American journal of translational research最新文献

{"title":"Anticoagulation approaches for arterial and venous thrombotic occurrences in membranous nephropathy: report of a patient with postponed diagnosis.","authors":"Fangzhong Huang, Xiaolei Lan, Xuchun Xu, Shuangqing Li, Jian Huang","doi":"10.62347/LGLV6130","DOIUrl":"10.62347/LGLV6130","url":null,"abstract":"<p><p>Vascular thrombosis and hypercoagulability are frequently observed in individuals with nephrotic syndrome (NS), particularly those diagnosed with membranous nephropathy (MN). It is extensively recognized that venous thrombosis occurs far more frequently than arterial thrombosis. However, we report a patient who experienced two significant arterial and venous thrombotic events within the past two years, and he was a 35-year-old man with nephrotic syndrome secondary to membranous nephropathy. In contrast to most previous similar studies that had shown only a single demonstration of venous embolism or arterial embolism, this case highlighted the occurrence of both venous and arterial embolic events. This suggests and prompts considerations for future research avenues and anticoagulant treatment strategies.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5970-5977"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of tirofiban combined with endovascular treatment on hemorrhagic transformation and neurological function in patients with ischemic stroke.","authors":"Xing Yuan, Dan Lu, Yiteng Xue, Lei Chen, Shuaibing Hu, Naibing Wang","doi":"10.62347/HAIW5465","DOIUrl":"10.62347/HAIW5465","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of Tirofiban combined with endovascular treatment on hemorrhagic transformation (HT) and neurological function in patients with ischemic stroke.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 94 patients with ischemic stroke treated at Xi'an International Medical Center Hospital from January 2020 to January 2023. Among them, 45 patients underwent endovascular treatment only and served as the control group. Another 49 patients received Tirofiban in addition to endovascular treatment and they formed the study group. The pre-treatment and 14-day post-treatment NIHSS scores were compared between the two groups. The 24-hour HT rate and the incidence of post-treatment adverse events were also compared between the two groups. Multivariate Cox regression analysis was used to identify factors influencing patient prognosis.</p><p><strong>Results: </strong>The NIHSS scores in the study group were significantly lower than those in the control group 14 days after treatment (P<0.05). There was no statistically significant difference in the 24-hour HT rate between the two groups (P>0.05). In addition, there were no significant differences in the incidence of adverse events between the two groups (P>0.05). Multivariate Cox regression analysis showed that treatment regimen, age, and time from onset to admission were independent factors affecting 90-day prognosis (P<0.01). A prognostic model based on β-coefficients was constructed: Cox risk = 2.729 * treatment regimen + 2.881 * age + 2.795 * time from onset to admission. The Cox risk was significantly lower in the good prognosis group compared to the poor prognosis group (P<0.0001), with an area under the curve of 0.925 in predicting patient prognosis.</p><p><strong>Conclusions: </strong>Tirofiban combined with endovascular treatment can improve quality of life, neurological function, and short-term prognosis in patients with ischemic stroke without increasing the incidence of adverse effects and HT.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5552-5563"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of sequential blood purification therapy on myocardial injury and serum inflammatory cytokine levels in patients with organophosphate poisoning.","authors":"Po Mao, Jiangping Li, Bingwen Li, Zuxiong Su, Binbin Wu, Yi'na Li, Guoliang Huang, Xintan Chen","doi":"10.62347/FYHC6091","DOIUrl":"10.62347/FYHC6091","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of sequential blood purification therapy on myocardial injury and serum inflammatory cytokine levels in patients with organophosphorus poisoning.</p><p><strong>Methods: </strong>The clinical data of 67 patients hospitalized for organophosphorus poisoning from January 2020 to January 2021 in Anxi County Hospital were retrospectively analyzed. The patients were divided into a control group (n = 30, received conventional treatment plus hemoperfusion) and a research group (n = 37, received conventional treatment plus sequential blood purification therapy [hemoperfusion plus continuous veno-venous hemofiltration (CVVH)]). The clinical efficacy, myocardial injury indicators, inflammatory cytokine levels, liver and kidney function, incidence of complications, and mortality rate were compared between the two groups.</p><p><strong>Results: </strong>The research group showed a significantly higher total effective rate of 94.59% compared to 73.33% in the control group (P < 0.05). Fewer doses of penehyclidine were administered in the research group, compared to the control group (P < 0.05). In addition, the duration of penehyclidinezation, wakefulness, recovery of CHE activity, mechanical ventilation and hospitalization in the research group was significantly shorter than those in the control group (all P < 0.05). After treatment, both groups exhibited decreased levels of serum NSE, cTnI, CK-MB, LDH, Myo, WBC, CRP, PCT and IL-6, with lower levels in the research group (P < 0.05). Conversely, both groups showed elevated levels of serum CHE, BUN, Scr, urine protein, AST, TBIL and ALT, with higher levels in the control group (P < 0.05). On the 1st and 2nd days after treatment, the serum NSE levels in the observation group were lower than those in the control group, while the serum CHE levels were higher than those in the control group (all P < 0.05). On the 3rd day after treatment, serum NSE and CHE levels were not significantly different between the two groups. The incidence of rebound in the research group was significantly lower (8.11% vs. 30.00%, P < 0.05) than that in the control group. The mortality rates did not show statistically significant differences between the two groups (10.00% vs. 2.70%, P > 0.05).</p><p><strong>Conclusion: </strong>Sequential blood purification therapy can effectively mitigate myocardial injury, reduce the expressions of inflammatory cytokines, and protect liver and kidney function in patients with organophosphorus poisoning, with a favorable safety profile.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"6041-6051"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRP platelet-rich plasma injection combined with aquatic exercise therapy improves functional recovery of basketball players with knee joint injury.","authors":"Rongrong Qin, Min Zhao","doi":"10.62347/PIQQ7236","DOIUrl":"10.62347/PIQQ7236","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effect of PRP platelet-rich plasma injection combined with aquatic exercise therapy on the functional recovery of basketball players with knee joint injury.</p><p><strong>Methods: </strong>This retrospective study included 60 basketball players who sustained knee joint injury between January 2021 to June 2023. Among them, 28 patients received PRP platelet-rich plasma injection (control group), while the other 32 patients received PRP platelet-rich plasma injection combined with aquatic exercise therapy (observation group). We compared the improvements in knee joint pain level, knee joint mobility, knee joint muscle strength and other indexes between the two groups before and after the interventions.</p><p><strong>Results: </strong>After 8 weeks of intervention, the visual analogue scale (VAS) score in the observation group was significantly lower than that before the intervention; Besides, the knee flexion range and Lysholm knee function score in the observation group were significantly improved (all P<0.05); and all these improvements were more substantial than those in the control group (all P<0.05). The KOOS scores of both groups increased significantly after 8 weeks of intervention as compared to pre-intervention, and the scores in the observation group were significantly higher than those in the control group (all P<0.05).</p><p><strong>Conclusion: </strong>PRP injection combined with aquatic exercise therapy significantly improves knee mobility, muscle strength and function, and reduces pain severity, in basketball players with knee injuries.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5700-5707"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between small for gestational age infants and maternal health: a meta-analysis.","authors":"You Lu, Di Qie, Fan Yang, Jinhui Wu","doi":"10.62347/EGPT7518","DOIUrl":"10.62347/EGPT7518","url":null,"abstract":"<p><strong>Background: </strong>Fetal growth restriction, commonly referred to as small for gestational age (SGA) in academic contexts, is associated with increased mortality rates and significant health risks. Fetal development is influenced by a complex interplay of maternal factors, fetal characteristics, and placenta fiction. This meta-analysis explored the relationship between the prevalence of SGA infants and various maternal conditions, such as overall health, lifestyle choices, and underlying medical conditions.</p><p><strong>Methods: </strong>A comprehensive literature search on maternal factor and SGA was conducted in PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang, and China Biology Medicine (CBM) (SinoMed) databases from 2000 to 2022. The Cochrane Collaboration tool was adopted to assess the quality of the selected literature. STATA 14.0 software was used to perform the statistical analysis and graphic presentation. Meta-analysis was registered with International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) (202410045).</p><p><strong>Results: </strong>In total, 15 studies with 41,446 infants identified as being SGA were included in this Meta-analysis. SGA occurrence was not associated with maternal age or multi-parameter, but was related to abnormal Body Mass Index (BMI) (RR=2.23, 95% CI [1.24, 4.00]). Smoking was strongly associated with SGA (RR=3.09, 95% CI [1.53, 6.23]), while drinking was not. SGA was negatively correlated with pregestational diabetes (RR=0.59, 95% CI [0.40, 0.88]) and pregnancy complications, including gestational diabetes (RR=0.74, 95% CI [0.56, 0.97]), hypertension (RR=2.84, 95% CI [1.88, 4.29]) and preeclampsia (RR=2.38, 95% CI [1.77, 3.20]).</p><p><strong>Conclusions: </strong>Maternal risk factors, including BMI, smoking, pregestational diabetes, gestational diabetes, gestational hypertension, and preeclampsia, are associated with SGA.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5191-5206"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value of rehabilitation nursing after internal fixation of distal radius fractures.","authors":"Lita Yuan, Wen Shao, Liyong Yuan, Jianlin Ma","doi":"10.62347/MOLI6474","DOIUrl":"10.62347/MOLI6474","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical value of rehabilitation nursing following internal fixation of distal radius fractures (DRFs).</p><p><strong>Methods: </strong>This retrospective study analyzed the medical records of 114 patients who underwent internal fixation for DRFs between July 2019 and May 2023. Among them, 54 patients received routine nursing care (control group) and 60 patients received rehabilitation nursing (observation group). Comparative analyses were conducted on postoperative pain (Visual Analogue Scale [VAS]), swelling, rehabilitation indicators (healing time, time to regain limb mobility, and hospital stays), wrist joint functional recovery (grip strength, Gartland-Werley Scale, rate of excellent and good reduction), quality of life (Short-Form 36 [SF-36]), adverse emotions (Self-Rating Depression Scale [SDS] and Self-Rating Anxiety Scale [SAS]), and nursing satisfaction.</p><p><strong>Results: </strong>The observation group exhibited a significant stepwise decrease in VAS and swelling scores on postoperative days 3 and 7 compared to preoperative levels (all P<0.05), and these scores were lower than those of the control group (all P<0.05). The observation group also showed significantly shorter healing time, faster recovery of limb mobility, and reduced hospital stays (all P<0.05). Additionally, patients in the observation group demonstrated higher grip strength, a greater rate of excellent and good reduction, and significantly lower Gartland-Werley, SDS, and SAS scores compared to the control group (all P<0.05). Higher SF-36 scores and greater nursing satisfaction were also observed in the observation group (both P<0.05).</p><p><strong>Conclusions: </strong>Rehabilitation nursing after internal fixation of DRFs has significant clinical value, evidenced by substantial relief of postoperative pain and swelling, reduction in adverse emotions, enhanced rehabilitation, improved wrist joint function, and higher quality of life and nursing satisfaction.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5900-5908"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of serum H-FABP, sTREM-1, and HMGB1 levels with severity and prognosis of sepsis.","authors":"Shaoxiong Jiang, Lipeng Liu, Xiaolin Zhu","doi":"10.62347/KELZ4296","DOIUrl":"10.62347/KELZ4296","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between serum levels of Heart-type fatty acid binding protein (H-FABP), Soluble Triggering Receptor Expressed on Myeloid Cells 1 (sTREM-1), and High mobility group box 1 protein (HMGB1) with disease severity, and their prognostic value in sepsis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the clinical data from 86 sepsis patients admitted to West China Hospital of Sichuan University between June 2021 and December 2023, and these cases constituted the observation group. In addition, clinical data from 80 healthy individuals who underwent medical examinations at our hospital during the same period served as the control group. Serum levels of H-FABP, sTREM-1, and HMGB1 were measured in both groups. Based on disease severity, the patients were categorized into mild (n=42), severe (n=28), and shock (n=16) groups. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score was used to assess the patients' condition. Follow-up evaluations showed that 60 patients survived and 26 died.</p><p><strong>Results: </strong>Serum levels of H-FABP, sTREM-1, and HMGB1 were significantly higher in the observation group compared to the control group (all P<0.05). Among the sepsis patients, the severe and shock groups exhibited significantly elevated levels of H-FABP, sTREM-1, and HMGB1 compared to the mild group, with the shock group showing the highest levels (all P<0.05). The levels of H-FABP, sTREM-1, and HMGB1 were positively correlated with APACHE II scores (r=0.760, r=0.715, r=0.709, all P<0.001). Furthermore, the levels of these biomarkers were significantly higher in patients who died than in survivors (all P<0.05). The AUCs of H-FABP, sTREM-1, and HMGB1 for predicting prognosis were 0.786, 0.790, and 0.781, respectively. Their combined prediction yielded an AUC of 0.834. Log-rank test showed that the survival time of patients with different expression levels of sTREM-1 (<856.50 pg/ml, ≥856.50 pg/ml) and HMGB1 (<395.80 ng/ml, ≥395.80 ng/ml) were significantly different (P<0.05).</p><p><strong>Conclusion: </strong>Serum levels of H-FABP, sTREM-1, and HMGB1 are elevated in sepsis patients and closely associated with the disease severity, making them valuable biomarkers for monitoring the severity of sepsis. Combined detection of serum H-FABP, sTREM-1, and HMGB1 shows promising prognostic value in sepsis, with lower levels of sTREM-1 and HMGB1 linked to improved survival.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5846-5855"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zhi Zhu Ma Ren pill relieves constipation in mice through endoplasmic reticulum stress-mediated apoptosis.","authors":"Yong Wen, Yu Zhan, Jun Li, Ling Xu, Chengzi Huang, Rong Wu, Xuegui Tang","doi":"10.62347/YLIE1988","DOIUrl":"10.62347/YLIE1988","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores the detailed effects and mechanisms of Zhi Zhu Ma Ren Pill (ZZMRP) on constipation.</p><p><strong>Methods: </strong>Mouse constipation was induced by using loperamide (Lop). The effects and mechanisms of ZZMRP on constipation were addressed by various methods including charcoal meals, hematoxylin and eosin (H&E) staining, immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), terminal deoxynucleotidyl transferase deoxyuridine triphosphate (dUTP) nick end labelling (TUNEL), transmission electron microscopy, and western blot experiments.</p><p><strong>Results: </strong>Lop-treated mice exhibited delayed transit and reduced ink progradation rates after charcoal meal administration. H&E staining confirmed severe pathologic symptoms in these mice. Additionally, a decline in interstitial Cajal cells (ICCs) was observed in Lop-treated mice, accompanied by reduced concentrations of 5-hydroxytryptamine (5-HT), acetylcholinesterase (AchE), substance P (SP), and vasoactive intestinal peptide (VIP), coupled with an elevated concentration of nitric oxide synthase (NOS). However, ZZMRP treatment markedly ameliorated these changes. In addition, ZZMRP introduction significantly reversed the Lop-induced enhancement in apoptosis rate, endoplasmic reticulum (ER) stress, and levels of proapoptotic proteins and ER stress proteins, and the decrease in the expression of antiapoptotic proteins. These effects were further confirmed with the use of 4-phenylbutyrate (4-PBA), which also reversed the changes in apoptosis rate and protein levels.</p><p><strong>Conclusion: </strong>ZZMRP alleviates constipation primarily through modulating ER stress-mediated apoptosis in Lop-treated mice, suggesting its use as a therapeutic agent for constipation.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5829-5845"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation, immunity and biomarkers in procoagulant responses of critically ill patients.","authors":"Hui Lian, Huacong Cai, Hongmin Zhang, Yan Zhang, Xiaoting Wang","doi":"10.62347/EDAR9565","DOIUrl":"10.62347/EDAR9565","url":null,"abstract":"<p><p>Understanding the pathobiology of critical illness is essential for patients' prognosis. Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. As part of the host response, procoagulant responses, one of the most primitive reactions in biology, start at the very beginning of diseases and can be monitored throughout the process. Currently, we can achieve near-complete monitoring of the coagulation process, and procoagulant responses serve as indicators of the severity of host response in critically ill patients. However, the rapid interpretation of the complex results of various biomarkers remains a challenge for many clinicians. The indicators commonly used for coagulation assessment are complex, typically divided into three categories for clarity: process index, functional index, and outcome index. Monitoring and understanding these indicators can help manage procoagulant responses. The intervention of procoagulant response should be part of the bundle therapy, alongside the treatment for primary disease, management for hemodynamics, and controlling for host response. Early intervention for procoagulant response mainly includes anti-inflammation, antiplatelet and anticoagulant therapy, as well as management of primary disease. In this review, we systemically introduce the onset, assessment and intervention of procoagulant response.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5797-5812"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effects of hysteroscopic adhesiolysis on postoperative pregnancy rates and fertility outcomes in patients with intrauterine adhesions.","authors":"Yulin Hu, Ying Ma, Wenjuan Li, Jinglan Qu","doi":"10.62347/GRAK9062","DOIUrl":"10.62347/GRAK9062","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the long-term effects of hysteroscopic adhesiolysis on postoperative pregnancy rates and fertility outcomes in patients with intrauterine adhesions (IUA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 105 patients with IUA treated at Baoji Maternal and Child Health Hospital from June 2022 to December 2023. All patients underwent hysteroscopic adhesiolysis. Based on the adjunctive treatment, patients were divided into two groups: the observation group (n=55), which received adhesiolysis plus balloon uterine stent placement, and the control group (n=50), which received adhesiolysis alone. We compared clinical efficacy, changes in endometrial thickness, menstrual volume, and serum estrogen levels, including estrogen receptor (ER) and progesterone receptor (PR) levels, between the two groups. Additionally, we recorded and compared the 3-month postoperative recurrence rate of IUA, pregnancy rates and outcomes, and complications. The predictive value of ER and PR levels for postoperative pregnancy was also analyzed. We then compared the general data of patients who became pregnant after surgery with those who did not, and used multivariate logistic regression to analyze the factors influencing postoperative non-pregnancy.</p><p><strong>Results: </strong>The overall treatment efficacy was significantly higher in the observation group than in the control group (P<0.05). The observation group showed significantly greater improvements in endometrial thickness, menstrual volume, and serum estrogen levels compared to the control group (all P<0.05). The recurrence rate of adhesions during follow-up was significantly lower in the observation group than in the control group (P<0.05). The postoperative pregnancy rates and fertility outcomes were also significantly better in the observation group (both P<0.05). The sensitivity and specificity of ER levels in predicting postoperative pregnancy were 78.05% and 70.31%, respectively, with an AUC of 0.788. For PR levels, the sensitivity was 75.61%, specificity was 71.88%, and AUC was 0.834. Multivariate regression analysis indicated that age, adhesion severity, adhesion recurrence, and the use of a balloon uterine stent were independent risk factors affecting postoperative pregnancy in patients with IUA (P<0.05).</p><p><strong>Conclusion: </strong>The combination of adhesiolysis and intrauterine balloon stent placement in patients with moderate to severe intrauterine adhesions significantly IUA increases endometrial thickness and volume, promotes menstrual recovery, prevents re-adhesion, and improves pregnancy outcomes. This approach is recommended for clinical application.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"16 10","pages":"5605-5613"},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}