ObjectiveTo explore effect of Xianlian Jiedu prescription on the recurrence of colorectal cancer （CRC） and investigate the related mechanisms. MethodsA postoperative recurrence model was established in 25 Balb/c mice by injecting CT26 cells subcutaneously into the armpit， followed by surgical removal of 99% of the subcutaneous tumor. The mice were randomly divided into model group， low-dose Xianlian Jiedu prescription （XLJDP-L） group （6.45 g·kg^-1·d^-1）， medium-dose Xianlian Jiedu prescription （XLJDP-M） group （12.9 g·kg^-1·d^-1）， high-dose Xianlian Jiedu prescription （XLJDP-H） group （25.8 g·kg^-1·d^-1）， and 5-fluorouracil （5-FU） group （1×10^-3 g·kg^-1·d^-1）. The mice were euthanized after 14 days of continuous intervention， and recurrent tumor tissue was harvested. Hematoxylin and eosin （HE） staining was used to observe pathological and morphological changes in the recurrent tumor tissue. Immunohistochemistry （IHC） was employed to assess the expression of proliferating cell nuclear antigen （Ki67）， vascular endothelial growth factor （VEGF）， and platelet-endothelial cell adhesion molecule （CD31） in recurrent tumor tissue. The Western blot was used to detect the protein expression levels of angiopoietin-2 （ANG-2）， VEGF， phosphorylated-protein kinase B （p-Akt）， protein kinase B （Akt）， phosphorylated-phosphatidylinositol 3-kinase （p-PI3K）， and phosphatidylinositol 3-kinase （PI3K） in recurrent tumor tissue. ResultsBefore treatment， there were no statistical differences in tumor volume， tumor weight， and body mass among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group， indicating model stability. After treatment， compared with those in the model group， the tumor volume and tumor weight in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01）， showing dose dependency. Meanwhile， there were no significant differences in body weight among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group. HE staining showed that compared with that in the model group， tumor tissue in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group had loosely arranged cells， increased intercellular spaces， small and shriveled nuclei， light staining， fewer mitotic figures and atypical nuclei， and increased necrotic areas. IHC showed that compared with those of the model group， the positive rates of Ki67， VEGF， and CD31 in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01） in a dose-dependent manner. Western blot results showed that compared with those of the model group， the protein expression levels of ANG-2 and VEGF in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly downregulated （P<0.05， P<0.01）， and the p-Akt/Akt and p-PI3K/PI3K ratios were significantly decreased in a dose-dependent manner （P<0.05， P<0.01）. ConclusionXianlian Jiedu prescription significantly inhibits the recurrence of CRC in mice after subcutaneous tumor surgery. The mechanism may involve regulating the PI3K/Akt pathway and downregulating key angiogenic proteins such as ANG-2， VEGF， and CD31.

AIM: To explore the factors affecting the whole-eye astigmatism after pterygium excision combined with autologous limbal stem cell transplantation.METHODS: A retrospective analysis was conducted on the medical records of 42 patients(42 eyes)with primary pterygium admitted in the ophthalmology department of Xijing Hospital from January 2023 to October 2023. They underwent pterygium excision combined with autologous limbal stem cell transplantation. The maximum invasion depth of pterygium into the cornea was measured with anterior segment optical coherence tomography(AS-OCT)before operation, the length of the pterygium invading cornea, the width of the limbus and the area of the invading cornea were measured during the operation, and three-dimensional values of corneal astigmatism of anterior segment, index of surface variance(ISV), index of vertical asymmetry(IVA), best corrected visual acuity(BCVA)and whole-eye astigmatism were collected before and at 1 mo after surgery. Patients with astigmatism ≤0.50 D or >0.50 D of the whole eye at 1 mo after surgery were assigned to group A and B, respectively. The differences of clinical data before and at 1 mo after surgery between the two groups, and the correlation between pre-operative clinical indicators and whole-eye astigmatism were analyzed. The decision tree algorithm was performed to explore the influencing factors of whole-eye astigmatism at 1 mo postoperatively.RESULTS: The maximum invasion depth of pterygium in the group A was significantly less than that in the group B [80.00(40.00, 180.00)μm vs 175.00(123.00, 190.00)μm, P=0.002]. Preoperative BCVA(LogMAR), whole-eye astigmatism, cornea astigmatism, ISV, IVA and maximum invasion depth of pterygium were positively correlated with whole-eye astigmatism at 1 mo after surgery(rs=0.317, P=0.041; rs=0.545, P<0.001; rs=0.448, P=0.003; rs=0.389, P=0.011; rs=0.382, P=0.013; rs=0.391, P=0.010). The decision tree algorithm screened out two influential factors: the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. The risk of whole-eye astigmatism >0.50 D at 1 mo after operation was higher with maximum invasion depth of pterygium into the cornea >95 μm than that with ≤95 μm. Among the patients with whole-eye astigmatism >2.63 D before operation, the probability of residual whole-eye astigmatism >0.50 D was 88.9%, and the predictive model AUC was 0.804.CONCLUSION: The whole-eye astigmatism after pterygium resection is mainly affected by the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. When the maximum invasion depth of pterygium into the corneal is >95 μm and the whole-eye stigmatism is >2.63 D before surgery, the patient should receive surgical treatment as soon as possible in order to obtain good clinical benefits.

ObjectiveTo investigate the effects of Congrong Zonggan capsules （CRZG） on cognitive impairment in the Alzheimer's disease （AD） model of mice and its related mechanisms. MethodsSPF grade 4-week-old 5×FAD mice were divided into a model group， low-dose CRZG （0.819 g·kg^-1） and high-dose CRZG （1.638 g·kg^-1） groups， and Donepezilepezil hydrochloride group （2 mg·kg^-1）， with eight mice in each group. Eight C57 mice with the same background were set as the normal group. After one week of adaptive feeding， mice were orally administered continuously for six months. On the 5th month of drug administration， Y maze， new object recognition， and Morris water maze tests were conducted separately. After administration， mouse brain tissue was taken， and the levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in brain tissue were detected by enzyme-linked immunosorbent assay （ELISA）. Immunofluorescence （IF） was used to detect the expression of small glial cell markers Iba1， astrocyte markers GFAP， and amyloid protein 1-42 （Aβ_1-42） in the hippocampus of the brain tissue. The hematoxylin-eosin （HE） staining was used to detect pathological changes in the hippocampus of brain tissue. Western blot was used to detect the expression of nuclear factor-κB （NF-κB） p65， NOD-like receptor protein 3 （NLRP3）， cleaved Caspase-1， apoptosis-associated speck-like protein containing a CARD （ASC）， and other proteins in the brain tissue. ResultsCompared with those in the normal group， the mice in the model group had obvious cognitive impairment. The spontaneous alternation rate of the Y maze was decreased， and the discrimination index of novel object recognition was decreased significantly （P<0.01）. The escape latency in the water maze was shortened significantly （P<0.01）. The contents of IL-6 and TNF-α in brain tissue were increased. The fluorescence levels of Iba1 and Aβ_1-42 in the hippocampus were significantly increased （P<0.01）. There was a significant increase in neuronal lesions， neuronal atrophy， loose arrangement of tissue structure， and abnormal erythrocyte aggregation in the hippocampus. The protein expressions of p-NF-κB p65/NF-κB p65， cleaved Caspase-1， ASC， IL-6， and IL-1β were significantly increased （P<0.05， P<0.01）. Compared with the model group， the spontaneous alternation rate and discrimination index of the high-dose CRZG group were increased significantly （P<0.01）， and the escape latency was shortened significantly （P<0.05， P<0.01）. The content of IL-6 decreased in the brain， and that of TNF-α dropped significantly （P<0.01）. The expression of Iba1 protein and Aβ_1-42 in the hippocampus decreased significantly （P<0.05， P<0.01）. The hippocampal neurons were densely arranged， and the pyramidal nuclei were clear and centered. The abnormal aggregation of red blood cells was alleviated. The value of p-NF-κB/NF-κB proteins and the expression of ASC， cleaved Caspase-1， IL-6， and IL-1β were significantly decreased （P<0.05， P<0.01）. ConclusionCRZG can effectively improve cognitive impairment in 5×FAD mice with Alzheimer's disease， and its mechanism may be related to the regulation of the NF-κB/NLRP3 pathway to reduce the abnormal activation of microglia and inhibit neuroinflammation.

ObjectiveTo explore the therapeutic effect and mechanism of Xianglian Huazhuo prescription on chronic atrophic gastritis （CAG） in rats based on the Hedgehog signaling pathway. MethodsThe CAG rat model was established by sodium salicylate， N-methyl-N′-nitro-N-nitroguanidine （MNNG）， and irregular feeding. The successfully modeled rats were randomly divided into a model group （180 mg·L^-1）， a moradan group （1.4 g·kg^-1）， and Xianglian Huazhuo Prescription groups with high， medium， and low doses （36， 9， 18 g·kg^-1）， followed by drug intervention. Hematoxylin-eosin （HE） staining was used to observe morphological changes in the gastric mucosa. Transmission electron microscopy was used to observe the ultrastructure of gastric mucosa cells. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of Sonic Hedgehog （Shh）， Patched 1 （Ptch1）， and Glioma-associated oncogene homolog 1 （Gli1）. Western blot was used to detect the protein expression levels of Shh， Ptch1， and Gli1 in the gastric mucosa. Immunohistochemistry was used to observe the protein expression of the epithelial marker E-cadherin. ResultsCompared with the normal group， the CAG model group showed a reduction in gastric mucosal intrinsic glands and infiltration of inflammatory cells. The ultrastructure of gastric mucosal cells showed nuclear pyknosis， fewer mitochondria， and abnormal mitochondrial structure. The mRNA and protein expression of Shh， Ptch1， and Gli1 in the gastric mucosa were significantly decreased （P<0.05）， and E-cadherin protein expression was decreased. Compared with the model group， the intervention groups showed varying degrees of improvement in histopathological morphology and cellular ultrastructure. The mRNA and protein expression of Shh， Ptch1， Gli1， and E-cadherin increased to varying degrees. Xianglian Huazhuo Prescription upregulated the expression of key Hedgehog pathway factors and E-cadherin at both the mRNA and protein levels （P<0.05）. ConclusionXianglian Huazhuo prescription has a therapeutic effect on CAG in rats， and its mechanism may be related to activation of the Hedgehog signaling pathway and inhibition of epithelial-mesenchymal transition （EMT）.

Glycosylation modification is an important post-translational modification of proteins, which participates in regulating protein half-life, biological activity, and immunogenicity, thereby affecting their functions. Glycoproteins expressed in Pichia pastoris predominantly carry high-mannose type glycans, primarily composed of mannose residues, which starkly contrasts with the complex-type glycans synthesized by mammalian cells. This study aims to transform the high mannose glycosylation modification of P. pastoris into a hybrid glycosylation modification similar to that of mammalian cells through genetic engineering technology. We introduced the mannosidase Ⅰ gene (MDSⅠ) from Trichoderma viride and the human β-1,2-N-acetylglucosaminyltransferase I gene (GnTⅠ) into a previously constructed P. pastoris strain (∆och1) capable of producing Man₈GlcNAc₂ glycans. To precisely regulate the expression of MDSⅠ and GnTⅠ, we designed various promoter combinations, including the strong inducible AOX promoter and the constitutive GAP promoter. The receptor-binding domain (RBD, residues 377-588) of the spike protein from the Middle East respiratory syndrome coronavirus (MERS-CoV) was selected as the reporter protein for this investigation (MERS-RBD). The N-glycosylation profile of MERS-RBD was systematically analyzed using PNGase F digestion coupled with mass spectrometry. The results showed that after the knockout of och1 and the introduction of MDSⅠ and GnTⅠ genes with different promoter combinations, P. pastoris strains capable of producing GlcNAcMan₅GlcNAc₂ glycans were successfully generated. When the AOX promoter was used to control the MDSⅠ gene and the GAP promoter was used to control the GnTⅠ gene, the engineered strain exhibited the highest proportion of hybrid-type GlcNAcMan₅GlcNAc₂ glycans, which accounted for 68.38% of the total N-glycosylation. In conclusion, we successfully engineered a P. pastoris strain capable of synthesizing hybrid-type GlcNAcMan₅GlcNAc₂ glycans, establishing a foundation for subsequent research on the biosynthesis of complex-type N-glycans in P. pastoris.
Glycosylation ; Glycoproteins/genetics* ; Polysaccharides/metabolism* ; N-Acetylglucosaminyltransferases/metabolism* ; Pichia/metabolism* ; Humans ; Mannosidases/metabolism* ; Genetic Engineering ; Trichoderma/genetics* ; Recombinant Proteins/genetics* ; Saccharomycetales

Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH＜1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(＜35,35-＜40,40-51 years old)and five different serum AMH levels(＜0.06 ng/ml,0.06-＜0.20 ng/ml,0.20-＜0.50 ng/ml,0.50-＜0.80 ng/ml,0.80-＜1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P＜0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P＜0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P＜0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P＜0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P＜0.001).Conclusions:Patients with low AMH level(＜1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.

Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH＜1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(＜35,35-＜40,40-51 years old)and five different serum AMH levels(＜0.06 ng/ml,0.06-＜0.20 ng/ml,0.20-＜0.50 ng/ml,0.50-＜0.80 ng/ml,0.80-＜1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P＜0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P＜0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P＜0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P＜0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P＜0.001).Conclusions:Patients with low AMH level(＜1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.

Objective:To analyze long-term prognosis and influencing factors of recurrence in vocal fold leukoplakia treated by endoscopic cordectomy with CO 2 laser. Methods:A retrospective review was conducted on 599 patients with vocal fold leukoplakia [566 males and 33 females, aged 17-84 years (median age 55 years)], undergoing endoscopic cordectomy by CO 2 laser under general anesthesia at the Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital, Capital Medical University, from January 2000 to December 2023. The study analyzed the clinical features, pathological grade, surgical methods, postoperative voice function, recurrence, malignant changes and analyzed the long-term efficacy and and its influencing factors. The patients were followed up for a duration of 6-249 months postoperatively, with a median follow-up time of 48 months. SPSS 20.0 software was used for statistical analysis. Results:Among the 599 patients, the histopathological grades included simple squamous cell hyperplasia in ( n=264, 44.08%), mild dysplasia ( n=96, 16.03%), moderate dysplasia ( n=74, 12.35%), severe dysplasia( n=43, 7.81%), carcinoma in situ( n=35, 5.84%), and carcinoma in situ with microinvasion( n=87, 14.52%). The 3-year and 5-year overall recurrence rates were 12.91% and 16.00%, respectively. In patients with precancerous lesion, 3.91% of recurrences presented with an upgraded pathologic grade and 2.34% evolved into carcinoma. The risk of recurrence was higher in lesions involving the anterior commissure, larger lesions, significant reduction/absence of mucosal waves, neovascularization/suspected neovascularization, and pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinvasion( F=44.76,21.54,11.55,8.78,23.20,respectively, P<0.05). Additionally, patients with recurrent disease exhibited higher reflux symptom index scores compared to those without recurrence. Exophytic lesion characteristics and the inability to cease smoking postoperatively were identified as independent risk factors for recurrence with an upgraded pathological grade, with odds ratios of 8.675 and 11.380 times greater than those with non-exophytic lesions and successful smoking cessation, respectively. At the 6-months postoperative assessment, patients who underwent subepithelial cordectomy (typeⅠ) demonstrated a statistically significant increase in fundamental frequency ( t=-3.38, P<0.05), and while other voice acoustic parameters were not significantly different.Conversely, those who underwent transmuscular cordectomy (TypeⅢ) exhibited significant alterations in multiple voice acoustic parameters when compared to preoperative values ( P<0.05). Furthermore, postoperative vocal fold adhesions developed in 84 patients with 13 of these individuals requiring surgical intervention for adhesion release. Conclusions:Lesions involving the anterior commissure, larger lesions, pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinfiltration, significant reduction/absence of vocal fold mucosal waves, and neovascularization visible under NBI are indicative of an increased risk of recurrence, whereas exophytic lesions and the inability to cease smoking postoperatively significantly increase the risk of recurrence with elevated pathologic grade. Recovery of postoperative voice quality is procedure-dependent, underscoring the importance of surgical approach selection in the management of vocal fold leukoplakia.

Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH＜1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(＜35,35-＜40,40-51 years old)and five different serum AMH levels(＜0.06 ng/ml,0.06-＜0.20 ng/ml,0.20-＜0.50 ng/ml,0.50-＜0.80 ng/ml,0.80-＜1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P＜0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P＜0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P＜0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P＜0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P＜0.001).Conclusions:Patients with low AMH level(＜1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.

Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH＜1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(＜35,35-＜40,40-51 years old)and five different serum AMH levels(＜0.06 ng/ml,0.06-＜0.20 ng/ml,0.20-＜0.50 ng/ml,0.50-＜0.80 ng/ml,0.80-＜1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P＜0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P＜0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P＜0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P＜0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P＜0.001).Conclusions:Patients with low AMH level(＜1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.