Objective:To investigate the correlation between imaging features of mixed ground-glass nodules(mGGNs)under dual lung enhanced CT and pathological subtypes of lung adenocarcinoma.Methods:Retrospective analysis of clinical data of 102 isolated mGGN lung adenocarcinoma patients admitted to Dalian Central Hospital from October 2016 to October 2018.The patients were divided into adenocarcinoma in situ(AIS)group,minimally invasive adenocarcinoma(MIA)group and invasive adenocarcinoma(IAC)group according to postoperative pathological examination results.Measure the maximum diameter lesions,the maximum diameter of solid components and the proportion of solid components to evaluate imaging features of three groups.The relationship between pathological subtypes of lung adenocarcinoma and baseline features,imaging features,mGGN lesions,maximum diameter of solid components and proportion of solid components were analyzed.The diagnostic value of the maximum diameter of lesions,the maximum diameter of solid components,and the proportion of solid components in IAC were analyzed by receiver operating characteristic(ROC)curves.Results:102 patients were divided into AIS group(n=20),MIA group(n=29)and IAC group(n=53)based on postoperative pathological diagnosis.There was a statistically significant difference in age among the three groups(P＜0.05).Tumor distribution locations:35 cases in the upper lobe of the right lung,10 cases in the middle lobe of the right lung,and 15 cases in the lower lobe of the right lung;23 cases in the upper lobe of the left lung and 19 cases in the lower lobe of the left lung,the tumor distribution locations in the upper lobe of the right lung was relatively high in various pathological subtypes.The lesions in AIS and MIA groups were mostly circular or elliptical in shape,whiile the lesions in the IAC group was mostly irregular in shape.There was a statistically significant difference in morphological comparisons among the three groups(P＜0.05).There was a statistically significant difference in burr sign between MIA group and IAC group(P＜0.05).There was a statistically significant difference in pleural indentation sign and bronchial inflation sign between MIA group and IAC group(P＜0.05).There was a statistically significant difference in the maximum diameter of lesions and the maximum diameter of solid components among the three groups(P＜0.05).The proportion of solid components in IAC group was higher than that in AIS and MIA groups,and the difference was statistically significant(P＜0.05).The ROC curve shows that,the area under curve(AUC)for diagnosing IAC based on the maximum diameter of the lesion,the maximum diameter of the solid component,and the proportion of the solid component were 0.840,0.966 and 0.816,respectively.The AUC of diagnosing IAC with the maximum diameter of the solid component was greater than the AUC of the maximum diameter of the lesion and the proportion of solid components(P＜0.05).Conclusion:Dual lung enhanced CT can evaluate the imaging features of mGGN,and it can distinguish the pathological subtypes of lung adenocarcinoma,when the maximum diameter of the lesion is ≥ 16.5 mm,the maximum diameter of the solid component is ≥5.5 mm,or the proportion of solid component is ≥47.00％,it can effectively diagnose IAC,the maximum diameter of solid components has the best diagnostic efficiency for IAC.

Objective:To investigate whether malignant tumors affect the laboratory outcomes of patients in their first controlled ovarian hyperstimulation (COH) cycle.Methods:This study was a retrospective case-control study that analyzed the clinical and laboratory data of patients who underwent fertility preservation before chemotherapy and radiotherapy due to malignant tumors, as well as patients with infertility caused by tubal factors who first underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2020 to May 2024. Patients who underwent fertility preservation were designated as the research group, while patients who underwent assisted reproduction due to tubal factors during the same period were designated as control group. After 1∶3 propensity score matching (PSM), 40 patients were included in the research group and 118 patients were included in control group. The ovarian response, oocyte retrieval outcomes, and embryonic development after fertilization in the first COH cycle were compared between the two groups. Results:After PSM, the research group and control group showed statistically significant differences in the gonadotropin (Gn) starting dosage [225.00 (162.50, 300.00) U vs. 193.75 (150.00, 225.00) U, P=0.002], duration of Gn used [10.00 (8.00, 11.00) d vs. 12.00 (10.00, 13.00) d, P<0.001], and average estradiol levels on human chorionic gonadotropin trigger day [2 487.00 (1 461.25, 4 090.25) pmol/L vs. 10 738.50 (8 400.00, 16 507.25) pmol/L, P<0.001]. However, no statistically significant difference was found in the total dosages of Gn used between the two groups ( P>0.05). There were no significant differences between the groups in terms of the number of oocytes retrieved, the number of metaphase Ⅱ oocytes, two pronuclei (2PN) rate, 2PN cleavage rate, available embryo rate, high-quality embryo rate, blastocyst formation rate, and available blastocyst formation rate (all P>0.05). Conclusion:Compared with infertility patients with tubal factors, there is no significant difference in the laboratory outcomes of malignant tumor patients undergoing COH for fertility preservation prior to chemotherapy and radiation.

Objective:To investigate the effects of male body mass index (BMI) on semen parameters and perinatal outcomes following artificial insemination by husband (AIH) treatment.Methods:A retrospective cohort study was conducted to analyze the clinical data of 5 053 patients underwent AIH treatment at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University, from January 2017 to February 2024. The study focused on factors such as male semen parameter abnormalities, male sexual dysfunction, female cervical factors, reproductive tract malformations, and unexplained infertility. Patients were classified into three groups based on male BMI: normal weight group (18.5-23.9 kg/m2, n=1 673), overweight group (24.0-27.9 kg/m2, n=2 078), and obese group (BMI≥28.0 kg/m2, n=1 302). The primary objective was to assess the differences in semen parameters and perinatal outcomes among the three groups. Multivariable logistic regression and linear regression analyses were applied to adjust for potential confounders that could influence semen parameters and perinatal outcomes. Results:Semen volume in the normal weight group and overweight group [4.00 (3.00, 5.50) mL, 4.00 (3.00, 5.50) mL] was higher than that in the obese group [4.00 (3.00, 5.00) mL], with a significant difference among the three groups ( P<0.001, a P<0.001). The total sperm count in the normal group and overweight group [207.60 (121.90, 341.75)×10 6, 211.80 (119.88, 334.83)×10 6] was higher than that in the obese group [188.40 (110.96, 323.41)×10 6], with a significant difference among the three groups ( P=0.007, a P<0.001). The total progressive sperm motility count in the normal group [88.18 (43.63, 163.80)×10 6] was higher than that in the obese group [75.30 (40.29, 147.86)×10 6], with a significant difference among the three groups ( P=0.001, a P<0.001). The percentage of forward motile sperm in the normal group [(45.37±17.16)%] was higher than that in the overweight group [(44.03±17.36)%] and the obese group [(43.80±17.21)%], with a significant difference compared among the three groups ( P=0.020, a P=0.016]. In terms of perinatal outcomes, after multivariate logistic regression analysis, only the overweight and obese groups had higher newborn birth weights [(3 389.53±472.65) g, (3 408.57±507.90) g] compared with the normal group [(3 271.32±532.02) g], with a significant difference among the three groups ( P=0.010, a P=0.009). Conclusion:Higher male BMI is associated with decreased semen quality and may increase newborn birth weight following AIH treatment.

Objective:To investigate the correlation between imaging features of mixed ground-glass nodules(mGGNs)under dual lung enhanced CT and pathological subtypes of lung adenocarcinoma.Methods:Retrospective analysis of clinical data of 102 isolated mGGN lung adenocarcinoma patients admitted to Dalian Central Hospital from October 2016 to October 2018.The patients were divided into adenocarcinoma in situ(AIS)group,minimally invasive adenocarcinoma(MIA)group and invasive adenocarcinoma(IAC)group according to postoperative pathological examination results.Measure the maximum diameter lesions,the maximum diameter of solid components and the proportion of solid components to evaluate imaging features of three groups.The relationship between pathological subtypes of lung adenocarcinoma and baseline features,imaging features,mGGN lesions,maximum diameter of solid components and proportion of solid components were analyzed.The diagnostic value of the maximum diameter of lesions,the maximum diameter of solid components,and the proportion of solid components in IAC were analyzed by receiver operating characteristic(ROC)curves.Results:102 patients were divided into AIS group(n=20),MIA group(n=29)and IAC group(n=53)based on postoperative pathological diagnosis.There was a statistically significant difference in age among the three groups(P＜0.05).Tumor distribution locations:35 cases in the upper lobe of the right lung,10 cases in the middle lobe of the right lung,and 15 cases in the lower lobe of the right lung;23 cases in the upper lobe of the left lung and 19 cases in the lower lobe of the left lung,the tumor distribution locations in the upper lobe of the right lung was relatively high in various pathological subtypes.The lesions in AIS and MIA groups were mostly circular or elliptical in shape,whiile the lesions in the IAC group was mostly irregular in shape.There was a statistically significant difference in morphological comparisons among the three groups(P＜0.05).There was a statistically significant difference in burr sign between MIA group and IAC group(P＜0.05).There was a statistically significant difference in pleural indentation sign and bronchial inflation sign between MIA group and IAC group(P＜0.05).There was a statistically significant difference in the maximum diameter of lesions and the maximum diameter of solid components among the three groups(P＜0.05).The proportion of solid components in IAC group was higher than that in AIS and MIA groups,and the difference was statistically significant(P＜0.05).The ROC curve shows that,the area under curve(AUC)for diagnosing IAC based on the maximum diameter of the lesion,the maximum diameter of the solid component,and the proportion of the solid component were 0.840,0.966 and 0.816,respectively.The AUC of diagnosing IAC with the maximum diameter of the solid component was greater than the AUC of the maximum diameter of the lesion and the proportion of solid components(P＜0.05).Conclusion:Dual lung enhanced CT can evaluate the imaging features of mGGN,and it can distinguish the pathological subtypes of lung adenocarcinoma,when the maximum diameter of the lesion is ≥ 16.5 mm,the maximum diameter of the solid component is ≥5.5 mm,or the proportion of solid component is ≥47.00％,it can effectively diagnose IAC,the maximum diameter of solid components has the best diagnostic efficiency for IAC.

Objective:To investigate whether malignant tumors affect the laboratory outcomes of patients in their first controlled ovarian hyperstimulation (COH) cycle.Methods:This study was a retrospective case-control study that analyzed the clinical and laboratory data of patients who underwent fertility preservation before chemotherapy and radiotherapy due to malignant tumors, as well as patients with infertility caused by tubal factors who first underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2020 to May 2024. Patients who underwent fertility preservation were designated as the research group, while patients who underwent assisted reproduction due to tubal factors during the same period were designated as control group. After 1∶3 propensity score matching (PSM), 40 patients were included in the research group and 118 patients were included in control group. The ovarian response, oocyte retrieval outcomes, and embryonic development after fertilization in the first COH cycle were compared between the two groups. Results:After PSM, the research group and control group showed statistically significant differences in the gonadotropin (Gn) starting dosage [225.00 (162.50, 300.00) U vs. 193.75 (150.00, 225.00) U, P=0.002], duration of Gn used [10.00 (8.00, 11.00) d vs. 12.00 (10.00, 13.00) d, P<0.001], and average estradiol levels on human chorionic gonadotropin trigger day [2 487.00 (1 461.25, 4 090.25) pmol/L vs. 10 738.50 (8 400.00, 16 507.25) pmol/L, P<0.001]. However, no statistically significant difference was found in the total dosages of Gn used between the two groups ( P>0.05). There were no significant differences between the groups in terms of the number of oocytes retrieved, the number of metaphase Ⅱ oocytes, two pronuclei (2PN) rate, 2PN cleavage rate, available embryo rate, high-quality embryo rate, blastocyst formation rate, and available blastocyst formation rate (all P>0.05). Conclusion:Compared with infertility patients with tubal factors, there is no significant difference in the laboratory outcomes of malignant tumor patients undergoing COH for fertility preservation prior to chemotherapy and radiation.

Objective:To investigate the effects of male body mass index (BMI) on semen parameters and perinatal outcomes following artificial insemination by husband (AIH) treatment.Methods:A retrospective cohort study was conducted to analyze the clinical data of 5 053 patients underwent AIH treatment at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University, from January 2017 to February 2024. The study focused on factors such as male semen parameter abnormalities, male sexual dysfunction, female cervical factors, reproductive tract malformations, and unexplained infertility. Patients were classified into three groups based on male BMI: normal weight group (18.5-23.9 kg/m2, n=1 673), overweight group (24.0-27.9 kg/m2, n=2 078), and obese group (BMI≥28.0 kg/m2, n=1 302). The primary objective was to assess the differences in semen parameters and perinatal outcomes among the three groups. Multivariable logistic regression and linear regression analyses were applied to adjust for potential confounders that could influence semen parameters and perinatal outcomes. Results:Semen volume in the normal weight group and overweight group [4.00 (3.00, 5.50) mL, 4.00 (3.00, 5.50) mL] was higher than that in the obese group [4.00 (3.00, 5.00) mL], with a significant difference among the three groups ( P<0.001, a P<0.001). The total sperm count in the normal group and overweight group [207.60 (121.90, 341.75)×10 6, 211.80 (119.88, 334.83)×10 6] was higher than that in the obese group [188.40 (110.96, 323.41)×10 6], with a significant difference among the three groups ( P=0.007, a P<0.001). The total progressive sperm motility count in the normal group [88.18 (43.63, 163.80)×10 6] was higher than that in the obese group [75.30 (40.29, 147.86)×10 6], with a significant difference among the three groups ( P=0.001, a P<0.001). The percentage of forward motile sperm in the normal group [(45.37±17.16)%] was higher than that in the overweight group [(44.03±17.36)%] and the obese group [(43.80±17.21)%], with a significant difference compared among the three groups ( P=0.020, a P=0.016]. In terms of perinatal outcomes, after multivariate logistic regression analysis, only the overweight and obese groups had higher newborn birth weights [(3 389.53±472.65) g, (3 408.57±507.90) g] compared with the normal group [(3 271.32±532.02) g], with a significant difference among the three groups ( P=0.010, a P=0.009). Conclusion:Higher male BMI is associated with decreased semen quality and may increase newborn birth weight following AIH treatment.

Objective:Analyzing the influence of morphological evaluation parameters of blastocysts, including days of blastocyst development [day 5 (D5) and day 6 (D6)], degree of blastocyst expansion (4, 5, 6), inner cell mass and trophectoderm grade, on the occurrence of chromosomal karyotype abnormalities of chorionic villi in missed abortion after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment and fresh/frozen-thawed single blastocyst transfer. Methods:The clinical data of patients with missed abortion after IVF/ICSI treatment and fresh/frozen-thawed single blastocyst transfer from February 2015 to February 2023 in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were included. Using a case-control study, the data were divided into two groups according to the detection results of chromosomal copy number variations (CNVs) in chorionic villi of missed abortion abnormal karyotype group ( n=139) and normal karyotype group ( n=82). The baseline data between the two groups were compared. Univariate logistic regression was used to investigate the effect of blastocyst morphological rating parameters on the occurrence of chromosomal karyotype abnormalities of chorionic villi in aborted tissues, and multivariate logistic regression was also used to adjust confounding factors. Results:Male age [(34.12±6.49) years], sperm morphology rate [5.00 (4.00,6.00)%] and female age [33.00 (30.00, 37.00) years] in abnormal karyotype group were higher than those in the normal karyotype group [(32.38±4.69) years, 4.00 (2.00,5.00)% and 31.50 (29.00,34.00) years], and the differences were statistically significant ( P=0.022, P=0.020, P=0.009). Univariate and multivariate logistic regression analyses showed that days of blastocyst development, degree of blastocyst expansion, inner cell mass and trophectoderm grade did not increase the risk of chromosomal karyotype abnormalities of chorionic villi (all P>0.05). Conclusion:There is no significant correlation between blastocyst morphological evaluation parameters and chromosomal karyotype abnormalities in chorionic villi of missed abortion after fresh/frozen-thawed single blastocyst transfer with IVF/ICSI treatment.

Objective:Analyzing the influence of morphological evaluation parameters of blastocysts, including days of blastocyst development [day 5 (D5) and day 6 (D6)], degree of blastocyst expansion (4, 5, 6), inner cell mass and trophectoderm grade, on the occurrence of chromosomal karyotype abnormalities of chorionic villi in missed abortion after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment and fresh/frozen-thawed single blastocyst transfer. Methods:The clinical data of patients with missed abortion after IVF/ICSI treatment and fresh/frozen-thawed single blastocyst transfer from February 2015 to February 2023 in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were included. Using a case-control study, the data were divided into two groups according to the detection results of chromosomal copy number variations (CNVs) in chorionic villi of missed abortion abnormal karyotype group ( n=139) and normal karyotype group ( n=82). The baseline data between the two groups were compared. Univariate logistic regression was used to investigate the effect of blastocyst morphological rating parameters on the occurrence of chromosomal karyotype abnormalities of chorionic villi in aborted tissues, and multivariate logistic regression was also used to adjust confounding factors. Results:Male age [(34.12±6.49) years], sperm morphology rate [5.00 (4.00,6.00)%] and female age [33.00 (30.00, 37.00) years] in abnormal karyotype group were higher than those in the normal karyotype group [(32.38±4.69) years, 4.00 (2.00,5.00)% and 31.50 (29.00,34.00) years], and the differences were statistically significant ( P=0.022, P=0.020, P=0.009). Univariate and multivariate logistic regression analyses showed that days of blastocyst development, degree of blastocyst expansion, inner cell mass and trophectoderm grade did not increase the risk of chromosomal karyotype abnormalities of chorionic villi (all P>0.05). Conclusion:There is no significant correlation between blastocyst morphological evaluation parameters and chromosomal karyotype abnormalities in chorionic villi of missed abortion after fresh/frozen-thawed single blastocyst transfer with IVF/ICSI treatment.

Objective:To analyze the equity of Traditional Chinese medicine(TCM)human resource allocation across 31 provinces in China and explore its influencing pathways,aiming to provide scientific reference for optimizing the allocation of TCM human resources.Methods:The Health Resource Density Index(HRDI)was employed to measure the equity of TCM human resource allocation in China,and the fuzzy-set qualitative comparative analysis(fsQCA)was utilized to explore the configurational pathways influencing this equity.Results:Based on the data from 2021,the HRDI of TCM human resources in China exhibited significant regional disparities,manifesting as a distribution pattern of"high in the east and low in the west."Three pathways promoting high equity were identified:the internal-external balance-driven pathway(H1),the economy-demand co-driven pathway(H2),and the government-led driving pathway(H3).Meanwhile,three pathways leading to low equity were also recognized:the economy-demand constraint pathway(L1)and the internal-external constraint pathways(L2、L3).Conclusion:There are notable regional disparities in the equity of TCM human resource allocation in China,with multiple factors jointly influencing this equity,among which population density serves as a core factor.In subsequent efforts to enhance equity,it is advisable to consider optimizing the synergies among multiple factors and implementing precise policies for different regions to promote efficient allocation and balanced development of TCM human resources.

Objective:To establishing a clinical prediction model can assist clinicians in identifying at-risk patients early and intervening promptly to decrease AUR incidence.Methods:A retrospective collection of 313 elderly patients with hip fracture treated between 1st July and 31st August 2023 at the Emergency Department of our hospital. Patients were categorised into two groups: The AUR group (45 patients) and the non-AUR group (268 patients) based on the presence or absence of AUR. Basic characteristics, laboratory indicators and bladder volume were compared between the two groups. Factors independently associated with the incidence of AUR were analysed using Logistic regression. Analysis of the independent risk factors impacting the occurrence of AUR, development of a clinical prediction model for the risk of AUR in elderly patients with hip fractures, and internal validation of the model.Results:Comorbid psycho-behavioural symptoms of dementia ( OR=3.334, 95% CI 1.258-8.839, P=0.015), use of hypnotic sedatives ( OR=6.758, 95% CI 2.184-20.912, P=0. 001), increased heart rate ( OR=1.041, 95% CI 1.013-1.070, P=0.004), and increased bladder volume ( OR=1.005, 95% CI 1.004-1.007, P<0.01) were all identified as risk factors. The study identified independent risk factors for AUR in elderly patients who suffered a hip fracture. Based on these factors, the research team developed a prediction model which underwent internal validation using the Bootstrap method. The analysis indicated that the model’s prediction curves aligned closely with the standard model curves. The average absolute error was 0.021. The study's ROC results showed an AUC of 0.083 and a 95% CI of 0.767-0.909. Conclusions:Comorbid psycho-behavioural symptoms of dementia, the use of hypnotic sedative drugs, an increased heart rate, and an increased bladder volume are independent risk factors for the occurrence of AUR in elderly patients who have suffered a hip fracture. The creation of a chart prediction model using columns allows for a visual evaluation of the likelihood of AUR in elderly patients with hip fractures. This model provides important reference material for emergency physicians.