Peptides that are composed of dextrorotary (d)-amino acids have gained increasing attention as a potential therapeutic class. However, our understanding of the in vivo fate of d-peptides is limited. This highlights the need for whole-body, quantitative tracking of d-peptides to better understand how they interact with the living body. Here, we used mouse models to track the movement of a programmed death-ligand 1 (PD-L1)-targeting d-dodecapeptide antagonist (DPA) using positron emission tomography (PET). More specifically, we profiled the metabolic routes of [⁶⁴Cu]DPA and investigated the tumor engagement of [⁶⁴Cu/⁶⁸Ga]DPA in mouse models. Our results revealed that intact [⁶⁴Cu/⁶⁸Ga]DPA was primarily eliminated by the kidneys and had a notable accumulation in tumors. Moreover, a single dose of [⁶⁴Cu]DPA effectively delayed tumor growth and improved the survival of mice. Collectively, these results not only deepen our knowledge of the in vivo fate of d-peptides, but also underscore the utility of d-peptides as radiopharmaceuticals.

Objective:To improve the technique of oocyte retrieval in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles and reduce the cancellation rate of IVF/ICSI cycle. Methods:The clinical data of a case of IVF/ICSI cycle using transvaginal combined with abdominal oocyte retrieval was reported.Results:The right ovary of one infertile patient who received ICSI due to male factors was not detected repeatedly by transvaginal ultrasound during ovulation induction. The right lower abdominal pain occurred day 5 after using gonadotropin. We considered that the position of the right ovary was high due to pelvic adhesion after previous appendectomy, and was further confirmed by abdominal ultrasound. Two mature oocytes were obtained from the left and right ovaries respectively. Four embryos were obtained after ICSI insemination, and biochemical pregnancy occurred after transplantation.Conclusion:Transabdominal ultrasound-guided oocyte retrieval is relatively safe and effective, and can obtain similar clinical outcomes as conventional transvaginal ultrasound-guided oocyte retrieval. For IVF/ICSI women with difficulty in obtaining oocytes through vagina, transabdominal ultrasound-guided oocyte retrieval can be tried. During IVF/ICSI treatment cycles, it is necessary to improve the quality of medical history inquiry, pre-cycle evaluation, ovulation induction monitoring, oocyte retrieval and embryo transfer.

Objective:To improve the technique of oocyte retrieval in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles and reduce the cancellation rate of IVF/ICSI cycle. Methods:The clinical data of a case of IVF/ICSI cycle using transvaginal combined with abdominal oocyte retrieval was reported.Results:The right ovary of one infertile patient who received ICSI due to male factors was not detected repeatedly by transvaginal ultrasound during ovulation induction. The right lower abdominal pain occurred day 5 after using gonadotropin. We considered that the position of the right ovary was high due to pelvic adhesion after previous appendectomy, and was further confirmed by abdominal ultrasound. Two mature oocytes were obtained from the left and right ovaries respectively. Four embryos were obtained after ICSI insemination, and biochemical pregnancy occurred after transplantation.Conclusion:Transabdominal ultrasound-guided oocyte retrieval is relatively safe and effective, and can obtain similar clinical outcomes as conventional transvaginal ultrasound-guided oocyte retrieval. For IVF/ICSI women with difficulty in obtaining oocytes through vagina, transabdominal ultrasound-guided oocyte retrieval can be tried. During IVF/ICSI treatment cycles, it is necessary to improve the quality of medical history inquiry, pre-cycle evaluation, ovulation induction monitoring, oocyte retrieval and embryo transfer.

Objective:To investigate the clinical effects and pregnancy outcomes of the early follicular long-term protocol and antagonist protocol in the treatment of unexplained infertility patients.Methods:From January 2018 to January 2019, 642 cases of unexplained infertility patients with early follicular long-term protocol and antagonist protocol in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) were collected using the clinical assisted reproductive technologies management system software database of the Department of Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University. Patients were divided into early follicular long-term protocol ( n=283) and antagonist protocol ( n=359) groups. The clinical outcomes of the two groups were analyzed retrospectively, including the implantation rate, the clinical pregnancy rate, and the live birth rate. Furthermore, the pregnancy outcomes of different age and body mass index (BMI) patients were further analyzed. Results:1) The BMI in the antagonist protocol group was higher than that in early follicular long-term protocol group [(22.17±2.96) kg/m 2vs. (21.68±2.29) kg/m 2, P=0.018]. The other based data did not exhibit remarkable difference between the two groups ( P>0.05). 2) The starting dosage of gonadotropin (Gn) in early follicular long-term protocol group was less than that of antagonist group [(149.74±36.24) IU vs. (177.97±38.85) IU, P<0.001]. While the total duration and dosage of Gn used in early follicular long-term protocol group were significantly higher than those in antagonist group [(11.93±2.26) d vs. (8.86±1.45) d, P<0.001; (1 908.35±632.36) IU vs. (1 638.57±497.23) IU, P<0.001). The cleavage embryo implantation rate, the clinical pregnancy rate and the live pregnancy rate in fresh cycle in early follicular long-term protocol group were significantly higher than those in the antagonist group [57.14% (152/266) vs. 39.53% (68/172), P<0.001; 66.48% (121/182) vs. 51.72% (60/116), P=0.011; 59.89% (109/182) vs. 40.52% (47/116) , P=0.001]. The incidence of moderate and severe ovarian hyperstimulation syndrome between the two groups were not statistically different ( P>0.05). Multivariate logistic regression analysis showed that different protocols and age were both risk factors for clinical pregnancy and live birth of cleavage embryo transfer [2.261(95% CI=1.333-3.836), P=0.002; 0.928(95% CI=0.869-0.991), P=0.026; 2.598(95% CI=1.535-4.397), P<0.001; 0.906(95% CI=0.849-0.967), P=0.003]. 3) In patients under 35 years old, the clinical pregnancy rate and the live birth rate in early follicular long-term protocol group were higher than those of the antagonist group, but there was no statistical difference (all P>0.05). The fresh embryo cycle implantation rate, the clinical pregnancy rate and the live birth rate of 35-39 years old patients in the early follicular long-term protocol group were higher than those in the antagonist group, but there was no statistical difference (all P>0.05). 4) In normal BMI group, the implantation rate, the clinical pregnancy rate and the live birth rate in early follicular long-term protocol group were significantly higher than those in the antagonist group [55.71% (122/219) vs. 37.82% (45/119), P=0.002; 63.58% (96/151) vs. 46.99% (39/83), P=0.014; 58.94% (89/151) vs. 39.76% (33/83), P=0.005]. In the overweight population, the implantation rate and the clinical pregnancy rate in early follicular long-term protocol group were significantly higher than those in the antagonist group [68.09% (32/47) vs. 43.40% (23/53), P=0.013; 81.25% (26/32) vs. 57.14% (20/35), P=0.034], but there was no statistically significant difference in the live birth rate ( P>0.05). Conclusion:Compared with the antagonist protocol, early follicular long-term protocol for unexplained infertility patients may achieve higher clinical pregnancy outcomes in IVF fresh cycle, but it could increased the duration of descending, the duration and dosage of Gn used.

Objective:To investigate the clinical effects and pregnancy outcomes of the early follicular long-term protocol and antagonist protocol in the treatment of unexplained infertility patients.Methods:From January 2018 to January 2019, 642 cases of unexplained infertility patients with early follicular long-term protocol and antagonist protocol in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) were collected using the clinical assisted reproductive technologies management system software database of the Department of Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University. Patients were divided into early follicular long-term protocol ( n=283) and antagonist protocol ( n=359) groups. The clinical outcomes of the two groups were analyzed retrospectively, including the implantation rate, the clinical pregnancy rate, and the live birth rate. Furthermore, the pregnancy outcomes of different age and body mass index (BMI) patients were further analyzed. Results:1) The BMI in the antagonist protocol group was higher than that in early follicular long-term protocol group [(22.17±2.96) kg/m 2vs. (21.68±2.29) kg/m 2, P=0.018]. The other based data did not exhibit remarkable difference between the two groups ( P>0.05). 2) The starting dosage of gonadotropin (Gn) in early follicular long-term protocol group was less than that of antagonist group [(149.74±36.24) IU vs. (177.97±38.85) IU, P<0.001]. While the total duration and dosage of Gn used in early follicular long-term protocol group were significantly higher than those in antagonist group [(11.93±2.26) d vs. (8.86±1.45) d, P<0.001; (1 908.35±632.36) IU vs. (1 638.57±497.23) IU, P<0.001). The cleavage embryo implantation rate, the clinical pregnancy rate and the live pregnancy rate in fresh cycle in early follicular long-term protocol group were significantly higher than those in the antagonist group [57.14% (152/266) vs. 39.53% (68/172), P<0.001; 66.48% (121/182) vs. 51.72% (60/116), P=0.011; 59.89% (109/182) vs. 40.52% (47/116) , P=0.001]. The incidence of moderate and severe ovarian hyperstimulation syndrome between the two groups were not statistically different ( P>0.05). Multivariate logistic regression analysis showed that different protocols and age were both risk factors for clinical pregnancy and live birth of cleavage embryo transfer [2.261(95% CI=1.333-3.836), P=0.002; 0.928(95% CI=0.869-0.991), P=0.026; 2.598(95% CI=1.535-4.397), P<0.001; 0.906(95% CI=0.849-0.967), P=0.003]. 3) In patients under 35 years old, the clinical pregnancy rate and the live birth rate in early follicular long-term protocol group were higher than those of the antagonist group, but there was no statistical difference (all P>0.05). The fresh embryo cycle implantation rate, the clinical pregnancy rate and the live birth rate of 35-39 years old patients in the early follicular long-term protocol group were higher than those in the antagonist group, but there was no statistical difference (all P>0.05). 4) In normal BMI group, the implantation rate, the clinical pregnancy rate and the live birth rate in early follicular long-term protocol group were significantly higher than those in the antagonist group [55.71% (122/219) vs. 37.82% (45/119), P=0.002; 63.58% (96/151) vs. 46.99% (39/83), P=0.014; 58.94% (89/151) vs. 39.76% (33/83), P=0.005]. In the overweight population, the implantation rate and the clinical pregnancy rate in early follicular long-term protocol group were significantly higher than those in the antagonist group [68.09% (32/47) vs. 43.40% (23/53), P=0.013; 81.25% (26/32) vs. 57.14% (20/35), P=0.034], but there was no statistically significant difference in the live birth rate ( P>0.05). Conclusion:Compared with the antagonist protocol, early follicular long-term protocol for unexplained infertility patients may achieve higher clinical pregnancy outcomes in IVF fresh cycle, but it could increased the duration of descending, the duration and dosage of Gn used.

Objective Using of cumulative live birth rate(CLBR)per oocytes retrieved cycle,to assess the clinical outcomes of in vitro fertilization or intracytoplasmic sperm injection(IVF/ICSI),and to explore impact factors on CLBR following utilization of all fresh and frozen embryos in one complete IVF/ICSI cycle using gonadotropin-releasing hormone(GnRH)agonist, GnRH-antagonist and clomiphene mild stimulation protocols. Methods Of the patients who underwent IVF/ICSI from January 1st, 2014 to December 31st, 2015 in the First Affiliated Hospital, Nanjing Medical University, a total of 6 142 oocytes retrieved cycles were included. The clinical and laboratory parameters of different ovarian stimulation protocols, and the effects of the age, number of oocytes retrieved and number of embryos available on the CLBR of each oocytes retrieved cycle were analyzed.Results The CLBR was 69.0%(2 004/2 906)in the GnRH-agonist protocol versus 67.4%(644/955)in the GnRH-antagonist protocol (P>0.05); the CLBR of clomiphene mild stimulation protocol was 53.2%(1 215/2 281),significantly lower than those of the other two protocols (all P<0.05). The CLBR significantly decreased with age increased. When divided into four groups according to the patients′ age, we found that CLBR were not statistically significant using three different protocols in the 20-25 years old group(all P>0.05).There was a strong association between the number of oocytes retrieved and embryos available on CLBR. CLBR rose significantly with an increasing number of oocytes up to 6, then the rising trend slowed down. Patients were categorized into four groups according to the number of oocytes retrieved,CLBR was significantly higher using GnRH-antagonist protocol (50.0%)than mild stimulation protocol(37.0%)in low ovarian responder(0-4 oocytes)group(P<0.05). The CLBR were no significant difference among three protocols in normal(10-15 oocytes)and high responders(≥15 oocytes)group(all P>0.05).The incidence rate of ovarian hyperstimulation syndrome in GnRH-agonist protocols(5.2%,152/2 906)were significantly higher than those of GnRH-antagonist(4.4%, 42/955)and clomiphene mild stimulation protocols(1.5%,34/2 281;all P<0.05).Conclusions CLBR is an important index to assess the clinical outcomes of IVF/ICSI. Age, number of oocytes retrieved and embryos available could affect CLBR obviously. According to the different age and ovarian response of patients, we should design ovarian stimulation protocols based on target oocytes number in order to get higher CLBR and reduce complications.

Objective To investigate the effect of the nursing care of critically ill patients in intensive care unit(ICU) with non-invasive ventilation assisted by sedation simultaneously. Methods During the intervention phase from June 2012 to June 2013 of 28 patients in ICU treated by non-invasive ventilation, sedatives were adjusted according to Ramsay Scale, and the parameters of the life signs (heart rate, blood pressure, oxygen saturation,etc) were measured by nurses. Results 89.3%(25/28) patients obtained the improvement of the disease despite of the complications such as over-sedation and instable hemodynamics. Conclusion The key points can increase tolerance of non-invasive ventilation and improve clinical outcomes, develop comprehensive nursing strategies on safety and effectiveness of sedation and non-invasive ventilation .

Objective:Selected virulence factors more than and high virulent Aeromonas hydrophia strain made into inactivated vaccine,to study the immunization effect of inactivated vaccine.Methods:Crucian were vaccinated with formalin-killed vaccine via in-traperitoneal injection.Controls were injected with the same volumes of saline.Then the antibody titres, histopathology and relative percent survival were analyzed from samples of both groups.Results: The antibody in the indirect agglutination reaction could be detected in vaccinated fish once a weeks after immunization and reached highest level 6 weeks after immunization.The histopathology analysis indicated that the vaccine had a good protective effect on crucian target organs.Vaccinated fish showed 100%relative percent survival and the immune period would be 6 month.Conclusion:The vaccine in this study has a significant protective effect on crucian and may be used as effective fish vaccines against bacterial septicemia.

Objective To explore the feasibility and efficiency of the treatment of lumbar degenerative diseases after transforaminal lumbar interbody fusion(TLIF)and posterolateral fusion(PLF)procedures in which unilateral pedicle screw fixation was used.Methods From December 2006 to August 2008,78 cases with the lumbar degenerative diseases who received lumbar posterolateral fusion were analyzed.There were 48 cases of which underwent TLIF and PLF procedures with unilateral pedicle screw fixation(unilateral group),including 25 males and 23 females with an average of 47.6 years;and 30 cases of which underwent TLIF and PLF procedures with bilateral pedicle screw fixation(bilateral group),including 21 males and 9 females with an average of 50.5 years.The clinical effects between the two groups were evaluated with Oswestry disability index and visual analogue score(VAS)index.The operation time,blood loss,fusion rates and intervertebral collapse rates were also compared.Results Oswestry disability index,low back pain VAS index and skelalgia VAS index in both groups showed statistical significance between preoperation and 3 months,or 3 months and 1 year postoperatively.There was no difference in score improvement between the two groups.There were difference in operation time,blood loss and cost of hospitalization between unilateral and bilateral group.The former was lower.There was no difference in postoperative length of stay between the two groups.The fusion rate of unilateral group and bilateral group were 91.7%(44/48)and 93.3%(28/30),respectively.Conclusion Auto graft combined with unilateral pedicle screw fixation provids better spinal instant stability.TLIF and PLF with unilateral pedicle screw fixation was a satisfactory method in treating degenerative disease of lumbar vertebrae.

Objective To summarize the keypoints of clinical diagnosis of chondroblastoma and the experience on the treatment Methods The clinical materials of 16 cases(11 males,aged from 12 to 26 years)from June 1992 to February 2003 of pathologically diagnosed chondroblastoma were analyzed retrospectively. The tumor located at distal femur in 6 cases,great trochanter in 1 case,proximal tibia in 6 cases,proximal humerus in 2 cases, talus in 1 case. The main symptoms were swelling and painful joint. All the 16 cases were treated with curettage and autologous bone graft from iliac crest. Results Twelve cases were followed up for 6 months to 5 years .averaging 3. S years. All the bone graft healed well. One case., recurred 2 years after the initial curettage and was treated with curettage again. No recurrence occurred at the last follow-up 6 months after the second curettage. The function of the involved joints was nearly normal in all cases except for one case with slight limitation of knee flexion. Conclusions Mastering the image and clinical characteristics of chondroblastoma can avoid misdiagnosis and mistreatment Curettage can control the tumor satisfactorily. Postoperative rehabilitation can improve the function of the involved limb.