Objective:To detect the levels of sex hormones and insulin in follicular fluid(FF)and the expression level of phosphatase and tensin homolog deleted on chromosome ten(PTEN)in granulosa cells in the infertile patients with polycystic ovary syndrome(PCOS),and to preliminarily explain the correlations between the insulin level and the expression level of PTEN mRNA.Methods:Seventy infertile patients were selected as the subjects and divided into PCOS group and control group(tubal obstruction or infertility due to male factors)according to infertility factors.All patients received in vitro fertilization-embryo transfer(IVF-ET)treatment.FF and ovarian granulosa cells were collected on the day of ovulation.The expression levels of PTEN mRNA in ovarian granulosa cells of the patients in two groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.The levels of sex hormone and insulin in FF were measured by electrochemiluminescence.The correlations of the PTEN mRNA expression level in ovarian granulosa cells and testosterone(T)in FF with the level of insulin in FF were analyzed by Spearman correlation analysis method.Results:There were no significant differences in age,infertility years,body mass index(BMI),basic sex hormone,total dose of gonadotropin(Gn)and days of ovulation induction in two groups(P＞0.05).Compared with control group,the anti-Mullerian hormone(AMH)and antral follicle counting(AFC)of the patients in PCOS group were significantly increased(P＜0.05).The RT-qPCR results showed that the PTEN mRNA expression level in ovarian granulosa cells of the patients in the PCOS group was higher than that in control group(P＜0.001).The electrochemiluminescence results showed that the levels of T and insulin in FF of the patients in PCOS group were higher than those in control group(P＜0.05),whereas the estrogen and progesterone levels were lower than those in control group(P＜0.05).The Spearman correlation analysis showed that that T level in FF was positively correlated with the insulin level of the patients in PCOS group(r=0.577,P＜0.001),and the PTEN mRNA expression level in ovarian granulosa cells was positively correlated with the insulin levels in FF(r=0.616,P＜0.001);in control group,there was no correlation between T level and insulin level in FF(r=0.266,P=0.123),and there was no correlation between the expression level of PTEN mRNA in granulosa cells and the insulin level in FF in control group(r=-0.214,P=0.216).Conclusion:The high expression of PTEN in granulosa cells of the infertile patients with PCOS may be related to the local hyperinsulin level in the ovary,and PTEN participates in the occurrence and development of PCOS.

Objective:To develop an indicator system for defining the health services provided by family doctors within the "Healthy Subdistrict" initiative in China.Methods:An initial set of indicators was developed through literature review and qualitative research, followed by the design of an expert consultation questionnaire. Twenty-one experts with extensive experience in community family doctor services in Beijing were selected. Two rounds of Delphi consultations were conducted via email between December 2024 and February 2025. Expert demographics and authority coefficients were collected and the indicator system was finalized.Results:The response rate was 100% for both rounds. The average expert authority coefficient ( Cr) was 0.860 (range: 0.700-1.000). Kendall′s W for importance and feasibility increased from 0.129 and 0.196 in the first round to 0.230 and 0.268 in the second round (all P<0.001), indicating strong consensus. The final system includes 5 first-level and 23 second-level indicators, categorized as: Integrated Preventive and Clinical Care Services, Healthy Community Promotion Services, Basic Medical Services, Public Health Services, and Services for Promoting Equity in Citizen Health and Well-being. The highest-weighted first-level indicators were Basic Medical Services (0.281) and Integrated Preventive and Clinical Care Services (0.281), followed by Services for Promoting Equity in Citizen Health and Well-being (0.191), Healthy Community Promotion Services (0.124), and Public Health Services (0.124). All indicators had importance and feasibility scores above 3.5. Conclusion:This study establishes a weighted indicator system to guide and evaluate the health services provided by family doctors within the "Healthy Subdistrict" initiative, clarifying key service priorities.

Objective:To develop an indicator system for defining the health services provided by family doctors within the "Healthy Subdistrict" initiative in China.Methods:An initial set of indicators was developed through literature review and qualitative research, followed by the design of an expert consultation questionnaire. Twenty-one experts with extensive experience in community family doctor services in Beijing were selected. Two rounds of Delphi consultations were conducted via email between December 2024 and February 2025. Expert demographics and authority coefficients were collected and the indicator system was finalized.Results:The response rate was 100% for both rounds. The average expert authority coefficient ( Cr) was 0.860 (range: 0.700-1.000). Kendall′s W for importance and feasibility increased from 0.129 and 0.196 in the first round to 0.230 and 0.268 in the second round (all P<0.001), indicating strong consensus. The final system includes 5 first-level and 23 second-level indicators, categorized as: Integrated Preventive and Clinical Care Services, Healthy Community Promotion Services, Basic Medical Services, Public Health Services, and Services for Promoting Equity in Citizen Health and Well-being. The highest-weighted first-level indicators were Basic Medical Services (0.281) and Integrated Preventive and Clinical Care Services (0.281), followed by Services for Promoting Equity in Citizen Health and Well-being (0.191), Healthy Community Promotion Services (0.124), and Public Health Services (0.124). All indicators had importance and feasibility scores above 3.5. Conclusion:This study establishes a weighted indicator system to guide and evaluate the health services provided by family doctors within the "Healthy Subdistrict" initiative, clarifying key service priorities.

Objective:To observe any effect of repeated magnetic stimulation of the spine on lower urinary tract function and the life quality of patients with neurogenic bladder after suprasacral spinal cord injury (SCI).Methods:Fifteen suprasacral SCI patients whose lower urinary tract function was not improving were enrolled. In the first 2 weeks, all received water drinking management and intermittent catheterization, while in the following 4 weeks they were additionally provided with daily transspinal magnetic stimulation at the level of the spinous process of the first lumbar vertebra five times a week. The stimulation frequency was 1Hz. The patients kept voiding diaries. Their urodynamics were quantified using neurogenic bladder symptom scoring (NBSS) and a life quality scale.Results:The frequency of catheterization and the average voided volume, as well as the maximum detrusor pressure during the storage phase, maximum bladder capacity, maximum urethral pressure during the voiding phase and voiding efficiency at the end of the sixth week were significantly different from those at the end of the second week and before the intervention. The average NBSS and life quality scores then showed significant differences from the earlier time points.Conclusion:Repeteitive transspinal magnetic stimulation of the spine can improve lower urinary tract functioning and the life quality of persons with neurogenic bladder after a suprasacral SCI.

Humans ; Neutrophils ; Receptors, Cell Surface ; GPI-Linked Proteins ; HIV Infections ; Isoantigens

Type 2 diabetes mellitus (T2DM) is a global metabolic disease with potentially life- threatening complications. Liver metabolism plays a vital role in the occurrence and development of diabetes mellitus. It has been reported that the Chinese medicinal Anemarrhenae rhizoma (AR) can relieve insulin resistance and diabetes mellitus. However, the effect on abnormal liver metabolism in diabetes mellitus is still unclear. Therefore, we extracted liver proteins of T2DM rats induced by high-fat diet (HFD) and streptozotocin (STZ), T2DM rats treated with AR extract (ARE), obesity rats (fed with HFD), and normal control rats (fed with normal diet). Then, through tandem mass tag (TMT) labeling combined with mass spectrometry (MS), we obtained the quantitative proteomic data. Bioinformatics software was used for hierarchical cluster analysis and principal component analysis of the data in each group. The volcano map for differentially expressed proteins (P < 0.05, fold change > 1.5) was plotted. It was found that the treatment group was closer to the normal control group, indicating that the quantitative proteomic data of liver tissue can reflect the therapeutic effect of ARE on T2DM rats. Key protein clusters closely related to the treatment of ARE were screened out. The Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of the protein clusters were analyzed by David, and the result showed that AR's alleviation of abnormal fatty acid metabolism in livers of T2DM rats may be related to the regulation of the expression of key proteins Ndufa6 and Prkar2b.
Rats ; Animals ; Diabetes Mellitus, Type 2/metabolism* ; Proteomics/methods* ; Drugs, Chinese Herbal/therapeutic use* ; Anemarrhena ; Liver/metabolism*

OBJECTIVE: To explore the clinical features and genetic etiology for a neonate with Smith-Magenis syndrome (SMS). METHODS: Copy number variation sequencing (CNV-seq) was applied to the neonate and his parents, and the genotype-phenotype correlation was analyzed. RESULTS: On the second day after birth, the neonate had presented with pathological jaundice and immunodeficiency. Cranial MRI revealed ventricular enlargement and enlargement of cisterna magna. At 3 months, the infant has presented with square face, prominent forehead, deep-set eyes, hypertelorism, palpebral fissure upward and button noses. Genetic testing showed that he had carried a 2.9 Mb deletion in 17p11.2 region, seq[GRCh37] del(17)(p11.2)(chr17:16 836 379-19 880 992). The same deletion was not found in either parent. CONCLUSION SMS is mostly diagnosed in child and adulthood, but rarely in neonates. For neonates with SMS, the neurological and behavioral abnormalities have not been shown, but pathological jaundice, CNS abnormalities and immune deficiency may be the characteristics, which require attention of neonatal physicians.
Adult ; Chromosome Deletion ; Chromosomes, Human, Pair 17 ; DNA Copy Number Variations ; Genetic Testing ; Humans ; Infant, Newborn ; Intellectual Disability/genetics* ; Male ; Phenotype ; Smith-Magenis Syndrome/genetics*

Objective:To optimize the ethanol reflux extraction process of total saponins in total saponins of Trillium tschonoskii Rhizome. Methods:On the basis of single factor tests, making the total extraction rate of three main compounds [paris saponin Ⅵ, paris saponin Ⅶ and pennogenin-3- O-α-L-rhamnopyranosyl-(1→4)-[O-α-L-rhamnopyranosyl (1→2)]- O-β-D-glucopyranoside (PRRG)] as the indicator, the optimal extraction parameter was selected with the main influencing factors: the ethanol concentration, solid-liquid ratio, and extraction time by the central composite design-response surface method.Results:The optimal extraction parameter for the ethanol extract of total saponins of Trillium tschonoskii Rhizome was as follows: ethanol concentration 69%, extraction time 1.9 h, and solid liquid ratio 1∶9.7. The binomial fitting complex correlation coefficient r = 0.966 1, and the deviation between the extracted predicted value and the actual value is 4.68%. Conclusion:The central composite design-response surface method is simple and reliable for the optimization of extraction process of total saponins of Trillium tschonoskii Rhizome.

BACKGROUND: Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated. OBJECTIVE: In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed. SEARCH STRATEGY: The search strategy was structured by medical subject headings and search terms such as "acupuncture therapy" and "functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020. INCLUSION CRITERIA: SRs that investigated the effectiveness and safety of acupuncture for managing FC were included. DATA EXTRACTION AND ANALYSIS: Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A κ index was used to score the level of agreement between the 2 reviewers. RESULTS: Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as "critically low" confidence and one study as "low" confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have "low risk" of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as "moderate" quality, 57.5% (23/40) as "low" quality, and 20.0% (8/40) as "very low" quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment. CONCLUSION: Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020189173.
Acupuncture Therapy ; Constipation/therapy* ; Humans ; Quality of Life ; Systematic Reviews as Topic

Objective:To examine the effects of preimplantation genetic testing for aneuploidies (PGT-A) using blastocyst biopsy on maternal and perinatal outcomes for women of advanced age.Methods:A retrospective cohort study was conducted during January 2016 to December 2018 at Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital. Women who were aged ≥35 years, underwent intracytoplasmic sperm injection (ICSI, control group) or PGT-A after ICSI (PGT-A group) with single frozen-thawed blastocyst transferred were eligible in this study. They were further divided into 35-37 years old subgroup and ≥38 years old subgroup according to age. The primary outcome was live birth, and the secondary outcomes were human chorionic gonadotropin (hCG) positivity, clinical pregnancy, pregnancy loss, hypertension in pregnancy, gestational diabetes mellitus, gestational age, preterm birth, caesarean section, low birth weight, small gestational age, and large gestational age.Results:For women aged ≥35 years, the live birth rate in PGT-A group was significantly higher than that in control group [38.0% (89/234) vs. 26.8% (237/885), OR(95% CI)=1.49(1.13-1.97), P=0.047], the miscarriage rate was significantly lower than that in control group [17.6% (19/108) vs. 29.0% (116/443), OR(95% CI)=0.45(0.24-0.85), P=0.013]. We found that for women who aged ≥38 years, the live birth rate [ OR(95% CI)=3.01(1.67-5.44), P<0.001], hCG positivity rate [ OR(95% CI)=2.08(1.25-3.47), P=0.005], clinical pregnancy rate [ OR(95% CI)=2.39(1.40-4.07), P=0.001] in PGT-A group were significantly higher than those in control group, and the miscarriage rate in PGT-A group was significantly lower than that in control group [ OR(95% CI)=0.34(0.13-0.85), P=0.022]; for women aged 35-37 years, there were no statistically significant differences in pregnancy outcomes between the two groups (all P>0.05). Moreover, there were no statistically significant differences in the rates of obstetric complications and perinatal outcomes for women aged ≥35 years between PGT-A group and control group (all P>0.05), and similar results were found in the subgroup analyses for women who aged 35-37 years or ≥38 years. Conclusion:PGT-A using blastocyst stage biopsy strategy in single blastocyst thaw transferred cycles could significantly improve the rates of hCG positivity, clinical pregnancy, and live birth, and significantly reduce the miscarriage rate for women aged ≥38 years, but could not improve the pregnancy outcomes for women aged 35-37 years. In addition, the use of PGT-A does not increase the risk of obstetric complications and perinatal outcomes for women of advanced age.