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Objective:To explore the selection strategy of blastocyst transfer number in freeze-thaw cycle for women over 40 years old, so as to provide reference for reducing twin rate and improving perinatal clinical outcome.Methods:A retrospective analysis was made of 377 patients who underwent freeze-thaw blastocyst transplantation in the reproductive center of Guangdong Maternal and Child Health Hospital from January 2017 to December 2019. They were divided into single blastocyst and double blastocyst transplantatio groups according to the number of blastocyst transplantation. The clinical pregnancy rate, implantation rate, abortion rate, live birth rate, premature delivery rate, twin rate and singleton delivery rate were compared between the two groups.Results:⑴There was no significant difference between two groups regarding the majority of baseline characteristics, including age at retrieval, age at transfer, body mass index (BMI), antral follicle count (AFC), basal follicle stimulating hormone (FSH), anti Mullerian hormone (AMH), endometrial thickness at transfer day, number of oocytes retrieved, Gn starting dose, Gn days, Gn dosage, embryos at cleavage stage and top-quality embryos ( P>0.05). ⑵ There was no significant difference in the rate of implantation, early pregnancy loss, late pregnancy loss and live birth between two groups ( P>0.05). ⑶ The preterm birth rate was higher in the double blastocyst transplantation group compared with the single blastocyst transplantation group, albeit not reaching significant difference (31.7% vs 12.5%, P=0.083). ⑷ The clinical pregnancy rate and the twin pregnancy rate was significantly higher in the double blastocyst transplantation group compared with the single blastocyst transplantation group ( P<0.05). ⑸ The singleton birth rate was significantly lower in the double blastocyst transplantation group compared with the single blastocyst transplantation group (75.61% vs 95.83%, P<0.05). Conclusions:In women ≥40 years old, transferring a single blastocyst can result in live birth rate that is similar as transferring two blastocysts while dramatically reducing the risk of twin pregnancy rate and increasing singleton birth rate.
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Objective To study the efficacy of Tripterygium wilfordii polyglycosides combined with doxycycline in the treatment of palmoplantar pustulosis.Methods From June 2014 to November 2017,144 patients with palmoplantar pustulosis treated in the Second People's Hospital of Changzhi were selected and divided into three groups according to different treatment methods,with 48 cases in each group.The doxycycline group was treated with doxycycline.The Tripterygium wilfordii polyglycosides group was treated with Tripterygium wilfordii polyglycosides.The combination group was treated with Tripterygium wilfordii polyglycosides combined with doxycycline.The symptom score decline index (SSRI),clinical effect and changes of T lymphocyte subsets in peripheral blood were compared among three groups.Results The SSRI improvement rates of pustule,erythema,scab and pruritus in the combination group were 95.83％ (46/48),93.75％ (45/48),97.92％ (47/48),97.92％ (47/48),respectively,which were higher than those in the doxycycline group [72.92％ (35/48),70.83％ (34/48),75.00％ (36/48),77.08％ (37/48)] and the Tripterygium wilfordii polyglycosides group [83.33 ％ (40/48),81.25 ％ (39/48),85.42％ (41/48),89.58 ％ (43/48)],the differences were statistically significant (x2 =9.417,8.542,10.568,6.306,all P ＜ 0.05).The total effective rate of the combination group was 95.83％ (46/48),which was higher than that of the doxycycline group [66.67 ％ (33/48)] and the Tripterygium wilfordii polyglycoside group [81.25 ％ (39/48)] (x2 =5.285,P ＜0.05;x2 =1.771,P =0.076).There were statistically significant differences in CD4+,CD4+,CD4+/CD4+ among the three groups (F =3.854,4.856,5.019,P =0.017,0.024,0.030).Conclusion Tripterygium wilfordii polyglycoside combined with doxycycline can improve the clinical symptoms and T lymphocyte immune function in patients with palmoplantar pustulosis.
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Objectives To investigate the relationship of methylenetetrahydrofolate reductase (MTHFR) and methioninesynthase reductase (MTRR) with unexplained recurrent spontaneous abortion (URSA). Methods Case control study was used to select 244 patients with URSA (miscarriage group) and 116 normal women (control group) who were admitted to Tianjin Medical University General Hospital and Tianjin Women’s and Children’s Health Center from January 2013 to March 2015. The oral mucosal epithelial cells were extracted using fluorescence quantitative PCR to detect MTHFR gene C677T, A1298C and MTRR gene loci of A66G single nucleotide polymorphisms (SNP). The relationship between folate metabolism related gene polymorphisms of MTHFR and MTRR and URSA was analysed. Results The frequency of C677T genotype MTHFR was significantly higher in URSA group than that in the control group, and the frequency of CT genotype was significantly lower than that of the control group (P<0.05). There was no significant difference in the frequencies of A1298C MTRR and A66G MTHFR between the two groups. The activity of MTHFR, red cell folate and plasma folate levels were significantly lower in URSA group than those of control group. Homocysteine levels were significantly higher in URSA group than those of control group (P<0.05). There were no significant differences in serum folic acid, red cell folate, homocysteine cysteine levels between patients <35 years old and ≥ 35 years old in URSA group. Conclusion C677TMTHFR gene polymorphism is associated with unexplained recurrent spontaneous abortion.
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OBJECTIVE To explore the incidence of sharp instrument injuries among nurses from the various classes of medical institutions and to analyze the cause and investigate the preventive countermeasures.METHODS To survey the sharp instrument injuries in nursing among 1050 nurses from 50 medical institutions.From 1050 questionaires,1028 were performed.RESULTS Among 1028 nurses from 50 medical institutions,903 nurses suffered different degrees of sharp instrument injuries with 87.84%,of which 40.75% and 31.12% were caused respectively in working age of 6-10 years and 11-15 years.All injury cases added up to 7059,with average of 7.80 times per person and 287(31.78%) cases were with over 10 times.Injuries for ampule in dispensing and clearance of instruments accounted for 70.63% and 15.54%,with the times of 4986 and 1097.Degrees of injury:the light injury of skin accounted for 57.69% with 4076 cases.CONCLUSIONS It is suggested to reform the craft of ampules and safety of instruments continually.Instrument cleaner is recommended if necessary.The key point is to strengthen the education of awareness on occupational protection and do self-protection best,which is sharply important to reduce the incidence of injuries.