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Chinese Journal of Family Planning

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  • 2021 Volume 29 Issue 2
    Published: 15 February 2021
      
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  • The effects of exercise and dietary intervention on pregnancy outcomes in overweight or obese women：a Meta-analysis
    Ren Lijie,Li Qi,Zhou Jing,Bai Xue,Yang Yan
    2021, 29(2): 216.
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    To study the effects of exercise and dietary intervention on gestational diabetes  in overweight or obese women by Metaanalysis.Methods: The Cochrane Library , PubMed, EMbase, CNKI and Wanfang database were retrieved from the establishment of the library to May 2019 on exercise and dietary interventions for gestational diabetes in overweight and obese women. Two investigators rigorously evaluated the quality of the literature 、extracted the data and used the Revman 5.3 software for Metaanalysis of randomized controlled trials that met the criteria.Results: Ten articles were included, including 5436 subjects. Compared with routine care, exercise and dietary intervention did not reduce the incidence of gestational diabetes（RR= 0.98，95%CI=0.87-1.11，p=0.77） and the incidence of cesarean section（RR=0.94 ，95%CI=0.87-1.02，p=0.12） in overweight and obese women, but  reduced the incidence of giant children （RR=0.83 ，95%CI=0.730.94，p=0.004） and the weight gain during pregnancy（MD=0.69，95%CI=（-1.29-0.09），P=0.02）.Conclusions: Because of the intervention duration or the poor compliance of pregnant women, the exercise and diet intervention started after pregnancy could not prevent the occurrence of gestational diabetes or reduce the rate of cesarean section in overweight or obese women.For overweight or obese childbearing women, clinical staff should give them prepregnancy health counseling to effectively improve their pregnancy outcome.
  • Effect and mechanism of BSYQHX prescription on ovarian reserve function of rats
    YIN Yan1，JIN Zhichun2，YANG Yaqin1，TANG Na1，LI Hui1
    2021, 29(2): 221.
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    To observe the effect and mechanism of BSYQHX prescription on ovarian reserve function of model rats with declined ovarian reserve (DOR). Methods: The DOR model rats were developed, and they were randomly divided into six groups (8 rats in each group). The rats in group A were given normal 15 ml/kg, the rats in group B were given tripterygium glycosides 50 mg/kg, the rats in group C were given estradiol valerate 0.2mg/kg, and the rats in group D1 were given BSYQHX prescription 4.31g/kg, the rats in group D2 were given BSYQHX prescription 8.62g/kg, and the rats in group D3 were given BSYQHX prescription 17.25g/kg. The vaginal smear in estrous cycle and the change of ovarian histomorphology of the rats in the 6 groups were observed under microscope. The follicle stimulating hormone (FSH) , luteinizing hormone (LH), levadiol (E2), and anti mullerian hormone (AMH) of the rats in the 6 groups were measured by ELLels, the expression of VEG and its receptor protein levels of the rats in the 6 groups were measured by immunohistochemistry, and the expression of VEGFmRNA in ovarian tissue of the rats in the 6 groups was detected by RT-PCR. Results: The duration of estrus cycle of the rats in group B had prolonged significantly, and the levels of ovarian and uterine indexes of the rats in group B had decreased significantly (P＜0.01). The serum levels of FSH and FSH/LH value of the rats in group B had increased significantly (P＜0.01), but the levels of AMH and E2 of the rats in group B had decreased significantly (P＜0.01). The levels of the ovarian and uterine indexes of the rats in group D3 were significant higher than those of the rats in group in group B (P＜0.01). The FSH level and FSH/LH value of the rats in group D2 and group D3 had been decreased significantly, and the E2 and AMH levels had been increased significantly (P＜0.01). The level of FSH of the rats in group D2 and group D3 was significant lower than that of the rats in group C group (P＜0.01). The level of E2 in D1 and D2 groups was significant higher than that of the rats in C group (P＜0.01). The levels of VEGF, its receptor Flt-1, and KDR protein of the rats in group B were significant lower than those of the rats in group A (P＜0.05). The expression levels of Flt-1 and KDR protein levels and their corresponding mRNA expressions of the rats in groups D1, D2 and D3 were significant higher than those of the rats in group B (P＜0.01), but which had no statistical significant different from those of the rats in group C (P>0.05). Conclusion: BSYQHX prescription can effectively improve the DOR of rats, reduce their FSH serum level and FSH/LH value, increase the levels of their E2 and AMH, and promote the neovascularization of their ovarian tissue. The mechanism may be related to the up regulation of VEGF/VEGFR protein and related to its corresponding mRNA expression.
  • Analysis on the pregnancy age trend of primiparas with planning pregnancy in rural areas in Minle county of Gansu province from 2013 to 2019
    SHI Shengzhen1, HAN Chunying2, MU Rongwei2, ZENG Shuai2, WANG Long2, YANG Ying3, MA Xu3
    2021, 29(2): 226.
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    To analyze the pregnancy age trend of primiparas with planning pregnancy in rural areas, and to provide data support for reducing the risk of adverse pregnancy outcomes and for improving reproductive quality. Methods: 2606 rural Han Chinese women who participated in the National Free Pre-pregnancy Health Examination in Minle County of Gansu Province and got pregnant in 2013-2019 were included in this study. The distribution of pregnancy age in different years was described, and the simple linear regression and generalized regression models were used to test the annual change of pregnant age. The marginal effects model was used to analyze the pregnant age difference of primiparas between 2013-2015 or 2017-2019 and 2016, and the simple linear regression model was used to test annual change of pregnant age. Results: The pregnant age of participants has increased from 23.33 (95% CI: 23.14-23.52) years old in 2013 to 26.05 (95% CI: 25.68-26.42) years old in 2019, P trend <0.001. And the average pregnant age had increase 2.72 (95% CI: 2.30-3.14) years old in these 7 years, with an annual increasing of 0.26 (95% CI: 0.21-0.32) years old. The marginal effects also showed that comparing that in 2016, the difference of pregnant age had increased from-0.78 (95% CI: -1.17-0.39) years old in 2013 to 0.87 (95% CI: 0.43-1.32) years old in 2019, P trend <0.001. The absolute difference of average pregnant age was 1.65 years old, with an annual increasing of 0.26 (95% CI: 0.21-0.31) years old. Conclusion: The pregnant age of rural primipara in Minle county is increasing year by year, it is suggests that the pregnancy of advanced age women should be strengthened by maternal and child health workers for reducing the rate of adverse pregnancy events.
  • Investigation and analysis of pre-pregnancy eugenics health check of pregnant women and their pregnancy outcomes
    LIU Li, TANG Ting
    2021, 29(2): 230.
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    To investigate the influence of pre-pregnancy eugenics health examination of pregnant women on their pregnancy outcomes. Methods: 1037 women were selected and were divided into 524 cases in experimental group (women with pre-pregnancy eugenics health examination) and 513 cases in control group (women without pre-pregnancy eugenics health examination) from 2017 to 2018. Questionnaires were used to investigate the knowledge and pregnancy outcomes of these women in the two groups. The influence factor of the women participated in pre-pregnancy eugenics health examination was analyzed. Results: The knowledge-related scores and the rate of normal pregnancy outcomes of the women, and the scores of newborns in the experimental group were significant higher than those in the control group, while the rate of adverse pregnancy outcomes of the women in the experimental group was significant lower (P＜0.05). There were significant differences in the rates of planning pregnancy, and not knowing, no need and no time for, and the participation rate of prepregnancy health eugenics examination between the women with adverse pregnancy outcomes and the women with normal pregnancy outcomes (P＜0.05). Logisitic analysis showed that unplanned pregnancy, and not knowing, no need and no time for pre-pregnancy health eugenics examination were the risk factors that affecting participation pre-pregnancy health eugenics examinations of women, while previous pre-pregnancy health eugenics examination was a protective factor. Conclusion: The publicity and education of pre-pregnancy eugenics health examination of pregnant women should be strengthened, and their positivity of participation should be improved, and pregnancy should be planned for reducing the occurrence of adverse pregnancy.
  • Analysis of external quality assessment of laboratories of national free pre-pregnancy eugenics examination program from 2012 to 2018 in Yunnan province
    CHEN Juanjuan, XIE Zhenyuan, ZHAO Qin, SUN Hong, YANG Ruwen, YE Hanfeng
    2021, 29(2): 234.
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    To improve the quality of clinical laboratory examination in different levels of maternity and child care agency of Yunnan province, and to provide objective evidence for developing the formulation of related management programs. Methods: From 2012 to 2018, the data of external quality assessment of national free pre-pregnancy eugenics examination program in Yunnan province, such as whole blood cell count, routine biochemical, infectious markers, and urine chemical analysis were collected and statistically analyzed. Results: In the past 7 years, the scores of external quality assessment had improved significantly. The qualified rate of participating institutions had significantly improved from 56% to 100%, and the excellent rate of participating institutions had significantly increased from 8% to 70%. The qualified rate of each item of laboratory quality assessment had improved significantly, which included that of routine biochemical had increased significantly from 51% to 97%, that of whole blood cell count had increased significantly from 81% to 99%, that of infectious markers had increased significantly from 84% to 96%, and that of urine chemical analysis had increased significantly from 90% to 100%. Conclusion: Through the external quality assessment, the accuracy of the test results of national free pre-pregnancy eugenics examination program in different levels of maternity and child care agency has increased effectively, and which’s detection level has also improved significantly.
  • Analysis on the talents cultivation of reproductive health service and management guided by social needs
    ZHOU Wei
    2021, 29(2): 237.
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    To explore the current situation and needs of reproductive health personnel training, so as to provide data support for strengthening the training of reproductive health service and management professionals. Methods：A survey of reproductive health enterprises and employees was conducted. Results： 94.1% of enterprises need reproductive health services and management talents in the next three years. The enterprise's demand for relevant professional positions was: reproductive health consulting service (91.2%), eugenic and good childbearing service (91.2%), and maternal and child health care service (73.5%). The relevant professional courses and skills required by practitioners were as follows: obstetrics and gynecology (57.5%), maternal and child health care (42.5%), knowledge of laws and regulations (57.5%), and guidance on healthy birth and childbearing (64.4%). Conclusion: Reproductive health enterprises have a great demand for professional talents, and the employees are in urgent need of reproductive health professional knowledge, skills and laws and regulations. We can establish a unified and standardized reproductive health service and management standards, establish a convergence mechanism between national vocational training of reproductive health consultants and vocational education professionals, and can explore professionals oriented by social needs to promote the training of reproductive health service and management professionals.
  • Clinical effect of different operation schemes for treating women with type Ⅱ cesarean scar pregnancy
    LIU Shuiping1, SUN Ni2, LI Zhenzhen1
    2021, 29(2): 240.
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    To compare the clinical effect of different schemes combined with hysteroscopic curettage for treating women with type Ⅱcesarean scar pregnancy (CSP). Methods: 96 women with type Ⅱ CSP were treated with hysteroscopic curettage were included and were divided into two groups (48 cases in each group) from February 2018 to January 2019. The women in the control group were treated by hysteroscopic curettage after uterine artery embolization, and the women in the observation group were treated by hysteroscopic curettage after mifepristone pretreatment. The conditions of operation, postoperative recovery, and βhCG level decline situation, and complications rate of the women were compared between the two groups. Results: There were no significant differences in the operative time, the intraoperative blood loss, the rate of transfer to laparotomy, and the hysterectomy rate of women between the two groups (P>0.05). The vaginal bleeding time (18.7±4.7d), the menstrual recovery time (34.1±6.5d), and the time of β-HCG level recovery to normal (26.8±6.0d) of women in the observation group were significant shorter than those of women in the control group (P＜0.05). After treatment, the rate of β-HCG level decreased of women in both groups had increased significantly with time extension, but the degreeβ-HCG level decline of women in the observation group was significant more than that of women in the control group (P＜0.05). The total incidence of complications of women (29.2%) in the observation group was significant higher than that (12.5%) of women in the control group (P＜0.05). Conclusion: Mifepristone pretreatment or uterine artery embolization combined with hysteroscopic curettage for treating women with type Ⅱ CSP both have effectiveness, but the recovery time of the women after mifepristone pretreatment is shorter. The prevention and treatment of the complications of these women should be paid more attention to.
  • Association of the gene polymorphisms of progesterone receptor of women with their susceptibility of recurrent miscarriage
    XU Wei, JIANG Yingying
    2021, 29(2): 243.
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    To investigate association of the gene polymorphism of progesterone receptor (PGR) of women with their susceptibility of recurrent miscarriage. Methods: 110 pregnant women with recurrent miscarriage were enrolled in group A from January 30, 2016 to May 30, 2019, and 110 normal pregnant women were selected in group B during the same period. The polymorphisms of gene rs590688 and rs1942836 of PGR of these women were detected, and their correlation with recurrent abortion of women was analyzed. Results: The genotype frequencies of gene rs590688, gene rs1942836 CC and gene rs1942836 TC, and the allele frequencies of gene rs590688 and gene rs1942836 C of women in group A were significant higher than those of women in group B, but the genotype frequency of gene rs1942836 TT of women in group A was significant lower (all P<0.05). The risk of recurrent abortion of women with genotype rs590688 CC (OR=2.05, P<0.05), and with genotype rs1942836 TC and CC (OR=1.35, 2.88, P<0.05) had increased significantly. Conclusion: The polymorphisms of gene rs590688 and rs1942836 of PGR of women are significantly associated with their susceptibility of recurrent miscarriage, and the women with genotype CC has an increased risk of recurrent miscarriage.
  • Effects of high intensity focused ultrasound combined with gnrrho-a on serum CA125, PGF2a and adiponectin levels of patients with adenomyosis
    WANG Xiaolan1, ZHAO Hong2, CHEN Xing3
    2021, 29(2): 246.
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    To study the effects of high intensity focused ultrasound combined with gnrrho-a (GnRH-a) on the serum CA125, PGF2a and adiponectin levels of patients with adenomyosis. Methods: 122 patients with adenomyosis were selected and divided into observation group (60 cases) and control group (62 cases) by randomized double-blind controlled trial from June 2018 to June 2019. The patients in the control group were given high intensity focused ultrasound, and the patients in the observation group were given high intensity focused ultrasound combined with GnRH-a. Dysmenorrhea and menstrual volume scores, uterine volume and lesion volume, and the changes of serum CA125, PGF2a and APN levels of the patients before and 6 months after surgery were compared between the two groups. The influence of high intensity focused ultrasound or combined with GnRH-a for treating the patients on their ovarian functional parameter, such as serum FSH, LH, and E2 levels was analyzed. The recurrence rate and incidence of adverse reactions of the patients were observed 6 months after surgery. Results: After operation, the dysmenorrhea score (1.83±0.23 points), menstrual volume score (1.57±0.16 points), uterine volume (159.4±34.3 cm3), and lesion volume(18.46±5.32 cm3) of patients in the observation group were significant less than those of patients in the control group (P＜0.05). After operation, the serum CA125, PGF2a and APN levels of patients in the observation group were 22.32±3.42 U/ml, 237.54±54.38 pg/ml, and 8.15±2.04μg /ml, respectively, which had significant different from those (51.83±9.42 U/ml, 425.91±60.32 pg/ml, and 7.23±1.95 μg /ml, respectively) of patients in the control group (P＜0.05). The serum levels of FSH, LH and E2 of patients in the observation group were significant lower those of patients in the control group (P＜0.05). The recurrence rate (6.5%) and incidence of adverse reactions (62.9%) of patients in the observation group were significant lower that those (0% and 8.3%) of patients in the control group (P＜0.05). Conclusion: High intensity focused ultrasound combined with GnRH-αfor treating  patients with adenomyosis can effectively relieve their dysmenorrhea symptoms and menstrual blood volume, reduce their volume of the uterus and lesions, decrease the serum CA125 and PGF2a levels, and increase the serum adiponectin level, which is a safe and effective treatment.
  • Effect of intrauterine perfusion of autologous peripheral blood mononuclear cells of women with repeated implantation failure in IVF-ET on their pregnancy outcomes
    LEI Lina, ZHANG Yongyong, LU Lijuan
    2021, 29(2): 251.
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    To investigate the effect of intrauterine infusion of autologous peripheral blood mononuclear cells (PBMCs) of the women with repeated implantation failure (RIF) during in vitro fertilization and embryo transfer (IVF-ET) on their pregnancy outcomes. Methods: 80 infertility women with RIF were selected and were divided into two groups (40 cases in each group) by random number table method. The women in the two groups were treated by IVF-ET. The women in the study group had received autogenous PBMCs culture and intrauterine perfusion before embryo transfer, while the women in the control group had not received PBMCs intrauterine perfusion. The change of cytokines levels in intrauterine fluid of the women before and after PBMCs intrauterine perfusion in the study group was observed. The leukemia inhibitory factor (LIF) level, integrin αVβ3 level, and pregnancy outcomes of the women were compared between the two groups. Results: After intrauterine perfusion, the level of interleukin-6 (IL-6) in the secreta of cervix uteri of the women in the study group after PBMCs intrauterine perfusion was significant higher than that of the women in the control group (355.85±65.74ng/L vs. 94.80±16.69ng/L), but the level of TNF-α in the secreta of cervix uteri of the women in the study group was significant lower than that of the women in the control group (14.29±1.78ng/L vs. 17.20±1.86ng/L) (P＜0.05). There were no significant different in the levels of LIF and integrin αVβ3 in culture medium of embryo on D1 and D3 of women between the two groups (P>0.05), but the levels of LIF and integrin αVβ3 in culture medium of embryo on D5 of women in both groups had significantly increased, and which of women in the study group were significant higher than those of women in the control group (P＜0.05). There were significant differences in embryo implantation rate (32.5% vs. 12.5%) and clinical pregnancy rate (52.5% vs. 27.5%) of women between the two groups (P＜0.05), but the abortion rate (5.0% vs. 0%) of women had no significant different between the two groups (P>0.05). Conclusion: Intrauterine perfusion of autologous PBMCs of infertility women with RIF before embryo transfer can effectively improve their endometrial receptivity, can regulate Th1/Th2 immune balance, increase embryo implantation rate and pregnancy success rate, which can improve pregnancy outcomes.
  • Association between DNMT3L gene polymorphism of women with endometriosis and their infertility
    ZHANG Tong1, LI Haiping2, ZHANG Qi1, LIU Rong1, REN Xiaoli3
    2021, 29(2): 255.
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    To investigate the association between DNMT3L gene polymorphism of women with endometriosis and their infertility. Methods: During June 2016 to November 2018, 137 infertility women with endometriosis were selected in study group, and 137 healthy women were selected in control group during the same time. The polymerase chain reaction (PCR) was used to measure DNMT3L gene polymorphism. Genotype and allele frequencies were calculated by direct gene counting method, and the coincidence degree of Hardy-Weinberg (HWE) balance was evaluated by Pearson's goodness-of-fit chi-square statistics. Fisher's test was used to assess the differences of allele and genotype frequencies of the women between the study group and the control group. Results: There was no significant difference in HWE balance of genotype frequency of the women between the study group and the control group (P>0.05). In addition, there were no statistical significant differences in the rates of rs8129776 and rs7354779 gene polymorphism of the women between the two groups (P>0.05), while there were statistical significant differences in the rates of rs113593938 and rs2276248 gene polymorphism of the women between the two groups (P＜0.05). In the dominant and recessive genetic models of rs113593938 polymorphism, the OR and 95%CI of the study group were 0.37 and 0.18-0.79, and those of the control group were 2.69 and 1.23-5.88. In the dominant and recessive genetic models of rs2276248 polymorphism, the OR and 95%CI of the study group were 2.44 and 1.18-5.06, and those of the control group were 0.34 and 0.15-0.81. Conclusion: The gene polymorphism of rs8129776 and rs7354779 site of DNMT3L is not correlated with infertility of the women with endometriosis, but the recessive genetic model of rs113593938 and the dominant gene model of rs2276248 maybe correlated with infertility of the women with endometriosis.
  • Effect of western medicine combined with traditional Chinese medicine about promoting blood circulation and removing blood stasis for treating women with of uterine myoma and its influence on their serum ER and Bcl-2 protein levels
    JIANG Yan，HUANG Wenying，ZHAO Peiru，DU Jing
    2021, 29(2): 258.
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    To study the curative effect of western medicine combined with traditional Chinese medicine (TCM) about promoting blood circulation and removing blood stasis for treating women with of uterine myoma, and to study the influence on their levels of estrogen receptor (ER) and Bcl-2 protein. Methods: 100 women with uterine myoma were divided into two groups (50 cases in each group) from October 2017 to March 2019. The women in the control group were treated with conventional western medicine, and the women in the study group were treated with western medicine combined with TCM about promoting blood circulation and removing blood stasis. The clinical efficacy of the women was compared between the two groups. Results: After treatment, the level of interleukin-2 (IL-2) of the women in the study group was significant higher than that of the women in the control group, but the levels of ER and Bcl-2 of the women in the study group were significant lower. The uterine artery resistance index (0.9±0.2) of the women in the study group was significant higher than that of women in the control group, but the peak systolic velocity value (25.0±5.2 cm/s) and the minimum diastolic flow velocity value (5.5±0.9cm/s) of the women in the study group were significant lower. The total effective rate (94.0%) and the quality of life score (89.1±7.9 points) of the women in the study group were significant higher than those (80.0% and 77.2±7.0 points) of the women in the control group (all P＜0.05). Conclusion: Western medicine combined with traditional Chinese medicine about promoting blood circulation and removing blood stasis for treating women with uterine myoma can regulate the expression of ER, Bcl2 and IL2, can reduce the blood circulation of their uterus, and can improve their quality of life.
  • The effect of hormone replacement therapy for treating women with premenopausal symptom after premenopause hysterectomy
    WANG Ruoxi1, LIU Ying2, LIU Yongqi1
    2021, 29(2): 262.
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     To explore the influence of hormone replacement therapy for treating women with premenopausal symptom after premenopause hysterectomy on their postoperative sex hormone level, serum bone alkaline phosphatase (BALP) level, and body mass index (BMI) value. Methods: 76 women with premenopausal symptom after premenopause hysterectomy were selected and randomly divided into observation group and control group from February 2017 to March 2019. The women in the control group had received tibolone, and the women in the observation group had received estradiol valerate. The BMI value, sex hormone level, and serum BALP level, and other ovarian function index of women after 6 months treatment were compared between the two groups. Results: After 3 months of treatment, serum E2 level of women in the observation group (71.46±4.53pg/ml) was significant higher than that (65.80±5.42pg/ml) of women in the control group, but the levels of BALP and follicle stimulating hormone of women in the observation group (15.64±4.31μg/ml and 7.83±1.62mU/ml) were significant lower than those (21.57±5.74μg/ml and 9.25±1.78mU/ml) of women in the control group (all P＜0.05). The number of sinus follicle of women in the two groups had decreased significantly, but that of women in the observation group (7.65±1.23) was significant higher than that (5.51±1.04) of women in the control group (P＜0.05). There were no significant differences in the values of BMI and uterine volume of women between the two groups and between before and after treatment (P>0.05). Conclusion: Hormone replacement therapy can effectively improve the level of estrogen and bone metabolism of women with premenopausal symptom after premenopause hysterectomy, and can improve the decline of their ovarian function without increasing the incidence of obesity.
  • Influence of GnRH-α combined with levonorgestrel intrauterine device system for treating women with adenomyosis on their pain symptoms, serum MMPs  level, and recurrence rate
    WANG Lijuan1, TANG Chunhui2
    2021, 29(2): 266.
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    To investigate the influence of gonadotropin releasing hormone agonist (GnRH-α) combined with levonorgestrel intrauterine device system (LNG-IUS) for treating women with adenomyosis (AM) on their pain symptoms, serum matrix metalloproteinases (MMPs) level, and recurrence rate. Methods: 121 women with AM were randomly divided into control group (n=59) and observation group (n=62). The women in the control group were given LNG-IUS, and the women in the observation group were given GnRH-α combined with LNG-IUS. After 6 months of treatment, the efficacy, the endometrial thickness, the uterine volume, the dysmenorrhea visual analog scale (VAS) score, the pictorial blood loss assessment chart (PBAC) scores of women were compared between the two groups. The serum levels of cancer antigen 125 (CA125), the nerve growth factor (NGF), MMP-2, and MMP-9 of the women in the two groups were detected. Results: After 6 months of treatment, the total effective rate of the women in the observation group (91.9%) was significant higher than that (76.3%) of the women in the control group. The degree of the decline value of uterine volume, endometrial thickness, dysmenorrhea VAS score, and PBAC score, and the levels of serum CA125, NGF, MMP-2 and MMP-9 of the women in the observation group were significant more than those of the women in the control group (P＜0.05). The rate of vaginal bleeding time prolonged, the irregular bleeding rate, and the decyclizing rate of the women in the observation group were 3.2%, 4.8%, and 3.2%, respectively, which were significant lower than those (18.6%, 62.7%, and 22.0%, respectively) of the women in the control group (P＜0.05).
    After 12 months of followed up, the recurrence rate of the women in the observation group was 4.8%, which was significant lower than that (18.6%) of the women in the control group (P＜0.05). Conclusion: GnRH-α combined with LNG-IUS is safe and feasible for treating women with AM, it can significantly alleviate the symptoms of dysmenorrhea, reduce the rate of LNG-IUS expulsion rate and recurrence rate of AM with safety, which’s mechanism may be related to the regulation of the expression of MMPs.
  • Comparison of efficacy of different drugs combined with laparoscopic and hysteroscopic surgery for treating infertility women with early and middle stage of endometriosis
    GUO Chen, WANG Liqun
    2021, 29(2): 271.
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    To explore the clinical effect of different drugs combined with laparoscopic and hysteroscopic surgery for treating infertility women with I and II stage of endometriosis (EMs). Methods: The infertility women with I and II stage of endometriosis by intraoperative pathology after standard laparoscopic and hysteroscopic surgery were included in the study from January 2016 to January 2018. These women were randomly divided into two groups according to different postoperative medication. The women in group A had received drospirenone II tablets for three months and the women in group B had received gestrinone tablets for three months. Postoperative followed up was conducted for 1-1.5 years to compare the improvement of postoperative clinical symptoms and pregnancy outcomes of the women in the two groups. Results: The postoperative CA125 level and VAS scores of the women in the two groups had decreased significantly (P<0.05), but which had no significant different between the two groups (P>0.05). The serum levels of FSH, E2 and AMH the women in the two groups 3 months after the operation had no significant changed significantly (P<0.05), and which had also no significant different between the two groups (P>0.05). The pregnancy rate (72.2%) of the women in group A was significant higher than that (51.6%) of the women in group B, but the adverse drug reaction of the women in group A was （7.5%）, which was significant lower than that (22.2%) of the women in group B (P<0.05). Conclusion: The clinical effect of laparoscopic and hysteroscopic surgery combined with drospirenone II or gestrinone for treating infertility women with early and middle stage endometriosis is good, and drospirenone II can improve their pregnancy rate and reduce the drug adverse reaction rate.
  • Effect of different treatment methods for treating women after hysteroscopic excision of uterus septum on their pregnancy outcomes
    WANG Juan, ZHANG Renqi, LI Yan
    2021, 29(2): 275.
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    To analyze the influence of different treatment methods for treating women after hysteroscopic excision of uterus septum on their pregnancy outcomes. Methods: 210 women after hysteroscopic excision of uterus septum were divided into group A (74 cases), group B (71 cases), and group C (65 cases) according to the actual situation and their wishes. The women in group C were given general nursing and microwave physical therapy, the women in group A were given artificial period by estradiol valerate for 2 months except to general nursing and microwave physical therapy, and the women in group B were given IUD and the treatment of women in group A for 2 months. The treatment effect of the women in the three groups were followed up and evaluated. Results: There were no significant differences in operative time, intraoperative blood loss, perioperative dosage of liquid for uterus expansion of the women among the three groups (P>0.05). Incidence of postoperative residual of the women in group A and group B (4.1% and 5.6%) was significant lower than that (20.0%) of the women in group C, and the satisfaction of endometrial epithelial change of the women in group A and group B (48.6% and 67.6%) were significant better than that (16.9%) of the women in group C. The postoperative pregnancy rate (192 times, 91.4%) of the women after operation in the three groups was significant higher than that (130 times, 61.9%) before operation. The full-term pregnancy rate (70.3%) of the women after operation in the three groups was significant higher than that (17.7%) before operation. And the incidences of preterm birth, abortion, and ectopic pregnancy of the women after operation in the three group were significant lower than those before operation (all P＜0.05). There were 30 women with miscarry. Among 162 women with delivery, the rate of vaginal delivery was 37.0%, which was significant lower than that (63.0%) of cesarean section (P＜0.05). There was no any woman with complications, such as uterine rupture, placental implantation, and postpartum hemorrhage. There were no significant differences in the incidence of complications, such as placental adhesion and premature rupture of membranes of the women among the three groups (P>0.05). Conclusion: Timely excision of uterus septum of women can significantly improve their pregnancy rate and pregnancy outcomes, but there is no significant difference in the therapeutic results of different adjuvant treatments such as artificial cycle or IUD, which needs further prospective, longterm, largescale study for identify.
  • Influence of adding or subtracting Shenghua decoction for treating women with endometrial polyps after hysteroscopic electrotomyon on their endometrial thickness and recurrence rate
    LIU Ying, SUN Cong, LI Congcong
    2021, 29(2): 280.
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    To investigate the influence of adding or subtracting Shenghua decoction for treating women with endometrial polyps after hysteroscopic electrotomyon on their endometrial thickness and recurrence rate. Methods: 144 women with endometrial polyps selected and were divided into experimental group and control group (72 cases in each group) according to the random number table method from January 2017 to January 2019. The women in both groups had received hysteroscopic endometrial electrotomy. The women in the control group were treated with mafulon and cyprogesterone acetate, and the women in the experimental group were treated with mafulon and cyprogesterone acetate combined with adding or subtracting Shenghua decoction. The menstrual status, serum hormone level, treatment effect, recurrence rate, and incidence of adverse reactions of women before and after treatment were compared between the two groups. Results: After treatment, the menstrual volume, menstrual period, endometrial thickness, serum E2, FSH and LH levels of women in the experimental group were all significant lower than those of women in the control group (P＜0.05). The total effective rate (94.4%) of women in the experimental group was significant higher than that (81.9%) of women in the control group, but the incidence of adverse reactions and recurrence rate (1.4% and 1.4%) of women in the experimental group were significant lower than those (8.3% and 9.7%) of women in the control group (all P＜0.05). Conclusion: Adding or subtracting Shenghua decoction for treating women with endometrial polyps after hysteroscopic electrotomyon can effectively reduce their endometrial thickness and recurrence rate, and can improve their sex hormone level and menstrual status with less adverse reactions, so it is worthy of clinical application.
  • Effect of magnesium sulfate combined with aspirin for treating gestational hypertension and its influence on superoxide dismutase and endothelin-1
    NIU Huikun, WU Na, WANG Suying, WANG Wei, WANG Jing, CHENG Xiulan, ZHANG Huichen, GUO Zhankun
    2021, 29(2): 284.
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    To investigate the influence of magnesium sulfate combined with aspirin for treating pregnant women with gestational hypertension on their outcomes of delivery, fetal growth restriction rate, and the levels of endothelin (ET)-1 and superoxide dismutase (SOD). Methods: 124 women with gestational hypertension were selected as the study subjects and randomly divided into the observation group and the control group (62 cases in each group) from June 2017 to September 2018. From 16 gestational weeks to before delivery, the women in the control group were treated by magnesium sulfate, and the women in the observation group were treated by magnesium sulfate combined with aspirin. The outcomes of delivery and the rate of fetal growth restriction of the women were compared between the two groups, and the levels of ET-1 and SOD of the women in the two groups before and after treatment were detected. Results: After treatment, the values of diastolic blood pressure and systolic blood pressure of women in both groups had decreased significantly, and those (81.42±10.24mmHg and 133.05±18.82mmHg) of the women in the observation group were significant lower than those (90.45±9.26mmHg and 148.21±18.03 mmHg) of the women in the control group (P＜0.05). The rates of cesarean section and fetal growth restriction (38.7% and 1.6%) of the women in the observation group were significant lower than those (72.6% and 8.1%) of the women in the control group (P＜0.05). After treatment, the ET-1 level of the women in both groups had decreased significantly, and that (78.53±13.48ng/L) of the women in the observation group was significant lower than that (84.33±17.02ng /L) of the women in the control group. After treatment, the SOD level of the women in both groups had increased significantly, and that (55.87±16.85NU/ml) of the women in the observation group was significant higher than that (49.35±15.30NU/ml) of the women in the control group (all P＜0.01). Conclusion: Magnesium sulfate combined with aspirin for treating pregnant women with gestational hypertension can improve their delivery outcomes, reduce the rate of fetal growth restriction, decrease their serum ET-1 level, and increase their SOD level.
  • Effects of metformin hydrochloride combined with glibenclamide for treating pregnant women with gestational diabetes mellitus on their serum levels of VEGF, APN, and Hcy
    ZHANG Chenxin1, YANG Shan2
    2021, 29(2): 288.
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    To investigate the effects of metformin hydrochloride combined with glibenclamide for treating pregnant women with gestational diabetes mellitus (GDM) on their serum levels of VEGF, APN, and Hcy. Methods: 80 pregnant women with GDM were enrolled and were randomly divided into control group and observation group (40 cases in each group) from June 20 to May 2019. The women in the control group had received metformin hydrochloride alone, and the women in the observation group had received metformin hydrochloride combined with glibenclamide. The levels of blood glucose, blood lipids, vascular endothelial growth factor (VEGF), adiponectin (APN), and homocysteine (Hcy) of the women before and after treatment were compared between the two groups. Results: There were no statistically significant different in the levels of blood glucose, blood lipid, VEGF, APN, and Hcy of the women between two groups (P>0.05). After treatment, the levels of FBG, 24PG, HbA1c, TC, TG, LDL- C, VEGF, and Hcy of women in the observation group were significant lower than those of women in the control group (P＜0.05), but the levels of HDL-C and APN of women in the observation group were significant higher (all P＜0.05). Conclusion: Metformin hydrochloride combined with glibenclamide for treating pregnant women with GDM can effectively improve their levels of blood glucose, blood lipids, serum VEGF, APN and Hcy, which has good therapeutic effect.
  • Influence of delayed cord clamping and umbilical cord milking on preterm infants less than 34 gestational weeks
    SHI Shuang1, LIANG Zhenxin2, FAN Tianyun1, ZHOU Manli1
    2021, 29(2): 292.
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    To analyze the influence of delayed cord clamping(DCC) and umbilical cord milking(UCM) on the rates of jaundice and anemia, and cerebral hemodynamic parameters of preterm infants with less than 34 gestational weeks. Methods: The pregnant women who would experince vaginal delivery during 28-34 gestational weeks were selected and were divided into immediate cord clamping (ICC) group, DCC group, and UCM group according to the random number. The bilirubin level by percutaneous detection, phototherapy rate, hemoglobin (Hb) value in bleeding from umbilicus and heel, hematocrit (HCT) value, blood flow peak systolic velocity (Vs), end-diastolic velocity (Vd), mean blood flow velocity (Vm), and resistance index (RI) of middle cerebral artery (MCA) of newborns were compared among the three groups. Results: 1 day after birth, the bilirubin value of newborns in DCC group and UCM group was significant higher than that in ICC group (P＜0.001), but that had no statistical difference between DCC group and UCM group (P>0.05). 2 and 3 day after birth, the bilirubin value and phototherapy rate of newborns had no statistical difference among ICC group, DCC group and UCM group (all P>0.05). 48h and 72h after birth, the values of Hb and HCT in bleeding from umbilicus and heel of newborns in DCC group and UCM group were significant higher than those in ICC group (P＜0.05), but those of newborns in DCC group had no statistical different from those of newborns in UCM group (P>0.05). 48h and 72h after birth, the values of Vs and Vm of MCA of newborns in DCC group and UCM group were significant higher than those in ICC group (P＜0.05), but those of newborns in DCC group had no statistical different from those of newborns in UCM group (P>0.05). There were no statistical different in the values of Vd and RI of MCA of newborns among the three groups (P>0.05). Conclusion: DCC and UCM have the similar effects in increasing blood volume and improving cerebral perfusion of preterm infants with less
    than 34 gestational weeks.
  • Value of combined detection of urinary β2-MG, KIM-1, and Ang-1 for dignosing of early renal injury in women with hypertensive disorder complicating pregnancy
    ZHANG Xiaoming, ZHI Ruilian, HAN Zhiping, QIN Huijun
    2021, 29(2): 293.
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    To investigatethe value of combined detection of urinary β2-microglobulin (β2-MG), renal injury molecule 1 (KIM-1), and angiotensin 1 (Ang-1) for diagnosing early renal injury of pregnant women with hypertensive disorder complicating pregnancy (HDCP). Methods: 100 pregant women with HDCP were selected and were divided in group A1 (31 women with gestational hypertension) and group A2 (69 women with preeclampsia) and divided in group B1 (64 women with renal injury) and group B2 (36 women without renal injury) from March 2016 to March 2019. 50 healthy women were selected in control group during the same period. The levels of urinary β2-MG, KIM-1, Ang-1 of women were compared among these groups. The correlations between the levels of urinary β2-MG, KIM-1, Ang1 of women and their renal function indicators were also analyzed. Results: The levels of urea nitrogen, uric acid, and urinary protein, and urinary protein/creatinine value of the women in group A2 were the highest, followed by those of the women in group A1, and those of the women in control group were the lowest. The GFR level of the women in control group was the highest, followed by that of the women in group A1, and that of the women in group A2 was the lowest. The levels of urinary β2-MG, KIM-1 and Ang-1 of the women in group A2 were the highest, followed by the women in group A1, and those of the women in control group were the lowest (P＜0.05). The levels of urinary β2-Mg, KIM-1 and Ang-1 of the women in group B1 were the highest, followed by those of the women in group B2, and those of the women in control group were the lowest (P＜0.05). The level of urinary β2Mg, KIM-1, or Ang-1 were positively correlated with urea nitrogen level, uric acid level, 24h urinary protein value, or urinary protein/creatinine value (P＜0.05). The area under the ROC curve of the combined detection ofβ2-MG, KIM-1 and Ang-1 for diagnosing early renal injury of pregnant women with HDCP was 0.881. Conclusion:β2-MG, KIM-1 and Ang-1 are the sensitive indicators for diagnosing early renal injury of pregnant women with HDCP, and the combined detection ofβ2-MG, KIM-1 and Ang-1 levels has the highest diagnosis accuracy. 
  • Effect of doxorubicin combined with topotecan for treating patients with ovarian cancer
    ZHANG Yongxiang, MENG Ping, DUAN Gangting
    2021, 29(2): 300.
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    To explore the Effect of doxorubicin combined with topotecan for treating patients with ovarian cancer. Methods: 128 patients with ovarian cancer were selected and were divided into two groups (64 cases in each group) from February 2019 to January 2020. The patients in the control group were treated with doxorubicin, while the patients in the study group were treated with doxorubicin combined with topotecan. The ovarian function, therapeutic effect, adverse reactions, and serological indicator of the patients were compared between the two groups. Results: After treatment, the serum vascular endothelial growth factor (VEGF) level, basic fibroblast growth factor (BFGF) level, tumor antigen CAL25 level, luteinizing hormone (LH) level, and  follicle-stimulating hormone (FSH) level of the patients in the observation group were 233.0±154.0ng /L, 70.8±16.2ng/L, 283.7± 198.3U /L, and 20.6±1.2 U/L, respectively, which were significant lower than those of the patients in the control group, but the levels of tumor necrosis factor and estradiol of the patients in the observation group were 67.5±16.8 ng/L and 261.3±11.2 pmol/L, which were significant higher than those of the patients in the control group. The total clinical efficacy (92.2%) of the patients in the observation group was significant higher than that (70.3%) of the patients in the control group, but the total incidence of adverse reaction (6.3%) of the patients in the observation group was significant lower than that (23.4%) of the patients in the control group (all P＜0.05). Conclusion: Doxorubicin combined with topotecan for treating the patients with ovarian cancer has significant effectiveness, it can protect their ovarian function with less adverse reaction and with high safety.
  • Influence of IKAP-guided diversified health education on stigma, health knowledge and compliance of infertile patients
    SHI Shuo, PENG Ling, SUN Tao
    2021, 29(2): 304.
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    To explore the influence of diversified health education guided by information-knowledge-attitude-practice (IKAP) on stigma, health knowledge level, and compliance of infertile patients. Methods: 96 infertile patients were selected and randomly divided into two groups according to the ratio of 1:1 from July 2018 to May 2020. 48 patients were given routine nursing in control group, and 48 patients were given diversified health education guided by IKAP in study group. The Infertility Stigma Scale (ISS) and the simple health survey schedule SF-36 were used to evaluate the stigma and quality of life of the patients in the two groups before and after 6 months of nursing. The self-made questionnaire was used to investigate the awareness of health knowledge of the patients in the two groups, and the treatment compliance of the patients in the two groups was observed within 6 months treatment. Results: After nursing, the ISS score of the patients in the two groups had decreased significantly, and that (78.27±6.30 points) of the patients in the study group was significant lower than that (96.51±7.04 points) of the patients in the control group. The compliance rate to all trentment and the awareness rate of health knowledge of the patients in the study group were significant higher than those of the patients in the control group (P＜0.05). After nursing, the scores of the items of SF-36 of the patients in both groups had increased significantly, and the scores of physiological function, psychological function, social function, and general health of the patients in the study group were 82.91±7.60 points, 78.25±5.43 points, 77.14±5.53 points, and 79.02±8.29 points, respectively, which were significant higher than those (73.07±6.42 points, 66.20±6.39 points, 68.13±6.26 points, 68.03±7.36 points, respectively) of the patients in the control group (all P＜0.05). Conclusion: The implementation of IKAP-guided diversified health education for infertile patients can significantly reduce their stigma, significantly improve their health knowledge level and treatment compliance, which can improve their quality of life significantly.
  • Preliminary study of embryo culture medium used for chromosome screening
    HAN Ruiyu, WANG Xueying，DENG Peipei，HE Wei，YAO Guanfeng, GUO Wei
    2021, 29(2): 308.
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    To preliminary explore the embryo culture medium used for chromosome screening, and to provide date and technical support for the non-invasive screening system of high-quality embryos. Methods：The culture medium of 86 embryos and 36 blastocysts were collected, which included 56 embryos cultured by ICSI-ET and 30 embryos cultured by IVF-ET. Full-genome amplification and library construction of MALBAC single cells were performed on blastocysts and embryo culture media by the universal gene sequencing library kit. High-throughput sequencing platform was used for sequencing, and ChromGoTM2.0 data analysis platform was used to detect the deletion and/or duplication of chromosome aneuploidy, and fragments over 10M. Results：Chromosome karyotype was not found in culture medium of 27 of the 86 embryos, among which, 36 specimens were collected in the early stage, which’s detection success rate was 41.7%. The improved method was used to collect the other 50 specimens, which’s detection success rate increased to 88%. By comparing the chromosome results of 36 blastocysts with their culture medium, a total of 18 embryos were cultured by IVF-ET, with the chromosome ploidy consistency rate of 38.9%, false positive rate of 50% and false negative rate of 0%. In 18 cases of ICSI-ET, the consistent rate of chromosome ploidy was 77.8%, the false positive rate was 16.7%, and the false negative rate was 5.6%. Conclusion： The culture medium of embryos for chromosome screening of ICSI-ET is superior to that of IVF-ET, and the establishment of culture medium collection process is benefit for embryo chromosome detection.
  • Influence of sperm DNA damage on embryo quality and clinical outcomes of IVF-ET
    ZHU Sai，PANG Shuting，XIN Ni
    2021, 29(2): 311.
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    To investigate the influence of sperm DNA damage on embryo quality and clinical outcomes of the in vitro fertilization-embryo transfer (IVF-ET). Methods: From January 2015 to July 2018, 2008 couples with wives less than 35 years old were selected in this study, and the wives in these couples were treated with IVF-ET, and the husbands in these couples had accepted routine semen test and sperm DNA detection. According to the percentage of the sperm DNA fragmentation index (DFI), the couples were divided in group A (90 cases with DFI<15%)), group B (1831 cases with DFI 15%-30%), and group C (87 cases with DFI≥30%). Baseline state, semen routine, embryo quality, and clinical outcomes were compared among the three groups. Results: The sperm density, sperm motility, and sperm normal morphology rate in group A and group B were significant higher than those in group C (P＜0.05). There were no significant differences in female age, male age, duration of infertility, basal follicle stimulating hormone (FSH), basal luteinizing hormone (LH), total dosage and total days used of GN among the three groups (P>0.05). There were no significant differences in average number of eggs obtained, mature egg rate, fertilization rate, normal fertilization rate, cleavage rate, excellent embryo rate, and blastocyst formation rate among the three groups (P>0.05). 55 cases had accepted fresh embryos transplantation in group A, 1154 cases had accepted fresh embryos transplantation in group B, and 54 cases had accepted fresh embryos transplantation in group C. There were no significant differences in the mean number of embryos transplantation, the rate of cleavage embryos transplantation, the rate of blastocysts transplantation, the clinical pregnancy rate, the implantation rate, and the abortion rate among the three groups (P>0.05). Pearson analysis showed that there was no correlation between DFI and body mass index (r=0.314, P=0.722), and between DFI and age (r=0.159, P=0.873). Conclusion: Sperm DNA damage may affect sperm quality, but it might have no adverse effect on embryo quality and clinical outcomes after IVF-ET.
  • The changes and the clinical significances of serum thyroid hormone and TPO-Ab levels during different pregnant stage
    WU Rong, XIE Hailin
    2021, 29(2): 315.
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    To investigate the changes and the clinical significances of serum thyroid hormone and thyroid peroxidase antibody (TPO-Ab) levels of pregnant women during the first, second, and third trimester of pregnancy. Methods: The clinical data of 106 pregnant women in group A from January 2018 to January 2019 were retrospectively analyzed, which included 25 women during the first trimester of pregnancy in group A1, 38 women during the second trimester of pregnancy in group A2, and 43 women during the third trimester of pregnancy in group A3. And 106 healthy non-pregnant women were selected in group B during the same period. Serum of these women was collected for detecting their levels of thyroid hormone and TPO-Ab. The levels of the thyroid hormone and TPO-Ab of the women were compared between the groups. Results: The TSH level of the women in group A1 and group A2 were significant lower than that of the women in group B. The FT3 and FT4 levels of the women in group A1, group A2, and group A3 were significant lower than those of the women in group B, but the TPO-Ab level of the women in group A1, group A2, and group A3 was significant higher than that of the women in group B (all P＜0.05). The positive rate of TPO-Ab of the women in group A3 was significant lower than that of the women in group A1 (P＜0.05). Spearman correlation analysis showed that serum TSH level of the pregnant women in group A1 and group A2 was positively correlated with their positive rate of TPO-Ab (P＜0.05). Conclusion: Serum thyroid hormone and TPO-Ab levels of pregnant women during the first, second, and third trimester of pregnancy are altered y, which may play a role for assessing the thyroid disease of women during pregnancy.
  • Effect of microsurgery via inferior inguinal spermatic vein ligation and open surgery for treating infertility patients because of varicocele and their influence on FSH, LH and T levels
    XIAO Ge, YIN Jie, CHEN Xiangxin, HE Guowei, WU Yabin, LIN Jingbo, CHEN Qinbiao
    2021, 29(2): 319.
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    To observe the efficacy of via inferior inguinal microscopic spermatic vein ligation (MSV) for treating infertility patients because of varicocele, and to study its influence on their levels of reproductive hormone follicle stimulating hormone (FSH), luteinizing hormone (LH), and androgen (T). Methods: 206 infertility patients because of varicocele from September 2015 to May 2019 were collected retrospectively, and were divided into group A (124 patients with traditional high ligation of spermatic vein) and group B (82 patients with MSV). The operative effect and the changes of FSH, LH and T levels in semen before and after operation of the patients were compared between the two groups. Results: The operative time (91.8±4.7min) of the patients in group B was significant longer than that (57.1±4.7min) of the patients in group A, but hospital stay (3.7±0.5d) of the patients in group B was significant shorter than that (7.3±0.9d) of the patients in group A, and the incision VAS score (1.1±0.3 points) of the patients in group B was significant less than that (7.5±1.7 points) of group A (P＜0.05). Sperm density, sperm vitality, sperm motility, normal sperm rate, and A+B grade motility sperm rate of the patients in both groups had increased significantly after operation, and those of the patients in group B were significant higher than those of the patients in group A (P＜0.05). The testicular artery recognition rate and semen quality improvement rate of the patients in group B were significant higher than those of the patients in group A, but the incidences of testicular hydrocele, scrotal edema, and the recurrence of varices testicular hydrocele, the incidence of scrotal edema and the recurrence rate of varicose veins of the patients in group B were significant lower than those of the patients in group A (P＜0.05). The postoperative levels of LH and T in semen of the patients in both groups had decreased significantly, but postoperative T level in semen of the patients in both groups had increased significantly, which’s improvement degree of the patients in group B was significant better than that of the patients in group A (P 0.05). The cumulative pregnancy rate of the patients in group B in 1 to 12 months after operation was 73.2%, which was significant higher than that (46.8%) of the patients in group A (P＜0.05). Conclusion: MSV for treating infertility patients because of varicocele can significantly improve their sperm quality and reproductive endocrine hormone imbalance. Although the operation time is long, it has the advantages of high recognition rate of arteries, fewer complications after operation, short hospitalization time, less incision pain, and high pregnancy rate of their spouses within one year after operation. So it is worthy of clinical promotion and application.
  • Relationship between the levels of anti-Mullerian hormone type II receptor, follicle stimulating hormone receptor, and luteinizing hormone receptor of women and their ovarian reserve
    ZHAO Ke1, WANG Yan2，TAO Yin3
    2021, 29(2): 324.
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    To investigate the expression of anti-Mullerian hormone type II receptor (AMHRII), follicle stimulating hormone receptor (FSHR), and luteinizing hormone receptor (LHR) in follicular fluid and granulosa cells of women with different ovarian reserve, and to study their correlation. Methods: 110 women had undergone in vitro fertilizationembryo transfer (IVF-ET) from December 30, 2016 to May 30, 2019 were enrolled and were divided into 3 groups group A (43 women with normal ovarian function), group B (37 women with ovarian dysfunction), and group C (30 women with premature ovarian failure) according to their ovarian function. The follicular fluid and granulosa cells of the women in the three groups were obtained. The relative expression of AMHRII, FSHR and LHR mRNA of the women in the three groups were detected by qRT-PCR. Results: Age, body mass index, follicle stimulating hormone (FSH) level, and luteinizing hormone (LH) level of the women in group C were significant higher than those of the women in groups A and B, and the number of sinus follicles, number of eggs obtained, and the levels of AMH, estradiol (E2), and progesterone (P) of the women in group C were significant lower than those of the women in groups A and B (P＜0.05). AMHR Ⅱ, FSHR, or LHR minimum relative expression of the women in group C was the lowest, followed by those of the women in group B, those of the women in group A was the highest (P＜0.05). Correlation analysis showed that FSHR expression of the women in group A was positively correlated with the level of LHR or AMHR Ⅱ, and LHR expression was positively correlated with the level of AMHR Ⅱ(all P＜0.05). FSHR expression of the women in group B was positively correlated with the level of LHR or AMHR Ⅱ, and POFFSHR expression was positively correlated with the level of AMHR Ⅱ(all P＜0.05). Conclusion: The expressions of patients with different ovarian reserve have differences, its suggests that AMHRII, FSHR and LHR may be involve in the occurrence of abnormal ovarian reserve of the patients.
  • Effect of ovarian drilling combined with letrozole and human chorionic gonadotropin for treating women with polycystic ovary syndrome
    XIAO Lisha1, ZHANG Pan2
    2021, 29(2): 328.
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    To analyze the effect of ovarian drilling combined with letrozole and human chorionic gonadotropin (HCG) for treating women with polycystic ovary syndrome (PCOS) on their sex hormone levels and ovulation rate. Methods: The clinical data of 80 infertility women with PCOS from August 2016 to May 2018 were analyzed retrospectively. According to the treatment method, these women were divided into two groups. The women in the study group were given ovarian drilling combined with letrozole and HCG, and the women in the control group were given ovarian drilling combined with HCG. The curative effect of the women was compared between the two groups. Results: After treatment, the mature follicle number (1.9±0.8), average mature follicle diameter (23.5±3.7 mm), ovulation rate (91.4%), and pregnancy rate (51.4%) of women in the study group were significant higher than those (1.5±0.6, 20.4±3.5 mm, 71.1%, and 26.7%) of women in the control group. The levels of serum total cholesterol (TC), low density lipoprotein (LDL), and triglycerides (TG) of women in the two groups had decreased significantly after treatment, but the levels of serum high-density lipoprotein (HDL) of women in the two groups had increased significantly after treatment. The levels of TC and TG levels, body mass index value, ratio of luteinizing hormone/follicle stimulating hormone, and testosterone level of women in the study group were significant lower than those of women in the control group (all P＜0.05). Conclusion: Ovarian puncturing combined with letrozole and HCG can improve the ovulation rate and pregnancy rate of women with PCOS, and can improve their sex hormone and blood lipid levels, and BMI value.
  • Correlation of the levels of serum oxidized protein products and reactive oxygen species of pregnant women with gestational diabetes mellitus and their insulin resistance
    YANG Yamei, WANG Wenping, QU Dacheng
    2021, 29(2): 332.
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    To explore the correlation between the levels of advanced oxidation protein product (AOPP) and reactive oxygen species (ROS) in serum of pregnant women with gestational diabetes mellitus (GDM) and their insulin resistance (IR). Methods：From June 2017 to July 2019, 150 pregnant women with GDM were selected in study group, and another 100 normal pregnant women were selected in control group during the same period. The serum AOPP and ROS levels of the women were compared between the two groups. Univariate analysis, Pearson correlation analysis and multiple linear regression analysis were performed. Results：The value of body mass index (BMI), and the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 HPG), glycosylated hemoglobin (HbAlc), and fasting insulin (FINS), and the value of insulin resistance index (HOMA IR) of the women in the study group were significant higher than those of the women in the control group (P＜0.05). There were no significant differences in age, gestational weeks, and the levels of high density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST) of the women between the two groups (P>0.05). The serum AOPP and ROS levels of the women in the study group were significant higher than those of the women in the control group (P＜0.05). In the study group, the levels of AOPP and ROS of the women were positively correlated with their IR indexes (FINS, HOMA-IR) (P＜0.05), and BMI value, and the levels of TG, ALT, AOPP and ROS were the risk factors of IR. Conclusion：The AOPP and ROS levels of pregnant women with GDM are abnormally elevated, which have closely relevant to the IR of these women.
  • Value of serum Cys C, KIM-1 and β2-MG levels for diagnosing renal injury of pregnant women with hypertensive disorder complicating pregnancy
    CHANG Lihua1, LIANG Wanqi1, LI Yanchuan2, ZHANG Xingxing1, ZHANG Mei1, WANG Jing1
    2021, 29(2): 336.
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    To investigate the levels of serum cystatin C (Cys C), urinary kidney injury molecule-1 (KIM-1), and urinary β2-microglobulin (β2-MG) for diagnosing renal injury of pregnant women with hypertensive disorder complicating pregnancy (HDCP). Methods: A retrospective analysis of pregnant women with HDCP from July 2017 to July 2019 was conducted. These women were divided into group A (31 women with preeclampsia) and group B (58 women with gestational hypertension) according to the severity of HDCP. In addition, 35 normal pregnant women during the same period were selected in group C. The serum levels of Cys C, KIM-1,β2-MG of the women in the three groups were analyzed, and which’s diagnostic value for renal injury were also explored. Results: The 24h urinary protein value and Ccr level of the women in group A were significant higher than those of the women in group B. The levels of Cys C, KIM-1, and β2-Mg of the women in group B were significant higher than those of the women in group C, and those of the women in group A were significant higher than those of the women in group B (all P＜0.05). Pearson correlation analysis showed that the levels of Cys C, KIM-1, and β2-MG were positively correlated with their 24h urinary protein value (r=0.796, 0.638, 0.579, P＜0.05). The AUC of the levels of Cys C level, KIM-1 level, and β2-MG level for diagnosing renal injury of the women with gestational hypertension were 0.847, 0.852, and 0.878, respectively, and their cutoff values were 0.76 mg/L, 1.54 mg/L and 7.41ng/L, respectively. The combined detection of Cys C, KIM-1, and β2-MG levels for diagnosing renal injury had the highest AUC, the highest sensitivity (93.6%), the highest specificity (88.2%), and the highest accuracy (89.6%). Conclusion: The levels of serum Cys C, urinary KIM-1, and urinary β2-MG of pregnant women with HDCP can reflect their severity of HDCP， and the combined detection of Cys C, urinary KIM-1, and urinary β2-MG have high diagnostic efficacy for renal injury of pregnant women with HDCP.
  • The levels of serum miR-21 and miR-155 of pregnant women with immune thrombocytopenia and their relationship with Th17/Treg balance
    XU Dan, SUN Haiyan, DONG Shiye
    2021, 29(2): 340.
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    To investigate the levels of serum microRNA-21 (miR-21) and microRNA-155 (miR-155) of pregnant women with immune thrombocytopenia (ITP), and to study their relationship with the balance of help T cell 17 (Th17)/regulatory T cell (Treg). Methods: 86 pregnant women with ITP were selected in research group from February 2017 to June 2020, and 79 normal pregnant women were selected in control group during the same time. The levels of serum miR-21 and miR-155 were detected by real-time fluorescence quantitative PCR (qRT-PCR), the levels of Th17 cells and Treg cells were detected by flow cytometry, and the ratio of Th17/Treg was calculated. The levels of serum interleukin (IL)-10, IL-17, IL-21 and transforming growth factor-β (TGF-β) were detected by enzyme-linked immunosorbent assay (ELISA). Pearson method was used to analyze the correlation between the levels of miR-21 and miR-155 of the women and their Th17/Treg value and serum inflammatory factors levels. Multivariate Logistic regression analysis was used to analyze the factors influencing the occurrence of ITP during pregnancy. Results: The levels of miR-21, miR-155, Th17 cells, IL-17 and IL-21, and Th17/Tregin value of the women in the research group were significant higher than those of the women in the control group, while the levels of Treg cells, TGF-β and IL-10 of the women in the research group were significant lower than those of the women in the control group (P＜0.05). In the research group, the levels of miR-21 and miR-155 were positively correlated the Th17/Treg value (r=0.538, 0.526, P＜0.05). The levels of miR-21 and miR-155, and the Th17/Treg value were positively correlated with the levels of IL-17 and IL-21, but which were negatively correlated with the levels of TGF-β and IL-10 (P＜0.05). The levels of miR-21 and miR-155, and Th17/Treg value were the independent risk factors of ITP occrence during pregnancy (P<0.05). Conclusion: The imbalance of Th17/Treg of pregnant women with ITP is in a state of serious imbalance, which may be closely related to the miR-21 and miR-155 levels.
  • Correlation between glycosylated albumin level of pregnant women with gestational diabetes mellitus during the third trimester of pregnancy and their neonatal respiratory diseases
    QIN Shuang1, MENG Wenying1, YANG Jie2, ZHAO Jianli2
    2021, 29(2): 345.
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    To explore the correlation between glycosylated albumin (GA) level of pregnant women with gestational diabetes mellitus (GDM) during the third trimester of pregnancy and their neonatal respiratory diseases. Methods: 1362 singleton fullterm pregnant women were selected and were divided into study group (245 women with GDM) and control group (1117 women without GDM) from June 2016 to September 2019. The levels of blood glucose and blood lipid were detected by automatic biochemical analyzer, the level of HbA1c was detected by immunoturbidimetric method, and the level of GA was detected by enzyme method. According to the median of serum GA level, the women in the study group was divided into group A (121 women with high level of GA) and group B (124 women with low level of GA). The neonatal situation was compared between group A and group B. Multivariate Logistic regression analysis was used to analyze the risk factors of neonatal respiratory diseases. Results: The levels of blood glucose, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), HbA1c, and GA of the women in study group were significant higher than those of the women in control group (P＜0.05). There was no significant difference in the incidence of neonatal respiratory diseases between the two groups (13.5% vs. 11.4%). The neonatal birth weight (2805.6±317.3g) and cesarean section (29.4) of the women in the study group were significant higher than those (2742.7±322.5g and 18.6%) of the women in the control group, but the neonatal Apgar score at 1 min after birth (8.7±0.4 points) in the study group was significant lower than that (9.0±0.5 points) in the control group. The rates of neonatal death, macrosomia, small for gestational age, neonatal complications, and neonatal hyperbilirubin in the study group were significant higher than those in the control group (P＜0.05). In the study group, the incidence of neonatal respiratory diseases (19.0%) in group A was significant higher than that (8.1%) in group B (P＜0.05), but there were no significant differences in 1 min Apgar score of newborns, and the rates of neonatal NRDS, apnea, asphyxia, wet lung, pneumonia, and pneumothorax between the two groups (P＜0.05). Elevated HbA1c and GA levels during the third trimester of pregnancy, and cesarean section of pregnant women with GDM were the risk factors of the occurrence of their neonatal respiratory diseases. Conclusion: The GA level of pregnant women with GDM during the third trimester of pregnancy has elevated, which is a risk factor of their neonatal respiratory diseases. So monitoring the change of GA level is helpful for early intervention of the women with GDM and has certain clinical significance for improving their neonatal quality of life.
  • Clinical significance of placental growth factor and soluble vascular endothelial growth factor receptor-1 in peripheral blood and placenta of 56 pregnant women with pre-eclampsia
    MIN Zhihong, DU Qiaoling
    2021, 29(2): 350.
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    To investigate the correlation and clinical significance of placental growth factor (PLGF) and soluble vascular endothelial growth factor receptor-1 (sVEGFR1) in peripheral blood and placenta of pregnant women with pre-eclampsia. Methods: From January 2017 to December 2018, 56 pregnant women with severe pre-eclampsia were included in group A, 56 pregnant women with mild pre-eclampsia were selected in group B, and 56 normal pregnant women were selected in group C. The protein levels of PLGF and sVEGFR-1 in peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA). The protein levels of PLGF and sVEGFR-1 mRNA in placenta was determined by PR-PCR. The state of disease and pregnancy outcomes of these women was analyzed. Results: The PlGF protein level in serum and placental tissues of the women in group A was the lowest, and that of the women in group C was the highest. The SVEGFR-1 protein level in serum and placental tissues of the women in group A was the highest, and that of the women in group C was the lowest (all P＜0.05). The protein levels of PLGF in serum and placental of the women with pre-eclampsia were negatively correlated with their 24h proteinuria value, and systolic and diastolic blood pressure. The protein levels of SVEGFR-1 in serum and placental of the women with pre-eclampsia were positively correlated with their 24h proteinuria, and systolic and diastolic blood pressure (all P＜0.05). There were 1 perinatal infant with adverse clinical outcomes in group C, 6 perinatal infants with adverse clinical outcomes in group B, and 15 perinatal infants with adverse clinical outcomes in group A (P＜0.05). The levels of PLGF mRNA in serum and placental of the women with adverse pregnancy outcomes were significant lower than those of women with normal pregnancy outcomes, but the levels of SVEGFR-1 protein in serum and placental of the women with adverse pregnancy outcomes were significant higher than those of women with normal pregnancy outcomes (all P＜0.05). Conclusion: The levels of PLGF and sVEGFR-1 in peripheral blood and placental of pregnant women with preeclampsia maybe correlation with their severity of pre-eclampsia and the outcomes of perinatal infants.
  • TORCH-IgM detection of childbearing age women and the relationship between adverse pregnancy history of the women and their TORCH infection
    ZHANG Lan，ZENG Li, TAO Xinmei
    2021, 29(2): 355.
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    To analyze the significance of TORCH-IgM detection of normal childbearing age women, and to explore the relationship between adverse pregnancy history of the women and their TORCH infection. Methods: 6000 normal childbearing age women who had undergone TORCH-IgM antibody detection from January 2016 to March 2020 were selected in this study. TORCH-IgM antibody was detected by enzyme-linked immunosorbent assay (ELISA). The antibody positive rate of Toxoplasma (Tox), Rubellavirus (RV), Cytomegalovirus (CMV), Herpesvirus (HSV), and other microorganisms (O) of these women were analyzed. The adverse pregnancy history of these women and their TORCH infection situation were also analyzed. Results: The positive rate of TORCH-IgM of these 6000 women was 2.23%, among them, the positive rate of HSV-IgM (1.37%) was significant higher than that of TOX-IgM (0.23%), that (0.30%) of RV-IgM, and that (0.33%) of CMV-IgM (P＜0.05). The infection rates of TOX, RV, CMV, and HSV of the women with adverse pregnancy history were 8.33%, 11.67%, 10.00%, and, 25.00%, respectively, which were significant higher than those (0%, 0%, 0%, and 1.67%, respectively) of women without adverse pregnancy history. The neonatal infection rates of TOX, RV, CMV, and HSV of women with adverse pregnancy history were 6.67%, 10.0%, 8.33%, 20.00%, respectively, which were higher than those (0%, 0%, 0%, and 0%, respectively) of women without adverse pregnancy history. The positive rate of TORCH infection of women during the second and the third trimesters of pregnancy were 18.33% and 20.00%, which was significant higher than that (6.67%) of women during the first trimester of pregnancy (P＜0.05). Conclusion: TORCH-IgM detection of normal childbearing age women should be conducted before pregnancy, especially for those women with adverse pregnancy history. TORCH-IgM detection should be involved in the routine prenatal screening item for reducing birth defects.
  • Relationship between the fetal central nervous system malformation by ultrasonography and their chromosomal abnormalities
    LI Wei1, WANG Hongqiao1, LI Hualin2
    2021, 29(2): 358.
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    To analyze the situation of chromosomal abnormalities of the fetus with central nervous system malformation detected by ultrasonography. Methods: 111 pregnant women with fetal cranial central nervous system malformation by ultrasonography who had undergone chromosomal microarray analysis (CMA) from January 2016 to August 2018 were selected as subjects. The risk of chromosomal abnormalities of fetus with different types of cranial central nervous system malformation or with other systemic malformations by ultrasonography was analyzed. Results: Among the 111 fetuses with central nervous system malformation, there were 23 (20.7%) fetuses with abnormal CMA results. The rate of abnormal CMA (31.3%) of the fetuses with cerebral malformation was significant higher than that (12.7%) of fetuses with neural tube defects (P=0.017). The detection rate of CMA abnormalities of the fetuses with central nervous system and other system malformations (37.1%) was significant higher than that (13.2%) of the fetuses with central nervous system alone (P=0.004). The detection rate of abnormal CMA result of the fetuses with holoprosencephaly was the highest, which was significant higher than that of the fetuses without holoprosencephaly (P=0.018, OR=5.830). The detection rate of abnormal CMA result of the fetuses with cardiovascular system malformation was significant higher than that of the fetuses without cardiovascular system malformation (P=0.008, OR=9.000). Conclusion: The fetuse with holoprosencephaly or cardiovascular malformation examined by ultrasound has the highest risk of chromosomal abnormalities.
  • Expression and of the plasma miR-197 of women with gestational diabetes mellitus and its correlation with their clinical index
    LIU Hongxue, HAN Xiao, ZHANG Muling
    2021, 29(2): 362.
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    To determine the expression level of miR-197 in plasma of women with gestational diabetes mellitus (GDM), and to study its correlation with clinical indicators of the women. Methods: 84 pregnant women with GDM were selected in group A, 50 pregnant women with abnormal glucose tolerance were selected in group B, and 84 pregnant women with normal glucose tolerance were selected in group C from January to June 2019. RT-qPCR was used to detect maternal plasma miR-197 level. The fasting glucose (FPG) and fasting insulin (FINS) levels were detected by radioimmunoassay and glucose oxidase methods. The insulin resistance index (HOMA-IR) was calculated by steady-state model. Spearman correlation analysis was used to study the correlation of serum miR-197 level with the levels of FINS and FPG, and HOMA-IR value. ROC curve was used to analyze the sensitivity and the specificity of the miR-197 level for predicting GDM. Results: The relative expression level of miR-197 of the women in group A (1.86±0.13) was significant lower than that (7.02±0.44) of the women in group C and that (4.595±0.20) of the women in group B (F=78.00, P＜0.001). Correlation analysis showed that the expression of miR-197 level of the women in group A was negatively correlated with their FPG level, FINS level, and HOMA-IR value (r=-0.862, -0.874, -0.939, P=0.01). The sensitivity, the specificity, and ROC area of miR-197 level for predicting GDM were 79.1%, 88.1%, and 0.924 (95%CI: 0.890-0.957, P=0.00). Conclusion: miR-197 level of the pregnant women with GDM is low, which is closely related to blood glucose-related indicators, so it is expected to be a potential indicator for diagnosing GDM.
  • The characteristics of blood flow parameters of caesarean scar pregnancy site detected by ultrasound and its value for predicting the bleeding during curettage
    HU Hongyan1, CHI Yujun1, LIU Jie2
    2021, 29(2): 365.
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    To explore the characteristics of blood flow parameters of caesarean scar pregnancy (CSP) site detected by ultrasound, and to study its value for predicting the bleeding during curettage. Methods: 98 women with CSP from January 2017 to December 2019 were selected in observation group retrospectively, and 90 women with normal pregnancy after cesarean section were selected in control group. The trophoblast artery resistance index (RI), pulse index (PI), systolic peak/end-diastolic flow rate (S/D), vascular index (VI), blood flow index (FI), and blood flow index (VFI) of the embryo implantation site of the women in the two groups were detected by ultrasound. Results: The RI, PI, and S/D values of the women in the observation group were significant lower than those of the women in the control group (P＜0.05), but which had no statistical significant different between the women with type I CSP and the women with type II+III CSP (P>0.05). The VI, FI, and VFI values of the women with type II and III CSP were significant higher than those of the women with type I CSP or the women in the control group (P＜0.05), but which had no statistical significant different between the women with type I CSP and the women with type II and III CSP (P>0.05). In the observation group, the serum RI value of the women with β-HCG level≥40000U/L was significant lower than that of the women with β-HCG level＜40000U/L (P＜0.05), but the values of VI, FI, and VFI of the women with β-HCG level≥40000U/L were significant higher than those of the women with β-HCG level＜40000U/L (P＜0.05), there were no significant different in PI and S/D values between the women with β-HCG level ≥40000U/L and the women with β-HCG level <40000U/L (P>0.05). In the observation group, the RI value, VI value, FI value, or VFI value had no correlation with the serum β-HCG level(P>0.05). There were no significant different in RI, PI, and S/D values between the women with bleeding loss ≥100ml during curettage and the women with bleeding loss ＜100ml during curettage  (P>0.05). β-HCG level combined with VFI value had the best efficiency for predicting blood loss ≥100ml during curettage, which’s sensitivity and specificity were 82.4% and 78.3%. Conclusion: The blood flow of embryo implantation site of the women with CSP is the status of low resistance. Three dimensional energy blood flow parameters by ultrasound has certain reference value for the predicting bleeding loss during curettage.
  • Comparison of the effect of Aptima detection and HC2 detection for diagnosing lesions with ≥ cervical intraepithelial neoplasiasⅡgrade
    YU Xinying1, JI Jing2
    2021, 29(2): 370.
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    To explore the value of detection of HPV E6/E7 mRNA (Aptima) and HPV DNA second generation hybridization capture (HC2) for diagnosing lesions with ≥ cervical intraepithelial neoplasia (CIN) Ⅱgrade. Methods: 100 patients with suspected cervical lesions were selected and were given Aptima and HC2 detections, and which’s results were compared with pathological results from January 2018 to June 2019. Results: Among the 100 patients, there were 9 patients with chronic inflammation, 23 patients with CIN Ⅰ, 34 cases of patients with CIN Ⅱ, 22 patients with CIN Ⅲ, and 12 patients with cervical cancer. The HPV E6/E7 mRNA of the patients with CIN Ⅱ, CIN Ⅲ, and cervical cancer were 5102.39 (3378.82, 7800.83) copies/ml, 27801.19 (16781.29, 32011.88) copies/ml, and 6770.28 (4100.28, 7220.22) copies/ml, respectively, which were significant higher than those of the patients with chronic inflammation and CIN Ⅰ(P＜0.05). The sensitivity of Aptima for diagnosing cervical CIN Ⅱ, CIN Ⅲ, and cervical cancer was 82.4%, which was significant lower than that (94.1%) of HC2 (P＜0.05), while there were no significant differences in the positive predictive value and negative predictive value between of Aptima and HC2 for diagnosing cervical CIN Ⅱ, CIN Ⅲ, and cervical cancer (P>0.05). Conclusion: The detection of Aptima and HC2 has some effect for diagnosing CIN Ⅱ, CIN Ⅲ, and cervical cancer.
  • Value of serum HE4 and CA125 detection in shunt management of postmenopausal uterine cavity hydrops
    HE Ying1, MA Chunxing1, WANG Jing1, HE Hongmei2
    2021, 29(2): 373.
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    To explore the value of serum human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) detection in shunt management of postmenopausal women with uterine cavity hydrops. Methods: 300 postmenopausal women with uterine cavity hydrops were selected in this study from January 2019 to December 2019. These women were all given transvaginal ultrasound, hysteroscopy, and diagnostic curettage. The positive rates and the levels of HE4 and CA125 were measured. The efficacy of HE4 and CA125 for differentiate diagnosing benign or malignant endometrial diseases of the women with uterine cavity hydrops were evaluated. Results: Among these 300 women, there were 33 cases with primary endometrial cancer, and 267 cases with benign endometrial disease. The levels of HE4 and CA125 of women with endometrial cancer (126.93±42.79 pmol/L and 41.49±17.27 U/ml) were significant higher than those (73.98±26.75 pmol/L and 22.22±10.64 U/ml) of the women with benign endometrial diseases, and the positive rates of HE4 and CA125 of women with endometrial cancer (33.3% and 63.6%) were significant higher than those (0% and 12.0%) of the women with benign endometrial diseases (all P＜0.05). There were no statistically significant difference in the incidence of vaginal bleeding between the women with benign endometrial diseases and the women with malignant endometrial diseases (P>0.05). ROC curves showed that the AUC of combined of HE4 level and CA125 level for diagnosing endometrial cancer was 0.948. The sensibility of HE4 level for diagnosing endometrial cancer (81.8%) was the highest, and the specificity of CA125 level for diagnosing endometrial cancer (91.8%) was the highest. Conclusion: The combined serum HE4 level and CA125 level for differentiate diagnosing benign or malignant endometrial diseases of the women with uterine cavity hydrops has high efficacy, which is conducive to shunt management of these women.
  • Clinical value of serum CA125, CA199 and HE4 levels for the differential diagnosis of women with endometriosis cyst
    LI Ling1, HE Xiaoqi2，GAO Yong1
    2021, 29(2): 377.
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    To analyze the value of serum carbohydrate antigen (CA) 125, CA199, and human epididymal secretory protein 4 (HE4) for the differential diagnosis of women with endometriosis cyst. Methods: 256 women with pelvic neoplasm who underwent laparoscopic surgery from January 2016 to December 2018 were selected in this study retrospectively. According to the pathological results, 152 patients with endometriosis cyst were in group A, 47 patients with benign ovarian tumors were in group B, and 57 patients with malignant ovarian tumors were in group C. The serum CA125 and CA199 levels of these women were detected by electrochemiluminescence, and their HE4 levels were detected by ELISA. Results: The levels of CA125 and HE4 of the women in group C were significant higher than those of the women in group A and group B, and the CA125 and CA199 levels of the women in group A were significant higher than those of the women in group B (all P＜0.05). The positive rates of the CA125 level, the CA199 level, or, the HE4 level alone for diagnosing endometriosis cyst were 62.5%, 45.4%, and 0.7%, respectively, and the positive rate of combined detection of the CA125 level, the CA199 level, and the HE4 level was 73.0%. ROC curve analysis showed that the sensitivity of the CA125 level, the CA199 level, or the HE4 level alone, or combined detection of the levels of serum CA125, CA199 and HE4 for diagnosing endometriosis cyst were 62.5%, 45.4%, 0.7%, 73.0%, respectively. The specificity of the CA125 level, the CA199 level, or the HE4 level alone, or combined detection of the levels of serum CA125, CA199 and HE4 for diagnosing endometriosis cyst were 61.5%, 79.8%, 75.0%, 48.1%, respectively. The area under the curve of the CA125 level, the CA199 level, or the HE4 level alone, or combined detection of the levels of the serum CA125, the CA199. and the HE4 for diagnosing endometriosis cyst were 0.622, 0.634, 0.601, and 0.611, respectively. Conclusion: Serum CA125 and CA199 levels can be used as the tumor markers to differentiate diagnosing endometriosis cysts from benign ovarian cysts. The combined detection of the levels of serum CA125, CA199 and HE4 can improve the sensitivity of diagnosis.
  • Expression and clinical significance of serum sICAM-1, sVCAM-1 and TNF-αof women with intrahepatic cholestasis of pregnancy
    YU Shuang, WANG Hu
    2021, 29(2): 381.
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    To investigate the expression and the clinical significance of serum intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and tumor necrosis factor-α (TNF-α) of women with intrahepatic cholestasis of pregnancy (ICP). Methods: 38 pregnant women with severe ICP were selected in group A, 62 pregnant women with mild ICP were selected in group B, and 30 normal pregnant women were selected in group C. The levels of the sICAM-1, sVCAM-1, TNF-α, and blood lipids of the women in the three groups were detected. Correlation analysis was performed, and the value of sICAM-1 level, sVCAM-1 level, or TNF-α level for diagnosing ICP was evaluated by ROC curve. Results: The serum levels of sICAM-1, sVCAM-1 and TNF-α of the women in group A and group B were significant higher than those of the women in group C, and those of the women in group A were significant higher than those of the women in group B (P＜0.05). Pearson correlation analysis showed that the serum levels of sICAM-1, sVCAM-1 and TNF-αof the women with ICP were positively correlated with their total cholesterol, triglyceride, and low density lipoprotein levels, but were negatively correlated with their high density lipoprotein level (all P＜0.05). ROC curve analysis showed that the area under the curve of the sICAM-1 level, sVCAM-1 level, or TNF-αlevel for diagnosing ICP was 0.838 (95%CI: 0.769-0.908), 0.831 (95%CI: 0.747-0.915), and 0.832 (95%CI: 0.759-0.905), respectively. The sensitivity of the sICAM-1 level, sVCAM-1 level, or TNF-αlevel for diagnosing ICP was 79.4%, 78.6%, and 77.2%, respectively. And the specificity of the sICAM-1 level, sVCAM-1 level, or TNF-αlevel for diagnosing ICP was 79.6%, 80.1%, and 82.3%, respectively. The area under the curve of the sICAM-1 level, sVCAM-1 level, or TNF-αlevel for diagnosing severe ICP was 0.798 (95%CI: 0.711-0.884), 0.751 (95%CI: 0.645-0.857), and 0.771 (95%CI: 0.676-0.866), respectively. The sensitivity of the sICAM-1 level, sVCAM-1 level, or TNF-αlevel for diagnosing severe ICP was 80.1%, 81.6%, and 75.4%, respectively. And the specificity of the sICAM-1 level, sVCAM-1 level, or TNF-αlevel for diagnosing severe ICP was 75.8%, 72.4%, and 82.5%, respectively. Conclusion: The abnormal expression of ICAM-1, VCAM-1 and TNF-α of the pregnant women may play an important role in the development of ICP, which can be used as assistant factors for clinical diagnosis of ICP.
  • Influence of uterine myoma or hysteromyomectomy of pregnant women on their pregnancy outcomes
    JIAN Yanlin, WANG Ying, LI Chengli
    2021, 29(2): 385.
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    To explore the difference of pregnancy outcomes between the pregnant women with hysteromyomectomy and the pregnant women with uterine myoma. Methods: The clinical data of 73 pregnant women with uterine myoma after delivery from December 2017 to April 2019 were collected retrospectively. These women were divided into group A (46 women with laparoscope hysteromyomectomy during pregnancy) and group B (43 women with hospitalized expectant treatment of uterine myoma). The pregnancy outcomes of the women in the two groups were observed. Results: There were no significant differences in the incidences of hypothyroidism during pregnancy, intrahepatic cholestasis of pregnancy, gestational diabetes mellitus during pregnancy, and gestational hypertension of the women between the two groups (P>0.05). The incidences of adverse pregnancy outcomes, such as cesarean section (89.1% vs. 86.0%), fetal distress (13.0% vs. 9.3%), and postpartum hemorrhage (2.2% vs. 4.7%) of the women had no significant different between group A and group B (P>0.05), but the incidences of preterm rupture of membranes (17.4%) and preterm delivery (13.0%) of the women in group A were significant higher than those (4.7% and 2.3%) of the women in group B (P＜0.05). Conclusion: There is no significant difference of pregnancy outcomes between the pregnant women with hysteromyomectomy and the pregnant women with uterine myoma.
  • Analysis of the incidence and influencing factors of hypothyroidism of women during pregnancy
    FAN Yicui, XU Zhihong
    2021, 29(2): 388.
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    To investigate the incidence of hypothyroidism of pregnant women, and to analyze the relevant factors affecting the occurrence of hypothyroidism. Methods: The clinical data of 2864 pregnant women treated in a top three hospital in Sichuan province from January 2018 to August 2019 were retrospectively analyzed. Age, childbearing history, family history, disease history, education level, thyroid hormone levels, and hypothyroidism occurrence of these women were recorded. The incidence of hypothyroidism was compared among the women with different clinical characteristics, and related factors affecting hypothyroidism during pregnancy were analyzed. Results: In these 2864 pregnant women, there were 248 (8.7%) cases with hypothyroidism, which included 38 cases with clinical hypothyroidism and 210 cases with subclinical hypothyroidism. The incidence of hypothyroidism of pregnant women with over 35 years old, parity> 3 times, history of spontaneous abortion, family history of hypothyroidism, hypertension during pregnancy, and diabetes, or junior college and below of education level had increased significantly (P＜0.05). Unconditional multi-factor logistic regression model analysis showed that age over 35 years old, parity> 3 times, history of spontaneous abortion, family history of hypothyroidism, hypertension during pregnancy, and diabetes, and  junior college and below of education level of the women were independent risk factors of hypothyroidism during pregnancy (P＜0.05). Conclusion: Subclinical hypothyroidism is more common type of hypothyroidism during pregnancy, so the risk factors of hypothyroidism of pregnant women should be paid more attention to in clinical practice, and intervention measures should be given to these women for reducing their adverse pregnancy outcomes.
  • The pregnancy outcomes of the women with severe intrauterine adhesion adhesectomy after postoperative placement of anti-adhesive membrane or waterfilled balloon
    WANG Guifang
    2021, 29(2): 392.
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    To analyze the effect of the anti-adhesive membrane or water injection balloon placement on the pregnancy outcomes of women after severe intrauterine adhesectomy. Methods: The clinical data of 104 women with severe intrauterine adhesions who had undergone hysteroscopic intrauterine adhesectomy from August 2017 to August 2018 was analyzed retrospectively. According to the different postoperative treatment methods, these women were divided in group A (32 women with postoperative intrauterine device (IUD) inserted) were in, group B (35 women with postoperative anti-adhesion membrane inserted), and group C (37 women with postoperative water-filled balloon inserted). The clinical efficacy, the recovery situation of uterine morphology, the incidence of complications, and the pregnant situation within postoperative 2 years of the women were compared among the three groups. Results: The total effective rate and the delivery rate within postoperative 2 years of the women in group B were 94.3% and 76.5%, and those of the women in group C were 89.2% and 72.2%, which were all significant higher than those (65.6% and 41.7%) of the women in group A (all P＜0.05). The incidence of complications and the postoperative intrauterine adhesion scores of the women in group A were 37.5% and 9.1±1.5 points, which were all significant higher than those (11.4%, 4.3±1.1 points) of the women in group C and those (16.2% and 4.7±1.2 points) of the women in group B (all P＜0.05). There were no significant differences in total effective rate, the delivery rate within postoperative 2 years, the intrauterine adhesion score, and the complication rate of the women between group B and group C (P>0.05). Conclusion: The placement of anti-adhesive membrane or water injection balloon of women after severe intrauterine adhesions surgical can improve their menstrual situation, and can effectively prevent intrauterine re-adhesion, can increase the postoperative pregnancy rate and delivery rate, and help to improve their pregnancy outcomes.
  • The effect of transvaginal hysterosalpingography by four-dimensional echocardiography for diagnosing tubal patency
    Minaval·Wu Tiku，CAO Chunning，JI Tiantian, XU Xiumei, ZHOU Jing, DU Jing, ZHAI Hong
    2021, 29(2): 396.
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    To investigate the effect of transvaginal hysterosalpingography by four-dimensional echocardiography (4 D-HyCOSY) for diagnosing tubal patency. Methods: The clinical data of 45 infertility women who had accepted 4 D-HyCOSY were collected retrospectively. Their examination results, adverse reactions, and results pregnancy within 1 year of followed up were analyzed. Results: After examination, there were 24 women with bilateral tubal obstruction, 14 women with unilateral tubal obstruction, and 7 women with unobstructed fallopian tubes. The obstruction rate of fallopian tube in these women was 84.44%. There were 33 (66.7%) women with mild abdominal pain, 12 (26.7%) women with mild nausea, and 4 (8.9%) women with vomiting. In 1 year after followed up, there were 5 women with nature pregnancy, which included 3 with unobstructed fallopian tubes, 1 woman with unilateral tubal obstruction, and 1 woman with bilateral tubal obstruction. Conclusion: 4 D-HyCOSY for evaluating tubal patency has good effect, which is simple, economical, noninvasive, less side effects, and highly accepted by infertility women.
  • Study on the influencing factors of two-dimensional ultrasound imaging of fetal heart during the first trimester of pregnancy
    LUAN Zedong, ZHANG Xiaoping, SUN Xiaoyan, WANG Xiaoyan, LIU Yaqin, ZOU Yanli, LI Songyang, WANG Haoling, YANG Nan
    2021, 29(2): 399.
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     To explore the influencing factors of two-dimensional ultrasound imaging of fetal heart during the first trimester of pregnancy (11-14 gestational weeks). Methods: The clinical data of 692 pregnant women with single pregnancy who had undergone ultrasound examination of fetal heart from December 2018 to July 2019 were collected retrospectively. The fetal heart was examined and recorded by high-definition color Doppler imaging to obtain the five views, which included upper abdominal transverse view (UAT), four-chamber view (4C), left and right ventricular outflow tracts (LVOT and RVOT), and three-vessel and trachea view (3VT). And the maternal age, history of pregnancy, fetal crown-rump length, maternal body mass index, maternal abdominal wall thickness, and the depth of the abdominal wall depression when moderately pressurized of these women were recorded. The influencing factors of two-dimensional ultrasound imaging of fetal heart were analyzed. Results: The visualization rate of UAT view, 4C view, LVOT view, RVOT view, and 3VT view of 692 fetus were 83.2% (576/692), 91.3% (632/692), 67.3% (466/692), 63.3% (438/692), and 61.0% (422/693), respectively. The unirariate analysis showed that there were significant different in the history of pregnancy, fetal rown-rump length, maternal body mass index, maternal abdominal wall thickness, and the depth of the abdominal wall depression between the women with visualization of the five views and the women without visualization of the five views (P＜0.05), but there was no significant different in age of the women (P>0.05). The multivariate analysis showed that fetal rown-rump length less than 64 mm, maternal abdominal wall thickness ≥35mm, and the depth of the abdominal wall depression less than 10mm were the influencing factors of  two-dimensional ultrasound imaging of fetal heart during the first trimester of pregnancy (P＜0.05). Conclusion：It is necessary to analyze various influencing factors of two-dimensional ultrasound imaging of fetal heart during the first trimester of pregnancy, and targeted to improve the corresponding influencing factors, so as to obtain clearer ultrasound imaging and to improve the prenatal detection rate of heart malformations during the first trimester of pregnancy.
  • Relationship between the serum C-peptide and glycosylated hemoglobin levels of pregnant women before cesarean section and their neonatal hypoglycemia occurrence
    LI Jianwei, GAO Xuejun, WANG Xin, ZHAO Huirong
    2021, 29(2): 403.
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    To explore the relationship between the serum C-peptide and glycosylated hemoglobin levels of pregnant women before cesarean section and their neonatal hypoglycemia occurrence. Methods: 127 pregnant women who accepted cesarean section were selected and were divided into group A (97 cases with normal neonatal blood glucose) and group B (30 cases with neonatal hypoglycemia) according to the neonatal blood glucose level of the women after cesarean section from January to Augrst 2020. The level of C-peptide of the women before cesarean section was detected by chemical immunoassay, and their level of glycosylated hemoglobin was detected by high performance liquid chromatography. Pearson method was used to analyze the correlation between the levels of serum C-peptide and glycosylated hemoglobin of the women before cesarean section and their neonatal blood glucose level. The value of serum C-peptide and glycosylated hemoglobin levels for diagnosing neonatal hypoglycemia was evaluated by receiver operating characteristic curve (ROC). Logistic regression analysis was used to analyze the related factors of neonatal hypoglycemia. Results: The serum C-peptide and GHb levels of the women in group B were 1.27±0.32 ng/ml and 5.24±0.65%, which were significant higher than those (0.93±0.27 ng/ml and 4.65±0.57%) of the women in group A (P＜0.05). Pearson correlation analysis showed that C-peptide and GHb expression levels were negatively correlated with the level of neonatal blood glucose (P＜0.05). ROC showed that AUC of the serum C-peptide level and GHb level for diagnosing neonatal hypoglycemia of the women before cesarean section were 0.785 and 0.713, respectively, and which’s the cutoff values were 1.121 ng/ml and 5.142%, respectively. When the cutoff value of serum C-peptide level was 1.121 ng/ml, the sensitivity and the specificity for diagnosing neonatal hypoglycemia were 77.6% and 73.4%, respectively. When the cutoff value of serum GHb level was 5.142%, the sensitivity and the specificity for diagnosing neonatal hypoglycemia were 63.3% and 76.1%, respectively. The AUC of the combined detection of serum C-peptide and GHb for diagnosing neonatal hypoglycemia was 0.841, and which’s sensitivity and specificity were 72.1% and 85.2%, respectively. High expression of serum C-peptide and GHb, and gestational diabetes mellitus occurrence were the independent risk factors of neonatal hypoglycemia. Conclusion: The serum C-peptide and glycosylated hemoglobin levels of pregnant women before cesarean section can be used as potential biological indicators for evaluating neonatal hypoglycemia.
  • Value of serum phosphatase of regenerating liver-3 for differential diagnosing high-grade and low-grade serous ovarian cancer
    ZOU Chunling1, WANG Liming1, SHEN Xiaoping2
    2021, 29(2): 407.
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    To analyze the expression of phosphatase of regeneration of liver-3 (PRL-3) in serum of women with high and low grade serous ovarian cancer, and to analyze its differential diagnostic value of high and low grade serous ovarian cancer. Methods: 106 women with serous ovarian cancer were selected in group A from March 2015 to January 2019, and according to the grading system proposed by the American M.D. Anderson Cancer Center, these women were divided into group A1 (45 cases with low-grade serous ovarian cancer) and group A2 (61 cases with high-grade serous ovarian cancer). In addition, 98 healthy women were selected in group B during the same period. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of serum PRL-3 of the women in the three groups, and the level of serum PRL-3 of the women was compared among the three groups. The receiver operating characteristic curve (ROC) was used to predict the value of PRL-3 level for diagnosing high or low serous ovarian cancer. Results: There were no significant differences in age, BMI, and the ratios of diabetes and high blood pressure of the women among the three groups (P>0.05). The ratio of the women with FIGO staging Ⅲ and Ⅳ in group A2 was significant higher than that of the women in group A1 (P＜0.05). The expression level of PRL-3 in serum (2.61±0.72) of the women in group A2 was the highest, followed by that (1.39±0.69) of the women in group A1, and that (1.16±0.43) of the women in group B was the lowest (P＜0.05), but there was no significant differences in the expression level of PRL-3 among the women with different FIGO staging. The area under the ROC curve, the cutoff value, the sensitivity, and the specificity of PRL-3 level for diagnosing high and low grade serous ovarian cancer were 0.887 (95%CI: 0.811-0.940), 1.95, 90.2%, and 77.8%, respectively. Conclusion: The expression of serum PRL-3 of women with serous ovarian cancer has up-regulated, and the expression of PRL-3 of women with high-grade serous ovarian cancer patients is significant higher than that of women with low-grade serous ovarian cancer. So the level of PRL-3 has certain differential diagnostic value for high-grade and low-grade serous ovarian cancer.
  • Comparison of clinical efficacy between open myomectomy and drug treatment of uterine fibroid
    LU Xia, XIAO Lin, KE Jinping, CAO Dangen
    2021, 29(2): 411.
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    To investigate the effect of clinical efficacy of open myomectomy and drug treatment of uterine fibroids. Methods: A total of 120 women with uterine fibroids were enrolled and were divided into study group and control group by the envelope method from June 2017 to May 2019. The women in the control group received conventional drug therapy and the women in the study group received open myomectomy. The complication rate, the serum hormone levels, and clinical efficacy of women were compared between the two groups. Result: After treatment, the serum levels of progesterone, estradiol, luteinizing hormone, and follicle stimulating hormone of women in the two groups had increased significantly, and those of women in the study group were significant lower than those of women in the control group (P＜0.05). The total clinical effective rate of women in the study group was 91.7%, which was significant higher than that (80.0%) of women in the control group. The incidence of complications such as fatigue, fever, lethargy, skin itch, nausea and vomiting, irregular vaginal bleeding of women in the study group was 13.3%, which was significant lower than that (43.3%) of women in the control group (all P＜0.05). Conclusion：The clinical effect of open myomectomy for treating uterine fibroids is better, which can reduce the incidence of complications and can improve serum hormone levels, so it is superior to mifepristone treatment.
  • Influence of post abortion care on anxiety and depression scores and contraceptive effect of unmarried women with abortion
    WANG Yilin，XU Hong，BAO Zhengjuan，ZHU Xue，SHI Qin
    2021, 29(2): 414.
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    To investigate the influence of post abortion care (PAC) services on anxiety and depression scores, knowledge and implementation of contraception of unmarried women with artificial abortion. Methods: 90 unmarried women with abortion were selected in this study from January 2018 to December 2018. The selfrating depression scale (SDS) and self-rating anxiety scale (SAS) were used to compare the mental health status scores of these women before and after PAC service, and the contraceptive knowledge and the effect of contraception of the women before and after PAC service were also compared. Results: The scores of depression and anxiety of the women before PAC service were 58.38±3.71 points and 59.11±2.67 points, which were significant lower than those (40.44±2.64 points and 42.08±3.69 points) of the women after PAC service (P＜0.05). After receiving PAC service, The excellent and good rate of contraceptive knowledge of the women after PAC service was 98.9%, which was significant higher than that (83.3%) of the women before PAC service (P＜0.05). The contraceptive implementation rate was of the women after PAC service 100%, which was significant higher than that (28.9%) of the women before PAC service (P＜0.05). Conclusion: After PAC service, the depression and anxiety status of the women can be better improved, and their contraceptive knowledge and the implementation rate of contraceptive measures can be enhanced after abortion.
  • Study of selection and safety of inducing labor common methods in obstetrics
    XIE Mengxiao，WANG Xin
    2021, 29(2): 417.
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    With the emergence of complications of cesarean section, safe natural delivery has been paid more and more attention in clinic. Induced labor has become the main clinical means to deal with high-risk pregnancy, reduce the rate of cesarean section, and promote natural delivery in obstetrics. Different methods of induced labor have different clinical effects and safety. While paying attention to the effectiveness, security is also particularly important. How to choose the appropriate method of promoting cervical maturation and induced labor is related to the success rate of induced labor and the safety of mother and fetus. This article will review the domestic and overseas researches on the safety of cervical maturation and induced labor, especially those researches on the selection methods of promoting cervical maturation and induced labor when women with common obstetrical complications.