IAS-FET: An intelligent assistant system and an online platform for enhancing successful rate of in-vitro fertilization embryo transfer technology based on clinical features.

BACKGROUND: Among all of the assisted reproductive technology (ART) methods, in vitro fertilization-embryo transfer (IVF-ET) holds a prominent position as a key solution for overcoming infertility. However, its success rate hovers at a modest 30% to 70%. Adding to the challenge is the absence of effective models and clinical tools capable of predicting the outcome of IVF-ET before embryo formation. Our study is dedicated to filling this critical gap by aiming to predict IVF-ET outcomes and ultimately enhance the success rate of this transformative procedure. METHODS: In this retrospective study, infertile patients who received artificial assisted pregnancy treatment at Gansu Provincial Maternity and Child-care Hospital in China were enrolled from 2016 to 2020. Individual's clinical information were studied by cascade XGBoost method to build an intelligent assisted system for predicting the outcome of IVF-ET, called IAS-FET. The cascade XGBoost model was trained using clinical information from 2292 couples and externally tested using clinical information from 573 couples. In addition, several schemes which will be of help for patients to adjust their physical condition to improve their success rate on ART were suggested by IAS-FET. RESULTS: The outcome of IVF-ET can be predicted by the built IAS-FET method with the area under curve (AUC) value of 0.8759 on the external test set. Besides, this IAS-FET method can provide several schemes to improve the successful rate of IVF-ET outcomes. The built tool for IAS-FET is addressed as a free platform online at http://www.cppdd.cn/ART for the convenient usage of users. CONCLUSIONS: It suggested the significant influence of personal clinical features for the success of ART. The proposed system IAS-FET based on the top 27 factors could be a promising tool to predict the outcome of ART and propose a plan for the patient's physical adjustment. With the help of IAS-FET, patients can take informed steps towards increasing their chances of a successful outcome on their journey to parenthood.

A portable, integrated microfluidics for rapid and sensitive diagnosis of Streptococcus agalactiae in resource-limited environments.

Streptococcus agalactiae (Group B Streptococcus, GBS) has been the leading cause of infections in newborns. Rapid and accurate diagnosis of GBS in pregnant women is a deterministic strategy to prevent newborn infection. Conventional detection methods based on nucleic acid amplification assay have been applied in GBS diagnosis in central laboratories, with demonstrated high sensitivity. However, their heavy dependence on instrumentation and trained technicians forms remarkable obstacles to GBS detection in wide scenarios, including self-testing, and bedside-/community-screening. Furthermore, the structures of GBS bring about extra challenges to the nucleic acid extraction and purification. Novel GBS diagnosis platforms integrating sample processing, amplification, and read-out, are highly desired in clinical. Here, we report a portable, integrated microfluidics that enables rapid extraction of DNA from sampling swabs (<10 min), power-free DNA amplification (<30 min), and simple read-out in GBS detection. The platform works without an external pump, achieving rapid and highly efficient DNA extraction from clinical samples, with a significantly reduced time from 6 h to less than 50 min. Systematic clinical tests based on 47 patient samples validated the high performance of the platform, highlighted with a low limit of detection (LOD, 103 copies/ml), high sensitivity (100%), and specificity (100%). Head-to-head comparisons showed that the device improved the LOD by an order of magnitude than the traditional PCR method, showing a simple yet powerful POCT platform for home-/community-based testing towards GBS (and other pathogens) prevention in remote areas.

Pain nursing for gynecologic cancer patients.

Gynecological malignancy remains a prevalent cause of mortality among women. Chronic cancer pain, as a severe complication of malignancy and its therapies, accounts for a substantial burden of physical and psychological distress in affected patients. Accordingly, early identification, assessment, and standardized management of such pain are crucial in the prevention or delay of its progression. In the present review, we provide a comprehensive overview of the pathological factors that contribute to pain in patients with gynecological malignancy while highlighting the underlying mechanisms of pain in this population. In addition, we summarize several treatment modalities targeting pain management in gynecologic cancer patients, including surgery, radiotherapy, and chemotherapy. These interventions are crucial for tumor elimination and patient survival. Chronic cancer pain exerts a significant impact on wellbeing and quality of life for patients with gynecologic cancer. Therefore, our review emphasizes the importance of addressing this pain and its psychological sequelae and advocates for a multidisciplinary approach that encompasses nursing and psychological support. In summary, this review offers valuable insights into the pathological factors underlying pain, reviews pain management modalities, and stresses the critical role of early intervention and comprehensive care in enhancing the quality of life of these patients.

Peripheral blood transcriptome analysis of patients with ovarian hyperstimulation syndrome through high-throughput sequencing.

Ovarian hyperstimulation syndrome (OHSS) is a frequent iatrogenic complication that arises during assisted reproduction and accounts for approximately 30% of all in vitro fertilization cycles. Using high-throughput sequencing, we investigated the peripheral blood transcriptome of patients with OHSS. Methods: Peripheral blood samples were obtained from 15 patients in each of the OHSS high-risk and low-risk groups on the ovum pick-up day. Subsequently, high-throughput sequencing was used to obtain the peripheral blood transcriptomes of five patients each from the high- and low-risk groups. Bioinformatic tools were used for mRNA expression profile mapping and screening of differentially expressed genes (DEGs). Bioinformatics techniques were also implemented in the Kyoto Encyclopedia of Genes Genomes (KEGG) signal pathway, Gene Ontology (GO) function, and protein-protein interaction (PPI) network analyses of DEGs. Results: A total of 20,031 genes were identified and 148 were found to be differentially expressed (P <0.05, |log2FC| > 0.58), with 52 upregulated and 96 downregulated genes. GO and KEGG analyses indicated that these genes were involved in extracellular corpuscles (GO: 0070062), plasma membrane (GO: 0005886), extracellular regions (GO: 0005576), immune system response (GO: 0006955), PI3K-Akt signaling pathways (hsa04151), cell adhesion molecules (CAMs, hsa04514), focal adhesion (hsa04510), and complement and coagulation cascades (hsa04610). The PPI network and realtime fluorescence quantitative polymerase chain reaction (qPCR) verification predicted that complement C3, von Willebrand factor, and vascular cell adhesion protein 1 proteins are highly implicated in OHSS and may serve as potential biomarkers for future OHSS studies. Conclusion: Transcriptome analysis revealed several DEGs related to OHSS risk factors in the peripheral blood, indicating that these DEGs may be novel players in OHSS development.

Effect of subclinical depression on moral judgment dilemmas: a process dissociation approach.

Dual-process theory of moral judgment indicates that moral decision-making is guided by emotional or cognitive processing, competing with each other. While emotional processing overwhelms cognitive processing, individuals preferentially make deontological judgments. Further, while cognitive processing dominates emotional processing, individuals preferentially make utilitarian judgments. This theory predicts that individuals with subclinical depression associated with emotion regulation deficits may deliver more utilitarian judgments. Experiment 1 indicated that higher depressive symptoms predicted utilitarian judgment. However, previous studies have not determined why individuals with subclinical depression make a utilitarian judgment. Thus, Experiment 2 employed the process-dissociation approach, which can separately measure the relative strength of individual deontological and utilitarian inclinations. Deontological inclination (parameter D) was associated with emotional processing, whereas utilitarian inclination (parameter U) was related to cognitive processing. In Experiment 2, the two groups (higher depressive symptoms/minimal depressive symptoms) completed the moral task of the process-dissociation approach to investigate the underlying mechanism. There was a significant interaction effect between the group and parameter of process dissociation. Parameter D in the higher depressive symptoms group was weaker than in the minimal depressive symptoms group. Individuals with subclinical depression bias their utilitarian judgments by making fewer deontological moral judgments.

Application and clinical efficacy of Sufu medical chitosan hydrogel dressing in radiation skin damage caused by radiotherapy for cervical cancer.

Objectives: To investigate the benefits of Sufu medical chitosan hydrogel dressing(Sufu) in the prevention and control of radiation skin damage during radiotherapy for cervical cancer as a combined modality. Methods: Ninety-seven cervical cancer patients who underwent radiotherapy at the Cancer Hospital of China Medical University between May 2017 and November 2018 were recruited according to given inclusion and exclusion criteria. The patients were assigned to a control group (n=48, washing the perineal area with normal saline) and an observation group (n=49, application of Sufu onto the site of radiotherapy in addition to washing the perineal area with normal saline). The treatment regimens for the two groups continued until the end of radiotherapy. A comparison of the RTOG (Radiation Therapy Oncology Group) grading of acute radiation-induced skin reactions (ARISRs), pain intensity (measured by the verbal rating scale (VRS)) and post-treatment wound healing was drawn between the two groups. Results: In the observation group, 81.6% (40/49) of the patients had radiation dermatitis, which was significantly lower than the incidence rate (95.8%, 46/48) in the control group (P <0.05). The observation group was at higher risk of radiation dermatitis when given a high radiation dose, while the control group was more likely to have radiation dermatitis when administered with a moderate radiation dose (P <0.05). The median time of occurrence of pain and the median time of onset of skin reactions were significantly later in the observation group as compared with the control group (P <0.05, respectively). In the observation group, the pain relief rate was 92.50% at Day-3, and the wound healing rate was 95.0% at Day-7, significantly higher than in the control group (73.9% and 80.4%) (P <0.05, respectively). Conclusions: During radiotherapy for cervical cancer, Sufu can effectively prevent and control radiation-induced skin and mucous membrane damage, delay the onset of radiation dermatitis and substantially reduce the incidence rate, relieve radiation dermatitis and pain and promote wound healing.

A meta-analysis of the prognostic value of circulating tumor cells in ovarian cancer.

OBJECTIVE: To evaluate the prognostic value of circulating tumor cells (CTCs) in ovarian cancer. METHODS: Chinese databases (Wanfang, Cqvip, CNKI) and English databases (PubMed, Web of Science, Embase, SinoMed, Cochrane Library) were retrieved to collect relevant studies on CTCs evaluation of ovarian cancer prognosis. Data were extracted to analyze the effect of CTCs on the overall survival (OS) and progression-free survival (PFS) of patients, and a meta-analysis was performed using Stata 15 software. RESULTS: Nineteen studies were included in this meta-analysis. The results showed that ovarian cancer patients with positive CTCs had a shorter OS and higher death rate, (HR=1.57, 95% CI: 1.30, 1.84), a shorter PFS and an increased risk of disease progression (HR=1.29, 95% CI: 1.04, 1.54) compared with patients with negative CTCs. Subgroup analysis showed that the HRs for death and disease progression were higher in CTCs-positive patients after treatment than those patients with negative CTCs (P<0.05). CONCLUSION: CTCs detection has a high application value in the prognosis assessment of ovarian cancer.

Comparison between embryos transferred with self-spent and fresh medium on reproductive outcomes: a prospective randomized trial.

As the final and critical step in in vitro fertilization (IVF), embryo transfer has always received much attention and deserves continuous optimization. In the present study, to explore the role of autocrine factors in embryo self-spent culture media, we prospectively compared embryo transfer with self-spent culture medium and fresh medium on clinical pregnancy outcomes. A total of 318 fresh IVF/intracytoplasmic sperm injection (ICSI) cycles were randomly allocated into two subgroups based on their transfer media (using a self-spent culture medium or new pre-equilibrated culture media), and the clinical outcomes were compared between groups. The implantation rates, clinical pregnancy rates and live birth rates for transfer using self-spent medium instead of new pre-equilibrated culture medium were slightly improved without statistical significance. Interestingly, however, biochemical pregnancy rate was found to be significantly decreased after transfer using self-spent medium for Day 3 embryos compared with new pre-equilibrated culture media. In short, embryo transfer with self-spent culture medium has shown some advantages, and large sample size studies are still needed to confirm these observations. ABBREVIATIONS: ART: assisted reproductive technologies; ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilization; ET: embryo transfer.

Targeted Next Generation Sequencing Revealed a Novel Homozygous Loss-of-Function Mutation in ILDR1 Gene Causes Autosomal Recessive Nonsyndromic Sensorineural Hearing Loss in a Chinese Family.

Hereditary hearing impairment is one of the major and common birth defects in Chinese population. Non-syndromic sensorineural hearing loss (NSHL) is the most common types of hereditary hearing impairment. Genotypically and phenotypically NSHL is extremely heterogenous and follow either autosomal dominant or autosomal recessive or X-linked mode of inheritance. Presently, 127 genes have been identified to be associated with both syndromic and (NSHL). Here, we studied a Chinese family with moderate and profound hearing impairment. The proband is a 30-year old Chinese man. The proband was born with normal hearing and at the age of 5-years, the proband was first noticed with hearing impairment. Gradually and progressively the proband was presented with loss of hearing in his both right and left ears at the age of 30 years. The clinical symptoms, age of onset or progression to loss of hearing was similar in both the proband and his younger brother. The proband's parents are phenotypically normal and non-consanguineous. Clinical diagnosis of the proband and his younger brother has been done by classical pure tone audiogram (PTA). Computed Tomography (CT) found no abnormality in bilateral external ear, middle ear and inner ear. Targeted next generation sequencing was performed with a panel of 127 genes reported to be associated with hereditary hearing impairment. A novel homozygous single nucleotide deletion (c.427delT) in exon 4 of ILDR1 gene has been identified in proband and in his younger brother. Sanger sequencing confirmed that proband's father and mother are carrying this mutation in a heterozygous manner. This mutation has not been identified in 100 normal healthy control individuals. This mutation (c.427delT) causes frameshift (p.Tyr143Ilefs∗19) which leads to the formation of a truncated ILDR1 protein of 162 amino acids instead of the wild type ILDR1 protein of 546 amino acids. ILDR1 associated hereditary hearing impairment is very rare and this is the first report of identifying a loss-of-function mutation in ILDR1 gene associated with hereditary hearing impairment in Chinese population. Our present study also emphasized the significance of rapid, accurate and cost-effective screening for the patient with hereditary hearing impairment by targeted next generation sequencing.

Teratozoospermia with amorphous sperm head associate with abnormal chromatin condensation in a Chinese family.

Male infertility affects approximately 7% of the male population. In about 40% of affected patients, the etiology remains unknown. Here, we report the cases of two infertile brothers who have a uniquely prevalent sperm phenotype with completely amorphous sperm heads. To investigate the mechanisms of familial teratozoospermia with amorphous sperm heads, chromatin condensation was assessed by aniline blue staining, western blot, sperm chromatin structure assay and atomic force microscopy in both the two brothers and 40 control fertile donors. Our results showed an abnormal condensation of chromatin with amorphous headed sperm. We suggest that abnormal chromatin condensation which was induced by disturbances in the process of histone-protamine replacement may be a possible cause of familial teratozoospermia with amorphous head, and the elasticity of sperm nuclei could be a new index to assess sperm quality. Additionally, for the first time, the current study provided a new biomechanics strategy for evaluating pathological sperm contributes to our understanding of teratozoospermia.Abbreviations: SCSA: sperm chromatin structure assay; AFM: atomic force microscopy; ICSI: intracytoplasmic sperm injection; HDS: high DNA stainability; DFI: DNA fragmentation index; PBS: phosphate-buffered saline; DTT: dithiothreitol; FITC: fluorescein isothiocyanate; DAPI: 4',6-diamidino-2-pheneylindole; SSC: standard saline citrate.

Protective effects of Paederia scandens extract on rheumatoid arthritis mouse model by modulating gut microbiota.

ETHNOPHARMACOLOGICAL RELEVANCE: Paederia scandens (Lour.) Merr. (P. scandens) has been traditionally used to treat the pain of rheumatism. AIM OF THE STUDY: The purpose of this study was to investigate the possible influences of P. scandens on the progression of rheumatoid arthritis (RA), inflammatory responses and gut bacterial communities in RA mouse model. MATERIALS AND METHODS: collagen-induced arthritis (CIA) mice were orally administered with P. scandens extract (PSE) for 24 days. Then, pro-inflammatory cytokine levels in the serum were measured, and gut microbiota was examined with Illumina HiSeq. RESULTS: Compared with the vehicle group, PSE significantly inhibited paw swelling and reduced arthritis score. Histological examination of ankle soft tissue of demonstrated PSE effectively inhibited the tissue fibrosis and inflammatory cell infiltration. The increased serum levels of TNF-α, IL-1ß, IL-6, IL-7, and IL-23 in RA mice were significantly suppressed by PSE. Moreover, PSE treatment help restore gut microbial ecosystem altered in RA mice including decreasing relative abundance of inflammatory related microorganisms, Desulfovibrio, Mucispirillum, Helicobacter, and Lachnospiraceae. CONCLUSION: These results suggest that PSE has therapeutic effects in RA mice with CIA, showing the potential as anti-arthritis reagent.

Alpinia oxyphylla Miq. Extract Prevents Diabetes in Mice by Modulating Gut Microbiota.

Recently, the role of gut microbiota in the development of obesity and type 2 diabetes mellitus (T2DM) has been highlighted. We performed an 8-week administration protocol on T2DM (C57BL/6J db-/db-) mice and fecal samples were collected. Comparisons of fecal bacterial communities were performed between db-/db- mice and normal mice (DB/DB) and between the db-/db mice treated and untreated with AOE using next-generation sequencing technology. Our results showed that the db-/db-AOE group had improved glycemic control and renal function compared with the db-/db-H2O group. Compared with the db-/db-H2O group, AOE administration resulted in significantly increased ratio of Bacteroidetes-to-Firmicutes in db-/db- mice. In addition, the abundance of Akkermansia was significantly increased, while Helicobacter was significantly suppressed in the db-/db-AOE group compared with the db-/db-H2O group. Our data suggest that AOE treatment decreased blood glucose levels and significantly reduced damage of renal pathology in the T2DM mice by modulating gut microbiota composition.

The Association between Dietary Vitamin C/E and Gestational Hypertensive Disorder: A Case-Control Study.

A case-control study of 10,228 gestational women was conducted in Lanzhou, China, between 2010 and 2012. This study aimed to evaluate the associations between the risk of gestational hypertensive disorders and dietary intake of vitamin C/E. Among this study's participants, 5.41% (n=553) were diagnosed with gestational hypertensive disorders. Of these disorders, 69.44% (n=384) were preeclampsia and 30.56% (n=169) were considered to be gestational hypertension. After adjustment for confounding variables and other relevant dietary nutrients, no association was found between the risk of gestational hypertensive disorders and dietary intake of vitamin C, vitamin E, copper or manganese before or during pregnancy. However, zinc and selenium intake was associated with the decrease risk of gestational hypertensive disease during different stages of pregnancy (p<0.05). Gestational dietary intake of zinc and selenium can significantly decrease the risk of gestational hypertensive disorders. No association was found between gestational hypertensive disorders and vitamin C, vitamin E, copper or manganese intake.

[Effects of Tansvaginal Aspiration of Hydrosalpinx Combined Auricular Point Sticking on IVF-ET Outcomes].

OBJECTIVE: To explore effective pretreated methods for hydrosalpinx before frozen embryo transfer (FET). METHODS: A randomized controlled study was performed on 229 FET cycles of hydrosalpinx patients. They were assigned to two groups by random digit table, Group A (94 cases), Group B (89 cases), and Group C (46 cases). Patients in Group A received transvaginal aspiration of hydrosalpinx combined with auricular point sticking. Those in Group B received transvaginal aspiration of hydrosalpinx group. Those in Group C received no transvaginal aspiration of hydrosalpinx. Pregnancy outcomes of FET, endometrial and subendometrial blood flow distribution on the embryo transfer day were compared among the three groups. RESULTS: There was no statistical difference in the endometrial thickness on FET day, the number of transfer embryos, the number of transferred good quality embryos among the three groups (P > 0.05). The clinical pregnancy rate and the embryo implantation rate were significantly higher in Group A than in Group C (P < 0.05), and the clinical pregnancy rate was significantly higher in Group A than in Group B (P < 0.05). The early abortion rate and the transfer cycle cancel rate were significantly lower in Group A than in Group C (P < 0.05). Type A endometrial and subendometrial blood flow distribution was dominant in Group A, which was significantly higher in Group A than the rest two groups (P < 0.05). Type A distribution rate was also significantly higher in Group B than in Group C (P < 0.05). CONCLUSION: Transvaginal aspiration of hydrosalpinx combined with auricular point sticking before FET could improve the endometrial receptivity and improve outcomes of IVF.