Adapting female ovariectomized Bama mini pigs as experimental animals, it is to compare commercially available progesterone vaginal gel with self-made progesterone sustained release vaginal ring in the pharmacokinetic characteristics, and to optimize the prescription process and provide a scientific basis for the determination of the release of self-made vaginal ring in vitro. Methods: On the basis of the preliminary experiment, gel and self-made vaginal ring of progesterone were administered to the Bama mini pigs, and then blood samples were collected at different time points, and the validated LC MS/MS method was used for detection. Then it had been conducting a comparative study on the pharmacokinetic characteristics. Results: The correlation between in vivo and in vitro of self-made vaginal ring of progesterone was good. The highest blood drug concentration of self-made vaginal ring and commercial gel were 7.054 ng/ml and 10.818 ng/ml, respectively. The blood drug concentration of self-made vaginal ring of progesterone in vivo was more stable. Conclusion: Compared with commercial progesterone gel, self-made vaginal ring of progesterone has more stable blood concentration in vivo and can reduce the times of administration. Based on the reference reports and preliminary research results, it is estimated that the release amount of progesterone vaginal ring for assisted reproduction in vitro should be in the range of 20-25 mg/d.

2021 Vol. 29　(7):　1322- [Abstract]（ 844 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To investigate the time to pregnancy of women of childbearing age in Henan Province, and to analyze the related influencing factors so as to provide basis for carrying out health education and raising fertility of women of childbearing age. Methods: 953 women of childbearing age in Henan province who wanted to pregnancy were enrolled in this prospective cohort study by cluster sampling method. Chi square test and ANOVA were used to compare the pregnancy status of different subgroups. Multivariate analysis was performed by Cox proportional hazards model to study the factors influencing time to pregnancy of the women. Results: The average age of these 953 women was 31 years old. The main occupation was peasants and their education level was mainly undergraduates and above. There were 463 women with pregnancy in the following up period and there were 490 women without pregnancy. Compared with that of the young women, time to pregnancy was gradually prolonged with the age, and that of the women in the age of 30-34 years old was the longest (FR=0.547, P＜0.05). Compared with that of the peasant women, time to pregnancy of civil servant women was significant shorter (FR=1.460，P＜0.05). Compared with that of the women with normal weight, time to pregnancy of obese women was significant longer (FR=0.541, P＜0.05). The women with history pregnancy or with irregular menstruation had longer time to pregnancy. Conclusion: It is necessary to carry out reproductive health education targeted at older women, peasant, obese women, women with history pregnancy, and women with irregular menstruation, so as to improve their fertility.

2021 Vol. 29　(7):　1331- [Abstract]（ 893 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To investigate the stigma for disease and reproductive pressure of infertile women, and to analyze the related influencing factors. Methods: 338 infertile women were selected as the research objects. The general situation questionnaire, scale of stigma for disease, and fertility pressure questionnaire were issued to evaluate the stigma for disease and fertility pressure of these infertile women, and the related influencing factors of their stigma for disease and fertility pressure were analyzed. Results: The total scores of stigma for disease and birth pressure of the infertile women were 58.64±21.73 points and 143.52±25.73 points, respectively. From high to low, the average scores of each item of stigma for disease were social withdrawal, self derogation, family members' humiliation, and the humiliation of the surrounding people. From high to low, the average score of each items of reproductive pressure were childless lifestyle, parents' role needs, social relations, marital relations, and sexual relations. There were no significant differences in the total scores of stigma for disease and reproductive pressure among the infertile women with different ages and occupations (P＞0.05). There was no significant differences in the total score of stigma for disease between the infertility women with one child and the infertility women with more than one child (P＞0.05). There were statistically significant differences in the total score of stigma for disease among the infertile women with different education levels, among the infertile women with different residence, among the infertile women with different family monthly income, among the infertile women with different pregnancy and childbearing history, or among the infertile women with different family life types. There were statistically significant differences in the total score of fertility stress among the infertile women with different education levels, among the infertile women with different residence, among the infertile women with different family monthly income, between the infertile women with whether one children, between the infertile women with whether pregnancy history, between the infertile women with whether childbearing history, or among the infertile women with different family life types (P＜0.05). Multiple linear analysis showed that education level, residence, average monthly family income, pregnancy history, childbearing history, and family life type were the influencing factors of the total score of stigma for disease (P＜0.05). Education level, place of residence, only child, birth history and family life type were the influencing factors of the total score of fertility stress (P＜0.05). Conclusion: The stigma for disease of infertile women is in the middle level, but the level of reproductive pressure is high. Family income, education level, family care, and pregnancy preparation time are the main factors affecting the stigma for disease and reproductive pressure.

2021 Vol. 29　(7):　1339- [Abstract]（ 399 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the effect of Xuefuzhuyu capsule combined with drospirenone ethinylestradiol tablets for preventing endometrial polyp (EP) recurrence of women after hysteroscopic endometrial polyp excision. Methods: The women with EP after hysteroscopy endometrial polyps excision were selected as the study objects from February 2016 to October 2018. These women were divided into observation group and control group according to the principle of random number. The women in the observation group were treated with Xuefuzhuyu capsule combined with drospirenone ethinylestradiol tablets, and the women in the control group were treated with drospirenone ethinylestradiol tablet. The endometrial thickness, menstrual volume, complications rate, and EP recurrence rate in 6 months, 12 months and 18 months of the women after operation were compared between the two groups. Results: The endometrial thickness and PBAC score in 6, 12 and 18 months after operation of the women in the two groups had decreased significantly, and which of the women in the observation group were significant lower than those of the women in the control group (all P＜0.05). There were no significant differences in the incidences of gastrointestinal reactions and irregular vaginal bleeding of the women between the two groups (P＞0.05). There was no significant difference in the recurrence rate of EP (1.1% vs.0.0%) of the women in 6 months after operation between the two groups (P＞0.05), but which (3.1% and 7.3%) of the women in the observation group in 12 and 18 months after operation were significant lower than those (11.7% and 19.2%) of the women in the control group (P＜0.05). There was no significant difference in the rate of the women with the average diameter of maximum polyps ≥2.0cm in 6 months after surgery between the two groups (P＞0.05), but which (2.0% and 4.1%) of the women in the observation group in 12 and 18 months after operation were significant lower than those (15.4% and 23.1%) of the women in the control group (P＜0.05). There was no significant difference in the rate of the women with the average diameter of maximum polyps <2.0cm in 6, 12, and 18 months after operation between the two groups (P＞0.05). There was no significant difference in the rate of the women with the number of polyps ≥3 in 6 months after operation between the two groups (P＞0.05), but which (4.3% and 4.3%) of the women in the observation group in 12 and 18 months after operation were significant lower than those (19.1% and 23.8%) of the women in the control group (P＜0.05). There was no significant difference in the rate of the women with the number of polyps <3 in 6, 12, and 18 months after operation between the two groups (P＞0.05). Conclusion: The efficacy of Xuefuzhuyu capsule combined with drospirenone ethinylestradiol tablets for preventing EP recurrence after hysteroscopy endometrial polyps excision is superior to that of drospirenone ethinylestradiol tablets used alone, especially for the women with large or multiple polyps.

2021 Vol. 29　(7):　1348- [Abstract]（ 467 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

To compare the clinical effect of propofol combined with nalbuphine, dezocine, or sufentanil for analgesia in painless induced abortion. Methods: From January 2019 to June 2020, 156 pregnant women who wanted painless induced abortion during the first trimester of pregnancy were selected and were divided into three groups by random number table, which included group A (52 women accepted propofol combined with dezocine for analgesia), group B(52 women accepted propofol combined with nalbuphine for analgesia), and group C (52 women accepted propofol combined with sufentanil for analgesia). The values of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and blood oxygen saturation (SpO2) of the women at different times, anesthesia effect, and adverse reactions rate of the women were compared among the three groups. Results: The values of SBP, DBP, and SpO2 of the women before administration of anesthesia drug and when eyelash reaction disappeared in group B were significant higher than those of the women in group A and group C (P＜0.05). The dosage of propofol (113.7±10.3mg) and awaken time (3.35±0.4min) of the women in group B were significant less than those (132.2±21.5mg and 7.1±1.3 min) of the women in group A, and those (129.4±15.7mg and 5.8±0.9min) in group C (P＜0.05). The total incidence of adverse reaction (19.2%) of the women in group B was significant lower than that (57.7%) of the women in group A, and that (53.9%) of the women in group C (P＜0.05). Conclusion: The efficacy and safety of propofol combined with nalbuphine for anesthesia in painless induced abortion are better than those of propofol combined with dezocine or sufentanil.

2021 Vol. 29　(7):　1356- [Abstract]（ 357 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the application of transversus abdominal plane block (TABP) combined with patient-controlled intravenous analgesia (PCIA) for postoperative analgesia of women after cesarean section. Methods: 90 women who underwent cesarean section were enrolled and were divided into two groups (45 cases in each group) by random number table method from February 2018 to February 2020. The women in the control group were given PCIA, while the women in the observation group were given TABP combined with PCIA. The score of visual analogue scale (VAS), the situation of analgesic pump used, the sufentanil dosage, the extubation time, the anal exhaust time, the hospitalization time, the values of hemodynamic indexes systolic blood pressure (SBP), the diastolic blood pressure (DBP) value, and heart rate (HR), and the incidence of complications of the women were compared between the two groups. Results:  The dynamic VAS scores of the women in the observation group at 4h, 6h, 8h, 24h and 48h after operation were significant lower than those of the women in the control group (P＜0.05), but there was no significant difference in the VAS scores of the women between the two groups (P＞0.05). The duration from operation finished to the first pressure of analgesia pump (12.5±5.1h) of the women in the observation group was significant longer than that of the women in the control group. The number of pressure times of analgesia pump (2.1±0.7 times) and the amount of sufentanil (50.6±6.3 mg) in 24h after surgery of the women in the observation group were significant lower than those of the women in the control group. The anal exhaust time (4.7±1.2d) of the women in the observation group was significant shorter than that of the women in the control group. The values of SBP, DBP and HR before and after extubation of the women in the observation group were significant lower than those of the women in the control group. The complication rate (13.3%) of the women in the observation group was significant lower than that (31.1%) of the women in the control group (all P＜0.05). Conclusion: TABP combined with PCIA for postoperative analgesia after cesarean section has better effectiveness, which can reduce the PCIA dosage, the stabilize hemodynamics, and the promote gastrointestinal peristalsis, with relatively higher safety.

2021 Vol. 29　(7):　1364- [Abstract]（ 356 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To investigate the effect of estradiol valerate combined with dydrogesterone for treating women with climacteric syndrome, and to study its influence on immune function, sex hormone levels, endometrial thickness, and bone mineral density of the women. Methods: 165 women with climacteric syndrome were divided into study group (n=84) and control group (n=81) by random number table method between February 2017 and September 2019. The women in the control group were treated with estradiol valerate, and the women in the study group were treated with estradiol valerate combined with dydrogesterone. The curative effect of the women, and the influence on the immune function, the sex hormone levels, and the endometrial thickness of the women in the two groups were analyzed. Results: After treatment, the efficacy (94.1%) of the women in the study group was significant higher than that (81.0%) of the women in the control group. The values of the immune indexes, such as CD3+, CD4+ and CD4+/CD8+ of the women in both groups had increased significantly, but the value CD8+ of the women in both groups had decreased significantly, and the change range of the women in the study group was significant more than that of the women in the control group. The endometrial thickness (5.15±0.12mm) of the women in the study group was significant higher than that (5.03± 0.23mm) of the women in the control group, and the bone mineral density values of bilateral femur and L1-4 level of the women in the study group were significant higher than those of the women in the control group. The levels of inflammatory factors of the women in the study group were significant lower than those of the women in the control group. The levels of follicle stimulating hormone and luteinizing hormone of the women in the study group were significant lower than those of the women in the control group, but the levels of estradiol and progesterone of the women in the study group were significant higher (all P＜0.05). Conclusion: Estradiol valerate combined with dydrogesterone for treating women with climacteric syndrome, which can significantly relieve their clinical symptoms, improve their immune function, increase their sex hormone levels, and promote the recovery of their endometrial thickness.

2021 Vol. 29　(7):　1374- [Abstract]（ 399 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To investigate the influence of levothyroxine (LT4) for intervening pregnant women with subclinical hypothyroidism and negative thyroid gland peroxidase antibody (TPOAb) during different gestational weeks on the pregnancy outcomes and the neurological function of infants. Methods：1158 pregnant women with subclinical hypothyroidism and negative TPOAb were enrolled and divided into group A (447 women with 2.5 mIU/L<TSH level≤4.0 mIU/L) and group B (681 women with TSH level >4.0mIU/L) according to the different TSH levels from April 2015 to June 2019. Another 200 pregnant women with TPOAb negative and normal thyroid function were selected in group C. The women in group A were further divided into group A1 (257 women with LT4 treatment during less than 10 gestational weeks) and group A2 (220 women without LT4 treatment) according to LT4 treatment time. The women in group B were further divided into group B1 (198 women without LT4 treatment), group B2 (154 women with LT4 treatment during less than 10 gestational weeks), group B3 (176 women with LT4 treatment during 10-16 gestational weeks), and group B4 (153 women with LT4 treatment during 16-24 gestational weeks). The pregnancy outcomes, and the neurobehavioral and physical function of children with 1.5 years old assessed by Gesell Development Diagnosis Scales were analyzed. Results：The incidences of gestational diabetes mellitus and preterm delivery of the women in groups A2 and B1 were significant higher than those of the women in group C, group A1, group B4, group B3, and group B2 (P＜0.05). There were no significant differences in the values of physical development indexes (body weight, body length, and head circumference) of the children among these groups (P＞0.05). The neurobehavioral ability score of the children in group A2 was significant higher than that of the children in group B1, and which of the children in group B1 was significant lower than that of the children in group C (P＜0.05). There were significant differences in infant development quotient, response DQ, language DQ, and social abilities DQ among groups of the children among group B1, group B2, group B3, and group B4 (P＜0.05). The time of LT4 intervention for pregnant women was negatively correlated with the developmental quotient, the motor ability DQ, fine motor, the response, the social ability, and the language ability of their children (P＜0.05). Conclusion：The later intervention time of LT4 for pregnant women is, the higher incidence of gestational diabetes mellitus and premature delivery, and the more severity of neurobehavioral impairment of their infants. 

2021 Vol. 29　(7):　1383- [Abstract]（ 295 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To explore the effects of colonization of group B streptococcus (GBS) in reproductive tract of pregnant women during the third trimester of pregnancy on their reproductive tract microecology and pregnancy outcomes. Methods: 876 pregnant women during the third trimester of pregnancy were selected as the research objects from January 2019 to December 2019. PCR chromatography was used to detect the colonization situation of GBS. The reproductive tract microecology of these women was tested, and pregnancy outcomes of these women were tracked. Results: Among these 876 pregnant women, the positive rate of GBS colonization was 16.9%. There were significant differences in the proportions of the vaginal cleanliness I-II (75.7% vs. 89.2%), the vaginal cleanliness III-IV (24.3% vs. 10.9%), bacterial vaginosis (6.1% vs. 2.1%), aerobic vaginitis (4.1% vs.1.1%), candida vaginitis  (7.4% vs. 1.8%), respectively. There were no significant differences in the rates of imbalance of the reproductive tract bacteria distribution (17.6% vs. 5.0%) and pH>4.5 (31.8% vs. 12.1%) between the women with positive of GBS colonization and the women with negative of GBS colonization (P＜0.05). The incidences of the amniotic fluid pollution, the chorionic amniotis, the premature rupture of membranes, the intrauterine infection, the fetal distress, puerperal infection, the neonatal infection, the neonatal asphyxia, and the neonatal pneumonia of the women with positive of GBS colonization were significant higher than those of the women with negative of GBS colonization (P＜0.05). The incidences of the prenatal fever, the preterm delivery, and the neonatal septicemia had no difference between the women with positive of GBS colonization and the women with negative of GBS colonization (P＜0.05). Conclusion: The positive colonization of GBS in the reproductive tract of pregnant women during the third trimester of pregnancy may be closely related to their microecological disorders of the reproductive tract, which will increase the risk of amniotic fluid pollution, intrauterine infection, premature rupture of membranes, and poor neonatal prognosis.

2021 Vol. 29　(7):　1392- [Abstract]（ 751 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To analyze the effect of iodine nutrition combined with thyroid hormone replacement therapy for pregnant women with subclinical hypothyroidism. Methods: 150 pregnant women with subclinical hypothyroidism were selected and divided into two groups according to the number random table method from January 2018 to March 2020. 75 women in control group were given iodine nutrition, and 75 women in observation group were given iodine nutrition combined with thyroid hormone replacement therapy. The changes of thyroid function indexes levels and pregnancy outcomes of the women were compared between the two groups. Results: During 32 gestational weeks, the level of serum free thyroxine 4 (FT4) (9.80±2.63 pmol/L) of the women in the observation group was significant higher than that (8.10±2.49 pmol/L) of the women in the control group, and the level of thyroid stimulating hormone (TSH) (1.50±0.51 mIU/L) of the women in the observation group was significant lower than that (2.01±0.49 mIU/L) of the women in the control group. The variation coefficients of the values of 24h SBP (11.05± 1.24mmHg) and 24h DBP (6.24± 1.15mmHg) of the women in the observation group were significant lower than those (13.46± 1.36mmHg and 7.36± 1.20mmHg) of the women in the control group. The incidence of adverse pregnancy outcomes (4.0%) of the women in the observation group was significant lower that (13.3%) of the women in the control group (all P＜0.05). There was no significant difference in the incidence of adverse outcomes (1.3% vs. 4.0%) of perinatal infants between the two groups (P＞0.05). During the treatment period, the women in both groups were able to tolerate. 1 woman (1.3%) in the observation group had palpitation discomfort at the beginning of treatment, and which symptoms had disappeared after increasing the dosage of FT4, and then had no any discomfort after gradually increased the dosage of FT4. All the women in the control group had completed the treatment without any palpitation and other discomfort. Conclusion: Iodine nutrition combined with thyroid hormone replacement therapy for pregnant women with subclinical hypothyroidism can significantly improve their thyroid function, which can reduce the occurrence of adverse pregnancy outcomes with higher safety.

2021 Vol. 29　(7):　1399- [Abstract]（ 400 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To analyze the effect of kangfu antiphlogistic suppository for promoting uterine involution of parturients after different delivery mode. Methods: 280 parturients were selected and were divided two groups (140 cases in each group) from March 2018 to March 2019. The parturients in the control group had received conventional treatment, and the parturients in the study group had received kangfu antiphlogistic suppository except to conventional treatment. The speed of uterine fundus declined within 3 days after delivery, vaginal bleeding volume, uterine contractility pain score, and duration of lochia of the parturients were compared between the two groups. Results: The score of uterine contractility pain within 3 days after delivery, the amount of vaginal bleeding, and the duration of lochia of the parturients in the study group were all significant lower than those of the parturients in the control group (P＜0.05), and there was no significant difference in the speed of uterine fundus declined within 3 days after delivery of the parturients between the two groups (P>0.05). The postpartum uterine contraction pain score within 3 days after delivery, vaginal bleeding volume, and the duration of lochia, and postpartum uterine contraction pain score, and vaginal bleeding amount in the second day or the 3rd day of the parturients with cesarean section or vaginal delivery in the study group were significant less than those of the parturients with the same delivery mode in the control group (all P＜0.05). There were no significant differences in the speed of uterine fundus declined within 3 days after delivery, the vaginal bleeding volume, uterine contractility pain score in the first day after delivery, and the speed of uterine fundus declined in the first ,second ,or third day between the parturients with cesarean section or vaginal delivery (P>0.05). Conclusion: Kangfu antiphlogistic suppository can promote uterine involution, and it has the same effect for the parturients with cesarean section or vaginal delivery.

2021 Vol. 29　(7):　1407- [Abstract]（ 572 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To analyze the change of the expression levels of plasma angiogenin-1 (Ang-1), and the CD1a, and CD56 in fetal sac tissue of the women with abnormal uterine bleeding after medical abortion by mifepristone. Methods: 85 women after medical abortion by mifepristone were included and were divided into group A (women with abnormal uterine bleeding >14d) and group B (women with uterine bleeding <14d). Radioimmunoassay was used to detect the plasma Ang-1 level, and immunohistochemical method was used to detect the CD1a and CD56 levels in fetal sac tissue. Logistics regression model was used to analyze the relationship between the expression levels of Ang-1, CD1a, and CD56 of the women with medical abortion by mifepristone and their abnormal uterine bleeding. Results: The levels of Ang-1 (365.38±32.15 ng/L), CD1A (25.38±5.21%), and CD56 (15.81±3.39%) of the women in group A were significant higher than those (258.67±28.91 ng/L, 8.65%±2.13%, and 5.68%±1.58%) of the women in group B (P＜0.05). The high levels of Ang-1, CD1A, and CD56 expression were the independent risk factors of abnormal uterine bleeding of the women after medical abortion by mifepristone (P＜0.05). Conclusion: The levels of Ang-1, CD1a and CD56 the women with abnormal uterine bleeding after medical abortion by mifepristone are abnormally high expression, and the high levels of Ang-1, CD1A, and CD56 expression are all the independent risk factors of their abnormal uterine bleeding occurrence.

2021 Vol. 29　(7):　1414- [Abstract]（ 386 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the effect of transvaginal debridement and incision diverticulum repair of pregnant lesions, and laparoscopic surgery for treating women with cesarean scars pregnancy (CSP). Method: The clinical data of 180 women with CSP from October 2014 to October 2017 were analyzed retrospectively, and these women were divided into group A (92 women with transvaginal debridement and incision diverticulum repair of pregnant lesions) and group B (88 women with laparoscopic surgery for debridement and incision diverticulum repair of pregnant lesions) according to the different treatments. The operative indexes, the situations of diverticulum and menstrual improvement before and after treatment, and the rates of complications and recurrence of the women were compared between the two groups. Results: Postoperative vaginal bleeding time, intraoperative bleeding, operation time, and hospitalization time of the women in group B were significant better than those of the women in group A. The diverticulum depth and diverticulum width of the women in both groups had decreased significantly, and the menstrual period of the women in both groups had shortened significantly (P＜0.05), but which all of the women after treatment had no significant differences between the two groups (P＞0.05). There was no significant difference in pregnancy rate (51.1% vs.51.1%) of the women within 2 years after operation between the two groups (P=0.995). The intrauterine pregnancy rate of the women in group A was significant higher than that of the women in group B (P＜0.05). There were no significant differences in the rates of scar pregnancy, diverticular pregnancy, and secondary infertility of the women between the two groups. There was no significant difference in the complication rate (4.4% vs.5.7%) of the women between the two groups (P=0.681). Conclusion: Both transvaginal pregnancy lesion debridement and incision diverticulum repair and laparoscopic surgery for treating CSP have good curative treatment. So in order to achieve the best therapeutic effect, appropriate surgical methods should be selected according to the specific situation in clinical practice.

2021 Vol. 29　(7):　1423- [Abstract]（ 356 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To study the expression of serum plasminogen activator inhibitor-1 (PAI-1), soluble human leukocyte antigen-G (sHLA-G), macrophage mobility inhibitor (MMIF) of women with endometriosis, and to study their significance for clinical diagnosis in endometriosis (Ems). Methods: 68 women with Ems were included in study group from January 2019 to June 2020. In addition, 65 healthy women were selected in control group during the same period. The levels of serum PAI-1, SHla-G, and MMIF of the women in the two groups were analyzed. The serum PAI-1, SHla-g and MMIF levels for diagnosing Ems was analyzed by receiver operating characteristic (ROC) curve. Results: The serum levels of PAI-1 (193.56±61.68 mg/L), SHLA-G (10.68±1.74μg/L), and MMIF (2.01±0.42 ng/ml) of the women in the study group were significant higher than those of the women in the control group. The serum levels of PAI-1, SHLA-G, and MMIF of the women with II stage of Ems were the lowest, and then followed by those of the women with III stage of Ems, and those of the women with IV stage of Ems were the highest. The serum levels of the PAI-1, the SHLA-G, and the MMIF of the women with mild dysmenorrhea were the lowest, and then followed by those of the women with moderate dysmenorrhea, and those of the women with severe dysmenorrhea were the highest (all P＜0.05). The AUC of the PAI-1 level for predicting Ems was 0.983, and its 95%CI was 0.935-1.000. The AUC of the sHLA-G level for predicting Ems was 0.986, and its 95%CI was 0.975-0.993. The AUC of MMIF for predicting Ems was 0.981, and its 95%CI was 0.959-0.992. The AUC of combined detection levels of the PAI-1, the sHLA-G, and the MMIF for predicting Ems was 0.996, and its 95%CI was 0.993-1.000, which were significant higher than those of the PAI-1 level, the sHLA-G level, or the MMIF level alone (P＜0.05).The specificity (93.2%) and the accuracy (94.3%) of combined detection levels of the PAI-1, the sHLA-G, and the MMIF for predicting Ems were both significant higher than those of the PAI-1 level, the sHLA-G level, or the MMIF level alone. Conclusion: The expression levels of serum PAI-1, SHla-g, and MMIF of the women with Ems are closely related to their different stages of Ems and their severe degree of dysmenorrhea, so the levels of the serum PAI-1, SHla-g, and MMIF have high predictive value for Ems.

2021 Vol. 29　(7):　1431- [Abstract]（ 416 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the correlation between serum estradiol (E2), 25-OH vitamin D ［25(OH)D］ levels of the women and their clinical pregnancy outcome after single frozen-thawed blastocyst transfer (SFBT). Methods: The clinical data of 204 women who had received SFBT from June 2018 to July 2020 were analyzed retrospectively, and according to the clinical pregnancy outcomes, these women were divided into group A (107 women with clinical pregnancy) and group B (97 women without clinical pregnancy). The general data of the women were compared between the two groups. The level of serum E2 of the women was measured by microparticle chemiluminescence method, and the level of serum 25(OH) D of the women was determined by high performance liquid chromatography-tandem mass spectrometry. Logistic regression analysis was used to analyze the influencing factors of clinical pregnancy outcomes, and receiver operating characteristic (ROC) curve was used to analyze the predicting value of serum E2 and 25(OH) D levels for clinical pregnancy outcomes. Results: There were no significant differences in age, duration of infertility, body mass index, endometrial thickness, infertility type, and basal follicle stimulating hormone (bFSH) level of the women between the two groups (P＞0.05). The levels of serum E2 (544.92±108.63 pmol/L) and 25(OH) D (65.37±16.26 nmol/L) of the women in group A were significant higher than those (365.73±72.57 pmol/L and 41.65±10.44 nmol/L) of the women in group B (P＜0.05). The levels of serum E2 and 25(OH) D of the women were the protective factors affecting their clinical pregnancy outcomes (P＜0.05), but age of the women was the risk factor affecting their clinical pregnancy outcomes (P＜0.05). The area under the curve (AUC), the cutoff value, the sensitivity, and the specificity of the E2 level for predicting the clinical pregnancy outcomes of the women after SFBT were 0.892, 444.76 pmol/L, 89.7%, and 79.4%. The AUC, the cutoff value, the sensitivity, and the specificity of the 25(OH) D level for predicting the clinical pregnancy outcomes of the women after SFBT were 0.893, 52.72 nmol/L, 88.7%, and 78.5%, respectively. And the AUC, the sensitivity, and the specificity of combinational E2 and 25 (OH) D levels for predicting the clinical pregnancy outcomes of the women after SFBT were 0.949, 87.6%, and 93.5%, respectively. Conclusion: The levels of serum E2 and 25(OH) D of the women without pregnancy after SFBT are low, which may affect the clinical pregnancy outcomes of the women after SFBT. The combination of the detected levels of E2 and 25(OH) D of the women after SFBT can improve the predictive value for clinical pregnancy outcomes.

2021 Vol. 29　(7):　1439- [Abstract]（ 343 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To study the relationship between the infections of urealytium (UU) and choamydiae (CT) of women and their infertility and recurrent spontaneous abortiont. Methods: 125 women with UU and CT infections from June 2018 to June 2020 were collected retrospectively, and the women were divided into group A (38 women with abortion), and group B (38 women with infertility), and group C (23 normal women) according to the different conditions of the women. The situations of UU and CT infections of the women were compared among the three groups, and the related factors were analyzed. Results: All the categorical variables did not conform to normal distribution, so nonparametric test was used in this study. The rate of UU infection (76.3%) or CT infection (63.2%) of the women in group B was the highest, and then followed by that (44.7% or 34.2%) of the women in group A, and that (17.4% or 17.4%) of the women in group C was the lowest (P＜0.05). The independent risk factors infecting UU infection of the women had included cervical disease, abnormal menstruation, abnormal immunity, and frequent sexual life. The independent risk factors infecting CT infection of the women had included endocrine abnormality and hereditary thrombosis. UU infection rate was positively correlated with cervical disease, frequent sexual life, abnormal menstruation, and immune abnormality. CT infection rate was positively correlated with endocrine abnormality and hereditary thrombosis (all P＜0.05). Conclusion: UU and CT infections of the women are closely related to their recurrent spontaneous abortion and infertility, so early screening should be focused in the diagnosis and treatment of UU and CT infections in time.

2021 Vol. 29　(7):　1449- [Abstract]（ 702 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

2021 Vol. 29　(7):　1457- [Abstract]（ 295 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To investigate the maternal vaginal microecological imbalance of full-term pregnant women with premature rupture of membranes (PROM), and to study the changes of their serum B7-H4, interleukin-6 (IL-6), and interleukin-22 (IL-22) levels. Methods: 96 full-term pregnant women with PROM from June 2016 to January 2020 were collected in observation group retrospectively, and 50 fullterm pregnant women without PROM were included in control group. The relationship between the PROM and the vaginal microecological change of the women was analyzed, and the changes of the serum B7-H4, IL-6, IL-22 levels of the women with PROM were also analyzed. Results: The ratios of vaginal lactobacilli (21.9%), G+ bacilli (13.5%), and G+ cocci (32.3%) of the women in the observation group were significant different from those (54.0%, 38.0%, and 6.0%) of the women in the control group. The proportion of vaginal microorganism imbalance (93.8%) of the women in the observation group was significant higher than that (60.0%) of the women in the control group. The levels of serum B7H4 (13.02±2.16ng /ml), IL-6 (28.46±6.63pg /ml), and IL-22 (43.15±6.78pg /ml) of the women in the observation group were significant higher than those of the women in the control group (P＜0.05). Conclusion: Maternal vaginal microecological imbalance of full-term pregnant women with PROM is severe. And the dominant bacteria in the vagina have also changed significantly. Serum B7-H4, IL-6, and IL-22 levels of the women increase, which may be related to the decrease of pathogen clearance ability and the enhancement of inflammatory response because of the vaginal microecological imbalance. 

2021 Vol. 29　(7):　1467- [Abstract]（ 370 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

2021 Vol. 29　(7):　1475- [Abstract]（ 453 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

2021 Vol. 29　(7):　1484- [Abstract]（ 348 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the perinatal management and maternal and infant outcomes of the delayed delivery of women with multiple pregnancy. Methods: The clinical data of delayed delivery of 11 women with multiple pregnancies were analyzed retrospectively. The clinical treatment situation, the gestational weeks of delivery, and the interval time of delayed delivery, and the prognosis of newborn and pregnant women were analyzed. These women were divided into two groups, which included the women with normal C-reactive protein (CRP) level in group A and the women with abnormal CRP level in group B according to the CRP level of the women in 1 week after delivery of the first fetus. The white blood cell count, the neutrophil percentage, the neonatal weight, and the interval time of delayed delivery of the women on the day of symptom onset, on the day of the first fetus delivery, and in 1 week after the first fetus delivery were analyzed and compared between the two groups. Results: There were 7 twin pregnancies and 4 triplet pregnancies. The average gestational weeks of the first fetus was 18.8 weeks, the average birth weight of the first fetus was 190g, and the perinatal survival rate was 0%. The interval time of delayed delivery of the second fetus was 1-140 d, with an average of 65.9 d. The average gestational weeks of the second fetus when delivery was 28.0 weeks, and the average birth weight of the retaining fetus was 1188 g. There were 6 fetuses survived, and the survival rate is 6/14. The perinatal fetal survival rate was 23.1% (6/26). The birth weight of the surviving newborns was 2260 (1550-2950g). There were significant differences in the fetal birth weight and the delay interval time between group A and abnormal B (P＜0.05). Conclusion: Delayed delivery of the women with multiple pregnancies after the first fetus born can significantly prolong the gestational weeks and improve perinatal survival rate of the other fetuses. CRP value level of the pregnant women in the first week after delivery of the first fetus can be used as a prognostic indicator.

2021 Vol. 29　(7):　1492- [Abstract]（ 321 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To explore the value of the levels of serum ferritin (SF), hemoglobin (Hb), and glycosylated hemoglobin (HbA1c) of the pregnant women during the first and the second trimester of pregnancy for predicting their risk of gestational diabetes mellitus (GDM). Methods: The clinical data of 300 singleton pregnant women during 12-16 gestational weeks between June 2017 and June 2019 were collected. During the first and the second trimester of pregnancy, the levels of SF, Hb, and HbA1c of these women were detected, and 75g oral glucose tolerance test (OGTT) for screening GDM was conducted. These women were divided into group A (women with GDM) and group B (women without GDM). The levels of SF, Hb, and HbA1c of the women were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the value of the levels of SF, Hb, and HbA1c of the women for predicting the risk of GDM, and used to analyze their correlation with the level of fasting plasma glucose (FPG). Results: The levels of FPG, 1h and 2h blood glucose, and HbA1c of the women in group A were significant higher than those of the women in group B (P＜0.05). The incidences of premature delivery, premature rupture of membranes, polyhydramnios, and fetal macrosomia of the women in group A were significant higher than those of the women in group B (P＜0.05). The SF level of the pregnant women during the first and the second trimester of pregnancy for predicting their GDM was the highest (P＜0.05), which’s cut-off value, area under the curve (AUC), sensitivity, and specificity were 132.96 μg/L, 0.860, 79.3%, and 96.7%, respectively. The levels of HbA1c and SF of the pregnant women during the first and the second trimester of pregnancy for predicting their GDM was the second highest, which’s cut-off value, AU), sensitivity, and specificity were 5.16%, 0.774，67.2%, and 90.1%, respectively. The Hb level of the women during the first and second trimester of pregnancy for predicting their GDM was lowest, which’s cut-off value, AU), sensitivity, and specificity were 118.63 g/L, 0.740, 70.7%, and 83.1%, respectively. The levels of Hb, HbA1c, and SF of the women with GDM during the first and the second trimester of pregnancy were positively correlated with their FPG level (r=0.223, 0.431, 0.521, P＜0.05). Conclusion: The SF, Hb and HbA1c levels of the pregnant women with GDM during the first and the second trimester of pregnancy are significant higher than those of the pregnant women without GDM. The comprehensive efficiency of the SF level for predicting GDM is the highest, and then followed by the HbA1c level. Monitoring the SF, HbA1c and Hb levels of the women with GDM during the first and the second trimester of pregnancy can provide evidences for early diagnosing GDM.

2021 Vol. 29　(7):　1502- [Abstract]（ 333 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To investigate the clinical outcomes of different induction methods of pregnant women with complete placenta previa during the second trimester of pregnancy. Methods: Retrospective analysis was conducted in 200 pregnant women with complete placenta previa during the second trimester of pregnancy from January 2015 to December 2019. According to the different induced labor methods, these women were divided into group A (82 women accepted drug for induced labor), group B (71 women accepted drug combined with uterine artery embolization (UAE) for induced labor), and group C (47 women accepted caesarean section). The clinical characteristics and the outcomes of induced labor of the women were compared among the three groups. Results: In group A, 5 cases (6.1%) underwent emergency caesarean section, 30 cases (36.6%) underwent emergency UAE, and the success rate of vaginal delivery was 93.9%. The success rate of vaginal delivery of the women in group B was 100%. The placental residual rate of the women in group B (16.9%) was significant higher than that (0%) of the women in group C and that (8.5%) of the women in group A. The labor induction time (28.9±10.5h) of the women in group B was significant longer than that (5.7±1.8h) of the women in group C and that (24.3±10.2h) of the women in group A. The blood loss during induced labor (320.6±230.4ml) was of the women in group B was significant lower than that (615.4±315.6lml) of the women in group C and that (395.4±262.5ml) of the women in group A (all P＜0.05). Conclusion: The success rate of vaginal delivery of the pregnant women with complete placenta previa after UAE combined with drug induction during the second trimester of pregnancy is high, which can effectively reduce the amount of bleeding during induction and the risk of emergency surgery.

2021 Vol. 29　(7):　1511- [Abstract]（ 394 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the expression of acetaldehyde dehydrogenase 1 (ALDH1), estrogen receptor (ER), and progesterone receptor (PR) in endometrial carcinoma, and to study its relevant to the clinicopathological features of endometrial carcinoma. Methods: The clinicopathologic data of 104 patients with endometrial-related disease who underwent surgery and other treatments from December 2018 to June 2020 were collected. The immunohistochemical detection method was used to detect the expressions of ER, PR, and ALDH1 in the abnormal endometrial tissues of these patients. The correlation between the ER, PR and ALDH1 levels in the abnormal endometrial tissues of the patients and their pathological features, and the diagnostic value of the ER, PR and ALDH1 levels for endometrial carcinoma were analyzed. Results: The positive rates of ER and PR in endometrial cancer tissues were significant lower than those in normal endometrial tissues, but the positive rate of ALDH1 in endometrial cancer tissues was significant higher. The positive expression rates of ER and PR in endometrial carcinoma tissues were negatively correlated with the depth of muscular invasion, pathological stage, and degree of cell differentiation of the endometrial carcinoma (P＜0.05), but which were not correlated with lymph node metastasis, menopause, or obesity of the patients (P＞0.05). Person correlation analysis had showed that the positive expression of ALDH1 in endometrial carcinoma tissues was negatively correlated with the expression of ER and PR, while the expression of ER was positively correlated with the expression of PR (P＜0.05). ROC curve analysis showed that ALDH1 level had certain diagnostic value for endometrial cancer (AUC=0.875), while ER and PR levels had low diagnostic value for endometrial cancer (AUC=0.587 and 0.666). Conclusion: The expressions of ER, PR and ALDH1 in endometrial cancer are abnormal, and the ALDH1 expression level can provide important reference for clinical diagnosis and treatment of endometrial cancer.

2021 Vol. 29　(7):　1519- [Abstract]（ 423 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

2021 Vol. 29　(7):　1532- [Abstract]（ 377 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )