Objective:To analyze the effects of biodegradable-polymer sirolimus-eluting stents (BP-SES) and durable polymer sirolimus-eluting stents (DP-SES) implantation on serum endothelin 1 levels and the incidence of coronary restenosis in patients with coronary heart disease (CHD).Methods:A total of 114 patients with CHD admitted to the First People's Hospital of Xianyang in Shaanxi Province from May 2022 to January 2024 were selected. According to the principle of comparable baseline characteristics between groups, patients were divided into two groups by random number table method, with 57 cases in each group. After pretreatment of diseased vessels, DP-SES group underwent implantation of DP-SES with appropriate length and diameter, while BP-SES group underwent implantation of BP-SES with appropriate length and diameter. After implantation, non-compliant balloons were used for in-stent post-dilation. Comparisons of vascular endothelial function, levels of inflammatory factors and hemodynamic indicators before operation and at 6 months between groups were made postoperatively, also, the incidence rates of major adverse cardiovascular events (MACE) and coronary restenosis within 6 months were also compared. Measurement data with normal distribution was expressed as “xˉ±s”, independent sample t-test was used on comparison between groups, paired t-test was used for intra-group comparisons before and after treatment. Counting data was expressed as rate or composition ratio, χ2 test was used on comparison between groups. Results:At 6 months after surgery, the levels of endothelin 1 and VEGF were lower in BP-SES group compared to DP-SES group,[(72±5) ng/L vs. (77±7) ng/L, (147±25) ng/L vs. (157±27) ng/L, t=3.76, P<0.001, t=2.16, P=0.033]. The level of nitric oxide was higher in BP-SES group compared to DP-SES group [(79±7) μmol/L vs. (76±8) μmol/L, t=2.46, P<0.001]. At 6 months after surgery, the levels of TNF-α, IL-1 and CRP in DP-SES group were higher than those before surgery, and were all higher compared to BP-SES group[(81±5) ng/L vs. (75±5) ng/L, (159±18) ng/L vs. (151±16) ng/L, (31±4) mg/L vs. (29±3) mg/L, t=6.87, P<0.001, t=2.24, P=0.027, t=2.51, P=0.014]. At 6 months after surgery, the level of whole blood viscosity and plasma viscosity in both group were lower than those before surgery, and the level of Hct in BP-SES group was lower than those before surgery, the differences were statistically significant ( P<0.001), while the differences between groups were not statistically significant( P>0.05). The difference of incidence rates of MACE and coronary restenosis within 6 months between groups before surgery and 6 months after surgery were not statistically significant [7.0%(4/57) vs. 12.3%(7/57), χ2=0.91, P=0.341; 3.7%(2/57) vs. 8.3%(5/57), χ2=0.61, P=0.443]. Conclusion:Both BP-SES implantation and DP-SES implantation could effectively restore coronary blood supply, and are highly safe. However, the former can reduce damage to vascular wall and better improve endothelial function in patients.

Objective:To analyze the effects of biodegradable-polymer sirolimus-eluting stents (BP-SES) and durable polymer sirolimus-eluting stents (DP-SES) implantation on serum endothelin 1 levels and the incidence of coronary restenosis in patients with coronary heart disease (CHD).Methods:A total of 114 patients with CHD admitted to the First People's Hospital of Xianyang in Shaanxi Province from May 2022 to January 2024 were selected. According to the principle of comparable baseline characteristics between groups, patients were divided into two groups by random number table method, with 57 cases in each group. After pretreatment of diseased vessels, DP-SES group underwent implantation of DP-SES with appropriate length and diameter, while BP-SES group underwent implantation of BP-SES with appropriate length and diameter. After implantation, non-compliant balloons were used for in-stent post-dilation. Comparisons of vascular endothelial function, levels of inflammatory factors and hemodynamic indicators before operation and at 6 months between groups were made postoperatively, also, the incidence rates of major adverse cardiovascular events (MACE) and coronary restenosis within 6 months were also compared. Measurement data with normal distribution was expressed as “xˉ±s”, independent sample t-test was used on comparison between groups, paired t-test was used for intra-group comparisons before and after treatment. Counting data was expressed as rate or composition ratio, χ2 test was used on comparison between groups. Results:At 6 months after surgery, the levels of endothelin 1 and VEGF were lower in BP-SES group compared to DP-SES group,[(72±5) ng/L vs. (77±7) ng/L, (147±25) ng/L vs. (157±27) ng/L, t=3.76, P<0.001, t=2.16, P=0.033]. The level of nitric oxide was higher in BP-SES group compared to DP-SES group [(79±7) μmol/L vs. (76±8) μmol/L, t=2.46, P<0.001]. At 6 months after surgery, the levels of TNF-α, IL-1 and CRP in DP-SES group were higher than those before surgery, and were all higher compared to BP-SES group[(81±5) ng/L vs. (75±5) ng/L, (159±18) ng/L vs. (151±16) ng/L, (31±4) mg/L vs. (29±3) mg/L, t=6.87, P<0.001, t=2.24, P=0.027, t=2.51, P=0.014]. At 6 months after surgery, the level of whole blood viscosity and plasma viscosity in both group were lower than those before surgery, and the level of Hct in BP-SES group was lower than those before surgery, the differences were statistically significant ( P<0.001), while the differences between groups were not statistically significant( P>0.05). The difference of incidence rates of MACE and coronary restenosis within 6 months between groups before surgery and 6 months after surgery were not statistically significant [7.0%(4/57) vs. 12.3%(7/57), χ2=0.91, P=0.341; 3.7%(2/57) vs. 8.3%(5/57), χ2=0.61, P=0.443]. Conclusion:Both BP-SES implantation and DP-SES implantation could effectively restore coronary blood supply, and are highly safe. However, the former can reduce damage to vascular wall and better improve endothelial function in patients.

Objective:To explore the impact of severe ovarian hyperstimulation syndrome (OHSS) after fresh embryo transfer on the maternal and neonatal outcomes of patients.Methods:A respective cohort study was performed. Totally 155 patients with severe OHSS (OHSS group) treated in the Department of Obstetrics and Gynecology of Chongqing Health Center for Women and Children and received fresh embryo transfer in the Reproductive Center from January 2018 to December 2018 were selected, and 366 clinical pregnant patients without OHSS after transplantation served as control group (non-OHSS group). According to Mathur's OHSS time classification standard, OHSS patients were divided into early-onset subgroup, occurring within 9 d (including 9 d) after oocytes retrieved, and late-onset subgroup, occurring within 10 d or more after oocytes retrieved; according to the number of pregnancies, patients were divided into singleton subgroup and twin subgroup. The differences in maternal and neonatal outcomes (primary indicators) and clinical indicators (secondary indicators) were compared between the two groups.Results:In OHSS group, 34 early-onset and 121 late-onset, 80 singletons and 75 twins were included and in non-OHSS group 194 singletons and 172 twins were included. Compared with non-OHSS group, patients in OHSS group had lower maternal age [(29.99±4.02) years vs. (31.85±3.62) years, P<0.001] and bigger number of oocytes retrieved (11.62±4.17 vs. 9.48±4.39, P<0.001). For OHSS patients, compared with late-onset group, the ovarian size [(7.95±1.46) cm vs. (7.26±1.41) cm], depth of chest water [(5.83±4.57) cm vs. (3.69±4.20) cm], hematocrit (HCT) [(44.59±4.85)% vs. (42.03±4.53)%], D-dimer [(2.87±1.84) mg/L FEU vs. (2.01±1.09) mg/L FEU], percentage of patients undergoing abdominal puncture and hospitalization days [(12.91±6.64) d vs. (10.12±6.18) d] were higher in early-onset group ( P=0.013, P=0.012, P=0.005, P<0.001, P=0.023, P=0.024), while the number of oocytes retrieved, serum albumin (ALB), level of liver enzyme and percentage of patients undergoing pleural puncture were not significantly different between the two groups (all P>0.05). The clinical data had no significant differences between singleton subgroup and twin subgroup (all P>0.05). The twins rate, the miscarriage rate, the ectopic pregnancy rate and the live birth rate were not significantly different between OHSS group and non-OHSS group (all P>0.05). There were no statistically significant differences in twin rate, live birth rate, obstetric complications, cesarean section rate, postpartum hemorrhage rate or neonatal outcomes between the early and late OHSS patients (all P>0.05). Whether in singleton pregnancy or twin pregnancy, the obstetric complications, preterm birth rate, postpartum bleeding rate and neonatal outcome were not significantly different between OHSS group and non-OHSS group (all P>0.05). Whether in OHSS or non-OHSS patients, the preterm birth rate [54.46% (116/213)], the cesarean section rate [96.71% (206/213)] and the low birth weight rate [59.39% (253/426)] were higher in twin subgroup than in singleton subgroup [11.60% (29/250), P<0.001; 74.00% (185/250), P<0.001; 5.20% (13/250), P<0.001]. Conclusion:The presentation and onset time of severe OHSS after fresh embryo transplantation had no adverse effect on the long-term pregnancy complications and pregnancy outcomes. Early-onset severe OHSS increased adverse effects on maternal in early pregnancy. Multiple pregnancies significantly increase the neonatal adverse outcomes.

Objective:To explore the impact of severe ovarian hyperstimulation syndrome (OHSS) after fresh embryo transfer on the maternal and neonatal outcomes of patients.Methods:A respective cohort study was performed. Totally 155 patients with severe OHSS (OHSS group) treated in the Department of Obstetrics and Gynecology of Chongqing Health Center for Women and Children and received fresh embryo transfer in the Reproductive Center from January 2018 to December 2018 were selected, and 366 clinical pregnant patients without OHSS after transplantation served as control group (non-OHSS group). According to Mathur's OHSS time classification standard, OHSS patients were divided into early-onset subgroup, occurring within 9 d (including 9 d) after oocytes retrieved, and late-onset subgroup, occurring within 10 d or more after oocytes retrieved; according to the number of pregnancies, patients were divided into singleton subgroup and twin subgroup. The differences in maternal and neonatal outcomes (primary indicators) and clinical indicators (secondary indicators) were compared between the two groups.Results:In OHSS group, 34 early-onset and 121 late-onset, 80 singletons and 75 twins were included and in non-OHSS group 194 singletons and 172 twins were included. Compared with non-OHSS group, patients in OHSS group had lower maternal age [(29.99±4.02) years vs. (31.85±3.62) years, P<0.001] and bigger number of oocytes retrieved (11.62±4.17 vs. 9.48±4.39, P<0.001). For OHSS patients, compared with late-onset group, the ovarian size [(7.95±1.46) cm vs. (7.26±1.41) cm], depth of chest water [(5.83±4.57) cm vs. (3.69±4.20) cm], hematocrit (HCT) [(44.59±4.85)% vs. (42.03±4.53)%], D-dimer [(2.87±1.84) mg/L FEU vs. (2.01±1.09) mg/L FEU], percentage of patients undergoing abdominal puncture and hospitalization days [(12.91±6.64) d vs. (10.12±6.18) d] were higher in early-onset group ( P=0.013, P=0.012, P=0.005, P<0.001, P=0.023, P=0.024), while the number of oocytes retrieved, serum albumin (ALB), level of liver enzyme and percentage of patients undergoing pleural puncture were not significantly different between the two groups (all P>0.05). The clinical data had no significant differences between singleton subgroup and twin subgroup (all P>0.05). The twins rate, the miscarriage rate, the ectopic pregnancy rate and the live birth rate were not significantly different between OHSS group and non-OHSS group (all P>0.05). There were no statistically significant differences in twin rate, live birth rate, obstetric complications, cesarean section rate, postpartum hemorrhage rate or neonatal outcomes between the early and late OHSS patients (all P>0.05). Whether in singleton pregnancy or twin pregnancy, the obstetric complications, preterm birth rate, postpartum bleeding rate and neonatal outcome were not significantly different between OHSS group and non-OHSS group (all P>0.05). Whether in OHSS or non-OHSS patients, the preterm birth rate [54.46% (116/213)], the cesarean section rate [96.71% (206/213)] and the low birth weight rate [59.39% (253/426)] were higher in twin subgroup than in singleton subgroup [11.60% (29/250), P<0.001; 74.00% (185/250), P<0.001; 5.20% (13/250), P<0.001]. Conclusion:The presentation and onset time of severe OHSS after fresh embryo transplantation had no adverse effect on the long-term pregnancy complications and pregnancy outcomes. Early-onset severe OHSS increased adverse effects on maternal in early pregnancy. Multiple pregnancies significantly increase the neonatal adverse outcomes.

Objective:To analyze the high risk factors of intramural ectopic pregnancy, and to improve the clinical diagnosis and treatment of intramural ectopic pregnancy.Methods:From January 2015 to July 2019, the clinical data of 9 patients with intramural pregnancy in Chongqing Maternal and Child Health Hospital were retrospectively analyzed. The high risk factors, clinical manifestations, treatment outcomes of intramural pregnancy were summarized.Results:Nine patients with intramural pregnancy, 6 cases had previous history of abortion, uterine or abdominal cavity surgery. Five cases had history of embryo transfer. The uterine integrity was preserved in 9 patients after treatment with medication, hysteroscopy, laparoscopy or transabdominal intramural pregnancy clearance. Pregnancy continued after laparoscopic treatment in a patient with early pregnancy complicated with intramural pregnancy.Conclusion:Patients with high risk factors should be treated at the early stage of pregnancy. Hysteroscopy combined with laparoscopic exploration is an effective method for the treatment of intramural pregnancy, which can make a quick and definite diagnosis and perform minimally invasive surgery, and preserve uterine integrity and fertility.

Objective:To analyze the high risk factors of intramural ectopic pregnancy, and to improve the clinical diagnosis and treatment of intramural ectopic pregnancy.Methods:From January 2015 to July 2019, the clinical data of 9 patients with intramural pregnancy in Chongqing Maternal and Child Health Hospital were retrospectively analyzed. The high risk factors, clinical manifestations, treatment outcomes of intramural pregnancy were summarized.Results:Nine patients with intramural pregnancy, 6 cases had previous history of abortion, uterine or abdominal cavity surgery. Five cases had history of embryo transfer. The uterine integrity was preserved in 9 patients after treatment with medication, hysteroscopy, laparoscopy or transabdominal intramural pregnancy clearance. Pregnancy continued after laparoscopic treatment in a patient with early pregnancy complicated with intramural pregnancy.Conclusion:Patients with high risk factors should be treated at the early stage of pregnancy. Hysteroscopy combined with laparoscopic exploration is an effective method for the treatment of intramural pregnancy, which can make a quick and definite diagnosis and perform minimally invasive surgery, and preserve uterine integrity and fertility.