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Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.
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Objective To investigate changes in the serum expression levels of decorin (DCN),chondroitin sulfate (CS) and C-terminal crosslinking telopeptide of type Ⅱ collagen (CTX-Ⅱ) and analyze the relationship between the expression levels and clinical characteristics,aiming to provide evidence for clinical diagnosis and treatment of arthritis.Methods Ninety subjects were divided into the osteoarthritis (OA),rheumatoid arthritis (RA) and control groups (n=30 for each group).The OA and RA patients were diagnosed in Department of Rheumatism Immunity of Shanxi Dayi Hospital,and the healthy volunteers who were doing physical check-up in the Physical Check-up Center of Shanxi Dayi Hospital were recruited as the control subjects.Visual analogue scale (VAS) was utilized to evaluate the degree of pain.X-ray was performed to assess the severity of joint lesions.Enzyme linked immunosorbent assay (ELISA) was adopted to quantitatively measure the serum expression levels of DCN,CS and CTX-Ⅱ.The correlation among these parameters was statistically analyzed.Measurement data among different groups were statistically compared by one-way analysis of variance (ANOVA)and comparison between two groups was conducted by Tambane's T2.The correlation between two factors was analyzed by using Spearman correlation analysis.Results The difference of the serum expression levels of DCN in the OA,RA and control groups [(3.19±1.38) ng/ml,(1.90±0.62) ng/ml,(1.33 ±0.33) ng/ml] was statistically significant,which of the OA group was higher than the control group (P＜0.01),which of the RA group was higher than control group (P＜0.01),which of the OA group was higher than the RA group (P＜0.001).The difference of the serum expression levels of CS in the OA,RA and control groups [(0.57±0.12) ng/ml,(0.95±0.47) ng/ml,(0.36±0.09) ng/ml] was statistically significant,in which,the OA group was higher than the control group (P＜0.01),RA group was higher than control group (P＜0.01),OA group was lower than RA group (P＜0.01).The serum expression levels of CTX-Ⅱ in the OA and RA groups [(3.08±0.86) ng/ml,(3.03±1.14) ng/ml] were significantly up-regulated compared with those in the control group [(2.17±0.82) ng/ml](P＜0.001,P=0.005).The expression level of CTX-Ⅱ did not significantly different between the OA and RA groups (P=0.996).In the OA and RA groups,the serum levels of DCN,CS,CTX-Ⅱ were po-sitively related to X-ray and VAS,the correlation of DCN was the highest,the correlation was high in both OA (r=0.777,P＜0.01;r=0.622,P＜0.01) and RA (r=0.640,P＜0.01;r=0.493,P=0.006).Conclusion The serum levels of DCN,CS and CTX-Ⅱ in arthritis patients are significantly up-regulated compared with those in healthy controls,which are positively correlated with the degree of pain,and the severity of cartilage and bone defects.DCN is probably valuablein the differential diagnosis of early OA and RA.However,the clinical application remains to be further validated by evidence-based studies.
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Objectives To investigate the risk factors for rheumatoid arthritis in middle-aged and elderly residents in Luohe City,Henan Province.Methods Survey questionnaires and measurements of biochemical parameters were conducted in individuals 45 years old or above,using the two-stage cluster sampling method.Risk factors for rheumatoid arthritis were evaluated according to the criteria for the classification of RA by the American College of Rheumatology and European League Against Rheumatism(ACR/EULAR) (2010).Results Among the 8 610 residents covered by the survey,8,274 people responded,representing a response rate of 96.1％.There were 3 361 male (40.62％)and 4 913 female(59.38％)respondents,with an average age of 61.4±7.4(45-91)years.The age group of 60-64 years had the highest rates of joint involvement,with those scoring 2,3 and 5 points at 2.90％,2.02％ and 0.26％,respectively.The rheumatoid factor (RF)and the anti-cycliccitrullinatedpeptide(anti-CCP)antibody titer showed skewed distributions.The low titer-positive rate of RF and anti-CCP antibody,the ESR and CRP in female residents were evidently higher than in male residents(each P＜0.05).Smoking was an independent factor for RA(OR:1.79,95 ％CI:1.34～ 3.41,P＜0.01).The risk for RA occurrence increased with the frequency of drinking ＞1 time/d(OR:6.71,95 ％ CI:0.88 ～ 51.23,P＜ 0.01).The prevalence of RA was significantly higher in rural areas than in urban and suburb areas(0.93％ to 0.48％ and 0.53％,each P＜0.05).Living on higher floors was a protective factor for RA (OR:0.61,95 ％ CI:0.36 ～ 0.94,P =0.036).Family history was an independent risk factor for RA (OR:3.09,95 ％ CI:1.53 ～ 6.27,P ＜ 0.01),and being first degree relatives of RA patients was a risk factor(OR=6.45,95 ％ CI:1.67～ 17.83,P＜0.01).Multiple factor analysis showed that female gender,first floor of residential buildings,smoking and genetics were key risk factors for RA.Conclusions The risk factors for rheumatoid arthritis in middle-aged and elderly residents in Luohe City of Henan Province are female gender,smoking and genetics.
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Objective To modified doxorubicin liposome with transferrin(TF),and to investigate its inhibition efficacy on the proliferation of human breast cancer cells.Methods The liposome was prepared by thin film ultrasonic,and doxorubicin liposomal was prepared by sulfuric acid gradient.The TF-doxorubicin lipo-some was prepared by the post insertion method.The uptake of TF-liposomal doxorubicin on breast cancer cells MCF-7 and MDA-MB-231 were detected by confocal microscopy.The killing ability of TF-doxorubicin liposomal targeting for MCF-7 and MDA-MB-231 were detected by MTT assay.Inhibitory effect of TF-doxorubicin lipo-some on the growth of MCF-7 and MDA-MB-231 were detected by soft agar colony assay.Results Confocal microscopy result showed that the uptake of TF-liposomal doxorubicin on MCF-7 and MDA-MB-231 were signifi-cantly higher than doxorubicin liposomal.Cell-killing ability on MCF-7 and MDA-MB-231 showed that the IC50 in TF-liposomal doxorubicin [MCF-7 cells:(20.8 ±3.2)μmol/L;MDA-MB-231 cells:(20.1 ±3.0)μmol/L)] were significantly lower than the liposomal [(1 58.6 ±24.6)μmol/L;(1 60.1 ±25.1 )μmol/L)]and free doxorubicin [(1 61 .7 ±26.2)μmol/L;(1 66.9 ±27.0)μmol/L)],with significant differences(F =1 1 6.03, P <0.001 ;F =75.29,P <0.001 ).Soft agar colony assay showed that the inhibition of TF-doxorubicin lipo-some on colony growth were significantly higher than doxorubicin liposome,free doxorubicin and control [dia-meter of MDA-MB-231 cells:(60.5 ±10.4)μm,(94.3 ±16.8)μm,(1 31 .8 ±22.6)μm,(162.8 ±30.3)μm;diameter of MCF-7 cells:(31 .8 ±5.5)μm,(62.1 ±11 .1 )μm,(108.6 ±1 8.6)μm,157.4 ±29.3)μm],with significant differences (F =87.17,P <0.000 1 ;F =178.23,P <0.000 1 ).Conclusion TF-doxorubicin lipo-some has a significant inhibitory effect on the proliferation of breast cancer cells in vitro,and can effectively and specifically kill the breast cancer cells,which provides theoretical basis for the treatment of breast cancer in vivo.
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Objective To investigate the feasibility of high?resolution microendoscopy( HRME) im?aging for animal gastrointestinal mucosa. Methods Mucosal tissues were harvested from the stomach, small intestine, and large intestine of Japanese big?ear white rabbits. The effects of HRME imaging of different lo?cations such as the gastric antrum and fundus, small intestine and large intestine were observed, and those of different exposure time were compared.Accuracy of HRME imaging was compared with pathology. Results The specific tissues of the gastrointestinal mucosa could be clearly distinguished from the HRME images. In the superficial layer of the fundic mucosa, numerous closely arranged glands as well as oval or elongated branched openings of the gastric pits and linear peripheral cracks were visible;the nuclei were arranged reg?ularly. In the superficial layer of the antral mucosa, irregular or tubular openings of the gastric pits and cracked glandular cavities were visible, with the cells surrounding the gastric pits regularly arranged and the nuclei small and densely distributed. In the superficial layer of the small intestine mucosa, stereoscopic thick?finger?shaped villi cluster was visible. The intervillous spaces were crack?like, and the surface was cov?ered by regularly arranged reflective, absorptive cells. In the superficial layer of the large intestine mucosa, many regularly arranged daisy?like round crypts of uniform size, as well as reflective, goblet cells surrounding the crypt and the interval space between crypts were visible. When the exposure time increased, the nuclei became brighter. An excellent correlation was noted between the results of histologic examination and those obtained by using HRME. Conclusion HRME can produce accurate images of the animal gastro?intestinal mucosae and may be a novel technique for further studies of human gastrointestinal pathology.
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Objective To explore the feasibility of high?resolution micro?endoscopy for diagnosis of gastric cancer. Methods A retrospective analysis of HRME pictures of gross specimen of gastric carcinoma of 20 cases of gastric cancer and normal gastric mucosa was made. Picture characteristics were studied and the HRME diagnostic criteria for normal gastric mucosa and gastric cancer tissues were developed. Based on the diagnostic criteria, a prospective study on gastric biopsy specimens of 64 cases of suspected gastric carci?noma was conducted and the diagnostic value of HRME for gastric carcinoma was evaluated by comparing HRME pre?diagnostic results with pathological findings. Results In the superficial layer of the fundic muco?sa, numerous regularly branched arranged glands as well as oval or elongated openings of the gastric pits and linear peripheral cracks were visible;the nuclei were arranged regularly. In the superficial layer of the antral mucosa, irregular or tubular openings of the gastric pits and cracked glandular cavities were visible, with the cells surrounding the gastric pits regularly arranged and the nuclei small and densely distributed. In the gas?tric carcinoma, nuclei sizes were different, arranged messy. Gland sizes were various, with unclear structure or glandular structures that could not be observed. Structure of gastric pits was damaged and normal gastric pits disappeared. After HRME imaging was performed on 64 cases of gastric biopsy specimens, the sensitivi?ty, specificity, accuracy, negative predictive value and positive predictive value of HRME diagnosis of gastric carcinoma were 96?4%( 53/55 ) , 88?9%( 8/9 ) , 95?3%( 61/64 ) , 98?1%( 53/54 ) and 80?0%( 8/10) respectively. Conclusion HRME, a new and instant pathological imaging tool with low price and simple operation, can distinguish normal gastric mucosa and gastric cancer tissue clearly, with a high diagno?sis value for gastric cancer.
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Objective To summarize the picture features of high resolution micro-endoscopy (HRME) for normal gastrointestinal mucosa. Methods We select 10 cases' normal esophageal mucosa, gastric and duodenal mucosa, in-testinal mucosa and colonic mucosal biopsies for this study, use HRME to observe the specimens and describe the features of different parts of the digestive tract normal mucosa according to the collected HRME pictures. Results After HRME imaging, all specimens were sent to pathological examination. We obtained 1 284 HRME pictures for 50 cases of biopsy specimens, 400 pictures were selected for results analysis after screening. HRME image charac-teristics of different parts of the digestive tract normal mucosa are as follows. Esophageal mucosa: cell arrangement rules, round and bright nucleus, the same size, nuclear spacing normal, the number of cells per field in basically are the same. Fundic mucosa: numerous closely arranged glands as well as oval or elongated branched openings of the gastric pits and linear peripheral cracks were visible; the nuclei were arranged regularly. Antral mucosa: irregular or tubular openings of the gastric pits and cracked glandular cavities were visible, with the cells surrounding the gastric pits regularly arranged and the nuclei small and densely distributed. Duodenal mucosa:visible villi was large fingers,on both sides of lint jagged depression, stereoscopic obviously, a cluster-like arrangement and the gap was crack-like. Intestinal mucosa:villous structures wider gap is wider, less than the number of the duodenum. Colonic mucosa:the nucleus of the same size, shape rules, round or oval and daisy-like glandular structures. All specimens were confirmed normal mucosa by pathology. Conclusion HRME can accurately identify the different parts of the diges-tive tract normal mucosa and it has a high consistency compared with pathological results.
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ObjectiveTo compare the efficacy of precise and traditional liver resection in the treatment of intrahepatic bile duct stones. MethodsOne hundred and twenty-seven patients with intrahepatic bile duct stones who were treated with surgery in our hospital from December 2008 to December 2014 were selected and divided into precise liver resection group (n=72) and traditional liver resection group (n=55) based on the type of surgery. The operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, postoperative complications (incision infection, biliary fistula, lung infection, and pleural effusion), hospitalization cost, postoperative residual calculi, and postoperative calculus recurrence were compared between the two groups. Between-group comparison of continuous data was made by t test, and between-group comparison of categorical data was made by χ2 test. Survival data were analyzed using survival function. ResultsThere were significant differences in operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, and hospitalization cost between the precise liver resection group and the traditional liver resection group (t=3.720, 58.681, 19.169, 5.990, and 6.944; all P＜0.05). There were no significant differences in postoperative complications including incision infection, biliary fistula, lung infection, and pleural effusion between the two groups (all P＞0.05). There were also no significant differences in the incidence rates of postoperative residual calculi and calculus recurrence between the two groups (all P＞0.05). The survival analysis of postoperative calculus recurrence time showed that there was no significant difference in calculus recurrence time between the two groups (P＞0.05). ConclusionCompared with traditional liver resection, precise liver resection has the advantages of shorter operation time, less intraoperative bleeding, less postoperative drainage, and faster recovery; however, precise liver resection raises hospitalization cost. Moreover, precise liver resection does not increase the risks of postoperative complications including incision infection, biliary fistula, lung infection, and pleural effusion; however, it does not reduce the incidence rates of postoperative residual calculi and calculus recurrence.
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ObjectiveTo compare the efficacy of precise and traditional liver resection in the treatment of intrahepatic bile duct stones. MethodsOne hundred and twenty-seven patients with intrahepatic bile duct stones who were treated with surgery in our hospital from December 2008 to December 2014 were selected and divided into precise liver resection group (n=72) and traditional liver resection group (n=55) based on the type of surgery. The operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, postoperative complications (incision infection, biliary fistula, lung infection, and pleural effusion), hospitalization cost, postoperative residual calculi, and postoperative calculus recurrence were compared between the two groups. Between-group comparison of continuous data was made by t test, and between-group comparison of categorical data was made by χ2 test. Survival data were analyzed using survival function. ResultsThere were significant differences in operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, and hospitalization cost between the precise liver resection group and the traditional liver resection group (t=3.720, 58.681, 19.169, 5.990, and 6.944; all P＜0.05). There were no significant differences in postoperative complications including incision infection, biliary fistula, lung infection, and pleural effusion between the two groups (all P＞0.05). There were also no significant differences in the incidence rates of postoperative residual calculi and calculus recurrence between the two groups (all P＞0.05). The survival analysis of postoperative calculus recurrence time showed that there was no significant difference in calculus recurrence time between the two groups (P＞0.05). ConclusionCompared with traditional liver resection, precise liver resection has the advantages of shorter operation time, less intraoperative bleeding, less postoperative drainage, and faster recovery; however, precise liver resection raises hospitalization cost. Moreover, precise liver resection does not increase the risks of postoperative complications including incision infection, biliary fistula, lung infection, and pleural effusion; however, it does not reduce the incidence rates of postoperative residual calculi and calculus recurrence.
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Objective To investigate perilla oil on human breast cancer MCF7 cell growth inhibition and induction of apoptosis , and provide a theoretical basis for the development of perilla oil anti-tumor .Methods Breast cancer MCF7 cells were treated with different dilutions of perilla oil to do tumor cell growth inhibition MTT experiment ,to observe the changes in the nuclear morpholo-gy of apoptotic cells with Hoechst 33258 and PI staining and fluorescence microscopy ,and to detect rate of apoptosis and apoptotic peak with flow cytometry .Results Perilla oil inhibited the proliferation on human breast cancer cell line MCF7 with a time-and concentration-dependent manner .Typical apoptotic nuclear morphological changes could be observed with Hoechst 33258 and PI staining under a fluorescence microscope .Detected by flow cytometry ,apoptosis rate was increased with time and concentration . Conclusion Perilla oil can inhibit human breast cancer MCF7 cell proliferation and induce apoptosis ,suggesting that it may be used as an anticancer drug in clinical practice .