Objective:To explore the risk factors for tubal patency after partial salpingectomy and end-to-end anastomosis,and their impact on pregnancy outcomes.Methods:A total of 300 patients with tubal pregnancy who underwent partial salpingectomy and end-to-end anastomosis in Zhengzhou Maternal and Child Health Hospital from January 2020 to April 2023 were enrolled in the study.Hysterosalpingography was performed after surgical treatment to examine the tubal patency.Lasso-Logistic regression was used to analyze the risk factors for postoperative tubal patency,and Spearman's correlation was used to analyze the impact of each risk factor on the pregnancy rate.Results:Hysterosalpingography showed that the fallopian tube was not obstructed in 225 cases(unobstructed group),the tube was not completely patent(n=54)or blocked(n=21)(obstructed group).Univariate analysis showed that age,diameter of the tubal pregnancy sac,location of tubal pregnancy,timing of surgery,pelvic adhesion,anastomotic method,length of remaining tubal,history of pelvic surgery,number of intraoperative electrocoagulation,intraoperative blood loss,and experience of surgeons were factors affecting postoperative tubal patency(all P＜0.01).Lasso regression analysis identified location of tubal pregnancy,pelvic adhesion,anastomotic method,length of remaining tubal,history of pelvic surgery,number of intraoperative electrocoagulation,and experience of surgeons as influencing factors.Multivariate Logistic regression analysis showed that tubal isthmus pregnancy,pelvic adhesion,open anastomosis surgery,history of pelvic surgery,and number of intraoperative electrocoagulation were independent risk factors for postoperative tubal patency,while length of remaining tubal and years of surgeon's work experience were independent protective factors for postoperative tubal patency(all P＜0.01).A total of 295 patients were followed up for 1 year,192 cases(65.08%)were pregnant,including 172 cases of intrauterine pregnancy(89.58%)and 20 cases of ectopic pregnancy(10.42%).Spearman correlation analysis showed that tubal isthmus pregnancy,pelvic adhesion,open abdominal anastomosis surgery,pelvic surgery history,and times of intraoperative electrocoagulation were negatively correlated with postoperative pregnancy,while the remaining tubal length and years of surgeon's working experience were positively correlated with postoperative pregnancy rate(all P＜0.01).Conclusions:For tubal patency of patients after partial salpingectomy combined with end-to-end anastomosis,the history of tubal isthmus pregnancy,pelvic adhesion,open abdominal anastomosis,pelvic surgery,and the number of intraoperative electrocoagulation are independent risk factors,which are negatively correlated with postoperative pregnancy.The remaining tubal length and the years of surgeon's work experience are independent protective factors,which are positively correlated with postoperative pregnancy.

Objective:To analyze the efficacy of the reconstruction of the proximal humerus by reverse shoulder arthroplasty with three-dimensional (3D) printing technology after tumor rescetion.Methods:A retrospective analysis was conducted on the data of eight patients undergoing semi-constrained reverse shoulder arthroplasty with 3D printing technology after the resection of bone tumors in proximal humeri at the Affiliated Wuxi People's Hospital of Nanjing Medical University from December 2017 to January 2021. There were four males and four females with an average age of 55.1 (range, 31-73) years, all of whom had unilateral onset, 2 on the left and 6 on the right. There was one case of leiomyosarcoma (Enneking IIB), two cases of chondrosarcomas (one Enneking IA and one Enneking IB), four cases of Campanacci grade 3 giant cell tumor of bone, and one case of bone metastasis of lung adenocarcinoma. Individualized prosthesis and implantation protocol were completed preoperatively in all patients. The glenoid baseplate was manufactured using 3D printing technology. During the surgery, Malawer type I tumor resection and semi-constrained reverse shoulder arthroplasty were performed, with 6 cases simultaneously using allograft-prosthetic composite reconstruction. The follow-up was scheduled, and the patient received X-ray examination of the shoulder. The range of motion of the shoulder was measured, the Constant-Murley score and musculoskeletal tumor society (MSTS) score were recorded.Results:All 8 patients successfully completed the surgery, with a surgical time of 173.8±46.7 min (range, 130-260 min), intraoperative blood loss of 487.5±334.6 ml (range 200-1,200 ml), and proximal humeral resection of 9.9±4.6 cm (range, 4.5-19.0 cm). All patients were followed up for a period of 45.6±12.5 months (range, 24-60 months). At the last follow-up, the abduction ranges of motion of the affected shoulders increased from 27.5°±14.4° pre-operatively to 106.3°±21.8° post-operatively, with a statistically significant difference ( t=11.37, P<0.001). The forward flexion ranges increased from 28.1°±12.8° pre-operatively to 115.6°±24.0° post-operatively, with a statistically significant difference ( t=11.49, P<0.001). The Constant-Murley score was improved from 40.5±14.3 pre-operatively to 79.3±11.2 post-operatively, with a statistically significant difference ( t=9.58, P<0.001). The MSTS score was 25.6±2.2 (range, 23-28), including 6 excellent cases and 2 good cases. At 2 weeks after surgery, one patient experienced joint dislocation that was successfully reduced manually. Up to the final follow-up, all patients had survived without local tumor recurrence, metastasis, prosthesis infection and loosening. Conclusion:3D printing technology assisted shoulder arthroplasty is helpful for effective reconstruction and shoulder joint function recovery after resection of proximal humeral tumors, with satisfactory outcomes in the early and middle stages.

To investigate the awareness of cognitive impairment disorders among residents of the Xizang Autonomous Region and its influencing factors, thereby providing a basis for targeted prevention and treatment efforts.