Medicine
-
Observational Study
Improving pregnancy outcomes in patients with recurrent implantation failure: The power of RNA-seq-based endometrial receptivity testing.
To evaluate whether RNA-seq-based endometrial receptivity testing (rsERT) can improve pregnancy outcomes in personalized frozen-thawed embryo transfer (pFET) during hormone replacement therapy (HRT) cycles among patients with recurrent implantation failure (RIF). We conducted a retrospective cohort study involving 98 RIF patients undergoing HRT for FET. The experimental group consisted of 58 patients who underwent pFET after rsERT, while the control group included 40 patients who refused rsERT and underwent conventional ET. ⋯ The HCG-positive rate, implantation rate, and clinical pregnancy rate (CPR) in the experimental group were significantly higher than those in the control group, at 75.86% versus 50.00% (P = .030), 56.38% versus 31.43% (P = .002), and 68.97% versus 47.50% (P = .033), respectively. Our study demonstrated that utilizing rsERT technology to guide pFET in HRT cycles significantly enhances implantation and CPRs in RIF patients. Importantly, our findings confirm the effectiveness of rsERT technology and establish a scientific rationale for personalized reproductive medical interventions.
-
Case Reports
Successfully intravenous thrombolytic therapy in systemic lupus erythematosus-related ischemic stroke: A case report.
Stroke is a relatively frequent complication occurring in patients with systemic lupus erythematosus (SLE). The increasing number of patients with Ischemic Stroke secondary to SLE aroused the clinician's concern. SLE thrombosis markers, diagnostic high-resolution magnetic resonance image (HR-MRI), and therapeutic interventions for acute ischemic stroke were recently coming into focus perspectives from the field. ⋯ After thrombolysis, the NIHSS score of the patient decreased to zero. The computed tomography scan was reexamined 24 hours later, and no acute changes or hemorrhage were identified in the infarcted area. Subsequent imaging and serological analyses indicated that HR-MRI of the responsible vessel was negative, but the infarction in this patient was still regarded as being caused by vasculitis of the right posterior cerebral artery in the region supplying the thalamus. This is the first case of successful intravenous thrombolytic therapy with rt-PA in a patient with SLE secondary to stroke with an NIHSS score of 3. This provides further evidence for expanding the reference of indications with rt-PA intravenous thrombolysis.
-
Observational Study
The rate of change in clinical indicators can predict the progression of hepatitis B virus-related acute-on-chronic preliver failure.
The objective of this study was to investigate the predictors and predictive model construction of the progression of HBV-Pre. Acute-on-chronic liver failure (ACLF), a total of 133 patients with HBV-Pre. ACLF was divided into the progressive group (52 patients) and the recovery group (81 patients) according to whether they progressed to ACLF or not. ⋯ The patients with a higher logitP score (> -0.22) had an increased risk for progression to ACLF (P <.05). The novel model logitP shows good predictive value for the disease progression of HBV-Pre. ACLF.
-
This retrospective study aimed to investigate the clinical efficacy of single-channel percutaneous endoscopic nucleotomy combined with annulus fibrosus suturing for treating lumbar disc herniation (LDH). The study included 86 patients with LDH treated in our spinal department from August 2020 to January 2022. The suture group consisted of 26 males and 18 females, while the control group (nucleotomy alone) included 25 males and 17 females. ⋯ However, the suture group had a lower intervertebral disc height loss rate compared to the control group (22.3% ± 4.6% vs 29.8% ± 6.2%, X2=6.390, P < .001). In conclusion, single-channel percutaneous endoscopic nucleotomy combined with annulus fibrosus suturing is a safe and reliable treatment for LDH. It effectively reduces the recurrence rate, slows disc degeneration and loss of disc height, and achieves excellent early outcomes.
-
To retrospectively explore the role of magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) in analyzing the corticospinal tract injury in acute cerebral anterior circulation infarction in the basal ganglia region and the correlation between DTI parameters and neurological function scores, patients with acute cerebral infarction and stroke had undergone plain MRI and DTI sequence scanning were enrolled. Diffusion tensor tractography was used to perform 3-dimensional reconstruction of bilateral corticospinal tracts (CST). The image data were processed to obtain fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values, and the correlation between the DTI parameters and neurological function scores of National Institutes of Health Stroke Scale (NIHSS) was evaluated. ⋯ The FA and ADC values were not significantly (P > .05) different according to the CST scores 0, 1, 2, 3, or 4 between the ischemic and healthy sides. There was a significant (P < .05) negative correlation between the FA value on the infarcted side and the NIHSS score. In conclusion, with the DTI technology, varying degrees of damage to the corticospinal tract at the infarcted side can be detected and important clinical information can be provided for the diagnosis and prognosis of acute cerebral infarction by evaluating the degree of corticospinal tract injury.