Objective: To establish a HPLC method for determing of the content and related substances of gestodene in sustained release contraception microneedles. Methods: The chromatographic conditions of the HPLC method, Diamonsil C18 column (250 mm × 4.6 mm, 5 μm), the mobile phase consisted of acetonitrile and water (55:45, v/v) at the flow rate of 1 ml/min, detection wavelength was 239 nm. Results: The results of specific tests showed that the blank accessories did not interfere with the determination of the main drug. Gestodene and impurities, degradation products could achieve a good separation. The calibration curve of gesterdene had acceptable linearity in the range of 0.5-20 μg/ml.The limit of quantification and detection of gestodene were 7.5ng/ml and 2.5ng/ml, respectively. The average recovery was 98.4%. The determination method of this content was good in precision, stability and repeatability. Conclusion: This method has the advantages of strong specificity, accuracy, good reproducibility and simple operation, which can be used for quality control of gestodene sustained release contraception microneedls.

2018 Vol. 26　(10):　897- [Abstract]（ 398 ） HTML (0 KB)  PDF  (0 KB)  ( 85 )

Objective: To investigate the expression of preleukemia transcription factor 3 (PBX3) in cervical carcinoma tissue, and to analyze its relationships with clinicopathological features and prognosis. Methods: The cervical carcinoma and para cancerous tissues of 82 women were collected. The expression of PBX3 protein in these tissues was detected by Western blot and immunohistochemistry. The relationships of different tissues with the clinicopathological features and prognosis were analyzed. COX regression was performed for analysis the clinical factors which might be affected the survival of patients. All women were followedup for 30 months, and their survival rates were analyzed by KaplanMeier, and the difference of survival of women between the two groups was detected by LogRank method. Results: Compared with those in para cancerous tissue, the positive expression rate of PBX3 protein in cervical cancer tissues was significant higher (P< 0.05). The expression of PBX3 protein was not related to age, pathological type or depth of tumor invasion (P>0.05), but which was related to tumor staging, tumor differentiation, tumor diameter, and infiltration degree lymph node metastasis (P<0.05). In the 3 year followup, there was 30 people died, and the mortality rate was 36.59%. COX multivariate analysis showed that tumor staging, tumor differentiation, tumor diameter, lymph node metastasis and PBX3 were independent factors affected the prognosis of the patients. 18 cases died in PBX3 positive expression group, and 12 cases died in PBX3 negative expression group. KaplanMeier survival curve showed that there was significant difference in KaplanMeier survival curve between the two groups (P<0.05). Conclusion: The upregulated expression of PBX3 in cervical carcinoma is related to the stage of tumor, degree of differentiation, lymph node metastasis and so on, so it may be a biological indicator of the prognosis of cervical cancer patients.

2018 Vol. 26　(10):　904- [Abstract]（ 391 ） HTML (0 KB)  PDF  (0 KB)  ( 93 )

Objective: To observe the clinical efficacy of drug enema in different positions for treating patients with sequelae of pelvic inflammatory disease. Methods: 120 patients with sequelae of pelvic inflammatory disease who had been treated in Chongqing red cross hospital from June 2016 to August 2017 were selected and divided into control group (n=60) and study group (n=60) according to the random number table method. The patients in control group were given drug retention enema based on traditional left lateral position, while patients in study group were given drug retention enema in prostration position. The drug retention time in the intestinal tract, the score of sense integral after the enema, the changes of symptoms and signs, the improvement of the pelvic masses and the fluid accumulation, and white blood cell count (WBC), the percentage of neutrophils (NEU%) and the percentage of lymphocyte (LYM%) were compared between the two groups. And the clinical efficacy of patients in the two groups was evaluated. Results: The retention time in the intestinal tract and the total effective rate of patients in study group were (836.7±158.4) min and 96.7% (58/60), which were significant better than those of patients in control group ［(561.8±103.7) min and 81.7% (49/60), respectively］. Compared with that before treatment, the symptoms and signs of all patients both in the two groups had alleviated significantly, and alleviated degrees of symptoms and signs of patients in study group were greater than those of patients in control group. The improvement of pelvic effusion, the pelvic masses, and the score of sense integral after the enema of patients in study group were better than those of patients in control group (P<0.05).Compared with those before treatment, there were no significant changes in WBC, NEU% and LYM% after treatment in both groups (P>0.05). Conclusion: The treatment of the sequelae of pelvic inflammatory disease by drug enema in the prone position can obviously improve the clinical effect, prolong the drug retention time in the intestinal tract, and can relieve the clinical symptoms, and has high safety. So it is worth clinical application.

2018 Vol. 26　(10):　913- [Abstract]（ 343 ） HTML (0 KB)  PDF  (0 KB)  ( 85 )

Objective: To observe the influence of methyldopa combined with labetalol for treating pregnant women with preeclampsia on the blood pressure control and expression of serum LIF and Apelin. Methods：100 pregnant women with preeclampsia in maternal and child health care hospital of Jiyuan city from February 2016 to April 2017 were selected and divided into control group and study group randomly (50 cases in each group). The women in control group were received routine treatment, while the women in observation group were treated by methyldopa combined with labetalol on the basis of routine treatment. The clinical efficacy was observed after 7 days of treatment. Results：The clinical effective rate of women in observation group (90.0%) was significant higher than that of women in control group (76.0%)（χ2=4.710，P=0.029）. The effect of blood pressure control of women in observation group was significant better than that of women in control group, and the amount of 24h urine protein of women in observation group was significant lower than that of women in control group (P<0.05), and the expression of serum LIF and Apelin women in in observation group was significant lower than that women in control group (P<0.05), and the incidence of adverse reactions of women had no significant different between the two groups (P>0.05).Conclusion：Methyldopa combined with labetalol for treating pregnant women with preeclampsia can effectively control the blood pressure, can regulate serum LIF and Apelin levels. And it has perfect effectiveness and safety, so it is worthy of clinical application.

2018 Vol. 26　(10):　919- [Abstract]（ 285 ） HTML (0 KB)  PDF  (0 KB)  ( 86 )

Objective: To investigate the influence of GnRHa combined with add-back therapy on level of anti-Mullerian hormone and ovarian reserve function of women with laparoscopic unilateral ovarian endometriotic cystectomy. Methods: 150 patients with unilateral ovarian endometriotic cyst who undergone conservative laparoscopic cystectomy were randomly divided into 3 groups. Patients in group A (n=50) had received laparoscopic conservative cystectomy only, patients in group B (n=50) were given GnRHa after laparoscopic conservative cystectomy, and patients in group C (n=50) had received GnRHa combined with addback therapy after laparoscopic conservative cystectomy. The clinical efficacy, rate of side effect, and recurrence rate of patients were compared among the three groups. Serum levels of antiMullerian hormone (AMH), follitropin (FSH), estradiol (E2), luteinizing hormone (LH) of all included women were detected. Results: Serum level of AMH of patients in group C was significantly lower than that of before surgery, or that of patients in group B and group C at 1, 3, 6 and 12 months followed up after cystectomy (P<0.05). Serum levels of AMH of patients in group B and C had basically recovered to preoperative levels at 12 months followed up after cystectomy,and there was no significant difference in level of AMH between group B and C (P>0.05). The levels of E2, FSH and LH of patients in the three groups were recovered to preoperative levels at 6 or 12 months followed up after cystectomy, but the fluctuations of levels of E2, FSH and LH of patients in group B were greater within 6 months after cystectomy (P<0.05). Compared with those of patients in group A,the total remission rate and pregnancy rate of patients in group B and C were significant higher,and the recurrence rate was significant lower (P<0.05), but the total remission rate, pregnancy rate, and the recurrence rate of patients had no significant different between groups B and C (P>0.05).The rate of perimenopausal symptoms of patients in group C were significant lower than that of patients in group B (P<0.05). Conclusion: GnRHa treating patients after laparoscopic unilateral ovarian cystectomy can help the elevation of serum AMH level, can recovery of ovarian reserve function, and can improve clinical efficacy and reduce the recurrence rate. And GnRHa combined reverse-addition treating patients can reduce perimenopausal symptoms.

2018 Vol. 26　(10):　927- [Abstract]（ 376 ） HTML (0 KB)  PDF  (0 KB)  ( 76 )

Objective: To explore the clinical value of Yi Qi Yang Yin decoction combined with insulin. Methods: 92 pregnant women with gestational diabetes mellitus (GDM) and dual deficiency of Qi-Yin who had admitted in Nanjing pukou district central hospital between Aug 2015 and Aug 2017 were selected as study subjects, and they were divided randomly into observation group (46 patients) and control group (46 patients). The women in control group were treated by insulin, and the women in observation group were treated by Yi Qi Yang Yin decoction combined with insulin. The changes of blood glucose and serum adipokine levels before treatment and before delivery, the occurrence of adverse reactions of all women during treatment and their pregnancy outcomes were observed in the two groups. Results: There were no significant different in blood glucose and serum adipokines levels before treatment between the two groups (P>0.05). Before delivery, the levels of fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2h PBG), leptin (LP), petinolbinding protein-4 (RBP-4) of women in observation group were significant lower than those of women in control group(P<0.05), but the level of adiponectin (ADPN) of women in observation group was significant higher than that of women in control group(P<0.05).The incidence of adverse reactions of women in observation group was 10.9%, which had no significant difference (P>0.05) from that of women in control group (15.2%). The cesarean section rate, and the incidence of premature delivery, polyhydramnios, and macrosomia of women in observation group were significant lower than those of women in control group (P<0.05). The incidence of postpartum hemorrhage, neonatal asphyxia, and neonatal hypoglycemia had no statistically significant different between the two groups.Conclusion: When Yi Qi Yang Yin decoction combined with insulin is used for treating women with GDM and dual deficiency of Qi-Yin, it can effectively control blood glucose, regulate the level of adipokines, and improve pregnancy outcomes, and it has high safety, so it is worth clinical application.

2018 Vol. 26　(10):　937- [Abstract]（ 355 ） HTML (0 KB)  PDF  (0 KB)  ( 91 )

Objective: To investigate the expression features of miR-29 and miR-200a in peripheral blood of pregnant women with gestational diabetes mellitus (GDM), and to study its clinical significance. Methods: 80 pregnant women with GDM were selected into observation group, and another 80 normal pregnant women were included in control group. The expression of miR-29, miR-200a, and miR-375 in peripheral blood of all included women were detected, and plasma FINS, FPG, 2hPG, and HbAlc levels of women in both groups were also tested. The expression of miR-29, miR-200a, and miR-375, and the levels of plasma FINS, FPG, 2hPG, and HbAlc of women were compared between the two groups. The correlations between the expression of miR-29, miR-200a, miR-375 and blood glucose related indicators were analyzed. Results: The level of FINS of women in observation group was significant lower than that of women in control group, but the levels of FPG, 2hPG and HbAlc of women in observation group were significant higher than those of women in control group (P<0.05). The expression of miR-29 in the peripheral blood of the women in the observation group was significant lower than that in the control group. The expression of miR-29 in the peripheral blood of women in observation group was significant higher than that of women in control group,but the expressions of miR-375 and miR-200a in the peripheral blood of women in observation group were significant higher than those of women in control group (P<0.05). Correlation analysis showed that the ΔCt value of miR-29 expression was positively correlated with level of FPG, 2hPG or HbAlc, but negatively correlated with level of FINS (P<0.05). The ΔCt values of miR-375 and miR-200a were negatively correlated with level of FPG, 2hPG, or HbAlc, but positively correlated with level of FINS (P<0.05). Conclusion: The expression of miR-29, miR-200a or miR-375 in peripheral blood of women with GDM is closely related to blood glucose related indicators. The abnormal expressions of miR-29, miR-200a and miR375 indicate the susceptibility of GDM. In clinical practice, the detection of the expression of peripheral blood miR-29 and miR-375 can provid a certain evidence for clinical diagnosis GDM early.

2018 Vol. 26　(10):　947- [Abstract]（ 395 ） HTML (0 KB)  PDF  (0 KB)  ( 89 )

Objective: To explore the value of B-ultrasound combined with maternal serum level of alpha-fetoprotein (AFP), free beta-hCG and estriol (uE3) in screening and diagnosing fetal central nervous system malformations. Methods: The date of 308 pregnant women in the obstetrics and gynaecology clinic of Ju county maternal and child health care and family planning service center from October 2016 to May 2018 were analyzed retrospectively. All included pregnant women had been examinated by B-ultrasound and received detection of the levels of serum AFP, Freeβ-hCG, and uE3. The value of levels of serum AFP, Freeβ-hCG,and  uE3 combined with B-ultrasound examination for diagnosing fetal central nervous system malformation was evaluted. Results: Among all women, 17 cases had fetal with central nervous system malformation who had been confirmed after induction or delivery, the detection rate was 5.5%, which included 6 cases of hydrocephalus, 5 cases of spina bifida, 2 cases of anterior whole brain, 6 cases without brain, and 1 case of brain swelling. In 29 cases with abnormal value of the median multiple (MOM), 8 cases of central nervous system malformation were confirmed, which included 3 cases of hydrocephalus, 2 cases of spina bifida, 1 case of anterior whole brain, 1 case of no brain, and brain 1 case of bulging. 12 cases had central nervous system malformation by ultrasound detected, which included 4 cases of hydrocephalus, 3 cases of spina bifida, 2 cases of anterior whole brain, 2 cases without brain, and 1 case of brain swelling. The correct rate of diagnosing fetal central nervous system malformation by ultrasound was 70.6%, the diagnostic accuracy of fetal central nervous system malformation by level of serum AFP, Freeβ-hCG and uE3 was 47.1%.The correct rate of diagnosing fetal central nervous system malformation by ultrasound examination combined with detection of level of serum AFP, Freeβ-hCG and uE3 was 88.2%,that was highest. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the curve (AUC) of ultrasound examination combined with detection of level of serum AFP, Freeβ-hCG and uE3 for diagnosing fetal central nervous system malformation were 85.3%, 88.0%, 75.2%, 89.7%, 90.6%, 0.86 (95% CI: 0.506-0.892). Conclusion: B-ultrasound examination and detection of levels of maternal serum AFP, Freeβ-hCG, and uE3 have certain diagnosis value for screening fetal central nervous system malformation, which can improve the diagnostic accuracy.

2018 Vol. 26　(10):　954- [Abstract]（ 374 ） HTML (0 KB)  PDF  (0 KB)  ( 99 )

Objective: To investigate the correlation between serum soluble lectin-like oxidized low density lipoprotein receptor-1 (sLOX-1) or human chorionic gonadotropin (β-hCG) and pregnancy outcomes of pregnant women with pregnant induced hypertension. Methods: 68 pregnant women with pregnant induced hypertension in Jurong people's hospital of Jiangsu province were selected into observation group. During the same period, another 68 healthy pregnant women who had received normal prenatal examination were selected into control group. Enzyme-linked immunosorbent assay (ELISA) was used for measuring serum sLOX-1 concentration , chemiluminescence assay was used to detect serum β-hCG levels of all included pregnant women. And the level of serum sLOX-1 or β-hCG related to adverse outcomes of pregnant women were compared between the two groups. Results: The levels of serum sLOX-1and β-hCG pregnant women in observation group were significant higher than those of pregnant women in control group (P<0.05). The levels of serum sLOX-1 and β-hCG of pregnant women with severe pregnancy-induced hypertension were significant higher than those of pregnant women with moderate pregnancy- induce hypertension, and those of pregnant women with moderate pregnancy induced hypertension were significant higher than those of pregnant women with mild pregnancy induced hypertension (P<0.05). The pearson correlation analysis had showed that there was a positive correlation between levels of serum sLOX-1 and β-hCG with pregnancy-induced hypertension (r=0.742, P=0.000). The level of serum sLOX-1 of pregnant women in observation group was positively correlated with pregnancy induced hypertension, premature delivery, fetal distress, premature rupture of membranes, and fetal growth restriction (P<0.05). The level ofβ-hCG of pregnant women in observation group was positive correlated with pregnancy induced hypertension, fetal distress and fetal growth restriction (P<0.05), but was not correlated with preterm labor and premature rupture of membranes (P>0.05). Conclusion: The levels of serum sLOX-1 and β-hCG of pregnant women with pregnancy induced hypertension increase are associated with adverse pregnancy outcomes. In clinical practice, the adverse pregnancy outcomes of pregnant women with pregnancy induced hypertension maybe predicted by detecting serum sLOX-1and β-hCG levels.

2018 Vol. 26　(10):　961- [Abstract]（ 391 ） HTML (0 KB)  PDF  (0 KB)  ( 75 )

Objective: To investigate the correlation between the type and thickness of endometrium examed by vaginal B ultrasound and the situation of pregnancy after in vitro fertilization and embryo transfer (IVF-ET). Methods: A retrospective analysis of 288 infertility patients who underwent IVF-ET in center of reproductive medicine of the general hospital of Jinan military commandv from February 2016 to March 2017 was conducted. The endometrial type, thickness, and situation of pregnancy after IVF-ET of all patients were analyzed. Results: In the 288 women who had received IVF-ET, there were 168 pregnant women (58.3%) and 120 non-pregnant women (41.7%). Compared with those of women in non-pregnant group, the age of women in pregnant group was signifficent younger (P<0.05), the number of women with type A or type B endometrium in pregnant group was signifficent more (P<0.05), and the average thickness of endometrium in pregnant group was also signifficent thicker (P<0.05). Conclusion: Monitoring endometrial thickness and typing not only can assess endometrial receptivity, but also can predict the situation of pregnancy after IVF-ET.

2018 Vol. 26　(10):　968- [Abstract]（ 344 ） HTML (0 KB)  PDF  (0 KB)  ( 77 )

Objective: To explore the value of positive rate of high risk HPV mRNA for diagnosing different cervical lesions. Methods: 70 gynecological admissions patients with cervical disease in Zhongda hospital affiliated to southeast university were included in the study, their HPV DNA were detected by gene chip flow-through hybridization, and their high risk HPV mRNA were detected by DNA hybridization capture technology. Cervical histopathology results were as the gold standard, the diagnostic accuracy of HPV DNA and high risk HPV E6 / E7 mRNA for diagnosing cervical lesions were compared. Results: The positive rate of patients with cervical lesions detected by HPV DNA was 68.57%, which slightly higher than that of patients detected by high risk HPV E6 / E7 mRNA (61.43%), but there was no statistically significant different (P>0.05). The positive rates of patients with CINⅠ, Ⅱ and Ⅲ detected by high risk HPV E6/E7 mRNA were significant higher than those of patients with chronic cervicitis (P<0.05). In patients with chronic cervicitis or CIN Ⅰ, the positive rate detected by HPV DNA was significant higher than that detected by high-risk HPV E6 / E7 mRNA (P<0.05). In patients with CIN Ⅱ or CIN Ⅲ, the positive rate detected by high-risk HPV E6 / E7 mRNA had no significant different from that detected by HPV DNA (P>0.05). The consistency of detection by HPV DNA and by HPV mRNA had increased along with the severity of cervical lesions. The sensitivity, specificity and negative predictive value of patients with high-grade cervical lesions detected by HPV mRNA were significant higher than those detected by HPV DNA (P<0.05). Conclusion: The detection of high-risk HPV mRNA has high diagnostic sensitivity and specificity for high-grade cervical lesions, and it has highly accurate for identification of high-low grade cervical lesions.

2018 Vol. 26　(10):　976- [Abstract]（ 315 ） HTML (0 KB)  PDF  (0 KB)  ( 92 )

Reproductive tract microorganisms play a lot of important physiological functions. The imbalance of reproductive tract bacteria can lead to many diseases, such as reproductive tract infection, infertility, tumor and so on. Probiotics can maintain or reconstruct the balance of bacteria, which can provide new treatment of restoration and maintenance of the structure and quantity of normal flora.

2018 Vol. 26　(10):　999- [Abstract]（ 351 ） HTML (0 KB)  PDF  (0 KB)  ( 77 )

Objective: To study the clinical effect of drospirenone ethinyl estradiol tablets (II) for contraception and acne treatment after abortion. Methods: 212 women with moderate or above acne after induced abortion from 2016 to 2017 in Wuxi maternal and child health care hospital were divide into two groups, and 100 cases in observation group were given oral drospirenone ethinyl estradiol tablets (II), and 112 cases in control group were given other contraception. The clinical effects of women 6 months after abortion in the two groups were observed. Results: The menstrual recovery and contraceptive effect of women in observation group were significant better than those of women in control group(P<0.05).The clinical effect of acne treatment in observation group was significant better than that of women in control group(P<0.05). Conclusion: Oral drospirenone ethinyl estradiol tablets (II) used for women after abortion has obvious advantages in contraception and acne treatment, especialy for women with moderate or above acne.

2018 Vol. 26　(10):　1010- [Abstract]（ 425 ） HTML (0 KB)  PDF  (0 KB)  ( 87 )