Objective:To investigate the awareness levels of doctors from various departments regarding fertility preservation to provide reference and suggestions for further improving awareness and promoting multidisciplinary development in fertility preservation.Methods:From November to December 2023, the China Alliance of Fertility Preservation initiated this survey covering 88 hospitals in 23 cities across 20 provinces in China. The survey focused on the degree of understanding of basic concepts, technological perceptions, treatment concepts, and related challenges regarding fertility preservation. Descriptive statistics and Fisher's exact test were used to analyze the difference in awareness levels across various departments.Results:There was a significant difference in the awareness of fertility preservation guidelines among physicians from different departments ( P<0.001). Reproductive center physicians had the highest level of understanding [68.3% (41/60)]. Doctors in the reproductive centers had a higher awareness rate of the five fertility preservation techniques (ovarian tissue cryopreservation, oocyte cryopreservation, sperm cryopreservation, testicular tissue cryopreservation, and embryo cryopreservation) than that in other departments (all P<0.05). Regarding treatment concepts, more reproductive center physicians believed that psychological counselling about fertility preservation before oncological treatment was necessary ( P=0.016). Hematologists had more worries and concerns about fertility preservation treatment. Additionally, 96.7% (58/60) of reproductive center physicians expressed the need to establish effective referral mechanisms within the same city, province, or across provinces. However, 55.6% (35/63) of oncologists, 64.6% (31/48) of hematologists, and 77.8% (7/9) of pediatricians considered treating primary tumors far more important than fertility preservation. Conclusion:Doctors from different departments have varying levels of understanding regarding fertility preservation. It is necessary to strengthen the dissemination and training of fertility preservation knowledge among physicians from various departments, as well as to promote a multidisciplinary treatment model to improve efficiency, to establish a comprehensive referral mechanism to improve patients' opportunities for fertility preservation.

Objective:To investigate the clinicopathological and molecular genetic characteristics of diffuse gliomas with the features of polymorphous low-grade neuroepithelial tumor of the young (PLNTY) and their prognostic values.Methods:A retrospective analysis was performed on 14 cases of diffuse gliomas with PLNTY features diagnosed at the First Affiliated Hospital of Fujian Medical University, Fuzhou, China from June 2020 to August 2024. Their clinicopathological characteristics were examined, and their molecular genetic and epigenetic features were assessed using next-generation sequencing (NGS) and methylation analysis. Factors influencing prognosis were also analyzed.Results:Among the 14 patients, there were 8 males and 6 females, aged 3-62 years, median 29 (9, 50) years. All cases were initially diagnosed as low-grade diffuse gliomas histologically but exhibited the histological and immunohistochemical features of PLNTY. At the molecular level, all cases showed molecular abnormalities involving the mitogen-activated protein kinase pathway, including 5 cases with FGFR3-TACC3 (F3T3) fusion, 3 cases with FGFR2 fusion, 5 cases with BRAF V600E mutation, and 1 case with FGFR1 mutation. Among them, TERT promoter mutations were frequently observed in tumors with F3T3 fusion (5/5), while NCOR2 in-frame insertion mutations were prominent in tumors with non-F3T3 fusions. Clinical follow-up showed recurrence in 3 cases, all of which had F3T3 fusion and concurrent TERT promoter mutations. Prognostic analysis confirmed that F3T3 fusion with concurrent TERT promoter mutation was associated with poor prognosis.Conclusions:Diffuse gliomas with PLNTY features exhibit heterogeneity in clinicopathology and molecular genetics, with FGFR3/FGFR2 fusions and BRAF/FGFR1 mutations as the most common molecular alteration. They often have concurrent F3T3 fusion and TERT promoter mutations, which are related to poor prognosis. The possibility of molecular glioblastoma should be considered for these tumors. It is thus recommended to perform genetic testing on diffuse gliomas with PLNTY features in order to facilitate integrated diagnosis and provide molecular evidence for accurate evaluation of prognoses.

Objective To analyze the relationship between abnormal expression of serum neurohemoglobin(NGB)and myelin basic protein(MBP)and the cerebral neurodevelopment of neonates with hypoxic-ischemic encephalopathy(HIE).Methods A total of 89 preterm infants with HIE admitted in the hospital between January 2023 and March 2024 were selected as the observation group,and 60 preterm infants without HIE during the same period were selected as the control group.Serum levels of MBP,NGB and secretagogues in two groups were detected,and the neonates amplitude integration electroencephalogram score was evaluated.The neurological function of neonates was evaluated using 20 items of Neonatal Behavioral Neurological As-sessment(NBNA).The correlation test and diagnostic value were evaluated using Spearman method and re-ceiver operating characteristic(ROC)curve.Results The serum levels of NGB,MBP and secretagogue in the ob-servation group were higher than those in the control group(P<0.05),and the amplitude integration electroencepha-logram score was lower than that in the control group(P<0.05).The serum MBP,NGB and secretagogue levels in the mild,moderate,and severe groups increased sequentially(P<0.05),NBNA score and amplitude integration e-lectroencephalogram score decreased sequentially(P<0.05).The levels of NGB,MBP and secretagogue were the risk factors affecting NBNA score(P<0.05),and the amplitude integration electroencephalogram score was a protective factor affecting NBNA score(P<0.05).The area under the curve of NGB and MBP in diag-nosing HIE was greater than 0.8,which had high application value.Conclusion Serum NGB and MBP levels are closely related to the severity of HIE,and have certain connection with NBNA score.Elevated levels of NGB and MBP in neonates with HIE may be related to the body's stress response to nerve damage,which could reflect to some extent the brain nerve function damage in with HIE.

Objective:To investigate the awareness levels of doctors from various departments regarding fertility preservation to provide reference and suggestions for further improving awareness and promoting multidisciplinary development in fertility preservation.Methods:From November to December 2023, the China Alliance of Fertility Preservation initiated this survey covering 88 hospitals in 23 cities across 20 provinces in China. The survey focused on the degree of understanding of basic concepts, technological perceptions, treatment concepts, and related challenges regarding fertility preservation. Descriptive statistics and Fisher's exact test were used to analyze the difference in awareness levels across various departments.Results:There was a significant difference in the awareness of fertility preservation guidelines among physicians from different departments ( P<0.001). Reproductive center physicians had the highest level of understanding [68.3% (41/60)]. Doctors in the reproductive centers had a higher awareness rate of the five fertility preservation techniques (ovarian tissue cryopreservation, oocyte cryopreservation, sperm cryopreservation, testicular tissue cryopreservation, and embryo cryopreservation) than that in other departments (all P<0.05). Regarding treatment concepts, more reproductive center physicians believed that psychological counselling about fertility preservation before oncological treatment was necessary ( P=0.016). Hematologists had more worries and concerns about fertility preservation treatment. Additionally, 96.7% (58/60) of reproductive center physicians expressed the need to establish effective referral mechanisms within the same city, province, or across provinces. However, 55.6% (35/63) of oncologists, 64.6% (31/48) of hematologists, and 77.8% (7/9) of pediatricians considered treating primary tumors far more important than fertility preservation. Conclusion:Doctors from different departments have varying levels of understanding regarding fertility preservation. It is necessary to strengthen the dissemination and training of fertility preservation knowledge among physicians from various departments, as well as to promote a multidisciplinary treatment model to improve efficiency, to establish a comprehensive referral mechanism to improve patients' opportunities for fertility preservation.

Objective:To investigate the clinicopathological and molecular genetic characteristics of diffuse gliomas with the features of polymorphous low-grade neuroepithelial tumor of the young (PLNTY) and their prognostic values.Methods:A retrospective analysis was performed on 14 cases of diffuse gliomas with PLNTY features diagnosed at the First Affiliated Hospital of Fujian Medical University, Fuzhou, China from June 2020 to August 2024. Their clinicopathological characteristics were examined, and their molecular genetic and epigenetic features were assessed using next-generation sequencing (NGS) and methylation analysis. Factors influencing prognosis were also analyzed.Results:Among the 14 patients, there were 8 males and 6 females, aged 3-62 years, median 29 (9, 50) years. All cases were initially diagnosed as low-grade diffuse gliomas histologically but exhibited the histological and immunohistochemical features of PLNTY. At the molecular level, all cases showed molecular abnormalities involving the mitogen-activated protein kinase pathway, including 5 cases with FGFR3-TACC3 (F3T3) fusion, 3 cases with FGFR2 fusion, 5 cases with BRAF V600E mutation, and 1 case with FGFR1 mutation. Among them, TERT promoter mutations were frequently observed in tumors with F3T3 fusion (5/5), while NCOR2 in-frame insertion mutations were prominent in tumors with non-F3T3 fusions. Clinical follow-up showed recurrence in 3 cases, all of which had F3T3 fusion and concurrent TERT promoter mutations. Prognostic analysis confirmed that F3T3 fusion with concurrent TERT promoter mutation was associated with poor prognosis.Conclusions:Diffuse gliomas with PLNTY features exhibit heterogeneity in clinicopathology and molecular genetics, with FGFR3/FGFR2 fusions and BRAF/FGFR1 mutations as the most common molecular alteration. They often have concurrent F3T3 fusion and TERT promoter mutations, which are related to poor prognosis. The possibility of molecular glioblastoma should be considered for these tumors. It is thus recommended to perform genetic testing on diffuse gliomas with PLNTY features in order to facilitate integrated diagnosis and provide molecular evidence for accurate evaluation of prognoses.

Objective:To investigate the risk factors, pregnancy outcomes of intrauterine pregnancy with tubal pregnancy after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods:The study was a retrospective case-control study that collected clinical data of patients diagnosed with intrauterine combined with tubal pregnancy after IVF/ICSI for infertility at Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital from January 2009 to December 2021. The study group consisted of patients diagnosed with intrauterine combined with tubal pregnancy after IVF/ICSI and treated with surgery ( n=91). The control group consisted of patients diagnosed with early intrauterine pregnancy after IVF/ICSI in a 1∶4 ratio during the same period ( n=364). General information, assisted reproduction and pregnancy-related data of the two groups were analyzed, and risk factors for intrauterine combined with tubal pregnancy after IVF/ICSI were determined through univariate and logistic analyses. Furthermore, the study group was divided into two subgroups according to different pregnancy outcomes, miscarriage and live birth, and risk factors that may affect pregnancy outcomes of patients with intrauterine combined with tubal pregnancy were analyzed between the two subgroups. Results:There were no significant differences in age, body mass index, gestational times, basal hormone levels, endometrial thickness before transplantation and human chorionic gonadotropin level after transplantation between the study group and control group (all P>0.05). The live birth rate of the two groups was similar ( P>0.05). A history of ectopic pregnancy ( OR=2.605, 95% CI: 1.352-5.016, P=0.004) and hydrosalpinx ( OR=26.012, 95% CI: 2.942-229.974, P=0.003) were risk factors for intrauterine combined with tubal pregnancy after IVF/ICSI. Patients with intrauterine combined with tubal pregnancy were divided into live birth subgroup and abortion subgroup. There were no significant differences in the proportion of abdominal pain, uterine hemoperitoneum and other symptoms between the two subgroups (all P>0.05), and there were no statistical differences in operation time, gestational age and intraperitoneal hemorrhage between the two subgroups (all P>0.05). Vaginal bleeding after transplantation ( OR=3.128, 95% CI: 1.067-9.172, P=0.038) in the abortion subgroup may be a risk factor for miscarriage in intrauterine combined with tubal pregnancy. Conclusion:Live birth rate in intrauterine pregnancy combined with tubal pregnancy patients after surgery was similar with patients with normal intrauterine pregnancy. Ectopic pregnancy history and hydrosalpinx may be risk factors for patients with intrauterine pregnancy combined with tubal pregnancy after IVF/ICSI, and vaginal bleeding after transplantation may be a high risk factor for abortion in those patients.

Objective:To analyze the clinical characteristics, pregnancy outcomes and factors affecting live birth of patients undergoing multifetal pregnancy reduction (MFPR), in order to provide reference for clinical strategies.Methods:A retrospective cohort study was conducted on all patients who underwent multifetal pregnancy reduction among polychorionic multifetal pregnancy patients at the Center for Reproductive Medicine, Department of Obstetrics and Gynecology of Peking University Third Hospital during a period of 12 years from January 1, 2009 to December 31, 2020. The overall and annual clinical characteristics were analyzed, pregnancy outcomes were followed up. Patients were divided into live birth group ( n=1 555) and not live birth group ( n=205), and factors affecting live birth were analyzed by multivariate logistic. Through further subgroup analysis, multiple pregnancies were divided into three subgroups: dichorionic diamniotic twin, triplet pregnancy, and four or more high sequence multiple pregnancy. Results:A total of 1 925 patients who underwent MFPR were included, and 1 760 pregnancy outcomes were followed up. In the past 12 years, there had been an increase in dizygotic twins, and the proportion of transabdominal fetal reduction had significantly increased, from 3% in 2009 to 77% in 2020. The annual live birth rate of reduction patients fluctuated between 83% and 94%. The live birth rate of patients with MFPR was related with the type of multiple pregnancies, the method of reducing pregnancies, and the number of retained embryos. The live birth rate of four or more high sequence multiple pregnancies [75.8% (72/95)] was lower than that of dichorionic diamniotic twins [90.0% (796/884), P<0.001], the dichorionic diamniotic twins [89.9% (241/268), P<0.001], the trichorionic triamniotic triplet pregnancy [86.9% (446/513), P=0.005]. The live birth rate of transabdominal fetal reduction [91.4% (655/717)] was higher than that of transvaginal fetal reduction with fetal cardiac activity area injection of KCl [84.9% (304/358), P=0.001], and vaginal embryo aspiration [87.0% (596/685), P=0.009]. There was no statistically significant difference in the live birth rate between vaginal KCl injection and vaginal aspiration ( P=0.351). The survival rate of patients with retained singletons [89.7% (1 062/1 184)] was higher than that of patients with retained twins [85.6% (493/576), P=0.012]. After adjusting for confounding factors such as age, assisted pregnancy method, type of multiple pregnancies, and number of retained embryos, transabdominal fetal reduction was an independent protective factor for live birth rate ( P=0.040, OR=1.604, 95% CI: 1.021-2.519). Conclusion:With the change of transplantation strategy, the proportion of dichorionic diamniotic twins increased, and the proportion of transabdominal fetal reduction increased, which pregnancy outcomes might be better. There was no difference in pregnancy outcomes between those who underwent vaginal aspiration and transvaginal fetal reduction with fetal cardiac activity area injection of KCl. The outcomes of four or more high sequence multiple pregnancies were poor, and it was necessary to strictly control the number of embryo transfers and optimize ovulation promotion plans in clinical practice.

Objective:To investigate the risk factors, pregnancy outcomes of intrauterine pregnancy with tubal pregnancy after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods:The study was a retrospective case-control study that collected clinical data of patients diagnosed with intrauterine combined with tubal pregnancy after IVF/ICSI for infertility at Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital from January 2009 to December 2021. The study group consisted of patients diagnosed with intrauterine combined with tubal pregnancy after IVF/ICSI and treated with surgery ( n=91). The control group consisted of patients diagnosed with early intrauterine pregnancy after IVF/ICSI in a 1∶4 ratio during the same period ( n=364). General information, assisted reproduction and pregnancy-related data of the two groups were analyzed, and risk factors for intrauterine combined with tubal pregnancy after IVF/ICSI were determined through univariate and logistic analyses. Furthermore, the study group was divided into two subgroups according to different pregnancy outcomes, miscarriage and live birth, and risk factors that may affect pregnancy outcomes of patients with intrauterine combined with tubal pregnancy were analyzed between the two subgroups. Results:There were no significant differences in age, body mass index, gestational times, basal hormone levels, endometrial thickness before transplantation and human chorionic gonadotropin level after transplantation between the study group and control group (all P>0.05). The live birth rate of the two groups was similar ( P>0.05). A history of ectopic pregnancy ( OR=2.605, 95% CI: 1.352-5.016, P=0.004) and hydrosalpinx ( OR=26.012, 95% CI: 2.942-229.974, P=0.003) were risk factors for intrauterine combined with tubal pregnancy after IVF/ICSI. Patients with intrauterine combined with tubal pregnancy were divided into live birth subgroup and abortion subgroup. There were no significant differences in the proportion of abdominal pain, uterine hemoperitoneum and other symptoms between the two subgroups (all P>0.05), and there were no statistical differences in operation time, gestational age and intraperitoneal hemorrhage between the two subgroups (all P>0.05). Vaginal bleeding after transplantation ( OR=3.128, 95% CI: 1.067-9.172, P=0.038) in the abortion subgroup may be a risk factor for miscarriage in intrauterine combined with tubal pregnancy. Conclusion:Live birth rate in intrauterine pregnancy combined with tubal pregnancy patients after surgery was similar with patients with normal intrauterine pregnancy. Ectopic pregnancy history and hydrosalpinx may be risk factors for patients with intrauterine pregnancy combined with tubal pregnancy after IVF/ICSI, and vaginal bleeding after transplantation may be a high risk factor for abortion in those patients.

Objective:To analyze the clinical characteristics, pregnancy outcomes and factors affecting live birth of patients undergoing multifetal pregnancy reduction (MFPR), in order to provide reference for clinical strategies.Methods:A retrospective cohort study was conducted on all patients who underwent multifetal pregnancy reduction among polychorionic multifetal pregnancy patients at the Center for Reproductive Medicine, Department of Obstetrics and Gynecology of Peking University Third Hospital during a period of 12 years from January 1, 2009 to December 31, 2020. The overall and annual clinical characteristics were analyzed, pregnancy outcomes were followed up. Patients were divided into live birth group ( n=1 555) and not live birth group ( n=205), and factors affecting live birth were analyzed by multivariate logistic. Through further subgroup analysis, multiple pregnancies were divided into three subgroups: dichorionic diamniotic twin, triplet pregnancy, and four or more high sequence multiple pregnancy. Results:A total of 1 925 patients who underwent MFPR were included, and 1 760 pregnancy outcomes were followed up. In the past 12 years, there had been an increase in dizygotic twins, and the proportion of transabdominal fetal reduction had significantly increased, from 3% in 2009 to 77% in 2020. The annual live birth rate of reduction patients fluctuated between 83% and 94%. The live birth rate of patients with MFPR was related with the type of multiple pregnancies, the method of reducing pregnancies, and the number of retained embryos. The live birth rate of four or more high sequence multiple pregnancies [75.8% (72/95)] was lower than that of dichorionic diamniotic twins [90.0% (796/884), P<0.001], the dichorionic diamniotic twins [89.9% (241/268), P<0.001], the trichorionic triamniotic triplet pregnancy [86.9% (446/513), P=0.005]. The live birth rate of transabdominal fetal reduction [91.4% (655/717)] was higher than that of transvaginal fetal reduction with fetal cardiac activity area injection of KCl [84.9% (304/358), P=0.001], and vaginal embryo aspiration [87.0% (596/685), P=0.009]. There was no statistically significant difference in the live birth rate between vaginal KCl injection and vaginal aspiration ( P=0.351). The survival rate of patients with retained singletons [89.7% (1 062/1 184)] was higher than that of patients with retained twins [85.6% (493/576), P=0.012]. After adjusting for confounding factors such as age, assisted pregnancy method, type of multiple pregnancies, and number of retained embryos, transabdominal fetal reduction was an independent protective factor for live birth rate ( P=0.040, OR=1.604, 95% CI: 1.021-2.519). Conclusion:With the change of transplantation strategy, the proportion of dichorionic diamniotic twins increased, and the proportion of transabdominal fetal reduction increased, which pregnancy outcomes might be better. There was no difference in pregnancy outcomes between those who underwent vaginal aspiration and transvaginal fetal reduction with fetal cardiac activity area injection of KCl. The outcomes of four or more high sequence multiple pregnancies were poor, and it was necessary to strictly control the number of embryo transfers and optimize ovulation promotion plans in clinical practice.

Objective:To analyze the pregnancy outcome, influencing factors and pregnancy complications after hysteroscopic submucosal myomectomy in patients with infertility or recurrent abortion.Methods:The clinical data of patients who underwent hysteroscopic submucosal myomectomy in Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital from January 2010 to December 2020 were reviewed. The relationship between age, myoma classification, size, number and location and postoperative pregnancy was retrospectively cohort analyzed, and the related complications during pregnancy were discussed.Results:A total of 212 patients underwent surgery during the study period. The proportions of type 0, type 1, type 2 and mixed submucosal myoma were 9.4% (20/212), 33.5% (71/212), 51.4% (109/212) and 5.7% (12/212), respectively. Totally 85.4% (181/212) of patients underwent hysteroscopic resection of a single submucosal myoma, and the size of submucosal myoma of 79.3% (168/212) patients were ≤2 cm in diameter. Submucosal myoma were mainly located in the anterior and posterior wall, accounted for 31.6% (67/212) and 30.2% (64/212), respectively. Scissors removal accounted for 25.9% (55/212), and bipolar electroresection accounted for 72.2% (153/212). Totally 88 patients (41.5%) got pregnancy after hysteroscopic submucosal myomectomy. The postoperative pregnancy rate showed a downward trend over time, and the pregnancy rate in the first year after operation was 77.2% (68/88). Logistic analysis showed that pregnancy was related to age ( P<0.001), but not to the type, size, number and location of submucosal myoma (all P>0.05). Among the patients with postoperative pregnancy, there was no uterine rupture during pregnancy and delivery. Five cases (5.7%) had abnormal placental attachment, including 3 cases of placental implantation, 1 case of placental adhesion and 1 case of central placenta previa. Among the 5 patients, there were 2 cases with previous intrauterine adhesion and 4 cases with ≥2 times of myomectomy. Conclusion:The pregnancy rate of patients with infertility or recurrent abortion after submucosal myomectomy is the highest within the first year. The location and size of submucosal myoma should be combined to determine whether contraception and contraception time after operation. Those with a history of multiple intrauterine surgery may have abnormal placental attachment during pregnancy.