Objective:To figure out the clinical factors contributing to the oocytes utility rate (OUR) of high responders in in vitro fertilization (IVF)-embryo transfer treatment.Methods:OUR was defined by the number of usable embryos for transfer and (or) cryopreservation divided by the number of oocytes retrieved in a freeze-all cycle. The cycles with ≥15 eggs were included from January 2013 to December 2019. Those with OUR at the top 10% (Group A) and the bottom 10% (Group B) were picked and compared for patients′ characteristics, parameters relating to ovary stimulation and pregnant outcomes. Multifactorial logistic regression was applied to reveal the risk factors affecting OUR in them.Results:A total of 43 patients were included in Group A (OUR: 77.4%, 601/776) and 47 for Group B (OUR: 11.9%, 104/874). Previous IVF/intracytoplasmic sperm injection (ICSI; OR=0.10, 95% CI: 0.01-0.81) and endometriosis ( OR=0.16, 95% CI: 0.03-0.84) were negative factors for OUR ( P<0.05); dual suppression protocol ( OR=3.74, 95% CI: 1.06-26.86) and longer days of stimulation ( OR=3.24, 95% CI: 1.25-8.42) were protective factors in terms of ovarian stimulation ( P<0.05), on contrary to that, any decline of estradiol during the stimulation led to poorer OUR ( OR=0.16, 95% CI: 0.04-0.64). Although two groups had similar quantities of eggs and metaphase of meiosis Ⅱ (MⅡ) oocytes, distinguished cumulative clinical pregnancy rate and cumulative live birth rate were seen in Group A and group B respectively [95.3% (41/43) vs 40.4% (19/47) and 90.7% (39/43) vs 31.9% (15/47), all P<0.01]. Conclusions:High responders with attempted IVF/ICSI and endometriosis should be considered as risk factors for OUR. Over ovarian stimulation, dual suppression and a slightly longer stimulating duration could be tried; besides, estradiol decline should be prevented for a better OUR.

Adult ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Spondylitis, Ankylosing ; diagnosis ; drug therapy ; Tripterygium ; chemistry

OBJECTIVE To realize the situation of nosocomial infection and usage of antibiotic in order to prevent and control nosocomial infection effectively. METHODS According to the request of countrywide nosocomial infection net,using the method of clinic investigation and case history investigation,we have investigated the infection complexion about all patients in 19 May 2006 and 24 May 2007,including the duration,transferring department and dead case.Then to analyze the comparison between two results. RESULTS 3489 cases were investigated,including 186 infection cases.The prevalence rate of nosocomial infection was 5.33%.Five departments had the high prevalence rate of nosocomial infection.They were hematology department,ICU,pediatrics department,neonatal unit and cadre ward.The highest rate was 31.30%.The lowest was 0.The infection site focused on lower respiratory tract.The antibiotic utilizing rate was high. CONCLUSIONS Enhanceing the management of nosocomial infection in key departments,regulating the antibiotic utilizing,to reduce the prevalence rate of nosocomial infection.

Objective To evaluate the therapeutic responses to transsphenoidal surgery and medical therapy in terms of normalization of prolactin(PRL),mortality,morbidity and the cost-effectiveness of PRL normalization in order to establish an individualized therapeutic protocol for the patients with prolactinoma.Methods A retrospective study was undertaken of a consecutive series of patients with prolactinoma who were followed for at least 1 year after transsphenoidal surgery or medical treatment.The clinical characteristics and the long-term outcomes(normalization of PRL,morbidity or mortality)were assessed.Utilizing the principle of medical economics and data from the two types of treatment,we worked out a Markov chain and calculated the lowest cost of two kinds of therapeutic protocols.Results(1)The success rate of normalizing serum PRL through surgical treatment in microadenoma was 85%(22/26),and that of medical treatment was 95%(19/20).There was no statistical difference between the two therapies(P＞0.05).The success rate of normalizing serum PRL through surgical treatment in macroadenoma was45%(19/42),and that of medical treatment was 5/5.There was a statistical difierence between the two therapies(P＜0.05).(2)According to the Markov model,it would cost a microprolactinoma patient 25 129.25 yuan to normalize serum PRL by surgical treatment.This is comparable to the cost of medical treatment which would be 24 943.99 yuan.Whereas for a macroprolactinoma patient surgery would cost 35 208.20 yuan and medical treatment would cost 25 344.38 yuan.Conclusions Medical therapy is superior to surgical treatment in regard to complication rate and cost-effectiveness for macro-and extra big prolactinomas.Transsphenoidal surgery remains an option for patients with microadenomas.Markov model is an effective way to predict the treatment cost for patients with hyperprolactinoma at different ages and with different canses

OBJECTIVETo observe the therapeutic efficacy and safety of gonadotropin-releasing hormone agonist (GnRHa) combined Wenshen Xiaozheng Decoction (WXD) in auxiliary treating endometriosis after laparoscopy.

METHODSOne hundred and thirty-four endometriosis patients with confirmative pathological diagnosis were assigned to three groups depending on whether they would receive adjuvant therapy or Chinese medicine treatment, i.e., the control group, the observation 1 group, and the observation 2 group. The 22 patients in the control group received no adjuvant therapy after laparoscopy. The 42 patients in the observation 1 group were treated with GnRHa 3.6 mg by subcutaneous injection starting from the 1st day to the 5th day of menstruation, once per 28 days. The 70 patients in the observation 2 group were treated with GnRHa 3.6 mg by subcutaneous injection in combination with WXD starting from the 1st day to the 5th day of menstruation, once per 28 days. They also took WXD for 7 doses, one cycle per every 28 days. The treatment lasted for three to six months. Serum levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and cancer antigen 125 (CA125), as well as clinical efficacy, and adverse drug reactions were observed before and after treatment.

RESULTSThere was statistical difference in serum levels of E2, FSH, or LH between the control group and the observation 1 and 2 groups (P < 0.05). There was no statistical difference in serum levels of E2, FSH, or LH between the observation 1 group and the observation 2 group (P > 0.05). There was statistical difference in the clinical efficiency among the 3 groups (P < 0.05). There was statistical difference in the pre-post difference of CA125 levels among the three groups (P < 0.01). Compared with the control group, there was no statistical difference in the pre-post difference of CA125 levels between the observation 1 group and the observation 2 group (P > 0.05). No obvious adverse reaction occurred during the treatment.

CONCLUSIONSGnRHa combined WXD showed confirmative clinical efficacy in treating endometriosis after laparoscopy. It also could lower serum levels of E2, FSH, and LH levels. So it was an ideal solution for treatment of endometriosis.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; surgery ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Laparoscopy ; Treatment Outcome

OBJECTIVETo explore the correlation between hand and face-mouth, so as to provide nerve reflex basis for the theory "Hegu (LI 4) regulates face and mouth".

METHODSSeven hundred and sixty-three participants who met the inclusive criteria were divided into different age groups. The skin around participants' thenar eminence was gently scraped to be observed whether there was an involuntary movement around the face or mouth, which was palmomental reflex. The results of palmomental reflex were recorded.

RESULTSThe total occurrence rate of palmomental reflex was 46.26%. For those who were 0 to 1 years old, the palmomental reflex was all positive; for those who were 21 to 36 years old, the positive rate was 20.45%, which was the lowest; for those who were 65 to 85 years old, more than half of them were positive. The majority of those who were 0 to 2 years old were bilateral positive palmomental reflex, while the majority of those who were 65 to 85 years old were unilateral positive palmomental reflex.

CONCLUSIONThere is a certain connection between hand and face-mouth. The occurrence rate of palmomental reflex changes from high to low over age increasing, and then changes from low to high with the aging, presenting a "high-low-high" U-shaped curve, which is possible related to the growth and recession of nervous system.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Face ; physiopathology ; Female ; Hand ; physiopathology ; Humans ; Infant ; Male ; Middle Aged ; Mouth ; physiopathology ; Reflex ; Young Adult

The ideal treatment and recovery of osteoarticular injury remain to be resolved. Small intestinal submucosa (SIS), a naturally-occurring decellularized extracellular matrix, has been recognized as an ideal scaffold for tissue engineering and widely used in repairing various tissues and organs. Nowadays its application has also been gradually increased in the field of orthopedics. We reviewed laboratorial studies and clinical trails about the application of SIS in bone and joint repair, aiming to evaluate its effects on the repair of bone, cartilage, meniscus, ligament and tendon. SIS has showed promising results in repairing bone, meniscus, ligament or tendon. However, additional studies will be required to further evaluate its effects on articular cartilage and tendon-bone healing. How to optimize SIS material,is also a focused problem concerned with making SIS a potential therapeutic option with high value for orthopedic tissue repair.
Animals ; Cell- and Tissue-Based Therapy ; Humans ; Intestinal Mucosa ; cytology ; Intestine, Small ; cytology ; Joint Diseases ; physiopathology ; surgery ; therapy ; Tissue Engineering ; instrumentation ; methods ; Tissue Scaffolds ; chemistry

With low molecular weight chitosan and poloxamer 188 as the joint carriers, ginsenoside Rg3 solid dispersions were prepared by using the solvent evaporation method for an in vitro dissolution test. Subsequently, differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and X-ray diffraction (X-RD) were adopted for a phase analysis. The results showed that the 60 min in vitro cumulative dissolution rate of ginsenoside Rg3 solid dispersions prepared with low molecular weight chitosan and poloxamer 188 at the ratio of 2:1 exceeded 90%, and the drug was dispersed in carriers in an amorphous state. Therefore, ginsenoside Rg3 solid dispersions prepared with low molecular weight chitosan and poloxamer 188 could help significantly improve the drug dissolution, with a practical application value.
Chitosan ; chemistry ; Drug Compounding ; methods ; Ginsenosides ; chemistry ; Molecular Weight ; Poloxamer ; chemistry ; Solvents ; chemistry

OBJECTIVE To explore the characteristic of nosocomial infection and formulate the effective measures of nosocomial infection management. METHODS According to the underlying disease condition and method ICD10,the infection data were to classifed and colleced which including of 160 795 cases during 2003-2006.Then the prospective and retrospective investigation were done for studying the nosocomial infection condition. RESULTS The nosocomial infection rate was 4.69%. The highest infection rate was caused by hematological disease (15.43%). By site of infection the upper respiratory infection rate was 35.34%,the lower respiratory infection rate was 28.22%,the gastrointestinal infection rate was 6.82%,and the intra-abdominal infection was 3.75%. In these infection cases,G-bacteria infection occupied 58.35% (which ranked No.1 in all pathogens),and the fungal infection occupied 17.09%. CONCLUSIONS In order to reduce the infection rate,we must enhance the work of preventing the key diseases,standard the measures of disinfection and isolation,increaseing the quarantine inspection rate and applying antibiotic according to the results of antifugal susceptibility testing.

Objective Toinvestigatethepossibilityandquantitativerangeofpepsinogen(PG)usedas the screening marker of gastric cancer by detecting serum pepsinogen level in different gastric mucous pathologic status.Method ThelevelofserumpepsinogenⅠ(PGⅠ)andpepsinogenⅡ(PGⅡ)bytimeresolvedfluoro-immunoassay(TRFIA)in 64 chronic atrophic gastritis patients,63 gastric mucous atypical hyperplasia patients, 67 gastric cancer patients and 20 healthy volunteers were defeeted ,and the ratio of PGR(PGⅠ/PGⅡ)was calculated.Then the three kinds of diseases were graded.The data was analyzed between groups and sub-groups.Result ①Compared with normal control group,the median PGⅠvalues were 1 24.01 ,91 .23 and 71 .23 respectively,which were all lower than that of healthy group (1 52.00).There were significant differ-ences(Z=-2.52,P=0.01 7 0;Z=-3.42,P=0.001 4;Z=-3.57,P=0.000 9).The median PGR values were 7.61 ,5.21 and 4.32 respectively,which were also lower than that of healthy group,the differences were significant(Z=-2.98,P=0.002 9;Z=-3.1 7,P=0.000 2;Z=-2.89,P=0.000 1 ).The PGⅡlevel of these diseases were not significantly different with control group.②The serum PGⅠlevel of gastric mucous atypical hyperplasia and gastric cancer were reduced significantly in contrast with atrophic gastritis (Z =-3.42,P =0.001 4;Z=-3.62,P=0.000 9);the levels of PGⅡand PGR were varied without significance (P>0.05 );③The levels of PGⅠamong atrophy gastritis and gastric cancer subgroup have no significant difference(χ2 =2.86,P=0.41 4 3;χ2 =1 .67,P=0.1 36 8).But the level of PGⅠwas significantly different in gastric atypical hyperplasia(χ2 =0.83,P=0.043 0).It decreased in light and medium grade dysplasia and went up in severe grade dysplasia.The levels of PGⅡ and PGR were varied without significance(P>0.05).④The areas under the ROC curves performed by the PGⅠ and PGR from normal control group and atypical hyperplasia group were 0.782 and 0.831 respectively;The sensitivity and specificity of PGⅠ≤72.1 2 μg/L and PGR≤4.32 for gastric dysplasia were 89.48%and 76.31%respectively.Conclusion ①The level of PGⅠand PGR were decreased along with the seriousness of gastric pathological changes and probably regarded as the screening markers of gastric mucous malignant transformation.②Serum pepsinogen level is closely correlated with gastric precancerous lesion,PGI≤72.1 2 μg/L and PGR≤4.32 has better specificity and sensitivity for gastric atypical hyperplasia in this area.