Objective The plasma von Willebrand factor(vWF)level in patients with primary microvascular angina(PMVA)were measured to evaluate the vascular endothelial function of the patients.The change of vWF level in patients after the treatment with Shexiangbaoxin Pill were observeg.Methods Totally 69 patients who were definitely diagnosed as PMVA,They were randomly divided into conventional treatment group(33cases)and ShexiangBaoxin Pill group(36cases).The plasma vWF levels of the two groups were measured before and after treatment.Results The level of vWF before treatment in conventional treatment group was(50.93±32.98)μg/L.The level of vWF before treatment in ShexiangBaoxin Pill group was(27.45±25.02)μg/L.The level of vWF in conventional treatment group after treatment was(49.65±35.12)μg/L.The level of vWF after treatment in ShexiangBaoxin Pill group was(17.37±15.68)μg/L.The difference of vWF decrease in Baoxin Pill group after treatment(10.08±16.47)μg/L,was lower than that in conventional treatment group(1.28±12.37)μg/L,the difference is significant(P<0.05).Conclusion Shexiang Baoxin Pill has the function of protecting vascular endothelium,and PMVA patients can benefit from treatment.

Objective:To analyze levels of oral Streptococcus sanguinis( Ss)in middle-aged and elderly patients with primary microvascular angina(PMVA)and changes in vascular endothelial function. Methods:In this case-control study, 21 middle-aged and elderly patients diagnosed with PMVA at the Department of Cardiology, Hangzhou Red Cross Hospital between January 2019 and July 2022(the PMVA group)were recruited, with ages ranging from 45 to 80(63.4±12.3)years, while 23 healthy individuals receiving health checkups during the same period served as the control group, with ages ranging from 48-76(62.5±6.5)years.The 21 middle-aged and elderly PMVA patients underwent tests for the measurement of subgingival plaque Ss levels of the oral cavity and levels of plasma vascular von Willebrand factor(VWF)and homocysteine(Hcy). Pearson linear regression analysis was conducted.Results:Ss was not found in subgingival plaque of the oral cavity in the control group, but low levels of Ss were detected in patients from the PMVA group(percentage: 1.754×10 -4; 6.218×10 -5, 4.450×10 -4). The VWF level in the PMVA group was higher than in the control group[(20.22 ± 4.44)μg/L vs.(12.00 ± 6.60)μg/L, t=4.890, P<0.01]. There was no statistical difference in the Hcy level between the PMVA group and the control group[(15.28±6.40)μmol/L vs.(12.86±2.63)μmol/L, t=1.615, P>0.05]. There was no significant correlation between Ss levels and VWF levels in the PMVA group( r=0.038, P>0.05). Conclusions:Ss can be detected in subgingival plaque of the oral cavity in PMVA patients, but not in healthy middle-aged and elderly people.The VWF level in PMVA patients is significantly higher than in healthy people, indicating that vascular endothelial function is impaired in middle-aged and elderly PMVA patients.However, there is no correlation between subgingival plaque Ss levels of the oral cavity and VWF levels in PMVA patients.

OBJECTIVE: To assess the application value of mapping allele with resolved carrier status (MaReCs) technique for preimplantation genetic testing (PGT). METHODS: The characteristics of MaReCs for PGT and outcome of patients were retrospectively analyzed. RESULTS: Compared with those who could not use the technique, carriers who have used the MaReCs technique were younger, had significantly higher level of anti-Mullerian hormone, more antral follicles, occytes, mature occytes, biopsied embryos and euploid embryos, and lower risks for de novo chromosomal abnormality (P<0.05). It was necessary for couples with fewer oocytes, mature oocytes and balstocyst to preserve discarded embryos to facilitate the test. Carriers who have used the MaReCs technique had higher clinical pregnancy rate and abortion rate compared with those undergoing routine PGT, albeit no significant difference was found between the two groups (P> 0.05). Carriers undergoing MaReCs test could preferentially select embryos with normal chromosome structures for the transfer. CONCLUSION Application of MaReCs has a prerequisite for having a minimum number of occytes and biopsied embryos and using discarded embryos sometimes. MaReCs is efficient for the detection of carrier status of embryos and attaining higher rate of pregnancy and live birth, which can significantly improve the outcome for couples carrying chromosomal translocations.
Alleles ; Aneuploidy ; Blastocyst ; Female ; Fertilization in Vitro ; Genetic Testing ; Humans ; Pregnancy ; Preimplantation Diagnosis ; Retrospective Studies ; Translocation, Genetic

Objective:To explore the effects of estrogen pretreatment on the outcomes of in vitrofertilization and embryo transfer (IVF-ET) treatment of gonadotrophin-releasing hormone antagonist (GnRH-A) protocol with controlled ovarian hyperstimulation. Methods:Retrospective analysis was performed on the clinical data of 1042 patients who have underwent IVF-ET treatment of GnRH-A protocol in the Center of Reproductive Medicine Teaching Hospital of Fujian University of Traditional Chinese Medicine from January 2015 to December 2016. According to whether the estrogen pretreatment were conducted, patients were divided into pretreatment group and non-pretreatment group. Clinical data and treatment outcomes of IVF-ET between two groups were compared according to different ovarian reactions (high response, normal response, and low response).Results:Compared with non-pretreatment group, the level of serum follicle stimulation hormone (FSH) and luteinizing hormone (LH), antral follicle diameter and coefficent of varience (CV) significantly decreased in pretreatment group (all P<0.001). Total dosage and duration of gonadotropin (Gn) used [(1 693.4±569.8) IU， (2 242.5±635.8) IU， (2 686.4±833.8) IU； (9.7±1.1) d， (9.6±1.1) d， (9.5±1.6) d] in non-pretreatment group were less than those in pretreatment group [(1 897.9±508.0) IU， (2 458.9±759.1) IU， (2 942.1±756.0) IU； (10.8±1.1) d， (10.5±1.4) d， (10.5±1.6) d] ( P<0.001， P=0.019， P=0.029； P<0.001， P<0.001， P<0.001). In patients with normal ovarian response and poor ovarian response, the follicular unsynchronization rate in Gn used day 5/6, day 7/8 and the day of human chorionic gonadotropin (hCG) injection significantly reduced with estrogen pretreatment (all P<0.05), and the number of follicles with a diameter≥14 mm on the day of hCG injection, the number of oocytes retrieved and mature oocytes, two pronuclear fertilization rate and the number of high-quality embryos of pretreatment group were larger than those of non-pretreatment group (all P<0.05). In patients with high ovarian response, the follicular unsynchronization rate (17.7%) in Gn used day 5/6 of pretreatment group was lower than that of non-pretreatment group (26.7%, P=0.012), while other clinical outcomes and indexes relevant to the laboratory of two groups were not statistically significant (all P>0.05). In patients with normal and poor ovarian response, the differences in the number of oocytes retrieved, mature oocytes, and high-quality embryos between pretreatment group and non-pretreatment group were statistically significant ( P<0.001, P<0.001; P<0.001, P<0.001; P<0.001, P=0.018).In patients with normal ovarian response, the cumulative clinical pregnancy rate (81.3%) of pretreatment group was higher than that of non-pretreatment group (70.5%， P=0.044). In people with different ovarian responses, the clinical pregnancy rate, the miscarriage rate in fresh cycle and the clinical pregnancy rate in the first thaw cycle after freeze-all were not statistically significant between the two groups (all P>0.05). Conclusion:In patients with normal and poor ovarian response, estrogen pretreatment before GnRH-A protocol can improve the homogeneity of follicular development, increase the number of mature oocytes and high-quality embryos, and thus improve clinical pregnancy outcomes. While in patients with high ovarian response, estrogen pretreatment show no superiority and clinical application value for its larger total Gn dosage and stimulation duration.

Objective:To explore the effects of estrogen pretreatment on the outcomes of in vitrofertilization and embryo transfer (IVF-ET) treatment of gonadotrophin-releasing hormone antagonist (GnRH-A) protocol with controlled ovarian hyperstimulation. Methods:Retrospective analysis was performed on the clinical data of 1042 patients who have underwent IVF-ET treatment of GnRH-A protocol in the Center of Reproductive Medicine Teaching Hospital of Fujian University of Traditional Chinese Medicine from January 2015 to December 2016. According to whether the estrogen pretreatment were conducted, patients were divided into pretreatment group and non-pretreatment group. Clinical data and treatment outcomes of IVF-ET between two groups were compared according to different ovarian reactions (high response, normal response, and low response).Results:Compared with non-pretreatment group, the level of serum follicle stimulation hormone (FSH) and luteinizing hormone (LH), antral follicle diameter and coefficent of varience (CV) significantly decreased in pretreatment group (all P<0.001). Total dosage and duration of gonadotropin (Gn) used [(1 693.4±569.8) IU， (2 242.5±635.8) IU， (2 686.4±833.8) IU； (9.7±1.1) d， (9.6±1.1) d， (9.5±1.6) d] in non-pretreatment group were less than those in pretreatment group [(1 897.9±508.0) IU， (2 458.9±759.1) IU， (2 942.1±756.0) IU； (10.8±1.1) d， (10.5±1.4) d， (10.5±1.6) d] ( P<0.001， P=0.019， P=0.029； P<0.001， P<0.001， P<0.001). In patients with normal ovarian response and poor ovarian response, the follicular unsynchronization rate in Gn used day 5/6, day 7/8 and the day of human chorionic gonadotropin (hCG) injection significantly reduced with estrogen pretreatment (all P<0.05), and the number of follicles with a diameter≥14 mm on the day of hCG injection, the number of oocytes retrieved and mature oocytes, two pronuclear fertilization rate and the number of high-quality embryos of pretreatment group were larger than those of non-pretreatment group (all P<0.05). In patients with high ovarian response, the follicular unsynchronization rate (17.7%) in Gn used day 5/6 of pretreatment group was lower than that of non-pretreatment group (26.7%, P=0.012), while other clinical outcomes and indexes relevant to the laboratory of two groups were not statistically significant (all P>0.05). In patients with normal and poor ovarian response, the differences in the number of oocytes retrieved, mature oocytes, and high-quality embryos between pretreatment group and non-pretreatment group were statistically significant ( P<0.001, P<0.001; P<0.001, P<0.001; P<0.001, P=0.018).In patients with normal ovarian response, the cumulative clinical pregnancy rate (81.3%) of pretreatment group was higher than that of non-pretreatment group (70.5%， P=0.044). In people with different ovarian responses, the clinical pregnancy rate, the miscarriage rate in fresh cycle and the clinical pregnancy rate in the first thaw cycle after freeze-all were not statistically significant between the two groups (all P>0.05). Conclusion:In patients with normal and poor ovarian response, estrogen pretreatment before GnRH-A protocol can improve the homogeneity of follicular development, increase the number of mature oocytes and high-quality embryos, and thus improve clinical pregnancy outcomes. While in patients with high ovarian response, estrogen pretreatment show no superiority and clinical application value for its larger total Gn dosage and stimulation duration.

Objective To investigate the clinical value of platelet parameters in patients with acute myocardial infarction(AMI) in plateau.Methods A total of 72 patients diagnosed as acute myocardial infarction in our department from January 2016 to June 2017 were enrolled into this study.Clinical data and outcomes were analyzed.Platelet parameters were measured within 24 h after AMI occurrence.The relationship between platelet distribution width (PDW),mean platelet volume (MPV),and the severity of disease,infarct size as well as short-term prognosis were further investigated.Results Compared with control group,PDW and MPV were positively correlated with the severity of disease (PPDW=0.039,PMPV=0.038) and infarct size (rPDW=0.305,P=0.009;rMPV=0.263,P=0.025).The AUC of PDW was 0.827,optimal operating point (OOP) was 16.3％,the AUC of MPV was 0.813,OOP was 13.1 fl,the AUC of GRACE was 0.865,OOP was 145.Conclusions PDW and MPV could be regarded as laboratory index to evaluate the severity of disease,infarct size,pathological changes of coronary artery and short-term prognosis of acute myocardial infarction in plateau.