Objective:To investigate the influence of inner cell mass and trophectoderm cytoplasmic strings during blastocyst expan-sion on embryonic development and pregnancy outcome.Methods:A retrospective cohort analysis was performed for the clinical data of patients who received pre-implantation genetic testing for aneuploidy(PGT-A)and underwent single blastocyst transplantation in our hospital from June 2019 to December 2021.A total of 530 patients were enrolled,and genetic testing was performed for 2132 blasto-cysts.According to the presence or absence of cytoplasmic strings during blastocyst expansion,the blastocysts were divided into cyto-plasmic strings(+)group with 534 blastocysts and cytoplasmic strings(-)group with 1598 blastocysts,and quality and PGT-A results were compared between the two groups.After the transfer of euploid blastocysts,pregnancy outcome was compared between the 115 blastocysts with cytoplasmic strings and the 415 blastocysts without cytoplasmic strings.Results:The rates of cytoplasmic strings(+)in the high-,average-,and low-quality blastocyst groups were 30.19%,24.62%,and 12.63%,respectively.The correlation analysis showed a correlation coefficient of-0.115(P<0.001)between embryo quality and the rate of cytoplasmic strings(+).There was no sig-nificant difference in euploidy rate between the two groups(45.3%vs.44.6%).There were no significant differences between the euploid blastocysts with cytoplasmic strings and those without cytoplasmic strings in implantation rate(72.17%vs.66.02%,P=0.213),miscarriage rate(14.46%vs.12.77%,P=0.691),and live birth rate(61.74%vs.57.59%,P=0.424).Conclusion:The presence of cyto-plasmic strings is associated with the morphological quality of blas-tocysts,while it has no impact on embryo ploidy or clinical outcome after euploid embryo transfer.Further research is needed to confirm the impact of cytoplasmic strings on embryonic development.

AIM:To investigate the effect of 3% diquafosol sodium eye drops on tear film homeostasis in patients wearing overnight orthokeratology lenses.METHODS:Retrospective study. A total of 340 patients(564 eyes)fitted with night-worn orthokeratology lenses from June to December 2022 were respectively divided into a diquafosol sodium group(200 cases, 323 eyes, treated with 3% diquafosol sodium eye drops)and a sodium hyaluronate group(140 cases, 241 eyes, treated with sodium hyaluronate eye drops). The uncorrected visual acuity(LogMAR), ocular surface disease index(OSDI), non-invasive tear film break-up time(NIBUT), meibomian gland infrared imaging score, and corneal epithelial fluorescein staining were analyzed and compared between the two groups.RESULTS:Compared to baseline, both groups showed significant improvements in uncorrected visual acuity(LogMAR)at 1 wk, 1, and 3 mo after lens wear(all P<0.01). However, no statistically significant difference in uncorrected visual acuity(LogMAR)was observed between the two groups at any time point(all P>0.05). No significant differences in NIBUT or OSDI scores were found between the groups before and at 1 wk after lens wear(all P>0.05). At the 1- and 3 mo follow-ups, the 3% diquafosol sodium group demonstrated significantly longer NIBUT(all P<0.001)and lower OSDI scores(all P<0.001)compared to the sodium hyaluronate group. After wearing lens for 3 mo, the meibomian gland infrared imaging scores were significantly better in the diquafosol sodium group(P<0.001), whereas no significant intergroup difference was observed in corneal fluorescein staining(P>0.05). Furthermore, the incidence of adverse events during the study period did not differ significantly between the two groups(P>0.05).CONCLUSION:Compared with sodium hyaluronate, 3% diquafosol sodium eye drops were more effective in maintaining tear film homeostasis in patients wearing overnight orthokeratology lenses.

Objective:To explore the effect of morphokinetic parameters during embryo development on pregnancy outcome of euploid single blastocyst transfer cycles, and to evaluate the predictive value of morphokinetic parameters for selective euploid single blastocyst transfer strategy.Methods:A retrospective cohort study was conducted to analyze the clinical data of 394 patients who received preimplantation genetic testing-frozen-thawed embryo transfer (PGT-FET) in Center for Reproductive Medicine of Women and Children's Hospital of Chongqing Medical University from January 2019 to June 2021. According to the pregnancy outcomes, the patients were divided into non-implantation group ( n=153), clinical miscarriage group ( n=16) and live birth group ( n=225). The patients' baseline characteristics, embryo quality and morphokinetic parameters were compared among the three groups. Results:The maternal age in the non-implantation group [(32.51±4.08) years] was significantly higher than that in the live birth group [(31.34±4.23) years, P=0.025], and the proportion of high-quality embryos in the non-implantation group [26.80% (41/153)] was significantly lower than that in the live birth group [42.22% (95/225), P=0.007]. There were no significant differences in the body mass index and the proportion of high-quality embryos between the clinical miscarriage group and the non-implantation group ( P>0.05). There was no significant difference in the proportion of high-quality embryos between the clinical miscarriage group and the non-implantation group ( P>0.05). There were no significant differences in the morphokinetic parameters of time to pronuclei appearance (tPNa), time to PN fading (tPNf), time to 2-cell (t2), t3, t4 and t8 among the three groups (all P>0.05). The average timing of compacted morula (tM) [(86.96±7.59) h] and timing of starting blastulation (tSB) [(96.73±7.20) h] of embryos in the non-implantation group were significantly higher than those in the live birth group [(85.00±7.00) h, P=0.010; (95.14±7.30) h, P=0.037, respectively] and the clinical miscarriage group [(82.89±6.33) h, P=0.040; (93.02±6.10) h, P=0.048]. After adjusting for age and embryo quality, the regression analysis showed that the morphokinetic parameters had no significant effect on implantation results (all P>0.05). Conclusion:The morphokinetic parameters during embryonic development do not affect the pregnancy outcome of euploid single blastocyst transfer and cannot be used to predict the pregnancy outcome of euploid blastocyst transfer.

Objective:To explore the effect of morphokinetic parameters during embryo development on pregnancy outcome of euploid single blastocyst transfer cycles, and to evaluate the predictive value of morphokinetic parameters for selective euploid single blastocyst transfer strategy.Methods:A retrospective cohort study was conducted to analyze the clinical data of 394 patients who received preimplantation genetic testing-frozen-thawed embryo transfer (PGT-FET) in Center for Reproductive Medicine of Women and Children's Hospital of Chongqing Medical University from January 2019 to June 2021. According to the pregnancy outcomes, the patients were divided into non-implantation group ( n=153), clinical miscarriage group ( n=16) and live birth group ( n=225). The patients' baseline characteristics, embryo quality and morphokinetic parameters were compared among the three groups. Results:The maternal age in the non-implantation group [(32.51±4.08) years] was significantly higher than that in the live birth group [(31.34±4.23) years, P=0.025], and the proportion of high-quality embryos in the non-implantation group [26.80% (41/153)] was significantly lower than that in the live birth group [42.22% (95/225), P=0.007]. There were no significant differences in the body mass index and the proportion of high-quality embryos between the clinical miscarriage group and the non-implantation group ( P>0.05). There was no significant difference in the proportion of high-quality embryos between the clinical miscarriage group and the non-implantation group ( P>0.05). There were no significant differences in the morphokinetic parameters of time to pronuclei appearance (tPNa), time to PN fading (tPNf), time to 2-cell (t2), t3, t4 and t8 among the three groups (all P>0.05). The average timing of compacted morula (tM) [(86.96±7.59) h] and timing of starting blastulation (tSB) [(96.73±7.20) h] of embryos in the non-implantation group were significantly higher than those in the live birth group [(85.00±7.00) h, P=0.010; (95.14±7.30) h, P=0.037, respectively] and the clinical miscarriage group [(82.89±6.33) h, P=0.040; (93.02±6.10) h, P=0.048]. After adjusting for age and embryo quality, the regression analysis showed that the morphokinetic parameters had no significant effect on implantation results (all P>0.05). Conclusion:The morphokinetic parameters during embryonic development do not affect the pregnancy outcome of euploid single blastocyst transfer and cannot be used to predict the pregnancy outcome of euploid blastocyst transfer.

Objective:To understand the reliability and validity of quality of life instruments for cancer patients-brain neoplasm [QLICP-BN (V1.0)], a self-developed quality of life scale for cancer patients.Methods:The quality of life of 112 patients with brain neoplasms in Yunnan Cancer Hospital from March 2012 to November 2013 was measured. The general data questionnaire and QLICP-BN (V1.0) were used for data collection. The reliability, validity and responsiveness of the scale were tested, and then the metric characteristics of the scale were evaluated.Results:The split-half reliability of the total score of the scale was 0.95, the Cronbach αcoefficient was 0.92, and the test-retest correlation coefficient rwas 0.78. After extracting common factors by the principal component method and rotating with the maximum variance, the specific module obtained three principal components, and the cumulative variance contribution rate was 64.18%. The score of specific module was 75.30±17.44 before treatment and 78.91±12.20 after treatment ( t=-2.481, P=0.015). The total score of scale before treatment was 65.26±12.29, and that after treatment was 69.62±10.41, with a statistically significant difference ( t=-4.492, P<0.001). The total responsiveness of the scale was 0.456, showing moderate responsiveness. Conclusion:QLICP-BN (V1.0) has good reliability, validity and a certain degree of responsiveness. It can be used as a measurement tool for the quality of life of patients with brain neoplasms in China.

Objective: To investigate the clinical application value of single nucleotide polymorphism (SNP) haplotype analysis in the preimplantation genetic diagnosis (PGD) of monogenic diseases. Methods: The whole genome amplification products of biopsied trophectoderm cells were analyzed by SNP haplotype analysis and verified by Sanger sequencing. Results: A total of 205 embryos were performed SNP haplotype analysis and Sanger sequencing. Among them, Sanger sequencing failed in 14.63% (30/205) of embryos, and SNP haplotype analysis failed in 0.98% (2/205) of embryos. The failure rate of the latter was significantly lower than that of the former (P＜0.05). There were consistent results in 155 (75.61%) embryos, and inconsistent results in 18 (8.78%) embryos. Forty-five embryos in 41 cycles were performed embryo transplantation. The clinical pregnancy rate was 70.73% (29/41) and the implantation rate was 71.11% (32/45). The results of prenatal diagnosis of amniotic fluid during the second trimester of pregnancy were completely consistent with those of SNP haplotype analysis. Conclusion SNP haplotype analysis is accurate, and its failure rate is lower than that of Sanger sequencing. It can be effectively used in the PGD of clinical monogenic diseases.

Objective To investigate the risk factors associated with post traumatic cerebral infarction (PTCI) after craniotomy hematoma evacuation for severe traumatic brain injury (sTBI) so as to provide clinical reference for the early prevention of postoperative PTCI.Methods A retrospective case control study was conducted to analyze the clinical data of 558 sTBI patients who received craniotomy hematoma evacuation admitted to Changsha Hospital of Traditional Chinese Medicine from October 2006 to June 2016.There were 340 males and 218 females,aged 15-71 years,with an average of 47.8 years.Among them,75 patients were at the age of less than 30 years,315 were at 30-50 years,and 168 were above 50 years.According to the Glasgow coma score (GCS),there were 127 patients with 3-4 points,124 with 5-6 points,and 307 with 7-8 points.The patients were divided into PTCI group (51 patients)and non-PTCI group (507 patients).The related indicators of the two groups of patients after admission were collected,including gender,age,injury cause,GCS,skull base fracture,traumatic subarachnoid hemorrhage (tSAH),cerebral hernia,hypotension,the time from injury to craniotomy,and whether decompressive craniectomy was performed.Univariate analysis was first performed for these factors,followed by multivariate logistic regression analysis.Results There were no significant differences in gender,age,injury cause,skull base fracture,and decompressive craniectomy between PTCI group and control group (P ＞ 0.05).In the PTCI group,there were 29 patients with GCS of 3-4 points,17 with 5-6 points,and five with 7-8 points;there were 48 patients with tSAH,37 patients with cerebral hernia,and 18 patients with hypotension.In terms of the time from injury to craniotomy,it took ＜ 3 hours in 30 patients,3-6 hours in 12,6-12 hours in five,and ＞ 12 hours in four.In the non-PTCI group,there were 98 patients with GCS of 3-4 points,107 with 5-6 points,and 302 with 7-8 points.There were 34 patients with tSAH,117 with cerebral hernia,and 35 with hypotension.In terms of the time from injury to craniotomy,it took ＜3 hours in 294 patients,3-6 hours in 130,6-12 hours in 68,and ＞ 12 hours in 15.The differences between the two groups were statistically significant (P ＜ 0.05).Multivariate logistic regression analysis indicated that GCS of 3-6 points,tSAH,cerebral hernia,time from injury to craniotomy,and hypotension were significantly associated with PTCI after operation for sTBI (P ＜ 0.01).Conclusions GCS of 3-6 points,tSAH,cerebral hernia,duration from injury to craniotomy,and hypotension time ＞ 3 hours are the high risk factors of PTCI in sTBI patients after craniotomy.For patients with these high risk factors,craniotomy should be performed in time,and the perioperative blood pressure and intracranial pressure stability should be maintained so as to relieve vasospasm.

Objective To analyze the clinical features and definitive repair strategies of bile duct strictures after hepatectomy.Methods The clinical data of patients undergoing definite repair for bile duct strictures after hepatectomy in the PLA General Hospital from 2000 to 2014 and Beijing Tsinghua Changgung Hospital from 2014 to 2017 were retrospectively collected.Results Twenty-one patients with bile duct stricture after hepatectomy were treated with reoperation.Among them,13 cases showed continuous bile leakage after operation.The types of hepatectomy include 10 cases of left or extended left hemihepatectomy,7 cases of right or extended right hemihepatectomy,2 cases of mesohepatectomy,and 2 cases of hepatic caudate labectomy.According to classification formulated by the Biliary Surgery Group of Chinese Medical Association,the types of injuries of the patients included four of Ⅱ 2,twelve of Ⅱ 3,and five of Ⅱ 4 respectively.19 of 21 patients underwent definitive repair with hepaticojejunostomy.The long-term follow-up success rate was 89.0％.Conclusions Biliary injury after hepatectomy in which the injury affects the secondary or below hepatic ducts requires surgical repair.Hepaticjejunostomy is an effective definitive repair method.Hepaticjejunostomy for bile duct stenosis after right hemihepatectomy always need to dissect the left intrahepatic bile duct by a hilar plate approach or UPV approach,due to the effect of hepatic portal transposition.Surgical repair for bile duct stenosis after the left hepatectomy,always need the incision of the right anterior and right posterior hepatic duct,due to extensive injuries of hepatic duct.

Objective: To explore the key technique and outcome of transoral radiofrequency ablation microsurgery for early stage of glottic carcinoma with anterior commissure involvement (ACI). Methods: A retrospective analysis was conducted on 31 patients, who were diagnosed as early stage glottic carcinoma during January 2010 to March 2016 in ENT Department. According to whether the anterior commissure was involved or not, two groups were divided. There were eleven cases with ACI (stages T1a, T1b, and T2). Twenty cases without ACI (stages Tis, T1a, and T2). All the patients received transoral radiofrequency ablation microsurgery and followed up closely.Only one case received radiotheraphy after surgery. SPSS19.0 software was used to analyze data. Results: The follow-up time was 12-67 months, and the median follow-up time was 30 months. Nine among 11 cases with ACI obtained good oncologic outcomes, initial local recurrence was identified in 2/11 cases, including 2 cases of T2. Two cases ultimately required salvage total laryngectomy. Meanwhile, initial local recurrence was identified in 2/20 cases without ACI, including 1 case of T1a and 1 case of T2. One case underwent elective neck dissection, and another one received salvage total laryngectomy.Compared to the patients without ACI, it seemed that the cases with ACI always accomponied with a little higher initial local recurrence and lower overall laryngealpreservation, but the difference had no significance (P>0.05). Conclusions Transoral radiofrequency ablation microsurgery is an effective treatment for glottic carcinoma with ACI. Its advantages, such as more flexibility and deformability, make it more feasible to operate at the narrow space of anterior commissure assisted with laryngeal endoscopy.Good oncologic outcomes can be obtained by this technique with lower initial local recurrence as well as higher overall laryngeal preservation rate.

Objective To analyze the epidemiological problems concerning cruiser-related infectiousdiseases reported since 1973,so as to provide evidences for the diagnosis,prevention and control of diseases.Methods Information retrieval was made by using Pubmed,Medline and China Knowledge Resource Integrated Database (CNKI) to find out papers concerning cruiser-related infectious diseases reported from 1973 to the present,and at the same time,data concerning cruiser-related gastrointestinal infectious diseases published by the Center for Disease Control (CDC) were also sorted out,and finally statistical analyses were made on such related factors as the category of diseases,types of pathogens and the areas of navigation.Results Research results indicated that gastrointestinal infectious diseases and respiratory infectious diseases,the gastrointestinal infectious diseases in particular,were the two main types of cruiser-related infectious diseases.Norovirus,shigella and Escherichia coli were the most commonly detected pathogens in the gastrointestinal infectious disease pathogens,whereas the most pathogenic factor for respiratory diseases were influenza virus,followed by varicella and legionella.In all the cruisers that were affected by infectious diseases,those sailing in tropical waters had the higher incidence rate,which was significantly higher than those sailing in temperate and frigid zones,which accounted for 72.72％,13.64％ and 13.64％ respectively.Conclusions Gastrointestinal infectious diseases and respiratory infectious diseases were the main types of cruiser-related infectious diseases,and the distribution of pathogens had their special patterns,which were closely related with the geographic regions of sailing.Knowledge about cruiser-related infectious diseases was of important significance for rapid diagnosis,prevention and control of related diseases.