were 104 cases of AEH and EEC collected from 9 hospitals in the multi-center research network platform of fertility-preserving therapy of endometrial carcinoma in China from January 2005 to May 2019. Thirth-one cases of them relapsed from four hospitals mentioned above,who achieved CR after primary fertility-preserving therapy,was analyzed retrospectively. Of the 31 cases, 27 cases chose fertility-preserving re-treatment. The demographic characteristics, re-treatment effect, clinical factors and pregnancy outcomes were observed. Results: (1) There were 16 AEH cases and 11 ECC cases among 27 recurrent patients who chose fertility-preserving therapy again. After re-treatment, CR was found in 13 out of 16 cases of AEH and 9 out of 11 cases of EEC. The overall CR rate was 81% (22/27). (2) After CR of recurrence, 5 cases (23%, 5/22) of re-recurrence were found after with a median time of 33 months (range 21-80 months). There were 4 cases underwent comprehensive surgical staging, and 1 patient chose the third round of fertility preservation therapy with fully informed consent, and CR was reached after 15 months. (3) There were 16 cases with pregnancy intention, with a total of 12 pregnancies, including 5 cases were natural pregnancy and 7 cases were assisted reproductive technology pregnancy. There were 5 live births. The follow-up time was up to May 2019, and the median follow-up time was 73 months (range 0-123 months). All 27 patients had disease free survival. Conclusions Recurrent patients with AEH and EEC after achieving successful fertility-preserving therapy could choose fertility-preserving therapy again with comprehensive assessment and fully informed consent. After re-treatment, there is a certain tumor CR rate and pregnancy rate, while the close follow-up is required during treatment.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

Objective To investigate the biomechanical effects of lingual metal-reinforced denture bases on edentulous implant-supported prostheses by three-dimensional finite element analysis,and provide references for the treatment of edentulous jaws.Methods Two implant-supported Locator-type overdenture models with lingual metal-reinforced and non-reinforced denture bases were constructed.A 150 N vertical load on the fovea of the posterior teeth,a 150 N oblique load on the fovea of the posterior teeth,and a 150 N vertical load on the anterior teeth were applied to simulate the centric occlusion,left and right lateral chewing,and anterior teeth cutting,and stresses on the tissues of two models were analyzed.Results When the posterior and anterior teeth were loaded vertically,the stress distribution on each organization was similar between the two denture base designs.The maximum stress difference was between 0 and 0.16 MPa.Under unilateral masticatory chewing,the range of stress concentration on denture base,implant and mucoperiosteum,and the maximum stress of the implant and peri-implant bone without metal reinforcement were significantly greater than those with metal reinforcement,and the maximum stress difference was between 0.59 MPa and 2.99 MPa.Conclusions Lingual metal-reinforced denture base can play a role in stress dispersion,or reduce the risk of bone resorption and denture base fracture to a certain extent.