2023 Vol. 31　(7):　1506- [Abstract]（ 397 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the clinical effect of transvaginal pregnant lesion resection (TPLR) or uterine artery embolization (UAE) combined with curettage for treating patients with type II or type III of cesarean scar pregnancy (CSP). Methods: 77 patients with type II or III CSP were selected and were randomly divided into two groups from March 2017 to January 2023. 36 patients in the observation group were treated with TPLR, and 41 patients in the control group were treated with UAE combined with curettage. The treatment success rate, the hospital expenses, the time of hospital stay, the time of human chorionic gonadotropin (hCG) value returned to the normal range, the total amount of bleeding during the operation, the time of the first menstrual cycle recovery after the operation, the incidence of complications，and the pain score after the operation of the patients were compared between the two groups. Results: There were no significant differences in the treatment success rate (100.0% vs. 97.6%), the intraoperative blood loss (24.4±13.9ml vs. 22.4±8.6ml), and the time of hospital stay (7.3±1.7d vs. 7.0±2.1d) of the patients between the two groups (P>0.05). The hospitalization cost (10808.3±2310.7 yuan), the time of serum hCG level turn to normal range (16.0±3.6d), the menstrual recovery time (30.3±2.1d), the complication rate (0), and the postoperative pain score (4.72±1.67 points) of the patients in the observation group were all significantly lower than those (16888.7±4004.5 yuan, 18.4±3.0d, 32.8±4.6d, 9.8%, and 7.89±1.41 min) of the patients in the control group (all P<0.05). Conclusion: TPLR and UAE combined with curettage for treating the patients with type II or type III CSP have the same therapeutic effectiveness, but TPLR has better recovery and fewer complications after operation.

2023 Vol. 31　(7):　1518- [Abstract]（ 567 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

2023 Vol. 31　(7):　1527- [Abstract]（ 756 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To observe the effects of hysteroscopic transcervical resection of polyp (TCRP) combined with drospirone ethinylestradiol tablets for treating patients with endometrial polyp on their endometrium, and their hemoglobin and high-density lipoprotein cholesterol (HDL-C) levels. Methods: 186 patients with endometrial polyps admitted to hospital were selected as subjects, and were randomly divided into two groups by envelope method from February 2019 to August 2021. 90 patients in the control group were treated with TCRP, and 96 patients in the observation group were treated with TCRP combined with drospirone ethinylestradiol tablets. The endometrial thickness, the menstruation time, the hemoglobin level, the menstrual blood loss assessment table (PBAC) score, the levels of sex hormone, lipid metabolism indexes, and vascular endothelial growth factor (VEGF), and the postoperative complication rate of the patients before treatment, and in 6 months and 12 months after treatment were compared between the two groups. Results: The endometrial thickness, the duration of operation, the PBAC score, and the levels of hemoglobin and high density lipoprotein-cholesterol of the patients in both groups after 6 and 12 months of treatment had increased significantly, but the levels of follicle stimulating hormone, triglyceride, luteinizing hormone, and VEGF of the patients in both groups after 6 and 12 months of treatment had decreased significantly, and the 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 incidence (3.1%) of the postoperative complications, such as vaginal bleeding and sexual dysfunction of the patients in the observation group was significantly lower than that (11.1%) of the patients in the control group (P<0.05). Conclusion: TCRP combined with drospirenone ethinyl estradiol tablets for treating the patients with endometrial polyp can regulate their physiological function, which can improve their levels of hemoglobin and high-density lipoprotein cholesterol and can reduce their complications.

2023 Vol. 31　(7):　1537- [Abstract]（ 491 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To analyze the effects of bipolar electrocoagulation and suture for hemostasis during laparoscopic ovarian cystectomy of patients with different anatomical positions of ovarian cyst on the ovarian reserve function and pregnancy of the patients. Methods: 124 patients with ovarian cysts who wanted laparoscopic ovarian cystectomy were selected and were randomly divided into group A (62 patients with bipolar electrocoagulation hemostasis during surgery) and group B (62 patients with suture hemostasis during surgery) according to the random number table method from March 2020 to March 2021. The levels of sex hormones, such as follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2), and the anti-Mullerian hormone (AMH) level of the patients in the two groups on the 3rd day of menstruation before surgery and in 3 months after surgery were detected. The vaginal ultrasound examination was performed to measure the number of bilateral ovarian antral follicles of the patients in the two groups. In the 12th month after surgery, the pregnancy statuses of the patients in the two groups were followed up. Results: The FSH and LH levels of the patients with proximal hilar cyst in group A in the 3rd month after surgery were significantly higher than before surgery, but the E2 and AMH levels, and the number of follicles in bilateral ovarian were significantly lower than those of the patients before surgery (all P<0.05). There were no significant differences in the FSH and LH levels, and the number of follicles in bilateral ovarian of the patients with proximal hilar cyst in group B compared between before and after surgery (P>0.05). The levels of FSH and LH, and the number of follicles in bilateral ovarian of the patients in group B were significantly lower than those of the patients in group A, but the levels of E2 and AMH of the patients in group B were significantly higher (all P<0.05). There were no significant differences in the levels of the sex hormones and AMH, and the number of follicles in bilateral ovarian of the patients with distal ovarian hilar cyst before surgery and 3 months after surgery between the two groups. There were no significant differences in the adverse pregnancy outcomes between the patients with proximal ovarian hilar cyst and the patients with distal ovarian hilar cyst (P>0.05). Conclusion: For the patients with proximal ovarian hilar cysts, the suture hemostasis during laparoscopic ovarian cystectomy is more helpful to protect the ovarian function when comparing with those of the bipolar electrocoagulation hemostasis, but for the patients with distal ovarian hilar cysts, bipolar electrocoagulation hemostasis is recommended as the preferred choice. The bipolar electrocoagulation and suture for hemostasis during laparoscopic ovarian cystectomy of the patients with different anatomical locations of the ovarian cysts all have no adverse influence on the pregnancy outcomes of the patients.

2023 Vol. 31　(7):　1546- [Abstract]（ 715 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To explore the effect of sodium hyaluronate gel combined with estradiol valerate for preventing intrauterine adhesion of women after high-risk abortion, and to study its impact on the levels of inflammatory factors of the women. Methods: A total of 120 women who had undergone the high-risk abortion were selected and randomly divided into two groups (60 cases in each group) from May 2020 to May 2022. The women in the control group were treated with sodium hyaluronate gel, and the women in the study group were treated with sodium hyaluronate gel combined with estradiol valerate. The time of menstruation recovery, the bleeding time, the bleeding volume, the abnormal uterine bleeding rate, the degree of cervical adhesion, the values of serum cervical adhesion indexes, the levels of human vascular endothelial growth factor (VEGF), human transforming growth factor (TGF-β), human laminin (LN), and human fibronectin (FN), the values of hemorheological indexes, such as whole blood viscosity and plasma viscosity, the levels of inflammatory factors, such as interleukin 18 (IL-18) and leukocyte Interleukin-10 (IL-10), and the incidence of adverse reactions of the women were compared between the two groups. Results: The cervical adhesion rate (3.3%) of the women in the study group in the 3rd month after surgery was significantly lower than that (16.7%) of the women in the control group. After treatment, the levels of serum VEGF, TGF-β, LN, FN, and IL-18, and the values of whole blood viscosity and plasma viscosity of the women in both groups had increased significantly, while the IL-10 level of the women in both groups had decreased significantly, and the change ranges of which of the women in the study group were significantly less than those of the women in the control group (all P<0.05). There were no significant differences in the proportion of abnormal uterine bleeding (16.7% vs.25.0%) and the total incidence of adverse reactions (5.0% vs.11.8%) of the women between the two groups (P>0.05). The duration of menstruation (25.1±2.5d), the duration of vaginal bleeding (4.7±0.6d), and the amount of menstrual bleeding (45.7±4.7ml) of the women in the study group were significantly lower than those (28.6±2.9d, 5.1±0.6d, and 48.5±4.9ml) of the women in the control group (all P<0.05). Conclusion: Sodium hyaluronate gel combined with estradiol valerate for treating the women after high-risk abortion can effectively relieve the degree of intrauterine adhesions, abnormal uterine bleeding, and inflammation, and can promote the recovery of the women, and with safety and effectiveness.

2023 Vol. 31　(7):　1557- [Abstract]（ 633 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the efficacy of pelvic floor electromyographic biofeedback for treating perimenopausal women with pelvic floor dysfunction, and to study its influence on the bladder function and urodynamic state of these women. Methods: 108 perimenopausal women with pelvic floor dysfunction were selected and were divided into two groups (54 cases in each group) by the simple randomization method from January 2021 to January 2022. The women in the two groups were given routine pelvic floor muscle rehabilitation exercise for 3 months continuously, and the women in the observation group were given pelvic floor electromyographic biofeedback therapy additionally. The pelvic floor muscle strength, the values of bladder function indexes, such as the first bladder volume (FVS), the maximum bladder volume (MVS), and the post-voiding residual volume (PVR), the values of urodynamics indexes, such as average urine flow rate (AFR), maximum urine flow rate (MFR), and urination time, and the quality-of-life score by Pelvic Floor Impact Questionnaire 7 (PFIQ-7) of the women before treatment and after 3 months of treatment were compared between the two groups. Results: There was significant difference in the pelvic floor muscle strength of the women after 3 months of treatment between the two groups (P<0.05). The values of FVS, MVS, AFR, and MFR of the women in both groups after treatment had increased significantly, and which of the women in the observation group (234.78±12.65ml, 435.95±14.28ml, 22.78±2.15ml/s, and 26.95±2.28 ml/s) were significantly higher than those (216.38±10.59ml), 428.86±13.40 ml, 20.38±2.29 ml/s, and 24.86±2.40 ml/s) of the women in the control group. The values of PVR, urination time, and PFIQ-7 score of the women in the two groups after treatment had decreased significantly, and which (5.49±2.07ml, 22.49±3.04s, and 40.78±8.15 points) of the women in the observation group were significantly lower than those (8.52±2.25ml, 26.53± 3.24s, and 50.33±12.25 points) of the women in the control group (all P<0.05). Conclusion: Pelvic floor electromyographic biofeedback therapy of the perimenopausal women with pelvic floor dysfunction can effectively improve their bladder function and promote their recovery of pelvic floor muscle strength, and which is beneficial to the prognosis of these women.

2023 Vol. 31　(7):　1567- [Abstract]（ 538 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

2023 Vol. 31　(7):　1576- [Abstract]（ 603 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To compare the analgesic effect and adverse reactions of ropivacaine combined with dexmedetomidine or fentanyl during hysteroscopic surgery. Methods: A retrospective analysis was performed on 92 patients who underwent gynecological hysteroscopy elective surgery between September 2019 and April 2022. According to the different anesthesia drugs used, these patients were divided into group A (30 patients with 7.5 mg ropivacaine administered in subarachnoid space), group B (30 patients with 7.5 mg ropivacaine combined with 5μg dexmedetomidine in subarachnoid space), and group C (32 patients with 7.5 mg ropivacaine combined with15 μg fentanyl in subarachnoid space). The onset time of sensory and motor block, the maintain time of sensory and motor block, the postoperative pain score, the sedation score, and the adverse reactions situation of the patients were recorded. Results: There were no significant differences in the onset time of sensory and motor block of the patients between group B and group C, but which of the patients in group B and group C were significantly shorter than those of the patients in group A. The duration of sensory block (191.25±35.28min) of the patients in group B was significantly longer than that (149.86±33.97min) of the patients in group C and that (139.44±25.21min) of the patients in group A (P<0.05). There was no significant difference in the motor block duration of the patients among the three groups (P>0.05). The Ramsay sedation score of the patients in group B was significantly higher than that of the patients in group A and that of the patients in group C (all P<0.05). The VAS score of the patients in group B in postoperative 6h and 12h (0.31±0.14 and 2.05±0.87) were significantly lower than those (1.35±0.52 and 4.25±1.22) of the patients in group A and those (0.79±0.33 and 3.11±1.04) of the patients in group C (P<0.05). There were 2 (6.3%) patients with bradycardia occurred in group C, and the overall incidence of adverse reactions (46.9%) of the patients in group C was significantly higher than that (13.3%) of the patients in group A and that (16.7%) of the patients in group B (P<0.05). Conclusion: Compared with those of fentanyl, dexmedetomidine combined with ropivacaine used in hysteroscopic surgery has better sedative and analgesic effect, and with less adverse reactions and higher safety.

2023 Vol. 31　(7):　1585- [Abstract]（ 572 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To analyze the effects of anesthesia induction by esketamine during gynecological hysteroscopic surgery of patients on their hemodynamics and stress response. Methods: 110 patients who wanted gynecologic hysteroscopic surgeries were included and were randomly divided in group A (55 patients with sufentanil combined with propofol for anesthesia induction) and group B (55 patients with esketamine combined with propofol for anesthesia induction) from October 2019 to September 2022. The values of anesthesia related indicators (onset time of anesthesia, eye opening time, recovery time of orientation, number of body movements during operation, and propofol dosage), the values of hemodynamics indicators (MAP and HR), the postoperative pain score by VAS, the values of stress response indicators (FC, ANP, E, and NE), the MMSE score of cognitive function, and the rates of adverse reactions (nausea and vomiting, dizziness, lethargy, hypotension, and cough) of the patients were compared between the two groups. Results: The anesthetic onset time, the eye opening time, the orientation recovery time, the intraoperative body movement times, and the propofol dosage (0.69±0.17min, 2.76±0.62min, 6.59±1.49min, 1.36±0.33 times, and 85.49±6.76mg) of the patients in group B were significantly lower than those (0.87±0.21min, 4.15±1.04min, 8.54±2.01min, 1.50±0.47 times, and 97.83±8.21mg) of the patients in group A (P<0.05). The MAP values of the patients in group B after anesthesia induction, at the time of cervical dilation, after surgery, and at the time of awakening (96.55±5.38mmHg, 94.74±3.82mmHg, 96.67±4.09 mmHg, and 98.15±3.24mmHg) were significantly higher than those of the patients in group A (90.63±6.22mmHg, 86.14±4.37mmHg, 89.65±3.77mmHg, and 94.85±3.48mmHg). The HR values of the patients in group B after anesthesia induction, at the time of cervical dilation, after surgery, and at the time of awakening (80.12±4.99 times/min, 87.93±5.57 times/min, 84.15±3.89 times/min, and 79.75±4.11 times/min) were significantly lower than those (85.25±5.62 times/min, 92.54±6.00 times/min, 95.87±4.33 times/min, and 87.47±5.25 times/min) of the patients in group A (P<0.05). The VAS scores (1.25±0.27 points, 2.06±0.32 points, 2.87±0.83 points, and 2.29±0.76 points) of the patients in group B at 2, 6, 12 and 24 hours after surgery were significantly lower than those (1.71±0.34 points, 2.23±0.45 points, 3.35±1.00 points, and 3.04±0.84 points) of the patients in group A (P<0.05). The levels of FC, ANP, E, and NE (12.76±1.60 μg/dl, 0.29±0.04 nmol/L, 38.63±4.90 ng/L, and 162.78±45.87 ng/L) of the patients in group B  1 day after surgery were significantly lower than those (15.36±1.88μg/dl, 0.33±0.05 nmol/L, 45.43±6.31 ng/L, and 180.95±50.62 ng/L) of the patients in group A (P<0.05). The MMSE score (26.70±0.85 points) of the patients in group B was significantly higher than that (25.98±0.90 points) of the patients in group A (P<0.05). The incidence of adverse reactions (3.8%) of the patients in in group B was significantly lower than 12.5% of the patients in group A (P<0.05). Conclusion: Anesthesia induction by esketamine during gynecological hysteroscopic surgery of the patients has better effect, which can reduce the number of body movements and the amount of propofol used during the surgery, can stabilize the hemodynamic indicators, and can reduce the postoperative pain and stress response of the patients, and with less impacts on the cognitive function and adverse reactions of the patients.

2023 Vol. 31　(7):　1596- [Abstract]（ 452 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To investigate the effect comparison of the different doses of ropivacaine combined with fentanyl for stepwise labor analgesia. Methods: A total of 165 full-term pregnant women who wanted labor analgesia were selected and were divided into three groups by random number table method from January 2022 to June 2022. The women in the three groups were given epidural labor analgesia in the L3-L4 space, and the analgesic drug formulation was 100 ml of 0.1% ropivacaine hydrochloride combined with 2.0μg/ml fentanyl citrate, with the load was 8 ml, the single pressing dose was 6 ml, and the interval was 15 min. The women in group C were given the hourly pulsed bolus dosage of 6 ml during labor. The women in group A or in group B were given the hourly pulsed bolus dosage of 6 ml firstly, and then after the cervical opening to 5 cm, the infusion pulse volume was changed to 8 ml/h or 10 ml/h. Analgesic pump was stopped for the women in the three groups after their cervical opening to 10 cm. The VAS score, the modified Bromage score, and the uterine contraction situation of the women in the three groups were recorded when the cervix opening to 2 cm, 5 cm, and 10 cm, and at the time of delivery. The total labor time, the total dosage of analgesic drugs by pump infusion, the situation of oxytocin used, the delivery mode, the adverse reactions, the fetal heart changes, and the scores of neonatal Apgar of the women in the three groups were also recorded. Results：The VAS score of women at the cervix opening to 10 cm and at delivery in group C, group A, and group B had decreased gradually. The durations of the total labor and the first stage of labor of women in group C, group A, and group B had shortened gradually. The total dosage of analgesic drugs by pump infusion of women in group C, group A, and group B had decreased gradually (all P<0.05). There were no significant differences in the rate of oxytocin used, the Bromage score, the fetal heart rate change, the adverse reactions rate, the delivery outcomes, and the neonatal Apgar score of the women among the three groups (P>0.05). Conclusion: It is safe and effective to increase the infusion dosage of ropivacaine combined with fentanyl used for stepwise labor analgesia when the cervical opening to 5cm of the women, which can reduce the pain score by VAS, shorten the durations of the total labor and the first labor, and reduce the total dosage of analgesic drug by pump infusion of the women, and without increasing the adverse reactions. The analgesic effect was better when the infusion drug dosage was 10 ml/h.

2023 Vol. 31　(7):　1606- [Abstract]（ 556 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To study the correlation between the sleep quality measured by wearable devices of pregnant women during the third trimester of pregnancy and their risk of prenatal depression. Methods: From February 2021 to October 2022, 204 pregnant women who had been given antenatal examination in hospital were enrolled in this study. During the third trimester of pregnancy, these women had worn a wearable sleep detection device (Actiwatch-2) for 7 consecutive days to collect their sleep related data, such as sleep latency, sleep efficiency, night sleep duration, and sleep duration in 24h. The sleep quality and daytime sleepiness of the women were assessed by the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). The depression of the women was assessed by the center for epidemiologic studies depression (CES-D), with the CES-D score ≥16 points as the threshold of depression identification. Results: There were 61 (29.9%) pregnant women with CES-D score ≥16 points during the third trimester of pregnancy. Multivariate regression analysis found that the unemployment (OR=1.204, 95% 1.119-2.986) and the sleep efficiency rate <85% (OR=3.86, 95% CI 1.72-8.65) of the women were the independent risk factors for their prenatal depression during the third trimester of pregnancy (all P<0.05). Conclusion: The pregnant women during the third trimester of pregnancy have different degree of sleep disorders and have higher incidence of prenatal depression. The unemployment and the rate of sleep efficiency <85% of the pregnant women are the independent risk factors affecting their prenatal depressions.

2023 Vol. 31　(7):　1618- [Abstract]（ 916 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To analyze the application effect of continuous nursing based on the concept of doughtiness in patients during laparoscopic radical resection of cervical cancer. Methods: A total of 116 patients who wanted laparoscopic radical resection of cervical cancer were recruited as the research subjects from October 2019 to December 2021, including 56 patients treated with routine nursing in control group and 56 patients treated with continuous nursing based on the concept of doughtiness in observation group. The quality of life, the self-care ability, the emotional state, and the postoperative clinical indicators of the patients were compared between the two groups. Results: The scores of FACT-G scale and CCS scale in the different dimensions, such as physiological status, social/family status, emotional status, and functional status, and the scores of ESEA scale in the different dimensions, such as self-concept, sense of self-care, self-care skills, and health knowledge level of the patients in the observation group after nursing were significantly higher than those of the patients in the control group. The scores of self-rating anxiety scale (45.2±4.6 points) and self-rating depression scale (46.1±6.4 points) of the patients in the observation group were significantly lower than those (50.6±6.8 points and 54.5±6.7 points) of the patients in the control group. The time to the first get out of bed (32.4±9.4h), the time to the first exhaust (50.3±7.9h), and the time of hospital stay (8.7±2.7d) of the patients in the observation group were significantly shorter than those (49.2±11.0h, 64.2±11.8h, and 12.8±3.2d) of the patients in the control group (P<0.05). Conclusion: Continuous nursing based on the concept of doughtiness for the patients with laparoscopic radical resection of cervical cancer can effectively improve their quality of life, increase their self-care ability, relieve their negative emotions, and shorten their postoperative recovery time.

2023 Vol. 31　(7):　1627- [Abstract]（ 562 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To investigate the effects of the ovulation induction treatment and the different ovulation induction protocols on the sex ratio of offspring after artificial insemination with donor (AID). Methods: A retrospective analysis was performed on the data of 1,346 offspring of the women with singleton pregnancy and live birth after AID from January 2015 to December 2020. These women were included the cases with natural cycle (NC) in group A, and the cases with ovulation induction cycle (OIC) in group B according to whether the women received ovulation induction therapy or not. The women in group B were further divided into four subgroups according to the different ovulation induction protocols, including the women with clomifene citrate (CC) for ovulation induction in group B1, the women with CC combined with human menopause gonadotrophin (hMG) for ovulation induction in group B2, the women with letrozole (LE) for ovulation induction in group B3, and the women with LE combined with hMG for ovulation induction in group B4. The differences of the sex ratio of the offspring of the women were compared between group A and group B, and among group B1, B2, B3, and B4. Univariate and multivariate Logistics regression analysis were used to analyze the influence of the ovulation induction treatment and the ovulation induction protocols of the women on the sex ratio of their offspring after AID. Results: The sex ratio of the offspring in this study was 108.0. The sex ratio (108.2) of the offspring in group B had no significantly different from that (107.9) of the offspring in group A (P＞0.05). There was no significant difference in the sex ratio (107.9 vs.109.8 vs.105.3 vs.109.5) of the offspring after AID among groups B1, B2, B3, and B4 (χ2=0.05, P＞0.05). Multivariate logistic regression showed that the ovulation induction protocols of the women during AID had no impact on the sex ratio of their offspring (OR=1.00, 95%CI 0.929-1.073). Conclusion: The ovulation induction therapy and the ovulation induction protocols for treating the women during AID have not showed any impact on the sex ratio of their offspring.

2023 Vol. 31　(7):　1636- [Abstract]（ 373 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To investigate the values of transvaginal ultrasound examination combined with the serum anti Mullerian hormone (AMH) and carbohydrate antigen-125 (CA125) levels for diagnosing and evaluating the prognosis of the threatened abortion of women during the first trimester of pregnancy. Methods: The clinical data of 248 pregnant women who came to hospital for antenatal examination during the first trimester of pregnancy from June 2019 to June 2022 were selected as the research objects, including 80 cases with normal pregnancy in control group and 168 cases with threatened abortion in study group. According to the outcomes of the threatened abortion, the women in the study were further divided into group A (105 cases with continued pregnancy) and group B (63 cases with abortion). Enzyme linked immunosorbent assay (ELISA) was used to detect the expression levels of serum AMH and CA-125 of the women. The values of the ultrasound parameters and the AMH and CA-125 levels of the women for diagnosing and evaluating the prognosis of the women with threatened abortion were analyzed by receiver operator characteristic (ROC) curve. Results: The level of serum CA125 (54.24±12.86 mIU/ml) of the women in group B was significantly higher than that (34.89±9.47 mIU/ml) of the women in group A and that (24.63±6.32 mIU/ml) of the women in the control group. The AMH level (7.75±1.79 μg/L) of the women in group B was significantly lower than that (10.16±3.01 μg/L) of the women in group A and that (11.75±3.32 μg/L) of the women in the control group. The ultrasonic parameters values of intervillous artery flow, such as resistance index (RI), ascending acceleration time (ACT) of systolic branch, and yolk sac diameter of the women in group B were significantly higher than those of the women in group A and in the control group. The values of peak systolic flow velocity (PSV) and the diameter of gestational sac of the women in group B were significantly lower than those of the women in group A and in the control group (all P＜0.05). The area under the curve (AUC) of the parameters values of transvaginal ultrasonography combined with the levels of AMH and CA125 of the pregnant women for diagnosing their threatened abortion and adverse pregnancy outcomes were 0.966 and 0.993, which were significantly higher than those of the parameters values of transvaginal ultrasonography or the levels of AMH and CA125 alone (all P＜0.05). Conclusion: The combination of the levels of AMH and CA125 and the parameters values of transvaginal ultrasonography of the pregnant women for diagnosing their threatened abortion can obviously improve the diagnostic efficacy and the evaluative efficacy of the prognosis of the women.

2023 Vol. 31　(7):　1646- [Abstract]（ 571 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the efficacy of hysteroscopic polypectomy combined with doxycycline for treating patients with chronic endometritis and endometrial polyp, and to study it influences on the pregnancy outcomes of these patients. Methods: The clinical data of 88 patients with chronic endometritis and endometrial polyp from January 2019 to January 2021 were collected. These patients were divided into study group (40 patients with doxycycline treatment) and control group (48 patients without doxycycline treatment) based on their treatment with doxycycline after hysteroscopic polyp removal. The distribution of intrauterine bacterial culture, the cure rate of endometritis, and the positive plasma cell count of membrane heparan sulfate proteoglycan ligand proteoglycan-1 (CD138) of the patients were compared between the two groups. The time of endometritis cure, the postoperative complications rate, the polyp recurrence situation, and the pregnancy outcomes within 6 months after chronic endometritis cure of the patients were counted. Results: The CD138 positive cells count (2.1±3.7) and the cure rate of chronic endometritis (89.6%) of the patients in the control group had no significantly different from those (3.2±3.2 and 75.0%) of the patients in the study group (P>0.05). The time of postoperative endometritis recovery (42.3±5.2d) of the patients in the control group was significantly less than that (56.5±32.3d) of the patients in the study group (P＜0.05). There were no significant differences in the detection rate of lactic acid bacteria and the postoperative complications rate of the patients between the two groups. The rate of endometrial polyps recurrence (10.0%) of the patients in the study group had no significantly different from that (6.3%) of the patients in the control group (all P>0.05). There were 35 patients with postoperative pregnancy in both groups, and there were no significant differences in the mode of delivery and the incidence of post-pregnancy abortion of the patients between the two groups (P>0.05). The clinical pregnancy rate (74.3%) of the patients in the control group was significantly higher than that (34.3%) of the patients in the study group, and the time from pregnancy preparation to pregnancy (80.5±55.7d) of the patients in the control group was significantly lower than that (120.6±68.6d) of the patients in the study group (P＜0.05). Conclusion: The polyp resection for treating the patients with chronic endometritis and endometrial polyps has better cured efficacy, but which combined with the postoperative treatment of doxycycline can delay the postoperative recovery, decrease the postoperative pregnancy rate, and delay the postoperative pregnancy.

2023 Vol. 31　(7):　1655- [Abstract]（ 477 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

2023 Vol. 31　(7):　1665- [Abstract]（ 522 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To explore the predictive value of the fetal electrocardiogram (FECG) analysis of the pregnant women with pregnancy-induced hypertension (PIH) for their fetal intrauterine hypoxia. Methods: A total of 137 pregnant women with PIH between January 2019 and January 2021 were collected retrospectively. According to the Apgar scores of the neonates at 1min after born, these women were divided into group A (women with fetal intrauterine hypoxia) and group B (women without fetal intrauterine hypoxia). The abnormal detection rates of the electrocardiogram and FECG of the women were compared between the two groups. The values of the electrocardiogram and the FECG of the women with PIH for predicting their fetal intrauterine hypoxia were analyzed by receiver operating characteristic (ROC) curve. Results: In 137 women with PIH, there were 24 women with fetal intrauterine hypoxia. The 1min Apgar score (6.0±1.0 points) of the neonates in group A was significantly lower than that (9.5±2.0 points) of the neonates in group B. The incidences of the sinus bradycardia and the ST-T segment changes in electrocardiography of the neonates in group A were significantly higher than those of the neonates in group B. The total abnormal rate of electrocardiogram (45.8%) of the women in group A was significantly higher than that (10.6%) of the women in group B. The incidences of the abnormal FST segment deviation, the abnormal heart rate, and the insufficient fluctuation amplitude of the fetal heart rate in FECG of the fetuses in group A were significantly higher than those of the fetuses in group B, and the total abnormal rate (54.2%) of the FECG results of the fetuses in group A was significantly higher than that (14.2%) of the fetuses in group B (all P＜0.05). ROC analysis showed that the area under the curve (AUC) of the electrocardiogram examination of the pregnant women and the FECG examination for predicting their fetal hypoxia were 0.676 and 0.700. The AUC and the specificity of the combined electrocardiogram examination of the pregnant women and the FECG examination for predicting the fetal hypoxia were 0.859 and 83.3%, and both of which were significantly higher than those of the electrocardiogram examination of the pregnant women or the FECG examination alone (P＜0.05). Conclusion: The abnormal rates of the electrocardiogram and the FECG of the pregnant women with PIH and intrauterine hypoxia are higher than those of the pregnant women with PIH but without intrauterine hypoxia. The combined electrocardiogram examination and FECG examination of the pregnant women has higher predictive value for their fetal intrauterine hypoxia.

2023 Vol. 31　(7):　1675- [Abstract]（ 455 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To detect the expression levels of anti-Mullerian hormone (AMH), and the value luteinizing hormone (LH)/follicle-stimulating hormone (FSH) in serum of women with polycystic ovary syndrome (PCOS), and to explore the diagnostic value of vaginal color Doppler ultrasound parameters values combined with serum AMH level and the LH/FSH value of the women for their PCOS. Methods: A total of 95 women with PCOS who visited the gynecological outpatient department from March 2019 to March 2022 were included in research group. Another 68 healthy women who underwent physical examination during the same period were included in control group. The serum AMH, LH, and FSH levels of the women in the two groups were detected. The ovarian volume, the follicle number, and the endometrial thickness of the women in the two groups were examined by vaginal color Doppler ultrasound. Pearson correlation analysis was used to analyze the correlation between the serum AMH level and the LH/FSH value of the women and their vaginal ultrasound parameters values. Multivariate logistic regression was used to analyze the influencing factors of PCOS occurrence, and receiver operating characteristic (ROC) curves was used to analyze the diagnostic efficacy of the combined vaginal color Doppler ultrasound combined with the serum AMH level and the LH/FSH value for PCOS. Results: The serum AMH level (9.56±2.75ng/ml) and the LH/FSH value (2.24±0.76) of the women in the research group were significantly higher than those (5.74±1.48ng/ml and 1.21±0.28) of the women in the control group. The ovarian volume and the number of follicles of the women in the research group were significantly higher than those of the women in the control group, and the endometrial thickness of the women in the research group were significantly less (all P＜0.05). In the research group, the serum AMH level and the LH/FSH value of the women were positively correlated with their ovarian volume and number of follicles, and were negatively correlated with their endometrial thickness (all P＜0.05). Multivariate logistic regression analysis showed that the increased AMH level, the LH/FSH value, the ovarian volume, the follicle number, and the decreased endometrial thickness of the women were all the factors influencing their PCOS occurrence (all P＜0.05). The diagnostic efficacy of the color Doppler ultrasound parameters values combined with the serum AMH level and the LH/FSH value of the women for their PCOS occurrence was significantly higher than that of the color Doppler ultrasound parameters values, the serum AMH level, or the LH/FSH value alone (P＜0.05). The area under the curve and the sensitivity of the color Doppler ultrasound parameters values combined with the serum AMH level and the LH/FSH value of the women for their PCOS occurrence were 0.962 and 95.7%. Conclusion: The serum AMH level and the LH/FSH value of the women with PCOS increase obviously. The vaginal color Doppler ultrasound parameters values combined with the serum AMH level and the LH/FSH value of the women for diagnosing their PCOS occurrence can improve the efficiency.

2023 Vol. 31　(7):　1684- [Abstract]（ 921 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To learn about the incidence of maternal complications and the pregancy outcomes of the women from the maternal surveillance institution, and to provide the scientific evidences for the district maternal management. Methods: A retrospective study conducted on the data from National Severe Maternal Surveillance Information Management System (reporting directly by network). The incidence of pregnancy-related complications and the pregnancy outcomes of the women who had delivered between October 1, 2017 and September 30, 2022 were analyzed. Results: The incidence of the pregnancy complications of the women in 7514 cases was 72.8%. There were significant differences in the incidences of the all kinds of pregnancy complications in the last five years among the women in different quarters, and among the women with different age range (P<0.05). Multivariate Logistic regression analysis showed that the number of the antenatal examination ≥8 times of the women was the protective factor of their pregnancy complications (OR=0.490，95%CI 0.295-0.813). The maternal age ≥35 years old of the women was the risk factor of their pregnancy complications (OR=1.398，95%CI 1.218-1.605). The proportions of the adverse pregnancy outcomes, such as low body weight of the newborns, premature delivery, cesarean section, and macrosomia of the women with complications were significantly higher than those of the women without complications (P<0.05). Conclusion: The age-appropriate marriage and the antenatal care regularly of the women should be promoted, and the complications of the women during pregnancy and childbirth should be found timely, and the early intervention and treatment of these complications should be conducted, so as to avoid the occurrence of maternal death and the adverse pregnancy outcomes.

2023 Vol. 31　(7):　1694- [Abstract]（ 556 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To investigate the predictive value of the levels of serum placental leucine aminopeptidase (P-LAP) and nesfatin 1 (NSF-1) of pregnant women during the first trimester of pregnancy for their gestational diabetes mellitus (GDM). Methods: The pregnant women during the first trimester of pregnancy who received prenatal examination in hospital were selected as the research objects from January 2020 to June 2020. The fasting venous blood in the morning of these women during 6-12 gestational weeks was collected to detect the serum P-LAP and NSF-1 levels and the glucose and lipid metabolism indicators values of the women. The GDM screening was performed for the women during 24-28 gestational weeks, and based on the GDM screening results, the women were divided into group A (women with GDM) and group B (women with normal glucose tolerance (NGT)). The clinical data of the women were compared between the two groups. Logistic regression model was used to analyze the influencing factors of GDM, and receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of the serum P-LAP and NSF-1 levels of the women for their GDM. Results: A total of 284l pregnant women were included in this study, of which, 61 women were diagnosed as GDM, with the incidence of 21.5%. The body mass index (BMI) value, the levels of fasting blood glucose (FPG), glycated hemoglobin (HbA1c), fasting insulin (FINS), and serum NSF-1 of the women in group A were significantly higher than those of the women in group B, and the P-LAP level of the women in group A was significantly lower (all P＜0.05). Logistic regression analysis showed that the abnormal P-LAP and NSF-1 levels of the women were the independent factors influencing their GDM occurrence (P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of the serum P-LAP level and the NSF-1 level of the women for predicting their GDM were 0.799 and 0.808, the sensitivity of which were 95.1% and 52.9%, and the specificity of which were 65.6% and 88.3%. The AUC, the sensitivity, and the specificity of the combined serum P-LAP and NSF-1 levels of the women for predicting their GDM were 0.872, 78.7%, and 81.2%, respectively. Conclusion: Both the decrease of the serum P-LAP level and the increase of the NSF-1 level of the pregnant women during the first trimester of pregnancy are the independent risk factors of their GDM, and which have high predictive value for the GDM occurrence of these women.

2023 Vol. 31　(7):　1703- [Abstract]（ 466 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To explore the efficacy of cold knife conization (CKC) in day surgery under intravenous anesthesia for treating patients with high grade squamous intraepithelial lesions (HSIL). Methods: In this retrospective cohort study, 189 patients with HSIL who had accepted CKC were included as the study subjects. Among these patients, 90 patients in the observation group were treated with day surgical management under intravenous anesthesia and 99 patients in the control group were treated with surgery under subarachnoid block for anesthesia. The open treatment of cervical wounds without shaping and reinforcement of the patients in the two groups were conducted. The satisfaction of surgery, the postoperative complication rate, the time of hospital stay, the score of postoperative pain evaluation, and the incidence of adverse reactions of anesthesia of the patients were compared between the two groups. Results: There were no significant differences in the operation time, the intraoperative blood loss, the cone height of surgical sample, the score of the postoperative pain evaluation, and the incidence of adverse anesthetic reactions of the patients between the two groups (P＞0.05), but the time of hospital stay of the patients in observation group was significantly shorter than that (5.6±1.2 d) of the patients in the control group (P=0.000). In the observation group, the opening treatment of cervical wound for the patients did not increase the incidences of their postoperative infection and bleeding. Conclusion: The patients with HSIL are treated by the day CKC surgery under intravenous anesthesia and their cervical wound are opening during the surgery, and which are safe and feasible.

2023 Vol. 31　(7):　1713- [Abstract]（ 408 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To explore the correlation between the serum soluble CD14 (sCD14) and toll-like receptor 2 (TLR2) levels of pregnant women with gestational diabetes mellitus (GDM) and their islet cell function and pregnancy outcomes. Methods: A total of 113 pregnant women with GDM from January 2020 to June 2022 were selected in study group retrospectively, and 96 normal pregnant women admitted for physical examination during the same period were selected in control group. The levels of serum sCD14, TLR2, fasting insulin (FINS) and fasting blood glucose (FPG) of the women in the two groups were detected, and the values of insulin resistance index (HOMA-IR) and islet beta cell function index (HOMA-β) of the women in the two groups were calculated. The levels of serum sCD14 and TLR2, the values of HOMA-IR and HOMA-β, and the pregnancy outcomes of the women were analyzed and compared between the two groups. Pearson correlation was used to analyze the correlation between the serum sCD14 and TLR2 levels of the women with GDM and their islet cell function. Multivariate logistic regression was used to analyze the influencing factors of the pregnancy outcomes of the women with GDM. Results: The levels of serum sCD14, TLR2, FPG, and FINS, and the HOMA-IR value of the women in the study group were significantly higher than those of the women in the control group, but the HOMA-β value of the women in the study group was significantly lower (P＜0.05). Pearson correlation analysis showed that the serum sCD14 level of the women with GDM was positively correlated with their HOMA-IR value, and was negatively correlated with their HOMA-βvalue. The serum TLR2 level of the women with GDM was positively correlated with their HOMA-IR value, and was negatively correlated with their HOMA-β value (all P＜0.05). The overall incidence of adverse pregnancy outcomes (38.9%) of the women in the study group was significantly higher than that (16.7%) of the women in the control group (P＜0.05). The levels of serum sCD14 and TLR2 of the women with poor pregnancy outcomes in the study group were significantly higher than those of the women with normal pregnancy outcomes (P＜0.05). Multivariate logistic regression analysis showed that the age ≥30 years old, the pre-pregnancy body mass index >28kg/m2, the adverse pregnancy history, the poor blood glucose control, and the levels of serum sCD14 ≥310.44ng/ml and TLR2 ≥17.14g/L of the women with GDM were all the risk factors of their adverse pregnancy outcomes (P＜0.05). Conclusion: The levels of serum sCD14 and TLR2 of the women with GDM are increased abnormally, and both of which are closely related to the function of islet cells and the adverse pregnancy outcomes of these women.

2023 Vol. 31　(7):　1722- [Abstract]（ 801 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To investigate the levels of serum fibroblast growth factor 21 (FGF-21) and homocysteine (Hcy) of pregnant women with hypothyroidism, and to study their correlation with the thyroid hormone level of the women. Methods: A total of 102 pregnant women with hypothyroidism were selected in study group and 102 pregnant women with normal thyroid function were selected in control group from December 2020 to December 2022. The values of biochemical indexes, and the levels of FGF-21, Hcy, and thyroid hormone of the women in the two groups were analyzed. The correlation between the FGF-21 and Hcy levels of the women and their thyroid hormone level was analyzed by Pearson analysis. Results: The levels of triglyceride, total cholesterol, and low density lipoprotein of the women in the study group were significantly higher than those of the women in the control group. The levels of FGF-21 (216.44±67.59 pg/ml) and Hcy (9.87±3.11μmol/L) of the women in the study group were significantly higher than those (114.37±34.58pg/ml and 7.46±2.58μmol/L) of the women in the control group. The level of thyroid stimulating hormone (TSH) of the women in the study group was significantly higher than that of the women in the control group, the level of free triiodothyronine (FT3) of the women in the study group was significantly lower (all P＜0.05). There was no significant difference in the level of free thyroid hormone (TF4) of the women between the two groups (P>0.05). In the study group, the levels of FGF-21 and Hcy of the women were positively correlated with their TSH level, and were negatively correlated with their FT3 level (all P＜0.05). Conclusion: The FGF-21, Hcy, and thyroid hormone levels of the pregnant women with hypothyroidism are expressed abnormally. The FGF-21 and Hcy levels of the women with hypothyroidism are correlated with their thyroid hormone level.

2023 Vol. 31　(7):　1732- [Abstract]（ 450 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To investigate the risk factors of intrauterine adhesion after myomectomy. Methods: The clinical data of 152 patients with myomectomy from June 2020 to June 2022 were collected, and the incidence of the postoperative intrauterine adhesion of these patients was observed. Univariate and multivariate Logistic regression analysis were used to explore the influencing factors of the intrauterine adhesion after myomectomy. Receiver operator characteristic (ROC) curve was drawn to observe the predictive value of the combination of the independent risk factors of the patients for their postoperative intrauterine adhesion. Results: Among the 152 patients, 27 (17.8%) cases had intrauterine adhesions, including 5 cases with severe adhesions, 8 cases with moderate adhesions, and 14 cases with mild adhesions. Univariate analysis showed that the previous history of uterine surgery, the maximum fibroid diameter, the maximum fibroid type, the surgical approach, and the incision of uterine cavity of the patients were correlated with their intrauterine adhesion after myomectomy (P＜0.05). Multivariate analysis showed that the history of uterine surgery, the surgical approach with laparotomy, and the incision of uterine cavity of the patients were the independent risk factors of their uterine adhesions after myomectomy (P＜0.05). ROC curve showed that the area under the curve of the combination of the previous history of uterine surgery, the surgical approach with laparotomy, and the incision of uterine cavity of the patients for predicting their postoperative uterine adhesion was 0.696 (P=0.001, 95%CI 0.587-0.804). Conclusion: The patients with the previous history of uterine surgery, with the surgical approach with laparotomy, or with the incision of uterine cavity have higher risk of intrauterine adhesion after myomectomy, which should be paid more attention to in clinical practice.

2023 Vol. 31　(7):　1742- [Abstract]（ 460 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

The colonization and evolution of the gut flora of the children in the early life are the complex and dynamic process, and which can be influenced by a variety of prenatal and postnatal factors. Increasing number of the studies have found that the development of the gut flora in the early life is closely linked to the development of the nervous system of the children, and which can be involved in the development of the nervous system through various pathways, and have a profound impact on it. The dysbiosis of the gut flora in the early life of the children may lead to various kinds of neurodevelopmental disorders later. In recent years, the increasing studies have found that the influence of gut flora of the children on their nervous system by the brain-gut axis. In this paper, the influence of gut flora in the early life on the neurodevelopment of the infants and young children is reviewed.

2023 Vol. 31　(7):　1751- [Abstract]（ 399 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )