Objective: To delineate the mutation spectrum of congenital cataracts of Chinese population based on database of PubMed and CNKI. Methods: The articles related to congenital cataracts were searched from database, such as PubMed and CNKI. Then the genes, variations and information of population were extracted from the articles using the text mining method. The relationship between the genes, variations was identified by the sentencelevel concurrence. Mutation frequency in Chinese and nonChinese populations were summarized at the gene, exon and mutation levels, respectively. The differences of mutation spectrum were observed between Chinese and nonChinese. Results: Mutation spectrum of congenital cataracts in Chinese was delineated. The 169 mutations associated with congenital cataract were distributed on the 60 exons or splice sites of the 32 genes. Conclusion：It is feasible to establish the mutation database of congenital cataract in Chinese population, and it is possible to obtain the mutation spectrum through a combination of text mining and manual inspection based on database of PubMed and CNKI. The method can try to apply to compile the mutation spectrum of other monogenic disorder in Chinese population.

2018 Vol. 26　(07):　545- [Abstract]（ 436 ） HTML (0 KB)  PDF  (0 KB)  ( 87 )

Objective: To investigate the reproduction features and pregnancy outcomes of multipara in Beijing after the twochild policy implementation. Methods: From November 1 to December 31 in 2016, clinical data of 2335 women who had come to 3 hospitals in Haidian district of Beijing for labor were collected. According to maternal parity, all included women were divided into primipara group or multipara group. The data of women in the two groups were analyzed to explore the maternal reproduction features and pregnancy outcomes of multipara after adjusting fertility policy. Results: Among the 2335 women, 1465 (62.7%) were primipara, and 870 (37.3%) were multipara. The proportion of the maternal aged equal to or more than 35 years was 15.6% in primipara group and 55.7% in multipara group. Compared to primipara group, the proportion of maternal gravidity equal to or more than 3 times, the rate of prepregnancy overweight and obesity, and scared uterus in multipara group were significant higher (P<0.05). After adjusted age and occupation factors, the rate of placenta accreta, cesarean section and macrosomia in multipara group were 2.52 times, 1.29 times, and 1.93 times of those in primipara group, respectively, which had statistical significant (P<0.05). Conclusion：After the implementation of the comprehensive two-child policy, the proportion of multipara with high-risk or elder multipara was increased significantly, and the occurrence of adverse pregnancy outcomes also increased. Maternal health management should be strengthened to promote maternal and child health.

2018 Vol. 26　(07):　555- [Abstract]（ 416 ） HTML (0 KB)  PDF  (0 KB)  ( 95 )

Objective: To investigate the cognition and screening status of women who newly diagnosed cervical cancer in Wanning city of Hainan Province, and to analyze the possible influencing factors further. Methods: 400 women who were first diagnosed cervical cancer in Wanning city people's hospital from March 2015 to March 2018 were selected as the subjects. The questionnaire included demographic data and the knowledge of cervical cancer was used to investigate the cognitive and screening status of cervical cancer of women who newly diagnosed cervical cancer, and its influencing factors were also analyzed. Results: 21.0% of included women had low cognitive level of cervical cancer, 57.0% of women had common cognitive level, and 22.0% of women had high cognitive level. 70.8% of women had never accessed cervical cancer screening, 26.0% of women had undergone screening in 1 to 3 years, and 3.2% of women had undergone screening 3 years ago. Multi factor analysis had showed that age (31-45 years old), marriage (married), education (high school / Junior College), and residence (rural) were the main factors which affected cognitive level of women (P<0.05). Conclusion: The level of knowledge for preventing and treating cervical cancer, cognitive and screening of women who newly diagnosed cervical cancer are low. Especially for women in rural areas, at the high school or junior college level of education, or married women at 31-45 years old, effective measures should be complement to improve level of awareness and screening of cervical cancer in order to improve the health of women.

2018 Vol. 26　(07):　563- [Abstract]（ 299 ） HTML (0 KB)  PDF  (0 KB)  ( 59 )

Objective: To establish High Performance Liquid Chromatography (HPLC) method for detecting related substances in compound anastrozole vaginal ring, and to study on methodology of the HPLC method. Methods：The compound anastrozole vaginal ring was synthesized by the way of injection molding, and the breaking test was conducted under strong acid, strong alkaline, high temperature, oxidant or strong illumination. The repeatability, stability, accuracy, and the limit of detection (LOD) of the ring were also detected by HPLC method with a column of Diamonsil C18(2) (250mm × 4.6mm, 5μm) and UV detection at 210 nm. The mobile phase consisted of acetonitrile water (42:58, v/v) at a flow rate of 1.0 ml/min. The sample size was 20 μl and column temperature was 35 ℃. Results：The result of specificity test showed that the main drug and the related impurities, degradation products were well separated. Blank excipient had no interference for determination. Anastrozole detection limit was 3 ng/ml. The RSD of the reproducibility was 1.6 % and the RSD of the stability was 1.8 %. Conclusion：The established method for detecting related substances in compound anastrozole vaginal ring has the characteristics of operative simplicity, strong specificity and good repeatability.

2018 Vol. 26　(07):　570- [Abstract]（ 362 ） HTML (0 KB)  PDF  (0 KB)  ( 39 )

Objective: To explore the relationship between ultrasound indexes and endocrine metabolism parameters of patients with polycystic ovary syndrome (PCOS) and metabolic syndrome (MS). Methods: A total of 126 patients with PCOS and MS who had admitted to the first people's hospital of Wutai county from February 2016 to December 2017 were selected into observation group, and another 60 infertile patients with two way of basal body temperature were selected into control group. Ultrasound examination indexes and endocrine metabolism parameters of all patients were collected, and their correlations were analyzed. Results: The follicle number (FN), ovarian stromal area (SA), total ovarian area (TA), and uterine artery resistance index (RI) of patients in observation group were significant more than those of women in control group, but ovarian stromal artery RI of patients in observation group was significant less than that of women in control group. The levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) of patients in observation group were significant lower than those of women in control group, but level of testosterone (T) of patients in observation group was significant higher than that of women in control group (P <0.05). The level of TG, TC, LDL-C, FPG, FINS, and HOA-IR indexes of patients in observation group were significant higher than those of women in control group, but level of HDL-C testosterone (T) of patients in observation group was significant higher than that of women in control group (P <0.05). In observation group, there was positive correlation between FN and Tor BMI. There were also positive correlation between SA or TA and T. Uterine artery RI had positively correlated with BMI. Ovarian interstitial artery RI had negatively correlated with FINS, HOMA-IR, or BMI. In control group, there was no correlation between ultrasonographic indexes and endocrine metabolism parameters. Conclusion: The patients with PCOS and MS have certain characteristics in ultrasonographic indexes and endocrine metabolism parameters, and their ultrasonographic indexes have correlations with endocrine metabolism parameters, which can be used to diagnose and foretell the prognosis of patients with POCS and MS.

2018 Vol. 26　(07):　578- [Abstract]（ 320 ） HTML (0 KB)  PDF  (0 KB)  ( 76 )

Objective: To analyze the pregnancy outcomes of women pregnancy again after uterine artery chemoembolization (UACE) combined with dilation and curettage (D&C) for treating cesarean scar pregnancy (CSP). Methods: From January 2010 to April 2014, a total of 96 pregnant women who had treated by UACE combined with D&C because of CSP were included and followed up, and their outcomes of pregnancy again were analyzed. Results: The average time of followed up of all women were 43.8±12.6 months. 7 pregnant women among them had lost of follow-up. In 25 women with wanted pregnancy, 20 women had 24 times of spontaneous pregnancy. And in these spontaneous pregnancies, there was 6 women experienced repeated CSP (RCSP), and other 8 women had live term deliveries without the presence of placenta previa, placenta accreta, uterine rupture, or postpartum hemorrhage in the perinatal period. Conclusion: The reproductive women have the opportunity to conceive normally after UACE combined with D&C used to treat previous CSP. The subsequent pregnancy again includes intrauterine normal pregnancy, missed abortion and RCSP. If the pregnancy keeps to the third trimester, the overall perinatal outcomes were favorable.

2018 Vol. 26　(07):　588- [Abstract]（ 421 ） HTML (0 KB)  PDF  (0 KB)  ( 82 )

Objective: To explore the expression of E cadherin, P63 and Ki67 in cervical squamous cell carcinomas, and to identify its significance. Methods: A retrospective analysis included 150 patients (in study group) with cervical squamous cell carcinomas who received therapy in school of medical and life sciences of Wenzhou medical university from June 2015 to January 2016, at the same time, 92 patients with normal cervix who undergo total hysterectomy because of  cervical myoma were selected in control group. The expressions of E cadherin, P63 and Ki67 in cervical tissues of all women were tested by immunohistochemical staining, and were compared between the two groups. The correlation of the expressions of E cadherin, P63, Ki67  to the clinicopathological of women with cervical squamous cell carcinomas were observed. Results: The positive expression rate of E cadherin in study group was significant lower than that in control group (P<0.05), but the positive expression rates of P63 and Ki67 in cervical squamous cell carcinomas group were significant higher than those in control group (P<0.05). There were no significant difference in the expression of E cadherin, P63, and Ki67 among different age women with cervical squamous cell carcinomas (P>0.05). The expression of E cadherin in cervical tissues of women with low differentiation, clinical stage II, lymph node metastasis, or death cervical squamous cell carcinomas was significant lower than that of women with welldifferentiated, clinical stage I, or no lymph node metastasis (P<0.05), and the expressions of P63 and Ki67 in cervical tissues of women with low differentiation, clinical stage II, lymph node metastasis, or death cervical squamous cell carcinomas were significant higher than those of women with well differentiated, clinical stage I, no lymph node metastasis, or still survival (P<0.05). Survival rate of women with positive expression of E cadherin was significant lower than that of women with negative expression of E cadherin, and survival rate of women with P63 and Ki67of positive expression was also lower than that of women with negative expression of P63 and Ki67 (P<0.05). Conclusion: The expression of E cadherin, P63, and Ki67 can be used as important biomarkers for diagnosing and judging malignancy degree of cervical squamous cell carcinomas, and it may be also used for predicting prognosis.

2018 Vol. 26　(07):　596- [Abstract]（ 314 ） HTML (0 KB)  PDF  (0 KB)  ( 85 )

Objective:To compare the clinical efficacy of transvaginal ultrasound interventional injection with intramuscular injection of methotrexate for treating cesarean scar pregnancy (CSP). Method: 68 patients with CSP from March 2016 to March 2018 were randomly divided into observation group and control group according random number table (34 cases in each group). The patients in observation group were treated by local transvaginal injection of methotrexate under ultrasound, and patients in control group were treated by a single intramuscular injection of methotrexate. The effect of cure, the serum correlation index, and the rate of adverse reactions of patients were compared between the two groups. Results: In observation group, the amount of hemorrhage, the time of returning to normal HCG, the recovery time of menstruation, and the time of discharge of patients, and the number of needing additional methotrexate in observation group were all significant less than those of patients in control group (P<0.05). After 7 days of treatment, the cure rate of patients in observation group was 97.1%, which was significant higher than that of patients (64.7%) in control group (P<0.05). After patients were given additional medication, the cure rate of patients (100.0%) in observation group was still significant higher than that of patients (79.4%) in control group (P<0.05). There was no significant difference in level of serum PAPP A, VEGF, and INH A, and rate of blood supply between the two groups before treatment (P>0.05), but on the 3 and the 7 day after treatment, the above indexes of patients in observation group were significant lower than those of patients in control group (P<0.05). The incidence of adverse reactions of patients (11.8%) in observation group was significant lower than that of patients (35.3%) in control group (t=15.39, P<0.05). Conclusion: The local injection of methotrexate transvaginal ultrasound for treating CSP has perfect effectiveness, and has less adverse reaction, so it is worthy of clinical application.

2018 Vol. 26　(07):　603- [Abstract]（ 349 ） HTML (0 KB)  PDF  (0 KB)  ( 87 )

Objective: To explore clinical value of intensive comprehensive intervention on pregnant outcomes of pregnant women with gestational diabetes mellitus (GDM) when early pregnant stage. Method: A total of 120 pregnant women with GDM at 24-28 gestation weeks who admitted to the first people’s hospital of Lianyungang city from January 2016 to July 2017 were enrolled, and were randomly assigned to common intervention group (n=50) or early intervention group (n=70). The pregnant women in early intervention group had received intervention from starting pregnancy examination in early pregnancy stage, which included regular monitoring of blood glucose, diet control, exercise guidance and insulin therapy. The gestational weeks when labor and pregnant outcomes of maternal and child were compared between the two groups. Results: The gestational weeks when labor of women in early intervention group (39.5±0.8 weeks) was significant longer than that of women in common intervention group (38.2±1.3 weeks), and the rates of complication of maternal and child in early intervention group (4.3%, 5.7%) were much lower than those (16.0%, 18.0%) in early intervention group (P<0.05). Conclusion: Intensive comprehensive intervention can greatly improve maternal and child outcomes of pregnant women with GDM.

2018 Vol. 26　(07):　612- [Abstract]（ 361 ） HTML (0 KB)  PDF  (0 KB)  ( 44 )

Objective: To analyze the related factors and perinatal outcomes of the dangerous placenta previa. Methods: A retrospective analysis included the clinical data of 60 patients with dangerous placenta preplacenta ( in observation group) and 100 patients with nonlethal placenta previa ( in control group) who received therapy in maternal and child health care hospital of Gansu province from January 2015 to December 2017. The univariate analysis and multifactor analysis were used for analyzing the clinical data of women in both groups, and the perinatal outcomes were compared between the two groups. Results: The incident of gestational diabetes and gestational hypertension had no significant difference between the two groups (P>0.05). The age, education level, gravidity times, and number of abortion and cesarean section of women in observation group were all significantly higher than those of women in control group (P<0.05). There was significant difference in residence of women between the two groups (P<0.05). Logistic regression model analysis showed that the age, education level, residence, gravidity times, and number of abortion and cesarean section were the independent risk factors for the dangerous placenta. The volume of prenatal bleeding and postpartum hemorrhage, the rate of premature infant, neonatal asphyxia, and 1-minute Apgar score<7 in observation group were significantly higher than those in control group (P<0.05). Conclusion: The older age, education level, residence, b gravidity times, and number of abortion and cesarean section are the independent risk factors for the dangerous placenta, so the management of high-risk pregnant women should be strengthened for reducing postpartum hemorrhage, and premature birth, and for decreasing other adverse perinatal outcomes.

2018 Vol. 26　(07):　618- [Abstract]（ 293 ） HTML (0 KB)  PDF  (0 KB)  ( 76 )