Women with poor ovarian response (POR) is really hard to respond to controlled ovarian stimulation, which leads to lower success rates in in vitro fertilization. The management of these special group of people has been proved to be one of the main difficulties in assisted reproductive technology (ART). Compared with the Bologna Criteria, POSEIDON criteria which has suggested a new categorization of ART in patients with POR, is much better in individuation patient management and is significant to improve the pregnancy outcome of patients to some extent. The review aims to summarize recent insights on individualized management of POR patients, including the diagnosis, controlled ovarian stimulation plans, triggering of ovulation and individual assisted therapy.

Women with poor ovarian response (POR) is really hard to respond to controlled ovarian stimulation, which leads to lower success rates in in vitro fertilization. The management of these special group of people has been proved to be one of the main difficulties in assisted reproductive technology (ART). Compared with the Bologna Criteria, POSEIDON criteria which has suggested a new categorization of ART in patients with POR, is much better in individuation patient management and is significant to improve the pregnancy outcome of patients to some extent. The review aims to summarize recent insights on individualized management of POR patients, including the diagnosis, controlled ovarian stimulation plans, triggering of ovulation and individual assisted therapy.

Objective The study was to analyze the relationship between HDL particles,the level of HDL-C and the concordance of HDL-C and apoA-Ⅰand the degree of coronary stenosis,then to explore their values in predicting coronary artery disease.Methods 591 patients were collected for coronary angiography,and calculated Gensini score respectively.HDL particles and the level of HDL-C,apoA-Ⅰwere analyzed in coronary artery disease (CAD)group and non-CAD group,stable angina pectoris(SAP)group and acute coronary syndrome(ACS)group and four groups divided by quartile of Gensini score(A,B,C,D).To investigate the relationship between the con-cordance of HDL-C and apoA-Ⅰand the severity of coronary artery disease,HDL-C,apoA-Ⅰwere divided into low and high group according to the 50 percentile,then pair wise combination was done into four groups. Results Compared with non-CAD group,HDL particles,the level of HDL-C,apoA-Ⅰwere significantly reduced in CAD group(P<0.001).Compared with SAP group,similar results were found in ACS group.HDL particles,the level of HDL-C,apoA-Ⅰwere decreased gradually in A,B,C,D group(P<0.001).The concordance of HDL-C and apoA-Ⅰwas related to the risk of CAD(P<0.001).The area under curve(AUC)of HDL particles was higher than that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.Conclusions HDL particles,HDL-C,the concordance of HDL-C and apoA-Ⅰwere related to coronary stenosis.The value of HDL particles in predicting CAD risk was su-perior to that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.

Objective To sum up and analyze the clinical and pathological characteristics in patients with both IgA nephropathy (IgAN) and diabetes mellitus. Methods A total of 500 patients were recruited, including 25 patients with both IgAN and diabetes mellitus, and 475 patients with IgAN only, who were diagnosed by renal-biopsy during Jan 2015 to Jan 2017 at the First Affiliated Hospital of Zhengzhou University. The clinical and pathological data were collected and analyzed using SPSS 22.0. Propensity Score Matching was used to match and select the patients in the both groups, and thereafter the depth of the basement membrane from the matched patients were compared using electron microscopy. The data of the patients whose follow - up time was ≥3 months were retrospectively collected, and Kaplan-Meier analysis was used to compare the difference of the prognosis. Results Compared to the patients with IgAN only, patients with both IgAN and diabetes mellitus were older [(46.36±13.49) years vs (34.00±13.80) years, P<0.001], had higher level of serum triglyceride [2.06(1.52, 3.11) mmol/L vs 1.51(1.01, 2.25) mmol/L, P=0.012] and thicker basement membrane [(384.33 ± 61.20) nm vs (346.72 ± 52.65) nm, P=0.044]. The patients with both IgAN and diabetes mellitus were more prone to reach the composite endpoint [4/7(57.14％) vs 25/265(9.33％), P<0.001] and had worse prognosis (Log-Rank test, P=0.004). Conclusions IgAN patients with diabetes mellitus have different clinical, pathological characteristics and prognosis from patients with IgAN alone. These patients need to be closely monitored and actively treated.

Objective To investigate the effect and potential mechanism of PSRC1 overexpression on foam cell formation of oxidized low-density lipoprotein(ox-LDL)-induced RAW264.7. Method After 48-h treat-ment of 100 μg/ml ox-LDL,changes of the accumulation of cholesterol esters in two groups was detected by oil red O staining.The protein expression of SR-AⅠand LDLR was detected by Western blot assay.Besides,ELISA was used to detect levels of IL-6 and TNF-α.Result The accumulation of cholesterol esters was lower in Ad-PSRC1 group than that in Ad-GFP group(P<0.05). The protein expression of SR-AⅠand LDLR was decreased signifi-cantly(P<0.05),and levels of the secreted IL-6 and TNF-α were also significantly decreased(P<0.05).Con-clusion Our data indicates that PSRC1 overexpression suppresses the formation of foam cells through improving lipid metabolism and down-regulating inflammatory cytokine IL-6 and TNF-α in macrophages.

Objective To observe the changes of A20 in mesangial cells of diabetic nephropathy (DN) rat model in?duced by lipopolysaccharide (LPS)-rat, and to explore its possible mechanism. Methods (1)Thirty health male Wistar rats were randomly divided into two group. Model rats were given streptozotocin (STZ) at a dose of 60 mg/kg by intraperitoneal in?jection. Rats in the control group received the same volume of citrate buffer in the same way. Levels of blood glucose and uri?nary microalbumin were detected in two groups at the 6th and the 8th week. Changes of renal pathology were observed by HE staining. Changes of protein A20 were observed by immunohistochemistry. (2) Expression changes of gene and proteins A20, nuclear factor (NF)-κB, IκB, IKKγand MCP-1 in renal cells treated with LPS were determined after treatment with different time points (0, 2, 4, 6, 12, 24, 48 and 72 h) and different concentrations (0.1, 1 and 10μg/L). Results (1) Levels of blood glucose and urinary microalbumin were significantly increased in model group compared with those of control group ( P <0.01). HE stainig showed that hyaline degeneration in tubular epithelial cells was found in model group, especially at the 8th week. Results of immunohistochemistry showed that expression of protein A20 significantly decreased in kidney tubules and nearly disappeared in glomerulus in model group compared with that of control group, which expressed less at the 8th week. (2) There was no significant difference in the expression of IKKγbetween different concentrations and different times. Com?pared with 0 h, the expression of A20 protein was increased at 2 h and 4 h, except that the expression of A20 protein in?creased after 6 h (P<0.05). Meanwhile NF-κB expression increased and IκB expression decreased in different time points (P<0.05). In addition, the expressions of A20 and IκB were decreased concentration-dependently (P<0.05). The expres?sion levels of NF-κB and MCP-1 were increased concentration-dependently (P<0.05). Conclusion A20 may involve in the development of diabetic nephropathy by regulating the NF-κB pathway.

Objective To investigate the clinical manifestation and inspection method about abnormal uter-ine bleeding due to cesarean section scar diverticulum.Methods retrospective analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum.Analysis the relevance ratio,the starting time of clinical symptom,related influencing factors,the information of examine and misdiagnose.Results there are 12 cases cesare-an section scar diverticulum in 2010;30 cases in 2011;26 cases in 2012;37 cases in 2013;51 cases in 2014.The starting time of clinical symptom is 1 ~6 month pose menstrual in 48 cases;6 months to 2 years pose menstrual in 89 cases,2 years later pose menstrual in 19 cases.98 cases don′t have evidential abnormality even through many times ultrasonograph.43 patients subjected diagnosis curettage.The uterine bleeding time obviously longer comparing retro-position of uterus with anteposition and msposition of uterus.Conclusion the morbidity of abnormal uterine bleeding cases due to cesarean section scar diverticulum is low,but the rate of misdiagnosis and missed diagnosis is little high-er.We need to elevate the rate of diagnosis,and to research the preservation and magagement gradually.