[Effects of dyslipidemia on IVF/ICSI pregnancy outcome in patients with polycystic ovary syndrome].

Objective: To investigate the impact of dyslipidemia on in-vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) pregnancy outcome in patients with polycystic ovary syndrome (PCOS) . Methods: From July 2013 to March 2016, 468 PCOS patients with antagonist protocol in IVF/ICSI of First Affiliated Hospital of Nanjing Medical University, cycles were divided into dyslipidemia group (108 cases) and normol blood lipids group (360 cases) according to the serum cholesterol, triglyceride (TG) , high-density lipoprotein, low density lipoprotein levels. The general condition and clinical outcomes of the two groups were analyzed retrospectively, including the implantation rate, clinical pregnancy rate, live birth rate and the incidence of moderate to severe ovarian hyperstimulation syndrome (OHSS) , etc. Besides, stratified analysis and multivariate logistic regression analysis were used to correct the impact of body mass index (BMI) . Results: (1) Comparing the based data of dyslipidemia group and normal blood lipids group: age, years of infertility, basic FSH, basic LH, basic estradiol and other indexes had no significant differences (all P>0.05) , but BMI of dyslipidemia group was significantly higher than normal blood lipids group [ (25.0±3.0) versus (23.1±3.0) kg/m(2)], difference had statistical significance (P<0.01) . (2) The high score embryo rate, endometrial thickness on the day of hCG injection, progesterone and LH levels on the day of hCG injection, moderate to severe OHSS rate and miscarriage rate in the two groups did not exhibit remarkable differences (all P>0.05) . However, the number of dominant follicle, retrieved oocyte number, estrogen level on the day of hCG injection, implantation rate, biochemical pregnancy rate, clinical pregnancy rate and the live birth rate in dyslipidemia group were significantly less than those of normal blood lipids group (all P<0.05) , the dose of gonadotropin (Gn) and days of stimulation were significantly higher compared with the normal blood lipids group, there were significant differences statistically (all P<0.05) . (3) Stratified analysis showed that no matter in BMI<24 or BMI≥24 kg/m(2) group, the dose of Gn and days of stimulation were significantly higher in the dyslipidemia group than those of the normal blood lipids group, the difference was statistically significant (P<0.05) . However, the number of oocytes retrieved, estrogen level on the day of hCG injection had obvious downtrend, and the difference was statistically significant (P<0.05) in BMI≥24 kg/m(2) group. Multivariate logistic regression analysis found that, even after the correction of BMI, dyslipidemia still had negative impact on implantation rate, biochemical pregnancy rate, clinical pregnancy rate and the live birth rate (P<0.05) . (4) Further analysis of the different components of blood lipids in the clinical pregnancy group and unobtained pregnancy group revealed that the level of triglyceride (TG) in the unobtained pregnancy group was significantly higher than that in the pregnancy group, and the difference was statistically significant (P<0.05) ; logistic regression analysis also showed that the increase of TG levels was negatively correlated with the clinical pregnancy rate of PCOS patients (P<0.05) . Conclusions: PCOS patients combined with dyslipidemia have a higher BMI, and dyslipidemia increases the dosage of Gn, reduces the implantation rate, clinical pregnancy rate and live birth rate, especially the increase of TG level,which has adverse effects on IVF/ICSI outcome in patients with PCOS.

[Cumulative live birth rates per oocytes retrieved cycle: evaluation of clinical outcomes of IVF/ICSI].

Objective: Using of cumulative live birth rate (CLBR) per oocytes retrieved cycle, to assess the clinical outcomes of in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) , and to explore impact factors on CLBR following utilization of all fresh and frozen embryos in one complete IVF/ICSI cycle using gonadotropin-releasing hormone (GnRH) agonist, GnRH-antagonist and clomiphene mild stimulation protocols. Methods: Of the patients who underwent IVF/ICSI from January 1st, 2014 to December 31st, 2015 in the First Affiliated Hospital, Nanjing Medical University, a total of 6 142 oocytes retrieved cycles were included. The clinical and laboratory parameters of different ovarian stimulation protocols, and the effects of the age, number of oocytes retrieved and number of embryos available on the CLBR of each oocytes retrieved cycle were analyzed. Results: The CLBR was 69.0% (2 004/2 906) in the GnRH-agonist protocol versus 67.4% (644/955) in the GnRH-antagonist protocol (P>0.05); the CLBR of clomiphene mild stimulation protocol was 53.2% (1 215/2 281) , significantly lower than those of the other two protocols (all P<0.05). The CLBR significantly decreased with age increased. When divided into four groups according to the patients' age, we found that CLBR were not statistically significant using three different protocols in the 20-25 years old group (all P>0.05). There was a strong association between the number of oocytes retrieved and embryos available on CLBR. CLBR rose significantly with an increasing number of oocytes up to 6, then the rising trend slowed down. Patients were categorized into four groups according to the number of oocytes retrieved, CLBR was significantly higher using GnRH-antagonist protocol (50.0%) than mild stimulation protocol (37.0%) in low ovarian responder (0-4 oocytes) group (P<0.05) . The CLBR were no significant difference among three protocols in normal (10-15 oocytes) and high responders (≥15 oocytes) group (all P>0.05) . The incidence rate of ovarian hyperstimulation syndrome in GnRH-agonist protocols (5.2%, 152/2 906) were significantly higher than those of GnRH-antagonist (4.4%, 42/955) and clomiphene mild stimulation protocols (1.5%, 34/2 281; all P<0.05) . Conclusions: CLBR is an important index to assess the clinical outcomes of IVF/ICSI. Age, number of oocytes retrieved and embryos available could affect CLBR obviously. According to the different age and ovarian response of patients, we should design ovarian stimulation protocols based on target oocytes number in order to get higher CLBR and reduce complications.

Role of the IL-11/STAT3 signaling pathway in human chronic atrophic gastritis and gastric cancer.

The expression of interleukin-11 (IL-11) and its products STAT3 and phospho-STAT3 (p-STAT3) in patients with chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), and gastric cancer (GC) may provide insight into the diagnostic role of the IL-11/STAT3 signaling pathway in GC. Gastric mucosa specimens and serum samples were collected from 90 patients with CSG, CAG, and GC (30/group). The expression of IL-11, STAT3, and p-STAT3 was detected via immunohistochemistry and western blot. Additionally, serum levels of IL-11 were measured by enzyme-linked immunosorbent assay. For IL-11, 60% stained positive in CAG and 83.3% stained positive in GC, which were both higher than the value observed for CSG (33.3%). Moreover, the percent positive for IL-11 in GC was higher than that in CAG (P < 0.05). The percent positive for STAT3 in CAG (80%) and GC (83.3%) was higher than that in CSG (53.3%) (P < 0.05). Compared with CSG (36.7%), the percent positive for p-STAT3 in CAG (63.3%) and GC (86.7%) was also significantly higher. STAT3 expression was similar in GC and CAG, which was significantly higher than that in CSG. Expectedly, p-STAT3 expression gradually increased from CSG to CAG to GC. Furthermore, p-STAT3 levels were higher in GC tissues than in CAG (P < 0.01). Intriguingly, serum IL-11 levels gradually increased from CSG to CAG to GC, which coincided with disease severity. Together, these results suggest that the IL-11/STAT3 signaling pathway plays a critical role in human CAG, and may provide new targets to prevent and treat GC.

[Efficacy of ablendazole emulsion in treatment of 212 patients with cystic echinococcosis].

OBJECTIVE: To verify the efficacy of abendazole emulsion, a new formulation of abendazole, in treatment of human cystic echinococcosis. METHODS: 212 patients with liver cystic echinococcosis were treated orally with albendazole emulsion at a daily dose of 10 mg/kg or 12.5 mg/kg for 3 to 12 months or over one year. The therapeutic efficacy was mainly evaluated by image feature examined with B ultrasound examination, a short-term efficacy at the completion of treatment and a long-term efficacy followed-up for 1-4 years. RESULTS: In 212 patients treated with albendazole emulsion at a daily dose of 10 mg/kg and 12.5 mg/kg, the average cure rate, improved rate and the rate of no avail were 74.5%, 99.1% and 0.9% respectively after termination of the treatment, and the average long-term rates were 83.1%, 89.3% and 0.6% respectively. Recurrence occurred in 18 patients(10.2%). The results indicated that the best efficacy was seen in patients treated with albendazole 12.5 mg/kg daily for 9 months. Better response was also found when the recurrent patients were re-treated with albendazole. CONCLUSION: The efficacy of albendazole emulsion on patients with liver cystic echinococcosis is much better than that of albendazole tablet or capsule and mebendazole. Meanwhile, the efficacy of albendazole emulsion is stable with less adverse effects. The results suggest that albendazole emulsion could be the drug of choice for treatment of cystic hydatid disease.

[Preparation and identification of anti-Trichomonas vaginalis monoclonal antibodies].

Hybridomas producing monoclonal antibodies (McAb) directed against Trichomonas vaginalis have been produced by fusing NSI myeloma cells with spleen cells of BALB/c mice immunized with Trichomonas vaginalis. IFA technique was used to test the binding activity of four McAbs produced. The McAb belonged to the IgG subtypes IgG1 (2A2, 2A4 McAb), IgG3 (2H9 McAb) and IgG 2b (2A12 McAb). Three McAbs, designated 2A2, 2A4, 2A12, reacted with a surface membrane component of live Trichomonas vaginalis. One (2A12) of them produced complement-dependent cytolysis of the parasites. Others (2A2,2A4) produced complement-independent cytotoxicity of the parasites. 2H9 McAb which reacted with the nucleus of the organisms did not agglutinate the parasites. The four McAbs which did not have cross reaction with some protozoa of Zoomastigophorea species were specific antibodies against Trichomonas vaginalis. (Figs. 1-3).