The application value of sperm nuclear DNA integrity and sperm morphology in the treatment of ICSI / 中国基层医药

Objective To investigate the effects of sperm DNA fragmentation (SDF)and sperm morphology on the fertilization and embryo development in ICSI.Methods SDF and sperm morphology were detected in the meanwhile of taking eggs in 1 45 ICSI treatment cycle.On the basis of SDF index (DFI)divided into group A (DFI≤30%)and group B (DFI >30%).According to the normal sperm morphology divided into group C (NMSR≥4%), group D (1 %≤NMSR 30% and NMSR 0.05).(2)The normal fertilization rate was statistically significant in group C,group D,group E (χ2 =34.5,65.8,11 .8,all P 0.05).(3 )The normal fertilization rate,embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate in group F were significantly higher than those in group G,and normal fertilization rate,embryos utilization rate,good quality embryo rate had statistically significant differences (χ2 =37.5,1 1 .0,4.3,all P <0.05). Conclusion Sperm abnormal morphology has negative effect on fertilization,and the high DNA fragments have negative effects on fertilization and embryo development.

Outcome of modified intracytoplasmic sperm injection using zona pellucida -bound spermatozoa in male ;infertility / 中国基层医药

Objective To investigate the treatment outcome of modified intracytoplasmic sperm injection (ICSI)using zona pellucida(ZP)-bound sperm.Methods 82 patients with less,weak,abnormal sperm disease who were conformed to ICSI,were divided into traditional ICSI group and the group of modified ICSI using ZP-bound sperm according to ICSI case number.The results of normal fertilization rate,cleavage rate,high-quality embryo rate, planting rate,clinical pregnancy rate and early abortion rate were compared.Results The women's age,the sterility year,mature egg rate,normal fertilization rate,cleavage rate in the two groups had no statistically significant differ-ences (all P>0.05).The planting rate and clinical pregnancy rate of the observation group (46.6%,63.3%)were higher than those of the control group(38.5%,53.6%),but there were no statistically significant differences(all P>0.05).The using embryo rate and high-quality embryo rate of the observation group (73.9%,51.0%)were signifi-cantly higher than those of control group(65.8%,38.6%),the differences were statistically significant(χ2 =5.84,χ2 =11.6,all P<0.05).Conclusion Modified ICSI using ZP-bound sperm can effectively improve the embryos quality in ICSI.

Correlation Analysis of the Detection Rate of Carbapenems-resistant Gram-negative Bacillus with Drug Consumption in Our Hospital / 中国药房

OBJECTIVE:To provide reference for standardizing the clinical use of carbapenem antibiotics and controlling drug-resistant bacteria infection. METHODS:The detection of 3 kinds of carbapenems-resistant Gram-negative bacillus in our hospi-tal during 2011-2016 were analyzed retrospectively. The consumption,target cure rate and treatment course of carbapenem antibiot-ics were analyzed statistically. The correlation between detection rate of drug-resistant bacteria with the consumption of carbapenem antibiotics was investigated by Pearson test. RESULTS:During 2011-2016,1222 strains of carbapenems-resistant Acinetobacter bauman (CRAB),655 strains of carbapenems-resistant Pseudomonas aeruginosa (CRPA) and 53 strains of carbapenem-resistant Escherichia coli (CRE) were detected in our hospital. The detection rates increased from 23.88%,8.92%,0.09% in 2011 to 80.34%,35.74%,0.97% in 2016. The types of carbapenem antibiotics in our hospital were mainly imipenem and meropenem. The consumption of them increased from 4222,145 g in 2011 to 7218,4387 g in 2016. The both target cure rates were all lower than 60%,and the proportion of the patients with treatment course >14 d was more than 65%. The detection rates of CRAB,CR-PA and CRE were positively correlated with the consumption of carbapenem antibiotics (r>0.9,P<0.05). CONCLUSIONS:The detection rate of carbapenems-resistant Gram-negative bacillus and drug consumption increase year by year in our hospital,and they have certain correlation. The target cure rate of carbapenem antibiotics in our hospital is in low level,and there is a long treatment course. They are should be standardized in the clinic. The selection of carbapenem antibiotics should be strictly followed clinical in-dications so as to reduce the generation of drug-resistant strains.

Comparison of prognostic models for patients with early-stage diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>Early-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.</p><p><b>RESULTS</b>Ninety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively.</p><p><b>CONCLUSION</b>NCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.</p>

Effects of palm pressing PICC and mandible-pressing-on-shoulder on PICC′s misplacement in jugular veins / 现代临床护理

Objective To study effects of palm pressing peripherally inserted untral catheter(PICC) and mandible-pressing-on-shoulder on PICC′s misplacement in jugular veins during intubation. Methods Seventy-six patients undergoing intubation with PICC were randomized into observation group and control group equally by random digital table. The palm pressing PICC method was used in the observation group and the mandible-pressing-on-shoulder method was used in the control group. The two groups were compared in terms of the incidence of PICC misplacement. Result The misplacement rate of PICC in the experiment group was significantly lower than that in control group (P<0.01). Conclusion Palm pressing method is much effective in prevention of PICC misplacement in jugular veins and worth promoting especially in hospitals of basic level.

Advances in leukoaraiosis / 国际脑血管病杂志

Leukoaraiosis (LA) is not only found in patients with vascular dementia,Alzheimer's disease,brain trauma,carbon monoxide poisoning Binswanger's disease,mild cognitive impairment,diabetes,but also have a certain proportion in the normal elderly.This article reviews the advances in research on the risk factors,pathogenesis,pathological changes,clinical manifestations,imaging characteristics and treatment of LA.

Functional Research of Cassette Chromosome Recombinase C Mediated Staphylococcal Cassette Chromosome mec Istand Excision / 中国医科大学学报

Objective To construct 2 recombinant plasmids carrying cassette chromosome recombinase C(ccrC)and ccrAB respectively and introduce the plasmids into methicillin-resistant Staphlococcus aureus(MRSA)strain 81/0432,and to observe the precise excision of Staphylococcal cassette chromosome mec(SCCmec)island from bacterial chromosome.Methods ccrC and ccrAB genes were amplified with chromosomal DNAs isolated from MRSA strains 81/0342 and N31S as PCR templates.We constructed recombinant plasmids pSR5C and pSR2AB by cloning ccrC and ccrAB genes into temperature-sensitive plasmid pYI3,after introducing them into MRSA strains 81/0432 and N315 by electroporation.PCR was performed to identify SCCmec excision from the bacterial chromosome.The transformants were serial passaged for 10 days,and then the drug resistance of these rransformants was detected by replica experiment.Results The fragment length of ccrC gene was 1.9 kb,smaller than the fragment length of ccrAB from N315.The recombinant plasmids of pSR5C and pSR2AB were successfully constructed.After these 2 recombinant plasmids were introduced into MRSA strain 81/0342,type-V SCCmec island was excised from the chromosome and formed a closed circular structure in the bacteria.However,type-Ⅱ SCCmec island could be excised only in N31S strain after the expression of pSR2AB.Replica experiment verified that transformed strains of 0342(pSR2AB),0342(pSR5C),and N315 (pSR2AB)were mostly susceptible to ceftizoxim or tobramycin after the excision of SCCmec island.Conclusion cciC could serve as a recombinase as ccrAB,which could mediate precise excision of SCCmec island from the chromosome of type-V MRSA strain.This study shows that type-V SCCmec island is widely disseminated between Staphylococcus aweus strains in community setting.

Long-term results of prophylactic cranial irradiation for limited-stage small-cell lung cancer in complete remission / 中华放射肿瘤学杂志

Objective To evaluate the effects of prophylactic cranial irradiation (PCI) on the survival and brain metastatic rates in patients with limited stage small cell lung cancer (SCLC) in complete remission. Methods Fifty one patients with limited stage SCLC in complete remission after chemoradiotherapy were randomly divided into prophylactic cranial irradiation (PCI) group (n=26) and control group (n=25). Patients in PCI group received irradiation to a dose of 25.2～30.6?Gy by 1.8～2.0?Gy per fraction. With the survival rates of the two groups analyzed by life table and compared by Log Rank test, the difference in cranial metastatic rates between the two groups were tested by ? 2 test. The patients' clinical features such as age, sex, effect of treatment before PCI were comparable between the two groups. Results The incidence of cranial metastasis was 3.8% in the PCI group as compared with 32.0% in the control group, with the difference significant (? 2=5.15, P= 0.02 ). The 1 , 3 , 5 year survival rates were 84.6%, 42.3%, 34.6% in the PCI group and 72.0%, 32.0%, 24.0% in the control group, with no significant difference between the two groups (? 2=2.25, P=0.13). No serious complications were observed in patients who received PCI. Conclusion For patients with limited stage SCLC complete response after chemoradiotherapy, PCI can decrease the incidence of cranial metastasis and tends to improve the survival rate.