[The value of serum estradiol concentration on the day of endometrial transformation in predicting the outcome of frozen-thawed embryo transfer in hormone replacement cycle].

To analyze whether the serum concentration of estradiol on the day of progesterone conversion could predict the pregnancy outcome of frozen-thawed embryo transfer in hormone replacement cycle. In this paper, a case-control study was conducted to retrospectively analyze the 230 cycles of hormone replacement therapy-frozen thawed embryo transfer(HRT-FET)conducted by the Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2018 to December 2020. The concentration of serum estradiol was between 139.5-3 941.0 pg/ml. According to the percentile of serum estradiol concentration on the day of endometrial transformation, patients were divided into three groups: control group (<25th percentile, n=58), high estradiol group (25th-75th percentile, n=112) and ultra-high estradiol group (>75th percentile, n=60). Comparing the basic characteristics and pregnancy outcome of the three groups, the main observation index was the live birth rate, and the secondary observation index was the clinical pregnancy rate. F test and Kruskal-Wallis (H) test were used to compare the measurement data, and χ2 test was used to compare the counting data. The results showed that there was no significant difference in age, anti-Müllerian hormone(AMH), antral follicle count(AFC), body mass index(BMI), years of infertility and the proportion of primary infertility among the three groups(F=2.375, H=5.479, H=5.374, F=1.391, H=4.779, χ²=1.969, P>0.05). FET cycle treatment: There was no significant difference in the concentration of progesterone (P) before transformation, the thickness of endometrium on the day of transformation, the proportion of single embryo transfer and blastocyst transfer among the three groups (H=5.359, H=5.957, χ²=0.626, χ²=4.532, P>0.05). The days of estrogen administration before endometrial transformation in the three groups during the FET cycle were 13.0 (12.0, 14.0) days in the high estradiol group and 13.0 (12.0, 15.0) days in the ultra-high estradiol group, which were significantly longer than those in the control group 13.0(12.0, 13.3)days. The E2 concentration before intimal transformation in high estradiol group was 1 560.4 (1 170.2, 1 848.2) pg/ml, while that in ultra-high estradiol group was 2 420.9 (2 131.0, 2 849.2) pg/ml, which was significantly higher than that in control group 238.8 (206.9, 287.0) pg/ml. The pregnancy outcome of the three groups: the clinical pregnancy rate of the three groups was 37.9% in the control group, 51.8% in the high estradiol group and 40.0% in the ultra-high estradiol group, of which the high estradiol group had the highest clinical pregnancy rate, followed by the ultra-high estradiol group. But there was no significant difference among the three groups (χ²=3.853, P>0.05). The embryo implantation rate of the three groups was 19.3%, 25.0%, 32.8%, respectively, and the embryo implantation rate of the ultra-high estradiol group was the highest, but there was no significant difference among the three groups (χ²=5.544,P>0.05).The live birth rate of the three groups was 37.9%, 39.3%, 40.0%, respectively, and the difference was not statistically significant (χ²=0.05, P>0.05). A total of 14(13.5%) abortions occurred in 104 clinical pregnancies, all of which occurred in the high estradiol level group. Of the 104 clinical pregnancies, 24 (23.1%) had twin pregnancies, which occurred in the high estradiol level group (10 cases) and the ultra-high estradiol level group (14 cases). There were no twin pregnancies in the control group. Ectopic pregnancy occurred in 4 of 230 FET cycles (1.7%), 2 in control group and 2 in high estradiol group, and no ectopic pregnancy in ultra-high estradiol group.

[Clinical analysis of hepatic perivascular epithelioid cell neoplasm: a report of eleven cases].

Objective: To investigate the clinical features, diagnosis and therapy of hepatic perivascular epithelioid neoplasms (PEComa). Methods: The clinical data of eleven patients with hepatic PEComa who received surgical treatment at Shengjing Hospital Affiliated to China Medical University from April 2012 to October 2017 were collected. The clinical manifestations, imaging features, diagnostic and therapeutic strategies, pathologic features, prognosis were analyzed. Results: The patients aged from 35 to 55 years (mean: 47 years , 3 males and 8 females). Two patients had epigastric pain, the others rarely had any clinical symptom. Hepatitis C virus (HCV) infection was present in one patient 9.09%(1/11), the rate of correct diagnosis by imageological examination before operation was only 9.09%(1/11). All patients received a surgical resection, the final diagnosis of hepatic PEComa was made with pathology and immunohistochemistry. The antibodies used for immunohistochemistry varied from patient to patient. The positive rates of Melan A, HMB45, smooth muscle actin and S-100 were 100%(10/10), 90%(9/10), 77.8%(7/9)and 33.3%(3/9) respectively, the Ki-67 positive index was 1%-10%. One patient died after surgery because of hemorrhage, other ten patients received long-term follow-up(5-71 months), and no recurrence or metastasis was observed. Conclusion: Hepatic PEComa is a rare mesenchymal neoplasm which expresses both melanocytic and myogenic markers. Middle aged females are susceptive to hepatic PEComa, and patients rarely have any specific clinical presentation. It's difficult to make a correct diagnosis before operation. The diagnosis finally depends on the pathological examination. Surgical resection and close follow-up are the principal methods for the management of hepatic PEComa.

The expression of circulating tumor cells in peripheral blood of patients with non-small cell lung cancer and its detection.

This study aimed to investigate the expression of circulating tumor cells (CTCs) in peripheral blood and relevant detection methods as well as the clinical values of determination of CTCs for the diagnosis of non-small cell lung cancer (NSCLC). Peripheral blood specimens were acquired from the patients with NSCLC who came to the Thoracic Surgery Department of Jining No.1 People’s Hospital, Shandong, China for the first visit between January 2015 and November 2016. Whether there was metastasis of CTCs or not was determined by detecting the number of epithelial cell adhesion molecules (EpCAM) which had expression in the CTCs of the peripheral blood with fluorescence polymerase chain reaction. Moreover, the correlation between the expression level of EpCAM of patients with NSCLC during postoperative adjuvant treatment and the efficacy of adjuvant therapy was initially explored. The expression level of EpCAM of the NSCLC patients was remarkably different to that of the patients with benign lung diseases. The expression level of EpCAM of the patients with NSCLC was notably different with that of the healthy volunteers. The expression level of EpCAM of the patients with NSCLC was much higher than that of patients with benign lung diseases and the volunteers. Moreover, the expression level of NSCLC at stages I, II and IIIA had significant differences; the expression level of EpCAM tended to increase as the stage of NSCLC developed. The expression level of EpCAM in CTCs of peripheral blood can be regarded as a reference for the early diagnosis and detection of NSCLC before and after surgery.

[Inflammatory myofibroblastic tumor of the hepatobiliary pancreatic system: report of three cases and literature review].

Objective: To improve the understanding, diagnosis and treatment of inflammatory myofibroblastic tumor (IMT) of the hepatobiliary pancreatic system through the cases review. Methods: The clinical data of three cases of pathologically-proved IMT of the hepatobiliary pancreatic system was reported and relevant literatures were reviewed. Results: Among three cases of IMT discussed, there consisted of a case of liver, a case of gallbladder and a case of pancreas. The clinical manifestations were nonspecific, and the preoperative diagnosis was difficult. All the patients with suspected malignant tumors underwent surgical treatment. The prognosis was good, with no recurrence. Conclusion: IMT is a benign tumor and is rare in hepatobiliary pancreatic system. The clinical manifestations are not typical and the imaging examinations are not specific. Its diagnosis depends on pathology. Surgery is an effective treatment. IMT has a tendency of recurrence, and its postoperative follow-up is of great significance.