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Objective:To investigate the effect of scar uterus on assisted reproduction treatment strategy.Methods:From January 1, 2017 to December 31, 2017, 109 cases of scar uterus group and 63 cases of vaginal delivery history group who underwent in vitro fertilization-embryo transfer (IVF-ET) assisted pregnancy fresh embryo transfer in our hospital were retrospectively analyzed. Results:⑴ There was no significant difference in the total amount of gonadotropin (Gn) and the total days of GN in patients <35 between scar uterus group and the vaginal delivery history group ( P>0.05), but there were significant differences in the number of oocytes, mature oocytes, two pronucleus (2PN) and excellent embryos between the scar uterus group and the vaginal delivery history group ( P<0.05). When the age was ≥35 years old, there was no significant difference in the total number of GN, the total days of GN, the number of oocytes obtained, the number of mature oocytes, the number of 2PN and the number of excellent embryos between the two groups ( P>0.05). ⑵ There were no statistically significant differences in clinical pregnancy rate and embryo implantation rate between the two groups of patients < 35 years old, no matter single embryo transplantation or double embryos transplantation. When transplant two embryos, the clinical pregnancy rate and embryo implantation rate in the scar uterus group were slightly lower than those in the vaginal delivery history group (57.57% vs 71.05% and 39.39% vs 47.37%, respectively), but with no significant difference ( P>0.05). There were no statistically significant differences in the clinical pregnancy rate and embryo implantation rate between single embryo transplantation and double embryo transplantation in patients≥35 years old ( P>0.05). ⑶ There were no statistically differences in biochemical pregnancy rate, early abortion rate, preterm birth rate and average newborn weight between the scar uterus group and the vaginal delivery history group ( P>0.05). Conclusions:Cesarean section may affect the ovarian function. For patients with previous cesarean section, early evaluation of ovarian function is recommended. Single embryo transfer does not reduce the outcome in IVF-ET. It is recommended to perform single embryo transfer for patients with scar uterus to reduce the risk during pregnancy of twin pregnancy.
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Objective To assess the effects of artificial cycle after long-acting gonadotropin-releasing hormone (GnRH) agonist down regulation scheme and artificial cycle only scheme in preparation of endometrium before frozen embryo transfer in polycystic ovary syndrome (PCOS) patients on pregnancy outcome.Methods A retrospective analysis was made on the frozen embryo transfer of 132 PCOS patients in the reproductive center of Hunan Maternal and Child Health Hospital from November 2016 to October 2017.The patients were divided into GnRH-a down regulation + artificial cycle group (n =66) and simple artificial cycle group (n =66) according to the different endometrial preparation schemes before frozen embryo transplantation.The transplantation cycle and pregnancy outcome of the two groups were compared.Results (1) There was no statistically significant difference in age,primary infertility rate,infertility years and body mass index (BMI) between the two groups (P ＞ 0.05).(2) In the artificial cycle group,4 cases in which the transplantation was cancelled,including 2 cases who were cancelled due to breakthrough bleeding and 2 cases due to endometrial thickness that were less than 7 mm.There was a statistically significant difference in the cancellation rate between the two groups (x2 =4.13,P =0.04).There were no statistically significant difference in embryo frozen storage time,retrieved oocytes in fresh embryo cycle,frozen thawed embryos in the survival rate,graftage embryonic number,high-quality embryonic rate,endometrium thickness in conversion day (P ＞ 0.05).Estrogen level,luteinizing hormone (LH) levels on endometrium conversion day in GnRH-a down regulation plus artificial cycle group and artificial cycle group were respectively as [(1 439.38 ± 357.43) nmoL/ml vs (1 580.54 ± 479.69) nmol/ml and (2.32 ± 0.94) mIU/ml vs (9.46 ±1.52) mIU/ml],with statistically significant difference (x2 =53.64,P ＜ 0.001;x2 =14.32,P ＜ 0.001).(3) The biochemical pregnancy rates of the patients in the GnRH-a down regulation plus artificial cycle group and artificial cycle group were 72.73％ and 53.23％ respectively,with statistically significant difference (x2 =5.23,P =0.036).The clinical pregnancy rate (65.15％) in GnRH-a down regulation plus artificial cycle group was higher than that of the artificial cycle group (46.77％),with statistically significant difference (x2 =4.39,P =0.022).There was no statistically significant difference in early abortion rate and ectopic pregnancy rate between the two groups.Conclusions In frozen embryo transplantation cycle,long-term GnRH-a down regulation after artificial cycle scheme is superior to simple artificial cycle scheme with significantly reduced cycle cancellation rate,low estrogen and LH levels in endometrium transformation day and higher biochemical pregnancy rate and clinical pregnancy rate.
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Objective To investigate the effects of the frozen embryo transplantation for patients with poor outcome of endometrial growth by using growth hormone (GH) intrauterine perfusion combined with replacement cycle in the treatment of thin endometrium.Methods This was a prospective study and study participants were consecutively recruited between Jun 2014 and September 2015.A total of 88 frozen thawed embryo transfer cycles was divided into two groups from the Reproductive Center of Hunan Provincial Maternal and Child Health Hospital.Group A were 63 hormone replacement therapy (HRT) cycles and Group B were 25 GH intrauterine perfusion combined HRT cycles.Results The endometrial thickness of 22 thin endometrium patients from Group B were increased above 7 mm on progesterone day.The endometrial thickness on transplant day of Group A was (9.28 ± 1.64) mm,which was significantly higher than Group B (7.9 ± 0.86) mm (P ＜ 0.05).The clinical pregnancy rate (50.79％ vs 52.0％),implantation rate 31.1％ vs 47.17％),miscarriage rate (9.38％ vs 15.38％) had no significant difference between Groups A and B.The endometrial thickness from 7 mm to 7.9 mm on transplant day,the clinical pregnancy rate (30.76％ vs 54.54％) had no significant difference in two groups (P ＞0.05),but the implantation rate of group A was significantly lower than that of group B (20％ vs 52.17％) (P ＜0.05).When the endometrial thickness was above 8 mm on transplant day,the clinical pregnancy rate (58.33％ vs 63.63％),implantation rate (36.36％ vs 50％) had no significant difference between groups A and B (P ＞ 0.05).Conclusions GH uterine cavity perfusion was a useful method for treatment of thin endometrium,and was helpful for improvement of endometrial thickness and receptivity,improved embryo implantation environment by assistance for HRT under the high estrogen levels.
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Objective To evaluate the curative effect between conventional fraction radiotherapy (CFRT) and intensity modulated radiation therapy (IMRT) combined with concurrent chemotherapy for unresectable esophageal carcinoma.Methods 144 patients were enrolled into this study.They were divided into CFRT group and IMRT group.CFRT group (60 cases):irradiation field encompassed primary lesion and mediastinal lymph drainage regin.Neck and thoracic upper segment cases were made front thorax T field irradiation first,DT 36 Gy/18 f,followed by two front oblique field made Iso-central irradiation,field width was 4.5-5.0 cm,gantry angle 50°-60°,wedge filter 30°,DT added to 66 Gy.For thorax middle or lower segment patients,field width was 6.0-6.5 cm,field length was that the tumor upper and lower each extended 3.0-5.0 cm,vertically irradiated in thoracic front and at the back,after DT 36 Gy/18 f,changed to two back ablique field,made Iso-central irradiation,DT added to 66 Gy.IMRT group (84 cases):GTV was esophageal primary lesion and metastasis lymph node (GTVnd);CTV included GTV,GTVnd and mediastinal lymph drainage region,at GTV around all was widened 0.8-1.0 cm,its upper and lower each extended 3.0-5.0 cm;PTV were in the basis of CTV,all were widened 0.5 cm again.With ≥95 ％ isodose curve covering the PTV and the target dose was prescribed to PTV 60-64 Gy/30-32 f.Organ at risk (OAR):both lungs V20≤30 ％,spinal cord ≤45 Gy/6 weeks,heart V30≤40 ％.Chemotherapy of two groups was same,DDP 25-30 mg/m2 × 3-5 days,5-Fu 450-500 mg/m2 × 5 days civ,28 days were one period,total 2 period,after 1-3 months,strengthen chemotherapy 3-4 period.Results Leucopenia and radiation-induced esophagitis as shown by the WHO staging system were the most common acute toxicities,but were mainly grade 1 or 2.The incidence rate of leucopenia and radiation-induced esophagitis in CFRT group were 78.3 ％ (47/60) and 83.3 ％ (50/60),IMRT group were 82.1％ (69/84) and 79.8 ％ (67/84).After symptomatic treatment,all patients completed the planner treatment.During radiotherapy and after treatment,the patients showed grade 1-2 radiation-induced pneumonitis,CFRT group were 36.7 ％ (22/60),but IMRT group were only 9.5 ％ (8/84) (x2 =9.99,P ＜ 0.01).In CFRT group and IMRT group,the 1-,3-,5-year survival rates were 75.0 ％ (45/60),36.7 ％ (22/60),20.0 ％ (17/84) and 79.8 ％ (67/84),35.7 ％ (30/84),21.4 ％ (18/84),respectively.Conclusion The overall response and 5-year survival rates of CFRT and IMRT combined with concurrent chemotherapy are similar,however,the incidence of grade 1-2 radiation-induced pneumonitis of IMRT is low,which indicates that IMRT can reduce the lungs irradiational volume and dose.
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This article was aimed to study the intestinal absorption about main active ingredients of pectolinarin and pectolinarigenin in Carboned Cirsium japonicum DC. The absorption rate and absorption rate constant were taken as indicators. The intestinal absorption of pectolinarin and pectolinarigenin were compared by everted rat intestinal sac method among different parts of the small intestine. The results showed that the absorption rate constant of pectoli-narin among duodenum, jejunum, ileum and colon parts were 0.505 1 ± 0.192 7, 0.936 0 ± 0.187 2, 0.732 0 ±0.133 5, 0.251 3 ± 0.027 6 (μg·h-1·cm-2). The absorption rate constant of pectolinarigenin among the duodenum, je-junum, ileum and colon were 0.059 1 ±0.008 3, 0.093 3 ±0.029 2, 0.112 3 ± 0.035 6, 0.029 4 ± 0.009 1 (μg·h-1·cm-2). It was concluded that the absorption of both ingredients increased over time. The absorption of both ingredi-ents in the jejunum and ileum was higher than other parts of the small intestine. The absorption rate of pectolinarin in the entire small intestine was much higher than the absorption rate of pectolinarigenin.
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Objective To seek the curative effect of stereotactic radiation therapy (SRT) combined with gemcitabine for unresectable advanced pancreatic carcinoma.Methods 24 patients were treated by SRT of 6MV X-ray.Patients were fixed with the rack of stereotactic localization and heated plastics mould.The CT scanning results were put into the treatment planning system.According to the target area of tumor,sensitive organs and moving error drew GTV,CTV and PTV.The best plan was selected by the dose-volume histogram (DVH).5 to 7 beams of non-coplanar radiation ray were chosen.PTV was surrounded by ≥95 ％ isodose curves.Conventional fraction,5 fractions per week,1.8-2 Gy per fraction was used.All patients received a total dose of 50-60 Gy.Gemcitabine was performed 1000 mg/m2,once a week,iv gtt,in the 1st,2nd and 4th,5 th weeks.Results In chemo-radiotherapy,50.0 ％ (12/24) patients showed light nausea,41.7 ％ (10/24) patients showed leucopenia or thrombocytopenia of grade 1 or 2,after symptomatic treatment,all patients completed the planned treatment.In a period of one month to three months,after SRT combined with chemotherapy,appetite improvement was 83.3 ％ (20/24),jaundice disappeared in 6 of 6 patients (100.0 ％),abdominal pain was relieved in 21 of 24 patients (87.5 ％),3 patients were relieved completely among them.The complete remission (CR) rate was 16.7 ％ (4/24) and partial remission (PR) rate was 66.7 ％ (16/24),with CR+PR rate of 83.4 ％ (20/24).One-year survival rate was 70.8 ％ (17/24).As a consequence of cachexia,intestinal obstruction or bleeding,7 patients died within one year.Nobody survived more than 2 years.Conclusions SRT combined with gemcitabine for advanced pancreatic carcinoma may relieve symptoms.It is an effective approach to improve life quality and prolong survival time for advanced pancreatic carcinoma,especially lod and weak patients are more suitable to select SRT combined with gemcitabine.
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ObjectiveTo evaluate the fourth-generation ultrasonic lithotripsy system for treating the urinary tract stones.Methods243 cases of urinary tract stones who received treatment of fourth-generation EMS ultrasonic lithotripsy system were analyzed retrospectively.ResultsImmediate phase I lithotrotrisy was performed successfully in 227 cases and the successful rate of phase I was 93.3％ (227/243).Delayed phase Ⅱ lithotripsy was performed for 16 patients.Complications happened in 2 cases,one case occurred hydropneumothorax during operation,required indwelling thoracic drainage tube processing,the other had severe bleeding which conservative treatment was ineffective,cured by the intervention of super-selective renal artery embolization.Conclusion Fourth generation of ultrasonic lithotripsy for treating stones on different anatomical locations of urinary system was safe,practical and efficient,worthy of clinical application.
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Objective To discuss the effect of somatostain SS on metabolism of free radicals in animal models of osteoarthritis,so to discuss the treatment mechanism of intra- articular injection of somatostatin on osteoarthritis.MethodsForty experimental Japanese big-ear rabbits were randomly divided into four groups:normal control group,blank model group,normal saline group and SS group,n =10 for each group.After modeling,the rats in SS group and normal saline group received intra- articular injection of somatostain and saline respectively on the right knee.Ten weeks after the modeling,we measured the movement of right knee joint in rabbits,the levels of nitric oxide ( NO ) and hyaluronic acid (HA) in serum from the heart blood,and the activity of SOD and the content of MDA in synovial tissue.Results Compared with the blank model group,the movement of the knee joint was significantly increased in SS group,(96.01 ± 1.06)vs (50.21 ± 1.80) (P ＜ 0.01 ).In the blank model group,the levels of NO and HA (μmoL/mL) in serum were ( 111.60 ± 2.76) and ( 309.11 ± 1.89 ),which was significantly decreased in SS group,which was( 80.14 ± 1.67 ) and ( 133.73 ± 2.75 ) ( P1 =0.0049,P2 =0.0052,P ＜ 0.01 ).Compared with the blank model group,the SOD activity was (15.77 ± 2.76) and the MDA in serum nmol/mg prot was( 1.33 ±1.03),while was significantly increased in SS group,(24.74 ± 1.67) ( P ＜ 0.01 ),and the levels of MDA in serum was significantly decreased in the SS group,(0.89 ±1.46) (P＜0.01).Conclusion Intra-articular injection of somatostatin in knee osteoarthritis can improve the oxidative stress,enhance the activity of the knee joint.
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Objective To investigate the cellular localization of the neural precursor cell-expressed, developmentally downregulated isoforms(Nedd4), Nedd4- 1/2 and Nedd4- 2, and the serum glucocorticoid- inducible kinasel(SGK1) in various subregions of the rat cochlea. Methods The expression patterns of Nedd4-1/2, Nedd42 and SGK1 in the cochlea of rat were studied by immunohistochemistry with the specific polyclonal rabbit antibodies against the rat Nedd4-1/2, Nedd4-2 and SGK1. Results All three proteins were extensively expressed in various regions of the rat cochlea. They were found in the stria vascularis, spiral ligament, organ of Corti, spiral limbus, spiral ganglion and Reissner's membrane. Conclusion Our findings suggest that there exists a Na+ transport system in the cochlea consisting of SGK1, Nedd4 isoforms and ENaC, which may work in concert to transport Na+ and to maintain homeostasis in the inner ear as they do in other tight epithelia.
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OBJECTIVE To explore the characteristics of cochlear hair cell injuries in guinea pigs exposed to blast underpressure(BUP). METHODS The guinea pigs were killed 14 days after exposure to experimental BUP. Their basilar membranes were stained by silver nitrate and the hair cell injuries were quantitatively assessed using the light microscope. RESULTS The outer hair cells(OHCs) of the guinea pigs clearly appeared to be injured following exposure to the experimental BUP at a peak underpressure varying between -22.4kPa and -63.3kPa. The most obvious injury was in the second turn and OHC loss was smallest in the first row and more severe in the second and third rows. OHC loss was seen in all of three experimental groups of animals following exposure to BUP. Furthermore, the higher the peak of underpressure, the more obvious the injury of OHCs. Quantitative morphological analysis of cochlear hair cells showed that the total OHC loss rates in all the experimental groups of guinea pigs exposed to BUP were significantly higher than that of control group animals(P
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Objective To investigate the cellular localization of aquaporins(AQPs) and its significance in various subregions of the cochlea and endolymphatic sac of guinea pig.Methods Adult guinea pigs were used and the expression patterns of AQP1,2,3 and 4 in the cochlea and endolymphatic sac were studied immunocytochemically. Paraffin- embedded sections were labeled with the specific polyclonal rabbit antibodies against the rat AQP1, 2, 3, and 4.Results In the cochlea, AQP1, 3, 4 were widely distributed in various subregions including the stria vascularis, spiral ligament, organ of Corti and spiral ganglion in the similar patterns except that AQP3 in the stria vascularis was weaker than AQP1 and AQP4. AQP2 was labeled only in the Reissner's membrane. In the endolymphatic sac, AQP1, AQP3 and AQP4 were strongly expressed in the epithelial cells and subepithelial cells with the exception that AQP3 was a little weaker than AQP1 and AQP4. No AQP2 immunoreactivity was detected in the endolymphatic sac.Conclusion Our immunohistochemical results suggest that different members of AQPs family in labyrinth may work in concert to regulate endolymph and to maintain homeostasis in the inner ear.
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Intermittent overpressure of 20cmH 2 O was delivered to the external ear canal of guinea pigs. Histopathological changes in the middle and inner ear were examined under light microscope. Auditory evoked potential was recorded. The expression of atrial natriuretic peptide (ANP) was investigated by immunohistochemical SP method. We found that intermittent overpressure could minimize, but could not interrupt the development of endolymphatic hydrops,and could not improve hearing function. Expression of ANP decreased in the cochlear lateral wall after 2 week intermittent overpressure. The results suggested that intermittent overpressure of 20cmH 2 O was suitable in this experiment, and that ANP positive cells had an autocrine/paracrine function.
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ObjectiveTo investigate the expression of asubunit isforms of Na,K-ATPase in stria vascularis of guinea pig, and the effect of gentamicin on it. MethodsThe expression of a subunit isoforms of Na, K-ATPase in stria vascualris of guinea pig and its change after gentamicin exposure were identified immunocytochemically using the specific mouse antibodies a gainst the α1 ,α2 and α3 subunits of rat Na,K-ATPase. ResultsAll marginal cells,intermediate cells and basal cells of stria vas cualris showed positive expression of α1 isoform and negative expression of α2 and α3 isoforms. The immunostaining of α1 isform was attenuated significantly after gentamicin esposture. ConclusionGentamicin significantly inhibits the expression of Na, K-ATPase α1 subunit isoform of the stria vascularis, sequentially inhibits the activity of Na,K-ATPase.
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Objective To investigate the effect of cisplatin ototoxicity on apoptosis of spiral ganglion cells(SGC), and relation between signal transportation of Caspase-3 and apoptosis of SGC.Methods Forty guinea pigs were randomly divided into 4 groups, and injected cisplatin (1, 2, 4 day group and control group). ABR and AERP (40 Hz Auditory Event Related Potentials) were tested every day after the injection, to find out the threshold changes of guinea pigs. Apoptosis was detected by terminal deoxynucleotidyl transferase(TdT)-mediated deoxyuridine triphosphate(d-UTP) nick end labeling method (TUNEL), and immunohistochemistry method was used to detect Caspase-3 p20 segment of SCGs.Results It was observed that the more cisplatin injected, the worse hearing guinea pigs got, and the damnification of threshold on 8KHz was significantly higher than that on 1 kHz. At the same time, TUNEL staining and the expression of Caspase-3p20 segment rose up gradually, and significant difference was observed compared with control group ( P
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Objective To study the difference between the mRNA expressions of hyaluronan synthase in the epithelial cells of endolymphatic sac and renal tubules with the oligonucleotide probe. Methods The oligonucleotide probe of hyaluronan synthase was designed and synthesized, the mRNA expressions of hyaluronan synthase in the epithelial cells of endolymphatic sac and renal tubules were detected with hybridization in situ. Results mRNA of hyaluronan synthases were strongly expressed in some epithelial cells of endolymphatic sac and renal tubules. Conclusion It is confirmed that a dual regulatory system for hyaluronan /hyaluronidase exists in the epithelial cells of endolymphatic sac and renal tubules at the level of molecular biology.
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Objective To investigate the distribution and its significance of ? subunit isoforms of Na,K-ATPase in the inner ear of guinea pig.Methods The expression of ? subunit isoforms of Na,K-ATPase in labyrinth was studied immunocytochemically with the specific mouse antibodies against the ? 1?? 2 and ? 3 subunits of rat Na,K-ATPase.Results The expression of Na,K-ATPase ? subunit isoforms varied among different cell regions of the inner ear. The ? 1 subunit isoform was widely distributed in almost all regions, and was most abundant in the stria vascularis, sensory cells of the crista ampullaris and macula of the saccule, and the spiral ganglion cells, while the ? 2 and ? 3 subunit isoforms were present primarily in the spiral ganglion cells,the organ of Corti and stria vascularis.Conclusion The differential expression of Na,K-ATPase subunit isoforms presumably reflects different K + and Na + transport capacities among inner ear cells which, working in concert, serve to maintain homeostasis in inner ear.
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Objective To study the effect of substance P (SP), calcitonin gene-related peptide (CGRP) on the blood flow and the function of endolymphatic sac (ES) in guinea pigs to clarify the pathogenesis of some inner ear diseases further.Methods The guinea pig model of superior cervical ganglion (SCG) resection was set up. The ESs of the model animals were stained by SP and CGRP immunocytochemically. The staining images were analysed by the computer. The ESBF was measured with the biologic microphere method.Results Compared with the control group, the staining of SP decreased sharply in the model group, however, the staining of CGRP remained unchanged. In the model animals, the ESBF was decreased either.Conclusion SP and CGRP could take part in the regulation of ESBF to affect the function of ES further.