2022 Vol. 30　(2):　256- [Abstract]（ 655 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the association of spontaneous abortion with the risk of subsequent preterm birth. Methods: The data of the objects in this study were from the archival information of couples who intended to have a child and had pre-pregnancy health examination under the National free pre-pregnancy health examination project in Yunnan province between 2010 and 2017. The pregnancy situation and pregnancy outcomes of the objects were followed up after examination. Describe analysis, stratified analysis, and logistic regression model were performed for data analysis by using SAS 9.4. Results：A total of 173,663 pregnancies were included in this analysis. Of them, 3.1% had a history of spontaneous abortion, 4.5% (95% CI 4.38-4.57) women had reported the preterm births for terminating the pregnancy. Results of multivariate logistic regression analysis indicated that the risk of subsequent preterm birth in women having one spontaneous abortion history (OR 0.94, 95%CI: 0.82-1.07), and those having two or more spontaneous abortions were largely similar (OR 1.02, 95%CI:  0.75-1.39) to that in women having no previous spontaneous history. Conclusion：A previous spontaneous abortion history does not increase the risk of subsequent preterm birth.

2022 Vol. 30　(2):　266- [Abstract]（ 509 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

2022 Vol. 30　(2):　275- [Abstract]（ 357 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the influence of self-designed prescription combined with ethinylestradiol and cyproterone acetate tablets for treating infertile women with polycystic ovary syndrome (PCOS) on their sex hormone level and pregnancy outcomes. Methods: 80 women with PCOS were selected and were randomly divided into control group and observation group (40 cases in each group) from January 2019 to October 2019.  The women in the control group were treated by ethinylestradiol and cyproterone acetate tablets, while the women in the observation group were treated by self-designed prescription combined with ethinylestradiol and cyproterone acetate tablets. The serum sex hormone levels, ovulation situation, and pregnancy outcomes, clinical efficacy, and adverse reactions rate of the women in the two groups were analyzed. Results: After treatment, the levels of luteinizing hormone (6.51±1.60 U/L), follicle stimulating hormone (2.11±0.92 U/L), testosterone (1.50±0.4 ng/mL), and estradiol (60.48±8.51 pmol/L) of the women in the observation group were significant lower than those of the women in the control group. The ovulation rate (87.5%) and pregnancy rate (62.5%) of the women in the observation group were significant higher than those (57.5% and 32.5%) of the women in the control group, and the total effective rate (85.0%) of the women in the observation group was significant higher than that (62.5%) of the women in the control group (all P＜0.05). There was no significant difference in the rate of adverse reaction (7.5% vs. 10.0%) of the women between the two groups (P＞0.05).  Conclusion: The self-designed prescription combined with ethinylestradiol and cyproterone acetate tablets for treating infertile women with PCOS can effectively improve the levels of sex hormones, promote the ovulation, and improve the pregnancy rate.

2022 Vol. 30　(2):　284- [Abstract]（ 281 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

2022 Vol. 30　(2):　291- [Abstract]（ 343 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

To observe the influence of aspirin combined with Shengui yangxue tablets used as pre-pregnancy intervention of patients with positive anticardiolipin antibody (ACA) and recurrent spontaneous abortion (RSA) on their thrombosis occurrence. Methods: 114 patients with positive ACA and RSA were selected and were randomly divided into two groups (57 cases in each group). The patients in the control group were given aspirin treatment, and the patients in the observation group were given treatment of aspirin combined with Shengui yangxue tablets. The conversion situations of ACA, lupus anticoagulant (LA), and anti-β2glycoprotein antibody (β2-GPI) of the patients after treatment were compared between the two groups. The values of coagulation index, such as D-dimer, platelet aggregation rate, activated partial thromboplastin time (APTT), the prothrombin time (PT), thrombin time (TT), and fibrinogen (FIB), and the values of hemorheology parameters, such as whole blood high shear viscosity, whole blood low shear viscosity, and plasma viscosity, and the values of uterine artery resistance index (RI) and the ratio of peak systolic velocity to end-diastolic end diastolic velocity (S/D) of the patients in the two groups before and after treatment were detected. Results: After treatment, the ratios of serum ACA negative conversion (86.0%) and β2-GPI (80.8%) of the patients in the observation group were significantly higher than those (63.2% and 58.7%) of the patients in the control group (P<0.05), but there was no significant difference in the ratio of LA negative conversion of the patients between the two groups (P>0.05). The values of APTT and PT of the patients in the observation group were significantly higher than those of the patients in the control group, while the D-dimer level, the platelet aggregation rate, and the values of whole blood high viscosity, whole blood low viscosity, and plasma viscosity of the patients in the observation group were significantly lower than those of the patients in the control group (P<0.05), and there was no significant difference in the TT level of the patients between the two groups (P>0.05). The uterine artery RI and S/D values of the patients in the observation group were significantly lower than those of the patients in the control group. The rate of successful pregnancy (73.7%) of the patients in the observation group was significantly higher than that (57.9%) of the patients in the control group, and the rate of the pregnancy again (7.1%) of the patients in the observation group was significantly lower than that (18.2%) of the patients in the control group (P<0.05). Conclusion: Aspirin combined with Shengui yangxue tablets used for adjuvant therapy of the patients with positive ACA and RSA is beneficial to improve their thrombosis, which can regulate uterine blood perfusion, improve the success rate of subsequent pregnancy, and can reduce the risk of re-abortion.

2022 Vol. 30　(2):　301- [Abstract]（ 325 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the influence of quadratus lumborum block (QLB) combined with general anesthesia on the postoperative analgesia of the patients after laparoscopic ovarian cystectomy. Methods: A total of 80 patients who underwent laparoscopic ovarian cystectomy from 2016 to 2019 were selected and were randomly divided into group A and group B. The patients in group A received ultrasound-guided QLB after induction of general anesthesia, and the patients in group B received ultrasound-guided transverse abdominal block (TAPB) after induction of general anesthesia, and the laparoscopic ovarian cystectomy was performed for the patients in the two groups after anesthesia induction. The time of operation, the time of revive from anesthesia, the time of extubation, and the dosage of intraoperative and postoperative sufentanil used of the patients in the two groups were recorded. The scores of resting and moving visual analogue scoring (VAS) of the patients in the two groups at postoperative 2h, 6h, 12h, and 24h were evaluated. The incidence of complications related to postoperative analgesia of the patients was compared between the two groups. Results: There was no significant difference in the operation time of the patients between the two groups. The time of revive from anesthesia (4.0±0.8 min), the tracheal catheter extraction time (5.3±1.3 min), the dose of intraoperative sufentanil used (29.6±5.8μg), and the dose of postoperative dose of sufentanil used (17.5±8.3μg) of the patients in group A were significant lower than those (4.7±0.8 min, 7.6±1.5 min, 36.0±3.6μg, and 36.2±11.4μg) of the patients in group B (P<0.05). The resting VAS score (3.35±1.10 points and 2.74±0.91 points) of the patients in group A at postoperative 2h and 6h were significantly lower than those (3.86±1.08 points and 3.16±0.96 points) of the patients in group B (P<0.05). There were no significant different in the resting VAS score of the patients at postoperative 12h and 24h between the two groups (P>0.05). The scores of the moving VAS of the patients at postoperative different time in group A were significantly lower than those of the patients in group B (P<0.05). The total complication rate (12.5%) of the patients in group A was significantly lower than that (32.5%) of the patients in group B (P<0.05). Conclusion: QLB combined with general anesthesia during laparoscopic ovarian cystectomy can effectively reduce the dosage of intraoperative and postoperative sufentanil used of the patients, can effectively improve the postoperative analgesic effect, and can reduce the occurrence of related complications of the patients.

2022 Vol. 30　(2):　311- [Abstract]（ 371 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the effect of accelerated rehabilitation surgery (ERAS) for evaluating perioperative emotion and pain of patients with cesarean scar pregnancy (CSP) during uterine artery embolization (UAE). Methods: 100 patients with CSP in this study were treated with UAE and hysteroscopic pregnancy tissue resection from January 2019 to June 2020. These patients were randomly divided into two groups (50 cases in each group) by random number table. During the perioperative period, the patients in the control group were given routine nursing intervention, and the patients in the study group were given ERAS management. Self rating Anxiety Scale (SAS), self rating Depression Scale (SDS), and digital Rating Scale (NRs) were used to evaluate the effect of the patients in the two groups before and after intervention. The patients with NRs score > 3 points were given intravenous analgesia with flurbiprofen axetil. The NRs score and the time of NRs score reduced to ≤ 3 points of the patients in the two groups after analgesia were observed. The psychological status, pain index, and clinical examination index of the patients were compared between the two groups. Results: After intervention, the scores of SAS (26.18±4.38 points) and SDS (29.15±5.75 points) of the patients in the study group were significantly lower than those (31.25±3.28 points and 35.09±4.97 points) of the patients in the control group (P＜0.05). The patients in both groups had different degrees of pain after UAE, and there was no significant different in median NRs score of the patients between the two groups (P＞0.05). However, the NRs scores of the patients in the study group in 60min and 120min after analgesia (3.0 ［2.0, 5.0］ and 2.0 ［1.0, 4.0］) were significantly lower than those (4.0 ［3.0, 5.0］ and 3.0 ［2.0, 5.0］) of the patients in the control group (P＜0.05). Conclusion: ERAS model is helpful to improve the negative emotion and relieve the degree of pain of the patients with CSP after UAE. Flurbiprofen axetil used as analgesic treatment after UAE is safe and effective, which can improve the comfort and satisfaction of patients during the treatment process.

2022 Vol. 30　(2):　319- [Abstract]（ 402 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the analgesic effect and safety of preemptive analgesiaon by ketorolac tromethamine combined with sufentanil of the patients after hysterectomy. Methods: 184 patients who wanted laparoscopic hysterectomy in selected time were randomly divided into experimental group (n=92) and control group (n=92) from January 2018 to January 2020. The patients in both groups were given preemptive analgesia at 30min before skin incision, and the patients in the control group were given 10μg sufentanil as preemptive analgesia, while the patients in the experimental group were given 5μg sufentanil combined with 15mg ketorolac tromethamine as preemptive analgesia. After operation, all patients were given controlled intravenously analgesia (PCIA), and the patients in the control group were given 1μg/kg sufentanil, while the patients in the experimental group were given 3mg/kg ketorolac tromethamine combined with 1μg/kg sufentanil. The visual analogue scale (VAS) scores of the patients in the two groups immediately after operation (T1), 2h after operation (T2), 6h after operation (T3), 12h after operation (T4), 24h after operation (T5), and 2h after PCIA withdrawal (T6) were observed. The levels of serum substance P and serotonin (5HT) of the patients in the two groups before anesthesia (T0), at T2 and T5 were detected. The incidences of postoperative analgesic adverse reactions of the patients in the two groups were recorded. Results: VAS scores at T1 (2.95±0.77 points), T2 (3.41±0.75 points), T3 (3.12±0.79 points) of the patients in the experimental group were significantly lower than those (3.33±0.69 points, 3.86±0.84 points, and 3.45±0.75 points) of the patients in the control group (P<0.05), but which of the patients at T4, T5 and T6 had no significant different between the two groups (P>0.05). The levels of serum substance P and 5-HT of the patients in the experimental group at T2, T5, and T6 were significantly lower than those of the patients in the control group. The total incidence of adverse analgesia reaction (5.4%) of the patients in the experimental group was significantly lower than that (15.2%) of the patients in the control group (all P<0.05). Conclusion: Ketorolac tromethamine combined with sufentanil used as preemptive analgesia of the patients with hysterectomy can significantly reduce the level of their serum pain-causing substances during early postoperative stage, with good postoperative analgesic effect and low incidence of adverse reactions.

2022 Vol. 30　(2):　327- [Abstract]（ 388 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the effect of continuous epidural anesthesia combined with automatic control analgesia pump epidural during the second stage of labor of pregnant women on their postpartum hemorrhage. Methods: A total of 120 pregnant women were selected in this study and were divided into two groups (60 cases in each group) according to the random number table method from June 2018 to July 2019. All the women were given continuous epidural anesthesia combined with epidural catheter connected self-controlled analgesic pump for labor analgesia. The women in the control group turned off analgesic pump during the second stage of labor, and the women in the study group continually used the analgesic pump during the second stage of labor. The analgesic effects at different time, postpartum hemorrhage, and delivery mode of the women, and the adverse neonatal outcomes were compared between the two groups. Results: VAS scores at 30min (1.9±0.7 points), 60min (1.5±0.6), and 90min (1.3±0.9 points) after analgesia of the women in the study group were significantly lower than those (2.1±0.6 points, 1.9±0.7 points, and 1.8±1.0 points) of the women in the control group. The blood loss at postpartum 2h, 12h, and 24h (115.3±ml, 158.7±23.7ml, and 188.6±28.5ml), and the onset time of hemostasis (16.2±2.2min) of the women in the study group were significantly lower than those (153.4±25.0 ml, 214.2± 32.2ml, and 265.6±35.2 ml, and 23.3±2.4min) of the women in the control group (all P<0.05). There were no significant differences in the delivery mode and the incidence of neonatal adverse outcomes between the two groups (P＞0.05). Conclusion: Continuous epidural anesthesia combined with epidural catheter connected automatic control analgesic pump during the second stage of labor of the pregnant women has better analgesic effect.

2022 Vol. 30　(2):　336- [Abstract]（ 345 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To observe the curative effect of elagolix for alleviating pain of women with moderate or severe endometriosis, and to study its influence on the peripheral blood pain stress factors levels of the women. Methods: 80 women with moderate or severe pain related endometriosis were selected and were randomly divided into two groups from January to December 2020. 39 women in the observation group had received elagoli treatment for 3 months, and 41 women in the observation group had received placebo for 3 months. The scores of dysmenorrhea, non-menstrual pelvic pain, pain during intercourse, and digital analog scale (NRS) of the women before and after treatment were compared between the two groups. The value of bone mineral density (BMD) of lumbar spine L1-4 and femoral neck of the women in the two groups were measured, and the levels of serum pain stress factor prostaglandin E2 (PGE2) and nerve growth factor (NGF) of the women in the two groups were detected. Results: After 3 months of treatment, the scores of dysmenorrhea (1.44±0.38 points), non-menstrual pelvic pain (1.25±0.33 points), and pain during intercourse (1.19±0.39 points), and NRS (3.12±0.72 points) of the women in the observation group were significantly lower than those (1.81±0.41 points, 1.44±0.46 points, 1.41±0.42 points, and 5.01±1.01 points) of the women in the control group, and the rate of pain reduction with clinical significance of the women in the observation group was significantly higher than that of the women in the control group (P<0.05). The levels of PGE2 and NGF of the women in the two groups had decreased significantly, and which (249.71±33.05 pg/ml and 167.43±51.27 pg/ml) of the women in the observation group were significantly lower than those (589.92±132.51 pg/ml and 301.43±90.23 pg/ml) of the women in the control group (P<0.05). The BMD value of the women in the two groups after treatment had no significant different from that before treatment (P>0.05). The incidences of hot flashes (25.6%) and total incidence (84.6%) of the women in the observation group were significantly higher than those (7.3% and 56.1%) of the women in the control group (P<0.05). Conclusion: Elagolix for alleviating pain of women with moderate or severe endometriosis has significant effectiveness, especially for alleviating their dysmenorrhea and nonmenstrual pelvic pain, and which can reduce the levels of serum pain stress factors with less adverse influence on the BMD value of these women.

2022 Vol. 30　(2):　344- [Abstract]（ 353 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To investigate the effect of epidural sufentanil combined with ropivacaine for labor analgesia, and to study its influence on the neonatal physical signs. Methods: A total of 752 pregnant women were selected as the research subjects between August 2018 and December 2019. According to the advices of doctors and the wishes of the women, these women were divided into control group (426 women without labor analgesia) and observation group (326 with epidural sufentanil combined with ropivacaine for labor analgesia). The pain grading criterion of WHO was used to evaluate the analgesia effect of the women in the two groups. The duration of labor stage, the rate of transferring to cesarean section, the postpartum hemorrhage volume, the neonatal physiological indexes, Apgar score, and the incidence of adverse reactions of the women were compared between the two groups. Results: The pain degree of the women in the observation group was significantly lower than that of the women in the control group when the uterine orifice opened to 5 cm and 10 cm. The duration of the first stage of labor (321.3±31.9min) of the women in the observation group was significantly shorter than that (432.6±40.2min) of the women in the control group, but the duration of the second stage of labor (85.7±3.8min) of the women in the observation group was significantly longer than that (54.1±2.7min) of the women in the control group. The rate of transferring to cesarean section (4.0%) and postpartum bleeding volume (122.45±20.0ml) of the women in the observation group were significantly lower than those (11.7% and 126.4± 21.1mL) of the women in the control group. The incidence of neonatal asphyxia (0%) in the observation group was significantly lower than that (2.6%) in the control group (all P<0.05). There were no significant differences in the neonatal physiological indexes (body weight, height, head circumference), Apgar score, and the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: The curative effect of epidural sufentanil combined with ropivacaine for labor analgesia is good, which can significantly shorten duration of the first stage of labor, reduce the rates of transferring to cesarean section and the incidence of neonatal asphyxia, and can decrease the postpartum hemorrhage volume without increasing the adverse influences on the neonatal physiological indexes and quality of life.

2022 Vol. 30　(2):　353- [Abstract]（ 366 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the clinical effects of intrauterine device (IUD) inserted of women in different periods after abortion. Methods: The clinical data of 160 women who had undergone abortion from March 2018 to March 2020 were collected. According to IUD inserted in different periods, these women were divided 80 women with IUD inserted in 3-7 days of the first menstruation end after abortion in group A and 80women with IUD inserted immediately after abortion in group B. The menstrual conditions of the women after IUD inserted were compared between the two groups. The women in the two groups were followed up for 6 months, and the contraceptive effect and the complications situation of the women in the two groups were analyzed. Results: There were no significant differences in the menstrual recovery time, the bleeding time after abortion, the menstrual period, and the menstrual volume of the women after IUD inserted between the two groups. There were no significant differences in the incidences of complications, such as abdominal distension, breast distension, waist and knee acerbity, leucorrhea increase of the women after 3 and 6 months of IUD inserted (P＞0.05). There were no significant differences in the rates of continue IUD used for 3 months (96.3% vs. 97.5%) and for 6 months (92.5% vs.95.0%) of the women between the two groups (P＞0.05). Conclusion: The safety and contraceptive effect of the women with IUD inserted in 3-7 days of the first menstruation end after abortion and the women with IUD inserted immediately after abortion are similar and are both high. IUD inserted immediately after abortion can avoid operation again, which has greater clinical value.

2022 Vol. 30　(2):　361- [Abstract]（ 709 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the effects of follicular fluid wing spiral/forkhead transcription factor gene 2 (FOXL2) of women on their dosage of gonadotropin (Gn) during superovulation and their clinical outcomes. Methods: 98 women with in vitro fertilization-embryo transfer or intracytoplasmic sperm injection were selected in this study from April 2017 to April 2020. According to the total dose of gonadotropin (Gn) used during ovulation induction, these women were divided into group A (29 women with <2000IU of Gn), group B (42 women with 2000-4000IU of Gn), and group C (27 women with ≥4000IU of Gn). The clinical data, the laboratory indicators, the pregnancy outcomes, and the levels of FOXL2 and serum estradiol (E2) on the day of human chorionic gonadotropin (hCG) used of these women were obtained. The risk factors affecting pregnancy of the women were analyzed. Results: The level of basal luteinizing hormone (LH) and the dosage of Gn used of the women in group A, group B, and group C had increased gradually, while the antrum follicles count (AFC), the number of harvested eggs, the rate of high-quality embryos, the FOXL2 level in follicular fluid, and the E2 level on the day of hCG used had decreased gradually (all P＜0.05). There were no significant differences in the normal fertilization rate and the clinical pregnancy rate of the women among the three groups (P＞0.05). The dosage of Gn used of the women with pregnancy was significantly lower than that of the women without pregnancy, but FOXL2 level in follicular fluid of the women with pregnancy was significantly higher (P＜0.05). Logistic regression analysis showed that excessive dosage of Gn used and decrease of FOXL2 level in follicular fluid of the women were the risk factors of pregnancy outcomes of the women after assisted reproductive technology (OR=2.285, 95%CI=1.287-5.195, P=0.021). Conclusion: The older of the women, the more dosage Gn was used. The increasing dosage of Gn used will reduce the level of FOXL2 in follicular fluid. The less dosage of Gn used during ovulation induction, the greater the ovarian response was to Gn. The level of FOXL2 increases, the ovarian response to hyperovulation drugs is greater, the number of eggs obtained is more, the rates of high-quality embryos and the clinical pregnancy are higher, which contribute to the outcomes of assisted reproduction.

2022 Vol. 30　(2):　370- [Abstract]（ 510 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the expressions and correlation of anti-Mullerian hormone type II receptor(AMHRII), granulosa cell follicle stimulating hormone receptor(FSHR) and luteinizing hormone receptor(LHR) in follicular fluid and granulosa cells of women with different ovarian reserve. Methods: A total of 110 women undergone in vitro fertilization-embryo transfer were enrolled in this study from December 30, 2016 to May 30, 2019. These women were divided into group A(43 cases with normal ovarian function), group B(37 cases with ovarian dysfunction(DOS)), and group C(30 cases with ovarian premature aging(POF)) according to their ovarian function. The follicular fluid and granulosa cells of the women in the three groups were obtained, and the relative expressions of AMHRII, FSHR, and LHR mRNA in follicular fluid and granulosa cells were detected by qRT-PCR. Results: The age, the body mass index value, the FSH and LH levels of the women in group C were significantly higher than those of the women in group A and group B, but the number of ovarian follicles, the number of eggs obtained, and the levels of AMH, estradiol(E2), and progesterone(P) of the women in group C were significantly lower than those of the women in group A and group C(P<0.05). The relative expression levels of AMHR Ⅱ, FSHR, and LHR of the women in group C were the lowest, followed by those of the women in group B, and which of the women in group A were the highest(P<0.05). Correlation analysis showed that FSHR level of the women in group A was positively correlated with their LHR and AMHR Ⅱ expression levels, the LHR level of the women in group A was positively correlated with their AMHR Ⅱ expression level(all P<0.05). In group B, the FSHR level of the women was positively correlated with their LHR and AMHR Ⅱlevels(P<0.05). In group C, the FSHR level of the women was positively correlated with their AMHR Ⅱlevel(P<0.05). Conclusion: The expression levels of AMHRII, FSHR, and LHR of the women with different ovarian reserve are different, which may be related to the mechanism of abnormal ovarian reserve.

2022 Vol. 30　(2):　379- [Abstract]（ 334 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the correlation between the level of sperm oxygen active substances (OAS) of the men with infertility and their sperm morphological morphology and sperm DNA fragments, so as to provide theoretical basis for the antioxidation treatment of these men. Methods：250 male semen samples from August 2018 to August 2020 were selected to detect their sperm morphology, sperm DNA integrity, and the level of OAS. According to sperm morphology, these sperms were divided into group A1 (sperm with normal morphology), group A2 (sperm with head deformity, group A3 (sperm with neck deformity, group A4 (sperm with tail deformity), and group A5 (sperm with mixed deformity). These sperms were also divided into group B1 (sperm with sperm DNA fragment index (DFI) <15%), group B2 (sperm with sperm DFI 15%-30%, and group B3 (sperm with sperm DFI >30%) according to the rate of DFI. The sperm OAS levels in different groups were analyzed and its correlation with male infertility was analyzed. Results: Among these 250 sperm samples, there were 60.4% samples with normal sperm morphology, and there were 39.6% samples with abnormal sperm morphology, which included sperm head deformity of 47.5%, sperm neck deformity of 35.4%, sperm tail deformity 13.1%, and sperm mixed deformity 4.0%. There were no significant difference in the OAS level of sperm (715.49±203.82 U/L vs. 711.39±206.24 U/L vs. 718.83±201.57 U/L vs. 721.31±200.67 U/L) among group A2, group A3, group A4, and group A5, but the OAS level of sperm in group A2, group A3, group A4, or group A5 was all significantly higher than that (462.76±148.76 U/L) in group A1 (P<0.05). The rates of sperm DFI in group B1, group B2, and group B3 were 55.6%, 32.4%, and 12.0%, respectively, which had significant different among these groups. The OAS level of sperm in group B3 (719.74±205.39 U/L), in group B2 (637.24±183.65 U/L), and in group B1 (457.68±151.46 U/L) had decreased gradually (all P<0.05). Pearson correlation analysis showed that normal sperm morphology rate of the men was negatively correlated with their sperm OAS level. The rate of sperm neck deformity, sperm neck deformity, and sperm tail deformity of the men were positively correlated with their sperm OAS level, and the sperm head deformity rate had the highest correlation with the sperm OAS level. The rate of sperm DFI was positively correlated with the sperm OAS level (all P<0.05). Conclusion: The abnormal morphology of sperm may be an important source of oxygen free radicals, and the increase of sperm DNA fragments will increase the ROS level of sperm, which may accelerate the process of germ cell apoptosis and lead to male infertility.

2022 Vol. 30　(2):　387- [Abstract]（ 376 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the value of abdominal ultrasound combined with contrast-enhanced ultrasound for distinguish of uterine fibroids (UF) and adenomyosis of women. Methods: 80 women with uterine focal lesions were selected and were divided 47 women with UF in group A and 33 women with adenomyosis in group B from March 2018 to March 2020. Another 30 normal women were selected in group C during the same period. The values of blood flow velocity (Vs), resistance index (RI), and pulsatile index (PI) of ultrasonic contrast-enhanced quantitative parameters, and the values of start increase time (AT), time to peak (TTP), and peak intensity maxmum (IMAX) of ultrasound contrast quantitative parameters of the women were measured and compared among the three groups. Results: There were no significant differences in the values of Vs and PI of the women among the three groups (P＞0.05). The value of RI of the women in group A was significantly lower than that of the women in group B, and which of the women in group B was significantly lower than that of the women in group C (P＜0.05). The values of AT and TTP of the women in group A were significantly higher than those of the women in group C. The values of TTP and IMAX of the women in group B were significantly lower than those of the women in group C. The values of AT, TTP, and IMAX of the women in group A were significantly higher than those of the women in group B (all P＜0.05). ROC curve showed that the values of RI, AT, TTP, and IMAXI had certain diagnostic value for UF, and which AUC were 0.867, 0.823, 0.804, and 0.764, respectively. The AUC and the sensitivity of abdominal ultrasound combined with contrast-enhanced ultrasound for diagnosing UF were 0.980 and 0.967, which were significantly higher than those of ultrasound or contrast-enhanced ultrasound alone. The values of RI, TTP, and IMAXI had certain diagnostic value for adenomyosis, and which AUC were 0.850, 0.792, and 0.887, respectively. The AUC and the sensitivity of abdominal
ultrasound combined with contrast-enhanced ultrasound for diagnosing adenomyosis were 0.910 and 0.900, which were significantly higher than those of ultrasound or contrast-enhanced ultrasound alone. Conclusion: Ultrasound and contrast-enhanced ultrasound can distinguish of UF and adenomyosis of women, but combined the ultrasound and contrast-enhanced ultrasound has higher diagnostic efficiency.

2022 Vol. 30　(2):　394- [Abstract]（ 345 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the influence of the indexes of blood coagulation and blood routine of pregnant women during the third trimester of pregnancy on their eclampsia occurrence and pregnancy outcomes. Methods: The clinical data of healthy pregnant women (in control group) and pregnant women patients with eclampsia (in study group) from 2015 to 2018 were selected as the research subjects. The differences of the indexes of blood coagulation and blood routine of the women were compared between the two groups. The correlation between the indexes of blood coagulation and blood routine of the women and their eclampsia occurrence was analyzed. The incidence of adverse pregnancy outcomes of the women with eclampsia was recorded. The relationship between the indexes of blood coagulation and blood routine of the women and their pregnancy outcomes was analyzed. Results: The values of plasma thrombin time (TT), prothrombin time (PT), activated prothrombin time (APTT), antithrombin Ⅲ (AT-Ⅲ) activity， and platelet (PLT) count of the women in the study group were significantly lower than those of the women in the control group, while the values of D-dimer, fibrinogen (FIB), and hematocrit (HCT) of the women in the study group were significantly higher (P＜0.05). There were no significant differences in the values of red blood cell count (RBC), white cell count (WBC), mean platelet volume (MPV), and hemoglobin concentration (Hb) of the women between the two groups (P＞0.05). Logistic multivariate analysis showed that the risk factors of eclampsia included D-dimer (OR=0.238), FIB (OR=0.368), and PLT count (OR=0.685) (all P＜0.05). The incidences of premature delivery, cesarean section, low birth weight, neonatal asphyxia, and perinatal mortality of the women had increased with the increase of the abnormal iteams of the indexes of blood coagulation and abnormal blood routine (P＜0.05). Conclusion: The indexes of blood coagulation and blood routine of the pregnant women are related to their eclampsia occurrence. The abnormal indexes of blood coagulation and blood routine of the pregnant women can lead to the adverse pregnancy outcomes, so which should be paid attention to in clinic.

2022 Vol. 30　(2):　402- [Abstract]（ 284 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the curative effect of laparoscopic and hysteroscopic surgery for treating patients with type Ⅱ of submucosal uterine fibroids, and to study their influence on the cervical local microcirculation and the serum anti-Mullerian hormone (AMH) level of the patients. Methods: The clinical data of 112 patients with type Ⅱ of submucosal uterine fibroids from June 2018 to June 2019 were analyzed retrospectively. These patients were divided into group A (56 patients with laparoscopic surgery) and group B (56 patients with hysteroscopy surgery) according to different surgical procedures. The operation-related indicators, and the situations of postoperative complications, pregnancy, and recurrence of the patients were compared between the two groups. The cervical local microcirculation parameters and the serum levels of AMH, follicle stimulating hormone (FSH), estradiol (E2) of the patients before and after surgery were measured. Results: The operative time, intraoperative blood loss, postoperative anal exhaust time, and hospital stay time of the patients in group B were significantly lower than those of the patients in group A, and the rate of one-time resection of myoma (100.0%) of the patients in group A was significantly higher than that (91.1%) of the patients in group B (all P＜0.05). There were no significant changes in the cervical capillary diameter and the blood perfusion volume, and the serum AMH, FSH, and E2 levels of the patients between the two groups and between before and after operation (P＞0.05). There were no significant differences in the incidences of complications (14.3% vs. 7.1%), the recurrence rate of uterine fibroids (10.7% vs. 3.6%), and the pregnancy rate after operation (76.7% vs. 68.1%) of the patients between the two groups (all P＞0.05). The duration of post operation to pregnancy of the patients in group B was significant shorter than that of the patients in group A (P＜0.05). Conclusion: Laparoscopic and hysteroscopic surgery for treating the patients with type Ⅱ of submucosal uterine fibroids have significant effect with less influence on the local cervical microcirculation and the AMH level of the patients. Laparoscopic surgery has higher rate of resection at once, but hysteroscopic surgery has advantage of less trauma and less blood loss during operation, which is more conducive to shorten the duration of post operation to pregnancy.

2022 Vol. 30　(2):　411- [Abstract]（ 360 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To investigate the immunoreactivity of placental fractalkine (CX3CL1) in placenta of pregnant women with preeclampsia, and to study its correlation with their placental histopathological changes and their adverse pregnancy outcomes. Methods: 68 pregnant women with preeclampsia were selected in observation group and 30 healthy pregnant women were selected in control group from June 2017 to June 2020. The levels of CX3CL1 in placental tissue of the women in the two groups were determined by immunohistochemical method. The relationship between the levels of CX3CL1 of the women and their pathological changes and adverse pregnancy outcomes was analyzed. Results: In the observation group, there were 26 women with mild preeclampsia in group A and 42 women with severe preeclampsia in group B. There were significant differences in neonatal weight, gestational weeks of delivery, the rates of intrauterine growth restriction and premature delivery, and the values of diastolic blood pressure, systolic blood pressure, and 24h urinary protein level of the women among group A, group B, and the control group (P<0.05). The proportions of syncytiotrophoblast basement membrane thickening, syncytial knots, and fibrinoid necrosis in placenta tissue, and the score of vascularization of terminal villi of the women in the control group, group A, and group B had increased gradually. There were significant differences in CX3CL1 immune reactivity scales in placental trophoblastic cells and in capillary endothelial among the control group, group A, and group B (all P<0.05). In the observation group, the immunoreactivity of CX3CL1 in placental tissue of the women was correlated with their fetal intrauterine growth restriction, premature delivery, thickening of syncytiotrophoblast basement membrane, syncytial node, fibrinoid necrosis, and terminal villus vascularization. Conclusion: Compared with that of the normal pregnant women, fractalkine immunoreactivity in placental tissues of the pregnant women with preeclampsia is enhanced, and which is correlated with the pathological changes of their placental tissues and their adverse pregnancy outcomes, which means that CX3CL1 and its related pathways may be involved in the pathogenesis of preeclampsia.

2022 Vol. 30　(2):　419- [Abstract]（ 535 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the value of the levels of serum placental growth factor (PLGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) of high-risk pregnant women during the first trimester of pregnancy for predicting their preeclampsia occurrence. Methods: The clinical data of 100 high-risk pregnant women who received regular antenatal care and delivery from January 2018 to January 2021 were collected retrospectively. These women were included 42 women with preeclampsia in observation group, and 58 women without preeclampsia in control group. The women in the observation group were further divided in group A (22 women with mild preeclampsia) and group B (20 women with severe preeclampsia) according to the severity of preeclampsia. The differences of the serum PLGF and sFlt1 levels of the women during the first trimester of pregnancy were compared among these groups. The values of the serum PLGF and sFlt-1 levels of the women for predicting their preeclampsia was analyzed. Results: There were significant differences in the serum PLGF level (38.69±9.62 pg/ml vs. 58.17±14.33 pg/ml) and the serum SFLT-1 level (1468.88±217.14 pg/ml vs. 998.62±148.37 pg/ml) of the women during the first trimester of pregnancy between the observation group and the control group. There were significant differences in the serum PLGF level (44.13±10.16 pg/ml vs. 25.89±7.12 pg/ml) and the serum SFLT-1 level (1228.49±175.55 pg/ml vs. 1802.60±246.10 pg/ml) of the women during the first trimester of pregnancy between group A and group B (P＜0.05). Pearson correlation analysis showed that the serum PLGF level of the women during the first trimester of pregnancy was negatively correlated with the severity of preeclampsia (r=-0.582, P＜0.05), and the serum SFLT-1 level of the women was positively correlated with the severity of preeclampsia (r=0.604, P＜0.05). When the optimal cut-off value of the PLGF level was 46.23 pg/ml, the AUC, the sensitivity and the specificity of the PLGF level for predicting preeclampsia of the high-risk pregnant women were 0.766, 78.9%, and 74.6%, respectively. When the optimal cut-off value of the sFlt-1 level was 1145.50 pg/ml, the AUC, the sensitivity, and the specificity of the sFlt-1 level for predicting preeclampsia of the high-risk pregnant women were 0.783, 80.02%, and 76.11%, respectively. The AUC, the sensitivity and the specificity of the combined of the levels of PLGF and sFlt-1 for predicting preeclampsia were 0.946, 91.2%, and 92.7%, respectively. Conclusion: The decrease of the serum PLGF level and the increase of the serum sFlt-1 level of the high-risk pregnant women may be related to their occurrence and progression of preeclampsia during the first trimester of pregnancy. Detections of serum PLGF and sFlt-1 levels of the high-risk pregnant women can be used as the reference indicators for predicting preeclampsia.

2022 Vol. 30　(2):　430- [Abstract]（ 507 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the Influence of the rate of blood glucose elevation (Vmean) evaluated by oral glucose tolerance test (OGTT) of pregnant women with gestational diabetes mellitus (GDM) on their abnormal lipid metabolism and insulin resistance. Methods: 216 pregnant women with GDM were selected as subjects from April 2017 to October 2020. The general data of these women were collected, OGTT and insulin release test (IRT) were performed on these women. The levels of serum lipid metabolism index and insulin resistance index of these women were recorded, and Vmean of these women was calculated. According to the mean of Vmean, the women were divided into group A (women with Vmean<0.109 mmol/L·min) and group B(women with Vmean≥0.109 mmol/L·min). Results: Age, the body mass index value, and the HbA1c level of the women in group B were significantly higher than those of the women in group A (P<0.05). The levels of serum TG, TC, and LDL of the women in group B were significantly higher than those of the women in group A (P<0.05), while the HDL level of the women in group B was significantly lower than those of the women in group A (P<0.05). The value of HOMA-IR of the women in group B was significantly higher than those of the women in group A, but the values of HOMA-β andΔI30/ΔG30 of the women in group B were significantly higher than those of the women in group A (P<0.05). The Vmean of the women with GDM was positively correlated with their age, BMI value, HbA1c level, TG level, and HOMA-IR level (r=0.266, 0.307, 0.855, 0.705, 0.289), and was negatively correlated with their values of HOMA-β andΔI30/ΔG30 (r=-0.773, -0.252). Age, BMI value, and HbA1c level of the women with GDM were the independent risk factors of their increase of Vmean (OR=2.305, 95%CI 1.162-3.576; OR=2.168, 95% CI 1.14-4.126; OR=2.983, 95% CI 1.534-5.801). Conclusion: The high Vmean of the pregnant women with GDM can aggravate the degree of their abnormal lipid metabolism and insulin resistance, and advanced age, obesity, and high level of HbA1c are the influencing factors of Vmean of these women.

2022 Vol. 30　(2):　439- [Abstract]（ 355 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

To investigate the proportion of Treg to Th17 (Treg/Th17) cells in peripheral blood of pregnant women with condyloma (CA), and to study its influence on the pregnancy outcomes of these women. Methods: From October 2018 to October 2020, 112 pregnant women with CA were selected in study group, and 112 normal pregnant women were selected in control group during the same period. Flow cytometry was used to detect the proportion of Treg/Th17 cells in peripheral blood of the women in the two groups. The influence of the imbalance of Treg/Th17 cells in peripheral blood of the women with CA on their pregnancy outcomes was analyzed. Results: The level of Treg (4.56±1.44%) and the proportion of Treg/Th17 cells (4.38±1.48) in peripheral blood of the women in the study group were significantly higher than those (2.60±0.72% and 1.64±0.56) of the women in the control group. The levels of Th17 (1.04±0.35%) in peripheral blood of the women in the study group was significantly lower than that (1.62±0.46%) of the women in the control group (all P＜0.05). ROC curve analysis showed that the Treg and Th17 levels, and the proportion of Th17 and Treg/Th17 cells in peripheral blood of the women had certain values for diagnosing CA (AUC=0.813, 0.814, and 0.946). The rates of cesarean delivery (50.0%) and forceps delivery (12.9%) of the women with CA and the imbalance of Treg/Th17 cells were significantly higher than those (28.6% and 4.8%) of the women without the imbalance of Treg/Th17 cells, but the rate of natural delivery (37.1%) of the women with CA and the imbalance of Treg/Th17 cells was significantly lower than that (66.7%) of the women without the imbalance of Treg/Th17 cells (P＜0.05). There were no significant differences in the rates of full-term birth, preterm birth, abortion, and HPV positive rate of the women, and the rates of perinatal death, neonatal asphyxia, neonatal low body weight, and the incidences of neonatal HPV infection and respiratory papilloma after followed up for 6 months of born between of the women with the imbalance of Treg/Th17 cells and the women without the imbalance of Treg/Th17 cells (all P＞0.05). Conclusion: The women with CA have the imbalance of Treg/Th17 cells in peripheral blood during pregnancy, which may affect the maternal delivery outcomes to a certain extent, but has no significant impact on the adverse pregnancy outcomes of both mothers and infants.

2022 Vol. 30　(2):　448- [Abstract]（ 253 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the expressions of NOB1 and miR-21 in cervical lesions tissues of women, and to study its association with the cervical high-risk human papillomavirus (HR-HPV) infection of the women. Methods: The clinical data of 138 women with cervical lesions from January 2018 to May 2020 were selected for retrospective analysis. These women included 52 cases with cervical cancer in group A, 54 cases with cervical squamous intraepithelial lesions in group B, and 32 cases with chronic cervicitis group C. The positive rate of NOB1, the proportion of positive cells, and the comprehensive score of staining intensity of the cells, the expression level of miR-21, the positive rate of HR-HPV, and the DNA load of the women were compared among the three groups. The correlation between the positive rate of NOB1 and the miR-21 level of the women with their HR-HPV infection was analyzed. The efficiency of the positive rate of NOB1 and the miR-21 level of the women for diagnosing the cervical cancer and for predicting their HR-HPV infection were evaluated. Results: The positive rate of NOB1, the proportion of positive cells, the comprehensive score of staining intensity of the cells, and the expression level of Mir-21 of the women in group A, group B, and group C had decreased gradually. The HR-HPV positive rate, and the proportions of HR-HPV DNA load of 100-1000 and ≥1000 of the women in group A were significantly  higher than those of the women in the other two groups (P＜0.05), but there was no significant difference in the proportion of HR-HPV DNA load of 1-100 of the women among the three groups (P>0.05). Kendall's TaU-B correlation analysis showed that the proportion of NOB1 positive cells, the comprehensive score of staining intensity of the cells, and the miR21 expression level of the women with HR-HPV infection were positively correlated with their HR-HPV DNA load (r=0.137, 0.143, all P<0.05). Multiple stepwise regression analysis showed that the proportion of NOB1 positive cells and the comprehensive score of staining intensity of the cells were the influencing factors of HR-HPV positive rate. ROC curve analysis showed that the AUC of the proportion of NOB1 positive cells and the comprehensive score of staining intensity of the cells, and the miR21 expression level of the women for diagnosing their cervical cancer were 0.950 and 0.975 (P<0.05). The AUC of the proportion of NOB1 positive cells and the comprehensive score of staining intensity of the cells, and the miR21 expression level of the women for predicting their HR-HPV infection were 0.739 and 0.712 (P<0.05). Conclusion: NOB1 of the women with cervical cancer is positive. The miR-21 level of the women with cervical cancer is high and is positively correlated with their HR-HPV DNA load, which has some values for diagnosing their cervical cancer and for predicting their HR-HPV infection.

2022 Vol. 30　(2):　457- [Abstract]（ 352 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To study the influencing factors of postoperative cervical cancer recurrence, and to analyze the levels of human epididymis protein 4 (HE4), fibrinogen (FIB), and P16 gene protein (P16) for predicting the recurrence of cervical cancer. Methods: The clinical data of 90 patients with cervical cancer from Mar. 2019 to Mar. 2020 were selected and these patients were divided into group A (16 patients with recurrence of cervical cancer) and group B (74 patients without recurrence of cervical cancer). The general information and the levels of HE4, Fib and P16 of the patients were compared between the two groups. Based on the results of pathological examination, the predictive efficiency for the postoperative recurrence of cervical cancer was compared among the HE4 level, the FIB level, and the P16 level. Results: There were no significant differences in age, the value of body mass index, the smoking history, and the family history of cervical cancer of the patients between the two groups (P＞0.05), but there were significant differences in tumor diameter ≥4cm, the lymph node metastasis rate, the clinical stage, the positive rates of HE4, FIB, and P16 expressions of the patients between the two groups (P＜0.05). The levels of HE4 and FIB of the patients in group A were significantly higher than those of the patients in group B, but the positive expression rate of P16 of the patients in group A was significantly lower (P＜0.05). The tumor diameter ≥4cm, the lymph node metastasis, the clinical stage II, the increased levels of HE4 and FIB, and the positive P16 expression of the patients were the independent risk factors of their postoperative recurrence of cervical cancer (P＜0.05). The accuracy, the sensitivity, and the specificity of the HE4 level for diagnosing the recurrence of cervical cancer were 76.7%, 82.6%, and 76.8%, respectively. The accuracy, the sensitivity, and the specificity of the FIB level for diagnosing the recurrence of cervical cancer were 73.8%, 79.4%, and 73.7%, respectively. The accuracy, the sensitivity, and the specificity of the P16 level for diagnosing the recurrence of cervical cancer were 81.6%, 85.1%, and 79.7%, respectively. Conclusion: The abnormal levels of HE4, FIB, and P16 are the independent risk factors of the postoperative recurrence of cervical cancer, which all have some clinical significances for predicting the postoperative recurrence of cervical cancer and the P16 level has higher predictive value.

2022 Vol. 30　(2):　466- [Abstract]（ 528 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the influence of baseline variability of fetal heart rate (BFHR) on the delivery mode and perinatal outcomes. Methods: The clinical data of 100 pregnant women with weaken of BFHR (in observation group) and 100 pregnant women with normal BFHR (in control group) from October 2018 to January 2020 were retrospectively analyzed. The results of electronic fetal heart rate monitoring, the NST type, and the oligohydramnios rate were compared between the two groups. These women were followed up to the end of pregnancy, and the delivery mode and the perinatal outcomes were compared between the two groups. Results: There were 67 (67.0%) women with normal NST, 20 (20.0%) women with atypical NST, and 13 (13.0%) women with abnormal NST in the observation group, which had significant different from those (87.0%, 13.0%, and 0%) of the women in the control group (P＜0.05). The incidences of amniotic fluid contamination, oligohydramnios, placental abruption, vela placenta, and racquet placenta of the women in the observation group were 10.0%, 15.0%, 17.0%, 10.0%, and 18.0%, repectively, which were significantly higher than those (0.0%, 2.0%, 2.0%, 0%, and 3.0%, repectively) of the women in the control group. The rates of cesarean section, stillbirth, intrauterine asphyxia, and small gestational age in the observation group were 70.0%, 10.0%, 15.00%, and 16.0%, repectively, which were significantly higher than those (48.0%, 0%, 2.0%, and 0%, repectively) in the control group. The percantages of neonatal blood gas analysis result of pH <7.2 and neonatal Apgar score <7 in the observation group were 13.0% and 36.0%, which were significantly higher than those (0% and 8.0%) in the control group. Logistic analysis showed that the weakened of BFHR was an independent risk factor of adverse perinatal outcomes (β=2.134, P=0.000). Conclusion: The weakened BFHR indicates the possibility of fetal distress in uterus and the higher risk of adverse perinatal outcomes, so the pregnant women with weakened BFHR should be focused on.

2022 Vol. 30　(2):　474- [Abstract]（ 420 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the pathogenic genetic mutation of a family with ATR-X syndrome. Methods: Whole exome sequencing was performed on the proband of the family with ATR-X syndrome. The candidate pathogenic variants were screened by bioinformatics analysis. Polymerase chain reaction (PCR) and Sanger sequencing were used to verify the pathogenic genetic mutation site of the family members. Results: Whole exome sequencing revealed a novel hemizygous variation  (c.161_162del，p.Ser54Ter) of ATRX gene on X chromosome of the proband. The verification of family members by Sanger sequencing showed that the variation was conformed to the co-segregation in the family. Conclusion: The novel mutation (c.161_162del) of ATRX gene is the genetic factor causing ATR-X syndrome in this family.

2022 Vol. 30　(2):　483- [Abstract]（ 298 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )