BACKGROUND:It has been found that abnormal apoptosis of bone tissue cells induced by abnormal iron metabolism plays an important role in the progression of osteoporosis. OBJECTIVE:To investigate the effect of naringin on iron metabolism and cell apoptosis in bone tissue of rats with osteoporosis. METHODS:Fifty 2-month-old female Sprague-Dawley rats were randomly divided into five groups with 10 rats in each group:sham group,osteoporosis group,naringin low-dose group,naringin high-dose group,and naringin high-dose+DKK-1 group.Except for the sham group,rat models of osteoporosis were established by removing bilateral ovarian tissues in the other groups.At 8 weeks after modeling,rats in the naringin low-and high-dose groups were given 100 and 400 mg/kg/d naringenin by gavage,respectively,and rats in the naringenin high dose+DKK-1 group were given 400 mg/kg/d naringin by gavage and subcutaneous injection of 25 mg/kg/d DKK-1,an inhibitor of the Wnt1 signaling pathway,for 7 consecutive days.Relevant indexes were detected after administration. RESULTS AND CONCLUSION:Compared with the osteoporosis group,naringin could enhance the bone mineral density and serum calcium and superoxide dismutase levels in rats(P<0.05),and reduce the serum levels of osteocalcin,malondialdehyde,and phosphorus(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Micro-CT scanning,hematoxylin-eosin and TUNEL staining showed that compared with the osteoporosis group,naringin significantly improved bone microstructure and reduced the rate of cell apoptosis,while DKK-1 partially inhibited the interventional effect of naringin.Immunofluorescence staining results showed that compared with the osteoporosis group,naringin could reduce the oxygen content,anti-tartaric acid phosphatase expression,and elevate the expression of alkaline phosphatase in active tibia tissues(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Prussian blue staining and immunohistochemical staining showed that compared with the osteoporosis group,naringin reduced iron deposition in bone and liver tissues as well as the expression of transferrin receptor 1(P<0.05),and elevated the protein expression of ferroportin 1(P<0.05)in bone tissue,and DKK-1 partially inhibited the intervention of naringin(P<0.05).PCR and western blot assay of tibia specimens showed that compared with the osteoporosis group,naringin decreased the expression of anti-tartrate acid phosphatase,transferrin receptor 1 and Bax(P<0.05),and elevated the expression of alkaline phosphatase,ferroportin 1,Bcl-2,Wnt1 and β-catenin(P<0.05),while DKK-1 partially inhibited the interfering effect of naringin(P<0.05).To conclude,naringin inhibits the progression of osteoporosis by reducing iron deposition and apoptosis rate in bone tissue,which may be related to the activation of the Wnt1 signaling pathway.

Objective:To compare and evaluate the difference in maxillary dentition position using an anatomical facebow and jaw movement analyzer.Methods:From March to May 2023, 15 medical interns from Yantai Stomatological Hospital were recruited, including 9 males and 6 females, aged 20-25 years. Digital models and plaster models of maxillary dentition were obtained from the 15 medical interns. The anatomical facebow group (AFB) and jaw movement analyzer group (JMA) were used to transfer the position of the maxillary dentition to the virtual articulator. The virtual occlusal articulator module of exocad denture design software was used to measure the inclination angle of the occlusal plane of the two groups, the distance between the mesio-incisal angle of the left maxillary central incisor and the lateral center point of the lateral condylar sphere of the virtual occlusal articulator, the distance between the mesial buccal cusp of the maxillary first molar and the lateral center point of the lateral condyle sphere of the virtual articulator. The same marks (mesial incisor point of left maxillary central incisor and mesial buccal cusp point of both maxillary first molars) were measured in two groups of maxillary dentition, and the root-mean-square error between 3 points was calculated.Results:The occlusal plane inclination angle in AFB group (9.11°±3.85°) was significantly larger than that in JMA group (4.94°±2.69°) ( t=10.45, P<0.001). There were significant differences between AFB and JMA groups. The distances from the mesial cusp of the left first molar to the lateral center of the left condylar, from the mesial cusp of the left maxillary central incisor to the lateral center of the left condylar[(91.75±3.05), (129.09±4.60) mm]were significantly smaller than those in the JMA group[(95.68±5.45), (132.41±5.64) mm]( t=-4.48, P=0.001; t=-4.21, P=0.001). In both groups of models, the distance of the mesial cusp of the left maxillary central incisor was (8.81±2.56) mm, and the distance between mesial buccal cusp of maxillary left first molar was (7.56±2.49) mm, the distance between mesial buccal cusp of maxillary right first molar was (7.13±2.77) mm; the root mean square error was (7.93± 2.94) mm. Compared with 0, the difference was statistically significant ( t=10.45, P<0.001). Conclusions:There were differences between the two methods (anatomical facebow and the jaw movement analyzer) for transferring the maxillary dentition position to the three-dimensional space position of the virtual articulator.

Objective:To investigate the clinical and radiologic characteristics of children with congenital pseudarthrosis of the tibia (CPT) in a single center.Methods:This is a retrospective case series study. According to inclusion and exclusion criteria, clinical data of 497 children(507 limbs) with CPT who were treated at Department of Orthopedics, the Children′s Hospital Affiliated to Xiangya School of Medicine, Central South University from January 2011 to December 2020 were collected. Baseline data included gender, age at initial visit, age at onset of symptoms, accompanying symptoms, domicile, whether first treated at our hospital, and treatment-related information such as surgical or conservative treatment, surgical complications, etc., were extracted and analyzed using the health information system. Imaging data of the children, including Crawford classification, bilateral leg lengths, presence of fibular pseudarthrosis, and location of pseudarthrosis along the tibia segment, were analyzed using the Picture Archiving and Communication System. Data were compared using independent sample t test or χ2 tests. Results:Among 497 children with CPT, there were 305 males (61.4%) and 192 females (38.6%). The age at initial visit was (3.6±3.2) years (range: 0.1 to 16.2 years). Neurofibromatosis type 1 (NF1) symptoms were positive in 340 children (68.4%), and negative in 157 children (31.6%). Among NF1-positive children, those with symptoms onset before 1 year of age were significantly more than NF1-negative children (74.1%(252/340) vs. 66.2%(104/157); χ2=9.24, P=0.001), and the proportion of fractures (92.9%,316/340) was significantly higher than that in the NF1-negative group (84.7%,133/157) ( χ2=8.33, P=0.004). According to imaging data, Crawford type Ⅳ was the most common type, with 321 limbs (63.3%), followed by type Ⅱ in 100 limbs (19.7%), type Ⅲ in 54 limbs (10.7%) and type Ⅰ in 32 limbs (6.3%). Pseudarthrosis occurred in the proximal third of the tibia in 14 limbs (2.8%), in the middle third in 185 limbs (36.5%), and in the distal third in 308 limbs (60.8%). Seventy-four children (14.9 %) had associated fibular pseudarthrosis. The lateral proximal tibial angle was 86.91°±5.21°(range: 72.17° to 102.08°), and the lateral distal tibial angle was 87.27°±10.73°(range: 51.07° to 128.17°). A total of 421 children (84.7%) underwent surgical treatment with (3.1±2.4) surgeries performed per child (range:0 to 12 surgeries); 76 children (15.3%) received conservative treatment. Postoperative complications mainly included ankle valgus (77 cases), leg length discrepancy (71 cases),refracture (48 cases), osteomyelitis (11 cases), and hardware failure (10 cases). NF1-positive children underwent more surgeries than NF1-negative children ((5.1±2.2)times vs.(2.1±1.8)times; t=14.93, P<0.01). Conclusions:Crawford type Ⅳ is the most common type of CPT in children in this study. CPT predominantly occurs in the middle or distal third of the tibia. The majority of children with CPT experienced symptoms and were seen at outpatient clinics before the age of 3 years. The main surgical complications currently associated with CPT treatment are ankle valgus and leg length discrepancy. Compared with CPT without NF1, children with NF1-positive CPT tend to have earlier symptom onset and may require more frequent treatments.

Objective:To discuss the effect of mangiferin(MGF)on the healing of hip fracture in the rats by regulating the Wnt/β-catenin signaling pathway,and to clarify the mechanism.Methods:The hip fracture model in the SD rats was established.After successful modeling,the rats were divided into model group,MGF group,and MGF+XAV-939(Wnt/β-catenin signaling pathway inhibitor)group,and sham operation group was set up,and there were 15 rats in each group.From the first day after surgery,the rats in each group received MGF or XAV-939 interventions every two days,totally for 14 times.Lane-Sandhu X-ray scoring method was used to detect the fracture healing in the second and fourth weeks after surgery;micro CT was used to detect the microstructural parameters of the bone,such as bone volume(BV),number of bone trabeculae(Tb.N),bone volume fraction(BV/TV),and bone trabecular thickness(Tb.Th);HE staining was used to observe the morphology of callus tissue of the rats in various groups;enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of osteogenic markers bone alkaline phosphatase(BALP)and type Ⅰ procollagen N-terminal propeptide(PINP)and bone resorption markers tartrate resistant acid phosphatase-5b(TRACP-5b)and Carboxy-terminal terminalpeptide of type Ⅰcollagen(CTX)in serum of the rats in various groups;Western blotting method was used to detect the expression levels of β-catenin,Runt-associated transcription factor 2(Runx2),and bone morphogenetic protein-2(BMP-2)in callus tissue of the rats in various groups.Results:Compared with sham operation group,the rats in model group showed distinct fracture lines,an abundance of fibrous tissue at the fracture site,and no bony callus at the 2nd and 4th weeks after fracture,the Lane-Sandhu X-ray scores and microstructural parameters BV,Tb.N,BV/TV,and Tb.Th of the rats in model group were decreased(P＜0.05),the serum level of BALP was decreased(P＜0.05),while the levels of PINP,TRACP-5b,and CTX were increased(P＜0.05),and the expression levels of β-catenin,Runx2,and BMP-2 proteins in callus tissue were decreased(P＜0.05).Compared with model group,the rats in MGF group showed significantly increased new bone callus at 2nd weeks after fracture,almost no visible fracture line at the 4th weeks,faster fracture healing,and replacement of fibrous tissue by bone tissue at the fracture site,the Lane-Sandhu X-ray scores and microstructural parameters BV,Tb.N,BV/TV,and Tb.Th of the rats in MGF group were increased(P＜0.05),the serum level of BALP was increased(P＜0.05),the levels of PINP,TRACP-5b,and CTX were decreased(P＜0.05),and the expression levels of β-catenin,Runx2,and BMP-2 proteins in callus tissue were increased(P＜0.05).Compared with MGF group,the rats in MGF+XAV-939 group showed only a small amount of new bone callus at the fracture site at 2nd and 4th weeks after fracture,with no formation of the marrow cavity,and the Lane-Sandhu X-ray scores and microstructural parameters BV,Tb.N,BV/TV,and Tb.Th of the rats in MGF+XAV-939 group were decreased(P＜0.05),the serum level of BALP was decreased(P＜0.05),the levels of PINP,TRACP-5b,and CTX were increased(P＜0.05),and the expression levels ofβ-catenin,Runx2,and BMP-2 proteins in callus tissue were decreased(P＜0.05).Conclusion:MGF can promote the healing of hip fracture in the rats,and its mechanism may be related to activation of Wnt/β-catenin signaling pathway.

Objective Motortherapy and neck muscle resistance training are used to study the effects of resistance training on neck pain level and surface myoelectric activity of student pilots of carrier aircraft.Methods We conducted an intervention experiment on the neck pain of the carrier-based aircraft student pilots.The experiment period was 3 months.The experimental subjects were male carrier-based aircraft student pilots aged from 23 to 35.Questionnaires,including the Cervical Dysfunction Index and the Chinese Physical Activity Questionnaire,were issued,followed by cervical muscle function tests,including cervical maximum muscle strength,cervical range of motion,and surface electromyography tests.The experimental subjects were randomly divided into the control group and the resistance training group,with 8 in each.The subjects in the control group recieved usual military training.Those in the resistance training group recieved targeted training programs developed by using the self-developed cervical spondylosis prevention training device in addition to usual military training.The programs were carried out for resistance training three times a week for 20 minutes in each.Cervical maximum muscle strength,cervical range of motion,and surface electromyography were tested again before the end of the intervention experiment.The data were analyzed by SPSS 22.0.The results were expressed by mean±standard deviation((-x)±s).P<0.05 was considered statistically significant.Results(1)After 12-week intervention,resistance training had a significant effect on visual pain analog scale(VAS).(2)After the intervention,the comparison results of the subjects'cervical spine dysfunction index(NDI)before and after their own tests showed that the level of cervical spine dysfunction was significantly improved.(3)After the intervention,the results of inter-group comparison of the subjects'own joint motion showed that the self-variation difference of the subjects in the resistance training group was significantly different in forward flexion,backward extension,left flexion,right flexion,right rotation and left rotation.(4)After the intervention,the comparison results between the two groups of subjects'own neck muscle strength showed that there was no significant difference in the self-change of the six movements of subjects in the resistance training group.(5)The root mean square(RMS)values in the four movement tests of flexion,extension,flexion and flexion before and after the intervention in the resistance training group showed no significant difference between the left and right sternocleidomastoid muscle and the right and right trapezius muscle.(6)The integrated electromyography(iEMG)in the four movement tests of flexion,extension,flexion and flexion before and after the intervention in the resistance training group showed no significant difference between the left and right sternocleidomastoid muscle and the right and right trapezius muscle superior bundle.Conclusion After 12 weeks of resistance training,VAS scores and NDI scores of resistance training subjects are significantly reduced,indicating that resistance training can alleviate neck pain and improve cervical spine dysfunction.12-week resistance training can enhance the strength of neck muscles of carrier-based aircraft student pilots and improve the anti-fatigue ability of neck muscles.Meanwhile,it can enhance the range of motion of neck joints,improve the load of the deep and shallow muscle fibers of the four tested muscles in the neck and optimize the activation mode of the deep and shallow muscles in the neck.

Objective Neuromuscular electrical stimulation(NMES)-evoked kinesthetic information in muscle spindle can be purely extracted from the mixed motor and sensory afferents using Ischemic nerve block(INB).This study aims to investigate the somatosensory cortical response evoked by NMES activating muscle spindle afferents in forearm.Methods All subjects performed four experimental tasks designed according to a 2×2 factors,including one factor of the INB state(without INB and within INB)and the other of the stimulation intensity(above and below motor threshold).During the experiment,we recorded EEG data with 64 channels and then beta event-related desynchronization(Beta ERD)were utilized quantize somatosensory cortical excitability evoked by the tasks.The subjective perception about the sensation and movement of the right hand were evaluated by a psychophysical test after the right wrist was performed by INB.Results INB significantly reduced beta ERD on the contralateral somatosensory cortex evoked by NMES above the motor threshold,and there was significant difference of NMES-evoked beta ERD values on the contralateral somatosensory cortex between above and below motor threshold.Meanwhile,contralateral dominance of NMES-evoked beta ERD on the somatosensory cortex was transferred to ipsilateral hemisphere under INB.Conclusion INB can significantly reduce NMES-evoked somatosensory cortical response above motor threshold and decrease cortical perception on the stimulus intensity,which may be due to INB resulting in rapid functional reorganization of somatosensory cortex.

Objective To explore the intervention effect of badminton exercise on neck pain in naval carrier-based aircraft flight trainees,and provide data support for the prevention and relief of neck pain in these trainees.Methods A total of 16 naval carrier-based aircraft flight trainees were selected as subjects based on inclusion and exclusion criteria,and randomly divided into the sports rehabilitation group and the control group,with eight participants in each group.The sports rehabilitation group engaged in badminton exercise three times a week for one hour each time,in addition to their regular military training.The control group received no other interventions apart from their regular military training.Neck Disability Index(NDI),Visual Analog Scale(VAS)for pain simulation,Cervical Range of Motion(CROM),maximum neck strength,Root Mean Square(RMS)value of surface electromyographic signals,and integrated electromyography(iEMG)values were used as evaluation indexes for the intervention effect of neck pain.Results There was a significant difference in NDI scores among members of the sports rehabilitation group before and after intervention(P<0.05).However,there was no significant difference observed in NDI scores among members of the control group before and after intervention(P>0.05).Furthermore,there was a significant difference in VAS scores among members of the sports rehabilitation group before and after intervention(P<0.01).The VAS scores of the control group members showed no significant difference compared to pre-intervention testing(P>0.05).The maximum range of motion in all directions increased for the exercise rehabilitation group,with significant differences observed in left and right flexion(P<0.05),but no significant differences were found in other directions(P>0.05)compared to pre-intervention levels.There was no significant change in maximum range of motion within the control group before and after intervention(P>0.05).The exercise rehabilitation group demonstrated a significant increase in neck muscle strength during forward flexion,backward extension,left flexion(P<0.01),and right flexion as well as left and right rotation values(P<0.05)compared to pre-intervention levels.There was no significant difference observed between RMS values on both sides of the sternocleidomastoid muscles during movement in four different directions for the exercise rehabilitation group(P>0.05).However,there was a significant difference observed on the left side of the upper trapezius muscle during forward and rightward movements(P<0.05),but not during backward or leftward movements(P>0.05).No statistically significant differences were found among any direction's iEMG values before or after intervention for four muscles tested except that iEMG value increased slightly without significance after intervention when performing forward bending,backward extension and rightward bending exercises within exercise rehabilitation groups(P>0.05).Conclusion After badminton training,neck pain among carrier-based fighter pilots is allivated while cervical dysfunction recovers somewhat.Furthermore,their neck flexibility increases along with their neck muscle strength while deep muscles are activated to maintain stability to effectively enhance fatigue resistance capacity within these muscle groups around their necks.

Objective:To investigate the clinical and radiologic characteristics of children with congenital pseudarthrosis of the tibia (CPT) in a single center.Methods:This is a retrospective case series study. According to inclusion and exclusion criteria, clinical data of 497 children(507 limbs) with CPT who were treated at Department of Orthopedics, the Children′s Hospital Affiliated to Xiangya School of Medicine, Central South University from January 2011 to December 2020 were collected. Baseline data included gender, age at initial visit, age at onset of symptoms, accompanying symptoms, domicile, whether first treated at our hospital, and treatment-related information such as surgical or conservative treatment, surgical complications, etc., were extracted and analyzed using the health information system. Imaging data of the children, including Crawford classification, bilateral leg lengths, presence of fibular pseudarthrosis, and location of pseudarthrosis along the tibia segment, were analyzed using the Picture Archiving and Communication System. Data were compared using independent sample t test or χ2 tests. Results:Among 497 children with CPT, there were 305 males (61.4%) and 192 females (38.6%). The age at initial visit was (3.6±3.2) years (range: 0.1 to 16.2 years). Neurofibromatosis type 1 (NF1) symptoms were positive in 340 children (68.4%), and negative in 157 children (31.6%). Among NF1-positive children, those with symptoms onset before 1 year of age were significantly more than NF1-negative children (74.1%(252/340) vs. 66.2%(104/157); χ2=9.24, P=0.001), and the proportion of fractures (92.9%,316/340) was significantly higher than that in the NF1-negative group (84.7%,133/157) ( χ2=8.33, P=0.004). According to imaging data, Crawford type Ⅳ was the most common type, with 321 limbs (63.3%), followed by type Ⅱ in 100 limbs (19.7%), type Ⅲ in 54 limbs (10.7%) and type Ⅰ in 32 limbs (6.3%). Pseudarthrosis occurred in the proximal third of the tibia in 14 limbs (2.8%), in the middle third in 185 limbs (36.5%), and in the distal third in 308 limbs (60.8%). Seventy-four children (14.9 %) had associated fibular pseudarthrosis. The lateral proximal tibial angle was 86.91°±5.21°(range: 72.17° to 102.08°), and the lateral distal tibial angle was 87.27°±10.73°(range: 51.07° to 128.17°). A total of 421 children (84.7%) underwent surgical treatment with (3.1±2.4) surgeries performed per child (range:0 to 12 surgeries); 76 children (15.3%) received conservative treatment. Postoperative complications mainly included ankle valgus (77 cases), leg length discrepancy (71 cases),refracture (48 cases), osteomyelitis (11 cases), and hardware failure (10 cases). NF1-positive children underwent more surgeries than NF1-negative children ((5.1±2.2)times vs.(2.1±1.8)times; t=14.93, P<0.01). Conclusions:Crawford type Ⅳ is the most common type of CPT in children in this study. CPT predominantly occurs in the middle or distal third of the tibia. The majority of children with CPT experienced symptoms and were seen at outpatient clinics before the age of 3 years. The main surgical complications currently associated with CPT treatment are ankle valgus and leg length discrepancy. Compared with CPT without NF1, children with NF1-positive CPT tend to have earlier symptom onset and may require more frequent treatments.

Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health.Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023.Their demographic data and physical exercise data were surveyed with questionnaires.Total sperm count,sperm concentration,total sperm motility,forward movement and normal sperm morphology were analyzed with computer aided analysis.Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality.Results After adjustment for confounding factors such as age,body mass index,alcohol consumption and smoking,logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity(OR=2.103,OR=2.229).Compared with the participants with physical exercise ≤10 min per session,those with＞20 min per session had a lower risk of abnormal semen quality(OR=0.357,0.256,0.289 for exercise time for＞20～30,＞30～60,＞60 min,respectively).There was no statistical significance between physical exercise frequency and semen quality(P＞0.05).The participants having exercise well were at a lower risk for abnormal semen quality(OR=0.711).Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration(β=7.474,95％CI:4.800～10.149,P＜0.05);the time of physical exercise per session was an influencing factor for total sperm count(β=20.632,95％CI:7.634～33.629);the intensity of physical exercise(β=-1.461,95％CI:-2.392～-0.530)and time of physical exercise per session(β=2.608,95％CI:1.404～3.812,P＜0.05)were influencing factors for percentage of forward motility sperm(P＜0.05);and physical exercise intensity(β=-1.934,95％CI:-3.238～-0.630),time of physical exercise per session(β=4.211,95％CI:2.525～5.897)and frequency of physical exercise(β=-2.008,95％CI:-3.480～-0.536)were influencing factors of total sperm motility(P＜0.05).Conclusion Physical exercise may affect semen quality,greater intensity of physical exercise may be a risk factor for abnormal semen quality,and longer physical exercise time may be related to improving semen quality.Therefore,proper physical exercise can help improve semen quality.

Objective:To summarize the ultrasonographic characteristics, genetic etiology, and perinatal prognosis of fetuses with absence of ductus venosus (ADV).Methods:A retrospective study enrolled 84 singleton pregnancies that underwent prenatal ultrasound examination and were diagnosed with fetal ADV at the First Affiliated Hospital of Zhengzhou University from June 2017 to July 2022. Based on prenatal ultrasonographic findings, the cases were divided into isolated ADV group ( n=37), ADV with ultrasound soft markers group ( n=9), and ADV with definite ultrasound abnormalities group ( n=38). According to the gestational age at the initial diagnosis of ADV, they were categorized into early pregnancy group (11-13 weeks of 6 days) with 17 cases, mid-pregnancy group (14-27 weeks of 6 days) with 45 cases, and late pregnancy group (≥28 weeks) with 22 cases. Depending on the direction of blood flow in the intra-abdominal segment of the umbilical vein, they were classified into umbilical vein directly entering the portal sinus group ( n=75), intrahepatic umbilical vein abnormal shunt group ( n=4), and extrahepatic umbilical vein shunt group ( n=5). The clinical characteristics of each group were summarized, and compared using the Chi-square, trend Chi-square tests, Fisher's exact test and Bonferroni correction test. Results:The common ultrasonographic abnormalities in the 84 cases of ADV fetuses were cardiac anomalies (27.4%, 23/84), cystic hygroma (10.7%, 9/84), fetal hydrops (9.5%, 8/84), and body cavity effusion (8.3%, 7/84). The proportions of fetuses with ADV and definite ultrasound abnormalities detected in the early, mid, and late pregnancy were 16/17, 44.4% (20/45), and 9.1% (2/22), respectively, with a higher proportion of definite ultrasound abnormalities associated with earlier detection of ADV ( χ 2trend=27.25, P<0.001). Among them, 21 cases underwent chromosomal karyotyping and/or chromosomal copy number variation sequencing or expanded non-invasive prenatal testing, with five abnormalities detected, including 45,X, trisomy 13, trisomy 22 mosaicism, trisomy 7 mosaicism, and a 14 Mb duplication at 22q12.3q13.33. The neonatal survival (28 days after birth) rates with ADV detected in the early, mid, and late pregnancy gradually increased, at 1/17, 43.9% (18/41), and 90.5% (19/21), respectively ( χ 2trend=27.04, P<0.001). The neonatal survival rates of the isolated ADV group and the group with ultrasound soft markers were higher than that of the group with definite ultrasound abnormalities [93.9% (31/33) and 6/9 vs. 2.7% (1/37), Bonferroni corrected, both P<0.001]. The neonatal survival rates of the umbilical vein directly entering the portal sinus group, intrahepatic umbilical vein abnormal shunt group, and extrahepatic umbilical vein shunt group were 50.0% (35/70), 0/4, and 1/5, respectively, with no statistically significant difference (Fisher's exact test, P=0.105). Conclusions:The earlier the detection of fetal ADV, the more likely it is to be associated with definite ultrasound abnormalities and have lower neonatal survival rates. This highlights the importance of ultrasonographic examination of the fetal ductus venosus. Once ADV is detected, attention should be paid to other potential ultrasound abnormalities, and genetic testing should be completed.