Objective To analyze the coordination strategies of residual solvent control in various pharmacopoeias with the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Guidelines for residual solvents(ICH Q3C),aiming to provide ideas and solutions for coordinating residual solvents in the Chinese Pharmacopoeia with ICH Q3C.Methods Through literature research and review,compare the coordination process between residual solvent control in various pharmacopoeias and ICH Q3C,analyze the implementation strategies of mainstream pharmacopoeia residual solvent control and ICH Q3C coordination in foreign countries,and clarify the differences in residual solvent control between the Chinese Pharmacopoeia and foreign pharmacopoeias.Results It is necessary to coordinate the control of residual solvents in the Chinese Pharmacopoeia with ICH Q3C.Conclusion It is recommended to steadily promote the overall coordination of residual solvent control in Chinese pharmacopoeia and ICH by drawing on the experience of coordination between foreign pharmacopoeias and ICH Q3C,based on the national conditions of China.

Medical professional spirit is an indispensable and important component in the modern medical system.It not only plays a key role in the harmonious development of doctor-patient relationships,but also is of great significance for the im-provement of medical quality and medical services.This article will start from the problems faced by the medical environment in the broader context,and take the cultivation of the"Guangdong Doctor"spirit,namely"cherishing life,respecting science,be-ing willing to contribute,and being united and enterprising",as an example to explore the importance of reshaping the medical professional spirit.Through specific measures such as strengthening professional spirit education,setting up role models,promo-ting the advanced,improving systems,strengthening supervision,and creating a good working environment,which aims to en-hance the professional quality and ethics of doctors,with the expectation of providing useful references for promoting harmonious doctor-patient relations and improving the quality of medical services.

Background:Colorectal cancer(CRC)is a major cause of cancer death worldwide,and about 30%to 35%of CRC arises from the serrated pathway.Aims:To analyze the clinicopathological and histomorphological characteristics of colorectal superficially serrated adenoma(SuSA),and to investigate the malignant transformation potential of SuSA and further elucidate the role of RSPO2 and RSPO3 in its carcinogenic mechanism.Methods:A total of 169 serrated colorectal lesions confirmed pathologically and fulfilling the inclusion criteria were collected from Shanxi Bethune Hospital from February 2019 to May 2023.Among them,there were 84 cases of SuSA,23 sessile serrated lesions(SSL),32 traditional serrated adenomas(TSA),and 30 hyperplastic polyps(HP).Thirty-nine cases of tubular adenoma(TA),32 CRC,and 33 normal colorectal mucosal tissues were served as controls.The clinicopathological and histomorphological parameters were collected and recorded.Immunohistochemical staining was used to detect the protein expressions of RSPO2,RSPO3,p53,MLH1 and β-catenin.Results:Patients with SuSA were male predominance,with a mean age of 51.89 years.The average diameter of the lesions was 0.20 cm,predominantly located in the left colon and rectum,and frequently complicated with other polyps/adenomas.The histomorphological features of SuSA were as follows:the glandular necks and crypt bases exhibited straight tubular structure with low-grade dysplasia;the superficial layer demonstrated a serrated architecture,with or without dysplasia,and contained a variable number of goblet cells.Immunohistochemically,there were no statistically significant differences in RSPO2,RSPO3,and p53 expressions between SuSA and TSA(all P>0.05).A strong positive correlation was observed between RSPO2 and RSPO3 in colorectal lesions,excluding HP.Expressions of MLH1 and β-catenin showed no statistically significant differences between SuSA and other colorectal lesions(all P>0.05).Conclusions:SuSAs are more common in males,occur mostly in the left colon and rectum,and are often associated with other polyps/adenomas.They might be precursors of KRAS-mutated TSA and microsatellite stable CRC with high malignant potential.RSPO2 and RSPO3 might play an important role in the carcinogenesis of SuSA.

Medical professional spirit is an indispensable and important component in the modern medical system.It not only plays a key role in the harmonious development of doctor-patient relationships,but also is of great significance for the im-provement of medical quality and medical services.This article will start from the problems faced by the medical environment in the broader context,and take the cultivation of the"Guangdong Doctor"spirit,namely"cherishing life,respecting science,be-ing willing to contribute,and being united and enterprising",as an example to explore the importance of reshaping the medical professional spirit.Through specific measures such as strengthening professional spirit education,setting up role models,promo-ting the advanced,improving systems,strengthening supervision,and creating a good working environment,which aims to en-hance the professional quality and ethics of doctors,with the expectation of providing useful references for promoting harmonious doctor-patient relations and improving the quality of medical services.

Background:Colorectal cancer(CRC)is a major cause of cancer death worldwide,and about 30%to 35%of CRC arises from the serrated pathway.Aims:To analyze the clinicopathological and histomorphological characteristics of colorectal superficially serrated adenoma(SuSA),and to investigate the malignant transformation potential of SuSA and further elucidate the role of RSPO2 and RSPO3 in its carcinogenic mechanism.Methods:A total of 169 serrated colorectal lesions confirmed pathologically and fulfilling the inclusion criteria were collected from Shanxi Bethune Hospital from February 2019 to May 2023.Among them,there were 84 cases of SuSA,23 sessile serrated lesions(SSL),32 traditional serrated adenomas(TSA),and 30 hyperplastic polyps(HP).Thirty-nine cases of tubular adenoma(TA),32 CRC,and 33 normal colorectal mucosal tissues were served as controls.The clinicopathological and histomorphological parameters were collected and recorded.Immunohistochemical staining was used to detect the protein expressions of RSPO2,RSPO3,p53,MLH1 and β-catenin.Results:Patients with SuSA were male predominance,with a mean age of 51.89 years.The average diameter of the lesions was 0.20 cm,predominantly located in the left colon and rectum,and frequently complicated with other polyps/adenomas.The histomorphological features of SuSA were as follows:the glandular necks and crypt bases exhibited straight tubular structure with low-grade dysplasia;the superficial layer demonstrated a serrated architecture,with or without dysplasia,and contained a variable number of goblet cells.Immunohistochemically,there were no statistically significant differences in RSPO2,RSPO3,and p53 expressions between SuSA and TSA(all P>0.05).A strong positive correlation was observed between RSPO2 and RSPO3 in colorectal lesions,excluding HP.Expressions of MLH1 and β-catenin showed no statistically significant differences between SuSA and other colorectal lesions(all P>0.05).Conclusions:SuSAs are more common in males,occur mostly in the left colon and rectum,and are often associated with other polyps/adenomas.They might be precursors of KRAS-mutated TSA and microsatellite stable CRC with high malignant potential.RSPO2 and RSPO3 might play an important role in the carcinogenesis of SuSA.

Objective To analyze the coordination strategies of residual solvent control in various pharmacopoeias with the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Guidelines for residual solvents(ICH Q3C),aiming to provide ideas and solutions for coordinating residual solvents in the Chinese Pharmacopoeia with ICH Q3C.Methods Through literature research and review,compare the coordination process between residual solvent control in various pharmacopoeias and ICH Q3C,analyze the implementation strategies of mainstream pharmacopoeia residual solvent control and ICH Q3C coordination in foreign countries,and clarify the differences in residual solvent control between the Chinese Pharmacopoeia and foreign pharmacopoeias.Results It is necessary to coordinate the control of residual solvents in the Chinese Pharmacopoeia with ICH Q3C.Conclusion It is recommended to steadily promote the overall coordination of residual solvent control in Chinese pharmacopoeia and ICH by drawing on the experience of coordination between foreign pharmacopoeias and ICH Q3C,based on the national conditions of China.

Objective:To explore the expression levels of adrenomedullin (ADM) in follicular fluid of patients with polycystic ovary syndrome (PCOS) and its correlation with ovarian function and inflammation.Methods:To conduct a cohort study, the data on infertile couples who received an antagonistic regimen of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) to promote ovulation from March to December 2023 at the Reproductive Medicine Center of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital) were collected. PCOS patients were selected as the PCOS group, and patients who underwent IVF/ICSI assisted pregnancy solely due to tubal and/or male factors during the same period were selected as control group. The general clinical data of two groups of patients were analyzed, and the expression of ADM, interleukin 1β (IL-1β), IL-18, transforming growth factor β (TGF-β) in the follicular fluid were compared between the two groups of patients. And taking the concentration of ADM in follicular fluid as the main research indicator, correlation and multiple linear regression analysis were conducted with other indicators. Simultaneously the ADM mRNA expression, cell cycle and cell apoptosis of granulosa cells were compared between the two groups. Results:This study included 20 cases in the PCOS group and 20 cases in control group. Compared with control group, the expression of ADM in follicular fluid and granulosa cells of patients with PCOS were significantly lower (both P<0.001), while its testosterone, the ratio of luteinizing hormone and follicle-stimulating hormone, antral follicle count (AFC), number of retrieved eggs, ovarian sensitivity index, as well as IL-1β, IL-18 and TGF-β in follicular fluid were higher and negatively correlated with ADM ( r=-0.37, P=0.019; r=-0.32, P=0.047; r=-0.50, P<0.001; r=-0.38, P=0.017; r=-0.38, P=0.016; r=-0.44, P=0.005; r=-0.37, P=0.018; r=-0.54, P<0.001). Multiple linear regression showed that AFC, gonadotropin initiation dose, IL-1β and TGF-β were the independent related factors that affect local ADM levels ( r=-0.37, P=0.008; r=-0.27, P=0.035; r=-0.28, P=0.028; r=-0.45, P<0.001). There was no statistically significant difference in the cell cycle of granulocytes between the two groups ( P>0.05), but the apoptosis rate (AR) of granulocytes was higher in the PCOS group than in control group (median AR in the PCOS group was 46.07%, median AR in control group was 28.57%, n=10, P=0.036). Conclusion:The decreased expression of ADM in follicles of PCOS patients is related to ovarian endocrine disorders, multiple vesicles, high ovarian responsiveness and local inflammatory status.

Objective:To explore the expression levels of adrenomedullin (ADM) in follicular fluid of patients with polycystic ovary syndrome (PCOS) and its correlation with ovarian function and inflammation.Methods:To conduct a cohort study, the data on infertile couples who received an antagonistic regimen of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) to promote ovulation from March to December 2023 at the Reproductive Medicine Center of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital) were collected. PCOS patients were selected as the PCOS group, and patients who underwent IVF/ICSI assisted pregnancy solely due to tubal and/or male factors during the same period were selected as control group. The general clinical data of two groups of patients were analyzed, and the expression of ADM, interleukin 1β (IL-1β), IL-18, transforming growth factor β (TGF-β) in the follicular fluid were compared between the two groups of patients. And taking the concentration of ADM in follicular fluid as the main research indicator, correlation and multiple linear regression analysis were conducted with other indicators. Simultaneously the ADM mRNA expression, cell cycle and cell apoptosis of granulosa cells were compared between the two groups. Results:This study included 20 cases in the PCOS group and 20 cases in control group. Compared with control group, the expression of ADM in follicular fluid and granulosa cells of patients with PCOS were significantly lower (both P<0.001), while its testosterone, the ratio of luteinizing hormone and follicle-stimulating hormone, antral follicle count (AFC), number of retrieved eggs, ovarian sensitivity index, as well as IL-1β, IL-18 and TGF-β in follicular fluid were higher and negatively correlated with ADM ( r=-0.37, P=0.019; r=-0.32, P=0.047; r=-0.50, P<0.001; r=-0.38, P=0.017; r=-0.38, P=0.016; r=-0.44, P=0.005; r=-0.37, P=0.018; r=-0.54, P<0.001). Multiple linear regression showed that AFC, gonadotropin initiation dose, IL-1β and TGF-β were the independent related factors that affect local ADM levels ( r=-0.37, P=0.008; r=-0.27, P=0.035; r=-0.28, P=0.028; r=-0.45, P<0.001). There was no statistically significant difference in the cell cycle of granulocytes between the two groups ( P>0.05), but the apoptosis rate (AR) of granulocytes was higher in the PCOS group than in control group (median AR in the PCOS group was 46.07%, median AR in control group was 28.57%, n=10, P=0.036). Conclusion:The decreased expression of ADM in follicles of PCOS patients is related to ovarian endocrine disorders, multiple vesicles, high ovarian responsiveness and local inflammatory status.

Objective:To analyse the influence of endometrial polyps (EPs) treatment on the frozen-thawed embryo transfer (FET) pregnancy outcome.Methods:Using a retrospective case-control study, the data of patients were collected who received in vitro fertilization (IVF) and hysteroscopy in the Reproductive Medicine Center of Children's Hospital of Shanxi and Women Health Center of Shanxi from June 2021 to December 2022. Patients undergoing hysteroscopy were studied. According to the diagnosis results of hysteroscopy and pathology, they were selected as the EPs group or the non-endometrial polyps (NEPs) group. Then analysis of EPs risk factors was made, and the pregnancy outcome of FET after the EPs treatment was compared. Results:A total of 3 413 patients underwent hysteroscopy in this study. The EPs group included 444 patients and the NEPs group included 1 501 patients respectively. The prevalence of EPs was 13.01% (444/3 413). There were significant differences between EPs group and NEPs group in gravidity, parity, spontaneous abortion times, induced abortions times, basal follicle-stimulating hormone (bFSH), basal luteinizing hormone (bLH), infertility duration, infertility types, the prevalence of chronic endometritis, the history of polyps removal and endometriosis (all P<0.05). Multivariate logistic regression analysis of risk factors associated with EPs showed that infertility duration ( OR=1.068, 95% CI: 1.029-1.109, P<0.001), chronic endometritis ( OR=1.925, 95% CI: 1.481-2.502, P<0.001), primary infertility ( OR=1.803, 95% CI: 1.408-2.308, P<0.001), history of polyps removal ( OR=9.424, 95% CI: 5.586-15.897, P<0.001), endometriosis ( OR=2.432, 95% CI: 1.344-4.401, P=0.003) were independent risk factors for EPs, and bLH ( OR=0.954, 95% CI: 0.916-0.993, P=0.022) was an independent protective factor for EPs. Compared with NEPs transplantation group, there were no significant differences in clinical pregnancy rate, on-going pregnancy rate and none implantation rate in the EPs treatment transplantation group (all P>0.05). Conclusion:Infertility duration, chronic endometritis, primary infertility, history of polyps removal, endometriosis were independent risk factors, and bLH was an independent protective factor. Patients in EPs treatment transplantation group could achieve the similar pregnancy outcome as NEPs transplantation group.

Objective:To analyse the influence of endometrial polyps (EPs) treatment on the frozen-thawed embryo transfer (FET) pregnancy outcome.Methods:Using a retrospective case-control study, the data of patients were collected who received in vitro fertilization (IVF) and hysteroscopy in the Reproductive Medicine Center of Children's Hospital of Shanxi and Women Health Center of Shanxi from June 2021 to December 2022. Patients undergoing hysteroscopy were studied. According to the diagnosis results of hysteroscopy and pathology, they were selected as the EPs group or the non-endometrial polyps (NEPs) group. Then analysis of EPs risk factors was made, and the pregnancy outcome of FET after the EPs treatment was compared. Results:A total of 3 413 patients underwent hysteroscopy in this study. The EPs group included 444 patients and the NEPs group included 1 501 patients respectively. The prevalence of EPs was 13.01% (444/3 413). There were significant differences between EPs group and NEPs group in gravidity, parity, spontaneous abortion times, induced abortions times, basal follicle-stimulating hormone (bFSH), basal luteinizing hormone (bLH), infertility duration, infertility types, the prevalence of chronic endometritis, the history of polyps removal and endometriosis (all P<0.05). Multivariate logistic regression analysis of risk factors associated with EPs showed that infertility duration ( OR=1.068, 95% CI: 1.029-1.109, P<0.001), chronic endometritis ( OR=1.925, 95% CI: 1.481-2.502, P<0.001), primary infertility ( OR=1.803, 95% CI: 1.408-2.308, P<0.001), history of polyps removal ( OR=9.424, 95% CI: 5.586-15.897, P<0.001), endometriosis ( OR=2.432, 95% CI: 1.344-4.401, P=0.003) were independent risk factors for EPs, and bLH ( OR=0.954, 95% CI: 0.916-0.993, P=0.022) was an independent protective factor for EPs. Compared with NEPs transplantation group, there were no significant differences in clinical pregnancy rate, on-going pregnancy rate and none implantation rate in the EPs treatment transplantation group (all P>0.05). Conclusion:Infertility duration, chronic endometritis, primary infertility, history of polyps removal, endometriosis were independent risk factors, and bLH was an independent protective factor. Patients in EPs treatment transplantation group could achieve the similar pregnancy outcome as NEPs transplantation group.