Comparison of ovarian preservation versus oophorectomy on fertility outcomes in patients with endometriosis post-laparoscopic surgery:A prospective study

BACKGROUND Endometriosis is a chronic inflammatory condition affecting a significant proportion of women of reproductive age.Although laparoscopic surgery is commonly the preferred treatment,the decision to preserve or remove the ovaries remains controversial.Previous studies have yielded inconsistent results regarding the impact of ovarian preservation vs oophorectomy on fertility outcomes and disease recurrence.This prospective study aimed to address this knowledge gap by comparing the effects of these surgical approaches on spontaneous pregnancy rates,time to pregnancy,recurrence rates,and postoperative pain in patients with endometriosis.AIM To compare the reproductive outcomes and recurrence rates between ovarian preservation and oophorectomy in women undergoing laparoscopic surgery for endometriosis.METHODS This study was conducted at a tertiary care hospital between January 2019 and December 2023.A total of 312 women aged 18 to 40 years,diagnosed with endometriosis and undergoing laparoscopic surgery,were included.The patients were categorized into the ovarian preservation group(n=204)and the oophorectomy group(n=108).The primary outcome measure was the achievement of spontaneous pregnancy within 24 months post-surgery.Secondary outcomes included time to spontaneous pregnancy,recurrence rates,and postoperative pain scores.RESULTS The ovarian preservation group exhibited a significantly higher spontaneous pregnancy rate than that in the oophorectomy group(43.6%vs 28.7%,P=0.006).Moreover,the median time to spontaneous pregnancy was shorter in the ovarian preservation group(8.2 months vs 11.4 months,P=0.018).Nonetheless,endometriosis recurrence was more prevalent in the ovarian preservation group(22.1%vs 11.1%,P=0.014).The postoperative pain scores demonstrated similar improvements in both groups,with no significant differences observed.Subgroup analyses indicated that the benefit of ovarian preservation on spontaneous pregnancy rates was more evident among younger women(≤35 years)and those with advanced-stage endometriosis.CONCLUSION Ovarian preservation is associated with a high spontaneous pregnancy rate and a short time to pregnancy.However,because of the increased risk of recurrence,the decision should be based on age,fertility aspirations,and disease severity.

Coinfection of SARS-CoV-2 Omicron variant and other respiratory pathogens in children

Since the outbreak of coronavirus disease 2019(COVID-19),the entire world has been affected by the epidemic[1,2].On November 9,2021,a variant of the novel coronavirus B.1.1.529 was detected for the first time from case samples in South Africa.The Omicron strain spread and mutated significantly fast.This variant has the characteristics of escape immunity,which can induce relatively extreme disease and reduce the neutralization of antibodies in vaccinators,and is more likely to be reinfected[3,4].The clinical presentation of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)in children has mild symptoms and a lower risk of hospitalization and death.

Risk factors for avian influenza virus in backyard poultry flocks and environments in Zhejiang Province,China:a crosssectional study

Background:Human infection of avian influenza virus(AIV)remains a great concern.Although live poultry markets are believed to be associated with human infections,ever more infections have been reported in rural areas with backyard poultry,especially in the fifth epidemic of H7N9.However,limited information is available on backyard poultry infection and surrounding environmental contamination.Methods:Two surveillance systems and a field survey were used to collect data and samples in Zhejiang Province.In total,4538 samples were collected by surveillance systems and 3171 from the field survey between May 2015 and May 2017,while 352 backyard poultry owners were interviewed in May 2017 by questionnaire to investigate factors influencing the prevalence of avian influenza A virus and other AIV subtypes.RT-PCR was used to test the nucleic acids of viruses.ArcGIS 10.1 software was used to generate maps.Univariate and logistic regression analyses were conducted to identify risk factors for AIV infection.Results:Of the 428 poultry premises observed by the surveillance system,53(12.38%)were positive for influenza A virus.Of the 352 samples from poultry premises observed by field survey,13(3.39%)were positive for influenza A virus.The prevalence of AIV was unevenly distributed and the dominant subtype differed among cities.Eastern(Shaoxing and Ningbo)and southern(Wenzhou)cities exhibited a higher prevalence of AIV(16.33,8.94,and 7.30%respectively).Contamination of AIV subtypes was most severe in January,especially in 2016(23.26%,70/301).The positive rate of subtype H5/H7/H9 was 2.53%(115/4538).Subtype H5 was the least prevalent,while subtypes H7 and H9 had similar positivity rates(1.50 and 1.32%respectively).Poultry flocks and environmental samples had a similar prevalence of AIV(4.46%vs 5.06%).The type of live birds was a risk factor and the sanitary condition of the setting was a protective factor against influenza A contamination.Conclusions:AIV subtypes were prevalent in backyard poultry flocks and surrounding environments in Zhejiang Province.The types of live birds and sanitary conditions of the environment were associated with influenza A contamination.These findings shine a light on the characteristics of contamination of AIV subtypes and emphasize the importance of reducing AIV circulation in backyard poultry settings.