Influence of assisted reproductive technology and related factors on chromosomal abnormalities in early spontaneous abortions / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the influence of assisted reproductive technology(ART) on the incidence of fetal chromosomal abnormalities by analyzing spontaneous abortions during the first trimester following natural conception(NC) or assisted reproductive technology(ART).</p><p><b>METHODS</b>Three hundred and fourteen chorionic villus samples of women with first trimester spontaneous abortion were collected. Cell culture and G-banding karyotyping analysis were carried out, which included 125 cases by in vitro fertilization(IVF), 87 cases by intracytoplasmic sperm injection(ICSI) and 102 cases by natural conception(NC).</p><p><b>RESULTS</b>Chromosomal aberrations were found in 167(53.2%) of the 314 cases. No significant difference was found in the spectrum of karyotypic abnormalities between NC and ART groups. The incidence of chromosomal abnormalities has increased along with the maternal age. Compared with the fresh embryo-transfer(ET) group, frozen-thawed embryo transfer(FET) group showed a slightly lower incidence of chromosomal abnormalities, albeit with no statistical significance(47.3% vs. 53.8%, P>0.05).</p><p><b>CONCLUSION</b>Fetal chromosomal abnormalities are the main cause for spontaneous abortion during the first trimester regardless the ways of conception. Their incidence is associated with maternal age. FET is relatively safe as well as fresh ET. ART is a relatively safe treatment which does not increase the rate of fetal chromosomal abnormalities.</p>

Decision tree analysis of pelvic MRI in diagnosis of endometrial cancer with ovarian malignant tumor / 中国介入影像与治疗学

Objective To explore the value of pelvic MRI combined with clinical information in diagnosis of endometrial cancer (EC) with ovarian malignant tumor (OMT) using decision tree analysis.Methods The clinical information and pelvic MRI characteristics of 58 cases with ovarian malignant tumor (EC-OMT group) and 743 cases without ovarian malignant tumor (EC group) were reviewed and compared.The diagnostic efficacy of pelvic MRI was evaluated.Decision tree analysis was used in determining the performance on the diagnosis.Results In EC-OMT group,the depth of myometrial invasion,the frequency of cervical and cornua uteri involvement,adnexal mass,pelvic or para-aortic lymph nodes involvement and peritoneum metastasis were higher than those in EC group (all P＜0.01).Para-uterine involvement showed no significant difference between two groups (1.72％ vs 0.40％,P=0.26).In diagnosis of EC with OMT,the sensitivity and specificity value of MRI was 51.72％ (30/58) and 99.87％ (742/743),respectively.Cornua uteri involvement,adnexal mass and CA125 level were screened as helpful indicators for pre-operation diagnosis by decision tree,and the sensitivity was 89.66％ (52/58).Conclusion The diagnosis model of pelvic MRI combined with clinical information by using decision tree analysis can promote sensitivity in diagnosis of EC with OMT.

Visceral sensitivity, gut barrier function and autonomic nerve function in patients with diarrhea-predominant irritable bowel syndrome / 中南大学学报(医学版)

Objective:To evaluate visceral sensitivity,gut barrier function and autonomic nerve function (ANF) in patients with diarrhea-predominant irritable bowel syndrome (IBS-D),and to explore their roles in IBS-D pathophysiology.Methods:A total of 46 IBS-D patients (IBS-D group) were selected from the Department of Gastroenterology of China-Japan Friendship Hospital from October 2015 to March 2016,and 20 healthy volunteer were served as a control group (HC group).Clinical and psychological symptoms were evaluated by questionnaire,and visceral sensitivity to rectal balloon distention,gut barrier function and autonomic nerve function (ANF) were examined.The difference in the abovementioned indexes were compared between the 2 groups,and the correlations in the parameters were analyzed in the IBS-D group.Results:The scores of IBS symptom severity scale (IBS-SSS),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and visceral sensitivity index (VSI) were significantly higher in the IBS-D group than those in the HC group (P＜0.01).In the visceral sensitivity test,maximum tolerable threshold in the IBS-D group was significantly decreased compared to that in the HC group (P＜0.01);there was no significant difference in first sensation threshold and defecating sensation threshold between the two groups (P＞0.05).As gut barrier function markers,the serum diamine oxidase (DAO) and d-lactate were significantly increased in the IBS-D group (P＜0.05).In ANF test,the total score and parasympathetic score as well as the proportion of abnormal scores in the IBS-D group were significantly higher than those in the HC group (P＜0.05).In IBS-D group,the HAMA,VSI and serum DAO were positively correlated with IBS-SSS (r=0.528,0.575,0.507;P＜0.01),while the 3 visceral sensitivity thresholds were negatively correlated with IBS-SSS (r=-0.636,-0.476,-0.697;P＜0.01);in addition to the IBS-SSS,the HAMA,HAMD,VSI and serum DAO were also significant negatively correlated with the visceral sensitivity thresholds (all P＜0.05);no significant correlations were found between the ANF and the other parameters.Conclusion:IBS-D patients show psychological symptoms,visceral hypersensitivity,impaired gut barrier function and abnormal ANF characterized by parasympathetic dysfunction;the former 3 factors are all associated with disease severity,and thus may play vital roles in IBS-D pathophysiology.

Investigation of dose-dependent association between bedtime routines and sleep outcomes in infants and toddlers / 中华儿科杂志

Objective@#To investigate the current bedtime routine among Chinese children less than 3 years of age and explore its dose-dependent association with sleep duration and sleep quality.@*Method@#Healthy full-term born children aged 0-35 months were selected by stratified cluster random sampling method from 8 provinces in China following the "Hospital of Province-City-County" sampling technical route during 2012-2013.Brief Infant Sleep Questionnaire(BISQ) was used to assess sleep conditions of these children.Children′s personal and family information was obtained by Shanghai Children′s Medical Center Socio-demographic Questionnaire.Both of these questionnaires were filled in by parents. The effects of bedtime routine on children′s sleep duration and quality were analyzed by multivariate analysis of variance.@*Result@#The children′s average age was(12±10) months(n=1 304), of whom 689 were males (52.8%, 689/1 304). There were 48.5%(632/1 304)of the parents reported that their children had not established regular sleep routines. There was a consistent dose-dependent association between bedtime routine and sleep duration, as well as other indicators for sleep quality (all P<0.05). The more regular the sleep routines, the longer the sleep duration, the earlier the children went to sleep, the shorter the sleep onset latency, the fewer the nighttime wakeup and the shorter the nighttime waking.The nighttime sleep duration was significantly longer for those with a bedtime routine 'every night’ than those who 'never’ had a bedtime routine (9.5(95%CI: 9.4-9.6)vs. 8.9(95%CI: 8.6-9.3)h, t=3.345, P=0.001). Compared with children who never had bedtime routines, children with regular bedtime routines had fewer night wakeup (1.3(95%CI: 1.2-1.4) vs. 2.4( 95%CI: 2.0-2.9), t=3.182, P=0.001) and shorter night waking duration(16.6(95%CI: 14.6-18.8) vs. 59.2 (95%CI: 47.0-72.7)min, t=6.383, P<0.01).@*Conclusion@#The percentage of children who have established regular bedtime routine is low in China. There is significant dose-dependent association between regular bedtime routine and sleep outcomes, especially sleep quality. The more regular the sleep routines, the better the sleep quality.

Preoperative T stage of non-small cell lung cancer: comparison of the efficacy of 64-MDCT versus 3.0T MR imaging / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the diagnostic efficacies of 64-MDCT and 3.0-T MRI in determining the T stage of non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Approval from the institutional ethics committee and informed consent from patients were obtained before the study started. 40 patients with NSCLC proved by pathology were enrolled in the study. All the 40 patients underwent non-enhanced MRI, enhanced MRI, and enhanced MDCT. Their T stages were preliminarily evaluated according to these imaging manifestations by 3 groups of experienced chest radiologists respectively, and correlated with that of postoperative pathology using the Kappa test. The diagnostic efficacies of these three imaging modalities for determining the T stage of NSCLC were compared using the McNemar test.</p><p><b>RESULTS</b>The preoperative diagnostic accuracy rate for the T stage of NSCLC was 85.0% (34 of 40) by non-enhanced MRI, 87.5% (35 of 40) by enhanced MRI, and 80.0% (32 of 40) by enhanced CT, showing no significant differences between the non-enhanced MRI and enhanced CT, enhanced MRI and enhanced CT, and non-enhanced MRI and enhanced MRI for determining the T stage of NSCLC (P>0.05).</p><p><b>CONCLUSIONS</b>Compared with the enhanced MDCT, non-enhanced MRI and enhanced MRI provide slightly superior diagnostic efficacy for the preoperative T staging of NSCLC. For the patients with intolerance to contrast medium on MDCT scan, 3.0T MRI may be an alternative for determining the preoperative T stage of NSCLC.</p>

Evaluation on lnsulin Combined HCG Improved Method in Establishment of Obese PCOS Rat Models / 世界科学技术-中医药现代化

This study was aimed to establish and evaluate obese polycystic ovary syndrome (PCOS) rat model. Rats were randomly divided into the blank control group, high-fat model group, insulin (INS) combined human chorionic gonadotropin (HCG) model group, and INS combined HCG plus high fat emulsion model group. The obese PCOS rat model was induced by subcutaneous injection of INS and HCG on the nape, respectively. The intragastric administration of high fat emulsion was also used in the PCOS rat model establishment. The estrous cycle of rat was monitored. The detection was also made the weight increasing rate of rats, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), testosterone (T), high-density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), cholesterol (TC), fasting plasma glucose (FPG), fasting insulin (FINS), 2 h blood glucose and 2 h INS. Calculation was made on the HOMA index, related viscera index and bilateral ovaries HE staining. The results showed that when INS combined HCG improved method (INS combined HCG plus high fat emulsion model group) rats were sacrificed, the body weight, weight increasing rate, ovary viscera index, T, LH, and HOMA index were significantly higher than that of the blank control group, high-fat model group and INS combined HCG model group (P < 0.05,P < 0.01); HDL was significantly decreased (P < 0.05,P < 0.01). FPG, FINS, and 2 h INS of the INS combined HCG improved method group were significantly higher than that of the high-fat model group (P <0.01). It was concluded that INS combined HCG improved method was one of the ideal animal model establishment methods in the pathogenesis study of PCOS.

Progress Review on Transduction Mechanism of Obese PCOS and IR through Kidney-tonifying, Spleen-invigorating and Phlegm-resolving / 世界科学技术-中医药现代化

This paper elaborated the research progress on transduction mechanisms of obese polycystic ovary syndrome (PCOS) and insulin resistance (IR). The action mechanisms of kidney-tonifying, spleen-invigorating and phlegm-resolving in the treatment of obese PCOS and IR were explored. It provided new ideas for the treatment of obese PCOS patients in the clinical practice of traditional Chinese medicine (TCM) gynecology. Literatures on TCM theories and modern signal pathways were used in the analysis of spleen-kidney deficiency and phlegm-dampness retention, which were the key pathogenesis of obese PCOS and IR. The scientific nature of treating obese PCOS and IR from the method of kidney-tonifying, spleen-invigorating and phlegm-resolving was demonstrated. The results showed that the scientific nature of treating obese PCOS and IR from the method of kidney-tonifying, spleen-invigorating and phlegm-resolving was initially demonstrated by the organic combination of TCM and modern medicine theories. It innovatively proposed that the treatment study strategy of transduction molecular mechanism took the interactive dialogue between PI-3K/Akt signal pathway and TNF-α signal pathway as its target. The regulatory role and action mechanism of this method in the treatment of obese PCOS and IR were discussed.

Evaluation and Screening on Animal Models of Polycystic Ovary Syndrome of Etiology and Pathogenesis in Traditional Chinese Medicine / 世界科学技术-中医药现代化

By combing differe nt modelin g factors and evaluation indicators of experimental animals of polycystic o-vary syndrome (PCOS), application scope, advantages and disadvantages were analyzed among various kinds of animal models, in order to screen models of etiology and pathogenesis in traditional Chinese medicine (TCM). Through the collection of 77 Chinese literatures published since 1979, the database on PCOS of modeling factors (i.e., animal species, age, modeling reagent and dose, etc.) and evaluation indicators (i.e., ovarian morphology and hormone levels) were established, analyzed and summarized. The results showed that the experimental PCOS models established by researchers both at home and abroad included androgen method, combination method of androgen with HCG, combi-nation method of progestrone with HCG, estrogen method, aromatic cyclase inhibitor method, combination method of HCG with insulin, combination method of androgen with insulin, insulin method, and etc. The SD and Wistar rats at the age of 3-50 days were commonly used. Chemicals, such as dehydroepiandrosterone (DHEA), testosterone propi-onate, sodium prasterone sulfate, dihydrotestosterone (DHT), levonorgestrel, estradiol valerate, letrozole, insulin and HCG were chosen to build the animal models. The evaluation indicators included ovarian morphology, the total num-ber of follicles at different levels, sex hormones (E2, P, T, FSH, LH) and insulin resistance (IR) index (FINS, FPG, HOMA). It was concluded that each modeling method described above had its own advantages and disadvantages, which cannot completely simulate clinical onset process of PCOS patients. Researchers should choose appropriate reagent and evaluation index according to different purpose. DHEA, DHT slow-release, progesterone combined with HCG modeling methods are more suitable for the study of the role of IR in the pathogenesis of PCOS. Kidney-defi-ciency and dampness-phlegm is fundamental etiology and pathogenesis of obese type of PCOS. DHEA method, com-bination method of levonorgestrel with HCG, aromatic cyclase inhibitor method conformed obese type of PCOS. The evaluation indicators included body weight, sex hormones, IR index and ovarian morphology. The method of kidney-tonifying and phlegm-reducing was often used in the treatment of obese type of PCOS in the clinical practice.

The association between night waking and infant cognitive development / 临床儿科杂志

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire;sleep information were collected via the Brief Infant Sleep Questionnaire (BISQ);Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86%(59/116) were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91%of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03%of children over one year old. The frequency of night waking was signiifcantly different between children under one year old and children over one year old (P<0.01). The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was signiifcantly different (Z=4.35, P<0.001). In children over one year old, the more frequent night waking, the lowered MDI scores (F=3.98, P=0.024). The waking duration was negatively correlated with MDI scores in children over one year old (r=-0.26, P=0.035). Neither night waking duration nor night waking frequency had signiifcant correlation with MDI scores in children under one year old. Multivariable linear regression conifrmed that night waking was an independent inlfuential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.

Computer-aided detection of nodule in low-dose CT screening for lung cancer / 中华放射学杂志

ObjectiveTo evaluate the performance of computer-aided detection (CAD) system for detection of pulmonary nodules in 64-slice low-dose CT screening and to investigate whether CAD can improve the performance of radiologists in detecting pulmonary nodules.MethodsOne hundred low-dose screening CT examinations were randomly selected from the database containing 578 consecutive cases between Jun 2007 and Jun 2008.All the examinations were performed on a 64-MSCT scanner with the exposure of 120 kVp,30 or 40 mA,or automatic exposure control.Before the study started,the screening reports had been made with double reading by two radiologists.All the selected images were analyzed with the lung VCAR software from GE Healthcare with a nodule diameter threshold 3.0 mm.All discrepancies between the screening reports and the CAD results were reviewed and the true non-calcified nodules were determined in consensus by two experienced chest radiologists.Detected nodules were classified by density,size and location.The performance of the double reading and the CAD system were compared and analyzed statistically.McNemar-Bowker test was used for the statistical analysis.ResultsA total of 257 true noncalcified nodules were determined in all 100 low-dose screening CT examinations.The detection rate of CAD system was 91.1％ (234/257),with the missed rate of 8.9％ (23/257).Twenty three nodules were missed by CAD,in which 10 were solid with the diameter ranged from 2.4 to 6.0 mm,and 13 were nonsolid with the diameter ranged from 2.1 to 8.6 mm.Of the 23 nodules,17 were located in the outer zones of lungs and 6 in the inner zones.The double reading showed a detection rate of 59.1％ ( 152/257 )and a missed rate of 40.9％ ( 105/257),which was significantly lower than CAD.The diameter of all the 105 missed nodules by radiologists were ranged from 2.4 to 11.8 mm,in which 94 nodules were solid,10 were partly solid and 1 was nonsolid,with 69 located in outer zones of lungs and 36 in the inner zones. Conclusions The capability of the CAD system for detecting non-calcified pulmonary nodules is superior to double reading in low-dose screening CT examination,especially for the nodules located in the inner zone of the lung.When lung VCAR is used,nonsolid pulmonary nodules are more easily missed so that it should be paid more attentions by radiologists.

MRI features of Hirayama disease at different cervical flexion angles / 中华放射学杂志

Objective To analyze MRI features of different cervical flexion positions in Hirayama disease (HD) and discuss the effects on these features by different cervical flexion angles.Methods The cervical MR images of neutral and different flexion positions (20°, 25°, 30°, 35° ,40°) of 20 patients, who were clinically diagnosed as HD,were studied.At flexion positions, the appearance of anterior shifting of the posterior wall of the cervical dural canal and widening of epidural space was recorded.The maximum sagittal diameters (d) of widened cervical epidural space and the cervical canal sagittal diameters (D) on the same level were measured to calculate d/D value for quantitative evaluation of the two signs.Comparisons of appearance of the signs among different flexion positions were made using F/sher's exact test.Repeated measures analysis of variance (rmANOVA) was used to compare mean d/D values among groups with different positions, and paired comparisons were also performed.Results The appearance of anterior shifting of the posterior wall of the cervical dural canal were different between 20° group (70%, 14/20) and other 4 larger angles groups (100%) (χ2 =5.76, P=0.020).The d/D values were 0.51±0.06,0.54±0.08,0.57±0.09,0.61±0.09,0.59±0.07 respectively at abovementioned 5 flexion positions, which were different among groups( F = 3.450 ,P = 0.013 ).The value was greater at 35° than that at 20° and 25°( P <0.05 ), and it was also greater at 40° than that at 20° ( P < 0.05 ).Conclusion Cervical flexion angle has an effect on anterior shifting of the posterior wall of the cervical dural canal and widening of epidural space.

Impact of magnetic attachment keepers on magnetic resonance imaging examination / 北京大学学报(医学版)

Objective:To evaluate the effects of magnetic attachment keepers on MRI images.Me-thods:In in vitro part,keepers of MAGFIT EX 400,MAGFIT EX 600 and MAGNEDISC 800 magnetic attachment systems were cast into standard root-caps with different alloy respectively,including nickel-chromium alloy and gold-palladium alloy,or not be cast for contrast.In in vivo part,volunteers with keepers in different position and amount were included.All the specimens and volunteers were imaged by a Siemens SONATA 1.5-T MRI scanner.Extent of the artifacts in every slice was measured.The magnitude of the artifacts and the distortion of the anatomic structures were compared.Results:All kinds of keepers being studied produced obvious MRI artifacts.The extent of MRI artifacts induced by MAGFIT EX 400 keepers,MAGFIT EX 600 keepers and MAGNEDISC 800 keepers are 158.94 mm,168.52 mm and 173.00 mm,respectively.The images of mental region,tongue,palate,jawbone and sinus were evidently obscured by artifacts in all cases.When keeper was put in the molar region,the keeper-related MRI artifact may obscure the imaging of brain,spinal cord.SE sequence with right-left frequency-encoding direction was more desirable in MRI for the patients with magnetic attachment keepers.Conclusion:Keepers of magnetic attachment system did induce obvious artifacts in MRI examination.