Objective:To explore the influencing factors of embryos quality during the cycle of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and pregnancy outcomes of frozen-thawed embryo transfer (FET) in patients with polycystic ovary syndrome (PCOS). Methods:A retrospective case-control study design was used to analyze patients who received IVF/ICSI treatment at the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital from January 2015 to December 2019, underwent whole embryo cryopreserved and performed the first FET. The 1233 cycles included were divided into control group ( n=561) and PCOS group ( n=672) according to PCOS diagnosis. The general clinical characteristics, laboratory-related indicators and pregnancy outcomes of patients between the two groups were compared, and the affecting factors of the late miscarriage rate were analyzed by multivariate logistic regression. Results:1) In terms of the general clinical characteristics between the two groups, the differences of duration of infertility [(3.95±2.01) years vs. (4.84±2.91) years, P=0.007], body mass index (BMI) [(21.96±2.52) kg/m 2vs. (23.96±3.50) kg/m 2, P<0.001], basal luteinizing hormone [(4.71±2.38) mU/L vs. (8.18±5.40) mU/L, P<0.001], basal estradiol [(45.49±31.80) ng/L vs. (56.67±54.17) ng/L, P=0.032], basal testosterone [(42.80±13.45) ng/L vs. (53.45±38.67) ng/L, P=0.001], gonadortopin initial used dosage [(230.80±54.07) U vs. (192.11±53.79) U, P<0.001] were statistically significant. The endometrium preparation plan in the FET cycle, more PCOS group patients received hormone replacement treatment [64.1% (431/672) vs. 26.6% (149/561)], while more patients in control group received natural cycle transplantation [73.4% (412/561) vs. 35.9% (241/672)], and the differences were statistically significant (all P<0.001). 2) In terms of the laboratory results, the number of oocytes retrieved in PCOS group (23.36±9.53) was higher than that in control group (20.32±8.81, P=0.002). The number of high-quality embryos and the rate of high-quality embryos in PCOS group [2.94±3.13; 33.3% (2016/6048)] were lower than those in control group [4.17±3.65, P=0.034; 46.3% (2339/5049), P<0.001], and the differences were statistically significant. 3) In the pregnancy outcomes, the high-quality embryo transfer rate and the biochemical pregnancy rate in control group were higher than those in PCOS group [71.0% (743/1046) vs. 59.3% (761/1284), P<0.001; 7.3% (41/561) vs. 4.5% (30/672), P=0.033], and the late miscarriage rate in PCOS group [10.3% (43/418)] was higher than that in control group [4.3% (16/326), P=0.002]. 4) Logistic regression analysis was performed on the influencing factors of late miscarriage. After correcting the confounding factors, PCOS ( OR=2.573, 95% CI=1.270-5.212, P=0.009) and maternal high BMI ( OR=1.080, 95% CI=0.991-1.176, P=0.031) were the risk factors for late miscarriage. Conclusion:The number of high-quality embryos and the rate of high-quality embryos in PCOS patients were lower than those in non-PCOS patients. PCOS and high BMI were risk factors for late miscarriage in patients. Improving endocrine disorders and weight control in PCOS patients before fertility treatment is of positive significance for improving the pregnancy outcome of patients.

Objective:To explore the influencing factors of embryos quality during the cycle of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and pregnancy outcomes of frozen-thawed embryo transfer (FET) in patients with polycystic ovary syndrome (PCOS). Methods:A retrospective case-control study design was used to analyze patients who received IVF/ICSI treatment at the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital from January 2015 to December 2019, underwent whole embryo cryopreserved and performed the first FET. The 1233 cycles included were divided into control group ( n=561) and PCOS group ( n=672) according to PCOS diagnosis. The general clinical characteristics, laboratory-related indicators and pregnancy outcomes of patients between the two groups were compared, and the affecting factors of the late miscarriage rate were analyzed by multivariate logistic regression. Results:1) In terms of the general clinical characteristics between the two groups, the differences of duration of infertility [(3.95±2.01) years vs. (4.84±2.91) years, P=0.007], body mass index (BMI) [(21.96±2.52) kg/m 2vs. (23.96±3.50) kg/m 2, P<0.001], basal luteinizing hormone [(4.71±2.38) mU/L vs. (8.18±5.40) mU/L, P<0.001], basal estradiol [(45.49±31.80) ng/L vs. (56.67±54.17) ng/L, P=0.032], basal testosterone [(42.80±13.45) ng/L vs. (53.45±38.67) ng/L, P=0.001], gonadortopin initial used dosage [(230.80±54.07) U vs. (192.11±53.79) U, P<0.001] were statistically significant. The endometrium preparation plan in the FET cycle, more PCOS group patients received hormone replacement treatment [64.1% (431/672) vs. 26.6% (149/561)], while more patients in control group received natural cycle transplantation [73.4% (412/561) vs. 35.9% (241/672)], and the differences were statistically significant (all P<0.001). 2) In terms of the laboratory results, the number of oocytes retrieved in PCOS group (23.36±9.53) was higher than that in control group (20.32±8.81, P=0.002). The number of high-quality embryos and the rate of high-quality embryos in PCOS group [2.94±3.13; 33.3% (2016/6048)] were lower than those in control group [4.17±3.65, P=0.034; 46.3% (2339/5049), P<0.001], and the differences were statistically significant. 3) In the pregnancy outcomes, the high-quality embryo transfer rate and the biochemical pregnancy rate in control group were higher than those in PCOS group [71.0% (743/1046) vs. 59.3% (761/1284), P<0.001; 7.3% (41/561) vs. 4.5% (30/672), P=0.033], and the late miscarriage rate in PCOS group [10.3% (43/418)] was higher than that in control group [4.3% (16/326), P=0.002]. 4) Logistic regression analysis was performed on the influencing factors of late miscarriage. After correcting the confounding factors, PCOS ( OR=2.573, 95% CI=1.270-5.212, P=0.009) and maternal high BMI ( OR=1.080, 95% CI=0.991-1.176, P=0.031) were the risk factors for late miscarriage. Conclusion:The number of high-quality embryos and the rate of high-quality embryos in PCOS patients were lower than those in non-PCOS patients. PCOS and high BMI were risk factors for late miscarriage in patients. Improving endocrine disorders and weight control in PCOS patients before fertility treatment is of positive significance for improving the pregnancy outcome of patients.

Objective:To investigate the effect of body mass index (BMI) on clinical pregnancy and neonatal outcomes in patients with polycystic ovary syndrome (PCOS) during frozen-thawed embryo transfer.Methods:A total of 650 patients with PCOS who received routine in vitro fertilization or intracytoplasmic sperm injection treatment for frozen-thawed embryo transfer from June 2014 to June 2019 in Tianjin Central Hospital of Gynecology Obstetrics were retrospectively analyzed. According to BMI, PCOS patients were divided into group A (18.5≤BMI<23 kg/m 2, n=253), group B (23≤BMI<25 kg/m 2, n=167), and group C (BMI≥25 kg/m 2, n=230). The general information, clinical pregnancy outcomes, pregnancy complications, the incidence of macrosomia and low-birth-weight infants were compared in the three groups, and the influencing factors of neonatal birth weight were analyzed. Results:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate all showed downward trend with the increase of BMI, but the differences were not statistically significant (all P>0.05). The live birth rate in group C [47.0% (108/230)] was significantly lower than those in groups A and B, with statistical significance ( χ2 =7.43, P=0.024). The late miscarriage rate was higher in group C [9.4% (13/139)] than in groups A and B ( χ2 =7.66, P=0.022). The birth rates of macrosomia in groups B [22.2% (16/72)] and group C [21.1% (16/76)] were significantly higher than that in group A, and the difference was statistically significant ( χ2 =14.15, P=0.001). There was no statistically significant difference in the incidence of gestational diabetes between the three groups ( χ2 =3.81, P=0.149). The incidence of hypertension disorders complicating pregnancy increased with the increase of BMI, and the difference was not statistically significant ( P>0.05). Regression analysis showed that macrosomia was significantly associated with maternal pre-pregnancy BMI and gestational weeks, and the risk of macrosomia increased by 15% (95% CI: 3%-28%) for every increase in maternal BMI. Conclusions:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of PCOS patients in frozen-thawed embryo transfer cycles show downward trend with the increase of BMI. Obese patients with PCOS have a significant increase in late miscarriage rate and a significant decrease in live birth rate. The incidence of hypertension disorders complicating pregnancy in PCOS patients in the obese group has an increasing trend, and the birth rate of macrosomia has increased significantly. Therefore, it is recommended that obese women with PCOS lose weight scientifically before pregnancy to improve pregnancy and neonatal outcomes.

Objectives:To investigate the effect of sequential embryo transfer, cleavage stage and blastocyst stage embryo transfer on the clinical outcome of patients with recurrent implantation failure (RIF) and the relationship between the number of sequential transfered embryos and multiple pregnancy.Methods:A retrospective case-control study was conducted and the outcome of 317 patients with a history of RIF were analyzed, of which 50 women underwent sequential embryo transfer of two embryos on Day 3 and Day 5/6 (group A), 61 women underwent sequential embryo transfer of three embryos on Day 3 and Day 5/6 (group B), 124 women underwent Day 3 embryo transfer only (group C) and 82 women underwent Day 5/6 embryo transfer only (group D) at the Reproductive Medical Center of Tianjin Central Hospital of Gynecology and Obstetrics from January 2015 to January 2019. General information, controlled ovarian hyperstimulation outcome and pregnancy outcome were analyzed among four groups.Results:There were no significant differences in age, duration of infertility, body mass index (BMI), and basal hormone levels between the groups. The embryo implantation rate of groups A, B and D (36.0%, 31.1% and 31.3%) was significantly higher than that of group C (17.0%, P<0.001, P<0.001, P=0.026). The clinical pregnancy rate, the ongoing pregnancy rate and the live birth rate of group A (62.0%, 56.0%, 52.0%) and group B (60.7%, 49.2%, 47.5%) were significantly higher than those in group C (28.2%, 20.2%, 17.7%, all P<0.001) and group D (40.2%, 31.7%, 30.5%; group A vs. group D, P=0.015, P=0.006, P=0.014; group B vs. group D, P=0.016, P=0.034 , P=0.037). The early abortion rate of group A (3.2%) was significantly lower than that of group C (25.7%, P=0.028). The multiple pregnancy rate in group B (32.4%) was higher than that in group A (16.1%), group C (14.3%), and group D (21.2%), but the difference was not statistically significant ( P>0.05). The preterm birth rate in group B (34.5%) was higher than that in group A (25.9%), group C (13.0%), and group D (8.0%). The difference in preterm birth rate between group B and group D was statistically significant ( P=0.020). Conclusion:Sequential embryo transfer of frozen-thawed embryo transfer cycle can effectively improve the clinical pregnancy rate of patients with RIF. Especially, the sequential embryo transfer of 2 embryos can significantly improve the clinical pregnancy rate and the live birth rate without increasing the multiple pregnancy rate. Sequential transplantation can be used as an effective treatment for RIF patients.

Objectives:To investigate the effect of sequential embryo transfer, cleavage stage and blastocyst stage embryo transfer on the clinical outcome of patients with recurrent implantation failure (RIF) and the relationship between the number of sequential transfered embryos and multiple pregnancy.Methods:A retrospective case-control study was conducted and the outcome of 317 patients with a history of RIF were analyzed, of which 50 women underwent sequential embryo transfer of two embryos on Day 3 and Day 5/6 (group A), 61 women underwent sequential embryo transfer of three embryos on Day 3 and Day 5/6 (group B), 124 women underwent Day 3 embryo transfer only (group C) and 82 women underwent Day 5/6 embryo transfer only (group D) at the Reproductive Medical Center of Tianjin Central Hospital of Gynecology and Obstetrics from January 2015 to January 2019. General information, controlled ovarian hyperstimulation outcome and pregnancy outcome were analyzed among four groups.Results:There were no significant differences in age, duration of infertility, body mass index (BMI), and basal hormone levels between the groups. The embryo implantation rate of groups A, B and D (36.0%, 31.1% and 31.3%) was significantly higher than that of group C (17.0%, P<0.001, P<0.001, P=0.026). The clinical pregnancy rate, the ongoing pregnancy rate and the live birth rate of group A (62.0%, 56.0%, 52.0%) and group B (60.7%, 49.2%, 47.5%) were significantly higher than those in group C (28.2%, 20.2%, 17.7%, all P<0.001) and group D (40.2%, 31.7%, 30.5%; group A vs. group D, P=0.015, P=0.006, P=0.014; group B vs. group D, P=0.016, P=0.034 , P=0.037). The early abortion rate of group A (3.2%) was significantly lower than that of group C (25.7%, P=0.028). The multiple pregnancy rate in group B (32.4%) was higher than that in group A (16.1%), group C (14.3%), and group D (21.2%), but the difference was not statistically significant ( P>0.05). The preterm birth rate in group B (34.5%) was higher than that in group A (25.9%), group C (13.0%), and group D (8.0%). The difference in preterm birth rate between group B and group D was statistically significant ( P=0.020). Conclusion:Sequential embryo transfer of frozen-thawed embryo transfer cycle can effectively improve the clinical pregnancy rate of patients with RIF. Especially, the sequential embryo transfer of 2 embryos can significantly improve the clinical pregnancy rate and the live birth rate without increasing the multiple pregnancy rate. Sequential transplantation can be used as an effective treatment for RIF patients.

Objective: To investigate the effect of the number of previous spontaneous abortions on the first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycle. Methods: A retrospective case-control study was conducted to analyze the clinical data of 1 279 patients who received IVF/ICSI treatment for the first time from July 2014 to July 2018 in Tianjin Central Hospital of Gynecology Obstetrics;they were divided into 0 time group (group A, n=924), 1 time group (group B, n=267) and 2 times group (group C, n=88) for comparison, according to the previous frequency of spontaneous abortions. Results: There were no statistically significant differences in age, basal testosterone, estradiol, progesterone, prolactin and embryo quality in group A, B and C (all P>0.05). The biochemical pregnancy rate of group C (9.1%) was higher than those of the other two groups (4.1% and 4.1%; all P>0.05). The clinical pregnancy rate of group A (42.5%) [>group B (40.4%) and >group C (35.2%)] was not statistically significant(P>0.05).Early abortion rate in group A (8.9%) wasP<0.05).The live birth rate of group C (21.6%) was significantly lower than that of group A (35.5%; P<0.05), but the difference between group C and group B (30.7%) was not statistically significant (P>0.05). Conclusions Women with a history of one- or two-time spontaneous abortion have no obvious effect on embryo quality, and have a negative impact of clinical pregnancy rate, early abortion rate, live birth rate in the first IVF/ICSI cycle; especially for patients with a history of two times spontaneous abortion, early abortion rate has a significant increase, live birth rate decreases significantly, suggesting that patients with a history of two times of spontaneous abortion should find the causes of miscarriage according to the process of recurrent spontaneous miscarriage and receive treatment if necessary before subsequent pregnancy.

Objective To investigate the effect of the number of previous spontaneous abortions on the first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycle. Methods A retrospective case?control study was conducted to analyze the clinical data of 1 279 patients who received IVF/ICSI treatment for the first time from July 2014 to July 2018 in Tianjin Central Hospital of Gynecology Obstetrics;they were divided into 0 time group (group A, n=924), 1 time group (group B, n=267) and 2 times group (group C, n=88) for comparison, according to the previous frequency of spontaneous abortions. Results There were no statistically significant differences in age, basal testosterone, estradiol, progesterone, prolactin and embryo quality in group A, B and C (all P>0.05). The biochemical pregnancy rate of group C (9.1%) was higher than those of the other two groups (4.1% and 4.1%; all P>0.05). The clinical pregnancy rate of group A (42.5%) [>group B (40.4%) and>group C (35.2%)] was not statistically significant(P>0.05).Early abortion rate in group A (8.9%) was0.05). Conclusions Women with a history of one? or two?time spontaneous abortion have no obvious effect on embryo quality, and have a negative impact of clinical pregnancy rate, early abortion rate, live birth rate in the first IVF/ICSI cycle; especially for patients with a history of two times spontaneous abortion, early abortion rate has a significant increase, live birth rate decreases significantly, suggesting that patients with a history of two times of spontaneous abortion should find the causes of miscarriage according to the process of recurrent spontaneous miscarriage and receive treatment if necessary before subsequent pregnancy.

Objective To monitor the dynamic change of soluble myeloid cells trigger receptor 1 (sTREM-1)and the clearance rate of sTREM-1 (sTREM-1 c) in patients with sepsis shock and to explore its value in assessing the prognosis.Methods A total of 54 patients from January to December 2016 were divided into improved group and death group,sTREM-1 and sTREM-1c level at 1,5,7 and 9 d were monitored and the receiver-operating characteristic curve analysis was used to judge its value in prognosis.Results Comparison of baseline of APACHE Ⅱ score,PCT and age in 2 groups was statistically significant.After treatment,the sTREM-1 level declined,especially in improved group.Similarly,sTREM-1c in improved group at 5,7 and 9 d dropped more significantly than that in death group (P ＜ 0.05).At different time points,sTREM-1 7 topped the predictive value of AUC on the prognosis,followed by APACHE Ⅱ and sTREM-1 5,PCT,sTREM-1 9,sTREM-1c 9 and sTREM-1 1,and sTREM-1c 5 and sTREM-1c 7 were the minimum.Conclusion Effect of dynamic monitoring of sTREM-1 and sTREM-1c analysis in clinic is better than that of simply monitoring of sTREM-1.

Objective To construct a eukaryotic expression plasmid carrying human full-length Notch ligand Delta-like 3 (DLL3) gene and study the effect of DLL3 knockdown and overexpression on the proliferation of gastric cancer cells in vitro. Methods Human full-length DLL3 gene was amplified by PCR and cloned into the eukaryotic expression vector pCMV-Tag4. After verification by restriction enzymes and sequencing, the recombinant DLL3/pCMV-Tag4 vector was transiently transfected into HEK293T cells, in which the expressions of human DLL3 mRNA and protein were detected using real-time quantitative PCR and Western blotting, respectively. The expression of DLL3 in normal gastric epithelial cells and gastric cancer cell lines was detected by qRT-PCR and Western blotting. DLL3/pCMV-Tag4 was transfected into 3 gastric cancer cell lines, and their proliferation was assessed with MTT assay. Human gastric cancer cells MGC803 and MKN45 were also transfected with a specific human DLL3-siRNA to assess the effect of DLL3 down-expression on the cell proliferation. Results The recombinant eukaryotic expression vector DLL3/pCMV-Tag4 was successfully constructed and human full-length DLL3 was expressed in HEK293T cells. MTT assay showed that DLL3 over-expression obviously promoted the proliferation and down-regulation of DLL3 inhibited the proliferation of the gastric cancer cells. Conclusion DLL3 overexpression can promote the proliferation of gastric cancer cells in vitro, and down-regulation of DLL3 inhibits the proliferation of gastrc cancer cells,which provides a novel strategy for targeted thrapy of gastric cancer.

Objective To construct a eukaryotic expression plasmid carrying human full-length Notch ligand Delta-like 3 (DLL3) gene and study the effect of DLL3 knockdown and overexpression on the proliferation of gastric cancer cells in vitro. Methods Human full-length DLL3 gene was amplified by PCR and cloned into the eukaryotic expression vector pCMV-Tag4. After verification by restriction enzymes and sequencing, the recombinant DLL3/pCMV-Tag4 vector was transiently transfected into HEK293T cells, in which the expressions of human DLL3 mRNA and protein were detected using real-time quantitative PCR and Western blotting, respectively. The expression of DLL3 in normal gastric epithelial cells and gastric cancer cell lines was detected by qRT-PCR and Western blotting. DLL3/pCMV-Tag4 was transfected into 3 gastric cancer cell lines, and their proliferation was assessed with MTT assay. Human gastric cancer cells MGC803 and MKN45 were also transfected with a specific human DLL3-siRNA to assess the effect of DLL3 down-expression on the cell proliferation. Results The recombinant eukaryotic expression vector DLL3/pCMV-Tag4 was successfully constructed and human full-length DLL3 was expressed in HEK293T cells. MTT assay showed that DLL3 over-expression obviously promoted the proliferation and down-regulation of DLL3 inhibited the proliferation of the gastric cancer cells. Conclusion DLL3 overexpression can promote the proliferation of gastric cancer cells in vitro, and down-regulation of DLL3 inhibits the proliferation of gastrc cancer cells,which provides a novel strategy for targeted thrapy of gastric cancer.