Objective To explore the influence of blood uric acid (serum uric acid, SUA) and fasting plasma glucose (FPG） on the occurrence of coronary heart disease in patients with type 2 diabetes mellitus (T2DM). Methods T2DM patients admitted to 3201 Hospital from January 2021 to January 2024 were selected and divided into a combined coronary heart disease(CHD) and a simple diabetes mellitus (DM). The clinical data were collected, and the blood SUA and FPG levels were analyzed. The basic characteristics and biochemical indicators of the two groups were analyzed. Risk factors affecting the severity of coronary lesions were identified by multivariate logistic regression analysis. The interaction between SUA and FPG was also evaluated. Results A total of 98 T2DM patients were included in this study, including 53 and 45 patients in the DM and combined CHD groups, respectively. Compared with the DM group, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglycerides (TG), SUA and FPG levels were significantly higher in the combined CHD group. The differences were all statistically significant (P<0.05). The multivariate logistic regression model analysis showed that LDL-C (OR=1.490, 95%CI: 1.044-1.824), HDL-C (OR=1.182, 95%CI: 0.846-1.314), TC (OR=1.075, 95%CI: 0.891-1.190), TG (OR=1.695, 95%CI: 1.230-2.164), SUA (OR=1.820, 95%CI: 1.294-2.424) and the FPG level (OR=2.154, 95%CI: 1.532-3.079) could be an independent risk factor for the development of CHD (OR value>1, P<0.05). The results of the interaction analysis showed a positive and additive interaction between SUA and FPG, and the difference was statistically significant (P<0.05). Conclusion Both SUA and FPG levels are independent risk factors for the occurrence of CHD. A positive additive interaction between the two may together contribute to the risk of CHD in T2DM patients.

Objective:To investigate the influencing factors and perinatal outcomes associated with monozygotic twins (MZT) following elective single embryo transfer (eSET) via in vitro fertilization or intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was conducted on 12 079 patients who achieved pregnancy after undergoing IVF/ICSI-eSET at Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between January 2015 and September 2023. Patients were stratified into two groups based on ultrasound findings 30 d post-transfer: singleton pregnancy group and MZT pregnancy group. Finally, 300 MZT and 1 500 single pregnancies, which were randomly matched according to 1∶5 were included by study period. General patients' characteristics, embryo-related factors, and perinatal outcomes were compared between the two groups. A multivariate logistic regression model was employed to identify risk factors for MZT after single embryo transfer, adjusting for potential confounding variables.Results:The incidence of twin pregnancy following single embryo transfer was 2.48% (300/12 079), which was higher than that of naturally conceived monozygotic twin pregnancy. No significant difference was found in baseline characteristics between the two groups (all P>0.05). The blastocyst transfer rate was higher in the MZT pregnancy group [93.3% (280/300)] than in the singleton pregnancy group [88.8% (1 332/1 500), P=0.022]. Multivariate logistic regression analysis also showed that blastocyst transfer was associated with an increased risk of MZT ( OR=0.552, P=0.016, 95% CI: 0.341-0.894). Analysis of blastocyst cycles showed that the risk of MZT was higher when transferring high-quality blastocysts [79.6% (223/280) vs. 67.8% (903/1 332), P<0.001], where as a trophectoderm (TE) grading of C [20.4% (57/280) vs. 32.2% (429/1 332), P<0.001] had a lower risk of MZT. After adjusting for confounding factors, the risk of MZT was found to increase with the transfer of blastocysts with a B-grade inner cell mass (ICM) ( OR=0.601, P=0.001, 95% CI: 0.442-0.819) and A/B grade TE (grade A: OR=2.951, P<0.001, 95% CI: 1.980-4.399; grade B: OR=1.840, P<0.001, 95% CI: 1.315-2.576). The risk of complications during pregnancy [47.7% (143/300) vs. 19.3% (289/1 500), P<0.001], preterm labor [55.1% (140/254) vs. 7.4% (101/1 368), P<0.001], and the risk of stillbirth [3.7% (11/300) vs. 1.5% (22/1 500), P=0.016] were significantly higher in the MZT pregnancy group than in the singleton pregnancy group. Conclusion:Assisted reproductive technology may contribute to the risk of MZT. Transfer of blastocysts, particularly those with loose ICM arrangement and dense TE arrangement, appears to increase the risk of MZT in patients undergoing eSET.

Objective:To investigate the impact of day 3 embryo quality on pregnancy outcomes in frozen-thawed single blastocyst transfer cycles and analyze its value in embryo selection.Methods:A retrospective cohort study was conducted on clinical data from patients undergoing frozen-thawed single blastocyst transfer at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2020 to December 2023. A total of 4 691 cycles of high-quality day 3 embryo (H-D3) group and 2 598 cycles of low-quality day 3 embryo (L-D3) group in the same period were included. Multivariate logistic regression was used to analyze the effects of day 3 embryo quality on clinical pregnancy rate (CPR) and live birth rate (LBR). All the cycles were stratified according to developmental day and quality of blastocyst: 3 920 cycles of high-quality day 5 blastocysts (H-D5), 1 271 cycles of low-quality day 5 blastocysts (L-D5), 834 cycles of H-D6 group and 1 264 cycles of L-D6, the influence of day 3 embryo quality was subsequently analyzed under different conditions.Results:1) Significant differences were observed between H-D3 and L-D3 groups in female age [(31.79±4.42) years vs. (32.28±4.43) years, P<0.001], basal follicle-stimulating hormone levels [6.24 (5.32,7.35) U/L vs. 6.48 (5.42,7.62) U/L, P<0.001], proportion of primary infertility [35.86% (1 682/4 691) vs. 31.99% (831/2 598), P<0.001], proportion of ≥2 prior failed embryo transfer cycles [3.77% (177/4 691) vs. 5.93% (154/2 598), P<0.001], proportion of gonadotropin-releasing hormone agonist/antagonist controlled ovarian hyperstimulation protocol in fresh cycles [93.33% (4 378/4 691) vs. 89.80%(2 333/2 598), P<0.001], embryo cryopreservation duration [3.10 (2.23,7.27) months vs. 3.60 (2.30,15.40) months, P<0.001], proportion of day 5 blastocyst transfers [74.82% (3 510/4 691) vs. 64.70% (1 681/2 598), P<0.001] and proportion of high-quality blastocyst transfers [72.59% (3 405/4 691) vs. 51.92% (1 349/2 598), P<0.001]. No significant differences were found in body mass index, infertility duration, endometrial preparation program or endometrial thickness on transfer day (all P>0.05). 2) Multivariable logistic regression analysis demonstrated that the L-D3 group had significantly lower CPR ( OR=0.837, 95% CI: 0.754-0.929, P<0.001) and LBR ( OR=0.880, 95% CI: 0.794-0.974, P=0.014) compared with the H-D3 group. 3) In H-D5 and L-D5 cycles, L-D3 did not significantly affect CPR ( aOR=0.941, 95% CI: 0.805-1.101, P=0.449; aOR=0.910, 95% CI: 0.724-1.142, P=0.415) or LBR ( aOR=1.034, 95% CI: 0.893-1.196, P=0.657; aOR=0.917, 95% CI: 0.729-1.153, P=0.457). However, in D6-H and D6-L cycles, L-D3 significantly reduced CPR ( aOR=0.732, 95% CI: 0.542-0.987, P=0.041; aOR=0.648, 95% CI: 0.515-0.815, P<0.001) and LBR ( aOR=0.645, 95% CI: 0.479-0.869, P=0.004; aOR=0.670, 95% CI: 0.526-0.854, P=0.001). Conclusion:Day 3 embryo quality significantly impacts both CPR and LBR in frozen-thawed day 6 single blastocyst transfer cycles. This suggests that day 3 embryo quality retains clinical relevance as a selection criterion when prioritizing day 6 blastocysts for transfer.

Objective:To investigate the influencing factors and perinatal outcomes associated with monozygotic twins (MZT) following elective single embryo transfer (eSET) via in vitro fertilization or intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was conducted on 12 079 patients who achieved pregnancy after undergoing IVF/ICSI-eSET at Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between January 2015 and September 2023. Patients were stratified into two groups based on ultrasound findings 30 d post-transfer: singleton pregnancy group and MZT pregnancy group. Finally, 300 MZT and 1 500 single pregnancies, which were randomly matched according to 1∶5 were included by study period. General patients' characteristics, embryo-related factors, and perinatal outcomes were compared between the two groups. A multivariate logistic regression model was employed to identify risk factors for MZT after single embryo transfer, adjusting for potential confounding variables.Results:The incidence of twin pregnancy following single embryo transfer was 2.48% (300/12 079), which was higher than that of naturally conceived monozygotic twin pregnancy. No significant difference was found in baseline characteristics between the two groups (all P>0.05). The blastocyst transfer rate was higher in the MZT pregnancy group [93.3% (280/300)] than in the singleton pregnancy group [88.8% (1 332/1 500), P=0.022]. Multivariate logistic regression analysis also showed that blastocyst transfer was associated with an increased risk of MZT ( OR=0.552, P=0.016, 95% CI: 0.341-0.894). Analysis of blastocyst cycles showed that the risk of MZT was higher when transferring high-quality blastocysts [79.6% (223/280) vs. 67.8% (903/1 332), P<0.001], where as a trophectoderm (TE) grading of C [20.4% (57/280) vs. 32.2% (429/1 332), P<0.001] had a lower risk of MZT. After adjusting for confounding factors, the risk of MZT was found to increase with the transfer of blastocysts with a B-grade inner cell mass (ICM) ( OR=0.601, P=0.001, 95% CI: 0.442-0.819) and A/B grade TE (grade A: OR=2.951, P<0.001, 95% CI: 1.980-4.399; grade B: OR=1.840, P<0.001, 95% CI: 1.315-2.576). The risk of complications during pregnancy [47.7% (143/300) vs. 19.3% (289/1 500), P<0.001], preterm labor [55.1% (140/254) vs. 7.4% (101/1 368), P<0.001], and the risk of stillbirth [3.7% (11/300) vs. 1.5% (22/1 500), P=0.016] were significantly higher in the MZT pregnancy group than in the singleton pregnancy group. Conclusion:Assisted reproductive technology may contribute to the risk of MZT. Transfer of blastocysts, particularly those with loose ICM arrangement and dense TE arrangement, appears to increase the risk of MZT in patients undergoing eSET.

Objective:To investigate the impact of day 3 embryo quality on pregnancy outcomes in frozen-thawed single blastocyst transfer cycles and analyze its value in embryo selection.Methods:A retrospective cohort study was conducted on clinical data from patients undergoing frozen-thawed single blastocyst transfer at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2020 to December 2023. A total of 4 691 cycles of high-quality day 3 embryo (H-D3) group and 2 598 cycles of low-quality day 3 embryo (L-D3) group in the same period were included. Multivariate logistic regression was used to analyze the effects of day 3 embryo quality on clinical pregnancy rate (CPR) and live birth rate (LBR). All the cycles were stratified according to developmental day and quality of blastocyst: 3 920 cycles of high-quality day 5 blastocysts (H-D5), 1 271 cycles of low-quality day 5 blastocysts (L-D5), 834 cycles of H-D6 group and 1 264 cycles of L-D6, the influence of day 3 embryo quality was subsequently analyzed under different conditions.Results:1) Significant differences were observed between H-D3 and L-D3 groups in female age [(31.79±4.42) years vs. (32.28±4.43) years, P<0.001], basal follicle-stimulating hormone levels [6.24 (5.32,7.35) U/L vs. 6.48 (5.42,7.62) U/L, P<0.001], proportion of primary infertility [35.86% (1 682/4 691) vs. 31.99% (831/2 598), P<0.001], proportion of ≥2 prior failed embryo transfer cycles [3.77% (177/4 691) vs. 5.93% (154/2 598), P<0.001], proportion of gonadotropin-releasing hormone agonist/antagonist controlled ovarian hyperstimulation protocol in fresh cycles [93.33% (4 378/4 691) vs. 89.80%(2 333/2 598), P<0.001], embryo cryopreservation duration [3.10 (2.23,7.27) months vs. 3.60 (2.30,15.40) months, P<0.001], proportion of day 5 blastocyst transfers [74.82% (3 510/4 691) vs. 64.70% (1 681/2 598), P<0.001] and proportion of high-quality blastocyst transfers [72.59% (3 405/4 691) vs. 51.92% (1 349/2 598), P<0.001]. No significant differences were found in body mass index, infertility duration, endometrial preparation program or endometrial thickness on transfer day (all P>0.05). 2) Multivariable logistic regression analysis demonstrated that the L-D3 group had significantly lower CPR ( OR=0.837, 95% CI: 0.754-0.929, P<0.001) and LBR ( OR=0.880, 95% CI: 0.794-0.974, P=0.014) compared with the H-D3 group. 3) In H-D5 and L-D5 cycles, L-D3 did not significantly affect CPR ( aOR=0.941, 95% CI: 0.805-1.101, P=0.449; aOR=0.910, 95% CI: 0.724-1.142, P=0.415) or LBR ( aOR=1.034, 95% CI: 0.893-1.196, P=0.657; aOR=0.917, 95% CI: 0.729-1.153, P=0.457). However, in D6-H and D6-L cycles, L-D3 significantly reduced CPR ( aOR=0.732, 95% CI: 0.542-0.987, P=0.041; aOR=0.648, 95% CI: 0.515-0.815, P<0.001) and LBR ( aOR=0.645, 95% CI: 0.479-0.869, P=0.004; aOR=0.670, 95% CI: 0.526-0.854, P=0.001). Conclusion:Day 3 embryo quality significantly impacts both CPR and LBR in frozen-thawed day 6 single blastocyst transfer cycles. This suggests that day 3 embryo quality retains clinical relevance as a selection criterion when prioritizing day 6 blastocysts for transfer.

Magnetic particle testing, as an efficient non-destructive testing method, has been widely applied in the field of defect detection for precision components. This study reports a case of occupational ultraviolet cataract caused by prolonged exposure of a magnetic particle testing worker to ultraviolet radiation exceeding standard intensity levels. Insufficient awareness of the potential ocular damage caused by long-wave ultraviolet radiation, inadequate provision of protective goggles, and non-compliant occupational hygiene monitoring and health examinations were identified as the primary contributing factors to this case.

Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.

Objective To introduce a modified technique of right ventricular outflow tract (RVOT) reconstruction using a handmade bicuspid pulmonary valve crafted from expanded polytetrafluoroethylene (ePTFE) and to summarize the early single-center experience. Methods Patients with complex congenital heart diseases (CHD) who underwent RVOT reconstruction with a handmade ePTFE bicuspid pulmonary valve due to pulmonary regurgitation at Guangdong Provincial People’s Hospital from April 2021 to February 2022 were selected. Postoperative artificial valve function and right heart function indicators were evaluated. Results A total of 17 patients were included, comprising 10 males and 7 females, with a mean age of (18.18±12.14) years and a mean body weight of (40.94±19.45) kg. Sixteen patients underwent reconstruction with a handmade valved conduit, with conduit sizes ranging from 18 to 24 mm. No patients required mechanical circulatory support, and no in-hospital deaths occurred. During a mean follow-up period of 12.89 months, only one patient developed valve dysfunction, and no related complications or adverse events were observed. The degree of pulmonary regurgitation was significantly improved post-RVOT reconstruction and during follow-up compared to preoperative levels (P<0.001). Postoperative right atrial diameter, right ventricular diameter, and tricuspid regurgitation area were all significantly reduced compared to preoperative values (P<0.05). Conclusion The use of a 0.1 mm ePTFE handmade bicuspid pulmonary valve for RVOT reconstruction in complex CHD is a feasible, effective, and safe technique.

Objective:To evaluate the clinical efficacy of mitral valve transcatheter edge-to-edge repair (TEER) in patients with non-central degenerative mitral regurgitation (DMR).Methods:This retrospective study included patients with non-central DMR who underwent TEER at Fuwai Hospital between January 2021 and February 2024. Patients were categorized into two groups: the commissure-involved group and the non-commissure group, based on whether the mitral valve commissures were involved. Clinical data, surgical outcomes, and echocardiographic findings at 3 months postoperatively were collected and compared, and patients were followed up. The primary endpoint was the procedural success rate at discharge.Results:A total of 59 patients were included, aged (68.6±9.3) years, including 23 females (39%). In the overall study population, 78% (46/59) of patients had severe mitral regurgitation. Forty-two cases were in the non-commissure group, and 17 cases were in the commissure-involved group. Patients in the non-commissure group mainly had lesions in the A1/P1 region, while patients in the commissure-involved group mainly had lesions in the A3/P3 region. There was no significant difference in the procedural success rate at discharge (93% vs. 88%, P=0.95) and the incidence of postoperative complications (5% vs. 6%, P=1.00) between the two groups. Two patients in the commissure-involved group experienced single leaflet device attachment, with one of them requiring conversion to surgical mitral valve surgery; In the non-commissure group, two patients experienced single-valve clamping, and one of them was converted to surgical mitral valve surgery. The follow-up time of the entire cohort was (15.5±10.3) months. In the non-commissure group, 2 patients died and 2 were readmitted. While in the commissure-involved group, no patients died and only 1 patient was readmitted. Conclusion:TEER is an effective treatment for patients with non-central DMR involving the commissures, without increasing the incidence of postoperative complications.

Magnetic particle testing, as an efficient non-destructive testing method, has been widely applied in the field of defect detection for precision components. This study reports a case of occupational ultraviolet cataract caused by prolonged exposure of a magnetic particle testing worker to ultraviolet radiation exceeding standard intensity levels. Insufficient awareness of the potential ocular damage caused by long-wave ultraviolet radiation, inadequate provision of protective goggles, and non-compliant occupational hygiene monitoring and health examinations were identified as the primary contributing factors to this case.