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Intracytoplasmic sperm injection (ICSI) is an important treatment option for male infertility at pre-sent.However, a few patients still suffer from repeated ICSI fertilization failure because their sperm is unable to activate oocytes.Artificial oocyte activation (AOA) technology can improve the fertilization rate, pregnancy rate, live birth rate, etc., but it remains unknown whether AOA has short- and long-term effect on offspring.In this article, recent literature about the effect of AOA technology on perinatal outcomes, genetics, physical development and neurological development of offspring was summarized.This paper aims to provide reference for reproductive medicine workers and pediatricians in clinical practice.
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Objective:To investigate the clinical diagnostic value of joint test of retinol-binding protein (RBP), cystatin C (CYSC) and urinary (albumin/creatinine ratio, ALB/Cr) ALB/Cr in early diabetes nephropathy.Methods:Data of 50 early diabetic nephropathy patients (EDN group) from Jan. 2020 to Jun. 2021 in our hospital, another 50 pure type 2 diabetic patients (T2DM group), and 50 healthy subjects (control group) were compared and analysed. RBP, CYSC and urinary ALB/Cr were tested for the 3 groups. Then the clinical diagnostic value between single index test and joint test for the early diabetes nephropathy were compared.Results:Group EDN had higher RBP, CYSC and urinary ALB/Cr [ (114.66±0.56) mg/L, (2.64±0.33) mg/L, (351.81±15.48) ] mg/g than group T2DM [ (83.58±0.83) mg/L, (1.41±0.29) mg/L, (113.65±12.55) mg/g] and control group[ (38.61±0.66) mg/L, (0.53±0.26) mg/L, (16.36±5.61) mg/g]. The difference was statistically significant ( P<0.05). The specificity and sensitivity of early diabetes nephropathy were 95.38% and 96.21%, both higher than single index test. Conclusion:The combined detection of serum RBP, CYSC and urine ALB/Cr has certain reference value for the clinical diagnosis of early diabetic nephropathy.
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Objective: To analyze the clinical efficacy of fertility-preserving therapy in patients with atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EC). Methods: The general condition, pathological type, treatment plan, tumor outcomes and pregnancy outcomes of 110 patients with AEH and EC treated with fertility-preserving therapy in Peking University People's Hospital from December 2005 to September 2019 were retrospectively analyzed. Kaplan-Meier and Log rank tests were used for survival analysis. Results: The response rate of 110 cases of AEH (62 cases) and EC (48 cases) was 94.5% (104/110) after fertility-preserving therapy. There were 93 cases (84.5%) achieved complete response and 11 cases (10.0%) achieved partial response, and the recurrence rate was 29.0% (27/93). The complete response rates of AEH and EC were 90.3% (56/62) and 77.1% (37/48), respectively, without significant difference (P=0.057). The recurrence rates of EC were significantly higher than that of AEH (40.5% vs 21.4%; P=0.022). Forty-one patients with complete response had pregnancy intention, the pregnancy rate was 70.7% (29/41), and the live birth rate was 56.1% (23/41). The live birth rate of AEH was 68.2% (15/22) and that of EC was 42.1% (8/19), the difference was statistically significant (P=0.032). The pathological type was related with the recurrence (P=0.044). Conclusions: Patients with AEH and EC can obtain high complete response rate and pregnancy rate after fertility-preserving therapy. The recurrence rate of EC is higher than that of AEH, while the live birth rate of AEH is higher than that of EC.
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Female , Humans , Pregnancy , Endometrial Hyperplasia/surgery , Endometrial Neoplasms/surgery , Fertility , Fertility Preservation , Retrospective StudiesABSTRACT
Objective:To understand the current living and health status of leprosy survivors in Fengxian District， Shanghai， and to provide scientific evidence for improving their quality of life. Methods:In January 2018-June 2020， professionally trained CDC staff performed a household investigation on 41 patients with leprosy （case group） and 82 non-leprosy persons （control group） every year. Living and health status， and routine laboratory examinations such as blood pressure， blood glucose， and blood lipids were monitored. Results:Majority of the patients with leprosy had low educational level （68.29% being primary school） and were mostly farmers （51.22%）.The patients had abnormal residual Ⅱ level 5 （12.20%） and mostly were tb-like （TT） （53.66%）. Moreover， some patients were not incapacitated （46.34%）， had no family financial difficulties （29.27%）， did not acquire the national subsistence allowance policy （58.54%）， and asked for "regular physical examination" （68.29%）.Compared to the 82 control persons， the patients with leprosy had significantly different body mass index （BMI） and blood pressure （P<0.05）. Conclusion:Living and health status of leprosy survivors in Fengxian District remains to be further improved. The China Disabled Persons’ Federation （CDF）， Red Cross， civil affairs， and health administration need to further strengthen the cooperation.
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Objective:To investigate the efficacy and pregnancy outcome of fertility-preserving treatment for patients with stage Ⅰa, grade 2 endometrial cancer (EC).Methods:Clinical data was retrospectively collected for EC or atypical endometrial hyperplasia (AEH) patients treated in Peking University People's Hospital, Foshan First People's Hospital of Guangdong Province and First Affiliated Hospital of Sun Yat-sen University, from 2010 to 2019. Inclusion criteria for fertility-preserving treatment included: (1) Age ≤45 years. (2) EC with histological differentiation of G 1, G 2 or endometrial AEH. (3) EC disease should be stage Ⅰa, confined to the endometrium without myometrial invasion, lymph node or extrauterine metastasis. Treatment regimen: patients were given oral progestin therapy and endometrial pathology was evaluated every three months. Patients were divided into three groups as G 2 EC group, G 1 EC group and AEH group based on the histological differentiation. Oncological and pregnancy outcomes were compared among them. Results:(1) Totally 57 eligible patients were included in this study, including 11 cases with G 2 EC, 22 cases with G 1 EC, and 24 cases with AEH. (2) Oncological outcome: among the three groups of G 2 EC, G 1 EC and AH, the complete remission rates (9/11, 91% and 96%, respectively) and recurrence rates (3/9, 30% and 22%, respectively) were not significantly different (all P>0.05). Median remission time was significantly longer in the G 2 EC group than those in the other two groups (8, 6 and 4 months; P=0.046). Among 9 G 2 EC patients who recurred after complete remission, three patients relapsed at 7, 18 and 53 months, respectively. All 3 patients chose fertility-sparing treatment again, and all achieved complete remission after retreatment. (3) Pregnancy outcome: among the three groups, the assisted reproduction technology rates (4/8, 5/18 and 36%, respectively) and pregnancy rates (6/8, 5/18 and 36%, respectively) had no significant difference ( P>0.05). However, time interval to pregnancy was shorter in G 2 EC patientsthan the other two groups (4, 9 and 22 months, respectively; P=0.006). Conclusions:Fertility-preserving treatment for patients with stageⅠa, G 2 endometrial cancer, may obtain a relatively high remission rate and an acceptable pregnancy rate. However, further exploration is needed due to the limited number of cases.
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ObjectiveThere are few reports about abnormal oligonucleotide binding fold domain protein genes (OBGs) affecting the initiation of DNA replication in hepatocellular carcinoma through the microchromosome maintenance (MCM) complex. This study aims to explore the roles of reverse-transcription-related genes (RTGs) in Hepatocellular Carcinoma cells (HCC) and the correlation between gene polymorphisms and abnormal gene expression.Methods We created a mouse model by injecting hepatocellular carcinoma cell line H22 (logarithmic growth phase) and dissected the tumor bodies from tumor-forming mice. The control group was treated by isotonic saline without H22. The healthy liver tissue cells were taken from the control mice. The total RNA of the H22 group and control group were extracted, and differentially expressed genes were analyzed. Screening of differentially expressed reverse transcription-related DEGs (RDEGs), GO and KEGG analysis of RDEGs. The interaction analysis of RDEGs encoded proteins, and the correlation analysis of RDEGs polymorphism and gene expression.ResultsThere were 193 differentially expressed RTGs in HCCs, which were involved in two biological procedures, three cell components, one molecular function, three signal pathways, and three functional sites; Its function is mainly concentrated in DNA replication, especially the construction of MCM complex and telomere complex in which OBGs participate in the initiation of replication. Most related genes had OB fold domains. The results also showed that both AS and SNV caused gene polymorphism was positively correlated with gene expression, and most OBGs in HCC had SNV phenomenon, but not occurred in healthy liver tissue.Conclusion Collectively, AS and SNV may be important regulatory factors for gene expression. SNV may particularly affect the function of OBGs in the MCM complex to abnormally initiate DNA replication in HCC.
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Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disorder of childbearing-age women,with clinical symptoms in⁃cluding ovulatory dysfunction and hyperandrogen⁃ism.Diagnosis of PCOS must exclude other causes of ovulation disorders and hyperandrogenism.
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Large-scale cohort study has unique advantages in the field of etiology research for its large sample size a multi-time point data, but it also brings great difficulty in data management and quality control at the same time. Recently, China has initiated a number of large-scale population cohort studies, posing enormous challenges to the management and quality control of related cohort data. This paper summarizes the existing experience and consensus in the field of cohort study in China from the characteristics of the cohort data, aiming at the types and main forms of the four main sources of questionnaire data, clinical diagnosis and treatment data, biological sample detection data and observation outcome data, from the data storage, circulation and transmission work.The contents and methods of queue data management are comprehensively summarized. Corresponding data quality control strategies are advised in the questionnaire evaluation, data logic verification, survey object sampling and multi-database review, etc. The goal of this review is to provide guidance for the management of data and the formulation of quality control strategies in the cohort study in China.
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Objective To investigate the status and the influencing factors of thyroid volume of children aged 8-10 years in Hefei City.Methods In 2016,according to the requirements of "National Iodine Deficiency Disorders Surveillance Plan (the 2016 Edition)",the method of multistage stratified sampling was used in 9 counties (cities,districts) of Hefei.Five primary schools were randomly selected from each county (city,district),with one in each direction (the east,west,south,north and center),then 40 children aged 8-10 years (male ∶ female =1 ∶ 1,with similar age distribution) were randomly chosen in each primary school.The thyroid volume,height and weight were measured.In addition,a questionnaire with the items including personality,learning pressure,dietary habits,related disease history and contact history was designed and used to collect the data of the subjects.Results Totally 1 800 children aged 8-10 years were selected from 45 primary schools in 9 counties (cities,districts).The mean thyroid volume was (3.009 ± 1.197) ml.Totally 71 people were found with thyroid enlargement and the goiter rate was 3.9％,which was in the range described in the elimination iodine deficiency disorders (IDD) standard (＜ 5％).Univariate analysis showed that for children in different age groups,seafood consumption frequency,radiological examination,height,and body mass,the thyroid volumes were significantly different (P＜ 0.05);Multivariate linear regression showed that body weight and height were main factors affecting the thyroid volume of children aged 8-10 years in Hefei City,the standard partial regression coefficient are 0.288 and 0.140,respectively.Conclusions The thyroid volume of the 8-10 years old children is generally in the normal range in Hefei.Goiter rate is lower than the standard for elimination of iodine deficiency The findings have showed that not only age,but also height,body mass and other factors should be considered while evaluating the influencing factors of the thyroid volume of school-aged children.
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Prostasomes are one of the subcellular structures secreted by prostatic epithelial cells.They present in human semen as membranous vesicles with average diameter of 150nm(40-500nm).440 proteins have been identified in human prostasomes and possess many physical functions.Prostasomes may not only exert a motility function for spermatozoa by delaying the acrosome reaction,but also have immune regulatory function,antibacterial and antioxidant characteristics.Prostasomes can be isolated from the serum and urine,and they present both in normal and prostatic cancer tissues.Prostasome can be a special prostatic biomarker and has a close association with prostatitis and prostate cancer.
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Objective To understand the current situation and existing problems in the training of healthcare-asso-ciated infection(HAI)management,and provide scientific basis for strengthening the management of HAI preven-tion and control system.Methods A questionnaire survey was adopted to investigate situation of training on HAI in 15 provincial-level HAI training agencies in China during the past 30 years,and basic condition of training on HAI management in recent 5 years.Results Among 15 provincial-level training agencies,66.67%(n=10)were respon-sible by HAI management quality control centers,80.00% have already conducted training in each city,53.33%carried out training for 10 to 20 times,33.34% performed training for ≤2 times per year.Of 33 728 trainees in 2011-2015,41.30% were 41-50 years old,61.82% were nursing staff,50.56% had bachelor degree,43.96%were with the intermediate professional title.Most trainers were HAI prevention and control experts in their respec-tive province,accounting for 68.07%,the curriculums were mainly designed on professional course,and only 26.78% were involved in management.Conclusion Professional structure of HAI management personnel is not reasonable,faculty is imbalance,knowledge update is lacking,and HAI training and education system need to be improved further.
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The research data at home and abroad show that the overall burnout rate of clinical professional graduate students was high. They are vulnerable to burnout because of long duty hours, learn-ing pressure, intense and overloading work and especially the significantly reduced personal accomplish-ment in the situation of the contradiction between doctors and patients in our country. Burnout not only re-sults in psychological distress and physical symptoms, but also has negative effect on the quality of graduate medical education during residency training. Therefore, educators need to develop an active awareness of burnout and ought to perform interventions such as formulating the appropriate learning goals, improving the work efficiency, reducing work hours, positive psychological counseling and stress management training to prevent such occurrences.
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Objective:To study the effects of miR-20a on the osteogenic differentiation potential of inflammatory periodontal liga-ment cells(IPDLSCs).Methods:Cells were isolated and cultured from the healthy and inflammatory periodontal ligament samples (HPDLSCs and IPDLSCs)respectively.miR-20a expression was analyzed by qRT-PCR.Alizarin red staining,Western blot and PCR were used to evaluate the osteogenic differentiation potential of IPDLSCs after transient transinfection of miR-20a mimics or inhib-itor.Results:miR-20a expression in IPDLSCs was lower than that in HPDLSCs,and the osteogenic differentiation potential of IP-DLSCs were promoted by miR-20a mimics,and reduced by miR-20a inhibitor.Conclusion:The miR-20a in IPDLSCs was down reg-ulated.miR-20a can promote the osteogenic differentiation potential of IPDLSCs.
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Objective:To study the clinical characteristics of odontogenic cutaneous fistula.Methods:6 cases of odontogenic cutane-ous fistula were represented and the reports of 60 cases of the lesion were reviewed.Results:The fistula was mainly located in cheek, chin,para-nasal part,sub-mandibular area and the lower border of the mandible,and respectively corresponding to mandibular third molar,mandibular incisor,maxillary canine,mandibular first and second molar,the corresponding teeth were mainly in mandible (71 .2%).In middle and old aged patients the lesion usually in para-nasal or mandible area,In younger patients the lesion mostly loca-ted in cheek or sub-mandibular area.After root canal therapy for the teeth with apical periodontitis or extraction of none-curable teeth,the odontogenic cutaneous sinus tract disappeared.Conclusion:Proper treatment of focal teeth can cure the odontogenic cutaneous fistulas.
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Objective To observe the short- and long-term efficacies of acupuncture in treating metabolic syndrome (MS). Method A hundred MS patients were randomized into an acupuncture group and a Western medication group. In addition to basic treatment, acupuncture was used in the acupuncture group, while Western medication was adopted in the Western medication group. The fasting plasma glucose (FPG), high-density lipoprotein (HDL), insulin (INS), triglyceride (TG), blood pressure (BP), weight circumference (WC), body mass index (BMI), and MS score were evaluated before and after treatment, and a month and 3 months after the treatment. Result There was no significant difference in comparing the short-term therapeutic efficacy between the two groups after treatment, while the long-term therapeutic efficacy of the acupuncture group was superior to that of the Western medication group (P<0.01); the FPG, INS, TG, HDL, BP, and MS score were significantly improved after treatment and a month after the treatment in both groups (P<0.01); the acupuncture group had significant improvements in WC and BMI after treatment and a month after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01); the acupuncture group showed marked improvement in INS, HDL, WC, and BMI 3 months after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01,P<0.05). Conclusion Acupuncture can produce a similar short-term but a better long-term therapeutic efficacy compared to Western medication. Hence, acupuncture can be taken as an assistant intervention for MS.
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Objective To explore the effect of diabetic liaison nurses on controlling blood sugar levels in patients with hyperglycemia in department other than endocrinology. Methods Four hundred diabetic patients with high blood sugar were selected from January to December, 2014 in department other than endocrinology. They were divided randomly into 2 groups equally:the control group and the observation group. The control group received traditional nursing care, while blood sugar management was carried out by diabetic liaison nurse in the observation group. Result Pre-discharge sugar metabolism in the observation group was significantly better than that in the control group (P<0.05). Conclusion The diabetic liaison nurses in other departments than the endocrinology department can help control blood sugar levels in patients with hyperglycemiain.
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Objective To investigate the status and risk factors of surgical site infection (SSI)in hospitals in Chi-na,so as to provide theoretical basis for the prevention and treatment of SSI.Methods Four types of surgeries (colorectal surgery,abdominal hysterectomy,femoral neck repair surgery,and vascular surgery)in 29 hospitals were monitored prospectively,risk factors for SSI were analyzed.Results A total of 6 309 surgical procedures were investigated,incidence of SSI was 1 .60%.Incidences of SSI in patients receiving colorectal surgery,abdominal hys-terectomy,femoral neck repair surgery,and vascular surgery were 4.47%(74/1 655 ),1 .03%(22/2 139),0.21 %(5/2 372),and 0.00% (0/143 )respectively.The incidences of SSI were different among different regions (χ2 =114.213,P <0.05).The most common SSI was superficial incisional infection,the next was deep incisional infec-tion.The major pathogens causing SSI were Escherichia coli ,Enterococcus spp .,coagulase negative staphylococ-cus ,Staphylococcus aureus ,and Klebsiella pneumoniae .The independent risk factors for SSI were male patients, long duration of surgery,and high NNIS score.Conclusion The risk of SSI is varied with different types of surger-ies.Male,long duration of surgery,and high NNIS score can increase the risk of postoperative SSI.
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Objective To explore the incidence of surgical site infection (SSI)and compliance to bundled interven-tion measures,and evaluate the effect of bundled interventions on controlling SSI.Methods From October 2013 to September 2014,three types of surgeries (colorectal surgery,abdominal hysterectomy,and femoral neck repair sur-gery)in 29 hospitals in China were monitored,October 2013 to March 2014 was baseline investigated stage,April 2014 to September 2014 was intervention stage.Results A total of 6 166 episodes of surgeries were monitored,the incidence of SSI was 1 .64%,incidence of SSI following colorectal surgery,abdominal hysterectomy,and femoral neck repair surgery were 4.47%,1 .03%,and 0.21 % respectively.The P 75 time of three types of surgeries were 3,2,and 2 hours respectively.Compared with the baseline stage,the compliance to most intervention measures im-proved after intervention,the largest increase in the compliance to interventions was disinfection with chlorhexidine-containing disinfectant at surgical sites of colorectal surgery (increased by 29.09%),followed by preoperative shower of femoral neck repair surgery (increased by 26.24%),preoperative shower of colorectal surgery(increased by 22.95%),and skin preparation on the day of operation (increased by 20.75%).Incidences of SSI in three types of surgeries were not significantly different before and after intervention(all P >0.05).Conclusion The incidences of SSI are different among different types of surgeries,the compliance to most bundled intervention measures has im-proved to some extent after intervention,but effectiveness of intervention measures needs to be further observed.
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Objective To evaluate the effect of evidence-based bundle intervention strategy on reducing the inci-dence of central line-associated bloodstream infection (CLABSI).Methods Prospective and multicenter study was adopted,patients admitted to 54 intensive care units (ICUs)of 41 hospitals and with central venous catheters (CVCs)between October 1 ,2013 and September 30,2014 were monitored .Baseline data between October 2013 and March 2014 were collected as pre-intervention data;from April to September 2014,the participated hospitals performed intervention strategy,post-intervention data were compared with pre-intervention data.Results The usage rate of CVCs before and after intervention was significantly different (44.18% vs 44.63%,χ2 =5.526,P =0.019).Incidence of CLABSI before and after intervention was not significantly different(RR ,0.82[95%CI ,0.59-1 .13],P =0.10).Constituent ratio of catheter insertion sites between pre-and post-intervention was significantly different (χ2 =76.264,P <0.001),femoral vein catheterization rate as well as proportion of two and above catheter insertion sites after intervention decreased(17.25% VS 13.72%;2.27% VS 1 .44%,respectively);hand hygiene implementation rate and accuracy rate after intervention were both higher than before intervention (79.73% vs 76.14%,P <0.001 ;91 .47% vs 74.26%,P <0.001 ,respectively);constituent ratio of skin disinfectant applica-tion before and after intervention was significantly different(χ2 =3.861 ,P <0.001 ),proportion of chlorhexidine ethanol increased (29.62% VS 50.56%);except daily assessment and record,compliance to other prevention and control measures before and after intervention were all significantly different(all P <0.001);utilization rate of max-imal sterile barrier,qualified rate of dressing of operators,and port disinfection were all significantly enhanced. Conclusion Bundle intervention in intubation and maintenance are implemented effectively,but intervention effect on CLABSI needs further study.
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Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs. Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs.