To investigate the transcriptomics change of brown adipose tissue (BAT)of pregnant mice with gestational diabetes mellitus (GDM), and to study its influence on the thermogenic activity changes. Methods: The transcriptome expression profiles of 6 pregnant mice were analyzed by high-throughput sequencing, which included 3 normal pregnant mice in group A and 3 pregnant mice with GDM in group B. The differentially expressed genes of the mice were screening. The gene ontology (GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG)analyses were performed. The expression of the uncoupling protein 1 (UCP1)of marker protein of the mice was detected by immunohistochemistry, Western blot, and real-time PCR in order to evaluate the thermogenic activity of BAT of the mice with GDM. Results: The high-throughput sequencing had identified 372 differentially expressed genes, of which, 255 genes of the mice with GDM were down-regulated and 117 genes were up-regulated. GO and KEGG analysis showed that the main targets of these differential genes of the mice were closely related to the abnormal lipid metabolism and the insulin signal transduction. Compared with those of the mice in group A, BAT of the mice in group B showed the increased lipid droplets, the loose texture, and the decreased UCP1 protein and gene expressions. Conclusion: The transcriptome profiles in BAT of the mice with GDM are significantly different from that of the mice with normal pregnancy. The thermogenic activity of the mice with GDM decreases, which may cause the glucolipid metabolism and insulin resistance disorders of these mice.

2023 Vol. 31　(3):　495- [Abstract]（ 1364 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To investigate the knowledge, attitudes, and practices (KAP)towards combined oral contraceptives (COCs)among obstetrician-gynecologist in China, and to provide the evidences for the application and extension of COCs in China. Methods: The study subjects were recruited via the national family planning practitioner network. The eligible obstetrician-gynecologists were invited to complete a self-administered questionnaire between June 2021 to April 2022. The information of the background and KAP about COCs of the respondents was collected. Category analysis, Cochran-Mantel-Haenszel test, latent class analysis, and two-level binomial logistic regression were used for data analysis. Results: A total of 1600 subjects were screened. Of them, 1450 (90.63%)were eligible and completed questionnaires. The median of COC knowledge scores of the subjects was 73.2(60.6-80.3)points. The scores of COC advantages and disadvantages, mechanisms, contraindications, and non-contraceptive indications of the subjects were 72.9(52.1-77.1)points, 80.0(80.0-100.0)points, 77.8 (66.7-88.9)points, and 88.9 (77.8-100.0)points, respectively. Regarding the attitude towards COCs of the subjects, “users lack of awareness of COCs” (85.2%)and “increasing risk of venous thrombosis” (75.5%)were the top two reasons for reluctant using  COCs. “clients having contraceptive needs without contraindication” (89.9%), “clients having treatment needs without contraindication” (86.9%), and “clients choosing COCs due to ineligible for the use of intrauterine devices” (84.9%)were the top three reasons for using COCs. The results of two-level binomial logistic regression indicated that the good COC knowledge (OR=1.74, 95%CI 1.25-2.44)and the positive attitude towards COCs (OR=4.33, 95%CI 2.77-6.76)of the obstetrician-gynecologists had significantly associated with their clinical application of COCs. Conclusion: The insufficient knowledge and the negative attitude toward COCs of obstetrician-gynecologists in China are found in this survey, and which impact the obstetrician-gynecologists in their clinical practice behavior for providing COC services. It is recommended to strengthen the training of contraceptive knowledge of obstetrician-gynecologists, so as to provide high-quality family planning counseling and guidance services for their clients.

2023 Vol. 31　(3):　505- [Abstract]（ 489 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To explore the clinical effect of thunder fire moxibustion combined with Guizhi fuling pills for treating patients  with chronic pelvic inflammatory disease (CPID), and to study its influence on the transforming growth factor-β1/drosophila mothers against decapentaplegic protein (TGF-β1/Smads)pathway of the patients. Methods: 102 patients with CPID were selected and were divided into two groups according to the random number table method from February 2019 to February 2021. 51 patients in the control group received treatment of metronidazole combined with evofloxacin, and 51 patients in the observation group were treated with thunder fire moxibustion combined with Guizhi fuling pills except to the treatment of the patients in the control group. The scores of TCM symptoms, such as primary symptom, secondary symptom, and local signs, the levels of TGF-β1/Smads pathway, such as TGF-β1,Smad2, and Smad3, the levels of mediators, such as erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor α(TNF-α), the values of hemorheology, such as high-cut whole blood viscosity, low-cut whole blood viscosity, plasma viscosity, and hematocrit, and the values of imaging indicators, such as enlarged attachments, pelvic fluid, and pelvic mass, of the patients before and after treatment were analyzed and compared between the two groups. The clinical efficacy and safety of the patients in the two groups after treatment were also analyzed and compared. Results: The quantitative scores of main symptoms, secondary symptoms, and local signs of the patients in both groups after treatment 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 levels of TGF-β1 mRNA, Smad2 mRNA, Smad3 mRNA, ESR, hs-CRP, and TNF-α, and the values of whole blood viscosity high cut, whole blood viscosity low cut, plasma viscosity, and erythrocyte ratio of the patients in both 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. B-ultrasound examination after treatment showed that the proportions of the thickened appendages, pelvic effusion, and pelvic mass of the patients in both 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 (all P＜0.05). The total effective rate (92.2%)of the patients in the observation group was significantly higher than that (76.5%)of the patients in the control group (P＜0.05), and there was no significant difference in the adverse reaction (13.7% vs.11.8%)of the patients between the two groups (P＞0.05). Conclusion: Thunder fire moxibustion combined with Guizhi fuling pills for treating the patients with CPID can inhibit their TGF-β1/Smads pathway, reduce their symptoms and body inflammation, improve their blood rheology and imaging indicators, and which has higher efficacy, with safety and reliability.

2023 Vol. 31　(3):　515- [Abstract]（ 474 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To explore the effects of combined intravenous and inhalation anesthesia used during laparoscopic myomectomy of patients on their stress status, recovery quality, and cognitive function. Methods: 114 patients who wanted laparoscopic myomectomy were selected and were divided into two groups (57 cases in each group)according to the simple random method from February 2020 to September 2021. The patients in group A were given intravenous general anesthesia, and then were given intravenous pump injection of remifentanil combined with propofol for anesthesia maintenance, while the patients in group B were given combined intravenous and inhalation anesthesia, and then were given intravenous pump injection of remifentanil combined with inhalation of sevoflurane for anesthesia maintenance. The hemodynamic indicators, such as heart rate (HR), mean arterial pressure (MAP), and blood oxygen saturation (SpO2), before anesthesia induction (T0), at 5 min before establishment of pneumoperitoneum (T1), at 5 min after pneumoperitoneum (T2), and at the end of surgery (T3), the anesthesia recovery quality, the stress status, such as cortisol (COR)level, noradrenaline (NA)level, and blood glucose (Clu)level before anesthesia induction, at the end of surgery, and at 2h after surgery, the cognitive function by Mini-Mental State Examination(MMSE)before surgery and at 6 h, 24 h, and 48 h after surgery, and the adverse drug reactions rate of the patients were compared between the two groups. Results: The values of HR and MAP of the patients in group B at T2 and T3 were significantly lower than those of the patients in group A. The spontaneous respiration recovery time, extubation time, awaking time, and orientation recovery time of the patients in group B were significantly lower than those of the patients in group A. The Steward score of the patients in group B at 15min or 30min after extubation was significantly higher than that of the patients in group A (all P＜0.05). The levels of Cor, ALD, and Glu in peripheral blood of the patients in both groups at the end of surgery and 2h after surgery were significantly higher than those before anesthesia, but which of the patients in group B were significantly lower than those of the patients in group A (P＜0.05). The MMSE scores of the patients in both groups after surgery had decreased significantly, and which of the patients in group B at postoperative 6h and 24h were significantly higher than those of the patients in group A. The incidence of cognitive impairment (3.5%)of the patients in group B at 24h after surgery was significantly lower than that (14.0%)of the patients in group A (all P＜0.05). There was no significant difference in the incidence of adverse reactions (7.0% vs. 10.5%)of the patients between the two groups (P＞0.05). Conclusion: Combined intravenous inhalation and anesthesia used during laparoscopic myomectomy of the patients can effectively maintain their hemodynamic stability, reduce their stress response and incidence rate of postoperative cognitive impairment, with higher recovery quality.

2023 Vol. 31　(3):　527- [Abstract]（ 855 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To analyze the effects of dezocine used in general anesthesia during laparoscopic surgery of patients on their postoperative extubation reaction and chills. Methods: A total of 93 patients who wanted laparoscopic surgery under general anesthesia were selected as the study subjects and were randomly divided into study group (n=46)and control group (n=47)from January 2021 to December 2021. The patients in the study group were given intravenous injection of dezocine 0.1mg/kg within half an hour before the end of the surgery, while the patients in the control group were given intravenous injection of the same amount of normal saline. The changes of the hemodynamic and Ramsay sedation score of the patients in the two groups were observed before administration (T0), at 10min after administration (T1), immediately after extubation (T2), and at 5min after extubation (T3). The occurrence of extubation reactions, such as coughing and agitation, the operation time, the awakening time, the chills situation evaluated by Wrench, and the postoperative adverse reactions of the patients in the two groups were observed. Results: The scores of hemodynamics and Ramsay sedation of the patients in the study group at T1, T2, and T3 were significantly lower than those of the patients in the control group. The incidence of extubation reaction (4.4%)of the patients in the study group was significantly lower than that (19.2%)of the patients in the control group (P＜0.05). There were no significant differences in the operation time and the awakening time of the patients between the two groups (P＞0.05). The incidence of postoperative chills (40.4%)of the patients in the control group was significantly higher than that (13.0%)of the patients in the study group (P＜0.05). The incidence of adverse reactions within 24 hours after surgery (25.5%)of the patients in the study group was not different from that (17.4%)of the patients in the control group (P＞0.05). Conclusion: The intraoperative application of dezocine in general anesthesia during laparoscopic surgery of the patients can significantly reduce the incidences of their extubation reaction and postoperative chills, and which can effectively stabilize the changes of intraoperative hemodynamic and the depth of sedation of the patients.

2023 Vol. 31　(3):　537- [Abstract]（ 475 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To explore the effect of bevacizumab combined with docetaxel and gemcitabine for treating patients with recurrent platinum-resistant advanced ovarian cancer, and to study its influence of the levels of serum carbohydrate antigen 125 (CA125), human epididymal protein 4 (HE4), and high mobility group protein B1 (HMGB1), and the prognosis of the patients. Methods: A total of 62 patients with recurrent platinum-resistant advanced ovarian cancer were enrolled and were divided into observation group (31 cases)and control group (31 cases)according to random number table method from January 2019 to December 2020. The patients in the control group were treated with docetaxel and gemcitabine, while the patients in the observation group were treated with bevacizumab combined with docetaxel and gemcitabine. After 6 treatment cycles, the clinical curative effect and the occurrence of adverse reactions of the patients were compared between the two groups. The levels of serum CA125, HE4, and HMGB1 of the patients in the two groups before and after treatment were detected. The scores of Karnofsky performance status (KPS)and the survival rate within 1 year after treatment of the patients were compared between the two groups. Results: After 6 cycles of treatment, the remission rate of ovarian cancer (83.9%)and KPS score (72.13±8.78 points)of the patients in the observation group were significantly higher than those (61.3% and 63.78±7.35 points))of the patients in the control group, and the levels of serum CA125 (35.65±7.55 U/ml), HE4 (124.35±29.27 pmol/L), and HMGB1 (85.44±8.90μg/ml)of the patients in the observation group were significantly lower than those (50.22±8.95 U/ml, 175.54±26.10 pmol/L, and 100.28±12.40μg/ml)of the patients in the control group. The 1-year survival rate (74.2%)of the patients in the observation group was significantly higher than that (48.4%)of the patients in the control group (all P＜0.05). There was no significant difference in the total incidence of adverse reactions (35.5% vs.25.8%)of the patients between the two groups (P＞0.05). Conclusion: Evacizumab combined with docetaxel and gemcitabine for treating the patients with recurrent platinum-resistant advanced ovarian cancer can effectively reduce their levels of serum CA125, HE4, and HMGB1, improve their quality of life, prolong their survival time, and increase their survival rate, without the increased adverse reactions.

2023 Vol. 31　(3):　547- [Abstract]（ 936 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To explore the effect of continuous suture and interrupted suture of perineal lateral incision of women, and to study their influence on the recovery of the incision of the women. Methods: 141 women with perineal lateral incision after natural delivery were selected as the research subjects and were divided into two groups by random number table method between March 2019 and March 2021. 71 women in group A were given continuous suture of perineal lateral incision, and 70 women in group B were given interrupted suture of perineal lateral incision. The women in the two groups were followed up for 3 months. The time differences of incision suture, healing, incision pain, and hospital stay of the women were compared between the two groups. The incision healing situations of the women in the two groups after 3 days of delivery were analyzed. The sexual function of the women in the two groups in the 3th month after delivery were evaluated by Female Sexual Function Index (FSFI), and the incidences of the adverse reactions in incision of the women during hospitalization and follow-up were compared between the two groups. Results: The perineal incision suture time (15.5±2.7 min), the healing time (5.9±2.0 d), the incision pain time (2.3±0.6 d), and the time of hospital stay (5.8±1.1 d)of the women in group A were all significantly shorter than those (20.1±2.6 min, 7.3±1.9 d, 3.0±0.7 d, and 6.8±1.6d)of the women in group B. The wound healing quality of the women in group A in the 3rd day after delivery was significantly better than that of the women in group B. The scores of FSFI of the women in group A in the postpartum 3rd month were significantly higher than those of the women in group B (all P＜0.05). There were no significant differences in the incidence of the line reaction in incision, and the scar tenderness and infection of the women between the two groups (P＞0.05). The incidence of subcutaneous scleroma (2.8%)of the women in group A was significantly lower than that (11.4%)of the women in group B (P＜0.05). Conclusion: The operation time of continuous suture of perineal lateral incision of the women is shorter than that of interrupted suture, which is beneficial to the incision healing and the maternal sexual function, with less adverse reactions after suture.
 

2023 Vol. 31　(3):　557- [Abstract]（ 421 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To study the best method of umbilical cord ligation of the neonates during cesarean section, and to study its influence on the outcomes, blood gas analysis results and the neurobehavioral function of the neonates. Methods: A prospective study was conducted on 120 women who wanted cesarean section from January 2019 to January 2021. These women were randomly divided into three groups. The umbilical cord of the neonates of the women in group A was squeezed in 60s after born, and then was ligated within 1 to 3 minutes. The umbilical cord of the neonates of the women in group B was ligated within 60s after born, and then was squeezed in 3 minutes. The umbilical cord of the neonates of the women in group C was ligated within 60s. The values of heart rate and oxygen partial pressure at 10min after birth, the values of bilirubin and nerve function in the 4th day after birth of the neonates were compared among the three groups. Results: The heart rate of the neonates at 10min after birth in group A (146.69±1.77 beats/min), in group B (148.22±2.87 beats/min), and in group C (158.81±1.66 beats/min)had increased gradually. The value of oxygen partial pressure of the neonates at 10min after birth in group A (98.96±2.64%), in group B (96.28±2.43%), and in group C (92.62±2.25%)had decreased gradually. The values of RBC count, hemoglobin, and hematocrit of the neonates in 24h after birth in group A, group B, and group C had decreased gradually. The scores of primitive reflex, passive muscle strength, behavioral ability, and active muscle strength, and the general condition of the neonates in group A, group B, and group C had decreased gradually. The total score of neurobehavioral function of the neonates in group A (36.94±2.51 points), in group B (34.76±2.45 points), and in group C (32.38±2.78 points)had decreased gradually (all P＜0.05). Conclusion: The squeezing neonatal umbilical cord and then delayed ligation of the neonates during cesarean section can significantly increase the values of the neonatal hemoglobin and blood cells, and can improve the neonatal neurobehavioral function scores.

2023 Vol. 31　(3):　566- [Abstract]（ 451 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To explore the effect of aspirin combined with prednisone for treating patients with recurrent abortion, and to study its influence on the immune balance and pregnancy outcomes of these patients. Methods: 82 patients with recurrent abortion were selected prospectively, and were divided into two groups by digital table method (41 cases in each group)from January 2018 to January 2020. The patients in the control group received treatment of aspirin, while the patients in the study group received treatment of aspirin combined with prednisone. The levels of serum immune factor, vitamin D, thrombine-activated fibrinolytic inhibitor (TAFI), and the pregnancy outcomes before and after treatment of the patients were compared between the two groups. Results: The total effective rate (97.7%)and the success rate of pregnancy (80.5%)of the patients in the study group were significantly higher than those (78.1% and 58.5%)of the patients in the control group. The rate of preterm birth (24.4%)of the patients in the study group was significantly lower than that (51.2%)of the patients in the control group (all P＜0.05). There were no significant differences in the placental abruption, the premature rupture of membranes, and the live birth rates of the patients between the two groups (P＞0.05). The serum interleukin-2 (IL-2)levels and the IL-2/IL-10 value of the patients in both groups after treatment had decreased significantly, and the IL-10 level of the patients in both groups after treatment had increased significantly, and the IL-2 level (10.28±1.48pg/ml)and the IL-2/IL-10 value (0.89±0.06)of the patients in the study group after treatment were significantly lower than those (12.95±1.74pg/ml and 1.39±0.25)of the patients in the control group. The IL-10 level (11.85±1.48pg/ml)of the patients in the study group after treatment was significantly higher than that (9.73±1.28pg/ml)of the patients in the control group (all P＜0.05). The activated thrombin time (APTT)value of the patients in both groups after treatment had increased significantly, while the levels of platelet (PLT)and fibrinogen (FIB)of the patients in both groups after treatment had decreased significantly. The APTT value (35.8±3.9s)of the patients in the study group after treatment was significantly higher than that (33.81±3.16s)of the patients in the control group. The levels of PLT (153.67±20.24 109/L)and FIB (2.54±0.15g/L)of the patients in the study group after treatment were significantly lower than those (165.83±21.85 109/L and 2.69±0.35g/L)of the patients in the control group. The levels of serum vitamin D and TAFI of the patients in both groups had increased significantly, and the levels of vitamin D (45.71±2.85ng/ml)and TAFI (14.86±1.85μg/ml)of the patients in the study group were significantly higher than those (38.71±3.75ng/ml and 12.75±1.74μg/ml)of the patients in the control group (P＜0.05). There were 1 patient with nausea and vomiting and 1 patient with dizziness in the control group, and there were 2 patients with nausea and vomiting and 1 patient with lower limb edema in the study group. The total incidence of adverse reactions (4.9% vs. 7.3%)of the patients had no significantly different between the two groups. No serious adverse reactions occurred of the patients in the two groups during treatment. The adverse reactions of the patients in both groups had obviously relieved after drug withdrawal. Conclusion: Aspirin combined with prednisone for treating the patients with recurrent abortion can promote their immune balance and improve their pregnancy outcomes, with good safety.

2023 Vol. 31　(3):　575- [Abstract]（ 857 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To explore the evaluative values of the levels of inhibin B(INHB), anti-Mullerian hormone (AMH), and basal follicle stimulating hormone (bFSH)of women with infertility induced by polycystic ovary syndrome (PCOS)for their ovarian reserve function. Methods: A total of 87 women with PCOS induced infertility (in study group)and 53 healthy women (in control group)between October 2019 and October 2020 were collected respectively. The levels of serum INHB, AMH, and bFSH of the women in the two groups were detected. According to the number of retrieved oocytes, the women in the study group were divided into group A (women with ovarian low response)and group B (women with normal ovarian response). And the levels of serum INHB, AMH, and bFSH of the women for evaluating their ovarian reserve function was analyzed. Results: The levels of serum INHB (149.78±36.92 pg/ml)and AMH (10.94±3.21 ng/ml)of the women in the study group were significantly higher than those (96.85±31.29 pg/ml and 3.29±0.95 ng/ml) of the women in the control group. The bFSH level (13.08±3.41 IU/L)of the women in the study group was significantly lower than that (16.29±4.74 IU/L)of the women in the control group. The serum INHB and AMH levels of the women in group A were significantly higher than those of the women in group B, but the bFSH level of the women in group A was significantly lower (all P＜0.05). Pearson correlation analysis showed that in the study group, the serum INHB level of the women was positively correlated with their AMH level (r=0.516)and was negatively correlated with their bFSH level (r=-0.637), and the AMH level of the women was negatively correlated with their BFSH level (r=-0.453)(all P＜0.05). The receiver operator characteristic curve showed that the area under the curve (AUC)of the serum INHB, AMH, and bFSH levels of the women for evaluating their ovarian reserve function were 0.726, 0.774, and 0.695, respectively, and the AUC of the combined detections of serum INHB, AMH, and bFSH levels of the women for evaluating their ovarian reserve function was 0.887, with the sensitivity of 92.3%. Conclusion: The levels of INHB, AMH, and bFSH of the women with PCOS induced infertility are abnormal, which are of certain predictive values for predicting their ovarian reserve function. The combinations of serum INHB, AMH, and bFSH levels of the women can increase the value for evaluating their ovarian reserve function.

2023 Vol. 31　(3):　586- [Abstract]（ 453 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To study the changes of the levels of hypoxia inducible factor-1α(HIF-1α), angiopoietin-1 (ANG-1), and p53 protein levels in gestational trophoblastic disease tissues of women, and to study their predictive efficacy for the malignant transformation of hydatidiform mole of the women. Methods: 88 women with gestational trophoblastic disease diagnosed and treated in hospital were selected in study group, and 88 normal pregnant women with abortion and curettage during early pregnancy were selected in control group from January 2018 to January 2021. The levels of HIF-1α, ANG-1, and p53 protein in gestational trophoblastic disease tissues of the women were compared between the two groups, and the predictive efficacy of which  for the malignant transformation of hydatidiform mole of the women was analyzed. Results: The relative expression levels of HIF-1α, ANG-1, and p53 protein of the women in the study group were significantly higher than those of the women in the control group. The expressions levels of HIF-1α, ANG-1, and p53 protein in choriocarcinoma tissue, in invasive hydatidiform mole tissue, and in hydatidiform mole tissue of the women in the study group had significantly different (all P＜0.05). The specificity of the combined levels of HIF1α, ANG-1, and p53 protein of the women for diagnosing their choriocarcinoma or invasive hydatidiform mole was 58.1% or 54.8%, which was significantly higher than that of HIF-1αlevel, ANG-1 level, or p53 protein level alone. The areas under receiver operating characteristic (ROC)curve of the levels of HIF-1α, ANG-1, and p53 protein of the women for diagnosing their invasive hydatidiform mole and choriocarcinoma were 0.909 and 0.998. The critical values of HIF1αlevel, ANG-1 level, and p53 protein level of the women for diagnosing their invasive hydatidiform mole or choriocarcinoma were 1.88 or 2.91, 2.61 or 2.89, and 3.77 or 3.30, respectively. Conclusion: The changes of HIF-1α, ANG-1, and p53 protein levels in gestational trophoblastic disease tissues of the women are abnormal, and the combined detections of HIF-1α, ANG-1, and p53 protein levels of the women have certain predictive value for the malignant transformation of hydatidiform mole of the women.

2023 Vol. 31　(3):　594- [Abstract]（ 513 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To explorethe expression levels of serum folate-receptor 1/alpha (FOLR1)and mesothelin (MSLN)of women with endometriosis (EMs), and to study their correlation with the clinical symptoms of the women. Methods: A total of 96 women with EMs were selected in group A, and were divided into group A1 (22 cases with stage I of EMs), group A2 (30 cases with stage II of EMs), group A3 (26 cases with stage III of EMs), and group A4 (18 cases with stage IV of EMs)according to r-AFS staging from May 2018 to May 2021. 80 healthy women with similar age were selected in group B during the same period. The levels of serum FOLR1 and MSLN of the women in the two groups were detected by enzyme-related immunosorbent assay, and the differences of which of the women were compared among these groups. Receiver operating characteristic curve (ROC)was drawn to determine the cut-off values of the levels of serum FOLR1 and MSLN of the women for diagnosing their EMs, and Pearson correlation was used to analyze the correlation between the levels of serum FOLR1 and MSLN of the women with Ems and their clinical symptoms. Results: The levels of serum FOLR1 (365.20±80.41 pg/ml)and MSLN (10.36±2.33μg/L)of the women in group A were significantly lower than those (113.25±30.36 pg/ml and 3.25±0.66μg/L)of the women in the control group, and which of the women in group A1, in group A2, in group A3, and in group A4 of the women had increased gradually (all P＜0.05). ROC curve analysis showed that the cut-off values of the levels of serum FOLR1 and MSLN of the women for diagnosing their EMs were 230.22pg/ml and 6.52μg/L. According to the cut-off values of the levels of serum FOLR1 and MSLN, the women in group A were divided into group A5 (women with high levels of FOLR1 and MSLN)and group A6 (women with low levels of FOLR1 and MSLN). The scores of clinical symptom, such as dysmenorrhea, pelvic pain, coital pain, and anal bulge of the women in group A5 were significantly higher than those of the women in group A6 (P＜0.05). The levels of serum FOLR1 and MSLN of the women in group A were positively correlated with their clinical symptoms (r=0.421, 0.388, all P＜0.05). Conclusion: The levels of serum FOLR1 and MSLN of the women with EMs increase abnormally, and the changes of which are positively correlated with the clinical of these women.

2023 Vol. 31　(3):　602- [Abstract]（ 460 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To investigate the predictive values of the abnormal expression levels of the serum vascular endothelial growth factor (VEGF)and brain-derived neurocytotrophic factor (BDNF)of women with ovarian endometriosis cyst (OEC)for their pregnancy outcomes. Methods: 152 women with OEC were collected in study group, and 100 women who came to hospital for physical examination were selected in control VEGF and BDNF group from March 2018 to January 2020. The serum of the women in the study group at the time of admission and the women in the control group during physical examination were obtained for detecting the levels of VEGF and BDNF. The pregnancy outcomes of the women in the two groups and the women with different stages of OEC were counted. Receiver operating characteristic curve (ROC)was used to analyze the predictive values of the levels of serum VEGF and BDNF for the pregnancy outcomes of the women with OEC. Results: The levels of serum VEGF and BDNF (406.35±123.27 pg/ml and 1079.22±209.32 ng/L)of the women in the study group were significantly higher than those (305.27±100.34 pg/ml and 659.34±100.24 ng/L)of the women in the control group, which of the women in the study group had increased significantly with the increase of OEC stage, and the levels of which of the women without pregnancy were significantly higher than those of the women with pregnancy, the levels of which of the women with inferior embryos were significantly higher than those of the women with high-quality embryos, the levels of which of the women without abortion were significantly higher than those of the women with spontaneous abortion, and the levels of which of the women with normal pregnancy were significantly higher than those of the women with poor pregnancy (all P＜0.05). ROC curve analysis showed that the AUC of the VEGF level or the BDNF level of the women with OEC for predicting their pregnancy outcomes was 0.748 (95%CI 0.606-0.890)or 0.720 (95%CI 0.581-0.859), the critical values of which was 406.845 pg/ml or 992.071 ng/L, the sensitivity of which was 68.4% or 42.8%, and the specificity of which was 68.0% or 88.0%. The AUC, the sensitivity, and the specificity of the combined VEGF and BDNF levels of the women with OEC for predicting their pregnancy outcomes were 0.919 (95%CI 0.872-0.966), 93.8%, and 30.5%, respectively. Conclusion: The levels of the serum VEGF and BDNF of the women with OEC increase abnormally, and which increase with the elevation of the OEC stage of the women. Early detections of the serum VEGF and BDNF of the women with OEC can assist predicting their pregnancy outcomes in clinical, and the value of the combined detections of the serum VEGF and BDNF of the women for predicting their pregnancy outcomes is higher.

2023 Vol. 31　(3):　609- [Abstract]（ 480 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To explore the value of Toll- like receptor 4 (TLR4)signaling pathway for predicting the occurrence of unexplained recurrent spontaneous abortion (URSA)of women with polycystic ovary syndrome (PCOS). Methods: 92 women with PCOS complicating URSA were collected in study group and another 50 women with PCOS and normal pregnancy were collected in control group from October 2019 to January 2022. The mRNA expression levels of TLR4 and nuclear factorKappa B (NF-kB)of the women were compared between two groups. Multivariate logistic regression model was used to analyze the factors affecting the occurrence of PCOS and URSA of the women. Spearman's correlation test was used to the correlative analysis. Receiver operating characteristic (ROC)curve was used to evaluate the efficacy of the TLR4 and NF-kB mRNA levels of the women for predicting their PCOS and URSA. Results: The body mass index (BMI)value, and the rates of alcohol consumption, smoking, and insulin resistance, and the mRNA levels of TLR4 and NF-kB of the women in the study group were significantly higher than those of the women in the control group (P＜0.05). Multivariate logistic regression analysis showed that BMI, drinking, smoking, insulin resistance, and the TLR4 and NF-kB mRNA levels of the women were all the influencing factors of their PCOS complicating URSA (P＜0.05). Correlation analysis indicated that the mRNA levels of TLR4 and NF-kB of the women were positively correlated with their PCOS and URSA occurrence (r=0.474, 0.511, all P＜0.001). ROC analysis showed that the predictive efficacy (AUC=0.792)of the combined levels of TLR4 and NF-kB mRNA of the women for their PCOS and URSA occurrence was significantly higher than that of the TLR4 mRNA level or NF-kB mRNA level alone, and the sensitivity, the specificity, and the critical value of which were 80.4%, 74.0%, and 2.6, respectively. Conclusion: TLR4 signaling pathway of the women with URSA is closely related to their occurrence of PCOS, the molecules TLR4 and NF-kB related with this pathway are the influencing factors of PCOS complicating URSA, and the TLR4 and NF-kB levels have good predictive efficacy for PCOS complicating URSA. 

2023 Vol. 31　(3):　620- [Abstract]（ 456 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To analyze the levels of serum human AHSG and pregnancy-associated plasma protein-A (PAPP-A)of pregnant women with gestational diabetes mellitus, and to study their correlation with the pregnancy outcomes of the women. Methods: A total of 102 pregnant women with GDM were selected in research group, 102 healthy pregnant women were selected in control group between February 2018 and February 2021. The level of serum AHSG was detected by enzyme-linked immunosorbent assay, and the level of serum PAPP-A was detected by immunofluorescence assay. The predictive value of the serum AHSG and PAPP-A levels of the women for GDM was analyzed by receiver operating characteristic (ROC)curve. The correlation between the levels of serum AHSG and PAPP-A of the women and their pregnancy outcomes was analyzed by Pearson analysis. Results: The level of serum AHSG (263.07±53.28μg/L)of the women in the research group was significantly higher than that (173.94±47.51μg/L)of the women in the control group, and the level of PAPP-A (21.42±1.47 ng/ml)of the women in the research group was significantly lower than that (26.05±1.39 ng/ml)of the women in the control group. In the research group, the level of serum AHSG of the women with adverse pregnancy outcomes was significantly higher than that of the women with normal pregnancy outcomes, and the level of PAPP-A of the women with adverse pregnancy outcomes was significantly lower. The level of serum AHSG level of the women in the research group was positively correlated with their adverse pregnancy outcomes (r=0.215), and the PAPP-A level of the women in the research group was negatively correlated with their adverse pregnancy outcomes (r=-0.757)(all P＜0.05). ROC analysis showed that the area under the curve of the serum AHSG level, the PAPP-A level, and the combined levels of AHSG and PAPP-A of the women for predicting their GDM were 0.784, 0.724, and 0.844, respectively. Conclusion: The levels of serum AHSG and PAPP-A of the pregnant women with GDM are abnormal, and which are correlated with the adverse pregnancy outcomes. The detections of the serum AHSG and PAPP-A levels of the women have certain clinical value for predicting the occurrence of their GDM, and which provide guidance for the clinical intervention of GDM timely.

2023 Vol. 31　(3):　628- [Abstract]（ 367 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To analyze the clinical characteristics of patients with ovarian endometriosis cyst (OEC)recurrence, and to study the efficacy of gonadotropin-releasing hormone agonist (GnRH-a)combined with laparoscopic surgery for treating the patients with OEC recurrence. Methods: From May 2019 to May 2021, 24 patients with OEC recurrence after laparoscopic surgery were included in study group, and 80 patients without OEC recurrence were included in control group. The clinical characteristics of the patients in the two groups were observed. In addition, the patients in the study group were divided into the group A (12 patients with treatment of laparoscopic surgery)and group B (12 patients with treatment of laparoscopic surgery combined with VEGF). The sex hormones levels, the menstruation, and the clinical efficacy of the patients were compared between group A and group B. Results: Logistic regression model analysis showed that the bilateral cystic wall, the R-AFS stage Ⅲ to Ⅳ of OEC, and the thick cystic wall of the patients with OEC were their independent risk factors of the postoperative recurrence of OEC (P＜0.05). After treatment, the levels of estradiol, follicle stimulating hormone, and luteinizing hormone of the patients in the study group had decreased significantly, but the improvement of which of the patients in group B was significantly better than those of the patients in group A. The score of menstrual pain degree (3.2±0.9 points)of the patients in group B was significantly lower than that (5.3±1.3 points)of the patients in group A, and the total clinical effective rate (100.0%)of the patients in group B was significantly higher than that (66.7%)of the patients in group A (all P＜0.05). Conclusion: The lateral classification of the cystic wall, R-AFS stage of OEC, and the thickness of the cystic wall of the patients are all infecting their postoperative recurrence of OEC. The combined treatment of GnRH-a and laparoscopic surgery can significantly improve the levels of sex hormones and alleviate menstrual pain of the patients, with better clinical efficacy.

2023 Vol. 31　(3):　636- [Abstract]（ 1225 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To study the prenatal three-dimensional ultrasound and chromosomal microarray analysis (CMA)for screening abnormal fetus with bone malformation, and to analyze the genetic etiology of these abnormal fetus. Methods: 20 fetuses with confirmed bone malformation by prenatal diagnosis from May 2019 to January 2022 were included as research objects. According to the guidelines of the American Society of genetic medicine, 20 fetuses with confirmed bone malformation included 5 cases with pathogenic copy number variations (CNV)in group A, 10 cases with benign CNVs in group B, and 5 cases with unknown causes (Vous)of bone malformation in group C. The ultrasonic abnormalities of the fetuses were compared among the three groups. The correlation between the results of ultrasonic examination of the fetuses in group A and their CMA was analyzed. Results: There were no significant differences in the maternal age and height, the gestational weeks of delivery, and the mode of conception among the three groups (P＞0.05). There were significant differences in rates of the increased heart-chest ratio and the decreased thighbone-chest circumference ratio of the fetuses among the three groups (P＜0.05). There were no significant differences in the rates of bone loss and facial deformity of the fetuses among the three groups (P＞0.05). There were 3 fetuses with chromosome deletion and 2 fetuses with chromosome duplication in group A. Logistics multifactor analysis showed that the increased heart-chest ratio and the decreased thighbone-chest circumference of the fetuses by ultrasound were the independent risk factors of pathogenic CNVs and unknown causes of bone malformation of the fetuses. Conclusion: Prenatal three-dimensional ultrasound screening for the diagnosing abnormal fetuses with bone malformations has a strong correlation with the results of CNVs of these fetuses. The genetic abnormalities of the fetuses with bone malformations are abnormalities in 1, 6, 15, and X chromosome mainly.

2023 Vol. 31　(3):　646- [Abstract]（ 444 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To investigate the curative effect of bilateral uterine artery suture combined with intrauterine balloon tamponade for treating postpartum hemorrhage of women with placenta previa. Methods: The data of 100 women with postpartum hemorrhage because of placenta previa from January 2018 to January 2022 were analyzed retrospectively. These women were divided two groups according to the different treatment of postpartum hemorrhage. The women in the control group were treated with routine gauze tamponade for hemostasis, and the women in the study group were treated with bilateral uterine artery suture combined with intrauterine balloon tamponade for hemostasis. The hemostatic effect, the operation time, the blood loss in 24 hours after operation, the peripheral blood leukocyte count, and the complications rate of the women were compared between the two groups. Results: The hemostatic effective rate (96.0%)of the women in the study group was significantly higher than that (80.0%)of the women in the control group. The operative time (48.2±8.7min), the retention time (19.3±3.9 h), the postoperative blood loss (202.7±21.6 ml), and the peripheral blood white blood cell count ［(9.24±1.12）×109 piece/L］ of the women in the study group were significantly lower than those ［64.0±10.1min, 23.5±4.3 h, 265.2±30.5 ml, and （13.37±1.48）×109 piece/L］ of the women in the control group. The incidence of total complications (8.0%), such as hysterectomy, postoperative infection, fever, hemorrhagic shock, and other complication of the women in the study group was significantly lower than that (34.0%)of the women in the control group (all P＜0.05). There were no significant differences in the levels of estradiol, follicle stimulating hormone, and luteinizing hormone of the women in the 6th months after surgery between the two groups (P＞0.05). Conclusion: Bilateral uterine artery suture combined with intrauterine balloon tamponade for treating postpartum hemorrhage because of placenta previa of the women has better hemostatic effect, which can shorten the operation time, reduce the amount of bleeding, with higher safety.

2023 Vol. 31　(3):　654- [Abstract]（ 400 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To investigate the levels of serum C1q/tumor necrosis factor related protein 6 (CTRP6)and soluble tumor necrosis factor receptor (sTNFR)-Ⅱ of pregnant women with preeclampsia (PE), and to study their diagnostic values for PE. Methods: The clinical data of 148 pregnant women with confirmed PE (in group A)from June 2021 to June 2022 were selected. These women were divided group A1 (85 cases with mild PE)and group A2 (63 cases with severe PE)according to the severity of PE. 75 healthy pregnant women were selected in group B during the same period. The expression levels of serum CTRP6 and sTNFR-Ⅱ of the women in these groups were determined by enzyme-linked immunosorbent assay (ELISA). Pearson method was used to analyze the correlation between the serum CTRP6 level of the women with PE and the level of their sTNFR-Ⅱ. Receiver operating characteristic (ROC)curve was used to analyze the diagnostic value of CTRP6 and sTNFR-Ⅱ for the occurrence and development of PE. Results: The levels of urinary protein quantity, ALT, Fib, and Cr, the values of systolic and diastolic blood pressure, and the serum CTRP6 and sTNFR-Ⅱ levels of the women in group A2, group A1, and group B had decreased gradually, and the PT value of the women in group A2, group A1, and group B had increased gradually (all P＜0.05). Correlation analysis showed that the serum CTRP6 level of the women with PE was positively correlated with their sTNFR-Ⅱ level (r=0.354, P＜0.001). ROC curve analysis showed that the area under the curve (AUC)of the CTRP6 level combined with the sTNFR-Ⅱ level of the women for diagnosing their PE (0.975)was significantly higher than that of the CTRP6 level and the sTNFR-Ⅱ level alone, and the sensitivity and the specificity of which were 79.7% and 92.3%. The AUC, the sensitivity, and the specificity of the CTRP6 level combined with the sTNFR-Ⅱ level for diagnosing severe PE was 0.925, 39.7%, and 98.8%, respectively, and which were significantly higher than that of the CTRP6 level and the sTNFR-Ⅱ level alone (all P＜0.001). Conclusion: The levels of serum CTRP6 and sTNFR-Ⅱ of the pregnant women with PE increase abnormally, both of which are related to the severity of PE, and the diagnostic efficacy of the combined levels of serum CTRP6 and sTNFR-Ⅱ for PE is higher.

2023 Vol. 31　(3):　662- [Abstract]（ 360 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To explore the clinical application effect of special staining technique of cervical exfoliated cells in the screening of cervical lesions. Methods: A total of 1176 women who underwent the screening of cervical lesions in several medical centers were selected in this study from March 2021 to June 2022. These women received two cervical cancer screening tests, including human papillomavirus (HPV)combined with thinprep cytologic test (TCT)and special staining technique of cervical exfoliated cells for cervical exfoliated cells. Based on the pathological results of cervical biopsy as the gold standard, the comparative analysis of clinical application effect of the HPV, TCT, and special staining technique of cervical exfoliated cells in the screening of cervical lesions was conducted. Results: The consistent rate of the positive cases detected by TCT (40.1%), by special staining technique of cervical exfoliated cells (28.8%), and by HPV (19.6%)had decreased gradually (P＜0.05). There were no significant differences in the sensitivity (62.1% vs. 53.8%)and the accuracy (80.1% vs. 89.8%)for screening cervical lesions between the special staining technique of cervical exfoliated cells and TCT (P＞0.05). Conclusion: The sensitivity and the accuracy of special staining test of cervical exfoliated cells for screening of cervical lesions are equivalent to those of TCT. Special staining test of cervical exfoliated cells has the characteristics of high portability, simple operation, rapid detection, and economy and practicality, etc, and which as a cervical cancer screening technology is suitable for implementation by the primary level health service agencies.

2023 Vol. 31　(3):　670- [Abstract]（ 461 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

2023 Vol. 31　(3):　680- [Abstract]（ 355 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To investigate the status and the risk factors of nosocomial infection of puerpera after cesarean section, and to provide the preventive measures for nosocomial infection. Methods: The clinical data of 3538 puerpera delivered by cesarean section from June 2018 to June 2022 were collected retrospectively. The puerpera were divided into group A (parturients with nosocomial infection)and group B (parturients without nosocomial infection)according to the situation of the nosocomial infection. The infection sites of the parturients were counted. And the pathogenic bacteria of the infection of the puerpera were cultured and analyzed, and the susceptibility testing of the pathogenic bacteria was conducted. The differences of the clinical data of the puerpera were compared between the two groups. And the influencing factors of the nosocomial infection of the puerpera after cesarean section were analyzed. Results: There were 274 (7.7%)puerpera with nosocomial infection after cesarean section. The main infection sites of the puerpera were surgical incision (31.8%), genitourinary system (29.6%), and upper respiratory tract (21.2%). The pathogenic bacteria of the infection of the puerpera were mainly gram-negative bacteria, such as Escherichia coli (29.5%), pseudomonas aeruginosa (23.4%), and Klebsiella pneumoniae (22.6%), and which all were sensitive to quinolones antibiotics. Multiple logistic regression analysis showed that the vaginal examination during labor ≥3 times, the hospital stay ≥7d, the pregnancy complications, the anemia, the gestational diabetes mellitus, the catheter used time ≥24h of the puerpera were all the independent risk factors of their nosocomial infection after cesarean section (P＜0.05). The high education level of the puerpera was an independent protective factor of their nosocomial infection after cesarean section (P＜0.05). Conclusion: The incidence of nosocomial infection of the puerpera after cesarean section is 7.74% in this investigation. The infection sites are mainly located in the surgical incision, urogenital system, and upper respiratory tract. The pathogenic bacteria of the nosocomial infection are mainly caused by gram-negative bacteria, and which are sensitive to quinolones. The frequency of vaginal examination during labor, the duration of hospitalization, the pregnancy complications, the anemia, and the gestational diabetes mellitus, the time of catheter used, and the educational level of the puerpera are all the factors influencing their nosocomial infection after cesarean section.

2023 Vol. 31　(3):　689- [Abstract]（ 391 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To study the correlation between the persistent human papillomavirus (HPV)infection of puerperae and their reproductive tract microbial level and their maternal and infant adverse pregnant outcomes. Methods: 460 puerperae who had undergone antenatal examination from January 2019 to January 2021 were selected as the research objects, and which including 105 puerperae with HPV infection in group A and 355 puerperae without HPV infection in group B. In group A, 50 puerperae with HR-HPV in group A1 and 55 puerperae with other HPV in group A2. The differences of vaginal microorganisms and the pregnancy outcomes of the puerperae were compared between group A and group B, and between group A1 and group A2. The correlation between the HPV and HR-HPV infections of the puerperae and their vaginal flora and pregnancy outcomes was analyzed. Results: There were significant differences in the intensity, diversity, and microecology of vaginal flora of the puerperae among group B, group A1, and group A2. The incidences of premature delivery, the premature rupture of membranes, and the fetal growth restriction and respiratory distress syndrome of the puerperae in group A were significantly higher than those of the puerperae in group B. Correlation analysis showed that the HPV and HR-HPV infection of the puerperae were positively correlated with their intensity, diversity, and microecology of vaginal flora, the preterm birth, the premature rupture of membranes, and the fetal growth restriction and the respiratory distress syndrome (P＜0.05). Conclusion: The persistent HPV infection of the puerperae is correlation with their reproductive tract microbial level and their maternal and infant outcomes significantly. It is suggested that maternal HPV testing of the puerperae should be carried out regularly.

2023 Vol. 31　(3):　698- [Abstract]（ 1155 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To observe the effect of laparoscopic total hysterectomy with uterus free lifting for treating patients with high-grade cervical intraepithelial neoplasia (CIN). Methods: A total of 58 patients with high-grade CIN were selected and were divided into two groups according to the blind drawing method from October 2021 to May 2022. 30 patients in observation group were given laparoscopic total hysterectomy with uterus free lifting, and 28 patients in control group were given of laparoscopic total hysterectomy with uterus lifting. The surgery related indicators of the patients were compared between the two groups. Results: The postoperative pain score (2.0, 1.0-2.25)of the patients in the observation group was significantly lower than that (3.0, 2.0-3.75)of the patients in the control group (P＜0.05). There were no significant differences in the operation time, the intraoperative and postoperative blood loss, the hemoglobin (Hb)value, and the duration of hospital stay of the patients between the two groups (P>0.05). Analysis of the learning curve showed that the operation time (105.0±31.74 min)of the first 15 patients was significantly longer than that (79.67±22.64 min)of the later 15 patients (P＜0.05). Conclusion: Laparoscopic total hysterectomy with uterus free lifting for treating the patients with high-grade CIN is safe and feasible, but which can be mastered by the surgeon after completing the surgeries at least 15 patients. 

2023 Vol. 31　(3):　706- [Abstract]（ 395 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

2023 Vol. 31　(3):　716- [Abstract]（ 502 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

Biological circadian rhythm, also known as circadian rhythm, is an intracellular mechanism that regulates most physiological and metabolic activities of the body with a cycle of about 24 hours and is produced by the body to adapt to changes in the external environment. Circadian rhythm is the central regulator of human health. It plays a very important role in the developments of nerve, cardiovascular, and other organs. Circadian rhythm disorders are associated with the developments of diabetes, metabolic diseases, tumor, and many other diseases. At present, more and more studies have shown that circadian rhythm also affects the developments of testis, ovaries, follicles, and germ cells, so abnormal circadian rhythm can also lead to the occurrence of diseases related to the reproductive system. The maintenance of circadian rhythm is mainly regulated by core clock genes. In this paper, the expression dynamics of core clock gene in related tissues of reproductive system and its regulation of reproductive function were summarized. Understanding of the clock genes how to regulate the relationship between reproductive functions will provide idea and targets for the development of the new clock-oriented treatment strategies, and will help to further improve the therapeutic effect of the reproductive system related diseases caused by abnormal clock genes.

2023 Vol. 31　(3):　725- [Abstract]（ 381 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )