Objective To investigate the correlation between tongue and pulse indicators and the out-come of live birth in patients undergoing frozen-thawed embryo transfer(FET),as well as the association between these indicators and patients'endocrine parameters. Methods This study was conducted at Reproductive Medicine Center,Shuguang Hospital Af-filiated to Shanghai University of Traditional Chinese Medicine,Shanghai,China,from March 8,2021 to January 5,2022.Patients undergoing FET were divided into live birth and non-live birth groups according to their live birth outcome.The differences between the endocrine pa-rameters[basic follicle stimulating hormone(b FSH),basic luteinizing hormone(b LH),basic estradiol(b E2),basic progesterone(b P),basal endometrial thickness,follicle stimulating hormone(FSH)on endometrial transition day,luteinizing hormone(LH)on endometrial transition day,estradiol(E2)on endometrial transition day,progesterone(P)on endometrial transition day,and endometrial thickness on endometrial transition day]and the tongue and pulse indicators[tongue body(TB)-L,TB-a,TB-b,tongue coating(TC)-L,TC-a,TC-b,perAll,perPart,h1,h4,h5,t1,h1/t1,and h4/h1]of patients in the two groups were analyzed,with the correlation between these variables analyzed as well using Spearman's correlation coefficient.Multivariate logistic regression was employed to identify the influential factors in the live birth prediction models across various datasets,including Model 1 consisting of endocrine indica-tors only,Model 2 solely consisting of tongue and pulse indicators,and Model 3 consisting of both tongue,pulse,and endocrine indicators,as well as to evaluate efficacy of the models de-rived from different datasets. Results This study included 78 patients in live birth group and 144 patients in non-live birth group.Compared with non-live birth group,live birth group exhibited higher levels of TB-L(P=0.01)and TB-a(P=0.04),while demonstrated lower levels of b FSH(P=0.01),perAll(P=0.04),and h4/h1(P=0.03).The Spearman's correlation coefficient analysis revealed statisti-cally significant correlation(P<0.05)between TB-L,TB-b,TC-L,TC-b,perAll,perPart,h4,h5,t1,h1/t1 and b FSH,b LH,basal endometrial thickness,LH on endometrial transition day,E2 on endometrial transition day,P on endometrial transition day,and endometrial thickness on endometrial transition day in live birth group.The multivariate logistic regression analysis showed that the prediction Model 3 for live birth outcome[area under the curve(AUC):0.917,95%confidence interval(CI):0.863-0.971,P<0.001]surpassed the Model 1(AUC:0.698,95%CI:0.593-0.803,P=0.001),or the Model 2(AUC:0.790,95%CI:0.699-0.880,P<0.001).The regression equations for the live birth outcomes,integrating tongue and pulse indicators with endocrine parameters,included the following measures:FSH on endometrial transition day[odds ratio(OR):0.523,P=0.025],LH on endometrial transition day(OR:1.277,P=0.029),TB-L(OR:2.401,P=0.001),perPart(OR:1.018,P=0.013),h1(OR:0.065,P=0.021),t1(OR:4.354,P=0.024),and h4/h1(OR:0.018,P=0.016). Conclusion In infertility patients undergoing FET,there exists a correlation between tongue and pulse indicators and endocrine parameters.The corporation of tongue and pulse indica-tors significantly improved the predictive capability of the model for live birth outcomes.Specifically,tongue and pulse indicators such as TB-L,perPart,h1,t1,and h4/h1 exhibited a discernible correlation with the ultimate live birth outcomes.

AIM: To investigate the interactive effects of blood glucose and blood calcium on the prognostic impact of patients with acute severe pancreatitis (SAP) and to analyze their predictive efficacy on prognosis. METHODS: One hundred and seven patients with SAP admitted to our hospital from September 2019 to October 2022 were selected for the study and were divided into poor and good groups according to their prognosis within 28 d. The blood glucose, blood calcium, modified Marshall score, bedside acute pancreatitis severity score (BISAP) were compared between the two groups before treatment, after 3 d of treatment, and after 7 d of treatment, and the correlation between blood glucose, blood calcium and modified Marshall score and BISAP score was analyzed. The blood glucose levels of patients with different blood calcium were compared. Cox regression was used to analyze the factors associated with prognosis. The presence and type of interaction between blood glucose and blood calcium on prognosis were analyzed using the interaction coefficient γ and relative risk (RR) values. The subject operating characteristic curve (ROC) was used to analyze the predictive efficacy of blood glucose and blood calcium on prognosis. RESULTS: The blood glucose, modified Marshall score, and BISAP score of the adverse group after treatment were higher than those of the good group, while the blood calcium was lower than that of the good group (P<0.05). After 3 and 7 days of treatment, blood glucose was positively correlated with improved Marshall score and BISAP score (P<0.05). The blood glucose level in patients with decreased blood calcium was higher than that in patients with normal blood calcium (P<0.05). The decrease of blood calcium had positive interaction with the increase of blood glucose (P<0.05). After 3 and 7 days of treatment, the AUC of blood glucose combined with blood calcium was greater than that predicted by single index (P< 0.05). CONCLUSION: Blood glucose and blood calcium are related to the severity of the disease in SAP patients. There is an interaction between blood glucose and blood calcium in predicting the prognosis of SAP patients. The combined detection of blood glucose and blood calcium has a certain predictive effect on the prognosis of SAP patients.

Objective:To explore the prognostic value of lymphocyte subsets in adult hemophagocytic syndrome (HPS).Methods:A total of 172 adult HPS patients diagnosed in 8 medical centers from January 2013 to August 2020 were selected for the study, of whom 87 were male (50.6%, 87/172), and 85 were female (49.4%, 85/172), with 68 survivors and 104 deaths. The clinical data were summarized, and variables such as lymphocyte subsets, immunoglobulin characteristics and fibrinogen were retrospectively analyzed, and the correlation between the mentioned variables and patient prognosis was analyzed. The optimal cut-off values of continuous variables were calculated by MaxStat, and the prognostic factors of HPS patients were screened based on the Cox proportional hazard regression model.Results:The median age of HPS patients was 56 (42, 66) years old, and the 5-year cumulative survival rate was 37.4% (37.4/100). The median age, platelet and albumin were 48 (27, 63) years, 84×10 9/L and 32.3 g/L in the survival group, and 59 years, 45.5×10 9/L, and 27.3 g/L in the death group, respectively. The differences between the two groups was statistically significant ( Z=?3.368, P=0.001; Z=?3.156, P=0.002; Z=?3.431, P=0.001). Patients with differentiated cluster 8+(CD8+)<11.1%, CD3+<64.9%, CD4+>51%, and CD4/CD8 ratio>2.18 had poor prognosis (χ 2=7.498, P=0.023; χ 2=4.169, P=0.041; χ 2=4.316, P=0.038; χ 2=9.372, P=0.002). Multivariable analysis showed that CD4/CD8 ratio, age, fibrinogen and hemoglobin were independent prognostic factors in HPS patients ( HR=2.435, P=0.027; HR=5.790, P<0.001; HR=0.432, P=0.018; HR=0.427, P=0.018). Conclusion:Peripheral blood lymphocyte subsets can be used to evaluate the prognosis of patients with HPS; CD4/CD8 ratio, age, fibrinogen, and hemoglobin are independent prognostic factors in HPS patients.

Objective:Factors influencing the prognosis of hemophagocytic lymphohistiocytosis (HLH) in adults were analyzed based on multicentric data.Methods:Clinical data of 124 adult patients with HLH diagnosed in eight medical centers in the Huaihai Lymphoma Working Group from March 2014 to July 2020 were collected. The optimal truncation value of continuous variables was obtained based on the Maxstat algorithm, X-Tile software, and restricted cubic spline. Cox proportional risk regression model was used to construct the adult HLH risk prediction model, and the visualization of the model was realized through the histogram. The bootstrap resampling method was used to verify the model, C-index and calibration curve was used to verify the histogram, and the prediction accuracy was checked. Kaplan-Meier analysis was used to calculate the survival rate and draw the survival curve. Furthermore, the differences between groups were tested by log-rank.Results:The median age of the 124 patients was 55 (18-84) years, including 61 (49.19%) males. The most common etiology was infection. Serum ferritin increased in 110 cases (88.71%) , hepatosplenomegaly in 57 cases (45.97%) . Of the 124 patients, 77 (62.10%) died, and the median survival time of the patients was 7.07 months. Univariate results showed that the prognosis of adult HLH was influenced by sex, age, fibrinogen, serum creatinine, alanine aminotransferase, and albumin ( P<0.05) . The results of multivariate analysis showed that gender, platelet, albumin, alanine aminotransferase, and treatment regimens were independent influencing factors for prognosis. Based on the above five risk factors, the prediction model of the histogram was established, and the C-index of the model was 0.739. Finally, the calibration chart showed good consistency between the observed and predicted values of HLH. Conclusion:The prognosis of the adult hemophagocytic syndrome is influenced by many factors. Gender, platelet, albumin, alanine aminotransferase, and treatment regimens are independent risk factors. Therefore, the established histogram provides a visual tool for clinicians to evaluate the prognosis of adult HLH.

Objective: To observe the clinical efficacy of traditional Chinese medicine(TCM) directing therapy in the treatment of pelvic inflammatory disease sequelae (SPID) with the syndrome of Qi stagnation and blood stasis. Methods: From April 2016 to April 2018, 60 patients of SPID with the syndrome of Qi stagnation and blood stasis in the Traditional Chinese Medicine Hospital of Pudong New Area of Shanghai were randomly divided into the treatment group and the control group according to the digital table, with 30 cases in each group.The control group was treated with FukeQianjin capsules, and the treatment group was treated with TCM directing therapy, with a course of 1 month.The clinical efficacy was observed, and the TCM syndrome score and gynecological examination score were compared. Results: The total effective rate of the treatment group was 96.67%(29/30), which was significantly higher than 80.00%(24/30) of the control group (χ²=4.043, P<0.05). The gynecological examination score of the control group after treatment was (8.87±3.26)points, which was significantly lower than that before treatment [(16.50±5.35)points] (t=9.34, P<0.05). The gynecological examination score of the treatment group after treatment was (6.47±3.19)points, which was significantly lower than that before treatment [(17.83±4.47)points](t=10.92, P<0.05). The TCM syndrome score of the control group after treatment was (11.33±4.18)points, which was significantly lower than that before treatment [(26.33±7.61)points](t=9.99, P<0.05). The TCM syndrome score of the treatment group after treatment was (8.93±3.74)points, which was significantly lower than that before treatment [(29.67±7.61)points](t=13.37, P<0.05). After treatment, the decrease of TCM syndrome score in the treatment group was obviously better than that in the control group (t=2.23, P<0.05). And the decrease of the gynecological examination score in the treatment group was obviously better than that in the control group(t=2.50, P<0.05). Conclusion TCM directing therapy has good efficacy in the treatment of SPID with the syndrome of Qi stagnation and blood stasis.

Objective To investigate the association between the level of polymorphism of APOE gene and cognitive impairment in patients with CNS demyelinating diseases. Methods 56 patients with central nervous system demyelinating disease were applied APOE genotyping,MoCA and expanded disability status (EDSS) scale score. Patients with MOCA scores <26 were divided into cognitive impairment group, and those with MOCA scores ≥26 were divided into normal cognitive preserved group. Results The probability of cognitive dysfunction in patients with central nervous system demyelinating diseases was 53.57%. There was no significant difference in age, gender, and disease duration between the CI group and the CP group(P>0.05), the difference in age and education among groups is statistically significant (P<0.05). There was no statistical significance in the difference in age, sex, education years and EDSS score between APOEε4 gene positive group and APOEε4 gene negative group (P<0.05). The difference of visual space and attention between different cognitive domains is statistically significant(P<0.05). Years of schooling is a risk factor for cognitive dysfunction in patients with central nervous system demyelinating disease(P<0.01). Conclusion The central nervous system demyelinating disease is impaired cognitive function. Patients with APOEε4 gene positive are more severely impaired in visual space and attention than patients with negative APOEε4 gene.Years of education are the risk factors of cognitive dysfunction in patients with central nervous system demyelinating disease. The course of disease and disabled function may not be significant related to cognitive impairment.

Objective To investigate the clinical effect of anterior and posterior decompression internal fixation in the treatment of spinal cord injury without fracture and dislocation(CSCIWFD).Methods The clinical data of sixty-five patients with CSCIWFD in Worker's Hospital and Handan Central Hospital from December 2013 to May 2015 was analyzed.According to the surgical methods,the patients were divided into two groups,31 cases in the anterior group,accepted the anterior cervical decompression and internal fixation,34 cases in the posterior group,treated with posterior cervical open-door laminoplasty fixation.The operation time, intraoperative blood loss,neurological function recovery and complications of each group were recorded.Results The operative time in the anterior group was(63.2 ± 15.1)min and in the posterior group was(113.8 ±21.5)min,there was significant difference between the two groups(P<0.05).The intraoperative blood loss in the anterior group was lower than that in the posterior group((116.3 ± 18.9)ml vs.(236.3 ± 41.0)ml,t=55.837,P<0.05).In the anterior group,the JOA score was(6.9±1.6)points before operation,(9.6±1.9) points at 2 weeks after operation,(11.7±2.6)points at 3 months after operation and(13.5±3.1)points at the last follow-up,there were significant differences between the preoperative level and postoperative level(F between groups=33.759,P<0.05;F grouP=5.213,P<0.05;F interaction=6.769,P<0.05).In the posterior group,the JOA score was(6.7 ± 1.5)points before operation,(8.7 ± 1.8)points at 2 weeks after operation, (10.9±2.5)points at 3 months after operation and(13.1±3.4)points at the last follow-up,the differences were all statistically significant(P<0.05).Based on the JOA scores,there was significant difference between the two groups at 2 weeks after operation(P<0.05).The anterior group had 1 case of recurrent laryngeal nerve injury and 1 case of cerebrospinal fluid leakage,while the posterior group had 1 case of wound infection,1 case of liquefaction necrosis and 1 case of epidural hematoma.There was no significant difference in the complication rate between the two groups(X2= 0.000,P= 1.000).Conclusion The anterior decompression has the advantages of less operative trauma,shorter operation time,less intraoperative blood loss and quick recovery of nerve function.The selection of surgical method should be based on the compression section of the spinal cord.

Objective:To establish an HPLC method to simultaneously determine the content of protocatechualdehyde, rosmarinic acid and salvianolic acid A in Salvia miltiorrhiza Bunge. Methods: The chromatographic column was a Linksil-ODS ( 250 mm × 4. 6 mm,5 μm) column,the mobile phase was 1% acetic acid water solution-acetonitrile (7∶3) with the flow rate of 0. 8 ml·min-1 . The detection wavelength was 280nm , the column temperature was 30℃ and the injection volume was 20 μl. Results: The linear range of protocatechualdehyde, rosmarinicacid and salvianolic acid A was 3-300 μg·ml-1(r>0. 999 0), and the recovery was within the range of 95. 22%-99. 68% with RSD below 2% (n=5). Conclusion:The method is accurate, rapid and reproducible, and can be used to control the quality of Salvia miltiorrhiza Bunge.

Objective Inflammation plays a critical role in the presence , development and maintenance of atrial fibrillation ( AF) , but it remains unclear what factors induce inflammation in AF patients , especially in those with valvular heart disease ( VHD) . The aim of this paper was to investigate the role of the shedding of Syndecan -4 in left atrial inflammation in patients with valvular atrial fibrillation. Methods Sixty VHD patients scheduled for valvuloplasty or valve replacement surgery were divided into three groups of equal number:sinus rhythm (SR), paroxysmal atrial fibrillation (PaAF), and persistent atrial fibrillation (PeAF).Another 10 pa-tients with congenital heart disease but no valve damage and atrial fibrillation were included in a control group .Baseline clinical data were recorded and tissues were obtained from the left atrial appendage during operation .The expressions of iNOS , HMGB1, and Syn-decan-4 in the left atrium were detected by Western blot , and the pathological changes of the left atrial tissue observed by HE staining . Results Western blot analysis was performed to detect expression levels of proteins .The iNOS level was significantly higher in pa-tients from the paroxysmal AF group (1.61 ±0.10) and persistent AF group (1.67 ±0.08) than those from sinus group (1.06 ± 0.11) and control group (1.02 ±0.12), as was the protein level of HMGB1 (0.63 ±0.05, 0.95 ±0.10, 0.45 ±0.07 and 0.46 ± 0.06 in paroxysmal AF group, persistent AF group, sinus group and controlgroup respectively ).Inflammatory cell infiltration in-creased, while syndecan 4 was down-regulated in AF groups.All these comparisons were significant (P<0.05). Conclusion The decreased expression of Syndecan-4 and enhanced inflammatory response in the left atrial tissue indicate that the shedding of Synde-can-4 may play a role in the presence and development of inflamma-tion in the left atrium .

Obiective To observe the value of speckle tracking imaging(STI)in assessing left atrial(LA) function in patients with chronic heart failure(CHF).Methods Twenty-two patients with CHF[LVEF(37.1± 10.5)%]and twenty normal controls[LVEF(61.94±10.68)%]were studied.CHF group was subdevided into patients with normal or abnormal LV filling pressure.Velocity vector imaging(Siemens Medical Solutions)was used to acquire 2-D images at parasternallong axis and apical 4-chamber views.The LA dimension and volume,LV volume and ejection fraction,ratio of mitral valve E wave and mitral annulus velocity e'E/e')were measured. LA tangential and radial velocity(Vt-As,Vr-As)and time to peak velocity(TVt-As,TVr-As)were analysed on Syngo Workplace offline.Results Vt-As and Vr-As of the CHF group were significantly smaller than those of the controls(P＜0.05),and Vr-As was even decreased in patient with elevated LV filling pressure(P＜0.05), however,TVt-AS and TVr-AS didn't show evident impairment in the CHF group(P＞0.05).Vt-As and Vr-AS were closely correlated with LVEF,EDV and ESV(P＜0.05).Vt-As was negtively correlated with LA volume (P＜0.05).Conclusions STI can quickly and accurately assess LA function,and help to recognize patients with elevated LV filling pressure,which is useful in the risk stratification,treatment evaluation and prognosis prediction of CHF patients.