Ethical Issues in the Application of IVF from the Perspective of Females Undergoing IVF / 中国医学伦理学

Infertile women experience complex biological and social experiences in the process of receiving IVF. From the perspective of females undergoing IVF, it is helpful to analyze the ethical and social problems that IVF may face more intuitively and concretely. In this study, 213 women who were undergoing IVF were randomly selected to carry out a questionnaire survey. The results showed that the choice of IVF for infertile women was driven by multiple pressures from family and society, not entirely on their own; They are not aware of the technology, but have a positive attitude, and are eager to be fully informed in the treatment process. In addition, the treatment brings great economic pressure to women who were undergoing IVF and has no significant impact on the relationship between husband and wife. Only by paying attention to the above problems and solving them can we benefit more infertile women and help them realize their reproductive wishes.

Research Progress on the Relationship between Obesity-Inflammation-Aromatase Axis and Male Infertility.

Aromatase is a key enzyme in the transformation of androgen into estrogen. Its high expression will destroy the hormonal balance in the male body, and the excessive transformation of androgen into estrogen in the body will further damage the spermatogenic function of the testis, affect the normal development of the sperm, and cause spermatogenic disturbance. Adipose tissue has a high expression of aromatase and shows high enzymatic activity and ability to convert estrogen. Adipose tissue is the most estrogen-producing nongonadal tissue in the body because of its large size, accounting for about 20% of the body mass in healthy adults. PPARγ is recognized as the key adipose differentiation in the transcriptional regulation of the transcription factor. In the process of adipocyte differentiation, PPARγ regulate the expression of aromatase. The increase of aromatase is associated with the inflammatory response in adipose tissue caused by obesity. After obesity, the increase of proinflammatory factors in adipocytes will lead to enhanced transcription of the CYP19 gene encoding aromatase in adipocytes, which in turn will lead to increased expression of aromatase in adipocytes. This article reviews the regulation of male sterility from the angle of the "obesity-inflammation-aromatase" axis.

Effects of sequential and single-step culture media systems on human oocyte fertilization and early embryo development / 吉林大学学报(医学版)

Objective: To compare the effects of sequential and single-step culture media systems on the development of human early embryo in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles, and to provide a reference for the selection and evaluation of the human embryo culture system of assisted reproductive technology (ART). Methods, A total of 155 patients received IVF/ICSI treatment were selected and the ova from the same patient were divided into two groups. The ova were cultured in Vitrolife sequential media system G-IVF/G1/G2 culture solution (sequential culture group) and Irvine single-step media system CSCC culture solution (single-step culture group) for IVF and embryo culture. The fertilization and early embryo development in the different culture systems in two groups were observed. Results: Compared with single-step culture group, the fertilization rate, 2PN fertil ization rate and multi-nuclear fertilization rate of the patients in sequential culture group had no significant differences (P>0. 05). In the IVF patients, there were no significant differences in the cleavage rates, quality embryo rates, high quality embryo rates and blastocyst formation rates between sequential culture group and single-step culture group (P>0. 05). In the ICSI patients, there were also no significant differences in the cleavage rates, quality embryo rates and blastocyst formation rates between sequential culture group and singlestep culture group (P>0. 05). However, the high quality embryo rate of the patients in sequential culture group was significantly higher than that in single-step culture group (P=0. 015). Both in the IVF and ICSI patients, the percents of densification embryos in single-step culture group were significantly higher than those in sequential culture group (P = 0.001). Moreover, the embryos cultured in sequental culture group were smooth and homogeneous, but the embryos cultured in single-step culture group were rough and granular. Conclusion: There are no significant differences in fertilization and early embryo development between the two culture media systems.

Cause and management of difficult laparoscopic appendectomy / 中国医师进修杂志

Objective To study the cause and management of difficult laparoscopic appendectomy.Method A retrospective analysis of 102 difficult laparoscopic appendectomies was performed. Results The associating factors leading to operative difficulty were as follows:adhesion of peri-appendix in 44 cases,gangrene at root of appendix in 21 cases,special location of appendix in 17 cases,abdominal adhesion in 12 cases,obesity and inflatable intestine in 8 cases. Laparoscopic appendectomy was successfully performed in 96 cases(94.1%,96/102) ,and no intestinal leakage or massive hemorrahge occurred. Conclusions Adhesion of peri-appendix is the most common cause in difficult laparoscopic appendectomy,and gangrene at root of appendix is the most difficult one. Reasonable management for appendix stump contributes to successful operation.

The effect of palliative resection on incurable colorectal cancer survival / 中国医师进修杂志

Objective To quantify the benefit of primary Pdmor removal in patients with differently presenting incurable coloreetal cancer,while no other therapy combined.Methods One hundred and forty-three consecutive patients were operated for incurable colorectal cancer(91 undergoing resective and 52 non-resective procedures),with the purpose of comparing homogenous populations and of identifying whether the patients got benefit from primary tumor resection.Results In patients with resectable primary tumors,resective procedures were associated with longer median survival than non-resective procedures(10 months vs 3 months),patients with distant spread without neoplastic ascites/implanting metastasis got benefit from primary tumor removal(P＜0.01).The complication of resective procedures was not significantly differ-ent from that of non-resective procedares(P＞0.05).Conclusion Palliative resection of primary colorectal cancer should be pursued in patients with unresectable distant metastasis whenever the primary tumor is technically resectable.