To explore a suitable strategy of preconceptional health examination for the western region of China. Methods: Three sample points were selected from Gansu province to conduct a spot study of three different strategies for preconceptional health examination, including Zhuanglang County, Liangzhou District, Zhangjiachuan Hui autonomous County. The risk identification rates and costs of different strategies were collected. The cost-effectiveness ratio (CE) of different strategies was analyzed to evaluate the applicability of strategies. Results: In the pilot areas, the detection rates of high-risk population by the first (as the current pre-pregnancy health examination strategy), the second, and the third strategies of preconceptional health examination were 79%, 69.6%, and 91.7%, respectively. The cost of the first, the second, and the third strategies were 475.33 Yuan per couple, 249 Yuan per couple, and 662.67 Yuan per couple, respectively. The cost-effectiveness ratios of the three strategies were also calculated. The CEs for the three strategies were 601.68 Yuan/case, 357.76 Yuan/case, and 722.65 Yuan/case, respectively. Compared with that of the second strategy, the incremental cost-effectiveness ratio (marginal cost) of the first and the third strategies were 2407.77 Yuan/case and 1475.12 Yuan/case. Conclusion: The second strategy of preconceptional health examination, including the required items in Chinese guideline of preconception and pregnancy services (2018), has the beat economical efficiency.

2023 Vol. 31　(9):　2016- [Abstract]（ 397 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

To analyze the effects of uterine artery embolization (UA) combined with ethacridine and mifepristone used for induced labor of pregnant women with placenta previa during the second trimester of pregnancy on their prognosis. Methods: The clinical data of pregnant women with scarred uterus and placenta previa during the second trimester of pregnancy who had been induced labor from January 2017 to January 2022 were analyzed retrospectively. Based on the matching by the general data, these women were divided 70 cases with ethacridine combined with mifepristone for induced labor in control group and 70 cases with UV combined with ethacridine and mifepristone for induced labor in observation group. The situations of labor induction, such as the time of labor induction, the blood loss during labor induction, the blood transfusion, the hospitalization time, and the hospitalization cost, the menstrual recovery situations after labor induction, such as the time of menstruation recovery, the menstrual cycle, the menstrual period, and the menstrual blood volume, and the levels of sex hormones, such as luteinizing hormone(LH), estradiol (E2), and follicle-stimulating hormone (FSH) of the women were compared between the two groups. The values of the coagulation indicators, such as prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and D-dimer (D-D) of the women before and after induced labor were compared between the two groups. The incidences of adverse events of induced labor, such as soft birth canal laceration, residual placenta, puerperal infection, fever, transition to cesarean section, and hysterectomy of the women in the two groups were statistically analyzed. Results: The duration of labor induction (26.5±7.9h), the blood loss during induced labor (314.5±67.5ml), the rate of blood transfusion (4.3%), and the hospital stay (5.1±1.1d) of the women in the observation group were all significantly lower than those (29.6±7.9h, 359.6±85.3ml, 15.7%, and 6.2±1.2d) of the women in the control group. The hospitalization cost (10369±547 Yuan) of the women in the observation group was significantly higher than that (5042±280 Yuan) of the women in the control group (all P<0.05). There were no significant differences in the duration of menstruation, the time of menstrual cycle, the menstrual period time, and the menstrual volume of the women between the two groups (P＞0.05). At the end of the first menstrual cycle, the levels of LH (6.57±1.32U/L) and FSH (7.23±1.44U/L) of the women in the observation group were significantly lower than those (7.06±1.64U/L and 7.92±1.51U/L) of the women in the control group, but the E2 level (134.66±7.79pg/ml) of the women in the observation group was significantly higher than that (130.53±6.62pg/ml) of the women in the control group. At 24h after induction, the values of PT, APTT, and FIB of the women in both groups were significantly higher than those before induction, and the D-D levels was significantly lower than that before induction. The levels of PT, APTT, and FIB (13.60±1.59s, 26.66±1.43s, 3.78±0.41g/L) of the women in the observation group were significantly higher than those (12.71±1.23s, 25.16±1.23s, and 3.35±0.36g/L) of the women in the control group, but the D-D level(2.31±0.34mg/L) and the total incidence of adverse events (11.4%) of the women in the observation group were significantly lower than those (3.25±0.51mg/L and 42.9% ) of the women in the control group (all P<0.05). Conclusion: UA combined with mifepristone and ethacridine used for induced labor of the pregnant women with scarred uterus and placenta previa has better clinical effect, with safety and reliability.

2023 Vol. 31　(9):　2025- [Abstract]（ 344 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To observe the efficacy of gonadotropin-releasing hormone agonist (GnRH-a) combined with contrast-enhanced ultrasound (CEUS)-guided percutaneous radiofrequency ablation (PFA) for treating adenomyosis (AM). Methods: From June 2019 to December 2022, 148 patients with AM were selected and were randomly divided into two groups. 74 cases in the control group were treated with CEUS-guided PFA alone, and 74 cases in the observation group were treated with CEUS-guided PFA combined with GnRH-a. The clinical efficacy, the score of dysmenorrhea by numerical rating scale (NRS), and the score by pictorial blood loss assessment chart (PBAC) before treatment and 3 months after treatment of the patients were compared between the two groups. The lesion volume and uterine volume of the patients in the two groups were measured. The levels of serum sex hormone, cancer antigen 125 (CA125), vascular endothelial growth factor (VEGF), and hemoglobin (Hb) of the patients in the two groups were detected. Results: The effective rates of the patients in observation group in 3 months (100%) and 6 months (92.5%) after treatment were significantly higher than those (83.8% and 66.2%) of the patients in the control group, and the recurrence rate (4.1%) of the patients in the observation group was significantly lower than that (12.2%) of the patients in the control group. After 3 months of treatment, the NRS and PBAC scores of the patients in both groups had decreased significantly, the lesion volume and the uterine volume of the patients in both groups had decreased significantly, and the change degrees of which of the patients in the observation group were significantly more than those of the patients in the control group. The levels of serum estradiol (E2), luteinizing hormone (LH), and follicle stimulating hormone (FSH) of the patients in the observation group were significantly lower than those of the patients in the control group. The decreasing amplitude of the CA125 and VEGF levels and the increasing amplitude of the Hb level of the patients in the observation group were significantly better than those of the patients in the control group (P<0.05). There was no significant difference in the adverse reaction rate (4.1% vs. 0) of the patients between the two groups (P＞0.05). Conclusion: CEUS-guided PFA combined with GnRH-a for treating the patients with AM can improve their clinical efficacy, and which can regulate the sexual hormone levels, can reduce the levels of CA125 and VEGF, can effectively relieve the dysmenorrhea and improve the menstrual disorders, and can reduce the recurrence rate of AM of the patients, without increasing the adverse reaction.

2023 Vol. 31　(9):　2034- [Abstract]（ 506 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To explore the effects of protective motivation theory applied in early education for treating pregnant women with gestational diabetes mellitus (GDM) on their self-care ability, blood glucose level, and pregnancy outcomes. Methods: 92 women with GDM were selected and were randomly divided into two groups (46 cases in each group) from October 2020 to March 2023. The women in the study group were added protective motivation theory in the education, and the women in the control group were given routine education. The indexes of cord blood flow dynamics, the levels of fasting blood glucose (FPG), 2 hours postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbAlc), the pregnancy coping attitude, the self-care ability score (ESCA), and the incidence of adverse pregnancy of the women in the two groups were observed. Results: The end-systolic blood flow velocity (Vs) of the women in the study group after intervention was significantly lower than that of the women in the control group, and the end-diastolic blood flow velocity (Vd) of the women in the study group after intervention was significantly higher than that of the women in the control group. The levels of FPG, 2hPG, and HbAlc of the women in the study group were significantly lower than those of the women in the control group (all P<0.05). The positive coping score (29.06±5.33 points) of the women in the study group was significantly higher than that (26.93±4.68 points) of the women in the control group, the negative coping score (8.39±1.26 points) of the women in the study group was significantly lower than that (10.52±1.18 points) of the women in the control group, and the ESCA score of the women in the study group was significantly higher than that of the women in the control group. The overall complication rate (8.7%) of the women in the study group was significantly lower than that (34.8%) of the women in the control group (P<0.05). Conclusion: Protective motivation theory applied in early education for treating pregnant women with GDM can enhance their self-care ability, promote the women positive coping their pregnancy, effectively improve the cord blood flow dynamics index and blood glucose level of the women with GDM, and can reduce their incidence of adverse pregnancy, with good clinical application effect.

2023 Vol. 31　(9):　2044- [Abstract]（ 457 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To analyze the impacts of laparoscopic sacral bone pexis for treating patients with moderate and severe uterine prolapse on their pelvic floor function and quality of life. Methods: 120 elderly patients with moderate and severe uterine prolapse from August 2018 to June 2022 were collected in this study retrospectively. According to the different treatments, these patients were divided into two groups. 60 patients in group A were given laparoscopic sacral bone pexis, and 60 patients in group B were given transvaginal sacrospinous ligament suspension. The values of indexes related to operation, the values of each indicator point by pelvic organ prolapse quantification (POP-Q), the score of quality of life before and after operation, and the occurrence of postoperative complications of the patients were compared between the two groups. Results: The operative time, the exhaust time, the postoperative hospitalization days, and the intraoperative blood loss of the patients in group A were all significantly less than those of the patients in group B. In the 6th month after operation, the anterior vaginal wall, the vaginal apex, the perineal body length, and the posterior vaginal wall of the patients in both groups were significantly longer than those before operation, the length of genital tract hiatus and total vaginal length (TVL) of the patients in both groups were significantly shorter than those before operation, and the TVL of the patients in group A was significantly shorter than that of the patients in group B. In the 6th month after operation, the scores of pelvic floor distress inventory (PFDI-20) and pelvic floor disorders influence questionnaire (PFIQ-7) of the patients in both groups were significantly lower than those before operation, and the score of female sexual function index scale (FSFI) of the patients in both groups was significantly higher than that before operation, and all of which (11.32±3.16 points, 12.86±5.14 points, and 26.25±4.49 points) of the patients in group A were significantly better than those (16.28±3.45 points, 21.88±7.12 points, and 19.32±4.73 points) of the patients in group B. The total incidence (8.3%) of the postoperative complications, such as urinary retention, intestinal obstruction, infection, and intercourse pain of the patients in group A was significantly lower than that (26.7%) of the patients in group B (all P<0.05). Conclusion: Laparoscopic sacral bone pexis for treating patients with moderate and severe uterine prolapse can effectively improve their pelvic floor function recovery and their quality of life, and which can reduce the incidence of postoperative complications.

2023 Vol. 31　(9):　2054- [Abstract]（ 514 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

2023 Vol. 31　(9):　2063- [Abstract]（ 485 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

To investigate the effect of free position combined with delivery ball used during delivery of women, and to study its influence on the pregnancy outcomes and the neonates of the women. Methods: 82 women were randomly divided into two groups (41 cases in each group) from January 2020 to April 2023. The women in the study group were given free position combined with ball delivery during delivery, and the women in the control group were given routine midwifery protocol. The delivery model, the duration of labor, the anxiety, the pain, the self-efficacy, and the different pregnancy outcomes of the women were compared between the two groups. Results: The natural delivery rate (90.2%) of the women in the study group was significantly higher than that (68.3%) of the women in the control group. The cesarean section rate (2.4%) of the women in the study group was significantly lower than that (19.5%) of the women in the control group. The duration of labor, and the scores of visual analogue scale anxiety (VAS-A), existing pain intensity index (PPI) scale, visual analogue scale (VAS), and pain rating index (PRI) scale of the women in the study group were significantly lower than those of the women in the control group. The total score of delivery selfefficacy (103.15±5.73 points) of the women in the study group was significantly higher than that (82.99±8.28 points) of the women in the control group. The postpartum hemorrhage rate (0) of the women in the study group was significantly lower than that (12.2%) of the women in the control group, and the neonatal Apgar score (9.8±0.1 points) in the study group was significantly higher than that (9.1±0.1 points) in the control group (all P<0.05). Conclusion: The free position combined with delivery ball used during delivery of the women can significantly improve their rate of natural delivery, shorten their duration of labor, and reduce their anxiety and other adverse emotions, and which is conducive to improving the self-efficacy and pregnancy outcomes and to promoting the postpartum recovery of the women.

2023 Vol. 31　(9):　2073- [Abstract]（ 526 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To compare the anesthetic effect of ropivacaine and bupivacaine used during the pregnancy termination surgery of pregnant women with cardiovascular diseases. Methods: 120 pregnant women with cardiovascular diseases who wanted pregnancy termination surgery were included in this study from January 2019 to January 2021. According to the admission time, these women were randomly divided into two groups (60 cases in each group). The women in the control group were given bupivacaine for anesthetic during surgery and the women in the observation group were given ropivacaine for anesthetic during surgery. The anesthetic effect, the difficulty of cervical dilatation, the degree of lower abdominal pain and Bromage score at 30 minutes after surgery, the perioperative bleeding volume, the vital signs, and the levels of myocardial enzyme spectrum, such as lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB), and aspartate aminotransferase (AST), the brain natriuretic peptide (BNP) level, the electrocardiogram result, and the adverse reactions rate of the women were compared between the two groups. Results: There were no significant differences in the cervical dilation, the anesthesia effect, and the postoperative pain degree of the women between the two groups (P＞0.05). After operation, the rates of Bromage scores of grade 0, grade I, grade II, and grade III of the women in the control group in the observation group were 11.1%, 46.0%, 34.9%, and 3.2%, respectively, and which of the women in the observation group were 63.5%, 30.2%, 1.6%, and 0, respectively. The grade 0 and grade I of the women in the observation group were significantly better than those of the women in the control group (P<0.05). There were no significant differences in the amount of blood loss, the operation time, and the time from drug withdrawal to awakening of the women between the two groups (P＞0.05). The time of discharge from hospital of the women in the observation group was significantly less than that of the women in the control group (P<0.05). There were no significant differences in the values of perioperative blood pressure, heart rate, and oxygen saturation of finger pulse of the women between the two groups (P＞0.05). The levels of LDH, CK, CK-MB, AST, and BNP of the women in the observation group were significantly lower than those of the women in the control group (P<0.05). There was no significant difference in the abnormal rate of perioperative ECG of the women between the two groups (P＞0.05). The rate of perioperative adverse reactions (6.7%) of the women in the observation group was significantly lower than that (17.1%) of the women in the control group (P<0.05). Conclusion: Ropivacaine and bupivacaine used during the pregnancy termination surgery of the pregnant women with cardiovascular diseases had the same anesthetic effect, but ropivacaine has less impact on the myocardial enzymes and BNP of the patients， fewer adverse reactions, and faster postoperative recovery.

2023 Vol. 31　(9):　2083- [Abstract]（ 517 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To explore the influence of the perioperative period mind mapping based seamless nursing mode combined with path-based nursing in operating room for patients on their hysteromyoma surgery efficacy. Methods: 118 patients who wanted hysteromyoma surgery were randomly divided into two groups (59 cases in each group) from January 2021 to August 2022. The patients in the control group were treated with the path-based nursing intervention in the operating room, and the patients in the study group were treated with the path-based nursing intervention combined with perioperative period mind mapping based seamless nursing mode in operating room. The vital signs and the postoperative complications of the patients before anesthesia induction (T1), at the end of surgery (T2), and 24h after operation (T3) were compared between the two groups. The adverse moods of the patients were evaluated by Self Rating Anxiety Scale (SAS) and Self Rating Depression Scale (SDS). Results: There was no significant difference in the body temperature of the patients at each perioperative time point between the two groups (P＞0.05). The values of heart rate, diastolic blood pressure, and systolic blood pressure of the patients in the study group at T2 and T3 were significantly lower than those of the patients in the control group. The values of heart rate, diastolic blood pressure, and systolic blood pressure of the patients in the control group at T2 and T3 were significantly higher than those at T1, and which of the patients in the control group at T2 were significantly lower than those at T3. The total incidence of postoperative complications (5.1%) of the patients in the study group was significantly lower than that (18.6%) of the patients in the control group (all P<0.05). After nursing, the SAS and SDS scores of the patients in both groups had decreased significantly, and which (44.3±5.2 points and 45.2±4.1 points) of the patients in the study group were significantly lower than those (49.6±6.8 points and 50.3±5.7 points) of the patients in the control group (P<0.05). Conclusion: The application of mind mapping based seamless nursing mode combined with path-based nursing in operating room for the patients who has undergone hysteromyoma surgery is helpful to reduce their perioperative stress reaction and negative emotions.

2023 Vol. 31　(9):　2095- [Abstract]（ 479 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

2023 Vol. 31　(9):　2105- [Abstract]（ 330 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

2023 Vol. 31　(9):　2115- [Abstract]（ 291 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

2023 Vol. 31　(9):　2127- [Abstract]（ 822 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To investigate the clinical significances of the luteal blood flow index monitored by ultrasound, and the levels of peripheral blood anti-thyroid peroxidase antibodies (TPOAb) and β-human chorionic gonadotrophin (β-hCG) of women with threatened abortion for predicting their prognosis. Methods: 92 women with early threatened abortion in study group and 92 healthy pregnant women in control group from May 2019 to January 2021 were collected retrospectively. The luteal ultrasonic perfusion index (PI), resistance index (RI), and the levels of peripheral blood TPOAb and β-hCG of the women were compared between the two groups. The women in the study group were followed up and were divided into group A (women with normal prognosis) and group B (women with poor prognosis) according to the pregnancy outcomes of the women. The values of PI and RI, and the levels of TPOAb and β-hCG of the women were compared between group A and group B. The correlation between the values of PI and RI, and the levels of TPOAb and β-hCG of the women and their poor prognosis was analyzed. Results: The values of PI (0.96±0.14) and RI (2.85±0.53) of the women in the study group were significantly higher than those (0.71±0.12 and 1.75±0.48) of the women in the control group. The serum TPOAb level (221.11±1.23 IU/ml) of the women in the study group was significantly higher than that (1.89±0.57 IU/ml) of the women in the control group, but the β-hCG level (46422.85±500.53 mIU/ml) of the women in the study group was significantly lower than that (49621.75±513.48 mIU/ml) of the women in the control group. The values of BPI and RI of the women in group B were significantly higher than those of the women in group A, the serum TPOAb level of the women in group B was significantly higher than that of the women in group A, and the β-hCG level of the women in group B was significantly lower than that of the women in group A (all P<0.05). Pearson regression analysis showed the PI and RI values by luteal ultrasound and the serum TPOAb and β-hCG levels of the women with early onset threatened abortion were associated with their poor prognosis (all P<0.05). Conclusion: The luteal blood flow PI and RI values monitored by ultrasound and the peripheral blood TPOAb andβ-hCG levels of the women have clinical significances for their prognosis.

2023 Vol. 31　(9):　2134- [Abstract]（ 389 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To investigate the predictive value of endometrial-myometrial junction index measured by three-dimensional transvaginal ultrasound (3D-TVUS) for the pregnancy outcomes of women with adenomyosis after assisted reproduction. Methods: 292 women with adenomyosis who had been assisted reproduction were selected and were divided into group A (women with pregnancy) and group B (women without pregnancy) acceding to the pregnant situation from June 2020 to February 2022. The general data, the endometrial-myometrial junction indexes, such as the endometrial thickness and morphology measured by 3DTVUS on the day of HCG injection of the women were compared between the two groups. Binary logistic regression analysis was used to explore the influencing factors of pregnancy failure of the women with adenomyosis. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of the endometrial-myometrial junction indexes measured by 3D-TVUS of the women with adenomyosis on their pregnancy outcomes after assisted reproduction. Results: In 292 women who had been given IVF/ICSI-ET, there were 122 (41.8%) women with clinical pregnancy in group A, and 170 (58.2%) women without clinical pregnancy in group B. The thickness (8.6±2.2 mm) of endometrium-myometrial junction measured by 3D-TVUS and the abnormal rate of endometrial shape (55.3%) of the women in group B were significantly higher than those (5.2±1.8 mm and 24.6%) of the women in group A (all P<0.05). Regression analysis showed that the advanced age, the increased thickness of endometrio-myometrial junction area, and the abnormal endometrial shape were the independent factors of the pregnancy failure of the women with adenomyosis (P<0.05). Both the thickness and shape of the endometrium- myometrial junction area of the women with adenomyosis had certain predictive values for their pregnancy outcomes after assisted reproduction. The area under the curve, the sensitivity, and the specificity of the combined of the thickness and shape of the endometrium-myometrium junction area of the women with adenomyosis for their pregnancy outcomes were 0.896, 81.8%, and 84.4%, respectively. Conclusion: The endometrial-myometrial junction indexes measured by 3D-TVUS of the women with adenomyosis can well predict their pregnancy outcomes. The increases thickness and the abnormal shape of the endometrial-myometrial junction area of the women with adenomyosis can increase their pregnancy failure rate after assisted reproductive.

2023 Vol. 31　(9):　2142- [Abstract]（ 593 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To observe the value of the uterine artery Doppler parameters combined with the levels of serum angiopoietin-2 (Ang-2) and cyclooxygenase-2 (COX-2) of women for diagnosing their endometriosis (EMS). Methods: 86 women with EMS were selected in study group, and 86 women with gynecological benign diseases and without EMS were selected in control group from February 2019 to December 2021. Color Doppler ultrasonography was performed for the women in the two groups to measure their uterine artery Doppler parameters, such as end-diastolic velocity (EDV), peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI). The serum Ang-2 and COX-2 levels of the women in the two groups were detected. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic values of the uterine artery Doppler parameters, and the levels of the serum Ang-2 and COX-2 of the women for their EMS. The correlation between the uterine artery Doppler parameters and the levels of the serum Ang-2 and COX-2 of the women with different stage of EMS and their clinical EMS stages was observed. Results: The values of EDV and PSV of the women in the study group were significantly lower than those of the women in the control group. The values of PI and RI and the serum Ang-2 and COX-2 levels of the women in the study group were significantly higher than those of the women in the control group (P<0.05). ROC curve showed that the maximum area under the curve (AUC) of the combination of the values of Doppler parameters and the levels of serum Ang-2 and COX-2 of the women for diagnosing their EMS was 0.983, and the sensitivity and the specificity of which were 96.5% was 96.5%. The values of EDV and PSV of the women with EMS had decreased gradually with their increased clinical stage of EMS, and the serum Ang-2 and COX-2 levels of the women with EMS had increased gradually with their increased clinical stage of EMS (P<0.05). Spearman correlation analysis showed that the values of EDV and PSV of the women with EMS were negatively correlated with their clinical stage of EMS, and the serum Ang-2 and COX-2 levels of the women with EMS were positively correlated with their clinical stage of EMS (all P<0.05). Conclusion: The uterine artery Doppler parameters values combined with the serum Ang-2 and COX-2 levels of the women with EMS are related to their severity of EMS. The combination of the values of Doppler parameters and the levels of serum Ang-2 and COX-2 of the women for diagnosing their EMS has higher efficacy.

2023 Vol. 31　(9):　2152- [Abstract]（ 462 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To analyze the clinical effect of the multimodal ultrasound for monitoring endometrial parameters of patients during perioperative period to evaluate the fullterm birth after frozen-thawed embryo transfer. Methods: The clinical data of 248 childbearing age patients with 437 freeze-thaw embryo transplatation cycles from May 2019 to July 2022 were collected retrospectively. The transvaginal multimodal ultrasound technology was used to monitoring the endometrum of these patients. The endometrial score of these patients were given by transvaginal multimodal ultrasound, and based on the score, these patients were divided group A (patients with 86 cycles and <12 points) and group B (patients with 351 cycles and ≥12 points). The baseline data, the freeze-thaw embryo data, the score by transvaginal multimodal ultrasound, the clinical pregnancy outcomes, and the other indicators of the patients in the two groups were analyzed. The influencing factors of full-term birth of the patients after frozen-thawed embryo transfer were also analyzed. Results: The clinical pregnancy rate (47.7%), the live birth rate (39.5%), the premature birth rate (34.2%), and the full-term birth rate (48.8%) of the patients in group A were significantly lower than those (59.0%, 51.6%, 13.0%, and 74.4%) of the patients in group B. The rates of early pregnancy loss, late pregnancy loss, and ectopic pregnancy of the patients in group A were significantly higher than those of the patients in group B (all P<0.05). Pearson univariate analysis showed that the endometrial score by multimodal ultrasound, the cause of infertility, and the twin pregnancy or not of the patient with freeze-thaw embryo transplantation were the influence factors of their full-term birth. Multivariate logistic regression analysis showed that the endometrial score < 12 points by multimodal ultrasound, the secondary infertility, and the twin pregnancy of the patient were the independent influencing factors of their full-term birth after embryo transfer (all P<0.05). Conclusion: Transvaginal multimodal ultrasound can accurately and noninvasively assess the endometrial receptivity of the patients during the window of the pregnancy after frozen-thaw embryo transfer, which provides an early intervention for improving the full-term birth of the patients after embryo transfer.

2023 Vol. 31　(9):　2160- [Abstract]（ 264 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

To investigate the correlation between the thyroid function, the serum placental growth factor (PLGF), and the hematocrit (HCT) levels of pregnant women with preeclampsia (PE) and their fetal growth restriction (FGR). Methods: 108 pregnant women with PE admitted and delivered in hospital were selected in study group from June 2020 to December 2021. Among them, 42 cases with FGR were in group A and 66 cases without FGR were in group B. 55 normal pregnant women were selected in group C during the same period. The serum levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPO-Ab), PLGF, and HCT of the women in the three groups were measured by immunoassay, and the correlation between which and the FGR occurrence of the women was analyzed. Results: The incidence of the thyroid dysfunction of the women in group C, in group B, and in group A had increased gradually, and the serum levels of TSH, FT4, PLGF, and HCT of the women had significant differences among the three groups (all P<0.05). There was no significant difference in the TPO-Ab level of the women among the three groups (P＞0.05). The serum TSH and HCT levels of the women in group C, in group B, and in group A had increased gradually, while the FT4 level of the women in group C, in group B, and in group A had decreased gradually (all P<0.05). Further logistic regression analysis showed that the thyroid dysfunction, the decreased serum PLGF level, and the HCT level ≥0.35 of the women with PE were the independent risk factors of their FGR occurrence (P<0.05). Conclusion: The abnormal thyroid function changes and the serum PLGF and HCT levels of the pregnant women with PE are the risk factors of their FGR occurrence, and which should be paid more attention to in clinic.

2023 Vol. 31　(9):　2171- [Abstract]（ 440 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To observe the prediction values of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) during the first trimester of pregnancy combined with ultrasound umbilical artery resistance indexes (UA-RI) during the second trimester of pregnancy of pregnant women for their early-onset preeclampsia (EOPE). Methods: 2000 pregnant women who had been registered in hospital for prenatal examination from June 2019 to June 2022 were selected in this study. The blood samples were collected to detect the values of NLR and PLR during 10-13 gestational weeks of pregnancy, and the UA-RI value of the women was examined by ultrasound during 20-24 gestational weeks. These women were followed up to the end of pregnancy, and the occurrence of EOPE of the women was observed. The pregnant women with EOPE were included in study group, and the pregnant women without EOPE were selected in control group based on the ratio of 1:3. The clinical data, the values of NLR, PLR, and UA-RI of the women were compared between the two groups. The values of NLR, PLR, and UA-RI of the women with different severity of EOPE were observed. The correlation between the values of NLR, PLR, and UA-RI of the women and their severity of EOPE was analyzed. Logistic regression analysis was used to analyze the influencing factors of EOPE. Receiver operating characteristic (ROC) curve was drawn to explore the predictive efficacy of the values of NLR, PLR, and UA-RI of the women for their EOPE. Results: A total of 2000 pregnant women were followed up until delivery, and 357 women were lost to follow-up. Among the 1643 pregnant women who had completed the followed up, there were 64 (3.9%) women in the study group and 192 women were randomly selected from the other 1579 women without EOPE in the control group. The values of NLR and UARI of the women in the study group were significantly higher than those of the women in the control group, and the PLR value of the women in the study group was significantly lower. The UA-RI of the women with severe EOPE was significantly higher than that of the women with non-severe EOPE (all P<0.05). There were no significantly difference in the values of NLR and PLR between the women with severe EOPE and the women with non-severe EOPE (P＞0.05). Pearson correlation analysis showed that the UA-RI value of the women was positively correlated with their severity of EOPE (P<0.05). Logistic regression analysis showed that the age, and the abnormal increased NLR and UA-RI values of the women were the independent risk factors of their EOPE, and the increased PLR value of the women was the independent protective factor of their EOPE (all P<0.05). ROC curve showed that the area under the curve (AUC) of the NLR value, the PLR value, and the UA-RI value of the women for predicting their EOPE occurrence were 0.729, 0.599, and 0.892, respectively, which had certain predictive significance for EOPE, and the combined of the values of NLR, PLR, and UA-RI for EOPE had the highest prediction efficiency (AUC=0.920). Conclusion: The values of NLR and PLR of the pregnant women during the first trimester of pregnancy combined with the ultrasound umbilical artery resistance indexes UA-RI of the pregnant women during the second trimester of pregnancy are closely related to the occurrence of their EOPE. The combined of the values of NLR, PLR, and UA-RI of the women can improve the predictive efficiency of their EOPE.

2023 Vol. 31　(9):　2181- [Abstract]（ 453 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To study the correlation between the semen quality and sperm motion parameter of patients with prostatitis and their levels of macrophage colony-stimulating factor (M-CSF) and nuclear transcription factor-kB (NF-kB) in prostatitis patients. Methods: 300 patients with prostatitis diagnosed and treated in hospital from May 2019 to December 2022 were selected in study and divided into group A (patients with mild prostatitis), group B (patients with moderate prostatitis), group C (patients with severe prostatitis). 95 healthy men who came to hospital for physical examination during the same period were selected in control group. The semen quality, the values of sperm motion parameter, and the levels of M-CSF and NF-kB in prostatic fluid of the men in the study group and control group were detected. The correlation between the semen quality and values of sperm motion parameter of the patients and their levels of M-CSF and NF-kB in prostatic fluid was analyzed. Results: The semen volume, the pH value, the sperm concentration, the total sperm motility, the sperm survival rate, and the percentage of forward motile sperm of the patients in the study group were significantly lower than those of the men in the control group, while the semen liquefaction time, and the levels of M-CSF and NF-kB of the patients in the study group were significantly higher than those of the men in the control group (P<0.05). The semen volume, the semen liquefaction time, and the levels of M-CSF and NF-kB of the patients in group A, in group B, and in group C had increased gradually. The pH value, the sperm concentration, the total sperm motility, the sperm survival rate, and the percentage of forward motile sperm of the patients in group A, in group B, and in group C had decreased gradually. The semen volume and the sperm liquefaction time of the patients in the study group were positively correlated with their M-CSF and NF-kB levels, while the pH value, the sperm concentration, the sperm survival rate, the total sperm motility, and the percentage of forward motile sperm of the patients in the study group were negatively correlated with their M-CSF and NF-kB levels (all P<0.05). Conclusion: The semen quality parameters, the sperm movement parameters, and the NF-kB and MSCF levels of the patients with prostatitis are abnormally expressed, and the semen quality and sperm movement of the patients with prostatitis are closely correlated with their NF-kB and MSCF levels.

2023 Vol. 31　(9):　2190- [Abstract]（ 482 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To explore the correlation between the levels of serum homocysteine (Hcy), folic acid (FA), and methylenetetrahydrofolate reductase (MTHFR) of pregnant women and their pregnancy-induced hypertension (PIH) occurrence. Methods: 104 pregnant women with PIH were included in study group, and 67 healthy pregnant women were included in control group from October 2020 to October 2022. The women in the study group were divided in group A (women with mild PIH), group B (women with moderate PIH), and group C (women with severe PIH). The genotypes and alleles of MTHFR of the women were determined by fluorescence quantitative PCR. The serum Hcy and FA levels and the polymorphism of MTHFR gene C677T of the women were compared among these groups. Spearman correlation analysis was used to analyze the correlation between the serum Hcy and FA levels of the women and their severity of PIH. Logistic regression analysis was used to evaluate the risk factors of PIH of the women. Results: The levels of CRP, UA, TC, TG, ApoA1, ApoB, and Hcy of the women in the study group were significantly higher than those of the women in the control group, but the FA level of the women in the study group was significantly lower than that of the women in the control group. The CT and TT genotype and the total mutated T allele frequency of the MTHFR gene 677 of the women in the study group were significantly higher than those of the women in the control group, and all which of the women had significant differences among group A, group B, and group C (all P<0.05). Spearman correlation analysis showed that the serum Hcy level of the women in the study group was positively correlated with their severity of PIH, but the FA level was negatively correlated with their severity of PIH (P<0.05). Multivariate logistic regression analysis showed that genotype CT, genotype TT, and T alleles of the MTHFR gene 677 of the women were all the independent risk factors of their PIH occurrence (P<0.05). Conclusion: The level of serum Hcy of the pregnant women with PIH increases abnormally, the level of FA decreases significantly, and both of which are related to the severity of PIH. Early detection of the levels of the serum Hcy and FA of the women can provide evidences for evaluating their severity of PIH. The genotype CT, genotype TT, and T alleles of the MTHFR gene 677 of the women are all their independent risk factors of PIH occurrence.

2023 Vol. 31　(9):　2199- [Abstract]（ 497 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

To explore the interaction between the expressions of serum lymphocyte subsets of patients with low ovarian reserve and their ovarian reserve function indicator. Methods: 82 patients with low ovarian reserve function were selected in study group and 50 health women confirmed by the physical examination were selected in control group from September 2020 to September 2022. The levels of serum lymphocyte subpopulation, such as CD3 +, CD4 +, and CD8 +, of the patients in both groups were detected. The CD4 +/CD8 + ratio of the patients in both groups was calculated. The levels of luteinizing hormone (LH), FSH (FSH), progesterone (P), testosterone (T), estradiol (E2), prolactin (PRL), inhibin B (INHB), and anti-seedling hormone (AMH) of the patients were compared between the two group. Ultrasound was used to examine the ovarian indexes of the patients in both groups. Results: The levels of CD3+ and CD8+ of the patients in the study group were significantly higher than those of the patients in the control group. The levels of CD4+ and the CD4+/CD8+ ratio of the patients in the study group were significantly lower than those of the patients in the control group. The levels of LH, FSH, and E2 of the patients in the study group were significantly higher than those of the patients in the control group. The levels of T, PRL, INHB, and AMH of the patients in the study group were significantly lower than those of the patients in the control group. The antral follicle counting, the number of follicles, the ovarian volume, the endometrial thickness, and the diastolic and systolic blood flow of ovarian artery of the patients in the study group were significantly lower than those of the patients in the control group (all P<0.05). Interaction analysis by linear regression method showed that the levels of CD3+, CD4+, and CD8+, the CD4+/CD8+ ratio of the patients had interaction with their levels of LH, FSH, P, T, E2, PRL, INHB, and AMH (△R2=0.983, P=0.000). There were interactions between the levels of CD3+, CD4+, and CD8+, and the CD4+/CD8+ ratio of the patients and their ovarian ultrasound indexes values (△R2=0.995, P=0.000). Conclusion: There is an interaction between the T lymphocyte subsets in the peripheral blood of the patients with low ovarian reserve function and their ovarian reserve function indicators. The patients with the increased levels of CD3+ and CD8+, or with the decreased levels of CD4+ and CD4+/CD8+ ratio are more likely to have lower ovarian reserve function.

2023 Vol. 31　(9):　2208- [Abstract]（ 458 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To study the values of the parameters of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of elderly patients with cervical cancer for differential diagnosing their pathological classification and pathological grading. Methods: 86 elderly patients with cervical cancer found during the physical examination from January 2019 to June 2022 were selected in this study. The magnetic resonance imaging T1WI, T2WI, IVIM-DWI, and DCE-MRI sequences were used for measuring the values of the parameters of the patients, such as apparent diffusion coefficient (ADC), slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion fraction (f), volume transfer constant (Ktrans), rate constant (Kep), and volume fraction (Ve). Receiver operating characteristic (ROC) curve was used to analyze the values of these parameters of the patients for differential diagnosing their pathological classification and pathological grading of the cervical cancer. Results: The values of ADC and D of the elderly patients with squamous cell carcinoma were significantly lower than those of the elderly patients with non-squamous cell carcinoma, while the values of D*, f, Ktrans, and Kep of the elderly patients squamous with squamous cell carcinoma were significantly higher (P<0.05). The values of ADC and D of the elderly patients with poorly differentiated squamous cell carcinoma were significantly lower than those of the patients with moderately and well-differentiated squamous cell carcinoma, while the values of D*, Ktrans, and Kep of the patients with poorly differentiated squamous cell carcinoma were significantly higher (P<0.05). The area under the curve (AUC) of the values of ADC, D, D*, f, Ktrans, and Kep of the elderly patients for differential diagnosing their cervical squamous cell carcinoma were 0.688, 0.856, 0.770, 0.592, 0.771, and 0.805, respectively. The AUC, the sensitivity, and the specificity of the combined values of ADC, D, D*, f, Ktrans, and Kep of the elderly patients parameters for diagnosing their cervical squamous cell carcinoma were 0.948, 95.5%, and 94.4%, respectively. The AUC of the values of ADC, D, D*, Ktrans, Kep, and Ve of the elderly patients for differential diagnosing their moderately and well-differentiated cervical squamous cell carcinoma were 0.696, 0.716, 0.586, 0.642, 0.704, and 0.746, respectively. The AUC, the sensitivity, and the specificity of the combined values of ADC, D, D*, Ktrans, Kep, and Ve of the elderly patients for diagnosing their moderately and well-differentiated cervical squamous cell carcinoma were 0.900, 97.6%, and 75.0%, respectively. Conclusion: The values of IVIM-DWI and DCE-MRI parameters of the elderly patients with different pathological classification and pathological grading of cervical squamous cell carcinoma are differences, and the combined valuese of the IVIM-DWI and DCE-MRI parameters of the patients can provide the reference informations for differential diagnosing their pathological nature of the cervical cancer.

2023 Vol. 31　(9):　2219- [Abstract]（ 406 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To analyze the effect of hysteroscopic resection and gonadotropin-releasing hormone agonists (GnRHa) injection combined with levonorgestrel- intrauterine system (LNG-IUS) for treating patients with early endometrial cancer (EC). Methods: A total of 105 patients with early EC from June 2014 to June 2019 were analyzed retrospectively. These patients were divided into control group (n=48) and observation group (n=57) according to different treatment methods. All patients had undergone hysteroscopic resection of the EC lesion, then the patients in the control group were treated with oral megestrol acetate combined with GnRHa injection, and the patients in the observation group were treated with LNG-IUS combined with GnRHa injection. The curative effect, the levels of tumor markers and inflammatory factors, the pregnancy outcomes, and the complications rate of the patients were observed and compared between the two groups. Results: The cumulative complete remission rate of these 105 patients in 3, 6, 9, and 12 months after operation were 60.0%, 73.3%, 81.0%, and 84.8%, respectively. There was no significant difference in the complete remission rate (87.7% vs. 81.3%) of the patients in 12 months after operation between the two groups (P＞0.05). The complication rate (15.8%) of the patients in the observation group was significantly lower than that (33.3%) of the patients in the control group (P<0.05). 105 patients were followed up for 29.8±9.3 months, and during this period, there were 50 patients with complete remission in the observation group with the pregnancy rate of 34.0% (17/50), and there were 39 patients with complete remission in the control group with the pregnancy rate of 28.2% (11 patients). The pregnancy rate of the patients had no significant difference between the two groups (P＞0.05). Univariate COX regression analysis showed that the value of body mass index <28 kg/m2 of the patients could shorten the time to complete remission after treatment (P=0.003). After 6 months of treatment, the levels of estrogen receptor, the inflammatory factors, and the tumor markers of the patients in the observation group were significantly lower than those of the patients in the control group (all P<0.05). Conclusion: Hysteroscopic resection and GnRHa injection combined with LNG-IUS for treating the patients with early EC has better prognosis, lower adverse reactions, and which has certain clinical application prospects, but it is necessary to strictly grasp the treatment indications of the patients and the patients should be followed up regularly.

2023 Vol. 31　(9):　2229- [Abstract]（ 467 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

To investigate the risk factors of the anxiety of patients with ectopic pregnancy, and to summarize the targeted nursing countermeasures. Methods: 200 patients with ectopic pregnancy admitted to hospital were selected as research objects to measure their self-rating anxiety scale (SAS) score from September 2020 to September 2022. The demographic data, previous gynecological history, maternity data, and economic conditions of the patients were counted. Single factor and multi-factor analysis were used to analyze the risk factors of the anxiety of the patients, and the nursing countermeasures were summarized. Results: The SAS score of the 200 patients was 54.74±10.46 points. The SAS score of the patients with unmarried, without history of childbirth, with ≥2 times of abortion, or with the paid for medical expenses by themselves was significantly higher than that of the patients with married, with ≥2 times of births, with ≥2 times of abortion, or the paid for medical expenses by medical insurance (all P<0.05). Logistic regression analysis showed that unmarried, no history of childbirth, ≥2 miscarriages, or the paid for medical expenses by themselves of the patients with ectopic pregnancy were the independent risk factors of their anxiety (P<0.05). Conclusion: The patients with ectopic pregnancy have a high incidence of anxiety. The patients with unmarried, without history of childbirth, with abortion ≥2 times, or with the paid for medical expenses by themselves have the higher risk of anxiety, so these patients should be paid more attention to, and the targeted psychological nursing should be carried in these patients for improve their psychological state and their therapeutic effect.

2023 Vol. 31　(9):　2239- [Abstract]（ 538 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

To investigate the values of the expression levels of serum angiopoietin-2 (Ang-2), human epididymal secretory protein 4 (HE4), and insulin-like growth factor1 (IGF-1) of women with uterine fibroids for predicting their hysteroscopic postoperative recurrence of uterine fibroids. Methods: 126 women with uterine fibroids who had treated with hysteroscopic surgery in hospital from January 2019 to October 2020 in study group were analyzed retrospectively. 100 healthy women who had been physical examination during the same period were selected in control group. The levels of the serum Ang-2, HE4, and IGF-1 were compared between the women in the study group before surgery and the women in the control group on the day of physical examination. The women in the study group were given postoperative follow-up for 1 year, and which were further divided in group A (women with the recurrence of uterine fibroids) and group B (women without the recurrence of uterine fibroids) based on the results of clinical imaging and pathological examination of the women. The levels of serum Ang-2, HE4, and IGF-1 of the women were compared between group A and group B. Pearson correlation analysis was used to analyze the correlation between the levels of serum Ang-2, HE4, and IGF-1 of the women in the study group and their recurrence of uterine fibroids after surgery. The values of Ang-2, HE4, and IGF-1 levels of the women in the study group for predicting their recurrence of uterine fibroids after hysteroscopic surgery were analyzed by operating characteristic curve (ROC). Results: The serum Ang-2, HE4 and IGF-1 levels of the women in the study group were significantly higher than those of the women in the control group, and which of 14 women in group A were significantly higher than those of 112 women in group B (all P＜0.05). The levels of serum Ang-2, HE4, and IGF-1 of the women in the study group were positively correlated with their postoperative recurrence (P＜0.05). The sensitivity of the levels of serum Ang-2, HE4, and IGF-1 of the women for predicting their postoperative uterine fibroids recurrence were 83.8%, 71.6%, and 51.4%, respectively, and the specificity of which were 78.8%, 75.0%, and 73.1%, respectively. The area under the curve, the sensitivity, and the specificity of the combined levels of serum Ang-2, HE4, and IGF-1 of the women for predicting their postoperative uterine fibroids recurrence were 0.906, 85.1%, and 86.5%, respectively. Conclusion: The expression levels of serum Ang-2, HE4, and IGF-1 of the women with uterine fibroids are abnormal, and the combined levels of serum Ang-2, HE4, and IGF-1 of the women for predicting their postoperative uterine fibroids recurrence has higher value.

2023 Vol. 31　(9):　2247- [Abstract]（ 465 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

Follicle is the basic functional unit of the ovum production and sex hormone secretion. The development of the follicle is a continuous and dynamic process, involving lots of signaling pathways and the regulating effect by hormones. The development of the follicle is closely related to the female reproductive health, however, the current researches on follicles are still limited to the single target-single pathway, and the systematic molecular network mechanism is lack. Plenty of studies have shown that the biological processes of the signaling pathways involved in the regulation of follicle development mainly include oocyte meiosis, primordial follicle activation, granulosa cell proliferation, and sex hormone synthesis and secretion. Therefore, this paper reviews the follicle development related signaling pathways and their mechanism of action, aiming to provide theoretical basis and idea for the follow-up basic research and clinical treatment of the follicular dysplasia related diseases.

2023 Vol. 31　(9):　2256- [Abstract]（ 313 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )