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ObjectiveTo compare the outcomes in controlled ovarian stimulation （COH） and fresh embryo transfer between women with and those without a high basal luteinizing hormone （bLH） level in polycystic ovary syndrome （PCOS）. MethodsThe clinical data of PCOS patients at the Reproductive Medicine Center of the Sixth Hospital of Sun Yat-sen University from January 2015 to December 2021 were retrospectively analyzed. They were divided into the high group （LH≥10 U/L） and normal group （LH<10 U/L） according to the bLH levels. The results of COH and pregnancy outcomes after fresh transfer were compared， including gonadotropin （Gn） initiation dose， Gn duration， total Gn dose， number of oocytes obtained， two pronuclei （2PN） rate， available embryos rate， high-quality embryos rate， blastocyst formation rate， human chorionic gonadotrophin （HCG） positive rate， clinical pregnancy rate （CPR）， spontaneous abortion rate （SAR）， ongoing pregnancy rate （OPR） and live birth rate （LBR）. The differences in hormonal trends during COH were also analyzed. ResultsThere were no statistically significant differences in age， body mass index， anti-Mullerian hormone， and type of infertility between the two groups. Compared with the normal group， the Gn initiation dose and Gn duration were not statistically significant （P>0.05）， while the total Gn dose was significantly lower （P<0.001） in the high group. The number of oocytes retrieved， 2PN rate， available embryos rate， high-quality embryos rate， and blastocyst formation rate were comparable between the two groups （all P>0.05）. After fresh embryo transfer， they had similar pregnancy outcomes in the HCG positive rate， CPR， SAR， OPR and LBR （all P > 0.05）. ConclusionsIn patients with PCOS， high bLH levels do not affect COH or pregnancy outcomes in fresh transfer cycles. Further studies are needed to determine whether LH levels need to be lowered prior to COH and whether frozen-all strategy is required in patients with elevated bLH levels.
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Tacrolimus and cyclosporine are both calcineurin inhibitors ( CNI) that widely used for immunosuppression and have the characteristics of great intra-and inter-variabilities in phar-macokinetics and pharmacodynamics.CNI undergoes extensive first-pass metabolism and is substrate for cytochrome P450 (CYP) 3A4, CYP3A5 and P-glycoprotein in intestine and liver.'Hie functions of the enzyme and transporter are determined by complex interactions including gene polymorphisms, induction or inhibition of drugs and endogenous substances ( such as inflam-matory factors).This review summarizes the clinical determinants of CNI treatment variability, including food intake, diarrhea and other intestinal diseases, anemia, hypoproteinemia, hyperlipidemia, liver and kidney disease and combination medications.The underlying mechanisms are also discussed.
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ObjectiveThe correlation of intestinal flora diversity in infants undergoing cochlear implantation (CI) with different general anesthetics remains unclear. The aim of this study was to observe the effects of propofol and sevoflurane on intestinal flora diversity in infants undergoing cochlear implantation.MethodsFrom January 2018 to August 2018, twenty infants with hearing impairment who underwent CI in the Department of Anesthesiology, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were randomly divided into propofol group (10 cases) and sevoflurane group (10 cases). The propofol group (group P) received intravenous injection while the sevoflurane group (group S) received inhalation. Genomic DNA was extracted for PCR and 16S rDNA sequencing technique was used to analyze the diversity of intestinal flora (intestinal flora taxonomic composition, flora alpha diversity index, and intestinal flora PICRUSt function prediction).ResultsThe analysis of intestinal flora taxonomic composition showed that the intestinal flora of infants in the two groups were mainly Firmicutes and Bacteroidetes after operation. There was no significant difference in species diversity of intestinal flora (Actinobacteria, Bacteriodetes, Firmicutes, etc.) between Group S and Group P（P＞0.05）. The analysis of flora alpha diversity index showed that there was no significant difference in metrics (species information index, chaol index, Shannon index, etc.) between Group S and Group P（P＞0.05）. The analysis of intestinal flora PICRUSt function prediction showed that there were significant differences in Peptidase metabolism (1.82±0.08, 1.91±0.07, P=0.02), Protein Kinase metabolism (0.32±0.03, 0.28±0.03, P=0.02) and Tuberculosis pathway (0.14±0.01,0.15±0.01,P=0.049) between Group S and Group P after operation.ConclusionSevoflurane and propofol can regulate the functional diversity of intestinal flora through affecting different metabolic pathways of KO function in the functional diversity of intestinal flora and provide new guidance for the use of clinical anesthetics in infants undergoing CI.
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<p><b>OBJECTIVE</b>To investigate the effects of valsartan on expression of angiotensin II receptors in different regions of heart after myocardial infarction (MI).</p><p><b>METHODS</b>Canines were divided into sham-operated control group (n=7), infarction group (n=7) and Valsartan group (10 mg x kg(-1) x day(-1) for 4 weeks after MI operation, n=7). Four weeks after operation, Doppler tissue imaging (DTI) was used to evaluate regional ventricular function in the noninfarcted myocardium (apical and basal near to the infarction region). The mRNA and protein expressions of angiotensin II type 1 receptor (AT1-R) and angiotensin II type 2 receptor (AT2-R) on the corresponding regions were detected by competitive reverse-transcriptase polymerase chain reaction technique and immunohistochemical technique respectively. Results The protein and mRNA expressions of AT1-R were significantly increased in both apical and basal regions near to the infarction in dogs with MI compared with those in control group (P < 0.05) which could be downregulated by valsartan (P < 0.05). AT2-R expressions were significantly upregulated in infarction group in both apical and basal regions compared with those in control group and valsartan further increased AT2-R expressions in both areas (P < 0.05). Myocardial peak systolic velocity (Sm), myocardial peak early diastolic velocity (Em) and myocardial peak late diastolic velocity (Am) at both apical and basal regions near to the infarction regions were significantly lower in MI group than those in the control group which could be significantly improved by valsartan.</p><p><b>CONCLUSION</b>Both mRNA and protein expressions of AT1-R and AT2-R are upregulated in noninfarcted regions near MI, valsartan improved myocardial function via inhibiting AT1-R upregulation and enhancing AT2-R upregulation.</p>