The programmed cell death-1 (PD-1)/PD-ligand 1 (PD-L1) pathway is critical for normal pregnancy by promoting regulatory T (Treg) cell development and inhibiting the Th17 response. However, the ...relationship between the PD-1/PD-L1 pathway and the Treg/Th17 imbalance in pre-eclampsia (PE) is an enigma. In this study, decreased PD-1 and PD-L1 expression and a Treg/Th17 imbalance were observed at the maternal-fetal interface in PE. The regulatory effects of the PD-1/PD-L1 pathway on the Treg and Th17 cell quantities were determined in vitro by targeting T-cell proliferation, differentiation and transdifferentiation. First, decreased PD-1 expression might contribute to a higher Th17 cell frequency by promoting proliferation in PE. Second, the percentages of Treg but not Th17 cells differentiated from peripheral naive CD4
T cells were increased by PD-L1 Fc administration. This effect was accompanied by decreased PI3K/AKT/m-TOR and increased PTEN mRNA expression and was completely reversed by PD-1 blockade. Finally, the percentage of IL-17-producing Treg cells increased and was positively associated with the Th17 cell frequency in PE. Increased RORγt and IL-17 but not Foxp3 and IL-10 mRNA expression by Treg cells was observed with PD-1 blockade. Similar findings occurred when Treg cells were exposed to IL-6/IL-23/IL-1β and were reversed by PD-L1 Fc. Taken together, our findings indicate that the PD-1/PD-L1 pathway contributes to the Treg/Th17 imbalance via 'one-two punch' approaches: (i) promoting Th17 cell proliferation, (ii) inhibiting Treg cell differentiation and (iii) enhancing Treg cell plasticity into Th17 cells in PE. The therapeutic value of PD-L1 Fc for PE treatment will be explored in the future.
A successful human pregnancy requires the maternal immune system to recognize and tolerate the semi-allogeneic fetus, allowing for appropriate trophoblasts invasion and protecting the fetus from ...invading pathogens. Therefore, maternal immunity is critical for the establishment and maintenance of pregnancy, especially at the maternal-fetal interface. Anatomically, the maternal-fetal interface has both maternally- and fetally- derived cells, including fetal originated trophoblasts and maternal derived immune cells and stromal cells. Besides, a commensal microbiota in the uterus was supposed to aid the unique immunity in pregnancy. The appropriate crosstalk between fetal derived and maternal originated cells and uterine microbiota are critical for normal pregnancy. Dysfunctional maternal-fetal interactions might be associated with the development of pregnancy complications. This review elaborates the latest knowledge on the interactions between trophoblasts and decidual immune cells, highlighting their critical roles in maternal-fetal tolerance and pregnancy development. We also characterize the role of commensal bacteria in promoting pregnancy progression. Furthermore, this review may provide new thought on future basic research and the development of clinical applications for pregnancy complications.
Due to the high risk of complications in fresh transfer cycles among expected high ovarian response patients, most choose frozen-thawed embryo transfer (FET). There are currently few researches on ...whether the FET outcomes of expected high ovarian response patients with regular menstrual cycles are similar to those of normal ovarian response. Therefore, our objective was to explore and compare pregnancy outcomes and maternal and neonatal outcomes of natural FET cycles between patients with expected high ovarian response and normal ovarian response with regular menstrual cycles based on the antral follicle count (AFC).
This retrospective cohort study included 5082 women undergoing natural or small amount of HMG induced ovulation FET cycles at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2017, to March 31, 2021. The population was divided into expected high ovarian response group and normal ovarian response group based on the AFC, and the differences in patient characteristics, clinical outcomes and perinatal outcomes between the two groups were compared.
Regarding clinical outcomes, compared with the normal ovarian response group, patients in the expected high ovarian response group had a higher clinical pregnancy rate (57.34% vs. 48.50%) and live birth rate (48.12% vs. 38.97%). There was no difference in the early miscarriage rate or twin pregnancy rate between the groups. Multivariate logistic regression analysis suggested that the clinical pregnancy rate (adjusted OR 1.190) and live birth rate (adjusted OR 1.171) of the expected high ovarian response group were higher than those of the normal ovarian response group. In terms of maternal and infant outcomes, the incidence of very preterm delivery in the normal ovarian response group was higher than that in the expected high ovarian response group (0.86% vs. 0.16%, adjusted OR 0.131), Other maternal and infant outcomes were not significantly different. After grouping by age (< 30 y, 30-34 y, 35-39 y), there was no difference in the incidence of very preterm delivery among the age subgroups.
For patients with expected high ovarian response and regular menstrual cycles undergoing natural or small amount of HMG induced ovulation FET cycles, the clinical and perinatal outcomes are reassuring. For patients undergoing natural or small amount of HMG induced ovulation FET cycles, as age increases, perinatal care should be strengthened during pregnancy to reduce the incidence of very preterm delivery.
The normal physiological function of LH requires a certain concentration range, but because of pituitary desensitization, even on the day of HCG, endogenous levels of LH are low in the ...follicular-phase long protocol. Therefore, our study aimed to determine whether it is necessary to monitor serum LH concentrations on the day of HCG (LH
) and to determine whether there is an optimal LH
range to achieve the desired clinical outcome.
A retrospective cohort study included 4502 cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from January 1, 2016, to June 30, 2019, in a single department. The main outcome measures included retrieved eggs, available embryos, and live birth rate.
The LH
was divided into five groups: Group A (LH ≤ 0.5), Group B (0.5 IU/L < LH ≤ 1.2 IU/L), Group C (1.2 IU/L < LH ≤ 2.0 IU/L), Group D (2.0 IU/L < LH ≤ 5.0 IU/L), Group E (LH > 5 IU/L). In terms of the numbers of retrieved eggs (15.22 ± 5.66 vs. 13.54 ± 5.23 vs. 12.90 ± 5.05 vs. 12.30 ± 4.88 vs. 9.6 ± 4.09), diploid fertilized oocytes (9.85 ± 4.70 vs. 8.69 ± 4.41 vs. 8.39 ± 4.33 vs. 7.78 ± 3.96 vs. 5.92 ± 2.78), embryos (7.90 ± 4.48 vs. 6.83 ± 4.03 vs. 6.44 ± 3.88 vs. 6.22 ± 3.62 vs. 4.40 ± 2.55), and high-quality embryos (4.32 ± 3.71 vs. 3.97 ± 3.42 vs. 3.76 ± 3.19 vs. 3.71 ± 3.04 vs. 2.52 ± 2.27), an increase in the LH
level showed a trend of a gradual decrease. However, there was no significant difference in clinical outcomes among the groups (66.67% vs. 64.33% vs. 63.21% vs. 64.48% vs. 63.33%). By adjusting for confounding factors, with an increase in LH
, the number of retrieved eggs decreased (OR: -0.351 95%CI - 0.453-- 0.249).
In the follicular-phase long protocol among young women, monitoring LH
is recommended in the clinical guidelines to obtain the ideal number of eggs.
During the charging and discharging process of LiNi
0.5
Mn
1.5
O
4
(LNMO) battery, Ni
2+
and Mn
2+
dissolve into the electrolyte and cause oxidation decomposition, which seriously affects the cycle ...life of the battery. In addition, the impurity phase in the material can also make the structure unstable, causing poor cycle and rate performance. In this paper, LNMO and LiNi
0.5-x
Ti
4x
Mn
1.5-3x
O
4
((
x
)Ti-LNMO,
x
= 0.02, 0.03, 0.04, 0.06) with spinel structure are synthesized by hydrothermal and high-temperature calcination using metal–organic frameworks (MOFs) as precursors. The obtained LNMO and Ti-LNMOs are further analyzed by a series of characterization and electrochemical performance tests. The XRD results and the Rietveld refinements show that the impurity phases gradually disappear and the lattice parameters of the materials increase with the doping of Ti
4+
. From the TEM and XPS results, we have observed the Ti-LNMO surface has a uniform Li
2
CO
3
coating layer, which can isolate the direct contact between the electrolyte and the cathode material. The rate and cyclic performance of LNMO are simultaneously improved by a dual modification of Ti doping and in situ coating. When
x
(Ti) = 0.03, discharge specific capacity is 91.2 mAh/g at 15 C, while the undoped LNMO is only 72.1 mAh/g. Besides, the capacity retention rates of LNMO and 0.03 Ti-LNMO after 200 cycles are 83.2% and 93.8%, respectively. These excellent electrochemical properties are mainly attributed to the more stable crystal structure of the material after titanium doping, the generation of in situ coating layers, the reduction of impurity phases, the suitable particle size, and the stable chemical interface.
With the increasing penetration of renewable energy in China, the primary frequency regulation (PFR) performance of coal-fired units plays more critical role in sustaining the security and stability ...of the electrical power system. A case study regarding the 350 MW combined heat and power (CHP) unit is conducted to analyze the response capacity to large frequency disturbances of the grid. Simulation models of PFR are developed to reflect the unit characteristics. The PFR capacity is evaluated for six common operating load points in the heating season, and only some load points could satisfy the power demand when grid frequency deviations are −0.122 Hz to −0.165 Hz. Further, the feasibility of the PFR control strategy combining high pressure valve adjustment and heating extraction steam adjustment is explored, resulting in enhanced response capacity of the unit. The maximum increment of PFR capacity under above large disturbances is 6.03 MW, an improvement of 48.72%. Moreover, large grid frequency deviation disturbances are simulated, results show that the power contribution index increases from 56.2% to 88.9% with the novel PFR control strategy. Above-mentioned results mean that the PFR capacity of CHP units is enhanced in response to large grid frequency disturbances in the heating season.
Integrated energy supply via the high-capacity combined heat and power (CHP) system is an effective way to achieve “win-win cooperation” for regional carbon reduction. A case study of the CHP system ...with both civil and industrial heat users is conducted to analysis the mixed impact of integrated energy supply on CHP systems. The steam-water equations and the off-design calculation model are developed to analyze the heat-power coupling mechanism of the CHP system. The linear-calculating diagram is obtained, which provides operational guidance for CHP system with simultaneous power, civil heat and industrial loads. Further, the analysis of economy, energy efficiency and environment within the operation region is performed. The results show that for a constant main steam flow rate, the industrial heat load is more profitable than the civil heat load. Moreover, the energy efficiency of the CHP unit can be further improved by undertaking the industrial heat load, despite at the expense of part capacity to supply civil heat. The average value of CO2 emissions per unit profit is reduced by approximately 7.69% overall after the stable industrial heat load of 100 MW, which means about 1.64 tons of CO2 can be reduced per 1000 USD profit.
Sodium-ion hybrid capacitor (SIHC) is one of the most promising alternatives for large-scale energy storage due to its high energy and power densities, natural abundance, and low cost. However, ...overcoming the imbalance between slow Na
+
reaction kinetics of battery-type anodes and rapid ion adsorption/desorption of capacitive cathodes is a significant challenge. Here, we propose the high-rate-performance NiS
2
@OMGC anode material composed of monodispersed NiS
2
nanocrystals (8.8 ± 1.7 nm in size) and N, S-co-doped graphenic carbon (GC). The NiS
2
@OMGC material has a three-dimensionally ordered macroporous (3DOM) morphology, and numerous NiS
2
nanocrystals are uniformly embedded in GC, forming a core–shell structure in the local area. Ultrafine NiS
2
nanocrystals and their nano–microstructure demonstrate high pseudocapacitive Na-storage capability and thus excellent rate performance (355.7 mAh/g at 20.0 A/g). A SIHC device fabricated using NiS
2
@OMGC and commercial activated carbon (AC) cathode exhibits ultrahigh energy densities (197.4 Wh/kg at 398.8 W/kg) and power densities (43.9 kW/kg at 41.3 Wh/kg), together with a long life span. This outcome exemplifies the rational architecture and composition design of this type of anode material. This strategy can be extended to the design and synthesis of a wide range of high-performance electrode materials for energy storage applications.
With the increasing use of frozen embryo transfer (FET), the best endometrial preparation protocol is continuously being discussed. The hormone replacement therapy (HRT) cycle and letrozole-induced ...ovulation (L-OI) cycle are available protocols for patients with abnormal ovulation. Previous comparisons of the two protocols have focused on pregnancy outcomes, with less attention to perinatal outcomes, and population heterogeneity was large; thus, convincing conclusions about which protocol is more appropriate could not be drawn.
We performed a retrospective cohort study using propensity score matching (PSM) analysis for a population of patients undergoing FET cycles in the reproductive center of the Third Affiliated Hospital of Zhengzhou University from January 2016 to September 2020. The main outcome measures were clinical pregnancy rate, live birth rate, very preterm delivery (VPTD), preterm delivery (PTD), low birth weight (LBW), macrosomia, small for gestational age (SGA), large for gestational age (LGA), hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), premature rupture of membranes (PROM), placenta previa, and congenital abnormality.
A total of 8010 women were enrolled. Due to the large heterogeneity among the patients, we conducted 1:1 PSM, and 1461 women matched in each group. Compared with the HRT group, the L-OI group had a smaller proportion of thin endometrium (27.38% vs. 41.07%) and thicker endometrium on the day of embryo transfer (9.63 ± 1.82 vs. 8.91 ± 1.38). There were no significant differences in clinical pregnancy rate, early abortion rate or live birth rate between the groups. There was no significant difference in perinatal outcomes of singleton live birth, including VPTD, PTD, postterm delivery, LBW, macrosomia, SGA, LGA, GDM, HDP, placenta previa, and congenital malformation.
For women with abnormal ovulation, the pregnancy and perinatal outcomes of HRT and L-OI protocols are reassuring. It seems that both protocols are safe and effective for endometrial preparation in frozen-thawed embryo transfer in the clinic.
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