To describe the current distribution of the interpregnancy intervals(IPI) of women with planned pregnancies in China, and to identify its influencing factors. Methods: The women of reproductive age who participated in the national free pre-pregnancy checkups project twice between January 2010 and December 2018 were selected as the study population. When performing the analysis, IPI was used as both quantitative and qualitative variables, and the women were divided into three groups bases on the qualitative variables, which including the women with <18 months of short IPI in group A, the women with ≥60 months of long IPI in group B and the women with 18-59 months of suitable IPI in the control group. Descriptive epidemiological methods were used to study the distribution of IPI of the women, and generalized linear regression models and logistic regression models were used to explore the factors influencing of IPI, and were used to estimate the indicator β of the associative strength by odds ratio(OR) and its 95% confidence intervals(CI). Results: The median IPI of the women in this study was 21.3 months, 40.7% of women had short IPI and 1.6% of women had long IPI. The risk of short IPI of those women aged ≥35 years old had decreased by 87.0%(95%CI 86.0-88.0) than those women aged 20-24 years old. Compared with those of the women with Han nationality, with lower than high school education level, with normal weight, or with history of adverse pregnancy outcomes in the previous delivery, the risk of short IPI of the women with ethnic minorities, with high school and above education level, with underweight, or with adverse pregnancy outcomes in the previous delivery had increased by 21.0%(95%CI 16.0-26.0), 3.0%(95%CI 1.0-5.0), 5.0%(95%CI 2.0-9.0) or 11.0%(95%CI 8.0-13.0), respectively. Compared with those of the women with rural household registration, with farmer occupation, with normal weight, without drinking, or with vaginal delivery in the previous delivery, the risk of short IPI of the women with urban household registration, with other occupation out of farmer, with overweight, with alcohol consumption, or with cesarean section in the previous delivery had reduced by 24.0%(19.0-28.0), 11.0%(95%CI 9.0-16.0), 8.0%(95%CI 6.0-10.0), 25.0%(95%CI 16.0-33.0) or 53.0%(95%CI 52.0-55.0), respectively. The risk of short IPI of the women from North China had significantly decreased than those women from the other regions of China(all P<0.05). Conclusion: Nearly half of the women with planned pregnancies in China experience either too short or too long IPI. In the future, the publicity and education should be strengthened for the women with short IPI susceptibility characteristics, such as low age, ethnic minorities, high school and above education level, underweight, rural householders, farmers, or experienced vaginal delivery or adverse pregnancy outcomes in the previous pregnancy, so as to help them to choose the appropriate IPI.

2024 Vol. 32　(8):　1727- [Abstract]（ 66 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

2024 Vol. 32　(8):　1740- [Abstract]（ 64 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To explore the correlation between the psychological pressure of pregnant women with gestational diabetes mellitus(GDM) and their coping style and self-care ability. Methods: A total of 108 pregnant women with GDM admitted to the hospital from October 2020 to October 2023 were selected in this study. The baseline data survey scale, the pregnancy stress scale(PPS), the simple coping style scale(SCSQ) and the self-care ability scale(ESCA) were used to investigate the basic characteristics, the psychological pressure, the coping style and the self-care ability of the women. The difference of PPS score was compared among the women with GDM and with different baseline characteristics. Pearson correlation coefficient model was used to analyze the correlation between the SCSQ and ESCA scores of the women with GDM and their PPS score. Multiple linear stepwise regression analysis model was used to explore the influencing factors of the psychological pressure of the women with GDM. Results: A total of 108 questionnaires were distributed and 105 valid questionnaires were collected, with an effective rate of 97.2%. The PPS score of the women with GDM was 39-74 points, with an average of 54.02±14.37 points. The highest average score of each item of PPS of the women was the stress caused by ensuring the health and safety of mother and child. There was significant difference in the PPS score among the women with different ages, between the women with and without planned pregnancy, among the women with different family monthly income, among the women with different maternal type and between the women with and without abortion history(P<0.05). In the SCSQ scale, the scores of positive coping and negative coping of the women were 23.57±4.92 points and 11.93±1.68  points. The ESCA score of the women was 84.26±13.80 points. Pearson correlation coefficient model analysis showed that the positive coping score and the ESCA score in SCSQ scale of the women with GDM were negatively correlated with their PPS score, while the negative coping score in SCSQ scale of the women with GDM was positively correlated with their PPS score(P<0.05). Due to the obvious collinearity between the SCSQ score of the women and their ESCA score, so both the scores of SCSQ and ESCA of the women were included in the multiple linear stepwise regression model, and the results showed that the SCSQ score was included in this model, the unplanned pregnancy, the primiparity, the abortion history, the low score of positive coping and the high score of negative coping in SCSQ scale of the women with GDM were the main influencing factors of their psychological stress, and in the model of ESCA score, the unplanned pregnancy, the primiparity, the abortion history, the low score of ESCA of the women with GDM were the main influencing factors of their psychological stress(all P<0.05). Conclusion: The psychological pressure of the women with GDM is obvious, and which is closely related to the coping style and the self-care ability of the women. Improving the coping style and the self-care ability of the women may be the potential way to reduce the psychological pressure of the women.

2024 Vol. 32　(8):　1750- [Abstract]（ 153 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To investigate the level and the influencing factors of maternal sense of control over personal life. Methods: The puerperas who delivered successfully in the obstetrics department from March 2022 February 2023 were selected in this study. The questionnaires survey was conducted by the general data questionnaire, the personal life control scale［the total score(7-35 points) of 7 items］, the general self-efficacy scale and the perceptive social support scale. Results: A total of 187 questionnaires were distributed and 185 were returned, with an effective rate of 98.9%. The total score of the maternal sense of control over personal life was 25.01±5.04 points. The total score and the score of each item of the maternal sense of control over personal life of the puerperas were positively correlated with their social support and self-efficacy. Multiple linear regression analysis showed that the low education level, the self-efficacy and the perceived social support of the puerperas were the independent factors influencing the maternal sense of control over personal life(all P<0.05). Conclusion: The sense of personal life control of the puerperas in this survey was at a medium level. It is suggested that that clinical practice can start based on these influencing factors, give their more information support, enhance their confidence in postpartum recovery, help them establish a positive thinking mode when coping with stress, so as to improve their level of personal life control and improve their effect of postpartum recovery. Conclusion: The maternal sense of control over personal life in this survey is at the medium level. It is suggested that the clinical practice can start from the influencing factors of the sense of control over personal life of the puerperas to give them more information support, enhance them confidence in postpartum recovery, help them establish the positive thinking mode of coping stress, so as to improve the level of personal life control and improve the effect of the postpartum recovery of the puerperas.

2024 Vol. 32　(8):　1762- [Abstract]（ 55 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To investigate the effect of chinese patent drug Guilingji combined with levocarnitine for treating male patients with infertility because of kidney-yang deficiency. Methods: 205 male patients with oligospermia and asthenospermia were selected and were randomly divided into group A(102 cases) and group B(103 cases) from January 2022 to December 2023. The patients in both groups were given basic symptomatic treatment and asthenospermia, and the patients in group B was given Guilingji additionally. The patients in both groups were treated for 12 weeks continually. The therapeutic effect, the TCM syndrome score, the sperm quality, the levels of sex hormones, such as luteinizing hormone(LH), testosterone(T) and follicle stimulating hormone(FSH), and the levels of oxidative stress, such as seminal plasma malondialdehyde(MDA), reactive oxygen species(ROS) and superoxide dismutase(SOD) of the patients in the two groups were counted. Results: In group A, there were 99 patients were included, with 1 case withdrawing by himself and 2 cases without complete the study records. In group B, there were 101 patients were included, with 1 case lost to follow-up and 1 case withdrew due to personal factors. The scores of primary symptom(8.51±2.53 points), the second symptom and tongue symptom(3.34±1.02 points) and the total TCM syndrome(11.85±3.45 points) of the patients in group B after treatment were significantly lower than those(12.15±3.20 points, 5.02±1.24 points and 17.17±3.83 points) of the patients in group A. The total effective rate(82.2%) of the patients in group B after treatment was significantly higher than that(67.7%) of the patients in group A. The sperm concentration(30.15±5.45×106/ml), the percentages of grade A(27.26±4.33%) and grade A +B(54.46±6.58%) of sperm forward movement of the patients in group B were significantly higher than those(22.04±4.62 ×106/ml,(24.36±4.18% and 48.52±5.16%) of the patients in group A. The levels of the serum luteinizing hormone(3.87±1.01 U/L) and follicle-stimulating hormone(5.24±1.78 U/L), and the levels of seminal plasma ROS(425.26±86.18U/ml) and MDA(6.25±1.73nmol/L) of the patients in group B were significantly lower than those(4.21±1.23 U/L, 6.32±2.26U/L, 463.73±82.67U/ml and 7.12±1.64nmol/L) of the patients in group A. The levels of serum testosterone(15.54±1.96nmol/L) and seminal plasma SOD(102.54±18.02U/ml) of the patients in group B were significantly higher than those(13.68±2.02nmol/L and 95.10±15.25U/ml) of the patients in group A(all P<0.05). Conclusion: Guilingji combined with levocarnitine for treating the male infertility patients can significantly alleviate their clinical symptoms and improve the therapeutic effect, which may be related to the improvement of the sperm quality, to the regulation of sex hormones expressions and to the reduction of oxidative stress injury of the patients.

2024 Vol. 32　(8):　1772- [Abstract]（ 53 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To investigate the expression and significance of the protein DJ-1/stable nuclear factor erythroid 2-related factor 2(DJ-1/Nrf2) in oxidative stress of the spermatogenic cells of patients with asthenozoospermia related to varicocele. Methods: The clinical data of 120 male patients diagnosed with asthenozoospermia related to varicocele admitted to the hospital from December 2021 to December 2023 were collected in this study, and 60 newly diagnosed patients were included in group A, 60 patients who had received treatment of vitamin C combined with vitamin E for 3 months were included in group B. 40 healthy males who underwent premarital health examination were collected in group C during the same time. The morphology of the semen germ cells, the levels of protein and mRNA of DJ-1 and Nrf2 of the spermatogenic cells in seminal fluid, the levels of oxidative stress indexes, such as superoxide dismutase(SOD), malondialdehyde(MDA) and glutathione peroxidase(GSH Px) in peripheral blood, and the levels of DJ-1 and Nrf2 of the males in the three groups were detected. Results: There were no significant differences in the age, the body mass index, the semen volume and the sperm tail malformation rate of the males among the three groups(P>0.05). The rate of the normal sperm morphology of the males in group C, group B and group A had decreased gradually, and the rates of the sperm head malformation, the sperm body malformation and the sperm head malformation combined the sperm body malformation of the males in group C, group B and group A had increased gradually. The DJ-1 level of the spermatogenic cells of the males in group C, group B and group A were 0.35±0.11, 0.71±0.16 and 0.89±0.12, respectively, and which had increased gradually. The Nrf2 protein level of the spermatogenic cells of the males in group C, group B and group A were 0.31±0.09, 0.62±0.14 and 0.78±0.13, respectively, and which had increased gradually. The levels of MDA, DJ-1 and Nrf2 of the males in group C, group B and group A had increased gradually. The levels of SOD and GSH-Px of the males in group C, group B and group A had decreased gradually(all P<0.05). Conclusion: Activating the DJ-1/Nrf2 pathway may help to enhance the antioxidant capacity of the spermatogenic cells of the patients with asthenozoospermia related to varicocele, and which can protect the spermatogenic cells from damage caused by oxidative stress. The DJ-1/Nrf2 pathway might be a potential molecular target for treating the asthenozoospermia related to varicocele.

2024 Vol. 32　(8):　1781- [Abstract]（ 60 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To investigate the application efficacy of esketamine used before the skin incision of patients with laparoscopic total hysterectomy(LTH) on their postoperative depression and sleep quality.Methods: From February2021 to May 2023，110 patients with LTH were selected and were randomly divided into two groups(55 cases in each group) by random number table. All these patients were given treated with the selective LTH under general anesthesia. The patients in observation group were given intravenous injection of esketamine 0.3 mg/kg before skin incision,and the pa- tients in control group were injected with the same dose of normal saline at the same time point. The scores of Hamilton de- pression scale-17(HAMD-17)，numeric rating scales(NRS)and Pittsburgh sleep quality index(PSQI) of the patients in the two groups at each time point were calculated. The levels of the serum neurotransmitters,such as dopamine(DA), epinephrine(E), norepinephrine(NE),of the patients were compared between the two groups. And the adverse reaction rates of the patients in the two groups were counted. Results: In observation group,53 patients were included for analysis after excluding 1 case of conversion to open surgery and 1 case of with- drawal due to personal factors.In control group, 1 patient with incomplete data was excluded, and 54 patients were included for analysis. The NRS scores at rest of the patients at 4 h, 12 h, 24 h,48 h after operation in observation group were 2.27±0.36 points,2.53±0.41 points,2.40±0.30 points and 2.12±0.32 points，respectively, which were significantly lower than those(2.62±0.40 points,3.08±0.46 points,2.85±0.38 points and 2.52±0.42 points) of the patients in control group. The HAMD-17 score in the 2nd day and in the 5th day after operation(13.24±2.16 points and 10.16±2.42 points) and the PSQI score in the 2nd day and in the 5th day after operation(12.46±1.84 points and 9.35士1.75 points) of the patients in observation group were significantly lower than those(15.07±2.33 points and 11.59±2.51 points,13.85±2.13 points and 10.08±1.92 points) of the patients in control group. The levels of serum norepinephrine(NE)(129.45±17.25 ng/L), epinephrine(E)(33.46±5.42 ng/L) and DA(7.02±1.16μg/L) of the patients in observation group in the 5th day after operation were significantly higher than those(113.62±13.48 ng/L, 30.72±4.15 ng/L, 7.03±0.72μg/L) of the patients in control group(all P<0.05). There was no significant difference in the total incidence of the adverse reactions of the patients between the observation group(17.0%) and the control group(14.8%)(P>0.05). Conclusions: Esketamine used before the skin incision of the patients with LTH can alleviate their postoperative pain，regulate their expression level of neurotransmitters,and improve their depression and sleep status, and without increasing the adverse reactions.

2024 Vol. 32　(8):　1791- [Abstract]（ 67 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To observe the clinical effect of the growth hormone(GH) combined with kidney tonifying prescription for treating advanced patients with reduced ovarian reserve function. Methods: A total of 90 patients with ≥35 years old who met the diagnostic criteria of reduced ovarian reserve function were included and were randomly divided into three groups. The patients in group A were given treatment of GH for 3 months, the patients in group B were given treatment of kidney tonifying prescription for 3 months, and the patients in group C were given treatment of GH combined with kidney tonifying prescription for 3 months. The changes of the clinical symptom scores of the patients before and after treatment in the three groups were recorded. The levels of the serum anti-Mullerian hormone(AMH), estradiol(E2), follicle stimulating hormone(FSH) and luteinizing hormone(LH) of the patients in the three groups were detected, and the antral follicle count(AFC) of the patients in the three groups was examined by the transvaginal ultrasound. Results: After 3 months of treatment, the total effective rate of the patients in group A(50.0%), in group B(60.0%) and in group C(73.3%) had increased gradually(P<0.05). The TCM syndrome scores of the patients in the three groups after 3 months of treatment had decreased significantly, and which of the patients in group B and in group C were significantly lower than those of the patients in group A. The menstrual blood loss chart score of the patients in the three groups after treatment had increased significantly, and which of the patients in group B or in group C was significantly higher than that of the patients in group B(all P<0.05). The AFC of the patients in the three groups after treatment had increased significantly, the AMH, E2, FSH and LH levels of the patients in the three groups after treatment had decreased significantly, and the changes of all which of the patients in group C were significantly more than those of the patients in group A(all P<0.05). There was no any patient with obvious abnormality or adverse reaction in the three groups during treatment. The successful pregnancy rate of the patients in group A(6.7%), in group B(13.3%) and in group C(23.3%) had increased gradually within 1 year of follow-up after treatment(P<0.05). Conclusion: GH combined with kidney tonifying prescription for treating the advanced patients with reduced ovarian reserve function has better clinical benefit, and the treatment lasting for at least 3 months may reveal the good clinical effect.

2024 Vol. 32　(8):　1801- [Abstract]（ 83 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To investigate the effects of butorphanol combined with dexmedetomidine used during laparoscopic myomectomy of patients on their immune function, postoperative cognition and inflammatory response. Methods: 204 overweight patients with the body mass index(BMI) of 24.0-27.9kg/m2 who were scheduled to undergo laparoscopic myomectomy treatment in the hospital from January 2020 to October 2022 were selected and were divided into two groups(102 cases in each group). The patients in the control group were given remifentanil and butorphanol for analgesia and sedation during surgery, while the patients in the observation group were given remifentanil, butorphanol and dexmedetomidine for analgesia and sedation during surgery. The perioperative related indicators, the immune function before and after operation, the cognitive function evaluated by mini mental state examination(MMSE), the pain degree evaluated by visual analogue scale(VAS), the levels of inflammatory response, such as interleukin-6(IL-6), interleukin-6(IL-8), tumor necrosis factor alpha(TNF-a) and C-reactive protein(CRP), and the postoperative adverse reactions rate of the patients were recorded and compared between the two groups. Results: There was no significant difference in the operation time of the patients between the two groups(P>0.05). The intraoperative blood loss and the postoperative exhaust time of the patients in the observation group were significantly less than those of the patients in the control group(all P<0.05). There were no significant differences in the values of the immune function indexes and the inflammatory indexes before operation, and the scores of MMSE and VAS of the patients between the two groups(all P>0.05). The levels of IgG(7.25±1.32), IgA(1.59±0.39), IgM(1.06±0.43), CD3(52.69±6.85%) and CD4(38.69±3.24%) of the patients in the observation group at 12 hours after operation were significantly higher than those(6.80±1.65, 1.45±0.46, 0.95±0.32, 49.99%±6.24% and 37.26%±3.16%) of the patients in the control group, and the levels of CD8(35.69±4.21%), IL-6(102.63±32.65 ng/L), IL-8(106.98±13.65 ng/L), TNF-a(162.89±36.77 pg/L) and CRP(32.156.98 Mg/L) of the patients in the observation group at 12 hours after operation were significantly lower than those(38.05%±4.36%, 125.62±39.89 ng/L, 124.78±14.58 ng/L, 179.65±42.05 pg/L and 45.06±7.06 mg/L) of the patients in the control group (all P<0.05). There were no significant differences in the levels of IgG, IgA, IgM, CD3, CD4, CD8, MMSE, VAS, IL-6, IL-8, TNF- a and CRP of the patients at 24 hours after operation between the two groups(all P>0.05). There was no significant difference in the postoperative adverse reactions rate(6.9% vs.5.9%) of the patients between the two groups(P=0.580). Conclusion: The combination of butorphanol and dexmedetomidine used during laparoscopic myomectomy of the overweight patients can improve their immune function, postoperative cognition and inflammatory response.

2024 Vol. 32　(8):　1813- [Abstract]（ 77 ） HTML (0 KB)  PDF  (0 KB)  ( 15 )

To explore the effect of Ziyinbuyang sequential method combined with western medicine for treating patients with polycystic ovary syndrome(PCOS), and to study its influence on the ovarian reserve function of the patients. Methods: 126 patients with PCOS were selected and were divided into control group(63 cases) and study group(63 cases) by simple randomization(lottery method) from August 2021 to October 2022. The patients in the control group were treated with western medicine therapy, while the patients in the study group were given Ziyinbuyang sequential method combined with western medicine therapy. The clinical efficacy, the traditional Chinese medicine(TCM) symptoms scores, the indicators of ovarian reserve, ovarian and follicular change, and the adverse reactions rate of the patients were compared between the two groups. The patients in the two groups were followed up for 1 year, and the ovulation and the pregnancy status of the patients in the two groups were recorded. Results: The total effective rate(93.7%) of the patients in the study group after treatment was significantly higher than that(81.0%) of the patients in the control group. The TCM symptom scores of the patients in the two groups after treatment had decreased significantly, and which of the patients in the study group were significantly lower than those of the patients in the control group. The levels of follicle-stimulating hormone, inhibin B and anti-Mullerian hormone, and the value of luteinizing hormone /follicle-stimulating hormone of the patients in the two groups after treatment had decreased significantly, and which of the patients in the study group were significantly lower than those of the patients in the control group. The values of ovarian volume and AFC of the patients in both groups after treatment had decreased significantly, and which(5.18±0.84mm and 8.63±1.27) of the patients in the study group were significantly lower than those(5.83±0.57mm and 10.45±1.82) of the patients in the control group(all P<0.05). There was no significant difference in the incidence of adverse reactions(4.8% vs.1.6%) of the patients between the two group(P=0.310). Within 1 year of follow-up, the ovulation rate(88.9%) and the pregnancy rate(39.7%) of the patients in the study group were significantly higher than those(71.4% and 22.2%) of the patients in the control group(all P<0.05). Conclusion: Ziyinbuyang sequential method combined with western medicine for treating patients with PCOS improve their clinical symptoms, promote their ovarian reserve function, and enhance their ovulation and pregnancy rate, and with good safety.

2024 Vol. 32　(8):　1823- [Abstract]（ 58 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To explore the effect of the pre hospital and in hospital seamless integrated emergency mode for treating critically ill pregnant women or puerperas in emergency treatment, and to study its impact on the maternal and infant outcomes. Methods: 83 critically ill pregnant women or puerperas who were treated by the traditional emergency mode in emergency treatment from May 2022 to February 2023 were selected in control group, and 85 critically ill pregnant women or puerperas who were treated by the pre hospital and in hospital seamless integrated emergency mode in emergency treatment from March 2023 to January 2024 were selected in study group. The time of emergency treatment, the effectiveness of emergency treatment and the incidence of the adverse maternal and infant outcomes of the critically ill pregnant women or puerperas were compared between the two groups. Results: The pre-hospital emergency response time (6.4±1.6 min), the intrahospital transfer time (10.3±3.1 min), the emergency treatment time (21.5±6.8 min) of the critically ill pregnant women or puerperas in the study group were significantly shorter than those (8.1±1.8 min, 13.8±4.2 min and 24.5±6.4 min) of the critically ill pregnant women or puerperas in the control group. The preparation time of the emergency materials of the critically ill pregnant women or puerperas in the study group was significantly shorter than that of the critically ill pregnant women or puerperas in the control group. The total effective rate (95.3%) of the critically ill pregnant women or puerperas in the study group was significantly higher than that (85.5%) in the control group. The incidences of the adverse maternal outcomes (3.5%), the low birth weight or macrosomia (4.7%), the neonatal asphyxia (5.9%) and the mortality (1.2%) of the critically ill pregnant women or puerperas in the study group were significantly lower than those (13.3%, 15.7%, 16.9% and 9.6%) of the critically ill pregnant women or puerperas in the control group (all P<0.05). Conclusion: Adopting the integrated pre hospital and in hospital seamless emergency mode for treating of the critically ill pregnant women or puerperas can significantly improve the efficiency of their emergency treatment and can improve the maternal and infant outcomes.

2024 Vol. 32　(8):　1834- [Abstract]（ 58 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

To explore the correlation between the genotype and phenotype of patients with Sotos syndrome diagnosed by gene sequencing in China. Methods: A retrospective analysis was conducted on the clinical data and genetic results of a child with Sotos syndrome diagnosed by familial Trio-whole exome sequencing(Trio-WES). The clinical data and the genetic results of the patients who met the inclusion criteria of Sotos syndrome were obtained through literature review. Results: This female patient with 4 year old exhibited the height of 119cm(+3.8 SD), the head circumference of 52.5cm(+1.7 SD), the high anterior hairline, the depressed nasal bridge, the hypertelorism of eyes, the pointed chin, the delayed language and motor developments, and the excessive growth since childhood. The chromosome karyotype analysis of this patient revealed no abnormalities. Trio-WES sequencing identified a de novo variant in the NM_022455.5(NSD1) gene:(C.4765+1 G>C), and that was not previously documented in the human gene database. This variant of the patient led to a diagnosis of Sotos syndrome in combination with her clinical symptoms. In China, 26 patients with Sotos syndrome and NSD1 gene variants had been reported. The clinical phenotype was primarily characterized by the craniofacial deformities, the overgrowth and the developmental delay, and their genetic analysis focused on microdeletions. De nove variants in NSD1 gene of the patients were common, while the familial inheritance of the patients was rare. Conclusion: The C.4765 +1 G>C variant in NSD1 gene of the patients is likely pathogenic for their craniofacial deformities, overgrowth and developmental delay in language and movement. Trio-WES sequencing helps to diagnose Sotos syndrome of the individuals presenting with craniofacial abnormalities, overgrowth, and cognitive impairments.

2024 Vol. 32　(8):　1844- [Abstract]（ 87 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To analyze the application effect the personalized 1+1+X continuous nursing mode assisted by Wechat for patients with intrauterine adhesion after operation. Methods: From March 2020 to June 2022, 128 infertile patients with intrauterine adhesions who wanted hysteroscopic surgery were selected and were divided into two groups(64 cases in each group) according to the random number table method. The patients in the control group were given conventional postoperative care, while the patients in the observation group were given the personalized 1+1+X continuous nursing mode assisted by Wechat. The endometrial thickness, the level serum estradiol(E2), and the postoperative complications and the nursing satisfaction of the patients were compared between the two groups. Results: The endometrial thickness and the E2 level of the patients in the two groups after 3 months of nursing had improved significantly, and which(0.91±0.22 cm and 46.49±6.83 nmol/L) of the patients in the observation group were significantly better than those(0.72±0.15 cm and 36.16±6.25 nmol/L) of the patients in the control group. The postoperative complications incidence(4.7%) of the patients in the observation group after intrauterine adhesion surgery was significantly lower than that(15.6%) of the patients in the control group, but the nursing satisfaction(92.2%) of the patients in the observation group was significantly higher than that(73.4%) of the patients in the control group(all P<0.05). Conclusion: The personalized 1+1+X continuous nursing mode assisted by Wechat for the patients after intrauterine adhesion surgery can effectively promote their fertility function recovery, reduce their postoperative complications and improve their nursing satisfaction.

2024 Vol. 32　(8):　1853- [Abstract]（ 52 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To explore the effects of the mindfulness combined with the sensory perception information support intervention for patients with in vitro fertilization-embryo transfer(IVF-ET) on their readiness and negative emotion. Methods: 143 patients who wanted IVF-ET were selected and were divided into control group(patients with the mindfulness course intervention) and study group(patients with the mindfulness course combined with sensory perception information support intervention) from July 1, 2023 to October 1, 2023. The preoperative self-preparation scale and the birth preparedness assessment index(BPAI) were used to evaluate the preconception readiness of the patient who would accept elective IVF-ET in the two groups. The Amsterdam preoperative anxiety and information scale(APAIS) and self-rating anxiety scale(SAS) were used to evaluate the negative emotions of the patients in the two groups. The preparation and the negative emotions of the patients were compared between the two groups. Results: After intervention, the scores of the preoperative self-preparation scale and the BPAI of the patients in the two groups had increased significantly, and which(93.90±10.84 points and 12.00±1.35 points) of the patients in the study group were significantly higher than those(89.46±11.91 points and 11.22±1.36 points) of the patients in the control group. The scores of APAIS and SAS of the patients in the two groups had decreased significantly, and which(9.76±2.11 points and 27.30±6.53) of the patients in the study group were significantly lower than those(10.94±2.67 points and 30.03±6.98 points) of the patients in the control group(all P<0.05). Conclusion: The mindfulness combined with the sensory perception information support intervention for the patients can improve their preparation before IVF-ET and decrease their negative emotions.

2024 Vol. 32　(8):　1860- [Abstract]（ 51 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To investigate the factors influencing the treatment effect of hysteroscopic and laparoscopic surgery for treating patients with cesarean scar pregnancy(CSP), and to study the predictive efficacy of these influence factors for the treatment effect. Methods: The clinical data of 100 patients with CSP whom were treated with hysteroscopic and laparoscopic surgery in the hospital from January 2019 to January 2024 were selected in this study. All the patients were divided into 83 cases with effective treatment in group A and 17 cases with ineffective treatment in group B according to the treatment results. The general data, the vaginal ultrasound index value, the preoperative β-human chorionic gonadotropin(β-hCG) level and other clinical data of the patients in the two groups were collected. Binary Logistic regression analysis was used to screen the factors affecting the efficacy of hysteroscopic and laparoscopic surgery for treating patients with CSP. Receiver operating characteristic(ROC) curve was used to evaluate the predictive efficacy of the influencing factors on the ineffective treatment of hysteroscopic and laparoscopic surgery. Results: Univariate analysis showed that the number of cesarean section, the gestational weeks, the type of scar pregnancy, the gestational sac volume, the muscular layer thickness of uterine scar, the blood flow classification of scar and the preoperative serum β-hCG level of the patients with CSP were related to their treatment effect by hysteroscopic and laparoscopic surgery(P<0.05). Logistic multivariate analysis showed that the exogenous type of scar pregnancy(OR=4.300), the large gestational sac volume(OR=1.674), the grade Ⅲ blood flow of the scar(OR=2.811), the less muscular thickness of the scar(OR=0.070) and the high preoperative serum β-hCG level(OR=1.003) of the patients with CSP were the influencing factors of their ineffective treatment by hysteroscopic and laparoscopic surgery(P<0.05). ROC analysis showed that all the above influencing factors had certain predictive efficacy for the ineffective treatment of the patients with CSP by hysteroscopic and laparoscopic surgery, and the area under the curve(AUC) of all the above influencing factors for predicting the efficacy of hysteroscopic and laparoscopic surgery were 0.707, 0.760, 0.727, 0.872 and 0.938, respectively. Conclusion: The type of scar pregnancy, the gestational sac volume, the blood flow classification of scar, the muscular layer thickness of uterine scar and the preoperative serum β-hCG level of the patients with CSP are all infecting their effect of hysteroscopic and laparoscopic surgery, and which all have certain predictive values for the effect of hysteroscopic and laparoscopic surgery. The patients with CSP and the risk of the ineffective treatment by hysteroscopic and laparoscopic surgery can be identified based on these influence factors early, and the corresponding measure should be conducted to improve the prognosis of the patients.

2024 Vol. 32　(8):　1869- [Abstract]（ 73 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To construct a prediction model of infertility risk of patients with endometriosis(EMS) in childbearing age based on their clinical characteristics, and to provide guidance for clinical prevention and treatment of the infertility of the patients caused by EMS. Methods: A total of 200 patients with EMS in childbearing age were selected and were divided into infertility group(92 cases with secondary infertility) and control group(108 cases without secondary infertility) according to whether the secondary infertility occurred or not from July 2021 to July 2023. The clinical characteristic data of the patients in the two groups were collected to screen the independent predictors of the infertility risk of the patients with EMS in childbearing age, and the prediction model was constructed based on their clinical characteristics. Results: There were significant differences in the age, the duration of menstruation, the EMS duration, the location of EMS lesions, the revisedAmerican fertility society(r-AFS) stage, the score of endometriosis fertility index(EFI), and the rates of the complication of the gynecologic inflammation, luteal dysfunction, hyperprolactinemia and cervical stenosis of the patients between the two groups(P<0.05). Eight factors, including the age, the EMS duration, the rAFS stage and EFI score of EMS, the complicating with gynecological inflammation, the luteal dysfunction, the hyperprolactinemia and cervical stenosis of the patients were initially found by Lasso regression analysis. Logistic regression analysis showed that the age(OR=4.828, 95%CI 1.629-14.312), the EMS duration(OR=3.909, 95%CI 1.405-10.873), the r-AFS stage of EMS(OR=6.983, 95%CI 2.386-20.439), the complicating with gynecological inflammation(OR=4.212, 95%CI 1.774-15.675), the luteal dysfunction(OR=6.127, 95%CI 2.051-18.306), the hyperprolactinemia(OR=5.896, 95%CI 2.140-16.245) and the cervical stenosis(OR=4.952, 95%CI 1.813-13.528) of the patients with EMS in childbearing age were the independent risk factors of their infertility risk, and the EFI score(OR=0.526, 95%CI 0.316-0.877) of EMS of the patients was a independent protective factor of their infertility risk(P<0.05). Receiver operator characteristic(ROC) curve analysis showed that the area under the curve(AUC) of the age, the EMS duration, the r-AFS stage and the EFI score of EMS, the complicating with gynecological inflammation, the luteal dysfunction, the hyperprolactinemia, or the cervical stenosis of the patients with EMS in childbearing age for predicting their infertility risk was all above 0.6. The prediction model was constructed according to the above independent factors, and the fitting degree was good, with the calibration degree of 0.854 and the consistency index of 0.906. ROC curve analysis showed that the AUC, the sensitivity and the specificity of the prediction model for the infertility risk of the patients with EMS in childbearing age were 0.932(95%CI 0.882-0.984), 93.5% and 90.7%. Conclusion: The predictive value of the prediction model structured based on the age, the EMS duration, the r-AFS stage and the EFI score of EMS, the complicating with gynecological inflammation, the luteal dysfunction, the hyperprolactinemia, or the cervical stenosis of the patients with EMS in childbearing age for their infertility risk is reliable, and which can provide guidance information for clinical prevention and treatment of infertility of patients with EMS in childbearing age.

2024 Vol. 32　(8):　1878- [Abstract]（ 51 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To investigate the results of 4-dimensional hysterosalpingo-contrast sonography(4D HyCoSy) for treating patients with tubal infertility, and to study the correlation between the treatment of 4D HyCoSy for the patients and their natural pregnancy. Methods: The clinical data of 120 patients aged 22-40 years old who were suspected tubal infertility and were at least one fallopian tube unobstructed or bilateral fallopian tube slightly obstructed from November 2021 to July 2023 were selected in this study. The general clinical data and the imaging data of the patients were collected, and the natural pregnancy of the patients within 6 months after 4D HyCoSy radiography was followed up. These patients were divided into group A(32 patients with natural pregnancy) and group B(88 patients without natural pregnancy) based on the situation of the natural pregnancy of the patients. The general data, the tubal patency status and the natural pregnancy situation of the patients were compared between the two groups. The influence factors of the natural pregnancy of the patients after 4D HyCoSy were analyzed by multivariate analysis. Results: There were 32(26.7%) patients with pregnancy within 6 months after 4D HyCoSy. The age and the infertility duration of the patients in group A were significantly less than those of the patients in group B. The fallopian tube patency of the patients in group A was significantly better than that of the patients in group B. Logistic regression analysis showed that the advanced age, the longer duration of infertility and the poor tubal patency of the patients were the influencing factors of their natural pregnancy within 6 months after 4D HyCoSy(all P<0.05). Conclusion: 4D-HyCoSy can improve the natural pregnancy in the short term after4D-HyCoSy of the patients with tubal infertility. The advanced age, the longer duration of infertility and the poor tubal patency of the patients can influence their natural pregnancy after 4D HyCoSy.

2024 Vol. 32　(8):　1888- [Abstract]（ 50 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

2024 Vol. 32　(8):　1898- [Abstract]（ 61 ） HTML (0 KB)  PDF  (0 KB)  ( 13 )

2024 Vol. 32　(8):　1909- [Abstract]（ 60 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To analyze the influencing factors of the delayed recovery of patients in the resuscitation room of gynecological surgery under general anesthesia. Methods: The clinical data of 220 patients undergoing gynecological surgery under general anesthesia in the hospital from June 2022 to June 2023 were analyzed retrospectively. The recovery time of these patients in the resuscitation room of gynecological surgery was recorded, and 56 patients with the delayed recovery were included in the observation group and 164 patients without the delayed recovery were included in the control group. Univariate and multivariate logistic regression analysis were used to analyze the related influencing factors of the patients with the delayed recovery, and their nursing countermeasures were summarized. Results: The recovery time(161.73±11.27 min) of the patients in the observation group was significantly longer than that(54.39±10.23 min) of the patients in the control group. The proportions of the patients with the age ≥60 years old, with the anemia, with the operation time >2h, with the intraoperative average temperature <36.5℃ or with the additional anesthetic drugs used of the patients in the observation group were significantly higher than those of the patients in the control group(P<0.05). Multivariate regression analysis showed that the operation time >2h, the average intraoperative temperature <36.5℃ and the additional intraoperative anesthetic drugs used of the patients were the risk factors of their delayed recovery(all P<0.05). Conclusion: The operation time >2h, the average intraoperative temperature <36.5℃ and the additional intraoperative anesthetic drugs used of the patients are the risk factors of their delayed recovery, so the preoperative prevention should be conducted for these patients. The symptomatic treatment measures should be actively adopted according to the recovery situation of the patients in the recovery room to reduce the incidence of their delayed recovery after general anesthesia.

2024 Vol. 32　(8):　1918- [Abstract]（ 76 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To analyze the occurrence and the influencing factors of the agitation during anesthesia recovery of patients after laparoscopic total hysterectomy(LTH) under general anesthesia. Methods: 86 patients with TLH under general anesthesia admitted to the hospital from January 2021 to January 2024 were collected and were divided into group A(patients with agitation during anesthesia recovery) and group B(patients without agitation during anesthesia recovery) based on whether the agitation occurred during anesthesia recovery or not. The differences of the relevant information of the patients were compared between the two groups. Logistic analysis was used to analyze the influencing factors of the agitation occurred of the patients during their anesthesia recovery. Results: In 86 patients, there were 18 cases with the agitation occurred during anesthesia recovery, with an incidence of 20.9%. There were significant differences in the ASA classification, the complication with diabetes, the nerve block rate, the anesthesia time, the operation time, the intraoperative hypothermia rate, the heat preservation management, the hypoxemia rate, the residual rate of muscle relaxation drug, the timing of indwelling catheter, the postoperative VAS score, the postoperative analgesia status and dexmedetomidine used of the patients between the two groups(P<0.05). There were no significant differences in the age, the body mass index value and the hypertension rate of the patients between the two groups(P>0.05). Logistic analysis showed that the complication with diabetes mellitus, the long time of anesthesia and operation time, the low temperature, the hypoxemia, the muscle relaxants residues and the high score of postoperative VAS of the patients were the risk factors of their agitation occurred during anesthesia recovery. The low ASA grade, the nerve block, the heat preservation management, the timing of indwelling catheter before, the postoperative analgesia used and the dexmedetomidine used of the patients were the protective factors of their the agitation occurred during anesthesia recovery(all P<0.05). Conclusion: The incidence of the agitation occurred during anesthesia recovery of the patients with LTH under general anesthesia is higher, and which has many influencing factors. It is suggested that the clinical preventive measures based on these influencing factors should be taken to reduce the incidence of the agitation occurred during anesthesia recovery and improve the safety of surgery of the patients.

2024 Vol. 32　(8):　1927- [Abstract]（ 58 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

2024 Vol. 32　(8):　1938- [Abstract]（ 61 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

2024 Vol. 32　(8):　1948- [Abstract]（ 58 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To explore the influence of the lipemia of pregnant women on their biochemical test results, and to study the correlation between the lipemia of the pregnant women and their adverse pregnancy outcomes. Methods: A total of 102 pregnant women with hyperlipidemia who received antenatal examination and delivered in the hospital from December 2018 to December 2023 were collected in observation group retrospectively, and 102 normal pregnant women who received antenatal examination and delivered in the same hospital during the same period were selected in control group. The blood samples of the women in the observation group were handled by low temperature and high speed centrifugation, and the changes of the levels of the serum biochemical indexes, such as creatinine, alkaline phosphatase(ALP), creatine kinase isoenzyme(CK-MB), fasting blood glucose, aspartate aminotransferase(AST) and alanine aminotransferase(ALT) of the women in the observation group were compared between before and after handling the blood samples. The adverse maternal and infants outcomes were compared between the two groups. Receiver-operating characteristic(ROC) curve was used to analyze the assessment value of the hyperlipidemia of the women for their adverse pregnancy outcomes. Spearman correlation was used to analyze the correlation between the lipemia of the pregnant women and their adverse pregnancy outcomes. Results: The Cr, ALP, CK-MB, FBG, AST and ALT levels in the blood samples of the women in the observation group after handling the blood samples had decreased significantly, and the blood TC, TG, HDL-C and LDL-C levels of the women in the observation group were significantly higher than those of the women in the control group(all P<0.05). The adverse pregnancy outcomes rate(23.5%) of the women in the observation group was significantly higher than that(6.9%) of the women in the control group(P<0.05), but which had no significant different among the women diagnosed hyperlipidemia during the different gestational weeks in the observation group(P>0.05). The area under the ROC curve, the specificity and the sensitivity of the lipemia detection of the pregnant women with hyperlipidemia for their adverse pregnancy outcomes were 0.720, 57.2% and 90.3%, respectively. The blood lipid levels of the pregnant women with hyperlipidemia were positively correlated with the maternal and fetal adverse outcomes(all P<0.001). Conclusion: The lipemia of the pregnant women has certain influence on the other biochemical test items of the women, and the low temperature and the centrifugal reprocessing for the lipemia samples of the pregnant women has certain effect for decreasing the influence on the other biochemical test items of the women. The pregnant women with lipemia have the higher incidence of adverse pregnancy outcomes.

2024 Vol. 32　(8):　1959- [Abstract]（ 83 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )