Objective To sort out the distribution characteristics of literature evidences on tradi-tional Chinese medicine interventions for postoperative endometrial polyps(EPs),understand the current application status of traditional Chinese medicine in improving the postoperative status and preventing recurrence in patients with endometrial polyps,explore potential research directions,and summarize the deficiencies.Methods Clinical studies on traditional Chinese medicine treatment for EPs were searched in databases including China National Knowledge Infrastructure(CNKI),Wan-fang Data Knowledge Service Platform(WanFang),VIP Chinese Journal Service Platform(VIP),Chinese Biomedical Literature Database(SinoMed),Chinese Clinical Trial Registry(CHICTR),PubMed,Cochrane Library,Web of Science,Embase,and Clinical Trials.gov(CT.gov).The Chinese Medical Journal Full-text Database was also supplemented for retrieval.The search period spanned from the establishment of each database to January 2025.The basic characteristics,outcome indicators,and methodological quality assessments of the included studies were presented in graphical form.Results A total of 150 articles were included,comprising 4 systematic reviews/Meta-analyses,146 clinical studies,and 0 expert consensuses or clinical pathways.The clinical studies were predominantly two-arm trials with sample sizes concentrated between 60 and 120 cases.Oral administration of traditional Chinese medicine decoctions was the primary intervention,with treatment durations mostly lasting 3 months.Outcome indicators mainly included clinical efficacy,recurrence rate,and menstrual condi-tions,among others.However,the evaluation criteria were inconsistent,and patients' quality of life was neglected.Randomized controlled trials exhibited biases in blinding implementation,randomiza-tion processes,and outcome reporting.Non-randomized controlled trials faced issues with imbal-anced sample sizes between groups.Observational studies demonstrated biases in measuring expo-sure factors.Systematic reviews/Meta-analyses showed deficiencies in methodological and reporting quality.Conclusion Traditional Chinese medicine demonstrates advantages in improving the post-operative status and preventing recurrence in patients with endometrial polyps.Subsequent research should enhance the quality of study design and implementation,adopt objective outcome indicators,standardize efficacy criteria for traditional Chinese medicine syndromes,and improve the evidence quality of evidence-based medicine research.

Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

The sequelae of pelvic inflammatory disease (SPID) is a gynecological disease that seriously affects the reproductive health and quality of life of women of childbearing age,which is repeated and intractable. In traditional Chinese medicine (TCM),it belongs to the categories of women's abdominal pain,zhengjia,infertility,etc. The uterus xuanfu-collaterals can maintain the orderly progress of female physiological function by adjusting the circulation of qi and liquids,and also play an important role in the pathological process of SPID. If the opening and closing of the uterus xuanfu-collaterals are orderly,and the qi and liquids are circulating smoothly,the pelvic microcirculation will maintain a balance of homeostasis. If the uterus xuanfu-collaterals are stagnated,the qi and liquids do not circulate smoothly,the pelvic microcirculation will be disordered,leading to the occurrence of SPID. Therefore,from the perspective of the pathogenesis of xuanfu-collaterals stasis,taking opening xuanfu and dredging collaterals as the treatment method,it can be used to smooth qi,relieve stagnation,supplement deficiency,and remove blockage in order to restore the microcirculation in the pelvic region,which can provide new ideas and methods for the treatment of SPID with TCM.

Objective:To investigate the efficacy and mechanism of modified Yinjia formula in the treatment of persistent genital tract chlamydia trachomatis infections based on the targeted regulation of CD8+T cell autophagy pathway.Methods:Thirty-six BALB/c mice,except for the blank group,were inoculated intravaginally with chlamydia to establish a model of persistent chlamydia trachomatis infection.After successful modeling,patients were divided into groups and given low,medium and high doses of Yinjia modifiedformula and azithromycin by continuous gavage for 4 weeks,respectively.HE staining was used to observe the histomorphologic changes of uterus and fallopian tube tissues of the mice.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression level of chlamydia trachomatis genes in the low reproductive tract.Proportion of OX40 and LAG-3 positive cells in mouse lymph nodes was detected by flow cytometry.Immunoblotting was used to detect the expression of autophagy-related protein Beclin-1,Atg5,LC3Ⅱ/LC3Ⅰ,p62,and Ras/Raf/MEK/ERK pathway protein in mouse splenic CD8+T cells.Results:Compared with the model group,the inflammatory cell infiltration was reduced to different degrees in all treatment groups.Among them,only a very small amount of in-flammatory cell infiltration was observed in the uterus and fallopian tubes in the high-dose group of traditional Chi-nese medicine,and no significant inflammatory exudation and thickening was observed in the fallopian tubes.Compared with the model group,the expression of Beclin-1,Atg5,LC3Ⅱ/LC3Ⅰ was decreased in all treatment groups(P＜0.01),while the protein expression of p62,Ras,P-Raf,P-MEK and P-ERK was up-regulated(P＜0.01).Additionally,the proportion of OX40 and LAG-3 positive cells in lymphocytes was decreased(P＜0.01).A-mong them,Beclin-1,Atg5,LC3Ⅱ/LC3Ⅰ protein expression as well as the percentage of OX40 and LAG-3 positive cells were the lowest in the high-dose group of traditional Chinese medicine(P＜0.01).Conclusions:The modi-fied Yinjia formula may inhibit the autophagic activity of CD8+T cells through the Ras/Raf/MEK/ERK signaling pathway,thereby enhancing the targeted clearance function of chlamydia trachomatis inclusion bodies by CD8+T cells and delaying the process of persistent chlamydia trachomatis infection in the reproductive tract.

Objective:To investigate the efficacy and mechanism of modified Yinjia formula in the treatment of persistent genital tract chlamydia trachomatis infections based on the targeted regulation of CD8+T cell autophagy pathway.Methods:Thirty-six BALB/c mice,except for the blank group,were inoculated intravaginally with chlamydia to establish a model of persistent chlamydia trachomatis infection.After successful modeling,patients were divided into groups and given low,medium and high doses of Yinjia modifiedformula and azithromycin by continuous gavage for 4 weeks,respectively.HE staining was used to observe the histomorphologic changes of uterus and fallopian tube tissues of the mice.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression level of chlamydia trachomatis genes in the low reproductive tract.Proportion of OX40 and LAG-3 positive cells in mouse lymph nodes was detected by flow cytometry.Immunoblotting was used to detect the expression of autophagy-related protein Beclin-1,Atg5,LC3Ⅱ/LC3Ⅰ,p62,and Ras/Raf/MEK/ERK pathway protein in mouse splenic CD8+T cells.Results:Compared with the model group,the inflammatory cell infiltration was reduced to different degrees in all treatment groups.Among them,only a very small amount of in-flammatory cell infiltration was observed in the uterus and fallopian tubes in the high-dose group of traditional Chi-nese medicine,and no significant inflammatory exudation and thickening was observed in the fallopian tubes.Compared with the model group,the expression of Beclin-1,Atg5,LC3Ⅱ/LC3Ⅰ was decreased in all treatment groups(P＜0.01),while the protein expression of p62,Ras,P-Raf,P-MEK and P-ERK was up-regulated(P＜0.01).Additionally,the proportion of OX40 and LAG-3 positive cells in lymphocytes was decreased(P＜0.01).A-mong them,Beclin-1,Atg5,LC3Ⅱ/LC3Ⅰ protein expression as well as the percentage of OX40 and LAG-3 positive cells were the lowest in the high-dose group of traditional Chinese medicine(P＜0.01).Conclusions:The modi-fied Yinjia formula may inhibit the autophagic activity of CD8+T cells through the Ras/Raf/MEK/ERK signaling pathway,thereby enhancing the targeted clearance function of chlamydia trachomatis inclusion bodies by CD8+T cells and delaying the process of persistent chlamydia trachomatis infection in the reproductive tract.

【Objective】 To analyze the difference of Ct value of HBsAg-/HBV DNA + in blood samples from different types of voluntary blood donors by double ELISA and HBV DNA (MP6) detection, and to investigate the correlation between Ct value and the frequency of repeated blood donation, the first nucleic acid reactivity and the interval time of previous blood donation, so as to provide reference for laboratory evaluation of the effectiveness of nucleic acid testing(NAT) strategy for repeated blood donors occult hepatitis B virus infection(OBI). 【Methods】 The Ct value and information of blood donors from February 2019 to January 2022 in our laboratory were collected. According to the cumulative number of blood donations, they were divided into two groups:first-time blood donor group (Group A) and repeated blood donor group (Group B). Group B was subdivided into Group C 1( twice of blood donation) and group C 2(three or more times of blood donation) according to the cumulative times of blood donation, and Group D 1(< 1 year), Group D 2(1-3 years), Group D 3(3 years or more) according to the first NAT reactivity and the time of previous blood donation, the difference of Ct value and resolution yeild of HBV DNA in each group was compared. The yeild of HBV DNA in two groups was compared by chi-square test, and the difference of Ct values were compared by Nonparametric test. 【Results】 From February 2019 to January 2022, a total of 270 283 blood donors were tested, including 135 695 in Group A and 134 588 in Group B. The yeild of HBV DNA in Group A was 0.150% (203/135 695), which was higher than that in Group B [0.083% (111/134 588)] (P <0.05).All Ct values were non-normal distribution by normal distribution test, and were expressed as median (quartile), the median values of MP6 and resolution Ct were 37.0(35.9,38.2) and 35.5(33.7,36.9) in Group A, 37.2(36.4,38.1) and 36.5(35.5,37.6) in Group B, respectively. Ct values of MP detection and resolution in Group A, of MP detection and resolution in group B, and of resolution in group A and B were all significant (P<0.05) From the cumulative number of blood donations to compare, the median values of MP detection and resolution Ct were 37.5(36.6,38.3) and 36.5(35.4,37.6) in Group C1,37.1(36.4, 37.9) and 36.6(35.6,37.8) in Group C2, respectively. Significant difference in resolution Ct value between Group A and Group C1, Group A and C2 was noticed(P<0.05), the median values of MP detection Ct in D1, D2 and D3 groups were 37.2(36.3,38), 37.1(36.5,37.9), 37.8(36.6.38.9),respectively, with median resolution CT values at 37.0(35.7,37.8), 35.9(34.8,36.9), 36.9(36.1,37.7), respectively. There was a significant difference in the resolution Ct values between between Group A and D1 and D3 groups (P<0.05), and there was a significant difference between the MP detection and resolution Ct values in D2 Group (P<0.05). The resolution Ct values in D2 and D3 Group were lower than those in D1 Group (P<0.05).The interquartile distribution of Ct values in Group A was wider than that in other groups, and the interquartile distribution of Ct values in Group B was more concentrated. Conclusion The Ct value of HBV DNA detected by nucleic acid in blood donors was correlated with different times of blood donation and different intervals of blood donation. The laboratories of blood station should pay attention to the nucleic acid test results of different types of blood donors to ensure blood safety.

【Objective】 To evaluate the infection status and potential infectivity of Treponema pallidum specific antibody (anti-TP) reactive blood donors, and to provide reference for the key prevention and screening of TP under the current screening strategy. 【Methods】 From February to October 2021, 133 blood donors were tested reactive by two different anti-TP ELISA kits (77 cases were dual-reagent reactive and 56 cases were single-reagent reactive). Syphilis specific IgM antibody (TP-IgM) and IgG antibody (TP-IgG) were detected by Western blot (WB), and TRUST was conducted. The results were analyzed. 【Results】 Of the 133 samples, 24 (18.05%) were positive for TP-IgM, 40 (30.07%) were positive for TP-IgG, and 3 (2.26%) were positive for TRUST. Among them, 12 cases (15.58%) were TP-IgM positive and 40 cases (51.95%) were TP-IgG positive in 77 cases of double reagent reactivity, and 12 cases (21.43%) were TP-IgM positive and 0 was TP-IgG positive in 56 cases of single reagent reactivity. There was no significant difference in the positive rate of TP-IgM between the two groups (P>0.05), while the positive rate of TP-IgG in donors with double reagent reaction was higher than that in donors with single reagent reaction (P<0.05). In addition, among the 133 anti-TP-reactive blood donors, 15 cases were positive for single TP-IgM (11.28%, accounting for 62.50% of the total positive number of TP-IgM, a total of 12 cases of TP-IgM positive among the single reagent reactive patients, and all of them were TP-IgM positive and TP-IgG negative); 30 cases were positive for single TP-IgG (22.56%, accounting for 75.00% of the total positive number of TP-IgG). There were 55 cases (41.35%) who were negative for TP-IgM and TP-IgG, and 8 cases (6.02%) were both positive. 【Conclusion】 The TP-IgM positive donors in anti-TP reactive blood donors are infectious, but the positive rate is not high. Those with single reagent reactivity and single TP-IgM positive are prone to miss detection, which should be controlled. Those who were both TP-IgM and TP-IgG negative and those who were only TP-IgG positive may be false reactivity and the phenomenon of lifelong antibody expression. It is suggested to consider adding TP-IgM detection as a measurement index for permanent deferral of both reagents.

Objective To observe efficacy of Zishen Ankun Granules in treatment of mice with immune premature ovarian insufficiency(POI)and its influence on cytokines interleukin 2(IL2),interleukin 6(IL6)and transforming growth factor-β(TGF-β)Methods Screening female mice with regular estrus to establish immune POI mice model with zona pellucida 3(ZP3)as antigen.Low and high doses of Zishen Ankun Granules were set up for treatment,and estradiol valerate was used as a positive control.Observing the estrous cycle of mice by papanicolaou staining,observing the morphological changes of ovarian tissues by HE staining,and detecting serum estradiol(E2),follicle-stimulating hormone(FSH),anti mullerian hormone(AMH),IL2,IL6 and TGF-β levels by ELISA.Results Compared with the blank control group,the estrous cycle of model group was prolonged and disordered,inflammatory cell were infiltrated in the ovarian stroma,growth follicles were decreased,and atresia follicles were increased(P<0.05,P<0.01);serum E2,AMH and TGF-βlevels were decreased(P<0.01),serum FSH,IL2 and IL6 levels were increased(P<0.01).Compared with model group,the estrous cycle disorder and inflammatory cell infiltration were improved in each treatment group,in which the growing follicles increased in the high dose group of Zishen Ankun and the atretic follicles decreased in the estradiol valerate group(P<0.05);serum E2,AMH and TGF-βlevels were increased in Zishen Ankun high dose group and estradiol valerate group(P<0.05,P<0.01),Serum FSH and IL6 levels in Zishen Ankun high-dose group were decreased(P<0.05),Serum IL2 levels was decreased in each treatment group(P<0.05,P<0.01).Conclusion Zishen Ankun granules can improve the levels of serum reproductive hormone,IL2,IL6 and TGF-βin immune POI mice,reduce the inflammatory response of ovary,regulate immune disorders,improve the ovarian reserve capacity,and play a protective role on the ovary.

With the extensive application of highly sensitive genetic techniques in the field of prenatal diagnosis, prenatal chromosomal mosaicisms including true fetal mosaicisms and confined placental mosaicisms are frequently identified in clinical settings, and the diagnostic criteria and principle of genetic counseling and clinical management for such cases may vary significantly among healthcare centers across the country. This not only has brought challenges to laboratory technician, genetic counselor and fetal medicine doctor, but can also cause confusion and anxiety of the pregnant woman and their family members. In this regard, we have formulated a consensus over the prenatal diagnosis and genetic counseling for chromosomal mosaicisms with the aim to promote more accurate and rational evaluation for fetal chromosomal mosaicisms in prenatal clinics.
Consensus ; Female ; Genetic Counseling ; Humans ; Mosaicism ; Placenta ; Pregnancy ; Prenatal Diagnosis/methods*

Objective:To investigate the reproducibility of whole-heart and volume-targeted balanced steady-state free precession (bSSFP) non-contrast MR coronary angiography (CMRA) for displaying coronary trunks.Methods:From February and September 2021, the whole-heart and volume-targeted CMRA examinations of 58 volunteers were prospectively and consecutively acquired in The First Affiliated Hospital of Fujian Medical University. Each volunteer underwent CMRA twice within a week. The subjective score, vessel-to-myocardium ratio (VMR), vessel-to-fat ratio (VFR), signal-noise ratio (SNR), and coronary corresponding coordinate was analyzed and extracted. Inter-observer, intra-observer and inter-scan consistency were evaluated by intraclass correlation coefficient (ICC), Bland-Altman analysis, Hausdorff Distance (HD), and Dice Similarity Coefficient (DSC).Results:The inter-observer and intra-observer consistencies of subjective scores, VMR, and VFR of the whole-heart and volume-targeted coronary artery images were excellent (ICC>0.76, P<0.001). The inter-scan VFR consistencies of RCA, LM, and LCX of whole-heart coronary scans were moderate (ICC=0.235, 0.264, 0.380, all P<0.05), while the consistencies of the remaining variables were good, (all ICCs>0.49, P<0.001). Bland-Altman method showed that most VMR, VFR, and SNR of two CMRA imaging were within the 95% limits of agreement. Whole-heart CMRA inter-and intra-observer mean HD was 1.79 (1.35, 3.25), 1.68 (1.09, 4.10), mean DSC was 0.96±0.04, 0.97±0.03. Volume-targeted CMRA inter-and intra-observer mean HD were 1.74 (1.63, 3.11), 1.74 (1.63, 1.98), and the mean DSC was 0.91±0.10, 0.95±0.05. The subjective score of raw images of the total artery trunk of volume-targeted CMRA [3.86 (3.68,4.00) vs. 3.80 (3.58,3.96) ], VMR [1.45 (1.27,1.58) vs. 1.22 (1.13,1.41) ], and VFR [7.36 (6.44,8.60) vs. 5.97 (4.97,6.64) ] were better than those of whole-heart CMRA (all P<0.05). The overall subjective score of whole-heart CMRA coronary trunk curved projection reformation was better than volume-targeted CMRA [3.75 (3.57, 3.88) vs. 3.63 (3.44, 3.71)] ( P<0.001). Conclusions:Whole-heart and volume-targeted bSSFP non-contrast CMRA represent good reproducibility and image quality in the main coronary artery of healthy volunteers. Both of the two methods have their advantages and complement each other.