To evaluate the correlation between gene polymorphisms in rs1256049 and rs4986938 sites of estrogen receptor β (ERβ) and male infertility. Methods: The related literatures were retrieved from CNKI, Pubmed, Wanfang, and so on. State software was used for statistical analysis. Results: This meta-analysis included 11 articles on rs1256049 site of 1914 infertility and 2012 healthy males, and 10 articles on rs4986938 SNP site of 2136 infertility and 2257 healthy males. For the rs1256049 site of ERβ, there was significant correlation between gene AG and gene GG (OR=1.35, 95%CI: 1.01-1.80), which suggested that gene polymorphisms in rs1256049 site of ERβof males was correlation with their infertility. The subgroup analysis based on different race and genotyping methods showed that the models of A compared with G (OR=2.47, 95%CI:1.37-4.44), AG compared with GG (OR=2.51, 95%CI 1.34-4.72), and AA + AG compared with GG (OR=2.55, 95%CI 1.38-4.73) suggested that gene polymorphisms in rs4986938 site of ERβof males increased risks the infertility of Caucasian males. There were no significant different among 5 comparison models of gene in rs4986938 site of ERβ. In the subgroup analysis according to the genotyping methods, the gene AG compared with GG (OR=0.48, 95%CI 0.24-0.94) suggested that decreased risk of male infertility. Conclusion: Gene rs1256049 site of ERβmay be a susceptible site of male infertility, while AG genotype of rs4986938 site of ERβ may reduce the risk of male infertility.

2022 Vol. 30　(10):　2181- [Abstract]（ 378 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To investigate the depression status of women during pregnancy, and to analyze the influencing factors of the depression of these women and the influence on their pregnancy outcomes. Methods: The convenience sampling method was used to select 462 pregnant women who underwent obstetric examination and were divided into group A (women with depression) and group B (women without depression) according to Edinburgh Postnatal Depression Scale (EPDS) from March 1, 2022 to June 30, 2022. The questionnaire was used to collect the basic information of these women, and the possible risk factors of depression of the women were analyzed and screened. The levels of glucose and lipid metabolism indicators of the women were detected, and the adverse pregnancy outcomes of the women were followed up. The correlation between the depression of the women and their adverse pregnancy outcomes was analyzed. Results: The EPDS score of 462 pregnant women was 8.03±4.20 points. There were 155 (33.6%) women in group A (59 cases with moderate to severe depression and 96 cases with mild depression), and there were 307 (66.5%) women in group B. Univariate analysis showed that there were significant differences in the prepregnancy body mass index value, the diet structure, and the rates of unintended pregnancy, history of infertility, less exercise during pregnancy, disharmony relationship with their spouse, and unsatisfied sleep status of the women between group A and group B (P＜0.05).  Logistic multifactor regression analysis shows that the history of infertility was not the independent risk factor of depression of the women during pregnancy (P＞0.05), but the high pregnancy body mass index value, the unbalanced diet, the unintended pregnancy, the less exercise during pregnancy, the disharmony relationship with their spouse, the unsatisfied sleep condition were the independent risk factors of depression of the women during pregnancy (P＜0.05). The levels of fasting blood glucose, cholesterol, and triacylglycerol (TG) of the women during the third trimester of pregnancy in group A was no correlated with their depression situation (all P>0.05). The proportions of cesarean section (42.0%) and neonatal hypoglycemia (8.0%) of the women in group A were significantly higher than those (24.5% and 0) of the women in group B (all P＜0.05). Conclusion: The depression during pregnancy of the pregnant women is not conducive to their pregnancy outcomes. It suggests that the risk factors of depression during pregnancy should be paid attention to in clinic, and the targeted intervention should be carried out for reducing the incidence of adverse pregnancy outcomes.

2022 Vol. 30　(10):　2194- [Abstract]（ 253 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To compare and analyze the application effect of visual vacuum aspiration and ultrasound-guided vacuum aspiration for induced abortion. Methods: 940 women who volunteer wanted induced abortion were selected in this study from August 2020 to November 2021. Among them, 470 women who wanted pregnancy termination by visual vacuum aspiration were in group A, and 470 women who wanted pregnancy termination by ultrasound-guided vacuum aspiration were in group B. The intraoperative and postoperative indicators of the women were compared between the two groups, and the incidence of complications of the women in the two groups was counted. Results: There was no significant difference in the operation time of the women between the two groups (P＞0.05). However, the intraoperative blood loss (12.25±2.61ml), the uterine aspiration times (1.74±0.32 times), the postoperative bleeding time (4.5±1.2 days), the postoperative abdominal pain time (1.6±0.4 days), and the postoperative menstrual recovery time (31.2±3.3 days) of the women in group A were significantly lower than those (18.64±3.85 ml, 2.79±0.41 times, 5.8±1.3 days, 2.1±0.4 days, and 34.9±3.7 days) of the women in group B. The total incidence of postoperative complications (0.7%) of the women in group A had no significant different from that (4.2%) of the women in group B (P＞0.05). Conclusion: Compare with those of ultrasound-guided vacuum aspiration, visual vacuum aspiration for induced abortion of the women can reduce the damage to their endometrium and is beneficial to their recovery after abortion.

2022 Vol. 30　(10):　2204- [Abstract]（ 293 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

2022 Vol. 30　(10):　2213- [Abstract]（ 280 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the influence of laparoscopic cystectomy for treating women with unilateral ovarian endometriotic cysts (OEC) on their arterial hemodynamics and their serum perredoxin (PRX) subtypes expression. Methods: The clinical data of 122 women with unilateral OEC in observation group and 45 healthy women in control group from February 2017 to March 2020 were analyzed retrospectively. The women in the observation group had received laparoscopic cystectomy. The total effective rate, the operative time, the intraoperative blood loss, the hospitalization time, the recurrence rate, the values of uterine artery hemodynamics, such as RI, PI, and S/D, and the levels of serum perredoxin subtypes, such as PRX1, PRX2, and PRX3 before and in 7 days after operation, and the ovarian function-related indicators of the women in the observation group were observed. According to the OEC recurrence after operation, the women in the observation group were divided into group A 28 women with OEC recurrence) and group B (94 women without OEC recurrence). The relevant factors affecting OEC recurrence of the women in the observation group after operation were analyzed. The values of RI, PI, and S/D, and the levels of PRX1, PRX2, and PRX3 for predicting postoperative OEC recurrence of the women were assessed by receiver operator characteristic curve (ROC). Results: The total effective rate after treatment, the operation time, the intraoperative blood loss, the hospital stay, and the OEC recurrence rate after 12 months of follow-up of the women in the observation group were 93.4%, 82.2±12.3min, 54.3±5.3ml, 4.1±1.3 days, and 23.0%, respectively. The preoperative hemodynamic indexes values of the women in the observation group were significantly higher than those of the women in the control group, while the expressions levels of PRX1, PRX2, and PRX3 of the women in the observation group were significantly lower. After treatment, the hemodynamic indexes values of the women in the observation group had decreased significantly, while the expressions levels of PRX1, PRX2, and PRX3 of the women in the observation group had increased significantly (all P＜0.05). The levels estradiol (E2), follicle stimulating hormone (FSH), and luteinizing hormone (LH) of the women in the observation group had no changed after treatment, and which had no significantly different from those of the women in the in the control group (P＞0.05). There were no significant differences in the body mass index value, the age of menarche, the number of induced abortion, the levels of E2, FSH, and LH, and the maximum cyst significant diameter of the women between group A and group B (P＞0.05), but there were significant differences in the age, the OEC duration, the OEC r-AFS stage, the number of postoperative pregnancy, the values of RI, PI, and S/D, and the PRX1, PRX2, and PRX3 levels of the women between group A and group B (P＜0.05). Binary logistic regression analysis showed that OEC r-AFS stage Ⅲ-Ⅳ, the no postoperative pregnancy, the younger age, the longer disease course, the abnormal RI, PI, and SD values, and the abnormal expressions of PRX1, PRX2, and PRX3 of the women with OEC were the  risk factors of their postoperative OEC recurrence (P＜0.05). ROC analysis showed that the AUC of the values of RI, PI, and SD, and the levels of PRX1, PRX2, and PRX3 of the women with OEC for predicting their recurrence after OEC were 0.580, 0.661, 0.826, 0.680, 0.754, and 0.752, respectively (P＜0.05). Conclusion: Laparoscopic cystectomy for treating women with OEC has high effect, which is beneficial to reduce the recurrence rate of OEC. The arterial hemodynamics and the PRX subtype detection of the women with OEC can be used as the reference indicators for predicting the postoperative OEC recurrence of these women.

2022 Vol. 30　(10):　2222- [Abstract]（ 281 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To investigate the effects of single injection of dexmedetomidine (Dex) during laparoscopic hysterectomy of patients on their observer's assessment of alertness/sedation (OAA/S) score and their restlessness in recovery period. Methods: 70 patients who wanted laparoscopic hysterectomy were selected and were divided into three groups by random number table from January 2018 to December 2021. 23 patients in group A were given continuous pump injection of Dex 0.3 μg/(kg·h) from 15 minutes before induction of anesthesia to 20 minutes at the end of the operation, 24 patients in group B were given single intravenous injection of Dex 0.6 μg/kg before induction of anesthesia, and 23 patients in group C were given conventional general anesthesia. The heart rate (HR), mean arterial pressure (MAP), OAA/S score, rate of adverse reactions during recovery period, extubation time, orientation recovery time, and staying time in the anesthesia recovery room of the patients were compared among the three groups. Results: The HR value of the patients in group A and group C at T1 (immediately after abdominal pressure reached 10mmHg), T2 (5min), T3 (10min), T4 (20min), and T5 (40min) were significantly higher than those at T0 (before pneumoperitoneum establishment). The HR value of the patients in group B, group A, and group C at T0, T1, T2, T3, T4 and T5 had increased gradually (all P＜0.05). The MAP value of the patients in the three groups at T1, T2, T3, T4, and T5 was significantly higher than that of the patients at T0. The MAP value of the patients in group B, group A, and group C at T0, T1, T2, T3, T4, and T5 had increased gradually (all P＜0.05). The score of OAA/S of the patients in group B or group A was significantly better than that of the patients in group C (P＜0.05). The total incidence of adverse reaction (8.3%) of the patients in group B was significantly lower than that (39.1%) of the patients in group A or that (56.5%) of the patients in group C. The extubation time (14.02±2.54 min), the directional force recovery time (18.24±6.05 min), and the stay time in anesthesia recovery room (22.56±7.48 min) of the patients in group B were significantly shorter than those (23.12±3.05 min, 24.75±8.19 min, 26.84±8.89 min) of the patients in group A or those (19.33±2.86 min, 20.18±6.67 min, 34.37±11.13 min) of the patients in group C (all P＜0.05). Conclusion: Single injection of Dex during laparoscopic total hysterectomy of the patients has better anesthetic effect, which can stabilize their hemodynamic indicators, shorten their recovery time of anesthesia, improve their quality during anesthesia recovery period, and reduce their occurrence of adverse reactions during the recovery period.

2022 Vol. 30　(10):　2233- [Abstract]（ 321 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the effects of sub-anesthetic dose of esketamine for anesthesia induction during hysteroscopic surgery of women on their haemodynamics. Methods: A total of 82 women who wanted hysteroscopic surgery were selected and were randomly divided into two groups (41 cases in each group) from June 2021 to March 2022. The women in both groups were given anesthesia induction by sufentanil 0.1μg/kg and etomidate 0.2mg/kg. The women in the observation group were given 0.2mg/kg esketamine additionally, while the women in the control group were given 0.2mg/kg sodium chloride solution additionally. The values of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure, and blood oxygen saturation (SpO2), and the levels of blood glucose and arterial lactic acid of the women in the two groups were counted. The anesthetic effect and adverse reactions rate of the women were compared between the two groups. Results: The values of HR, SBP, DBP, and SpO2 of the women before induction of anesthesia (T1) and immediately after awakening (T4) had no significantly different between the two groups, but which of the women in the observation group immediately before entry laryngoscope (T2) and at the end of examination (T3) were significantly higher than those of the women in the control group (all P＜0.05). There were no significant differences in the levels of epinephrine and norepinephrine of the women at each test point between the two groups (P＞0.05). The levels of epinephrine and norepinephrine of the women in the two groups at T2 and T3 were significantly higher than those at T1 (P＜0.05), and which of the women in the two groups had no significant difference between at T4 and at T1 (P＞0.05). The blood glucose level of the women in the two groups after induction of anesthesia had increased significantly, and which of the women in the observation group was significantly lower than that of the women in the control group. The lactic acid level of the women in the two groups had decreased significantly after induction of anesthesia (P＜0.05). The effective rate of anesthesia (100%) of the women in the observation group was significantly higher than that (87.8%) of the women in the control group (P＜0.05), and the total incidence of adverse reactions (2.4% vs.7.3%) of the women had no significant difference between the two groups (P＞0.05). Conclusion: 0.2mg/kg of esketamine is helpful to stabilize the hemodynamics of the women during hysteroscopic surgery, with good anesthetic effect and safety.

2022 Vol. 30　(10):　2243- [Abstract]（ 255 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the effect of sevoflurane combined with epidural anesthesia during cesarean section of puerperae with severe preeclampsia, and to study its influence on the hemodynamics and analgesic effect of the puerperae. Methods: 120 puerperae with severe preeclampsia who wanted cesarean section were selected and were divided into two groups (60 cases in each group) by the random number table method between September 2018 and September 2021. The puerperae in observation group were given sevoflurane combined with epidural anesthesia, while the puerperae in control group were given epidural anesthesia only. The hemodynamics values, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood oxygen saturation (SpO2) at different analgesic time points, the analgesic effect by Visual Analogue Scale (VAS) in 1, 5, 15 and 30 min after surgery, and the sedation effect evaluated by Ramsay sedation score in 4, 8, 12, 24 and 48 h after surgery, and comfortable degree evaluated by Bruggrmann Comfort Scale (BCS) of the puerperae were compared between the two groups. The occurrence of adverse reactions, neonatal Apgar score, and intraoperative blood loss of the puerperae were also compared between the two groups. Results: There were significant differences in the values of SBP and HR of the puerperae between the two groups, among different time points, and between the interactions, and there was significant difference in the value DBP of the puerperae between the two groups and between interactions (all P＜0.05). There was no significant difference in the value of DBP of the puerperae among different time points, and there was no significant difference in the value SpO2 of the puerperae between the two groups, among different time points, and between interactions (all P＞0.05). The values of SBP, DBP, and HR at T2, and the HR value at T3 of the puerperae in the observation group were significantly lower than those of the puerperae in the control group. The values of SBP, DBP, and HR at T2, and the HR value at T3 of the puerperae in the control were significantly high than those at T0 (all P＜0.05). There was significant difference in the VAS score of the puerperae between the two groups, and among different time points. The VAS scores of the puerperae in the observation group at 1, 5, 15, and 30min after operation were significantly lower than those of the puerperae in the control group (all P＜0.05). The Ramsay sedation score of the puerperae in the two groups had significant difference among different time points (P＜0.05), but which had no significant difference between the two groups and between the interactions (all P＞0.05). The BCS score of the puerperae had significant difference between the two groups and among different time points (all P＜0.05), but which had no significant difference between the interactions (P＞0.05). There were no significant differences in the scores of Ramsay sedation and BCS of the puerperae in 4, 8, 12, 24, and 48 hours after operation between the two groups (all P＞0.05). There were no significant differences in the adverse reactions rate, the neonatal Apgar score, and the intraoperative blood loss of the puerperae between the two groups (all P＞0.05). Conclusion: Sevoflurane combined with epidural anesthesia during cesarean section of puerperae with severe preeclampsia can effectively stabilize their hemodynamics, with better analgesic effect and safety.

2022 Vol. 30　(10):　2253- [Abstract]（ 233 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To observe the efficacy of high-intensity focused ultrasound (HIFU) combined with taxel and cisplatin (TP) chemotherapy and Chinese medicine for treating patients with cervical cancer above IIb stage. Methods: 60 patients with cervical cancer above IIb stage were selected and were randomly divided into two groups (30 cases in each group) according to the random number table from August 2018 to February 2021. The patients in the two groups were treated with TP chemotherapy combined with traditional Chinese medicine therapy. On this basis, the patients in the observation group were given HIFU therapy additionally. The effective rate, the MR apparent diffusion coefficient (ADC), the maximum tumor diameter, and the serum tumor marker levels, such as carcinoembryonic antigen (CEA), carbohydrate antigen 125(CA125), and squamous cell carcinoma antigen (SCC-Ag), of the patients in 1, 3, and 6 months after treatment were compared between the two groups. Results: The effective rate (83.3%) of the patients in the observation group was significantly higher than that (56.7%) of the patients in the control group (P＜0.05). The ADC values of the patients in the two groups after treatment were significantly higher than those before treatment. The maximum diameter of the tumor of the patients after treatment was significantly lower than that before treatment. The ADC value of the patients in the observation group in 1, 3, or 6 months after treatment (0.99±0.10×10-3mm2/s, 1.17±0.12×10-3mm2/s, or 1.39±0.14×10-3mm2/s) was significantly higher than those (0.92±0.09×10-3mm2/s, 1.06±0.10×10-3mm2/s, or 6.39±0.23×10-3mm2/s) of the patients in the control group . The maximum diameter of tumor of the patients in 1, 3, or 6 months after treatment (3.52±0.15cm, 3.31±0.14cm, or 3.12±0.13cm) was significantly lower than that (3.94±0.1cm6, 3.82±0.15cm, or 3.55±0.14cm) of the patients in the control group (all P＜0.05). The serum levels of CEA, CA125, and SCC-Ag of the patients in the two groups after treatment had decreased significantly, and which of the patients in 1, 3, and 6 months after treatment in the observation group were significantly lower than those of the patients in the control group  (all P＜0.05). During the treatment, there were patients in both groups with adverse reactions, such as abdominal pain and diarrhea, leukopenia, hemoglobin reduction, and neutropenia, but the rate of which of the patients had no significant difference between the two groups (P＞0.05). The proportion of nausea and vomiting (13.3%) of the patients in the observation group was significantly lower than that (36.7%) of the patients in the control group (P＜0.05). Conclusion: HIFU combined with TP chemoradiotherapy and traditional Chinese medicine therapy for treating patients with advanced cervical cancer over IIb staging can effectively reduce their level of tumor markers and can inhibit the growth of their tumor foci with definite clinical effect, and which can reduce the proportion of their nausea and vomiting during treatment.

2022 Vol. 30　(10):　2262- [Abstract]（ 294 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To study the effect of tranexamic acid combined with cabletide for treating women with dangerous placenta previa after cesarean section, and to explore its influence on their uterine arterial blood flow dynamics and maternal and infant outcomes. Methods: 200 pregnant women with dangerous placenta previa were selected and divided into experimental group (n=105) and control group (n=95) by random number table method from January 2018 to January 2022. The women in the control group were treated by capitin, and the women in the experimental group were treated by capitin combined with tranexamic acid. The efficacy, the values of hemodynamics of uterine artery, the intraoperative and postoperative blood loss, the postoperative blood transfusion, the maternal and infant outcomes, and the incidence of adverse reactions of the women were compared between the two groups. Results: The total effective rate (98.1%) of the women in the experimental group after treatment was significantly higher than that (81.1%) of the women in the control group. The values of uterine artery blood flow pulsatile index (PI) and resistance index (RI) of the women in the two groups after treatment were significantly higher than those before treatment, and the amplitudes of which of the women in the experimental group were significantly greater than those of the women in the control group. The intraoperative blood loss (1118.5±49.6 ml), the postoperative blood loss (82.6±25.9 ml), and the intraoperative blood transfusion volume (438.3±43.8 ml) of the women in the experimental group were significantly lower than those (1161.4±58.3 ml, 329.0±36.5 ml, and 1025.6±36.8 ml) of the women in the control group (all P＜0.05). There was no significant difference in the incidence of neonatal death (0 vs. 2.1%) between the two groups (P＞0.05). The incidences of neonatal asphyxia (1.0%), premature birth (2.9%), and hysterectomy (0) of the women in the experimental group were significantly lower than those (7.4%, 11.6%, and 4.2%) of the women in the control group (all P＜0.05). There was no significant difference in the total incidence of adverse reactions (6.7% vs. 9.5%) between the two groups (P＞0.05). Conclusion: Tranexamic acid combined with cabletide for treating women with dangerous placenta previa after cesarean section has high effect, which can improve their hemodynamics of uterine artery and their maternal and infant outcomes.

2022 Vol. 30　(10):　2272- [Abstract]（ 252 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

2022 Vol. 30　(10):　2280- [Abstract]（ 219 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To observe the efficacy of the recovery of postpartum pelvic floor function women after the pelvic floor muscle exercise during the third trimester of pregnancy combined with the postpartum neuromuscular electric stimulation. Methods: 118 pregnant women were selected and were randomly divided into two groups (59 cases in each group) from August 2019 to August 2020. The women in the control group were given pelvic floor muscle function exercise after postpartum 42 days, and the women in the study group were given pelvic floor muscle function exercise during 28 gestational weeks combined with neuromuscular electric stimulation after postpartum 42 days for 2 months. The pelvic floor muscle tension score, the values of pelvic floor muscle potential activity and fatigue degree, the incidence of urinary incontinence, the degree of pelvic floor organ prolapse, the pelvic floor function, and the quality of life of the women in the postpartum 3rd month were compared between the two groups. Results: The normal rate of postpartum pelvic floor muscle tension (81.4%) of the women in the study group was significantly higher than that (61.0%) of the women in the control group. The potential activity value of pelvic floor muscle of the women in the study group in the 3rd month after delivery was significantly higher than that of the women in the control group. The value of pelvic floor muscle fatigue of the women in the study group was significantly lower than that of the women in the control group. The incidence of stress urinary incontinence (5.1%) of the women in the study group was significantly lower than that (20.3%) of the women in the control group (all P＜0.05). The degree of pelvic floor muscle organ prolapse of the women in the study group was mostly distributed in degree 0 andⅠ, which had significantly different from that of the women in the control group (P＜0.05). The pelvic floor function and quality of life of the women in the two groups after treatment had improved significantly. The scores of quality of life impacted by pelvic floor disease (25.53±3.55 points) and the symptom of pelvic floor dysfunction disease (21.06±3.15 points) of the women in the study group were significantly lower than those (42.23±4.32 points and 30.14±4.01points) of the women in the control group (all P＜0.05). Conclusion: The pregnant women are given pelvic floor muscle function exercise during 28 gestational weeks combined with postpartum neuromuscular electrical stimulation can improve their physiological condition of pelvic floor muscle, and can reduce the incidences of their urinary incontinence and pelvic floor organ prolapse, and which can improve the postpartum recovery of the women.

2022 Vol. 30　(10):　2289- [Abstract]（ 264 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To study the clinical efficacy of intrauterine perfusion of growth hormone (GH) combined with hormone replacement therapy (HRT) for treating women with thin endometrium (TE) after the frozen thawed embryo transfer. Methods: The clinical data of 90 infertile women who received in vitro fertilization-frozen thawed embryo transfer (IVF-FET) between July 2019 and July 2020 were analyzed retrospectively. According to the different endometrial preparation regimens, these women were divided into 38 cases with nature circle in group A and 52 cases with HRT cycle in group B. The women in both groups were given intrauterine perfusion of GH, and on this basis, the women in group A was given natural cycle and the women in group B were given HRT cycle. The endometrial thickness and blood flow signal of the women were compared between the two groups. When the endometrial thickness of the women in the two groups was ≥7 mm, the blastomere was thawed and the embryo transfer was performed for these women. The pregnancy status of the women in the two groups was observed. Results: The endometrial thickness of the women in the two groups in 1d before FET was significant thicker than that in the first day of the admission of drug, and the values of vascular resistance index (RI), pulse index (PI), and the ratio of end-systolic/end-diastolic blood flow velocity (S/D) of the women in the two groups in 1d before FET were significantly lower than those of the women in the first day of the admission of drug, and the changes of which of the women in group B were significantly greater than those of the women in group A (all P＜0.05). The serum E2 level (1823.74±206.19 pg/ml) and the clinical pregnancy rate (62.0%) of the women in group B in 1d before FET were significantly higher than those (1095.38±145.82 pg/ml and 38.7%) of the women in group A, and the cycle cancellation rate (3.9%) of the women in group B in 1d before FET was significantly lower than that (18.4%) of the women in group A (all P＜0.05). Conclusion: Intrauterine perfusion of GH combined with HRT for treating women with TE can promote their endometrial growth and improve their blood circulation, and help to reduce their cycle cancellation rate and increase their clinical pregnancy rate after FET, which has positive effect on their FET treatment.

2022 Vol. 30　(10):　2299- [Abstract]（ 314 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

2022 Vol. 30　(10):　2309- [Abstract]（ 203 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To investigate the effects of the incubation period of delivery, the timing of termination, and the mode of delivery of pregnant women with preterm premature rupture of membranes (PPROM) on their pregnancy outcomes. Methods: The clinical data of 267 pregnant women with PPROM (in 35-36 gestational weeks) from January 2017 to June 2020 were analyzed retrospectively. According to the incubation period of delivery < 24h or ≥ 24h and the treatment scheme, these women were divided into three groups, which included 52 women without treatment in 24h after membrane rupture and waiting for natural delivery in group A, 138 women without uterine contraction within 24 hours after rupture of membranes were given oxytocin intravenous drip to induce delivery in group B, and 77 women who had been given ritodrine or magnesium sulfate intravenously after membrane rupture to inhibit uterine contraction and protect the fetus until delivery in group C. The pregnancy outcomes (cesarean section rate), and the maternal and infant complications, such as intrauterine infection rate, puerperal infection rate, postpartum hemorrhage rate, neonatal respiratory distress syndrome, and perinatal death rate of the women were compared among the three groups. Results: 80(30.0%) women in 267 women with PPROM had terminated their pregnancy by cesarean section. The cesarean section rate (59.7%) of the women in group C was significantly higher than that (16.7%) of the women in group B or that (21.2%) of the women in group A. The rates of intrauterine infection (26.0%) and puerperal disease (23.4) of the women in group C were significantly higher than those (7.2% and 5.8%) of the women in group B or those (5.1% and 3.9%) of the women in group A (all P＜0.05). There was no significant difference in the incidence of maternal and infant complications of the women among the three groups (P＞0.05). Conclusion: The mature fetus (≥34 gestational week) of the pregnant women with PPROM and within 24h after membrane rupture should be consider terminating pregnancy in time, and their mode of delivery should be determined according to obstetric routine, so as to obtain the good pregnancy outcomes.

2022 Vol. 30　(10):　2321- [Abstract]（ 285 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To explore the influence of different surgical methods for treating advanced women with adenomyosis on their pregnancy outcomes after surgery. Methods: The clinical data of 116 advanced women with adenomyosis who had undergone adenomyosis focal resection and had fertility requirements from December 1, 2011 to December 1, 2016 were analyzed retrospectively. Among them, 52 women with transabdominal adenomyoma focal resection were in group A, and 64 women with laparoscopic adenomyoma focal resection were in group B. In addition, 78 pregnant women with adenomyosis who had hospitalized and delivered during the same period were selected in group C. The pregnant situation of the women was compared among the three groups, and the influencing factors were analyzed. Results: Among 116 women with adenomyosis who had undergone adenomyosis focal resection, 65 (56.0%) women were pregnancy within 2 years after surgery. There were no significant differences in the rates of pregnancy and recurrence of adenomyosis of the women in 6 months, 1 year, and 2 years after surgery between group A and group B (P＞0.05). The rates of age ≥40 years old, no recurrence of adenomyosis, no residual lesion, and assisted reproductive technology used of the women with postoperative pregnancy in group A and B were significant higher than those of the women without postoperative pregnancy (P＜0.05). Multivariate logistic regression analysis showed that age ≥40 years old, and no assisted reproduction used after surgery of the women were the risk factors of their postoperative pregnancy (OR=3.580, 4.927, P＜0.05). The no postoperative recurrence of adenomyosis and no postoperative residual lesion of the women were the protective factors of their postoperative pregnancy (OR=0.220, 0.173, P＜0.05). The incidences of preterm birth (9.2%), abortion (13.9%), low birth weight (10.7%), placenta previa (6.2%), delivery infection (7.7%), and pelvic adhesions (10.8%) of the women in group A and group B were significantly higher than those (1.3%, 2.5%, 2.6%, 0, 0, and 1.3%) of the women in the control group (all P＜0.05). Conclusion: Advanced age, postoperative recurrence of adenomyosis, residual lesions of adenomyosis, and no assisted reproductive technology used after surgery of the women with adenomyosis can affect their postoperative pregnancy, and these women after pregnancy have higher incidence of pregnancy adverse outcomes. Therefore, the advanced women with adenomyosis who have fertility requirements maybe try to pregnancy with the disease of adenomyosis.

2022 Vol. 30　(10):　2330- [Abstract]（ 173 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To analyze the correlation between the expression levels of exportin 4 (XPO4), tissue kinesin family member 23 (KIF 23), and milk fat globule epidermal growth factor 8 (MFG-E8) in endometrial carcinoma tissue of patients and their clinicopathology. Methods: The clinical data of total 98 patients with endometrial carcinoma who received surgical treatment from January 2019 to June 2021 were collected. Immunohistochemical staining was used to detect the expressions of XPO4, KIF 23, and MFG-E8 in endometrial carcinoma tissue of these patients. The correlation between the expression levels of XPO4, KIF 23, and MFG-E8 in endometrial carcinoma tissue of these patients and their pathological parameters of endometrial carcinoma was analyzed. Results: The positive expression rate of XPO4 protein (37.8%) in endometrial carcinoma tissues of the patients was significantly lower than that (67.4%) in normal uterine tissues of the patients, and the positive expression rates of KIF 23 and MFG-E8 protein (74.5% and 81.6%) in endometrial carcinoma tissues were higher than those (17.4% and 6.1%) in the normal uterine tissues (all P＜0.05). The level of XPO4 protein in the endometrial carcinoma tissues of the patients was correlated with their tumor diameter, myometrium invasion, FIGO stage, and lymph node metastasis. The expression of KIF 23 protein of the patients was correlated with their tumor myometrium invasion, FIGO stage, and lymph node metastasis. The expression of MFG-E8 protein of the patients was correlated with their tumor diameter, myometrium invasion, FIGO stage, and lymph node metastasis (all P＜0.05). Receiver operating characteristic curve analysis showed that the expressions of XPO4, KIF 23, and MFG-E8 protein for diagnosing endometrial carcinoma were 0.841, 0.816, 0.875, respectively, respectively, with the sensitivity of 84.6%, 83.3%, and 86.6%, respectively, and with the specificity of 83.6%, 82.1%, and 83.2%, respectively. Conclusion: The expression of XPO4 protein in endometrial carcinoma tissue is low, and the expressions of KIF 23 and MFG-E8 proteins are high. The XPO4, KIF 23 and MFG-E8 expressions are closely related to the clinical pathology of endometrial carcinoma, which has certain value for clinical diagnosis of endometrial carcinoma.

2022 Vol. 30　(10):　2340- [Abstract]（ 183 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the values of the pre-pregnancy basal hormone and anti-mü llerian duct hormone levels of advanced women of childbearing age for screening their ovarian reserve function. Methods: A total of 498 advanced women of childbearing age who underwent pre-pregnancy examination were selected as the research subjects and were divided into group A (156 cases aged in <30 years old), group B (168 cases aged in 31-35 years old), and group C (174 cases aged in >35 years old) according to their age from April 2018 to April 2020. The levels of serum estradiol 2 (E2), follicle stimulating hormone (FSH), and luteinizing hormone (LH), anti-mullerian hormone (AMH) of the women in the three groups were detected. The value of the basic sex hormones levels combined with the AMH level of the women for screening their ovarian reserve function was analyzed by receiver operating characteristic curve. Results: The levels of serum FSH, E2, FSH/LH of the women in group A, group B, and group C had increased gradually, while the AMH level of the women in group A, group B, and group C had decreased gradually. The percentage of ovarian reserve function decreased of the women in group A, group B, and group C were 10.9%, 16.7%, and 25.3%, which had increased gradually (all P＜0.05). The area under the curve (AUC), the sensitivity, and the specificity of the basic sex hormones levels for screening ovarian reserve function of advanced women were 0.711, 71.2%, and 81.8%, respectively. The AUC, the sensitivity, and the specificity of the AMH level for screening ovarian reserve function of advanced women were 0.762, 74.3% and 87.4%, respectively. The AUC, the sensitivity, and the specificity of the basic sex hormones levels combined with the AMH level for screening ovarian reserve function of advanced women were 0.883, 84.2%, and 90.2%, respectively. Conclusion: The basic sex hormones levels combined with the AMH level of the advanced women for screening their ovarian reserve function can increase the detection value, which can be as the effective indicators for guiding the reproductive health care of the advanced women in clinic.

2022 Vol. 30　(10):　2349- [Abstract]（ 228 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To investigate the situation of the infections of group B streptococci (GBS), ureaplasma urealyticum (UU), and chlamydia trachomatis (CT) of pregnant women with premature rupture of membranes, and to study the risk factors of the infection and the adverse pregnancy outcomes of these women. Methods: 121 pregnant women with PROM were selected in observation group and 136 pregnant women with normal delivery were selected in control group from January 2019 to January 2021. The positive detective rates of GBS, UU, and CT of the women were compared between the two groups. The related risk factors affecting the occurrence of PROM of the women were analyzed. The influence of the infections of the women with PROM on their pregnancy outcomes was compared among the women infected by different pathogens. Results: The positive infection rates of GBS (21.5%), UU (17.4%), and CT (12.4%) of the women in the observation group were significantly higher than those (8.8%, 3.7%, and 5.2%) of the women in the control group (all P＜0.05). The pregnancy history, induced abortion history, diabetes history, immune disease history, sitting bath, sex life during menstrual period, and the GBS, UU, or CT infection were the independent risk factors of PROM occurrence of the pregnant women (P＜0.05). In the observation group, the incidence rates of preterm birth (30.8%), intrauterine infection (24.4%), fetal distress (15.4%), chorioamnionitis (19.2%), and neonatal asphyxia (10.3%) of the women with GBS, UU, or CT infection were significantly higher than those (11.9%, 10.2%, 3.4%, 5.1%, and 1.7%) of the women without GBS, UU, or CT infection (all P＜0.05). Conclusion: The positive detective rates of GBS, UU, and CT of the pregnant women with PROM increase, so the detection of reproductive tract infection of the pregnant women during the third trimester of pregnancy should be strengthened and the normative treatment of reproductive tract infection should be conducted in order to alleviate the adverse pregnancy outcomes of these women.

2022 Vol. 30　(10):　2358- [Abstract]（ 282 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the clinical effect of alendronate sodium combined with calcium carbonate and calcitriol for treating perimenopausal patients with osteoporosis. Methods: The clinical data of 115 perimenopausal patients with osteoporosis between January 2019 and September 2020 were collected retrospectively. According to the treatment regimens, these patients were divided into control group (56 cases with the treatment of calcium carbonate and calcitriol) and observation group (59 cases with the treatment of alendronate sodium combined with calcium carbonate and calcitriol). The therapeutic efficacy, the changes of bone metabolism-related indicators and bone mineral density (BMD), and the adverse reactions rate of the patients in the two groups after medication were analyzed. Results: The total effective rate (86.4%) of the patients in the observation group after 1 year of treatment was significantly higher than that (71.4%) of the patients in the control group. The values of BMD of lumbar spine (0.88±0.09g/cm2), femoral neck (0.78±0.12 g/cm2), and intertrochanteric femur (0.86±0.14 g/cm2) of the patients in the observation group were significantly higher than those (0.84±0.12 g/cm2, 0.19±0.03 g/cm2, and 0.81±0.11 g/cm2) of the patients in the control group. The levels of serum osteocalcin and β-I collagen carboxyl terminal peptide of the patients in the two groups after treatment had decreased significantly, and the level of bone-derived alkaline phosphatase of the patients in the two groups had increased significantly, and the changes of which of the patients in the observation group were significantly higher than those of the patients in the control group (all P＜0.05). There was no significant difference in the incidence of adverse reactions (5.1% vs.1.8%) of the patients between the two groups (P＞0.05). Conclusion: Alendronate sodium combined with calcium carbonate and calcitriol therapy of the perimenopausal patients with osteoporosis can improve their bone metabolism indicators and bone mineral density betterly, and can significantly increase their clinical efficacy with safety of treatment.

2022 Vol. 30　(10):　2365- [Abstract]（ 277 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To study the correlation between the abnormal thyroid function of pregnant women and their nutrition status, blood lipid level change, and QT interval. Methods: A total of 188 pregnant women with abnormal thyroid function who had been diagnosed and treated were included in this study from January 2020 to December 2020, which included 98 women with hyperthyroidism in group A and 90 women with hypothyroidism in group B. 50 health pregnant women were selected in group C during the same period. The levels of thyroid function indexes, the nutrition status, the blood lipid levels changes, and the QT interval of the women were compared among the three groups. The correlation between the abnormal thyroid function of the women and their nutrition status, blood lipid level change, and QT interval was analyzed. Results: There were significant differences in the serum levels of triiodothyronine (T3), tetraiodothyronine (T4), thyroid stimulating hormone (TSH), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), total protein (TP), and albumin (ALB), and the QT interval (336.68±12.72 ms vs. 370.25±22.72 ms vs. 368.04±22.26 ms) of the women among the three groups (all P=0.000). Correlation analysis showed that the levels of serum T3, T4 and TSH of the pregnant women with abnormal thyroid function were correlated with their levels of TC, HDL, LDL, TP, and ALB, and their QT interval (all P=0.000). Conclusion: The abnormal thyroid function during pregnancy of the women is significantly correlated with their nutrition indexes, blood lipid level change, and QT interval.

2022 Vol. 30　(10):　2374- [Abstract]（ 267 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To analyze the influencing factors of postpartum hemorrhage in pregnant women who failed vaginal trial delivery and converted to cesarean section. Methods: The clinical data of 397 pregnant women who failed vaginal trial delivery and converted to cesarean section from June 2020 to December 2021 were selected retrospectively. According to whether postpartum hemorrhage occurred or not, these women were divided into group A (38 women with postpartum hemorrhage) and group B (359 women without postpartum hemorrhage). The influencing factors of postpartum hemorrhage of the women in group A were analyzed by multivariate logistic regression. Results: There were 38 (9.6%) women with postpartum hemorrhage in 397 women. Multivariate logistic regression analysis showed that long time of vaginal trial delivery (OR =6.450, 95%CI 2.427-10.635), the edema of lower segment of uterus and cervix (OR=5.168 95%CI 1.5636.948), the incision tear (OR=8.016, 95%CI 2.725-12.130), the coagulation disorders (OR=3.020, 95%CI 1.758-7.322), the neonatal weight (OR=5.037, 95%CI 2.014-9.386) of the women who had been converted to cesarean section after vaginal trial delivery failure were the risk factors of their postpartum hemorrhage (P＜0.05), and labor analgesia (OR=0.201, 95%CI 0.108-0.514) was a protective factor of their postpartum hemorrhage (P＜0.05). Conclusion: Some measure, such as monitoring and reasonably controlling fetal weight during pregnancy, correctly grasping the trial delivery time, scientifically using labor analgesia, and dynamically evaluating the progress of labor in the process of labor, can prevent or reduce the occurrence of the edema of soft birth canal, and can alert the occurrence of intraoperative uterine incision tear, which is helpful to prevent or reduce the occurrence of postpartum hemorrhage of the pregnant women who have failed vaginal trial delivery and converted to cesarean section.

2022 Vol. 30　(10):　2382- [Abstract]（ 185 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To explore the imaging features and diagnostic value of magnetic resonance imaging (MRI) of cesarean scar pregnancy (CSP). Methods: The clinical data of 106 patients with CSP treated in the hospital between March 2018 and March 2021 were collected retrospectively. The uMR780 scanner was used to obtain pelvic MRI images of all these patients. Imaging features of MRI of the patients and its diagnostic value were analyzed. Results: In the imaging features of MRI for diagnosing CSP of 104 patients, there were 75 (72.1%) patients with simple cystic gestational sacs of round, and oval long T1 and long T2 signals and clear boundaries, and 29 (27.9%) patients with mass-shaped gestational sacs of round, and lumpy long T1 and the mixed high and low T2 signals. The maximum diameter, gestational sac volume, and length of intersection with the uterine scar of the mixed mass-shaped gestational sac were significantly higher than those of simple cystic gestational sac (P<0.05). Among the 106 patients with CSP, there were 43 (41.3%) cases with endogenous CSP, and 61 (58.7%) cases with exogenous CSP. The scar thickness and gestational sac volume of the endogenous CSP were significantly higher than those of the exogenous CSP, and the area of the contact surface between the sac and the scar, and the ratio of abundant blood supply around the gestational sac of the endogenous CSP were significantly lower than those of the exogenous CSP (P<0.05). The detection rate of cystic and mixed mass of CSP by MRI was 98.1%, and the detection rate of endogenous or exogenous CSP by MRI was 97.2%, which had no statistically significant different from those of pathological results (P＞0.05). Conclusion: MRI scan can show the imaging features of CSP, and there are differences in the maximum diameter, the gestational sac volume, and length of intersection of the gestational sac with uterine scars between mixed mass and cystic gestational sac. Besides, there are significant differences in the thickness of the thinnest part of the scar, the gestational sac volume, and the abundance of blood supply around the gestational sac between the endogenous and the exogenous gestational sacs. Clinically, the CSP classification based on relevant features can improve the detection rate of the patients with CSP.

2022 Vol. 30　(10):　2389- [Abstract]（ 214 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

To analyze the vaginal microecological characteristics of patients from gynecological clinic. Methods: From January 1, 2012 to August 30, 2021, 174,290 patients with symptoms including vulva pruritus, increased leucorrhea, the leucorrhea having unusual smell, or vulva burning or tingling from gynecology outpatients of Peking University Third Hospital were enrolled. The results of vaginal microecology of these patients were analyzed retrospectively. Results: Among 174,290 patients, 45995 (26.4%) patients were diagnosed as vaginitis, which included 23 332 (13.4%) patients with bacterial vaginitis (BV), 17,753 (10.2%) patients with vulvovaginal candidiasis (VVC)，628 (0.4%) patients with trichomonal vaginitis (TV), 3330 (1.9%) patients with VVC combined with BV, and 952 (0.5%) patients with TV combined with BV. Among the patients without diagnosed vaginitis and with normal vaginal flora, the percentage of normal pH value >4.5 and cleanliness III of the patients were 37.9% and 10.7%. In addition, the percentages of vaginal flora inhibition and pH value >4.5 of the patients without vaginitis and aged in ≥50 years old were significantly higher than those of the patients aged in <50 years old, while the percentage of vaginal cleanliness III of the patients without vaginitis and aged in ≥50 years old was significantly lower (all P＜0.05). Conclusion: The patients with different vaginal symptoms from gynecological clinic have different vaginal microecological disorders. The vaginal microecological evaluation system of the patients can guide clinicians to evaluate the vaginal microecological status accurately and comprehensively, so as to reduce the recurrence of vaginal infection repeatedly.

2022 Vol. 30　(10):　2398- [Abstract]（ 218 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )