Objective To investigate the impact of the proportion of ova obtained from large and medium follicles on day of oocyte retrieval on outcomes of in vitro fertilisation(IVF).Methods A total of 120 infertile patients undergoing IVF treatment were selected as study subjects.Single follicle aspiration was performed for oocyte retrieval,and the volume of follicular fluid was measured.Follicu-lar fluid diameter was converted using V=4/3πR3,dividing follicles into large(diameter≥18 mm,V≥3 mL),medium(diameter of＞14 mm to＜18 mm,V of＞1.5 mL to＜3 mL)and small(di-ameter ≤14 mm,V≤1.5 mL)categories.The proportion of oocytes derived from large and medium follicles out of the total retrieved oocytes was calculated and categorised into high-proportion group(proportion of oocytes from large and medium follicles ≥ 71％,n=63)and low-proportion group(proportion＜71％,n=57).Comparisons were made between the two groups regarding follicular maturity,normal fertilisation rate[presence of two pronuclei(2PN)],fertilisation rate,embryo de-velopment and pregnancy outcomes.Results The number of follicles with a diameter＞14 mm on the day of human chorionic gonadotropin(HCG)injection was significantly higher in the high-propor-tion group than that in the low-proportion group(P＜0.05).Rates of mature oocytes(MII),normal fertilisation,fertilisation,high-quality embryo,available blastocyst,frozen embryos and oocyte utilisation rates were significantly higher in the high-proportion group compared to the low-proportion group(P＜0.05).There was no significant difference between the two groups in terms of female age,the number of transferred embryos,rate of transferring high-quality embryos and embryo implantation rate(P＞0.05).Conclusion The actual size of follicles on the day of oocyte retrieval is signifi-cantly correlated with embryo quality and developmental potential.When the proportion of oocytes from large and medium follicles is 71％and above,their maturation rate,fertilisation rate,and em-bryo developmental potential are significantly improved.

Objective:In order to improve the normativity and integrity of informed consent exemption from ethical review of retrospective clinical trials initiated by investigators in hospital settings, protecting the legitimate rights and interests of research participants, and improving the efficiency of ethical review.Methods:According to the relevant ethical review regulations at all levels and combined with the practical experience of ethical management in the second affiliated hospital of Wenzhou medical university in Zhejiang province, the present research took the primary review of clinical research projects initiated by investigators at the above institution as the research objectives, analyzed the problems existing during the application and ethical review of informed consent exemption, and summarized the construction and implementation effect of the hospital's clinical research ethical management system.Results:Main problems in the application for exemption of informed consent and ethical review were poor understanding of the essence of informed consent, insufficient consideration of privacy protection, the risk of abuse of informed consent exemption and inadequate effort of ethical review. With the aim of improving the standardization of ethical review of exempt consent, it was recommended to clarify the scope of exemption review, formulate strict exemption procedures, and strengthen the ethics training of all relevant personnel.Conclusions:Standardizing the ethical review management of investigator-initiated retrospective clinical trials contributes to protecting the legal rights and interests of research participants, and promoting the high-quality development of the ethical review norms of clinical research.

Objective:In order to improve the normativity and integrity of informed consent exemption from ethical review of retrospective clinical trials initiated by investigators in hospital settings, protecting the legitimate rights and interests of research participants, and improving the efficiency of ethical review.Methods:According to the relevant ethical review regulations at all levels and combined with the practical experience of ethical management in the second affiliated hospital of Wenzhou medical university in Zhejiang province, the present research took the primary review of clinical research projects initiated by investigators at the above institution as the research objectives, analyzed the problems existing during the application and ethical review of informed consent exemption, and summarized the construction and implementation effect of the hospital's clinical research ethical management system.Results:Main problems in the application for exemption of informed consent and ethical review were poor understanding of the essence of informed consent, insufficient consideration of privacy protection, the risk of abuse of informed consent exemption and inadequate effort of ethical review. With the aim of improving the standardization of ethical review of exempt consent, it was recommended to clarify the scope of exemption review, formulate strict exemption procedures, and strengthen the ethics training of all relevant personnel.Conclusions:Standardizing the ethical review management of investigator-initiated retrospective clinical trials contributes to protecting the legal rights and interests of research participants, and promoting the high-quality development of the ethical review norms of clinical research.

CRISPR-Associated Protein 9 ; Gene Editing ; CRISPR-Cas Systems/genetics*

Objective:To analyze the specific reasons for journal articles being retracted due to biomedical research-related ethical issues after publication and propose corresponding preventive measures.Methods:Journal articles that were retracted between January 1, 2021, and January 1, 2023, were retrieved from PubMed, a literature database in the biomedical field. The retraction statements of those articles that were retracted due to ethical-related issues were analyzed with a summarization of detailed reasons and types.Results:A total of 77 and 128 articles were retracted due to ethical issues in 2021 and 2022 respectively, accounting for 3.9% and 5.4% of all retracted articles in the same period. The major ethical issue was the lack of valid ethical approval. Among articles retracted for ethical issues related to human trials, the proportion of articles retracted due to lack of valid ethical approval increased from 45.9% in 2021 to 57.0% in 2022, which also increased from 50.0% in 2021 to 67.3% in 2022 among retracted articles related to animal experiments. Other ethical issues included problems in the informed consent process, delay in obtaining ethical approval, inconsistency between ethical approvals and the content of the article, and violation of the principles of laboratory animal welfare.Conclusions:The ethical review of medical research involving humans and laboratory animal welfare needs to be strengthened. By promoting the construction of an institutional ethical review system, encouraging researchers to study ethics-related knowledge, standardizing ethical applications and approvals, improving the informed consent process, and attaching importance to the welfare of laboratory animals, the retraction due to ethical issues can be prevented.

Neurogenic bowel dysfunction is one of the common complications after spinal cord injury. Long-term constipation and fecal incontinence can cause great troubles in the daily life of patients and seriously affect their quality of life. The key to the solution is effective intestinal intervention, including the establishment of defecation patterns, dietary interventions, and drug interventions, enema, electromagnetic stimulation, and enterostomy, etc. At the same time, a personalized bowel management plan is formulated based on the specific conditions of the patient to better manage the bowel and improve the patient′s quality of life.

The construction of clinical teaching faculty team in the practice base for master of nursing specialist plays an important role in the clinical practice and training process of nursing postgraduates with professional master's degree. This study comprehensively retrieves relevant domestic literature, summarizes the current status, core competence, access standards, training requirements and other research progress of teaching faculty team construction in the domestic practice base for master of nursing specialist and explores the urgent need for teaching faculty team construction in practice bases for master of nursing specialist, so as to provide a reference for construction of teaching faculty team in the practice base for master of nursing specialist.

Objective Improve the ethical review models of multi-center clinical trial.Methods Analyze the ethical review models of multi-center clinical trial in China,and summarize advantages and disadvantages of the different methods.Then,clarify the development of ethical review methods of multi-center clinical trial in our hospital.Results Four methods were used to review the multi center clinical trial in China,including independent ethical review,central institutional ethical review,central review made by committee cooperation,collaborative review.Each method has its advantages and disadvantages.Collaborative review about multi-center clinical trial is adopted now in our hospital.Conclusions Using collaborative review model of multi-center clinical trial,the ethical review could achieve timely and uniformly.

Objective To assess the performance of pediatric clinical illness score (PCIS), pediatric risk of mortality scoreⅢ(PRISMⅢ), pediatric logistic organ dysfunction score 2 (PELOD-2), and pediatric multiple organ dysfunction score (P-MODS) in predicting mortality in critically ill pediatric patients. Methods The data of critically ill pediatric patients admitted to Pediatric Intensive Care Unit (PICU) of First Affiliated Hospital of Sun Yat-Sen University from August 2012 to May 2017 were retrospectively analyzed. The gender, age, basic diseases, the length of PICU stay were collected. The children were divided into survival group and non-survival group according to the clinical outcome during hospitalization. The variables of PCIS, PRISMⅢ, PELOD-2, and P-MODS were collected and scored. Receiver operating characteristic (ROC) curve was plotted, the efficiency of PCIS, PRISMⅢ, PELOD-2, and P-MODS for predicting death were evaluated by the area under ROC curve (AUC). Hosmer-Lemeshow goodness of fit test was used to evaluate the fitting degree of each scoring system to predict the mortality and the actual mortality. Results Of 461 critically ill children, 35 children were excluded because of serious data loss, hospital stay not exceeding 24 hours, and death within 8 hours after admission. Finally, a total of 426 pediatric patients were enrolled in this study. 355 pediatric patients were survived, while 71 were not survived during hospitalization, with the mortality of 16.7%. There was no significant difference in gender, age, underlying diseases or length of PICU stay between the two groups. PCIS score in non-survival group was significantly lower than that of survival group [80 (76, 88) vs. 86 (80, 92)], and PRISMⅢ, PELOD-2 and P-MODS scores were significantly increased [PRISMⅢ: 16 (13, 22) vs. 12 (10, 15), PELOD-2: 6 (5, 9) vs. 4 (2, 5), P-MODS: 6 (4, 9) vs. 3 (2, 6), all P < 0.01]. ROC curve analysis showed that the AUCs of PCIS, PRISMⅢ, PELOD-2, and P-MODS for predicting death of critical ill children were 0.649, 0.731, 0.773, and 0.747, respectively. Hosmer-Lemeshow test showed that PCIS predicted the mortality and the actual mortality in the best fitting effect (χ2= 7.573, P = 0.476), followed by PELOD-2 and P-MODS (χ12 = 9.551, P1= 0.145; χ22 = 10.343, P2= 0.111), while PRISMⅢ had poor fitting effect (χ2= 43.549, P < 0.001). Conclusions PRISMⅢ, PELOD-2 and P-MODS can discriminate between survivors and moribund patients well, and assessing the condition of critically ill pediatric patients with relatively accuracy. PCIS was the best fitting effect in predicting mortality and actual mortality, followed by PELOD-2 and P-MODS, while PRISMⅢ had poor fitting effect.

Objective To investigate the Mycobacterium tuberculosis infections in 2014 among Beijing army recruits, and evaluate a new method for screening latent tuberculosis infections.Methods A total of 194 army recruits were subjected to chest X-ray examination purified protein derivative(PPD) skin test, antibody detection, and interferon gamma release assay(IGRA) by ELISA combined with recombinant protein CFP10-ESAT6 and latent infection protein Rv2628.Results The positive rates of PPD skin test and antibody test were 49.7% and 15.5%, respectively.The latent infection rate of IGRA test was 22.2% in 194 cases after CFP10-ESAT6 stimulation.After stimulation of latent tuberculosis infection(LTBI) with Rv2628, IFN-γ level was significantly higher than that in healthy control group (P<0.05).The weak positive group of TST (5 mm≤diameter<15 mm) had a significantly higher level of IFN-γ than the strong positive group(diameter≥15 mm)(P<0.05),but after stimulation with CFP10-ESAT6,IFN-γ levels were not significantly different between the two groups(P>0.05).There was no significant difference between antibody negative and positive groups after stimulation by CFP10-ESAT6 and Rv2628 (P>0.05).The area under the ROC curve of Rv2628 diagnosis of tuberculosis infection was 0.84.When Youden index was 0.621,the specificity was 94.7% and sensitivity was 67.4%.ConclusionCombined detection of antigens Rv2628 and CFP10-ESAT6 specific IFN-γ values can be potentially used for differential diagnosis of active or latent tuberculosis infections.