Abstract:Severe acute pancreatitis is a common critical emergency in the digestive system. It is difficult to treat in clinic and has high mortality. According to the new Atlanta classification standard proposed in 2012, the treatment of acute pancreatitis mainly focused on early indentification, maintenance of organ function, anti-inflammatory response, intestinal function maintenance and other measures, so as to improve the success rate of the treatment. As more patients with severe acute pancreatitis have successfully crossed the acute phase, the prevention and treatment of subsequent complications of acute pancreatitis have been increasingly valued. To focus on the "secondary attack" of acute pancreatitis, it is necessary to carry out clinical research on the subsequent complications such as the accumulation of peripancreatic fluid, infectious necrosis, and vascular complications, and to reduce the mortality. This is a change in the focus of acute pancreatitis treatment and a further extension of the concept of multidisciplinary collaboration in acute pancreatitis.

Abstract:Objective To explore the risk factors of neurological complication (NC) after the endovascular treatment of unruptured intracranial aneurysm (UIA), so as to provide strategies for reducing the incidence of NC. Methods We retrospectively analyzed the clinical and imaging features of patients with UIA, who underwent endovascular treatment in Changhai Hospital, Navy Medical University (Second Military Medical University) from Jan. 2010 to Jan. 2017. Univariate analysis and multivariate logistic analysis were performed to analyze the risk factors of NC. Results NC occurred in 60 (5.02%) of 1 196 patients with UIA in this study. Univariate analysis showed that hypertension (P=0.026), smoking (P=0.038), previous transient ischemic attack or cerebral infarction (P<0.001), cardiovascular comorbidities (P=0.002), aneurysm maximum diameter (P<0.001), irregular shape or having a daughter sac (P=0.008) and stent types (P=0.001)were associated with NC. Multivariate analysis showed that previous transient ischemic attack or cerebral infarction (OR=3.407, P<0.001), cardiovascular comorbidities (OR=3.175, P=0.003), aneurysm maximum diameter >10 mm (OR=3.139, P<0.001) and irregular shape or having a daughter sac (OR=2.096, P=0.026) were independent risk factors of NC. Conclusion Previous transient ischemic attack or cerebral infarction, cardiovascular comorbidities, aneurysm maximum diameter >10 mm and irregular shape or having a daughter sac are independent risk factors of NC after endovascular treatment of UIA.

Abstract:Objective To investigate the risk factors of restless leg syndrome (RLS) in maintenance hemodialysis patients. Methods The clinical data of 74 maintenance hemodialysis patients in Eastern Hepatobiliary Surgery Hospital of Navy Medical University (Second Military Medical University) from July 2016 to September 2017 were retrospectively analyzed. The gender, age, diabetes mellitus and other biochemical indicators of the patients with or without RLS were compared. The univariate logistic regression analysis was performed with the gender, age, diabetes mellitus and other biochemical indicators as covariates, and the RLS as dependent variable. According to the 2003 International Restless Leg Syndrome Study Group (IRLSSG) criteria, the patients with RLS were divided into mild, moderate, severe and very severe groups, with the patients without RLS as controls; the variables that were significantly different between the groups as analyzed by univariate logistic regression analysis were compared by t-test and multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve for the main relevant factors was plotted, and the area under the curve was calculated to determine the best critical value and the corresponding sensitivity and specificity. Results A total of 74 maintenance hemodialysis patients were enrolled in this study, including 46 males and 28 females; the patients aged from 21 to 87 years, with an average age of (56.70±14.52) years; 55 patients without RLS, and 19 with RLS. The serum calcium in patients with RLS was significantly higher than that without RLS ([2.56±0.38] mmol/L vs[2.26±0.29] mmol/L, t=2.61, P=0.02). Multivariate logistic regression analysis showed that serum parathyroid hormone (PTH)>515.39 pg/mL was an independent risk factor for RLS in maintenance hemodialysis patients (OR=1.00, 95% CI 1.00-1.01, P=0.03). With the cut-off value being 515.39 pg/mL, area under ROC curve performed by PTH for RLS was 0.759, with the 95% CI being 0.610-0.907, and the sensitivity and specificity being 0.47 and 0.98, respectively. Conclusion RLS is a common complication in maintenance hemodialysis patients. Chronic kidney disease-mineral and bone metabolism disorder may be related to the occurrence of RLS in maintenance hemodialysis patients.

Abstract:Objective To investigate the relationship between M2 macrophages and prognosis of patients with human colorectal cancer by using CD163 protein as a marker. Methods The clinical data and paraffin samples of 648 patients with newly diagnosed colorectal cancer and the paraffin specimens of the tumor tissues after operation were collected from Jan. 2010 to Dec. 2011 in the Department of Colorectal Surgery, Changhai Hospital, Navy Medical University (Second Military Medical University). All patients were diagnosed by postoperative pathology. Paracancerous tissues of the above 38 patients, normal colorectal mucosal tissues of 37 patients undergoing hemorrhoidectomy (PPH), and colorectal adenoma tissues of 33 patients receiving endoscopic treatment served as controls. All specimens were made into tissue microarrays, and the expression of CD163 protein was detected by immunohistochemistry. The relationships between the expression of CD163 protein and clinicopathological parameters and prognosis of patients with colorectal cancer were analyzed. Results The expression level of CD163 was related to the degree of tumor differentiation, serum carbohydrate antigen 19-9 (CA19-9) and tumor recurrence and metastasis (all P<0.05). Survival analysis showed that the high CD163 expression group had lower disease-free survival and overall survival rates and poor prognosis compared with the low CD163 expression group (P<0.001). Cox multivariate analysis showed that serum expression levels of carcinoembryonic antigen (CEA) and CD163 were independent prognosis factors of patients with colorectal cancer (P<0.05). Conclusion M2 macrophage marker CD163 has a good reference value for the prognosis of patients with colorectal cancer.

Abstract:Objective To analyze the health-related quality of life of elderly people living alone in Shanghai according to the survey data. Methods The data were extracted from the fifth national health services survey of Shanghai, and the data of 11 103 elderly people from 17 districts were analyzed. The elderly people living alone and those not living alone were matched using propensity score matching method, and the health-related quality of life of elderly people was measured by the European quality of life 5-dimensions (EQ-5D). The health-related quality-of-life indicators between the elderly people living alone and not living alone, including selection of EQ-5D dimensions, EQ-5D scores and EQ-VAS scores, were compared by Chi-square test and Mann-Whitney U test. Results The baselines of the elderly people living alone and not living alone matched well by propensity score matching, and there were no significant differences in selection of each dimension of the health-related quality of life, EQ-5D index scores or EQ-VAS scores between the two groups. Conclusion There is no difference in health-related quality of life between elderly people living alone and not living alone in Shanghai.

Abstract:Objective To investigate the effect of syntenin-1 on the assembly of hepatitis C virus (HCV) particles. Methods The content of syntenin-1 in human primary hepatocytes was detected by Western blotting analysis. Human hepatocellular carcinoma cell line Huh7.5.1 was transfected with lentiviral plasmids to construct syntenin-1 overexpressed cell line and green fluorescent protein (GFP) overexpressed cell line. After transferring HCV RNA into Huh7.5.1 cells, syntenin-1 overexpressed cells and GFP overexpressed cells by electroporation, the effects of syntenin-1 overexpression on HCV in the cells were investigated in terms of RNA replication, viral protein contents and secretion of infectious virus particles by luciferase analysis, Western blotting and virus titer, respectively. The density of viral particles was assessed by isopycnic ultracentrifugation to analyze the distributions of HCV RNA and infective titer. Results The contents of syntenin-1 in three human primary hepatocytes were higher than that in the Huh7.5.1 cells (P<0.01). Syntenin-1 overexpression had no effect on HCV RNA replication in host cells; the infectivity of HCV derived from syntenin-1 overexpressed cells was not significantly different compared with the Huh7.5.1 cells or GFP overexpressed cells. In syntenin-1 overexpressed cell culture supernatants, some infectious HCV particles mainly concentrated in the region of concentration of 1.08-1.16 g/mL gradually transferred to the low-density region of 1.01-1.02 g/mL. Conclusion Syntenin-1 overexpression alters the distribution of density components of infectious HCV particles.

Abstract:Objective To analyze the treatment of acute ischemic stroke in the hyperacute stage in Changhai Hospital of Navy Medical University (Second Military Medical University), and to explore the effect of the establishment of Stroke Center on the treatment of in-hospital ischemic stroke (IHIS). Methods A total of 33 IHIS patients were retrospectively enrolled; they received acute treatment in Changhai Hospital of Navy Medical University (Second Military Medical University) from September 2013 to May 2017 (after the establishment of Stroke Center), and 765 patients with acute ischemic stroke attacked in community-based clinics and treated in Changhai Hospital served as controls. All patients received intravenous thrombolysis and arterial thrombectomy within the time window of onset. The onset to call time, the number of patients receiving acute treatment and the ratio of them to hospitalized patients in the same term, and the time from onset to onset (door to needle time, DNT) of IHIS and community ischemic stroke patients were recorded and analyzed. At the same time, the departments and main diseases related to IHIS in our hospital were analyzed. Results After the establishment of the emergency process, the number of thrombolysis and thrombectomy treatment in hyperacute IHIS patients was increased annually, and the onset to call time was shortened annually. The median DNT of patients with IHIS in our hospital from September 2013 to May 2017 was 39.0 (39.0, 45.0) min, and there was no significant difference compared with the control group (38.0[30.0, 45.5] min; Z=1.872, P=0.061). IHIS patients were most common in the Depatment of Cardiology and Department of Thoracic Surgery, with 11 cases (33.3%) and 6 cases (18.2%), respectively. Atrial fibrillation was the main ralated disease of IHIS. Conclusion After the establishment of the treatment process in the hyperacute stage, the number of thrombolysis and thrombectomy treatment in IHIS patients is increased; IHIS most occurrs in the Depatment of Cardiology and Department of Thoracic Surgery.

Abstract:Objective To investigate the effect of interleukin 6 (IL-6) on autophagy and apoptosis of human umbilical vein endothelial cells (HUVECs) and the interaction between autophagy and apoptosis. Methods HUVECs were cultured in vitro and stimulated with 5, 10, 20, 50 ng/L IL-6 for 24 h. The cell proliferation was detected by cell counting Kit-8 (CCK-8) assay, the apoptosis was detected by flow cytometry, the acidic vesicle organelles were observed by monodansyl cadaverine staining, the ultra-microstructural cellular structure was observed by transmission electron microscope, and the expressions of apoptosis-related protein cleaved caspase-3 and autophagy-related proteins, including microtubule-associated protein 1 light chain 3 (LC3) and p62, were detected by Western blotting. HUVECs were stimulated with IL-6 combined with autophagy inhibitor 3-methyladenine (3-MA) or autophagy inducer sirolimus (SRL), and then the changes of cell proliferation, cell apoptosis and expressions of the above proteins were analyzed. Results Compared with the control group, the cell proliferation and the ratio of LC3Ⅱ/LC3Ⅰin HUVECs in the IL-6 groups were significantly decreased (P<0.05), the apoptosis and the expressions of cleaved caspase-3 and p62 were significantly increased (P<0.05), the apoptotic vacuole number was significantly decreased (P<0.05), and the autophagy was reduced. The above effects were concentration-dependent (P<0.05). Compared with the IL-6 group, the autophagy of HUVECs in the IL-6 combined with 3-MA group was inhibited, the numbers of autophagosome and apoptotic vacuole were significantly decreased (P<0.05), LC3Ⅱ/LC3Ⅰratio was significantly decreased (P<0.05), and the cell apoptosis and the expression of cleaved caspase-3 and p62 were significantly increased (P<0.05). Compared with the IL-6 group, the autophagy of HUVECs in the IL-6 combined with SRL group was promoted, the numbers of autophagosome and apoptotic vacuole were significantly increased (P<0.05), LC3Ⅱ/LC3Ⅰratio was significantly increased (P<0.05), and the cell apoptosis and the expression of cleaved caspase-3 and p62 were significantly decreased (P<0.05). Conclusion IL-6 can induce the apoptosis of HUVECs by inhibiting autophagy.

Abstract:Objective To establish and improve the abdominal heterotopic heart transplantation model in mice, so as to provide references for the research on organ transplantation immunology. Methods C57BL/6 mice were selected as donors and recipients for syngeneic cardiac transplantation and recipients for allogeneic cardiac transplantation; BALB/c mice were selected as donors for allogeneic cardiac transplantation. The ascending aorta and pulmonary artery of the heart of the donors were end-to-side anastomosed with the abdominal aorta and inferior vena cava of the recipients, respectively, to establish abdominal heterotopic heart transplantation models in mice. Furthermore, the techniques of preparing recipient heart before implantation, extracting and preparing donor heart, and vascular anastomosis were improved, and the surgical results and advantages were observed and analyzed. Results Preliminary experiments were performed on 50 pairs of mice. For formal experiments, syngeneic cardiac transplantation was performed on 20 pairs and the success rate was 85.0% (17/20); allogeneic cardiac transplantation was performed on 15 pairs and the success rate was 86.7% (13/15). The total success rate of abdominal heterotopic heart transplantation was 85.7% (30/35). The average time for preparing recipient before vascular anastomosis was (11.2±2.5) min, the average time for extracting and preparing donor heart was (13.6±3.3) min, and the average time for vascular anastomosis was (21.7±3.5) min. Conclusion The improved abdominal heterotopic heart transplantation model in mouse has the advantages of easy-to-perform and high success rate, which lays a foundation for the further study of transplantation immunology.

Abstract:Objective To establish a thioacetamide (TAA)-induced bile duct carcinoma rat model and to observe the effect of aspirin on bile duct carcinoma by interrupting the model. Methods Sprague-Dawley (SD) male rats were given drinking water containing TAA (300 mg/L) for 5 months, and tumor formations of the livers were observed by H-E staining at the 8^th, 12^th, 16^th, and 20^th weeks, respectively. The expression of carbonic anhydrase 2 (CA-2) in liver tissues was also detected by immunohistochemistry. SD male rats were also selected and treated with aspirin after exposing to TAA for 12 weeks. And then the tumor formations of the livers were observed by H-E staining at the 3^rd and 6^th months, and the expression of CA-2 was detected by immunohistochemistry. Bile duct carcinoma cells QBC939 were obtained and treated with aspirin (0 mmol/L and 5 mmol/L), and the expression of CA-2 was detected by Western blotting after culturing for 48 h. Results Obvious fibrosis was found in the livers of some rats at 12^th weeks after exposing to TAA; large number of fibrous tissue hyperplasia and microscopic or suspected tumors were found in the livers at the 16^th weeks; visible tumors in the livers were found in all the rats at the 20^th weeks. The incidence of hepatic tumors or suspected tumors was 28.6% (2/7) in rats treated with aspirin for 6 months, while it was 100% (7/7) in rats without aspirin treatment. The expression of CA-2 in liver tissues was gradually increased with the development of bile duct carcinoma in rats, while the expression of CA-2 in liver tissues was decreased after treating with aspirin. The expression of CA-2 in QBC939 cells treated with 5 mmol/L aspirin for 48 h was significantly decreased versus the untreated control group (P<0.01). Conclusion TAA can successfully induce intrahepatic bile duct carcinoma. Aspirin can interrupt the development of bile duct carcinoma and may be used to prevent intrahepatic bile duct carcinoma.

Abstract:Objective To explore the relationship between D320N locus polymorphism in proprotein convertase subtilisin/kexin type 9 (PCSK9) gene and coronary heart disease. Methods A total of 3 450 patients with coronary heart diseases (angina pectoris, myocardial infarction, asymptomatic myocardial ischemia, ischemic cardiomyopathy, and sudden death), who were treated in Hebei General Hospital from Jan. 2014 to Jan. 2016, were enrolled as the case group, with 1 100 healthy people in the same period served as controls. Serum lipid levels and PCSK9 concentrations of subjects in the two groups were detected. PCR assay combined with DNA direct sequencing method was applied in genotyping of D320N (A/G) polymorphic locus in PCSK9 gene. Logistic regression analysis was used to analyze the relationship between D320N locus polymorphism in PCSK9 gene and different types of coronary heart diseases. Results Serum concentrations of PCSK9, levels of total cholesterol, triacylglycerol and low density lipoprotein cholesterol, ratio of coronary heart disease family, and ratio of smoking of subjects in the case group were significantly higher than those in the control group (P<0.001), while the level of high density lipoprotein cholesterol was significantly lower than that in the control group (P<0.001). The frequencies of genotype AA and GA in the case group were 3.6% and 13.9%, respectively, which were significantly higher than those in the control group, respectively (1.1%, 7.0%; χ²=20.502, 39.646; P<0.001); the frequency of allele A in the case group was significantly higher than that in the control group (10.5% vs 4.6%, χ²=70.481, P<0.001). The frequencies of genotype AA, genotype GA and allele A were the highest in the sudden death group, and were the lowest in the asymptomatic myocardial ischemia group. Logistic regression analysis showed that genotypes AA and GA of D320N (A/G) polymorphic in PCSK9 gene were risk factors of coronary heart disease (both P<0.001). Conclusion The D320N (A/G) locus polymorphism in PCSK9 gene was associated with coronary heart disease, and genotype AA may be an independent risk factor of coronary heart disease.

Abstract:Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic synovial membrane inflammation. The pathogenesis of RA is unknown, and the related researches mainly focus on inflammation and immune response. Recent researches have found that metabolism is closely related to immunity. Besides, hypoxia and metabolic disorders of glucose and fat can also affect the development, differentiation and function of immune cells, and then lead to occurrence of autoimmune diseases. In recent years, more and more studies have focused on the role of metabolic pathways in the immunity and pathogenesis of RA, in order to explore the pathogenesis of RA from different perspectives and to provide new ideas for the treatment of RA. In this review, we summarized the role of hypoxia, glucose metabolism and fat metabolism in immunity and pathogenesis of RA.

Abstract:Chronic obstructive pulmonary disease (COPD) has high morbidity and mortality, and it poses heavy burdens on the patients and society. Currently, there are no effective therapies to prevent or reverse the progression of COPD. Therefore, it is significant in clinic to explore the pathological process and new therapeutic approaches of COPD using animal models. In this review, we summarized the recent progress in several frequently-used COPD animal models and their establishment methods.

Abstract:Transdermal drug delivery has become one of the research focuses in pharmaceutical formulations due to its potential advantages. In order to overcome the natural barrier function of the skin, several physical, chemical and pharmaceutical enhancement strategies have been developed to promote the transdermal permeation and adsorption of drugs. Electret is a kind of functional dielectric material with permanent electric polarization state. The electrostatic filed and micro-current produced by electret can be used as physical permeation enhancer to improve the transdermal drug delivery. In this article, we reviewed the mechanism, influencing factors and current research progress of electret as one of the physical enhancing permeation strategies.

Abstract:Independent duty corpsmans (IDCs) are mainly responsible for the primary health care service of United States Navy. United States Navy has established a set of strict system and accumulated rich practical experience in the selection and training of IDCs. The training modes and methods of IDCs can provide an important reference for the training of medical officers in Chinese navy warship troops. In this paper, we introduced the training modes of IDCs, and analyzed the problems and countermeasures of the training of medical officers in our navy warship troops in terms of talent cultivation, education and training system, curriculum reform, and teaching techniques by combining the actual situation of our navy.

Abstract:Objective To investigate the risk factors influencing the recurrence of calcium oxalate kidney stone. Methods The clinical data of patients with calcium oxalate kidney stone were collected; they were hospitalized in Changhai Hospital, Navy Medical University (Second Military Medical University) from Sep. 2015 to Dec. 2015. The patients were divided into the first-time calcium oxalate stone group (first-time group) and the recurrent of calcium oxalate stone group (recurrent group) according to the stone histories. The concentrations of clusterin in serum and urine, and the concentrations of serum interleukin (IL)-1β, IL-2 and IL-6 in the two groups were detected by ELISA. The independent risk factors influencing the recurrence of calcium oxalate kidney stones were analyzed by univariate and multivariate logistic regression analysis. Results Thirty-six patients were included in each group. Univariate analysis showed that there were no significant differences in age, gender, body mass index (BMI),estimated glomerular filtration rate (eGFR), maximum stone diameter or the concentrations of serum clusterin, IL-1β, IL-2 and IL-6 between the two groups (all P>0.05). The concentration of urinary clusterin in the recurrent group was significantly lower than that in the first-time group ([44.35±15.44] ng/mL vs[56.76±16.80] ng/mL, t=-3.262, P<0.05). Multivariate logistic regression analysis showed that urinary clusterin concentration (OR=0.939, 95% CI 0.900-0.979, P<0.05) was an independent risk factor influencing the recurrent of calcium oxalate kidney stone. Conclusion The concentration of urinary clusterin is decreased in patients with recurrence of calcium oxalate stone compared the first-time stone patients, suggesting that the clusterin in urine may be closely related to the recurrence of stones.

Abstract:Objective To explore the clinical factors influencing the prognosis of patients with gestational trophoblastic neoplasia (GTN) after chemotherapy. Methods The clinical data of 55 patients with gestational trophoblastic diseases in our hospital from 2009 to 2016 were retrospectively analyzed, including 26 cases with hydatidiform mole and 29 cases with GTN (23 cases of invasive mole and 6 cases of choriocarcinoma). Among them, 23 GTN patients with the follow-up human chorionic gonadotropin (HCG)<5 U/L for 3 times after chemotherapy were included in this study. The age, reproductive history, lung metastasis, International Federation of Gynecology and Obstetrics (FIGO) stage and other clinical factors which might affect the cure time of GTN patients were analyzed by Cox regression analysis. The relationship between age and reproductive history and cure time were analyzed by Kaplan-Meier survival analysis. Results Cox regression univariate analysis showed that term delivery and abortion were related to the cure time of GTN patients (both P<0.05), and the age was close to statistical significance (P=0.051). Cox multivariate analysis showed that term delivery was an independent factor influencing the cure time of GTN patients (P=0.020). Kaplan-Meier survival analysis showed that age (P=0.043), term delivery (P=0.016) and abortion (P=0.026) were related to the cure time of GTN patients after chemotherapy. Conclusion Older women or women who have histories of term delivery or abortion should be alerted to the occurrence of GTN, which has long cure time and the dynamic changes of blood HCG need to be closely monitored.

Abstract:Objective To rapidly identify the chemical constituents in a traditional Chinese medicine Yine Abrus (Xiangsiteng) by high-performance liquid chromatography-time of flight mass spectrometry (HPLC-TOF/MS) analysis technique. Methods A formula database including 28 compounds of Xiangsiteng was developed by Agilent software "Formula-Database Generator". The total ion chromatograms of the Xiangsiteng extracts were obtained by HPLC-TOF/MS, and the chemical components were identified by automatic matching method according to the exact mass-to-charge ratio of each chemical component. The separation was performed on a Agilent Zorbax Eclipse SB-C₁₈ column (3.0 mm×100 mm, 3.5 μm). The mobile phase composing of acetonitrile and 0.1% formic acid aqueous solution was used for gradient eluting. The flowing rate was 0.4 mL/min; the temperature of column was 25℃; the UV detection wavelength was 254 nm; and the sample selection was 10 μL. The electrospray ionization (ESI) source was applied for MS analysis under positive ion and negative ion modes, with the mass scan range being m/z 100-1 200. Results HPLC-TOF/MS identified a total of 15 chemical components from Xiangsiteng extracts, including 10 in positive ion mode and 11 in negative ion mode, and 6 both in both positive and negative ion modes. Conclusion A rapid and efficient method for identifying the chemical components of traditional Chinese medicine Xiangsiteng by HPLC-TOF/MS has been established, and the chemical components of Xiangsiteng has been clarified, which lays a foundation for the quality control and further pharmacological study of Xiangsiteng.

Abstract:Objective To explore the effects of in vitro culture time of frozen cleavage embryo after thawing on clinical pregnancy rate during frozen-thawed embryo transfer (FET) cycles. Methods The clinical data of 692 patients were analyzed; they received FET in the Department of Reproductive Medicine Center, Changhai Hospital, Navy Medical University (Second Military Medical University) from January to December in 2016. According to the days of in vitro culture between thawing and transferring, the patients were divided into three groups:no in vitro culture group, 1-day in vitro culture group and 2-day in vitro culture group. The pregnancy outcomes were compared between the three groups. Results There were no significant differences in age, body mass index, infertile duration, basic follicle-stimulating hormone (FSH) level or endometrial preparation protocol between the three groups (all P>0.05). The embryo loss rates of the no in vitro culture group, the 1-day in vitro culture group and the 2-day in vitro culture group were 0.0% (0/706), 13.3% (64/481) and 43.0% (114/265), respectively, and the difference was statistically significant (P<0.01). There were no significant differences in number of transfered embryo or endometrial thickness on transplantation day between the three groups (both P>0.05). The good-quality embryo transfer rates in the 2-day in vitro culture group and 1-day in vitro culture group were significantly lower than that in the no in vitro culture group (both P<0.01), and the clinical pregnancy rate in the 2-day in vitro culture group was significantly higher than that in the no in vitro culture group (P<0.01). Conclusion In vitro culture for 1-2 days after thawing frozen cleavage embryos may increase the embryo loss rate, but it can improve the clinical pregnancy rate by screening the embryos with developmental potential.

Abstract:Objective To discuss the clinical characteristics and early diagnosis of patients with cerebral venous sinus thrombosis (CVST) mainly presented as isolated headache. Methods The clinical data of 6 patients with CVST presented as isolated headache were collected, and they were hospitalized in the Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine from Jan. 2012 to Dec. 2016. The clinical features, D-dimer level, non-contrast cranial CT imaging and cranial contrast-enhanced magnetic resonance venography (CE-MRV) imaging of the patients were retrospectively analyzed. Results All the 6 patients were young, including 5 males and 1 female, with acute headache as a single clinical manifestation. The degrees of the headache were moderate to severe, and continuously became worse. The headaches were located in the frontotemporal and occipital areas, and the pains were mainly distending and throbbing. The levels of D-dimer were increased in 4 cases and normal in 2 cases. The non-contrast cranial CT imaging showed that the densities of transverse sinus were increased in 5 patients. CVST was finally confirmed by cranial MRI+CE-MRV in all the patients, and the most involved sinuses were transverse sinus and sigmoid sinus. All the 6 patients were relieved of headache after anticoagulant therapy, and the prognosis was good. Conclusion Patients with CVST mainly presented as isolated headache are extremely rare. Therefore, we need to pay attention to the patients with newly progressive isolated headache in clinc. These patients need early diagnosis by cranial MRI+CE-MRV to avoid misdiagnosis even if the D-dimer levels are normal, and then they can have good outcomes after early diagnosis and treatment.

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