Objective:To compare the embryo development potential and clinical outcomes between the patients with and without oocyte degeneration.Methods:This retrospective cohort study included a total of 242 cycles underwent ICSI that cultured in time-lapse incubator from January 2019 to June 2023 at the Reproductive and Genetic Center of Suzhou Municipal Hospital and all 3 119 oocytes were evaluated. Data collection continued to February 5th,2024 until the last birthing of the study. Patients were divided into degenerated group (140 cycles) and control group (102 cycles) according to whether oocyte degenerated after ICSI. Then the embryo developmental potential and clinical outcomes were compared. Furthermore, we also investigated whether embryo morphokinetics could be different between the two groups.Results:Female age, duration of infertility, body mass index, basal follicle sitmulating hormone, basal luteinizing hormone, basal estrogen (E 2), antral follicle count, anti-Müllerian hormone, factors of infertility and source of semen were similar between the two groups ( P>0.05). E 2 on human chorionic gonadotropin triggered day [2 513.00 (1 842.20, 3 638.50) ng/L], number of oocytes retrieved (13.56±4.80) and oocyte maturation rate [84.35% (1 601/1 898)] were significantly higher in degenerated group than those in control group [2 270.50 (1 472.00, 3 044.20) ng/L, P=0.019; 11.97±4.71, P=0.011; 81.08% (990/1 221), P=0.017], while normal fertilization rate [69.33% (1 103/1 591)], day 3 (D3) good-quality embryos [57.85% (634/1 096)], blastocyst formation rate [50.87% (469/922)] and embryo utilized rate [58.30% (643/1 103)] were significantly lower in degenerated group than those in control group [85.56% (847/990), P<0.001; 65.72% (556/846), P<0.001; 61.26% (446/728), P<0.001; 66.12% (560/847), P<0.001] . In addition, the proportion of low cell number (<7) of D3 embryos [33.76% (370/1 096)] and high fragmentation (fragmentation ≥50%, fragmentation 20%-50%) of D3 embryos [10.01% (109/1 089), 18.64% (203/1 089)] in degenerated group were significantly higher than those in control group [27.19% (230/846), P=0.002; 6.06% (51/841), P=0.002; 14.15% (119/841), P=0.009], and so were the incidence of DC1 and CC [5.98% (66/1 103) vs. 2.48% (21/847), P<0.001; 2.45% (27/1 103) vs. 0.94% (8/847), P=0.013]. As regard to the utilized embryos, there were no significant differences in t5, cc2, cc3 and s2 ( P>0.05), but tPNf [22.82(21.13, 24.84) h], t2 [25.37 (23.62, 27.37) h], t3 [35.64 (33.10, 38.03) h] and t4 [36.85 (34.70, 39.52) h] in degenerated group were significantly earlier than those in control group [23.04 (21.76, 25.41) h, P=0.001; 25.91 (24.15, 28.05) h, P=0.001; 36.16 (33.11, 38.81) h, P=0.040; 37.39 (35.11, 40.27) h, P=0.026]. Further more, after the first transfer of fresh or frozen embryos, there were no significant differences in clinical pregnancy rate, implantation rate, early abortion rate, live birth rate, sex ratio, preterm birth rate, low birth weight rate and birth defect rate between the two groups (all P>0.05). ICSI degeneration was not an independent factor of implantation rate, early abortion rate and live birth rate after ICSI treatment, but number of embryos transferred was an independent factor of implantation rate and live birth rate after ICSI treatment ( OR=2.806, 95% CI: 1.179-6.677, P=0.020; OR=2.622, 95% CI: 1.129-6.090, P=0.025). Conclusion:The presence of oocyte degeneration after ICSI may affect the overall developmental potential of its sibling oocytes and may also disturb the morphokinetics of the embyos, however the pregnancy outcomes and neonatal birth outcomes may not be affected if transfer the best embryo in the first fresh or frozen cycle.

Objective:To compare the embryo development potential and clinical outcomes between the patients with and without oocyte degeneration.Methods:This retrospective cohort study included a total of 242 cycles underwent ICSI that cultured in time-lapse incubator from January 2019 to June 2023 at the Reproductive and Genetic Center of Suzhou Municipal Hospital and all 3 119 oocytes were evaluated. Data collection continued to February 5th,2024 until the last birthing of the study. Patients were divided into degenerated group (140 cycles) and control group (102 cycles) according to whether oocyte degenerated after ICSI. Then the embryo developmental potential and clinical outcomes were compared. Furthermore, we also investigated whether embryo morphokinetics could be different between the two groups.Results:Female age, duration of infertility, body mass index, basal follicle sitmulating hormone, basal luteinizing hormone, basal estrogen (E 2), antral follicle count, anti-Müllerian hormone, factors of infertility and source of semen were similar between the two groups ( P>0.05). E 2 on human chorionic gonadotropin triggered day [2 513.00 (1 842.20, 3 638.50) ng/L], number of oocytes retrieved (13.56±4.80) and oocyte maturation rate [84.35% (1 601/1 898)] were significantly higher in degenerated group than those in control group [2 270.50 (1 472.00, 3 044.20) ng/L, P=0.019; 11.97±4.71, P=0.011; 81.08% (990/1 221), P=0.017], while normal fertilization rate [69.33% (1 103/1 591)], day 3 (D3) good-quality embryos [57.85% (634/1 096)], blastocyst formation rate [50.87% (469/922)] and embryo utilized rate [58.30% (643/1 103)] were significantly lower in degenerated group than those in control group [85.56% (847/990), P<0.001; 65.72% (556/846), P<0.001; 61.26% (446/728), P<0.001; 66.12% (560/847), P<0.001] . In addition, the proportion of low cell number (<7) of D3 embryos [33.76% (370/1 096)] and high fragmentation (fragmentation ≥50%, fragmentation 20%-50%) of D3 embryos [10.01% (109/1 089), 18.64% (203/1 089)] in degenerated group were significantly higher than those in control group [27.19% (230/846), P=0.002; 6.06% (51/841), P=0.002; 14.15% (119/841), P=0.009], and so were the incidence of DC1 and CC [5.98% (66/1 103) vs. 2.48% (21/847), P<0.001; 2.45% (27/1 103) vs. 0.94% (8/847), P=0.013]. As regard to the utilized embryos, there were no significant differences in t5, cc2, cc3 and s2 ( P>0.05), but tPNf [22.82(21.13, 24.84) h], t2 [25.37 (23.62, 27.37) h], t3 [35.64 (33.10, 38.03) h] and t4 [36.85 (34.70, 39.52) h] in degenerated group were significantly earlier than those in control group [23.04 (21.76, 25.41) h, P=0.001; 25.91 (24.15, 28.05) h, P=0.001; 36.16 (33.11, 38.81) h, P=0.040; 37.39 (35.11, 40.27) h, P=0.026]. Further more, after the first transfer of fresh or frozen embryos, there were no significant differences in clinical pregnancy rate, implantation rate, early abortion rate, live birth rate, sex ratio, preterm birth rate, low birth weight rate and birth defect rate between the two groups (all P>0.05). ICSI degeneration was not an independent factor of implantation rate, early abortion rate and live birth rate after ICSI treatment, but number of embryos transferred was an independent factor of implantation rate and live birth rate after ICSI treatment ( OR=2.806, 95% CI: 1.179-6.677, P=0.020; OR=2.622, 95% CI: 1.129-6.090, P=0.025). Conclusion:The presence of oocyte degeneration after ICSI may affect the overall developmental potential of its sibling oocytes and may also disturb the morphokinetics of the embyos, however the pregnancy outcomes and neonatal birth outcomes may not be affected if transfer the best embryo in the first fresh or frozen cycle.

Objective:To investigate the predictive value of early thyroid function changes on the efficacy of patients with Graves′ disease (GD) after 131I therapy. Methods:Data of patients with GD (59 males, 214 females; age (37.4±11.4) years) who underwent single therapy of 131I in Tianjin Medical University General Hospital from November 2017 to January 2019 were retrospectively analyzed. Symptoms, signs and laboratory tests (serum free triiodothyronine (FT 3) and serum free thyroxine (FT 4)) of patients were observed to assess the efficacy of 131I treatment. Efficacy was divided into complete remission (CR), partial remission (PR), non-remission (NR) or relapse. The changes of thyroid function (ΔFT 3=FT 3 before treatment-FT 3 after treatment)/FT 3 before treatment×100%; ΔFT 4=FT 4 before treatment-FT 4 after treatment)/FT 4 before treatment×100%) 1 month after 131I therapy in each efficacy group and differences among them were compared by using independent-sample t test, χ2 test, one-way analysis of variance and the least significant difference t test. ROC curves were drawn to analyze the predictive values of early thyroid function changes on the efficacy of 131I treatment for GD. Logistic regression analyses were performed to identify the influencing factors for the efficacy of 131I therapy. Results:CR rate and total effective rate of 273 GD patients after single therapy of 131I were 67.03%(183/273) and 92.67%(253/273), respectively. After 1 month, CR rate of euthyroidism group ( n=95) was significantly higher than that of hyperthyroidism group ( n=178; 81.05%(77/95) vs 59.55%(106/178); χ2=4.60, P=0.032). ΔFT 3 and ΔFT 4 at the first month were statistically significant and decreased sequentially in the CR group ( n=183), PR group ( n=70), NR or relapse groups ( n=20; F values: 15.40, 12.54, both P<0.001). ROC curve analysis showed that patients with ΔFT 3≥73.64% and (or) ΔFT 4≥59.03% had a higher probability of achieving CR, with sensitivities of 84.3% and 86.7%, and specificities of 62.6% and 62.6%, respectively. Logistic regression analysis showed that 24 h radioactive iodine uptake (odds ratio ( OR)=1.095, 95% CI: 1.031-1.139), dose of 131I given per gram of thyroid tissue ( OR=1.562, 95% CI: 1.321-1.694), ΔFT 3 ( OR=1.354, 95% CI: 1.295-1.482), ΔFT 4 ( OR=1.498, 95% CI: 1.384-1.608) were factors affecting the outcome of patients with GD treated with 131I treatment (all P<0.05). Conclusion:Effects of 131I treatment can be predicted based on the change of the thyroid function at the first month after 131I treatment in patients with GD.

Objective:To study the infection and epidemiological characteristics of soil borne nematode disease in Sihong County, Suqian City, and to provide scientific basis for further development of prevention and control measures.Methods:In 2022, according to geographic location, Sihong County was divided into east and west areas. Jieji Town, Shiji Township, and Linhuai Town were selected from the east area, and Tianganghu Township, Meihua Town from the west area. One administrative village was selected as a survey point in each township. Using cluster sampling method, 450 permanent residents aged 3 years old and older in the village were selected as the respondents for questionnaire survey and fecal sample collection. The infection status of hookworms, roundworms, whipworms and pinworms in fecal samples were examined, transparent tape anal swab method for detecting pinworm eggs in children, and influencing factors were analyzed.Results:A total of 2 264 survey subjects were included, 18 cases of soil borne nematodes were detected as positive, with an overall positive rate of 0.80%. Among them, 15 cases were positive for hookworms, 1 case was positive for whipworms, and 2 cases were positive for pinworms, with detection rates of 0.66%, 0.04%, and 0.09%, respectively. No ascaris lumbricoides were detected. Transparent tape anal swab method was used to examine 142 children, and the positivity rate of 1.41% (2/142). By township, the detection rate of soil borne nematodes was the highest in Jieji Town, at 2.41% (11/457); the others were Meihua Town, Tianganghu Township, Shiji Township, and Linhuai Town, with detection rates of 0.89% (4/451),0.66% (3/454), 0 (0/451) and 0 (0/451), respectively. There was a statistically significant difference between different townships (χ 2 = 19.21, P < 0.001). Among the 18 positive cases of soil borne nematode, 7 were males and 11 were females, with detection rates of 0.66% (7/1 063) and 0.92% (11/1 201), respectively, the difference was not statistically significant (χ 2 = 0.47, P = 0.491). The age distribution showed the highest detection rate in the 40 - < 60 age group, at 1.42% (9/634), with statistically significant differences between different age groups (χ 2 = 6.41, P = 0.033). The occupational distribution showed the highest detection rate in farmers, at 1.46% (9/617), with statistically significant differences between different professions (χ 2 = 8.00, P = 0.034). The differences in total soil borne nematode and hookworm detection rates were statistically significant among different methods of treating human and animal feces (χ 2 = 11.01, 9.02, P = 0.003, 0.011). Conclusions:The main species of soil borne nematode infections in Sihong County, Suqian City are hookworms, with fewer infections of whipworms and pinworms, and no roundworm infections observed. There are regional differences in detection rate. In the future, it is necessary to strengthen health education for key populations, enhance health knowledge publicity, and effectively intervene to change unhealthy production and lifestyle, further reducing the infection of soil borne nematodes in Suqian City.

Objective:To re-evaluate the systematic reviews of the effectiveness of virtual reality technology in pain management in children.Methods:Using computers to search for systematic reviews of the effectiveness of virtual reality technology in pain management for pediatric patients in China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, China Biology Medicine disc, Cochrane Library, PubMed, Embase, CINAHL and Web of Science. The retrieval period was from the establishment of the databases to November 4, 2022. Literature screening and data extraction were conducted independently by two researchers, methodological quality evaluation was performed for the included studies using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, and the evidence quality rating was evaluated using Grades of Recommendations Assessment, Development and Evaluation (GRADE) system.Results:A total of 14 systematic reviews were included. AMSTAR 2 evaluation results showed that the methodological quality of 2 systematic reviews was low, and 12 were extremely low. GRADE was used to evaluate the quality of evidence of the outcome indicators, and the results showed that among the 26 outcome indicators included, 23.08% (6/26) were medium evidence, 76.92% (20/26) were low evidence, and the quality of no evidence was high.Conclusions:There is a lack of high-quality evidence to support the conclusion that virtual reality technology can relieve pain in children. The methodological quality and evidence quality of systematic reviews are low, and more standardized and rigorous studies need to be carried out in the future to further verify the application effect of virtual reality technology in pain management of children.

Acute intermittent porphyria(AIP) is a rare inherited metabolic disease that can cause severe and fatal acute attacks. This article shares the treatment and management of a severe AIP patient. It is proposed that (1) avoiding incentives is essential; (2) emotional problems easily overlooked should be paid attention; (3) long-term follow-up and patient education can improve the prognosis. The patient underwent renal biopsy during the remission period. We found a red-brown-yellow-white refractive index crystal under a polarized light microscope that had not been reported in the previous literature, which was speculated to be a porphyrin crystal.

Objective:To investigate the clinical features of patients with recurrent or metastatic differentiated thyroid carcinoma(DTC)after 131I therapy. Methods:From December 2000 to December 2017, a total of 40 patients[14 males amd 26 females, median age 48(29-60)years] with recurrent or metastatic DTC after 131I therapy in Tianjin Medical University General Hospital were reviewed. We analyzed the clinical pathological features of the patients receiving the initial 131I ablation to screen the relevant factors affecting the time of recurrence or metastasis, the dynamic serological changes, imaging characteristics and the iodine uptake in the lesion at diagnosis. Chi- square test, Mann- Whitney U test and Kaplan- Meier analysis were used to compare the differences between the two groups. Results:The time of recurrence or metastasis of DTC after 131I therapy was not statistically different in the patient′s age, gender, multifocal cancer, lymph node metastasis, the interval between the initial 131I therapy and the operation, stimulated thyroglobulin(Tg)levels before the initial ablation and last 131I therapy, and times of 131I therapy( P > 0.05), but associated with the T-stage of in-situ tumor, soft tissue metastasis and initial therapeutic dose of 131I. Patients with the T4-stage of in-situ tumor( P=0.033), soft tissue metastasis( P=0.008)and tumor initial dose≤3.7 GBq( P=0.002)were more prone to early recurrence or metastasis. From termination of 131I therapy to the diagnosis of tumor recurrence or metastasis, Tg [Tg antibodys(TgAb)negative] and TgAb(TgAb positive)showed a gradually increasing trend. Recurrent or metastatic lesions were mostly located in the cervical lymph nodes, and most of them were multiple. Among the 40 patients with recurrent or metastatic DTC, only 3 patients had iodine-avid lesions. Conclusion:The T-stage of in-situ tumor, soft tissue metastasis and initial therapeutic dose of radioiodine are important factors affecting the time of recurrence or metastasis after 131I therapy in DTC patients. Most of the recurrent or metastatic lesions don′t ever concentrate radioiodine, so it′s difficult to benefit from continued 131I therapy.

Objective: To compare the ablation efficacy and therapy response with 1.1 GBq and 3.7 GBq ¹³¹I in postoperative patients with low- and intermediate-risk differentiated thyroid carcinoma(DTC). Methods: A total of 190 patients (43 males, 147 females, age: (45.8±11.1)years) were enrolled from July 2016 to July 2017. Among them, 96 patients received 1.1 GBq ¹³¹I and 94 were given 3.7 GBq ¹³¹I. Diagnostic whole-body scan was performed 6 months after ¹³¹I ablation for treatment response evaluation, and the successful rate of ¹³¹I ablation was calculated. χ² test or Fisher′s exact test was used for data analysis. The cut-off value of ⁹⁹Tc^m-pertechnetate uptake for predicting the successful rate of remnant thyroid ablation in 1.1 GBq group was determined by receiver operating characteristic (ROC) curve analysis. Results: The successful ablation rates in 1.1 GBq and 3.7 GBq groups were 79.2%(76/96) and 81.9%(77/94), respectively (χ²=0.229, P>0.05). There was no significant difference in the therapy response between the two groups (χ²=1.371, P>0.05). The successful ablation rate in 3.7 GBq group was higher than that in 1.1 GBq group for patients with stage Ⅲ (5/6 vs 1/7, P=0.029). Moreover, for patients with 5 μg/Lvs 10/13, P=0.038). ROC curve analysis showed the cut-off value of ⁹⁹Tc^m-pertechnetate uptake for prediction of the successful ablation rate in 1.1 GBq group was 0.061 5. Conclusion The low- and intermediate-risk DTC patients with stage Ⅲ disease, 5 μg/L99Tc^m-pertechnetate uptake of remnant thyroid should be given 3.7 GBq other than 1.1 GBq ¹³¹I to obtain a better ablation efficacy.

Objective To estimate the effect of blastocysts morphological score on pregnancy outcomes and neonate′s condition in vitrified-warmed single-blastocyst transfer cycles. Methods A retrospective analysis of 586 cycles of vitrified-warmed single-blastocyst transfer from Mar. 2010 to Feb.2016 was performed and the influ-ence of day of vitrification,inner cell mass(ICM)and trophectoderm(TE)scores on pregnancy outcomes and neo-nate′s condition were observed. Results There were no significant differences in clinical pregnancy rate,birth weight and sex ration of newborn between different vitrification day,ICM score and TE score.The day of vitrifica-tion and ICM score can significantly influence pregnancy loss rate,and were the two primary predictors of pregnan-cy loss rate. Vitrification day,ICM score and TE score exerted significant influence on live birth rate(P < 0.05) and TE score was the primary factor of live birth rate. Conclusions Day 5 vitrified blastocysts with higher quality of ICM and TE can provide high live birth rate and low pregnancy loss rate,but it could not predict the weight and gender of the newborn.

Objective To investigate the influencing factors for trauma-induced tibia1 infection in underground coal mine.Methods A retrospective analysis was performed for the clinical data of 1 090 patients with tibial fracture complicated by bone infection who were injured in underground coal mine and admitted to our hospital from January 1995 to August 2015,including the type of trauma,injured parts,severity,and treatment outcome.The association between risk factors and infection was analyzed.Results Among the 1 090 patients,357 had the clinical manifestations of acute and chronic bone infection,219 had red and swollen legs with heat pain,and 138 experienced skin necrosis,rupture,and discharge of pus.The incidence rates of tibial infection from 1995 to 2001,from 2002 to 2008,and from 2009 to 2015 were 31％,26.9％,and 20.2％,respectively.The incidence rate of bone infection in the proximal segment of the tibia was significantly higher than that in the middle and distal segments (42.1％ vs 18.9％/27.1％,P＜0.01).As for patients with different types of trauma (Gustilo typing),the patients with type Ⅲ fracture had a significantly higher incidence rate of bone infection than those with type Ⅰ/Ⅱ infection (52.8％ vs 21.8％/24.6％,P＜0.01).The incidence rates of bone infection after bone traction,internal fixation with steel plates,fixation with external fixator,and fixation with intramedullary nail were 20.7％,43.5％,21.4％,and 26.1％,respectively,suggesting that internal fixation with steel plates had a significantly higher incidence rate of bone infection than other fixation methods(P＜0.01).The muhivariate logistic regression analysis showed that the position of tibial fracture and type of fracture were independent risk factors for bone infection.Conclusion There is a high incidence rate of trauma-induced tibial infection in workers in underground coal mine.The position of tibial fracture and type of fracture are independent risk factors for bone infection.Vacuum sealing drainage and Ilizarov technique can achieve a satisfactory therapeutic effect.