Ultrasound-guided embryo transfer improves pregnancy rates and increases the frequency of easy transfers

BACKGROUND: Recent reports have suggested that ultrasound (US) guidance during embryo transfer might improve pregnancy rates. METHODS: A prospective randomized (computer-generated random table) trial was performed to compare embryo transfer under abdominal US guidance (n = 255 women) with clinical touch embryo transfer (n = 260). RESULTS: The clinical pregnancy rate was 26.3% (67/255) in the US-guided transfer group compared with 18.1% (47/260) in the clinical touch transfer group (P < 0.05). The implantation rate was 11.1% (100/903) in the US group compared with 7.5% (66/884) in the clinical touch group (P < 0.05). US-guided transfer was associated with a decrease in the difficulty of the transfers: 97% of transfers were easy in the US-guided group compared with 81% in the clinical touch group (P < 0.05). CONCLUSIONS: US-guided embryo transfer increased pregnancy and implantation rates in IVF cycles, as well as the frequency of easy transfers. It is suggested that the decrease in cervical and uterine trauma can play a role in the increase in pregnancy rates associated with US-guided transfer. It is recommended that embryo transfer should be performed under US guidance.     

Kinetics of viremia and acute liver injury in relation to outcome of neonatal woodchuck hepatitis virus infection

The kinetics of serum viral responses and acute liver injury were studied during neonatal woodchuck hepatitis virus (WHV) infection in relation to the chronic or resolved outcome. The mean concentrations of serum WHV DNA and surface antigen were significantly higher by week 10 post infection in chronic infections compared to resolving infections, and diverged even further by the time of peak viral load development in serum (week 12). After week 12, these viral markers were detected less frequently with time and at lower concentrations in the resolved outcome. In both outcomes, mean serum activities of hepatic enzymes became increased significantly above baseline by weeks 10-12, peaked at week 14, and normalized by weeks 20-22, thus indicating transient acute liver injury. The increasing liver injury responses were comparable between outcomes at week 12, when serum viral load was markedly higher in the developing chronic infections. This suggested a deficiency in early non-cytolytic control of infection in the chronic outcome. At week 14, liver injury was significantly greater in the resolved outcome and associated with higher mean Fas ligand (FasL) and perforin messenger RNAs (mRNAs) in liver compared to the chronic outcome. This indicated greater immune-mediated killing of infected hepatocytes during resolution. Thus, chronicity as an outcome of neonatal WHV infection develops relatively early during the acute phase of infection due to reduced immune-mediated clearance of infected hepatocytes by both cytolytic and non-cytolytic processes.     

Specific cellular immune responses to pancreatic antigen in chronic pancreatitis and Sjögren's syndrome

The specific cellular immune response to the partially purified pancreatic antigen was studied by the peripheral blood lymphocyte proliferation assay in patients with chronic pancreatitis, Sjögren's syndrome, and primary biliary cirrhosis. A significant positive result (stimulation index >2.0) was observed in 7 of 21 patients with idiopathic chronic pancreatitis (33%;P<0.05), 6 of 7 patients with Sjögren's syndrome-associated chronic pancreatitis (86%;P<0.0005), and 6 of 11 patients with Sjögren's syndrome (55%;P<0.01), compared to normal controls whose stimulation index was 0.94±0.28 (mean ± SD;n=14; range, 0.56–1.60). On the other hand, patients with alcoholic chronic pancreatitis (17%;n=12), stone-related chronic pancreatitis (0%;n=7), primary biliary cirrhosis-associated chronic pancreatitis (33%;n=3), primary biliary cirrhosis (0%;n=4), systemic lupus erythematosus (17%;n=6), and autoimmune thyroiditis (0%;n=6) showed no significant difference from normal controls. Furthermore, in patients with idiopathic chronic pancreatitis who had positive results, a lymphocyte proliferative response to the pancreatic antigen was observed in T cells, especially in the CD4⁺ T cell subpopulation. These results suggest that the pancreatic antigen plays a role in the pathogenesis of a part of idiopathic chronic pancreatitis and Sjögren's syndrome in association with T cell responses and, also, suggest that autoimmunity may be a possible etiological factor in chronic pancreatitis.     

The effects of inflammatory cytokines on steroidogenic acute regulatory protein expression in macrophages

Objective: To investigate the expression of steroidogenic acute regulatory protein (StAR) in macrophages and the effects of inflammatory cytokines on StAR expression. Methods: The macrophages isolated from ApoE knockout mice and C57BL/6J mice and RAW264.7 cells (a cell line from mouse macrophage. ATCC Number: TIB-71^TM) were cultured in DMEM containing 10% fetal bovine serum. RAW264.7 cells were treated with different inflammatory cytokines (TNF-α, IFN-γ and TGF-β1) and 8-Br-cAMP, a cAMP analog. RT-PCR and Western blot analysis were applied to evaluate the effects of inflammatory cytokines on StAR expression. Results: RT-PCR and Western blot analysis demonstrated the expression of StAR in the macrophages isolated from ApoE knockout mice, C57BL/6J mice and RAW264.7 cells. Proinflammatory cytokines TNF-α and IFN-γ significantly decreased StAR mRNA and protein levels in RAW264.7 cells. The inhibition was dose- and time-dependent. In contrast, anti-inflammatory cytokine TGF-β1 increased StAR mRNA and protein levels. At 1:15 molecular ratio, TGF-β1 blocked the down-regulation of StAR expression mediated by TNF-α. cAMP also induced StAR expression in RAW264.7 cells. When the cells were co-treated with 8-Br-cAMP and TNF-α, 8-Br-cAMP failed to induce StAR expression. Conclusion: Our results provide interesting evidence that inflammatory cytokines regulate StAR expression in macrophages. Received 12 August 2006; returned for revision 28 September 2006; returned for final revision 28 May 2007; accepted by M. Katori 22 June 2007     

肾综合征出血热病毒特异性双价纯化免疫血清F（ab）2的制备和临床治疗应用

１９８８年至１９９１年对收治的发病５日以内的肾综合征出血热（ＨＦＲＳ）病人应用姬鼠型ＨＦＲＳＶ陈株及家鼠型ＨＦＲＳＶＲ２２株，免疫猪所制备的特异性双价纯化免疫血清Ｆ（ａｂ）２（称Ｆ（ａｂ）２血清），治疗ＨＦＲＳ病人６５例作为研究组，以４４例作为对照组。治疗结果表明：①球结膜水肿渗出减轻，２４小时出血减轻；②白细胞病毒抗原消失迅速；③研究组出院平均早９．１天；④在洽疗后２、４日，对照组的特异性免疫荧光ＩｇＭ抗体明显高于研究组的。⑤其他实验室检测指标都以研究组为优。提纯后的免疫血清Ｆ（ａｂ）２无抗体－介导反应，无副作用及过敏反应。它含有特异性中和抗体及其他免疫因子，可中和清除体内的病毒抗原，减轻病毒血症及毛细血管壁的损伤，阻断病情发展，促进病情恢复。     

伴有22三体的t(5;17)变异易位急性早幼粒细胞白血病

目的 探讨一例核型为47,XY,t(5;17),+22的少见急性早幼粒细胞白血病(acute promyelo-cytic leukemia,APL)的临床和实验特征.方法 在常规核型分析的基础上,应用荧光原位杂交(fluorescencein situ hybridization,FISH)和多重荧光原位杂交(multiplex fluorescence in situ hybridization,M-FISH)技术进一步检测该病例的细胞遗传学异常,并结合文献分析此类少见变异易位的临床特点.结果 FISH检测PML-RARa阴性,但77%的细胞显示存在17号RARa基因的重排或复制;BCR-ABL阴性,但74%的细胞显示有22号染色体的复制或重排.M-FISH明确RARa基因重排系5号与17号染色体易位所致,并证实了22号三体的存在.结论 变异型t(5;17)易位,形成NPM-RARa融合基因的急性早幼粒细胞白血病是APL中少见的类型.骨髓形态表现为奥氏小体缺如,核型中常伴有其它附加染色体异常,全反式维甲酸(all-trans retinoicacid,ATRA)联合化疗有效,但易复发,合并弥漫性血管内凝血及高白细胞者预后凶险.     

Ultrasound-guided in utero injections allow studies of the development and function of the eye

Ultrasound-guided in utero injections into the brain of murine embryos has been shown to facilitate gene delivery. We investigated whether these methods would allow gene transfer into ocular structures. Gene transfer using retroviral vectors or electroporation was found to be quite effective. We determined the window of time, as well as compared several strains of mice, that yield a high degree of survival and successful gene transfer. Several retroviral constructs were tested for expression and coexpresssion of two genes in retinal cell types. In addition, a retroviral vector was engineered to give cone photoreceptor-enriched expression, and a retroviral vector was demonstrated to provide RNAi-mediated loss-of-function. These methods enable access to early ocular structures and provide a more rapid method of assessment of gene and promoter function than possible using genetically engineered mice.     

Asymmetry of Doppler spectrum in stenosis differentiation

The asymmetry of the spectral distribution of ultrasonic Doppler flow velocity signals, assessed using the coefficient of skewness, is discussed as a criterion of stenosis differentiation. Its performance is compared with that of the index of turbulence intensity for both in vitro and in vivo flow Doppler signals, recorded distal to a stenosis. The power spectral distributions are computed using the direct Fourier transform and maximum likelihood method. The asymmetry of spectral distribution has proved to be a more efficient criterion than the turbulence intensity. The maximum likelihood method ensures better stenosis differentiation than the direct FFT method.     

重组人干扰素α-2b鼻腔喷雾剂预防治疗恒河猴感染SARS-CoV的试验研究

目的评价重组人干扰素α-2b鼻腔喷雾剂对恒河猴感染SARS-CoV的预防治疗作用。方法采用鼻腔喷雾法(剂量为60万单位/鼻孔)研究了重组人干扰素α-2b鼻腔喷雾剂对感染SARS-CoV的恒河猴预防治疗效果。结果试验组(5只)和对照组(5只)相同时间检测的咽拭子等标本中,Real-time PCR检测和病毒分离均未检出病毒。攻毒后病毒导致机体产生的中和抗体和IgG抗体的反应也较对照组弱。血液学指标检测结果表明试验组动物攻毒后各项指标较试验前比较没有显著性改变;病理结果显示试验组2只恒河猴肺组织形态基本正常,其余3只猴有肺间质性炎,表现肺间隔增厚、单核样细胞为主的炎细胞浸润,其中1只增厚的肺间隔有局灶相互融合,这3只猴肺部病变与对照组的病变表现相似,且病变累及范围较对照组小;其他各受检脏器均未见明显异常。结论重组人干扰素α-2b鼻腔喷雾剂可以有效阻断或减弱SARS-CoV对恒河猴的感染。     

保留瓣下结构的几种机械瓣下游血流动力学多普勒超声研究

了解二尖瓣置换术mitralvalvereplacement,MVR保留瓣下结构对不同类型机械瓣下游血流动力学的影响,为合理选择术式以最大限度减少手术并发症提供科学依据。方法采用彩色多普勒超声结合计算机图像分析技术,对保留瓣下结构的不同类型机械瓣置换术后患者机械瓣下游湍流剪应力turbulentshearstress,TSS等指标进行体内定量研究。结果无论保留全瓣或后瓣,跨瓣血流边界位点TSS在两种不同构型机械瓣组间均存在显著性差异(P<0.05),单叶机械瓣(单叶瓣)TSS较双叶机械瓣(双叶瓣)高。对于单叶瓣,TSS在保留全瓣瓣下结构组(保留全瓣组)、保留后瓣瓣下结构组(保留后瓣组)与未保留瓣下结构组(未保留组)间均存在显著差异(P<0.05)。而对于双叶瓣,保留全瓣组TSS均高于其它2组(P<0.05)。结论保留瓣下结构可改善术后患者心功能,但却在一定程度上增加跨瓣血流扰动性,使下游TSS增大。这种影响以全瓣保留者为著,单叶瓣甚于双叶瓣。对于心功能较差,有必要保留全瓣瓣下结构者,可尽量使用双叶瓣,以减轻对人工心瓣下游血流动力学可能产生的不良影响。