Objective:To observe the pregnancy outcomes of patients with unexplained recurrent spontaneous abortion (URSA) after interventional treatment or expectant treatment.Methods:This prospective study followed up 398 patients with recurrent spontaneous abortion from March 2017 to September 2022 in seven hospitals. Among them, 267 patients were diagnosed with URSA, including 124 patients who were initially diagnosed in the interventional treatment hospital and 143 patients who were initially diagnosed in the expectant treatment hospital. All URSA patients were followed up for 33 months. Ongoing pregnancy rates were observed as main outcome indicators.Results:A total of 127 patients became pregnant, and 107 of them had sustained pregnancies, the ongoing pregnancy rate was 84.25% (107/127). The ongoing pregnancy rate was 86.11% (31/36) in the interventional treatment group and 83.52% (76/91) in the expectant treatment group, with no significant difference ( P>0.05). During the follow-up, the ongoing pregnancy rates in the interventional treatment hospital and the expectant treatment hospital were 75.71% (53/70) and 94.74% (54/57), respectively, with a significant difference ( P<0.05). The ongoing pregnancy rate after interventional treatment in the interventional treatment hospital was 82.76% (24/29), which was similar to the 94.00% (47/50) after expectant treatment in the expectant treatment hospital ( P>0.05). Conclusion:The ongoing pregnancy rate of interventional treatment for URSA patients has not been significantly improved, suggesting that it may not be necessary to carry out this treatment.

In December 2024, the European Association for the Study of the Liver (EASL) released the 2024 edition of EASL clinical practice guidelines: management of hepatocellular carci-noma (HCC). Compared to the 2018 edition, the 2024 edition includes significant updates in several areas, such as personalized surveillance strategies based on individual risk assessment, standardiza-tion of liver imaging protocols and diagnostic criteria, the use of minimally invasive surgical approaches in complex cases, an updated approach to liver transplantation integration, transitions between surgery, locoregional, and systemic therapies, as well as the positioning of radiotherapy and the use of combination immunotherapy at various stages of the disease. The authors systematically interpret the main updates related to treatment strategies in the new guidelines, aiming to provide clinicians with clear decision-making references for treatment.

Objective:To observe the pregnancy outcomes of patients with unexplained recurrent spontaneous abortion (URSA) after interventional treatment or expectant treatment.Methods:This prospective study followed up 398 patients with recurrent spontaneous abortion from March 2017 to September 2022 in seven hospitals. Among them, 267 patients were diagnosed with URSA, including 124 patients who were initially diagnosed in the interventional treatment hospital and 143 patients who were initially diagnosed in the expectant treatment hospital. All URSA patients were followed up for 33 months. Ongoing pregnancy rates were observed as main outcome indicators.Results:A total of 127 patients became pregnant, and 107 of them had sustained pregnancies, the ongoing pregnancy rate was 84.25% (107/127). The ongoing pregnancy rate was 86.11% (31/36) in the interventional treatment group and 83.52% (76/91) in the expectant treatment group, with no significant difference ( P>0.05). During the follow-up, the ongoing pregnancy rates in the interventional treatment hospital and the expectant treatment hospital were 75.71% (53/70) and 94.74% (54/57), respectively, with a significant difference ( P<0.05). The ongoing pregnancy rate after interventional treatment in the interventional treatment hospital was 82.76% (24/29), which was similar to the 94.00% (47/50) after expectant treatment in the expectant treatment hospital ( P>0.05). Conclusion:The ongoing pregnancy rate of interventional treatment for URSA patients has not been significantly improved, suggesting that it may not be necessary to carry out this treatment.

In December 2024, the European Association for the Study of the Liver (EASL) released the 2024 edition of EASL clinical practice guidelines: management of hepatocellular carci-noma (HCC). Compared to the 2018 edition, the 2024 edition includes significant updates in several areas, such as personalized surveillance strategies based on individual risk assessment, standardiza-tion of liver imaging protocols and diagnostic criteria, the use of minimally invasive surgical approaches in complex cases, an updated approach to liver transplantation integration, transitions between surgery, locoregional, and systemic therapies, as well as the positioning of radiotherapy and the use of combination immunotherapy at various stages of the disease. The authors systematically interpret the main updates related to treatment strategies in the new guidelines, aiming to provide clinicians with clear decision-making references for treatment.

Hepatocellular carcinoma (HCC) is the most common primary hepatic malign-ancy in clinic. The prognosis of patients remains extremely poor because of the high malignancy and easy recurrence and metastasis of HCC. In recent years, the roles of platelets in promoting the malignant progression of HCC have increasingly attracted much attention. It is known that platelets could promote HCC cells proliferation and invasion through tumor microenvironment. On the other hand, platelets are capable to promote HCC cells distant metastasis by facilitating tumor cells evasion of immune surveillance. Besides, the platelet-derived growth factors and proangiogenic factors are also involved in the proliferation, invasiveness, and neovascularization of HCC. In addition, patients with HCC normally have a background of cirrhosis, and it is still controversial that whether the thrombocytopenia by portal hypertension and hypersplenism can promote the malignant progress of HCC. In view of this, the diagnostic and prognostic value of platelet levels, as well as platelet-associated scores in HCC have increasingly become research focus. The authors elaborate the detailed mechanisms of platelets in malignant progression of HCC, and discuss the recent research progress of platelets as effective diagnostic or prognostic tools for the assessment of HCC, which is of great importance to optimize the current treatment regimen and explore novel therapeutic strategies against HCC.

Objective To investigate the safety,feasibility and clinical application effect of upper arm totally implantable venous access port (TIVAP) inserted by the combination of oncologists and nurses in patients with tumor.Methods A total of 34 patients,who needed long-term transfusion treatment,were included in this study with upper arm TIVAP from March 2017 and December 2017.There were 20 males and 14 females.The median age was 63 (35 ～ 83) years.Upper arm TIVAP was implanted by both doctors and nurses into the patients with tumor,and the TIVAP related success rate,complications and patients satisfaction were recorded.Results 34 patients all succeeded in TIVAP implantation with the operation success rate of 100％.The average operation time was about 40 minutes (30 to 60 minutes) from the disinfecting cloth to the end of the suture.The operations of all patients were successful.After the operation two patients died of cancer progression,one patient had soft tissue infection around capsular bag,None of the patients had other complications such as blocked infusion,catheter shift,port reversal,and so on,and the incidence of complication was 2.94％ (1/34).Conclusions Upper arm TIVAP has the advantages of safe puncture,shorter operation time,few intra-operative and post-operative complications and higher feasibility for operation by both oncologist and nurse,which can supplement the limitations and deficiencies of the chest wall port and PICC in a certain extent,therefore is a good choice for clinical application.

Objective To investigate the effects of sperm DNA fragmentation (SDF)and sperm morphology on the fertilization and embryo development in ICSI.Methods SDF and sperm morphology were detected in the meanwhile of taking eggs in 1 45 ICSI treatment cycle.On the basis of SDF index (DFI)divided into group A (DFI≤30%)and group B (DFI >30%).According to the normal sperm morphology divided into group C (NMSR≥4%), group D (1 %≤NMSR <4%),group E (NMSR <1 %).According to the sperm DFI and NMSR divided into group F (DFI≤30% and NMSR≥4%)and group G (DFI >30% and NMSR <4%).Statistically analyzed ICSI outcome of research group:fertilization rate,embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate.Results (1 )The normal fertilization rate,embryos utilization rate,good quality embryo rate,implan-tation rate in group A were significantly higher than those in group B (χ2 =6.96,8.95,5.49,3.92,all P <0.05), but clinical pregnancy rate had no significant difference (χ2 =1 .08,P >0.05).(2)The normal fertilization rate was statistically significant in group C,group D,group E (χ2 =34.5,65.8,11 .8,all P <0.05),but there were no significant differences in embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate (P >0.05).(3 )The normal fertilization rate,embryo utilization rate,good quality embryo rate,implantation rate and clinical pregnancy rate in group F were significantly higher than those in group G,and normal fertilization rate,embryos utilization rate,good quality embryo rate had statistically significant differences (χ2 =37.5,1 1 .0,4.3,all P <0.05). Conclusion Sperm abnormal morphology has negative effect on fertilization,and the high DNA fragments have negative effects on fertilization and embryo development.

Objective To investigate the treatment outcome of modified intracytoplasmic sperm injection (ICSI)using zona pellucida(ZP)-bound sperm.Methods 82 patients with less,weak,abnormal sperm disease who were conformed to ICSI,were divided into traditional ICSI group and the group of modified ICSI using ZP-bound sperm according to ICSI case number.The results of normal fertilization rate,cleavage rate,high-quality embryo rate, planting rate,clinical pregnancy rate and early abortion rate were compared.Results The women's age,the sterility year,mature egg rate,normal fertilization rate,cleavage rate in the two groups had no statistically significant differ-ences (all P>0.05).The planting rate and clinical pregnancy rate of the observation group (46.6%,63.3%)were higher than those of the control group(38.5%,53.6%),but there were no statistically significant differences(all P>0.05).The using embryo rate and high-quality embryo rate of the observation group (73.9%,51.0%)were signifi-cantly higher than those of control group(65.8%,38.6%),the differences were statistically significant(χ2 =5.84,χ2 =11.6,all P<0.05).Conclusion Modified ICSI using ZP-bound sperm can effectively improve the embryos quality in ICSI.

Objective To investigate the mechanism of Depression proliferation in human hepatocarcinoma cells by Abscisic acid.Methods To detect protein expression o of P53,Ki-67 and Cyclin D1 by immunocyte chemistry; detect mRNA expression of P53 and telomerase by RT-PCR. Results The protein expression level of mtP53, Cyclin D1, Ki-67 and the mRNA expression level of mtP53 and hTERT all decreased in cells treated by ABA,HMBA and ABA+ HMBA(P

Objective To study the relationship between polymorphisms of E-selectin gene and ischemic stroke (IS) in Zhuang nationality of Guangxi province. Methods The G98T polymorphism in the exon 2 and the S128R polymorphism in the exon 4 of E-selectin gene were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis and DNA sequencing among 205 patients with IS of Zhuang nationality in Guangxi and 210 healthy controls. The serum level of E-selectin was determined by enzyme-linked immunosorbent assay (ELISA). Results IS group showed significantly higher serum levels of E-selectin than control group (P0.05). Conclusion E-selectin S128R polymorphism was associated with IS, and R allele may be a genetic risk factor of IS among Guangxi Zhuang natioalities, in whom the E-selectin SR genotype carriers maybe increase the risk of ischemic stroke by enhancing the E-selectin expression.