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BACKGROUND: Social participation of older adults is a crucial component of China's aged care services and an important strategy for actively addressing the aging population. Analyzing policy texts on older people's social participation can inform future policy formulation and the development of relevant programs. OBJECTIVES: This study aims to quantitatively analyze the transformation of China's social participation policies for older people from 1999 to 2023, employing institutional network analysis and policy text analysis. METHOD: A two-dimensional policy analysis framework was constructed based on the perspective of "policy tools and social participation stages." Using Rost Content Mining 6.0 and Nvivo 11.0 Plus software, 55 national-level policy texts were coded. Structural analysis of policy-issuing subjects and topic words was conducted to visualize the findings. RESULTS: The analysis revealed that the policy-issuing subjects demonstrated strong authority but weak coordination, with a lack of communication and cooperation across subjects. The use of policy tools was imbalanced, with an over-reliance on supply-type tools and insufficient use of demand-type tools. Additionally, the lack of effective policy tools to support various social participation stages has limited policy implementation. CONCLUSION: With technological advancement and changing needs of the elderly population, there is a need for a more systematic and forward-looking top-level design of elderly social participation policies: accelerating the systematization and precision of technological elements in policies for elderly social participation, integrating social organizations via technological platforms to mobilize diverse stakeholder engagement, and addressing the digital divide between the elderly and new technologies is imperative.
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Participação Social , Humanos , China , Idoso , Masculino , Feminino , Idoso de 80 Anos ou maisRESUMO
Background: Multiple organ dysfunction syndrome (MODS) is common after sepsis and increases mortality. Lactate (Lac) can assess the prognosis of patients. Albumin (Alb) is closely associated with inflammatory response in sepsis patients. This work evaluated the predictive value of Lac/Alb for prognosis of sepsis patients. Methods: Data of 160 sepsis patients were retrospectively collected. Lac and Alb levels were measured upon admission, at 24 hours and 48 hours later. Using 0.45 as the cutoff value for Lac/Alb, patients were rolled into high-level (HL) and low-level (LL) groups. MODS rates and mortality rates were analyzed. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive value of 48-hour Lac/Alb for patient prognosis. Correlation between Lac/Alb and APACHE II and SOFA scores was assessed. Results: The 12-month follow-up revealed 52 deaths (32.5%), and MODS occurred in 49 cases (30.6%) on the 7th day. The MODS group possessed elevated Lac and Lac/Alb and decreased Alb to the N-MODS group (P<0.05), and similar results were observed by comparison the survival and death group (P<0.05). The sensitivity, specificity, and area under the ROC curve (AUC) of Lac/Alb in predicting MODS were 81.63%, 85.59%, and 0.89, respectively, while those in predicting death were 94.23%, 88.89%, and 0.91, respectively. Lac/Alb was positively correlated with APACHE II and SOFA scores (r=0.718 and 0.808, respectively). Conclusions: Lac/Alb was linked to MODS and mortality in sepsis patients and can be based to predict adverse outcomes.
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Thyroid nodules (TNs) have emerged as the most prevalent endocrine disorder in China. Fine-needle aspiration (FNA) remains the standard diagnostic method for assessing TN malignancy, although a majority of FNA results indicate benign conditions. Balancing diagnostic accuracy while mitigating overdiagnosis in patients with benign nodules poses a significant clinical challenge. Precise, noninvasive, and high-throughput screening methods for high-risk TN diagnosis are highly desired but remain less explored. Developing such approaches can improve the accuracy of noninvasive methods like ultrasound imaging and reduce overdiagnosis of benign nodule patients caused by invasive procedures. Herein, we investigate the application of gold-doped zirconium-based metal-organic framework (ZrMOF/Au) nanostructures for metabolic profiling of thyroid diseases. This approach enables the efficient extraction of urine metabolite fingerprints with high throughput, low background noise, and reproducibility. Utilizing partial least-squares discriminant analysis and four machine learning models, including neural network (NN), random forest (RF), logistic regression (LR), and support vector machine (SVM), we achieved an enhanced diagnostic accuracy (98.6%) for discriminating thyroid cancer (TC) from low-risk TNs by using a diagnostic panel. Through the analysis of metabolic differences, potential pathway changes between benign nodule and malignancy are identified. This work explores the potential of rapid thyroid disease screening using the ZrMOF/Au-assisted LDI-MS platform, providing a potential method for noninvasive screening of thyroid malignant tumors. Integrating this approach with imaging technologies such as ultrasound can enhance the reliability of noninvasive diagnostic methods for malignant tumor screening, helping to prevent unnecessary invasive procedures and reducing the risk of overdiagnosis and overtreatment in patients with benign nodules.
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Nódulo da Glândula Tireoide , Zircônio , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/patologia , Humanos , Zircônio/química , Ouro/química , Metabolômica , FemininoRESUMO
Bone and tooth defects can considerably affect the quality of life and health of patients, and orthopedic implants remain the primary method of addressing such defects. However, implant materials cannot coordinate with the immune microenvironment because of their biological inertness, which may lead to implant loosening or failure. Motivated by the microstructure of nacre, we engineered a biomimetic micro/nanoscale topography on a tantalum surface using a straightforward method. This comprised an organized array of tantalum nanotubes arranged in a brick wall structure, with epigallocatechin gallate acting as "mortar." The coating improved the corrosion resistance, biocompatibility, and antioxidant properties. In vitro and in vivo evaluations further confirmed that coatings can create a favorable bone immune microenvironment through the synergistic effects of mechanochemistry and enhance bone integration. This research offers a new viewpoint on the creation of sophisticated functional implants, possessing vast potential for use in the regeneration and repair of bone tissue.
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Osseointegração , Tantálio , Tantálio/química , Osseointegração/efeitos dos fármacos , Animais , Camundongos , Materiais Revestidos Biocompatíveis/química , Materiais Revestidos Biocompatíveis/farmacologia , Catequina/química , Catequina/análogos & derivados , Catequina/farmacologia , Nanotubos/química , Imunomodulação/efeitos dos fármacos , Propriedades de Superfície , Antioxidantes/química , Antioxidantes/farmacologia , HumanosRESUMO
To determine the optimal temperature range for the development and reproduction of three spider mites (Eotetranychus sexmaculatus, Eotetranychus orientalis, and Oligonychus biharensis), this study investigated their developmental period, survival rate, lifespan, and reproduction under five temperatures, 21, 24, 27, 30, and 33°C, to predict and control in the field. With the gathered data, a two-sex life table was constructed for each of them. The results revealed that as the temperature increased, both O. biharensis and E. orientalis displayed a gradual reduction in their generation period. Furthermore, an inverse relationship was observed between lifespan and temperature for all three spider mite species. When examining the survival rates at varying temperatures, E. sexmaculatus exhibited the highest rate (98%) at 33°C, while E. orientalis and O. biharensis demonstrated their highest survival rates at 24°C, reaching 90% and 100% respectively. Regarding reproduction, O. biharensis displayed the highest oviposition rates at 30°C with an average of 17.45 eggs per individual. Conversely, E. sexmaculatus and E. orientalis exhibited the highest oviposition rates at 33°C, averaging at 15.22 and 21.38 eggs per individual respectively. Significantly higher intrinsic growth rates were observed for O. biharensis and E. orientalis at 33°C, with rates of 0.22 and 0.26 respectively. In contrast, E. sexmaculatus demonstrated the highest intrinsic growth rate at 27°C. The temperature of 27°C was more suitable for the growth of the E. sexmaculatus, while 33°C was the optimal temperature for the E. orientalis and O. biharensis. The current findings provide valuable guidance for the control and prevention of these three spider mites.
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Tábuas de Vida , Temperatura , Tetranychidae , Animais , Tetranychidae/fisiologia , Tetranychidae/crescimento & desenvolvimento , Feminino , Masculino , Reprodução , Longevidade , Oviposição , Hevea/crescimento & desenvolvimentoRESUMO
The mechanism of Y on H/H2 adsorption performance of Mg17Al12 were studied by the density functional theory. We obtained that for the Y-adsorbed systems, Y tended to occupy on the bridge site between adjacent Mg atoms. For the Y-substituted surfaces, Y atoms inclined to replace Mg atoms on the surfaces. We found that hydrogen (H/H2) absorption on the Mg17Al12(110) systems were improved by adding Y, the order of adsorption energy was as follows: clean Mg17Al12(110) > the Y-substituted surfaces > the Y-adsorbed surfaces. In addition, H2 molecules could dissociate on the Y-containing systems without barrier energy. Electronic properties showed that for H2 adsorption, the s states of atomic H mainly hybridized with the d states of Y. The formations of the Y-H bonds and the interactions between Y and H atoms could expound the mechanism for the promoted hydrogenation performance of the Y-containing surfaces.
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The B-box (BBX) family, which is a class of zinc finger transcription factors, exhibits special roles in plant growth and development as well as in plants' ability to cope with various stresses. Even though Rubus chingii is an important traditional medicinally edible plant in east Asia, there are no comprehensive studies of BBX members in R. chingii. In this study, 32 RcBBX members were identified, and these were divided into five groups. A collinearity analysis showed that gene duplication events were common, and when combined with a motif analysis of the RcBBX genes, it was concluded that group V genes might have undergone deletion of gene fragments or mutations. Analysis of cis-acting elements revealed that each RcBBX gene contained hormone-, light-, and stress-related elements. Expression patterns of the 32 RcBBX genes during fruit ripening revealed that highest expression occurred at the small green fruit stage. Of note, the expression of several RcBBX genes increased rapidly as fruit developed. These findings, combined with the expression profiles of anthocyanin biosynthetic genes during fruit ripening, allowed us to identify the nuclear-targeted RcBBX26, which positively promoted anthocyanin production in R. chingii. The collective findings of this study shed light on the function of RcBBX genes in different tissues, developmental stages, and in response to two abiotic stresses.
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Leaves play a crucial role in the growth and development of rice (Oryza sativa) as sites for the production of photosynthesis. Early leaf senescence leads to substantial drops in rice yields. Whether and how DNA methylation regulates gene expression and affects leaf senescence remains elusive. Here, we demonstrate that mutations in rice ARGONAUTE 2 (OsAGO2) lead to premature leaf senescence, with chloroplasts in Osago2 having lower chlorophyll content and an abnormal thylakoid structure compared with those from wild-type plants. We show that OsAGO2 associates with a 24-nt microRNA and binds to the promoter region of OsNAC300, which causes DNA methylation and suppressed expression of OsNAC300. Overexpressing OsNAC300 causes the similar premature leaf senescence as Osago2 mutants and knocking out OsNAC300 in the Osago2 mutant background suppresses the early senescence of Osago2 mutants. Based on yeast one-hybrid, dual-luciferase, and electrophoresis mobility shift assays, we propose that OsNAC300 directly regulates transcription of the key rice aging gene NAC-like, activated by APETALA3/PISTILLATA (OsNAP) to control leaf senescence. Our results unravel a previously unknown epigenetic regulatory mechanism underlying leaf senescence in which OsAGO2-OsNAC300-OsNAP acts as a key regulatory module of leaf senescence to maintain leaf function.
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This study investigates the expression and functional roles of SUGT1 in ovarian cancer, utilizing data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) projects. Our analyses reveal that SUGT1 is significantly upregulated in ovarian cancer tissues compared to normal controls. We further explore the prognostic value of SUGT1, where elevated expression correlates with poorer patient outcomes, particularly in ovarian cancer. The functional implications of SUGT1 in cancer biology were assessed through in vitro and in vivo experiments. Gene Set Enrichment Analysis (GSEA) indicates a significant association between high SUGT1 expression and the activation of glycolytic pathways, suggesting a potential role in metabolic reprogramming. Inhibition of SUGT1 via siRNA in ovarian cancer cell lines results in decreased proliferation and increased apoptosis, along with reduced migration and invasion capabilities. Additionally, our study identifies the transcription factor ELF1 as a significant regulator of SUGT1 expression. Through promoter analysis and chromatin immunoprecipitation, we demonstrate that ELF1 directly binds to the SUGT1 promoter, enhancing its transcription. This regulatory mechanism underscores the importance of transcriptional control in cancer metabolism, providing insights into potential therapeutic targets. Our findings establish SUGT1 as a crucial player in the oncogenic processes of ovarian cancer, influencing both metabolic pathways and transcriptional regulation. This highlights its potential as a biomarker and therapeutic target in managing ovarian cancer.
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The low solubility of chitosan (CS) imposes adverse effects on its application. In this work, one of the aims is to improve the water solubility of CS. By introducing water-soluble side chains to CS, this aim was achieved. Besides, fluorescent moieties were incorporated into the side chains, the fluorescent copolymers were endowed with Cr3+ and Cu2+ ions recognition ability. Firstly, a reversible addition-fragmentation chain transfer polymerization (RAFT) reagent with naphthalimide units and CC groups was prepared. Water-soluble monomer methyl acrylic acid (MAA) was employed in the RAFT polymerization. Thus, water-soluble polymer with fluorescent unit and -C ≡ C on both ends of the polymer was obtained. They were introduced into CS, and the CS-based fluorescent copolymers were obtained eventually. The amount of MAA introduced could be tuned to obtain three side chains of different lengths. It was found that the more MAA was introduced, the better the solubility of CS-TP was. The detection limits (LOD) of Cr3+ and Cu2+ were 44.6 nM and 54.5 nM, respectively. The detection of Cr3+ and Cu2+ ions is further combined with a mobile APP to realize real-time, portable, and visual detection. And the application in the logic gate, a new detection platform, is prepared.
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Quitosana , Cromo , Cobre , Corantes Fluorescentes , Solubilidade , Água , Quitosana/química , Cobre/química , Cobre/análise , Cromo/análise , Cromo/química , Corantes Fluorescentes/química , Água/química , Limite de Detecção , Íons , Polimerização , Espectrometria de Fluorescência/métodosRESUMO
Poor vacuum stability limits the application of many matrices in matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) that requires long-term measurement duration in high vacuum. In this study, a new approach using conjugate polymer anchor to protect unstable matrix from volatilizing in MALDI source based on ion bond is provided. Unlike strong covalent bonds which often introduce unnecessary groups, the weaker ion bonds are more conducive to breaking under laser radiation while effectively preventing matrix volatilization in a vacuum environment. The results confirm that conjugate polymer anchor will neither introduce additional ion peaks nor affect signal intensity, yet maintains comparable quantification properties. Vacuum stability of three kinds of typical matrices is enhanced using polymer anchors, and the in situ MALDI MS imaging of mouse brain and liver cancer is improved significantly.
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BACKGROUND: Caloric restriction (CR) might be effective for alleviating/preventing Alzheimer's disease (AD), but the biological mechanisms remain unclear. In the current study, we explored whether CR caused an alteration of gut microbiome and resulted in the attenuation of cognitive impairment of AD animal model. METHODS: Thirty-week-old male APP/PS1 transgenic mice were used as AD models (AD mouse). CR was achieved by 30% reduction of daily free feeding (ad libitum, AL) amount. The mice were fed with CR protocol or AL protocol for six consecutive weeks. RESULTS: We found that with CR treatment, AD mice showed improved ability of learning and spatial memory, and lower levels of Aß40, Aß42, IL-1ß, TNF-α, and ROS in the brain. By sequencing 16S rDNA, we found that CR treatment resulted in significant diversity in composition and abundance of gut flora. At the phylum level, Deferribacteres (0.04%), Patescibacteria (0.14%), Tenericutes (0.03%), and Verrucomicrobia (0.5%) were significantly decreased in CR-treated AD mice; at the genus level, Dubosiella (10.04%), Faecalibaculum (0.04%), and Coriobacteriaceae UCG-002 (0.01%) were significantly increased in CR-treated AD mice by comparing with AL diet. CONCLUSIONS: Our results demonstrate that the attenuation of AD following CR treatment in APP/PS1 mice may result from alterations in the gut microbiome. Thus, gut flora could be a new target for AD prevention and therapy.
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Doença de Alzheimer , Precursor de Proteína beta-Amiloide , Restrição Calórica , Microbioma Gastrointestinal , Camundongos Transgênicos , Animais , Microbioma Gastrointestinal/fisiologia , Restrição Calórica/métodos , Doença de Alzheimer/microbiologia , Doença de Alzheimer/dietoterapia , Doença de Alzheimer/prevenção & controle , Masculino , Camundongos , Precursor de Proteína beta-Amiloide/genética , Presenilina-1/genética , Peptídeos beta-Amiloides/metabolismo , Modelos Animais de Doenças , Aprendizagem em Labirinto/fisiologia , Encéfalo/metabolismo , Camundongos Endogâmicos C57BLRESUMO
The chirality of materials directly influences their transport and biological effects in physiological conditions. However, the impact of chiral materials on cellular metabolic reprogramming remains incompletely elucidated. In this study, we have synthesized chiral gold particles through a light-driven particle growth approach and demonstrated that d-Au particles exhibited superior macrophage activation ability compared to l-Au particles. An inflammatory creatine-phosphocreatine shunt was induced following d-Au stimulation. This shunt, facilitated by the upregulated expression of creatine kinase muscle-type (CKM), also resulted in a reduction in cytosolic levels of creatine. Pharmacological inhibition and genetic ablation of CKM further suppressed the secretion of pro-inflammatory cytokines, without compromising mitochondrial respiration. Moreover, the activation of macrophages induced by d-Au was mediated through the activation of the NF-κB and NLRP3 inflammasome pathways. Inhibition of CKM expression not only decreased the secretion of CXCL2 but also attenuated IL-1ß by suppressing the NLRP3 inflammasome pathways. Our investigation into the metabolic reprogramming mechanism of chiral materials on macrophage activation is pivotal for the application of chiral-based anticancer therapies.
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The development of advanced neural modulation techniques is crucial to neuroscience research and neuroengineering applications. Recently, optical-based, nongenetic modulation approaches have been actively investigated to remotely interrogate the nervous system with high precision. Here, we show that a thin-film, silicon (Si)-based diode device is capable to bidirectionally regulate in vitro and in vivo neural activities upon adjusted illumination. When exposed to high-power and short-pulsed light, the Si diode generates photothermal effects, evoking neuron depolarization and enhancing intracellular calcium dynamics. Conversely, low-power and long-pulsed light on the Si diode hyperpolarizes neurons and reduces calcium activities. Furthermore, the Si diode film mounted on the brain of living mice can activate or suppress cortical activities under varied irradiation conditions. The presented material and device strategies reveal an innovated optoelectronic interface for precise neural modulations.
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Neurônios , Optogenética , Silício , Animais , Silício/química , Neurônios/fisiologia , Camundongos , Optogenética/métodos , Cálcio/metabolismo , Luz , Encéfalo/fisiologiaRESUMO
Atmospheric microplastics are important contributors to environmental contamination in aquatic and terrestrial systems and pose potential ecological risks. However, studies on atmospheric microplastics are still limited in urban regions of the Tibetan Plateau, a sentinel region for climate and environmental change under a warming climate. In this study, the occurrence and potential ecological risk of atmospheric microplastics were investigated in samples of suspended atmospheric microplastics collected in Lhasa city during the Tibetan New Year in February 2023. The results show that the average abundance of atmospheric microplastics in Lhasa was 7.15 ± 2.46 MPs m-3. The sizes of the detected microplastics ranged from 20.34 to 297.18 µm, approximately 87% of which were smaller than 100 µm. Fragmented microplastics (95.76%) were the dominant shape, followed by fibres (3.75%) and pellets (0.49%). The primary polymer chemical components identified were polyamide (68.73%) and polystyrene (16.61%). The analysis of meteorological data and the backwards trajectory model indicated the air mass in Lhasa mainly controlled by westwards, and the atmospheric microplastics mainly originated from long-distance atmospheric transport. The potential ecological risk index assessment revealed that the atmospheric microplastic pollution in Lhasa was relatively low. This study provides valuable insights and a scientific foundation for future research on the prevention and control of atmospheric microplastic pollution in Lhasa and other ecologically sensitive cities.
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Poluentes Atmosféricos , Cidades , Monitoramento Ambiental , Microplásticos , Microplásticos/análise , Poluentes Atmosféricos/análise , Medição de Risco , Tibet , Atmosfera/química , Tamanho da PartículaRESUMO
Stillbirth is a major global issue, with over 5 million cases each year. The multifactorial nature of stillbirth makes it difficult to predict. Artificial intelligence (AI) and machine learning (ML) have the potential to enhance clinical decision-making and enable precise assessments. This study reviewed the literature on predictive ML models for stillbirth highlighting input characteristics, performance metrics, and validation. The PubMed, Cochrane, and Web of Science databases were searched for studies using AI to develop predictive models for stillbirth. Findings were analyzed qualitatively using narrative synthesis and graphics. Risk of bias and the applicability of the studies were assessed using PROBAST. Model design and performance were discussed. Eight studies involving 14,840,654 women with gestational ages ranging from 20 weeks to full term were included in the qualitative analysis. Most studies used neural networks, random forests, and logistic regression algorithms. The number of predictive features varied from 14 to 53. Only 50% of studies validated the models. Cross-validation was commonly employed, and only 25% of studies performed external validation. All studies reported area under the curve as a performance metric (range 0.54-0.9), and five studies reported sensitivity (range, 60- 90%) and specificity (range, 64 - 93.3%). A stacked ensemble model that analyzed 53 features performed better than other models (AUC = 0.9; sensitivity and specificity > 85%). Available ML models can attain a considerable degree of accuracy for prediction of stillbirth; however, these models require further development before they can be applied in a clinical setting.
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Embryonic stem cells (ESCs) can differentiate into all cell types of the embryonic germ layers. ESCs can also generate totipotent 2C-like cells and trophectodermal cells. However, these latter transitions occur at low frequency due to epigenetic barriers, the nature of which is not fully understood. Here, we show that treating mouse ESCs with sodium butyrate (NaB) increases the population of 2C-like cells and enables direct reprogramming of ESCs into trophoblast stem cells (TSCs) without a transition through a 2C-like state. Mechanistically, NaB inhibits histone deacetylase activities in the LSD1-HDAC1/2 corepressor complex. This increases acetylation levels in the regulatory regions of both 2C- and TSC-specific genes, promoting their expression. In addition, NaB-treated cells acquire the capacity to generate blastocyst-like structures that can develop beyond the implantation stage in vitro and form deciduae in vivo. These results identify how epigenetics restrict the totipotent and trophectoderm fate in mouse ESCs.
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Diferenciação Celular , Inibidores de Histona Desacetilases , Células-Tronco Embrionárias Murinas , Trofoblastos , Animais , Trofoblastos/citologia , Trofoblastos/metabolismo , Trofoblastos/efeitos dos fármacos , Camundongos , Células-Tronco Embrionárias Murinas/metabolismo , Células-Tronco Embrionárias Murinas/citologia , Células-Tronco Embrionárias Murinas/efeitos dos fármacos , Inibidores de Histona Desacetilases/farmacologia , Diferenciação Celular/efeitos dos fármacos , Reprogramação Celular/efeitos dos fármacos , Histona Desmetilases/metabolismo , Histona Desacetilase 1/metabolismo , Histona Desacetilase 2/metabolismo , Epigênese Genética , Feminino , Acetilação/efeitos dos fármacos , Histona Desacetilases/metabolismo , Ácido Butírico/farmacologiaRESUMO
Manufacturing biodegradable lignocellulosic films from spent coffee grounds (SCG) as an alternative to commercial plastics is a viable solution to address plastic pollution. Here, the biodegradable lignocellulosic films from SCG were fabricated via a sequential alkaline treatment and ionic liquid-based dissolution process. The alkaline treatment process could swell the cell wall of SCG, change its carbohydrates and lignin contents, and enhance its solubility in ionic liquids. The prepared SCG films with different lignin contents exhibited outstanding UV blocking capability (42.07-99.99 % for UVB and 20.96-99.99 % for UVA) and light scattering properties, good surface hydrophobicity (water contact angle = 63.2°-88.7°), enhanced water vapor barrier property (2.28-6.79 × 10-12 g/m·s·Pa), and good thermal stability. Moreover, the SCG films exhibit excellent mechanical strength (50.10-81.56 MPa, tensile strength) and biodegradability (fully degraded within 30 days when buried in soil) compared to commercial plastic. The SCG films represent a promising alternative that can replace non-biodegradable plastics.
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Café , Lignina , Plásticos , Lignina/química , Café/química , Plásticos/química , Interações Hidrofóbicas e Hidrofílicas , Resistência à Tração , Biodegradação Ambiental , Solubilidade , Permeabilidade , Plásticos Biodegradáveis/química , Vapor , ResíduosRESUMO
OBJECTIVE: This study aimed to evaluate the oncological and reproductive outcomes of fertility-preserving re-treatment in progestin-resistant endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) women who desire to maintain their fertility. METHODS: Our study included 61 progestin-resistant EC/AEH patients. These patients underwent treatment with gonadotropin-releasing hormone agonist (GnRHa) solely or a combination of GnRHa with levonorgestrel-releasing intrauterine system (LNG-IUD) or aromatase inhibitor (AI). Histological evaluations were performed every 3-4 months. Upon achieving complete remission (CR), we recommended maintenance treatments including LNG-IUD, cyclical oral contraceptives, or low-dose cyclic progestin until they began attempting conception. Regular follow-up was conducted for all patients. The chi-square method was utilized to compare oncological and fertility outcomes, while the Cox proportional hazards regression analysis helped identify risk factors for CR, recurrence, and pregnancy. RESULTS: Overall, 55 (90.2%) patients achieved CR, including 90.9% of AEH patients and 89.7% of EC patients. The median re-treatment time was 6 months (ranging from 3 to 12 months). The CR rate for GnRHa alone, GnRHa + LNG-IUD and GnRHa + AI were 80.0%, 91.7% and 93.3%, respectively. After a median follow-up period of 36 months (ranging from 3 to 96 months), 19 women (34.5%) experienced recurrence, 40.0% in AEH and 31.4% in EC patients, with the median recurrence time of 23 months (ranging from 6 to 77 months). Among the patients who achieved CR, 39 expressed a desire to conceive, 20 (51.3%) became pregnant, 11 (28.2%) had successfully deliveries, 1 (5.1%) was still pregnant, while 8 (20.5%) suffered miscarriages. CONCLUSION: GnRHa-based fertility-sparing treatment exhibited promising oncological and reproductive outcomes for progestin-resistant patients. Future larger multi-institutional studies are necessary to confirm these findings.