Objective To analyze the phenomenon of monozygotictwin(MZT)in in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET),and explore possible laboratory-related factors that may contribute to MZT. Methods Patients who transferred single embryo in our center from January 2015 to October 2016,including 1786 fresh embryo transfer cycles and 1710 thawed embryo transfer cycles and 49 preimplantation genetic diagnoses(PGD)cycles,were retrospectively analyzed. Correlation between fresh embryo,embryo freez-ing and thawing,embryo quality,artificial assistant hatching and MZT were analyzed. Results (1)There was no significant difference in the MZT rate between embryo age ,in vitro culturing time and in vitro fertilization mode (P > 0.05).(2)The MZT rate between fresh blastocysts and frozen-thawed blastocysts showed significant differ-ence(0.88%vs. 3.08%,P<0.05).(3)The incidence of MZT was significantly higher in laser hatching than that in mechanical hatching in PGD(25.00% vs. 0.00%,P < 0.05). Conclusion Frozen and assisted incubation of blastocyst are risk factors for MZT.

Objective To explore the clinical significance of the changes of renal artery blood stream parameters in patients with essential hypertensive by color Doppler ultrasonography. Methods Ninety patients with essential hypertension were enrolled and divided into three groups (grade 1,2,3 ) according to their clinical blood pressure from May 2006 to July 2010 and each group included 30 cases. Thirty normal individuals were assigned to the control group. Color Doppler ultrasonography was used to determine the blood flow spectrum of bilateral main renal arteries, segmental arteries and interlobar arteries of kidneys. The parameters included Vmax, Vmin, Vmin/Vmax, resistance index (RI) were recorded and analyzed. Results In the control group, the Vmax,Vmin,Vmin/Vmax and RI in main renal arteries were (63.99 ± 7.68)cm/s, (23.86 ± 3.07) cm/s,0. 38 ± 0. 05 and 0. 62 ± 0. 05 ;in segmental arteries were ( 52. 93 ± 4. 24) cm/s, ( 20. 89 ± 2. 47 ) cm/s,0. 40 ±0. 04 and 0. 60 ±0. 04;in interlobar arteries were (35. 32 ±4. 22)cm/s, ( 15.07 ±2. 54) cm/s,0. 43 ±0. 04 and 0. 57 ± 0. 04. Compared to the control, only Vmin, Vmin/Vmax and RI in interlobar arteries were statistically changed in grade 1 hypertension group ( P ＜ 0. 05 ). While in grade 2 hypertension group, all the blood flow parameters except Vmax in main renal arteries statistically changed compared to the control group(P ＜ 0.05 ). In grade 3 hypertension group, all the blood flow parameters showed statistically differences when compared to control group (P ＜ 0. 05 ). The Vmax, Vmin, Vmin/Vmax decreased along with the blood pressure increased,however, the RI increased along with BP. Conclusion The renal artery blood stream parameters determined by color Doppler ultrasonography can provide important information to evaluate abnormal renal function in patients with hypertension.

Objective: Signet-ring cell carcinoma is a relatively rare cancer which occurs principally in the stomach,colon-rectum,bladder and breast,but seldom in other parts.This article analyzes the clinical and pathologic features of 3 extremely rare cases of primary signet-ring cell carcinoma in the uterus.Methods: Three cases of primary signet-ring cell carcinoma in the uterus were observed by HE and immunohistochemical staining,their clinical features analyzed and the relevant literature reviewed.Results: Of the 3 cases,2 presented nodose tumors in the cervix while the other in the uterine cavity.Histologically,there was a diffuse infiltration of the tumor cells,with an appearance of signet-ring cells.Periodic acid-Sciff(PAS) staining revealed PAS-positive diastase resistant introcytoplasmic material.Immunohistochemically,the tumor cells were positive for CK and CEA.Conclusion: Primary signet-ring cell carcinoma of the uterus is extremely rare.It is always necessary to rule out a metastatic neoplasm by clinical examination and to differentiate it from other tumors/lesions with signet-ring cell features.

Objectives To study the clinical effects and therapeutic mechanisms of the application of Chinese traditional medicine,the Decoction of Jie Du Hua Yu Tang,in the treatment of psoriasis.Meth-ods The clinical effects were observed in50patients with psoriasis vulgaris,to whom the Decoction of Jie Du Hua Yu Tang was given.The mice were used as experimental models whose tail scale epidermis was nat-urally lacking granular layer,similar to psoriatic epidermis.The mice were fed with Jie Du Hua Yu Tang and the effects on the formation of granular layer in their tail scale epidermis were noticed.Results The clinical cure rate was42%and the total response rate was90%with the Jie Du Hua Yu Tang.There was a signifi-cantly strong promoting effect on the formation of granular layer in mouse tail scale epidermis with the use of Jie Du Hua Yu Tang,in comparison with the control group.Conclusions The Decoction of Jie Du Hua Yu Tang is effective for the treatment of psoriasis vulgaris.The decoction could promote the formation of granu-lar layer in mouse tail scale epidermis.The therapeutic mechanism of the decoction may be related to the inhibition of proliferation of epidermal cells.

Objective To explore the effect of carbohydrate administration on postoperative insulin resistance after gastroenteric tumor resection.Methods Sixty elective gastroenteric tumor resection patients were divided into observation group and control group by random number table method,with 30 cases in each.Observation group was given carbohydrate administration before surgery,that was 2 h before anesthesia oral carbohydrates 300 ml containing 50 g glucose;control group was treated according to the traditional methods,preoperative fasting 12 h,6 h forbidden to drink.The blood samples were collected to measure the levels of fasting blood glucose (FBG) and fasting insulin (FINS) at 3 h before operation and 1,3,7 d postoperation respectively.Homeostasis model assessment (HOMA) was applied to calculate the insulin resistance index.Results The levels of FBG,FINS,HOMA-IR at 1,3 d postoperation in two groups were significantly higher than those at 3 h preoperation [observation group:(10.65 ± 1.78),(7.32 ± 1.48) mmol/L vs.(5.09 ±0.43) mmol/L,(25.78 ± 12.43),(16.23 ±7.56) mU/L vs.(10.48 ± 1.57) mU/L,11.67 ±6.32,5.12 ± 2.11 vs.2.35 ± 0.54;control group:(11.18 ± 1.25),(8.04 ± 1.53) mmol/L vs.(5.12 ± 0.39) mmol/L,(39.67 ± 10.37),(24.34 ± 6.78) mU/L vs.(9.98 ± 2.04) mU/L,19.07 ± 5.49,8.56 ± 2.87 vs.2.28 ± 0.39](P ＜ 0.05).The levels of FINS,HOMA-IR at 1,3 d postoperation in control group were higher than those in observation group (P ＜ 0.05).The levels of FINS and HOMA-IR at 7 d postoperation in observation group were returned to the 3 h preoperative (P ＞ 0.05),while the levels in control group [(16.32 ± 4.56) mU/L,3.87 ± 1.12] was still higher than those at 3 h preoperation (P ＜0.05).Conclusion Carbohydrate administration may shorten the insulin resistance durion after gastroenteric tumor resection,and reduce the intensity of insulin resistance,thus contributing to the rehabilitation of patients.

Objective To investigate the effect of preoperative carbohydrate fluid intake on postoperative insulin resistance and immune function.Methods Sixty elective gastroenteric tumor resection patients were randomly divided into test (n =30) and control (n =30) groups.Control group were fasted before surgery,while test group were given oral carbohydrate before surgery.The blood samples were collected to measure the levels of fasting blood glucose (FBG),fasting insulin (FINS),and cellular immunity (CD3 +,CD4 +,CD8 +,and CD4 +/CD8 +) before operation and 1,3,7 day postoperation,respectively.Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance.Results Compared to preoperation,the levels of CD4 +,CD4 + / CD8 +,and HOMA-IR at 1 day postoperation in both control and test groups were significantly higher (P ＜ 0.05).Compared to test group,the levels of CD4 +,CD4 +/CD8 +,and HOMA-IR at 1,3 day postoperation in control group were significantly higher (P ＜ 0.05).At the seventh day after surgery,HOMA-IR levels in the test group were returned to the preoperative level (P ＞ 0.05),while the control group was still higher than before surgery (P ＜ 0.05).There were no differences in CD4 + and CD4+/CD8 + at seventh days after surgery between two groups (P ＞ 0.05).Conclusions Preoperative carbohydrate administration may shorten the insulin resistance duration after gastrointestinal cancer surgery,reduce the intensity of insulin resistance,and improve immune function.Thus contributes to the rehabilitation of patients.

AIM: To study the changes of serum levels of nitric oxide (NO) and nitric oxide synthase (NOS) in patients during liver transplantation. METHODS: Samples were obtained from 30 patients in end liver disease at five time points during liver transplantation. NO level and NOS activity were measured by radioimmunoassay and colorimetry, respectively. Arterial and mixed venous blood samples used for blood gas analysis were taken at the same time. Intrapulmonary shunt (Qs/Qt) was calculated according to the standard formula. The hemodynamics parameters including continuous cardic output (CO), HR, MABP, CVP, SVR were measured during liver transplantation. RESULTS: (1) NO_2-/NO_3-level at 10 min before anhepatic period was significantly higher than the baseline level. Compared with NO_2-/NO_3-level at 10 min before anhepatic period, NO_2-/NO_3-level at 30 min after anhepatic period was significantly decreased. NO_2-/NO_3-level at 30 min after neohepatic period was significantly higher than the baseline level and at 30 min after anhepatic period. (2) No significant change of tNOS activity was observed. Compared with the baseline activity of inducible nitric oxide synthase (iNOS), the activity at 10 min before anhepatic period and at 30 min after neohepatic period was significantly increased. The activity at 30 min after neohepatic period was significantly higher than that at 30 min after anhepatic period. (3) MABP decreased significantly when opening the inferior vena cava. CO and CVP decreased in the anhepatic stage and increased in the reperfusion stage. SVR increased during anhepatic stage and decreased significantly during neohepatic period. (4) Qs/Qt decreased significantly during anhepatic stage and increased significantly at 30 min after neohepatic period. CONCLUSIONS: Serum level of NO and NOS activity are significantly changed during liver transplantation. High level of NO may result in low systemic vascular resistance and increasing in intrapulmonary shunt.

AIM: To study the changes of serum levels of thromboxane A_2(TXA_2) and prostacyclin(PGI_2) in cirrhosis patients during liver transplantation.METHODS: Samples were obtained from 24 cirrhosis patients in end at five time points during liver transplantation.TXA_2 and PGI_2 level were measured by radioimmunoassay.Arterial and mixed venous blood samples used for blood gas analysis were taken at the same time.Intrapulmonary shunt(Qs/Qt) was calculated according to the standard formula.The hemodynamics parameters including continuous cardiac output index(CI),HR,mean artery blood pressure(MABP),MPAP,CVP,PAWP,SVRI,PVRI were measured during liver transplantation.RESULTS:(1) MABP decreased significantly in the early stage of anhepatic period and neohepatic period.(2) CVP,MPAP and PAWP decreased significantly during anhepatic period.They increased significantly after graft reperfusion and remain the high level.(3) CI declined significantly during anhepatic period and increased at 10 min postreperfusion of new liver.(4) SVRI and PVRI increased during anhepatic period and were higher than baseline level at 15 min after reperfusion.SVRI was lower than baseline level at 30 min after reperfusion.(5) Compared with the baseline level,6-keto-PGF1? and TXB_2 increased significantly.Compared with the level before vascular cross-clamping,6-keto-PGF1? decreased during neohepatic period and it had significant difference in statistics at the end of operation.CONCLUSION: Serum levels of TXA_2 and PGI_2 significantly change during liver transplantation and may affect the system and pulmonary circulation to some extent.

Objective To investigate low density lipoprotein receptor (LDLR)gene mutation in familial hypercholesterolemia (FH) patients. Methods The proband was given clinical diagnosis of homozygous FH based on marked features and blood lipid tests results. After apoB100R3500Q mutation was excluded, the promoter region and all of the 18 exons of LDLR gene were amplified by touch-downpolymerase chain reaction (PCR). The PCR products were analyzed by single-strand conformationalpolymorphism (SSCP). The PCR products with abnormal single strands were sequenced directly. Thesecondary structures of the mutational and wild type proteins were analyzed and compared byANTHEPROT5.0, and then the tertiary structures of the mutant and wild type LDLR were predicted atSWISS MODEL homepage online. Results A homozygous mutation A606T at exon 13 of the patients wasfound by SSCP and confirmed by DNA sequencing. GOR Ⅰ method in ANTHEPROT5.0 indicates that therandom coils and turns would replace some helixes at the mutation site. The online prediction from theSWISS MODEL homepage indicates the backbone structure of the mutant LDLR has no difference from thewild type one. Conclusion The results suggest the A606T mutation of LDLR gene is the cause of the FH inthis pedigree.