To analyze the expression of miR-134 in human ovarian cancer cells of paclitaxel resistance, and to study its possible mechanisms involved in paclitaxel resistance.Methods: From March 2016 to March 2020, the ovarian cancer samples of 19 patients with paclitaxel-resistant of ovarian cancer in group A and the ovarian cancer samples of 21 patients without paclitaxel-resistant of ovarian cancer in group B were included in this study.The miR-134 level in human ovarian cancer cells in the two groups were tested。The chip of Agilent Human miRNA V21.0 was used to spectral analysis of miRNA gene expression in paclitaxel resistant cells and paclitaxel sensitive cells.The gene clusters with large expression differences of miR-134 were selected, and which were verified based on the results of the chip.Bioinformatics analysis software was used to predict the potential target genes of miR-134, and part of target genes were verified by Western blot.Results: The expression level of Mir-134 in ovarian cancer skOV3-TR30 cells with paclitaxel-resistant was low.A total of 128 potential target genes of Mir134 were predicted by analysis software.The expression level of target gene c-MyC protein in ovarian cancer cells with drug-resistance was significantly higher than that in ovarian cancer cells without drug-resistance (P＜0.05).After overexpression of miR-134 in SkOV3-TR30 cells, the expression of C-MyC gene had decreased, and which protein encoded had also decreased.After low expression of miR-134 in SkOV3-TR30 cells, the expression of C-MyC gene had increased, and which protein encoded had also increased (all P＜0.05).Conclusion: MiR-134 expression in ovarian cancer cells with paclitaxel-resistance is less expressed than that in sensitive cancer cells, and which affects the paclitaxel resistance.The mechanism may be produce drug resistance by regulating the expression of c-Myc protein.

2022 Vol. 30　(3):　500- [Abstract]（ 733 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To understand the contraceptive knowledge and situation of women with abortion within postpartum 1 year, to explore the causes of their unwanted pregnancy within postpartum 1 year, and to study the corresponding countermeasures of their postpartum contraceptive health care services. Methods: From July 2019 to June 2020, 290 women who underwent abortion because of unwanted abortion within postpartum 1 year in Minhang district of Shanghai were recruited for questionnaire survey on their contraceptive knowledge, postpartum contraceptive situation, acquisition situation of postpartum contraceptive knowledge, the time and causes of unwanted pregnancy within postpartum 1 year, etc. Results: The median time (M P25, P75) of postpartum menstrual recovery and sexual life recovery of these women were 3.0 (2.0, 4.0) months and 3.0 (2.0, 3.0) months, respectively. The time of postpartum sexual life of 17.9%（52/290）women was earlier than that of their menstrual recovery. The median time (M P25, P75) of the unwanted pregnancy within postpartum 1 year was 8.0 (6.0, 9.5) months, and which shortest time of one women was postpartum 2 months. The causes of postpartum unwanted pregnancy included 53.8% (156/290) women without postpartum contraception used and 46.2% (134/290) women with contraceptives failed, of which 98.5% (132/134) women with low efficient contraceptives used. 76.1% (175/230) women without contraception used or without strict contraception used were caused by contraception misunderstanding. 11.7% (34/290) women did not know how to choose contraception during postpartum lactation, and 53.5% (155/290) women did not know the contraception of lactation amenorrhea. 29.0% (84/290) women had not received postpartum contraceptive education because of the simple form and content of postpartum contraceptive education during pregnancy and childbirth. Conclusion: It is necessary to establish the postpartum contraceptive health services during the perinatal period for the women, which can help their implement postpartum contraception effectively and can ensure their reproductive health.

2022 Vol. 30　(3):　509- [Abstract]（ 620 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

2022 Vol. 30　(3):　520- [Abstract]（ 402 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

2022 Vol. 30　(3):　529- [Abstract]（ 283 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To compare the effect of cold knife operation and electrosurgical resection for treating incomplete uterine septum.Methods: A total of 80 patients with incomplete uterine septum were selected and were randomly divided into observation group (40 cases) and control group (40 cases).Surgery was performed in 3-7 days after the menstruation.The patients in the control group were given electrosurgical resection of the incomplete uterine septum, and the patients in the observation group were given knife surgery of the incomplete uterine septum.Hysteroscopy or water-contrast ultrasound was performed for evaluated the clinical efficacy on the patients in the two groups in the 3rd month after the operation.The operation time, the blood loss, the intrauterine adhesions situation, and the intraoperative complications of the patients were compared between the two groups.The levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (E2), the complications rate, and the pregnancy outcomes of the patients in the two groups before treatment and 3 months after treatment were compared.Results: The total effective rate (95.0%) of the patients in the observation group was significantly higher than that (75.0%) of the patients in the control group, the operation time (15.2±3.3 min) of the patients in the observation group was significantly shorter than that (25.4±5.8 min) of the patients in the control group (all P＜0.05).The LH and FSH levels of the patients in the observation group were significantly lower than those of the patients in the control group, but the E2 level of the patients in the observation group was significantly higher (all P＜0.05).There was no significant difference in the total incidence of complications (5.0% vs.12.5%) of the patients between the two groups (P＞0.05).The normal delivery rate (90.0%) of the patients in the observation group was significantly higher than that (67.5%) of the patients in the control group, and the spontaneous abortion rate (10.0%) of the patients in the observation group was significantly lower than that (32.5%) of the patients in the control group (all P＜0.05).There were no any patient with stillbirths occurred in both groups.Conclusion: Both cold knife surgery and electrical resection can effectively treat the uterine septum.However, cold knife surgery can increase the rate of nature delivery and reduce the rate of spontaneous abortion with the simpler operation.

2022 Vol. 30　(3):　538- [Abstract]（ 378 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

 To observe the efficacy and safety of leuprorelin injection combined with high intensity focused ultrasound (HIFU) for treating adenomyosis.Methods: 68 patients with adenomyosis were selected as research objects and were randomly divided into observation group and control group (34 cases in each group) from February 2018 to February 2019.All of these patients were given HIFU for treatment, and the patients in the observation group were treated by subcutaneous injection of leuprorelin additionally.The clinical efficacy and safety of the patients in both groups were observed during the followed up for 12 months.Results: There were no significant differences in treatment time, irradiation time, treatment intensity, irradiation dose, and treatment power of HIFU of the patients between the two groups (P＞0.05).VAS score, menstrual volume, uterine volume, and serum CA125 level of the patients in the two groups before treatment were significantly lower than those before treatment, and in 3, 6 and 12 months after treatment, and which of the patients in the observation group were significantly lower than those of the patients in the control group.VAS score, menstrual volume, uterine volume, and serum CA125 level of the patients in the observation group in 3, 6 and 12 months after treatment had decreased gradually.The effective rate (94.1%) of the patients in the observation group was significantly higher than that (73.5%) of the patients in the control group (all P＜0.05).There were no significant differences in the adverse reactions rates, such as pain in therapy area (85.3% vs.88.2%), pain in hips and sacral (47.1% vs.41.2%), skin hot (38.2% vs.32.4%), and vaginal discharge (17.7% vs.11.8%) of the patients between the two groups (P＞0.05).Conclusion: Leuprorelin combined with HIFU for treating the patients with adenomyosis can effectively reduce the lesion of adenomyosis, can alleviate the clinical symptoms, and can improve the clinical efficacy.It has the advantages of non-invasive and high safety without more adverse reaction.

2022 Vol. 30　(3):　547- [Abstract]（ 290 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the efficacy of dynamic monitoring glucose combined with insulin pump infusion for treating pregnant women with gestational diabetes mellitus (GDM), and to study its influence on the control effect of glucose and lipid metabolism of the women.Methods: A total of 226 pregnant women with GDM who had received dynamic monitoring glucose were selected and randomly divided into control group and observation group (113 cases in each group) from October 2019 to June 2020.The women in the control group were given insulin by multiple daily injections (MDI), and the women in the observation group were given insulin pump infusion.The blood glucose control effect of the women was compared between the two groups.The levels of fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA1c), the values of insulin resistance index (HOMA-IR) and mean amplitude of glycemic excursions (MAGE), the percentages of time for hypoglycemia and time for hyperglycemia, and the levels of total cholesterol (TC), triglycerides (TG), highdensity lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) of the women were compared between the two groups.The indexes of serum adiponectin (APN), fatty acid binding protein 4 (FABP4), and chemotactic (Chemerin) of the women in the two groups were detected.The pregnancy outcomes and the perinatal outcomes of the women in the two groups were followed up.Results: After treatment, insulin dosage (31.02±5.01 U/d) and the time of blood glucose level returned to normal (3.31±0.59 d) of the women in the observation group were significantly lower than those (36.74±8.12U/d and 3.94±0.73 d) of the women in the control group.The rate of reaching the standard of HbA1c (69.9%) of the women in the observation group during 34 gestational weeks was significantly higher than that (54.9%) of the women in the control group.The levels of FPG, 2H PG, HbAlc, MAGE, the HOMA-IR value, the ratio of hyperglycemia, and the levels of serum hypoglycemia, TG, TC, LDL-C, FABP4, and Chemerin of the women in the observation group were significantly lower than those of the women in the control group, while the APN level of the women in the observation group was significantly higher (all P＜0.05).The incidences of hypertension, premature delivery, postpartum infection, perinatal asphyxia, and neonatal hypoglycemia of the women in the observation group were significantly lower than those of the women in the control group (P＜0.05).Conclusion: Dynamic monitoring glucose combined with insulin pump for treating the pregnant women with GDM can improve their effect of blood sugar control and pregnancy outcomes by regulating glucose and lipid metabolism indexes and adipocytokines.

2022 Vol. 30　(3):　556- [Abstract]（ 285 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the influence of body mass index (BMI) before pregnancy and gestational weight gain (GWG) of pregnant women on their gestational diabetes mellitus (GDM). Methods: Retrospective cohort study method was used to collect the data of 4524 delivered women in Xuanwu Hospital from 2017 to 2021. The incidence of GDM of the women with different pre-pregnancy BMI and GWG (in different groups) was compared. Logistic regression was used to compare the occurrence and the influencing factors of GDM of the women in different groups. Multiplication and additive models were used to analyze the interaction between prepregnancy BMI and GWG influenced on GDM. Results: Overweight, obesity before pregnancy, and the insufficient GWG were the risk factors of GDM (OR=1.46, 95%CI: 1.22-1.75; OR=2.17, 95% CI: 1.68-2.80; and OR=1.74, 95%CI: 1.45-2.09), and the low body weight before pregnancy and the excessive GWG were the protective factors of GDM (OR=0.67, 95%CI: 0.51-0.89; OR=0.83, 95% CI: 0.71-0.98). Weight standard before pregnancy insufficient GWG was the risk factor of GDM (OR=1.95, 95%CI: 1.55-2.45)，and overweight before pregnancy-excess GWG was the protective factor of GDM (OR=0.54, 95%CI: 0.38-0.77). Multiplication model and additive model showed there was no interaction between prepregnancy BMI and GWG influenced on GDM. Conclusion: Both prepregnancy BMI and GWG can affect GDM occurrence, but there was no statistical interaction between prepregnancy BMI and GWG influenced on GDM.

2022 Vol. 30　(3):　567- [Abstract]（ 300 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To investigate the influence of compound danshen injection combined with labetalol for treating pregnant women with preeclampsia on their oxidative stress reaction factors level in peripheral blood and their delivery outcomes.Methods: 100 pregnant women with preeclampsia were selected and were divided into two groups (50 cases in each group) from June 2019 to December 2020.The women in the control group were treated with magnesium sulfate injection and labetalol hydrochloride, while the women in the observation group were treated with compound danshen injection combined with magnesium sulfate injection and labetalol hydrochloride.The improvement of symptoms, the change of oxidative stress response factors levels in peripheral blood, or the incidence of adverse pregnancy outcomes of the women before and after treatment was compared between the two groups.Results: The values of diastolic blood pressure, systolic blood pressure, 24h urinary protein, and the levels of serum angiotensin Ⅱ(Ang Ⅱ), lipid peroxide (LPO), malondialdehyde (MDA), protein oxidation product (AOPP), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) of the women in the two groups after treatment had decreased significantly, and which of the women in the observation group were significantly lower than those of the women in the control group (all P＜0.05).The values of neonatal weight (2.77±0.33 kg) and Apgar score (8.03±1.44 points) in the observation group were significantly higher than those (2.14±0.40 kg and 6.78±0.35 points) in the control group (all P＜0.05).There was no significant difference in the total incidence of adverse reactions (12.0% vs.8.0%) of the women between the two groups (P＞0.05).The total incidence of adverse pregnancy outcomes (18.0%) of the women in the observation group was significantly lower than that (38.0%) of the women in the control group (P＜0.05).Conclusion: Compound danshen injection combined with labetalol for treating pregnant women can effectively alleviate their clinical symptoms, reduce the oxidative stress and inflammatory reaction factors levels in peripheral blood, which can help to maintain the growth and development of fetus and reduce the occurrence of adverse pregnancy outcomes.

2022 Vol. 30　(3):　577- [Abstract]（ 375 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the effects of combined spinal and epidural anesthesia of pregnant women with pulmonary arterial hypertension (PAH) during cesarean section on their hemodynamics and maternal and infant outcomes.Methods: 125 pregnant women with PAH were selected and were divided into group A (63 women were given combined spinal anesthesia and epidural anesthesia) and group B (62 women were given continuous epidural anesthesia) according to different methods of anesthesia during cesarean section from February 2015 to March 2020.The values of mean arterial pressure (MAP), SPO2, and heart rate (HR), the levels of interleukin (IL)-1, IL-6, and tumor TNF-α, the time of ICU retention, the hospital stay time, the rates of the parturient bleeding and neonatal asphyxia, and the neonatal mortality of the women at different time (before anesthesia, 15 min after anesthesia, end of cesarean section, 2h after cesarean section) were compared between the two groups.Results: There were significant differences in the values of MAP and HR, and the levels of IL-1, IL-6, and TNF-α of the women among different time, when interaction comparation, and between the two groups (all P＜0.05).The SPO2 value of the women in the two groups had no significant difference among different time and when interaction comparation (all P＞0.05), but which of the women had significant difference between the two groups (all P＜0.05).The values of MAP, SPO2, and HR of the women in group A at 15min after anesthesia, the end of surgery, and 2h after surgery were significantly higher than those of the women in group B (all P＜0.05).There were no significant differences in ICU stay time and hospital stay time, and postpartum bleeding rate of the women, and the rates of neonatal mortality rate and asphyxia between the two groups (all P＞0.05).Conclusion: Combined spinal-epidural anesthesia of the pregnant women with PAH during caesarean section is beneficial to stabilize their hemodynamics and decrease inflammatory factors levels.

2022 Vol. 30　(3):　587- [Abstract]（ 342 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To study the effects of calcium gluconate combined with misoprostol and oxytocin on intrapartum and postpartum blood loss of primiparas.Methods: A total of 149 full-term primiparas with the high risk factor of postpartum hemorrhage (PPH) were selected and were divided into control group (74 cases) and study group (75 cases) by random number table method from October 2017 to February 2020.The primiparas in the control group were treated with misoprostol and oxytocin, while the primiparas in the study group were treated with calcium gluconate combined with misoprostol and oxytocin.The intrapartum and postpartum blood loss, the postpartum situations, and changes of coagulation function indexes, blood calcium, and coagulation factors of the primiparas before and after delivery were compared between the two groups.And adverse reactions of the primiparas in the two groups were counted.Results: There was no significant difference in maternal bleeding volume between the two groups (P＞0.05).The blood loss in postpartum 2h (71.42±28.83 ml) and in postpartum 24h (61.48±17.62 ml) of the primiparas in the study group were significantly lower than those (82.53±31.61 ml and 69.62±19.28 ml) of the primiparas in the control group (P＜0.05).There were no significant differences in Apgar score and the incidence of PPH at postpartum 1min and 5min of the primiparas between the two groups (P＞0.05).However, the duration of the third stage of labor (8.4±2.7 min) and the incidence of severe PPH (0) of the primiparas in the study group were significantly lower than those (10.2±3.5 Min and 8.1%) of the primiparas in the control group (P＜0.05).There were no significant differences in Apgar scores of the newborn at 1min and 5min after born between the two groups (P＞0.05), but the time of the third stage of labor and the incidence of postpartum hemorrhage of the primiparas in the study group were significantly lower than those of the primiparas in the control group (P＜0.05).The postpartum prothrombin time (13.56±2.73 s) and plasma thrombin time (15.52±2.76s) of the primiparas in the study group were significantly lower than those (14.59±3.54s and 16.34±2.15s) of the primiparas in the control group (P＜0.05).There were no significant differences in the other indicators of the primiparas between the two groups (P＞0.05).The postpartum prothrombin time (13.56±2.73 s) and plasma thrombin time (15.52±2.76s) of the primiparas in the study group had no significantly different between before and after delivery, but which of the primiparas in the control group had significantly increased, and which of the primiparas in the control group were significantly higher than those of the primiparas in the study group (P＜0.05).The prenatal NO and BNP levels of the primiparas had no significant different between the two groups (P＞0.05), but which of the primiparas in both groups had significantly decreased after delivery, and which of the primiparas in the study group were significantly lower than those of the primiparas in the control group (P＜0.05).There was no significant difference in the total incidence of maternal adverse reactions between the two groups (P＞0.05).Conclusion: The application of calcium gluconate combined with misoprostol and oxytocin can effectively improving the coagulation function of the primiparas and can prevent their PPH occurrence with good safety and effectiveness.

2022 Vol. 30　(3):　596- [Abstract]（ 470 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the effects of low-dose atosiban used before freeze thawing embryo transplantation (F-ET) of elderly infertility women with endometriosis (EMS) on their pregnancy outcomes. Methods: The clinical data of 156 elderly infertility women with EMS who underwent F-ET from April 2019 to November 2020 were analyzed retrospectively, which included 81 women were given atosiban on the F-ET day (in observation group) and 75 women were not given atosiban on the F-ET day (in control group). The pregnancy outcomes and the changes of the positive rates of serum carcinoembryonic antigen 125 (CA125) and antiendometrial antibody (EMAb) of the women were compared between the two groups. The influencing factors of pregnancy outcomes of these women were analyzed. Results: During assisted reproductive therapy, there were no significant differences in the endometrial thickness, the number of transplanted embryos, the number of high-quality embryos, and transfer rate of resuscitated embryos of the women between the two groups (P＞0.05). The serum CA125 level (36.91±17.58 IU/ml) and the EMAb positive rate (6.2%) of the women in the observation group were significantly lower than those (40.58±18.26 IU/ml and 17.3%) of the women in the control group. The embryo implantation rate (33.6%), the clinical pregnancy rate (72.8%), the biochemical pregnancy rate (75.3%), and the live birth rate (60.5%) of the women in the observation group were significantly higher than those (18.2%, 46.7%, 49.3%, and 28.0%) of the women in the control group, and the abortion rate (6.8%) of the women in the observation group was significantly lower than that (22.9%) of the women in the control group (P＜0.05). Univariate and logistic multivariate analysis showed that the situation of atosiban used and the number of high-quality embryos transplanted were beneficial to the pregnancy outcomes of elderly infertility women with EMS (P＜0.05). Conclusion:  The application of low-dose atosiban of elderly infertility women with EMS before F-ET can significantly improve their pregnancy outcomes, and increase their clinical pregnancy outcomes.

2022 Vol. 30　(3):　605- [Abstract]（ 323 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the levels of serum 25-hydroxyvitamin D3 (25-(OH) D3) and anti-Mullerian hormone (AMH) of women relevant to their ovarian reactivity, and to study their values for predicting the outcomes of these women after freeze-thaw embryo transfer (FET). Methods：According to the ovarian reactivity of these women after ovulation induction by drugs during assisted reproduction, these women were divided into group A (32 women with low response of ovarian), group B (69 women with normal response of ovarian), and group C (38 women with high response of ovarian). The serum 25-(OH) D3 and AMH levels were compared among the three groups, and which relevant to the ovarian response of the women in the three groups was analyzed. According to pregnancy outcomes, these women were also divided into group D (56 cases) and group E (83 cases). The serum 25-(OH) D3 and AMH levels of the women were compared between group D and group E. The predictive value of the serum 25-(OH) D3 and AMH levels for pregnancy outcomes of the women after FET was explored. Results：With the increase of ovarian reactivity, the age, total amount of exogenous gonadotropin decrease, the number of days of exogenous gonadotropin stimulation, the number of eggs obtained, the number of mature eggs, and the number of high-quality embryos had increased, and the levels of serum 25(OH)D3 and AMH had increased significantly (all P＜0.05). The levels of the levels of serum 25(OH) D3 and AMH of the women were positively correlated with their ovarian reactivity, but were negatively correlated with their age (P＜0.05). The levels of 25(OH) D3 and AMH of the women in group D were significantly higher than those of the women in group E (P＜0.05). The area under the curve of the serum 25(OH)D3 level, the AMH level, or the combination of serum 25(OH)D3 level and the AMH level of the women for predicting their pregnancy outcomes after FET was 0.737, 0.817, or 0.838, respectively. The sensitivity of the serum 25(OH)D3 level, the AMH level, or the combination of serum 25(OH)D3 level and the AMH level of the women for predicting their pregnancy outcomes after FET was 53.6%, 94.6%, 96.4%, respectively. The specificity of the serum 25(OH)D3 level, the AMH level, or the combination of serum 25(OH)D3 level and the AMH level of the women for predicting their pregnancy outcomes after FET was 88.0%, 54.2%, 50.6%, respectively (P＜0.05). Conclusion: The levels of serum 25-(OH) D3 and AMH of the infertility women after FET are significantly correlated with their ovarian reactivity, and which will increases with the ovarian reactivity enhancing. The combination of serum 25(OH) D3 level and the AMH level of the women for predicting the pregnancy outcomes of the women after FET has high value.

2022 Vol. 30　(3):　614- [Abstract]（ 361 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

 To explore the value of abdominal color ultrasonography combined with serum sex hormone level for differential diagnosing early ectopic pregnancy. Methods: The clinical data of 60 women with ectopic pregnancy (in group A) and 60 women with normal pregnancy (in group B) during April 2019 to March 2021 were collected retrospectively. The serum levels of β- human chorionic gonadotropin (β-HCG), luteinizing hormone (LH), follicular follicular hormone (FSH), and estradiol (E2) of the women in both groups were detected. The endometrial thickness and uterine adnexal characteristics of the women in both groups were examined by abdominal color ultrasound. The differential diagnosis value of abdominal color Doppler ultrasonography combined with serum hormone level for early ectopic pregnancy was calculated based on the final clinical definite diagnosis results. Results: The levels of FSH (31.67±7.88 U/L) and LH (27.16 ± 5.92 U/L) of the women in group A were significantly higher than those (10.48 ± 6.39 U/L and 9.17±3.14 U/L) of the women in group B. The levels of β-HCG (1979.4 ± 592.1 IU/L) and E2 (206.03 ±35.24 pg/ml), and the endometrial thickness (0.85 ± 0.14 cm) of the women in group A were significantly lower than those (2894.1 ± 769.5 IU/L, 875.34±110.61Pg/mol, and 1.17 ± 0.14 cm) of the women in group B. The detection rate of mass of uterine adnexal (81.7%) and pelvic effusion positive rate (70.0%) of the women in group A were significantly higher than those (35.0% and 38.3%) of the women in group B. The detection rate of intrauterine pregnancy sac (15.0%) of the women in group A was significantly lower than that (100.0%) of the women in group B (P＜0.05). The area under the curve of ultrasonography examination combined with four hormone indexes for diagnosing ectopic pregnancy was 0.956, and which missed diagnosis rate (1.7%) and misdiagnosis rate (0) were significantly lower than those of ultrasonography examination or four hormone indexes alone. Conclusion: Abdominal color ultrasonography combined with serum sex hormone detection can greatly improve the diagnostic accuracy of ectopic pregnancy.

2022 Vol. 30　(3):　622- [Abstract]（ 283 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To explore the relationship between the serum alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and angiopoietin levels of pregnant women with recurrent spontaneous abortion and their early abortion. Methods: A total of 112 pregnant women who had accepted curettage because of abortion were enrolled as the research objects from May 2019 to May 2020, which included 60 pregnant women with once abortion in control group and 52 cases with over once abortion in study group. The levels of serum AFP and HCG of the women in the two groups were detected by full-automatic electrochemical luminescence analyzer. The expression levels of angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) in chorion and decidua tissues of the women in the two groups were detected by immunohistochemical SP method. Results: The levels of serum AFP (3.15±0.24 ng/ml) and HCG (78.16±3.67 IU/L) of the women in the study group were significantly lower than those (8.35±1.62 ng/ml and 89.74±4.58 IU/L) of the women in the control group. Pearson correlation analysis showed that the serum AFP level of the women in the two groups was positively correlated with their HCG level (P＜0.05). Pathological section analysis showed that the levels of intracytoplasm Ang-1 and Ang-2 were expressed in trophoblast cells, cytoplasm of mesenchymal cells of villus tissue, and in glandular epithelial cells and stroma cells of decidua tissue of the women in both groups, but the expressions of Ang-1 and Ang-2 in villus tissue of the women in the study group were significantly higher than those of the women in the control group, but which in the decidua tissue of the women in the study group were significantly lower (all P＜0.05). Conclusion: The levels of serum AFP and HCG of the pregnant women with recurrent spontaneous abortion during the first trimester of pregnancy are abnormal decreasing, and the AFP level is positive correlation with the HCG level. The Ang-1 and Ang-2 in chorion and decidua tissues are overexpression, which indicate that the detections of serum AFP and HCG of the pregnant women with recurrent spontaneous abortion during the first trimester of pregnancy is benefit to the prognosis of these women. The normal expression of angiopoietin in chorion tissues of the pregnant women is of important roles in maintaining normal pregnancy.

2022 Vol. 30　(3):　630- [Abstract]（ 373 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To observe the correlation between the ovarian function of women after curettage of missed abortion and their infertility caused by intrauterine adhesions infertility. Methods: The clinical data of 180 women with missed abortion after curettage from January 2018 to October 2019 were analyzed retrospectively. According to the results of followed up of the women after curettage, these women were divided group A (20 women with infertility due to intrauterine adhesions) and group B (160 women without infertility due to intrauterine adhesions). The levels of the ovarian function indicators, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), and estradiol (E2), of the women in the two groups were detected in 2-3 months after curettage. The correlation between the ovarian function of the women after curettage of missed abortion and their infertility caused by intrauterine adhesions was analyzed by regression analysis. Receiver operating characteristic (ROC) curve was drawn to analyze the value of the hormone’s levels of the ovarian function for predicting infertility caused by intrauterine adhesion. Results: The level of E2 of the women in group A was significantly lower than that of the women in group B, but the levels of FSH, LH, and T of the women in group A were significantly higher (all P<0.05). Logistic regression analysis showed that the FSH, LH, T and E2 levels of the women in group A affected their infertility caused by intrauterine adhesion after curettage (OR>1, P<0.05). ROC curve was drawn based on the test variables of the levels of FSH, LH, T, and E2, and the results showed that the AUC of FSH level, LH level, T level, E2 level, or the combined detection of the FSH, LH, and T levels for predicting infertility were 0.965, 0.878, 0.943, 0.994, and 0.971, respectively. Conclusion: The hormonal levels of ovarian function of the women with missed abortion after curettage have certainly relevent to their infertility caused by intrauterine adhesions. In order to reduce the infertility caused by intrauterine adhesion, regular monitoring of ovarian function should be conducted in the women who want pregnancy after curettage of missed abortion, and should be reasonablely intervene their low expression level of E2 and high expression levels of FSH, LH, and T.

2022 Vol. 30　(3):　638- [Abstract]（ 322 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To analyze the relationship between the abnormal numbers of the chromosome and the copy of chromosome of women and their recurrent spontaneous abortion, and to study the influence factors of the recurrent spontaneous abortion. Methods: 90 women with recurrent abortion were selected in study group from March 2019 to December 2020, which included 36 women with two times of abortion, 34 women with three times of abortion, and 20 women with four times of abortion. Another 50 women with once occasional abortion were selected in control group during the same period. The abnormal chromosome number and copy number of chromosome in amniotic fluid cells of the women with different abortion characteristics were compared. The risk factors of the recurrent spontaneous abortion of the women were analyzed. Results: There was no significant difference in the rate of chromosome tetrisomy and polyploidy in amniotic fluid cells of the women between the two groups (P>0.05), but the rates of chromosome monomer (14.4%) and trisomy (50.0%) of the women in the study group were significantly lower than those (2.0% and 30.0%) of the women in the control group. In the study group, there was no significant difference in the rate of chromosome tetrisomy among the women with different abortion times (P>0.05), but the rates of chromosome monomer and chromosome trisomy of the women had significant different among the women with different abortion times (P<0.05). The number of abnormal chromosome of the women in the study group was significantly higher than that of the women in the control group. The rate of abnormal abnormal chromosome copy (84.4%) of the women in the study group was significantly higher than that of the women in the control group (42.0%). The pathogenic mutation rate of copy of chromosome (15.6%) of the women in the study group was significantly higher than that (4.0%) of the women in the control group. The pathogenic mutation rate of copy of chromosome of the women with two times of abortions (8.3%), of the women with three times of abortions (11.8%), and of the women with four times of abortions (35.0%) had increased gradually (all P<0.05). In the women with recurrent spontaneous abortion, the age (34.2±2.6 years old), the number of abortions (3.1±0.5 times), and the positive rate of autoimmune antibody (28.9%) of the women with abnormal chromosome number and abnormal copy number of chromosome were higher than those (26.9±2.8 years, 2.7±0.6 times, and 10.0%) of the women with normal chromosome number and normal copy number of chromosome. Multivariate analysis showed that advanced age, repeatedly abortions, and high positive rate of autoimmunity antibody of the women were risk factors of their abnormal chromosome number and abnormal copy of chromosome (P>0.05). Conclusion: The incidences of abnormal chromosome number and abnormal chromosome copy number of the women with recurrent spontaneous abortion increase. Age, times of abortion, and the autoimmunity antibody level of the women were the risk factors of their chromosome abnormalities, which should be paid attention to in clinic.

2022 Vol. 30　(3):　647- [Abstract]（ 421 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the levels of fibrinogen (Fg), D-dimer (D-D), and platelet (PLT) in venous blood of pregnant women with threatened abortion during early pregnancy, and to study their clinical significance. Methods: 60 pregnant women with threatened abortion were selected in study group and 59 normal pregnant women were selected in control group from January 2018 to January 2020. Venous blood samples of these women were collected to detect their Fg, DD, and PLT levels. The levels of Fg, DD, and PLT of the women were compared between the two groups, and which were also compared among the women with different abortion history and among the women with different pregnancy outcomes in the study group. Results: The levels of DD, Fg, and PLT of the women in the study group were significantly higher than those of the women in the control group (P＜0.05). There were significantly different in D-D level of the women in the study group among the women with natural delivery, the women with inevitable abortion, and the women with missed abortion (P＜0.05). The levels of DD, Fg, and PLT of the women with abortions less than twice were significantly lower than the women with twice or more abortions (P＜0.05). Conclusion: The D-D, Fg, and PLT levels in venous blood of the pregnant women with threatened abortion during the first trimester of pregnancy are abnormal increasing, and which increase with the increase of the abortion times, so it suggests that the D-D, Fg, and PLT levels may be used to judge threatened abortion during early pregnancy and the adverse outcomes of the pregnant women.

2022 Vol. 30　(3):　656- [Abstract]（ 381 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To observe the expression of cyclooxygenase (COX)-2 in endometrial tissue of patients with endometriosis (EMS). Methods: 195 patients with EMS were selected in study group, and 50 patients without EMS underwent myomectomy or hysterectomy due to cervical lesions were selected in control group from May 2015 to December 2019. The expression of COX-2 protein of these patients was detected by immunohistochemistry and MiR-26b expression in endometrial tissue of these patients was detected by real-time PCR, and the difference of which of the patients were compared between the two groups. The relationship between the COX-2 level of the patients in the study group and their mir-26b expression was analyzed. The relationship between the COX-2 level and the expression of the mir-26b of the patients in the study group and their EMS stage and pain grade was also analyzed. Results: The expression level of COX-2 of the patients in the study group was significantly higher than that of the patients in the control group, but MiR-26b mRNA expression (0.81±0.27) of the patients in the study group was significantly lower than that (1.93±0.46) of the patients in the control group (P＜0.05). There was a positive correlation between the COX-2 expression of the patients in the study group and their pain grade (r=0.724), and there was a weak negative correlation between the Mir-26b expression and their pain grade (r=-0.308) (all P＜0.05). There was no significant correlation between r-AFS stage of Ems of the patients and their expressions of COX-2 and Mir-26b. The expression of COX-2 of the patients in the study group was negatively correlated with their Mir-26b expression (r=-0.522) (P＜0.05). There was no correlation between the COX-2 expression of the patients in the control group and their Mir-26b expression. Conclusion: The expression level of COX-2 in endometrial tissue of the patients with Ems is high, but the expression of MiR-26b is low, and the expression level of COX-2 is negative correlation with the expression of MiR-26b. MiR-26b may be involved in the regulation of COX-2 level in the pathological process of the patients with EMS.

2022 Vol. 30　(3):　664- [Abstract]（ 352 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To analyze the relationship between the velocity of blood glucose level increase after oral glucose tolerance test (OGTT) and the insulin secretion situation of pregnant women with gestational diabetes mellitus (GDM) and their adverse pregnancy outcomes. Methods: 258 pregnant women with GDM were selected in this study from January 2017 to December 2019. According to trigrams of the velocity mean (Vmean) of blood glucose level increase after OGTT, these women were divided into group A (women with low Vmean), group B (women with medium Vmean), and group C (women with high Vmean). The insulin secretion patterns at I0, I30, I60, I120, and I180, the insulin resistance indicators values, and the adverse pregnancy outcomes were compared among the three groups. And the correlation between the Vmean of the women and their insulin resistance indicators values and adverse pregnancy outcomes was analyzed. Results: The peak of insulin secretion of the women in group C was delayed. The peak of insulin secretion of the women in group A, group B, and group C at I0 and I120 had increased gradually (P＜0.05). The peak of insulin secretion of the women in group C at I30, I60, or I180 was significantly higher than that of the women in group A and group B (P＜0.05). There was no significant difference in the peak of insulin secretion of the women at I30, I60, and I180 between group A and group B (P＞0.05). The homeostasis model assessment of insulin resistance (HOMA-IR) of the women in group A, group B, and group C had increased gradually (P＜0.05). The values of homeostasis model assessment of insulin islet β cell (HOMA-β) and early phase insulin secretion index (δ I30/ δ G30) of the women in group C were significantly higher than those of the women in group A and group B (P＜0.05), and which of the women in group A had no significant different from those of the women in group B (P＞0.05). The value of HOMA-IR of the women was positively correlated with their Vmean value (P＜0.001). The incidence of poor blood glucose control and the total incidence of adverse pregnancy outcomes of the women in group C were significantly higher than those of the women in group A and group B (P＜0.05), and which of the women had no significant difference between group A and group B (P＞0.05). The incidences of polyhydramnios and fetal distress of the women in group C were significantly higher than those of the women in group A and group B (P＜0.05), and which of the women had no significant difference between group A and group B (P＞0.05). Age ≥35 years, poor blood glucose control, gestational weight gain ≥15kg, Vmean≥0.119mmol/L/min were the independent risk factors of adverse pregnancy outcomes (P＜0.05). Conclusion: The higher velocity of blood glucose level increase of the pregnant women with GDM can aggravate their insulin resistance and can increase their risk of adverse pregnancy outcomes.

2022 Vol. 30　(3):　672- [Abstract]（ 352 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the relationship between the levels of blood glucose control of pregnant women with gestational diabetes mellitus (GDM) and their pregnancy outcomes. Methods: 180 pregnant women with GDM were selected and were divided into group A (84 with good blood glucose control) and group B (96 women with bad blood glucose control) according to the blood glucose control situation of the women during whole pregnancy. And 90 healthy pregnant women were selected in group C. The pregnancy and neonatal outcomes of the women in the three groups were recorded, and the correlation between blood glucose control level of the women with GDM and their pregnancy outcomes was analyzed. Results: The incidences of pregnancy-induced hypertension, premature delivery, polyhydramnios, cesarean section, premature rupture of membranes, and intrahepatic cholestasis of pregnancy of the women in group B were significantly higher than those of the women in group A and in group C (P＜0.05), and there were no significant differences in the incidences of postpartum hemorrhage and postpartum infection of the women among the three groups (P＞0.05). The incidences of perinatal fetal asphyxia, fetal distress, macrosomia, fetal growth restriction, neonatal asphyxia, neonatal hypoglycemia, neonatal bilirubin levels, high or low birth weight of newborns, neonatal pneumonia, and neonatal polycythemia disease of the women in group B were significantly higher than those of the women in group A and group C (P＜0.05), there were no significant differences in the incidences of perinatal stillbirth and the birth defects among the three groups (P＞0.05). Multivariate logistic stepwise regression analysis showed that in pregnant women with GDM, the rate of premature rupture of membrane in group B was 1.214 times higher than that in group A, the rate of intrahepatic cholestasis of pregnancy in group B was 3.046 times higher than that in group A, the rate of premature delivery in group B was 1.178 times higher than that in group A, the rate of macrosomia in group B was 7.267 times higher than that in group A, the rate of fetal growth restriction in group B was 1.219 times higher than that in group A, and the rate of neonatal hypoglycemia in group B was 3.057 times higher than that in group A. Conclusion: Poor blood glucose control of the pregnant women with GDM will lead to the high risk of their adverse pregnancy outcomes and perinatal outcomes.

2022 Vol. 30　(3):　681- [Abstract]（ 449 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the influence of laparoscopic and hysteroscopic surgery to remove uterine intermural fibroids of patients on their later pregnancy outcomes, and to analyze the related factors of residual fibroids recurrence after surgery. Methods: The clinical data of 150 patients with uterine intermural fibroids from January 2015 to January 2020 were analyzed retrospectively. These patients were divided into group A (82 cases with laparoscopic surgery) and group B (68 cases with hysteroscopy surgery) according to different surgical method. The pregnancy outcomes of the patients were compared between the two groups. The situation of residual fibroids recurrence after surgery was obtained after followed up for post operative 12 months. Multivariate Logistic regression analysis was used to analyze the factors related to residual fibroids recurrence after surgery. Results: There were no significant differences in the postoperative pregnancy rate, the pregnancy loss rate, the full-term cesarean section rate, and the rate of cesarean section due to myomectomy history of the patients between the two groups (all P＞0.05). The time from remove uterine intermural fibroids to pregnancy of the patients in group B was significantly shorter than that of the patients in group A (P＜0.05). There was no significant different in postoperative residual fibroids recurrence rate (25.6% vs. 29.4%) of the patients between the two groups (P＞0.05). Multivariate analysis had showed that age ≥40 years old was an independent protective factor of postoperative fibroids residual recurrence (OR=0.406, 95%CI 0.166-0.994). Premenopausal (OR=3.356, 95%CI 1.275-8.830), fibroid diameter ≥4cm (OR=4.430, 95%CI 1.787-10.983), and without postoperative drug therapy (OR=2.811, 95%CI 1.180-6.699) were the independent risk factors of postoperative fibroids residual recurrence. Conclusion: Laparoscopic and hysteroscopic surgery to remove uterine intermural of patients have similar later pregnancy outcomes. The related factors of residual fibroids recurrence after surgery include age, menopausal status, fibroids diameter, postoperative drug treatment, etc, which indicate relevant intervention measures should be adopted to reduce the risk of residual fibroids recurrence after surgery.

2022 Vol. 30　(3):　691- [Abstract]（ 480 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

2022 Vol. 30　(3):　699- [Abstract]（ 508 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the changes of urine microalbumin/creatinine ratio (ACR) of pregnant women with preeclampsia (PE), and to analyze their correlation with the severity of preeclampsia and the pregnancy outcomes of these women. Methods: 280 pregnant women with PE were collected in study group, and were divided in group A (n=147 women with high ACR) and group B (n=153 women with low ACR) according to the ACR value between March 2019 and March 2021. Meanwhile, 280 normal pregnant women were selected in control group. The values of mean arterial pressure, 24-hour urine protein content, and ACR value of the women were compared between the study group and the control group and among the women with different severity of PE. The pregnancy outcomes of the women in the study group were followed up. Results: The 24h urinary protein content (0.36±0.09 g), and the values of ACR (73.52±12.73 mg/mmol) and the mean arterial pressure (112.75±8.96 mmHg) of the women in the study group were significantly higher than those (0.07±0.02 g, 20.83±4.65 mg/mmol, and 96.37±5.18 mmHg) of the women in the control group, and which of the women with severe PE were significantly higher than those of the women with mild PE (all P＜0.05). Multiple linear regression analysis showed that the ACR value of the women with PE was significantly positively correlated with their 24h urinary protein content and their mean arterial pressure value (P＜0.05). The incidences of amniotic fluid contamination ≥Ⅲ (21.1%), premature or induced labor (89.1%), fetal death (14.3%), placental abruption (6.8%), and fetal intrauterine distress (17.7%) of the women in group A were significantly higher than those (9.0%, 75.9%, 6.0%, 0.8%, and 9.0%) of the women in group B (P＜0.05). Conclusion: The ACR value of the pregnant women with PE is higher, which is related to their severity of PE and their adverse pregnancy outcomes, so which should be monitored in clinic.

2022 Vol. 30　(3):　707- [Abstract]（ 493 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To explore the influence of delivery mode of the women with full-term pregnancy on their spontaneous preterm birth (sPTB) of the next pregnancy. Methods: A retrospective study was conducted on the singleton women who had delivered their second child from February 2018 to April 2021 were divided into group A, group B (women with sPTB), and group C (women with therapeutic preterm birth) according to their delivery outcomes. The clinical data of the women were compared among the three groups. Logisitic regression was used to analyze the influence of delivery mode of the women with full-term pregnancy on the sPTB and the therapeutic preterm birth of the women during the next pregnancy. Results: The emergency cesarean section when the cervix uteri dilated to 10cm of the primipara (OR=2.062, 95%CI 1.405-3.026) was a risk factor of their sPTB during the second pregnancy. The selective cesarean section (OR=2.308, 95%CI 1.266-4.208), the emergency cesarean section when the cervix uteri dilated <4cm (OR=4.683, 95%CI 990-11.022), and the emergency cesarean section when the cervix uteri dilated 4-9cm (OR=2.432, 95%CI 1.206-4.906) of the primipara were the risk factors of their therapeutic therapeutic preterm birth during the second pregnancy. Conclusion: Emergency cesarean section when the cervix uteri dilated to 10cm of the primipara is related to their sPTB during the second pregnancy and delivery. The selective cesarean section, the emergency cesarean section when the cervix uteri dilated <4cm, and the emergency cesarean section when the cervix uteri dilated 4-9cm of the primipara are related to their therapeutic therapeutic preterm birth during the second pregnancy.

2022 Vol. 30　(3):　715- [Abstract]（ 415 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

Intravascular leiomyoma （IVL）is a rare and special type of uterine of leiomyoma. The growth of IVL is not limited to the myometrium and uterine veins, and it can extend to the heart and even to the pulmonary arteries through a variety of ways, such as the internal iliac vein and other ways. Thus the corresponding clinical manifestations can seriously threat the health of the patients, or even threat their lives. Compared with those of other types of uterine fibroids, IVL has a variety of clinical manifestations with high rate of misdiagnosis and missed diagnosis, so it requires a lot of imaging examinations for diagnosis. Under the pathological examination microscope, the proliferation of blood vessels around the tumor tissue without atypical cells and coagulative necrosis can be seen. Immunohistochemical performance is positive for desmin, antiwave protein, estrogen, and progesterone receptors, which can be used to guide disease diagnosis and adjuvant treatment. Most of the patients with IVL require surgical treatment, but the postoperative recurrence rate is high, so appropriate drugassisted treatment for them is required. Gonadotropin-releasing hormone agonists can be assisted after surgery, and macrolide immunosuppressants also have certain therapeutic effect. IVL has diversity of chromosomal and genetic changes, and the study on its genes can further provide targeted therapy and postoperative recurrence prevention. This article mainly reviews the latest research on IVL.

2022 Vol. 30　(3):　724- [Abstract]（ 338 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )