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PURPOSE: To investigate the association between different treatments of tubal ectopic pregnancy (EP) -expectant management, methotrexate (MTX), selected or recommended laparoscopic surgery-and the subsequent reproductive outcomes. METHODS: We conducted a retrospective cohort study including 228 EPs. The patients were divided into four treatment groups: 28 (12.3%) with expectant management successfully, 60 (26.3%) with MTX successfully, 140 patients with laparoscopic salpingectomy, of which 47 (20.6%) were assigned to selected surgery group because they opted for surgical treatment versus MTX, 93 (40.8%) were assigned to recommended surgery group as recommended by the attending physician. RESULTS: The recommended surgery group had the lowest rate of intrauterine pregnancy (IUP) (77.42%) and live birth (LB) (72.04%), while the incidence of recurrent EP (REP) (20.43%) was the highest, but the statistical differences were not significant. We did not observe significant differences of the EP-IUP time interval, rates of LB and miscarriage (MIS) between the four groups. Compared to the MTX group, recommended surgery was negatively associated with IUP (adjusted OR, 95%CI: 0.34, 0.11-1.03) and LB (0.35, 0.14-0.92), while it had higher risk for REP (3.48, 1.03-11.74) in the subsequent pregnancy. Further, compared to selective surgery group, recommended surgery was negatively associated with IUP (0.15, 0.03-0.68) and LB (0.23, 0.07-0.74), while it had higher risk for REP (6.83, 1.43-32.67) in the subsequent pregnancy. Expectant treatment was negatively associated with assisted reproductive technology (ART) (0.08, 0.02-0.40) compared with MTX. Of the185 patients who had LBs, all adverse outcomes were not statistically different between the four groups. CONCLUSION: Patients with recommended laparoscopic salpingectomy had worse reproductive outcomes than the other treatment groups. The disease status of EP may play an important role in the association rather than the surgery alone.
Asunto(s)
Embarazo Tubario , Embarazo , Femenino , Humanos , Estudios Retrospectivos , Embarazo Tubario/epidemiología , Embarazo Tubario/cirugía , Salpingectomía , Metotrexato/uso terapéutico , Técnicas Reproductivas AsistidasRESUMEN
Terahertz science and technology has recently shown new application prospects in artificial intelligence. It is found that terahertz unipolar stimulation can activate cell membrane hydrophilic pores. However, the behaviors of Na+, K+-ATPase and energy consumption during this period remain unknown. This paper investigates these behaviors by Na+, K+-ATPase and electroporation models, based on the interaction theory between terahertz fields and ions at the cellular level. The effective diameters of life ions are considered in the aqueous solution. From results, Na+, K+-ATPases can be activated and stay for a while before close after the stimulation. Their life ion flows are far lower than the flows via the pores. And their power dissipation is as low as 10-11 W in both rat neostriatal neurons and guinea pig ventricular myocytes. The results keep tenable in 0.1-1.2 THz. These lay the basis for investigations of information communication mechanisms in cells under terahertz stimulation.
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Under the background of increasing and sustainable development of nuclear industry, it is significant to develop materials with high adsorption capacity and high selectivity of uranium as adsorbents. In this work, novel Mg-Co layered-double-hydroxide (LDH) with hierarchical structure was synthesized successfully via self-sacrifice template by ZIF-67. X-ray diffraction (XRD) technique, scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy (FT-IR), Brunauer-Emmett-Teller surface area measurement (BET) and X-ray photoelectron spectroscopy (XPS) characterization were conducted, which confirmed the specifically hollow structured material possesses high surface area and abundant mesopores that makes uranium ions diffuse into it more easily. In typical batch adsorption experiments, varieties of parameters were investigated in details. In addition, adsorption of trace concentration of uranium (ppb level) in simulated seawater was also studied. The results showed as-prepared Mg-Co LDHs are promising adsorbents for extraction of uranium from simulated seawater.
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Different forms of heavy metals in soil will produce different environmental effects, and will directly influence the toxicity, migration and bioavailability of heavy metals. This study used lime, fly ash, dried sludge, peanut shells as stabilizers in the treatment of heavy metals in mineral waste residues. Morphological analyses of heavy metal, leaching experiments, potted plant experiments were carried out to analyze the migration and transformation of heavy metals. The results showed that after adding stabilizers, the pH of the acidic mineral waste residues increased to more than neutral, and the organic matter content increased significantly. The main existing forms of As, Pb, and Zn in the mineral waste residues were the residual. The contents of exchangeable and organic matter-bound As decreased by 65.6% and 87.7% respectively after adding fly ash, dried sludge and peanut shells. Adding lime, fly ash and peanut shells promoted the transformation of As from the Fe-Mn oxide-bound to the carbonate-bound, and adding lime and fly ash promoted the transformation of Pb and Zn from the exchangeable, Fe-Mn oxide-bound, organic matter-bound to the residual. After the early stage of the stabilization treatment, the contents of As, Pb and Zn in the leachate had varying degrees of decline, and adding peanut shells could reduce the contents of As, Pb and Zn in the leachate further. Among them, the content of As decreased most significantly after treatment with fly ash, dried sludge and peanut shells, with a decline of 57.4%. After treatment with lime, fly ash and peanut shells, the content of Zn decreased most significantly, by 24.9%. The addition of stabilizers was advantageous to the germination and growth of plants. The combination of fly ash, dried sludge and peanut shell produced the best effect, and the Vetiveria zizanioides germination rate reached 76% in the treated wasted mineral residues.