BACKGROUND:Superovulation is a common therapy in assisted reproductive technology.In clinical practice,some patients experience repeated superovulation to get pregnant. OBJECTIVE:To explore the effect of repeated superovulation on the developmental potential of oocytes in mice and humans. METHODS:Both animal experiments and retrospective clinical research were conducted.The animal study involved 90 SPF grade ICR 8-week-old female mice,who were randomly divided into three groups for 1,3,and 5 superovulations,respectively.The clinical study involved 306 patients who had undergone three consecutive in vitro fertilization cycles.The number of ovules obtained and embryonic development in different cycles were compared. RESULTS AND CONCLUSION:(1)The animal study indicated that repeated superovulation did not affect the embryonic development or developmental speed of mouse embryos.Similarly,there was no significant difference in the mouse blastocyst apoptosis,DNA damage,or the formation of inner cell mass and trophectoderm(P>0.05).(2)The clinical study also revealed no significant differences in the number of retrieved oocytes(8.60±5.04,8.58±4.87,and 8.38±4.63,P=0.81)and transferable embryos(2.42±1.99,2.40±1.92,and 2.64±2.00,P=0.26)over the three cycles.(3)In both the young group(<35 years)and the old group(≥35 years),the embryo quality was not affected by repeated superovulation(P>0.05).(4)These findings show that repeated superovulation does not affect the developmental potential of oocytes in mice and humans.

BACKGROUND:A large number of studies have confirmed that tissue engineering scaffolds can almost completely repair osteochondral defects.However,when osteochondral defects are complicated with infection,even after thorough debridement in the early stage,the repair effect of simple osteochondral tissue engineering scaffolds is often unsatisfactory. OBJECTIVE:To prepare fibroin/chitosan/nano-hydroxyapatite scaffold loaded with vancomycin hydrochloride sustained release microspheres,and to investigate the repair effect on infected osteochondral defect in distal femur of rabbit. METHODS:(1)Vancomycin hydrochloride sustained release microspheres were prepared by emulsified solvent evaporation method.The sustained-release microspheres of different weights(7.5,10,and 12.5 mg)were mixed with fibroin protein-chitosan nanohydroxyapatite solution,and the scaffolds of fibroin protein/chitosan/nano-hydroxyapatite were prepared by chemical crosslinking method.The porosity,water absorption and expansion rate,hot water loss rate of the scaffolds,and drug sustained-release in vitro were characterized.(2)Forty-five New Zealand white rabbits were randomly divided into blank group,control group,and experimental group,with 15 rabbits in each group.The osteochondral defect and infection model of the distal femur of the right hind limb was established in both groups.The blank group was not treated,and the control group was implanted with fibroin protein-chitosan-nano-hydroxyapatite scaffold.Vancomycin hydrochloride sustained-release microspheres(10 mg)of fibroin/chitosan/nano-hydroxyapatite scaffold were implanted in the defect of the experimental group.The levels of C-reactive protein and leukocytes in blood samples were detected 1 week after operation.At 4,8 and 12 weeks after operation,the tissue of the operative area was taken for gross observation and pathological observation. RESULTS AND CONCLUSION:(1)With the increase of sustained-release microspheres content,the porosity of scaffolds decreased,and there was significant difference among groups(P＜0.05).There were no significant differences in the pore size,water absorption expansion rate and hot water loss rate among the three groups(P＞0.05).Vancomycin hydrochloride was released sustainably in vitro for more than 30 days in all three groups of scaffolds.(2)The levels of C-reactive protein and leukocytes in blood samples of the experimental group were lower than those of the blank group and control group(P＜0.05).The repair of gross cartilage in the experimental group was significantly better than that in the blank group and the control group.Hematoxylin-eosin,Masson,Alcian blue and type Ⅱ collagen immunohistochemical stainings showed that the osteochondral repair effect of the experimental group was significantly better than that of the blank group and the control group at each time point.(3)The results showed that fibroin/chitosan/nano-hydroxyapatite scaffolds loaded with vancomycin hydrochloride sustained-release microspheres could effectively promote the repair of open osteochondral defects.

Objective:To investigate the knowledge of Sixth Chinese national consensus report on the management of Helicobacter pylori infection ( treatment excluded) (hereinafter referred to as sixth national consensus) and 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment (hereinafter referred to as the guideline)among medical staff from general hospitals in Hainan. Methods:From February 20 to May 7, 2023, a questionnaire survey on the diagnosis and treatment of Helicobacter pylori ( H. pylori) infection was conducted among 1 463 medical staff from 15 general hospitals in Hainan Province. The questionnaire was drawn up according to the sixth national consensus and the guideline, covering knowledge of 6 sections, induding H. pylori related diseases, detection of H. pylori, eradication, prevention and influence factors of eradication of H. pylori, etc. Chi-square test was used for statistical analysis. Results:A total of 1 463 valid questionnaires were collected with the effective responsive rate of 100.00%.The 1 463 subjects included 225 gastroenterologists and 1 238 other medical staff(including 503 physicians from other departments, 264 surgeons and 471 medical technologists and pharmacists). About 78.67%(177/225)of gastroenterologists agreed that the overall infection rate of H. pylori in China was more than 20%, the awareness rate was higher than that of other medical staff (physicians from other departments 65.41%(329/503), surgeons 61.74%(163/264), medical technologists and pharmacists 60.30%(284/471); the following datas were sorted by this position), and the difference was statistically significant ( χ2=30.97, P<0.001). About 51.11%(115/225) of gastroenterologists considered that H. pylori serological antibody test could not be used as a diagnostic method for current infection, the awareness rate was higher than that of other medical staff(22.07%(111/503), 14.02%(37/264), 12.31%(58/471)), and the difference was statistically significant( χ2 =152.66, P<0.001). Proton pump inhibitor and potassium-competitive acid blocker should be discontinued for 2 weeks, and antibiotics and bismuth should be discontinued for 4 weeks before urea breath test, and the awareness rates of gastroenterologists were higher than those of other medical staff (38.67%(87/225) vs. 23.26%(117/503), 19.70%(52/264), 18.47%(87/471); 60.89%(137/225) vs. 26.64%(134/503), 25.76%(68/264), 23.78%(112/471)), and the differences were statistically significant ( χ2 =133.70 and 165.51, both P<0.001). For refractory H. pylori infection, 98.67%(222/225)of gastroenterologists agreed with the individualized diagnosis and treatment of H. pylori infection should be guided by bacterial culture, antibiotic susceptibility test or drug resistance gene test, and the awareness rate was higher than that of other medical staff (91.85%(462/503), 93.56%(247/264), 93.21%(439/471)), and the difference was statistically significant( χ2=20.55, P=0.002). About 70.67% (159/225) of gastroenterologists recommended a bismuth containing quadruple regimen, 80.44% (181/225) supported a 10 to 14 day H. pylori eradication course, and the awareness rates were higher than other medical staff (46.92%(236/503), 33.33%(88/264), 32.91%(155/471); 67.20%(338/503), 59.09%(156/264), 53.93%(254/471)), and the differences were statistically significant ( χ2=111.25 and 59.99, both P<0.001). The understanding rates of the sixth national consensus and the guideline in gastroenterologists was 85.33% (192/225), which was higher than that of other medical staff (64.21%(323/503), 66.67%(176/264), 57.96%(273/471)), and the difference was statistically significant ( χ2=85.47, P<0.001). Conclusions:Gastroenterologists from general hospitals in Hainan Province have a better understanding of the sixth national consensus and the guideline than other medical staff. However, there is still a lack of deep understanding of the sixth national consensus and the guideline, and it is necessary to further strengthen the learning and application of the sixth national consensus and the guideline.

We here investigated the effect of MS4A6D(the membrane spanning 4-domain subfamily A(MS4A)superfamily protein 6D),one of the tetraspanins which specifically expresses on the membrane of macrophages,on carrageenan(CGN)-induced mouse foot pad swelling and its possible mechanism.Male C57BL/6 wild-type(WT)and various gene knockout(including Ms4a6d-/-,Nlrp3-/-,Casp-1-/-and IlR1-/-)mice were recruited and injected with 100 μl 1%CGN(w/v)and 20 μl CaCl2(50 mmol/L)to establish the foot pad swelling model,and then the severity of foot pad swelling in WT and gene knockout mice were compared.H&E staining was performed to investigate the pathological changes,and immunofluorescence was used to detect the infiltration of F4/80+ macrophages in the foot pad tissue.Finally,Western blot was used to determine the protein expression of NLRP3,IL-1 β,TNF-α and IL-6.Data showed that the combined injection of 100 μl 1%CGN(w/v)and 20 μl CaCl2(50 mmol/L)significantly promoted the swelling of foot pads,while the degree of foot pad swelling in Ms4a6d-/-mice was significantly lower than that in WT littermates(P<0.05);Significant tissue damage and inflammatory infiltration as well as necrotic lesions were observed in the WT foot pads,whereas,the degrees from Ms4a6d-/-foot pads showed significantly reduced;The protein levels of Caspase-1 and IL-1β in the foot pad tissue of the WT model were significantly higher than those of the Ms4a6d-/-groups;Compared with WT controls,the degree of foot pad swelling in Nlrp3-/-,Casp-1-/-,and IlR1-/-mice induced by 1%CGN(w/v)and CaCl2(50 mmol/L)were also significantly reduced(P<0.05).Taken together,MS4A6D promotes the activation of NLRP3 inflammasome in macrophages and induces IL-1β secretion,by thus deteriorates CGN-mediated swelling of mouse foot pads.

OBJECTIVE: To evaluate the application of surgical strategies for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) involving the C ₂ segment. METHODS: The literature about the surgery for cervical OPLL involving C ₂ segment was reviewed, and the indications, advantages, and disadvantages of surgery were summarized. RESULTS: For cervical OPLL involving the C ₂ segments, laminectomy is suitable for patients with OPLL involving multiple segments, often combined with screw fixation, and has the advantages of adequate decompression and restoration of cervical curvature, with the disadvantages of loss of cervical fixed segmental mobility. Canal-expansive laminoplasty is suitable for patients with positive K-line and has the advantages of simple operation and preservation of cervical segmental mobility, and the disadvantages include progression of ossification, axial symptoms, and fracture of the portal axis. Dome-like laminoplasty is suitable for patients without kyphosis/cervical instability and with negative R-line, and can reduce the occurrence of axial symptoms, with the disadvantage of limited decompression. The Shelter technique is suitable for patients with single/double segments and canal encroachment >50% and allows for direct decompression, but is technically demanding and involves risk of dural tear and nerve injury. Double-dome laminoplasty is suitable for patients without kyphosis/cervical instability. Its advantages are the reduction of damage to the cervical semispinal muscles and attachment points and maintenance of cervical curvature, but there is progress in postoperative ossification. CONCLUSION OPLL involving the C ₂ segment is a complex subtype of cervical OPLL, which is mainly treated through posterior surgery. However, the degree of spinal cord floatation is limited, and with the progress of ossification, the long-term effectiveness is poor. More research is needed to address the etiology of OPLL and to establish a systematic treatment strategy for cervical OPLL involving the C ₂ segment.
Humans ; Longitudinal Ligaments/surgery* ; Ossification of Posterior Longitudinal Ligament/surgery* ; Treatment Outcome ; Osteogenesis ; Decompression, Surgical/methods* ; Cervical Vertebrae/surgery* ; Laminoplasty/methods* ; Kyphosis/surgery* ; Retrospective Studies

【Objective】 To analyze the comprehensive factors causing adverse reactions to apheresis platelet donation(ARAPD), so as to provide references for effective prevention of ARAPD. 【Methods】 The 272 cases of ARAPD from 2012 to 2019 in Lanzhou were statistically analyzed, and factors that induced ARAPD were studied. Statistical analysis were performed according to the gender, nationality, occupation, age, weight, donation units, and number of donations. 【Results】 As to the factors inducing ARAPD, anticoagulant reactions accounted for the first(32.4%, 88/272). Women and students were prone to develop ARAPD. Among all age groups, 18~25 years old were most likely to develop ARAPD(53.68%, 10 572/35 265). The incidence of ARAPD were significantly different by ages and weights(P<0.05), and donors with lighter weight were more prone to develop ARAPD(P<0.05). The incidence of ARAPD were also significantly different between first-time and repeated donors(P<0.05), but not among the donation units. 【Conclusion】 The anticoagulant reactions are the leading reason for ARAPD. For female, student, young, light-weight, and first-time blood donors, special attention should be paid and corresponding interventions taken to them.

【Objective】 To study the current situation of apheresis platelets collection in various regions of Gansu province by comparing and analyzing relevant data from blood stations in 14 prefecture-level cities of Gansu province. 【Methods】 The units of collected platelets and rate of double-dose collection in 13 regional blood stations and 1 provincial blood center from 2016 to 2020, as well as the clinical supply and demand was statistically analyzed. 【Results】 From 2016 to 2020, the total units of platelets collected by 13 blood stations and 1 blood center in Gansu increased from 11 255 U to 15 270 U, with the increase rate at 35.7% in 5 years, and mainly were collected by the provincial blood center (74.57%, 50 253/ 67 392). Although the rate of double-dose collection in the province showed a steady upward trend, only 3 blood stations realized annual double-dose collection more than 20%. There was still a gap of about 10% between supply and clinical needs. 【Conclusion】 Although the number of platelet collections and units in each blood station in Gansu is on the rise in general, the units collected varies in each blood station. Therefore, further measures need to be taken from the aspects of publicity, recruitment, optimizing the collection process, improving the rate of double-dose collection, retention of regular blood donors and regional coordination to increase the collection units, narrow down the regional gap and ensure the balance between supply and demand.

Objective To evaluate the effect of pre-emptive analgesia on pain and inflammation control in patients with severe multiple trauma.Methods Severe multiple trauma patients treated in the emergency department from September 2014 to December 2014 were prospectively included based on the inclusion criteria including injury severity score (ISS) of 16 to 25,Glasgow Coma Scale (GCS) ≥ 13 and visual analogue scale (VAS) ≥ 4.The patients were assigned to pre-emptive analgesia group,traditional analgesia group and non-analgesia group,according to the random number table.Pre-emptive analgesia group had patient-controlled intravenous analgesia (PCIA) with sufentanil and tramadol on admission.Traditional analgesia group were administered intramuscular pethidine or subcutaneous morphine for temporary analgesia when the pain could not be tolerated.Non-analgesia group received no analgesia.VAS,systemic inflammatory response syndrome (SIRS) score and serum interleukin (IL)-6 concentration were compared among the groups on admission day,24,48,72,120,168 and 240 h after admission.Results Fifty-seven patients (46 males and 11 females) were included,and age was (39.61 ± 12.05)years.There were 18 patients in pre-emptive analgesia group,20 patients in traditional analgesia group,and 19 patients in non-analgesia group.Comparison between pre-emptive analgesia,traditional analgesia and non-analgesia groups showed no significant differences on admission with respect toVAS [(6.5±1.5),(6.6±1.4),(6.4 ±1.4)points],SIRS [(3.3±0.7),(3.4±0.6),(3.4±0.8) points] and IL-6 concentration [(109.2 ± 47.9),(99.9 ± 44.3),(106.3 ± 50.0) ng/L] (P ＞0.05).Compared to traditional analgesia and non-analgesia groups,VAS and SIRS score in pre-emptive analgesia group differed significantly at 24,48,72,120,168 and 240 h after admission,and IL-6 in pre-emptive analgesia group differed significantly at 48,72,120,168 and 240 h after admission (all P ＜0.05).VAS,SIRS score and IL-6 concentration declined faster in pre-emptive analgesia group than other two groups (P ＜ 0.05),while there were no significant differences between traditional analgesia and nonanalgesia groups (P ＞ 0.05).Positive correlation was noted between VAS and SIRS score,and between VAS and t IL-6 concentration (P ＜ 0.05).Conclusion Pre-analgesia provides quick and effective pain relief and attenuate excessive systemic inflammation response that contributes to stabilization and recovery of the severe multiple trauma patients.

Objective To analyze the related factors of foot blisters caused by long-distance weight-bearing march and to explore the pathogenesis of foot blisters to provide a useful way for the prevention and treatment.Methods After the 300 km march,counted the number who had accomplished the march,and then recorded the number of foot blisters,location of blisters,and abrasion of sole.Collected the data of gender,age,body mass index (BMI),hand dominance,and whether had bliters before the march through questionnaire.And the data were coded for analysis with SPSS 13.0 statistical package.Results The 7 cases who complete the whole march and 17 cases who already had foot blisters before the march were ruled out of the final statistics.Among the remaining 590 cases,there were 554 cases (93.9%)suffered from foot blisters.And there were 1 282 blisters in total,among which the plantar blisters occupied 98% (1 257 cases).The analysis showed that the incidence of foot blisters had no significant correlation with gender,left/right foot,hand dominance,BMI and age.The predilection sites of blisters were the second and third metatarsals (28.2%),the hallux (21.3%),the fifth metatarsal (18.1%),and the calcaneus (15.8%)of the left foot.The predilection sites of blisters were the second and third metatarsals (33.3%),the hallux (22.4%),the fifth metatarsal (18.6%),and the calcaneus (14.5%)of the right foot.In terms of the abrasion of sole,the lateral heel was worn out the most (34.6% on the left and 34.2% on the right).Conclusion The study confirmed that the incidence of foot blisters had no significant correla-tion with gender,left/right foot,hand dominance,BMI and age,which may be affected by the particularity of this march.Most of the foot blisters occurred in the planta,and the predilection sites of blisters were in accord with sites of of the abrasion of sole and the distribution of plantar shear force,which demonstrated the shear force is the most critical factor on the pathogenesis of foot blisters.

Objective To optimize antiarrhythmic drugs in the treatment of atrial fibrillation and atrial flutter patient different duration,improve the success rate and safety of cardioversion.Methods Make a retrospective analysis of 180 atrial flutter and 180 atrial fibrillation patients data,which were divided into group ibutilide,propafenone group and amiodarone group,Each group were further divided into duration ≤ 3d ＞ 3d,n =30,cardioversion rate was compared after 1.5h,and aralyzed by SPSS16.0.Results Atrial flutter cardioversion rate of ibutilide group ≤3d and 3d was 90％ and 83.33％ ;propafenone≤3d and 3d were 76.67％ and 36.67％,amineamiodarone were 73.33％ and 33.33％,cardioversion rate of three groups had no significant difference when atrial flutter duration ≤3d,P ＞ 0.05 ;Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ＞ 3d,P ＜0.05 ;atrial fibrillation cardioversion rate of ibutilide group≤3d and 3d was 80％ and 73.33％ ;propafenone≤3d and 3d were 43.33％ and 26.67％,amineamiodarone were 50％ and 36.67％,Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ≤3d,P ＜ 0.05; Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ＞ 3d,P ＜0.05 ;the atrial flutter,atrial fibrillation total cardioversion rate of three groups were 81.67％,45.83％,48.33％,ibutilide was significantly higher than propafenone,amiodarone (P ＜ 0.05 ) ;the atrial fluttercardioversion of ibutilide was significantly higher than the atrial fibrillation rate( P ＜ 0.05 ).Conclusion For the duration of ≤ 3d patients,atrial flutter cardioversion rate of ibutilide.oropafenone,and amiodarone did not differ significantly,but the atrial fibrillation cardioversion rate of ibutilide was significantly higher;For the duration of＞ 3d patients,the atrial flutter and atrial fibrillation cardioversion rate of Ibutilide were higher than propafenone and amiodarone,when choose ibutilide,propafenone,or amiodarone for treating atrial flutter and atrial fibrillation according to individual arrhythmia.