1.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
2.Immune reconstitution and influencing factors in HIV infected men who have sex with men with access to antiviral therapy in Guangxi Zhuang Autonomous Region from 2005 to 2021
Ni CHEN ; He JIANG ; Huanhuan CHEN ; Qiuying ZHU ; Xiuling WU ; Jianjun LI ; Nengxiu LIANG ; Qin MENG ; Xuanhua LIU ; Jinghua HUANG ; Wenxuan HOU ; Zhaoquan WANG ; Guanghua LAN
Chinese Journal of Epidemiology 2024;45(4):529-535
Objective:To analyze immune reconstitution and influencing factors in HIV infected men who have sex with men (MSM) with access to antiviral therapy (ART) in Guangxi Zhuang Autonomous Region (Guangxi) during 2005-2021.Methods:The data were collected from Chinese Disease Prevention and Control Information System. The study subjects were HIV infected MSM with access to the initial ART for ≥24 weeks in Guangxi from 2005 to 2021 and HIV RNA lower than the detection limit within 24 months. The proportion of infected MSM who had immune reconstitution after ART was calculated. Cox proportional hazard regression model was used to analyze the influencing factors of immune reconstitution. Software SPSS 24.0 was used for statistical analysis.Results:A total of 3 200 HIV infected MSM were enrolled, in whom 15.56 % (498/3 200) had no immune reconstitution, 14.78% (473/3 200) had moderate immune reconstitution, and the rate of complete immune reconstitution was 69.66% (2 229/3 200). The M ( Q1, Q3) of ART time for immune reconstitution was 12 (5, 27) months. Multivariate Cox proportional risk regression model analysis results showed that compared with those with initial ART at age ≥30 years, WHO clinical stage Ⅲ/Ⅳ illness, baseline BMI <18.50 kg/m 2 and baseline CD4 +T lymphocyte (CD4) counts <200 cells/μl, HIV infected MSM with initial ART at age <30 years, WHO clinical stageⅠ/Ⅱ illness, baseline BMI≥24.00 kg/m 2 and baseline CD4 counts ≥200 cells/μl were more likely to have complete immune reconstitution. Conclusions:In the HIV infected MSM in Guangxi, failures to achieve moderate and complete immune reconstitution were observed. Surveillance and ART regimen should be improved for key populations, such as those with older age and low baseline CD4 counts.
3.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
4.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
5.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
6.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
7.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
8.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
9.The Effect of Three-Layer Suturing of Myometrium on the Size of Diverticulum after Caesarean Section and the Analysis of Related Factors of the Formation of Diverticulum in Uterine Incision
Meng CHEN ; Kegong CHEN ; Huanhuan LI
Journal of Practical Obstetrics and Gynecology 2024;40(5):398-404
Objective:To investigate the effect of three-layer suturing of myometrium on the size of diverticu-lum after cesarean section and the related factors of the formation of uterine incision diverticulum(CSD).Meth-ods:The clinical data of 240 parturients who underwent cesarean section in Wuhu Hospital affiliated to East China normal University from April to November 2022 were analyzed retrospectively.According to the different suture methods of myometrium,they were divided into three-layer suture group(n=124)and double-layer suture group(n=116).According to the formation of CSD after operation,the parturients were divided into CSD group(n=23)and non-CSD group(n=217).The clinical characteristics of parturients in three-layer suture group and doub-le-layer suture group were compared.Multivariate Logistic regression were used to analyze the independent fac-tors affecting the formation of CSD and an artificial neural network model was constructed.The model was verified by receiver operating characteristics(ROC),calibration curve and clinical decision curve.Results:①The thick-ness of myometrium scar in the three-layer suture group was significantly higher than that in the double-layer su-ture group(7.06±2.09 mm vs.5.68±1.97 mm),while the formation of CSD(4.03%vs.15.52%)and the size of diverticulum(0.36±0.09 ml vs.0.47±0.12 ml)were significantly lower than those in the double-layer suture group(P<0.05).②Multivariate analysis showed that retroflexion of uterus,cesarean section frequency ≥2 times,premature rupture of membranes,perinatal infection and timing of cesarean section were independent risk factors for the formation of CSD(OR>1,P<0 05),while three layer suture of myometrium was a protective factor(OR<1,P<0.05).③The artificial neural network prediction model showed that the weights of cesarean section frequency,premature rupture of membranes and three-layer suture were higher.The ROC curve,calibration curve,and clinical decision curve validation showed that the model had good predictive ability.Conclusions:The formation of CSD is related to indicators such as retroflexion of uterus,times of cesarean section,premature rup-ture of membranes,perinatal infection and timing of cesarean section.Clinical attention should be focused on this.In addition,three-layer suture of myometrium can reduce the probability of formation of CSD,which is worth popu-larizing and application in clinic.
10.Combining robot-assisted gait training with task-oriented training can improve the walking ability of children with dyskinetic cerebral palsy
Huachun XIONG ; Suya YUAN ; Ning XIAO ; Yang LI ; Guohao TANG ; Huiling ZHAO ; Huanhuan FENG ; Wenbin MENG ; Jing LU
Chinese Journal of Physical Medicine and Rehabilitation 2024;46(9):806-811
Objective:To observe the effect of combining robot-assisted gait training (RAGT) with task-oriented training (TOT) on the walking ability of children with dyskinetic cerebral palsy (DCP).Methods:Sixty DCP children were randomly divided into a conventional intervention group, an RAGT group, and a combined intervention group, each of 20. All of the children received conventional rehabilitation therapy, while the RAGT and combined intervention groups were additionally provided with RAGT, and RAGT combined with TOT, respectively. Before the experiment and after 12 and 24 weeks of treatment, the subjects′ walking ability was evaluated using the 10-metre walk test (10MWT), and the D energy zone (standing position) and the E energy zone (walking, running and jumping) of the Gross Motor Function Measurement-88 (GMFM-88) instrument.Results:After 12 and 24 weeks of treatment, the average 10MWT speed and D and E energy zone scores of all three groups had improved significantly. After 24 weeks the combined group′s averages on all three measures were significantly better than those of the other two groups.Conclusion:RAGT combined with TOT and conventional rehabilitation training significantly improves the walking ability of DCP children.

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