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Objective To evaluate the epigenetic risk linked to assisted reproductive technology at oocyte level by analyzing methylation status of imprinted H19, PEG1 and KvDMR1 in human MII oocytes rescue-matured from MI/GV oocytes after long agonist stimulation. Study design 580 MI/GV oocytes from 275 patients receiving an ICSI procedure were additionally cultured for 24 h, and 221 rescue-matured MII oocytes were obtained. Pyrosequencing with confirmatory routine bisulfite sequencing were used to determine the methylation status of H19 DMR in 35 oocytes, PEG1 DMR in 47 oocytes, and KvDMR1 in 34 oocytes. Results Abnormal methylation status were found in 22.9% oocytes at H19 DMR, 17.0% oocytes at PEG1 DMR and 8.8% oocytes at KvDMR1 . Conclusion We hypothesize that the use of MII-rescue oocytes may increase the risk of imprinting defects because they might not have completed full imprinting programme.

Background The role of cell-cycle protein cyclin D1 in lung cancer remains controversial. To clarify its impact on survival in non-small-cell lung cancer (NSCLC), we performed a meta-analysis on the currently available medial literature to quantitatively assess its role on survival of NSCLC according to cyclin D1 status. Method Published studies that investigated the association between cyclin D1 expression and NSCLC survival were identified. Meta-analysis was performed by using a DerSimonian-Laird model. Funnel plot was used to investigate publication bias and sources of heterogeneity were identified by using meta-regression analysis. Result A total of 24 studies with 2731 patients were evaluable for this meta-analysis. No statistical significance was found that cyclin D1 expression was associated with poor prognosis in NSCLC (hazard ratio 1.08 [95% CI, 0.80-1.45]) without publication bias found. But there was significant heterogeneity present; meta-regression analysis was used to explore the sources of heterogeneity and revealed that the outcome of analysis was influenced by cutoff values and ethnicity. No difference between positive and negative studies on study quality assessment was present. Conclusion The cyclin D1 expression is unlikely to be useful as a prognostic marker for NSCLC in clinical practice from current evidence. The conclusion should be confirmed by a large well-designed prospective study.

To evaluate the effect of elevated basal follicle-stimulating hormone (FSH) on both the quantity and quality of oocytes and embryos and the clinical outcomes of pregnancy in women under 35 years of age.A retrospective analysis was conducted for inspecting 294 in vitro fertilization-embryo transfer (IVF-ET) cycles in women under 35 years of age. According to the basal FSH levels, the women were divided into groups A, B, and C with basal FSH of 10-14.99, 15-19.99 and ≥20 IU/L, respectively, to compare the average number of oocytes retrieved, morphologies of the oocytes and embryos, and clinical outcomes of pregnancy.Group A showed greater average numbers of oocytes collected, total embryos and good-quality embryos with a lower gonadotrophin dose required to achieve follicular maturity than groups B and C. The 3 groups showed no significant differences in the percentage of metaphase II oocytes, optimal embryos-blastomere number, normal fertilization rate, cleavage rate, good-quality embryo rate, implantation rate, pregnancy rates, live birth rate or miscarriage rate, but the pregnancy rates and live birth rate tended to decrease in women with basal FSH ≥15 U/L.In women below 35 years of age, an elevated serum FSH (especially one ≥15 U/L) indicates diminished ovarian reserve and reduced numbers of oocyte and embryo but not poor oocyte or embryos quality, and good clinical pregnancy rate can still be expected.

To study the value of basal antral follicle count (AFC) and age in predicting ovarian response and clinical outcome of in vitro fertilization-embryo transfer (IVF-ET).A total of 1319 oocyte retrieval cycles in women with an AFC≤10 and complete IVF/ICSI cycles were analyzed retrospectively. According to the AFC, the patients were divided into groups A, B, and C with AFC≤4, of 5-7, and of 8-10, respectively, and each was further divided into38 years old group and ≥38 years old group. The oocytes retrieved, ovarian response, implantation rate, cancellations, pregnancy, pregnancy loss, and live births were evaluated.As the AFC increased, the total gonadotrophin (Gn) dose increased and the follicles aspirated and oocytes retrieved decreased significantly (P0.001). Patients below 38 years of age had a lower total Gn dose and more follicles aspirated and oocytes retrieved than older patients. An AFC7 and age≥38 years was associated with significantly lower total Gn dose, greater number of follicles aspirated and oocytes retrieved, and lower pregnancy rate than an AFC≤7 and age38 years (P0.05). Bivariate correlation and linear regression analysis identified AFC as the best single predictor of ovarian response in IVF. The pregnancy rate differed significantly between the 3 groups, and older patients (≥38 years) had higher early miscarriage rate.Antral follicle count≤7 or age≥38 years old with AFC≤10 is the suitable threshold of diminished ovarian reserve in controlled ovarian stimulation for infertile women. Combination of AFC and age is the best predictor of ovarian response in IVF. Age has a better predictive value of pregnancy rate than AFC. AFC influences mainly the oocytes quantity, while age also affects oocyte quality.

Objective To evaluate the epigenetic risk linked to assisted reproductive technology (ART) by analyzing the methylation patterns of imprinted PEG1 gene in aborted human chorionic villus. Design Experimental research study. Setting Research laboratory. Patient(s) Four patients groups were tested: spontaneous abortion after ART (n = 44), multifetal reduction after ART (n = 22), spontaneous abortion of natural pregnancies (n = 45), and induced abortion of natural pregnancies (n = 47). Intervention(s) Methylation patterns of PEG1 in the aborted chorionic villus were determined. Main Outcome Measure(s) The DNA methylation patterns were analyzed using pyrosequencing and bisulfite sequencing polymerase chain reaction. The percentage of methylation was compared in chorionic villus from the four experimental groups. Result(s) Regardless of conception method, the PEG1 methylation percentage in chorionic villus from spontaneous abortions was significantly higher than in villus from induced abortions and multifetal reduction. In the spontaneous abortions groups, the percent methylation of PEG1 was similar in the villus derived from ART and from natural pregnancies. The two fertilization methods (IVF and intracytoplasmic sperm injection) did not show significant differences either. However, receiver operating characteristic curve analysis revealed a significant positive correlation between PEG1 methylation percentage and rate of early spontaneous abortions. Conclusion(s) As some studies have suggested, imprinting errors of PEG1 may contribute to spontaneous abortion, but ART procedures might not increase the occurrence of aberrant PEG1 methylation patterns.

To investigate the technique of the suprameatal approach for cochlear implantation in Chinese profound sensory hearing loss children.Suprameatal approach for cochlear implantation were used in 50 cases (total 53 ears) with profound sensory hearing loss from May 2005 to January 2007. The electrode was passed through the suprameatal tunnel and went between the incus and chorda tympani into the scala tympani.Electrodes were completely inserted in 51 ears. There were no postoperative complications in all cases. Although the long effect need to be observed, all cases received better hearing and speech development benefit from cochlear implantation in the follow-up period. Among the 50 cases, 26 had speech perception in the open condition; 18 patients could speak short sentences although not clearly; and 6 patients learned to speak individual words only.The suprameatal approach was found to be a simple and safe technique that does not need mastoidectomy and avoid endangering the facial nerve and the chorda tympani. It enables wide exposure of middle ear and is especially suitable for cases with narrow facial recess or anteriorly located facial nerve.

To investigate the methods of preoperative diagnosis and differentiation of different pathological tissue in middle ear and mastoid.The temporal bone lamellar CT findings in 106 patients with chronic suppurative otitis media (including cholesteatoma) were retrospectively analyzed. The CT value of pathological tissue were measured for 183 times and were compared with the surgical findings and postoperative pathological findings to definitude the CT value range of different pathological tissue. Sixty patients taken from 106 patients at random were analyzed and made the diagnosis again by the same doctor team according to the CT value of the different pathological tissue and surrounding histoclasia resulted by pathological tissue. The diagnose accordance rate was compared with the routine diagnose report from radiology department. The predetective diagnosis was made in 10 patients with chronic suppurative otitis media according to clinical manifestation (pathological changes of tympanic membrane, nature of otorrhea, character of hearing), temporal bone lamellar CT finding (CT value of pathological tissue, surrounding histoclasia) to validate the value of this study for preoperative diagnosis and differentiation of different pathological tissue in middle ear and mastoid.The CT value of cholesteatoma, granulation tissue, cholesteatoma combined with granulation tissue, effusion, calcified tissue, thickened and polypoid membrane was respectively (46.6 +/- 10.3) Hu, (26.6 +/-7.4) Hu, (42.1 +/- 11.4) Hu, (- 24.6 +/- 9.2) Hu, (223.6 +/- 63.7) Hu, (23.8 +/- 8.5) Hu. The diagnose accordance rate in 60 patients who were analyzed and made diagnosis again according to the CT value of the different pathological tissue and surrounding histoclasia resulted by pathological tissue raised from 68. 3% to 81.7% ( P0.05) . The predetective diagnose accordance rate reached at 90% according to clinical manifestation, temporal bone lamellar CT.It was not reliable to diagnose and differentially diagnose different pathological tissue in middle ear and mastoid only by the CT value, however, the CT value could still be considered to be a very significant information. The accurate rates of diagnosis and differentiation of different pathological tissue in middle ear and mastoid obviously raised by synthetically analyzing various kinds of pathological tissues in middle ear and mastoid according to clinical manifestation, temporal bone lamellar CT finding.