In recent years， the number of special clinical cases related to assisted reproductive technology （ART） for pregnancy has been on the rise annually. For example， gamete donation， assisted reproduction for couples of advanced maternal ages， and the ownership and disposition of embryos when one or both partners pass away， all involve the health of offspring and conflicts of interest in the implementation of ART. Although China’s ethical principles for ART include the protection of the offspring， the detailed rules are vague and urgently need to be supplemented and improved. In addition， the clinical application of ART lacks legislative collaborative governance. The corresponding administrative departments， practitioners， and infertile couples should work together. Starting from the perspective of focusing on the well-being of offspring born from the clinical application of ART， while conducting clinical research to address technical challenges， efforts should be made to overcome ethical dilemmas in the application of technology， comprehensively consider the well-being of offspring born from assisted reproductive treatments and help them seek the best care to promote their healthy growth.

Congenital orofacial cleft, the most common birth defect in the maxillofacial region, exhibits a wide range of prognosis depending on the severity of deformity and underlying etiology. Non-syndromic congenital orofacial clefts typically present with milder deformities and more favorable treatment outcomes, whereas syndromic congenital orofacial clefts often manifest with concomitant organ abnormalities, which pose greater challenges for treatment and result in poorer prognosis. This consensus provides an elaborate classification system for varying degrees of orofacial clefts along with corresponding diagnostic and therapeutic guidelines. Results serve as a crucial resource for families to navigate prenatal screening results or make informed decisions regarding treatment options while also contributing significantly to preventing serious birth defects within the development of population.
Humans ; Cleft Lip/diagnosis* ; Cleft Palate/diagnosis* ; Consensus ; Prenatal Diagnosis ; Female

Objective : To learn the epidemiological characteristics of acute hepatitis B in Jiangxi Province from 2014 to 2021, so as to provide insights into perfecting hepatitis B prevention and control strategy. Methods: Data pertaining to acute hepatitis B was collected through the Chinese Disease Prevention and Control Information System. The temporal, spatial and population distributions of acute hepatitis B were analyzed using a descriptive epidemiological method. The trend in incidence of acute hepatitis B was analyzed using annual percent change (APC). Results: Totally 8 890 cases of acute hepatitis B were reported in Jiangxi Province from 2014 to 2021, with the reported incidence showing a tendency towards a decline (APC=-11.730%, P<0.05). The average annual reported incidence rate of acute hepatitis B was 2.42/105. Acute hepatitis B occurred all the year round, without obvious seasonal characteristics. The top three highest incidence rates were reported in Pingxiang City (7.12/105), Ganzhou City (3.12/105) and Fuzhou City (2.87/105). The lowest and highest incidence rates of acute hepatitis B were seen among residents aged under 10 years (0.30/105) and 20-29 years (3.86/105). The incidence rate of males was higher than that of females (3.25/105 vs. 1.55/105, P<0.05). Farmers were predominant population affected acute hepatitis B (5 764 cases, 64.84%). Conclusions The incidence of acute hepatitis B showed a downward trend in Jiangxi Province from 2014 to 2021, and the disease predominantly affected young males, farmers. Health education should be strengthened, and hepatitis B vaccination coverage should be promoted.

Metabolic syndrome （MS） is a complex group of clinical syndromes with obesity， abnormal glucose and lipid metabolism and hypertension as the main clinical features. Swertia mussotii is a commonly used medicine among the Tibetan people in China. Its efficacy is consistent with the pathogenesis of MS， which has the potential for symptomatic treatment of MS. It is found that effective ingredients such as gentiopicroside， sweroside， swertiamarin， mangiferin， and oleanolic acid can improve MS by regulating glucose and lipid metabolism， improving obesity， regulating the cardiovascular system， inhibiting chronic inflammation， oxidative stress， endoplasmic reticulum and autophagy， and improving intestinal microflora disorder.

Objective: To evaluate the safety of free bivalent human papilloma virus (HPV) vaccine for junior middle school girls in Jiangxi Province, so as to provide the reference for HPV vaccination. Methods: The number of free inoculation of bivalent HPV vaccine for junior middle school girls in Jiangxi Province from August 1, 2023 to May 31, 2024 were collected by Jiangxi Provincial Immunization Planning Information System, and the cases of adverse events following immunization (AEFI) were collected by China Disease Prevention and Control Information System. A descriptive analysis was conducted to assess the incidence of AEFI among middle school girls who received free bivalent HPV vaccine. Results: Junior middle school girls in Jiangxi Province were vaccinated with free bivalent HPV vaccine for 1 061 023 doses, and 67 cases of AEFI were reported. Among the 67 cases, there were 50 cases of general reaction, 7 cases of abnormal reaction, 8 cases of psychogenic reaction and 2 cases of coupling syndrome. The reported incidence of AEFI, adverse reactions and psychogenic reactions were 6.31/100 000, 5.37/100 000 and 0.75/100 000 respectively. Adverse reactions were primarily general reactions (87.72%), with abnormal reactions counting for 12.28%. All AEFI cases were cured or improved, and no death or disability cases were reported. Conclusion The free vaccination of bivalent HPV for junior high school girls in Jiangxi Province is identified as highly safe, low adverse reaction reporting rate, and mainly general reactions, but attention should be paid to the prevention of psychogenic reactions in adolescents.

Background::Intrauterine valvuloplasty is an innovative therapy, which promotes ventricular growth and function in some congenital heart diseases (CHDs). The technique remains challenging and can only be performed in a few centers. This study aimed to assess the feasibility and mid-term outcomes of fetal cardiac intervention (FCI) in fetuses with critical CHD in an experienced tertiary center.Methods::Five fetal aortic valvuloplasty (FAV) or fetal pulmonary valvuloplasty (FPV) procedures were performed in our fetal heart center between August 2018 and May 2022. Technical success was defined as crossing the aortic or pulmonary valve and balloon inflation, followed by evidence of increased blood flow across the valve and/or new regurgitation. Follow-up clinical records and echocardiography were obtained during the prenatal and postnatal periods.Results::Five fetuses received FAV or FPV, including critical aortic stenosis ( n = 2) and pulmonary atresia with intact ventricular septum ( n = 3). The mean maternal age was 33.0 ± 2.6 years. The median gestational age (GA) at diagnosis was 24 weeks (range, 22-26 weeks). The median GA at intervention was 29 weeks (range, 28-32 weeks). All five cases underwent successful or partially successful procedures. One patient had pulmonary valve perforation without balloon dilation. No procedure-related deaths or significant complications occurred. However, one neonatal death occurred due to heart and renal failure. The median follow-up period was 29.5 months (range, 8.0-48.0 months). The four surviving patients had achieved biventricular circulation, exhibited improved valve, and ventricular development at the last follow-up visit. Conclusion::Intrauterine FCI could be performed safely with good prognosis in critical CHD.

Objective:To explore the association between polymorphisms of transforming growth factor-β(TGF-β)signaling pathway and non-syndromic cleft lip with or without cleft palate(NSCL/P)among Asian populations,while considering gene-gene interaction and gene-environment interaction.Methods:A total of 1 038 Asian NSCL/P case-parent trios were ascertained from an international consortium,which conducted a genome-wide association study using a case-parent trio design to investigate the genes affec-ting risk to NSCL/P.After stringent quality control measures,343 single nucleotide polymorphism(SNP)spanning across 10 pivotal genes in the TGF-β signaling pathway were selected from the original genome-wide association study(GWAS)dataset for further analysis.The transmission disequilibrium test(TDT)was used to test for SNP effects.The conditional Logistic regression models were used to test for gene-gene interaction and gene-environment interaction.Environmental factors collected for the study in-cluded smoking during pregnancy,passive smoking during pregnancy,alcohol intake during pregnancy,and vitamin use during pregnancy.Due to the low rates of exposure to smoking during pregnancy and al-cohol consumption during pregnancy(＜3％),only the interaction between maternal smoking during pregnancy and multivitamin supplementation during pregnancy was analyzed.The threshold for statistical significance was rigorously set at P=1.46 × 10-4,applying Bonferroni correction to account for multiple testing.Results:A total of 23 SNPs in 4 genes yielded nominal association with NSCL/P(P＜0.05),but none of these associations was statistically significant after Bonferroni's multiple test correction.How-ever,there were 6 pairs of SNPs rs4939874(SMAD2)and rs1864615(TGFBR2),rs2796813(TGFB2)and rs2132298(TGFBR2),rs4147358(SMAD3)and rs1346907(TGFBR2),rs4939874(SMAD2)and rs1019855(TGFBR2),rs4939874(SMAD2)and rs12490466(TGFBR2),rs2009112(TGFB2)and rs4075748(TGFBR2)showed statistically significant SNP-SNP interaction(P＜1.46 × 10-4).In contrast,the analysis of gene-environment interactions did not yield any significant results after being cor-rected by multiple testing.Conclusion:The comprehensive evaluation of SNP associations and interac-tions within the TGF-β signaling pathway did not yield any direct associations with NSCL/P risk in Asian populations.However,the significant gene-gene interactions identified suggest that the genetic architec-ture influencing NSCL/P risk may involve interactions between genes within the TGF-β signaling path-way.These findings underscore the necessity for further investigations to unravel these results and further explore the underlying biological mechanisms.

Objective:To delve into the intricate relationship between common genetic variations across the entire genome and the risk of non-syndromic cleft lip with or without cleft palate(NSCL/P).Methods:Utilizing summary statistics data from genome-wide association studies(GW AS),a thorough investigation to evaluate the impact of common variations on the genome were undertook.This involved assessing single nucleotide polymorphism(SNP)heritability across the entire genome,as well as within specific genomic regions.To ensure the robustness of our analysis,stringent quality control measures were applied to the GWAS summary statistics data.Criteria for inclusion encompassed the absence of missing values,a minor allele frequency≥1％,P-values falling within the range of 0 to 1,and clear SNP strand orientation.SNP meeting these stringent criteria were then meticulously included in our analy-sis.The SNP heritability of NSCL/P was calculated using linkage disequilibrium score regression.Addi-tionally,hierarchical linkage disequilibrium score regression to partition SNP heritability within coding re-gions,promoters,introns,enhancers,and super enhancers were employed,and the enrichment levels within different genomic regions using LDSC(v1.0.1)software were further elucidated.Results:Our study drew upon GWAS summary statistics data obtained from 806 NSCL/P trios,comprising a total of 2 418 individuals from the Chinese population.Following rigorous quality control procedures,490 593 out of 492 993 SNP were deemed suitable for inclusion in SNP heritability calculations.The observed SNP heritability of NSCL/P was 0.55(95％CI:0.28-0.82).Adjusting for the elevated disease pre-valence within our sample,the SNP heritability scaled down to 0.37(95％CI:0.19-0.55)based on the prevalence observed in the general Chinese population.Notably,our enrichment analysis unveiled significant enrichment of SNP heritability within enhancer regions(15.70,P=0.04)and super enhan-cer regions(3.18,P=0.03).Conclusion:Our study sheds light on the intricate interplay between common genetic variations and the risk of NSCL/P in the Chinese population.By elucidating the SNP heritability landscape across different genomic regions,we contribute valuable insights into the genetic basis of NSCL/P.The significant enrichment of SNP heritability within enhancer and super enhancer re-gions underscores the potential role of these regulatory elements in shaping the genetic susceptibility to NSCL/P.This paves the way for further research aimed at uncovering novel genetic pathogenic factors un-derlying NSCL/P pathogenesis.

Purpose/Significance To analyze the multidimensional interaction between the characteristics of traditional Chinese and western medicine in patients with type 2 diabetes mellitus and its influence on traditional Chinese medicine(TCM)syndrome differentia-tion.Method/Process Based on the real-world electronic medical record(EMR)data,the traditional association rule algorithm is im-proved,and the important TCM syndromes are screened out as dependent variables by increasing the respect index,and the logistic regres-sion algorithm is used to explore the influence of traditional Chinese and western medicine indexes on TCM syndromes.Result/Conclusion Based on 688 patients,112 association rules are obtained,of which 12 includes TCM syndromes.The respect of association rules between middle-earth stagnation syndrome and overweight/obesity is the highest,moreover,overweight/obesity patients have a higher prevalence rate of middle-earth stagnation syndrome.There is a strong correlation between middle-earth stagnation syndrome,peripheral neuropathy or hypertension and overweight/obesity.Patients with diabetic nephropathy are more likely to have qi and yin deficiency syndrome.

Objective To comprehensively evaluate the quality of Croci Stigma from different regions by using the entropy weighted TOPSIS,and to provide evidence for the quality evaluation and regions selection of Croci Stigma.Methods The contents of picrocrocin,crocin I,crocin II and crocin III were determined by HPLC wavelength switching method.The total content of four components,loss on drying,total ash,absorbance and extract were chosen as detection indexes for Croci Stigma,and the weight was calculated by entropy weight method,and the indexes were statistically analyzed by TOPSIS method.The quality of Croci Stigma was comprehensively evaluated.Results The analysis results of entropy weighted TOPSIS method showed that the mean values of relative closeness(Ci)values of Croci Stigma from Zhejiang,Tibet,Anhui,Jiangsu provinces and shanghai city were 0.654,0.396,0.426,0.326 and 0.341,respectively.Overall,the quality of Croci Stigma in Zhejiang province was the highest.Conclusion The established entropy weighted TOPSIS method is objective,comprehensive and effective,which can be used for the comprehensive quality evaluation of Croci Stigma.