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Multivariate analysis of pregnancy outcomes after transcervical resection of polyp in infertility patients

Yan GUO ; Enlan XIA ; Yu XIAO ; Xiaowu HUANG

Journal of Capital Medical University.2025;46(4):724-728. doi:10.3969/j.issn.1006-7795.2025.04.021

Objective To investigate the influencing factors of pregnancy outcomes after transcervical resection of polyp(TCRP)in infertility patients.Methods The data of 442 patients with infertility complicated with endometrial polyp(EP)underwent TCRP from March 2021 to March 2022 were retrospectively analyzed,and the postoperative follow-up time was 12-24 months,and they were divided into postoperative pregnancy group(pregnancy group)and non-pregnant group(control group).The two groups were compared with age,body mass index(BMI),infertility type,abnormal uterine bleeding,adverse pregnancy history,number of EP,EP size,intraoperative negative pressure uterine aspiration,endometritis,TCRP operation time,and uterine cavity depth,and multivariate analysis was conducted on the influencing factors of pregnancy outcomes after TCRP in infertility patients.Results Among 442 infertility patients with EP,274 cases(62.0%)were in the pregnancy group and 168 cases(38%)in the control group.The factors influencing pregnancy after TCRP were age(OR=0.925,95%CI:0.881-0.972,P<0.05),abnormal uterine bleeding before surgery(OR=0.646,95%CI:0.432-0.967,P<0.05)and primary infertility(OR=2.105,95%CI:1.295-3.423,P<0.05).Conclusion TCRP can improve pregnancy outcomes in infertility patients with EP.Age and abnormal uterine bleeding before operation were the protective factors to increase pregnancy after TCRP in infertility patients.Primary infertility is a risk factor for pregnancy after TCRP in infertility patients.

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Clinical characteristics of the patients with follicular cysts and menstrual disorders

Jing JIN ; Xiangyan RUAN ; Lin HUA ; Jiaojiao CHENG ; Yue ZHAO ; Xuanxuan TIAN

Journal of Capital Medical University.2025;46(4):620-625. doi:10.3969/j.issn.1006-7795.2025.04.006

Objective To explore the clinical characteristics of the patients with follicular cysts and menstrual disorders.Methods A total of 178 women with follicular cysts complicated by menstrual disorders were recruited,who were aged 23-53(38.62±6.35)years and came to the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital between August 2022 and July 2024.The participants were divided into three groups according to the age,with 27 women in the age group of 21-30 years(Group 1),77 in the age group of 31-40 years(Group 2),and 74 in the age group of>40 years(Group 3).The age and menstruation of these patients were collected,the body height,weight,follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),progesterone(Po),total testosterone(TT),prolactin(PRL),anti-müllerian hormone(AMH)and thyroid function[blood routine and blood clotting for patients with abnormal uterine bleeding(AUB)]were measured,and the diameter of ovarian cyst and the thickness of endometrium were examined.The clinical characteristics of the patients with follicular cysts complicated by menstrual disorders were described and compared with each other among the three age groups.Results ① Among 178 patients,61(34.3%)patients presented with complaints of cessation of regular menstruation or amenorrhea and 117(65.7%)with complaints of AUB.Out of 178 patients,13(7.3%)patients developed anemia due to AUB,and all the patients were treated with medication.② Follicular cysts disappeared in 1 month for 124(69.7%)patients,disappeared in 2 months for 176(98.9%)patients,and disappeared in 3 months for 178(100%)patients.A total of 177(99.4%)patients had follicular cysts with a diameter less than 5 cm,and only 1(0.6%)patient had follicular cysts with a diameter≥5 cm.③ The overall prevalence of diminished ovarian reserve(DOR)in patients with follicular cysts complicated by menstrual disorders was 82.0%,and the prevalence of DOR was 70.2%for the patients under 40 years old.The prevalence of DOR in three age groups was 37.0%(10/27),81.8%(63/77),and 98.6%(73/74),respectively.The prevalence of DOR gradually increased with age.④ The median AMH values for Group 1,Group 2,and Group 3 were 1.55,0.51,and 0.15 ng/mL,respectively.The FSH level in Group 3 was significantly higher than that in Groups 1 and 2(adjusted P<0.05),while the AMH level was significantly lower than that in Groups 1 and 2(adjusted P<0.05).The AMH level in Group 2 was lower than that in Group 1(adjusted P<0.05).Conclusion Patients with follicular cysts complicated by menstrual disorders are recommended to receive medication treatment,rather than just expecting treatment.The prevalence of DOR in patients with follicular cysts complicated by menstrual disorders is significantly higher than that in normal women,even in women younger than 40 years old.Therefore,it is essential to evaluate the ovarian reserve of these patients while treating menstrual disorders,particularly for young women with fertility needs.

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Correlation between thyroid autoimmunity and gestational diabetes mellitus in Chinese euthyroid women

Yue ZHAO ; Xiangyan RUAN ; Liying ZOU ; Jun MA ; Yuejiao WANG ; Xuanxuan TIAN ; Jing JIN

Journal of Capital Medical University.2025;46(4):626-631. doi:10.3969/j.issn.1006-7795.2025.04.007

Objective To explore the correlation between thyroid autoimmunity(TAI)and gestational diabetes mellitus(GDM)in Chinese euthyroid women.Methods A total of 508 euthyroid women were enrolled in the cross-sectional study,who performed their entire clinical/biological workup and oral glucose tolerance test(OGTT)from the department of Gynecology and Endocrinology of the Beijing Obstetrics and Gynecology Hospital,Capital Medical University from June 2023 to June 2024.At median 8(6-10)weeks of gestation,thyroid-stimulating hormone(TSH),free thyroxine(fT4),and thyroid peroxidase antibodies(TPOAb)were measured,baseline characteristics were recorded,and an OGTT was performed between 24 and 28 weeks of pregnancy.According to the OGTT results,they were divided into GDM group(n=169)and non GDM group(n=339).Thyroid parameters,the demographic and obstetric parameters,and the prevalence of TAI were compared with two groups.The factors associated with GDM were analyzed with multivariate Logistic regression analysis.Results The age,body mass index(BMI),and proportion of obese women before pregnancy in the GDM group were all significantly higher than those in the non-GDM group,with statistically significant differences(P<0.001).The proportion of pregnant women over 30 years old in the GDM group was significantly higher than that in the non-GDM group(59.17%vs 6.79%,χ2=168.667,P<0.001).The proportion of obese mothers(BMI≥28 kg/m2)before pregnancy in the GDM group was 24.26%,which was significantly higher than that in the non-GDM group(8.26%)(χ2=24.599,P<0.001).The incidence of TAI in the GDM group was 54.44%,while it was 15.93%in the non-GDM group.The difference between the two groups was statistically significant(χ2=81.659,P<0.001).The results of Logistic regression analysis showed that maternal age over 30 years and pre-pregnancy obesity increased the risk of GDM occurrence in TAI women by 6.08 times(OR=6.08,95%CI 3.61-10.25,P<.001).Conclusion Among early pregnancy women with normal thyroid function,as age increases during follow-up(especially over 30 years old),pre-pregnancy BMI increases(especially in obese individuals),and those with pre-pregnancy TAI,the risk of developing GDM during pregnancy significantly increases.It is necessary to explore preventive strategies for GDM in euthyroid TAI women,with a view to improving adverse pregnancy outcomes.

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Research progress on the long-term effects of subthalamic nucleus deep brain stimulation on non-motor symptoms in Parkinson's disease

Chenguan JIANG ; Yan LIU ; Zhou YANG ; Bingxin LI ; Jianguo ZHANG ; Lin SHI

Journal of Capital Medical University.2025;46(4):733-741. doi:10.3969/j.issn.1006-7795.2025.04.023

Deep brain stimulation(DBS)has witnessed rapid advancement as a neurosurgical intervention over the past four decades,addressing movement disorders and a spectrum of neuropsychiatric conditions.Notably,subthalamic nucleus deep brain stimulation(STN-DBS)is widely implemented in the management of Parkinson's disease(PD)patients experiencing refractory motor fluctuations and complications,and has shown promise in ameliorating non-motor symptoms(NMS).However,the long-term efficacy of STN-DBS on NMS remains a subject of scholarly discourse.This review endeavors to synthesize current knowledge regarding the long-term impacts,underlying mechanisms,and future research directions of STN-DBS in the context of NMS in Parkinson's disease.

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Impact of cryopreservation and thawing on human ovarian tissue

Yanglu LI ; Xiangyan RUAN ; Juan DU ; Jiaojiao CHENG ; Fengyu JIN ; Muqing GU ; Yanqiu LI ; O.Mueck ALFRED

Journal of Capital Medical University.2025;46(4):594-600. doi:10.3969/j.issn.1006-7795.2025.04.002

Objective To evaluate the impact of slow-freezing process on human ovarian tissue with the standard cryopreservation-thawing protocol of Fertility Protection Center of Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods Ovarian tissues of 12 patients were divided into fresh ovarian tissue group(fresh group)and freezing-thawing ovarian tissue group(F-T group).The freezing-thawing protocol was the standard protocol in our center.The number and activity of follicle were examined with Hematoxylin-eosin(HE)staining and calcein-AM(calcein acetoxymethylester)staining,and the proliferation and apoptosis was evaluated with the immunohistochemical staining of Ki-67 and caspase-3.The expressions of apoptosis-related proteins such as caspase-3,bax and FasL between the two groups were compared with Western blotting.Results There were no statistically significant differences in follicle counting and follicle activity in ovarian tissues pre-and post-freezing-thawing(P>0.05),and the positive rate of Ki-67 in ovarian tissues after freezing-thawing was significantly lower than that in fresh ovarian tissues(P<0.05),and there was no statistically significant difference in the positive rate of caspase-3 between the two groups(P>0.05).The expression of caspase-3 protein in ovarian tissues after freezing-thawing was significantly higher than that in fresh ovarian tissues(P<0.05),while the expressions of other apoptosis-related proteins such as bax and FasL were not significantly different(P>0.05).Conclusion The standard cryopreservation-thawing regimen in our center can effectively maintain the follicle number,morphology,and activity in ovarian tissues.After freezing and thawing,the cell proliferation level is decreased.The expression of apoptosis-related proteins such as bax and FasL are not increased,and the expression of caspase-3 is relatively increased.These results suggest our freezing-thawing regimen is good for human ovarian tissue.

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The current status of bone mineral density and influencing factors in early menopausal women

Anming LIU ; Xiangyan RUAN ; Zecheng WANG ; O.Mueck ALFRED

Journal of Capital Medical University.2025;46(4):601-606. doi:10.3969/j.issn.1006-7795.2025.04.003

Objective To analyze the current status of bone mineral density(BMD)in women with early menopause and explore the correlations between BMD with age,body mass index(BMI),total body fat mass,spinal fat mass,femoral fat mass,follicle-stimulating hormone(FSH),estradiol(E2),and testosterone(T).Methods A total of 106 women with early menopause,who first visited the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2023 to May 2025,were recruited after meeting the inclusion and exclusion criteria.The spinal BMD,femoral BMD,total body fat mass,femoral fat mass,and spinal fat mass were measured with dual-energy X-ray absorptiometry(DXA).The age,height,and weight of the patients were recorded,and serum levels of FSH,E2,and T were measured.Spearman correlation analysis was used to explore the correlations between spinal and femoral BMD and age,FSH,E2,T,BMI,total body fat content,femoral fat content,and spinal fat content.The patients were divided into three groups based on BMD:normal bone mass,osteopenia,and osteoporosis.Non-parametric Kruskal-Wallis H test was used to compare BMI,fat content,age,FSH,E2,and T levels among the three groups.Bonferroni-corrected Mann-Whitney U test was used for pairwise comparisons of significant differences.Multiple linear regression analysis was conducted to explore the influencing factors for femoral BMD T-score.Results Among the 106 patients with early menopause,30(28.3%)had normal bone mass,64(60.4%)had osteopenia,and 12(11.3%)had osteoporosis,with an average age of(43.99±0.16)years.Femoral BMD was positively correlated with BMI,total body fat mass,and spinal fat mass(all P<0.05).No significant differences were found in femoral fat mass,age,FSH,and T levels among the different bone mass groups,but,BMI,total body fat mass,spinal fat mass,and E2 were significantly different(P<0.05).BMI,total body fat mass,spinal fat mass and E2 were significantly higher in the normal bone mass group compared to the osteopenia group(P<0.05).The BMI of the normal bone mass group was significantly higher than that of the osteoporosis group(P<0.05).Multiple linear regression analysis showed that FSH were influencing factors for femoral BMD T-scores(P<0.05).Conclusion The osteoporosis is more prevalent in women with early menopause.Femoral BMD is positively correlated with BMI,total body fat mass and spinal fat content.Elevated FSH is a risk factor for reduced femoral BMD T-score.Attention should be paid to the risk of osteoporosis in women with early menopause,and individualized treatment plans should be developed to reduce the prevalence of osteoporosis.

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Changes of blood clinical parameters in patients with Graves'ophthalmopathy before and after treatment with tocilizumab

Rongrong XIE ; Xinyu XU ; Zhihui SONG ; Zhong XIN ; Lin HUA ; Tingting SHI

Journal of Capital Medical University.2025;46(4):710-717. doi:10.3969/j.issn.1006-7795.2025.04.019

Objective To systematically analyze the changes in clinical indicators including blood leukocytes and neutrophils,liver and kidney functions,coagulation function,lipids,and levels of thyroid hormones and antibodies in Graves'ophthalmopathy(GO)patients who had undergone effective treatment with tocilizumab(TCZ)and to explore their clinical significance.Methods Eighty-five patients with moderately or severely active GO who were effectively treated with TCZ were enrolled.Early morning fasting blood was collected and tested for routine blood,biochemical routine,coagulation function,thyroid hormone and antibodies,and basic information such as gender,age,duration of the disease,history of smoking,comorbidities,and medications were also collected from all patients,so changes in the clinical indicators before and after the treatment could be analyzed and correlation analyses could be carried out.Results Patients with moderately to severely active GO treated with TCZ showed a significant decrease in absolute blood leukocyte and neutrophil values compared with before,and a significant decrease in liver function(alanine transaminase,aspartate aminotransferase,creatinine),cholesterol(total cholesterol,high-density lipoprotein and low-density lipoprotein)levels were significantly higher than before,and concentrations of coagulation parameters[prothrombin time,activated partial thromboplastin time,fibrinogen(FIB)and D-dimer]were significantly decreased.The concentrations of thyroid hormone and thyroid-stimulating hormone levels increased significantly,and the antibody titer of thyrotropin receptor antibody(TRAB)was significantly down-regulated after treatment.TRAB levels were significantly correlated with FIB before treatment.Conclusion Thyroid function and antibody levels improved after TCZ treatment in patients with moderately to severely active GO,but blood leukocytes,liver function and coagulation function changed significantly compared with before.The results of this study confirm the therapeutic effect of TCZ on immune disorders in GO ophthalmopathy,while underscoring the importance of monitoring potential adverse effects in clinical treatment.

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The predictive value of serum β2M level for prognosis in exacerbated COPD and the results of when it is compared with other inflammatory markers

Wenping MAO ; Qian HAN ; Fengwei JIAO ; Jing WANG ; Kewu HUANG

Journal of Capital Medical University.2025;46(4):718-723. doi:10.3969/j.issn.1006-7795.2025.04.020

Objective To investigate the prognostic role of serum beta 2-microglobulin(β2M)as a systemic inflammatory biomarker in hospitalized patients with exacerbation of COPD,compared with other inflammatory biomarkers.Methods We retrospectively analyzed hospitalized patients with exacerbated COPD as the first diagnosis at Beijing Chao-Yang hospital,P.R.China,from December 31,2012 to December 28,2017.Serum β2M levels,laboratory and clinical indexes were measured or collected on admission,and all patients were followed up for 90 days.The prognostic performance of β2M was compared with the neutrophils-lymphocytes ratio(NLR),C-reactive protein values(CRP)and white blood cell(WBC)using MedCalc.Results For 30-day mortality,β2M,NLR,and CRP showed significant predictive value(all P<0.001)and were better than WBC(P=0.044,0.003 and 0.030,respectively)in hospitalized patients with exacerbated COPD,while WBC had no predictive significance.For 90-day mortality,β2M,NLR,CRP,and WBC were all statistically significant,but only NLR outperformed WBC(P=0.004).No significant differences were observed among β2M,NLR,and CRP.Conclusion As a systemic inflammatory biomarker,serum β2M was a useful prognostic biomarker for short-term death in hospitalized patients with COPD exacerbations.It performed slightly better than NLR and CRP for 30-day mortality prediction and slightly superior to CRP and slightly inferior to NLR for 90-day mortality prediction.

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Progresses in the application of autologous platelet-rich concentrate in female fertility remodeling

Jiaojiao CHENG ; Xiangyan RUAN ; Juan DU ; Fengyu JIN ; Muqing GU ; Yanglu LI

Journal of Capital Medical University.2025;46(4):637-643. doi:10.3969/j.issn.1006-7795.2025.04.009

Female infertility is recognized as a global public health issue by the World Health Organization.Female fertility remodeling includes ovarian function reconstruction and uterus/endometrium reconstruction,etc.It is emerging as a hot technology since it is ready to prepare autologous platelet-rich concentrate and it is safer and more acceptable in autologous application.It plays an important role in regenerative medicine,and it is currently widely applied in maxillofacial and plastic surgery,dermatology and other clinical practices.This article mainly reviews the progresses of the application of autologous platelet-rich concentrate in female fertility remodeling.

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Research progress of Piezo mechanosensitive ion channel in overactive bladder

Jiahui SHI

Journal of Capital Medical University.2025;46(4):749-753. doi:10.3969/j.issn.1006-7795.2025.04.025

In order to explore the role of Piezo mechanosensitive ion channel in overactive bladder(OAB),it provides a new idea for the clinical treatment of bladder dysfunction.This paper systematically reviews the importance and characteristics of Piezo1 and Piezo2 in the bladder,including their biophysical properties,localization,and function,with a particular focus on their connection to the pathophysiology of OAB.Although it is still too early to fully uncover the exact mechanism by which the Piezo channel regulates bladder function,altering urination function by inhibiting the Piezo1/2 channel as a new therapeutic strategy for OAB,based on existing research.With the further study of Piezo channel,it will undoubtedly become a potential target and therapeutic strategy for the treatment of OAB.

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