To investigate the expressions of extracellular regulatory protein kinase (ERK1/2) and nuclear factor κB (NF-κBp65) in (EMs) model rat endometrial tissue, and to study their association with the proliferation and invasion of endometriosis cell. Methods: 20 non-pregnant female SD rats were selected, and among them, the autologous transplantation of endometrium was used to induce the establishment of 10 models of rats with Ems and another 10 rats were as control. The expression of ERK1/2 and NF-κBp65 protein in rat endometrial tissue was detected by immunohistochemistry (IHC) and Western blot. The expressions of proliferating cell nuclear antigen (PCNA) and matrix metalloproteinase 9 (MMP9) were used to verify the changes of proliferation and invasiveness of lesions tissue of the ectopic endometrium. Results: In the lesions of model rats with EMs, the enlarged implantation was seen to be transparent or translucent cystic structure, containing light yellow clear or coffee-colored liquid, and blood vessel formation was observed on the surface of cystic structure and around. After hematoxylin eosin stain, the growth of glandular, stroma, or glandular epithelial cells were observed in the ectopic lesion. Immunohistochemical results showed that ERK1/2 was mainly expressed in the cytoplasm of endometrial glandular epithelial cells, and was less expression in the stroma of the cells, and had a very small amount in the nucleus of the cells. NF-κBp65 was mainly expressed in the nuclei of endometrial glands cells and stroma of the cells, and was less expression in the cytoplasm of the cells. Western blot results showed that the expression levels of ERK1/2 and NF-κBp65 protein in ectopic endometrium and eutopic endometrium of the model rats with Ems were significantly higher than those in normal endometrium of the rats, and which in ectopic endometrium of the model rats with Ems were significantly higher than those in eutopic endometrium of the model rats with Ems (P＜0.05). The expression levels of PCNA and MMP9 protein in ectopic endometrium and normal endometrium of the model rats of Ems were significantly higher than those in normal endometrium of the rats, and which in ectopic endometrium of the model rats with Ems were significantly higher than those in eutopic endometrium of the model rats with Ems (P＜0.05). Pearson correlation analysis showed that there was positive correlation between ERK1/2 level and NF-κBp65 protein expression level (r=0.657, P＜0.05) and in eutopic endometrium of the model rats of Ems (r=0.709, P＜0.05). Conclusion: The expressions of ERK1/2 and NF-κBp65 in the eutopic and ectopic endometrial tissues of the EMs rat model increase, which may improve the occurrence and development of EMs by affecting the proliferation and invasion ability of the ectopic endometrium.

2022 Vol. 30　(1):　5- [Abstract]（ 695 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the reproductive health status of elderly women who tried to conceive, and to analyze the influencing factors of their reproductive health status. Methods: A total of 1178 elderly pregnant women who tried to conceive and accepted preconception counseling were selected as the research objects. Their reproductive health status was investigated through preconception counseling, gynecological physical examination, vaginal ultrasound examination, and laboratory examination. The questionnaire was issued to collected general information of these women. The influencing factors of reproductive health of these women were analyzed. Results: There were 681(57.8%) cases with reproductive system related diseases, of which, there were 34 (2.9%) women with two kinds of reproductive system related diseases at the same time. Among the reproductive system diseases, the detection rate of cervical diseases (23.8%) was the highest, then followed by that (14.5% or 13.8%) of disease of uterus or vulvovaginal diseases, and which of accessory diseases or pelvic inflammatory diseases (5.01% or 3.65%) was relatively low. There was no significant difference in the detection rate of reproductive system diseases among the women with different registered residence, among the women with family income, among the women with BMI values, among the women with parity, among the women with adverse pregnancy history, among the women with other disease history, or among the women with different adverse living habits (P>0.05). There was significant difference in the detection rate of reproductive system diseases among the women with different ages, the women with educational levels, the women with number of abortion, the women with history of gynecological diseases, or the women with different past contraceptive methods (P<0.05). Multivariate analysis showed that age, education level, number of abortion, and history of gynecological diseases were the main factors affecting the reproductive health of elderly women who tried to conceive, and among them, higher education level was the protective factor of their reproductive health, nut the increasing age, history of abortion, and history of gynecological diseases were the risk factors of their reproductive health (P<0.05). Conclusion: The reproductive health status of elderly women who tried to conceive is not optimistic, so counseling and information on the main factors affecting reproductive health of these women should be carried out in order to improve their reproductive health status and reduce the incidence of adverse pregnancies.

2022 Vol. 30　(1):　16- [Abstract]（ 586 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To understand the effect of standardized participatory training of sexual and reproductive health counseling services for the relevant practitioners. Methods: A total of 315 people engaged in family planning and reproductive health consultation related work in Datong, Lanzhou, Wuhan, Chizhou, and Chongqing were enrolled for participatory training. Evaluations were conducted before and after the training, and the comprehensive evaluation was conducted for the training effect. Chi-square test and t test were used to compare the knowledge scores before and after the training. And multivariate analysis was performed by binary Logistic regression analysis. Results: The average knowledge score of the practitioners before training was 70.4±26.3, which was significantly higher than that (83.2±9.6) of the practitioners after training (t=-7.813, P<0.05). The passing rate of the practitioners before training was 79.7%, which was significantly higher than that (88.4%) of the practitioners after training (χ2=45.36, P<0.05). Multivariate logistic regression analysis showed that the passing rate of knowledge score of the people after training was significantly higher than that of the people before training. Conclusion: Standardized participatory training can significantly improve the knowledge related knowledge of the practitioners, which is of great practical value to train reproductive health counselors.

2022 Vol. 30　(1):　24- [Abstract]（ 335 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

2022 Vol. 30　(1):　32- [Abstract]（ 362 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the effects of gonadotropin-releasing hormone agonist (GnRH-a) for treating patients with moderate and severe endometriosis after laparoscopic surgery on their pregnancy. Methods: A total of 114 patients with stage Ⅲ and Ⅳ of endometriosis who had all received conservative laparoscopic surgery were selected in this study from September 2017 to April 2019. These patients were divided into observation group and control group according to their wishes. The patients in the observation group had received GnRH-a injection postoperatively, and the patients in the control group were not given GnRH-a injection postoperatively. The pregnancy status of the patients during postoperative 18 months in the two groups was followed up. Results: The CA125 level and the pelvic pain scale score of the patients in the two groups in the 6th month after operation were significantly lower than those of the patients before operation (P<0.05), but which had no significantly different between the two groups (P>0.05). There was no significant difference in the recurrence rate (3.5% vs.7.0%) of the patients in the 12th month after operation between the two groups (P>0.05). The pregnancy rate (31.6%) of the patients in the observation group in the 18th month after surgery was significantly higher than that (14.0%) of the patients in the control group (P<0.05). There was no significant difference in the pregnancy rate of the patients with Ⅲ stage of endometriosis between the two groups (P>0.05), but the pregnancy rate (25.0%) of the patients with Ⅳ stage of endometriosis in the observation group was significantly higher than that (3.9%) of the patients in the control group (P<0.05). Conclusion: The application of GnRH-a after laparoscopic conservative surgery of the patients with moderate and severe endometriosis has no obvious effect on the surgical effect, but can effectively increase of their pregnant rate after operation.

2022 Vol. 30　(1):　42- [Abstract]（ 426 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To analyze the relationship between the serum sex hormone binding globulin (SHBG) level of pregnant women with abnormal blood glucose levels at different OGTT time points and gestational diabetes mellitus (GDM) and their insulin secretion characteristics and adverse pregnancy outcomes. Methods: The pregnant women with GDM were selected in study group and were divided into group A, group B, group C, and group D according to blood glucose indexes levels at different time points of OGTT from January 2017 to October 2019. These women were also divided in group 1 (women with SHBG≥295) and group 2 (women with SHBG <295) according to their mean serum SHBG level. The pregnant women with normal OGTT results were selected in the control group. The serum SHBG and insulin levels of the women in these groups were detected, and insulin resistance related indexes of these women were calculated. Results: The serum SHBG level and HOMA-β value of the women in the study group were significantly lower than those of the women in the control group, while the serum FINS and HbA1c levels, and HOMA-IR value of the women in the study group were significantly higher (all P<0.05). The serum SHBG level and HOMA-β value of the women in group A, group B, group C, and group D had decreased gradually, while the serum FINS and HbA1c levels, and HOMA-IR value of the women in group A, group B, group C, and group D had increased gradually, which had no significant different between group B and group C (P>0.05), but which had significant different between group A and group D (P<0.05). The serum SHBG level of the women with GDM was negatively correlated with their HOMA-IR value (P<0.05), and was positively correlated with their HOMA-β value (P<0.05). The values of FINS, INS30, INS60, INS120, and INS180, the rate of insulin application, and the incidence premature rupture of membranes of the women in group 2 were significantly higher than those of the women in group 1, but the proportion of satisfied blood glucose control of the women in group 2 was significantly lower (all P<0.05). There were no significant differences in the incidences of premature delivery, polyhydramnios, hypertension during pregnancy of women, fetal distress, and neonatal asphyxia between group 1 and group 2 (P<0.05). The SHBG level <295nmol/L was an independent risk factor of the adverse pregnancy outcomes of the women with GDM (P<0.05). Conclusion: The serum SHBG level of GDM women with abnormal blood glucose at different OGTT time points is slightly different. The low SHBG level of pregnant women may increase the risk of their insulin resistance and adverse pregnancy outcomes.

2022 Vol. 30　(1):　50- [Abstract]（ 354 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To analyze the effect of transvaginal lesion resection of uterus cesarean scar pregnancy, and to study the postoperative recovery of patients.Methods: 120 patients with cesarean scar pregnancy（CSP) were selected and randomly divided into two groups（60 cases in each group) from March 2018 to January 2020.The patients in the control group were given conventional transabdominal lesion resection and the patients in the observation group were given transvaginal lesion resection.The values of surgery-related indicators, postoperative recovery-related indicators, and the incidence of postoperative complications rate of the patients were compared between the two groups.Results: The operative success rate（98.3%) of the patients in the observation group was significant higher than that（86.7%) of the patients in the control group.The operative time（43.4±17.6min), intraoperative blood loss（54.3±26.1 mL), and hospital stay（5.4±1.3 days) of the patients in the observation group were all significant lower than those of the patients in the control group（P<0.05).The time of menstruation return to normal（44.2±6.2d) and the time of lesion reduction（34.1±5.3d) of the patients in the observation group were all significant shorter than those of the patients in the control group, but the decrease rate of serum chorionic gonadotropin（β-hCG) in 1d, 3d, 5d, and 10d after operation of the patients in the observation group were all significant higher than those of the patients in the control group.The postoperative complications rate（8.3%) of the patients in the observation group was significant lower than that（23.3%) of the patients in the control group（P<0.05).Conclusion: Transvaginal lesion resection of cesarean scar pregnancy for treating the patients with scar pregnancy can optimize the surgical process, increase the operation success rate, shorten the postoperative recovery time, and can effectively reduce the incidence rate of complications.

2022 Vol. 30　(1):　60- [Abstract]（ 369 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To analyze the anesthesia effect of combined spinal-epidural anesthesia and epidural anesthesia during cesarean section of elderly pregnant women, and to study their influence on the maternal immunologic function. Methods: A total of 100 elderly pregnant women who wanted cesarean section were selected as the research subjects, and were randomly divided into observation group and control group (50 cases in each group) from Septenber 2017 to Septenber 2020. The women in the observation group were given combined spinal-epidural anesthesia, while the women in the control group were given epidural anesthesia. The anesthesia effect, the values of hemodynamic indexes and immune function indexes, and the rate of adverse reactions of the women in the two groups were analyzed. Results: There were 20(40.0%) cases with grade Ⅲ of anesthetic effect, 23(46.0%) cases with grade II of anesthetic effect, and 7(14.0%) cases with grade I of anesthetic effect in the observation group. There were 10(20.0%) cases with grade Ⅲ of anesthetic effect, 21(42.0%) cases with grade II of anesthetic effect, and 19(38.0%) cases with grade I of anesthetic effect in the control group. The anesthesia effect of the women in the observation group was significantly better than that of the women in the control group (P<0.05). The values of heart rate, systolic blood pressure, and mean arterial pressure of the women in both groups had increased significantly after anesthesia, but the change ranges of which of the women in observation group were significantly lower than those of the women in control group (all P<0.05). The levels of CD3+, CD4+, CD4+/CD8+, IgA, IgG, and IGM of the women in both groups were significantly lower than those before anesthesia, while CD8+ level of the women in both groups at 12h after operation was significantly higher than that before anesthesia, and change ranges of which of the women in observation group were significantly lower than those of the women in control group (all P<0.05). The incidence of adverse reactions during anesthesia and after operation (10.0% and 14.0%) of the women in the observation group were significantly lower than those (28.0% and 32.0%) of the women in the control group (P<0.05). Conclusion: Compared with that of epidural anesthesia, combined spinal-epidural anesthesia has better anesthesia effect during cesarean section of elderly pregnant women, and which can effectively alleviate their immune function inhibition, and help to improve their postoperative recovery.

2022 Vol. 30　(1):　67- [Abstract]（ 358 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

2022 Vol. 30　(1):　76- [Abstract]（ 314 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To explore the risk factors of affecting postpartum hemorrhage of women with the second cesarean section, and to construct and evaluate a nomogram prediction model. Methods: A retrospective analysis was conducted on the clinical data of 508 women who underwent the second cesarean section from March 2018 to June 2020. These women were divided into group A (women with postpartum hemorrhage) and group B (women without postpartum hemorrhage). Univariate analysis and multivariate Logistic regression analysis were used to select the risk factors affecting postpartum hemorrhage. Based on the selected risk factors, R software was used to establish a nomogram prediction model for postpartum hemorrhage, and the consistency of the model was tested. Results: The incidence of postpartum hemorrhage of 508 women with secondary cesarean section was 14.0%. Logistic regression analysis showed that breech position, placenta previa, less than 2 years after the previous cesarean section, and the prenatal blood loss ≥240ml were the risk factors of postpartum hemorrhage after the second cesarean section (P<0.05), while the use of oxytocin combined with misoprostol was a protective factor (P<0.05).  The nomogram prediction model was evaluated, and the area under the ROC curve was 0.838 (95%CI: 0.788-0.887), and the slope of the calibration curve was close to 1. Hosmer-lemeshow goodness of fit test showed =4.551, P=0.473. Conclusion: The constructed nomogram prediction model based on the risk factors of postpartum hemorrhage of the women with the second cesarean section has good discrimination and consistency, which helps obstetric medical staff to screen the pregnant women with high-risk of postpartum hemorrhage after the second cesarean section, and can provide certain guiding for preventive nursing intervention measures.

2022 Vol. 30　(1):　84- [Abstract]（ 419 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the value of transvaginal Doppler color ultrasound combined with serum human chorionic gonadotropin (β-hCG) level for diagnosing uterine scar healing. Methods: 140 pregnant women with scar uterus during the third trimester of pregnancy were selected from January 2017 to June 2019. After 35 gestational weeks, these women were given transvaginal Doppler color ultrasound examination and serumβ-hCG detection. The healing situation of scar uterus of these women was judged, and their delivery outcomes were compared. Results: In these 140 women, there were 117 (83.57%) grade I of uterine scar and theβ-hCG level (24335.35±236.51IU/L), 15 (10.71%) women with grade II of uterine scar and theβ-hCG (26456.84±313.57IU/L), 7 (5.00%) women with grade Ⅲ of uterine scar and theβ-hCG level (31467.67±974.51 IU/L), and 1 (0.72%) woman with grade Ⅳ of uterine scar and the β-hCG level (33451.58±1023.49 IU/L). The serum β-hCG level of the women with grade II, Ⅲ, or IV of uterine scar were significant higher than that of the women with grade I of uterine scar (P＜0.05). ROC curve analysis showed that the sensitivity, the specificity, and AUC of transvaginal Doppler color ultrasound combined with β-HCG level for diagnosing scar uterus were 64.6%, 97.2%, and 0.648, respectively. The vaginal delivery of the women with grade I of scar uterus accounted for 80.3%, and their cesarean delivery accounted for 19.7%. The vaginal delivery of the women with grade II of scar uterus accounted for 26.7%, and their cesarean delivery accounted for 73.3%. The cesarean delivery of the women with grade Ⅲ of scar uterus accounted for 100%, and there was 1 woman with grade Ⅳ of scar uterus had chosen cesarean delivery. The rate of cesarean delivery of the women with grade II or Ⅲ of scar uterus was significant higher than that of the women with grade I of scar uterus (P＜0.05). Conclusion: Transvaginal Doppler color ultrasound detection and serum β-hCG level for diagnosing uterine scar healing has good reference value, which can be as evidence for guiding delivery mode of the re-pregnant women with scar uterus.

2022 Vol. 30　(1):　94- [Abstract]（ 536 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the correlation between the sperm DNA fragmentation index (DFI) of men and their age, conventional semen parameters, and sperm motility parameters. Methods: Sperm DFI, semen routine parameters, and sperm motility parameters of 616 men were detected. And these men were divided into three groups according to DFI values, which included DFI <15% group, 15%≤DFI<30% group, and DFI≥30% group. The correlations between the difference of parameters of conventional semen and sperm motility of the men in different groups and their sperm DFI were analyzed. Results: There were statistically significant differences in the forward motile sperm rate, the total number of motile sperm, the curve velocity (VCL), and linear velocity (VSL) of the men among different DFI groups (P<0.01). Sperm DNA fragmentation index of the men was positively correlated with their age and total number of motile sperm (r=0.35, r=0.27), and was negatively correlated with their total number of forward motile sperm and VCL (r=-0.42, r=-0.33). Conclusion: There is correlation between the sperm DFI of men and their age, some conventional semen parameters, and sperm motility parameters. Thus, sperm DFI combined with conventional semen parameters and sperm motility parameters can be used to synergy evaluate the sperm quality, to guide clinical treatment, and to predict the pregnancy outcomes after assisted reproduction.

2022 Vol. 30　(1):　102- [Abstract]（ 395 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To analyze the changes of and clinical significance of the levels of serum anti-sperm antibody (AsAb) and anticardiolipin antibody (ACAb) of infertile women, and to study their clinical significance. Methods: 400 infertile women were selected in study group and 100 normal women who received physical examination were selected in control group from July 2018 to June 2020. The levels of serum AsAb and ACAb of the women in the two groups were detected by enzyme-linked immunosorbent assay (ELISA). The differences of the serum AsAb and ACAb levels of the women were compared between the two groups. In the study group, the differences of the serum AsAb and ACAb levels were compared among the women with different types of infertility and among the women with different abortion histories. Results: The positive rates of AsAb (25.8%) and ACAb (27.0%) of the women in the study group were significantly higher than those (3.0% and 4.0%) of the women in the control group. The positive rates of AsAb and ACAb of the women with the secondary infertility were significantly higher than those of the women with the primary infertility. The positive rates of AsAb and ACAb of the women with once, 2, and ≥3 times of abortions had increased in turn (P<0.05). Conclusion: The levels of serum AsAb and ACAb of infertile women increase, and which of the women with different types of infertility and different frequencies of miscarriage are different. It indicates that the detection of serum AsAb and ACAb levels should be enhanced for providing references of clinical etiological diagnosis of infertility women.

2022 Vol. 30　(1):　112- [Abstract]（ 427 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

2022 Vol. 30　(1):　118- [Abstract]（ 323 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To analyze the value of the anti-Müllerian hormone (AMH) level of women with polycystic ovary syndrome (PCOS) for predicting their response to ovarian stimulation after treatment of ovulation induction by clomiphene citrate tablets (CC) and human menopausal gonadotrophin (hMG). Methods: A total of 77 women with PCOS were selected and were given ovulation induction treatment by CC combined with hMG from January 2019 to June 2020. These women were divided into group A (56 women with response of ovarian) and group B (21 women without response of ovarian) according to the results after ovarian stimulation by CC combined with hMG. The clinical data and the AMH level of the women were compared between the two groups. ROC curve was used to analyze the value of the AMH level of the women for predicting their response to ovarian stimulation by CC combined with hMG. Results: After ovulation induction treatment by CC combined with hMG, the serum AMH level of the women (21 cases, 11.76±2.90 ng/ mL) in group B was significantly higher than that (56 cases, 8.24±2.15 ng/ml) of the women in group A (P<0.05), but the levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH/FSH, progesterone (P), and testosterone (T) of the women had no significant different between the two groups (P>0.05). ROC curve analysis showed that the area under the curve of the serum AMH level of the women with PCOS for predicting their response to ovarian stimulation was 0.901, the optimal limit cut-off value of the serum AMH level was 9.72ng/mL, and which sensitivity and specificity were 76.8% and 90.5%, respectively. Conclusion: The AMH level of the women with PCOS can effectively predict the response to ovarian stimulation after treatment by CC combined with and hMG.

2022 Vol. 30　(1):　126- [Abstract]（ 317 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

To investigate the relationship between the levels of neuropilin-1 and neuropilin-2 in peripheral blood of patients with endometriosis (EMs) and their severity of EMs and infertility. Methods: 104 patients with EMs were selected in study group, and 104 healthy women of childbearing age were selected in control group from January 2016 to July 2017. The patients in the study group were further divided into group A (24 cases with EMs stage I), group B (22 cases with EMs stage II), group C (30 cases with EMs stage III), and group D (28 cases with EMs stage IV) according to the American Reproductive Society staging standard (R-AFS). The patients in the study group were further divided into group 1 (45 cases with infertility) and group 2 (59 cases without infertility). The serum neuropilin-1 and neuropilin-2 levels were determined by enzyme-linked immunoassay. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the serum neuropilin-1 and neuropilin-2 levels of the patients for their EMs and infertility occurrences. Multivariate logistic regression was used to analyze the related factors of infertility complicated with EMs of the patients. Results: There were no significant differences in age, diabetes mellitus history, hypertension history, and family tumor history of the patients between the study group and the control group (P>0.05). The levels of serum neuropilin-1 and neuropilin-2 of the patients in the study group were significantly higher than those of the patients in the control group, and which had increased with the aggravation of EMs. The levels of serum neuropilin-1 and neuropilin-2 of the patients in group 1 were significantly higher than those of the patients in group
2(all P<0.05). ROC curve analysis showed that the area under ROC curve of neuropilin-1 level and neuropilin-2 level for predicting EMs complicated with infertility was 0.82 (95%CI: 0.74-0.92) and 0.72 (95%CI: 0.63-0.81). When the optimal cut-off points of neuropilin-1 level was 27.02μg/L, the sensitivity and the specificity of neuropilin-1 level and NRP-2 level for predicting EMs complicated with infertility were 81.3% and81.7%. When the optimal cut-off points of neuropilin-1 level was 22.84μg/L, the sensitivity and the specificity of NRP-2 level for predicting complicated with infertility were 70.3% and 71.1%. The neuropilin-1 level >27.02μg/L and the neuropilin-2 level >22.84μg/L were the risk factors of EMs complicated with infertility (P<0.05). Conclusion: The abnormal increasing of the levels of serum neuropilin-1 and neuropilin-2 of the patients with EMs are positively correlated with their severity of EMs and infertility, which have certain predictive value for EMs complicated with infertility of the patients.

2022 Vol. 30　(1):　135- [Abstract]（ 451 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To investigate the role of SDF-1/CXCR4 axis in the inflammatory pathogenesis of pregnant women with preeclampsia.  Methods: From January 2020 to October 2020, 30 pregnant women delivered by cesarean section because of severe preeclampsia were recruited in observation group. Meanwhile, 30 healthy pregnant women were randomly selected in control group. The expressions of CXCR4 and NF-κBp65 mRNA in serum of the women in the two groups were detected by RT-PCR. The levels of inflammatory factors, such as interleukin(IL)-6, tumor necrosis factor-a(TNF-a), high–sensitivity C-reactive protein (hsCRP), of the women in the two groups were measured by ELISA. Pearson method was used to analyze the correlation between the serum CXCR4 and NF-κBp65 levels of the women and their inflammatory factors levels. Results: The expression level of CXCR4 mRNA of the women in the observation group was significantly lower than that of the women in the control group, while the expression level of NF-κBp65 mRNA of the women in the observation group was significantly higher (all P<0.05). The serum levels of inflammatory factors (IL-6, TNF-A, and hsCRP) of the women in the observation group were significantly higher than those of the women in the control group (P<0.05). In the observation group, the CXCR4 mRNA level of the women was negatively correlated with their NF-κBp65 mRNA level (r=-0.857, P=0.007), and also was negatively correlated with their IL-6 level, TNF-a level, and hsCRP level (r=-0.763，P=0.010; r=-0.894，P=0.006; r=-0.904，P=0.005). Conclusion: The low expression of the serum CXCR4 level of the pregnant women with severe preeclampsia may lead to the activation of NF-κB pathway and to the releasing of varieties of inflammatory factors into the maternal blood circulation. Therefore, it is speculated that SDF-1/CXCR4 axis may play an important role in the inflammatory pathogenesis of preeclampsia, and the abnormal expression of SDF-1/CXCR4 may have detrimental impacts on the maternal and fetal health.

2022 Vol. 30　(1):　143- [Abstract]（ 397 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

2022 Vol. 30　(1):　151- [Abstract]（ 399 ） HTML (0 KB)  PDF  (0 KB)  ( 40 )

To analyze the expression level and clinical significance of serum adipocytokines of pregnant women with different glucose tolerance during the second trimester of pregnancy. Methods: The clinical data of 180 pregnant women from January 2018 to October 2020 were collected. These women were divided into 58 women with gestational diabetes mellitus (GDM) in group A, 60 women with the impaired glucose tolerance (IGT)in group B, and 62 women with normal glucose tolerance (NGT) in group C according to the results of their 75g oral glucose tolerance test (75g OGTT) during 24-28 gestational weeks. The biochemical indicators of glycolipid metabolism value, and the levels of leptin, chemokine (CHEM), adiponectin (ADPN), fatty acid binding protein 4 (FABP-4), retinol binding protein 4 (RBP-4), Nesfatin-1, and adipokines of the pregnant women in the three groups were detected. Results: The levels of serum fasting blood-glucose (FPG), 1h blood glucose, 2h blood glucose, fasting insulin, and glycosylated hemoglobin, the values of insulin resistance index (HOMA-IR) and islet β cell index (HOMA-β), and the levels of serum LEP, CHEM, FABP-4, RBP-4, and NESfatin-1 of the women in group A, group B, and group C had decreased gradually, but the level of serum ADPN of the women in group A, group B, and group C had increased gradually (P<0.05). The serum levels of LEP, CHEM, FABP-4, RBP-4, and Nesfatin-1 of pregnant women during the second trimester of pregnancy were positively correlated with their HOMA-IR value, while the ADPN level of pregnant women was negatively correlated with their HOMA-IR value (all P<0.05). Conclusion: The serum adipocytokines level of the pregnant women with different glucose tolerance during the second trimester of pregnancy is different, which is closely related to their insulin resistance. The serum adipocytokines may be involved in the occurrence and progression of GDM, so the clinical detection of serum adipocytokines level of the women during the second trimester of pregnancy has some significance to assess their glucose tolerance.

2022 Vol. 30　(1):　160- [Abstract]（ 394 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

2022 Vol. 30　(1):　168- [Abstract]（ 348 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To analyze the relationship between the levels of serum matrix metalloproteinase 9（MMP-9) and tissue inhibitor of metalloproteinase 1（TIMP-1) of patients with intrauterine adhesion（IUA) and their endometrial volume and the values of blood flow parameters by examined three-dimensional energy ultrasonic.Methods: The patients with IUA were selected in study group and the women with normal uterine cavity were selected in control group from January 2018 to May 2020.According to the severity of IUA, the patients in the study group were further divided into group A（patients with mild IUA), group B（patients with moderate IUA), and group C（patients with severe IUA).The levels of serum MMP-9 and TIMP-1, endometrial volume（V), endometrial vascular index（VI), blood flow index（FI), and vascular blood flow index（VFI) of the patients were compared among these groups.And the correlation between serum MMP-9 and TIMP-1 levels of patients and their values of three-dimensional energy ultrasonic parameters was analyzed.Results: The serum MMP-9 level（10.29±3.10 mg/L) of the patients in the study group was significant lower than that（16.77±4.92 mg/L) of the women in the control group, but the serum TIMP-1 level（131.21±28.23μg/L) of the patients in the study group was significant than that（105.83±30.41μg/L) of the women in the control group.The values of VI, FI and VFI of the patients in the study group were all significant lower than those of the women in the control group（P<0.05).The serum MMP-9 level, and the values of V, VI and VFI of the patients in group A, group B, and group C were decreased gradually, while the serum TIMP-1 level was increased gradually（P<
0.05).There was no significant difference in FI value of the patients between group C and group B（P＞0.05).The level of serum MMP-9 was negatively correlated with the degree of IUA, while the level of TIMP-1 was positively correlated with the degree of IUA（P<0.05).The serum MMP-9 level was positively correlated with the values of V and VFI, but the serum TIMP-1 level was negatively correlated with the values of V and VFI（P<0.05), and the serum MMP-9 and TIMP-1 levels were no correlated with the values of VI and FI（P＞0.05).Conclusion: The serum MMP-9 level decrease and TIMP-1 level increase with the aggravation of IUA, which are correlated with the rate of endometrial V type and the values of the blood flow parameters.

2022 Vol. 30　(1):　181- [Abstract]（ 356 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the effects of different surgical methods for treating women with dangerous placenta previa and placental implantation, and to study its influence on the maternal and infant outcomes. Methods: The clinical data of 89 pregnant women with dangerous placenta previa and placenta accreta from March 2018 to May 2020 were collected retrospectively. According to the different surgical methods, these women were divided into two groups. 49 cases in the study group were treated with abdominal aortic balloon occlusion combined with uterine remodeling, and 40 cases in the control group were treated with abdominal aortic balloon occlusion. The differences of indicators, such as clinical efficacy, of the women were compared between the two groups. Results: The amount of intraoperative blood loss (1572.5±514.4ml), the operation time (91.3±13.6min), and the time of hospital stay (4.5±1.4d) of the women in the study group were significantly less than those (2253.9±611.2 ml, 108.5±16.4 min, and 6.8±1.6d) of the women in the control group. The improving degrees of the levels of creatine kinase, alpha-fetoprotein, and soluble vascular endothelial growth factor receptor-1 of the women in the study group were significantly better than those of the women in the control group (P<0.05). The incidence of postoperative complications (8.2%) of the women in the study group was significantly lower than that (30.0%) of the women in the control group (P<0.05). There was no significant difference in Apgar score of newborns (9.1±0.7 vs. 8.9±0.5) between the two groups (P>0.05). Conclusion: Abdominal aortic balloon occlusion combined with uterine remodeling for treating the pregnant women with dangerous placenta previa and placenta accreta has better effect, which can also reduce maternal complications without affecting the health of newborns.

2022 Vol. 30　(1):　189- [Abstract]（ 330 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the correlation between the sexually transmitted pathogen infection of patients with high-risk human papillomavirus (HR-HPV) infection and their high-grade cervical lesions. Methods: 370 patients with positive HR-HPV who underwent cervical thin-layer liquid based cytology test (TCT) and colposcopic cervical biopsy from January 2015 to July 2020 were selected as study subjects. According to the TCT results, these patients were divided into group A1 (177 cases with normal cervical cytology), group A2 (104 cases with cervical cytology≤LSIL), and group A3 (89 cases with cervical cytology≥HSIL). According to the cervical histopathological results, these patients were also divided into group B1 (189 cases with normal cervical cytology or cervical inflammation), group B2 (99 cases with cervical intraepithelial neoplasias (CIN) I–II), and group B3 (86 cases with CIN Ⅲ or cervical cancer). PCR and diversion hybridization were used to detect the sexually transmitted pathogens in cervical exfoliated cells of these patients. Results: The infection rates of CT, UP, and UU of the patients in group A1, group A2, and group A3 had increased gradually (P<0.05), the infection rates of NG and HSV-2 of the patients in group A3 were significantly higher than those of the patients in group A1 (P<0.05), and there was no significant differences in the infection rates of NG and HSV-2 of the patients between group A1 and group A2 (P>0.05). The single infection rate of sexually transmitted pathogens of the patients in group A3 was significantly higher than that of the patients in group A1 or group A2 (P<0.05), and which of the patients had no significant different between group A1 and group A2 (P>0.05). The rate of multiple infection of the patients in group A1, group A2, and group A3 had increased gradually (P<0.05). The infection rates of UP and UU of the patients in group B1, group B2, and group B3 had increased gradually (P<0.05), the infection rates of NG and HSV-2 of the patients in group B3 were significantly higher than those of the patients in group B1 (P<0.05), there was no significant differences in the infection rates of NG and HSV-2 of the patients between group B1 and group B2 (P>0.05), and the CT infection rates of the patients in group B2 and group B3 were significantly higher than those of the patients in group B1 (P<0.05). There was no significant difference in CT infection rate of the patients between group B2 and group B3 (P>0.05), but the single infection rate and multiple infection rate of the patients in group B1, group B2, and group B3 had increased gradually (P<0.05). The UP infection and the multiple infection of the patients were the independent influencing factors of their cervical cytology ≥HSIL (P<0.05), the CT and UU infections of the patients had no correlation with their cervical cytology ≥HSIL (P>0.05), the UP infection and multiple infection of the patients were the independent influencing factors of their cervical histopathological results (P<0.05). The CT and UU infections of the patients had no correlation with their cervical histopathological results (P>0.05). Conclusion: UP infection and multiple sexually transmitted pathogen infection of the patients with positive HR-HPV may increase the risk of their high-grade cervical lesions, which is worthy of clinical attention.

2022 Vol. 30　(1):　198- [Abstract]（ 419 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

 To investigate the value of ultrasound monitoring the blood flow parameters of pregnant women and fetus, the serum vitamin D and placental growth factor (PLGF) levels for predicting the fetal growth restriction (FGR). Methods: 125 pregnant women with FGR from June 2018 to June 2021 were selected in study group retrospectively, and 125 normal pregnant women were selected in control group during the same period. All these women were monitored for the systolic/diastolic blood flow ratio (S/D), pulsatility index (PI), and resistance index (RI) of the artery (UA), middle cerebral artery (MCA), and uterine artery (UtA) by ultrasound during their 20-24 gestational weeks. The serum vitamin D and PLGF levels of these women were detected. Receiver operating characteristic (ROC) curve was used to evaluate the value of the indexes by ultrasound, and the serum vitamin D and PLGF levels for predicting FGR. Results: The values of S/D, PI, and RI of UA of the women in the study group were significantly higher than those of the women in the control group. The area under curve (AUC) of the value of S/D, PI, or RI for predicting FGR was 0.866, 0.817, and 0.849, respectively. The sensitivity of the value of S/D, PI, or RI for predicting FGR was 72.8%, 50.4%, and 72.8%, respectively. The specificity of the value of S/D, PI, or RI for predicting FGR was 91.2%, 100%, or 91.2%, respectively. The values of S/D, PI, and RI of MCA of the women in the study group were significantly lower than those of the women in the control group. The AUC of the value of S/D, PI, or RI for predicting FGR was 0.882, 0.869, or 0.834, respectively. The sensitivity of the value of S/D, PI, or RI for predicting FGR was 92.0%, 88.8%，or 90.4%, respectively. The specificity of the value of S/D, PI, or RI for predicting FGR was 74.4%，81.6%, or 72%, respectively. The values of S/D, PI, and RI of UtA of the women in the study group were significantly higher than those of the women in the control group. The AUC of the value of S/D, PI, or RI for predicting FGR was 0.866, 0.817, or 0.849, respectively. The sensitivity of the value of S/D, PI, or RI for predicting FGR was 91.2%，48%，or 48.8%, respectively. The specificity of the value of S/D, PI, or RI for predicting FGR was 52%, 90.4%，or 90.4%, respectively. The levels of D and PLGF of the women in the study group were significantly lower than those of the women in the control group. The AUC of the level of D or PLGF for predicting FGR was 54.4% or 99.2%, respectively. The sensitivity of the level of D or PLGF for predicting FGR was 54.4% or 99.2%. The specificity of the level of D or PLGF for predicting FGR was 91.2% or 52%. Conclusion: The blood flow parameters of UA, MCA, and UtA monitored ultrasound and the detection of the serum vitamin D and PLGF levels of the pregnant women during the second trimester of pregnancy have good value for predicting FGR. Comprehensive evaluation of the high risk pregnant women will reduce the FGR occurrence.

2022 Vol. 30　(1):　207- [Abstract]（ 299 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the value of transvaginal color Doppler sonography (TVCDS) combined with serum Survivin level for diagnosing cervical precancerous lesions. Methods: From May 2017 to December 2019, 164 women with cervical intraepithelial neoplasias (CIN) were selected in study group and 180 women with benign uterine lesions were selected in control group. The women in the study group were divided into group A (43 women with CINⅠ), group B (63 women with CINⅡ), and group C (58 women with CIN Ⅲ) according to the results of cervical pathological examination. The echo and blood flow of cervix were detected by TVCDS, and the blood flow resistance index (RI) of cervix was recorded. The expression level of serum Survivin was detected by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) was used to analyze the values of the blood flow RI and the serum Survivin level for diagnosing cervical precancerous lesions. And the risk factors of CIN were analyzed by Logistic regression. Results: The blood flow RI value of the women in the study group was significantly lower than that of the women in the control group, but the serum Survivin level and the positive rate of high-risk human papilloma virus (HR–HPV) of the women in the study group were significantly high (P<0.05), and the change ranges of which had increased with the increase of pathological degree of the cervical precancerous lesions (all P<0.05). The AUC of the blood flow RI value combined with the level of serum Survivin for diagnosing the cervical precancerous lesions of the women was 0.951, and the sensitivity and the specificity of which were 94.5% and 86.4%, respectively. The AUC, the sensitivity, and the specificity of the blood flow RI value combined with the level of serum Survivin for diagnosing the cervical precancerous lesions were significantly higher than those of the blood flow RI value or the level of serum Survivin alone. The positive HR-HPV, the lower blood flow RI value, and the higher serum Survivin level were the independent risk factors affecting cervical cancer precancerous lesions (P<0.05).  Conclusion: The blood flow RI value of patients with CIN decreases and their level of serum Survivin increases. The blood flow RI value combined with the level of serum Survivin for diagnosing the cervical precancerous lesions has better value.

2022 Vol. 30　(1):　216- [Abstract]（ 359 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the safety of autologous blood prepared of high-risk pregnant women. Methods: A total of 184 pregnant women hospitalized for expectant delivery due to high-risk pregnancy were selected as study subjects from January 2018 to December 2019. These women were randomly divided into study group (women with autogenous blood prepared before birth) and control group (women without autogenous blood prepared before birth). The blood loss during delivery of the women, and the weight and body length of the newborns were compared between the two groups. The values of hemoglobin (Hb), hematocrit (HCT), platelet count (PLT), blood pressure, pulse, and oxygen saturation of the women in the study group in 1 week before autogenous blood prepared and before delivery were observed. Results: There was no statistically significant difference in the Hb value (118.8 ± 8.5 g/L vs. 121.2 ± 9.9 g/L) of the women before delivery between the two groups (P=0.06). In the study group, there were no significant differences in the values of HCT, Hb, and PLT of the women within 1 week before autogenous blood prepared and before delivery (P>0.05). In the study group, the value of systolic blood pressure (112.2±8.5 mmHg) of the women before autogenous blood prepared was significantly higher than that (110.1±8.0mmHg) after autogenous blood prepared (P=0.0632), and the value of diastolic blood pressure (70.8±7.1 mmHg) of the women before autogenous blood prepared was significantly higher than that (69.1±7.8) after autogenous blood prepared (P=0.1027). In the study group, the values of pulse and oxygen saturation of the women before autogenous blood prepared had no significant different from those after autogenous blood prepared (P>0.05). Conclusion: It is safe to use autologous blood prepared of the high-risk pregnant women without the adverse reaction related to blood transfusion occurrence. In the hospital clinic, the rate of blood transfusion of the high-risk pregnant women is high, so autologous blood prepared of these women should be conducted after comprehensive evaluation of their specific situation.

2022 Vol. 30　(1):　225- [Abstract]（ 365 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

Blood hypercoagulable state, or prethrombotic state, may lead to variety of blood changes, such as thrombosis. When thrombus occurs in endometrium, it will cause a variety of adverse pregnancy outcomes, and recurrent spontaneous abortion (RSA) is one of them. Antiphospholipid antibodies, genetic factors, and metabolic disorders all will cause the formation of endometrial thrombosis, which will lead to the reduction of endometrial receptivity, poor placental perfusion, and eventually abortion. Therefore, in addition to routine examination, a thorough assessment of immunological, genetic, and endocrine etiology will determine the pregnancy outcomes of the pregnant women. The combined treatment of intervening inflammatory factors and maintaining coagulation balance can improve the endometrial receptivity, so as to protect the fetus. This paper summarizes above problems.

2022 Vol. 30　(1):　232- [Abstract]（ 355 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

Selective intrauterine growth restriction (sIUGR) is one of the serious complications of monochorionic twins, which increases perinatal mortality and morbidity, and causes long-term neurodevelopment and cognitive impairment of newborns, but its molecular mechanism is still unclear. Epigenetics refers to the fact that gene expression or cell phenotypes can be heritable in some way without changing the DNA sequence. The latest researches have found that there are DNA methylation, non-coding RNA regulation, and histone modification in placental tissue of the fetuses with sIUGR. The change in the way of epigenetic regulation proves that the epigenetic regulation mechanism affects the growth and development of the placenta, and it participates in the pathogenesis of sIUGR. Therefore, exploring the epigenetic regulation mechanism related to sIUGR can provide new ideas for understanding the pathogenesis of sIUGR and determining clinical diagnosis and treatment strategies.

2022 Vol. 30　(1):　241- [Abstract]（ 265 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )