Objective:To evaluate the impact of human papillomavirus(HPV)infection on the clinical outcomes of intrauterine insemination(IUI)in infertile women.Methods:The clinical data of 685 patients(1046 cycles)who underwent IUI treatment were retrospectively analyzed at Tangdu Hospital of Air Force Medical University from January 2019 to July 2021,including 554 cases of artificial insemination with husband sperm(AIH).According to HPV infection,patients were divided into two groups,HPV positive group and HPV negative group,propensity score matching(PSM,1 ∶ 2)was used for IUI(80 cases in HPV-positive group and 158 cases in HPV-negative group)and AIH(65 cases in HPV-positive group and 129 cases in HPV-negative group)treatment patients,and the clinical outcomes of these patients were compared respectively.Results:There was no statistically significant difference in clinical pregnancy rate,live birth rate,ectopic pregnancy rate,abortion rate,macrosomia birth rate,and low body weight birth rate between HPV-positive group and HPV-negative group after matching with IUI treat-ment patients(P>0.05).There was no statistically significant difference in clinical pregnancy rate,live birth rate,ectopic pregnancy rate,miscarriage rate,macrosomia birth rate,and low body weight birth rate between the HPV positive group and the HPV negative group after matching AIH treatment patients(P>0.05).Conclusions:HPV infection in infertile female may not affect the clinical outcomes of IUI patients.

Objective To explore the major risk factors of post transplantation diabetes mellitus (PTDM) and analyze the correlation between tacrolimus and PTDM after kidney transplantation. Methods Clinical data of 123 kidney transplant recipients were collected. All recipients were divided into the PTDM group (n=19) and non-PTDM group (n=104). Clinical data of all recipients in two groups were analyzed. The risk factors of PTDM were analyzed by binary logistic regression. Twenty-four mice were evenly divided into the control group (normal saline), low-dose tacrolimus (0.1 mg/kg), medium-dose tacrolimus (0.75 mg/kg) and high-dose tacrolimus groups (1.5 mg/kg). The solutions were given twice a day. The effect of tacrolimus on blood glucose metabolism in mice was evaluated. Results The incidence of PTDM was 15.4% (19/123) within 1 year after kidney transplantation. Age≥48 years old and the trough concentration of tacrolimus≥9 ng/mL within 3 months after kidney transplantation were the risk factors for PTDM after kidney transplantation (both P < 0.05). The fasting blood glucose levels of mice after administration in the low-, medium- and high-dose tacrolimus groups were significantly lower than those before administration (all P < 0.05) in a dose-independent manner (P=0.750). In the low-, medium- and high-dose tacrolimus groups, the postprandial blood glucose levels of mice after administration were significantly higher than those before administration (all P < 0.05) in a dose-dependent manner (P=0.012). Conclusions Tacrolimus is intimately correlated with the incidence of PTDM after kidney transplantation. Age≥48 years old and the trough concentration of tacrolimus ≥9 ng/mL within 3 months after kidney transplantation are the independent risk factors of PTDM. Tacrolimus affects the postprandial blood glucose levels of mice in a dose-dependent manner.

Objective To analyze the clinical characteristics of urinary tract infection after kidney transplantation and to analyze the distribution of pathogenic virulence factors.Methods From January 2014 to June 2016,a total of 255 cases were subjected to DCD renal transplantation in our center,and 45 cases of urinary tract infection occurred after operation.Among them,urinary tract E.coli infection occurred in 32 cases.The virulence factors gene aer,hly,irp2 and iucD in the 32 strains of E.coli isolated from urine were tested using PCR and multiple PCR.Results Thirty-two cases (71.1％) of urinary tract infection after renal transplantation was caused by E.coli,and divided into 9 cases of nosocomial infection group,and 23 cases of community-acquired group.The positive rate for aer,hly,irp2 and iucD in Nosocomial infection group was 66.7％,33.3％,88.9％ and 77.8％,and that in community-acquired group was 30.4％,8.70％,39.1％ and 34.7％,respectively.There were statistically significant differences among four kinds of virulence factors between two groups (P＜0.05).The positive rate of virulence factors was significantly higher in nosocomial infection group than in community-acquired groups.The total resistance rate was 84.38％,and there was significarit difference in multi-drug resistance rate between two groups (P＜0.01).Conclusion E.coli is the main pathogenic bacteria of urinary tract infection after renal transplantation,especially nosocomial infections.The detection rate of virulence factor is high,and the multiple drug resistance is outstanding,so the attention should be paid clinically.

OBJECTIVETo investigate the safety, effectiveness and long-term results of Jinling procedure.

METHODSA total of 1 100 patients with refractory constipation were admitted to the Institute of General Surgery between February 2000 and December 2013 and received Jinling procedure. There were 217 male and 883 female patients with an average age of (45±15) years and an average duration of (275±159) months. The Jinling procedure modifies the classic procedure of subtotal colectomy with colorectal anastomosis by adding a new side-to-side cecorectal anastomosis. The general clinical data, postoperative complications, gastrointestinal quality of life index (GIQLI), Wexner constipation score, satisfaction rate, body composition, nutritional status, homeostasis, anal manometry and defecography during follow-up were collected. Statistical analysis was performed by t-test analysis, χ(2) test or Fisher's exact probability.

RESULTSThe postoperative follow-up rate were 96.73%, 94.36%, 93.00% and 92.55% at 1, 3, 6, and 12 months. The satisfaction rate were 62.50%, 72.45%, 93.16% and 94.70% respectively during 1, 3, 6 and 12 months follow-up. The postoperative 1 month, GIQLI was lower than that of preoperative (P=0.038), but significantly better at postoperative 3 month than the preoperative (P=0.022), and gradually improve after then. Wexner score was significantly lower at postoperative 1 month than the preoperative (P=0.018), and with the gradually reduce. Compared to the preoperative baseline, all body composition and serum protein parameters decreased significantly at the one-month follow-up and then increased gradually over the remaining follow-up period. Weight and prealbumin were significantly higher than the preoperative at postoperative 12 month. Jinling procedure had no effect on electrolytes. All patients were detected in defecography before surgery, but these abnormal indicators were improved after surgery. Anal function, coordinated movement anorectal function, anorectal reflex and rectal sensation were injured at early postoperative, but as time goes on, these indicators gradually returned to preoperative levels, some indicators better than the preoperative level. Postoperative surgical site infection, anastomotic bleeding , anastomotic leakage, urinary retention, sexual dysfunction, recurrent constipation, bowel obstruction, anastomotic stricture and mortality rates were 4.36%, 5.45%, 6.00%, 6.91%, 0.64%, 0.45%, 8.82%, 4.00% and 0.27% respectively.

CONCLUSIONSJinling procedure is a safe and effective surgical procedure for refractory constipation. It can improve defecation function and quality of life significantly, and has a high follow-up satisfaction rate.

Adult ; Anastomosis, Surgical ; Colectomy ; Constipation ; surgery ; Defecation ; Defecography ; Female ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Male ; Middle Aged ; Postoperative Period ; Quality of Life ; Rectum ; Treatment Outcome

To explore the effects of Dachengqi Decoction (DCQD), a compound traditional Chinese herbal medicine, on pancreatic acinar cell apoptosis in a rat model of experimental acute pancreatitis.

OBJECTIVE: To investigate the occurring mechanism and clinical characteristics of severe acute pancreatitis (SAP) associated with hypoalbuminemia in early stage and its influence on prognosis of SAP and the preventive and therapeutic management of this disease. METHODS: One hundred and thirty-eight cases diagnosed as SAP complicated by hypoalbuminemia in early stage were accepted in our hospital from August 1, 2003 to December 31, 2004, and they were divided into 2 groups according to the level of plasma albumin: mild hypoalbuminemia (30 to 35 g/L) group and severe hypoalbuminemia (<30 g/L) group. The complications in the early stage, related parameters, and the incidence rate of infection and mortality in the later stage were evaluated respectively. RESULTS: The incidence rates of renal dysfunction, shock, cardiovascular failure and gastrointestinal hemorrhage, the score of acute physiology and chronic health evaluation II (APACHE II ) and the frequencies of pulse and breath in the severe hypoalbuminemia group were all higher than those in the mild hypoalbuminemia group (P<0.05 or P<0.01). The differences of incidence rate of hepatic failure and the scores of Ranson and Balthazar CT between these two groups had no statistical significance (P>0.05). The incidence rate of infection and the mortality in the severe hypoalbuminemia group were higher than those in the mild hypoalbuminemia group (P<0.01) in the later stage of SAP. CONCLUSION: Hypoalbuminemia in the early stage can accelerate the deterioration in pathophysiology of SAP. The lower level of the plasma albumin is in the early stage, the more complications and the higher incidence rate of infection and mortality will be in the later stage. To relieve the extent of systemic inflammatory response syndrome (SIRS) and abundant supplement of albumin, amino acid and lipid in time may be crucial to prevent the occurrence and deterioration of hypoalbuminemia.

OBJECTIVE: To study the therapeutic effects of Chaiqin Chengqi Decoction (CQCQD) in treating severe acute biliary pancreatitis. METHODS: Ninety patients with severe acute biliary pancreatitis were treated with CQCQD, and they were divided into two groups: early-treated group (54 patients treated with CQCQD within 3 days after the onset of severe acute biliary pancreatitis) and late-treated group (36 patients treated with CQCQD between 3 and 7 days after the onset of severe acute biliary pancreatitis). The complication incidence rate, operation rate, mortality rate and hospitalization period were examined. RESULTS: The incidence rates of encephalopathy, infection and gastrointestinal hemorrhage were lower in the early-treated group than those in the late-treated group (P<0.05). The hospitalization periods of the early- and late-treated groups were (24.9+/-18.4) days and (51.6+/-45.9) days respectively (P<0.05). The general mortality rate was 14.4%. The mortality rate of the early-treated group (7.4%) was significantly lower as compared with that of the late-treated group (25.0%) (P<0.05). The operation rate of the early-treated group (11.1%) was also significantly lower as compared with that of the late-treated group (27.8%) (P<0.05). CONCLUSION: Treating severe acute biliary pancreatitis with CQCQD in early stage may reduce the complication incidence rate, shorten the hospitalization period, and decrease the operation rate and mortality rate.