To investigate the expression of keratinocyte growth factor (KGF) and receptor (KGFR) of pregnant rats with renal ischemia reperfusion (RIR) induced by postpartum hemorrhage after treated byα-melanocyte stimulating hormone (α-MSH), normal saline, or non intervention. Methods: 60 rats of Sprague Dawley (SD) with full-term pregnancy were selected to establish RIR model, 30 cases of them were injected with normal saline (NS)in group A, the other 30 were injected with α-MSH intraperitoneally in group B. Meanwhile, 30 healthy full-term pregnant rats were selected in group C. At the end of 12 hours after the model completion, the life of these rat in the three groups were ended, and the water content of lung and kidney and renal function of rats were observed and compared among the three groups. Results: The levels of urine volume, serum creatinine (Scr) and urea nitrogen (UN) of rats in group A were significant higher than those of rats in the other two groups, but the urine osmotic pressure of rats in group A was significant lower (P＜0.05). And the urine volume of rats in group B was significant higher than that of rats in group C (P＜0.05), but there were no significant difference in the levels of Scr and BUN between group B and C (P＞0.05). The water content of kidney and lung of rats in group A and B were significant higher than those of rats in group C (P＜0.05). KGF mRNA could be expressed in the kidney and lung tissues of rats in the three groups, but KGF mRNA level of rats in group A was significant lower than that of rats in group B and C (P＜0.05). The average optical density and real-time quantitative of KGFR in kidney and lung tissue of rats in group A were significant lower than that of rats in group B and C (P＜0.05). Conclusion: KGF mRNA and KGFR in the kidney and lung of rats with renal ischemia-reperfusion induced by postpartum hemorrhage are related to their injury. α-MSH can protect theirkidney and lung by affecting their expression level of KGF and KGFR.

2020 Vol. 28　(9):　1334-1337 [Abstract]（ 339 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the correlation between the adverse pregnancy outcomes of women and their menstrual history and birth history, and to provide guidance for reducing adverse pregnancy outcomes. Methods: A retrospective cohort study method was conducted, and the women who had received the technical service registration of the national free pre-pregnancy eugenic health checkup project in Baoshan City of Yunnan Province were select in this study from 2010 to 2017. The pregnant women were included into followed up cohort and their baseline information was collected from the time of these women registered. And they were followed up until to delivery, and their delivery outcomes were observed. The related factors were performed based on the adverse pregnancy outcomes by multivariate COX regression analysis. Results: A total of 4285 pregnant women were surveyed in this study, and the incidence of adverse pregnancy outcomes was 15.0%. Multivariate COX regression analysis showed that the female with ethnic minority (HR=1.813, 95%CI: 1.008,3.261), the female age≥34 years old（HR=1.856, 95%CI: 1.043,3.301）, and the number of abortion（HR=1.585,95%CI:1.118,2.247）were the risk factors of adverse pregnancy outcomes (P<0.05). Conclusion: The education for women prepregnancy and during pregnancy should be paid attention to, and the health care system for women and children should be strengthened. In order to effectively reduce the incidence of adverse pregnancy outcomes, the women should be encouraged to have children at the right age and be encouraged to understand the relevant scientific knowledge on reproductive history for reducing induced abortion number.

2020 Vol. 28　(9):　1342-1345 [Abstract]（ 483 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To analyze the removal of IUD and related factors of postmenopausal women. Methods: From March 2019 to May 2019, 938 women aged of 45 years old and above who had an IUD and stopped their menstruation for 1 year or more were selected from the survey of sexual and reproductive health in the middle-aged and elderly, and their status of IUD removal and the influence factors were analyzed. Results: 592 (63.1%) women had not IUD removal when their menstruation stopped. Among them, 282 (47.6%) women had IUD removal within 1 year after menstruation stopped, 81 (13.7%) women had IUD removal more than 1 year after menstruation stopped, 113 (19.1%) women had no specific memory for IUD removal time, and 116 (19.6%) women had not IUD removal. Consciously unnecessary, afraid of pain, and troublesome were the main direct reasons for not removing IUD in time. Provinces, economic income, age, household registration, and urban or rural residence were the influencing factors of IUD removal after menopause (P＜0.05). Conclusion: In these province/city, there are certain women whose IUD have not been removed after menopause appropriately. The health care services for perimenopause women should be strengthened further and special attention should be paid to low-income and relatively younger women.

2020 Vol. 28　(9):　1351-1354 [Abstract]（ 426 ） HTML (0 KB)  PDF  (0 KB)  ( 54 )

To compare the application effect of subdermal implantation contraception and intrauterine device (IUD) TCu220 used after artificial abortion. Methods: 300 women who had undergone artificial abortion and had long-term contraceptive needs were selected as the research subjects from January 2016 to December 2017, and were divided into group A (157 women with subdermal implantation) and group B (143 women with IUD inserted) according to the random number table method. The incidences of adverse events such as pregnancy with subdermal implantation /IUD, expulsion, withdrawal due to disease, pelvic infection, and other adverse events of women during followed up were compared between the two groups. The rates of contraceptive related adverse reactions and continue used of women in both groups were recorded. The quality of life of the women before and after abortion was evaluated by short-form health questionnaire (SF-36). Results: During 24 months of followed up, the rates of removal due to disease, total adverse events, menorrhagia, menostaxis, and total discomfort of women in group A were 1.4%, 1.4%, 2.0%, and 1.4%, respectively, which were significant lower than those (6.3%, 11.9%,7.0%, 13.3%, and 9.1%, respectively) of women in group B, but the rate of oligomenorrhea or amenorrhea of women in group A was 7.5%, which was significant higher than that (1.4%) of women in group B (all P＜0.05). 24 months after abortion, the continuation rate of women in group A was 95.9%, which was significant higher than that (89.5%) of women in group B. 6, 12 and 24 months after abortion, SF-36 scores of women in the two groups had significantly increase, and SF-36 scores of women in group A in 12 and 24 months after abortion were significant higher than those of women in group B (all P＜0.05). Conclusion: Both subdermal implantation and copper-containing IUD used after artificial abortion have good contraceptive effects, which are positive for improving the quality of life of women. The rates of adverse events contraceptive-related side effects, and continue using of subdermal implantation contraception are lower.

2020 Vol. 28　(9):　1360-1363 [Abstract]（ 487 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To compare the application effect of intrauterine suction system and guided by abdominal ultrasound for treating women with induced abortion of early scarred uterus pregnancy. Methods: The women with scar uterus and induced abortion were selected as subjects, and were divided into control group and observation group according to the principle of random number. The women in the control group were given suction evacuation guided abdominal ultrasound, and the women in the observation group were given suction evacuation through intrauterine suction system. The intraoperative indicators, postoperative vaginal bleeding time, menstrual recovery, and complications rate of women were compared between the two groups. And the incidence of complications of women with different postoperative time of induced abortion by two methods was analyzed. The amount of intraoperative blood loss (25.10±10.0ml), postoperative vaginal bleeding time (5.1±1.8d) and the proportion of reduced menstrual volume (6.3%) of women in the observation group were all significant lower than those of women in the control group (P＜0.05). There were no significant different in the abortion time and postoperative menstrual recovery time of women between the two groups (P＞0.05). The incidences of intrauterine or cervical adhesions, and complications of women in the observation group were 0.6% and 2.5%, which were significant lower than those (4.4% and 7.5%) of women in the control group (P＜0.05). There were no significant different in the incidences of uncompleted abortion, abortion syndrome, and infection of women between the two groups (P＞0.05). For those women with different interval from last cesarean section, intraoperative blood loss volume of women in the observation group was significant lower than that of women in the control group (P＜0.05). For those women within 1 year after last cesarean section, postoperative vaginal bleeding time of women in the observation group was 5.5±1.1d, which was shorter than that (7.9±2.1d)  of women in the control group (P＜0.05). For those women within more than 1 year of interval from last cesarean section, there was no different in postoperative vaginal bleeding time between the two groups (P＞0.05). Conclusion: As for those women within 1 year after last cesarean section, intrauterine suction system can reduce the endometrium injury and reduce the risk of complications.

2020 Vol. 28　(9):　1368-1371 [Abstract]（ 311 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To explore the correlation between serum mir-146a level, estrogen level, or endometrial receptivity of women with polycystic ovary syndrome (PCOS) and their pregnancy. Methods: From September 2016 to September 2018, 140 women with PCOS were selected in study group, another 110 women without PCOS who underwent ovulation treatment due to ovulation disorder during the same period were selected in control group. The serum samples of the women in the two groups were collected. The expression of miR-146a was detected by quantitative real-time PCR (qRT-PCR), and the levels of serum estradiol (E2), luteinizing hormone (LH), and follicle stimulating hormone (FSH) were measured by chemiluminescence immunoassay. The endometrial receptivity, the indexes, pulsation index (PI), resistance index (RI), and endometrial thickness (Em) of these women were measured by B-ultrasound. The women with PCOS were followed up for one year in outpatient service, and were divided into group A (71 women with pregnancy) and group B (69 women without pregnancy). Pearson test was used to analyze the correlation, and multivariate logistic regression was used to analyze the risk factors of pregnancy of women with PCOS after treatment. Results: The levels of serum Mir-146a, LH, and FSH PI, and the values of PI and RI of women in the study group were significant higher than those of women in the control group, but E2 level and Em value of women in the study group were significant lower (all P＜0.05). In the study group, the levels of serum Mir-146a, LH, and FSH, and the values of PI and RI of women without pregnancy were significant higher than those of women with pregnancy, but E2 level and Em value of women without pregnancy were significant lower (all P＜0.05). The levels of Mir-146a, E2, LH, and FSH, and the values of PI, RI, and Em of the women with PCOS were all the independent risk factors of pregnancy after treatment (P＜0.05). Conclusion: The levels of serum MiR-146a, LH, and FSH and the values of PI and RI of the women with PCOS decrease, which may affect the endometrial receptivity and participate in the occurrence and development of PCOS.
 

2020 Vol. 28　(9):　1375-1379 [Abstract]（ 324 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To investigate human papilloma virus (HPV) infection of patients with different features of cervical lesions, and to study its correlation with infertility. Methods: 78 patients with cervical cancer were in group A, 65 patients with cervical intraepithelial neoplasia (CIN) were in group B, 62 patients with infertility were in group C, and 50 normal women were in group D. The HPV infection status and subtypes were detected by flow-through rapid hybridization. The relationship between cervical cancer pathology and HPV infection was analyzed. The characteristics of HPV infection in infertility were summarized, and the risk factors of high-risk HPV infection in infertile women were screened. Results: The rates of HPV infection and high-risk HPV infection of women in group A, B, and C were significant higher than those (20.0% and 12.0%) of women in group D, and those (92.3%、86.4%) of patients in group A were the highest (P＜0.05). There was no significant different in the multiple infection rate among the four groups (P＞0.05). The high-risk HPV infection rate of patients with stage III cervical cancer was significant higher than that of patients with stage Ⅰ and Ⅱ cervical cancer. The high-risk HPV infection rate and the multiple infection rate of patients with lymphatic invasion of cervical cancer were significant higher than those of patients without lymphatic invasion of cervical cancer (all P＜0.05). The first sexual life occurrence less than 20 years old and cervical erosion history were the risk factors of high-risk HPV infection of infertile patients (P＜0.05). Conclusion: The patient with cervical cancer or infertility has higher HPV infection rate and high-risk HPV subtype infection rate. The rate of HPV infection increases with the progression of cervical cancer. The smaller years old of women when their first sexual life occurrence and the cervical erosion history of women are both the risk factors of infection of infertile patients. So they should be paid attention to, and infection screening and treatment should be conducted in clinical practice.

2020 Vol. 28　(9):　1383-1387 [Abstract]（ 408 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the curative efficacy of low-dose aspirin combined with labetalol for treating women with pregnancy induced hypertension disease, and to study its influence on the levels of serum soluble lectin-like oxidized low density lipoprotein receptor-1(sLOX-1) and soluble receptors for advanced glycation end products(sRAGE). Methods: 115 pregnant women with pregnancy induced hypertension disease were selected and were divided into 60 cases in the observation group and 55 cases in the control group by the random number table from January 2016 to October 2018. The women in the control group were treated with labetalol, while the women in the observation group were treated with labetalol combined with low-dose aspirin. The changes of the values of blood pressure, 24-hour urinary protein, uterine artery hemodynamics, and serum sLOX-1 and sRAGE levels of women before and on the 7th day after treatment, and the adverse pregnancy outcomes and adverse reactions of women were compared between the two groups. Results: On the 7th day  after treatment, the values of systolic blood pressure (SBP), diastolic blood pressure (DBP), urine protein at 24h, uterine artery pulse index (PI), resistance index (RI), and ratio of systolic and end-diastolic maximum blood flow velocity (S/D) of women in the observation group were all significant lower than those of women in the control group. The serum SLOx-1 level of women in the observation group was 167.46 ±19.40 g/ml, which was significant lower than that of women in the control group, but the serum sRAGE level of women in the observation group was 302.46±34.57 ng/L, which was significant higher than that (181.13±21.19 g/ml) of women in the control group. The incidences of cesarean section, premature delivery, and fetal distress of women in the observation group were significant lower than those of women in the control group (all P＜0.05). The incidence of postpartum hemorrhage (8.3%), neonatal asphyxia, death, and total adverse reactions (8.3%) of women in the observation group had no significant different from those of women  in the control group (P＞0.05). Conclusion: Low-dose aspirin combined with labetalol for treating women with pregnancy induced hypertension disease had good curative effect, which can effectively regulate serum sLOX-1 and  sRAGE level, and uterine artery blood flow value, can improve maternal and infant outcomes, and do not increase adverse drug reactions it's worthy for popularizing.

2020 Vol. 28　(9):　1392-1395 [Abstract]（ 406 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

To investigate the effect of single-dose amoxicillin-clavulanic acid for preventing postpartum infection of women after vaginal delivery, and to study the influence factor of infection. Methods: 1003 women who underwent vaginal delivery were randomly divided into the experimental group (507 cases) and the control group (496 cases) from February 2016 to April 2019. The women in the experimental group were given 20ml amoxicillin-clavulanate potassium dry suspension (7:1) within 3-6 hours after delivery, and the women in the control group were not given any antibiotics after delivery. The infection situation within postpartum 42 days of women in the two groups were followed up. The risk factors of postpartum infection was analyzed. Results: There were no significant different in the rates of conversion cesarean section, perineal side cut, vaginal midwifery, the second stage of labor prolonged, oxytocin used, postpartum hemorrhage, and indwelling catheterization >3 days of women between the two groups (P>0.05). The incidence of postpartum infection was 14.74% (143/970) within 42 days of all women after delivery, and the incidence of postpartum infection of women in the experimental group was 10.86% (53/488), which was significant lower than that (18.67%, 90/482) of women in the control group (χ2=11.773, P=0.000). The rates of vaginal midwifery, perineal side cut, premature rupture of fetal membranes, the second stage of labor prolonged, gestational diabetes mellitus, postpartum hemorrhage, and indwelling catheterization >3 days of women with postpartum infection were significant higher than those of women without postpartum infection. Multivariate logistic regression analysis showed that postpartum infection in women with vaginal midwifery, perineal side cutting, postpartum hemorrhage, or indwelling catheterization >3 days was independent risk factors of postpartum infection (P<0.05). Postpartum application of amoxicillin clavulanate potassium was a protective factor for preventing postpartum infection (P<0.05). Conclusion: Prophylactic application of clavulanate potassium in the early postpartum period can reduce the incidence of postpartum infection. Strict aseptic operation in the perineal side cutting and vaginal midwifery can also reduce the incidence of postpartum infection.

2020 Vol. 28　(9):　1402-1406 [Abstract]（ 320 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

2020 Vol. 28　(9):　1412-1416 [Abstract]（ 284 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To explore the correlation between the level of antithrombin III (AT-III), protein C (PC), or D-dimer and fetal growth restriction (FGR), and to explore the clinical efficacy of anticoagulant therapy. Methods: 120 pregnant women with FGR were selected in study group, and 120 normal pregnant women were selected in control group. The plasma AT-III, PC, and D-mer levels of women in the two groups were detected, and which’s differences were analyzed between the two groups. The correlation between the level of AT-III, PC, or D-mer and FGR were also analyzed. The women in the study group were divided into group A and B by random number table method. 60 women in group A were treated with low molecular weight heparin anticoagulation, and 60 women in group B had received basic treatment only. The levels of plasma AT-III, PC, D-mer, and drag index (RI), pulsatility index (PI), and S/D value of umbilical artery flow, and the values of uterine height, head circumference, abdominal circumference, biparietal diameter, femur growth, and pregnancy outcomes of women in group A and B were observed before and after treatment. Results: The levels of plasma AT-III and PC of women in the study group were significant lower than those of women in the control group (P＜0.05). Spearman correlation analysis showed that the levels of plasma AT-III and PC were negatively correlated with FGR (F=-0.421, -0.502, P＜0.05), but D-dimer level was positively correlated with FGR (r=0.473, P＜0.05). The levels of AT-III and PC, and the values of uterine height, head circumference, abdominal circumference, biparietal diameter, and femur long growth, and neonatal birth weight in group A were significant higher than those in group B (P＜0.05), but the D-dimer level, and the values of RI, PI, and S/D of umbilical blood flow, and the rates of preterm birth and cesarean section in group A were significant lower than those in group B (P＜0.05). Conclusion: The AT-III and PC levels of women with FGR decrease, but their D-dimer level increase, which all may be involved in the pathogenesis of FGR. Low molecular weight heparin anticoagulant therapy can significantly reduce D-dimer level, increase AT-III and PC activity, promote fetal growth and development, improve cord blood dynamics, and can reduce the adverse pregnancy outcomes.

2020 Vol. 28　(9):　1420-1424 [Abstract]（ 574 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the application of dexmedetomidine for anesthesia during cesarean section, and to study its effect on postoperative chill occurrence. Methods: 80 women who needed to cesarean section were treated by epidural anesthesia, and were divided into control group and study group (40 cases in each group) from March 2017 to May 2018. The women in the control group were instilled saline after epidural anesthesia, and were target controlled infusion saline if postoperative chill occurrence. The women in the study group were instilled metomomidin after epidural anesthesia, and were target controlled infusion metomomidin if postoperative chill occurrence. The values of mean arterial pressure (MAP), heart rate (HR), pulse, oxygen saturation (SaO2), intraoperative basal metabolic rate (BMR), postoperative adverse reactions rate, and chill rate of women were compared between the two groups. Results: The values of MAP, HR and SaO2, and intraoperative BMR of women in the study group were significant lower than those of women in the control. The incidence of postoperative adverse reactions such as nausea and vomiting of women in the study group was 5.0%, which was significant lower than that (47.5%) of women in the control group, the incidence of grade 0 of chill of women in the study group was 85.0%, which was significant higher than that (55.0%) of women in the control group (all P＜0.05). There was no any women with the grade 3 and 4 of chill in both groups. Conclusion: The application of dexmedetomidine during caesarean section has good anesthetic effect, which can reduce adverse reactions and can decrease the postoperative chill rate.

2020 Vol. 28　(9):　1429-1431 [Abstract]（ 346 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To investigate the distribution of AZF microdeletion in Y chromosome of males, and to discuss its relevant to the clinical feature. Method: 920 infertility males from outpatient service were collected into experimental group, and another 100 normal males were served in control group. Multiple PCR was used to examine the 15 STS sites in AZFa, AZFb and AZFc regions, and the distributions of microdeletions in these regions were analyzed. Results: In the experimental group, 18 cases (1.96%) with AZF microdeletion, which included 12 cases with AZFa deletion, 4 cases with AZFb deletion, 1 case with AZFc deletion, and 1 case with both AZFb and AZFc deletion. 6 types of microdeletion in AZF were found. No abnormality was found in control group. Among 17 males with AZF microdeletion, 6 cases were diagnosed as aspermia, 9 cases were diagnosed as asthenozoospermia or oligoasthenozoospermia, and 2 cases were diagnosed as necrozoospermia. Conclusion: Multiple types of AZF microdeletion were existed in Y chromosome of infertility males, among which, the proportion of AZFc microdeletion is the highest. So microdeletion detection of chromosome Y should be as routine examination and paid more attention to before diagnosing or treating by artificial assisted reproduction.

2020 Vol. 28　(9):　1435-1438 [Abstract]（ 649 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To analyze the influence factor analysis of recurrent adverse pregnancy of women after abortion of tubal ectopic pregnancy Methods: The data of pregnant women from 2008 to 2018 were collected retrospectively. 1688 women with recurrent adverse pregnancy after abortion of tubal ectopic pregnancy were selected in the observation group, and 17,072 women with normal again pregnancy after abortion of tubal ectopic pregnancy were included in the control group. The basic clinical data of women were compared between the two groups, and the rates of preeclampsia and fetal dysplasia in the observation group were observed. Results: The rates of women with ≤25 years old, spouse smoking during pregnancy, pre-pregnancy overweight, and gynecological history, and poor nutritional status of women in the observation group were significant higher than those of women in the control group (P＜0.05). There were no significant different in tubal ectopic pregnancy treatment method, diet situation, number of births, IVF-ET history, education level, occupation situation, and family income per capita between the two groups (all P＞0.05). In observation group, there were 122 (7.2%) women with preeclampsia and 259 (15.3%) women with poor fetal growth. The rate of adverse pregnancy outcomes of women with pregnancy interval <12 months was 92.7%, which was the highest (all P＜0.05). Conclusion: The women with pregnancy again after abortion of tubal ectopic pregnancy should control their weight as much as possible, avoid smoking environment, and prolong the interval of pregnancy over one year, and strengthen pre-pregnancy care to prevent adverse pregnancy.

2020 Vol. 28　(9):　1442-1444 [Abstract]（ 376 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To explore the influence of preoperative goserelin used combined with laparoscopic surgery on uterine blood flow resistance, fibroid volume and hemoglobin (Hb) level of patients with uterine fibroids. Methods: Clinical data of 48 uterine fibroids patients with uterine volume ≥14 gestational weeks who had treated by goserelin combined with laparoscopic surgery in observation group and 42 uterine fibroids patients with uterine volume of 10-12 gestational weeks who had treated by laparoscopic surgery in control group were collected retrospectively. The uterine volume, uterine fibroid volume, Hb level, and uterine blood flow resistance index, such as uterine artery resistance index (RI), main fibroid vascular resistance index (RI)of patients were compared before and after treatment between the two groups. And the perioperative indexes, the rate of postoperative complications, and the rate of adverse drug reactions were also compared between the two groups. Results: The uterine volume and uterine fibroid volume of patients in the observation group before treatment were significant lower than those of patients before treatment (P＜0.05), while the Hb level of patients in the observation group was significant higher (P＜0.05). There were no significant different in the uterine volume, uterine fibroid volume, and Hb level of patients before treatment between the two groups (P＞0.05). The values of uterine artery RI and fibroid vascular RI of patients in the observation group had increased significantly after treatment (P＜0.05), and were significant higher than those of patients in the control group before treatment, but the operative time, intraoperative blood loss, postoperative hospital stay, and total incidence rate of postoperative complications of patients in the observation group were significant lower (P＜0.05). In the observation group, there were 81.3% patients with amenorrhea, 47.9% patients with hot flashes, 25.0% patients with insomnia, and 10.4% patients with limb pain after treatment. Conclusion: Preoperative goserelin used can promote the successful completion of laparoscopic surgery of patients with uterine fibroids, and can reduce postoperative complications, which has significance for promoting postoperative rehabilitation of patients.

2020 Vol. 28　(9):　1449-1452 [Abstract]（ 474 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the clinical efficacy of levothyroxine sodium (L-T4) for treating pregnant women with thyroid peroxidase antibody（TPOAb） negative of subclinical hypothyroidism. Methods: 140 pregnant women with TPO-Ab negative of subclinical hypothyroidism were randomly divided into two groups (70 cases in each groups). The women in experimental group were treated with L-T4 combined with routine treatment, and the women in experimental group were treated with routine treatment. The rates of pregnancy outcomes and pregnant complications of women in both groups were observed. Results: The abortion rate (8.6%) and preterm birth rate (4.3%) of women in experimental group were significant lower than those (14.6% and 10.0%) of women in the control group. The levels of serum total cholesterol, triacylglycerol and low-density lipoprotein of women in experimental group were significant higher than those of women in the control group, but the high-density lipoprotein level was significant lower. The improvement of thyroid function indexes of women in experimental group was significant better than that of women in the control group (all P＜0.05). The incidence of gestational hypertension (5.1%), anemia (21.6%), gestational diabetes (2.9%), or intrahepatic cholestasis (2.9%) was significant lower than that of women in the control group (P＜0.05). Conclusion: L-T4 can improve thyroid function, perioperative outcomes, and reduce the incidence of complications of women with TPOAb negative of subclinical hypothyroidism significantly.

2020 Vol. 28　(9):　1459-1461 [Abstract]（ 402 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the efficacy of hysteroscopy combined with laparoscopy for treating infertility women with endometriosis, and to study its influence on postoperative pregnancy. Methods: The clinical data of 108 infertility women with endometriosis from May 2016 to May 2017 were retrospectively analyzed. These women were divided into two groups according to different treatment schemes (51 cases in each group). The women in the control group underwent laparoscopic surgery, while the women in the study group underwent hysteroscopy combined with laparoscopy. After operation, the women in both groups were treated with gonadotropin-releasing hormone agonist (GnRH-a) on the 2nd to the 5th day after menstruation for 6 months. The intraoperative blood loss, operation time, postoperative hospital stay, pregnancy rate within postoperative 2 years, clinical efficacy, and complication rate of women were compared between the two groups. Logistic regression analysis were used to analyze the related influence factors of postoperative pregnancy. Results: There were no significant different in intraoperative blood loss, operative time, and postoperative hospital stay of women between the two groups (P＞0.05). The effective rate (96.5%) and pregnancy rate within 2 years after operation (63.2%) of women in the study group were significant higher than those (80.4% and 41.2%) of women in the control group, but the incidence of complications (3.5%) of women in the study group was significant lower than that (15.7%) of women in the control group (P＜0.05). There were no significant different in the age, BMI, infertility time, history of pelvic surgery, and postoperative pregnancy of women between the two groups (P＞0.05), but there were significant different in the different stages of endometriosis (r-AFS stage), the unblocked fallopian tube situation, the application of assisted reproductive technology, the standardized postoperative medication, and postoperative pregnancy of women after different surgical treatment scheme between the two groups (P＜0.05). Multifactor analysis showed that clinical endometrial r -AFS staging Ⅲ-Ⅳ, fallopian tube blocked, without assisted reproductive technology, without standardized postoperative medication were the risk factors of postoperative pregnancy (P＜0.05). Hysteroscopy combined with laparoscopy therapy was the protective factor of postoperative pregnancy (P＜0.05). Conclusion: Application of hysteroscopy combined with laparoscopy for treating infertility women with endometriosis can improve the postoperative pregnancy safely and effectively. r-AFS stage I-II, fallopian tube unblocked, application of assisted reproductive technology, hysteroscopy combined with laparoscopy, and standardized postoperative medication can improve the postoperative pregnancy rate.

2020 Vol. 28　(9):　1467-1470 [Abstract]（ 425 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To investigate the re-pregnancy outcomes of women with different types of cesarean section scar pregnancy (CSP) after treatment. Methods: 150 women with CSP who had re-pregnancy requirement were selected and all received uterine artery embolization plus hysteroscopic lesion resection from April 30, 2016 to April 30, 2017. These women were divided into 64 women with type I CSP in group A, 56 women with type II CSP in group B, and 30 women with type III CSP in group C according to CSP classification criteria. The surgical effect,  postoperative recovery, pregnancy status, and pregnancy outcomes of women were compared among the three groups. Results: The operative time or intraoperative blood loss volume of women in group C was the highest, but that of women in group A was the lowest. The success rate of once operation of women in group C was the lowest, but that of women in group A was the highest (all P＜0.05). There were no significant different in the time of menstruation and hCG level returned to normal among the three groups (P＞0.05). In 24-36 months of followed up, there were 98 women with natural pregnancy in the three groups, and the natural pregnancy rate of women in group A (79.7%) was significant higher than that (69.6%) of women in group B and that (27.6%) of women in group C (P＜0.05). In 113 times of the natural pregnancy, the spontaneous abortion rate of women in group C (50.0%) was significant higher than that (17.8%) of women in group B and that (16.4%) of women in group A (P＜0.05). Multiple factors analysis showed that the protection factors of the postoperative natural pregnancy of women in group C were age<30 years old, and scar muscle layer thickness >3 mm. The risk factor was curettage history (P＜0.05). Conclusion: After treatment, the re-pregnancy rate and spontaneous abortion rate, and pregnancy outcomes of women with type Ⅲ CSP are lower than those of women with type Ⅰ and Ⅱ CSP.

2020 Vol. 28　(9):　1475-1478 [Abstract]（ 293 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the serum levels of cytokines and pregnancy outcomes of pregnant women with group B Streptococcus (GBS) infection during the third trimester pregnancy, and to analyze the related risk factors of GBS infection. Methods: 800 pregnant women during 34-41 gestational weeks were included in this study, of which 400 women were infected by GBS in observation group and 400 women were not infected by GBS in control group. The serum levels of procalcitonin (PCT) and interleukin-6 (IL-6), and pregnancy outcomes of women were compared between  the two groups. The risk factors of GBS infection of pregnant women were analyzed. Results: The levels of serum PCT and IL-6 of women in the observation group were 0.14 ±0.04 ng/mL and 15.14±1.67 pmoL/mL, which were significant higher than those of women in the control group (P＜0.05). Age, body mass index (BMI), gestational diabetes mellitus (GDM), vulvovaginal candidiasis (VVC), abortion history and delivery history of women were closely related to the occurrence of GBS infection (P＜0.05). Logistic regression analysis showed that advanced age, high BMI, GDM, VVC, abortion history, and delivery history were independent risk factors of GBS infection of women during the third trimester of pregnancy (P＜0.05). The incidences of premature delivery, intrauterine infection, premature rupture of membranes, amniotic fluid pollution, cesarean section, neonatal asphyxia and neonatal pneumonia of women in the observation group were 22.5%, 23.0%, 16.0%, 25.3%, 17.8%, 15.5%, and 3.5%, respectively, which were significant higher than those of women in the control group (P＜0.05). Conclusion: GBS infection can increase the level of serum inflammatory factors of pregnant women during the third trimester of pregnancy, and can increase the risk of adverse outcomes, such as premature delivery, intrauterine infection, and amniotic fluid contamination. Therefore, GBS screening and controlling should be strengthened, especially for those women with advance age, high BMI, GDM, VVC, abortion history, and delivery history, in order to reduce the GBS infection during the third trimester of pregnancy.

2020 Vol. 28　(9):　1482-1485 [Abstract]（ 351 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the correlations between the blood flow resistance index (RI) by Doppler ultrasound and the levels of serum angiopoietin-like protein 4 (ANGPTL4) and angiotensin-2 (Ang-2) of women with ovarian cancer. Methods: From October 2016 to October 2019, 84 women with ovarian tumors were collected in the study group, which included 23 women with benign tumors, 28 women with borderline tumors, and 33 women with malignant tumors based on the pathological results. In addition, 85 healthy women were selected in control group during the same period. The blood flow resistance index (RI) value of women in the two groups was detected by Doppler ultrasound, and the serum ANGPTL4 and Ang-2 levels were detected by ELISA. Pearson's method was used to analyze the correlation between RI value and ANGPTL4 level or Ang-2 level, and between ANGPTL4 level and Ang-2 level in the study group. Spearman method was used to analyze the relationship between the levels of RI, ANGPTL4 and Ang-2 levels of women and their benign and malignant diseases in the study group. The RI value (0.50±0.08) of women in the study group was significant lower than that (0.63±0.12) of women in the control group, but the serum of ANGPTL4 level (52.29±8.91 ng/ml) and Ang-2 level (32.48±5.17 ng/ml) of women in the study group were significant higher. RI value of women with benign tumor, with borderline tumor, and with malignant tumor were 0.63±0.09, 0.54±0.07, and 0.37±0.06, respectively, which had decreased in turn, while the serum levels of ANGPTL4 and Ang-2 increased in turn (P＜0.05). RI value of women with ovarian tumor was negatively correlated with the levels of ANGPTL4 and Ang-2. And RI value was negatively correlated with benign and malignant diseases, but serum ANGPTL4 and Ang-2 levels were positively correlated with benign and malignant diseases (all P＜0.05). Conclusion: The RI value is closely related to the levels of serum ANGPTL4 and Ang-2, and the tumor benign and malignant, which has some reference value of clinical diagnose and therapy.

2020 Vol. 28　(9):　1490-1493 [Abstract]（ 346 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To explore the effect of post abortion care (PAC). Methods: 2000 healthy women who required abortion were randomly divided into observation group and control group from January 2016 to December 2017. The women in the observation group were given PAC, and the women in the control group were given routine propaganda and education. The menstrual recovery situation, contraceptive implementation rate, repeated abortion rate within 1 year after abortion were compared between the two groups. Questionnaire surveys were conducted before abortion and 14 days after abortion to compare the knowledge rate of contraceptive between the two groups. Results: The implementation rate of highly effective and longterm effective contraceptive measures after abortion of women in the observation group was 93.2%, which was significant higher than that (30.4%) of women in the control group (P＜0.05). The repeated abortion rate of women in the observation group within 1 year after abortion was 0.7%, which was significant lower than that (5.7%) of women in the control group (P＜0.05). The menstrual recovery time of women in the observation group after abortion was 25.4±3.4 days, which was significant shorter than that (32.4±4.2 days) of women in the control group (P＜0.05). The rate of reproductive health knowledge awareness after abortion of women in the observation group was 91.1%, which was significant higher than that (69.1%) of women in the control group (P＜0.05). Conclusion: PAC can significantly improve the implementation rate of highly effective and long-term effective contraceptive measures after abortion, can reduce the rate of repeated abortions within 1 year after abortion, can increase the awareness rate of contraceptive knowledge, and can enhance contraceptive awareness of women.

2020 Vol. 28　(9):　1498-1500 [Abstract]（ 550 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

Spontaneous abortion is one of the pathological pregnancies, and its etiology and pathogenesis are complicated. Some of the causes have been generally accepted. However, there are still 50% of spontaneous abortions with unknown causes, and its pathogenesis is still unclear. In recent years, researches have found that the MAPK signal pathway plays an important role in embryonic development, trophoblast cells invasion, and decidual immune microenvironment. The occurrence of pathological pregnancy may be greatly related to the abnormal MAPK signal pathway. Therefore, this article will review the relationship between MAPK signal pathway and spontaneous abortion, in order to provide theoretical evidences for the clinical prevention and treatment of spontaneous abortion.

2020 Vol. 28　(9):　1504-1508 [Abstract]（ 446 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )