BACKGROUND:Extracellular vesicles mediate intercellular signal transduction through the proteins,nucleic acids,and lipids they carry,thereby influencing the function of target cells.This vesicle-mediated communication mechanism is involved in regulating female reproductive development.OBJECTIVE:To summarize and analyze the regulatory roles of extracellular vesicle-mediated intercellular communication in female reproductive development.METHODS:A search was conducted in the PubMed database using the search terms"extracellular vesicles,exosomes,reproduction,maternal-embryo communication,maternal-fetal crosstalk,embryo implantation,endometrium,oviduct,follicle."The initial screening was carried out by reading the titles and abstracts of the literature,and then the literature with poor relevance to the research purpose,outdated content,and duplication was excluded according to the inclusion and exclusion criteria.Ultimately,69 relevant articles were included for comprehensive analysis.RESULTS AND CONCLUSION:Extracellular vesicles play a crucial role in key processes of female reproductive development,from folliculogenesis to implantation.(1)Extracellular vesicles mediate intercellular communication within the follicle,particularly the interactions between oocytes and follicular cells,which are essential for follicle development and maturation.(2)Extracellular vesicles and their contents facilitate interactions between the embryo and the fallopian tube,influencing the trajectory of embryonic development.(3)Extracellular vesicles and their contents promote implantation by mediating bidirectional communication between the embryo and the endometrium.Uterine-derived extracellular vesicles regulate processes such as embryo adhesion,invasion,and decidualization,while embryo-derived extracellular vesicles modulate endometrial receptivity,convey embryonic signals,and adjust the endometrial microenvironment.Studying the roles of extracellular vesicles in female reproductive development can provide valuable insights into the mechanisms of infertility and support the development of new therapeutic strategies.

BACKGROUND:Extracellular vesicles mediate intercellular signal transduction through the proteins,nucleic acids,and lipids they carry,thereby influencing the function of target cells.This vesicle-mediated communication mechanism is involved in regulating female reproductive development.OBJECTIVE:To summarize and analyze the regulatory roles of extracellular vesicle-mediated intercellular communication in female reproductive development.METHODS:A search was conducted in the PubMed database using the search terms"extracellular vesicles,exosomes,reproduction,maternal-embryo communication,maternal-fetal crosstalk,embryo implantation,endometrium,oviduct,follicle."The initial screening was carried out by reading the titles and abstracts of the literature,and then the literature with poor relevance to the research purpose,outdated content,and duplication was excluded according to the inclusion and exclusion criteria.Ultimately,69 relevant articles were included for comprehensive analysis.RESULTS AND CONCLUSION:Extracellular vesicles play a crucial role in key processes of female reproductive development,from folliculogenesis to implantation.(1)Extracellular vesicles mediate intercellular communication within the follicle,particularly the interactions between oocytes and follicular cells,which are essential for follicle development and maturation.(2)Extracellular vesicles and their contents facilitate interactions between the embryo and the fallopian tube,influencing the trajectory of embryonic development.(3)Extracellular vesicles and their contents promote implantation by mediating bidirectional communication between the embryo and the endometrium.Uterine-derived extracellular vesicles regulate processes such as embryo adhesion,invasion,and decidualization,while embryo-derived extracellular vesicles modulate endometrial receptivity,convey embryonic signals,and adjust the endometrial microenvironment.Studying the roles of extracellular vesicles in female reproductive development can provide valuable insights into the mechanisms of infertility and support the development of new therapeutic strategies.

ObjectiveTo explore the possible mechanisms of Wenyang Huazhuo Formula （温阳化浊方， WHF） in improving reproductive aging from the perspective of the ovarian mechanical microenvironment. MethodsThe experiment included five groups， 3-month group （20 female mice at 3 months of age）， 6-month group （20 female mice at 6 months of age）， 6-month + WHF group （20 female mice at 5 months of age treated with WHF）， 9-month group （20 female mice at 9 months of age）， and 9-month + WHF group （20 female mice at 8 months of age treated with WHF）. The 6-month + WHF group and 9-month + WHF group were orally administered WHF 41.2 g/（kg·d） once daily for 4 consecutive weeks. The other three groups received no intervention. Reproductive hormone levels were measured by ELISA. HE staining was used to count the numbers of various stages of follicles. Ovarian hyaluronic acid （HA） content and collagen fiber content were measured to evaluate the ovarian mechanical microenvironment. Superovulation was performed to observe the number of eggs obtained， as well as the number of offspring and birth weight to assess fertility. The in vitro fertilization and blastocyst culture of oocytes from female offspring in each group were observed to evaluate the effect of WHF on offspring reproductive potential. ResultsCompared with the 3-month group， the 6-month group and 9-month group showed significantly decreased serum levels of gonadotropin-releasing hormone （GnRH）， follicle-stimulating hormone （FSH）， and luteinizing hormone （LH）， decreased ovarian collagen content， and reduced numbers of primordial and secondary follicles. In contrast， the numbers of primary follicles， antral follicles， and atretic follicles increased. The levels of anti-Müllerian hormone （AMH）， ovarian HA content， and the fertilization rate， cleavage rate， and blastocyst formation rate of oocytes from offspring were significantly lower （P＜0.05）. Compared with the 6-month group， the 6-month + WHF group showed significantly reduced serum levels of GnRH， FSH， and LH， with a significant decrease in primary follicles， antral follicles， and atretic follicles as well as increase of AMH levels， ovarian HA content， number of primordial and secondary follicle， egg count， and offspring birth weight （P＜0.05）. Compared with the 9-month group， the 9-month + WHF group exhibited reduced GnRH， FSH， and collagen fiber content， as well as reduced number of primary follicles， antral follicles， and atretic follicles. However， AMH levels， ovarian HA content， number of primordial and secondary follicle， egg count， offspring numbers， birth weight， fertilization rate， cleavage rate， and blastocyst formation rate of oocytes from offspring all significantly increased （P＜0.05）. ConclusionWHF can significantly improve the ovarian reserve， fertility， and reproductive potential in offspring during reproductive mid-life and late-life stages. Its effect may be related to the remodeling of the mechanical microenvironment of aging ovaries. Moreover， the effect on the mechanical microenvironment remodeling of late-stage ovaries and the improvement of the offspring reproductive potential is more significant.

Objective:To conduct a scoping review of risk prediction models for the development of intraoperative hypothermia in patients undergoing cancer surgery to inform clinical nursing practice and future research.Methods:Relevant literature on constructing or validating intraoperative hypothermia risk prediction models for cancer surgery patients in five foreign language databases (PubMed, Embase, Web of Science, Cochrane Library, CINAHL) and four Chinese language databases (China National Knowledge Infrastructure, Wanfang, VIP, Chinese Biomedical Database) were searched from the time of library construction to June 1, 2024, extracted information on the applicable target, incidence of intraoperative hypothermia, methodology of model construction, predictors and performance, etc. The Prediction model Risk Of Bias Assessment Tool was used to evaluate the risk of bias of the studies, and the included literature was analyzed and discussed.Results:A total of 15 pieces of literature involving 18 models were included, with the study population focussing on patients undergoing surgery for colorectal cancer. The rate of intraoperative hypothermia ranged from 15.14% to 61.5%. Model construction methods included 2 types of Logistic regression models and machine learning, and model presentation was based on column-line plots. There were 8 predictors that appeared with a frequency of ≥5, including age, body mass index, operation time, anaesthesia time, operating room temperature, intraoperative rehydration volume, intraoperative bleeding volume, and heat preservation method.Conclusions:The performance of the included model was good, but the risk of bias was high for the predictors and the analysis part, and nursing staff should pay close attention to the risk factors of intraoperative hypothermia in patients undergoing cancer surgery, construct a risk prediction model with low bias and high applicability, and validate and improve the existing risk prediction model.

Lipids play an important role in the regulation of cell life processes.Although there are various lipid detection methods,Raman spectroscopy,a non-invasive technique,provides the detailed chemical composition of lipid profiles without a complex sample preparation procedure and possesses greater potential in basic biology,clinical diagnosis and disease therapy.In this review,we summarized the characteristics and advantages of Raman-based techniques and their primary contribution to illustrating cellular lipid metabolism.

Acute ischemic stroke(AIS)is associated with high mortality and disability rates,presenting a substantial challenge to global public health challenge.Intravenous thrombolysis(IVT)is recognized as a cornerstone of early AIS treatment and is recommended as the standard therapeutic approach by both national and international guidelines.However,the clinical efficacy of IVT remains suboptimal due to several limitations,including a narrow therapeutic time window and the inevitable activation of the coagulation system and platelet aggregagation during thrombolysis.These factors may contribute to adverse outcomes such as early neurological deterioration(END)and vascular re-occlusion.Antiplatelet therapy(APT),which inhibits platelet aggregations,reduces microthrombus formation,and stabilizes the vascular endothelium with multifaceted mechanisms,has emerged as a promising adjunctive strategy to IVT,offering potential synergistic effects.This review summarized the latest evidence from both domestic and international studies,focusing on the mechanisms of APT,recent clinical advancements in IVT combined with APT,and the safety and efficacy of APT administration at different time windows relative to IVT.Emphasis is placed on the influence of various antiplatelet agents,dosing regimens,and initiation timing on therapeutic outcomes,alongside a comprehensive evaluation in the context of current guideline recommendations and clinical practice.Current guidelines recommend initiating APT 24 h after IVT,following imaging confirmation to exclude the risk of intracranial hemorrhage.However,the efficacy and safety of earlier APT initiation remain inconclusive.Individualized treatment strategies,such as early administration of low-dose,short-acting APT or combination therapy in specific patient subgroups,may effectively balance therapeutic benefits and risks.The adjunctive use of APT in IVT holds promise for enhancing efficacy and improving clinical outcomes,but precise stratification of safety and efficacy is essential.Future research should focus on optimizing combination IVT and APT strategies through individualized patient profiling,appropriate drug selection,and dynamic imaging monitoring to achieve precision management in AIS treatment.

OBJECTIVE To understand the disinfectant-resistant genes in the gram-negative bacteria isolated from the dirt retention on air recure filters of air conditioners and observe the drug resistance.METHODS The dirt re-tention samples were collected from the air return filters of air conditioners of some wards in 3 hospitals of Wuhan(Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan Central Hospital,and Hubei Provincial Maternal and Child Health Hospital)from 2018 to 2024.The gram-negative bac-teria were screened out,the disinfectant-resistant genes in the strains were detected by polymerase chain reaction(PCR),and the results of drug susceptibility test were analyzed.RESULTS Of 354 dirt retention samples that were collected from the air return filers of air conditioners,77 were detected with 138 strains of gram-negative bacteria,87 of which were Acinetobacter baumannii,50 were Enterobacteriaceae,and 1 was Pseudomonas aerug-inosa.The detection rates of qacEΔ1,qacEΔ1-sul1,aceI and qacA/B were 73.19％,82.61％,69.57％and 2.90％,respectively.None of the strains were detected with qacC,qacH or qacJ.The result of drug susceptibility test showed that 76.81％of the gram-negative bacteria were resistant to at least 1 type of antibiotic;93 strains of multidrug-resistant gram-negative bacteria were isolated,most of which were isolated from intensive care unit(ICU).The detection rates of qacEΔ1 and qacEΔ1-sul1 were higher in the drug-resistant strains than those in the non-drug-resistant strains;there were significant differences in the drug resistance rates to carbapenems,quin-olones and β-lactams between the qacEΔ1-sul 1-positive strains and the qacEΔ1-sul1-negative strains(P＜0.05).CONCLUSIONS There are drug-resistant gram-negative bacteria contaminations in some wards of the 3 hospitals in Wuhan.The carrying rates of disinfectant-resistant genes of the strains are high,and the strains show varying degree of resistance to the commonly used antibiotics;the strains carrying the qacEΔ1-sul1 have certain statistical association with the drug resistance.It is suggested that the hospital should take targeted disinfec-tion measures for the environment and reasonably use antibiotics.

During decidualization, lactic acid is produced and accumulated in large amounts, becoming a prominent feature of the decidual microenvironment. Lactic acid not only serves as a key product in metabolic pathways, participating in rapid energy generation and conversion, but also influences cellular functional states by regulating the acid-base balance of the microenvironment. Furthermore, as a signaling molecule, lactic acid plays a central role in regulating decidual immune metabolism, promoting decidual angiogenesis, and facilitating trophoblast invasion, all of which are crucial for embryo implantation. In recent years, the role of lactic acid in epigenetics has also gradually emerged, with lactylation modifications involved in regulating gene expression and maintaining the homeostasis of the decidual microenvironment. This article will delve into the specific roles of lactic acid in the decidual microenvironment, aiming to provide new perspectives and theoretical foundations for the study of pregnancy-related diseases.

Decreased endometrial receptivity is a critical factor contributing to the decline in fertility among women of advanced age. With the increase of age, the endometrium exhibits diminished hormonal responsiveness, a phenomenon known as inflammaging, and an imbalance in immune cell populations. These changes impede the processes of endometrial epithelial-mesenchymal transition and decidualization, thereby negatively impacting embryo implantation and reducing overall fertility potential. Furthermore, adverse lifestyle choices, exposure to environmental factors, inflammatory conditions, and repeated interventions within the uterine cavity can result in pathological aging of the endometrium that does not align with its chronological age. This misalignment may be associated with the emergence of various reproductive disorders, even in younger women. This paper seeks to investigate the relationship between pathological aging of the endometrium and reproductive disorders, particularly in the context of embryo implantation, with the aim of providing new insights into the pathogenesis, clinical diagnosis, and treatment of reproductive disorders.

Objective:The clinical effect of astragalus membranaceus and mifepristone on endometriosis and its effects on patiens' immune function and inflammatory factors were analyzed.Methods:A total of 86 patients with cold-coagulation and blood-stasis endometriosis treated in Henan Provincial Hospital of Traditional Chinese from October 2021 to October 2022 were selected and divided into mifepristone group(41 cases)and astragalus and mifepristone combination group(45 cases)by random number table method.Evaluated the TCM syndrome score level of patients before and after treatment;detection of luteinizing hormone(LH),follicle-stimu-lating hormone(FSH),estradiol(E2),anti-mullerian hormon(AMH),hypersensitive C-reactive egg(hs-CRP),IL-6,IL-8,TNF-α,CD4+T,CD8+T,CD4+T/CD8+T and the number of Antral Follicle Coun(AFC)were compared between the two groups.Results:After treatment,the levels of abdominal pain,dysphoria,cold shape and limb cold score,LH,FSH,E2,hs-CRP,IL-6,IL-8,TNF-α,CD8+T and AMH in combination group were lower than those in mifepristone group(P<0.05).CD4+T,CD4+T/CD8T+and AFC were higher than those in mifepristone group(P<0.05).The total effective rate of the combination group after treatment was higher than that of the mifepristone group(P<0.05).Conclusion:By combining astragalus and mifepristone,the traditional Chinese medicine syndrome scores of patients with cold coagulation and blood stasis type endometriosis are reduced,sexual hormones and ovarian function are improved,inflammatory reactions are alleviated,and the clinical treatment effect is remarkable.