To investigate the correlation between the skewed X-chromosome inactivation (SXCI) of women and their recurrent spontaneous abortion (RSA). Methods: The databases, such as PubMed, Medline, Cochrane, CNKI, CBM and Wanfang, were searched by computer from the established database until June, 2023 to collect the case-control studies about the correlation between SXCI of the women and their RSA. A meta-analysis was performed on the related-data of 3,706 women (1,673 women in case group and 2 033 women in control group) from 15 studies that were included after strict screening by Revman 5.3 and Stata 16.0 software. Results: In the overall analysis, the proportion of SXCI of the women in the case group was significantly higher than that of the women in the control group (OR=1.68， 95% CI=1.29-2.18， P<0.000). In the stratified analysis of the different degrees of SXCI, there was no statistical significance difference in the proportion of the moderate SXCI of the women between the two groups (OR=1.11， 95% CI=0.56-2.18，P=0.760), while the proportions of the high SXCI (OR=2.32, 95% CI=1.31-4.11, P=0.004) and the extreme SXCI (OR=4.71, 95% CI=1.77-12.52, P=0.002) of the women in the case group were significantly higher than those of the women in the control group. In the stratified analysis of the women with different abortion numbers, the number of the miscarriages ≥2 times (OR=5.06, 95% CI=2.46-10.40, P<0.000) and the number of the miscarriages ≥3 times (OR=2.48, 95% CI=1.66-3.68, P<0.000) of the women in the case group had significantly higher proportions of the high SXCI and the extreme SXCI compared with those of the women in the control group. Conclusion: The SXCI, especially the high SXCI or the extreme SXCI, of the women was significantly associated with the increased risk of their RSA, and the more number of the miscarriages of the women, the greater association is likely to be.

2024 Vol. 32　(4):　730- [Abstract]（ 109 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

 To investigate and analyze the utilization status and the influencing factors of the nutrition management service for women during pregnancy and childbirth in obstetric outpatient department. Methods: The clinical data of 2002 pregnant and lying-in women who were received services from obstetric outpatient department of the hospital were selected in this study from December 2020 to December 2022. 1564 women who accepted the nutrition management service less than 3 times in the past month were selected in group A, and 438 women who accepted the nutrition management service ≥3 times in the past month were selected in group B. The demographic data and the maternal health care situation of the women were compared between the two groups. Logistic regression was used to analyze the influencing factors of the utilization of the maternal nutrition management services. Results: Among 2002 women in this survey, 21.9% (438/2002) of them had the high utilization of the maternal nutrition management services. The main contents of the utilization of the maternal nutrition management services were the establishment of nutrition management files (82.5%), the nutrition consultation and evaluation (48.9%), the individualized nutrition support therapy (46.3%), the nutrition treatment for the pregnancy complications (56.1%) and the health education (56.1%). Multivariate analysis showed that education level of junior college or below, the family per capita monthly income <10 000 RMB, the number of antenatal examinations <4 times, the postpartum visits <3 times and the dissatisfaction or general satisfaction for the maternal nutrition management services of the women were the influencing factors of their utilization of maternal nutrition management services (all P<0.05). Conclusion: The utilization status of the nutrition management service of the pregnant and lying-in women in the obstetric outpatient department is not optimistic. For the pregnant and lying-in women with different educational and economic levels, the targeted nutrition management service should be adopted for them and the actively optimized model of the maternal nutrition management services of the pregnant and lying-in women should be conducted, so as to improve their utilization of the maternal nutrition management services.

2024 Vol. 32　(4):　744- [Abstract]（ 75 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To analyze the risk factors of the expulsion or the downward shift of the commonly used intrauterine devices (IUD). Methods: A nested case-control study was established for the women who had been inserted the top 10 number of IUD types based on their IUD first-diagnosed registration from 2015 to 2020, and these women were included in the cohorts of this study. The results of the corresponding examinations were collected retrospectively or prospectively. There were 994 women with the expulsion or the downward shift of IUD in the case group, and the women matched in the control group according to 1:3. The conditioned logistic regression analysis model was used to screen out the suspicious risk factors of the expulsion or the downward shift of IUD. Results: The type of IUD, the history of cesarean section, the side effect and the lactation of the women were all the influencing factors of the expulsion or the downward shift of their IUD. The risk of the expulsion or the downward shift of GCu200 (odds ratio(OR) =2.01, 95%CI 1.36-2.96), GCu220 (OR=1.60, 95%CI 1.08-2.37), OCu200 (OR=2.00，95%CI 1.25-3.22), TCu220C (OR=1.56, 95%CI 1.10-2.23), fixed IUD (OR=2.00，95%CI 1.36-2.95), active 165 (OR=2.43, 95%CI 1.62-3.64), Gamma Cu IUD (OR=1.77, 95%CI 1.21-2.59) and YCu 200 (OR=1.45, 95%CI 1.02-2.06) was significantly higher than that of active Gamma Cu IUD (memory alloy). The risk of the expulsion or the downward shift  of GCu220 (OR=1.67，95%CI 1.07-2.60) or fixed IUD（OR=1.66， 95%CI 1.06-2.61）was significantly higher than that of HCu280. The risk of the expulsion or the downward shift of GCu220 (OR=0.66，95%CI 0.45-0.97), HCu280 (OR=0.50，95%CI 0.31-0.79), TCu220C (OR=0.64，95%CI 0.45-0.92) and the Yuan Cu 200IUD (OR=0.60, 95%CI 0.42-0.85) was significantly lower than that of active 165 IUD. The history of cesarean section (OR=1.29，95%CI 1.09-1.52), the side effect after IUD inserted (OR=3.55，95%CI 2.80-4.49) and the lactation (OR=4.62, 95%CI 1.09-19.63) increased the risk of the expulsion or the downward shift of IUD. Conclusion: It is suggested that the appropriate type and the model of IUD should be selected for the women according to the risk factors of the expulsion or downward shift of their IUD, so as to improve the reproductive health level of the women of childbearing age.

2024 Vol. 32　(4):　755- [Abstract]（ 82 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To explore the effect and safety of the different dosages of lidocaine combined with propofol for the intravenous anesthesia during induced abortion of women. Methods: 100 women who planned to undergo induced abortion were selected as research objects from January 2021 to January 2023. According to the numerical table method, these women were randomly divided into two groups (50 cases in each group). The women in group A were given propofol combined with 2% lidocaine for intravenous anesthesia during abortion and the women in group B were given propofol combined with 1% lidocaine for intravenous anesthesia. The anesthetic effect, the pain score of VAS, the hemodynamics, the inflammatory factors levels and the incidence of the adverse reactions of the women were compared between the two groups. Results: The time of the conscious recovery (4.7±0.8 min) and the time of the orientation recovery (6.1±0.6 min) of the women in group B were significantly shorter than those (9.1±0.6 min and 10.6±1.0 min) of the women in group A. The operation time (12.4±0.4 min) and the dosage of propofol (106.6±3.4 mg) of the women in group B were significantly higher than those (10.2±0.6 min and 97.9±1.3 mg) of the women in group A (P<0.05). The values of the mean arterial pressure (MAP) and heart rate (HR) during waking of the women in the two groups had increased significantly, but which (80.3±1.5 mmHg and 82.8±1.2 beats /min) of the women in group A were significantly lower than those (84.7±1.7 mmHg and 86.3±0.8 beats /min) of the women in group B. The VAS scores of the women in the two groups at 30min after abortion had decreased significantly, and the MAP and HR values of the women in of the two groups at 30min after abortion were significantly higher than those before anesthesia. The MAP and HR values of the women in group A were significantly lower than those of the women in group B. The TNF-αand IL-6 levels of the women in the two groups at 10min after abortion had increased significantly, and which (34.35±3.11 pg/ml and 24.93±2.65 pg/ml) of the women in group A were significantly lower than those (50.25±2.95 pg/ml and 50.50±2.74 pg/ml) of the women in group B (all P<0.05). There was no significant difference in the incidence of the adverse reactions (26.0% vs.12.0%) of the women between the two groups (P>0.05). Conclusion: 2% lidocaine combined with propofol for the intravenous anesthesia during induced abortion of the women can improve their analgesic effect, and which can help to shorten the operation time and increase the amount of propofol uased of the women, reduce the influence of the surgical anesthesia on the hemodynamics and inflammation of the women. 1% lidocaine combined with propofol for the intravenous anesthesia during induced abortion of the women can help to promote their recovery of consciousness and orientation, and the incidences of respiratory depression, nausea and vomiting, dizziness and other side effect of the women are less, with the higher safety.

2024 Vol. 32　(4):　764- [Abstract]（ 83 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

2024 Vol. 32　(4):　774- [Abstract]（ 81 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To investigate the efficacy of ursodesoxycholic acid (UDCA) combined with adenosylmethionine butanedisulfonate (SAMe) for treating pregnant women with chronic hepatitis B and intrahepatic cholestasis in pregnancy (ICP), and to study the factors influencing the adverse pregnancy outcomes of the women. Methods: 86 pregnant women with chronic hepatitis B and ICP were selected and were divided into two groups according to the different treatment methods from June 2020 to June 2023. 40 women in the study group were treated with UDCA combined with SAMe, while 46 women in the control group were treated with single-agent UDCA. The clinical efficacy of the women was compared between the two groups. The levels of liver function indexes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT) and serum total bilirubin (TBIL), of the women in the two groups were detected, and the influence of which on the pregnancy outcomes of the women were analyzed. Results: The total clinical efficacy rate (92.5%) of the women in the study group was significantly higher than that (76.1%) of the women in the control group (P<0.05). The liver function-related indexes levels of the women in the two groups after treatment had improved significantly, and which of the women in the study group were significantly better than those of the women in the control group (all P<0.05). There was no significant difference in the incidence of the adverse reactions (5.0% vs.4.3%) of the women after treatment between the two groups (P>0.05). The incidence of the adverse pregnancy outcomes (7.5%) of the women in the study group was significantly lower than that (23.9%) of the women in the control group (P<0.05). Multivariate logistic regression analysis showed that the elevations of the levels of liver function indexes, such as ALT, AST and HbsAg, of the pregnant women with chronic hepatitis B and ICP were all the independent risk factors of their adverse cy outcomes (P<0.05). Conclusion: UDCA combined with SAMe for treating the pregnant women with chronic hepatitis B and ICP has better efficacy, and without increase the side effect. The high levels of ALT, AST and HbsAg of the pregnant women with chronic hepatitis B and ICP are all the independent risk factors of their adverse pregnancy outcomes.

2024 Vol. 32　(4):　784- [Abstract]（ 85 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

2024 Vol. 32　(4):　793- [Abstract]（ 77 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To study the effects of the high-dose vitamin D combined with insulin for treating pregnant women with gestational diabetes mellitus (GDM) on the levels of their serum visceral adipose-specific serine protease inhibitor (vaspin) and visfatin, and their pregnancy outcomes. Methods: A total of 105 pregnant women with GDM admitted to the hospital were divided into study group (53 cases) and control group (52 cases) according to the random number table method from December 2021 to March 2023. In addition to adjusting the diet and exercising, the women in both groups received insulin aspartate therapy for 4 weeks, and the women in the study group were given high-dose vitamin D supplement therapy for 4 weeks additionally. The changes of the glucose and lipid metabolism, the insulin resistance, and the levels of the blood 25 hydroxyvitamin D3 ［25 (OH) D3］ and the adipokine of the women before and 4 weeks after treatment were compared between the two groups. The women in both groups were followed up until the end of their pregnancy, and the pregnancy outcomes and the adverse reactions rate of the women were compared between the two groups. Results: The levels of the fasting blood glucose (5.26±0.53 mmol/L), the 2h postprandial blood glucose (6.62±0.78 mmol/L), the glycosylated hemoglobin (5.12±0.6%), the total cholesterol (3.24±0.56 mmol/L), the triglyceride (2.96±0.53 mmol/L), the low density lipoprotein cholesterol (2.51±0.55 mmol/L), the fasting insulin (12.52±2.63 mU/L), the vaspin (23.15±2.74 ng/ml) and the visfatin (102.56±20.27 ng/ml), and the insulin resistance index value (2.12±0.14) of the women in the study group after treatment were significantly lower than those of the women in the control group, but the 25 (OH) D3  level (26.52±5.71 ng/ml) of the women in the study group was significantly higher than that of the women in the control group (all P<0.05). The natural delivery rate (75.5%) of the women in the study group was significantly higher than that (55.8%) of the women in the control group, and the incidences of the cesarean section (15.1%) and the macrosomia (3.8%) of the women in the study group were significantly lower than those (32.7% and 15.4%) of the women in the control group (all P<0.05). There was no significant difference in the adverse reactions rate (7.5% vs. 5.8%) of the women between the two groups (P>0.05). Conclusion: The insulin combined with the high-dose vitamin D for treating the pregnant women with GDM has a significant effect on regulating their glucose and lipid metabolism, and it is speculated that which can reduce insulin resistance and improve pregnancy outcomes of the women by down-regulating their vaspin and visfatin levels and by increasing their 25 (OH) D3 level.

2024 Vol. 32　(4):　804- [Abstract]（ 90 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To explore the effect of the mindfulness meditation training combined with moderate aerobic exercise for pregnant women with hypertension disorder complicating of pregnancy (HDP). Methods: 116 pregnant women with HDP who had been antenatal examination were selected and were randomly divided into two groups (58 cases in each group) by the random number table method from January 2022 to June 2023. The women in the two groups were given routine nursing intervention. The women in the experimental group were given mindfulness meditation training combined with moderate aerobic exercise intervention additionally. The blood pressure valu, the scores of the general quality of life inventory-74 (GQOL-74), the depression anxiety and stress scale (DASS) and the mindful attention awareness scale (MAAS), the nursing satisfaction, and the incidence of adverse delivery outcomes of the women before and after nursing care were recorded and compared between the two groups. Results: After 8 weeks of nursing care, the indexes of the women in the two groups had improved significantly. The values of the systolic blood pressure (125.4±16.3 mmHg) and diastolic blood pressure (83.7±10.9 mmHg) of the women in the experimental group were significantly lower than those (137.7±19.3 mmHg and 89.4±9.8 mmHg) of the women in the control group. The DASS score of the women in the experimental group was significantly lower than that of the women in the control group. The quality of life of the women in the experimental group was significantly higher than that of the women in the control group. The MAAS scale (69.57±11.24 points) and the nursing satisfaction (98.3%) of the women in the experimental group were significantly higher than those (58.14±12.30 points and 87.9%) of the women in the control group. The incidence of the adverse delivery outcomes (8.6%) of the women in the experimental group was significantly lower than that (31.0%) of the women in the control group (all P>0.05). Conclusion: The mindfulness meditation training combined with moderate aerobic exercise intervention for the pregnant women with HDP can relief their hypertension, improve their quality of life and negative emotions, increase their mindfulness levels, enhance their nursing satisfaction and reduce their incidence of adverse delivery outcomes.

2024 Vol. 32　(4):　816- [Abstract]（ 83 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the effects of the doula delivery under family coordination combined with the painless delivery for primiparas on their delivery outcomes and satisfaction. Methods: A total of 82 primiparas were included and were divided into observation group and control group (41 cases in each group) by the random number table method from January 2021 to October 2023. The primiparas in the two groups were given routine obstetric delivery intervention, while the primiparas in the observation group received the doula delivery under family coordination combined with the painless delivery additionally. The total labor duration, the scores of fears of childbirth questionnaire (FCQ), delivery control scale (LAS) and general self-efficacy scale (GSES), the labor pain grading, the delivery mode, the postpartum anxiety (SAS) and depression (SDS) self-rating scale scores, the maternal and neonatal adverse outcomes, and the maternal satisfaction rate of the primiparas were compared between the two groups. Results: The duration of the total stage of labor of the primiparas in the observation group was significantly shorter than that of the primiparas in the control group. The scores of FCQ, LAS and GSES of the primiparas in the observation group were significantly better than those of the primiparas in the control group. The labor pain grade of the primiparas in the observation group was significantly better than that of the primiparas in the control group. The natural delivery rate (97.6%) of the primiparas in the observation group was significantly higher than that (73.2%) of the primiparas in the control group. The vaginal midwifed rate and the incidence of the natural delivery turned to cesarean section of the primiparas in the observation group were significantly lower than those of the primiparas in the control group. The scores of the postpartum SAS (41.28±5.29 points) and SDS (42.93±4.95 points) of the primiparas in the observation group were significantly lower than those (49.36±6.23 points and 50.46±5.92 points) of the primiparas in the control group. The incidences of the maternal and the neonatal adverse outcomes (2.4% and 0) of the primiparas in the observation group were significantly lower than those (17.1% and 12.2%) of the primiparas in the control group. The maternal delivery satisfaction rate (95.1%) of the primiparas in the observation group was significantly higher than that (80.5%) of the primiparas in the control group (all P<0.05). Conclusion: The doula delivery under family coordination combined with the painless delivery for the primiparas can shorten their total stage of labor duration, reduce their fear of childbirth, improve their self-efficacy, alleviate their labor pain, increase their rate of natural delivery, improve their postpartum psychological state and reduce the maternal and neonatal adverse outcomes, and with the better maternal satisfaction.

2024 Vol. 32　(4):　825- [Abstract]（ 71 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

2024 Vol. 32　(4):　834- [Abstract]（ 82 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To investigate the predictive value of the coagulation factor VIII (FVIII) activity and plasminogen activator inhibitor-1 (PAI-1) level of pregnant women with threatened miscarriage during the first trimester of pregnancy for their tocolytic outcomes. Methods: The clinical data of 345 pregnant with threatened miscarriage during the first trimester of pregnancy from January 2020 to December 2022 were analyzed retrospectively. According to the tocolytic outcomes, these women were divided into group A (124 cases with the failure of tocolytic outcomes) and group B (221 cases with the successful tocolytic outcomes). The FVIII activity and the levels PAI-1, beta human chorionic gonadotropin (β-hCG), serum estradiol(E2) and progesterone (P) of the women in the two groups were detected. The endometrial thickness (ET) of the women in the two groups was examined by ultrasound. Multivariate logistic regression analysis was conducted to identify the influencing factors of the successful tocolytic outcomes of the pregnant women with threatened miscarriage during the first trimester of pregnancy. Results: The FVIII activity (168.31±25.84%) and the PAI-1 level (54.39±6.05μg/l) of the women in group A were significantly higher than those (138.64±24.61% and 49.31±5.87μg/l) of the women in group B. The ET value (10.06±3.26 mm) and the levels of β-hCG (1763.86±706.77U/L), E2 (1051.16±369.57 poml/L) and P (32.96±15.72 noml/L) of the women in group A were significantly lower than those (12.55±1.91 mm, 3299.46±1831.59U/L, 3571.36±1126.29 poml/L and 64.38±17.24 noml/L) of the women in group B (all P<0.05). Multivariate logistic regression analysis showed that the increase of the FVIII activity and the decrease of the levels ofβ-hCG, E2 and P were risk factors for the successful tocolytic outcomes of the pregnant women with threatened miscarriage during the first trimester of pregnancy (P<0.05), while the PAI-1 level was not a risk factor for their successful tocolytic outcomes. Conclusion: The increase of FVIII activity of the pregnant women with threatened miscarriage during the first trimester of pregnancy affects their success of tocolysis, which can be used as a reference, so as to reduce the risk of the blind tocolysis in clinical practice.

2024 Vol. 32　(4):　844- [Abstract]（ 80 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To investigate the expressions of interleukin 6 (IL-6), procalcitonin (PCT) and fibrinogen of patients with torsion of ovarian cyst, and to study their diagnostic values. Methods: The clinical data of 106 patients with ovarian cyst torsion (in study group) and 82 patients without ovarian cyst torsion (in control group) admitted to hospital from January 2020 to December 2022 were collected. The patients in the study group were divided into group A (patients with ovarian cyst necrosis) and group B (patients without ovarian cyst necrosis) according to the postoperative pathological results of the patients. The expression levels of IL-6, PCT and fibrinogen of the patients were compared among these groups, and their diagnostic values for the ovarian cyst torsion was analyzed. Results: The levels of IL-6 (12.8±0.6 pg/ml), PCT (0.6±0.1 ng/ml) and fibrinogen (3.0±0.8 g/L) of the patients in the study group were significantly higher than those (8.2±0.3 pg/ml, 0.1±0.0 ng/ml and 1.2±0.4 g/L) of the patients in the control group, and which of the patients in group A were significantly higher than those of the patients in group B (all P<0.05). Receiver operating characteristic curve analysis showed that the area under the curve of the IL-6 level, the PCT level, the fibrinogen level or the combination levels of IL-6, PCT and fibrinogen of the patients with ovarian cyst for diagnosing their torsion of ovarian cyst was 0.811, 0.891, 0.635 or 0.953, respectively. The sensitivity, the specificity and the accuracy of the combination levels of iIL-6, PCT and fibrinogen of the patients with ovarian cyst for diagnosing the torsion of their ovarian cyst were 98.1%, 92.3 and 89.8%, respectively. Conclusion: The combined levels of IL-6, PCT and fibrinogen of the patients with ovarian cyst for diagnosing their torsion of ovarian cyst has higher value, which can be used to guide the clinical practice.

2024 Vol. 32　(4):　853- [Abstract]（ 74 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To explore the value of the combined levels of betatrophin and angiopoietin like protein 4 (ANGPTL4) of pregnant women with gestational diabetes mellitus (GDM) for predicting their pregnancy outcomes. Methods: A total of 128 pregnant women with GDM delivered in hospital from October 2019 to September 2022 were collected in study group retrospectively, 128 healthy pregnant women who delivered in hospital were collected in control group during the same period. The serum betaprophin and ANGPTL4 levels, and the pregnancy outcomes of the women were compared between the two groups. The influencing factors of the adverse pregnancy outcomes of the women in the study group were analyzed by logistic regression analysis. The predictive values of the levels of serum Betaprophin and ANGPTL4 of the women with GDM for their pregnancy outcomes were analyzed by receiver operator characteristic (ROC) curve. Results: The serum betatrophin level (390.27±65.05 pg/ml) and the incidence of adverse pregnancy outcomes (34.4%) of the women in the study group were significantly higher than those (291.56±48.59 pg/ml and 8.6%) of the women in the control group. The level of ANGPTL4 (4.23±1.40 ng/ml) of the women in the study group was significantly lower than that (8.22±2.74 ng/ml) of the women in the control group. The proportion of the family history of diabetes and the serum betatrophin level of the women with GDM and adverse pregnancy outcomes were significantly higher than those of the women with GDM and normal pregnancy outcomes, and the level of ANGPTL4 of the women with GDM and adverse pregnancy outcomes was significantly lower. The family history of diabetes, the higher betatrophin level and the lower ANGPTL4 level of the women with GDM were the risk factors of their adverse pregnancy outcomes (all P<0.05). The area under the curve (AUC) of the serum betatrophin level and the ANGPTL4 level of the women with GDM for predicting their adverse pregnancy outcomes were 0.864 and 0.877. The AUC, the sensitivity and the specificity of the combined levels of betatrophin and ANGPTL4 of the women with GDM for predicting their adverse pregnancy outcomes were 0.968, 97.7% and 85.7%, respectively. Conclusion: The level of serum betaprophin of the women with GDM is higher and the level of serum ANGPTL4 is lower, and both of which are the risk factors of the adverse pregnancy outcomes of the women. The combined levels of betatrophin and ANGPTL4 of the women with GDM has better value for predicting their pregnancy outcomes.

2024 Vol. 32　(4):　861- [Abstract]（ 78 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To observe the correlation between the levels of the serum matrix metalloproteinase-9 (MMP-9), endothelin-1 (ET-1) and soluble fms-like tyrosine kinase-1(sFlt-1) of pregnant women with hypertensive disorder complicating pregnancy(HDP). Methods: A total of 80 pregnant women with HDP from January 2020 to October 2023 were selected in study group retrospectively, and 80 healthy pregnant women during the same period were selected in control group. The levels of serum MMP-9, ET-1 and sFlt-1 of the women were compared between the two groups, and the correlation between which of the women and the disease severity of their HDP was analyzed. According to the perinatal outcomes, the women in the study group were divided into group A (women with normal pregnancy outcomes) and group B (women with adverse pregnancy outcomes). The predictive values of the serum MMP-9, ET-1 and sFlt-1 levels of the women with HDP for their perinatal outcomes were analyzed by receiver operating characteristic (ROC) curve. Results: The serum MMP-9 level(0.37±0.05ng/ml) of the women in the study group was significantly lower than that (0.66±0.15ng/ml) of the women in the control group. The levels of ET-1(30.63±4.17ng/ml) and sFlt-1 (4459.74±62.25ng/L) of the women in the study group were significantly higher than those (19.67±2.28ng/ml and 2371.16±48.52ng/L) of the women in the control group. In the study group, the MMP-9 level of the women with mild HDP was significantly higher than that of the women with moderate or severe HDP, and the levels of ET-1 and sFlt-1 of the women with mild HDP were significantly lower than those of the women with moderate or severe HDP (all P<0.05). Spesrman correlation analysis showed that the severity of HDP of the women with HDP was negatively correlated with their level of MMP-9 (r=-0.496), and was positively correlated with their ET-1 level (r=0.472) and their sFlt-1 level (r=0.508) (P<0.05). In 80 women with HDP, there were 19 women with adverse perinatal outcomes. The serum MMP-9 level of the women in group B was significantly lower than that of the women in group A, and the serum ET-1 and sFlt-1 levels of the women in group B were significantly higher than those of the women in group A (all P<0.05). ROC analysis showed that the best cut-off values of the MMP-9 level, the ET-1 level and the sFlt-1 level of the women with HDP for predicting their adverse perinatal outcomes were 0.365 ng/ml, 29.425 ng/ml and 4495.65 ng/L, respectively. The area under the curve and the specificity of the combined levels of the MMP-9, ET-1 and sFlt-1 of the women with HDP for predicting their adverse perinatal outcomes were 0.906 and 91.8%, and which were significantly higher than those of the MMP-9 level, the ET-1 level or the sFlt-1 level alone (all P<0.05). Conclusion: The serum levels of MMP-9, ET-1 and sFlt-1 of the pregnant women with HDP are closely related to their disease severity and perinatal outcomes. The combined detection of the MMP-9, ET-1 and sFlt-1 levels of the pregnant women with HDP has higher predictive value for their adverse perinatal outcomes.

2024 Vol. 32　(4):　869- [Abstract]（ 90 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To investigate the effect of the laparoscopy combined with the hysteroscopy for treating patients with endometriosis. Methods: 80 patients with endometriosis admitted to the obstetrics and gynecology department were selected and were divided into two groups according to the different operation methods from June 2020 to June 2023. 40 patients in the observation group were given laparoscopy combined with hysteroscopy surgery and 40 patients in the control group were given laparoscopy surgery. The therapeutic effect, the pregnancy rate within 2 years after operation, the operation-related indicators and the sex hormone levels before and after operation of the patients were compared between the two groups. Results: There were no significant differences in the operation-related indicators values of the patients between the two groups (P>0.05). The total effective rate (97.5%) and the pregnancy rate (60.0%) of the patients in the observation group were significantly higher than those (85.0% and 37.5%) of the patients in the control group (all P<0.05). The levels of the follicle-stimulating hormone, luteinizing hormone and estradiol of the patients in the two groups in 1 month after operation had decreased significantly, and which (5.16±1.21 U/L, 8.56±2.78 U/L and 102.23±38.20 pg/ml) of the patients in the observation group were significantly lower than those (7.18±1.45 U/L, 15.14±3.69 U/L and 167.34±42.18 pg/ml) of the patients in the control group (all P<0.05). Conclusion: The combination of laparoscopy and hysteroscopy for treating the patients with endometriosis can not only improve their curative effect, but also improve their levels of sex hormones and their postoperative pregnancy rate.

2024 Vol. 32　(4):　881- [Abstract]（ 89 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

2024 Vol. 32　(4):　889- [Abstract]（ 83 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To investigate the clinical effect, safety and reproductive prognosis of the hysteroscopic intrauterine bigatti shave (IBS) and hysteroscopic electricity resection (HEC) for treating endometrial polyps (EPs) of patients. Methods: The clinical data of 330 patients with EPs who were treated in hospital from April 2019 to April 2021 were collected retrospectively. These patients were divided into group A (114 cases with the operative mode of IBS) and group B (216 cases with the operative mode of HEC) according to the different operative mode. The operation-related conditions, the postoperative menstrual rehydration time, the postoperative endometrial recovery situation in 1, 6, and 12 months after surgery, and the surgery outcomes, such as healed, unhealed, intrauterine adhesions, spontaneous pregnancy and recurrence of Eps of the patients were compared between the two groups. Results: The operation time (9.5±1.3min) of the patients in group A was significantly shorter than that (13.1±1.2min) of the patients in group B, and the intraoperative uterine fluid perfusion (2265±19ml) of the patients in group A was significantly less than that (3305±32ml) of the patients in group B (all P<0.05). There were no significant differences in the intraoperative blood loss, the intraoperative complications rate and the duration of hospital stay of the patients between the two groups (P>0.05). The postoperative sodium level (138.88±0.130 mmol/L) of the patients in group A was significantly higher than that (138.23±0.280 mmol/L) of the patients in group B (P<0.05). There was no significant difference in the levels of postoperative potassium, calcium and hemoglobin of the patients between the two groups (P>0.05). The results of the postoperative follow-up showed that the patients in the two groups were cured that evaluated by vaginal color Doppler ultrasound in 1 month after operation. There was no significant difference in the endometrial thickness of the patients during follicular phase between the two groups (P>0.05). The endometrial thickness of the patients in group A during follicular phase in 6 and 12 months after operation (6.6±0.2mm and 6.8±0.2mm) were significantly thicker than those (5.7±0.1mm and 6.2±0.2mm) of the patients in group B. The natural pregnancy rate (66.6%) of the patients in group A was significantly higher than that (29.6%) of the patients in group B (P<0.05). There was no any patient with intrauterine adhesions in both groups after operation. The recurrence rate (0) of the patients in group B in 1 year after operation had no significantly different from that (3.2%) of the patients in group A (P>0.05). Conclusion: IBS for treating the patients with EPs has the advantages of the shorter operation time, the faster postoperative endometrial repair and the higher pregnancy rate, because it avoids the electric heat to damage the endometrium of the patients in a certain extent, and which can improve the protection of the endometrium of the patients.

2024 Vol. 32　(4):　898- [Abstract]（ 109 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the values of the levels of serum calcium, phosphorus and D-dimer of pregnant women before delivery for predicting their uterine inertia-induced postpartum hemorrhage. Methods: 106 women who had delivered in hospital from October 2018 to October 2023 were collected in this study retrospectively. These women were divided in 21 cases with uterine inertia-induced postpartum hemorrhage in observation group and 85 cases without uterine inertia-induced postpartum hemorrhage in control group according to whether the uterine inertia-induced postpartum hemorrhage occurred or not. The medical records of the women in the two groups were collected. The levels of the prenatal serum calcium, phosphorus and D-dimer of the women were compared between the two groups. Multivariate Logistic regression analysis was used to screen the risk factors of the uterine inertia-induced postpartum hemorrhage of the women. The values of the levels of the prenatal serum calcium, phosphorus and D-dimer of the women for predicting their uterine inertia-induced postpartum hemorrhage was analyzed. Results: The levels of the prenatal serum calcium (2.39±0.31 mmol/L) and phosphorus (1.27±0.30 mmol/L) of the women in the observation group were significantly lower than those (2.66±0.28 mmol/L and 1.53±0.35 mmol/L) of the women in the control group. The prenatal serum D-dimer level (0.40±0.09 mg/L) of the women in the observation group was significantly higher than that (0.32±0.10 mg/L) of the women in the control group (all P<0.05). Logistic regression analysis showed that the low serum calcium and phosphorus levels, the high D-dimer level, the advanced age, the high body mass index value and the prolonged labor duration of the women were the risk factors of their uterine inertia-induced postpartum hemorrhage (P<0.05). The area under the curve (AUC), the sensitivity and the specificity of the combined levels of the serum calcium, phosphorus, and D-dimer of the women for predicting their uterine inertia-induced postpartum hemorrhage were 0.912, 95.2% and 50.6%, respectively, and the predictive efficacy of which was significantly higher than that of the serum calcium level, the phosphorus level or the D-dimer level alone (all P<0.05). Conclusion: The low levels of calcium and phosphorus, and the high D-dimer levels before delivery, the advanced age, the prolonged labor duration and the high body mass index value of the women are the risk factors of their uterine inertia-induced postpartum hemorrhage. The combined detection of the serum calcium, phosphorus, and D-dimer levels of the women can effectively predicting the occurrence of their uterine inertia-induced postpartum hemorrhage.

2024 Vol. 32　(4):　908- [Abstract]（ 88 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

2024 Vol. 32　(4):　917- [Abstract]（ 102 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

2024 Vol. 32　(4):　926- [Abstract]（ 76 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To explore the influencing factors of the onset of gestational diabetes mellitus (GDM) of pregnant women, and to study their correlation with the adverse pregnancy outcomes of the women. Methods: The clinical data of 120 pregnant women with GDM (in study group) and 120 healthy pregnant women (in control group) that had been accepted the antenatal examinations in hospital from February 2021 to February 2023 were selected in this study. The clinical factors and the laboratory indicators of the women were compared between the two groups. The influencing factors of the GDM occurrence of the women were analyzed by multivariate logistic regression analysis. The rate of the adverse pregnancy outcomes of the women was compared between the two groups. Results: The proportions of the age ≥35 years old, the body mass index (BMI) during pregnancy ≥28kg/m2, and the weight gain during pregnancy ≥8kg, and the levels of malondialdehyde (MDA), triglyceride (TG), and total cholesterol (TC) of the women in the study group were significantly higher than those of the women in the control group, but the level of superoxide dismutase (SOD) of the women in the study group was significantly lower (all P<0.05). Logistic regression analysis showed that the age ≥35 years old, the gestational BMI≥28kg/m2, the gestational weight gain ≥8kg, the abnormal increase of the levels of MDA, TG and TC of the women were the influencing factors of their GDM occurrence, and the increase of the SOD level of the women was the protective factor of their GDM occurrence. The incidences of the macrosomia, premature rupture of membranes, cesarean section, neonatal jaundice and premature delivery of the women in the study group were significantly higher than those of the women in the control group (P<0.05). Conclusion: The GDM occurrence of the pregnant women is associated with their age, their gestational BMI and weight gain, and their abnormal levels of MDA, TG, TC, and SOD. The GDM occurrence of the pregnant women can increase the risk of their adverse pregnancy outcomes.

2024 Vol. 32　(4):　938- [Abstract]（ 66 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the correlation between the expressions of the estrogen receptor (Er), progesterone receptor (Pr) and human epidermal growth factor receptor 2 (Her2) of patients with breast cancer and their magnetic resonance imaging (MRI) signs. Methods: The clinical data of 125 patients with breast cancer who had been operated in hospital from January 2021 to December 2022 were analyzed retrospectively. These patients underwent MRI examination in 1 to 2 weeks after menstruation. The MRI signs of the lesions of the patients were analyzed and diagnosed by two associate chief physicians according to the results of MRI examination of the patients. The MRI signs included the tumor diameter, the tumor morphology, the enhancement pattern, the tumor margin, the early enhancement rate and the time-signal intensity curve (TIC). The expressions of the ER, PR and Her2 in tumor tissues were detected by immunohistochemical SP method. Results: The MRI examination showed that the positive expression rate of PR of the patients was different among the patients with different tumor diameter, margin, shape or TIC, and the positive expression rate of ER of the patients was different among the patients with different tumor morphology or TIC (all P<0.05). There was no significant difference in the positive expression rates of ER, PR and Her2 among the patients with different other MRI signs (P>0.05). The tumor margin of MRI signs of the patients was negatively correlated with their ER and Her2 positive expressions (P<0.05), and the early enhancement pattern of the patients was negatively correlated with their Her2 positive expression (P<0.05). The other MRI signs of the patients had no significant correlation with the positive expression rates of their ER, PR and Her2 (P>0.05). Conclusion: The levels of the ER, PR and Her2 of the patients are correlated with their MRI signs of the breast cancer, such as the tumor diameter, the tumor morphology, the tumor margin and the enhancement pattern. The MRI features of the breast cancer of the patients can be used as the preliminary evaluations of the histopathological changes of their breast cancer, and which can provide the references for the clinical diagnosis, treatment and prognosis evaluation of the breast cancer of the patients.

2024 Vol. 32　(4):　948- [Abstract]（ 74 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To analyze one Turner syndrome patient without relevant clinical symptoms, and to provide the references for the clinicians to identify the patient with skewed X-chromosome inactivation. Methods: The peripheral blood samples of one patient with primary infertility for 3 years, and her husband and parents were collected for the chromosome karyotype analysis and the female chromosomal copy number variations (CNVs), and the genetic analysis was conducted. Results: The chromosome karyotype in the peripheral blood of the patient with the primary infertility was 46, X, del(X) (q22.3), and the chromosome karyotype results of her parents and husband were normal. The CNV results of the patient indicated that the deletion of Xq22.3-q27.3 was 40.62Mb, and which was a pathogenic change. The ratio of the missing skewed X-chromosome inactivation of this patient was 98:2, and which indicated that this patient with the extreme skewed X-chromosome inactivation. Conclusion: The clinicians should consider the possibility of the women with skewed X-chromosome inactivation, so the patients with the chromosome abnormalities should be found as early as possible to avoid the risk of their fertility and their neonatal birth defects.

2024 Vol. 32　(4):　959- [Abstract]（ 90 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )