Research progress in clinical application of lymphoplasmapheresis in immune-related diseases / 中国输血杂志

Lymphoplasmapheresis(LPE) is a combination of plasma exchange and lymphocyte separation technology. It can not only remove autoimmune antibodies, but also remove the immune active cells producing these antibodies. At the same time, it can inhibit cellular and humoral immune responses, and improve the efficiency and reliability of treatment. This technology is safe, reliable, and easy to operate. In recent years, it has been widely used in the treatment of various autoimmune diseases and the suppression of immune rejection after organ transplantation, especially in the treatment of critically ill patients. This paper summarizes the clinical application status of LPE in immune-related diseases at home and abroad, analyzes the problems existing in the clinical promotion of LPE, and makes a prospect of its application value.

Ovarian response and pregnancy outcome in hyper-responders during repeated in vitro fertilization and embryo transfer / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the ovarian response and pregnancy outcomes in patients with excessive ovarian response receiving long-protocol pituitary down-regulation during repeated in vitro fertilization and embryo transfer (IVF-ET).</p><p><b>METHODS</b>Sixty IVF-ET cycles from January 2008 to December 2011 were analyzed retrospectively. The clinical characteristics were compared between the various treatment cycles.</p><p><b>RESULTS</b>Compared with those with the first treatment cycle, the patients receiving repeated cycles had a significantly older age (P<0.001), reduced initial doses of Gn (P=0.049), and moderately lowered estrogen level on the day of hCG administration (E₂) (P=0.027) and the number of oocytes retrieved (P=0.030). The high-quality embryo formation rate (P<0.001) and clinical pregnancy rate (P=0.009) were both significantly higher in patients with repeated cycles. The dose for down-regulation, total Gn dose, duration of Gn stimulation, number of two pronuclei (PN), number of fertilized oocyte, and the cancellation rate for a high risk of ovarian hyperstimulation syndrome (OHSS) were all comparable between the two groups (P>0.05). The recurrence rate of ovarian excessive respond was 40% (12/30).</p><p><b>CONCLUSIONS</b>For patients receiving repeated IVF treatment cycle with a high ovarian response, a smaller initial dose of Gn should be used to minimize the risk of hyper-response and improve the outcome of assisted reproductive treatment.</p>

The change and its clinical significance of deceleration capacity of heart rate in elderly coronary artery disease / 中华老年医学杂志

Objective To investigate the change and its clinical significance of the deceleration capacity (DC) of heart rate in elderly patients with coronary heart disease (CHD).Methods A total of 105 elderly CHD patients and 86 elderly non-CHD patients were selected.All patients underwent 24 h ambulatory electrocardiographic recording.DC,heart rate variability (HRV) time domain index,heart rate turbulence (HRT) parameters including turbulence onset (TO) and turbulence slope (TS),and the occurrence of ventricular arrhythmias were off-line calculated.Results The values of DC,HRV and HRT were decreased in elderly patients with CHD.DC had positive correlations with standard deviation of normal-to-normal intervals (SDNN),the square root of the mean squared successive differences between normal-to-normal RR intervals (rMSSD) and percentage of adjacent normal-to-normal intervals that differed more than 50 ms (pNN50) (r=0.60,0.51,0.49,0.41,respectively,all P ＜0.05) and had a negative correlation with the occurrence of ventricular arrhythmias (r=-0.34,P＜0.05).The value of DC was much decreased in elderly CHD patients with type 2 diabetic or acute myocardial infarction.Conclusions The decreased DC value is correlated with heart rate variability,turbulence slope and the occurrence of ventricular arrhythmias in elderly CHD patients.The deceleration capacity of heart rate is a better noninvasive method for screening and predicting sudden death in high-risk elderly patients with CHD.