To know the change of family planning operations in Haidian district of Beijing from 2014 to 2018 year, and to provide evidence for family planning under the new situation. Methods: The documents about family planning surgery submitted by medical institutions with qualified of family planning surgery of Haidian district from 2014 to 2018 were analyzed retrospectively. Results: The total number of family planning surgeries about family planning institutions at all levels in Haidian district had showed a decreasing trend (P<0.05). The proportion of family planning surgeries of women with household registration of Beijing had increased from 32.4% to 41.5% (P<0.05). The amount of surgeries on intrauterine device (IUD) inserted or removal and tubal ligation surgeries had decreased year by year. The proportion of various contraception had significant different (P<0.05). The total number of induced abortion had decreased year by year, among which, the number of surgical abortion had decreased by 50.7%, painless abortion had decreased by 55.0%, and medical abortion had decreased by 36.5%. Conclusion: Reproductive health education and popularize should be strengthen, and long-acting contraceptive measures should be improved, and humanistic care for women after abortion should be enhanced.

2020 Vol. 28　(5):　638- [Abstract]（ 385 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To study the influence of microdissection of testicular sperm extraction (MD-TESE) on the complications and sperm acquisition rate of patients with nonobstructive azoospermia. Methods: 100 patients with non-obstructive azoospermia were selected and were divided into TESE group and MD-TESE group according to the operation methods (50 cases in each group) from May 2017 to May 2019. Radioimmunoassay was used to detect the levels of total testosterone (T), FSH and LH of all patients before and after operation. The erectile function and psychological evaluation of all patients were conducted, and sperm acquisition rate and the incidence of complications were analyzed. Results: The levels of T and LH of patients in both groups after operation had decreased significantly, but the FSH level had increased significantly, and the changes of the levels of T, LH and FSH of the patients in MD-TESE group were significant lower than those of women in TESE group. The IIEF-5 scores of the patients in the two groups after operation had increased significantly, but that of the patients in MD-TESE group was significant higher than that of women in TESE group (P<0.05). The postoperative sperm acquisition rate of the patients in MD-TESE group was 48.0%, which was significant higher than that (28.0%) of the patients in TESE group  (P<0.05). The postoperative depression and anxiety score of the patients in TESE group had decreased significantly, but that of the patients in MD-TESE group had no changed significantly (P>0.05), and the postoperative depression and anxiety score of the patients in MD-TESE group was significant lower than that of the patients in TESE group (P<0.05). The incidence of complications of the patients in MD-TESE group was 4.0%, which was significant lower than that (18.0%) of the patients in TESE group (P<0.05). Conclusion: MD-TESE can reduce the postoperative complications of patients with non-obstructive azoospermia, improve their rate of sperm acquisition, and have little adverse effect on sexual function and psychological status of patients.

2020 Vol. 28　(5):　645- [Abstract]（ 332 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

To explore the effect of laparoscopic tubal pregnancy clearance combined with proximal obstruction for treating patients with tubal pregnancy on their ovarian reserve function and reproductive function. Methods: 140 patients with tubal pregnancy were selected as the subjects and were divided into three groups according to the different surgical methods from January 2013 to June 2017. 43 patients in group A were given laparoscopic tubal pregnancy clearance combined with proximal obstruction, 61 patients in group B were given laparoscopic conservative salpingectomy, and 36 patients in group C were given laparoscopic salpingectomy. The postoperative sex hormone levels, ovarian reserve function, and reproductive function of patients in three groups were observed. Results: There were no significant difference in the levels of FSH, LH and E2 of all patients between before operation and 1 month, 3 months and 1 year after operation, and there were no significant difference in the levels of FSH, LH and E2 of patients among the three groups (P>0.05). The number of ovarian sinus follicles and the ovarian cross-sectional area of patients in group A and B were significant higher than those of patients in group C, but the resistance index of ovarian artery of patients in group A and B was significant lower (P<0.05), but there were no significant difference in the number of ovarian sinus follicles, the ovarian cross-sectional area, and the resistance index of ovarian artery of patients between group A and B (P>0.05). 1 year after operation, the intrauterine pregnancy rate of patients in group A was 83.7%, which was significant higher than that (65.6%) of patients in group B, and that of patients in group B was significant higher than that (41.7%) of patients in group C (P<0.05), but there were no significant difference in intrauterine pregnancy rate of patients between group A and B (P>0.05). The rate of ectopic pregnancy of patients in group A and B was 11.6% or 14.8%, which was significant lower than that (33.4%) of patients in group C (P<0.05), but there were no significant difference in the rate of ectopic pregnancy of patients between group A and B (P>0.05). The rate of infertility rate of patients in group A was 4.7%, which was significant lower than that (19.8%) of patients in group B that (25.0%) of patients in group C (P<0.05). Conclusion: Laparoscopic tubal pregnancy clearance combined with proximal obstruction for treating patients with tubal pregnancy has less adverse effect on their ovarian reserve function, and can improve the success rate of pregnancy effectively.

2020 Vol. 28　(5):　652- [Abstract]（ 415 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the risk factors of postoperative infections of women after cesarean section, and to study the changes of their T lymphocyte subsets and interleukin clusters (ILs) levels. Methods: 631 women undergone cesarean sections were enrolled in the study from January 2017 to January 2019. The postoperative infection status and its related risk factors were analyzed. The levels of peripheral blood T lymphocyte subsets and ILs (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-12) of women were detected and compared between the women with infection and the women without infection. Results: There were 42 women with postoperative infection after cesarean section, and the infection rate was 6.7%. The mainly infections was surgical site infection (2.2%), urinary system infection (1.9%), and reproductive system infection (1.3%). The Gram-negative bacterium was the main pathogens, which accounted for 73.9%. Logistic regression analysis showed that age ≥35 years old, body mass index (BMI) ≥28kg/m 2, fetal macrosomia, multiple pregnancy, emergency cesarean section, operation time ≥90min, intraoperative blood loss ≥500 mL, invasive operation ≥4 times, malnutrition, premature rupture of membranes, diabetes mellitus,  without prevented medication, and trial production time ≥5h were risk factors for postoperative infection of women after cesarean section (P<0.05). The levels of serum CD3+, CD4+, CD4+/CD8+, and IL-12 of women with postoperative infection were significant lower than those of women without postoperative infection, but the levels of serum CD8+ and serum IL-1β, IL-2, IL-4,IL-6, IL-8 of women with postoperative infection were significant higher than those of women without postoperative infection (P<0.05). Conclusion: There is a high incidence of postoperative infection of women with cesarean section, and variety risk factors are relevant with postoperative infection of women. Postoperative infection can cause the disorder of T lymphocyte subset and abnormal ILs secretion, so it is important to reduce the infection rate by actively preventing infection and by targeted intervention based on detecting related indicators.

2020 Vol. 28　(5):　660- [Abstract]（ 318 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To investigate the effect of Shenghua decoction combined with hemabate for treating women with postpartum placenta residual. Methods: 106 women with postpartum placenta residual were randomly divided into two groups (53 women in each group) according to random number table method from February 2018 to February 2019. The women in the control group were treated with hemabate and 53 women in the study group were treated with Shenghua decoction combined with hemabate, After the treatment, postpartum blood loss, uterine decline rate, serum  human chorionic gonadotropin (β-hCG) level, endometrial thickness, placental residual area, excretion time of residual tissue, and adverse reactions rate of women were compared between the two groups. Results: The total effective rate of women in the study group was 90.5%, which was significant higher than that (71.7%) of women in the control group, the bleeding volume postpartum 2h or 24h of women in the study group was significant less than that of women in the control group, but the rate of uterine decline of women in the study group was significant higher than of women in the control group (all P<0.05). After treatment, β-hCG level, endometrial thickness, and placental residual area of women in both groups had decreased significantly, and those of women in the study group were significant superior to those of women in the control group  (all P<0.05). The excretion time of residual tissues of women in the control group was 27.28±8.87 d, which was significant longer than that (17.63±5.19 d) of women in the study group (P<0.05), but there was no significant difference in the rate of adverse reaction (3.8% and 1.9%) of women between the two groups (P>0.05). Conclusion: Shenghua decoction combined with hemabate for threating women with postpartum placenta residual has effectiveness and safety without side effect.

2020 Vol. 28　(5):　670- [Abstract]（ 292 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To observe the influence of ultrasound-guided transverse abdominis plane (TAP) block combined with general anesthesia during laparoscopic total hysterectomy on their postoperative analgesia and restlessness during resuscitation, and their cognitive function. Methods: 40 women who wanted elective laparoscopic total hysterectomy were randomly divided into study group and control group. The women in both groups were given bilateral TAP block by ultrasound guidance after anesthesia induction, and the women in the study group were given 0.33% ropivacaine hydrochloride 30mL injected, while the women in the control group were given equal volume normal saline injected. Intraoperative dosage of fentanyl, postoperative recovery time, spontaneous breathing recovery time, and incidence of restlessness during resuscitation of women in both groups were recorded. VAS analgesia score at 2h, 12h, and 24h after surgery, as well as postoperative and the score of postoperative cognitive function（MMSE）were evaluated and recorded. Results: The dosage of intraoperative fentanyl, the recovery time of spontaneous breathing, the postoperative recovery time, and the incidence of restlessness during resuscitation of women in the study group were 253.6±72.8 g, 9.3±1.7min, 6.3±0.9min, and 15.0%, respectively, which were all significant lower than those of women in the control group. The VAS scores of women at 2h and 12h after the operation in the study group were also significant lower than those of women in the control group (all P <0.05). There were no significant difference in preoperative MMSE score and postoperative independent breathing recovery time of women between the two groups (P>0.05). After operation, the MMSE score of women at 12h and 48h after the in the two groups had significantly decreased, and that in the study group was significant higher than that of women in the control (P <0.05). Conclusion: Compared with intravenous general anesthesia alone, TAP block combined with general anesthesia can significantly reduced fentanyl dosage during laparoscopic total hysterectomy, can improve the early postoperative recovery and analgesia effect, reduce the incidence of restlessness during awakening, improve the quality of awakening and improve cognitive function, which can help to accelerate the implementation of the concept of rehabilitation of surgery.

2020 Vol. 28　(5):　678- [Abstract]（ 344 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To investigate the effect of Shugan jianpi pecipe combined with insulin pump for treating women with gestational diabetes mellitus (GDM) because of liver stagnation and spleen deficiency on their blood lipid metabolism, pregnancy outcomes, and TLR4 classical signaling pathway of peripheral blood mononuclear cells. Methods: According to the randomized double-blind method, 100 pregnant women with GDM because of liver stagnation and spleen deficiency were divided into control group and study group (50 cases in each group) from October 2017 to February 2019. The women in the control group were treated with continuous subcutaneous injection of insulin pump, and the women in the study group were treated with Shugan jianpi pecipe combined with injection of insulin pump. The blood glucose and lipid metabolism, TCM syndrome scores, pregnancy outcomes, neonatal complications rate, and TLR4 gene expression were compared between the two groups. Results: The levels of FPG, 2hPBG, HbA1c, total cholesterol, triglyceride, TCM syndrome scores, mRNA and protein expression of TLR4 gene of women in the study group were significant lower than those of women in the control group (P<0.05). The incidences of cesarean section and abortion of women in the study group were 20.0% and 2.0%, which were significant lower than those (38.0% and 14.0%) of women in the control group (P<0.05). There were no significant different in the incidences of oligohydramnios, premature rupture of membranes, and pregnancy-induced hypertension between the two groups (P>0.05). The total incidence of neonatal complications in the study group was 14.0%, which was significant lower than that (32.0%) in the control group (P<0.05). Conclusion: Shugan jianpi pecipe combined with insulin pump for treating women with GDM because of liver stagnation and spleen deficiency can effectively decrease blood lipid level, improve pregnancy outcomes, and inhibit the expression of TLR4 in peripheral blood mononuclear cells.

2020 Vol. 28　(5):　685- [Abstract]（ 336 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To observe the amount of absorbed and bleeding volume during hysteroscopic resection by endoscopic monitor, and to provide skill for accurate monitoring and preventing the occurrence of complications. Methods: 30 patients with transcervical resection of endometrium (TCRE) were selected in group A, 30 patients with transcervical resection of myoma (TCRM) were selected in group B. The operative time, the absorbed volume of irrigation liquid and bleeding volume were supervised by endoscopic monitor. Electrolytes of patients before surgery and one hour after surgery were detected. Results: The absorbed volume of irrigation liquid, volume of blood loss, the average operation time of patients in Group A were 300.5±80.6 ml, 34.4±9.9 ml, and 34.7±8.7 min, respectively, and those of patients in group B were 315.2±113.4 ml, 101.4±24.0 ml, and 41.1±7.5 min respectively. There were no significant different in the complications rates of patients between the two groups. The operation time of patients in group A and group B was positively correlated with the total volume of perfusion fluid, the absorbed volume of irrigation liquid, or the amount of blood loss. And the amount of blood loss of patients in group A and group B was positively correlated with the uterine pressure, the uterine cavity depth, the endometrial thickness of patients. And the absorbed volume of irrigation liquid of patients in group A and group B was positively correlated with the uterine pressure, the uterine cavity depth uterine fibroids size, or the amount of blood loss (all P<0.01). The concentrations of K+, Na+, Ca2+, Cl- and CO2-CP of postoperative patients in the two groups had all significant lower than those before surgery (P<0.01). Conclusion: The endoscopic monitors can realtime and accurate monitoring the amount of absorbed and bleeding volume during surgery, which is valuable for accurate monitoring and preventing occurrence of transurethral resection of the prostate syndrome.

2020 Vol. 28　(5):　693- [Abstract]（ 322 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To investigate the effects of altitude environment on placental maturity, umbilical arterial hemodynamics, and pregnancy outcomes. Methods: 78 pregnant women from the plateau area were selected in observation group, and 67 pregnant women from the plain area were selected in control group from July 2017 to December 2018. The maturity degree of placenta of women in the two groups was graded according to the Grannum criteria. The systolic peak velocity (PS), diastolic flow rate (PD), S/D resistance index (RI), and pulsatility index (PI) of the uterine artery and umbilical artery of women in the two groups were measured by color Doppler ultrasound. The women in both groups were followed up until the end of delivery, and the neonatal body weight, and the placental weight and volume of women in the two groups were recorded. Pearson correlation analysis in SPSS software was used for analyzing correlation between the plateau environment and placental maturity, umbilical cord arterial hemodynamics, or pregnancy outcomes. Results: The proportion of the maturity grade II and III of placenta of women in the observation group was significant higher than that of women in the control group (P<0.05), but the value of the PS of uterine arterial blood of women in the observation group was significant lower (P<0.05). There were no significant difference in the values of PD, S/D, RI and PI of women between the two groups (P>0.05). The value of PD of umbilical artery blood, the neonatal body weight, and the placental weight and volume of women in the observation group were significant less than that of women in the control group, but the values of S/D and RI of women in the observation group were significant higher. Correlation analysis showed that plateau environment was positively correlated with placental maturity grade, but was negatively correlated with the values of umbilical artery hemodynamics and pregnancy outcomes of women (P<0.05). Conclusion: The plateau environment can reduce the hemodynamics of umbilical arteries, accelerate the early maturity and aging of the placenta, and had adverse affect on pregnancy outcomes, so fetal monitoring and treatment under the guidance by doctors for promoting fetal growth and development should be strengthen.

2020 Vol. 28　(5):　702- [Abstract]（ 339 ） HTML (0 KB)  PDF  (0 KB)  ( 40 )

To study the effect of gongliuxiao capsules combined with danazol capsules on the related factors of patients with endometriosis. Methods: 110 patients with endometriosis were enrolled in this study and were randomly divided into control group and treatment group (55 cases in each group) from January 2017 to December 2018. The patients in the control group were treated with danazol capsules for 3 months, and the patients in the treatment group were treated with gongliuxiao capsules combined with danazol capsules for 3 months. The serum PGE2, TNF-α, IL-1β, MMP-2, MMP-9, CA125, CA199, VEGF, Ang -2, MMIF, MDA, SOD of patients in the two groups before and after treatment were detected and compared. Results: After treatment, the serum PGE2 and SOD levels of patients in the two groups had significantly increased, but the serum levels of TNF-α, IL-1β, MMP-2, MMP-9, CA125, CA199, VEGF, Ang-2, MMIF, and MDA had significantly decreased (P<0.05), and the change of those levels of patients in the treatment group was significant more than those of patients in the control group (P<0.05). Conclusion: Gongliuxiao capsules combined with danazol capsules can reduce the serum levels of inflammatory cytokines of patients with endometriosis, which can help to improve the vascular endothelial function and reduce the oxidative stress reaction of patients.

2020 Vol. 28　(5):　710- [Abstract]（ 371 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To study the influence of DNA fragmentation index (DFI) on the outcome of in vitro fertilization embryo transfer (IVF-ET). Methods: 486 pairs who accepted IVF-ET were selected in this study from September 2015 to September 2018. Sperm chromatin structure assay (SCSA) combined with flow cytometry was used to detect the Dan DNA fragments of spermatozoa, and these included pairs were divided into group A (DFI≤15%), group B (15% ＜DFI≤ 30%), and group C (DFI>30%). The process of in vitro fertilization embryo transfer of pairs in the three groups was observed, and their embryos were cultured. Results: There were no significant different in the abstinence time, semen volume, sperm concentration, normal fertilization rate, cleavage rate, biochemical pregnancy rate, and clinical pregnancy rate among the three groups (P>0.05). The forward sperm viability, normal sperm morphology rate, high-quality embryo rate, high-quality embryo sac rate, blastocyst formation rate，biochemical pregnancy rate, and clinical pregnancy rate of group C were significant lower than those of group A and B (P<0.05)，but which had no significant different between group A and B (P>0.05). Conclusion: The increasing of DNA fragment index of spermatozoa will reduce of sperm forward motility and semen quality, so as to decrease the rate of high-quality embryo and embryo sac, blastocyst formation, which will lead to adverse pregnancy outcomes.

2020 Vol. 28　(5):　718- [Abstract]（ 315 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To investigate the clinical efficacy of clomiphene combined with progesterone for treating infertile women caused by polycystic ovary syndrome (PCOS), and to study its effect on ovarian function of women. Methods: 100 infertile women caused by PCOS were divided into two groups (50 cases in each group). The women in the control group were treated by clomiphene alone, and the women in the study group were treated by clomiphene combined with progesterone. The clinical efficacy of women was compared between the two groups. Results: After treatment, the endometrial thickness, the number of mature follicles, and the diameter of the largest follicles of women in the study group were significant higher than those of women in the control group, but the HMG dosage and the average treatment period of women in the study group were significant less (P<0.05). Compared with those before treatment, the T level and value of LH/FSH on HCG day of women in both groups had decreased significantly, but the E2 level had increased significantly (P<0.05). After treatment, the E2 level on HCG day of women in the study group was significant higher than that of women in the control group (P<0.05). The clinical pregnancy rate and the total effective rate of treatment of women in the study group were 56.0% and 88.0%, which were significant higher than those (28.0% and 66.0%) of women in the control group (P<0.05). There were no significant difference in the ovulation rate, abortion rate, multiple pregnancy rate, and the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Clomiphene combined with progesterone for treating infertile women caused by PCOS can promote endometrial thickening effectively, can reduce the dosage of gonadotropin used, can improve ovarian function, and can increase clinical pregnancy rate.

2020 Vol. 28　(5):　726- [Abstract]（ 390 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the value of combined detection of the levels of placenta protein-13 (PP13), placental growth factor (PIGF), and soluble vascular endothelial growth factor receptor-1 (sFlt-1) for predicting and diagnosing preeclampsia early. Methods: Between January 2018 and June 2019, a prospective study was conducted in 800 pregnant women. The general situation and the serum factor changes of these women during the first, second, and third trimester of pregnancy. 68 women with preeclampsia were in group A (women with mild preeclampsia in group A1 and women with severe preeclampsia in group A2), and 732 women withou preeclampsia were in group B. The levels of PP13, PIGF, sFlt-1 of women were compared between group A and group B, and the PP13, PIGF, sFlt-1 levels of women were compared between group A1 and A2. The risk factors of the preeclampsia onset were analyzed, and ROC curve was used to analyze the prediction and diagnostic value of the combination PP13, PIGF and sFlt-1 levels for early preeclampsia. Results: Among the 800 pregnant women, 68 (8.5%) women had developed preeclampsia during pregnancy. There were significant different in PP13, PIGF and sflt-1 levels of women with different degrees of preeclampsia during the first, second, and third trimester of pregnancy (all P<0.05). The sensitivity and the specificity of the combination detection of PP13, PIGF and sflt-1 levels for predicting preeclampsia were 81.01% and 86.32%, and the sensitivity and the specificity of the combination of PP13, PIGF and sflt-1 levels for diagnosing preeclampsia were 80.28% and 88.36%, which were the best. Conclusion: The combination detection of PP13, PIGF and sflt-1 levels can further improve the accuracy of predicting and diagnosing preeclampsia and the severity degree of preeclampsia.

2020 Vol. 28　(5):　734- [Abstract]（ 357 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To analyze the value of color Doppler ultrasonography for evaluating fetal middle cerebral artery blood flow of twin to twin transfusion syndrome (TTTs). Methods: The data of 66 pregnant women diagnosed as TTTs between March 2013 and March 2018 were retrospectively. These women were included in research group, and another 66 pregnant women with normal twins were included in control group during the same period. The estimated fetal body weight of blood recipient fetus and blood donor fetus when admitted to hospital, the maximum vertical amniotic fluid depth, the fetal age when birth, the birth weight, the blood flow velocity of umbilical vein and umbilical artery, the middle cerebral artery peak systolic velocity (MCA-PSV), umbilical artery pulsation index (UA-PI), middle cerebral artery pulsation index (MCA-PI), and cerebroplacental ratio (CPR) of women in the research group were measured by ultrasonography. Results: In the research group, the estimated fetal body weight when admitted to hospital, maximum vertical amniotic fluid depth, birth weight, and the heart rate per minute, left chest area ratio, and left and right cardiac work index of the blood donor fetus were significant lower than those of the blood recipient fetus (all P<0.05). The levels of MCA-PSV, MCA-PI and CPR of fetal brain of women in the research group were significant lower than those of women in the control group. In the research group, the levels of MCA-PSV, MCA-PI and CPR of fetal brain of the blood recipient fetus were significant lower than those of the blood donor fetus. The UA-PI level of fetal brain of women in the research group was significant higher than those of women in the control group. In the research group, the UA-PI level of fetal brain of the blood recipient fetus was significant lower than that of the blood donor fetus (all P<0.05). Conclusion: Color Doppler ultrasonography can evaluated fetal middle cerebral artery blood flow of the blood recipient fetus of women with TTTs, and the change of fetal middle cerebral artery blood flow suggests that the fetal cerebral blood flow of women with TTTs has a paroxysmal transitional filling feature.

2020 Vol. 28　(5):　743- [Abstract]（ 393 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To analyze the correlation factors of difficult removal of intrauterine device (IUD). Methods: Based on the clinical data of 9562 women who had experienced IUD removal From 22 county-level family planning service institutions, 2 provincial-level family planning service institutions, and 5 grade-three general hospitals of different provinces, the relationship between the situation of IUD used or the level of providers who performed the operation of IUD removal and the difficulty of IUD removal was analyzed. Results: The incidence of difficulties for the IUD removal is 5.7%, The Logistic regression analysis showed that the menopause status (OR 1.994，95%CI=1.54~2.59), a history of cesarean section (OR=1.440，95%CI=1.07~1.94), the cervix uteri surgery (OR=1.444，95%CI=1.16~1.80), abnormal uterine size (OR= 1.449，95%CI=1.08~1.95), and low level of medical institution of providers worked (OR=2.342，95%CI=1.59~3.45), < 5 working years of provider (OR= 1.364，95%CI=1.03~1.80) were risk factors for the difficulty of IUD removal. And the providers's education level  equal to or over medical master (OR= 0.300，95%CI=0.10~0.95),  anterior or median uterus，the younger age of women, and the shorter duration of IUD used were protective factors for the difficulty of IUD removal.

2020 Vol. 28　(5):　752- [Abstract]（ 318 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To evaluation of the clinical efficacy of high intensity focused ultrasound (HIFU) of patients with uterine fibroids. Methods: 56 patients with uterine fibroids were treated by HIFU from July 2016 to July 2019. Before and after treatment, the symptom scores and the scores of health-related quality of life (UFS-QOL) of these patients were evaluated by questionnaires, their volumes of uterine fibroid were measured, their levels of immune-related indicators were detected, and the change of estrogen receptor (ER) and Bcl-2 levels of the patients were analyzed. Results: The volume of uterine fibroids of the patients 1, 3, 6 and 12 months after treatment were 21.72± 3.65cm3, 13.42± 2.38cm3, 8.72±1.87cm3, and 5.72±1.02 cm3, respectively, which had decreased gradually (P<0.05). The symptom scores of the patients 1, 3, 6 and 12 months after treatment were 16.26±3.95 points, 14.13±2.05 points, 8.84±1.21 points, and 5.03±0.62 points, respectively, which had decreased gradually (P<0.05). The score of UFS-QOL of the patients at 1, 3, 6 and 12 months after treatment were 82.65±7.02 points, 87.04±7.86 points, 93.87±8.75 points, 98.02±9.54 points, respectively, which had increased gradually (P<0.05). 1 month after treatment, the immune-related indicators, such as the levels of CD3+, CD4+, CD8+, CD4+/CD8+, and NK of patients were all significant higher than those before treatment, but the levels of estrogen receptor ER and bcl-2 expression were significant lower than before treatment (P<0.05). Conclusion: High intensity focused ultrasound for treating patients with uterine fibroids can reduce the volume of the tumor significantly, can alleviate the clinical symptoms, and can improve the quality of life of patients.

2020 Vol. 28　(5):　760- [Abstract]（ 264 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To study the change and clinical significance of non-high density lipoprotein-cholesterol (non-HDL-C) level of pregnant women with gestational hypertension or preeclampsia. Methods：From 2016 to 2017, 218 normol pregnant women were selected in group A, 99 pregnant women with gestational hypertension were included in group B, 69 pregnant women with mild preeclampsia were included in group C, 52 pregnant women with late onset severe preeclampsia were included in group D, and 148 pregnant women with early onset severe preeclampsia were included in group E. The general information and blood lipids index of women in the five groups were collected. The value of total cholesterol–high densitylipoprotein was calculated. And the correlation between the levels of TC, TG, LDL-C, non-HDL-C, LPa, APOA and APOB, and the value of systolic blood pressure and diastolic blood pressure were anlyzed. The related factors of gestational hypertension and preeclampsia were analyzed. ROC curve analysis was used to determine the appropriate pointcut of non-HDL-C for predicting gestational hypertension and preeclampsia. Results：There were significant difference in the levels of TG, TC, non-HDL-C, LDL-C, LPa APOA and APOB of women among the five groups (P<0.05). Multiple regression analysis showed that non-HDL-C level was positively correlated with value of systolic blood pressure, and the levels of TG and TC were positively correlated with value of diastolic blood pressure (all P<0.05). The non-HDL-C level was a high risk factor of gestational hypertension or preeclampsia. ROC curve analysis showed that the appropriate cut-off value of non-HDL-C level for predicting gestational hypertension or preeclampsia by ROC curve was 4.89mmol/L. Conclusion：Non-HDL-C is an independent risk factor of gestational hypertension and preeclampsia occurence. When the level of nonHDL-C of women exceed 4.89mmol/L, it should be alert to the occurrence of gestational hypertension or preeclampsia, so intervention should be done in advance for improving pregnancy outcomes of pregnant women with gestational hypertension or preeclampsia.

2020 Vol. 28　(5):　767- [Abstract]（ 320 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

To analyze the characteristics change of uterine arterial blood flow indictor by ultrasonic examination of women with missed abortion, and to explore its predictive value for missed abortion. Methods: Women with the first trimester pregnancy who had undergone ultrasound examination were selected as research objects, and were divided into group A (58 women with missed abortion), group B (31 women in transition period of missed abortion), and group C (120 normal pregnant women) according to the results by ultrasonic examination. Uterine artery blood flow was detected by transvaginal Doppler ultrasound, and the predictive value of uterine artery blood flow peak/end diastolic flow rate(S/D), resistance index (RI), and pulse index (PI) for missed abortion were compared among the three groups. Results: During initial diagnosis of women with missed abortion, <10 gestational weeks, or 10 -12 gestational weeks, the values of S/D, RI and PI of uterine artery of women in group B were significant higher than those of women in group A, while those were significant lower than those of women in group C (P<0.05). RI value of uterine artery had some predictive effect for missed abortion (P<0.001), which’s AUC, the cutoff value, the sensitivity, and the specificity were 0.802, 0.854, 84.5%, and 74.8%, respectively. But the values of PI and S/D of uterine artery had no predictive efficacy for missed abortion (P>0.05). Conclusion: The S/D, RI and PI values of uterine artery tend to rise before missed abortion, so the uterine artery blood flow resistance indexes by transvaginal Doppler ultrasound has certain predictive value for missed abortion.

2020 Vol. 28　(5):　775- [Abstract]（ 286 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )