The treatment process of multiple fertilization failure and salvage fertilization in a male infertile patient was retrospectively analyzed. The patient underwent in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in another hospital for 3 cycles, all of which had fertilization abnormalities. The complex heterozygous mutation of PLCZ1 gene was detected by infertility gene paneland confirmed by Sanger sequencing in the Reproductive Medicine Center of Renmin Hospital, Hubei University of Medicine, and the gene mutation was derived from both parents. No abnormal mutations were found in the woman's genetic testing. The woman underwent progestin-primed ovarian stimulation, resulting in the retrieval of 9 oocytes. ICSI combined with 10 μmol/L ionomycin assisted oocyte activation (AOA) was applied to all mature eggs,resulting in 7 normal fertilized oocytes and 7 cleavage embryos, 2 high-quality cleavage embryos were frozen. Two months later, the woman underwent frozen-thawed embryo transfer to obtain biochemical pregnancy. Simultaneously, we reviewed the literature on PLCZ1 gene mutations and AOA related literature at home and abroad. From this case we can draw the following conclusions: 1) When no fertilization or polyspermia occurs in an IVF cycle and total fertilization fails in ICSI, genetic testing of both spouses is required to find genetic factors. 2) The mutation of PLCZ1 gene mainly leads to fertilization failure. ICSI combined with AOA is an effective method to rescue fertilization failure. Ionomycin has a significant effect on oocyte activation, and has no effect on embryo formation. However, we still need to accumulate case data to verify the safety of ionomycin AOA.

Indwelling urinary catheterization is one of the most widely used invasive procedures in clinical practice, playing a critical role in disease diagnosis, treatment, and monitoring. In 2024, the European Association of Urology Nurses (EAUN) released the Best Practice Guidelines for Indwelling Urinary Catheterization in Adults-Transurethral and Suprapubic Catheterization (hereinafter referred to as the Guideline), aiming to provide evidence-based clinical guidance and health education information for healthcare professionals. This article interprets the section on "Nursing Principles" within the Guideline, which spans the entire process of catheter management. Key aspects covered include pre-insertion preparation, catheter insertion procedure, catheter maintenance and securement, observation of urine color, prevention of constipation, and catheter removal. The aim is to help urology nurses and related healthcare personnel gain an in-depth understanding of the recommendations in the Guideline, promote its standardized application in clinical practice, improve the quality of indwelling catheter care, and ensure patient safety.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To explore the mechanism of 1,25-dihydroxy vitamin D3[1,25(OH)2D3]in renal interstitial fibrosis mediated by nuclear factor κB(NF-κB)and inflammatory cytokines.Methods Taking the renal interstitial fibrosis model induced by transforming growth factor-β1(TGF-β1)as the research object,they were divided into blank group(HK-2 cells+complete culture medium),model group(5ng/ml TGF-β1 stimulated HK-2 cells for 48 hours),intervention group A[with 10-7mol/L 1,25(OH)2D3 intervention for 24 hours on the basis of model group],intervention group B[with 10-7mol/L 1,25(OH)2D3 intervention for 48 hours on the basis of model group]and intervention group C[with 10-7mol/L 1,25(OH)2D3 intervention for 72 hours on the basis of model group].The cell morphology,activity,protein expression and inflammatory factor levels of each group were observed and compared.Results The cell viability of model group was significantly lower than that of blank group(P＜0.05),the cell viability of intervention groups A,B and C was significantly higher than that of model group(P＜0.05).The protein expressions of p-NF-κBp65/NF-κBp65 and smooth muscle actin α(α-SMA),as well as the levels of interleukin-6(IL-6)and tumor necrosis factor α(TNF-α)in model group were significantly higher than those in blank group,while the protein expression of E-cadherin was significantly lower than that in blank group(P＜0.05).The protein expressions of p-NF-κBp65/NF-κBp65 and α-SMA,as well as the levels of IL-6 and TNF-α in intervention groups A,B and C were significantly lower than those in model group,while protein expression of E-cadherin was significantly higher than that in model group(P＜0.05).Among them,the change in intervention group A was the most significant.Conclusion 1,25(OH)2D3 can alleviate renal interstitial fibrosis by regulating the NF-κB signaling pathway and inflammatory cytokines,and 24 hours may be the optimal intervention time window.

Objective:To analyze the molecular characteristics of the virus in a local outbreak of dengue fever in Jiangsu province in 2023, and to provide a basis for the prevention and control of the outbreak.Methods:Serum samples were collected from suspected dengue patients in the acute phase of the outbreak for virus detection and serotyping by real-time fluorescence quantitative RT-PCR (RT-qPCR). Positive specimens were amplified with full-length genomic fragments and subjected to second-generation sequencing and related evolutionary analyses.Results:Four confirmed cases of dengue were found in Changzhou city, Jiangsu province, from October 18 to 21, 2023, with epidemiological association between the cases, which was recognized as a dengue outbreak. The serum RT-qPCR result of the four cases were all dengue type 1, and the whole genome sequences of three of the cases were obtained. The evolutionary tree of the E gene and the whole genome showed that the three sequences were located in the 3rd branch of the 1-I genotype, which is similar to the genotype 1-I. The genome-wide sequences of the E gene and the genome-wide evolution tree showed that the three sequences were located in the 3rd branch of the 1-I genotype, which is similar to the genome-wide genotype 1-Ⅰ. The E gene and the genome-wide evolutionary tree showed that all three sequences were located on branch 3 of genotype 1-Ⅰ, with high sequence similarity to the dengue virus epidemic strains in Guangdong and Yunnan provinces in 2023. Amino acid variant site analysis showed that there were 16 branch-specific amino acid site changes in the sequences of the three cases, among which the structural proteins, C protein and prM protein, had one variant site each, E protein had two, and the non-structural proteins had the largest number of NS5 variant sites (9).Conclusions:The local outbreak in Jiangsu was caused by dengue fever type 1 virus, with high nucleotide sequence similarity to strains from other regions of China, and amino acid site alterations.

Objective:To investigate the effects of area of the posterior malleolus fracture and injury to the distal tibiofibular syndesmosis on functional recovery of the ankle joint in Bartoní?ek type 2 ankle fractures.Methods:A retrospective analysis was conducted of the clinical data of 47 patients with Bartoní?ek type 2 ankle fracture who had been treated at Department of Orthopedics, Huashan Hospital Affiliated to Fudan University from January 2016 to January 2022. There were 22 males and 25 females with an age of (46.0±15.6) years. All patients were treated by open reduction and closed reduction. Pearson correlation analysis and multiple regression analysis were used to investigate the relationships respectively between the American Association of Foot and Ankle Surgeons (AOFAS) ankle-hindfoot scores at the last follow-up and the preoperative proportion of posterior ankle fracture area, and the anterior and posterior tibiofibular distances.Results:All patients were followed up for (17.2±0.6) months after surgery. The Pearson correlation analysis showed that the proportion of posterior ankle fracture area ( P=0.160) and the posterior tibiofibular distance ( P=0.078) were significantly correlated with the AOFAS ankle-hindfoot score at the last follow-up. There was no significant correlation between the anterior tibiofibular distance and the AOFAS ankle-hindfoot score at the last follow-up ( P=0.689). The multiple regression analysis showed that the proportion of posterior ankle fracture area ( P=0.043) and the posterior tibiofibular distance ( P=0.022) had significant negative effects on the AOFAS ankle-hindfoot score at the last follow-up. Conclusions:In Bartoní?ek type 2 ankle fractures, the proportion of posterior ankle fracture area and the posterior tibiofibular distance are important predictors for postoperative functional recovery of the ankle. Therefore, in Bartoní?ek type 2 ankle fractures, surgical indications for the posterior malleolar fracture depend not only on the size of the fracture, but also on whether the fracture involves the lower tibiofibular syndesmosis.

AIM:To observe the effects of Huangqi-Danggui mixture(HQDG)on the pyroptosis of brain tis-sues in rats with middle cerebral artery occlusion/reperfusion(MCAO/R),and to explore the mechanism of neuroprotec-tion provided by HQDG.METHODS:Sixty-four SD rats were randomly divided into 4 groups:sham group,model group,HQDG group,and Xuesaitong(XST)group.The infarct volume of brain tissues was observed by 2,3,5-triphenyl-tetrazolium chloride staining,while hematoxylin-eosin staining was used to observe the pathological changes of brain tis-sues.Immunofluorescence was employed to assess the expression of nucleotide-binding oligomerization domain-like recep-tor protein 3(NLRP3),cleaved caspase-1 and gasdermin D(GSDMD)in the ischemic penumbra of brain tissues.The se-rum levels of interleukin-1β(IL-1β)and IL-18 were measured using ELISA.Western blot was used to detect NLRP3,cleaved caspase-1,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),IL-1β and IL-18 in brain tissues.RESULTS:Compared with sham group,the neurological deficit scores of the rats in model group were significantly increased(P<0.01),while those in HQDG and XST groups were significantly reduced compared with model group(P<0.01).The cerebral infarct volume ratio was significantly reduced in HQDG and XST groups compared with model group(P<0.01).The pathological damage of brain tissue in HQDG and XST groups was significantly reduced compared with model group.The positive rates of NLRP3,cleaved caspase-1 and GSDMD in the ischemic penumbra of brain tissues were significantly decreased in HQDG group compared with model group(P<0.01).The expression of pyrop-tosis-related proteins,NLRP3,cleaved caspase-1 and ASC,in the ischemic penumbra of brain tissues was significantly el-evated in model group compared with sham group(P<0.01),and significantly decreased in HQDG group compared with model group(P<0.01).The serum levels of IL-1β and IL-18 were significantly increased in model group compared with sham group(P<0.01),and significantly reduced in HQDG group compared with model group(P<0.01).CONCLU-SION:The HQDG effectively attenuates brain tissue injury in rats with MCAO/R,and its mechanism may be related to the inhibition of neural cell pyroptosis.

Objective To explore the traditional Chinese medicine(TCM)syndrome characteristics of patients with Chikungunya hemorrhagic fever and to provide empirical data to support the application of TCM in diagnosing and treating Chikungunya hemorrhagic fever.Methods A cross-sectional survey was conducted to collect clinical data(sex,age,days since onset,and comorbidity underlying disease conditions)and TCM with four-examination information(symptoms,tongue manifestations,and pulse manifestations)from 255 patients with Chikungunya hemorrhagic fever who visited Lecong Hospital of Shunde,Foshan,the Third People's Hospital of Shunde District of Foshan,Shunde Hospital of Southern Medical University Affiliated Chencun Hospital between July 23 and July 29,2025.Factor and cluster analyses were used to summarize TCM syndrome characteristics and analyze core pathogenesis in conjunction with clinical features.Results Among the 255 patients with Chikungunya hemorrhagic fever,131 were male and 124 were female,with a age of(49.05±17.93)years and a disease duration of(3.26±1.78)days.Among the four types of examination information in TCM,35 items exhibited a frequency exceeding 10%.The most prevalent symptoms were arthralgia(180 patients,70.59%),exanthem(153 patients,60.00%),fatigue(99 patients,38.82%),anhidrosis(98 patients,38.43%),pruritus(96 patients,37.65%),and fever(92 patients,36.08%).Tongue and pulse manifestations were primarily white fur(155 patients,60.78%),pink tongue(111 patients,43.53%),slippery pulse(143 patients,56.08%),and greasy fur(134 patients,52.53%).Patients with disease onset≤3 d had a higher incidence of arthralgia,fatigue,fever,aversion to cold,generalized muscle pain,aversion to wind,insomnia,headache,sweating,low-grade fever,poor appetite,loose stool,hyperhidrosis,and red tongue than those with disease onset≥4 d(P<0.05).Patients with disease onset≥4 d had a higher incidence of pink tongue and thick fur than those with disease onset≤3 d(P<0.05).The syndrome elements in patients with Chikungunya hemorrhagic fever predominantly manifested on the defensive exterior,with involvement of the sinew-bone joints,skin-muscle,and spleen.Pathogenic factors were primarily characterized by external winds,dampness,and heat.Factor and cluster analysis result indicated three TCM pathogenesis progression patterns:imbalance of the defensive exterior with wind-dampness conflict and heat transformation;dampness-heat flowing into muscles and meridians causing joint obstruction and qi blood stasis;and dampness-heat congelation resulting in qi mechanism obstruction,consumption of body fluids,and infiltration of the skin.Conclusion Patients with Chikungunya hemorrhagic fever primarily present with fever,joint pain,and rashes.In TCM,this condition falls under the category of"dampness-warmth"syndrome.Its etiology is attributed to pathogens,with transmission occurring through mosquito bites.The core pathogenesis of TCM is the invasion of the defensive exterior and dampness-toxic heat accumulation.The therapeutic principles focus on clearing heat pathogens,resolving dampness pathogens,dispersing wind pathogens,and promoting the resolution of rashes.

Health behavior motivation significantly affects the quality of life of patients with cardiovascular diseases.Assessing the level of health behavior motivation can measure the health behavior of individuals,help to promote the participation rate of cardiac rehabilitation,reduce the readmission rate of patients,and promote patients'healthy lifestyles.This article reviews the content,characteristics and application of assessment tools for health behavior motivation of patients with cardiovascular diseases at home and abroad,with the aim of providing references for the development and application of such tools in China,and offering a basis for scientifically assessing their health behavior motivation level and formulating effective strategies to promote health behavior motivation.

The number of patients with chronic diseases in China has been increasing year by year,followed by the increase of treatment burden.It is particularly important to effectively evaluate the treatment burden of patients with chronic diseases.This paper reviews the main contents,application scope,advantages and disadvantages of the assessment tools for the treatment burden of patients with chronic diseases at home and abroad,so as to provide references and basis for medical staff to reasonably select assessment tools and conduct relevant clinical research.