Objective To analyze the influencing factors of clinical pregnancy and live birth rates in patients undergoing frozen-thawed embryo transfer(FET)for the first time.Methods The clinical data of 1 458 patients who underwent FET cycle-assisted pregnancy for the first time were retrospectively analyzed and divided into four groups according to clinical pregnancy and live bith outcomes.The clini-cal data were compared to analyze the factors affecting clinical pregnancy and live birth rates in FET cycles that were included in multiple logistic regression analysis.Results Of the 1458 cycles,the clinical pregnancy and live birth rates were 44.0% and 34.0%,respectively.The mean age of the clinical pregnancy and live birth groups was lower than that in non-clinical pregnancy and stillbirth groups(P<0.05).The clinical pregnancy and live birth rates of patients aged<35 years were higher than those aged≥35 years(P<0.05).The clinical preg-nancy and live birth rates of patients with≥8 mm endometrial thickness were higher than those with<8 mm endometrial thickness(P<0.05).The clinical pregnancy rate of natural cycles of endometrial preparation regimen was higher than that of HRT cycles(P<0.05).The clinical pregnancy and live birth rates of double-embryo transfers were higher than that of single-embryo transfers(P<0.05).The clinical pregnancy and live birth rates of blastocyst transfers were higher than those of cleavage stage(P<0.05).Conclusion Age,endometrial thickness,number of transplanted embryos,and embryo morphology were the independent factors influencing clinical pregnancy and live birth outcomes during FET cycle transplantation.

Objective:To establish ulcerative colitis(UC)rat model of spleen deficiency and dampness,and to explore effect of Jianpi-Huazhu pill and its different deconditions on TLR-4/MyD88/NF-κB pathway.Methods:A total of 64 Wistar rats were ran-domly divided into normal control group(n=8)and model group(n=56).UC rat model was established by traditional Chinese medi-cine syndrome combined with ethanol-2,4,6-trinitrobenzene sulfonic acid enema method.After successfully modeling,rats were ran-domly divided into model group(M),Mesalazine group(A),Jianpi-Huazhi pill group(B),Jianpi-Qinghua decoction group(C),Jianpi-Qinghua-Huoxue decoction group(D),Jianpi-Qinghua-Daozhi decoction group(E)and Qinghua-Daozhi-Huoxue decoction group(F),with 8 rats in each group,given corresponding drugs by gavage for 4 weeks.At end of course of treatment,all rats were sacrificed and samples were taken.Changes of body weight,disease activity and pathological changes of colon were observed.TNF-α expression in colon tissue was detected by ELISA and immunohistochemistry.RT-PCR and Western blot were used to detect mRNA and protein expressions of TLR-4,MyD88 and NF-κB in rat colon tissue.Results:Rats weight in Jianpi-Huazhi pill group,Jianpi-Qinghua decoction group,Jianpi-Qinghua-Huoxue decoction group and Jianpi-Qinghua-Daozhi decoction group were obviously higher than that of model group(P<0.01),all treatment groups could obviously improve UC model rat pathological damage and disease activity index in colon tissue,and Jianpi-Huazhi pill group and Jianpi-Qinghua-Huoxue group showed better efficacy.All treatment groups could inhibit mRNA and protein expressions of TLR-4,MyD88 and NF-κB in colon tissue(P<0.001).Mesalazine group,Jianpi-Huazhi pill group,Jianpi-Qinghua-Daozhi group and Qinghua-Daozhi-Huoxue group were significantly better than Jianpi-Qinghua group and Jianpi-Qinghua-Huoxue group in reducing NF-κB mRNA and protein expressions(P<0.05).All groups could reduce expres-sion of TNF-α in colon tissue(P<0.001),and there was no significant difference between groups(P>0.05).Conclusion:Jianpi-Huazhi pill and its various deconditions may play roles through TLR-4/MyD88/NF-κB pathway.Among them,Coptid-Rhizoma coptifo-lia,stews woody incense,Fengwei herb and gung ginger may be core drugs of this recipe,which has certain guiding significance for clinical practice.

Objective:To systematically review and integrate the caring experience of caregivers of lung transplant patients.Methods:Qualitative studies on the caregiving experience of caregivers of lung transplant patients were searched by computer from PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang data, and the search period was from establishment of the databases to April 30, 2023. The qualitative research quality evaluation criteria (2016 edition) of the Joanna Briggs Institute Evidence Based Health Care Center in Australia were used to evaluate the quality of the included literature, and the Meta-synthesis was used to integrate the literature results.Results:A total of ten articles were included, and 33 clear research results were extracted, which were summarized into eight new categories, and finally summarized into four integrated results, such as heavy burden experience, strong demand, positive experience and satisfaction with the medical service system.Conclusions:Medical workers should attach importance to and pay attention to the burden and needs of caregivers of lung transplant patients, provide professional and emotional support to caregivers, improve their caring ability and quality, and ultimately improve the quality of life of lung transplant patients.

Objective:To investigate the recent epidemic trends and spatiotemporal distribution characteristics of gonorrhea in China, and to provide a reference for precise prevention and control of gonorrhea.Methods:Data on reported cases of gonorrhea in China (not including Hongkong, Macau and Taiwan regions of China) were collected from the Infectious Diseases Surveillance System of Chinese Disease Prevention and Control Information System from 2018 to 2023. The trends in reported incidence rates of gonorrhea in China were analyzed using the Joinpoint regression model. Global spatial autocorrelation analysis with the Moran's index and global G-statistic, as well as local spatial autocorrelation analysis, were employed to explore the clustering patterns and hotspot regions of gonorrhea at the county level. In the spatiotemporal scanning analysis, a Poisson distribution model was employed to identify clusters of gonorrhea cases.Results:The reported incidence rates of gonorrhea in China decreased from 9.59 per 100 000 in 2018 to 7.35 per 100 000 in 2023, with an average annual percent change of -4.9%, but this decreasing trend was not statistically significant ( P = 0.11). The reported incidence rates of gonorrhea at the county level in China exhibited a significant positive global spatial autocorrelation, with the global Moran's indices ranging from 0.39 to 0.60 (all P < 0.001) ; the Getis-Ord general G test statistic Z (G) values were all greater than 1.96, indicating a high-value clustering pattern of gonorrhea cases. The local spatial autocorrelation analysis showed that hotspot regions were predominantly distributed in southeastern coastal areas and southwestern China. A total of 70 clusters were identified through the spatiotemporal scanning analysis, and mainly located in southeastern coastal areas and southwestern China. Conclusions:In recent 6 years, the overall reported incidence rates of gonorrhea in China showed a fluctuating decline; there was a significant spatiotemporal clustering characteristic with regard to gonorrhea epidemic at the county level in China, and the hotspot regions were basically consistent with the spatiotemporal clusters, which were mainly distributed in southeastern coastal areas and southwestern China. Further investigation into the causes and precise prevention and control measures are needed.

Objective:To investigate the epidemic trends and spatiotemporal distribution characteristics of genital Chlamydia trachomatis infection in China in recent years, and to provide a reference for its precise prevention and control.Methods:Data on reported cases of genital Chlamydia trachomatis infection in China (not including Hongkong, Macau and Taiwan regions of China) were collected through the Infectious Diseases Surveillance System of Chinese Disease Prevention and Control Information System from 2018 to 2023. The trend in the incidence rate was analyzed using the Joinpoint 4.9.1 software. Global and local spatial autocorrelation analyses at the county level were conducted using the ArcGIS 10.5 software. Spatiotemporal scanning analysis was carried out with the SaTScan 10.1.2 software.Results:The reported incidence rates of genital Chlamydia trachomatis infection slightly declined from 12.66 per 100 000 in 2018 to 12.45 per 100 000 in 2023, with an average annual percent change of -1.42%, which was not statistically significant ( t = -1.14, P = 0.318). The reported incidence rates of genital Chlamydia trachomatis infection at the county level in China showed a significant positive global spatial autocorrelation, with the global Moran's indices ranging from 0.68 to 0.74 (all P < 0.001) ; the standardized statistic Z (G) values for the Getis-Ord general G were all greater than 1.96, indicating a high-value clustering pattern. Local spatial autocorrelation analysis revealed that hotspot areas were predominantly located in southern and eastern China. In the spatiotemporal scanning analysis, 38 statistically significant spatiotemporal clusters were identified, mainly distributed in southern and eastern China and consistent with the hotspot areas. Conclusions:From 2018 to 2023, the reported incidence rates of genital Chlamydia trachomatis infection showed a slight decline, and the epidemic exhibited spatiotemporal clustering characteristics in China. Targeted prevention and control measures need to be implemented in hotspot areas and spatiotemporal clusters.

Objective:To investigate the epidemiological trends and spatio-temporal distribution characteristics of syphilis in China from 2010 to 2023.Methods:Data on syphilis cases reported from 31 provinces, autonomous regions or municipalities from 2010 to 2023 were collected from the Infectious Diseases Surveillance System of Chinese Disease Prevention and Control Information System. Joinpoint 5.2.0 software was used to analyze the epidemiological trends of syphilis, ArcGIS 10.5 software was used for spatial autocorrelation analysis at the county level, and SaTScan 10.2.3 software was used for space-time scan analysis.Results:The national reported incidence rates of syphilis increased from 26.86 per 100 000 in 2010 to 37.60 per 100 000 in 2023, with an average annual percent change of 1.82% (95% CI: 0.81% - 2.89%), and the upward trend in the reported incidence rates was statistically significant ( P = 0.002). There was a positive spatial autocorrelation in the reported incidence rates of syphilis at the county level in China (Moran's Ⅰ range: 0.47 - 0.60, all P < 0.001), and all of the Getis-Ord general test statistic Z (G) values were > 1.96, indicating a high-value clustering pattern in the reported incidence rates of syphilis. The local spatial autocorrelation analysis showed that the annual number of hotspot areas ranged from 180 to 294, which were mainly located in Xinjiang, Qinghai, Guizhou, Sichuan and Yunnan. A total of 92 spatio-temporal clusters were identified by space-time scan analysis, which were mainly distributed in Zhejiang, Guangxi, Guangdong and Fujian from 2010 to 2012, in Xinjiang from 2013 to 2017, and in Sichuan, Guizhou, Chongqing, etc., from 2019 to 2023. Conclusions:From 2010 to 2023, the reported incidence rates of syphilis in China exhibited a fluctuating increase on the whole, with obvious spatio-temporal clustering characteristics. The hotspot areas were basically consistent with the spatio-temporal clusters, and were mainly distributed in the northwestern, southeastern coastal and southwestern areas. Over time, the spatio-temporal clusters gradually changed from the southeast coastal and northwestern areas to the southwestern areas.

Objective:To analyze the effect of enzyme replacement therapy (ERT) in 18 patients of Pompe disease.Methods:Clinical data, laboratory tests, acid alpha-glucosidase (GAA) enzyme activity, GAA gene, outcome and follow-up of ERT in 18 cases of infantile and late-onset Pompe disease admitted to the First Affiliated Hospital of Sun Yat-sen University from October 2020 to May 2023 were retrospectively collected and analyzed. Results:Among the 18 patients with Pompe disease, 9 are males, and 9 are females; 4 had infantile onset, 5 had late-onset in children, and 9 had late-onset in adults; age of onset ranged from 4 months to 43 years; ERT was received from 1 to 61 times, with only 1 adverse reaction during infusion. Among the 4 infantile onset patients after standardized ERT, 2 had stable motor and respiratory function, 1 had difficulty removing from vetilator, and 1 died. Most of the muscle strength of extremities of late-onset patients were difficult to reverse, and creatine kinase gradually decreased or remained stable, while subjective symptoms, exercise endurance, and respiratory function were significantly improved. ERT was most effective in the early stages and the disease remained stable for 1 to 2 years after treatment.Conclusions:ERT is safe and effective, which can help delay disease progression and improve the quality of life of patients. Early standard treatment is beneficial for both infantile- and late-onset patients.

Objective To analyze the level of 25-hydroxyvitamin D[25(OH)D]in patients with type 2 diabetes mellitus,and preliminarily investigate the correlation between serum 25(OH)D level and metabolic indicators such as glycosylated hemoglobin(HbA1c)and pancreatic islet function in patients with type 2 diabetes mellitus.Methods A total of 459 patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrinology,Xinxiang First People's Hospital from January 2020 to December 2020 were selected as the research subjects.Clinical data of the patients were collected,including gender,age,serum 25(OH)D,fasting insulin,C-peptide,HbA1c,fasting blood glucose,postprandial blood glucose,urinary microalbumin,urinary albumin-to-creatinine ratio,blood calcium,blood uric acid(UA),triglyceride(TG),total cholesterol(TCH),low-density lipoprotein(LDL),and high-density lipoprotein(HDL).According to the serum 25(OH)D level,the patients were divided into sufficient group[n=20,25(OH)D≥30 μg·L-1],insufficient group[n=95,20 μg·L-125(OH)D＜30 μg·L-1],deficient group[n=231,10 μg·L-1 ≤25(OH)D＜20 μg·L-1],and severely deficient group[n=113,25(OH)D＜10 μg·L-1].Differences in metabolic indicators of patients in the four groups were compared,and the correlation between 25(OH)D level and metabolic indicators was analyzed by using the Pearson correlation.Results The serum 25(OH)D level of patients with type 2 diabetes mellitus was 3.00-46.59(15.75±0.35)μg·L-1;the serum 25(OH)D level of male patients was significantly higher than that of female patients(P＜0.05).The prevalence of 25(OH)D deficiency in patients with type 2 diabetes mellitus was 74.9％(344/459).The 25(OH)D deficiency mainly occurred in January,February,March,April,November,and December.Patients in the insufficient,deficient,and severely deficient groups had significantly higher HbA1c levels than those in the sufficient group(P＜0.05),and the HbA1c levels of patients in the deficient and severely deficient groups were significantly higher than those in the insufficient group(P＜0.05);there was no statistically significant difference in the HbA1c level between the deficient group and the severely deficient group(P＞0.05).There was no statistically significant difference in fasting blood glucose between the sufficient group and insufficient group,and between the deficient group and severely deficient group(P＞0.05);fasting blood glucose of patients in the deficient and severely deficient groups was significantly higher than that in the sufficient and insufficient groups(P＜0.05).There was no statistically significant difference in fasting insulin,urinary microalbumin,daily total urinary albumin,and urinary albumin-to-creatinine ratio of patients among the sufficient,insufficient,and deficient groups(P＞0.05);the fasting insulin of patients in the severely deficient group was significantly lower than that in the sufficient,insufficient,and deficient groups(P＜0.05);the urinary microalbumin,daily total urinary albumin,and urinary albumin-to-creatinine ratio of patients in the severely deficient group were significantly higher than those in the sufficient,insufficient,and deficient groups(P＜0.05).There was no statistically significant difference in the homeostasis model assessment for insulin resistance(HOMA-IR),serum albumin,blood creatinine,1-hour postprandial blood glucose,2-hour postprandial blood glucose,3-hour postprandial blood glucose,fasting C-peptide,1-hour postprandial C-peptide,2-hour postprandial C-peptide,3-hour postprandial C-peptide,TG,TCH,LDL,HDL,blood UA,and blood calcium of patients among the four groups(P＞0.05).Pearson correlation analysis showed that serum 25(OH)D levels in patients with type 2 diabetes mellitus were negatively correlated with HbA1c,urinary microalbumin,and urinary albumin-to-creatinine ratio(r=-0.093,-0.166,-0.157;P＜0.05),and positively correlated with fasting insulin(r=0.089,P＜0.05).Serum 25(OH)D levels in patients with type 2 diabetes mellitus had no correlation with fasting blood glucose,HOMA-IR,serum albumin,blood creatinine,1-hour postprandial blood glucose,2-hour postprandial blood glucose,3-hour postprandial blood glucose,fasting C-peptide,1-hour postprandial C-peptide,2-hour postprandial C-peptide,3-hour postprandial C-peptide,TG,TCH,LDL,HDL,blood UA,and blood calcium(P＞0.05).Conclusion 25(OH)D deficiency and insufficiency are common in patients with type 2 diabetes mellitus,especially in female patients.In patients with type 2 diabetes mellitus,25(OH)D level is positively correlated with fasting insulin and negatively correlated with HbAlc,urinary microalbumin,and urinary albumin-to-creatinine ratio.25(OH)D deficiency in patients with type 2 diabetes mellitus is mainly distributed in January,February,March,April,November,and December.

Objective To observe the value of dynamic contrast enhanced MRI(DCE-MRI)for evaluating the early efficacy of chemotherapy in rabbit models of VX2 malignant bone tumor.Methods Models of VX2 malignant bone tumor were established in 30 rabbits,among which 14 were treated with intravenous cisplatin by 7 mg/kg body mass(chemotherapy group),while the other 16 were injected with equal dose of normal saline(control group).Non-contrast MRI and DCE-MRI were acquired 2 weeks after tumor implantation(before intervention)and 3 days later injection(after intervention),respectively.Point-to-point comparisons were performed between images and pathological findings,and the values of volume transfer constant(Ktrans),rate constant(Kep),extravascular and extracellular volume fraction(Ve),plasma volume fraction(Vp)and microvessel density(MVD)in tumor region were obtained.MRI findings before and after intervention within groups,as well as those after intervention were compared between groups.The efficacy of the above parameters forjudging whether the tumor being treated with chemotherapy or not was evaluated with receiver operating characteristic(ROC)curve and the area under the curve(AUC),and the correlations between DCE-MRI parameters after intervention and MVD were analyzed.Results No statistical difference of the maximum diameter of tumors shown on plain MRI was found before and after intervention in chemotherapy group(P＞0.05).Compared with those before intervention,Ktrans and Kep in tumor region decreased in chemotherapy group but increased in control group after intervention(allP＜0.05),while no significant difference of Ve nor Vp was found in both groups(all P＞0.05).Ktrans and Kep in chemotherapy group were lower than those in control group(both P＜0.05),while no significant difference of Ve nor Vp between groups after intervention(both P＞0.05).The AUC of Ktrans,Kep,Ve and Vp for judging whether the tumor treated with chemotherapy or not was 0.964,0.933,0.317 and 0.455,respectively.MVD in tumor regions in chemotherapy group was lower than that in control group after intervention(P＜0.05).Ktrans and Kep in tumor region in both groups were positively correlated with MVD(r=0.876,0.881,both P＜0.05),while Ve and Vp did not significantly correlated with M VD(r=0.118,0.202,both P＞0.05).Conclusion DCE-MRI quantitative parameters Ktrans and Kep could be used to sensitively observe the early reflection of rabbit models of VX2 malignant bone tumor to chemotherapy and changes of MVD.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.