激光辅助孵化对冻融胚胎种植潜力的影响

目的分析不同年龄段患者的胚胎冻融后进行激光辅助孵化对临床妊娠率的影响。方法对713例患者,根据年龄、是否辅助孵化、培养不同时间后行辅助孵化进行分组,比较各组间临床妊娠率。结果 〈35岁的患者,2组临床妊娠率无差异;而〉34岁的患者,临床妊娠率AH组高于非AH组,但无显著差异。复苏后立即对胚胎行辅助孵化再培养,相对于复苏后培养16～18h于移植前行辅助孵化对提高临床妊娠率更有帮助,尤其对高龄患者,作用更明显（P〈0.05）。结论辅助孵化技术的应用对冻融胚胎移植妊娠率的提升有一定帮助,尤其是胚胎复苏后立即行辅助孵化能显著提高高龄患者的临床妊娠率。     

全国血吸虫病监测点现场病原学检测效果及质控评估

目的 了解全国血吸虫病监测点血吸虫病病原学检测能力,评价尼龙绢集卵孵化法现场检测效果,为建立血吸虫病监测点病原学诊断质控体系提供参考依据。方法 收集2011年全国12个省（市、自治区）81个血吸虫病监测点血检阳性居民病原学检查资料,分析Kato?Katz法和尼龙绢集卵孵化法的检测效果;由各监测点采用单盲法检测国家血吸虫病诊断参比实验室统一提供的血吸虫虫卵孵化质控样本,比较两种病原学诊断方法检测的符合率、误检率和漏检率。结果2011年全国81个血吸虫病监测点共采用Kato?Katz法和尼龙绢集卵孵化法检测3 780例血检阳性居民,查出双阳性127例,双阴性3 513例,总符合率为96.30%;其中Kato?Katz法检出阳性173例,阳性率为4.58%;尼龙绢集卵孵化法检出阳性221例,阳性率为5.85%。两法共检出阳性267例,总阳性检出率为7.06%,较单纯Kato?Katz法阳性检出率提高54.15%（ χ2 = 21.32,P < 0.01）。2012年全国12个省（市、自治区）80个血吸虫病监测点共检测病原学孵化质控样240份（阳性160份,阴性80份）,检出阳性样本105份,阴性样本67份,总符合率为71.67%（172/240）,总漏检率为34.38%（55/160）,其中强阳性样本漏检率为32.50%（26/80）,弱阳性样本漏检率为36.25%（29/80）,阴性误检率为16.25%（13/80）。安徽、湖北、湖南、江苏、江西和四川6省血吸虫病监测点对病原学孵化质控样本检出率分别为61.11%、80.00%、77.08%、90.48%、58.33%和59.26%,差异有统计学意义（χ2 = 14.27,P < 0.05）。结论 尼龙绢集卵孵化法现场检测血吸虫病效果显著优于Kato?Katz法,但大多数血吸虫病监测点对尼龙绢孵化法的掌握程度较低,需进一步加强血吸虫病诊断技术培训。     

Mechanical zona pellucida removal of vitrified-warmed human blastocysts does not affect the clinical outcome

Research QuestionDoes complete mechanical removal of the zona pellucida modify the outcome of transfer of vitrified–warmed human blastocysts?DesignIn a prospective randomized controlled study, 419 couples were allocated to either zona pellucida-free (n = 209) or zona intact (n = 210) vitrified–warmed embryo transfer. Main outcome measures included clinical pregnancy, implantation and ongoing pregnancy rates.ResultsTransfer of zona pellucida-free blastocysts resulted in clinical pregnancy, implantation and ongoing pregnancy rates (35,9%, 33,9% and 32,1%, respectively), similar to those achieved with zona intact control embryos (39%, 36,4% and 33,1%, respectively).ConclusionTotal mechanical removal of the zona pellucida did not affect the tested parameters of clinical outcomes.     

Development of EKC after eximer laser photorefractive surgery and subsequent recurrence of EKC-like keratitis

This research focuses on four cases of patients having undergone eximer laser photorefractive surgery who were diagnosed with adenoviral keratoconjunctivitis during the postoperative period and who later developed epidemic keratoconjunctivitis (EKC)-like keratitis. Two of the patients had undergone laser-assisted subepithelial keratectomy (LASEK), one had undergone laser in situ keratomileusis and one had photorefractive keratectomy. After the surgery adenoviral keratoconjunctivitis and recurrent late-developing EKC-like keratitis were observed in the patients. Recurrent late-developing EKC-like keratitis occurred in one of the patients, who had received LASEK as many as three times. The others had only one or two episodes.The corneal infiltrates of keratitis mainly occurred in the central cornea. Successful resolution of recurrent late-developing EKC-like keratitis was achieved through the use of topical steroids without sequelae and the final best-corrected visual acuity was as good as the base line. These keratitis infiltrates have been presumed to represent an immune response to the suspected adenoviral antigens deposited in corneal stroma during the primary adenoviral infection. Previous reports argued that patients with a history of adenoviral ketatoconjunctivitis were succeptible to adenoviral keratoconjunctivitis becoming reactivated; however, in our research, our patients had their first adenoviral infections after the eximer laser photorefractive surgery and reactivation was confirmed. We recommend that attention be paid to adenoviral infection after laser refractive operations, because these patients seem to have more frequent recurrences.     

激光辅助孵化对冻融双胚胎移植后胚胎存活及双胎子代发育的影响

目的 通过分析来自激光辅助孵化(LAH)的冻融D3卵裂期双胚胎移植后胚胎存活情况、双胎新生儿发育及周岁婴幼儿发育情况,评估LAH技术对胚胎存活及新生儿与婴幼儿发育的影响。方法 选取2017年1月至2019年12月浙江省人民医院收治的843例双胚胎移植不孕症患者,根据移植前是否需激光辅助孵化(LAH)分为LAH组381例和非LAH组462例。LAH组移植前采用LAH处理,非LAH组移植前无LAH处理步骤。比较两组妊娠结局,并选择双胚胎存活的156例患者(其中LAH组65例,非LAH组91例)双胎出生后代的生长发育指标,包括出生孕龄、体重、畸形情况及周岁时身高、体重等,分析LAH对胚胎及婴幼儿发育的长期影响。结果LAH组与非LAH组胚胎存活率比较,差异无统计学意义(P0.05);LAH组与非LAH组A胎出生体重、B胎出生体重、先天性畸形的比例比较,差异均无统计学意义(P0.05);两组双胎婴幼儿1周岁时均无身高、体重、认知、出牙、运动能力的异常,差异无统计学意义(P0.05)。结论 LAH的应用对冻融双胚胎移植后的胚胎存活率、双胎子代新生儿发育及1周岁婴幼儿发育影响均无明显影响,对于双胎新生儿畸形率的影响尚需更多病例的研究。     

Laser-assisted vessel repair in the rat abdominal aorta

The use of laser energy to thermally denature proteins and produce tissue bonding has potential applications in both the repair and anastomosis of small arteries. The repair of longitudinal arteriotomies in the rat abdominal aorta using the argon laser has been studied in 42 animals with survival times of up to ten weeks. This was compared to vessel repair by conventional suture techniques in 15 animals.Vessels subjected to laser repair showed a high incidence of failure (40%) within the first eight days post operatively compared to no failures in the sutured group. There were no failures of the repaired vessels in the animals surviving longer than eight days. Mechanical bursting pressures of greater than 500 mm Hg were found in both groups of animals at 3 and 10 weeks. Angiography prior to sacrifice showed satisfactory patency of vessels subjected to both types of repair with negligible constriction. Histological examination of the repaired aorta revealed pseudo-aneurysm formation in (29%) of the vessels subjected to laser repair, while the sutured vessels showed greater foreign body tissue reaction.     

激光辅助孵化对冻融胚胎移植临床结局的影响

目的 探讨激光削薄法辅助孵化(AH)对冷冻第3天胚胎移植结局的影响.方法 选取行第3天冷冻胚胎移植患者的1 024周期,其中964个周期行常规的第3天冻存胚胎移植(非AH组),60个周期于第3天冻存胚胎复苏后,用激光将1/4透明带削薄2/3后移植(AH组);分析两组的种植率、临床妊娠率、多胎率、活产率、流产率及生化妊娠率.结果 两组的种植率、临床妊娠率、多胎率、活产率、流产率及生化妊娠率分别为43.2％和24.2％、58.3％和43.2％、45.7％和26.9％、78.4％和77.7％、21.6％和22.3％、6.7％和4.4％;其中AH组的种植率、临床妊娠率及多胎率与非AH组比较,差异有统计学意义(P＜0.05);而活产率、流产率及生化妊娠率高于非AH组,但差异无统计学意义(P＞0.05).结论 采用激光削薄方法进行AH可以提高冷冻复苏第3天胚胎移植后的种植率及临床妊娠率,而对活产率无明显影响.     

Unraveling the drug distribution in brain enabled by MALDI MS imaging with laser-assisted chemical transfer

Accurate localization of central nervous system (CNS) drug distribution in the brain is quite challenging to matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI), owing to the ionization competition/suppression of highly abundant endogenous biomolecules and MALDI matrix. Herein, we developed a highly efficient sample preparation technique, laser-assisted chemical transfer (LACT), to enhance the detection sensitivity of CNS drugs in brain tissues. A focused diode laser source transilluminated the tissue slide coated with α-cyano-4-hydroxycinnamic acid, an optimal matrix to highly absorb the laser radiation at 405 nm, and a very thin-layer chemical film mainly containing drug molecule was transferred to the acceptor glass slide. Subsequently, MALDI MSI was performed on the chemical film without additional sample treatment. One major advantage of LACT is to minimize ionization competition/suppression from the tissue itself by removing abundant endogenous lipid and protein components. The superior performance of LACT led to the successful visualization of regional distribution patterns of 16 CNS drugs in the mouse brain. Furthermore, the dynamic spatial changes of risperidone and its metabolite were visualized over a 24-h period. Also, the brain-to-plasma (B/P) ratio could be obtained according to MALDI MSI results, providing an alternative means to assess brain penetration in drug discovery.     

透明带辅助孵化获68例临床妊娠

目的采用蛋白酶消化透明带和激光打孔的方法增加胚胎着床的机会,获得临床妊娠。方法对具有透明带增厚(≥15μm);年龄≥35岁;前次胚胎种植失败;胚胎发育延迟及基础FSH≥12mIU/ml共141周期及105个冻融移植(FET)周期的胚胎,予10IU/mlPronase溶液消化或透明带激光打孔后移植。结果68例获临床妊娠,其中22例妊娠来自FET后。2例3胎妊娠,16例双胎妊娠,50例单胎妊娠。结论两种透明带辅助孵化的方法均获得临床妊娠,是方便且实用的辅助生殖技术。