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These should have been captured as " SP 2 sp Xiamen key laboratory of perinatal-neonatal infection, Xiamen, China"; " SP 3 sp Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, China". " SP † sp Ya-sen Wang, Wei Shen, Rui-miao Bai, Juan Zhang, Wen-ting Yu, Juan Kong contributed equally to this work", however, in the published version, this was incorrectly captured as " SP † sp Ya-sen Wang, Wei Shen, Juan Zhang, Yi-jia Zhang, Shi-rong Song, Juan Kong contributed equally to this work." Jian Mao, Xiao-mei Tong, Zhan-kui Li, Fan Wu, Xin-zhu Lin are co-corresponding author on this paper, but in the published version, only Xin-zhu Lin has been captured as such. [Extracted from the article]

Background: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease, primarily affects preterm newborns and occurs after 7 days of life (late-onset NEC, LO-NEC). Unfortunately, over the past several decades, not much progress has been made in its treatment or prevention. This study aimed to analyze the risk factors for LO-NEC, and the impact of LO-NEC on short-term outcomes in very preterm infants (VPIs) with a focus on nutrition and different onset times., Method: Clinical data of VPIs were retrospectively collected from 28 hospitals in seven different regions of China from September 2019 to December 2020. A total of 2509 enrolled VPIs were divided into 2 groups: the LO-NEC group and non-LO-NEC group. The LO-NEC group was divided into 2 subgroups based on the onset time: LO-NEC occurring between 8 ~ 14d group and LO-NEC occurring after 14d group. Clinical characteristics, nutritional status, and the short-term clinical outcomes were analyzed and compared among these groups., Results: Compared with the non-LO-NEC group, the LO-NEC group had a higher proportion of anemia, blood transfusion, and invasive mechanical ventilation (IMV) treatments before NEC; the LO-NEC group infants had a longer fasting time, required longer duration to achieve the target total caloric intake (110 kcal/kg) and regain birthweight, and showed slower weight growth velocity; the cumulative dose of the medium-chain and long-chain triglyceride (MCT/LCT) emulsion intake in the first week after birth was higher and breastfeeding rate was lower. Additionally, similar results including a higher proportion of IMV, lower breastfeeding rate, more MCT/LCT emulsion intake, slower growth velocity were also found in the LO-NEC group occurring between 8 ~ 14d when compared to the LO-NEC group occurring after 14 d (all (P < 0.05). After adjustment for the confounding factors, high proportion of breastfeeding were identified as protective factors and long fasting time before NEC were identified as risk factors for LO-NEC; early feeding were identified as protective factors and low gestational age, grade III ~ IV neonatal respiratory distress syndrome (NRDS), high accumulation of the MCT/LCT emulsion in the first week were identified as risk factors for LO-NEC occurring between 8 ~ 14d. Logistic regression analysis showed that LO-NEC was a risk factor for late-onset sepsis, parenteral nutrition-associated cholestasis, metabolic bone disease of prematurity, and extrauterine growth retardation., Conclusion: Actively preventing premature birth, standardizing the treatment of grade III ~ IV NRDS, and optimizing enteral and parenteral nutrition strategies may help reduce the risk of LO-NEC, especially those occurring between 8 ~ 14d, which may further ameliorate the short-term clinical outcome of VPIs., Trial Registration: ChiCTR1900023418 (26/05/2019)., (© 2024. The Author(s).)

Background: S100P is a member of the S100 family of calcium-binding proteins, and it participates in pathophysiological events, such as tumor growth and invasion. Based on the striking similarities between trophoblast cells and tumor cells with regard to proliferative and invasive properties, we raised the question of whether and how S100P expresses in trophoblast cells during development. This study aimed to investigate the expression pattern of S100P in the human placenta during pregnancy development., Materials and Methods: In this experimental study, we collected 16 first-trimester placental tissues, 10 second-trimester placental tissues, and 12 term placentas. The mRNA expression levels of S100P were detected by reverse-transcription-polymerase chain reaction (RT-PCR) and quantitative real-time PCR, the protein expression levels were detected by western blot, and the localization of S100P was measured by immunohistochemical staining. The values obtained from PCR and western blot analysis were expressed as the mean ± SD. Levene's test was used to test equal variances, and one-way analysis of variance (ANOVA) was used to evaluate differences between groups., Results: Protein and mRNA expression of S100P could be detected in placenta during pregnancy, with minor higher levels in first-trimester (p>0.05). Immunohistochemical staining revealed that S100P protein was strongly expressed in syncytiotrophoblasts, and moderate expression was detected in villous cytotrophoblasts and cytotrophoblast columns. The S100P protein was localized to both cytoplasm and nuclei in syncytiotrophoblasts, while it only existed in the cytoplasm of cytotrophoblasts., Conclusion: S100P was strongly detected in human placenta during pregnancy. The specific expression and distribution of S100P in human placenta throughout gestation suggested that S100P function might vary with its location in the placenta.

Objective: To explore the application of Femoston in hormone replacement treatment-frozen embryo transfer (HRT-FET) versus endometrial preparation with Progynova and examine the effects of different endometrial thickness and estradiol levels on clinical outcomes., Methods: Retrospective analysis was conducted for a total of 1072 HRT-FET cycles at our center during January-June 2012. According to the type of medication, the patients were divided into 2 groups: Group A: Progynova only (798 cycles). Group B: non-satisfactory endometrial thickness or E2 level only by Progynova or repeated implantation failure, Progynova plus Femoston for preparing endometrium (274 cycles). Then the inter-group differences of basic profiles and clinical outcomes were compared. Comparison of clinical outcomes was performed based on different estradiol (E2) levels and endometrial thickness on the day of using progesterone. And then, the patients whose endometrial double thickness was thinner than 7 mm in Progynova + Femoston group were compared with the group of similar endometrial thickness in 2011. The data were analyzed with SPSS 16.0., Results: In Group A, the percentage of first transfer, average endometrial thickness on the day of using progesterone in FET cycles were all significantly higher than Group B. And the ratio of < 7 mm was significantly higher in Group B (8.8% vs 2.4%). However, no significant differences existed in clinical pregnancy rate (54.8% vs 52.9%) or embryo implantation rate (38.1% vs 35.8%). With endometrial thickening, both clinical pregnancy and embryo implantation rates increased. There was no significant difference in maximum E2 level. Clinical pregnancy rate, embryo implantation rate and live birth rate of the patients whose endometrial double thickness was thinner than 7 mm in Group B were all higher than those of similar endometrial thickness (all Progynova only) in 2011., Conclusion: For patients with thin endometrium, vaginal Femoston may be added if ideal endometrial thickness or E2 level is not achieved by Progynova alone. It improves endometrial receptivity and clinical outcomes are more satisfactory.

Objective: This study aimed to review the available literature on fertility-preserving treatment and pregnancy outcomes in patients with early-stage endometrial carcinoma who desired to preserve their fertility., Data Sources: The PubMed database (1992-2012) was searched for the words "conservative "OR" fertility sparing "OR" fertility preserving" AND "endometrial neoplasms" (MeSH). All relevant articles in English and the relevant references were collected., Study Selection: Data from published articles about fertility-preserving treatment of endometrial cancer, including the response and recurrence rate of conservative treatment, strategies of infertility treatment, pregnancy, and obstetric outcomes, were selected. Data were mainly extracted from 41 studies, which are listed in the reference section of this review., Results: Hormone therapy was the most common method used for early-stage endometrial carcinoma in patients who wished to preserve fertility. Sixty percent of the patients became pregnant after remission of the carcinoma. The percentage of patients who conceived in the assisted reproductive technology group was higher than that of the natural pregnancy group (80.0% vs. 43.2%, P < 0.01). A higher rate of preterm labor and multiple pregnancies was observed in the assisted reproductive technology group than that in the natural pregnancy group. The majority of pregnancies (71.4%) in the assisted reproductive technology group were achieved by in vitro fertilization-embryo transfer. The clinical pregnancy rate of transfer cycles in patients with endometrial carcinoma was 34.1%., Conclusions: Assisted reproductive technology is a good option in well-selected patients with early-stage endometrial carcinoma who have completed conservative treatment. In vitro fertilization-embryo transfer offers an opportunity to achieve an immediate pregnancy.

Objective: To explore the risk factors associated with twin pregnancy in double embryo transfer., Methods: A retrospective analysis was performed for 2970 double embryo transfer cycles, including 1984 cycles of fresh embryo transfer and 986 cycles of frozen-thawed embryo transfer (FET). Multiple factor Logistic regression was used. The twin pregnancy rate was studied in group of age < 35 or age ≥ 35 years old, in group of zero, single or double high-quality embryos transferred and group of fresh embryo transfer or FET cycles., Results: (1) There was a significantly negative correlation between women's age and twin pregnancy according to the analysis of multiple factor Logistic regression (P < 0.01). And a significantly positive correlation existed between the number of high-quality embryos transferred, FET and twin pregnancy (P < 0.01); (2) the twin pregnancy rate of both fresh embryo transfer and FET cycles was higher in group of age < 35 years than that in group of age ≥ 35 years (16.0% vs 8.0%, P < 0.01; 26.9% vs 14.2%, P < 0.01); (3) the twin pregnancy rate of fresh embryo transfer cycles with double high-quality embryos transferred was higher than that with zero or single high-quality embryos transferred (19.1% vs 5.4%; 19.1% vs 11.0%, P < 0.01); the twin pregnancy rate of FET cycles with double high-quality embryos transferred was also higher than that with zero or single high-quality embryos transferred (32.7% vs 10.8%; 32.7% vs 20.7%, P < 0.01); (4) the twin pregnancy rate of FET cycles was significantly higher than that of fresh embryo transfer cycles (24.7% vs 14.9%, P < 0.01)., Conclusion: Women's age, the number of high quality embryos transferred and FET are risk factors associated with twin pregnancy. At reproductive centers with a mature technique of FET, we recommend performing single high-quality embryo transfer in FET cycles to reduce the occurrence of twin pregnancy.

Objective: To investigate the transfer strategy of low-quality embryo in in vitro fertilization and embryo transfer (IVF-ET) cycle., Methods: A retrospective analysis was performed for the clinical data of 621 IVF-ET cycles under controlled ovarian hyperstimulation, including 574 fresh embryo transfer (ET) cycles (Group T1) and 47 frozen-thawed embryo transfer (FET) as the first ET cycles (Group C1). Logistic regression was used to model the probability of clinical pregnancy rate based on the cycle-specific factors., Results: The clinical pregnancy rate was significantly higher in Group C1 than Group T1 [38.3% (18/47) vs 22.1% (127/574), P < 0.05]. Multivariate logistic regression analysis revealed that patient age and ET method were significantly associated with the clinical pregnancy rate. After adjusting for patient age, the clinical pregnancy rate remained significantly higher in Group C1 than Group T1 (OR: 2.107, 95%CI: 1.128 - 3.939, P < 0.05)., Conclusion: The use of FET instead of fresh ET may improve the clinical pregnancy rate in low-quality embryo cycles.

Objective: To analyze the risk factors for triplet pregnancy after a simultaneous transfer of triplicate embryos., Methods: The investigators carried out a retrospective analysis of 769 cycles in which three embryos were transferred in one treatment cycle, including 298 fresh embryo transfer (ET) cycles and 471 frozen-thawed ET (FET) cycles. The impact of patient age and the number of good embryos transferred on the rates of clinical pregnancy and triplet pregnancy was studied according to different cycle types., Results: (1) The rates of clinical and triplet pregnancy were significantly higher in the FET group (P < 0.05) than those in the fresh ET group; (2) all patients with a triplet pregnancy in the fresh ET group (n = 6) were younger than 35 years old (P < 0.01). There was no significant difference between the subgroups in the FET cycle according to patient age (P > 0.05); (3) when none, 1, 2 or 3 good embryos were transferred in the fresh ET cycle, the clinical pregnancy rates were 28.3%, 46.7%, 50.6% and 58.7% and the triplet pregnancy rates 0, 2.3%, 4.7% and 6.8% respectively. A similar clinical pregnancy rate (P > 0.05) and a significantly lower triplet pregnancy rate (P < 0.05) were observed when 1 good embryo was transferred versus 2 good embryos (P < 0.05). When 0, 1, 2 or 3 good embryos were transferred in the FET cycle, the clinical pregnancy rates were 38.9%, 54.8%, 59.7%, 63.9% and the triplet pregnancy rates 0, 5.0%, 13.8%, 15.8% respectively. A similar clinical pregnancy rate (P > 0.05) and a significantly lower triplet pregnancy rate (P < 0.05) were observed when 1 good embryo was transferred versus two good embryos (P < 0.05). All triplet pregnancies occurred in cycles in which more than 1 good embryo was transferred (P < 0.05)., Conclusion: The patients have more triplet pregnancies in the FET cycle than in the fresh ET cycle. In the FET cycle, the patient age is irrelevant. It is recommended that no more than 2 embryos should be transferred. Selective single blastocyst embryo transfer is preferable if there are more than 2 good embryos available for transfer. No more than 2 embryos should be transferred in the fresh ET cycle if good embryos are available and a patient is under 35 years old.

Objective: To compare the surgical outcomes for staging by laparoscopy and laparotomy in patients with endometrial cancer, evaluate the feasibility of laparoscopic surgical treatment of endometrial cancer, compare the difference between clinical and surgical staging of endometrial cancer and elucidate the advantages and feasibility of its surgical staging., Methods: Fifty-six patients diagnosed pre-operatively as stage I endometrial cancer were reviewed for surgery for staging. They were assigned into laparoscopic group (n = 34) and laparotomic (open) group (n = 22). The operative parameters including operating time, intra-operative blood loss, the number of lymph nodes removed, gastrointestinal recovery time, urinary catheterization time, complications and post-operative hospital stay were compared., Results: The pre-operative clinical characteristics before operation between two groups were similar. No significant differences were found in age and body mass index between two groups. As compared with the open group, the laparoscopic group had a longer operation time (213 min ± 49 min vs 162 min ± 30 min, P < 0.05), less hemoglobin change (12 g/L ± 8 g/L vs 19 g/L ± 8 g/L, P < 0.05), shorter hospital stay (6.3 d ± 1.7 d vs 9.5 d ± 1.8 d, P < 0.01) and shorter gastrointestinal recovery time (1.8 d ± 0.6 d vs 2.7 d ± 1.2 d, P < 0.01). While there was no significant difference between two groups in the number of lymph nodes removed, urinary catheterization time, costs and complications. The total coincidence was 57.14% between clinical and surgical staging., Conclusion: Laparoscopic staging surgery is both feasible and safe in the treatment of endometrial cancer. And the surgical staging truly reflects the extent of cancer invasion and it is thus necessary for early-stage endometrial cancer.

Objective: To explore the fertilizing ability, cleavage potential and inheritance risks of globozoospermia., Methods: A globozoospermic patient was diagnosed by sperm morphological staining and transmission electron microscope. From his wife the investigators obtained 26 oocytes in which 6 oocytes were donated and the other 19 (in 20) MII oocytes injected into 19 round-headed sperms. Six donated oocytes accepted in vitro fertilization (IVF). This patient's chromosome and microdeletion in AZFa, AZFb and AZFc in Y chromosome were checked through 6 sequence tag sites of sY84, sY86, sY127, sY134, sY254 and sY255., Results: Only 4 (in 19) were normally fertilized and cleaved. All 6 donated oocytes were normally fertilized and cleaved. The fertilizing rate was significantly higher than that of this patient (100% vs 21.1%, P < 0.01). But the cleavage rate has no statistical difference (100% vs 100%, P > 0.05). This patient had normal chromosome (46, XY) and there was no deletion in Y chromosome. His wife became pregnant after accepting two thawed embryos and then gave birth to a boy whose chromosome was normal (46, XY). The acceptor also gave birth to a healthy boy after accepting two thawed embryos., Conclusions: Despite a lower fertilizing rate, intracytoplasmic sperm injection is still an effective therapy for globozoospermic infertility.

Objective: To evaluate the clinical efficacy of Metzenbaum scissors in the transcervical incision of a complete septate uterus., Methods: Eight patients with a complete septate uterus were identified and recruited. The age range was 24 to 39 years old. After diagnosis by hysteroscopy, the transcervical incision was performed by Metzenbaum scissors and followed by hysteroscopic incision of corporal portion. The associated diseases were treated using laparoscopy., Results: All patients were successfully treated and the operation duration was 5 - 10 minutes. The postoperative period was uneventful and there was no perforation, pelvic organ damage or water intoxication. Three months later, hysteroscopy revealed no uterine scarring or adhesion. And the shape of uterine cavity was normal., Conclusion: Using Metzenbaum scissors for transcervical incision of cervical portion of complete septate uterus, followed by hysteroscopic incision of corporal portion, is convenient, fast and safe. This approach has no effect upon the growth of endometrium.

Objective: To find valuable implantation-related genes associated with endometrial receptivity by scanning the complete genome array of endometrium at the luteal phase of superovulation cycle and the natural cycle., Methods: Twenty endometrial samples were obtained from patients who were to undergo invitro fertilization and embryo transfer because of the ovarian or male factors, underwent real-time quantitative PCR (QPCR) to confirm the differentially expressed genes and pathological examination to confirm the stages. Five of the 20 endometrial samples from days of LH + 4, LH + 7, or HCG + 7 underwent HU133 plus2.0 microarray scanning. The other 15 samples were divided into 2 groups: 7 samples were taken on the day LH + 7, and 8 samples taken on the day HCG + 7., Results: 581 genes were expressed differentially in the LH + 7 and LH + 4 samples: 395 were up-regulated and 186 were down-regulated. 320 genes were expressed differentially in the HCG + 7 and LH + 7 samples: 175 genes were up-regulated, and 145 genes were down-regulated. QPCR test showed that the expression levels of some up-regulated genes were much lower on the day HCG + 7 than on the day LH + 7, such as PAEP, S100P, SOD and GDF15., Conclusion: Microarray scanning provides a global gene expression spectrum of human endometrium at different phases. A set of genes are active at the implantation window phase of endometrium. These genes don't show adequate expression after superovulation, which may lead to the change of endometrial receptivity.