OBJECTIVE: To assess the feasibility of first polar body transfer (PB1T) combined with preimplantation mitochondrial genetic testing for blocking the transmission of a pathogenic mitochondrial DNA 8993T>G mutation. METHODS: A Chinese family affected with Leigh syndrome which had attended the Reproductive Medicine Centre of the First Affiliated Hospital of Anhui Medical University in September 2021 was selected as the study subject. Controlled ovarian hyperstimulation was carried out for the proband after completing the detection of the mitochondrial DNA 8993T>G mutation load among the pedigree members. Mature MII oocytes were inseminated by intracytoplasmic sperm injection (ICSI), cultured in vitro for 5 to 6 days to the blastocyst stage, and trophoblastocytes were obtained by microbiopsy. Mitochondrial DNA testing (PGT-MT) and chromosomal aneuploidy (PGT-A) analyses were carried out after whole-genome amplification, and the embryos with zero mutation load were selected for transfer. Amniotic fluid and umbilical cord blood samples were collected during middle pregnancy and after birth respectively for mitochondrial DNA testing to verify the reliability of embryo screening. As an attempt, PB1 with good morphology of MII oocytes was selected for transfer into the enucleated oocytoplasm from healthy donors, followed by ICSI fertilization, blastocyst culture and PGT of embryos using the same procedure. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. 2021zhyx-B12). RESULTS: An antagonist protocol was used for ovarian stimulation, and a total of 19 oocytes were obtained, of which 14 MII were fertilized by ICSI, and 2 had developed into blastocysts. PGT-MT was carried out on biopsied trophoblastocytes, in which the mitochondrial DNA 8993T>G mutation load was not detected in one embryo, the other was 100% mutated, and the mutation loads of the remaining unfertilized eggs and developmentally arrested embryos ranged from 0% ~ 100%, presenting a clear biased distribution. With fully informed consent, one PGT-MT zero mutation load blastocyst was transferred and clinical pregnancy was achieved. Mitochondrial DNA and chromosomal testing of amniotic fluid cells during middle pregnancy had revealed no abnormalities. The proband had delivered a healthy boy through Caesarean section at 39⁺⁵ weeks of gestation, and no mutation was detected in the cord blood sample. Five well-formed PBs from 14 eggs were selected for PB1 transfer, followed by ICSI and culture, and two of the reconstituted embryos had formed blastocysts, with none of the above mutations detected in the biopsied samples. CONCLUSION The PGT-MT technology can help families affected with mitochondrial diseases to have healthy offspring. PB1 transfer in combination with ICSI and PGT-MT holds the promise of turning waste into treasure and providing an alternative means of fertility for such families.
Humans ; Preimplantation Diagnosis/methods* ; Female ; DNA, Mitochondrial/genetics* ; Genetic Testing/methods* ; Pregnancy ; Mitochondrial Diseases/genetics* ; Polar Bodies ; Adult ; Feasibility Studies ; Sperm Injections, Intracytoplasmic/methods* ; Embryo Transfer/methods* ; Mutation ; Male ; Blastocyst/metabolism* ; Pedigree

Objective:To understanding the epidemiological characteristics of self-injury/suicide among residents in Jiangsu Province, as well as grasping the current situation and patterns, will provide support and a basis for reducing the occurrence of self-injury/suicide harm.Methods:Data on self-injury/suicide cases from 2006 to 2022 were collected from 12 national injury surveillance sentinel hospitals in Jiangsu Province. The prevalence characteristics were analyzed using R 4.2.1 software, employing the chi-square test and Post Hoc testing for pairwise comparisons between groups, with adjusted standardized residuals to assess group differences.Results:From 2006 to 2022, there were 5 504 cases of self-injury/suicide monitored in Jiangsu Province, comprising 2 016 males and 3 488 females, resulting in a male-to-female ratio of 1∶1.73. The top three months for self-injury/suicide incidents were June (10.12%), May (9.85%), and July (9.25%). The peak times for these incidents were between 00:00-01:00 and 20:00-21:00. The majority of self-harm/suicide incidents occurred at home (73.64%). The primary methods of self-harm/suicide were poisoning and injuries caused by sharp objects, accounting for 47.11% and 35.32%, respectively. The frequently injured body parts were the upper limbs (34.97%) and generalized injuries throughout the body (25.56%). In terms of severity, mild cases predominated (49.78%). Further analysis reveals that, compared to male, self-harm/suicidal characteristics, female self-harm/suicidal behavior is more likely to occur at home, with poisoning as the predominant method, injuries affecting multiple body areas, and the severity of injuries being relatively mild ( P<0.001). In the 15-29 age group, self-harm/suicidal injuries predominantly affect the upper limbs ( P<0.001). Self-harm/suicidal behavior is more likely to occur at home, with poisoning being the primary method, injuries affecting multiple body areas, and the severity of injuries being more severe (all P<0.001) for individuals aged 60 and above. Conclusions:To prevent and control self-harm/suicidal behavior and reduce the suicide mortality rate, it is essential to strengthen support and care for key populations such as women, those aged 15 to 29, and individuals aged 60 and above. Monitoring and management should be enhanced in key locations where self-harm/suicide is more likely to occur, such as homes, public living spaces, schools, and public areas, to enable early detection. Controlling potential methods of suicide is crucial, such as continuing to strengthen regulations and restrictions on highly toxic pesticides and reducing the likelihood of fatal overdoses from medications.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To understanding the epidemiological characteristics of self-injury/suicide among residents in Jiangsu Province, as well as grasping the current situation and patterns, will provide support and a basis for reducing the occurrence of self-injury/suicide harm.Methods:Data on self-injury/suicide cases from 2006 to 2022 were collected from 12 national injury surveillance sentinel hospitals in Jiangsu Province. The prevalence characteristics were analyzed using R 4.2.1 software, employing the chi-square test and Post Hoc testing for pairwise comparisons between groups, with adjusted standardized residuals to assess group differences.Results:From 2006 to 2022, there were 5 504 cases of self-injury/suicide monitored in Jiangsu Province, comprising 2 016 males and 3 488 females, resulting in a male-to-female ratio of 1∶1.73. The top three months for self-injury/suicide incidents were June (10.12%), May (9.85%), and July (9.25%). The peak times for these incidents were between 00:00-01:00 and 20:00-21:00. The majority of self-harm/suicide incidents occurred at home (73.64%). The primary methods of self-harm/suicide were poisoning and injuries caused by sharp objects, accounting for 47.11% and 35.32%, respectively. The frequently injured body parts were the upper limbs (34.97%) and generalized injuries throughout the body (25.56%). In terms of severity, mild cases predominated (49.78%). Further analysis reveals that, compared to male, self-harm/suicidal characteristics, female self-harm/suicidal behavior is more likely to occur at home, with poisoning as the predominant method, injuries affecting multiple body areas, and the severity of injuries being relatively mild ( P<0.001). In the 15-29 age group, self-harm/suicidal injuries predominantly affect the upper limbs ( P<0.001). Self-harm/suicidal behavior is more likely to occur at home, with poisoning being the primary method, injuries affecting multiple body areas, and the severity of injuries being more severe (all P<0.001) for individuals aged 60 and above. Conclusions:To prevent and control self-harm/suicidal behavior and reduce the suicide mortality rate, it is essential to strengthen support and care for key populations such as women, those aged 15 to 29, and individuals aged 60 and above. Monitoring and management should be enhanced in key locations where self-harm/suicide is more likely to occur, such as homes, public living spaces, schools, and public areas, to enable early detection. Controlling potential methods of suicide is crucial, such as continuing to strengthen regulations and restrictions on highly toxic pesticides and reducing the likelihood of fatal overdoses from medications.

Objective:To assess the feasibility of first polar body transfer (PB1T) combined with preimplantation mitochondrial genetic testing for blocking the transmission of a pathogenic mitochondrial DNA 8993T>G mutation.Methods:A Chinese family affected with Leigh syndrome which had attended the Reproductive Medicine Centre of the First Affiliated Hospital of Anhui Medical University in September 2021 was selected as the study subject. Controlled ovarian hyperstimulation was carried out for the proband after completing the detection of the mitochondrial DNA 8993T>G mutation load among the pedigree members. Mature MII oocytes were inseminated by intracytoplasmic sperm injection (ICSI), cultured in vitro for 5 to 6 days to the blastocyst stage, and trophoblastocytes were obtained by microbiopsy. Mitochondrial DNA testing (PGT-MT) and chromosomal aneuploidy (PGT-A) analyses were carried out after whole-genome amplification, and the embryos with zero mutation load were selected for transfer. Amniotic fluid and umbilical cord blood samples were collected during middle pregnancy and after birth respectively for mitochondrial DNA testing to verify the reliability of embryo screening. As an attempt, PB1 with good morphology of MⅡ oocytes was selected for transfer into the enucleated oocytoplasm from healthy donors, followed by ICSI fertilization, blastocyst culture and PGT of embryos using the same procedure. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. 2021zhyx-B12). Results:An antagonist protocol was used for ovarian stimulation, and a total of 19 oocytes were obtained, of which 14 MⅡ were fertilized by ICSI, and 2 had developed into blastocysts. PGT-MT was carried out on biopsied trophoblastocytes, in which the mitochondrial DNA 8993T>G mutation load was not detected in one embryo, the other was 100% mutated, and the mutation loads of the remaining unfertilized eggs and developmentally arrested embryos ranged from 0% ~ 100%, presenting a clear biased distribution. With fully informed consent, one PGT-MT zero mutation load blastocyst was transferred and clinical pregnancy was achieved. Mitochondrial DNA and chromosomal testing of amniotic fluid cells during middle pregnancy had revealed no abnormalities. The proband had delivered a healthy boy through Caesarean section at 39+ 5 weeks of gestation, and no mutation was detected in the cord blood sample. Five well-formed PBs from 14 eggs were selected for PB1 transfer, followed by ICSI and culture, and two of the reconstituted embryos had formed blastocysts, with none of the above mutations detected in the biopsied samples.Conclusion:The PGT-MT technology can help families affected with mitochondrial diseases to have healthy offspring. PB1 transfer in combination with ICSI and PGT-MT holds the promise of turning waste into treasure and providing an alternative means of fertility for such families.

Objective:To assess the feasibility of first polar body transfer (PB1T) combined with preimplantation mitochondrial genetic testing for blocking the transmission of a pathogenic mitochondrial DNA 8993T>G mutation.Methods:A Chinese family affected with Leigh syndrome which had attended the Reproductive Medicine Centre of the First Affiliated Hospital of Anhui Medical University in September 2021 was selected as the study subject. Controlled ovarian hyperstimulation was carried out for the proband after completing the detection of the mitochondrial DNA 8993T>G mutation load among the pedigree members. Mature MII oocytes were inseminated by intracytoplasmic sperm injection (ICSI), cultured in vitro for 5 to 6 days to the blastocyst stage, and trophoblastocytes were obtained by microbiopsy. Mitochondrial DNA testing (PGT-MT) and chromosomal aneuploidy (PGT-A) analyses were carried out after whole-genome amplification, and the embryos with zero mutation load were selected for transfer. Amniotic fluid and umbilical cord blood samples were collected during middle pregnancy and after birth respectively for mitochondrial DNA testing to verify the reliability of embryo screening. As an attempt, PB1 with good morphology of MⅡ oocytes was selected for transfer into the enucleated oocytoplasm from healthy donors, followed by ICSI fertilization, blastocyst culture and PGT of embryos using the same procedure. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. 2021zhyx-B12). Results:An antagonist protocol was used for ovarian stimulation, and a total of 19 oocytes were obtained, of which 14 MⅡ were fertilized by ICSI, and 2 had developed into blastocysts. PGT-MT was carried out on biopsied trophoblastocytes, in which the mitochondrial DNA 8993T>G mutation load was not detected in one embryo, the other was 100% mutated, and the mutation loads of the remaining unfertilized eggs and developmentally arrested embryos ranged from 0% ~ 100%, presenting a clear biased distribution. With fully informed consent, one PGT-MT zero mutation load blastocyst was transferred and clinical pregnancy was achieved. Mitochondrial DNA and chromosomal testing of amniotic fluid cells during middle pregnancy had revealed no abnormalities. The proband had delivered a healthy boy through Caesarean section at 39+ 5 weeks of gestation, and no mutation was detected in the cord blood sample. Five well-formed PBs from 14 eggs were selected for PB1 transfer, followed by ICSI and culture, and two of the reconstituted embryos had formed blastocysts, with none of the above mutations detected in the biopsied samples.Conclusion:The PGT-MT technology can help families affected with mitochondrial diseases to have healthy offspring. PB1 transfer in combination with ICSI and PGT-MT holds the promise of turning waste into treasure and providing an alternative means of fertility for such families.

OBJECTIVE To establish the fingerprints of Tianma jiannao granules （TJG） and the method for content determination to evaluate the quality of TJG comprehensively combined with chemometric analysis. METHODS High-performance liquid chromatography （HPLC） was used to establish the fingerprints of 13 batches （S1-S3） of TJG and determine the contents of inosine， gastrodin， parishin B and parishin E. Cluster analysis， principal component analysis， and orthogonal partial least squares- discriminant analysis were performed using SPSS 20.0 and SIMCA 18 software； using variable importance projection （VIP） value greater than 1 as a criterion， marker components that affected quality were screened. RESULTS A total of 28 common peaks were identified in the 13 batches of TJG with similarities greater than 0.9， and 7 common peaks were identified， which were gastrodin， p-hydroxybenzyl alcohol， parishin B， parishin E， rhynchophylline， inosine and salidroside. The 13 batches of TJG were clustered into 3 categories， S1-S2， S8-S10 and S12 were clustered into one category； S3 and S7 were clustered into one category； S4-S6， S11 and S13 were clustered into one category. VIP of inosine was greater than 1. The contents of inosine， gastrodin， parishin B and parishin E were 62.637-176.677， 17.821-37.642， 5.748-16.077 and 5.660-13.510 μg/g. CONCLUSIONS The established HPLC fingerprints and content determination method are stable， reliable and highly reproducible， which can be used to evaluate the quality of TJG in combination with chemometric analysis. Inosine may be a marker component that affects the quality of TJG. There are differences in the quality of 13 batches of TJG.

The coronary artery disease is a frequent severe disease of cardiovascular system in recent years. Meanwhile, lung cancer, with its high morbidity and mortality, is the most frequent malignant tumor of respiratory system in the world. Clinical studies have shown that the incidence of coronary artery disease and lung cancer is high throughout the year, and comorbidities are becoming more common, especially in elderly patients. The incidence of lung cancer and coronary heart disease may be related. This article summarizes the common risk factors (smoking and environmental pollution, fibrinogen, estrogen, and age), and treatment (surgical treatment, neoadjuvant therapy, and targeted therapy) progress of the two diseases, providing a theoretical basis for clinical prevention and treatment.

Objective To investigate the immunotoxicity effect of triphenyl phosphate (TPHP) on thymus tissue of mice, and analyze the related mechanism. Methods Specific pathogen free BALB/c mice were randomly divided into control group, low-, medium- and high-dose groups, with 12 mice per group (equal gender distribution). Mice in these four groups were orally administered doses of 0, 1, 10, and 150 mg/kg body weight of TPHP daily for 60 days. After the exposure, the complete blood count of mice was detected, thymus tissue was collected, coefficient of thymus organs was calculated, and the histopathology changes of thymus were observed. Real-time quantitative polymerase chain reaction was used to assess the expression of genes related to inflammation, oxidative stress, cellular autophagy, and apoptosis in thymic tissues. Results During the exposure period, male mice in the high-dose group had poor fur condition, whisker loss, and increased irritability, while these phenomena were not observed in female mice. At the end of the exposure period, there were no significant changes in mice body weight or thymus organ coefficients among the groups. However, male mice in the high-dose group showed cellular apoptotic changes in the thymic tissue. The amount of white blood cell, lymphocyte, neutrophil granulocyte, red blood cell distribution width, platelet and the plateletcrit of male mice was lower in the high-dose group than that in the control group (all P<0.05). The relative mRNA expression of interleukin (Il)-1β, Il-6, catalase (Cat), P62, as well as the ratio of B-cell lymphoma 2 (Bcl-2) associated X protein (Bax)/Bcl-2 in thymic tissue of male mice were higher in the low-dose group than that in the control group (all P<0.05). The relative mRNA expression of nuclear factor erythroid-2 related factor 2 (Nrf2), superoxide dismutase 1 (Sod1), glutathione peroxidase 1 (Gpx1), P62, as well as the ratio of Bax/Bcl-2 in the thymic tissue of male mice were higher in the medium-dose group than that in the control group (all P<0.05). The relative mRNA expression of Nrf2, Cat, Sod1, Gpx1, P62, cysteinyl aspartate specific proteinase-3, as well as the ratio of Bax/Bcl-2 in the thymic tissue of male mice were higher in the high-dose group than that in the control group (all P<0.05). The relative mRNA expression of Il-1β and the ratio of Bax/Bcl-2 in thymic tissue of female mice were higher in the low- and medium-dose group (all P<0.05), while the relative mRNA expression of interferon-γ, Nrf2, Cat, P62, microtubule-associated protein light chain 3, as well as the ratio of Bax/Bcl-2 in thymic tissue of female mice were higher in the high-dose group than that in the control group (all P<0.05). Conclusion Although TPHP exposure had not significantly affected the body weight, thymus organ coefficient and histopathology of mice, it induced changes in oxidative stress-related indicators in thymic tissue, promoted cellular autophagy, apoptosis, and inflammation in the thymic tissue, with observed gender difference.