高剂量来曲唑在卵巢低反应患者微刺激方案中的临床观察#br#

Objective?To explore the clinical application value of high-dose letrozole in poor ovarian response(POR) patients during mild ovarian stimulation protocols receiving IVF/ICSI. Methods?A retrospective analysis was performed on 102 patients with POR treated with letrozole mild ovarian stimulation in IVF/ICSI at our reproductive Center from January 2016 to December 2018. The high-dose letrozole group (7.5 mg/d×5 d) was the high-dose group (n=50), and the conventional letrozole group (5 mg/d×5 d) was the conventional dose group (n=52). Results?The age and basal FSH of the high-dose group were higher than those of the conventional dose group (P<0.05), and the number of sinus follicles (AFC) in the high-dose group was significantly lower than that in the conventional dose group (P<0.05). The time of use of gonadotropin (Gn) in high dose group was shorter than that in conventional dose group (P<0.05), the daily serum E2 level of human chorionic gonadotropin (hCG) was significantly decreased (P<0.05), the egg number was lower than that in conventional dose group, but the egg MⅡrate was significantly higher than that in conventional dose group (P<0.05). The clinical pregnancy rate and live birth rate per fresh transplant cycle increased in the high-dose group [55.56% vs 50%; 55.56% vs 37.5%], but the difference was not statistically significant compared with the conventional dose group (P>0.05). Conclusion?For POR patients receiving ART, high-dose letrozole with mild ovarian stimulation protocol can improve the clinical pregnancy outcome of POR patients to some extent without obvious adverse reactions, especially for POR patients with poor ovarian reserve, which may benefit from improving oocyte quality and high MII rate suggesting improved follicle quality.     

IVF—ET周期中黄体期雌激素水平变化与妊娠关系的临床研究

目的：探讨体外受精-胚胎移植（IVF—ET）周期中黄体期雌激素变化与临床妊娠的关系，从而分析黄体期补充雌激素的必要性。方法：92个超排卵IVF／gg细胞浆单精子注射（ICSI）-ET周期按妊娠结局分为妊娠组和未妊娠组，两组患者均在取卵后常规单纯注射黄体酮60mg，在卵泡成熟日，即人绒毛膜促性腺激素（hCG）日及取卵后第7、10、13天（d7、d10、d13）测定血清雌二醇（E：）水平。①比较妊娠组和未妊娠组hOG日、d7、d10、d13E2水平及d7、d10、d13E2水平与hOG日E2水平的比值[E2（dn）／E2（hCG日）]。②分别以E2（d7）／E2（hOG日）、E2（d10）／E2（hCG日）、E2（d13）／E2（hOG日）值的25％、50％和75％为界点将所有患者分为A组（〈25％）、B组（25％-50％）、c组（〉50％～75％）、D组（〉75％）组，比较各组妊娠率。结果：①仅取卵后d13E2水平及E2（d13）／E2（hOG日）值妊娠组与未妊娠组差异有统计学意义（Z=-6．229，P〈0．01；Z=-3．426，P〈O．01）；②以E2（dn）／E2（hOG日）值的分组比较，仅d13的4组差异有统计学意义（P〈0．05）。结论：在使用超排卵的IVF／ICSI—ET周期中，黄体期雌激素的变化并不影响临床妊娠率，因而可不补充雌激素。     

康复训练护理对促进尺桡骨双骨折患者功能恢复及提高护理满意度的作用

目的:探讨康复训练护理对促进尺桡骨双骨折患者功能恢复及提高护理满意度的作用。方法:选取我院骨科2016年1月-2017年3月接收的尺桡骨双骨折患者90例,采用数字表法将患者均分为对照组与研究组,对照组患者实施常规护理措施进行干预,研究组患者给予康复训练护理,对比两组患者护理后功能恢复情况及护理满意度。结果:研究组患者护理结束后前臂旋前、前臂旋后、腕掌屈、腕背伸角度差异与对照组相比差异显著(P0.05);研究组患者护理满意度95.56%显著高于对照组80.00%,差异有统计学意义(P0.05)。结论:尺桡骨双骨折患者实施康复训练护理可促进其功能恢复,且护理满意度显著提高,值得临床推广应用。     

丹红注射液对X综合征血管内皮功能影响的临床研究

目的观察丹红注射液对X综合征（CSX）病人内皮功能变化、临床疗效及平板运动试验的影响。方法对90例42～72岁X综合征病人。在常规西药的基础上随机分为3组,分别为丹红注射液高剂量组（A组）、〗常规剂量组（B组）和丹参注射液组（C组）,静点两周后比较三组中血管内皮功能变化,临床症状和平板运动试验后ST-T改变。结果 A组和B组在升高一氧化氮（NO）水平、血流介导的血管扩张（FMD）均明显高于C组;在症状缓解、平板试验改善方面AB组强于C组。结论丹红注射液能改善血管内皮功能,改善心绞痛症状及平板试验心电图ST-T变化。