Nomogram to predict severe retinopathy of prematurity in Southeast China

AIM:To define the predictive factors of severe retinopathy of prematurity(ROP)and develop a nomogram for predicting severe ROP in southeast China.METHODS:Totally 554 infants diagnosed with ROP hospitalized in the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University and hospitalized in Taizhou Women and Children’s Hospital were included.Clinical data and 43 candidate predictive factors of ROP infants were collected retrospectively.Logistic regression model was used to identify predictive factors of severe ROP and to propose a nomogram for individual risk prediction,which was compared with WINROP model and Digirop-Birth model.RESULTS:Infants from the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University(n=478)were randomly allocated into training(n=402)and internal validation group(n=76).Infants from Taizhou Women and Children’s Hospital were set as external validation group(n=76).Severe ROP were found in 52 of 402 infants,12 of 76 infants,and 7 of 76 infants in training group,internal validation group,and external validation group,respectively.Birth weight[odds ratio(OR),0.997;95%confidence interval(CI),0.996-0.999;P<0.001],multiple births(OR,1.885;95%CI,1.013-3.506;P=0.045),and non-invasive ventilation(OR,0.288;95%CI,0.146-0.570;P<0.001)were identified as predictive factors for the prediction of severe ROP,by univariate analysis and multivariate analysis.For predicting severe ROP based on the internal validation group,the areas under receiver operating characteristic curve(AUC)was 78.1(95%CI,64.2-92.0)for the nomogram,32.9(95%CI,15.3-50.5)for WINROP model,70.2(95%CI,55.8-84.6)for Digirop-Birth model.In external validation group,AUC of the nomogram was also higher than that of WINROP model and Digirop-Birth model(80.2 versus 51.1 and 63.4).The decision curve analysis of the nomogram demonstrated better clinical efficacy than that of WINROP model and Digirop-Birth model.The calibration curves demonstrated a good consistency between the actual severe ROP incidence and the predicted probability.CONCLUSION:Birth weight,multiple births,and noninvasive ventilation are independent predictors of severe ROP.The nomogram has a good ability to predict severe ROP and performed well on internal validation and external validation in southeast China.

FPR1 Antagonist (BOC-MLF) Inhibits Amniotic Epithelial-mesenchymal Transition

Objective:Premature rupture of membranes(PROM)is a common pregnancy disorder that is closely associated with structural weakening of fetal membranes.Studies have found that formyl peptide receptor 1(FPR1)activates inflammatory pathways and amniotic epithelial-mesenchymal transition(EMT),stimulates collagen degradation,and leads to membrane weakening and membrane rupture.The purpose of this study was to investigate the anti-inflammatory and EMT inhibitory effects of FPR1 antagonist(BOC-MLF)to provide a basis for clinical prevention of PROM.Methods:The relationship between PROM,FPR1,and EMT was analyzed in human fetal membrane tissue and plasma samples using Western blotting,PCR,Masson staining,and ELISA assays.Lipopolysaccharide(LPS)was used to establish a fetal membrane inflammation model in pregnant rats,and BOC-MLF was used to treat the LPS rat model.We detected interleukin(IL)-6 in blood from the rat hearts to determine whether the inflammatory model was successful and whether the anti-inflammatory treatment was effective.We used electron microscopy to analyze the structure and collagen expression of rat fetal membrane.Results:Western blotting,PCR and Masson staining indicated that the expression of FPR1 was significantly increased,the expression of collagen was decreased,and EMT appeared in PROM.The rat model indicated that LPS caused the collapse of fetal membrane epithelial cells,increased intercellular gaps,and decreased collagen.BOC-MLF promoted an increase in fetal membrane collagen,inhibited EMT,and reduced the weakening of fetal membranes.Conclusion:The expression of FPR1 in the fetal membrane of PROM was significantly increased,and EMT of the amniotic membrane was obvious.BOC-MLF can treat inflammation and inhibit amniotic EMT.

Application of mesenchymal stem cell therapy for premature ovarian insufficiency: Recent advances from mechanisms to therapeutics

The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complications that profoundly affect female reproductive function and overall health.Unfortunately,current clinical treatment strategies for this condition are limited and often yield unsatisfactory outcomes.These approaches typically involve hormone repla-cement therapy combined with psychological support.Recently,mesenchymal stem cell(MSC)therapies for POI have garnered considerable attention in global research.MSCs can restore ovarian reproductive and endocrine functions through diverse mechanisms,including controlling differentiation,promoting angiogenesis,regulating ovarian fibrosis,inhibiting apoptosis,enhancing autocrine and paracrine effects,suppressing inflammation,modulating the immune system,and genetic regulation.This editorial offers a succinct summary of the application of MSC therapy in the context of POI,providing evidence for groundbreaking medical approaches that have potential to enhance reproductive health and overall well-being for women.

Significance of oxidative stress and antioxidant capacity tests as biomarkers of premature ovarian insufficiency: A case control study

BACKGROUND Premature ovarian insufficiency(POI)is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage.Early follicular depletion results in intractable infertility,thereby considerably reducing the quality of life of females.Given the continuum in weakened ovarian function,progressing from incipient ovarian failure(IOF)to transitional ovarian failure and further to POI,it is necessary to develop biomarkers for predicting POI.The oxidative stress states in IOF and POI were comprehensively evaluated via oxidative stress[diacron-reactive oxygen metabolites(d-ROMs)]test and anti-oxidant capacity[biological antioxidant potential(BAP)].METHODS Females presenting with secondary amenorrhea over 4 mo and a follicle stimulating hormone level of>40 mIU/mL were categorized into the POI group.Females presenting with a normal menstrual cycle and a follicle stimulating hormone level of>10.2 mIU/mL were categorized into the IOF group.Healthy females without ovarian hypofunction were categorized into the control group.Among females aged<40 years who visited our hospital from January 2021 to June 2022,we recruited 11 patients into both POI and IOF groups.For the potential antioxidant capacity,the relative oxidative stress index(BAP/d-ROMs×100)was calculated,and the oxidative stress defense system was comprehensively evaluated.RESULTS d-ROMs were significantly higher in the POI and IOF groups than in the control group,(478.2±58.7 U.CARR,434.5±60.6 U.CARR,and 341.1±35.1 U.CARR,respectively)(U.CARR is equivalent to 0.08 mg/dL of hydrogen peroxide).However,no significant difference was found between the POI and IOF groups.Regarding BAP,no significant difference was found between the control,IOF,and POI groups(2078.5±157.4μmol/L,2116.2±240.2μmol/L,and 2029.0±186.4μmol/L,respectively).The oxidative stress index was significantly higher in the POI and IOF groups than in the control group(23.7±3.3,20.7±3.6,and 16.5±2.1,respectively).However,no significant difference was found between the POI and IOF groups.CONCLUSION High levels of oxidative stress suggest that evaluating the oxidative stress state may be a useful indicator for the early detection of POI.

An Improved Harris Hawk Optimization Algorithm for Flexible Job Shop Scheduling Problem

Flexible job shop scheduling problem(FJSP)is the core decision-making problem of intelligent manufacturing production management.The Harris hawk optimization(HHO)algorithm,as a typical metaheuristic algorithm,has been widely employed to solve scheduling problems.However,HHO suffers from premature convergence when solving NP-hard problems.Therefore,this paper proposes an improved HHO algorithm(GNHHO)to solve the FJSP.GNHHO introduces an elitism strategy,a chaotic mechanism,a nonlinear escaping energy update strategy,and a Gaussian random walk strategy to prevent premature convergence.A flexible job shop scheduling model is constructed,and the static and dynamic FJSP is investigated to minimize the makespan.This paper chooses a two-segment encoding mode based on the job and the machine of the FJSP.To verify the effectiveness of GNHHO,this study tests it in 23 benchmark functions,10 standard job shop scheduling problems(JSPs),and 5 standard FJSPs.Besides,this study collects data from an agricultural company and uses the GNHHO algorithm to optimize the company’s FJSP.The optimized scheduling scheme demonstrates significant improvements in makespan,with an advancement of 28.16%for static scheduling and 35.63%for dynamic scheduling.Moreover,it achieves an average increase of 21.50%in the on-time order delivery rate.The results demonstrate that the performance of the GNHHO algorithm in solving FJSP is superior to some existing algorithms.

Exploration of standard dosage for GnRH antagonist protocol and dosage adjustments after premature luteinizing hormone surge

The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.

Predictors and Complications of Prematurity in Two Health Facilities in Fako Division, Southwest Region, Cameroon

Background: Prematurity is the leading cause of neonatal mortality. Most preterm births can be associated to an identifiable risk factor. In Cameroon, especially in the Southwest Region, there is limited data regarding prematurity associated risk factors. The aim of this study was to evaluate the risk factors and complications of prematurity in two health facilities in the Fako division, the BRH and RHL. Methods: A hospital based retrospective case control study was done from the 1st of January 2021 to 28th of February 2022. We assessed the gestational ages at which preterm birth occurred and their short-term outcome using a structured pretested questionnaire to collect data from files. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 26. Results: The minimum sample size was 137 preterms. 45.5% of cases were born between 34 and increased the risk of having a preterm birth meanwhile being married (AOR: 0.410;95% CI: 0.217 - 0.773;p = 0.006) decreased the risk. Hospital complications were neonatal infection 103 (51.5%), respiratory distress 79 (39.5%) and neonatal jaundice 61 (30.50%). Among the cases, 97 (48.50%) stayed in the hospital for 2 to 4 weeks and 177 (88.5%) were discharged alive. Conclusions: Modifiable factors that increased the risk of prematurity were advanced maternal age, secondary level of education, rural residence, and prenatal alcohol consumption. Being married decreased the risk. The most common hospital complications in both the cases and controls were neonatal infection, respiratory distress syndrome and neonatal jaundice.

Being a Father of a Premature Newborn: The Parental Experience and the Father/Premature Newborn Relationship: A Study Carried out in the Department of Neonatology Intensive Care Unit of Mohammed VI University Hospital

Introduction: Despite advances in obstetrics and pediatrics over the past 20 years, premature birth remains an unpredictable event that can have a devastating impact on parenthood. This study aimed to analyze the psycho-affective experiences of fathers of premature newborns. Methods: This was a descriptive cross-sectional study, carried out in the department of neonatology and neonatal intensive care unit of the CHU Mohamed VI in OUJDA, over 6 months from March 2022 to August 2022. It focused on 30 fathers of premature newborns hospitalized in our department. Results: The majority of fathers described a state of fear and stress, and attributed their negative experience to the unexpected nature of the premature birth. At the first meeting, half the fathers had a positive image of their newborn’s physical appearance, while 22% of fathers reported feeling uncomfortable about their newborn’s low weight. Most fathers reported that they appreciated the welcome they received, the skill with which they cared for their newborn, and the availability of the pediatrician to provide information on their child’s state of health. Two fathers enjoyed skin-to-skin contact with their newborns. None of the fathers met a psychologist. When they returned home, half the fathers had a positive outlook, marked by happiness at being able to fully invest in their role as fathers, the other half reported being torn between the desire to see their child integrated into the family cocoon and the fear of not being able to manage delicate situations properly without a medical team. Conclusion: Bringing a premature baby into the world can be a difficult experience, leading to the development of even minor psychological distress in some fathers, and hence the need for specific psychological care.

Research Progress on the Prevention of Premature Infant Lung Injury and Neonatal Respiratory Support

In the past 40 years,advances in neonatal intensive care unit(NICU)technology have enabled premature infants with lower birth weight and younger gestational age to survive.But with it comes an increase in the incidence of long-term respiratory dysfunction,mainly in the form of bronchopulmonary dysplasia(BPD).Preventing lung injury is crucial for preventing BPD and improving the long-term prognosis of premature infants.Therefore,how to avoid ventilator-associated lung injury has become a focus of clinical and scientific research in premature infants in recent years.This article will elaborate on the susceptibility and pathophysiology of premature infant lung injury,ventilation strategies for preventing lung injury,and new advances in neonatal respiratory support.

射精功能障碍

在射精功能障碍(ejaculatory dysfunction)中,早泄(premature ejaculation,PE),射精延迟(delayed ejaculation,DE),不射精(anejaculation,AE)和逆行射精(retrograde ejaculation,RE)是最为常见的射精功能障碍类型,其他还包括高潮障碍(orgasmic disorder)、射精疼痛(painful ejaculation)、射精后综合征(postorgasmic illness syndrome)等少见情况[1],根据临床的常见情况,本文重点介绍PE和DE。

Extracellular vesicles from iPSC-MSCs alleviate chemotherapy-induced mouse ovarian damage via the ILK-PI3K/AKT pathway

Chemotherapy can significantly reduce follicle counts in ovarian tissues and damage ovarian stroma,causing endocrine disorder,reproductive dysfunction,and primary ovarian insufficiency(POI).Recent studies have suggested that extracellular vesicles(EVs)secreted from mesenchymal stem cells(MSCs)exert therapeutic effects in various degenerative diseases.In this study,transplantation of EVs from human induced pluripotent stem cell-derived MSCs(iPSC-MSC-EVs)resulted in significant restoration of ovarian follicle numbers,improved granulosa cell proliferation,and inhibition of apoptosis in chemotherapy-damaged granulosa cells,cultured ovaries,and in vivo ovaries in mice.Mechanistically,treatment with i PSC-MSC-EVs resulted in up-regulation of the integrinlinked kinase(ILK)-PI3K/AKT pathway,which is suppressed during chemotherapy,most likely through the transfer of regulatory microRNAs(miRNAs)targeting ILK pathway genes.This work provides a framework for the development of advanced therapeutics to ameliorate ovarian damage and POI in female chemotherapy patients.

The trajectories of physical growth in 4 months postnatal corrected age among preterm infants discharged from neonatal intensive care units and associated factors: A prospective study

Objectives Growth retardation is a risk for premature infants.In addition to demographic and perinatal factors,preterm infants’physical growth may be affected by neonatal intensive care unit(NICU)stress,maternal postpartum depression,and mother-infant interaction.This study aimed to investigate the trajectories of physical growth in 4 months corrected age among preterm infants discharged from the NICU and the impactors on these trajectories.Methods A prospective study was conducted among 318 preterm infants from September 2019 to April 2021 in Shanghai,China.Latent growth modeling was applied to identify the weight,length,and head circumference growth trajectories in 4 months corrected age and explore the effects of demographic and medical characteristics,infant stress during NICU stay,maternal postpartum depression,and mother-infant interaction on each trajectory.Results Unconditional latent growth models showed curve trajectories with increasingly slower growth in weight,length,and head circumference until 4 months of corrected age.Conditional latent growth models showed that a longer length of stay in the NICU and more skin punctures were negatively associated with weight at 40 weeks corrected gestational age(β=−0.43 and−0.19,respectively,P<0.05).The maternal postpartum depression between 40 weeks corrected gestational age and 1 month corrected postnatal age was associated with a lower growth rate of length(β=−0.17,P=0.040),while between 2 and 3 months corrected postnatal age,there were lower growth rates of weight and head circumference(β=−0.15 and−0.19,respectively,P<0.05).The mother-infant interaction scores between 40 weeks corrected gestational age and 1 month corrected postnatal age negatively predicted the growth rate of weight(β=−0.19,P=0.020).Conclusion The physical growth trajectories of preterm infants discharged from the NICU were influenced by infant stress during the NICU stay,maternal postpartum depression and mother-infant interaction.

Recurrence risk factors of intravitreal ranibizumab monotherapy in retinopathy of prematurity:a retrospective study at one center

AIM:To identify risk factors of recurrence of this disorder after intravitreal ranibizumab(IVR)monotherapy.METHODS:Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity(ROP)at our center were retrospectively reviewed between April 1,2016 and December 31,2017.Patient demographics,the side of ROP,multiple gestations,Apgar scores,zone,stage,plus disease,postmenstrual age at injection,surfactant therapy,blood transfusion therapy,hemorrhage before IVR,hemorrhage after IVR,gestational diabetes mellitus,pregnancy-induced hypertension,anemia,intraventricular hemorrhage,sepsis,respiratory distress syndrome,carbohemia,and congenital heart defects were recorded.Adjusted hazard ratios(HRs)and 95%confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression.RESULTS:Of the 33 eyes,12(36.4%)had ROP recurrences 45.3(5.1,50.9)mo after initial IVR treatments.The independent risk factors for ROP recurrences were zone(ⅡvsⅠ,HR:0.056,P=0.003)and gestational diabetes mellitus(no vs yes,HR:0.095,P<0.001).The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR(0.13,0.70)at 55.0(51.0,58.9)mo after the initial IVR treatment.The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR(0.19,0.63)at 48.0(43.8,58.4)mo after the initial IVR treatment.CONCLUSION:Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zoneⅠand gestational diabetes mellitus are identified,and the mean uncorrected visual acuity is 0.46 logMAR at 51.0(44.0,58.9)mo.The findings of this study are important for followup management and for improving the visual function of ROP patients.

Effect of Selective Dorsal Neurectomy on Erectile Function in Rats

Objective This study aimed to investigate the effect of penile selective dorsal neurectomy(SDN)on erectile function in rats.Methods Twelve adult male Sprague-Dawley rats(15 weeks old)were divided into three groups(n=4 per group):in control group,rats received no treatment;in sham group,rats underwent a sham operation;in SDN group,rats underwent SDN with half of the dorsal penile nerve severed.The mating test was performed,and the intracavernous pressure(ICP)assessed six weeks after the surgical treatment.Results At postoperative six weeks,the mating test revealed no significant difference in mounting latency and mounting frequency among the three groups(P>0.05),while the ejaculation latency(EL)was significantly longer and ejaculation frequency(EF)lower in the SDN group than in the control and sham groups(P<0.05).There were no significant differences in preoperative and postoperative ICP and ICP/mean arterial blood pressure(MAP)among the three groups(P>0.05).Conclusion SDN does not adversely affect the erectile function and sexual desire of rats,and at the same time it can reduce EL and EF,providing an application basis for SDN in the clinical treatment of premature ejaculation.

Analysis of oxidative stress and antioxidative potential in premature ovarian insufficiency

BACKGROUND Premature ovarian insufficiency(POI)is characterized by an early decline in ovarian function,inducing secondary amenorrhea.While the cause of POI has not yet been identified,the function of mitochondria in the ovaries and the cytotoxicity associated with reactive oxygen species(ROS)have been implicated in follicle pool depletion and a decline in follicle quality.Recently developed tests have enabled easy measurement of diacron-reactive oxygen metabolites(d-ROMs)and biological antioxidant potential(BAP).The combination of these two tests is used to comprehensively assess oxidative stress in the blood.AIM To comprehensively assess the oxidative stress of d-ROMs and BAP in POI.METHODS Participants were classified into two groups:A POI group of 11 women aged<40 years examined between January 2021 and June 2022 with a history of secondary amenorrhea for at least 4 mo in our hospital and an FSH value of≥40 mIU/mL;and a control group of healthy women of the same age with normal ovarian function in our hospital.Plasma d-ROMs and BAP were measured in both these groups underwent.Differences between groups were assessed using the t-test.RESULTS The mean age and mean body mass index(BMI)were 35.8±3.0 years and 20.1±1.9 kg/m2 in the control group and 35.8±2.7 years and 19.4±2.5 kg/m2 in the POI group,respectively.The mean gravidity and parity in control and POI groups were 0.6±0.7 and 0.4±0.5 and 0.6±0.9 and 0.3±0.5,respectively.The two groups did not differ significantly in terms of mean age,BMI,gravidity,or parity.The d-ROMs level was significantly higher in the POI group than in the control group(478.2±58.7 vs 341.1±35.1 U.CARR;P<0.001);however,the BAP level did not significantly differ between the two groups(2078.5±157.4 vs 2029.0±186.4μmol/L).The oxidase stress index(d-ROMs/BAP×100)was significantly higher in the POI group than in the control group(23.7±3.3 vs 16.5±2.1;P<0.001).CONCLUSION Oxidative stress was significantly greater in the POI group than in the control group,suggesting oxidative stress as a factor that can serve as a POI biomarker.

Heterotopic pregnancy after assisted reproductive techniques with favorable outcome of the intrauterine pregnancy:A case report

BACKGROUND Heterotopic pregnancy(HP)is a rare condition in which both ectopic and intrauterine pregnancies occur.HP is uncommon after natural conception but has recently received more attention due to the widespread use of assisted reproductive techniques(ART)such as ovulation promotion therapy.CASE SUMMARY Here,we describe a case of HP that occurred after ART with concurrent tubal and intrauterine singleton pregnancies.This was treated successfully with surgery to preserve the intrauterine pregnancy,resulting in the birth of a low-weight premature infant.This case report aims to increase awareness of the possibility of HP during routine first-trimester ultrasound examinations,especially in pregnancies resulting from ART and even if multiple intrauterine pregnancies are present.CONCLUSION This case alerts us to the importance of comprehensive data collection during regular consultations.It is important for us to remind ourselves of the possibility of HP in all patients presenting after ART,especially in women with an established and stable intrauterine pregnancy that complain of constant abdominal discomfort and also in women with an unusually raised human chorionic gonadotropin level compared with simplex intrauterine pregnancy.This will allow symptomatic and timeous treatment of patients with better results.

Anesthetic management of a patient with preoperative R-on-T phenomenon undergoing laparoscopic-assisted sigmoid colon resection:A case report

BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.

Adaptive Multi-Updating Strategy Based Particle Swarm Optimization

Particle swarm optimization(PSO)is a stochastic computation tech-nique that has become an increasingly important branch of swarm intelligence optimization.However,like other evolutionary algorithms,PSO also suffers from premature convergence and entrapment into local optima in dealing with complex multimodal problems.Thus this paper puts forward an adaptive multi-updating strategy based particle swarm optimization(abbreviated as AMS-PSO).To start with,the chaotic sequence is employed to generate high-quality initial particles to accelerate the convergence rate of the AMS-PSO.Subsequently,according to the current iteration,different update schemes are used to regulate the particle search process at different evolution stages.To be specific,two different sets of velocity update strategies are utilized to enhance the exploration ability in the early evolution stage while the other two sets of velocity update schemes are applied to improve the exploitation capability in the later evolution stage.Followed by the unequal weightage of acceleration coefficients is used to guide the search for the global worst particle to enhance the swarm diversity.In addition,an auxiliary update strategy is exclusively leveraged to the global best particle for the purpose of ensuring the convergence of the PSO method.Finally,extensive experiments on two sets of well-known benchmark functions bear out that AMS-PSO outperforms several state-of-the-art PSOs in terms of solution accuracy and convergence rate.

Comprehensive prevention strategies for retinopathy of prematurity:a literature review

Retinopathy of prematurity(ROP)is a kind of disease that can be seen in premature infants.It may cause a series of short-and longterm complications such as poor vision in premature infants,causing irreversible damage to them.Therefore,if we can prevent this disease,we can solve the above problems.This study summarized some factors that influence ROP,such as low gestational age,low birth weight,irrational oxygen use,anemia,blood transfusion,and thrombocytopenia;and also summarized a series of interventions that can prevent or delay the progression of ROP,such as reducing blood transfusion,the application of antenatal corticosteroids,and delaying clip umbilical cord,which can provide some reference for better clinical practice of preventing ROP.

Intermittent spontaneous ovulation in patients with premature ovarian failure:Three case reports and review of literature

BACKGROUND Premature ovarian failure(POF)is the end-stage of a decline in ovarian function prior to the age of 40 years that involves symptoms associated with low estradiol(E2)levels and a minimal probability of pregnancy.This increases the physical and psychological burden experienced by young women of reproductive age,particularly with regards to over-diagnosis.CASE SUMMARY Here,we report three cases(29,22,and 33 years-of-age)diagnosed with POF after experiencing secondary amenorrhea for more than one year,serum levels of follicle-stimulating hormone(FSH)>40 IU/L on two occasions with an interval of more than 4 wk,and negative progesterone withdrawal tests.All three patients were intermittently administered with drugs to create an artificial cycle.During the subsequent discontinuation period,the patients experienced intermittent follicular growth and spontaneous ovulation.One patient experienced two natural pregnancies(both with embryo arrest).CONCLUSION Our findings suggest that young patients with POF can experience unpredictable and intermittent spontaneous follicular development,ovulation,and even natural pregnancy.Clinicians should provide appropriate medical guidance and individualized treatments according to fertility requirements,genetic risks and hypoestrogenic symptoms as soon as possible.