Humanização como tema de ensino em um programa de pós-graduação: um relato de experiência / Humanization as a teaching topic in a postgraduate program: an experience report

Relatar a experiência vivenciada por enfermeiras mestrandas e docente de disciplina eletiva de universidade pública do interior de Minas Gerais. Método: estudo descritivo, do tipo relato de experiência, a fim de relatar reflexões críticas acerca da Política Nacional de Humanização (PNH) realizadas em disciplina de Programa de Pós-graduação stricto sensu ministrada entre agosto e novembro de 2023. Resultados: participaram sete enfermeiras, todas do sexo feminino, com vivências em instituições de saúde públicas e privadas. Foi possível compreender sobre diversos aspectos, e duas categorias foram elaboradas: Repercussões e entraves referentes à implantação plena da PNH; Humanização e ensino teórico-prático nas instituições formadoras. Também foi produzido um mapa mental sobre a temática. Conclusão: destaca-se a importância de discutir sobre humanização nas instituições de ensino para o aprofundamento do tema e disseminação do conhecimento associado ao olhar prático humanizado.(AU)

To report on the experience of master's degree nurses and a lecturer in an elective course at a public university in the interior of Minas Gerais. Method: this is a descriptive, experience-report type study, aimed at reporting critical reflections on the National Humanization Policy (NHP) carried out in a stricto sensu postgraduate program course taught between August and November 2023. Results: Seven nurses took part, all female, with experience in public and private healthcare institutions. It was possible to understand various aspects, and two categories were created: Repercussions and obstacles regarding the full implementation of the PNH; Humanization and theoretical-practical teaching in training institutions. A mind map on the subject was also produced. Conclusion: The importance of discussing humanization in educational institutions is highlighted in order to deepen the subject and disseminate knowledge associated with a practical humanized approach.(AU)

Relatar la experiencia de enfermeros de maestría y de un profesor en un curso electivo de una universidad pública del interior de Minas Gerais. Método: se trata de un estudio descriptivo, de tipo experiencia-informe, con el objetivo de relatar reflexiones críticas sobre la Política Nacional de Humanización (PNH) realizadas en una asignatura del programa de posgrado stricto sensu impartida entre agosto y noviembre de 2023. Resultados: Participaron siete enfermeras, todas del sexo femenino, con experiencia en instituciones de salud públicas y privadas. Se pudieron conocer diversos aspectos y se desarrollaron dos categorías: repercusiones y obstáculos en la plena implantación de la PNH; humanización y enseñanza teórico-práctica en las instituciones de formación. También se elaboró un mapa mental sobre el tema. Conclusión: Se destaca la importancia de discutir la humanización en las instituciones de enseñanza para profundizar el tema y difundir el conocimiento asociado a un abordaje humanizado práctico.(AU)

Modelo para la gestión de flujos de pacientes, validado en un servicio de cirugía general

Introducción: La modelación de los flujos de pacientes se considera una herramienta clave para el análisis y mejora de las trayectorias intrahospitalarias. Objetivo: Desarrollar y validar, en un servicio de cirugía general, un modelo matemático para la gestión de flujos de pacientes en servicios hospitalarios. Métodos: Se desarrolló una investigación de tipo cuantitativa descriptiva. Se analizaron diferentes modelos de gestión y se identificaron brechas a solventar. Para su concepción se diseñó un procedimiento metodológico que tiene en cuenta la agrupación de pacientes en categorías diagnósticas mayores, en función de características clínicas homogéneas y similar consumo de recursos. Resultados: Se identificó como problema principal la insuficiente gestión de los flujos de pacientes. Se construyó un modelo matemático de simulación discreta que se validó mediante la comparación de datos reales del servicio y las opiniones subjetivas de especialistas. Se identificó que los recursos limitantes del sistema son las enfermeras y las camas con porcentajes de utilización de 93,377 % y 89,265 % respectivamente. Conclusiones: Se desarrolla un modelo para la gestión de los flujos de pacientes en el servicio de cirugía general y se demuestra su influencia en el análisis, el proceso de toma de decisiones y la mejora de la gestión.

Introduction: Patient flow modeling is considered a key tool for the analysis and improvement of in-hospital trajectories. Objective: To develop and validate a mathematical model for the patient flows management in hospital in a General Surgery service. Methods: A descriptive quantitative research was developed. Different management models were analyzed and gaps to be solved were identified. For its conception, a methodological procedure was designed that takes into account the grouping of patients in Major Diagnostic Categories according to homogeneous clinical characteristics and similar resource consumption. Results: Insufficient patient flow management was identified as the main problem. A mathematical model of discrete simulation was built and validated by comparing real data from the service and the subjective opinions of specialists. It was identified that the limiting resources of the system are nurses and beds with utilization percentages of 93.377% and 89.265% respectively. Conclusions: A model for the patient flows management in the General Surgery service is developed and its influence on the analysis, decision-making process and management improvement is demonstrated.

The outcome of down-regulation+hormone replacement cycle endometrial preparation regimen in frozen-thawed embryo transfer in advanced age women / 重庆医学

Objective To analyze the effects of down-regulation+hormone replacement therapy(HRT)endometrial preparation regimen on the pregnancy outcomes of advanced age women(≥35 years old)undergoing frozen-thawed embryo transfer.Methods The clinical data of 329 patients with frozen-thawed em-bryo transfer in this hospital from June 2020 to June 2022 were analyzed retrospectively.Among them,149 pa-tients receiving gonadotropin-releasing hormone analogue(GnRHa)down-regulation+HRT endometrial preparation were included in the group A,and the other 180 patients with HRT endometrial preparation were included in the group B.The basic situation,endometrial transformation day situation and clinical outcome were compared between the two groups.The group A and group B were further divided into the two sub-groups according to age:group A1(35-＜40 years old,n=101),group A2(≥40 years old,n=48),group B1(35-＜40 years old,n=99)and group B2(≥40 years old,n=81).The effects of two endometrial prepara-tion regimens were compared among the different age groups.Results There were no significant differences in the age,infertility years,BMI,anti-Mullerian hormone level,as well as basal hormones levels such as estra-diol,progesterone,follicle-stimulating hormone,luteinizing hormone(LH),prolactin and testosterone between the two groups(P＞0.05).The levels of estradiol and LH on the endometrial transformation day in the group A were significantly lower than those in the group B(P＜0.05),the endometrial thickness,proportion of the patients with endometrial thickness ≥8 mm and proportion of the patients with type Ⅲ blood intima in the group A were significantly higher than those in the group B(P＜0.05).There was no significant difference in the number of transplanted embryos and the number of transplanted excellent embryos between the two groups(P＞0.05).The clinical pregnancy rate and embryo implantation rate in the group A were significantly higher than those in the group B(46.31％vs.35.56％;33.33％vs.25.18％,P＜0.05),and there was no significant difference in the early miscarriage rate between the two groups(P＞0.05).The further subgroup analysis showed that the clinical pregnancy rate and embryoimplantation rate in the group A2 were significant-ly higher than those in the group B2(35.42％vs.18.52％;21.43％vs.12.40％,P＜0.05),while there was no significant difference between the group A1 and group B1(P＞0.05).Conclusion The advanced age pa-tients undergoing frozen-thawed embryo transfer could select GnRHa down-regulation+HRT regimen to a-chieve better pregnancy outcomes,especially for those age ≥40 years old.

Research on EEG recognition method based on common spatial patterns and transfer learning / 国际生物医学工程杂志

Objective:Aiming at the problem of target user electroencephalogram (EEG) recognition, an EEG recognition method was presented based on common spatial patterns (CSP) and transfer learning.Methods:Firstly, preprocess was adopted on the original EEG data, and time windows 0.5~2.5 s and broad frequency band 8~30 Hz EEG signals, which contained α and β wave, were selected. Here event-related desynchronization (ERD) phenomenon existed significant differences. Afterwards, by CSP preprocessed EEG signals of multi-user were conducted to extract feature and feature vectors were obtained, respectively. Finally, by transfer learning target user EEG recognition was completed.Results:In channel Cz, ERD of right hand motor imagery was higher than ERD of foot motor imagery. The classification accuracy of users aa, al, av, aw, and ay were 93.8%, 100.0%, 84.2%, 94.6%, and 94.4%, respectively. The average classification accuracy was 92.4%, which was better than the commonly used classifiers SVM and EM. The method was only lower than the method of the first winner in the competition adopted by Tsinghua University 1.8%.Conclusions:EEG recognition method based on CSP and transfer learning increased target user EEG recognition performance by using non-target users and had important implications for the study of motor imagery brain-computer interface.

Predictive value of combination of normal morphology sperm percentage and sperm DNA fragmentation index for in vitro fer-tilization embryo transfer outcomes / 临床检验杂志

Objective To investigate the effects of combined assessment of normal morphology sperm rate(MNS)with sperm DNA fragmentation index(DFI)on the outcomes of in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis was conducted on the clinical data of 641 patients who underwent IVF-ET in our center from June 2020 to February 2023.According to MNS and DFI levels,the patients were divided into group A(MNS＜4％,DFI＜25％,403 cases),group B(MNS ≥4％,DFI ≥25％,9 ca-ses),group C(MNS≥4％,DFI＜25％,125 cases),group D(MNS＜4％,DFI≥25％,104 cases),group A1(MNS＜1％,DFI＜25％,106 cases)and group D1(MNS＜1％,DFI≥25％,60 cases).The general information,semen parameters,embryo develop-ment and pregnancy outcomes were compared among all the 6 groups.Results No statistically significant differences were found be-tween female and male age among these groups(P＞0.05).Significant differences were observed in sperm motility,progressive motili-ty,sperm concentration and fertilization rates(P＜0.05),but no differences of usable embryo rates,good-quality embryo rates,clinical pregnancy rates,early miscarriage rates,or live birth rates(P＞0.05)among the groups A,B,C,D,A1 and D1.Conclusion The decreased MNS and increased DFI in males were associated with reduced sperm motility and concentration,affecting fertilization rates in IVF-ET,but had no significant impact on clinical pregnancy outcomes.The combined assessment of MNS with DFI had limited pre-dictive value for IVF-ET pregnancy outcomes.

Analysis of Cumulative Live Birth Rate of Selective Single Embryo Transfer by Time-lapse Monitoring System and Conventional Morphological Assessment in IVF/ICSI-ET / 实用妇产科杂志

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Trajectories and influencing factors of post-traumatic stress disorder in women with multiple in vitro fertilization embryo transfer failures / 中国实用护理杂志

Objective:To explore the potential categories of post-traumatic stress disorder (PTSD) trajectories in women with multiple in vitro fertilization-embryo transfer (IVF-ET) failures, and to analyze the effects of different demographic characteristics and psychological factors on the potential categories of PTSD trajectories.Methods:This was a prospective empirical research, from May 2021 to October 2022, women with IVF-ET failure ≥ 2 times in the reproductive department of Shanghai First People′s Hospital from May 2021 to October 2022 were selected as the research objects. Post-traumatic stress disorder civilian version scale was used for 4 follow-ups at 3 d (T1), 10 d (T2), 20 d (T3) after the last transplantation failure and 3 d before the next transplantation cycle (T4). Telephone follow-up and online follow-up were combined to obtain the PTSD level at 4 time points. Potential categories of PTSD score trajectories at four time points were identified using a latent category growth model, and analyze influencing factors using unordered multi classification logistic analysis.Results:Totally 196 IVF-ET women were admitted, aged (29.42 ± 4.13) years. Three PTSD trajectories were fitted in this study, including 82 cases (42%) in non-PTSD group, 61 cases (31%) in mild PTSD group and 53 cases (27%) in elevated PTSD group. Logistic regression analysis showed that age, education level, fertility pressure and marital adjustment level were the predictors of PTSD trajectory in women with multiple IVF-ET failures. Compared with the non-PTSD group, women aged ≥35 years, with lower education level and marital adjustment level were more likely to enter the elevated PTSD group ( OR=4.570, 8.540, 0.949, all P<0.05). Women aged 35 years and with greater reproductive pressure were more likely to enter the mild PTSD group ( OR=3.871, 1.063, both P<0.05). Conclusions:There is group heterogeneity in the trajectories of PTSD in women with multiple IVF-ET failures in the next transplantation cycle. Old age, low education level, high fertility pressure and poor marital adjustment can predict the trajectories of PTSD. Fertility stress and marriage adjustment are changeable variables. Medical staff can relieve women′s fertility pressure through health education and mindfulness intervention, promote a good state of marriage adjustment, and minimize the adverse effects of PTSD on the next cycle of conception.

A study on the relationship between irrational fertility cognition and reproductive life quality of in vitro fertilization-embryo transfer female patients: the mediating effect of psychological resilience / 中国实用护理杂志

Objective:To investigate the relationship between psychologicalresilience and irrational parenthood cognition and fertility life quality in female patients with in vitro fertilization-embryo transfer, and to analyze the mediating effect of psychological resilience on irrational parenthood cognition and fertility life quality, so as to provide guidance for infertility patients to improve their psychological resilience and fertility life quality.Methods:A cross-sectional study method was used to conveniently sample 460 female patients with in vitro fertilization-embryo transfer who were admitted to the Women′s Hospital, School of Medicine Zhejiang University from October 2022 to April 2023.General data questionnaire, Connor-Davidson Resilience Scale, Irrational Parenthood Cognitions Questionnaire and the Fertility Quality of Life were used for investigation.Results:A total of 449 valid questionnaires were retrieved. Patients aged (33.31 ± 4.99) years old. The total scores of irrational parenthood cognition, psychological resilience and the fertility quality of life were (38.73 ± 9.31), (63.19 ± 15.40) and (68.18 ± 11.89) points respectively for female patients with IVF-ET. The total score of irrational parenthood cognition was negatively correlated with the total score of fertility quality of life ( r = - 0.513, P<0.01), and the total score of psychological resilience was positively correlated with the total score of fertility quality of life ( r = 0.424, P<0.01). Pychological resilience played a partial mediating role between irrational parenthood cognition and fertility life quality, with the mediating effect accounting for 28.01% of the total effect. Conclusions:The irrational parenthood cognition of female patients with IVF-ET is at a medium level, and the psychological resilience and the fertility quality of life are at a low level. The irrational parenthood cognition has a direct negative predictive effect on the fertility life quality of patients, while the psychological resilience is a positive predictor of fertility life quality. Irrational parenthood cognition can directly or indirectly affect patients′ fertility life quality through psychological resilience. Clinical medical staff should take effective measures to reduce patients′ irrational parenthood cognition level and improve their psychological resilience, so as to improve patients′ fertility life quality.

Role of complement C3 in early predicting pregnancy outcomes of frozen-thawed embryo transfer / 实用医学杂志

Objective To investigate the role of complement C3 in early predicting pregnancy outcomes of frozen-thawed embryo transfer(F-ET).Methods A total of 378 F-ET cycles were prospectively collected and divided into group A(complement C3≤1.05,120 cycles)and group B(complement C3>1.05,258 cycles)based on the best cutoff value of complement C3 for predicting F-ET pregnancy outcomes.The outcomes of the two groups were compared,and the best cutoff value of complement C3 for predicting F-ET spontaneous abortion was analyzed in group B.Results Age was a risk factor for successful F-ET pregnancy(P<0.05),and complement C3 and embryo type were protective factors for successful F-ET pregnancy(P<0.05).The area under the receiver-operating characteristic curve(ROC)of complement C3 for predicting F-ET pregnancy outcome was 0.702,and the best cutoff value was 1.05 g/L,with a clinical pregnancy sensitivity of 87.60%and a specificity of 52.00%.The clinical pregnancy rate and embryo implantation rate in group B were both significantly higher than those in group A(67.05%vs.52.75%,P<0.05).The best cutoff value of complement C3 for predicting spontaneous abortion after F-ET was 1.32 g/L,with an area under the ROC curve of 0.760,a sensitivity of 69.00%,and a specificity of 81.20%.Conclusions Complement C3 is of significance in the early prediction of F-ET pregnancy outcome.When complement C3 exceeds the level of 1.32 g/L,it may lead to an increase in the rate of spontaneous abortion.

Effect of Zishen-Yutai pills on refrozen-thawed embryo transfer in patients with diminished ovarian reserve / 中国组织工程研究

BACKGROUND:Currently,hormone replacement therapy is the main treatment in Western medicine for patients with decreased ovarian function,but these patients are not sensitive to exogenous hormones,leading to unsatisfactory therapeutic effect.Zishen-Yutai pills can nourish the blood and calm the fetus,tonify the kidney and spleen,invigorate qi and strengthen the body.Studies have confirmed that Zishen-Yutai pill is effective in reducing follicle-stimulating hormone index and improving traditional Chinese medicine symptoms in patients with diminished ovarian reserve.However,few studies have been conducted to improve the implantation rate of patients by improving endometrial receptivity. OBJECTIVE:To evaluate the effect of Zishen-Yutai pills on the clinical outcome of patients with diminished ovarian reserve undergoing frozen-thawed embryo transfer again. METHODS:A total of 300 patients with diminished ovarian reserve who underwent frozen-thawed embryo transfer to assist pregnancy after the first failure in the Center of Reproductive Medicine,Changzhou Maternal and Child Health Care Hospital from January 2019 to December 2021 were selected as the study subjects.Subjects were randomly treated with a placebo or Zishen-Yutai pills in a ratio of 1:2,with 100 cases in the treatment group and 200 cases in the control group.However,13 patients fell off due to lack of contact,refusal to take medicine or other reasons.Finally,90 cases in the treatment group and 197 cases in the control group were included in the study.Oral medication was administered 7 days before frozen-thawed embryo transfer transplantation at a dose of 5 g/time,3 times/day.To investigate whether taking Zishen-Yutai pills could improve the clinical outcome of patients with diminished ovarian reserve after frozen-thawed embryo transfer again,the primary outcome measures included clinical pregnancy rate,implantation rate,abortion rate,live birth rate,offspring birth weight and birth defects. RESULTS AND CONCLUSION:Compared with the control group,the clinical pregnancy rate(P<0.05)and implantation rate(P=0.009)were significantly increased after the oral administration of Zishen-Yutai pills.Correlation analysis showed that taking the Zishen-Yutai pill was positively correlated with the number of implanted embryos(r=0.200,P=0.001)and clinical pregnancy(r=0.235,P=0.000).There was no correlation between taking Zishen-Yutai pills and indexes of endometrial thickness and blood flow.It is indicated that Zishen-Yutai pills can improve the clinical pregnancy rate and implantation rate of frozen-thawed embryo transfer recurrence in patients with diminished ovarian reserve.

Strength of association between follicular fluid melatonin levels and pregnancy rates in single-cycle in vitro fertilization-embryo transfer women / 中国组织工程研究

BACKGROUND:In vitro fertilization-embryo transfer is commonly used to solve infertility,but its success rate is not high,the more common reasons are poor endometrial receptivity,poor egg quality,etc.The follicular fluid melatonin can inhibit the aging of the ovary,to a certain extent,can promote the development of embryos,improve the probability of conception,but whether there is a correlation between the two is not known. OBJECTIVE:To explore the correlation between follicular fluid melatonin level and pregnancy rate of single-cycle in vitro fertilization-embryo transfer women. METHODS:A total of 112 female patients who received in vitro fertilization-embryo transfer treatment in the First Affiliated Hospital of Anhui Medical University from December 2020 to April 2021 were selected as the study subjects.They were divided into quartile array(Q1-Q5)according to the follicular fluid melatonin level from low to high.Among them,the melatonin level of group Q1 was<6.99 ng/L(n=18),that of group Q2 was 7.00-9.99 ng/L(n=26),that of group Q3 was 10.00-11.99 ng/L(n=27),and that of group Q4 was 12.00-13.99 ng/L(n=18);and melatonin levels in group Q5 were 14.00-19.99 ng/L(n=23).Clinical data characteristics of the five groups were compared.Multi-factor Logistic regression was used to analyze the correlation between follicular fluid melatonin level and pregnancy rate of women with single-cycle in vitro fertilization-embryo transfer and embryo transfer.A restricted cubic spline Logistic regression model was established to analyze the dose-response relationship,and the model was evaluated by clinical decision curve. RESULTS AND CONCLUSION:(1)Compared with the study population with the lowest melatonin quintile(Q1),with the increase of melatonin level(Q2-Q5),the levels of egg harvest and pregnancy success were gradually increased,and the body mass index was gradually decreased,and the differences were significant(P<0.05).(2)Multivariate Logistic regression analysis showed that after adjusting for confounding factors such as global mass index,number of eggs retrieved,luteinizing hormone,estradiol,progesterone and other confounding factors,follicular fluid melatonin level was still independently correlated with pregnancy rate of single-cycle in vitro fertilization-embryo transfer women(OR=1.538,95%CI:1.032-1.837,P<0.05),and there was significant difference in trend test of follicular fluid melatonin level from low to high quintile array(Ptrend<0.05).(3)The sensitivity test analysis showed that E value was 2.117.Subgroup analysis showed that the study population with higher levels of luteinizing hormone in follicular fluid had a more significant association between follicular fluid melatonin and pregnancy rate in single-cycle in vitro fertilization-embryo transfer women(P interaction=0.008).(4)The results of restricted cubic spline model analysis showed that there was a nonlinear dose-response relationship between follicular fluid melatonin level and pregnancy rate of single-cycle in vitro fertilization-embryo transfer women(P<0.05),and there was an overall positive correlation between follicular fluid melatonin level and pregnancy rate of single-cycle in vitro fertilization-embryo transfer women.(5)The results of clinical decision curve analysis showed that the follicular fluid melatonin level had important clinical value in predicting the pregnancy rate of single-cycle in vitro fertilization-embryo transfer women.(6)Follicular fluid melatonin level is closely related to the pregnancy rate of single-cycle in vitro fertilization-embryo transfer women,and with the decrease of follicular fluid melatonin level,the pregnancy rate of single-cycle in vitro fertilization-embryo transfer women also decreases.

Effect of cell mechanics on morphogenesis of MDCK lobular organoid / 中国组织工程研究

BACKGROUND:The development of tissues and organs in the body is a precise and autonomously regulated process,and the function of biomechanical factors at this macroscale is a basic scientific question worth exploring. OBJECTIVE:To investigate the roles of cell mechanics in morphogenesis of the lobular organoid of 3D Madin-Darby canine kidney(MDCK). METHODS:The formation of MDCK lobular organoid was visualized by fluorescence resonance energy transfer technology,and the influence of different cellular mechanical signals and extracellular matrix environment on lobular organoid formation and corresponding changes in extracellular regulated protein kinases(ERK)activity were examined. RESULTS AND CONCLUSION:(1)Inhibition of ERK signaling pathway can inhibit the growth of MDCK lobular organoid.(2)Inhibition of cell contractile force signals such as ROCK pathway and Myosin Ⅱ activity,reduced ERK activity and lobular organoid size.(3)Selective inhibition of calcium channels in plasma membrane and endoplasmic reticulum led to reduced ERK activity and lobular organoid growth.(4)By inhibiting the mechanically-sensitive receptor Piezo ion channel or integrin signal on the cell membrane,the lobular organoid became smaller or MDCK cells could not generate tissue morphology.(5)Extracellular matrix compositions affected the morphogenesis of lobular organoid.The addition of type I collagen in Matrigel changed the lobular organoid to elongated shape.(6)The results of this study preliminarily show that mechanical signals in the cells and extracellular matrix environment play an important role in culturing MDCK lobular organoid,and provides certain molecular mechanisms.

Thermal dose of experimental animals exposed in electromagnetic field / 中国医学物理学杂志

The study explores the thermal dose of experimental animals exposed in electromagnetic field.The simulation environment containing electromagnetic and thermal doses is established based on the bioheat equation and the three-dimensional rat model,and the effects of specific absorption rate,metabolic rate and boundary condition on temperature distribution and variation are assessed.The result shows that the core temperature rises with increasing whole body average specific absorption rate(WBASAR).At WBASAR of 4 W/kg,the midbrain and testes have higher specific absorption rates due to the skin effect,resulting in a more significant temperature rise in organ tissues than in the core;and at WBASAR of 0.4 W/kg,the temperature variation of the shallow organs caused by the sudden changes of metabolic and external environment reaches 1℃,which is much larger than that of the core.The experiment demonstrates target organs such as the head and testicles as critical subjects in thermal dose assessment.The experimental conditions should be regulated to reduce the effects of metabolic rate and boundary condition on thermal dose.The study has guiding significance for bioelectromagnetic experimental design and effect evaluation on thermal dose.

Influencing Factors of Three-Dimensional Amide Proton Transfer Weighted Imaging on Right Kidney in Normal Chinese / 中国医学影像学杂志

Purpose The study aims to investigate the effects of various ages,genders and body mass index(BMI)on amide proton transfer weighted(APTw)in the right kidney of normal Chinese.Materials and Methods A total of 182 healthy volunteers enrolled from September 2021 to February 2022 at Xi'an GaoXin Hospital were prospectively performed.There were 7 groups(11-80 years)according to age per 10 years;2 groups according to gender,male and female;4 groups according to BMI,slim group,normal group,overweight group and obese group.3D-APTw imaging of the right kidney was performed via intermittent breath-holding.The correlation between APT values and age and BMI was analyzed,and the differences in APT values between age groups,different BMI groups and gender were analyzed,respectively.Results A total of 131 cases were finally included.There was a weak positive correlation between APT and age(r=0.325,P<0.001).There were statistical difference in APT values among different age groups(F=3.566,P=0.003),the post-hoc analysis showed that the APT values of 11-20 years[(1.853±0.357)%]old group was significantly lower than those of 41-50 years[(2.387±0.432)%]old group and 51-60 years[(2.336±0.451)%]old group(P<0.05);the APT value of male[1.980(2.320,1.820)%]was significantly lower than that of female[2.284(2.586,1.825)%;Z=2.301,P=0.021].There was a very weak positive correlation between APT and BMI(r=0.181,P=0.039),with statistically different APT values among BMI groups(F=3.265,P=0.024).The results of intra-group analysis showed that APT values in emaciation group were significantly lower than those in normal group,overweight group and obesity group,respectively(all P<0.05).Conclusion The APT value of the right kidney may be correlated with age and BMI,with males lower than females.The effect of age,gender and BMI on APT on the clinical application of 3D-APTw may be considered.

Study on the feasibility of MRI technique with APT in predicting the prognosis of acute ischemic stroke / 中国医学装备

Objective:To study the feasibility of magnetic resonance imaging(MRI)technique with amide proton transfer(APT)in predicting the prognosis of cerebral stroke.Methods:A total of 71 patients with acute cerebral stroke who admitted to the Nanjing First Hospital,Nanjing Medical University from September 2022 to May 2023 were selected.All of them underwent the test of National Institute of Health Stroke Scale(NIHSS),and received the MRI examination with chemical exchange saturation transfer(CEST).According to the modified Rankin scale(mRS)values of 1-month follow-up,they were divided into favorable recovery group(mRS<2,44 cases)and poor group(mRS≥2,27 cases).The asymmetric magnetization transfer ratio(MTRasym)image(APT)was obtained by analyzing data with special software.And then,the difference(△APTw)of APT values between ischemic zone and contralateral normal tissue was further calculated.The △APTw values of two groups were compared and analyzed,and the Pearson correlation analysis was adopted to analyze the correlation among △APTw,NIHSS and mRS.The receiver operating characteristics(ROC)curve was drawn,and the area under curve(AUC)of ROC curve was calculated.Results:There were significant positive correlations among △APTw,NIHSS and mRS scores(R2=0.659,0.522,P<0.001),and the differences of △APTW,NIHSS and mRS scores between the favorable recovery group and poor group were significant(t=5.73,6.36,13.92,P<0.05),respectively.The AUC value was 0.886,and the sensitivity and specificity of prediction were respectively 77.8%and 95.5%.The positive and negative predictive values were respectively 91.3%and 87.5%.Conclusion:APT imaging technique has feasibility in predicting the prognosis of acute cerebral ischemic stroke.

Study on the Distribution and Clinical Characteristics of TCM Syndromes in Infertility Patients with Autoimmune Thyroiditis / 中国中医药信息杂志

Objective To investigate the distribution and clinical characteristics of TCM syndromes in infertility patients with autoimmune thyroiditis(AIT).Methods By referring to the relevant literature on the distribution of TCM syndromes of AIT and infertility in women of childbearing age,the TCM Syndromes Survey of Infertility Patients with Autoimmune Thyroiditis was formulated.256 cases of infertility patients with AIT who underwent in vitro fertilization-embryo transfer(IVF-ET)at the Reproductive Center of The First Affiliated Hospital of University of Science and Technology of China from June 2019 to December 2020 were retrospectively analyzed.The data of basic information,TCM syndromes,basic thyroid-stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(TG-Ab)were collected.By means of frequency analysis and systematic cluster analysis,the distribution regularity of TCM syndromes in infertility patients with AIT were concluded.Results After analysis,the following 5 common syndrome elements were obtained,namely,qi deficiency,liver depression,spleen deficiency,kidney deficiency and blood stasis.In addition,it was concluded that this disease was more common in complex syndromes.Through systematic clustering analysis,main TCM syndromes of this disease were obtained,which were qi deficiency and liver depression syndrome(69 cases,26.9%),spleen and kidney deficiency syndrome(45 cases,17.6%),spleen qi deficiency syndrome(38 cases,14.8%),qi deficiency and blood stasis syndrome(36 cases,14.1%),kidney deficiency and liver depression syndrome(32 cases,12.5%)and other syndrome types(36 cases,14.1%).The basic TSH level was higher in patients with qi deficiency and liver depression syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome than other syndrome types,with statistical significance(P<0.05).There was no significant difference in TPO-Ab and TG-Ab titers among different syndromes(P>0.05).Conclusion TCM syndromes of infertility patients with AIT can be clustered into qi deficiency and liver depression syndrome,spleen and kidney deficiency syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome,kidney deficiency and liver depression syndrome and other syndrome.The main element of syndrome is qi deficiency,and the pathological sites involved spleen,kidney and liver.Stasis blood is a main pathological product.It is required to pay close attention to the thyroid function in AIT patients with qi deficiency.

Assessment of dynamic cerebral autoregulation in pilots after acute positive acceleration exposure / 中华超声影像学杂志

Objective:To explore the changes of dynamic cerebral autoregulation ability in pilots exposed to acute positive acceleration(+ Gz) by transcranial Doppler combined with beat-to-beat blood pressure.Methods:A total of 26 pilots enrolled in the + 8Gz manned centrifuge trial at the Air Force Medical Center, Air Force Medical University from June to October 2022 were prospectively included. Blood pressure and heart rate were monitored in the resting state before the trial and within 5 min after centrifugation. Transcranial Doppler combined with noninvasive continuous beat-to-beat blood pressure monitor were used to detect bilateral middle cerebral artery blood flow velocity and beat-to-beat pulse pressure respectively. The transfer function analysis was applied to derive the parameters of cerebral blood flow autoregulation in each frequency band from 0.02 to 0.50 Hz, and the phase, gain and coherence were calculated. The above parameters were compared between resting state and after acute + 8Gz positive acceleration exposure.Results:Compared with the resting state, in all of the 26 pilots after acute + 8Gz positive acceleration exposure, the systolic and diastolic blood pressure and heart rate increased significantly ( P<0.001), the phase significantly increased and the gain significantly decreased in the ultra-low frequency band (0.02-0.07 Hz) ( P<0.05); whereas there were no statistical differences of gain and phase in the low frequency band (0.07-0.20 Hz) and the high frequency band (0.20-0.50 Hz) (all P>0.05). Conclusions:Transcranial Doppler combined with beat-to-beat pulse pressure can be used for the assessment of changes in immediate dynamic cerebral autoregulation after acute + Gz exposure, and transfer function analysis of ultra-low frequency band parameters is suitable for this type of evaluation.

Experimental study on quantitative evaluation of renal redox metabolism using chemical exchange saturation transfer imaging at 3.0 T MRI / 中华放射学杂志

Objective:To explore the feasibility of chemical exchange saturation transfer (CEST) imaging at 3.0 T MRI in quantifying renal redox metabolism in vitro models and experimental animals.Methods:Redox metabolites in vitro models with physiological concentrations were prepared, including reduced metabolites (glutamate, alanine, glutathione) and oxidized metabolites (2-ketoglutarate, pyruvate, glutathione disulfide, ammonium hydroxide). CEST examinations were performed at 3.0 T MRI. The imaging parameters were as follows: CEST images with different saturation pulse intensity (B 1) (1, 2, 3, 4 μT) and a fixed radio frequency (RF) duration of 2 000 ms; CEST images with different RF durations (1 500 and 2 000 ms) were acquired with a fixed B 1 value of 2 μT to obtain the optimal scanning parameters. CEST examinations with optimized parameters were performed on the left kidneys of seven healthy rabbits, and the differences in magnetic resonance ratio asymmetry (MTR asym) between rabbit renal cortex and outer medulla were measured. A paired t-test was used to compare the differences. Results:The optimal B 1 for CEST examination of redox metabolites was 2 μT, and the optimal RF duration was 2 000 ms. The MTR asym peaks of glutathione disulfide, glutathione, glutamic acid, and alanine were at 3.75, 3.5, 3, and 1.5 ppm, respectively. The MTR asym peaks of pyruvate, 2-ketoglutarate, and ammonium hydroxide were at 1 ppm. The MTR asym peak values of reduced metabolites were higher than those of oxidized metabolites. When the B 1 value was 2 μT and the RF duration was 2 000 ms, the MTR asym signal of the renal cortex was (2.60±1.10) %, (2.86±1.32) %, (3.04±1.06) %, and (2.98±0.91) % at 1, 3, 3.5, and 3.75 ppm, respectively. The MTR asym signal of the outer medulla was (1.00±0.56) %, (2.43±0.94) %, (2.29±0.88) % and (1.98±0.58) %, respectively. The MTR asym signal of the renal cortex was higher than that of the outer medulla, and the differences were statistically significant ( t=3.04, P=0.023; t=2.56, P=0.043; t=3.50, P=0.013; t=3.45, P=0.014). Conclusion:CEST imaging at 3.0 T MRI can be used to quantitatively evaluate redox metabolism of healthy rabbit kidneys in vitro model and normal experimental rabbits.

Influencing Factors of Live Birth of Embryo Transfer After Hysteroscopic Adhesiolysis / 中国微创外科杂志

Objective To investigate the clinical factors affecting live birth rate in patients who underwent hysteroscopic adhesiolysis and subsequent embryo transfer.Methods A total of 643 patients who had undergone hysteroscopic surgery to remove various degrees of intrauterine adhesion(IUA)and subsequently received embryo transfer between January 2018 and December 2020 were retrospectively analyzed.Postoperative treatment regimens and pregnancy outcomes after embryo transfer were collected.The primary endpoint was live birth rate.A multivariate logistic regression analysis was performed to further investigate the factors affecting pregnancy outcomes.Results Among the 643 IUA patients,20.5%(132/643)patients were diagnosed as having mild IUA,63.6%(409/643)patients moderate IUA,and15.9%(102/643)patients severe IUA.The median time from hysteroscopy to the first cycle of embryo transfer was 126(73,225)d.The clinical pregnancy rate was 32.7%(210/643)and the live birth rate was 24.7%(159/643).Logistic regression analysis found that age(OR =0.926,95%CI:0.880-0.974,P =0.003)and endometrial thickness on the day of transplantation(OR =1.188,95%CI:1.030-1.370,P =0.018)were prognostic factors of live birth.The live birth rate significantly decreased with age in the mild and moderate adhesion groups(P =0.004 and 0.018),while in the severe adhesion group,the live birth rate decreased with age,but the difference was not significant(P =0.526).Postoperative estrogen dosage,number of artificial cycles,interval between hysteroscopy and transplantation,fresh or frozen-thawed embryo transfer,and type of embryo transferred had no significant impact on live birth.Conclusions Maternal age and endometrial thickness on the day of transplantation are the most important predictors of live birth in patients undergoing embryo transfer after hysteroscopic adhesiolysis.Fresh or frozen-thawed embryo transfer after surgery and the interval between hysteroscopy and transplantation do not affect the live birth rate.

Expression level of tRF-31-PER8YP9LON4VD in serum of breast cancer patients and its effect on cell function / 中华检验医学杂志

Objective:To detect the expression level of tRF-31-PER8YP9LON4VD in the serum of breast cancer patients and to explore its effect on the function of breast cancer cells.Methods:The serums of 57 breast cancer patients, 39 breast benign tumor patients and 40 normal physical examination patients in the Affiliated Cancer Hospital of Nanjing Medical University from April to August in 2022 were collected. Real-time quantitative polymerase chain reaction(RT-qPCR) to detect the expression level of tRF-31-PER8YP9LON4VD in breast cancer cell lines and serum of breast cancer patients. Cell invasion assay, migration assay and CCK-8 proliferation assay were used to analyze the effect of tRF-31-PER8YP9LON4VD on breast cancer cell function. The receiver operating characteristic curve (ROC) curve was used to analyze the diagnostic efficacy of tRF-31-PER8YP9LON4VD in serum in breast cancer. The chi-square test was used to analyze the correlation between tRF-31-PER8YP9LON4VD and clinical features.Results:The expression levels of tRF-31-PER8YP9LON4VD in breast cancer cell lines MDA-MB-231 (0.50±0.22 vs 1.00±0.01), T-47D (0.33±0.02 vs 1.00±0.01) and MCF-7 (0.50±0.02 vs 1.00±0.01) were significantly lower than those in normal mammary epithelial cell lines (1.00±0.01), and the difference was statistically significant (all P<0.05). The expression level of tRF-31-PER8YP9LON4VD in the serum of breast cancer patients (1.35±1.25) was lower than that in the serum of patients with normal physical examination (6.42±3.13) and patients with benign breast tumors (9.57±2.11), and the difference was statistically significant (both P<0.001). Compared with the control group, the invasiveness of overexpressing tRF-31-PER8YP9LON4VD T-47D (86.67±12.22 vs 532.00±22.68, P<0.001) and MDA-MB-231 (535.33±99.12 vs 1 055.67±24.00, P=0.002) was weaker, and that of T-47D (442.67±81.79 vs 1 210.67±115.02, P=0.002) and MDA-MB-231 (278.67±108.40 vs 571.33±95.37, P=0.015) had weaker migration ability, and T-47D and MDA-MB-231 had weaker proliferative ability (all P<0.05). The area under the curve of serum tRF-31-PER8YP9LON4VD for the diagnostic efficacy of breast cancer was 0.743 (95% CI 0.644-0.842), and the sensitivity and specificity were 89.50% and 53.10%, respectively. Conclusion:tRF-31-PER8YP9LON4VD is low expressed in the serum of breast cancer patients, and it may inhibit the proliferation, migration and invasion of breast cancer cells.