Objective To investigate how to optimize the protocol of embryo cryopreservation to improve the success of frozen-thawed embryo transfer (FET), reduce multiple pregnancy rate and increase the cumulative pregnancy rate from one oocyte retrieval process. Methods The clinical data of 1 166 FET cycles were retrospectively analyzed and separated into different groups:445 for vitrification and 721 for slow-freezing. The vitrification group was divided into single embryo (28 cy?cles), double embryos (71 cycles) and triple embryos (346 cycles). 0-1 optimal embryo was called O0-1 group (235 cycles), 2 optimal embryos were called O2 group (80 cycles), 3 optimal embryos were called O3 group (130 cycles). The difference preg?nancy outcomes (implantation rate, clinical pregnancy, abortion rate and live-birth rate) were compared between groups. Results (1) There were significantly higher embryo survival rate(98.3%vs 73.1%), embryo recovery rate without damaging (83.3%vs 62.1%), implantation rate(36.8%vs 29.9%), clinical pregnancy(57.1%vs 44.0%) and live-birth rate(47.9%vs 34.5%) in vitrification group than those of slow freezing group(P<0.05). (2) There were significantly higher clinical pregnan?cy rate(62.7%vs 39.4%vs 32.1%), multiple pregnancy rate(37.6%vs 10.7%vs 0%)and live-birth rate(52.6%vs 31.0%vs 21.4%)in triple embryos group than those of the single and double embryos groups (P<0.05). (3) There were significantly higher implantation rate(33.0%vs 27.1%), clinical pregnancy(65.2%vs 48.1%), multiple pregnancy rate(38.0%vs 20.4%) and live-birth rate(56.2%vs 39.2%) in O2-3 group than those of O0-1 group(P<0.05). (4) There were significantly higher im?plantation rate(36.8%vs 26.3%) and multiple pregnancy rate (46.7%vs 21.3%) in O3 group than those of O2 group (P<0.05). There were no significant differences in clinical pregnancy(69.2%vs 58.8%), abortion rate(15.6%vs 10.6%), ectopic preg?nancy rate(0 vs 0), live-birth rate(58.5%vs 52.5%) and preterm birth rate(26.3%vs 14.3%) between two groups (P>0.05). Conclusion Vitrification technology can improve the clinical pregnancy and live-birth rate, and decrease multiple preg?nancy rate. Two optimal embryos in one tube are supposed to be the preferred method for embryo cryopreservation.

Objective To review the imaging appearances and clinical symptoms of primary hepatic and gallbladder neuroendocrine carcinomas (PHGNC). Methods Five patients (4 females and 1 male) were examined. Long-term diarrhea not controlled by drug was found in four patients, and two of them accompanied by abdominal pain. The liver rupture occurred in one case due to the huge tumor bleeding. Five patients were examined by using ultrasonography (US), four patients by CT, and three patients by hepatic angiography. The tumor originated from liver in three cases, from liver and gallbladder in one case, and from gallbladder in one case. The tumors were diagnosed by surgery in 3 cases, by biopsy and by autopsy in 1 case, respectively. Results Multiple hyperechoic inhomogeneous masses in two cases and hypoechoic inhomogeneous masses in one case were revealed, all with some small fluid areas and abundant vessels. A huge cyst-solid tumor was clearly demonstrated by using US. A small mural nodule along the gallbladder wall was displayed by using US in a gallbladder tumor, and it showed no specific sign in the diagnosis. CT findings included hypodense inhomogeneous masses on plain CT scan, and slightly enhanced masses with some small fluid areas after injection of contrast agent. A huge cyst-solid tumor was clearly displayed by CT due to the hemorrhage, necrosis, and cystic changes in the tumor. Hepatoangiography displayed abundant vessels and stain in the solid part of the tumor, and absent vessel in the cystic region of the cyst-solid tumor accompanied by dislocation of surrounding vessels. Conclusion Imaging appearances of the liver tumor were inhomogeneous mass with abundant vessels and tumor stains. Imaging appearances of the gallbladder tumor were raised mural nodule along the gallbladder wall without specific sign in the diagnosis of the tumor. The tumor may develop hemorrhage, necrosis, and cystic changes if it is large enough. PHGNC was prone to hepatic metastases. The patients often presented with diarrhea and abdominal pain.

Objective To investigate the role of genistein (Gen) in the expression of connective tissue growth factor (CTGF) induced by parathyroid hormone (PTH) in human renal tubular epithelia cells. Methods Real-time PCR, Western blotting and reporter gene assay were employed to detect the role of Gen in PTH-induced CTGF expression in HK-2 cells. The activity of NF-κB was measured by EMSA to investigate the mechanism by which PTH induced CTGF expression in HK-2 cells. Inhibitors of NF-κB signaling pathway were used to ascertain which signal pathway was involved. Results HK-2 cells had basic amount of CTGF mRNA and protein, which, however, increased significantly after treatment with PTH, and the luciferase activity increased to a higher level as compared with control group after treatment with 10-10 mol/L PTH for 12 h (1.89±0.08 vs 0.99±0.03, P＜0.01). Gen decreased the expressions of CTGF mRNA and protein induced by PTH in dose-dependent manner. The NF-κB of nucleus was inactivation without PTH, while the activity of NF-κB significantly increased after exposed to PTH, with the maximal response of PTH at a concentration of 10-10 mol/L and the best stimulating time at 30 minute. The NF-κB inhibitor PDTC reduced the increase of CTGF transcript levels in response to PTH stimulation. Gen blunted PTH-mediated NF-κB activation. Conclusion Gen inhibits CTGF expression induced by PTH through bloking NF-κB signaling pathway in human renal tubular epithelial cells.

Objective PCT and sTREM-1 combined with APACHE Ⅱ score for assessing diagnosis of sepsis and prognostic value.Methods The clinical data for related patients who had hospitalized between January and October 2015 were collected by prospective study methods.According to China guidelines for treatment of severe sepsis/septic shock (2014).The patients were divided into SIRS group,sepsis group,severe sepsis group,septic shock group,and control group.Results Levels of CRP and sTREM-1 were significantly higher in total sepsis group and subgroups than in SIRS group and control group,with a statistical difference (P ＜ 0.05);but there were no significant differences among he subgroups.Lactic acid level differed statistically between both total sepsis group and its subgroups and both control group and SIRS group,so did level of lactic acid between the other groups and septic shock group (P ＜ 0.05).PCT was significantly higher in total sepsis group and its subgroups than in the control group and SIRS group,so did it in septic shock and severe sepsis group than in sepsis group.PCT level was significantly higher in septic shock than in severe sepsis (P ＜ 0.05).APACHE Ⅱ scores were markedly in total sepsis group and its subgroups than in SIRS group and the control group;and it differed statistically between septic shock group and sepsis group (P ＜ 0.05).According to the ROC curve analysis,the area under the curve was 0.935,0.877,0.816,and 0.856 for PCT,sTREM-1,APACHE Ⅱ,CRP,and lactic acid,respectively.Conclusions Detection of serum PCT and sTREM-1 combined with APACHE Ⅱ score can be used to assess diagnosis of sepsis and prognostic value,which has more benefit to the diagnosis and treatment of sepsis.

Objective To study the clinical value of sTREM-1, PCT, CRP in sepsis. Methods A prospective study was conducted and clinical data of related patients from January to October 2015 were collected. Thirty-nine cases of sepsis patients , 15 patients with SIRS and 12 normal controls were detected by ELISA then the prognostic value of sTREM-1, PCT, CRP was determined in sepsis. Results In sepsis and SIRS group, sTREM-1 and PCT level were significantly higher than those in control group (P < 0.05); CRP only in sepsis group and control group was statistically significant (P < 0.05). In sepsis group, sTREM-1,PCT and CRP were significantly higher than those in SIRS group (P < 0.05). The ROC curve analysis indicated that sTREM-1,PCT and CRP for SIRS and non SIRS area under the curve was 0.914,0.887 and 0.831 respectively. Conclusion sTREM-1 is a good indicator for early diagnosis of sepsis, and it has high sensitivity and specificity.

Objective:To investigate the effective method to avoid the ovarian hyperstimulation syndrome(OHSS)in infertile patients underwent in vitro fertilization-embryo transfer(IVF-ET)and whole embryo freezing and thawing 2-3 cycles after egg retrieval.Methods:The controlled ovarian hyperstimulation(COH),the number of retrieved oocytes,the number of embryo freezing,and clinical pregnancy rate were compared between 239 patients with the ET cycle(group A)and 164 patients with whole embryo freezing and thawing(group B).Results:The levels of initial dosage of gonadotropins(Gn)and total dosage of Gn were higher in group A compared with those of group B(P ＜ 0.01).The level of estradiol(E2)on day of human chorinonic gonadotrophin(hCG),the number of retrieved oocytes and the number of embryo freezing were lower in group A compared with those of group B(P＜ 0.01).There were no differences in patient age,COH,rate of OHSS and clinical pregnancy rate between group A and group B.Conclusion:Freezing the whole embryos and thawing ET 2-3 cycles after egg retrieval didn't influence the treatment results in infertile patients.

Fifty Cases of chronic B—hepatitis were treated withTCM based on differentiation of syndromes and com-pared with a control group of 50 cases treated withwestern remedies.Results showed that for the treatinggroup,the rate of negative return of HBeAg was64%,and the rate of positive return of HBe was 48%,while that of the control group were 20% and 10% re-spectively.

AIM:To develop a new identification and analyfical method for Cornu Cervi Pantotrichum . METHODS: Powder X ray diffraction Fourier fingerprint pattern was adopted. RESULTS: The reference X ray diffraction Fourier fingerprint pattern and characteristic diffraction peaks of Cornu Cervi Pantotrichum were obtained by three samples of Cornu Cervi Pantotrichum and one sample of Cornu Cervi Pantotrichum . CONCLUSION: This method can be used for identification of Cornu Cervi Pantotrichum .

Objective: To analyze the influence of semen processing methods on the proportion of the aneuploid sperm by detecting the sperm's chromosome X, Y, 18 using fluorescence in situ hybridization. Methods: Ten patients with mild ohgoasthenosperia, who were received ICSI treatment, were included in this study. Five semen samples of the patients were randomly selected to detect using Swim-up method (A group) and 5 using sperm-grad double-density centrifugation method (B group).Another 5 patients with mild oligo-asthenosperia were as control (C group). The CEPX / Y and CEP18 probe was used to detect the sperm of these 15 patients by fluorescence in situ hybridization. The proportion of aneuploid sperm was compared in three groups. Results: The sex chromosome aneuploid rates were (4.21±2.49)%, (3.24～1.49) % and (2.62±0.89) % in control, A and B groups. The rates of aneuploid chromosome 18 were (3.00±1.22)%, (2.00～1.22)% and (2.00±1.22)% in control, A and B groups. There were no significant differences in three groups (P＞0.05). Conclusion: The results showed that the methods of Swim-up and Sperm-Grad double-density gradient centrifugation could select sperms in motility potential and teratospermia,but not in normal chromosome sperms.

Objective To explore the effect of serum uric acid on the clinical manifestations,pathological characteristics and prognosis of IgA nephropathy.Methods Four hundred and fifty-six cases of primary IgA nephropathy confirmed by renal biopsy from Jan 2007 to Oct 2010 in the Ji'nan Military General Hospital were reviewed retrospectively.The clinical manifestations and pathological characteristics of all the patients were analyzed,x2-test and t-test were used for statistical analysis.Results There were 127 cases with hyperuricemia in 456 IgAN patients (27.9％).The mean age,percentage of male patients,number of patients with hypertension,the serum cholesterol and triglyceride level,body mass index (BMI),serum creatinine and 24 hour urine protein level in hyperuricemia group were significantly higher than those with normal serum uric acid (P＜0.01).The renal pathological changes,glomerular score (8.1 ±0.8 v 5.3t0.9 ),tubulointerstitial score (4.2±0.4 vs 2.7±0.4) and vasculopathy score ( 1.43±0.60 vs 0.76±0.29) in the hyperuricemia group were more severe than those with normal serum uric acid (P＜0.01).Conclusion High level of serum uric acid can affect IgA nephropathy significantly.It is effe-ctive to delay the kindey damage and progression of IgA nephropathy by decreasing the level of uric acid and control the clinical parameters listed above.