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ZHANG Bian1,2, YANG Xue2, LIU Ying2, ZHAO Xujing3
To evaluate the efficacy of the different vitamins supplementation for preventing the bronchopulmonary dysplasia (BPD) of preterm infants. Methods: The randomized controlled trials (RCTs) on vitamin supplementation for preventing BPD of preterm infants were searched in the databases，such as PubMed, EMbase, Cochrane Library, Web of Science, CNKI and Wan fang. The RCTs that met the inclusion criteria were screened, and the qualities of the RCTs were evaluated by Cochrane Risk of Bias Assessment Tool. The efficacy of the different vitamins supplementation for preventing BPD of the preterm infants was analyzed and compared by Bayesian net meta-analysis. Results: A total of 21 RCTs, including 3188 preterm infants, were included in this meta-analysis. Compared with those of the infants in the placebo group, the medium-dose supplementation with vitamin D (400-800IU/d, OR=0.41, 95% Cl 0.18-0.90), and the low-dose supplementation with vitamin A (<1333IU/kg/d, OR=0.50, 95% Cl 0.25-0.95) of the infants were associated with their reduced incidence of BPD. The low-dose vitamin D supplementation (<400IU/d, OR=12.36, 95%, Cl 1.00-600.21) of the infants might be associated with their increased preterm mortality. The confidence intervals of the low-dose vitamin E supplementation (OR=0.59, 95%Cl 0.23-1.36) and the high-dose vitamin E supplementation (OR=0.74, 95%Cl 0.14-3.64) of the infants were wide, and both of which were not strongly associated with the prevention of BPD of the infants. Conclusion: In the vitamin supplementation programmes for the preterm infants, the medium-dose supplementation with vitamin D and the low-dose supplementation with vitamin A can effectively prevent their BPD, but the low-dose supplementation of vitamin D may increase the preterm mortality of the preterm infants, thus the vitamin D supplementation for the preterm infants should be given in appropriate doses. The effectiveness of vitamin E supplementation of the preterm infants for preventing their BPD has not been adequately demonstrated.
2024 Vol. 32 (5): 972- [Abstract]（
109
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LIN Xiuhong1, NI Fuyong2, ZHANG Linzhi3, FENG Xiaoqi1, WANG Siyu4, MO Lichun1, LUO Junjie1, ZOU Yan5
To explore the influence of the social media on the fertility intentions and its related factors of the residents in Greater bay area under the three-child policy. Methods: A self-designed questionnaire was used in this investigation. From November 2021 to September 2022, the people of childbearing age in 9 cities of the Greater bay area were randomly selected in this investigation. The content of the investigation included the general demographic data and the social media used situation, as well as the fertility intention and its possible influencing factors of the residents in the Greater bay area under the three-child policy. Results: A total of 3656 questionnaires were distributed and 3556 valid questionnaires were returned, with an effective rate of 97.3%. Among them, there were 318 (8.9%) residents without the intention of any child, 782 (22.0%) residents with the intention of one child, 2085 (58.6%) residents with the intention of two children and 371 (10.4%) residents with the intention of three or more children. Among the residents who planned to have child within three years, the proportion (38.0%) of the respondents with one child was significantly higher than that (15.2%) of the respondents with two children (P<0.001). There was significant difference in the ideal number of children among the residents with different age, between the residents with different gender, among the residents with different education levels, among the residents with different marital status, among the residents with different household registration situations, among the residents with different job nature, among the residents with different family annual household income and among the residents with different social media used time (P<0.05). The social media used of the residents had greater impact on their fertility intention, logistic regression model analysis showed that the duration of the social media used of the residents was correlated with their ideal number of children. Conclusion: The residents in Greater bay area have strong intention to the second child, but have low intention to the third child. The fertility intention of the residents is related to their social media used situation, and which is also affected by their family planning, age, education level, annual family income and job stability, and so on. The government should pay attention to the impact of the social media used of the residents on their fertility intention, so as to improve the fertility intention.
2024 Vol. 32 (5): 983- [Abstract]（
88
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ZHANG Wei, GUO Jian, CHEN Wei
To understand the status of pain disclosure of women with artificial insemination, and to analyze its influencing factors. Methods: A total of 148 women with artificial insemination infertility admitted to the hospital from April 2021 to April 2023 were selected in this study. The general data questionnaire, the distress disclosure index (DDI), the perceived social support scale (PSSS) and the Locke-Wallace marriage adjustment test scale (MAT) were used for investigation. Pearson correlation coefficient model was used to analyze the correlation between the scores of IPSSS and MAT of the women with artificial insemination and the level of their pain disclosure. And multiple linear regression model was used to analyze the influencing factors of the pain disclosure of the women with artificial insemination. Results: A total of 148 questionnaires were distributed and 138 valid questionnaires were returned, with an effective rate of 93.2%. The DDI score of 138 women was 35.25±5.48 points, and the low level of DDI score accounted for 14.5%, the medium level of DDI score accounted for 73.2% and the high level of DDI score accounted for 12.3%. The score of the PSSS and the MAT of the women with artificial insemination were 53.15±9.67 points and 99.56±12.21 points. Univariate analysis showed that there was statistically significant difference in the pain disclosure score among the women with different age, among the women with different family per capita monthly income, among the women with different place of residence, between the women with and without artificial insemination by their husband, and among the women with different artificial insemination methods (P<0.05). Pearson correlation analysis showed that the PSSS and MAT scores of the women with artificial insemination were positively correlated with their DDI score (all P<0.001). Multiple linear regression analysis showed that the family per capita monthly income, whether the artificial insemination by husband or not, the PSSS score and the MAT score of the women with artificial insemination had the positive impacts on the level of their painful disclosure, and the number of artificial insemination of the women had the negative effect on the level of their pain disclosure (all P<0.05). Conclusion: The pain disclosure of the women with artificial insemination is at a medium level in this investigation. The family per capita monthly income, whether the artificial insemination by husband or not, the number of artificial insemination, the social support and the marital intimacy of the women with artificial insemination are the important influencing factors of their pain disclosure, so which should be paid attention to in clinic and the targeted nursing interventions should be given, so as to relieve the pain disclosure level and promote the physical and mental health of the women.
2024 Vol. 32 (5): 990- [Abstract]（
86
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LI Tao, GUO Xiaoxia, HAN Ting, LI Yan
To investigate the delivery psychological trauma status of puerperas after cesarean section, and to analyze its influencing factors. Methods: Convenience sampling method was used to select 112 puerperas after cesarean section between October 2021 and October 2023 in this study. All puerperas were investigated by the general information questionnaire, the city birth trauma scale (City BiTS), the social support rating scale (SSRS), the visual analogue scale (VAS) and the connor davidson resilience scale (CD-RISC). Then the influencing factors of the delivery psychological trauma of the puerperas after cesarean section were identified by univariate and multivariate logistic regression analysis. Results: A total of 112 questionnaires were distributed and 108 questionnaires were valid, with an effective recovery rate of 96.4%. In 108 puerperas, 33 puerperas met the criteria of delivery psychological trauma positive symptoms, with the positive rate of 30.6%. The overall score of delivery related symptoms of the puerperas was 49.0±4.6 (43-55) points. The scores of the fear of uncertain events, the delivery traumatic history, whether the gender of the child consistented with the expectation, the inappropriate nursing by medical staff, the unfamiliar delivery environment, the lack of postpartum mother-infant relationship and the social support (32.6±4.2 points), the pain score after cesarean section (6.1±1.5 points) and the resilience score (54.0±5.3 points) of the puerperas with delivery psychological trauma positive symptoms were significantly higher than those (37.4±4.2 points, 4.7±1 points and 59.8±4.7 points) of the puerperas with delivery psychological trauma negative symptoms (P<0.05). Multivariate logistic regression analysis showed that the fear of uncertain events, the history of traumatic delivery, the gender of the child without meeting the expectations, the inappropriate nursing by medical staff, the unfamiliar delivery environment, the lack of postpartum mother-infant relationship, the low social support score, the high postoperative pain score after cesarean section and the low psychological resilience score of the puerperas were the influencing factors of their delivery psychological trauma after cesarean section (all P<0.05). Conclusion: The delivery psychological trauma of the puerperas after cesarean section is quite common, and which is influenced by various factors, therefore, preventive and control interventions should be strengthened for these puerperas to reduce the occurrence of their delivery psychological trauma.
2024 Vol. 32 (5): 995- [Abstract]（
75
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ZHANG Yun, YANG Ying, JIA Dongmei
To analyze the current status of the caregiver burden of patients with gynecological malignant tumor, and to study its influencing factors. Methods: Convenience sampling method was used to select the caregivers of the patients with gynecological malignant tumor who visited to hospital from March 2022 to January 2024 in this questionnaire survey. The total score of caregivers burden inventory (CBI) used to evaluate the level of the care burden of the caregivers of the patients was 96 points, and these caregivers were divided into group A (the caregivers with CBI score of 0-32 points) and group B (the caregivers with CBI score of 3396 points). The univariate and multiple regression analysis were used to identify the possible influencing factors of CBI of the caregivers. Results: A total of 297 survey questionnaires were distributed and 290 valid questionnaires were returned, with an effective rate of 97.6%. The CBI score of 290 caregivers of the patients with gynecological cancer was 60.36±5.55 points, including 110 (37.9%) cases in group A and 180 (62.1%) cases in group B. The univariate and logistic regression analysis showed that the advanced age, the low education level, the low monthly income, the residence in rural, and the longer daily care time of the caregivers, and the longer duration of gynecological cancer and the more numbers of annual hospitalization of the patients were the factors affecting the CBI score of the caregivers (P<0.05). Conclusion: The CBI score of the caregivers of the patients with gynecological malignant tumor is higher, with the relatively heavy of care burden. The advanced age, the low education level, the low monthly income, the residence in rural and the longer daily care time of the caregivers, and the longer duration of gynecological malignant tumor and the greater number of annual hospitalization of the caregivers of the patients with gynecological malignant tumor are the independent factors affecting the CBI score of the caregivers. Improving the social and the family support, constructing a health management model based on the hospital-community-family triple linkage for the caregivers can help to alleviate their care burden, which is of great significance for the treatment and the rehabilitation of the patients with gynecological malignant tumor.
2024 Vol. 32 (5): 1002- [Abstract]（
82
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LI Jiaheng, LI Yijiang, LI Mengnuo, ZHAO Xianling, GUAN Yichun, LIU Yanli, JIA Qi, LI Jing, DU Shanshan, LV Yidong
To investigate the cognition of the fertility preservation (FP) of the young patients with cancer, the oncology related physicians and the reproductive physicians, in order to explore the factors affecting the cognition of the patients and the physicians, so as to provide more support for the implementation of FP. Methods: From November 2022 to June 2023, the physicians and the patients with cancer from 7 hospitals in Henan province were surveyed through a combination of online and offline questionnaire survey. The basic information, the FP cognition and other related data of the physicians and the patients were collected. The cognition and the attitude of the physicians and the patients towards FP were analyzed. Results: The valid questionnaires from 69 patients and 256 physicians were collected. 60.8% patients with cancer knew FP, but only 47.8% patients learned the FP related knowledge from the physicians. 63.8% patients concerned about the cancer recurrence because of the stimulating of FP and 46.4% patients concerned their age. The patients who were nulliparous or who had given birth to girls were more willing to learn about FP. The patients who had been aware of the damage of the chemoradiotherapy of the cancer before treatment had higher cognition on FP. The oncology related physicians with the intermediate professional titles, who had explained the effects of chemoradiotherapy to patients, who had understood the concept and significance of FP, or who had asked about the fertility needs of the young patients were more likely to recommend FP to the patients. Knowing that the patients with cancer could undergo FP of the reproductive physicians is an independent factor affecting their recommend FP to the patients. Conclusion: The patients lack the FP knowledge, the oncology and the reproductive related physicians have insufficient knowledge on FP and some hospitals have not carried out the FP practice, so it is necessary to establish a multidisciplinary collaboration platform of the oncology and reproduction.
2024 Vol. 32 (5): 1009- [Abstract]（
103
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PENG Bo, YE Bing, HU Wei, CHEN Long, ZHAO YUAN Xingzi
To analyze the application status of intrauterine device (IUD) in the adjuvant treatment of gynecological diseases in Guangdong province from 2017 to 2022, so as to provide reference for further expanding the application of IUD in the adjuvant treating for clinical diseases. Methods: The information on the front page of the medical records of the patients with gynecological diseases who had IUD inserted from January 2017 to December 2022 was statistically analyzed. The IUD inserted situations of the patients with different age or with different gynecological diseases, of the patients from different levels and types of medical institutions, and of the patients with different years of IUD used was analyzed. Results: From 2017 to 2022, the number of the patients with gynecological diseases who had IUD inserted during hospitalization increased year by year. In 2022, the age of the patients with IUD inserted during hospitalization for gynecological diseases had increased from 35.3±7.4 years old in 6 years ago to 38.3±6.5 years old, and the number of the patients had increased by 141.8%. The main medical institutions of the patients with IUD inserted were the tertiary general hospital. There was significant difference in the IUD inserted situation among the patients from different levels of medical institutions (P<0.05). The IUD used of the patients with endometrial polyps, with the endometrial hyperplasia or with the abnormal uterine bleeding had showed an upward trend. Conclusion: The number of the patients hospitalized for gynecological diseases who choose IUD inserted as an adjuvant treatment is increasing year by year, and the gynecological diseases of the patients mainly concentrate in the endometrial polyps, the endometrial hyperplasia or the abnormal uterine bleeding.
2024 Vol. 32 (5): 1017- [Abstract]（
67
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YANG Lihua, WANG Ying, LI Junshi, LI Xinfeng
To compare the anesthetic effect of esketamine combined with propofol and sufentanil combined with propofol used during painless abortion. Methods: A total of 102 women who wanted painless abortion were divided into two groups (51 cases in each group) according to random number table method from February 2023 to October 2023. The women in group A were given sufentanil 0.1μg/kg combined with propofol 2.0mg/kg for anesthesia during painless abortion, and the women in group B were given esketamine 0.2mg/kg combined with propofol 2.0mg/kg for anesthesia during painless abortion. The values of hemodynamic indexes, perioperative indexes, pain degree of contraction after recovery and the occurrence of adverse reactions of the women were compared between the two groups at different time points ［before anesthesia induction (T0), at 1min after administration (T1), at 3min after administration (T2), when consciousness disappeared (T3), at the beginning of surgery (T4), at the end of surgery (T5)］. Results: The values of diastolic blood pressure, systolic blood pressure, mean arterial pressure and heart rate of the women in group B at T3, T4 and T5 were significantly higher than those of the women in group A, and the blood oxygen saturation value of the women in group B at T4 was significantly higher than that of the women in group A. The total dosage of propofol (121.33±12.48mg/kg) and the time of loss of consciousness (32.59±3.87s) of the women in group B were significantly lower than those (150.49±14.26mg/kg and 37.06±4.52s) of the women in group A. The score of visual analogue scale (VAS) of the women in group B at 15 minutes (2.75±0.36 points) and at 30 minutes (3.15±1.02 points) after awakening were significantly lower than those (3.69±0.58 points and 4.48±1.59 points) of the women in group A, and the incidence of adverse reactions (13.7%) of the women in group B was significantly lower than that (31.4%) of the women in group A (all P<0.05). Conclusion: Esketamine combined with propofol used during the painless abortion of the women has better anesthetic effect than that of sufentanil combined with propofol used, which can effectively maintain the hemodynamic stability, reduce the dosage of propofol and the degree of pain because of uterine contraction after abortion of the women, and with less adverse reaction and higher safety.
2024 Vol. 32 (5): 1022- [Abstract]（
93
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ZHANG Zhenhzen, LI Ying, DANG Ronghua, lIU Jing
To explore the effects of multi-directional psychological intervention of women with unwanted pregnancy after induced abortion on their mental health and postoperative cognitive status. Methods: According to the order of admission, 62 women with unwanted pregnancy who underwent painless artificial abortion in the hospital from March 2022 to March 2023 were divided into study group and control group (31 cases in each group). The women in the control group were given routine nursing intervention, and 31 women in the study group were given multi-directional psychological intervention combined with routine nursing intervention. The cognitive score of reproductive health knowledge, the scores of Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Connor-davidson resilience scale (CD-RISC), the postoperative complications rate and the nursing satisfaction of the women before and after intervention were compared between the two groups. Results: After intervention, the total cognitive score of reproductive health knowledge (79.15±7.27 points) of the women in the study group was significantly higher than that (66.19±6.69 points) of the women in the control group, the total score of different dimensions of CD-RISC (75.17±6.42 points) and the nursing satisfaction (93.6%) of the women in the study group were significantly higher than those (61.07±7.29 points and 71.0%) of the women in the control group. The scores of HAMD (13.52±1.63 points) and HAMA (12.37±1.48 points), and the incidence of postoperative complications (6.5%) of the women in the study group were significantly lower than those (18.29±1.53 points, 16.55±1.54 points and 25.8%) of the women in the control group (all P<0.05). Conclusion: Multi-directional psychological intervention for the women with induced abortion because of unwanted pregnancy can improve their cognitive status of reproductive health knowledge, reduce their adverse emotions, enhance their psychological resilience, reduce their incidence of complications and improve their nursing satisfaction.
2024 Vol. 32 (5): 1027- [Abstract]（
75
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ZHU Yao, LV Dan, JING Yun
To observe the efficacy of leuprorelin combined with laparoscopic myomectomy for treating patients with uterine myoma, and to study its influence on the pelvic ovarian function and postoperative recurrence of the patients. Methods: A total of 162 patients with uterine myoma were selected and were divided into control group (81 cases) and observation group (81 cases) by random number table method from March 2019 to June 2022. The patients in the control group were given treatment of laparoscopic myomectomy alone, and the patients in the observation group were given treatment of subcutaneous injection of leuprelin acetate in 3 months before surgery combined with laparoscopic myomectomy. The values of the operative related indexes and the postoperative complications rate of the patients were compared between the two groups. The changes of the uterine volume and the levels of estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) of the patients in 3 months before and after surgery were compared between the two groups. Pelvic floor Dysfunction Questionnaire (PFDI-20) was used to evaluate the pelvic floor function of the patients in the two groups. The recurrence rates of the patients in the two groups were followed up in 6 months and in 12 months after surgery. Results: The intraoperative blood loss, the operation time, the drainage time, and the activity time of getting out of bed of the patients in the observation group were significantly less than those of the patients in the control group (P<0.05). There was no significant difference in the incidence of postoperative complications (1.2% vs. 3.7%) of the patients between the two groups (P>0.05). After drug pretreatment, the volume of uterine myoma (89.62±6.23 cm3) of the patients in the observation group had decreased, and which was significantly less than that (112.12±6.20 cm3) of the patients in the control group. Three months after operation, the uterine volume (181.53±8.47 cm3), the levels of E2 (151.24±8.43 pmol/L), LH (10.39±1.85 U/L) and FSH (13.58±2.16 U/L), and the PFDI-20 score of the patients in the observation group were significantly less than those (190.54±9.54 cm3, 168.47±9.34 pmol/L, 12.60±2.85 U/L and 15.39±3.05 U/L) of the patients in the control group (all P<0.05). There was no significant difference in the recurrence rate of uterine myoma of the patients in 6 months after operation between the two groups (P>0.05). The recurrence rate of uterine myoma (0) of the patients in the observation group in 12 months after operation was significantly lower than that (5.0%) of the patients in the control group (P<0.05). Conclusion: Leuprorelin combined with laparoscopic myomectomy for treating patients with uterine myoma has better efficacy, and which can improve their pelvic floor function and ovarian function recoveries and can reduce the recurrence rate of the uterine myoma of the patients in 12 months after operation, and without increase of the complications and with medication safety.
2024 Vol. 32 (5): 1032- [Abstract]（
79
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JIN Pingping1,2, LI WeiLi3, WANG Peipei4
To observe the effect of Erxian decoction combined with Guizhi fuling pills modifications for treating patients with polycystic ovary syndrome (PCOS), and to study its influence on the metabolic disorders and the ovarian hemodynamics of the patients. Methods: 104 patients with PCOS who visited the hospital and had been treated with Ethinylestradiol cyproterone acetate tablets were randomly divided into two groups (52 cases in each group) from March 2021 to March 2023. The patients in the observation group were treated with Erxian decoction combined with Guizhi fuling pills modifications additionally. The therapeutic effect of the patients in the two groups after three menstrual cycles of treatment was evaluated. The serum sex hormones and the metabolic indicators of the patients in the two groups were detected. The values of peak systolic blood flow velocity (PSV), resistance index (RI) and end diastolic blood flow velocity (EDV) of ovarian interstitial artery of the patients in the two groups were measured by ultrasound. Results: After treatment, the TCM syndrome score (5.58±1.89 points), the serum testosterone level (2.01±0.33 nmol/L), the fasting blood glucose level (4.65±0.37 mmol/L), the luteinizing hormone level (7.12±0.64 U/L), the total cholesterol level (4.11±0.32) mmol/L, the ratio of luteinizing hormone/follicle stimulating hormone (1.31±0.12), the low density lipoprotein cholesterol level (2.46±0.31 mmol/L), the fasting insulin (11.07±2.65) and the triglyceride level (1.09±0.19 mmol/L) of the patients in the observation group were significantly lower than those (7.96±2.03 points, 2.74±0.42 nmol/L, 5.22±0.51 mmol/L, 9.34±0.85 U/L, 4.52±0.36 mmol/L, 1.72±0.21, 2.67±0.43 mmol/L, 12.89±2.97 and 1.23±0.21 mmol/L) of the patients in the control group, and the level of estradiol (68.85±5.96 ng/L) of the patients in the observation group was significantly higher than that (62.48±5.17 ng/L) of the patients in the control group (all P<0.05). There was no significant difference in the levels of follicle stimulating hormone and highdensity lipoprotein cholesterol of the patients between the two groups (P>0.05). The values of ovarian PSV (12.21±1.98 cm/s) and EDV (10.02±2.17 cm/s) of the patients in the observation group were significantly lower than those (15.88±2.01 cm/s and 11.53±2.25 cm/s) of the patients in the control group. The RI value (0.82±0.21) and the total effective rate (98.1%) of the patients in the observation group were significantly higher than those (0.62±0.13 and 84.6%) of the patients in the control group (all P<0.05). Conclusion: Erxian decoction combined with Guizhi fuling pills modifications for treating the patients with PCOS can improve their clinical symptoms, correct their endocrine and glucose lipid metabolism disorders, improve their ovarian hemodynamics and enhance their clinical efficacy.
2024 Vol. 32 (5): 1037- [Abstract]（
83
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ZENG Zongjun, WANG Ding, MA Daici
To investigate the effects of the focused ultrasound ablation (FUAS) combined with dinorgestrel for treating patients with adenomyosis on their pain score, anemia degree, serum markers and hormone markers levels, immune function and safety. Methods: 86 patients with adenomyosis treated in hospital were randomly divided into control group (n=43) and observation group (n=43) according to 1:1 ratio from November 2022 to November 2023. The patients in the control group were treated with FUAS alone for 3 months, and the patients in the observation group were treated with FUAS combined with dinorgestrel for 3 months. The pain score, the degree of anemia, the levels of serum indexes and hormone indexes, the immune function and the adverse reactions rate of the patients before and after treatment were compared between the two groups. Results: After treatment, the visual analogue scale score (1.47±1.03 points) of the patients in the observation group was significantly lower than that (3.66±1.46 points) of the patients in the control group. The levels of hemoglobin (117.66±10.39 g/L), immunoglobulin (Ig) G (10.36±1.29 g/L) and IgM (1.36±0.29 g/L) of the patients in the observation group were significantly higher than those (±9.22 g/L, 8.73±1.58 g/L and 0.89±0.21 g/L) of the patients in the control group. The levels of mouse double microgene-2 (1.44±0.39 kU/L), carbohydrate antigen 125 (34.97±4.11 IU/ml), vascular endothelial growth factor (82.16±15.34 pg/ml), follicle stimulating hormone (3.47±1.03 U/L), estradiol (114.28±20.11 pmol/L) and luteinizing hormone (4.27±1.05 mg/ml) of the patients in the observation group were significantly lower than those (2.36±0.47 kU/L, 44.85±4.32 IU/ml, 98.46±17.28 pg/ml, 5.26±1.14 U/L, 134.69±21.20 pmol/L and 5.64±1.12 mg/ml) of the patients in the control group. The incidence of adverse reactions (9.3%) of the patients in the observation group was significantly lower than that (27.9%) of the patients in the control group (all P<0.05). Conclusion: FUAS combined with dinorgestrel for treating the patients with adenomyosis can effectively reduce their pain degree and anemia status, improve their serum indexes, hormone indexes and immune function, and with the higher safety.
2024 Vol. 32 (5): 1043- [Abstract]（
76
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SHI Xiu1, CHEN Huijun1, HU Ying2
To explore the efficacy of Longdan xiegan decoction combined with azithromycin for treating cervicitis of patients, and to study its influence on the vaginal microecology and cervical inflammatory response of the patients. Methods: A total of 80 patients with cervicitis treated in hospital were selected and were randomly divided into study group and control group (40 cases in each group) according to the numerical table method from January 2019 to October 2023. The patients in the two groups were treated with azithromycin, and the patients in the study group were treated with Longdan xiegan decoction additionally. The efficacy, the incidence of adverse reactions, the score of TCM syndrome, the values of immune function index, the inflammatory factors of cervical secretion and the relative abundance change of vaginal flora of the patients in the two groups after 1 month of treatment were observed. Results: After treatment, the total effective rate (90.0%) of the patients in the study group was significantly higher than that (70.0%) of the patients in the control group. Four TCM syndrome scores of increased leucorrhea, leucorrhea thickness, lower abdominal pain and vulva pruritus of the patients in the study group were significantly lower than those of the patients in the control group. The levels of CD3+ (54.47±1.85), CD4+ (27.84±1.79) and the relative abundance of lactobacillus (45.67±0.97) of the patients in the study group were significantly higher than those (46.19±2.49, 23.12±1.37 and 40.95±1.72) of the patients in the control group. The gardnerella relative abundance (5.10±0.07), and the levels of TNF-α (4.85±0.65 ng/L) and CRP (6.70±0.97 mg/L) of the patients in the study group were significantly lower than those (5.68±0.05, 6.91±0.61 ng/L and 10.68±1.07 mg/L) of the patients in the control group (all P<0.05). There was no significant difference in the incidence of the adverse reactions (15.0% vs.17.5%) of the patients between the two groups (P>0.05). Conclusion: Longdan xiegan decoction combined with azithromycin for treating cervicitis of the patients can improve the curative effect, can reduce inflammation response and control clinical symptoms, can improve the vaginal microenvironment and enhance the immunity of the patients, and without increasing the risk of adverse reactions, which is an effective and safe clinical treatment for the cervicitis of the patients.
2024 Vol. 32 (5): 1047- [Abstract]（
80
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SONG Xiaohong, BAI Wenpei
To explore the efficacy of Baofukang suppository as adjuvant method of the recombinant human interferon α-2b gel for treating patients with high-risk human papillomavirus (HR-HPV) infection, and to study its effect on HPV viral load and the cervicitis of the patients. Methods: 100 patients with HR-HPV infection were selected and were randomly divided into two groups (50 cases in each group) from January 2022 to February 2023. The patients in the two groups were treated with the recombinant human interferon α-2b gel, and the patients in the observation group were given Baofukang suppository as adjuvant treatment additionally. The clinical efficacy, the vaginal secretion cleanliness degree, the Nugent score, the HPV load, the cervical inflammation score and the levels of serum inflammatory factors, such as tumor necrosis factor-α(TNF-α) and transforming growth factor-β1 (TGF-β1), of the patients were compared between the two groups. Results: After treatment, the total clinical effective rate (94.0%) of the patients in the observation group was significantly higher than that (74.0%) of the patients in the control group. The vaginal secretion cleanliness degree (1.02±0.28), the Nugent score (2.19±0.37) and the RLU/CO of HR-HPV load ［4.37 (0.08, 2162.75)］ of the patients in the observation group were significantly lower than those (1.75±0.32, 2.84±0.50 and 78.63 (1.03, 2633.41) of the patients in the control group. The cervical inflammation score (10.15±1.16 points), the levels of serum TNF-α (5.83±1.52 ng/L) and TGF-β1 (16.37±2.41 ng/L) of the patients in the observation group were significantly lower than those (17.43±1.55 points, 11.49±2.58 ng/L and 21.56±2.67 ng/L) of the patients in the control group (all P<0.05). There was no significant difference in the total incidence of adverse reactions (10.0% vs. 20.0%) of the patients between the two groups (P>0.05). Conclusion: Baofukang suppository combined with recombinant human interferon α-2b gel for treating the patients with HR-HPV infection can increase the effectiveness, which can effectively improve the vaginal cleanliness, reduce the HPV load and relieve the cervical inflammation of the patients, and without increase of the adverse reactions.
2024 Vol. 32 (5): 1052- [Abstract]（
93
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PENG Xianxiu, XIU Xuemei, CHEN Wenxiang
To explore the efficacy of myofascial fingering relaxation combined with neuromuscular electrical stimulation for treating patients with pelvic floor pain, and to study its influence on the clinical symptoms, pelvic floor muscle strength and complications of the patients. Methods: 198 patients with pelvic floor pain who visited the hospital were enrolled and were divided into two groups (99 cases in each group) according to the random number table method from August 2021 to July 2023. The patients in group A were treated with neuromuscular electrical stimulation, while the patients in group B were given myofascial fingering relaxation combined with neuromuscular electrical stimulation. The clinical efficacy, the clinical symptoms scores evaluated by visual analogue scale (VAS) and Oswestry dysfunction index (ODI) before treatment, in 7 and 28 days of treatment and after 14 days of treatment, the pelvic floor muscle strength grading, the pelvic floor electromyography indicators before and after treatment, such as anterior resting potential, posterior resting potential, rapid contraction and continuous contraction, the score of pelvic floor impact questionnaire (PFIQ-7), the complications rate and the recurrence of the pelvic floor pain of the patients were compared between the two groups. Results: After 4 weeks of treatment, the total effective rate (89.9%) of the patients in group B was significantly higher than that (79.8%) of the patients in group A (P<0.05). In 7 days of treatment, in 28 days of treatment, and after 14 days of treatment, the VAS and ODI scores of the patients in the two groups had decreased gradually, and which of the patients in group B were significantly lower than those of the patients in group A. The pelvic floor muscle strength grade of the patients in the two groups after treatment was significantly better than that before treatment, and which of the patients in group B was significantly better than that of the patients in group A. The amplitude of anterior and posterior resting potential of the patients in the two groups had decreased significantly, and the rapid contraction and sustained contraction of the patients in the two groups had increased significantly. The amplitude of anterior and posterior resting potential of the patients in group B was significantly lower than that of the patients in group A. The score of PFIQ-7 of the patients in both groups had decreased significantly, and which of the patients in group B was significantly lower than that of the patients in group A (all P<0.05). There was no patient with obvious complication in the two groups during the treatment. In 3 months of follow-up after treatment, there was no significant difference in the pain recurrence rate (8.1% vs. 3.0%) of the patients between the two groups (P>0.05). Conclusion: Myofascial fingering relaxation combined with neuromuscular electrical stimulation for treating the patients with pelvic floor pain can improve their curative effect, effectively relieve their clinical symptoms, improve the pelvic floor muscle strength and functional function, and with the safety of treatment.
2024 Vol. 32 (5): 1057- [Abstract]（
72
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BAO LiXia1, WANG Mindan1, DUAN Dingnan2
To investigate the analgesic effect of remifentanil combined with propofol used in laparoscopic hysterectomy of patients, and to study its influence on the hemodynamics and stress indexes of the patients. Methods: 128 patients who wanted laparoscopic hysterectomy were selected and were randomly divided into observation group and control group (64 cases in each group) from January 2021 to December 2023. Laparoscopic hysterectomy was performed in both groups. The patients in the control group were given sufentanil combined with propofol for anesthesia induction, and then pumped continuously for analgesic maintenance during laparoscopic hysterectomy. The patients in the observation group were given remifentanil combined with propofol for anesthesia induction, and then pumped continuously for analgesic maintenance during laparoscopic hysterectomy. The values of hemodynamic indexes, stress indexes and pain indexes, the visual analogue score (VAS) and the adverse reactions rate of the patients were compared between the two groups. Results: The values of heart rate and mean arterial pressure of the patients in the observation group after anesthesia induction, at tracheal intubation, at the beginning of the operation and immediately after the operation were significantly lower than those of the patients in the control group. The levels of epinephrine, cortisol, serotonin and neuropeptide of the patients in the two groups immediately after operation were significantly lower than those before operation, and which (60.26±5.41 pg/ml, 84.22±5.03 ng/ml, 90.24±9.31 ng/L and 121.69±13.47μg/L) of the patients in the observation group were lower significantly than those (69.96±5.15 pg/ml, 92.15±6.39 ng/ml, 139.64±12.13 ng/L and 160.55±16.36μg/L) of the patients in the control group. The pain score of the patients in the two groups immediately after operation were significantly lower than that before operation, and which (2.95±0.21 points) of the patients in the observation group was significantly lower than that (3.37±0.32 points) of the patients in the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions (9.4% vs. 3.1%) of the patients between the two groups (P>0.05). Conclusion: Remifentanil combined with propofol used in aparoscopic hysterectomy for anesthesia can significantly improve the hemodynamic indexes and stress level, can reduce the pain mediator level and VAS score of the patients, and without increasing the adverse reactions.
2024 Vol. 32 (5): 1062- [Abstract]（
82
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CHEN Xiuying, CHEN Na, GAO Na, CUI Jiantao, LI Xiaodan, ZHANG Shibiao
To explore the correlation between the squamous-cell carcinoma antigen (SCC-Ag) level and neutrophil to lymphocyte ratio (NLR) of women with cervical cancer and their clinicopathological characteristics and prognosis. Methods: 108 women with cervical cancer in group A, 108 women with cervical intraepithelial neoplasia（CIN）in group B and 108 healthy women in group C were enrolled in this study. The levels of SCC-Ag and NLR of the women were compared among the three groups. The correlation between the levels of SCC-Ag and NLR of women in group A and their clinicopathological characteristics and prognosis was analyzed. Results: The levels of serum SCC-Ag and NLR of the women in group A (7.35±1.76 and 4.65±1.06), in group B (2.06±0.53 and 3.41±0.89), and in group C (0.54±0.12 and 1.53±0.34) had decreased gradually (P<0.05). The levels of the serum SCC-Ag and NLR of the women with cervical cancer were related to their pathological type, FIGO stage, pathological grade, depth of myometrial invasion and pelvic lymph node metastasis (P<0.05). Kaplan-Meier showed that the overall survival rate and the disease-free survival rate of the women with the high expressions of SCC-Ag and NLR were significantly lower than those of the women with the low expressions of SCC-Ag and NLR. The overall survival rate and the disease-free survival rate of the women with high expressions of SCC-Ag and NLR were the lowest (all P<0.05). Conclusion: The levels of serum SCC-Ag and NLR of the women with cervical cancer are related to their pathological type, FIGO staging, pathological grading and depth of muscular invasion. The higher of the levels of serum SCC-Ag and NLR, the worse of the prognosis of the women.
2024 Vol. 32 (5): 1067- [Abstract]（
88
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QIN Yan, NAN Fang, HE Fang
To investigate the effects of laparoscopic unilateral salpingectomy for treating patients with tubal pregnancy on their serum β-human chorionic gonadotropin (β-hCG) and Netrin-1 levels and postoperative pregnancy. Methods: From January 2021 to November 2022, 40 patients with tubal pregnancy who underwent laparoscopic unilateral salpingectomy (in observation group) and 40 patients with tubal pregnancy who underwent laparoscopic unilateral fallopian tubal fenestration for removing the embryo (in control group) were selected in this study. The surgery-related indicators, the complications, the serum β-hCG and Netrin-1 levels before and after surgery and the postoperative ovarian reserve function indicators of the patients in the two groups were counted. The pregnancy status within 1 year after surgery of the patients in the two groups was followed up. Results: The intraoperative blood loss (72.1±4.8ml) of the patients in the observation group was significantly more than that (66.1±12.4ml) of the patients in the control group. The incidence of the postoperative complications (7.5%) and the rate of postoperative ectopic pregnancy (0) of the patients in the observation group were significantly lower than those (25.0% and 17.5%) of the patients in the control group. In 6 months after surgery, the serum luteinizing hormone level (6.15±1.12 mU/ml) of the patients in the observation group was significantly higher than that (5.63±0.95mU/ml) of the patients in the control group, and the anti-Mullerian hormone level (3.33±0.58 ng/ml) of the patients in the observation group was significantly lower than that (3.64±0.79 ng/ml) of the patients in the control group (all P<0.05). There were no significant differences in the
levels of β-hCG and Netrin-1 on the 3rd day after surgery and the time of the levels of β-hCG and Netrin-1 decreasing to normal after surgery of the patients between the two groups (all P>0.05). Conclusion: Laparoscopic unilateral salpingectomy and fallopian tubal fenestration for treating the patients with tubal pregnancy can effectively remove the ectopically implanted embryo. Compared with those of fallopian tubal fenestration, laparoscopic unilateral salpingectomy can reduce the postoperative complications and the risk of ectopic pregnancy again of the patients, but which has the risks of more intraoperative bleeding and damaging the ovarian reserve function of the patients.
2024 Vol. 32 (5): 1072- [Abstract]（
71
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SHEN Jing, LI Wenxia, XIE Min, WANG Youlian
To explore the impacts of labetolol and nifedipine combined with positive psychological intervention for treating pregnant women with hypertensive disorder complicating pregnancy (HDP) on their blood pressure, negative emotions, and sleep quality. Methods: A total of 100 pregnant women with HDP were randomly divided into two groups (50 cases in each group) from January 2022 to December 2023. The women in the two groups were given nifedipine combined with positive psychological intervention, and the women in the observation group were given labetolol additionally. The blood pressure value, the negative emotions situation, the sleep quality, the adverse pregnancy outcomes and the incidence of adverse reactions of the women were compared between the two groups. Results: After 4 weeks of treatment, the systolic blood pressure and diastolic blood pressure values of the women in the two groups had decreased significantly, and which (117.8±4.6 mmHg and 76.2±2.1mmHg) of the women in the observation group were significantly lower than those (130.3±5.4 mmHg and 83.0±3.2mmHg) of the women in the control group. The scores of the self-rating anxiety scale and self-rating depression scale of the women in the two groups had decreased significantly, and which (38.22±2.96 points and 40.38±2.54 points) of the women in the observation group were significantly lower than those (46.38±4.41 points and 51.36±3.88 points) of the women in the control group. The Pittsburgh sleep quality index score of the women in the two groups had decreased significantly, and which (6.22±0.94 points) of the women in the observation group was significantly lower than that (8.86±1.25 points) of the women in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions (10.0% vs. 14.0%) of the women between the two groups (P>0.05). Conclusion: Labetolol and nifedipine combined with positive psychological intervention for treating the pregnant women with HDP can decrease their blood pressure, and improve their negative emotions and sleep quality.
2024 Vol. 32 (5): 1077- [Abstract]（
93
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XIANG Xuewen, LIU Chunhua, MU Shasha, LIU Suxia
To explore the impacts of the intrapartum ultrasound monitoring of fetal heart combined with the new partogram management for primiparas on the delivery modes and the pregnancy outcomes of the primiparas. Methods: The primiparas with singleton and full-term pregnancy who wanted vaginal trial delivery in hospital were selected and were divided into two groups according to the different intrapartum monitoring methods from October 2022 to October 2023. The primiparas in group A were given intrapartum electronic monitor combined with new partogram management. And the primiparas in group B were given intrapartum color Doppler ultrasound monitoring combined with new partogram management. After excluding the confounding factors of the baseline data of the primiparas by propensity score matching method, 134 primiparas in each group were obtained for analysis. The delivery modes, the duration of different stage of labor, the postpartum pelvic floor muscle function (activity value, work value and peak value), and the adverse delivery outcomes of the primiparas were compared between the two groups. Results: The rate of cesarean section (22.4%) of the primiparas in group B was significantly lower than that (34.3%) of the primiparas in group A. The durations of the first stage of labor (10.5±0.8h) and the second stage of labor (79.5±11.5min) of the primiparas in group B were significantly shorter than those (10.8±1.0h and 93.4±13.2min) of the primiparas in group A. The activity value, work value and peak value of the pelvic floor muscle of the primiparas with vaginal delivery in the two groups were significantly lower than those of the primiparas with cesarean section (P<0.05). There was no significant difference in the incidence of adverse delivery outcomes of the primiparas between the two groups (P>0.05). Conclusion: The application of the intrapartum ultrasound monitoring of fetal heart and the fetal position combined with the new partogram management for the primiparas can shorten their delivery stage duration, reduce their cesarean section rate and improve the maternal-infant outcomes.
2024 Vol. 32 (5): 1081- [Abstract]（
71
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LIU Lianting, SHI Jun, NIU Jinlan, ZHU Ping, YANG Baicai
To explore the application effect of the mobile health intervention based on the health belief model for patients with ovarian cancer (OC) after operation. Methods: 156 patients after OC operation were selected and were divided into experimental group and control group (78 cases in each group) according to the random lottery method from May 2020 to May 2023. The patients in the control group were given routine nursing intervention, and the patients in the experimental group were given mobile health intervention based on health belief model combined with the routine nursing intervention. The patients in both groups were intervened until 3 months after operation. The self-efficacy score evaluated by strategies used by people to promote health (SUPPH), the selfmanagement ability score evaluated by the exercise of self-care agency scale (ESCA), the negative emotions score evaluated by self-rating anxiety scale (SAS), and self-rating depression scale (SDS), and the situations of compliance and complications of the patients were compared between the two groups. Results: After intervention, the scores of the different dimensions of SUPPH and ESCA of the patients in the experimental group were significantly higher than those of the patients in the control group. The scores of SDS (45.31±5.45 points) and SAS (43.55±4.61 points) of the patients in the experimental group were significantly lower than those (50.41±6.38 points and 48.62±5.47 points) of the patients in the control group. The good rate (66.7%) and moderate rate (26.9%) of the compliance of the patients in the experimental group were significantly higher than those (47.7% and 28.2%) of the patients in the control group. The incidence of complications (5.1%) of the patients in the experimental group was significantly lower than that (15.4%) of the patients in the control group (all P<0.05). Conclusion: The mobile health intervention based on the health belief model for the patients after OC operation can enhance their self-efficacy and selfmanagement ability, reduce their unhealthy mood, improve their compliance and reduce the incidence of their complications.
2024 Vol. 32 (5): 1086- [Abstract]（
61
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ZHANG Zhihua, XU Aihua, ZHANG Chun, PAN Liuliu, SHI Liyun, XU Shuangqin
To explore the application effect of the stratified nursing in the management of the postpartum blood glucose of newborns delivered by pregnant women with gestational diabetes mellitus (GDM). Methods: 220 pregnant women with GDM and their newborns in hospital from March 2021 to March 2023 were collected and were divided into two groups (110 cases in each group) according to the orders of the admission to hospital of the women. The women in the control group had received routine nursing, while the women in the observation group had received the stratified nursing. The incidence of the hypoglycemia, the recovery time of the blood glucose, and the glucose supplementation situation of the newborns were compared between the two groups. The nursing satisfaction of the women in the two groups was evaluated. Results: The cumulative rate of the neonatal hypoglycemia (9.1%), the borderline hypoglycemia rate (13.6%) and the recurrent hypoglycemia rate (0) of the newborns in the observation group were significantly lower than those (22.7%, 33.6% and 6.4%) of the newborns in the control group (P<0.05). There was no significant difference in the incidence of the symptomatic hypoglycemia (0.9% vs. 3.6%) of the newborns between the two groups (P>0.05). The recovery time of the blood glucose level (75.32±13.59min) and the glucose supplement magnitude (30.01±3.69ml) of the newborns in the observation group were significantly lower than those (112.65±26.17min and 42.58±6.17ml) of the newborns in the control group. The maternal nursing satisfaction (96.4%) of the women in the observation group was significantly higher than that (85.5%) of the women in the control group (P<0.05). Conclusion: The stratified nursing for the pregnant women with GDM is beneficial for improving the quality of the blood glucose management of their newborns, which can reduce the incidence of the neonatal hypoglycemia, promote the blood glucose recovery of the hypoglycemic newborns, reduce the glucose supplementation for the newborns and improve the maternal satisfaction.
2024 Vol. 32 (5): 1091- [Abstract]（
86
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CAO Yingying, OU Yangping, SHEN Lingqing
To evaluate the effects of of "one to one" whole-course midwifery nursing for pregnant women with gestational diabetes mellitus (GDM) on their delivery quality. Methods: 120 pregnant women with GDM admitted to hospital were selected as the study subjects from June 2020 to November 2022. According to the different nursing methods, these women were randomly divided into study group (60 cases) and control group (60 cases). The women in the control group had received traditional routine midwifery nursing, while the women in the research group had received " one-to-one " whole-course midwifery nursing combined with traditional routine midwifery nursing. The values of the blood glucose control indicators and delivery quality indicators of the women were analyzed and compared between the two groups. The postpartum nursing satisfaction of the women was investigated by questionnaire. Results: There were no significant differences in the levels of glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG) and 2h postprandial plasma glucose (2hPG) of the women at the postpartum first visit between the two groups (P>0.05). The levels of postpartum HbA1c (5.91±1.03%), FPG (5.57±0.91 mmol/L), 2hPG (6.38±1.19 mmol/L) of the women in the study group were significantly lower than those (7.24%±1.45%, 6.19±1.14 mmol/L and 8.17±1.60 mmol/L) of the women in the control group. The total labor time (498.2±52.4min), the postpartum hemorrhage (134.3±20.8ml) and the visual analogue scale score (6.7±0.7 points) of the women in the study group were also significantly lower than those (605.9±78.7min, 169.1±36.0ml and 8.2±1.4 points) of the women in the control group. The natural delivery rate (88.3%) and the nursing satisfaction (91.7%) of the women in the study group were significantly higher than those (66.7% and 76.7%) of the women in the control group, and the incidence of neonatal complications (11.7%) of the women in the study group was significantly lower than that (31.7%) of the women in the control group (all P<0.05). Conclusion: The "one to one" whole-course midwifery nursing for the pregnant women with GDM can effectively control their blood glucose changes, reduce their body pain, and improve their delivery quality and nursing satisfaction.
2024 Vol. 32 (5): 1097- [Abstract]（
65
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AI Yinhui1, LUO Ying2, ZHANG Xinyuan2, OUYANG Yanqiong2
To investigate the status quo of the complementary alternative medicine (CAM) used in pregnant women, and to study the influencing factors of the number of the CAM kinds of the pregnant women used, so as to provide the reference for guiding the rational use of CAM therapy during pregnancy of the women. Methods: The Chinese version of the international complementary and alternative medicine questionnaire was used to collect the data of 551 pregnant women from Wuhan of Hubei province and Liuzhou of Guangxi Zhuang autonomous region. The use of CAM therapy of these women was analyzed. Results: A total of 600 questionnaires were distributed, and of which, 551 valid questionnaires were returned, with the effective rate of 91.8%. Among them, there were 446 (80.8%) pregnant women with the CAM therapy used. The top three providers of CAM therapy were 46.0% nurses, 35.2% western medicine doctors, and 22.1% clinical dietitians. The most popular types of CAM therapy included dietary supplements (85.4%), walking (62.6%) and music therapy (30.5%). Conclusion: The proportion of the pregnant women with CAM therapy used is higher, and their selection is influenced by their sociodemographic characteristics. Therefore, the health care providers should provide the reasonable guidance for the women to ensure their various safe CAM therapies during pregnancy.
2024 Vol. 32 (5): 1101- [Abstract]（
67
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HE Zhen1, HE Yuan2,3, MA Xu2, HUA Linlin3, ZHANG Qing3, JIANG Lifang3, SHI Xuezhong1
Previous studies had primarily confirmed the correlation between the abnormal pre-pregnancy body mass index (BMI) of pregnant women and their adverse pregnancy outcomes, but rare studies had focused on the stratification of the women with pre-pregnancy normal BMI and its impact on the preterm birth of the women. Methods: 418,397 women with pre-pregnancy BMIs of 18.5-23.9kg/m2 were randomly divided into the training cohort (313,799 women) and the validation cohort (104,598 women) at a 3:1 ratio. The levels of the pre-pregnancy blood glucose, liver enzymes and thyroid-stimulating hormones of the women were clustered using K-Means. Logistic regression analysis and sensitivity analysis were used to identify the correlation between the BMI of the women in different subgroups and their preterm birth. Results: Four distinct feature groups were identified in the training cohort, and which showed the consistent presence in the validation cohort, including the elevated liver enzyme group (ELE), the optimal blood glucose supply group (OBGS) and the elevated thyroid-stimulating hormone group (ETSH), and the low metabolic status group (LMS). Compared to that of the LMS group, only the OBGS group was associated with a reduced risk of the premature birth ［aOR (95% CI) of the training cohort=0.88 (0.84-0.92); aOR (95% CI) of the validation cohort=0.87 (0.80-0.95)］. Conclusion: Four replicable new subgroups exist in the women with the normal pre-pregnancy BMI. There is a lower rate of the premature births among the women with normal pre-pregnancy BMI when their pre-pregnancy blood glucose supply is optimal.
2024 Vol. 32 (5): 1107- [Abstract]（
71
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FU Fanghui, XU Yuanfang, LIN Jie
To explore the effect of high intensity focused ultrasound (HIFU) ablation for treating patients with adenomyosis, and to study its influence on the uterine artery blood flow parameters values, sex hormones levels and pain of the patients. Methods: A retrospective analysis was performed on 118 patients with adenomyosis admitted to hospital from June 2022 to June 2023. According to the different treatment methods, these patients were divided into the observation group (60 patients with treatment of HIFU ablation) and the control group (58 patients with treatment of lesion resection). The preoperative and postoperative menstrual blood volume evaluated by pictorial blood loss assessment chart (PBAC), the dysmenorrhea degree evaluated by visual analogue score (VAS), the uterine artery blood flow parameters, such as perfusion index (PI), resistance index (RI) and uterine arterial blood flow volume (BFV), the level of sex hormones, such as follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2), and the situations of the adverse reactions, fertility intention and the adenomyosis recurrence of the patients were compared between the two groups. Results: There were no statistically significant differences in the postoperative menstrual blood volume evaluated by PBAC in 3 and 6 months after surgery, the VAS score of dysmenorrhea degree and the adverse reactions rate (5.0% vs. 3.5%) of the patients between the two groups (P>0.05). The VAS score of surgical pain (3.48±1.12 points) of the patients in the observation group in 1d after surgery was significantly lower than that (4.20±1.32 points) of the patients in the control group (P<0.05). In the 6th month after surgery, the PI and BFV values, and the levels of FSH, LH and E2 of the patients in the two groups were significantly lower than those before operation, and the RI value of the patients in the two groups was significantly higher than that before operation, but all of which of the patients had no significant differences between the two groups. There was 1 patient with adenomyosis recurrence in both groups, and the adenomyosis recurrence rate of the patients had no significant difference between the two groups (all P>0.05). Conclusion: HIFU ablation for treating the patients with adenomyosis has effectiveness, which has the same effect as the surgical treatment, but it can reduce the of postoperative pain degree of the patients.
2024 Vol. 32 (5): 1113- [Abstract]（
79
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SHANG Qinqin, LIU Heli
To explore the application of the transvaginal color Doppler ultrasonography for diagnosing the heterotopic pregnancy (HP) of patients after in vitro fertilizationembryo transfer (IVF-ET), and to study the effect of the laparoscopic surgery for treating HP of the patients. Methods: The clinical data of 80 patients with HP after IVF-ET from March 2020 to December 2022 were analyzed retrospectively. The accuracy rate diagnosed by ultrasound, the clinical manifestations, the ultrasonogram characteristics, the situations of the laparoscopic surgery and the pregnancy outcomes of the patients were analyzed. Results: The HP of 71 patients was diagnosed by transvaginal color Doppler ultrasound, with the diagnostic accuracy rate of 88.8%. There were 4 (5.0%) patients with the delayed diagnosis of HP and 5 (6.3%) patients with the misdiagnosis of HP. There were 67 (83.8%) patients with the ectopic pregnancy in the uterine adnexa and 13 (16.3%) patients with the ectopic pregnancy in the uterine horn/stroma. There were 65 (81.2%) patients with pelvic effusion. The ultrasound signs showed that there were 32 (40.0%) patients with the adnexal or cornual mass, 4 (42.5%) patients with the gestational sac or gestational germ and 14 (17.5%) patients with the fetal heart and the fetal heart tube pulsation. All the patients had undergone laparoscopic surgery, of which, there were 9 (11.3%) patients with severe complications and 6 (7.5%) patients with the converted to open surgery. After surgery, there were 50 (62.5%) patients with spontaneous delivery, 21 (26.3%) patients with cesarean section and 9 (11.3%) patients with spontaneous abortion. Conclusion：Transvaginal color Doppler ultrasonography is the main measure for diagnosing HP of the patients after IVF-ET, and the diagnostic coincidence rate of which is nearly 90%, which has certain guiding significance for treating the patients with HP in the clinical practice.
2024 Vol. 32 (5): 1117- [Abstract]（
79
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LIU Changzhi, CHENG Moran, WANG Shouyu, CHEN Shuqing, ZHAO Xinjia
To explore the value of magnetic resonance diffusion-weighted imaging (DWI) combined with vaginal color Doppler ultrasound (TVCDS) for evaluating the lymph node metastasis of patients with endometrial cancer (EC). Methods: The clinical data of 105 patients with EC (in study group) who had been diagnosis and treatment in hospital from January 2018 to August 2023 were selected in this study, and these patients were divided into group A (54 cases with lymph node metastasis) and group B (51 cases without lymph node metastasis) based on whether their lymph node metastasis occurred or not. In addition, 105 patients who came to hospital for examination due to benign endometrial lesions were selected in control group. The quantitative parameters of DWI and TVCDS of the patients were compared among these groups. Logistic regression was applied to analyze the influencing factors of the lymph node metastasis of the patients with EC. ROC curve was applied to analyze the diagnostic value of the parameters of DWI and TVCDS of the patients with EC for their lymph node metastasis. Results: The values of ADC-stand (1.12±0.28×10-3mm2/s), the ADC-slow (0.64±0.16 ×10-3mm2/s), the ADC-fast (72.51±8.59 ×10-3mm2/s), the PI (0.52±0.12) and the RI (0.36±0.08) of the patients in the study group were significantly lower than those (1.63±0.34×10-3mm2/s, 1.02±0.25×10-3mm2/s, 83.62±8.73×103mm2/s, 0.84±0.22 and 0.59±0.14) of the patients in the control group, and which of the patients in group A were significantly lower than those of the patients in group B. The increase of the values of ADC-stand, ADC-slow, ADC-fast, PI and RI of the patients with EC were the independent protective factors for their lymph node metastasis (all P<0.05). The area under the curve (AUC) of the values of ADC-stand, ADC-slow, ADC-fast, PI and RI of the patients with EC for evaluating their lymph node metastasis were 0.735, 0.846, 0.836, 0.852 and 0.831, respectively. The AUC of the combined values of ADC-stand, ADC-slow, ADC-fast, PI and RI of the patients with EC for diagnosing their lymph node metastasis s of each index was 0.931, which was significantly superior to that of the ADC-stand value, the ADC-slow value, the ADC-fast value, the PI value or the RI value alone (P<0.05). Conclusion: The quantitative parameters of DWI and TVCDS of the patients with EC and lymph node metastasis decrease obviously, and the combination of the parameters of DWI and TVCDS values of the patients with EC for evaluating their lymph node metastasis has higher clinical value.
2024 Vol. 32 (5): 1121- [Abstract]（
79
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Lin Yanmin, Sheng Junxia
To explore the correlation between the levels of high mobility group A2 (HMGA2) and signal transducer and activator of transcription 3 (STAT3) protein of patients with uterine fibroids and their postoperative recurrence of uterine fibroids, and to study the values of the levels of HMGA2 and STAT3 of the patients for evaluating their postoperative recurrence of uterine fibroids. Methods: 168 patients with uterine fibroids who had undergone laparoscopic myomectomy in hospital from May 2019 to December 2020 and were followed up for 3 years after surgery were selected in this study. These patients were divided into group A (48 patients with the postoperative recurrence of uterine fibroids) and group B (120 patients without the postoperative recurrence of uterine fibroids). The general information of the patients was collected. ELISA method was applied to detect the levels of serum progesterone (P), luteinizing hormone (LH), estradiol (E2), follicle stimulating hormone (FSH), and prolactin (PRL) of the patients. Western blot was applied to quantitatively analyze the levels of HMGA2 and STAT3 in the excised uterine fibroids tissues. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic values of the HMGA2 and STAT3 levels of the patients for their postoperative recurrence of uterine fibroids. Multivariate logistic regression was applied to analyze the influencing factors of the postoperative uterine fibroids recurrence of the patients. Results: The levels of serum P, LH, E2, FSH and PRL of the patients in group A were significantly higher than those of the patients in group B. The levels of HMGA2 (1.42±0.28) and STAT3 (1.33±0.24) in the excised uterine fibroids tissues of the patients in group A were significantly higher than those (1.03±0.21, 1.02±0.18) of the patients in group B (all P<0.05). ROC curve analysis showed that the area under the curve (0.934) of the combined levels of HMGA2 STAT3 of the patients for predicting their postoperative uterine fibroids recurrence was significantly higher than that (0.885) of the HMGA2 level and that (0.858) of the STAT3 level (all P<0.05). Multivariate analysis showed that the increase of the preoperative levels of serum P, FSH and PRL, and the postoperative levels of HMGA2 and STAT3 in the excised uterine fibroids tissues of the patients were the influencing factors of their postoperative recurrence of uterine fibroids (all P<0.05). Conclusion: The upregulation of the HMGA2 and STAT3 levels in the excised uterine fibroids tissues of the patients is related to their postoperative recurrence of uterine fibroids. The combined detections of HMGA2 and STAT3 levels of the patients can assist to evaluating the prognosis of the patients in clinic.
2024 Vol. 32 (5): 1126- [Abstract]（
87
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WANG Hua, YIN Meiqin, CHEN Ailian
To study the differential diagnostic value of the ultrasound combined with the values of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), and the level of carbohydrate antigen 125 (CA125) of patients for their endometrial cancer. Methods: 92 patients with endometrial cancer admitted to hospital from January 2020 to October 2022 were selected in study group, and 82 patients with benign endometrial lesions were selected in control group during the same period. The values of blood flow pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV) of the patients in the two groups were detected by ultrasound. The NLR and PLR values and the serum level of CA125 of the patients in the two groups were detected. Receiver operating characteristic (ROC) curve was used to analyze the values of above indexes of the patients for differential diagnosing their endometrial cancer. Results: The PSV value of the ultrasound blood flow parameters of the patients in the study group was significantly higher than that of the patients in the control group, but the values of PI and RI of the patients in the study group were significantly lower than those of the patients in the control group. The values of PSV of the ultrasound blood flow parameters of the patients with stage III-IV of endometrial cancer in the study group were significantly higher than that of the patients with stage I-II of endometrial cancer, and the PI and RI values of the patients with stage III-IV of endometrial cancer were significantly lower than those of the patients with stage I-II of endometrial cancer. The levels of serum CA125, NLR and PLR of the patients in the study group were significantly higher than those of the patients in the control group, and which of the patients with stage III-IV of endometrial cancer in the study group were significantly higher than that of the patients with stage I-II of endometrial cancer (all P<0.05). ROC curve analysis showed that the area under the curve of the ultrasound blood flow parameters values, the CA125 level, the NLR level, the PLR level and the combined ultrasound blood flow parameters values and the levels of the CA125, NLR and PLR of the patients for differential diagnosing their endometrial cancer were 0.813, 0.892, 0.717, 0.632, and 0.952, respectively, and the combined ultrasound blood flow parameters values and the levels of the CA125, NLR and PLR of the patients for diagnosing their endometrial cancer had the best diagnostic efficiency, with a sensitivity of 98.2%. Conclusion: The ultrasound blood flow parameters values, and the CA125 level, the NLR level and the PLR level of the patients with endometrial cancer are abnormal. The combined ultrasound blood flow parameters values and the levels of the CA125, NLR and PLR of the patients for diagnosing their endometrial cancer has higher differential diagnostic efficiency, which has better clinical guiding value.
2024 Vol. 32 (5): 1131- [Abstract]（
75
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YIN Duo1,2, SHENG Wenwei1, LIU Yuefang2, JIN Xin2
To analyze the clinical effect of ultrasound combined with chromosomal examination for diagnosing the fetal cardiac malformations. Methods: 339 pregnant women with high-risk factors who diagnosed in hospital between January 2020 and May 2023 were taken as the study subjects, and the fetal cardiac development of these women were analyzed by the cardiac ultrasound and chromosome examination. The fetal cardiac abnormality was diagnosed by the abnormal result of the cardiac ultrasound or the chromosomal examination. The pregnant women and their fetuses were followed up and their prognosis was recorded. The results of the fetuses with defects by autopsy and by postnatal findings were used as the gold standard for diagnosing the fetal cardiac malformations in this study. Results: 339 high-risk pregnant women were examined by the fetal cardiac ultrasound, and there were 111 (32.7%) cases with fetal cardiac abnormalities. The top three fetal cardiac abnormalities were ventricular septal defect (9.7%), persistent left superior vena cava (7.1%) and aberrant right subclavian artery (5.3%). The number and structure of fetal chromosomes in 339 women were examined by amniocentesis and 36 (10.6%) fetuses with abnormal chromosome number or structure, including 32 (9.4%) cases with abnormal number and 4 (1.2%) cases with abnormal structure. The most common chromosome abnormalities were trisomy 21, trisomy 13 and trisomy 18. Among 111 cases with fetal cardiac malformation diagnosed by ultrasound, 28 fetuses had abnormal chromosome. Among 228 fetuses with normal cardiac development by ultrasound, 8 fetuses had chromosomal abnormalities (P<0.05). Based on those of the gold standard, the sensitivity and the specificity of the ultrasound for diagnosing the fetal cardiac abnormalities were 77.8% and 72.6%, and which of the chromosome examination were 25.2% and 96.5%. The sensitivity and the specificity of the combined detections of the ultrasound and the chromosome examination for diagnosing the fetal cardiac abnormalities were 93.1% and 97.3%. The combined detections of the ultrasound and the chromosome examination for the fetal cardiac abnormalities had higher diagnostic value. Conclusion: The combined detections of the ultrasound and the chromosome examination for diagnosing the fetal cardiac abnormalities has higher sensitivity and specificity, which has higher clinical application value.
2024 Vol. 32 (5): 1135- [Abstract]（
62
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ZHOU Jiaji1, ZHANG Cai2, ZHU Ling1, Li Hongyan1
To explore the influencing factors of the excessive intraoperative bleeding during laparoscopic hysteromyomectomy of patients with uterine fibroids. Methods: The clinical data of 80 patients with uterine fibroids who had received laparoscopic hysteromyomectomy from December 2020 to December 2023 were selected in this study. The difference of the intraoperative blooding amount of the patients with different size, location and number of the uterine fibroids was analyzed. The correlation between the operative time of the patients and their intraoperative blooding amount was analyzed. Logistic regression analysis was used to analyze the risk factors affecting the amount of intraoperative blood loss of the patients during laparoscopic hysteromyomectomy. Results: The amount of intraoperative blooding (84.16±19.33 ml) of the patients with uterine fibroids ≥5cm was significantly higher than that (50.79±23.97 ml) of the patients with uterine fibroids <5cm. The amount of the intraoperative blooding (82.63±23.61 ml) of the patients with uterine fibroids located in the wall of the uterine muscle was significantly higher than that (50.95±18.16 ml) of the patients with subserosal uterine fibroids. The amount of the intraoperative blooding (81.46±20.46 ml) of the patients with multiple uterine fibroids was significantly higher than that (55.02±22.46 ml) of the patients with single uterine fibroids. The amount of the intraoperative blooding (80.99±18.91 ml) of the patients with the operation time >62.85 min was significantly higher than that (59.72±23.47 ml) of the patients with operation time ≤62.85 min (all P<0.05). Pearson correlation analysis showed that there was a positive correlation between the operation time of the patients and their intraoperative blood loss (P<0.05). Logistic regression analysis showed that the uterine fibroids ≥5cm, the uterine fibroids located in the wall of the uterine muscle, the multiple number of uterine fibroids and the operation time of myomectomy > 62.85 min of the patients were the risk factors of their increased blood loss during laparoscopic myomectomy (P<0.05). There were 5 patients with the blood transfusion during the operation, including 3 cases with the anemia before operation and 2 cases with large uterine fibroids. There was no any patient with related complications occurred after operation. Conclusion: For the patients undergoing hysteromyectomy, the larger uterine fibroids, the uterine fibroids located in the wall of the uterine muscle, the multiple uterine fibroids and the longer operation time of the patients are the risk factors of their increased intraoperative blood loss, which need to be prevented and treated in clinic, and the blood transfusion is needed if necessary, so as to avoid the postoperative complications.
2024 Vol. 32 (5): 1140- [Abstract]（
86
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MA Qian1, LI Xiaoqing2, GU Lili1
To explore the situations of the neonatal intrauterine infection of pregnant women with different types of hepatitis B virus (HBV) infection and with different HBV-DNA load, and to study the correlation between the women with different types of HBV infections and their cytokine levels. Methods: A total of 100 pregnant women with HBV surface antigen (HBsAg) positive and their newborns who delivered at term after prenatal examination in hospital from January 2020 to October 2023 were selected in this study. The incidence of the neonatal intrauterine infection was calculated. The HBV viral load of the women was detected. The incidence of the neonatal intrauterine infection was compared among the women with different types of HBV infection and among the women with different HBV-DNA load. The differences of the interleukin-6 (IL-6) and interferon γ (IFN-γ) levels were compared among the women with different HBV-DNA load. Spearman correlation coefficient was used to analyze the correlation between the HBV load of the pregnant women and their IL-6 and IFN-γlevels. Results: Among 100 pregnant women, there were 36 (36.0%) cases with the positive HBsAg, HBeAg and HBcAb (in group A) and 64 (64.0%) cases with the positive HBsAg, HBeAb and HBcAb (in group B). The incidence of the neonatal intrauterine infection (22.2%) of the women in group A was significantly higher than that (3.1%) of the women in group B (P<0.05). There were 6 women with the negative HBV, 62 women with 103-105 HBV load of and 32 women with ＞105 HBV load. The incidence of the neonatal intrauterine infection (4.8%) and the level of IL-6 (8.11±0.89 pg/ml) of the women with 103-105 HBV load were Significantly lower than those (21.9% and 11.26±1.56 pg/ml) of the women with ＞105 HBV load. The IL-6 level of the women was positively correlated with their HBV load. The level of IFN-γ (68.47±7.10 pg/L) of the women with 103-105 HBV load of was significantly higher than that (51.22±5.65 pg/L) of the women with ＞105 HBV load, and which of the women was negatively correlated with their HBV load (all P<0.05). Conclusion: The risk of the neonatal intrauterine infection of the pregnant women with HBV infection increases. The type of the HBV infection of the pregnant women is mainly the positive HBsAg, HBeAb and HBcAb. The risk of the neonatal intrauterine infection of the pregnant women with the positive HBsAg, HBeAg and HBcAb or the women with high HBV load increases is high. The high HBV load of the pregnant women will increase their neonatal intrauterine infection rate, and which may be related to the regulation of Th1/Th2 immune imbalance of the women.
2024 Vol. 32 (5): 1144- [Abstract]（
74
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LIN Lili1, ZHAO Zhouying2
To explore the correlation between the clinical grade of cervical squamous intraepithelial lesions (SIL) of patients with human papillomavirus (HPV) infection and their typing of HPV infected. Methods: The clinical data of 300 patients with SIL by HPV-infected who had treated in hospital from April 2021 to April 2023 were included in this study, including 100 cases with the high-grade SIL (HSIL) in group A and 200 cases with the low-grade SIL (LSIL) in group B. The general data and the genotype of HPV-infected of the patients were compared between the two groups. Multivariate logistic regression analysis was performed to analyze the risk factors affecting the clinical grade of SIL of the patients with HPV infection. The distribution of HPV genotypes of the patients in the two groups was analyzed. Results: The proportions of the age >40 years old and the number of sexual partners ≥2 people, and the infection rate of the high-risk HPV of the patients in group A were significantly higher than those of the patients in group B (P<0.05). The top two HPV infection rates of the patients in group A were HPV35 (20.0%) and HPV52 (17.0%), and the top two HPV infection rates of the patients in group B were HPV39 (19.5%) and HPV33 (12.5%). The age >40 years old, the number of sexual partners ≥2 people and the high-risk HPV infection of the patients were the independent risk factors of their clinical grade of SIL (P<0.05). Conclusion: The advanced age, the more number of sexual partners and the high-risk HPV infection of the patients are all the influencing factors of their clinical grade of SIL, and the infection rates of HPV35, HPV52, HPV39, HPV33 and other subtypes of HPV of the patients with SIL are high, so which should be paid high attention in clinic.
2024 Vol. 32 (5): 1148- [Abstract]（
83
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YANG Min, LI Hongmei, ZHANG Lei, HE Liu, DENG Qiang, JIANG Haiyan
To investigate the level of hepatitis B virus (HBV) -DNA and the HB e antigen (HBeAg) positivity situation of pregnant women with high HBV load, and to analyze the effect of the antiviral treatment combined with standard blocking measures for preventing mother-to-child transmission of HBV during pregnancy. Methods: The clinical data of 120 pregnant women with high HBV load who gave birth in the hospital from January 2021 to January 2023 were collected retrospectively. The HBV-DNA level and the HBeAg positive rate of the women during pregnancy and before delivery were analyzed. Multivariate logistic regression analysis was conducted to identify the factors influencing of the positive HBeAg situation of the women. The efficacy and safety of the antiviral therapy for preventing mother-to-child transmission of HBV of the women during pregnancy were analyzed. Results: Among 120 pregnant women with the high HBV load, there were 93 cases had received antiviral therapy during pregnancy (in study group), including 56.6% women treated by tenofovir and 20.8% women treated by lamivudine, and there were 27 cases hadn’t received the antiviral therapy during pregnancy (in control group). There were no significant differences in the HBV-DNA load and the HBeAg positive rate of the women between the two groups (P>0.05). The proportion (7.5%) of the women with HBV-DNA load ≥106 IU/ml before delivery in the study group was significantly lower than that (92.6%) of the women in the control group (P<0.05), while there was no significant difference in the rate of positive HBeAg (90.3% vs. 92.6%) of the women between the two groups (P>0.05). Multivariate logistic analysis showed that the less age and the high HBV-DNA load of the women were the independent risk factors for their positive HBeAg status (P<0.05). The rate of preventing mother-to-child transmission of HBV (100.0%) of the women in the study group was significantly higher than that (92.6%) of the women in the control group (P<0.05). There were no significant differences in the neonatal weight, and the rates of preterm birth, cesarean section, pregnancy complications and complications during labor of the women between the two groups (P>0.05). Conclusion: The pregnant women with high HBV load have higher HBV-DNA level. The HBeAg positive rate of the women is related to their less age and high HBV-DNA load. The antiviral treatment during pregnancy for the women with HBV infection can decrease the level of HBV-DNA load of the women before delivery, and the antiviral treatment during pregnancy combined with standard blocking measures for treating the pregnant women with HBV infection can improve the blocking rate of mother-to-child transmission of HBV, and with good safety.
2024 Vol. 32 (5): 1153- [Abstract]（
70
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SHI Qinbo1, YUAN Fangling2
To investigate the application value of thin layer liquid cytology test (TCT) combined with human papillomavirus (HPV) detection for screening the cervical cancer, and to study the correlation between the cervical cancer of women and their vaginal infection. Methods: The clinical data of 483 women who underwent cervical lesion screening from July 2022 to July2023 were collected in this study, and these women were given TCT and HPV detection. According to the pathological diagnosis results, the women were divided into 467 women without cervical cancer in control group and 16 women with cervical cancer in observation group. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of TCT and HPV detection for screening the cervical cancer. The incidence of vaginal infection and the vaginal microecology of the women were compared between the two groups. Results: Based on the pathological results, the accuracy of TCT, HPV and the combined detection of TCT and HPV of the patients for diagnosing their cervical cancer were 92.3%, 92.6% and 98.1%, respectively. ROC analysis showed that the area under the curve of the combined TCT and HPV detection for diagnosing the cervical cancer was 0.953, which was significantly higher than that (0.777) of TCT and that (0.808) of HPV detection. The specificity and the sensitivity of the combined TCT and HPV detection for diagnosing the cervical cancer were 96.8% and 93.8%, and which were significantly higher (P<0.05). The vaginal infection rate (93.8%), and the positive rates of hydrogen peroxide (56.3%) and lactobacillus (50.0%) of the women in the observation group were significantly higher than those (29.1%, 31.1% and 21.0%) of the women in the control group. The positive rates of sialidase (6.3%) and leukocyte esterase (43.8%) of the women in the observation group were significantly lower than those (28.9% and 75.4%) of the women in the control group (all P<0.05). Conclusion: The combined TCT and HPV detection for screening the cervical cancer has higher application value. The vaginal infection rate of the women with cervical cancer increases, and the vaginal microecology of the women with cervical cancer has changed, which needs more clinical attention.
2024 Vol. 32 (5): 1158- [Abstract]（
65
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WANG Xiaoyu, ZHANG Ruimin
To analyze the infection status of human papillomavirus (HPV) of patients with cervical cancer, and to study the genotype distribution of HPV. Methods: The clinical data of 351 patients with cervical cancer who visited hospital from January 2021 to December 2023 were selected in this study. The HPV infection status and the genotype distribution of HPV of the patients were analyzed. Logistic regression analysis was applied to screen the independent risk factors of HPV infection of the patients with cervical cancer. Results: Among 351 patients with cervical cancer, there were 336 (95.7%) cases with HPV infection. There were significant differences in the number of sexual partners and the history of cervicitis between the patients with and without HPV infection (P<0.05). Logistic regression analysis showed that the number of sexual partners ≥2 people and the history of cervicitis of the patients with cervical cancer were the independent risk factors of their HPV infection. Among 336 patients with HPV infection, there 239 (71.1%) cases with the single HPV infection and 97 cases (28.9%) cases with the mixed infection of HPV, including 71 (21.1%) cases with double HPV infection and 26 (7.7%) cases with multiple HPV infection. There was significant difference in the single HPV infection rate among the patients with different pathological types of the cervical cancer, among the patients with different clinical stages of the cervical cancer, among the patients with different differentiation degrees of the cervical cancer cell and among the patients with different lymph node metastasis situations. There was significant difference in the mixed HPV infection rate among the patients with different clinical stages of the cervical cancer, among the patients with different differentiation degrees of the cervical cancer cell and among the patients with different lymph node metastasis situations. There was significant difference in the total HPV infection rate among the patients with different pathological types of the cervical cancer and among the patients with different clinical stages of the cervical cancer (all P<0.05). Among 239 cervical cancer patients with single HPV infection, there were 233 (97.5%) cases with high-risk HPV subtypes infection, and the top three infection rates of the HPV subtypes were HPV16 (45.8%), HPV18 (6.8%) and HPV58 (4.8%). Conclusion: This study shows that the patients with cervical cancer have the higher HPV infection rate. The number of sexual partners ≥2 people and the history of cervicitis of the patients with cervical cancer can increase their HPV infection risk. The HPV infection of the patients with cervical cancer is mainly the single HPV infection, the top three genotypes of HPV subtypes infection are HPV 16, HPV 18, and HPV 58.
2024 Vol. 32 (5): 1162- [Abstract]（
69
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YANG Lujia, LIU Xuan, LI Huijun, LI Yang, ZHANG Cuizhen, XUE Shuyuan
To explore the value of TORCH combined with the serum human chorionic gonadotropin (β-hCG), alpha-fetoprotein (AFP) and free estriol (uE3) levels of pregnant women with abnormal ultrasound soft index for diagnosing their fetus situation. Methods: A total of 324 pregnant women with abnormal fetal ultrasound soft indexes, including 300 with single abnormal ultrasound soft indexes and 24 with multiple abnormal ultrasound soft indexes, who underwent prenatal examination in hospital from July 2021 to December 2023 were selected in study group, and in addition, 300 healthy women who underwent prenatal examination in hospital during the same period were selected in control group. TORCH serological test and the detections of the levels of serum AFP, free-βhCG and uE3 were all performed in the pregnant women in the two groups. The results of TORCH and the serum β-hCG, AFP and uE3 levels of the women were compared between the two groups. The results of TORCH, and the serum β-hCG, AFP and uE3 levels were compared between among the women with different abnormal ultrasound soft indexes. Receiver operator characteristic (ROC) curve analysis was used to analyze the value of TORCH combined with the serum β-hCG, AFP and uE3 levels of the women with abnormal ultrasound soft indicators for diagnosing the fetus situation. Results: The positive rate of serum TORCH detection, and the β-hCG, AFP and uE3 levels of the women in the study group were significantly higher than those of the women in the control group, and the serum uE3 level of the women in the study group was significantly lower (all P<0.05). The positive rate of serum TORCH detection, and the β-hCG, AFP and uE3 levels of the women with multiple abnormal ultrasound soft indexes were significantly higher than those of the women with single abnormal ultrasound soft index, the serum uE3 level of the women multiple abnormal soft indexes was significantly lower (all P<0.05). ROC curve results showed that the area under the curve (AUC) of the combined detections of serum TORCH, β-hCG, AFP and uE3 of the women with abnormal ultrasound soft index for diagnosing their fetus situation was 0.927, which was significantly higher than that of the serum TORCH detection, the β-hCG level, the AFP level or the uE3 level alone. The sensitivity and the specificity of the combined detections of serum TORCH, and the β-hCG, AFP and uE3 levels of the pregnant women with abnormal ultrasound soft index for diagnosing their fetus situation were 90.00% and 92.59%, and which were higher. Conclusion: The serum TORCH detection combined with theβ-hCG, AFP and uE3 levels of the pregnant women with abnormal ultrasound soft index can help to improve the prenatal diagnosis rate of their fetuses abnormity, and which can provide an accurate and effective diagnositic method in clinic.
2024 Vol. 32 (5): 1167- [Abstract]（
64
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LIU Xubin, SUN Xue, ZHAO Yi, WANG Ying
To analyze the risk predictors of gestational diabetes mellitus (GDM) of women with polycystic ovary syndrome (PCOS) after pregnancy, and to study the pregnancy outcomes of the women. Methods: The clinical data of 104 women with PCOS who had been pregnancy and had delivered successfully after standardized treatment in hospital from June 2020 to June 2023 were selected in this study retrospectively. These women were divided into group A (31 women with GDM) and group B (73 women without GDM) according to whether the GDM occurrence or not of the women. The clinical data of the women were compared between the two groups. Multivariate logistic regression analysis was conducted to identify the influencing factors of the GDM of the pregnant women with PCOS. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the different factors of the women for their PCOS complicated with GDM. The pregnancy outcomes and the neonatal outcomes of the women were compared between the two groups. Results: The prepregnancy body mass index (BMI), the weight gain during pregnancy, the value of homeostasis model assessment of insulin resistance (HOMA-IR) and the level of fasting insulin (FINS) of the women in group A were 25.48±2.06kg/m2, 28.79±1.55kg, 4.28±0.63 and 19.66±3.45μU/ml, respectively, and which were significantly higher than those (23.30±1.98kg/m2, 6.73±1.14kg, 2.01±0.44 and 14.49±2.16μU/ml) of the women in group B (all P<0.05). Multivariate logistic regression analysis showed that the higher pre-pregnancy BMI, the more weight gain during pregnancy, the higher HOMA-IR value and FINS level of the women with PCOS were the independent risk factors of their GDM occurrence (P<0.05). ROC curve analysis showed that the area under the curve and the sensitivity of the combined pre-pregnancy BMI, the gestational weight gain, the HOMA-IR value and the FINS level of the pregnant women with PCOS for predicting their GDM were 0.893 and 93.6%, and the predictive efficiency of which were significantly higher than those of the pre-pregnancy BMI, the gestational weight gain, the HOMA-IR value or the FINS level alone (P<0.05). The incidences of gestational hypertension, preeclampsia, premature rupture of membranes and postpartum hemorrhage of the women in group A were 32.3%, 25.8%, 59.0% and 22.6%, respectively, and which were significantly higher than those (13.7%, 9.6%, 12.3% and 8.2%) of the women in group B. The incidence of neonatal hypoglycemia (22.6%) in group A was significantly higher than that (8.2%) in group B (all P<0.05). Conclusion: The high pre-pregnancy BMI, the more gestational weight gain, the elevated HOMA-IR value and FINS level of the pregnant women with PCOS all can cause their GDM occurrence. The pregnant women with PCOS and GDM can increase the incidence of their adverse pregnancy outcomes.
2024 Vol. 32 (5): 1170- [Abstract]（
86
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LIU Lingli, XIANG Xiaohong, HE Jingjing
To analyze the correlation of the psychological stress of pregnant women with gestational diabetes mellitus (GDM) and their coping style and self-care ability. Methods: 80 pregnant women with GDM were enrolled in this study From September 2022 to October 2023. The pregnancy stress rating scale, the simplified coping style questionnaire (SCSQ), and the self-care scale were used for investigation. The women were divided into group A (women with psychological stress) and group B (women without psychological stress) according to the score of the pregnancy stress rating scale. The basic information, the SCSQ score, and the self-care ability score of the women were compared between the two groups. Pearson correlation analysis was conducted to discuss the correlation of the psychological stress of the women with GDM and their coping style and self-care ability. Results: The psychological stress score of 80 women with GDM was 46.78±9.14 points, including 38 (47.5%) cases in group A and 42 (52.5%) cases in group B. The positive coping score (24.67±4.35 points) of the women in group A was significantly lower than that (29.12±5.03 points) of the women in group B, and the negative coping score (18.06±3.28 points) of the women in group A was significantly higher than that (14.17±2.65 points) of the women in group B. The scores of diet control, weight management, exercise management, drug management, regular review and blood glucose level monitoring of the women in group A were significantly lower than those of the women in group B (all P<0.05). The correlation analysis showed that the psychological stress score of the women with GDM was negatively correlated with their positive coping score and their total score of self-care ability, and was positively correlated with their negative coping score (all P<0.05). Conclusion: The results of this study show that the psychological stress of the pregnant women with GDM is at medium level, and the psychological pressure of the women is correlated with their coping style and self-care ability, which suggests that the positive coping and self-care ability of the women should be improved by reducing their psychological pressure in clinic.
2024 Vol. 32 (5): 1176- [Abstract]（
104
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LIU Rui, WANG Yaling, ZHAO Xiaojuan, ZHAO Hong
To analyze the correlation between the levels of interleukin-17 (IL-17) and nuclear transcription factor-κ(NF-κB) in peripheral blood of pregnant women with gestational condyloma acuminatum during pregnancy and their pregnancy outcomes. Methods: A total of 137 patients with gestational condyloma acuminatum admitted to hospital from September 2014 to September 2023 were included in observation group retrospectively. According to the matching principle of gender and age by 1:1 ratio, 137 healthy pregnant women who received routine pregnancy examination in the hospital during the same period were selected in control group. The pregnancy outcomes, and the IL-17 and NF-κB levels in peripheral blood of the women in the two groups were counted. The women in the observation group were divided into group A (the women with normal pregnancy outcomes) and group B (the women with adverse pregnancy outcomes) according to the pregnancy outcomes of the women. The clinical data and the IL-17, NF-κB levels in peripheral blood of the women were compared between group A and group B. The correlation between the IL-17 and NF-κB levels in peripheral blood of the women with gestational condyloma acuminatum and their pregnancy outcomes was analyzed by logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the value of the IL-17 and NF-κB levels in peripheral blood of the women with gestational condyloma acuminatum for evaluating their pregnancy outcomes. Results: There was no any woman with postpartum hemorrhage in these groups. The cesarean section rate (37.2%) and the total incidence of adverse pregnancy outcomes (13.9%) of the women in the observation group were significantly higher than those (1.5% and 0) of the women in the control group. The levels of IL-17 (91.27±28.33 pg/ml) and NFκB (8.66±4.05 ng/ml) in peripheral blood of the women in the observation group were significantly higher than those (15.31±4.04 pg/ml and 4.22±1.63 ng/ml) of the women in the control group. Among 137 women in the observation group, there were 19 cases in group B and 118 cases in group A, and there were no significant differences in the age, the gestational weeks, the previous pregnancy history, the number and area of condyloma acuminatum, and HPV typing of the women between group A and group B (P>0.05). The levels of IL-17 (121.20±16.90 pg/ml) and NF-κB (14.87±4.60 ng/ml) of the women in group B were significantly higher than those (86.45±30.17 pg/ml and 7.66±3.96 ng/ml) of the women in group A (all P<0.05). Logistic regression analysis showed that the levels of IL-17 and NF-κB in peripheral blood of the women with condyloma acuminatum were the risk factors of their adverse pregnancy outcomes (P<0.05). ROC curve showed that the area under the curve of the NF-κB level (0.949) of the women with condyloma acuminatum for evaluating their pregnancy outcomes was significantly higher than that (0.884) of the IL-17 level. The specificity of the combined levels of IL-17 and NF-κB of the women with condyloma acuminatum for evaluating their pregnancy outcomes was 97.5%. Conclusion: The levels of IL-17 and NF-κB in peripheral blood of the women with gestational condyloma acuminatum are abnormally elevated, and these women have the higher risk of adverse pregnancy outcomes, and the levels of IL-17 and NF-κB in peripheral blood of the women are related to their pregnancy outcomes. The combined levels of IL-17 and NF-κB of the women with condyloma acuminatum for evaluating their pregnancy outcomes has the advantages of high sensitivity, and which is worthy of clinical attention.
2024 Vol. 32 (5): 1180- [Abstract]（
74
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SHI Yingying, XIA Qiyun, ZU Cuihua
To explore the related factors of pelvic floor dysfunction after transabdominal total hysterectomy, and to provide reference for the countermeasures. Methods: The clinical data of 84 patients who had undergone total hysterectomy in hospital from January 2020 to November 2022 were collected retrospectively. These patients were divided into group A (32 case with pelvic floor dysfunction (PDF)) and group B (52 case without PDF) according to whether the patients with PDF complicated or not in 1 year after operation. The relevant clinical data of the patients in the two groups were collected. Univariate analysis was used to explore the possible influencing factors of the PDF occurrence of the patients after total hysterectomy, and then the independent influencing factors of the PDF occurrence of the patients were identified by multivariate logistic regression analysis. Results: In group A, there were 6 cases with simple pelvic organ prolapse, 4 cases with simple stress urinary incontinence, 3 cases with simple sexual dysfunction and 1 case with simple fecal incontinence, and there were 18 cases with more than two kinds of PDF. There were significant differences in the age, the body mass index, the menopause situation, the gravidity, the parity, the intraoperative blood loss, the time of postoperative indwelling catheter, and the early weight bearing situation of the patients between the two groups (P<0.05). Multivariate analysis showed that the menopause and the intraoperative blood loss of the patients were not the independent influencing factors of their PDF occurrence after transabdominal total hysterectomy (P>0.05). The advanced age (OR=1.270, 95%CI 1.036-1.558), the higher body mass index (OR=2.672, 95%CI 1.376-5.190), the more gravidity (OR=8.947, 95%CI 2.566-31.193), the more parity (OR=12.302, 95%CI 3.039-49.802), the longer time of postoperative indwelling catheter (OR=1.561, 95%CI 1.120-2.177) and the early weight bearing (OR=3.713, 95%CI 1.628-8.470) of the patients with transabdominal total hysterectomy were the independent risk factors of their PDF occurrence (all P<0.05). Conclusion: The PDF occurrence of the patients after transabdominal total hysterectomy is related to their age, body mass index, gravidity, parity, time of postoperative indwelling catheter and early weight-bearing. It is suggested that the high-risk patients with PDF should be identified based on the above factors, so as to enhance the perioperative management of the patients.
2024 Vol. 32 (5): 1185- [Abstract]（
60
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SUN Shuli1, YUE Jiayi2, WANG Xiaoli3, XIAO Xinyan1
To explore the incidence of the postpartum infection of puerperas after cesarean section, and to study the influencing factors of the postpartum infection. Methods: The clinical data of 987 puerperas who had undergone cesarean section from three hospitals of Liaocheng were selected in this study from January 2021 to January 2023. The incidence of the postpartum infections of the puerperas within 5 days of follow up after cesarean section was counted. Univariate and multivariate logistic regression were applied to analyze the factors affecting the postpartum infections of the puerperas after cesarean section. A nomogram model was constructed based on these influence factors, and receiver operating characteristic (ROC) curve was drawn to evaluate the discriminability of this model, and the calibration curve was drawn to evaluate the consistency of the model. Results: Among 987 puerperas with caesarean section, 72 puerperas had postoperative infections, with an infection rate of 7.3%, including 41 (56.9%) cases with incision infection, 20 (27.8%) cases with endometritis and 11 (15.3%) cases with other infections. There was significant difference in the proportion of the postpartum infections after cesarean section among the puerperas with different ages, among the puerperas with different number of cesarean sections, among the puerperas with different albumin levels, between the puerperas with and without GDM, between the puerperas with and without premature rupture of membranes, and between the puerperas with and without transferred to cesarean section because of the abnormal second stage of labor (P<0.05). Multivariate logistic regression analysis showed that the age ≥30 years old, the number of cesarean section ≥3 times, the GDM, the premature rupture of membranes, the albumin level <35g/L and the transferred to cesarean section because of the abnormal second stage of labor of the puerperas with cesarean section were the risk factors of their postpartum infection (P<0.05). The area under the ROC curve of the nomogram model for predicting the postpartum infection of the puerperas with cesarean section was 0.820, with better discrimination, and the H-L goodness of fit test was 8.013 (P=0.621), and which indicated the good consistency. Conclusion: The advanced age, the multiple cesarean sections, the low albumin level, the GDM, the premature rupture of membranes, and the transferred to cesarean section because of the abnormal second stage of labor of the puerperas are the risk factors of their postpartum infection after cesarean section. The nomogram model constructed based on these factors has good discrimination and consistency, which can predict the risk of the postpartum infections of the puerperas after cesarean section betterly and can guide the intervention in clinic, so as to reduce the postpartum infection rate of the puerperas.
2024 Vol. 32 (5): 1190- [Abstract]（
81
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ZHANG Xiaohong1, LI Yameng1, ZHANG Ting1, LIU Jinsong2
To explore the warning information of pregnant women before their preeclampsia (PE) onset, and to establish a predictive model for the risk of PE occurrence, so as to reduce the incidence of PE. Methods: 176 pregnant women with PE who had undergone regular prenatal checkups in the general hospital of the northern war zone of the Chinese people's liberation army from 2021 to 2022 were collected in study group, and 352 healthy pregnant women with singleton pregnancy who had undergone regular prenatal checkups in hospital during the same period were collected in control group at the ratio of 1:2. The clinical data of the women were recorded and were compared between the two groups. Univariate analysis was used to analyze the influential factors associated with preeclampsia of the women, and the significant influential factors were then selected for the binary logistic regression analysis. A predictive model for preeclampsia was developed, and the area under the curve (AUC) of receiver operator characteristic (ROC) curve and the Hosmer-Lemeshow test were applied to evaluate the efficacy of this model, and the relevant forest diagram was constructed. Results: Binary logistic regression analysis showed that the serum albumin (ALB) level (OR=0.547, 95%CI 0.481-0.622), the body mass index (BMI) value (OR=2.167, 95%CI 1.664-2.821), the urine protein level (OR=2.700, 95%CI 1.448-5.033), the fetal intrauterine growth restriction (FGR) rate (OR=3.030, 95%CI 1.369-6.708) and the edema rate (OR=3.643, 95%CI 1.603-8.281) of the women had significant effects on their preeclampsia occurrence. The predictive model for the risk of the preeclampsia occurrence was established, that is P=1/1+exp(W), and W=-13.911+0.603×serum ALB level (g/L)- 0.773×the change value of BMI (kg/m2) -0.993×urine protein positive situation (1 for the positive urine protein and 0 for the negative or weakly positive urine protein) -1.109×the intrauterine FGR situation (1 for FGR occurrence and 0 for no FGR occurrence) -1.293 ×the edema situation (1 for edema occurrence and 0 for no edema occurrence). The AUC of ROC curve of this predictive model for the preeclampsia occurrence was 0.932 (95%CI 0.906-0.957), and the Hosmer-Lemeshow test performed had showed that there was no statistically significant difference (P>0.05). According to this predictive model, the predictive model-related forest diagram was drawn. Conclusion: The serum ALB level, the change of BMI value, the urine protein level, and the FGR and edema occurrences of the pregnant women are the warning information for their preeclampsia occurrence, and those women who have the warning information should be included in the scope of the key maternal examination. The established prediction model for the risk of preeclampsia occurrence of the pregnant women based on above five indicators can predict the occurrence of preeclampsia in advance, so the achieve early prevention and timely intervention should be conducted to reduce the harm of the preeclampsia of the pregnant women to the mother and child.
2024 Vol. 32 (5): 1195- [Abstract]（
74
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SHAO Yu, LIANG Yingzhi, YANG Xuemei, LI Dandan, SHI Rui, MENG Chao, JIANG Hongqing
To explore the construction and the operation current status of the maternal near miss rescue network in Haidian district of Beijing. Methods: The “cases registration forms of the high risk or the near miss pregnant and lying-in women referral to the designated hospital in Haidian district” submitted by three maternal near miss rescue centers of Haidian District from 2020 to 2022 were summarized and analyzed. Results: From 2020 to 2022, the proportion of the high risk or the near miss pregnant and lying-in women in Haidian district had increased from 16.16% to 27.34% (χ2trend=923.56, P<0.001). The two-way referral rate by the maternal near miss rescue network in Haidian district had increased from 47.02% to 59.21% (χ2trend=26.03, P<0.001). The number of the monthly bed turnover of the three maternal near miss rescue centers was significantly higher than that of the lower-level midwifery institutions, and the allocation of the obstetric medical staff of the three maternal near miss rescue centers was also relatively few. The incidence rate of the high risk or the near miss pregnant and lying-in women in the lower-level midwifery institutions had decreased from 3.23‰ to 1.45‰ (χ2trend=8.81, P=0.003) and the maternal mortality rate in the lower-level midwifery institutions also had a decreasing trend (χ2trend=4.25, P=0.039). Conclusion: The operation effect of the maternal near miss rescue network in Haidian district of Beijing is relatively ideal, which has reduced the rates of the occurrence and the mortality of the high risk or the near miss pregnant and lying-in women. In the next step, the regional resource allocation should be strengthened and the information feedback and the personnel service capacity should be improved by relying on the application of the cloud women and children service platform.
2024 Vol. 32 (5): 1201- [Abstract]（
66
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ZHAO Yinzhu1, ZOU Xiaoxuan1, YIN Yanmin1, YANG Ying2
To analyze the situation of the live birth newborns in Haidian district in each year from 2020 to 2022, and to provide the oretical evidences for the related policy intervention. Methods: A retrospective study was conducted in this research to analyze the relevant data of 20564 newborns in Haidian district of Beijing from October 1, 2019 to September 30, 2022. The differences of the newborns were compared among the different years. Results: There were no significant differences in the gestational weeks, body length and weight at birth, and the incidence of macrosomia of the newborns among the different years, but the incidence of cesarean section of the newborns had decreased (χ2=249.30, P=0.000). The maternal age of the newborns had increased slightly (χ2=8.63, P=0.013). The proportion of maternal education level at bachelor's degree or above had increased year by year (χ2=58.73, P=0.000). The independent risk factors of the low birth weight of the newborns included the maternal advanced age (OR=1.373, 95%CI 1.107-1.703). Conclusion: The health education for the pregnant women should be strengthened and the safety of the mothers and the children should be paid attention to, especially for low birth weight infants, so as to omnibearing ensure the healthy growth of the newborns.
2024 Vol. 32 (5): 1207- [Abstract]（
79
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WANG Xiaorong, WU Ning, Xue Qing
Endometriosis of the women of reproductive age is a frequent estrogen-dependent disease, serving as a leading cause of dysmenorrhea or infertility of the women. The first-line treatment approaches of the endometriosis encompass hormonal and surgical interventions. Nevertheless, the prolonged administration of hormonal medications of the women with endometriosis may adversely impact their fertility. While the surgical intervention of the women exhibits the high recurrence rate of their endometriosis and may reduce their ovarian reserve. Therefore, improving the existing treatment strategies and exploring the new therapeutic drugs for the women with endometriosis are of significant importance. This paper elaborates on the pharmacological methods for treating the women with endometriosis, aiming to provide the new idea for treating the endometriosis.
2024 Vol. 32 (5): 1211- [Abstract]（
76
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