Objective:To investigate the effect of different schemes of intrauterine insemination (IUI) on pregnancy outcome in patients with unexplained infertility.Methods:The clinical data of 393 cases (934 cycles) with unexplained infertility patients who underwent IUI from March 2016 to August 2018 in Dalian Maternal and Child Health Hospital were retrospectively analyzed. The patients were divided into natural cycle group (402 cycles) and promote ovulation cycle group (532 cycles). In promote ovulation cycle group, the patients were divided into clomiphene (CC) subgroup (124 cycles), letrozole (LE) subgroup (107 cycles), menotropins (HMG) subgroup (87 cycles), CC + HMG subgroup (103 cycles), LE + HMG subgroup (111 cycles). The pregnancy outcomes of each group were compared.Results:The clinical pregnancy rate and live birth rate in promote ovulation cycle group were significantly higher than those in natural cycle group: 14.10% (75/532) vs. 9.20% (37/402) and 11.28% (60/532) vs. 7.21% (29/402), and there were statistical differences ( P<0.05). There were no statistical differences in abortion rate, ectopic pregnancy rate and twin pregnancy rate between 2 groups ( P<0.05). Ovarian hyperstimulation syndrome occurred in 7 cycles, all of which were in CC + HMG subgroup. The clinical pregnancy rate and live birth rate in LE subgroup, HMG subgroup, CC + HMG subgroup and LE + HMG subgroup were significantly higher than those in CC subgroup: 11.21% (12/107), 13.79% (12/87), 16.50% (17/103), 21.62% (24/111) vs. 8.06% (10/124) and 7.48% (8/107), 11.49% (10/87), 13.59% (14/103) and 20.72% (23/111) vs. 4.03% (5/124), the abortion rate was significantly lower than that in CC subgroup: 3/12, 1/12, 2/17 and 1/24 vs. 5/10; the clinical pregnancy rate and live birth rate in HMG subgroup, CC + HMG subgroup and LE + HMG subgroup were significantly higher than those in LE subgroup, the abortion rate was significantly lower than that in LE subgroup, and there were statistical differences ( P<0.05). Conclusions:When the patients with unexplained infertility are assisted by IUI, LE combined with HMG ovulation induction can achieve a better pregnancy outcome.

Objective To analyze the clinical features of patients with acute ST-elevation myocardial infarction treated with percutaneous coronary intervention (PCI) complicating to intraoperative reperfusion arrhythmias (RA).Methods A total of 175 patients with acute ST-elevation myocardial infarction were treated with PCI performed from January 2008 to September 2013.According to the occurrence of RA following PCI,the patients were divided into RA group and non-RA (NRA) group.Comparison of myocardial enzymes,peak troponin,the elevated ST segment returning back,length of hospital stay,incidence of adverse events such as cardiac death,shock,heart failure during hospitalization and within a month of postoperative period was carried out between groups,and the findings from echocardiography on the 30th day after PCI were also compared between two groups.Results PCI time window in RA group was significantly earlier than that of NRA group,and reperfusion arrhythmia was effectively controlled.Compared with NRA group,RA group had greater extent of ST segment normalized,and tbe incidence of adverse events was lower.On the 30th day after PCI,RA group had shorter duration of left ventricular diastole,and reduced left ventricular cavity dimensions and higher ejection fraction (LVEF) value.Conclusions Reperfusion arrhythmias occur immediately after PCI in patients with acute myocardial infarction,but as long as the PCI carried out timely,the prognosis is good.

Objective To study the prognostic value of fragmented QRS (fQRS) in the recurrence of cardiac events in acute STEMI patients underwent emergency percutaneous coronary intervention (PCI). Methods Ninety-two acute STEMI patients who underwent emergency PCI were enrolled. The presence of fQRS was evaluated by a 12-lead ECG in 72 h after PCI. Cardiac events (myocardial infarction, need for revascularization or cardiac death) and all-cause mortality were recorded in all patients during 12 months follow-up. Results Cardiac event rate[15 (31.3%) vs. 4 (9.1%)]were higher in the fQRS group (n=48) compared with the non-fQRS group (n=44) during a mean follow-up of 12 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events in the fQRS group (P < 0.004). The results of Cox regression model analysis revealed that signiifcant fQRS was an independent signiifcant predictor for cardiac events (HR 2.19, 95%CI 1.38-3.50, P=0.023). Conclusions The presence fQRS is an independent risk factor for poor prognosis in STEMI patients undergoing emergency PCI.

OBJECTIVE: To provide clinical reference by summarizing and analyzing characteristics, therapeutic principles and methods for special cases of esophageal foreign bodies. METHOD: Statistical analysis 182 cases with esophageal foreign bodies, including 41 special cases. Surgery 165 cases, 17 cases without surgery. RESULT: One hundred and seventy-five cases were cured, 7 cases improved. Hospitalization time 0.5-50 d (average 4.5 d). CONCLUSION It is important to learn about characteristics of esophageal foreign bodies, therapeutic principles and methods for special cases, and it's a key point to diagnosis early and remove the foreign bodies as soon as possible, and comprehensive treatment measures are really effective to process special cases.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Esophagus ; Female ; Foreign Bodies ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To evaluate the clinical effect of the cannulated screw fixation in treatment of the dens fracture under locational guidance. Methods The study involved 27 patients treated with the cannulated screw fixation under locational guidance from January 2005 to January 2009.There were 19 patients with type II fracture and eight with type light m fracture.The lateral and open mouth position X-ray examination of the cervical ventebrae was done to observe the fracture healing. Results The operation lasted for a range of 40 minutes to 1.3 hour (average 1.0 hour),which showed no any complications.The patients were followed up for average 6.5 months(3-12 months),which showed sound fracture healing in 26 patients but nonhealing in one. Conclusion The cannulated screw fixation for treatment of the dens fracture under locational guidance is characterized by easy operation,minor trauma and satisfactory outcome.

OBJECTIVE: Summarize the treatment skills of esophagus perforation caused by esophageal foreign bodies. METHOD: Retrospectively analyze the seven cases of esophagus foreign body perforation with various complications in our department. RESULT: Six cases recovered in 3 to 18 days after operation, on average 14.2 day, while one case recovered in 49 days by conservative method. CONCLUSION Foreign bodies removing, fistulae repairing, abscess incising, effusion rinsing, effective antibiotics administrating and support treatment are effective to treat esophagus perforation caused by esophageal foreign bodies. It will take a relative long time to be treated only by conservative way.
Adult ; Aged ; Esophageal Perforation ; diagnosis ; etiology ; therapy ; Esophagus ; Female ; Foreign Bodies ; complications ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.

In order to know the effects of caloric stimulation on neuronal firing in medial vestibular nuclei (MVN) by middle ear irrigation, the middle ear was irrigated with ice (4 degrees C), hot (44 degrees C), and warm (37 degrees C) water, and the firing rate of MVN neuron was extracellularly recorded. The results showed that the firing rate of MVN neuron was changed by caloric stimulation, and the majority of MVN neurons showed excitation by irrigation with hot water and inhibition by ice water (type A). The neuronal firing was recovered immediately after the cessation of the stimulation. I It was concluded that the neuronal firing rate in MVN was changed by caloric stimulation in middle ear cavity. The response was different in various neurons.
Animals ; Cold Temperature ; Ear, Middle ; Electrophysiology ; Endolymph ; physiology ; Female ; Hot Temperature ; Male ; Neurons ; classification ; physiology ; Rats ; Rats, Wistar ; Therapeutic Irrigation ; Vestibular Nerve ; physiology ; Vestibular Nuclei ; physiology

In order to know the effects of caloric stimulation on neuronal firing in medial vestibular nuclei (MVN) by middle ear irrigation, the middle ear was irrigated with ice (4 degrees C), hot (44 degrees C), and warm (37 degrees C) water, and the firing rate of MVN neuron was extracellularly recorded. The results showed that the firing rate of MVN neuron was changed by caloric stimulation, and the majority of MVN neurons showed excitation by irrigation with hot water and inhibition by ice water (type A). The neuronal firing was recovered immediately after the cessation of the stimulation. I It was concluded that the neuronal firing rate in MVN was changed by caloric stimulation in middle ear cavity. The response was different in various neurons.
Cold ; Ear, Middle ; Electrophysiology ; Endolymph/physiology ; Heat ; Irrigation ; Neurons/classification ; Neurons/physiology ; Rats, Wistar ; Vestibular Nerve/*physiology ; Vestibular Nuclei/*physiology

Objective To explore the therapeutic effect of different postoperative chemotherapy and administration pathways in primary hepatocellular carcinoma (PHC) patients with portal vein tumor thrombus (PVTT). Methods 60 PHC patients with PVTT were divided into A, B, C and D groups. A group was treated by transcatheter arterial chemo-embolization (TACE); B group was treated by TACE and portal vein intubation(PVI) with quick intravenous injection; C group was treated by TACE and PVI with slow infusion controlled by computer; and D group was treated by hepatic arterial intubation chemo-embolization (HAI) and PVI with slow infusion controlled by computer. Results The survival rate among groups A, B and C had a significant difference (P0.05). Conclusion PHC patients with PVTT could be treated by both hepatic arterial chemotherapy and portal vein chemotherapy throug portal vein continuous infusion. TACE or HAI was suitable for postoperative chemotherapy.