Preimplantation genetic testing for aneuploidy (PGT-A) is a crucial technique currently used to improve embryo implantation rate, reduce miscarriage rate, and shorten the time to pregnancy for patients who are of advanced maternal age (≥35 years), have experienced repeated implantation failures, or have a history of recurrent miscarriages. Conventional PGT-A necessitates an invasive embryo biopsy, which may pose potential risks to subsequent embryo development and long-term health outcomes. Consequently, there is a growing interest among reproductive medicine professionals in developing non-invasive, safe, accurate, and effective methods for assessing embryo chromosomal status and quality. This paper provides an overview of recent advancements in the use of next-generation sequencing for detecting cell-free DNA (cfDNA) in non-invasive preimplantation genetic testing for aneuploidy (niPGT-A). The review highlights both the potential of this approach and its existing limitations. Additionally, the paper proposes a novel hypothesis regarding the application of single-molecule nanopore technology for cfDNA detection in niPGT-A, offering new insights and serving as a reference for future research in this field.

Objective:To determine the optimal threshold for trigger-day progesterone levels in gonadotropin-releasing hormone (GnRH) antagonist protocols.Methods:A cohort study was performed. The clinical data were retrospectively analyzed from patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) for assisted reproduction at the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital between January 2014 and May 2023. The study included 5 760 fresh transfer cycles where the female partner had undergone ovarian stimulation using a GnRH antagonist protocol. This was a single-arm study. The primary outcome measures were clinical pregnancy rate and live birth rate. The association between progesterone level on the trigger day and clinical pregnancy outcome and the dose-response relationship were analyzed by restricted cubic spline. Results:The progesterone level on the day of human chorionic gonadotropin trigger was (1.33±0.38) μg/L. Among the included cycles, 2 900 cycles underwent conventional IVF fertilization, while 2 860 cycles underwent ICSI. The biochemical pregnancy rate was 44.79% (2 580/5 760), the clinical pregnancy rate was 40.35% (2 324/5 760), and the live birth rate was 31.46% (1 812/5 760). Progesterone levels on the trigger day in GnRH antagonist protocols showed a nonlinear association with both clinical pregnancy rate and live birth rate (both P<0.001). When progesterone levels were below 0.61 μg/L, the clinical pregnancy rate increased with rising progesterone levels, but decreased significantly once this threshold was exceeded. Similarly, the live birth rate increased with progesterone levels below 0.63 μg/L and declined beyond that point. Conclusion:Progesterone levels on the optimal trigger day for achieving the highest clinical pregnancy rate and live birth rate in GnRH antagonist protocols are peak values of 0.61 μg/L and 0.63 μg/L, respectively. Using these thresholds, the impact of progesterone levels on the trigger day shows a positive effect on both clinical pregnancy rate and live birth rate up to these points, after which the effects become negative.

Mild cognitive impairment(MCI)is a clinical condition that lies between normal aging and dementia and can be considered as the initial stage of dementia development.Executive dysfunction is one of the core symptoms of dementia, the maintenance and improvement of executive function play a central role in delaying the onset of dementia.At present, many studies have shown that cognitive training can improve executive function in MCI patients, but there are few researches and no consensus on the underlying mechanisms.This paper provides a review of the effects of cognitive training on executive function in patients with MCI, explores the impact of executive function deficits and cognitive training on the behavioral and neural levels of executive function in patients with MCI, and points out the limitations of current MCI intervention strategies and potential development directions, with the aim of providing new insights into the intervention and treatment of MCI.

Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4% males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2% after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.

Objective:To analyze the learning curve of TiRobot-assisted lumbar pedicle screw fixation (LPSF) by cumulative sum (CUSUM) test method.Methods:The clinical data of 50 patients who underwent TiRobot-assisted LPSF from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. CUSUM analysis and learning curve fitting were performed with robot usage time as the main indicator with the time for each step refined (robot registration time, path planning time and guide wire placement time), to select the best learning curve fitting model with the R2 value closest to 1. Using the turning point of the learning curve as the boundary, the learning curve was divided into two stages as learning stage and maturity stage, and then the observation indexes were compared between the two stages. Results:All 50 patients successfully completed the surgery without perioperative complications, with a total of 244 pedicle screws implanted. The total robot usage time and robot registration time showed a gradually decreasing trend with the increase of case number, and the learning curves were successfully fitted and reached their peaks at the seventeenth and thirteenth cases respectively. The entire learning process was divided into learning stage (17 cases) and maturity stage (33 cases) based on the turning point of the learning curve of total robot usage time. The path planning time and guide wire placement time did not show significant changes with the increase in the case number. The total robot usage time, robot registration time and the intraoperative blood loss in the learning stage were significantly higher than those in the maturity stage: (35.35 ± 1.58) min vs. (30.61 ± 0.43) min, (20.83 ± 1.56) min vs. (14.94 ± 0.29) min and 400 (150, 500) ml vs. 200 (110, 300) ml, the guide wire placement time of per screw was significantly lower than that in the maturity stage: 2.00 (1.83, 2.34) min/screw vs. 2.33 (2.13, 2.69) min/screw, and there were statistical differences ( P<0.05 or <0.01). There were no statistical difference in the path planning time, path planning time of per screw, guide wire placement time and the accuracy of screw placement between two stages ( P>0.05). Conclusions:TiRobot-assisted LPSF is a new technology with safety and effectiveness, and it has a relatively short learning curve. To achieve technological maturity, at least 17 surgeries are required with accumulated experience, and the robot registration is the main step of the learning process. After reaching maturity stage, the robot usage time is significantly shortened and intraoperative trauma is significantly reduced while the relatively high screw placement accuracy is ensured.

The health-associated infection in the department of stomatology is an important issue for global public health and is closely associated with the medical quality and the health of health care workers and patients.Al-though certain progress has been achieved in the prevention and control of the health-associated infections in de-partment of stomatology,considering the diversity of influencing factors,the joint effort of the global public health institutions,medical institutions and scientific research institutions remains necessary for the effective con-trol of the hospital-associated infections.The study focuses on the current status of hospital-associated infections in department of stomatology,risk factors and progress of research on prevention and control strategies in recent years so as to formulate more effective prevention and control strategies and provide reference for better prevention and control of the infections and protection of public heath.

Preimplantation genetic testing for aneuploidy (PGT-A) is a crucial technique currently used to improve embryo implantation rate, reduce miscarriage rate, and shorten the time to pregnancy for patients who are of advanced maternal age (≥35 years), have experienced repeated implantation failures, or have a history of recurrent miscarriages. Conventional PGT-A necessitates an invasive embryo biopsy, which may pose potential risks to subsequent embryo development and long-term health outcomes. Consequently, there is a growing interest among reproductive medicine professionals in developing non-invasive, safe, accurate, and effective methods for assessing embryo chromosomal status and quality. This paper provides an overview of recent advancements in the use of next-generation sequencing for detecting cell-free DNA (cfDNA) in non-invasive preimplantation genetic testing for aneuploidy (niPGT-A). The review highlights both the potential of this approach and its existing limitations. Additionally, the paper proposes a novel hypothesis regarding the application of single-molecule nanopore technology for cfDNA detection in niPGT-A, offering new insights and serving as a reference for future research in this field.

Objective:To determine the optimal threshold for trigger-day progesterone levels in gonadotropin-releasing hormone (GnRH) antagonist protocols.Methods:A cohort study was performed. The clinical data were retrospectively analyzed from patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) for assisted reproduction at the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital between January 2014 and May 2023. The study included 5 760 fresh transfer cycles where the female partner had undergone ovarian stimulation using a GnRH antagonist protocol. This was a single-arm study. The primary outcome measures were clinical pregnancy rate and live birth rate. The association between progesterone level on the trigger day and clinical pregnancy outcome and the dose-response relationship were analyzed by restricted cubic spline. Results:The progesterone level on the day of human chorionic gonadotropin trigger was (1.33±0.38) μg/L. Among the included cycles, 2 900 cycles underwent conventional IVF fertilization, while 2 860 cycles underwent ICSI. The biochemical pregnancy rate was 44.79% (2 580/5 760), the clinical pregnancy rate was 40.35% (2 324/5 760), and the live birth rate was 31.46% (1 812/5 760). Progesterone levels on the trigger day in GnRH antagonist protocols showed a nonlinear association with both clinical pregnancy rate and live birth rate (both P<0.001). When progesterone levels were below 0.61 μg/L, the clinical pregnancy rate increased with rising progesterone levels, but decreased significantly once this threshold was exceeded. Similarly, the live birth rate increased with progesterone levels below 0.63 μg/L and declined beyond that point. Conclusion:Progesterone levels on the optimal trigger day for achieving the highest clinical pregnancy rate and live birth rate in GnRH antagonist protocols are peak values of 0.61 μg/L and 0.63 μg/L, respectively. Using these thresholds, the impact of progesterone levels on the trigger day shows a positive effect on both clinical pregnancy rate and live birth rate up to these points, after which the effects become negative.

Tumor immunotherapy has attracted worldwide attention in cancer treatment because of its obvious advantages such as strong specificity and long curative effect.It is found that activation of STING signaling pathway in cells is one of directions to effec-tively realize tumor immunotherapy.However,due to low response rate of related drugs,difficult degradation,certain toxic and side effects,its clinical application has been seriously hindered.Nano-drug delivery system can achieve targeted drug delivery,improve drug stability,delivery rate,osmotic effect and long-term retention effect,reduce drug side effects,and show significant advantages in tumor immunotherapy.In this paper,research progress of nano-drug delivery system activating STING pathway in tumor immunother-apy in recent years is reviewed,and many nano-drug delivery systems that can activate STING signal pathway and their application ex-amples after loading drugs are listed,including nucleotide-based drug delivery system,non-nucleotide-based drug delivery system and metal-based drug delivery system,providing reference for application of nano-drugs in tumor immunotherapy.

Mild cognitive impairment(MCI)is a clinical condition that lies between normal aging and dementia and can be considered as the initial stage of dementia development.Executive dysfunction is one of the core symptoms of dementia, the maintenance and improvement of executive function play a central role in delaying the onset of dementia.At present, many studies have shown that cognitive training can improve executive function in MCI patients, but there are few researches and no consensus on the underlying mechanisms.This paper provides a review of the effects of cognitive training on executive function in patients with MCI, explores the impact of executive function deficits and cognitive training on the behavioral and neural levels of executive function in patients with MCI, and points out the limitations of current MCI intervention strategies and potential development directions, with the aim of providing new insights into the intervention and treatment of MCI.