To understand the reproductive intention of assisted reproduction technology(ART)of women with ≥35 years old, and to study the psychological state and its influencing factors of these women before assisted reproduction. Methods: A questionnaire survey was conducted among infertile women with ≥ 35 years old who received ART from February 2019 to February 2022. The cognitive level of ART, the fertility intention by ART, and the psychological state of these women were studied. The influencing factors of psychological state of these women before ART were analyzed. Results: 552 women were included in the survey. 337(61.1%)women had known the knowledge about ART, 450(81.5%)women had family support for ART, and 293(53.1%)women were willing to accept ART again after initial ART failure. The incidences of anxiety and depression of these women were 38.1% and 32.8%, respectively. There were no significant differences in the incidences of anxiety and depression among the respondents with different residences, among the respondents with different education levels, among the respondents with different occupation, among the respondents with different marital status, and among the respondents with different family attitudes for ART(P＞0.05). There were significant differences in the incidences of anxiety and depression among the respondents with different age, the respondents with different annual family income, the respondents with different infertility years, the respondents with different previous treatment cost, the respondents with different fertility history, the respondents with different fertility concepts, or among the respondents with different ART-related knowledge cognition level, or among the respondents with different attitudes toward ART aganin after failure of the initial ART(P＜0.05). Multivariate analysis showed that the women with ≥40 years old, the annual household income ≤60,000 Yuan, the duration of infertility ＞ 2 years, the previous treatment costs ＞50,000 Yuan, the women with no history of childbearing, the womrn with traditional conception of childbearing, the lack of knowledge about ART, and the reluctance to ART again after failure of the initial ART were all the influencing factors of the anxiety of the infertile women with advanced age before ART. Age ≥40 years old, the duration of infertility ＞2 years, the previous treatment costs ＞ 50,000 Yuan, no history of childbearing, no knowledge related to ART, and the reluctance to ART again after failure of the initial ART were all the risk factors of the depression of the infertile women with advanced age before ART(all P＜0.05). Conclusion: The infertile women with advanced age have a strong desire to give birth, but their attitude towards ART is still cautious. Most of the women have obvious anxiety and depression before ART, so the health education should be strengthen and psychological counseling should be conducted for maintaining the good psychological state of these women in clinic, so as to improve the success rate of assisted reproduction.

2022 Vol. 30　(11):　2423- [Abstract]（ 233 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To investigate the knowledge about diseases and breastfeeding, and the attitude for infant feeding of women with gestational diabetes mellitus (GDM), and to study their influence factors. Methods: 197 women with GDM who had given birth from November 2021 to April 2022 were investigated by convenience sampling. Results：The scores of disease and breastfeeding knowledge of the women with GDM and their infant feeding attitude were 9.35±3.24 points and 58.25±6.35 points. The degree of education, place of residence, education about breastfeeding, maternal early breastfeeding, and breastfeeding self-efficacy of the women, and the neonatal birth weight were the independent factors of breastfeeding knowledge of the women. The primary caregivers situation, medical treatment charge payment during pregnancy, breastfeeding self-efficacy, neonatal birth weight, neonatal treatment in neonatology department were the independent factors of the attitude for breastfeeding of the women. Conclusion: The knowledge about disease and breastfeeding of the women with GDM need to remain to be promoted. The infant feeding attitude of the women with GDM is not positive. The breastfeeding skills of the women are master, but the breastfeeding benefits of the women known are inadequate, so the personalized breastfeeding health education and proper breastfeeding intervention should be given for these women. The breastfeeding self-efficacy of the women with GDM should be help to promote and their breastfeeding knowledge should be strengthen, the infant feeding attitudes should be improved, so as to  promote maternal breastfeeding and the maternal and infant long-term health.

2022 Vol. 30　(11):　2434- [Abstract]（ 254 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To investigate the effect of dexmedetomidine combined with butorphanol for analgesia of patients after laparoscopic salpingectomy, and to study its influence on the expression level of serum anti-müllerian hormone(AMH)and tumor necrosis factor-α(TNF-α)of these patients. Methods: 108 patients requiring laparoscopic salpingectomy were selected and randomly divided into group A(54 cases)and group B(54 cases)by random number table method from March 2020 to August 2021. After routine anesthesia induction, the patients in the two groups were given horizontal block of transverse abdominal muscle(injection of 0.25% ropivacaine). Then the patients in group A were intravenously injected with dexmedetomidine, and the patients in group B were intravenously injected with dexmedetomidine and butorphanol. The levels of serum AMH and TNF-α at different times, the analgesic effect within 48 hours by pain visual analogue scale(VAS), the intraoperative propofol and remifentanil dosages, the number of compressions of analgesic pump, and the incidence of adverse reactions of the patients were compared between the two groups. Results: The serum AMH level of the patients in group B immediately after extubation, 24h and 48h after operation were 1.26±0.48μg/L, 1.22±0.47μg/L, and 1.21±0.43μg/L, respectively, which were significantly higher than those(1.06±0.49μg/L, 1.02±0.52μg/L, and 1.02±0.46μg/L, respectively)of the patients in group A. The serum TNF-α level of the patients in group B immediately after extubation, 24h and 48h after operation were 1.33±0.45 ng/ml, 1.13±0.42 ng/ml, and 1.41±0.23 ng/ml, respectively, which were significantly lower than those(2.46±0.57 ng/ml, 1.68±0.51 ng/ml, and 1.26±0.48 ng/ml, respectively)of the patients in group A. The VAS scores at 8h, 12h, and 24h after operation of the patients in group B were significantly lower than those of the patients in group A. The intraoperative doses of propofol(412.37±63.27 mg)and remifentanil(736.54±92.16μg)of the patients in group B were significantly lower than those(783.26±96.78 mg and 446.54±72.56μg)of the patients in group A. The times of analgesic pump pressing of the patients at 4h, 8h, 12h, 24h and 48h after operation were significantly less than those of the patients in group A(all P＜0.05). There was no significant difference in the total incidence of adverse reactions(9.26% vs.7.41%)between the two groups(P＞0.05). Conclusion: Dexmedetomidine combined with butorphanol for the patients after laparoscopic salpingectomy can increase their analgesia effect, and can relieve their stress reaction, reduce the dosages of propofol and remifentanil without increase their adverse reactions.

2022 Vol. 30　(11):　2447- [Abstract]（ 257 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To investigate the influence of Xuefu zhuyu capsules combined with progesterone capsules for treating women after endometrial polyps(EP)surgery on their endometrial changes and the recurrence of their EP, and to study its molecular mechanism. Methods: A total of 78 women with EP who underwent hysteroscopic polypectomy were selected and were divided into group A(39 women with treatment of Xuefu zhuyu capsules combined with progesterone capsules for three menstrual cycle)and group B(39 women with treatment of progesterone capsules for three menstrual cycle)according to the random number table method from February 2018 to February 2021. The endometrial thickness, the menstrual blood loss chart(PBAC)score, the syndrome score, the levels of serum inflammatory factors, such as interleukin(IL)-4, IL-6, and tumor necrosis factor-α(TNF-α), and the expressions of progesterone receptor(PR), estrogen receptor(ER), and proliferating nuclear antigen-67(Ki-67)of the women before and after treatment were compared between the two groups. The curative effect and the rates of the adverse reactions and recurrence of PE in the 6th month and the 12th month after operation of the women in the two groups were counted. Results: After treatment, the endometrial thickness(0.61±0.19mm), PBAC score(56.74±9.17 points), and TCM syndrome score(7.68±1.95 points)of the women in group A were significantly lower than those(0.74±0.21mm, 64.25±12.08 points, and 10.32±2.27 points)of the women in group B. The levels of serum IL-4 and PR of the women in group A were significantly higher than those of the women in group B. The levels of serum IL-6, TNF-α, ER, and Ki-67 of the women in group A were significantly lower than those of the women in group B. The total effective rate(94.9%)of the women in group A was significantly higher than that(79.5%)of the women in group B(all P＜0.05). There were no significant differences in the incidences of adverse reactions(15.4% vs. 10.3%)and the recurrence of PE in the 6th month(0 vs. 2.7%)and the 12th month(8.1% vs.13.5%)between the two groups(P＞0.05). Conclusion: The application of Xuefu zhuyu capsules combined with progesterone capsules for treating the women after hysteroscopic endometrial polypectomy can reduce their endometrial thickness and the postoperative recurrence of PE, improve their clinical symptoms with safe and effectiveness. The mechanism may be related to reducing the inflammatory response and to regulating the PR, ER and Ki-67 expressions levels of the women.

2022 Vol. 30　(11):　2457- [Abstract]（ 265 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the effects of Bushen jianpi huayu method combined with drospirenone and ethinylestradiol tablets for treating patients with polycystic ovary syndrome(PCOS)of kidney deficiency and blood stasis type on their TCM syndromes and ovarian function. Methods: 104 patients with PCOS of kidney deficiency and blood stasis type were selected and were randomly divided into control group and observation group(52 cases in each group)from January 2019 to January 2021. The patients in the control group were treated with drospirenone and ethinylestradiol tablets for 3 menstrual cycles, and the patients in the observation group were given Bushen jianpi huayu method on the basis of the medication of the control group additionally for 3 menstrual cycles. The scores of TCM syndromes of the patients before and after treatment were compared between the two groups, and the efficacy for TCM syndromes of the patients in the two groups was evaluated. The results by B ultrasound examination, such as the number of follicles, the endometrial thickness and the ovarian volume, and levels of sex hormones, such as luteinizing hormone(LH), testosterone(T), LH/follicle stimulating hormone(FSH), reproductive hormones anti-Müllerian hormone(AMH), inhibin B(IHNB), leptin(LP), and adiponectin(ADPN)of the patients before and after treatment were compared between the two groups. The menstrual recovery and ovulation recovery of the patients in the two groups were observed, and the adverse reactions of the patients in the two groups were evaluated. Results: After treatment, the TCM syndrome scores of the patients in the two groups had decreased significantly, and which of the patients in the observation group were significantly lower than those of the patients in the control group. The total effective rate of TCM syndrome(92.3%)of the patients in the observation group was significantly higher than that(76.9%)of the patients in the control group(all P＜0.05). The number of follicles, the ovarian volume, the endometrial thickness, the levels of serum LH, T, AMH, and LP, and LH/FSH value of the patients in the two groups had decreased significantly, the ADPN level of the patients in the two groups had increased significantly, and the range of changes of which of the patients in the observation group were significantly more than those of the patients in the control group(all P＜0.05). The recovery rates of menstruation and ovulation(86.5% and 78.9%)of the patients in the observation group were significantly higher than those(67.3% and 59.6%)of the patients in the control group(all P＜0.05). There was no any patient with obvious adverse reactions in the two groups. Conclusion: Bushen jianpi huayu method combined with drospirenone and ethinylestradiol tablets for treating the patients with PCOS of kidney deficiency and blood stasis type can significantly reduce their TCM syndromes scores, enhance their efficacy of TCM syndromes, effectively improve the ovarian reserve function, regulate the levels of sex hormones, down-regulate the level of their serum LP level, promote their ADPN level, and promote their menstrual recovery and ovulation recovery, with high safety in clinical application.

2022 Vol. 30　(11):　2468- [Abstract]（ 332 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the correlation between YAP1 and TAZ expression in placenta tissues of pregnant women with severe preeclampsia(PE)and their perinatal outcomes. Methods: 220 pregnant women with PE were selected as the research objects from March 2018 to September 2020, which included 102 cases with mild preeclampsia in group A and 118 cases with severe preeclampsia in group B. And 72 healthy pregnant women were selected in group C during the same period. The mRNA and protein levels of YAP1 and TAZ in placenta tissue were measured by RT-PCR and immunohistochemistry. The mRNA and protein levels of YAP1 and TAZ of the women were compared among the three groups. Pearson correlation analysis was used to explore the correlation between the mRNA and protein expression levels of YAP1, TAZ of the women and the severity of their PE and their maternal pregnancy outcomes. Results: The mRNA and protein expressions of YAP1 and TAZ of the women in groups C, group A, and group B had decreased gradually(all P＜0.05). The positive rates of YAP1 and TAZ of the women in group C, group A, and group B had decreased gradually(all P＜0.05). The severity of PE of the women was negatively correlated with their mRNA and protein levels of YAP1 and TAZ(all P＜0.05). The placental weight of the women, and the neonatal birth weight and 1 minute Apgar score in groups C, group A, and group B had decreased gradually, and the mRNA and protein levels of YAP1 and TAZ of the women were positively correlated with their placental weight and their neonatal birth weight and 1 minute Apgar score(all P＜0.05). Conclusion: The expressions of YAP1 and TAZ in placenta tissue of the women with severe PE decrease, which are correlated with the adverse perinatal outcomes of these women.

2022 Vol. 30　(11):　2480- [Abstract]（ 232 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To analyze the image feature of foramen ovale restriction or closure(FO-R/C)of fetus by prenatal echocardiography and to explore the value of prenatal echocardiography for diagnosing fetal FO-R/C. Methods: 80 pregnant women diagnosed as fetal FO-R/C by prenatal echocardiography were selected in case group, and 80 pregnant women with healthy fetuses were selected in control group from January 2018 to January 2020. The heart cavity size, such as right atrium(RA), right ventricle(RV), left atrium(LA), and left ventricle(LV), the inner diameter of main pulmonary artery(MPA), aortic(AO), foramen ovale(FO), the velocity aortic valve(VAO)and the pulmonary valve(VMPA)over the blood flow, and velocity foramen ovale(VFO)of maximum flow of the fetuses were measured by echocardiography. The clinical data of the women in the two groups were analyzed. Receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of the ultrasonic parameters for FO-R/C of the fetuses. Results: In the case group, there were 72 cases diagnosed as fetal FO-R, the average diameter of FO of the fetuses was 2.25±0.31mm, and there were 8 cases diagnosed as fetal FO-C. The findings of prenatal echocardiography included 60(75.0%)cases with the increase of RA and the decrease of left ventricular ratio of fetus, 44(55.0%)cases with atrial septal tumor of fetus, 56(70.0%)cases with varying degrees of tricuspid regurgitation of fetus, and 8(10.0%)cases with pericardial effusion. In the case group, 80 children were reexamined by transthoracic echocardiography again on the day of birth, all of them were confirmed to be FO-R/C, and the coincidence rate with prenatal diagnosis was 100.0%. There were significant differences in the values of RV/LV, RA/LA, MPA/AO, VMPA/VAO, FO/AO, and FO/RA of the fetus between the two groups(P＜0.05). ROC analysis showed that the values of RV/LV, RA/LA, MPA/AO, VMPA/VAO, and FO/RA were all the effective indicators for diagnosing fetal FO-R/C, and the areas under the curve of which were 0.933, 0.900, 0.838, 0.708, and 0.593, respectively. Conclusion: Prenatal echocardiography has high diagnostic value for fetal FO-R/C, and it can closely monitor the intrauterine situation of the fetus, which can guide the clinical practice of taking effective measures for improving the prognosis of FO-R/C of the fetuses.

2022 Vol. 30　(11):　2490- [Abstract]（ 364 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To explore the effects of psychological reconstruction based on bibliotherapy of pregnant women with reproductive tract group B streptococcus(GBS)infection on their prenatal anxiety and pregnancy outcomes. Methods: 107 pregnant women with reproductive tract GBS infection were selected as the research subjects and were divided into observation group(n=53)and control group(n=54)according to simple randomization method from March 2020 to August 2021. The women in the control group were given routine nursing intervention, while the women in the observation group were given psychological reconstruction nursing based on bibliotherapy additionally. The psychological status evaluated by Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS), the coping styles evaluated by Medical Coping Modes Questionnaire(MCMQ), the treatment compliance, and the pregnancy outcomes of the women before intervention and before and after delivery were compared between the two groups. Results: The psychological status, the coping styles, and the treatment compliance of the women in the two groups had changed after intervention. The SAS score(44.14±3.17 points and 46.77±3.88 points)and SDS score(43.35±3.11 points and 45.78±3.25 points)of the women in the two groups after intervention had decreased significantly, and the MCMQ face scores(22.16±4.11 points and 19.73±3.87 points)of the women in the two groups after intervention had increased significantly. The yield scores(12.71±3.44 points and 15.12±3.65 points)and avoidance scores(14.27±3.34 points and 16.51±3.28 points)of the women in the two groups after intervention had decreased significantly, and the range of change of which of the women in the observation group were significantly better than those of the women in the control group(all P＜0.05). The total compliance(92.5%)of the women in the observation group was significantly higher than that(77.8%)of the women in the control group(P＞0.05). There was no significant difference in the overall incidence of adverse pregnancy outcomes(7.6% vs.16.7%)of the women between the two groups(P＞0.05). Conclusion: Psychological reconstruction based on bibliotherapy for the pregnant women with reproductive tract GBS infection can significantly reduce their prenatal anxiety and depression, improve their coping styles and treatment compliance, and reduce the incidence rate of their adverse pregnancy outcomes, therefore it is worthy of recommendation.

2022 Vol. 30　(11):　2499- [Abstract]（ 260 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

2022 Vol. 30　(11):　2509- [Abstract]（ 305 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the effects of different delivery modes of primiparas on their anal sphincter complex, pelvic floor muscle strength, and sexual life. Methods: A total of 147 primiparas were selected and were divided into group A(84 cases with vaginal delivery)and group B(63 cases with cesarean section)according to different delivery modes between June 2020 and June 2021. The pelvic floor muscle strength and female sexual life quality questionnaire score of the primiparas in the 12th week after delivery were compared between the two groups. The three-dimensional ultrasound examinations of perineum and pelvic floor were conducted to evaluate the situation of the anal sphincter complexes of the primiparas in both groups, which included the proximal plane, middle plane, and distal plane of internal sphincter muscle of anus, the thickness of distal plane in external sphincter muscle of anus at 3, 6, 9 and 12 o'clock, the thickness of middle plane in puborectalis at 4 and 8 o'clock. The occurrence of postpartum complications of the primiparas was compared between the two groups. Results: The thickness of proximal plane in internal sphincter muscle of anus at 6 and 12 o'clock, and thickness of middle plane at 12 o'clock of the primiparas in group B were significantly higher than those of the primiparas in group A(P＜0.05). The thickness of distal plane in external sphincter muscle of anus at 12 o'clock of the primiparas in group B was significantly higher than that of the primiparas in group A(P＜0.05). The EMG values of type Ⅰ(12.36±1.40μV)and type Ⅱ muscle fibers(19.62±2.04μV)of the primiparas in group B were significantly higher than those(11.47±1.32μV and 17.78±2.45μV)of the primiparas in group A. The degrees of fatigue of type Ⅰand type Ⅱ muscle fibers(7.67±1.32 and 7.33±1.12)of the primiparas in group B were significantly lower than those(8.51±1.15 and 8.64±1.14)of the primiparas in group A(P＜0.05). The scores of female sexual life quality questionnaire of the primiparas in group B were significantly higher than those of the primiparas in group A(all P＜0.05). There was no significant difference in the incidence of postpartum complications(8.3% vs.6.3%)of the primiparas between the two groups(P＞0.05). Conclusion: Compared with those of vaginal delivery, cesarean section of the primiparas have less influence on their postpartum anal sphincter complex, pelvic floor muscle strength, and sexual life.

2022 Vol. 30　(11):　2517- [Abstract]（ 323 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To establish the preimplantation genetic testing (PGT) platform for α-thalassemia and β-thalassemia by implanting MALBAC-NGS technique combining with SNP serial analysis in southern Jiangxi area, and to observe its clinical application. Methods: 12 families with α-thalassemia and 8 families with β-thalassemia were analyzed to build their pedigree haplotypes. Totally 9 PGT treatment periods of the patients with α-thalassemia and 6 PGT treatment periods of the patients with β-thalassemia were completed. The transferable embryos were selected according to the copy number variation and the carrying status of pathogenic loci of chromosome of the embryos, and the amniotic fluid sampling of the pregnant women during the second trimester of pregnancy were obtained for prenatal diagnosis and verification. Internal quality control and external quality control were performed based on the embryos which couldn’t be qualified transplantation due to the embryos with both the copy number variation and the carrying status of pathogenic loci of chromosome of their parents. Results: The results of the established database of the embryo CNV-sequencing/ SNP-sequencing techniques in this laboratory were consistent with those reported by the third-party laboratories. The comparison and analysis of the results of two single-cell genome-wide amplification methods showed that MDA single-cell genome-wide amplification method had a high failure rate of the established database of the embryo CNV-sequencing/ SNP-sequencing techniques CNV/SNP sequencing. Conclusion: The MALBAC technique with more advantage is selected to build the technical platform of PGT of thalassemia successfully in southern Jiangxi area.

2022 Vol. 30　(11):　2526- [Abstract]（ 259 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To explore the effect of goserelin acetate sustained-release implant inserted or gestrinone used after laparoscopic surgery for treating patients with ovarian endometriosis, and to analyze the related factors of postoperative recurrence of endometriosis. Methods: 170 patients with ovarian endometriosis who had undergone laparoscopic surgery were included and were divided into two groups(85 cases in each group)according to the random number table method from January 2016 to October 2020. The patients in the control group were treated with gestrinone for 4 to 6 consecutive cycles, and the patients in the observation group were treated with goserelin acetate sustained-release implant for 4 to 6 consecutive cycles. The therapeutic effect, the serum reproductive hormones levels, and the main symptoms of the patients were compared between the two groups. The incidence of adverse reactions and the recurrence rate within 1year of follow up of the patients in the two groups were counted. Logistic multivariate analysis was used to analyze the related influencing factors of the recurrence of ovarian endometriosis. Results: The total efficacy(90.6%)of the patients in the observation group was significantly higher than that(77.7%)of the patients in the control group. The decrease ranges of the reproductive hormone levels of the patients in the observation group after 6 months of treatment were significantly higher than those of the patients in the control group. The scores of dysmenorrhea, dyspareunia, and pelvic pain of the patients in the observation group were significantly lower than those of the patients in the control group(all P＜0.05). The incidence of adverse reactions(18.8%)of the patients in the observation group had no significantly different from that(16.5%)of the patients in the control group(P＞0.05). The endometriosis recurrence rate within 1 year after operation(8.2%)of the patients in the observation group was significantly lower than that (25.9%)of the patients in the control group(all P＜0.05). Multivariate analysis showed that larger diameter of the largest cyst, the deep endometriosis, and the higher r-AFS score of the patients were the risk factors of their recurrence of ovarian endometriosis(P＜0.05), and the postoperative medication and pregnancy of the patients were the protective factors of their recurrence of ovarian endometriosis(P＜0.05).  Conclusion: The effect of goserelin acetate sustained-release implant for treating patients with ovarian endometriosis after operation is better, and the value of which for preventing endometriosis recurrence is high. The patients with ovarian endometriosis of large cyst diameter, high r-AFS score, or deep lesion have the high risk of postoperative endometriosis recurrence.

2022 Vol. 30　(11):　2537- [Abstract]（ 237 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To investigate the correlation between the expressions of miR-484 and microtubule-associated protein 2(MAP2)in ovarian malignant cyst tissue of patients and their prognosis. Methods: A total of 154 patients with ovarian malignant cysts from June 2015 to June 2018 were collected in study group retrospectively, and 154 patients with the similar general data who had undergone surgery for benign ovarian cysts were selected in control group. The cyst tissues of the patients in the two groups were collected. The expression of MAP2 in cyst tissues was detected by immunohistochemistry and Western blot, and the expression of miR484 in cyst tissues was detected by real-time fluorescence quantitative PCR(qRT-PCR)method. The correlation between the miR-484 expression and the MAP2 expression was analyzed by Pearson method. Kaplan-Meier method was used to analyze the relationship between the expression levels of different miR-484 and MAP2 of the patients and their survival time. Multivariate Cox regression risk model was used to analyze the prognostic factors of the patients with ovarian malignant cysts. Results: The expression of MAP2 of the patients in the study group was significantly higher than that of the patients in the control group, and the expression of miR-484 was of the patients in the study group was significantly lower, and the expression of MAP2 of the patients in the two groups was negative correlation with their expression of miR-484(r=-0.498)(all P＜0.05). The expressions of MAP2 and miR-484 in ovarian malignant cysts tissues of the patients were not related to their age, pathological type, tumor diameter and degree of invasion, but were related to their degree of differentiation, lymph node metastasis, omental metastasis, FIGO stage, and histopathological grade(all P＜0.05). Kaplan-Meier analysis showed that the 3-year cumulative survival rate(44.9%)of the patients with high MAP2 expression was significantly lower than that(65.8%)of the patients with low MAP2 expression(Log rank χ2=7.432, P=0.006). The 3-year cumulative survival rate(65.8%)of the patients with high miR-484 expression was significantly higher than that(44.0%)of the patients with low miR-484 expression(Log rank χ2=8.819, P=0.003). Cox results showed that the high expression of MAP2, the low expression of miR-484, the lymph node metastasis, the FIGO stage, the degree of differentiation, the high expression of MAP2, the low expression of miR-484, and the omentum metastasis of the patients were all the risk factors affecting their prognosis. Conclusion: The expression of miR-484 in ovarian malignant cyst tissues of the patients is low and the expression of MAP2 is high. The expression of miR-484 and the expression of MAP2 are negatively correlated each other, and both of which are closely related to the development and prognosis of ovarian malignant cysts of the patients.

2022 Vol. 30　(11):　2547- [Abstract]（ 292 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To analyze the pregnancy status of women after treatment of uterine fibroids by high intensity focused ultrasound (HIFU), and to study the affecting factors of the pregnancy outcomes of the women. Methods: 220 women with uterine fibroids who wanted pregnancy and had received HIFU treatment from April 2019 to May 2020 were selected retrospectively. These women were followed up for 2 years after treatment by HIFU. The pregnancy and delivery status of these women were recorded. The related factors affecting the pregnancy outcomes of these women were analyzed. Results: There were 148 (67.3%) women with successful pregnancy within 2 years after HIFU treatment, which included 135 women with natural pregnancy and 13 women with pregnancy by assisted reproductive technology. Among 148 women with successful pregnancy, there were 89 (60.1%) cases with delivered, which included 26 cases of vaginal delivery and 63 cases of cesarean section. There were 6 cases with postpartum hemorrhage, 4 cases with uterine compression suture hemostasis, and 2 cases with total hysterectomy. There were 59 cases with abnormal delivery, which included 39 cases with spontaneous abortion and 20 cases with termination of pregnancy due to ectopic pregnancy and placental insufficiency. There were no significant differences in the body mass index (BMI) value, the disease duration, the fibroid type, the maximum diameter of fibroids, the average diameter of fibroids, the fibroid location, and the irradiation power, the irradiation time, and the fibroid ablation rate after HIFU treatment between the women with normal delivery and the women without normal delivery (P＞0.05). There were significant differences in the age, the infertility history, the fibroid volume, and the number of fibroids between the women with normal delivery and the women without normal delivery (P＜0.05). Logistic regression model showed that advanced age, history of infertility, and large size of fibroids of the women were the independent influencing factors of their successful pregnancy and delivery after HIFU treatment (P＜0.05). Conclusion: The successful pregnancy rate of the women in 2 years after uterine fibroids operation by HIFU is high, and the pregnancy outcomes of the women are good. The factors affecting of pregnancy outcomes of these women should be paid attention to in clinic.

2022 Vol. 30　(11):　2557- [Abstract]（ 199 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

2022 Vol. 30　(11):　2566- [Abstract]（ 260 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To investigate the expressions of PAI-1 and HOXA10 genes and their clinical significances of infertility women with endometriosis (EMs). Methods：112 infertility women with endometriosis were selected in study group prospectively and were divided group A (61 women with Ⅰ-Ⅱ stage of EMs) and group B (51 women with Ⅲ-Ⅳstage of EMs) according to the endometriosis staging criteria of the American Fertility Society from April 2017 to October 2021. Another 112 normal women of childbearing age were selected in control group during the same period. The expression differences of PAI-1 and HOXA10 of the women were compared among these groups. The diagnostic efficacies of PAI-1 and HOXA10 of the infertile women for their Ems were analyzed. Results: The levels of PAI-1 (46.15±11.98 ng/ml) and HOXA10 (3.16±0.56) of the women in the study group were significantly higher than those (11.22±2.63 ng/ml and 1.56±0.12) of the women in the control group. The levels of PAI-1 (59.61±1.92 ng/ml) and HOXA10 (3.85±0.52) of the women in group B were significantly higher than those (30.05±2.49 ng/ml and 2.33±0.83) in group A (all P＜0.05). The specificity (57.3%) and the area under the curve (0.822) of the combined of the PAI-1 and HOXA10 levels of the women for diagnosing their EMs complicated with infertility were significantly higher than those of the PAI-1 level or HOXA10 level, and the diagnostic cut-off values of the PAI-1 and HOXA10 levels were 45.12 ng/ml and 3.15, respectively. Conclusion: The PAI-1 and HOXA10 levels of the infertility women with EMs increase abnormally, and which will increase with the development of EMs. The combined of the PAI-1 and HOXA10 levels of the women can increase the diagnostic values for their EMs.

2022 Vol. 30　(11):　2575- [Abstract]（ 259 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To study the value of magnetic resonance imaging (MRI) and transvaginal ultrasound combined with the levels of carbohydrate antigen (CA) 724 and human epididymis secretory protein 4 (HE4) for diagnosing ovarian cancer. Methods: 146 patients with benign or malignant ovarian tumors from September 2018 to September 2021 were analyzed retrospectively. These patients all had undergone vaginal ultrasonography and MRI, and their serum HE4 and CA724 levels were detected by chemiluminescence method. According to the postoperative pathological examination as the standard, these patients were divided into group A (70 patients with benign tumors) and group B (76 patients with malignant tumors). The diagnostic value of transvaginal ultrasound and MRI combined with the serum CA724 and HE4 levels of the patients for their ovarian cancer was analyzed. Results: The serum levels of CA724 (16.65±3.07 U/ml) and HE4 (176.06±23.42 pmol/L) of the patients in group B were significantly higher than those (7.32±1.72 U/ml and 74.85±13.67 pmol/L) of the patients in group A (all P＜0.05). The accuracy, the sensitivity, and the specificity of the HE4 level of the patients for diagnosing their ovarian cancer were 84.9%, 85.7%, and 84.2%, respectively. The accuracy, the sensitivity, and the specificity of the CA72 level of the patients for diagnosing their ovarian cancer were4 were 84.3%, 82.9%, and 84.5%, respectively. The accuracy, the sensitivity, and the specificity of the transvaginal ultrasound of the patients for diagnosing their ovarian cancer were 85.6%, 84.3%, and 98.9%, respectively. The accuracy, the sensitivity, and the specificity of MRI value of the patients for diagnosing their ovarian cancer were 90.4%, 92.9%, and 88.2%, respectively. The accuracy, the sensitivity, and the specificity of transvaginal ultrasound and MRI combined with the serum  CA724 and HE4 levels of the patients for diagnosing their ovarian cancer were 90.4%, 97.1%, and 84.2%, respectively. Conclusion: MRI and transvaginal ultrasound combined with the serum CA724 and HE4 levels of the patients for diagnosing their ovarian cancer is better than MRI, transvaginal ultrasound, the serum  CA724 level, or the HE4 level alone.

2022 Vol. 30　(11):　2583- [Abstract]（ 300 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To evaluate the value of magnetic resonance-perfusion weight imaging (MR-PWI) parameters in the assessment of endometrial receptivity of infertility women with adenomyosis. Methods:  53 infertility women with adenomyosi from June 2019 to June 2021 were collected in study group retrospectively. 50 normal women with the same age and normal reproductive function were selected in control group during the same period. MRI perfusion imaging was performed for the women in the two groups during the 19th-22nd days of menstrual cycle. The endometrial and subendometrial perfusion parameters, such as positive enhancement integral (PEI), maximum slope of increase (MSI), and mean time to enhance (MTE) of the women in the two groups were recorded. The MRI features and the perfusion parameters of endometrial and subendometrial blood flow of the women in the study group were analyzed. Results: There were 33 cases with diffuse adenomyosis in these 53 women in the study group, and the T2WI scan showed that the diffuse homogeneous or uneven thickening of uterine junctional zone in these 33 women. The thickness of uterine junctional zone (29.66±3.16 mm) of the women in the study group was significantly thicker than that (10.06±1.74mm) of the women in the control group (P＜0.001). A total of 42 lesions of the women in the study were found, which showed middle intensity of T1WI sequences, and hypointensity with scattered dot-like high signal inside of T2WI sequences. There were 20 cases with localized adenomyosis in the study group, and these women had limited enlargement of the body or bottom of the uterus and had thickened junctional zone in the localized adenomyosis. The thickness of uterine junctional zone (22.39±3.74mm) of the women in the study group was significantly thicker than that  of the women in the control group (P＜0.001). 27 lesions in these 20 cases with localized adenomyosis were identified , which showed  the middle intensity of T1WI and a mass shadow similar to the signal of the junctional zone of T2WI. The uterine volume of the women in the study was significantly bigger than thata of the women in the  control group, the endometrial thickness of the women in the study was significantly thinner, the values of MR-PWI perfusion parameters, such as PEI and MSI, in the endometrium and in sub-endometrium of the women in the study were significantly lower, and the MTE value of the women in the study was significantly higher (all P＜0.05). Correlation analysis showed that endometrial thickness of the women in the study was positively correlated with their endometrial thickness and their values of MR-PWI perfusion parameters, such as PEI and MSI (P＜0.05), while had no correlation with their MTE value (P＞0.05). Conclusion: MR-PWI parameters can be used as an auxiliary indexes to judge the prognosis of embryo implantation of the infertility women with adenomyosis.

2022 Vol. 30　(11):　2592- [Abstract]（ 228 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To analyze the differences of blood lipid and sex hormone levels of patients with polycystic ovary syndrome (PCOS) and different thyroid stimulating hormone (TSH) levels. Methods: 82 patients with PCOS were included in observation group, and 70 childbearing age women with the same age and regular menstruation were enrolled in control group. The percentage of the patients with TSH >4.0 μIU/ml was compared between the two groups. And the patients in the observation group were further divided group A (patients with TSH >4μIU/ml) and group B (patients with TSH  ≤4μIU/ml) according to their TSH levels. The detection rates of obesity, abdominal obesity, insulin resistance (IR), hyperandrogenemia, and positivity of thyroid-related antibodies of the patients were compared between group A and group B. The endocrine metabolic parameters, such as fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), estradiol (E2), progesterone (P), total testosterone (T), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), and LH/FSH of the patients in the observation group were recorded. Results: The proportion of the patients with TSH >4.0μIU/ml (23.5%) in observation group was significantly higher than that (2.9%) the patients in the control group (P＜0.05). In the observation group, the detection rates of obesity, abdominal obesity, IR, and positivity of thyroidrelated antibodies of the patients in group A were significantly higher than those of the patients in group B. The levels of E2, P, T, and HDL-C of the patients in group A were significantly lower than those of the patients in group B. The levels of RPL, TG, FBG, and FINS, and the HOMA-IR value of the patients in group A were significantly higher than those of the patients in group B (all P＜0.05). Conclusion: The incidence of the elevated TSH level of the patients with PCOS is higher than that of the normal women, and the increase of TSH level aggravates the obesity and IR of the patients with PCOS. The increase of THS level may affect the reproductive and endocrine disorders of the patients with PCOS by affecting their sex hormones and glucose and lipid metabolism.

2022 Vol. 30　(11):　2600- [Abstract]（ 241 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To analyze the clinical differential value of abdominal color doppler ultrasound combined with diffusion-weighted imaging for diagnosing uterine myoma and adenomyosis. Methods: A total of 140 patients suspected of having uterine fibroids and adenomyosis from January 2018 to June 2021 were included in this study. All of these patients were subjected to abdominal color Doppler ultrasound and diffusion-weighted imaging before surgery. Taking postoperative pathological examination as the gold standard, the imaging characteristics of ultrasound and diffusion-weighted imaging were analyzed. The differential diagnostic efficacy for uterine myoma and adenomyosis was compared between abdominal color doppler ultrasound and diffusion-weighted imaging. Results: In 140 patients, there were 78 cases of uterine fibroids and 62 cases of adenomyosis were confirmed by pathological examination. There were 67 patients with uterine fibroids detected by abdominal color Doppler ultrasound, with the diagnostic coincidence rate of 85.9%, and there were 47 patients with adenomyosis, with the diagnostic coincidence rate of 75.8%. There were 71 cases of uterine fibroids detected by diffusion weighted imaging, with the diagnostic coincidence rate of 91.0%, and there were 55 patients with adenomyosis, with the diagnostic coincidence rate of 88.7%. There was no significant difference in the diagnostic coincidence rate between the abdominal color Doppler ultrasound and diffusion weighted imaging (P＞0.05). The values of the uterine artery pulsatile index (PI) and resistance index (RI) of the patients with uterine fibroids were significantly lower than those of the patients with adenomyosis. The rate of clear mass boundary of (65.4%) of the patients with uterine fibroids was significantly higher than that (29.0%) of the patients with adenomyosis (all P＜0.05). There was no significant difference in the ratio of T1WI, T2WI and DWI signal intensity of the diffusion-weighted imaging between the patients with uterine fibroids and the patients with adenomyosis (P＞0.05). The rate of regular mass boundary of uterine fibroids was significantly higher than that of adenomyosis, and the  rate of blurred mass boundary of adenomyosis was significantly higher than that of uterine fibroids (P＜0.05). The ADC values in uterine fibroids and adenomyosis were significantly lower than those in normal myometrium tissue, and which in uterine fibroids was significantly higher than that in adenomyosis (P＜0.05). Receiver operating characteristic curve showed that the AUC of abdominal color Doppler ultrasound and diffusion-weighted imaging for differentiating uterine fibroids from adenomyosis were 0.801 and 0.846, with the sensitivity of 79.4% and 85.2%, and the specificity of 85.1% and 88.1%. The ACU, the sensitivity, and the specificity of abdominal color Doppler ultrasound and diffusion-weighted imaging for differentiating uterine fibroids from adenomyosis were 0.954, 99.2%, and  98.4%, respectively. Conclusion: Abdominal color Doppler ultrasound combined with diffusion-weighted imaging has great value for differential diagnosing uterine myoma from adenomyosis.

2022 Vol. 30　(11):　2611- [Abstract]（ 238 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To analyze the values of peak systolic blood flow velocity (PSV) and resistance index (RI) measured by transvaginal color Doppler ultrasound combined with serum cancer antigen 125 (CA125) level for differential diagnosing benign or malignant ovarian tumors. Methods: A total of 91 patients with ovarian tumors from December 2017 to December 2021 were collected retrospectively. These patients were divided into group A (56 patients with benign ovarian tumors) and group B (35 patients with malignant ovarian tumors) according to their pathological results after surgery. The values of PSV and RI, and the CA125 level of the patients were compared between the two groups. The diagnostic value of the values of PSV and RI, and the CA125 level of the patients for their benign or malignant ovarian tumors was analyzed by receiver operating characteristic (ROC) curve. Results: The PSV value and the CA125 level of the patients in group B were significantly higher than those of the patients in group A, and the RI value of the patients in group B was significantly lower (all P＜0.05). ROC curve analysis showed that the specificity of the RI value for differential diagnosing benign or malignant ovarian tumors was the highest (88.2%). The sensitivity (83.0%), the accuracy (84.6%), and the negative predictive value (91.1%) of the PSV and RI values combined with the CA125 level of the patients for differential diagnosing their benign or malignant ovarian tumors were significantly higher than those of the PSV value, the RI value, or the CA125 level alone. Conclusion: The PSV value, the RI value, and the CA125 level of the patients with benign or malignant ovarian tumors are different. The PSV and RI values combined with the CA125 level of the patients for differential diagnosing their benign or malignant ovarian can improve the sensitivity and the accuracy of diagnosis, which is conducive to the development of subsequent treatment plan.

2022 Vol. 30　(11):　2620- [Abstract]（ 265 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the value of serum pregnancy-associated plasma protein A (PAPP-A) combined with ultrasonography examination of pregnant women for diagnosing placental abruption early. Methods: The clinical data of 157 pregnant women with high risk factors from January 2018 to January 2021 were selected in this study, which included 112 cases without placental abruption in group A and 45 cases were with placental abruption in group B. The expression level of serum PAPP-A of the women in the two groups was detected by enzyme-linked immunosorbent assay, and the placenta situation of the women in the two groups was examined by color Doppler ultrasonography. Receiver operator characteristic (ROC) curve was used to analyze the values of PAPP-A level and ultrasonography examination of pregnant women for diagnosing their placental abruption. The consistency of clinical results was determined by Kappa test. Results: The expression level of serum PAPP-A of the women in group B was significantly lower than that of the women in group A (P＜0.05).  The area under curve, the specificity, the sensitivity, and the cut-off value of the serum PAPP-A level of the women for diagnosing their placental abruption were 0.899, 95.5%, 73.3%, and 3.88 U/L, respectively. The sensitivity, the specificity, and the negative predictive value of the serum PAPP-A level combined with ultrasonography examination for diagnosing their placental abruption were 93.3%, 93.6%, and 97.2%, respectively, which were significantly higher than those of the serum PAPP-A level or ultrasonography examination alone (all P＜0.05). The consistency between the ultrasonography examination and serum PAPP-A level of the women for diagnosing their placental abruption and their clinical results were higher and extremely high (Kappa=0.758, 0.848, all P＜0.05). The proportion of stillbirth, uterine placental apoplexy, and postpartum hemorrhage of the women, and low body weight infants in group B were significantly higher than those in group A (P＜0.05). Conclusion: Ultrasound examination combined with the level of serum PAPP-A of the pregnant women can improve the
clinical detection efficacy of their placental abruption.

2022 Vol. 30　(11):　2629- [Abstract]（ 307 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To explore the influence of maternal psycho-psychological and personal factors of pregnant women on their incidence of adverse delivery outcomes. Methods: The clinical data of 122 primiparas who gave birth in hospital from March 2020 to March 2022were collected. The incidence of adverse delivery outcomes of these primiparas was investigated. Self-rating Anxiety Scale (SAS) was used to evaluate the anxiety of the primiparas. Multivariate logistic regression was used to analyze the influencing factors of maternal adverse delivery outcomes. Results: The incidence of adverse delivery outcomes of these primiparas was 66.4%, including 45 cases with postpartum hemorrhage and 30 cases with neonatal asphyxia. The SAS score of these primiparas was 64.23±3.23 points, including 55 cases with mild anxiety, 43 cases with moderate anxiety, and 24 cases with severe anxiety. The maternal age ≥35 years and the moderate to severe anxiety of the primiparas were the risk factors of their postpartum hemorrhage, and the age ≥35 years old, the moderate to severe anxiety, the abnormal labor, the gestational diabetes mellitus, and the placenta previa of the primiparas were the risk factors of their neonatal asphyxia (all P＜0.05). Conclusions: The risk factors of adverse delivery outcomes, such as postpartum hemorrhage and neonatal asphyxia, include advanced age, prolonged duration of labor, gestational diabetes mellitus, placenta previa, and anxiety. The primiparas with these risk factors of adverse delivery outcomes should be paid attention in clinic. Timely treatment of the abnormal conditions of the primiparas can reduce the risk of their adverse delivery outcomes. 

2022 Vol. 30　(11):　2639- [Abstract]（ 280 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To investigate the risk factors of macrosomia delivered by pregnant women with gestational diabetes mellitus (GDM). Methods: The clinical data of 318 pregnant women with GDM from September 2019 to March 2021 were analyzed retrospectively. These women were divided into group A (82 women with macrosomia)and group B (236 women with normal weight newborns). The levels of blood glucose, secreted frirzzled-relaled prolein 4 (sFRP4), and ficolin-3 of the women were compared between the two groups. Multivariate Logistic regression was used to analyze the risk factors of macrosomia. Results: The fasting blood glucose (FBG)level (5.04±0.36 mmol/L)of the women in group A during 28-32 gestational weeks was significantly higher than that (4.71±0.43 mmol/L)of the women in group B (P＜0.05). There was no significant difference in the 1h blood glucose (BG)level of the oral glucose tolerance test (OGTT)of the women between the two groups (P＞0.05). The levels of 2hBG and 3hBG (8.78±1.34 mmol/L and 7.41±1.12 mmol/L)of the women in group A were significantly higher than those (8.26±1.38 mmol/L and 6.98±1.11 mmol/L)of the women in group B (P＜0.05). The levels of sFRP4 and ficolin-3 (125.79±30.78 ng/ml and 26.98±5.12 ng/ml)of the women in group A were significantly higher than those (105.98±25.52 ng/ml and 23.33±3.30 ng/ml)of the women in group B (P＜0.05). Multivariate analysis showed that maternal age ≥26 years old, the sFRP4 level ≥95.5 ng/ml, the ficolin-3 level ≥21 ng/ml, the FPG level ≥4.7 mmol/L during 28-32 gestational weeks, the values of maternal pre-pregnancy body mass index ≥25 kg/m2, and the abnormal gestational weight gain of the women were the risk factors of macrosomia (P＜0.05). Conclusion: The blood glucose level of the pregnant women with GDM during28-32 gestational weeks is abnormal, and their sFRP4 and ficolin-3 levels increase abnormally. The maternal age, the sFRP4 level, the ficolin-3 level, the FPG level during 28-32 gestational weeks, the maternal pre-pregnancy body mass index, and the abnormal gestational weight gain of the women were the risk factors of their macrosomia.

2022 Vol. 30　(11):　2647- [Abstract]（ 234 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

Recurrent spontaneous abortion (RSA) refers to the spontaneous loss of pregnancy of women within 20 gestational weeks that occurs three or more times in a row. The cause of RSA is still unclear. At present, the study of lymphocytes in the women with RSA is more and more in-depth. Many scholars believe that the occurrence of RSA of the women is related to the dysfunction and abnormal number of their natural killer cells, regulatory T cells, Th17 cells and other lymphocytes. To study the correlation between the various lymphocytes of the women and their RSA is undoubtedly to increase the understanding of the occurrence and development of RSA, and to provide a new direction for the treatment of RSA. This review mainly summarizes the researches on the correlation between the RSA occurrence and some immune cells (including NK cells, T lymphocytes, and B lymphocytes) in recent years, so as to expounds the research progress of the role of lymphocytes in RSA.

2022 Vol. 30　(11):　2655- [Abstract]（ 313 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )