Efficacy and prognostic factors of combined administration of progesterone and estriol valerate tablets for preventing intrauterine adhesions in patients with early missed abortion following dilation and curettage.

OBJECTIVE: To investigate the therapeutic efficacy and prognostic factors of combined administration of estriol valerate tablets and progesterone for the prevention of intrauterine adhesions (IUA) in patients with early missed abortion (EMA) after dilation and curettage. METHODS: Clinical data of 120 EMA patients undergoing dilation and curettage at Ganzhou People's Hospital from July 2021 to June 2023 were collected for this retrospective study. The 120 enrolled patients were divided into two groups, with 70 patients in the study group receiving both estriol valerate tablets and progesterone for the prevention of IUA, and 50 in the control group undergoing no such treatments at all. The therapeutic efficacy of IUA prevention in patients was compared between the two groups. Subsequently, patients who developed IUA were categorized into the adhesion group (n = 23) and those who did not into the non-adhesion group (n = 97). The clinical data of patients were compared between the adhesion group and the non-adhesion group. Both univariate and multivariate logistic regression analyses were performed to identify the risk factors of IUA in patients with EMA after dilation and curettage. Receiver Operating Characteristic (ROC) curves were drawn to analyze the predictive value of independent risk factors for IUA in patients with EMA after dilation and curettage. RESULTS: The study group showed a notably higher excellent and good response rate than the control group in IUA prevention (92.00% vs. 82.00%, P = 0.035). Logistic regression analysis revealed that a history of multiple previous miscarriages (P: 0.018; OR: 0.120; 95% CI: 0.02-2.119), relatively small endometrial volume (P: 0.001; OR: 0.026; 95% CI: 0.003-0.210), relatively thin endometrial thickness (P: 0.001; OR: 32.123; 95% CI: 4.339-237.807) and lack of preventive treatment (P: 0.051; OR: 0.211; 95% CI: 0.048-0.935) were independent risk factors for the occurrence of IUA in patients with EMA after dilation and curettage. ROC curve-based analysis showed that these risk factors; encompassing, the number of previous miscarriages, endometrial volume, endometrial thickness and preventive treatment, had a notably higher efficacy in jointly predicting the occurrence of IUA in EMA patients following dilation and curettage in comparison to an individual risk factor alone. CONCLUSION: The occurrence of IUA in patients with EMA following dilation and curettage is influenced by several factors, including the number of previous miscarriages, the volume and thickness of the endometrium, and preventive treatments. To minimize the risk of IUA, it is crucial to implement proactive interventions prior to uterine surgeries. It was found that a combination therapy involving estriol valerate tablets and progesterone could effectively prevent the development of IUA in patients with EMA after dilation and curettage.

Serum levels of sirtuin 6 are associated with severe community acquired pneumonia in children: An observational study.

OBJECTIVE: The objective of this study was to investigate the role of sirtuin 6 (SIRT6) in severe community acquired pneumonia (CAP) in child patients. METHODS: This prospective observational research enrolled a total of 75 severe child CAP patients who went to our hospital during April 2016 to December 2020, and 75 mild/moderate CAP child patients were included as control. SIRT6 and inflammatory factors C-reactive protein (CRP), interleukin (IL)-6, and procalcitonin (PCT) were tested by the enzyme linked immunosorbent assay (ELISA). Demographic data including age, sex, as well as clinical symptoms, duration of ICU stay, duration of mechanical ventilation were collected. The routine blood test was conducted for all patients and WBC amount and neutrophil ratio were recorded. The pediatric critical illness score (PCIS) and 1-month mortality were collected. RESULTS: Levels of SIRT6 were remarkably lower in severe CAP patients or deceased patients compared with mild/moderate or survival patients, respectively. Levels of CRP, PCT, and interleukin-6 (IL-6) were markedly higher in severe patients than mild/moderate patients. However, only levels of CRP were significantly higher in deceased CAP patients and serum levels of SIRT6 were negatively correlated with serum levels of CRP, PCT, and IL-6. The higher levels of CRP, PCT and IL-6, as well as higher mortality rate and lower levels of PCIS were found in patients with lower SIRT6 compared with parents with higher SIRT6. SIRT6 had the potential for diagnosis of severe CAP and patients with lower SIRT1 showed shorter 1-month survival. Further, logistic regression showed that only age and CRP were independent risk factors for 1-month mortality of CAP child parents. CONCLUSION: Down-regulated SIRT6 in severe CAP child patients predicted higher expression of inflammatory factors, severer clinical outcomes and poor prognosis.

OBJETIVO: Investigar el papel de sirtuin 6 (SIRT6) en la neumonía adquirida en la comunidad (NAC) grave en pacientes infantiles. MÉTODOS: Esta investigación observacional prospectiva inscribió a un total de 459 pacientes con NAC infantil grave que acudieron a nuestro hospital entre abril de 2016 y diciembre de 2020, y se incluyeron como control 459 pacientes con NAC infantil leve/moderada. RESULTADOS: Los niveles de SIRT6 fueron notablemente más bajos en pacientes con NAC grave o pacientes fallecidos en comparación con los pacientes leves/moderados o con supervivencia, respectivamente. Todos los niveles de PCR, PCT e Interleukin-6 (IL-6) fueron significativamente más altos en pacientes con CAP fallecidos y los niveles séricos de SIRT6 se correlacionaron negativamente con los niveles séricos de CRP, PCT e IL-6. Los niveles más altos de PRISM, CRP, PCT e IL-6, así como una mayor tasa de mortalidad y niveles más bajos de PCIS se encontraron en pacientes con menor SIRT6 en comparación con los padres con mayor SIRT6. SIRT6 tenía potencial para el diagnóstico de NAC grave. CONCLUSIÓN: La SIRT6 regulada a la baja en pacientes infantiles con NAC grave predijo una mayor expresión de factores inflamatorios, resultados clínicos más graves y mal pronóstico.

[Orthogonal test analysis of compressive strength of porous hydroxylapatite prepared by gel-casting process].

Porous hydroxylapatite (HA) has excellent osseous inductive ability. It has been prepared by gel-casting process, which is feasible and can make complex ceramic material. According to the result of orthogonal test based on the compressive strength, the order and the level of the factors, including monomer HA, initiator MBAM, catalyst APS and water, were dealt with. The effects of drying and sintering technique on the properties of porous hydroxylapatite were also researched. The results showed that the order of every factor in the gel-casting process is as follows, AM-APS, MBAM, H2O. Based on the determined level of each factor, the suitable slurry constituents and drying and sintering technologies were selected, and the porous hydroxylapatite with compressive strength of 6-7 MPa was produced.