Objective: To systematically evaluate the influencing factors for repeated implantation failure (RIF) after in vitro fertilization-embryo transfer (IVF-ET) in China, so as to provide the evidence for prevention of RIF. Methods: Literature on influencing factors for RIF in China were retrieved from CNKI, Wanfang Data, VIP, China Medical Literature Service System, PubMed, Web of Science, Cochrane Library and Embase from inception to September, 2024. A meta-analysis was performed using RevMan 5.3 and Stata 14.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was evaluated using Egger's test. Results: Initially 4 836 relevant articles were retrieved, and 12 of them were finally included, with a total sample size of 11 554 individuals. There were 10 case-control studies, 1 cohort study, and 1 cross-sectional study; and 10 high-quality studies and 2 medium-quality studies. The meta-analysis showed that factors including advanced age (OR=1.121, 95%CI: 1.035-1.215), prolonged infertility duration (OR=1.237, 95%CI: 1.091-1.403), abnormal hysteroscopy findings (OR=2.205, 95%CI: 1.119-4.348), positive anti-nuclear antibody (ANA) (OR=2.393, 95%CI: 1.473-3.886), and positive anti-beta2 glycoprotein Ⅰ antibody (β2-GPⅠ-Ab) (OR=2.824, 95%CI: 1.987-4.013) were associated with an increased risk of RIF; while factors including the large number of embryos transferred (OR=0.309, 95%CI: 0.098-0.973), thicker endometrium (OR=0.601, 95%CI: 0.556-0.650), and higher granulocyte colony-stimulating factor (G-CSF) levels (OR=0.657, 95%CI: 0.511-0.845) were associated with a reduced risk of RIF. Conclusion IVF-ET RIF is associated with age, infertility duration, number of embryos transferred, endometrial thickness, hysteroscopy findings, G-CSF levels, ANA and β2-GPⅠ-Ab.

Objective:To conduct a scoping review on the application of family resilience intervention in adults with chronic disease.Methods:Related studies published from database establishment to October 30, 2023 were systematically searched on PubMed, Web of Science, Cochrane Library, PsycINFO, CINAHL, Scopus, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biomedical Database. The included literature was summarized and analyzed.Results:A total of 9 articles were included. The intervention elements for family resilience included increasing awareness of diseases and family characteristics, solving and responding to family problems, engaging in family interaction and communication, integrating internal and external resources, and providing psychological and technical support. The outcome indicators were the level of family resilience and effectiveness.Conclusions:The intervention of family resilience in adults with chronic disease has certain effectiveness and clinical significance, but research is still in the exploratory stage. Further high-quality research is needed to verify the long-term intervention effect and feasibility, and to construct a diversified family resilience intervention program suitable for China.

Objective:To describe the family resilience experience of colorectal cancer patients′ spouses in the process of care, and to provide reference for making effective clinical nursing interventions.Methods:Objective sampling method was used to select the spouses of colorectal cancer patients who were hospitalized in Shanghai East Hospital from March to April 2023. A phenomenological research was used. Semi-structured, in-depth interviews were conducted with 10 spouses of colorectal cancer patients undergoing colostomy. Data was transcribed and analyzed using Colaizzi′s method.Results:Three themes were extracted: family crisis and coping pressure including increased burden of care, accompanying emotional internal friction, heavy economic pressure; internal adjustment and adaptation within the family including positive family beliefs, timely adjustment of family roles, clear and effective communication and interaction; integration and utilization of external resources including active access to information, medical professional support, social external support.Conclusions:With the help of the perspective of family advantage, medical staff should pay attention to the evaluation of care needs and family resilience of colorectal cancer patients′ spouses, to fully mobilize advantage resources and give effective intervention measures to improve the family and social adaptation level of patients and their spouses.

【Objective】 To investigate and summarize the clinical and imaging features of a few patients with coronavirus disease 2019 (COVID-19) in Lanzhou City. 【Methods】 We carried out a retrospective analysis of the epidemiological data, laboratory results and clinical imaging features of eight hospitalized patients with confirmed COVID-19 in The First Hospital of Lanzhou University from January 23 to February 23, 2020. 【Results】 The sex ratio (men to women) of the 8 patients was 5∶3 while their age ranged from 24 to 57 years old. The incubation period was 1-10 days. Of the 8 patients, 7(87.5%) had COVID-19 brought in from other places in China and 1(12.5%) was a secondary infection case. The main clinical manifestations included cough in 6 cases (75%), fever in 4 cases (50%), expectoration in 3 cases (37.5%), and fatigue in 2 cases (25%). All the 8 cases indicated abnormal manifestations in blood routine examinations, 4 cases (50%) decreased in WBC, 7 cases (87.5%) decreased in Lym count, 5 cases (62.5%) increased in LDH, 1 case (12.5%) increased in CK, 1 case(12.5%) increased in CK-MB, 4 cases (50%) increased in CRP, 2 cases (25%) increased in PCT, and 1 case (12.5%) increased in D-dimer. Of the 2 patients examined by chest digital radiography (DR), one DR finding was not typical and the other one suggested increased bilateral lung markings. Six patients were examined by HRCT, of whom four (50%) showed multiple ground glass opacities on both lobes and two (25%) showed multiple ground glass opacities only on the right lobe; none of the 6 imaging findings suggested pleural effusion. Six patients were discharged from hospital after being cured and 1 patient still underwent treatment. 【Conclusion】 Most of these 8 patients had COVID-19 imported from outside the city, and the patients were relatively young with few underlying diseases. Their major symptoms were fever, cough, and expectoration. All of them exhibited abnormal findings in blood routine examinations; half of them suggested increased CRP while a few ones showed abnormal CK and Ddimer values. The imaging manifestations of most patients were multiple ground glass opacities near the peripheral pleura.

Objective To observe the alteration and clinical significances of blood coagulation indicators in patients with lymphoplasmacytic lymphoma (LPL). Methods Twenty patients who were newly diagnosed LPL in the First People's Hospital of Changzhou from January 2008 to October 2017 and twenty healthy controls were studied. The patients were treated by chemotherapy, plasma exchange, supplement of coagulation factor or other supportive therapy. The parameters of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-dimer (D-D), and platelet count (Plt) were detected in LPL group and healthy controls. Results The levels of PT and APTT in LPL group were dramatically higher than those in control group [(12.9±1.2) s vs. (11.6±0.9) s, (41.7±9.8) s vs. (24.7±2.9) s], and the level of Plt in LPL group was lower than that in control group [112×109/L (3×109/L - 379×109/L) vs. 210×109/L (170×109/L - 271×109/L)], and the differences were statistically significant (all P< 0.05). There were no significant differences in FIB, TT and D-D levels between LPL group and control group (all P ＞0.05). There were no statistical differences in PT, APTT, FIB, TT, D-D and Plt levels among LPL patients with different types of immunoglobins (all P ＞ 0.05). After treatment, all the coagulation abnormalities got relieved and no patient died of hemorrhage or thrombosis. Conclusions The LPL patients have coagulation disorders and hypercoagulability, and this is independent of the type of immunoglobulin. Clinical attention should be paid to monitoring coagulation indicators to prevent the occurrence of adverse reactions.

Objective To analyze the risk factors related to adult patients of primary immune thrombocytopenia with infection,so as to provide basis for control and prevention of infection. Methods From January 2015 to December 2017,the clinical data of 166 adult patients of primary immune thrombocytopenia in the People's Hospital of Shaoxing-were retrospectively analyzed. Statistical analysis was performed by SPSS21. 0 statistical software. Results The infec-tion rate was 24. 70％ (41 / 166). The risk factors related to infection were age(OR = 1. 290,P = 0. 011),the number of bone marrow megakaryocytes(OR = 1. 220,P = 0. 022),diabetes(OR = 2. 163,P < 0. 001) and glucocorticoid (OR =2. 203,P <0. 001). There were 45 strains of pathogenic bacteria detected in 41 patients,gram negative bacteria accounted for 51. 11％ (23 / 45),gram positive bacteria accounted for 44. 44％ (20 / 45),and fungi accounted for 4. 44％ (2 / 45). Conclusion A variety of factors are related to infection in adult primary immune thrombocytopenia patients. It is necessary to take effective prevention measure,which will help reduce the incidence of infection.

Objective To detect and analyze nuclear factor kappa B (NF-κB),Helicobacter pylori (HP),Helicobacter pylori cytotoxin associated protein A (CagA),platelet (PLT) and platelet associated IgG (PA IgG) in 224 patients with idiopathic thrombocytopenic purpur(ITP) from three urban hospitals of Shaoxing,in order to explore the role of NF-κB and CagA in the pathogenesis of ITP,then to improve the prognosis of ITP.Methods SABC method was used to detect the NF-κB,13C breath test for the determination of the Hp infection.CagA and PA-IgG were tested by enzyme linked immunosorbent assay.Automatic blood cell analyzer was used to measure PLT.According to the test results,the patients were divided into Hp+cagA+NF-κB+,Hp+cagA+NF-κB-,Hp+cagA-NF-κB+,Hp+cagA-NF-κB-,Hp-NF-κB+,Hp-NF-κB-PLT groups,and PA-IgG,PLT of the six groups were statistically analyzed.Results Of 224 cases with ITP,175 cases of HP positive,the positive rate was 78.13%.CagA+ 91 cases in 175 cases of Hp+,accounting for 52%,overall 43.63%.NF-kappa B+ 108 cases,the positive rate was 46.21%,78 cases were found in Hp+cagA+,accounting for 85.71% in cagA+.In 84 cases of Hp+cagA-,there were 21 cases NF-κB+,the positive rate was 25%.In 49 of HP-,9 cases with NF-kappa B+,accounting for 18.37%.PLT and PA-IgG were compared among the groups.The count of PLT of group Hp+,group Hp+cagA+ and group NF-κB+ was lower than group Hp-,group Hp+cagA- and group NF-κB-.However,the level of PA-IgG of group Hp+,group Hp+cagA+ and group NF-κB+ was higher than group Hp-,group Hp+cagA- and group NF-κB-,the difference was statistically significant(P<0.05).Conclusion CagA maybe directly or through the activation of NF-kappa B take part in the immune response of ITP,cause PA-IgG increased and thrombocytopenia.

Purpose To evaluate the diagnostic value of high-frequency ultrasonography (HFUS) in the diagnosis of rheumatoid arthritis (RA) Achilles tendinopathy.Materials and Methods The Achilles tendon HFUS findings in 67 cases including a total of 93 feet were analyzed retrospectively,among which,11 cases including 22 feet were set as healthy control group (group A),36 cases including 40 feet as RA Achilles tendon group (group B) and 20 cases including 31 feet as non RA Achilles tendon group (group C).HFUS was used to observe the gray-scale imaging (GSI) and power Doppler imaging (PDI) features of the Achilles tendon:① the positive rate of Achilles tendon GSI abnormality.② The thickness and width of the starting point,mid point and ending point of Achilles tendon.③ The detection rate of retrocalcaneal bursal effusion.④ The detection rate of blood flow signal in the internal Achilles tendon.⑤ The level of blood flow signal.The data of each group were compared and analyzed.Restlts ① The positive rate of Achilles tendon GSI abnormality:there was no significant difference between group A and group B (x2=0.064,P＞0.05).Compared with group A and group B,group C had higher rate of abnormalities (x2=31.601 and 39.256,P＜0.05).② The thickness and width of Achilles tendon:the thickness of each point increased in group C than that in group A and group B (P＜0.05),and there was no significant difference in width between groups (P＞0.05).③ The detection rate of retrocalcaneal bursal effusion:negative in group A.The detection rate of group B (55％) was higher than that of group C (19.4％),the difference was statistically significant (P＜0.05).④ The detection rate of blood flow signal in the Achilles tendon:negative in group A.The detection rate of group B (97.5％) was higher than that of group C (45.2％),the difference was statistically significant (P＜0.05).⑤ The level of blood flow signal:level Ⅰ signal detection rate in group B (7.5％) was lower than that in group C (35.5％),while level Ⅱ signal detection rate in group B (35.0％) was higher than that of group C (9.7％),the differences were statistically significant (P＜0.05).Level Ⅲ signal was detected in only group B (45.0％) while not detected in group C.In addition,aspiration biopsy was performed on 3 patients of whom the fat pad of Achilles tendon was involved by level Ⅲ blood flow signal in PDI,and the pathological findings were consistent with ultrasonic manifestations.Conclusion HFUS is of great value in the diagnosis of RA Achilles tendinopathy and it can also be used to distinguish from non-RA Achilles tendinopathy.Moreover,it helps to achieve early diagnosis and early treatment in clinic to avoid Achilles tendon rupture and other bad progresses.

Objective To discuss the feasibility and accuracy of left atrial appendage (LAA)ejection fraction by real-time 3 dimensional imaging (3D-EF),and tissue velocity of the LAA wall by tissue Doppler imaging (TDI)via transesophageal echocardiography (TEE)in assessing LAA functions.Methods A total number of 76 patients with atrial fibrillation (AF)were included in the study consecutively and underwent TEE for LAA investigations.3D-EF,fractional area change by 2 dimensional imaging (2D-FAC),peak emptying velocity (PEV),LAA tissue velocity by TDI at the mid-portion of lateral wall (TDI-L),mid-portion of septal wall (TDI-S)and the apical tip (TDI-A)were calculated.Results Statistic analysis showed the following results:1 )2D-FAC,3D-EF,PEV,TDI-L,TDI-S and TDI-A were all significantly higher in patients with sinus rhythm than those with AF during the TEE examinations (all P <0.05),and significantly higher in patients without spontaneous echo contrast (SEC)than those who had SEC (all P <0.05);2)The results of 3D-EF showed a good correlation with 2D-FAC (r=0.727,P =0.000),and their correlations with PEV were similar (2D-FAC and PEV:r =0.685;3D-EF and PEV:r =0.632,both P =0.000);3)TDI-A [(14.95±4.63)cm/s]were significantly higher than TDI-L [(12.62±3.96)cm/s]and TDI-S [(12.68±3.59)cm/s](both P =0.000).The correlations of TDI-A with PEV,2D-FAC and 3D-EF were all marked higher than those of TDI-L and TDI-S (with PEV:r=0.840 vs r=0.564,r=0.524;with 2D-FAC:r=0.701 vs r=0.486,r=0.504;with 3D-EF:r=0.753 vs r=0.493,r=0.522,all P <0.05). Conclusions 3D TEE is feasible and reliable in assessing LAA emptying function.The best location for LAA tissue velocity evaluation is the apical tip.

Objective To compare the clinicopathological characteristics and prognosis of primary Waldeyer's ring non-Hodgkin lymphoma.Methods From Jan 2008 to Dcc 2013, 50 patients with primary Waldeyer's ring non-Hodgkin lymphoma were retrospectively analyzed.Kaplan-Meier method was used for survival analysis.Log-rank method was used for univariate analysis.Results Waldeyer's ring diffuse large B-cell lymphoma (DLBCL) and extranodal nasal-type NK/T-cell lymphoma (ENKTCL) were the common pathological types of primary Waldeyer's ring non-Hodgkin lymphoma accounting for 56 ％ (28/50) DLBCL and 34 ％ (17/50) ENKTCL, respectively.The age at onset of ENKTCL patients was younger than that of DLBCL patients.Two groups had different primary sites, including 50.0 ％ (14/28) of DLBCL with tonsillar disease and 88.2 ％ (15/17) of ENKTCL with nasopharynx disease.The short phase effect of DLBCL group was higher than that of ENKTCL group.The overall survival (OS) and progression-free survival (PFS) rates had significant differences between DLBCL and ENKTCL (x2 =4.45, P =0.035;x2=6.47, P =0.011).Conclusion DLBCL and ENKTCL are different in clinical characteristics.The short phase effect and prognosis of DLBCL are obviously better than those of the ENKTCL.