[Diagnostic values of BRAF(V600E) mutation analysis and Bethesda system for reporting thyroid cytopathology in thyroid nodules with TIRADS 4 and 5].

Objective: To evaluate the diagnostic efficacies of BRAF(V600E) testing and Bethesda system for reporting thyroid cytopathology (BSRTC) in thyroid nodules with thyroid imaging reporting and data system (TIRADS) category 4 and 5. Methods: A total of 187 thyroid nodules in 187 patients underwent the examinations of ultrasound-guided fine needle aspiration cytology (FNAC) and BRAF(V600E) mutation were analyzed retrospectively. Receive operating characteristic (ROC) curve was used to investigate the diagnostic values of both methods and the clinical application of BRAF(V600E) combined with BSRTC was evaluated. SPSS17.0 software was used to analyze the data. Results: Among 187 thyroid nodules, 123 were malignant nodules confirmed with histopathological examination and 64 benign nodules determined by FNAC, histopathological examination, or long-term follow-up. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BRAF(V600E) test were better than those of BSRTC [69.1%, 98.4%, 98.8%, 62.4%(χ(2)=77.3, P=0.000) vs 62.6%, 93.8%, 95.1%, 56.6%(χ(2)=54.4, P=0.000)]. While the sensitivity, specificity, PPV and NPV of the combined test of BRAF(V600E) and BSRTC for diagnosis of malignant thyroid nodules were 87.8%, 92.2%, 95.6%, 79.7%(χ(2)=112.6, P=0.000), respectively. The area under the ROC curve for the combined test was higher than that for each of tests (0.900 vs 0.858 or 0.838). Conclusions: The combined test of BRAF(V600E) mutation and BSRTC has a higher diagnostic efficacy for malignant thyroid nodules compared with BRAF(V600E) mutation or BSRTC alone.

Inter-generational effects of the in vitro maturation technique on pregnancy outcomes, early development, and cognition of offspring in mouse model.

In vitro maturation (IVM) of oocytes has been a highly successful method for avoiding the occurrence of severe ovarian hyperstimulation syndrome in some patients during in vitro fertilization. However, the safety of the protocol, especially the long-term effects, is still an issue of debate. The current study is to investigate the long-term effects of IVM on mice through two generations and reveal its inter-generational effects as well. The data indicate that the rates of embryo resorption and fetal death in the F1 generation were significantly increased while the newborn survival rate in the F1 and F2 generations were significantly decreased in the IVM group. Increased body weights in the F1 generation and mouse number per litter in the F2 generation were observed in both the IVM and VVM groups; however, no insulin resistance was detected. No significant differences were detected in birth defects, organ weights, testis histology and sperm motility, estrous cycle, and cognition among the IVM, VVM and N mice in either the F1 or F2 generations. Our results suggest that mouse IVM can affect pregnancy outcomes throughout two generations. IVM does not appear to influence the development and cognition of the offspring throughout two generations.

The effects of prenatal maternal depressive symptoms on pain scores in the early postpartum period.

Depression aggravates chronic pain. Currently, there is little information about the relationship between prenatal maternal depressive symptoms and pain scores in the early postpartum period of caesarean section. This investigation is to explore the prevalence of prenatal maternal depressive symptoms and their effects on pain scores in the early postpartum period of caesarean section. We performed depression scores and pain scores on 764 women after admission to the hospital and at 24 h, 48 h and 72 h after caesarean section. Up to 29.7% of women experienced positive depressive symptoms, and they had much higher pain scores in the early postpartum period of caesarean section. Pregnant women with positive depressive symptoms require further interventions and mental healthcare in order to relieve their pain in the early postpartum period.

Modified natural cycle for in vitro fertilization and embryo transfer in normal ovarian responders.

Controlled ovarian hyperstimulation (COH) using a gonadotrophin-releasing hormone (GnRH) analogue plus gonadotrophins is used widely in in vitro fertilization (IVF), but there can be significant complications. Sixty women with a normal ovarian response participated in a comparison of COH (triptorelin [GnRH agonist] 0.1 mg/day SC from day 21 of the menstrual cycle [before the IVF cycle] and recombinant follicle-stimulating hormone (FSH) 150 - 300 IU/day from day 2 of the IVF cycle, when triptorelin was reduced to 0.05 mg/day) with a modified natural cycle (MNC) treatment (human menopausal gonado trophin [HMG] 150 IU/day IM if serum oestradiol was ≤ 50 pg/ml on day 2 or 3 of the menstrual cycle). The groups did not differ significantly in implantation rate (21.1% and 22.6%, respectively) and clinical pregnancy rate (30.0% and 30.0%, respectively). When comparing successful pregnancies, MNC patients had significantly lower values than COH patients for total amount of gonadotrophin (HMG and recombinant FSH) used, number of oocytes retrieved and medication cost. It is concluded that MNC seems to be a feasible treatment option, with low medication cost, relatively low risk of complications and, possibly, greater patient acceptability.