Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects around 35%–50% of men during their lifetime. The efficacy of current oral medication for CP/CPPS remains limited. Recent studies demonstrated that vagus nerve stimulation may improve chronic pelvic and abdominal pain. Accordingly, transcutaneous auricular vagus nerve stimulation (taVNS) might represent a promising, non-invasive therapeutic approach for the clinical management of CP/CPPS.

The trial of Transcutaneous Auricular vagus nerve Stimulation for moderate to severe Chronic Prostatitis/CPPS is a prospective, randomised, sham-controlled trial with a 1:1 allocation ratio. Participants will be assigned randomly to either the taVNS group or the sham-taVNS group. The intervention period will consist of a 4-week treatment (a total of 40 sessions), followed by an 8-week follow-up period. The primary outcome is the change from baseline in the National Institutes of Health Chronic Prostatitis Symptom Score Index total score at week 4. Secondary outcomes include the International Prostate Symptom Score Scale, European Quality of Life 5-Dimensions-5-Levels questionnaire, Self-Rating Anxiety Scale and Self-Rating Depression Scale. Safety assessments will be conducted throughout the entire study period.

This study protocol and informed consent documents were reviewed and approved by the Institutional Review Board of Guang’anmen Hospital, China Academy of Chinese Medical Sciences (approval number: 2023-250 KY). Written informed consent will be obtained from all participants and/or their legal guardians prior to trial participation. The findings will be disseminated through publication in a peer-reviewed journal and presentations at scientific conferences. The research data will be made available on reasonable request.

NCT06287970.

Embryo aneuploidy increases substantially with maternal age, contributing to implantation failure and miscarriage. Conventional morphological assessment cannot determine euploidy. Non-invasive preimplantation genetic testing (ni-PGT) evaluates cell-free DNA in spent embryo culture medium, potentially improving embryo selection without trophectoderm biopsy. Robust evidence of clinical benefit in women aged 35–42 years remains limited.

This is a multicentre, open-label, parallel-group randomised controlled trial conducted in three centres in China. Infertile women aged 35–42 years undergoing their first intracytoplasmic sperm injection cycle and having ≥2 good-quality days 5–6 blastocysts (Gardner grade ≥4BC,defined as an expansion grade of at least 4, with an inner cell mass grade of B or better and a trophectoderm grade of C or better) will be randomised 1:1 to ni-PGT-guided embryo selection or conventional morphology-based selection. Randomisation will be stratified by study centre using variable permuted block sizes of 4 and 6 and implemented through a unified centralised randomisation system. After a multicentre set-up period for investigator training and harmonisation of spent culture-medium sampling procedures, during which no participant was enrolled or randomised, recruitment and randomisation commenced on 14 February 2025 at the lead site; additional sites started recruitment after local ethics approval and site initiation. A freeze-all strategy will be applied; frozen-thawed single blastocyst transfer will start from the second menstrual cycle after oocyte retrieval.

For the primary endpoint, embryo transfers using embryos from the index retrieval cycle that occur within 12 months after randomisation and within the first three frozen-thawed single embryo transfer attempts will contribute to the cumulative outcome, whichever occurs first. Clinical care will not be restricted beyond this prespecified analysis range. The primary outcome is the cumulative ongoing pregnancy rate within 12 months after randomisation, defined as the proportion of participants achieving at least one ongoing pregnancy (clinical pregnancy continuing to ≥12 weeks’ gestation) following a qualifying embryo transfer within the prespecified analysis range. Key secondary outcomes include early miscarriage rate (

The trial will be conducted according to the Declaration of Helsinki. Ethics approval has been obtained from all participating centres before participant recruitment at each site. Written informed consent will be obtained from all participants. Results will be disseminated through peer-reviewed publication and conference presentations.

ChiCTR2400088283

To establish optimal pre-pregnancy body mass index (BMI)-specific gestational weight gain (GWG) ranges for twin pregnancies and compare their association with maternal and neonatal adverse outcomes against Institute of Medicine (IOM) recommendations.

Retrospective cohort study. Retrospective cohort study. Adjusted ORs (aORs) with 95% CI were used to quantify associations; average marginal effects (AME) with 95% CI (in percentage points) were used to compare absolute risk differences.

Perinatal data from >70 obstetric institutions in Wuhan, China, collected via the Wuhan Maternal and Child Health Service Management Information System.

10 636 women with twin deliveries at ≥28 weeks (2011–2023). Pre-pregnancy BMI categorised using Chinese cut-offs: underweight

Hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), premature rupture of membranes (PROM), small for gestational age (SGA) and large for gestational age.

Optimal GWG ranges were: underweight 18.0–25.0 kg, normal 14.0–24.0 kg, overweight 12.2–24.0 kg, obesity 13.3–20.0 kg. Compared with IOM guidelines, study-derived ranges showed more favourable risk identification. In normal weight women, excessive GWG increased HDP risk (aOR 1.79, 95% CI 1.49 to 2.14); 13.57% versus 8.79%, AME 5.90 pp (95% CI 3.88 to 7.91 pp). In underweight women, inadequate GWG increased PROM (aOR 1.64, 95% CI 1.05 to 2.57); 14.48% versus 7.51%, AME 4.18 pp (95% CI 0.31 to 8.06 pp) and SGA (aOR 1.72, 95% CI 1.29 to 2.31); 45.58% versus 41.40%, AME 11.74 pp (95% CI 5.55 to 17.94 pp). In overweight women, excessive GWG increased HDP (aOR 1.81, 95% CI 1.21 to 2.70); 24.39% versus 16.32%, AME 9.68 pp (95% CI 2.49 to 16.88 pp) and inadequate GWG increased SGA (aOR 1.60, 95% CI 1.20 to 2.14); 35.15% versus 27.82%, AME 9.85 pp (95% CI CI 3.72 to 15.97 pp), which IOM failed to detect. In obese women, inadequate GWG increased SGA (aOR 2.76, 95% CI 1.37 to 5.53); 27.18% versus 17.16%, AME 17.95 pp (95% CI 5.74 to 30.17 pp), which was missed by IOM.

Our findings support adopting region-specific GWG standards for twin pregnancies in Asian populations.

Major depressive disorder (MDD) is a leading cause of disability among adolescents, yet available treatments remain limited. Bright light therapy (BLT) is a non-pharmacological intervention with demonstrated efficacy in adults. However, its clinical utility and underlying neural mechanisms in adolescents remain unclear. This trial aims to evaluate the clinical efficacy, time to onset, safety and applicability of home-based BLT in outpatient adolescents with MDD, and to explore its underlying neural mechanisms using functional near-infrared spectroscopy (fNIRS).

This is a randomised, placebo-controlled, three-arm multicentre clinical trial. A total of 126 outpatient adolescents aged 13–17 years with MDD will be randomly assigned to receive high-intensity BLT, medium-intensity BLT or placebo dim red light using a portable light box in a home-based setting for 40 min each morning over 4 weeks, followed by a 2-week follow-up. 42 age-matched and gender-matched healthy controls will also be enrolled for baseline assessments only, serving as normative references for comparison. The primary outcome will be the change in total scores on the 17-item Hamilton Rating Scale for Depression from baseline to week 4. All analyses will follow an intention-to-treat framework to ensure methodological rigour. The primary outcome will be analysed using analysis of covariance and linear mixed-effects models. Secondary outcomes will include response and remission rates, time to onset, maintenance of efficacy, self-reported depressive symptoms, sleep quality, cognitive function, anxiety, irritability, suicidal ideation, non-suicidal self-injury, self-efficacy and the overall safety profile of BLT. Prefrontal cortical activity will be measured using fNIRS at baseline and week 4 to explore potential neural mechanisms. Approximately 15% of participants will additionally take part in a qualitative substudy exploring experiences and acceptability of BLT.

The study protocol has been approved by the Ethics Committee of Peking University Sixth Hospital (approval number: 2025–24). Written informed consent will be obtained from all participants and their legal guardians prior to enrolment. Study findings will be disseminated through peer-reviewed journals and conference presentations.

NCT06913309.

This study aimed to explore the lived experiences of fear of complications (FoC) among hospitalised people with type 2 diabetes (T2D) in China and to provide insights for targeted nursing interventions.

A phenomenological research approach was employed to conduct semistructured interviews and the Colaizzi’s seven-step analysis method was used for data analysis. This study followed the Consolidated Criteria for Reporting Qualitative Research checklist.

15 people with T2D were purposively recruited between March and July 2025 from the endocrinology departments of two tertiary hospitals in Daqing City, Heilongjiang Province.

Three themes and 11 subthemes were identified: (1) experiencing multiple negative psychological responses (distress from negative emotions, contradictory and painful psychological states, social alienation); (2) the triggers of fear are complex (adverse outcomes of similar patients, illness uncertainty, symptom burden, self-perceived burden, economic burden) and (3) employing diverse coping strategies (negative avoidance, positive self-adjustment, seeking social support).

Healthcare professionals should pay greater attention to FoC among people with T2D. Early psychological assessment, identification of fear triggers, strengthening social support and promoting adaptive coping strategies may help reduce fear and improve quality of life.

This study investigated the knowledge and attitudes (KA) towards perioperative pulmonary embolism (PE) in patients undergoing major orthopaedic surgery, a population at particular risk.

A single-centre, cross-sectional study.

A tertiary care hospital in Shanghai, China.

454 patients scheduled for major orthopaedic surgery (Grade III or above) were enrolled between February and September 2024. Selection criteria included adult patients undergoing eligible procedures, while exclusion criteria encompassed cognitive impairment or refusal to participate. All enrolled participants completed the study.

The primary outcomes were the total scores on validated knowledge and attitude questionnaires. Secondary outcomes included the identification of demographic factors associated with these scores and the analysis of the direct relationship between knowledge and attitude using structural equation modelling (SEM).

The average knowledge score was 52.9% (23.82/45), indicating poor understanding. The average attitude score was 66.4% (29.88/45), indicating a moderate attitude. The multivariable analysis showed that a college diploma (OR=4.824, 95% CI 2.399 to 9.703, p

Patients undergoing major orthopaedic surgery possess poor knowledge but moderately positive attitudes toward PE. Educational level is a key factor influencing KA. Improving patient knowledge and attitudes is crucial for supporting informed surgical decision-making and enhancing perioperative self-management, though the complex relationship between knowledge and attitude warrants further investigation.

Mechanical ventilation during patient transport is a high-risk clinical practice. While the novel Mindray TV80, a high-performance emergency transport ventilator, offers potential advantages for use across complex transport settings, rigorous clinical data comparing its oxygenation performance in critically ill, mechanically ventilated patients during transport are lacking. This study aims to address this gap by evaluating the non-inferiority of TV80 to Hamilton T1 in maintaining oxygenation stability.

This is a prospective, single-blind, single-centre, parallel-group, non-inferiority randomised controlled trial. Mechanically ventilated patients (18–80 years) requiring intrahospital or interhospital transport will be recruited. Eligible patients will be randomised at a 1:1 ratio to the TV80 group (intervention) or Hamilton T1 group (control) using a permuted block design stratified by transport type (intrahospital vs interhospital) via the electronic data capture system. The intervention involves using the assigned ventilator during transport, with parameters replicated from the patient’s pre-transport ventilator. The primary outcome is the difference in oxygenation index (P/F) before (within 1 hour) and after (within 1 hour) transport as measured by blood gas analyser. Continuous SpO₂ monitoring will be performed throughout the transport period to capture real-time oxygenation changes. Secondary outcomes include transport preparation time, changes in PaCO₂ and pH, variability of ventilator parameters (tidal volume, FiO₂) and vital signs (heart rate, SpO₂, mean arterial pressure) and incidence of adverse events (AEs)/serious AEs. Sample size is 98 (49 per group) to achieve 80% power with a non-inferiority margin of –30 mm Hg. Pre-specified subgroup analyses by transport type will be performed.

This study has been approved by the Human Research Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval number: LSY-2025-0903). Written informed consent will be obtained from participants’ legal representatives. All results will be submitted to a peer-reviewed journal for publication.

NCT07198269 (ClinicalTrials.gov).

To synthesise existing qualitative and conceptual literature on the implementation, ethical considerations and policy implications of Medical Assistance in Dying for Mental Disorder as a Sole Underlying Medical Condition (MAiD MD-SUMC) in Canada and internationally.

A qualitative evidence synthesis using a thematic analysis approach. Empirical, conceptual and policy papers addressing MAiD for mental disorders were identified through major databases and grey literature. Studies were thematically analysed to identify recurring ethical, clinical and policy themes related to eligibility, assessment and implementation.

Data was extracted from a systematic search of Medline and Embase for peer-reviewed studies published from 1974 onwards, supplemented by relevant policy documents and legal cases.

Studies were included if they examined MAiD MD-SUMC and explored ethical, legal or clinical considerations or provided stakeholder perspectives. Exclusion criteria included studies focusing solely on non-psychiatric conditions or not published in English.

Two independent reviewers screened, extracted and analysed data using an iterative thematic synthesis approach. Key themes were identified through consensus discussions.

The synthesis identified four major themes: (1) Irremediability and treatment resistance—persistent uncertainty regarding when mental disorders can be considered irremediable. (2) Capacity and vulnerability—ongoing debate about assessing capacity amid fluctuating symptoms and social influences. (3) Ethical and policy considerations—divergent interpretations of autonomy, justice and safeguards highlighting the need for standardised criteria. (4) Public and professional perspectives—public and family support for inclusion, although clinician hesitancy exists.

The evidence supports a thoughtful, structured approach to potential implementation of MAiD MD-SUMC in Canada. Future priorities include refining criteria for irremediability, standardising capacity assessments, addressing disorder-specific complexities and strengthening mental health infrastructure. Continued research, engagement and transparent policy dialogue will be essential to ensure that any expansion of MAiD upholds ethical integrity, protects vulnerable persons and maintains public trust.