Piezoelectric Transducer-Based Structural Health Monitoring.

Piezoelectric effects were first discovered more than a hundred years ago and, since then, have been widely used across various fields [...].

Risk factors for habitual snoring among children aged 2-14 years in Chengdu, Sichuan.

PURPOSE: Habitual snoring (HS) is a prominent symptom of sleep-disordered breathing; thus, it is also important to consider the associated, multidimensional risk factors for HS in children. This study was aimed to identify risk factors for HS in children. METHODS: A cross-sectional survey was performed in Chengdu. Children aged 2-14 years from four districts were randomly chosen to participate. Questionnaires were voluntarily completed by the children's guardians. RESULTS: The survey included 926 boys and 622 girls, who were an average of 6.4 ± 3.0 years old. The sample included 463 habitual snorers (30.4%), 683 occasional snorers (44.8%), and 402 nonsnorers (26.4%). HS was found in 51.8% of children under 7 years old and 26.6% of children aged 7 years old or older. The prevalence of pregnancy complications was significantly lower in mothers who bore children with HS (p = .006). Among the HS group, 86.6% had an immediate family member who snores. Breastfeeding duration among the HS group was significantly less than among the occasional snoring and nonsnoring groups. History of symptoms of allergic rhinitis, rhinosinusitis, tonsillitis, and pneumonia/bronchitis in the past 6 months was associated with HS. Likewise, maternal smoking during pregnancy, maternal exposure to secondhand smoke during pregnancy, and child exposure to secondhand smoke were also associated with HS. CONCLUSION: The prevalence of HS was higher in children under 7 years old. Having a mother with more education, a family history of snoring, a shorter period of breastfeeding, upper respiratory tract inflammation, and passive smoking are important risk factors for HS. Pregnancy complications may be associated with lower prevalence of snoring in childhood.

Behavioral and cognitive outcomes of habitual snoring in children aged 2-14 years in Chengdu, Sichuan.

PURPOSE: Habitual snoring is associated with cognitive, behavioral, and other physiological problems of children. Few studies have reported specifically on the relationships between snoring and those problems in children as noticed by their parents. We aimed to identify the cognitive, behavioral, and sleep-related nocturnal problems in children with HS as noted by their parents. MATERIALS AND METHODS: A cross-sectional survey was performed in Chengdu, Sichuan, China. Children aged 2-14 years from four districts were randomly chosen to participate. Questionnaires were completed voluntarily by the children's parents/guardians. RESULTS: A total of 1548 questionnaires were analyzed and classified those children as 463 habitual snorers (HS group, 30.4 %), 683 occasional snorers (OS group, 44.8 %), and 402 non-snorers (NS group, 26.4 %). The percentages of children with sleep-related nocturnal symptoms were 94.6 %, 87.3 %, and 66.9 % in the HS, OS, and NS groups. Percentages of children with cognitive problems were 76.2 %, 74.6 %, and 64.9 % in the HS, OS, and NS groups, respectively (P < 0.001). The frequencies of daytime behavioral problems were 68.3 %, 61.5 %, and 46.8%in the HS, OS, and NS groups, respectively (P < 0.001).The average number of sleep-related nocturnal symptoms, cognitive symptoms and daytime behavioral problems was higher in the HS group than in the OS and NS groups. CONCLUSIONS: HS is a significant contributor to sleep-related nocturnal symptoms and daytime cognitive and behavioral problems in children, as reported by their parents/guardians. HS and OS are important contributors to poor sleep quality and daytime cognitive and behavioral problems in children.

Fatigue-Crack Detection and Monitoring through the Scattered-Wave Two-Dimensional Cross-Correlation Imaging Method Using Piezoelectric Transducers.

Piezoelectric transducers are convenient enablers for generating and receiving Lamb waves for damage detection. Fatigue cracks are one of the most common causes for the failure of metallic structures. Increasing emphasis on the integrity of critical structures creates an urgent need to monitor structures and to detect cracks at an early stage to prevent catastrophic failures. This paper presents a two-dimensional (2D) cross-correlation imaging technique that can not only detect a fatigue crack but can also precisely image the fatigue cracks in metallic structures. The imaging method was based on the cross-correlation algorithm that uses incident waves and the crack-scattered waves of all directions to generate the crack image. Fatigue testing for crack generation was then conducted in both an aluminum plate and a stainless-steel plate. Piezoelectric wafer transducer was used to actuate the interrogating Lamb wave. To obtain the scattered waves as well as the incident waves, a scanning laser Doppler vibrometer was adopted for acquiring time-space multidimensional wavefield, followed with frequency-wavenumber processing. The proof-of-concept study was conducted in an aluminum plate with a hairline fatigue crack. A frequency-wavenumber filtering method was used to obtain the incident wave and the scattered wave wavefields for the cross-correlation imaging. After this, the imaging method was applied to evaluate cracks on a stainless-steel plate generated during fatigue loading tests. The presented imaging method showed successful inspection and quantification results of the crack and its growth.

The role of acupuncture in women with advanced reproductive age undergoing in vitro fertilization-embryo transfer: A randomized controlled trial and follicular fluid metabolomics study.

BACKGROUND: The objective of this study was to determine the efficacy of acupuncture on the outcome of in vitro fertilization (IVF) in elderly infertile patients with kidney qi deficiency, and to explore its possible mechanism from the perspective of pseudo-targeted metabolomics of follicular fluid. METHODS: Sixty cases of elderly women undergoing IVF were sampled and randomly divided into 2 equal groups: the treatment and the elderly control (HA) group. In the treatment group, routine ovulation induction combined with acupuncture treatment was used. Routine ovulation induction combined with sham acupuncture was used in the HA group. Reproductive outcomes of the 2 groups were compared. The follicular fluid of patients obtained on the day of oocyte retrieval was analyzed by the ultra-high-performance liquid chromatography-mass spectrometry analysis system. RESULTS: Compared with the HA group, the score of kidney qi deficiency syndrome in the treatment group was significantly decreased, and the 2 PN fertilization rate, high-quality embryo rate and cumulative pregnancy rate were significantly increased (P < .05). Through the identification of target metabolites, 3 metabolic pathways were found to be closely related to the developmental potential of oocytes, namely: Retinol metabolism pathway; Glycine, serine, and threonine metabolism pathway; Glycerophospholipid metabolism pathway. CONCLUSION: From our findings, acupuncture can improve the quality of oocytes thus bettering the outcome of IVF-assisted pregnancy in elderly patients with kidney qi deficiency. TRIAL REGISTRATION: ChiCTR1800018329.

Immune-checkpoint protein VISTA in allergic, autoimmune disease and transplant rejection.

Negative checkpoint regulators (NCRs) reduce the T cell immune response against self-antigens and limit autoimmune disease development. V-domain Ig suppressor of T cell activation (VISTA), a novel immune checkpoint in the B7 family, has recently been identified as one of the NCRs. VISTA maintains T cell quiescence and peripheral tolerance. VISTA targeting has shown promising results in treating immune-related diseases, including cancer and autoimmune disease. In this review, we summarize and discuss the immunomodulatory role of VISTA, its therapeutic potential in allergic, autoimmune disease, and transplant rejection, as well as the current therapeutic antibodies, to present a new method for regulating immune responses and achieving durable tolerance for the treatment of autoimmune disease and transplantation.

[Determination of 15 carbonyl compounds in soil using improved solid phase extraction-high performance liquid chromatography].

An improved solid phase extraction (SPE)-high performance liquid chromatography method was established to determine 15 carbonyl compounds, namely, formaldehyde (FOR), acetaldehyde (ACETA), acrolein (ACR), acetone (ACETO), propionaldehyde (PRO), crotonaldehyde (CRO), butyraldehyde (BUT), benzaldehyde (BEN), isovaleraldehyde (ISO), n-valeraldehyde (VAL), o-methylbenzaldehyde (o-TOL), m-methylbenzaldehyde (m-TOL), p-methylbenzaldehyde (p-TOL), n-hexanal (HEX), and 2,5-dimethylbenzaldehyde (DIM), in soil. The soil was ultrasonically extracted with acetonitrile, and the extracted samples were derivatized with 2,4-dinitrophenylhydrazine (2,4-DNPH) to generate stable hydrazone compounds. The derivatized solutions were cleaned using an SPE cartridge (Welchrom® BRP) packed with N-vinylpyrrolidone/divinylbenzene copolymer. Separation was performed on an Ultimate® XB-C18 column (250 mm×4.6 mm, 5 µm), isocratic elution was performed with acetonitrile-water (65∶35, v/v) as the mobile phase, and detection was performed at a wavelength of 360 nm. The 15 carbonyl compounds in the soil were then quantified using an external standard method. The proposed method improves the sample processing method described in the environmental standard HJ 997-2018: Soil and sediment-Determination of carbonyl compounds-High performance liquid chromatography. A series of experiments revealed the following optimal conditions for soil extraction: acetonitrile as the extraction solvent, extraction temperature of 30 ℃, and extraction time of 10 min. The results showed that the purification effect of the BRP cartridge was significantly better than that of the conventional silica-based C18 cartridge. The 15 carbonyl compounds showed good linearities, and all correlation coefficients were above 0.996. The recoveries ranged from 84.6% to 115.9%, the relative standard deviations (RSDs) ranged from 0.2% to 5.1%, and the detection limits were 0.02-0.06 mg/L. The method is simple, sensitive, and suitable for the accurate quantitative analysis of the 15 carbonyl compounds in soil specified in HJ 997-2018. Thus, the improved method provides reliable technical support for studying the residual status and environmental behavior of carbonyl compounds in soil.

Efficacy of Acupoint Application on In Vitro Fertilization Outcome in Patients with Polycystic Ovary Syndrome: A UHPLC-MS-Based Metabolomic Study.

Objective: To explore the clinical effect of acupoint application on the outcome of in vitro fertilization-embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS) of the phlegm-dampness type and elucidate its possible mechanism of action from the perspective of follicular fluid metabolomics. Methods: A total of 90 patients undergoing IVF-ET due to infertility were selected and divided into three groups: the treatment group (PCOS with acupoint application, n = 30), the control group (PCOS without acupoint application, n = 30), and the normal group (non-PCOS, n = 30). All patients received a gonadotropin-releasing hormone agonist (GnRH-a) long protocol for controlled ovarian hyperstimulation (COH). Among them, the treatment group was also given the acupoint application from the day of pituitary downregulation to the day of the human chorionic gonadotrophin (hCG) trigger. Ultrahigh-performance liquid chromatography connected with quadrupole time-of-flight mass spectrometry (UHPLC-MS) was adopted for untargeted metabolomic analysis of follicular fluid collected from the three groups of patients on the day of oocyte pick-up (OPU). The significantly differential metabolites were screened using univariate and multivariate statistical analysis, and the related metabolic pathways were identified by the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Results: Metabolomic analysis showed that the treatment group's follicular fluid samples were aggregated with the normal group and separated from the control group. A total of 34 significantly differential metabolites were found in the follicular fluid of patients with phlegm-dampness PCOS and normal people. With the intervention of acupoint application, seven metabolites (pseudouridine, phenol, 2-oxoadipic acid, 9R,10S-EpOME, DL-lactate, nicotinamide, and DL-indole-3-lactic acid) were all downregulated, mainly involving the pathways of pyruvate metabolism, nicotinate and nicotinamide metabolism, protein digestion and absorption, biosynthesis of amino acids, and pyrimidine metabolism. Conclusions: Acupoint application can effectively improve the clinical symptoms and the outcome of IVF-ET treatment in patients with PCOS of the phlegm-dampness type, and its mechanism of action may be related to the regulation of the pathways of pyruvate metabolism, nicotinate and nicotinamide metabolism, protein digestion and absorption, biosynthesis of amino acids, and pyrimidine metabolism.

Clinicopathological characteristics of patients with carotid body tumor with cervical lymph node metastasis: A retrospective study of 10 cases and review of the literature.

Carotid body tumor (CBT), also known as carotid body chemoreceptor tumor or nonchromaffin paraganglioma, originates from the chemoreceptor behind the common carotid artery bifurcation in the carotid sheath. Most CBTs are benign. Malignant CBT (MCBT) is extremely rare, and cervical lymph node metastasis (CLNM) is usually regarded as a manifestation of malignant behavior. The association between CLNM, pathological features of the primary lesion, clinical manifestations, and prognosis deserves further investigation. The clinical materials of 133 patients with CBT who underwent total resection of the primary tumor and concomitant selective neck dissection (SND) from February 2002 to June 2018 in a single center were reviewed. Postoperative histopathology confirmed CLNM in 10 cases (10/133); clinical manifestations, pathological and imaging characteristics, and treatment outcome data were reviewed and analyzed. The average patient age was 50.5 years, with a female sex tendency (7/10). The mean and median follow-up periods of all cases were 6.9 years and 7 years, respectively. Nine patients (9/10) survived; one patient died of multiple systemic metastases 10 months after surgery when the tumor metastasized to the bilateral breast and other organs in an orderly manner. None of the patients had local recurrence, but postoperative residual lesions were detected by computer-aided 3-dimensional (3D) visualization computerized tomography in one (1/10). Most CBT cases with CLNM displayed adverse features, especially in patients without distant metastases. Immunohistochemically, the patient with distant metastases was negative for S-100, synaptophysin (Syn), and succinate dehydrogenase B (SDHB) expression. Most patients with CBT with CLNM have a good prognosis. Breast metastasis is an exceedingly rare manifestation of MCBT. Despite some association between clinical biological and histological malignancies in CBT with CLNM, the association seems to be vague in cases involving distant metastasis. The combination of certain immunohistochemical indicators (S-100, Syn, and SDHB) might be valuable for predicting the occurrence of distant metastasis. Computer-aided 3D visualization technology might be helpful for the diagnosis and postoperative follow-up of MCBT. Simultaneous SND can remove potentially metastatic lymph nodes and facilitate diagnosis and treatment.

A comparative and correlational study of the Vocal Fatigue Index (VFI) and the Voice Fatigue Handicap Questionnaire (VFHQ) in individuals with and without voice disorders.

OBJECTIVES: The aim of this study was to examine the difference and correlation between the Vocal Fatigue Index (VFI) and the Voice Fatigue Handicap Questionnaire (VFHQ) among individuals with and without voice disorders. STUDY DESIGN: Observational study. METHODS: This study was performed from June to December 2021. A total of 308 people were enrolled, including 72 men and 236 women. Questionnaire scores were obtained for both the VFI and the VFHQ. The Mann-Whitney U test and Spearman correlational analysis were used to analyze the data. RESULTS: Of the 308 participants, 186 had a voice disorder and 122 did not. The most common voice disorders were chronic laryngitis and vocal fold polyps. The VFI and VFHQ scores differed between groups with and without voice disorders and between men and women. The VFHQ total score correlated significantly with all subscale scores of the VFHQ and with the VFI factor scores. CONCLUSIONS: People with voice disorders have significantly worse voice-related quality of life and more severe vocal fatigue symptoms than those without. The scores on the VFI and VFHQ correlate significantly.

Survey of Referral Patterns in Southwestern Mainland China: How Do Pediatricians Manage Children with Dysphonia.

OBJECTIVE: Voice disorders are common in children and have a negative impact on their quality of life. However, presently, voice assessment and therapy are inaccessible in most pediatric departments of Mainland China. Thus, referring pediatric patients with voice disorders to otolaryngology is warranted for prompt and appropriate treatment. The purpose of this study is to investigate referral patterns and their influencing factors for pediatricians' managing children with dysphonia in Southwestern Mainland China. STUDY DESIGN: Observational study. METHODS: A 28-item questionnaire was designed by multidisciplinary experts, and an anonymous survey was performed online via Wenjuanxing between September 8, 2021 and October 8, 2021. The statistical analyses were performed using the independent sample median test, the linear/logistic regression model, the Kruskal-Wallis test, and Spearman's correlation test to determine any statistically significant relationships between the variables of interest. RESULTS: Predominantly recruited from institutions in Southwestern China, 368 pediatricians were surveyed. (1) The majority of the pediatricians reported that ≤10% of children sought medical help for voice disorders; (2) only 22.1% of the pediatricians' hospitals had equipment for evaluating voice disorders; (3) 74.6% of the pediatricians would refer children with dysphonia to otolaryngology, and the older pediatricians were more likely to refer their patients than were the younger pediatricians (P = 0.022); (4) in the group that would make a referral (n = 250), the pediatricians who had worked longer (P = 0.037) and practised in the Grade-A tertiary hospitals (P = 0.044) were more likely to trust their experience as a reason for making a referral. For each year worked the probability of referring children with dysphonia depending on the pediatrician's experience increased by 3.4%. CONCLUSION: Although the pediatricians encountered some barriers to diagnosing voice disorders, their attitude towards making referrals was positive. The age and work duration of the pediatricians and the hospital grade were the influencing factors in the referral patterns. Further publicity of vocal hygiene, ongoing education among Chinese pediatricians and the improvement of referral systems may be most useful for better managing children with dysphonia.

Recurrent chromosome reshuffling and the evolution of neo-sex chromosomes in parrots.

The karyotype of most birds has remained considerably stable during more than 100 million years' evolution, except for some groups, such as parrots. The evolutionary processes and underlying genetic mechanism of chromosomal rearrangements in parrots, however, are poorly understood. Here, using chromosome-level assemblies of four parrot genomes, we uncover frequent chromosome fusions and fissions, with most of them occurring independently among lineages. The increased activities of chromosomal rearrangements in parrots are likely associated with parrot-specific loss of two genes, ALC1 and PARP3, that have known functions in the repair of double-strand breaks and maintenance of genome stability. We further find that the fusion of the ZW sex chromosomes and chromosome 11 has created a pair of neo-sex chromosomes in the ancestor of parrots, and the chromosome 25 has been further added to the sex chromosomes in monk parakeet. Together, the combination of our genomic and cytogenetic analyses characterizes the complex evolutionary history of chromosomal rearrangements and sex chromosomes in parrots.

Adaptation and Validation of the Mandarin (Simplified) Chinese Version of the Voice Fatigue Handicap Questionnaire.

OBJECTIVE: The aim of this study was to assess the reliability and validity of the Mandarin (simplified) Chinese version of the Voice Fatigue Handicap Questionnaire (MC-VFHQ). METHODS: A total of 358 participants were included from June 2020 to April 2021: 243 patients with voice disorders (patient group) and 115 vocally healthy individuals (control group). The internal consistency, test-retest reliability, content validity, clinical, sensitivity and specificity were analyzed, and the cutoff point was determined. RESULTS: The internal consistency of the MC-VFHQ was high, and the internal consistency assessed with Cronbach α coefficients for the subscale scores ranged from 0.821 to 0.983; the values for the total score were 0.952 and 0.943 in the patient and control group, respectively. Test-retest reliability was high for the total score (intraclass correlation coefficient (ICC) = 0.924) and the subscales (ICCs = 0.969, 0.939, 0.922). The patient group had significantly higher total score, subscale scores, and item scores than the control group (P < 0.001). The cutoff point for screening between the two groups was 63.5, with a sensitivity of 84.8% and a specificity of 84.30%. CONCLUSIONS: The MC-VFHQ is a valid and reliable tool for identifying individuals with probable vocal fatigue. It has good reliability, validity, sensitivity, and specificity in the Mandarin Chinese-speaking population.

Supracricoid partial laryngectomy with cricohyoidoepiglottopexy for patients with laryngeal cicatricial stenosis: Safety and efficacy.

BACKGROUND: We assessed the safety and efficacy of supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCL-CHEP) in patients with laryngeal cicatricial stenosis. METHODS: Sixteen patients receiving SCL-CHEP for severe laryngeal cicatricial stenosis between 2017 and 2018 were reviewed. Decannulation rate and tracheostomy closure time were used to evaluate efficacy. The Voice Handicap Index-10 (VHI-10), Voice-related Quality of Life (V-RQOL) scale and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale were used to assess vocal function. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed and the Penetration-Aspiration Scale (PAS), Eating Assessment Tool-10 (EAT-10), and Swallow Quality of Life Questionnaire (SWAL-QOL) were used to assess swallowing function. RESULTS: Thirteen patients (81.25%) were decannulated successfully. The average tracheostomy closure time was 45.15 days. There was no observed postoperative complications or recurrence of stenosis. VHI-10 and V-RQOL scores showed significantly improved V-RQOL (p < 0.05). FEES-PAS, EAT-10, and SWAL-QOL showed no swallowing function damage. CONCLUSIONS: SCL-CHEP is effective and safe for patients with severe laryngeal cicatricial stenosis. Accurate pre-procedure evaluation is especially important for patient selection and surgical success.

Adaptation and Validation of the Mandarin Chinese Version of the Pediatric Voice Handicap Index-10 (pVHI-10).

OBJECTIVES: The purpose of this study was to adapt and validate the Mandarin Chinese version of the pediatric Voice Handicap Index-10 (pVHI-10). METHODS: A cross-sectional study was conducted from January 2018 to December 2019. A total of 422 parents completed the questionnaire, including 283 parents of children with voice disorders (dysphonic group) and 139 parents of children without voice disorders (control group). Internal consistency, test-retest reliability, clinical effectiveness, and cut-off value were evaluated. RESULTS: In the dysphonic group, the internal consistency of the Mandarin Chinese version of pVHI-10 was excellent (Cronbach's α = 0.95). The test-retest reliability was excellent for the total score of the Mandarin Chinese version of pVHI-10 (interclass correlation coefficient = 0.916). The total scores as well as scores on individual items were significantly higher in the dyphonic group compared to those in the control group (P <0.001). In addition, the optimum cut-off value for the Mandarin Chinese version of pVHI-10 was 6.5 (87% sensitivity and 86.3% specificity, respectively). CONCLUSION: The Mandarin Chinese version of the pVHI-10 is a valid tool that evaluates the quality of life of children with voice disorders from the parents' perspective.

Fn14-targeted BiTE and CAR-T cells demonstrate potent preclinical activity against glioblastoma.

T cell-engaging therapies involving bispecific T cell engager (BiTE) and chimeric antigen receptor T (CAR-T) cells have achieved great success in the treatment of hematological tumors. However, the paucity of ideal cell surface molecules that can be targeted on glioblastoma (GBM) partially reduces the immunotherapeutic efficacy. Recently, high expression of Fn14 has been reported in several solid tumors, so the strategy of exploiting this specific antigen for GBM immunotherapy is worth studying. Consequently, we constructed Fn14× CD3 BiTE and Fn14-specific CAR-T cells and investigated their cytotoxic activity against GBM in vitro and in vivo. First, expression of Fn14 was confirmed in glioma tissues and GBM cells. Then, we designed Fn14-specific BiTE and CAR-T cells and tested their cytotoxicity in GBM cell cultures and mouse models of GBM. Fn14 was highly expressed in GBM tissues and cell lines, while it was undetectable in normal brain samples. Fn14× CD3 BiTE, Fn14 CAR-T cells and Fn14 CAR-T/IL-15 cells were antigen-specific and highly cytotoxic, showing good antitumor activity in vitro and causing significant regression of established solid tumors in xenograft models. However, the xenografts treated with Fn14 CAR-T cells regrew, whereas xenografts treated with Fn14 CAR-T/IL-15 cells did not. IL-15 engineering augmented the antitumor activity of Fn14 CAR-T cells and resulted in significant antitumor effects similar to those of Fn14× CD3 BiTE. Our results suggest that Fn14 is an appropriate target for GBM. Anti-Fn14 BiTE and Fn14-specific CAR-T/IL-15 cells may be exciting immunotherapeutic options for malignant brain cancer.

Study protocol: a multi-center, double-blind, randomized, 6-month, placebo-controlled trial to investigate the effect of supplementing hormone therapy FET cycles with Gushen'antai pills on the outcomes of in vitro fertilization.

BACKGROUND: Infertility is a widespread global challenge. Currently, the most effective treatment strategy for infertility is in vitro fertilization (IVF), which is an assisted reproductive technique (ART). The use of IVF for assisted pregnancy dates back to the last 41 years when the first IVF baby was born. During IVF, many oocytes are obtained in an IVF cycle, and more than one embryo is formed. Subsequently, frozen-thawed embryo transfer (FET) is increasingly being used in IVF cycles for women in whom a fresh embryo transfer fails to result in a pregnancy, or in those who return for a second baby. However, the pregnancy success rates following FET treatment cycles are reportedly lower than in fresh embryo transfers. Therefore, recent related studies are increasing determining mechanisms of improving the sustained pregnancy rate of FET and reducing the rate of early abortion. The Gushen'antai pill (GSATP), which contains a mixture of 10 herbs, has been widely used in traditional Chinese medicine (TCM) as a pharmacological option to prevent miscarriage. However, randomized controlled trials (RCT) have never been conducted to provide high-level clinical evidence on the clinical efficacy of GSATP. The objective of this study is to investigate the effect of GSATP of hormone therapy (HT) FET cycles on pregnancy rate. METHODS: A total of 300 subjects aged between 18 and 40 years which prepared for HT cycle FET will be enrolled in the study. The patients were from five different hospitals, with 60 patients from each hospital. Patients were randomly divided into two groups, and medication was started on the day of endometrial transformation. After FET 28 days, B-ultrasound was done to determine whether to continue the medication. Baseline assessments were carried out before the trial and outcomes were collected 4, 6, 8, 10, and 12 weeks of each gestational cycle. DISCUSSION: Differences in ongoing pregnancy rate, clinical pregnancy rate, implantation rate, and threatened abortion rate between the two groups will be statistically analyzed. We can finally have an objective evaluation of the efficacy of the traditional Chinese medicine Gushen'antai pills. TRIAL REGISTRATION: ChiCTR1900026737 . Registered October 20, 2019.

[Treatment efficacy of electronic endoscope-guided botulinum toxin injection in adductor spasmodic dysphonia patients].

Objective:To investigate the treatment efficacy of electronic endoscope-Guided botulinum toxin injection in Adductor Spasmodic Dysphonia Patients. Method:Clinical characteristics of forty- three cases were retrospectively analyzed. The disease were diagnosed with adductor spasmodic dysphonia and graded according to the severity of the disease by experienced voice specialist. All the cases were treated by electronic endoscope-guided botulinum toxin type A injection in bilateral thyroarytenoid muscles. All the subjects underwent stroboscopic laryngoscope examination and filled in the Voice Handicap Index-10（VHI-10）. They also filled in the VAS score of Voice related symptoms by self evaluation and other evaluation . One month Later, the patients and someone they lived with filled in the VAS score of Voice related symptoms again. Result:After the first injection, the voice-related symptoms of 35 patients improved to varying degrees..All The average onset time of drug was（2.33±1.86） days. The duration of curative effect ranged from 1 to 6 months, the average duration was（2.42±1.65） months. After injection, no one had serious or persistent adverse reactions. There were significant differences in the total score of VHI-10, physiology（P） and function（F） dimensions in VHI-10 of moderate and severe SD patients before and after injection（P<0.05） in all patients. For moderate cases, no significant change in speech articulation（P>0.05）, overall evaluation of voice quality and any other subprojects are statistically significant（P<0.05） in the VAS score of Voice related symptoms; For severe cases, the degree of squeezing and effort during vocalization are no statistically significant（P>0.05）, overall evaluation of voice quality and any other subitems are statistically significant（P<0.05） in the VAS score of Voice related symptoms. Conclusion:In the absence of LEMG, electronic endoscope-guided botulinum toxin injection in adductor spasmodic dysphonia patients can significantly improve the voice quality and quality of life of adductive SD patients. The method is simple to operate, less traumatic, safe and effective, and easy to carry out outpatients service.

Association between 7-day serum ß-hCG levels after frozen-thawed embryo transfer and pregnancy outcomes: a single-centre retrospective study from China.

OBJECTIVE: Early monitoring of plasma human chorionic gonadotropin (ß-hCG) level is vital in predicting pregnancy outcome. This study investigated the predictive value of serum ß-hCG level on the seventh day after frozen-thawed embryo transfer (FET) for ongoing pregnancy (OP) and adverse pregnancy (AP). DESIGN: Retrospective study. SETTING: The Reproductive and Genetic Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China. PARTICIPANTS: 1061 pregnant women who underwent FET between January 2014 and January 2017. PRIMARY AND SECONDARY OUTCOME MEASURES: Pregnancy outcome. RESULTS: Serum ß-hCG levels on the seventh day after FET were higher in the single OP group compared with the biochemical pregnancy group (p<0.001). Besides, the serum ß-hCG cut-off level at 4.34 mIU/mL on the seventh day showed high predictive value (area under the curve (AUC)=0.852). Serum ß-hCG levels on the seventh day after FET were higher in the twin OP group compared with the single OP group (p<0.001). Also, the serum ß-hCG cut-off level at 17.95 mIU/mL on the seventh day showed high predictive value (AUC=0.903). Serum ß-hCG levels on the seventh day after FET were lower in the ectopic pregnancy group compared with the single OP group (p<0.001) whereas, serum ß-hCG cut-off level at 4.53 mIU/mL on the seventh day exhibited a high predictive value (AUC=0.860). Further, the serum ß-hCG levels on the seventh day after FET were lower in the single early spontaneous abortion group compared with the single OP group (p<0.001) while the serum ß-hCG cut-off level at 5.34 mIU/mL on the seventh day exhibited high predictive value (AUC=0.738). CONCLUSION: Serum ß-hCG on the seventh day after FET has good clinical significance for the prediction of OP and AP.

Association of TNF-α gene T-1031C polymorphism with endometriosis: A meta-analysis.

The single nucleotide polymorphism T-1031C has shown to have an important role in the regulation and transcription efficiency of TNF-α gene. Yet, the relationship between TNF-α T-1031C gene polymorphism and the development of endometriosis (EM) still remains unclear. The aim of this meta-analysis was to summarize the effects of TNF-α T-1031C gene polymorphism and clarify their possible association with EM. A comprehensive literature search was performed using PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials (up to August 10, 2019). A fixed- or random-effects model was employed according to the heterogeneity among studies. The log odds ratios and 95% confidence intervals (CIs) were estimated in the models of allele comparison (T vs C), homozygote comparison (TT vs CC) and (TC vs CC), dominant (TT vs TC + CC), hyperdominant (TT + CC vs TC), and recessive (TT + TC vs CC) to estimate the strength of the associations. A total of 7 case-control studies were included in this meta-analysis. Overall, significant associations between TNF-α T-1031C and EM were identified from (T vs C: log OR [95% CI] = 0.31 [-0.09, 0.71]; TT + CC vs TC: 0.27 [0.04, 0.50]; TC + CC vs TT: -0.83 [-1.19, -0.47]). On the other hand, no significant correlation was found in other gene models (TT vs TC: log OR [95% CI] = 0.89 [0.64, 1.13]; TT vs CC: 0.3 [-0.74, 1.36]; TT + TC vs CC: 0.17 [-0.81, 1.15]). In subgroup analyses by ethnicity or HWE P-value, there was a statistically significant association between TNF-α T-1031C polymorphisms and EM in the dominant model (TT vs TC + CC: log OR [95%] = -0.84 [-1.60, -0.09]) for the European population, and in hyperdominant model (TT + CC vs TC: log OR [95%] = 0.24 [0.001, 0.49]) for Asian population. To sum up, this meta-analysis showed that TNF-α T-1031C polymorphism was associated with EM susceptibility and has a protective effect in Asian and European populations.