囊胚期胚胎活检及玻璃化冻存的研究

目的：探讨不同质量囊胚活检后的继续发育潜力和玻璃化冻融后的复苏能力。方法选择体外受精-胚胎移植周期患者的剩余胚胎,根据授精后第5/6天囊胚质量等级分为高质量囊胚组和低质量囊胚组,两组囊胚根据活检与否分别分为活检组和对照组。其中活检组囊胚采用激光切割结合抽吸法活检滋养层细胞,而后将活检成功囊胚进行玻璃化冷冻;对照组囊胚不活检,直接进行玻璃化冷冻。比较不同分组囊胚的活检结局及玻璃化冻融效果。结果低质量囊胚活检成功率低于高质量囊胚,但差异无统计学意义（P＝0.183）,低质量囊胚活检后玻璃化冻融复苏率显著低于高质量囊胚（ P＝0.001）,但低质量囊胚和高质量囊胚活检组的玻璃化冻融复苏率与对照组相比差异均无统计学意义（ P＝0.597,P＝0.823）。结论囊胚期活检不影响胚胎继续发育能力及玻璃化冻融复苏效果。     

激光辅助孵化技术在冷冻复苏周期囊胚移植中的应用

目的 探讨激光辅助孵化(AH)技术在冷冻复苏周期囊胚移植中的应用效果.方法 选择复苏周期囊胚移植患者444例,根据有无行激光AH分为激光AH组(AH组)250例、非激光AH组(NAH组)194例,比较两组囊胚孵化程度、妊娠结局指标(胚胎植入率、生化妊娠率、临床妊娠率、活产率、流产率)和新生儿结局指标(新生儿出生体质量、...     

两组冷冻保护剂对卵裂期胚胎玻璃化冷冻效果的研究

［摘要］　目的　评价两组玻璃化冷冻保护剂对卵裂期胚胎的冷冻效果。方法　以体外受精-胚胎移植周期患者受精后第3天废弃胚胎为实验对象,共102枚胚胎入选,随机分为乙二醇+丙二醇(EG+PROH)组52枚,乙二醇+二甲基亚砜(EG+DMSO)组50枚。比较观察两组玻璃化冷冻保护剂对卵裂期胚胎冷冻解冻后胚胎的复苏效果。结果　玻璃化冻融后两组在复苏率上无显著差异,但在完整胚胎复苏率和卵裂球复苏率上EG+PROH组显著高于EG+DMSO组（P<0.05）。结论　对于卵裂期胚胎的玻璃化冷冻,选用EG+PROH作为冷冻保护剂可取得较好的效果。     

内细胞团及滋养外胚层对体外受精单囊胚移植结局的影响

目的：通过对非选择性单囊胚移植研究,探讨选择性单囊胚移植的临床价值以及内细胞团（ICM）、滋养外胚层（TE）在囊胚发育潜能中的作用。方法选择该中心非选择性单囊胚移植276周期,比较优质单囊胚与非优质单囊胚妊娠率、早期流产率;比较不同ICM和TE妊娠率、早期流产率。结果优质单囊胚移植临床妊娠率较非优质单囊胚临床妊娠率显著增高（ P＜0．05）;ICM A组的临床妊娠率较ICM C组的妊娠率显著增高（ P＜0．05）;TE A组的临床妊娠率较TE B组及TE C组显著增高（ P＜0．05）;各组早期流产率差异无统计学意义;多胎妊娠率为1．16％。结论单囊胚移植多胎率极低;优质单囊胚移植比非优质单囊胚移植可以获得较高临床妊娠率;CC级的囊胚仍有一定的妊娠率,在无其他可移植胚胎的情况下,经充分知情同意,可考虑移植CC级囊胚。     

封闭式麦管玻璃化冷冻法用于人早期胚胎冷冻效果观察

目的探讨封闭式麦管玻璃化法用于人早期胚胎（以下简称胚胎）冷冻的效果。方法将接受体外受精-胚胎移植（IVF—ET）患者移植后第3天的胚胎分别采用封闭式麦管玻璃化法（玻璃化组）及程序化慢速冷冻法（程序化组）冷冻,比较两组胚胎存活率、完全胚胎存活率、继续卵裂率及植入率、妊娠率和流产率等。结果玻璃化组的胚胎存活率、完全胚胎存活率、植入率明显高于程序化组,周期取消率明显低于程序化组（P均〈0．05）;继续卵裂率、临床妊娠率、流产率,两组比较均元显著性差异（P〉0．05）。结论封闭式麦管玻璃化法用于人早期胚胎冷冻可简化冷冻程序,更好地保存胚胎复苏后的发育潜能。     

不同冷冻方法造成的冻融胚胎卵裂球损伤对于移植完整胚胎发育潜能的影响

目的探讨分裂期胚胎经玻璃化冷冻法和慢速程序冷冻法冻融后,不同胚胎卵裂球的存活状态对移植完整胚胎后胚胎发育潜能的影响。方法回顾性分析994个（共2 081枚分裂期胚胎）冻融胚胎移植（FET）周期,根据胚胎冷冻保存方法和复苏后胚胎的卵裂球完整与否分为四组：玻璃化冷冻复苏后胚胎卵裂球均完整组（A组）552例,玻璃化冷冻复苏后胚胎卵裂球部分损伤组（B组）156例,慢速程序化冷冻复苏后胚胎卵裂球均完整组（C组）115例,慢速程序化冷冻复苏后胚胎卵裂球部分损伤组（D组）171例,四组均选择完整胚胎进行移植。比较四组的临床妊娠率、胚胎种植率及抱婴回家率。结果 B、D组复苏的胚胎数显著高于A、C组（P均〈0.01）,在临床妊娠率、胚胎种植率和抱婴回家率的比较中,A组显著高于B组（54.89%、44.87%,37.67%、31.39%,46.37%、35.90%（P均〈0.05）,C组与D组比较均无统计学差异（P均〉0.05）。结论经不同冷冻保存技术解冻的无卵裂球损伤的优质胚胎,都具有较高的发育潜能。玻璃化冷冻技术中,卵裂球损伤胚胎中剩余胚胎的发育潜能低于复苏后均完整的胚胎;而慢速程序化冷冻技术中,胚胎卵裂球损伤对剩余胚胎的发育基本无影响。     

体外受精治疗周期中剩余胚胎囊胚培养的临床价值

目的探讨体外受精治疗周期中d3移植和冷冻后剩余胚胎的体外发育潜能。方法对剩余胚胎继续培养至囊胚期,观察其囊胚发育率和质量,并分析治疗周期中剩余胚胎囊胚形成情况和妊娠结局的关系。结果收集115个IVF/ICSI-ET周期中的603枚剩余胚胎,囊胚培养后获得了222枚囊胚(36.82%),其中优质囊胚49枚(8.13%);36个周期(31.30%)共获得53枚冷冻囊胚(8.79%);12例含有剩余胚胎来源囊胚的解冻移植周期,临床妊娠4例;≥6细胞、2PN来源胚胎囊胚形成率显著高于其他组(P0.05);剩余胚胎有囊胚形成的周期临床妊娠率显著高于无囊胚形成组(P0.05)。结论根据d3胚胎形态学评分预测其发育潜能有一定局限性;通过囊胚培养筛选出剩余胚胎中具有发育潜能的并冷冻保存,是提高病人每个治疗周期可用胚胎数的可行方法;剩余胚胎囊胚形成情况可有效预测妊娠结局。     

玻璃化法冷冻保存对人胚胰岛的影响

目的:观察玻璃化法对人胚胰岛冻存复苏后形态功能的影响.方法:取胎龄18-28wk中期水囊引产死胎,用胶原酶分离胰岛后,分别采用传统微机程控缓慢降温和玻璃化超快速降温方法冷冻保存胰岛,复苏后,从胰岛形态、超微结构、胰岛素分泌功能方面比较两种冻存方法的效果.结果:两种方法冷冻保存的胰岛,复苏后形态保持完整,电镜下胰岛B细胞分泌颗粒和线粒体丰富,线粒体嵴规整,胰岛素释放试验中,二者的胰岛素水平与冻存前无明显差异(P>0.05),胰岛素基因表达水平与冻存前相似.结论:玻璃化法冷冻保存胰岛能够维持细胞的正常结构和功能,其冷冻效果与微机程控缓慢降温相比无明显差别.     

新鲜单卵裂胚与单囊胚移植周期妊娠结局及其影响因素分析

［摘要］　目的　分析新鲜单卵裂胚与单囊胚移植周期妊娠结局及其影响因素。方法　回顾性分析广西壮族自治区妇幼保健院生殖中心2002年10月至2020年10月行卵裂期与囊胚期单胚胎移植（SET）共5 543个周期的患者临床资料。根据胚胎移植时期分为第3天卵裂胚组（D3组,1 229例）和第5天囊胚组（D5组,4 314例）。比较两组临床资料及妊娠结局,采用二元logistic回归分析SET周期妊娠结局的影响因素。结果　SET周期临床妊娠率为48.13%（2 668/5 543）,活产率为39.49%（2 189/5 543）,多胎率为2.89%（77/2 668）。二元logistic回归分析结果显示,年龄和胚胎发育时期是SET临床妊娠结局和活产结局的共同影响因素（P<0.05）。分层分析结果显示,年龄≤30岁且优胚数>3枚的D3组和D5组的临床妊娠率（54.55% vs 54.76%）、活产率（49.09% vs 47.21%）比较差异无统计学意义（P>0.05）。结论　新鲜周期选择单卵裂胚和单囊胚移植均可获得较好的临床妊娠率和活产率。选择合适人群,单卵裂胚移植可获得与单囊胚移植周期相似的临床妊娠率和活产率。     

心肺复苏反馈技术对心脏骤停病人心肺复苏质量的影响

目的:探讨心肺复苏反馈技术对心脏骤停病人心肺复苏质量的影响。方法:选取2018年1月—2022年1月于我院急诊科就诊的192例心脏骤停病人作为研究对象,采用随机数字表法分为对照组和观察组,每组96例。对照组接受常规心肺复苏,观察组实施心肺复苏反馈技术。观察两组心肺复苏按压深度、频率、正确率、滞留率及自主循环恢复(ROSC)率、成功率、复苏成功用时、24 h存活率。同时观察两组复苏后血气及血流动力学相关指标[心率、平均动脉压(MAP)、动脉血氧分压(PaO₂)、呼吸频率、动脉二氧化碳分压(PaCO₂)、动脉血液酸碱度(pH)]、并发症发生情况及施救人员疲劳程度。结果:观察组按压深度、正确率均高于对照组,滞留率低于对照组(P<0.05),两组按压频率、ROSC率、心肺复苏成功率、24 h存活率相比,差异无统计学意义(P>0.05),观察组复苏成功用时短于对照组(P<0.05);观察组心率、MAP、PaO₂、呼吸频率均高于对照组,PaCO₂低于对照组(P<0.05);两组并发症发生...     

用超速玻璃化冻存人肝组织微团构建人工肝生物反应器的初步研究

本研究用胶原酶有限消化法将手术切除的小块成人肝组织消化成肝组织微团,用超速玻璃化法冻存,解冻后继续消化成较小组织微团并与胶原培养液混合灌注中空纤维反应器管外腔,在外腔中形成凝胶将肝组织微团悬浮其中,构建人工肝生物反应器,体外灌注检测了该反应器代谢合成功能,现报道如下.     

Circulating thyroid hormones in the chicken before and after hatching.

Plasma protein bound iodine (PBI) and total thyroxine (TT₄) change markedly during and after hatching. These changes do not follow exactly the same patterns although both show a peak, 6.0 μg I/100 ml and 3.0 μg T₄/100 ml, in the 1-day-old chick and decline in the week after hatching. Evidence is presented to show that PBI is not a good index of plasma iodohormone concentration in the chicken.T₄ and T₃ are the only identifiable iodoamino acids in plasma from 1-day-old chicks and the T₄:T₃ ratio is 4. Only minute amounts of T₄ (0.13 – 0.28%) and T₃ (0.11 – 0.19%) are in free solution in chicken plasma. The absolute concentration of free T₄ falls in the 3 weeks after hatching from 8.4 to 3.1 ng T₄/100 ml.     

Effects of loco regional treatments before living donor liver transplantation on overall survival and recurrence-free survival in South Korean patients with hepatocellular carcinoma

Background

We evaluated the effects of pre-transplant locoregional treatment on survival in living donor liver transplantation (LDLT), and the most accurate method for predicting survival after LDLT in patients who received pre-transplant locoregional treatment.

Methods

From December 2003 to December 2012, 234 patients underwent LDLT for hepatocellular carcinoma (HCC) at our transplant center. We retrospectively reviewed 86 patients newly diagnosed with HCC and who received pre-transplant locoregional treatments at our hospital.

Results

Of the 33 patients with HCC initially beyond the Milan criteria, 12 experienced successful down-staging after locoregional treatments, and the 5-year recurrence-free survival was 81.8%, which was comparable to those in patients with HCC initially within the Milan criteria. A bad responder according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) [HR, 4.874 (1.059–22.442), p = 0.042], and increased AFP levels [HR 4.002 (1.540–10.397), p = 0.004] during pre-transplant locoregional treatments were independent risk factors for HCC recurrence after LDLT in multivariate analysis.

Conclusions

Liver transplantation may be considered after successful down-staging in patients with HCC initially beyond the Milan criteria. The mRECIST and serum AFP level changes are better selection criteria for LDLT in patients who have received locoregional treatments.     

Effects of low dose rate irradiation on human marrow hematopoietic and microenvironmental cells: sparing effect upon survival of stromal and leukemic cells

The effects of different dose rates of in vitro irradiation on the proliferative capacity of marrow stromal, hematopoietic and leukemic colony-forming cells (CFC) are described. Marrow cell suspensions, HL-60 cells and trypsin-dispersed fibroblasts were irradiated at 5 or 45 cGy/min and then assayed for CFC. Irradiation at low (5 cGy/min) compared to high (45 cGy/min) dose rate showed a significant difference in survival of stromal and of HL-60 cells, but not of hematopoietic progenitors: the respective D0 values were 170 and 120 (p = 0.003) for marrow fibroblastic progenitors (CFU-F); 145 and 110 (p = 0.005) for passaged marrow fibroblasts (CFU-F); 170 and 140 (p = 0.045) for HL-60 cells; 85 and 85 for multipotential CFC (CFU-mix); 125 and 120 for erythroid progenitors (BFU-E); and 115 and 120 for granulomonopoietic progenitors (CFU-GM) (p = 0.5 for hematopoietic clonogenic cells). Marrow suspensions did not establish confluent stromal layers in long-term marrow cultures following irradiation with 600 cGy at 45 cGy/min, whereas after 840 cGy at 5 cGy/min confluent stromal layers were obtained. This indicates that low dose rate-sparing effect applies to all stromal cell progenitors. Confluent stromal layers derived from progenitors surviving irradiation sustained hematopoiesis as well as controls when co-cultured with fresh hematopoietic cells. Adherent layers in long-term marrow cultures irradiated after establishment with doses less than or equal to 1500 cGy at 5 or 45 cGy/min also showed normal hematopoietic supportive function when co-cultured with freshly isolated hematopoietic cells.(ABSTRACT TRUNCATED AT 250 WORDS)