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Efficacy of transvaginal ultrasound-guided local injections of absolute ethanol for ectopic pregnancies with intrauterine implantation sites

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World Journal of clinical Cases 2023年第4期11卷 788-796页

作者： Toshiyuki Kakinuma Kaoru Kakinuma Yoshio Matsuda Kaoru Yanagida Michitaka Ohwada HirotsuneKaijima Department of Obstetrics and Gynecology International University of Health and Welfare HospitalNasushiobara 329-2763Japan Minatomirai Yume clinic Yokohama 2200012Japan

BACKGROUND Cervical pregnancies,interstitial tubal pregnancies,and cesarean scar pregnancies,which are ectopic pregnancies with intrauterine implantation sites exhibit increasing trends with the recent widespread use of assisted reproductive technologies and increased rate of cesarean *** development of highsensitivity human chorionic gonadotropin testing reagents and the increased precision of transvaginal ultrasonic tomography have made early diagnosis possible and have enabled *** of ectopic pregnancies using methotrexate therapy and/or uterine artery embolization has been ***,delayed resumption of infertility treatments after methotrexate therapy is indicated,and negative effects on the next pregnancy after uterine artery embolization have been *** To examine the efficacy and safety of ultrasound-guided topical absolute ethanol injection in ectopic pregnancies with an intrauterine implantation *** In this study,we retrospectively examined the medical records of 21 patients who were diagnosed with an ectopic pregnancy with an intrauterine implantation site at our hospital,between April 2010 and December 2018,and underwent transvaginal ultrasound-guided local injections of absolute ethanol to determine the treatment *** evaluated the treatment methods,treatment outcomes,presence of bleeding requiring hemostasis measures and blood transfusion,complications,and treatment *** treatment was defined as the completion of treatment using transvaginal ultrasound-guided local injections of absolute ethanol *** There were 21 total cases comprising 10 cervical pregnancies,10 interstitial tubal pregnancies,and 1 cesarean scar *** patients completed treatment with this *** massive hemorrhaging or serious adverse reactions were observed during *** mean gestation ages at the time of diagnosis were 5.9 wk(SD,±0.9 wk)for cervical and 6.9 wk(SD,±2.1 wk)for interstitial

关键词： Embryo transfer Fertility Fertilization in vitro Pregnancy complications Prenatal care Ectopic pregnancy

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Berberine and Metformin in the Treatment of Type 2 Diabetes Mellitus: A Systemic Review and Meta-Analysis of Randomized clinical Trials

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Health 2021年第11期13卷 1314-1329页

作者： Li Wang Donglan Liu Guohong Wei Hui Ge Department of Healthcare The First Affiliated Hospital Sun Yat-sen University Guangzhou China outpatient clinic of Internal Medicine Department The First Affiliated Hospital Sun Yat-sen University Guangzhou China Department of Endocrinology The First Affiliated Hospital Sun Yat-sen University Guangzhou China

Objective: To assess the effects of berberine and metformin on glucose in patients with type 2 diabets mellitus (T2DM) with a systematic review and meta-analysis. Methods: The databases including PubMed, Excerpta Medica Database (EMBase), Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI), WanFang, the Chinese Scientific and Technical Journals database (VIP), China Doctor Dissertation Full-text Database (CDFD) and China Master Dissertation Full-text Database (CMFD) from the inception to April 2021 in Chinese or English language were searched. Randomized controlled trials (RCTs) of berberine only or combined with metformin versus metformin were included. Data extraction and paper quality assessment were conducted according to the Cochrane Handbook. RevMan 5.4 was used for the meta-analysis. Results: A total of thirteen studies were included, covering 1173 participants. The clinical heterogeneity of the included trials was relatively high. The methodological quality of most trials was generally low with bias in terms of random sequence generation, allocation concealment, blinding method, outcome data and selective reporting. Interventions were divided into two subgroups for analysis. Meta-analysis suggested that there was no statistical significance in the hypoglycemic effect between berberine and metformin for T2DM. However, berberine combined with metformin could reduce fasting plasma glucose (FPG) [MD = −1.49, 95% CI (−2.22, −0.76), P MD = −1.89, 95% CI (−2.94, −0.84), P = 0.0004], glycosylated hemoglobin A1c (HbA1c) [MD

关键词： Berberine Metformin Type 2 Diabetes Mellitus Efficacy Safety Meta-Analysis

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What every gastroenterologist needs to know about common anorectal disorders

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World Journal of Gastroenterology 2009年第26期15卷 3201-3209页

作者： Moonkyung Cho Schubert Subbaramiah Sridhar Robert R Schade Steven D Wexner Department of Gastroenterology and Hepatology Medical College of Georgia Department of Colorectal Surgery Cleveland Clinic Florida2950 Cleveland Clinic Boulevard

Anorectal complaints are very common and are caused by a variety of mostly benign anorectal *** anorectal conditions may be successfully treated by primary care physicians in the outpatient setting,but patients tend not to seek medical attention due to embarrassment or fear of *** a result,patients frequently present with advanced disease after experiencing significant decreases in quality of life.A number of patients with anorectal complaints are referred to ***,gastroenterologists' knowledge and experience in approaching these conditions may not be *** article can serve as a guide to gastroenterologists to recognize,evaluate,and manage medically or non-surgically common benign anorectal disorders,and to identify when surgical referrals are most prudent.A review of the current literature is performed to evaluate comprehensive clinical pearls and management guidelines for each *** reviewed include hemorrhoids,anal fissures,anorectal fistulas and abscesses,and pruritus ani.

关键词： Anal fissures Anorectal disease Anorectal fistulas and abscesses Hemorrhoids Pruritus ani

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Epidemiological study of hypertensive retinopathy in the primary care setting: Retrospective cross-sectional review of retinal photographs

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Family Medicine and Community Health 2016年第4期4卷 13-21页

作者： Lap-kin Chiang Michael K.C.Yau Cheuk-wai Kam Lorna V.Ng Benny C.Y.Zee Family Medicine and General outpatient Department Kwong Wah HospitalHospital AuthorityHong KongChina The Jockey Club School of Public Health and Primary Care The Chinese University of Hong KongHong KongChina

Objective:The objective is to estimate the prevalence and grading of hypertensive retinopa-thy in the primary care setting;examine the patient characteristics associated with hypertensive retinopathy;and examine the association of hypertensive retinopathy and other hypertension ***:This is a retrospective cross-sectional *** included adult hypertensive patients with available and gradable retinal ***:Two hundred fifty-six male hypertensive patients(34.3%)and 491 female hyper-tensive patients(65.7%)were *** average duration of hypertension was 7.2 years,and 49.8%and 41.2%of patients were taking one or two antihypertensive medications *** 1491 qualified retinal photographs(744 right eye and 747 left eye),24.9%,62.6%,and 12.5%were classified as showing normal,mild,and moderate hypertensive retinopathy *** three commonest retinal signs were generalized or focal arteriolar narrowing(650 cases,43.6%),hard exudates(168 cases,11.3%),and opacity(copper or silver wiring)of the arteriolar wall(166 cases,11.1%).Patients older than 61 years,having hypertension for more than 15 years,or taking three or more antihypertensive medications were significantly associated with hyperten-sive retinopathy(Pclinic in Hong Kong,77.1%of hypertensive patients had hypertensive *** hypertensive retinopathy was the commonest target organ damage for hypertensive patients in a primary care clinic.

关键词： Hypertensive retinopathy retinal photograph primary care

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Pregnancy Outcomes Associated with Ovarian Hyperstimulation Syndrome:A Retrospective Cohort Study of Infertile Women

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Maternal-Fetal Medicine 2023年第3期5卷 144-154页

作者： Ajleeta Sangtani Maryama lsmail Amy Weaver Zaraq Khan Department of Obstetrics and Gynecology Mayo ClinicRochesterMN 55905USA Mayo clinic Alix School of Medicine Mayo ClinicRochesterMN 55905USA Department of Health Sciences Research Mayo ClinicRochester.MN55905.USA

Objective To assess the relationship between ovarian hyperstimulation syndrome(OHSS)and adverse outcomes using population-based data in the United *** hypothesis is that patients with OHSS were more likely to deliver preterm and more likely to have hypertensive *** This retrospective cohort study identified 94 patients with OHSS and 183 matched referents in eight counties in *** were collected regarding pregnancy history,infertility treatment,and pregnancy *** the Rochester Epidemiology Project,study subjects were identified from female patients,aged 18 to 49 years,who were diagnosed with infertility from January 2,1995 to December 1,2017,and had a pregnancy greater than 20 weeks'*** primary outcome was preterm delivery or hypertensive disorder of pregnancy incidence in the OHSS group when compared with control ***-squared test,t test,and multivariate logistic models were used where *** Patients with OHSS were more likely to deliver preterm(odds ratio,2.14;95%confidence interval,1.26–3.65;P<0.01),and their neonates were more likely to be small for gestational age(odds ratio,4.78;95%confidence interval,1.61–14.19;P<0.01).No significant differences between the groups were observed in any other *** with OHSS are more likely to deliver preterm if they undergo fresh transfer compared with a freeze all and subsequent frozen transfer(odds ratio,3.03,95%confidence interval,1.20–7.66,P=0.02).Conclusion OHSS may lead to preterm birth and small-for-gestational-age neonates,which changes patient counseling and leads to arranging specialized obstetrical care for these patients with OHSS.

关键词： Obstetric labor,premature Hypertension Frozen cycle Fresh cycle

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长期存活肿瘤患儿不良预后的医学评估

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美国医学会杂志（中文版） 2008年第3期27卷 137-147页

作者： Maud M. Geenen, MD Mathilde C. Cardous-Ubbink, MSc Leontien C. M. Kremer, MD, PhD Cor van den Bos, MD, PhD Helena J. H. van der Pal, MD Richard C. Heinen, MSc Monique. M. Jaspers, PhD, MSc Caro C. E. Koning, MD, PhD Foppe Oldenburger, MD Nelia E. Langeveld, PhD, RN Augustinus A. M. Hart, MSc Piet J. M. Bakker, MD, PhD Huib N. Caron, MD, PhD Flora E. van Leeuwen, PhD, MSc 张成海(译) 武爱文(译) 徐光炜(校) Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Emma Children's Hospital/Academic Medical Center: Departments of Medical Oneology Department of Pediatric Oncology Academic Medical Center:and Departments of Radiotherapy Netherlands Cancer Institute Amsterdamthe Netherlands Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Department of Pediatric Oncology Epidemiology Netherlands Cancer Institute Amsterdamthe Netherlands Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Medical Informatics Netherlands Cancer Institute Amsterdamthe Netherlands Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Radiotherapy Netherlands Cancer Institute Amsterdamthe Netherlands Radiotherapy Netherlands Cancer Institute Amsterdamthe Netherlands

背景：癌症患儿存活改善与多种治疗相关并发症相伴。然而，绝大多数有关癌症儿童生存率的研究仅局限于单一的远期效应。目的：在一个有完整的长期随访资料的大型儿童癌症生存队列中对癌症长期存活的不良预后（临床或亚临床病症）的总负... 详细信息

背景：癌症患儿存活改善与多种治疗相关并发症相伴。然而，绝大多数有关癌症儿童生存率的研究仅局限于单一的远期效应。目的：在一个有完整的长期随访资料的大型儿童癌症生存队列中对癌症长期存活的不良预后（临床或亚临床病症）的总负荷进行评估。设计、地点及人群：于1362例已生存5年的儿童癌症患者中进行回顾性队列研究。患儿1966至1996年在荷兰一家医疗机构接受治疗。所有生存者均被邀请到晚期效应诊所进行不良事件医学评估。2004年1月以前发生的不良事件依据标准方式进行严重度分级。主要观测指标：随访结束时治疗别不良事件（依据严重性）的发生率以及各种治疗相关疾病高度或严重负荷（危险度92或危及生命或致残的不良事件≥1个）的相对危险度。结果：94．3％的生存者完成了随访（中位随访时间17年）。随访结束时中位年龄为24、4岁。大约75％的生存者有1个或更多不良事件，24．6％发生5个或以上不良事件。而且，40％的生存者至少有1个严重、危及生命或致残的不良事件。在接受单纯放疗的生存者中，55％的患者观察到高度或严重不良事件负荷。接受单纯化疗的生存者发生率为15％，而单纯手术治疗的存活者相应发生率则为25％（校正后相对危险分别为2．18[95％可信区间，1．62—2．95]和0．65[95％可信区间，0．46—0．90]）。不良事件高度或严重负荷最常见于骨肿瘤生存者（64％），较少见于白血病或Wilms瘤生存者（12％）。结论：在成年时，很大一部分儿童癌症生存者都存在高度或严重疾病负荷，尤其是在放疗后。这强调了对儿童癌症生存者根据危险分层进行终生医学监视的必要性。

关键词：医学评估肿瘤患儿长期存活不良预后单纯手术治疗癌症生存者相对危险度不良事件

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Ultrasound-guided local ethanol injection for fertility-preserving cervical pregnancy accompanied by fetal heartbeat: Two case reports

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World Journal of clinical Cases 2022年第11期10卷 3587-3592页

作者： Toshiyuki Kakinuma Kaoru Kakinuma Yoshio Matsuda Michitaka Ohwada Kaoru Yanagida Hirotsune Kaijima Department of Obstetrics and Gynecology International University of Health and Welfare HospitalNasushiobara 329-2763Japan Minatomirai Yume clinic Yokohama 220-0012Japan

BACKGROUND The incidence of cervical pregnancy is increasing due to the recent widespread application of assisted reproductive *** hysterectomy has been a treatment option,high-sensitivity human chorionic gonadotropin testing and improved accuracy of transvaginal ultrasound imaging have increased possibility of uterine *** and curettage with methotrexate therapy and uterine artery embolization have been reported as treatments with fertility preservation;however,certain disadvantages limit their *** SUMMARY In our two reported cases,we avoided massive bleeding and immediately resumed infertility treatment using ultrasound-guided local ethanol injection for cervical pregnancies with fetal *** This treatment may be a new fertility-preserving option for cervical pregnancy.

关键词： Ultrasonography Ethanol infertility Fertility preservation Methotrexate Case report

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Lycopene and male infertility

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Asian Journal of Andrology 2014年第3期16卷 420-425页

作者： Damayanthi Durairajanayagam Ashok Agarwal Chloe Ong Pallavi Prashast Center for Reproductive Medicine Glickman Urological and Kidney Institute Cleveland Clinic Cleveland Ohio USA Faculty of Medicine MARA University of Technology Sungai Buloh Selangor Malaysia.

Excessive amounts of reactive oxygen species （ROS） cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inflicted on spermatozoa. It is postulated that lycopene may have other beneficial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility--lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility.

关键词： antioxidants lycopene male infertility oxidative stress reactive oxygen species sperm parameters

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The Role of Moral Intelligence and Identity Styles in Prediction of Mental Health Problems in Healthcare Students

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Health 2014年第8期6卷 664-672页

作者： Mahbobeh Faramarzi Kolsoom Jahanian Mohamadreza Zarbakhsh Sirous Salehi Hajar Pasha Counseling clinic Babol University of Medical Science Babol Iran Department of Psychology Tonekabon Branch Islamic Azad University Tonekabon Iran Fatemeh Zahra infertility and Reproductive Health Research Center Babol University of Medical Sciences Babol Iran Social Determinants of Health Research Center Psychiatric Department Babol University of Medical Sciences Babol Iran

Background: Assessment of healthcare students’ mental health problems is an important aspect of health promotion. This study examined the roles of moral intelligence (MI) and identity styles in prediction of mental health problems in healthcare students. Methods: In a correlation study, two hundred healthcare students (100 girls, 100 boys) of Medicine, Density, and Paramedicine Colleges of Bobol University of Medical Sciences were selected. The subjects filled out three questionnaires;General Health Questionnaire (GHQ-28), Moral Competency Inventory (MCI), and Identity Style Inventory (ISI), and General Health Questionnaire (GHQ-28). Pearson correlation, multivariate analysis variance model (MANOVA), and multivariate regression used to analyze the data. Results: Boys and girls did not have a meaningful difference in the mean of total GHQ, MCI, normative and informational identity. Girls had significantly higher mean level of diffused-avoidant identity than boys. There was a positive and significant relationship between moral intelligence, normative identity and mental health problems of students. Also, there was a negative relationship (p < 0.05) between diffused-avoidant identity and mental health problems of students. Moral intelligence, informational and normative identity predicted 25.8% of the variance in mental health problems for girls’ students. Normative and diffused-avoidant identity predicted 21.6% of the variance in mental health problems for girls’ students. Conclusions: This study demonstrated that moral intelligence and identity status contributed to the mental health problems of healthcare students. University administrators should adopt strategies that strengthen the moral intelligence and identity maturity associated with university students’ mental health.

关键词： Mental Health Problems Moral Intelligence Identity Style

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A rare case of cardiac and ophthalmic manifestations of meningococcal septicemia

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World Journal of Emergency Medicine 2024年第4期15卷 328-330页

作者： Svetlana Rachina Anastasia Shchendrygina Heshan Radeesha de Silva Svetlana Tarasenko Nadezhda Mukhina Irina Komarova Ludmila Fedina Elena Burmistrova Elvira Martens Sergey Sidorenko Vladimir Gostev Dmitry Polev Alina Saitova Lyudmila Kraeva Nikita Goncharov Irina Zvetkova Department of Hospital Therapy I M Sechenov First Moscow State Medical UniversityMoscow 119048Russia outpatient clinic#64 Moscow 119048Russia Department of Cardiology City Clinical Hospital n.a.S.S.YudinMoscow 119048Russia Department of Medical Microbiology and Molecular Epidemiology Pediatric Research and Clinical Center for InfectiousDiseasesSaint Petersburg 197022Russia Department of Medical Microbiology North-Western State Medical University Named After I.I.MechnikovSaintPetersburg 191015Russia Department of Epidemiology Saint-Petersburg Pasteur InstituteSaint Petersburg 197101Russia

Acute pericarditis is usually a self-limiting disorder that commonly occurs due to viral etiology or unexplained *** pericarditis(MP)is a remarkably uncommon clinical entity that manifests as a complication during the acute or convalescent phase of meningococcal ***,its occurrence within the context of meningococcal septicemia has also been *** report a rare case of a previously healthy male patient who developed both acute pericarditis and uveitis as a presentation of meningococcal septicemia,with no characteristic skin rashes or meningeal signs.

关键词： acute Acute rare

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