Empty follicle syndrome (EFS), defined by the failure to retrieve oocytes despite normal follicle development following controlled ovarian stimulation, is a multifactorial condition in assisted reproductive treatment and categorized into genuine EFS (GEFS) and false EFS (FEFS). The etiology of GEFS is complex, involving genetic factors and ovarian dysfunction, with mutations in LHCGR and ZP genes being the major causes. However, the underlying cause remains unknown in most patients. Targeted therapies based on specific etiologies are crucial in GEFS management. Oocyte donation is considered as a final viable option when other precision treatments prove ineffective. The etiology of FEFS is relatively clear, primarily associated with inappropriate administration of ovulation-triggering drugs, which can be rescued by a second injection of human chorionic gonadotropin or change the medication regimen. This review summaries current advances in the diagnosis and treatment of EFS, aiming to provide guidance for clinical management and further etiology research.

Empty follicle syndrome (EFS), defined by the failure to retrieve oocytes despite normal follicle development following controlled ovarian stimulation, is a multifactorial condition in assisted reproductive treatment and categorized into genuine EFS (GEFS) and false EFS (FEFS). The etiology of GEFS is complex, involving genetic factors and ovarian dysfunction, with mutations in LHCGR and ZP genes being the major causes. However, the underlying cause remains unknown in most patients. Targeted therapies based on specific etiologies are crucial in GEFS management. Oocyte donation is considered as a final viable option when other precision treatments prove ineffective. The etiology of FEFS is relatively clear, primarily associated with inappropriate administration of ovulation-triggering drugs, which can be rescued by a second injection of human chorionic gonadotropin or change the medication regimen. This review summaries current advances in the diagnosis and treatment of EFS, aiming to provide guidance for clinical management and further etiology research.

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

Background Natural product sanguinarine chloride (SC) can significantly alleviate liver fibrosis and acute liver injury in mice, but whether it has a protective effect on mouse liver injury caused by sodium arsenite (SA) has not been studied. Objective To verify if SC may present preventive and therapeutic effects on SA-induced liver injury in mice. Methods A total of 140 SPF male Kunming mice were randomly divided into two sub-studies, which included a prevention sub-study and a treatment sub-study. In each sub-study, a blank group (normal saline), a model group (5 mg·kg⁻¹ SA), and a positive control group (11.375 mg·kg⁻¹ bicyclol and 182 mg·kg⁻¹ glutathione), as well as SC low, medium, and high dose groups (25, 50, and 100 mg·kg⁻¹) were arranged with 10 mice in each group. In the prevention sub-study, the blank group was given normal saline, the model group was given SA, and the other groups (the SC low, medium, and high dose groups and the positive control group) were given the corresponding treatment 30 min before gavage of SA, once a day, for 28 d. In the treatment sub-study, except for the blank group which was given normal saline, the other groups were given SA for 28 d, then the model group was given normal saline, and the other groups were given the corresponding treatment every day for 28 d. After the experiment, the mice were sacrificed to evaluate selected physiological and biochemical indicators in serum and liver tissue and to observe histopathological changes after HE staining. Results In either sub-study of preventive effect or treatment effect: compared with the blank group, body weight, liver weight, liver coefficient, as well as serum alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), malondialdehyde (MDA), glutathione peroxidase (GSH), and superoxide dismutase (SOD) among all SC groups were not significantly different (P>0.05); but compared with the model group, the SC groups showed increased body weight (P<0.01), decreased liver weight and liver coefficient (P<0.01), reduced ALT, AST, TBIL, and MDA (P<0.05 or P<0.01), and increased GSH and SOD with (P<0.05 or P<0.01) or without significance; compared with the positive control group, no differences were found in the above indicators (P＞0.05). The result of histopathological evaluation showed that the SC groups had a clear liver lobule structure, neatly arranged hepatic cords, and less infiltration of inflammatory cells. Conclusion SC has both preventive and therapeutic effects on SA-induced liver injury in mice.

In view of the fertility problems of patients with adenomyosis, especially when combined with infertility, nine experts were invited to comment on this issue from different angles, and to elaborate their views and point out the direction of how to conduct multi-disciplinary team when meeting this problem. We will summarize the opinions of the invited experts, put forward the hot issues that are controversial and can be further studied, and give some suggestions on how to better conduct multi-disciplinary team.

In view of the fertility problems of patients with adenomyosis, especially when combined with infertility, nine experts were invited to comment on this issue from different angles, and to elaborate their views and point out the direction of how to conduct multi-disciplinary team when meeting this problem. We will summarize the opinions of the invited experts, put forward the hot issues that are controversial and can be further studied, and give some suggestions on how to better conduct multi-disciplinary team.

The clinical diagnosis and treatment process of adenomyosis complicated with infertility involves multiple disciplines such as imaging department, gynecology department, reproductive department, pathology department and interventional department. The combination of the multi-disciplinary team (MDT) model and personalized comprehensive treatment is an effective way to make up for the lack of limited diagnosis and treatment breadth after in-depth subdivision. The development of a special topic review from the perspective of MDT experts for adenomyosis related infertility can effectively promote the multi-disciplinary and individualized diagnosis and treatment mode for patients with adenomyosis and provide the best path leading to live and healthy birth for such patients.

The clinical diagnosis and treatment process of adenomyosis complicated with infertility involves multiple disciplines such as imaging department, gynecology department, reproductive department, pathology department and interventional department. The combination of the multi-disciplinary team (MDT) model and personalized comprehensive treatment is an effective way to make up for the lack of limited diagnosis and treatment breadth after in-depth subdivision. The development of a special topic review from the perspective of MDT experts for adenomyosis related infertility can effectively promote the multi-disciplinary and individualized diagnosis and treatment mode for patients with adenomyosis and provide the best path leading to live and healthy birth for such patients.

Paget's disease of bone (PDB) is a common metabolic bone disease that is characterized by aberrant focal bone remodeling, which is caused by excessive osteoclastic bone resorption followed by disorganized osteoblastic bone formation. Genetic factors are a critical determinant of PDB pathogenesis, and several susceptibility genes and loci have been reported, including SQSTM1, TNFSF11A, TNFRSF11B, VCP, OPTN, CSF1 and DCSTAMP. Herein, we report a case of Chinese familial PDB without mutations in known genes and identify a novel c.163G>C (p.Val55Leu) mutation in FKBP5 (encodes FK506-binding protein 51, FKBP51) associated with PDB using whole-exome sequencing. Mutant FKBP51 enhanced the Akt phosphorylation and kinase activity in cells. A study of osteoclast function using FKBP51V55L KI transgenic mice proved that osteoclast precursors from FKBP51V55L mice were hyperresponsive to RANKL, and osteoclasts derived from FKBP51V55L mice displayed more intensive bone resorbing activity than did FKBP51WT controls. The osteoclast-specific molecules tartrate-resistant acid phosphatase, osteoclast-associated receptor and transcription factor NFATC1 were increased in bone marrow-derived monocyte/macrophage cells (BMMs) from FKBP51V55L mice during osteoclast differentiation. However, c-fos expression showed no significant difference in the wild-type and mutant groups. Akt phosphorylation in FKBP51V55L BMMs was elevated in response to RANKL. In contrast, IκB degradation, ERK phosphorylation and LC3II expression showed no difference in wild-type and mutant BMMs. Micro-CT analysis revealed an intensive trabecular bone resorption pattern in FKBP51V55L mice, and suspicious osteolytic bone lesions were noted in three-dimensional reconstruction of distal femurs from mutant mice. These results demonstrate that the mutant FKBP51V55L promotes osteoclastogenesis and function, which could subsequently participate in PDB development.
Acid Phosphatase ; Animals ; Asian Continental Ancestry Group ; Bone Diseases, Metabolic ; Bone Remodeling ; Bone Resorption ; Femur ; Humans ; Mice ; Mice, Transgenic ; Osteitis Deformans* ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Phosphorylation ; Phosphotransferases ; Tacrolimus Binding Proteins ; Transcription Factors

Objective To investigate the lipid hepatoprotective effect of silibinin on high fat diet-induced nonalcoholic fatty liver (NAFL) rat model and provide a theoretical basis for the treatment of silibinin on NAFL.Methods The NAFL rat model was established by administration of high fat emulsion and high fat diet.Rats in control group was treated with saline and normal diet.The model rats were randomly divided into model group,simvastatin (positive drug,1.8 mg/kg) group,Silibinin groups with low,middle and high doses (18.9,37.8 and 75.6 mg/kg).From the fifth week,NAFLrats were treated with different drugsonce a day for eight weeks.All rats were anaesthetized after final administration,Livertissues were weighed for the calculation of hepatic coefficient The hepatic morphology was observed through HE staining.Serum was obtained from abdominal aortic blood for detection of triglyceride separation (TG),total cholesterol (TC),high density lipoprotein (HDL),low-density lipoprotein (LDL),aspartate aminotransferase (AST),and alanine aminotransferase (ALT) levels.Results After eight-week treatment,compared with model group,middle and high doses of silibinin could significantly improve the hepatic steatosis.The levels of hepatic coefficient,serum TC,TG,AST and ALT in rats treated with individual dose of Silibinin were significantly decreased (P ＜ 0.05,0.01).Particularly,high dose of silibinin significantly reduced LDL level whereas elevated HDL level in serum (P ＜ 0.01).Conclusion Silibinin has a therapeutic effect on nonalcoholic fatty liver rats,and possible mechanism is related to lipid-lowering and hepatic protection.