To explore the potential mechanism of mulberry parasitic- teasel root for treating polycystic ovary syndrome (PCOS) by network pharmacology. Methods: The active components of mulberry parasitic- teasel root were retrieved in traditional Chinese medicine systematic pharmacological database platform (TCMSP), and all the targets of which were predicted. The genes were standardized by uniprot database. The PCOS related targets were obtained in the OMIM and Genecards databases. The drug and disease targets were merged to take the intersection and display as a Venn diagram. The network map of drugcomponent-disease-target was built by Cytoscape 3.7.2 software. The protein interaction PPI network map was built by STRING database, and the core target network map of drug-disease was also built by Cytoscape 3.7.2 software. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) of the shared targets were analyzed by DAVIDA database. Results: A total of 10 active ingredients of mulberry parasitic-teasel root were obtained after screening, 105 targets were predicted, and 2164 targets of PCOS were obtained. A total of 77 drug-disease targets were obtained by Venn diagrams, and of which, VEGFA, IL6, TP53, PTGS2, MAPK1, JUN, TNF, IL1B, EGF, EGFR, CCL2, and other targets played the key roles in the treatment of PCOS by mulberry parasiticteasel root. GO and KEGG enrichment analysis yielded 126 biological items  and 17 signaling pathways, of which, GO biological items involved in the positive regulations of nitric oxide biosynthetic process, cell proliferation, the extracellular space, the receptor activities of enzyme binding, steroid binding, steroid hormone, and other biological processes. KEGG pathway enrichment analysis found that the target genes were mainly enriched in estrogen signaling pathway, HIF-1 signaling pathway, TNF signaling pathway, PI3K-Akt signaling pathway, cancer signaling pathway, and other signaling pathways. Conclusion: The treatment of PCOS by mulberry parasitic- teasel root has the characteristics of multiple components, multiple targets, and multiple pathways, which provides a theoretical basis for further study the action mechanism.

2022 Vol. 30　(7):　1466- [Abstract]（ 329 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

 To explore the current situation of free contraceptive service in Guangdong province, and to provide scientific evidences for formulating the next step of the management plans of the contraceptive service. Methods: The contraceptives of free distribution in the cities of Guangdong province from 2019 to 2021 was analyzed and was compared with the population of childbearing age of Guangdong Province according to data of the 7th national population census. Results: Affected by the decrease of the distribution of free contraceptives in Guangzhou, the distribution of free contraceptives in Guangzhou city had showed the downward trend, with an average decrease of 3.6%. In terms of region, the distribution of the free contraceptives in Pearl River Delta region (except Guangzhou and Zhuhai), the eastern and western regions and mountainous areas had risen in 2021 significantly, but the coverage rate of the free contraceptives in Guangdong province only accounted for 1.45% of the population of childbearing age. Conclusion: The free contraceptive service of Guangdong province is affected by the level of regional economic development, which has presented the phenomenon of low social coverage and unbalanced service. So, it is necessary to formulate targeted plans according to local conditions, so as to improve the social coverage and balance of free contraceptives service.

2022 Vol. 30　(7):　1476- [Abstract]（ 475 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To know the satisfaction status of population of childbearing age for free contraceptives in Sichuan province, and to analyze its influencing factors. Methods: Multi-stage stratified sampling was used to select the survey sites and quota sampling was used to determine the respondents. A total of 9395 people aged 1560 years in Sichuan province were selected, and self-designed electronic questionnaire was used to conduct the survey. A total of 3186 respondents (1108 men and 2078 women) had used free contraceptives in the past year, so which were investigated the current situation of satisfaction for free contraceptives only. At the same time, for 2901 respondents (1108 men and 1793 women) who had used free condoms, multi-level logistic regression models were constructed to analyze the influence factors of the satisfaction for free contraceptives. Results: The respondents were highly satisfied with various aspects of different types of the free contraceptives, including the pick-up location, the distribution frequency, the ways of receiving, the quality, and the guidance and consulting services on contraceptives used, most of which were above 80%. However, the respondents were less satisfied with the quality of free condoms, the service location and quality of implants and intrauterine devices, and the service attitude of the providers, which were all lower than 80%. Age was a common influencing factor that was related to men's and women's satisfaction with pick-up location, distribution frequency, quality, and consulting services of the free condoms, and was related to men's satisfaction with the receiving ways of free condoms. Occupation, marital status, family monthly income per capita, and education level were also the influence factors that were related to satisfaction of the free contraceptives in some aspects. Conclusion: The respondents are highly satisfied with the services related to free contraceptives service in Sichuan province, but the attitude of the service providers, the quality of contraceptives, the privacy protection of pickup contraceptives, and the publicity of the free contraceptive policy need to be improved. In addition, the pick-up location, the distribution frequency, and the receiving ways of the free condoms should keep pace with times and should take full account of the needs of young people.

2022 Vol. 30　(7):　1484- [Abstract]（ 670 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To investigate the situation of induced abortion among women who have given birth in Wuzhishan city, and to analyze its related influencing factors. Methods: The pregnant women with given birth history who wanted abortion in the outpatient department were selected as the investigation objects, and were divided two groups (surgical abortion group or medical abortion group). Questionnaires were delivered to collect the related information of these women, such as demographic data, contraceptive behavior, and sexual behavior. The survey results of the women were compared between the two groups, and the influencing factors of abortion were analyzed. Results: There were no statistically significant difference in the domicile and occupation situations of the women between the two groups (P>0.05). The proportion of repeated abortion of the women with 35-39 years old or ≥40 years old, the women with junior middle school education or below, the women with two children, or the women without pregnancy planning in the future was significantly higher (P<0.05). The proportion of repeated abortion of the women with "whether contraception used in the first sexual life", the women with "contraceptive method in the first sexual life", the women with "contraceptive method in the last 3 months", or the women with "whether contraception used in this sex life leaded to pregnancy "  had no statistically significant difference (P>0.05). The proportion of repeated abortion of the women without contraception used in the last 3 months or the women with sex life more than 3 times per week were significantly higher (P<0.05). There were no significant differences in the abortion knowledge score and the abortion attitude score between the women with or without repeated abortion (P>0.05). Logistic regression analysis showed that high education level was the protective factor of the repeated abortion of the women with given birth history, but the more children, no future birth plan, and high frequency of sexual intercourse were the risk factors of their repeated abortion. Conclusion: Repeated abortion is more common in women who have given birth in Wuzhishan city. The education level, the number of children, and the frequency of sexual life of the women who have given birth are the main factors affecting their repeated induced abortion.

2022 Vol. 30　(7):　1496- [Abstract]（ 529 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To explore the clinical effect of two kinds of intrauterine devices (IUD) inserted immediately after painless abortion. Methods: 112 women who wanted voluntary IUD inserted immediately after painless abortion were selected and were divided into group A (56 women with indomethacin fixed IUD inserted) and group B (56 women with active γ IUD inserted) from October 2017 to October 2019. The postoperative pregnancy situation, and the rates of IUD discharged, IUD continuation used, and adverse reactions of the women in the two groups were followed up for 1 year after abortion. Results: The pregnant rates (1.8%), IUD discharged (0), IUD continuation used (91.1%), and the adverse reactions of IUD (8.9%) of the women in group A within 1 year after abortion had no significantly different from those (0, 1.8%, 89.3%, and 10.7%) of the women in group B (all P>0.05). Conclusion: Both indomethacin fixed IUD and active γIUD inserted immediately after painless abortion have good contraceptive effect with the same contraceptive effectiveness.

2022 Vol. 30　(7):　1507- [Abstract]（ 812 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

2022 Vol. 30　(7):　1514- [Abstract]（ 313 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

2022 Vol. 30　(7):　1525- [Abstract]（ 455 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

2022 Vol. 30　(7):　1534- [Abstract]（ 415 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

2022 Vol. 30　(7):　1543- [Abstract]（ 242 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the effects of low sugar diet combined with isometric resistance exercise during the treatment of pregnant women with gestational diabetes mellitus (GDM) and pregnancy outcomes. Methods: 82 pregnant women with GDM were selected and were divided in two groups according to their wishes and the matched of their basic clinical data from March 2019 to September 2020. 40 women in the control group had received conventional treatment, while 42 women in the study group had received conventional treatment combined with low sugar diet and long-term resistance exercise. The clinical effects of the women were compared between the two groups. Results: The blood glucose control level of the women in both groups after treatment had decreased significantly, but the fasting blood glucose level (5.20±0.38 mmol/L), the postprandial 2h blood glucose level (6.49±0.35 mmol/L), and the glycosylated hemoglobin level (5.34%±0.53%) of the women in the study group were significantly lower than those (5.63±0.41 mmol/L, 6.96±0.39 mmol/L, and 5.83%±0.49%) of the women in the control group. The improvement of hemodynamic indexes of umbilical artery of the women in the study group was significantly higher than those of the women in the control group. The incidence of adverse pregnancy outcomes (4.8%) of the women in the study group was significantly lower than that (27.5%) of the women in the control group (all P<0.05). There were no significant differences in the values of body weight and body mass index of the women after delivery between the two groups (P>0.05). Conclusion: Low sugar diet combined with long-term resistance exercise of pregnant women with GDM can significantly improve their blood glucose level, and can promote the recovery of their umbilical artery hemodynamics, and can improve their pregnancy outcomes.

2022 Vol. 30　(7):　1551- [Abstract]（ 217 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the value of transvaginal color Doppler ultrasound combined with serum β-human chorionic gonadotropin (β-HCG) level of women for diagnosing their uterine incision pregnancy. Methods: From February 2018 to November 2021, 90 women with suspected uterine incision pregnancy were selected as the research objects, which included 46 cases with normal pregnancy in group A and 44 cases with uterine incision pregnancy in group B after confirmed by surgical pathology. Enzyme linked immunosorbent assay (ELISA) was used to detect the level of serum β-HCG of these women, and the sac situation of these women was examinated by transvaginal color Doppler ultrasound. The consistency of results of transvaginal color Doppler ultrasound or serum β-HCG level, and clinical pathological for diagnosing uterine incision pregnancy was analyzed. And the values of transvaginal color Doppler ultrasound, the serum β-HCG level, and the examination of ultrasound combined with serum β-HCG level for diagnosing uterine incision pregnancy were also analyzed. Results: The level of serum β-HCG (1768.24±421.74 U/L) of the patients in group B was significantly higher than that (1020.83±302.44 U/L) of the patients in group A (P<0.05). Transvaginal color Doppler ultrasound and serum β-HCG level confirmed uterine incision pregnancy in 37 cases and 34 cases, respectively, which had high consistency with the clinicopathological diagnosis of uterine incision pregnancy (Kappa=0.710, 0.598, all P<0.05). 41 cases with uterine incision pregnancy were confirmed by the combination of transvaginal color Doppler ultrasound and the serum β-HCG level, which had excellent consistency with the clinicopathological diagnosis (Kappa=0.889, P<0.05). The sensitivity (90.9%), the accuracy (94.4%), and the negative predictive value (91.8%) of the combination of transvaginal color Doppler ultrasound and the serum β-HCG level for diagnosing uterine incision pregnancy were significantly higher than those of the serum β-HCG level or ultrasound alone, and the missed diagnosis rate (2.2%) of the combination of transvaginal color Doppler ultrasound and serum β-HCG level for diagnosing uterine incision pregnancy was significantly lower than that of the serum β-HCG level or ultrasound alone (all P<0.05). Conclusion: Transvaginal Color Doppler ultrasound combined with serum β-HCG level for diagnosing uterine incision pregnancy can effectively increase the diagnostic rate, and  decrease the missed diagnosis rate.

2022 Vol. 30　(7):　1560- [Abstract]（ 359 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the maternal and fetal circulation situation evaluated by the uterine artery blood flow indexes of ultrasonography, and to study their correlation with the pregnancy outcomes of the women. Methods: A total 69 pregnant women with preeclampsia were included as the research subjects from March 2018 to March 2021, which included 34 cases with mild preeclampsia in group A and 35 cases with severe preeclampsia in group B. In addition, 30 normal pregnant women were included in group C during the same time. The maternal and fetal blood flow parameters, the maternal-fetal circulation indicators by ultrasound, and the perinatal prognosis indicators in the three groups were examined. The blood flow parameter indexes included resistance index (RI) and pulsation index (PI) of umbilical artery and middle cerebral artery, maximum flow velocity (Vmax), internal diameter (Duv), and the ratio of peak systolic flow velocity to peak diastolic flow velocity (S/D) of venous and umbilical artery. The maternal and fetal circulation indicators by ultrasound included uterine artery PI, umbilical artery PI, middle cerebral artery PI, fetal venous catheter venous pulsation index (PIV), and cerebral placental blood flow ratio (CPR). And the perinatal prognosis indicators included gestational weeks at delivery, neonatal body weight, 5-minute Apgar score, umbilical artery PH, and placental weight. The blood flow parameters of fetus with different pregnancy outcomes were analyzed. The correlation between the fetal blood flow parameters and the adverse prognosis of the perinatal infants was analyzed by logistic regression. Results: The venous catheter diversion rate, and the values of umbilical artery PI, umbilical artery RI, and umbilical artery S/D in group B were significantly higher than those in group A and group C, and the values of middle cerebral artery PI, RI, and S/D in group B were significantly lower than those in group A and in group C (P<0.05). The values of uterine artery PI and umbilical artery PI in group B were significantly higher than those in group C and in group A, and the values of middle cerebral artery PI and CPR in group B were significantly lower than those in group C and in group A (P<0.05). The gestational weeks at delivery, the birth weight, the umbilical artery PH, Apgar score, and the placental weight of the perinatal infants in group B were significantly lower than those the perinatal infants in group A and in group C (P<0.05). Among 69 infants delivered by the pregnant women with preeclampsia, there were 21 cases (30.4%) with adverse outcomes. The venous catheter diversion rate, and the umbilical artery PI, umbilical artery RI, and umbilical artery S/D of the infants with adverse outcomes were significantly higher than those of the infants with normal pregnancy outcomes (P<0.05). Regression analysis showed that adverse perinatal prognosis was significantly correlated with the fetal venous catheter diversion rate, the values of PI, RI, and S/D of umbilical artery and middle cerebral artery (P<0.05). Conclusion: The ultrasound examinations of hemodynamic parameters of uterine artery of the pregnant women with preeclampsia, and the fetal umbilical artery, and the fetal middle cerebral artery and venous catheter can provide evidences for assessing fetal intrauterine conditions accurately in clinic, and which has certain correlation with the adverse pregnancy outcomes of the women with pregnancy induced hypertension.

2022 Vol. 30　(7):　1569- [Abstract]（ 293 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the effect of nifedipine combined with labetalol for treating pregnant women with hypertension during pregnancy, and to study its influence on the serum adiponectin level and blood viscosity of the women. Methods: A total of 60 pregnant women with hypertension during pregnancy were selected and were randomly divided into two groups (30 cases in each group) from October 2019 to May 2021. The women in the control group were treated with labetalol, and the women in the observation group were treated with nifedipine combined with labetalol. The blood viscosity situation, the blood urea nitrogen level, the 24h urine protein quantification value, the serum adiponectin level, the high-sensitivity C-reactive protein (hs-CRP) level, the leucine aminopeptidase (LAP) level, the clinical efficacy, and the incidence of adverse reactions of the women were compared between the two groups. Results: The blood viscosity, the levels of serum urea nitrogen, hs-CRP, 24h urine protein quantitation, and the values of diastolic blood pressure and systolic blood pressure of the women in the two groups after treatment had decreased significantly, and which of the women in the observation group were significantly lower than those of the women in the control group. The levels of serum adiponectin and LAP of the women in the two groups after treatment had increased significantly, and which of the women in the observation group were significantly higher than those of the women in the control group (all P<0.05). The clinical efficacy (90.0%) of the women in the observation group was significantly higher than that (63.3%) of the women in the control group (P<0.05). There was no significant difference in the total incidence (30.0% vs. 13.3%), such as loss of appetite, lower extremity edema, dizziness and fatigue, of the women between the two groups (P>0.05). Conclusion: Nifedipine combined with labetalol in the treatment of hypertension during pregnancy of the women can effectively regulate their blood viscosity, reduce their inflammation response, increase their serum adiponectin and LAP levels, reduce their vascular endothelial damage, and improve their safe and effective of clinical treatment.

2022 Vol. 30　(7):　1577- [Abstract]（ 500 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

2022 Vol. 30　(7):　1586- [Abstract]（ 635 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To analyze the effects of anterior quadratus lumborum and pudendal nerve block combined with general anesthesia during ovarian cancer operation of patients on their perioperative stress indicators and prognostic sexual function. Methods: The clinical data of 82 patients undergoing radical resection of ovarian cancer from January 2018 to December 2019 were collected, which included 43 cases with anterior quadratus lumborum and pudendal nerve block combined with general anesthesia in observation group and 39 cases with anterior quadratus lumborum block combined with general anesthesia in control group. The situations of operation and anesthesia-related adverse reactions of the patients in the two groups were recorded. The stress response stutas, such as the levels of cortisol (COR), norepinephrine (NE) of the patients before surgery and in the 1st day after surgery, and the quality of life evaluated by Functional Assessment of Cancer Therapy-Ovary Cancer (FACT-O) of the patients before surgery and in the 6th month after surgery were compared between the two groups. The changes of postoperative sexual life recovery and sexual function of the patients in the two groups were evaluated by Chinese Version of Female Sexual Function Index (CV-FSFI). Results: The intraoperative dosage of sufentanil (10.06±1.89μg) and the postoperative analgesia rate remedied (2.3%) of the patients in the observation group were significantly lower than those (11.53±2.11μg and 20.5%) of the patients in the control group. The time to wake up, the time to get out of bed for the first time, and the time to exhaust for the first time of the patients in the observation group were significantly lower than those of the patients in the control group. The incidence of anaesthesia related adverse reactions (16.3%) of the patients in the observation group was significantly lower than that (38.5%) of the patients in the control group (P<0.05). The levels of COR and NE of the patients in both groups in the 1st day after operation had increased significantly, and which of the patients in the control group were significantly higher than those of the patients in the observation group (P<0.05). There were no significant differences in FACT-O score in different dimensionality, the postoperative sexual recovery time, and the CV-FSFI score of the patients between the two groups (P>0.05). The physiological status and FACT-O score of functional status of the patients in both groups in the 6th month after operation were significantly higher than those before operation, while social/family status and FACt-O scores of emotional status of the patients in both groups in the 6th month after operation were significantly lower. CV-FSFI scores of the patients in both groups in the 12th month after operation were significantly lower than those before operation (all P<0.05). Conclusion: Anterior quadratus lumborum and pudendal nerve block combined with general anesthesia during radical resection of ovarian cancer has good analgesic effect, which can reduce the anesthetic dosage, decrees the risk of adverse reactions, and relieve the postoperative stress response. The decrease of the postoperative sexual function should be paid attention to in clinical practice.

2022 Vol. 30　(7):　1595- [Abstract]（ 462 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To study the correlation between the levels of fatty acid binding protein 4 (FABP4) and monocyte chemoattractant protein-1 (MCP-1) of women with polycystic ovary syndrome (PCOS) and their sex hormone level and their lipid metabolism. Methods: 119 women with PCOS were selected in study group and 107 healthy women underwent health examination were selected in control group from Jan 2020 to May 2021. The levels of FABP4 and MCP-1, the levels of sex hormones, such as luteinizing Hormone (LH)/Follicle Stimulating Hormone (FSH), testosterone (T), estradiol (E2), and prolactin (PRL), and the levels of the lipid metabolism indexes, such as total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C), of the women were compared between the two groups. The correlations between the levels of FABP4 and MCP-1 of the women with PCOS and their sex hormone level and their lipid metabolism were analyzed. Results: The levels of FABP4 (23.67±5.74 ng/ml) and MCP-1 (107.46±18.35 ng/L) of the women in the study group were significantly higher than those (8.52±2.31 ng/ml and 59.72±10.57 ng/L) of the women in the control group, and the LH/FSH value and the T level of the women in the study group were significantly higher than those of the women in the control group (all P<0.05). There were no significant differences in the E2 and PRL levels of the women between the two groups (P>0.05). The serum TG level of the women in the study group was significantly higher than that of the women in the control group, and the HDL-C level of the women in the study group was significantly lower than that of the women in the control group (all P<0.05), but there were no significant differences in the TC and LDL-C levels of  the women between the two groups (P>0.05). Spearman correlation analysis showed that the levels of FABP4 and McP-1 of the women were positively correlated with their LH/FSH value and their T and TG levels, while were negatively correlated with their HDL-C level (all P<0.05). Conclusion: The expressions of serum FABP4 and McP-1 of the pregnant women with PCOS increase abnormally, which are related to the levels of their sex hormone and lipid metabolism indexes, and can be used to reflect the changes of their sex hormone and lipid metabolism indexes levels.

2022 Vol. 30　(7):　1604- [Abstract]（ 282 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To investigate the correlation between the distribution of intestinal flora of infertile patients with polycystic ovary syndrome (PCOS) and their levels of serum sex hormones, thyroid-stimulating hormone (TSH), adipokines visceral fat-specific serine protease inhibitor (Vaspin), and Apelin. Methods: 82 infertility patients with PCOS were selected in study group and another 82 women with infertile due to abnormal fallopian tubes were selected in control group from January 2019 to January 2022. The content of intestinal flora, and the levels of luteinizing hormone (LH), testosterone (T), TSH, estradiol (E2), Vaspin, and Apelin of the women were detected and were compared between the two groups. The correlation between the content of intestinal flora of the women in the study group and their levels of serum LH, T, E2, FSH, TSH, Vaspin, and Apelin was analyzed. Results: The contents of intestinal bifidobacteria (8.64±0.82 lg CFU/g) and lactobacillus (9.22±0.84 lg CFU/g) of the women in the study group were significantly lower than those (9.92±0.94 lg CFU/g and 9.89±0.90 lg CFU/g) of the women in the control group, but the contents of intestinal enterococcus (8.25±0.79 lg CFU/g) and enterobacter (9.14±0.87 lg CFU/g) of the women in the study group were significantly higher than those (7.08±0.67 lg CFU/g and 7.21±0.69 Lg CFU/g) of the women in the control group. The levels of serum LH, T, E2, FSH, TSH, Vaspin, and Apelin of the women in the study group were significantly higher than those of the women in the control group (all P<0.05). The contents of bifidobacterium and lactobacillus of the women in the study group were negatively correlated with their levels of serum LH, T, TSH, Vaspin, and Apelin, while the contents of enterococcus and enterobacter of the women in the study group were positively correlated with their levels of serum LH, T, TSH, Vaspin, and Apelin (all P<0.05). Conclusion: The intestinal flora of the infertility women with PCOS is disorder, and which is significantly correlated with the levels of serum LH, T, TSH, Vaspin, and Apelin of the women.

2022 Vol. 30　(7):　1612- [Abstract]（ 333 ） HTML (0 KB)  PDF  (0 KB)  ( 51 )

To analyze the high risk factors of abnormal lipid metabolism of pregnant women with gestational diabetes mellitus (GDM) and normal pre-pregnancy body mass index (BMI), and to study their predictive value. Methods: From October 2018 to October 2020, 167 pregnant women with GDM and normal pre-pregnancy BMI were selected in observation group, and 180 pregnant women with normal glucose tolerance were selected in control group. According to the occurrence of abnormal lipid metabolism, the pregnant women in the observation group were further divided into group A (53 women with abnormal lipid metabolism) and group B (114 women with normal lipid metabolism). The incidence and high risk factors of abnormal lipid metabolism of the pregnant women with GDM were analyzed. The predictive value of clinical indicators of the pregnant women with GDM during the first trimester of pregnancy for their abnormal lipid metabolism was explored. Results: The incidence of abnormal lipid metabolism (30.5%) of the women in the observation group was significantly higher than that (6.1%) of the women in the control group (P<0.001). The proportions of age ≥40 years old, multiple fetus, polycystic ovary syndrome (PCOS), hypertensive disease during pregnancy, poor blood glucose control, and GDM with abnormalities of 3 items, and the levels of fasting insulin, thyroid stimulating hormone, serum transferring, and triglyceride of the women in group A were significantly higher than those of the women in group B (all P<0.05). There were no significant differences in the gravidity, the proportions of parturient women and the women with assisted reproductive technology, and the levels of serum total cholesterol, high density lipoprotein, and low density lipoprotein of the women between the two groups (all P>0.05). Age ≥40 years old, PCOS, hypertensive disease during pregnancy, poor blood glucose control, and abnormal elevation of the levels of serum fasting insulin, thyroid stimulating hormone, and transferrin of the pregnant women with GDM were the independent risk factors of their abnormal lipid metabolism (P<0.05). The levels of fasting insulin and serum transferrin of the pregnant women with GDM had predictive efficacy for their abnormal lipid metabolism (P<0.05), the area under the curve of which were 0.861 and 0.894, and the cut-off values of which were 12.8mU/L and 447.95mg/dl. Conclusion: The incidence of abnormal lipid metabolism of the pregnant women with GDM and normal pre-pregnancy BMI is still higher than that of the normal pregnant women, which should be paid more attention to in clinic. Some clinical indicators of the women during the first trimester of pregnancy can help predicting the risk of their abnormal lipid metabolism.

2022 Vol. 30　(7):　1621- [Abstract]（ 358 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To explore the changes of the blood lipid metabolism and the levels of peripheral blood soluble vascular growth factor receptor-1 (sFlt-1) and soluble endothelial factor (sEng) of pregnant women with preeclampsia (PE), and to analyze the correlation between the blood lipid metabolism of the women with their PE. Methods: A total of 124 pregnant women with PE were selected in study group and 117 normal pregnant women were enrolled in control group between January 2019 and January 2021. The blood lipid metabolism indicators and the levels of peripheral blood sFlt-1 and sEng of the women were compared between the two groups, and among the women with different clinical types of PE. Results: The levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), sFlt -1, and sEng of the women in the study group were significantly higher than those of the women in the control group, while the levels of serum high density lipoprotein cholesterol (HDL-C) and apolipoprotein A (ApoA) of the women in the study group were significantly lower than those of the women in the control group. The levels of serum TC, TG, LDL-C, sFlt, and sEng of the women with severe PE were significantly higher than those of the women with mild or moderate PE, and the levels of serum TC, TG, LDL-C, sFlt -1, and sEng of the women with late onset PE were significantly lower than those of the women with PE early onset PE (all P<0.05). Multiple linear regression analysis showed that the levels of sFlt-1 and sEng of the women with PE were positively correlated with their levels of TC, TG, and LDL-C (P<0.05), but which had no correlation with their levels of HDL-C and ApoA (P>0.05). Conclusion: The pregnant women with EP have abnormal blood lipid metabolism and the elevated peripheral blood sFlt-1 and sEng levels. The blood lipid metabolism indicators of the pregnant women with EP are correlated with their sFlt-1 and sEng levels, and which may be involved in the occurrence and development of their PE.

2022 Vol. 30　(7):　1631- [Abstract]（ 264 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

 To explore the correlation between vaginal microecology of pregnant women during the third trimester of pregnancy and their adverse pregnancy outcomes. Methods: The clinical data of 70 pregnant women during the third trimester of pregnancy from January 2019 to May 2020 were selected in this study. The vaginal secretions of these women collected to evaluate their vaginal microecological environment. These women were divided into the women with abnormal vaginal microecology in study group and the women with normal vaginal microecology in control group. The adverse pregnancy outcomes of the women were compared between the two groups. Results: Among these 70 women, there were 22 (31.4%) women with normal vaginal microecology, and 48 (68.6%) women with abnormal vaginal microecology, which included 10 (14.3%) cases with simple abnormal microecology, 14 (20.0%) cases with BV, 9 (12.9%) cases with TV, 7 (10.0%) cases with VVC, and 8 (11.4%) cases with mixed infection. The incidences of premature delivery (29.2%), intrauterine infection (33.3%), premature rupture of membranes (22.9%), low neonatal weight (31.3%), neonatal asphyxia (29.2%), and neonatal infection (25.0%) in the study group were significantly higher than those (4.6%, 0, 0, 0, 4.6%, and 0) in the control group (P<0.05), and there were no significant differences in the incidences of puerperal infection and postpartum hemorrhage of the women between the two groups (P>0.05). The incidences of premature delivery, intrauterine infection, and low neonatal weight of the women with BV, TV, VVC, or mixed infection were significantly higher than those of the women with simple abnormal vaginal microecology (P<0.05), but there were no significant differences in the incidences of premature rupture of membranes, puerperal infection, postpartum hemorrhage, neonatal asphyxia, and neonatal infection between the women with BV, TV, VVC, or mixed infection and the women with simple abnormal vaginal microecology (P>0.05). Conclusion:  The rate of the abnormal vaginal microecological environment of the pregnant women during the third trimester of pregnancy is high, which is closely related to their adverse pregnancy outcomes. It is important to pay attention to the vaginal microecological environment of the pregnant women during the third trimester of pregnancy, so as to prevent their adverse pregnancy outcomes.

2022 Vol. 30　(7):　1639- [Abstract]（ 286 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the changes of plasma antithrombin III (AT-III), activity protein C (PC) and protein S (PS) of women with recurrent spontaneous abortion (RSA), and to study the value of activity changes of plasma AT-III, PC, and PS for predicting RSA of the women. Methods:100 women with RSA (miscarriage >2 times) were selected in group A, 100 women with the first miscarriage were selected in group B, and 100 women with normal pregnancy and without history of miscarriage were selected in group C from January 2019 to March 2020. The levels of plasma AT-III, PC, and PS of the women were detected and were compared among the three groups. Results: The levels of plasma AT-III, PC, and PS activity of the women in group A, in group B, and in group C had increased gradually (P<0.05). The receiver operator characteristic (ROC) curve analysis showed that the optimal critical value of the plasma AT-III level for predicting RSA was 92.1%, the area under curve (AUC) of ROC of which was 0.779, the sensitivity of which was 83.7%, and the specificity of which was 64.9%. The optimal critical value of the plasma PC level for predicting RSA was 89.47%, AUC of ROC of which was 0.704, the sensitivity of which was 72.3%, and the specificity of which was 77.5%. The optimal critical value of the plasma PS level for predicting RSA was 84.3%, AUC of ROC of which was 0.752, the sensitivity of which was 79.2%, and the specificity of which was 70.3%. Conclusion: The activities of plasma AT-III, PC, PS of the women with RSA decrease abnormally, which suggests that there is a tendency to hypercoagulability of blood of these women. The detections of the plasma AT-III, PC and PS activity have clinical value for predicting RSA of the women.

2022 Vol. 30　(7):　1648- [Abstract]（ 312 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To analyze the value of ultrasonography combined with the levels of serum carcino-embryonic antigen (CEA) and cytokerantin 19-fragment (Cyfra21-1) for differentiating benign or malignant of ovarian unilocular tumors serum. Methods: From January 2019 to December 2020, 185 patients with unilocular cystic and nonhomogeneous mass of ovary were selected as the research subjects, and these patients were examined by ultrasonography, and were detected of serum CEA and Cyfra21-1. Based on the pathological results as the gold standard, the values of ultrasonography combined with the levels of serum CEA and Cyfra21-1 for differentiating benign or malignant of ovarian unilocular tumors were analyzed. Results: The levels of serum CEA and C yfra21- 1 of the patients with benign of ovarian unilocular tumors were significantly higher than those of the patients with benign of ovarian unilocular tumors (P<0.001). The coincidence rate of the results by ultrasonography combined with the levels of serum CEA and CyFRA21-1 for diagnosing malignant of ovarian unilocular tumors and the pathological diagnosis was 94.6%. The Kappa value, the sensitivity, the specificity, the positive predictive value, and the negative predictive value of the ultrasonography combined with the levels of serum CEA, CyFRA21-1 for diagnosing malignant of ovarian unilocular tumors were 94.6%, 0.88, 92.3%, 95.8%, 92.3%, and 95.8%, respectively, which were significantly higher than those of ultrasonography, serum CEA level, or serum C yfra21-1 level alone (P<0.05). There were no significant differences in the sensitivity, the specificity, the positive predictive value, and the negative predictive value for diagnosing malignant of ovarian unilocular tumors among ultrasonography, serum CEA level, and  serum Cyfra21-1 level (P>0.05). The receiver operation characteristic curve showed that ultrasonography combined with the levels of serum CEA and Cyfra21-1 had better differentiation efficacy for benign or malignant ovarian unilocular tumors, while the efficacy of ultrasonography, the serum CEA level, or the serum Cyfra21 level alone for differentiation of benign or malignant ovarian unilocular tumors was common. For the ovarian tumors with diameter <5cm and ≥5cm, the sensitivity and the specificity of ultrasonography combined with the levels of serum CEA and Cyfra21-1 for differentiating benign or malignant ovarian unilocular tumors were significantly higher than those of ultrasonography, the serum CEA level, or the serum Cyfra21 level alone (P<0.05). For the ovarian tumors with diameter <5cm, the sensitivity and the specificity of the serum CEA and CyFRA21-1 levels for differentiating malignant tumors were significantly higher than those of ultrasonography (P<0.05). For the ovarian tumors with diameter ≥5cm, there were no significant differences in the sensitivity and the specificity of the identification of the benign or malignant ovarian tumors among the serum CEA level, the serum Cyfra21-1 level, and ultrasonography (P<0.05). Conclusion: Differentiation efficacy for benign or malignant ovarian unilocular tumors of ultrasound combined with the serum CEA and Cyfra21-1 levels is better than that of ultrasonography, the serum CEA level, or the serum Cyfra21 level alone, especially for the tumors with shorter diameter has higher differentiation efficacy.

2022 Vol. 30　(7):　1655- [Abstract]（ 305 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To analyze the values of the levels of serum carbohydrate antigen 125 (CA125), progesterone (P), and anti-Müllerian hormone (AMH) for diagnosing ectopic pregnancy and for predicting the drug treatment efficacy. Methods: 76 women with ectopic pregnancy who had been diagnosed and treated were selected in study group, and 76 healthy pregnant women who received physical examination were selected in control group from October 2019 to October 2021. The levels of serum CA125, P, and AMH of the women in the two groups were detected. The women in the study group were divided into group A (women with effectively drug treatment) and group B (women without effectively drug treatment) according to the efficacy of drug after 1 month treatment. Receiver operating characteristic (ROC) curve was drawn to evaluate the values of the serum CA125, P, AMH levels for diagnosing ectopic pregnancy and for predicting the therapeutic efficacy. Results: The level of serum CA125 (32.57±4.31 IU/ml) of the women in the study group was significantly higher than that (26.74±3.78 IU/ml) of the women in the control group. The levels of AMH (106.71±10.26 ng/ml) and P (31.75±3.89 ng/ml) of the women in the study group were significantly lower than those (115.62±12.14 ng/ml and 35.49±4.21 ng/ml) of the women in the control group (all P<0.05). ROC curve showed that the sensitivity and specificity of the CA125 level for diagnosing ectopic pregnancy were the highest, and the sensitivity of AMH level for diagnosing ectopic pregnancy was significantly higher than that of P level, while the specificity of AMH level for diagnosing ectopic pregnancy was significantly lower that of P level. The diagnostic value of the combination of the levels of CA125, AMH, and P was the highest, and the area under the curve of which was 0.953. After 1 month of treatment, 61 (80.3%) women in the study group had effectiveness. The serum CA125 level of the women in group A was significantly lower than that of the women in group B, and the serum AMH and P levels of the women in group A were significantly higher than those of the women in group B (all P<0.05). ROC curve showed that the sensitivity of the serum P level for predicting the treatment effect was the highest, the specificity of the CA125 level for predicting the treatment efficacy was the highest. The combination of the levels of CA125, AMH, and P had the highest value for predicting the treatment efficacy, the area under the curve of which was 0.958. Conclusion: The level of serum CA125 of the women with ectopic pregnancy increase abnormally, and their levels of AMH and P decrease abnormally. The levels of serum CA125, AMH, and P are all the effective indicators for diagnosing ectopic pregnancy and predicting the efficacy of drug treatment. The combined detection of the levels of serum CA125, AMH, and P can improve the value of clinical guidance.

2022 Vol. 30　(7):　1664- [Abstract]（ 350 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To investigate the value of single nucleotide polymorphic microarray (SNP array) in prenatal diagnosis of fetal right aortic arch (RAA). Methods: A total of 151 fetuses diagnosed as RAA by ultrasound from January 2016 to December 2020 were collected. CNV of these fetuses was detected by SNP array, and the karyotype analysis of these fetuses was performed by G banding. Results: In 151 fetuses, there were 17 fetuses with abnormal chromosome karyotype with the detection rate of 11.26%, which included 2 cases with trisomy 21, 2 cases with trisomy 13, 1 case with trisomy 8 chimerism, 6 cases with 22Q deletion, 2 cases with Xp deletion, 1 case with suspected disease on chromosome 2, and 3 cases with chromosome microdeletion with unknown clinical significance. Conclusion: The fetal RAA during the second and third trimester of pregnancy in prenatal diagnosis is associated with their chromosomal abnormalities with the mainly chromosomal aneuploid syndrome and 22Q microdeletion. Meanwhile, molecular detection techniques, such as SNP array analysis, can find the pathogenic CNV, which can improve the diagnosis rate of genetic etiology of fetal RAA.

2022 Vol. 30　(7):　1672- [Abstract]（ 325 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )

To detect the antenatal plasma fibrinogen (Fib) level and thromboelastography (TEG) parameters of elderly pregnant women before cesarean section, and to analyze their predictive value for the postpartum hemorrhage of the women. Methods: A total of 232 elderly pregnant women (age ≥35 years old) who underwent cesarean section were selected as the research objects from March 2019 to March 2021. According to the definition of postpartum hemorrhage, these women were divided into group A (211 cases without postpartum hemorrhage) and group B (21 cases with postpartum hemorrhage). The levels of indexes of coagulation function, such as prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), and Fib, and the values of TEG parameters, such as coagulation reaction time (R), clot formation time (K), α angle, maximum amplitude (MA), and coagulation Index (CI), of the women in the two groups were detected. Logistic regression analysis was used to analyze the influencing factors of postpartum hemorrhage of the elderly pregnant women after cesarean section. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of the plasma Fib level combined with TEG for predicting postpartum hemorrhage of the women after cesarean section. Results: The Fib level (2.74±0.38 g/L) of the women in group B was significantly lower than that (4.68±0.63 g/L) of the women in group A, and the values of MA and CI of the women in group B were significantly lower than those of the women in group A (all P<0.05). There were no significant differences in the values of PT, TT, APTT, R, and α angle of the women between the two groups (P>0.05). Regression analysis showed that the prenatal Fib level, and the values of MA and CI of the women were low, and the K value was high, which all were the risk factors of postpartum hemorrhage of the elderly pregnant women after cesarean section (P<0.05). The area under the curve (AUC) of the prenatal Fib level, and the values of K, M, A and CI for predicting postpartum hemorrhage of the women after cesarean section were 0.909, 0.813, 0.794, and 0.816, respectively. The AUC, the sensitivity, and the specificity of the combination of the prenatal Fib level, and the values of K, M, A and CI for predicting postpartum hemorrhage of the women were 0.943, 96.7%, and 93.3%, respectively, with the highest predictive efficiency. Conclusion: The prenatal plasma Fib level and TEG parameters of the elderly pregnant women after cesarean section are closely related to their postpartum hemorrhage, which have certain predictive value for the occurrence of postpartum hemorrhage, and can provide evidences for clinical prevention intervention.

2022 Vol. 30　(7):　1680- [Abstract]（ 310 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To analyze the factors influencing premature rupture of membranes (PROM) of pregnant women after conization of cervix. Methods: From March 2016 to September 2020, 192 pregnant women who had undergone conization of cervix were selected as the research objects, which included 52 cases with PROM in study group and 140 cases without PROM in control group. Among women in the study group, there were 13 cases with preterm premature rupture of membranes (PPROM) in group A and 39 cases with PROM after full term in group B. The age, the body mass index (BMI) during pregnancy, and the surgery method of conization of cervix of these women were recorded. The length of cervix（CL) of these women during 20-24 gestational weeks was measured by transvaginal ultrasound. Results: The age, the BMI value before pregnancy, the proportions of conization of cervix by cold knife conical (CKC) and pregnancy within 6-12 months after conization of cervix of the women in the study group were significantly higher than those of the women in the control group, the CL value of the women in the study group was significantly less than that of the women in the control group (all P<0.05). There were no significant differences in the proportions of pluripara and the pregnancy by assisted reproduction, and the types of cervical lesions of the women between the study group and the control group (P>0.05). The Age, the BMI value before pregnancy, surgery by CKC, and pregnancy within 6-12 months after surgery were the independent risk factors of PROM occurrence (P<0.05), and the CL was the independent protective factor of PROM occurrence (P<0.05). The age, and the proportions of surgery by CKC and pregnancy within 6-12 months after surgery of the women in group A were significantly higher than those of the women in group B, but the CL value of the women in group A was significantly lower than that of the women in group B (all P<0.05). There were no significant differences in the BMI value before pregnancy, the proportions of pluripara and the pregnancy by assisted reproduction, and the types of cervical lesions of the women between group A and group B (P>0.05). The CL was the independent protective factor of PPROM occurrence (P<0.05). The optimal truncation value of the age, the BMI value before pregnancy, and the CL value of the women for predicting their PROM were 36 years old, 25.4kg/m2, and 25.1mm, respectively. The optimal truncation value of the CL of the women for predicting their PPROM was 23.6mm. Conclusion: The advanced age, the obesity before pregnancy, and the short CL during the second trimester of pregnancy of the women are the risk factors of their PROM occurrence during pregnancy after conization of cervix.

2022 Vol. 30　(7):　1689- [Abstract]（ 324 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )