Ovarian tissue cryopreservation and transplantation is currently the only feasible method for preserving both fertility and ovarian endocrine function in prepubertal female patients. It is indicated for those requiring gonadotoxic therapies such as chemo-therapy, radiotherapy, or bone marrow transplantation for malignant diseases, as well as for non-malignant diseases, including immunologic, metabolic, and hematologic benign diseases requiring bone marrow transplantation, and other populations at high risk of premature ovarian insufficiency. The procedure involves laparoscopic retrieval of ovarian tissue, typically via unilateral oophorectomy in young patients, followed by slow-programmed cryopreservation. When the primary disease is cured and fertility or hormonal function restoration is desired, the tissue is thawed and transplanted, most commonly to an orthotopic site. For patients at high risk of ovarian malignancy involvement, pre-transplantation assessment of minimal residual disease in the ovarian cortex is performed using histo-pathology and molecular biology techniques. Globally, while ovarian tissue cryopreservation and transplantation has led to over 300 live births, the majority result from tissue cryopreserved after puberty. Successful restoration of puberty and subsequent live births following transplantation of tissue frozen before puberty, although demonstrated in reported cases, remain less common. Therefore, this review systematically summarizes recent advances in the indications, current application status, timing and strategies of ovarian tissue cryopreservation and transplantation, risk assessment of tumor cell reintroduction, and clinical outcomes in prepubertal patients. It also discusses the potential value and current challenges of combining this approach with invitro oocyte maturation techniques, ainming to provide practical references for clinical practice.

Objective:To compare the clinical efficacy of navigation system and orthopedic robot-assisted nail placement in the treatment of lower cervical fracture and dislocation.Methods:A retrospective cohort study was conducted to analyze the clinical data of 49 patients with fracture and dislocation of the lower cervical spine who were admitted to Honghui Hospital, Xi′an Jiaotong University School of Medicine from May 2021 to October 2022, including 38 males and 11 females, aged 29-61 years [(39.3±7.3)years]. Injury segments involved C 3 in 12 patients, C 4 in 11, C 5 in 8, C 6 in 9 and C 7 in 9. Twenty-one patients were treated with S8 navigation system (navigation group, 84 screws), and 28 with TINAVI orthopedic robot (robot group, 112 screws). The two groups were compared in terms of the total surgical duration, single screw placement time, total screw placement time, distance between the screw and the anterior cortex, incision length, intraoperative radiation dose, intraoperative blood loss and length of hospital stay. The height of intervertebral space, Cobb angle, sliding distance between vertebral bodies and American Spinal Injury Association (ASIA) grade were assessed before surgery and at 3 days after surgery. Visual analogue scale (VAS), Japanese Orthopedic Association (JOA) score and neck dysfunction index (NDI) before surgery, at 3 days, 3 months after surgery and at the last follow-up were compared. The accuracy of screw placement, intraoperative invasion rate of adjacent facet joints and rate of postoperative complications (infection, screw loosening, etc.) were evaluated. Results:All the patients were followed up for 12-16 months [(13.6±1.9)months]. In the navigation group, the total surgical duration, distance from the screw to the anterior cortex and the intraoperative radiation dose were (236.2±30.6)minutes, (2.0±0.2)mm and (374.3±90.3)mGy respectively, which were significantly shorter or less than those in the robot group [(278.4±20.7)minutes, (10.6±2.9)mm and (448.4±77.9)mGy] ( P<0.01). The single screw placement time, total screw placement time, incision length and intraoperative blood loss were (3.5±0.4)minutes, (23.9±0.5)minutes, (9.1±2.4)cm and (422.2±30.4)ml respectively, which were significantly longer or more than those in the robot group [(2.6±0.2)minutes, (17.9±0.7)minutes, (6.6±2.6)cm and (360.3±56.3)ml] ( P<0.01). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). No significant differences were observed in the height of the intervertebral space, Cobb angle, sliding distance between the vertebral bodies and ASIA grade between the two groups ( P>0.05). At 3 days after surgery, the height of intervertebral space, Cobb angle, sliding distance between vertebral bodies and ASIA grade in both groups were significantly improved when compared with those before surgery ( P<0.05 or 0.01). There were no significant differences in VAS, JOA scores or NDI between the two groups before surgery, at 3 days, 3 months after surgery and at the last follow-up ( P>0.05). The VAS, JOA scores and NDI in both groups were gradually improved at 3 days, 3 months and at the last follow-up after surgery when compared with those before surgery ( P<0.05). There was no significant difference in the accuracy of screw placement of levels 0 and 0+1 between the two groups ( P>0.05). No significant difference in the intraoperative invasion rate of adjacent facet joints between the two groups was found ( P>0.05). There were no serious complications such as infection or screw loosening after surgery in both groups. Conclusions:For lower cervical fracture and dislocation, although there are more advantages in total surgical duration, screw holding force and radiation control regarding the navigation system, and more outstanding performance in screw placement efficiency, incision length and intraoperative blood loss regarding the orthopedic robot, both of them can effectively rebuild the cervical structure, improve neurological function, relieve postoperative pain, improve screw placement accuracy and reduce facet joint injury and serious complications. Selection of the best auxiliary screw placement system should comprehensively consider patients′ conditions and the experience of the surgical team.

[Objective]To investigate the effects of puerarin regulation of purinergic receptor P2X ligand-gated ion channel 7(P2X7)/nucleotide-binding oligomeric domain receptor protein 3(NLRP3)pathway on mast cell activity in mice with allergic rhinitis(AR).[Methods]BALB/c mice were randomly divided into normal group,AR group,puerarin low-dose group,puerarin high-dose group,dexamethasone group,puerarin high-dose+P2X7 activator adenosine triphosphate(ATP)group,with 12 mice in each group.Except for normal group and the AR mouse models in the other groups received intraperitoneal ovalbumin-alum sensitization followed by intranasal ovalbumin challenge to induce AR.After successful modeling,the puerarin low-and high-dose groups were intragastrically administered with puerarin at 12.5 mg·kg-1 and 50 mg·kg-1 respectively;the dexamethasone group was intragastrically administered with dexamethasone at 1 mg·kg-1;the puerarin high-dose+ATP group was intragastrically administered with puerarin at 50 mg·kg-1,and simultaneously injected with ATP(7.5×10-3 mmol per mouse)via the tail vein;the normal group and the AR group were given equal amounts of 0.9%sodium chloride solution via both intragastric administration and tail vein injection.The treatment was performed once a day for 14 consecutive days.AR score,serum immunoglobulin E(IgE),leukotriene,histamine,tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)and IL-1β levels were detected.Hematoxylin-eosin(HE)staining was used to detect nasal mucosa pathological Change.The number of mast cells,the number of degranulated mast cells and the degranulated rate were detected by toluidine blue staining.The mean optical density of Tryptase expression in nasal mucosa was detected by immunohistochemical staining.The expressions of P2X7,NLRP3,cleaved-Caspase-1 proteins in nasal mucosa were measured by Western blot.[Results]Compared with normal group,the nasal mucosal epithelium in AR group was significantly thickened,accompanied with a large number of inflammatory cell infiltration and significant mucosal interstitial edema.The levels of AR score,serum IgE,leukotriene,histamine and TNF-α,IL-18,IL-1β were raised(P<0.05).What's more,the number of mast cells and the number of degranulated mast cells were increased,with a corresponding rise in the degranulation rate(P<0.05).The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were all amplified(P<0.05).Compared with AR group,the pathological injury of nasal mucosa in puerarin low-dose group,puerarin high-dose group and dexamethasone group was reduced.The levels of AR score,serum IgE,leukotriene,histamine,TNF-α,IL-18 and IL-1β were decreased.Additionally,the number of mast cells and the number of degranulated mast cells were reduced,with a corresponding decrease in the degranulation rate.The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were also diminished(P<0.05).Compared with the puerarin high-dose group,the puerarin high-dose+ATP group showed more severe pathological damage to nasal mucosal tissues.The AR score,serum levels of IgE,leukotrienes,histamine,TNF-α,IL-18 and IL-1β were increased.Meanwhile,the number of mast cells and degranulated mast cells,the degranulation rate were significantly added,and the mean optical density of Tryptase expression,and the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa tissues were all amplified(P<0.05).[Conclusion]Puerarin may reduce the activity of mast cells in AR model mice by inhibiting the P2X7/NLRP3 pathway.

Objective To explore the clinical characteristics of the patients with follicular cysts and menstrual disorders.Methods A total of 178 women with follicular cysts complicated by menstrual disorders were recruited,who were aged 23-53(38.62±6.35)years and came to the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital between August 2022 and July 2024.The participants were divided into three groups according to the age,with 27 women in the age group of 21-30 years(Group 1),77 in the age group of 31-40 years(Group 2),and 74 in the age group of>40 years(Group 3).The age and menstruation of these patients were collected,the body height,weight,follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),progesterone(Po),total testosterone(TT),prolactin(PRL),anti-müllerian hormone(AMH)and thyroid function[blood routine and blood clotting for patients with abnormal uterine bleeding(AUB)]were measured,and the diameter of ovarian cyst and the thickness of endometrium were examined.The clinical characteristics of the patients with follicular cysts complicated by menstrual disorders were described and compared with each other among the three age groups.Results ① Among 178 patients,61(34.3%)patients presented with complaints of cessation of regular menstruation or amenorrhea and 117(65.7%)with complaints of AUB.Out of 178 patients,13(7.3%)patients developed anemia due to AUB,and all the patients were treated with medication.② Follicular cysts disappeared in 1 month for 124(69.7%)patients,disappeared in 2 months for 176(98.9%)patients,and disappeared in 3 months for 178(100%)patients.A total of 177(99.4%)patients had follicular cysts with a diameter less than 5 cm,and only 1(0.6%)patient had follicular cysts with a diameter≥5 cm.③ The overall prevalence of diminished ovarian reserve(DOR)in patients with follicular cysts complicated by menstrual disorders was 82.0%,and the prevalence of DOR was 70.2%for the patients under 40 years old.The prevalence of DOR in three age groups was 37.0%(10/27),81.8%(63/77),and 98.6%(73/74),respectively.The prevalence of DOR gradually increased with age.④ The median AMH values for Group 1,Group 2,and Group 3 were 1.55,0.51,and 0.15 ng/mL,respectively.The FSH level in Group 3 was significantly higher than that in Groups 1 and 2(adjusted P<0.05),while the AMH level was significantly lower than that in Groups 1 and 2(adjusted P<0.05).The AMH level in Group 2 was lower than that in Group 1(adjusted P<0.05).Conclusion Patients with follicular cysts complicated by menstrual disorders are recommended to receive medication treatment,rather than just expecting treatment.The prevalence of DOR in patients with follicular cysts complicated by menstrual disorders is significantly higher than that in normal women,even in women younger than 40 years old.Therefore,it is essential to evaluate the ovarian reserve of these patients while treating menstrual disorders,particularly for young women with fertility needs.

Objective To evaluate the impact of slow-freezing process on human ovarian tissue with the standard cryopreservation-thawing protocol of Fertility Protection Center of Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods Ovarian tissues of 12 patients were divided into fresh ovarian tissue group(fresh group)and freezing-thawing ovarian tissue group(F-T group).The freezing-thawing protocol was the standard protocol in our center.The number and activity of follicle were examined with Hematoxylin-eosin(HE)staining and calcein-AM(calcein acetoxymethylester)staining,and the proliferation and apoptosis was evaluated with the immunohistochemical staining of Ki-67 and caspase-3.The expressions of apoptosis-related proteins such as caspase-3,bax and FasL between the two groups were compared with Western blotting.Results There were no statistically significant differences in follicle counting and follicle activity in ovarian tissues pre-and post-freezing-thawing(P>0.05),and the positive rate of Ki-67 in ovarian tissues after freezing-thawing was significantly lower than that in fresh ovarian tissues(P<0.05),and there was no statistically significant difference in the positive rate of caspase-3 between the two groups(P>0.05).The expression of caspase-3 protein in ovarian tissues after freezing-thawing was significantly higher than that in fresh ovarian tissues(P<0.05),while the expressions of other apoptosis-related proteins such as bax and FasL were not significantly different(P>0.05).Conclusion The standard cryopreservation-thawing regimen in our center can effectively maintain the follicle number,morphology,and activity in ovarian tissues.After freezing and thawing,the cell proliferation level is decreased.The expression of apoptosis-related proteins such as bax and FasL are not increased,and the expression of caspase-3 is relatively increased.These results suggest our freezing-thawing regimen is good for human ovarian tissue.

Female infertility is recognized as a global public health issue by the World Health Organization.Female fertility remodeling includes ovarian function reconstruction and uterus/endometrium reconstruction,etc.It is emerging as a hot technology since it is ready to prepare autologous platelet-rich concentrate and it is safer and more acceptable in autologous application.It plays an important role in regenerative medicine,and it is currently widely applied in maxillofacial and plastic surgery,dermatology and other clinical practices.This article mainly reviews the progresses of the application of autologous platelet-rich concentrate in female fertility remodeling.

Objective To explore the clinical characteristics of the patients with follicular cysts and menstrual disorders.Methods A total of 178 women with follicular cysts complicated by menstrual disorders were recruited,who were aged 23-53(38.62±6.35)years and came to the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital between August 2022 and July 2024.The participants were divided into three groups according to the age,with 27 women in the age group of 21-30 years(Group 1),77 in the age group of 31-40 years(Group 2),and 74 in the age group of>40 years(Group 3).The age and menstruation of these patients were collected,the body height,weight,follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),progesterone(Po),total testosterone(TT),prolactin(PRL),anti-müllerian hormone(AMH)and thyroid function[blood routine and blood clotting for patients with abnormal uterine bleeding(AUB)]were measured,and the diameter of ovarian cyst and the thickness of endometrium were examined.The clinical characteristics of the patients with follicular cysts complicated by menstrual disorders were described and compared with each other among the three age groups.Results ① Among 178 patients,61(34.3%)patients presented with complaints of cessation of regular menstruation or amenorrhea and 117(65.7%)with complaints of AUB.Out of 178 patients,13(7.3%)patients developed anemia due to AUB,and all the patients were treated with medication.② Follicular cysts disappeared in 1 month for 124(69.7%)patients,disappeared in 2 months for 176(98.9%)patients,and disappeared in 3 months for 178(100%)patients.A total of 177(99.4%)patients had follicular cysts with a diameter less than 5 cm,and only 1(0.6%)patient had follicular cysts with a diameter≥5 cm.③ The overall prevalence of diminished ovarian reserve(DOR)in patients with follicular cysts complicated by menstrual disorders was 82.0%,and the prevalence of DOR was 70.2%for the patients under 40 years old.The prevalence of DOR in three age groups was 37.0%(10/27),81.8%(63/77),and 98.6%(73/74),respectively.The prevalence of DOR gradually increased with age.④ The median AMH values for Group 1,Group 2,and Group 3 were 1.55,0.51,and 0.15 ng/mL,respectively.The FSH level in Group 3 was significantly higher than that in Groups 1 and 2(adjusted P<0.05),while the AMH level was significantly lower than that in Groups 1 and 2(adjusted P<0.05).The AMH level in Group 2 was lower than that in Group 1(adjusted P<0.05).Conclusion Patients with follicular cysts complicated by menstrual disorders are recommended to receive medication treatment,rather than just expecting treatment.The prevalence of DOR in patients with follicular cysts complicated by menstrual disorders is significantly higher than that in normal women,even in women younger than 40 years old.Therefore,it is essential to evaluate the ovarian reserve of these patients while treating menstrual disorders,particularly for young women with fertility needs.

Objective To evaluate the impact of slow-freezing process on human ovarian tissue with the standard cryopreservation-thawing protocol of Fertility Protection Center of Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods Ovarian tissues of 12 patients were divided into fresh ovarian tissue group(fresh group)and freezing-thawing ovarian tissue group(F-T group).The freezing-thawing protocol was the standard protocol in our center.The number and activity of follicle were examined with Hematoxylin-eosin(HE)staining and calcein-AM(calcein acetoxymethylester)staining,and the proliferation and apoptosis was evaluated with the immunohistochemical staining of Ki-67 and caspase-3.The expressions of apoptosis-related proteins such as caspase-3,bax and FasL between the two groups were compared with Western blotting.Results There were no statistically significant differences in follicle counting and follicle activity in ovarian tissues pre-and post-freezing-thawing(P>0.05),and the positive rate of Ki-67 in ovarian tissues after freezing-thawing was significantly lower than that in fresh ovarian tissues(P<0.05),and there was no statistically significant difference in the positive rate of caspase-3 between the two groups(P>0.05).The expression of caspase-3 protein in ovarian tissues after freezing-thawing was significantly higher than that in fresh ovarian tissues(P<0.05),while the expressions of other apoptosis-related proteins such as bax and FasL were not significantly different(P>0.05).Conclusion The standard cryopreservation-thawing regimen in our center can effectively maintain the follicle number,morphology,and activity in ovarian tissues.After freezing and thawing,the cell proliferation level is decreased.The expression of apoptosis-related proteins such as bax and FasL are not increased,and the expression of caspase-3 is relatively increased.These results suggest our freezing-thawing regimen is good for human ovarian tissue.

Female infertility is recognized as a global public health issue by the World Health Organization.Female fertility remodeling includes ovarian function reconstruction and uterus/endometrium reconstruction,etc.It is emerging as a hot technology since it is ready to prepare autologous platelet-rich concentrate and it is safer and more acceptable in autologous application.It plays an important role in regenerative medicine,and it is currently widely applied in maxillofacial and plastic surgery,dermatology and other clinical practices.This article mainly reviews the progresses of the application of autologous platelet-rich concentrate in female fertility remodeling.

[Objective]To investigate the effects of puerarin regulation of purinergic receptor P2X ligand-gated ion channel 7(P2X7)/nucleotide-binding oligomeric domain receptor protein 3(NLRP3)pathway on mast cell activity in mice with allergic rhinitis(AR).[Methods]BALB/c mice were randomly divided into normal group,AR group,puerarin low-dose group,puerarin high-dose group,dexamethasone group,puerarin high-dose+P2X7 activator adenosine triphosphate(ATP)group,with 12 mice in each group.Except for normal group and the AR mouse models in the other groups received intraperitoneal ovalbumin-alum sensitization followed by intranasal ovalbumin challenge to induce AR.After successful modeling,the puerarin low-and high-dose groups were intragastrically administered with puerarin at 12.5 mg·kg-1 and 50 mg·kg-1 respectively;the dexamethasone group was intragastrically administered with dexamethasone at 1 mg·kg-1;the puerarin high-dose+ATP group was intragastrically administered with puerarin at 50 mg·kg-1,and simultaneously injected with ATP(7.5×10-3 mmol per mouse)via the tail vein;the normal group and the AR group were given equal amounts of 0.9%sodium chloride solution via both intragastric administration and tail vein injection.The treatment was performed once a day for 14 consecutive days.AR score,serum immunoglobulin E(IgE),leukotriene,histamine,tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)and IL-1β levels were detected.Hematoxylin-eosin(HE)staining was used to detect nasal mucosa pathological Change.The number of mast cells,the number of degranulated mast cells and the degranulated rate were detected by toluidine blue staining.The mean optical density of Tryptase expression in nasal mucosa was detected by immunohistochemical staining.The expressions of P2X7,NLRP3,cleaved-Caspase-1 proteins in nasal mucosa were measured by Western blot.[Results]Compared with normal group,the nasal mucosal epithelium in AR group was significantly thickened,accompanied with a large number of inflammatory cell infiltration and significant mucosal interstitial edema.The levels of AR score,serum IgE,leukotriene,histamine and TNF-α,IL-18,IL-1β were raised(P<0.05).What's more,the number of mast cells and the number of degranulated mast cells were increased,with a corresponding rise in the degranulation rate(P<0.05).The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were all amplified(P<0.05).Compared with AR group,the pathological injury of nasal mucosa in puerarin low-dose group,puerarin high-dose group and dexamethasone group was reduced.The levels of AR score,serum IgE,leukotriene,histamine,TNF-α,IL-18 and IL-1β were decreased.Additionally,the number of mast cells and the number of degranulated mast cells were reduced,with a corresponding decrease in the degranulation rate.The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were also diminished(P<0.05).Compared with the puerarin high-dose group,the puerarin high-dose+ATP group showed more severe pathological damage to nasal mucosal tissues.The AR score,serum levels of IgE,leukotrienes,histamine,TNF-α,IL-18 and IL-1β were increased.Meanwhile,the number of mast cells and degranulated mast cells,the degranulation rate were significantly added,and the mean optical density of Tryptase expression,and the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa tissues were all amplified(P<0.05).[Conclusion]Puerarin may reduce the activity of mast cells in AR model mice by inhibiting the P2X7/NLRP3 pathway.