Objective:To investigate the effect of lifestyle intervention on the clinical outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in overweight or obese patients with polycystic ovary syndrome (PCOS).Methods:This study was a non-randomized controlled trial. A total of 126 overweight or obese PCOS patients who received IVF/ICSI treatment for infertility in Shaoguan Maternal and Child Health Hospital from January 2021 to December 2022 were selected by semi-random sampling method. The patients were divided into the experimental group (39 cases) and the control group (87 cases) according to whether they received the comprehensive lifestyle intervention. The experimental group maintained a healthy lifestyle and emotional control, accepted balanced diet, performed aerobic exercise and resistance exercise regularly and quantitatively, the data changes related to body mass index were collected regularly. The control group implemented a weight loss regimen on their own, following a low-calorie diet and exercise interventions. After 2 to 3 months, both groups of patients entered the test tube cycle (the intervention duration for each patient was up to the effect and their willingness to weight loss). The baseline data, cycle characteristics and pregnancy outcomes were compared between the two groups with t test and Chi-square. And the effects of lifestyle interventions on the clinical outcomes of IVF/ICSI in overweight or obese PCOS patients were also analyzed. Results:Before the intervention, the serum level of anti-muller hormone (AMH) in the experimental group was significantly higher than that in the control group [(5.62±2.98) vs (4.47±2.64) μg/L]( P<0.05). But there were no significant differences in age, infertility years, basal follicle maturation hormone (FSH), antral follicle count (AFC), primary infertility ratio, ICSI ratio, body mass index, proportion of obese patients, abdominal circumference, waist-to-hip ratio, visceral fat area and body fat percentage between the two groups (all P>0.05). After intervention, the body mass index, proportion of obese patients, abdominal circumference, visceral fat area and body fat percentage in experimental group were all significantly lower than those before intervention [(26.56±2.92) vs (29.21±3.37) kg/m2, 25.64% vs 64.10%, (89.92±7.16) vs (95.27±7.38) cm, (78.46±15.92) vs (95.46±17.21) cm2, 33.71%±2.46% vs 36.27%±3.02%] (all P<0.05). After intervention, the visceral fat area in the control group was significantly lower than that before the intervention [(92.08±19.38) vs (98.84±19.65) cm2] ( P<0.05), and there was no significant differences in the other indexes (all P>0.05). After intervention, the total amount of gonadotropin (Gn) in experimental group was significantly lower than that in control group [(2 488.23±711.30) vs (2 935.67±854.78) U] ( t=2.301, P<0.05). Conclusion:A 2-3 month lifestyle intervention can significantly reduce the body mass index, waist circumference, visceral fat area, and body fat percentage of overweight or obese PCOS patients, as well as decrease the total amount of Gn used for ovulation induction. However, it does not show a significant improvement in clinical outcomes.

Objective:To investigate the correlation between cardiac polyps and gastroesophageal flap valve (GEFV).Methods:The clinical, endoscopic and pathological data of 349 patients with cardiac polyps (the cardiac polyp group) visiting Affiliated Hospital of Yangzhou University from January 1, 2016 to December 31, 2021 were retrospectively collected, and the same number of non-cardiac polyp patients (the non-cardiac polyp group) were matched in the same period as control according to the propensity score. The clinical, endoscopic and pathological data of the two groups were compared.Results:After matching with propensity score, there were 296 patients in each group, with no significant differences in smoking, acid reflux, heartburn, Helicobacter pylori infection, bile reflux, reflux esophagitis or pancreatitis between the two groups ( P>0.05). Compared with the non-cardiac polyp group, the risk of cardiac polyps increased in GEFV Ⅱ patients ( OR=3.046, 95%CI: 2.100-4.419, P<0.001) and GEFV Ⅲ patients ( OR=4.202, 95%CI: 2.299-7.681, P<0.001). Compared with the non-cardiac polyp group, the risk of cardiac polyps increased in patients with GEFV abnormalities ( OR=2.822, 95%CI: 1.615-4.931, P<0.001). GEFV abnormalities was associated with the cardiac polyp site ( χ2=22.169, P=0.003) and was not significantly associated with cardiac polyp size, number, morphology, intestinal metaplasia of the surrounding mucosa or intraepithelial neoplasia ( P>0.05). Conclusion:The occurrence of cardiac polyps is related to GEFV, and the patients with GEFV abnormalities are more likely to develop cardiac polyps.