Background::High body mass index (BMI) results in decreased fecundity, and women with high BMI have reduced rates of clinical pregnancy and live birth in in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Meanwhile, ovarian responses show great heterogeneity in patients with a high BMI. This study aimed to analyze the effects of a high BMI on IVF/ICSI outcomes in the Chinese female with normal ovarian response. Methods::We performed a retrospective cohort study comprising 15,124 patients from the medical record system of the Reproductive Center of Peking University Third Hospital, with 3530 (23.3%) in the overweight group and 1380 (9.1%) in the obese group, who had a normal ovarian response (5-15 oocytes retrieved) and underwent fresh embryo transfer (ET) cycles from January 2017 to December 2018, followed by linked frozen-thawed embryo transfer (FET) cycles from January 2017 to December 2020. Cumulative live birth rate (CLBR) was used as the primary outcome. Furthermore, a generalized additive model was applied to visually illustrate the curvilinear relationship between BMI and the outcomes. We used a decision tree to identify the specific population where high BMI had the greatest effect on IVF/ICSI outcomes.Results::High BMI was associated with poor IVF/ICSI outcomes, both in cumulative cycles and in separate fresh ET or FET cycles. In cumulative cycles, compared with the normal weight group, obesity was correlated with a lower positive pregnancy test rate (adjusted odds ratio [aOR]: 0.809, 95% confidence interval [CI]: 0.682-0.960), lower clinical pregnancy rate (aOR: 0.766, 95% CI: 0.646-0.907), lower live birth rate (aOR: 0.706, 95% CI: 0.595-0.838), higher cesarean section rate (aOR: 2.066, 95% CI: 1.533-2.785), and higher rate of large for gestational age (aOR: 2.273, 95% CI: 1.547-3.341). In the generalized additive model, we found that CLBR declined with increasing BMI, with 24 kg/m 2 as an inflection point. In the decision tree, BMI only made a difference in the population aged ≤34.5 years, with anti-Mullerian hormone >1.395 ng/mL, and the first time for IVF. Conclusions::High BMI was related to poor IVF/ICSI outcomes in women with a normal ovarian response, and CLBR declined with increasing BMI, partly due to suppressed endometrial receptivity. A high BMI had the most negative effect on young women with anticipated positive prognoses.

Objective To evaluate left ventricular ( LV ) myocardial mechanical transmural longitudinal displacement ( LD ) and radial displacement ( RD ) with contrast agent and different power irradiation in open‐chest Beagle canines by ultrasound velocity vector images ( VVI) workstation . Methods T he anesthetized open‐chest Beagle canines were assigned into two groups randomly :Group A ( n ＝6) for baseline ,diagnostic ultrasound power irradiation ( 300 mW) 5 min ,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ; Group B ( n ＝ 6 ) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively) conditions . T he standard short‐axis and long‐axis gray‐scale view s during three complete cardiac cycles in open‐chest Beagle canine models were acquired . T he peak LD subendomyocardium ( LD‐subendo) ,LD subepimyocardium ( LD‐subepi) ,RD subendomyocardium ( RD‐subendo) and RD subepimyocardium ( RD‐subepi ) of LV were analyzed using a dedicated Syngo VVI method . Results In group A ,the LV LD‐subendo ,LD‐subepi ,RD‐subendo and RD‐subepi in the most of segments showed increasing trend in diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min compared with baseline condition ,however the differences were not significant ( P ＞0 .05 ,respectively) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group A with the same condition were significant different ( all P ＜0 .05) . In group B ,LV LD‐subendo in ultrasonic power 3 W was lower than baseline condition ( P ＜ 0 .05 ) ,LV RD‐subendo was higher compared with baseline condition ( P ＜0 .05) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group B with the same condition were significant different ( all P ＜ 0 .05) . Conclusions On ultrasonic power 3 W ,LV LD‐subendo is decreased resulting to negative inotropic effect and RD‐subendo is increased to maintain the normal heart work .LV LD and RD on diagnostic ultrasound power irradiation 5 min , combined with contrast agent irradiation 5 min ,contrast agent 20 min conditions ,ultrasonic power 1 W and 2 W are not prominent changes .

Objective To analyze the process of clinical nursing operation assessment in a third-grade class-A hospital in China, and design the scoring system of clinical nursing operation examination (SSCNOE), and discuss its clinical application effect. Methods Through operation process analysis chart to analyze the flow of current clinical nursing operation assessment of shanxi provincial people's hospital to look for improvement priorities that can be optimized, and based on Microsoft Visual Basic technology and 15 commonly used clinical nursing operation, we developed SSCNOE. A total of 102 nurses were selected as subjects and were randomly divided into the experimental and control groups using random numbers. The experimental group accepted SSCNOE examination, while the control group received the traditional paper test. The differences in the examination time and examination cost between the two groups were compared. Results SSCNOE simplified the examination process of clinical nursing operation and saved a lot of manpower, material and financial resources. The time required to use SSCNOE was (202.13±24.69)min, shorter than the traditional assessment (347.67±6.51)min (t=12.99, P<0.01), and the overall cost was (948.13± 72.47)yuan, lower than the traditional test (1689.12 ± 126.72)yuan (t=13.56, P<0.01). Conclusion The research and application of SSCNOE can improve the efficiency of the assessment of nursing operation, save the cost of examination and improve the level of hospital nursing information construction.

Objective To evaluate left ventricular ( LV ) myocardial mechanical synchrony with contrast agent and different power irradiation in open-chest Beagle canines . Methods The anesthetized open-chest Beagle canines were assigned into two groups randomly : Group A ( n = 6 ) for baseline , diagnostic ultrasound power irradiation ( 300 mW ) 5 min ,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ;Group B ( n = 6) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively) conditions . The standard short-axis gray-scale views at levels of mitral annulus ( MV) ,papillary muscle( PM ) ,and apex( AP) during 3 complete cardiac cycles in open-chest Beagle canine models were acquired . The global radial displacement peak time ( RD-PT) and standard deviation of peak time ( RD-PT SD ) of LV subendomyocardium ( subendo ) and subepimyocardium ( subepi ) were measured and analyzed by using a dedicated Syngo velocity vector imaging ( VVI) method . Results In group A ,compared with baseline condition , the RD-PT and RD-PT SD of subendo and subepi had no significant different among diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min ( all P < 0 .05) . There was no significant different in the RD-PT and RD-PT SD between subendo and subepi in A group in all conditions ( all P < 0 .05) . In group B ,the RD-PT and RD-PT SD of subendo and subepi with power 1 W ,2 W and 3 W was higher than those with baseline condition ;the RD-PT and RD-PT SD of subendo were significant different on 2 W compared with those on baseline condition ( all P <0 .05) ;the RD-PT and RD-PT SD of subendo ,subepi were significant different on 3 W compared with baseline condition ( all P < 0 .05) ;the RD-PT and RD-PT SD were significant difference between subendo and subepi in only 3 W condition ( all P < 0 .05 ) . Conclusions Diagnostic ultrasound power irradiation 5 min and combined with contrast agent irradiation 5 min and contrast agent 20 min conditions do not effect the synchrony of LV myocardial mechanics . Power more than 1 W can induce the delay of RD-PT and RD-PT SD of LV subendo and subepi . Power 3 W can result in dyssynchrony of LV myocardial mechanics .

Objective To evaluate left ventricular ( LV ) myocardial mechanical rotation and twist with contrast agent and different power irradiation in open-chest beagle canines by ultrasound velocity vector images ( VVI ) . Methods The anesthetized open-chest Beagle canines were assigned into two groups randomly :group A ( n = 6 ) for baseline ,diagnostic ultrasound power irradiation ( 300 mW ) 5 min , combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ;group B ( n = 6) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively ) conditions . The standard short-axis gray-scale views at basal level (BL) ,and apical level( AL) during three complete cardiac cycles in open-chest beagle canine models were acquired . The peak subendomyocardium rotation ( subendo-rot) ,subepimyocardium rotation ( subepi-rot) of BL and AL were analyzed using a dedicated Syngo velocity vector imaging ( VVI) method and LV subendomyocardium twist ( subendo-twi) and subepimyocardium twist ( subepi-twi) were defined as apical subendo-rot/subepi-rot - basal subendo-rot/subepi-rot . Results In group A ,the LV subendo-twi ,subepi-twi ,subendo-rot and subepi-rot of BL and AL in the most of segments were significant different on diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min ( P < 0 .05 ) compared with baseline condition ;LV subendo-twi was higher than subepi-twi in group A under the same condition ( P < 0 .05) . In group B ,LV subendo-twi ,subepi-twi and subendo-rot ,subepi-rot of BL and AL on power 1 W ,2 W were higher and subendo-twi ,subepi-twi on power 3 W were lower than those on baseline condition ( P < 0 .05) ;There was no difference in subendo-rot and subepi-rot of LV BL compared with baseline condition ( P > 0 .05) ;subendo-rot and subepi-rot of LV AL were different compared with those on baseline condition ( P < 0 .05) ;LV subendo-twi and subepi-twi in group B under the same condition were significant difference ( P < 0 .05) . Conclusions LV rotation and twist increase on diagnostic ultrasound power irradiation 5 min ,combined with contrast agent irradiation 5 min ,contrast agent 20 min conditions ,1 W and 2 W ;LV twist and AL rotation decrease on ultrasound power 3 W ,but BL rotation is not affected on ultrasound power 3 W .

Objective To observe the clinical effects of mental nursing and psychological intervention on delirium in ICU pa -tients.Methods One hundred and twenty delirium patients treated in the ICU of the hospital were recruited as research subjects,and were randomly divided into the control group and the intervention group,each consisting of 60 patients.In accordance with different pri-mary diseases,corresponding routine treatment was given to all the critical care patients.The patients in the control group were given routine nursing,while those in the intervention group received psychological counseling and mental nursing in addition to the care re -ceived by the patients of the control group.Before and after intervention,DRS-R-98 was used to evaluate delirium in the patients of the 2 groups,and the obtained scores and therapeutic efficacy were compared between the patients of the 2 groups.Results Paired t-test a-nalysis revealed that the scores of delirium in the patients of the control group after nursing were lower than those before nursing(P<0.01),and the scores of delirium in the patients of the intervention group after nursing was also lower than those before nursing(P<0.01).Paired t-test analysis once again revealed that there were statistical differences in the delirium scores for the intervention group before and after intervention,as compared with those of the control group(P<0.01).Total effective rate of the intervention group (96.7%)was higher than that of the control group(73.3%).Conclusion Psychological intervention and mental nursing had a posi-tive role in the easing of delirium in ICU patients.The intervention measures were relatively simple and could be readily applied in clin-ical practice,and were of important clinical value for the promotion of mental health and life quality of delirium patients in ICU.

Objective To evaluate the left ventricular(LV)myocardial mechanical changes with contrast agent and different power irradiation in open-chest beagle canines.Methods The anesthetized open-chest beagle canines were assigned into two groups randomly:group A(n=6)for baseline,diagnostic ultrasound power irradiation(300 mW)5 min,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions;group B(n=6)for baseline and intensity ultrasound irradiation(1 W,2 W and 3 W,5 min respectively)conditions.The peak circumferential strain(CS),longitudinal strain(LS)and radial strain(RS)of LV myocardial wall were measured and analyzed using a dedicated Syngo velocity vector imaging(VVI)method.Results In group A,the peak CS and LS were increased significantly on diagnostic power irradiation,contrast agent irradiation 5 min and contrast agent 20 min(all P <0.05,respectively) compared with baseline condition;there was no significant difference of the peak RS on diagnostic power irradiation,contrast agent irradiation 5 min and contrast 20 min compared with baseline condition(P >0.05).In group B,the peak CS and LS were higher on power 1 W than on baseline condition(P <0.05), the peak RS was increased gradually on power 1 W than on baseline condition(P >0.05);the peak CS,LS, RS were lower on power 2 W than on baseline condition(P >0.05);the peak of CS,LS were lower on power 3 W than on baseline condition(P <0.05);the peak of RS was decreased gradually without significant changes between power 3 W on baseline condition(P >0.05).Conclusions These findings indicate potential positive inotropic effects with diagnostic ultrasound power irradiation 5 min,combined with contrast agent irradiation 5 min,contrast agent 20 min conditions,power 1 W and negative inotropic effects with power 3 W on LV myocardial CS,LS deformation.LV myofiber deformation reactions appear no significant differences on LV myocardial RS deformation in same disturbed setting.

ObjectiveTo evaluate the vitro anti-HIV-1 activity ofTaiqi Peiyuan Granules.MethodsMTT was used to detect cytotoxicity ofTaiqi Peiyuan Granules; cytopathy method was used to detect the inhibitory activity of Taiqi Peiyuan Granules on acute infection of HIV-1; HIV-1 p24 antigen ELISA detection was used to detect inhibitory activity ofTaiqi Peiyuan Granules for virus replication of HIV-1 acute infection cells, and count the medical therapeutic indexes.ResultsCC50ofTaiqi Peiyuan Granules in cytotoxicity test was 3.761±0.370 mg/mL; the EC50 of inhibition syncytial test was 0.454 5±0.204 6 mg/mL; the therapeutic index was between 5.84 and 12.97; p24 ofTaiqi Peiyuan Granules in inhibition experiments was 0.56±0.27 mg/mL, and the therapeutic index was between 5.30 and 8.74.ConclusionAnti-HIV-1 activity ofTaiqi Peiyuan Granules is relatively weak.

Objective To evaluate the infection status and genotype distribution of high risk human papillomavirus (HPV) in Chongqing women with different healthy status of cervix .Methods A retrospective analysis including 3 118 cases from June 2013 to March 2014 were performed ,945 of which were carried out multiplex real time PCR ,and data of cervix healthy status and HPV positive cases were subjected to chi‐square test .Results The general positive percentage of high risk HPV was 27 .49% ,16 .35%in healthy check‐up group ,and 24 .42% in cervicitis group and 39 .87% in cervical neoplasia lesion ,there was a significant difference of HPV positive ratio between these three groups(P< 0 .05) ;and HPV positive ratio was higher in older women without significant difference .In Chongqing region ,the three most common HPV types were HPV52 (21 .97% ) ,HPV16 (20 .00% ) and HPV58 (14 .75% ) .However ,the three most common HPV types in various groups are different :HPV52 (26 .20% ) ,HPV58 (14 .3% ) and HPV51 (10 .70% ) in health check‐up group ; HPV52 (21 .10% ) ,HPV58 (20 .00% ) and HPV16 (18 .90% ) in cervicitis group while HPV16 (29 .00% ) ,HPV52 (19 .80% ) and HPV58 (11 .50% ) in cervical neoplasia lesion group .The multiple infec‐tion rate of HPV was 5 .86% ,as the cervix status gets worse ,HPV concurrent infection increases ,and concurrent HPV types vary :mostly with HPV 52 in healthy check‐up group while with HPV 16 in cervical neoplasia lesion group .Conclusion The prevalence and genotype distribution of HPV in Chongqing women with different healthy status of cervix are significant difference.

Objective To analyze the reasons of hypoglycemia in patients with diabetic ophthialmopathy,and summarize the corresponding nursing measures in order to reduce the incidence of hypoglycemia in patients with diabetic ophthialmopathy. Methods The reasons for hypoglycemia were analyzed for 43 patients with diabetic ophthalmopathiy in our hospital from January 2009 to November 2011. Results Taking the hunger-cure arbitrarily,no regular diet,no corresponding adjustment for the insulin quantity after stopping taking hormone medicine,and also after the diabetic symptoms relieved,besides,less food-intake caused by high pressure of eyes,vomiting and appetite decreasing after the vitreous body dissection,and the paramedic had no enough cognition for the harm caused by hypoglycemia,combination medication with cardiovascular medicine were the primary reasons for the occurence of hypoglycemia in patients with diabetic ophthalmopathy. Conclusions Many reasons can cause hypoglycemia in patients with diabetic ophthalmopathy,We should strengthen management,propaganda and education,observation of medication and disease condition as well as improve the attention of eye health care workers for hypoglycemia in order to reduce the incidence of hypoglycemia.