Effectiveness of mild ovarian stimulation versus GnRH agonist protocol in women undergoing assisted reproductive technology: a meta-analysis.

OBJECTIVE: our meta-analysis was conducted to evaluate the effectiveness of the mild ovulation induction protocol using CC/gonadotropin/GnRH antagonist compared to the conventional GnRH agonist protocol in women undergoing ART. METHOD: Six electronic databases were searched from their date of establishment until August 2016. Outcomes in our analysis were calculated in terms of relative risk (RR) and weighted mean differences (WMD) and standard mean differences (SMD) with 95% confidence intervals (CI) using random effect models or fixed effect models. RESULTS: Six prospective controlled clinical trials with 1543 women comparing the clinical impacts of the two protocols were included. The synthesized results suggested a significant reduction in the quantity of gonadotropins (SMD: -1.96, 95% CI: -2.28 to 1.64, I2 = 78.5%), the incidence of OHSS (RR: 0.16, 95% CI 0.03-0.86, I2 = 0%) and an increase in the cycle cancelation rate (RR: 1.46, 95% CI 1.05-2.03, I2 = 89.4%). While no evidence of statistically significant differences between the groups existed in the other clinical outcomes. CONCLUSION: This study suggested that the probable benefits of the mild protocol, including its less costs and safer process without reducing the overall IVF treatment success rates, seemed to make it a better treatment option. Larger sample prospective trials evaluating live birth, clinical pregnancy, OHSS, multiple pregnancy incidence and so on were desired to establish.

[Primary Study on Predicting the Termination of Paroxysmal Atrial Fibrillation Based on a Novel RdR RR Intervals Scatter Plot].

Predicting the termination of paroxysmal atrial fibrillation (AF) may provide a signal to decide whether there is a need to intervene the AF timely. We proposed a novel RdR RR intervals scatter plot in our study. The abscissa of the RdR scatter plot was set to RR intervals and the ordinate was set as the difference between successive RR intervals. The RdR scatter plot includes information of RR intervals and difference between successive RR intervals, which captures more heart rate variability (HRV) information. By RdR scatter plot analysis of one minute RR intervals for 50 segments with non-terminating AF and immediately terminating AF, it was found that the points in RdR scatter plot of non-terminating AF were more decentralized than the ones of immediately terminating AF. By dividing the RdR scatter plot into uniform grids and counting the number of non-empty grids, non-terminating AF and immediately terminating AF segments were differentiated. By utilizing 49 RR intervals, for 20 segments of learning set, 17 segments were correctly detected, and for 30 segments of test set, 20 segments were detected. While utilizing 66 RR intervals, for 18 segments of learning set, 16 segments were correctly detected, and for 28 segments of test set, 20 segments were detected. The results demonstrated that during the last one minute before the termination of paroxysmal AF, the variance of the RR intervals and the difference of the neighboring two RR intervals became smaller. The termination of paroxysmal AF could be successfully predicted by utilizing the RdR scatter plot, while the predicting accuracy should be further improved.

A nomogram based on 4-lncRNAs signature for improving prognostic prediction of hepatocellular carcinoma.

PURPOSE: Long noncoding RNAs (lncRNAs) with abnormal expression are frequently seen in hepatocellular cancer patients (HCC). Previous studies have reported the correlation between lncRNA and prognosis processes of HCC patients. In this research, a graphical nomogram with lncRNAs signatures, T, M phases was developed using the rms R package to estimate the survival rates of HCC patients in year 1, 3, and 5. METHODS: To find the prognostic lncRNA and create the lncRNA signatures, univariate Cox survival analysis and multivariate Cox regression analysis were chosen. The rms R software package was used to build a graphical nomogram based on lncRNAs signatures to predict the survival rates in of HCC patients in 1, 3, and 5 years. Using "edgeR", "DEseq" R packages to find the differentially expressed genes (DEGs). RESULTS: Firstly, a total of 5581 DEGs including 1526 lncRNAs and 3109 mRNAs were identified through bioinformatic analysis, of which 4 lncRNAs (LINC00578, RP11-298O21.2, RP11-383H13.1, RP11-440G9.1) were identified to be strongly related to the prognosis of liver cancer (P < 0.05). Moreover, we constructed a 4-lncRNAs signature by using the calculated regression coefficient. 4-lncRNAs signature is identified to significantly correlated with clinical and pathological characteristics (such as T stage, and death status of HCC patients). CONCLUSIONS: A prognostic nomogram on the base of 4-lncRNAs markers was built, which is capable to accurately predict the 1-year, 3-year, and 5-year survival of HCC patients after the construction of the 4-lncRNAs signature linked with prognosis of HCC.

[Applications of blood oxygenation level dependent-functional magnetic resonance imaging, diffusion tensor imaging and intraoperative neurophysiology monitoring in secondary epileptic surgery in M1 area].

OBJECTIVE: To explore the applications of blood oxygenation level dependent-functional magnetic resonance imaging (BOLD-fMRI), diffusion tensor imaging (DTI) and cortical somatosensory evoked potentials (Co-SEP), motor evoked potentials (MEP) and electrocorticogram (ECoG) in secondary epileptic surgery of primary motor area (M1). METHODS: In 19 patients, preoperative BOLD-fMRI were performed to display the relationship between active zone, fiber bundle and epileptogenic lesions. Besides, Co-SEP, MEP and ECoG were also carried out intra-operatively to direct the resection of epileptogenic lesion and epileptogenic focus. At the same time, the nervous functions were protected as much as possible. Then fMRI was performed again to ensure that the post-operative nervous function was excellent. RESULTS: In preoperative BOLD-fMRI and DTI examinations, active zone and fiber bundle could be seen at the edge of lesions (n = 12); range reduced, become deformed or removed (n = 6); glioma epileptogenic lesion was close-up with M1 (n = 1). The central sulcus was confirmed by Co-SEP in all cases. And two cases were inconsistent with anatomical location; Stimulating precentral gyrus, MEP were elicited post-operatively from orbicularis oris, muscle of thenar, hypothenar muscle or flexor digitorum brevis. Under the monitoring of ECoG, spike-wave was monitored in all cases. Of these, epileptogenic focus was in M1 (n = 15). After treatment, spike-wave were reduced significantly or disappeared. At a post-operative follow-up of 6 - 12 months, seizure improvement has achieved Engel III level or above (n = 18). On re-examinations of BOLD-fMRI and DTI, active zone became bigger than before and fiber bundle was symmetric with opposite side. Two of 19 cases had transient motor aphasia incompletely or hemiparesis. No permanent neurological dysfunction occurred. There was no relapse in cases of glioma. CONCLUSION: BOLD-fMRI and Co-SEP, MEP and ECoG are complementary in M1 of secondary epilepsy surgery. It is effective to preserve nervous functions and enhance the quality of life for patients with epilepsy.

[Pharmacology and Clinical Evaluation of Ensartinib Hydrochloride Capsule].

Lung cancer is one of the most common malignancies with the highest incidence rate and mortality rate worldwide, and non-small cell lung cancer (NSCLC) accounts for about 85%. Only 5% NSCLC patients are anaplastic lymphoma kinase (ALK) rearrangement positive NSCLC, but the prognosis of these patients is poor, and treatment is urgent. Ensartinib (X-396), a next-generation ALK tyrosine kinase inhibitor (ALK-TKI), has shown greater potency on inhibiting ALK activity and controlling brain metastases than crizotinib, which is indicated for the treatment of crizotinib-resistant, ALK-positive NSCLC patients. Several phase I to III clinical trials included both healthy volunteers and NSCLC patients have been conducted both in China and abroad. In this review, we briefly summarized the results of these trials, and preliminary efficacy, safety, pharmacology and pharmacokinetics/pharmacodynamics of ensartinib were discussed.