ObjectiveTo systematically review the clinical effects of short-term and conventional fertilization for vitro fertilization-embryo transfer (IVF-ET). MethodsRandomized controlled trials (RCTs) about the clinical effects of short-term fertilization versus conventional fertilization for IVF-ET were searched in PubMed, The Cochrane Library (Issue 8, 2014), CBM, CNKI, WanFang Data and VIP from inception to August 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of six RCTs involving 1 373 patients were finally included. The results of meta-analysis indicated that:short-term fertilization was superior to conventional fertilization in increasing high quality embryo rates (OR=1.42, 95%CI 1.18 to 1.70, P=0.000 2) as well as clinical pregnancy rates (OR=1.67, 95%CI 1.33 to 2.09, P < 0.000 01). However, the two groups were alike in fertilization rates, polyspermy rates, and miscarriage rates. ConclusionCurrent evidence indicates that short-term fertilization is superior to conventional fertilization in increasing high quality embryo rates as well as clinical pregnancy rates. Due to limited quality and quantity of the included studies, the above conclusion should be verified by conducting more large-scale, high quality RCTs with long-term follow-up.
ObjectiveTo investigate the clinical manifestations, diagnosis and treatment of diaphrammatic paralysis (DP) in infants with congenital heart disease (CHD) after cardiac surgery. MethodsBetween October 2008 and June 2014, among 2 962 infant patients ( < 1 year) underwent cardiac surgery for congenital heart disease, postoperative DP was diagnosed in 31 patients. The paralysed hemidiaphragm was left side in 10 patients, right side in 15 patients, and bilateral in 6 patients. There were 22 males and 9 females. The age at operation was 1-12 (4.5±4.2) months on the average. The body weight at operation was 2.9 to 8.5 (5.6±2.2) kg on the average.All children received mechanical ventilation. ResultsNo patient died in this study.There was a statistical difference between preoperative and postoperative mechanical ventilation time at 123-832 (420±223) hours versus 15-212 (75±58) hours (P < 0.05). ConclusionsDP caused by phrenic nerve injury during surgical intervention for congenital heart disease is an important risk factor in terms of morbidity during the postoperative period. Diaphragmatic plication appears a good option, especially in infant children, to wean patients from mechanical ventilation and to prevent long-term side effects of mechanical ventilation.