[Clinical characteristics of severe late-onset ovarian hyperstimulation syndrome and its impact on the live birth outcome of IVF-ET].

Objective: To investigate the correlation between different clinical features and live birth in patients with severe late-onset ovarian hyperstimulation syndrome (OHSS) after in vitro fertilization-embryo transfer (IVF-ET). Methods: The clinical information of 330 patients who were pregnant after IVF-ET and referred to medical treatments diagnosed as late-onset severe OHSS in Peking University Third Hospital from January 2016 to December 2020 was retrospectively analyzed. The patients were divided into live birth achieved group (n=287) and non-live birth achieved group (n=43) according to pregnancy outcomes, and live birth achieved group was further divided into two subgroups, full-term birth group (n=222) and early-term birth group (n=65) according to gestational week at delivery for better analysis. Single factor and multi-factor analysis were utilized to clarify the influencing factors of both live birth and early-term birth. Results: Among all the patients who received IVF-ET, the incidence of severe OHSS was 0.67% (673/100 758). Among 330 severe late-onset OHSS patients, 42.4% (140/330) had pleural effusion, the incidence of abnormal liver function was 69.4% (229/330), and the live birth rate was 87.0% (287/330). Among the 287 patients who achieved live birth, 55.4% (159/287) had no pleural effusion, 18.5% (53/287) had a small amount of pleural effusion, and 26.1% (75/287) had medium or massive pleural effusion; in the non-live birth achieved group, there were more patients without pleural effusion and less patients with a small amount of pleural effusion; the difference was statistically significant (χ2=6.213, P=0.045). The rate of selective fetal reduction in live birth achieved group was 16.0% (46/287), which was significantly higher than that in the non-live birth achieved group, which was 2.3% (1/43; χ2=5.749, P=0.017). Multivariate logistic regression analysis revealed that moderately abnormal liver function was an independent risk factor for live birth (OR=3.15, 95%CI: 1.60-6.19), while selective fetal reduction was an independent protective factor for live birth (OR=0.13, 95%CI: 0.02-0.96). Additionally, subgroup analysis suggested that twin birth was an independent risk factor for preterm birth (OR=8.54, 95%CI: 4.31-16.91). Conclusions: Moderate hepatic dysfunction may be associated with adverse pregnancy outcomes in patients with severe late-onset OHSS. Selective fetal reduction and singleton pregnancy are recommended to ameliorate live birth rate, full-term delivery rate, also the maternal and neonatal prognosis for patients with multiple pregnancies.

[Association between plasma selenium and the risk of impaired glucose regulation].

Objective: To investigate the association between plasma selenium exposure and the risk of impaired glucose regulation (IGR). Methods: A case-control study was conducted to select IGR patients who were admitted to the outpatient clinic of the Department of Endocrinology to perform oral glucose tolerance test(OGTT) at the Tongji Hospital affiliated to the Tongji Medical College from September 2004 to 2016 as a case group. Participants with normal glucose tolerance recruited from an unselected group of population undergoing routine health examinations in the same hospital were selected as a control group. The control group was matched according to the age (±5 years old) and sex of the case group. The inclusion criteria for subjects recruited were as follows: age ≥30 years, body mass index (BMI) <40 kg/m(2), no history of a diagnosis of IGR or type 2 diabetes, and no history of receiving pharmacological treatment for hyperlipidemia or hypertension. Patients with any clinically systemic disease such as neurological or endocrine disease, acute illness, chronic inflammatory disease or infectious disease were excluded from the study. A total of 1 957 subjects, 897 in the case group and 1 060 in the control group, were included. Questionnaires were used to collect information of all subjects, and peripheral venous blood was collected after fasting and OGTT, respectively. Plasma selenium, fasting blood glucose, blood lipid (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol) and 2 h OGTT plasma glucose concentration were detected, respectively. The subjects were divided into low, medium and high concentration groups according to the tertiles of plasma selenium concentration in the control group. The multivariate unconditional logistic regression analysis was performed to analyze the association between plasma selenium exposure and IGR. Results: The age (mean±SD) of the case and control group was (53.71±11.38) and (53.95±12.17) years old. The plasma selenium concentration [M (P(25), P(75))] in the case group was 92.81(77.07, 107.05) µg/L, which was significantly higher than the control group [88.73 (77.13, 100.88) µg/L] (P<0.05). The results of multivariate unconditional logistic regression analysis showed that after adjusting for age, sex, BMI, family history of diabetes and hypertension, the risk of IGR was higher in the high-concentration group and the low-concentration group compared with the middle-concentration group, the values of OR (95%CI) were 1.22 (95%CI: 0.94-1.59) and 1.81 (95%CI: 1.42-2.30), respectively. Conclusion: The study suggested a U-shaped association between plasma selenium and IGR.

[Study on the features of Clostridioides difficile infection among diarrhea patients in Kunming from 2018 to 2020].

Objective: We analyze the characteristics of Clostridioides difficile (C. difficile) infection among diarrhea patients in Kunming from 2018 to 2020 and provide evidence for follow-up surveillance and prevention. Methods: A total of 388 fecal samples of diarrhea patients from four sentinel hospitals in Yunnan Province from 2018 to 2020 were collected. Real-time quantitative PCR was used to detect the fecal toxin genes of C. difficile. The positive fecal samples isolated the bacteria, and isolates were identified by mass spectrometry. The genomic DNA of the strains was extracted for multi-locus sequence typing (MLST). The fecal toxin, strain isolation, and clinical patient characteristics, including co-infection with other pathogens, were analyzed. Results: Among the 388 fecal samples, 47 samples with positive reference genes of C. difficile were positive, with a total positive rate of 12.11%. There were 4 (8.51%) non-toxigenic and 43 (91.49%) toxigenic ones. A total of 18 strains C. difficile were isolated from 47 positive specimens, and the isolation rate of positive specimens was 38.30%. Among them, 14 strains were positive for tcdA, tcdB, tcdC, tcdR, and tcdE. All 18 strains of C. difficile were negative for binary toxins. The MLST results showed 10 sequence types (ST), including 5 strains of ST37, accounting for 27.78%; 2 strains of ST129, ST3, ST54, and ST2, respectively; and 1 strain of ST35, ST532, ST48, ST27, and ST39, respectively. Fecal toxin gene positive (tcdB+) results were statistically associated with the patient's age group and with or without fever before the visit; positive isolates were only statistically associated with the patient's age group. In addition, some C. difficile patients have co-infection with other diarrhea-related viruses. Conclusions: The infection of C. difficile in diarrhea patients in Kunming is mostly toxigenic strains, and the high diversity of strains was identified using the MLST method. Therefore, the surveillance and prevention of C. difficile should be strengthened.

[Effect of arteether on Schistosoma japonicum].

NIH mice infected with Schistosoma japonicum cercariae for 3, 7, 14, 21 or 35 d were treated ig either with arteether or artemether at the daily dose of 100-200 mg.kg-1 for 2 d, the efficacy produced by both drugs was similar. The d 7 schistosomules and d 35 adult worms were more susceptible to arteether or artemether with respective worm reduction rates of 77.5%-87.2% and 51.7%-61.3%. Histological and histochemical studies showed that d 7 and d 35 schistosomes, harbored in mice treated with arteether 300 mg.kg-1.d-1 for 2 d appeared in cloudy swelling and vesiculation in the tegument, distension of intestine, apparent decrease or even disappearance of glycogen and inhibition of alkaline phosphatase activity in the tegument and parenchymal tissues, as well as formation of dead worm granuloma.

[Simultaneous determination of Cd2+, Pb2+, Cu2+ and Zn2+ by reversed-phase high performance liquid chromatography].

HPLC was used in the investigation of the reaction behavior of Cd2+, Pb2+, Cu2+ and Zn2+ with mesotetrakis (4-hydroxy-phenyl)porphine (THPP) and chromatographic behavior of their complexes. The reaction and chromatographic separation parameters were optimized and a method for the simultaneous determination of Cd2+, Pb2+, Cu2+ and Zn2+ by reversed-phase high performance liquid chromatography with THPP as pre-column derivatization reagent was established. The metal-THPP complexes formed in 0.1 mol/L borate buffer (pH 10.5) by heating in 60 degrees C water bath for 20 min and were extracted into ethyl acetate-benzene mixture. The metal-THPP complexes and THPP were separated on a Prodigy ODS, 5 microns, 250 mm x 4.6 mm i.d. column with methanol-0.05 mol/L borate buffer(90:10, V/V) (pH 8.0) as eluent and detected at 437 nm (Cd2+ and Zn2+), 465 nm (Pb2+) and 416 nm (Cu2+). The detection limits of the four metal ions in 5 microL injection solution were Cd2+ 0.02 ng, Pb2+ 0.02 ng, Cu2+ 0.02 ng, and Zn2+ 0.12 ng, and the linear ranges were Cd2+ 8 ng-1.5 micrograms, Pb2+ 8 ng-3.0 micrograms, Cu2+ 8 ng-5.0 micrograms, and Zn2+ 50 ng-10 micrograms in 10 mL reaction solution. The intra-day repeatability (as RSDs) was in the range of 2.8%-4.8% and the inter-day reproducibility was in the range of 3.7%-9.7%.

[Comparative studies on histological and histochemical alterations of Schistosoma japonicum induced by arteether and artemether].

Mice infected with 100 and 50 Schistosoma japonicum cercariae for 7 and 35 d respectively were treated with im artemether 100 mg.kg-1.d-1 or arteether 100 and 300 mg.kg-1.d-1 for 2 d. The mice were killed at different intervals within 28 d after medication and the livers were sectioned for histological and histochemical observations. The results showed that both artemether and arteether caused degeneration in the tegument, intestine and genital gland of the hepatic-shifted worms. The glycogen content and alkaline phosphatase (AKP) activity of schistosomula and adult worms decreased 7 d after treatment, especially remarkable in arteether 300 mg.kg-1.d-1 group.