Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

Objective:To evaluate the risk of developing pulmonary tuberculosis (PTB) among individuals with latent tuberculosis infection (LTBI) in schools and the protective effect of tuberculosis preventive treatment (TPT).Methods:A retrospective cohort study was conducted to collect data on 15 school outbreaks that occurred in Guangdong Province from 2017 to 2021. Baseline information on tuberculin skin test (TST) or interferon-gamma release test (IGRA) was obtained during contact surveys, as well as baseline information such as TPT. The incidence of PTB between 2017 and 2022 was queried using the Chinese Center for Disease Control and Prevention Information System. Poisson regression analysis was used to compare the incidence risk of PTB in the LTBI population under different TST states at baseline. Current cases, new cases and all cases (the sum of the two) were used as dependent variables. Cox regression models were used to analyze various risk factors affecting the risk of PTB in the LTBI population and evaluate the protective effect of TPT.Results:A total of 6 550 contacts were included in this study, of which 409 received TPT. Within 0-3 months after baseline survey, 119 cases were diagnosed as current cases [19.4‰, 119/(6 550-409)]. A total of 17 221.65 person-years of follow-up were conducted, during which 71 new cases were diagnosed (4.1/1 000 person-years, 71/17 221.65). The incidence density of PTB was 47.7/1 000 person-years, 6.6/1 000 person-years, 1.4/1 000 person-years, and 0.9/1 000 person-years, respectively, in TST strong/IGRA positive, TST moderate positive, TST generally positive, and TST and IGRA negative populations. The difference in PTB incidence density was statistically significant [likelihood ratio test LRT=153.16, P<0.001]. TPT was performed for individuals with strong TST or IGRA positivity, and the protection rate could reach 93% ( HR=0.07, 95% CI: 0.02-0.23). Conclusion:After the outbreak of the school epidemic, individuals with strong TST/IGRA positivity have a higher risk of developing PTB in the future. Targeted implementation of TPT can achieve better protection effects. In addition, the risk of developing PTB in individuals with moderate TST positivity is also worth noting.

Objective:To evaluate the risk of developing pulmonary tuberculosis (PTB) among individuals with latent tuberculosis infection (LTBI) in schools and the protective effect of tuberculosis preventive treatment (TPT).Methods:A retrospective cohort study was conducted to collect data on 15 school outbreaks that occurred in Guangdong Province from 2017 to 2021. Baseline information on tuberculin skin test (TST) or interferon-gamma release test (IGRA) was obtained during contact surveys, as well as baseline information such as TPT. The incidence of PTB between 2017 and 2022 was queried using the Chinese Center for Disease Control and Prevention Information System. Poisson regression analysis was used to compare the incidence risk of PTB in the LTBI population under different TST states at baseline. Current cases, new cases and all cases (the sum of the two) were used as dependent variables. Cox regression models were used to analyze various risk factors affecting the risk of PTB in the LTBI population and evaluate the protective effect of TPT.Results:A total of 6 550 contacts were included in this study, of which 409 received TPT. Within 0-3 months after baseline survey, 119 cases were diagnosed as current cases [19.4‰, 119/(6 550-409)]. A total of 17 221.65 person-years of follow-up were conducted, during which 71 new cases were diagnosed (4.1/1 000 person-years, 71/17 221.65). The incidence density of PTB was 47.7/1 000 person-years, 6.6/1 000 person-years, 1.4/1 000 person-years, and 0.9/1 000 person-years, respectively, in TST strong/IGRA positive, TST moderate positive, TST generally positive, and TST and IGRA negative populations. The difference in PTB incidence density was statistically significant [likelihood ratio test LRT=153.16, P<0.001]. TPT was performed for individuals with strong TST or IGRA positivity, and the protection rate could reach 93% ( HR=0.07, 95% CI: 0.02-0.23). Conclusion:After the outbreak of the school epidemic, individuals with strong TST/IGRA positivity have a higher risk of developing PTB in the future. Targeted implementation of TPT can achieve better protection effects. In addition, the risk of developing PTB in individuals with moderate TST positivity is also worth noting.

Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

Objective To investigate the mechanism and protective effect of Humanin(HN)on rotenone(Rot)-induced toxic damage for dopamine neurons.Methods The Rot-poisened PC12 cell model was constructed,and the control group,the Rot poisening group,the HN pretreated Rot poisening group,and the HN treatment group were set up.ELISA was used to detect the content of HN inside and outside of Rot-infected cells,CCK-8 assay was used to detect cell viability,and ATP detection kit was used to detect the intracellular ATP content.Dichloro-dihydro-fluorescein diacetate(DCFH-DA)assay was used to detect the level of reactive oxygen species(ROS)in cells.Western blotting was performed to detect the expression level of mitochondrial autophagy regulatory proteins Pink1,Parkin,p62,LC3,mitochondrial biogenesis regulatory protein PGC1α,division/fusion regulatory proteins OPA1,MFN2,DRP1,p-DRP1 and antioxidant stress regulatory proteins Keap1 and Nrf2.HBAD-mcherry-EGFP-LC3 adenovirus transfected cells was used to observed the number of autophagosomes and autophagolysosomes.Results The results showed that the intracellular concentration of HN in PC12 in the Rot poisening group was significantly higher than that in the control group(P＜0.05);Compared with the control group,the Rot poisening group had significantly decreased activity of PC12 cells,decreased ATP content and increased production of ROS.After the poisen of Rot in PC12 cells,the expression of Pink1 and p-Parkin,the ratio of LC3Ⅱ/LC3Ⅰ and the expression of p-DRP1 in mitochondrial fusion protein was increased,while the expression of p62,the expression of mitochondrial biogenesis protein PGC1 α,mitochondrial fusion proteins MFN2 and OPA1,and antioxidant stress proteins Keap1 and Nrf2 were decreased(all P＜0.05).The number of autophagosomes and autophagolysosomes in PC12 cells in the Rot poisening group was higher than that in the control group(P＜0.05),and HN pretreatment(20 μmol/L)could significantly improve the changes mentioned above caused by Rot poisening(P＜0.05).Conclusion HN ameliorates Rot-induced toxic damage for dopamine neurons by inhibiting mitophagy and mitochondrial division and promoting mitochondrial biogenesis and fusion,and anti-oxidative stress.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective:To compare the cumulative live birth rates per oocyte retrieval cycle in patients with normal ovarian response between the gonadotropin-releasing hormone agonist (GnRH-a) long protocol and the progestin-primed ovarian stimulation (PPOS) protocol.Methods:A retrospective cohort study was conducted in Centre of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine between January 2017 and December 2019. Women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment with normal ovarian reserve and <40 years of age were included. Other inclusion criteria included regular menstrual cycles, serum follicle-stimulating hormone level <10 U/L, and the antral follicle count >5. The primary outcome was the cumulative live birth rate (CLBR) within 18 months from the start of ovarian stimulation. Results:A total of 995 patients were included in the study, with 509 patients in the PPOS group and 486 patients in the GnRH-a long group. Both groups had almost comparable demographic and cycle stimulation characteristics except for duration of infertility which was shorter in the PPOS group [3 (2,4) years] than in the GnRH-a long group [3 (2,5) years, P=0.015]. In the GnRH-a long group, 372 patients (77%) underwent fresh embryo transfer, resulting in 218 clinical pregnancies and 197 live births. The clinical pregnancy rate, the ongoing pregnancy rate, and the live birth rate per embryo transfer cycle were 58.6% (218/372), 54.0% (201/372) and 53.0% (197/372), respectively. No fresh embryo transfer was performed in the PPOS group. During the study period, there were 662 frozen-thawed embryo transfer (FET) cycles in the PPOS group and 257 FET cycles in the GnRH-a long group. The PPOS group had a live birth rate of 31.1% (206/662) per FET cycle, which was notably lower than the GnRH-a long group [42.8% (110/257), OR=0.727; 95% CI: 0.607-0.871; P<0.001]. The implantation rate of all FET cycles in the PPOS group was also lower than that in the GnRH-a long group [29.2% (293/1 004) vs. 34.5% (157/455), OR=0.846, 95% CI: 0.721-0.992; P=0.041]. CLBRs after one complete IVF/ICSI cycle including fresh and subsequent FET cycles within 18 months follow up were significantly lower in the PPOS group [40.5% (206/509)] than in the long agonist group [63.2% (307/486), OR=0.641, 95% CI: 0.565-0.726]. Compared with the PPOS group, the GnRH-a long group had a significantly shorter duration from the start of ovarian stimulation to pregnancy and live birth ( P<0.001). In Kaplan-Meier analysis, the CLBR was significantly higher in the GnRH-a long group than in the PPOS group (long rank test, P<0.001). Adjusted Cox-regression analysis revealed stimulation protocol adopted was strongly associated with the CLBR ( OR=1.917, 95% CI: 1.152-3.190, P=0.012). Conclusion:Progestin primed ovarian stimulation was associated with a lower cumulative live birth rates and a long time to pregnancy/live birth than the long agonist protocol in women with a normal ovarian reserve.

Objective:To compare the cumulative live birth rates per oocyte retrieval cycle in patients with normal ovarian response between the gonadotropin-releasing hormone agonist (GnRH-a) long protocol and the progestin-primed ovarian stimulation (PPOS) protocol.Methods:A retrospective cohort study was conducted in Centre of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine between January 2017 and December 2019. Women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment with normal ovarian reserve and <40 years of age were included. Other inclusion criteria included regular menstrual cycles, serum follicle-stimulating hormone level <10 U/L, and the antral follicle count >5. The primary outcome was the cumulative live birth rate (CLBR) within 18 months from the start of ovarian stimulation. Results:A total of 995 patients were included in the study, with 509 patients in the PPOS group and 486 patients in the GnRH-a long group. Both groups had almost comparable demographic and cycle stimulation characteristics except for duration of infertility which was shorter in the PPOS group [3 (2,4) years] than in the GnRH-a long group [3 (2,5) years, P=0.015]. In the GnRH-a long group, 372 patients (77%) underwent fresh embryo transfer, resulting in 218 clinical pregnancies and 197 live births. The clinical pregnancy rate, the ongoing pregnancy rate, and the live birth rate per embryo transfer cycle were 58.6% (218/372), 54.0% (201/372) and 53.0% (197/372), respectively. No fresh embryo transfer was performed in the PPOS group. During the study period, there were 662 frozen-thawed embryo transfer (FET) cycles in the PPOS group and 257 FET cycles in the GnRH-a long group. The PPOS group had a live birth rate of 31.1% (206/662) per FET cycle, which was notably lower than the GnRH-a long group [42.8% (110/257), OR=0.727; 95% CI: 0.607-0.871; P<0.001]. The implantation rate of all FET cycles in the PPOS group was also lower than that in the GnRH-a long group [29.2% (293/1 004) vs. 34.5% (157/455), OR=0.846, 95% CI: 0.721-0.992; P=0.041]. CLBRs after one complete IVF/ICSI cycle including fresh and subsequent FET cycles within 18 months follow up were significantly lower in the PPOS group [40.5% (206/509)] than in the long agonist group [63.2% (307/486), OR=0.641, 95% CI: 0.565-0.726]. Compared with the PPOS group, the GnRH-a long group had a significantly shorter duration from the start of ovarian stimulation to pregnancy and live birth ( P<0.001). In Kaplan-Meier analysis, the CLBR was significantly higher in the GnRH-a long group than in the PPOS group (long rank test, P<0.001). Adjusted Cox-regression analysis revealed stimulation protocol adopted was strongly associated with the CLBR ( OR=1.917, 95% CI: 1.152-3.190, P=0.012). Conclusion:Progestin primed ovarian stimulation was associated with a lower cumulative live birth rates and a long time to pregnancy/live birth than the long agonist protocol in women with a normal ovarian reserve.

Perimenopausal syndrome is a common uncomfortable symptom in women during the perimenopausal period, with a high incidence, a long duration, and adverse effects on physical and psychological, patients bear a heavy burden of symptoms, and increase the risk of adverse events in the elderly stage, increase the social medical burden. With the development of sports rehabilitation research, more and more attention has been paid to the effect of exercise on human health. This paper reviews the studies on exercise rehabilitation in women with perimenopausal syndrome, including exercise forms, exercise intensity, exercise time and exercise effect, in order to provide basis for the relevant research and practice.

Objective:To evaluate the effect of WeChat platform in the diagnosis and treatment of menopausal-related diseases for gynecologists.Methods:In March 2017, 47 gynecologists who voluntarily participated in the offline continuing medical education project "Diagnosis and Treatment training of menopause-related diseases" in Beijing Shijitan Hospital Affiliated to Capital Medical University were selected as the control group (traditional teaching mode), and 52 gynecologists who volunteered to participate in WeChat platform training were selected as the experimental group (WeChat teaching mode). The main outcome measure was the knowledge level of menopause-related diseases and curriculum satisfaction before and after training. SPSS was used to perform t-test or chi-square test for inter-group data. Results:All gynecologists completed the study, the recovery rate of the evaluation questionnaire before and after training was 100%. Before training, the average score of menopause-related disease knowledge and the test passing rate of knowledge examination in experimental group were (63.65±21.42) and 65.4%, while those in the control group were (60.85±24.83) and 63.8%, respectively. No significant difference was found ( P>0.05). After training, the knowledge level of menopause-related diseases and the test passing rate significantly improved in both groups ( P<0.05). The average score of students and the passing rate in the experimental group were (77.50±16.19) and 90.1%, which were better than those in the control group [(78.72±16.89), 87.2%]. However, there was no significant difference between the two groups ( P>0.05). Besides, the experimental group was more satisfied, but the difference was not statistically significant compared with control group ( P>0.05). Conclusion:WeChat platform training for gynecologists not only has the same effects as the traditional teaching model on menopausal disease diagnosis and treatment training, but also gains higher training satisfaction, suggesting WeChat platform training can be further applied to other subdisciplines.