2021 Vol. 29　(9):　1790- [Abstract]（ 599 ） HTML (0 KB)  PDF  (0 KB)  ( 44 )

To analyze the contraceptive status of perimenopausal women, and to study their influencing factors of induced abortion, so as to provide decision-making evidences for targeted health education and effective intervention measures. Methods: Through face-to-face interview, the contraceptive status of perimenopausal women was analyzed.  And the statistic analysis of influencing factors of induced abortion of the women was conducted. Results: Among 1080 perimenopausal women, 431(39.9%) of the women had not used any contraceptive measurement, 499(46.2%) of the women had used inefficient contraceptive methods, and 150(13.9%) of the women had used high efficient contraceptive methods. The main causes of the unexpected pregnancy of these women were no contraception used (75.3%) and contraceptive failure (24.7%). The main influencing factors of induced abortion of these perimenopausal women included believing no need of contraception during menopause, could not be pregnancy after sexual intercourse once in a while, contraceptive methods used improperly, long-term contraception used without followed up on time, and low efficient of contraceptive methods used. Conclusion: Due to special physiological reasons and insufficient cognition, the perimenopausal women have weak contraceptive awareness, improper selection and using of contraceptive methods, and poor follow-up management of long-term contraceptive measures, and have unsatisfied contraceptive services. So the contraceptive and reproductive health problems of perimenopausal women should be paid attention to, so as to promoting the reproductive health services in the whole life cycle.

2021 Vol. 29　(9):　1800- [Abstract]（ 774 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the influencing factors, and the prevention and treatment of difficult hysteroscopic intrauterine device (IUD) removal of menopausal women. Methods: A retrospective analysis was conducted on 231 postmenopausal women who underwent hysteroscopic IUD removal from January 2019 to April 2020. The related influencing factors of difficult hysteroscopic IUD removal of these menopausal women were analyzed. Results: There were 231 women with IUD removal successfully by hysteroscopic direct vision, which included 89 (38.5%) women with metal ring IUD, 70 (30.3%) women with T-shaped IUD，42 (18.2%) women with V-shaped IUDs, and 30 (13.0%) women with other types IUD. There were 89 (38.5%) women with IUD removal smoothly. And 142 women with IUD removal difficultly, which included 49 (34.5%) women with metal ring IUD, 53 (37.3%) women with T-shaped IUD， 23(16.2%) women with V-shaped IUDs, and 17 (12.0%) women with other types IUD. IUD inserted during lactation or immediately after induced abortion, the duration of IUD used, the duration of menopause, and the types of IUD were the independent risk factors of difficulty IUD removal of the postmenopausal women (P<0.05). Conclusion: The publicity and education on family planning and contraception should be paid attention to, so as to alleviating the fears on IUD removal of the postmenopausal women. And the position of the IUD of the women should be examined regularly, IUD used beyond the prescribed period should be avoided, and IUD of the women should be removed within one year after menopause.

2021 Vol. 29　(9):　1808- [Abstract]（ 458 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

2021 Vol. 29　(9):　1815- [Abstract]（ 484 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To analyze the influence of cesarean section history and intrauterine device (IUD) type of the women on their occurrence of IUD incarceration. Methods: A retrospective analysis was conducted in this study. 56 women with IUD incarceration from June 2018 to April 2021 were selected in study group, and 48 women without IUD incarceration were selected in control group during the same period. Multivariate Logistic analysis was used to explore the influence of the cesarean section history and the type of IUD of the women on their occurrence of IUD incarceration. Results: The rate of incarceration of IUD of the women with history of cesarean section was significant higher than that of the women without history of cesarean section (OR=2.374, 95%CI 1.118-5.039). The rate of incarceration of IUD of the women with metal ring IUD was significant higher than that of the women with T-shaped IUD (OR=0.401, 95%CI 0.160-0.981). Conclusion: It is necessary to consider the comprehensive factors before IUD inserted. Both the appropriate type of IUD chosen and the reducing cesarean section all can decrease the occurrence of IUD incarceration to a certain extent.

2021 Vol. 29　(9):　1823- [Abstract]（ 751 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To compare the clinical effect of two blastocyst biopsy protocols used in preimplantation genetic testing (PGT). Methods: A retrospective analysis was conducted on the clinical data of the women who had received PGT from January 2019 to June 2020. The outcomes of the women were compared between group A and group B. The blastocyst of the women in group A was punch biopsy on the 3rd day (D3) and the blastocyst of the women in group B were punch hatching punch on the 5th day (D5)combined with the shrinkage blastocyst were biopsy on the 6th (D6). Results: The average age of these woman was 30.08±3.63 years old. There were 75 PGT cycles, which included 63 cycles of the women with chromosomal diseases, 6 cycles of the women with monogenic diseases, and 6 cycles of the women with recurrent miscarriage. 348 blastocysts were biopsied, and 339 were successfully biopsied with the biopsy success rate of 97.4%. The rate of normal blastocysts detected by PGT was 41.9% (142/339). There were 51 cycles of blastocysts transplantation in 45 women, and which clinical pregnancy rate was 64.7% (33/51). The blastocyst formation rate (64.8%) of the women in group A was significant lower than that (72.0%) of the women in group B (P=0.034), and the available blastocyst formation rate (63.7%) of the women in group A was significant lower than that (73.0%) of the women in group B (P=0.025). There were no significant differences in D3 optimal embryo rate, D3 available embryo rate, and clinical pregnancy rate of the women between the two groups. Conclusion: Compared with those of the method of D3 punch biopsy of blastocyst, the blastocyst formation rate and the usable blastocyst rate of the method of D5 punch hatching of blastocyst combined with D6 shrinkage biopsy of blastocyst are better.

2021 Vol. 29　(9):　1831- [Abstract]（ 452 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To study the effect of clomiphene citrate combined with low-dose aspirin for improving the symptoms of infertility women with polycystic ovary syndrome (PCOS), and to study its influence on the levels of miR-224 and miR-206 expression of the women. Methods: 120 infertility women with PCOS were included as the research objects and were randomly divided into two groups by random number method from February 2017 to December 2018. The women in the two groups were treated with clomiphene citrate from the fifth day of menstruation to the day of ovulation for 3 menstrual cycles. The women in the observation group were given low-dose aspirin additionally. The treatment effect, the sex hormone levels, the follicular and endometrial changes, the ovarian blood flow situation, the serum mir-224 and miR-206 levels, and the adverse reactions rate of the women were compared between the two groups. Results: After treatment, the pregnancy rate (61.7%) and the ovulation rate (78.3%) of the women in the observation group were significant higher than those (43.3% and 61.7%) of the women in the control group (P<0.05). After treatment, the dominant follicle number, the thickness of endometrial hyperplasia, and the cervical mucus score of the women in the two groups had increased significantly, and those of the women in the observation group were significant higher than those of the women in the control group. The levels of follicle-stimulating hormone, estradiol, luteinizing hormone of the women in the two groups had decreased significantly, and those of the women in the observation group were significant lower than those of the women in the control group. The values of the maximum velocity and resistance index of ovary blood flow index of the women in the two groups had improved significantly, and the improved degree of which of the women in the observation group were significant better than those of the women in the control group. The levels of Mir-224 and Mir-206 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 was no significant difference in the incidence of adverse reaction of the women between the two groups (P>0.05). Conclusion: Clomiphene citrate combined with low-dose aspirin for treating the infertility women with PCOS can decrease their sex hormone level significantly and the levels of mir-224 and miR-206, and can improve the therapeutic effect significantly with good safety.

2021 Vol. 29　(9):　1840- [Abstract]（ 361 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the clinical efficacy of hysteroscopic electrotomy combined with levonorgestrel intrauterine prolonged release system (LNG-IUS) for treating the women with endometrial polyps, and to study its effect on the sex hormone and lipid metabolism levels of the women. Methods: From January 2018 to January 2021, 50 women with endometrial polyp were given hysteroscopic surgery for treating endometrial polyps. According to the method of random number, these women were divided into observation group and control group (25 cases in each group). The women in the observation group were also inserted LNG-IUS. All these women were followed up for two years after surgery. The levels of follicular estrogen (FSH) and estradiol (E2), the total cholesterol (CHO), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), apolipoprotein A1 (LAA1), and apolipoprotein B (LAB) of the women in the two groups were measured before surgery, 6 months and 12 months after surgery. The incidences of complications, infection, and the recurrence of endometrial polyps of the women in the two groups were analyzed. Results: The curative effect (96.0%) of the women in the observation group was significant higher than that (76.0%) of the women in the control group (P<0.05). The FSH and LH levels of the women in the two groups had decreased significantly after treatment, and which of the women in the observation group was significant lower than that of the women in the control group. The levels of CHO, TG, LDL-C, LAA1, and LAB of the women in the observation group were significant lower than those of the women in the control group, but the HDL-C level of the women in the observation group was significant higher (all P<0.05). The rates of complications (4.0%) and the recurrence (0%) of the women in the observation group were significant lower than those (20.0% and 16.0%) of the women in the control group (P<0.05). The preoperative menstrual cycle duration and menstrual pain scores of the women in the observation group had no significant different than those before operation (P>0.05), but the preoperative menstrual blood loss of the women in the observation group had increased significantly (P<0.05). Conclusion: Hysteroscopic electrotomy combined with LNG-IUS for treating the women with endometrial polyps has exact efficacy, which can improve their levels of sex hormone and lipid metabolism.

2021 Vol. 29　(9):　1849- [Abstract]（ 366 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To observe the efficacy and mechanism of baofukang suppository combined with xinfuning for treating women with humanpapilloma virus (HPV) infection. Methods: 218 women with HPV infection were selected as subjects and were divided in two groups by random number table method from July 2018 to July 2020. 109 women in the control group were treated with xinfuning, and 109 women in the observation group were treated with baofukang suppository combined with xinfuning. The immune function ［the number of T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+) and Foxp3+ Tregs, and the levels of immunoglobulins (IgA, IgG, IgM)］, the levels changes of inflammation indicators ［tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), interleukin-2 (IL-2)］ of the women in the two groups were observed. The HPV conversion rate of the women was statistics analyzed. The clinical efficacy and safety of these women were evaluated, and their recurrence rate was followed up for 6 months. Result: After treatment, the numbers of T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+) and Foxp3+Tregs, and the levels of immunoglobulin (IgA, IgG, IgM) of the women in the two groups had increased significantly, and which of the women in the observation group were significant higher than those of the women in the control group. The levels of TNF-α, IL-6 and IL-2 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). The HPV negative conversion rate (93.6%) and total effective rate (95.4%) of the women in the observation group were significant higher than those (82.6% and 87.2%) of the women in the control group (P<0.05). There was no significant difference in the rate of adverse reactions (7.3% vs. 6.4%) of the women between the two groups (P=0.982). The recurrence rate (1.8%) of the women in the observation group was significant lower than that (9.2%) of the women in the control group (P=0.023). Conclusion: Baofukang suppository combined with xinfuning for treating the women with HPV infection can regulate their immune function and reduce their inflammation reaction, which has significant curative effect, good safety of medication, and low recurrence rate, and which mechanism may be related to the regulation of immunity and the reduction of inflammatory response

2021 Vol. 29　(9):　1858- [Abstract]（ 377 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

2021 Vol. 29　(9):　1868- [Abstract]（ 335 ） HTML (0 KB)  PDF  (0 KB)  ( 52 )

To investigate the effect of laparoscopic improved tubal abdomen fenestration to remove embryo and suture or laparoscopic salpingectomy for treating patients with tubal ectopic pregnancy on their ovarian reserve function. Methods: The clinical data of 89 patients with tubal ectopic pregnancy from October 2018 to October 2019 were analyzed retrospectively. According to the different surgical methods, these patients were divided into control group (44 patients accepted laparoscopic salpingectomy) and observation group (45 patients accepted laparoscopic improved tubal abdomen fenestration to remove embryo and suture). The serum hormone level, surgical-related indicators, ovarian reserve function, and pregnancy within 2 years after surgery of the patients were compared between the two groups. Results: The operation time (61.8±6.5min) of the patients in the observation group was significant longer than that (54.9±5.3min) of the patients in the control group (P<0.05). There were no significant differences in the intraoperative blood loss, time of getting out of bed, time of hospital stay, and the rate of repetitive ectopic pregnancy within 2 years after operation of the patients between the two groups (P>0.05). At hospital discharge and 6 months after hospital discharge, the levels of FSH, estradiol, and AMT of the patients in the observation group were significant lower than those of the patients in the control group, but the level of luteinizing hormone of the patients in the observation group was significant higher (P<0.05). There was no significant difference in the AFC of the ovary in the same side of tubal ectopic pregnancy at hospital discharge, and in the AFC of the ovary in the other side of tubal ectopic pregnancy at hospital discharge and 6 months after hospital discharge of the patients between the two groups (P>0.05). The AFC (5.9±1.7) of the ovary in the same side of tubal ectopic pregnancy of the patients in the observation group 6 months after hospital discharge was significant higher than that (3.5±1.5) of the patients in the control group. 2 years after operation, the rate of intrauterine pregnancy (75.6%) of the patients in the observation group was significant higher than that (64.6%) of the patients in the control group (P<0.05). Conclusion: Laparoscopic laparoscopic improved tubal abdomen fenestration to remove embryo and suture surgery has less influence on patients' ovarian reserve function than laparoscopic alpingectomy, which can reduce iatrogenic ovarian function damage.

2021 Vol. 29　(9):　1877- [Abstract]（ 345 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the relationship between obesity and vitamin D［25(OH) D］ deficiency of the pregnant women and their gestational diabetes mellitus (GDM) occurrence, and to study its influence on the pregnancy outcomes. Methods: Between January 2019 and January 2020, 85 pregnant women with GDM were selected in study group, and 80 healthy pregnant women with the matched gestational weeks of the women in the study group were selected in control group. The body mass index (BMI) value, 25 (OH) D level and pregnancy outcomes of the women were compared between the two groups. The incidences of GDM and adverse pregnancy outcomes of the women with different BMI or different 25 (OH) D levels were compared. Results: The BMI value (27.2±2.4kg/m2) of the women in the study group was significant higher than that (23.1±1.7kg/m2) of the women in the control group, but the 25 (OH) D level (17.4±2.3ng/ml) of the women in the study group was significant lower than that (34.1±3.8ng/ml) of the women in the control group (P<0.05). The incidences of gestational hypertension and adverse pregnancy outcomes of the women in the study group were significant higher than those of the women in the control group. The incidences of GDM and adverse pregnancy outcomes of the women with obesity and overweight, and the women with vitamin D deficiency or insufficiency were significant higher than those of the normal pregnant women (all P<0.05). BMI≥28.0kg/m2 and 25 (OH) D level <20ng/ml of the women were associated with their GDM occurrence and adverse pregnancy outcomes (all P<0.05). Conclusion: High BMI value and Vitamin D insufficiency or deficiency is common in the pregnant women with GDM, and the incidence of adverse pregnancy outcomes of the women with GDM is significant higher than that of the normal pregnant women. The higher BMI value and lower the 25(OH)D level of the pregnant women, the higher risk of adverse pregnancy outcomes is. The BMI value and the 25(OH)D level of the pregnant women can be used as important indicators for management and treatment of the pregnant women for early intervention, so as to reduce the incidences of adverse pregnancy outcomes.

2021 Vol. 29　(9):　1886- [Abstract]（ 595 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To explore the clinical value of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound HD-flow color blood flow imaging for prenatal diagnosing congenital cardiac dysplasia. Methods: 1100 singleton pregnant women who underwent prenatal routine two-dimensional ultrasound examination were selected in this study from January 2018 to April 2020. The women who had been suspected of intrauterine fetal cardiac dysplasia would be given examination of four-dimensional color Doppler ultrasound HD-flow. Based on the results by neonatal ultrasound diagnosis or pathological diagnosis after labor induction as the gold standard, the detection situation of fetal congenital heart diseases (FCHD) was analyzed, and the detection ratio of FCHD was compared between two-dimensional ultrasound alone and two-dimensional ultrasound combined with four-dimensional color ultrasound. Results: In the fetus of 1100 pregnant women, there were 30(2.73%) fetuses or newborns with FCHD. The detection rate of FCHD by two-dimensional ultrasound examination was 66. 7%, which was significant lower than that (90.0%) of the combined examination of two-dimensional ultrasound and four-dimensional color Doppler ultrasound HD-flow color blood flow imaging (P<0.05). There were 3 cases with misdiagnose by the combined examinations of the two ultrasound methods, which included 1 case with arterial arch malformation, 1 case with ventricular septal defect, and  1 case with pulmonary valve atresia. Conclusion: Conventional twodimensional ultrasound can be used as an important initial screening method for fetal congenital heart malformations. However, for those fetuses with abnormalities results by two-dimensional ultrasound, it is recommended to combination of two-dimensional ultrasound and four-dimensional color Doppler ultrasound HD-flow color blood flow imaging examination to further accurately evaluating the location and type of abnormalities.

2021 Vol. 29　(9):　1894- [Abstract]（ 321 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

 To analyze the differences of glucose and lipid metabolism and islet function of patients with polycystic ovary syndrome (PCOS) and with different model of menstrual cycles. Methods: A total of 328 patients with PCOS were selected as the research subjects from March 2018 to September 2020. According to their menstrual cycle, these patients were divided into group A (24 cases with frequent menstruation and irregular vaginal bleeding), group B (30 cases with regularity menstruation), group C (155 cases with sparse menstruation), and group D (119 cases with amenorrhea). The clinical characteristics, sex hormone levels, glucose and lipid metabolism, and islet function of the patients were compared among the four groups. The correlation between menstrual cycle of the patients and their hyperlipidemia and insulin resistance was analyzed. Results: The body mass index (BMI), the hip ratio (WHR), and the incidence of hairy of the patients in group C and group D were significant higher than those of the patients in group A and group B (P<0.05), and the WHR of the patients in group D was significant higher than that of the patients in group C (P<0.05). The levels of luteinizing hormone (LH) and testosterone (T), and the value of LH/FSH (folliclestimulating hormone) of the patients in group D were significant higher than those of the patients in group C, and which of the patients in group C and group D were significant higher than those of the patients in group A and group B (P<0.05). The levels of fasting plasma glucose (FPG), fasting insulin (FINS), total cholesterol (TC), and triglyceride (TG) of the patients in group C and group D were significant higher than those of the patients in group A and group B (P<0.05), but the HDL level of the patients in group C and group D was significant lower (P<0.05). The FINS level of the patients in group D was significant higher than that of the patients in group C, but the HDL level of the patients in group D was significant lower (P<0.05). The value of HOMA-IR of the patients in group C and group D were significant higher than those of the patients in group A and group B, but the value of HOMA-β of the patients in group C and group D was significant lower (P<0.05). There were no significant differences in the values of HOMA-IR and HOMA-βof the patients between group C and group D, and between group A and group B (P>0.05). BMI, WHR, sparse menstruation, and amenorrhea were the independent influence factors of hyperlipidemia of the patients, and age, BMI, WHR, sparse menstruation, and amenorrhea were the independent factors affecting insulin resistance of the patients (all P<0.05). Conclusion: The degree of glycolipid metabolism disorder and islet function decreasing of the patients with PCOS and sparse menstruation or amenorrhea is more severe, and the risk of hyperlipidemia and insulin resistance of these patients is higher.

2021 Vol. 29　(9):　1902- [Abstract]（ 315 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

 To analyze the changes of vitamin D and parathyroid hormone (PTH) levels of women with gestational diabetes mellitus (GDM), and to study the influencing factors. Methods: Pregnant women with GDM were selected in study group and normal pregnant women were selected in control group from February 2017 to April 2020. The fasting venous bloods of these women were collected when empty stomach for detecting their serum 25 (OH) D3 and PTH levels. In the study group, the women were further divided into group A1 (women with severe vitamin D deficiency), group A2 (women with mild vitamin D deficiency), and group A3 (women without vitamin D deficiency) according to whether or not of vitamin D deficiency. In the study group, the women were further divided into group B1 (women with low level of PTH), group B2 (women with middle level of PTH), and group B3 (women with high level of PTH) according to the PTH level of the women. The serum 25(OH)D3 and PTH levels of the women were compared among these groups, and the related factors of vitamin D deficiency and high PTH levels of the women were analyzed. Results: The serum levels of 25 (OH) D3 of the women in the study group was significant lower than that of the women in the control group. The proportion of the severe or mild vitamin D deficiency, and the serum PTH level of the women in the study group were significant higher than that of the women in the control groups (P<0.001). The age and the proportion of the curve of OGTT time-glucose (AUCglu) ≥16.8mmol/L/h, and the value of insulin resistance ratio index (HOMA-IR) of the women in group A3, group A2, group A1 had increased gradually (P<0.05). The values of body mass index (BMI), fasting plasma glucose (FPG), glucose tolerance test OGTT (1 h), OGTT (2 h) of the women in group A1 were significant higher than those of the women in group A2 and group A3 (P<0.05), but which had no significant difference between group A2 and group A3 (P>0.05). The proportion of multipara had no significant difference among groupA1, group A2, and group A3 (P>0.05). The proportion of AUCglu ≥16.8mmol/L/h, and the values of FPG and HOMA-IR of the women in group B1, group B2, group B3 had increased gradually, and the age, the OGTT (2h) value of the women in group B2, group B3 were significant higher than those of the women in group B1 (P<0.05). The age and the OGTT (2h) value of the women had no significant difference between group B2 and group B3 (P>0.05). The OGTT (1h) value of the women in group B3 was significant higher than that of the women in group B1 (P<0.05). The BMI value and the proportion of multipara had no significant difference among groupB1, group B2, and group B3 (P>0.05). Age ≥35 years old, AUCglu ≥16.8mmol/L/h, and HOMA-IR value of the women were associated with their severe or mild vitamin D deficiency and their higher level of PTH. The OGTT (2 h) value of the women was associated with their higher level of PTH (all P<0.05). Conclusion: The proportion of vitamin D deficiency and the level of PTH of pregnant women with GDM are high, especially for those women with older age, disordered glucose metabolism, and severe insulin resistance.

2021 Vol. 29　(9):　1911- [Abstract]（ 410 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

To analyze the change of shear wave elasticity value of the placenta of pregnant women with preeclampsia (PE), and to study its correlation with their blood flow parameters of umbilical artery. Methods: The pregnant women with PE were selected and divided into group A (women without severe PE) and group B (women with severe PE), and the normal pregnant women were selected in group C from August 2017 to December 2019. The elastic modulus of placenta and the blood flow parameters of umbilical artery of these women were examined by ultrasonography. The values of the elastic modulus of placenta and the blood flow parameters of umbilical artery of the women were compared among these groups. The correlation between the elastic modulus of placenta of the women and their blood flow parameters of umbilical artery was analyzed. Results: The areas of central fetal face, central matrix surface, and surface edges fetal face, the values of matrix and average elastic modulus of the placenta, and the values of PI, RI and S/D of the women in group C, group A, and group B had increased gradually (all P<0.05). The value of average elastic modulus of placenta of the women in group A was positively correlated with their PI, RI values of umbilical artery (P<0.001), but had no correlation with their umbilical artery S/D value (P>0.05). The value of average elastic modulus of placenta of the women in group B was positively correlated with their RI value of umbilical artery (P<0.001), but had no correlation with their umbilical artery PI and S/D values (P>0.05). Conclusion: The placenta hardness of pregnant women with PE increases abnormally. The shear wave elasticity value of the placenta of the women with PE is association with their blood flow parameters of umbilical artery.

2021 Vol. 29　(9):　1920- [Abstract]（ 350 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the correlation between the serum homocysteine (Hcy) and vitamin B12 (VB12) levels of the pregnant women with megaloblastic anemia (MA) during pregnancy and their prognosis. Methods: A total of 76 pregnant women with MA were selected in study group and 65 healthy pregnant women were selected in control group from January 2019 to June 2020. The general data, blood routine indexes, and serum Hcy and VB12 levels of the women were compared between the two groups. The women in the study group were divided into group A (31 women with good prognosis) and group B (45 women with bad prognosis) based on the results of the end of pregnancy. The main factors affecting the MA prognosis of the women were analyzed. Results: The levels of Hb, RBC, MCHC, and VB12 of the women in the study group were lower than those of the women in the control group, while the levels of MCV, MCH, and Hcy of the women in the study group were significant higher (P<0.05). Pearson's results showed that the serum VB12 level of the women in the study group was positively correlated with their levels of Hb, RBC and MCHC, and was negatively correlated with their levels of MCV and MCH. The serum Hcy level of the women in the study group was positively correlated with their levels of MCV and MCH, and was negatively correlated with their levels of VB12, Hb, RBC, and MCHC (all P<0.05). The levels of Hb, RBC, MCHC, and VB12 of the women in group B were significant lower than those of the women in group A, while the levels of MCV, MCH, and Hcy of the
women in group B were significant higher than those of the women in group A (all P<0.05). Multivariate logistic regression analysis showed that the levels of Hb, RBC, MCV, Hcy, and VB12 were the risk factors affecting the prognosis of the women with MA during pregnancy (P<0.05). Conclusion: The serum VB12 level of the pregnant women with MA decreases, but the Hcy level of them increases, which both are related to their blood routine index levels. The serum VB12 and Hcy levels are the risk factors affecting the prognosis of pregnant women with MA in clinic, which should be paid more attention to.

2021 Vol. 29　(9):　1930- [Abstract]（ 332 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

To explore the value of the score of endometriosis fertility index (EFI) and the serum Resistin level for diagnosing endometriosis complicated with infertility. Methods: 84 women with endometriosis were selected in group A, 47 women with endometriosis and infertility were selected in group B, and 53 healthy women were selected in group C from June 2018 to June 2020. The EFI score and serum Resistin level of the women in the three groups were detected. The value of the combination of the EFI score and serum resistin level of the women for diagnosing endometriosis complicated with infertility was analyzed. Results: The EFI score of the women in group C, group A, and group B had significantly decreased in turn, but the serum Resistin of the women in group C, group A, and group B level had significantly increased in turn (P<0.05). ROC curve analysis showed that the area under curve (AUC), the sensitivity, and the specificity of EFI score for diagnosing endometriosis complicated with infertility were 0.754, 0.727, and 0.792, respectively. The AUC, the sensitivity, and the specificity of serum Resistin level for diagnosing endometriosis complicated with infertility were 0.805, 0.845, and 0.736, respectively. The AUC, the sensitivity, and the specificity of EFI score combined with serum Resistin level for diagnosing endometriosis complicated with infertility were 0.886, 0.864, 0.849, respectively, which were significant higher than that of EFI score or serum Resistin level alone (P<0.05), and the consistency (Kappa=0.726) of which compared to the gold standard of clinical diagnosis was better. The sensitivity, the specificity, the positive predictive value, the negative predictive value, and the accuracy of the gold standard of clinical diagnosis for endometriosis complicated with infertility were 0.861, 0.867, 0.847, 0.879, and 0.864, respectively. Conclusion: EFI score combined with serum Resistin level has some diagnostic value for endometriosis complicated with infertility.

2021 Vol. 29　(9):　1939- [Abstract]（ 353 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To investigate the relationship between the mismatch repair (MMR) gene expression level of patients and their endometrial lesions. Methods: 180 patients with endometrial lesions from January 2017 to December 2019 were collected retrospectively, which included 60 patients with endometrial polyp in group A, 60 patients with endometrial atypical hyperplasia in group B, and 60 patients with endometrial cancer in group C. Tissue samples of the patients in the three groups were collected for detecting MMR protein expression level. The expression level of MMR protein in endometrial lesions tissues and the difference of the MMR protein expression and clinicopathological indexes in endometrial cancer tissue of the patients were analyzed. Among the three groups, the age and the incidence of deficiency of MMR (33.3%) of the patients in group C were the highest. The incidence of deficiency of MLH1 (23.3%) and the level of PMS2 (23.3%) of the patients in group C were also the highest, and which were significant higher than those of the patients in group A and B (P<0.05). The incidence of deficiency of MMR in endometrial cancer tissue was associated with the increased muscular invasion of cancer (P<0.05). Conclusion: MMR protein plays an important role in the occurrence and development of endometrial lesions.

2021 Vol. 29　(9):　1947- [Abstract]（ 231 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

To explore the repair effect of desogestrel and ethinyl estradiol used for adjuvant therapy of women after curettage because of missed abortion, and to study the changes of their levels of MMP9 and TGF-β3. Methods: The clinical data of 160 women after curettage because of missed abortion from January 2019 to December 2020 were collected. The postoperative complications, such as incomplete miscarriage, amenorrhea, and cervical adhesions, and the endometrial thickness, the vaginal bleeding time, and the time of menstrual recovery of the women were statistics analysed. The TGF-β3 and MMP9mRNA expression levels, and the correlation and the predictive value of which were also analyzed. Results: The rate of postoperative cervical adhesions (10.0%), the vaginal bleeding time (3.1±1.8 d), the time of menstrual recovery (26.9±2.7 d), and the endometrial thickness (2.4±0.7 mm) of the women had obviously improved after treatment. The levels of MMP-9 (0.931±0.026) and TGF-β3 (0.939±0.024) in endometrial tissue of the women had decreased significantly after treatment (all P<0.05). The levels of MMP-9 and TGF-β3 in endometrial tissue of the women were associated with their complications rate and endometrial thickness. The levels of MMP-9 and TGF-β3 combined with the complications and endometrial thickness of the women for evaluating the efficacy of postoperative treatment had certain clinical value (AUC=0.852), which sensitivity and specificity were 89.4% and 86.5%. Conclusion: Desogestrel and ethinyl estradiol used for adjuvant therapy of women after curettage because of missed abortion can significantly reduce the incidence of complicatios and fibrosis factor levels, can effectively alleviate the severity of endometrial injury after curettage, and can improve postoperative recovery.

2021 Vol. 29　(9):　1956- [Abstract]（ 312 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

2021 Vol. 29　(9):　1963- [Abstract]（ 259 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

2021 Vol. 29　(9):　1973- [Abstract]（ 456 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To investigate the changes and the reference value ranges of the serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) levels of healthy pregnant women during the first, the second, and the third trimester of pregnancy in Jiayuguan area. Methods: The clinical data of 5000 healthy pregnant women from January 2018 to December 2019 were collected retrospectively. According to the gestational weeks, these women were divided into group A (1806 women with 0-13 gestational weeks), group B (1573 women with 14-27 gestational weeks), and group C (1621 women with gestational weeks). The levels of serum FT3, FT4 and TSH of these women were detected by chemiluminescence immunoassay, which reference ranges were determined based on the 50th percentile (2.5th percentile-97.5th percentile) ［P50 (P2.5P97.5)］. Spearman test was used to analyze the correlation between the serum FT4 level of the women during the different gestational weeks and their TSH levels. Results: The serum FT3, FT4 levels of the women in group B and group C were significant lower than those of the women in group A, but the TSH level of the women in group B and group C was significant higher (P<0.05). The serum FT4 level of the women in group C was significant lower than that of the women in group B, but the TSH level of the women in group C was significant higher (P<0.05). The reference range of serum FT3 level of the women during the first, the second, and the third trimester of pregnancy were 3.80-5.36 pmol/L, 3.496.01 pmol/L, and 3.57-5.83 pmol/L, respectively. The reference range of serum FT4 level of the women during the first, the second, and the third trimester of pregnancy were11.04-22.85 pmol/L, 10.53-20.72 pmol/L, and 9.26-16.87 pmol/L, respectively. The reference range of serum TSH level of the women during the first, the second, and the third trimester of pregnancy were 0.05-4.36 mIU/L, 0.43-5.12 mIU/L, and 0.70-6.25 mIU/L, respectively. The serum FT4 level of the women during the first and the second trimester of pregnancy were negatively correlated with their serum TSH level (P<0.05), but the serum FT4 level of the women during the third trimester of pregnancy wasn’t correlated with their serum TSH level (P>0.05). Conclusion: The reference range of thyroid hormones established in this study may provide evidence for the diagnosis and treatment of thyroid diseases during pregnancy in Jiayuguan area.

2021 Vol. 29　(9):　1983- [Abstract]（ 449 ） HTML (0 KB)  PDF  (0 KB)  ( 42 )

 To investigate the value of serum ferritin level combined with miR-182 level detection for of pregnant women and for assessing neonatal prognosis. Methods: 52 pregnant women with chorioamnionitis were selected in study group and 50 healthy pregnant women were selected in control group from October 2016 to August 2019. The levels of serum ferritin and miR-182 relative expression level of the women in the two groups were measured. The receiver operating characteristic curve (ROC) was used to evaluate the value of the ferritin level and miR-182 expression level for diagnosing intrauterine infection of the women and for assessing neonatal prognosis. Pearson correlation analysis was used to analyze the correlation between the ferritin level and miR-182 expression level and Apgar score of the newborns. Results: The serum ferritin level (298.48±48.72μg/L) and mir-182 relative expression level (2.38±0.70) of the women in the study group were significant higher than those of the women in the control group (P<0.05). ROC curve analysis showed that when serum ferritin level (241.11μg/L) as the cut-off value, the sensitivity, the specificity, and area under of ROC curve of serum ferritin level for diagnosing intrauterine infection were 94.2%, 90.0%, and 0.950 (95%CI: 0.910-0.990, P<0.001). When the relative expression of Mir-182 (1.82) of the women as the cut-off value, the sensitivity, the specificity and area under of ROC curve relative expression of Mir-182 for diagnosing intrauterine infection were 80.8%, 90.0%, and 0.889 (95%CI: 0.8230.955, P<0.001). The sensitivity, the specificity, and area under of ROC curve of the combined detections of the serum ferritin level and the relative expression of Mir-182 for diagnosing intrauterine infection were 92.3%, 80.0%, and 0.990 (95%CI: 0.978-1.000, P<0.001), which diagnostic value was significant better than that of the serum ferritin level or the relative expression of Mir-182 alone. The incidences of neonatal intrauterine infection, respiratory distress syndrome, infectious pneumonia, perinatal brain injury, death, and Apgar score <7 points in the study group were significant higher than those in the control group (P<0.05), but there were no significant differences in the incidences of neonatal preterm birth and intrauterine distress between the two groups (P>0.05). Pearson correlation analysis showed that maternal serum ferritin level and Mir-182 level were negatively correlated with the neonatal Apgar score (P<0.05). Conclusion: The detection of the serum ferritin level combined with miR-182 level for diagnosing intrauterine infection has good diagnostic value. Both of the increase of the serum ferritin level and miR-182 expression level has negatively correlation with the Apgar score of the newborn. It is suggested that intrauterine infection of the pregnant women and neonatal prognosis can be evaluated according to the serum ferritin level and miR-182 expression, so as to conduct targeted treatment early.

2021 Vol. 29　(9):　1991- [Abstract]（ 296 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

To investigate whether cervical dilatation balloon increased puerperal infection. Methods: The pregnant women who gave birth between March 1, 2017 and February 28, 2021 were selected and were divided into two groups. The women in the study group were given cook cervical dilatation balloon, and the women in the control group were not given cook cervical dilatation balloon. Propensity score matching analysis was used to compare the incidence of the infection of the women between the two groups. Results: Before propensity score matching, age, basic illness, mode of delivery, time form induction to birth of the women had different between the two groups, but which of the women became balanced and comparable after propensity score matching. The incidence of infection (0.23%) of the women in the study group was significant higher than that (2.51%) of the women in the control group (OR=11.257, P<0.05). Conclusion: Cook cervical dilatation balloon used in the pregnant women can increase their incidence of puerperal infection.

2021 Vol. 29　(9):　2000- [Abstract]（ 344 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

Monogenic disease is one of the main causes of birth defects in newborns, which still cannot be cured effectively even if the development of medical technology today. Prenatal diagnosis can be used for genetic analysis of high-risk of monogenic disease of fetuses during the first and second trimester of pregnancy, which can effectively reduce the birth of fetuses with genetic defects. DNA analysis technology is an important link in prenatal diagnosis of monogenic disease. Different DNA analysis techniques combined with related biochemical tests can significantly improve the detection rate of monogenic disease of fetuses. There are a wide variety of DNA analysis technologies with different advantages and disadvantages. This paper focuses on DNA analysis technologies related to monogenic disease, including Sanger sequencing technology, next-generation sequencing technology, the third-generation sequencing technology, and the related biochemical detection techniques of single gene genetic diseases, including digital PCR, cyclocyclic single molecule amplification and resequencing technologies. It is believed that with the improvement and innovation of DNA analysis technology, the prenatal diagnosis technology of monogenic disease will have better clinical application prospect, and will more effectively reduce the rate of birth defects of monogenic disease in China.

2021 Vol. 29　(9):　2007- [Abstract]（ 431 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )