Objective:To compare the pregnancy and neonatal outcomes of in vitro fertilization-embryo transfer(IVF-ET)with fresh or frozen embryos in spouses of patients with severely low sperm concentration and motility.Methods:A total of 2300 patients whose spouses have severely low sperm concentration and motility underwent IVT-ET in the Reproduction Medicine Center,Sir Run Run Shaw Hospital from April 2018 to April 2022.After applying the propensity score matching(PSM),473 fresh embryo transferred cycles and 473 frozen embryo transferred cycles were selected for the study,and the pregnancy and neonatal outcomes were compared between the two groups.Results:There were no significant differences in pregnancy outcomes and neonatal outcomes between fresh and frozen embryo groups(all P＞0.05).In the stratification analysis,the number of retrieved oocytes in the fresh good-quality embryo transfer group was significantly increased compared with the fresh poor-quality embryo group(P＜0.05),but the very early pregnancy loss rates were similar between the two groups(P＞0.05),while the rate in fresh good-quality embryo transfer group was significantly higher than that in the frozen good-quality embryo transfer group(P＜0.05).Among different age groups of women,the number of retrieved oocytes and the level of estrogen in the fresh embryo transfer group was significantly higher in the 20 to＜30 years old group than that in the 30 to＜35 years old group(both P＜0.05),but the clinical pregnancy rate was lower in the 20 to＜30 years old group than that in the 30 to＜35 years old group(P＞0.05).Additionally,the very early pregnancy loss was significantly increased in the fresh embryo group compared with the frozen embryo group in the 20 to＜30 years age group(P＜0.05).Conclusions:There were no significant differences in pregnancy and neonatal outcomes between fresh and frozen embryo transfer in spouses of patients with severely low sperm concentration and motility undergoing IVF-ET.Due to the shorter transfer times,less embryo freezing damage and reduced costs,fresh embryo transfer can be considered as the first choice.However,it is not necessary to pursue fresh embryo transfer if maternal oestrogen levels are too high and there is a tendency of overstimulation.

OBJECTIVE To op timize the i ntegrated technology of producing area processing and decoction pieces processing of Curcuma longa （hereinafter refer to “integrated technology ”）. METHODS The content of ethanol-soluble extract in C. longa was determined by hot leaching method ；the contents of curcumin ，demethoxycurcumin and bisdemethoxycurcumin were determined by high performance liquid chromatography. On the basis of identification of producing area processing technology ， Using overall desirability （OD） value of the contents of ethanol-soluble extract ， curcumin， demethoxycurcumin and bisdemethoxycurcumin as evaluation indexes ，moisture content ，slice thickness and drying temperature as factors ，the integrated technology of C. longa was optimized by single factor tests combined with central composite design-response surface method ，and the validation tests were conducted. At the same time ，prepared product was compared with traditional decoction pieces prepared according to 2020 edition of Chinese Pharmacopoeia （part Ⅰ）. RESULTS The best integrated technology was that the fresh C. longa was boiled in boiling water for 5 min，dried at 50 ℃ to 40％ water content ，cut into 2 mm thin slices ，and dried at 50 ℃ until moisture content not exceeding 15.0％. After validation ，The deviation between the average OD value （0.811 3，RSD＝2.13％） and the predicted value （0.848 1）of the contents of ethanol-soluble extract ，curcumin，demethoxycurcumin and bisdemethoxycurcumin was 4.34％. OD value of the contents of ethanol-soluble extract ，curcumin，demethoxycurcumin and bisdemethoxycurcumin in decoction pieces prepared by integrated technology were all higher than those prepared by traditional technology. CONCLUSIONS The process optimized in this study is simple ，stable and feasible.

OBJECTIVE To explore the influence of Zingiber officinale and processed Z. officinale on pharmacodynamic indexes and intestinal flora on gastric ulcer rats with spleen -stomach deficiency and cold type before and after processing with sand . METHODS The SD rats were randomly divided into normal group ，model group ，positive control group （Compound tianqi weitong capsule 0.45 g/kg），Z. officinale high-dose（15.0 g/kg）and low -dose（7.5 g/kg）groups，processed Z. officinale high- dose（15.0 g/kg）and low -dose（7.5 g/kg）groups，with 10 rats in each group . The rat model of gastric ulcer with spleen -stomach deficiency and cold type was established by intragastric administration of vinegar （day 1-10）and absolute ethanol （day 11）. Administration groups were given relevant liquid intragastrically ，and normal group and model group were given water intragastrically（day 5-10）. One hour after intragastric administration of absolute ethanol ，blood was taken from the femoral artery of rats ，the serum contents of motilin （MTL），gastrin（GAS），epidermal growth factor （EGF）as well as 4 items of blood coagulation [activated partial thromboplastin time （APTT），prothrombin time （PT），thrombin time （TT），fibrinogen（FIB）] were detect. The ulcer index and inhibition rate of ulcer in gastric tissue were calculated . The pathological changes of gastric tissue were observed，and the number and area of erosions were recorded . The diversity of gut microbiota in fecal samples of rats was detected . RESULTS Compared with model group ，the contents of MTL （except for processed Z. officinale low-dose group ），GAS（except for processed Z. officinale low-dose group ），EGF（except forofficinale groups） and FIB （except for Z. officinale groups），inhibitory rate of ulcer （only positive control group ）were all increased significantly （P＜0.05）. APTT（except for Z. officinale groups），PT（only processed Z. officinale high- dose group ），TT（except for Z. officinale groups），ulcer index （except for Z. officinale groups），the number （except for Z. officinale groups）and area of erosions （except for Z. officinale groups）were shortened and decreased significantly （P＜0.05）； improvement effects of processed Z. officinale were better than those of the same dose of Z. officinale on EGF ，4 items of blood coagulation（except for PT ，TT，FIB of processed Z. officinale low-dose group ），ulcer index （except for processed Z. officinale low-dose group ）and inhibitory rate of ulcer （P＜0.05）. Compared with model group ，α diversity indexes as ACE ，Shannon and Simpson of intestinal microorganisms in rats were increased significantly in processed Z. officinale group；the relative abundance of Proteobacteria was decreased significantly in processed Z. officinale group，while that of Bacteroidetes was increased significantly （P＜0.05）； the relative abundance of Limosilactobacillus was decreased significantly in Z. officinale group （P＜0.05）. CONCLUSIONS Z. officinale and processed Z. officinale can improve the symptoms of spleen -stomach deficiency and cold ，and enhance gastrointestinal function by increasing the content of GAS and MTL . Processed Z. officinale can significantly inhibit gastric ulcer of spleen -stomach deficiency and cold type ，which is related to the promotion of mucosal protection and repair ，improvement of coagulation functionand adjustment of gut microbiotadisorder .

Objective:To analyze the characteristics of patients with Takayasu arteritis (TA) in the east China Takayasu arteritis (ECTA) cohort and their subgroups, and evaluate the disease characteristics.Methods:Patients diagnosed with TA in ECTA cohort from January 2009 to October 2019 were enrolled and their data were analyzed. The characteristics were analyzed and compared within subgroups using t-test or Wilcoxon rank sum test or Chi-square test. Results:A total of 454 patients were included, with the male to female ratio of 1∶4.75(79/375), and the main complaint were dizziness/headache, fatigue, and chest tightness/pain. The type Ⅴ and Ⅰ were the most common angiographic pattern, among which the subclavian artery and carotid artery were most vulnerable, manifested as vascular stenosis. Hypertension, tuberculosis and hepatitis B were common complications. In subgroup comparison, symptoms and inflammation index were much more evident in the active group, female group, <40 years old, and newly diagnosed group. C-reactive protein (CRP)[10(2, 33) mg/L vs 3(1, 14) mg/L, Z=-4.49, P<0.01), erythrocyte sedimentation rate (ESR) [(45±33) mm/1 h vs (25±23) mm/1 h, t=-5.82, P<0.01), in the active group were significantly higher than those in the inactive group, while the ESR in female patients was only higher than that in males, but without statistical significant difference. SAA in the young age group, ESR in the newly diagnosed group was significantly higher than that in the other subgroups [19(6, 95) mg/L vs 10(4, 39) mg/L, Z=2.06, P<0.05] [(44±34) mm/1 h vs (32±28) mm/1 h, t=3.77, P<0.01]. Conclusion:The TA patients are mainly young women, and are in active disease when first being diagnosed. The type Ⅴ and Ⅰ are the most common artery involve-ment pattern. Hypertension and tuberculosis are the most frequent complications.

Objective To observe the morphological changes of carotid artery wall by ultrasonography in patients with Takayasu arteritis,and to evaluate the diagnostic value of contrast-enhanced ultrasonography for active Takayasu arteritis.Methods High-frequency ultrasound technique was used to analyze the morphological changes of the carotid artery in 40 patients.NIH score was used as the gold standard and the complete clinical data and acute phase reactors were recorded.T test,Chi-square test,sensitivity and specificity were calculated for statistical analysis.Results The thickness of carotid artery wall in active group was much more thickened than the non-active group [(2.2±0.6) mm vs (1.8±0.5) mm,t=-2.142,P＜0.05].The CDD [(0.89±0.06) in active group vs (0.95±0.03) in non-active group,t=3.683,P＜0.01] and RDD [(0.17±0.06 in active group vs (0.09±0.05) in non-active group,t=-4.020,P＜0.01] were significantly different between the two groups.The distribution of neovascularization in the carotid artery wall of the active group was more diffuse in the central part of the wall.The sensitivity and specificity of contrast-enhanced ultrasonography to diagnose the active of Takayasu arteritis were 72.7％ and 87.5％ respectively,and the positive predictive value and the negative predictive value were 80.0％ and 82.4％ respectively.Conclusion Contrast-enhanced ultrasonography can be used as an effective way to assess the disease activity of TA patients.

Objective To evaluate the performance of Positron emision tomography (PET) in the assessment of disease activity of Takayasu arteritis (TA). Methods Information retrieval was based on database such as PubMed/Medline and CNKI, etc. The research before Dec 2016 involving Takayasu arteritis and PET were included.The quality of the research was evaluated by diagnostic accuracy studies-2Q(UADAS-2) and the data was analyzed by Meta-disc. Results Among the 70 research, nine studies were included in this study with a total of 126 patients and 254 controls. All patients were diagnosed according to the classification criteria of American College of Rheumatology. The disease activity was mostly assessed by the scoring system of National Institutes of Health and by clinical assessment in one study. The result of PET was evaluated by visual grade and semi-quantitative analysis. The pooled DOR of the 9 studies was 17.54, the pooled sensitivity and specificity was 84% and 73%,respectively.However,the heterogeneity of specificity was 81.4%. Two studies had included one patients repeatedly and suspected active patients were included in the in-active group in one study,which might impact the statistical result of the meta-analysis.After excluded these studies, the pooled DOR was 30.32. The pooled sensitivity and specificity was 86% and 85%, respectively, with better consistency. Conclusion PET shows stable sensitivity and variant specificity in the diagnosis and assess of disease activity of TA, which is a useful method in the clinically evaluation of disease activity of TA.

Objective To investigate the impact of an infant formula supplemented with 1.34 g/L oligosaccharides mixture (galactooligosaccharides and fructooligosaccharides,GOS+FOS) on growth,stool characteristics and fecal beneficial bacteria content in healthy infants.Methods 25 formula-fed (FF) infants and 29 breast-fed (BF) infants within 3 weeks after birth were included and followed up.FF infants were exclusively fed with GOS+FOS supplemented formula at the median age of 13d (1-27d).Body weight and head circumference at 6 and 12 weeks were measured.The frequency,consistency,and color of the infant's stool,and occurrences of spit-up or vomiting during the study period were recorded daily by the parents.Stool samples were collected at 6 and 12 weeks of age,and then subjected to quantitative real-time polymerase chain reaction assays for the enumeration of lactobacillus,bifidobacteria,Bifidobacterium longum,Bifidobacterium breve and Bifidobacterium adolescentis.Results No difference in daily weight gain was detected between the two groups (33.56 ± 7.03g vs.31.18 + 6.91g,P=0.22)during the observation phase from 6 to 12 weeks.FF infants had less frequent and firmer stools at 6 weeks than BF infants,and they both had similar stool frequency,color and consistency at the end of study.FF infants had less fecal Bifidobacterium,B.longum and B.breve at 6 weeks,but those differences became less significant at 12 weeks with more increase in fecal B.longum and B.breve levels in FF infants during the follow up.Conclusions The GOS+FOS supplemented formula provides adequate nutrition for growth,and promotes soft stools and intestinal bifidogenic effects in healthy infants.

Objective To investigate the clinical manifestations,radiographic presentations,histopathological features,treatment and clinical follow-up of IgG4 related disease (IgG4-RD).Methods Forty-nine cases in our hospital were enrolled from 2009 to 2012 and were followed up.Results Of the 49 patients with IgG4-RD,the male to female ratio was 2.1∶1,the mean age was (53±15) years,and the serum IgG4 ranged between 0.39 to 20.8 g/L.The most commonly affected organ was pancreas.Two or more organs were involved in 15 patients.Histopathological findings included tissue infiltration by lymphocytes,IgG+ plasma cells and IgG4+ plasma cells and diffuse fibrosis among 45 patients.The IgG4+ plasma cells were over 10/high power fields (HPF).Responses to glucocorticoid in combination with immunosuppressants were good except 3 patients suffered relapses.Conclusion IgG4-RD is an autoimmune disease affecting multiple organs,and the increased IgG4 positive plasma cells is characteristic.This disease can be effectively alleviated with prompt use of glucocorticoid.

BACKGROUNDReduced endometrial receptivity in hyperstimulated cycles may lead to a lower implantation rate and a lower clinical pregnancy rate, but it is unclear if it is also associated with an increase in pregnancy loss rate. The aim of this study was to compare the implantation, miscarriage, and pregnancy rates between fresh and frozen thawed transfer of one or two day-3 embryos, with a view to understanding whether or not reduced endometrial receptivity encountered in hyperstimulated cycles is associated with an increase in miscarriage rate.

METHODSThis study involved a consecutive series of 1 551 single day-3 embryo transfer cycles and consecutive 5 919 double day-3 embryo transfer cycles in the Assisted Reproductive Unit of the Sir Run Run Shaw Hospital, Hangzhou, China, between January 2010 and December 2012.

RESULTSThe implantation and clinical pregnancy rates (single embryo 30.7% and double embryos 33.4% and 51.4%) using fresh cycle were both significantly lower than that of frozen-thawed cycles (single embryo 35.8% and double embryos 38.1% and 57.8%). There was no difference in biochemical loss or clinical miscarriage rates between the two groups.

CONCLUSIONSImpairment of endometrial receptivity associated with ovarian hyperstimulation leads to implantation failure at a very early stage, resulting in an increased number of non-pregnancy. It does not lead to increase in biochemical or clinical losses. The significantly reduced ongoing pregnancy rates in both fresh single and double embryo transfer are therefore due to failure to achieve a pregnancy, rather than pregnancy loss after conception.

Adult ; Cryopreservation ; Embryo Implantation ; physiology ; Embryo Transfer ; methods ; statistics & numerical data ; Female ; Fertilization in Vitro ; methods ; statistics & numerical data ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Retrospective Studies

Objective To evaluate the risk of hyperuricemia in patients younger than 45 with coronary artery disease.Methods Six hundred and seventy-seven patients with coronary artery disease under 45 years old at disease onset were recruited retrospectively.The subjects were divided into hyperuricemia group (n=164) and normal uric acid group (n=513).Patients with coronary artery disease with hyperuricemia were analyzed for clinical characteristics.The risk of hyperuricemia was analyzed on the severity of coronary lesions.T-test,x2 test and Logistic regression analysis were used for statistical analysis.Results Comparing with patients with normal uric acid,patients in the hyperuricemia group were male predominant and more prevalent with hypertension [197(38.5％) and 93(56.7％) ; x2=16.85,P＜0.01],hypedipidemia [274(53.4％) and 130 (80.7％); x2=37.58,P＜0.01],and cardiac dysfunction [24 (4.7％) and 17 (10.4％); x2=7.18,P=0.01].Hyperuricemia increased the risk of coronary artery disease complicated with cardiac dysfunction [ORlcorrection=2.66,95％CI (1.28,5.53)],and it also increased the risk of coronary artery disease concurrent with cardiac arrhythmia [OR2correction=1.28,95％CI (1.00,1.65)] revealed by multivariate regression analysis.Conclusion In young patients under 45 years old with coronary artery disease,hyperuricemia is the independent risk factor for coronary artery disease complicated with cardiac dysfunction and arrhythmia.