Objective To investigate the effect of oxidative stress on the growth and development of human ovarian granulosa cells.Methods Human ovarian granulosa cells KGN were cultured in vitro and treated with different concentrations of hydrogen peroxide(H_2O_2),which were measured for the cell proliferation by CCK8 assay,detected for the production of intracellular reactive oxygen species(ROS)and the cell apoptosis by flow cytometry,and determined for the expression of proteins related to autophagy and apoptosis by Western blot.Results With the increasing concentrations of H_2O_2,the proliferation of granulosa cells was significantly inhibited in a dose-dependent manner(F = 4. 906,4. 825,4. 653,4. 614 and4. 587,respectively,each P < 0. 001). The intracellular ROS level increased with the increase of H_2O_2concentration,and the apoptosis rate also increased continuously. After the treatment of N-acetyl-L-cysteine(NAC),the ROS level recovered and the apoptosis rate decreased,indicating that cell apoptosis was correlated with ROS release. After the treatment of H_2O_2,the expression levels of LC3-Ⅱand cleaved-caspase 3 in KGN cells increased significantly(t = 4. 809 and 5. 789,respectively,each P < 0. 05),while the expression levels of LC3-Ⅰ,BCL-2 and P62 decreased significantly(t = 4. 014,3. 982 and 4. 415,respectively,each P < 0. 05),which indicated the inducing effect of H_2O_2on the cell autophagy and apoptosis of KGN cells.Conclusion H_2O_2can inhibit the proliferation of human ovarian granulosa cells and induce their cell autophagy and apoptosis. Oxidative stress can inhibit the growth and development of human ovarian granulosa cells,decreased the quality of oocytes and the ovarian reserve function.

Objective:To investigate the effect of diminished ovarian reserve (DOR) on perinatal outcomes of young patients obtained live births through frozen-thawed embryo transfer (FET) cycles.Methods:In this retrospective cohort study, data of perinatal outcomes of patients who underwent FET and achieved pregnancy ≥24 weeks from January 2006 to December 2018 in Reproductive Medicine Department of Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine were analyzed. Patients were divided into non-DOR group ( n=14 342) and DOR group ( n=1292). The main outcome measure was the rate of low birth weight of newborns. The secondary outcome measures included infant gestational age, birth weight, gender, and incidence of congenital defects, neonatal death, and pregnancy complications. Univariate and multivariate logistic regression were applied to analyze the correlation between DOR and the outcomes of newborns and the rates of pregnancy complications. Results:There was no statistically significant difference in the birth weight of newborns between DOR group and non-DOR group in both singleton and twin pregnancies (all P>0.05). There were no significant differences in incidence of low birth weight, preterm birth, congenital defects, neonatal death, and pregnancy complications between the two groups (all P>0.05). After adjusting for relevant confounders by multivariate logistic regression analysis, DOR was not a risk factor for patients ≤35 years old to obtain singletons and twins with low birth weight through FET (singletons adjusted OR=0.97, 95% CI=0.69-1.34, P=0.831; twins adjusted OR=1.14, 95% CI=0.95-1.36, P=0.166). Conclusion:The birth outcomes of live births obtained by FET in DOR patients ≤35 years old were comparable to those obtained in non-DOR patients.

Objective:To investigate the effect of diminished ovarian reserve (DOR) on perinatal outcomes of young patients obtained live births through frozen-thawed embryo transfer (FET) cycles.Methods:In this retrospective cohort study, data of perinatal outcomes of patients who underwent FET and achieved pregnancy ≥24 weeks from January 2006 to December 2018 in Reproductive Medicine Department of Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine were analyzed. Patients were divided into non-DOR group ( n=14 342) and DOR group ( n=1292). The main outcome measure was the rate of low birth weight of newborns. The secondary outcome measures included infant gestational age, birth weight, gender, and incidence of congenital defects, neonatal death, and pregnancy complications. Univariate and multivariate logistic regression were applied to analyze the correlation between DOR and the outcomes of newborns and the rates of pregnancy complications. Results:There was no statistically significant difference in the birth weight of newborns between DOR group and non-DOR group in both singleton and twin pregnancies (all P>0.05). There were no significant differences in incidence of low birth weight, preterm birth, congenital defects, neonatal death, and pregnancy complications between the two groups (all P>0.05). After adjusting for relevant confounders by multivariate logistic regression analysis, DOR was not a risk factor for patients ≤35 years old to obtain singletons and twins with low birth weight through FET (singletons adjusted OR=0.97, 95% CI=0.69-1.34, P=0.831; twins adjusted OR=1.14, 95% CI=0.95-1.36, P=0.166). Conclusion:The birth outcomes of live births obtained by FET in DOR patients ≤35 years old were comparable to those obtained in non-DOR patients.

Objective: To analyze the application of accelerated rehabilitation surgery in elderly patients with gastric cancer surgery and its influence on inflammation and nutritional indicators. Methods: From October 2017 to October 2018, 80 elderly patients with gastric cancer who underwent gastrectomy in Shaoxing People's Hospital were selected.According to random number table method, they were randomly divided into traditional control group and ERAS group, with 40 cases in each group.The traditional control group was treated by traditional perioperative treatment + operation, while ERAS group was treated with ERAS perioperative treatment + operation.The recovery and complications, inflammation and nutritional changes before operation, 1 day after operation and 3 days after operation, and the improvement of quality of life after operation were compared and analyzed between the two groups. Results: In the ERAS group, the first exhaust time[(2.3±0.8)d] and defecation time[(2.5±0.4)d]were shorter than those in the traditional control group[(3.5±0.5)d and (3.7±0.6)d], and the incidence rate of complications (7.5%) was lower than that in the traditional control group (35.0%), the differences were statistically significant (t=8.72, 10.52, χ²=9.04, all P<0.05). On the first day after operation, the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6(IL-6) in the ERAS group were (28.3±4.9)μg/L and (23.1±5.8)μg/L, respectively, which were lower than those in the traditional control group[(39.8±6.7)μg/L and (34.5±8.1)μg/L](t=8.76, 7.24, all P<0.05). The serum TNF-α and IL-6 levels in the ERAS group on the 3rd day after operation were (18.4±6.2)μg/L and (18.3±3.2)μg/L, respectively, which were lower than those in the traditional control group[(26.2±5.1)μg/L and (26.5±4.8)μg/L](t=6.14, 8.99, all P<0.05). The serum levels of albumin (Alb) and prealbumin (PRE) in the ERAS group on the first day after operation were (31.1±0.7)g/L and (161.3±7.2) mg/L, respectively, which were lower than those in the traditional control group[(30.2±0.9)g/L and (154.3±4.8)mg/L](t=4.99, 5.12, all P<0.05). The serum levels of Alb and PRE in the ERAS group on the 3rd day after operation were (33.4±0.5)g/L and (172.1±5.0)mg/L, respectively, which were lower than those in the traditional control group[(31.9±0.8)g/L and (165.3±3.2)mg/L](t=10.06, 7.24, all P<0.05). The WHOQOL-BREF score of the ERAS group[(91.4±6.5)points]was higher than that of the traditional control group[(80.3±7.8)points](P<0.05). Conclusion Accelerated rehabilitation surgery has good effect for elderly gastric cancer surgery.It can maintain the inflammation and nutritional status of patients after operation.It is worthy of clinical reference.

Objective To investigate the clinical efficacy of the curettage and aspiration technique in laparoscopic radical gastrectomy for the treatment of gastric cancer.Methods The clinical data of 55 patients who received laparoscopic radical gastrectomy by curettage and aspiration technique with Peng's multifunctional operative dissector at the Shaoxing People's Hospital from June 2008 to February 2011 were retrospectively analyzed.Tumors located at the upper stomach in 10 patients,at the middle stomach in 15 patients and at the lower stomach in 30 patients.The numbers of patients had tumor in TNM stage Ⅰ,Ⅱ,Ⅲ A were 16,35 and 4.Patients were followed up via phone call and out-patient examination till October 2013.Results Laparoscopic radical gastrectomy was successfully carried out on all the 55 patients.Of the 55 patients,39 received laparoscopic distal subtotal gastrectomy and 16 received laparoscopic total gastrectomy.The operation time,volume of intraoperative blood loss,number of lymph nodes dissected,distances of proximal and distal resection margins to the tumors,time to flatus,time to fluid diet and duration of postoperative hospital stay and incidence of postoperative complications were (241 ± 42)minutes,(273±115)mL,32 ±9,(5.8±1.4)cm,(5.1 ±l.7)cm,(78 ±24)hours,(95 ±17)hours,(12 ±4)days and 7.3％ (4/55),respectively.Two patients were complicated with pulmonary infection,1 with anastomotic fistula,1 with incisional infection,and all of them were cured by symptomatic treatment.No patients died perioperatively.All the 55 patients were followed up for 12.0-55.0 months,and the mean time of follow-up was 35.9 months.The cumulative 48-month survival rate was 54.8％.The postoperative recurrence and metastasis rate was 10.9％ (6/55).Peritoneal metastasis was detected in 2 patients,liver metastasis in 1 patient,para-aortic nodes metastasis in 1 patient,residual gastric metastasis in 1 patient,and bone metastasis in 1 patient.Conclusion Laparoscopic radical gastrectomy by curettage and aspiration technique is safe and feasible,with the advantages of minimal trauma,low morbidity and quick recovery.

Objective To investigate the effect of curcumin an extract of a Chinese medical herb on the sensitivity of CD133 + rectal cancer cells to radiotherapy.Methods In vitro experiments:CD133 +cells were purified with immunomagnetic beads from HRT-18 cell line and divided into curcumin group,radiotherapy group and curcumin plus radiotherapy group.MTT assay and Annexin V/PI staining were used to measure the proliferation and apoptosis of the cells.In vivo experiments:Transplanted rectal tumor was established in 46 nude mice and randomly divided into curcumin group,radiotherapy group and curcumin plus radiotherapy group.Tumor size and apoptosis were detected by daily observation and TUNEL staining respectively.Results Curcumin inhibited proliferation and apoptosis of CD133 + rectal cancer cells when combined with radiotherapy.It also significantly increased the growth inhibition of rectal tumor and promoted the apoptosis of rectal cancer in vivo.MTT assay showed that after 24 hours,compared with that of radiotherapy group(14.6％ ± 1.0％),curcumin plus radiotherapy group (18.7％ ± 1.7％) inhibited the growth of the tumor(P ＜ 0.01).Annexin V/PI showed that curcumin plus radiotherapy group (28.8％ ±3.7％) was significantly different from the radiotherapy group(13.1％ ± 1.4％) in cell apoptosis (P ＜0.01).In vivo,after 6 days,tumor volume (521 ± 79) mm3 in curcumin plus radiotherapy group was significantly lower than that of radiotherapy group(717 ± 134) mm3 (P ＜ 0.01) ; TUNEL staining results indicated that the RCST in curcumin plus radiotherapy group (26.1％ ± 3.3％) were higher than that in radiotherapy group (12.0％ ± 2.1％) (P ＜ 0.01).Conclusions Curcumin significantly enhances the radiosensitizing effect for CD133 + rectal cancer cells.