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Objective:The study was planned to evaluate the clinical utility of microcytic anemia factor (MAF) and low hemoglobin density (LHD%) in the screening of iron deficiency in blood donors.Methods:A total of 400 blood donors, 200 male and 200 female, were randomly admitted to Fujian Blood Center from January1, 2022 to February 28, 2022 by the way of stratified sampling. According to the fourth edition of Diagnostic and therapeutic criteria for hematological diseases, the patients were divided into three groups: normal group (N=299), iron depletion group (ID, n=54) and iron deficient erythropoiesis group (IDE, n=47), Blood routine indexes including hemoglobin (HGB), mean corpuscular volume hemoglobin (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC) and iron metabolism indexes including serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TS) and unsaturated iron binding capacity (UIBC) were measured, MAF and LHD% were calculated by formula.One-way ANOVA or Kruskal-Wallis H tests were used to analyze the differences among three groups. Spearman correlation analysis was used to analyze the correlation between MAF and LHD% and iron metabolism indexes.The Receiver Operating Characteristic (ROC) curve was used to evaluated the diagnostic value of MCH, MCHC, MAF and LHD% for iron deficiency in blood donors. Results:MAF in ID group which was 11.81±0.81 were higher than the IDE group which was 10.69±0.95 and lower than the healthy group which was 13.17±1.24, the total difference among the three groups was statistically significant ( F=110.784, P<0.001), the difference between two groups was statistically significant ( P<0.01); LHD% in ID group which was 2.61 (1.87, 3.91)% were lower than the IDE group which was5.60(2.99, 8.02)% and higher than the healthy group which was1.74 (1.22, 2.73)%, the total difference among the three groups was statistically significant ( H=62.166, P<0.001), the difference between two groups was statistically significant ( P<0.01).In 101 iron deficiency blood donors, Spearman correlation analysis showed that MAF was positively correlated with SF, SI and TS ( r=0.426, P<0.01; r=0.547, P<0.01; r=0.566, P<0.01);contrarily, LHD% was negatively correlated with SF, SI and TS ( r=-0.397, P<0.01; r=-0.400, P<0.01; r=-0.479, P<0.01).The areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic ID were 0.745, 0.646, 0.819 and 0.646, respectively;the cut-off value of MAF was 12.56, with a sensitivity of 67.90% and a specificity of 83.30%.While the areas under the ROC curve of MCH, MCHC, MAF and LHD% diagnostic IDE were 0.901, 0.834, 0.941 and 0.834, respectively; the cut-off value of MAF was 11.73, with a sensitivity of 87.60% and a specificity of 87.20%. Conclusions:MAF performed a high diagnostic value of iron deficiency, especially IDE, and can be used as a marker in the diagnosis of iron deficiency in blood donors.
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Objective:To investigate the protective effects of levosimendan combined with lyophilized recombinant human brain natriuretic peptide (rhBNP) on myocardium in patients with acute myocardial infarction complicated by heart failure.Methods:140 patients with acute myocardial infarction complicated by heart failure who received treatment in Changxing People's Hospital from June 2018 to June 2020 were included in this study. They were randomly assigned to receive either routine treatment (control group, n = 70) or routine treatment, levosimendan combined with rhBNP (study group, n = 70). Serum levels of creatine kinase (CK)-MB, cardiac troponin I (cTnI), lactate dehydrogenase (LDH), high-sensitivity C-reactive protein (hs-CRP), which were associated with myocardial injury, were measured in each group. In addition, the changes in cardiac ultrasound indexes left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were observed. Clinical effects on heart failure were evaluated. Adverse drug reactions were monitored during the treatment. Results:After treatment, CK-MB, cTnI, LDH and hs-CRP levels in the study group were (56.73 ± 12.15) U/L, (0.41 ± 0.19) μg/L, (126.83 ± 15.26) U/L and (1.59 ± 0.27) mg/L, respectively, which were significantly lower than those in the control group [(78.52 ± 14.07) U/L, (0.68 ± 0.21) μg/L, (187.25 ± 23.04) U/L, (2.84 ± 0.41) mg/L, t = 5.569-12.418, all P < 0.05]. LVEDD and LVESD in the study group were significantly lower than those in the control group, while LVEF in the study group was significantly higher than that in the control group ( t = 4.435-6.426, all P < 0.05). Total effective rate in the study group was significantly higher than that in the control group [88.57% (62/70) vs. 72.86% (51/70), χ2 = 5.552, P < 0.05]. There was no significant difference in total incidence of adverse drug reactions between study and control groups [11.43% (8/70) vs. 8.57% (6/70), χ2 = 0.317, P > 0.05]. Conclusion:Levosimendan combined with rhBNP can effectively alleviate myocardial injury in patients with acute myocardial infarction complicated by heart failure, improve myocardial function, is highly safe, and thereby deserves clinical application.
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Objective To explore the application of DCE-MRI and DWI in the preoperative diagnosis of breast cancer.Methods
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Objective The levels of multi-trace elements in whole blood of pregnant women in Zhejiang province were analyzed to establish the reference range for this population.Methods Routine physical exami-nation data of 21 151 pregnant women during January 2015 to September 2016 from Hangzhou Dian Medical Center were analyzed retrospectively.Three groups including early pregnancy group,middle pregnancy group and late pregnancy group were divided according to the pregnancy period.A total of 1 859 women range from 20 to 40 years old healthy without pregnant were selected as control group.The levels of copper(Cu),zinc (Zn),calcium(Ca),magnesium(Mg)and iron(Fe)in different pregnancy groups were analyzed statistically. The reference interval of each element in the early,middle and late pregnancy group should be established re-spectively if necessary.Results There were significant differences existed in the levels of Cu between early, middle,late pregnancy group and the control group(P<0.05).The levels of whole blood Cu increased gradu-ally with the time of pregnancy.Compared with the control group,the levels of Zn in other group were differ-ent,and the deficiency rates in early,middle,late pregnancy group were 5.6%,9.3% and 5.0% respectively. There was no significant difference in the level of Fe between the control group and the early pregnancy group (P=0.083).But the levels of Fe in middle and late pregnancy group showed significant difference with control group(P< 0.05).The reference ranges published in manufactures′ package inserts could not meet clinical needs.Conclusion The lack of trace elements existed in different stages of pregnancy.It′s important to moni-tor and analyze the levels of trace elements during each stages of pregnancy,and intervention measures should be done as necessary.T he taken of Cu supplement should based on its reference interval in each stage of preg-nancy respectively.T he taken of Fe supplement should based on the reference interval of healthy,reproductive-age w omen.
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Objective We conduct this survey one mergency department clinicians′ vascular thrombosis knowledge in Suzhou city to find if the reare questions related to this to picand provide effective strategies. Method 200self- made questionnaires were sent to Emergency Department clinicians in two THREE-GRADE hospitals. A cluster sampling method was adopted to carry out the secret test. The literature on vascular embolism diseases was reviewed, and the results were statistically analyzed. Result The age distribution of the medical and nursing staff in the emergency department decreased in turn, and the medical and nursing staff in the emergency department were not familiar with the common thrombus risk assessment scale; 51.37%(94/183)of the medical and nursing staff were trained, 25.14%(46/183)of the doctors and nurses participated in the thrombus conference, and 33.88% (62/183)of the medical staff passed self-study, and 18.03%(33/183)of the doctors and nurses passed the newspapers and newspapers. There are also 19.67%(36/183) health care workers through other means, and 98.36%(180/183)of medical staff know about thrombotic diseases. Conclusions The level of Three-A hospital clinicians′knowledge was higher than Three-B hospital clinicians’.It is essential for clinicians to strengthen vascular thrombosis prevention awareness. It is urgent to build the mechanism of vascular thrombosis prevention-management.
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Objective: To explore therapeutic effect of recombinant human brain natriuretic peptide (rhBNP) in aged patients with acute decompensated heart failure (ADHF).Methods: A total of 98 aged ADHF patients treated in our hospital were selected and randomly divided into routine treatment group (n=50) and rhBNP group (n=48, received intravenous injection of rhBNP based on routine treatment group).After 72h treatment, cardiac function indexes, total effective rate and incidence of adverse drug reactions (ADR) were measured and compared between two groups.Results: Compared with before treatment, after 72h treatment, there were significant rise in left ventricular ejection fraction (LVEF) and 24h urine volume in both groups(P=0.001 all);compared with routine treatment group after treatment, there were significant rise in LVEF [(45.9±7.8)% vs.(57.4±7.9)%] and 24h urine volume [(1637.5±103.2)ml vs.(1836.4±118.4)ml], P=0.001 all.On 7d after treatment, total effective rate of rhBNP group was significantly higher than that of routine treatment group (93.75% vs.82.00%, P=0.033).There was no significant difference in incidence rate of ADR between two groups, P=0.898.Conclusion: Recombinant human brain natriuretic peptide can significantly improve heart function, and the therapeutic effect is significant in aged patients with acute decompensated heart failure.
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Objective To compare effect and psychological state between ICU and conventional treatment in elderly patients with ischemic heart failure.Methods A total of 64 consecutives diagnosed as ischemic heart failure in the Second Center Hospital of Baoding from June 2013 to June 2014 were divided randomly into experiment and control group, each of 32 cases, after getting approval of our hospital's ethics committee and informed consent right of patients ,family members.The patients in experiment group were advised into ICU, and the patients in control group were into common ward, then compared the differences of cardiac functions,clinical effect and scale anxiety score (SAS), scale depression score (SDS).Results The left ventricular end diastolic diameter (LVEDd), ejection fraction (EF) and NYHA class in the two groups after treatment were both better than before, and the experiment group were significantly better than the control group (LVEDd: (56.7±4.1) mm vs.(59.2 ± 4.6) mm;EF : 0.49 ± 0.05 vs.0.42 ± 0.04;NYHAI degree: 23 vs 22;NYHA Ⅱ-Ⅲ degree: 11 vs 17;t =3.105,3.416;x2 =0.714,3.513;P＜0.05).The in-hosptical days and fees in experiment group were significantly less than the control group(t =3.846,3.913;P＜0.05).The treatment types in the two groups were no statistical difference (P ＞ 0.05).The death rate in-hosptical and follow-up in experiment group were both significantly lower than the control group(9.4％ vs.21.9％;12.5％ vs.28.1％;x2 =3.102,3.715;P＜0.05).The SAS, SDS scores in the two groups after treatment were both higher than before, and the control group were significantly higher than the treatment group(t =3.326,3.845;P＜0.05).Conclusion The serious condition of elderly patients with ischemic heart failure are better to ICU, which could greatly improve clinical effect and anxiety depression.
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Aims To study the effects of clenbuterol on anoxia/reoxygenation( A/R) injury in neonatal Wistar rat cardiomyocytes and to explore whether its mecha-nism is related to reperfusion injury salvage kinase ( RISK) or not. Methods The cultured primary neo-natal cardiomyocytes were randomly divided into eight groups: ①normal culture group; ②anoxia/reoxygen-ation( A/R) group;③ clenbuterol ( 1 μmol · L-1 ) +A/R;④ICI118,551(10 μmol·L-1) + clenbuterol ( 1 μmol · L-1 ) + A/R; ⑤Metoprolol ( 10μmol · L-1 ) + clenbuterol(1μmol·L-1 ) + A/R group;⑥Metoprolol ( 10 μmol · L-1 ) + A/R group; ⑦PD98059 ( 20 μmol · L-1 ) + clenbuterol ( 1 μmol · L-1 ) + A/R group;⑧ LY294002(10 μmol·L-1 ) +clenbuterol(1 μmol · L-1 ) + A/R group. Cell via-bility was determined by the conventional MTT reduc-tion assay. The content of LDH in cultured medium was measured with colorimetry. Cardiomyocyte apopto-sis was determined by Hoechst33342 . Intracellular re-active species( ROS) were monitored by the fluorescent DCFH-DA. Total ERK2 and phosphorylated ERK were detected by western blot. Results Compared with A/R group, clenbuterol significantly increased vaibility of cells, reduced LDH release, lowered the rate of apop-tosis and ROS production. When addedβ2 receptor an-tagonist ICI118 , 551 , PI3 K inhibitor LY294002 and ERK inhibitor PD98059 , the effects of clenbuterol a-bove were inhibited; but β1 receptor antagonist Meto-prolol protected the cardiomyocytes from A/R injury, as evidenced by decreased LDH release and increased cell viability. There were no synergistic effects in the combined use of clenbuterol and Metoprolol. Conclu-sion clenbuterol exerts cardioprotective effects against A/R injury by inhibiting oxidative stress and apopto-sis. The protection of clenbuterol is inhibited by ICI118 , 551 , LY294002 and PD98059 . clenbuterol protects cardiomyocytes against A/R injury via RISK pathway by activation of β2 receptor.
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Objective Sperm screening is an essential step in IVF procedures. The swim-up method, an assay on sperm motility, is used clinically to select the ideal sperm for subsequent manipulation. However, additional parameters, including acrosome reaction capability, chemotaxis, and thermotaxis are also important indicators of mammalian sperm health. To monitor both sperm motility and chemotaxis simultaneously during sperm screening, we designed and constructed a microdevice comprising a straight channel connected with a bi-branch channel that mimics the mammalian female reproductive tract. Methods The width and length of the straight channel were optimized to select the motile sperm. Cumulus cells were selectively cultured in the bi-branch channel to generate a chemoattractant-forming chemical gradient. Sperm chemotaxis was represented by the ratio of the sperm swimming towards different branches. Results The percentage of motile sperm was improved from ( 58. 5 ± 3. 8 ) % to ( 82. 6±2.9)% by a straight channel 7 mm in length and 1 mm in width. About 10% of sperm were found chemotactically responsive in our experiment, which is consistent with previous studies. Conclusion The combined evaluation of both sperm motility and chemotaxis was achieved for the first time, and the motile and chemotactically responsive sperm can be easily enriched on a lab-on-a-chip device to improve IVF outcome.
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Objective To compare clinical outcome of intracytoplasmic sperm injection(ICSI)cycle by using fresh and cryopreserved-thawed testicular and epididymal spermatozoa in azoospermic patients.Methods Between September 2006 and May 2007,208 azoospermic patients underwent in vitro fertilization(IVF)were treated in Center of Reproductive Medicine,Peking University Third Hospital.Those couples were divided into two groups based on their wishes,including 171 cases in fresh group and 37 cases in cryopreserved-thawed group.The cryopreserved testicular or epididymal spermatozoa were thawed and recovered before ICSI procedure iu thawed group.The outcomes of ICSI in each group were compared.including clinical outcomes(two pronuclear fertilization,high quality embryo,clinical pregnancy and embryo implantation)and pregnancy outcomes(spontaneous miscarriage,gestational weeks and neonatal birth weight).Results (1),The utilization rate were 92%(23/25)in cryopreserved-thawed testicular spermatozoa and 100%(12/12)in epididymal spermatozoa.(2)Between fresh and cryopreserved-thawed groups,no statistical difference was observed in two pronuclear fertilization rate[62.25%(973/1563)vs.64.53%(282/437),P=0.960],high quality embryo rate[78.9%(768/973)vs.79.1%(223/282),P=0.985],clinical pregnancy rate per embryo transfer[44.4%(60/135)vs.46.9%(15/32),P:0.688]and embryo implantation rate[29.3%(84/287)vs.33.3%(23/69),P=0.508].(3)No significant difference between flesh and cryopreserved group was found in spontaneous miscarriage rate (11%vs.7%,P＝1.000),gestational weeks(single birth:39.0 weeks vs.38.7 weeks,P:0.538;twins:36.8 weeks vs.36.3 weeks,P=0.571)and birth weight(single birth:3409 g vs.3350 g,P=0.699;twins:2584 g vs.2635 g,P=0.703).Conclusion It suggested that tissue from the azoospermic patients who underwent diagnostic testieular and epididymal biopsy should be eryopreseved for IVF-ET.
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Recently the combination of acupuncture with assisted reproductive technology (ART) to increase the outcomes of ART is being widely studied. In this article, the literatures concerning random controlled clinical trials since 2002 are reviewed and the designs of the trials, especially the timing of acupuncture, are evaluated. Over the past 5 years, the related clinical trials have primarily showed that acupuncture done immediately before and after embryo transfer might increase the assisted reproduction rates, but still requiring further high quality trials with large samples; in addition, different stimulation modes could produce different result, and so far there has not been a consensus as to the optimal time-point for the acupuncture intervention during the in vitro fertilization-embryo transfer (IVF-ET) course. Since the effects of acupuncture change with women's endocrine cycles, it is important and possible to make a breakthrough in ART outcomes if acupuncture is performed at a suitable time point during the cycle of IVF/ET combined with ART.
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BACKGROUND: Dihydrolycorine (DL) can inhibit the peripheral release of catecholamine from sympathetic nerve ending and block α, β adrenalinergic receptor. It has multiple pharmacological actions, such as vascular dilation, hypotension, anti-hypoglycemia and anti-ischemia.OBJECTIVE: To investigate the selective effect of DL on basilar artery,thoracic aorta and ventricular papillary muscle of rabbit by means of observing the vasoconstriction induced by noradrenaline bitartrate and KCl.DESIGN: Observation of comparative experiment.SETTING: Pharmacological Department of Yunyang Medical College.MATERIALS: This study was carried out at Pharmacological Department of Yunyang Medical College between March and July 2001, and 46 adult healthy New Zealand rabbits were selected.METHODS: New Zealand rabbits were put to death by intravenous injection of 10 mL air from the vein of aural edge, and soon after death, brain,thoracic aorta and heart were obtained. Basilar artery and thoracic aorta was linked into 4.0-5.0 mm vascular rings; meanwhile, ventricular papillary muscle were separated and connected with tension transducer. Obserdose of noradrenaline bitartrate or KCl: Sub-maximal constriction of thoracic aorta was induced by 0.1 mmol/L noradrenaline bitartrate or W60 mmol/L KCl, and when constriction curve became stable, DL or nimodipine of different dosage was added. Basilar artery was exposed to 0.1 mmol/L noradrenaline bitartrate or 60 mol/L KCl, and rinsing fluid was changed once every 20 minutes and thrice in all when vasocontratcion reached the peak level, then different dosage of DL or nimodipine was added 20 minutes later, and the changes of vasoconstriction curve due to administration of single dose of noradrenaline bitartrate or KCl were obconstriction of ventricular papillary muscular induced by electro-stimulation: Electro-stimulation was used to stimulate the ventricle papillary muscular synchronized constriction with the frequency of once per second,wavelength of 3 ms and threshold voltage of 120%; when constriction curve became stable, DL or nimodipine was administered in a accumulative way.ence of DL or nimodipine on the half-effective concentration of noradrenaline bitartrate or KCl that contributed to the vascular ring constriction of rabbit.RESULTS: Basilar artery, thoracic aorta and ventricular papillary muscle Resting tension of basilar artery was increased by DL but decreased by niof basilar artery and thoracic aorta induced by noradrenaline bitartrate and KCl can be relaxed by DL in a dose dependant manner, and the half-effective concentration was (6.69±3.12)×10-4, (3.41±1.52)×10-3mmol/L for basilar artery, and (1.49±0.59)×10-3, (2.91±0.99)×10-3 mmol/L for thoracic aorta, displaying stronger inhibition on the constriction of basilar artery induced by noradrenaline bitartrate than on the contraction induced by KCl.On the contrary, nimodipine showed stronger depression on KCl-induced constriction than on the constriction induced by noradrenaline bitartrate.ventricle papillary muscular induced by electro-stimulation in a dose-dependant manner, and the half-effective concentration of DL on the contraction of ventricle papillary muscle induced by electro-stimulation was significantly higher than that induced by noradrenaline bitartrate.CONCLUSION: DL displays obvious selective effect on basilar artery of rabbit, the possible existence of constrictive α1 receptor subtype and dilating β receptor on basilar artery might be correlated with the selective function of DL, which benefit, for the improvement of blood supply in the ischemic region.