[Analysis of factors affecting live birth outcome of frozen-thawed embryo transfer cycle].

Objective: To analyze the related factors affecting the success of frozen-thawed embryo transfer (FET). Methods: A total of 563 couples treated in the Reproductive Medicine Center of Guangdong Hospital of Traditional Chinese Medicine from January 2017 to March 2020 were selected as subjects. A total of 736 FET cycles were included to analyze the live birth outcomes of FET. Pregnancy outcomes, pregnancy complications and embryo status of patients between the live birth group and the non-live birth group were compared. A multivariate logistic regression model was used to evaluate the association between the 15 candidate factors and live birth outcomes for identifying independent factors associated with the live birth outcomes of the FET. Results: Among the enrolled subjects, the men were (33±5) years old at sperm extraction while the women were (31±4) years old at ovum pick-up (OPU) and (32±4) years old at embryo transfer (ET) and their infertility duration were (3.5±2.6) years. There were 333 (45.2%) live birth cycles and 403 (54.8%) non-live birth cycles in the 736 FET cycles. Pregnancy complications occurred in 49 cases (14.7%) of the live birth group. The age of the women at ET ((31±4) vs (32±4) years), the age of the women at OPU ((30±4) vs (32±4) years) and the age of the men at sperm extraction ((33±4) vs (34±5) years) in the live birth group were all lower than those in the non-live birth group. The infertility duration was shorter ((3.2±2.2) vs (3.6±2.8) years), and the proportion of primary infertility was higher ((63.1%, 210 cases) vs (49.6%, 200 cases)) in the live birth group (P<0.05) than those in the non-live birth group. Multivariate logistic regression analyses showed that the age of woman at ET (OR (95%CI): 0.50 (0.27-0.92), P=0.026), the types of infertility (0.62 (0.43-0.88), P=0.008), the numbers of optimal embryos transferred (1.60(1.11-2.31), P=0.012), and the types of embryos transferred (2.43 (1.46-4.01), P=0.001) were statistically significant related factors for live birth outcome of FET. Conclusion: The age of the woman at ET, the types of infertility, the numbers of optimal embryos transferred and the types of embryos transferred are associated factors for the outcomes of live birth after FET.

[Navigation-guided nasal endoscopy for removal of the cavernous hemangioma of the orbital apex through the sphenoid approach].

Objective: To explore the feasibility of navigation-guided nasal endoscopy for removal of the cavernous hemangioma of the orbital apex through the sphenoid approach. Methods: Retrospective case series study. From May 2012 to December 2019, 12 patients (12 eyes) with imaging findings of cavernous hemangioma in the orbital apex were collected at the Eye Hospital Affiliated to Nanchang University, including 3 males and 9 females aged 32 to 59 years. All patients underwent navigation-guided sinusoscopy through the sphenoid approach to remove the cavernous hemangioma of the orbital apex (video attached). Changes of visual function and complications after operation were analyzed. Results: In 3 patients without visual impairment, the postoperative visual function was still normal. Among the remaining 9 patients with preoperative visual impairment, visual function was fully recovered in 3 patients after operation, was improved in 2 patients, and had no change in 4 patients. There were no complications in 3 of the 12 patients, and 9 patients had transient, mildly limited intraocular rotation with diplopia after operation, which all returned to normal within 1 month. Conclusion: Navigation-guided sinus endoscopy through the sphenoid approach is effective and feasible in the removal of the cavernous hemangioma of the orbital apex. (Chin J Ophthalmol, 2021, 57: 837-843).

[Application of three-dimensional printing combined with surgical navigation and endoscopy in orbital fracture reconstruction].

Objective: To evaluate the clinical effect of three-dimensional printing combined with surgical navigation and endoscopy for orbital fracture reconstruction. Methods: A case series study. Twenty-eight patients (28 eyes) with orbital fractures (20 males and 8 females, aged 10-61 years, with simple orbital fractures in 22 patients and composite orbital fractures in 6 patients) were treated with three-dimensional printing combined with surgical navigation and endoscopy for orbital fracture reconstruction at Affiliated Eye Hospital of Nanchang University from July 2016 to June 2018. With the help of three-dimensional printed models and guides, navigation positioning guidance and endoscopic visualization performance, the soft tissue incarcerated in the orbital fracture area was loosened, and the repair material was implanted (video attached). Postoperative follow-up was conducted at 1 week and 3 months. The follow-up observation included the best corrected visual acuity, diplopia, dyskinesia of the eyes, enophthalmos, and orbital volume. The data were analyzed by the paired t-test, Wilcoxon and the Mann-Whitney U rank sum test. Results: The best corrected visual acuity before and 1 week after surgery was 4.714±0.400 and 4.732±0.377, respectively, and the difference was not statistically significant (t=1.724, P=0.096). The enophthalmos before and 1 week after surgery was 2.2 (2.0-5.0) mm and 0.3 (0.0-2.3) mm, respectively, and the difference was significant (Z=-4.604, P<0.01). The orbital volume before and 1 week after surgery was 2 008.10 (6.84-11 200.00) mm(3) and 478.76 (5.01-7 286.00) mm(3), respectively, and the difference was statistically significant (Z=-3.735, P<0.01).The preoperative diplopia degree was 0, Ⅰ, Ⅱ, and Ⅲ in 14, 11, 3, and 0 eyes, while the degree of diplopia 3 months after surgery was 0, Ⅰ, Ⅱ, and Ⅲ in 22, 6, 0, and 0 eyes, respectively. The difference was statistically significant (Z=-2.359, P=0.018). The preoperative dyskinesia degree of the eyes was 0, Ⅰ, Ⅱ, and Ⅲ in 11, 11, 3, and 3 eyes, while the dyskinesia degree of the eyes 3 months after surgery was 0, Ⅰ, Ⅱ, and Ⅲ in 23, 5, 0, and 0 eyes, respectively. The difference was statistically significant (Z=-3.456, P=0.001). No implant infection, displacement, and other serious complications were observed during the follow-up of 3 to 12 months. Conclusions: Three-dimensional printing technology combined with nasal endoscopy and surgical navigation, which is applied in the reconstruction of orbital fracture, can significantly improve the symptoms of diplopia, ocular dyskinesia, and ocular depression. It is a feasible assistant method. (Chin J Ophthalmol, 2019, 55: 658-664).

[Analysis of the effect of different surgical methods on the cavernous hemangioma of the deep orbit].

Objective: To explore the effect of the surgical removal of orbital deep cavernous hemangioma following the concept of minimal surgical invasion. Methods: Retrospective case series study. Sixty-three cases with surgical removal of deep orbital cavernous hemangioma were collected in the Affiliated Eye Hospital of Nanchang University from May 2012 to August 2015. There were 29 males and 34 females. The age was from 17 to 69 years with mean age (45±11) years.The surgical methods the conjunctival approach orbital surgery, lateral orbital surgery, medial skin orbital surgery, lateral orbital conjunctiva conjunctival pathway and endoscopic nasal approach were chosen for different cases. The visual acuity, visual field and electrophysiological examination were analyzed before and after operation. Result: Sixty-three patients underwent complete surgically removal of the tumor. Among them, 32 cases were conducted by conjunctival approach, 24 cases had improved visual acuity, 5 cases had no change of visual acuity, 3 cases had decreased visual acuity. Seventeen cases performed with lateral open orbital surgery had improved visual acuity in 11 cases, no change in visual acuity in 3 cases and decreased visual acuity in 3 cases postoperatively. Six cases with approach of the medial orbital surgery had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Six cases with approach of outside open orbital surgery combined with medial conjunctival pathway had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Two cases performed with endoscopic nasal approach. One of them had normal visual function and no change after surgery. Another had impaired visual function pre-operatively and it came back to normal postoperatively. Conclusions: With the concept of minimal surgical invasion, the choice of appropriate surgical approach can save patients with the greatest degree of visual function and even improve the visual function of the patients with orbital cavernous hemangioma. (Chin J Ophthalmol, 2017, 53: 288-293).

A comparison of clinical outcomes between healthcare-associated infections due to community-associated methicillin-resistant Staphylococcus aureus strains and healthcare-associated methicillin-resistant S. aureus strains.

There are limited data examining whether outcomes of methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated infections (HAIs) are worse when caused by community-associated (CA) strains compared to HA strains. We reviewed all patients' charts at our institution from 1999 to 2009 that had MRSA first isolated only after 72 h of hospitalization (n=724). Of these, 384 patients had a MRSA-HAI according to CDC criteria. Treatment failure was similar in those infected with a phenotypically CA-MRSA strain compared to a phenotypically HA-MRSA strain (23% vs. 15%, P=0.10) as was 30-day mortality (16% vs. 19%, P=0.57). Independent risk factors associated with (P<0.05) treatment failure were higher Charlson Comorbidity Index, higher APACHE II score, and no anti-MRSA treatment. These factors were also associated with 30-day mortality, as were female gender, older age, MRSA bloodstream infection, MRSA pneumonia, and HIV. Our findings suggest that clinical and host factors, not MRSA strain type, predict treatment failure and death in hospitalized patients with MRSA-HAIs.

Effects of diets with different energy and bile acids levels on growth performance and lipid metabolism in broilers.

This experiment was conducted to evaluate the effects of bile acids (BAs) on the growth performance and lipid metabolism of broilers fed with different energy level diets. 480 one-day-old Arbor Acres broilers (45.01 ± 0.26 g) were allotted to a 2 × 2 factorial design with 2 levels of energy (basal or high-energy level) and 2 levels of BAs (with or without BAs supplementation), resulting in 4 groups of 8 replicates; the experiment lasted 42 d. High-energy diets decreased the feed/gain ratio (F/G) from 1 to 21 d (P < 0.05), and increased the liver index and abdominal fat percentage at 42 d (P < 0.05). The serum total triglyceride (TG) and high-density lipoprotein cholesterol at 42 d were increased by high-energy diets (P < 0.05), while the hepatic lipoprotein lipase (LPL) activity at 21 and 42 d was decreased (P < 0.05). BAs supplementation increased the body weight at 21 d and decreased the F/G during entire period (P < 0.05), as well as improved the carcass quality reflected by decreased abdominal fat percentage at 42 d and increased breast muscle percentage at 21 and 42 d (P < 0.05). The serum TG at 21 and 42 d were decreased by BAs (P < 0.05), and the hepatic LPL activity at 42 d was increased (P < 0.05). In addition, high-energy diets increased the expression of sterol regulatory element binding transcription factor 1, acetyl-CoA carboxylase, and fatty acid synthase (P < 0.05), while BAs diets decreased these genes expression (P < 0.05). Moreover, BAs supplementation also increased the expression of carnitine palmitoyltransferase 1 (P < 0.05), which was increased in high-energy groups (P < 0.05). In conclusion, BAs supplementation could increase growth performance, elevate carcass quality, and improve lipid metabolism in broilers.

Curcumin attenuates heat-stress-induced oxidant damage by simultaneous activation of GSH-related antioxidant enzymes and Nrf2-mediated phase II detoxifying enzyme systems in broiler chickens.

The object of this study was to investigate the effect of curcumin on modulating the glutathione (GSH)-related antioxidant enzymes and antioxidant responses via NF-E2-related factor 2 (Nrf2) signaling pathway in heat-stressed broiler chickens. A total of 400 one-day-old male Arbor Acres broiler chicks was reared in an environmentally controlled room. At 21 d, broiler chicks were divided into 5 treatment groups and were fed one of 4 diets under 2 temperature conditions: 22°C + a basal diet (CON treatment); 34°C for 8 h (0900-1700) + a basal diet supplemented with 0, 50, 100, or 200 mg/kg curcumin (HS, CMN1, CMN2, and CMN3 treatments, respectively). The heat treatment lasted for 20 consecutive days. The results showed that heat stress significantly increased (P < 0.05) the weekly rectal temperature and average head and feet temperature. Compared to the HS treatment, feed conversion was significantly decreased (P < 0.05) in CMN1 and CMN2 treatments. CMN1 administration significantly improved (P < 0.05) the pH24 of muscle. The abnormal changes of serum malonaldehyde and corticosterone concentrations were prevented (P < 0.05) by curcumin. Mitochondrial GSH concentration in the liver was significantly increased (P < 0.05) in CMN1 and CMN2 treatments compared with the HS treatment. The CMN1, CMN2, and CMN3 supplementations significantly increased (P < 0.05) γ-GCL, GSH-Px, and GST activities. Curcumin significantly increased (P < 0.05) the expression of Nrf2, HO-1, and γ-GCLc in the liver as compared to the CON diet. The expression of Cu/ZnSOD and CAT were increased (P < 0.05) by feeding CMN2, respectively, as compared to the HS treatment. It was concluded that curcumin supplementation enhanced the resistance of broilers to heat stress, as evidenced by reversing the FC, increasing the GSH content and GSH-related enzyme activities, and inducing the expression of Nrf2 and Nrf2-mediated phase II detoxifying enzyme genes.

Whole-cell immobilization using cell surface-exposed cellulose-binding domain.

Specific adhesion of Eshcherichia coli with surface-exposed cellulose-binding domain (CBD) to cellulosic materials was investigated. Whole-cell immobilization was very specific, forming essentially a monolayer of cells onto the different supports. Cells with surface-exposed CBD bound specifically and tightly to cellulose supports at a wide range of pH. In contrast to CBD, which shows the highest binding to cellulose at 4 degrees C, highest cell loading was observed at 37 degrees C. The extent of immobilization was dependent on the amount of surface-exposed CBD. Cells binding increased with increasing amount of CBD until binding was saturated. Even induction of very low level of CBD (0.05 mM IPTG) was sufficient to provide specific and tight binding to cellulose support. Because optimal binding can be obtained under physiological conditions such as pH 7 and 37 degrees C, the results demonstrate the general utility of surface-exposed CBD as an efficient means of whole-cell immobilization.

Longitudinal observation of pediatric hand and wrist ganglia.

The purpose of this study was to examine the behavior of ganglia of the hand and wrist in young children treated without surgery. Fourteen consecutive children, less than 10 years of age, who presented with cysts of the hand and wrist were followed up by a single surgeon. The average age of the patient at the time of diagnosis was 38 months (range, 2 months to 9 years 3 months). The masses included 7 retinacular cysts, 5 volar wrist ganglia, and 2 dorsal wrist ganglia. These cysts had been present for an average of 3.3 months (range, 1-12 months) before medical advice was sought. None of the cysts were painful. Follow-up averaged 33 months (range, 9-112 months), with 79% of all cysts spontaneously resolving, the majority within a year. We believe that a child presenting with a benign hand lesion characteristic of a ganglion cyst should initially be treated by observation.

Pseudoaneurysm of the ulnar artery occurring after fracture of the distal radius and ulna: a case report.

A case of pseudoaneurysm of the ulnar artery occurring after distal radius and ulna fracture is presented. This case illustrates an uncommon complication following a fairly common injury.

One-bone forearm fusion for pediatric supination contracture due to neurologic deficit.

The purpose of this study was to review the construction of a one-bone forearm performed to change the position of the forearm in children with fixed supination deformity due to upper extremity neurologic deficit. The one-bone forearm arthrodesis has been previously described in treating trauma, tumors, infection, and congenital deformities. It has not been described to improve forearm position in neurologically impaired upper extremities. We retrospectively evaluated 6 pediatric patients with upper extremity weakness and severe supination contracture who underwent forearm arthrodesis in neutral or slight pronation. Five patients achieved fusion, and 1 patient had an atrophic nonunion (17% nonunion rate). Average follow-up was 6 years 6 months (range 1 year 9 months to 11 years 2 months), and all patients were satisfied with their new forearm position.

Selection of fusion position during forearm arthrodesis.

The purpose of this study was to determine the optimal position for forearm arthrodesis. We attempted to determine functional difficulties associated with different positions of simulated fusion and whether there was a difference between men and women in their preference for fusion position. The forearms of 30 subjects were immobilized in neutral, 45 degrees supination, and 45 degrees pronation. The subjects performed 2 functional tests in each splint: the Jebsen hand function test and a subjective evaluation of the difficulty of activities of daily living. Each subject was asked to choose a preferred position for forearm fusion. Overall, subjects found the supinated position the most difficult to adapt to; the majority (63.3%) preferred neutral. Based on the results of our study we recommend forearm fusion in neutral or slight pronation. A thorough preoperative activity history and functional assessment may assist in determining the desired forearm arthrodesis position in a given individual.

Hemothorax in a patient with asthma.

Treatment of chronic illnesses such as asthma can often become routine. This is a case report that emphasizes the importance of a thorough history and physical examination for each exacerbation of asthma. An 11-year-old girl with a history of asthma presented to the emergency room with wheezing and dyspnea that was assumed to be an exacerbation of her chronic illness. After careful history taking and physical examination, a chest radiograph was recommended. The x-ray revealed a hemothorax and a new diagnosis was made, thoracic Ewing's sarcoma.

The teres major muscle: an anatomic study of its use as a tendon transfer.

Eleven fresh-frozen cadaver shoulders were dissected to define the anatomy of the teres major muscle and tendon and to determine the muscle's potential for use as a tendon transfer to the humeral head. Of the 11 specimens, 7 had Mathes type II circulation. The primary and secondary pedicles, from the circumflex scapular artery, entered the muscle 4.1 cm and 0.5 cm from the scapula, respectively. The lower subscapular nerve entered 4.1 cm from the scapula. Mean tendon and muscle lengths were 2.0 and 11.8 cm, respectively. As a unipolar transfer, the tendon reached the greater tuberosity in all but 1 specimen. The bipolar transfer offered numerous theoretical possibilities. We believe that the teres major has an appropriate vascular supply and adequate length to make it suitable for tendon transfer to the humeral head.