early lithagogue rate.

Objective To explore the clinical application of endometrial scratching in patients with repeated implantation failure(RIF).Methods A total of 189 women with RIF who planned to undergo in vitro fertilization and embryo transfer(IVF‐ET)once again at the Reproductive Medicine Center of Tongji Hospital ,Huazhong University of Science and Technology ,be‐tween October 2013 and August 2014 ,were prospectively examined.These women were infertile due to tubal factors ,with their male partners having normal semen measurements.According to the case numbers ,the 189 patients were randomly divided into experimental group(n=96)and control group(n=93).In the experimental group ,endometrial scratching was conducted within 6 h of one menstrual cycle one month before oocyte retrieval ,while in control group ,no endometrial scratching was performed at that time.The outcomes of pregnancy were compared between the two groups after embryo transplantation.Results There was no statistical difference between the two groups in the patient age ,infertility duration ,body mass index(BMI) ,basal levels of follicle‐stimulating hormone(FSH) ,luteinizing hormone(LH) ,and progesterone(P) ,gonadotropin‐releasing hormone(Gn‐RH) injection days and doses ,the number of retrieved oocytes ,the number of transferred embryos ,the endometrial thickness and lev‐els of estradiol(E2 )and P on the day of HCG injection(P>0.05).The embryo implantation rate ,the clinical pregnancy rate and the ongoing pregnancy rate in the experimental group were much higher than those in the control group ,with statistically signif‐icant difference noted(P<0.01).Conclusion The endometrial scratching can improve the endometrial receptivity and enhance the clinical pregnancy rate of RIF patients.

Objective To study the mechanism of anti-keratin autoantibodies (AK auto Ab) inhibiting the keratinocytes proliferation. Methods Keratinocytes from normal human skin and squamous cell carcinoma were cultured, then treated with AK auto Ab in different doses. MTT and immunohistochemical technologies were applied to test the proteins related to proliferation and apoptosis. Results AK could inhibit the proliferation of these two kinds of cells with a dose related effect. AK auto Ab could promote the expression of p53,c-myc, and inhibited the expression of PCNA. Conclusions The results indicate that AK auto Ab plays an important role in the proliferation of keratinocytes both from normal skin and from SCC.

Objective To compare the effects of point contact-dynamic compression plates (PC-DCP) and dynamic compression plates (DCP) on cortical bone blood flow in an intact sheep tibia model. Methods Fifteen mature goats were used in this experiment. After the bilateral tibia of goats were fixed with DCP and PC-DCP respectively, the regional cortical bone blood flow was measured at four time intervals (1 day, 2, 6 and 12 weeks after operation) using radiolabelled microsphere technique. Results After operation, the cortical bone blood flow was acutely decreased at the first day, kept lower than normal level until six weeks and recovered at the 12th week. The blood supply under PC-DCP recovered to normal, even over normal level two weeks after operation and remained at a high level until 12 weeks. Conclusions PC-DCP can markedly protect cortical bone blood flow.

Objective To compare the effects of point contact-dynamic compression plates (PC-DCP) and dynamic compression plates (DCP) on bone structure and mechanical properties of the plated bone in the intact goat tibia model. Methods Ten matured goats were used. The bilateral intact tibia of goats were fixed with DCP and PC-DCP respectively. The goats were sacrificed at 12 and 24 weeks after operation, and the tibiae were harvested. The structure of bone under plate was studied both by CT scan and histomorphology. The mechanical properties of the plated bone were examined by torsional test. Results At 12 weeks after internal fixation, there was obvious osteoporosis in the cortical bone underneath the plate in the DCP group compared with that of the PC-DCP group. Both of the cortical bone thickness underneath the plate and the torsion strength of the plated tibiae were significantly higher in the PC-DCP group than that in DCP group (P0.05). Conclusion The underlying bone resorption after rigid plate fixation is induced by both the disturbance of the bone blood supply and stress shielding. However, the former is the main cause in the early stage of fixation. PC-DCP is able to prevent bone resorption in the early stage of fixation.

To investigate changes in density of platelet glycoprotein (GP)Ⅱb/Ⅲa receptor during the perioperative period of hepatectomy in rats with myocardial infarction. 26 adult SD rats were randomly divided into 2 groups: the control group(1)( n =13) and the infarction group(2)( n =13). Myocardial infarction was produced by celiac injection (1 time/d) of isoproterenol (30mg/kg) for 3 days. All rats underwent hepatectomy after 3 weeks. Platelet surface density of GPⅡb/Ⅲ receptors was determined by flow cytometric analysis before and 6, 12, 24, 48, 72 hours after the operation. 12 hours after the operation, the density of GPⅡb/Ⅲa was transiently increased compared with preoperative period in control group ( P

Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

Objective To understand the distribution and antimicrobial resistance of pathogens isolated from blood culture in a hospital in Sanya city.Methods Blood culture specimens and antimicrobial susceptibility testing results in this hospital from January 2013 to December 2015 were analyzed retrospectively.Results A total of 356 isolates of pathogenic bacteria were isolated from 3 195 blood culture specimens,the positive rate was 11.14％,including 215(60.39％)gram-negative bacterial strains,122(34.27％) gram positive bacterial strains,and 19(5.34％) fungi strains.The top 3 gram negative bacteria were Escherichia coli (n =90,25.28％),Klebsiella pneumoniae (n =60,16.85％),and Burkholderia pseudomallei (n =24,6.74％);the most common gram positive bacteria were Staphylococcus aureus (n =42,11.80 ％),coagulase-negative staphylococcus (n =38,10.67 ％),and Streptococcus spp.(n =33,9.27 ％).Resistance rates of Escherichia coli and Klebsiella pneumoniae to cefoperazone/sulbactam,amikacin,and carbapenems were all lower than 10.00％;resistance rates of Burkholderia pseudomallei to most antimicrobial agents were lower than 10.00％.There were no strains of main gram-positive bacteria that were found to be resistant to linezolid and vancomycin.Conclusion Gram-negative bacteria are the main pathogens causing bloodstream infection in this hospital in recent years,especially the isolation rate of Burkholderia pseudomallei is higher,which should arouse more attention in clinic.

Objective To determine the dynamic change of serum procalcitonin (PCT) level after traumatic brain injury and the rclated clinical significance.Methods Serum levels of PCT and adrenocorticotropic hormone (ATCH) in 137 patients with traumatic brain injury and 20 normal volunteers were measured by electrochemiluminescence assay.Correlation between serum PCT level and severity of traumatic brain injury was evaluated.Results Percentage of serum PCT level at low inflammatory-risk threshold detected from day 1 to day 14 after admission was descended from 80.3％ to 63.5％.Meanwhile,the percentage of serum PCT level at high inflammatory-risk threshold was a rising-fall-rising trend,but the percentages of serum PCT level at median and definite inflammatory-risk thresholds showed sustained increase from 13.9％ to 27.0％ and 0.7％ to 3.7％ separately.Based on the Glasgow Coma Scale (GCS),the dynamic change of serum PCT level demonstrated a distinct bimodal pattern in severe injury group,a gradual falling after rising mode in middle injury group which was significantly and positively correlated with GCS (r =0.463,P ＜ 0.05),and a rising-falling-slight rising tendency in minorinjury group.In addition,the GCS in each group only closely related to the positive detections of serum PCT level detected at days 3 and 7 (x2 =10.32,16.31 respectively P ＜ 0.01).Serum ATCH level at day 1 was far higher than that at day 14 in severe injury group and was significantly higher in severe injurygroup compared with minor and middle injury groups (P ＜ 0.01 or 0.05).Conclusions Positive serum PCT may be predictive of the traumatic brain injury and injury degree within 3-7 days after the injury.The dynamic change of serum PCT is associated with the specialized mechanism of traumatic brain injury and neuronendocrine response,and it may be a useful parameter to assess posttraumatic stress response and prognosis.

Background The present study investigated the prognostic value of medical comorbidities at admission for 30-day in-hospital mortality in patients with acute myocardial infarction (AMI). Methods A total of 5161 patients with AMI were admitted in Chinese PLA General Hospital between January 1,1993 and December 31,2007. Medical comorbidities including hypertension, diabetes mellitus, previous myocardial infarction, valvular heart disease, chronic obstructive pulmonary disease (COPD), renal insufficiency, previous stroke, atrial fibrillation and anemia, were identified at admission. The patients were divided into 4 groups based on the number of medical comorbidities at admission (0, 1, 2, and ≥ 3). Cox regression analysis was used to calculate relative risk (RR) and 95% confidence intervals (CI), with adjustment for age, sex, heart failure and percutaneous coronary intervention (PCI). Results The mean age of the studied population was 63.9 ± 13.6 years, and 80.1% of the patients were male. In 74.6% of the patients at least one comorbidity were identified. Hypertension (50.7%), diabetes mellitus (24.0%) and previous myocardial infarction (12%) were the leading common comorbidities at admission. The 30-day in-hospital mortality in patients with 0, 1, 2, and ≥ 3 comorbidities at admission (7.2%) was 4.9%, 7.2%, 11.1%, and 20.3%, respectively. The presence of 2 or more comorbidities was associated with higher 30-day in-hospital mortality compared with patients without comorbidity (RR: 1.41, 95% CI: 1.13-1.77, P = 0.003, and RR: 1.95, 95% CI: 1.59-2.39, P = 0.000, respectively).Conclusions Medical comorbidities were frequently found in patients with AMI. AMI patients with more comorbidities had a higher 30-day in-hospital mortality might be predictive of early poor outcome in patients with AMI.