[Objective] To investigate the effects of advanced male age on the incidence of polyspermy fertilization. [Methods] The study involved data of 4210 in vitro fertilization (IVF) cycles treated in our center during Jan.2016 and Sep.2022, including 4053 patients younger than 40 years and 157 patients above 40 years.After propensity score matching, 152 patients in the advance group and 421 in the young group were recruited.The baseline data and the difference in polyspermy fertilization rate were compared between the two groups. [Results] After propensity score matching, there were no significant differences between the two groups in terms of female age, infertility type, infertility years, infertility factors, female body mass index (BMI), male BMI, semen volume, semen pH value, sperm concentration, sperm motility, progressive motility rate, percentage of normal sperm morphology, number of fertilized eggs and number of MⅡ eggs (P>0.05). Among the 573 fresh IVF cycles, the rate of 3 PN cycles was 35.5%, and the incidence of polyspermy fertilization was 6.5%.There were no significant differences in the number of polyspermy fertilized eggs, transferable embryos, high-quality embryos, and blastocysts between the two groups. [Conclusion] Advanced male age has no significant effect on the incidence of polyspermy fertilization.

【Objective】 To observe the effects of paternal age on the pregnancy outcomes in frozen embryo transfer (FET) cycles. 【Methods】 The clinical data of two groups after propensity score matching (PSM) were retrospectively analyzed, including 738 cycles in the <40 year group and 387 cycles in the 40-60 year group. The differences in general information and pregnancy outcomes were compared between the two groups, and logistic regression analysis of pregnancy outcomes were conducted. 【Results】 There were no statistical differences in age, duration of infertility, female body mass index (BMI), infertility factors, fertilization method, endometrial preparation methods, endometrial thickness on the day of transformation, stage of embryo transfer, number of embryos transferred, and number of high-quality embryos between the two groups after PSM (P>0.05). The clinical pregnancy rate (52.2%vs. 67.2%) and live birth rate (41.1% vs. 57.2%) decreased in the 40-60 year group compared with those in the <40 year group (P<0.001), but there was no statistical difference in abortion rate (19.8% vs. 13.7%) (P>0.05). 【Conclusion】 Advanced paternal age decreases clinical pregnancy rate and live birth rate.

Objective:To explore the diagnostic value of chromosome karyotype analysis, chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in microcephaly.Methods:A total of 9 cases of microcephaly fetuses diagnosed by prenatal ultrasound or children with microcephaly diagnosed after birth were selected from the Sixth Affiliated Hospital of Guangzhou Medical University from January 2014 to August 2022.Karyotype analysis and/or CMA were used to detect. The cases with negative karyotype analysis and CMA results were further sequenced by trio-based WES (Trio-WES). Then the coding genes contained in the pathogenic copy number variation (CNV) fragments were analyzed by gene ontology (GO) enrichment. The genes related to the development of the central nervous system contained in the pathogenic CNV and the pathogenic genes found by Trio-WES were combined for gene interaction network analysis.Results:In this study, 9 cases of microcephaly were recruited, with the time of diagnosis ranged from 23 weeks of gestation to 7 years after birth, and the head circumference of fetus or children ranged from 18.3 to 42.5 cm (-7SD to -2SD). Karyotype analysis was detected in all 9 cases and no abnormality result was found. Eight cases were detected by CMA, and one abnormal was found. Five cases were detected by Trio-WES, and two cases were detected with likely pathogenic genes. The GO enrichment analysis of the coding gene in the 4p16.3 microdeletion (pathogenic CNV) region showed that: in biological process, it was mainly concentrated in phototransduction, visible light; in terms of molecular function, it was mainly concentrated in fibroblast growth factor binding; in terms of cell components, it was mainly concentrated in rough endoplasmic reticulum. Gene interaction network analysis suggested that CDC42 gene could interact with CTBP1, HTT and ASPM gene.Conclusions:CMA could be used as a first-line detection technique for microcephaly. When the results of chromosome karyotype analysis and/or CMA are negative, Trio-WES could improve the detection rate of pathogenicity of microcephaly.

Objective:To study and analyze the application effect of risk prevention and quality control nursing in peritoneal dialysis patients with renal failure.Methods:From January to December 2019, a total of 86 patients with renal failure in the Affiliated Hospital of Jining Medical College were recruited as the research objects by convenient sampling method. All the objects were divided into the observation group (43 cases) and the control group (43 cases) by the random number table method. The control group was treated with traditional risk prevention and control nursing, while the observation group was treated with risk prevention and control quality control nursing. The changes of albumin, hemoglobin, creatinine, blood urea nitrogen were compared between the two groups before and after intervention, and the incidence of complications such as peritonitis, catheter outlet infection, water retention and hypokalemia were compared between the two groups.Results:After the intervention, the albumin and hemoglobin levels of the observation group were higher than those of the control group, and the levels of creatinine and urea nitrogen in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.01) . During the intervention, the complication rate of the observation group was 23.26% (10/43) , which was lower than 46.51% (20/43) of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Risk prevention and quality control nursing in peritoneal dialysis patients with renal failure can improve renal function and reduce the occurrence of complications.

Pulmonary embolism (PE) refers to the endogenous or exogenous emboli blocking pulmonary trunk or branches, causing clinical and pathophysiological syndrome of pulmonary circulation disorder, the incidence rate is high. Sometimes PE patients were lack of specific symptoms and signs, or without any symptoms, which often result in misdiagnosis, un-timely diagnosis, and the delay of treatment. A PE case with syncope, vomiting and shock, which was proved to be pulmonary artery trunk and branch wide embolism later, was presented so as to improve the understanding of the disease.

Objective To explore the impacts of over-expression of microRNA-7 (miRNA-7) on the sensitivity of cis-platin in esophageal carcinoma cell line TE-1, and the possible mechanism thereof. Methods Lipofectmin 2000 method was used to transient transfect with miRNA-7 mimic into esophageal cancer cell line TE-1, which was taken as transfection group, mimic negative control was taken as transfection conrtol group. The expressions of miRNA-7 and epidermal growth factor receptor (EGFR) mRNA were detected by RT-PCR in the above two groups and normal control group. The total EGFR and EGFR in cytoplasmic and nucleus were detected with Western blot assay in transfection group and transfection control group. CCK-8 was used to detect IC50 of cisplatin in transfection group and transfection control group. The expression of EGFR was observed with immunofluorescence confocal microscope in two groups. Results The miRNA-7 expression was signifi-cantly increased in transfection group than that of transfection conrtol group and control group. The expression of EGFR mRNA was significantly reduced in transfection group (P<0.001). The total EGFR was significantly decreased in transfec-tion group than that of transfection conrtol group. The level of nuclear EGFR was significantly increased ( P<0.01),and cyto-plasm EGFR expression was significantly decreased in transfection group than that of transfection control group ( P<0.05). CCK-8 results showed that after the over expression of miRNA-7 in TE-1, the IC50 of cisplatin (48 h) increased in transfec-tion group than that of control group (P<0.01). Immunofluorescence results showed that EGFG in nuclear was higher in transfection group than that of transfection control group but its expressions reduced in cell membrane and cytoplasm. Con-clusion The over-expressed miRNA-7 in esophageal cancer cells TE-1 can reduce cisplatin sensitivity by the increased EGFR in nuclear translocation.

BACKGROUND:Poststroke depression is one of the most common psychological behavior disorders after stroke and its mechanism remains unclear. Studies have suggested that microRNAs (miRNAs) involved in neurogenesis and synaptogenesis may play an important role in psychology diseases. OBJECTIVE:To observe the expression of miR-137 in the blood and brain of poststroke depression rats and its effect on the behaviors of rats. METHODS:Thirty-six rats were equal y divided into six groups:control, model, agomir-137, agomir-NC, agomir-137+Grin2A and agomir-137+vector groups. Control group had no treatment. Poststroke depression models were established by ligation of middle cerebral artery and chronic mild stimulation in the latter four groups fol owed by receiving an injection of nothing, agomir-137, agomir-NC, LV-CMV-Grin2A or control plasmids into the left lateral ventricle, respectively. RESULTS AND CONCLUSION:We found significantly lower miR-137 levels in the brain and peripheral blood of post-stroke depression rats compared with normal rats. Vertical scores and horizontal scores on the behavior test were significantly higher in the agomir-137 group than the agomir-NC and model groups at 3 weeks after cerebral ischemia;while, sucrose consumption percentage was also higher in the agomir-137 group at the end of 2 weeks after cerebral ischemia. Luciferase assays showed miR-137 bound to the 3’ UTR of Grin2A, regulating Grin2A expression in a neuronal cel line. Grin2A gene overexpression in the brain of post-stroke depression rats noticeably suppressed the inhibitory effect of miR-137 on post-stroke depression. Overal , these findings show that miR-137 suppresses Grin2A protein expression through binding to Grin2A mRNA, thereby exerting an inhibitory effect on post-stroke depression and offering a new therapeutic target for poststroke depression.

Objective To evaluate the possible correlation between anxiety state and serum angiontensin Ⅱ levels in patients with vitiligo.Methods Sixty patients with progressive vitiligo and 30 normal human controls were included in this study.Self-rating anxiety scale (SAS) was used to evaluate the anxiety state,and enzyme linked immunosorbent assay was performed to determine the serum level of angiontensin Ⅱ,in these subjects.Results SAS score was significantly increased in patients compared with the controls (46.13 ±11.72 vs.36.73 ± 12.59,t =3.50,P ＜ 0.01),and 48.3％ of the patients were affected by anxiety.The SAS score and prevalence of anxiety were statistically higher in female than in male patients (t =2.47,x2 =4.58,both P ＜ 0.05),in unmarried than in married patients (t =2.59,P ＜ 0.01; x2 =6.17,P ＜ 0.05),in patients with lesions on exposed areas than in those with lesions on unexposed areas (t =3.60,P ＜ 0.01; x2 =5.84,P ＜0.05).In patients affected by anxiety,the level of serum angiontensin Ⅱ was significantly elevated compared with patients without anxiety (63.83 ± 10.92 vs.40.74 ± 8.70 ng/L,t =9.09,P ＜ 0.01 ).Conclusions Patients with vitiligo are usually affected by anxiety.The serum level of angiontensin Ⅱ is closely correlated with anxiety state in patients with vitiligo as well as with the development of vitiligo,and may have an impact on the initiation and progression of vitiligo.

ObjectiveTo compare and analyze conventional plan and inverse optimized plan in dosemetric of cervical cancer. MethodTwenty cases of cervical cancer treated with combination radical radiotherapy of EBT were selected,every case had two plans: one was conventional plan based A point prescription dose, the other was inverse optimized plan (IPSA, inverse planning with simulated annealing)based volume object dose.ResultsIPSA plans provided better values compared with the conventional plans in 90％ prescription dose volume V90[ (94 ± 15 )％ vs. (60 ± 17 )％], 100％ prescription dose volume V100[(90 ± 18)％ vs. (56 ± 14)％]and 100％ treatment volume dose D100[(54 ± 10)％ vs. (29 ±9)％](P ＜0.05),respectively. Meanwhile the organ at risk received lower dose volume. ConclusionsPlans generated using IPSA provide higher dose to the target volume but with lower dose to normal structure and less time. This study can help to guide the clinical application.

Objective To evaluate the safety and efficacy of 125I radioactive seeds implantation combined with postoperative chemotherapy as a treatment option for thoracic advanced esophageal squamous cell carcinoma(ESCC). Methods A prospective cohort study was carried out between 2000and 2005. According to preoperative CT staging criteria,298 patients in phase Ⅱ-Ⅲ of ESCC, who had were admitted to Oncology Center Surgery of Nanjing First Hospital Affiliated to Nanjing Medical University and Thoracic Surgery of YanCheng Oncology Hospital, were randomly divided into three groups: intraoperative 125I seeds implantation combined with postoperative chemotherapy (group A, 98cases), postoperative chemoradiotherapy (group B, 100 cases) and surgery alone (group C, 100cases). All patients received radical resection of esophageal cancer. According to pTNM staging criteria after operation, 233 patients in phase Ⅱb-Ⅲ of ESCC were finally enrolled in the study (78 in group A, 75 in group B, and 80 in group C). With 0. 5 m Ci of single seed, total activity of 5-11 mCi and matched peripheral dose in 60-70 Gy, 10-22 125I seeds were implanted into the target of patients in group A under direct vision in accordance with treatment planning system. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X-ray imaging. The postoperative complications were observed. The local recurrence of the cancer was demonstrated using CT scan. The survival rate of patients was followed up for 1-,3-,5- and 10 years. Results The satisfied quality assessment of 125I seeds was observed. There was no displacement or loss of seed. The local recurrence in group A, B and C was 11. 5%, 13. 3% and 38. 8%, respectively, with statistical significance (P ＜ 0. 05). There was no significant difference among three groups with respect to complications and 1-year survival (P＞0. 05). However, the overall survival rate 3-, 5- and 10-years was 64.8%,37. 7% and 25. 1% in group A respectively; 63.3%, 36.9% and 24.9% in group Brespectively; 43. 6i%, 25.0%, and 12.6% in group C, respectively (all P＜0. 05). The 3-,5- and 10-year progression free survival rates were 63.5 %, 37.4 % and 15.1% in group A respectively; 62.5 %,36.6% and 14. 4% in group B respectively; 42.5%, 25.6% and 6.2% in group C respectively (all P＜0. 05). Conclusions It is a safe, effective and simple method for intraoperative 125I seeds implantation combined with postoperative chemotherapy in treatment of advanced ESCC, which may reduce the local recurrence and improve survival rates in patients with ESCC.