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Objective:To analyze the expectations and their influencing factors of gynecological examination among female physical examination population.Methods:Convenience sampling method was used to select women undergoing gynecological examinations in the health management center of the Shandong Provincial Hospital Affiliated to Shandong First Medical University between April to June 2021. A face to face interview was conducted with a 20-item structured questionnaire including general information, the women?s feelings about a gynecological examination, expectations of doctors, preferences for the doctor ?s gender, and the presence of chaperones in male doctor examination scenarios. Of the 1 600 questionnaires distributed, 1 583 were valid, with a recovery rate of 98.93%. To compare the preferences for a doctor ?s gender and chaperones with different demographic characteristics, an χ2 test was used. Logistic regression was used to analyze the influencing factors of preferences for doctors ?gender and for chaperones. Results:For a gynecological examination, women were mainly worried about the possibility of bad results (77.4%), while the main expectation to doctors was communication before the examination (49.2%); most women wanted to be examined by a female doctor (85.5%), mainly because they felt relaxed (76.0%); most women did not want chaperones when examined by a female doctor (56.5%), while most of them preferred to be accompanied by a nurse when examined by a male doctor (50.1%). Women whose family income was lower than expenditure and had gynecological examination experiences with male doctors tended to have no preference for a doctor ?s gender. Additionally, there was a strong inverse association between the education level and likelihood of no preference for a doctor ?s gender, that is, the lower the education level, the more likely they were to have no preference for the doctor ?s gender ( P<0.05), when examined by a male doctor. Furthermore, women older than 55 years and who had a gynecological examination more than twice a year, was less likely to need chaperones, while women who had gynecological examination experience with male doctors tended to have no preference for chaperones. Conclusions:Women preferred gynecological examinations to be performed by female doctors who provide gentle and companion staff support during the examinations. Education level, family income, and examination experience of male doctors are the influencing factors for gender preferences of a doctor. Age, examination frequency, and examination experience of male doctors are the influencing factors affecting the preferences of choosing an accompanying person.
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AIM: To explore the effects of preoperative application of dezocine patient-controlled analgesia pump on stress response and cognitive function in elderly patients with lower extremity fractures. METHODS: A total of 80 elderly patients with lower extremity fractures who were treated from November 2018 to June 2020 were selected and randomly divided into a control group and a study group, 40 cases in each. The control group was not given a patient-controlled analgesia pump before anesthesia, and the study group was given intravenous analgesia with a dezocine patient-controlled analgesia pump before surgery. The postoperative stress response, cognitive function and safety were compared between the two groups.RESULTS: There were no significant differences in cognitive function MMSE score, stress response index (cortisol, epinephrine) levels, and inflammatory factors (IL-6, TNF-α) levels between the two groups before intervention (P>0.05). Compared with the indexes after operation, the MMSE scores of the study group at 12 h, 24 h and 3 days after operation were higher than those in the control group (P<0.05); The levels of cortisol, epinephrine, IL-6 and TNF-α in the study group were lower than those in the control group at 12 h and 24 h after operation (P<0.05); At the same time, the incidences of respiratory depression, urinary retention and nausea and vomiting in the study group were significantly lower than those in the control group (P<0.05).CONCLUSION: Preoperative application of dezocine patient-controlled analgesia pump in elderly patients with lower extremity fracture can significantly reduce postoperative stress response, reduce inflammatory response, and improve postoperative cognitive function, which is worthy of clinical application.
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Objective:To observe the effect of functional electrical stimulation (FES) combined with an ankle-foot orthosis (AFO) and gait training on lower limb motor function, gait parameters and the joint angles of hemiplegic stroke survivors.Methods:Thirty-two stroke survivors who met the inclusion criteria were selected and randomly divided into a control group ( n=10), an orthosis group ( n=10), and a combination therapy group ( n=12). In addition to routine medication and rehabilitation, the control group received only gait training, the orthosis group received gait training and an AFO and the combination therapy group was given FES, an AFO and gait training. All three groups were treated for four weeks. Then, the Fugl-Meyer lower extremity assessment (FMA-LE), the Brunnstrom lower extremity assessment (BRL), and Functional Ambulation Categories (FACs) were used to evaluate the lower limb motor function and walking ability of the three groups. The gait parameters of the three groups were quantified using a three-dimensional gait analyzer, and the changes in the hemiplegic gait before and after treatment were compared among the three groups. Results:After the treatment the average FMA-LE, FAC and BRL scores, time-space parameters, and joint angle parameters of all three groups had all improved significantly. After the intervention the average indicators in the combined therapy group (including stride frequency, stride length and walking speed) were all significantly better than in the other two groups.Conclusions:Adding FES to gait training with an AFO can effectively improve lower limb motor function and the walking ability of hemiplegic stroke survivors.
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Objective To analyze the risk factors of low birth weight (LBW) in infants who were conceived through flesh embryo transfer after in vitro fertilization.Methods We retrospectively reviewed the medical records of 4 930 live babies born after in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) at Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University between January 2011 to December 2016.They were 3 474 singletons and 1 456 pairs of dizygotic twins.According to their birth weight,all singletons were divided into two groups:the LBW singleton group (＜2 500 g,n=252) and the control singleton group (≥ 2 500 g,n=3 222).Two dizygotic twin groups,the LBW dizygotic twin group (＜2 500 g,n=1 014) and the control dizygntic twin group (≥ 2 500 g,n=442),were set up as well.Clinical characteristics of the infants in different groups and risk factors of LBW were analyzed.Independent samples t-test,Mann-Whitney U test,Chi-square test,and logistic regression were used for statistical analysis.Results (1) The rates of LBW were 7.25％ (252/3 474) in singletons and 69.64％ (1 014/1 456) in dizygotic twins.(2) In singleton pregnancies,the maternal body mass index (BMI) of the LBW group was lower than that of the control group [(20.9± 2.8) vs (21.3 ± 2.7) kg/m2,t=-2.162,P=0.031],while the rates of preterm delivery and blastocyst transfer were higher [61.7％ (153/252) vs 5.7％ (182/3 222),8.7％ (22/252) vs 5.1％ (163/3 222),x2=814.232 and 6.234,respectively,all P＜0.05].(3) In dizygotic twin pregnancies,maternal age,paternal age,the rate of preterm delivery and estradiol (E2) level [M(P25-P75)] at trigger were higher than those of the control group [(31.0±3.7)vs (30.5±3.9) years,(33.7±5.0) vs (32.7±4.5) years,63.0％ (631/1 014) vs 28.0％ (123/442),11 362.3 (7 549.2-16 716.1) vs 10 444.8(7 079.4-14 569.9) pmol/L;the values of t or x2 or Z were-2.498,-3.680,150.295 and-2.570,all P＜0.05].(4) Multivariate logistic regression analysis revealed that preterm delivery,maternal BMI＜18.5 kg/m2 and girl baby were independent risk factors for LBW in singleton pregnancies (adjusted OR=28.45,1.59 and 1.45,95％CI:20.87-38.80,1.06-2.41 and 1.06-1.97,all P＜0.05).Preterm delivery,high E2 level at trigger (＞10 970 pmol/L) and different gender of twins were independent risk factors for LBW in dizygotic twin pregnancies (adjusted OR=4.51,1.35 and 1.45,95％CI:3.50-5.82,1.06-1.74 and 1.09-1.93,all P＜0.05).Conclusions High maternal serum E2 level after controlled ovarian stimulation (COS) in fresh embryo transfer cycle may be one of the risk factors for LBW in twin pregnancies.
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Objective@#To compare the clinical outcomes of posterior maxillary implant surgery when using the regular transalveolar approach or with the crestal approach-sinus (CAS-KIT), a device for maxillary sinus membrane elevation by the crestal approach using a special drilling system and hydraulic pressure.@*Methods@#In this retrospective study 887 patients during Jan 2012 to July 2015 in Hangzhou Dental Hospital with underwent either regular transalveolar approach or CAS-KIT approach for maxillary augmentation; whereas 11 patients dropped out for the reason of serious membrane perforations. Totally, 876 patients with 1 204 plants, placed immediately after transalveolar maxillary augmentation, were included in this study. The data analysis was performed by radiological measures to assess the changes in height of maxillary sinus floor after the transalveolar augmentation at different time points. In addition, the complications after surgery, failure rates, osseointegration condition and the performance of rehabilitation were evaluated as well.@*Results@#Five hundred and three patients were experienced with regular transalveolar approach, and 7 patients were drop out for the serious membrane perforations. Thus, 496 patients received 653 implants in this group; the average lifted range in maxillary sinus floor height changes was (4.08±3.45) mm. The complications were minor membrane perforations during procedure in 64 patients, postoperative maxillary sinus infection happening in 2 patients and 13 patients experienced rehabilitation failure. Three hundred and eighty-four patients had CAS-KIT approach with 4 patients dropped out. Three hundred and eighty patients get 551 implants with the mean lifted range of (8.36±4.07) mm in maxillary sinus floor height changes. Minor membrane perforations during procedure occurred in 31 people and 2 got postoperative maxillary sinus infection. The 4 year overall survival rate of 1 204 implants was 97.26%, with four implants fell off after 3 months of rehabilitation and one implant occurred after one year of rehabilitation.@*Conclusions@#The regular transalveolar sinus lift technique is easier and time saving, but the compromised lifting range in maxillary sinus floor height and the comparatively high occurrence of intraoperative membrane perforations should be concerned. Using CAS-KIT could be an alternative method to perform maxillary sinus augmentation with a reduced incidence of complications. There was no statistically difference in implant failure rates and incidence of postoperative maxillary sinus infection between two groups.
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Implantation of the base bone in the implant after effective and rapid bone binding and prevention and treatment of bone resorption, to ensure the success of planting surgery is of great significance. This article reviews the mechanism of traditional Chinese medicine promoting bone integration and the etiopathological mechanism of bone resorption, and expounds the influence of traditional Chinese medicine on osseointegration and bone resorption.
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Objective:To investigate the influence of cognitive-behavior therapy on the psychological status of family members of terminal cancer patients. Method:A total of 60 families of terminal cancer patients were selected and randomly divided into observation group (30 cases) and control group (30 cases). The observation group was treated with cognitive-behavior therapy, while the control group was given general supportive psychological care. The Hamilton Depression Scale ( HAMD) , Hamilton Anxiety Scale ( HAMA) and Pittsburgh Sleep Quality Index ( PSQL) were used to evaluate the family members of the two groups of patients before and after the intervention. Results: Before the intervention, there was no statistical significance difference in the scores of HAMA, HAMD and PSQI between the two groups (P>0. 05). After the intervention, the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those before the intervention ( P <0 . 05 ); and the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those in the control group ( P<0 . 05 ) . Conclusion:Cognitive-behavior therapy can significantly improve the negative emotions of depression, anxiety and sleep disorder among family members of terminal tumor patients.
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Objective To analyze the results of diagnostic pars plana vitrectomy (PPV) in patients with uveitis of unknown cause.Methods This is a retrospective case series study.Sixty-five patients (67 eyes) with uveitis of unknown cause were enrolled in this study.There were 31 males (32 eyes) and 34 females (35 eyes).The ages were from 6 to 84 years,with the mean age of (55.00± 18.56) years.All eyes were received PPV.Examination of vitreous samples consisted of microbial stains and culture,microbial DNA and antibody detection,cytokine measurement,cytology,flow cytometry and gene rearrangement detection.Results Vitreous analysis was positive in 40 of 67 eyes (59.7％).Positive results indicated bacterial endophthalmitis in 20 of 40 eyes (50.0％),lymphoma in 11 eyes (27.5％),viral IgM and IgG increased significantly in 3 eyes (7.5％),fungal endophthalmitis in 3 eyes (7.5％),IgG of toxocara increased significantly in 2 eyes (5.0％),IgG of toxoplasma Gondii increased significantly in 1 eye (2.5％).Conclusion The diagnostic yield of vitreous samples in uveitis eyes of unknown cause is 59.7％.
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Objective To investigate the effect of progesterone combined with psychological intervention on threatened abortion. Methods According to the different treatment and nursing intervention mode selected from be January 2015 to January 2017 in our hospital 60 cases of patients with threatened abortion group: the control group used dydrogesterone + routine nursing intervention, the observation group with psychological nursing mode + progesterone intervention; the two groups of patients with clinical symptoms, the incidence of adverse reactions and nursing satisfaction were recorded in detail, and the relevant data for comparative analysis. Results The psychological nursing mode of progesterone +(observation group) intervention is better than the clinical effect of patients with threatened abortion and dydrogestrone + routine nursing (control group) the clinical intervention effect, clinical symptoms improved better than the control group, the incidence rate of adverse reaction was lower than the control group, nursing satisfaction was higher than the control group, the difference was statistically significant (P<0.05). Conclusion Threatened abortion patients choose progesterone + psychological intervention effect significantly, can effectively improve the clinical symptoms and adverse reactions and nursing satisfaction, is widely used in clinical intervention of threatened abortion patients.
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Objective To investigate the effects of labetalol, Magnesium Sulfate, psychological intervention combined with the clinical effect of treatment of gestational hypertension. Methods According to the different treatment and nursing intervention mode of 120 cases of hypertension patients in January 2015 to 2017 year in January in our hospital for diagnosis and treatment of pregnancy groups: control group with routine nursing intervention in the observation group, Magnesium Sulfate +, Magnesium Sulfate + + mode labetalol psychological nursing intervention; the detailed records of the two groups of patients with clinical curative effect, complications, etc. the situation, and the related data for comparative analysis of labetalol, Magnesium Sulfate, psychological intervention combined with the clinical effect of treatment of gestational hypertension. Results The psychological nursing mode of labetalol + Magnesium Sulfate (observation group) intervention effect in patients with hypertension during pregnancy is better than the Magnesium Sulfate + routine nursing (control group) the clinical intervention effect, clinical symptoms improved better than the control group, the complication rate was lower than the control group, nursing satisfaction was higher than the control group, the difference was statistically significant (P<0.05). Conclusion Patients with gestational hypertension selection effect of labetalol + Magnesium Sulfate +psychological nursing intervention significantly, can effectively improve the clinical symptoms and reduce the incidence of complications.
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Objective To analyze the clinical significance of patients self -intervention on self -efficacy and lipid levels in patients with cerebral infarction.Methods 300 patients with cerebral infarction in our hospital were selected from May 2014 to May 2015,and they were randomly divided into two groups by digital table method:the observation group(n =1 50)and the control group(n =1 50),the two groups of patients had no significant differences in the general data.The observation group treated according to the conventional rehabilitation treatments for rehabilitation nursing,in view of the self -management group.After three months,the two groups of patients'self -efficacy and lipid levels were recorded before and after the intervention and the patients'self management abilities were measured. Comparisons between before and after the intervention of the indicators and between the different groups were analyzed,and the relationship of self -management ability and lipid levels of patients was analyzed by Pearson correlation analysis.Results Before the intervention,there was no difference between the two groups in the self -efficacy scale(P >0.05).After the treatment,the self -efficacy scale of the observation group was (29.85 ±5.34), which of the control group was (22.74 ±4.73),the difference between the two groups was statistically significant(t =1 2.207,P <0.001 ).For the lipid levels after treatment,the TC,TG,LDL -C,HDL -C in the observation group were (4.06 ±0.58)mmol/L,(1 .26 ±0.56)mmol/L,(2.27 ±0.49)mmol/L,(1 .42 ±0.54)mmol/L,which in the control group were (4.86 ±1 .05)mmol/L,(1 .54 ±0.48)mmol/L,(3.1 5 ±0.29)mmol/L,(1 .23 ±0.37)mmol/L, the differences between the two groups were statistically significant (t =8.1 68,4.649,1 8.929,3.555,all P <0.001 ).The correlation analysis of self -management ability and the blood lipid improvement of the two groups showed that the observation group presented positive correlation.The patients'self -management ability was stronger, its lipid improve ability was better.Conclusion From the self -efficacy and the blood lipid level analysis,cerebral infarction patients'self -intervention can promote physical and mental health and improve the symptoms of cerebral infarction.In summary,it is helpful for recovery and has positive clinical effect on cerebral infarction.
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Objective To observe the efficacy of naloxone combined with Buyanghuanwu decoction on cong -nitive function of multi -infarct dementia(MID) patients.Methods 46 patients with MID were treated with Nalox-one Hydrochloride and Buyanghuanwu decoction .Mini -mental state examination ( MMSE ) , activity of daily living ( ADL) scale and hachinski ischemic scale score ( HIS) were used to estimate the therapeutic effect after the treatment for 30 days.Results Compared to 30 days before,the MMSE score and ADL score improved after the treatment (t=3.247,3.469,all P<0.05),and the score of HIS declined (t=3.384,P<0.05).Conclusion Application of nal-oxone combined with Buyanghuanwu decoction can significantly improve congnitive level and ADL function in multi -infarct dementia patients .
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Objective To discuss the effect of butylphthalide soft capsules in the treatment of type 2 diabetic patients with mild cog-nitive impairment.Methods Ninety cases of diagnosed type 2 diabetic with mild cognitive impairment were randomly divided into two groups:the treatment group (n=45) and the control group (n=45) .Patients in both groups were treated with the traditional therapy, but those in the study treatment group were given butylphthalide soft capsules.MoCA and P300 were used as the effect judge standard after June.Results Compared with the control group, the MoCA score was increased in the treatment group(P<0.01), P300 latency was shorten and P300 amplitude was increased (P<0.05).Conclusion Butylphthalide capsules can improve cognitive function in patients with type 2 diabetes patients with mild cognitive impairment, and worthy of further clinical promotion and application.
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Objective:To evaluate the prophylactic application of antibiotics in oral and maxillofacial surgery and to provide a scientific basis for its reasonable use .Methods: The use of prophylactic antibiotics in the oral and maxillofacial surgery was conducted in our hospital from January 2011 to August 2013 based on a retrospective survey , and the conditions and affecting factors were analyzed .Results:The utilization rates of prophylactic antibiotics were respectively 98.9%, 61.8%, and 24.6%, showing a downward trend .But the infection rate of surgical site did not significantly increase , and by Fisher ’ s exact test, the difference was not significant (P>0.05).Surgical site infections (SSI) rates did not rise between using and not using prophylactic antibiotics ( P>0 .05 ) .Conclusion: The use of prophylactic antibiotics is greatly influenced by the policy , and along with the decline in antibiotic usage , SSI have not increased significantly .
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Objective To realize the isolation of multidrug-resistant organisms (MDROs)from ward environment, and provide evidence for clinical prevention and control of MDRO transmission.Methods Patients with MDRO in-fection in a stomatology hospital from September 2012 to July 2014 were as trial group,12 randomly selected pa-tients without MDRO infection were as control group,environmental object surface in patients’ward were taken specimens and performed culture,isolated organisms were identified and performed antimicrobial susceptibility tes-ting.Results Of 44 patients with MDRO infection,13 patients’surrounding environment were detected MDROs,the total detection rate was 29.55%(13/44).The detection rate of methicillin-resistant Staphylococcus aureus (MRSA),multidrug-resistant Acinetobacter baumannii (MDRAB),and methicillin-resistant Staphylococcus epidermidis (MRSE)were 45.45%(5/11),66.67% (2/3)and 66.67%(6/9)respectively.Detection rates of MRSA from nasal cavity and hands of MRSA-infected patients were 72.73% and 54.54% respectively,from nasal cavity and hands of patients’caregivers were 36.36%and 18.18% respectively.The difference in bacterial count between trial group and control group was not significantly dif-ferent (all P >0.05).Conclusion Isolation rate of MDROs from ward environment of MDRO-infected patients is higher than that of non-MDRO-infected patients,monitoring,cleaning and disinfection for MDRO-infected patients’surrounding environment should be strengthened,so as to prevent the spread of MDROs in hospital.
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Objective To analyze the prevalence and risk factors of the hyperuricemia ( HUA) in the adult population (aged≥20)in Shandong Province.Methods A cross-sectional survey was conducted among 11 234 subjects(8399 males and 2835 females)selected in a randomized, stratified study between January and December of 2012.The serum samples were collected and some biochemical indicators were assayed including serum uric acid (SUA), glucose, blood lipids, liver function and renal function .The body height , body mass and blood pressure were also measured , and the body mass index (BMI)was calculated.Multiple linear regression was used to clarify the contributions of different variables to SUA .The risk factors of HUA were analyzed using univariate and multivariate logistic regression analysis .Results The overall incidence of HUA was 15.71%,and was 18.89% in men and 6.31% in women, respectively.After age 35,the level of SUA declined with age in males.However,the opposite was true in women .Our results also indicated that drinking , obesity, hyper-triglyceridemia , hypertension , serum creatinine ( SCr ) , blood urea nitrogen ( BUN ) , alanine aminotransferase ( ALT ) , serum gamma-glutamyltransferase ( GGT ) were associated with HUA in men while hypertension , low-density lipoprotein, hyper-triglyceridemia,ALT,SCr and BUN were related to HUA in women .Conclusion HUA is prevalent in Shandong Province .Drinking,obesity,hypertension,abnormal liver and renal functions might increase the risk of HUA while changing lifestyle by decreasing alcohol consumption , adopting a proper diet and controlling hypertension and obesity might decrease the risk of HUA .
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<p><b>OBJECTIVE</b>To observe the clinical effects of cardiac resynchronization therapy (CRT) in patients with chronic heart failure, and compare the clinical characteristics and outcome between responders and non-responders to define factors related to the efficacy of CRT.</p><p><b>METHODS</b>We retrospectively analyzed the data of patients underwent CRT-P/D implantation from January 2006 to December 2012 in our Hospital. All patients received long-term follow-up including NYHA classification, left ventricular ejection fraction (LVEF) and left ventricular internal dimension at end diastole (LVIDd).</p><p><b>RESULTS</b>A total of 204 patients were included (130 males, mean age (64.8 ± 11.9) years). The total response rate of CRT was 61.3%. Women, QRS duration ≥ 150 ms, and left bundle branch block (LBBB) were related with better response after CRT (all P < 0.05). Multivariate regression analysis showed that QRS duration was an independent determinant for CRT response. All-cause mortality rate was significantly lower in responder group than in non-responder group (P < 0.001).</p><p><b>CONCLUSIONS</b>In patients with chronic heart failure, women, QRS duration ≥ 150 ms, and LBBB are related with better CRT response rate post CRT. QRS duration ≥ 150 ms is an independent predictor of CRT response, and positive response is associated with lower all-cause mortality in this patient cohort.</p>
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Aged , Female , Humans , Male , Middle Aged , Bundle-Branch Block , Cardiac Resynchronization Therapy , Cardiovascular Diseases , Chronic Disease , Heart Failure , Therapeutics , Multivariate Analysis , Retrospective Studies , Treatment Outcome , Ventricular Function, LeftABSTRACT
Objective To investigate the factors influencing positive and negative affects ot orthodontic patients.Methods 145 orthodontic patients were selected and finished questionnaire survey.The questionnaires included demographic data,psychosocial impact of dental aesthetic questionnaire (PIDAQ),aesthetic content of index of orthodontic treatment need (IOTN-AC),perception of occlusion scale (POS),and positive affect and negative affect scale (PANAS).Mann-Whitney U-test,Kruskal-Walis H-test,and Spearman correlation analysis were used to analyze the relation between impact of dental aesthetics and positive and negative affects in orthodontic patients.Results The scores of adolescent patients were higher than adult patients in negative affect (U =1886.500,P＜0.05).The patients under orthodontic treatment scored higher than those before treatment (U=2228.000,P＜0.05).The subdomains of PIDAQ,such as social impact (x2=ll.794,P＜0.05),aesthetic attitude (x2 =45.853,P＜0.05),and dental confidence (x2 =33.551,P＜0.05) were related with negative affect.The scores of IOTN-AC,PIDAQ,POS demonstrated positive correlation with negative affect (P＜0.05).The scores of social impact showed negative correlation with positive affect (P＜0.05).Conclusions Adult orthodontic patients suffer more negative affect than adolescent patients.Orthodontic treatment could promote patients' positive affect.However,the negative psychosocial impact in dental aesthetics would strengthen the negative affect.
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BACKGROUND:Retinoic acid signaling pathways is very important in the formation pf nervous system, specialization of neurons and outgrowth of axons. The recent studies show that, retinoic acid plays an important role in the process of axonal regeneration, but few research reports its exact molecular mechanism. OBJECTIVE:To analyze and summarize the mechanism underlying retinoic acid signaling pathways in the process of axonal regeneration. METHODS:A computer-based online research was conducted among the VIP, CNKI, PubMed, BioMed Centeral, Springer, The Free Medical Journals, EBSCO and Foreign Journals Integration System between January 2000 and December 2013, with the key words of“retinoic acid, the central nervous system, nerve damage, axon regeneration, and mechanism”in Chinese and English. A total of 43 studies addressing the molecular mechanism of retinoic acid in axonal regeneration were screened. According to the supplementary documents, another five references were added. Repetitive research and atypical reports were excluded. RESULTS AND CONCLUSION:Fol owing acute central nervous system injury, axonal regeneration and functional recovery are extremely limited. For proper functionality fol owing injury, axons must regrow, reinnervate their targets, and remyelinate their axons. When the central nervous system injuries occur, retinoic acid signaling pathways express transcription factor retinoic acid receptorβ2 to induce axonal regeneration fol owing injury;in dorsal root ganglion neurons, cAMP levels are greatly increased by lentiviral retinoic acid receptorβ2 expression and contribute to neurite outgrowth. More recently, retinoic acid-retinoic acid receptorβ2 pathways directly transcriptional y repress a member of the inhibitory Nogo receptor complex, Lingo-1, under an axonal growth inhibitory environment in vitro as wel as fol owing spinal cord injury in vivo. Through these molecular mechanisms, retinoic acid signaling pathways play its important role in the process of axonal regeneration.
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Objective To evaluate the effect of the difficult embryo transfer on the clinical pregnancy outcome of in vitro fertili-zation-embryo transfer(IVF-ET) .Methods There were 209 fresh cycles of difficultly transferring and 2 489 fresh cycles of easily embryo transferring between January 2011 and December 2012 .The clinical outcome was compared .Results There were statistical-ly significant differences in the catheter blood staining rates (51 .20% vs 27 .68% ,P0 .05) .Conclusion Difficulty ET will in-fluence the clinical pregnancy .Therefore ,all efforts should be made to avoid the difficult transfer in order to increase the pregnant rate .