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LIU Juzhen, LU Yingzhou, QIAN Min, et al
Objective: To systematically evaluate the value of screening Down's syndrome (DS) with pregnancy associated plasma protein-A (PAPP-A) combined with free beta chorionic gonadotropin (F-βhCG) and fetal nuchal translucency (NT) in the first trimester. Methods: According to the method of systematic review, articles related to serum PAPP-A and F-βHCG levels as well as NT in the first trimester were searched in databases, such as MEDLINE (PubMed), EMBase, Cochrane library, Wangfang, CNKI and CBM. Meta Disc 1.4 software was used for heterogeneity test and meta-analysis. Results: Twelve studies were included for this meta-analysis, including 783 cases of DS and 213 943 controls. Threshold effect heterogeneity and non-threshold effect heterogeneity were not found in twelve articles. The results of pooled sensitivity, specificity, AUC and positive likelihood ratio were 88% (95% CI: 0.86-0.90), 95% (95% CI: 0.95-0.95), 0.97, and 19.17 (95% CI: 16.8-21.9), respectively. Conclusion: When the false positive is 5%, the sensitivity of this screening method is 88%, suggesting that this method has high value of screening DS.
2014 Vol. 22 (11): 725- [Abstract]（
58
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WANG Wei, SU Ning，ZHONG Zhi-min, et al
Objective: To develop a microfluidic chip for embryo dynamic culture method by mimicking the fluid-mechanical and biochemical stimulation embryos experience in vivo from ciliary currents and oviductal contractions. Methods: A microfluidic chip was designed and fabricated for testing the influence of continual fluid flow on embryo development. This gave rise to design of a microfluidics system using microchannels as conduits for fluid flow through a 16- microcellular where embryo resided. Mouse embryos were cultured in conventional microdrop-static control and dynamic conditions with microfluidics, and results obtained from the two methods were compared. Results: Embryonic development situation was the best and the blastocyst rate was the highest (47.9%, 23/48) when fluid velocity of microfluidic culture system was 10 u l per hour. The microfluidic chip dynamic culture method significantly improved the embryo development. The microfluidic dynamic method was superior to the microdrop-static method in terms of 5 to 8 cell embryo rate (53.1% vs. 46.6%), morula rate (50.3% vs. 41.5%) and blastocyst rate (45.5% vs. 35.5%, P all <0.05). There was no significant difference in the rate of 2 to 4 cell-embryo rate between these two methods (63.4% vs. 60.2%, P ＞0.05). Conclusion: The physical environment in the process of embryo culture can affect the quality of embryo. This microfluidic method maybe able to improve embryo development and show an advantage over the conventional method, which would be expected to serve as a powerful tool for embryo culture in the future.
2014 Vol. 22 (11): 730- [Abstract]（
54
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WANG Yi-qin, HOU Xiao, TENG Huai-xiang
Objective: To observe the effect of mifepristone on the expression of Fas and Fas ligand (FasL) in endometrial hyperplasia of rats, and to explore the therapeutic mechanism of endometrial hyperplasia. Method: Forty-five SD rats were included, of which 15 rats were randomly selected as normal control, and the other 30 were treated to be a rat model of endometrial hyperplasia with "estrogen load method". The model rats were randomly divided into mifepristone group (n=15) with intragastric administration of mifepristone suspension for 4 weeks and disease model group (n=15) with intragastric administration of normal saline at the same volume for 4 weeks. Expression levels of Fas and FasL were evaluated by immunohistochemistry method. Results: The expression level of Fas protein (146.90±24.12) in the model group was significantly lower than that in normal control group (116.63±16.94, P<001). There were no significant differences between the mifepristone group and the normal group(P＞0.05). The expression level of FasL protein in the model group (122.77±28.10) was significantly lower than that of normal control group (149.75±29.53, P<0.01). The expression level of FasL protein was (132.50±27.97), higher than that of the model group (P>0.05), but lower than that of the normal group (P>0.05). Conclusion: Abnormal apoptosis mediated by decreased expression level of Fas and increased expression level of FasL plays an important role in the pathogenesis of endometrial hyperplasia. Mifepristone could up-regulate the expression of Fas in endometrial tissue and inhibit the excessive expression of FasL. Presumably one of mechanism of the treatment of endometrial hyperplasia is possibly inhibit the endometrial hyperplasia by restoring the apoptosis balance of endometrial epithelial cell.
2014 Vol. 22 (11): 734- [Abstract]（
66
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ZHA Shu-wei, XU Hao-qin, LV Nian-qing, et al
Objective: To assess the urban-rural difference of the newborn population quality in Jiangsu and to provide fundamental references for further studies on the development of urban-rural integration. Methods: The relevant surveillance data retrieved from the results of the eugenics project and parasite prevention/treatment project completed by Jiangsu Population and Family Planning Committee during the periods of the 10th, 11th and 12th National Five-Year Plans were used to analyze the urban-rural and/or regional difference. Results: There were significant urban-rural differences in growth characteristics (height and weight) of children aged 2 to 7 years and the incidence of perinatal birth defect (including congenital and genetic disease). Significant urban-rural or regional differences were also found in the intelligence development of children under age 6, the social-life function of children under age 7, the incidence of birth defect (including congenital and genetic diseases) of children under age 7, and the death rate of children under age 5. Conclusion: The surveillance-related results, that reflect the newborn population quality, could be helpful to establish valuable evaluation parameters for the urban-rural differences at population level during the urban-rural integration.
2014 Vol. 22 (11): 738- [Abstract]（
62
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CHEN Qiu-yuan, GUO Chao, ZHENG Xiao-ying
Objective: To investigate the association of reproductive tract infection and the risk of irregular menstruation among married women of childbearing age, to provide a reliable basis for reducing and preventing their irregular menstruation risk, and improve woman's reproductive health. Methods: Using data from the survey on the health and risk factors among couples of childbearing age before pregnancy conducted in five provinces, this study analyzed the situation of irregular menstruation and reproductive tract infections among 8691 married women of childbearing age with descriptive methods, and explored the association of reproductive tract infection and the risk of irregular menstruation among married women of childbearing age by binary-logistic regression. Results: The prevalence of irregular menstruation among married women of childbearing age was 17.6%, and the risk of irregular menstruation among married women of childbearing age with reproductive tract infections was 1.56-fold (95% CI: 1.38 -1.76) of those without reproductive tract infections when controlling the age, educational level and economic status. Conclusion: Reproductive tract infection may be a risk factor for the irregular menstruation of married women of childbearing age, suggesting that reproductive health education should be strengthened to help reduce the risk of their irregular menstruation for married women of childbearing age.
2014 Vol. 22 (11): 743- [Abstract]（
71
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ZHOU Hui, XIE Qing-zhen
Objective: To compare the clinical outcome and application of subsequent frozen-thawed embryo transfer （FET） cycle and fresh embryo transfer (ET) cycle. Methods: The clinical pregnancy rate, implantation rate, live birth rate, ectopic pregnancy rate, miscarriage rate and ovarian hyper-stimulation syndrome (OHSS) rate were retrospectively analyzed between fresh ET（fresh ET group, n=324) and subsequent FET（FET group, n=179) after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI)-ET from January 2011 to December 2013 in Center for Reproductive Medicine, Renmin Hospital of Wuhan University. Results: There were no significant differences in age, infertility duration, basal follicle-stimulating hormone (FSH), initial gonadotropin (Gn) dosage, days of stimulation, fertilization rate, 2PN rate, cleavage rate, good-quality embryo rate and numbers of embryo transferred between two groups (P all >0.05). The total Gn dosage in FET group was significantly lower than that in fresh ET group (P<005), but the levels of estradiol (E2) and progesterone (P) on human chorionic gonadotrophin (hCG) day, the number of follicle on hCG day and the number of oocyte retrieved were significantly higher than those in fresh ET group respectively (P<0.05). The clinical pregnancy rate (37.23%) and implantation rate (59.22%) in FET group were significantly higher than those in fresh ET group (29.56% vs. 49.07%, P＜0.05), while there were no significant differences in live birth rate, multiple pregnancy rate and ectopic pregnancy rate between two groups (P all >0.05), and FET group has relatively lower ovarian hyper-stimulation syndrome (OHSS) rate (0.56%) compared with fresh ET group. Conclusion: For patients at high risk of OHSS, freezing whole embryos and subsequent FET can significantly improve the clinical pregnancy rate and implantation rate, and it can also effectively prevent OHSS, and get satisfactory clinical outcome.
2014 Vol. 22 (11): 747- [Abstract]（
61
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LIN Yi
Objective: To compare the safety and efficacy of double balloon dilation and propess for preinduction cervical ripening and labor induction in pregnancy women with oligohydramnios. Methods: Using a retrospective case-control study method, 220 pregnant women of full-term pregnancy with single term pregnant, proper fetal position, 50-80 of amniotic fluid index and indications for labor induction were recruited. One hundred and twenty women treated with double balloon were as the study group and 100 women with propess as the control group. The effect of induction, mode of delivery, the outcome of pregnancy and complications were compared between the two groups. Results: The cervical ripening rate of vaginal delivery in the study group was 100.00%, significantly higher than that in the control group (89.00%, P<0.05); the success rate of vaginal delivery in the study group (82.35%) was significantly higher than that in the control group (66.00%). A total of 120 women in the study group and 100 in the control group delivered naturally, and the effective rate were 82.35% and 66.00%, respectively. The cesarean section rate in the study group (17.65%) was significantly lower than that of the control group (34.00%, P<0.05). There were no significant differences in maternal and neonatal outcomes between the two groups (P＞0.05). Three (2.5%) women experienced complications in the study group and 4 (4.0%) in the control group, showing no significant difference between the two groups (P＞0.05). Conclusion: In promoting ripening of the cervix, double balloon is significantly better than propess, and the device can not increase the complications of mothers and newborns.
2014 Vol. 22 (11): 752- [Abstract]（
55
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ZHENG Wei-wei, SONG ge, ZHONG Xiao-ying, et al
Objective: To explore the effect of the duration of cryopreservation of donor sperm in liquid nitrogen on pregnancy outcome of artificial insemination by donor (AID) and the security of the offspring. Methods: Retrospective analysis of 6038 infertile couples who underwent 14 290 treatment cycles from April 2007 to April 2013 in our center was conducted. The relationship between the duration of cryopreservation of donor sperm (0.5 to 1 year, >1 to 3 years, >3 to 5 years, >5 to 7 years and >7 to 10 years, respectively) and the pregnancy and abortion rates as well as the incidence of birth defects in AID were evaluated. Results: No effect of the duration of cryopreservation of donor sperm on the pregnancy and abortion rates was found (P all>005). The incidence rate of birth defect was 1.33%, and no statistically significant difference was found among different duration of cryopreservation of donor sperm (P all >0.05). Conclusion: Long-term storage of donated sperm in liquid nitrogen maybe safe in AID due to no impact on clinical pregnancy rate, abortion rate and the incidence of birth defect. The effect is similar to those of natural pregnancy.
2014 Vol. 22 (11): 755- [Abstract]（
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NIE Zhao-yan, ZHEN Xiu-li, ZHANG Na,et al
Objective: To explore the influence of the duration of embryo culture after thawing on clinical pregnancy outcomes in frozen-thawed embryos transfer cycles. Methods: A retrospective analysis was performed on 1061 frozen-thawed embryo transfer cycles, which were divided into three groups according to different cultures times, namely, group A (2-4 hours after thawing, n=96) , group B (＞4-8 hours after thawing, n=615) and group C (＞8 hours after thawing, n=350). The clinical pregnancy rate, embryo implantation rate, abortion rate and live birth rate among groups were compared. Results: There were no significant difference in age, duration of infertility, body mass index, endometrial thickness on the embryo transplant day, the number of embryo transferred among the three groups. There were no significant differences among the three groups in the implantation rate (24.7% vs. 23.4% vs. 28.2%, P>005), clinical pregnancy rate (43.8% vs. 40.8% vs. 44.9%, P>0.05), early abortion rate (4.8% vs. 104% vs. 121%, P>0.05) and live birth rate (40.6% vs. 32.7% vs. 37.4%, P>0.05). Conclusion: The incubation time in vitro of frozen-thawed embryos may not significantly affect the pregnancy outcomes, and the embryo transplant time could be chosen according to clinical and patients' conditions.
2014 Vol. 22 (11): 759- [Abstract]（
67
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