Infertile women experience complex biological and social experiences in the process of receiving IVF. From the perspective of females undergoing IVF, it is helpful to analyze the ethical and social problems that IVF may face more intuitively and concretely. In this study, 213 women who were undergoing IVF were randomly selected to carry out a questionnaire survey. The results showed that the choice of IVF for infertile women was driven by multiple pressures from family and society, not entirely on their own; They are not aware of the technology, but have a positive attitude, and are eager to be fully informed in the treatment process. In addition, the treatment brings great economic pressure to women who were undergoing IVF and has no significant impact on the relationship between husband and wife. Only by paying attention to the above problems and solving them can we benefit more infertile women and help them realize their reproductive wishes.

ObjectiveTo adapt the Stanford Expectations of Treatment Scale（SETS） into Chinese（C-SETS） and test the feasibility， validity and reliability of its application in patients with diarrhea-predominant irritable bowel syndrome（IBS-D） with liver-constraint and spleen-deficiency syndrome treated with traditional Chinese medicine（TCM）. MethodsWe obtained authorisation from the developer of the SETS， and followed the principle of "two-way translation" to translate the SETS by literal translation and back translation to form the C-SETS. Ninety-six IBS-D patients with liver-constraint and spleen-deficiency syndrome were enrolled as respondents and filled out C-SETS before receiving treatment； the feasibility was assessed by the recall rate， completion rate and the duration of filling out the scale； the reliability was assessed by Cronbach's α； the structural validity was assessed by exploratory and confirmatory factor analysis， and the content validity was assessed by correlation analysis. ResultsThe C-SETS consists of 10 items， with the 1st， 3rd， and 5th rating items constituting the Positive Expectations subscale， and the 2nd， 4th， and 6th rating items constituting the Negative Expectations subscale， each of which is rated on a 7-point Likert Scale. The recall of C-SETS was 100%（96/96）， the completion rate was 89.58%（86/96）； Cronbach's α for the Positive and Negative Treatment Expectations subscales were 0.845 and 0.854， respectively； exploratory factor analysis showed that the coefficient of commonality for all six entries was larger than 0.4， and that the six entries could be used by both factors to explain 77.092% of the total variance； validation factor analysis showed that the goodness-of-fit index， comparative fit index， root mean square of approximation error， canonical fit coefficient， and chi-square degrees of freedom ratio took the values of 0.943， 1.003， 0， 0.943， and 0.626， respectively； and the results of Spearman's analysis suggested that the C-SETS had good content validity. ConclusionThe C-SETS has well feasibility， reliability， and validity， which initially proves that it can be used as a tool to assess the treatment expectation of patients with IBS-D with liver-constraint and spleen-deficiency syndrome before receiving TCM treatment.

Infertile women experience complex biological and social experiences in the process of receiving IVF. From the perspective of females undergoing IVF, it is helpful to analyze the ethical and social problems that IVF may face more intuitively and concretely. In this study, 213 women who were undergoing IVF were randomly selected to carry out a questionnaire survey. The results showed that the choice of IVF for infertile women was driven by multiple pressures from family and society, not entirely on their own; They are not aware of the technology, but have a positive attitude, and are eager to be fully informed in the treatment process. In addition, the treatment brings great economic pressure to women who were undergoing IVF and has no significant impact on the relationship between husband and wife. Only by paying attention to the above problems and solving them can we benefit more infertile women and help them realize their reproductive wishes.

Objective: To compare the effects of sequential and single-step culture media systems on the development of human early embryo in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles, and to provide a reference for the selection and evaluation of the human embryo culture system of assisted reproductive technology (ART). Methods, A total of 155 patients received IVF/ICSI treatment were selected and the ova from the same patient were divided into two groups. The ova were cultured in Vitrolife sequential media system G-IVF/G1/G2 culture solution (sequential culture group) and Irvine single-step media system CSCC culture solution (single-step culture group) for IVF and embryo culture. The fertilization and early embryo development in the different culture systems in two groups were observed. Results: Compared with single-step culture group, the fertilization rate, 2PN fertil ization rate and multi-nuclear fertilization rate of the patients in sequential culture group had no significant differences (P>0. 05). In the IVF patients, there were no significant differences in the cleavage rates, quality embryo rates, high quality embryo rates and blastocyst formation rates between sequential culture group and single-step culture group (P>0. 05). In the ICSI patients, there were also no significant differences in the cleavage rates, quality embryo rates and blastocyst formation rates between sequential culture group and singlestep culture group (P>0. 05). However, the high quality embryo rate of the patients in sequential culture group was significantly higher than that in single-step culture group (P=0. 015). Both in the IVF and ICSI patients, the percents of densification embryos in single-step culture group were significantly higher than those in sequential culture group (P = 0.001). Moreover, the embryos cultured in sequental culture group were smooth and homogeneous, but the embryos cultured in single-step culture group were rough and granular. Conclusion: There are no significant differences in fertilization and early embryo development between the two culture media systems.

OBJECTIVETo evaluate the clinical efficacy and safety of three-port transumbilical endoscopic cholecystectomy performed using conventional laparoscopic instruments.

METHODSThirty-two patients undergoing three-port transumbilical endoscopic cholecystectomy using conventional laparoscopic instruments (group A) with 3 ports around the umbilicus were compared with 96 patients (group B) receiving the conventional 4-port routine endoscopic cholecystectomy.

RESULTSAll the procedures were successfully completed without conversion to open laparotomy. In group A, the procedures were completed smoothly in 30 cases while 2 cases required another port (5 mm) punctured below the xyphoid due to severe adhesion around the cyst. The median operating time was 39.7∓5.2 min in group A, significantly longer than that in group B (25.3∓3.3 min, P<0.001), but the patients in group A obtained better cosmetic results (P<0.001); the median blood loss, recovery time of postoperative intestine function, length of postoperative hospital stay, and the rate of use of postoperative painkillers were comparable between the two groups. Bile leakage or other postoperative complications occurred in none of cases in the two groups.

CONCLUSIONIn cases without severe adhesion around the cyst, three-port transumbilical endoscopic cholecystectomy using conventional laparoscopic instruments is a safe and feasible alternative to routine endoscopic cholecystectomy with better cosmetic results.

Adult ; Aged ; Aged, 80 and over ; Cholecystectomy, Laparoscopic ; methods ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Umbilicus ; surgery ; Young Adult

Objective To study the cause and management of difficult laparoscopic appendectomy.Method A retrospective analysis of 102 difficult laparoscopic appendectomies was performed. Results The associating factors leading to operative difficulty were as follows:adhesion of peri-appendix in 44 cases,gangrene at root of appendix in 21 cases,special location of appendix in 17 cases,abdominal adhesion in 12 cases,obesity and inflatable intestine in 8 cases. Laparoscopic appendectomy was successfully performed in 96 cases(94.1%,96/102) ,and no intestinal leakage or massive hemorrahge occurred. Conclusions Adhesion of peri-appendix is the most common cause in difficult laparoscopic appendectomy,and gangrene at root of appendix is the most difficult one. Reasonable management for appendix stump contributes to successful operation.

In order to understand the situation of schistosomiasis in Fujian Province, the surveillance and field survey data of 16 counties (cities or districts) were statistically analyzed from 2003 to 2008 according to the national and provincial surveillance protocols. The snail areas were 69 400 m~2 in 2003, and 506 700 m~2 in 2004, then decreased to 57 700 m~2 in 2008 after the snail control in 2005 and 2006. Serological examinations were conducted in 18 000 people, among which 5 412 people were the mobile population from schistosome-endemic areas, and 110 persons were positive, among which 8 persons had eggs and miracidia in their stools, among 7 885 appendix samples, Schistosoma japonicum eggs were found in 8 samples of the patients who came from the o-riginal endemic areas. By the stool examination, 2 709 head of farm cattle in the region with snails were not found infected with Schistosoma japonicum. It is suggested that the areas of residual snails are large and widespread, and the imported patients are found frequently, so the danger of schistosomisis transmission still remains.

Objective To quantify the benefit of primary Pdmor removal in patients with differently presenting incurable coloreetal cancer,while no other therapy combined.Methods One hundred and forty-three consecutive patients were operated for incurable colorectal cancer(91 undergoing resective and 52 non-resective procedures),with the purpose of comparing homogenous populations and of identifying whether the patients got benefit from primary tumor resection.Results In patients with resectable primary tumors,resective procedures were associated with longer median survival than non-resective procedures(10 months vs 3 months),patients with distant spread without neoplastic ascites/implanting metastasis got benefit from primary tumor removal(P＜0.01).The complication of resective procedures was not significantly differ-ent from that of non-resective procedares(P＞0.05).Conclusion Palliative resection of primary colorectal cancer should be pursued in patients with unresectable distant metastasis whenever the primary tumor is technically resectable.

Objective To provide the basis for the differentiation with similar species of intestinal flukes through observing the figure of Haplorchis pumilio. Methods Adults of H. pumilio were collected from the intestine of the cat which was infected with the encysted cercariae of H.pumilio for 45 days. The worms were observed after staining. Eggs and metacercariae of H.pumilio were collected and examined for their shape, size and morphological characteristics. Pseudorasbora parva, the fish host, was examined for the parasitized sites of metacercariae. Results The principal characteristics of the adults is the acetabulum degradation. There are only the genital sucker with 44-48 hamuli. The average measurement of eggs is 31.2?16.7 ?m with a smooth shell. Its aceromion is not evident. The average diameter of metacercariae is 168.5 ?m. There are squamous spines on metacercaria. The metacercariae only parasitize in the muscle between the basis of the fin and the fish body. The average measurement of metacercaria cyst is 445?95?m, with squamous spines on the body surface. Hamuli are found on the genital sucker of metacercaria cyst. Conclusion The morphological figures and parasitic sites of metacercaria, the genital sucker of the adult, and the number and form of the hamulus on the genital sucker provide basis for distinguishing H. pumilio from other intestinal flukes.

Objective]To prove that Fujian Province is also a natural focus of Pagumogonimus veocularis(Pv).[Methods]The adult worms were obtained from a cat fed with Pv metacercariae.[Results]Pv were found in Jianou,Fujian Province.All 1 873 Semisulcospira libertina showed negative.The positive rate of Tricula fujianensis and Erhaia jianouenensis were 0.10%(1/695) and 0.25%(5/2 038), respectively. The main crab host was S.fujianensis.Ps alone and mixed infection with Pv were found in the Sinopotamon ,the infection rates were 36.8%(43/117)and 20.5%(24/117), respectively. The numbers of the metacercariae were 806 and 40, respectively. A cat was infected with 12 metacercariae of Pv , eggs were found in the stool 56 days after infection,and 6 worms were found in the lungs 68 days after infection. [Conclusion]Fujian is one of the natural focus of Pv, cat is the adequate host. The fluke was identified as Pv according to the characteristics of the metacercariae.