Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review.

Introduction: Recurrent reproductive failure (RRF) is a common pregnancy complication, imposing great physical, emotional and financial burden for the suffered couples. The leading cause of RRF is believed to be aneuploid embryo, which could be solved by preimplantation genetic testing for aneuploidy (PGT-A) in theory. With molecular genetic development, PGT-A based on comprehensive chromosomal screening (CCS) procedures and blastocyst biopsy is widely applied in clinical practice. However, its effects in RRF were not defined yet. Methods: A systematic bibliographical search was conducted without temporal limits up to June, 2023. Studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included. Results: Twenty studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included. It revealed that PGT-A could optimise the reproductive outcomes of RRF sufferers, especially in those with advanced age. However, in patients with multiple occurrences of pregnancy losses, the benefits of PGT-A were limited. Discussion: More randomized controlled trials with large sample size are required to evaluate the benefits of PGT-A in RRF sufferers and identify which population would benefit the most.

Pregnancy prediction via ultrasound-detected endometrial blood for hormone replacement therapy-frozen embryo transfer: a prospective observational study.

BACKGROUND: This study aimed to assess the predictive value of endometrial blood flow branches on pregnancy outcomes after hormone replacement therapy-frozen embryo transfer (HRT-FET). METHODS: This prospective observational study involved 292 reproductive-aged women who underwent endometrial receptivity assessment in a tertiary care academic medical center in southwest China using power Doppler ultrasonography during HRT-FET. Three-dimensional power Doppler ultrasound was performed on the day of endometrial transformation and the day before embryo transfer. The endometrial blood flow branches of the endometrial and subendometrial regions were compared in the non-pregnant and pregnant groups at the two time points mentioned above. RESULTS: The endometrial blood flow branches were higher in pregnant patients than in non-pregnant patients on the day of endometrial transformation (P = 0.009) and the day before embryo transfer (P = 0.001). Changes in endometrial blood flow pattern and endometrial blood flow branches at the two time points did not differ among the pregnancy outcome samples. After adjusting for age, antral follicles, and embryos transferred, the endometrial blood flow branches on the day before embryo transfer was the independent factor influencing the chance of clinical pregnancy, with an odds ratio of 3.001 (95% confidence interval: 1.448 - 6.219, P = 0.003). CONCLUSIONS: Endometrial blood flow perfusion during the peri-transplantation period of the HRT-FET cycle is a good indicator of pregnancy outcomes, suggesting that valuation of endometrial branches via power Doppler ultrasound is a simple and effective approach for achieving indicator measurements.

Does endometrial receptivity array improve reproductive outcomes in euploid embryo transfer cycles? a systematic review.

Besides chromosomal normality, endometrial receptivity is an important factor in determining successful pregnancies. Endometrial receptivity array (ERA), a promising endometrial receptivity test, was speculated to improve the reproductive outcomes. However, its effectiveness is controversial in clinical practice. Therefore, we conducted this review to investigate its role in in vitro fertilization (IVF) treatment. To eliminate the interference of embryo quality, we only analyzed studies that originally reported the reproductive outcomes of patients who underwent ERA-guided euploid embryo transfer (EET). Unexpectedly, it revealed that ERA could not optimize the reproductive outcomes in EET cycles, no matter in general infertile population or in patients with a history of previous failed embryo transfers.

Management of a Nulliparous IVF Patient with a Declined Ovarian Reserve After Discovery of an Atypical Ovarian Endometriotic Cyst.

Purpose: Endometriosis (EM) is a common cause of infertility, and an ovarian endometriotic cyst may affect the ovarian reserve, ovulation, and endometrial receptivity. The majority of EM cases are benign; however, EM may also be prone to malignant transformation, associated with infiltrative growth, and recurrent or distant metastasis. In this study, we report the management of an atypical cyst discovered through ovarian endometriotic cyst puncture prior to controlled ovarian stimulation (COS). Case Presentation: The patient required in vitro fertilization treatment due to EM and bilateral fallopian tube obstruction. Prior to initiating gonadotropin (Gn) treatment, the right ovarian EM cyst was punctured; cytological pathology of the obtained fluid revealed an atypical morphology. Subsequently, the case was discussed with the patient and ethically reviewed. Gn was initiated according to the patient's wishes, and six day-3 embryos were finally obtained and cryopreserved. Afterwards, laparoscopic cystectomy of the ovarian endometrioma revealed no malignant transformation. The patient achieved clinical pregnancy after resuscitation and transplantation of the embryo. Conclusion: In summary, patients with EM-associated infertility are at risk of ovarian cancer formation when undergoing assisted reproduction treatment; therefore, this risk should be evaluated and minimized before initiating such treatment.

Coinfection of SARS-CoV-2 and influenza A (H3N2) detected in bronchoalveolar lavage fluid of a patient with long COVID using metagenomic next-generation sequencing: a case report.

The growing number of long COVID cases has drawn clinical attention to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has been spreading worldwide since winter 2019. Its symptoms are not limited to fatigue and shortness of breath but also affect daily life. We report the use of metagenomic next-generation sequencing (mNGS) to detect coinfection with SARS-CoV-2 and influenza A virus in a patient with long COVID. The patient was admitted with fever, expectoration, fatigue, and shortness of breath. The PCR test was negative due to possible clearance of SARS-Cov-2 in the upper respiratory tract of patients with long COVID. Other routine microbiological tests were also negative, making the clinical diagnosis difficult. Bronchoalveolar lavage fluid (BALF) samples were tested using mNGS. The patient was diagnosed and treated promptly, recovered quickly, and continued taking azvudine after discharge; his condition was stable. This study illustrates that mNGS may be valuable for the timely diagnosis of patients with long COVID and their mixed infections.

Activation of the sirtuin silent information regulator 1 pathway inhibits pathological myocardial remodeling.

Myocardial remodeling refers to structural and functional disorders of the heart caused by molecular biological changes in the cardiac myocytes in response to neurological and humoral factors. A variety of heart diseases, such as hypertension, coronary artery disease, arrhythmia, and valvular heart disease, can cause myocardial remodeling and eventually lead to heart failure. Therefore, counteracting myocardial remodeling is essential for the prevention and treatment of heart failure. Sirt1 is a nicotinamide adenine dinucleotide+-dependent deacetylase that plays a wide range of roles in transcriptional regulation, energy metabolism regulation, cell survival, DNA repair, inflammation, and circadian regulation. It positively or negatively regulates myocardial remodeling by participating in oxidative stress, apoptosis, autophagy, inflammation, and other processes. Taking into account the close relationship between myocardial remodeling and heart failure and the involvement of SIRT1 in the development of the former, the role of SIRT1 in the prevention of heart failure via inhibition of myocardial remodeling has received considerable attention. Recently, multiple studies have been conducted to provide a better understanding of how SIRT1 regulates these phenomena. This review presents the progress of research involving SIRT1 pathway involvement in the pathophysiological mechanisms of myocardial remodeling and heart failure.

A case report of spontaneous ovarian hyperstimulation syndrome and the long-term management of the endocrine disorder.

Background: Spontaneous ovarian hyperstimulation syndrome (sOHSS) is a rarely reported clinical symptom of uncertain origin with the incidence of 0.2-1.2%. There is no report of the patients' follow-up situation after the remission of the clinical symptom and this is the first one. The aim of this study was to remind the medical staff of the necessity of long-term management. Case Description: We report a case of severe sOHSS with a normal 15 week gestation twin pregnancy in a 21-year-old primigravida who presented in our emergency room result from the 1 week's nausea and vomiting and progressively aggravated abdominal distension and pains for 3 days. The patient in our case had no significant precipitating factors and she had no previous outstanding medical history except that she had experienced acute glomerulonephritis when she was 9 years old. On ultrasound imaging, we found abnormally enlarged ovaries and massive ascites and moderate pleural fluid. A diagnosis of spontaneous ovarian hyperstimulation was made. The patient participated in followed-up visits for 1 year and experienced polycystic ovary syndrome (PCOS) and weight loss which up to 15kg after delivery. Conclusions: Typically, although sOHSS is potentially life-threatening, its clinical detection is often delayed. A proactive strategy should be encouraged in the management of high-risk patients. The therapeutic schedule of mild-to-moderate sOHSS can focus on symptomatic relief and supportive treatment. Our case report elucidates the possible long-term effects of sOHSS and reminds us of the need for long-term management of those affected.

Effect of Baduanjin Sequential Therapy on the Quality of Life and Cardiac Function in Patients with AMI After PCI: A Randomized Controlled Trial.

PURPOSE: The purpose of this study was to examine the effects of Baduanjin sequential therapy (BST) on the quality of life and cardiac function in patients with AMI after PCI. SUBJECTS: 96 patients with AMI after PCI were randomly assigned as subjects to two groups: BST group who received 24 weeks of BST training and control group who received no training. METHODS: The methods used in this study included the changes in SF-36 subscales, the measures of left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), the body mass index (BMI), and the abdominal circumference. RESULTS: Of the 96 participants, 82 total patients completed the entire study. At 12 weeks, role physical and health transition of SF-36 were significantly different between the two groups, with a difference of 26.12 (95% CI, 11.59 to 40.64) in role physical and a difference of 15.94 (95% CI, 5.60 to 26.28) in health transition (p < 0.05). However, there were statistically significant differences in all aspects of SF-36 between the two groups at 24 weeks (p < 0.05). The BST also lowered abdominal circumference and BMI as compared with the control group. In the 24-week follow-up, a significant difference was found in the decline of the LVEF in the control group (p=0.020), while there was a nonsignificant difference in the BST group (p=0.552). Compared with the control group, the BST group reduced 50 pg/ml on the NT-pro-BNP at 24 weeks (p=0.013). The effects of BST exercise were maintained at 24 weeks after the intervention. No serious adverse events were observed. CONCLUSIONS: The BST appears to improve the quality of life in patients with AMI after PCI, with additional benefits of lowered abdominal circumference and BMI and improved level of cardiac function. This trial is registered with NCT02693795.

Seated-Baduanjin as an adjuvant rehabilitation treatment for dysfunctional ventilatory weaning response: A case report.

RATIONALE: Seated-Baduanjin as adjuvant rehabilitation treatment in a patient with Dysfunctional ventilatory weaning response(DVWR) is extremely rare, and we report a case of a patient's rehabilitation exercise who suffered from DVWR. PATIENT CONCERNS: A 62-year-old patient was admitted for dyspnea for more than a month after surgery. DIAGNOSES: On arrival, the patient was conscious but anxious, and he had difficulty breathing. When attempting to disconnect the ventilator, the patient's autonomous respiration > 25 times /min, and the heart rate > 120 times /min. He had to rely on the ventilator to survive. According to the characteristics of the patient, we considered the patient with DVWR. INTERVENTIONS: We provided the same essential treatment as the last hospital and performed the Seated-Baduanjin for the patient which was a new form of bed exercise, 2 times a day, 30 minutes each time. OUTCOMES: The patient showed a gradual improvement in breathing and muscle strength. LESSONS: In this case report, the Seated-Baduanjin showed a remarkable therapeutic effect on a patient and might be an adjuvant treatment for DVWR.

Luteal phase clomiphene citrate for ovulation induction in women with polycystic ovary syndrome: a systematic review and meta-analysis.

OBJECTIVE: To assess the efficacy of late luteal phase clomiphene citrate (CC) administration relative to early follicular phase CC for ovulation induction for polycystic ovary syndrome (PCOS). STUDY DESIGN: Review. MATERIALS AND METHODS: A complete electronic databases including PubMed, Embase, The Cochrane Library, Web of Science, and CBM were searched for relevant randomized controlled trials (RCTs). The search was not restricted by language and publication time. Two reviewers selected trials and assessed trial quality by the Cochrane Handbook 5.1.0 independently. RESULTS: Four eligible RCT studies involving 708 women (934 cycles) were included. The results of the Meta-analysis: Late luteal phase group was associated with a number of higher total follicles (MD 1.82; 95% CI 0.86-2.78, p < 0.00001) and significant higher endometrial thickness on the day of HCG (MD 0.88; 95% CI 0.78-0.99, p < 0.00001) compared with early follicular group. There were no significant differences in the rate of pregnancy (RR 1.29; 95% CI 0.83-2.01, p = 0.26), ovulation rate (RR 0.99; 95% CI 0.86-1.14, p = 0.87), and abortion rate (RR 1.12; 95% CI 0.38 to 3.29, p = 0.84) between the two groups. CONCLUSION: It appeared that late luteal phase CC for ovulation induction might be an effective method for ovulation induction in women with PCOS compared to conventional CC administration. Further intensive randomized-controlled studies should be warranted to define the efficacy of CC used in late luteal phase.

Molecular cloning and expression of a novel laccase showing thermo- and acid-stability from the endophytic fungus Phomopsis liquidambari and its potential for growth promotion of plants.

A novel laccase (LACB3) from the endophytic fungus, Phomopsis liquidambari, was cloned and its potential to promote peanut growth was evaluated. The full-length cDNA is 1,731 bp, encoding a mature protein of 556 amino acids with a molecular mass of 60.1 kDa. Using 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonate), LACB3 exhibited a K m and k cat of 85 µM and 92.7 s(-1), respectively. The enzyme had maximal activity at pH 2.5 and 50 °C and retained 50 % of its activity after 20 h at 50 °C. When LACB3 was applied to soil, the peanut biomass was increased by 12 %, and the content of vanillic acid, coumaric acid and 4-hydroxybenzoic acid in soil were decreased by 21, 27 and 40 %, respectively. These results suggest substantial potential for the use of P. liquidambari or its laccase in agriculture.