Polycystic ovary syndrome (PCOS) is one of the most common gynaecological endocrine diseases in women and the main cause of anovulatory infertility. Compared with women with normal ovulation, PCOS patients are more likely to face ovarian hyperstimulation syndrome, poor-quality of oocyte and fertilization failure in assisted reproduction treatment, so ovulation induction in PCOS patients has attracted much attention in the reproductive field. Progestin-primed ovarian stimulation (PPOS) protocol uses exogenous progesterone effectively to block luteinizing hormone surge to achieve ideal number of retrieved oocytes, embryo quality and pregnancy outcomes. This article reviews the mechanism, clinical application and development of PPOS protocol in PCOS patients.

Polycystic ovary syndrome (PCOS) is one of the most common gynaecological endocrine diseases in women and the main cause of anovulatory infertility. Compared with women with normal ovulation, PCOS patients are more likely to face ovarian hyperstimulation syndrome, poor-quality of oocyte and fertilization failure in assisted reproduction treatment, so ovulation induction in PCOS patients has attracted much attention in the reproductive field. Progestin-primed ovarian stimulation (PPOS) protocol uses exogenous progesterone effectively to block luteinizing hormone surge to achieve ideal number of retrieved oocytes, embryo quality and pregnancy outcomes. This article reviews the mechanism, clinical application and development of PPOS protocol in PCOS patients.

Objective: To elucidate clinical characteristics and build a prognostic nomogram for patients with vulvar cancer. Methods: The study population was drawn from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly assigned to training and validation sets. Cox proportional hazards model and competing risk model were used to identify the prognostic parameters of overall survival (OS) and cancer-specific survival (CSS) to construct a nomogram. The nomogram was assessed by concordance index (C-index), area under the curve (AUC), calibration plot, and decision curve analysis (DCA). Results: A total of 20,716 patients were included in epidemiological analysis, of whom 7,025 patients were selected in survival analysis, including 4,215 and 2,810 in training and validation sets, respectively. The multivariate Cox model showed that the predictors for OS were age, marital status, histopathology, differentiation and tumor node metastasis (TNM) stages, whether to undergo surgery and chemotherapy. However, the predictors for CSS were age, race, differentiation and TNM stages, whether to undergo surgery and radiation. The C-index for OS and CSS in the training set were 0.76 and 0.80. The AUC in the training set for 1-, 3- and 5-year OS and CSS were 0.84, 0.81, 0.80 and 0.88, 0.85, 0.83, respectively, which was similar in the validation set. The calibration curves showed good agreement between prediction and actual observations. DCA revealed that the nomogram had a better discrimination than TNM stages. Conclusions The nomogram showed accurate prognostic prediction in OS and CSS for vulvar cancer, which could provide guidance to clinical practice.

Lung cancer is the most threatening tumor disease to human health. Early detection is crucial to improve the survival rate and recovery rate of lung cancer patients. Existing methods use the two-dimensional multi-view framework to learn lung nodules features and simply integrate multi-view features to achieve the classification of benign and malignant lung nodules. However, these methods suffer from the problems of not capturing the spatial features effectively and ignoring the variability of multi-views. Therefore, this paper proposes a three-dimensional (3D) multi-view convolutional neural network (MVCNN) framework. To further solve the problem of different views in the multi-view model, a 3D multi-view squeeze-and-excitation convolution neural network (MVSECNN) model is constructed by introducing the squeeze-and-excitation (SE) module in the feature fusion stage. Finally, statistical methods are used to analyze model predictions and doctor annotations. In the independent test set, the classification accuracy and sensitivity of the model were 96.04% and 98.59% respectively, which were higher than other state-of-the-art methods. The consistency score between the predictions of the model and the pathological diagnosis results was 0.948, which is significantly higher than that between the doctor annotations and the pathological diagnosis results. The methods presented in this paper can effectively learn the spatial heterogeneity of lung nodules and solve the problem of multi-view differences. At the same time, the classification of benign and malignant lung nodules can be achieved, which is of great significance for assisting doctors in clinical diagnosis.
Humans ; Lung/pathology* ; Lung Neoplasms/pathology* ; Neural Networks, Computer ; Tomography, X-Ray Computed/methods*

A global expert consensus (the Delphi consensus) on follicular development, pituitary inhibition, triggering ovulation, and luteal phase support was organized and published in 2021 by Merck Darmstadt, Germany, to further complement the 2019 European Society of Human Reproduction and Embryology (ESHRE) Guidelines on Ovarian Stimulation by in vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection(ICSI). Compared with the ESHRE guidelines, the Delphi consensus incorporates more types of research evidence and expert experience, and finally the expert group has reached a good consensus on follicular development, pituitary suppression and triggering of ovulation, but luteal support is still controversial. This article intends to provide a reference for the optimization of assisted reproductive technology through the interpretation of this consensus.

A global expert consensus (the Delphi consensus) on follicular development, pituitary inhibition, triggering ovulation, and luteal phase support was organized and published in 2021 by Merck Darmstadt, Germany, to further complement the 2019 European Society of Human Reproduction and Embryology (ESHRE) Guidelines on Ovarian Stimulation by in vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection(ICSI). Compared with the ESHRE guidelines, the Delphi consensus incorporates more types of research evidence and expert experience, and finally the expert group has reached a good consensus on follicular development, pituitary suppression and triggering of ovulation, but luteal support is still controversial. This article intends to provide a reference for the optimization of assisted reproductive technology through the interpretation of this consensus.

DNA methylation is a prevalent epigenetic modification in vertebrates, and it has been shown to be involved the regulation of gene expression and embryo development. However, it remains unclear how DNA methylation regulates sexual development, especially in species without sex chromosomes. To determine this, we utilized zebrafish to investigate DNA methylation reprogramming during juvenile germ cell development and adult female-to-male sex transition. We reveal that primordial germ cells (PGCs) undergo significant DNA methylation reprogramming during germ cell development, and the methylome of PGCs is reset to an oocyte/ovary-like pattern at 9 days post fertilization (9 dpf). When DNA methyltransferase (DNMT) activity in juveniles was blocked after 9 dpf, the zebrafish developed into females. We also show that Tet3 is involved in PGC development. Notably, we find that DNA methylome reprogramming during adult zebrafish sex transition is similar to the reprogramming during the sex differentiation from 9 dpf PGCs to sperm. Furthermore, inhibiting DNMT activity can prevent the female-to-male sex transition, sug-gesting that methylation reprogramming is required for zebrafish sex transition. In summary, DNA methylation plays important roles in zebrafish germ cell development and sexual plasticity.

Although assisted reproductive technology has made great progress, the recurrent implantation failure of embryos remains a dilemma to be solved. The key to improve the implantation rate lies in the developmental synchronization of endometrium with embryo and the maximum receptivity to embryos. Due to individualized differences in window of implantation (WOI) time, it is difficult in the field of assisted reproduction to accurately judge the optimal time for embryo implantation. Previous researches mostly used transvaginal ultrasound, serum estrogen and progesterone levels, endometrial biopsy and other methods to judge the time of endometrial WOI. However, errors remain. Recent years, big achievement has been made in modern molecular genetic diagnosis and microarray technology. Some scholars have also applied it to judge the endometrial receptivity and WOI, and found that it has a good guiding value. This article reviews the basic situation, clinical application and application prospect of endometrial receptivity array in order to provide reference for personalized embryo transfer (pET) in infertility patients.

Although assisted reproductive technology has made great progress, the recurrent implantation failure of embryos remains a dilemma to be solved. The key to improve the implantation rate lies in the developmental synchronization of endometrium with embryo and the maximum receptivity to embryos. Due to individualized differences in window of implantation (WOI) time, it is difficult in the field of assisted reproduction to accurately judge the optimal time for embryo implantation. Previous researches mostly used transvaginal ultrasound, serum estrogen and progesterone levels, endometrial biopsy and other methods to judge the time of endometrial WOI. However, errors remain. Recent years, big achievement has been made in modern molecular genetic diagnosis and microarray technology. Some scholars have also applied it to judge the endometrial receptivity and WOI, and found that it has a good guiding value. This article reviews the basic situation, clinical application and application prospect of endometrial receptivity array in order to provide reference for personalized embryo transfer (pET) in infertility patients.

Nowadays, nanotechnologies have shown wide application foreground in the biomedical field of medicine laboratory tests, drug delivery, gene therapy and bioremediation. However, in recent years, nanomaterials have been labeled poisonous, because of the disputes and misunderstandings of mainstream views on their safety. Besides, for the barriers of technical issues in preparation like: (1) low efficacy (poor PK & PD and low drug loading), (2) high cost (irreproducibility and difficulty in scale up), little of that research has been successfully translated into commercial products. Currently, along with the new theory of "physical damage is the origin of nanotoxicity", biodegradability and biocompatibility of nanomaterials are listed as the basic principle of safe application of nanomaterials. Combining scientific design based on molecular level with precision control of process engineering will provide a new strategy to overcome the core technical challenges. New turning point of translational medicine in nanotechnology may emerge.