[Objective] To evaluate the clinical application value of intrauterine perfusion with platelet-rich plasma (PRP) combined with in vitro fertilization-frozen-thawed embryo transfer (IVF-FET) in patients with chronic endometritis (CE). [Methods] A randomized controlled trial (RCT) was conducted, enrolling 60 CE patients undergoing artificial cycle frozen embryo transfer at our hospital from January 2022 to January 2024. Participants were randomly divided into three groups: Group A (routine frozen embryo transfer, n=20), Group B (routine frozen embryo transfer + one PRP intrauterine perfusion, n=20), and Group C (routine frozen embryo transfer + two PRP intrauterine perfusions, n=20). Endometrial thickness during the transformation and transplantation phases, uterine artery pulsatility index (PI), resistance index (RI), systolic peak velocity/end-diastolic velocity (S/D) ratio during transplantation, serum levels of IL-2, IL-4, IL-6, IL-10, and TNF-α during transplantation, as well as biochemical pregnancy rate, clinical pregnancy rate, live birth rate, and early miscarriage rate were compared across groups. [Results] No significant differences in endometrial thickness were observed among the three groups during the transformation phase (P>0.05). During the transplantation phase, endometrial thickness in Groups C and B was significantly higher than in Group A[9.54 (8.96-10.22) and 8.90 (8.34-9.72) vs 8.37 (7.89-8.75) mm, P<0.05], with Group C showing greater thickness than Group B (Z=3.733, P<0.05). Endometrial thickness in Groups C and B during transplantation was significantly increased compared to their respective transformation phases (Z=2.191, 2.462; P<0.05). Groups C and B exhibited lower PI, RI, and S/D values than Group A[PI:1.87 (1.77-1.97), 1.94 (1.88-2.15) vs 2.43 (2.35-2.49); RI:0.75 (0.73-0.77), 0.78 (0.75-0.81) vs 0.84 (0.83-0.86); S/D:2.61 (2.33-3.42), 3.01 (2.20-3.93) vs 3.72 (3.06-4.49); P<0.05]. Group C demonstrated lower PI and RI than Group B (P<0.05). IL-2 levels in Groups C and B were higher than in Group A[3.88 (2.71-5.01), 3.59 (2.73-4.38) vs 3.16 (2.11-3.25) ng/L, P<0.05], while IL-4, IL-6, IL-10, and TNF-α levels were significantly lower (IL-4: Z=1.428, 2.421; IL-6: Z=1.754, 2.435; IL-10: Z=1.754, 2.854; TNF-α: Z=1.961, 1.765; P<0.05). Group C had lower IL-6 levels than Group B (Z=3.976, P<0.05). Biochemical pregnancy rate, clinical pregnancy rate, and live birth rate in Group C were significantly higher than in Group A (75% vs 40%, 70% vs 35%, 60% vs 20%, P<0.05). No significant differences in early miscarriage rates were observed among the groups (χ²=3.750, P>0.05). [Conclusion] Intrauterine autologous PRP perfusion in CE patients enhances pregnancy and live birth rates, improves pregnancy outcomes post-FET, and demonstrates superior efficacy in endometrial repair and receptivity with two PRP perfusions compared to a single perfusion. This provides a safe and effective therapeutic option for optimizing outcomes in CE patients with prior implantation failure.

Objective To establish an artificial intelligence (AI)-assisted platform for detection of parasite eggs, and to evaluate its detection efficiency and accuracy, so as to provide technical supports for elimination of parasitic diseases. Methods A total of 1 003 slides of Enterobius vermicularis, horkworm, Trichuris trichiura, Clonorchis sinensis, Taenia, Ascaris lumbricoides, Schistosoma japonicum, Paragonimus westermani and Fasciolopsis buski eggs were collected, and converted into digital images with an automatated scanning microscope to create a dataset. Based on the Object Detection platform on the Baidu Easy DL model, an AI-assisted platform for detection of parasite eggs was created through procedures of uploading, labeling, training, evaluation and optimization. Then, 70% of the datasets were randomly selected for model training, and the precision, recall and average accuracy were calculated to evaluate the effectiveness of platform for recognition of parasite eggs. In addition, the platform was deployed on the computer and smart phone terminals for use. Results An AI-assisted platform for detection of parasite eggs was successfully created. If the platform was deployed using the public cloud application programming interface (API), the average accuracy, precision and recall of the platform were 93.42%, 92.55% and 89.32% for recognition of parasite eggs. If the platform was deployed using the offline software development kit (SDK), the average accuracy, precision and recall of the platform were 92.97%, 94.78% and 87.63% for recognition of parasite eggs. In addition, the precision of the platform was 97.00% and 96.23% for identification of Taenia and C. sinensis eggs, respectively. Conclusions The AI-assisted platform for detection of parasite eggs has been successfully created, which is high in the accuracy for recognition of parasite eggs and convenient in use. This platform may provide a powerful technical support for parasitic disease diagnosis.

Objective To explore the imaging manifestations of ectopic pancreas based on endoscopic findings in order to find out the causes of miss diagnosis and to improve the diagnostic accuracy.Methods The clinical and CT imaging data of ectopic pancreas patients who underwent CT examination and confirmed by endoscopy and pathology microscopy at Air Force Medical Center from July 2018 to March 2023 were collected.Their im-aging characteristics were analyzed according to the endoscopic findings and the miss diagnosis was analyzed.Results There were 13 patients with ectopic pancreas and 3 of them had no obvious symptoms.Ten patients presented with gastrointestinal symptoms,including epigastric discomfort and pain,incomplete obstruction,and melena.Lesion sites:8 cases were located in the gastric antrum and 5 cases were located in the small in-testine.In this group,two patients showed apical erosions and glandular opening-like depressions on endoscop-ic results,but only one patient showed a"ductal sign"shown by CT scanning.None of the 13 patients in this group made ectopic pancreatic diagnosis on imaging,of which 4 were diagnosed as thickening of the gastroin-testinal tract wall,3 were diagnosed as gastrointestinal stromal tumor,3 were diagnosed as benign tumors and 3 had no obvious abnormalities.Conclusions The imaging diagnosis of ectopic pancreas should be made by closely combinating with the results of endoscopy to improve the accuracy of imaging diagnosis.CT is of great significance for the diagnosis of ectopic pancreas,and adequate preparation before gastrointestinal examination is an important step to avoid misdiagnosis.

Objective To study the role and mechanisms of equilibrative nucleotide transporter 1(ENT1)on Alzheimer's disease(AD)by constructing ENT1 overexpression and knockdown plasmids.Methods Molecular cloning was used to construct the ENT1 overexpression(pAAV-ENT1-mCherry)and knockdown(pAAV-ENT1shRNA-ZsGreen)plasmids.The overexpression plasmids and the knockdown plasmids were transfected into N2A cells(mouse Neuro A2 cells)and N2A-APP cells(N2A cells stably expressing human APP695).The expression of ENT1 and inflammatory factors at mRNA and protein levels were detected by real-time qPCR and Western blotting,respectively,and the change in cell viability were measured with CCK-8 assay.Results Sequencing and real-time qPCR indicated that ENT1 overexpression and knockdown plasmids were successfully constructed.CCK-8 assay showed that ENT1 overexpression significantly reduced the cell survival rate within 24 h(P＜0.05),while its knockdown increased the cell survival rate(P＜0.01).Real-time qPCR displayed that overexpression of ENT1 enhanced the expression levels of inflammatory factors,such as IL-1β,TNF-α,C1q-a and C1q-b in N2A cells(P＜0.05),while ENT1 knockdown reversed the above changes in inflammatory factors in N2A-APP cells(P＜0.05).Conclusion Knockdown of ENT1 attenuates pathological changes in AD by reducing the inflammatory response.ENT1 may be a potential target in the pathological mechanism of AD.

Objective:To investigate the efficacy and safety of ab externo or ab interno transluminal trabeculotomy in the treatment of secondary glaucoma following pars plana vitrectomy (PPV).Methods:An observational case series method was performed.Seventeen eyes of 17 patients with glaucoma following PPV were enrolled in Henan Eye Hospital and Beijing Tongren Hospital from May 2016 to Feburary 2022.Primary conditions of patients receiving PPV included retinal detachment in 13 eyes, vitreous hemorrhage in 3 eyes, and entophthalmia in 1 eye.All the subjects underwent ab externo (11 eyes) or ab interno (6 eyes) transluminal trabeculotomy.The scope of all cases accepted trabeculotomy was ≥300°(11 cases of 360°, 4 cases of 330° and 2 cases of 300°).Before and at 1 week, 1 month, 6 months and 12 months after surgery, the intraocular pressure (IOP) was evaluated by Goldmann Tonometer and the best corrected visual acuity (BCVA) was measured using a standard visual acuity chart and converted to logrithm of minimal angle of resolution (LogMAR).The number of anti-glaucoma drug applications and surgery-related complications were recorded.The primary outcomes evaluated were IOP and surgical success rate.Secondary outcomes were medication quantity, BCVA (LogMAR) changes, and complications.Surgical success was defined as IOP reduction to <21 mmHg (1 mmHg=0.133 kPa) with or without the use of IOP-lowering medication.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[41]).Written informed consent was obtained from each subject.Results:Preoperative, 1-week, 1-month, 6-month, and 12-month postoperative mean IOP was (34.41±5.11), (21.88±11.72), (20.77±7.67), (19.50±7.01), and (16.32±4.68)mmHg, respectively, with an statistically significant overall difference ( F=20.779, P<0.001).IOP at difference time points after surgery were lower than that before surgery, showing statistically significant differences (all at P<0.01).Compared with before surgery, IOP was reduced more than 40% at 12 months after surgery in 14 eyes.Surgical success rates at 6 and 12 months after surgery were both 76.5%.The number of IOP-lowing drugs decreased significantly after operation ( Z=-4.580, P<0.001).The difference in BCVA between before and 6 months after surgery was not statistically significant ( Z=-1.311, P=0.190).No serious complications were seen in any of the operated eyes postoperatively. Conclusions:Ab externo or ab interno transluminal trabeculotomy is safe and effective in the treatment of secondary glaucoma after PPV.

OBJECTIVE: To explore the clinical and genetic characteristics of two children with Williams-Beuren syndrome (WBS). METHODS: Two children who had presented at the Department of Pediatrics, General Hospital of Ningxia Medical University respectively on January 26 and March 18, 2021 were selected as the study subjects. Clinical data and results of genetic testing of the two patients were analyzed. RESULTS: Both children had featured developmental delay, characteristic facies and cardiovascular malformation. Child 1 also had subclinical hypothyroidism, whilst child 2 had occurrence of epilepsy. Genetic testing revealed that child 1 has harbored a 1.54 Mb deletion in the 7q11.23 region, whilst child 2 has a 1.53 Mb deletion in the same region, in addition with a c.158G>A variant of the ATP1A1 gene and a c.12181A>G variant of the KMT2C gene. Based on the guidelines from the American College of Medical Genetics and Genomics, the c.158G>A and c.12181A>G variants were rated as variants of unknown significance (PM1+PM2_Supporting+PP2+PP3；PM2_Supporting). CONCLUSION Both children had characteristic features of WBS, for which deletions of the 7q11.23 region may be accountable. For children manifesting developmental delay, facial dysmorphism and cardiovascular malformations, the diagnosis of WBS should be suspected, and genetic testing should be recommended to confirm the diagnosis.
Child ; Humans ; Williams Syndrome/diagnosis* ; Genetic Testing ; Facies ; Epilepsy/genetics* ; Chromosomes, Human, Pair 7/genetics* ; Chromosome Deletion

The rapid spread of carbapenemase-producing Klebsiella pneumoniae(cpKP)poses seri-ous threats to public health;however,the underlying genetic basis for its dissemination is still unknown.We conducted a comprehensive genomic epidemiology analysis on 420 cpKP isolates col-lected from 70 hospitals in 24 provinces/autonomous regions/municipalities of China during 2009-2017 by short-/long-read sequencing.The results showed that most cpKP isolates were categorized into clonal group 258(CG258),in which ST11 was the dominant clone.Phylogenetic analysis revealed three major clades including the top one of Clade 3 for CG258 cpKP isolates.Additionally,carbapenemase gene analysis indicated that blaKPC was dominant in the cpKP isolates,and most blaKPC genes were located in five major incompatibility(Inc)groups of blaKPC-harboring plasmids.Importantly,three advantageous combinations of host-blaKPC-carrying plasmid(Clade 3.1+3.2-IncFⅡpHN7A8,Clade 3.1+3.2-IncFⅡpHN7A8:IncR,and Clade 3.3-IncFⅡpHN7A8:InCpA1763-KPC)were identified to confer cpKP isolates the advantages in both genotypes(strong correlation/coevolution)and phenotypes(resistance/growth/competition)to facilitate the nationwide spread of ST11/CG258 cpKP.Intriguingly,Bayesian skyline analysis illustrated that the three advanta-geous combinations might be directly associated with the strong population expansion during 2007-2008 and subsequent maintenance of the population of ST11/CG258 cpKP after 2008.We then examined drug resistance profiles of these cpKP isolates and proposed combination treatment regimens for CG258/non-CG258 cpKP infections.Thus,the findings of our systematical analysis shed light on the molecular epidemiology and genetic basis for the dissemination of ST11/CG258 cpKP in China,and much emphasis should be given to the close monitoring of advantageous cpKP-plasmid combinations.

Objective To detect the expression of EIF5A2 in hepatocellular carcinoma(HCC) and to explore its relation with clinicopathological characters and prognosis of HCC patients. Methods The expression of EIF5A2 mRNA and protein in 12 pairs of fresh HCC and corresponding non-tumor tissues adjacent to the cancer was examined by qRT-PCR and Western blot. The expression level of EIF5A2 in 284 pairs of HCC and adjacent non-tumor tissues was detected by IHC staining. Then we analyzed between EIF5A2 expression and clinical pathological parameters and prognosis of HCC patients. Results The relative expression levels of EIF5A2 mRNA and protein in fresh HCC tissues were significantly higher than those in the corresponding adjacent non-tumor tissues (t=5.305, P=0.0003; t=10.120, P < 0.001); EIF5A2 expression in 284 HCC tissues was significantly higher than that in the corresponding adjacent non-tumor tissues (z=-12.186, P < 0.001). The expression of EIF5A2 was significantly correlated with tumor size (χ²=13.079, P < 0.001), tumor multiplicity (χ²=4.589, P=0.032) and differentiation degree (χ²=4.844, P=0.028). The 3- and 5-year overall survival time and disease-free survival time of the patients with high expression of EIF5A2 were significantly shorter than those with low expression of EIF5A2 (P < 0.001). EIF5A2 was an independent prognostic factor affecting the 3- and 5-year overall survival time and disease-free survival time of HCC patients (P < 0.05). Conclusion The up-regulation of EIF5A2 expression may be related with the occurrence and development of hepatocellular carcinoma. The high expression of EIF5A2 is an independent influence factor for poor prognosis and EIF5A2 can be used as a potential molecular marker for predicting the prognosis of HCC patients.

Objective:To systematically compare the efficacy of different drugs in alleviating remifentanil-induced hyperalgesia.Methods:Databases such as PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang Data and CBM were searched using computers from inception to May 2020.The randomized controlled trials comparing the efficacy of different intervention measures for alleviating remifentanil-induced hyperalgesia were searched.After independently identifying the literature, the two reviewers conducted data extraction and evaluated the bias of the included studies, and Stata 14.0, ADDIS 1.16.5 and R4.0.2 softwares were used to analyze the data.Results:Thirty randomized controlled trials were included in our study.Compared with placebo, 3 out of 6 drugs could alleviate remifentanil-induced hyperalgesia, and the probability order for the effect was as follows: butorphanol with MD value (95% CI)-1.50 (-2.80, -0.24), dexmedetomidine with MD value (95% CI)-1.20 (-2.40, -0.09) and ketamine with MD value (95% CI) -0.88 (-1.60, -0.16). After sensitivity analysis, the efficacy of butorphanol remained to be verified.Two drugs could decrease the dosage of opioids within 24 h after operation, and the probability order for the effect was as follows: dexmedetomidine with MD value (95% CI) -14.00 (-28.00, -0.19) and ketamine with MD value (95% CI) -9.20 (-18.00, -0.08). One drug could decrease the incidence of postoperative nausea and vomiting within 24 h after operation: dexmedetomidine with RR value (95%CI) 0.28 (0.16, 0.22). Conclusion:The results of network meta-analyses show that dexmedetomidine has the best efficacy in alleviating remifentanil-induced hyperalgesia.

Objective:To investigate whether radiotherapy should be delivered before the application of immune checkpoint inhibitor PD-1 in patients with advanced non-small cell lung cancer (NSCLC) and evaluate the effect of previous radiotherapy on the efficacy and pulmonary toxicity of PD-1 inhibitor.Methods:Clinical data of patients with stage Ⅳ NSCLC who received immunotherapy in Henan Cancer Hospital from March 2015 to September 2019 were retrospectively analyzed. The baseline data of patients, the status of radiotherapy and immunotherapy and the pulmonary toxicity were collected. According to whether radiotherapy was given before PD-1 inhibitor application, all patients were divided into the previous radiotherapy and non-radiotherapy groups. Survival analysis was performed by Kaplan- Meier method. Results:A total of 90 patients were enrolled including 39 cases in the previous radiotherapy group and 51 cases in the non-radiotherapy group. The median follow-up time was 22.9 months. The median progression-free survival (mPFS) in the previous radiotherapy group was 7.5 months (95% CI 5.4-9.5 months), significantly longer compared with 4.1 months (95% CI 3.1-5.1 months) in the non-radiotherapy group ( P=0.003). The median overall survival (mOS) significantly differed between two groups[15.2 months (95% CI 12.3-18.1 months) vs. 9.3 months (95% CI 6.1-12.5 months)]( P=0.040). The incidence of pulmonary toxicity showed no significant difference between two groups ( P=0.154). Conclusions:Patients with stage Ⅳ NSCLC patients in the previous radiotherapy group obtain significantly better mPFS and mOS and similar pulmonary toxicity compared with their counterparts in the non-radiotherapy group. Nevertheless, the findings remain to be validated by subsequent investigations with larger sample size.