To evaluate the diagnostic value of uric acid level for preeclampsia. Methods: The relevant literatures in the  databases up to July 2020, such as Chinese national knowledge infrastructure (CNKI), Wanfang, VIP, China biomedical literature database, PubMed, Embase, Cochrane Library, Clinical registry and systematically, were searched. According to the inclusion and exclusion criteria, the original literatures were screened, the quality of the literatures was evaluated, and the data were extracted from the literatures. Results: There were 10 literatures included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratio, and diagnostic odds ratio were 0.72 (95%CI: 0.69-0.74), 0.61(95%CI: 0.60-0.62), 3.28 (95%CI: 1.98-5.48), 0.33(95%CI: 0.21-0.51), and 10.36 (95%CI: 5.10-21.05), respectively. Area under the curve was 0.8380. Meta-regression analysis showed that sample size and cutoff value were the main sources of heterogeneity. There was no statistical significance for the evaluation of publication bias by Deek funnel plot. Fagan graphs showed that the pre-test probability was 50%, and the post-test probability was 94%. Conclusion: Uric acid level has higher diagnostic efficiency for preeclampsia, but its specificity is slightly poor, which should be further confirmed by more prospective researches with large samples.

2021 Vol. 29　(6):　1084- [Abstract]（ 467 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To investigate the basic situation of personnel and service situation of premarital medical examination and pre-pregnancy health examination at county level of Jiangsu province, so as to improve the service quality. Methods: In order to understand the personnel situation and service implementing status, 11 and 26 service institutions of premarital and pre-pregnancy medical examination were selected in the form of on-site inspection, inquiry, and questionnaire in 2019 and 2020, respectively. Results: The mode of premarital and pre-pregnancy examination service in Jiangsu province was "one-stop", which accounted for 81.1%, and the other 18.9% was separated service mode. The consultation and guidance was conducted by attending physicians of county-level and above, which accounted for 81.1% of premarital medical examination and 89.2% of pre-pregnancy health examination, respectively. Most of the pre-pregnancy examination services (75.7%) had been carried out only at county level. The risk exposure rate of pre-pregnancy examination and the disease detection rate of premarital examination varied greatly among different institutions, which ranged from 1.1%-52.2% and 1.8%-26.5%, respectively. Conclusion: The personnel service quality training on the premarital examination and pre-pregnancy health care in Jiangsu province still further strengthen, the service process should be standardized, and the integration of the services should be promoted.

2021 Vol. 29　(6):　1092- [Abstract]（ 335 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To investigate the clinical effect of mifepristone combined with different drugs for treating uterine cavity residues after medical induced abortion. Methods: A retrospective study was used to select 312 women who had been diagnosed as uterine cavity residues after induced abortion and had been treated by drugs conservatively from January 1, 2016 to December 31, 2017. According to the treatment methods, these women were divided into three groups, and the therapeutic effects of the women in the three groups were compared. Results: The success rate of the therapy by mifepristone combined with oxytocin spray or oxytocin intramuscular injection was significant higher than that by mifepristone combined with motherwort capsule (P<0.05). The bleeding time and amount after the therapy by mifepristone combined with oxytocin spray or oxytocin intramuscular injection were significant less than thoase by mifepristone combined with motherwort capsule treatment (P<0.05). There were no significant differences in negative conversion rate and negative conversion time of hCG among the three groups (P>0.05). The compliance and satisfaction of the therapy by mifepristone combined with oxytocin spray or motherwort capsule was significant higher than that by mifepristone combined with oxytocin intramuscular injection (P<0.05). No serious adverse reactions occurred in the three groups during treatment, and there was no significant difference in adverse reaction rate among the three groups (P>0.05). Conclusion: Mifepristone combined with oxytocin intramuscular injection or oxytocin nasal spray can effectively promote the discharge of uterine cavity residues, and the treatment compliance and satisfaction of the women by mifepristone combined with oxytocin nasal spray are higher.

2021 Vol. 29　(6):　1100- [Abstract]（ 364 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

2021 Vol. 29　(6):　1109- [Abstract]（ 410 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To evaluate the clinical efficacy of hysteroscopy-assisted transvaginal repair and hysteroscopy electrocauterization for treating cesarean scar defect (CSD) of the patients with desire to conceive in future. Methods: 93 patients with CSD who had desire to conceive in future between January 2014 and January 2019 were analyzed retrospectively. Based on different treatment methods, these patients were divided into 45 patients treated by electrocauterization in group A and 48 patients treated by hysteroscopy-assisted transvaginal repair in group B. Perioperative and postoperative situations of the patients were compared between the two groups. Results: The operation time, the intraoperative blood loss, the time of passing flatus, the perioperative and postoperative complications rates, and duration of hospitalization of the patients had no significant different between the two groups (P>0.05). The postoperative bleeding time of the patients in group B was significant shorter than that of the patients in group A (P<0.05). After 6 months of followed up, the thickness of myometrium (9.7±1.0mm) of the patients in group B was significant thicker than that (3.2±0.7mm) of the patients in group A (P<0.05). One patient in group B was transferred to laparotomy due to surgical complications. The live birth rate (93%) of the patients in group B was significant higher than that (47%) of the patients in group A (P<0.05). Conclusion: Hysteroscopy-assisted transvaginal repair for treating CSD has better clinical effect with higher full-term birth rate as compared to that of hysteroscopy electrocauterization.

2021 Vol. 29　(6):　1117- [Abstract]（ 311 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the effect of laparoscopic hysteromyomectomy for treating women with uterine fibroids on their uterine microcirculation and the pregnancy later. Methods: 180 women with uterine fibroids were selected and divided into observation group (n=91) and control group (n=89) according to the operation method from January 2017 to January 2020. The women in the control group were treated with laparotomy hysteromyomectomy, and the women in the observation group were treated with laparoscopic hysteromyomectomy. The surgical situation, blood perfusion, capillary diameter, the values of vascularization index (VI), blood flow index (FI), vascularized blood flow index (VFI), the situation of pregnancy later, the serum progesterone (P) and estradiol (E2) levels, and the incidence of adverse reactions of the women were compared between the two groups. Results: The operation time (105.5±19.1min) of the women in the observation group was significant higher than that of the women in the control group, but the blood loss (61.3±12.4ml), anal exhaust time (12.1±3.3h), the time of off-bed for activity (1.3±0.8d), and hospital stay (3.1±1.2d) of the women in the observation group were significant lower (P＜0.05). After treatment, the blood perfusion, the capillary diameter, and the values of VI, FI, and VFI of the women in both groups had increased significantly, which of the women in the observation group were significant higher than those of the women in the control group (P＜0.05). There was no significant difference in the incidence of miscarriage of the women between the two groups. The time from operation to pregnancy later (11.6±4.3 months) and the rate of premature birth (5.5%) of the women in the observation group were lower than those of the women in the control group, but the rate of full-term birth (76.9%) was significant higher (P＜0.05). After treatment, the levels of P and E2 of the women in both groups had decreased significantly, which of the women in the observation group was significant lower than those of the women in the control group (P＜0.05). The incidence of complications (8.8%) of the women in the observation group was significant lower than that (27.0%) of the women in the control group (P＜0.05). Conclusion: Laparoscopic hysteromyomectomy for treating women with uterine fibroids has significant effect, which can effectively improve the uterine microcirculation and pregnancy later, with less complications.

2021 Vol. 29　(6):　1124- [Abstract]（ 340 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the clinical effect of Jiaolai decoction combined with progesterone for treating early threatened abortion complicated with subchorionic hematoma. Methods: 90 patients with early threatened abortion complicated with subchorionic hematoma were divided into observation group and control group (45 cases in each group) according to different treatment methods from January 2018 to June 2019. The patients in the observation group were treated with Jiaoai decoction combined with progesterone, while the patients in the control group were treated with progesterone alone. The levels of prothrombin time (PT), activated partial thrombin time (APTT), D-dimer (DD), the area of subhepatic hematoma, and the side effects rate of the patients were compared between before treatment and 2 weeks after treatment. Results: 2 weeks after treatment, PT level (12.35±0.71s) of the patients in the observation group was significant higher than that (11.51±1.72s) of the patients in the control group. The levels of APTT (28.42±2.97s) and DD (0.332±0.123 μg/ml) of the patients in the observation group were significant lower than those (34.33±1.61s and 0.491±0.142μg/ml) of the patients in the control group, but the effective rate (93.3%) of the patients in the observation group was significant higher than that (73.3%) of the patients in the control group (all P＜0.05). After 2 weeks of treatment, some patients in both groups had showed early pregnant symptoms, such as nausea and retching, but the symptoms were mild and within the tolerable range, and no obvious adverse reactions were observed in both groups. There were no significantly abnormal in routine reexaminations of blood, urine and stool, the electrolyte level, and the functions of liver and kidney of the patients in both groups. Conclusion: Jiaoyai decoction combined with progesterone for treating early threatened abortion complicated with subchorionic hematoma has better curative effect with good safety and less adverse reactions.

2021 Vol. 29　(6):　1132- [Abstract]（ 380 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the effect of pneumoperitoneum laparoscopic oophorocystectomy for treating patients with benign ovarian cyst on their sex hormone level and immune function. Methods: 114 patients with benign ovarian cyst were randomly divided into the pneumoperitoneal laparoscopic group A (57 patients with pneumoperitoneal laparoscopic oophorocystectomy) and group B (57 patients with laparotomy oophorocystectomy) according to the random number table method from March 2018 to March 2020. The patients in both groups were followed up to discharged from hospital. The operation indexes of the patients in the two groups were recorded. The levels of sex hormone before operation and 1 and 3 months after operation, and the values of immune functions indexes before operation and at the time of discharge from hospital of the patients were compared between the two groups. The complications during hospitalization of the patients in the two groups were observed. Results: The amount of intraoperative blood loss (35.5±6.9ml) of the patients in group A was significant lower than that of the patients in group B, and the time of operation (54.4±3.1min), the anal exhaust time (16.7±1.3h), and the time of postoperative getting out of bed (30.2±1.3h) of the patients in group A were significant shorter than those of the patients in group B (P＜0.05). 1 and 3 months after surgery, the serum levels of estradiol (E2) and anti-mullerin hormone (AMH) of the patients in both groups were significant lower than those before surgery. 3 months after surgery, the serum E2 and AMH levels of the patients in both groups were significant lower than those of the patients 1 month after surgery, but those of the patients in group A were significant higher than those of the patients in group B (all P＜0.05). 1 and 3 months after operation, the serum levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) of the patients in the two groups were significant higher than those before operation, but those of the patients in group A were significant lower than those of the patients in group B (P＜0.05). The serum levels of FSH and LH of the patients in group A 3 months after surgery were significant lower than those 1 month after surgery (P＜0.05). The level of serum immunoglobulin G of the patients in group A was significant higher than that of the patients in group B (P＜0.05). There was no significant differences in serum immunoglobulin A and immunoglobulin M levels of the patients between the two groups (P＞0.05). During hospitalization, the incidence of complications (5.3%) of the patients in group A was significant lower than that (17.5%) of the patients in group B (P＜0.05). Conclusion: The pneumoperitoneum laparoscopic oophorocystectomy has less influence on ovarian function and immune function of the patients with benign ovarian cyst, which can reduce intraoperative blood loss and postoperative complication rate, and is helpful to the postoperative rehabilitation of the patients.

2021 Vol. 29　(6):　1141- [Abstract]（ 347 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the imaging characteristics and clinical interventional therapy for bleeding of women with ectopic pregnancy. Methods：The clinical data of 145 patients with hemorrhage caused by ectopic pregnancy from June 2018 to June 2020 were collected retrospectively. These women had undergone CT examination before surgery, and digital substraction angiography (DSA) of their bilateral external iliac artery and renal artery angiography were performed to observe the imaging characteristics during surgery. These women were divided into group A and group B according to the treatment methods. 75 women in group A were treated with uterine artery embolization (UAE), and 70 women in group B were treated with conventional surgery to remove the lesions. The situations of operation and recovery, the adverse reactions rate, and the clinical efficacy of the women were compared between the two groups. The success rate of operation (100.0%) of the women in group A was significant higher than that (97.1%) of the women in group B, and the total clinical effect rate (96.0%) of the women in group A was significant higher than that (85.7%) of the women in group B. The operative time, amount of blood loss, postoperative intestinal recovery time, and the time of blood β-chorionic gonadotropin level recovery to normal of the women in group A were all significant lower than those of the women in group B. The incidence of adverse reactions (2.7%) of the women in group A was significant lower than that (8.6%) of the women in group B (all P＜0.05). Conclusion: The imaging characteristics of preoperative CT and intraoperative DSA of the women with hemorrhage caused by ectopic pregnancy are different from those of women with conventional hemorrhage during pregnancy. Interventional therapy for bleeding has effect significantly, which can increase the success rate of treatment, can reduce the time of operation technique and postoperative recovery, and can decrease complication rate.

2021 Vol. 29　(6):　1150- [Abstract]（ 371 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To detect the level of serum exosomes miR-30 of pregnant women with preeclampsia, to study the relationship between the miR-30 level of the women and their levels of thyroid stimulating hormone (TSH) and soluble fms-like tyrosine kinase-1 (sFlt-1), and to analyze the value of serum exosomes miR-30 level for diagnosing preeclampsia. Methods: 50 pregnant women with preeclampsia were selected in study group from January 2018 to June 2020, which included 25 women with mild preeclampsia in study group 1 and 25 women with severe preeclampsia in study group 2. 50 healthy pregnant women with singleton were randomly selected in control group during the same period. The levels of serum exosome miR-30, and TSH and sFlt-1 of the women in the three groups were detected, and the values of the levels of serum exosome miR-30,  TSH, and sFlt-1 for diagnosing preeclampsia were analyzed. Results: The miR-30 expression level (3.14±0.25), the TSH level (5.32±0.51 uU/ml), and the sFLT-1 level (5.47±0.48 ng/ml) of the women in the study group 2 were significant higher than those (2.26±0.19, 3.65±0.26 uU/ml, and 2.48±0.37ng/ml) of the women in the study group 1, and the miR-30 expression level, the TSH level, and the sFLT-1 level MiR-30 of the women in the study group were significant higher than those (1.02±0.15, 2.13±0.18 uU/ml, and 1.11±0.22 ng/ml) of the women in the control group. The miR-30 expression level of the women in the study group was positively correlated with their TSH level and sFLT-1 level. The serum exosomes miR-30, TSH, and sFLT-1 levels of the pregnant women with preeclampsia were positively correlated with their values of urine protein and blood pressure (P＜0.05). Logistic multivariate regression analysis showed that the increase of serum exosome miR-30, TSH and sFLT-1 levels were the independent risk factors of preeclampsia early (P＜0.05). The combination of serum exosome miR-30 level and the levels of serum TSH and sFLT-1 had the best diagnostic efficiency for preeclampsia, which’s AUG, sensitivity, and specificity were 0.81, 70.1%, and 64.0%, respectively. Conclusion: The levels of serum exosomes miR-30, TSH, and sFlt-1 are involved in the pathogenesis of preeclampsia, so which may be used as diagnostic markers for preeclampsia.

2021 Vol. 29　(6):　1158- [Abstract]（ 370 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the effects of vaginal hysteromyomectomy of patients with uterine fibroids on their perioperative indexes and complications occurrence. Methods: 78 patients with uterine fibroids were randomly divided into group A (patients experinced laparotomy hysteromyomectomy) and group B (patients experinced vaginal hysteromyomectomy). The perioperative indexes, postoperative condition, and the rate of complications of the patients in the two groups were observed. The sex hormones levels, ovarian function, sexual function, and serum biochemical indicators levels of the patients in the two groups were compared between before operation and in the 6th month after operation. Results: The operative time, the postoperative exhaust time, and the postoperative hospitalization time of the patients in group B were significant shorter than those of the patients in group A, the amount of postoperative blood loss of the patients in group B was significant less than that of the patients in group A, and the rate of postoperative analgesics application of the patients in group B was significant lower than that of the patients in group A. The total incidence of complications (5.1%) of the patients in group B was significant lower than that (20.5%) of the patients in group A (all P＜0.05). One week after operation, the levels of serum interferon-γ (IFN-γ), angiotensin II (Ang II), ischemic-modified albumin (IMA), and average myoglobin (MYO) of the patients in group A had increased significantly (P＜0.05), while which of the patients in group B had no changed significantly (P＞0.05), and which of the patients in group A had no significant different from those of the patients in group B (P＜0.05). Six months after operation, the serum estradiol level of the patients in both groups had decreased significantly, while the levels of follicle-stimulating hormone and luteinizing hormone had increased significantly, and the serum estradiol level of the patients in group B was significant higher than that of the patients in group A (all P＜0.05). Six months after operation, the ovarian function score of the patients in both groups had increased significantly, and the score by International Female Sexual Function Assessment Scale (BISF-W) of the patients in both groups had decreased significantly, and the change range of BISF-W score of the patients in group B was significant less than that of the patients in group A (all P＜0.05). Conclusion: Vaginal hysteromyomectomy for treating patients with uterine fibroids can effectively shorten the operative time, promote the postoperative rehabilitation, and effectively improve the postoperative oxidative stress injury, which’s effect is superior to that of traditional laparotomy hysteromyomectomy.

2021 Vol. 29　(6):　1167- [Abstract]（ 320 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To investigate the curative and economic analysis of lower uterine breakwater-like suture combined with ergonovine for treating postpartum hemorrhage of women with placenta previa. Methods: 102 women with placenta previa and postpartum hemorrhage were selected and divided into control group and observation group (51 cases in each group) according to different methods of hemostasis from January 2017 to June 2019. The women in the control group were given lower uterine breakwater-like suture only for hemostasis，and the women in the observation group were given lower uterine breakwater-like suture combined with ergonovine for hemostasis. The blood loss during operation and in postoperative 2 h and 24 h, the total blood loss, the hemoglobin (Hb) level, the red blood cell (RBC) count, the Ca2+ concentration, the coagulation function, the incidence of adverse reactions, the clinical efficacy, and economic analysis of the women were compared between the two groups. Results: The average drug treatment cost (287.7 Yuan) of the women in the observation group was significant lower than that (561.20 Yuan) of the women in the control group. The amount of blood loss during operation and in postoperative 2 h and 24 h, the total blood loss amount, the concentration of Ca2+, and the incidence of adverse reaction of the women in the observation group were significant lower than those of the women in the control group. The H) level and RBC counts of the women in the observation group were significant higher than those of the women in the control group. The drug cost-effectiveness ratio (2.95) of the women in the observation group was significant lower than that (6.41) of the women in the control group. The amount of intraoperative blood loss (361.12±154.31 ml), the amount of blood loss in postoperative 2h (403.51±113.71 ml), and the amount of blood loss in postoperative 24h (467.39±129.68 ml) of the women in the observation group were significant lower than those of the women in the control group (P＜0.05). Conclusion: Lower uterine breakwater-like suture combined with ergonovine for treating women with placenta previa can reduce the amount of blood loss during cesarean section and improve their coagulation function. The incidence of adverse reactions after treatment and the cost of therapy are low.

2021 Vol. 29　(6):　1176- [Abstract]（ 312 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the situation of bacterial vaginosis and the infection of mycoplasma and chlamydia of infertility women, and to analyze the drug sensitivity. Method: From January 2019 to December 2019, 200 infertility women were included and were divided in group A (100 women without bacterial vaginosis) and group B (100 women with bacterial vaginosis). And another 100 health women were selected in group C during the same period. The infection status of pathogenic microorganism and drug sensitivity of the women were compared among the three groups. Results: The rates of single infection and multiple infections of the women in group B were 31.7% and 68.3%. The rates of single infection and multiple infections of the women in group A were 75.6% and 24.4%. The rates of single infection and multiple infections of the women in group C were 4.9% and 1.2%. The majority of women with single infection were aged＜25 years old, and the majority of women with multiple infection were aged 26-35 years and > 35 years old (P＜0.05). Drug sensitivity analysis showed that doxycycline had higher sensitivity for UU + MH, azithromycin, doxycycline, clarithromycin, and sulfoxamycin had higher sensitivity for UU, and clarithromycin and doxycycline had higher sensitivity for MH. Conclusion: The infertility women with bacterial vaginosis has higher rate of mycoplasma and chlamydia infection. Therefore, it is necessary to strengthen the pathogenic microbial screening to achieve early detection, early diagnosis, and early treatment. And it should be reasonable select antibiotics based on the results of drug sensitivity.

2021 Vol. 29　(6):　1185- [Abstract]（ 302 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

 To explore the clinical effect of estradiol valerate combined with lactic acid bacteria vaginal capsules for treating senile vaginitis. Methods: 83 patients with senile vaginitis were selected as the research subjects and were randomly divided into two groups from March 2019 to March 2020. 41 patients in the control group were given baofukang suppository combined with estradiol valerate treatment, and 42 patients in the observation group were given lactic acid bacteria vaginal capsules except to the treatment of the control group. The laboratory indexes, the positive rate of lactic acid bacteria, the changes of quality of life, and clinical efficacy of the patients in the two groups were compared before and after treatment. Results: After treatment, the levels of progesterone, estradiol, luteinizing hormone, and interleukin-6, and vaginal pH value of the patients in the observation group were significant better than those of the patients in the control group, and the rates of vaginal itching, abnormal leucorrhea, and burning sensation, and the elimination time of vaginal congestion of the patients in the observation group were significant less than those of the patients in the control group. The positive rate of lactic acid bacteria of the patients in the observation group was significant higher than that of the patients in the control group. The scores of psychological, physiological, socio-cultural, and environmental aspects in quality of life of the patients in the observation group were significant better than those of the patients in the control group. And clinical efficacy (100.0%) of the patients in the observation group was significant higher than that (90.2%) of the patients in the control group (all P＜0.05). Conclusion: Estradiol valerate combined with lactic acid bacteria vaginal capsules for treating senile vaginitis can significantly reduce the vaginal pH value of the patients, adjust the level of estrogen, shorten the disappearance time of clinical symptoms, and improve the clinical efficacy.

2021 Vol. 29　(6):　1193- [Abstract]（ 374 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

2021 Vol. 29　(6):　1201- [Abstract]（ 382 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the effects of high-risk HPV infection of infertile patients on their vaginal microecology, immune function, and clinical outcomes after assisted reproduction treatment (ART). Methods: 60 infertility patients with high risk HPV infection after ART by fresh embryo transplantation were included in group A and 60 infertility patients without high risk HPV infection after ART by fresh embryo transplantation were included in group B from January 2018 to January 2020. The differences of vaginal microecology, the immune function, and the clinical outcomes of the patients in the two groups after ART were observed. Results: The incidences of lactobacillus abnormality, bacterial vaginitis, chlamydia, ureaplasma ureticum infection, and vaginal microecological dysregulation of the patients in group A were significant higher than those of the patients in group B (P＜0.05), but there were no differences in the infection rates of mold, mycoplasma, and trichomonas of the patients between the two groups (P＞0.05). The values of CD3+, CD4+, CD4+/CD8+ and NK of the patients in group A were significant lower than those of the patients in group B, while the CD8+ value of the patients in group A was significant higher (P＜0.05). There was no significant difference in B cells value of the patients between the two groups (P＞0.05). The values of CD3+, CD4+, CD4+/CD8+, NK of the patients were negatively correlated with their high-risk HPV infection rate (P＜0.05), but the CD8+ value was positively correlated with their highrisk HPV infection rate (P＜0.05). The distribution of CD4+/CD8+ of the patients was significant different between the two groups, the rate of distribution the value 1.1-1.9 of CD4+/CD8+ of the patients in group A was significant lower than that of the patients in group B (P＜0.05). There were no significant differences in the clinical outcomes (dosage and days of GN used, trigger day endometrium situation, number of mature eggs obtained, number of effective embryos, clinical pregnancy rate, live birth rate, abortion rate, ectopic pregnancy rate, and implantation rate) of the patients after ART between the two groups (P＞0.05). Conclusion: The high risk HPV infection of the infertile patients does not affect their clinical outcomes after ART, but it leads to vaginal microecological changes and imbalance of immune function, so HPV detection of infertile women after ART should be paid more attention to in clinical practice.

2021 Vol. 29　(6):　1208- [Abstract]（ 330 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To investigate the expressions of lncRNA NEAT1 and TLR2 in peripheral blood mononuclear cell (PBMC) of pregnant women with unexplained recurrent spontaneous abortion (URSA). Methods: The clinical data of pregnant women from May 2016 to March 2018 were analyzed retrospectively, which included 97 women with URSA in group A, 50 women with normal pregnancy who wanted induced abortion in group B, and 54 healthy non-pregnant women in group C. The expression levels of lncRNA NEAT1, TLR2mRNA, and TLR2 protein in PBMC, and the levels of serum TNF-α, IL-1β, and IL-6 of the women in the three groups were detected. Pearson correlation analysis was used to analyze the correlations between lncRNA NEAT1 level of the women with URSA and their TLR2, TNF-α, IL-1β and IL-6 levels. ROC curve was used to analyze the diagnostic values of lncRNA NEAT1 and TLR2 mRNA levels for URSA. Logisitic regression analysis was used to analyze the influencing factors of URSA. Results: Compared to those of the women in group C and B, the levels of lncRNA NEAT1 and mRNA and protein of TLR2 in PBMC of the women in group A were significant higher. The serum TNF-α level, the IL-1β level, and the IL-6 level of the women in group A were 19.73±4.47pg/ml, 7.51±1.01pg/ml, and 25.39±5.47pg/ml, which were all significant higher than those (9.31±2.57pg/ml, 2.39±0.54pg/ml, and 12.15±3.54pg/ml) of the women in group B, and those (10.24±3.15pg/ml, 2.58±0.59pg/ml, and 13.52±3.76pg/ml) of the women in group C (P＜0.05). In group A, lncRNA NEAT1 expression of the women was positively correlated with their expression levels of TLR2 mRNA, TNF-α, IL-1β and IL-6 (P＜0.05). Both lncRNA NEAT1 and TLR2 were the influencing factors of URSA. The sensitivity, the specificity, and area under curve of lncRNA NEAT1 level combined with TLR2 level for diagnosing URSA were 93.6%, 90.4%, and 0.906, which all were the highest (P＜0.05). Conclusion: lncRNA NEAT1 may be involved in the occurrence of URSA recurrent by regulating the expression of downstream related inflammatory factors of TLR2 signaling pathway, which is a potential therapeutic target.

2021 Vol. 29　(6):　1216- [Abstract]（ 360 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

2021 Vol. 29　(6):　1224- [Abstract]（ 302 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To explore the value of three-dimensional ultrasound combined with pregnancy associated plasma protein A (PAPP-A) level for diagnosing placental implantation. Methods: From December 2015 to December 2018, 400 pregnant women who underwent cesarean section were selected as the study objects. According to the analysis of pathological results after delivery, they were divided into 254 women with placenta implantation in group A and 146 women without placenta implantation in group B. All these women were examined by prenatal three-dimensional (3D) ultrasonography, and the levels of serum PAPP-A and vascular endothelial growth factor (VEGF) of these women were measured before delivery. Based on the pathological results after delivery as the "gold standard", the diagnostic value of 3D ultrasonography, the serum PAPP-A level, or the combination of 3D ultrasonography and serum PAPP-A level for placenta implantation was compared. Results: The serum PAPP-A level (685.69±201.47g/L) of the women in group A was significant lower than that (896.37±245.26g/L) of the women in group B, but the serum VEGF level (342.62±37.84 pg/ml) of the women in group A was significant higher than that (278.41±34.19 pg/ml) of the women in group B (P＜0.05). The sensitivity of 3D ultrasonography, serum PAPP-A level, and the combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation were 82.7%, 88.9%, and 89.4%, respectively. The specificity of 3D ultrasonography, serum PAPP-A level, and the combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation were 84.3%, 81.5%, and 89.0%, respectively. The diagnostic accuracy of 3D ultrasonography, serum PAPP-A level, and the combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation were 83.3%, 81.8%, and 89.3%, respectively. Conclusion: The combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation can significantly improve the sensitivity and the accuracy, which has higher clinical diagnostic value.

2021 Vol. 29　(6):　1233- [Abstract]（ 300 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To study the effect of color Doppler ultrasonography for diagnosing postpartum placenta increta, and to analyze its sonographic features. Methods: The clinical data of 30 women with diagnosed postpartum placenta implantation from February 2019 to February 2020 were collected. All these women had accepted color Doppler and magnetic resonance imaging (MRI) examination before delivery. Based on the postpartum placental tissue pathological results, the effect of diagnostical placenta increta was compared between color Doppler and MRI, and the sonographic features by color Doppler and MRI were analyzed. Results: The sensitivity of color Doppler for diagnosing placenta increta was 91.2%, which was significant higher than that (82.5%) of MRI (P＜0.05), but the diagnostic accuracy, the specificity, the negative predictive value, the positive predictive value, the false positive rate, the false negative rate, the exact ratio, the diagnostic index, and Kappa value had no significant different between color Doppler and MRI (P＞0.05). In 30 women who had examined by color Doppler, there was 1 case misdiagnosed as placental adhesion. Conclusion: The value of color Doppler ultrasound for diagnosing placenta increta is similar to that of MRI, which can provide reliable evidence for clinical treatment of placenta increta.

2021 Vol. 29　(6):　1241- [Abstract]（ 353 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

 To evaluate the diagnostic significance of cervical human papillomavirus (HPV) E6 / E7mRNA combined with thin-layer liquid-based cytology (TCT) for population shunt of women with atypical squamous cells of unclear significance (ASCUS). Methods: 120 women who were screened for cervical cancer were selected in this study from August 2016 to August 2019, and all of them had accepted HPV E6/E7mRNA test and TCT. Based on the gold standard of colposcopy biopsy results, the diagnostic efficacy of HPV E6/E7mRNA alone, TCT alone, or HPV E6/E7mRNA combined with TCT for ASCUS was evaluated. Results: Among the 120 women after cervical cancer screening, 52 women were diagnosed as ASCUS, and there were 68 women without tumor cells (NILM). Based on the gold standard of colposcopy biopsy results, the diagnostic sensitivity (94.2%), the specificity (88.2%), the accuracy (90.8%), the positive predictive value (86.0%), and the negative predictive value (95.2%) for diagnosing ASCUS by E6/E7mRNA combined with TCT were significant higher than those by E6/E7mRNA alone or TCT alone (P＜0.05). Conclusion: Both HPV E6/E7mRNA and TCT have certain diagnostic significance in the population shunt of the women with ASCUS, but the combined diagnostic efficiency of HPV E6/E7mRNA and TCT is higher, which can provide more reference for clinical diagnosis and treatment, and can improve the accuracy of screening cervical cancer early.

2021 Vol. 29　(6):　1247- [Abstract]（ 567 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To investigate the value of mean platelet volume (MPV) of pregnant women during 8-15 gestational weeks for predicting their early gestational diabetes mellitus (GDM) occurrence. Methods: The clinical data of pregnant women were collected retrospectively, which included 168 cases with GDM diagnosed by glucose tolerance test during 24-28 gestational weeks in group A and 200 cases with normal glucose tolerance in group B. The difference of clinical data of the women, such as MPV value, was compared between the two groups. The risk factors of GDM were analyzed by logistics regression. The predictive value for GDM of MPV value of the women during 8-15 gestational weeks was analyzed by receiver operating characteristic (ROC) curve. Results: There were significant differences in maternal age, family history of diabetes mellitus, the pre-pregnancy BMI value, and the FPG, MPV and TC levels during 8-15 gestational weeks of the women between the two groups (P＜0.05). There were no significant differences in education level, reproductive history, and the levels of WBC, RBC, ALT, AST and TG during 8-15 gestational weeks of the women between the two groups (P＞0.05). Logistics regression analysis found that age ≥35 years old, family history of diabetes, pre-pregnancy BMI≥24kg/m2, high levels of FPG, MPV and TC during 8-15 gestational weeks were all the independent risk factors of GDM (P＜0.05). ROC curve analysis showed that the optimal cut-off value of MPV value for predicting GDM of the women during 8-15 gestational weeks was 10.33 fl, and the AUC was 0.773 (95%CI 0.727-0.819), and the sensitivity and the specificity were 65.0% and 72.6%, respectively. Conclusion: High MPV value of the pregnant women during 8-15 gestational weeks is an independent risk factor of GDM, which also has some predictive value for GDM during the second trimester of pregnancy.

2021 Vol. 29　(6):　1254- [Abstract]（ 328 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To observe correlation between serum serum pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (β-hCG) levels of pregnant women and their occurrence of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes. Methods: The clinical data of 140 pregnant women with GDM and adverse pregnancy outcomes from January 2017 to January 2020 in observation group were collected retrospectively, and their type of adverse pregnancy was identified according to the pregnancy outcomes. 140 healthy primiparas with good pregnancy outcomes were selected in control group during the same period. The levels of serum PAPP-A and β-hCG of the women were compared between the two groups. Correlation analysis was performed. Results: The serum PAPP-A level of the women in the observation group was significant lower than that of the women in the control group. The serum β-HCG level of the pregnant women with threatened abortion or fetal intrauterine dysplasia in the observation group was significant higher than that of the women in the control group (P＜0.05), but the serum β-HCG level of the pregnant women with ectopic pregnancy in the observation group was significant lower than that of the women in the control group (all P＜0.05). Correlation analysis showed that serum PAPP-A level was negatively correlated with the rates of GDM, fetal intrauterine dysplasia, ectopic pregnancy, and threatened abortion, while serum β-HCG level was positively correlated with the rates of GDM, fetal intrauterine dysplasia and threatened abortion, and serum β-HCG level was negatively correlated with ectopic pregnancy rate (all P＜0.05). Conclusion: The levels of serum of PAPP-A and β-hCG are closely related to the occurrence of GDM and adverse pregnancy outcomes, which may be applied as indexes for evaluating the risk of GDM and adverse pregnancy outcomes.

2021 Vol. 29　(6):　1263- [Abstract]（ 244 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To study the levels of plasma homocysteine (Hcy), cystatin C (Cys C)，and high sensitivity C-reactive protein (hs CRP) in prognosis evaluation of pregnant women with gestational hypertension. Methods: The clinical data of 126 pregnant women with gestational hypertension from January 2019 to December 2019 were collected and included in observation group, and 126 normal pregnant women were selected in control group during the same period. The plasma Hcy, Cys C，and hs CRP) levels of the women in the two groups were detected and compared. The pregnancy outcomes of the women in the two groups were statistics analyzed. Results: The levels of plasma Hcy (18.7±3.9 umol/L), Cys C (1.5±0.5 mg/L), and hs-CRP (5.7±1.6 mg/L) of the women in the observation group were significant higher than those (5.1±1.4 umol/L, 0.8±0.1 mg/L, and 2.5±0.5Mg /L) of the women in control group (P＜0.05). The incidence of adverse pregnancy outcome (65.9%) of the women in the observation group was significant higher than that (18.3%) of the women in the control group (P＜0.05). Plasma levels of Hcy, Cys C, and hs-CRP were positively correlated with the occurrence of gestational hypertension (r=0.589, 0.678, 0.782, all P＜0.05). Conclusion: The detection of plasma Hcy, Cys C and hs-CRP levels has some clinical significance in the prognosis evaluation of pregnant women with gestational hypertension.

2021 Vol. 29　(6):　1270- [Abstract]（ 366 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To investigate the drug resistance of the group B streptococcus (GBS) infection of women during the third trimester of pregnancy, and to study its influence on the coagulation function. Method: The clinical data of 286 pregnant women during the third trimester of pregnancy from February 2017 to February 2020 were analyzed retrospectively. According to the situation of GBS infection (confirmed by bacterial culture), these women were divided into group A (96 women with GBS infection) and group B (190 women without GBS infection). The coagulation function and pregnancy outcomes of women in the two groups were evaluated. The women in group A were given antibiotics, and the coagulation function of the women and neonatal outcomes were observed after treatment. Results: 121 strains of GBS had showed no resistance to vancomycin, ampicillin, penicillin G, cefepime, ceftriaxone, meropenem and linezolid. Antibacterial strains resistant to erythromycin, levofloxacin, tetracycline, gatifloxacin and clindamycin had been detected. The values of prothrombin time (PT), activated partial thromboplastin time (APTT), international normal ratio (INR), and thrombin time (TT) of the women in group A were significant lower than those of the women in group B, while the fibrinogen (FIB) value, and the rates of premature rupture of membranes, intrauterine infection, fetal distress, and premature delivery of the women in group A were significant higher than those of the women in group B (P＜0.05). In group A, the values of PT, APTT, INR and TT of the women had increased
significantly after treatment for 3 days and 7 days, while the FIB value of the women had decreased significantly after treatment (P＜0.05). In group A, the values of PT, APTT and INR of the women after continuous treatment for 7 days were significant higher than those of the women after continuous treatment for 3 days, while the FIB value of the women after continuous treatment for 7 days was significant lower than those of the women after continuous treatment for 3 days (P＜0.05). In group A, the women had been treated with penicillin sodium, there were 1 (2.1%) case with neonatal pneumonia, 1 (2.1%) case with neonatal asphyxia, 2 (4.2%) cases with neonatal pathological jaundice, and 1 (2.1%) case with neonatal meningitis, and which total incidence of neonatal complications was 8.3%. Conclusion: GBS infection of the pregnant women is the important cause affecting their coagulation function and pregnancy outcomes. Appropriate antibiotic treatment is the key to improving pregnancy outcomes and reducing neonatal complications.

2021 Vol. 29　(6):　1277- [Abstract]（ 486 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

 To investigate the image feature of prenatal ultrasound diagnosis for obstetric hemorrhage of pregnant women during the third trimester of pregnancy. Methods: The clinical data of 84 pregnant women with suspected obstetric hemorrhage during the third trimester of pregnancy from December 2018 to December 2019 were collected retrospectively. All these pregnant women had received prenatal ultrasound examination, and the surgical pathological diagnosis result was used as the gold standard to analyze the image feature and efficacy of prenatal ultrasound diagnosis. Results: 78 (95.1%) women of the 84 pregnant women had obstetric hemorrhage during the third trimester of pregnancy, which included 49 cases with placenta previa, 17 cases with placental abruption, 10 cases with rupture of blood sinus at the edge of placenta, and 2 cases with placenta implantation. The sensitivity, the specificity, and the accuracy of ultrasonic diagnosis were 97.4%, 66.7%, and 95.2%, respectively. Prenatal ultrasound examination had the higher diagnostic accuracy for different type of obstetric hemorrhage, which’s rate of missed diagnosis and misdiagnosis were 1.3%. Conclusion: Prenatal ultrasound diagnosis for pregnant women with obstetric hemorrhage during the third trimester of pregnancy can accurately identify the cause of bleeding, which’s  accuracy and sensitivity are high, so it can provide effective references for the targeted implementation of clinical treatment.

2021 Vol. 29　(6):　1286- [Abstract]（ 318 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To analyze the influence of cesarean section of primiparas when different dilation degrees of uterine mouth during labor on their postpartum pelvic floor muscle function. Methods: The clinical data of women who underwent pelvic floor muscle function examination during postpartum 6-8 weeks from October 2018 to June 2020 were collected. According to the delivery mode, these women were divided into group A (women with vaginal delivery), group B (women with cesarean section before labor), and group C (women with cesarean section after labor). Then according to the dilation degrees of uterine mouth when cesarean section, the women in group C were further divided into group C1 (women with uterine mouth dilation <6cm), group C2 (women with uterine mouth dilation 6-10cm), and group C3 (women in the second labor process). The difference of pelvic floor muscle function of the women was compared among these groups. The influence of cesarean section at different stages of labor on postpartum pelvic floor muscle function was analyzed. Results: There was no significant difference in the incidence of abnormal pelvic floor muscle strength (76.1% vs.77.9%) of the women between group A and group C, but the incidence of abnormal pelvic floor muscle strength of the women in group A and group C was significant higher than that (60.7%) of the women in group B (P＜0.001). There was no significant difference in the composition ratio of abnormal pelvic floor muscle strength type of the women among group A, B, and C (P＞0.05). There were no significant difference in the rates of levator muscle ΔA, ΔC, ΔL, and ε of the women between group A and group C, but which were all significant higher than those of the women in group B (P＜0.001). There was no significant difference in the total incidence of abnormal pelvic floor muscle strength (89.4% vs. 91.4%) between group C2 and group C3, but which of the women in group C2 and group C3 were significant higher than that (69.2%) of the women in group C1 (P＜0.001). There was no significant difference in the composition ratio of abnormal pelvic floor muscle strength type of the women among group C1, C2, and C3 (P＞0.05). There were no significant difference in the rates of levator muscle ΔA, ΔC, ΔL, and ε of the women between group C2 and group C3, but which were all significant higher than those of the women in group C1 (P＜0.001). Maternal age, body mass index, neonatal birth weight, uterine mouth dilation to 6-10cm, cesarean section during the second stage of labor were all the influencing factors of abnormal pelvic floor muscle strength (P＜0.05).Conclusion: The damage to pelvic floor muscle of the primiparas with cesarean section of after labor has the similar to that of the primiparas with vaginal delivery. Cesarean section after uterine mouth dilation over 6cm will aggravate the damage to pelvic floor muscle function.

2021 Vol. 29　(6):　1294- [Abstract]（ 416 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

The major human histocompatibility antigen complex is called human leukocyte antigen (HLA). Human leukocyte antigen-G (HLA-G) is the most closely related non-classical HLA-Ib molecule with pregnancy. HLA-G low polymorphism is restriction distribution in maternal fetal interface of extravillous trophoblast and other immune tissues. The role of HLA-G in immune tolerance may be related to the change of endometrial natural killer cell (NK) activity. The change of HLA-G expression level is closely related to implantation, growth and development of the embryo, pregnancy outcomes after in vitro fertilization, normal pregnancy maintenance, and occurrence and development of pathological pregnancy (such as unexplained recurrent spontaneous abortion, preeclampsia, fetal growth restriction, premature rupture of membranes, and oligohydramnios). The research of the role of HLA-G in maternal-fetal immunity may have high clinical value for the prediction, prevention, and treatment of pathological pregnancy.

2021 Vol. 29　(6):　1302- [Abstract]（ 292 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )