To review the clinical characteristics, short-term outcomes, and risk factors of patients with infective endocarditis(IE) who underwent surgical treatment at a single center, and to summarize treatment experience.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.

Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.