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Background:. Existing clinical prediction models for in vitro fertilization are based on the fresh oocyte cycle, and there is no prediction model to evaluate the probability of successful thawing of cryopreserved mature oocytes. This research aims to identify and study the characteristics of pre-oocyte-retrieval patients that can affect the pregnancy outcomes of emergency oocyte freeze-thaw cycles. Methods:. Data were collected from the Reproductive Center, Peking University Third Hospital of China. Multivariable logistic regression model was used to derive the nomogram. Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test and calibration plots. Results:. The predictors in the model of “no transferable embryo cycles” are female age (odds ratio [OR] = 1.099, 95% confidence interval [CI] = 1.003–1.205, P = 0.0440), duration of infertility (OR = 1.140, 95% CI = 1.018–1.276, P = 0.0240), basal follicle-stimulating hormone (FSH) level (OR = 1.205, 95% CI = 1.051–1.382, P = 0.0084), basal estradiol (E2) level (OR = 1.006, 95% CI = 1.001–1.010, P = 0.0120), and sperm from microdissection testicular sperm extraction (MESA) (OR = 7.741, 95% CI = 2.905–20.632, P 10 mm on the day of hCG administration.

Background. Generic drugs are bioequivalent to their brand-name counterparts; however, concerns still exist regarding the effectiveness and safety of generic drugs because of small sample sizes and short follow-up time in most studies. The purpose of this study was to evaluate the long-term antihypertensive efficacy, cost-effectiveness and cardiovascular outcomes of generic drugs compared with brand-name drugs. Methods. In a multicenter, community-based study including 7955 hypertensive patients who were prospectively followed up for an average of 2.5 years, we used the propensity-score-matching method to match the patients using brand-name drugs to those using generic drugs in a ratio of 1:2, 2176 patients using brand-name drugs and 4352 patients using generic drugs. Results. There were no significant differences between generic drugs and brand-name drugs in blood pressure (BP)-lowering efficacy, BP control rate, and cardiovascular outcomes including coronary heart disease and stroke. The adjusted mean (95% confidence interval [CI]) of systolic BP (SBP)-lowering was –7.9 mmHg (95% CI, –9.9 to –5.9) in the brand-name drug group and –7.1 mmHg (95% CI, –9.1 to –5.1) in the generic drug group after adjusting for age, sex, body mass index, number of antihypertensive drugs and traditionally cardiovascular risk factors. Among patients aged

Background: Significant blood loss is still one of the most frequent complications in spinal surgery, which often necessitates blood transfusion. Massive perioperative blood loss and blood transfusion can create additional risks. Aprotinin, tranexamic acid (TXA), and epsilon-aminocaproic acid (EACA) are antifibrinolytics currently offered as prophylactic agents to reduce surgery-associated blood loss. The aim of this study was to evaluate the efficacy and safety of aprotinin, EACA, and low/high doses of TXA in spinal surgery, and assess the use of which agent is the most optimal intervention using the network meta-analysis (NMA) method. Methods: Five electronic databases were searched, including PubMed, Cochrane Library, ScienceDirect, Embase, and Web of Science, from the inception to March 1, 2018. Trials that were randomized and compared results between TXA, EACA, and placebo were identified. The NMA was conducted with software R 3.3.2 and STATA 14.0. Results: Thirty randomized controlled trial (RCT) studies were analyzed. Aprotinin (standardized mean difference [SMD]=－0.65, 95% credibility intervals [CrI;－1.25, －0.06]), low-dose TXA (SMD=－0.58, 95% CrI [－0.92, －0.25]), and high-dose TXA (SMD= －0.70, 95% CrI [－1.04, －0.36]) were more effective than the respective placebos in reducing intraoperative blood loss. Low-dose TXA (SMD=－1.90, 95% CrI [－3.32, －0.48]) and high-dose TXA (SMD=－2.31, 95% CrI [－3.75, －0.87]) had less postoperative blood loss. Low-dose TXA (SMD=－1.07, 95% CrI [－1.82, －0.31]) and high-dose TXA (SMD=－1.07, 95% CrI [－1.82, －0.31]) significantly reduced total blood loss. However, only high-dose TXA (SMD = －2.07, 95% CrI [－3.26, －0.87]) was more effective in reducing the amount of transfusion, and was significantly superior to low-dose TXA in this regard (SMD= －1.67, 95% CrI [－3.20, －0.13]). Furthermore, aprotinin (odds ratio [OR]= 0.16, 95% CrI [0.05, 0.54]), EACA (OR= 0.46, 95% CrI [0.22, 0.97]) and high dose of TXA (OR= 0.34, 95% CrI [0.19, 0.58]) had a significant reduction in transfusion rates. Antifibrinolytics did not show a significantly increased risk of postoperative thrombosis. Results of ranking probabilities indicated that high-dose TXA had the greatest efficacy and a relatively high safety level. Conclusions: The antifibrinolytic agents are able to reduce perioperative blood loss and transfusion requirement during spine surgery. And the high-dose TXA administration might be used as the optimal treatment to reduce blood loss and transfusion. Key words: Antifibrinolytics; Spine surgery; Blood loss; Transfusion; Network meta-analysis

Supplemental Digital Content is available in the text, Background Despite the growing epidemic of heart failure (HF), there is limited data available to systematically compare non-cardiac comorbidities in the young-old, old-old, and oldest-old patients hospitalized for HF. The precise differences will add valuable information for better management of HF in elderly patients. Methods A total of 1053 patients aged 65 years or older hospitalized with HF were included in this study. Patients were compared among three age groups: (1) young-old: 65 to 74 years, (2) old-old: 75 to 84 years, and (3) oldest-old: ≥85 years. Clinical details of presentation, comorbidities, and prescribed medications were recorded. Results The mean age was 76.7 years and 12.7% were 85 years or older. Most elderly patients with HF (97.5%) had at least one of the non-cardiac comorbidities. The patterns of common non-cardiac comorbidities were different between the young-old and oldest-old group. The three most common non-cardiac comorbidities were anemia (53.6%), hyperlipidemia (45.9%), and diabetes (42.4%) in the young-old group, while anemia (73.1%), infection (58.2%), and chronic kidney disease (44.0%) in the oldest-old group. Polypharmacy was observed in 93.0% elderly patients with HF. Additionally, 29.2% patients were diagnosed with infection, and 67.0% patients were prescribed antibiotics. However, 60.4% patients were diagnosed with anemia with only 8.9% of them receiving iron repletion. Conclusions Non-cardiac comorbidities are nearly universal in three groups but obviously differ by age, and inappropriate medications are very common in elderly patients with HF. Further treatment strategies should be focused on providing optimal medications for age-specific non-cardiac conditions.

Background: Luteal support is a key to patients undergoing in vitro fertilization and embryo transfer (IVF-ET) with gonadotropin-releasing hormone (GnRH)-antagonist protocol. This study aimed to compare the effect between vaginal progesterone (VP) and intramuscular progesterone (IMP) with GnRH-antagonist protocol after IVF-ET. Methods: A total of 1760 patients (18 years ≤ age ≤35 years) undergoing IVF-ET with GnRH-antagonist protocol were studied retrospectively between September 2014 and August 2015 in Peking University Third Hospital. In the patients, 1341 patients received VP (VP group) and 419 patients received IMP (IMP group) as luteal support. We compared clinical outcomes between these two groups. The primary objective of the study was the live birth rate. Measurement data between the two groups were conducted using independent samples t-test. The variables in line with non-normal distribution were expressed as median (p25 and p75) and were compared using nonparametric Mann–Whitney U-test. Results: Live birth rate in VP group was 38.55%, significantly higher than that in the IMP group, which was 30.79% (χ2 = 8.287, P = 0.004). The clinical intrauterine pregnancy rate and implantation rate in VP group were also significantly higher than those in the IMP group (clinical intrauterine pregnancy rate 47.35% vs. 41.29%, χ2 = 4.727, P = 0.030; implantation rate 30.99% vs. 25.26%, χ2 = 14.546, P < 0.001). Any statistically significant differences in ectopic pregnancy and abortion rates between two groups were not observed. Conclusion Luteal support with VP had better clinical outcomes for young women undergoing IVF-ET with GnRH-antagonist protocol.

Task-based measurement (TBM) is a method to assess the eight-hour A-weighted equivalent noise exposure level (L(Aeq.8h)) besides dosimeter. TBM can be better used in factories by non-professional workers and staffs. However, it is still not clear if TBM is equal or similar with dosimeter for L(Aeq.8h) measurement in general. This study considered the measurement with dosimeter as real personal noise exposure level (PNEL) and assessed the accuracy of TBM by comparing the consistencies of TBM and dosimeter in L(Aeq.8h) measurement.The study was conducted in one automobile firm among 387 workers who are exposed to unstable noise. Dosimeters and TBM were used to compare the two strategies and assess the degree of agreement and causes of disagreement. Worker's PNEL was measured via TBM for noise; the real PNEL was also recorded. The TBM for noise was computed with task/position noise levels measured via sound level meter and workers' exposure information collected via working diary forms (WDF) filled by participants themselves. Full-shift noise exposure measurement via personal noise dosimeters were taken as the real PNEL. General linear model (GLM) was built to analyze the accuracy of TBM for noise and the source of difference between TBM for noise and real PNEL.The L(Aeq.8h) with TBM were slightly higher than the real PNELs, except the electricians. Differences of the two values had statistical significance in stamping workers (P0.001), assembly workers (P = 0.015) and welding workers (P = 0.001). The correlation coefficient of L(Aeq.8h) with TBM and real PNELs was 0.841. Differences of the two results were mainly affected by real PNEL (F = 11.27, P = 0.001); and work groups (F = 3.11, P0.001) divided by jobs and workshops were also independent factors. PNEL of workers with fixed task/position ((86.53 ± 8.82) dB(A)) was higher than those without ((75.76 ± 9.92) dB(A)) (t = 8.84, P0.01). Whether workers had fixed task/position was another factor on the accuracy of TBM for noise (F = 4.36, P = 0.038).TBM for noise has acceptable accuracy on workers' PNEL measurement. The accuracy is affected by job categories, workshops and variability of task/position. TBM for noise can yield a relatively conservative result of worker's PNEL in most cases, so it can be used to measure and assess workers' real PNEL.

To further confirm and clarify the risk factors of melamine associated urolithiasis.Case control research was performed in 6 centers from 5 provinces/cities in China. Children less than 36 months old were screened for urolithiasis and recruited in the study. The children with urolithiasis were included as cases and those without urolithiasis as controls. The children with congenital abnormality of urinary tract were excluded. According to the case:control ratios of 1:1, we sampled the controls from healthy children screened randomly. Due to the complete missing data on factors of vomiting/diarrhea/fever in control group of Center 4, we analyzed the data from 6 centers and 5 centers respectively. The possible influencing factors for urolithiasis including melamine concentration, birth type, age, feeding style and history of vomiting or diarrhea or fever were analyzed by Logistic analysis.There were 1 329 cases and 1 317 controls with a mean age of 18.4 months. The analysis of data from 6 centers showed the children fed with high melamine formula were 6.26 times more likely to have stones (P0.01) than those with non melamine formula. Preterm infants were 2.03 times (P0.01) more likely to have urolithiasis than term infants. The children aged less than 0.5 year, 0.5 to 1 year, 1 to 2 year, 2 to 2.4 year were 2.78 (P0.01), 2.61 (P0.01), 2.09 (P0.01), 1.57 (P0.01), 1.44 (P0.05) times more likely to have stones than those more than 2.5 year. Boys were 1.19 times more likely to have stones than girls. Children fed with formula alone were 1.94 times (P0.01) more likely to have stones than those with formula and breast milk. The analysis of data from 5 centers showed that children fed with high melamine formula were 4.38 times (P0.01) more likely to have stones compared with those with non melamine formula. Children aged less than 1 year and 1 to 1.9 year were 2.24 (P0.01) and 1.31 (P0.05) times more likely to have stones than those more than 2 year. The children fed with formula alone were 1.67 times (P0.01) more likely to have stones compared to those with formula and breast milk. The children with any two symptoms of vomiting, diarrhea and fever were 15.21 times (P0.05) more likely to have urolithiasis. The multiple logistic regression model confirmed that above risk factors were independent risk factors for urolithiasis.We confirm that the children fed with high melamine infant formula, preterm infant, boy, children fed with formula alone, and the children with symptoms of vomiting or diarrhea or fever are more likely to have urolithiasis. We also found the risk for urolithiasis decreased with age.