To understand the development of life loss caused by birth defects in China in the 21st century, especially since the issuance of the twochild policy, so as to provide evidence for the objective understanding of the disease burden of birth defects in the new era. Methods: Using the Global Burden of Disease research data, this paper analyzed the life loss caused by early death of birth defects in four representative years of 2000, 2010, 2015 and 2017, and explored the life loss caused by early death of seven major birth defects. Results: Since the 21st century, the overall years of life lost (YLLs) and YLL rate of birth defects in China have gradually decreased, and the YLL rate has maintained a downward trend before and after the twochild policy. The YLL rate dropped from 315.2 per 100,000 in 2015 to 259.8 per 100,000 in 2017. At the same time, there were age and gender differences in life loss caused by the early death of all kinds of birth defects, with the highest of the 0 years old group, and then gradually decreasing with the growth of age. The YLLs and YLL rates of men were all around 1.3 times higher than those of women in each year. However, with the development of time, the YLLs and YLL rates of all kinds of diseases kept a downward trend year by year, but the specific development trend varied from year to year. Congenital heart disease ranked the first in the life loss caused by birth defects, with the YLL rate of 516.2 per 100,000, which is much higher than other birth defects. At the same period, the life loss caused by the death of neural tube defects was greatly improved, with the YLL rate decreasing from 76.3 per 100,000 in 2000 to 11.5 per 100,000 in 2017. Conclusion: Birth defects bring great burden to the society and family, especially the loss of life caused by early death of infants and men.

2020 Vol. 28　(8):　1154-1157 [Abstract]（ 311 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To understand the status of risky drinking among pregnant women in 6 cities of China, so as to provide the evidence for intervention study and making related policy. Methods: A multistage stratified method was used for sampling. Among Beijing, Shanghai, Guangzhou, Jinan, Chengdu and Harbin, each city was divided into urban and suburb areas which depend on the status of economic development. 1-2 districts were randomly selected from each area, which means that 46 districts were selected in each city. Subsequently, 2 tertiary referral centers were randomly selected in each selected district. The outpatient pregnant women who were taking parent education class in the hospital were asked to participate. Selfadministrated questionnaires were filled out by the participated pregnant women. Results: AUDIT-C, T-ACE and TWEAK showed that the number of pregnant women who had consumed alcohol in 6 cities in the past year was 712,729, and 729, respectively. Among those pregnant women, the number of risky drinking were 90(12.6%), 451(61.9%), and 471(64.6%), respectively. The rate of risky drinking were higher in those who were aged 16-22 years, in charge of housekeeping, with lower education, agricultural residence registration, and smoked in the previous 3 months of pregnancy（P＜0.05）. Conclusion: The risky drinking behavior of pregnant women is relatively common in China. Therefore, control strategies and intervention measures should be developed according to the characteristics of population distribution to prevent the risk of Fetal Alcohol Spectrum Disorder.

2020 Vol. 28　(8):　1162-1166 [Abstract]（ 400 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

Reproductive health is a fundamental element of human health, and is also an important part of the Healthy China strategy. Since the concept, strategies and actions were formally included in the Programme of Action in the International Conference on Human Development in Cairo in 1994, the Chinese government officially introduced this concept actively and promoted its implementation in the field of family planning and health work. This paper systematically discusses the theoretical development and practical innovation of reproductive health promotion in China from four aspects，which’s aim is to clarify the important status and role of reproductive health in the health of the whole people, to enhance the government departments at all levels and all sectors of society to pay attention to the reproductive health issues, and to promote the highquality development of maternal and child health undertaking throughout the country.

2020 Vol. 28　(8):　1170-1173 [Abstract]（ 411 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the contraceptive efficacy and safety of levonorges intrauterine device (IUD) inserted in different time of women with scarred uterus after induced abortion. Methods: 102 women with scarred uterus after induced abortion were divided into observation group and control group. 52 women in the observation group were inserted IUD immediately after abortion, and 50 women in the control group were inserted IUD after menstrual recovery. The contraceptive effect and complications of women were compared between the two groups. Results: The contraceptive success rate of women in the observation group was 100%, which had no significant different from that (98.0%, 49/50) of women in the control group (P>0.05). There were no significant different in the continuation rate (all>90%) of IUD of women in both groups in 3 months, 6 months and 12 months followed up (P>0.05). There was no significant difference in the rate of continuous use of women in 3 months, 6 months and 12 months after operation between the two groups (P>0.05). The menstrual period and the amount of menstruation of women after IUD inserted in the two groups had all increased significantly (P<0.05), but the menstrual cycle of them had no change significantly (P>0.05). There were no significant different in the menstrual period and the amount of menstruation of women after IUD inserted between the two groups (P>0.05). The adverse reactions such as lumbago, abdominal pain, irregular hemorrhage, prolonged menstruation, increased leucorrhea, increased and decreased menstrual volume had occurred in both groups in 3 months, 6 months and 12 months followed up after abortion, but which had no significant difference between the two groups (P>0.05). Conclusion: The contraceptive efficacy and safety of IUD inserted immediately after abortion and IUD inserted after menstrual recovery are similar, and IUD inserted immediately after abortion can avoid reoperation of uterine cavity.

2020 Vol. 28　(8):　1177-1180 [Abstract]（ 413 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To compare the pregnancy outcomes of triptorelin acetate, gestrinone and mifepristone tablets for treating infertile women with endometriosis (EMT). Methods: 132 infertility women with EMT were enrolled and had received laparoscopic conservative operation from May 2012 to July 2017. After operation, these women were divided into group A group (42 women treated by triptorelin acetate), group B (45 women treated by 45 gestrinone tablets cases), and group C (45 women treated by mifepristone tablets). The clinical efficacy, pain degree by VAS, sex hormones levels, pregnancy outcomes, and adverse reaction rate were compared among these three groups. Results: After treatment, the total effective rate of women in group A was 97.6%, followed was that (88.9%) of women in group C, and that (73.3%) of women in group B (P＜0.05). The levels of FSH, PRL and E2, the dysmenorrheal rate, and sexual intercourse, and VAS score of pelvic pain of women in the three groups had decreased significantly after treatment, but LH level had increased. The levels of FSH, PRL and E2 of women in group A and group C were significant lower than those of women in group B, but the LH level of women in group A and group C was significant higher. The dysmenorrheal rate, the sexual intercourse score, or VAS score of pelvic pain of women in group B was the highest. The rate of good pregnancy outcomes of women in group A was 90.5%, then was that (62.2%) of women in group C, and that (42.2%) of women in group B was the lowest. The incidence of adverse reaction of women in group A was 7.1%, followed by that (33.3%) of women in group C, and then that (40.0%) of women in group B (all P＜0.05). Conclusion: Laparoscopic surgery combined with triptorelin acetate for treating infertile women with EMT has the best curative effect, which can improve the pregnancy rate, and has better pregnancy outcomes and less adverse reaction.

2020 Vol. 28　(8):　1185-1189 [Abstract]（ 371 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

 To investigate the changes and the significance of autoimmune mechanism and ovarian blood flow parameters of women with premature ovarian failure (POF).  Methods: 100 women with POF were selected in study group, and 100 healthy women with normal menstrual cycles were selected in control group. The number of CD4+ and CD25+ regulatory T cells (Treg) , serum interferon gammaγ(IFN-γ) level , and the values of ovarian interstitial peak flow velocity (PSV), resistance index (RI), and maximum ovarian planar mean diameter (MOD), antral follicle number (AFC), and levels of serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) of women were detected and compared between the two groups. Results: The values of AFC and MOD，E2 level, the number of Treg in peripheral blood, and ovarian interstitial PSV value of women in the study group were significant lower than those of women in the control group, but the levels of serum FSH, LH and IFN-γ, and PSV value of women in the study group were significant higher (all P＜0.05). In the study group, the peripheral blood Treg count was positively correlated with ovarian interstitial PSV value, but was negatively correlated with RI value and IFN-γ level (P＜0.05). Serum FSH level of women with POF was negatively correlated with Treg count and ovarian interstitial PSV value, but was positive correlation with RI value and IFN-γ level (all P＜0.05). Conclusion: The women with POF have significant immune disorders and changes of ovarian interstitial blood flow, which may lead to the changes of their reproductive hormone levels.

2020 Vol. 28　(8):　1194-1196 [Abstract]（ 434 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To compare the efficacy and pregnancy status after operation between hysteroscopic endometrial polyp electrocision and hysteroscopic endometrial polypectomy by cold knife. Methods: 90 infertility women with endometrial polyp were selected and were divided into two groups from June 2015 to June 2018. 45 women in group A had received hysteroscopic endometrial polyp electrocision, while 45 women in group B had received hysteroscopic endometrial polypectomy by cold knife. The operation time, intraoperative blood loss, and the time of hospital stay of women were compared between the two groups. The women in both groups were followed up for 1 year, the postoperative complications rate, menstrual volume, recurrence rate and pregnancy situation of women in the two groups were observed. Results: There were no significant difference in intraoperative blood loss, the time of hospital stay, and recurrence rate of women between the two groups (all P＞0.05). The operative time and postoperative vaginal bleeding time of women in group B were 16.6±3.3m and 2.0±0.8d, which were significant shorter than those (25.9 ±3.5m and 5.3±1.1d) of women in group A. The pregnancy rates of women in group B in 6 and 12 months after operation were 64.4% and 77.8%, which were significant higher than those (33.3% and 57.8%) of women in group A (P＜0.05). There was no any woman with postoperative complication in both groups. Conclusion: The hysteroscopic endometrial polypectomy by cold knife is effective and safety, which can reduce the time of operation and time of vagina bleeding, and also can increase pregnancy rate after operation.

2020 Vol. 28　(8):　1201-1203 [Abstract]（ 427 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To investigate the clinical effect of different ovarian stimulation regimen for treating different age women with poor ovarian response (POR) assisted by in vitro fertilization-embryo transfer (IVF-ET). Methods: 336 cycles of women with POR who received IVF-ET were selected in this study from August 2016 to August 2019. They were divided into group A (age <35 years old, long-term regimen during early follicular phase, 75 cycles), group B (age <35 years old, antagonist regimen, 81 cycles) and group C (age ≥35 years old, long-term regimen during early follicular phase, 87 cycles), and group D (age ≥35 years old, antagonist regimen, 93 cycles). The clinical indicators and outcomes of women were compared among the four groups. Results: The total dosage of Gn, duration of Gn used, the endometrial thickness on the hCG day, the rates of fertilization, the available embryo number, the embryo implantation rate, and the pregnancy rate of women in group A were significant higher than those of women in group B, but the levels of estradiol (E2), luteinizing hormone (LH) and progesterone (P) on hCG day of women in group A were significant lower (all P＜0.05). There were no significant difference in the rates of cancellation, high quality embryo, abortion, multiple pregnancy, ectopic pregnancy, and preterm birth, and neonatal weight of women between group A and B (P＞0.05). The total dosage of Gn, duration of Gn used, the endometrial thickness on the hCG day, and the rates of the embryo implantation and pregnancy of women in group C were significant higher than those of women in group D, but the levels of E2, LH and P on the hCG day of women in group C were significantly lower (P＜0.05). There were no significant difference in the rates of cycle cancellation, fertilization, available embryo, high quality embryo, abortion, multiple pregnancy, ectopic pregnancy, and preterm birth, and neonatal weight of women between group C and D (P＞0.05). Conclusion: Application of long protocol during early follicular phase can effectively improve the clinical outcomes of different age women with POR assisted by IVF-ET, which has good clinical application value, but it will increase the total dosage and time of Gn used, and it will increase the cost.

2020 Vol. 28　(8):　1208-1212 [Abstract]（ 350 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To investigate the expression of microRNA-203 (mir-203) of pregnant women with preeclampsia, and to study its correlation with the clinical symptoms and pregnancy outcomes. Methods: 137 pregnant women were analyzed from August 2014 to November 2019, which included 52 pregnant women with preeclampsia in study group and 85 normal pregnant women in control group. The systolic blood pressure (SBP), diastolic blood pressure (DBP), proteinuria level, plasma mir-203 level, and pregnancy outcomes of women were compared between the two groups. The correlation between plasma mir-203 expression level and clinical symptoms and pregnancy outcomes of women with preeclampsia was analyzed. Results: The values of SBP and DBP, and the proteinuria level, the expression level of plasma mir-203 of women in the study group were significant higher than those of women in the control group (P＜0.05). The incidences of respiratory distress, intrauterine growth restriction, and mortality of perinatal infant in the study group were significant higher than those in the control group, but the Apgar score and birth weight of newborn in the study group were significant lower (P＜0.05). The expression of plasma miR-203 of women with preeclampsia was positively correlated with the values of SBP and DBP, and the proteinuria level, the rates of respiratory distress, intrauterine growth restriction, and perinatal mortality, but was negatively correlated with Apgar score and birth weight (P＜0.05). Conclusion: MiR-203 is highly expressed in the plasma of pregnant women with preeclampsia, and it is associated with clinical symptoms and pregnancy outcomes, so which can be used as a biomarker for diagnosing, monitoring, and evaluating the prognosis of preeclampsia.

2020 Vol. 28　(8):　1218-1220 [Abstract]（ 375 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To explore the effect of Qingre Liniao Tonglin recipe for treating patients with non gonococcal urethritis, and to study its influence on the related factors. Methods: 200 patients with non gonococcal urethritis were selected and were randomly divided into two groups (100 cases in each group). The patients in the two groups were all given western medicine antibiotics, and patients in the experimental group were given Chinese medicine Qingre Liniao Tongling recipe for 2 weeks additionally. The clinical symptom scores, and the levels of serum IL-2, IL-4 and IL-8 before and after treatment, and the clinical efficacy of patients were compared between the two groups. Results: After treatment, the rates of urinary frequency, dysuria, urinary urgency, urinary tract pruritus, and urethral secretion, and the score of yellow and red of urine of patients in the experimental group were significant lower than those of patients in the control group. After treatment, the serum IL-2, IL-4 and IL-8 levels of patients in the experimental group were 103.2±11.0 ng/L, 128.5±26.4 ng/L, and 75.1±16.3 ng/L, respectively, which were significant lower than those (114.2±13.5 ng/L, 143.2±28.1 ng/L, and 86.6±18.5 ng/L, respectively) of patients in the control group, but the total clinical efficacy of the patients in the experimental group was 95.8%, which was significant lower than that (92.9%) of patients in the control group (all P＜0.05). Conclusion: The effect of Chinese medicine Qingre Liniao Tonglin recipe combined with Western medicine for treating patients with non gonococcal urethritis is better than that of Western medicine used only, which can reduce the levels of inflammatory factor of patients.

2020 Vol. 28　(8):　1226-1229 [Abstract]（ 401 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the clinical effect of spinal anesthesia combined with intermittent epidural bolus (IEB) for treating women during maternal labor analgesia. Methods: 600 pregnant women with full term pregnancy were randomly divided into observation group and control group (300 cases in each group) by random number table from January 2014 to May 2019. The women in the control group were treated with IEB, and the women in the observation group were treated with spinal anesthesia combined with IEB. The analgesic effect, the indexes during and after operation, the situation of motor block, and the levels of T lymphocyte subsets， and inflammatory factors after delivery of women were compared between the two groups. Results: The VAS scores of women in the observation group 2h after anesthesia and during delivery were significant lower than those of women in the control group (P＜0.05). There were no significant different in the time of labor, the time of analgesia, the time of and duration of interval uterine contraction, the fetal heart rate, the adverse reactions rate, and neonatal Apgar scores between the two groups (P＞0.05). The rates of patient control epidural analgesia given, the oxytocin used, cesarean section, and motor block of women in the observation group were significant lower than those of women in the control group, but the satisfaction score of women in the observation group was significant higher (P＜0.05). 24h after delivery, the levels of CD3+, CD4+, CD4+/CD8+ of women in the observation group were significant higher than those of women in the control group (P＜0.05), but the levels of IL-6 and TNF-α during delivery and 24h after delivery of women in the observation group were significant lower (P＜0.05). Conclusion: IEB used in labor analgesia has better effect with less dosage of anesthetic drugs, and the satisfaction of women is high, which is helpful to reduce the rates of cesarean section and motor block, and can improve the immune suppression and inflammatory response of women.

2020 Vol. 28　(8):　1234-1237 [Abstract]（ 340 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the clinical value of serum homocysteine (Hcy), folic acid, and vitamin B12 for diagnosing hypertensive disorder complicating pregnancy. Methods: The data of 143 pregnant women with hypertensive disorder complicating pregnancy from April 2017 to October 2019 were analyzed retrospectively, which included 50 cases in group A (pregnant women with pregnancy-induced hypertension), 48 cases in group B (pregnant women with mild preeclampsia), and 45 cases in group C (pregnant women with severe preeclampsia). During the same time, 40 healthy pregnant women were selected in group D and 35 healthy non-pregnant women were selected in group E. The levels of serum Hcy, folic acid, and vitamin B12 of the women in the five groups were detected and compared. Receiver operating characteristic curve (ROC) was used to analyze the efficacy of the levels of serum Hcy, folic acid, and vitamin B12 for diagnosing hypertensive disorder complicating pregnancy. Logistic regression analysis was used to analyze the risk factors of pregnancy outcomes of pregnant women. Results: The Hcy level of pregnant women in group A, B, and C had increased in turn significantly, which was significant higher than that of women in group D or in group E. The folic acid and vitamins B12 levels of pregnant women in group A, B, and C had decreased in turn significantly, which were significant lower than those of women in group D or in group E (P＜0.05). The Hcy was negatively correlated with the levels of folic acid and vitamin B12 (P＜0.05), the folic acid level was positively correlated with the vitamin B12 level (P＜0.05). The levels of serum Hcy, folic acid, and vitamin B12 could be used to diagnose hypertensive disorder complicating pregnancy, and the diagnostic efficiency of the combination of the serum Hcy level, folic acid level, and vitamin B12 was the highest (P＜0.05). The serum Hcy level of women with normal pregnancy outcomes was significant higher than that of women with adverse pregnancy outcomes, but the levels of folic acid and vitamin B12 of women with normal pregnancy outcomes were significant lower (P＜0.05). Hcy, folic acid and vitamin B12 levels were independent influencing factors of adverse pregnancy outcomes of pregnant women with hypertensive disease during pregnancy (P＜0.05). Conclusion: The diagnostic efficiency of the combination of the serum Hcy, folic acid and vitamin B12 levels is higher than that of the serum Hcy level, folic acid level, or vitamin B12 level only. High serum Hcy level and low folic acid and vitamin B12 levels of women with hypertensive disorder complicating pregnancy indicate adverse pregnancy outcomes.

2020 Vol. 28　(8):　1242-1246 [Abstract]（ 411 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To analyze the ultrasonographic characteristics of blood flow of fetal aortic isthmus (AoI) of pregnant women with preeclampsia during the third trimester of pregnancy, and to study the efficiency of AoI for predicting fetal distress. Methods: The pregnant women with preeclampsia were selected as research objects from January 2017 to June 2019, which included women with mild preeclampsia in group A and women with severe preeclampsia in group B, and another normal pregnant women were selected in control group during the same period. The values of isthmus blood flow index (IFI) and isthmus contraction index (ISI) of fetal AoI of women during different gestational weeks were compared among the three groups. And the efficacy of IFI and ISI of AoI for predicting fetal distress was analyzed. Results: The value of IFI or ISI in the control group was the highest, and that in group B was the lowest (P＜0.001). The proportion of IFI-III type in group B was significant lower than that in group A (P＜0.05). The value of IFI or ISI of women in group B during 28-32 gestational weeks and 33-37 gestational weeks was the lowest, and that in the control group was the highest (P＜0.001). The values of IFI and ISI of AoI could predicate fetal distress, which’s cut-off value, sensitivity, and specificity were 0.89 and 0.20, 85.2% and 78.4%，and 72.8% and 63.6%, respectively. Conclusion: The values of IFI and ISI of fetal AoI of pregnant women with preeclampsia decrease, which have some efficacy for predicting fetal distress.

2020 Vol. 28　(8):　1250-1253 [Abstract]（ 311 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To investigate the effect of thyroid globulin (TG) gene screening for diagnosing and early interventing on children with congenital hypothyroidism (CH), and to study its influencing factors. Methods: 43 children diagnosed as CH were selected and were divided into group A (<30 d, n=25) and group B (>30 d, n=18) according to treatment timing. All children were given TG screening and early treatment. Logistic regression analysis was used to analyze the influential factors of CH. Results: Among the 43 children with CH, there were 36 (83.7%) children with TG gene mutations, and 7 (16.3%) children without TG gene mutations. The value of development quotient (DQ) of children with 6 months old in group A was 95.81±4.12, which was significant higher than that of children in group B (P<0.05). When the age of 1 year and 2 years old, the value of DQ of all the children in both groups had no change (P>0.05), but the DQ value of the children in group A was significant higher than that of the children in group B (P<0.05). The body mass index (BMI) of children in group A when 6 months old, 1 year old, and 2 years old were 7.84±0.48 kg/m2, 11.31±1.06 kg/m2, and 13.16±1.55 kg/m2, respectively, which were significant higher than those of children in group B (P<0.05). The body length of children in group A when 6 months old, 1 year old, and 2 years old were 68.25±2.46 cm, 76.47±2.11 cm, and 90.39±2.43 cm, which were significant longer than those of children in group B (P<0.05). Multiple factor analysis showed that maternal age ≥35 years, pregnancy complicated thyroid disease, family thyroid history, and medication history were the main risk factors of CH of children. Conclusion: TG level can help to clinical diagnose CH of child. In addition, early treatment intervention is conducive to growth and development of children with CH. The maternal age, pregnancy complicated thyroid disease, thyroid family history, and medication history are the main risk factors for CH.

2020 Vol. 28　(8):　1258-1261 [Abstract]（ 303 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the effect of hysteroscopy combined with uterine artery embolization for terminating pregnancy of women with uterine scar pregnancy (USP) after type II cesarean section. Methods: The clinical data of 150 women with USP after type II cesarean section from July 2016 to December 2018 were retrospectively collected. These women were divided into observation group and control group. The women in the observation group were given hysteroscopy combined prophylactic uterine artery embolization and methotrexate, and the women in the control group were given hysteroscopy combined with methotrexate. The differences of operation related indexes, such as operation time, intraoperative bleeding volume, vaginal bleeding time, hospitalization time, total effective rate after treatment, serum human chorionic gonadotropinβ (β-hCG), and other biochemical indexes, incidence of adverse reactions and prognosis  of women between the two groups were compared. Results: The operative time, hospital stay time, vaginal bleeding time, and the intraoperative blood loss of women in the observation group were 23.8±15.1min, 7.4±2.4d, 5.3±1.1d, and 67.9±7.5ml, respectively, which were significant less than those (37.9±18.6min, 11.4±2.5d, 6.2±2.0d, and 102.7±10.5ml, respectively) of women in the control group, but the total postoperative effective rate of women in the observation group was 90.6%, which was significant higher than that (72.2%) of women in the control group. The adverse reaction rate, the time of serumβ-hCG recovery to normal level, the time of menstruation recovery, and the proportion of CSP reoccurrence of women in the observation group were 5.2%, 29.7±3.1d, 38.0±12.3d, and 2.1%, respectively, which were significant less than those (14.8%, 31.3±3.1d, 44.4±12.6d, 16.7%, respectively) of women in the control group (all P＜0.05). Conclusion: Hysteroscopy combined with prophylactic uterine artery embolization for terminating pregnancy of women with CSP after type II cesarean section has good effective, which can increase surgical efficiency, reduce adverse reactions, contribute to postoperative recovery and improve prognosis.

2020 Vol. 28　(8):　1266-1269 [Abstract]（ 315 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the value of contrast-enhanced ultrasound (CEUS) with different T2WI signals for evaluating preoperative blood perfusion of women with uterine fibroids. Methods: The clinical data of 122 patients with uterine fibroids treated with high-intensity focused ultrasound (HIFU) were retrospectively analyzed. According to the preoperative magnetic resonance imaging (MRI) T2WI signals, they were divided into high signal group, equal signal group, and low signal group. The preoperative ultrasound contrast parameters, such as time to peak (TTP), peak intensity (PI), mean transit time (MTT), and treatment-related indexes of women were compared among the three groups. These women were also divided into satisfactory ablation group (ablation rate≥70%) and partial ablation group (ablation rate<70%). The correlation between preoperative ultrasound contrast parameters and ablation rate was evaluated. Results: There were 35 women in high signal group, 27 women in equal signal group, and 60 women in low signal group. TTP value and ablation rate of women in high signal group were significant lower than those of women in equal signal group, and in low signal group, but the values of PI and MTT, treatment time, treatment power value, and thermal dose of women in high signal group were significant higher (all P＜0.05). There were no significant differences in the values of TTP, PI, and MTT, treatment time, treatment power value, thermal dose, and ablation rate of women between equal signal group and low signal group (P＞0.05). There were 88 (72.1%) women in satisfactory ablation group and 34 (27.9%) women in partial ablation group. The value of TTP of women in satisfactory ablation group was significant higher than that of women in partial ablation group, while the values of PI and MTT of women in satisfactory ablation group were significant lower (P＜0.05). According to Pearson correlation analysis, it was found that ablation rate of HIFU treatment was significantly positively correlated with TTP value (r=0.352, P＜0.05), but was negatively correlated with the values of PI and MTT (r=-0.311, -0.394, P＜0.05). Conclusion: Contrast-enhanced ultrasonography with different T2WI signals for evaluating preoperative blood perfusion of women with uterine fibroids has a high application value. Ultrasound contrast parameters and HIFU ablation rate have significant correlations, which can be used to guide HIFU treatment.

2020 Vol. 28　(8):　1274-1277 [Abstract]（ 306 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the changes of ovarian ultrasound characteristics, hormone levels, and oxidative stress injury indicators of infertility women with polycystic ovary syndrome(PCOS). Methods: 96 infertility women with PCOS were selected in study group from January 2016 to August 2018, and 100 healthy women with normal menstrual cycle were selected in control group. The characteristics of vocal and blood flow of ovary, the levels of serum of Hormone(T), luteinizing hormone (LH), follicle stimulating hormone(FSH), estradiol(E2), and the values of total oxidation state(TOS), total antioxidant state(TAS), ovarian interstitial artery enddiastolic blood flow velocity (EDV), peak systolic blood flow velocity(PSV), pulsatility index(PI), and resistance index (RI) of women were compared between the two groups. Results: The medulla area, ovarian volume, total ovarian area, medulla area/ovary area,  and the serum T level of women in the study group were significant higher than those of women in the control group(P＜0.05), but there were no significant difference in the levels of LH, FSH and E2 of women between the two groups(P＞0.05). The values of TOS, ovarian artery EDV, PSV and PI of women in the study group were significant higher than those of women in the control group(P＜0.05), but the TAS value of women in the study group was significant lower(P＜0.05). There was no significant difference in the RI value of women between the two groups(P＞0.05). Conclusion: The infertility women with PCOS has typical ovary polycystic change and high androgen characteristics, their ovary also are enlargement, and the ovarian medulla area increase with varying degrees of oxidative stress injury.

2020 Vol. 28　(8):　1282-1284 [Abstract]（ 362 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To investigate the correlation between ultrasonic uterine artery blood flow index and early threatened abortion. Method: The clinical data of 128 pregnant women with threatened abortion from June 6, 2016 to June 6, 2018 were retrospectively analyzed. According to different outcomes of threatened abortion, these women were divided into group A (women with abortion less than 16 gestational weeks) and group B (women with pregnancy equal to or more than 16 gestational weeks), and the normal pregnant women in group C during the same period were selected as the healthy control group. The values of uterine artery blood flow parameters by transvaginal color Doppler ultrasound measurement, such as peak systolic blood flow velocity/end-diastolic velocity (S/D), pulse index (PI), and resistance index (RI) of women during 8 and 10-12 gestational weeks were compared among the three groups. Multivariable Logistic regression model was used to analyze the uterine arteries blood flow index correlation with early pregnancy threatened abortion. Results: During 8 gestational weeks, the values of S/D, PI and RI of women in group A were significant higher than those of women in group B and C (P＜0.05). During 10-12 gestational weeks, there was no statistical significant difference in the value of PI among the three groups (P＞0.05), but the values of S/D and RI values of women in group A were significant higher than those of women in group B and C (P＜0.05). Multiple Logistic regression model analysis showed that the values of S/D and RI of women during 8 and 10-12 gestational weeks were independent risk factors affecting adverse outcomes of threatened abortion during the first trimester of pregnancy (P＜0.05), but PI value had no correlation with the threatened abortion during the first trimester of pregnancy (P＞0.05). Conclusion: The uterine artery blood flow index by ultrasound is closely related to the outcomes of early threatened abortion, and the increasing of the values of S/D and RI of pregnant women during 8 and 1012 gestational weeks can improve risk of inevitable abortion, which can be used a predicting early threatened abortion.

2020 Vol. 28　(8):　1289-1291 [Abstract]（ 458 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To detect the expression levels of miR-590 and miR-16 in uterine tissues patients with uterine leiomyoma, to analyze the relationship between the expression levels of miR-590 and miR-16 in uterine tissues and the occurrence of uterine leiomyoma, and to study their clinical significances. Methods: 64 patients with uterine leiomyoma from January 2016 to December 2018 were selected in study group, and another 64 patients with uterine prolapse who underwent hysterectomy were selected in control group during the same time. The expression levels of miR-590 and miR-16 in uterine tissues of patients in the two groups were detected by qRT-PCR, and the relationships between the levels of miR-590 and miR-16 and hormone levels of patients with uterine leiomyoma, and the risk factors of uterine leiomyoma were analyzed by logistic regression. Results: The expression levels of Mir-590 and Mir-16 of patients in the study group were 0.52±0.14 and 0.46±0.11, which were significant lower than those (1.03±0.31 and 1.01±0.27) of patients in the control group, but the serum levels of estradiol (E2), progesterone (P), folliclestimulating hormone (FSH), and luteinizing hormone (LH) of patients in the study group were significant higher (all P＜0.05). The expression levels of Mir-590 and Mir-16 were negatively correlated with the E2 and P levels. The E2 and P levels elevated, and the expression of Mir-590 and Mir-16 decreased were risk factors of uterine fibroids (all P＜0.05). Conclusion: The expressions of miR-590 and miR-16 in uterine leiomyoma tissues are low, and are negatively correlated with their E2 and P levels, which may be related to the occurrence and development of uterine leiomyoma.

2020 Vol. 28　(8):　1296-1299 [Abstract]（ 377 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To analyze the value of hysteroscopy for diagnosing endometrial polypoid carcinoma or precancerous lesion, and to study the risk factors of endometrial polypoid or precancerous lesions. Methods: The clinical data of 633 patients who underwent hysteroscopic endometrial polypectomy from August 2014 to August 2019 were analyzed retrospectively. The values of hysteroscopy for diagnosing endometrial polypoid carcinoma and precancerous lesion were analyzed, and the consistency diagnosed by hysteroscopy and pathology was also analyzed. The high risk factors of patients with endometrial polypoid carcinoma or precancerous lesion was analyzed. Results: The coincidence rate of hysteroscopy diagnosis and pathological diagnosis was 98.7% and Kappa value was 0.86, which showed the results were consistent with the pathological results. The sensitivity, the specificity, the positive predictive value, and the negative predictive value of hysteroscopy for diagnosing polypoid or precancerous lesions of uterine membrane were 89.7%, 99.2%, 83.9%, and 99.5% respectively. The patients with endometrial polypoid carcinoma or precancerous lesions were significant older than that of patients with endometrial polyp alone (P＜0.001). The incidence of endometrial polypoid carcinoma or precancerous lesions of patients with BMI≥25kg/m2, irregular vaginal bleeding, or polyp diameter≥1.5cm was significant higher (P＜0.05). There was no statistical significant difference in the incidence of endometrial polypoid carcinoma or precancerous lesions between patients with and without history of childbirth, between the women with and without hypertension or diabetes, and between the women with single polyps and with multiple polyps (P＞0.05). Advanced age and BMI≥25kg/m2 were risk factors of endometrial polypoid or precancerous lesions (P＜0.05). Irregular vaginal bleeding and polyp diameter≥1.5cm were not correlated with endometrial polypoid or precancerous lesions (P＞0.05). Conclusion: Advanced age or obese of patients with endometrial polyps should be concerned on endometrial polypoid carcinoma or precancerous lesions, especially for those patients with irregular vaginal bleeding or large polyp. Hysteroscopy has a good value for preliminary diagnosing the situation of endometrial polyps.

2020 Vol. 28　(8):　1304-1307 [Abstract]（ 428 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To detect the expression levels of plasma angiotensinogen (AGT) and interleukin-22 (IL-22) of the patients with pregnancy induced hypertension, and to explore the relationships between AGT and IL-22 levels and the renal damage of these patients. Methods: From March 2018 to May 2019, 120 pregnant women with pregnancy induced hypertension were selected in the study group, which included group A (41 women with pregnancy induced hypertension), group B (39 women with mild preeclampsia), group C (40 women with severe preeclampsia), group D (46 women with KI), and group E (74 women without KI). And another 40 normal pregnant women were selected in the control group. The levels of plasma AGT and IL-22 and serum creatinine level of all included women were detected by ELISA. Pearson's method was used to analyze the correlations between the levels of plasma AGT and IL-22 and serum creatinine level of women with renal damage caused by pregnancy induced hypertension. And ROC curve was used to analyze the values of AGT and IL-22 levels, and serum creatinine level for predicting renal damage caused by pregnancy induced hypertension. Results: The levels of plasma AGT and IL-22 of women in the study group were significant higher than those of women in the control group, and which of women in group A, group B, and group C had increased in turn (P＜0.05). The levels of plasma AGT and IL-22, and serum creatinine level of women in group D were significant higher than those of women in group E (P＜0.05). There was a positive correlation between the levels of AGT and IL-22 of women and their serum creatinine level in group D (r=0.591, 0.586, P＜0.05). The sensitivity, the specificity, and area under the curve of the combination of the levels of AGT, IL-22 and creatinine for predicting renal damage of women with pregnancy induced hypertension were 84.8%, 94.6% and 0.936, respectively. Conclusion: The expressions of AGT and IL-22 of women with pregnancy induced hypertension decrease, which are related to the severity of the disease and the complication of KI. The combination of the levels of AGT, IL-22, and creatinine for predicting renal damage has high value, which is expected to be a molecular marker for evaluating renal damage of women with pregnancy induced hypertension.

2020 Vol. 28　(8):　1312-1313 [Abstract]（ 361 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the normal range of fetal NT value of pregnant women with normal single-fetus pregnancy during the first trimester of pregnancy in Wuhan area, and to study the fetal NT value correlation with gestational weeks, maternal age, and fetal gender. Methods: 3617 pregnant women with normal single-fetus pregnancy during 11-13 gestational weeks from January 2013 to December 2017 were selected in this study continually. Fetal NT values of these women were measured by ultrasound. The normal reference range of NT value of normal single fetus was established. The differences of NT value of fetus and its normal reference range of women with different gestational weeks, maternal age, or fetal sex were observed. Pearson analysis was used to explore the correlation between NT value and gestational weeks and maternal age. Results: There were 3548 women completed fetal NT value measurement, which’s successful measurement rate was 96.7%. Among them, 3316 women were followed up, which’s success followed up rate was 93.5%, and the date of 3273 women with single-fetal pregnancy were finally included for analysis except to 43 women with abortion, dead fetal, or birth defects. The NT value of 3273 normal fetuses was in accordance with the normal distribution. The normal fetus NT value was 1.73±0.68 mm, which’s 95% reference range was 0.78-2.85 mm. The NT value of normal male fetus was significant more than that of female fetus. The fetal NT value of women over 35 years old was more than women egual to or less than 35 years old (all P＜0.05). Pearson correlation analysis showed that NT value was positively correlated with maternal age (r=0.419, P＜0.05), but had no correlation with gestational weeks (r=0.130, P＞0.05). Conclusion: The 95% reference range of fetal NT value of pregnant women with normal single-fetus pregnancy during the first trimester of pregnancy in Wuhan area is 0.78-2.85mm, and the NT value of elderly pregnant women increases.

2020 Vol. 28　(8):　1321-1324 [Abstract]（ 415 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )