ABSTRACT
OBJECTIVES: To explore the risk factors for tubal patency after partial salpingectomy and end-to-end anastomosis, and their impact on pregnancy outcomes. METHODS: A total of 300 patients with tubal pregnancy who underwent partial salpingectomy and end-to-end anastomosis in Zhengzhou Maternal and Child Health Hospital from January 2020 to April 2023. Hysterosalpingography was performed after surgical treatment to examine the tubal patency. Lasso-Logistic regression was used to analyze the risk factors for postoperative tubal patency, and Spearman's correlation was used to analyze the impact of each risk factor on the pregnancy rate. RESULTS: Hysterosalpingography showed that the fallopian tube was not obstructed in 225 cases (unobstructed group), the tube was not completely patent (n=54) or blocked (n=21) (obstructed group). Univariate analysis showed that age, diameter of the tubal pregnancy sac, location of tubal pregnancy, timing of surgery, pelvic adhesion, anastomotic method, length of remaining tubal, history of pelvic surgery, number of intraoperative electrocoagulation, intraoperative blood loss, and experience of surgeons were factors affecting postoperative tubal patency (all P<0.01). Lasso regression analysis identified location of tubal pregnancy, pelvic adhesion, anastomotic surgical method, length of remaining tubal, history of pelvic surgery, number of intraoperative electrocoagulation, and experience of surgeons as influencing factors. Multivariate Logistic regression analysis showed that tubal isthmus pregnancy, pelvic adhesion, open anastomosis surgery, history of pelvic surgery, and number of intraoperative electrocoagulation were independent risk factors for postoperative tubal patency, while length of remaining tubal and surgeon's work experience were independent protective factors for postoperative tubal patency (all P<0.01). A total of 295 patients were followed up of 1 year, 192 cases (65.08%) were pregnant, including 172 cases of intrauterine pregnancy (89.58%) and 20 cases of ectopic pregnancy (10.42%). Spearman correlation analysis showed that tubal isthmus pregnancy, pelvic adhesion, open abdominal anastomosis surgery, pelvic surgery history, and times of intraoperative electrocoagulation were negatively correlated with postoperative pregnancy, while the remaining tubal length and years of surgeon's working experience were positively correlated with postoperative pregnancy rate (all P<0.01). CONCLUSIONS: For the tubal patency of patients after partial salpingectomy combined with end-to-end anastomosis, the history of tubal isthmus pregnancy, pelvic adhesion, open abdominal anastomosis, pelvic surgery, and the number of intraoperative electrocoagulation are independent risk factors, which are negatively correlated with postoperative pregnancy. The remaining tubal length and the surgeon's work experience are independent protective factors, which are positively correlated with postoperative pregnancy.
ABSTRACT
Abstract: A 2-year field experiment with a yellow-clay paddy soil in Zhejiang Province was conducted to study the effects of different planting measures combined with different fertilization practices on rice yield, soil nutrients, microbial biomass C and N and activities of urease, phosphatase, sucrase and hydrogen peroxidase at the maturity stage. Results showed that mechanical transplanting of rice with controlled release bulk blending (BB) fertilizer (BBMT) could achieve a significantly higher mean yield than traditional manual transplanting with traditional fertilizer (TFTM) and direct seeding with controlled release BB fertilizer (BBDS) by 16.3% and 27.0%, respectively. The yield by BBMT was similar to that by traditional manual transplanting with controlled release BB fertilizer (BBTM). Compared with TFTM, BBMT increased the contents of soil total-N, available N, available P and microbial biomass C, and the activities of urease, sucrase and hydrogen peroxidase by 21.5%, 13.6%, 41.2%, 27.1%, 50.0%, 22.5% and 46.2%, respectively. Therefore, BBMT, a simple high-efficiency rice cultivation method with use of a light-weighted mechanical transplanter, should be widely promoted and adopted.
