Efficacy of intracytoplasmic sperm injection in women with non-male factor infertility: A systematic review and meta-analysis.

INTRODUCTION: The use of intracytoplasmic sperm injection (ICSI) has dramatically increased in patients with non-male factor infertility during the last decades. However, whether ICSI provides a significant benefit over in vitro fertilization (IVF) in these patients is still controversial. In this study, we aimed to investigate the efficacy of ICSI on reproductive outcomes with non-male factor infertility and to provide updated evidence for clinical practice. MATERIAL AND METHODS: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from inception to March 2023. Randomized controlled trials (RCTs) comparing the efficacy between ICSI and IVF in patients with non-male factor infertility were included. The main outcomes were the live birth rate (LBR), fertilization rate (FR), and total fertilization failure (TFF). The pooled estimates were calculated using the random-effects models as relative risk (RR) with 95% confidence intervals (CIs). This systematic review and meta-analysis was registered in PROSPERO (CRD42023427004). RESULTS: We included 18 RCTs with 3249 cycles and 30 994 oocytes. The results demonstrated that ICSI reduced the risk of TFF (RR = 0.26, 95% CI: 0.13-0.50, I2 = 58%) and increased FR per oocyte inseminated/injected (RR = 1.14, 95% CI: 1.08-1.20, I2 = 69%), but it did not improve LBR (RR = 1.11, 95% CI: 0.94-1.30, I2 = 0%) or other outcomes compared with IVF. However, the difference in fertilization failure reduction between ICSI and IVF may be explained by different randomization methods (randomization based on patients vs. sibling oocytes). When considering only studies with randomization based on patients, we found no evidence of the difference between the groups (RR = 0.72, 95% CI: 0.48-1.06, I2 = 0%). Furthermore, no differences were observed in subgroup analyses based on other factors, including female age, study period, and controlled ovarian stimulation protocols. CONCLUSIONS: Our findings suggest that ICSI leads to no difference in reproductive outcomes compared to IVF in patients with non-male factor infertility. Considering the cost and safety of ICSI, we have no evidence to support the routine use of ICSI in these populations. High-quality RCTs with large sample sizes will be needed to confirm our results and explore clinical and neonatal outcomes.

Time trend of global uterine cancer burden: an age-period-cohort analysis from 1990 to 2019 and predictions in a 25-year period.

BACKGROUND: Uterine cancer remains a serious medical problem worldwide. This study aimed to explore the global time trends of uterine cancer burden using the age-period-cohort model and forecast incidence to 2044. METHODS: Data were downloaded from the Global Burden of Disease 2019. The age-period-cohort model was used to estimate age, period and birth cohort effects. We also predict uterine cancer incidence to 2044. RESULTS: Globally, there were 435,041 incident cases (95% UI: 245,710 to 272,470) and 91,640 deaths of uterine cancer (95% UI: 39,910 to 44,140) in 2019. During the past 30 years, the age-standardized incidence and death rates increased by 15.3% and decreased by 21.6%, respectively. Between 1990 and 2019, the high-sociodemographic index region had the highest overall annual percentage changes. The age effect showed the uterine cancer incidence rate first increased and then decreased with age. The period and cohort relative rate ratio showed upward trends during the study period. Incident cases of uterine cancer may increase to more than six hundred thousand in 2044. CONCLUSION: Uterine cancer causes a high disease burden in high-income regions and the global incidence may continue to increase in the future. Improving awareness of risk factors and reducing the proportion of the obese population are necessary to reduce future burden.

Correlations of apathy with clinical symptoms of Alzheimer's disease and olfactory dysfunctions: a cross-sectional study.

BACKGROUND: Apathy is one of the most common symptoms of Alzheimer's disease (AD), however, correlations of apathy with demographic variables, cognitive functions, neuropsychiatric symptoms, activity of daily living and olfactory functions in AD patients are still lacking comprehensive investigations. METHODS: This is a cross-sectional study. Total 124 typical AD patients were consecutively recruited from April 2014 to April 2017. In 124 AD patients, 47 cases (37.9%) were male and 77 cases were female; patients' age were 43-93 years with an average of 68 years. Patients were divided into AD with apathy (AD-A) and AD with no apathy (AD-NA) groups according to the score of Modified Apathy Evaluation Scale, then were evaluated cognitive functions, neuropsychiatric symptoms and activity of daily living, and tested olfactory functions. Above variables were compared between AD-A and AD-NA groups. Further correlation analyses and linear regression analysis were performed between apathy and above variables. RESULTS: Compared with AD-NA group, global cognitive level, verbal memory, verbal fluency and activity of daily living were significantly compromised in AD-A group (P < 0.002); depression and agitation were severely displayed in AD-A group (P < 0.002). Apathy was negatively correlated with global cognitive function, verbal memory, verbal fluency and activity of daily living (P < 0.05). There was no significant difference of olfactory functions between the two groups (P > 0.002), and correlations between apathy and olfactory threshold, olfactory identification and global olfactory function were significant (P < 0.05) but quite weak (|r| < 0.3). Further linear regression analysis showed that only verbal fluency and instrumental activities of daily living were independently associated with apathy. CONCLUSIONS: Independent correlations among apathy, verbal fluency and instrumental activities of daily living in AD patients might be related to the common brain area involved in their pathogeneses.

The silent information regulator 1 pathway attenuates ROS-induced oxidative stress in Alzheimer's disease.

We show that down-regulation of circular ribonucleic acid 0001588 with small interfering-circular ribonucleic acid 0001588 mimics promoted caspase-3 and caspase-9 activity levels, increased lactate dehydrogenase activity levels, and reduced cell growth of in vitro model. Circular ribonucleic acid 0001588 plasmids increased circular ribonucleic acid 0001588 expressions and promoted cell growth and reduced activity levels of lactate dehydrogenase, caspase-3, and caspase-9 activity levels in vitro model of Alzheimer's disease. Then, circular ribonucleic acid 0001588 down-regulation also promoted reactive oxygen species production and oxidative stress (malonaldehyde), and reduced superoxide dismutase, glutathione, and glutathione peroxidase levels by suppressing of silent information regulator 1/nuclear factor erythroid 2-related factor 2/heme oxygenase-1 in vitro. However, over-expression of circular ribonucleic acid 0001588 reduced reactive oxygen species production and malonaldehyde levels and increased superoxide dismutase, glutathione, and levels via activation signal pathway of silent information regulator 1/nuclear factor erythroid 2-related factor 2/heme oxygenase-1 signaling pathway by miR-211-5p up-regulation in vitro. Over-expression of miR-211-5p attenuated the role of circular ribonucleic acid 0001588 on Alzheimer's disease-induced oxidative stress. Also, activation of the silent information regulator 1 pathway attenuated the antioxidative effects of circular ribonucleic acid 0001588 down-regulation on oxidative stress by activating silent information regulator 1/nuclear factor erythroid 2-related factor 2/heme oxygenase-1 in vitro. In conclusion, our findings indicated that circular ribonucleic acid 0001588 induced the silent information regulator 1/nuclear factor erythroid 2-related factor 2-dependent heme oxygenase-1 pathway to prevent oxidative stress by miR-211-5p in the rat model or in vitro model of a sporadic type of Alzheimer's disease. Therefore, the expression of the circular ribonucleic acid 0001588 gene was inhibited in rodent Alzheimer's disease model.

Predictors of early left ventricular dysfunction after mitral valve replacement for rheumatic valvular disease.

OBJECTIVE: The purpose of this study was to determine the predictors of early left ventricular (LV) dysfunction in patients with rheumatic heart disease (RHD) after mitral valve replacement (MVR). We examined echocardiographic and nonechocardiographic predictors. METHODS: This study included 571 patients receiving MVR for RHD from 2012 to 2017. Their baseline characters, preoperative examination, operation data, and postoperative echocardiography were collected retrospectively. Univariate and multivariate logistic regression were used to evaluate the predictors of early LV dysfunction after MVR. The LV dysfunction was defined as left ventricular end-ejection fraction (LVEF) <50%. The interaction model was further performed to calculate interaction effects between predictors selected by logistic regression. RESULTS: In the 571 patients, 164 (28.7%) had early LV dysfunction after the operation, but only 94 (16.5%) had a preoperative LVEF <50%. Significant differences between two groups (LVEF ≥50% or LVEF <50%) were finally revealed in LV end-diastolic dimension, preoperative atrial fibrillation (AF), preoperative LVEF <50%, and the white blood cell (WBC) count measured after admission (>10 × 109 L -1 ) in the multivariate logistic regression. Corresponding odds ratios (ORs) were 1.06, 1.82, 3.63, and 2.64, respectively. Diabetes, lesion type, LV end-systolic dimension, aspartate transaminase, alanine transaminase, and serum creatinine were statistically significant (P < .05) in univariate logistic regression, with matched ORs 2.45, 1.66/0.65, 1.07, 2.50, 1.83, and 2.90, respectively. However, these variables were not significant anymore in the multivariate logistic model. Besides, the OR of early postoperative LV dysfunction increased to 7.00 when preoperative AF, preoperative LVEF <50%, and WBC >10 × 109 L-1 were all present. CONCLUSIONS: The preoperative LV dysfunction, a large LV volume, AF and over-normal WBC could independently predict postoperative LV dysfunction.

Recovery iron from cyanide tailings by anaerobic roasting-persulfate leaching: effect of roasting temperature.

Anaerobic roasting combined with the persulfate-leaching process was used to treat cyanide tailings. In this study, the effect of the roasting conditions on the iron leaching rate was investigated by the response surface methodology. Additionally, this study was focusing on the effect of roasting temperature on the physical phase transformation of cyanide tailings and the persulfate-leaching process of roasted products. The results showed that roasting temperature had significant influences on the leaching of iron. The roasting temperature determined the physical phase changes of iron sulfides in roasted cyanide tailings, which in turn affected the leaching of iron. At the temperature of 700 °C, all pyrite was converted to pyrrhotite, and the leaching rate of iron reached a maximum of 93.62%. At this point, the weight loss rate of cyanide tailings and the recovery rate of sulfur were 43.50% and 37.73%, respectively. The sintering of the minerals became more severe when the temperature raised to 900 °C, and the iron leaching rate gradually decreased. The leaching of iron was mainly attributed to the indirect oxidation by SO4-˙ and OH˙ rather than the direct oxidation by S2O82-. The oxidation of iron sulfides by persulfate produced iron ions along with a certain amount of SO4-˙. Iron ions continuously activated persulfate to produce SO4-˙ and OH˙ under the mediation of sulfur ions in iron sulfides.

Clinical features and brain structural changes in magnetic resonance imaging in Alzheimer's disease patients with apathy.

BACKGROUND: Apathy is common in Alzheimer's disease (AD) patients. However, its relation with other clinical symptoms in AD and brain structural changes in magnetic resonance imaging is unclear. RESULTS: Compared with AD with no apathy group, cognitive function and activities of daily living were significantly impaired and neuropsychiatric symptoms were obviously presented in AD with apathy group (P<0.05). The frequency of Apolipoprotein E genotypes was not significantly different (P>0.05). Correlation analyses and multiple linear analyses revealed that thickness of left temporal pole and volume of posterior corpus callosum were significantly and negatively correlated with Modified Apathy Estimation Scale score in AD patients (P<0.05). CONCLUSIONS: Apathy with AD is positively correlated with cognitive impairment, neuropsychiatric symptoms and poor activities of daily living. Atrophy of left temporal pole and posterior corpus callosum presented by MRI is positively related with apathy of AD. METHODS: In this study, 137 AD patients were recruited and divided into AD with apathy group and AD with no apathy group according to Modified Apathy Estimation Scale score. We evaluated patients' cognitive function, neuropsychiatric symptoms and activities of daily living, detected the frequency of Apolipoprotein E genotypes and measured cortical thickness and volume by magnetic resonance imaging (MRI).

The Relationship between Cerebral White Matter Integrity and Cognitive Function in Mild Stroke with Basal Ganglia Region Infarcts.

Mild stroke is a known risk factor for dementia. The relationship between cerebral white matter (WM) integrity and cognitive impairment (CI) in mild stroke patients with basal ganglia region infarcts is unknown. Total of 33 stroke patients and 19 age-matched controls underwent diffusion tensor imaging scans and a formal neuropsychological test battery. CI was defined as having a performance score 1.5 SD below the established norm. We compared the differences in Z-scores and Fraction Anisotropy (FA) values among controls, stroke with no CI (NCI) and stroke with CI groups. Multiple linear regressions were performed between FA values in affected regions and neuropsychological tests in stroke patients. The majority of stroke patients were in their 50s (56.90 ± 9.23 years). CI patients exhibited a significantly decreased Z score in visual delayed memory and remarkably decreased FA values in the right external capsule and right fornix (FWE-corrected) compared with NCI patients and controls. In stroke patients, the FA value in the right fornix was positively correlated with delayed visual memory. Mild stroke with basal ganglia region infarcts may be related to widespread abnormality of WM integrity. The lower WM integrity in the right fornix may be a marker of impaired delayed visual memory.

Life Span and Motility Effects of Ethanolic Extracts from Sophora moorcroftiana Seeds on Caenorhabditis elegans.

BACKGROUND: Sophora moorcroftiana is an endemic shrub species with a great value in folk medicine in Tibet, China. In this study, relatively little is known about whether S. moorcroftiana is beneficial in animals' nervous system and life span or not. MATERIALS AND METHODS: To address this question, under survival normal temperature (25°C), S. moorcroftiana seeds were extracted with 95% ethanol, and Caenorhabditis elegans were exposed to three different extract concentrations (100 mg/L, 200 mg/L, and 400 mg/mL) from S. moorcroftiana seeds. RESULTS: The 95% ethanolic extracts from S. moorcroftiana seeds could increase life span and slow aging-related increase in C. elegans and could not obviously influence the motility of C. elegans. CONCLUSION: Given these results by our experiment for life span and motility with 95% ethanolic extracts from S. moorcroftiana seeds in C. elegans, the question whether S. moorcroftiana acts as an anti-aging substance in vivo arises. SUMMARY: The 95% ethanolic extracts from S. moorcroftiana seeds have no effect on the life span in C. elegans when extract concentrations from S. moorcroftiana seeds <400 mg/LThe 400 mg/L 95% ethanolic extracts from S. moorcroftiana seeds could increase life span in C. elegansThe 95% ethanolic extracts from S. moorcroftiana seeds could not obviously influence the motility in C. elegans. Abbreviation used: S. moorcroftiana: Sophora moorcroftiana; C. elegan: Caenorhabditis elegan; E. coli OP50: Escherichia coli OP50; DMSO: Dimethyl sulfoxide.

Screening for cognitive impairment with the Montreal Cognitive Assessment in Chinese patients with acute mild stroke and transient ischaemic attack: a validation study.

OBJECTIVE: We aimed to establish the cut-off point of the Montreal Cognitive Assessment (MoCA-Beijing) in screening for cognitive impairment (CI) within 2 weeks of mild stroke or transient ischaemic attack (TIA). METHODS: A total of 80 acute mild ischaemic stroke patients and 22 TIA patients were recruited. They received the MoCA-Beijing and a formal neuropsychological test battery. CI was defined by 1.5 SD below the established norms on a formal neuropsychological test battery. RESULTS: Most stroke and TIA patients were in their 50s (53.95±11.43 years old), with greater than primary school level of education. The optimal cut-off point for MoCA-Beijing in discriminating patients with CI from those with no cognitive impairment (NCI) was 22/23 (sensitivity 85%, specificity 88%, positive predictive value=91%, negative predictive value=80%, classification accuracy=86%). The predominant cognitive deficits were characteristic of frontal-subcortical impairment, such as visuomotor speed (46.08%), attention/executive function (42.16%) and visuospatial ability (40.20%). CONCLUSIONS: A MoCA-Beijing cut-off score of 22/23 is optimally sensitive and specific for detecting CI after mild stroke, and TIA in the acute stroke phase, and is recommended for routine clinical practice.

Serotonergic dysfunctions and abnormal iron metabolism: Relevant to mental fatigue of Parkinson disease.

Fatigue is a very common non-motor symptom in Parkinson disease (PD) patients. It included physical fatigue and mental fatigue. The potential mechanisms of mental fatigue involving serotonergic dysfunction and abnormal iron metabolism are still unknown. Therefore, we evaluated the fatigue symptoms, classified PD patients into fatigue group and non-fatigue group, and detected the levels of serotonin, iron and related proteins in CSF and serum. In CSF, 5-HT level is significantly decreased and the levels of iron and transferrin are dramatically increased in fatigue group. In fatigue group, mental fatigue score is negatively correlated with 5-HT level in CSF, and positively correlated with the scores of depression and excessive daytime sleepiness, and disease duration, also, mental fatigue is positively correlated with the levels of iron and transferrin in CSF. Transferrin level is negatively correlated with 5-HT level in CSF. In serum, the levels of 5-HT and transferrin are markedly decreased in fatigue group; mental fatigue score exhibits a negative correlation with 5-HT level. Thus serotonin dysfunction in both central and peripheral systems may be correlated with mental fatigue through abnormal iron metabolism. Depression, excessive daytime sleepiness and disease duration were the risk factors for mental fatigue of PD.