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ZHAO Linlin1, LU Xiaolin1, LIU Xinli1, XIN Yu2, WANG Li1, YAO Xiuying1*
To investigate the relevance of polymorphism of interleukin 18 (IL18) gene rs187238 and the susceptibility of unexplained recurrent spontaneous abortion (URSA). Methods: The related articles were searched from database such as PubMed, Embase, and Wanfang up to December 18, 2016. Casecontrol studies that related to rs10830963 variant and the risk of URSA were included based on inclusion and exclusion criteria, and data were extracted independently by two reviewers. RevMan5.1 was used to analyze the value of pooled odds ratio(0R), to conduct subgroup analysis，to test publication bias, and to do sensitivity analysis. Results: A total of 6 articles matched the inclusion criteria and were involved in this Meta analysis, which included 1435 women with URSA and 1377 normal women. Homozygous mutant CC genotype carriers had significant higher risk of URSA than that of homozygous wild type GG allele carriers，with OR value (1.79, 95% CI 1.033.10). Moreover, the analysis of recessive genetic model（CC vs GG+GC）indicated that the pooled OR value and 95% CI were 1. 80 and 1.083.01. Conclusion: This Meta analysis showed that the rs187238 polymorphism might serve as a risk factor of URSA.
2017 Vol. 25 (11): 731- [Abstract]（
424
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SHI Gaosong, XU Fengjuan, LIANG Chao, WANG Zaijun*
The Chinese new family planning policy (comprehensive twochild) had implemented from 2016. As the wide coverage of familyplanning policy adjustment and the big change of policy adjustment, population growth will increase. Number of population is most important factor to determine the demand of health services, so the increases of population number could inevitably lead to increases of health services utilization. Based on the characteristics of the demand of health services and exploring the influence of demographic factors on the changes of health service demand, this study scientifically analyzed the impacting scope and degree of population change on the demand of health services in the future, and raised the main strategies, and provided evidences for correctly forecasting demand of health services increases and security of supply.
2017 Vol. 25 (11): 736- [Abstract]（
506
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YANG Shuzhen1, DAI liping2, ZHAO Wenji2, WU Lihua3, SHANG Caixia2
To know the current physical examination situation of multiparas before pregnancy who wanted the second child after the comprehensive twochild policy, and to analyze its influential factors. Methods: 227 multiparas who came to hospital for birthing the second child from two hospitals of Zhangye city in Gansu Province were investigated by self designed questionnaire. Results: The rate of physical examination before pregnancy of these women was 39.2(89/227). Multiariable logistic regression analysis showed that multiparas whom live in the city (OR 2.61， 95% CI 1.165.85), whose family income over 100000 yuan (OR 2.64, 95%CI 1.225.71), the education level of their husbands at senior high school (OR 1.60, 95% CI 0.614.16), and who had accepted physical examination before the first pregnancy(OR 11.44, 95% CI 5.4333.56）had higher rate of physical examination before the second pregnancy. But the multiparas with unwanted pregnancy had lower rate of physical examination before the second pregnancy (OR 0.37, 95% CI 0.170.80). Conclusion: This study shows that the rate of multiparas accepting physical examination before the second pregnancy is low. In order to increasing the ratio of wanted pregnancy and improving the acceptance of physical examination before pregnancy, different level of medical serves institutions should all strengthen publicity and education of family planning and physical examination before pregnancy.
2017 Vol. 25 (11): 739- [Abstract]（
465
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ZHAO Jun1, ZHANG Hongguang1, TIAN Aiping2
To analysis diseases composition and cis position of disabled children who applied for medical authentication, and to provide evidence for making priority preventing and cure strategies. Methods: Based on an utomatic classification process of standard ICD 10 diseases, 76726 diagnosed diseases corresponding to 65952 disabled children who applied for medical authentication at prefectural city level in Sichuan province were coded between 2004 and 2015. And the identification situation of approval disabled children, basic demographic characteristics, diseases classification, as well as overall cis position of these disabled children during 12 years were analyzed by SPSS statistics software. Results: Average approval ratio of medical authentication of 20 prefectural city of Sichuan province between 2004 and 015 was 74.11%, average age of disabled children when applied for medical authentication was 8.82 years old, male accounted for 56.77%, children from rural area accounted for 73.34%, sex ratio of rural area disabled children (14629) was higher than those of disabled children from urban area (98.29). 849 types of diseases were diagnosed by the authentication. Congenital malformations, deformations and chromosomal abnormalities (24.84%), diseases of the nervous system (17.87%), diseases of the eye and adnexa (11.01%), mental and behavioural disorders (1096%) were four major diseases categories. In congenital malformations, deformations and chromosomal abnormalities category, congenital malformation of circulatory system (30.56%), musculoskeletal system (23.57%), and genitourinary organs (10.58%) were major diseases. The top ten diseases were epilepsy (10.32%), unspecified mental retardation (6.61%), cerebral palsy (4.47%), disorders of refraction and accommodation (4.30%), other congenital malformations of heart (3.86%), visual disturbances (3.80%), congenital malformations of heart septum (2.70%), other hearing loss (2.13%), other congenital malformations of brain (1.84%), and sequelae of injuries of head (1.26%). Conclusion: Congenital malformations, deformations and chromosomal abnormalities were the most common reasons caused disabled children from the data of medical authentication of Sichuan province. In which, Epilepsy, mental retardation, cerebral palsy, disorders of refraction and accommodation, congenital malformations of heart were high incidence diseases. Effective prevention and cure strategies should be worked out for preventing these diseases. The registration and follow up service system should be built for families with disabled children, as to effectively control reproductive risk of high risk families and to improve the quality of birth population.
2017 Vol. 25 (11): 744- [Abstract]（
400
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HU Ming
To investigate the effect of low dose of propylthiouracil on the outcomes of pregnancy and liver function of pregnant women with hyperthyroidis. Methods: 296 pregnant women with hyperthyroidism from the Fourth Affiliated Hospital of Nanchang University were recruited between April 2015 and November 2016. The included pregnant women with hyperthyroidism were divided into the control group and the research group according to the random number table, and each group had 148 women. The women in the control group were treated with routine dose of propylthiouracil, women in the study group were treated with low dose propylthiouracil. The serum thyroid function related indexes (FT3, FT4 and TSH) and liver function related indexes (ALT, AST, ALP, GGT and TBIL) of all women were detected before and after treatment. The efficacy of treating hyperthyroidism of women was evaluated, and the adverse events of women were analyzed. Results: Before treatment, the levels of serum FT3, FT4 and TSH of women in the two groups were no significant difference (P>0.05), and after treatment, the levels of serum FT3 and FT4 of women in the two groups were significantly lower than those of women before treatment (P<0.05), while the level of TSH of women after treatment was significantly higher than that of women before treatment (P<0.05), but there was no statistical significant difference in levels of FT3, FT4 and TSH between the two groups (P>0.05). The total efficiency of treating hyperthyroidism had no significant difference between the two groups (P>0.05). The levels of serum ALP, GGT and TBIL of women in the two groups before treatment had no statistical significant difference when compared to those of women after treatment (P>0.05). After treatment, the levels of ALT and AST of women in the control group had increased, and were significant higher than those of women in the study group (P<0.05). The total incidence of adverse events of women in the study group (12.84%) was significant lower than that of women in the control group (22.97%) (χ2=3.96, P=0.000, <0.05). Conclusion: Compared with the conventional dose of propylthiouracil, low dose of propylthiouracil using in pregnant women with hyperthyroidism not only can achieve the treating efficacy of hyperthyroidism, but also can significantly reduce the degree of damage of liver function, decrease adverse reactions during pregnancy, and can improve the pregnancy outcomes.
2017 Vol. 25 (11): 751- [Abstract]（
519
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CHEN Ping, Xin Limei*, LI Sha， ZHU Jiang，ZHOU Ni
Though compared the local anesthesia single hole laparoscopic bipolar coagulation tubal sterilization with transabdominal proximal core package fallopian tube buried sterilization, to evaluate safety, effectiveness and acceptability of local anesthesia single hole laparoscopic tubal sterilization, and to explore the influence of these two kinds of fallopian tube sterilization operation on ovarian function shortterm and longterm. Methods: In 14 counties of Guizhou province, 914 patients experienced local anesthesia single hole laparoscopic bipolar coagulation tubal sterilization (in the laparoscopic group)were randomly selected from January 2014 to December 2014, and at the same time, 893 patients experienced transabdominal proximal core tube sterilization bag buried fallopian (in laparotomy group) were also randomly selected. The patients in the two groups were observed and evaluated during operation and at follow up post operation. Some of women in the two groups were given ovarian function assessment by venous blood samples. Results: The amount of bleeding during operation, the rate of complications, and rate of adverse influence on ovarian function at one month post operation of patients in the laparoscopic group were significant lower than those of patients in the laparotomy group (P<0.05). And pain degree during operation, operative time, rate of postoperative pain, postoperative observing time, and rate of satisfaction of patients in the laparoscopic group were significant better than those of patients in the laparotomy group (P<0.05). At one month after operation, though the level of Based sex hormone levels of patients in both group had no significant change, the number of patients with FSH > 10 U/L and FSH/LH over 2 in the laparotomy group was significantly higher than that of patients in the laparoscopic group. Conclusion:Local anesthesia single hole laparoscopic fallopian tube sterilization operation is a safe, effective, simple operation for fallopian tube sterilization, which has the characteristics of less pain, quick recovery, and good acceptability, and it has less adverse influence on ovarian function compared to transabdominal fallopian tube sterilization operation.
2017 Vol. 25 (11): 755- [Abstract]（
647
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GUO Ying，YANG Na，JIANG Xiangrong，YIN Xiurong
To investigate the influence on outcomes of different age women with diminished ovarian reserve（DOR）treated by growth hormone(GH) combined within GnRH antagonist protocol when undergone in vitro fertilization and embryo transfer（IVFET）. Methods：A total of 131 women with DOR were enrolled into this study，which included 69 women less than 35 years old and 62 women equal to or over 35 years old. All included women received the antagonist protocol. In order to observe the effect of GH on ovarian response and pregnancy outcome for different age women, women had used GH were in GH group, and women hadn’t used GH were in control group. Results：As for women with equal to or over 35 years old，the dosage of GH used of women in GH group was significantly lower than that of women in control group. Level of E2 and number of collected oocytes of women on the day of HCG administration had significantly increased compared to women in control group (P＜0.05). As for women less than 35 years old，there were no significant differences in clinical data and laboratory data. Conclusion：GH combine with a GnRH antagonist protocol could improve the ovarian response for equal to or over 35 years old women with diminished ovarian reserve，while there was no significant effect for women less than 35 years old.
2017 Vol. 25 (11): 760- [Abstract]（
509
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YANG Lin, LI Huimin, ZHU Yan
To explore the clinical effect of laparoscopic hysterectomy and pelvic lymph node dissection for treating uterine malignant tumor and its effect on the pelvic floor function and sexual function of patients. Methods: Dates of 97 patients with uterine malignancies in Shanxi Province Nuclear Industry 215 Hospital from January 2013 to June 2015 were retrospectively analyzed. Among them, 53 patients in laparoscopic group were treated by laparoscopic hysterectomy and pelvic lymph node dissection, and 44 patients in laparotomy group were treated by traditional laparotomy. Perioperative parameters and postoperative pelvic floor function index of patents in both groups were compared. Results: The operation time, bleeding volume, postoperative exhaust time and hospital stay time of patients in laparoscopic group were significantly lower than those of patients in laparotomy group (t=12.88, t=19.96, t=8.31, t=5.19, P<0.05). There was no significant difference in the number of lymph node dissection and the catheter indwelling time of patients between the two groups (t=1.32, t=0.88, P>0.05). The rate of surgical complications of patients in the laparoscopic group was 9.34%, which was significant lower than that of patients (25.00%) in laparotomy group (χ2=4.23, P<0.05). The incidence of stress urinary incontinence of patients (1.89%) in the laparoscopic group was significant lower than that of patients (13.64%) in laparotomy group (χ2=4.96, P<0.05). The rate of sexual satisfaction of patients (42.22%) in the laparoscopic group was significant higher than that of patients (2432%) in laparotomy group (Z=-2.299, P<0.05).Conclusion: Uterine malignant tumors treated by laparoscopic hysterectomy and pelvic lymph node dissection has advantages of less trauma, faster recovery, and has less bad influence on pelvic floor function and the quality of sexual life when compared to treated by traditional laparotomy.
2017 Vol. 25 (11): 764- [Abstract]（
616
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CONG Jing，TAO Xincheng，TANRongrong，GE Huan，CHEN Wenxi，XIA Jing，WU Jie*
To explore the influence of individualized nutrition instruction for pregnant women on pregnancy complications and perinatal outcomes. Methods: 685 healthy primipara were recruited from outpatient department of the First Affiliated Hospital of Nanjing Medical University between July 2015 and July 2017. All the pregnant women received regular antenatal care, and among them, 298 pregnant women who had received individualized diretary instruction were in intervention group. The other 387 pregnant women were in control group. The rate of pregnancy complications and perinatal outcomes of pregnant women were compared between the two groups. Results: 283 pregnant women (95%) in intervention group had normal weight gain(in the scope of the recommended), which was significant higher than that of 282 pregnant women (72.9%) in control group (P< 0.01). There was a significant positive relationship between weight gain of women during pregnancy and fetal birth weight (r= 0.664, P<0.01). The rate of pregnancy complications, rate of cesarean section rate, rate of preterm birth, rate of macrosomia and rate of low birth weight infant of women intervention group were all significant lower than those of women in control group (P< 0.05). But there were no significant difference in the incidence of premature rupture of membranes, preplacental placenta and postpartum bleeding (P> 0.05). At third trimester, the body composition (total water, mineral, fat and skeletal muscle) of pregnant women in control group was significantly increased compared to that of women in intervention group (P< 0.05), but the body composition of women had no significant difference between the two groups before pregnancy and at first trimester. Conclusion: Individualized dietary instruction of pregnant women during pregnancy can effectively reduce the complications of pregnancy and improve the perinatal outcomes, which is worthy clinical application.
2017 Vol. 25 (11): 768- [Abstract]（
443
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WANG Zeqin1，ZHONG Yuanyuan2
To investigate the influence of progesterone on maternal and child outcomes when treating pregnant women with uterine fibroids. Methods: Date of 92 pregnant women with uterine fibroids who came to the Ninth Hospital of Wuhan City of Hubei Province for tocolysis from Jan.2014 to Jan.2017 were retrospective analyzed. The included women were divided into treatment group (46 cases) and control group (46 cases) according to whether to used progesterone for tocolytic therapy. The progesterone levels, fibroids size before and after treated, incidence of red degeneration, rate of obstetric complications, and progesterone receptor expression of women in the two groups were compared. Results: There was no significant difference in progesterone level of women at first trimester between the two groups (P＞0.05), but progesterone level of women in treatment group at cesarean section time was significant higher than that of women in control group (P＜0.05). At cesarean section time, the sizes of fibroids of women in both groups was significant bigger than those of women at first trimester (P＜0.05), but there was no significant difference in sizes of fibroids of women at first trimester between the two groups (P＞0.05). The incidence of uterine fibroids red degeneration of women in treatment group was 60.9%, which had no statistical significant difference when compared to that of women(56.5%) in control group (P＞0.05). The total incidence of obstetric complications, Intraoperative blood loss, operative time, neonate apgar score and time of hospital stay of women between the two groups had no significant difference (P＞0.05). The positive rate of progesterone receptor of women in treatment group was 87.0%, which had no statistical significant difference when compared to that of women(80.7%) in control group (P＞0.05). Conclusion: When progesterone treating pregnant women with uterine fibroids for tocolysis, it has no side effect on uterine fibroids and complications of maternal and child, and it doesn’t increase the incidence of red degeneration of uterine fibroids.
2017 Vol. 25 (11): 772- [Abstract]（
390
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