ABSTRACT
Objective:To investigate the clinical outcomes of using the levofloxacin combined with intrauterine infusion of metronidazole for the treatment of the infertility patients with chronic endometritis (CE).Methods:Using a case-control study method. 82 infertility patients with CE admitted to Xuzhou Central Hospital from March 2018 to March 2021 were selected and randomly divided into an observation group and a control group using a random number table method, with 41 cases in each group. The control group was treated with oral levofloxacin hydrochloride, while the observation group was treated with metronidazole sodium chloride injection intrauterine infusion on the basis of the control group. Both groups were treated for 14 days. Compare the serum C-reactive protein (CRP) and tumor necrosis factor between two groups before and after treatment α(tumor necrosis factor-α, TNF-α) The levels of monocyte chemotactic protein 1 (MCP-1), natural pregnancy rate within six months, total effective rate, and incidence of adverse reactions during treatment were measured. The measurement data with normal distribution is expressed as: independent sample t-test is used for comparison between the two groups, and paired t-test is used for comparison before and after treatment within the group; The measurement data of non normal distribution is represented by M( Q1, Q3), and the comparison between groups is made by Wilcoxon Rank sum test. The counting data is represented by examples (%), and the comparison between groups is conducted using the χ 2 test. Results:Before treatment, two groups of serum CRP and TNF-α There was no statistically significant difference compared to the levels of MCP-1 (all P>0.05); After 14 days of treatment, both groups had serum CRP and TNF-α、MCP-1 were all lower than before treatment, and the observation group was lower than the control group [(4.12±1.9) ng/L vs (6.36±1.63) ng/L, (47.28±9.10) ng/L vs (62.79±9.34) ng/L, (212.04±24.82) ng/L vs (326.15±27.38) ng/L], with statistically significant differences ( t-values of 5.61, 7.62, and 19.77, all P<0.001). After 14 days of treatment, the total effective rate of the observation group was higher than that of the control group [95.12% (39/41) vs 78.05% (32/41)], with a statistically significant difference (χ 2=5.14, P=0.023). After 6 months of treatment, the natural pregnancy rate in the observation group was higher than that in the control group [53.66% (22/41) vs 31.71% (13/41)], with a statistically significant difference (χ 2=5.96, P=0.044). There was no statistically significant difference in the incidence of adverse reactions between the two groups during the treatment period (χ 2=0.55, P=0.457). Conclusions:The combination of levofloxacin and intrauterine infusion of metronidazole has a good clinical effect in treating infertility patients with CE. It can significantly improve the inflammatory state of the body, reduce serum inflammatory factor levels, increase the natural pregnancy rate within 6 months, and do not increase the incidence of adverse reactions.
ABSTRACT
Objective How to avoid the rejection of the synthetic patch and human tissue has become an urgent problem to be solved.The article investigated thein vivobiocompatibility of polypropylene mesh scaffold with adipose -derived stem cells(ADSCs) in rabbits. Methods Rabbit ADSC suspension were prepared.ADSCs were seeded onto polypropylene mesh scaffolds after passage and amplification and cultured invitro for 1 week .The polypropylene mesh and ADSC fixed polypropylene mesh were implanted respec-tively into the surface of rectus abdominis in rabbits.4 weeks later, adhesion and erosion of the meshes were evaluated, HE staining was used in histological observation and RT-PCR was applied to detect the dynamic changes of VEGF mRNA level.ADSCs were isola-ted from rabbit subcutaneous adipose tissue after collagenase digesting, filtrating and centrifuging. Results The results of flow cy-tometry showed that the expressions of CD44, CD73, CD90, CD45, CD14 and CD34 were 98.54%, 95.32%, 98.49%, 1.21%, 3.01%, 2.14%, respectively.Polypropylene mesh, ADSC-fixed polypropylene mesh had different degrees of corrosion and adhesion , but polypropylene mesh showed denser adhesion.In comparison with polypropylene,ADSC fixed polypropylene meshes induced a mil -der chronic inflammation response,with lower scores for inflammation (1.1 ±0.2 vs 0.6 ±0.1, P=0.001), higher scores for neovas-cularization (17.0 ±0.0 vs 2.6 ±0.3, P=0.000) and fibroblastic proliferation(0.9 ±0.1 vs 2.2 ±0.2, P=0.001).Relative a-mounts of VEGF mRNA of were significantly lower for ADSC-fixed polypropylene compared with the remaining polypropylene meshes (t=94.6, P<0.05). Conclusi on Polypropylene mesh scaffold with ADSCs exhibits excellent cellular compatibility and have a bright future in clinical practice.