Objective:To investigate the clinical application effect of Zishen Yutai Pill in patients with repeated implantation failure (RIF) undergoing frozen-thawed embryo transfer (FET) cycles.Methods:A retrospective case-control study was conducted, selecting 744 cycles of patients with RIF at the Department of Female Reproductive Medicine,State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University from October 2017 to April 2023. The patients were divided into experimental group (treated with Zishen Yutai Pill, n=279) and control group (treated without Zishen Yutai Pill, n=465) based on whether Zishen Yutai Pill was added to luteal support. The pregnancy outcomes between the two groups were compared. Based on the different endometrial preparation protocols in the FET cycles, the patients were used down-regulation protocol ( n=271) or non-down-regulation protocol ( n=473). The pregnancy outcomes of the two groups in each protocol were compared. Results:There were no statistically significant differences between the two groups in terms of biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate, early miscarriage rate, late miscarriage rate, and live birth rate (all P>0.05). However, the biochemical pregnancy rate [69.0% (58/84)], clinical pregnancy rate [59.5% (50/84)], and embryo implantation rate [59.4% (57/96)] in the experimental group of the down-regulated protocol were significantly higher than those in control group [56.1% (105/187), P=0.045; 46.5% (87/187), P=0.048; 44.9% (92/205), P=0.019], with statistically significant differences. In the non-down-regulated protocol, there were no statistically significant differences in pregnancy outcomes between the two groups (all P>0.05). Conclusion:In the FET down-regulated protocol, Zishen Yutai Pill can significantly improve the clinical pregnancy rate and the embryo implantation rate in patients with RIF, thereby improving pregnancy outcomes.

Objective:To investigate the clinical application effect of Zishen Yutai Pill in patients with repeated implantation failure (RIF) undergoing frozen-thawed embryo transfer (FET) cycles.Methods:A retrospective case-control study was conducted, selecting 744 cycles of patients with RIF at the Department of Female Reproductive Medicine,State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University from October 2017 to April 2023. The patients were divided into experimental group (treated with Zishen Yutai Pill, n=279) and control group (treated without Zishen Yutai Pill, n=465) based on whether Zishen Yutai Pill was added to luteal support. The pregnancy outcomes between the two groups were compared. Based on the different endometrial preparation protocols in the FET cycles, the patients were used down-regulation protocol ( n=271) or non-down-regulation protocol ( n=473). The pregnancy outcomes of the two groups in each protocol were compared. Results:There were no statistically significant differences between the two groups in terms of biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate, early miscarriage rate, late miscarriage rate, and live birth rate (all P>0.05). However, the biochemical pregnancy rate [69.0% (58/84)], clinical pregnancy rate [59.5% (50/84)], and embryo implantation rate [59.4% (57/96)] in the experimental group of the down-regulated protocol were significantly higher than those in control group [56.1% (105/187), P=0.045; 46.5% (87/187), P=0.048; 44.9% (92/205), P=0.019], with statistically significant differences. In the non-down-regulated protocol, there were no statistically significant differences in pregnancy outcomes between the two groups (all P>0.05). Conclusion:In the FET down-regulated protocol, Zishen Yutai Pill can significantly improve the clinical pregnancy rate and the embryo implantation rate in patients with RIF, thereby improving pregnancy outcomes.

Objective To analyze 25 cases of the half-sibling identification involving two mothers(same father,different mothers)by using family reconstruction method.Methods Hypothesis testing for half-sibling relationships were established using likelihood ratio methods.The family reconstruction was performed according to the rule of Mendelian inheritance.HSI values were calculated for dyads(two individuals),triads(three individuals with one biological mother),and tetrads(four individuals with two biological mothers)along with unrelated control groups,using 23 and 41 autosomal STR markers.Results Compared to the dyadic and triadic groups,the tetrad group exhibited a significant increase in HSI values(102～105),enabling clear discrimination of half-sibling relationships.Overlapping areas decreased,from 20.29％to 0.83％,which was reduced by 24 times,indicating enhanced system efficacy.Conclusion Incorporating additional reference samples is a feasible strategy to improve the efficacy of half-sibling identification under constrained analytical conditions.The approach enhances the detection reliability and offers valueable insights for forensic genetic practice.

Objective To analyze 25 cases of the half-sibling identification involving two mothers(same father,different mothers)by using family reconstruction method.Methods Hypothesis testing for half-sibling relationships were established using likelihood ratio methods.The family reconstruction was performed according to the rule of Mendelian inheritance.HSI values were calculated for dyads(two individuals),triads(three individuals with one biological mother),and tetrads(four individuals with two biological mothers)along with unrelated control groups,using 23 and 41 autosomal STR markers.Results Compared to the dyadic and triadic groups,the tetrad group exhibited a significant increase in HSI values(102～105),enabling clear discrimination of half-sibling relationships.Overlapping areas decreased,from 20.29％to 0.83％,which was reduced by 24 times,indicating enhanced system efficacy.Conclusion Incorporating additional reference samples is a feasible strategy to improve the efficacy of half-sibling identification under constrained analytical conditions.The approach enhances the detection reliability and offers valueable insights for forensic genetic practice.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore the clinical warning value of ischemic modified albumin (IMA) and IMA to human serum albumin (HSA) ratio (IMAR) in the development of pre-eclampsia (PE) and its severity.Methods:A total of 156 pregnant women with PE admitted to the Haidian District Maternal and Child Health Hospital of Beijing from April 2022 to March 2023 were collected as the PE group, and 156 healthy pregnant women with the same age and gestational age were matched as the control group. PE pregnant women were further divided into severe PE group (78 cases) and non-severe PE group (78 cases). Severe PE pregnant women were divided into emergency group (42 cases) and non-emergency group (36 cases) according to the disease progression time.All pregnant women were stratified according to their HSA levels (<30 g/L, 30-32 g/L, ≥32 g/L), and the peripheral blood IMA, HSA, and IMAR of pregnant women in different periods and subgroups were compared, and also the difference of IMA levels in umbilical artery blood. Bivariate correlation analysis was used to explore the correlation between severe PE and IMA or IMAR, and receiver operating characteristic (ROC) curves was used to analyze the diagnostic value of IMA, HSA, and IMAR for PE and severe PE.Results:(1) The IMA level and IMAR in peripheral serum of pregnant women in the PE group at diagnosis, and the IMA level in umbilical artery blood at delivery, and peripheral serum at 2 days after delivery were higher than those in the control group. The HSA level in peripheral serum was lower than that in the control group at diagnosis, and the differences were statistically significant (all P<0.001). (2) The IMA level and IMAR in the peripheral serum of pregnant women with severe PE were higher than those in the non-severe PE group at diagnosis, while the HSA level were lower than those in the non-severe PE group. The differences were statistically significant (all P<0.05). At diagnosis, the IMA level and IMAR in peripheral serum of pregnant women in the emergency group were higher than those in the non-emergency group, while the HSA level was lower than that in the non-emergency group. The differences were statistically significant (all P<0.05). When diagnosed, the peripheral serum IMA levels of pregnant women in the PE group were compared between subgroups with HSA<30 g/L, 30-32 g/L, ≥32 g/L, and there was no statistically significant difference ( F=0.366, P=0.694). However, the IMAR was compared between the three subgroups, and the difference was statistically significant ( F=28.544, P<0.001), which increased with the decrease of HSA levels. In the subgroup with HSA≥32 g/L, the peripheral serum IMA level and IMAR of pregnant women in the PE group were higher than those in the control group at diagnosis, and the differences were statistically significant (all P<0.001). (3) The severe PE manifestations positively correlated with peripheral serum IMAR at diagnosis include systolic blood pressure ( r=0.279), mean arterial pressure ( r=0.212), and urinary protein quantification ( r=0.277), while the severe PE manifestations negatively correlated include HSA levels ( r=-0.644) and newborn birth weight ( r=-0.305), all of which were significantly correlated ( P<0.05). (4) The area under curve (AUC) for IMAR diagnosis of PE was 0.875 (95% CI: 0.833-0.916), with the highest diagnostic efficiency at a cutoff value of 2.06, sensitivity of 72.5%, and specificity of 85.1%. The AUC for diagnosing severe PE was 0.871 (95% CI: 0.822-0.919), with the highest diagnostic efficacy at a cutoff value of 2.18, sensitivity of 72.3%, and specificity of 88.3%. The diagnostic efficacy of IMAR for PE and severe PE were higher than those of IMA and HSA levels. Conclusions:The level of IMA and IMAR in pregnant women with PE are higher than those in normal pregnant women. IMA and IMAR are correlated with the severity of PE, with IMAR changes occurring earlier and more significantly. IMAR could be considered as one of the evaluation indicators for the development of PE, or as a more sensitive PE severity warning indicator than HSA.

AIM:To explore the effect and mechanism of action of the aqueous extract of Fritillaria ussuriensis(FU-AE)against nonalcoholic fatty liver disease(NAFLD).METHODS:The association between Fritillaria ussuriensis Maxir.(FU)and NAFLD was analyzed by network pharmacology.A mouse model of NAFLD was induced in mice by high fat diet(HFD)+10%fructose drinking water,and three doses of Fritillaria ussuriensis aqueous extract were given to the mice for intervention.Colorimetric assay was used for detection of aspartate aminotransferase(AST),alanine aminotrans-ferase(ALT),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)levels in the serum of experimental mice.Hematoxylin and eosin staining was used to as-sess the pathological and histological changes in the liver of mice and to clarify the anti-NAFLD effect of aqueous extracts of Fritillaria ussuriensis.Liver tissue proteins were extracted,and expression of proteins related to the AMP-activated pro-tein kinase(AMPK)/acetyl-CoA carboxylase(ACC)pathway was detected by Western blot to clarify the mechanism of an-ti-NAFLD action of Fritillaria ussuriensis.The microbial composition of cecum contents was explored using 16S rRNA se-quencing to reveal the modulatory effect of the aqueous extract of Fritillaria ussuriensis on the structure of intestinal flora in mice with nonalcoholic fatty liver disease.RESULTS:Aqueous extract of Fritillaria ussuriensis(high dose)ameliorated exogenous adipocyte infiltration in the liver of mice with NAFLD(P<0.05).AST,ALT,TG,TC and LDL-C levels were significantly decreased(P<0.05)and HDL-C levels were significantly increased(P<0.05)in the high-dose group.Aque-ous extract of Fritillaria ussuriensis(high dose)significantly increased expression of phosphorylated AMPKα,AMPKα,and phosphorylated ACC in the livers of the model mice(P<0.05),significantly reduced expression of ACC(P<0.05),and significantly increased the relative abundance of the potentially beneficial bacteria Faecalibaculum rodentium,Lacto-bacillus johnsonii,Akkermansia muciniphila(P<0.05).CONCLUSION:Aqueous extract of Fritillaria ussuriensis may ameliorate NAFLD in mice by activating the AMPK/ACC pathway and modulating the structure of intestinal flora.

Objective:To compare the aneuploidy rate of embryos between poor ovarian response (POR) patients and women with normal ovarian reserve stratified by age, and to eliminate the influence of ovarian reserve on embryo quality.Methods:This was a retrospective case-control study of patients who underwent preimplantation genetic testing for aneuploidies (PGT-A) at the Department of Reproduction and Genetics in Hospital for Reproductive Medicine, Shandong University from January 2017 to December 2020. According to the POSEIDON criteria, POR patients were divided into group 1 [age<35 years, anti-Müllerian hormone (AMH)≥1.2 μg/L, number of oocytes retrieved≤9, 258 cycles], group 2 (age≥35 years, AMH≥1.2 μg/L, number of oocytes retrieved≤9, 397 cycles), group 3 (age<35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 99 cycles) and group 4 (age≥35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 377 cycles). The aneuploidy rate of the blastocysts in each group was compared with age-matched control women with normal ovarian reserve and normal ovarian response (non-POR 1 group, non-POR 2 group, non-POR 3 group and non-POR 4 group, AMH≥1.2 μg/L, number of oocytes retrieved>9). Based on the difference in sample size of POR groups and control groups, a 1∶2 propensity score matching (PSM) analysis was performed between the <35 years old POR groups and age-matched control groups (POR 1 group vs. non-POR 1 group, POR 3 group vs. non-POR 3 group) and a 1∶1 PSM analysis was performed between the ≥35 years old POR groups and age-matched control groups (POR 2 group vs. non-POR 2 group, POR 4 group vs. non-POR 4 group). The main outcomes were the rates of euploid and aneuploid embryo, the secondary outcomes were the numbers of oocytes retrieved, metaphaseⅡ oocytes, two pronuclei, embryos biopsied, euploid embryos, aneuploid embryos and mosaic embryos per cycle. Results:The number of oocytes retrieved and embryos biopsied embryos in POR 1-4 groups was significantly decreased compared with non-POR 1-4 groups [No. of oocytes retrieved: 7.0 (6.0, 9.0) vs. 16.0 (13.0, 20.0), 7.0 (5.0, 8.0) vs. 14.0 (11.0, 17.0), 6.0 (4.0, 9.0) vs. 16.0 (13.0, 20.0), 5.0 (3.0, 7.0) vs. 13.0 (11.0, 17.0), all P<0.001; No. of embryos biopsied: 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0,3.0) vs. 3.0 (2.0, 5), 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0, 3.0) vs. 3.0 (2.0, 5.0), all P<0.001]. After adjusting for repeated egg retrieval, PGT-A indications, ovarian stimulation protocol and total dosage of gonadotrophin, the embryo aneuploidy rate in group 4 POR patients was significantly higher than controls ( OR=1.252, 95% CI:1.053-1.488, P=0.011). However, no differences were identified in embryo aneuploidy rate between POR patients in groups 1, 2, 3 and corresponding controls, respectively (all P>0.05). Conclusion:The ovarian reserve adversely affects the quantity and quality of oocytes in advanced age POR women (≥35 years old). Decreased ovarian reserve in young women (<35 years old) mainly affects the number of oocytes retrieved.

Objective:To compare the aneuploidy rate of embryos between poor ovarian response (POR) patients and women with normal ovarian reserve stratified by age, and to eliminate the influence of ovarian reserve on embryo quality.Methods:This was a retrospective case-control study of patients who underwent preimplantation genetic testing for aneuploidies (PGT-A) at the Department of Reproduction and Genetics in Hospital for Reproductive Medicine, Shandong University from January 2017 to December 2020. According to the POSEIDON criteria, POR patients were divided into group 1 [age<35 years, anti-Müllerian hormone (AMH)≥1.2 μg/L, number of oocytes retrieved≤9, 258 cycles], group 2 (age≥35 years, AMH≥1.2 μg/L, number of oocytes retrieved≤9, 397 cycles), group 3 (age<35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 99 cycles) and group 4 (age≥35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 377 cycles). The aneuploidy rate of the blastocysts in each group was compared with age-matched control women with normal ovarian reserve and normal ovarian response (non-POR 1 group, non-POR 2 group, non-POR 3 group and non-POR 4 group, AMH≥1.2 μg/L, number of oocytes retrieved>9). Based on the difference in sample size of POR groups and control groups, a 1∶2 propensity score matching (PSM) analysis was performed between the <35 years old POR groups and age-matched control groups (POR 1 group vs. non-POR 1 group, POR 3 group vs. non-POR 3 group) and a 1∶1 PSM analysis was performed between the ≥35 years old POR groups and age-matched control groups (POR 2 group vs. non-POR 2 group, POR 4 group vs. non-POR 4 group). The main outcomes were the rates of euploid and aneuploid embryo, the secondary outcomes were the numbers of oocytes retrieved, metaphaseⅡ oocytes, two pronuclei, embryos biopsied, euploid embryos, aneuploid embryos and mosaic embryos per cycle. Results:The number of oocytes retrieved and embryos biopsied embryos in POR 1-4 groups was significantly decreased compared with non-POR 1-4 groups [No. of oocytes retrieved: 7.0 (6.0, 9.0) vs. 16.0 (13.0, 20.0), 7.0 (5.0, 8.0) vs. 14.0 (11.0, 17.0), 6.0 (4.0, 9.0) vs. 16.0 (13.0, 20.0), 5.0 (3.0, 7.0) vs. 13.0 (11.0, 17.0), all P<0.001; No. of embryos biopsied: 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0,3.0) vs. 3.0 (2.0, 5), 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0, 3.0) vs. 3.0 (2.0, 5.0), all P<0.001]. After adjusting for repeated egg retrieval, PGT-A indications, ovarian stimulation protocol and total dosage of gonadotrophin, the embryo aneuploidy rate in group 4 POR patients was significantly higher than controls ( OR=1.252, 95% CI:1.053-1.488, P=0.011). However, no differences were identified in embryo aneuploidy rate between POR patients in groups 1, 2, 3 and corresponding controls, respectively (all P>0.05). Conclusion:The ovarian reserve adversely affects the quantity and quality of oocytes in advanced age POR women (≥35 years old). Decreased ovarian reserve in young women (<35 years old) mainly affects the number of oocytes retrieved.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.