Objective:To compare the the cultivation effects of human embryos in dry and humid incubators.Methods:A total of 479 infertile patients who underwent in vitro fertilization (IVF) treatment at Reproductive Center of Guiyang Maternal and Child Health Care Hospital from October 2020 to April 2022. The study was divided into two stages. The first stage of the study was a self-comparative research with 95 cases from the same period and source. The embryos were divided into dry and humid incubator groups to compare the embryo development indicators. In the second stage of the study, the patients were divided into six groups, including 10 μL humid incubator group ( n=64), 20 μL humid incubator group ( n=64), 30 μL humid incubator group ( n=64), 10 μL dry incubator group ( n=64), 20 μL dry incubator group ( n=64), and 30 μL dry incubator group ( n=64). The general clinical data, embryo development indicators, pregnancy outcomes, and the osmotic pressure and pH values of each group at 24 h, 48 h and 72 h were detected and compared. Results:After cultivation of the same patient's embryos in dry and humid incubator, the total blastocyst formation rate [62.3% (162/260)] and high-quality blastocyst rate [24.6% (64/260)] in dry incubator were lower than those in the humid incubator [71.6% (252/352), P=0.015; 32.1% (113/352), P=0.043]. Compared with the other microdroplet groups, the osmotic pressure of cleavage culture medium in 10 μL group of dry incubator at 48 h and 72 h and blastocyst culture medium were significantly increased, the differences among the groups were significant (cleavage culture medium, all P<0.001; blastocyst culture medium, P=0.006, P=0.008). There was no significant difference in pH value among different microdroplet volume groups at the same period (all P>0.05). There were no significant differences in general data among the different microdroplet groups (all P>0.05). Compared with the other microdroplet groups, 10 μL dry incubator group exhibited significantly lower transferable embryo rate (all P<0.001). When compared with 20 μL and 30 μL groups in both dry and humid incubators, 10 μL dry incubator group showed a lower day 5 blastocyst formation rate, lower total blastocyst formation rate, and lower high-quality blastocyst formation rate, the differences among the groups were significant (all P<0.05). There were no significant differences in the number of transferred embryos, the ratio of cleavage-stage embryos and the ratio of high-quality embryos among different groups (all P>0.05). Compared with the other microdroplet groups, the clinical pregnancy rate, the embryo implantation rate, the live birth rate of fresh transplanted embryos and the cumulative pregnancy rate in 10 μL group in the dry incubator decreased, and the miscarriage rate increased, but all were not significant (all P>0.05). Conclusion:Compared with humid incubators, there are no significant differences in embryo development and pregnancy outcomes for droplet volumes of 20 μL or above in dry incubators. However, the 10 μL microdroplet culture in the dry incubator is not conducive to embryonic development, which may be related to the increased osmotic pressure of the microdroplet.

Objective:To compare the the cultivation effects of human embryos in dry and humid incubators.Methods:A total of 479 infertile patients who underwent in vitro fertilization (IVF) treatment at Reproductive Center of Guiyang Maternal and Child Health Care Hospital from October 2020 to April 2022. The study was divided into two stages. The first stage of the study was a self-comparative research with 95 cases from the same period and source. The embryos were divided into dry and humid incubator groups to compare the embryo development indicators. In the second stage of the study, the patients were divided into six groups, including 10 μL humid incubator group ( n=64), 20 μL humid incubator group ( n=64), 30 μL humid incubator group ( n=64), 10 μL dry incubator group ( n=64), 20 μL dry incubator group ( n=64), and 30 μL dry incubator group ( n=64). The general clinical data, embryo development indicators, pregnancy outcomes, and the osmotic pressure and pH values of each group at 24 h, 48 h and 72 h were detected and compared. Results:After cultivation of the same patient's embryos in dry and humid incubator, the total blastocyst formation rate [62.3% (162/260)] and high-quality blastocyst rate [24.6% (64/260)] in dry incubator were lower than those in the humid incubator [71.6% (252/352), P=0.015; 32.1% (113/352), P=0.043]. Compared with the other microdroplet groups, the osmotic pressure of cleavage culture medium in 10 μL group of dry incubator at 48 h and 72 h and blastocyst culture medium were significantly increased, the differences among the groups were significant (cleavage culture medium, all P<0.001; blastocyst culture medium, P=0.006, P=0.008). There was no significant difference in pH value among different microdroplet volume groups at the same period (all P>0.05). There were no significant differences in general data among the different microdroplet groups (all P>0.05). Compared with the other microdroplet groups, 10 μL dry incubator group exhibited significantly lower transferable embryo rate (all P<0.001). When compared with 20 μL and 30 μL groups in both dry and humid incubators, 10 μL dry incubator group showed a lower day 5 blastocyst formation rate, lower total blastocyst formation rate, and lower high-quality blastocyst formation rate, the differences among the groups were significant (all P<0.05). There were no significant differences in the number of transferred embryos, the ratio of cleavage-stage embryos and the ratio of high-quality embryos among different groups (all P>0.05). Compared with the other microdroplet groups, the clinical pregnancy rate, the embryo implantation rate, the live birth rate of fresh transplanted embryos and the cumulative pregnancy rate in 10 μL group in the dry incubator decreased, and the miscarriage rate increased, but all were not significant (all P>0.05). Conclusion:Compared with humid incubators, there are no significant differences in embryo development and pregnancy outcomes for droplet volumes of 20 μL or above in dry incubators. However, the 10 μL microdroplet culture in the dry incubator is not conducive to embryonic development, which may be related to the increased osmotic pressure of the microdroplet.

Background:Ischemic colitis is a gastrointestinal emergency caused by intestinal wall ischemia,and in severe cases,it can even be life-threatening.Currently,there is a lack of reliable detection methods for ischemic colitis.Clinically,there is an urgent need for a specific detection method to improve the early diagnosis rate of ischemic colitis.Aims:To explore the values of serum vascular endothelial growth factor(VEGF)and plasma D-dimer levels for early diagnosis of ischemic colitis.Methods:A total of 40 patients with ischemic colitis admitted from June 2021 to June 2023 at the Affiliated Jinhua Hospital,Zhejiang University School of Medicine were served as the experimental group.Meanwhile,51 patients with acute enteritis were served as controls.The clinical manifestations,as well as the laboratory,radiological,and endoscopic results were compared between the two groups.A binary Logistic regression model was employed to analyze the risk factors for the onset of ischemic colitis.ROC curve was used to assess the diagnostic performance of serum VEGF and plasma D-dimer levels for the early diagnosis of ischemic colitis.Results:Compared with the control group,the proportion of patients with abdominal pain accompanied by hematochezia,and the serum VEGF and plasma D-dimer levels in the experimental group were significantly increased(all P<0.05).The results of binary Logistic regression model indicated that serum VEGF and plasma D-dimer levels were the risk factors for onset of ischemic colitis(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum VEGF and plasma D-dimer for diagnosing ischemic colitis were 0.93 and 0.88,respectively.The combination of these two indicators could further increase the diagnostic specificity and the AUC.Conclusions:Serum VEGF and plasma D-dimer levels can be served as early diagnostic markers for ischemic colitis.The combination of these two indicators can greatly improve the early diagnostic performance.

Background:Ischemic colitis is a gastrointestinal emergency caused by intestinal wall ischemia,and in severe cases,it can even be life-threatening.Currently,there is a lack of reliable detection methods for ischemic colitis.Clinically,there is an urgent need for a specific detection method to improve the early diagnosis rate of ischemic colitis.Aims:To explore the values of serum vascular endothelial growth factor(VEGF)and plasma D-dimer levels for early diagnosis of ischemic colitis.Methods:A total of 40 patients with ischemic colitis admitted from June 2021 to June 2023 at the Affiliated Jinhua Hospital,Zhejiang University School of Medicine were served as the experimental group.Meanwhile,51 patients with acute enteritis were served as controls.The clinical manifestations,as well as the laboratory,radiological,and endoscopic results were compared between the two groups.A binary Logistic regression model was employed to analyze the risk factors for the onset of ischemic colitis.ROC curve was used to assess the diagnostic performance of serum VEGF and plasma D-dimer levels for the early diagnosis of ischemic colitis.Results:Compared with the control group,the proportion of patients with abdominal pain accompanied by hematochezia,and the serum VEGF and plasma D-dimer levels in the experimental group were significantly increased(all P<0.05).The results of binary Logistic regression model indicated that serum VEGF and plasma D-dimer levels were the risk factors for onset of ischemic colitis(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum VEGF and plasma D-dimer for diagnosing ischemic colitis were 0.93 and 0.88,respectively.The combination of these two indicators could further increase the diagnostic specificity and the AUC.Conclusions:Serum VEGF and plasma D-dimer levels can be served as early diagnostic markers for ischemic colitis.The combination of these two indicators can greatly improve the early diagnostic performance.

Objectives:To explore the association of interleukin-19 gene polymorphisms with susceptibility and clinical phenotypes of Crohn′s disease (CD) . Methods:A retrospective case-control study was conducted. Eighty-three CD patients and 120 healthy people in Jinhua Municipal Central Hospital with matched gender and age as controls were enrolled. Allele and genotype frequencies of interleukin-19 gene rs2243188 and rs2243193 loci were detected by Sanger sequencing. The differences in allele and genotype frequencies of rs2243188 and rs2243193 loci between the two groups were compared, and the association between gene polymorphisms of the above loci and disease phenotype (disease site and disease behavior) and drug efficacy was analyzed. Results:The allelic and genotypic frequencies of the rs2243188 and rs2243193 loci differed between the two groups (all P<0.05) . Compared with control group, genotype CC+CA of rs2243188 frequency was higher in patients with ileocolonic CD (86.67% vs. 60.00%, OR = 4.333, 95% CI: 1.891-9.929, P = 0.001) , allele C of rs2243188 frequencies were higher in patients with terminal ileal CD (44.44% vs. 37.08%, OR = 5.589, 95% CI: 5.378-5.918, P = 0.019) and ileocolonic CD (50.00% vs. 37.08%, OR = 6.589, 95% CI: 6.378-7.918, P = 0.018) . However, genotype GA+AA of rs2243193 frequencies were lower in patients with terminal ileal CD (55.56% vs. 93.33%, OR = 0.089, 95% CI: 0.020-0.399, P = 0.002) and ileocolonic CD (75.00% vs. 93.33%, OR = 0.214, 95% CI: 0.085-0.540, P = 0.001) , allele A of rs2243193 frequencies were lower in patients with terminal ileal CD (50.00% vs. 70.83%, OR = 0.809, 95% CI: 0.724-0.908, P = 0.023) and ileocolonic CD (47.50% vs. 70.83%, OR = 0.132, 95% CI: 0.008-0.502, P = 0.018) . Furthermore, compared with control group, allele C (49.28% vs. 37.08%, OR = 1.607, 95% CI: 1.397-2.927, P = 0.021) and genotype CC+CA (84.06% vs. 60.00%, OR = 3.515, 95% CI: 1.676-7.374, P = 0.001) of rs2243188 frequencies were higher in patients with ileal lesion, allele A (47.83% vs. 70.83%, OR = 0.742, 95% CI: 0.709-1.741, P = 0.015) and genotype GA+AA (72.46% vs. 93.33%, OR = 0.188, 95% CI: 0.077-0.458, P = 0.002) of rs2243193 frequencies were lower in patients with ileal lesion.Compared with control group, allele A (50.00% vs. 70.83%, OR = 0.243, 95% CI: 0.352-0.679, P = 0.014) and genotype GA+AA (66.67% vs. 93.33%, OR = 0.143, 95% CI: 0.030-0.680, P = 0.006) of rs2243193 frequencies were lower in patients with penetrating CD. Moreover, the rs2243188 polymorphisms were not associated with disease behavior (all P>0.05) , the rs2243188 and rs2243193 polymorphisms were not associated with the efficacy of corticosteroid and infliximab (all P>0.05) . Conclusions:The gene mutation of the interleukin-19 gene rs2243188 locus may contribute to an increased risk for the CD with ileal lesions. But the gene mutation of rs2243193 locus may contribute to an decreased risk for CD with ileal lesions and penetrating CD.

Objective:To summarize the clinical characteristics, diagnosis, treatment, and prognosis of neonatal meningitis caused by Mycoplasma hominis. Methods:We present the clinical data, diagnosis and treatment of a premature infant with Mycoplasma hominis meningitis who was admitted to the Department of Neonatology, the Second Affiliated Hospital of Wenzhou Medical University in June 2020. Relevant literature up to May 2021 was retrieved with the strategy of "( Mycoplasma hominis) AND (meningitis OR central nervous system OR cerebrospinal fluid) AND (newborn)" from CNKI, Wanfang, and PubMed database. The clinical manifestations, examinations, diagnosis, treatments and prognosis of cases with complete clinical data were summarized using two-sample rank sum test. Results:A premature female infant at gestational age of 27 +4 weeks presented with repeated low-grade fever and apnea since the 7 days of life. Cerebrospinal fluid testing in a local hospital showed neutrophil-based leukocytosis, which indicated purulent meningitis. However, empiric antibiotic treatment did not improve the infant's condition. The patient was transferred to our hospital due to dyspnea for 32 days and repeated fever for 25 days. Mycoplasma hominis was detected from the cerebrospinal fluid samples using metagenomic next generation sequencing (NGS). Treatment with erythromycin was ineffective, but the patient improved and discharged after changing to chloramphenicol for 18 d without any side effects. A total of 21 English articles were retrieved, and no Chinese literature was retrieved, involving 22 infants. Of the 23 cases including the present case, 14 were preterm, eight were term and one with no available data; 19 were born by vaginal delivery; the median age of onset was 11.0 d ( P25- P75: 7.0-18.0 d). The initial symptoms included fever, convulsions, irritability, and apnea. Blood routine examination showed elevated white blood cell count in ten cases and elevated C-reactive protein in seven cases. In the cerebrospinal fluid testing, white blood cell count increased in 19 cases, protein increased in 20 cases, and glucose decreased in 13 cases. Eight cases were confirmed by 16S RNA polymerase chain reaction amplification technology, seven by serum antibodies test, two cases by culture and microscopic findings, two cases by culture alone, one case by Mycoplasma kit, and one by NGS. The main treatment was the administration of tetracyclines, quinolones, chloramphenicol, lincosamides, etc. (alone or in combination). Two cases improved without using special anti- Mycoplasma drugs. Of the 23 patients, 15 had hydrocephalus, eight had intracranial hemorrhage, four had cerebral ischemic infarction, and two had cerebral abscess. Four cases had good prognosis,16 cases had adverse prognosis, and other three without available data. The median time to start sensitive antibiotic therapy in children with good prognosis was 4.5 d(3.6-5.0 d) after diagnosis, which was earlier than that in children with adverse prognosis [16.8 d (7.0-25.0 d)]( Z=－2.27, P=0.023). Conclusions:Mycoplasma hominis infection has non-specific clinical manifestations and should be considered for infants with intracranial infection that is not responding to empirical antibiotic treatment. NGS is helpful in detecting Mycoplasma hominis and chloramphenicol can be an option for the treatment.

Objective:To study the clinical characteristics of purulent meningitis complicated with hydrocephalus in neonates, and to analyze the risk factors of the disease.Methods:Neonates diagnosed with purulent meningitis complicated with hydrocephalus who hospitalized in the department of neonatology of the Second Affiliated Hospital of Wenzhou Medical University from January 2002 to August 2021 were selected as the case group. Neonates with positive pathogen cultures but no hydrocephalus during the same period were assigned by random number table method as the control group. The ratio of the control group and the case group was 2 ∶1. The clinical data such as bacteria distribution, cranial imaging, therapy and prognosis were compared between the two groups. The risk factors for hydrocephalus were predicted. Statistical analysis was conducted using chi-square test and multiple logistic regression analysis.Results:There were 33 cases in the case group and 66 cases in the control group. A total of 27 cases had confirmed pathogen results, of which 20 cases (74.1%) were Gram-negative bacteria and seven cases (25.9%) were Gram-positive bacteria. The time of diagnosis for hydrocephalus were 13.0(5.5, 28.5) days after the onset. Twenty-six cases received non-surgical treatment, while seven cases received surgery. The cure rate of case group was 42.4%(14/33), which was lower than that of control group (72.7%, 48/66), and the difference was statistically significant ( χ2=8.63, P=0.003). Univariate analysis showed that the incidences of protein>3 g/L in cerebrospinal fluid, glucose<2 mmol/L in cerebrospinal fluid, convulsions, central respiratory failure, intracranial hemorrhage and encephalomalacia in the case group were all higher than those in the control group, with statistical significance ( χ2=19.72, 12.04, 19.04, 5.73, 11.85 and 17.48, respectively, all P<0.050). Multivariate logistic regression analysis showed that convulsions (odds ratio ( OR)=4.476, 95% confidence interval ( CI) 1.091 to 18.363, P=0.037), intracranial hemorrhage ( OR=8.031, 95% CI 1.894 to 34.059, P=0.005) and encephalomalacia ( OR=35.189, 95% CI 2.954 to 419.150, P=0.005) were risk factors for neonatal purulent meningitis complicated with hydrocephalus. Conclusions:Gram-negative bacteria are common pathogen of neonatal purulent meningitis complicated with hydrocephalus. Convulsions, intracranial hemorrhage and encephalomalacia are important predictors for neonatal purulent meningitis complicated with hydrocephalus.

Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.

Objectives:To explore the association of interleukin-19 gene polymorphisms with susceptibility and clinical phenotypes of Crohn′s disease (CD) . Methods:A retrospective case-control study was conducted. Eighty-three CD patients and 120 healthy people in Jinhua Municipal Central Hospital with matched gender and age as controls were enrolled. Allele and genotype frequencies of interleukin-19 gene rs2243188 and rs2243193 loci were detected by Sanger sequencing. The differences in allele and genotype frequencies of rs2243188 and rs2243193 loci between the two groups were compared, and the association between gene polymorphisms of the above loci and disease phenotype (disease site and disease behavior) and drug efficacy was analyzed. Results:The allelic and genotypic frequencies of the rs2243188 and rs2243193 loci differed between the two groups (all P<0.05) . Compared with control group, genotype CC+CA of rs2243188 frequency was higher in patients with ileocolonic CD (86.67% vs. 60.00%, OR = 4.333, 95% CI: 1.891-9.929, P = 0.001) , allele C of rs2243188 frequencies were higher in patients with terminal ileal CD (44.44% vs. 37.08%, OR = 5.589, 95% CI: 5.378-5.918, P = 0.019) and ileocolonic CD (50.00% vs. 37.08%, OR = 6.589, 95% CI: 6.378-7.918, P = 0.018) . However, genotype GA+AA of rs2243193 frequencies were lower in patients with terminal ileal CD (55.56% vs. 93.33%, OR = 0.089, 95% CI: 0.020-0.399, P = 0.002) and ileocolonic CD (75.00% vs. 93.33%, OR = 0.214, 95% CI: 0.085-0.540, P = 0.001) , allele A of rs2243193 frequencies were lower in patients with terminal ileal CD (50.00% vs. 70.83%, OR = 0.809, 95% CI: 0.724-0.908, P = 0.023) and ileocolonic CD (47.50% vs. 70.83%, OR = 0.132, 95% CI: 0.008-0.502, P = 0.018) . Furthermore, compared with control group, allele C (49.28% vs. 37.08%, OR = 1.607, 95% CI: 1.397-2.927, P = 0.021) and genotype CC+CA (84.06% vs. 60.00%, OR = 3.515, 95% CI: 1.676-7.374, P = 0.001) of rs2243188 frequencies were higher in patients with ileal lesion, allele A (47.83% vs. 70.83%, OR = 0.742, 95% CI: 0.709-1.741, P = 0.015) and genotype GA+AA (72.46% vs. 93.33%, OR = 0.188, 95% CI: 0.077-0.458, P = 0.002) of rs2243193 frequencies were lower in patients with ileal lesion.Compared with control group, allele A (50.00% vs. 70.83%, OR = 0.243, 95% CI: 0.352-0.679, P = 0.014) and genotype GA+AA (66.67% vs. 93.33%, OR = 0.143, 95% CI: 0.030-0.680, P = 0.006) of rs2243193 frequencies were lower in patients with penetrating CD. Moreover, the rs2243188 polymorphisms were not associated with disease behavior (all P>0.05) , the rs2243188 and rs2243193 polymorphisms were not associated with the efficacy of corticosteroid and infliximab (all P>0.05) . Conclusions:The gene mutation of the interleukin-19 gene rs2243188 locus may contribute to an increased risk for the CD with ileal lesions. But the gene mutation of rs2243193 locus may contribute to an decreased risk for CD with ileal lesions and penetrating CD.

Objective To explore the CT and MRI characteristics of hepatic epithelioid angiomyolipomas (H EA)in order to improve recognition and diagnostic accuracy of the disease.Methods The CT and MR imaging data of 8 patients with HEA proved by pathology were analyzed retrospectively.Among these patients,4 cases underwent plain and enhanced CT scans,2 plain and enhanced MRI scans and 2 both CT and MRI scans.Results In the 8 cases,7 were female.All lesions were solitary and well-defined,with maximum diameters ranging from 42 mm to 68 mm.6 leions on plain CT displayed slightly low density,of which 1 showed fat density and other 2 showed patchy cystic areas.MRI showed 4 masses with slight hypointensity on T1 WI,slight hyperintensity or hyperintensity on T2 WI,of which one demonstrated decreased signal on out-phase of T1 WI.On enhanced MR images,7 masses were significantly inhomogeneous in arterial phase,5 showed "fast wash-in and slow wash-out",2 "fast wash-in and wash-out"and 1 "slow wash-in and wash-out".6 showed"central vascular sign"in arterial phase and 2 displayed incomplete pseudocapsule in the portal venous and delayed phases.Conclusion Inhomogeneous enhancement in arterial phase,central vascular sign,fast wash-in and slow wash-out enhancement and no pseudocapsule are imaging features of HEA,which can help to improve the diagnostic accuracy.Its diagnosis still depends on histopathology and immunohistochemistry.