Objective:To investigate influencing factors of polyspermy during conventional in vitro fertilization (IVF) in super-long protocol. Methods:This study was a retrospective case-control analysis. From October 2018 to August 2021, 316 patients who underwent conventional IVF using super-long protocol in the Department of Reproductive Medicine, Yuncheng Central Hospital of Shanxi Province were selected and divided into normal fertilization group and polyspermy fertilization group according to polyspermy fertilization incidence in this cycle. The general data and clinical assisted pregnancy data in the two groups were analyzed. The correlation factors of P<0.15 in the single factor analysis were included in logistic regression model for multivariate analysis. Results:There were 227 polyspermy fertilization cycles out of 316 IVF cycles, and the incidence of polyspermy fertilization was 71.84%. There were no significant differences in female age, infertility duration, primary infertility ratio, infertility factors, body mass index (BMI), basal follicle-stimulating hormone (FSH) level and basal anti-Müllerian hormone (AMH) level between normal fertilization group and polyspermy fertilization group (all P>0.05). There were no significant differences in gonadotropin (Gn) initiation dosage, total dosage and duration of Gn used, and progesterone (P) on human chorionic gonadotropin (hCG) injection day between normal fertilization group and polyspermy fertilization group (all P>0.05). The number of follicles with a diameter of ≥14 mm, estradiol (E 2) on hCG injection day and the number of retrieved oocytes in polyspermy fertilization group were significantly higher than those in normal fertilization group [13.66±4.51 vs. 11.78±3.54, P<0.001; (17 247.49±9 450.74) pmol/L vs. (14 135.29±7 369.84) pmol/L, P=0.002; 17.48±7.37 vs. 13.01±6.17, P<0.001]. Luteinizing hormone (LH) level on hCG injection day in polyspermy fertilization group was significantly lower than that in normal fertilization group [(0.79±0.51) U/L vs. (1.02±0.78) U/L, P=0.014]. Logistic regression results showed that the number of follicles with a diameter of ≥14 mm, E 2 and P level on hCG injection day could not enter the regression equation ( OR=1.063, OR=1.676 and OR=1.078, respectively, all P>0.05); LH level on hCG injection day and the number of retrieved oocytes were correlated with polyspermy ( OR=1.900, P=0.028; OR=2.539, P=0.003). Conclusion:The incidence of polyspermy fertilization cycle during conventional IVF in super-long protocol was high. The number of follicles with a diameter of ≥14 mm, E 2 and LH levels on hCG injection day and the number of retrieved oocytes were significantly correlated with the occurrence of polyspermy. Lower LH level on hCG injection day and larger number of retrieved oocytes were independent risk factors of conventional IVF polyspermy fertilization in super-long protocol, and the number of retrieved oocytes had the greater influence on polyspermy fertilization.

Objective:To investigate influencing factors of polyspermy during conventional in vitro fertilization (IVF) in super-long protocol. Methods:This study was a retrospective case-control analysis. From October 2018 to August 2021, 316 patients who underwent conventional IVF using super-long protocol in the Department of Reproductive Medicine, Yuncheng Central Hospital of Shanxi Province were selected and divided into normal fertilization group and polyspermy fertilization group according to polyspermy fertilization incidence in this cycle. The general data and clinical assisted pregnancy data in the two groups were analyzed. The correlation factors of P<0.15 in the single factor analysis were included in logistic regression model for multivariate analysis. Results:There were 227 polyspermy fertilization cycles out of 316 IVF cycles, and the incidence of polyspermy fertilization was 71.84%. There were no significant differences in female age, infertility duration, primary infertility ratio, infertility factors, body mass index (BMI), basal follicle-stimulating hormone (FSH) level and basal anti-Müllerian hormone (AMH) level between normal fertilization group and polyspermy fertilization group (all P>0.05). There were no significant differences in gonadotropin (Gn) initiation dosage, total dosage and duration of Gn used, and progesterone (P) on human chorionic gonadotropin (hCG) injection day between normal fertilization group and polyspermy fertilization group (all P>0.05). The number of follicles with a diameter of ≥14 mm, estradiol (E 2) on hCG injection day and the number of retrieved oocytes in polyspermy fertilization group were significantly higher than those in normal fertilization group [13.66±4.51 vs. 11.78±3.54, P<0.001; (17 247.49±9 450.74) pmol/L vs. (14 135.29±7 369.84) pmol/L, P=0.002; 17.48±7.37 vs. 13.01±6.17, P<0.001]. Luteinizing hormone (LH) level on hCG injection day in polyspermy fertilization group was significantly lower than that in normal fertilization group [(0.79±0.51) U/L vs. (1.02±0.78) U/L, P=0.014]. Logistic regression results showed that the number of follicles with a diameter of ≥14 mm, E 2 and P level on hCG injection day could not enter the regression equation ( OR=1.063, OR=1.676 and OR=1.078, respectively, all P>0.05); LH level on hCG injection day and the number of retrieved oocytes were correlated with polyspermy ( OR=1.900, P=0.028; OR=2.539, P=0.003). Conclusion:The incidence of polyspermy fertilization cycle during conventional IVF in super-long protocol was high. The number of follicles with a diameter of ≥14 mm, E 2 and LH levels on hCG injection day and the number of retrieved oocytes were significantly correlated with the occurrence of polyspermy. Lower LH level on hCG injection day and larger number of retrieved oocytes were independent risk factors of conventional IVF polyspermy fertilization in super-long protocol, and the number of retrieved oocytes had the greater influence on polyspermy fertilization.

Objective:To explore the effect of acceptance and commitment nursing therapy on the psychological resilience and post-traumatic growth of patients with hematopoietic stem cell transplantation.Methods:From January 2018 to December 2019, convenience sampling method was used to select 88 patients who underwent hematopoietic stem cell transplantation in Ningbo First Hospital as the research object. All patients were divided into control group and intervention group with the method of random number table, with 44 cases in each group. Control group was treated with conventional nursing care and medication, and intervention group received acceptance and commitment nursing therapy on this basis. We compared the scores of psychological resilience, post-traumatic growth and quality of life of patients between two groups before and after intervention.Results:Before intervention, there was no statistically significant difference in the total scores of psychological resilience, post-traumatic growth, quality of life and scores in each dimension between two groups ( P>0.05) . After intervention, the total scores of psychological resilience, post-traumatic growth and quality of life of intervention group were higher than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:Acceptance and commitment nursing therapy can improve the psychological resilience, post-traumatic growth and quality of life of patients with hematopoietic stem cell transplantation, which is worthy of clinical promotion.

Objective:To investigate the diagnosis, treatment and prevention of intrauterine pregnancy with intramural pregnancy (IMP) after in vitro fertilization-embryo transfer (IVF-ET). Methods:A retrospective clinical study and literature review were performed to analyze one intrauterine pregnancy with intramural pregnancy after IVF-ET.Results:After double embryo transfer, the patient got conceived. Ultrasound showed early pregnancy in utero with intramural pregnancy on the 40th day of her pregnancy. So the patient underwent laparoscopic hysterectomy in Northwest Women's and Children's Hospital. The patient is now 20 weeks pregnant, and has a intrauterine singleton pregnancy.Conclusion:IVF-ET increases the risk of ectopic pregnancy. The treatment of intrauterine pregnancy with intramural pregnancy should take clinical manifestations, examination results and the patient's own wishes into account.

Objective:To investigate the diagnosis, treatment and prevention of intrauterine pregnancy with intramural pregnancy (IMP) after in vitro fertilization-embryo transfer (IVF-ET). Methods:A retrospective clinical study and literature review were performed to analyze one intrauterine pregnancy with intramural pregnancy after IVF-ET.Results:After double embryo transfer, the patient got conceived. Ultrasound showed early pregnancy in utero with intramural pregnancy on the 40th day of her pregnancy. So the patient underwent laparoscopic hysterectomy in Northwest Women's and Children's Hospital. The patient is now 20 weeks pregnant, and has a intrauterine singleton pregnancy.Conclusion:IVF-ET increases the risk of ectopic pregnancy. The treatment of intrauterine pregnancy with intramural pregnancy should take clinical manifestations, examination results and the patient's own wishes into account.

OBJECTIVE： To establish the method for simultaneous determination of curdione， curcumenol， germacrone， furanodiene and β-elemene in Curcuma wenyujin， and to optimize its processing method in production place. METHODS： HPLC method was adopted. The determination was performed on ODS SP C18 column with mobile phase consisted of acetonitrile-0.05％ phosphoric acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 214 nm， and column temperature was 30 ℃. The sample size was 10 μL. 18 batches of sample medicinal materials were prepared by steaming-drying （10， 20， 30， 40 min）， or cooking-drying （drying temperature 50， 60， 70 ℃）， and then the contents of 5 components were determined. Relative relational degree （ri） obtained by grey relational analysis method as indexes was used to optimize the processing methods of C. wenyujin in production place using. RESULTS： The linear range of curdione， curcumenol， germacrone， furanodiene and β-elemene were 25.56-409.0， 2.05-32.8， 6.36-102.0， 9.14-146.0， 8.62-138.0 μg/mL （r≥0.999 2）， respectively. RSDs of precision， stability and reproducibility tests were all lower than 2.0％ （n＝6）. Quantitative limits were 0.34， 0.62， 0.11， 0.14 and 1.20 μg/mL， and detection limits were 0.10， 0.19， 0.03， 0.04 and 0.42 μg/mL， respectively. The average recoveries were 101.3％， 98.7％， 99.0％， 99.6％， 96.4％， respectively （RSD＜2.8％， n＝6）. The results of grey relational analysis showed that the relative relational degree （ri） from the processing technology of “boil for 10 min-drying at 50 ℃” was greatest， which had relatively small comprehensive effect on the contents of curdione， curcumenol， germacrone， furanodiene and β-elemene respectively. CONCLUSIONS： Established HPLC method can be used for content determination of 5 components in C. wenyujin. The results of optimization can provide reference for the selection of processing method of C. wenyujin in production place.

Objective To analyze the clinical value of combined detection of tuberculous T cell enzyme-linked immuno spot assay (T-SPOT.TB) and adenosine deaminase (ADA) in tuberculous pleurisy patients of different ages.Methods From February 2014 to February 2018,three hundred and thirty-six patients with pleural effusion were admitted to Hebei Thoracic Hospital.Among them,two hundred and fifty five cases were diagnosed as tuberculous pleurisy and 81 cases were diagnosed as non-tuberculous pleurisy.The patients were divided into two groups according to their age.The younger group (214 cases) was 16-59 years old and the older group (122 cases) was over 60 years old.The sensitivity and specificity of T-SPOT.TB combined with ADA in the diagnosis of tuberculous pleurisy were compared between the two groups.Results The sensitivity and specificity of T-SPOT.TB were 85.5％ (153/179) and 71.4％ (25/35) in the young and middle-aged group,73.7％ (56/76) and 58.7％ (27/46) in the old group,respectively.The sensitivity of the young and middle-aged group was significantly higher than that of the old group (x2 =4.990,P =0.045).The sensitivity and specificity of T-SPOT.TB combined with ADA were 98.9％ (177/179) and 94.3％ (33/35) in the young and middle-aged group,96.1％ (73/76) and 89.1％ (41/46) in the elderly group,respectively.There was no significant difference in sensitivity and specificity between the two groups (x2 =0.256,P=0.393、x2=0.655,P=0.218).Conclusion The diagnostic efficacy of T-SPOT.TB combined with ADA in patients with tuberculous pleurisy at different ages has been improved,especially for those who can not tolerate pleural biopsy and elderly patients.

Objective To observe the CALR mutation in patients with Ph negative chronic myeloproliferative neoplasms(MPNs) and its clinical significance. Methods From January 2012 to January 2015,the clinical data of ninety-seven patients with chronic myeloproliferative neoplasms was retrospectively analyzed and followed up to analyze different types of MPNs, including the clinical characteristics and gene mutation of polycythemia vera(PV),essential thrombocythemia(ET)and primary myelofibrosis (PMF).The hematological parameters and prognosis of patients with different mutation types were compared ( Cox regression model). Results Among the patients,the incidence of JAK2 mutation was the highest,64. 95% (63/97), followed by CALR mutation ( 19. 59% ( 19/97 ) ) and triple negative ( 10. 31% ( 10/97 ) ) . The incidence of MPL mutation was 5. 15% (5/97),which was the lowest and CALR mutations in ET and PMF were 28. 57%(10/35) and 28. 13% (9/32),respectively. The difference was not statistically significant (χ2 =1. 616,P>0. 05);the CALR gene mutation was not detected in PV patients. Compared with the JAK2 mutation, the hemoglobin,leukocyte and neutrophils in the patients with CALR mutation were lower (P<0. 05),PLT levels were lower in CALR-mutant ET patients ( P<0. 017) ,whereas platelet levels in CALR-mutant PMF patients were higher (P<0. 017). The incidence of disease progression in JAK2 and CALR mutation was 47. 62% (30/63)and 31. 58% (6/19) (χ2=1. 525,P>0. 05). The risk of disease progression in patients with CALR mutation was significantly lower than that of JAK2 mutation ( HR=0. 46,95%CI 0. 26-0. 98,P<0. 05) . Conclusion The clinical characteristics of MPNs patients with different gene mutations are different. The prognosis of MPNs patients with CALR mutation is better than that of JAK2 mutation.

Aim To explore micro RNAs-integrated pathogenic signaling to control endothelial-mesenchy-mal transition ( EndMT ) in pulmonary hypertension ( PH) by a network bioinformatic approach. Methods Literature-mining method was used to find PH-relat-ed genes and EndMT/EMT-related miRNAs. Bioinfor-matic prediction approach ( DIANA3 , Miranda4 , PicT-ar5 , TargetScan6 , miRDB7 and microT-CDS8 ) was used for miRNA target prediction. Hypergeometric a-nalysis was used to predict miRNAs related to EndMT in PH. The analysis of interactions between PH-rele-vant genes( PH network) was performed with the use of Biological General Repository for Interaction Datasets ( BioGRID ) . These miRNAs were ranked with the highest probability of substantial overlap among their gene targets in the PH-network, the relationship be-tween their targets and the PH functional categories which include hypoxia, inflammation, and transforming growth factor/BMP signaling. Then, the part of results was validated by animal experiment. Lastly the miR-NA-Target network was built using Cytocape 3 . Results List of 230 genes was compiled that were directly im-plicated in the development of PH and 189 miRNAs were related to EndMT in PH. Among 189 miRNAs, only 22 microRNAs(miR-let-7 family, miR-124, miR-130 family, miR-135, miR-144, miR-149, miR-155, miR-16-1, miR-17, miR-181 family, miR-182, miR-200 family, miR-204, miR-205, miR-21, miR-224, miR-27, miR-29 family, miR-301a, miR-31, miR-361 and miR-375) were related to hypoxia, inflamma-tion, and transforming growth factor/BMP signaling. Among these miRNAs, the levels of let-7g, miR-21, miR-124 and miR-130 family were significantly changed in the pulmonary artery in hypoxia-induced PH rats. Conclusions Among numerous miRNAs,22 of which may be involved in hypoxia, inflammation, and transforming growth factor/BMP signaling and re-lated to EndMT in PH by network bioinformatic ap-proach, which provides a theoretical basis for further investigation of EndMT in PH.

OBJECTIVE: To explore the role of calpain in pulmonary vascular remodeling in hypoxia-induced pulmonary hypertension and the underlying mechanisms.
 METHODS: Sprague-Dawley rats were randomly divided into the hypoxia group and the normoxia control group. Right ventricular systolic pressure (RVSP) and mean pulmonary artery pressure (mPAP) were monitored by a method with right external jugular vein cannula. Right ventricular hypertrophy index was presented as the ratio of right ventricular weight to left ventricular weight (left ventricle plus septum weight). Levels of calpain-1, -2 and -4 mRNA in pulmonary artery were determined by real-time PCR. Levels of calpain-1, -2 and -4 protein were determined by Western blot. Primary rat pulmonary arterial smooth muscle cells (PASMCs) were divided into 4 groups: a normoxia control group, a normoxia+MDL28170 group, a hypoxia group and a hypoxia+MDL28170 group. Cell proliferation was detected by MTS and flow cytometry. Levels of Ki-67 and proliferating cell nuclear antigen (PCNA) mRNA were determined by real-time PCR.
 RESULTS: RVSP, mPAP and right ventricular remodeling index were significantly elevated in the hypoxia group compared to those in the normoxia group. In the hypoxia group, pulmonary vascular remodeling was significantly developed, accompanied by up-regulation of calpain-1, -2 and -4. MDL28170 significantly inhibited hypoxia-induced proliferation of PASMCs concomitant with the suppression of Ki-67 and PCNA mRNA expression.
 CONCLUSION Calpain mediates vascular remodeling via promoting proliferation of PASMCs in hypoxia-induced pulmonary hypertension.
Animals ; Calpain ; genetics ; physiology ; Cell Proliferation ; Dipeptides ; physiology ; Hypertension, Pulmonary ; chemically induced ; genetics ; physiopathology ; Hypertrophy, Right Ventricular ; Hypoxia ; Ki-67 Antigen ; drug effects ; Myocytes, Smooth Muscle ; physiology ; Proliferating Cell Nuclear Antigen ; drug effects ; Pulmonary Artery ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Up-Regulation ; Vascular Remodeling ; genetics ; physiology