Objective:To investigate the effect of the transfer of blastocysts that have not re-expanded after 2-4 h of thawing on pregnancy and neonatal outcomes.Methods:A retrospective cohort study was performed to analyze the clinical data from 2 428 vitrified frozen-thawed single blastocyst transfer cycles at the Reproductive Medicine Center of the 901st Hospital of the Joint Logistics Support Force of PLA between January 2015 and March 2024. Based on the re-expansion status of the blastocoel cavity after thawing, the cycles were divided into group A (110 non-re-expanded) and group B (2 318 re-expanded). After propensity score matching, there were 109 cycles in each group. Pregnancy and neonatal outcomes between the two groups were compared.Results:Before propensity score matching, there were statistical differences in percentage of good-quality blastocyst transfer, percentage of degree 4 blastocyst, percentage of endometriosis and others in reasons for infertility between the two groups (all P<0.05). After propensity score matching, there were no statistical differences in baseline characteristics between the two groups (all P>0.05). The clinical pregnancy rate [27.52% (30/109)], the ongoing pregnancy rate [21.10% (23/109)] and the live birth rate [19.27% (21/109)] in group A were all significantly lower than those in group B [61.47% (67/109), 51.38% (56/109), 47.70% (52/109), all P<0.001]. Neonatal outcomes showed no statistically significant differences between the two groups in terms of birth weight, neonatal length, malformation rate, monozygotic twin rate and male neonatal rate (all P>0.05). Conclusion:Transfer of non-re-expanded blastocysts after thawing may reduce clinical pregnancy rate but does not negatively affect neonatal outcomes.

Objective Exploring the diagnostic value of T-cell enzyme-linked immunospot assay(T-SPOT.TB)combined with rifampicin-resistant Mycobacterium tuberculosis real-time fluorescence quantitative nucleic acid ampli-fication detection(XpertMTB/RIF)in geriatric AIDS patients with Mycobacterium tuberculosis(MTB)infection.Methods From May 2022 to May 2024,86 elderly patients with AIDS suspected MTB in Hengshui Third People's Hospital were gathered and separated into AIDS complicated with MTB(research group)and AIDS without MTB(control group)according to the pathological examination results.MTB culture,T-SPOT.TB and XpertMTB/RIF were performed.Kappa analysis was applied to evaluate the consistency between T-SPOT.TB combined with Xpert-MTB/RIF and the gold standard for diagnosing MTB coinfection in AIDS patients.ROC curve and four grid table were plotted to analyze the value of the combination of T-SPOT.TB and XpertMTB/RIF in the diagnosis of AIDS complicated with MTB infection.Results The blood γ-interferon,the positive detection rates of T-SPOT.TB and XpertMTB/RIF in the research group were higher than those in the control group(P＜0.05).The AUC of T-SPOT.TB in diagnosing AIDS with MTB infection was 0.810,that of Xpert MTB/RIF in diagnosing AIDS with MTB infection was 0.835,and the AUC of the two in diagnosing AIDS with MTB infection was 0.910.The Kappa values of T-SPOT.TB,Xpert MTB/RIF and their combined diagnosis for AIDS with MTB infection were 0.624,0.674 and 0.825,respectively.The accuracy of T-SPOT.TB in the diagnosis of AIDS with MTB was 82.56%,the accuracy of XpertMTB/RIF in the diagnosis of AIDS with MTB was 84.88%,and the accuracy of the combined di-agnosis for AIDS with MTB was 91.86%.Conclusions T-SPOT.TB combined with XpertMTB/RIF can improve the accuracy of diagnosis of AIDS with MTB,and can be used as a clinical auxiliary diagnosis method for AIDS pa-tients complicated with MTB.

Objective:To investigate the effect of the transfer of blastocysts that have not re-expanded after 2-4 h of thawing on pregnancy and neonatal outcomes.Methods:A retrospective cohort study was performed to analyze the clinical data from 2 428 vitrified frozen-thawed single blastocyst transfer cycles at the Reproductive Medicine Center of the 901st Hospital of the Joint Logistics Support Force of PLA between January 2015 and March 2024. Based on the re-expansion status of the blastocoel cavity after thawing, the cycles were divided into group A (110 non-re-expanded) and group B (2 318 re-expanded). After propensity score matching, there were 109 cycles in each group. Pregnancy and neonatal outcomes between the two groups were compared.Results:Before propensity score matching, there were statistical differences in percentage of good-quality blastocyst transfer, percentage of degree 4 blastocyst, percentage of endometriosis and others in reasons for infertility between the two groups (all P<0.05). After propensity score matching, there were no statistical differences in baseline characteristics between the two groups (all P>0.05). The clinical pregnancy rate [27.52% (30/109)], the ongoing pregnancy rate [21.10% (23/109)] and the live birth rate [19.27% (21/109)] in group A were all significantly lower than those in group B [61.47% (67/109), 51.38% (56/109), 47.70% (52/109), all P<0.001]. Neonatal outcomes showed no statistically significant differences between the two groups in terms of birth weight, neonatal length, malformation rate, monozygotic twin rate and male neonatal rate (all P>0.05). Conclusion:Transfer of non-re-expanded blastocysts after thawing may reduce clinical pregnancy rate but does not negatively affect neonatal outcomes.

The monitoring unit used in the nuclear magnetic resonance system,as an important unit of the system,faces a high thermal risk during its entire life cycle.This paper ensures the high efficiency and reliability of the thermal design of the product module from the two dimensions of structural design and device derating design.In order to reduce the risk of thermal design of electronic modules and comprehensively verify the effectiveness of thermal design of electronic modules,the design verification is carried out by combining simulation and experiment.In the simulation process,by establishing a thermal simulation model at the circuit board level,the crustal temperature of the core device is numerically calculated,and the index is compared with the thermal design index value and the test value,on the one hand,to verify the correctness of the simulation model.On the other hand,the validity of thermal design is verified.In the testing process,a thermal test platform for product modules is built,and the thermal characteristics test values of the core components of the module under extreme electrical conditions are obtained,and the corresponding conversion methods are used to predict the thermal performance and thermal design margin of the product at different altitudes.The results show that the electronic module can meet the thermal design requirements in terms of structural design and derating design of core components,and can ensure that the product module can work safely and reliably during the entire life cycle of the NMR system.

Objective:To investigate the clinical value of single embryo transfer for the patients with gonadotropin-releasing hormone (GnRH) antagonist protocol.Methods:The clinical data of the patients underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in Reproductive Medicine Center, the 901th Hospital of the Joint Logistics Support Force of PLA from January 2017 to March 2021 were retrospectively analyzed in this cohort study. According to the days of embryo development and No. of embryos, patients were divided into day 3 (D3) single top-quality cleavage-stage embryo transfer group (single top-quality embryo group), D3 double top-quality cleavage-stage embryo transfer group (double top-quality embryos group), and single blastocyst transfer group. In fresh cycles, there were 301 patients in single top-quality embryo group, 253 patients in double top-quality embryos group and 127 patients in single blastocyst group in frozen-thawed embryo transfer (FET) cycles,there were 84 patients in single top-quality embryo group, 136 patients in double top-quality embryos group and 396 patients in single blastocyst group in first FET cycles after all embryos frozen,there were 69 patients in single top-quality group and 161 patients in single blastocyst group. The rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy in the fresh and FET cycles were compared among single top-quality embryo group, double top-quality embryos group and single blastocyst group. Also, the rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy of single top-quality embryo transfer and single blastocyst transfer were compared between the fresh cycle and the first FET cycle. One-way ANOVA and chi-square test were used in this study. Results:There were no significant difference in duration of infertility, body mass index (BMI), the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, anti-Müllerian hormone (AMH), gonadotropin (Gn) and the numbers of oocytes retrieved among all the groups (all P>0.05). There were no significant differences in the rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy between single top-quality embryo group and single blastocyst group (all P>0.05) in fresh cycle, while the clinical pregnancy rate [46.18% (139/301)], the ongoing pregnancy rate [40.86% (123/301)] and the multiple pregnancy rate [0% (0/139)] in single top-quality embryo group were significantly lower than those in double top-quality embryos group [58.89% (149/253), P<0.001; 52.17% (132/253), P<0.001; 30.20% (45/149), P<0.001], with the similar implantation rate between the two groups ( P>0.016 7). The rates of clinical pregnancy, implantation and ongoing pregnancy were comparable between single top-quality embryo group and double top-quality embryos group in FET cycle ( P>0.016 7), while which were all significantly lower than those in single blastocyst group [62.88% (249/396), P<0.001; 63.89% (253/396), P<0.001; 55.30% (219/396), P<0.001]. The multiple pregnancy rate of double top-quality embryos group [20.37% (11/54)] was significantly higher than that of single top-quality embryo group [0% (0/27), P=0.013] in FET cycle. The ongoing pregnancy rate of the single top-quality embryo transfer in first FET cycle [27.54% (19/69)] was significantly lower than that in fresh cycle [40.86% (123/301), P=0.040], while the clinical pregnancy rate [63.35% (102/161)] and the implantation rate [63.98% (103/161)] of single blastocyst transfer in first FET cycle were significantly higher than those in fresh cycle [50.39% (64/127), P=0.027; 51.97% (66/127), P=0.040]. Conclusion:The clinical outcomes of D3 single top-quality cleavage-stage embryo transfer were similar to D5 single blastocyst transfer in fresh cycle, while the clinical outcomes of single blastocyst transfer in FET cycle were better compared with fresh cycle for the patients with GnRH antagonist protocol. Single embryo transfer can significantly reduce the multiple pregnancy rate of IVF/ICSI .

Objective:To investigate the clinical value of single embryo transfer for the patients with gonadotropin-releasing hormone (GnRH) antagonist protocol.Methods:The clinical data of the patients underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in Reproductive Medicine Center, the 901th Hospital of the Joint Logistics Support Force of PLA from January 2017 to March 2021 were retrospectively analyzed in this cohort study. According to the days of embryo development and No. of embryos, patients were divided into day 3 (D3) single top-quality cleavage-stage embryo transfer group (single top-quality embryo group), D3 double top-quality cleavage-stage embryo transfer group (double top-quality embryos group), and single blastocyst transfer group. In fresh cycles, there were 301 patients in single top-quality embryo group, 253 patients in double top-quality embryos group and 127 patients in single blastocyst group in frozen-thawed embryo transfer (FET) cycles,there were 84 patients in single top-quality embryo group, 136 patients in double top-quality embryos group and 396 patients in single blastocyst group in first FET cycles after all embryos frozen,there were 69 patients in single top-quality group and 161 patients in single blastocyst group. The rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy in the fresh and FET cycles were compared among single top-quality embryo group, double top-quality embryos group and single blastocyst group. Also, the rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy of single top-quality embryo transfer and single blastocyst transfer were compared between the fresh cycle and the first FET cycle. One-way ANOVA and chi-square test were used in this study. Results:There were no significant difference in duration of infertility, body mass index (BMI), the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, anti-Müllerian hormone (AMH), gonadotropin (Gn) and the numbers of oocytes retrieved among all the groups (all P>0.05). There were no significant differences in the rates of clinical pregnancy, implantation, multiple pregnancy, early abortion and ongoing pregnancy between single top-quality embryo group and single blastocyst group (all P>0.05) in fresh cycle, while the clinical pregnancy rate [46.18% (139/301)], the ongoing pregnancy rate [40.86% (123/301)] and the multiple pregnancy rate [0% (0/139)] in single top-quality embryo group were significantly lower than those in double top-quality embryos group [58.89% (149/253), P<0.001; 52.17% (132/253), P<0.001; 30.20% (45/149), P<0.001], with the similar implantation rate between the two groups ( P>0.016 7). The rates of clinical pregnancy, implantation and ongoing pregnancy were comparable between single top-quality embryo group and double top-quality embryos group in FET cycle ( P>0.016 7), while which were all significantly lower than those in single blastocyst group [62.88% (249/396), P<0.001; 63.89% (253/396), P<0.001; 55.30% (219/396), P<0.001]. The multiple pregnancy rate of double top-quality embryos group [20.37% (11/54)] was significantly higher than that of single top-quality embryo group [0% (0/27), P=0.013] in FET cycle. The ongoing pregnancy rate of the single top-quality embryo transfer in first FET cycle [27.54% (19/69)] was significantly lower than that in fresh cycle [40.86% (123/301), P=0.040], while the clinical pregnancy rate [63.35% (102/161)] and the implantation rate [63.98% (103/161)] of single blastocyst transfer in first FET cycle were significantly higher than those in fresh cycle [50.39% (64/127), P=0.027; 51.97% (66/127), P=0.040]. Conclusion:The clinical outcomes of D3 single top-quality cleavage-stage embryo transfer were similar to D5 single blastocyst transfer in fresh cycle, while the clinical outcomes of single blastocyst transfer in FET cycle were better compared with fresh cycle for the patients with GnRH antagonist protocol. Single embryo transfer can significantly reduce the multiple pregnancy rate of IVF/ICSI .

Objective:To investigate the effects of blastulation and transferred blastocyst derived from the 4-5-cell grade I to III (4/I-5/III) embryos on day 3 on clinical outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods:A total of 884 IVF cycles with blastocyst culture in the 901st Hospital of the Joint Logistics Support Force of PLA from January 2016 to February 2019 were retrospectively analyzed. The blastocyst formation status was compared among the 4/I-5/III embryos. Blastocyst derived from 4/I-5/III embryos in transfer cycle was served as group A ( n=164), blastocyst derived from good-quality cleavage stage embryos (7/I-10/II) in transfer cycle was served as group B ( n=247) according to quality of cleavage stage embryos on day 3. The clinical outcomes were compared between the two groups. The effects of different blastomere number and grade on clinical pregnancy rate and spontaneous abortion rate were evaluated among the 4/I-5/III embryos. Results:Good-quality blastulation rate for 4/I, 4/II, 4/III, 5/I, 5/II and 5/III were 5.6%, 1.8%, 0.6%, 8.3%, 8.4% and 1.6%, respectively. The differences reached statistical significances ( P<0.05). There were no significant differences in number of oocytes retrieved, number of mature oocytes, fertilization rate, cleavage rate, number of transferred embryos, percentage of good-quality blastocyst transfer cycles, clinical pregnancy rate, spontaneous abortion rate, implantation rate and ongoing pregnancy rate between group A and group B ( P>0.05), group A had higher number of embryo transfer cycles ( P=0.034) and lower good-quality embryo rate on day 3 ( P<0.001). There were no significant differences in clinical pregnancy rate and spontaneous abortion rate between transferred blastocyst derived from the 4-cell and 5-cell embryo (51.6% vs. 50.0%；15.2% vs. 26.8%, respectively). There were no significant differences in clinical pregnancy rate and spontaneous abortion rate between transferred blastocyst derived from grade I+II and grade III (4/I-5/III) (53.6% vs. 41.2%； 22.4% vs. 21.4%, respectively). Conclusion:Blastocyst derived from 4/I-5/III embryos and good cleavage stage embryos both are similar clinical outcomes in blastocyst transfer cycles, there are no effects of blastomere number and grade on clinical pregnancy rate and abortion rate in blastocyst transfer cycles, but blastulation rate derived from 5-cell embryo was significantly higher than that of 4-cell embryo.

Objective:To investigate the effects of blastulation and transferred blastocyst derived from the 4-5-cell grade I to III (4/I-5/III) embryos on day 3 on clinical outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods:A total of 884 IVF cycles with blastocyst culture in the 901st Hospital of the Joint Logistics Support Force of PLA from January 2016 to February 2019 were retrospectively analyzed. The blastocyst formation status was compared among the 4/I-5/III embryos. Blastocyst derived from 4/I-5/III embryos in transfer cycle was served as group A ( n=164), blastocyst derived from good-quality cleavage stage embryos (7/I-10/II) in transfer cycle was served as group B ( n=247) according to quality of cleavage stage embryos on day 3. The clinical outcomes were compared between the two groups. The effects of different blastomere number and grade on clinical pregnancy rate and spontaneous abortion rate were evaluated among the 4/I-5/III embryos. Results:Good-quality blastulation rate for 4/I, 4/II, 4/III, 5/I, 5/II and 5/III were 5.6%, 1.8%, 0.6%, 8.3%, 8.4% and 1.6%, respectively. The differences reached statistical significances ( P<0.05). There were no significant differences in number of oocytes retrieved, number of mature oocytes, fertilization rate, cleavage rate, number of transferred embryos, percentage of good-quality blastocyst transfer cycles, clinical pregnancy rate, spontaneous abortion rate, implantation rate and ongoing pregnancy rate between group A and group B ( P>0.05), group A had higher number of embryo transfer cycles ( P=0.034) and lower good-quality embryo rate on day 3 ( P<0.001). There were no significant differences in clinical pregnancy rate and spontaneous abortion rate between transferred blastocyst derived from the 4-cell and 5-cell embryo (51.6% vs. 50.0%；15.2% vs. 26.8%, respectively). There were no significant differences in clinical pregnancy rate and spontaneous abortion rate between transferred blastocyst derived from grade I+II and grade III (4/I-5/III) (53.6% vs. 41.2%； 22.4% vs. 21.4%, respectively). Conclusion:Blastocyst derived from 4/I-5/III embryos and good cleavage stage embryos both are similar clinical outcomes in blastocyst transfer cycles, there are no effects of blastomere number and grade on clinical pregnancy rate and abortion rate in blastocyst transfer cycles, but blastulation rate derived from 5-cell embryo was significantly higher than that of 4-cell embryo.

Objective: To investigate the mechanism of apoptosis of CD8⁺T lymphocyte in peripheral blood of patients with hepatocellular carcinoma (HCC). Methods: The proportion and apoptosis of peripheral blood CD8⁺T lymphocytes in 30 healthy controls, 30 patients with cirrhosis and 60 HCC patients were detected by Flow cytometry, and the expression of Fas on the surface of CD8⁺T lymphocytes was reported. The differences between groups were compared using independent sample t-test, and data of variance were tested with Mann-Whitney U non-parametric test, P < 0.05 was considered statistically significant. Results: The proportion of CD8⁺T lymphocytes in peripheral blood of patients with HCC was 26.4% ± 9.2%, higher than that of 24.5% ± 7.1% in cirrhosis (t = 0.783, P = 0.489), and and healthy control 19.7% ± 4.7% (t = 2.920, P = 0.004). The proportion of apoptotic CD8⁺T lymphocytes in peripheral blood of HCC patients was 25.3% ± 6.5%, of the total CD8⁺T lymphocytes, which was significantly higher than that of healthy controls 12.1%±6.5% (t = 7.555, P < 0.001) and cirrhotic 13.6% ± 5.8% (t = 5.213, P < 0.001), the differences were statistically significant. The proportion of Fas⁺CD8⁺T lymphocytes in the HCC group was 62.2% ± 18.5%, higher than that in the healthy control group 42.6%±16.5% (t = 4.127, P < 0.001) and 46.1% ± 14.5% (t = 2.561, P < 0.01)of the cirrhosis group, the differences were statistically significant. Fas expression was positively correlated with the apoptosis of CD8⁺T lymphocytes (r ² = 0.113, P < 0.05). Conclusion The proportion of CD8⁺T lymphocytes in peripheral blood of patients with HCC is higher than that of healthy controls, but the proportion of CD8⁺T lymphocyte apoptosis based on Fas/FasL pathway increased, which may be an important mechanism for tumor cell immune escape.

OBJECTIVE: The aim of this study was to investigate associations between the morphology score of blastocysts and blastocoele re-expansion speed after warming with clinical outcomes, which could assist in making correct and cost-effective decisions regarding the appropriate time to vitrify blastocysts and to transfer vitrified-warmed blastocysts. METHODS: A total of 327 vitrified-warmed two-blastocyst transfer cycles in women 38 years old and younger were included in this retrospective study. RESULTS: The clinical pregnancy rate (CPR) and implantation rate (IR) of transfers of two good-morphology grade 4 blastocysts vitrified on day 5 (64.1% and 46.8%, respectively) were significantly higher than the CPR and IR associated with the transfers of two good-morphology grade 3 blastocysts vitrified on day 5 (46.7% and 32.2%, respectively). No significant differences were found in the CPR and IR among the transfers of two good-morphology grade 4 blastocysts regardless of the day of cryopreservation. Logistic regression analysis showed that blastocoele re-expansion speed after warming was associated with the CPR. CONCLUSION: The selection of a good-morphology grade 4 blastocyst to be vitrified could be superior to the choice of a grade 3 blastocyst. Extending the culture of grade 3 blastocysts and freezing grade 4 or higher blastocysts on day 6 could lead to a greater likelihood of pregnancy. Since re-expansion was shown to be a morphological marker of superior blastocyst viability, blastocysts that quickly re-expand after warming should be prioritized for transfer.
Blastocyst* ; Cardiopulmonary Resuscitation ; Cryopreservation ; Embryo Transfer ; Embryonic Development ; Female ; Freezing ; Humans ; Logistic Models ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Rate ; Pregnancy* ; Retrospective Studies