Associations of Body Mass Index, Visceral Fat Area, Waist Circumference, and Waist-to-Hip Ratio with Cognitive Function in Western China: Results from WCHAT Study

OBJECTIVES

This study examined the relationship between cognitive performance and obesity parameters, such as body mass index (BMI), visceral fat area (VFA), waist circumference (WC), and waist-to-hip ratio (WHR) in western China.

STUDY DESIGN

A cross-sectional study.

METHODS

3914 participants, aged ≥50 years, were recruited in this study. Anthropometrics measurements, life-style factors, chronic disease comorbidities, and sleep qualities were recorded for each participant. Among the anthropometrics, BMI, WC, and WHR were assessed using standard procedures, while VFA was calculated using bioelectrical impedance analysis. Cognitive performance was estimated using the Short Portable Mental Status Questionnaire (SPMSQ). Finally, relationships between cognitive abilities and BMI, VFA, WC, and WHR were evaluated using univariate and multivariate regression analyses.

RESULTS

Cognitive decline (CD) occurred at a rate of 13.29% among the 3914 participants. A strong correlation was observed between cognitive abilities and BMI of male patients aged 50-59 yrs (OR 1.116,95% CI1.002-1.242), in the adjusted model. Alternately, WHR was shown to be significantly related to CD in females aged ≥70 years (OR 0.041, 95% CI0.002-0.671). WC was shown to have a strong association with CD in males (OR 1.023,95% CI1.003-1.024). Lastly, WHR was closely connected to CD in participants with BMI < 25 kg/m2 (OR 0.022,95% CI0.002-0.209).

CONCLUSIONS

Our findings suggest that a higher middle age BMI is associated with CD, whereas, in the elderly population, a higher WHR is related to improved cognitive performance. Further investigation is warranted to elucidate a relationship between VFA and CD.

Comorbid Depressive Symptoms, Visual Impairment, and Sarcopenia among Middle-Aged and Older Women: Findings from the West China Health and Aging Trend study

Previous reports have described close relationships between sarcopenia and either visual impairment or depression, but there have been few analyses investigating the association between sarcopenia and the coexistence of both visual impairment and depression. Herein, we sought to explore the associations between sarcopenia and comorbid depressive symptoms and visual impairment among older females. A cross-sectional analysis of females between the ages of 50 and 95 (n = 2454) from the West China Health and Aging Trend (WCHAT) study was conducted. Patient muscle mass was assessed via a bioimpedance-based approach using an InBody 770 device, while muscle strength was estimated based on handgrip strength as quantified with a digital grip strength dynamometer. Depressive systems were evaluated with the 15-item Geriatric Depression Scale (GDS-15), and a questionnaire was employed to evaluate patient visual functionality. Associations between sarcopenia and comorbid depressive status and visual impairment were explored through logistic regression analyses. Comorbid depressive symptoms and visual impairment were observed in 6.2% of the women included in this study, while 18.9% suffered from sarcopenia. Following adjustment for covariates, relative to normal controls, study subjects with only depression (OR=1.45, 95%CI=1.04-2.02), only visual impairment (OR=1.69, 95%CI=1.27-2.26), or comorbid depression and visual impairment (OR=1.76, 95% CI=1.16-2.67) exhibited a higher risk of sarcopenia. These results suggest that comorbid depression and visual impairment are linked to the prevalence of sarcopenia in older Chinese women. As such, further efforts to screen older women for these two comorbid conditions may thus be necessary.

The Combined Effect of Hearing Impairment and Cognitive Impairment with Health-Related Outcomes in Chinese Older People

OBJECTIVES

To determine the risk of poor health-related outcomes in older adults with cooccurring hearing impairment and cognitive impairment, and to compare the risk of hearing impairment only, cognitive impairment only, and multiple morbidities.

DESIGN

Cross-sectional study.

SETTING

Community-dwelling older adults aged 60 years and older were included.

PARTICIPANTS

The data of missing hearing and cognitive status were excluded, and 3770 older people participated in the study.

MEASUREMENTS

The hearing function evaluation was conducted by questionnaire survey. Assessment of cognitive function was completed using the SPMSQ scale. The subjects were divided into hearing impairment and cognitive impairment group, hearing impairment only group, cognitive impairment only group and neither group. Multiple logistic regression was used to analyze the risks of hearing and cognitive impairment and health-related condition.

RESULTS

The prevalence of hearing impairment and cognitive impairment, hearing impairment only, cognitive impairment only, and neither were 9.4%, 8.3%, 29.9% and 52.4%, respectively. Compared with the control group, the individuals with hearing impairment and cognitive impairment were associated with depression (OR=3.48, 95% CI=2.66, 4.56), anxiety (OR=2.35, 95% CI=1.92, 3.33), frailty (OR=4.30, 95% CI=2.89, 6.40), and ADL impairment (OR=2.77, 95% CI=2.03, 3.77).

CONCLUSION

The studies shows that hearing impairment combined with cognitive impairment is significantly associated with anxiety, depression, frailty, and ADL impairment. Comprehensive management and intervention should be provided for older people to reduce the occurrence of adverse health consequences.

17β-Estradiol promotes LC3B-associated phagocytosis in trained immunity of female mice against sepsis

Sepsis is a common serious clinical infectious disease accompanied by more severe injuries and higher mortality rates in men than women. The much higher level of 17β-estradiol (E₂) in female is one of the significant reasons for better sepsis resistance ability. Trained immunity is a novel way to fight against infection by improving innate immunity. However, whether β-glucan-induced trained immunity can promote macrophage phagocytosis to clear infections in early sepsis has not been clarified. And whether E₂ involved in this process needs further investigation. Symptoms among male, female and ovariectomized (OVX) C57BL/6 mice in early sepsis were detected. The effect of trained immunity on macrophage LC3B-associated phagocytosis (LAP) and the mechanism of E₂ functioned in this process have also been explored. We demonstrated compared with male mice, female has significantly more mild symptoms and more reactive oxygen species (ROS) production and stronger NADPH oxidase 2 (NOX2) expression in the macrophage of major organs. In contrary, these characteristics are disappeared in OVX mice. Furthermore, in macrophage cell lines and primary bone marrow- derived macrophages (BMDMs), β-glucan-induced trained immunity can increase ROS production by activating NOX2 to promote macrophage LAP. E₂ can up-regulate RUBICON through estrogen receptor α (ERα) to further facilitate macrophage LAP. These results indicated that trained immunity can improve sepsis resistance ability by stimulating macrophage LAP. E₂ can boost ROS production and RUBICON expression to further promote macrophage LAP, which can provide a new perspective to recognize the mechanism of trained immunity in gender differences when responding to sepsis.

Improvement of thermal stability of oyster (Crassostrea gigas) ferritin by point mutation

Ferritin can be widely used as functional nanomaterial. But the physiological activity of ferritin can be damaged under excessive temperatures, which affect the self-assembly property. In this study, point mutation was produced in Asp¹²⁰ to Gly¹²⁰ of ferritin amino acid sequence and the heat resistance was improved significantly. The thermal denaturation temperature of mutated ferritin is 89.17 °C and has increased by 13 °C more than the wild-type oyster ferritin. The effect of thermal treatment on the denaturation, aggregation state, particle size and the structure of ferritin was not changed before 90 °C. The computational modeling and analysis indicated that mutated ferritin promotes the overall structural stability assembly via decreasing the interaction energies of 62 percent energies in 3-fold interface. Improving the thermal stability of oyster ferritin by point mutation enhances its applications as a food ingredient.

Efficacy of intrauterine perfusion of peripheral blood mononuclear cells (PBMC) for infertile women before embryo transfer: meta-analysis

This meta-analysis was intended to evaluate the effects of intrauterine perfusion of peripheral blood mononuclear cells (PBMC) on the pregnancy outcomes including clinical pregnancy rates, embryo implantation rates, live birth rates and miscarriage rates of infertile women who were undergoing in vitro fertilisation (IVF) treatment. By searching Pubmed, Embase database, five articles meeting the inclusion criteria were included, and 1173 women were enrolled (intrauterine PBMC group: n = 514; NO-PBMC group: n = 659). For the entire IVF/ICSI population and one or two embryo transfer failure patients, there was no significant difference in endometrial thickness, embryo implantation rates, live birth rates, and miscarriage rates between the PBMC group and NO-PBMC group. Although the clinical pregnancy rates of the PBMC group were higher than that of the NO-PBMC group, the confidence interval was close to the line of unity. As for the patients with three or more implantation failures, the clinical pregnancy rates, embryo implantation rates and live birth rates were much higher in the PBMC group than that of the NO-PBMC group. In summary, current evidence suggests that intrauterine perfusion of PBMC can significantly improve pregnancy outcomes in patients who have three or more implantation failures.Impact statementWhat is already known on this subject? An increasing number of studies have shown that immune cells play an important role in embryo transfer. There is no reliable evidence to confirm the clinical efficacy of intrauterine perfusion of PBMC.What do the results of this study add? The current evidence suggests that intrauterine perfusion of PBMC can significantly improve pregnancy outcomes in patients who have three or more implantation failures.What are the implications of these findings for clinical practice and/or further research? To the best of our knowledge, this meta-analysis is the first to evaluate the effect of intrauterine perfusion of PBMC on pregnancy outcomes before embryo transfer. Our study indicated that intrauterine perfusion of PBMC significantly increased clinical pregnancy rates, embryo implantation rates, and live birth rates in patients who failed more than three implants.

CT and MRI features of giant cell tumours with prominent aneurysmal bone cysts in the extremities: a comparison with primary aneurysmal bone cysts

AIM

To test the hypothesis that computed tomography (CT) and magnetic resonance imaging (MRI) could help distinguish between giant cell tumours with prominent aneurysmal bone cysts (GABCs) and primary aneurysmal bone cysts (PABCs) of the extremities.

MATERIALS AND METHODS

CT and MRI features of 13 patients with GABCs and 13 patients with PABCs in the extremities were analysed retrospectively. The ages and sex of the patients were also recorded. Independent-samples t-tests were used for continuous variables and Fisher's exact tests were used for categorical variables to compare the differences between the two groups. Diagnostic accuracy, sensitivity, and interobserver agreement were calculated.

RESULTS

The average age of patients with GABCs (38.2±15.8 years) was higher than that of patients with PABCs (19.3±12.7 years; p=0.003). The transverse/longitudinal diameter ratio was different between GABCs (0.8±0.3) and PABCs (0.6±0.2; p=0.007). Subchondral bone involvement (92.3% versus 30.8%, p=0.004) and deep lobulation (38.5% versus 0%, p=0.039) were more likely to be noted in patients with GABCs. Surrounding blood vessels were identified in six cases of PABCs (6/13), but not in GABCs (p=0.015). The following characteristics were suggestive of GABCs, older patient age, higher transverse/longitudinal diameter ratio, subchondral bone involvement, and deep lobulation indicated a sensitivity of 84.6%, 76.9%, 75%, and 100%, and a specificity of 84.6%, 69.2%, 90%, and 61.9%, respectively. Conversely, surrounding blood vessels were suggestive of PABCs, with a sensitivity of 46.2% and specificity of 100%. The concordance between the two readers was moderate to nearly perfect.

CONCLUSION

Age, subchondral bone involvement, lobulation, transverse/longitudinal diameter ratio, and surrounding blood vessels can be used to distinguish GABCs from PABCs.

Long non-coding RNA WT1-AS inhibits cell aggressiveness via miR-203a-5p/FOXN2 axis and is associated with prognosis in cervical cancer

OBJECTIVE

Substantial evidence has demonstrated that long non-coding RNAs (lncRNAs) play pivotal roles in tumorigenesis and tumor progression. The lncRNA Wilms tumor 1 Antisense RNA (WT1-AS) is a potential tumor suppressor in some types of cancers. The objective of this study was to evaluate the biological roles of WT1-AS in cervical cancer.

PATIENTS AND METHODS

The Cancer Genome Atlas (TCGA) was used to identify differentially expressed lncRNAs in cervical carcinoma. The level of lncRNA WT1-AS in cervical carcinoma tissues and cell lines was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The lentiviral vector encoding WT1-AS (LV-WT1-AS) or miR-203a-5p mimic was transfected into cervical carcinoma cells. Cell Counting Kit-8 (CCK-8), wound healing and transwell invasion assays were applied to assess the role of WT1-AS in cervical cancer cell growth and migration. WT1-AS directly bound to miR-203a-5p was confirmed using Luciferase reporter assay. The level of forkhead box N2 (FOXN2) was assessed by quantitative Real Time-Polymerase Chain Reaction analysis. A xenograft model was constructed to explore the role of WT1-AS in cervical cancer cell growth in vivo.

RESULTS

WT1-AS was down-regulated in both cervical cancer tissues and cell lines. Functional analyses indicated that the over-expression of WT1-AS remarkably inhibited cervical carcinoma cell growth, migration and invasion. The results of the Luciferase reporter assays verified that miR-203a-5p is a direct target of WT1-AS. Moreover, FOXN2 was identified as a direct target gene of miR-203a-5p, and the up-regulation of miR-203a-5p reversed the inhibitory effects of WT1-AS in cervical cancer cells.

CONCLUSIONS

Our results demonstrated that WT1-AS was under-expressed in cervical carcinoma and suppresses cervical cancer cell growth and aggressiveness via a miR-203a-5p/FOXN2 axis.

Optimization and mechanism of postponing aging of polysaccharides from Chinese herbal medicine formula

To study the extraction technology of polysaccharides (AAP) from Chinese herbal medicine formula and its mechanism of delaying aging. First, L9(3)4 orthogonal test was used to optimize the optimal enzyme-assisted extraction parameters of polysaccharides. And the anti-aging effects was evaluated by detecting mitochondrial function, protein, DNA, adhesion molecules and cell cycle in aging rats. The optimal extraction process parameters were the cellulase concentration of 1.5%, the pH at 5, the enzyme temperature at 50°C and the extraction time of 180 min. The anti-aging results showed that AAP can effectively increase the activities of malate dehydrogenase, succinate dehydrogenase and superoxide dismutase. It also can decrease the activity of monoamine oxidase and methane dicarboxylic aldehyde levels in the brain tissue. Meanwhile, the polysaccharides enhanced telomerase activity while reduced p16 protein expression of the brain mitochondria. In addition, the polysaccharides continued to improve heart damage and significantly lessen mitochondrial DNA concentrations. For a certain period of time, it also enhanced the activity of superoxide dismutase, reduced glutathione, glutathione peroxidase and decreased protein carbonyl and methane dicarboxylic aldehyde content of kidney in D-galactose-induced aging rats. Furthermore, the polysaccharides restored the number of cells in the peripheral blood lines and BMNC through inhibiting the drop of the number of red blood cells, white blood cells, platelets in the peripheral blood and bone marrow mononuclear cell of the aging rats. At the same time, AAP accelerated G1 phase cell to enter S phase in cell cycle in aging rats. Our research suggests that the polysaccharides may be a potential anti-aging agent and can be further developed as a functional food or new drug to delay aging or treat aging-related diseases.

0571 Repolarization Variability Predicts Cardiovascular Death in Obstructive Sleep Apnea

Introduction

Patients with untreated obstructive sleep apnea (OSA) have a 2-3—fold increased risk of cardiovascular mortality (CVD) compared with individuals without OSA. QTc prolongation and increased QT variability among OSA patients may contribute to this association.

Methods

Patients with OSA from the Sleep Heart Health study were identified based on polysomnography criteria and their continuous electrocardiograms (ECG) analyzed for QTc duration and QT variability. Both Fridericia’s and Bazett’s heart rate corrections were used to calculate QTc. QT variability was measured as standard deviation of QT intervals (SDQT) and normalized QT interval variance (QTVN) at 1- and 5-minute intervals and short-term interval beat-to-beat QT variability (STVQT) was measured at 5-minute intervals. Lasso with elastic-net regularization was used as the variable/covariate selection method. Cox proportional hazards regression models were used to determine predictors of CVD.

Results

Data from 365 patients with OSA were screened. Ninety-seven patients were excluded from analysis due to low quality ECG data (n=50) or extremely high (&gt; ln (10)) variability in QT/QTc and/or QT variability (n=12). Fifty two percent of the sample was male with mean age 65 years (±10). Fifty-six of these patients died of CVD. The mean (SD) QTc in the group that died was 411 (30) ms and 416 (34) ms compared to 406 (24) ms and 411 (25) ms using Fridericia (Cox LR p-value 0.055) and Bazett (p=0.090), respectively. Gender, age, race, diabetes, SDQT and STVQT were significant predictors for CVD. We fit models with the covariates and SDQT (at both 1 and 5 min) and STVQT as three models and demonstrate that both SDQT and STVQT are significantly associated with CVD death (p-values of 0.0048, 0.0089, and 0.0113, respectively) and all models had high area under the curve (0.8095, 0.8085, and 0.8125, respectively).

Conclusion

In patients with OSA, QT variability was associated with CVD.

Support

American Academy of Sleep Medicine Foundation

Comparisons of different classification algorithms while using text mining to screen psychiatric inpatients with suicidal behaviors

OBJECTIVE

To compare the performance of methods based on text mining to screen suicidal behaviors according to chief complaint of the psychiatric inpatients.

METHODS

Electronic Medical Records of inpatients with mental disorders were collected. Text mining method was adopted to screen suicidal behaviors. The performances of different combinations of six algorithms and two term weighting factors were compared under various training set sizes, which were assessed by precision, recall, F1-value and accuracy.

RESULTS

A total of 3600 psychiatric inpatients (1800 with suicidal behaviors and 1800 without suicidal behaviors) were included in this study. In chief complaints of suicidal inpatients, "suicide", "notion" and "suspicion" were the commonest statements, appearing 1228, 705 and 638 times respectively. In contrast, "excitement", "instability" and "impulsion" appeared more frequently in chief complaints of patients without suicidal behaviors (599, 599, 534 times respectively). The performance of each algorithm was generally improved with the increasing training set sizes and tended to be stable when the number of training cases reached 1000, where most of them could achieve satisfactory accuracy values (>0.95). Results of testing set showed that SVM, Random Forest and AdaBoost weighted by TF had better generalization ability. The F1 values were 0.9889 for SVM, 0.9838 for random forest and 0.9828 for AdaBoost, respectively.

CONCLUSION

This study confirmed the feasibility of filtering suicidal inpatients with small amounts of representative terms. SVM, Random Forest and AdaBoost weighted by TF have better performance in this task. Our findings provided a practical way to automatically classify patients with or without suicidal behaviors before admission to hospital, which potentially led to considerable savings in time and human resources for identification of high-risk patients and suicide prevention.

Prognostic value and association of systemic inflammation for patients with stage IV gastric cancer

OBJECTIVE

The present study is aimed at investigating the prognostic value and association of systemic inflammation (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and lymphocyte-to-monocytes ratio) for patients with stage IV gastric cancer.

METHODS

In this retrospective study, patients with stage IV gastric cancer between January 2008 and December 2017 were included. A summary was performed on clinicopathological characteristics and a multivariate cox regression analysis was performed to identify the prognostic factors.

RESULTS

304 patients with stage IV gastric cancer were included in the study. On multivariate analysis, the systemic chemotherapy (p < .001), the jaundice (p = .004), the high neutrophil-to-lym- phocyte ratio (p = .005) and the high platelet-to-lymphocyte ratio (p = .041) were independent prognostic factors for patients with stage IV gastric cancer.

CONCLUSION

As systemic inflammation response markers, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are significantly associated with OS for stage IV gastric cancer patients. Systemic chemotherapy shows a clear overall survival benefit in patients with stage IV gastric cancer and Jaundice indicates poor overall survival.

Transcriptome of Tetranychus urticae embryos reveals insights into Wolbachia-induced cytoplasmic incompatibility

The endosymbiont Wolbachia is known for manipulating host reproduction in selfish ways. However, the molecular mechanisms have not yet been investigated in embryos. Here, we found that Wolbachia had no effect on the number of deposited eggs in Tetranychus urticae Koch (Acari: Tetranychidae) but caused two types of reproductive manipulation: killing uninfected female embryos via cytoplasmic incompatibility (CI) and increasing the hatching ratio of infected female embryos. RNA sequencing analyses showed that 145 genes were differentially expressed between Wolbachia-infected (WI) and Wolbachia-uninfected (WU) embryos. Wolbachia infection down-regulated messenger RNA (mRNA) expression of glutathione S-transferase that could buffer oxidative stress. In addition, 1613 and 294 genes were identified as CI-specific up-/down-regulated genes. Compared to WU and WI embryos, embryos of CI cross strongly expressed genes involved in transcription, translation, tissue morphogenesis, DNA damage and mRNA surveillance. In contrast, most of the genes associated with energy production and metabolism were down-regulated in the CI embryos compared to the WU and WI embryos, which provides some clues as to the cause of death of CI embryos. These results identify several genes that could be candidates for explaining Wolbachia-induced CI. Our data form a basis to help elucidate the molecular consequences of CI in embryos.

Acute Damage to the Sperm Quality and Spermatogenesis in Male Mice Exposed to Curcumin-Loaded Nanoparticles

Background

Curcumin has shown many pharmacological activities in both preclinical and clinical studies. Many technologies have been developed and applied to improve the solubility and bioavailability of curcumin, especially the nanotechnology-based delivery systems. However, there has been evidence that certain nanoparticles have potential reproductive toxicity in practice.

Methods

Curcumin-poly (lactic-co-glycolic acid) (PLGA)-PEG nanoparticles (Cur-PLGA-NPs for short) were prepared. The Cur-PLGA-NPs were evaluated with its effect on the proliferation of mouse testicular cell lines in vitro and spermatogenesis in vivo, while PLGA-NPs were used as control. For animal experiments, male BALB/c mice were treated with 20 mg/kg of Cur-PLGA-NPs for continuous 10 days via tail vein injection.

Results

We found the curcumin nanoparticles suppressed the proliferation of testicular cell lines in vitro. Furthermore, a short-term intravenous delivery of curcumin-loaded nanoparticles could be harmful to the differentiation of spermatogonia, the elongation of spermatids, as well as the motility of mature sperms.

Conclusion

In the present study, we disclosed the acute damage on mouse spermatogenesis and sperm parameters by curcumin-loaded nanoparticles. Our results suggested that the reproductive toxicity of nanoformulated curcumin needs to be prudently evaluated before its application.

Response of soil enzyme activities and bacterial communities to the accumulation of microplastics in an acid cropped soil

The ecological stress of microplastics (MPs) contamination in agroecosystems raise worldwide concerns. However very few studies concentrated on the effects of MPs exposure on soil microbial community. The alterations of enzymatic activities and bacterial communities were assayed by spiking 1% and 5% (w/w) of polyethylene (PE) and polyvinyl chloride (PVC) MPs in an acid soil. The results showed that both PE and PVC addition inhibited fluorescein diacetate hydrolase activity and stimulated urease and acid phosphatase activities, and declined the richness and diversity of the bacterial communities. More severe effects were observed in the PE treated soils compared to the PVC treated soils generally. The relative abundances of families Burkholderiaceae increased significantly (p < .05) after MPs addition, suggesting the bacteria associated with nitrogen fixation stimulated by the MPs input. Meanwhile, significant (p < .05) decline of Sphingomonadaceae and Xanthobacteraceae after addition of 5% PVC and 1% PE MPs, respectively implied that MPs might inhibit the biodegradation of xenobiotics in the soil. Mover, the PICRUSt analysis demonstrated that membrane transporter was a sensitive prediction functional gene of microplastics exposure in the soil. Future studies could be focused on the role of MPs on the regulation of nitrogen cycling and organic compounds degradation in soils.

Loss of CDYL Results in Suppression of CTNNB1 and Decreased Endometrial Receptivity

Impaired endometrial receptivity is one of the major causes of recurrent implantation failure (RIF), although the underlying molecular mechanism has not been fully elucidated. In the present study, we demonstrated that chromodomain Y like (CDYL) was highly expressed in the endometrium at mid-secretory phase during the normal menstrual cycles. However, the expression of CDYL was downregulated in the endometrial tissues obtained from women with RIF, consistently with the protein level of LIF, which is a marker of endometrial receptivity. In CDYL-knockdown human endometrial Ishikawa cells, we identified 1738 differentially expressed genes (DEGs). Importantly, the catenin beta 1 (CTNNB1) expression was dramatically reduced responding to the CDYL inhibition, both in Ishikawa cells as well as the primary endometrial epithelial and stromal cells. In addition, the expression of CTNNB1was decreased in the endometrium from RIF patients as well. These results suggested that the expression of CTNNB1 was regulated by CDYL in endometrium. The cell migration was impaired by CDYL-knockdown in Ishikawa cells and primary endometrial stromal cells (ESCs), which could be rescued by CDYL or CTNNB1 overexpression. Collectively, our findings indicated that the decreased expression of CDYL may suppress endometrial cell migration capability by affecting CTNNB1 expression, which would contribute to poor endometrial receptivity in women with RIF.