Xu Chen

Purpose: Polycystic ovary syndrome (PCOS) is closely associated with chronic low-grade inflammation. Systemic immune-inflammation index (SII) based on complete blood cell count has shown superior discriminative value in a variety of diseases, but its role in PCOS is still unclear. This study aimed to investigate the association between SII and PCOS in women undergoing their first in vitro fertilization (IVF) treatment with a gonadotropin-releasing hormone (GnRH) antagonist protocol. Materials and Methods: A total of 334 women undergoing their first IVF treatment with a GnRH antagonist protocol from January 2019 to December 2025 were included in this study. They were divided into the PCOS group (n=160) and the non-PCOS group (n=174). Demographic and physical indicators, reproductive endocrine indicators, systemic inflammatory indicators, infertility situation, ovulation induction treatment parameters, and trigger day indicators were collected. Binary logistic regression was used to identify the independent associated factors of PCOS. Results: The results of the multivariate analysis indicated that anti-Mullerian hormone (AMH) (OR=1.437, 95% CI: 1.222– 1.690, P< 0.001), basal follicle-stimulating hormone (FSH) (OR=0.718, 95% CI: 0.519– 0.993, P= 0.046), luteinising hormone (LH) (OR=1.293, 95% CI: 1.100– 1.519, P=0.002), testosterone (T) (OR=14.533, 95% CI: 2.162– 97.677, P=0.006), SII (OR=2.030, 95% CI: 1.079– 3.819, P=0.028), and LH level on the trigger day (OR=1.284, 95% CI: 1.061– 1.554, P=0.010) were independently associated with PCOS. Conclusion: Among patients undergoing their first IVF treatment, SII was independently associated with PCOS. This further supported the crucial role of chronic low-grade inflammation in the pathophysiology of PCOS. In the future, its efficacy needs to be verified through large-scale studies. Before it is fully confirmed, it is not recommended to use it as an independent clinical tool.

Background: PI3K/Akt/mTOR pathway is crucial in some cancers, but its relation with tumor-infiltrating immune cells in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) is unanalyzed. This study aimed to determine if ACTR3 overexpression affects CC survival and explore its impact on the tumor immune microenvironment. Methods: Research investigated ACTR3 expression levels related to PI3K/Akt/mTOR pathway and its influence on tumor immunology and clinical outcomes. Methods included RNA-seq data analysis, immune cell infiltration evaluation, survival analysis, gene enrichment analysis, and single-cell RNA-seq data integration. ACTR3 expression in cervical cancer specimens was evaluated by immunohistochemistry. Results: Least absolute shrinkage and selection operator (LASSO) Cox regression identified ten key genes including ACTR3 with prognostic value. High ACTR3 expression correlated with poor outcomes, suggesting it as a prognostic biomarker. The prognostic model was validated by time-dependent receiver operating characteristic (ROC) curves for 1-, 3-, and 5-year survival. A nomogram combining ACTR3 expression and clinical parameters estimated patient survival. Single-cell RNA sequencing showed ACTR3-expressing immune cells in CESC include dendritic cells (DCs), T cells, and tissue stem cells. Conclusion: This research elucidated a distinct signature linked to the PI3K/Akt/mTOR signaling pathway, particularly focusing on ACTR3, which plays a role in both the onset and advancement of CESC. Moreover, ACTR3 has the potential to act as a prognostic biomarker for patients diagnosed with CESC, thereby offering novel perspectives for the development of clinical therapeutic approaches.

Background: Fear of childbirth (FOC) is a prevalent issue among pregnant women and significantly relates to adverse outcomes for the mother and child. However, it is not clear the prevalence and risk factors of FOC among pregnant women in a region with a moderate level of economic development in China. The aim of this study was to investigate the prevalence and risk factors of FOC among pregnant women in the third trimester of pregnancy in Lianyungang city, Eastern China. Methods: A cross-sectional survey was conducted from December 2022 to February 2023 among pregnant women in the third trimester who met the inclusion criteria and visited Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China. A structured questionnaire including sociodemographic characteristics, clinical characteristics, FOC, family function, doctor-patient communication, social support, general self-efficacy, anxiety, depression, insomnia symptoms, and quality of life was used to collect data. A multiple linear regression model was used to identify predictors of FOC. Results: This study included 535 pregnant women in the third trimester. The mean score of FOC was 30.67 ± 10.18, and the median score was 29.00. The prevalence of FOC was 56.64%. Multiple linear regression analysis revealed that pregnant women with electronic screen exposure time more than 5 h per day (β = 2.02, 95%CI: 0.50–3.53, P < 0.05), no history of cesarean section (β = 2.66, 95%CI: 0.61–4.71, P < 0.05), likes sour food or hates greasy food (β = 1.75, 95%CI: 0.00-3.50, P < 0.05), anxiety (β = 0.50, 95%CI: 0.21–0.80, P < 0.05) and depression (β = 0.30, 95%CI: 0.04–0.57, P < 0.05) were more likely to have a greater level of FOC than their counterparts. However, a significantly lower level of FOC was observed in pregnant women who were multipara (β=-1.64, 95%CI: -3.27–0.01, P < 0.05), not worrying about delivery without family members (β=-3.75, 95%CI: -5.26–2.25, P < 0.001), had good family function (β=-0.32, 95%CI: -0.64–0.00, P < 0.05) and doctor-patient communication (β=-0.33, 95%CI: -0.64–0.02, P < 0.05). Conclusions: The prevalence of FOC was high in Lianyungang city, Eastern China. FOC is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of FOC in the third trimester of pregnancy, and to pay attention to pregnant women with risk factors for FOC.