A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision.

Objective: The aim of this study was to compare the treatment effects of high-intensity focused ultrasound (HIFU) and laparoscopic excision (LE) in patients with adenomyosis and infertility.Materials and methods: A total of 93 patients with adenomyosis and infertility who were treated with HIFU (50 patients) or LE (43 patients) from January 2012 to January 2017 at the Third Xiangya Hospital of Central South University were retrospectively analyzed. Clinical characteristics including dysmenorrhea severity pain score, menorrhagia severity scores, reproductive outcomes, complications during pregnancy and delivery, adverse effects, surgical complications, and other clinical variables were compared between the HIFU and LE groups.Results: Of the total 93 patients with adenomyosis and infertility, 50 were treated with HIFU and 43 underwent LE. Both HIFU and LE treatments achieved significant relief of dysmenorrhea and menorrhagia. The total hospital stay was shorter in patients treated with HIFU than in those who underwent LE surgery. Neither HIFU nor LE treatment led to severe complications after treatment. Most importantly, patients treated with HIFU showed significantly higher pregnancy rates and natural conception rates than those who underwent LE surgery. Notably, in the HIFU treatment group, those with diffuse adenomyotic lesions had significantly lower postoperative pregnancy rates than those with focal adenomyosis.Conclusion: HIFU showed a safe and effective profile as a therapeutic management option for patients with adenomyosis. In comparison with LE, HIFU treatment achieved better postoperative reproductive outcomes. HIFU treatment should be encouraged and implemented in clinical practice.

The Effect of Comprehensive Care on the Patients Received Minimally Invasive Percutaneous Nephrolithotomy.

BACKGROUND: We analyzed the effect of comprehensive care on the patients who received minimally invasive percutaneous nephrolithotomy (MPCNL). METHODS: Patients hospitalized from 2013-2014 in Zhumadian Central Hospital (n=124) were enrolled and divided into two groups on random basis. The control group was treated with routine nursing model while the observation group was given comprehensive care additionally. The surgery time, degree of comfort, complications and successful cases, hospitalization time, sleep quality, nursing satisfaction and changes of systolic pressure, pulse and respiratory at different time were observed and analyzed. RESULTS: The surgery time of the control group was significantly longer than that of observation group (P<0.05). The observation group felt more comfortable and showed more significant successful cases than the control group. Moreover, the hospitalization time were significantly reduced in observation group when compared with control group (P<0.05). The sleep quality of the observation group was significantly better than that of the control group (P<0.05). Before anesthesia, diastolic blood pressure, systolic blood pressure, pulse and respiration were not significantly different between the two groups. The diastolic blood pressure, systolic blood pressure, pulse and respiration after anesthesia, intraoperative 30 min, postoperative 30 min and other moments were significantly different. The incidence of complications in the control group was significantly higher than that in the observation group. The nursing satisfaction of the observation group was significantly higher than that of the control group. CONCLUSION: The comprehensive care on the patients undergoing MPCNL was effective, and it can dramatically shorten surgery time, improve the success rate, improve the sleep quality of patients, keep life sign stable and minimize the complications.

[Changes in T-cell receptor repertoire in aplastic anemia and effects of Shengxue Mixture].

OBJECTIVE: To explore the immune pathogenesis of aplastic anemia (AA) and the therapeutic effects of Shengxue Mixture (SM) through the gene expressions of subfamilies of T-cell receptor variable region beta (TCR Vbeta) using immunologic and molecular biologic technology. METHODS: Gene expressions of TCR Vbeta sub-families in peripheral blood mononuclear cells from 20 AA patients were detected before and after treatment with SM using RT-PCR and gene scanning method. RESULTS: TCR Vbeta gene repertoire of the 24 subfamily genes deviated in AA patients, and the oligoclonal gene expressions increased obviously compared with those in healthy people (P < 0.01), including Vbeta2, 5, 6, 15, 16, 22, and 23 were found in 30%-50% AA patients, and Vbeta8, 21 were in more than 50% patients. These oligoclonal genes reduced significantly after treatment with SM compared with those before treatment (P < 0.05). CONCLUSION: Multiple TCR Vbeta subfamilies of clonal proliferation participate in the pathogenesis of AA. SM can rectify the deviation of TCR Vbeta gene repertoire, reduce the abnormal clonal proliferation of T cells, thus to alleviate the immune injury to hematopoietic tissue, and thus to benefit the recovery of hematopoiesis of bone marrow.