Objective:To analyze the epidemiological characteristics of hospitalized patients diagnosed with sepsis in a large class Ⅲ general hospital in Southwest China in a period of 2 years, and to explore the risk factors related to death in patients with sepsis.Methods:A retrospective study was conducted to select patients with sepsis admitted to Sichuan Provincial People's Hospital from September 1, 2021 to August 31, 2023, and general characteristics such as gender, age, discharge diagnosis, discharge department, hospitalization cost, length of stay, and prognosis during hospitalization were collected. The baseline of two groups of patients were compared, and the risk factors of in-hospital cause of death in patients with sepsis were analyzed by multivariate Logistic regression.Results:A total of 3 568 patients with sepsis were included with median age of 58 (35, 74) years old. Of all patients, there were 2 147 males (60.17%). The median length of hospitalization was 13 (8, 24) days, and the median hospitalization cost was 3.98 (1.87, 8.83) ten thousand yuan. The departments with more than 100 cases of sepsis in 2 years were central intensive care unit (ICU), pediatrics department, nephrology department, emergency medicine department, emergency intensive care unit (EICU), infectious department, respiratory medicine department, hematology department, neonatal care unit and emergency surgical department. A total of 1 210 patients (33.91%) admitted to ICU (including central ICU and EICU). The hospitalization cost of ICU patients were higher [6.7 (3.1, 15.5) ten thousand yuan], the hospitalization duration was longer [9 (3, 17) days], and the mortality was higher [35.29% (427/1 210)]. Among 3 568 patients with sepsis, 448 died and 3 120 survived during hospitalization. The age, male proportion and hospitalization cost of patients with sepsis in the death group were significantly higher than those in the survival group [age (years old): 75 (60, 86) vs. 57 (30, 71), male proportion: 67.86% (304/448) vs. 59.07% (1 843/3 120), hospitalization cost (ten thousand yuan): 6.7 (3.0, 16.9) vs. 3.7 (1.8, 8.1)], the ratio of diabetes mellitus was significantly lower than that of survival group [4.91% (22/448) vs. 10.45% (326/3 120)], the length of hospitalization was shorter than that of survival group [days: 10.0 (3.0, 19.0) vs. 13.0 (8.0, 24.0)], the differences were statistically significant (all P < 0.01). Multivariate Logistic regression analysis showed that male [odds ratio ( OR) = 0.75, 95% confidence interval (95% CI) was 0.59-0.96], elder ( OR = 1.04, 95% CI was 1.03-1.05) and diabetes ( OR = 0.32, 95% CI was 0.19-0.54) were independent risk factors for in-hospital death in patients with sepsis (all P < 0.05). Conclusions:Sepsis is a heavy burden in Southwest China, especially for ICU, with high mortality, high hospitalization costs, and heavy economic burden on patients and society. Male, elder and diabetes were independent risk factors for in-hospital death of sepsis patients.

Objective:To investigate the effect of low-dose oxytocin receptor antagonist atosiban on the pregnancy outcome of the elective single embryo transfer (eSET).Methods:A retrospective cohort study was performed on the clinical data of patients who got eSET at Department of Reproductive Medicine, Tianjin First Central Hospital from January 2015 to August 2021 and had a first- or second-time embryo transfer. They were divided into fresh cleavage stage embryo cycles, frozen-thawed cleavage stage embryo cycles, and frozen-thawed blastocyst cycles, depending on the days of embryological development and the treatment strategy. Patients were divided into atosiban group and control group according to whether or not they received an intravenous injection of 6.75 mg of atosiban 30 min before implantation. Propensity score matching (PSM) with a ratio of 1∶2 was utilized to match the patients in each group. The differences in the rates of biochemical pregnancy, clinical pregnancy, abortion, ectopic pregnancy, live birth, and birth defects were evaluated.Results:PSM included 243 patients in fresh cleavage stage embryo cycles (81 patients in the atosiban group and 162 patients in control group), 210 patients in frozen-thawed cleavage stage embryo cycles (70 patients in the atosiban group and 140 patients in control group), and 216 patients in frozen-thawed blastocyst cycles (72 patients in the atosiban group and 144 patients in control group). At eSET of fresh cleavage stage embryos, frozen-thawed cleavage stage embryos, or frozen-thawed blastocysts, the biochemical pregnancy rate, the clinical pregnancy rate, the miscarriage rate, the ectopic pregnancy rate, the live birth rate, and the birth defect rate in atosiban group were not statistically different from those in control group (all P>0.05). Conclusion:Intravenous injection of low dosage of atosiban before eSET failed to significantly improve the pregnancy outcome of infertile patients.

Objective:To investigate the effect of low-dose oxytocin receptor antagonist atosiban on the pregnancy outcome of the elective single embryo transfer (eSET).Methods:A retrospective cohort study was performed on the clinical data of patients who got eSET at Department of Reproductive Medicine, Tianjin First Central Hospital from January 2015 to August 2021 and had a first- or second-time embryo transfer. They were divided into fresh cleavage stage embryo cycles, frozen-thawed cleavage stage embryo cycles, and frozen-thawed blastocyst cycles, depending on the days of embryological development and the treatment strategy. Patients were divided into atosiban group and control group according to whether or not they received an intravenous injection of 6.75 mg of atosiban 30 min before implantation. Propensity score matching (PSM) with a ratio of 1∶2 was utilized to match the patients in each group. The differences in the rates of biochemical pregnancy, clinical pregnancy, abortion, ectopic pregnancy, live birth, and birth defects were evaluated.Results:PSM included 243 patients in fresh cleavage stage embryo cycles (81 patients in the atosiban group and 162 patients in control group), 210 patients in frozen-thawed cleavage stage embryo cycles (70 patients in the atosiban group and 140 patients in control group), and 216 patients in frozen-thawed blastocyst cycles (72 patients in the atosiban group and 144 patients in control group). At eSET of fresh cleavage stage embryos, frozen-thawed cleavage stage embryos, or frozen-thawed blastocysts, the biochemical pregnancy rate, the clinical pregnancy rate, the miscarriage rate, the ectopic pregnancy rate, the live birth rate, and the birth defect rate in atosiban group were not statistically different from those in control group (all P>0.05). Conclusion:Intravenous injection of low dosage of atosiban before eSET failed to significantly improve the pregnancy outcome of infertile patients.

【Objective】 To evaluate the clinical efficacy and safety of one kind of human prothrombin complex concentrate in treatment of patients with hemophilia B. 【Methods】 The clinical data of 36 patients with hemophilia B treated with human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. from May 2018 to April 2019 were retrospectively analyzed, and its clinical efficacy and safety were analyzed. 【Results】 A total of 35 subjects entered the full analysis set (FAS)and safety set (SS), 33 subjects entered the per protocol Set (PPS). Thirty minutes after the first infusion of FAS subjects, the activity of coagulation factor Ⅸ increased from (3.93±0.975) IU/dL to (25.61±9.337) IU/dL, and the infusion efficiency was (96.43±22.007)%. The increased value of coagulation factor Ⅱ activity was (73.25±14.874) IU/dL. The activity of coagulation factor Ⅶ was (42.79±16.847) IU/dL. The increased value of coagulation factor Ⅹ activity was (65.29±17.042) IU/dL. The increased value of coagulation factor Ⅸ activity was (21.68±9.434%) IU/dL. Twenty-four hours after the first infusion of FAS subjects, the improvement of bleeding symptoms and signs was excellent in 21 cases (60%), improved in 14 cases (40.0%), and the effective rate was 100%. The incidence of adverse reactions was 2.9%(1/35), and there was no antibody to human coagulation factor Ⅸ and new virus infection. 【Conclusion】 Infusion of human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. in the treatment of hemophilia B has significant clinical efficacy and good safety.

【Objective】 To evaluate the efficacy and safety of human coagulation factor Ⅷ developed by Shenzhen Weiguang Biological products Co, Ltd in the treatment of patients with hemophilia A. 【Methods】 A prospective, multi-center, open, single-group clinical study was conducted. A total of 65 subjects with hemophilia A were enrolled, and human coagulation factor Ⅷ(FⅧ) was injected according to the patients’ bleeding severity. The improvement score of bleeding symptoms and signs after the first infusion of the first bleeding event and the transfusion efficiency of FⅧ activity at 10 min and 1 hour after infusion were taken as the main efficacy indexes. The improvement scores of bleeding symptoms and signs after the first infusion and the increase of FⅧ activity at 10 min and 1 hour after infusion were the secondary efficacy indexes. 【Results】 The 65 subjects were enrolled in safety analysis set (SS) and full analysis set (FAS), and 58 of them were enrolled in protocol analysis set (PPS). Ten minutes and one hour after the first infusion, the level of factor Ⅷ activity in the subjects increased significantly, and the FⅧ activity increased by 100% or more in more than 79% of the subjects. The average infusion efficiency of FⅧ activity in all subjects was more than 100%. In 70% of the subjects, the pain was relieved rapidly and /or the bleeding symptoms were significantly improved 8 hours after each bleeding infusion, and the improvement rate of bleeding symptoms and signs reached 100% 72 hours after infusion. 【Conclusion】 After infusion of human coagulation factor Ⅷ, the activity level of factor Ⅷ in patients with hemophilia A significantly increased. The infusion efficiency can reach a optimal level, and the bleeding symptoms can be significantly improved.

Objective:To evaluate the clinical value of blastocysts derived from poor-quality embryos after day 3 (D3) transplantation and frozen, to investigate the best embryo strategies of frozen-thawed blastocysts.Methods:A retrospective cohort study was conducted on 362 frozen-thawed blastocyst transfer cycles were retrospectively analyzed in the Department of Reproductive Medicine, Tianjin First Central Hospital from July 2015 to March 2020. According to the days of culture, they were divided into day 5 (D5) and day 6 (D6) blastocyst transplantation group; according to the number of embryos transferred, they were divided into single blastocyst transplantation group and double blastocyst transplantation group; according to the embryo quality, single blastocyst transplantation group was divided into single high-quality embryo group and single poor-quality embryo group. The double blastocyst transplantation group was divided into double high-quality blastocyst group, a high-quality embryo matching a poor-quality blastocyst transplantation group and the double poor-quality blastocyst group. Clinical pregnancy rate, implantation rate and multiple pregnancy rate were compared in each group.Results:The clinical pregnancy rate and the implantation rate of D5 blastocyst transplantation group in thawing cycles were higher than those of D6 blastocyst transplantation group [62.96% (102/162) vs. 42.50%(85/200), 53.98% (122/226) vs. 35.86% (104/290)](all P<0.001), and there was no statistically significant difference of early abortion rate and multiple pregnancy rate between the D5 and D6 groups ( P>0.05). There was no statistically significant difference in the clinical pregnancy rate and the early abortion rate of D5 single blastocyst groups and double blastocyst pregnancy ( P>0.05), the implantation rate of single blastocyst group was higher than that of the double blastocyst group [62.24% (61/98) vs. 47.66% (61/128)] while the multiple pregnancy rate of single blastocyst group was lower than that of the double blastocyst group [3.28% (2/61) vs. 46.34% (19/41)] ( P=0.029, P<0.001). The clinical pregnancy rate and the multiple pregnancy rate of D6 single blastocyst group were lower than those of D6 double blastocyst pregnancy group [35.45% (39/110) vs. 51.11% (46/90), 5.13% (2/39) vs. 26.09% (12/46)] ( P=0.026, P=0.009), there were no statistically significant differences in implantation rate and early abortion rate (all P>0.05). There were no statistically significant differences in clinical pregnancy rate, implantation rate, early abortion rate and multiple pregnancy rate between single high-quality embryo and poor-quality embryo group in D5 and D6 single blastocyst transplantation group (all P>0.05). There were no statistically significant differences in clinical pregnancy rate, implantation rate, early abortion rate, and multiple pregnancy rate of the double high-quality blastocyst transplantation group, a high-quality embryo matching a poor-quality blastocyst transplantation group and the double poor-quality blastocyst group in D5 ( P>0.05). The implantation rate of D6 double poor-quality embryo group [26.67% (24/90)] was lower than that of the double high-quality embryo group [47.62% (20/42)] and a high-quality embryo matching a poor-quality embryo group [43.75% (7/16)]( P=0.029), while there were no statistically significant differences in clinical pregnancy rate, early abortion rate, and multiple pregnancy rate (all P>0.05). Conclusion:After the high-quality D3 embryo transfer and freezing, the remaining poor-quality embryos can be cultured to form blastocyst, better clinical pregnancy rate was obtained for transfer the frozen-thawed blastocysts, it increases the value of embryos and reduces the cost of treatment. The quality of D5 blastocyst is better than that of D6 blastocyst. The single blastocyst transplantation of D5 is preferred to reduce the rate of multiple pregnancy without affecting the clinical pregnancy rate.

Objective:To evaluate the clinical value of blastocysts derived from poor-quality embryos after day 3 (D3) transplantation and frozen, to investigate the best embryo strategies of frozen-thawed blastocysts.Methods:A retrospective cohort study was conducted on 362 frozen-thawed blastocyst transfer cycles were retrospectively analyzed in the Department of Reproductive Medicine, Tianjin First Central Hospital from July 2015 to March 2020. According to the days of culture, they were divided into day 5 (D5) and day 6 (D6) blastocyst transplantation group; according to the number of embryos transferred, they were divided into single blastocyst transplantation group and double blastocyst transplantation group; according to the embryo quality, single blastocyst transplantation group was divided into single high-quality embryo group and single poor-quality embryo group. The double blastocyst transplantation group was divided into double high-quality blastocyst group, a high-quality embryo matching a poor-quality blastocyst transplantation group and the double poor-quality blastocyst group. Clinical pregnancy rate, implantation rate and multiple pregnancy rate were compared in each group.Results:The clinical pregnancy rate and the implantation rate of D5 blastocyst transplantation group in thawing cycles were higher than those of D6 blastocyst transplantation group [62.96% (102/162) vs. 42.50%(85/200), 53.98% (122/226) vs. 35.86% (104/290)](all P<0.001), and there was no statistically significant difference of early abortion rate and multiple pregnancy rate between the D5 and D6 groups ( P>0.05). There was no statistically significant difference in the clinical pregnancy rate and the early abortion rate of D5 single blastocyst groups and double blastocyst pregnancy ( P>0.05), the implantation rate of single blastocyst group was higher than that of the double blastocyst group [62.24% (61/98) vs. 47.66% (61/128)] while the multiple pregnancy rate of single blastocyst group was lower than that of the double blastocyst group [3.28% (2/61) vs. 46.34% (19/41)] ( P=0.029, P<0.001). The clinical pregnancy rate and the multiple pregnancy rate of D6 single blastocyst group were lower than those of D6 double blastocyst pregnancy group [35.45% (39/110) vs. 51.11% (46/90), 5.13% (2/39) vs. 26.09% (12/46)] ( P=0.026, P=0.009), there were no statistically significant differences in implantation rate and early abortion rate (all P>0.05). There were no statistically significant differences in clinical pregnancy rate, implantation rate, early abortion rate and multiple pregnancy rate between single high-quality embryo and poor-quality embryo group in D5 and D6 single blastocyst transplantation group (all P>0.05). There were no statistically significant differences in clinical pregnancy rate, implantation rate, early abortion rate, and multiple pregnancy rate of the double high-quality blastocyst transplantation group, a high-quality embryo matching a poor-quality blastocyst transplantation group and the double poor-quality blastocyst group in D5 ( P>0.05). The implantation rate of D6 double poor-quality embryo group [26.67% (24/90)] was lower than that of the double high-quality embryo group [47.62% (20/42)] and a high-quality embryo matching a poor-quality embryo group [43.75% (7/16)]( P=0.029), while there were no statistically significant differences in clinical pregnancy rate, early abortion rate, and multiple pregnancy rate (all P>0.05). Conclusion:After the high-quality D3 embryo transfer and freezing, the remaining poor-quality embryos can be cultured to form blastocyst, better clinical pregnancy rate was obtained for transfer the frozen-thawed blastocysts, it increases the value of embryos and reduces the cost of treatment. The quality of D5 blastocyst is better than that of D6 blastocyst. The single blastocyst transplantation of D5 is preferred to reduce the rate of multiple pregnancy without affecting the clinical pregnancy rate.

Objective:To evaluate the efficacy and safety of regional citrate and heparin anticoagulation in continuous renal replacement therapy (CRRT) in critically ill patients by Meta-analysis.Methods:Randomized controlled trials (RCT) comparing the efficacy and safety of regional citrate and heparin anticoagulation in English or Chinese were retrieved from Medline, Embase, Cochrane library, Web of Science, CNKI, Wanfang Database by electronic and manual search before December 2019. The primary outcomes were mortality and circuit life span, and the secondary outcomes were complications such as bleeding, heparin-induced thrombocytopenia (HIT), metabolic alkalosis, and hypocalcemia. Meta-analysis of the literature was conducted using the methods recommended by the Cochrane Collaboration's software RevMan 5.3 and funnel plot was used to analyze whether there was publication bias in each study.Results:Sixteen RCTs with 1 229 patients were included. Meta-analysis showed that there was no significant difference in mortality between the regional citrate and heparin anticoagulation in CRRT [relative risk ( RR) = 0.95, 95% confidence interval (95% CI) was 0.83-1.09, P = 0.47]. The circuit life span in the regional citrate group was 15.37 hours (95% CI was 10.09-20.65, P < 0.000 01) longer than that in the heparin group. Bleeding risk ( RR = 0.29, 95% CI was 0.19-0.44, P < 0.000 01) and HIT ( RR = 0.35, 95% CI was 0.16-0.74, P = 0.006) were lower in the regional citrate group than those in the heparin group, whereas the regional citrate anticoagulation could cause hypocalcemia ( RR = 4.67, 95% CI was 1.88-11.60, P = 0.000 9). There was no significant difference in the incidence of metabolic alkalosis between the two groups ( RR = 0.76, 95% CI was 0.42-1.37, P = 0.36). The funnel plot showed that there were no significant publication bias in the included studies. Conclusion:Regional citrate anticoagulation could significantly prolong circuit life span and decrease the risk of bleeding, and should be preferentially selected for the CRRT anticoagulation in critically ill patients.

Objective To compare and study the two kinds of quality control methodologies related to intelligent quality management system ( iQM) and traditional quality control , and the quality control performance of iQM equivalent to traditional quality control were evaluated , ensuring the accuracy of the results of blood gas testing.Methods Beijing Chaoyang Hospital of Capital Medical University , Beijing Tiantan Hospital of Capital Medical University , Shanghai Longhua Hospital of Shanghai University of Chinese Medicine, and Sichuan Provincial People′s Hospital, these 4 medical institutions were selected to implement this study.During the period from June 2016 to December 2016, in the routine detection of total 3 712 specimen, the iQM and traditional quality control modes were used simultaneously to calculate the mean values of all blood gas parameters quality controls , SD, CV (%) and Sigma values, to evaluate the quality control performance and difference of the two quality control modes .Results During the process of testing blood gas samples from 3 712 specimen in 4 hospitals, iQM process control solution ( PCS) A, B, C ran 1 089, 7 678 and 154 quality control samples respectively , and 732 external quality control samples were run by traditional quality control mode .Considering the most sensitive parameters of blood gas testing pO 2, iQM PCS A, B, C′s Sigma value are higher than 8, however, the traditional quality control′s Sigma value are less than 6; For parameters pCO2, pO2and Na+, there exists significant difference between two quality control methods (P＝0.004 8,P＝0.000 1,P＝0.004 4,P＜0.01), other parameters pH, K+, Ca ++, Glu, Lac and Hct, there exists no significant difference between two quality control methods (P＝0.250 6, P＝0.062 3,P＝0.034 0,P＝0.346 9,P＝0.186 3,P＝0.823 1,P＞0.01).Totally 22 errors detected by iQM, includes 14 micro-clots and 8 interferences samples, which were not detected by traditional quality control .Conclusions The error in blood gas analysis mainly comes from the pre-analytical phase.iQM enhanced specimen inspection capabilities and make up for the inability of traditional quality control to monitor the quality of specimens , enabling full-scale, real-time, and dynamic monitoring of each specimen , powerful error detection capabilities , and automatic error correction capabilities . Besides, automatic documentation saves staff much time.The system can effectively ensure the accuracy of blood gas test results, meet the quality requirements of related laws and regulations and related industry standards , and also can meet the clinical intended use , providing new ideas for POCT quality management and improvement.

Objective To study the effect of inflammatory markers on the level of reactive oxygen species (ROS) and mitochondrial DNA (mtDNA) copy numbers in granulosa cells of patients without polycystic ovary syndrome (PCOS). Methods Fifty patients without PCOS treated with in vitro fertilization and embryo transfer (IVF-ET) were selected in this study. The granulosa cells were extracted and cultured in vitro. Cells were randomly divided into treatment group and control group. The 5 nmol/L interleukin (IL)-1, IL-6 and tumor necrosis factor (TNF)-αwere given to treatment group, and same amount of inflammatory diluted solution was added to control group. The levels of ROS and copy numbers of mtDNA were compared between two groups. Results The ROS levels and mtDNA copy number of granulosa cells were significantly higher in IL-1, IL-6 and TNF-αtreatment groups than those of control group (P<0.05). Conclusion Inflammatory markers of IL-1, IL-6 and TNF-αincrease the level of ROS and damage mtDNA in granulosa cells.