Objective To explore the function of electroacupuncture(EA)on body mass,fasting blood glucose,heat pain threshold,and transient receptor potential vanilloid 4(TRPV4)in the dorsal root ganglia(DRG)of rats with diabetic neuropathic pain(DNP).Methods A DNP rat model was formed by intraperitoneally injecting the animals with STZ.From days 15 to 21,bilateral Zusanli and Kunlun points of the DNP rat model were treated with electroacupuncture once daily for 30 min.We then measured their body mass,fasting blood glucose,and heat pain threshold.The co-expression of TRPV4 and NeuN in the rat L4～L6 DRG was detected by immunofluorescence.The effects of the TRPV4 agonist GSK1016790A on body mass,fasting blood glucose,and the heat pain threshold of DNP rats treated with electroacupuncture were detected.Results After the 7th day,body mass was significantly decreased(P<0.01)and fasting glucose was significantly increased(P<0.01)in the model group compared with the normal group.After the 21st day,compared with the model group,heat pain threshold of the model+electroacupuncture group was significantly higher(P<0.01);the results of co-expression of TRPV4 and NeuN immunofluorescence on rat L4～L6 DRG showed that:the expression of positive cells in the model group was significantly higher(P<0.01)than that in the normal group,the co-expression of TRPV4 and NeuN positive cells in L4～L6 DRG of rats in the model+electroacupuncture group was significantly lower(P<0.01)than that in the model group.The TRPV4 agonist GSK1016790A can reverse the downregulation of thermal pain threshold induced by electroacupuncture in DNP rats(P<0.01).Conclusion Electroacupuncture alleviated the DNP induced by STZ,and its mechanism may involve the inhibition of TRPV4 protein expression in the DRG.

Objective To explore the function of electroacupuncture(EA)on body mass,fasting blood glucose,heat pain threshold,and transient receptor potential vanilloid 4(TRPV4)in the dorsal root ganglia(DRG)of rats with diabetic neuropathic pain(DNP).Methods A DNP rat model was formed by intraperitoneally injecting the animals with STZ.From days 15 to 21,bilateral Zusanli and Kunlun points of the DNP rat model were treated with electroacupuncture once daily for 30 min.We then measured their body mass,fasting blood glucose,and heat pain threshold.The co-expression of TRPV4 and NeuN in the rat L4～L6 DRG was detected by immunofluorescence.The effects of the TRPV4 agonist GSK1016790A on body mass,fasting blood glucose,and the heat pain threshold of DNP rats treated with electroacupuncture were detected.Results After the 7th day,body mass was significantly decreased(P<0.01)and fasting glucose was significantly increased(P<0.01)in the model group compared with the normal group.After the 21st day,compared with the model group,heat pain threshold of the model+electroacupuncture group was significantly higher(P<0.01);the results of co-expression of TRPV4 and NeuN immunofluorescence on rat L4～L6 DRG showed that:the expression of positive cells in the model group was significantly higher(P<0.01)than that in the normal group,the co-expression of TRPV4 and NeuN positive cells in L4～L6 DRG of rats in the model+electroacupuncture group was significantly lower(P<0.01)than that in the model group.The TRPV4 agonist GSK1016790A can reverse the downregulation of thermal pain threshold induced by electroacupuncture in DNP rats(P<0.01).Conclusion Electroacupuncture alleviated the DNP induced by STZ,and its mechanism may involve the inhibition of TRPV4 protein expression in the DRG.

【Objective】 To investigate the differences in efficacy and long-term prognosis between locally progressive low and intermediate rectal cancer patients receiving fluorouracil-based neoadjuvant chemotherapy alone (mFOLFOX6/CapeOX) and neoadjuvant radiotherapy, and to compare the therapeutic efficacy in the two groups. 【Methods】 We retrospectively analyzed the clinicopathological data of 118 patients with locally progressive low and intermediate rectal cancer who received neoadjuvant therapy from January 2019 to December 2021 at The First Affiliated Hospital of Xi’an Jiaotong University, including gender, age, body mass index (BMI), and other clinicopathological parameters. The t-test, Mann Whitney test, chi-square test or Fisher’s exact test were used to compare the differences between the two groups of patients who received neoadjuvant chemotherapy alone or neoadjuvant radiochemotherapy in terms of short-term efficacy, lymph node manifestations and long-term prognosis, respectively. Survival rates were calculated and survival curves were plotted using the Kaplan-Meier method. 【Results】 In terms of efficacy, patients in the neoadjuvant radiotherapy group achieved better tumor regression (Z=-2.05, P=0.04) and solid tumor efficacy (Z=-2.42, P=0.015), but the difference between the two groups in terms of downstaging effect of clinical stage was not statistically significant. The number of lymph nodes detected was significantly lower in the neoadjuvant radiotherapy group (neoadjuvant chemotherapy vs. neoadjuvant radiochemotherapy, 13.19±3.83 vs. 9.55±4.00, t=5.02, P<0.001), but the two groups did not differ significantly in the number of lymph node positives and lymph node positive ratio. In terms of long-term prognosis, there was no statistically significant difference in the overall survival rate or disease-free survival rate of the two groups. 【Conclusion】 Compared with neoadjuvant chemotherapy alone, neoadjuvant radiotherapy showed better short-term efficacy in patients with locally progressive low and intermediate rectal cancer, but there was no statistically significant difference between the two treatment regimens in terms of long-term prognosis.

In order to meet the fertility needs of infertile patients as much as possible during the pandemic of COVID-19 Omicron strain, this expert group reviewed global and domestic literature, combined with the current epidemic situation and prevention and control policies, fully considered the service procedures and characteristics of assisted reproductive institutions and sperm banks in China, and then put forward specific recommendations on institutional prevention and control management, and treatment and surgical management of COVID-19 infected patients, so as to guide and standardize the related practices in assisted reproductive institutions and sperm banks. In the practical application process, assisted reproductive institutions and sperm banks in various provinces and cities should develop personalized institutional prevention and control measures and patient management procedures based on local prevention and control requirements and the actual situation of their own institutions.

In order to meet the fertility needs of infertile patients as much as possible during the pandemic of COVID-19 Omicron strain, this expert group reviewed global and domestic literature, combined with the current epidemic situation and prevention and control policies, fully considered the service procedures and characteristics of assisted reproductive institutions and sperm banks in China, and then put forward specific recommendations on institutional prevention and control management, and treatment and surgical management of COVID-19 infected patients, so as to guide and standardize the related practices in assisted reproductive institutions and sperm banks. In the practical application process, assisted reproductive institutions and sperm banks in various provinces and cities should develop personalized institutional prevention and control measures and patient management procedures based on local prevention and control requirements and the actual situation of their own institutions.

Objective:To evaluate the application value of three-dimensional shear wave elastography(3D-SWE) with quantitative parameters and qualitative analysis of stiff rim sign in differentiating benign and malignant breast masses.Methods:One hundred and seventeen female patients (121 breast masses) admitted to the First Affiliated Hospital of Soochow University from January 2020 to February 2021 were examined by conventional ultrasound, two-dimensional shear wave elastography (2D-SWE) and 3D-SWE. Surgical or puncture pathology were used as the gold standard, the ROC curves of 2D-SWE and 3D-SWE were drawn to obtain the optimal qualitative and quantitative indicators. Afterwards, BI-RADS category was adjusted according to the optimal indicators, which could be used to evaluate the diagnostic value in differentiating benign and malignant breast masses.Results:The area under ROC curve (AUC) of BI-RADS category was 0.846, the sensitivity and specificity were 89.6% and 79.6%, respectively. The AUC value of mass-to-fat elasticity ratio(Eratio) of coronal plane was 0.869, which was the highest among all quantitative parameters and was significantly higher than that of 2D-SWE ( P<0.05). In addition, the AUC value of stiff rim sign of coronal plane was significantly higher than those of 2D-SWE, sagittal plane and transverse plane (All P<0.05). The AUC of combination of stiff rim sign of coronal plane and conventional US was 0.901, which was significantly higher than that using conventional ultrasound alone( P<0.05). Conclusions:Compared with 2D-SWE, Eratio and stiff rim sign of coronal plane of 3D-SWE yield better diagnostic efficiency.Adjusting stiff rim sign coronal plane to BI-RADS category can effectively improve the diagnostic efficiency.

Objective:To evaluate the efficacy and safety of domestic recombinant human chorionic gonadotropin (r-hCG) for injection in Chinese women undergoing assisted reproductive technology (ART) of controlled ovarian hyperstimulation (COH).Methods:In a multicenter, randomized, double-blind, positive, parallel controlled clinical trial, the infertile women with normal ovarian reserve who received COH in seven reproductive medical centers from July 2017 to October 2018 were randomly divided into two groups: experimental group (domestic r-hCG, n=112) and control group (imported r-hCG, n=116). Interactive web response system was used to randomize. The total number of oocytes obtained, cleavage cells, two pronuclei fertilization, mid-division oocytes rate, positive serum hCG rate, early embryo loss rate, clinical pregnancy rate, sustained pregnancy rate and the incidence of adverse reactions were compared between the two groups during the cycle of COH. Results:During the initiation cycle of ovulation induction therapy, the total number of oocytes obtained in experimental group and control group were (12.1±5.6) and (12.0±6.7) respectively, with no statistically significant difference ( P>0.05). There were no significant differences in the rate of mid-division oocytes, the number of cleavage cells, the number of double pronuclear fertilization, the positive rate of serum hCG during the transplantation cycle, the loss rate of early embryo, the clinical pregnancy rate, and the sustained pregnancy rate between the two groups (all P>0.05), and the 90% confidence interval ( CI) of the difference between the two groups fell within the preset equivalence threshold (-3, +3). The difference in immunogenicity assessment between the two groups was not statistically significant ( P>0.05). The incidence of ovarian hyperstimulation syndrome (OHSS) and other adverse reactions in treatment period were not significantly different between the two groups (all P>0.05), which were known adverse reaction occurred in the imported r-hCG. Conclusion:In the COH cycle of Chinese infertile women with normal ovarian reserve, the effectiveness and safety of domestic r-hCG are equivalent to imported r-hCG.

Objective:To evaluate the efficacy and safety of domestic recombinant human chorionic gonadotropin (r-hCG) for injection in Chinese women undergoing assisted reproductive technology (ART) of controlled ovarian hyperstimulation (COH).Methods:In a multicenter, randomized, double-blind, positive, parallel controlled clinical trial, the infertile women with normal ovarian reserve who received COH in seven reproductive medical centers from July 2017 to October 2018 were randomly divided into two groups: experimental group (domestic r-hCG, n=112) and control group (imported r-hCG, n=116). Interactive web response system was used to randomize. The total number of oocytes obtained, cleavage cells, two pronuclei fertilization, mid-division oocytes rate, positive serum hCG rate, early embryo loss rate, clinical pregnancy rate, sustained pregnancy rate and the incidence of adverse reactions were compared between the two groups during the cycle of COH. Results:During the initiation cycle of ovulation induction therapy, the total number of oocytes obtained in experimental group and control group were (12.1±5.6) and (12.0±6.7) respectively, with no statistically significant difference ( P>0.05). There were no significant differences in the rate of mid-division oocytes, the number of cleavage cells, the number of double pronuclear fertilization, the positive rate of serum hCG during the transplantation cycle, the loss rate of early embryo, the clinical pregnancy rate, and the sustained pregnancy rate between the two groups (all P>0.05), and the 90% confidence interval ( CI) of the difference between the two groups fell within the preset equivalence threshold (-3, +3). The difference in immunogenicity assessment between the two groups was not statistically significant ( P>0.05). The incidence of ovarian hyperstimulation syndrome (OHSS) and other adverse reactions in treatment period were not significantly different between the two groups (all P>0.05), which were known adverse reaction occurred in the imported r-hCG. Conclusion:In the COH cycle of Chinese infertile women with normal ovarian reserve, the effectiveness and safety of domestic r-hCG are equivalent to imported r-hCG.

Objective:To explore whether the body mass index (BMI) of women with regular menstruation is associated with ovarian response to ovarian hyperstimulation and the outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods:This retrospective cohort study uses data of IVF during the study period from the Center for Reproductive Medicine of the Third Affiliated Hospital of Guangzhou Medical University. According to the Asian BMI classification standard recommended by World Health Organization (WHO), the patients who met the inclusion criteria were divided into 4 groups: low BMI group (BMI<18.5 kg/m 2, n=212), normal BMI group (BMI 18.5-23.0 kg/m 2, n=1076), high BMI group (BMI 23.0-25.0 kg/m 2, n=308) and obesity group (BMI≥25.0 kg/m 2, n=287). The main outcome measures were the number of oocytes retrieved, ovarian response and ongoing pregnancy rate. Results:There were no significant differences in the number of oocytes retrieved and ovarian response among the four groups ( P>0.05). Outcomes of embryo culture (including M II oocyte rate, fertilized number, numbers of available embryos and high-quality embryos) and the number of transferred embryos were not statistically significant in high BMI group and obesity group when compared with normal BMI group ( P>0.05). Furthermore, no significant differences were found in the rate of high-quality embryo transferred, the freeze-all rate due to ovarian hyperstimulation syndrome (OHSS) risk, rates of implantation, clinical pregnancy, early miscarriage and ongoing pregnancy among the four groups ( P>0.05). In addition, after adjusting for confounding factors by logistic regression analysis, no association was found between BMI and ovarian response and ongoing pregnancy rate. Conclusion:The increase of BMI in women with regular menstruation has no influence on ovarian response and IVF pregnancy outcome.

Objective:To explore whether the body mass index (BMI) of women with regular menstruation is associated with ovarian response to ovarian hyperstimulation and the outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods:This retrospective cohort study uses data of IVF during the study period from the Center for Reproductive Medicine of the Third Affiliated Hospital of Guangzhou Medical University. According to the Asian BMI classification standard recommended by World Health Organization (WHO), the patients who met the inclusion criteria were divided into 4 groups: low BMI group (BMI<18.5 kg/m 2, n=212), normal BMI group (BMI 18.5-23.0 kg/m 2, n=1076), high BMI group (BMI 23.0-25.0 kg/m 2, n=308) and obesity group (BMI≥25.0 kg/m 2, n=287). The main outcome measures were the number of oocytes retrieved, ovarian response and ongoing pregnancy rate. Results:There were no significant differences in the number of oocytes retrieved and ovarian response among the four groups ( P>0.05). Outcomes of embryo culture (including M II oocyte rate, fertilized number, numbers of available embryos and high-quality embryos) and the number of transferred embryos were not statistically significant in high BMI group and obesity group when compared with normal BMI group ( P>0.05). Furthermore, no significant differences were found in the rate of high-quality embryo transferred, the freeze-all rate due to ovarian hyperstimulation syndrome (OHSS) risk, rates of implantation, clinical pregnancy, early miscarriage and ongoing pregnancy among the four groups ( P>0.05). In addition, after adjusting for confounding factors by logistic regression analysis, no association was found between BMI and ovarian response and ongoing pregnancy rate. Conclusion:The increase of BMI in women with regular menstruation has no influence on ovarian response and IVF pregnancy outcome.