Tuberculosis (TB) is a prominent infectious disease globally that imposes a substantial health burden. Genital TB (GTB), an extrapulmonary manifestation, leads to complications such as tubal adhesions, blockage, and diminished ovarian function, culminating in infertility, and is recognized as a prevalent cause of infertility in nations with high-burden TB. In regions with low TB rates, infertility and active TB during pregnancy have been reported to be most common among female immigrants from countries with high-burden TB. In the context of TB, pregnant women often exhibit exacerbated symptoms after in vitro fertilization-embryo transfer (IVF-ET), heightening the risk of dissemination. Miliary pulmonary TB and tuberculous meningitis pose a serious threat to maternal and fetal health. This article integrates recent epidemiological data and clinical research findings, delineating the impact of TB on infertility and assisted reproduction and particularly focusing on the diagnosis and treatment of GTB, underscored by the imperative of TB screening before IVF-ET. Our objective is to increase awareness among respiratory and reproductive health professionals, promoting multidisciplinary management to enhance clinical vigilance. This approach seeks to provide patients with judicious reproductive plans and scientifically rigorous pregnancy management, thereby mitigating adverse pregnancy outcomes related to TB activity.

Objective:To investigate the incidence rate and development trend of birth defects in offspring after assisted reproductive technology (ART) in Beijing from 2010 to 2019.Methods:The institutions that carry out ART in Beijing were retrospectively investigated. The follow-up outcomes and the incidence of birth defects in a total of 389 978 ART treatment cycles were collected from 8 ART institutions between January 1, 2010 to December 31, 2019.Results:There were 1 367 ART pregnancies with birth defects, and the overall incidence rate was 120.87/10 000. The most common anomalies were malformations of circulatory system. The annual increase in birth defects was slightly higher during the pregnancy loss cycles (108.36%) than during the delivery cycles (103.77%). There was no significant difference in the prevalence of birth defects between artificial insemination (123.15?) and in vitro fertilization technology (105.23? , P=0.097). Conclusion:In recent 10 years, the incidence rate of birth defects in offspring conceived by ART at 8 reproductive centers in Beijing showed an increasing trend. The implementation of the tertiary prevention strategy of birth defects should be further strengthened to reduce the number of newborns with birth defects.

Objective:To explore the curative effect of fertility-preserving therapy for endometrial carcinoma patient with KRAS gene mutation and the choice of pregnancy-assisting strategy. Methods:We reported the fertility-preserving treatment and pregnancy-assisted process of a case of endometrial carcinoma patient with KRAS gene mutation and analyzed the related literatures. Results:After 20 months of treatment with highly effective progestogen and intrauterine levonorgestrel-releasing intrauterine system (LNG-IUS), the patient achieved complete remission. Antagonist plus letrozole was used to induce ovulation. After LNG-IUS was taken out, the pregnancy from blastocyst transfer was achieved after downregulation and artificial cycle, and a live baby girl was born at term.Conclusion:Endometrial carcinoma patient with KRAS gene mutation can achieve complete remission and fertility after combined treatment, but the treatment period is long, therefore, it is necessary to closely monitor changes of the disease.

Objective:To investigate the incidence rate and development trend of birth defects in offspring after assisted reproductive technology (ART) in Beijing from 2010 to 2019.Methods:The institutions that carry out ART in Beijing were retrospectively investigated. The follow-up outcomes and the incidence of birth defects in a total of 389 978 ART treatment cycles were collected from 8 ART institutions between January 1, 2010 to December 31, 2019.Results:There were 1 367 ART pregnancies with birth defects, and the overall incidence rate was 120.87/10 000. The most common anomalies were malformations of circulatory system. The annual increase in birth defects was slightly higher during the pregnancy loss cycles (108.36%) than during the delivery cycles (103.77%). There was no significant difference in the prevalence of birth defects between artificial insemination (123.15?) and in vitro fertilization technology (105.23? , P=0.097). Conclusion:In recent 10 years, the incidence rate of birth defects in offspring conceived by ART at 8 reproductive centers in Beijing showed an increasing trend. The implementation of the tertiary prevention strategy of birth defects should be further strengthened to reduce the number of newborns with birth defects.

Objective:To explore the curative effect of fertility-preserving therapy for endometrial carcinoma patient with KRAS gene mutation and the choice of pregnancy-assisting strategy. Methods:We reported the fertility-preserving treatment and pregnancy-assisted process of a case of endometrial carcinoma patient with KRAS gene mutation and analyzed the related literatures. Results:After 20 months of treatment with highly effective progestogen and intrauterine levonorgestrel-releasing intrauterine system (LNG-IUS), the patient achieved complete remission. Antagonist plus letrozole was used to induce ovulation. After LNG-IUS was taken out, the pregnancy from blastocyst transfer was achieved after downregulation and artificial cycle, and a live baby girl was born at term.Conclusion:Endometrial carcinoma patient with KRAS gene mutation can achieve complete remission and fertility after combined treatment, but the treatment period is long, therefore, it is necessary to closely monitor changes of the disease.

Objective:To explore the economical and effective strategies for patients treated with intrauterine insemination (IUI).Methods:We retrospectively analyzed in a cohort study the clinical data of the first IUI cycle of 2266 couples who were treated from January 1, 2020 to December 31, 2020 in Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital. According to the times of insemination in one IUI treatment cycle, patients were divided into two groups: single IUI group (2158 cycles) and double IUI group (108 cycles). The differences in clinical pregnancy rate and cost-effectiveness were analyzed. According to the whether treated with ovulation induction and ovulation induction medicines, patients were divided into two groups: natural cycle group (1163 cycles) and ovulation induction cycle group (1103 cycles). The ovulation induction cycle group were further divided into three subgroups according to ovulation induction medicines: clomiphene (CC)/CC+human menopausal gonadotropin (hMG) subgroup ( n=324), letrozole (LE)/LE+hMG subgroup ( n=670) and hMG subgroup ( n=109). IUI outcomes were compared and analyzed in these groups. Results:1) There were no significant differences in age, body mass index (BMI), duration of infertility, endometrial thickness and clinical pregnancy rate between single IUI group and double IUI group (all P>0.05). The medical expenses of the double IUI group was significantly higher than that of the single IUI group [(1 786.06±173.80) yuan vs. (3 172.99±174.91) yuan, P<0.001]. 2) There was no statistically significant difference in the clinical pregnancy rate between single IUI and double IUI group with female factor, male factor, unexplained infertility, natural cycle and ovulation induction cycle (all P>0.05). For single IUI, there was a significant difference in the clinical pregnancy rate among the three different causes of infertility ( P=0.012), and the difference between the female infertility and the unknown cause of infertility was statistically significant ( P=0.003). For double IUI, there was no significant difference in the clinical pregnancy rate among the three groups ( P=0.477). The clinical pregnancy rate of ovulation induction cycle [14.0% (145/1039)] was higher than that of natural cycle [7.8% (87/1119), P<0.001]. There was no significant difference in clinical pregnancy rate between ovulation induction cycle group and natural cycle group in patients with double IUI ( P=0.774). 3) After ovulation induction, the clinical pregnancy rates of CC/CC+hMG and LE/LE+hMG subgroups [13.9% (45/324),14.6% (98/670)] were significantly higher than that of the natural cycle group [7.9% (92/1163); P=0.001, P<0.001]. Ovulation induction with CC/CC+hMG or LE/LE+hMG was an independent factor improving the clinical pregnancy rate of IUI by multivariate logistic regression analysis [ OR(95% CI)=1.794(1.216-2.647), P=0.003; OR(95% CI)=1.892(1.382-2.589), P<0.001]. Conclusion:Double IUI had similar clinical pregnancy rate with the single IUI, but the treatment cost was higher. So the double IUI is not recommended. Ovulation induction therapy could improve the clinical pregnancy rate. Ovulation induction with LE/LE+hMG had the highest clinical pregnancy rate and good security as well.

Objective:To explore the economical and effective strategies for patients treated with intrauterine insemination (IUI).Methods:We retrospectively analyzed in a cohort study the clinical data of the first IUI cycle of 2266 couples who were treated from January 1, 2020 to December 31, 2020 in Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital. According to the times of insemination in one IUI treatment cycle, patients were divided into two groups: single IUI group (2158 cycles) and double IUI group (108 cycles). The differences in clinical pregnancy rate and cost-effectiveness were analyzed. According to the whether treated with ovulation induction and ovulation induction medicines, patients were divided into two groups: natural cycle group (1163 cycles) and ovulation induction cycle group (1103 cycles). The ovulation induction cycle group were further divided into three subgroups according to ovulation induction medicines: clomiphene (CC)/CC+human menopausal gonadotropin (hMG) subgroup ( n=324), letrozole (LE)/LE+hMG subgroup ( n=670) and hMG subgroup ( n=109). IUI outcomes were compared and analyzed in these groups. Results:1) There were no significant differences in age, body mass index (BMI), duration of infertility, endometrial thickness and clinical pregnancy rate between single IUI group and double IUI group (all P>0.05). The medical expenses of the double IUI group was significantly higher than that of the single IUI group [(1 786.06±173.80) yuan vs. (3 172.99±174.91) yuan, P<0.001]. 2) There was no statistically significant difference in the clinical pregnancy rate between single IUI and double IUI group with female factor, male factor, unexplained infertility, natural cycle and ovulation induction cycle (all P>0.05). For single IUI, there was a significant difference in the clinical pregnancy rate among the three different causes of infertility ( P=0.012), and the difference between the female infertility and the unknown cause of infertility was statistically significant ( P=0.003). For double IUI, there was no significant difference in the clinical pregnancy rate among the three groups ( P=0.477). The clinical pregnancy rate of ovulation induction cycle [14.0% (145/1039)] was higher than that of natural cycle [7.8% (87/1119), P<0.001]. There was no significant difference in clinical pregnancy rate between ovulation induction cycle group and natural cycle group in patients with double IUI ( P=0.774). 3) After ovulation induction, the clinical pregnancy rates of CC/CC+hMG and LE/LE+hMG subgroups [13.9% (45/324),14.6% (98/670)] were significantly higher than that of the natural cycle group [7.9% (92/1163); P=0.001, P<0.001]. Ovulation induction with CC/CC+hMG or LE/LE+hMG was an independent factor improving the clinical pregnancy rate of IUI by multivariate logistic regression analysis [ OR(95% CI)=1.794(1.216-2.647), P=0.003; OR(95% CI)=1.892(1.382-2.589), P<0.001]. Conclusion:Double IUI had similar clinical pregnancy rate with the single IUI, but the treatment cost was higher. So the double IUI is not recommended. Ovulation induction therapy could improve the clinical pregnancy rate. Ovulation induction with LE/LE+hMG had the highest clinical pregnancy rate and good security as well.

Inflammatory bowel disease (IBD) is more common in young and middle-aged people and they face the problems of childbirth and eugenics. Therefore, the evaluation of fertility in patients with IBD is important to guide pregnancy and fertility. This article reviews the common indicators of fertility evaluation and the changes of fertility in patients with IBD. It is recommended to evaluate the fertility of women and men before pregnancy if it is necessary, especially to evaluate the disease activity and medications. Multidisciplinary team (MDT) consultation including departments of gastroenterology, surgery, obstetrics and gynecology, reproductive medicine and andrology should be carried out when conditions permit, so as to increase pregnancy success rate, reduce pregnancy complications and pregnancy loss rates, achieve safe and rational use of medication and the goal of eugenics.

Inflammatory bowel disease (IBD) is more common in young and middle-aged people and they face the problems of childbirth and eugenics. Therefore, the evaluation of fertility in patients with IBD is important to guide pregnancy and fertility. This article reviews the common indicators of fertility evaluation and the changes of fertility in patients with IBD. It is recommended to evaluate the fertility of women and men before pregnancy if it is necessary, especially to evaluate the disease activity and medications. Multidisciplinary team (MDT) consultation including departments of gastroenterology, surgery, obstetrics and gynecology, reproductive medicine and andrology should be carried out when conditions permit, so as to increase pregnancy success rate, reduce pregnancy complications and pregnancy loss rates, achieve safe and rational use of medication and the goal of eugenics.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult