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ZHANG Wen, WU Shangchun
Objective: To evaluate the safety of manual vacuum aspiration (MVA). Methods: We searched medical databases including CBMdisc (1978-2014), CNKI (1979-2014), Wanfang Database (1982-2014), VIP Database (1989-2014), PubMed (1966-2014), Cochrane Library by computer and manually searched other related journals to screen randomized controlled trials (RCTs) that involved in the comparison of MVA and Electric vacuum aspiration (EVA). The quality of included trials was assessed. RevMan5.0 software was used for meta-analysis. Results: Twelve trials were included, in which 3 RCTs were graded B and 9 were graded C. The blood loss of MVA was lower than that of electric vacuum aspiration (EVA), showing statistically significant difference ［WMD (95% CI) value was -8.01 (-8.86, -7.17)］. There were no significant differences in pain perception degree between MVA and EVA in two subgroups with different anesthesia methods ［RR (95% CI) values were 1.78 (0.07, 42.83), 0.28 (0.02, 5.19), respectively］. The pain perception of participants in MVA group when dilating cervix before the operation did not vary with the level of the doctor, while they felt less pain when operated by the faculty doctor than the resident doctor in the EVA group. There was no significant difference between MVA and EVA in terms of the operation time ［WMD (95% CI) value was -1.34 (-2.83, 0.15)］. The incidence of artificial abortion syndrome of MVA was lower than that of EVA, showing a statistically significant difference ［RR (95% CI) value was 0.06 (0.01, 0.38)］. The incidence of adverse reactions of MVA and EVA was low and there was no significant difference between two groups. Conclusion: Based on the current best evidence, MVA has the similar safety to EVA , and what is more MVA could reduce blood loss and the incidence of artificial abortion syndrome.
2015 Vol. 23 (5): 292- [Abstract]（
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JIAO Yanna, LI Jianhui, GAO Xiaobo,et al
Objective: To study effects of N-acetylcysteine (NAC) on apoptosis and autophagy induced by sodium arsenite in H9C2 rat myocardial cells and the underlying mechanism. Methods: H9C2 cells were divided as four groups: control group, sodium arsenite group, NAC group, arsenic and NAC group. Cell viability was measured by CCK-8 colorimetry. Changes in morphology and the amount of apoptotic cells were detected by Hoechst 33258 staining. Intracellular level of reactive oxygen species (ROS) was measured by DCFH-DA staining. Expressions of P53, Bcl-2, Bax and LC3 were evaluated by Western Blot, as well as the level of phosphorylation and total of ERK1/2 in H9C2 cells. Results: Compared with the control group, 15 μM sodium arsenite decreased cell viability, while increased the level of intracellular ROS and induced apoptosis and autophagy (P < 0.01). And pre-treatment with 1 mM NAC decreased the expression of proapoptotic proteins, such as P53 and Bax, while increased the antiapoptotic protein, Bcl-2. And the ratio of LC3-II/LC3-I was also reduced. Further research showed that sodium arsenite induced the expression of phosphorylation of ERK1/2（P<0.01）, while co-treatment with NAC and arsenic inhibited it. Conclusion: NAC could inhibit apoptosis and autophagy of H9C2 cells induced by sodium arsenite via reducing the ROS production and the level of phosphorylation of ERK1/2.
2015 Vol. 23 (5): 299- [Abstract]（
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ZHENG Xin, ZHU Li
Objective: To explore the expression and the localization of transient receptor potential vanilloid type 1(TRPV1) and SLIT2 in women with and without adenomyosis. Methods: Ectopic and homologous eutopic endometria from 35 women suffering adenomyosis and endometria from 20 women without adenomyosis were sampled for immunohistochemical analysis of TRPV1 and SLIT2. Results: The positive expression rate of SLIT2 in ectopic endometria was significantly greater than those in normal and eutopic endometria (P<0.01). Compared with normal and eutopic endometria, the immunoreactivity of TRPV1 was significantly increased in ectopic endometrium (P＜0.01). The immunoreactivities of both TRPV1 and SLIT2 were positively correlated with the severity of dysmenorrheal (r=0.627 P<0.01; r=0.583 P<0.01). Expressions of SLIT2 and TRPV1 were positively correlated (r=0.376 P=0.026). Conclusion: TRPV1 and SLIT2 may be involved in the severity of dysmenorrheal and found to be significant indicators for dysmenorrheal severity in women with adenomyosis.
2015 Vol. 23 (5): 305- [Abstract]（
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MAO Wancheng, LU Yanqiang, XUE Yan,et al
Objective: To investigate gene polymorphisms of methylenetetrahydrofolate reductase (MTHFR) C677T, A1298C and methionine synthase (MTRR) A66G among the Han, Miao and Tujia women in Sinan County, Tongren City, Guizhou Province, and to explore the genetic characteristic of these three population. Methods: A total of 1232 Han, Miao and Tujia women in Sinan County were recruited from December 2013 to December 2014 and collected oral cells. Gene polymorphisms of MTHFR and MTRR were evaluated with FQ-PCR technology. Results: There was significant difference in frequencies of alleles of (MTHFR) C677T, A1298C gene between the Han and Tujia women in Sinan County (χ2=7.53, P<0.05). Conclusion: The MTHFR 677TT polymorphism distribution of the Han women in Sinan County is higher than that of Tujia ones. More and longer folic acid supplement should be promoted so as to achieve the purpose of primary prevention.
2015 Vol. 23 (5): 310- [Abstract]（
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CHEN Aixia, YI Yanping, HU Ailian, et al
Objective: To survey reproductive health related knowledge, attitudes, behaviors and the demand for reproductive health education. Methods: Totally 1091 married women, from September 2013 to June 2014, were chosen and investigated with a self-filling questionnaire for knowledge, attitudes, behaviors and the demand for reproductive health education in Luogang District. Results: In 959 effective respondents, there were 452 (47.13%) women being eager for reproductive health education. There were 872 women (90.92%) thought the reasons that influenced their participation in community health education activities were objective factors, but 87 (9.07%) considered those were subjective factors. A total of 517 (53.9%) women considered the source of reproductive health knowledge was hospital, 348 (36.3%) thought it books and magazines, 251 (20.1%) considered that was websites. As for the highest score in the questionnaire of reproductive health knowledge, the 36-46 year-old group in the age groups, the undergraduate group in the education groups, and medical staffs and teachers in the professional groups were found. There were significant differences among groups (Pall <0.05). Conclusion: The married women in Luogang District have a great demand for reproductive health education. A sound, systematic and effective reproductive health education model is urgent.
2015 Vol. 23 (5): 314- [Abstract]（
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LIU Nian, YAN Jiong, YANG Lin
Objective: To explore the relationship between the gene polymorphism of methylenetetrahydrofolate reductase（MTHFR）C677T，A1298C and methionine synthase reductase（MTRR）A66G among women with abnormal pregnancy history. Methods: A total of 359 women with abnormal pregnancy history (study group) and 1032 controls were included in this study. Oral epithelial cell samples were collected to extract genome DNA, and fluorescence quantitative polymerase chain reaction（FQ-PCR）technique was used to detect gene polymorphism of MTHFR and MTRR and analyze the correlation between MTHFR and MTRR gene polymorphism distribution and the occurrence of undesirable pregnancy. Results: The frequencies of MTHFR 677TT, MTHFR 1298CC and MTRR 66GG homozygous mutation in the study group were statistically significantly higher than those in the control group（χ2＝4.95，P＜0.05；χ2＝5.92，P＜0.05；χ2＝10.73，P＜0.01）; The frequencies of MTHFR 677AA, MTHFR 1298AA and MTRR 66AA homozygous in the study group were statistically significantly lower than those in the control group. Conclusion: The homozygous mutation of MTHFR C677T, MTHFR A1298C and MTRR A66G may be related to the increased risk of abnormal pregnancy.
2015 Vol. 23 (5): 318- [Abstract]（
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DU Wuying
Objective: To observe and study curative effects and clinical safety of using leonurus injection combined with oxytocin in prevention of postpartum hemorrhage after secarean section. Methods: From June 2013 to June 2014 in our hospital 160 pregnant women experincing cesarean section were recruited and randomly divided into the observation group and the control group (80 cases in each group). Women in the observation group were given uterine muscle injection of 2 ml leonurus injection and intravenous drip of 20 U oxytocin immediately after cesarean section. And 2 ml of leonurus injection were given 4 h, 16 h after surgery and once a day, lasting for 3 to 5 days. Women in the control group were given 20 U oxytocin and intravenous drip of 20 U oxytocin after cesarean section, and 20 U oxytocin injection 2 h after surgery, followed by 10 U oxytocin injection every 12 h. The postpartum hemorrhage rate, and 2 h, 24 h of intraoperative and postoperative amount of blood loss, and the change of hemoglobin level and the incidence of adverse reactions of two groups were observed and compared. Results: In the observation group, the amount of incision bleeding in 77 (96.3%) women significantly reduced, and no patients needed other intervention and blood transfusion therapy. While in the control group, the amount of incision bleeding in 70 (87.5%) women significantly reduced, and 6 patients needed other intervention and blood transfusion therapy (n=2). The effective rate of two groups had a significant difference (χ2= 4.103, P<0.05). Intraoperative blood loss, 2 h and 24 h postoperative blood loss in the observation group were significant lower than those in the control group (t=7.116, 6.878, 8.853, P<0.05). Hemoglobin variations 24 h after surgery in the observation group was (16.55±5.78) g/L, which was significantly lower than that in the control group ［(27.80±6.26) g/L, t =11.810, P< 0.05］. Uterine instauration in the observation group was obviously better than that in the control group (t=13.403, 14.425, P<0.05). Adverse reactions in two groups were mainly nausea, vomiting, facial blushing, high blood pressure and mild chest discomfort, and the incidence of the observation group was significantly lower than that in the control group (χ2= 3.608, P< 0.05). Conclusions: Oxytocin combined with leonurus injection has better clinical curative effects and higher safety in preventing postpartum hemorrhage after cesarean delivery, which could also promote uterine instauration and would be worthy of clinical popularization and application.
2015 Vol. 23 (5): 321- [Abstract]（
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QU Yanxia, CHEN Guilan, LI Zhihua, et al
Objective: To explore the applicable scheme and the clinical significance for prevention of thalassemia by analyzing results of the screening and prenatal diagnosis on thalassemia with doubtful fetal in Guangzhou. Methods: A total of 257 pregnant women who were α- or β- thalassemia gene carrier were performed amniocentesis to test the fetus' thalassemia gene from 2010 to 2012. Fetus of all respondents were followed up after delivery. Results: In 257 cases, there were 10 Hb Bart's hydrops fetus, 20 HbH cases, 14 severe β-thalassemia cases, 2 intermeditate β-thalassemia cases, 109 α-thalassemia carriers, 30 β-thalassemia carriers, 12 co-inheritance of α- and β-thalassemia cases (including 1 severe αβ compound thalassemia fetus), and 60 normal fetuses. Results of postpartum follow-up were consistent with those of prenatal diagnosis. Conclusion: The birth of children with severe thalassemia could be prevented effectively and the quality of population could be increased by prenatal diagnosis.
2015 Vol. 23 (5): 324- [Abstract]（
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GUO Weiwei, WU Shangchun, HOU Zihong, et al
Objective: To explore the contraceptive knowledge, attitude and behavior of post-abortion women and analyze the effectiveness of consultation on contraceptive method choice of them to provide scientific theory for hospitals to better provide post-abortion contraception services. Methods: A total of 500 women who did abortion operation from October 8, 2013 to January 8, 2014 in Tianjin Medical University General hospital were recruited. A questionnaire was used to survey the postpartum contraceptive knowledge, attitude and behavior. A consulting service was provided for them and the change in contraceptive method choice was evaluated. Results: An overall accuracy of contraceptive knowledge was 29.1%, and the average score was 2.93 points (10 points of total score). About 67.1% women of post-abortion thought it was necessary or very necessary to know the contraceptive knowledge. The unexpected pregnancy reason were no contraceptive use (14.6%), effective contraceptive use (10.6%), and using condom (68.0%). Through consulting women who chose effective and highly effective contraceptive methods increased by 12.5%. Conclusion: Post-abortion women are lack of contraceptive knowledge, but have a good contraceptive attitude. The main reason of unexpected pregnancies is no use of effective or any contraceptive methods. Consultation can effectively improve the proportion of highly effective contraceptive use, therefore it is around the corner to strengthen post-abortion contraception services.
2015 Vol. 23 (5): 352- [Abstract]（
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CHEN Huijun, ZHAI Xianhua
Objective: To explore the clinical effect of levonorgestrel-releasing intrauterine system (LUG-IUS, Mirena) inserted immediately after induced abortion and 4 to 7 days of menstrual period . Methods: One hundred and ninety-four women were chosen in our hospital from March 2011 to November 2013 and were divided into two groups. Women in the observation group (n=90) underwent LUG-IUS insertion immediately after surgical abortion, and those in the control group inserted LUG-IUS on 4 to 7days of menstrual period (n=104). The pregnancy rate, the expulsion rate, side effects and continuation rate were compared between the two groups. Results: Compared with the control group, women in the observation group were slightly higher in the continuation rate, while lower in the expulsion rate (χ2=0.265，0.209，P>0.05). The relative amenorrhea rate in the observation group and the control group were 92.22% and 94.23%, showing no statistical difference (χ2=0.311，P=0.577). Twenty-five women in the control group and 25 in the observation group were found bleeding spotting (χ2=0.235，P=0.627), and there were no statistical differences between two groups in abnormal bleeding and amenorrhea (χ2=0.008，0.379，P>0.05). Conclusion: Immediate insertion of LUS-IUS after abortion is safety and feasibility, which is worthy of clinical application.
2015 Vol. 23 (5): 357- [Abstract]（
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