To assess the effectiveness of the sitting position during the second stage on labor of puerpera . Methods: Database such as PubMed, Embase, CENTRAL, CINAHL, CBM, CNKI, VIP, and WanFang were searched from inception to February, 2017, and the randomized controlled trials (RCTs) about the effectiveness of the sitting position during the second stage of labor were collected. Two reviewers had independently selected and included literatures according to the inclusion and exclusion criteria, and also had independently extracted data and assessed the bias risk of included studies. Then, metaanalysis was conducted by RevMan 5.3 software. Results:  A total of 16 RCTs which involved 3268 patients were included. Metaanalysis showed that duration of second stage(MD=2302, 95%CI 28.18 to 17.87,P<0.001), caesarean section rate(RR=0.50, 95%CI 0.40 to 0.62, P<0001)、neonatal asphyxia rate(RR=0.42, 95%CI 0.32 to 0.5), P<0.00001) of puerpera in the sitting position group were significantly lower than those of puerpera in the supine position group, but the rate of spontaneous labor (RR=1.15, 95%CI 1.07 to 125), P=0.000) of puerpera in the sitting position group was significantly higher than that of puerpera in the supine position group. Subgroup analysis showed that there were no significant differences on the rate of postpartum hemorrhage (RR=0.81, 95%CI 0.60 to 1.11, P=0.200) between the puerpera in sitting position on obstetric bed group and the puerpera in supine position group. But there was significant differences in the rate of postpartum hemorrhage (RR=3.29, 95%CI 1.72 to 6.26), P=0.000) between the puerpera in sitting position group and the puerpera in supine position group. Conclusion: Current evidence shows that, comparing to supine position, the effectiveness of the sitting position during the second stage of labor can shorten duration of second stage, promote natural delivery, reduce the rate of caesarean section and neonatal asphyxia. And sitting position during the second stage of labor cannot increase the risk of postpartum hemorrhage, but using obstetric chair as support tools may be increase postpartum hemorrhage. However, as the results limited by quality of included literatures, more highquality studies should be conducted in the future to confirm the above conclusion.

2017 Vol. 25　(12):　812- [Abstract]（ 400 ） HTML (0 KB)  PDF  (0 KB)  ( 45 )

Objective: To investigate the relationships between the release rate of drug and the solubility (CSIL) or the diffusion coefficient (DSIL) in silicone elastomer in intravaginal ring (IVR). Methods：The solubilities of progesterone (PGT), gestodene (GEST), and mifepristone (RU486) in silicone elastomer were investigated by the methods of differential scanning calorimetry (DSC). The matrixtype IVR was prepared by injection molding method, and the core of reservoirtype IVR was was the matrixtype IVR, and the  controlling sheath was prepared by heating vulcanization method. The release rate of the IVRs in 7 days were tested by in vitro releasing measurement. Results: The solubilities of progesterone, gestodene, mifepristone in MED6382 were 13.06 mg/g, 18.71 mg/g, and 7.5 mg/g, respectively. The cumulative releases of the IVRs carried 300mg drugs in 7 days were progesterone (149.8 mg), gestodene (29.2 mg), mifepristone (15.6 mg), which had showed that the release rates and solubilities of drugs in silicone elastomer had no completely linear relationships. The diffusion coefficient of drug was changed by adding diatomite, chitosan, lactose and isopropyl alcohol, which caused the changes of the release rate and daily release. The diffusions of the drugs were prevented by adding diatomite, lactose and chitosan, which reduced the release rates, but the isopropyl alcohol could promote the drugs to the surface of IVRs, which increased day 1 burst of matrix type vaginal rings . Conclusion: The release rate of drug is determined by both the solubility and the diffusion coefficient of drug in silicone elastomer.In order to regulating the release rates of drugs, the solubilities of drugs in silicone elastomer and the diffusion coefficients influenced by various additives must be considered.

2017 Vol. 25　(12):　825- [Abstract]（ 310 ） HTML (0 KB)  PDF  (0 KB)  ( 73 )

Objective: To investigate the status of social support and it’s influencing factors. And to provide scientific evidence for preconception care, mental intervention and improving mental health of preparing pregnant women. Methods：454 preparing pregnant women were investigated by questionnaire which based on Social Support Rating Scale made by Xiao Shuiyuan. And all collected data were statistical analyzed by SPSS21.0 software. Results: In general, preparing pregnant women reported that they had received the mediate social supporting, but objective social support was lower. Specially, 57.9% of preparing pregnant women had the low level objective support. level of support availability of most of them were mediate or high. And 63.7% of them had experienced the high subjective social support. Finally, the results of multiple linear regression analysis showed that main influence factors of social support were relationship with their parentsinlaw and gravidity, and the total contribution rate was 10.6%. Conclusion: Preparing pregnant women have lower level of objective social support. The relationship with their parentsinlaw and gravidity are the most important factors of social support.

2017 Vol. 25　(12):　838- [Abstract]（ 2428 ） HTML (0 KB)  PDF  (0 KB)  ( 187 )

Objective: To observe the clinical efficacy of low molecular weight heparin sodium combined with low dose progesterone for treating pregnant women with threatened abortion. Methods: 150 pregnant women with threatened abortion were randomly divided into study group and control group (75 cases in each group). The pregnant women in control group were treated by routine dose of progesterone, and the pregnant women in study group were treated by low doses of progesterone combined with low molecular heparin. Results: The time of bleeding stop, and time of abdominal and backache pain remission of women in study group were significantly shorter than those of women in control group, (P<0.05). The incidence of adverse effect of women (5.3%) in study group was significant lower than that of women (16%) in control group (P<0.05). Birth weight of newborn and gestational days before birth were significant greater than those of women in the control group (P<0.05). Malformation rate of newborn had no significant difference between the two groups (P>0.05). Conclusion: Compared to the conventional dose of progesterone treatment, low molecular weight heparin combined with low doses of progesterone can significantly reduce the bleeding time and abdominal pain relief time, can improve the therapeutic effectiveness for treating threatened abortion, can reduce rate of adverse effect of drugs, and has better safety and effectiveness of drugs.

2017 Vol. 25　(12):　848- [Abstract]（ 443 ） HTML (0 KB)  PDF  (0 KB)  ( 69 )

Objective: To evaluate the clinical application of p16/Ki67 dual staining in the diagnosis of cervical precancerous disease. Methods: A total of 92 women who were screened at Peking University Third Hospital from January 2017 to May 2017 were recruited in this study. The sensitivity, specificity, positive and negative likelihood ratio, and the area under the ROC curve (AUC)in the detection of ≥CIN2 lesions were compared among the p16 / Ki67dualstaining, TCT and HRHPV for detecting cervical precancerous disease. The clinical value of p16/Ki67 dual staining was further evaluated for the identification of ≥ CIN2 lesions in women with positive HRHPV or elder than 30 years old. Results: For detection of ≥ CIN2 lesions, p16/Ki67 dualstaining had similar sensitivity when compared with TCT and HRHPV (86.36% vs 84.85% vs 92.42%, P=1.000, P=0.424), and specificity was significant higher than TCT and HRHPV (76.92 vs 30.77% vs 26.92%, P=0.001, P=0.001), AUC was also higher than TCT and HRHPV (0.816 vs 0.578 vs 0.597, P=0.001, P<0.001). Similar patterns were observed in the subgroup of women with positive HRHPV or over than 30 years old. Conclusion: p16 / Ki67dualstaining can improve the specificity of diagnosing ≥CIN2 lesions, and has good clinical application value.

2017 Vol. 25　(12):　855- [Abstract]（ 2100 ） HTML (0 KB)  PDF  (0 KB)  ( 162 )

Objective: To explore the clinical outcomes of different ways of in vitro fertilization (IVF) or intracytoplasmic sperm injectionon(ICSI) for patients with a little oocytes retrieved cycles. Methods: 190 cycles with no more than 3 oocytes retrieved and used normal semen between January 2013 and June 2016 were retrospective analyzed. The clinical outcomes of patients in IVF group(n=97) and in ICSI group(n=93) were compared. Results：Basal characteristics were similar in both group including the normal fertilization rate (61.6％ vs 59.9%), the cleavage rate (91.8% vs973%) , the high quality embryo rate(67.9% vs 66.1%), the complete fertilization failure rate (11.3% vs 20.4%), the available embryto rate (91.1% vs 94.5% ) , the cycle cancellation rate (35.1% vs 28.0%), the implantation rate (321% vs 20.8%), the pregnancy rate (46.0% vs 27.3%), the clinical live birth rate (83.3% vs 60.0%), the cumulative pregnancy rate (35.7% vs 24.1%) and the cumulative birth rate (32.1% vs 18.5), which all had no significant difference(P＞ 0.05). However, there was significant difference in the multiple precision number (PN) rate (14.1% vs 1.6%) (P<0.05). Conclusion: When retrieved oocyte number is equal to or less 3, and patients has no ICSI indications, selecting ICSI can reduce the multiple PN rate, but the other clinical outcomes have no significant improvement.

2017 Vol. 25　(12):　864- [Abstract]（ 1676 ） HTML (0 KB)  PDF  (0 KB)  ( 146 )