OBJECTIVE To investigate the application and influencing factors of sodium-dependent glucose transporters 2 inhibitors（SGLT-2i） in patients with heart failure with preserved ejection fraction（HFpEF） in the real world. METHODS Data from 358 patients with HFpEF who were hospitalized at the First Affiliated Hospital of Chongqing Medical University from May 2023 to May 2024 were retrospectively collected. The patients were divided into the SGLT-2i group and the non-SGLT-2i group based on whether they were prescribed SGLT-2i upon discharge. Baseline characteristics， comorbidities， and differences in drug treatment were compared between the two groups. Based on univariate analysis， multivariate Logistic regression analysis was performed to identify independent influencing factors of SGLT-2i use in patients with HFpEF， followed by further stratified analysis. RESULTS Among 358 HFpEF patients， the overall utilization rate of SGLT-2i was 33.5%. Combined with type 2 diabetes [OR＝9.063，95%CI（4.924-16.679） ] ， atrial fibrillation [OR＝3.135，95%CI（1.590-6.178） ] ， coronary artery heart disease [OR＝1.888，95%CI（1.072-3.327） ] and the use of loop diuretics [OR＝3.822， 95%CI （1.588-9.200） ] were all independent influencing factors for the use of SGLT-2i in patients with HFpEF （ P ＜0.05）. The results of the stratified descriptive analysis were consistent with those of the multivariate analysis， showing a higher utilization rate of SGLT-2i among patients with concomitant T2DM，atrial fibrillation， coronary artery heart disease， and those receiving loop diuretics （ P ＜0.05）； whereas the utilization rate of SGLT-2i was comparable across patients with different levels of renal function （ P ＞0.05）. CONCLUSIONS In the real-world clinical practice， the utilization of SGLT-2i in patients with HFpEF remains suboptimal， and treatment coverage still needs to be improved. Their use of SGLT-2i is primarily influenced by the presence of type 2 diabetes， atrial fibrillation， coronary artery heart disease， and the use of loop diuretics.

Objective:To evaluate the efficacy of cyclophosphamide in patients with T-cell large granular lymphocytic leukemia (T-LGLL) and the maintenance of treatment-free remission (TFR) following drug discontinuation.Methods:Clinical data were collected from 37 patients with T-LGLL who received oral cyclophosphamide at the Regenerative Medicine Clinic of the Institute of Hematology and Blood Diseases Hospital between June 2019 and March 2024. Patient clinical characteristics, treatment efficacy, and long-term TFR were analyzed.Results:The median age of the 37 patients was 60 years (range: 37-86), and 22 (59.5%) were male. Anemia was observed in 30 patients (81.1%), and 28 (75.7%) met the diagnostic criteria for secondary pure red cell aplasia. Neutropenia occurred in 15 patients (40.5%), lymphocytosis in 11 (29.7%), and thrombocytopenia in three (8.1%). Sixteen patients (43.2%) had not received prior immunosuppressive therapy (treatment-naive group), while 21 patients (56.8%) were refractory to or had relapsed after immunosuppressive treatment (refractory/relapsed group). All patients met the treatment criteria and received oral cyclophosphamide at doses of 50-100 mg/day. Among the 36 evaluable patients, hematologic remission was achieved in 25 (69.4%), with a median time of 2.0 months (range: 0.7-7.0). There was no statistically significant difference in remission rates between the treatment-naive and refractory/relapsed groups (68.5% vs. 66.7%, P=0.589). Among the 25 patients who achieved hematologic remission, 24 discontinued cyclophosphamide. With a median follow-up of 39.0 months (range: 8.0-56.0), the median TFR duration was not reached. The estimated TFR rates were (90.87± 6.16) % at 12 months and (75.72±11.04) % at 36 months. No significant difference in TFR was observed between the treatment-naive and refractory/relapsed groups ( P=0.451) . Conclusion:Oral cyclophosphamide is effective in the treatment of T-LGLL, and patients may maintain long-term TFR following drug discontinuation.

Objective:To evaluate the efficacy of cyclophosphamide in patients with T-cell large granular lymphocytic leukemia (T-LGLL) and the maintenance of treatment-free remission (TFR) following drug discontinuation.Methods:Clinical data were collected from 37 patients with T-LGLL who received oral cyclophosphamide at the Regenerative Medicine Clinic of the Institute of Hematology and Blood Diseases Hospital between June 2019 and March 2024. Patient clinical characteristics, treatment efficacy, and long-term TFR were analyzed.Results:The median age of the 37 patients was 60 years (range: 37-86), and 22 (59.5%) were male. Anemia was observed in 30 patients (81.1%), and 28 (75.7%) met the diagnostic criteria for secondary pure red cell aplasia. Neutropenia occurred in 15 patients (40.5%), lymphocytosis in 11 (29.7%), and thrombocytopenia in three (8.1%). Sixteen patients (43.2%) had not received prior immunosuppressive therapy (treatment-naive group), while 21 patients (56.8%) were refractory to or had relapsed after immunosuppressive treatment (refractory/relapsed group). All patients met the treatment criteria and received oral cyclophosphamide at doses of 50-100 mg/day. Among the 36 evaluable patients, hematologic remission was achieved in 25 (69.4%), with a median time of 2.0 months (range: 0.7-7.0). There was no statistically significant difference in remission rates between the treatment-naive and refractory/relapsed groups (68.5% vs. 66.7%, P=0.589). Among the 25 patients who achieved hematologic remission, 24 discontinued cyclophosphamide. With a median follow-up of 39.0 months (range: 8.0-56.0), the median TFR duration was not reached. The estimated TFR rates were (90.87± 6.16) % at 12 months and (75.72±11.04) % at 36 months. No significant difference in TFR was observed between the treatment-naive and refractory/relapsed groups ( P=0.451) . Conclusion:Oral cyclophosphamide is effective in the treatment of T-LGLL, and patients may maintain long-term TFR following drug discontinuation.

Objective:To investigate the relationship between serum estradiol(E2)levels on the day before transcervical resection of adhesion(TCRA)and pregnancy outcomes in moderate-severe intrauterine adhesion(IUA).Methods:Clinical data of patients with moderate-severe IUA diagnosed and received TCRA in the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2019 were extracted and ana-lyzed.The primary outcome indicator was the pregnancy rate during the 12-month follow-up period.Multiple re-gression analysis,smoothed curve fitting and recursive algorithm analysis were applied in this study.Results:A-mong the 288 patients who met the inclusion criteria,222 met the criteria and were finally included in the analysis.The results of multiple regression analysis showed that the E 2 level on the day before surgery was negatively cor-related with the pregnancy rate after TCRA(aOR 0.77,95% CI 0.63-0.93,P=0.0074).Recursive algorithm a-nalysis showed that when the preoperative serum E2 level was less than 380.6 pmol/L,for every increase of 36.7 pmol/L pregnancy rate decreased by approximately 20% (aOR 0.78,95% CI 0.67-0.89,P=0.0004).Conclusions:The results suggest that preoperative serum E2 levels are negatively associated with pregnancy outcomes in patients with moderate-to-severe IUA.

Objective:To investigate the relationship between serum estradiol(E2)levels on the day before transcervical resection of adhesion(TCRA)and pregnancy outcomes in moderate-severe intrauterine adhesion(IUA).Methods:Clinical data of patients with moderate-severe IUA diagnosed and received TCRA in the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2019 were extracted and ana-lyzed.The primary outcome indicator was the pregnancy rate during the 12-month follow-up period.Multiple re-gression analysis,smoothed curve fitting and recursive algorithm analysis were applied in this study.Results:A-mong the 288 patients who met the inclusion criteria,222 met the criteria and were finally included in the analysis.The results of multiple regression analysis showed that the E 2 level on the day before surgery was negatively cor-related with the pregnancy rate after TCRA(aOR 0.77,95% CI 0.63-0.93,P=0.0074).Recursive algorithm a-nalysis showed that when the preoperative serum E2 level was less than 380.6 pmol/L,for every increase of 36.7 pmol/L pregnancy rate decreased by approximately 20% (aOR 0.78,95% CI 0.67-0.89,P=0.0004).Conclusions:The results suggest that preoperative serum E2 levels are negatively associated with pregnancy outcomes in patients with moderate-to-severe IUA.

Objective:To investigate the relationship between serum estradiol(E2)levels on the day before transcervical resection of adhesion(TCRA)and pregnancy outcomes in moderate-severe intrauterine adhesion(IUA).Methods:Clinical data of patients with moderate-severe IUA diagnosed and received TCRA in the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2019 were extracted and ana-lyzed.The primary outcome indicator was the pregnancy rate during the 12-month follow-up period.Multiple re-gression analysis,smoothed curve fitting and recursive algorithm analysis were applied in this study.Results:A-mong the 288 patients who met the inclusion criteria,222 met the criteria and were finally included in the analysis.The results of multiple regression analysis showed that the E 2 level on the day before surgery was negatively cor-related with the pregnancy rate after TCRA(aOR 0.77,95% CI 0.63-0.93,P=0.0074).Recursive algorithm a-nalysis showed that when the preoperative serum E2 level was less than 380.6 pmol/L,for every increase of 36.7 pmol/L pregnancy rate decreased by approximately 20% (aOR 0.78,95% CI 0.67-0.89,P=0.0004).Conclusions:The results suggest that preoperative serum E2 levels are negatively associated with pregnancy outcomes in patients with moderate-to-severe IUA.

Objective:To investigate the relationship between serum estradiol(E2)levels on the day before transcervical resection of adhesion(TCRA)and pregnancy outcomes in moderate-severe intrauterine adhesion(IUA).Methods:Clinical data of patients with moderate-severe IUA diagnosed and received TCRA in the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2019 were extracted and ana-lyzed.The primary outcome indicator was the pregnancy rate during the 12-month follow-up period.Multiple re-gression analysis,smoothed curve fitting and recursive algorithm analysis were applied in this study.Results:A-mong the 288 patients who met the inclusion criteria,222 met the criteria and were finally included in the analysis.The results of multiple regression analysis showed that the E 2 level on the day before surgery was negatively cor-related with the pregnancy rate after TCRA(aOR 0.77,95% CI 0.63-0.93,P=0.0074).Recursive algorithm a-nalysis showed that when the preoperative serum E2 level was less than 380.6 pmol/L,for every increase of 36.7 pmol/L pregnancy rate decreased by approximately 20% (aOR 0.78,95% CI 0.67-0.89,P=0.0004).Conclusions:The results suggest that preoperative serum E2 levels are negatively associated with pregnancy outcomes in patients with moderate-to-severe IUA.

Objective:To investigate the relationship between serum estradiol(E2)levels on the day before transcervical resection of adhesion(TCRA)and pregnancy outcomes in moderate-severe intrauterine adhesion(IUA).Methods:Clinical data of patients with moderate-severe IUA diagnosed and received TCRA in the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2019 were extracted and ana-lyzed.The primary outcome indicator was the pregnancy rate during the 12-month follow-up period.Multiple re-gression analysis,smoothed curve fitting and recursive algorithm analysis were applied in this study.Results:A-mong the 288 patients who met the inclusion criteria,222 met the criteria and were finally included in the analysis.The results of multiple regression analysis showed that the E 2 level on the day before surgery was negatively cor-related with the pregnancy rate after TCRA(aOR 0.77,95% CI 0.63-0.93,P=0.0074).Recursive algorithm a-nalysis showed that when the preoperative serum E2 level was less than 380.6 pmol/L,for every increase of 36.7 pmol/L pregnancy rate decreased by approximately 20% (aOR 0.78,95% CI 0.67-0.89,P=0.0004).Conclusions:The results suggest that preoperative serum E2 levels are negatively associated with pregnancy outcomes in patients with moderate-to-severe IUA.

Objective:To investigate the relationship between serum estradiol(E2)levels on the day before transcervical resection of adhesion(TCRA)and pregnancy outcomes in moderate-severe intrauterine adhesion(IUA).Methods:Clinical data of patients with moderate-severe IUA diagnosed and received TCRA in the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2019 were extracted and ana-lyzed.The primary outcome indicator was the pregnancy rate during the 12-month follow-up period.Multiple re-gression analysis,smoothed curve fitting and recursive algorithm analysis were applied in this study.Results:A-mong the 288 patients who met the inclusion criteria,222 met the criteria and were finally included in the analysis.The results of multiple regression analysis showed that the E 2 level on the day before surgery was negatively cor-related with the pregnancy rate after TCRA(aOR 0.77,95% CI 0.63-0.93,P=0.0074).Recursive algorithm a-nalysis showed that when the preoperative serum E2 level was less than 380.6 pmol/L,for every increase of 36.7 pmol/L pregnancy rate decreased by approximately 20% (aOR 0.78,95% CI 0.67-0.89,P=0.0004).Conclusions:The results suggest that preoperative serum E2 levels are negatively associated with pregnancy outcomes in patients with moderate-to-severe IUA.

Objective:To investigate the relationship between serum estradiol(E2)levels on the day before transcervical resection of adhesion(TCRA)and pregnancy outcomes in moderate-severe intrauterine adhesion(IUA).Methods:Clinical data of patients with moderate-severe IUA diagnosed and received TCRA in the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2019 were extracted and ana-lyzed.The primary outcome indicator was the pregnancy rate during the 12-month follow-up period.Multiple re-gression analysis,smoothed curve fitting and recursive algorithm analysis were applied in this study.Results:A-mong the 288 patients who met the inclusion criteria,222 met the criteria and were finally included in the analysis.The results of multiple regression analysis showed that the E 2 level on the day before surgery was negatively cor-related with the pregnancy rate after TCRA(aOR 0.77,95% CI 0.63-0.93,P=0.0074).Recursive algorithm a-nalysis showed that when the preoperative serum E2 level was less than 380.6 pmol/L,for every increase of 36.7 pmol/L pregnancy rate decreased by approximately 20% (aOR 0.78,95% CI 0.67-0.89,P=0.0004).Conclusions:The results suggest that preoperative serum E2 levels are negatively associated with pregnancy outcomes in patients with moderate-to-severe IUA.