To explore the correlation between the psychological pressure of pregnant women with gestational diabetes mellitus(GDM) and their coping style and self-care ability. Methods: A total of 108 pregnant women with GDM admitted to the hospital from October 2020 to October 2023 were selected in this study. The baseline data survey scale, the pregnancy stress scale(PPS), the simple coping style scale(SCSQ) and the self-care ability scale(ESCA) were used to investigate the basic characteristics, the psychological pressure, the coping style and the self-care ability of the women. The difference of PPS score was compared among the women with GDM and with different baseline characteristics. Pearson correlation coefficient model was used to analyze the correlation between the SCSQ and ESCA scores of the women with GDM and their PPS score. Multiple linear stepwise regression analysis model was used to explore the influencing factors of the psychological pressure of the women with GDM. Results: A total of 108 questionnaires were distributed and 105 valid questionnaires were collected, with an effective rate of 97.2%. The PPS score of the women with GDM was 39-74 points, with an average of 54.02±14.37 points. The highest average score of each item of PPS of the women was the stress caused by ensuring the health and safety of mother and child. There was significant difference in the PPS score among the women with different ages, between the women with and without planned pregnancy, among the women with different family monthly income, among the women with different maternal type and between the women with and without abortion history(P<0.05). In the SCSQ scale, the scores of positive coping and negative coping of the women were 23.57±4.92 points and 11.93±1.68  points. The ESCA score of the women was 84.26±13.80 points. Pearson correlation coefficient model analysis showed that the positive coping score and the ESCA score in SCSQ scale of the women with GDM were negatively correlated with their PPS score, while the negative coping score in SCSQ scale of the women with GDM was positively correlated with their PPS score(P<0.05). Due to the obvious collinearity between the SCSQ score of the women and their ESCA score, so both the scores of SCSQ and ESCA of the women were included in the multiple linear stepwise regression model, and the results showed that the SCSQ score was included in this model, the unplanned pregnancy, the primiparity, the abortion history, the low score of positive coping and the high score of negative coping in SCSQ scale of the women with GDM were the main influencing factors of their psychological stress, and in the model of ESCA score, the unplanned pregnancy, the primiparity, the abortion history, the low score of ESCA of the women with GDM were the main influencing factors of their psychological stress(all P<0.05). Conclusion: The psychological pressure of the women with GDM is obvious, and which is closely related to the coping style and the self-care ability of the women. Improving the coping style and the self-care ability of the women may be the potential way to reduce the psychological pressure of the women.

 To investigate the changes of the levels of serum carbohydrate antigen 125 (CA125) and matrix metalloproteinase (MMP-3) of patients with adenomyosis  (AM) after the high intensity focused ultrasound (HIFU) combined with gonadotropin releasing hormone agonist (GnRHa) treatment, and to study their correlation with the dysmenorrhea severity of the patients. Methods: A prospective study was conducted to select 100 patients with AM who were treated with HIFU combined with GnRHa in the hospital from January 2022 to January 2024 as the research objects. The serum CA125 and MMP-3 levels of the patients were measured before treatment, and in the 3rd month and in the 6th month after treatment. The severity of dysmenorrhea of the patients was evaluated by visual analogue scale (VAS) score. The correlation between the changes of the serum CA125 and MMP-3 levels of the patients and the severity of their dysmenorrhea was analyzed by bivariate Pearson (N). According to the severity of dysmenorrhea of 
the patients before treatment, these patients were divided into group A (48 cases with mild dysmenorrhea), group B (33 cases with moderate dysmenorrhea) and group C (19 cases with severe dysmenorrhea). The clinical baseline data and the serum CA125 and MMP-3 levels of the patients were compared among the three groups. The influencing factors of the dysmenorrhea severity of the patients were analyzed by ordinal logistic regression. Results: The levels of serum CA125 and MMP-3 and the VAS score of the patients before treatment (72.99±6.44 U/ml, 43.60±5.76 ng/ml and 7.10±1.26 points), in the 3rd month after treatment (65.57±5.64U/ml, 19.47±5.86ng/ml and 2.27and 2.27±0.59 points), and in the 6th month after treatment (43.51±4.58U/ml, 14.06±4.38ng/ml and 1.31±0.43 points) had decreased gradually. Bivariate Pearson (N) analysis showed that the serum CA125 and MMP-3 levels of the patients were positively correlated with their VAS score of dysmenorrhea. The lesion volume, the gravidity and the serum CA125 and MMP-3 levels of the patients in group A, in group B and in group C had increased gradually. Logistic regression analysis showed that the increased lesion volume, the gravidity and the serum CA125 and MMP-3 levels of the patients with AM were the independent factors affecting their degree of dysmenorrhea (all P<0.05). Conclusion: HIFU combined with GnRHa for treating the patients with AM can increase their serum CA125 and MMP-3 levels and relieve their dysmenorrhea. At the same time, the serum CA125 and MMP-3 levels of the patients are positively correlated with their pain degree. The increased lesion volume, the gravidity and the serum CA125 and MMP-3 levels of the patients with AM are the independent factors affecting their degree of dysmenorrhea.

To analyze the clinical value of human papillomavirus DNA(HPV-DNA) detection combined with the levels of squamous cell carcinoma antigen(SCC-Ag), carbohydrate antigen 19-9(CA19-9) and alpha-fetoprotein (AFP) for diagnosing cervical cancer. Methods: The clinical data of 80 women with cervical cancer(in group A) and 80 patients with benign cervical lesions(in group B) between March 2018 and March 2022 were collected respectively. 50 healthy women were enrolled in group C. The expression levels of the serum SCC-Ag, CA19-9 and AFP, and the positive rates of HPV-DNA, SCC-Ag, CA19-9 and AFP of the women were compared among the three groups. In group A, the expression levels of the serum SCC-Ag, CA19-9 and AFP, and the positive rates of HPVDNA, SCC-Ag, CA19-9 and AFP were compared among the women with different FIGO stages. The results of the pathological diagnosis was used as the “gold standard”, the efficiencies of the HPV-DNA level, the SCC-Ag level, the CA19-9 level or the AFP level alone, and the combination of the HPV-DNA and the SCC-Ag CA19-9 and AFP levels of the women for diagnosing their cervical cancer were evaluated. Results: The expression levels of the serum SCC-Ag, CA19-9 and AFP of the women in group A were significantly higher than those of the women in group B and those of the women in group C. The positive rates of HPV-DNA, SCC-Ag, CA19-9 and AFP of the women in group A were also significantly higher than those of the women in group B and those of the women group C. In group A, the expression levels of the serum SCC-Ag, CA19-9 and AFP of the women with stage III-IV cervical cancer were significantly higher than those of the women with stage I-II cervical cancer, and the positive rates of HPV-DNA, CA19-9 and AFP of the women with stage III-IV cervical cancer were also significantly higher than those of the women with stage I-II cervical cancer(all P<0.05). The sensitivity(96.3%) and the accuracy(91.8%) of the combination of the HPV-DNA and the SCC-Ag, CA19-9 and AFP levels of the women for diagnosing their cervical cancer were significantly higher than those of the HPV-DNA level, the SCC-Ag level, the CA19-9 level or the AFP level alone, and the specificity of the AFP level(100.0%) of the women for diagnosing their cervical cancer was the highest(P<0.05). Conclusion: The combination of the HPV-DNA and the SCC-Ag, CA19-9 and AFP levels of the women for diagnosing their cervical cancer can increase the efficacy.

 To explore the possible influencing factors of the adverse pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy (ICP). Methods: The clinical data of 225 patients with ICP admitted to the hospital from January 2018 to January 2023 were collected. The basic information and the hematological indicators values of the patients were collected, and the patients were followed up for 12 months. Logistic regression was used to analyze the possible influencing factors of the adverse pregnancy outcomes of the patients. Receiver operating characteristic (ROC) curve was plotted to evaluate the efficacy of the influencing factors for predicting the adverse pregnancy outcomes of the patients. Results: The incidence of the adverse pregnancy outcomes of the patients with ICP was 37.8% (85/225). Logistic regression analysis showed that the abnormally increased serum glycholic acid level and the total bile acid level and the albumin/alkaline phosphatase ratio of the patients with ICP were the independent influencing factors of their adverse pregnancy outcomes. ROC curve analysis showed that the area under the curve (AUC) of the serum glycholic acid level, the total bile acid level, the albumin/alkaline phosphatase ratio, and the combined the serum glycholic acid level, the total bile acid level and the albumin/alkaline phosphatase ratio of the patients with ICP for predicting their adverse pregnancy outcomes were 0.692, 0.713, 0.689 and 0.876, respectively. Conclusion: The abnormally increased serum glycholic acid level, the total bile acid level and the albumin/alkaline phosphatase ratio of the patients with ICP are the independent influencing factors of their adverse pregnancy outcomes, and which have certain efficacy for predicting the adverse pregnancy outcomes of the patients.

To explore the effect of the family participatory dignity therapy for intervening patients with advanced gynecological malignant tumor. Methods: From January 2021 to January 2023, a total of 102 patients with advanced gynecological malignancies were included and were divided into observation group (51 cases) and control group (51 cases) by random number table method. The routine nursing intervention was given to the patients in the two groups, and the family participatory dignity therapy was given to the patients in the observation group additionally. During the intervention, there were 3 patients with fell off in the observation group and 1 patient with fell off in the control group. The scores of the patient dignity scale (PDI), psychological pain management screening tool (DMSM), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), cancer pain score (NRS) and quality of life scale (QLQ-C30), and the satisfaction of the patients in the two groups before and after intervention were evaluated by questionnaire. Results: After the intervention, the sores of PDI, DMSM, HAMA, HAMD, NRS and QLQ-C30 of the patients in the two groups had improved significantly, and which (49.76±5.05 points, 4.59±0.49 points, 18.34±3.11 points, 20.69±2.16 points, 3.95±0.58 points and 66.83±3.74 points) of the patients in the observation group were significantly better than those (59.73±4.21 points, 5.72±0.56 points, 22.15±3.26 points, 25.34±2.85 points, 4.95±0.76 points and 57.23±4.92 points) of the patients in the control group. The satisfaction rate (95.8%) of the patients in the observation group was significantly higher than that (82.0%) of the patients in the control group (all P<0.05). Conclusion: The family participatory dignity therapy for intervening the patients with advanced gynecological malignant tumor has positive effect, which can better improve their dignity level, relieve their psychological pain, anxiety and depression, reduce their degree of cancer pain, improve their quality of life, and with higher intervention satisfaction.

To evaluate the predictive value of the levels of placental alpha 1-microglobulin (PAMG-1) and fetal fibronectin (fFN) in the cervical discharge of pregnant women for their spontaneous preterm labor. Methods: The clinical data of 128 pregnant women with spontaneous preterm labor (in study group) from April 2021 to April 2023 were collected, and another 128 normal pregnant women who underwent antenatal examination and delivered at full term were included in control group during the same period. The clinical data and the levels of PAMG-1 and fFN in the cervical discharge of the women were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the PAMG-1 and fFN levels of the pregnant women for their spontaneous preterm labor. Results: The predictive accuracy, the positive predictive value and the negative predictive value of the PAMG-1 level of the women for predicting their spontaneous preterm labor were 68.0%, 76.1% and 63.7%, respectively, and which of the fFN level of the women for predicting their spontaneous preterm labor were 67.6%, 73.2% and 64.2%, respectively. The accuracy and the positive predictive value of the combined PAMG-1 and fFN levels of the women for predicting their spontaneous preterm labor were 69.9% and 79.3%, and which were significantly higher than those of the PAMG-1 level and the fFN level (P<0.05). ROC curve analysis showed that the area under the curve, the sensitivity and the specificity of the PAMG-1 level of the women for predicting their spontaneous preterm labor were 0.680, 52.3% and 83.6%, respectively, which of the fFN level of the women for predicting their spontaneous preterm labor were 0.679, 55.5% and 79.7%, respectively, and which of the combined PAMG-1 and fFN levels of the women for predicting their spontaneous preterm labor were 0.699, 53.9% and 85.9%, respectively. Conclusion: The PAMG-1 and fFN levels in the cervical discharge of the pregnant women can be used as the predictors for their spontaneous preterm labor, and the combined PAMG-1 and fFN levels of the women has higher predictive efficiency.

To observe the clinical effect of the growth hormone(GH) combined with kidney tonifying prescription for treating advanced patients with reduced ovarian reserve function. Methods: A total of 90 patients with ≥35 years old who met the diagnostic criteria of reduced ovarian reserve function were included and were randomly divided into three groups. The patients in group A were given treatment of GH for 3 months, the patients in group B were given treatment of kidney tonifying prescription for 3 months, and the patients in group C were given treatment of GH combined with kidney tonifying prescription for 3 months. The changes of the clinical symptom scores of the patients before and after treatment in the three groups were recorded. The levels of the serum anti-Mullerian hormone(AMH), estradiol(E2), follicle stimulating hormone(FSH) and luteinizing hormone(LH) of the patients in the three groups were detected, and the antral follicle count(AFC) of the patients in the three groups was examined by the transvaginal ultrasound. Results: After 3 months of treatment, the total effective rate of the patients in group A(50.0%), in group B(60.0%) and in group C(73.3%) had increased gradually(P<0.05). The TCM syndrome scores of the patients in the three groups after 3 months of treatment had decreased significantly, and which of the patients in group B and in group C were significantly lower than those of the patients in group A. The menstrual blood loss chart score of the patients in the three groups after treatment had increased significantly, and which of the patients in group B or in group C was significantly higher than that of the patients in group B(all P<0.05). The AFC of the patients in the three groups after treatment had increased significantly, the AMH, E2, FSH and LH levels of the patients in the three groups after treatment had decreased significantly, and the changes of all which of the patients in group C were significantly more than those of the patients in group A(all P<0.05). There was no any patient with obvious abnormality or adverse reaction in the three groups during treatment. The successful pregnancy rate of the patients in group A(6.7%), in group B(13.3%) and in group C(23.3%) had increased gradually within 1 year of follow-up after treatment(P<0.05). Conclusion: GH combined with kidney tonifying prescription for treating the advanced patients with reduced ovarian reserve function has better clinical benefit, and the treatment lasting for at least 3 months may reveal the good clinical effect.

To investigate the effects of the breast milk olfactory stimulation combined with the music intervention for the neonates with venipuncture on their analgesia and puncture success rate. Methods: 102 neonates who wanted venipuncture in hospital were selected and were divided into two groups from December 2021 to December 2023. 51 neonates in the control group were given conventional venipuncture method, and 51 neonates in the observation group were given the breast milk olfactory stimulation combined with the music intervention additionally. The scores of neonatal pain assessment scale (NIPS) and neonatal face coding system (NFCS), the onset and duration of crying, the success rate of once puncture, the values of heart rate and oxygen saturation (SpO2) and the puncture related complications rate of the neonates were compared between the two groups. Results: The NIPS scores during puncture and at 1 min and 2 min after puncture (4.83±0.74 points, 2.35±0.67 points and 0.78±0.40 points), the NFCS score (5.02±1.14 points, 3.18±0.75 points and 1.04±0.33 points), the crying duration (54.3±7.2s), the HR value during puncture and at 1 min and 2 min after puncture (148.1±4.9 times/m, 149.3±4.8 times/min and 142.1±4.2 times/min), and the incidence of puncture related complications (5.9%) of the neonates in the observation group were significantly lower than those (5.32±0.88 points, 3.49±0.56 points, 1.43±0.47 points, 5.78±1.09 points, 4.22±0.93 points, 1.51±0.4 8 points, 110.82±12.28 s, 153.8±5.2 times/min, 155.4±4.9 times/min, 146.3±4.2 times/min, and 19.6%) of the neonates in the control group. The onset time (2.8±0.4 s) of the neonatal crying in the observation group was significantly later than that (2.1±0.2 s) in the control group. The success rate of once puncture (96.1%), and the SpO2 value during puncture and at 1 min and 2 min after puncture (95.8±1.9%, 95.2±1.8% and 95.0±1.7%) of the neonates in the observation group were significantly higher than those (82.4%, 94.5±1.7%, 94.0±1.6% and 93.6±1.6%) of the neonates in the control group (all P<0.05). Conclusion: The breast milk olfactory stimulation combined with the music intervention for the neonates with venipuncture can effectively reduce their pain perception, reduce their crying time, improve their success rate of once puncture and reduce their risk of puncture related complications.

To explore the influence of the lipemia of pregnant women on their biochemical test results, and to study the correlation between the lipemia of the pregnant women and their adverse pregnancy outcomes. Methods: A total of 102 pregnant women with hyperlipidemia who received antenatal examination and delivered in the hospital from December 2018 to December 2023 were collected in observation group retrospectively, and 102 normal pregnant women who received antenatal examination and delivered in the same hospital during the same period were selected in control group. The blood samples of the women in the observation group were handled by low temperature and high speed centrifugation, and the changes of the levels of the serum biochemical indexes, such as creatinine, alkaline phosphatase(ALP), creatine kinase isoenzyme(CK-MB), fasting blood glucose, aspartate aminotransferase(AST) and alanine aminotransferase(ALT) of the women in the observation group were compared between before and after handling the blood samples. The adverse maternal and infants outcomes were compared between the two groups. Receiver-operating characteristic(ROC) curve was used to analyze the assessment value of the hyperlipidemia of the women for their adverse pregnancy outcomes. Spearman correlation was used to analyze the correlation between the lipemia of the pregnant women and their adverse pregnancy outcomes. Results: The Cr, ALP, CK-MB, FBG, AST and ALT levels in the blood samples of the women in the observation group after handling the blood samples had decreased significantly, and the blood TC, TG, HDL-C and LDL-C levels of the women in the observation group were significantly higher than those of the women in the control group(all P<0.05). The adverse pregnancy outcomes rate(23.5%) of the women in the observation group was significantly higher than that(6.9%) of the women in the control group(P<0.05), but which had no significant different among the women diagnosed hyperlipidemia during the different gestational weeks in the observation group(P>0.05). The area under the ROC curve, the specificity and the sensitivity of the lipemia detection of the pregnant women with hyperlipidemia for their adverse pregnancy outcomes were 0.720, 57.2% and 90.3%, respectively. The blood lipid levels of the pregnant women with hyperlipidemia were positively correlated with the maternal and fetal adverse outcomes(all P<0.001). Conclusion: The lipemia of the pregnant women has certain influence on the other biochemical test items of the women, and the low temperature and the centrifugal reprocessing for the lipemia samples of the pregnant women has certain effect for decreasing the influence on the other biochemical test items of the women. The pregnant women with lipemia have the higher incidence of adverse pregnancy outcomes.

To discover the research progress of the female secondary infertility, and to explore the important research hotspots and the future development trends on the female secondary infertility. Methods: Taking the secondary infertility as the research theme, the literatures published in CNKI, Wanfang Database, SinoMed, Web of Science Core Collection and PubMed from the establishment of the database to December 31, 2023 were retrieved. The published languages of the literatures included in this study were limited in Chinese and English. The publication year, authors and cooperation network, keywords, etc. of the literatures were visualized and analyzed using VOSviewer software. Results: A total of 2330 domestic studies (2269 literatures published in Chinese and 61 literatures published in English) and 788 foreign studies were included. The number of the domestic studies related to the female secondary infertility began to increase in 1990 significantly, and the number of the literatures reached its peak in 2011. Since 2005, the number of the foreign research literatures related to the female secondary infertility increased significantly. A number of the stable research teams on the female secondary infertility had been formed. The top 10 keyword categories in the domestic research literatures related to the female secondary infertility were “secondary infertility” “clinical diagnosis and treatment” “associated factor” “investigation and analysis” “pregnancy” “fallopian tube” “ART” “endometrium” “nulliparous women” and “fertility”, and in which, the corresponding English keywords were also included. The top 10 keyword categories in the foreign research literatures related to the female secondary infertility were “secondary infertility” “associated factors” “diagnosis” “ART” “reproduction” “diseases” “treatment” “biology” “physiology” and “research methodology”. In the domestic research literatures related to the female secondary infertility, the overall changes in the frequency of the keywords had increased gradually except to "nullipara ". In the foreign research literatures related to the female secondary infertility, the keywords, such as "associated factors", "ART", "secondary infertility" and "diagnosis", had increased gradually with time.  Conclusion: The female secondary infertility has received a high level of attention overall, but the communication and cooperation among the different research teams need to be further strengthened. Continuing to explore the risk factors of the female secondary infertility plays an important role in the development of the comprehensive prevention and control strategies for the female secondary infertility. Therefore, the researches related to the female secondary infertility should be strengthened to provide more scientific evidences for further improving the female reproductive health. 

To analyze the predictive effect Prediction effect of the prognostic nutrition index (PNI) value for the acute radiation enteritis of patients with cervical cancer and radiotherapy. Methods: The clinical data of 80 patients with cervical cancer admitted to the hospital from January 2020 to August 2023 were included in this study. According to the occurrence of the acute radiation enteritis after radiotherapy, these patients were divided into group A (patients with acute radiation enteritis) and group B (patients without acute radiation enteritis). The clinical data, such as the pathological classification, the clinical stage of cervical cancer and the PNI value of the patients were compared between the two groups. Logistic multivariate model was used to analyze the related factors affecting the occurrence of the acute radiation enteritis of the patients. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of the PNI value of the patients for predicting the occurrence of their acute radiation enteritis. Results: Among 80 patients, there were 17 patients with acute radiation enteritis, with an incidence of 21.3%. The clinical symptoms of the patients were mainly the grade 1-2 diarrhea and the grade 1-2 abdominal pain. Logistic multivariate regression analysis showed that the body mass index (BMI) <18.5 kg/m2, the FIGO stage III-IV, the lymph node metastasis, the hemoglobin (Hb) <110 g/L, and the PNI value <48.84 of the patients were all the independent risk factors affecting the occurrence of their acute radiation enteritis (P<0.05). ROC curve showed that the area under the curve (AUC), the sensitivity and the specificity of the PNI value of the patients for predicting their acute radiation enteritis were 0.875, 88.3% and 87.3%, respectively. Conclusion: The PNI value of the patients with cervical cancer and radiotherapy can provide a reliable reference for predicting their acute radiation enteritis occurrence.

To systematically evaluate the prevalence of the anxiety and depression of patients during the treatment of assisted reproductive technology. Methods: The databases, such as PubMed, Cochrane Library, EMBASE, Web of Science, CBM, CNKI and WanFang, from the inception dates to April 4, 2023 were searched by computer to collect the cross-sectional studies on the current status of the anxiety and depression of the patients during the treatment of assisted reproductive technology. Two researchers selected the literature, extracted the data and evaluated the risk of bias of the included studies independently. The meta-analysis was performed using Stata 15.1. Results:  A total of 27 cross-sectional studies were included in for meta-analysis, with a total sample size of 9876 with anxiety and 13,207 patients with depressed. Meta analysis showed that the prevalence of the anxiety and the depression of the male patients were 13% and 28%, and the prevalence of the anxiety and the depression of the female patients were 32% and 36%. The subgroup analysis showed that the prevalence of the mild, moderate, and severe anxiety of the patients were 21.0%, 4.0%, and 0.6%, respectively, and the prevalence of the mild, moderate, severe and very severe depression of the patients were 28.0%, 11.0%, 1.0% and 0.3%, respectively. The prevalence of the anxiety of the patients with assisted reproductive technology in South China, Northwest China, Central China, Southwest China, North China and East China were 24%, 21%, 34%, 10%, 30% and 29%, respectively, and the prevalence of the depression of the patients with assisted reproductive technology in South China, Northwest China, Central China, Southwest China, North China and East China were 39%, 41%, 38%, 27%, 29% and 33%, respectively. Conclusion: The evidences available showed that the prevalence of anxiety and depression of the patients during the treatment of assisted reproductive technology is still at a high level, and which should be confirmed by more high-quality studies because of the limited of this meta-analysis by the quantity and the quality of the included studies.

To explore the effect of the electrical stimulation for treating patients with vaginal dryness, and to study its influence on the pelvic floor function of the patients. Methods: A retrospective analysis on the data of the patients with vaginal dryness who received treatment from June 2022 to June 2023 was conducted. Among them, 70 patients who received conventional drug treatment were included in group A, and 70 patients who received electrical stimulation combined with conventional treatment were included in group B. After treatment, the changes of the scores evaluated by vaginal health index score (VHIS) and sexual function index (FSFI), and the values of the pelvic floor muscle surface electromyography indexes and pelvic floor muscle strength indexes of the patients were compared between the two groups. Results: After treatment, the scores of the VHIS subitems, such as vaginal mucosa elasticity, the secretion type and viscosity, the vaginal mucosal epithelial integrity and the vaginal wetness, of the patients in the two groups had increased, and which (4.15±0.42 points, 4.31±0.49 points, 4.52±0.39 points and 4.49±0.41 points) of the patients in group B were significantly higher than those (3.26±0.36 points, 3.82±0.46 points, 3.91±0.41 points and 3.73±0.39 points) of the patients in group A. The scores of FSFI sub-items, such as the sexual desire, subjective sex arousal, the vaginal lubrication situation during sexual activity, the satisfaction with orgasm sexual life, the dyspareunia and the total score, of the patients in both groups had increased significantly, and which of the patients in group B were significantly higher than those of the patients in group A. The scores of the subitems and the total score of FSFI of the patients in both groups had decreased significantly in the pre-resting phase, in the type Ⅱ muscle testing phase and in the postresting phase, but which of the patients in both groups had increased significantly in the type Ⅰ muscle testing phase and in the endurance test phase, and the changes of the scores of the subitems and the total score of FSFI of the patients in group B were significantly greater than those of the patients in group A. The sustained systolic pressure and the contractile maintenance time of type Ⅰ and type Ⅱ muscle of the patients in the two groups had increased significantly, and which of the patients in group B were significantly higher than those of the patients in group A (all P<0.05). There was no significant difference in the adverse reactions rate (17.1% vs. 8.6%) of the patients between the two groups (P>0.05). Conclusion: Electric stimulation for treating the patients with vaginal dryness can further improve their clinical indicators, alleviate their clinical symptoms and enhance their pelvic floor function.

To explore the efficacy and safety of Gongliuxiao capsule for treating patients with abnormal uterine bleeding(AUB), and to study its influence on the levels of the hemoglobin(HGB), sex hormones and coagulation function indexes of the patients. Methods: 82 patients with AUB were selected and were divided into the study group and control group(41 cases in each group) by random number table from January 2021 to September 2023. The patients in the two groups were given treatment of dydrogesterone tablet, and the patients in the study group were given Gongliuxiao capsule additionally. The clinical efficacy and the safety of the patients after 3 months of treatment were compared between the two groups. The changes of the levels of HGB and sex hormones levels, the endometrial thickness and the coagulation function indexes levels of the patients in the two groups before and after treatment were monitored. Results: The total effective rate(92.7%) and the Hb level(126.93±16.53 g/L) of the patients in the study group after treatment were significantly  higher than those(75.6% and 101.16±13.46 g/L) of the patients in the control group. The levels of luteinizing hormone(35.12±5.64 U/L), estradiol(185.73±11.26 U/L) and follicle stimulating hormone(24.86±4.59 U/L), and the values of activated partial thromboplastin time(24.68±1.09 s), prothrombin time(12.26±0.13 s) and thrombin time(15.03±0.27 s), the fibrinogen level(2.65±0.24 g/L) and the endometrial thickness(6.67±1.24 mm) of the patients in the study group after treatment were significantly lower than those(43.56±3.82 U/L, 248.53±9.36 U/L, 32.37±5.14 U/L, 29.74±2.36 s, 13.27±0.39 s, 17.39±0.86 s, 3.49±0.43 g/L and 9.37±2.01 mm) of the patients in the control group. The incidence of the adverse reactions(7.3%) of the patients in the study group was significantly lower than that(24.4%) of the patients in the control group(all P<0.05). Conclusion: The dydrogesterone tablet combined with Gongliuxiao capsule for treating the patients with AUB can improve the efficacy, which can effectively promote the levels of the HGB and sex hormones, and the endometrial thickness recovery, and improve the coagulation function of the patients, and with the higher safety.

To analyze the levels changes of the serum transforming growth factor-β1 (TGF-β1), interleukin-2 (IL-2) and matrix metalloproteinase-9 (MMP-9) of the women with tubal obstructive infertility, and to study their clinical significance. Methods: A total of 60 women with tubal obstructive infertility diagnosed and treated in the hospital were selected in study group and 50 women with normal pregnancy and delivery were selected in control group from March 2022 to October 2023. The serum TGF-β1, IL-2 and MMP-9 levels of the women were measured and compared between the two groups, and the correlation among which was analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of the serum TGF-β1, IL-2 and MMP-9 levels of the women for their infertility, and the influencing factors of the tubal obstructive infertility of the women were analyzed by logistic multivariate regression. Results: The preoperative levels of the serum TGF-β1 (593.79±148.23 ng/L), IL-2 (3.90±0.75 ng/L) and MMP-9 (384.88±86.87 ng/ml) of the women in the study group were significantly higher than those (239.42±113.37 ng/L, 3.09±0.84 ng/L and 178.98±80.85 ng/ml) of the women in the control group. The levels of the serum TGF-β1, IL-2 and MMP-9 of the women after surgery were significantly lower than those before surgery, the serum TGF-β1 level of the women was positively correlated with their serum IL-2 and MMP-9 levels, and the serum IL-2 level of the women was positively correlated with their serum MMP-9 level (all P<0.05). ROC curve analysis showed that the area under curve (AUC), the sensitivity and the specificity of the TGF-β1 level of the women for diagnosing their infertility were 0.941, 88.3% and 94.0%, respectively, which of the IL-2 level of the women for diagnosing their infertility were 0.778, 66.7% and 84.0%, respectively, which of the MMP-9 level of the women for diagnosing their infertility were0.946, 88.3% and 86.0%, respectively, and which of the combined levels of the serum TGF-β1, IL-2 and MMP-9 of the women for diagnosing their infertility were 0.992, 93.3% and 100.0%, respectively. Logistic regression analysis showed that the abnormal increasing serum TGF-β1, IL-2 and MMP-9 levels of the women were the risk factors of the infertility caused by fallopian tube obstruction of the women (all P<0.05). Conclusion: The levels of the serum TGF-β1, IL-2 and MMP-9 of the infertility women caused by fallopian tube obstruction are highly expressed, which are the risk factors of their infertility. The combined detections of the serum TGF-β1, IL-2 and MMP-9 of the women for diagnosing their infertility has high value for their tubal obstructive infertility.

To analyze the influencing factors of the delayed recovery of patients in the resuscitation room of gynecological surgery under general anesthesia. Methods: The clinical data of 220 patients undergoing gynecological surgery under general anesthesia in the hospital from June 2022 to June 2023 were analyzed retrospectively. The recovery time of these patients in the resuscitation room of gynecological surgery was recorded, and 56 patients with the delayed recovery were included in the observation group and 164 patients without the delayed recovery were included in the control group. Univariate and multivariate logistic regression analysis were used to analyze the related influencing factors of the patients with the delayed recovery, and their nursing countermeasures were summarized. Results: The recovery time(161.73±11.27 min) of the patients in the observation group was significantly longer than that(54.39±10.23 min) of the patients in the control group. The proportions of the patients with the age ≥60 years old, with the anemia, with the operation time >2h, with the intraoperative average temperature <36.5℃ or with the additional anesthetic drugs used of the patients in the observation group were significantly higher than those of the patients in the control group(P<0.05). Multivariate regression analysis showed that the operation time >2h, the average intraoperative temperature <36.5℃ and the additional intraoperative anesthetic drugs used of the patients were the risk factors of their delayed recovery(all P<0.05). Conclusion: The operation time >2h, the average intraoperative temperature <36.5℃ and the additional intraoperative anesthetic drugs used of the patients are the risk factors of their delayed recovery, so the preoperative prevention should be conducted for these patients. The symptomatic treatment measures should be actively adopted according to the recovery situation of the patients in the recovery room to reduce the incidence of their delayed recovery after general anesthesia.

To study the correlation between the umbilical artery blood flow parameters values of pregnant women with intrahepatic cholestasis during pregnancy (ICP) and their fetal distress occurrence. Methods: 101 pregnant women with ICP were selected in study group and 85 healthy pregnant women were selected in control group from March 2018 to March 2021. The women in the study group were divided into group A (women with fetal distress) and group B (women without fetal distress). The correlation between the umbilical artery blood flow parameters values of the women in these groups and their fetal distress was analyzed. Results: The values of S/D (4.23±0.35), RI (1.66±0.32) and PI (1.05±0.15) of the umbilical artery blood flow parameters of the women in the study group were significantly higher than those (3.61±0.25, 1.01±0.21 and 0.74±0.23) of the women in the control group, and which of the women in group A were significantly higher than those of the women in group B. Correlation analysis showed that the values of S/D, RI and PI of the umbilical artery blood flow of the women with ICP were positively correlated with their occurrence of fetal distress (all P<0.05). Conclusion: The umbilical artery blood flow parameters values of the pregnant women with ICP are abnormal, and are correlated with their fetal distress occurrence, and which has the clinical significance for gilding the ICP control of the pregnant women.

To explore the analgesia effect of transversus abdominis plane block (TAPB) with the combined dexamethasone, dexmedetomidine and ropivacaine for puerperae after cesarean section. Methods: A total of 80 puerperae who had undergone cesarean section in the hospital were enrolled as the research objects between April 2021 and April 2023. After the surgery, all the puerperae were given ultrasound-guided bilateral TAPB for analgesia. According to the random number table method, these puerperae were divided into group D (40 cases with dexmedetomidine combined with ropivacaine for TAPB) and group S (40 cases with dexamethasone combined with ropivacaine for TAPB). The time of getting out of bed, the hospitalization stay, the time of the first analgesic pump compression, the number of the analgesic pump effective compression within postoperative 24h, the cumulative dosage of sufentanil, the maternal satisfaction, the scores of visual analogue scale (VAS) under rest/exercise state and the quality of recovery 40 questionnaire (QoR40) score, and the incidence of adverse reactions of the puerperae were compared between the two groups. Results: The time of getting out of bed (7.71±0.86 h), the duration of hospital stay (5.39±0.41d), the number of effective pressing analgesia pump within postoperative 24h (2.01±1.31 times) and the cumulative dosage of sufentanil used within postoperative (46.39±0.72μg) of the puerperae in group S were significantly lower than those (8.93±1.15h, 6.05±0.72d, 2.73±1.62 times and 48.33±0.63μg) of the puerperae in group D. The first analgesic pump pressing time (689.72±68.17min) and the maternal satisfaction (8.11±0.87) of the puerperae in group S were significantly higher than those (552.63±52.15min and 6.33±1.23) of the puerperae in group D. At 6h, 12h, 24h and 48h after operation, the VAS scores under rest/exercise state of the puerperae in group S at postoperative 6h, 12h, 24h and 48h were significantly lower than those of the puerperae in group D. The scores of comfort, emotion, self-care ability, social interaction, pain and QoR-40 of the puerperae in group S were significantly higher than those of the puerperae in group D. The total QoR-40 score (169.52±7.01 points) of the puerperae in group S was significantly higher than that (152.17±7.23) of the puerperae in group D (all P<0.05). There was no significant difference in the incidence of the adverse reactions of the puerperae between the two groups (P>0.05). Conclusion: Dexamethasone combined with ropivacaine for TAPB of the puerperae after cesarean section has better analgesia effect, which can effectively prolong the analgesia time, relieve the postoperative pain and improve the postoperative recovery quality of the puerperae, and with the better safety.

To explore the predictive factors of neonates with hypoglycemia delivered by the pregnant women with gestational diabetes mellitus (GDM), and to put forward the preventive measures accordingly. Methods: The clinical data of 122 pregnant women with GDM and their neonates admitted to the hospital from January 2020 to January 2023 were analyzed retrospectively. According to whether the neonates had hypoglycemia, there were 26 women with neonatal hypoglycemia and 96 women without neonatal hypoglycemia. Univariate analysis and logistic multivariate regression model were used to explore the influencing factors of the neonatal hypoglycemia of the pregnant women with GDM. The regression prediction model was established, and its predictive power was evaluated. Results: In 122 pregnant women with GDM, there were 26 women with neonatal hypoglycemia within 48 h after birth, with the incidence of 21.3%. Multivariate analysis showed that poor blood glucose control of the women during pregnancy, the neonatal premature delivery and low birth weight, the time ≥30 minutes from the neonatal birth to the first feeding and the neonatal hyperbilirubinemia were the independent risk factors of the hypoglycemia occurrence of the neonates delivered by the women with GDM, and the regular prenatal care during pregnancy of the women with GDM was an independent protective factor for their neonatal hypoglycemia occurrence (all P<0.05). The regression prediction model established based on the above factors had a high goodness of fit. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve, the sensitivity, the specificity and the accuracy of this model for predicting the hypoglycemia occurrence of the neonates delivered by pregnant women with GDM were 0.866, 61.5%, 94.8% and 87.7%, respectively. Conclusion: The poor blood glucose control during pregnancy, the neonatal premature birth and low birth weight, the time ≥30 minutes from the neonatal birth to the first feeding, the neonatal hyperbilirubinemia and the nonregular prenatal examination during pregnancy of the pregnant women with GDM are all the influencing factors of their neonatal hypoglycemia occurrence, and the prediction model constructed based on these influencing factors has the good predictive efficacy.

To explore the correlation between the depression and anxiety of patients with the first assisted reproductive technology and their family function and stigma, and to study its influence on the outcomes of assisted reproduction. Methods: A total of 162 patients who received assisted reproductive technology for the first time in the hospital from October 2022 to October 2023 were selected in this study. On the first day of the treatment cycle, the general data questionnaire, the self-rating depression scale(SDS), the self-rating anxiety scale(SAS), the family APGAR index(APGAR) and the infertility stigma scale(ISS) were used to investigate the baseline data, the situation of anxiety and depression, the family function and the stigma of these patients. The differences of the baseline data, the family function and the stigma were compared between the patients with and without depression and anxiety symptoms. The correlation between the family function and stigma of the patients with the first assisted reproductive technology and their depression and anxiety symptoms after adjusting confounding factors was analyzed by logistic regression analysis model. The depression and anxiety symptoms of the patients with assisted reproduction were observed. Results: A total of 162 questionnaires were delivered, and 152 effective questionnaires were returned, and with the effective rate of 93.8%. The scores of APGAR, ISS, SDS and SAS of these patients were 7.68±0.82 points, 70.44±16.13 points, 43.71±8.53 points and 47.94±9.05 points, respectively. The detection rates of depression and anxiety of these patients were 30.9% and 38.8%. The age, the place of residence, the education level, the duration of infertility, the abortion history, the APGAR and ISS scores of the patients with the first assisted reproductive technology were correlation with their depressive symptoms. And the place of residence, the family income, the duration of infertility, the abortion history, the APGAR and ISS scores of the patients with the first assisted reproductive technology were correlation with their anxiety symptoms(all P<0.05). There was a significant collinearity between the APGAR score of the patients and their ISS score. So the APGAR score and the ISS score of the patients were introduced into the multivariate logistic regression model respectively, and after adjusting the confounding factors of the depression and anxiety, the results showed that the high APGAR score of the patients was an independent protective factor of their depression and anxiety after assisted reproductive technology(OR=0.405, 0.427), but the high ISS score was an independent risk factor of their depression and anxiety(OR=1.299, 1.271). The clinical pregnancy rate of the patients with depression or anxiety(48.9% or 45.8%) was significantly lower than that(67.6% or 72.0%) of the patients without depression or anxiety(all P<0.05). Conclusion: The patients with the first-time assisted reproduction are prone to depression and anxiety symptoms, which can adversely influence on their outcomes after assisted reproduction. The systematic family and psychological intervention may be a potential way to improve the depression and anxiety symptoms of the patients.

To understand the postpartum depression status of advanced multiparas(≥35 years old), and to analyze the influencing factors of the postpartum depression. Methods:  Convenience sampling method was used to select the advanced multiparas who had delivered hospitalized in Hangzhou obstetrics and gynecology hospital from June to December 2023 as the research objects. The demographic information and the delivery data of these multiparas were collected. The postpartum depression status and the social support level of these multiparas were investigated by Edinburgh postpartum depression scale(EPDS) and social support rating scale(SSRS). Logistic regression was used to analyze the related influencing factors of the postpartum depression of these multiparas. Results: There were 88(31.0%) cases with postpartum depression(EPDS score ≥13 points) in 284 advanced multiparas. Multivariate logistic regression analysis showed that the family per capita income <4000 Yuan(OR=2.61, 95%CI 1.27-5.36), the unplanned pregnancy(OR=3.21, 95%CI 1.43-7.22), the low birth weight of the newborns(OR=5.11,95%CI 2.01-12.97), the prenatal depression(OR=4.03, 95%CI 1.76-9.19), the sleep disorders(OR=2.07, 95%CI 1.15-3.71) and the artificial feeding(OR=3.06, 95%CI 1.37-6.83) of the advanced multiparas were the independent risk factors of their postpartum depression occurrence(P<0.05). The social support level(OR=0.26, 95%CI 0.11-0.66) of the advanced multiparas was the protective factor of their postpartum depression occurrence(P<0.05). Conclusion: The incidence of postpartum depression of the advanced multiparas is high, which is related to their low family economic status, their unwanted pregnancy, their low neonatal weight, their artificial feeding, their prenatal depression, their sleep disorder and their insufficient social support, and so on.

To analyze the anesthesia effect of low-dose esketamine used in laparoscopic uterine fibroid surgery. Methods: 102 patients who wanted laparoscopic uterine fibroids surgery were divided into study group (n=51) and control group (n=51) using a random number table method from January 2022 to December 2023. The anesthesia induction and maintenance methods of the patients in both groups were the same. The patients in the study group received intravenous injection esketamine (0.5mg/kg) before skin incision, followed by continuous intravenous infusion of 0.125mg/(kg·h) of esketamine. The patients in the control group received an equal amount of 0.9% sodium chloride injection at the same time. The anesthesia time, the surgical time, the postoperative recovery time, the extubation time, the VAS pain score at different time points, the Ramsay sedation score, the levels of stress response, such as adrenaline, norepinephrine and cortisol, and the incidence of postoperative adverse reactions of the patients in the two groups were observed and recorded. Results: The VAS scores of the patients in the study group at 6h and 12h after operation (2.01±0.22 points and 2.33±0.36 points) were significantly lower than those (3.25±0.28 points and 3.62±0.47 points) of the patients in the control group. The levels of epinephrine, norepinephrine and cortisol of the patients in the two groups at 24h after operation had increased significantly, but which (69.62±8.54 pg/ml, 198.96±23.29 pg/ml and 290.92±27.19 ng/ml) of the patients in the study group were significantly lower than those (85.52±7.63 pg/ml, 175.60±24.79 pg/ml and 320.25±28.74ng/ml) of the patients in the control group (all P<0.05). There was no significant difference in the total incidence of adverse reactions (19.6% vs. 29.4%) of the patients between the two groups (P>0.05). Conclusion: Low dose esketamine can enhance the postoperative analgesic effect, reduce the postoperative stress reactions and do not increase anesthesia related adverse reactions of the patients, which has certain safety and effectiveness.

To explore the predictive value of the vaginal microecological imbalance combined with the serum human leukocyte antigen-G (HLA-G) and human leukocyte antigen (HLA-E) levels of patients with cervical high-grade squamous intraepithelial lesion (HSIL) after cold knife conization (CKC) for their persistent human papillomavirus (HPV) infection. Methods: The clinical data of 137 patients with HSIL admitted to the hospital from January 2021 to December 2022 were collected retrospectively. These patients were treated with CKC and were followed up for 1 year after CKC. The HPV persistent infection of these patients after CKC was observed. The vaginal microecology and the serum HLA-G and HLA-E levels of the patients were measured. The correlation between the vaginal microecology and the serum HLA-G and HLA-E levels of the patients and their cervix HPV persistent infection was analyzed. The value of the vaginal microecology and the serum HLA-G and HLA-E levels of the patients for predicting their HPV persistent infection were evaluated. Results: There were 31 patients with the persistent HPV infection (in group A) and 106 cases without the persistent HPV infection (in group B) in 137 patients. There were significant
differences in the vaginal pH value, the density and diversity of the vaginal flora and the rate of trichomonas vaginitis of the patients between the two groups. The vaginal microecological imbalance rate of the patients in group A was significantly higher than that of the patients in group B. The levels of the serum HLAG (19.84±3.53 ng/ml) and HLA-E (75.39±15.83 pg/ml) of the patients in group A were significantly higher than those (16.93±2.96 ng/ml and 68.42±12.51 pg/ml) of the patients in group B. In group A, the levels of serum HLA-G and HLA-E of the patients with vaginal microecological imbalance were significantly higher than those of the patients with normal vaginal microecology (all P<0.05). Spearman correlation analysis showed that the vaginal microecological imbalance and the serum HLA-G and HLA-E levels of the patients were positively correlated with their postoperative persistent HPV infection (r=0.633, 0.529, 0.608, all P<0.05). Receiver operating characteristic curve analysis showed that the area under the curve of the vaginal microecological imbalance, the serum HLA-G level, the HLA-E level, and  the combined vaginal microecological imbalance and the serum HLA-G and HLA-E levels of the patients for evaluating their postoperative persistent HPV infection were 0.601, 0.773, 0.805 and 0.885, respectively (P<0.05). Conclusion: The vaginal microecological imbalance combined with the serum HLA-G and HLA-E levels of the patients with HSIL after CKC has certain predictive value for their postoperative HPV persistent infection.

To explore the characteristics and the risk factors of the nosocomial infection of neonates with body weight≤1000g. Methods: 232 neonates with body weight ≤1000g who had delivered in the hospital were selected as the research subjects from January 2020 to December 2023. According to the infection status of the neonates, these neonates were divided into study group(63 neonates with nosocomial infection) and control group(169 without nosocomial infection). The characteristics of the nosocomial infection of these neonates were analyzed, and the high-risk factors of the nosocomial infection of these neonates were analyzed by multivariate Logistic regression analysis. Results: There were 63 neonates with the nosocomial infection in 232 neonates, and with the incidence was 27.2%. The main infection sites of the neonates were the lower respiratory infection(52.4%) and the ventilator-associated pneumonia(25.4%). A total of 48 pathogens of the nosocomial infection were detected, and the top three of which were Enterobacter cloacae(14.6%), Klebsiella pneumoniae(14.6%) and Escherichia coli(12.5%). Multivariate logistic regression analysis showed that the surgery, the prolonged hospitalization, the mechanical ventilation and the placement of central venous catheter of the neonates were the independent risk factors of their nosocomial infection. Conclusion: The lower respiratory tract infection is the more common nosocomial infection of the neonates with body weight ≤1000g. It is necessary to pay attention to the neonates with low birth weight who have undergone surgery, long hospitalization time, long-term ventilator-assisted breathing of long-term placement of central venous catheter in clinic.

To study the anesthetic effect and safety of the different dosages of etomidate combined with propofol of patients during laparoscopic total hysterectomy. Methods: The clinical data of 80 patients who had accepted laparoscopic total hysterectomy in the hospital from January 2019 to March 2022 were selected in this study. According to the different ratios of propofol and etomidate, these patients were divided into group A(32 patients with 1.5 mg/kg propofol and 0.075 mg/kg etomidate), group B(23 patients with 1.0 mg/kg propofol and 0.15 mg/kg etomidate) and group C(25 patients with 0.5 mg/kg propofol and 0.225 mg/kg etomidate). The disappearance time of eyelid reflex, the awakening time and the extubation time of the patients were compared among the three groups. The values of heart rate, mean arterial pressure(MAP) and bispectral index(BIS) of the patients at 1 min before anesthesia induction(T0), before intubation(T1), at 1 min after intubation(T2), at 3 min after intubation(T3) and at 5 min after intubation(T4), and the incidence of adverse events of the patients were compared among the three groups. Results: The disappearance time of eyelid reflex(1.94±0.28 min) of the patients in group C was significantly longer than that(1.70±0.24 min) of the patients in group A and that(1.94±0.28 min) of the patients in group B(P<0.05). There were no significant differences in the recovery time, the extubation time and the HR value of the patients in different time point among the three groups(P>0.05). The MAP value of the patients in group A at T2 and at T3(84.80±9.17 mmHg and 69.94±6.52 mmHg) were significantly lower than those(93.46±8.12 mmHg and 76.05±6.44 mmHg) of the patients in group C(P<0.05), and there were no significant difference in the MAP value of the patients at T0, T1 and T4 among the three groups(P>0.05). There was no significant difference in the BIS value of the patients at T0 and T1 among the three groups(P>0.05), and the BIS value of the patients in group A at T2-T4 was the highest(P<0.05). The incidence of myoclonus(25.0%) of the patients in group A was significantly lower than that(60.0%) of the patients in group C(P<0.05). There was no significant difference in the other adverse events rate of the patients among the three groups(P>0.05). Conclusion: The anesthetic effect of 1.5 mg/kg propofol and 0.075 mg/kg etomidate used during laparoscopic total hysterectomy of the patients is more ideal, which can maintain their hemodynamic balance, and with the lower probability of the adverse events.

To investigate the factors influencing the treatment effect of hysteroscopic and laparoscopic surgery for treating patients with cesarean scar pregnancy(CSP), and to study the predictive efficacy of these influence factors for the treatment effect. Methods: The clinical data of 100 patients with CSP whom were treated with hysteroscopic and laparoscopic surgery in the hospital from January 2019 to January 2024 were selected in this study. All the patients were divided into 83 cases with effective treatment in group A and 17 cases with ineffective treatment in group B according to the treatment results. The general data, the vaginal ultrasound index value, the preoperative β-human chorionic gonadotropin(β-hCG) level and other clinical data of the patients in the two groups were collected. Binary Logistic regression analysis was used to screen the factors affecting the efficacy of hysteroscopic and laparoscopic surgery for treating patients with CSP. Receiver operating characteristic(ROC) curve was used to evaluate the predictive efficacy of the influencing factors on the ineffective treatment of hysteroscopic and laparoscopic surgery. Results: Univariate analysis showed that the number of cesarean section, the gestational weeks, the type of scar pregnancy, the gestational sac volume, the muscular layer thickness of uterine scar, the blood flow classification of scar and the preoperative serum β-hCG level of the patients with CSP were related to their treatment effect by hysteroscopic and laparoscopic surgery(P<0.05). Logistic multivariate analysis showed that the exogenous type of scar pregnancy(OR=4.300), the large gestational sac volume(OR=1.674), the grade Ⅲ blood flow of the scar(OR=2.811), the less muscular thickness of the scar(OR=0.070) and the high preoperative serum β-hCG level(OR=1.003) of the patients with CSP were the influencing factors of their ineffective treatment by hysteroscopic and laparoscopic surgery(P<0.05). ROC analysis showed that all the above influencing factors had certain predictive efficacy for the ineffective treatment of the patients with CSP by hysteroscopic and laparoscopic surgery, and the area under the curve(AUC) of all the above influencing factors for predicting the efficacy of hysteroscopic and laparoscopic surgery were 0.707, 0.760, 0.727, 0.872 and 0.938, respectively. Conclusion: The type of scar pregnancy, the gestational sac volume, the blood flow classification of scar, the muscular layer thickness of uterine scar and the preoperative serum β-hCG level of the patients with CSP are all infecting their effect of hysteroscopic and laparoscopic surgery, and which all have certain predictive values for the effect of hysteroscopic and laparoscopic surgery. The patients with CSP and the risk of the ineffective treatment by hysteroscopic and laparoscopic surgery can be identified based on these influence factors early, and the corresponding measure should be conducted to improve the prognosis of the patients.

 To investigate the effects of the evidence-based practice of perioperative thermal insulation for women with cesarean section on their core body temperature and circulatory function. Methods: 92 pregnant women who wanted cesarean section were selected and were divided into two groups (46 cases in each group) by numerical odd-even method between November 2019 and November 2023. The women in the two groups were given the perioperative routine care intervention, and the women in the observation group were given the evidence-based practice of perioperative thermal insulation additionally. The perioperative core body temperature value, the circulatory function, the incidences of complications, such as agitation, chills and hypothermia, and the nursing satisfaction of the women were compared between the two groups. Results: The core temperature values of the women in the observation group at skin incision (37.10±0.19℃), at 15min of operation (36.64±0.39℃), at fetal delivery (36.31±0.35℃) and at the end of operation (36.52±0.33℃) were significantly higher than those  (36.84±0.20℃, 36.12±0.41℃, 35.85±0.47℃ and 35.81±0.45℃) of the women in the control group. The change values of the heart rate, the diastolic blood pressure, the systolic blood pressure and the mean arterial pressure of the women in the observation group at 15min of operation and at the end of operation were significantly lower than those of the women in the control group. The incidences of shivering (2.2%) and hypothermia (4.4%) of the women in the observation group were significantly lower than those (13.1% and 21.7%) of the women in the control group. The nursing satisfaction (93.5%) of the women in the observation group was significantly higher than that (76.1%) of the women in the control group (all P<0.05). Conclusion: The application of the evidencebased practice of perioperative thermal insulation for the pregnant women with cesarean section can effectively maintain their perioperative core body temperature, improve their circulatory function and reduce the risk of their hypothermia and chills, and which is accepted by the women widely.

To investigate the effects of butorphanol combined with dexmedetomidine used during laparoscopic myomectomy of patients on their immune function, postoperative cognition and inflammatory response. Methods: 204 overweight patients with the body mass index(BMI) of 24.0-27.9kg/m2 who were scheduled to undergo laparoscopic myomectomy treatment in the hospital from January 2020 to October 2022 were selected and were divided into two groups(102 cases in each group). The patients in the control group were given remifentanil and butorphanol for analgesia and sedation during surgery, while the patients in the observation group were given remifentanil, butorphanol and dexmedetomidine for analgesia and sedation during surgery. The perioperative related indicators, the immune function before and after operation, the cognitive function evaluated by mini mental state examination(MMSE), the pain degree evaluated by visual analogue scale(VAS), the levels of inflammatory response, such as interleukin-6(IL-6), interleukin-6(IL-8), tumor necrosis factor alpha(TNF-a) and C-reactive protein(CRP), and the postoperative adverse reactions rate of the patients were recorded and compared between the two groups. Results: There was no significant difference in the operation time of the patients between the two groups(P>0.05). The intraoperative blood loss and the postoperative exhaust time of the patients in the observation group were significantly less than those of the patients in the control group(all P<0.05). There were no significant differences in the values of the immune function indexes and the inflammatory indexes before operation, and the scores of MMSE and VAS of the patients between the two groups(all P>0.05). The levels of IgG(7.25±1.32), IgA(1.59±0.39), IgM(1.06±0.43), CD3(52.69±6.85%) and CD4(38.69±3.24%) of the patients in the observation group at 12 hours after operation were significantly higher than those(6.80±1.65, 1.45±0.46, 0.95±0.32, 49.99%±6.24% and 37.26%±3.16%) of the patients in the control group, and the levels of CD8(35.69±4.21%), IL-6(102.63±32.65 ng/L), IL-8(106.98±13.65 ng/L), TNF-a(162.89±36.77 pg/L) and CRP(32.156.98 Mg/L) of the patients in the observation group at 12 hours after operation were significantly lower than those(38.05%±4.36%, 125.62±39.89 ng/L, 124.78±14.58 ng/L, 179.65±42.05 pg/L and 45.06±7.06 mg/L) of the patients in the control group (all P<0.05). There were no significant differences in the levels of IgG, IgA, IgM, CD3, CD4, CD8, MMSE, VAS, IL-6, IL-8, TNF- a and CRP of the patients at 24 hours after operation between the two groups(all P>0.05). There was no significant difference in the postoperative adverse reactions rate(6.9% vs.5.9%) of the patients between the two groups(P=0.580). Conclusion: The combination of butorphanol and dexmedetomidine used during laparoscopic myomectomy of the overweight patients can improve their immune function, postoperative cognition and inflammatory response.

To describe the current distribution of the interpregnancy intervals(IPI) of women with planned pregnancies in China, and to identify its influencing factors. Methods: The women of reproductive age who participated in the national free pre-pregnancy checkups project twice between January 2010 and December 2018 were selected as the study population. When performing the analysis, IPI was used as both quantitative and qualitative variables, and the women were divided into three groups bases on the qualitative variables, which including the women with <18 months of short IPI in group A, the women with ≥60 months of long IPI in group B and the women with 18-59 months of suitable IPI in the control group. Descriptive epidemiological methods were used to study the distribution of IPI of the women, and generalized linear regression models and logistic regression models were used to explore the factors influencing of IPI, and were used to estimate the indicator β of the associative strength by odds ratio(OR) and its 95% confidence intervals(CI). Results: The median IPI of the women in this study was 21.3 months, 40.7% of women had short IPI and 1.6% of women had long IPI. The risk of short IPI of those women aged ≥35 years old had decreased by 87.0%(95%CI 86.0-88.0) than those women aged 20-24 years old. Compared with those of the women with Han nationality, with lower than high school education level, with normal weight, or with history of adverse pregnancy outcomes in the previous delivery, the risk of short IPI of the women with ethnic minorities, with high school and above education level, with underweight, or with adverse pregnancy outcomes in the previous delivery had increased by 21.0%(95%CI 16.0-26.0), 3.0%(95%CI 1.0-5.0), 5.0%(95%CI 2.0-9.0) or 11.0%(95%CI 8.0-13.0), respectively. Compared with those of the women with rural household registration, with farmer occupation, with normal weight, without drinking, or with vaginal delivery in the previous delivery, the risk of short IPI of the women with urban household registration, with other occupation out of farmer, with overweight, with alcohol consumption, or with cesarean section in the previous delivery had reduced by 24.0%(19.0-28.0), 11.0%(95%CI 9.0-16.0), 8.0%(95%CI 6.0-10.0), 25.0%(95%CI 16.0-33.0) or 53.0%(95%CI 52.0-55.0), respectively. The risk of short IPI of the women from North China had significantly decreased than those women from the other regions of China(all P<0.05). Conclusion: Nearly half of the women with planned pregnancies in China experience either too short or too long IPI. In the future, the publicity and education should be strengthened for the women with short IPI susceptibility characteristics, such as low age, ethnic minorities, high school and above education level, underweight, rural householders, farmers, or experienced vaginal delivery or adverse pregnancy outcomes in the previous pregnancy, so as to help them to choose the appropriate IPI.

Maternal and child health is not only related to the happiness of families, but also to the development of the country and the future of the nation. In recent years, with the proportion of the advanced pregnant and delivery women has increased gradually, and the incidence of the urgent and critical illnesses in pregnant and delivery women has also been increasing continuously. The urgent and critical illness of the pregnant and delivery women have the characteristics of rapid onset and rapid disease progression, if which have not been treated in a timely manner, it can seriously affect the pregnancy outcomes and can greatly damage the health of mothers and infants. The prehospital emergency is an important link in the treatment of the urgent and critical illness in the pregnant and delivery women. Building a comprehensive prehospital chain first aid process system can save the valuable treatment time of the urgent and critical illness in the pregnant and delivery women and can improve the maternal and infant outcomes. This article summarizes the pregnancy outcomes of the pregnant and delivery women with urgent and critical illness, the construction method of the prehospital chain first aid process, and the correlation between the pregnancy outcomes of the pregnant and delivery women with urgent and critical illness and their prehospital chain first aid process, aiming to provide the reference for reducing the impact of the urgent and critical illness on the maternal and infant health.

To investigate the psychological health status of infertile patients before in vitro fertilization-embryo transfer (IVF-ET), and to study its correlation with the coping style of the patients. Methods: From January 2020 to December 2023, a total of 220 infertile patients who received IVE-ET for assisting pregnancy in the reproductive center of the hospital were selected in this study. The survey was conducted by the general information questionnaire, 90 symptom checklists (SCL-90), the fertility stress inventory (FPI), and the medical coping style questionnaire (MCMQ). Result: 211 infertile patients had completed the questionnaire survey, with the effective rate of 95.9%. The total score of SCL-90 of 211 infertile patients was 140.13±44.12 points, and which was significantly higher than that of the normal level (P<0.05). The total score of FPI was 166.04±21.69 points, and the scores of the face MCMQ, avoidance and yield of the patients were 18.45±2.89 points, 15.87±2.64 points and 9.36±2.81 points, and all of which were at the moderate level. The SCL-90 score of the patients was significantly negatively correlated with their face MCMQ score, and was positively correlated with their scores of PFI, avoidance and yielding. Meanwhile, the PFI score of the patients was negatively correlated with their face MCMQ score, and was positively correlated with their scores of avoidance and yielding (all P<0.05). Conclusion: The infertility patients generally have different degrees of the psychological health problems before IVF-ET, which are related to their coping styles. It is suggests that the clinical interventions should be carried out to guide the patients to adopt the positive coping styles and reduce the negative coping styles, which is conducive to improving their psychological health.

To explore the application value of the levels of serum pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PlGF) of pregnant women during the first trimester of pregnancy for evaluating their preeclampsia (PE). Methods: The clinical data of 80 pregnant women with PE in study group who were registered in hospital during the first trimester of pregnancy and treated until delivery from October 2018 to November 2021 were analyzed retrospectively. The women in the study group were divided 35 women with severe PE in group A and 45 women with mild PE in group B. The clinical data of 84 healthy pregnant women who had pregnancy examination and were followed up until delivery in control group during the same period were also analyzed retrospectively. The levels of serum PAPP-A and PlGF and the urine protein value (24h urine protein) during the first trimester of pregnancy (11-13 gestational weeks), and the values of blood pressure (systolic blood pressure and diastolic blood pressure) during the third trimester of pregnancy of the women were compared among these groups. Pearson correlation coefficient was used to analyze the correlation between the levels of serum PAPP-A and PlGF of the women during the first trimester of pregnancy and their urine protein value (24h urine protein) during the first trimester of pregnancy and the values of blood pressure (systolic blood pressure and diastolic blood pressure) during the third trimester of pregnancy. The predictive efficacy of the serum PAPP-A and PlGF levels during the first trimester of pregnancy of the women for their PE was analyzed by receiver operating characteristic (ROC) curve. Results: The levels of serum PAPP-A (25.91±2.64 ng/ml) and PlGF (18.07±2.93μg/L) of the women in the study group were significantly lower than those (28.15±3.42 ng/ml and 21.77±4.35μg/L) of the women in the control group. The 24h urine protein quantification level and the values of the systolic blood pressure and diastolic blood pressure of the women in the study group were significantly higher than those of the women in the control group. The levels of serum PAPP-A and PLGF of the women in group A were significantly lower than those of the women in group B (all P<0.05). Correlation analysis showed that the serum PAPP-A and PlGF levels of the women with PE were negatively correlated with their 24-hour urinary protein quantitative level and systolic blood pressure and diastolic blood pressure values. ROC curve analysis showed that the sensitivity, the specificity and the area under the curve (AUC) of the PAPP-A level of the pregnant women during the first trimester of pregnancy for predicting their PE occurrence were 74.3%, 66.7% and 0.676, respectively. The sensitivity, the specificity and the AUC of the PlGF level of the pregnant women during the first trimester of pregnancy for predicting their PE occurrence were 60.0%, 68.9% and 0.671, respectively (P<0.05). Conclusion: The levels of PAPP-A and PlGF of the pregnant women with PE during the first trimester of pregnancy are lower than those of the healthy pregnant women, and which of the women decrease with their PE severity. The levels of PAPP-A and PlGF of the pregnant women during the first trimester of pregnancy have certain predictive values for their PE occurrence.

To understand the anxiety of unmarried women before induced abortion, to explore the influencing factors and its predictive value of the women, and to provide reference for the effective psychological intervention. Methods: A total of 148 unmarried women who planned to undergo induced abortion in the hospital from May 2020 to May 2022 were selected in this study. The self-made general information questionnaire, the self-rating anxiety scale (SAS) and the pain disclosure index scale (DDI) were used for the anonymous investigation. Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors of the anxiety of the unmarried women before induced abortion. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the related influencing factors of the unmarried women for their anxiety before induced abortion. Results: A total of 142 unmarried women who planned to undergo induced abortion were included in this study, and with the SAS score of 52.97±4.03 points. And among them, there were 102(71.8%) cases with anxiety, and the SAS score of the 102 women was 57.82±3.26 points. There were 40(28.2%) cases without anxiety, and the SAS score of these 40 women was 40.61±4.59 points. Univariate analysis showed that the age, the occupation, the history of induced abortion, the understanding of reproductive health knowledge, the abortion method, the contraceptive attitude of the sexual partners and the self-disclosure of the unmarried women were significantly related to their anxiety before induced abortion (P<0.05). Multi-factor analysis showed that the proposed medical abortion, the young women, the poor reproductive health knowledge level and the low level of self-disclosure of the unmarried women had significantly greater risk of their anxiety before induced abortion (P<0.05). ROC curve analysis showed that the each influencing factor of the unmarried women all had the good predictive value for their anxiety occurrence before abortion, and with the area under the curve of 0.622-0.655. Conclusion: The medical abortion, the young women, the poor reproductive health knowledge level and the low level of self-disclosure of the unmarried women are significantly related to their anxiety before induced abortion, and all of which has certain predictive efficacy for their anxiety before induced abortion, and so the clinical countermeasures should be taken accordingly.

To investigate the expressions and clinical significances of the vascular endothelial growth factor A (VEGFA) and hypoxia inducible factor (HIF)-1α in placental tissue of pregnant women with fetal growth restriction (FGR). Methods: From May 2020 to September 2022, 116 pregnant women diagnosed with FGR and hospitalized for delivery in the hospital were selected in study group. Another 116 healthy pregnant women who gave birth in the hospital were included in control group. QRT-PCR was applied to detect the mRNA expressions of VEGFA and HIF-1α in placental tissue of the women in the two groups. Immunohistochemistry was applied to detect the protein expressions of VEGFA and HIF-1α. Pearson correlation was applied to analyze the correlation between the VEGFA level of the women and their HIF-1αlevel and the correlation between the VEGFA and HIF-1αlevels of the women with FGR and their clinical data. Multivariate logistic regression was applied to analyze the factors affecting the FGR occurrence of the women. Results: The positive expression rate (25.9%) of the VEGFA protein of the women in the study group was significantly lower than that (64.7%) of the women in the control group, and the positive expression rate (67.2%) of the HIF-1α protein of the women in the study group was significantly higher than that (24.1%) of the women in the control group. The VEGFA mRNA expression level (0.75±0.20) in the placenta tissue of the women in the study group was significantly lower than that (1.00±0.23) of the women in the control group and the HIF-1αmRNA expression level (1.26±0.25) in the placenta tissue of the women in the study group was significantly higher than that (1.01±0.19) of the women in the control group (all P<0.05). The VEGFA mRNA level in placental tissues of the women with FGR was negative correlation with their HIF-1α mRNA level (P<0.05). The neonatal Apgar score at 1 min after birth, the placental weight, the placental volume and weight of the women with FGR were positively correlated with the expression level of their VEGFA, and were negatively correlated with the expression level of their HIF-1α. The increased HIF1αlevel of the women was a risk factor of their FGR occurrence, and the increased VEGFA level of the women was a protective factor of their FGR occurrence (all P<0.05). Conclusion: The VEGFA expression level in the placental tissue of the pregnant women with FGR is low and their HIF-1α expression level in the placental tissue is high, and both of which of the women affect their FGR occurrence and neonatal birth quality.

To explore the effect of nasal intermittent positive pressure ventilation (NIPPV) combined with less invasive surfactant administration (LISA) for treating premature infants with neonatal respiratory distress syndrome (NRDS), and to study its influence on the arterial blood gas and incidences of adverse events of the premature infants. Methods: From June 2020 to September 2023, 96 premature infants with NRDS were selected and were divided into observation group (48 cases) and control group (48 cases) according to the simple randomization grouping method. The infants in both groups were given non-invasive assisted ventilation in the neonatal intensive care unit. The infants in the control group received NCPAP treatment, while the infants in the observation group received NCPAP combined with LISA treatment. The clinical treatment status, the values of arterial blood gas indicators, such as arterial partial oxygen pressure (PaO2), arterial partial pressure of carbon dioxide (PaCO2), arterial oxygen saturation (SiO2) and PH, the values of pulmonary oxygenation indexes, such as arterial partial oxygen pressure/partial alveolar oxygen pressure (PaO2/PAO2) and oxygenation index (OI), and the incidence of adverse events of the infants were compared between the two groups. Results: After treatment, the non-invasive ventilation time (5.3±1.7d), the proportion of invasive ventilation (16.7%), the total oxygen therapy time (10.7±2.2d), and the duration of hospital stay (27.9±4.3d) of the infants in the observation group were significantly lower than those (6.6±2.0d, 35.4%, 12.4±2.5d and 31.6±5.1d) of the infants in the control group. The successful rate of stopping ventilation (87.5%) of the infants in the observation group was significantly higher than that (72.9%) of the infants in the control group. The values of PaO2, SiO2, PaO2/PAO2 and PH of the infants in the two groups after treatment had increased significantly, and the PaCO2 and OI values of the infants in the two groups after treatment had decreased significantly, and the improvement of which of the infants in the observation group were significantly greater than those of the infants in the control group. The total incidence of adverse events (8.3%) of the infants in the observation group was significantly lower than that (25.0%) of the infants in the control group (all P<0.05). Conclusion: NIPPV combined with LISA for treating the premature infants with NRDS can effectively improve their arterial blood gas, enhance their pulmonary ventilation, promote the improvement of their clinical symptoms and shorten their hospital stay.