To understand the real disease experience of ovarian cancer(OC) patients with restriction association site DNA 51(RAD51) mutation, and to provide theoretical basis for the follow-up development of the corresponding intervention measures of the patients. Methods: Objective sampling method was used to select the ovarian cancer patients with RAD51 gene mutation and without treatment from the department of gynecology in a third-class hospital in Beijing from January 2022 to December 2022 as the research object. The semi-structured interview was conducted with the method of phenomenology, and the on-site recording was made. The interview data were analyzed with the method of Colaizzi phenomenology 7-step analysis to extract the theme. Results: This study summarized and extracted three themes, including the positive and negative emotion coexist, the hope for professional guidance and the change of behavior concept. OC patients with RAD51 gene mutation had obvious negative emotions, but also had a tendency to develop a positive mental attitude. There was a change in the concept of self behavior of the patients. The patients were willing to supervise the behavior of susceptible relatives. The patients had low level of recognition of OC and had hoped to receive professional guidance. Conclusion: The OC patients with RAD51 gene mutation have negative emotions and insufficient cognition, so, medical staff should pay attention to their negative emotions in time, promote their positive mental attitude and correct their bad cognition. Medical institutions should establish the OC genetic testing consultation system as soon as possible to provide the follow-up guidance for the patients after the professional genetic testing.

2024 Vol. 32　(1):　10- [Abstract]（ 351 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To understand the situation of women with eligible age from Dongcheng district participated in the free two-cancer screening, and to provide the corresponding evidences for the departments that formulated the policy. Methods: The self-designed questionnaires were distributed to the women based on the women's and children's working system of the jurisdiction street by systematic sampling. The relevant factors affecting the free two-cancer screening of the women from Dongcheng district were analyzed. Results: Multivariate logistic regression analysis showed that the women who had not participated the two-cancer screening organized by their employer were more willing to accept the two-cancer screening (OR=1.37, 95%CI 1.15-1.63), and the willing was 1.4 times of those women who participated the two-cancer screening organized by their employer. The women who had participated thinprep cytology test (TCT) (TCT) and human papilloma virus (HPV) detection organized by their employer were more reluctant to attend the two-cancer screening (OR=0.41, 95%CI 0.23-0.71). Conclusion: Dongcheng district should enhance the publicity of the two-cancer screening and improve the awareness rate of the population. it is suggested that the standard two-cancer screening from the physical examination organized by their employer should be included in the statistical scope of the two-cancer screening coverage rate.

2024 Vol. 32　(1):　20- [Abstract]（ 356 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To investigate the effect of esketamine combined with propofol for anesthesia during painless abortion of women, and to study its influence on the anxiety and depression of the women. Methods: 80 pregnant women who wanted painless abortion were selected and were divided into two groups(40 cases in each group) according to the random number table from August 2022 to June 2023. The women in the observation group were given esketamine combined with propofol for anesthesia during abortion, and the women in the control group were given sufentanil combined with propofol for anesthesia during abortion. The dosage of propofol used, the induction time of anesthesia, the awakening time, the conservative time in hospital and the VAS score of the women were observed and were compared between the two groups. The anxiety(SAS) and depression(SDS) scales were used to measure the psychological status and resilience before abortion and in 1 week after abortion, and the quality of recovery of the women. Results: There were no significant differences in the dosage of propofol used, the induction time of anesthesia, the awakening time, the conservative time in hospital and the VAS score of the women between the two groups(P>0.05). In 1 week after abortion, the SAS and SDS scores of the women in the two groups had decreased significantly, and which(45.08±8.76 points and 44.93±8.26 points) of the women in the observation group were significantly lower than those(52.01±7.99 points and 50.15±6.71 points) of the women in the control group. The psychological resilience and recovery quality score of the women in the two groups had increased significantly, and which of the women in the observation group were significantly higher than those of the women in the control group(all P<0.05). Conclusion: Esketamine combined with propofol uses for anesthesia during abortion of the women, which can relieve the postoperative adverse emotions, such as anxiety and depression, and can improcve the quality of life of the women under the premise of satisfying the anesthetic effect. So, esketamine combined with propofol for anesthesia can be used as a feasible choice for the clinical optimization of anesthesia program.

2024 Vol. 32　(1):　29- [Abstract]（ 299 ） HTML (0 KB)  PDF  (0 KB)  ( 8 )

To investigate the clinical value of the vascular endothelial growth factor(VEGF) level in peripheral blood of patients with advanced ovarian cancer after neoadjuvant chemotherapy treatment(NACT) for predicting their tumor reduction satisfaction. Methods: 110 patients with advanced ovarian cancer who had been treated with neoadjuvant chemotherapy from January 2017 to March 2018 were collected. All patients had received 2 courses of neoadjuvant chemotherapy, mainly platinum drugs, and then given cytoreductive surgery and 20 days chemotherapy for least 6 courses after surgery. All patients were divided into group A1(patients with tumor reduction satisfaction) and A2(patients without tumor reduction satisfaction) based on the size of residual tumor lesions after surgery, the patients were divided into group B1(patients with VEGF level ≤151 pg/ml) and group B2(patients with VEGF level＞51 pg/ml) based on the preoperative VEGF level in peripheral blood of the patients, and the patients were divided into group C1(patients with the percentage decrease of VEGF level ≤82%) and group C2(patients with the percentage decrease of VEGF level＞82%) based on the percentage of VEGF level in peripheral blood decrease after surgery. Results: The preoperative VEGF level in peripheral blood(199.96±15.43 pg/ml) of the patients in group A2 was significantly higher than that(145.78±15.37 pg/ml) of the patients in group A1, and the percentage of decrease of the VEGF level(79.98±5.17%) in peripheral blood of the patients in group A2 was significantly lower than that(84.45±5.49%) of the patients in group A1. The satisfaction rate of tumor reduction(97.4%) of the patients in group B1 was significantly higher than that(54.5%) of the patients in group B2, and the satisfaction rate of tumor reduction(95.5%) of the patients in group C2 was significantly higher than that(38.1%) of the patients in group C1(all P<0.05). The influencing factors of the tumor reduction satisfaction of the patients with advanced ovarian cancer were the high preoperative VEGF level and the low postoperative percentage of the VEGF level decrease(all P<0.05). These patients were followed up for at least 5 years, 35 cases survived and 65 cases died, with a mortality rate of 59.1%. The cause of death of all the patients was the ovarian cancer recurrence. The median survival time of the patients in group B1(>60 months) was significantly higher than that(43 months) of the patients in group B2(P<0.05). There was no significant difference in the median survival time(51.8 months vs. 52.3 months) of the patients between group C1 and group C2(P>0.05). Conclusion: The VEGF level in peripheral blood of the patients with advanced ovarian cancer after NACT can be used to predict their satisfactory tumor reduction and 5-year survival situation.

2024 Vol. 32　(1):　39- [Abstract]（ 325 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

2024 Vol. 32　(1):　48- [Abstract]（ 321 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To investigate the effects of esketamine used for anesthesia during laparoscopic total hysterectomy of patients on their inflammatory factor levels and stress response. Methods: 100 patients who wanted laparoscopic total hysterectomy were randomly divided into two groups(50 cases in each group) from July 2019 to July 2021. The patients in the control group received anesthesia induction by propofol combined with fentanyl, while the patients in the observation group consisted of 50 patients received anesthesia induction by propofol combined with esketamine, and the other anesthesia methods of the women in the two groups were the same. The vital signs, the inflammatory factor levels, the stress reactions, and the adverse reactions(respiratory depression, nausea and vomiting, chills, restlessness and delayed awakening) of the patients were compared between the two groups. Results: The values of the mean arterial pressure and heart rate of the patients in the two groups immediately before intubation, at 1min and 3min after intubation were significantly lower than those before anesthesia induction, but which of the patients in the observation group were significantly higher than those of the patients in the control group. The levels of serum interleukin-6 and tumor necrosis factor-α of the patients in the two groups after operation had increased significantly, and which(70.53±10.02 ng/L and 11.42±2.97 ng/L) of the patients in the observation group were significantly lower than those(96.24±12.84 ng/L and 17.93±4.48 ng/L) of the patients in the control group. The levels of cortisol, epinephrine and norepinephrine of the patients in the two groups after operation had increased significantly, and which(12.45±1.96μg/dl, 40.17±5.93 ng/L and 164.73±41.80 ng/L) of the patients in the observation group were significantly lower than those(16.27±2.11μg/dl, 54.16±7.22 ng/L and 181.95±50.65 ng/L) of the patients in the control group. The total incidence of adverse reactions(10.0%) of the patients in the observation group was significantly lower than that(26.0%) of the patients in the control group(P<0.05). Conclusion: Esketamine used for anesthesia during laparoscopic total hysterectomy of patients has good effectiveness, which can decrease the fluctuation of their haemodynamics, reduce the influence on their inflammatory factor levels, alleviate their stress reactions, and reduce their adverse reactions.

2024 Vol. 32　(1):　58- [Abstract]（ 330 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To explore the effect of intraspinal anesthesia by ropivacaine combined with lidocaine under ultrasound guidance used in caesarean section of obese women with pregnancy-induced hypertension(PIH). Methods: 96 obese women with PIH who wanted caesarean section were divided into two groups(48 cases in each group) by the random number table method from January 2020 to July 2022. The women in the observation group received the intraspinal anesthesia by ropivacaine combined with lidocaine under ultrasound guidance used in caesarean section, and the women in the observation group received the traditional intraspinal anesthesia by ropivacaine combined with lidocaine. The puncture condition and the anesthesia effect of the women were compared between the two groups. Results: There was no significant difference in the puncture success rate(100% vs. 89.6%) of the women between the two groups(P>0.05). The incidence of puncture related complications(4.2%) of the women in the observation group was significantly lower than that(20.1%) of the women in the control group. The lumbar space positioning time(1.50±0.36 min), the anesthesia puncture time(4.40±1.17 min), the onset time of anesthesia(11.70±2.24 min) and the puncture number(1.12±0.30 times) of the women in the control group were significantly lower than those(4.12±1.18 min, 7.25±1.20 min, 16.00±2.35 min and 1.84±0.50 times) of the women in the control group. The rate of anesthetic effect of grade I(97.9%) of the women was significantly higher than that(85.4%) of the women in the control group. The blood pressure value of the women in the two groups at 10 minutes after anesthesia had decreased significantly, but the change range of which of the women in the observation group was significantly less than that of the women in the control group. The levels of serum cortisol, C-peptide and advanced oxidation protein products of the women in the two groups in 12 hours after operation had increased significantly, but the change ranges of which of the women in the observation group were significantly less than those of the women in the control group(all P<0.05). There were no significant differences in the umbilical artery blood gas indexes values and Apgar scores at 1min and 5min after delivery of the newborns between the two groups(P>0.05). Conclusion: Ultrasound-guided intravertebral anesthesia by ropivacaine combined with lidocaine during caesarean section of the obese women with PIH can improve the success rate of puncture, reduce the related complications, and which has less influence on the maternal hemodynamics and stress hormones, and with good anesthesia effect.

2024 Vol. 32　(1):　68- [Abstract]（ 329 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To observe the related factors affecting the level of pain catastrophe of parturients after cesarean section, and to explore the targeted intervention strategies. Methods: A total of 283 parturients who underwent cesarean section in hospital from October 2022 to February 2023 were selected as the research objects by convenience sampling method. A cross-sectional survey was conducted on the parturients through the general situation questionnaire, pain catastrophizing scale(PCS), numerical rating scale(NRS), pain self-efficacy scale(PSEQ), generalized anxiety scale(GAD-7), Edinburgh postnatal depression scale(EPDS) and family care index questionnaire(APGAR). Multivariate linear stepwise regression analysis was used to explore the independent influencing factors of the pain catastrophizing level of the parturients after cesarean section. Results: The average PCS score of 269 parturients included in the study was(28.09±9.24) points, of which, there were 64(23.8%) parturients with PCS score ≥38 points. There was significant differences in the PCS score among the parturients with different educational levels or among the parturients with different occupations(P<0.05). Pearson correlation analysis showed that the PCS score of the parturients with caesarean section was positively correlated with their scores of NRS, GAD-7 and EPDS, and was negatively correlated with their PSEQ and APGAR scores(P<0.05). Multivariate linear stepwise regression analysis found that the higher education level, and the higher PSEQ and APGAR scores of the parturients were, the lower level of pain catastrophizing after cesarean section. The higher of the NRS, GAD-7 and EPDS scores of the parturients were, the higher level of pain catastrophizing after cesarean section(all P<0.05). Conclusion: The influencing factors of the level of pain catastrophizing of the parturients after cesarean section include the education level, the pain intensity, the pain self-efficacy, the anxiety symptoms, the depressive symptoms and the family support. The improving postoperative pain management and health education of the parturients can improve their pain coping ability, reduce their negative emotions, and enhance their family support, and which may be effective ways to reduce the level of pain catastrophizing of the parturients.

2024 Vol. 32　(1):　78- [Abstract]（ 327 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To investigate the role of gestational hypothyroidism and thyroid function changes of pregnant women in their severe preeclampsia occurrence, and to study their influence on the pregnancy outcomes and the neonates of the women. Methods: 80 pregnant women with severe preeclampsia(in group A), 80 pregnant women with mild preeclampsia(in group B), and 80 healthy pregnant women who underwent physical examinations(in group C) were selected as research subjects from January 2020 to December 2022. The thyroid function and the thyroid related antibodies of these women were tested. The correlation between the different thyroid functions of the women and their severity of preeclampsia was analyzed. The influences of hypothyroidism and thyroid function changes of the women on their pregnancy outcomes and the outcomes of their perinatal infant were also analyzed. Results: The serum thyroid stimulating hormone level(5.7±1.3 mIU/L) of the women in group A was significantly higher than that(3.5±0.9 mIU/L) of the women in group B and that(3.4±0.8 mIU/L) of the women in group C. The levels of free triiodothyronine(2.9±0.7 pmol/L) and free thyroxine(9.5±1.9 pmol/L) of the women in group A were significantly lower than those(4.3±0.8 pmol/L and 12.8±2.3 pmol/L) of the women in group B and those(4.5±0.9 pmol/L and 13.0±2.2) of the women in group C. The positive rates of thyroid peroxidase antibody(47.5%) and thyroglobulin antibody(36.3%) of the women in group A were significantly higher than those(10.0% and 6.3%) of the women in group B and those(8.8% and 5.0%) of the women in group C(all P<0.05). The incidences of the placental abruption, the premature delivery, the low birth weight, the perinatal asphyxia, the jaundice and the hypocalcemia of the women in group A were significantly higher than those of the women in group B and those of the women in group C(P<0.05), but which of the women had no significant different between group B and group C(P>0.05). Conclusion: The gestational hypothyroidism and the changes of thyroid function during pregnancy of the pregnant women may be one of the risk factors of their severe preeclampsia occurrence, and which can increase the risks of adverse pregnancy and perinatal infant outcomes. It is suggested that the thyroid function of the women with high-risk pregnancy should be monitored regularly and the herapeutic regimen of the women should be adjusted in time to reduce the incidence of complications.

2024 Vol. 32　(1):　88- [Abstract]（ 322 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

2024 Vol. 32　(1):　97- [Abstract]（ 320 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To observe the influence of warm midwifery nursing mode of accompanied by family members for primiparas on their delivery outcomes and postpartum recovery. Methods: A total of 115 primiparas admitted to the obstetrics department were included and were divided into two groups by random number table method from April 2022 to May 2023. 58 primiparas in the control group received routine delivery care, and 57 primiparas in the observation group received warm midwife nursing of accompanied by family members. 2 cases in the control group and 1 case in the observation group were lost for follow-up. The delivery outcomes, the neonatal outcomes, the postpartum hemorrhage, the labor pain sore evaluated by visual analogue scale(FPS-R), the scores of postpartum anxiety(SAS) and depression(SDS) self-rating scale, the total labor process duration, the hospitalization time and the nursing satisfaction rate of the primiparas were compared between the two groups. Results: The rate of successful vaginal delivery of the primiparas in the two groups was 100.0%. The incidence of complications(0) of the primiparas after delivery in the observation group was significantly lower than that(7.1%) of the primiparas in the control group. The incidence of the neonatal adverse events(0) of the primiparas in the observation group was significantly lower than that(8.9%) of the primiparas in the control group. The amount of postpartum hemorrhage(216.2±10.8ml) of the primiparas in the observation group was significantly lower than that(289.7±15.2ml) of the primiparas in the control group. The scores of FPS-R(7.9±0.4 points), SAS(36.5±3.0 points) and SDS(34.8±5.2 points) of the primiparas in the observation group were significantly lower than those(8.9±0.5 points, 42.4±3.8 points and 41.8±4.8 points) of the primiparas in the control group. The total duration of labor(516.23±9.76 min) and the hospital stay(2.14±0.22 d) of the primiparas in the observation group were significantly shorter than those(612.34±10.65 min and 2.95±0.26 d) of the primiparas in the control group. The maternal nursing satisfaction rate(96.4%) of the primiparas in the observation group was significantly higher than that(85.7%) of the primiparas in the control group(all P<0.05). Conclusion: The warm midwifery nursing mode of accompanied by family members for the primiparas can alleviate their adverse psychological state of primiparas, improve their delivery outcomes, promote their postpartum recovery, and reduce their adverse delivery outcomes, and can increase their satisfaction.

2024 Vol. 32　(1):　108- [Abstract]（ 312 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To explore the impact of exercise rehabilitation intervention based on the hierarchy of needs theory for treating patients with gynecological tumor chemotherapy on their frailty. Methods: 80 patients with gynecological malignant tumors chemotherapy were selected and were divided into two groups From January 2022 to July 2023. The patients in the control group received routine rehabilitation nursing intervention, while the observation patients in the group received exercise rehabilitation nursing intervention based on the hierarchy of needs theory. The frailty status and quality of life of the patients were compared between the two groups. Results: After intervention, the incidence of chemotherapy-related adverse reactions of the patients in the observation group was significantly lower than that of the patients in the control group. The frailty score of the patients in the two groups had decreased significantly. The scores of physical weakness(7.73±1.82 points), psychological weakness(17.43±3.57 points), social weakness(13.83±3.19 points), environmental weakness(10.43±2.27 points) and simplified frailty inventory(2.94±0.64 points) of the patients in the observation group were significantly lower than those(10.76±2.25 points, 22.48±4.16 points, 17.14±4.33 points, 13.48±3.15 points and 4.35±0.82 points) of the patients in the control group. The cancer-related fatigue score of the patients of the two groups had decreased significantly, and which(2.94±0.64 points) of the patients in the observation group was significantly lower than that(4.35±0.82 points) of the patients in the control group(all P<0.05). Conclusion: Exercise rehabilitation intervention based on the hierarchy of needs theory for treating patients with gynecological tumor chemotherapy can reduce their adverse reactions related to chemotherapy, alleviate their weak degree and cancer-related frailty symptoms.

2024 Vol. 32　(1):　116- [Abstract]（ 304 ） HTML (0 KB)  PDF  (0 KB)  ( 7 )

To observe the application effect of Doula accompaniment combined with labor analgesia for primiparas. Methods: A total of 82 primiparous that planned to vaginal delivery were divided into two groups by random number table method from November 2022 to October 2023. 41 primiparous in the control group received the labor analgesia and routine obstetric care, while 41 primiparous in the observation group received Doula accompaniment additionally. The pain score by visual analogue scale(VAS), the labor progress and the natural delivery rate of the primiparous were compared between the two groups. Results: The VAS score during the first stage of labor(2.42±0.78 points), the second stage of labor(3.51±1.14 points) and the third stage of labor(5.06±1.17 points) of the primiparous in the observation group were significantly lower than those(4.53±1.49 points, 5.32±1.76 points and 7.21±1.36 points) of the primiparous in the control group. The durations of the first stage of labor(502.42±54.18 min), the second stage of labor(70.56±15.37 min), the third stage of labor(12.28±1.13 min) and the total stage of labor(585.26±61.84 min) of the primiparous in the observation group were significantly shorter than those(559.45±69.23) min, 108.23±33.52 min, 16.94±2.86 min and 684.62±70.76 min) of the primiparous in the control group. The natural delivery rate(85.4%) of the primiparous in the observation group was significantly higher than that(65.9%) of the primiparous in the control group(all P<0.05). Conclusion: Doula accompaniment combined with labor analgesia for the primiparous can alleviate their pain, shorten their labor process, and increase their natural delivery rate.

2024 Vol. 32　(1):　124- [Abstract]（ 359 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To explore the effect of integrated online and offline nutrition and weight management for pregnant women on their pregnancy outcomes. Methods: A total of 108 pregnant women were included in the study, and these women were divided into two groups(54 cases in each group) by random number table method from January 2022 to February 2023. The women in the control group received routine pregnancy management and nursing, and the women in the observation group received the integrated online and offline nutrition and weight management based on the intervention of the women in the control group. The pregnancy complications, the weight gain of during pregnancy, the birth weight of newborns, the changes of the maternal self-care management questionnaire(SQHMP) score at the time of enrollment and delivery, the delivery outcomes, the neonatal outcomes and the satisfaction rate of the women in the two groups were observed. Results: The rate of pregnancy complications(1.9%) of the women in the observation group was significantly lower than that(13.0%) of the women in the control group, and the weight gain during pregnancy(12.89±1.10 kg) and the neonatal birth weight(3.20±0.14 kg) of the women in the observation group were significantly lower than those(17.23±1.56 kg and 3.78±0.27 kg) of the women in the control group. The SQHMP score of the women in the two groups during delivery had increased significantly, and which(105.23±6.23 points) of the women in the observation group was significantly higher than that(92.54±7.63 points) of the women in the control group. The dystocia rate(0) of the women in the observation group was significantly lower than that(7.4%) of the women in the control group, and the natural delivery rate(83.3%) of the women in the observation group was significantly higher than that(64.8%) of the women in the control group. The neonatal Aparg score(9.53±0.31 points) and the maternal satisfaction rate(96.3%) of the women in the observation group were higher than those(9.10±0.26 points and 83.3%) of the women in the control group, the incidence of macrosomia(0) of the women in the observation group was lower than that(9.3%) of the women in the control group(all P<0.05). Conclusion: Integrated online and offline nutrition and weight management for the pregnant women can improve their maternal self-care and delivery outcomes.

2024 Vol. 32　(1):　133- [Abstract]（ 326 ） HTML (0 KB)  PDF  (0 KB)  ( 8 )

To evaluate the effect of the fixed intrauterine device(IUD) inserted after induced abortion of women with unwanted pregnancy. Methods: 213 nulliparous women who wanted voluntarily induced abortion from July 2021 to July 2022 were selected and were given post-abortion care(PAC), including 103 cases with IUD inserted for contraception in observation group and 110 cases with other contraceptive methods in control group. Questionnaire survey was conducted to compare the knowledge, attitude and practice(KAP) for the harm of induced abortion of the nulliparous before and after intervention between the two groups. The recovery time of sexual life after abortion of the nulliparous was compared between the two groups. The unwanted pregnancy again and its causes and then induced abortion situation of the nulliparous were followed up for 1 year. Results: The scores of the theory cognition, the attitude and belief, and behavior ability about the induced abortion hazards knowledge of the nulliparous in the two groups after the intervention had increased significantly(P<0.05), but which of the nulliparous had no significantly different between the two groups. After intervention, the recovery time of sexual life(3.7±0.1 months) of the nulliparous in the observation group was significantly shorter than that(3.2±0.9 months) of the nulliparous in the control group, and the incidence of the unintended pregnancy(8 cases, 7.8%) of the nulliparous in the observation group was significantly lower than that(24 cases, 21.8%) of the nulliparous in the control group(P<0.05). There was no significant difference in the incidence of the induced abortion again(0.9% vs.1.9%) of the nulliparous between the two groups. The reasons of unintended pregnancy of the nulliparous in the observation group were IUD expulsion, and which of the nulliparous in the control group were contraceptive failure(11 cases, 45.8%) and no contraception or incorrectly contraception used(13 cases, 54.2%). Conclusion: Fixed IUD is effective in reducing the unwanted pregnancy again of the women after induced abortion, and the IUD expulsion should be focused on.

2024 Vol. 32　(1):　142- [Abstract]（ 313 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To analyze the level of serum human chorionic gonadotropin(β-hCG) combined with transvaginal ultrasound of patients for diagnosing their ectopic pregnancy. Methods: The clinical data of 90 patients with suspected ectopic pregnancy diagnosed and treated in hospital from February 2020 to February 2023 were collected retrospectively. The serum β-hCG level and the transvaginal ultrasound results of the patients were analyzed. The surgical and pathological diagnosis of the patients was as the gold standard to analyze the value of the serum β-hCG level, the transvaginal ultrasound results, and the combined detection of the β-hCG level and the transvaginal ultrasound results for diagnosing the ectopic pregnancy of the patients. Multivariate logistic regression analysis was used to analyze the influencing factors of diagnosing the ectopic pregnancy. Results: The positive values of theβ-hCG level, the transvaginal ultrasound results, and the combined detection of the β-hCG level and the transvaginal ultrasound results of the patients for diagnosing their ectopic pregnancy were 71.1%, 71.4% and 84.8%, respectively, and the negative predictive values of which were 75.6%, 72.9% and 90.9%, respectively. Both the β-hCG level and the transvaginal ultrasound results of the patients had certain diagnostic value for their ectopic pregnancy, and the area under the curve of the β-hCG level and the transvaginal ultrasound results of the patients for diagnosing their ectopic pregnancy was 0.74 and 0.732. The area under the curve of the combined detection of the β-hCG level and the transvaginal ultrasound results of the patients for diagnosing their ectopic pregnancy was 0.890, which was the highest(P<0.05). Multivariate logistic regression analysis showed that the negative results of theβ-hCG level and the transvaginal ultrasound of the patients were the risk factors affecting the diagnosis of their ectopic pregnancy. Conclusion: The combined β-hCG level and the transvaginal ultrasound results of the patients for diagnosing their ectopic pregnancy can improve the diagnostic efficacy, with higher sensitivity and specificity. The negative results of theβ-hCG level and the transvaginal ultrasound of the patients are the risk factors affecting the diagnosis of their ectopic pregnancy.

2024 Vol. 32　(1):　150- [Abstract]（ 335 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To investigate the efficacy of transvaginal ultrasound combined with contrast-enhanced ultrasound(CEUS) for diagnosing the uterine myoma. Methods: The clinical data of 112 patients with uterine myomas confirmed by surgery and pathology who were admitted to the hospital from January 2021 to January 2023 were analyzed retrospectively. All patients were given the examination by transvaginal ultrasound and CEUS. The results of the examination by transvaginal ultrasound and CEUS of the patients were compared with their pathological results. The value of transvaginal ultrasound or CEUS alone, or the combination of transvaginal ultrasound and CEUS of the patients for diagnosing their uterine myoma was analyzed. Results: In 112 patients with uterine myomas, there were 72 cases with type Ⅰ of uterine myomas and 40 cases with type Ⅱ of uterine myomas, there were 21 cases with submucosal leiomyoma, 62 cases with intramural leiomyoma and 29 cases with subserous leiomyoma, and there were 58 cases with single leiomyoma and 54 cases with multiple leiomyoma. A total of 173 lesions of the uterine myomas of the patients were found, including 25 lesions of submucosal myomas, 112 lesions of intramural leiomyoma and 36 lesions of subserous myomas. Compared with that of pathological results, the accuracy of the combination of transvaginal ultrasound and CEUS for diagnosing the uterine myoma was 100.0%, which was significantly higher than that(89.3%) of transvaginal ultrasound and that(93.8%) of CEUS. The rate of the missed diagnosis of the combination of transvaginal ultrasound and CEUS for the uterine myoma was 0, which was significantly lower than that(10.7%) of transvaginal ultrasound and that(6.3%) of CEUS(all P<0.05). The accuracy of the combination of transvaginal ultrasound and CEUS for diagnosing the type Ⅰof uterine myoma or the type Ⅱ of uterine myoma was 100.0%, which was significantly higher than that(90.3% or 87.5%) of transvaginal ultrasound and that(94.4% or 90.0%) of CEUS. The diagnostic rate of the combination of transvaginal ultrasound and CEUS of the patients for diagnosing their uterine myoma was significantly higher than that of transvaginal ultrasound or CEUS alone(all P<0.05). There was no significant difference in the diagnostic rate for the submucosal and subserous uterine myoma among the three diagnostic methods(P>0.05). The detection rate of the combination of transvaginal ultrasound and CEUS for diagnosing the uterine myoma was significantly higher than that of transvaginal ultrasound or CEUS alone(all P<0.05). There was no significant difference in the detection rate of the submucosal and subserous uterine myoma among the three diagnostic methods(P>0.05). Conclusion: The combination of transvaginal ultrasound and CEUS of the patients for diagnosing their uterine myoma improves the diagnostic efficacy, which can help to determine the location and number of uterine myomas accurately, and has higher detective rate for the subserous uterine myoma. The combination of transvaginal ultrasound and CEUS of the patients provides the evidences for selecting the reasonable treatment plan in clinical practice.

2024 Vol. 32　(1):　158- [Abstract]（ 303 ） HTML (0 KB)  PDF  (0 KB)  ( 8 )

To explore the high-risk factors of postoperative recurrence of the uterine myoma, and to put forward the preventive measures. Methods: The clinical data of 200 patients with uterine myomas who had undergone surgical treatment in the hospital from January 2020 to March 2022 were analyzed retrospectively. According to whether the patients with recurrence of the uterine myomas or not in 1 year of follow-up after surgery, these patients were divided in group A(patients with the recurrence of the uterine myomas) and group B(patients without the recurrence of the uterine myomas). The high-risk factors of the postoperative recurrence of the uterine myomas were analyzed by univariate and multivariate Logistic regression. Results: The recurrence rate of uterine myomas of the patients within 1year after surgery was 15.0%. There were significant differences in the body mass index, the diameter and number of uterine myomas, and the levels of estradiol(E2), follicle estrogen(FSH), luteinizing hormone(LH), carcinoembryonic antigen-125(CA125) and connective tissue growth factor(CTGF) of the patients between the two groups(all P<0.05). Multivariate logistic regression analysis showed that the number of uterine myoma >2, the high levels of FSH, LH, CA125 and CTGF of the patients in 1 year after surgery were the independent risk factors of their uterine myoma recurrence(P<0.05), and the high level of E2 of the patients in 1 year after surgery was a protective factor of their uterine myoma recurrence(P<0.05). The area under the curve(AUC) of the CA125 and CTGF levels of the patients in 1 year after surgery for predicting the recurrence of their uterine myoma in 1 year after surgery was 0.726 and 0.921. Conclusion: The high-risk factors of the postoperative uterine myoma recurrence of the patients include the multiple uterine myoma, the abnormal sex hormone indexes levels and the high expressions of serum CA125 and CTGF, and which should be strengthen monitoring and the targeted intervention should be conducted to reduce the risk of the postoperative recurrence of the uterine myomas.

2024 Vol. 32　(1):　167- [Abstract]（ 321 ） HTML (0 KB)  PDF  (0 KB)  ( 7 )

To investigate the value of the transvaginal ultrasound combined with the levels of carcinoembryonic antigen(CEA), carbohydrate antigen(CA) 125 and 153 of patients for differential diagnosing their benign or malignant uterine space-occupying lesions. Methods: The clinical data of 117 patients with suspected uterine space-occupying lesions from February 2021 to May 2023 were collected. These patients were divided into 56 patients with malignant uterine space-occupying lesions(endometrial cancer) in group A and 61 patients with benign uterine space-occupying lesions(endometrial benign polyps) in group B according to the results of their uterine dilatation and curettage or postoperative pathological examination. The differences of the results of the transvaginal ultrasound examination and the serum indexes levels of the patients were compared between the two groups. Receiver operating characteristic(ROC) curve was used to analyze the efficacy of the result of the transvaginal ultrasound examination and the serum indexes levels of the patients for differential diagnosing their benign or malignant uterine space-occupying lesions. Results: There was no significant difference in the peak systolic blood flow velocity of the patients between the two groups(P>0.05). The resistance index of the patients in group A was significantly lower than that of the patients in group B. The endometrial thickness of the patients in group A was significantly higher than that of the patients in group B. The levels of serum CEA, CA 125 and CA 153 of the patients in group A were significantly higher than those of the patients in group B(all P<0.05). The results of ROC curve showed that the AUC of the transvaginal ultrasound examination, the serum the CEA level, the CA 125 level, the CA 153 level, or the combination of the transvaginal ultrasound examination and the levels of the CEA, CA125 and CA153 of the patients for differential diagnosing their benign or malignant uterine space occupying lesions were 0.822, 0.713, 0.728, 0.797 and 0.915, respectively, and all of which had diagnostic values, but the combination of the transvaginal ultrasound examination and the levels of the CEA, CA125 and CA153 of the patients for differential diagnosing their benign or malignant uterine space occupying lesions had the highest value. Conclusion: The combinations of the transvaginal ultrasound examination and the levels of the CEA, CA125 and CA153 of the patients for differential diagnosing their benign or malignant uterine space occupying lesions have the higher efficacy and better clinical application value.

2024 Vol. 32　(1):　177- [Abstract]（ 331 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

2024 Vol. 32　(1):　184- [Abstract]（ 325 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To explore the risk factors of the macrosomia delivery of pregnant women with gestational diabetes mellitus (GDM), and to establish the relative risk prediction model of macrosomia. Methods: The clinical data of 218 pregnant women with GDM who were registered and delivered in hospital from January to December 2022 were collected retrospectively, including 27 cases with macrosomia in study group and 191 cases with normal weight of the newborns in control group. The risk factors of the macrosomia delivery of the women with GDM were analyzed by logistic regression analysis. R software was used to establish the nomogram model of macrosomia GDM, and a calibration curve was drawn. Results: Among 218 pregnant women with GDM, 27 cases delivered macrosomia, with an incidence of 12.4%. The BMI28kg/m2 before pregnancy (OR=5.410, 95%CI 2.142-11.938), the weight gain during pregnancy >14kg (OR=3.056, 95%CI 1.4277.016), the prolonged of the gestational weeks (OR=2.724, 95%CI 1.180-5.794), the fasting blood glucose level ≥4.7mmol/L during the third trimester of pregnancy (OR=3.218，95%CI 1.049-5.801), the triglycerides (TG) level ≥2.9mmol/L (OR=1.841, 95%CI 1.132-4.017) of the women with GDM were the independent risk factors of their macrosomia, and a nomogram model for predicting the macrosomia occurrence of the pregnant women with GDM was established based on these independent risk factors. The area under the curve (AUC) of the model curve for predicting the macrosomia was 0.921 (95%CI 0.896-0.938), and the sensitivity and the specificity of which were 83.7% and 86.9%, and the AUC, and the sensitivity and the specificity indicated that the accuracy of the model was acceptable. Conclusion: The pregnant women with GDM complicated with macrosomia are related to their obesity before pregnancy, excessive weight gain during pregnancy, prolonged gestational weeks, and the elevated levels of TG and FBG. The prediction model for the macrosomia is well differentiated, and which can scientifically, intuitively and simply identify the risk of macrosomia of the pregnant women with GDM.

2024 Vol. 32　(1):　195- [Abstract]（ 328 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

 To analyze the risk factors of the postpartum hemorrhage(PPH) occurrence of women with gestational diabetes mellitus(GDM), and to provide the countermeasure and suggestion. Methods: A cluster sampling method was applied to select the clinical date of 2984 women with GDM admitted to three hospitals from January 2021 to February 2023. These women were divided into study group(women with PPH) and control group(women without PPH) based on their 24-hour postpartum bleeding volume. The clinical data of the women in the two groups were collected. Logistic regression analysis model was used to screen the risk factors leading to PPH of the women with GDM. Results: Among 2984 women with GDM patients, there were 539(18.1%) cases with PPH. The proportions of the age ≥35 years old, pre-pregnancy body mass index(BMI) ≥24kg/m2, history of curettage, history of cesarean section, gravidity ≥2 times, multiparity, complicated with gynecological inflammation, fasting blood glucose(FBG) ≥7mmol/L, premature rupture of membranes, placental abruption, placenta previa, placenta residue, polyhydramnios, prolonged labor and HbA1c ≥6.5% of the women in the study group were significantly higher than those of the women in the control group. Multivariate logistic regression analysis showed that the age ≥35 years old, the BMI≥24kg/m2 before pregnancy, the history of curettage, the history of cesarean section, the multiparity, the complicated with gynecological inflammation, the placental abruption, the residual placenta, the polyhydramnios and the HbA1c≥6.5% of the women were the risk factors for their PPH occurrence(all P<0.05). Conclusion: The women with GDM and age ≥35 years old, prepregnancy BMI ≥24kg/m2, history of curettage, history of cesarean section, multiparity, complicated with gynecological inflammation, placental abruption, or polyhydramnios should be paid attention to, and their residual placenta should be removed timely and completely. It is also remind that the pregnant women should be control their fetal weight by controlling their diet, so as to reduce the incidence of PPH.

2024 Vol. 32　(1):　207- [Abstract]（ 328 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To explore the high-risk factors of the adverse neonatal outcomes of pregnant women with gestational diabetes mellitus(GDM), and to establish a Logistic risk model. Methods: The clinical data of 196 pregnant women with GDM who were admitted to the obstetrics clinic of the hospital from February 2020 to August 2022 were selected. According to the neonatal outcomes, these women were divided into study group(women with adverse neonatal outcomes) and control group(women without adverse neonatal outcomes). Logistic regression analysis was used to determine the high-risk factors of the adverse neonatal outcomes of the pregnant women with GDM, and Logistic risk model was established. Hosmer-Lemeshow test was used to determine the goodness of fit of the risk model. Receiver operating characteristic(ROC) curve was used to explore the predictive effect of this risk model. Results: Among 168 pregnant women, there were 44 cases with adverse neonatal outcomes and 124 cases without adverse neonatal outcomes. There were significant differences in the hypertensive disorders complicating pregnancy occurrence, the depressive symptoms, the pre-pregnancy BMI value, the weight gain during pregnancy, and the levels of fasting plasma glucose(FPG), 1-hour plasma glucose(1h PG) and glycosylated hemoglobin(HbA1c) before delivery of the women between the two groups. Logistic regression analysis showed that the hypertensive disorders complicating pregnancy, the depressive symptoms, the excessive weight gain during pregnancy and the high HbA1c level before delivery of the women with GDM were the independent risk factors of their adverse neonatal outcomes(all P<0.05). A logistic risk model was established based on these independent risk factors, which was Logit(P)=-15.610+1.472× hypertensive disorder complicating pregnancy(yes=1, no=0)+0.884×depressive symptoms(yes=1, no=0)+1.014×weight gain during pregnancy(excessive weight gain=2, insufficient weight gain=1). Normal weight gain during pregnancy=0)+2.053×HbA1c(%) before delivery. Hosmer-Lemeshow test(χ2=9.952, P=0.268) had a good goodness of fit for this model. ROC curve showed that the area under the curve of this logistic risk model for predicting the adverse neonatal outcomes of the pregnant women with GDM was 0.792, 95%CI=0.707-0.877, the best predictive sensitivity and specificity of this logistic risk model for the adverse neonatal outcomes were 77.3% and 72.6%. Conclusion: The high-risk factors of the adverse neonatal outcomes of the pregnant women with GDM include the hypertensive disorders complicating pregnancy, the depressive symptoms, the excessive weight gain during pregnancy and the high HbA1 c level before delivery. The Logistic risk model established by these high-risk factors of the adverse neonatal outcomes has a good predictive effect, and which can provide evidences for clinical intervention.

2024 Vol. 32　(1):　216- [Abstract]（ 311 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To analyze the efficacy of the blood flow resistance characteristics evaluated by ultrasound combined with the carbohydrate antigen detection of patients for diagnosing their endometrial cancer. Method: 35 women with endometrial cancer diagnosed and treated in hospital from January 2021 to June 2023 were selected in group A retrospectively, and 21 women with benign endometrial lesions were selected in group B. In addition, 56 healthy women who came to hospital for physical examination during the same period were included in group C. All the women in the three groups had undergone ultrasound examination to obtain the blood flow resistance related parameters values. The level of carbohydrate antigens(CA) the women in the three groups was detected. Multivariate logistic regression was used to analyze the risk factors of endometrial cancer occurrence. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of the blood flow resistance characteristics evaluated by ultrasound combined with the CA level of the women for their endometrial cancer. Results: The proportion of the coexistence of blood flow high and low resistance of the women in group A, group B, and group C had decreased gradually, and the serum levels of CA125, CA199, and CA153 of the women in group A, group B, and group C had also decreased gradually(all P<0.05). Multivariate logistic regression analysis showed that the low values of the blood flow resistance and the high levels of CA125, CA199 and CA153 of the women were the independent risk factors of their endometrial cancer occurrence(P<0.05). The area under the curve of the ultrasonic blood flow resistance parameters values and the levels of CA125, CA199 and CA153 of the women for diagnosing their endometrial carcinoma were 0.734, 0.711, 0.705, and 0.722, respectively. The area under the curve, the sensitivity, the specificity and the accuracy of the combined ultrasonic blood flow resistance parameters values and the CA levels of the women for diagnosing their endometrial carcinoma were 0.821, 87.5%, 78.6% and 83.0%, respectively, and which were significantly higher than those of the ultrasonic blood flow resistance parameters values or the CA levels. Conclusion: The accuracy of the combined ultrasonic blood flow resistance parameters values and the CA levels of the women for diagnosing their endometrial carcinoma is high, and which has certain clinical application value.

2024 Vol. 32　(1):　227- [Abstract]（ 294 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To explore the expression levels and the clinical significance of ficolin-3 and pentraxin 3(PTX3) of pregnant women with hypertensive disorder complicating pregnancy(HDCP). Methods: A total of 153 pregnant women with HDCP admitted to hospital from October 2018 to October 2020 were collected in study group retrospectively. According to the pregnancy outcomes of the women, these women were divided into group A(128 cases with normal pregnancy outcomes) and group B(25 cases with adverse pregnancy outcomes). 132 healthy pregnant women were included in control group during the same period. The general data of the women were compared between the study group and the control group. Enzyme-linked immunosorbent assay(ELISA) was used to detect the plasma ficolin-3 and PTX3 levels of the women in these groups. Pearson method was used to analyze the correlation between the plasma ficolin-3 level of the women with HDCP and their PTX3 level. Logistic regression was used to analyze the effects of the plasma ficolin-3 and PTX3 levels of the women with HDCP on their adverse pregnancy outcomes. Receiver operating characteristic(ROC) curve was used to analyze the predictive value of the plasma ficolin-3 and PTX3 levels of the women with HDCP for their adverse pregnancy outcomes. Results: The expression of plasma ficolin-3(32.85±8.96μg/L) of the women in the study group was significantly higher than that(20.47±6.58μg/L) of the women in the control group, and the expression of PTX3 level(2.79±0.34μg/L) of the women in the study group was significantly lower than that(2.94±0.27μg/L) of the women in the control group. The plasma ficolin-3 level of the women in group B was significantly higher than that of the women in group A, and the PTX3 level of the women in group B was significantly lower(all P<0.05). The results of Pearson analysis showed that the plasma ficolin -3 of the women with HDCP was negatively correlated with their PTX3 level(r=0.369, P<0.05). The high expression of plasma ficolin -3 and the low expression of PTX3 of the women with HDCP were the risk factors of their occurred adverse pregnancy outcomes. The results of ROC curve analysis showed that the area under the curve(AUC) of the plasma ficolin-3 and PTX3 of the women for predicting their adverse pregnancy outcomes were 0.875 and 0.745, the cutoff value of which were 31.27 μg/L and 2.75 μg/L, the sensitivity of which were 82.8% and 61.7%, and the specificity of which were 84.0% and 80.0%. The AUC, the sensitivity and the specificity of combined plasma ficolin-3 and PTX3 levels of the women for predicting their adverse pregnancy outcomes were 0.904, 81.3% and 92.0%, respectively. Conclusion: The plasma Ficolin-3 level of the women with HDCP is highly expressed, while the PTX3 level is lowly expressed, and both of which are related to their adverse pregnancy outcomes and can be used as the potential biological indicators for predicting their pregnancy outcomes.

2024 Vol. 32　(1):　237- [Abstract]（ 305 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

With the continuous increase of the cesarean section rate in the world, scholars at home and abroad have carried out a lot of researches on the current global cesarean section rate trends and regional differences. This paper analyzes the prevalence, differences and management status of the global cesarean section rate through a narrative review, analyzes the differences in the implementation, management and control measures of the non-fingered cesarean section at home and abroad, summarizes the measures taken to reduce the cesarean section rate at home and abroad and their effects, and puts forward the management methods for reducing the cesarean section rate that are suitable for China at present according to the differences and results. Although there is still no effective management method that can effectively reduce the high cesarean section rate in some high-income countries and developing countries, the indications and relevant policies of the cesarean section should also be strictly followed to control the cesarean section rate, should increase the trial birth rate of vaginal delivery after cesarean section, and carry out certain intervention for the women who wish to cesarean section without any indicator, and encourage the natural delivery of the women, so as to ensure the public health safety.

2024 Vol. 32　(1):　248- [Abstract]（ 349 ） HTML (0 KB)  PDF  (0 KB)  ( 8 )