个体动态化体重管理对体外受精-胚胎移植超重肥胖患者体重控制及妊娠结局的影响

目的:针对接受体外受精-胚胎移植(IVF-ET)的超重肥胖患者实施个体动态化体重管理,探讨该干预方法对体重控制及妊娠结局的影响。方法:选择2017年5月至2018年12月就诊于我院拟行IVF-ET的超重肥胖患者共99例纳入本研究,随机分为实验组50例与对照组49例,分别采取个体动态化体重管理及常规干预的方法对两组进行体重管理,记录并统计干预前后相关指标的组间差异。结果:两组干预前后BMI的差值差异有统计学意义(P0.05);内膜厚度、获卵数、可用胚胎数、移植胚胎数的组间比较差异无统计学意义(P0.05)。两组临床妊娠率与活产率差异有统计学意义(P0.05);出生婴儿体重组间差异无统计学意义(P0.05);干预满意度评分差异有统计学意义(P0.05)。结论:个体动态化体重管理的干预方法可有效减轻接受IVF-ET的超重肥胖患者的体重,降低体重指数,提高IVF-ET的移植成功率、活产率,值得临床推广应用。     

Effects of Multivitamin/Mineral Supplementation on Trace Element Levels in Serum and Follicular Fluid of Women Undergoing in Vitro Fertilization (IVF)

We investigated effects of multivitamin/mineral supplementation on element levels in serum and follicular fluid of women undergoing IVF. We used three groups in this study. The first group was used as an age-matched and nonpregnant control (n = 13). Group 2 (n = 30) constituted the IVF group and women in the third group who were undergoing IVF also received a multivitamin/mineral tablet daily for 45 days. Follicular fluid and serum selenium and zinc levels and follicular fluid copper levels were lower in IVF patients than in controls although follicular fluid aluminum and iron levels were higher in IVF patients than in controls. However, follicular fluid and serum aluminum, copper, zinc and selenium levels, and serum magnesium levels were higher in the multivitamin/mineral group than in the IVF group although follicular fluid iron levels were lower in the multivitamin/mineral group than in the IVF group. In conclusion, we observed that copper, zinc, and selenium in serum and follicular fluid decreased in women undergoing IVF. Multivitamin/mineral supplementation in serum and follicular fluid of women undergoing IVF normalized the trace element levels.     

Impaired Glucose Metabolism in Response to High Fat Diet in Female Mice Conceived by In Vitro Fertilization (IVF) or Ovarian Stimulation Alone

Individuals conceived by in vitro fertilization (IVF) may be at increased risk of cardio-metabolic disorders. We recently reported that IVF conceived male mice displayed impaired glucose metabolism at normal and high body weights. In this study, we examined glucose metabolism in mature female C57BL/6J mice that were conceived by natural conception (NC), by ovarian stimulation (OS) or by IVF following chow or high-fat diet (HFD) for 8 weeks. By design, litter size was comparable between groups, but interestingly the birth weight of IVF and OS females was lower than NC females (p≤0.001). Mature IVF female mice displayed increased fasting glucose as compared to NC and OS mice, irrespective of diet. Mature IVF and OS mice were also more susceptible to the metabolic consequences of high fat diet as compared with NC females, with impaired glucose tolerance (p≤0.01), whereas peripheral insulin resistance and increased hepatic expression of gluconeogenic genes Ppargc1α, Pck1 and G6pc was observed in IVF mice only (p<0.05). This study suggests that ovarian stimulation alone and IVF program distinct metabolic effects in females, but that high fat diet may be required to unmask these effects. This study adds to the growing body of literature that assisted reproduction procedures may increase the risk of developing type 2 diabetes in an obesity prone environment.     

Low Dose Rate Radiosensitization of Hepatocellular Carcinoma In Vitro and in Patients

Transarterial radioembolization (TARE) with ⁹⁰Y microspheres delivers low dose rate radiation (LDR) to intrahepatic tumors. In the current study, we examined clonogenic survival, DNA damage, and cell cycle distribution in hepatocellular carcinoma (HCC) cell lines treated with LDR in combination with varying doses and schedules of 5-fluorouracil (5-FU), gemcitabine, and sorafenib. Radiosensitization was seen with 1 to 3 μM 5-FU (enhancement ratio 2.2–13.9) and 30 to 100 nM gemcitabine (enhancement ratio 1.9–2.9) administered 24 hours before LDR (0.26 Gy/h to 4.2 Gy). Sorafenib radiosensitized only at high concentrations (3–10 μM) when administered after LDR. For a given radiation dose, greater enhancement was seen with LDR compared to standard dose rate therapy. Summarizing our clinical experience with low dose rate radiosensitization, 13 patients (5 with HCC, 8 with liver metastases) were treated a total of 16 times with TARE and concurrent gemcitabine. Six partial responses and one complete response were observed with a median time to local failure of 7.1 months for all patients and 9.9 months for patients with HCC. In summary, HCC is sensitized to LDR with clinically achievable concentrations of gemcitabine and 5-FU in vitro. Encouraging responses were seen in a small cohort of patients treated with TARE and concurrent gemcitabine. Future studies are needed to validate the safety and efficacy of this approach.     

The Experience of Chinese Couples Undergoing In Vitro Fertilization Treatment: Perception of the Treatment Process and Partner Support

Background

Couples undergoing In Vitro Fertilization (IVF) Treatment suffer as dyads from the stressful experience of the painful treatment and the fear that the IVF cycle will fail. They are likely to report that their marital relationship has become unstable due to the prolonged period of treatment.

Methods

This is a qualitative study that was conducted to explore the experiences that Chinese couples have had with IVF treatment, especially their perceptions of the process and the support between couples.

Results

The interviews revealed that couples suffered from the process, experiencing physical and emotional pain, struggling with the urgency and inflexibility of bearing a child, and experiencing disturbances in their daily routines and work. The participants described how they endured the hardships as a couple and how it affected their relationship. The couples felt that sharing feelings and supporting each other contribute to psychological well-being and improves the marital relationship. They also identified some unfavorable aspects in their partner relationship. They were ambivalent about receiving social support from friends and family members.

Conclusions

With the couples indicating that the support that they received from each other affected their experience during the treatment process, it is suggested that a supportive intervention that focuses on enhancing the partnership of the couples and dealing with their inflexibility on the issue of bearing a child might result in improvements in the psychological status and marital relationship of infertile couples undergoing IVF treatment.     

Noninvasive Digital Detection of Fetal DNA in Plasma of 4-Week-Pregnant Women following In Vitro Fertilization and Embryo Transfer

The discovery of cell-free fetal DNA (cfDNA) circulating in the maternal blood has provided new opportunities for noninvasive prenatal diagnosis (NIPD). However, the extremely low levels of cfDNA within a high background of the maternal DNA in maternal circulation necessitate highly sensitive molecular techniques for its reliable use in NIPD. In this proof of principle study, we evaluated the earliest possible detection of cfDNA in the maternal plasma by a bead-based emulsion PCR technology known as BEAMing (beads, emulsion, amplification, magnetics). Blood samples were collected from in vitro fertilization (IVF) patients at 2 to 6 weeks following embryo transfer (i.e., 4 to 8 week pregnancies) and plasma DNA was extracted. The genomic regions of both X and Y chromosome-specific sequences (AMELX and AMELY) were concurrently amplified in two sequential PCRs; first by conventional PCR then by BEAMing. The positive beads either for AMELX or AMELY gene sequences were counted by a flow cytometer. Our results showed that the pregnancies yielding boys had significantly higher plasma AMELY gene fractions (0.512 ± 0.221) than the ones yielding girls (0.028 ± 0.003) or non-pregnant women (0.020 ± 0.005, P= 0.0059). Here, we clearly demonstrated that the BEAMing technique is capable of reliably detecting cfDNA in the blood circulation of 4-week-pregnant women, which is only two weeks after the embryo transfer. BEAMing technique can also be used to early detect fetal DNA alterations in other pregnancy-associated disorders.     

Association between Genetic Polymorphisms in Cav2.3 (R-type) Ca2+ Channels and Fentanyl Sensitivity in Patients Undergoing Painful Cosmetic Surgery

Individual differences in the sensitivity to fentanyl, a widely used opioid analgesic, lead to different proper doses of fentanyl, which can hamper effective pain treatment. Voltage-activated Ca²⁺ channels (VACCs) play a crucial role in the nervous system by controlling membrane excitability and calcium signaling. Ca_v2.3 (R-type) VACCs have been especially thought to play critical roles in pain pathways and the analgesic effects of opioids. However, unknown is whether single-nucleotide polymorphisms (SNPs) of the human CACNA1E (calcium channel, voltage-dependent, R type, alpha 1E subunit) gene that encodes Ca_v2.3 VACCs influence the analgesic effects of opioids. Thus, the present study examined associations between fentanyl sensitivity and SNPs in the human CACNA1E gene in 355 Japanese patients who underwent painful orofacial cosmetic surgery, including bone dissection. We first conducted linkage disequilibrium (LD) analyses of 223 SNPs in a region that contains the CACNA1E gene using genomic samples from 100 patients, and a total of 13 LD blocks with 42 Tag SNPs were observed within and around the CACNA1E gene region. In the preliminary study using the same 100 genomic samples, only the rs3845446 A/G SNP was significantly associated with perioperative fentanyl use among these 42 Tag SNPs. In a confirmatory study using the other 255 genomic samples, this SNP was also significantly associated with perioperative fentanyl use. Thus, we further analyzed associations between genotypes of this SNP and all of the clinical data using a total of 355 samples. The rs3845446 A/G SNP was associated with intraoperative fentanyl use, 24 h postoperative fentanyl requirements, and perioperative fentanyl use. Subjects who carried the minor G allele required significantly less fentanyl for pain control compared with subjects who did not carry this allele. Although further validation is needed, the present findings show the possibility of the involvement of CACNA1E gene polymorphisms in fentanyl sensitivity.     

Live Birth Sex Ratio after In Vitro Fertilization and Embryo Transfer in China - An Analysis of 121,247 Babies from 18 Centers

In order to study the impact of procedures of IVF/ICSI technology on sex ratio in China, we conducted this multi-center retrospective study including 121,247 babies born to 93,895 women in China. There were 62,700 male babies and 58,477 female babies, making the sex ratio being 51.8% (Male: Female  = 107∶100). In univariate logistic regression analysis, sex ratio was imbalance toward females of 50.3% when ICSI was preformed compared to 47.7% when IVF was used (P<0.01). The sex ratio in IVF/ICSI babies was significantly higher toward males in transfers of blastocyst (54.9%) and thawed embryo (52.4%) when compared with transfers of cleavage stage embryo (51.4%) and fresh embryo (51.5%), respectively. Multiple delivery was not associated with sex ratio. However, in multivariable logistic regression analysis after controlling for related factors, only ICSI (adjusted OR = 0.90, 95%CI: 0.88–0.93; P<0.01) and blastocyst transfer (adjusted OR = 1.14, 95% CI: 1.09–1.20; P<0.01) were associated with sex ratio in IVF/ICSI babies. In conclusion, the live birth sex ratio in IVF/ICSI babies was influenced by the use of ICSI, which may decrease the percentage of male offspring, or the use of blastocyst transfer, which may increase the percentage of male offspring.     

In Vitro Embryo Culture and Induction of Multiple Shoots in Lychee (Litchi chinensis Sonn.)

Immature embryos of different sizes and ages from commercialvarieties of lychee (Litchi chinensis Sonn.) were cultured ina range of different media. Embryos as small as 3 mm could becultured using in vitro techniques and subsequently grown intoplants. MS solid medium with 2% sucrose supplemented with 150ml l^–1 coconut water was most effective in stimulatingthe germination of immature lychee embryos. Embryos of lycheewere treated to induce adventitious buds from embryonic shootsas a means of achieving multiplication. The different varietiesexhibited differences in response, with Bengal embryonic shootsproducing 15 adventitious buds after pretreatment with 100 mgl^–1 BAP for 3 h. Root formation was achieved in 65% ofadventitious shoots using MS medium supplemented with 0.5 mgl^–1 NAA and activated charcoal. These plants were successfullydeflasked and grown on in the glasshouse. This technique providesof means of producing some multiple shoots from lychee embryosand has value for multiplication in a breeding program wherea method of micropropagation is unavailable. Litchi chinensis Sonn., lychee, embryo culture, multiple shoots, in vitro     

Polymorphisms in the Melanocortin‐1 Receptor (MC1R) and Agouti Signaling Protein (ASIP) Genes in Korean Vitiligo Patients

We have examined the frequency of SNP polymorphisms within the melanocortin‐1 receptor (MC1R) and agouti signaling protein (ASIP) genes in 114 Korean vitiligo patients and 111 normal controls to assess the association of these loci with vitiligo risk. Using direct sequencing techniques, we found the following five MC1R coding region SNPs: Arg67Gln (G200A), Val92Met (G274A), Ile120Thr (T359C), Arg160Arg (C478A), and Gln163Arg (A488G). Of these, the most common were Val92Met at 14% in patients vs. 9% in controls (P = 0.17) and Gln163Arg at 17% in patients vs. 17% in controls (P = 0.84). Presence of the A allele of Val92Met (G274A) was higher in vitiligo patients {P = 0.12, odds ratio (OR) [95% confidence interval (CI)] = 1.68 (0.86–3.25)}. The other three variants showed a frequency <5% of both patients and controls. The ASIP 3′UTR genotype (g.8818A‐G) was also assessed in the same subjects. The frequency of the G allele of 3′UTR in ASIP was 17% in vitiligo and 12% in controls [P = 0.14, OR (95% CI) = 1.49 (0.87–2.54)]. Carriage of the G allele was higher in vitiligo patients [P = 0.17, OR (95% CI) = 1.50 (0.83–2.72)], and those who also carried MC1R Val92Met were more prone to vitiligo [eight of 111 patients vs. four of 111 in controls, P = 0.14, OR (95% CI) = 2.75 (0.71–8.69)]. None of these associations, however, reached statistical significance.     

Interaction between Glucocorticoids and Epidermal Growth Factor In Vitro in the Growth of Palatal Mesenchymal Cells from the Human Embryo

Previous studies of ours have shown that palatal mesenchymal cells from the human embryo (HEPM cells) are responsive both to the glucocorticoid dexamethasone (DEX) and epidermal growth factor (EGF) through mechanisms associated with cytoplasmic and cell surface receptors, respectively. HEPM cell growth was inhibited by DEX and was stimulated by EGF. In the present study, the interactions between DEX and EGF were investigated. DEX (10^–6 M) enhanced EGF-stimulated HEPM cell growth as assessed by an increase in cell number and ornithine decarboxylase activity under serum-free cell culture conditions. DEX also enhanced the specific binding of ¹²⁵I-EGF to these cells, which was reflected in an increase in both the number and the affinity of EGF receptors. EGF (1 ng/ml), on the other hand, decreased the number of sites per cell which specifically bind ³H-DEX. EGF completely prevented the inhibition by DEX of HEPM cell growth. These results indicate that DEX and EGF interact with each other in the process(es) regulating HEPM cell growth. This interaction may be partially influenced by direct modulation of existing receptors for DEX and EGF present in the cells.     

花叶千年木单个生殖器官和营养器官的体外直接再生的控制——单个器官直接再生的规律性

花叶千年木(Dracaena fragrans cv.massangeana Hort．)的各种单个器官(花被片、花芽、花序分枝、花序、成年态营养芽和幼态营养芽)在离体培养中被愈伤组织直接再生了。在这些单个器官的再生期间,一些规律性现象被观察到了。首先,单个再生器官种类的范围与分离外植体的器官在植物个体发育中被分化的时期有密切关系。从植株个体发育某个时期(时期A)分化的地上部分器官上分离的外植体能够分别再生下面这些地上部分器官：稍晚于时期A分化的器官,与时期A同期分化的器官和早于时期A分化的所有器官。其次,在这个范围内,究竟再生哪一种器官被再生取决于培养基中外源生长素的浓度。随着2,4-D浓度从0．005mg／L逐渐升高到0．5mg／L,单个再生器官的种类将按如下的次序变化：营养芽,花序,花序分枝,花芽,花被片。这些规律性现象将被用于诱导一个给定的被子植物地上部分器官的直接再生。     

Inverse Correlation between ABA Content and Germinability throughout the Maturation and the In Vitro Culture of the Embryo of Phaseolus vulgaris

Prevost, I. and Le Page-Degivry, M. Th. 1985. Inverse correlationbetween ABA content and germinability throughout the maturationand the in vitro culture of the embryo of Phaseolus vulgaris.—J.exp. Bot. 36: 1457–1464. Changes in embryo abscisic acid (ABA) content during the maturationof the seed of Phaseolus vulgaris cv. Contender were followed,using a radio-immunoassay. The pattern of change is similarto that already described in several species: a rapid increase(from the 18th to 29th day after anthesis), was followed bya decrease, the ABA level being ten times lower on the 48thday than on the 29th. Embryos isolated from the 18th to the48th day after anthesis were able to ‘germinate’when cultivated on a mineral medium supplemented with sucroseand agar. The development pattern varied throughout the embryogenesisand could be correlated with the differentiation of the embryoat the time of isolation. Before germination could take place,we observed a lag phase, the duration of which could be correlatedwith embryo ABA content. As ABA content increased in the youngestembryos the duration of the lag phase increased. In the sameway, the number of days to germination was shown to diminishas ABA content decreased. Inverse correlation between ABA contentand germinability was thus demonstrated throughout the developmentof the embryo. During in vitro culture, free ABA content decreased in the embryoand reached low values a few days before germination occurred.So the beginning of root elongation in culture was again wellcorrelated with the disappearance of free endogenous ABA. Atransfer experiment inducing an earlier germination associatedwith a more limited development suggests that the lag phaseis associated with an active continuation of embryonic development Key words: Embryo maturation, abscisic acid, germinability     

花叶千年木单个生殖器官和营养器官的体外直接再生的控制--单个器官直接再生的规律性

花叶千年木(Dracaena fragrans cv.massangeana Hort.)的各种单个器官(花被片、花芽、花序分枝、花序、成年态营养芽和幼态营养芽)在离体培养中被愈伤组织直接再生了.在这些单个器官的再生期间,一些规律性现象被观察到了.首先,单个再生器官种类的范围与分离外植体的器官在植物个体发育中被分化的时期有密切关系.从植株个体发育某个时期(时期A)分化的地上部分器官上分离的外植体能够分别再生下面这些地上部分器官:稍晚于时期A分化的器官,与时期A同期分化的器官和早于时期A分化的所有器官.其次,在这个范围内,究竟再生哪一种器官被再生取决于培养基中外源生长素的浓度.随着2,4-D浓度从0.005 mg/L逐渐升高到0.5 mg/L,单个再生器官的种类将按如下的次序变化:营养芽,花序,花序分枝,花芽,花被片.这些规律性现象将被用于诱导一个给定的被子植物地上部分器官的直接再生.     

Evidence of Associations between Cytokine Genes and Subjective Reports of Sleep Disturbance in Oncology Patients and Their Family Caregivers

The purposes of this study were to identify distinct latent classes of individuals based on subjective reports of sleep disturbance; to examine differences in demographic, clinical, and symptom characteristics between the latent classes; and to evaluate for variations in pro- and anti-inflammatory cytokine genes between the latent classes. Among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM) was used to identify latent classes of individuals based on General Sleep Disturbance Scale (GSDS) obtained prior to, during, and for four months following completion of radiation therapy. Single nucleotide polymorphisms (SNPs) and haplotypes in candidate cytokine genes were interrogated for differences between the two latent classes. Multiple logistic regression was used to assess the effect of phenotypic and genotypic characteristics on GSDS group membership. Two latent classes were identified: lower sleep disturbance (88.5%) and higher sleep disturbance (11.5%). Participants who were younger and had a lower Karnofsky Performance status score were more likely to be in the higher sleep disturbance class. Variation in two cytokine genes (i.e., IL6, NFKB) predicted latent class membership. Evidence was found for latent classes with distinct sleep disturbance trajectories. Unique genetic markers in cytokine genes may partially explain the interindividual heterogeneity characterizing these trajectories.     

电针结合红外线照射对反复着床失败患者子宫内膜容受性、胚胎移植及妊娠情况的影响

目的:观察电针结合红外线照射对反复着床失败(RIF)患者子宫内膜容受性、胚胎移植及妊娠情况的影响。方法:选取102例于2015年5月-2018年5月在我院行复苏胚胎移植的RIF患者,按照随机数字表法将患者分为电针结合红外线照射治疗组(A组,38例)、安慰针刺组(B组,34例)及空白对照组(C组,30例)。比较三组治疗前后血清雌二醇、孕酮水平,于治疗前后检测子宫内膜容受性超声学指标,包括子宫内膜厚度、内膜容积、血管血流指数(VFI)、内膜血流指数(FI)、阻力指数(RI),比较三组胚胎移植及妊娠情况。结果:三组治疗前后血清雌二醇、孕酮水平比较无统计学差异(P0.05)。治疗后A组子宫内膜厚度、内膜容积大于治疗前及B组、C组,VFI、FI高于治疗前及B组、C组,RI低于治疗前及B组、C组(P0.05)。三组移植胚胎数、生化妊娠率、临床妊娠率比较无统计学差异(P0.05),A组胚胎着床率高于B组、C组(P0.05)。结论:电针结合红外线照射治疗RIF患者可以改善子宫内膜容受性,提高胚胎着床率。     

辅酶Q10联合金凤丸对体外授精-胚胎移植患者卵巢功能及子宫内膜容受性的影响

目的:探讨辅酶Q10联合金凤丸对体外授精-胚胎移植患者卵巢功能及子宫内膜容受性的影响。方法:选择2017年7月～2017年10月接诊的185例体外授精-胚胎移植患者进行研究,通过随机数表法将其分为观察组(n=95)和对照组(n=90)。对照组采用金凤丸进行治疗,观察组在对照组的基础上加用辅酶Q10进行治疗。治疗后,比较两组血清卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮(T)、雌二醇(E_2)、胰岛素(INS)、子宫内膜厚度、孕激素(P)水平、获卵数、受精率及妊娠率。结果:治疗后,两组患者血清FSH、LH、T、E_2、INS水平均较治疗前明显下降,且观察组以上指标水平均显著低于对照组(P0.05);两组患者子宫内膜厚度和血清P水平均较治疗前明显升高,且观察组以上指标均显著高于对照组(P0.05);两组患者获卵数无明显差异,观察组患者受精率、妊娠率均显著高于对照组(P0.05)。结论:辅酶Q10联合金凤丸可明显增加子宫内膜厚度,提高妊娠率。     

Associations between Red Cell Polymorphisms and Plasmodium falciparum Infection in the Middle Belt of Ghana

Background

Red blood cell (RBC) polymorphisms are common in malaria endemic regions and are known to protect against severe forms of the disease. Therefore, it is important to screen for these polymorphisms in drugs or vaccines efficacy trials. This study was undertaken to evaluate associations between clinical malaria and RBC polymorphisms to assess biological interactions that may be necessary for consideration when designing clinical trials.

Method

In a cross-sectional study of 341 febrile children less than five years of age, associations between clinical malaria and common RBC polymorphisms including the sickle cell gene and G6PD deficiency was evaluated between November 2008 and June 2009 in the middle belt of Ghana, Kintampo. G6PD deficiency was determined by quantitative methods whiles haemoglobin variants were determined by haemoglobin titan gel electrophoresis. Blood smears were stained with Giemsa and parasite densities were determined microscopically.

Results

The prevalence of clinical malarial among the enrolled children was 31.9%. The frequency of G6PD deficiency was 19.0% and that for the haemoglobin variants were 74.7%, 14.7%, 9.1%, 0.9% respectively for HbAA, HbAC, HbAS and HbSS. In Multivariate regression analysis, children with the HbAS genotype had 79% lower risk of malaria infection compared to those with the HbAA genotypes (OR = 0.21, 95% CI: 0.06–0.73, p = 0.01). HbAC genotype was not significantly associated with malaria infection relative to the HbAA genotype (OR = 0.70, 95% CI: 0.35–1.42, p = 0.33). G6PD deficient subgroup had a marginally increased risk of malaria infection compared to the G6PD normal subgroup (OR = 1.76, 95% CI: 0.98–3.16, p = 0.06).

Conclusion

These results confirm previous findings showing a protective effect of sickle cell trait on clinical malaria infection. However, G6PD deficiency was associated with a marginal increase in susceptibility to clinical malaria compared to children without G6PD deficiency.