To investigate the situation of sexual behavior and contraceptive knowledge of adolescents from school in Chongqing, and to provide evidences for reasonability contraction of adolescents. Methods: A survey was conducted in the adolescents from 2 schools of Chongqing by stratified random sampling and questionnaire, and the correlation analysis was done. Results: 978 qualified questionnaires in 1350 distributed questionnaires were returned and analyzed. Among 5.8% adolescents with sexual behavior, there were 0.5 (1.9%) adolescents with≤13 years old, 21(8.0%) adolescents with 14-15 years old, and 31(13.5%) adolescents with≥18 years old, and which had statistically significant different (P=0.000). There were significant different in the rate of sexual behavior between the adolescents from divorced family (25, 25.8%) and the adolescents (32, 3.6%) from non-divorced family (P=0.000). While there was no significant different in the sexual behavior rate among the adolescents with different gender, ethnicity, growing background, family income, or education level of guardian (P＜0.05). Conclusion: Sexual behavior occurrence of adolescents from school is relate to their age, and the adolescents from divorced families are more likely to have sexual behavior. Education on contraceptive knowledge for adolescents from school can improve their comprehension of contraception.

2021 Vol. 29　(1):　5- [Abstract]（ 633 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the effect of hyaluronic acid for preventing the adhesion of pelvic cavity after cesarean section, and to study its influence on the expressions of matrix metalloproteinase-9 (MMP9) and transforming growth factor-β1 (TGF-β1). Methods: From August 2017 to August 2019, 428 women who wanted cesarean section were selected and were divided into treatment group and control group (214 cases in each group) by random number table. The women in the control group were given conventional cesarean section, and the women in the treatment group were given hyaluronic acid during cesarean section. The pelvic adhesion rate, the levels of hematology indexes, such as RBC, hematocrit, and whole blood viscosity, and the levels of serum MMP-9 and MMP2, the levels of adhesion related factors, such as (FN), collagen IV (C IV), and transforming growth factor (TGF)-β1, and the levels of inflammatory factors (IL-6, IL-10, TNF-α) of women were compared between the two groups. Results: The incidence of pelvic adhesion of women in the treatment group (4.2%) was significant lower than that (11.2%) of women in the control group (P＜0.05). The RBC aggregation index level, hematocrit, and whole blood viscosity of women after operation in the two groups had increased significantly, and those of women in the treatment group were significant lower than those of women in the control group (all P＜0.05). After operation, the time of postoperative vaginal bleeding, the amount of postoperative vaginal bleeding, and the time of the menstruation recovery of the women in the treatment group were significant lower than those of women in the control group, but the thickness of endometrium of the women in the treatment group was significant higher (all P＜0.05). The levels of serum FN, CIV, TGF-β1 and other adhesion factors, and the levels of IL-6, IL-10, TNF-α and other inflammatory factors of women after operation in the two groups had increased significantly, and those of the women in the treatment group were significant lower (P＜0.05). The levels of MMP9 and MMP2 of the women in the two groups had increased significantly, and those of the women in the treatment group were significant higher (P＜0.05). Conclusion: Hyaluronic acid used during cesarean section can reduce the levels of inflammatory factors and adhesion related factors effectively, shorten the postoperative vaginal bleeding time and the menstrual recovery time, reduce bleeding volume, alleviate the pelvic adhesion, and improve the recovery of the endometrium. Hyaluronic acid has high safety and effectiveness.

2021 Vol. 29　(1):　12- [Abstract]（ 374 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To investigate the influence of laparoscopy combined with leuprolide acetate for treating infertility women with endometriosis (EMS) on their pregnancy outcomes. Methods: 80 infertility women with endometriosis were selected and were divided in to study group and control group (40 cases in each group) between March 2017 and March 2019. The women in the study group were given laparoscopic treatment combined with leuprolide acetate, and the women in the control group were given laparoscopic treatment. The clinical efficacy, the scores of menopausal symptoms (Kupperman), VAS score of pelvic pain, the level of serological indicator, and the rates of recurrence and pregnancy within 1 year of women were compared between the two groups. Results: The effective rate of women in the study group (95.0％) was significant higher than that (67.5%) of women in the control group. The scores of Kupperman and VAS of women in the study group (5.80±2.11 points and 1.59±0.22 points) were significant lower than those (8.52±3.84 points and 2.04±0.51 points) of women in the control group. The levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), serum matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), human epididymis protein (HEP), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199) of women in the study group were significant lower than those of women in the control group. The recurrence rate of women within 1 year in the study group (5.0%) was significant lower than that (25.0%) of women in the control group. The pregnancy rate of women within 1-year in the study group (45.0%) was significant higher than that (20.0%) of women in the control group (P＜0.05). Conclusion: Laparoscopy combined with leuprolide acetate for treating infertility women with endometriosis has high effectiveness, which can relieve clinical symptoms and pain, improve sex hormone levels, reduce the rate of recurrence, and increase the pregnancy rate.

2021 Vol. 29　(1):　21- [Abstract]（ 364 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the effect of goserelin acetate sustained-release implant combined with laparoscopic surgery for treating women with endometriosis. Methods: 80 women with endometriosis were selected and were randomly divided into 2 groups (40 cases in each group). These women had received laparoscopic surgery according to the r-AFS staging. The women in the study group were given goserelin acetate sustained-release implant 3.6 mg, 1 times every 4 weeks for 6 months, and the women in the control group were given received gestation three ketone 2.5mg, 1 times every 2 weeks for 6 months. The clinical effect of women was compared between the two groups. The levels of serum vascular endothelial growth factor (VEGF), matrix metalloproteinase-9/tissue inhibitor of metalloproteinase -1 (MMP-9/TIMP-1) of women in the two groups were detected before operation and 6 months after operation. The scores of visual analogue scale (VAS) and health-related quality of life assessed by SF-36 questionnaire of women in both groups were recorded. And the rates of recurrence and adverse reaction of women in both groups in 3 years after operation were oversexed. Results: The effective rate of women in the control group (75.0%) was significant lower than that (92.5%) of women in the study group (P＜0.05). 6 months after operation, there were no significant different in the serum VEGF level (158.41±56.28 ng/L vs. 119.63±47.13ng/L), MMP-9/TIMP-1 (1.35±0.25 vs. 1.14±0.23), physiological health score (64.20±12.81 points vs. 78.53±13.23 points), mental health score (69.14±13.26 points vs. 80.35±14.59 points), and VAS scores (1.21±0.46 points vs. 0.84±0.39 points) of women between the two groups (P＜0.05). No case with adverse reactions occurred in the study group. The recurrence rate of women in the control group in 3 years after operation (27.5%) was significant higher than that (10.0%) of women in the study group (P＜0.05). Conclusion: Goserelin acetate sustained-release implant combined with laparoscopic surgery for treating women with endometriosis has definite effectiveness, which can reduce the vascular invasion index levels and the recurrence rate, and improve the quality of life with high safety.

2021 Vol. 29　(1):　28- [Abstract]（ 308 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To analyze the effects of hysteroscopic electrotomy for treating women with endometrial polyps on their endometrial thickness, serum vascular endothelial growth factor (VEGF) level, and menstrual blood volume. Methods: 100 women with endometrial polyps were selected and were divided into two groups according to the random number table method from April 2015 to September 2018. The women in the observation group were treated with hysteroscopic electrotomy, and the women in the control group were treated with hysteroscopic curettage. After 12 months of followed up, the bleeding volume, operation time, hospitalization time, endometrial thickness, serum VEGF level, pictorial blood loss assessment chart (PBAC) scores, and the rates of recurrence and pregnancy of women were compared between the two groups. Results: There were no significant differences in intraoperative blood loss, operative time, and hospital stay time of women between the two groups (P＞0.05). After 3, 6, and 12 months of followed up, the endometrial thickness, serum VEGF level, and PBAC score of women in both groups had all decreased significantly, and those of women in the observation group were significant lower than those of women in the control group (P＜0.05). Within 12 months after operation, there were 3 (5.9%) cases with recurrence and 30 (60.0%) cases with pregnancy in the observation group, and there were 10 (20.0%) cases with recurrence and 28 (56.5%) cases with pregnancy in the control group. The recurrence rate of women in the observation group was significant lower than that of women in the control group (P＜0.05). Conclusion: Hysteroscopic electrotomy for treating women with endometrial polyps has high effectiveness, which has higher improvement degree of endometrial thickness, VEGF level, and PBAC score of women when compared to those of hysteroscopic curettage, and has less recurrence rate.

2021 Vol. 29　(1):　38- [Abstract]（ 294 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

 To explore the expression of FOXP3 mRNA and RORγt mRNA in peripheral blood of women with recurrent spontaneous abortion (RSA), and to study their diagnostic efficiency in clinical practice. Methods: From January 2018 to December 2019, 106 women with RSA were selected in group A, 39 healthy early pregnant women were selected in group B, and 42 healthy women were selected in group C. Real-time fluorescence PCR was used to determine the levels of FOXP3 mRNA and RORγtmRNA in peripheral blood of women in the three groups. Enzyme-linked immunosorbent assay was used to detect the levels of interleukin-6 and 7 (IL-6 and IL-7), and human thymus activation regulatory chemokine 17 (CCL17), CC chemokine receptor 4 (CCR4) of women in the three groups. ROC curves was drawn to analyze the value of FOXP3 mRNA and RORγt mRNA levels for diagnosing RSA. Results: The FOXP3 mRNA level of women in group A was significant higher than that of women in group C, but was significant lower than that of women in group B. The levels of RORγtmRNA, IL-6, and IL-7 of women in group A were significant higher than those of women in group B and C. The CCL17 and CCR4 levels of women in group A were significant lower than those of women in group C, but were significant higher than those of women in group B (all P＜0.05). ROC curve analysis showed that the area under the curve, the sensitivity, the specificity, and the accuracy of FOXP3mRNA level combined with RORγtmRNA level for diagnosing women with RSA were 0.962， 94.34%, and 92.18%, and 100%, which were all significant higher than those of FOXP3 mRNA level or RORγtmRNA level alone (P＜0.05). Conclusion: The abnormal expression of FOXP3 mRNA and RORγt mRNA in peripheral blood of women with RSA may be related to their immune disorders. The detection of FOXP3mRNA level combined with RORγtmRNA level has higher value for diagnosing RSA.

2021 Vol. 29　(1):　45- [Abstract]（ 299 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To analyze the influence of serum levels of alpha-fetoprotein (AFP), D-dimer and placenta growth factor (PLGF) on pregnancy outcomes of women with preeclampsia (PE). Methods: 330 women with PE were divided into group A (117 women with mild PE) and group B (213 women with severe PE) from January 2016 to September 2018. 30 normal pregnant women were selected in group C during the same period. The levels of serum AFP, D-dimer and PLGF of women in the three groups were detected, and ROC curve were drawn to analyze the efficacy of the levels of serum AFP, D-dimer and PLGF for predicting PE. Spearman correlation analysis was used to study the correlation between the levels of serum AFP, D-dimer and PLGF and disease condition, and to analyze the efficacy of serum AFP, D-dimer and PLGF levels for predicting the pregnancy outcomes of women with PE. Results: There was no significant difference in AFP level of women between women with and without PE (P＞0.05). The D-dimer level of women in group A and B was significant higher than that of women in group C, while PLGF level of women in group A and B was significant lower (P＜0.05). The AUC value of D-dimer level for predicting PE was the highest (387.51μg/L), which’s sensitivity and specificity were 80.6% and 100.0%, respectively. The AUC value of PLGF level for predicting the pregnancy outcomes was the second highest (217.33pg/ml), which’s sensitivity (96.7%) was significant higher than that of D-dimer level. There were no significant different in serum AFP and PLGF levels of women with different severity PE (P＞0.05), but the level of D-dimer of women in group A was significant lower than that of women in group B (P＜0.05). There was no correlation between AFP level and PE severity (r=0.093, P=0.078), D-dimer level was positively correlated with PE severity (r=0.796, P=0.000), and PLGF level was negatively correlated with PE severity (r=0.114, P=0.031). In the group A and B, the serum D-dimer level of women with complications or fetal adverse outcomes was significant higher than that of women without complications or fetal adverse outcomes (P＜0.05), and there were no significant differences in AFP and PLGF levels between the women with and without complications or fetal adverse outcomes (P＞0.05). D-dimer level had value for predicting the complications of women with PE. When the cut-off value of D-dimer level was 579.53 μg/L, the sensitivity and the specificity of D-dimer level for predicting the complications of women with PE were 80.9% and 61.9%, respectively. The levels of AFP and PLGF had no value for predicting pregnancy outcomes of women with PE. Conclusion: Among the serum AFP, D-dimer and PLGF levels, D-dimer level has the most significant value for predicting PE and is closest correlation with PE. The sensitivity of D-dimer level for predicting PE is high, but its specificity is low.

2021 Vol. 29　(1):　55- [Abstract]（ 299 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the relationship between the level of serum alanine aminotransferase (ALT) of pregnant women before pregnancy and their risk of gestational diabetes mellitus (GDM). Methods: A retrospective cohort study was conducted from the start of participating National Free Pre-pregnancy Check-up Project (NFPCP) through the entire pregnancy course until the time of GDM diagnosis as end point. People enrolled in this study were 1398 pregnant women who had participated in NFPCP and then established obstetric archives and gave birth at the Obstetrics Clinic of the Maternal and Child Health Hospital of Haidian District in Beijing from January 2013 to October 2017. Relevant information about diagnosis and treatment from baseline to GDM outcomes were collected retrospectively. Multivariable adjusted logistic regression models were used to evaluate the effect of the ALT level of these women before pregnancy on the risks of GDM, and the additive interaction effects between the BMI value of these women before pregnancy as modifiers and their ALT level was analyze. Results: Compared with the normal range (0-40 U/L) of ALT level of women before pregnancy, the odds ratio (OR) of GDM risk in the women with elevated serum ALT (ALT level > 40U/L) was 2.52 (95% CI 1.39-4.58) after multivariable adjustment. The average risk of GDM increased by 31.7% (P<0.001) for ALT increment of 10U/L within normal range comparing with ALT level<10 U/L. Moreover, the women who were overweight or obesity with elevated serum ALT level before pregnancy had significantly enhanced their risks of GDM about 6.72 times, compared with the women who had BMI value < 24 with normal ALT level, with an OR of 7.72 (95 % CI 3.20-18.60) in the stratification analysis. Finally, in the additive interaction analysis, positive interaction effects were found the BMI value of the women before pregnancy had forward additive interaction for the association between their serum ALT level and their GDM occurrence, which’s relative excess risk due to interaction (RERI) was 4.38. Conclusion: Elevated serum ALT level of pregnant women before pregnancy can significantly increase their risk of GDM, and positive correlation is found between serum ALT level increasing and the risk of GDM. In addition, overweight or obesity has a synergistic effect on the increasing risk of GDM caused by elevated ALT level of pregnant women before pregnancy.

2021 Vol. 29　(1):　65- [Abstract]（ 360 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

2021 Vol. 29　(1):　75- [Abstract]（ 399 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the effect of medroxyprogesterone combined with compound sophora flavescens injection on serum tumor markers levels and immune function of patients with endometrial carcinoma. Methods: From March 2017 to March 2019, 86 patients with endometrial cancer were selected and divided into observation group and control group (43 cases in each group) according to the method of random digital table. All patients were given the same chemotherapy regimen. In addition, the patients in the control group were treated with medroxyprogesterone acetate, and the patients in the observation group were treated with compound sophora flavescens injection on the basis of the treatment in the control group. The levels of the serum tumor markers and the relevant indexes of the immune function, and the value of living state related indexes, the scores of KPS, the treatment effect, and the occurrence rate of the adverse reactions of patients were compared between the two groups. Results: After treatment, the levels of serum human epididymal protein 4 (HE4), carcinoembryonic antigen (CEA), carbohydrate antigen 125(CA125) of patients in both groups had decreased significantly, but KPS score, body mass value, and daily food intake of the patients in both groups had increased significantly, and the changed degree of these indexes of patients in the observation group were significant more than those of patients in the control group. The levels of CD3, CD4, and CD4/CD8 of patients in the observation group had increased significantly after treatment, but the CD8 level had decreased significantly. The objective remission rate of patients in the observation group (76.1%) and clinical benefit rate (100.0%) of patients in the observation group were significant higher than those (51.2% and 88.4%) of patients in the control group, and the adverse reaction rate of patients in the observation group (30.2%) was significant lower than that (65.1%) of patients in the control group (all P＜0.05). Conclusion: Medroxyprogesterone combined with compound sophora flavescens injection for treating patients with endometrial carcinoma has a good clinical effect, which can obviously inhibit the growth of tumor, enhance the immune function, and improve the living conditions of patients with less side effects, so it is worthy of clinical application.

2021 Vol. 29　(1):　84- [Abstract]（ 385 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To analyze the effect of the multimodal analgesia by ropivacaine-parecoxib sodium for postoperative analgesia of women with tubal infertility after hysteroscopy. Methods: 112 patients with tubal infertility who underwent laparoscopic surgery were selected and divided into observation group (56 cases) and control group (56 cases) according to random number table method from January 2018 to January 2019. The women in both groups were injected 0.5% ropivacaine 10ml around each laparoscopic incision. The women in the observation group were given intravenous injection parecoxib sodium 40mg, and the women in the control group were given the same volume of 0.9% sodium chloride. Visual analogue scale (VAS) was used to evaluate the degree of pain of women in both groups at 1, 4, 12, 24 and 48 hours after operation. The restlessness score and Ramsay sedation score at 5 minutes and immediately after extubation, the dosage of remifentanil during operation, and the pressing times of patient-controlled intravenous analgesia (PCA) pump after operation, and the incidence of adverse reactions of women were compared between the two groups. Results: VAS scores at different time points after extubation of women in the observation group were significant lower than those of women in the control group. The scores of restlessness immediately and 5min after extubation of women in the observation group (1.38±0.71 points and 0.74±0.48 points) were significant lower than those (1.94±0.77 points and 1.43±0.45 points) of women in the control group. The scores of Ramsay sedation immediately and 5 min after extubation of women in the observation group (1.86±0.55 points and 2.65±0.72 points) were significant higher than those (1.55±0.58 points and 2.14±0.64 points) of women in the control group. The pressing times of PCA pump after operation of women in the observation group (2.75±1.48 times) was significant lower than that (5.39±1.58 times) of women in the control group (all P＜0.05). There were no significant differences in the dosage of remifentanil and the total incidence (14.3% vs. 21.4%) of postoperative adverse reactions, such as nausea and vomiting, respiratory depression, incision edema, and infection of women between the two groups (P＞0.05). Conclusion: Ropivacaine combined with parecoxib sodium multimodal analgesia can effectively reduce the pain state of patients after uterine and abdominal surgery, and can reduce the occurrence of postoperative adverse reaction, which is worthy of clinical popularization and application.

2021 Vol. 29　(1):　93- [Abstract]（ 319 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the effect of bionic aerocyst midwifery for treating women with scar uterus during vagina delivery, and to study its influence on their immunological stress. Methods: 360 pregnant women with scar uterus were selected as the research objects. They were divided into two groups (180 cases in each group) by random number table method from July 2016 to July 2019. The women in group A had accepted routine vaginal delivery, and the women in group B accepted bionic aerocyst midwifery vaginal delivery. The women in both groups who failed in vaginal delivery had transfer to cesarean section. The delivery situation and the levels of T-lymphocyte (CD4+, CD8+, CD4+/CD8+) before and after delivery, and the levels of noradrenaline (NE) and cortisol (COR) of women were compared between the two groups. Results: The total time of stages of labor, bleeding amounts during delivery, and 2h postpartum hemorrhage of women in group B were 7.45±3.15h, 108.65±32.14ml, and 186.14±52.75ml, respectively, which were significant less than those (9.68±2.97h, 140.56±38.54ml and 248.15±62.24ml, respectively) of women in group A, but the rate of vaginal natural delivery (93.3%) of women in group B was significant higher than that (81.1%) of women in group A (all P＜0.05). There were no significant different in the incidences of fetal distress, asphyxia, maternal uterine rupture, postpartum hemorrhage, puerperal infection, and neonatal status (weight and Apgar score) between the two groups. The hospitalization time and cost of women in group B was significant less than that of women in group A (P＜0.05). The levels of CD4+ and CD4+/CD8+ of women in the two groups at 12h and 48h postpartum had decreased significantly, but CD8+ level had increased significantly, the change of T lymphocyte level of women in group A was significant more than that of women in group B (P＜0.05). Conclusion: Bionic aerocyst midwifery used for women with scar uterus can improve the success rate of vaginal delivery and decrease their immunosuppression.

2021 Vol. 29　(1):　102- [Abstract]（ 328 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

 To investigate the levels of antimullerian hormone (AMH) and hyaluronic acid in follicular fluid of women with low ovarian reserve, and to study their relevant to the results of oocyte retrieval. Methods: 190 infertile women were selected and divided into group A (42 low ovarian reserve) and group B (148 women with normal ovarian reserve) according to the ovarian reserve function evaluation criteria from January 2018 to March 2019. The AMH and hyaluronic acid levels in follicular fluid of women were measured and compared between the two groups. Results: The AMH level (1.22±0.32ng/ml), the hyaluronic acid level (280.92±68.82g/L), and the number of eggs retrieval (3.3±0.7) of women in group A were all significant lower than those of women in group B (P＜0.05). The levels of AMH and hyaluronic acid in follicular fluid were positively correlated with the number of eggs retrieval (r=0.618 and 0.358, P＜0.05). The area under ROC curve of the levels of AMH and hyaluronic acid in follicular fluid for predicting low ovarian reserve were 0.934 and 0.808, respectively (P＜0.05), and which’s cut off values were 1.73 ng/ml and 305.50g/L, respectively. The sensitivity of the levels of AMH and hyaluronic acid in follicular fluid for predicting low ovarian reserve were 91.2% and 82.5%, and the specificity of them were 90.0% and 78.0%, respectively. Conclusion: The levels of AMH and hyaluronic acid in follicular fluid of women with low ovarian reserve have certain relevant to their oocyte retrieval, which has some application value for predicting ovarian reserve function.

2021 Vol. 29　(1):　110- [Abstract]（ 373 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

2021 Vol. 29　(1):　118- [Abstract]（ 278 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the expression of antisense non-coding RNA in the long non-coding RNA (lncRNA) INK4 locus (ANRIL) and vascular endothelial growth factor (VEGF) in villi of women with unexplained recurrent spontaneous abortion (URSA). Methods: 62 women with URSA were selected in observation group from August 2017 to June 2019, and 62 health women with abortion because of unwanted pregnancy were selected in control group. Fresh placental villi of women in the two groups were collected, and the expression levels of lncRNA ANRIL and VEGF mRNA in villi were detected by real-time fluorescence quantitative PCR (qRT-PCR). Pearson method was used to analyze the correlation between the lncRNA ANRIL level and the VEGF mRNA level in the villi. Multivariate logistic regression analysis was used to analyze the influencing factors of the occurrence of URSA. Results: The expression levels of lncRNA ANRIL (0.74±0.20) and VEGF mRNA (0.30±0.09) in the villi of women in the observation group were all significant lower than those (1.00±0.25, 1.00±0.18) of women in the control group (P＜0.05). LncRNA ANRIL level was significantly positively correlated with VEGF mRNA level (r=0.484, P＜0.05). The lncRNA ANRIL and VEGF mRNA expression levels were protective factors affecting the occurrence of URSA (P＜0.05). Conclusion: The down-regulated of expression levels of lncRNA ANRIL and VEGF in the villi of women with URSA is closely related each other significantly, which may jointly affect the occurrence of URSA.

2021 Vol. 29　(1):　126- [Abstract]（ 394 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

To explore the associated risk factors, clinical manifestations, diagnosis and treatment of rare ectopic pregnancy (REP). Methods：The clinical data of 3 women with REP from China-Japan Friendship Hospital were analyzed retrospectively, which included the medical history, auxiliary examination, and the diagnosis and treatment. The related literatures on REP were also reviewed. Results: All of these women were given preoperative surgical exploration and were conformed as REP by intraoperative findings and postoperative pathology. The serum β-HCG level had decreased gradually to normal range after operation followed up. Conclusion: The emergency treatment of childbearing age women should be alerted to the possibility of ectopic pregnancy in clinical practice. Early diagnosis and treatment of women with ectopic pregnancy can reduce the occurrence of complications.

2021 Vol. 29　(1):　134- [Abstract]（ 283 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the situation of chromosomal karyotype abnormality based on gene chip analyzed of fetal malformation after ultraphonic screening. Methods: From November 2016 to October 2019, the data of 312 pregnant women who had experienced gene chip technique because of their fetal malformation after ultraphonic screening were collected retrospectively. The results of fetal chromosome gene chip and karyotype analysis of these women were statistically analyzed. Results: Among the fetus of these 312 pregnant women, there were 65 cases with neurological abnormalities, 57 cases with thickened NT/NF, and 45 cases with cardiovascular abnormalities after ultrasound screening. There were 63 abnormal case diagnosed by gene chip technique, and the detection rate of multiple malformations was the highest (54.6%). Among 260 cases with successful karyotype analysis, there were 29 cases with abnormal chromosome karyotype, and the detection rate of tumor (36.8%), the multiple malformation rate (30.0%) was the highest, which included 2 cases with 47, XN, + mar, 1 case with balanced translocation, 1 case with roche translocation, and 1 case with sex chromosome abnormal. There were 23 cases with karyotype abnormalities, which were consistent with the results of gene chip technique. 1 case with sex chromosomal mosaic by gene chip technique was confirmed by cerotype analysis. Conclusion: Gene chip technique can improve the detection rate of fetal malformation chromosome abnormality, and the detection rate of gene chip technique is higher than that of chromosome karyotype.

2021 Vol. 29　(1):　143- [Abstract]（ 294 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the correlation between TORCH infection and the lower genital tract infection of women during the second and the third trimester of pregnancy and the occurrence of birth defects. Methods: 3,594 pregnant women who had accepted TORCH examination were enrolled in this study from February 2015 to January 2019. According to the results of TORCH examination, these women were divided into group A (254 women with TORCH infection) and group B (3340 women without TORCH infection). All these women were followed up to delivery, and birth defects of their newborns were recorded. The rate of birth defects was compared between the two groups. The correlation between TORCH infection and birth defects was analyzed. Results: Among these 3594 pregnant women, there were 254 (7.07%) cases with TORCH infection, which included the highest infection rate of CMV was 3.53%, and then followed by that (1.53%) of TOX infection, and the other infections were low. Among 3594 newborns, there were 49 cases with birth defects, which included 44 cases with single malformation and 5 cases with multiple malformations, and the total incidence of birth defects was 13.63‰. The incidence of congenital heart disease (5.56%) was the highest, then followed by cleft lip and palate (3.90%), finger/toe malformation (1.67%), spina bifida (1.39%), and external ear malformation (1.11%). The incidence of birth defects of newborns in group A (14.96%) was significant higher than that (0.33%) of newborns in group B (P＜0.05). The incidence of congenital heart disease of newborns was positively associated with the infections of CMV, TOX, RV, and HSV of the pregnant women (r>0，P＜0.05), but had no correlation with other infections (P＞0.05). The incidence of cleft lip and palate was positively correlated with CMV infection (r>0，P＜0.05), but had no correlation with the infections of TOX, RV and HSV, and other infections (P＞0.05). The incidences of finger/toe deformity, spina bifida, and ear deformity were not correlated with TORCH infection (P＞0.05). Conclusion: The infections of CMV, TOX, RV, and HSV of pregnant women are associated with the congenital heart disease of their newborns, and the infection of CMV is associated with congenital cleft palate of their newborns. It suggests that TORCH infection examination should be paid attention to in clinical practice, and prevention and treatment of TORCH infection for women should be strengthen to reduce the occurrence of birth defects.

2021 Vol. 29　(1):　149- [Abstract]（ 270 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

2021 Vol. 29　(1):　156- [Abstract]（ 256 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the value of non-invasive prenatal genetic testing (NIPT) for diagnosing prenatal fetal abnormal chromosome of advanced pregnant women. Methods: From September 2018 to January 2020, a retrospective analysis was made on 984 advanced pregnant women who volunteered to undergo NIPT test. Amniocentesis and chromosome karyotype analysis were performed in women with abnormal chromosome detected by NIPT. The pregnancy outcomes of these advanced pregnant women were followed up by telephone. Results: There were 14 (1.42%) pregnant women with chromosomal abnormalities by NIPT, which included 4 cases with trisomy 21, 3 cases with trisomy 18, 2 cases with trisomy 13, 3 cases with abnormal sex chromosome, and no other abnormal chromosomes. The positive predictive value of NIPT for screening fetal abnormal chromosome were 75.0%, 66.7%, 100%, 75.0%, and 0%, respectively. After followed up, 9 women in 10 women with fetal chromosome abnormality identified by antenatal diagnosis had experienced termination of pregnancy, which included 3 cases with fetal trisomy 21 (47，XN，+21), 2 cases with fetal trisomy 18 (47，XN，+18), 2 cases with fetal trisomy 13 (47，XN，+13), 1 case with fetal abnormal X chromosome (45，X), and 1 case with fetal abnormal Y chromosome (47，XXY). 1 women with fetal abnormal X chromosome (47，XXX) continued to pregnancy, which’s newborn was normal. All 4 women with fetal normal chromosome (46, XN) by antenatal diagnosis had delivered normal newborns. Conclusion：NIPT has good screening value for advanced pregnant women, but it suggests that pregnant women with suspected fetal abnormal chromosome should be given interventional prenatal detection, so as to avoid false positive or unnecessary induced labor.

2021 Vol. 29　(1):　164- [Abstract]（ 398 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To analyze the situation of endometrial polyps of infertility women with endometriosis (EM), and to study the pathological characteristics of EM. Methods: 67 infertility women with EM were selected in observation group, and 82 infertility women without EM were selected in control group from January 2016 to January 2017. The incidence of endometrial polyps of the women was compared between the two groups. In the observation group, the incidence of endometrial polyps of the women with different revised American fertility society (r-AFS) stages and the clinical pregnancy rate after treatment of the women were analyzed. The pathological characteristics of endometrial polyps of the infertile women with EM were also analyzed. Results: The incidence of endometrial polyps (31.3%) and the recurrence rate of endometrial polyps (11.9%) of the women in the observation group were significant higher than those (12.2% and 2.4%) of the women in the control group (P＜0.05). The incidence of endometrial polyps of the women with r-AFSⅠstage in the observation group was 17.7%, but their endometrial polyps had no recurrence. The incidence of endometrial polyps of the women with r-AFS Ⅱ stage in the observation group was 32.0%, and the recurrence rate of their endometrial polyps was 8.0%. The incidence of endometrial polyps of the women with r-AFS Ⅲ stage in the observation group was 40.0%, and the recurrence rate of their endometrial polyps was 20.0%. The incidence of endometrial polyps of the women with r-AFS Ⅳ stage in the observation group was 40.0%, and the recurrence rate of their endometrial polyps was 30.0% . There were no significant differences in the incidence and recurrence rate of endometrial polyps among the women with different r-AFS stages in the observation group (P>0.05). The incidence of endometrial polyps of the women with ovarian EM was 25.0%, and the recurrence rate of their endometrial polyps was 10.0%. The incidence of endometrial polyps of the women with peritoneum EM was 29.0%, and the recurrence rate of their endometrial polyps was 9.7%. The incidence of endometrial polyps of the women with DIE EM was 43.8%, and the recurrence rate of their endometrial polyps was 18.8%. There were no significant differences in the incidence and recurrence rate of endometrial polyps among the women with different pathological types of EM (P>0.05). Conclusion: The infertility women with EM have a high risk of endometrial polyps, and surgical treatment endometrial polyps timely can improve their pregnancy rate. It is suggested that early diagnosis and treatment for infertility women with EM should be conducted in clinical practice.

2021 Vol. 29　(1):　171- [Abstract]（ 272 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the effects of chemotherapy on the vaginal microecology of women after initial surgery of endometrial cancer, and to analyze its relationship with vaginal stump infection. Methods: The clinical data of 64 women with endometrial cancer surgical who had undergone postoperative chemotherapy (in observation group) and 64 women with endometrial cancer surgical who had not undergone postoperative chemotherapy (in control group) from January 2012 to March 2013 were retrospectively analyzed. The levels of tumor markers, such as carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), the situation of vaginal microecosystem, and the rate of vaginal stump infection of women before operation and 6 months after operation were compared between the two groups. The 5-year overall survival rate and tumor-free survival rate of women in the two groups were recorded. The survival curve drawn by KaplanMeier method was used for evaluating postoperative survival situation of women in the two groups. Results: 6 months after operation, the serum levels of CA125 and CA199 had decrease significantly, and those of women in the observation group were significant lower than those of women in the control group (P＜0.05). 6 months after operation, the abnormal rate of vaginal cleanliness (28.1%), pathogen infection rate (20.3%) and incidence of vaginal stump infection (17.2%) of women in the observation group were all significant higher than those (12.5%, 7.8%, and 4.7%) of women in the control group (P＜0.05). 5 years after surgery, the overall survival rate (90.6%) and the disease-free survival rate (81.3%) of women in the observation group were both significant higher than those (76.6 % and 65.6%) of women in the control group (P＜0.05). Conclusion: Chemotherapy after initial surgery of en dometrial cancer can destroy the vaginal microecological balance and increase the risk of vaginal stump infection, but chemotherapy can control long-term recurrence and metastasis of endometrial cancer, and prolong the survival time, and it is benefit for the long-term prognosis of women with endometrial cancer. It suggests that the prevention and control of vaginal microecological damage after chemotherapy should be paid attention to in clinical practice.

2021 Vol. 29　(1):　181- [Abstract]（ 383 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the value of transvaginal color Doppler ultrasound (TVCDS) combined with HE4 and microRNA-21 levels for diagnosing endometrial carcinoma early. Methods: From March 2017 to January 2019, 91 patients with early endometrial cancer confirmed by pathological examination were selected in group A, and 86 patients with benign endometrial lesion confirmed by pathological examination after elective surgery were selected in group B. All patients were examined by TVCDS and their serum HE4 and microRNA-21 levels were detected before operation. The images by TVCDS of the patients in the two groups were observed. The value of TVCDS, and HE4 and microRNA-21 levels for diagnosing endometrial cancers early were evaluated based on the pathological biopsy results. Results: The results of TVCDS showed that the main features of early endometrial cancer were the enlargement of uterine morphology, interruption of hypoechoic halo between the serosa and the endometrium of uterus, lesion invasion of endometrum and myometrium of uterus, abundant signals and proliferation of neovascularization. There was significant difference in the blood flow signals of lesion of the patients between the two groups (P<0.05). The blood flow signals of lesion of the patients in group A were mostly dendritic or reticular, while those of the patients in group B were mostly punctate or short rod. The endometrial thickness, serum HE4 and microRNA-21 levels of the patients in group A were significant higher than those of the patients in group B, while the pulsation index and resistance index of the patients in group A were significant lower (P<0.05). The specificity and the sensitivity of TVCDS for diagnosing
endometrial carcinoma were 80.4% and 83.5%, respectively. The critical value, the specificity, and sensitivity of HE4 level for diagnosing endometrial carcinoma were 71.35 pmol/L, 78.3%, and 85.9%, respectively. The critical value, the specificity, and sensitivity of miR-21 level for diagnosing endometrial carcinoma were 1.32, 85.7%, and 88.4%, respectively. The specificity, the sensitivity, and Jorden index of TVCDS combined with serum HE4 and MiR-21 levels for diagnosing endometrial carcinoma were 95.1%, 94.5%, and 0.899, respectively, which were significant higher than those of TVCDS, serum HE4 level, or the MiR-21 level alone (F=15.382, P<0.05). Conclusion: The HE4 and miR-21 levels of patients with early endometrial carcinoma are both increase, and TVCDS combined with serum HE4 and MiR-21 levels for diagnosing endometrial carcinoma can increase the diagnostic efficiency of early endometrial carcinoma.

2021 Vol. 29　(1):　189- [Abstract]（ 367 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To screen genes related to azoospermia by exome sequencing technology, and to enrich male infertility gene pool. Methods：Peripheral blood of 20 patients with azoospermia was collected, and DNA was extracted from their peripheral blood. DNA libraries were constructed by hybrid capture methods, and highthroughput sequencing technology was used to detect the exon regions and flanking contents of 20099 genes in the human exome subregion (20bp), the sequencing data was compared with the human genome hg19 reference sequence, and the mutant genes were screened. The mutation sites were verified by Sanger sequencing. Results：A total of 43 mutation sites of 26 genes were screened out, and 15 autosomal recessive single mutation sites and 13 mutation sites related to sperm motility were excluded. The remaining 15 mutation sites of 11 genes may be related to the disorders of spermatogenesis, which included 5 genes, such as FAM71B, STARD9, CLTCL1, PCBP3, S100PBP, were high expression in testicular tissue. And 6 genes including SYCE3, EFCAB6, DDX4, KDM5D, RGS22, and MTL5 could be related to spermatogenesis disorders. Conclusion：The genes that may affect male infertility have be screened in this research, which can provide evidence for the genetic diagnosis of male infertility.

2021 Vol. 29　(1):　198- [Abstract]（ 383 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

With the development of the antineoplastic treatments, the survival rate of cancer patients has been greatly improved, so fertility preservation of these patients has been paid more attention to by physician and patients. At present, the effective methods of the fertility preservation for the women with malignant tumors include oocytes cryopreservation, embryos cryopreservation, ovarian transposition, ovarian tissue cryopreservation, and transplantation, and uterine fixation. This paper discusses the methods of the fertility preservation for the women with malignant tumors.

2021 Vol. 29　(1):　207- [Abstract]（ 231 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )