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 influence of hospital- based transitional care on the rehabilita-tion of patients with enterostomy, and provide evidence- based reference for specialist care of the enterostomy patients. Methods The randomized controlled trials on the hospital- based transitional care in enterostomy patients were collected by computer using China National Knowledge Infrastructure Database, Chinese Science Technology Periodical Database, Wanfang Periodical Database, Foreign Medical Information Resources Database and PubMed from the building of the database till December 2014, and analyzed by RevMan 5.2 software. Results Sixteen articles were included in the study, involving 1 263 patients with enterostomy. The results of Meta- analysis revealed that the incidence of complications in transitional care patients was lower than that in conventional discharge guidance patients, odds ratio(95% confidence interval) was 0.31 (0.21-0.45), the difference was significant (Z=6.02, P<0.01), and the quality of life was raised (including the physical function, cognitive function, role function, emotional functions, social function and the total quality of life), weighted mean differences (95% confidence interval) were 13.81 (8.23-19.39), 22.00 (17.21-26.79), 15.22(11.71-18.73), 16.68(13.01-20.35), 22.60(16.58-28.62), 17.46(13.53-21.38),the differences were significant(P<0.01). Conclusions The transitional care model giving priority to hospital service resources can provide a higher level professional care for patients after enterostomy, and avoid or reduce the complications, promote the recovery earlier as well as constantly improve the quality of life.

OBJECTIVE: To establish a HPLC method for the determination of content of entecavir and its related substances. METHODS: The HPLC condition was consisted of a Luna C18 column with a column temperature at 25 ℃, using gradient eluate method, the mobile phase was acetonitrile,with a flow rate of 1.0 mL?min-1 and detection at 254 nm. RESULTS: The calibrated linear curve of entecavir was within 0.033 45～0.167 2 mg?mL-1(r=0.999 98). The average recovery was 100.09%,RSD=0.20%, The content of related substance was 0.54%～1.48%. CONCLUSION: This accurate and reliable HPLC method is applicable for the quality control of entecavir and its related substances.

Objective To compare the effect of three different fertilization modes of frozen-thawed embryos and blastocysts on the pregnancy outcome after thawed transplantation .Methods 3 586 cycles of frozen embryos transplantation (FET ) treatment in our center from January 2012 to December 2013 were retrospectively analyzed and divided into 3 groups according to the fertilization modes .The group A adopted the conventional in vitro fertilization (IVF) of frozen-thawed embryo transfer in 2 008 cases and blas-tocysts transfer in 954 cases .The group B adopted intracytoplasmic sperm injection (ICSI) of frozen-thawed embryo transfer in 361 cases and blastocysts transfer in 129 cases ;the group C was given early remedy intracytoplasmic sperm injection (r-ICSI) of frozen-thawed embryo transfer in 87 cases and blastocysts transfer in 47 cases .The recovery rate of embryo and blastocyst ,pregnancy rate ,abortion rate ,ectopic pregnancy rate were compared for determining whether the differences among the indexes existed . Results The thawing recovery rate ,pregnancy rate ,abortion rate and ectopic pregnancy rate in the three different fertilization modes of embryo and blastocyst had no statistically significant differences (P>0 .05) .Conclusion Compared with conventional in vitro fertilization and intracytoplasmic sperm injection ,early r-ICSI is one of effective treatment means .

BACKGROUND:Since the first frozen embryo transplantation succeeded in 1983, embryo cryotechnique has been an important component in human assisted reproductive techniques. It is controversial which embryos and blastocysts after cryopreservation is selected.
OBJECTIVE:To compare the birth outcomes and neonatal status of frozen thawed embryos and blastocysts.
METHODS:In frozen thawed embryo group (n=1 273) and frozen thawed blastocyst group (n=471), we compared pregnancy rate, abortion rate, ectopic pregnancy rate, premature delivery rate, average premature gestational weeks, term yield, average ful-term gestational age, newborn sex, birth weight, birth defects and so on.
RESULTS AND CONCLUSION:There were frozen thawed blastocyst thaw cycles in 478 cases, 471 cases of transplantation period (including 7 cases without blastocyst transfer were canceled), 236 cases of pregnancy, 201 cases of delivery. Delivery number was 251, including 140 boys and 111 girls. The third day embryo thawing cycle of freezing and thawing appeared in 1 280 cases, 1 273 cases of transplantation period (including 7 cases of no embryo transplantation were canceled), 415 cases of pregnancy, 343 cases of delivery. The delivery number was 431, including 225 boys and 206 girls. Rate of pregnancy was significantly higher in frozen thawed blastocysts compared with frozen thawed embryos. No significant differences were detected in rate of miscarriage, ectopic pregnancy rate, premature delivery rate, average premature gestational weeks, term yield, average ful-termgestational age, newborn sex, and birth weight between frozen thawed embryos and blastocysts. There was no increase in birth defects between frozen thawed embryos and blastocysts. Results suggested that no significant difference was detected in birth outcomes and neonatal status of frozen thawed embryos and blastocysts. Nevertheless, pregnancy outcome is better in frozen thawed blastocysts than frozen thawed embryos.

BACKGROUND:Embryo viability assessment is directly related to the selection of embryo transplantation and clinical outcome of assisted reproduction.
OBJECTIVE:To summarize the assessment methods for early embryonic development.
METHODS:The first author searched PubMed database for relevant articles published from January 1990 to
December 2013 using the keywords of“assisted reproductive technology, art;pre-implantation embryo;embryonic development viability;evaluation methods”in English. Final y, 63 articles were included in result analysis.
RESULTS AND CONCLUSION:In the embryo quality evaluation, the most widely used method is morphological evaluation method which is characterized as rapid, non-invasive, and simple. With the development of assisted reproductive technology, the morphological evaluation combined with time-lapse imaging analysis system has been recognized in embryo selection. Recently, targeted-metabolic analysis has been proposed as a useful tool for assessment of embryo development potential, involving pyruvate acid, glycometabolism, amino acid, and embryo-derived cytokines (soluble human leukocyte antigen G1, platelet-activating factor, etc.). Furthermore, the pre-implantation genetic screening method targeting gene and chromosome abnormality is expected to find more effective markers for evaluating embryo developmental potential.

Objective To investigate the application of combined detection of serum calcitonin(PCT),interleukin-6 (IL-6)and C reactive protein(CRP)in early diagnosis of sepsis in intensive care unit(ICU).Methods ICU ward diagnosed 89 cases of patients with early sepsis(sepsis group),fever and did not peak use of antibiotics,send blood to blood culture and detection of PCT,IL-6,CRP level,and at the same time to select 132 cases of healthy subjects(healthy control group),blood samples were collected to detect PCT,IL-6,CRP;PCT,IL-6 for the detection of electrochemical luminescence method.The detection of CRP by immunoturbidimetric method.Results ICU patients with sepsis in PCT,IL-6,CRP detection value is significantly higher than the control group,and the difference was statistically significant(P＜0.01);combined detection sensitivity and specificity was significantly higher than that of single detection,PCT+ IL-6,PCT+ CRP,PCT+ IL-6-+-CRP sensitivity of three kinds of combined detection were 91.3 ％,90.5％ and 91.9％,the specificity was 89.5％,88.3％ and 89.4％,and accuracy were 85.5％,85.3％ and 85.6％.Conclusion Combined detection of PCT+ IL-6 + CRP or PCT+ IL-6 or PCT+CRP,is helpful to the clinical recognition of early sepsis.

Objective To analyze the effects of fertilization methods and sperm sources in intra‐cytoplasmic sperm injection (ICSI) on the developmental capacity of surplus embryos .Methods A retrospective study was carried out to compare the blasto‐cyst rate of the surplus embryos from 2 697 patients .According to the fertilization methods ,the embryos were divided into IVF group and ICSI group .According to sperm sources ,the ICSI group was divided into ejaculated group and testicular sperm group . The rates of blastocyst formation and good quality blastocysts were compared between different fertilization methods and sperm sources .Results There were 8 426 embryo developed in 2 697 patients .The blastocyst formation rate of surplus embryos was high‐er in the IVF group(n=1 048 ,53 .18% ) than that in the ICSI group(n=1 378 ,49 .27% ) ,but with no statistically significant differ‐ent(P> 0 .05) .The rates of blastocyst were not statistically significant different between the IVF group and in the rescue ICSI group(P>0 .05) .The rates of blastocyst were not statistically significant different between the ejaculated group and the testicular sperm group(P>0 .05) .Conclusion There were not statistically significant different of the rate of blastocyst between different fer‐tilization methods and sperm sources in ICSI .