BACKGROUND: The mechanisms distinguishing metabolically healthy from unhealthy phenotypes within the same BMI categories remain unclear. This study aimed to investigate the associations between regional fat distribution and metabolically unhealthy phenotypes in Chinese adults across different BMI categories. METHODS: This cross-sectional study involving 11833 Chinese adults aged 20 years and older. Covariance analysis, adjusted for age, compared the percentage of regional fat (trunk, leg, or arm fat divided by whole-body fat) between metabolically healthy and unhealthy participants. Trends in regional fat percentage with the number of metabolic abnormalities were assessed by the Jonckheere-Terpstra test. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. All analyses were performed separately by sex. RESULTS: In non-obese individuals, metabolically unhealthy participants exhibited higher percent trunk fat and lower percent leg fat compared to healthy participants. Additionally, percent trunk fat increased and percent leg fat decreased with the number of metabolic abnormalities. After adjustment for demographic and lifestyle factors, as well as BMI, higher percent trunk fat was associated with increased odds of being metabolically unhealthy [highest vs. lowest quartile: ORs (95%CI) of 1.64 (1.35, 2.00) for men and 2.00 (1.63, 2.46) for women]. Conversely, compared with the lowest quartile, the ORs (95%CI) of metabolically unhealthy phenotype in the highest quartile for percent arm and leg fat were 0.64 (0.53, 0.78) and 0.60 (0.49, 0.74) for men, and 0.72 (0.56, 0.93) and 0.46 (0.36, 0.59) for women, respectively. Significant interactions between BMI and percentage of trunk and leg fat were observed in both sexes, with stronger associations found in individuals with normal weight and overweight. CONCLUSIONS Trunk fat is associated with a higher risk of metabolically unhealthy phenotype, while leg and arm fat are protective factors. Regional fat distribution assessments are crucial for identifying metabolically unhealthy phenotypes, particularly in non-obese individuals.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Adipose Tissue ; Body Fat Distribution ; Body Mass Index ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Phenotype

Objective:To compare the clinical outcome of whole frozen-thawed embryo transfer in patients with high ovarian response using gonadotropin-releasing hormone agonist (GnRH-a) single trigger or combined with low-dose human chorionic gonadotropin (hCG) dual trigger in the gonadotropin-releasing hormone antagonist (GnRH-A) protocol.Methods:Retrospective cohort study was conducted in Center for Reproductive Medicine, Department of Obstetrics and Gynecology of Peking University Third Hospital between January 2018 to December 2020, and the patients with high ovarian response undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) were divided into GnRH-a single trigger group (group A, n=251) and GnRH-a combined with low-dose hCG dual trigger group (group B, n=741) according to the trigger protocol. The clinical outcome was compared between the two groups. Results:There were no significant differences in clinical characteristics between group A and group B. Estrogen level on the day of trigger, number of embryos formed, number of two pronuclei (2PN) embryos formed, number of high-quality embryos formed and rate of embryo formation in group A were significantly higher than those in group B [(22 905.84±9 513.28) pmol/L vs. (17 200.82±6 811.64) pmol/L, P<0.001; 18.84±9.50 vs. 17.34±8.04, P=0.025; 16.06±8.24 vs. 14.87±7.07, P=0.042; 11.25±6.92 vs. 10.25±5.97, P=0.027; 68.6% (4 730/6 899) vs. 66.5% (12 852/19 326), P=0.002]. However, there were no significant differences in number of oocytes retrieved, mature oocyte rate and high-quality embryo rate between group A and group B (all P>0.05). There were also no significant differences in hCG positive rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate, persistent pregnancy rate and live birth rate per frozen-thawed embryo transfer between the two groups (all P>0.05). There were no significant differences in cumulative persistent pregnancy rate, cumulative live birth rate, proportion of low birth weight infants and birth defects per ovarian stimulation cycle between the two groups (all P>0.05). The incidence of early-onset severe ovarian hyperstimulation syndrome (OHSS) in group A was lower than that in group B, but there was no significant difference [0% vs. 1.5% (11/741), P=0.075]. Conclusion:The pregnancy outcome of whole frozen-thawed embryo transfer in patients with high ovarian response using GnRH-a single trigger was comparable to dual trigger combined with low-dose hCG in the GnRH-A protocol, and the risk of early onset severe OHSS was low. Therefore, in patients with high ovarian response in IVF/ICSI cycle using GnRH-A protocol, the use of GnRH-a single trigger followed by whole frozen-thawed embryo transfer could be considered as an optimal choice to minimize the risk of early onset OHSS without loss of pregnancy outcome.

Objective:To compare the clinical outcome of whole frozen-thawed embryo transfer in patients with high ovarian response using gonadotropin-releasing hormone agonist (GnRH-a) single trigger or combined with low-dose human chorionic gonadotropin (hCG) dual trigger in the gonadotropin-releasing hormone antagonist (GnRH-A) protocol.Methods:Retrospective cohort study was conducted in Center for Reproductive Medicine, Department of Obstetrics and Gynecology of Peking University Third Hospital between January 2018 to December 2020, and the patients with high ovarian response undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) were divided into GnRH-a single trigger group (group A, n=251) and GnRH-a combined with low-dose hCG dual trigger group (group B, n=741) according to the trigger protocol. The clinical outcome was compared between the two groups. Results:There were no significant differences in clinical characteristics between group A and group B. Estrogen level on the day of trigger, number of embryos formed, number of two pronuclei (2PN) embryos formed, number of high-quality embryos formed and rate of embryo formation in group A were significantly higher than those in group B [(22 905.84±9 513.28) pmol/L vs. (17 200.82±6 811.64) pmol/L, P<0.001; 18.84±9.50 vs. 17.34±8.04, P=0.025; 16.06±8.24 vs. 14.87±7.07, P=0.042; 11.25±6.92 vs. 10.25±5.97, P=0.027; 68.6% (4 730/6 899) vs. 66.5% (12 852/19 326), P=0.002]. However, there were no significant differences in number of oocytes retrieved, mature oocyte rate and high-quality embryo rate between group A and group B (all P>0.05). There were also no significant differences in hCG positive rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate, persistent pregnancy rate and live birth rate per frozen-thawed embryo transfer between the two groups (all P>0.05). There were no significant differences in cumulative persistent pregnancy rate, cumulative live birth rate, proportion of low birth weight infants and birth defects per ovarian stimulation cycle between the two groups (all P>0.05). The incidence of early-onset severe ovarian hyperstimulation syndrome (OHSS) in group A was lower than that in group B, but there was no significant difference [0% vs. 1.5% (11/741), P=0.075]. Conclusion:The pregnancy outcome of whole frozen-thawed embryo transfer in patients with high ovarian response using GnRH-a single trigger was comparable to dual trigger combined with low-dose hCG in the GnRH-A protocol, and the risk of early onset severe OHSS was low. Therefore, in patients with high ovarian response in IVF/ICSI cycle using GnRH-A protocol, the use of GnRH-a single trigger followed by whole frozen-thawed embryo transfer could be considered as an optimal choice to minimize the risk of early onset OHSS without loss of pregnancy outcome.

Sexual orientation is influenced by both environmental factors and biological factors. Family and twin studies have shown that genetic factors play an important role in the formation of male homosexuality. Genome-wide scan also revealed candidate chromosomal regions which may be associated with male homosexuality, but so far no clearly related genes have been found. This article reviews the progress of relevant studies and candidate genes which are related to male homosexuality.
Animals ; Aromatase ; genetics ; Catechol O-Methyltransferase ; genetics ; Homosexuality, Male ; genetics ; Humans ; LIM-Homeodomain Proteins ; genetics ; Male ; Receptors, Dopamine D1 ; genetics ; Transcription Factors ; genetics

Objective To evaluate the outcomes and the prognostic factors for advanced squamous cervical cancer after concurrent chemoradiotherapy (CCRT).Methods Totally 172 patients with International Federation of Gynecology and Obstetrics stage Ⅱ b-Ⅳ who were treated in Cancer Hospital,Chinese Academy of Medical Sciences between January 2007 and December 2008 were retrospectively analyzed.Patients were received external radiotherapy,high-dose rate brachytherapy and cisplatin-based chemotherapy concurrently.Results The median follow-up period was 54.5 months.The 2-year and 5-year overall survival (OS) were separately 81.5％ and 68.8％.The 2-year and 5-year progress-free survival (PFS) were separately 69.2％ and 63.1％.Using univariate analysis followed with multivariate analysis,the results showed that these clinicopathological factors including stage (Ⅲ and above versus Ⅱ b; P =0.021,HR =1.95 ; P =0.020,HR =1.86),maximum diameter of local tumor size (＞4 versus ≤4 cm; P =0.009,HR =2.55 ; P =0.033,HR =1.94),squamous cell carcinoma antigen (SCC) level before treatment (＞3 versus ≤3 μg/L; P =0.010,HR =2.47; P =0.013,HR =2.09) and retroperitoneal lymph node status on imaging (para-aortic lymph node positive versus negative,P =0.009,HR =3.00,P=0.010,HR =2.74; pelvic lymph node positive only versus negative,P =0.044,HR =1.98,P =0.033,HR =1.92) had the significant effect on OS and PFS.Patients with no above adverse prognostic factor were assigned to Group A (n =18),those with one factor were assigned to Group B (n =43),and those with no less than two factors were assigned to Group C (n =1 11).Among three groups,the 2-year OS were separately 94.1％,97.7％ and 73.1％,the 5-year OS were separately 81.4％,90.1％ and 58.6％,the 2-year PFS were separately 88.2％,90.4％ and 57.9％,the 5-year PFS were 82.4％,87.9％ and 50.0％.The results showed that group C was significant difference from Group A or B in OS and PFS (all P ＜ 0.05),while Group A had no significant difference from Group B in OS and PFS (P ＞ 0.05).Conclusions Stage Ⅲ or above,maximum diameter of local tumor size ＞ 4 cm,SCC level ＞ 3 μg/L before treatment and positive retroperitoneal lymph nodes on imaging are four independent adverse factors for prognosis of squamous cervical cancer of advanced stage after CCRT.The treatment of patients with no less than two adverse factors should be considered to be improved.

Three-dimensional finite element models of the large defect of proximal femur were reconstructed with allograft prosthesis composite in clinical bone-healing phase; current model was under the given conditions of 138mm-intramedullary stem-length of host bone and 135mm defect-length of proximal femur. The femur was constructed with efilm software from CT data, then three-dimensional concrete models were created by using Proe-Wildfire software; the three-dimensional finite element models of allograft prosthesis composite were made in ANSYS11 software. Loads were simulated using the peaking values during stance walking. The stress on femur-cement-callus-prostheses and the influence of stress on the clinical bone-healing phase were analysed. The highest stress value of femur is on the medial side of the tip of the prostheses. The highest stress value of cement mantle is on the medical side of the cement mantle at the tip of the stem. The highest stress value of the prostheses is on the medial side near the upper 4cm of the stem tip. The highest stress value on the callus is at the medial side of the callus layer. The highest stress value on every part is under the corresponding fatigue strength. Clinical bone-healing phase model is well enough for stance walking.
Biomechanical Phenomena ; Female ; Femoral Neoplasms ; diagnostic imaging ; surgery ; Finite Element Analysis ; Hip Prosthesis ; Humans ; Imaging, Three-Dimensional ; Male ; Osteosarcoma ; diagnostic imaging ; surgery ; Tomography, Spiral Computed ; Weight-Bearing ; physiology ; Wound Healing

[Objective]To find an effective method of surgical treatment of fibrous dysplasia of bone involving the femur associated with severe varus deformity.[Method]Thirteen patients with fibrous dysplasia of bone involving 14 femurs with severe varus deformity were reviewed from Feb 2002 and Jul 2005.Medial displacement of valgus or valgus osteotomies,curettage and allograft,reconstructional nail have been adolted to treat fibrous dysplasia of bone involving the femur with severe varus deformity.[Result]All patients were followed up from 8 months to 41 months with an average of 21 months.Forteen femoral mechanical alignments(axis)had been corrected completely rdiologically;the preoperative average neck-shaft angle of 75?(range,55?~100?),corrected to the average 120?(range,95 ?~135?)of postoperative,the average shortening of the femur was 3.4 cm(range,2.0~4.5 cm)preoperatively,then enlongthened by 2.8 cm(range,1.8~3.6 cm)in postoperation.Ninteen location of osteotomies showed good union in 14 femur.All bone grafts were absorbed slightly beginning at 3 months and markedly at 10 to 14 months postoperatively.Preoperation,4 patients walked with bilateral crutches,2 used unilateral cane,5 can't walk due to pathological fracture,2 without support;after operation,11 patients walk without support,2 ambulated with the aid of unilateracane.Eleven patients were painless,2 moderate pain.All had no infections and recurrent fracture and progression of the deformity.[Conclusion](1)This method can correct varus deformity,improve function,as well as restore biomechanical axis of femur.(2)It is able to effectively eradicate lesions and prevent recurrence.(3)Impaction allograft is the key of prompting allograft incorporating fully and preventing pathological fracture.