BACKGROUND The presence of a right-sided sigmoid colon is a rare anatomical variation usually discovered incidentally during surgical interventions.This case report details an unexpected right-sided sigmoid colon iden...BACKGROUND The presence of a right-sided sigmoid colon is a rare anatomical variation usually discovered incidentally during surgical interventions.This case report details an unexpected right-sided sigmoid colon identified during a laparoscopic appendectomy and examines the pertinent literature to explore its clinical importance.CASE SUMMARY A 71-year-old woman presented with acute appendicitis.A preoperative computed tomography(CT)scan showed peri-appendiceal inflammation but no significant anatomical abnormalities.During laparoscopic surgery,an unexpected finding was encountered:The sigmoid colon was situated on the right side and exhibited an abnormal relationship with the cecum and ascending colon.Postoperative pathological examination confirmed appendicitis with no additional pathological findings.The right-sided sigmoid colon anomaly was verified through intraoperative assessment and later re-evaluation with CT and colonographic imaging.The patient underwent a laparoscopic appendectomy and experienced a smooth postoperative recovery.CONCLUSION This case highlights the necessity of being attentive to anatomical variations during laparoscopic surgery,particularly when managing appendicitis.A review of the literature indicated that the occurrence of a right-sided sigmoid colon is infrequent and may be associated with anomalies in midgut rotation during embryonic development.Awareness of this variation can help prevent surgical complications and inform future clinical practice.展开更多
Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patie...Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patients who underwent blastocyst transfer in frozen-thawed cycles at day 5 or 6 were matched for potential confounding factors.A total of 2207 matched pairs of FBT cycles were included from January 2016 to December 2019 in our Reproductive Medicine Center.Results The clinical pregnancy rate(CPR)and live birth rate(LBR)were significantly increased in day 5 blastocyst transfers when compared to day 6 blastocyst transfers,in terms of the same embryo quality.For FBT cycles with good-quality embryo,the CPR at day 5 and 6 was 61.30%and 57.56%,respectively(P=0.045),and the LBR was 44.79%and 36.16%,respectively(P<0.001).For FBT cycles with poor-quality embryo,the CPR at day 5 and 6 was 48.61%and 40.89%,respectively(P=0.006),and the LBR was 31.71%and 25.74%,respectively(P=0.019).The CPR for FBT cycles with good-quality embryo was statistically higher at day 6 than that at day 5 with poor-quality embryo transferred(57.56%vs.48.61%,P=0.001).Maternal age,anti-Müllerian hormone(AMH),endometrial thickness,embryo quality,and the day of blastocyst expansion were independently correlated with the CPR and LBR.The FBT cycles at day 5 had significantly higher CPR(adjusted odds ratio[OR]=1.246,95%confidence intervals[CI]:1.097–1.415,P=0.001)and LBR(adjusted OR=1.435,95%CI:1.258–1.637,P<0.001)than those at day 6.Conclusion The embryo quality is the primary indicator for FBT cycles.Day 5 blastocysts should be preferred when the quality of embryo at day 5 is the same as that at day 6.展开更多
BACKGROUND Portal venous gas(PVG)is a rare clinical condition usually indicative of severe disorders,including necrotizing enterocolitis,bowel ischemia,or bowel wall rupture/infarction.Pneumatosis intestinalis(PI)is a...BACKGROUND Portal venous gas(PVG)is a rare clinical condition usually indicative of severe disorders,including necrotizing enterocolitis,bowel ischemia,or bowel wall rupture/infarction.Pneumatosis intestinalis(PI)is a rare illness characterized by an infiltration of gas into the intestinal wall.Emphysematous cystitis(EC)is relatively rare and characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging.Our study reports a rare case coexistence of PVG presenting with PI and EC.CASE SUMMARY An 86-year-old woman was admitted to the emergency room due to the progressive aggravation of pain because of abdominal fullness and distention,complicated with vomiting and stopping defecation for 4 d.The abdominal computed tomography(CT)plain scan indicated intestinal obstruction with ischemia changes,gas in the portal vein,left renal artery,superior mesenteric artery,superior mesenteric vein,some branch vessels,and bladder pneumatosis with air-fluid levels.Emergency surgery was conducted on the patient.Ischemic necrosis was found in the small intestine approximately 110 cm below the Treitz ligament and in the ileocecal junction and ascending colon canals.This included excision of the necrotic small intestine and right colon,fistulation of the proximal small intestine,and distal closure of the transverse colon.Subsequently,the patient displayed postoperative short bowel syndrome but had a good recovery.She received intravenous fluid infusion and enteral nutrition maintenance every other day after discharge from the community hospital.CONCLUSION Emergency surgery should be performed when CT shows signs of PVG with PI and EC along with a clinical situation strongly suggestive of bowel ischemia.展开更多
In this experimental prospective study, we aimed to analyze the effect of transient scrotal hyperthermia on the male reproductive organs, from the perspective of sperm parameters, semen plasma biochemical markers, and...In this experimental prospective study, we aimed to analyze the effect of transient scrotal hyperthermia on the male reproductive organs, from the perspective of sperm parameters, semen plasma biochemical markers, and oxidative stress, to evaluate whether different frequencies of heat exposure cause different degrees of damage to spermatogenesis. Two groups of volunteers （10 per group） received testicular warming in a 43~C water bath 10 times, for 30 min each time： group 1：10 consecutive days; group 2： once every 3 days. Sperm parameters, epididymis and accessory sex gland function, semen plasma oxidative stress and serum sex hormones were tested before treatment and in the 16-week recovery period after treatment. At last, we found an obvious reversible decrease in sperm concentration （P = 0.005 for Group 1 and P = 0.008 for Group 2 when the minimums were compared with baseline levels, the same below）, motility （P= 0.009 and 0.021, respectively）, the hypoosmotic swelling test score （P-- 0.007 and 0.008, respectively）, total acrosin activity （P = 0.018 and 0.009, respectively）, and an increase in the seminal plasma malondialdehyde concentration （P = 0.005 and 0.017, respectively）. The decrease of sperm concentration was greater for Group 2 than for Group 1 （P = 0.031）. We concluded that transient scrotal hyperthermia seriously, but reversibly, negatively affected the spermatogenesis, oxidative stress may be involved in this process. In addition, intermittent heat exposure more seriously suppresses the spermatogenesis compared to consecutive heat exposure. This may be indicative for clinical infertility etiology analysis and the design of contraceptive methods based on heat stress.展开更多
文摘BACKGROUND The presence of a right-sided sigmoid colon is a rare anatomical variation usually discovered incidentally during surgical interventions.This case report details an unexpected right-sided sigmoid colon identified during a laparoscopic appendectomy and examines the pertinent literature to explore its clinical importance.CASE SUMMARY A 71-year-old woman presented with acute appendicitis.A preoperative computed tomography(CT)scan showed peri-appendiceal inflammation but no significant anatomical abnormalities.During laparoscopic surgery,an unexpected finding was encountered:The sigmoid colon was situated on the right side and exhibited an abnormal relationship with the cecum and ascending colon.Postoperative pathological examination confirmed appendicitis with no additional pathological findings.The right-sided sigmoid colon anomaly was verified through intraoperative assessment and later re-evaluation with CT and colonographic imaging.The patient underwent a laparoscopic appendectomy and experienced a smooth postoperative recovery.CONCLUSION This case highlights the necessity of being attentive to anatomical variations during laparoscopic surgery,particularly when managing appendicitis.A review of the literature indicated that the occurrence of a right-sided sigmoid colon is infrequent and may be associated with anomalies in midgut rotation during embryonic development.Awareness of this variation can help prevent surgical complications and inform future clinical practice.
基金supported by the National Natural Science Foundation of China(No.81701509).
文摘Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patients who underwent blastocyst transfer in frozen-thawed cycles at day 5 or 6 were matched for potential confounding factors.A total of 2207 matched pairs of FBT cycles were included from January 2016 to December 2019 in our Reproductive Medicine Center.Results The clinical pregnancy rate(CPR)and live birth rate(LBR)were significantly increased in day 5 blastocyst transfers when compared to day 6 blastocyst transfers,in terms of the same embryo quality.For FBT cycles with good-quality embryo,the CPR at day 5 and 6 was 61.30%and 57.56%,respectively(P=0.045),and the LBR was 44.79%and 36.16%,respectively(P<0.001).For FBT cycles with poor-quality embryo,the CPR at day 5 and 6 was 48.61%and 40.89%,respectively(P=0.006),and the LBR was 31.71%and 25.74%,respectively(P=0.019).The CPR for FBT cycles with good-quality embryo was statistically higher at day 6 than that at day 5 with poor-quality embryo transferred(57.56%vs.48.61%,P=0.001).Maternal age,anti-Müllerian hormone(AMH),endometrial thickness,embryo quality,and the day of blastocyst expansion were independently correlated with the CPR and LBR.The FBT cycles at day 5 had significantly higher CPR(adjusted odds ratio[OR]=1.246,95%confidence intervals[CI]:1.097–1.415,P=0.001)and LBR(adjusted OR=1.435,95%CI:1.258–1.637,P<0.001)than those at day 6.Conclusion The embryo quality is the primary indicator for FBT cycles.Day 5 blastocysts should be preferred when the quality of embryo at day 5 is the same as that at day 6.
文摘BACKGROUND Portal venous gas(PVG)is a rare clinical condition usually indicative of severe disorders,including necrotizing enterocolitis,bowel ischemia,or bowel wall rupture/infarction.Pneumatosis intestinalis(PI)is a rare illness characterized by an infiltration of gas into the intestinal wall.Emphysematous cystitis(EC)is relatively rare and characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging.Our study reports a rare case coexistence of PVG presenting with PI and EC.CASE SUMMARY An 86-year-old woman was admitted to the emergency room due to the progressive aggravation of pain because of abdominal fullness and distention,complicated with vomiting and stopping defecation for 4 d.The abdominal computed tomography(CT)plain scan indicated intestinal obstruction with ischemia changes,gas in the portal vein,left renal artery,superior mesenteric artery,superior mesenteric vein,some branch vessels,and bladder pneumatosis with air-fluid levels.Emergency surgery was conducted on the patient.Ischemic necrosis was found in the small intestine approximately 110 cm below the Treitz ligament and in the ileocecal junction and ascending colon canals.This included excision of the necrotic small intestine and right colon,fistulation of the proximal small intestine,and distal closure of the transverse colon.Subsequently,the patient displayed postoperative short bowel syndrome but had a good recovery.She received intravenous fluid infusion and enteral nutrition maintenance every other day after discharge from the community hospital.CONCLUSION Emergency surgery should be performed when CT shows signs of PVG with PI and EC along with a clinical situation strongly suggestive of bowel ischemia.
基金ACKNOWLEDGMENTS This study was supported by the National Science and Technology Support Program of the Ministry of Science and Technology （No. 2012BAI31B08）, the National Natural Science Foundation of China （No. 31171380）.
文摘In this experimental prospective study, we aimed to analyze the effect of transient scrotal hyperthermia on the male reproductive organs, from the perspective of sperm parameters, semen plasma biochemical markers, and oxidative stress, to evaluate whether different frequencies of heat exposure cause different degrees of damage to spermatogenesis. Two groups of volunteers （10 per group） received testicular warming in a 43~C water bath 10 times, for 30 min each time： group 1：10 consecutive days; group 2： once every 3 days. Sperm parameters, epididymis and accessory sex gland function, semen plasma oxidative stress and serum sex hormones were tested before treatment and in the 16-week recovery period after treatment. At last, we found an obvious reversible decrease in sperm concentration （P = 0.005 for Group 1 and P = 0.008 for Group 2 when the minimums were compared with baseline levels, the same below）, motility （P= 0.009 and 0.021, respectively）, the hypoosmotic swelling test score （P-- 0.007 and 0.008, respectively）, total acrosin activity （P = 0.018 and 0.009, respectively）, and an increase in the seminal plasma malondialdehyde concentration （P = 0.005 and 0.017, respectively）. The decrease of sperm concentration was greater for Group 2 than for Group 1 （P = 0.031）. We concluded that transient scrotal hyperthermia seriously, but reversibly, negatively affected the spermatogenesis, oxidative stress may be involved in this process. In addition, intermittent heat exposure more seriously suppresses the spermatogenesis compared to consecutive heat exposure. This may be indicative for clinical infertility etiology analysis and the design of contraceptive methods based on heat stress.
