OBJECTIVES: To evaluate the strategies and outcomes of assisted reproductive technology (ART) for fertility preservation and promotion in women with malignant tumors, and to analyze ART outcomes across different tumor types. METHODS: We conducted a retrospective analysis of female patients who underwent ART for fertility preservation or treatment at the Reproductive Center of the Women's Hospital, Zhejiang University School of Medicine, between January 1, 2018, and December 31, 2023. A total of 163 ART-aided pregnancy patients with malignant tumors were included in the case group, among which 6 patients underwent embryo cryopreservation for fertility preservation before radiotherapy or chemotherapy. Additionally, 11 unmarried women underwent oocyte cryopreservation due to borderline ovarian tumors, ovarian cancer, breast cancer, or hematological malignancies. The control group was selected from women without a history of malignant tumors who received ART treatment during the same period, using propensity score matching at a ratio of 1∶2, resulting in 326 cases. Data were collected through the reproductive medical record system and telephone follow-up (as of October 31, 2024). Baseline characteristics, controlled ovarian hyperstimulation parameters, laboratory indicators, and pregnancy outcomes were compared between case and control groups and among patients with different tumor types, and the tumor recurrence of the patients was followed up. RESULTS: Patients in the case group had significantly lower ovarian reserve (AMH, AFC) and a higher proportion of diminished ovarian reserve compared to the control group (all P<0.01). Regarding the ovulation induction protocol, the proportion of patients using the minimal stimulation protocol in the case group was significantly higher than that in the control group (29.45% vs. 12.88%, P<0.01), and the total dosage of gonadotropins used was lower (P<0.01). In terms of assisted reproductive outcomes, there were no statistically significant differences between the two groups in the number of retrieved oocytes, number of high-quality embryos, fertilization rate, cumulative pregnancy rate, cumulative live birth rate, or miscarriage rate (all P>0.05). However, the number of oocyte retrieval cycles and embryo transfer cycles required to achieve a live birth outcome in the case group were significantly higher than those in the control group (both P<0.05). Subgroup analysis showed that there were no significant differences in cumulative pregnancy rate and live birth rate among patients with different tumor types (thyroid cancer, reproductive system tumors, breast cancer, lung cancer). Nevertheless, lung cancer patients had the lowest ovarian reserve and required the most oocyte retrieval cycles due to their older age; breast cancer patients had a relatively lower fertilization rate partially because some of them were complicated with male factors. A follow-up of 154 tumor patients (with a follow-up rate of 88.5%) revealed that 6 patients (4.20%) had tumor recurrence, and 1 breast cancer patient died due to tumor recurrence. None of the 11 unmarried patients who had undergone oocyte cryopreservation had used the cryopreserved oocytes for assisted pregnancy yet, and 1 patient who had undergone fertility preservation died due to tumor recurrence. CONCLUSIONS Women of reproductive age with malignant tumors are at risk of diminished fertility. ART can effectively preserve and promote fertility, enabling favorable pregnancy and live birth outcomes. It is recommended to initiate a multidisciplinary assessment promptly prior to radiotherapy/chemotherapy and formulate an individualized ART regimen for fertility preservation or promotion, so as to achieve reproductive goals or safeguard future fertility potential.

OBJECTIVE: The study investigates the performance parameters of a nebulizer for pressurized intraperitoneal aerosol chemotherapy (PIPAC). METHODS: Laser diffraction spectroscopy was used to measure the median droplet diameter ( D ₅₀) and spray angle during the steady-state aerosol phase. RESULTS: The minimum droplet diameter of aerosol was achieved when using a nozzle of 0.2 mm diameter and 0.07 mm thickness. The nebulizer could not produce steady-state aerosol when the liquid flow rate was less than or equal to 0.3 mL/s. When the liquid flow rate was greater than or equal to 0.5 mL/s, as the working pressure increased, the median particle size gradually decreased and the spray angle gradually increased. When the pressure is greater than or equal to 200 psi（1 psi=6 894.76 Pa）, as the liquid flow rate increased, the spray angle gradually increased. At a flow rate of 0.7 mL/s and working pressure of 300 psi, the median droplet diameter of aerosol D ₅₀ was 16 μm with a spray angle up to 89.2°. CONCLUSION As a novel intraperitoneal drug delivery technology, PIPAC requires further research focusing on reducing droplet size, expanding drug distribution, improving tissue permeability, and increasing drug concentration.
Nebulizers and Vaporizers ; Aerosols ; Particle Size ; Pressure ; Drug Delivery Systems

It is very important for epilepsy treatment to distinguish epileptic seizure and non-seizure. In this study, an automatic seizure detection algorithm based on dual density dual tree complex wavelet transform (DD-DT CWT) for intracranial electroencephalogram (iEEG) was proposed. The experimental data were collected from 15 719 competition data set up by the National Institutes of Health (NINDS) in Kaggle. The processed database consisted of 55 023 seizure epochs and 501 990 non-seizure epochs. Each epoch was 1 second long and contained 174 sampling points. Firstly, the signal was resampled. Then, DD-DT CWT was used for EEG signal processing. Four kinds of features include wavelet entropy, variance, energy and mean value were extracted from the signal. Finally, these features were sent to least squares-support vector machine (LS-SVM) for learning and classification. The appropriate decomposition level was selected by comparing the experimental results under different wavelet decomposition levels. The experimental results showed that the features selected in this paper were different between seizure and non-seizure. Among the eight patients, the average accuracy of three-level decomposition classification was 91.98%, the sensitivity was 90.15%, and the specificity was 93.81%. The work of this paper shows that our algorithm has excellent performance in the two classification of EEG signals of epileptic patients, and can detect the seizure period automatically and efficiently.
Algorithms ; Electroencephalography ; Epilepsy/diagnosis* ; Humans ; Seizures/diagnosis* ; Signal Processing, Computer-Assisted ; Support Vector Machine ; Wavelet Analysis

Objective:To evaluate the application effect of problem-based learning (PBL) combined with tutorial system mode in the capacity of literature retrieval and academic writing in specialist nurses of assisted reproductive technology (ART).Methods:A total of 61 ART nurse specialists trained in Women's Hospital, School of Medicine, Zhejiang University from 2017 to 2018 were recruited in the study. These specialist nurses were trained with PBL combined with tutorial system mode during the training. Nursing Research Capacity of Self-Evaluation Scale and questionnaires were used to evaluate the capacity of literature retrieval and academic writing before and after the training. The data was analyzed by SPSS 19.0.Results:After the training, the total score of nursing research capacity was significantly higher than before ( P<0.05), and the capacity of literature retrieval, the publication number of papers and research projects were also higher than before ( P<0.01). Conclusion:PBL combined with tutorial system is an effective way to improve the capacity of literature retrieval and academic writing of ART clinical specialist nurses.

Family caregivers of cancer patients have a huge burden of care and psychological pressure. At the same time, they also get positive benefits in caring for patients. This article reviews the conceptual analysis of the benefit finding of cancer family caregivers from domestic and foreign scholars, the application of measuring tools, the influencing factors of benefit findings and the interventions. Transferring psychological focusing view, it explores the psychological rehabilitation implication of benefit findings in cancer family caregivers in China from the aspect of positive psychology.

Objective To understand the status and influencing factors of benefit finding in patients with cancer.Methods 350 patients with cancer were collected with convenience sampling method from two Jiangsu hospitals.All patients received a questionnaire survey.Multiple linear regression analysis was used to analyze the influencing factors of benefit finding in patients with cancer.Results (1) The score of benefit finding in patients with cancer was statistically significant in different frequency of physical exercise (F=8.37,P=0.00),different character (F=3.04,P=0.04) and different educational level (F=2.91,P=0.03).(2) There was a positive correlation between benefit finding(78.53± 10.50) and communication with physicians(7.27±2.19),medical coping(43.48±4.50),optimism(17.33±2.24) and social support(44.81±3.91)(r=0.31,0.35,0.29,0.23,all P＜0.05) in patients with cancer.The benefit finding in patients with cancer was negatively correlated with depression(8.59± 1.83) (r=-0.37,P＜0.05).(3) Multiple linear regression analysis results showed that medical coping modes-confrontation,objectively social support and utilization,physical exercise,depression,communication with physicians and character were the factors influencing benefit finding in patients with cancer(△R2 =28％,P＜ 0.05;△R2 =5.5％,P＜ 0.05;△R2 =3.1％,P＜ 0.05;△R2 =1.9％,P＜0.05;△R2 =1.7％,P＜0.05;△R2 =1.0％,P＜0.05;△R2 =1.1％ P＜0.05),which explained 42.0％ of the total variance.Conclusion Medical coping modes-confrontation,objectively social support and utilization,physical exercise,depression,communication with physicians and character are the factors influencing benefit finding in patients with cancer.

Objective To describe the psychological experience of benefit finding in colorectal cancer patients with the permanent colostomy.Methods A total of 18 colorectal cancer patients with the permanent colostomy were interviewed in depth with the qualitative research method. The data collected were analyzed by the Colaizzi's analysis procedure.Results The promoting factors of benefit finding in colorectal cancer patients with the permanent colostomy could be classified into four themes: the change of disease-related cognition, regaining the feeling of self-control, increasing the social support, re-realizing a sense of self-worth. Conclusions The production of benefit finding in colorectal cancer patients with the permanent colostomy needs diversified and multipath support.

Objective To evaluate the effects of network video in the continuing nursing care of discharged cervical cancer patients with postoperative catheter.Methods A number of 53 patients with cervical cancer underwent radical hysterectomy in Nantong Tumor Hospital from January to December 2016 were randomly recruited as the observation group. Another 53 patients with cervical cancer underwent radical hysterectomy from January 2012 to December 2015 were retrospectively studied as control group. Patients in the control group were discharged from the hospital with removal catheter after the professional nursing of 15 days. Patients in the observation group were discharged from the hospital with the indwelling catheter one week after the surgery, and the catheter was removed after one week of network video on continuation nursing care.Results After the removal catheter, there were two cases (4％) of increased residual urine, two cases (4％) of urinary retention, and eight cases (15％) of urinary tract infection in the observation group;one case (2％) of increased residual urine, two cases (4％) of urinary retention, and eight cases (15％) of urinary tract infection were found in the control group. No differences were observed between the two groups (P>0.05). The score of patients' satisfaction was (4.85±0.12) in the observation group and (4.82±0.10) in the control group, with no difference between the two groups (t=1.479,P>0.05).Conclusions The application of network video in continuing nursing care of patients with cervical cancer after radical hysterectomy is feasible, whereas the preparation before discharge is required.

Objective To investigate whether the new mechanically-activated (MA) cation channel Piezo 1 protein can cause the apoptosis of human chondrocytes under compressive loading,using a Flexercell unit by activating MAPK/ERK5 signal pathway.Methods Primary human chondrocytes were isolated,cultured,and then subjected to the static compressive loading for 2 h,12 h,24.h and 48 h,respectively.The GsMTx4,which is the special inhibitor of the Piezo1 protein and the BIX02188,which is the inhibitor of the ERK5 served as the inhibitor group.The immunofluorescence was used to locate the expression of the Piezo 1 protein.The expressions of Piezo1 and ERK5 were assessed by reverse transcription-polymerase chain reaction (RT-PCR),as well as the apoptosis gene B cell lymphoma/leukemia-2 (Bcl-2),Bcl-associated X protein (Bax) and Bcl-associated death promoter (BAD).In addition,Piezo1 inhibitor,GsMTx4,was used to block the MA cation channel Piezo1,served as the inhibitor group.AVPI was used to detect the apoptosis of the OA chondrocytes.Results The location of the Piezo1 was expressed in nucleus and cytoplasm of chondrocytes.The expression of the Piezo1,ERK5,BAD,and Bax mRNA in the OA chondrocytes is weak.The 12 h stretch force group was significant increased,and the 24 h stretch force group was the highest expression.However,the expression of the 48 h group was decreasing.The expression of the Bcl-2 in the 12 h group was decreasing,and the 12 h stretch force group was the lowest expression while the 24 h stretch force group was increasing.In the GsMTx4 group,the expression of the Piezo1,ERK5,BAD,Bax was decreasing while the Bcl-2 was increasing.In the BIX02188 group,the expression of the ERKS,BAD,Bax was increasing while the Bcl-2 was decreasing,while the expression of the Piezo1 was not change.The result of AV-PI shown that the 2 h stretch force group increased early stage of apoptosis.The 12 h stretch force group increased late stage of apoptosis,and the 24 h stretch force group's apoptotic rate was the highest.However,the apoptotic rate of the 48 h group was lower than the 24 h stretch force group.The GsMTx4 could inhibit the late stage of apoptosis.Conclusion Piezo 1 plays an important role in the apoptosis of human chondrocyte through the MAPK/ERK5 signal pathway.

BACKGROUND: The main reason for the postoperative loosening of cemented prosthesis is interfacial debonding and bone cement internal damage. Most studies have suggested that both of them occur in the process of fatigue damage, however, little is reported on primary loading that results in the initial damage to the bone cement-stem interface and inside of bone cement. OBJECTIVE: To study the mechanical properties of bone cement-stem interface, and the effect of crack formation in bone cement on interfacial loosening. METHODS: The cement-titanium al oy handle implant components were prepared. The maximum adhesive force of bone cement-stem interface was measured using push-in experiment. The cement damage and crack in the process of bone cement-handle interfacial debonding were monitored online using acoustic emission tester. The non-destructive testing on the metal surface and the inner layer of bone cement cylinder was conducted using three-dimensional surface profiler, ultrasonic microscopy and X-ray detector. RESULTS AND CONCLUSION: The online monitoring results of debonding experiment and acoustic emission tester demonstrated that the initial damage of bone cement initiated in the primary loading of patients after operation, rather than at fatigue damage stage. Bone cement coffin caused cracks initiation mainly due to the combination effect of radial and axial stress. The bone cement-stem interfacial shear lag effect could not prevent the gradual extension of interface and inner coffin crack from top to bottom. The bone cement defects formed in solidification process was likely to affect the mechanical properties of the material, and eventual y induced the crystal face and macromolecular chain fractures, forming silver striated cracks and leading component failure.