Occupational, educational and residential factors are associated with the outcomes of in vitro fertilization-embryo transfer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the associations of occupational, educational and residential factors with the outcomes of in vitro fertilization -embryo transfer (IVF-ET).</p><p><b>METHODS</b>A retrospective analysis was conducted among 3998 patients undergoing the first treatment with IVF-ET and 3064 perinatal infants in our center between January, 2010 and June, 2014. The relation of the patients' occupation, educational background, and residence registry with IVF-ET outcomes was analyzed.</p><p><b>RESULTS</b>The risk of abortion in the first trimester was significantly higher in female patients engaged in agriculture (OR=4.319, P=0.047). Occupation and educational background of the patients and their spouse were related with the incidence of ectopic pregnancy following IVF-ET. The total incidence rate of perinatal birth defects was 2.1% in this cohort, and was the highest in Shenzhen (5.5%) but this difference was not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>The patients' occupation and educational background are related with the outcomes of IVF-ET, suggesting the importance of health education and prenatal examination.</p>

Endotoxic damage to the stria vascularis: the pathogenesis of sensorineural hearing loss secondary to otitis media

The incidence of sensorineural hearing loss [SNHL] secondary to otitis media is higher than recognied. This study presents animal experiments on endotoxin [LPS] damage to the inner ear with special reference to the stria vascularis. A dose of micro g / 5 microL LPS is injected into the perilymphatic space of the inner ear of guinea pigs. Only 5 microL normal saline is given in control group. Audiometric measurement with ultrastructural evaluation on the stria vascularis is done before and 1, 3, and 5 days after the treatment. In the control group no significant difference is found audiometrically as well as ultrastructurally. CAP thresholds of the LPS ears were raised and N 1/P 1 latencies prolonged, indicating SNHL induction. The stria vascularis in LPS ears shows marked damage of the organelles mainly in the marginal cells. The mitochondria were swollen with their crests in disorder, broken or vanished. Intercellular space is widened, Secondary lysosomes are increased and enzymal reactant of Na[+]-K[+] ATPase diminished. LPS induced otoxicity in the stria vascularis provides presumptive ion imbalance, causing change of endolymph composition and failure of energy supply to the Cotrical organ. The fact is responsible for the pathogenesis of SNHL secondary to otitis media

Tracheotomy in the management of respiratory failure

In less than a century indications for tracheotomy have been extended from laryngeal obstruction to respiratory failure due to secretory obstruction [RFSO] in the lower airway. Of the 242 patients who have undergone tracheotomy during 1961-1992, 119 cases required the procedure for RFSO. According to the cause RFSO patients were divided into five subgroups:[a] neuromuscular diseases; [b] coma; [c] chemical burns, foreign body, or infection in lower airway [d] reduced mobility of the ribcage [e] adjacent compression in the mediastinum. Secretions collected in lower airway can be deterimental to life. RFSO is seen in lots of comatosed patients. They usually die of drown-lung and asphyxia instead of underlying disorders as the major problem for RFSO is hypercapnia rather than simply hypoxemia oxygen inhalation is useless and even harmful. The key measure to break up this pernicious circle is to aspirate secretion accumulated in lower airway to promote alveolar gas exchange. Once RFSO is diagnosed a timely tracheotomy is helpful to assist ventilation, frequent bronchial toilet and artificial respiration. It provides better chance to rescue suffocated patients. Only Sixteen patients [13.4%] developed complications in this series