OBJECTIVETo observe the effects of autologous blood injection and 0.9% NaCl at Zusanli (ST 36) on ovarian function in patients with primary ovarian insufficiency.

METHODSSixty patients with primary ovarian insufficiency were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the observation group were treated with injection of autologous blood at Zusanli (ST 36); the patients in the control group were treated with 0.9% NaCl with identical volume at Zusanli (ST 36). Both the treatments were given once a week for 3 months. The ovarian function, including follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E) were tested before treatment, 1 month, 2 months and 3 months after first acupoint injection; the endometrial thickness before and after treatment and clinical efficacy were compared in the two groups.

RESULTSCompared before treatment, FSH was lowered in the observation group after 1-month treatment (<0.05), while FSH and LH were lowered and Ewas increased after 2-month treatment and 3-month treatment (all<0.05). Compared with 1-month treatment, FSH and LH were lowered and Ewas increased in the observation group after 2-month treatment and 3-month treatment (all<0.05). Compared with 2-month treatment, FSH was lowered and Ewas increased in the observation group after 3-month treatment (both<0.05). The differences of all serum tests before and after treatment were insignificant in the control group (all>0.05). The FSH after 1-month treatment, and FSH, LH and Eafter 2-month treatment and 3-month treatment in the observation group were significantly different from those in the control group (all<0.05). The endometrial thickness after treatment in the observation group was higher than that before treatment (<0.05), while the endometrial thickness after treatment in the control group was similar to that before treatment (>0.05); the difference of endometrial thickness before and after treatment in the observation group was higher than that in the control group (<0.05). The clinical effective rate was 83.3% (25/30) in the observation group, which was superior to 46.7% (14/30) in the control group (<0.05).

CONCLUSIONThe autologous blood injection at Zusanli (ST 36) can significantly improve ovarian function, promote endometrial growth in patients with primary ovarian insufficiency.

Objective·To explore the predictive value of diuretic renal scintigraphy parameters such as 20-minute residual rate(R20)for pyeloplasty in children with congenital unilateral ureteropelvic junction obstruction(UPJO).Methods·The clinical data and diuretic renal scintigraphy results of 110 children with congenital unilateral UPJO who were first treated at the Department of Nuclear Medicine,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine from August 2018 to August 2023 were retrospectively analyzed.The imaging results and the progress of hydronephrosis were followed up after the first diuretic renal scintigraphy.According to the outcome event of pyeloplasty due to the progression of hydronephrosis,the children were divided into operation group and non-operation group.Age,gender,side of hydronephrosis,and baseline diuretic renal scintigraphy parameters including blood perfusion rate(BPR),differential renal function(DRF),time to peak(Tmax),time to half(T1/2)and R20 were compared between the two groups.Logistic regression was used to analyze the effect of various parameters on the progression of hydronephrosis.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of diuretic renal scintigraphy parameters for surgical intervention.Wilcoxon test was used to compare the examination parameters of two diuretic renal dynamic imaging.Results·During the follow-up,60 children underwent pyeloplasty after progression,and the other 50 children did not progress.The differences in DRF,Tmax,T1/2 and R20 between the two groups of children at baseline were statistically significant(all P<0.05).Univariate and multivariate Logistic regression analysis showed that only R20 was an independent predictor of pyeloplasty(OR=4.730,95%CI 1.009-1.178,P=0.030).R20 predicted pyeloplasty with a sensitivity of 88.3%,specificity of 56%,the area under the ROC curve of 0.758(95%CI 0.667-0.850,P=0.000),and the cut-off value of 90.08%.During the follow-up,38 children underwent the second diuretic renal scintigraphy,and the DRF was lower than before.The difference between the two DRFs was statistically significant(Z=-2.589,P=0.010),especially in children with R20≥90.08%(Z=-2.166,P=0.030).R20 in the non-operation group decreased significantly compared with the baseline(Z=-2.062,P=0.039).However,R20 in the operation group was higher than baseline,but the difference was not statistically significant(P>0.05).Conclusion·R20 plays an important role in the prediction of pyeloplasty in children with congenital unilateral UPJO.For children with R20≥90.08%,pyeloplasty should be performed as soon as possible to prevent further deterioration of renal function.