Objective:To explore the developmental trajectories of depression and their influencing factors among women conceiving through assisted reproductive technology (ART) from the beginning of the treatment cycle to late pregnancy.Methods:A convenience sampling method was used to recruit 863 women who successfully conceived through ART at the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University between January 2017 and November 2019. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D) at the beginning of the ART cycle (T1), early pregnancy (12-14 weeks, T2), mid-pregnancy (22-24 weeks, T3), and late pregnancy (32-34 weeks, T4). Group-based trajectory model was applied to identify developmental trajectories of antenatal depression, and multivariate Logistic regression was used to analyze influencing factors.Results:The detection rates of depressive symptoms among the 863 women conceiving through ART at T1, T2, T3, and T4 were 29.9% (258/863), 33.3% (287/863), 17.1% (148/863), and 19.8% (171/863), respectively. Three distinct trajectory groups were identified: persistently normal group (51.1%, 441/863), high-then-decreasing group (42.3%, 365/863), and persistently high-depression group (6.6%, 57/863). Multivariate Logistic regression analysis revealed that anxiety symptoms, sleep quality, spouse's age, passive smoking, and pre-pregnancy body mass index were significant influencing factors of the developmental trajectories of antenatal depression ( P<0.05) . Conclusions:Healthcare providers should pay close attention to antenatal depression in women conceiving through ART. Targeted interventions addressing the identified influencing factors should be developed to safeguard maternal and infant health.

Objective To compare the efficacy and safety of osimertinib and aumolertinib in the treatment of advanced non-small cell lung carcinoma(NSCLC)with epidermal growth factor receptor(EGFR)mutation.Methods A total of 139 patients with EGFR-mutated advanced NSCLC treated in the First People's Hospital of Yunnan Province from January,2019 to December,2022 were retrospectively collected.After screening by that row of criteria,104 patients were included in this study.According to the treatment drugs,they were divided into osimertinib group and aumolertinib group,with 52 cases in each group.The osimertinib group received osimertinib mesylate tablets 80 mg once daily,and the aumolertinib group received aumolertinib mesylate tablets 110 mg once daily.The disease control rate(DCR),objective remission rate(ORR)and progression-free survival(PFS)of the two groups were observed.PFS and overall survival(OS)were evaluated.The Cox regression model was used to analyze the key factors affecting patient survival.Results The ORR of aumolertinib group was significantly higher than that of osimertinib group.The median progression-free survival(mPFS)of aumolertinib group was significantly longer than that of osimertinib group(P=0.045).Cox regression model showed that clinical stage Ⅲ(HR=2.25,95%Cl 1.28～3.95,P=0.005),no brain metastasis(HR=0.59,95%Cl 0.35～0.98,P=0.040),third generation TKI type aumolertinib(HR=1.82,95%CI 1.15～2.87,P=0.011).Conclusion Aumolertinib and osimertinib have similar clinical efficacy in the treatment of advanced NSCLC patients with EGFR mutation.However,in terms of long-term efficacy,aumolertinib has significantly better median PFS and overall OS,and higher safety than osimertinib.

Objective:To explore the developmental trajectories of depression and their influencing factors among women conceiving through assisted reproductive technology (ART) from the beginning of the treatment cycle to late pregnancy.Methods:A convenience sampling method was used to recruit 863 women who successfully conceived through ART at the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University between January 2017 and November 2019. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D) at the beginning of the ART cycle (T1), early pregnancy (12-14 weeks, T2), mid-pregnancy (22-24 weeks, T3), and late pregnancy (32-34 weeks, T4). Group-based trajectory model was applied to identify developmental trajectories of antenatal depression, and multivariate Logistic regression was used to analyze influencing factors.Results:The detection rates of depressive symptoms among the 863 women conceiving through ART at T1, T2, T3, and T4 were 29.9% (258/863), 33.3% (287/863), 17.1% (148/863), and 19.8% (171/863), respectively. Three distinct trajectory groups were identified: persistently normal group (51.1%, 441/863), high-then-decreasing group (42.3%, 365/863), and persistently high-depression group (6.6%, 57/863). Multivariate Logistic regression analysis revealed that anxiety symptoms, sleep quality, spouse's age, passive smoking, and pre-pregnancy body mass index were significant influencing factors of the developmental trajectories of antenatal depression ( P<0.05) . Conclusions:Healthcare providers should pay close attention to antenatal depression in women conceiving through ART. Targeted interventions addressing the identified influencing factors should be developed to safeguard maternal and infant health.

Objective:To explore the sleep trajectory during pregnancy and its influencing factors in patients receiving assisted reproductive technology (ART) .Methods:Convenience sampling was used to select 1 249 patients with ART who underwent prenatal checkups at the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University from May 2017 to January 2022 as study subjects. The patients' sleep quality was assessed using the Pittsburgh Sleep Quality Index at 12 to 14 weeks of gestation (T1), 22 to 24 weeks of gestation (T2), and 32 to 34 weeks of gestation (T3), respectively. The latent class growth model was applied to explore the trajectory of sleep during pregnancy in patients receiving ART, and multicategorical Logistic regression were used to analyze the factors influencing the trajectory of sleep.Results:A total of 1 249 questionnaires were distributed and 1 090 valid questionnaires were finally recovered, with a validity rate of 87.27% (1 090/1 249). There were three types of sleep trajectories during pregnancy in 1 090 patients receiving ART, including sleep improvement group (7.89%, 86/1 090), sleep deterioration group (7.43%, 81/1 090), and good sleep group (84.68%, 923/1 090). Multicategorical Logistic regression analysis showed that age, annual household income, aspirin use before embryo transfer, vomiting, secondhand smoke exposure, anxiety, and depression were influencing factors of the sleep trajectory in patients with ART ( P<0.05) . Conclusions:There are differences in sleep quality during pregnancy among patients with ART. Healthcare professionals can intervene based on the influencing factors to improve sleep quality during pregnancy.

Objective:To explore the sleep trajectory during pregnancy and its influencing factors in patients receiving assisted reproductive technology (ART) .Methods:Convenience sampling was used to select 1 249 patients with ART who underwent prenatal checkups at the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University from May 2017 to January 2022 as study subjects. The patients' sleep quality was assessed using the Pittsburgh Sleep Quality Index at 12 to 14 weeks of gestation (T1), 22 to 24 weeks of gestation (T2), and 32 to 34 weeks of gestation (T3), respectively. The latent class growth model was applied to explore the trajectory of sleep during pregnancy in patients receiving ART, and multicategorical Logistic regression were used to analyze the factors influencing the trajectory of sleep.Results:A total of 1 249 questionnaires were distributed and 1 090 valid questionnaires were finally recovered, with a validity rate of 87.27% (1 090/1 249). There were three types of sleep trajectories during pregnancy in 1 090 patients receiving ART, including sleep improvement group (7.89%, 86/1 090), sleep deterioration group (7.43%, 81/1 090), and good sleep group (84.68%, 923/1 090). Multicategorical Logistic regression analysis showed that age, annual household income, aspirin use before embryo transfer, vomiting, secondhand smoke exposure, anxiety, and depression were influencing factors of the sleep trajectory in patients with ART ( P<0.05) . Conclusions:There are differences in sleep quality during pregnancy among patients with ART. Healthcare professionals can intervene based on the influencing factors to improve sleep quality during pregnancy.

OBJECTIVE To study the intervention effect of Hippophae rhamnoides oil on glucocorticoid resistance in superantigen-induced atopic dermatitis （AD） mice，and to explore the mechanism of action. METHODS Fifty mice were randomly divided into 5 groups，i.e. normal control group （group A），model group （group B），dexamethasone intervention group （positive control，group C），H. rhamnoides oil intervention group （group D），dexamethasone+H. rhamnoides oil intervention group （group E），with 10 mice in each group. Except for group A，other groups were given 2，4-dinitrochlorobenzene+staphylococcal enterotoxin B to induce the AD mice model. Starting from the 7th day of the experiment，groups C，D and E were given dexamethasone （1.5 mg/kg） and/or H. rhamnoides oil （10 mL/kg） intragastrically，once a day，for 28 consecutive days. After the last medication，the pathomorphological changes of ear tissue were observed by 节作用。E-mail：57667478@qq.com HE staining； the serum levels of immunoglobulin E （IgE） and interleukin 4 （IL-4） were detected by enzyme-linked immunosorbent assay. Positive cell count of glucocorticoid receptor α （GRα） and GRβ in the ear tissue of mice was detected by tyramide signal amplification. The expressions of GRα protein，GRβ protein，and protein kinase B （AKT）/ribosomal protein S6 kinase 1，S6K1 （S6K1） signaling pathway-related proteins were determined by Western blot assay. RESULTS Compared with group B，the skin inflammation in the left ear of the mice was significantly reduced in groups C，D and E，the serum levels of IgE and IL-4 were decreased significantly in groups D and E （P＜ 0.05），while the number of GRα positive cells and GRα protein expression were increased significantly （P＜0.05）； the protein levels of G protein inhibitory subunit 1 （Gαi1），Gαi3，phosphorylated S6K1 （p-S6K1） and phosphorylated AKT （p-AKT） were decreased significantly （P＜0.05）； the number of GRβ positive cells and protein expression of GRβ was decreased significantly in group E（P＜0.05）. Compared with group C，the skin inflammation in the left ear of the mice was almost clear away in group E，the serum levels of IgE and IL-4 were decreased significantly （P＜0.05）； the number of GRα positive cells and GRα protein expression were increased significantly in groups D and E （P＜0.05）； the protein levels of GRβ，Gαi1，p-S6K1 and p-AKT were all decreased significantly in groups D and E（P＜0.05）； and protein level of Gαi3 was decreased significantly in group E （P＜0.05）. CONCLUSIONS H. rhamnoides oil has an intervention effect on superantigen-induced glucocorticoid resistance of AD mice，which may be exerted by inhibition of the Gαi1/3-induced AKT/S6K1 signaling pathway.

Objective:To compare the clinical efficacy between modified open wedge high tibial osteotomy (MOWHTO) versus traditional open wedge high tibial osteotomy (TOWHTO) for varus knee osteoarthritis (KOA).Methods:A retrospective study was conducted to analyze the 50 patients (60 knees) with varus KOA who had received high tibial osteotomy at Department of Sports Medicine, The Affiliated Hospital of Qingdao University between September 2019 and December 2020. The patients were divided into 2 groups according to different ways of osteotomy: a traditional group and a modified group. In the traditional group subjected to TOWHTO, there were 25 cases (30 knees); in the modified group subjected to MOWHTO, there were 25 cases (30 knees). In MOWHTO, the bone block attached to the medial collateral ligament (MCL) of the knee was first chiseled at the MCL insertion before osteotomy to reduce excessive stripping of the MCL in the osteotomy area, and then the bone fragment attached to the MCL was filled into the osteotomy area to increase bone filling and bone coverage after the alignment of the lower limb was corrected. The hip-knee-ankle angle (HKAA), medioproximal tibial angle (MPTA), and joint line convergence angle (JLCA) were measured preoperatively and at 18 months postoperatively in both groups to evaluate correction of the alignment of the lower limb. Fracture healing time, bone loss in the osteotomy area, Hospital for Special Surgery (HSS) knee score and visual analogue scale (VAS) were recorded to evaluate the postoperative efficacy.Results:There was no statistically significant difference between the TOWHTO and MOWHTO groups in the general clinical data before operation, showing comparability ( P>0.05). At 18 months after operation, HKAA was (179.1° ± 1.1°) in the TOWHTO group and (179.3° ± 0.7°) in the MOWHTO group while MPTA was (91.9° ± 0.4°) in the TOWHTO group and (91.9° ± 0.4°) in the MOWHTO group, showing no statistically significant difference between the 2 groups ( P>0.05) but a significant difference between preoperation and postoperation in each group ( P<0.05). At 18 months after operation, JLCA was (1.8° ± 0.4°) in the TOWHTO group, significantly larger than that in the MOWHTO group (1.5° ± 0.4°), HSS score was 81.5 (79.5, 83.0) points in the TOWHTO group, significantly lower than that in the MOWHTO group [85.0 (82.5, 87.5) points], and VAS was 1.8 (1.6, 2.0) points in the TOWHTO group, significantly higher than that in the MOWHTO group [1.5 (1.5, 2.0) points] (all P<0.05). At 18 months after operation, the preoperative JLCA was significantly improved in both groups ( P<0.05). The time required for a fracture healing score higher than 4 points was (3.3 ± 0.6) months in the TOWHTO group and (4.5 ± 0.9) months in the MOWHTO group, and the rate of bone loss in the osteotomy area was 20% in the TOWHTO group (6/30) and 0 (0/30) in the MOWHTO group, both showing a significant difference between the 2 groups ( P<0.05). Conclusions:Both TOWHTO and MOWHTO can effectively treat varus KOA. MOWHTO is more effective in promoting bone healing in the osteotomy area, reducing bone defects in the osteotomy area and improving knee function.

Inflammatory myofibroblastic tumor (IMT)is a potentially or low-grade malignant mesenchymal neoplasm, which is rare in clinic. Renomedullary interstitial cell tumor(RICT) is a clinically rare benign renal tumor. The combination of these two diseases in one patient has not been reported. A 25-year-old female patient was admitted to the hospital due to left back pain for 12 days and hematuria for 1 week. MRI of kidneys showed a mass in the left renal pelvis, which was considered as renal pelvic carcinoma. Urine cytopathological examination was negative. Robot-assisted laparoscopic radical left nephroureterectomy was performed. There was no tumor recurrence or metastasis during the follow-up for more than 6 months after operation.

Objective:To investigate the experience and results of the modified lateral prostate capsule sparing robot-assisted radical cystectomy-orthotopic ileal neobladder (LPCS-RARC-OIN).Methods:From December 2018 to November 2020, 19 patients received LPCS-RARC-OIN by a single surgeon in Sun Yat-sen Memorial Hospital, Sun Yat-sen University. LPCS-RARC-OIN was performed on male patients with high-risk non-muscle-invasive bladder cancer or muscle-invasive bladder cancer cT 2N 0M 0 without tumour in the bladder neck or urethra, and prostate cancer was ruled out by MRI and serum PSA<2.5ng/ml. The average age was 57.6 years, the average IIEF-5 score was 20.4. Separating the prostatic adenoma and the lateral prostate capsule from the base to the apex of the prostate, and retaining the lateral prostate surgical capsule or lateral prostate capsule about 1-2mm thickness. Patients were followed up and urinary function, sexual function and oncological outcomes were recorded. Results:All 19 operations were finished successfully. The average operation time was 279.9 (225-345) min and average estimated blood loss was 88.9 (30-200) ml. The average postoperative hospital stays was 15.8 (9 -23) days. The average lymph node yields was 23.3 (11-42). All surgical margins were negative and no incidental prostate cancer was found. 2 weeks, 1 month, 3 months and 6 months after catheter removal, the daytime and nighttime continence were 42.1% (8/19)and 36.8% (7/19), 63.2% (12/19)and 63.2% (12/19), 78.9% (15/19) and 73.7% (14/19), 94.7% (18/19) and 89.5% (17/19), respectively. 3 months and 6 months after operation, the average IIEF-5 score was 7.2 and 10.1 points respectively. The average follow-up was 10.6 months (5.4-26.1 months)and no recurrence or distant metastasis was found in this study.Conclusions:LPCS-RARC-OIN could improve the urinary and sexual function in selected patients. However, the long-term follow up is needed for functional and oncological outcomes.

【Objective】 To investigate the effect of allogeneic platelet-rich on the healing and regeneration of diabetic foot wounds. 【Methods】 A total of 86 patients with diabetic foot ulcer treated in our hospital from January 2019 to June 2020 were selected for this study. They were divided into 2 groups by the random number table method, with 43 patients in each group. The control group was given conventional treatment according to the Guidelines for the Diagnosis and Treatment of Diabetic Foot in China, and the observation group was further treated with platelet-rich gel (APG) from the allogeneic blood bank.The clinical efficacy, general conditions, wound conditions, inflammatory factors, serum levels of transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF) and hyaluronic acid (HA) were compared between the two groups. 【Results】 The total effective rate of patients in the observation group was 93.02%, higher than 76.73% in the control group (P<0.05). The wound healing time (15.08±3.19 vs 17.38±4.02) d and hospitalization time (16.12±4.03 vs 18.27±5.11) d in the observation group were shorter than those in the control group (P<0.05). Before treatment, there were no significant differences in hsCRP (4.25±0.39 vs 4.10±0.41) mg/L, TNF-α (5.70±1.29 vs 5.81±1.33) μ g/L and IL-6 (96.38±24.02 vs 99.64±25.17) mg/L between the two groups (P>0.05). After treatment, hsCRP (2.35±0.50 vs 2.83±0.44) mg/L, TNF-α(3.15±0.82 vs 4.02±1.07) μ g/L and IL-6 (50.82±18.54 vs 72.93±20.25) mg/L in the observation group were lower than those in the control group (P < 0.05). Before treatment, there were no significant differences in TGF-β 1 (5.66±1.25 vs 5.81±1.31) ng/L, VEGF (11.03±3.62 vs 10.83±3.72) μ g/L and ha (71.19±20.84 vs 70.82±21.03) mg/L between the two groups (P>0.05). After treatment, the levels of TGF-β 1 (17.29±4.09 vs 14.03±3.72) ng/L, VEGF (43.03±14.17 vs 37.04±11.05) and ha (177.96±39.08 vs 151.94±36.17) in the observation group were higher than those in the control group (P<0.05). 【Conclusion】 On the basis of conventional treatment, allogeneic blood bank concentrated platelet APG can effectively improve the curative effect of diabetic foot wound and shorten the wound healing time and hospitalization time. The mechanism may be related to reducing the level of inflammatory factors and increasing TGF-β 1, VEGF and HA.