Objective To analyze the risk factors for acute kidney injury(AKI)in patients with acute non-variceal upper gastrointestinal bleeding(ANVUGIB)and establish a prediction model.Methods A total of 286 ANVUGIB patients admitted to our hospital from August 2021 to August 2024 were enrolled.Patients were divided into an observation group(with AKI,n=43)and a control group(without AKI,n=243).The influencing factors for AKI in ANVUGIB patients were analyzed,and a nomogram prediction model was con-structed to evaluate its predictive efficacy.Results Among 286 ANVUGIB patients,43 cases(15.03%)de-veloped AKI.Logistic regression analysis showed that platelet count had no significant effect on AKI compli-cation in ANVUGIB(P>0.05).Hemoglobin,albumin,and sodium were independent protective factors for AKI complication(P<0.05),while comorbid coronary heart disease,bleeding volume,blood transfusion,and risk grade were independent risk factors(P<0.05).The nomogram prediction model for AKI complication in ANVUGIB demonstrated good fit in the Hosmer-Lemeshow test.ROC curve analysis revealed an AUC of 0.908(95%CI:0.868 to 0.939),with a sensitivity of 83.72%and specificity of 84.77%.The calibration curve showed a Brier score of 0.075 and calibration slope of 0.808,indicating good calibration.Conclusion Comorbid coro-nary heart disease,bleeding volume,blood transfusion,risk grade,hemoglobin,albumin,and sodium are signif-icant influencing factors for AKI complication in ANVUGIB.The nomogram model based on these factors shows favorable predictive performance and serves as a reliable tool for AKI risk stratification in ANVUGIB patients,supporting early clinical intervention decisions.

Objective:To investigate the effect of luteinizing hormone (LH) levels on the clinical outcome and cumulative live birth rate of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) fresh embryo transfer in patients with normal ovarian reserve function after application of a flexible protocol of gonadotropin-releasing hormone antagonist (GnRH-A) to promote ovulation with the addition of GnRH-A. Methods:A retrospective cohort study was conducted to analyze the data of 685 patients with normal ovarian reserve function who underwent IVF/ICSI after ovulation induction with antagonist flexible regimen between January 2016 and June 2021 at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University. The quartile method was used to group patients after the addition of the antagonist by the mean value of serum LH each time they were monitored (usually twice, depending on the rate of follicular growth and patients' need) until the day of the trigger, and were divided into group A (smaller than the 25th percentile of the mean LH level of the included population, LH<1.25 U/L, n=166), group B (in the 25th to 50th percentile of the mean LH level of the included population, 1.25 U/L≤LH<1.91 U/L, n=174), group C (in the 50th to 75th percentile of the mean LH level of the included population, 1.91 U/L≤LH<2.85 U/L, n=171), and group D (greater than the 75th percentile of the mean LH level of the included population, 2.85 U/L≤LH≤7.55 U/L, n=174). The general condition, clinical data, embryo laboratory indices, clinical outcome indices of fresh embryo transfer cycle and cumulative live birth rate were compared among the 4 groups. Results:After correcting for confounding factors by multifactorial linear regression, the number of high-quality embryos and the rate of blastocyst formation of patients in group C were significantly higher than those in group A, and the differences were statistically significant ( B=0.600, 95% CI: 0.086-1.114, P=0.022; B=0.134, 95% CI: 0.052-0.216, P=0.001). The number of high-quality embryos, the number of available embryos, and the rate of blastocyst formation of patients in group D were significantly higher than those in group A, and the differences were statistically significant ( B=0.771, 95% CI: 0.259-1.284, P=0.003; B=0.730, 95% CI: 0.205-1.255, P=0.007; B=0.085, 95% CI: 0.003-0.167, P=0.042).After multifactorial logistic regression, there was no statistically significant difference in live birth rate between group A and groups B, C and D ( P>0.05). The cumulative live birth rate of patients in group D was significantly higher than that in group A, and the difference was statistically significant ( aOR=2.439, 95% CI: 1.169-4.974, P=0.014). Conclusion:In patients with normal ovarian reserve function, a flexible protocol of antagonists was applied to promote ovulation, and the addition of antagonists had no significant effect on the clinical outcome of the fresh embryo transfer cycle in terms of mean LH levels, but the quality of the embryos was significantly reduced when the mean LH level was <1.25 U/L, and this may consequently reduce the developmental potential of the embryos and the cumulative live birth rate.

Objective:To investigate the effect of luteinizing hormone (LH) levels on the clinical outcome and cumulative live birth rate of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) fresh embryo transfer in patients with normal ovarian reserve function after application of a flexible protocol of gonadotropin-releasing hormone antagonist (GnRH-A) to promote ovulation with the addition of GnRH-A. Methods:A retrospective cohort study was conducted to analyze the data of 685 patients with normal ovarian reserve function who underwent IVF/ICSI after ovulation induction with antagonist flexible regimen between January 2016 and June 2021 at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University. The quartile method was used to group patients after the addition of the antagonist by the mean value of serum LH each time they were monitored (usually twice, depending on the rate of follicular growth and patients' need) until the day of the trigger, and were divided into group A (smaller than the 25th percentile of the mean LH level of the included population, LH<1.25 U/L, n=166), group B (in the 25th to 50th percentile of the mean LH level of the included population, 1.25 U/L≤LH<1.91 U/L, n=174), group C (in the 50th to 75th percentile of the mean LH level of the included population, 1.91 U/L≤LH<2.85 U/L, n=171), and group D (greater than the 75th percentile of the mean LH level of the included population, 2.85 U/L≤LH≤7.55 U/L, n=174). The general condition, clinical data, embryo laboratory indices, clinical outcome indices of fresh embryo transfer cycle and cumulative live birth rate were compared among the 4 groups. Results:After correcting for confounding factors by multifactorial linear regression, the number of high-quality embryos and the rate of blastocyst formation of patients in group C were significantly higher than those in group A, and the differences were statistically significant ( B=0.600, 95% CI: 0.086-1.114, P=0.022; B=0.134, 95% CI: 0.052-0.216, P=0.001). The number of high-quality embryos, the number of available embryos, and the rate of blastocyst formation of patients in group D were significantly higher than those in group A, and the differences were statistically significant ( B=0.771, 95% CI: 0.259-1.284, P=0.003; B=0.730, 95% CI: 0.205-1.255, P=0.007; B=0.085, 95% CI: 0.003-0.167, P=0.042).After multifactorial logistic regression, there was no statistically significant difference in live birth rate between group A and groups B, C and D ( P>0.05). The cumulative live birth rate of patients in group D was significantly higher than that in group A, and the difference was statistically significant ( aOR=2.439, 95% CI: 1.169-4.974, P=0.014). Conclusion:In patients with normal ovarian reserve function, a flexible protocol of antagonists was applied to promote ovulation, and the addition of antagonists had no significant effect on the clinical outcome of the fresh embryo transfer cycle in terms of mean LH levels, but the quality of the embryos was significantly reduced when the mean LH level was <1.25 U/L, and this may consequently reduce the developmental potential of the embryos and the cumulative live birth rate.

Objective:To investigate the composition of the renal disease spectrum and epidemiological characterisics for renal biopsy cases in Xinjiang Uygur Autonomous Region.Methods:The clinical and pathological data of 10 684 renal biopsy cases from 12 hospitals in Xinjiang Uygur Autonomous Region from August 1986 to December 2019 were collected and the composition of renal diseases and pathological types were analyzed retrospectively.Results:Among the 10 684 renal biopsy cases with 5 595 males and 5 089 females, 7 804 cases (73.04%) were Han nationality, 2 357 cases (22.06%) were Uygur nationality and 523 cases (4.90%) were other nationalities. Among the 10 684 cases of renal biopsy, primary glomerular disease, secondary glomerular disease, tubulointerstitial disease, end-stage renal disease, genetic and congenital disease and post transplant glomerular disease were 8 533 cases (79.87%), 1 740 cases (16.29%), 229 cases (2.14%), 121 cases (1.13%), 46 cases (0.43%) and 15 cases (0.14%), respectively. The distribution of kidney diseases in Han, Uygur and other nationalities (except Han and Uygur in this region) was the same as that in general. There was no significant difference in disease type composition between Han and Uygur, Han and other nationalities, and Uygur and other nationalities (all P>0.05). Among the 8 533 cases of primary glomerular diseases, the top five pathological types were IgA nephropathy (3 095 cases, 36.27%), mesangial proliferative glomerulonephritis (2 008 cases, 23.53%), membranous nephropathy (1 503 cases, 17.61%), minimal glomerulopathy (567 cases, 6.64%) and focal segmental glomerulosclerosis (494 cases, 5.79%). The top five pathological types of primary glomerular diseases were different between Han and Uygur, and Han and other nationalities (both P<0.01). There was no statistically significant difference between Uygur and other nationalities in the top five pathological types of primary glomerular diseases ( P=0.113). Among 1 740 cases of secondary glomerular diseases, the top five pathological types were lupus nephritis (517 cases, 29.71%), Henoch-Sch?nlein purpura nephritis (304 cases, 17.47%), diabetic glomerulosclerosis (285 cases, 16.38%), benign renal arteriosclerosis (196 cases, 11.26%) and systemic vasculitis (101 cases, 5.80%). It was different between Han and Uygur, Han and other nationalities, and Uygur and other nationalities in the top five pathological types of secondary glomerular diseases. Conclusions:Primary glomerular disease accounts for 79.87% of renal diseases in Xinjiang Uygur Autonomous Region. IgA nephropathy is the main pathological type, followed by mesangial proliferative glomerulonephritis and membranous nephropathy. The most common pathological type of secondary glomerular disease in this region is lupus nephritis, followed by Henoch-Sch?nlein purpura nephritis and diabetic glomerulosclerosis. The top five pathological types of primary glomerular diseases and secondary glomerular diseases are different in different ethnic groups in Xinjiang Uygur Autonomous Region.