Objective:To investigate whether blastulation time would impact maternal and neonatal outcomes following single euploid blastocyst transfer.Methods:A retrospective cohort study was conducted at the Centre for Reproductive Medicine of Renji Hospital, Shanghai Jiao Tong University School of Medicine between October 2017 and June 2021. Totally 893 patients who received preimplantation genetic testing for aneuploidies (PGT-A) and delivered singleton live birth after frozen single euploid blastocyst transfer were included. Patients were divided into day 5 (D5) group ( n=768) and day 6 (D6) group ( n=125) according to timing of blastulation. Propensity score matching (PSM) with a ratio of 2∶1 was conducted to balance potential confounding factors including female age, body mass index (BMI) and infertility duration. After PSM, there were 250 patients in D5 group and 125 patients in D6 group. Basic characteristics, ovarian stimulation and embryo transfer cycle characteristics, pregnancy complications and neonatal outcomes of the two groups were compared. Furthermore, patients were divided into <35 years old group and ≥35 years old group by maternal age to conduct stratified analysis. Results:There were no statistically significant differences in the baseline characteristics including female age, BMI, infertility duration and indication for infertility treatment between the two groups after PSM (all P>0.05). The number of oocytes retrieved and the number of two pronuclei (2PN) did not differ between the two groups (all P>0.05), while the number of embryos cryopreserved was significantly increased in D5 group than in D6 group [5.00 (3.00, 7.00) vs. 3.00 (2.00, 5.00), P<0.001]. The proportion of cycles transferring good-quality embryos was significantly higher in D5 group than in D6 group [81.6% (204/250) vs. 40.0% (50/125), P<0.001]. No significant differences were observed in the incidences of gestational diabetes, hypertensive disorders of pregnancy, thyroid diseases during pregnancy, premature preterm rupture of membranes, preterm delivery, placenta disorder and postpartum hemorrhage between the two groups (all P>0.05). The birth weight, gestational age, neonate sex, the incidences of low birth weight, macrosomia, small for gestational age, large for gestational age and birth defects did not differ as well (all P>0.05). In stratified analysis, there were no significant differences in maternal and neonatal outcomes between D5 group and D6 group for women who aged <35 years or ≥35 years (all P>0.05). Conclusion:Timing of blastulation in euploid blastocysts does not impact maternal and neonatal outcomes.

Objective:To investigate whether blastulation time would impact maternal and neonatal outcomes following single euploid blastocyst transfer.Methods:A retrospective cohort study was conducted at the Centre for Reproductive Medicine of Renji Hospital, Shanghai Jiao Tong University School of Medicine between October 2017 and June 2021. Totally 893 patients who received preimplantation genetic testing for aneuploidies (PGT-A) and delivered singleton live birth after frozen single euploid blastocyst transfer were included. Patients were divided into day 5 (D5) group ( n=768) and day 6 (D6) group ( n=125) according to timing of blastulation. Propensity score matching (PSM) with a ratio of 2∶1 was conducted to balance potential confounding factors including female age, body mass index (BMI) and infertility duration. After PSM, there were 250 patients in D5 group and 125 patients in D6 group. Basic characteristics, ovarian stimulation and embryo transfer cycle characteristics, pregnancy complications and neonatal outcomes of the two groups were compared. Furthermore, patients were divided into <35 years old group and ≥35 years old group by maternal age to conduct stratified analysis. Results:There were no statistically significant differences in the baseline characteristics including female age, BMI, infertility duration and indication for infertility treatment between the two groups after PSM (all P>0.05). The number of oocytes retrieved and the number of two pronuclei (2PN) did not differ between the two groups (all P>0.05), while the number of embryos cryopreserved was significantly increased in D5 group than in D6 group [5.00 (3.00, 7.00) vs. 3.00 (2.00, 5.00), P<0.001]. The proportion of cycles transferring good-quality embryos was significantly higher in D5 group than in D6 group [81.6% (204/250) vs. 40.0% (50/125), P<0.001]. No significant differences were observed in the incidences of gestational diabetes, hypertensive disorders of pregnancy, thyroid diseases during pregnancy, premature preterm rupture of membranes, preterm delivery, placenta disorder and postpartum hemorrhage between the two groups (all P>0.05). The birth weight, gestational age, neonate sex, the incidences of low birth weight, macrosomia, small for gestational age, large for gestational age and birth defects did not differ as well (all P>0.05). In stratified analysis, there were no significant differences in maternal and neonatal outcomes between D5 group and D6 group for women who aged <35 years or ≥35 years (all P>0.05). Conclusion:Timing of blastulation in euploid blastocysts does not impact maternal and neonatal outcomes.

Objective To investigate the feasibility and safety of portal 125I seed stent implantation combined with doxorubicin-eluting beads transcatheter arterial chemoembolization (DEB-TACE) for the treatment of hepatocellular carcinoma (HCC) associated with main portal vein tumor thrombus (MPVTF).Methods Prospective single-arm study was designed.Seven HCC patients with MPVTT were sequentially enrolled in this study to receive treatment.Portal pressure before and after portal vein stent implantation were determined,the liver function were tested before and 1-3 days,4 days,5-7 days after portal vein stent implantation,the results and the postoperative complications were analyzed.Results All 7 patients were in BCLC-C stage,with Child-Pugh classification being A-B level.All patients were diagnosed as massive type HCC complicated by portal vein tumor thrombus.The lesions were located in hepatic left lobe (n=l) and hepatic right lobe (n=6),tumor thrombus in left branch of portal vein was seen in one patient and tumor thrombus in right branch of portal vein was found in 6 patients,MPVTT was observed in all 7 patients.Portal 125I seed stent implantation plus DEB-TACE was successfully accomplished in all 7 patients.The portal pressure before and after stent implantation was 15.3 cmH2O and 10.2 cmH2O respectively,the postoperative pressure showed an obvious reduction.After stent implantation,a transient elevation of the serum total bilirubin (TB),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) could be observed,which gradually decreased in 3-4 days;the recovery of TB level was slower than that of ALT and AST levels.Two patients had concomitant myocardial damage,which was gradually recovered in 2-3 days.Conclusion For the treatment of HCC associated with MPVTT,portal 125I seed stent implantation plus DEB-TACE is safe and feasible,although its long-term curative effect needs to be further clarified.

Objective To investigate the clinical application value of 3D printing coplanar template in treating pancreatic cancer with 125I seed implantation.Methods Clinical data of 10 patients with pancreatic cancer,who received 3D printing coplanar template-guided 125I seed implantation during the period from January 2016 to June 2017,were retrospectively analyzed.According to preoperative CT scan results and treatment planning system findings,a 3D coplanar template was designed and printed,guided by which percutaneous puncture and 125I seed implantation were conducted.Dosimetric verification was performed after 125I seed implantation.Both preoperative and postoperative 90％ dose of target volume (D90),90％ target volume of prescription dose (V90),100％ target volume of prescription dose (V100) and 150％ target volume of prescription dose (V150) were calculated.The success rate of puncture location of 3D printing coplanar template-guided 125I seed implantation was calculated.The coincidence between preoperative dosimetric plan and postoperative dosimetric parameter was assessed,and the complications were recorded.Results Under the guidance of 3D coplanar template,percutaneous puncture and 125I seed implantation were successfully accomplished in all 10 patients with pancreatic cancer.The postoperative dosimetric parameter D90 was consistent with preoperative planning.No statistically significant difference in D90 existed between preoperative value and postoperative one (P＞0.05).The postoperative V90,V100 and V150 were (94.3±2.4)％,(90.4±4.1)％ and (62.1±13.4)％ respectively,which were compliance with therapeutic dosimetry requirements.Local hematoma occurred in one patient after the treatment.Conclusion 3D printing coplanar template appears to be a safe and effective guiding tool,it is very helpful for precise implantation of 125I seeds in treating pancreatic cancer,and with the help of 3D printing coplanar template the postoperative dose parameters will be able to meet the preoperative planning requirements.