Comparison of pregnancy outcomes among patients of different ages who underwent frozen-thawed high-quality single blastocyst transfer.

OBJECTIVE: To investigate the feasibility of performing frozen-thawed high-quality single blastocyst transfer in women of different ages. METHODS: A total of 1,279 women were divided into four groups: a 38-40-year-old group (n = 147), 35-37-year-old group (n = 164), 30-34-year-old group (n = 483), and < 30-year-old group (n = 485). Intergroup comparisons of baseline characteristics and pregnancy and neonatal outcomes were made. RESULTS: The clinical pregnancy rate (47.6%), and live birth rate (34.0%) in the 38-40-year-old group were significantly lower than those in the 30-34-year-old group (64.4%, 50.9%, respectively; all P < 0.001) and < 30-year-old group (62.9%, 50.7%, respectively; all P < 0.001). However, the 35-37-year-old group did not differ from the other three groups in these two dimensions (all P > 0.05). Moreover, there were no differences in the rates of biochemical pregnancy, miscarriage, or obstetric or neonatal complications among the four groups (all P > 0.05). According to the multivariate logistic regression analysis, the 35-37-year-old group was not associated with non-live birth outcomes, adverse pregnancy outcomes, or obstetric or neonatal complications. However, being 38-40 years of age was a risk factor for non-live birth (OR = 2.121, 95% CI: 1.233-3.647) and adverse pregnancy outcomes (OR = 1.630, 95% CI: 1.010-2.633). Post hoc power analysis showed that the study was sufficiently powered to detect meaningful differences. CONCLUSION: Frozen-thawed high-quality single blastocyst transfer produces the same satisfactory pregnancy outcomes for women aged 35-37 years as younger patients. Future prospective randomized controlled studies with larger populations are needed to verify the feasibility and safety of this method.

Association between uric acid level and contrast-induced acute kidney injury in patients with type 2 diabetes mellitus after coronary angiography: a retrospective cohort study.

BACKGROUND: This study assessed the predictive value of uric acid (UA) for contrast-induced acute kidney injury (CI-AKI) in patients with type 2 diabetes mellitus (T2DM) who underwent coronary angiography (CAG). A nomogram to aid in the prediction of CI-AKI was also developed and validated, and the construction of a prognostic nomogram combined with clinical features was attempted. METHODS: This study retrospectively enrolled T2DM patients who underwent CAG between December 2019 and December 2020 at the Affiliated Zhongda Hospital of Southeast University. Multivariable logistic regression analysis was used for the analysis of clinical outcomes. Receiver operating characteristic (ROC) analyses were performed to determine the area under the ROC curve (AUC) and the cut-off points for continuous clinical data. The prediction accuracies of models for CI-AKI were estimated through Harrell's concordance indices (C-index). Nomograms of the prognostic models were plotted for individualized evaluations of CI-AKI in T2DM patients after CAG. RESULTS: A total of 542 patients with T2DM who underwent CAG were included in this study. We found that a high UA level (≥ 425.5 µmol/L; OR = 6.303), BUN level (≥ 5.98 mmol/L; OR = 3.633), Scr level (≥ 88.5 µmol/L; OR = 2.926) and HbA1C level (≥ 7.05%; OR = 5.509) were independent factors for CI-AKI in T2DM patients after CAG. The nomogram model based on UA, BUN, Scr and HbA1C levels presented outstanding performance for CI-AKI prediction (C-index: 0.878). Decision curve analysis (DCA) showed good clinical applicability in predicting the incidence of CI-AKI in T2DM patients who underwent CAG. CONCLUSION: High UA levels are associated with an increased incidence of CI-AKI in T2DM patients after CAG. The developed nomogram model has potential predictive value for CI-AKI and might serve as an economic and efficient prognostic tool in clinical practice.

Extraction of Ampelopsis japonica polysaccharides using p-toluenesulfonic acid assisted n-butanol three-phase partitioning: Physicochemical, rheological characterization and antioxidant activity.

Polysaccharides as the biopolymers are showing various structural and modulatory functions. Effective separation of carbohydrate structures is essential to understanding their function. In this study, we choose an efficient organic acid in combination with recyclable organic solvent three-phase partitioning technology for the simultaneous extraction of polysaccharides from Ampelopsis japonica (AJPs) to ensure the integrity of linear and branched polysaccharide. The monosaccharide composition, glycosidic linkage information, structural and physicochemical analyses and associations with antioxidant activities were extensively analyzed. Synergistic extraction was compared with the conventional hot water extraction method and the results showed that AJPs-HNP exhibited better elastic properties and excellent antioxidant activity. Correlation analysis confirmed that the antioxidant activity of AJPs was significantly correlated with relative molecular weight, uronic acid content and terminal glycoside linkage molar ratios. The collaborative processing has significantly improved the utilization potential of AJPs and provides a sound theoretical foundation for the effective extraction and separation of polysaccharides. Overall, this work provides systematic and comprehensive scientific information on the physicochemical, rheological and antioxidant properties of AJPs, revealing their potential as natural antioxidants in the functional food and pharmaceutical industries.

Assisted Reproductive Technology Outcomes in Women with Normal Ovarian Response Receiving Recombinant Luteinizing Hormone/Human Menopausal Gonadotropin: An Observational Study.

Objective: Additive human menopausal gonadotropin (HMG)/recombinant luteinizing hormone (r-LH) to follicle-stimulating hormone (FSH) can improve pregnancy outcomes in patients with poor ovarian response during assisted reproductive procedures. However, their effects on patients with normal ovarian response during such procedures are unclear, which formed the aim of this study. Methods: This retrospective study enrolled 456 infertile women who underwent in vitro fertilization or intracytoplasmic sperm injection treatment. Group 1 received FSH; Group 2 received FSH+HMG/r-LH; Group 3 received FSH+HMG+r-LH. Results: The age and Body Mass Index were significantly greater in Group III. The endometrial thickness was greater in Groups II and III, suggesting better endometrial receptivity. Better pregnancy and birth outcomes were seen in Group 3. In sub-cohorts of women older than 32 years old or with overweight/obesity, pregnancy and birth outcomes were also much better in Group 3, albeit without statistical significance. Conclusion: The addition of both HMG and r-LH to FSH may improve the chance of infertile women with normal ovarian responses to have more success in having live birth babies, specifically in those over 32 years of age or with overweight/obese patients who typically face challenges in conceiving and sustaining a pregnancy.

Skin healthcare protection with antioxidant and anti-melanogenesis activity of polysaccharide purification from Bletilla striata.

In this study, we investigated the structural characterization and biological activities of Bletilla striata polysaccharides (BSPs) for their role as antioxidants and anti-melanogenesis agents in skin healthcare protection. Three neutral polysaccharides (BSP-1, BSP-2, and BSP-3) with molecular weights of 269.121 kDa, 57.389 kDa, and 28.153 kDa were extracted and purified. Their structural characteristics were analyzed by ion chromatography, GC-MS, and 1D/2D NMR. The results showed that BSP-1, which constitutes the major part of BSPs, was composed of α-D-Glcp, ß-D-Glcp, ß-D-Manp, and 2-O-acetyl-ß-D-Manp, with the branched-chain accompanied by ß-D-Galp and α-D-Glcp. BSP-1, BSP-2, and BSP-3 can enhance the total antioxidant capacity of skin fibroblasts with non-toxicity. Meanwhile, BSP-1, BSP-2, and BSP-3 could significantly inhibit the proliferative activity of melanoma cells. Among them, BSP-1 and BSP-2 showed more significance in anti-melanogenesis, tyrosinase inhibition activity, and cell migration inhibition. BSPs have effective antioxidant capacity and anti-melanogenesis effects, which should be further emphasized and developed as skin protection components.

Protective effects of degraded Bletilla striata polysaccharides against UVB-induced oxidative stress in skin.

The Bletilla striata polysaccharides (BSP) extracted through alkali-assisted method exhibit significant antioxidant activity, but its bioaccessibility was inadequate due to its tightly filamentous reticulation structure and high molecular weight. The anti-photoaging and anti-melanogenesis effects of degraded BSP (DBSPs) against UVB-induced oxidative stress on the skin were investigated. The molecular weights of the DBSPs were reduced to 153.94 kDa, 66.96 kDa, and 15.54 kDa from an initial value of 298.82 kDa. The degradation treatment altered the branched chain structure of the DBSPs, while the backbone structure, triple-helix structure, and crystallinity remained. DBSPs with a lower molecular weight exhibit better in vitro antioxidant activity. DBSPs did not show cytotoxicity to HSF cells but inhibited B16F10 cell proliferation. The addition of DBSPs protected HSF and B16F10 cells from oxidative stress and reduced ROS levels, B16F10 melanin content, and B16F10 tyrosinase activity after UVB damage, but DBSP-10 particles were slightly less effective due to aggregation. In contrast, DBSP-5 demonstrated effectiveness in reducing MDA levels in cells stressed by oxidative stress, increased total antioxidant capacity, and inhibited melanogenesis in B16F10, suggesting that DBSP-5 has potential as a topical therapeutic agent for the treatment of skin diseases associated with oxidative stress.

Comparison of frozen-thaw blastocyst transfer strategies in women aged 35-40 years: a retrospective study.

Objective: To compare the effects of five different frozen-thaw embryo transfer (FET) strategies in women aged 35-40 years. Methods: Data from 1,060 patients were divided into five groups according to the number and quality of transferred blastocysts: a high-quality single blastocyst group (group A, n= 303), a high-quality double blastocysts group (group B, n= 176), a high-quality plus poor-quality double blastocysts group (group C, n= 273), a poor-quality double blastocysts group (group D, n= 189), and a poor-quality single blastocyst group (group E, n= 119). Comparative analyses were then performed between groups with regard to primary conditions, pregnancy, and neonatal outcomes. Results: Group A had the lowest twin pregnancy rate (1.97%) and incidence of low-birth-weight infants (3.45%), which were significantly different from groups B, C, and D. In addition, the preterm birth rate (7.89%), neonatal birth weight (3300 g [3000, 3637.5]), and neonatal birth age (39.14 weeks [38.43, 39.61]) in group A were different from those in groups B and C. Double blastocyst transfer (DBT) was associated with a 20.558-fold (Risk Ratio [RR]=20.558, 95% confidence interval [CI], 6.628-63.763) and 3.091-fold (RR=3.091, 95% CI, 1.69-5.653) increased risk of twin pregnancy and preterm delivery in unadjusted analysis, respectively, when compared with single blastocyst transfer (SBT). In the adjusted analysis, we observed similar risk estimates (adjusted RR=26.501, 95% CI, 8.503-82.592; adjusted RR=3.586, 95% CI, 1.899-6.769). Conclusion: Although, high-quality SBT resulted in a lower live birth rate than high-quality DBT, it also significantly reduced the risk of adverse pregnancies, thus resulting in more benefits for both the mother and baby. Collectively, our data indicate that high-quality SBT remains the optimal FET strategy for women aged 35-40 years and warrants further clinical application.

Comparative study on the extraction efficiency, characterization, and bioactivities of Bletilla striata polysaccharides using response surface methodology (RSM) and genetic algorithm-artificial neural network (GA-ANN).

This research established the optimal conditions for alkali-assisted extraction (AAE) of bioactive polysaccharides from Bletilla striata integrated with response surface methodology (RSM) and the genetic algorithm-artificial neural networks (GA-ANN). In comparison with RSM, the ANN model showed a relatively higher determination coefficient in the global output values (RSM: ANN = 0.9270: 0.9742) performing more satisfactorily in the validation. Under the optimum conditions (52 °C; 167 min, and 0.01 mol/L NaOH), the extraction yields, IC50 of ABTS, and FRAP value were 29.53 ± 0.97 %, 3.41 mg/mL, and 39.11 µmol Fe2+/g, respectively. The results indicated that BSPs-A was mainly composed of glucose and mannose with small amounts of arabinose, galactose, and galacturonic acid, while possessed a molecular weight of about 305.94 kDa (Mw). The structural characterization of BSPs-A was initially characterized by FT-IR, SEM, and Congo red tests, which indicated that BSPs-A possessed a triple helix conformation of typical Bletilla striata polysaccharides. In addition, BSPs-A exhibited excellent antioxidant activity, which was further confirmed by a series of in vitro antioxidant activity assays including DPPH, ABTS, FRAP, and ORAC. After incubation in the BSA-glucose system for 15 days, BSPs-A showed inhibition of the advanced glycation end products (AGEs) formation for the first time.

High-strength and super-hydrophobic multilayered paper based on nano-silica coating and micro-fibrillated cellulose.

Herein, a facile strategy was proposed for preparing a high-strength and super-hydrophobic packaging paper with improved moisture and air barrier properties, which was derived from cellulosic pulps, micro-fibrillated cellulose (MFC), and nano-silica (n-SiO2). Owning to the laminated process followed by spraying approach, MFC and n-SiO2 were assembled onto two surfaces of the cellulose paper base, respectively, endowing the mechanical behaviors and superhydrophobic performance of this biodegradable composite papers as packaging material. The as-obtained multilayered papers demonstrated impressive dry tensile strength and remarkable wet tensile strength of 6542.5 N/m and 5875 N/m, which were increased by 56% and 2277%, respectively. In addition, the multilayered paper with rational mechanical properties possessed low permeabilities of air (3.17 × 10-3 µm·Pa-1·s-1), oxygen (9.687 cm3·m-2·day-1·atm), and water vapor (378.24 g·m-2·day-1), respectively, as well as a superhydrophobic performance with the contact angle of ~151.2°. Overall, the feasibility of large-scale production of biodegradable packaging materials in the paper-making industry is demonstrated by the fact that the micro/nanostructures and hydrophobic surfaces could be directly constructed on cellulosic paperboard.

Structural characterization and antioxidant activities of Bletilla striata polysaccharide extracted by different methods.

Bletilla striata polysaccharides (BSPs) are effective for anti-inflammatory, detumescence, and radicals scavenging, with important applications in the area of food chain, pharmacy science, and health care. In this study, we comprehensively studied the interplay between the polysaccharides' formation, physicochemical properties, rheological properties, and associated antioxidant activities of BSPs from different extraction methods. The crude polysaccharides obtained from Bletilla striata by using the hot water extraction (BSPs-H), alkali-assisted extraction (BSPs-A), boiling water extraction (BSPs-B), and ultrasonic-assisted extraction (BSPs-U) methods showed different molecular weights, monosaccharide compositions, glycosidic bond compositions, and zeta potentials, but with the same IR spectra characteristic and thermal stability. By the above-mentioned four kinds of extraction methods, the resultant BSPs exhibited various degrees of reticular and lamellar structure. All the BSPs solutions exhibited shear-thinning behavior with the increase of the shear rate. Among these BSPs, BSPs-A exhibited better DPPH and ABTS radical scavenging activities and reducing power, whereas BSPs-H showed better hydroxyl radical scavenging activities.

Silver-Nanoparticle-Embedded Hybrid Nanopaper with Significant Thermal Conductivity Enhancement.

Nanopapers derived from nanofibrillated cellulose (NFC) are urgently required as attractive substrates for thermal management applications of electronic devices because of their lightweight, easy cutting, cost efficiency, and sustainability. In this paper, we provided a facile fabrication strategy to construct hybrid nanopapers composed of dialdehyde nanofibrillated cellulose (DANFC) and silver nanoparticles (AgNPs), which exhibited a favorable thermal conductivity property. AgNPs were in situ proceeded on the surface of DANFC by the silver mirror reaction inspired by the aldehyde groups. Owing to the intermolecular hydrogen bonds inside the hybrid nanopapers, the DANFC enables the uniform dispersion of AgNPs as well as promotes the formation of the hierarchical structure. It was found that the AgNPs-coated DANFC (DANFC/Ag) hybrid nanopapers could easily form an effective thermally conductive pathway for phonon transfer. As a result, the thermal conductivity (TC) of the obtained DANFC/Ag hybrid nanopapers containing only 1.9 vol % of Ag was 5.35 times higher than that of the pure NFC nanopapers along with a significantly TC enhancement per vol % Ag of 230.0%, which was supposed to benefit from the continuous heat transfer pathway constructed by the connection of AgNPs decorated on the cellulose nanofibers. The DANFC/Ag hybrid nanopapers possess potential applications as thermal management materials in the next-generation portable electronic devices.

Increased flammability hazard when ionic liquid [C6mim][Cl] is exposed to high temperatures.

Industrial use of ionic liquids may require exposure to high temperatures. We demonstrate that such applications may result in an increase in flammability hazard due to chemical decomposition. The ionic liquid, 1-hexyl-3-methylimidazolium chloride ([C6mim][Cl]), was selected as the study sample. The flash point and other properties were measured using a commercially available flash point analyzer, a thermogravimetric analyzer (TGA), Fourier transform infrared spectroscopy (FTIR), an integrated TGA-FTIR system, and pyrolysis-gas chromatography-mass spectrometer. We found that thermal decomposition occurred with the release of chloromethane, 1-chlorohexane, 1-hexene, 1-methylimidazole, and 1-hexylimidazole as [C6mim][Cl] was heated. Such decomposition changed the components of the residual liquid phase. Vaporization of the [C6mim][Cl] decomposition products increased the mass loss rate on TGA as [C6mim][Cl] was heated to high temperatures, resulting in a high concentration of flammable gases and a decrease in the flash point, which increased the flammability hazard.

[The combined application of dissociate skin flap and vacuum sealing drainage on the defect of the large neck neoplasms after surgical procedures].

OBJECTIVE: To evaluate the effect of the combined application of dissociate skin flap and vacuum sealing drainage (VSD) for the repairing for defect after surgical management of huge neck neoplasms. METHOD: Nineteen patients with huge neck malignant tumor involving the skin of the neck were given radical operation, making use of VSD covering the wound surface. After giving 6.65-7.98 mm Hg continuous negative pressure drainage for 72 h, the patients turned to be treated by intermittent negative pressure therapy with 2 min free interval after each treatment period for 5 min. After dismantling the VSD at 7th to 10th day postoperatively, the good wounds covered by granulation tissue were treated by the skin graft operation with dissociate skin flap from thighs; as for the wounds of which the granulation tissue didn't grow well and important cervical tissues was not fully covered by the granulation tissue, VSD was applied again for 1 week, followed by the skin graft operation. RESULT: Nineteen patients have received a total of 23 times of VSD wound treatment, one-stage operation time was significantly shortened. The granulation tissue grew faster on the wound after VSD treatment, and the important cervical tissues such as great vessels could be well covered. The infection and tumor recurrence were observed directly after dismantling the VSD. The skin graft transplantation would be performed after 1-3 weeks. CONCLUSION: The treatment by vacuum sealing drainage combined with skin graft for surgical wounds of huge neck tumor postoperatively has the advantages of simple operation, little injury and promotion of the wound healing, which is an effective way for treatment of neck skin defect by surgical operation for the huge tumor.

[A three-dimensional quantitative measurement related to sigmoid sinus by using multi-slices spiral CT].

OBJECTIVE: To provide a valuable imaging anatomic method for operation of the posterior transpetrosal approach and accurate positioning among relative structures in order to reduce the incidence of surgical complications. METHODS: The clinical information of 119 adult cases (238 sides) was analyzed. All the cases underwent 16 layer helix CT scanning and three-dimensional image reconstruction of skull base without a skull base disease. Axial and coronal images were reconstructed using multiplanar reconstruction technique of ADW 4.2 workstation, and the anatomic objective structure were displayed by rotating imaging slices. The data were analyzed in statistically and compared with the published cadaver data. RESULTS: Quantitative measurement of anatomic structure was shown as below: The distance of width of sigmoid sinus was (11.14 + or - 2.13) mm, the distance of depth of sigmoid sinus was (6.04 + or - 1.67) mm; the distance from the lateral wall of sigmoid sinus to the surface of mastoid process was (9.74 + or - 2.95) mm; the distance from the anterior wall of sigmoid sinus to the posterior wall of external auditory meatus was (12.98 + or - 2.71) mm; the distance from the most posterior portion of the posterior semicircular canal to the anterior wall of sigmoid sinus was (9.87 + or - 2.60) mm; the distance from the most posterior portion of the posterior semicircular canal to the posterior pyramidal wall was (3.18 + or - 1.30) mm; the distance from the posterior extremity of long axis of the lateral semicircular canal to the anterior wall of sigmoid sinus was (13.17 + or - 2.59) mm; the distance from the posterior extremity of long axis of the lateral semicircular canal to the posterior pyramidal wall was (5.46 + or - 1.38) mm; the vertical distance from the lateral semicircular canal to the jugular bulb was (6.69 + or - 3.08) mm; and the distance from the vertical portion of facial nerve to the jugular bulb was (5.32 + or - 2.13) mm. Statistically, there were no significant differences between imaging quantitative measurement and published cadaver data. However, the measurement result, included the distance from the lateral wall of sigmoid sinus to the surface of mastoid process and the distance from the lateral semicircular canal to the jugular bulb as well as the distance from the vertical portion of facial nerve to the jugular bulb, were found a positively correlated to the distance from the anterior wall of sigmoid sinus to the posterior wall of external auditory meatus (r value was 0.284, 0.145, 0.208, respectively, all P < 0.05). CONCLUSIONS: The result of three-dimensional quantitative measurement by using multiplanar reconstruction technique of 16 layer spiral CT could represent a real distance of anatomic structures. The reconstruction of spiral CT images could display a anatomic feature of temporal bone accurately, and it may provide a valuable method for surgical approach and accurate positioning of relative structure in operation. As the location of sigmoid sinus moving forward, the lateral shift of it may occur more easily and the jugular bulb become closer to the vertical portion of facial nerve, while the extension of anterior location in sigmoid sinus should be a positively correlated to the height of jugular bulb.