Objective:To explore the pregnancy outcome of intracytoplasmic sperm injection (ICSI)/rescure-ICSI (Re-ICSI) patients with gear-like transparent dense zona pellucida and small perivitelline oocytes.Methods:Totally 6 couples with abnormal zona pellucida came to the Reproductive Medicine Center of Shijiazhuang the Fourth Hospital from January 2015 to June 2020 were retrospectively case control analyzed. A total of 8 cycles had zona pellucida abnormalities, of which 5 couples, the proportion of M I oocytes was ≥50% (part oocytes M I arrest) in 6 cycles and 1 couple (2 cycles) was all oocytes M I arrest. ICSI or in vitro fertilization (IVF) short-term fertilization was performed on M II oocytes with abnormal zona pellucida in controlled superovulation, IVF short-time fertilization failed completely, and Re-ICSI was performed. M I oocytes were performed ICSI/Re-ICSI simultaneously. The ICSI/Re-ICSI fertilization rate, degeneration rate, cleavage rate, high-quality embryo rate and blastocyst rate were compared between the two groups of M II oocytes and M I oocytes, as well as all oocytes M I arrest and part oocytes M I arrest groups, respectively. Results:Totally 37 M II oocytes and 65 M I oocytes underwent ICSI/Re-ICSI. M I oocytes fertilization and 2PN fertilization rates were lower than M II oocytes [46.2%(30/65) vs. 89.2% (33/37); 32.3% (21/65) vs. 83.8% (31/37), all P<0.001]. Both groups had high-quality embryos and blastocyst formation. Compared with part oocytes M I arrest and all oocytes M I arrest, there was no statistical difference in fertilization rate, degeneration rate, high-quality embryo rate and blastocyst formation rate between the two groups (all P>0.05). Conclusion:ICSI/Re-ICSI for patients with abnormal zona pellucida with a high proportion of M I oocytes can increase the patients' oocytes utilization rate and available embryos.

Objective:To explore the pregnancy outcome of intracytoplasmic sperm injection (ICSI)/rescure-ICSI (Re-ICSI) patients with gear-like transparent dense zona pellucida and small perivitelline oocytes.Methods:Totally 6 couples with abnormal zona pellucida came to the Reproductive Medicine Center of Shijiazhuang the Fourth Hospital from January 2015 to June 2020 were retrospectively case control analyzed. A total of 8 cycles had zona pellucida abnormalities, of which 5 couples, the proportion of M I oocytes was ≥50% (part oocytes M I arrest) in 6 cycles and 1 couple (2 cycles) was all oocytes M I arrest. ICSI or in vitro fertilization (IVF) short-term fertilization was performed on M II oocytes with abnormal zona pellucida in controlled superovulation, IVF short-time fertilization failed completely, and Re-ICSI was performed. M I oocytes were performed ICSI/Re-ICSI simultaneously. The ICSI/Re-ICSI fertilization rate, degeneration rate, cleavage rate, high-quality embryo rate and blastocyst rate were compared between the two groups of M II oocytes and M I oocytes, as well as all oocytes M I arrest and part oocytes M I arrest groups, respectively. Results:Totally 37 M II oocytes and 65 M I oocytes underwent ICSI/Re-ICSI. M I oocytes fertilization and 2PN fertilization rates were lower than M II oocytes [46.2%(30/65) vs. 89.2% (33/37); 32.3% (21/65) vs. 83.8% (31/37), all P<0.001]. Both groups had high-quality embryos and blastocyst formation. Compared with part oocytes M I arrest and all oocytes M I arrest, there was no statistical difference in fertilization rate, degeneration rate, high-quality embryo rate and blastocyst formation rate between the two groups (all P>0.05). Conclusion:ICSI/Re-ICSI for patients with abnormal zona pellucida with a high proportion of M I oocytes can increase the patients' oocytes utilization rate and available embryos.

Femoral neck fractures in pediatric fractures account for less than 1% which is very rare, and its mechanism is commonly caused by high-energy trauma. If children with femoral neck fracture cannot receive timely and effective treatment, they are at high risk of avascular necrosis of the femoral head (AVN), coxa vara, bone nonunion, premature physeal closure, leg length discrepancy and other complications. Surgical treatment is currently preferred over conservative treatment, which has a higher complication rate. Among them, AVN is one of the most common and the most difficult complications to manage. So far, no effective treatment measures and reliable predictors have been reported, and the related factors affecting the occurrence of AVN have also been controversial. Once femoral head necrosis occurs in children, the prognosis is not ideal due to the lack of appropriate treatment methods. Therefore, this paper reviews the research progress on the related factors of AVN after femoral neck fracture in children based on the literature reports in the past decade.

Objective: To analyze the quality of final exam papers of Surgery and Field Surgery for five-year medical students from comprehensive class of Grade 2014, so as to check the mastery of different students, perfect the construction of item banking, verify the quality of teaching and learning, and thus provide references to further teaching reform. Methods: SPSS 21.0 was used for statistical analysis of 133 Surgery and Field Surgery papers of students from comprehensive class of Grade 2014. Results: The highest score was 93.5, the lowest score was 52.0, and the average score was (70.60±9.00). Among those 133 students, six students were failed, occupying 4.51%. The overall difficulty coefficient of examination paper (P) was 0.71, and P value of multiple choice questions and blank-filling questions was 0.4-0.7. Difference degrees (D) of question types were more than 0.600 and the overall reliability was 0.764. Scores of examination paper were generally in normal distribution. The average scores of students form anesthesiology major were higher than those of students from navigation medicine major, but the average scores of students from above two majors were higher than those of students from psychology major, with statistically significant differences (P<0.05). Conclusion Question types of this paper are comprehensive and reasonable. The overall difficulty is not high, the difference degree is good, the reliability is good and the score distribution is reasonable. However, the question should be further improved, focusing on the reasonable distribution of difficulty of question. In addition, we should strengthen the teaching of the course in students from psychology major.

Objective To analyze and evaluate the application of indirect hemagglutination test (IHA) method in the epidemic area of Meriones unguiculatus in Inner Mongolia.Methods The plague monitoring summary and epidemic analysis reports of each year in Inner Mongolia from 1996 to 2016 were collected.The serum results of the IHA method were analyzed,including the time,region and the distribution of host animals.Results From 1996 to 2016,a total of 38 096 serum samples were detected from various host animals,and 172 positive samples were detected,with a positive rate of 0.45％.In the 21 years,except 2001 and 2015,the occurrence and prevalence of plague were judged by the IHA method for the remaining 19 years.There were 10 counties detected positive sera by IHA method;the positive results were detected by IHA method in 6 kinds of host animals,including 5 rodents and 1 carnivorous,and the positive rate of Rhombomys opimus was up to 6.17％ (91/1 475),the highest titer of the seropositive host animals was as high as 1:10 240.Conclusions The IHA method is easy to operate and economical.It plays a huge role in the timely detection of the epidemic in systematic monitoring of the Meriones unguiculatus in Inner Mongolia.

Objective: To investigate the influences of bone marrow stromal cells, components of extracellular matrix and cytokine secreted by stromal cells on the chemotherapeutic sensitivity of acute lymphoblastic leukemia cells to cytosine arabinoside (Ara-C). Methods: The co-culture model of acute lymphoblastic leukemia cell Sup-B15 and bone marrow stromal cell OP9 was constructed. Sup-B15 cells were cultured alone or co-cultured with OP9 cells, inactivated OP9 cells, the conditional medium (CM) of co-cultured OP9 cells and Sup-B15 cells, the CM of OP9 cells alone or Sup-B15 cells alone, respectively. The effects of different concentrations of Ara-C on the proliferation of each Sup-B1 cell group mentioned above were detected by cell counting kit-8 (CCK-8) method. The effects of different concentrations of Ara-C on the apoptosis of each group were detected by flow cytometry (FCM). The expressions of Bcl-2 protein in each group were detected by western blot. Results: The results of CCK-8 test showed that the inhibitory efficiency of Ara-C was in a dose-dependent manner. With different concentrations of Ara-C treatment for 48 hours, the half maximal inhibitory concentrations (IC₅₀) of Sup-B15 and OP9 co-cultured group, Sup-B15 and inactivated OP9 co-cultured group were 0.510 and 0.339 μg/ml, respectively, significantly higher than 0.091 μg/ml of Sup-B15 cultured alone group (P<0.05). The IC₅₀ of CM of Sup-B15 and OP9 co-cultured group was 0.204 μg/ml, significantly higher than 0.087 μg/ml of the CM of OP9 cultured alone group (P<0.05) and 0.097 μg/ml of the CM of Sup-B15 cultured alone group (P<0.05). The results of flow cytometry showed that with 0.10 μg/ml Ara-C treatment for 24 hours, the early apoptotic cell percentages of Sup-B15 and OP9 co-cultured group, Sup-B15 and inactivated OP9 co-cultured group and Sup-B15 cultured alone group were (6.67±2.19) %, (8.95±3.04) % and (20.46±2.63) %, respectively. The early apoptotic cell percentages of Sup-B15 and OP9 co-cultured group, Sup-B15 and inactivated OP9 co-cultured group were significantly lower than that of Sup-B15 cultured alone group (P<0.05). The early apoptotic cell percentages of the CM of Sup-B15 and OP9 co-cultured group, the CM of OP9 cultured alone group and the CM of Sup-B15 cultured alone group were (11.16±2.97)%, (22.08±2.71)% and (19.25±1.57)%, respectively, the former two of which were significantly lower than the last one (P<0.05). The results of western blot showed that the relative expression levels of Bcl-2 protein of Sup-B15 cultured alone group, Sup-B15 and OP9 co-cultured group, Sup-B15 and inactivated OP9 co-cultured group, the CM of Sup-B15 and OP9 co-cultured group, the CM of OP9 cultured alone group and the CM of Sup-B15 cultured alone group were 1.00±0.00, 1.53±0.03, 1.38±0.01, 1.26±0.05, 1.03±0.01 and 0.98±0.02, respectively. The expression levels of bcl-2 protein of three combined groups were significantly higher than that of Sup-B15 cultured alone group (P<0.05). while no statistically significant difference was observed between the CM of OP9 cultured alone group and the CM of Sup-B15 cultured alone group (P>0.05). Conclusion Bone marrow stromal cell OP9, the components of bone marrow extracellular matrix and cytokine secreted by stromal cells are involved in the induction of the chemotherapeutic resistance of Sup-B15 cells to Ara-C.

BACKGROUND:Intervertebral disc degeneration is one of the ancient and common clinical diseases. Its complex pathogenesis affected by various factors, such as environment and genes, is stil in debate. Because of the technical limitations, there is stil no deep understanding on the molecular mechanism of intervertebral disc degeneration. However, its molecular mechanism in recent years has made considerable development. OBJECTIVE: To summarize and discuss the molecular mechanism of intervertebral disc degeneration, thereby providing the basis for the effective treatment. METHODS: CNKI and Medline databases were retrieved by the first author using computer to search relevant articles published from 2005 to 2015. The key words were “intervertebral disc degeneration, molecular mechanism, environmental factors, genes, matrix, degradation enzyme,inflammatory factor, biological environment, treatment” in Chinese and English, respectively. Mechanisms of intervertebral disc degeneration, involving genes, cel senescence and apoptosis, degradation enzyme and substrate, inflammatory cytokines, were summarized to explore the pathogenesis and possible effective treatment of intervertebral disc degeneration. RESULTS AND CONCLUSION:Totaly 153 articles were initialy retrieved and finaly 52 articles were included in result analysis according to inclusive and exclusive criteria. Unique structure and biochemical properties of the intervertebral disc are easy to cause intervertebral disc degeneration. Traditionaly, environmental factors, such as occupation and smoking, are considered as the main factors inducing intervertebral disc degeneration; however, more and more studies have shown that genes have the most important influence on intervertebral disc degeneration. Declined extracelular matrix, increased degradation enzymes, and overexpression of inflammatory factors can al destroy the entire structure of intervertebral disc, and accelerate the process of intervertebral disc degeneration. Effective treatment for intervertebral disc degeneration can be formulated depending on the deep understanding on its molecular mechanisms. Although there is a further understanding on the molecular medium of intervertebral disc degeneration, the complex biochemical environment within the intervertebral disc is stil a great chalenge to the treatment of intervertebral disc degeneration.

BACKGROUND: Cervical intervertebral foramen stenosis induced by cervical spondylosis of nerve root type usual y requires surgical treatment. The ways mainly include anterior cervical discectomy and fusion and cervical posterior intervertebral foramen decompression. Which is the best way is stil inconclusive. With innovation, anterior cervical discectomy and fusion for cervical spondylosis of nerve root type has become the mainstream in the current treatment. OBJECTIVE: To study the relationship between curative effects and intervertebral foramen-associated parameter changes in patients with cervical spondylosis of nerve root type after anterior cervical discectomy and fusion. METHODS: From March 2011 to April 2013, 132 patients with cervical spondylosis of nerve root type were treated with anterior cervical discectomy and fusion in the Changzheng Hospital Affiliated to the Second Military Medical University. Neck pain and arm pain visual analogue score, neck disability index score and imaging changes were evaluated before and after treatment. RESULTS AND CONCLUSION: 132 patients were fol owed up for 25(4-28) months. Significant differences in neck pain visual analogue scale, anterior intervertebral disc height, posterior intervertebral disc height, intervertebral foramen height, anterior and posterior diameters of the intervertebral foramen, the area of the intervertebral foramen, and the Cobb angle of the fused segment were detected in al patients before and after treatment (P < 0.05). Posterior intervertebral disc height was positively correlated with intervertebral foramen area (r=0.427, P=0.000). The increased Cobb angle of the fused segment was negatively associated with the size of intervertebral foramen (r=-0.273, P=0.003). Intervertebral foramen area was negatively associated with arm pain visual analogue score (r=-0.502, P=0.000). These results indicated that anterior cervical discectomy and fusion with an interbody fusion cage can obviously enlarge intervertebral foramen in patients with cervical spondylosis of nerve root type, and obtain good curative effect. The size of the intervertebral foramen is negatively related to the axial pain. The reconstruction of the intervertebral disc height is necessary to expand the intervertebral foramen. However, the increase of the curvature fusion segments is not helping to expand the intervertebral foramen.

Objective To study the characteristics of vestibular autorotation test (VAT) in patients with the posterior circulation transient ischemic attacks(PCTIA) ,further reveal the pathogenesis vestibular function damage because of PCTIA .Methods VAT was performed on 41 patients with posterior circulation transient ischemic at‐tacks(PCTIA group) and 30 healthy controls(control group) .Parameters analyzed included gains ,phases and a‐symmetry of VAT .The positive result of the test could be defined if any of the paramaeters was abnormal .Results In the PCTIA group and control group ,gains were enhanced without being reduced as showed in 25 (62 .5% ,25/40) cases and 5(16 .7% ) ,respectively (χ2 =7 .09 ,P<0 .01) ,gains were enhanced with reduced as showed in 10(25% ) cases and 0(0% ) ,respectively (χ2 =8 .78 ,P<0 .01) .Conclusion The results of VAT in patients with the PCTIA can show gains enhanced with reduced in different frequency .VAT can provide valuable reference on positioning as‐sessment of vestibular system damage in patients with PCTIA .

Objective To investigate epidemiological characteristics of animal plague in Microtus brandti plague foci in China from 2005-2013,and to found the reason for cross epidemic of Microtus brandti and Mongolian gerbil plague.Methods Totally 135 Yesinia pestis (Y.pestis) were isolated in Microtus brandti plague foci from 2005 to 2013.According to the typing method of Y.pestis and The Criteria of Plague Natural Foci and Animal Plague Epidemic(GB 16883-1997),bacteria type was identified using biochemical tests and sugar alcohols glycolysis test.Monitoring reports of the plague epidemic situation in Abag Banner,Xilinhot,Sonid left Banner,Xi Ujimqin Banner,Dong Ujimqin Banner,Inner Mongolia were collected.The epidemiological distribution of animal plague in Microtus brandti plague foci was analyzed.Results In 135 strains tested which were isolated from 2005-2007 and 2010,128 strains were fermented farinose,unfermented rhamnose; and 7 strains were fermented rhamnose,unfermented arabinose in 2008.According to the types of Microtus brandti Y.pestis (fermented rhamnose,unfermented arainose) and Mongolian gerbil Y.pestis (fermented arainose,unfermented rhamnose),Microtus brandti plague was identified in the epidemic in Xilinhot and Dong Ujimqin Banner in 2008.The Mongolian gerbil plague was epidemic in Abag Banner,Xilinhot and Xi Ujimqin Banner in2005-2007 and 2010.Conclusions In 2005,Mongolian gerbil type of Y.pestis is first isolated in Abag Banner,Xilinhot and Xi Ujimqin Banner.It is confirmed a newly discovered Mongolian gerbil plague foci.Abag Banner,Xilinhot,Sonid left Banner,Xi Ujimqin Banner and Dong Ujimqin Banner are Microtus brandti plague foci,only Dong Ujimqin Banner is Microtus brandti plague foci,others are two types of Microtus brandti and Mongolian gerbil plague foci.Since 2005,new epidemic situation is found,the Microtus brandti plague foci is becoming complex.It is a serious threat to human being.We must further strengthen the research and prevention in future.