Treatment of acetabular fracture involving anterior and posterior columns using a single pararectus approach: surgical experience and preliminary results.

PURPOSE: This study aims to evaluate the efficacy of single pararectus approach in patients confirmed with acetabular fracture involving anterior and posterior columns. METHODS: A total of 58 patients confirmed with acetabular fracture involving anterior and posterior columns and treated at our hospital between January 2015 and January 2020 were retrospectively analyzed. A single pararectus approach was applied for all patients. Routine X-rays were performed at follow-up of one, three, six, 12, and 18 months, and three-dimensional CT scans were added at six and 18 months. Fracture reduction quality was assessed using the Matta score system, and functional assessment used the Modified Merle D'Aubigné and Postel score system. Post-operative complications, including fat liquefaction and deep vein thrombosis, were recorded and analyzed. RESULTS: The median operation time was 186 min while the intra-operative blood loss was 421 mL. The rate of good-to-excellent reduction was 94.8%, and the rate of good-to-excellent hip function score reached 93.1%. Seven patients presented with post-operative complications, including three intra-operative small vascular injuries, two peritoneal small perforations, one fat liquefaction, and one deep vein thrombosis. CONCLUSION: Using a single pararectus approach is convenient and effective for treating acetabular fracture involving anterior and posterior columns, especially those involving the quadrilateral area. TRIAL REGISTRATION: ChiCTR, ChiCTR2100054604. Registered 21 December 2022. Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=144783 .

Optimum oocyte retrieved and transfer strategy in young women with normal ovarian reserve undergoing a long treatment protocol: a retrospective cohort study.

PURPOSE: This study aimed to investigate the relationship between the number of oocytes retrieved and clinical outcomes in young women with normal ovarian reserve who were undergoing their first in vitro fertilization and embryo transfer (IVF-ET) cycle. The transfer strategy based on yielded oocytes was also discussed in this article. METHODS: A total of 1567 patients who underwent first long protocol of IVF treatment in our reproductive medical center between January 2010 and June 2014 were categorized into five groups based on the retrieved oocyte number, namely, 4∼6, 7∼9, 10∼12, 13∼15, and ≥16. Baseline parameters were similar among the groups. Primary outcome was defined as the cumulative live birth rate (CLBR), and secondary outcomes included the rate of patients with high risks for ovarian hyperstimulation syndrome (OHSS). RESULTS: It was found that the CLBR increased with the number of oocytes, as well as the rate for high risks of OHSS. In fresh cycles, 10∼12 oocyte group demonstrated the highest implantation rate (53.32 %), clinical pregnancy rate (CPR) (73.13 %), and live birth rate (LBR) (61.14 %), with no significant differences. Moreover, both cumulative CPR (CCPR) and CLBR became significantly higher in the 10∼12 oocyte group, compared with 4∼6 and 7∼9 groups. However, when the retrieved oocytes increased to 13∼15 or ≥16, the cumulative results did not have a significant increase. Also, the high risk rate of OHSS was much lower in the 10∼12 group (11.53 %) than that in the 13∼15 group (29.97 %) and ≥16 group (77.30 %). Unconditional multivariate logistic regression analysis showed that when ≥10 oocytes were retrieved, the CLBR increased significantly (P < 0.01). When oocyte number exceeded 16, the CPR of frozen embryo transfer cycle was much higher than that of fresh cycle (P < 0.05). CONCLUSIONS: For young women with normal ovarian reserve, retrieving 10∼12 oocytes might result in optimized pregnancy outcomes in a fresh cycle with low OHSS risk and would not compromise cumulative outcomes. When ≥16 oocytes were retrieved, a "freeze-all" embryo strategy might be preferable.

[Pregnancy outcome of frozen-thawed embryo transfers in different endometrial progesterone preparation time].

OBJECTIVE: To investigate the pregnancy outcome of frozen-thawed embryos transfer in different endometrial progesterone preparation time. METHODS: From January to December 2012, pregnant outcome of 1 103 frozen-thawed embryo transfer cycles using artificial periodic endometrial preparation were studied retrospectively in Reproductive Medical Center of Henan Provincial People's Hospital. It was divided into 4 groups: group 3-3 (n = 543, 3 days after endometrial progesterone preparation and transfer D3 embryo), group 4-3(n = 330, 4 days after endometrial progesterone preparation and transfer D3 embryo), group 5-5 (n = 150, 5 days after endometrial progesterone preparation and transfer D5 blastula), group 6-5 (n = 80, 6 days after endometrial progesterone preparation and transfer D5 blastula). The rate of implantation, pregnancy, ectopic pregnancy, multiple pregnancy, and first trimester abortion were compared among those groups. RESULTS: (1) With the different endometrial progesterone preparation methods and transfer D3 embryos, implantation rate [group 3-3:39.9% (429/1 074); group 4-3:44.1% (286/648)], pregnancy rate [group 3-3:56.0% (304/543); group 4-3:59.4% (196/330)], ectopic pregnancy rate [group 3-3:3.3% (10/304); group 4-3:2.6% (5/196)], multiple pregnancy rate[group 3-3: 38.5% (117/304) ; group 4-3: 43.4% (85/196)]and early abortion rate [group 3-3: 13.5% (41/304); group 4-3:13.3% (26/196)] had no significant differences between group 3-3 and group 4-3 (all P > 0.05). (2) With the different endometrial progesterone preparation methods and transfer D5 blastocysts, implantation rate [group 5-5:64.7% (191/295) ; group 6-5:69.4% (100/144)], pregnancy rate [group 5-5:80.7% (121/150) ; group 6-5:78.8% (63/80)], ectopic pregnancy rate [group 5-5:2.5% (3/121); group 6-5:0], multiple pregnancy rate[group 5-5:55.4% (67/121); group 6-5: 46.3% (37/80)] and early abortion rate [group 5-5: 5.8% (7/121); group 6-5:7.9% (5/63)]. However, there were no significantly differences between group 5-5 and group 6-5(all P > 0.05). CONCLUSIONS: The two different progesterone transformed endometrial methods can obtain satisfactory clinical outcome with D3 embryo or D5 blastocysts transfor. It is convenient to clinical and laboratory work arrangements.

The effect of gonadotropin-releasing hormone agonist downregulation in conjunction with hormone replacement therapy on endometrial preparation in patients for frozen-thawed embryo transfer.

Objective: To investigate the effects of combining gonadotropin-releasing hormone agonist (GnRHa) downregulation with hormone replacement therapy (HRT, GnRHa-HRT) on the clinical outcomes of patients undergoing frozen-thawed embryo transfer (FET). Methods: In this retrospective study, we included patients who had FET between January 2018 and December 2022. They were categorized into HRT and GnRHa-HRT groups based on the endometrial preparation protocol. The study compared the clinical outcomes of patients in two groups. Possible factors affecting clinical outcomes were analyzed using univariate analysis. To analyze the impact of two endometrial preparation methods on clinical outcomes, multifactorial logistic regression was performed. Results: The rates of clinical pregnancy (47.31% vs. 59.60%), embryo implantation (37.58% vs. 49.65%), biochemical pregnancy (52.36% vs. 64.31%), and early abortion (7.07% vs. 10.77%) were statistically different between the two groups (p < 0.05). Analysis using multifactorial logistic regression showed that there was a 1.65-fold increase in clinical pregnancy rates (OR = 1.65, 95% CI: 1.29-2.12, p < 0.001) and a 1.55-fold increase in embryo implantation rates (OR = 1.55, 95% CI: 1.27-1.90, p < 0.001) in the GnRHa-HRT group when compared to the HRT group. For blastocyst transfer, the clinical pregnancy and implantation rates of the GnRHa-HRT group were significantly higher than those of the HRT group (OR = 1.75, 95% CI: 1.30-2.37, p < 0.001; OR = 1.73, 95% CI: 1.35-2.21, p < 0.001). Conclusion: In FET cycles, leuprorelin (as a GnRHa) downregulation combined with HRT may improve the clinical outcome of patients compared to the HRT cycle, especially for the clinical pregnancy and embryo implantation rates of patients with blastocyst transfer.

Impact of progesterone concentration on human chorionic gonadotropin trigger day on clinical outcomes with one top-quality cleavage-stage embryo or blastocyst transfer in fresh in vitro fertilization cycles.

Objective: To investigate the impact of the progesterone concentration on the human chorionic gonadotropin (hCG) trigger day on clinical outcomes with an antagonist protocol. Methods: The retrospective cohort study included a total of 1,550 fresh autologous ART cycles with one top-quality embryo transfer. Multivariate regression analysis, curve fitting, and threshold effect analysis were performed. Results: A significant association was found between the progesterone concentration and clinical pregnancy rate (adjusted OR, 0.77; 95% CI, 0.62-0.97; P = 0.0234), especially in blastocyst transfer (adjusted OR, 0.56; 95% CI, 0.39-0.78; P = 0.0008). The association between the progesterone concentration and the ongoing pregnancy rate was insignificant. The clinical pregnancy rate showed a linear relationship with an increased progesterone concentration in cleavage-stage embryo transfer. In blastocyst transfer, as the progesterone concentration increased, the clinical and ongoing pregnancy rates showed a parabolic reverse-U curve; the curve initially increased before declining at high progesterone concentrations. The clinical pregnancy rate increased with a progesterone concentration up to 0.80 ng/mL rather than tended to be stable. The clinical pregnancy rate significantly decreased when the progesterone concentration was ≥0.80 ng/mL. Conclusion: The progesterone concentration on the hCG trigger day exhibits a curvilinear relationship with pregnancy outcomes in blastocyst transfer cycles, and the optimal threshold of the progesterone concentration is 0.80 ng/mL.

Association of HOMA-IR with Ovarian Sensitivity Index in Women Undergoing IVF/ICSI: A Retrospective Cohort Study.

Background: Insulin resistance (IR) may adversely impact the in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) outcomes. However, the association of IR with ovarian sensitivity during controlled ovarian hyperstimulation (COH) remains controversial. Purpose: We aimed to explore the association between homeostasis model assessment of insulin resistance (HOMA-IR) and ovarian sensitivity index (OSI). Patients and Methods: In this retrospective cohort study, 7836 patients aged between 20 and 39 years with good ovarian reserve were included consecutively between June 2018 and May 2022. HOMA-IR was calculated to evaluate the degree of IR and OSI was used to measure ovarian sensitivity. Owing to skewed distribution, HOMA-IR and OSI were log e transformed to Ln HOMA-IR and Ln OSI. Smoothing splines were generated by generalized additive models to explore the correlation between Ln HOMA-IR and Ln OSI. Then, the relationship between Ln HOMA-IR and Ln OSI was tested with multivariable linear regression model after adjustments for the potential confounders. Results: We observed negative association between Ln HOMA-IR and Ln OSI after adjustment for potential confounders by using smoothing spline fitting curves in generalized additive model. In the multivariable linear regression model, after full adjustments, each one unit increase in Ln HOMA-IR was related to reduced Ln OSI values (ß = -0.12, 95% CI, -0.15, -0.09). As sensitivity analysis, those who had HOMA-IR of quartile 3 (HOMA-IR 2.33-3.43) and quartile 4 (HOMA-IR ≥3.43) had decreases in Ln OSI values (ß = -0.07, 95% CI -0.11, -0.03 and ß = -0.18, 95% CI -0.22, -0.13, respectively) when compared with patients in the quartile 1 (HOMA-IR <1.63). Furthermore, stratified and interaction analysis showed a strong inverse association of Ln HOMA-IR with Ln OSI in subgroups of PCOS patients and overweight/obese populations (P-value for interaction <0.0001). Conclusion: HOMA-IR value was negatively associated with the ovarian sensitivity assessed by OSI. Among the PCOS and overweight/obese populations, this inverse relationship may be strong. These findings will increase the understanding of the contribution of IR to the development of decreased ovarian sensitivity within the assisted reproductive technology (ART) setting. It may have implications for optimizing gonadotropin dose manipulation in patients with IR undergoing IVF/ICSI.

Association between HOMA-IR and ovarian sensitivity index in women with PCOS undergoing ART: A retrospective cohort study.

Introduction: Insulin resistance (IR) may play a central role in the pathophysiology of polycystic ovary syndrome (PCOS). Controlled ovarian stimulation (COS) in PCOS women in the setting of assisted reproductive technology (ART) is always a challenge for clinicians. However, it remains unclear whether IR in women with PCOS correlates with reduced ovarian sensitivity to exogenous gonadotropin (Gn). This study aimed to explore the association between homeostasis model assessment of insulin resistance (HOMA-IR) and ovarian sensitivity index (OSI). Methods: In this retrospective cohort study, we explored the association between Ln HOMA-IR and Ln OSI based on smoothing splines generated by generalized additive model (GAM). Then the correlation between HOMA-IR and OSI was further tested with a multivariable linear regression model and subgroup analysis. Results: 1508 women with PCOS aged 20-39 years undergoing their first oocyte retrieval cycle were included consecutively between 2018 until 2022. We observed a negative association between Ln HOMA-IR and Ln OSI by using smoothing splines. In multivariable linear regression analysis, the inverse association between Ln HOMA-IR and Ln OSI was still found in PCOS women after adjustment for potential confounders (ß = -0.18, 95% CI -0.25, -0.11). Compared with patients with the lowest tertile of HOMA-IR, those who had the highest tertile of HOMA-IR had lower OSI values (ß = -0.25, 95% CI -0.36, -0.15). Discussion: Our study provided evidence for the inverse correlation between IR and the ovarian sensitivity during COS in PCOS women. Herein, we proposed new insights for individualized manipulation in PCOS patients with IR undergoing ART.

Identification of TUBB8 Variants in 5 Primary Infertile Women with Multiple Phenotypes in Oocytes and Early Embryos.

Tubulin beta 8 class VIII (TUBB8) is a ß-tubulin isotype that is specifically expressed in human oocytes and early embryos. It has been identified as a disease-causing gene in primary female infertility by affecting oocyte maturation arrest. This study investigated the genetic cause of female infertility in five patients from four families. Five women with primary infertility were recruited. Medical-exome sequencing and Sanger sequencing were performed on the patients, and their family members to identify candidate genes that explained infertility. Additionally, the morphology of oocytes and zygotes from the patients and controls were assessed. We observed recurrent oocytes MI arrest, oocytes abnormal fertilization, uncleaved embryos, and embryo transfer failure in the patients. Heterozygous missense variants in TUBB8, c.538G > A (p.V180M), c.527C > G (p.S176W), c.124C > G (p.L42V), and c.628A > C (p.I210L), were verified in four unrelated families. This study expanded the mutational spectrum of TUBB8 by identifying three novel heterozygous missense variants. Screening for TUBB8 mutation demonstrated the diagnostic utility of female infertility.

Live birth after letrozole-stimulated cycles versus hormone replacement treatment cycles for the first frozen embryo transfer in women with polycystic ovary syndrome: protocol for a multicentre randomised controlled trial.

INTRODUCTION: Hormone replacement treatment (HRT) is the most commonly used endometrial preparation protocol for frozen embryo transfer (FET) in patients with polycystic ovary syndrome (PCOS). However, studies have found that HRT may increase the risk of hypertensive disorders of pregnancy and some obstetric complications. Letrozole is a new first-line ovulation induction drug for PCOS and can effectively induce spontaneous ovulation by reducing oestrogen levels. However, letrozole is still rarely used in FET and has only been reported in a few studies in Asian populations. High-quality, well-powered randomised controlled trials (RCTs) comparing HRT and letrozole-stimulated protocols are lacking. The aim of this study is to compare the efficacy and safety of two protocols in patients with PCOS. METHODS AND ANALYSIS: This is a multicentre, open-label RCT in four reproductive medical centres in China. In total, 1078 women with PCOS will be randomised (1:1) to the letrozole-stimulated or HRT group in their first FET cycle and their pregnancy and perinatal outcomes during this cycle will be followed up and analysed. The primary outcome is live birth. Secondary outcomes are cycle cancellation rate, biochemical pregnancy, clinical pregnancy, miscarriage, ectopic pregnancy, obstetric and perinatal complications, neonatal complications and birth weight. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Institutional Review Board of Reproductive and Genetic Hospital of CITIC-XIANGYA (LL-SC-2022-001). Written informed consent will be obtained from each participant. The findings will be disseminated through conference presentations and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05227391.

Association of SARS-CoV-2 Infection During Controlled Ovarian Stimulation With Oocyte- and Embryo-Related Outcomes.

Importance: SARS-CoV-2 infection has had significant effects on the health of people worldwide. Whether SARS-CoV-2 infection during controlled ovarian stimulation (COS) is associated with laboratory outcomes in assisted reproductive technology remains unclear. Objective: To investigate the association between SARS-CoV-2 infection during COS with oocyte- and embryo-related outcomes. Design, Setting, and Participants: A multicenter cohort study was conducted of couples undergoing assisted reproductive technology treatments in 7 reproductive centers in 4 provinces in China from October 1, 2022, to December 31, 2022. All couples received nucleic acid testing for SARS-CoV-2 during COS. The SARS-CoV-2-positive group included couples in which either partner was infected with SARS-CoV-2. The SARS-CoV-2-negative group comprised couples without infection. Exposure: In the SARS-CoV-2-positive group, either partner was infected with SARS-CoV-2 during COS, defined as a positive test result for the SARS-CoV-2 antigen. Main Outcomes and Measures: Primary outcomes were the available embryo and blastocyst and top-quality embryo and blastocyst rates. Secondary outcomes were the number of oocytes retrieved, the mature oocyte rate, normal fertilization (2 pronuclei observed on day 1 after insemination [2PN]), oocyte degeneration, 2PN cleavage, and blastocyst formation rates. Results: A total of 585 heterosexual couples with infertility participated in the study (median [IQR] age for female partners, 33 [30-37] years), with 135 couples in the SARS-CoV-2-positive group and 450 in the SARS-CoV-2-negative group. The characteristics of the groups were similar. The SARS-CoV-2-positive group had a significantly lower top-quality embryo rate (odds ratio [OR], 0.83; 95% CI, 0.71-0.96), top-quality blastocyst rate (OR, 0.59; 95% CI, 0.45-0.77), available blastocyst rate (OR, 0.70; 95% CI, 0.59-0.82), and blastocyst formation rate (OR, 0.61; 95% CI, 0.52-0.71) than the SARS-CoV-2-negative group. Analysis of the associations of infection by sex showed that the female positive group had impaired oocyte and embryo quality regarding mature oocyte rate, 2PN cleavage rate, top-quality embryo rate, blastocyst formation rate, available blastocyst rate, and top-quality blastocyst rate compared with the SARS-CoV-2-negative group. Compared with the SARS-CoV-2-negative group, the male positive group and the group of couples with both positive partners had significantly decreased available blastocyst rate, top-quality blastocyst rate, and blastocyst formation rate compared with the SARS-CoV-2 negative group. Conclusions and Relevance: In this cohort study, SARS-CoV-2 infection during COS was negatively associated with embryo and blastocyst quality. Reproductive physicians should be more attentive to patients with SARS-CoV-2 infection during COS and should give couples who have been infected adequate counseling.

Infertility treatment for Chinese women with P450 oxidoreductase deficiency: Prospect on clinical management from IVF to FET.

Cytochrome P450 oxidoreductase deficiency (PORD) is a rare recessive disease with multiple clinical manifestations, which is usually diagnosed in neonates and children because of ambiguous genitalia or skeletal malformations. Moreover, the paucity of studies does not allow us to establish whether adult-onset PORD is associated with infertility. Here, we report clinical and laboratory findings in two phenotypically normal women diagnosed with PORD who underwent in vitro fertilization (IVF) and frozen embryo transfer (FET). We modified the gonadotropin stimulation protocol during controlled ovarian hyperstimulation (COH) and suggest the use of the vaginal 17ß-estradiol route for endometrium preparation in hormone replacement therapy (HRT) cycles. We presume that PORD may be associated with infertility in several aspects, including disordered steroidogenesis, endometrium impairment, attenuation of drug metabolism, and the high risk of miscarriage. Our observations will help the early diagnosis and make a tailored approach to infertility management in adult-onset PORD.

Blastocyst quality and perinatal outcomes of frozen-thawed single blastocyst transfer cycles.

Objective: To investigate the effects of blastocyst quality and morphological grade on the perinatal outcomes in patients undergoing frozen-thawed single blastocyst transfer cycles. Methods: This single-center retrospective cohort study included 2648 singleton neonates resulting from frozen-thawed single blastocyst transfers performed between January 2017 and September 2021. Multivariate logistic regression was performed to evaluate perinatal outcomes for their association with blastocyst quality and morphological parameters. Result: Transfer of a good-quality blastocyst in a frozen-thawed cycle was associated with a lower rate of preterm delivery (PTD, adjusted OR =0.7, 95% CI 0.5-0.9; P=0.020) and a higher likelihood of a male neonate (adjusted OR =1.2, 95%CI 1.0-1.5; P=0.048). Compared with grade C inner cell mass (ICM) blastocyst transfer, grade B ICM (adjusted OR =0.5, 95%CI 0.2-0.9; P=0.027) and grade A ICM (adjusted OR =0.6, 95%CI 0.3-1.5; P=0.290) blastocyst transfers were associated with a lower rate of PTD, which was more evident for grade B ICM. After adjusting for confounders, the likelihood of a male neonate (grade B TE, OR =1.2, 95%CI 1.0-1.5, P=0.037; grade A TE OR =1.9, 95%CI 1.3-28, P=0.002) increased with increasing trophectoderm (TE) quality. Compared with expansion stage 4, the likelihood of a male neonate was 1.5 times greater with transfer of a stage 6 blastocyst (OR =1.5, 95%CI 1.0-2.3; P=0.06), and the risk of small for gestational age (SGA) was greater with transfer of a stage 5 blastocyst (adjusted OR =3.5, 95%CI 1.5-8.0; P=0.004). The overall grading of the blastocyst, expansion stage, ICM grade, and TE grade were not associated with length at birth, birthweight, large for gestational age (LGA), or birth defects (all P>0.05). Conclusions: In frozen-thawed single blastocyst transfer cycles, transfer of a good-quality blastocyst was associated with a lower rate of PTD and a greater likelihood of a male neonate. Transfer of grade B ICM blastocysts decreased the rate of PTD, and TE quality was positively correlated with the likelihood of a male neonate.

Bamboo cellulose fibers prepared by different drying methods: Structure-property relationships.

Bamboo cellulose fibers (BCFs) has attracted increasing attention in many fields due to its high mechanical strength and interconnected porous structure. Drying is a key factor that determines the final structure and properties of BCFs. In this work, three kinds of BCFs, i.e., conventional-dried (CD-BCFs), freeze-dried (FD-BCFs), and supercritical CO2-dried (SD-BCFs), were prepared via different drying methods. The effects of drying methods on their supramolecular structure, porosity, and mechanical properties were studied, and the structure-property relationships were proposed. The CD-BCFs composed of well-aligned crystalline nanofibrils with a dense structure exhibited the best mechanical properties (tensile strength of 854.54 MPa). The SD-BCFs featured with interconnected 3D microfibril networks give a highly porous structure and the highest surface area of 9.162 m2/g. The FD-BCFs showed medium mechanical properties and surface area owing to the stacked lamellar microfibril network. This work provides guidelines for designing BCFs with proper structure for various end-use applications.

Comparison of Cumulative Live Birth Rates Between GnRH-A and PPOS in Low-Prognosis Patients According to POSEIDON Criteria: A Cohort Study.

Objective: To compare the cumulative live birth rate (CLBR) of a gonadotropin-releasing hormone (GnRH) antagonist regimen and a progestin-primed ovarian stimulation (PPOS) regimen in low-prognosis patients according to POSEIDON criteria. Design: Single-center, retrospective, observational study. Setting: Henan Provincial People's Hospital, Zhengzhou, China. Patients: Women aged ≤40 years, with a body mass index <25 kg/m2, who underwent in vitro fertilization (IVF) or intracytoplasmic sperm microinjection (ICSI) and met POSEIDON low-prognosis criteria. Intervention: GnRH or PPOS regimen with IVF or ICSI. Main Outcome Measure: CLBR per oocyte retrieval cycle. Results: Per oocyte retrieval cycle, CLBR was significantly higher with GnRH antagonist versus PPOS (35.3% vs 25.2%; P<0.001). In multivariable logistic regression analysis, CLBR per oocyte retrieval cycle was significantly lower with PPOS versus GnRH antagonist before (OR 0.62 [95% confidence intervals (CI): 0.46, 0.82; P=0.009]) and after (OR 0.66 [95% CI: 0.47, 0.93; P=0.0172]) adjustment for age, body mass index, infertility type, infertility duration, baseline follicle stimulating hormone, anti-Müllerian hormone (AMH), antral follicle count (AFC), and insemination method. CLBR was numerically higher with the GnRH antagonist regimen than with PPOS, across all of the POSEIDON groups, and was significantly higher in patients aged ≥35 years with poor ovarian reserve [AFC <5, AMH <1.2 ng/mL] (unadjusted, P=0.0108; adjusted, P=0.0243). Conclusion: In this single-center, retrospective, cohort study, patients had a higher CLBR with a GnRH antagonist versus PPOS regimen, regardless of other attributes.

Construction of a Phytic Acid-Silica System in Wood for Highly Efficient Flame Retardancy and Smoke Suppression.

The intrinsic flammability of wood restricts its application in various fields. In this study, we constructed a phytic acid (PA)-silica hybrid system in wood by a vacuum-pressure impregnation process to improve its flame retardancy and smoke suppression. The system was derived from a simple mixture of PA and silica sol. Fourier transform infrared spectroscopy (FTIR) indicated an incorporation of the PA molecules into the silica network. Thermogravimetric (TG) analysis showed that the system greatly enhanced the char yield of wood from 1.5% to 32.1% (in air) and the thermal degradation rates were decreased. The limiting oxygen index (LOI) of the PA/silica-nanosol-treated wood was 47.3%. Cone calorimetry test (CCT) was conducted, which revealed large reductions in the heat release rate and smoke production rate. The appearance of the second heat release peak was delayed, indicating the enhanced thermal stability of the char residue. The mechanism underlying flame retardancy was analyzed by field-emission scanning electron microscope coupled with energy-dispersive spectroscopy (SEM-EDS), FTIR, and TG-FTIR. The improved flame retardancy and smoke-suppression property of the wood are mainly attributed to the formation of an intact and coherent char residue with crosslinked structures, which can protect against the transfer of heat and mass (flammable gases, smoke) during burning. Moreover, the hybrid system did not significantly alter the mechanical properties of wood, such as compressive strength and hardness. This approach can be extended to fabricate other phosphorus and silicon materials for enhancing the fire safety of wood.

The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China.

Objective: To investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles. Methods: A total of 42,132 fresh cycles between 1 January 2013 and 31 December 2019 were included in this retrospective cohort study. Data were collected from five reproductive centers of large academic or university hospitals in China. All patients were divided into different groups according to their endometrial thickness on hCG trigger day. Multivariate regression analysis, curve fitting and threshold effect analysis were performed. Results: After adjusting for age, body mass index, infertility type, number of embryos transferred, number of retrieved oocytes and COS (controlled ovarian stimulation) protocols, significant associations were found between endometrial thickness and clinical pregnancy rate (adjusted odds ratio [aOR]: 1.05; 95% confidence interval [CI]: 1.06-1.08, P < 0.0001), live birth rate (aOR: 1.04; 95% CI: 1.03-1.05, P < 0.0001) as well as miscarriage rate(aOR: 0.96; 95% CI: 0.94 - 0.98, P < 0.0001). When the endometrial thickness was less than 12mm, the clinical pregnancy rate and live birth rate were increased significantly by 10% and 9%(OR:1.10; 95%CI: 1.08-1.12, OR:1.09; 95%CI: 1.07-1.11), respectively, along with the increase of each millimeter increment of endometrial thickness. However, when the EMT ranged from 12-15 mm, were stable at the ideal level, that were not significantly associated with EMT growth. Additionally, clinical pregnancy rate and live birth rate were slightly reduced by 6% and 4% when EMT was ≥15mm. Meanwhile, the miscarriage rate was significantly declined by 8% (OR:0.92; 95%CI: 0.90-0.95)with each millimeter increment of EMT. And when EMT was thicker than 12mm, the miscarriage rate didn't change any more significantly. Conclusions: Endometrial thickness exhibits a curvilinear relationship with pregnancy outcomes in fresh embryo transfer cycles. Clinical pregnancy rate, live birth rate and miscarriage rate may achieve their optimal level when EMT ≥ 12 mm, but some adverse pregnancy outcomes would be observed when EMT ≥15 mm especially for clinical pregnancy.

Engineering of Aerogel-Based Biomaterials for Biomedical Applications.

Biomaterials with porous structure and high surface area attract growing interest in biomedical research and applications. Aerogel-based biomaterials, as highly porous materials that are made from different sources of macromolecules, inorganic materials, and composites, mimic the structures of the biological extracellular matrix (ECM), which is a three-dimensional network of natural macromolecules (e.g., collagen and glycoproteins), and provide structural support and exert biochemical effects to surrounding cells in tissues. In recent years, the higher requirements on biomaterials significantly promote the design and development of aerogel-based biomaterials with high biocompatibility and biological activity. These biomaterials with multilevel hierarchical structures display excellent biological functions by promoting cell adhesion, proliferation, and differentiation, which are critical for biomedical applications. This review highlights and discusses the recent progress in the preparation of aerogel-based biomaterials and their biomedical applications, including wound healing, bone regeneration, and drug delivery. Moreover, the current review provides different strategies for modulating the biological performance of aerogel-based biomaterials and further sheds light on the current status of these materials in biomedical research.

Sigma-1 receptor is involved in diminished ovarian reserve possibly by influencing endoplasmic reticulum stress-mediated granulosa cells apoptosis.

Sigma non-opioid intracellular receptor 1 (sigma-1 receptor), a non-opioid transmembrane protein, is located on cellular mitochondrial membranes and endoplasmic reticulum. Current research has demonstrated that sigma-1 receptor is related to human degenerative diseases. This study is focused on the effects of sigma-1 receptor on the pathophysiological process of diminished ovarian reserve (DOR) and granulosa cells (GCs) apoptosis. Sigma-1 receptor concentration in follicular fluid (FF) and serum were negatively correlated with basal follicle-stimulating hormone (FSH) and positively correlated with anti-mullerian hormone (AMH), antral follicle count (AFC). Sigma-1 receptor reduction in GCs was accompanied by endoplasmic reticulum stress (ERS)-mediated apoptosis in women with DOR. Plasmid transfection was used to establish SIGMAR1-overexpressed and SIGMAR1-knockdown human granulosa-like tumor (KGN) cell and thapsigargin (TG) was used to induce ERS KGN cells. We found that KGN cells treated with endogenous sigma-1 receptor ligand dehydroepiandrosterone (DHEA) and sigma-1 receptor agonist PRE-084 showed similar biological effects to SIGMAR1-overexpressed KGN cells and opposite effects to SIGMAR1-knockdown KGN cells. DHEA may improve DOR patients' pregnancy outcomes by upregulating sigma-1 receptor and downregulating ERS-mediated apoptotic genes in GCs. Thus, sigma-1 receptor may be a potential ovarian reserve biomarker, and ligand-mediated sigma-1 receptor activation could be a future approach for DOR therapy.

Dynamic limited axial compression yields favorable functional outcomes in the fixation of Pauwels type-3 femoral neck fractures: A retrospective cohort study.

PURPOSE: Pauwels type-3 femoral neck fractures are challenging injuries to manage with high rates of complications after internal fixation and no consensus has been reached regarding the optimal fixation construct. The current study aims to evaluate the effect of dynamic limited axial compression in parallel screws combined with medial buttress plate (SMBP) or lateral compression plate (LCP) fixation of Pauwels type-3 femoral neck fractures. METHODS: We performed a retrospective analysis of 51 cases of Pauwels type-3 femoral neck fractures who were fixed by SMBP or LCP. Specifically, the screw fixing the femoral head in the buttress plate was omitted. Postoperative complications and functional outcomes were mainly studied. RESULTS: With a mean follow-up of 19.9 months, the rate of neck shortening was higher in the LCP group than that in SMBP group (32.1% vs. 8.7%, p = 0.04). Neither nonunion nor avascular necrosis was observed in both groups. Good-to-excellent Harris hip score accounts for 95.2% in SMBP group and 89.3% in LCP group (p = 0.40). Moreover, older age, fracture comminution and compression plate fixation predispose to neck shortening. CONCLUSION: Dynamic limited axial compression by SMBP or LCP fixation was effective to improve the functional outcome of patients with Pauwels type-3 femoral neck fractures.

Preparation and Characterization of Superabsorbent Polymers Based on Sawdust.

Sawdust, a cheap by-product of the timber and forestry industry, was considered as a framework structure to prepare superabsorbent polymer with acrylic acid (AA) and acrylamide (AM), the synthetic monomers. The effects of initiator content, crosslinker content, AA content, AM content, degree of neutralization of AA, and reaction temperature on the swelling rate of superabsorbent polymer were investigated. The synthesized polymer was characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and thermogravimetric analysis (TGA). Under optimal synthesis conditions, the results showed that the swelling rate of the polymer in deionized water and 0.9% NaCl solution reached 738.12 and 90.18 g/g, respectively. The polymer exhibits excellent swelling ability, thermal stability, and reusability. After the polymer was introduced into the samples (soil or coal), the water evaporation rate of the samples was significantly reduced, and the saturated water holding capacity and pore structure were also significantly improved.