Objective: To investigate incidence status and risk factors of Postpartum Depression (PD) in Rudong county，and could provide scientific evidences for early recognition and intervene of PD. Method During July 2013 and October 2014, 166 postpartum women, who received postpartum health service provided by rural doctors, were included in this study. Self rating depressive scale (SDS) used in pregnancy, and Edinburgh postpartum depression scale (EPDS) and self developed questionnaire used in postpartum, were all for evaluating psychological status and investigating social effect factors. Results: At 10～14days or 28days of postpartum, the incidence rate of PD was 9.67%，5.79%, respectively. There were 12 factors associated with PD (all had statistically significant difference, P<0.05), which included depression during pregnancy, age, degree of education, prenatal examination, highest risk scale, delivery way, gestational age, feeding patterns, healthy status of newborn and mother, family relationships, the knowledge of maternal and infant care. The self developed questionnaire showed that there were one or more triggers in 73.5% postpartum depression patients. Conclusion: The incidence rate of PD in Rudong County was as same as others reported in literatures. Women with high risk facts must be cared. Early screening, early detection, early intervention should reduce the incidence rate of postpartum depression.

2015 Vol. 23　(10):　652- [Abstract]（ 68 ） HTML (1 KB)  PDF  (0 KB)  ( 65 )

Objective: To analyze the feasibility of providing post abortion family planning services in hospital settings in Shanghai. Methods: 596 doctors from 60 hospitals were selected using cluster random sampling, and anonymous questionnaire was used to collect information. Results: The average age of doctors was 39.0±7.52(24-60). The median number of patients every day was 40(10-120). The median time for every abortion patient was 15 minutes (5-90). The median time for post family planning counselling was 5 minutes (1-30). Doctors' level of knowledge about post abortion family planning choice on emergency contraception and intra-uterus device was high, but on oral contraceptives, progesterone only methods and spermicide was limited. Though 61.9% doctors felt that it's their responsibilities to provide post abortion family planning counseling, their perception on the best and the feasible way to provide post abortion family planning advocacy and counseling was different(P<0.01). Barriers affecting the provision of post family planning services included that doctors can't ensure the quality of counseling because of too much workload (89.6%), no special personnel took charge of counseling (66%), and no appropriate place to protect patient's privacy (38.8%), and limited choice of contraceptive at the out-patient clinic (29.1%), and women didn't have urgent needs (17.4%). Conclusion: Health professional training alone is not enough. It's possible to increase the feasibility of providing post family planning services in hospital settings including hospital support, performance management, hardware facility improvement, ensuring contraceptive supply and population health education.

2015 Vol. 23　(10):　659- [Abstract]（ 66 ） HTML (1 KB)  PDF  (0 KB)  ( 90 )

Objective: To study the thalassaemia gene carrying rate,  common mutation types, and its frequency in middle school students of Bouyei Nationality from Duyun of Qiannan Prefecture in Guizhou Province. Methods:  1700 middle school students who all up to three generations Bouyei people were screened for thalassaemia  hematology. Testing haematological phenotype by MINDRAY DC-5390 blood cell analyzer was used. Mediterranean anaemia gene was detected in 436 people, whose average red blood cells in venous blood volume were ≤ 82 fl and average content of erythrocyte were ≤ 27 pg. Results: In the 1700 students, 184 of them were found the alpha thalassemia gene deletion, rate of 10.8%, which including alpha thalassemia I gene (SEA) （42.86%）, alpha thalassemia II gene（3.7） （32.2%）, alpha thalassemia II gene（4.2）（13.1%）, alpha thalassemia and alpha thalassemia II gene（1.63%）, and alpha thalassemia double heterozygote gene(3.7+4.2)(1.07%). 119 of them were found the beta thalassemia mutation gene, carrying rate of 7% and four kinds of mutation gene were CD17 (52.94%), D41-42 (42.86%), BE (2.52%),   -28 (1.68%). Conclusion: The alpha thalassemia gene deletion rate and the beta thalassaemia carrying rate in Bouyei middle school students were 10.8% and 7%. It is important for controlling the birth of children with thalassemia major and improving the quality of the newborn by population screening, genetic counseling, the old concept of marriage and childbirth change, and rational marriage guiding.

2015 Vol. 23　(10):　667- [Abstract]（ 57 ） HTML (1 KB)  PDF  (0 KB)  ( 88 )

Objective: To analyze the effect of progynova combined with  progesterone to prevent intrauterine adhesions of patients with missed abortion after uterine curettage. Method：One hundred and four patients with missed abortion were recruited and divided into the observation group (52 cases) and the control group ( 51 cases). Patients in control group were not given any medication after uterine curettage, while patients in observation group took progynova (2 mg, once a day) for 5 days and progesterone capsules (50 mg, once a day) for 3 weeks after curettage. The bleeding duration and bleed volume, the duration and the degree of abdominal pain, the change of menstrual and the rate of intrauterine adhesion were observed in both groups. Result: Compare to control group, bleeding volume, duration of bleeding or abdominal pain was significant lower (t=4.615, 5.037, 10.620, P<0.01). In observation group, most of the patients were mild abdominal pain, and the degree of pain was significant lower (χ2=7.890, P<0.05). The rate of hypomenorrhea and amenorrhea was also lower in observation group significantly (χ2=6.272, P<0.05) and the time of menses recovery was shorter (t=6.537, P<0.01). The incidence of intrauterine adhesions was significantly lower (χ2 =4.039, P<0.05). Conclusion: Using progesterone combined with progynova can effectively prevent intrauterine adhesions in patients with missed abortion after uterine curettage.

2015 Vol. 23　(10):　674- [Abstract]（ 83 ） HTML (1 KB)  PDF  (0 KB)  ( 85 )

Objective: To explore the relationship between chromosome karyotyping and male infertility. Method: Chromosome karyotyping and semen analysis were carried out in 5437 infertile men from September 2011 to October 2013 at Shenzhen zhongshan urology hospital. The patients were assigned to three groups according to their semen parameters. Chromosome karyotyping was performed for all patients in three groups. Results: The chromosome abnormality rate of patients in azoospermia group was 8.33%, which was significantly higher than that of in normal semen parameters group(1.02%). The chromosome abnormality rate of patients in oligo- or astheno- or teratozoospermia group was 2.84%, which was also higher than that of in normal semen parameters group. The incidence of chromosomal polymorphisms did not significantly differ in patients among the three groups. Conclusion: Chromosomal abnormality is one of the important causes of male infertility, while chromosome polymorphism does not cause spermatogenesis failure. Chromosome Karyotyping should be carried out in all patients with male infertility.

2015 Vol. 23　(10):　681- [Abstract]（ 64 ） HTML (1 KB)  PDF  (0 KB)  ( 78 )

Objective: To explore the clinical effect of the traditional chinese medicine treatment Based upon Differentiation of Syndromes in patients with gestational diabetes mellitus(GDM). Methods: 120 cases of gestational women with GDM who received antenatal care in Guangdong Women and Children Hospital were recruited. According to outcomes of physical assessment of these women by Chinese medicine, all the women were divided into balance type group(n=60) or imbalance type group(n=60). Serum levels of glucose and lipid metabolism indexes were determined for all women. All women were given dietary guidance and chinese medicine treatment based on syndrome differentiation. Glucose and lipid metabolism indexes were analyzed before and after intervention, and the effects of traditional chinese medical were evaluated. Results: Levels of fasting plasma glucose(FPG), fasting insulin(FINS), triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and total cholesterol(TC) in patients with imbalance type was higher than that of patients with balance type, but the levels of Visfatin, high density lipoprotein cholesterol(HDL-C), apolipoprotein A(ApoA) and ApoA/ApoB was lower than that of patients in the balance type group, the differences was statistically significant(P<0.05). After the traditional chinese medicine intervention, 42 cases of gestational women with imbalance type were changed into balance type. The levels of FPG, FINS, glycosylated hemoglobin A1c (HbA1c), TG, TC, LDL-C and apolipoprotein B(ApoB) in the pregnant women with imbalance type were significantly lower than that of pretherapy(P<0.05). However, the levels of Visfatin, HDL-C, ApoA and ApoA/ApoB were higher than that of pretherapy(P<0.05). Conclusion: Most of pregnant women with GDM are imbalance types. The traditional chinese medicine treatment based on syndrome differentiation is effective in treating GDM, which can improve the metabolism of glucose and lipid disorders.

2015 Vol. 23　(10):　688- [Abstract]（ 49 ） HTML (1 KB)  PDF  (0 KB)  ( 69 )