2022 Vol. 30　(4):　734- [Abstract]（ 742 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To observe the effect of fixed intrauterine device (IUD) inserted immediately after abortion of young nulliparous women. Methods: 207 young nulliparous women who had no planned parenthood within 2 years after abortion because of the unwanted pregnancy during 6-10 gestational weeks were selected in this study from July 2019 to February 2020. These women were given contraceptive methods after abortion based on one-on-one consultation. The women in group A were given fixed IUD and the women in group B were given short-acting oral contraceptives or condoms. The change of postoperative menstruation, the rate of complications, and the clinical efficacy of contraceptive within 12 months after abortion of the women were compared between the two groups. Results: There were no significant differences in the uterine depth, the pain score, and the bleeding after abortion of the women between the two groups. After 12 months of followed up, the continuation rate of contraceptive method (96.0%) of the women in group A was significantly higher than that (62.0%) of the women in group B, and the repregnancy rate (0) of the women in group A was significantly higher than that (9.0%) of the women in group B (P＜0.05). There were no significant differences in the abnormal bleeding rate (6.0% vs.1.0%) and the complication rate (3.0% vs.3.0%) of the women between the two groups (all P＞0.05). Conclusion: Compared with those of oral contraceptive pills or condoms, fixed IUD inserted after abortion for young women nulliparous has less impact on their menstruation, and the occurrences of dysmenorrhea and complications of the women are also less, which is suitable for women without birth plans within two years after abortion.

2022 Vol. 30　(4):　743- [Abstract]（ 879 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To explore the expressions of DJ-1 and miR-20b-5p in endometriosis (EMT) tissue, and to study the correlation between the DJ-1 and miR-20b-5p levels and the level of tumor suppressor gene PTEN. Methods: The tissues of eutopic endometrium (in group A) and ectopic endometrium (in group B) from 65 patients with EMT who had undergone laparoscopic surgery were selected in this study from March 2019 to March 2021, and another normal endometrial tissues from 60 patients who had undergone uterine myomectomy were selected in group C. The protein expression levels of DJ-1 and PTEN in endometrial tissues of the three groups were detected by immunohistochemistry, and the expression levels of DJ-1, miR-20b-5p, and PTEN mRNA in endometrial tissues of the three groups were detected by real-time fluorescent quantitative PCR (qRT-PCR). Pearson correlation analysis was used to analyze the relationship between the levels of DJ-1 and miR-20b-5p and the PTEN mRNA expression level in endometrial tissues of group A and B. Results: The results of immunohistochemistry showed that the expression level of DJ-1 protein in group C, in group A, and in group B had increased gradually, while the expression level of PTEN protein in group C, in group A, and in group B had decreased gradually (all P＜0.05). PCR results showed that the mRNA expression levels of DJ-1 and Mir-20B-5p in group C, in group A, and in group B had increased gradually, while the mRNA expression level of PTEN in group C, in group A, and in group B had decreased gradually (P＜0.05). Pearson correlation analysis showed that the expression levels of DJ-1 and Mir-20B-5p mRNA were negatively correlated with the PTEN mRNA level (r=-0.716, -0.587, P＜0.01). Conclusion: The expressions of DJ-1 and miR-20b-5p in endometrial tissues of EMT are up-regulated, which lead to the occurrence of EMT by negatively regulating the expression of PTEN and enhancing the proliferation of ectopic endometrial cells.

2022 Vol. 30　(4):　752- [Abstract]（ 405 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To explore the clinical efficacy of cervix loop electrosurgical excision procedure (LEEP) combined with recombinant human interferon α-2b effervescent capsules and anti-HPV bioprotein dressings for treating women with cervical high-grade squamous intraepithelial lesions (HSIL) and high-risk human papilloma virus (HPV) infection. Methods: The women with HSIL and high-risk HPV infection who underwent LEEP treatment were selected and were divided in two groups (46 cases in each group) from January 2019 to December 2020. The women in the study group were given treatment of LEEP combined with recombinant human interferon α-2b effervescent capsules and anti-HPV bioprotein dressings additionally. The clinical efficacy, the HPV viral load before and after treatment, the positive expression rates of Survivin and Ki-67, the postoperative complications rate, and the situation of high-risk HPV negative conversion during 6 and 12 months of followed up of the women were compared between the two groups. Results: The total effective rate of the treatment of cervical lesion (95.7%) of the women in the study group was significantly higher than that (82.6%) of the women in the control group. HPV viral load and positive rates of Survivin and Ki-67 were affected significantly by different time point effect, intergroup effect, time point, and intergroup interaction effect. The level of HPV viral load (6.6±0.8), and the degree decreased of the positive rates Survivin (24.0±2.9%) and Ki-67 (19.2±2.1%) of the women in the study group after treatment were significantly better than those of the women in the control group (all P＜0.05). There were no significant differences in the incidences of complications, such as cervical adhesion and other, of the women between the two groups (P＞0.05). The negative rate of the women in the study group in postoperative 6 months (87.0%) or in postoperative 12 months (93.5%) was significantly higher than that (65.2% or 78.3%) of the women in the control group (all P＜0.05). Conclusion: The clinical efficacy of LEEP combined with recombinant human interferon α-2b and anti-HPV biological protein dressing for treating the women with HSIL and high-risk HPV infection is superior to that of LEEP only, which can effectively inhibit virus proliferation and promote high-risk HPV infection returning to negative, and can reduce the postoperative recurrence rate of HSIL.

2022 Vol. 30　(4):　761- [Abstract]（ 442 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

 To investigate the effects of metformin combined with insulin aspart for treating pregnant women with gestational diabetes mellitus (GDM) on their pregnancy outcomes and their levels of nesfatin-1 and irisin. Methods: In this random and double-blind control trial, 120 pregnant women with GDM were selected and randomly divided into the control group (n=60) and observation group (n=60) by random number table method from January 2018 to January 2019. The women in the control group were treated with insulin aspart, while the women in the observation group were treated with metformin. The indexes of metabolic blood glucose, islet β cell function index, and serum nesfatin-1 and Irisin levels of the women in the two groups were detected. The pregnancy outcomes and adverse reactions situation of the women were compared between the two groups. Results: After treatment, the levels of fasting blood glucose, 2h postprandial blood glucose, and hba1c of the women in the two groups had decreased significantly, and which of the women in the observation group were significantly lower than those of the women in the control group (P＜0.05). The fasting insulin level and insulin resistance index value of the women in the two groups after treatment had decreased significantly, and the values of insulin secretion index and insulin sensitivity index of the women in the two groups after treatment had increased significantly, and the degrees of the change of which of the women in the observation group were significantly more than those of the women in the control group (all P＜0.05). The rates of cesarean section, hyperhydramnios, and premature delivery of the women, and the rates of macrosomia, neonatal jaundice, and neonatal hypoglycemia in the observation group were significantly lower than those of the women in the control group (all P＜0.05). There was no significant difference in the incidence of adverse reactions (21.7% vs.15.0%) of the women between the two groups (P＞0.05). After treatment, the level of serum nesfatin-1 of the women in the two groups had decreased significantly, and the level of serum Irisin of the women in the two groups had increased significantly, and the levels of serum nesfatin-1 and Irisin (1.33±0.19μg/L and 7.59±1.30 mmol/L) of the women in the observation group had significant different from those (1.71±0.25μg/L and 6.74±1.63 mmol/L) of the women in the control group (P＜0.05). Conclusion: Metformin combined with insulin aspart for treating the pregnant women with GDM can better control their blood glucose level, improve their insulin resistance and islet β cell function related indicators, and reduce the occurrence of adverse maternal and neonatal outcomes by increasing the serum nesfatin-1 level and increasing the irisin level, which has better therapeutic effect with higher safety.

2022 Vol. 30　(4):　770- [Abstract]（ 322 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To investigate the effects of different doses of hydromorone combined with ropivacaine for epidural labor analgesia of women, and to study its influence on the values of their SPO2, mean arterial pressure (MAP), and heart rate (HR). Methods: 120 full-term primiparas with single-fetus were selected and divided into four groups (30 cases in each group) by the principle of block randomization from September 2020 to April 2021. After epidural anesthesia, pulse automatic epidural pump was used for analgesia maintenance of the women in the four groups. And the parameters of automatic epidural pump included the analgesia drugs were diluted by 250 ml normal saline, the pulse dose was 8ml/h, the automatic analgesia dose was 6 ml/time, and the time was locked for 30 min. The women in group A were given 0.1% ropivacaine for analgesia maintenance. Except to the 0.1% ropivacaine given, the women in group B were given 5μg·ml-1 hydromorphone additionally, the women in group C were given 10μg·ml-1 hydromorphone additionally, and the women in group D were given 15μg·ml-1 hydromorphone additionally. The visual analog pain score (VAS), the onset time of anesthesia, the labor time, the values of MAP, SPO2, and HR at preanalgesia, post-analgesia 30min, and fetal delivery, Bromage score value at 30min after analgesia and delivery of the women, and the newborn Apgar score after birth were compared among the four groups. The safety of the drug used was also evaluated. Results: There was no significant difference in VAS scores at 10min, 30min, 2h, and 4h after labor analgesia, and the onset time of anesthesia of the women between group C and group D, but which of the women in group C and group D were all significantly lower than those of the women in group B and group A (P＜0.05). There were no significant differences in the durations of the first stages of labor, the second stages of labor, and the third stages of labor, and the values of MAP, SPO2, and HR of the women before analgesia, at 30min after analgesia, and at delivery, Bromage score of the women at 30min after analgesia and during delivery, and Apgar score of the newborn at 1 min and 5 min after birth, and the incidences of maternal nausea, vomiting, respiratory depression, and sedation score among the four groups (all P＞0.05). Conclusion: Hydromorphone (10μg/ml as recommended concentration) combined with ropivacaine for epidural labor analgesia has good effect.

2022 Vol. 30　(4):　780- [Abstract]（ 430 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

 To investigate the influence of bupropion combined with dexmedetomidine for anesthesia induction of patients during laparoscopic myomectomy on their hemorheology and the levels of their endothelin-1 (ET-1) and angiotensin II (Ang II). Methods: 182  patients who wanted laparoscopic myomectomy were selected and simply randomly divided into two groups (91 cases in each group) by the random number table method from January 2020 to December 2020. At 15 min before anesthesia induction, the patients in the observation group were given dexmedetomidine injection (0.5 μg/kg) combined with bupropion injection (0.02 mg/kg), and the patients in the control group were given dexmedetomidine injection (0.5 μg/kg) combined with normal saline (equal amount of bupropion). The levels of ET-1, Ang-II, and fibrinogen, and the values of whole blood specific viscosity, plasma viscosity of the patients at the time of entering room (T0), after induction of anesthesia (T1), 30 min after surgery (T2), and 2 h after surgery (T3) of the patients were compared between the two groups. Results: The values of plasma viscosity and whole blood specific viscosity of the patients in the observation group at T1, T2, and T3 were significantly lower than those at T0, and the fibrinogen level of the patients in the observation group at T1 was significantly higher than those at T0, T2, and T3 (all P＜0.05). The plasma viscosity value of the patients in the observation group at T1, T2, and T3 was significantly lower than that of the patients in the control group, the value of whole blood specific viscosity of the patients in the observation group at T1 and T2 was significantly lower than that of the patients in the control group, and the value of
plasma viscosity of the patients in the observation group at T1 was significantly higher than that of the patients in the control group (all P＜0.05). The levels of ET-1 and ANG-II of the patients in the two groups at T0, T1, T2, and T3 had increased gradually, which of the patients in the observation group at T1, T2, and T3 was significantly lower than that of the patients in the control group (all P＜0.05). The incidence of adverse reactions (25.3%) of the patients in observation group was significantly lower than that (39.6%) of the patients in control group (P＜0.05). Conclusion: Butorphanol combined with dexmedetomidine for anesthesia induction of patients during laparoscopic myomectomy can reduce the adverse influences on their hemodynamics, which can inhibit the increase of ET-1 and Ang II levels, and can decrease the occurrence of postoperative anesthesia-related adverse reactions.

2022 Vol. 30　(4):　788- [Abstract]（ 369 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the effects of intravenous infusion of oxytocin combined with cervical dilatation balloon for induced labor of pregnant women during the third trimester of pregnancy on their cervical Bishop score, stage of labor, and maternal and infant outcomes. Methods: A total of 106 pregnant women who wanted labor induction during the third trimester of pregnancy were selected and were randomly divided into two groups from January 2019 to September 2020. 53 women in the study group were given intravenous infusion of oxytocin combined with cervical dilatation balloon for labor induction, and 53 women in the control group were given intravenous infusion of oxytocin for labor induction. Before labor induction and at 12h after labor induction, the cervical ripening situation of these women was evaluated by cervical Bishop score. The duration of the stages of labor of these women was recorded. The effect of labor induction was judged, and the incidences of vaginal delivery and the maternal and infant adverse outcomes were counted. Results: The Bishop score of the women in the two groups at 12h of labor induction had increased significantly, and which of the women (7.34±1.15 points) in the study group was significantly higher than that (5.78±0.93 points) of the women in the control group. The total effective rate of labor induction (96.2%) of the women in the study group was significantly higher than that (83.0%) of the women in the control group. The duration of different labor stags and the total labor duration of the women in the study group were significantly shorter than those of the women in the control group. The rate of vaginal delivery (94.3%) of the women in the study group was significantly higher than that (79.3%) of the women in the control group, and the incidence of maternal and infant adverse outcomes (7.6%) of the women in the study group was significantly lower than that (24.5%) of the women in the control group (all P＜0.05). Conclusion: The effect of oxytocin combined with cervical dilatation balloon for labor induction of the pregnant women during the third trimester of pregnancy can effectively promote cervical ripening, can shorten the duration of the stage of labor, can increase the rate of vaginal delivery, and can reduce the incidence of adverse maternal and infant outcomes with better effectiveness.

2022 Vol. 30　(4):　797- [Abstract]（ 392 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To analyze the effect of participation health education of spouse on the knowledge and behavior of female with human papilloma virus (HPV) infection. Methods: A total of 2268 married women who underwent gynecological examinations were selected and randomly divided into two groups (1134 cases in each group) from January 2018 to June 2020. The women in group A had accepted health education by herself, while the women in group B had accepted Health education together with her husband. The cognitive level and preventive behavior of HPV before and after education of the women were compared between the two groups. The women in the two groups were followed up for 12 months and the HPV infection rate of the women was compared between the two groups. Results: 22 cases in 2268 married women had dropped out or dropped off during followed up, the other 2246 (99.0%) women were analyzed eventually，which included 1118 cases in group A and 1128 cases in group B. After health education, the qualified rates of mastering knowledge about HPV infection transmission route, the susceptibility factors of HPV, the screening methods, the high risk factors, the prevention and treatment measures, and the vaccine knowledge of cervical cancer of the women in the two groups had increased significantly, and which of the women in group B were significantly higher than those of the women in group A. The rates of preventive behaviors, such as frequent change of underwear, no sex during menstruation, cleaning of vulva before sex, contraceptive used, and seeking medical treatment with symptoms, after health education of the women in the two groups had increased significantly, and which of the women in group B were significantly higher than those of the women in group A (all P＜0.05). During the 12 months of followed up, there were 41 (3.4%) women with HPV infection, 22 (2.0%) women with high-risk HPV infection, and 16 (1.4%) women with low-risk HPV infection in group A, there were 14 (1.2%) women with HPV infection, 8 (0.7%) women with high-risk HPV infection, and 6 (0.5%) women with low-risk HPV infection in group B, and which had significant different between the two groups. Conclusion: The married women accepted health education together with her husband can effectively improve their cognition level of HPV infection and can enhance their prevention behaviors of HPV infection, so as to reduce the HPV infection rate, which play an important role in actively preventing and treating female HPV infection.

2022 Vol. 30　(4):　805- [Abstract]（ 515 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To explore the influence of midwife-led group health care model during pregnancy on the fear of childbirth, the neonatal Apgar score, and the breastfeeding rate of primiparas. Methods: A total of 192 pregnant women who had established the card of pregnant health care and had accepted antenatal examination were selected and were divided into two groups by convenience sampling method from June 2020 to Norember 2020. 96 women in the control group were given the traditional pregnancy health care model, and 96 women in the observation group were given midwife-led group health care model during pregnancy. The score of fear of childbirth of the women, neonatal Apgar score, and the rate of exclusive breastfeeding of the women were compared between the two groups. Results: After intervention, the fear score of childbirth of the women in both groups had decreased significantly, and which (29.32±2.78 points) of the women in the observation group was significantly lower than that (32.76±3.14 points) of the women in the control group (P＜0.05). Apgar score of newborns at 1min after birth showed no significant different between the two groups (P＞0.05), but Apgar score of newborns at 5min after birth (9.67±1.68 points) in the observation group was significantly higher than that (9.15±1.53 points) of the women in the control group (P＜0.05). The exclusive breast-feeding rate (75.0%) of the women in the observation group was significantly higher than that (57.3%) of the women in the control group (all P＜0.05). Conclusion: The midwife-led group health care model during pregnancy can effectively reduce the fear of childbirth, and can improve the neonatal Apgar score and the rate of exclusive.

2022 Vol. 30　(4):　815- [Abstract]（ 348 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To analyze the related influencing factors of natural pregnancy in child bearing age women with ovarian endometrioma (OEM) after laparoscopic surgery. Methods: A total of 150 child bearing age women with OEM who had undergone laparoscopic surgery between December 2016 and December 2019 were analyzed retrospectively. According to whether or not natural pregnancy successfully within 3 years after surgery, these women were divided into group A (66 cases with natural pregnancy) and group B (84 cases without natural pregnancy). The clinical data, such as age, body mass index (BMI), types of ovarian cyst, scores of endometriosis fertility index (EFI), staging based on the revised American Fertility Society (rAFS), previous pelvic surgery history, and postoperative tubal patency, of the women in two groups were analyzed. The possible factors influencing the natural pregnancy of the women after laparoscopic surgery were analyzed by Logistic regression analysis. Results: Logistic regression analysis showed that age >35 years old, bilateral fallopian tube cysts, and the postoperative fallopian tube patency of the women with OEM were the independent factors influencing their natural pregnancy after laparoscopic surgery. Logistic regression risk prediction model of the natural pregnancy of the child bearing age women with OEM after laparoscopic surgery was established: P=1/［1+ E(-2.427+0.621×(age) + 0.615×(cyst side) + 0.722×(postoperative oviduct patency)］, and Hosmer-Lemeshow χ2=4.703, P=0.789. Receiver operating characteristic curve (ROC) analysis showed that the risk prediction model for predicting the postoperative natural pregnancy was 0.776. Conclusion: Clinical screening should be carried out for the related factors affecting the natural pregnancy after laparoscopic surgery, and preventive intervention measures should be conducted as early as possible to control the related factors and to improve the postoperative natural pregnancy rate.

2022 Vol. 30　(4):　824- [Abstract]（ 376 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the therapeutic effect of acupuncture and moxibustion at Bliao point combined with dehydroepiandrosterone (DHEA) for treating infertility women with premature ovarian insufficiency (POI). Methods: A total of 108 infertility women with POI 2020 were selected and randomly divided into two groups (54 cases in each group) from January 2018 to December. The women in the control group were given treatment of luteal support combined with DHEA, and the women in the observation group were given treatment of luteal support and DHEA combined with acupuncture and moxibustion at Bliao point. The values of ovarian reserve function, uterine artery blood flow, endometrial thickness before and after treatment, and the pregnant situation of the women in 6 months after treatment were observed and compared between the two groups. Results: The total effective rate of the women in the observation group was significantly higher than that of the women in the control group (P＜0.05). The anti-Mullerian hormone (AMH) level and the total ovarian volume (TOV) value, and the number of antral follicle count (AFC) of the women after treatment in the two groups had increased significantly, and which of the women in the observation group were significantly higher than those of the women in the control group (P＜0.05). The values of PI, RI and S/D of the women after treatment in the two groups had decreased significantly, and which of the women in the observation group were significantly lower than those of the women in the control group (P＜0.05). The endometrial thickness of the women after treatment in the two groups had increased significantly, and which of the women in the observation group was significantly higher than that of the women in the control group. The type A of endometrium and the pregnancy rate of the women in the observation group were significantly higher than those of the women in the control group (P＜0.05). Conclusion: Acupuncture and moxibustion at Bliao point combined with DHEA for treating the infertility women with POI can further enhance their ovarian reserve function, improve their blood flow of the uterine artery, and promote the growth of their endometrium, thereby increasing the natural pregnancy rate of these women.

2022 Vol. 30　(4):　832- [Abstract]（ 417 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To explore the curative effect and safety of transumbilical single-port laparoscopic myomectomy (SPLM) for treating women with uterine fibroids. Methods: A retrospective analysis was performed on 100 women who had undergone myomectomy from January 2018 to December 2019, which included 50 women who had undergone SPLM in group A and 50 women who had undergone conventional multiport laparoscopic myomectomy in group B. The conditions of basic perioperation, the postoperative complications, and the satisfaction on the appearance of the incision, postoperative ovarian function, and pregnancy of the women were compared between the two groups. Results: There were no significant differences in the operative time, the intraoperative blood loss, the proportion of blood transfusion, and the postoperative hemoglobin value decreased of the women between the two groups (P＞0.05). The scores of immediate postoperative pain (lose efficacy of anesthesia) (4.1±0.8 points) of the women in group A was significantly lower than that (4.6±1.1 points) of the women in group B, and the postoperative hospital stay (2.6±0.7 days) of the women in group A was significantly shorter than that (3.8±1.1 days) of the women in group B (P＜0.05). There was no significant difference in the postoperative complication rate (6.0% vs. 4.0%) of the women between the two groups (P＞0.05). The postoperative satisfaction of the women in group A was significantly better than that of the women in group B (P＜0.05). The levels changes of serum estradiol, follicle stimulating hormone, and antimullerin hormone of the women in the two groups in the 6th month after operation had no significantly different, and which also had no significant different of the women between the two groups. There were no significant differences in the postoperative pregnancy rate, the live birth rate, and the adverse pregnancy outcomes of the women between the two groups (all P＞0.05). Conclusion: SPLM used for treating uterine fibroids is safe and feasible, which has more advantages of mild postoperative pain and quick recovery after operation than those of MPLM, so it can better meet the aesthetic requirement of the women after operation.

2022 Vol. 30　(4):　841- [Abstract]（ 429 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To observe the changes of coagulation index and inflammatory factors of patients with stage Ⅲ/Ⅳ endometriosis (EMs), and to analyze the correlation between the changes of blood coagulation function and inflammatory factors of patients with EMs and their pelvic pain and adhesion. Methods: From March 2020 to August 2021, 207 patients with stage III/IV EMs were collected and were divided into group A1 (132 patients with stage III EMs) and group A2 (75 patients with stage IV EMs) according to the modified endometriosis staging method (r-AFS). These patients were divided into group B1 (28 patients without pain), group B2 (121 patients with mild to moderate pain), and group B3 (58 patients with severe pain) according to the degree of pain of the patients. And these patients were also divided into group C1 (25 patients without pelvic adhesion), group C2 (138 patients with mild to moderate pelvic adhesion), and group C3 (44 patients with severe pelvic adhesion) according to the pelvic adhesion situation. Another 200 healthy women were selected in control group during the same period. The coagulation function indexes and inflammatory factor levels of the patients were detected and were compared among these groups. The relationship between the coagulation function indexes and inflammatory factor levels of the patients and their degree of EMs-related pain and adhesion were analyzed. Results: The values of thrombin time (PT), activated partial thrombin time (APTT), and prothrombin time (TT) of the patients with Ems were significantly shorter than those of the patients in the control group, and the levels of fibrinogen (FIB), D-dimer (D-D), neutrophil to lymphocyte count ratio (NLR), monocyte chemokine factor-1 (McP-1), tumor necrosis factor -α (TNF-α), interleukin (IL) -6, and IL-8 of the patients with Ems were significantly higher than those of the patients in the control group (all P＜0.05). The levels of FIB, D-D, NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients in group A2 were significantly higher than those of the patients in group A1 (P＜0.05). There were no significant differences in the values of coagulation function indexes among patients with different pelvic pain degree (P＞0.05), but the levels of NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients with Ems had increased with the severity of their pelvic pain. The PT value of the patients with Ems had decreased with the increase of their pelvic adhesion, while the levels of FIB, D-D, NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients with Ems had increased with the increase of their pelvic adhesion (all P＜0.05). The PT value of the patients with Ems was negatively correlated with their degree of pelvic adhesion, while the levels of FIB, D-D, NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients with Ems were positively correlated with their degree of pelvic pain and adhesion (all P＜0.05). Conclusion: The patients with stage III/IV EMs have different degrees of hypercoagulability of blood and inflammatory response. The coagulation function indexes and inflammatory factors levels of the patients with stage III/IV EMs are related to their degree of pelvic adhesion, and the inflammatory factors of the patients are also closely related to their EMs-related pelvic pain.

2022 Vol. 30　(4):　851- [Abstract]（ 335 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

To investigate the relationship between serum glucose transporter 4 (GLUT4) and complement C1q/tumor necrosis factor-related protein-3 (CTRP3) of women and their polycystic ovary syndrome (PCOS) and insulin resistance (IR). Methods: 190 women with PCOS were enrolled in this study and were divided into group A (51.6% women with IR) and group B (48.4% women without IR) according to the occurrence of IR from June 2017 to June 2020. The levels of serum GLUT4 and CTRP3 of the women were compared between the two groups. The relationship between the levels of serum GLUT4 and CTRP3 of the women and their levels of fasting insulin (FINS) and fasting plasm glucose (FPG), and their values of body mass index (BMI), waist-to-hip ratio (WHR), HOMA-IR, and blood lipid metabolism indexes was analyzed. Results: The values of BMI and WHR, and the levels of FINS, HOMA-IR, HbA1c total cholesterol (TC), and triglyceride (TG) of the women in group A were significantly higher than those of the women in group B, and the high-density lipoprotein (HDL-C) level of the women in group A was significantly lower. The serum levels of GLUH4 (2.26±0.51 pg/ml) and CTRP3 (311.51±63.69 ng/ml) of the women in group A were significantly lower than those (4.17±0.73 pg/ml and 373.63±75.65 ng/ml) of the women in group B (all P＜0.05). Correlation analysis showed that serum GLUH4 level of the women with PCOS was negatively correlated with their WHR and HOMA-IR values, and their FINS level. The serum CTRP3 level of the women with PCOS was negatively correlated with their BMI, WHR, and HOMA-IR values, and the levels of HbA1c and TG, but which was positively correlated with their HDL-C level (all P＜0.05). Multiple linear stepwise regression analysis showed that the WHR and HOMA-IR values of the women with PCOS were the significant factors affecting their serum GLUH4 level, while the HOMA-IR value and the TG level of the women with PCOS were the significant factors affecting their CTRP3 level. Conclusion: In the women with PCOS, the proportion of IR was higher, and the levels of GLUT4 and CTRP3 of the women with IR are lower than those of the women without IR. The serum GLUT4 level of the women with PCOS is closely related to their WHR and HOMA-IR values, and GLUT4 may be involves in the progression of abdominal obesity and IR of the women. The serum CTRP3 level of the women with PCOS was closely correlated with their HOMA-IR value and their TG level, which suggests that CTRP3 may be involved in the IR and lipid metabolism disorder of the women with PCOS.

2022 Vol. 30　(4):　860- [Abstract]（ 491 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To analyze the clinical effect of loop electrosurgical excision procedure (LEEP) for treating patients with cervical intraepithelial neoplasia (CIN), and to study its correlation with the pregnancy outcomes and delivery mode of the patients. Methods: 60 patients with CIN from October 2019 to January 2018 were selected retrospectively, and these patients were divided into two groups according to the different cervical operative method. The patients in the experimental group were given LEEP, and the patients in the control group were given cold knife conization (CKC). The operation time, the intraoperative blood loss, the time of hospital stay, the healing time, the pregnancy outcomes, and the delivery mode of the patients were analyzed and were compared between the two groups. The relationships among the operation time, the intraoperative blood loss, the time of hospital stay, the healing time, the pregnancy outcomes, and the delivery mode of the patients were also analyzed. Results: The operative time (7.8±2.2min), the intraoperative blood loss (10.4±1.7ml), the time of hospital stay (5.3±2.5d), and the healing time (28.6±4.3d) of the patients in the experimental group were significantly lower than those of the patients in the control group (P＜0.05). In the experimental group, the pregnancy outcomes of the patients was moderately positively correlated with their operative method (0.551) and their operative time (0.538), and was negatively correlated with their intraoperative blood loss (0.445). In the experimental group, the delivery mode of the patients was moderately positively correlated with their operation time (0.557), their intraoperative blood loss (0.682), and their operative mode (0.556) (all P＜0.05). The independent risk factors of the adverse pregnancy outcomes were operative time, smoking history, abortion history, and number of pregnancy, etc. The incidence of complications (13.3%) of the patients in the experimental group was significantly lower than that (46.7%) of the patients in the control group (P＜0.05). Conclusion: LEEP for treating the patients with CIN can shorten their operative time, reduce their amount of bleeding, accelerate their rehabilitation, reduce their adverse pregnancy outcomes, and improve their delivery mode.

2022 Vol. 30　(4):　869- [Abstract]（ 495 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

To explore the effect of the tubal patency evaluated by transvaginal dynamic three-dimensional hysterosalpingography ultrasound (RT 3D-HyCoSy), and to study the related influence factors. Methods: 80 infertility women with 152 fallopian tubes were examined by RT 3D-HyCoSy from March 2018 to March 2020. The imaging characteristics of the patency of these fallopian tubes were observed and evaluated. The result of the laparoscopic examination of meilantong passed was regarded as the "gold standard". The diagnostic effect of RT 3D-HycoSY was observed based on the uterine position of the women, whether or not of the contrast agent refluxed in muscular layer, and whether or not of adnexal mass. Results: Compared with those of the gold standard, the sensitivity, the specificity, and the diagnostic coincidence rate of RT 3D-HyCOSY for diagnosing 154 fallopian tubes were 83.3%, 90.6%, and 88.3%, respectively. The coincidence rate of diagnosing pre-uterine/post-uterine position was significantly higher than that of diagnosing mid-uterine position. The coincidence rate of diagnosing no contrast agent refluxed in muscular layer was significantly higher than that of diagnosing contrast agent refluxed in muscular layer. The coincidence rate of diagnosing no mass in adnexa uteri was significantly higher than that of diagnosing mass in adnexa uteri (P＜0.05). Conclusion: RT 3D-HyCoSy for evaluating fallopian tube patency has higher accuracy. The position of the uterus, myometrial reflux of contrast agent, and mass in adnexa uteri can all affect the diagnostic coincidence rate of RT 3D-HyCoSy.

2022 Vol. 30　(4):　878- [Abstract]（ 348 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To evaluate the value of Logistic regression scoring model of antenatal ultrasound examination and the levels of serum vascular endothelial growth factor (VEGF) and sFlt-1 of pregnant women with placenta previa for diagnosing their placenta adhesion and their placenta invasion degree of myometrium. Methods: A total of 215 pregnant women with placenta previa who all had accepted color Doppler ultrasound examionation and serum VEGF and sFlt-1 detection, and had the complete clinical examination records from June 2018 to June 2020 were collected retrospectively. These women were divided into group A (172 women without placental attachment or abnormal attachment) and group B (43 women with placental abnormal invasion) according to the postoperative pathological results. Logistic regression analysis was used to construct the regression score model. According to the degree of the placenta invasion, these women were also divided into non-invasive placenta group, PA group, PI group, and PP group. The differences of serum VEGF and sFlt-1 levels of the women were compared among these groups. Receiver operator characteristic curve (ROC) was used to analyze and evaluate the value of the levels of serum VEGF and sFlt-1 of the pregnant women with placenta previa for diagnosing their placenta adhesion and placenta invasion degree of myometrium. Results: Logistic regression score model of antenatal ultrasound examination was lnP/1-P=2.817+ 1.768X1+ 3.625X2-0.559X3-1.823X4+ 3.072X5- 2.785X6. There was no significant difference in the serum VEGF level of the women between group PP and group PI, but there was significant difference in the serum VEGF level of the women among other groups. There was no significant difference in the serum SFLT-1 level of the women between the non-invasive placenta group and group PA, but there was significant difference in the serum SFLT-1 level of the women among other groups (all P＜0.05). The areas under of ROC of the ultrasound examination, serum VEGF level, and serum sFLT-1 level for diagnosing placenta previa adhesion and invasion of myometrium were 0.801, 0.717, and 0.706, respectively, and the diagnostic critical values of which were 5.245, 279.80pg/ml, and 2.66pg/ml, respectively. Conclusion: Prenatal ultrasound Logistic regression score model, and the levels of serum VEGF and sFlt-1 have certain valus for diagnosing their placenta adhesion and their placenta invasion degree of myometrium.

2022 Vol. 30　(4):　887- [Abstract]（ 414 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To evaluate the value of the signs score by ultrasound combined with vascularization parameters by three-dimensional energy Doppler for diagnosing placenta previa complicated with placenta implantation of pregnant women during the third trimester of pregnancy. Methods: The clinical data of 71 pregnant women with placenta previa during the third trimester of pregnancy from June 2019 to October 2020 were collected retrospectively, which included 19 women with placenta implantation in group A and 52 women without placenta implantation in group B. Three-dimensional energy Doppler and virtual organ computer-aided analysis technology were used to compare the values of the vascularization parameters, such as vascularization index (VI), flow index (FI), and vascular flow index (VFI), of the women between the two groups. Receiver operator characteristic curve (ROC) was used to analyze the value of the VI, FI, and VFI values of the women for diagnosing their placenta previa and placenta implantation. And the values of the signs score by ultrasound and the vascularization parameters values by three-dimensional energy Doppler for diagnosing placenta implantation of the women were evaluated. Results: There were significant differences in the values of VI, FI, and VFI of the women between the two groups (P＜0.05). The values of VI, FI, and VFI of the women had certain diagnostic values for placenta previa and placenta implantation. The area under curve (AUC) of ROC of VI value, FI value, and VFI value for diagnosing placenta previa and placenta implantation were 0.831, 0.696, and 0.735, respectively, and their critical values were 31.60, 33.25, and 16.05, respectively. There was no significant difference in the diagnostic consistency between the signs score or the vascularization parameters value and the pathological diagnosis, and between the signs score combined with vascularization parameters values and the pathological diagnosis (P＞0.05), and the Kappa values of which were 0.744, 0.584, and 0.856, respectively. The efficiency of the signs score combined with vascularization parameters value for diagnosing placenta previa and placenta implantation was higher, with the sensitivity of 89.5%, the specificity of 96.2%, the positive predictive value of 89.5%, and the negative predictive value of 96.2%. Conclusion: The signs score by ultrasound combined with vascularization parameters by three-dimensional energy Doppler of pregnant women during the third trimester of pregnancy for diagnosing their placenta previa and placenta implantation have certain qualitative and quantitative value, which can provide the reference evidences for choosing the time limit of treatment and treatment mode of the disease further.

2022 Vol. 30　(4):　895- [Abstract]（ 286 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

2022 Vol. 30　(4):　903- [Abstract]（ 354 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

To investigate the factors related to successful induction of pregnant women by oxytocin only during the third trimester of pregnancy and their delivery outcomes. Methods: A retrospective analysis was performed on 293 primiparas with fetal position of the head who had indications of oxytocin induction from August 1, 2020 to December 31, 2020. Binary logistic regression analysis was used to analyze the affect factors of successful induction of these women. The women with near the time of labour and successful induction were divided into two groups according to whether they continued to use oxytocin or not, and the delivery outcomes of the women were compared between the two groups. Results: The improvement of cervical score at 4h after oxytocin induced labor on the first day was the influencing factor of vaginal delivery success (OR=62.46, 95%CI 8.83-471.03). Whether to continue using oxytocin during induce labor did not affect the cesarean section rate (χ2=0.53, P=0.469). Conclusion: The improvement of cervical conditions of the women is closely related to their success of induced labor. Continued oxytocin used during induction does not change the outcomes of cesarean section.

2022 Vol. 30　(4):　911- [Abstract]（ 562 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To investigate the correlation between the insulin-like growth factor I (IGF-I), interleukin-18 (IL-18), and tumor necrosis factor-α(TNF-α) levels of pregnant women and their subclinical hypothyroidism (SCH) occurrence. Methods: 123 pregnant women with SCH were selected in study group and 153 healthy pregnant women were selected in control group between January 2019 and December 2020. The levels of serum IGF-1, IL-18, and TNF-α of the women were compared between the two groups. Results: The level of thyroid stimulating hormone (TSH) of the women in the study group was significantly higher than that of the women in the control group. During the first, the second, and the third trimester of pregnancy, the IGF-1 level of the women in the study group was significantly lower than that of the women in the control group, while the levels of IL-18 and TNF-α of the women in the study group were significantly higher than those of the women in the control group (all P＜0.01). The IGF-1 level of the women was negatively correlated with their SCH occurrence, while the levels of IL-18 and TNF-α of the women were positively correlated with their SCH occurrence. Multiple linear regression analysis showed that during the first trimester of pregnancy, the IGF1 level of the women was negatively correlated with their TSH level (Beta=-0.463, P=0.003), while the IL-18 level (Beta=-0.144, P=0.007) and the TNF-α level (Beta=0.133, P=0.009) of the women were positively correlated with their TSH level. Conclusions: The levels of IGF-1, IL-18, and TNF-α of the pregnant women are all correlate with their TSH level, which maybe as the detection indexes of SCH in clinic.

2022 Vol. 30　(4):　918- [Abstract]（ 326 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the related factors of early onset severe preeclampsia (EOSP) and fetal growth restriction (FGR) of pregnant women, and to study their influence on the pregnancy outcomes of these women. Methods: 80 pregnant women with EOSP were selected and were divided into group A (23 women with EOSP and FGR) and group B (57 women with EOSP only) depended on the existence of FGR from January 2018 to February 2020. The perinatal indicators, the complication rate, the neonatal conditions, and the pregnancy outcomes of the women in the two groups were analyzed. The related influencing factors that led to EOSP and FGR of the women were also analyzed. Results: There were significant differences in the gestational weeks of EOSP occurrence, the proportions of the increases of the systolic blood pressure to the diastolic blood pressure ratio (S/D) ratio of the fetal umbilical artery, the 24 h urine protein value, and the D-dimer (D-D) level, the cereal third transaminase (ALT) level, the aspertate aminotransferase (AST) level, and the lactate dehydrogenase (LDH) level, and the proportions of the decreases of the platelet (PLT) value, the oligohydramnios level, the alkaline phosphatase (ALP) level of the women between two groups (P＜0.05). There were no significant differences in age, the prepregnancy body mass index value, the proportions of the increase of serum uric acid (UA) level and the increase of the hemoglobin (HB) level of the women between the two groups (P＞0.05). Multivariate logistic regression analysis showed that the increase of S/D ratio, and the high levels of 24h urine protein, D-D, ALT, and LDH of the women were the independent risk factors of their EOSP and FGR occurrences (P＜0.05). There were no significant differences in the incidences of hypertensive syndrome, heart failure, abnormal liver function, placental abruption, pleural, abdominal effusion, and fundus vascular lesions of the women between the two groups (P＞0.05). The incidence of abnormal renal function (52.2%) of the women during pregnancy in group A was significantly higher than that (14.0%) of the women in group B, the newborn weight (1.4±0.7 kg) and gestational age (32.35±4.52 weeks) of the women in group A were significantly lower than those (2.9±0.8 kg and 36.9±4.6 weeks) of the women in group B. The incidence of neonatal asphyxia (43.5%) and perinatal death (17.4%) of the women in group A were significantly higher than those (15.8% and 1.8%) of the women in group B (all P＜0.05). There was no significant difference in perinatal outcomes, such as fetal distress, neonatal hyaline membrane disease, neonatal cardiac dysplasia, neonatal anemia, neonatal jaundice, and neonatal septicemia, of the women between the two groups (P＞0.05). Conclusion: The intervention should be strengthened on the risk factors of the pregnant women with EOSP and FGR for reducing the risk of their pregnancy complications and perinatal adverse outcomes in clinic.

2022 Vol. 30　(4):　927- [Abstract]（ 549 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the delivery outcomes of puerperae with shoulder dystocia by delivery modes of different postures. Methods: The delivery data of puerperae with shoulder dystocia from August 2015 to June 2019 were analyzed retrospectively. These puerperae were divided into control group (46 puerperae with semirecumbent position of thigh flexion and knee-holding) and observation group (46 puerperae with hand-knee support prone position) according to the different delivery positions. After propensity score march was used to exclude the influences of the confounding factors, such as age, gestational weeks, and gravidity, the puerperae with shoulder dystocia in the two groups were included in this study finally. The delivery mode, the duration of delivery, and the hemorrhage volume in postpartum 2h of the puerperae, and the rate of neonatal complications were compared between the two groups. The situations of perineal wound healing and comprehensive contractility of pelvic muscles of the puerperae were assessed in the 6th month after vaginal delivery. Results: The rate of vaginal delivery (82.6%) of the puerperae in the observation group was significantly higher than that (58.7%) of the puerperae in the control group. The rate of cesarean section (15.2%) of the puerperae in the observation group was significantly lower than that (34.8%) of the puerperae in the control group. The duration of labor of the puerperae in the observation group was significantly shorter than that of the puerperae in the control group, and the volume of 2h postpartum blood loss (148.2±43.5mL) of the puerperae in the observation group was significantly lower than that (188.3±52.2ml) of the puerperae in the control group (all P＜0.05). There was no significant difference in the birth weight (3872.23± 215.25g vs. 3889.58± 195.68g) between the two groups (P＞0.05). The incidence of neonatal asphyxia (12.8%) and the total incidence of neonatal complications (15.4%) in the observation group were significantly lower than those (35.9% and 53.9%) in the control group (P＜0.05). The grade of perineal wound healing and the grade of pelvic muscle contractility of the puerperae in the observation group were significantly better than those of the puerperae in the control group (P＜0.05). Conclusion: Hand-knee support prone position for correcting the fetal position of the puerperae with shoulder dystocia during delivery can significantly improve the natural delivery rate, reduce the cesarean section rate, shorten the delivery duration, reduce the postpartum hemorrhage volume, and also can effectively reduce the risk of neonatal asphyxia and other complications. It is beneficial to the healing of the perineal wound and the recovery of the pelvic function after delivery.

2022 Vol. 30　(4):　936- [Abstract]（ 347 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To explore the independent risk factors of uterine scar pregnancy (USP) of women. Methods: 79 women with USP in study group from May 2019 to December 2020 were analyzed retrospectively. 84 normal early pregnant women with a history of cesarean section who had experienced abortion during the same period were selected in control group. The clinical data of the women were compared between the two groups. Logistic regression was used to analyze the independent risk factors of USP. Results: The number of pregnancies (OR=0.073, 95%CI 0.009-0.608), and the time from the last cesarean section to the current pregnancy (OR=1.020, 95%CI 1.006-1.033) of the women were the independent risk factors of their USP. Conclusion: The independent risk factors of the USP, such as the number of pregnancies and the time from the last cesarean section to the current pregnancy, should be paid attention to, and the publicity and education of clinical contraception for the women after cesarean section should be done well.

2022 Vol. 30　(4):　944- [Abstract]（ 571 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To analyze the situation of free cervical cancer screening of women with eligible age in Beijing from 2008 to 2020. Methods: The results of free cervical cancer screening in Beijing from January 2008 to December 2020 were analyzed. Results: A total of 3,000,435 women with eligible age were screened. The average abnormal cytological detection rate of cervical exfoliative cytology of these women was 2.5%, and the abnormal detection rate by colposcopy of these women was 61.2%. The detection rate of cervical cancer and cervical precancerous lesions of these women was 231.5/100,000, among which, the detection rate of precancerous lesions of cervical cancer was 222.0/100,000, and the detection rate of cervical cancer was 9.5/100 000. During the 13th Five-Year Plan period, the detection rates of abnormal cervical cytology, abnormal colposcopy, cervical cancer, and cervical precancerous lesions, and the early diagnosis rate of early cervical cancer had increased significantly in Beijing. Conclusion: The work of free cervical cancer screening of women with eligible age in Beijing has achieved some success. In the future, the coverage of screening population and the quality of screening should be further explored and improved in order to provide beneficial practice for realizing WHO goal of eliminating cervical cancer as soon as possible.

2022 Vol. 30　(4):　949- [Abstract]（ 351 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )