In the study of embryo development process, the morphological features at different stages are essential to evaluate developmental competence of the embryo, which can be used to optimize and improve the system for
Blastocyst ; Embryo Culture Techniques ; Embryonic Development ; Fertilization in Vitro

Objective To compare the sonographic features as well as clinical histopathological features of follicular variant papillary thyroid carcinoma(FVPTC) and conventional papillary thyroid carcinoma (CPTC) in pediatric patients.Methods From Jan.2006 to Dec.2017,26 FVPTC patients and 82 CPTC patients were enrolled in this study.The clinical histopathological findings and the sonographic features were compared between the two groups.FVPTCs and CPTCs were divided into PTC-like and follicular neoplasm(FN)-like based on sonographic characteristics.Results The mean nodule size of FVPTCs was larger than that of conventional PTCs.Extrathyroid invasion and cervical lymph node metastasis did not have significant difference between CPTC and FVPTC patients(53.8％ vs 62.2％ and 76.9％ vs 82.9％,respectively).Multiple nodules(P=0.000)and distant pulmonary metastases(P=0.024) were more frequent in CPTCs than in FVPTCs(P＜0.05).The rate of an ill-defined margin (P=0.000) and calcification (P=0.003)in terms of sonographic features were lower in FVPTCs than conventional PTCs(P＜0.05).A Ⅴ+Ⅵ diagnosis of PTC on FNAC of FVPTCs was less common than that of conventional PTCs (P=0.014).Multifocality(P=0.000),extrathyroidal invasion (P=0.000),and lymph node metastasis (P=0.000) were significantly different between PTC-like FVPTCs and FN-like FVPTCs.Conclusion FVPTC in children and adolescents shows a relatively larger size,more benign sonographic features,and a lower diagnostic rate of PTC by FNAC compared with conventional PTCs in pediatric patients.

Objective To screen for and identify targets of let-7a microRNA (miRNA) in A375 melanoma cells by using isobaric tags for relative and absolute quantitation (iTRAQ) technology,and to explore mechanisms underlying the tumor-suppressing effect of let-7a.Methods Cultured A375 cells were classified into two groups to be transfected with 100 nmol/L hsa-1et-7a mimics (hsa-let-7a mimics group) or negative control mimic (NC group).After 54-hour incubation,A375 cells were collected and total proteins were collected.iTRAQ technology was used to analyze and identify differentially expressed proteins,bioinformatic analysis was performed to assess let-7a candidate targets and their functions,and a dual-luciferase reporter system was utilized to verify let-7a targets.Results As mass spectrometry showed,a total of 327 differentially expressed proteins were identified in the hsa-1et-7a mimics group compared with the NC group,including 151 up-regulated proteins with iTRAQ ratio ＞ 1.2 and 176 down-regulated proteins with iTRAQ ratio ＜ 0.8.Of 176 down-regulated proteins,47 were predicted as miRNA targets by the miRWalk software.The dual-luciferase reporter system showed that the relative luciferase activity of the 3' untranslated region (UTR) of the wild-type HMGA2 and THOC2 genes were reduced by 64.3％ and 46.4％,respectively,in the hsa-1et-7a mimics group compared with the NC group.Conclusion A total of 47 candidate let-7a targets were screened out in A375 melanoma cells by using iTRAQ technology and bioinformatic analysis,and HMGA2 and THOC2 genes were identified as direct targets of let-7a.

Primary biliary cholangitis is an organ-specific chronic cholestatic autoimmune liver disease characterized by intrahepatic cholestasis, presence of anti-mitochondrial antibody in circulating blood, and progressive and non-suppurative damage of small intrahepatic bile ducts, which finally lead to extensive hepatic duct damage, biliary cirrhosis, and even liver failure. This article overviews the advances in the epidemiology, pathogenesis, diagnosis, and treatment of primary biliary cholangitis and points out that the safety and efficacy of the new drugs such as fibrates in the treatment of primary biliary cholangitis need to be confirmed by further studies.

Objective To study the influence of treatment communication on negative emotions and self-efficacy of patients with cerebral infarction. Methods A total of 98 unrelated patients with cerebral infarction in neurology department in the period between September 2013 and February 2015, in accordance with the random number table, were divided into treatment group ( 48 cases with treatment communication ) and control group(50 cases with normal communication). The change of negative emotions and self-efficacy at 10 days after intervention were collected and compared.Results High, medium and low self-efficacy status in the treatment group were 31.25%, 54.17% and 14.58%, respectively, which was obviously superior to the control group with 14.00%, 34.00% and 52.00%(P<0.05). The SDS and SAS scores were(43.31±4.37),(43.46± 4.95)in the treatment group, which were significantly lower than(48.16±3.23),(46.34±3.19) of the control group(P<0.05).Conclusions The implementation of treatment communication is conducive to improve the self-efficacy of patients with cerebral infarction and relieve depression and anxiety. It is of great significance to improve the physical and mental health of patients.

Objective To create a three-dimensional speckle tracking imaging (3DSTI) multiparameter analysis model to improve the diagnostic efficiency of obstructive coronary artery stenosis.Methods One hundred and four patients with chest pain were divided into two groups:coronary heart disease(CHD) group (61 patients) and control group (43 patients) according to the result of selective coronary angiography (SCA).The two groups' clinical data and echocardiographic parameters were aquired,including mitral flow E and A velocities,E peak deceleration time,isovolumic relaxation time (IVRT),mitral annulus velocity e' and a' peak in diastolic and s' peak in systolic by tissue Doppler imaging (TDI),and left ventricular ejection fraction (LVEF).The global longitudinal peak strain (2D-GLPS) by two dimensional speckle tracking,global longitudinal peak strain (3D-GLPS),circumferential peak strain(3D-GCPS),radial peak strain (3D-GRPS) and area peak strain (3D-GAPS) were acquired.Results For conventional parameters,there were no significant difference between the two groups.Compared with control group,TDI e' peak,3D-GRPS decreased,significantly E/e',2D-GLPS,3D-GLPS,3D-GAPS,3D-GCPS increased significantly (P ＜0.01).For single parameter,area under the ROC curve (AUC) were successively 3D-GAPS(0.766) ＞ 3D-GLPS(0.746) ＞ 2D-GLPS(0.746) ＞3D-GRPS(0.727) ＞ s' (0.703) ＞E/e' (0.688)＞3D-GCPS(0.686).AUC for single and multi technology were successively p-Union(0.856)＞p-3DSTI(0.772) ＞ p-TDI (0.757) ＞ p-2DSTI (0.746).Conclusions 3DSTI together with multi-parameter analysis model can significantly improve the diagnostic efficiency of obstructive coronary artery stenosis.Area strain is an independent predictor of obstructive coronary artery stenosis.

OBJECTIVE:To consolidate the results of special antibacterial drug rectification so as to improve the rational medi-cation of antibacterial drugs. METHODS:By using the method of retrospective analysis,the antibacterial drug application data in 2011(before rectification and initial stage of rectification),2012(middle stage thereof)and 2013(later stage thereof)were sum-marized,compared and analyzed. RESULTS:After special rectification(Jan. 2011 vs. Dec. 2013),the utilization rate of antibacte-rial drugs in perioperative period for class I incision decreased from 80.42% to 24.49%. That of antibacterial drugs in emergency treatment decreased from 53.79% to 36.23%. The examination rate of microbial samples in inpatients who would use special-grade antibacterial drugs increased from 16.12% to 94.17%. The use intensity of antibacterial drugs by inpatients decreased from 70.28 DDDs/(100 persons·d) to 27.44 DDDs/(100 persons·d). The utilization rate of antibacterial drugs by inpatients decreased from 65.99% to 46.45%. CONCLUSIONS:Special rectification has remarkable effects on rational clinical application of antibacterial drugs. Regulation and evaluation should be strengthened to maintain the effects and continuously improvement should be made.

Objective To evaluate left ventricular systolic synchronicity in patients with dilated cardiomyopathy by V-plane imaging and compare with clinical commonly used tissue Doppler imaging (TDI),evaluate the relevance and consistency between these two parameters.Methods 20 patients diagnosed with DCM and 20 healthy controls were enrolled,2D images,V-plane imaging and TDI waveform were acquired.Time to peak velocity of left ventricular 12 segments were measured by TDI and the standard deviation (TDI_SD) were calculated.Displacement time to peak were measured by V-plane and the standard deviation (V-plane_SD) were calculated.Results Compared with control group,TDI_SD and V-plane_SD increased significantly (P ＜ 0.01),TDI time to peak increased and V-plane time to peak decreased significantly(P ＜0.01).In the two group,12 segment time to peak measured by V-plane were significantly higher than TDI(P ＜ 0.01).There was a significant correlation between TDI_SD and V-plane_SD (r =0.925,P ＜0.001).Bland-Altman plot showed that 95％ plots of ratio of TDI_SD and V-plane_SD were among limits of agreement,which was (0.50,1.36).Conclusions Left ventricular systolic synchronicity in DCM patients can be observed by V-plane imaging.V-plane has significant relevance and consistency with TDI,and can overcome the limitations of TDI that 12 segments can not be displayed in the same cardiac cycle.

Objective To investigate the level and influencing factors of falls efficacy among older patients with type 2 diabetes (T2DM) .Methods A total of 218 older patients with T2DM were investigated by the modified falls efficacy scale(MFES) and Morse Fall Scale (MFS) ,questionnaire and observation were both used .Results The average score of falls efficacy was 8 .15 ± 2 .91 .The scores were lowest in the items of walking up and down stairs and going to bed and getting out of bed ,and highest were in the items of dressing and sitting down and standing up from a chair .The multivariate linear regression analysis showed that dura‐tion of diabetes ,diabetic complications and fall history were the main factors influencing their falls efficacy .Conclusion Falls in eld‐erly T2DM patients were in the medium level ,and it′s closely related with duration of diabetes ,its complications and fall history .

Objective To observe and care Ahmed glaucoma valve implantation early postoperative complications for diabetic patients with neovascular glaucoma , hoping to reduce complications and all its implications hazard .Methods The clinical data of 38 patients ( 38 eyes ) with diabetic neovascular glaucoma who underwent Ahmed glaucoma valve implantation were observed and targeted treatments .Results Among 38 patients (38 eyes) with diabetic neovascular glaucoma , there were 7 cases (7 eyes) with ocular hypotension and shallow anterior chamber , 4 cases ( 4 eyes ) with transient ocular hypertension , 12 cases ( 12 eyes ) with hyphema, 2 cases (2 eyes) with valve tube blockage in the early postoperative .Compared postoperative intraocular pressure with that of preoperative , intraocular pressure was decreased with the average decline (34.17 ±14.99)mmHg.There were 11 cases (11 eyes) with improved vision, one case (one eye) with decreased vision, and 26 cases (26 eyes) with stable vision.Conclusions Blood sugar of stability control in perioperative , patient psychological counseling , individualized treatment of intraoperative and timely detection of postoperative complications to give the right treatment and care with the doctors , can get a more satisfactory clinical efficacy .