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Objective:To detect the levels of γ-glutamyl transferase (GGT) in the amniotic fluid of normal pregnancies at 19-23 +6 gestational weeks and to analyze the changes in GGT level with gestational age. Methods:This study retrospectively collected the amniotic fluid supernatant from 383 singleton pregnant women (102, 103, 82, 68 and 28 cases at 19-19 +6, 20-20 +6, 21-21 +6, 22-22 +6, 23-23 +6 weeks of gestation, respectively) who underwent amniocentesis for prenatal diagnosis but had normal genetic diagnosis results in Cheeloo Hospital of Shandong University from January 2021 to September 2022. The levels of GGT in the amniotic fluid supernatant were tested and the statistical parameters including xˉ± s, min-max, median ( M), P1, P2.5, P5, P95, P97.5 and P99 values of GGT levels at each gestational week were calculated. GGT were non-normal data and converted into natural logarithms (lnGGT), and a least square linear regression equation was established to analyze the relationship between lnGGT and gestational week. Results:At 19-19 +6, 20-20 +6, 21-21 +6, 22-22 +6, and 23-23 +6 gestational weeks, the xˉ± s of amniotic fluid GGT were (385.8±235.7), (331.8±219.4), (253.7±197.9), (226.7±166.4), and (155.3±96.8) U/L, and the weekly declines were 14.0%, 23.5%, 10.6%, and 31.5%, respectively; the M values were 311.0, 288.0, 199.0, 160.5, and 105.5 U/L, and the weekly declines were 7.4%, 30.9%, 19.3%, and 34.3%, respectively; the P1- P99 were 67.1-1 404.5, 63.2-1 189.1, 36.0-849.8, 44.0-787.3, and 32.0-375.6 U/L, respectively. lnGGT was negatively correlated with gestational age ( R 2=0.148, P<0.001). Conclusions:In normal pregnancies at 19-23 +6 gestational weeks, GGT levels in amniotic fluid decrease with gestational age. Therefore, gestational age should be considered when establishing the reference value for amniotic fluid GGT in normal pregnancies.
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OBJECTIVE: To explore the effect of domestic recombinant follicle stimulating hormone(rFSH)in the course of controlled ovarian hyperstimulation using long protocol in patients with different ovarian reserve functions.METHODS: A retrospective cohort study was made on 1284 patients who were treated with in vitro fertilization/intracytoplasmic sperm injection-embryo transfer with standard long protocol for ovulation induction from January 2016 to January 2018 in Reproductive Medicine Center,Yuhuangding Hospital of Yantai. According to their AMH level,they were divided into normal ovarian reserve group(AMH:1.2-4.5μg/L,678 patients)and high response group(AMH>4.5μg/L,606 patients).Each group was divided into domestic rFSH subgroup(Jinsaiheng)(340 patients in normal ovarian reserve group,330 patients in high response group)and imported rFSH subgroup(338 patients in normal ovarian reserve group,276 patients in high response group)according to the different use of gonadotrophin on the start-up day.The clinical and laboratory indexes of the two subgroups were compared under different ovarian reserve functions.RESULTS: Regardless of normal or high ovarian reserve function,there was no significant difference in Gn dosage[(1983.15±510.00)U vs.(1913.32±422.12)U,P=0.053;(1816.86±506.37)U vs.(1786.63±453.90)U,P=0.44],days of Gn[(8.96±1.33)days vs.(8.87±1.24)days,P=0.36;(9.45±1.51)days vs.(9.44±1.47)days,P=0.91],dosage of Hermetic[(144.20±67.39)U vs.(143.42±56.73)U,P=0.86;(149.52±62.38)U vs.(160.21±84.87)U,P=0.09],number of eggs obtained(8.14±3.57 vs.8.44±3.37,P=0.25;11.47±4.74 vs.11.66±4.49,P=0.62),MⅡoocyte rate(82.08% vs. 82.01%,P=0.96;82.78% vs. 82.94%,P=0.90),fertilization rate(82.17% vs. 80.98%,P=0.30;80.75% vs. 82.16%,P=0.33),cleavage rate(94.55% vs. 93.91%,P=0.52;94.12% vs. 94.84%,P=0.49),blastocyst formation rate(58.43% vs. 59.55%,P=0.69;61.14% vs. 63.09%,P=0.46),clinical pregnancy rate(59.49% vs. 56.54%,P=0.54;62.84% vs.58.70%,P=0.57),early abortion rate(7.36% vs. 6.80%,P=0.42;11.30% vs. 11.11%,P=0.93)or the incidence of moderate to severe ovarian hyperstimulation syndrome(OHSS)(3.53% vs. 4.73%,P=0.71;7.58% vs. 9.06%,P=0.53)between the two subgroups.However,the daily LH level of HCG in domestic rFSH group was significantly higher than that in imported rFSH group[(2.83±1.31)U/L vs.(2.49±1.14)U/L,P=0.007;(2.35±1.10)U/L vs.(2.11±0.94)U/L,P=0.005].In the normal ovarian reserve group,the daily E2 concentration of HCG and the number of follicles above 1.6 cm in the domestic rFSH group were lower,but the rate of good quality embryos was significantly higher(67.23% vs. 62.51%,P=0.038),the difference being statistically significant(P=0.038).CONCLUSION: Domestic rFSH has the same clinical pregnancy outcome as imported rFSH after ovulation induction,but domestic rFSH has higher LH concentration on hCG day after ovulation induction,and patients with normal ovarian reserve have higher good quality embyro rate after using domestic rFSH.
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<p><b>OBJECTIVE</b>To investigate the influence of bone marrow blasts ratio after induction chemotherapy for 2 weeks in patients with PhALL, and it's influence on complete remission (CR) and overall prognosis.</p><p><b>METHODS</b>A total of 172 patients with PhALL in our hospital from March 2012 to February 2016 were selected. The bone marrow blast ratio was analyzed by the receiver-operating characteristic curve (ROC) in patients after induction chemotherapy for 2 weeks, at same time its influence on CR and overall prognosis of PhALL patients was evaluated.</p><p><b>RESULTS</b>The cutoff value of CR was 0.075, its area under ROC was 0.763; the comparison of area under ROC with A=0.5 showed statistically significant difference, therefore 172 patients with PhALL were grouped according to bone marrow blast ratio after induction chemotherapy for 2 weeks: 104 cases (60.5%) with bone marrow blast ratio <0.075, 68 cases (39.5%) with bone marrow blast ratio ≥0.075. The PhALL patinets with bone marrow blast ratio <0.075 who achieved CR and finally achieved CR after induction chemotherapy for 4 weeks acconnted for 89 (85.6%) and 99(95.2%) respectively, which were significantly higher than those in PhALL patients with bone marrow blast ratio≥0.075, [29(42.6%) and 52 (76.5%)](P<0.05). In addition, the influencing factor clinically reducing the OS and DFS rate of patients and enhancing the ralapse rate of patients were mainly chemotherapy, the failure of induction chemotherapy (patients did not achieve CR after induction therapy for 4 weeks), the bone marrow blast ratio≥0.075 after induction treatment for 2 weeks, and CNSL at diagnosis and so on, while the enhaced WBC count at diagnosis was poor factor affecting the DFS rate of patients.</p><p><b>CONCLUSION</b>After induction chemotherapy for 2 weeks, the elevated bone marrow blast ratio in PhALL patients will be infavourable to CR, and the overall prognosis is poor.</p>
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Objective To determine whether prenatal ultrasonography (US) score is more effective than renal pelvic anterior posterior diameter (PAPD) for the prognostic evaluation of fetal hydronephrosis.Methods Fetuses with hydronephrosis (PAPD≥ 10 mm) were examined by prenatal US in the third trimester.PAPD,renal parenchyma thickness (RPT) and pelvicaliceal morphology (PM) were measured and graded from 0 to 3 score on the basis of severity of hydronephrosis,then the total US score of each kidney was obtained.According to the follow-up results after birth,all the cases were divided into two groups:physiological and pathological hydronephrosis.Via Z test,paired comparison was made to analyze area under the curve (AUC) of US score and each of the other three factors.Results Confirmed by postnatal US and other clinical examinations,of 198 kidneys (158 cases ) with hydronephrosis,139 (70.20％ ) were physiological hydronephrosis and 59 (29.80％ ) were pathological hydronephrosis.AUC of PAPD,RPT,PM,US score was 0.897 (minimum),0.957,0.944 and 0.982 (maximum) respectively,and there was significant difference between AUC of US score and each of the other three ( P ＜0.05).US score was the best approach for differential diagnosis of fetal hydronephrosis.Conclusions Prenatal US score is more effective and accurate than the single factor (PAPD,RPT,PM) to differentiate fetal physiological and pathological hydronephrosis.It was a new quantitative method to evaluate the prognosis of fetal hydronephrosis,and should be disseminated and applied clinically.
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Objective To explore the effects of recombinant human hormone(rhGH) on the plasma total protein,plasma albmin,healing of Wound surfaces in patients with the second degree burns wound.Methods 38 pa- tients with the second degree burns wound were divided into treatment group and control group randomly.All the patients were subject general.19 patients in the treatment group were given rhGH in a dose of 0.2U/kg for 14 days beginning from postoperative 5 days.The plasma total protein concentration,plasma albumin concentration,healing rat of wound surface and scar of patients of the two group were compared.Results The plasma total protein concen- tration plasma albumin concentration of the treatment group were significantly in creased,the scar hyperplasia of the treatment group were significantly mitigated and the healing time of wound surfaces of the treatment group were sig- nificantly shortened.Conclusion rhGH is found to promote protein anabotism and shorten the healing time of wound surfaces and mitigate the scar hyperplasia patients with the second degree burns wound.