Objective:To study the sex-related growth difference (SRGD) of embryo morphological parameters and early serum β-human chorionic gonadotropin (β-hCG) level in single embryo transfer (SET) singleton live birth cycles.Methods:A retrospective cohort study analyzed the clinical data of patients with fresh and frozen non-donor, SET, and singleton live birth cycles from January 2020 to December 2022 in the Reproductive Medicine Center of Yantaishan Hospital ( n=311), and the neonatal sex group was grouped by gender, with 154 cases in the male infant group and 157 cases in the female infant group. The embryo transfer stage (93 cases in cleavage stage, 218 cases in blastocysts) and embryo quality (250 cases in the good-quality embryo group and 61 cases in the non-good-quality embryo group) were analyzed by subgroup stratification. Univariate and binary logistic/stepwise regression analysis were used to analyze whether there were embryonic morphological parameters and early β-hCG levels in the embryonic development stage and early pregnancy. Results:Univariate analysis showed that the general data matching of patients, such as parents' age, body mass index, embryo transfer stage, embryo quality, insemination method, and cycle type were comparable (all P>0.05). Univariate analysis of sex-related morphological parameters showed that the number of cells on the day 2 (D2) embryo in the male infant group (4.25±0.94) was larger than that in the female infant group (3.98±0.84, P=0.007). Binary logistic regression analysis showed that the number of cells on D2 embryo was positively correlated with the number of live-born males ( OR=1.428, 95% CI: 1.052-1.938, P=0.022). Subgroup analysis of blastocysts showed that the number of cells on D2 embryo ( OR=1.522, P=0.021) and blastocyst expansion ( OR=2.969, P=0.029) were positively correlated with live-born males. The early β-hCG level in the male infant group [776.40 (521.95, 1 127.25) U/L] was higher than that in the female infant group [634.60 (425.80, 973.05) U/L, P=0.003], and it was related to the embryo transfer period ( β=0.139, P=0.012) and embryo quality ( β=0.136, P=0.014). In the stratified analysis of different embryo stages and quality subgroups, β-hCG levels in male infant group during the cleavage stage, blastocyst stage, and high-quality embryos [677.20 (462.63, 1 028.50) U/L, 838.30 (557.50, 1 191.00) U/L, 816.00 (563.95, 1 199.75) U/L] were higher than those in female infant group [538.40 (344.80, 804.80) U/L, 724.95 (446.83, 1 016.75) U/L, 651.40 (431.30, 985.73) U/L], and the differences were statistically significant ( P=0.041, P=0.044, P=0.001). Subgroup regression analysis of blastocysts showed that β-hCG level was positively correlated with higher blastocyst expansion ( β=0.162, P=0.010) and higher trophectoderm grade ( β=0.344, P<0.001). Conclusion:In the single live birth cycle of SET, the number of D2 embryo cells and the early β-hCG level of male infants were higher than those of female infants, and the expansion degree of blastocyst is related to sex, and there is SRGD.

Objective:To study the sex-related growth difference (SRGD) of embryo morphological parameters and early serum β-human chorionic gonadotropin (β-hCG) level in single embryo transfer (SET) singleton live birth cycles.Methods:A retrospective cohort study analyzed the clinical data of patients with fresh and frozen non-donor, SET, and singleton live birth cycles from January 2020 to December 2022 in the Reproductive Medicine Center of Yantaishan Hospital ( n=311), and the neonatal sex group was grouped by gender, with 154 cases in the male infant group and 157 cases in the female infant group. The embryo transfer stage (93 cases in cleavage stage, 218 cases in blastocysts) and embryo quality (250 cases in the good-quality embryo group and 61 cases in the non-good-quality embryo group) were analyzed by subgroup stratification. Univariate and binary logistic/stepwise regression analysis were used to analyze whether there were embryonic morphological parameters and early β-hCG levels in the embryonic development stage and early pregnancy. Results:Univariate analysis showed that the general data matching of patients, such as parents' age, body mass index, embryo transfer stage, embryo quality, insemination method, and cycle type were comparable (all P>0.05). Univariate analysis of sex-related morphological parameters showed that the number of cells on the day 2 (D2) embryo in the male infant group (4.25±0.94) was larger than that in the female infant group (3.98±0.84, P=0.007). Binary logistic regression analysis showed that the number of cells on D2 embryo was positively correlated with the number of live-born males ( OR=1.428, 95% CI: 1.052-1.938, P=0.022). Subgroup analysis of blastocysts showed that the number of cells on D2 embryo ( OR=1.522, P=0.021) and blastocyst expansion ( OR=2.969, P=0.029) were positively correlated with live-born males. The early β-hCG level in the male infant group [776.40 (521.95, 1 127.25) U/L] was higher than that in the female infant group [634.60 (425.80, 973.05) U/L, P=0.003], and it was related to the embryo transfer period ( β=0.139, P=0.012) and embryo quality ( β=0.136, P=0.014). In the stratified analysis of different embryo stages and quality subgroups, β-hCG levels in male infant group during the cleavage stage, blastocyst stage, and high-quality embryos [677.20 (462.63, 1 028.50) U/L, 838.30 (557.50, 1 191.00) U/L, 816.00 (563.95, 1 199.75) U/L] were higher than those in female infant group [538.40 (344.80, 804.80) U/L, 724.95 (446.83, 1 016.75) U/L, 651.40 (431.30, 985.73) U/L], and the differences were statistically significant ( P=0.041, P=0.044, P=0.001). Subgroup regression analysis of blastocysts showed that β-hCG level was positively correlated with higher blastocyst expansion ( β=0.162, P=0.010) and higher trophectoderm grade ( β=0.344, P<0.001). Conclusion:In the single live birth cycle of SET, the number of D2 embryo cells and the early β-hCG level of male infants were higher than those of female infants, and the expansion degree of blastocyst is related to sex, and there is SRGD.

Objective:To investigate the clinical efficacy and safety of modified Shaoyao Gancao decoction in the treatment of hyperprolactinemia caused by amisulpride. Methods:Ninety patients with hyperprolactinemia caused by amisulpride who received treatment in Kangci Hospital from June 2018 to October 2019 were included in this study. They were randomly divided into the placebo control, control and observation groups ( n = 30/group). The placebo control group was treated with the decoction with the taste and color (without drug ingredients) similar to that of modified Shaoyao Gancao decoction. The control group was treated with Shaoyao Gancao decoction. The observation group was treated with modified Shaoyao Gancao decoction. All patients were treated for 8 weeks. Clinical efficacy, serum prolactin level and Positive and Negative Syndrome Scale score before and after treatment, Treatment Emergent Symptom Scale score after treatment, glucose and lipid metabolism, liver and kidney function before and after treatment were compared among the three groups. Results:The effective rate in the placebo control, control and observation groups was 90.0% (27/30), 96.7% (29/30) and 100.0% (30/30), respectively, and the difference among the three groups was statistically significant (χ 2 = 7.027, P < 0.05). After treatment, serum prolactin level in the observation group [(48.2 ± 15.7) μg/L] was significantly lower than that in the control group [(52.5 ± 13.7) μg/L] and placebo control group [(57.7 ± 16.9) μg/L, t = 7.134, 7.034, both P < 0.05]. After treatment, Positive and Negative Syndrome Scale score in the observation group [(51.02 ± 3.98) points] was significantly lower than that in the control group [(54.07 ± 4.19) points] and placebo control group [(58.13 ± 4.24) points, t = 5.813, 6.317, both P < 0.05]. After treatment, Treatment Emergent Symptom Scale score in the observation group [(5.2 ± 1.3) points] was significantly higher than that in the control group [(4.9 ± 1.4) points] and placebo control group [(4.4 ± 1.2) points, t = 7.011, 7.231, both P < 0.05]. After treatment, blood glucose, low-density lipoprotein cholesterol, triglyceride, total cholesterol, alanine aminotransferase, aspartate aminotransferase levels in the observation group were significantly lower than those in the placebo control and control groups (all P < 0.05). Serum level of high-density lipoprotein cholesterol in the observation group was significantly higher than that in the placebo control and control groups (both P < 0.05). Conclusion:Modified Shaoyao Gancao decoction is highly effective in the treatment of hyperprolactinemia caused by amisulpride. It can reduce serum prolactin level and has good safety.

Objective To summarize the nursing experience of patients with artificial airway in intensive care unit(ICU).Methods 126 patients with artificial airway in ICU were collected,by using the digital table method,the patients were randomly divided into observation group(69 cases)and control group(57 cases).The control group was only given traditional nursing method,the observation group was given cluster nursing.The hospital time,indwelling time,unplanned extubation,ventilator associated pneumonia and the patients' satisfaction were assessed.Results After treatment,the hospital time,indwelling time,unplanned extubation,ventilator associated pneumonia of the observation group were(7.47±1.35)days,(4.16±0.89)days,four cases(5.80%),six cases(8.70%),respectively,which of the control group were(14.06±2.39)days,(9.64±2.34)days,nine cases(15.79%),fifteen cases(26.32%),respectivelywhich was lower than those of the control group [(14.06±2.39)days,(9.64±2.34)days,nine cases(15.79%),fifteen cases(26.32%)].The hospital time,indwelling time,the incidence rate of unplanned extubation and ventilator associated pneumonia of the observation group were shorter or lower than those of the control group(t=4.785,5.312,x2=4.991,5.471,all P<0.05).The satisfaction of the observation group was higher than that of the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion Cluster nursing can significantly reduce the length of stay in hospital,extubation time,and reduce the incidence of accidental extubation and ventilator associated pneumonia.At the same time,psychological nursing can improve the satisfaction of patients and promote the recovery of patients.

Objective To compare the success rate, operation time, complication rate and the degree of tolerance of two kinds of endoscopic placement of small intestine decompression tube. Method 68 intestinal obstruction patients treated with transnasal ileus tube were randomly divided into 2 groups, group A and group B, 34 cases in each. Patients in group A were treated by endoscopic placement, while in group B placement was guided by nasal endoscope. Results The catheterization success rate and complications between the two groups have no statistical significance (P > 0.05) while the differences of catheter operation time (P < 0.05) and placement tolerance (P < 0.01) have statistical significance. Conclusion Endoscopic placement of small intestinal decompression tube has clinical application value while placement guided by nasal endoscope has certain advantages.

Objective To study the changes of lipid levels and body weight during the treatment of bipolar disorder by lithium carbonate combined with olanzapine or lithium. Methods Lipid and body weight was measured in forty-six patients with bipolar disorder in the first six months (treated by lithium carbonate combined with olanzapine) and in the second six months (treated by lithium only). Then the results were compared with the data before the treatment. Results When the first six months was over,the levels of the total cholesterol, triglyceride and apolipoprotein B increased(P＜ 0.05 ) ,and when the second six months was over,the levels of the total cholesterol,triglyceride,low density lipoprotein cholesterol (LDL-C),and apolipoprotein B increased Significantly (P ＜ 0.05 ). The levels of the total cholesterol, triglyceride, LDL-C were more than the normal level,but apolipoprotein B didn't exceed the normal level. When the first six months was over, the body weight was higher than that before treatment [ (68.70 ± 8.35 ) kg vs. (64.85 ±7.52 ) kg, P ＜ 0.05 ]. When the second six months was over, the body weight [ (71.72 ± 7.96 ) kg ] was higher than that at the end of the first six months (P ＜ 0.05 ). Gender difference showed non-statistical significance.Conclusions The lipid levels and body weight will both increase whether treated with lithium carbonate combined with olanzapine or with lithium only. The lipid level changes apparently in treatment with lithium separately, and the risk of coronary heart disease will increase.