Effects of cumulus cells on vitreous cryopreservation of human mature oocytes and clinical pregnancy outcomes

The purpose of this study was to explore the effects of cumulus cells on vitreous cryopreservation of human mature oocytes and clinical pregnancy outcomes. The study was divided into group A (cumulus cells were removed from the oocytes before freezing) containing 24 participants and 193 oocytes and group B (cumulus cells were retained with the oocytes before freezing) containing 26 participants and 240 oocytes. Based on no significant differences in age, duration of infertility, infertile causes, and number of retrieved oocytes between both groups when oocytes were retrieved from infertile women, we found that the survival rate of post thaw oocytes (88% vs 58%), cleavage rate (80% vs 56%), and high-quality embryo rate (75% vs 59%) were significantly higher in group B than in group A. Under the conditions that there were no significant differences between the 2 groups in the general status of the participants undergoing embryo transfer, the embryo implantation rate (37% vs 15%) and the clinical pregnancy rate (50% vs 17%) were significantly higher in group B than in group A, all with Ps < .05. We conclude that the retention of cumulus cells can improve the developmental competence of vitrified-thawed human mature oocytes and clinical pregnancy outcomes.     

The effect of long zona dissection using ICSI pipettes for mechanical assisted hatching in vitrified-thawed blastocyst transfers

Objective

To investigate the effect of long zona dissection (LZD) compared with partial zona dissection (PZD) using ICSI pipettes for mechanical assisted hatching (AH) in vitrified-thawed blastocyst transfers.

Design

Prospective study.

Setting

University IVF clinic.

Patient(s)

A total of 120 women ≦ 38 years old undergone vitrified-thawed blastocyst transfers with LZD or PZD.

Intervention(s)

The culture of all pronucleate embryos to the blastocyst stage and the selection of blastocysts ≧ grade 3BB (Gardner and Schoolcraft score), followed by vitrified-thawed blastocyst transfers with LZD (n = 60) or with PZD (n = 60)

Main outcome measure(s)

Complete hatching rates, implantation rates, pregnancy rates.

Result(s)

At 5 h after thawing, complete hatching rates of blastocysts were significantly higher in LZD group compared with PZD group, 52.4 % vs. 31.8 % (P = 0.001). Implantation and clinical pregnancy rates were significantly higher in LZD group compared with PZD group, 40.9 % vs. 25.7 % and 63.0 % vs. 40.0 %, respectively (P = 0.010, P = 0.011).

Conclusion(s)

LZD using ICSI pipettes for mechanical AH improves significantly complete hatching, implantation and pregnancy rates in vitrified-thawed blastocyst transfers.     

The Neuroprotective Effect of Platelet‐rich Plasma on Erectile Function in Bilateral Cavernous Nerve Injury Rat Model

IntroductionNeurogenic erectile dysfunction resulting from cavernous nerve (CN) injury is a major complication caused by radical prostatectomy. The use of platelet‐rich plasma (PRP) on the nerve‐injured site has shown promising results for the nerve regeneration. However, the effects of PRP injection in corpus cavernosum after bilateral CN injury have never been investigated.AimTo assess the neuroprotective effect of PRP injection in corpus cavernosum after bilateral CN injury.MethodsMale Sprague‐Dawley rats were randomly divided into three groups: Group I underwent sham operation, while the remaining two groups underwent bilateral CN crush. Crush injury groups were treated at the time of injury with an application of PRP or normal saline only injection in the corpus cavernosum, respectively. Four weeks later, erectile function (EF) was assessed by CN electrosimulation, and CNs as well as penile tissue were collected for histology.Main Outcome MeasuresIntracavernous pressure (ICP) monitored during electrical stimulation of CNs; myelinated axons number of CNs and dorsal penile nerve; collagen type change, number of apoptotic cells, and mRNA expression of caspase‐3 and transforming growth factor‐β1 (TGF‐β1) in the corpus cavernosum.ResultsFour weeks after surgery, in the vehicle‐only group, the functional evaluation showed a lower mean maximal ICP than that in the sham group (P < 0.05). PRP treatments resulted in significant recovery of EF, as compared with the vehicle‐only group (P < 0.05). Histologically, the PRP‐treated group had a significant preservation of myelinated axons of CNs compared with the vehicle‐only group (P < 0.05) and reduced the apoptotic index. The mRNA expression of TGF‐β1 in the corpus cavernosum tissue was significantly decreased in the PRP group compared with the vehicle‐only group (P < 0.05).ConclusionsPRP injection in the corpus cavernosum increased the number of myelinated axons and facilitated recovery of EF in the bilateral CN injury rat model. Wu C‐C, Wu Y‐N, Ho H‐O, Chen K‐C, Sheu M‐T, and Chiang H‐S. The neuroprotective effect of platelet‐rich plasma on erectile function in bilateral cavernous nerve injury rat model. J Sex Med 2012;9:2838–2848.     

成年人鼻声反射与鼻阻力测量的正常参数

目的:研究正常成人鼻声反射(AR)及鼻阻力(RM)测量的正常值,以及它们之间的关系.方法:健康成人82例,采用AR检查,获得单侧鼻腔第一狭窄面积(UA1),第二狭窄面积(UA2),最小截面积(UMCA),0～5 cm、2～5 cm鼻腔容积(UV5、UV2～5).RM为通过前鼻主动测压法测量鼻压差为150 Pa 时的RM值,如鼻压差达不到150 Pa,则采用Broms(半径为200 Pa)的RM值表示,分别测量单侧吸气阻力(URins150、URins200)、单侧呼气阻力(URexp150、URexp200)及鼻气道总阻力(TRins150、TRins200、TRexp150、TRexp200),并对RM和AR测量结果进行相关性分析.结果:健康成年男女UA1分别为(0.63±0.14)、(0.60±0.14)cm2;UA2分别为(0.72±0.48)、(0.6±0.4)cm2;UMCA分别为(0.50±0.16)、(0.47±0.18)cm2;UV5分别为(5.68±1.73)、(5.16±1.85)cm3 ;UV2～5分别为(4.13±1.56)、(3.83±1.66)cm3.男女各参数值比较均差异无统计学意义(T值分别为0.093、0.134、0.392、0.408,均P>0.05).有25例鼻压差未达到150 Pa,采用Broms测量,URins150、URins200、URexp150、URexp200、TRins150、TRinst200、TRexp150、TRexp200结果分别为(0.86±0.96)、(0.45±0.61)、(0.83±0.71)、(0.52±0.88)、(0.38±0.34)、(0.18±0.24)、(0.38±0.27)、(0.19±0.24)Pa/(cm3·s).URins150、URexp150、TRins150、TRexp150与UMCA、UV5、UV2～5有显著相关性(均P<0.05).结论:RM与AR测量结果有一定相关性,可为临床提供鼻腔状态的客观参数.     

影像导航下经鼻内镜视神经减压治疗伴脑脊液鼻漏的创伤性视神经病

目的:探讨影像导航系统在伴有脑脊液鼻漏的创伤性视神经病患者手术治疗中的应用。方法:回顾性分析2006-06-2010-01期间收治的12例伴脑脊液鼻漏的创伤性视神经病患者,均在影像导航下经鼻内镜行视神经减压术,并同时行脑脊液鼻漏修补术。结果:随访3个月～1年,脑脊液鼻漏全部修补成功,患者视力恢复到0.3～0.6者1例,0.1～0.3者2例,0.1以下者1例,手动1例,恢复光感2例,总有效率为58.33%。结论:鼻内镜和影像导航系统的结合应用使手术视野开阔、定位精确并增加了安全性,尤其在局部解剖结构因外伤而导致毗邻关系改变的情况下,可有效减小创伤,提高安全性,是一种安全有效的治疗方法。     

学龄前听障儿童五项认知能力的研究

目的了解学龄前听障儿童五项认知能力的发展规律。方法选取3～6岁学龄前听障儿童267人为研究对象,其中男童150人,女童117人;3岁组62人,4岁组74人,5岁组68人,6岁组63人,采用华东师范大学言语听觉康复科学研究院编制的五项认知能力测验系统(多媒体软件版),对各年龄组儿童进行目标辨认、空间次序、逻辑类比、图形推理、动作系列的发展情况测试,所获得的有效数据采用SPSS 16.0软件进行统计分析。结果从各年龄组听障儿童五项认知能力评估得分看,年龄的主效应显著,随着年龄的增长,目标辨认、空间次序、逻辑类比、图形推理、动作系列等各项能力有不同程度的提高,但各年龄组听障儿童得分均低于文献报道的健听儿童;性别的主效应不显著;性别与年龄的交互作用不显著。结论学龄前听障儿童各年龄段五项认知能力总体发展趋势向上,但发展较健听儿童缓慢。     

Gender-specific prevalence and associated risk factors of prehypertension among rural children and adolescents in Northeast China: a cross-sectional study

Little is known about the prevalence and risk profile of prehypertension among Chinese children and adolescents. The aim of the present study was to investigate the prehypertensive status and its associated risk factors among rural Chinese children and adolescents. We conducted a cross-sectional study including 5,245 children and adolescents (2,732 boys and 2,513 girls) aged 5–18 years in Northeast China. Main anthropometric data and related information were collected. The overall prevalence of prehypertension and hypertension was 15 % and 20.2 %, respectively. The prevalence of prehypertension among boys was 15.7 %, compared to that of 14.2 % among girls (P?=?0.256). After adjusting for age, race, weight status, waist circumference, triceps skinfold, family income, smoking and drinking status, boys aged 12–14 and 15–18 years had a 2.86- and 5.97-fold risk of prehypertension, respectively, compared to those aged 5–8 years. Overweight and obese boys had an increased risk of prehypertension in comparison to those with normal weight (overweight: odds ratio [OR]?=?1.837, 95 % confidence interval [CI] 1.321–2.556; obese: OR?=?2.941, 95 % CI 1.783–4.851). A larger triceps skinfold (≥90th percentile) was significantly related to increased odds of prehypertension (OR?=?2.32; 95 % CI, 1.516–3.55) among boys. For girls, only older age was found to be a risk factor for prehypertension. Conclusion: Pediatric prehypertension is highly prevalent in rural Northeast China. The risk factors for prehypertension differed among boys and girls. A more comprehensive risk profile of prehypertension among children and adolescents needs to be established for early prevention.     

儿童移位性肱骨髁上骨折240例4种治疗方法比较

目的 比较4种治疗方法 治疗儿童肱骨髁上移位性骨折的效果.方法 2000年1月-2006年6月收治的肱骨髁上骨折患儿240例应用手法复位、骨牵引、经皮交叉克氏针内固定、切开复位治疗,并进行随访,随访时间0.5-6.0 a.将240例患儿分为4组:手法复位组、骨牵引组、经皮交叉克氏针内固定组、切开复位组.以肘关节运动丧失的度数和携物角的度数为Flynn标准评定.并对结果 采用K×2列表的X2检验.结果 240例患儿平均随访2.43 a.手法复位组88例,优59例,良13例,优良率81.8%;骨牵引组92例,优83例,良2例,优良率92.3%;经皮穿针组12例,优10例,良1例,优良率91.3%;切开复位组48例,优37例,良4例,优良率83.3%.4种治疗方法 比较无显著性差异(X2=5.120 5 P>0.05).结论 手法整复操作简易、关节功能恢复较快,但对骨折端旋转纠正不太理想,稳定性差,易出现再移位;尺骨鹰嘴骨牵引简单易行,安全性较高,肘部功能恢复快,住院时间相对较长,护理麻烦;闭式复位经皮交叉克氏针内固定治疗肱骨髁上骨折固定效果可靠,创伤小,恢复效果好,内侧进针时有尺神经损伤的可能,操作中受x线辐射时间较长;切开复位对位理想,但切开复位加重了肘部肌肉及周围软组织的损伤,术后肘部功能恢复所需时间较长.4种方法 各有优劣,可根据患儿和医院的具体情况加以选择.