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To compare the treatment efficacies of high-intensity focused ultrasound (HIFU), HIFU combined with gonadotrophin-releasing hormone agonist (GnRH-a), and HIFU combined with GnRH-a and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis.We conducted a literature search in SCIENCE DIRECT, COCHRANE LIBRARY, WILLEY ONLINE LIBRARY, PUBMED, and TAYLOR FRANCIS. A total of 471 articles identified, 12 were included in a systematic review, and 11 of them deemed quantitively eligible included in the meta-analysis. The efficacies of the three treatment regimens were assessed using the dysmenorrhea and menstrual scores at 3, 6, 12, 24 months.Of the three regimens, HIFU combined with GnRH-a and LNG-IUS provides the best outcome. On dysmenorrhea score at 6 months there was significantly different higher heterogeneity with P

Background: To compare the clinical outcomes and treatment efficiencies of advanced surgical treatments including High-Intensity Focused Ultrasound (HIFU), robotic surgery and laparoscopic surgery in the uterine fibroid patients. Methods: A total of 512 studies from 1995 to 2021 were identified by screening from Science Direct, Cochrane library, Medscape, Willey Online Library, PubMed, and Taylor Francis. From these studies 29 articles were qualitatively included in our systematic review and 24 of them considered quantitively eligible were included in the meta-analysis. Study analyzed by pooling the weighed mean difference (WMD) with the 95% confidence interval (CI) were study provided as a mean + (SD) and pooled risk ratio (RR) was expressed for dichotomous variables. Pooled results were assessed with either a random-effect or fixed-effect model. Heterogeneity was evaluated using the I2 statistic. Results: Comparison of HIFU and robotic surgeries with operation times of 86.13 ± 36.37 minutes to 120.2 ± 63 minutes and 166 ± 48.5 minutes to 278 ± 67 minutes were higher significant differences (I2 = 97%, p < 0.00001), (WMD –111.88 [–189.68, –34.08]) with statistically significant (p = 0.005). Comparison of HIFU and laparoscopic surgery in operation time of 86.13 ± 36.37 minutes to 120.2 ± 63 minutes and 79 ± 30 minutes to 106.4 ± 38.5 minutes were not statistically significant (p = 0.75) with higher significant differences heterogeneity (I2 = 96%, p < 0.00001), (5.51 [–27.82, 38.83]). Comparison of between blood losses and fibroid sizes at 154 ± 75 mL to 278 ± 164.6 mL and 6.5±2.9 cm to 13.6 ± 3.1 cm respectively in laparoscopic surgery was higher significant differences (I2 = 91%, p < 0.0007), (WMD 202.29 [87.77, 316.80]) with statistically significant (p = 0.0005). Between hospital stay and blood loss in laparoscopic surgery at 1.2 ± 0.9 days to 5.4 ± 0.2 days and 200 ± 107 mL to 278 ± 164.6 mL showed significant differences (I2 = 90%, p < 0.0001), (WMD –269.71 [–361.33, –178.09]) with statistically significant (p < 0.00001) while in robotic surgery was not significant. The follow up uterine fibroid symptom & health-related quality of life questionnaire (UF-QOL) at 3 months 45.3 + 26.9 to 70.6 + 26.9 in fibroids group and 61.6 + 41.4 to 79.64 + 17.91 in adenomyosis group and both shows significantly different (I2 = 83%, p = 0.02), (WMD 14.08 [4.42, 23.75]) with statistically significant (p = 0.0004) and (I2 = 97%, p < 0.00001), (WMD –15.95 [–28.06, –3.84]) with (p = 0.010). SSS follow up 3 months 27.2 + 15.7 to 36.6 + 7.9 in fibroids of HIFU, the heterogeneity test showed significant differences (I2 = 95%, p < 0.00001), (WMD 16.22 [8.33, 24.11]) with statistically significant (p < 0.0001). In terms of pregnancy outcome, delivery outcome in live birth between HIFU and laparoscopic surgery 4 (8) within 165 (219) and (7) 23 within 158 (224), the heterogeneity was not significant (I2 = 0%, p = 0.44), (RR 1.06 [0.97, 1.17]) neither with for risk of delivering was not significant (p = 0.20). Conclusions: HIFU treatment reveals more efficient clinical and treatment outcomes than robotic or laparoscopic surgery, including improved symptoms, absence of bleeding, shorter operative time, shorter recovery time, and good benefits in both short-term and long-term quality-of-life.

Background/objectives: Mongolian diets are characterized by high meat consumption, which may contribute to dietary iron intake and influence ferritin levels and cardiovascular risk. Elevated ferritin levels have been associated with inflammation and cardiovascular disease (CVD) risk in various populations; however, the specific effects of high meat intake and ferritin levels on CVD risk in Mongolian individuals with diabetes remain unclear. This study aimed to assess the relationship between meat intake, ferritin levels, and cardiovascular risk markers in a diabetic Mongolian population., Methods: A cross-sectional study was conducted involving 171 Mongolian adults with diabetes. Meat intake was assessed using 24 h dietary recall interviews, and participants were categorized into tertiles of low, medium, and high intake. Blood samples were collected to measure ferritin, lipid profiles, and other CVD markers. The Framingham Risk Score was calculated for each participant., Results: Participants in the highest tertile of meat intake exhibited significantly elevated ferritin levels compared to those in the lower tertiles (275.6 ng/mL vs. 119.6 ng/mL, p = 0.001). Elevated ferritin levels were observed in 40% of participants and were associated with higher LDL cholesterol (3.75 vs. 3.22 mmol/L, p = 0.002), total cholesterol (5.63 vs. 5.2 mmol/L, p = 0.012), and Framingham Risk Scores (13.97 vs. 11.4, p = 0.0001). However, ferritin levels showed no significant association with other cardiovascular or inflammatory markers, including BMI, HbA1c, CRP, and IL-6 ( p > 0.05). Mediation analysis revealed that ferritin partially mediated the relationship between meat intake and cardiovascular risk (beta coefficient = 0.539, p = 0.001), though the indirect effect was not statistically significant. Interaction analysis indicated no significant effect modification of meat intake and ferritin levels on cardiovascular risk ( p = 0.844)., Conclusions: In this diabetic Mongolian population, high meat intake was associated with elevated ferritin levels, which may have reflected dietary iron intake rather than systemic inflammation or increased CVD risk.

Background : While a positive correlation between age and HbA1c has been suggested in non-diabetic individuals, warranting higher HbA1c reference ranges for older adults, evidence among individuals with diabetes is less clear and may reveal an inverse trend. This study aimed to examine the relationship between age and HbA1c in a diabetic population, considering red cell parameters and other confounding factors; Methods : This cross-sectional study included 268 diabetic participants from Mongolia-Japan University Hospital (mean age 57.0 ± 9.9 years, 38.8% male, median diabetes duration 8.0 years, mean HbA1c 9.2 ± 3.3%). We analyzed the association between age and HbA1c using linear regression models, adjusting for diabetic characteristics, chronic complications, inflammation markers, and red cell indices. Subgroup analyses were conducted based on red cell distribution width (RDW) median splits; Results : A significant negative association between age and HbA1c was observed, with an unstandardized B coefficient (95% CI) of -0.112 (-0.166; -0.058, p < 0.001). This association persisted after adjustment for diabetic characteristics, complications, inflammation markers, and red cell indices (-0.115, -0.179; -0.051, p = 0.001). Subgroup analyses indicated a stronger negative association in participants with lower RDW levels (-0.174, -0.269; -0.079, p < 0.001) compared to those with higher RDW (-0.080, -0.147; -0.014, p = 0.019), suggesting that red cell characteristics may modify this relationship. No significant interactions were identified except for RDW; Conclusions : Our findings reveal a distinct negative association between age and HbA1c in diabetic individuals, independent of diabetic characteristics, complications, and inflammation markers. This association is particularly pronounced in individuals with lower RDW levels, highlighting the potential role of red cell morphology in influencing HbA1c levels with aging in diabetes.

Background: This study aims to assess the demographic, lifestyle, and clinical characteristics associated with varying levels of triglycerides (TGs) in a large population sample., Methods: This cross-sectional study utilized data from a nationwide health screening program in Mongolia. A total of 125,330 participants (mean age: 43.8 ± 15.3 years) were included. TG levels were categorized into normal, borderline high, high, and very high. Due to the small number of participants in the very high TG group, they were combined with the high TG category for analysis. Multivariate logistic regression was performed to identify independent predictors of elevated TG levels., Results: The majority of participants (80.3%) had normal TG levels, while 10.3% had borderline high, 8.7% had high, and 0.7% had very high TG levels. Significant predictors of elevated TG levels included age (OR 1.013, 95% CI 1.012-1.014), male (OR 2.328, 95% CI 2.251-2.408), obesity (OR 1.920, 95% CI 1.855-1.987), central obesity (OR 1.866, 95% CI 1.801-1.933), smoking (OR 1.399, 95% CI 1.347-1.453), alcohol use (OR 1.233, 95% CI 1.176-1.292), and non-regular exercise (OR 1.144, 95% CI 1.118-1.171). Sex-specific analysis revealed that elevated TG levels were more prevalent among males, regardless of other risk factors such as obesity and smoking., Conclusions: Male sex, obesity, and smoking were the strongest predictors of elevated TG levels.

Chronic neutrophilic leukemia (CNL) is a rare type of myeloproliferative neoplasm, characterized by sustained neutrophilia, splenomegaly, bone marrow granulocytic hyperplasia (without evidence of dysplasia) and an absence of the Philadelphia chromosome. Thus far, ~150 cases of CNL have been described in the literature; however, none have demonstrated overexpression of the ecotropic viral integration site-1 (EVI-1, also known as MECOM ) gene. The present study describes a case that fulfilled the World Health Organization diagnostic criteria for CNL, and was associated with overexpression of EVI-1, as well as novel concurrent mutations of colony stimulating factor 3 receptor ( CSF3R ) and SET binding protein-1 ( SETBP1 ). In addition, the current study briefly reviewed the relevant literature regarding novel genetic findings associated with the diagnosis and treatment of CNL. To the best of our knowledge, this is the first case report of CNL with associated EVI-1 overexpression, and concurrent CSF3R and SETBP1 mutations.