RESUMO
Background: Terminally ill patients can benefit from hospice care, which specifically addresses the needs of patients and families affected by terminal illness. However, there is a lack of standardized evaluation criteria to assess the quality of hospice care for terminally ill patients in the ICU, and it is impossible to evaluate the service quality of hospice care. To use the Delphi method to construct a hospice care system for terminally ill patients in ICU that meets clinical needs, and to provide theoretical support for nursing decision-making of terminally ill patients in clinical ICU. Methods: Obtain relevant literatures by entering specific key words into the database, the hospice care nursing system for terminally ill patients in ICU was preliminarily drawn up by literature analysis, and 24 experts in this field were consulted for 3 rounds by Delphi method to discuss the development status of hospice care and finally establish the hospice care nursing system. Results: In the three rounds of letter inquiries, the positive coefficients of experts were all high, the expert authority coefficient (Cr) were 0.864, 0.849, 0.832, and the expert opinion coordination coefficient(W) were 0.186, 0.319, 0.224; The system includes 8 first-level indicators, 27 second-level indicators and 9 third-level indicators. Conclusion: In this study, three rounds of Delphi consultation methods were used to construct an evaluation index system for the nursing quality of hospice care for ICU patients. The evaluation indicators formulated closely focus on the physiological and psychological characteristics of ICU patients, which can provide a better reference for ICU patients with advanced life in the future.
RESUMO
The Arp2/3 complex is a critical actin nucleator, which promotes actin assembly and is widely involved in a diverse range of actin-related processes such as cell locomotion, phagocytosis and the establishment of cell polarity. Previous studies showed that the Arp2/3 complex regulates spindle migration and asymmetric division during mouse oocyte maturation; however, the role of the Arp2/3 complex in early mouse embryo development is still unknown. The results of the present study show that the Arp2/3 complex is critical for cytokinesis during mouse embryo development. The Arp2/3 complex was concentrated at the cortex of each cell at the 2- to 8-cell stage and the peripheral areas of the morula and blastocyst. Inhibition of the Arp2/3 complex by the specific inhibitor CK666 at the zygote stage caused a failure in cell division; mouse embryos failed to undergo compaction and lost apical-basal polarity. The actin level decreased in the CK666-treated group, and two or more nuclei were observed within a single cell, indicating a failure of cell division. Addition of CK666 at the 8-cell stage caused a failure of blastocyst formation, and CDX2 staining confirmed the loss of embryo polarity and the failure of trophectoderm and inner cell mass formation. Taken together, these data suggest that the Arp2/3 complex may regulate mouse embryo development via its effect on cell division.
Assuntos
Complexo 2-3 de Proteínas Relacionadas à Actina/fisiologia , Citocinese/fisiologia , Desenvolvimento Embrionário/fisiologia , Complexo 2-3 de Proteínas Relacionadas à Actina/antagonistas & inibidores , Complexo 2-3 de Proteínas Relacionadas à Actina/metabolismo , Fatores Etários , Análise de Variância , Animais , Polaridade Celular/efeitos dos fármacos , Citocinese/efeitos dos fármacos , Primers do DNA/genética , Desenvolvimento Embrionário/efeitos dos fármacos , Fluorescência , Indóis/farmacologia , Camundongos , Microscopia Confocal , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Objective: To explore the effect of the application of the 'Internet+' nursing teaching mode on the comprehensive teaching 'Fundamentals of Nursing'. Trial design: Parallel design and convenient sampling were used to select vocational nursing students from the Nursing College of Capital Medical University. Methods: Selected students were randomly divided into two groups. The control group consisted of 30 students in Grade 2020 higher vocational nursing education (traditional teaching mode). The observation group consisted of 30 students in Grade 2021 higher vocational nursing education (Internet+ mixed teaching mode). Training assessment results, automatic learning ability, professional identity, and satisfaction were compared between the two groups. Results: Compared with the control group, the students in the observation group scored higher in the following operation practices: venous blood sampling, intradermal injection, cardiopulmonary resuscitation (CPR), sputum aspiration, and putting on and taking off robes (84.01 ± 0.87 vs. 92.14 ± 1.23; 91.41 ± 0.82 vs. 96.86 ± 0.27; 87.56 ± 0.31 vs. 93.91 ± 2.79; 88.11 ± 0.51 vs. 93.75 ± 0.29; and 82.29 ± 0.29 vs. 90.96 ± 0.34, respectively, with p < 0.05 for all scores). The total scores for autonomous learning ability and subjective satisfaction were also higher in the observation group compared with the control group (82.98 ± 4.72 vs. 93.17 ± 5.01 and 96.67% vs. 90.00%, respectively, with p < 0.05 for all scores). Conclusion: In the post-epidemic era, the 'Internet+ hybrid teaching mode' was applied to comprehensive nursing teaching. This changed the traditional education mode, which focuses only on professional knowledge. The 'Internet+' teaching mode results showed that the professional, ideological, and political courses exhibited the same value guidance, which improved students' independent learning ability, practical operation ability, professional identity, and satisfaction.
RESUMO
Interspecies intracytoplasmic sperm injection has been carried out to understand species-specific differences in oocyte environments and sperm components during fertilization. While sperm aster organization during cat fertilization requires a paternally derived centriole, mouse and hamster fertilization occur within the maternal centrosomal components. To address the questions of where sperm aster assembly occurs and whether complete fertilization is achieved in cat oocytes by interspecies sperm, we studied the fertilization processes of cat oocytes following the injection of cat, mouse, or hamster sperm. Male and female pronuclear formations were not different in the cat oocytes at 6 h following cat, mouse or hamster sperm injection. Microtubule asters were seen in all oocytes following intracytoplasmic injection of cat, mouse or hamster sperm. Immunocytochemical staining with a histone H3-m2K9 antibody revealed that mouse sperm chromatin is incorporated normally with cat egg chromatin, and that the cat eggs fertilized with mouse sperm enter metaphase and become normal 2-cell stage embryos. These results suggest that sperm aster formation is maternally dependent, and that fertilization processes and cleavage occur in a non-species specific manner in cat oocytes.
Assuntos
Oócitos/metabolismo , Injeções de Esperma Intracitoplásmicas/veterinária , Espermatozoides/metabolismo , Animais , Gatos , Núcleo Celular/metabolismo , Cromatina/metabolismo , Cricetinae , Feminino , Histonas/metabolismo , Masculino , Camundongos , Oócitos/citologia , Interações Espermatozoide-Óvulo/fisiologia , Espermatozoides/citologiaRESUMO
Objective: This study aimed to explore the efficacy of hospice care for terminally ill emergency patients in the COVID-19 context. Methods: A total of 86 terminally ill emergency patients at the authors' hospital from February 2020 to October 2020 were included in this study, they were randomly allocated into a control (n = 42) and an intervention (n = 44) group, respectively. The control group received routine nursing care, and the intervention group received hospice care. Results: Following treatment, the survival time (as the primary outcome) in the intervention group was longer than in the control group (P < 0.05). Distress thermometer and psychological pain-related factor scores for the intervention group were lower than those of the control group (P < 0.001 for both). The comfort scores of all dimensions in the intervention group were higher than in the control group (P < 0.05). The scores for survival puzzle, symptom distress, independence, and mental well-being in all dimensions related to a sense of dignity were lower in the intervention than in the control group (P < 0.05 for all). The intervention group's yield, avoidance, and total scores were lower than in the control group, whereas the face score was higher than in the control group (P < 0.05 for all). Conclusion: In the current COVID-19 context, the telehealth (psychological, physical, online remote support, critical illness communication, and death education) approach adopted by the Anning care team for terminally ill emergency patients and other aspects of peace care could help improve the physical and mental health of patients. Hospice care can minimise the physical and psychological pain of terminally ill patients in the emergency department and assist them in their final stage of life by providing a calming and comfortable environment.
RESUMO
In this study, Tb3+-doped natural sodium feldspar (NaAlSi3O8) phosphors have been successfully prepared using high-temperature solid-state method with natural sodium feldspar as a substrate. Energy-dispersive X-ray spectrometry analysis (EDX) of NaAlSi3O8 showed that 0.03 wt% of Eu element was present, and elemental distribution mapping analysis showed that the distribution of trace Eu in minerals was aggregated. The crystal structure and luminescence properties of the natural sodium Eu-containing feldspar and synthetic sodium feldspar NaAlSi3O8:Eu3+, Tb3+ phosphors are discussed in detail. The crystal structure analysis of the samples showed that the Na+ in the natural matrix was partly replaced by the doped Tb3+. Studies on the photoluminescence properties of the samples indicate that Eu does not form a luminescent center in the natural mineral, however, the strong characteristic peak of Eu3+ at 615 nm appears after doping with Tb3+ and the peak at 615 nm increases with the increase of Tb3+ concentration. According to the above spectral results, the energy transfer from Tb3+ to Eu3+ is obtained. Through the measurement and analysis of color coordinates, it is found that with the increase of Tb3+ concentration, the luminescence color of the samples can be regulated in the green to red region. NaAlSi3O8:Eu3+ Tb3+ phosphors has potential application value.
RESUMO
AIM: To determine whether midkine (MK) and its truncated form (tMK) contribute to gastric tumorigenesis using in vitro and in vivo models. METHODS: Human MK and tMK plasmids were constructed and expressed in BGC823 (a gastric adenocarcinoma cell line) to investigate the effect of over-expressed MK or tMK on cell growth and turmorigenesis in nude mice. RESULTS: The growth of MK-transfected or tMK-transfected cells was significantly increased compared with that of the control cells, and tMK-transfected cells grew more rapidly than MK-transfected cells. The number of colony formation of the cells transfected with MK or tMK gene was larger than the control cells. In nude mice injected with MK-transfected or tMK-transfected cells, visible tumor was observed earlier and the tumor tissues were larger in size and weight than in control animals that were injected with cells without the transfection of either genes. CONCLUSION: Over-expressed MK or tMK can promote human gastric cancer cell growth in vitro and in vivo, and tMK has greater effect than MK. tMK may be a more promising gene therapeutic target compared with MK for treatment of malignant tumors.
Assuntos
Proliferação de Células , Citocinas/metabolismo , Neoplasias Gástricas/patologia , Animais , Linhagem Celular Tumoral , Citocinas/genética , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Midkina , Neoplasias Gástricas/metabolismoRESUMO
DNA vaccines, the third-generation vaccines, were extensively studied. The attenuated Salmonella choleraesuis (S. choleraesuis) was widely focused as a carrier to deliver DNA vaccines in the chromosome-plasmid balanced-lethal system. The efficacy of inhibin DNA vaccine delivered by attenuated S. choleraesuis was proved in mice and cows in our previous studies. In this study, the efficacy of inhibin DNA vaccine was confirmed in rhesus monkeys. To further study the biodistribution and safety, the mice were immunized under laboratory conditions. The results of the rhesus monkeys showed the plasma IgA and IgG titres against inhibin were elevated, and the oestradiol (E2 ) and progesterone (P4 ) levels were increased with immunizing inhibin DNA vaccine. The biodistribution and safety assessment displayed the body weight, pathological change and haematology indexes where there is no significant difference between vaccinated mice and control. And the genomics analysis showed there was no integration of the inhibin gene into the mouse genome 2 months after immunization. This study indicated the inhibin DNA vaccine delivered by attenuated S. choleraesuis was safe. And this vaccine was a potential means to improve their reproductive traits in primates and other animals.
Assuntos
Portadores de Fármacos , Imunoterapia/métodos , Infertilidade/terapia , Inibinas/imunologia , Salmonella arizonae/genética , Vacinas de DNA/efeitos adversos , Vacinas de DNA/imunologia , Animais , Estradiol/sangue , Imunidade Humoral , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Imunoterapia/efeitos adversos , Inibinas/genética , Macaca mulatta , Camundongos , Progesterona/sangue , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologia , Vacinas Atenuadas/farmacocinética , Vacinas de DNA/administração & dosagem , Vacinas de DNA/farmacocinética , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/imunologiaRESUMO
OBJECTIVE: To study the expression of tumor necrosis factor receptor-associated protein 1 (TRAP1) in gastric cancer tissue and its correlation with malignant biology. METHODS: Gastric cancer tissue and adjacent normal tissue were collected, and mRNA content and protein content of TRAP1 were detected; gastric cancer cell lines SGC7901, BGC823, AGS and MGC803 were cultured, and mRNA contents and protein contents of TRAP1, CyclinB1, CyclinD1, CyclinE, MMP-2 and VEGF were detected. RESULTS: mRNA and protein expression levels of TRAP1 in gastric cancer tissue were significantly higher than those in adjacent normal tissue, and mRNA and protein expression levels of TRAP1 in gastric cancer tissue with muscularis and serosa infiltration, lymph node metastasis, distant organ metastasis and TNM â ¢/â £ stage were significantly higher than those in gastric cancer tissue with mucosa and submucosa infiltration, non-lymph node metastasis, non-distant organ metastasis and TNM â /â ¡ stage. mRNA and protein expression levels of TRAP1, CyclinB1, CyclinD1, CyclinE, MMP-2 and VEGF in MGC803 were the highest, and mRNA and protein expression levels of TRAP1, CyclinB1, CyclinD1, CyclinE, MMP-2 and VEGF in SGC7901 were the lowest. mRNA and protein expression levels of TRAP1 in gastric cancer cell lines were positively correlated with mRNA and protein expression of CyclinB1, CyclinD1, CyclinE, MMP-2 and VEGF. CONCLUSIONS: The expression of TRAP1 significantly increases in gastric cancer tissue; TRAP1 may regulate the malignant biology of cells by increasing the expression of CyclinB1, CyclinD1, CyclinE, MMP-2 and VEGF, thereby resulting in the occurrence and development of gastric cancer.
RESUMO
OBJECTIVE: To clone the truncated Midkine from gastric carcinogenesis tissue and express in Escherichia coli. METHODS: A pair of PCR specific primers were designed according to the reported human tMK cDNA sequence in Genbank. The target DNA fragment was obtained by RT-PCR from gastric carcinoma patient's carcinogenesis tissue and cloned into pMD 18 T-vector. After sequencing, the tMK nucleotide fragment was inserted into an E. coli expression vector pBV222. The recombinant plasmid was transferred into E. coli DH5alpha and an E. coli DH5alpha expressed recombinant tMK protein, DH5alpha/pBV222-tMK, was obtained. DH5alpha/pBV222-tMK was cultured and induced with 42 degrees C. RESULTS: Truncated Midkine was cloned from gastric carcinogenesis tissue and the efficiently expressed recombinant tMK protein was obtained. SDS-PAGE indicated the molecular weight of recombinant tMK protein accorded with anticipation. CONCLUSION: The tMK was expressed in gastric carcinoma of Chinese patients' carcinogenesis tissue. The efficient expression of tMK protein was actualized in E. coli by clone and recombination.
Assuntos
Citocinas/biossíntese , Escherichia coli/metabolismo , Neoplasias Gástricas/genética , Adenocarcinoma/genética , Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Clonagem Molecular , Citocinas/genética , Escherichia coli/genética , Humanos , Midkina , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/genética , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Células Tumorais CultivadasRESUMO
The associations between the aortic dimensions (of the aortic sinus, aortic annulus and aortic arch) and physiological variables have not been established in the Chinese population. The present study examined the associations among physiological variables to determine the aortic root and arch dimensions echocardiographically. The diameters of the aortic sinus, annulus and arch were measured in 1,010 subjects via 2-D echocardiography with a 3.5-MHz transducer in a trans-thoracic position. The images of the aortic sinus and aortic annulus were obtained from a standard parasternal long-axis view. The maximum diameter of the valve orifice was measured at the end of systole. The aortic arch dimension was visualized in the long-axis using a suprasternal notch window and the maximum transverse diameter was measured. Epidata 3.0, Excel 2007 and SPSS version 17.0 were used to collect and analyze the data. A total of 1,010 subjects were enrolled. The mean age was 55.0±17.0 years (range of 18 to 90 years). The body surface area (BSA) was the best predictor of all the studied physiological variables and may be used to predict aortic sinus, annulus and arch dimensions independently (r=0.54, 0.37 and 0.39, respectively). Gender, blood pressure, age and BSA are significant predictors of the aortic dimensions. Of these, BSA was the best predictor.
RESUMO
The microRNAs (miRNAs) miR482 and miR1448 are disease resistance-related miRNAs; the former is ubiquitously distributed in seed plants whereas the latter has only been reported in Populus trichocarpa. The precursor and mature sequences of poplar miR1448 are highly homologous to those of poplar miR482, and these two miRNAs are located in one transcript as a polycistron. Therefore, we hypothesized that the MIR1448 gene may have evolved from the MIR482 gene in poplar. However, the molecular evolution patterns of this process remain unclear. In this study, utilizing cloning and Blast analysis in NCBI ESTs and whole-genome shotgun contigs (WGS) dataset, we determined that the MIR482-MIR1448 polycistron is a family-specific clustered miRNA in Salicaceae. Moreover, phylogenetic analysis illustrated that MIR1448 is the product of a tandem duplication event from MIR482. Nucleotide substitution analysis revealed that both MIR482 and MIR1448 have more rapid evolution ratios than ribosomal DNA (rDNA) genes, and that compensatory mutations that occurred in the stem region of the secondary structure were the main mechanisms that drove the evolution of these MIRNA genes. Furthermore, by comparing the substitution patterns in the miRNA-target complexes of miR482 and miR1448, we inferred that co-evolution between miRNAs and their targets was the major force that drove the "duplicated MIR482" evolve to MIR1448. We propose a novel miRNA-target pairing pattern called the "frameshift targeted mechanism" to explain the gain of target genes by miR1448. The results also imply that the major role of miR482 was in resistance to disease or other stresses via NBS-LRR proteins, whereas the biological functions of miR1448 are more diverse.
Assuntos
Evolução Molecular , Regulação da Expressão Gênica de Plantas , Genes de Plantas , MicroRNAs , Filogenia , Populus/genética , RNA de Plantas , Arabidopsis/genética , Sequência de Bases , Clonagem Molecular , Duplicação Gênica , Dados de Sequência Molecular , Família Multigênica , Oryza/genética , Populus/classificação , Populus/imunologia , Dobramento de RNA , Homologia de Sequência do Ácido NucleicoRESUMO
BACKGROUND: The effect of Doxorubicin, a widely used chemotherapeutic agent, on early mouse embryonic development has not been previously characterized. MATERIALS AND METHODS: Expression of apoptosis-related genes and poly(ADP-ribose) polymerase (PARP) family genes were assessed by real-time reverse transcription polymerase chain reaction (RT-PCR). Apoptosis in mouse blastocysts was tested using the terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. Cleaved (c)-PARP was analyzed by western blot. RESULTS: A 20 h exposure to doxorubicin caused rapid cytoplasmic fragmentation, DNA condensation and disruption of the cytoskeleton in mouse embryos. Doxorubicin altered the expression of genes involved in DNA repair and apoptosis and blocked early embryonic development, suggesting that doxorubicin affects DNA synthesis and repair. Furthermore, the effect of doxorubicin on early embryo development was determined by assessing the rates of development to different stages and an apoptosis index. Both assays confirmed that doxorubicin altered embryonic development. In conclusion, doxorubicin blocked pre-implantation development in early mouse embryos by altering apoptosis-related gene expression and inactivating DNA repair by PARP.
Assuntos
Antibióticos Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Blastocisto/efeitos dos fármacos , Doxorrubicina/farmacologia , Inibidores de Poli(ADP-Ribose) Polimerases , Animais , Blastocisto/citologia , Blastocisto/enzimologia , Dano ao DNA , Técnicas de Cultura Embrionária , Feminino , Camundongos , Camundongos Endogâmicos ICR , Poli(ADP-Ribose) Polimerase-1 , Poli(ADP-Ribose) Polimerases/metabolismo , Zigoto/citologia , Zigoto/efeitos dos fármacosRESUMO
OBJECTIVE: To investigate the molecular mechanism of mouse oocyte polarity loss during aging. DESIGN: Experimental study. SETTING: Academic basic research laboratory. ANIMAL(S): Mice. INTERVENTION(S): Oocytes were collected 16 hours after injection of hCG and cultured in M16 medium for an additional 14 hours with or without caffeine. MAIN OUTCOME MEASURE(S): Expression and localizations of actin nucleators actin-related protein 2/3 complex, JMY, and WAVE2 were examined by immunofluorescence staining, and their messenger RNA levels were examined by real-time reverse transcription-polymerase chain reaction. RESULT(S): The protein and messenger RNA levels of actin-related protein 2/3 complex, JMY, and WAVE2 were decreased in aged oocytes, but the levels were normal in caffeine-treated aged oocytes. CONCLUSION(S): Our data indicated that the loss of oocyte polarity may be due to the degradation of actin nucleators in aged oocytes.
Assuntos
Complexo 2-3 de Proteínas Relacionadas à Actina/metabolismo , Actinas/metabolismo , Polaridade Celular , Senescência Celular , Proteínas Nucleares/metabolismo , Oócitos/metabolismo , Transativadores/metabolismo , Família de Proteínas da Síndrome de Wiskott-Aldrich/metabolismo , Complexo 2-3 de Proteínas Relacionadas à Actina/genética , Animais , Cafeína/farmacologia , Proteínas de Ciclo Celular , Polaridade Celular/efeitos dos fármacos , Gonadotropina Coriônica/farmacologia , Feminino , Fármacos para a Fertilidade Feminina/farmacologia , Imunofluorescência , Regulação da Expressão Gênica , Camundongos , Camundongos Endogâmicos ICR , Proteínas Nucleares/genética , Oócitos/efeitos dos fármacos , Indução da Ovulação/métodos , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Tempo , Transativadores/genética , Família de Proteínas da Síndrome de Wiskott-Aldrich/genéticaRESUMO
OBJECTIVE: To explore the quality of the embryos, clinical outcomes and birth defects resulting from intracytoplasmic sperm injection (ICSI) treatment using sperms of different origins and parameters. METHODS: A total of 980 ICSI-ET (embryo-transfer) cycles were divided into 4 groups, namely normal sperm or mild oligozoospermia group (group A), severe oligozoospermia group (group B), epididymal aspirates group (group C) and testicular biopsies group (group D). The cleavage rate, embryo quality, fertilization rate, clinical pregnancy rate, and rates of birth defects were compared between the groups. RESULTS: The fertilization rate, cleavage rate and good-quality embryo rate were not significantly different among the 4 groups (P>0.05), and the embryo implantation rate and clinical pregnancy rate were significantly higher in group C than in groups A and B (P<0.05). Groups A, B and C showed no significant differences in the rates of birth defects (P>0.05), and no birth defects occurred in group D. CONCLUSIONS: Sperms of different parameters and origins used in ICSI treatment can achieve similar fertilization rate, good-quality embryo rate and delivery rate. The embryo implantation rate and clinical pregnancy rate of epididymal sperm group are higher than those of ejaculated groups, possibly due to the younger age of the patients and a greater number of oocytes retrieved in group C than in groups A and B.
Assuntos
Anormalidades Congênitas/etiologia , Injeções de Esperma Intracitoplásmicas/efeitos adversos , Espermatozoides , Feminino , Fertilização , Humanos , Masculino , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the clinical outcomes of intracytoplasmic sperm injection (ICSI) and conventional in vitro fertilization (IVF) using sibling oocytes for treatment of primary and secondary infertility. METHODS: A total of 149 cycles of IVF and ICSI were conducted between January, 2003 and December, 2008 in our center, including 98 cycles in patients with primary infertility and 51 in those with secondary infertility. According to the embryos derived from ICSI, IVF and their combination, the clinical pregnancy rate, delivery rate and birth defect of the 3 groups were analyzed. RESULTS: The fertilization failure rate of IVF was significantly higher in primary infertility group than in secondary infertility group (10.2% vs 3.9%, P<0.05). No fertilization failure occurred in ICSI group. The fertilization rates and good quality embryo rates in ICSI group were significant higher than those in IVF group, and the abnormal fertilization rate was significantly lower in ICSI group (P<0.05). No significant difference were found in the implantation rates, clinical pregnancy rates, delivery rates or the rates of birth defects of the offsprings between IVF, ICSI and IVF+ICSI groups. CONCLUSION: IVF combined with ICSI may result in increased fertilization rate and avoid total fertilization failure with favorable clinical outcomes in patients with long-term infertility, and ICSI may not increase the birth defects of the offspring in these patients.
Assuntos
Fertilização in vitro/métodos , Infertilidade Feminina/terapia , Injeções de Esperma Intracitoplásmicas , Adulto , Transferência Embrionária , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To study the clinical features and outcomes of in vitro fertilization and embryo transfer (IVF-ET) in infertile patients due to polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO). METHODS: This study involved 189 infertile patients with polycystic ovary syndrome (PCOS), with 129 polycystic ovaries (PCO), and 142 without PCOS or PCO (control) undergoing IVF-ET. The dosage of gonadotrophin (Gn), sex hormone level on the day of HCG administration, clinical pregnancy rate, spontaneous abortion rate and ovarian hyperstimulation syndrome (OHSS) rate were analyzed and compared between the 3 groups. RESULTS: No significant differences were found in the clinical pregnancy rate between the PCOS group (202 cycles), PCO group (134 cycles) and control group (150 cycles) (51.0%, 53.0% and 46.0%, respectively). The levels of LH and T and early spontaneous abortion rates were significantly higher in PCOS group than in PCO group and control group (P<0.05). The P level on HCG day was the highest in PCO group (P<0.05). The early spontaneous abortion rates and clinical pregnancy rate showed no significant differences between PCO group and control group (P>0.05). The dosage of Gn was significantly lower and OHSS rate higher in PCOS and PCO groups than in the control group (P<0.05). CONCLUSIONS: The clinical pregnancy rate of infertile patients with PCOS is similar with that of PCO patients and control patients undergoing IVF-ET treatment. PCOS, however, is associated with increased spontaneous abortion rate, possibly due to abnormality of LH and T release. The clinical outcomes in PCO patients are similar with those in the control patients, and elevated P level in the late follicular phase does not obviously influence the outcomes of IVF. Both PCOS and PCO are associated with increased risk of OHSS.
Assuntos
Transferência Embrionária , Fertilização in vitro , Infertilidade Feminina/terapia , Cistos Ovarianos/complicações , Síndrome do Ovário Policístico/complicações , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Infertilidade Feminina/etiologia , Gravidez , Resultado da Gravidez , Estudos RetrospectivosRESUMO
OBJECTIVE: To investigate the association of the clinical characteristics and the outcome of in vitro fertilization and embryo transfer (IVF-ET) in infertile women with polycystic ovarian syndrome (PCOS) of different subtypes. METHODS: A total of 189 infertile women with PCOS undergoing IVF-ET were enrolled in this study. According to Rotterdam PCOS diagnosis criteria, the patients were classified into 3 PCOS subtypes, namely type I with PCO ultrasonography and oligo-ovulation/anovulation and hyperandrogenism (54 women, for whom 58 fresh IVF-ET cycles were performed); type II with PCO ultrasonography and oligo-ovulation/anovulation (117 women with 126 cycles); type III with PCO ultrasonography and hyperandrogenism (18 women with 18 cycles). The number of retrieved oocytes, fertilization rate, implantation rate, clinical pregnancy rate, spontaneous abortion rates and incidence of ovarian hyperstimulation syndrome (OHSS) were compared between the 3 groups. RESULTS: Except for the baseline serum T concentration in the early phase of menstrual cycle, which was significantly higher in groups I and III than in group II, no significant difference was found in the clinical characteristics between the 3 groups (P>0.05). Group I had the highest initial Gn dose, and the oocyte retrieval rates were significantly lower in groups I and III (P<0.05). The patients in group I had lower implantation rate and the clinical, on-going and cumulative pregnancy rates than groups II and III, but the differences were not statistically significant; the embryo early loss rate and spontaneous abortion rate appeared to be higher in groups I and III (P>0.05). Significantly elevated incidence of OHSS were noted in groups I and III (P<0.05). CONCLUSION: The women with different PCOS subtypes according to the Rotterdam criteria all have similar IVF-ET outcomes, and the increased embryo loss rate and spontaneous abortion rate in groups I and III might be associated with excessive androgen that disturbs oocyte and embryo development.