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Objective: To investigate the effect of preimplantation genetic testing for aneuploidies (PGT-A) on pregnancy outcome and perinatal outcome of single live birth in patients with unexplained recurrent spontaneous abortion (URSA). Methods: The clinical data of 351 cycles of the first transfer of a blastocyst through whole embryo freezing in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from 2019 to 2021 were retrospectively analyzed. According to whether PGT-A was performed before the transfer, the patients were divided into two groups: the PGT-A group (160 cycles) and the control group (191 cycles) were treated with in vitro fertilization/intracytoplasmic sperm microinjection (IVF/ICSI). To adjust for confounding factors, propensity score matching (PSM) was carried out in a 1∶1 ratio between the two groups of patients. After matching, 98 patients in the PGT-A group and 98 patients in the control group were compared for pregnancy outcome and perinatal outcome of singleton live births. Results: Before PSM, the female age in the PGT-A group was (33.6±4.0) years, lower than that in the control group (34.5±4.5) years ( P =0.049). Male age in the PGT-A group was (33.6±4.1) years, lower than that in the control group (35.3±5.1) years ( P <0.001). There were statistically significant differences between the two groups in infertility factors, female body mass index (BMI), years of infertility, number of spontaneous abortions, basal follicle stimulating hormone (FSH), endometrial thickness on the day of transfer and the percentage of high-quality blastocysts (all P values<0.05); After PSM, there was a statistically significant difference in fertilization methods and infertility factors between the two groups ( P <0.05), while other differences were not statistically significant (all P values>0.05); There were statistically significant differences between the two groups in implant rate [63.3% (62 cycles) vs. 49.0% (48 cycles), P =0.044], clinical pregnancy rate [63.3% (62 cycles) vs. 49.0% (48 cycles), P =0.044], and live birth rate [42.9% (42 cycles) vs. 28.6% (28 cycles), P =0.037]. There was no statistically significant difference in perinatal outcomes between the PGT-A group and the control group in obtaining single birth live births ( P >0.05). Conclusion: Compared with conventional IVF/ICSI assisted pregnancy, PGT-A assisted pregnancy significantly improves implantation rate, clinical pregnancy rate, and live birth rate in URSA patients. PGT-A improves the pregnancy outcomes in URSA patients but not perinatal outcomes in patients with singleton live births.

Objective: To investigate the knowledge, use and barriers when prescribing GLP-1RA and SGLT2i among cardiologists, endocrinologists and general practitioners, and explore the influencing factors that hinder the use of these medications. Methods: A questionnaire was conducted among physicians in the above departments in Peking University Third Hospital and health service institutions at all levels in its medical consortium. A total of 342 physicians were involved. Among them, 40.6% (139) were cardiologists, 28.9% (99) were endocrinologists and 30.4% (104) were general practitioners; 66.7% (270) came from Beijing while 33.3% (72) from other provinces. The survey included clinicians' knowledge and current use of GLP-1RA and SGLT2i, and the possible reasons that influenced the prescription of these medications. Medical therapies of physicians were investigated by simulating different clinical scenarios. The difference of measures among physicians in different departments was compared. Results: A total of 342 physicians were involved, with the average age of 40 (35, 46) years old and the average working time of 13 (7, 20) years. Among them, 40.6% (139) were male. 77.5% (265) physicians had comprehensive knowledge of SGLT2i and prescribed it, which was higher than that for GLP-1RA (70.5%, 241) ( P <0.001). 21.1% (72) physicians prescribed SGLT2i more than 20 times per month, which was higher than that for GLP-1RA (8.2%, 28) ( P <0.001). Endocrinologists had more knowledge and prescribed more GLP-1RA and SGLT2i compared with other physicians (both P values < 0.001). 38.1% (53) cardiologists, 22.2% (22) endocrinologists, and 30.8% (32) general practitioners believed patients needed an endocrinologist to evaluate and adjust GLP-1RA, which was the primary barrier for the use of medications ( P= 0.042). 27.4% (38) cardiologists, 14.1% (14) endocrinologists, and 30.8% (32) general practitioners believed patients needed an endocrinologist to evaluate and adjust SGLT2i, which was the primary barrier for the use of medications ( P= 0.018). 21.6% (30) cardiologists, 45.5% (45) endocrinologists, and 31.7% (33) general practitioners believed side effects of SGLT2i was the primary barrier for the use of medications ( P< 0.001). For patients with unqualified glycemic control and cardiovascular complications, 65.4% (75) cardiologists, 69.7% (69) endocrinologists, and 43.3% (45) general practitioners chose the above medications ( P <0.001). For patients with qualified glycemic control, combined with cardiovascular complications and diabetic organ damage, 35.3% (49) cardiologists, 52.5% (52) endocrinologists, and 25.0% (26) general practitioners chose the above medications ( P< 0.001). Conclusions: Physicians had more knowledge and prescription of SGLT2i than that of GLP-1RA. Endocrinologists had more knowledge and prescription of the above medications than other physicians. The side effect of medications was potential primary barrier for the use of the novel hypoglycemic agent with cardiovascular benefits. In clinical practice, most of physicians considered that high-risk patients with cardiovascular comorbidities need to be referred to cardiologist or endocrinologist to adjust clinical therapies.

Objective: To analyze the relationship between angiopoietin 2 (Ang2) and vascular endothelial factor and vasodilation function in hypertensive patients. Methods: Patients with new onset grade 1~2 hypertension ( n= 40) and healthy control group ( n= 25) wereenrolledprospectively. Serum Ang2 and nitric oxide (NO), nitric oxide synthase (eNOS), endothelin-1 (ET-1) were measured in both groups. Flow-mediated vasodilation (FMD) were measured in hypertensive patients. The above indicators were reviewed in hypertensive patients after antihypertensive treatment until blood pressure<140/90 mmHg. Results: Compared with the control group, serum Ang2 ( P= 0.049) and ET-1 ( P< 0.001) were significantly higher. Serum NO ( P< 0.001) and eNOS ( P< 0.001) was significantly lower in the hypertensive group. Compared with baseline, serum Ang2 ( P= 0.049) and ET-1 ( P< 0.001) were decreased significantly, meanwhile serum NO ( P< 0.001) and eNOS ( P< 0.001) were significantly increased. Serum Ang2 after antihypertensive treatment was not significantly different from that of the control group, but no statistical difference was observed in FMD after antihypertensive therapy. Correlation analysis found that serum Ang2 was positively correlated with mean arterial pressure ( R =0.432, P< 0.001), and negative correlated with serum NO( R =-0.374, P= 0.001) and FMD ( R =-0.368 0, P= 0.002). Multiple linear regression found that serum Ang2 was independently associated with body mass index, mean arterial pressure, and serum NO. Conclusion: Serum Ang 2 can reflect the degree of endothelial and vasodilation impairment in hypertensive patients. Antihypertensive therapy can improve endothelial function, but whether it can restore damaged vasodilation function needs further verification.

Objective: To determine the relative percentage of skeletal muscle mass (SMM) in elderly patients with coronary heart disease, analyse the relationship between percentage of SMM and cardiorespiratory fitness (CRF), predict exercise capacity and cardiac reserve. Methods: Patients aged 65 years and over after PCI, receiving cardiopulmonary exercise testing (CPET) during February 2014 to December 2016 in Department of Cardiology at Peking University Third Hospital were enrolled.All patients' basic data, percentage of SMM and CPET related parameters, including peak oxygen uptake (VO(2)peak), oxygen pulse (VO(2)/HR), oxygen uptake efficiency slope (OUES) and other cardiorespiratory endurance indicators were collected, to do correlation analysis. Results: There were 402 patients enrolled, with average age (71±5) years, including 283 cases of male (70.40%) and 119 cases of female patients (29.60%). There were 62 patients with acute myocardial infarction (15.42%), 113 patients with old myocardial infarction (28.11%), and 227 patients diagnosed with angina pectoris (56.47%). The percentage of SMM was correlated to CRF.The percentage of SMM[97.00 (92.05, 102.10)%] and VO(2)/HR ( r =0.231, P <0.001) and OUES ( r =0.264, P <0.001) were positively correlated.Body mass index was negatively correlated with VO(2)peak( r =-0.162, P =0.001). Visceral fat area (VFA) was also negatively correlated with VO(2)peak( r =-0.126, P =0.016). Multiple linear regression analysis showed that Body mass index and VFA were negatively correlated with VO(2)peak ( r =-0.204, P =0.014; r =-0.031, P =0.013). The percentage of SMM was positively independently correlated with OUES( r =11.020, P <0.001). Conclusions: Muscle content is positively correlated with exercise capacity of patients.The percentage of skeletal muscle mass determines the core index of cardiorespiratory fitness, such as the slope of oxygen pulse and oxygen uptake efficiency.These indexes can be used as an important criterion for predicting and guiding rehabilitation exercise in patients with coronary heart disease.

Objective: To explore the relationship between early heart function impairment and exercise tolerance in patients with acute ST-elevation myocardial infarction (STEMI) and normal left ventricular ejection fraction (LVEF)., Methods: A total of 229 patients with a LVEF of ≥ 50% were retrospectively reviewed. There were 199 males and 30 females with a mean age of 56.2 ± 11.1 years. They underwent cardiopulmonary exercise testing (CPET) early after STEMI in a single exercise laboratory. Demographic data, presence of concomitant diseases, characteristics of STEMI, echocardiography and CPET findings were evaluated., Results: Their mean LVEF was 60.2% ± 6.9% and the values of Vo(2 peak) and Vo(2AT) were (21.8 ± 5.7) ml×kg(-1)×min(-1) and (19.4 ± 4.8) ml×kg(-1)×min(-1) respectively. Peak oxygen uptake (Vo(2 peak)) showed a positive correlation with LVEF (r = 0.17, P = 0.012), E/A (r = 0.15, P = 0.033) and peak myocardial systolic velocity (Sm) (r = 0.30, P < 0.001). On the contrary, it varied inversely with peak A wave velocity (A) (r = -0.20, P = 0.005), E/Em (r = -0.16, P = 0.022) and left atrial pressure (LAP) (r = -0.16, P = 0.021). And there was a similar correlation between oxygen uptake at anaerobic threshold (Vo(2AT)) and LAP (r = -0.17, P = 0.031). After adjustments of subject demographic features and cardiovascular risk factors, Vo(2 peak) was still associated with LVEF (β = 0.149, s = 0.051, sβ = 0.178, 95%CI 0.048 - 0.250, P = 0.004) and Sm (β = 0.606, s = 0.167, sβ = 0.245, 95%CI 0.277 - 0.936, P < 0.001). So did the relationship between Vo(2AT) and LAP (β = -0.271, s = 0.117, sβ = -0.172, 95%CI -0.501 - -0.040, P = 0.022)., Conclusion: The exercise tolerance may be affected by early heart function impairment in STEMI patients. CPET is a sensitive detection tool of decreased heart function.

Objective: To investigate the changes of cytoskeleton and induced apoptosis in human umbilical venous endothelial cells (HUVEC) and WISH cells during the invasion of Staphylococcus aureus., Methods: S. aureus suspension was collected routinely and used to infect HUVEC and WISH cells for 10, 30, 60 and 120 min respectively. The cell-invading ability of S. aureus was observed by microscope and the rearrangement of cytoskeleton of these cells observed under fluorescent microscope. DAPI fluorescent staining and DNA agarose electrophoresis were performed to analyze the apoptosis in HUVEC cells induced by S. aureus., Results: There was bacterial invasion after staphylococcus aureus was co-incubated with HUVEC and WISH cells for 10 min. The rates of infection were (54.9 +/- 2.4)% and (56.1 +/- 2.4)% at 60 min respectively. The ratios of F-actin rearrangements at 10 min, 30 min, 60 min and 120 min after the invasion of HUVEC and WISH cells with S. aureus were different at (54.7 +/- 2.8)%, (63.0 +/- 2.9)%, (71.0 +/- 2.6)%, (39.5 +/- 2.7)% and (63.3 +/- 2.6)%, (65.0 +/- 2.9)%, (77.0 +/- 2.4)% and (44.0 +/- 1.8)% respectively. The ratios of F-actin rearrangements at 10 min, 30 min and 60 min were higher than those at 120 min (P < 0.05). There was no change of microtubule observed in both cells at the same time. The apoptotic appearance was observed after the invasion of HUVEC cells with s. aureus at 60 min., Conclusion: S. aureus may invade the HUVEC and WISH cells through F-actin rearrangement. Apoptosis is induced in HUVEC cells at 60 min.

Objective: To observe the effects of 6-hydroxydopamine (6-OHDA) on the levels of phosphorylation of signal transducer and activator of transcription (STAT) 1 and STAT3, and the role of STASD in the neurotoxicity of 6-OHDA on dopaminergic neurons so as to help study the treatment of Parkinson's disease., Methods: Dopaminergic neurons, human neuroblastoma cells of the line SH-SY5Y were cultured and were treated with 6-OHDA of the concentrations of 50, 100, 200, and 400 micromol/L respectively. SH-SY5Y cells not treated with 6-OHDA were used as control group. MTT method was used to observe the cell viability rate 24, 48, and 72 h later. 3H-thymidine deoxyribose (TdR) was added into the culture fluid 12, 36, or 60 h after the treatment of 6-OHDA for 12 h, then the cell viability rate was observed. Western blotting was used to detect the levels of STAT1 and STAT3 phosphorylation., Results: Twenty-four hours after the treatment of 50 - 400 micromol/l 6-OHDA the cell viability rates decreased to 8.1% - 81.9% that of the control cells (all P < 0.05 or P < 0.01), e.g., 100 micromol/L 6-OHDA decreased the cell viability rate to 50% that of the control cells (P < 0.01). 3H-TdR proliferation assay showed that the cell viability rate decreased with the increase of the 6-OHDA concentration and time of treatment too. Western blotting showed that 0.5 - 24 h after the treatment with 100 micromol/L 6-OHDA, the STAT3 phosphorylation level was decreased obviously with the comparative band density of 0.747 +/- 0.011 - 0.238 +/- 0.007, and 2 hours after the treatment with 50 - 200 micromol/L 6-OHDA the comparative band density of STAT3 phosphorylation was 0.895 +/- 0.003 - 0.633 +/- 0.002 (all P < 0.05). However, the level of STAT1 phosphorylation was not influenced by the treatment of 6-OHDA of the concentration of 100 mol/L at different time points., Conclusions: Decreased STAT3 phosphorylation may be involved in the neurotoxicity mechanisms of 6-OHDA on dopaminergic neurons.