Efficacy of Qizi Yusi Pill on Pregnancy Outcomes in Women of Advanced Reproductive Age: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evalvate efficacy of Qizi Yusi Pills (QYP), a Chinese medicine compound preparation, on in vitro fertilization-embryo transfer (IVF-ET) in women of advanced reproductive age.@*METHODS@#This multicenter, randomized, double-blind, placebo-controlled trial was conducted from June 2018 to October 2019. A total of 124 patients were randomly allocated to either the QYP group or the placebo group using a stratified block randomization design, with 62 patients in each group. All patients completed controlled ovarian stimulation using a standard gonadotropin-releasing hormone agonist (GnRH-a) long protocol. As the QYP group, QYP was administered while the control group received placebo. QYP and placebo were administered for a total of 24 to 30 days from the day of GnRH-a pituitary downregulation to transvaginal oocyte retrieval. Both medications were taken orally at doses of 10 g three times each day. The primary outcome was cumulative pregnancy rate, and the secondary outcomes were periodic medication, follicular status, serum hormone and endometrial receptivity. Follow-up continued until 4 weeks after delivery. Maternal and neonatal complications, such as gestational diabetes, were also observed.@*RESULTS@#Overall, 119 patients completed the study, 60 in the QYP group and 59 in the placebo group. Per protocol (PP) analysis revealed that 6-month cumulative pregnancy rate in the QYP group was significantly higher than that in the placebo group [43.33% (26/60) vs. 25.42% (15/59), P=0.040). Additionally, more oocytes were retrieved from the QYP group than those from the placebo group (8.95 ± 3.12 vs. 7.85 ± 1.91, P=0.022). Moreover, the endometrial thickness of HCG day in the QYP group was significantly higher than that in the placebo group (11.78 ± 2.27 mm vs. 10.68 ± 2.07 mm, P=0.012). Maternal and neonatal complications between the two groups were not significantly different (P>0.05). Intention-to-treat analysis was in line with PP results.@*CONCLUSIONS@#QYP can enhance ovarian reserve capacity and ovarian response, and possibly promote endometrial receptivity. QYP effectively improves cumulative pregnancy rates in older patients (⩾35 years) undergoing IVF-ET. (Registration No. ChiCTR1800014427).

Perioperafive management of neurosurgical patients with recurrent epileptic seizures / 中华神经医学杂志

Objective To investigate the clinical features of recurrent epileptic seizures and perioperative management principles and methods of neurosurgical patients with recurrent epileptic seizures.Methods The clinical data,reasons for aggravated seizures,seizure characteristics,and treatment methods and results of 9 patients with recurrent epileptic seizures were analyzed retrospectively.Results Of all the 9 patients,3 were combined with glioma,1 with arachnoid cyst,1 with cavernous hemangioma and 1 with encephalomalacia; epilepsy history was noted in 7 patients; frontal lobe epilepsy was noted in 7,and temporal lobe epilepsy in 2.The reasons for seizure aggravation included drug-decrement(n=3),recent-diagnosed brain tumor(n=2)and surgical operation during intracranial electrode implantation(n=1); and unknown reason was noted in the other 3.Epileptic seizure types included partial seizure and secondary generalized seizure; the frequency of seizure ranged from 3 minutes of interval to several hours of interval.Patients given multiple antiepileptic drugs,including oral and parenteral administration,received good seizure-control; and levetiracetam showed good curative effect during the treatment.Conclusion Recurrent seizures show drug refractory,and is hard to control.The AEDs having good curative effect in partial seizure should be combined used in these patients with higher dosage than conventional initial dose; intravenous and intramuscular administration can be used; the seizures should be controlled as soon as posible.Levetiracetam has good curative effect on patients with recurrent seizures for its fast oral-absorption,rapid onset of action and good antiepileptic effect.

Expression and Immune Effect Study of Therapeutic Recombinant Protein Vaccine VP22?-mE6?/mE7 / 中国生物工程杂志

In order to investigate the biological effects of the VP22?-mE6?/mE7 built-in adjuvant fusion protein vaccine on the tumor associated with HPV-16 infection.HSV-1 VP22? and HPV-16 mE6?/mE7 genes were cloned,and the pET28a-VP22?-mE6?/mE7 recombinat prokaryotic expression vector was constructed.Vector was transformed into Rosetta(DE3)E.coli string and expressed under the induction of IPTG.The re-naturalized protein was then purified via Ni2+ affinity adsorbent column and identified by SDS-PAGE and Western blot.Purified protein was immunized BalB/C and C57BL/6 mice to evaluate the immunogenicity and anti-tumor activity.The expressed recombinant protein formed as inclusion body with a prediction MW about 34kDa and contained approximately 45% of total somatic protein.The VP22?-mE6?/mE7 immunization induced higher titer of specific IgG against HPV,higher level of lymphocyte proliferation and better effect on suppressing HPV16 positive TC-1 tumor growth than the mice immunized with mE6?/mE7 alone.The results showed that the recombined built-in adjuvant vaccine could induce specific cellular immune response in vitro and inhibit the TC-1 tumor proliferation in vivo,that would be a foundation for further studies and developments of inner adjuvant vaccines.