To summarize the risk factors of embryo damage by meta-analysis, and to provide evidence for preventing embryo damage. Methods： The literatures were searched in the databases, such as Pubmed，CNKI，Wanfang, and other, till to June 1, 2021 by the key terms of "missed abortion"，"embryonic cessation of development"，and "influencing factors"，"relevant factors", and "risk factors". The case-control studies about the risk factors of embryo damage were collected and were screened according to the determined inclusion and exclusion criteria. Meta-analysis was performed by Revman5.3.0. Results：A total of 30 studies with 34848 cases were enrolled，which included 9850 cases with embryo damage and 24998 without embryo damage. The risk factors of embryo damage were the age of pregnant women ≥35 years old (OR=1.65，95%CI 1.25-2.17)，the chlamydial trachomatis infection (OR=4.15, 95%CI 1.96-8.77), the ureaplasma urealyticum infection (OR=8.15, 95%CI 3.46-19.19)， the smoking (OR=3.02, 95%CI 1.74-5.24)，the alcohol consumption (OR=4.97，95%CI 3.92-6.30)，the previous abortion history (OR=5.59, 95%CI 3.19-9.51)，the unhealthy emotions (OR=3.51, 95%CI 2.34-5.28)，the bad environment(OR=4.36, 95%CI 2.089.17), and the fetal chromosome abnormality (OR=5.83, 95%CI 4.36-7.78), etc. While the folic acid supplementation was a protective factor of embryo damage (OR=0.30, 95%CI 0.21-0.45). Conclusion：There are many risk factors of embryo damage. Early identification and intervention for the pregnant women are conducive to prevent the occurrence of embryo damage, so as to realize the eugenics.

2022 Vol. 30　(5):　968- [Abstract]（ 773 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To study the effects of hypothyroidism of pregnant mice on the glucose metabolism of their offspring. Methods: In this study, 80 female SPF newborn mice were randomly divided into model group and control group (40 mice in each group). The mice in the model group were fed with 0.02% propyl thiouracil for establishing the model mouse with hypothyroidism, and the mice in the control group were fed with normal drinking water. After these mice were found to have vaginal emboli, they were reared in separate cages for 0, 3, 7, 14, and 21 days, and the blood of these mice were collected from their posterior orbit. The levels of thyroid hormone T4, thyroid stimulating hormone (TSH), and blood glucose of the mice were detected by chemiluminescence method. Results: The T4 level of the mice in the model group before enrolled in this study (D0) and in the 3rd day after intervention (D3) had no significant different from that of the mice in the control group (P>0.05), but which of the mice in the model group in D7, D14, or postpartum (P1) was significantly higher than that of the mice in the control group (P<0.05). The TSH level of the mice in the model group at D0 had no significant different from that of the mice in the control group (P>0.05), but which of the mice in the model group in D3, D7, D14, or P1 was significantly higher than that of the mice in the control group (P<0.05). There were no significant differences in the gestational days and number of babies of the mice between the two groups (P>0.05). The values of gestational weight gain of the mice and the birth weight of the offspring in the model group were significantly lower than those offspring in the control group. The random blood glucose level of the offspring in the model group was significantly higher than that of the offspring in the control group. There was no significant difference in the fasting, or postprandial 15 min or 30 min blood glucose level of the offspring between the two groups (P>0.05). The postprandial 60 min or 120 min blood glucose level of the offspring in the model group was significantly higher than that in the control group (P>0.05). Conclusion: The blood glucose levels of the pregnant mice with hypothyroidism and their offspring are abnormal.

2022 Vol. 30　(5):　980- [Abstract]（ 370 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To investigate the stigma and the status of fertility related stress of women with in vitro fertilization embryo transfer (IVF-ET), and to analyze their related influencing factors. Methods: 303 female IVF-ET patients in our hospital were selected as the research object. The questionnaire of stigma and fertility related stress was distributed, and the survey results and influencing factors of stigma were analyzed. Results: The total score of fertility related stress was (161.35 ± 29.78), and the score of "parental role demand" was the highest. The total score of shame was (71.72 ± 20.36), and the score of "social withdrawal" was the highest. There was a significant positive correlation between the dimensions of disease shame and the scores of fertilities related stress in female patients with IVF-ET, and there was also a positive correlation between the total score of disease shame and the total score of fertility related stress (P<0.05). There was no significant difference in the total score of shame among female patients with IVF-ET in different ages, religious beliefs, marital status, number of abortions, family life types, whether they accepted adoption, previous treatment methods, history of assisted reproductive treatment and current assisted pregnancy cycle (P>0.05). There were significant differences in the total score of shame among female patients with IVF-ET in different places of residence, educational level, whether they were the only child, occupation, personal income, marriage time, years of infertility, reproductive history, causes of infertility, whether they expected to have boys, and the main source of reproductive pressure (P < 0.05). Regression analysis showed that the model passed the F test, R2 = 0.798, residence in rural areas, education level of junior middle school and below, personal income ≤ 3000 yuan/month, expected childbearing boys, husbands, parents and generations, the main source of childbearing pressure, and the total score of childbearing related pressure could positively predict the total score of stigma (P < 0.05). Conclusion: Female patients with IVF-ET generally have obvious disease shame, and fertility related pressure is high. There is a positive correlation between disease shame and fertility related pressure. Fertility related pressure, personal income level, residence, source of fertility pressure and gender preference are the main factors affecting disease shame.

2022 Vol. 30　(5):　989- [Abstract]（ 471 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To understand the utilization situation of maternal health care services of the women in Shanxi province，so as to provide a theoretical basis for improving the utilization level of maternal health care services and promoting maternal and child health work in Shanxi province. Methods: By the method of stratified cluster random sampling，a questionnaire survey was conducted in 3522 married women aged 20-49 who were hospitalized and delivered in 11 cities of Shanxi province from June to December 2020. The utilization of pregnancy health care services of these women was investigated. Results: There were 3490 valid questionnaires, of which 3201 (91.7%) women had registered during the first trimester of pregnancy. 3073 (88.1%) women had finished five or more prenatal examinations, 3231 (92.6%) respondents believed the nutrition guidance during pregnancy was necessary, and 78.8% respondents had received nutrition and weight gain guidance during pregnancy in maternity hospitals. 2962 (84.9%) respondents believed that psychological screening assessment during pregnancy was necessary, but only 39.8% respondents had been given the psychological screening assessment during pregnancy. There were 2545 (72.9%) women with less than 3 times of learning in school for pregnant women during pregnancy. Conclusion: The utilization of maternal health care services in Shanxi province is good，but it is still necessary to strengthen the maternal nutrition guidance and the psychological screening and evaluation services for the pregnant women，and to improve their learning in school for pregnant women.

2022 Vol. 30　(5):　1000- [Abstract]（ 304 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

2022 Vol. 30　(5):　1009- [Abstract]（ 293 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the therapeutic effect of Guizhi fuling pill combined with gonadotropin-releasing hormone agonist (GnRH-a) for treating patients with endometriosis (EMT) after laparoscopic surgery. Methods: 104 patients with EMT who would receive laparoscopic surgery were selected as study subjects, and were divided into two groups (52 cases in each group) according to the principle of random number from January 2018 to August 2019. The patients in the control group were treated with GnRH-a after surgery, while the patients in the observation group were treated with Guizhi fuling pill combined with GnRH-a after surgery. The dysmenorrhea score, the degree dysmenorrhea alleviated, and the serological markers levels of the patients were compared between the two groups. Results: The dysmenorrhea scores of the patients in both groups had decreased significantly after treatment, and which of the patients in both groups in the 12th month after treatment were significantly higher those in the 6th month after treatment, and which of the patients in the observation group in the 6th and the 12th month after treatment were significantly lower those of the patients in the control group (P<0.05). There was no significant difference in the total effective rate of dysmenorrhea (90.4% and 76.9%) of the patients between the two groups (P>0.05), and the recurrence rate of dysmenorrhea of the patients in the observation group (3.9%) was significantly lower than that (17.3%) of the patients in the control group (P<0.05). The levels of serum carbohydrate antigen 125 (CA125), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) of the patients in the two groups after 6 and 12 months of treatment had decreased gradually, and the levels of CA125 and TNF-α of the patients in the observation group were significantly lower than those of the patients in the control group. The level of serum IL-6 of the patients in the two groups after 12 months of treatment was significantly lower than that of the patients in the control group (all P<0.05), but there was no significant difference in the IL-6 level of the patients after 6 months of treatment between the two groups (P>0.05). Conclusion: Guizhi fuling pill combined with GnRH-a for treating patients with EMT after laparoscopic surgery can further improve their inflammatory response state, and can reduce their recurrence of dysmenorrhea.

2022 Vol. 30　(5):　1018- [Abstract]（ 370 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To compare the curative effect of short-acting oral contraceptives and estrogen-progesterone sequential therapy for treating women after abortion. Methods: 120 women who underwent abortion were included and were divided into three groups (40 cases in each group) according to the different postoperative treatments between January 2020 and September 2020. The women in the control group were given conventional treatment, and the women in group A were given shortacting oral contraceptives combined with conventional treatment, and the women in group B were given oral estrogen-progesterone sequential therapy combined with conventional treatment. The postoperative recovery status, the sex hormones levels, and the incidence of postoperative complications of the women were compared among the three groups. Results: After treatment, the duration of vaginal bleeding, the menstrual recovery time, and the bleeding volume of the women in group A and in group B were significantly less than those of the women in the control group, and the duration of vaginal bleeding and the bleeding volume of the women in group A were significantly less than those of the women in group B (all P<0.05). The endometrial thickness of the women in group A was significantly thinner than that of the women in group B, and which of the women in both group B and group A after treatment was significantly thicker than that before treatment, and which of the women in both group B and group A was significantly thicker than that of the women in the control group. The score of menstrual discomfort scale (MDQ) of the women in both group B and group A was significantly was significantly lower than that of the women in
the control group (all P<0.05). The levels of follicle-stimulating hormone (FSH), luteinizing hormone, and estradiol of the women had no significant difference between group A and group B, but which of the women in both group B and group A was significantly higher than that of the women in the control group (P<0.05). The incidence of complications (7.5% vs. 5.0%) of the women had no significant difference between group A and group B, but which of the women in both group B and group A was significantly lower than that (32.5%) of the women in the control group (P<0.05). Conclusion: Both Short-acting oral contraceptives and estrogen-progesterone sequential therapy for treating the women after abortion can reduce their postoperative bleeding volume, enhance their menstrual cycle recovery, improve their menstrual discomfort, and increase their sex hormones levels, and reduce their postoperative complications.

2022 Vol. 30　(5):　1026- [Abstract]（ 425 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

 To investigate the efficacy of modified laparoscopic surgery for treating infertility patients with ovarian endometriosis cyst, and to study its influence on their Tlymphocytes level and pregnancy outcomes. Methods: 123 infertility patients with ovarian endometriosis cysts were selected and were divided into two groups according to the different treatments. 60 patients in the study group were treated by modified laparoscopic oophorocystectomy, while 63 patients in the control group were treated by conventional laparoscopic oophorocystectomy. The clinical efficacy of the patients was compared between the two groups. Results: The time of the first postoperative anal exhaust (1.3±0.4d), the intraoperative blood loss (23.2±3.9ml), and the hospital stay (6.5±1.1d) of the patients in the study group were significantly lower than those (1.9±0.6d, 29.5±4.5 ml, and 8.3±1.4d) of the patients in the control group. The improvement degrees of the sex hormone indexes related to ovarian reserve function, and the levels of T lymphocyte subgroup indexes of the patients in the study group after operation were significantly better than those of the patients in the control group. The pregnancy rate (67.5%) of the patients in the study group was significantly higher than that (44.4%) of the patients in the control group (all P<0.05). Conclusion: Modified laparoscopic surgery for treating infertility patients with ovarian endometriosis cyst can increase the effectiveness, and reduce the adverse effect on their ovarian reserve function and immune function, which is beneficial to their rehabilitation after operation and improve their pregnancy rate.

2022 Vol. 30　(5):　1036- [Abstract]（ 352 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the effect of blood glucose control of metformin combined with insulin for treating pregnant women with gestational diabetes mellitus (GDM), and to study the perinatal outcomes of the women. Methods: A total of 104 pregnant women with GDM were selected and were divided into study group (52 women were given metformin combined with insulin therapy) and control group (52 women were given insulin therapy alone) according to the random number table method between December 2018 and January 2020. The levels of blood glucose control indexes, such as fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), and glycosylated albumin (GA), of the women at different pregnant stage were compared between the two groups. The levels of the indexes of islet function, such as homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment ofβinsulin secretion (HOMA-β), the levels of inflammatory factors, such as acute phase serum amyloid A (ASAA) and interleukin-6 (IL-6), and the levels of disease-related factors, such as glucagon-like peptide-1 (GLP-1) and omentin-1, of the women in the two groups were compared between before and after pregnancy, and between before and after delivery. The values of perinatal outcomes and medication safety indexes of the women in the two groups were compared between before and after pregnancy, and between before and after delivery. Results: After treatment, the levels of FBG, 2hPG, HbA1c, and GA of the women in the study group during the first trimester of pregnancy were significantly lower than those of the women in the control group (P<0.05), but which of the women during the second and third trimester of pregnancy had no significant different between the two groups (P>0.05). The HOMA-IR value and the levels of inflammatory factors of the women in the two groups before delivery were significantly lower than those before treatment, while the HOMA-β values and the disease-related factors levels of the women in the two groups before delivery were significantly higher than before treatment (all P<0.05), but which of the women all had no significant different between the two groups (P>0.05). The incidences of the low birth weight infants (3.9%) and the neonatal hypoglycemia (11.5%) in the study group were significantly lower than those (17.3% and 30.8%) in the control group (P<0.05), but there were no significant differences in the incidences of cesarean section, premature delivery, pregnancy complications, macrosomia, and other neonatal complications between the two groups (P>0.05). There was no significant difference in the classification of medication safety of the women between the two groups (P>0.05). Conclusion: Metformin combined with insulin for treating the women with GDM during the first trimester of pregnancy has better blood glucose control effect, and which can improve the perinatal outcomes of these women.

2022 Vol. 30　(5):　1045- [Abstract]（ 319 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To investigate the effect and safety of sevoflurane combined with dexmedetomidine for general anesthesia during laparoscopic total hysterectomy. Methods: A total of 100 patients who wanted laparoscopic total hysterectomy were selected and randomly divided into two groups (50 cases in each group) from January 2018 to February 2021. The patients in the two groups were given general anesthesia by compound inhalation of sevoflurane. The patients in the research group were treated with intravenous infusion of dexmedetomidine, and the patients in the control group were given the same amount of normal saline. The awakening time, the extubation time, the minimum alveolar concentration for adrenergic response (MACBAR) value of sevoflurane, and the Ramsay sedation score after extubation of the patients in the two groups were observed. The heart rate (HR), the mean arterial pressure (MAP), and the sevoflurane concentrations of the patients before dexmedetomidine infusion (T0), 5 min after dexmedetomidine infusion (T1), at pneumoperitoneum established (T2), 30 min after surgery (T3), and after surgery (T4) of the patients were compared between the two groups. The adverse reactions rate during anesthesia of the patients was compared between the two groups. Results: There were significant differences in the awakening time (6.84±1.61min vs. 9.19±2.07min), the extubation time (10.83±2.16min vs.13.80±2.94min), and the MACBAR value of sevoflurane (2.49±0.85% vs. 4.64±0.97%), and the Ramsay score of extubation (3.43±0.80 points vs. 2.26±0.63 points) of the patients between the two groups (P<0.05). There were no significant differences in the values of HR and MAP of the patients at T0 between the two groups (P>0.05), and the values of HR and MAP of the patients in the research group at T1, T2, T3, and T4 were significantly lower than those of the patients in the control group (P<0.05). There was no significant difference in the sevoflurane concentration of the patients at T0 or at T1 between the two groups (P>0.05), and the sevoflurane concentration of the patients in the research group at T2, T3, or T4 was significantly lower than that of the patients in the control group (P<0.05). The incidence of adverse reactions during anesthesia (8.0%) of the patients in the research group had significant different from that (26.0%) of the patients in the control group (P<0.05). Conclusion: The general anesthesia by sevoflurane combined with dexmedetomidine during laparoscopic hysterectomy can not only reduce the dosage of sevoflurane, but also effectively stabilize the hemodynamics of the patients, which can improve the sedative and analgesic effects and can reduce the incidence of adverse reactions during the anesthesia.

2022 Vol. 30　(5):　1055- [Abstract]（ 316 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To explore the effects of sevoflurane inhalation combined anesthesia guided by bispectral index (BIS) during laparoscopic radical resection of cervical cancer of patients on their cognitive function and their serum cortisol (Cor) and angiotensin II (Ang-II) levels. Methods: A total of 106 patients who wanted laparoscopic radical resection of cervical cancer were enrolled and were randomly divided into two groups (53 cases in each group) between January 2018 and March 2021. The patients in the two groups were all given sevoflurane inhalation combined with propofol for anesthetics. The patients in the control group were given the anesthetics according to clinical experience of anesthesiologists, while the patients in the observation group were given the anesthetics guided by BIS. The dosages of anesthetics, the values of blood pressure indexes, such as systolic blood pressure (SBP), diastolic blood pressure (DPB), the heart rate (HR), the values of serum indexes, such as Cor and Ang-II, the recovery quality score, and the score of cognitive function MMSE of the patients were compared between the two groups. Results: There was no significant difference in the dosage of sevoflurane of the patients between the two groups (P>0.05), and the dosage of propofol of the patients in the observation group was significantly lower than that of the patients in the control group (P<0.05). The HR value of the patients in the observation group at 10min or 30min after pneumoperitoneum, or at the end of the operation was significantly lower than that of the patients in the control group, but the values of SBP and DPB of the patients in the observation group were significantly higher than those of the patients in the control group. The levels of Cor and Ang-Ⅱof the patients in the observation group at the end of the operation or at postoperative 2h were significantly lower than those of the patients in the control group, and the postoperative consciousness recovery time, the spontaneous breathing recovery time, and the awake time of the patients in the observation group were significantly shorter than those of the patients in the control group (all P<0.05). There was no significant difference in the cognitive function of the patients at 7 days before and after operation between the two groups (P>0.05). MMSE score of cognitive function of the patients in the observation group in the 1st d, the 3rd d, or the 5th d after operation was significantly higher than that of the patients in the control group (P<0.05). Conclusion:  Sevoflurane inhalation combined anesthesia guided by BIS during laparoscopic radical resection of cervical cancer of the patients can reduce their dosages of related anesthetics used, can decrease their stress response, and can fast the recovery of their postoperative cognitive function, which is also of positive significance in avoiding awakening delay.

2022 Vol. 30　(5):　1065- [Abstract]（ 309 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

 To explore the expression and clinical significance of murine double minute 4 (MDM4) and microRNA-144-3p (miR-144-3p) in endometrial tissues of infertility patients with endometriosis (EMS) during the nidation window period. Methods: During October 2019 to August 2021, 62 infertility patients with EMS who had completed data were included in group A, and 59 infertility patients due to fallopian tube factors were included in group B during the same period. Realtime fluorescence quantitative-polymerase chain reaction (RT-qPCR) method was used to detect the expression levels of MDM4 mRNA and miR-144-3p in the endometrial tissues of the patients in the two groups, and immunohistochemistry was used to detect the expression level of MDM4 protein in endometrial tissue of the patients in the two groups. Pearson method and Spearman method were used to analyze the correlation between the levels of MDM4 mRNA, protein of the patients with EMS in the endometrial tissues during the nidation window period and follicular phase and their miR-144-3p level. Results: The mRNA level and the protein positive rate of MDM4 in the endometrial tissue of the patients in group A were significantly higher than those of the patients in group B, and the mir-144-3p level of the patients in group A was significantly lower than that of the patients in group B (P<0.05). There were no significant differences in the Mir-144-3p and MDM4 mRNA levels, and the positive rate of MDM4 protein of the patients between the two groups (P>0.05). Pearson method analysis showed that the MDM4 mRNA level in the endometrial tissue of the patients with EMS during the nidation window period and follicular phase was negatively correlated with their Mir-144-3p level (r=-0.679, -0.359, P<0.05). Spearman analysis showed that the MDM4 protein level in the endometrial tissue of the patients with EMS during the nidation window period and follicular phase was negatively correlated with their Mir-144-3p levels (r=-0.502, -0.432, P<0.05). Conclusion: The expression of miR-144-3p in the endometrial tissue of the patients with EMS during the nidation window period and follicular phase is low, but the expression of MDM4 is high, and they are negatively correlated each other. Both MiR-144-3p and MDM4 may be jointly involved in the occurrence of infertility caused by EMS.

2022 Vol. 30　(5):　1075- [Abstract]（ 381 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the value of serum alpha fetoprotein（AFP）and creatine kinase（CK）levels combined with magnetic resonance imaging (MRI) during the second and the third trimester of pregnancy for evaluating the placenta previa complicated with placenta accrete of pregnant women. Methods: A total of 80 pregnant women with placenta previa complicated with placenta accreta who had delivered by cesarean section from January 2018 to January 2021 were selected in research group retrospectively，which included 29 cases with adhesion type of placenta previa in group A，27 cases with implant type of placenta previa in group B, and 24 cases with penetration type of placenta previa in group C according to the results of MRI. In addition，60 pregnant women who required regular antenatal examination and MRI examination after cesarean section and during the same period were selected in control group. The serum AFP，CK levels and the results of MRI examination during the second and the third trimester of pregnancy of the women in the two groups were analyzed. Results: The serum AFP and CK levels of the women in group C, group B, and group A had decreased gradually, and which of the women were all significantly higher than those of the women in the control group (P<0.05). There was no significant difference in the diagnostic coincidence rate of MRI (92.6%, 85.2% vs. 83.3%) of the women among group A, group B, and group C (P>0.05). The area under the curve (AUC) of serum AFP and CK levels combined with MRI for evaluating the placenta previa complicated with placenta implantation during the second trimester of pregnancy were 0.924 (95%CI: 0.805-0.982) and 0.905 (95%CI: 0.821-0.964), respectively, the sensitivity of which were 90.2% and 88.4%, respectively, and the specificity of which were 95.3% and 91.8%, respectively. The AUC of MRI for evaluating the placenta previa complicated with placenta implantation during the third trimester of pregnancy was 0.811 (95%CI: 0.691-0.863), the sensitivity of which was 80.7%, and the specificity of which was 93.2%. The AUC of serum AFP level for evaluating the placenta previa complicated with placenta implantation during the second and the third trimester of pregnancy were 0.705 (95%CI：0.602-0.764) and 0.782 (95%CI：0.7010.835), respectively, the sensitivity of which were 70.0% and 78.4%, respectively, and the specificity of which were 69.3% and 71.3%, respectively. The AUC of serum CK level for evaluating the placenta previa complicated with placenta implantation during the second and the third trimester of pregnancy were 0.692 (95%CI：0.591-0.702) and 0.764 (95%CI：0.624-0.820), respectively, the sensitivity of which were 69.9% and 75.2%, respectively, and the specificity of which were 74.3% and 70.3%, respectively. Conclusion: The serum AFP and CK levels combined with MRI of the pregnant women during the second and the third trimester of pregnancy for evaluating the placenta previa complicated with placenta accreta has higher value in clinic.

2022 Vol. 30　(5):　1085- [Abstract]（ 360 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To investigate the serum changes and clinical significance of serum anti Mullerian hormone（AMH)，interleukin (IL)-6， IL-8, and tumor necrosis factor alpha (TNF-α) levels of women with preterm premature rupture of membranes (PPROM) complicated with intrauterine infection. Methods: The clinical data of 86 pregnant women with PPROM from January 2020 to August 2021 were selected in this study. Among them, 47 cases with intrauterine infection were included in group A，and 39 cases without intrauterine infection were included in group B. And these women were also divided in group C (55 cases with premature rupture of membranes time <24h) and group D (31 cases with premature rupture of membranes time≥24h). Another 40 women with preterm birth and intact fetal membranes were selected in control group during the same period. The levels of serum AMH，IL-6，IL-8, and TNF-α of the women were compared among these groups. Results: The serum levels of AMH, IL-6, IL-8, and TNF-α of the women in group A, group B, and group C had decreased gradually (P<0.05). The serum levels of IL-6, IL-8, and TNF-α of the women in group D were significantly higher than those of the women in group C (P<0.05), but there was no significant difference in the AMH level of the women between group C and group D (P>0.05). Spearman correlation analysis showed that the AMH level of the women was correlated with their serum TNF-α level (P<0.05), but was no correlation with their IL-6 and IL-8 levels (P>0.05). The levels of TNF-α, IL-6, and IL-8 of the women were positively correlated (P<0.05). Conclusion: The levels of the serum AMH，IL-6，IL-8, and TNF-α of the pregnant women with PPROM are high expression obviously, and the levels of serum IL-6，IL-8, and TNF-of the women increase with the longer their membrane rupture time and the complicating of intrauterine infection. It is suggested that the levels of the serum AMH，IL-6，IL-8, and TNF-α of the pregnant women may be valuable for early identification of PPROM, especially for those women complicated with intrauterine infection.

2022 Vol. 30　(5):　1094- [Abstract]（ 306 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To analyze the correlation between the serum level of thyroid stimulating hormone（TSH）of women with polycystic ovary syndrome（PCOS）and their indexes of glucolipid metabolism. Methods: 224 women with PCOS were selected as the study subjects from March 2018 to August 2020. All of these women were given the detections of thyroid function and glucolipid metabolism indicators. According to the tertiles of TSH level，these women were divided into group A (women with low-level TSH)，group B (women with middle-level TSH) and group C (women with high-level TSH). The correlation between the TSH level of the women and their glucolipid metabolism indexes was analyzed. Results: The incidence of metabolic syndrome (MS) of the women in group A, group B, and group C had increased gradually, the levels of FPG and FINS and the value of homeostasis model assessment of insulin resistance (HOMA-IR) of the women in group A, group B, and group C had also increased gradually (P<0.05). The values of body mass index (BMI) and waist to hip ratio (WHR), and the levels of total cholesterol (TC), triglyceride (TG), and low density lipoprotein (LDL) of the women in group C were significantly higher than those of the women in group A and in group B, and the High density lipoprotein (HDL) level of the women in group C was significantly lower (P<0.05). There were no significant differences in the values of BMI and WHR, and the levels of TC, TG, HDL, and LDL of the women between group A and group B (P>0.05). There was no correlation between the serum TSH level of the women with PCOS only and their BMI, WHR, and HOMA-IR values, and their levels of TC, TG, HDL, LDL, fasting blood glucose (FPG), and fasting insulin (FINS) (P>0.05). The TSH level of the women with subclinical hypothyroidism was positively correlated with their TC, TG, FPG, and FINS levels, and their HOMA-IR value (P<0.05). The TSH level of the women with PCOS and subclinical hypothyroidism was positively correlated with their BMI, WHR, and HOMA-IR values, and their levels of TC, TG, LDL, FPG, and FINS, but which was negatively correlated with their HDL level (all P<0.05). The TSH level of the women has predictive value for PCOS complicated with MS (P<0.001), and the area under the curve (AUC), the cut-off value, the sensitivity, and the specificity of which were 0.719, 4.32mIU/L, 69.7%, and 76.2%, respectively. Conclusion: The higher TSH level of the women with PCOS，the higher risk of their MS occurrence. However，the TSH level only in the women with PCOS complicated with subclinical or clinical hypothyroidism is correlated with their glucolipid metabolism indexes.

2022 Vol. 30　(5):　1102- [Abstract]（ 275 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To analyze the clinical characteristics and the changes of serum inflammatory factors levels of patients with deep infiltrating endometriosis (DIE). Methods: 244 patients with endometriosis who underwent surgical treatment from March 2018 to February 2020 were collected retrospectively. These patients were divided into group A (patients with DIE) and group B (patients without DIE). The clinical data, the operative situation，and the levels of serum interleukin-8（IL-8)，tumor necrosis factor-α (TNF-α), and transforming growth factor-β（TGF-β）of the patients were compared between the two groups. Results: The age, the duration of endometriosis, and the serum CA125 level of the patients in group A were significantly higher than those of the patients in group B. The degree of dysmenorrhea, and the pain rate during intercourse and the incidence of the diarrhea during menstruation of the patients in group A were significantly higher than those of the patients in group B. The detection rate of the blue nodules in vaginal wall, the tenderness nodules of the uterine sacral ligament, and the tenderness nodules of the uterine posterior fornix by gynecological examination of the patients in group A were significantly higher than those of the patients in group B (all P<0.05). There were no significant differences in the value of body mass index, the incidences of chronic pelvic pain, anal belly, and urinary symptoms, and the rate of uterine fixation by gynecological examination of the patients between the two groups (P>0.05). The R-AFS stage and the pelvic adhesion degree of the patients in group A during operation were significantly higher than those of the patients in group B, and the serum IL-8, TNF-α, and TGF-β levels of the patients were significantly higher than those of the patients in group B (all P<0.05). There was no significant difference in the rate of complicated with ectopic ovarian cyst of the patients between the two groups (P>0.05). The severe dysmenorrhea, ≥2 positive results of gynecological examination, and the elevation of serum CA125, IL-8, TNF-α, and TGF-β levels were the independent factors affecting the occurrence of DIE (P <0.05). Conclusion: The clinical characteristics of the patients with DIE are diffrent from those of the patients without DIE. The patient with severe dysmenorrhea，≥2 positive results of gynecological examination, or the elevation of serum CA125 and inflammatory factor levels has high possibility of DIE.

2022 Vol. 30　(5):　1110- [Abstract]（ 416 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To analyze the correlation of the levels of the serum immunoglobulins, such as IgG，IgM, and IgA, and the inflammatory factors of pregnant women with gestational diabetes mellitus (GDM) during the third trimester of pregnancy and their puerperal infection. Methods: 106 pregnant women with GDM during the third trimester were enrolled in this study and were divided into group A (22 women with puerperal infection) and group B (84 women without puerperal infection) according to the presence or absence of puerperal infection between March 2020 and August 2021. Meanwhile，30 healthy pregnant women with normal delivery were selected in group C. The levels of serum IgG，IgM，IgA, tumor necrosis factor -α (TNF-α), interleukin-6 (IL-6), hypersensitive C-reactive protein (HS-CRP) of the women were compared among the three groups, and the correlation between which and the puerperal infection of the women with GDM was analyzed. Results: The serum levels of IgG, IgM, and IgA of the women in group A, group B, and group C had increased in turn, while the levels of TNF-α, hsCRP, and IL-6 of the women in group A, group B, and group C had decreased in turn (all P<0.05). The levels of serum IgG, IgM, and IgA of the pregnant women with GDM during the third trimester of pregnancy were negatively correlated with their puerperal infection occurrence (r=-0.443, -0.455, -0.398, all P<0.05), but the levels of serum TNF-α, hs-CRP, and IL-6 of the pregnant women with GDM during the third trimester of pregnancy were positively correlated with their puerperal infection occurrence (r=0.383, 0.343, 0.440, all P<0.05). Conclusion: The immunity of the pregnant women with GDM during the third trimester of pregnancy decreases，which may lead to their puerperal infection occurrence and decrease the levels of their serum immunoglobulin, such as IgG，IgM，and IgA. The occurrence of puerperal infection of the pregnant women with GDM is negatively correlated with the levels of their serum immunoglobulin, such as IgG，IgM，and IgA during the third trimester of pregnancy，and was positively correlated with the levels of their serum TNF-α，hs-CRP，and IL-6.

2022 Vol. 30　(5):　1119- [Abstract]（ 471 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To explore the changes of the levels of serum visfatin and sex hormone-binding globulin (SHBG) of pregnant women with gestational diabetes mellitus (GDM), and to study the correlation between the levels of serum visfatin and SHBG of the women and their condition of GDM and their pregnancy outcomes. Methods：The clinical data of 102 pregnant women with GDM (in observation group) who had received regular prenatal examination and delivery from November 2017 to December 2019 were selected. Another 98 healthy pregnant women were selected in control group during the same period. The expression levels of visfatin and SHBG，the value of homeostasis model assessment of insulin resistance (HOMA-IR), and the pregnancy outcomes of the women were compared between the two groups. Pearson method was used to analyze the correlation between the expression levels of visfatin and SHBG of the women and their HOMA-IR value. According to the occurrence of adverse pregnancy outcomes，the women with GDM were divided into group A (49 women with adverse pregnancy outcomes) and group B (53 women with normal pregnancy outcomes). The expression levels of visfatin and SHBG of the women were compared between group A and group B. Multivariate Logistic regression model analysis was used to analyze the risk factors of the adverse pregnancy outcomes of the women with GDM. Receiver operating characteristic (ROC) curve was used to analyze the value of serum visfatin and SHBG levels of the women with GDM for evaluating their adverse pregnancy outcomes. Results：The serum visfatin level (64.73±18.26 mmol/L) and the HOMA-IR value (2.79±0.91) of the women in the observation group were significantly higher than those (33.59±10.91 mmol/L and 1.72±0.63) of the women in the control group. The SHBG level (415.05±50.54 mmol/L) of the women in the observation group was significantly lower than that (573.41±59.68 mmol/L) of the women in the control group (all P=0.000). The serum visfatin level was positively correlated with their HOMA-IR value (r=0.469, P=0.000), and the serum SHBG level of the women with GDM was negatively correlated with their HOMA-IR value (r=-0.474, P=0.000). The incidences of hypertension, cesarean section, macrosomia, and neonatal hypoglycemia of the women in the observation group were significantly higher than those of the women in the control group. The serum visfatin level of the women in group A was significantly higher than that of the women in group B, but the SHBG level of the women in group A was significantly lower (all P<0.05). The serum visfatin and SHBG levels of the women with GDM were the independent risk factors of their adverse pregnancy outcomes (P<0.05). The area under the curve (0.871) of the combination the serum visfatin and SHBG levels for evaluating the adverse pregnancy outcomes of the women with GDM was significantly higher than that (0.782) of the serum visfatin level alone and that (0.734) of the serum SHBG level alone (P<0.05). Conclusion：The level of visfatin of the women with GDM significantly increases, and the level of SHBG of the women with GDM significantly decreases，and both of which are related to the HOMA-IR value of the women. The levels of serum visfatin and SHBG of the women with GDM may be used to evaluate their adverse pregnancy outcomes.

2022 Vol. 30　(5):　1128- [Abstract]（ 308 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To investigate the value of ultrasound combined with serum hypoxia-inducible factor-1α (HIF-1α)，β-human chorionic gonadotropin β (β-HCG), and C-reactive protein (CRP) levels of pregnant women for diagnosing their fetal intrauterine distress (FIUD). Methods: 87 pregnant women with FIUD were collected in observation group and 60 healthy pregnant women were selected in control group from January 2019 to June 2020. The values of ultrasonic parameters, such as the fetal middle cerebral artery（MCA)，and the pulse index（PI), the resistance index（RI)，and the peak systolic velocity（PSV)/end diastolic velocity（EDV）ratio（S/D) of the fetal umbilical artery were examined by ultrasound. The levels of serum HIF-1α，β-HCG, and CRP of the women on the day of ultrasonic examination were detected. The values of ultrasonic parameters combined with the levels of serum HIF-1α，β-HCG , and CRP for diagnosing FIUD was analyzed. Results: The values of PI, RI, and S/D of fetal MCA in the observation group were significantly lower than those in the control group, and the values of PI, RI, and S/D of fetal umbilical artery in the observation group were significantly higher than those in the control group (all P<0.05). Based on the "gold standard" of clinical diagnosis, the sensitivity, the specificity, and the accuracy of ultrasonic parameters for diagnosing FIUD were 72.4%, 90.0%, and 79.6%, respectively. The levels of serum HIF-1α, β–hCG, and CRP of the women in the observation group were significantly higher than those in the control group (P<0.05). Receiver operating characteristic (ROC) curve showed that the serum HIF-α level for diagnosing FIUD had the highest efficacy (AUC=0.816),
and the diagnostic efficacy of the combination of the levels of serum HIF-1α，β-HCG , and CRP for diagnosing FIUD had been improved (AUC=0.953). The diagnostic efficacy of the values of ultrasonic parameters combined with the levels of serum HIF-1α，β-HCG , and CRP for diagnosing FIUD was the highest (AUC=0.995). Conclusion: The abnormal resistance index of fetal MCA and umbilical artery blood by ultrasound can indicate the FIUD occurrence，while the diagnostic accuracy of which is limited. The diagnostic efficacy of the ultrasonic parameters values  combined with the levels of serum HIF-1α，β-HCG , and CRP for diagnosing FIUD can effectively improve the diagnostic efficacy, which is beneficial to know the fetal situation and formulate the corresponding measures for improving the  maternal and infant outcomes in clinic.

2022 Vol. 30　(5):　1137- [Abstract]（ 297 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the levels of serum folic acid and vitamin B12（VB12）of pregnant women with gestational hypertension and their adverse pregnancy outcomes. Methods：The clinical data of 188 pregnant women with gestational hypertension and delivery from March 2020 to September 2020 were collected. According to the pregnancy outcomes，these women were divided into group A (76 cases with adverse pregnancy outcomes) and group B (112 cases with normal pregnancy outcomes). The clinical data of these women were collected. Enzyme-linked immunoassay was performed to measure the expression levels of serum folic acid and VB12 of these women. Pearson method was used to analyze the correlation between the serum folic acid level and the serum VB12 level. Receiver operating characteristic（ROC）curve was performed to evaluate the diagnostic value of serum folate and VB12 levels for adverse pregnancy outcomes. The factors influencing the adverse pregnancy outcomes of the women were analyzed. Results：The levels of serum folic acid (17.98±3.85 nmol/L) and VB12 (210.21±61.89ρmol/L) of the women in group A were significantly lower than those (21.31±4.56 nmol/L and 278.56±79.54ρmol/L) of the women in group B. The values of systolic blood pressure, diastolic blood pressure, and 24h urinary protein of the women in group A were significantly higher than those of the women in group B. The gestational weeks and the gestational weeks of gestational hypertension onset of the women in group A were significantly lower than those of the women in group B (all P<0.05). The serum folic acid level of the women with gestational hypertension was positive correlation with their serum VB12 level (r=0.296, P<0.05). ROC curve showed that the area under the curve (AUC) of the serum folic acid level and the VB12 level of the women with gestational hypertension for predicting their adverse pregnancy outcomes were 0.751 (95%CI：0.683-0.811) and 0.748 (95%CI：0.679-0.808), the sensitivity of which were 79.2% and 77.2%, and the specificity of which were 65.5% and 67.8%. The AUC of the combined serum folic acid and VB12 levels for predicting adverse pregnancy outcomes was 0.834 (95%CI: 0.773-0.884), the sensitivity and the specificity of which were 79.2% and 72.4%. Logistic regression analysis showed that the abnormal levels of folic acid and VB12, the abnormal 24h urinary protein value, and the increased diastolic and systolic blood pressure values of the women with gestational hypertension were their risk factors of adverse pregnancy outcomes. Conclusion：The expressions of serum folic acid and VB12 of the pregnant women with gestational hypertension decrease, and there are positively correlation between the folic acid level and the VB12 level, which suggest that the serum folic acid and VB12 levels can be used to predict their adverse pregnancy outcomes of the pregnant women with gestational hypertension.

2022 Vol. 30　(5):　1146- [Abstract]（ 304 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To detect the expression of placental growth factor (PLGF)，pregnancy associated plasma protein-A (PAPP-A), and β-human chorionic gonadotropin (β-HCG) of pregnant women, and to explore the correlation between the levels of PLGF, PAPP-A, β-HCG of the women and their occurrence of hypertensive disorder complicating pregnancy. Methods：From February 2019 to July 2021，127 pregnant women with hypertensive disorder complicating pregnancy who were registered and had accepted regular antenatal examination were selected in study group，and were divided into group A ( women with pregnancy induced hypertension), group B ( women with mild preeclampsia)，and group C ( women with severe preeclampsia). 160 normal pregnant women were selected in control group during the same period. Enzyme linked immunosorbent assay was used to detect the expression levels of serum PLGF and PAPP-A, and  automatic chemiluminescence immunoassay analyzer was used to detected the serum level of β-HCG. Pearson method was used to analyze the correlation between the levels of serum PLGF，PAPP-A，β-HCG of the women with hypertensive disorder complicating pregnancy and their adverse pregnancy outcomes. Receiver operating characteristic（ROC）curve was used to analyze the value of the levels of serum PLGF，PAPP-A，β-HCG of the women for predicting their adverse pregnancy outcomes, and Logistic regression analysis was used to analyze the related factors affecting the adverse pregnancy outcomes. Results：The levels of PAPP-A and β-HCG of the women in group A, group B, and group C had increased gradually, and which were significantly higher than those of the women in the control group. The level of PLGF of the women in group A, group B, and group C had decreased gradually, and which was significantly lower than that of the women in the control group (all P<0.05). The rates of fetal growth restriction, fetal distress, and preterm delivery of the women in the study group were significantly higher than those of the women in the control group (P<0.05). The serum PLGF level of the women with adverse pregnancy outcomes was significantly lower than that of the women with normal pregnancy outcomes, and the levels of serum PAPP-A and β-HCG of the women with adverse pregnancy outcomes were significantly higher (all P<0.05). The serum PLGF level of the women was negatively correlated with the rates of their fetal growth restriction, fetal distress, and preterm delivery, while the serum PAPP-A and β-HCG levels of the women were positively correlated with the rates of their fetal growth restriction, fetal distress, and preterm delivery (all P<0.05). The area under the curve of the combined serum PLGF, PAPP-A, and β-HCG levels for predicting the occurrence of adverse pregnancy outcomes of the women in the study group was 0.929, which was significantly higher than that of the serum PLGF level, PAPP-A level, or β-HCG level alone (P<0.05). The high level of serum PLGF was a protective factor of the adverse pregnancy outcomes of the women, and the high levels of serum PAPP-A and β-HCG were the independent risk factors of the adverse pregnancy outcomes of the women. Conclusion：The expression levels of serum PLGF, PAPP-A, andβ-HCG of the pregnant women with hypertensive disorder complicating pregnancy were abnormal, which are closely related to their occurrence of adverse pregnancy outcomes. The levels of serum PLGF，PAPP-A, and β-HCG can be used as the potential biological indicators to evaluate the adverse pregnancy outcomes of the pregnant women with hypertensive disorder complicating pregnancy.

2022 Vol. 30　(5):　1154- [Abstract]（ 310 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To study the value of chromosome microarray (CMA) technology combined with the nuchal translucency (NT) thickness screening by ultrasound of pregnant women in prenatal screening during the second trimester of pregnancy for diagnosing their fetal nasal bone defect/dysplasia. Methods：80 pregnant women with high risk of nasal bone defect/dysplasia of fetus from January 2014 to January 2021 were included in this study. All of the women were given fetal CMA technology and the fetal abnormal NT thickness screening by ultrasound. The efficiencies of the fetal CMA technology and the fetal abnormal NT screening by ultrasound for diagnosing the nasal bone deficiency/ dysplasia of fetus were analyzed. Results：There were 7 (8.8%) cases with abnormal karyotype by CMA, which included 2 cases with arr ［hg19］ 5Q23.1 (118,253,123-120,744,968)×3, 2.4Mb variation, 1 case with arr ［hg19］ 15q13.3 (31,967, 496-32, 444,043)×1, 1 case with 476.5 KB, arr ［hg19］ 16q23.3 (83,741, 751-84, 087,310) ×3,  345.5Kb, and 3 cases with arr ［hg19］ 15Q11.2 (24,940, 792-25,282,886)× 3,342 Kb. The area under curve and the specificity of CMA combined with NT by ultrasound for diagnosing nasal bone defect/ dysplasia of fetus were 0.923 and 97.4%, which had high diagnostic efficacy. Conclusion：CMA technology combined with prenatal ultrasonic NT detection for screening fetal nasal bone defect/dysplasia of the pregnant women during the second trimester of pregnancy has higher diagnostic value.

2022 Vol. 30　(5):　1163- [Abstract]（ 365 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To study the value of serum immunoglobulin G (IgG) anti-A (B) antibody titer of pregnant women with blood type O for predicting the hemolytic disease of newborn (HDN). Methods：385 pregnant women with blood type O were selected as the study subjects from December 2016 to December 2020. Antiglobulin detection was used to detect serum IgG anti-A（B）antibody titer of these women，and serological test for HDN was performed in the newborns of these women. Receiver operating characteristic （ROC）curve was used to analyze the value of serum IgG anti-A（B）antibody titer of the women for predicting their HDN. Results：In the 385 pregnant women with blood type O, the proportions of their serum IgG anti-A (B) antibody titers ≤1:32, 1:64, 1:128, 1:256, ≥ 1:5152 were 17.7%, 27.0%, 21.8%, 18.7%, 14.8%, respectively. The proportion of IgG anti-A (B) antibody titer ≥1:512 of the pregnant women with blood type O-A was significantly higher than that of the pregnant women with blood type O-B and O-AB (P<0.05), and there was no significant difference in the positive rate of HDN among the women with blood type O-A, O-B, and O-AB (P>0.05). The incidence of HDN in the pregnant women with serum IgG anti-A (B) antibody titer ≥ 1:512 had no significant different from that of the pregnant women with serum IgG anti-A (B) antibody titer 1:256, but which was significantly higher than that of the pregnant women with serum IgG anti-A (B) antibody titer ≤1:32, 1:64, or 1:128. The incidence of HDN in the pregnant women with serum IgG anti-A (B) antibody titer ≤1:32, 1:64, 1:128 had increased gradually (P<0.05). ROC curve analysis showed that the sensitivity, the specificity, and the area under curve of the serum IgG anti-A (B) antibody titer for predicting the HDN were 96.0%, 68.0%, and 0.848, respectively. Conclusion：The serum IgG anti-A（B）antibody titer of the pregnant women with blood type O for predicting their HDN occurrence has higher value，which maybe as a reference index for early intervention in clinic.

2022 Vol. 30　(5):　1171- [Abstract]（ 349 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To analyze the incidence of birth defects trend under new screening mode. Methods：3471 birth defect diagnosed from January 1, 2009 to December 31, 2018 were analyzed retrospectively. Results：The incidence of birth defects in international peace maternal and child health hospital had showed an upward trend from 2009 to 2018, among which, the incidence of congenital heart disease of the newborns always ranked first. Under the new screening mode, the proportions of simple chromosome abnormality and urological malformation of the newborns had increased. The abnormal rate of prenatal diagnosis， such as congenital heart disease, congenital diaphragmatic hernia, limb shortening, limb skeletal dysplasia, and cleft lip of the newborns had increased significantly, which had reached 52.7% in 2018. The prenatal diagnosis rates of complex congenital heart disease of the newborns from 2015 to now were 100%. Small malformations, such as cleft palate, rectoanal atresia or stenosis, and multiple fingers of the newborns were difficult to diagnose prenatally. Conclusion：With the development of non-invasive prenatal testing (NIPT), interventional prenatal diagnostic techniques, fetal cardiac ultrasound, and fetal magnetic resonance imaging (MRI), the incidences of fetal chromosome abnormality and urinary malformation by prenatal diagnosis have increased. The prenatal diagnosis rates of congenital heart disease, congenital diaphragmic hernia, cleft lip, and other malformations of the newborns increase, but small malformations, such as cleft palate, rectoanal atresia or stenosis, and multiple fingers of the newborns by prenatal diagnosis are still difficult.

2022 Vol. 30　(5):　1179- [Abstract]（ 340 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the effect of caring education and follow-up management for improving the long-acting reversible contraceptive (LARC) used of female adolescents after abortion. Methods: A total of 264 female adolescents who wanted abortion due to unexpected pregnancy were selected and divided into study group and control group by random number table method (132 cases in each group). The female adolescents in the control group were given conventional PAC services, and the female adolescents in the observation group were given caring education and follow-up management. The questionnaire scores of LARC knowledge of the female adolescents in the two groups were analyzed. The differences of the rate of LARC used after abortion immediately, the continuation rate of LARC within 6 months after abortion, the rate of repeated abortions, the rate of discontinuation rate, and the satisfaction of contraceptive effect of the female adolescents in the two groups were also analyzed. Results：Before intervention, there were no statistically significant differences in the number of items with correct answer rate above 50.0% (3 items) and the LARC knowledge score of the female adolescents between the two groups (P>0.05). The number of items with correct answer rate above 50.0% (10 items) and the knowledge score of intrauterine device (10.0±2.0) of the female adolescents in the observation group after intervention were significantly better than those (5 items and 6.3±1.8) of the female adolescents in the control group (P<0.05), and which of the female adolescents in the observation group after intervention had significantly different from those before intervention (P<0.05). The rate of LARC used after abortion immediately (51.5%), the continuation rate (48.5%), the discontinuation rate (2.9%)， and the satisfaction of contraceptive effect (97.1%) of the female adolescents in the observation group after intervention were significantly better than those (13.6%, 9.1%, and 72.2%) of the female adolescents in the control group (P<0.05). There was no significant difference in repeated abortion rate (0.8% vs. 2.3%) of the female adolescents between the two groups (P>0.05). Conclusion：Caring education and follow-up management can help to improve the female adolescents to aware LARC knowledge and to use LARC after abortion immediately，which can also improve the continuation rate of LARC，reduce the discontinuation rate of LARC，and increase the satisfaction of the contraceptive effect of the female adolescents.

2022 Vol. 30　(5):　1187- [Abstract]（ 379 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To evaluate the efficacy of balloon dilation and injection of sodium hyaluronate combined with artificial cycle therapy for preventing the intrauterine readhesion of patients with severe intrauterine adhesion after the uterine separative operation. Methods：124 patients with severe intrauterine adhesions who had been given sodium hyaluronate injected into the uterine cavity and a 3-5ml balloon inserted for supporting the uterine cavity after hysteroscopic adhesions separation operation were involves in this study from June 2017 to June 2020. 60 patients in the observation group were given balloon dilatation in the first and the second week after operation，and 64 patients in the control group were not given balloon dilatation. All the patients in the two groups were treated with high-dose estrogen combined with artificial cycle. The recovery of uterine cavity and the menstrual situation of the patients in the two groups were followed up. Results：The rate of intrauterine readhesion (18.3%) of the patients in the observation group within 1 month after operation was significantly lower than that (40.6%) of the patients in the control group. The rate of menstrual improvement (83.3%) of the patients in the observation group was significantly higher than that (59.4%) of the patients in the control group (all P<0.05). Conclusion: Hysteroscopic intrauterine adhesion separation combined with postoperative balloon dilatation for treating the patients with severe intrauterine adhesions can significantly prevent their intrauterine readhesion, and can improve their menstrual recovery.

2022 Vol. 30　(5):　1196- [Abstract]（ 280 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

Periostin is an extracellular matrix protein，which is expressed in many tissues and organs of the human body and participates in the physiological and pathological regulation of the body through a variety of cytokines and signal pathways. In recent years， Periostin has been confirmed to play an important role in the female reproductive system. In the endometrium，the expression of Periostin is regulated by ovarian steroid hormones, and it can be used as a marker of endometrial receptivity，which also plays an important role in the progression of embryonic implantation and pregnancy. Meanwhile, Periostin is involved in the regulation of endometriosis，and which is highly expressed in the patients with uterine fibroids and polycystic ovary syndrome. Periostin plays an important role in the invasion and the metastasis of endometrial，cervical, and ovarian cancers. This article reviews the studies related to the expression and role of Periostin in the female reproductive system and its influences on the pregnancy of female systematically.

2022 Vol. 30　(5):　1204- [Abstract]（ 632 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )