Objective To compare the early embryonic developmental potential and clinical outcomes of oocytes matured in vivo and those matured by modified in vitro maturation(LVM)technology during the same controlled ovarian hyperstimulation(COH)cycle,and to explore the clinical application of melatonin-supplemented IVM technology.Methods 159 patients were recruited into the study.920 mature oocytes were collected during their COH cycles processed for conventional IVF/ICSI protocols,while 1 283 immature oocytes from the same cycles were matured in a melatonin-supplemented IVM medium before ICSI was performed.A retrospective analysis was conducted to compare the impact of conventional assisted reproductive technology and improved IVM technology on the outcomes of assisted reproductive therapy and pregnancy outcomes.Results Compared with mature oocytes collected from COH cycles treated with conventional IVF/ICSI,oocytes promoted by improved melatonin-supple-mented IVM technology had a lower rate of high-quality blastocyst formation.However,after embryo transfer,there was no significant difference in the clinical outcomes of mature oocytes obtained through two methods,including clinical pregnancy rate,full-term birth rate,neonatal length,and neonatal Apgar score.Conclusion The applica-tion of melatonin-supplemented IVM significantly increases the utilization of immature oocytes collected from COH cycles,improving the pregnancy outcomes of patients assisted by assisted reproductive technology.

Objective:To evaluate knee biomechanics of patients about 12 months after anterior cruciate ligament(ACL)reconstruction during cutting and determine the abnormal biomechanical characteristics.Methods:Sixteen males about 12 months after ACL reconstruction were recruited for this study.Three-dimensional kinematic and kinetic data were collected during cutting movement.Knee joint angles and moments were calculated.Paired t-tests were used to compare the differences in knee biomechanics be-tween the surgical leg and nonsurgical leg.Results:The peak posterior ground reaction force(surgical leg:0.380±0.071;nonsurgical leg:0.427±0.069,P=0.003)and vertical ground reaction force(surgical leg:1.996±0.202,nonsurgical leg:2.110±0.182,P=0.001)were significantly smaller in the surgical leg than in the nonsurgical leg.When compared with the uninjured leg,the surgical leg demonstrated a smaller knee flexion angle(surgical leg:38.3°±7.4°;nonsurgical leg:42.8°±7.9°,P＜0.001)and larger external rotation angle(surgical leg:10.3°±2.4°;nonsurgical leg:7.7°±2.1°,P=0.008).The surgical leg also demonstrated a smaller peak knee extension moment(surgical leg:0.092±0.031;nonsurgical leg:0.133±0.024,P＜0.001)and peak knee external rotation moment(surgical leg:0.005±0.004;nonsurgical leg:0.008±0.004,P=0.015)when com-pared with the nonsurgical leg.Conclusion:The individuals with ACL reconstruction mainly showed asymmetrical movements in the sagittal and horizontal planes.The surgical leg demonstrated a smaller peak knee flexion angle,knee extension moment,and knee external rotation moment,with greater knee external rotation angle.

Objective:To evaluate and summarize the best evidence of energy and protein intake targets and calculation in adult critically ill patients, and to provide evidence-based basis for critical nutrition management.Methods:Evidence related to energy and protein intake targets and calculation of adult critically ill patients, including guideline, expert consensus, systematic review and evidence summary, were systematically searched in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), Web of Science, SinoMed, Medive, China National Knowledge Infrastructure, Wanfang database, VIP database, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), and Society of Critical Care Medicine (SCCM) from January 2012 to June 2022. Two researchers independently evaluated the quality of the included literatures using the JBI Evidence-based Health Care Center evaluation tool and the Appraisal of Clinical Practice Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), extracted and summarized the best evidence for the nutritional intake goal and calculation of adult critically ill patients, and described the evidence.Results:A total of 18 literatures were included, including 5 clinical guidelines, 8 expert consensus, 3 systematic reviews and 2 evidence summaries. After literature quality evaluation, 18 articles were all enrolled. The evidence was summarized from the four aspects, including energy target calculation method, dose body weight, energy and protein intake target, and calculation method, 24 pieces of the best evidence were finally formed.Conclusions:The best evidence of energy and protein intake targets and calculation for critically ill patients was summarized based on evidence-based. Clinical medical staff can choose indirect calorimetry to calculate energy goals when equipment is available. Patient's height, body weight should be recorded accurately, dose body weight can be determined by body mass index (BMI). Meanwhile, blood urea nitrogen (BUN) loss, fat-free body weight, simple formulas and other methods should be used to continuously evaluate and adjust protein intake targets, to achieve the purpose of optimizing intensive nutrition support.

Objective:To develop a recombinase-aided amplification (RAA)-clustered regularly interspaced short palindromic repeats(CRISPR)/Cas12a-based nucleic acid assay for monkeypox virus with high specificity and sensitivity.Methods:RAA primers and CRISPR RNA (crRNA) were designed based on the known conserved regions of the monkeypox virus gene and synthesized, and specific crRNAs were screened using fluorescence detection. The sensitivity and specificity of the detection system were evaluated.Results:An RAA-CRISPR/Cas12a-based nucleic acid assay for monkeypox virus was developed with a sensitivity of 2.5 copies/reaction and high specificity without cross-reactivity with ectromelia virus and vaccinia virus.Conclusions:An RAA-CRISPR/Cas12a-based nucleic acid assay for monkeypox virus was established, which would provide a powerful tool for efficient, rapid and specific detection of monkeypox virus.

Objective : To investigate the expression characteristics of mu opioid receptor ( MOR) in rat colon smooth muscle cells by cultured rat primary colonic smooth muscle cells . Methods : colonic smooth muscle cells were isolated , cultured and identified ; immunofluorescence double labeling method was used to observe the distribution characteristics of MOR , Endomorphin⁃2 (EM2) , and calmodulin (CaM) in colonic smooth muscle cells ; Western Blot method was used to detect the expression of MOR and EM2 in smooth muscle cells of the colon . After the intervention measures Acetylcholine (ACh) ( 1 × 10 - 3 mol/L) and EM2 (2 μmol/L) were applied , the changes of CaM protein expression were observed ; The calciumion imaging method was used to detect the changes of calciumi on concentration in smooth muscle cells. Results: The colonic smooth muscle cells were cultured and identified . The positive cells labeled with α ⁃smooth muscle actin ( α ⁃SMA) accounted for more than 95% of the total number of cells . Immunofluorescence double labeling showed that there were MOR and EM2 distributions in colonic smooth muscle cells , and all MOR and EM2 positive cells coexisted with α ⁃SMA . Western Blot results showed that there were MOR and EM2 expressions in colonic smooth muscle cells . CaM in the ACh group significantly increased at 10 minutes (P < 0. 05) , CaM in the EM2 group significantly decreased ( P < 0. 05) ; The calciumion imaging results showed that alone applied ACh , the calciumion concentration in smooth muscle cells significantly increased ( P <0. 05) ; Alone applied EM2 , the calciumion concentration in colonic smooth muscle cells was down⁃regulated (P <0. 05) ; Applied ACh and EM2 sequentially , EM2 significantly reduced the increase of the calciumion concentration in smooth muscle cells induced by ACh (P < 0. 05) . Conclusion MOR and EM2 are expressed in colonic smooth muscle cells , and EM2 may inhibit the expression of CaM and reduce the concentration of calcium ions through MOR .

With the wide application of tyrosine kinase inhibitor (TKI), to obtain treatment-free remission (TFR) has gradually become the long-term goal for patients with chronic myelogenous leukemia (CML). Self-renewing leukemia stem cells during disease progression are related with the recurrence, and surveillance of residual leukemic cells is hypothesized to be one of the critical factors in successful TFR. On the way to obtain TFR, many breakthroughs have been made in innate and adaptive immunity of CML cells. This paper reviews the immune function of CML patients, the role of the immune markers in maintaining TFR, and the exploration of TKI combined with new immunomodulator therapy to achieve a greater degree of TFR.

Objective:To improve the consistency of test results through reducing inter-laboratory variation in SARS-CoV-2 antibody detection with WHO SARS-CoV-2 antibody candidate international standard (IS, sample G) and antibody reference panel (samples E, F, H, I, J).Methods:Ten WHO samples (A-J) including the candidate IS and reference panel were evaluated using different methods, such as microneutralization tests based on live SARS-CoV-2, pseudovirus neutralization assay and commercial ELISA kits. The test results were compared using statistical analysis.Results:Using IS (sample G) as a reference, the relative concentrations of other samples could be determined with less variation. ELISA and pseudovirus neutralization assay had consistent results with those obtained with the microneutralization test based on SARS-COV-2 strain HB02. Weakly positive samples could be detected only by a certain kit.Conclusions:The availability of an IS for antibodies would facilitate the standardization of SARS-CoV-2 antibody detection methods. The reference panel fitted all the assays based on the SARS-CoV-2 prototype Wuhan strain. Pseudovirus neutralization assay and ELISA could be used as alternatives to live SARS-CoV-2-based neutralization test to some extent.

Objective:To explore the clinical effect of Intensive Care Unit (ICU) catheter whole life cycle management system.Methods:An ICU catheter whole life cycle management system was constructed and applied in clinical practice. This study collected data on catheter management and hospital infection of patients in ICU of Zhejiang Hospital before the application of the catheter whole life cycle management system from April to December 2019 and after the application of the catheter whole life cycle management system from April to December 2020. The accuracy of catheter recording, the compliance rate of daily catheter nursing quality, and the incidence of major catheter-associated infections were compared before and after the application of the ICU catheter whole life cycle management system. The time-consuming of catheter information recording under the two methods of applying the ICU catheter whole life cycle management system and computer manual input was analyzed, and the nurses' experience of using the ICU catheter whole life cycle management system was investigated through semi-structured interviews.Results:After the application of the ICU catheter whole life cycle management system, the accuracy rate of catheter recording increased from 89.96% (22 491/25 001) to 96.09% (30 897/32 155) , and the difference was statistically significant ( P<0.05) . The compliance rate of daily catheter nursing quality increased from 89.81% (22 453/25 001) to 95.94% (30 849/32 155) , and the difference was statistically significant ( P<0.05) . There was no significant difference in the incidence of major catheter-associated infections before and after system application ( P>0.05) . In addition, the time-consuming of catheter recording by nurses using the ICU catheter whole life cycle management system was less than that of manual input by computer, and the difference was statistically significant [ (0.98±0.28) min vs. (1.78±0.50) min, P<0.05] . The semi-structured interview results showed that nurses had a good experience in using the ICU catheter whole life cycle management system. Conclusions:The ICU catheter whole life cycle management system provides nurses with a systematic, convenient and standardized catheter management method. The system has a good user experience, can improve the accuracy of nurse catheter recording and the catheter nursing quality, and shorten catheter recording time. However, further studies are needed to confirm whether it helps to reduce the incidence of major catheter-associated infections.

Objective:To systematically evaluate the application effect of high flow nasal cannula (HFNC) in patients with chronic obstructive pulmonary disease (COPD) .Methods:Cochrane Library, PubMed, Ovid, CNKI, Wanfang database and other Chinese and English databases were searched for randomized controlled trials or cohort studies on the effect of HFNC in COPD patients. The retrieval time limit was from the establishment of the databases to September 30, 2021. Two researchers independently screened the literature, evaluated quality of the literature and extracted data. RevMan 5.0 software was used to conduct a meta-analysis on the literature that met the inclusion criteria.Results:A total of 8 literatures were included, including 4 English literatures and 4 Chinese literatures, with a sample size of 575 cases. Meta-analysis results showed that there were no statistically significant statistical differences between the HFNC group and the non-invasive mechanical ventilation group patients in the 24-hour heart rate [ WMD=-2.65, 95% CI (-7.17-1.86) , P=0.25], 24-hour mean arterial pressure [ WMD=0.45, 95% CI (-3.10-4.00) , P=0.80], 24-hour arterial partial pressure of oxygen [ WMD=-0.08, 95% CI (-0.89-0.74) , P=0.85], 24-hours arterial blood carbon dioxide partial pressure [ WMD=-0.96, 95% CI (-2.29-0.36) , P=0.15], 24-hour oxygenation index [ WMD=0.87, 95% CI (-4.85-6.58) , P=0.77], length of stay in ICU [ WMD=-0.83, 95% CI (-1.79-0.14) , P=0.09], tracheal intubation rate [ RR=0.98, 95% CI (0.58-1.64) , P=0.93], incidence of aspiration [ RR=0.30, 95% CI (0.08-1.18) , P=0.08]and 28-day mortality rate [ RR=1.12, 95% CI (0.61-2.03) , P=0.72] ( P>0.05) . Compared with non-invasive mechanical ventilation, HFNC could reduce the 24-hour respiratory rate in COPD patients [ WMD=-0.78, 95% CI (-1.48--0.08) , P=0.03], the incidence of nasal and facial pressure injury [ RR=0.14, 95% CI (0.05-0.39) , P=0.000 1] and improved 24-hour arterial blood pH [ WMD=0.03, 95% CI (0.01-0.04) , P<0.01]. Conclusions:Compared with non-invasive mechanical ventilation, HFNC can reduce the 24-hours respiratory rate, the incidence of nasal and facial pressure injury and improve the 24-hours arterial blood pH in COPD patients. However, more high-quality, multicenter randomized controlled trials are needed to verify the results of this study in the future.

Objective:To systematically evaluate the application effect of high flow nasal cannula (HFNC) in patients with chronic obstructive pulmonary disease (COPD) .Methods:Cochrane Library, PubMed, Ovid, CNKI, Wanfang database and other Chinese and English databases were searched for randomized controlled trials or cohort studies on the effect of HFNC in COPD patients. The retrieval time limit was from the establishment of the databases to September 30, 2021. Two researchers independently screened the literature, evaluated quality of the literature and extracted data. RevMan 5.0 software was used to conduct a meta-analysis on the literature that met the inclusion criteria.Results:A total of 8 literatures were included, including 4 English literatures and 4 Chinese literatures, with a sample size of 575 cases. Meta-analysis results showed that there were no statistically significant statistical differences between the HFNC group and the non-invasive mechanical ventilation group patients in the 24-hour heart rate [ WMD=-2.65, 95% CI (-7.17-1.86) , P=0.25], 24-hour mean arterial pressure [ WMD=0.45, 95% CI (-3.10-4.00) , P=0.80], 24-hour arterial partial pressure of oxygen [ WMD=-0.08, 95% CI (-0.89-0.74) , P=0.85], 24-hours arterial blood carbon dioxide partial pressure [ WMD=-0.96, 95% CI (-2.29-0.36) , P=0.15], 24-hour oxygenation index [ WMD=0.87, 95% CI (-4.85-6.58) , P=0.77], length of stay in ICU [ WMD=-0.83, 95% CI (-1.79-0.14) , P=0.09], tracheal intubation rate [ RR=0.98, 95% CI (0.58-1.64) , P=0.93], incidence of aspiration [ RR=0.30, 95% CI (0.08-1.18) , P=0.08]and 28-day mortality rate [ RR=1.12, 95% CI (0.61-2.03) , P=0.72] ( P>0.05) . Compared with non-invasive mechanical ventilation, HFNC could reduce the 24-hour respiratory rate in COPD patients [ WMD=-0.78, 95% CI (-1.48--0.08) , P=0.03], the incidence of nasal and facial pressure injury [ RR=0.14, 95% CI (0.05-0.39) , P=0.000 1] and improved 24-hour arterial blood pH [ WMD=0.03, 95% CI (0.01-0.04) , P<0.01]. Conclusions:Compared with non-invasive mechanical ventilation, HFNC can reduce the 24-hours respiratory rate, the incidence of nasal and facial pressure injury and improve the 24-hours arterial blood pH in COPD patients. However, more high-quality, multicenter randomized controlled trials are needed to verify the results of this study in the future.