2024 Vol. 32　(9):　1977- [Abstract]（ 68 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To investigate the status quo and the influencing factors of the disease acceptance of patients with cervical cancer. Methods: 160 patients with cervical cancer during in-patient and out-atient from January 2021 to December 2023 were selected as research objects. The score of illness ccceptance questionnaire (IAQ) of the patients was measured. The demographic data and disease characteristics of the patients were counted. Single factor and multiple factor analysis were used to screen the influencing factors of the disease acceptance of the patients with cervical cancer. Results: Among 160 patients with cervical cancer, there were 58 cases with low acceptance of the disease, accounting for 36.3%, there were 87 cases with moderate acceptance of the disease, accounting for 54.4%, and there were 15 cases with high acceptance of the disease, accounting for 9.4%. There were statistically significant differences in the IAQ score among the patients with different age, among the patients with different marital status, among the patients with different medical payment method, among the patients with different number of children, or among the patients with different stages, recurrence or metastasis of cervical cancer (P<0.05). The results of multiple regression model indicated that the young age, the spinsterhood, the medical payment method as the basic medical insurance of urban and rural residents, the less number of children, the high stage of cervical cancer, and the recurrence or metastasis of cervical cancer of the patients were all the influencing factors of their disease acceptance (all P<0.05). Conclusion: The affecting factors of the disease acceptance of the patients with cervical cancer should be focused on in clinic. The patients with cervical cancer should be given counseling and psychological support actively to increase the treatment compliance, to improve the treatment effect and to promote the postoperative recovery of the patients.

2024 Vol. 32　(9):　1988- [Abstract]（ 69 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To analysis the self-efficacy correlation factors and countermeasure of neonatal father support breastfeeding. Methods: From March 2021 to January 2024, neonatal 170 fathers in hospital were selected as the study subjects, and a questionnaire survey was conducted on these fathers before the discharge of the neonates. The general data of the neonatal father and mothers were collected. The comprehensive breastfeeding knowledge scale (CBKS), the Iowa infant feeding attitude scale (IIFAS) and the short father breastfeeding support self-efficacy scale form (FBSES-SF) were used to assesses the knowledge of breastfeeding, attitudes towards infant feeding and self-efficacy in breastfeeding support of the fathers. Pearson analysis was used to analyze the correlation between the infant feeding attitudes and the breastfeeding knowledge level of the neonatal fathers and their self-efficacy in support of breastfeeding. Multiple linear regression analysis was used to analyze the factors affecting the self-efficacy in support of breastfeeding of the neonatal fathers. Results: 170 neonatal fathers filled in the questionnaire, and the qualified rate was 95.3% (162/170). The scores of FBSES-SF, IIFAS  and CBKS of 162 fathers were 49.82±7.14 points, 49.02±5.24 points and 61.14±6.58 points. Univariate analysis showed that the educational level, the couple’s parity, the type of neonates and the neonatal feeding pattern of the fathers before the neonatal discharge were related to their self-efficacy in supporting breastfeeding (P<0.05). There was a positive correlation between the infant feeding attitude and the knowledge level of breastfeeding of the neonatal fathers and their self-efficacy in supporting breastfeeding (P<0.05). The low education level, the parity of one, the low infant feeding attitude and the low knowledge level of breastfeeding of the neonatal fathers, and the feeding pattern without breastfeeding before discharge were the influencing factors of the self-efficacy in supporting breastfeeding of the neonatal fathers (all P<0.05). Conclusion: The level of self-efficacy in supporting breastfeeding of the fathers needs to be improved. The targeted intervention strategies should be conducted according to the relevant factors to improve the self-efficacy in supporting breastfeeding of the neonatal fathers in clinical practice.

2024 Vol. 32　(9):　1999- [Abstract]（ 77 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

To investigate the fear of childbirth and its influencing factors analysis of pregnant women during the third trimester of pregnancy. Methods: A convenience sampling method was used to select 490 pregnant women during the third trimester of pregnancy from September to December 2023 as the study subjects. The childbirth fear scale (CAQ), childbirth self-efficacy inventory (CBSEI-C32), and anxiety self assessment scale (SAS) were used to collect the situations of the fear of childbirth, the prenatal anxiety and the self-efficacy in childbirth of the women. The factors affecting the fear of childbirth of the women were analyzed. Results：The incidence of the childbirth fear of the women was 59.8%. Logistic regression analysis showed that the prenatal anxiety was an independent risk factor of the childbirth fear of the pregnant women during the third trimester of pregnancy (OR=1.861, 95%CI 1.224-2.829). The history of pregnancy and childbirth (OR=0.590, 95%CI 0.393-0.886), and the high score of childbirth in self-efficacy (OR=0.177, 95%CI 0.118-0.266) of the women were the independent protective factors of their childbirth fear during the third trimester of pregnancy. Conclusion: The rate of the childbirth fear of the pregnant women during the third trimester of pregnancy is higher, and the childbirth fear of the women is influenced by the factors, such as the pregnancy and childbirth history, the anxiety, and the self-efficacy in childbirth, which should be paid attention in the clinical work, and the targeted intervention strategies should be developed.

2024 Vol. 32　(9):　2011- [Abstract]（ 63 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To observe the effects of pelvic floor biomimetic electrical stimulation therapy for patients with thin endometrium infertility on their endometrial receptivity and pregnancy outcomes. Methods: 8 patients with mesosterenotic endometrial infertility were randomly divided into observation group (40 cases given conventional hormone therapy combined with pelvic floor biomimetic electrical stimulation) and control group (40 cases given conventional hormone therapy). The patients in both groups were treated for 3 courses of treatment (1 menstrual cycle as 1 course). The endometrial status, such as the endometrium type, the endometrial thickness (EMT) and the endometrial volume, the values of uterine artery hemodynamic parameters, such as pulsatility index (PI), resistance index (RI) and peak systolic velocity/end diastolic velocity (S/D), and the levels of sex hormones of the patients before treatment and after 3 courses of treatment were compared between the two groups. The pregnancy status of the patients in the two groups within 1 year after the end of treatment was statistically analyzed. Results: After 3 courses of treatments, the proportion (67.5%) of type A endometrium, the EMT (9.48±0.65mm) and the endometrial volume (2.34±0.38 cm2) of the patients in the observation group were significantly higher than those (32.0%, 8.23±0.79mm and 1.71±0.36 cm2) of the patients in the control group, and the levels of serum estradiol (E2) and progesterone (P) of the patients in the observation group were significantly higher than those of the patients in the control group, while the values of uterine artery hemodynamic parameters and the levels of the luteinizing hormone (LH), testosterone (T), folliclestimulating hormone (FSH) and prolactin (PRL) of the patients in the observation group were significantly lower than those of the patients in the control group. The pregnancy rate (42.5%) of the patients in the observation group was significantly higher than that (20.0%) of the patients in the control group (all P<0.05). Conclusion: Pelvic floor biomimetic electrical stimulation adjuvanting the hormone therapy for the patients with thin endometrium infertility can effectively enhance their endometrial receptivity and improve their hemodynamics and sex hormones levels, and it has a positive effect on the improvement of the pregnancy rate of the patients.

2024 Vol. 32　(9):　2020- [Abstract]（ 70 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To investigate the clinical efficacy and safety of Wenyang huashi zhuyu decoction for treating the chronic pelvic pain (CPP) of the cold and damp stasis type of patients caused by the sequelae of pelvic inflammatory disease (SPID). Methods: 64 patients with the cold and damp stasis type CPP caused by SPID were divided into two groups (32 patients in each group) randomly. The patients in the observation group were treated with Wenyang huashi zhuyu decoction, while the patients in the control group were treated with Guizhi poria capsule. The scores of visual analogue scale (VAS) and the traditional Chinese medicine (TCM) syndrome, and the change of the pelvic sign score of the patients after treatment were compared between the two groups. Results: The total effective rate (96.9%) of the patients in the observation group in 12 weeks after treatment was significantly higher than that (75.0%) of the patients in the control group (χ2=16.74, P<0.05). The scores of VAS, TCM syndrome and pelvic signs of the patients in the two groups at each time point after treatment had decreased significantly, and the decrease degree of the VAS score at each time point (1.46±1.62 points, 2.50±1.62 points and 3.34±1.80 points) of the patients in the observation group were significantly more than those (0.65±0.65 points, 1.31±0.86 points and 1.68±1.02 points) of the patients in the control group. At the same time, the improvement of the scores of TCM syndromes and pelvic signs of the patients in the observation group were significantly better than those of the patients in the control group (P<0.05). Conclusion: The Wenyang huashi zhuyu decoction for treating the cold and damp stasis type CPP of the patients caused by SPID has the definite clinical efficacy, which can alleviate the pain symptoms and pelvic signs of the patients, and with good safety.

2024 Vol. 32　(9):　2030- [Abstract]（ 39 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To investigate the effects of the different doses of femostonon for treating patients with menopausal syndrome on their lipid metabolism and endocrine function. Methods: 106 patients with menopausal syndrome treated in hospital were selected and were randomly divide into two groups (53 cases in each group) from August 2021 to May 2023. The patients in group A were given the conventional dose of femoston for treatment and the patients in group B were given the low dose of femoston for treatment. The score of Kuppeman menopause rating scale, the levels of the blood lipids and sex hormones, and the adverse reactions rate of the patients were compared between two groups. Results: The Kupperman score of the patients in both groups had decreased significantly, and which (8.61±2.13 points) of the patients in group A were significantly lower than that (9.57±2.24 points) of the patients in group B (P<0.05). The levels of the total cholesterol, triglyceride, low density lipoprotein cholesterol of the patients in the two groups after treatment had decreased significantly, but the high-density lipoprotein cholesterol level of the patients in the two groups after treatment had increased significantly (P<0.05), but all of which of the patients had no significant differences between the two groups (P>0.05). After treatment, the estradiol level of the patients in both groups had increased significantly, but which (40.58±3.25ng/L) of the patients in group A was significantly higher than that (34.16±3.12ng/L) of the patients in group B. The levels of follicle-stimulating hormone (37.52±4.28 mU/ml) and luteinizing hormone (21.04±2.68mU/ml) of the patients in group A were significantly lower than those (44.67±4.86 mU/ml and 25.14±2.77mU/ml) of the patients in group B (all P<0.05). The incidence of adverse reactions (17.0%) of the patients in group A had no significantly different from that (9.4%) of the patients in group B (P>0.05). Conclusion: The different doses of femostonon for treating patients with menopausal syndrome can effectively improve their clinical symptoms, abnormal lipid metabolism and endocrine disorders, but the conventional dose of femoston has the better efficacy without increasing the risk of adverse reactions.

2024 Vol. 32　(9):　2039- [Abstract]（ 60 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

2024 Vol. 32　(9):　2048- [Abstract]（ 66 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To compare the effects of the total hysterectomy and the subtotal hysterectomy of patients with uterine fibroids on their postoperative physical and psychological health. Methods: 86 patients with uterine fibroids admitted to hospital were selected and were divided into two groups (43 cases in each group) based on different hysterectomy method from March 2019 to May 2024. The patients in group A were given total hysterectomy and the patients in group B were given subtotal hysterectomy. The ovarian function, such as the antral follicle count and the levels of serum estradiol (E2), luteinizing hormone (LH) and folliclestimulating hormone (FSH) before surgery and in 3 and 6 months after surgery, the negative psychology evaluated by self-rating anxiety scale (SAS), selfrating depression scale (SDS), Pittsburgh sleep quality index (PSQI) and female sexual function index (FSFI), the persisted symptoms situation before surgery and the complications rate of the patients in the two groups were recorded. Results: The sinus follicle number of the patients in group B in 3 postoperative months had no significant change (P>0.05). The serum E2 level, the scores of SAS, SDS and PSQI, the sexual desire, the situations of the vaginal lubrication and pain, the sexual arousal, the orgasm and the sexual satisfaction during sex, and the FSFI total score of the patients in two groups had decreased significantly, however, the levels of LH and FSH, and the scores of SAS, SDS and PSQI of the patients in two groups had increased significantly. The sinus follicle number, the serum E2 level, the sexual desire, the situations of the vaginal lubrication, dyspareunia, sexual arousal, orgasm and satisfaction, and the FSFI total score of the patients in the in group A were significantly lower than those of the patients in group B, and the LH and FSH levels of the patients in group A were significantly higher than those of the patients in group B (P<0.05). The scores of SAS (56.24±2.19 points), SDS (60.34±2.58 points), PSQI (11.95±2.71 points) of the patients in group A in 6 months after surgery were significantly lower than those (62.05±2.34 points, 66.18±3.19 points and 14.09±2.48 points) of the patients in group B (P<0.05). There was no significant difference in the postoperative complications rate (11.6% vs. 20.9%) of the patients between the two groups (P>0.05). Conclusion: For the patients with uterine fibroids who have indications for the hysterectomy, the total hysterectomy of the patients has more impact on the postoperative ovarian function and the sexual quality of life comparing those of the subtotal hysterectomy. However, the hidden dangers of the subtotal hysterectomy maybe lead to the negative emotions of the patients. It is recommended that the discuss with the patients before surgery to help them make a more rational decision in clinic.

2024 Vol. 32　(9):　2057- [Abstract]（ 57 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To explore the effect of the different doses of remrazolam for sedation and analgesia during hysteroscopic surgery of patients, and to study the differences of the adverse reactions of the patients. Methods: 90 patients who wanted hysteroscopic surgery in the obstetrics and gynecology department of the hospital were randomly divided into three groups (30 cases in each group) from September 2020 to July 2022. All the patients in the three groups were given sufentanil 0.2μg/kg and remimazolam 0.2mg/kg for anesthesia induction, and then the patients in group A, in group B and in group C were given 0.5mg/kg/h, 1.0mg/kg/h, and 1.5mg/kg/h remimazolam for anesthesia maintained, respectively. The values of anesthesia indicators, such as anesthesia onset time and awakening time, the values of sedation effect, such as BIS control time and BIS value, the levels of stress response indicators, such as Cortisol (Cor), C -reactive protein (CRP) and interleukin 6 (IL-6), and the rates of the rescue analgesia and restlessness during awakening, and the rate of adverse reactions, such as intraoperative physical activity, respiratory depression, nausea and vomiting and hypotension of the patients in three groups were observed. Results: There was no significant difference in the anesthesia on-set time of the patients among the three groups (P>0.05). The awaking time of the patients in group B (557.26±141.47 s) or in group in C (550.25±139.93 s) was significantly longer than that (388.34±103.34 s) of the patients in group A (all P<0.05). There was no significant difference in the BIS value of the patients among the three groups (P<0.05). The BIS control time of the patients in group C (48.93±81.15 s), in group B (63.64±9.11 s), and in group A (75.52±12.24 s) had increased gradually (P<0.05). The levels of serum Cor, CRP and IL-6 of the patients in group B and in group C were significantly lower than those of the patients in group A. The incidence of rescue analgesia of the patients in group B and group C (16.7% and 13.3%) and the incidence of agitation during awaking of the patients in group B and group C (10.0% and 6.7%) were significantly lower than those (43.3% and 33.3%) of the patients in group A (all P<0.05). There was no significant difference in the incidence of the adverse reactions (26.7% vs. 20.0% vs. 16.7%) of the patients among the three groups (P>0.05). Conclusion: There are differences in the application effect of the different doses of remrazolam for the anesthesia maintenance during hysteroscopic surgery of the patients. 1.0mg/kg/h remrazolam used for anesthesia maintenance can meet the surgical requirement, which has better sedative and analgesic effect, and has mild stress reactions of the patients, with fewer adverse reactions.

2024 Vol. 32　(9):　2068- [Abstract]（ 63 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To compare the influence of the different techniques of pulmonary surfactant (PS) administration for treating premature infants with neonatal respiratory distress syndrome (NRDS) on their pulmonary function and adverse reactions. Methods: 105 premature infants with NRDS selected and were divided into control group (n=52) and observation group (n=53) by simple randomization method with the help of random number table from August 2019 to August 2023. The infants in the control group were treated with PS administration by tracheal intubation-use of pulmonary surfactant-extubation technique (INSURE) combined with caffeine, while the infants in the observation group were treated with PS administration by minimally invasive pulmonary surfactant administration technique (LISA) combined with caffeine. The curative effect at 24h after treatment, the values of pulmonary function indexes at the time of the infants with the corrected age of 36 weeks, such as tidal volume (VT), respiratory rate (RR), minute ventilation (MV), time to peak value ratio (TPTEF/TE), peak volume ratio (VPEF/VE), expiratory flow at 25%, 50% and 75% of tidal volume (FEF25%, FEF50%, FEF75%), the values of respiratory mechanics indexes before treatment and at 24 h after treatment, such as airway resistance, static lung compliance and endogenous positive end-expiratory pressure (PEEP), the values of blood gas analysis, such as partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and pH, the values of the time indexes of the infants received treatment, such as dyspnea disappeared time, total noninvasive ventilation time and the hospital stay, the adverse reactions rate during the medication and the incidence of complications during hospitalization of the infants were compared between the two groups. Results: After 24 hours of treatment, the curative effect (94.3%) of the infants in the observation group was significantly higher than that (88.8%) of the infants in the control group. When the infants reached the corrected age of 36 weeks, the values of RR, airway resistance and endogenous PEEP of the infants in the observation group were significantly lower than those of the infants in the control group. The values of MV, TPTEF/TE, VPEF/VE, FEF25%, FEF50% and FEF75%, and the static lung compliance of the infants in the observation group were significantly higher than those of the infants in the control group. The values of some indexes of blood gas analysis of the infants in the two groups were significantly recovered compared with those before treatment. The PaO2 and pH values of the infants in the observation group were significantly higher than those of the infants in the control group, and the PaCO2 value of the infants in the observation group was significantly lower than that of the infants in the control group (all P<0.05). The time of hospital stay (18.63±1.83d) of the infants in the observation group was significantly shorter than that (20.57±2.07d) of the infants in the control group (all P<0.05). There were no significant differences in the various adverse reactions and the incidence of complications of the infants between the two groups (P>0.05). Conclusion: The PS administration by both INSURE technique and LISA technique combine with caffeine for treating the premature infants with NRDS are effective, but LISA technique is more effective, which has good influence on the pulmonary function, respiratory function and blood gas value of the premature infants, and can promote the rehabilitation of the infants, and without increase of the incidence of adverse reaction and complications of the infants during medication and hospitalization.

2024 Vol. 32　(9):　2079- [Abstract]（ 52 ） HTML (0 KB)  PDF  (0 KB)  ( 14 )

2024 Vol. 32　(9):　2090- [Abstract]（ 57 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To investigate the application effect of “1+1” delivery accompaniment combined with the appropriate protection of perineum during the second stage of primiparas with latericumbent posture in vaginal delivery. Methods: The data of 100 primiparas who accepted “1+1” delivery accompaniment combined with the appropriate protection of perineum during the second stage of primiparas with latericumbent posture in vaginal delivery (in research group) from January 2023 to September 2023 were collected, and the data of another 100 primiparas with routine delivery (in control group) selected by propensity score matching method were also collected. The situation of perineal damage, the pain degree, the labor stress hormone level, the labor fear and psychosocial adjustment situation of the primiparas were compared between the two groups. Results: The incidences of episiotomy (12.0%), the perineum tear (44.0%), the perineum edema (41.0%) of the primiparas in the research group were significantly lower than those (24.0%, 71.0% and 59.0%) of the primiparas in the control group. The proportion of mild pain (39.0%) of the primiparas in the research group was significantly higher than that (25.0%) of the primiparas in the control group, the proportion of severe pain (13.0%) of the primiparas in the research group was significantly lower than that (30.0%) of the primiparas in the control group. The levels of adrenal cortical hormone (42.33±11.57 pmol/L) and cortisol (765.23±158.90 nmol/L) of the primiparas in the research group were significantly lower than those (49.52±9.85 pmol/L and 808.15±114.28 nmol/L) of the primiparas in the control group. The Wijma childbirth expectancy questionnaire score (72.57±10.22 points) of the primiparas in the research group was significantly lower than that (81.35±9.72 points) of the primiparas in the control group, and the maternal psychosocial adjustment scale score (44.33±8.47 points) of the primiparas in the research group was significantly higher than that (39.91±9.65 points) of the primiparas in the control group (all P<0.05). Conclusion: The “1+1” delivery accompaniment combined with the appropriate protection of perineum during the second stage of primiparas with latericumbent posture in vaginal delivery can not only reduce the tear risk of the perineum, decrease the labor pain and the labor stress hormone levels, but also have a positive role for decreasing the maternal fear.

2024 Vol. 32　(9):　2099- [Abstract]（ 45 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

To investigate the effect of the dynamic symptom management model for intervening patients with ovarian cancer in their perioperative symptom cluster management. Methods: 118 middle-aged patients with ovarian cancer who had admitted to hospitals were selected and were divided into two groups (59 cases in each group) by random number table method from January 2019 to December 2023. The patients in the two groups were given routine nursing and symptom management records, and the patients in the experimental group were given the intervention of the dynamic symptom management model additionally. The interventions of the patients in the two groups were conducted at 4 time points, including at 1-3 days before surgery (T1), and at the 1st day after surgery (T2), 2nd-3rd day after surgery (T3) and 5th day after surgery (T4). The differences of the symptoms with different severity situation at each time point and the differences of the quality of life of the patients were compared between the two groups. Results: There were significant differences in the time effect, the group effect and the interaction effect of the symptom score of the patients after intervention between the two groups (P<0.05). The evaluations of the society function, the role function, the cognitive function, the emotional function and the general function of the patients in the experimental group after intervention had increased significantly, but the scores of fatigue, pain, loss of appetite, diarrhea and respiratory difficulties of the patients in the experimental group after intervention had decreased significantly. The evaluations of the cognitive function, the emotional function and the general function of the patients in the experimental group were significantly higher than those of the patients in the control group. The scores of fatigue, pain and loss of appetite of the patients in the experimental group after intervention were significantly lower than those of the patients in the control group (all P<0.05). Conclusion: The dynamic symptom management model in the perioperative symptom cluster management of the patients with ovarian cancer has better interventive effect, and which can improve the quality of life and promote the recovery of the patients.

2024 Vol. 32　(9):　2108- [Abstract]（ 54 ） HTML (0 KB)  PDF  (0 KB)  ( 12 )

2024 Vol. 32　(9):　2117- [Abstract]（ 53 ） HTML (0 KB)  PDF  (0 KB)  ( 11 )

2024 Vol. 32　(9):　2127- [Abstract]（ 56 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

2024 Vol. 32　(9):　2136- [Abstract]（ 66 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To study the expressions and clinical significance of mutant p53 gene (Mt-p53), DNA mismatch repair gene 1 (hMLH1) and mismatch repair gene 2 (hMSH2) in benign or malignant ovarian tumors. Methods: The clinical data of 95 patients with ovarian tumors from July 2017 to July 2021 were analyzed retrospectively. These patients were divided into 32 cases with benign ovarian tumor in group A, 21 cases with borderline tumor in group B and 42 cases with malignant tumor in group C according to their pathological results. The expressions of Mt-p53, hMLH1 and hMSH2 in the specimens of ovarian tumor of the patients with different pathological types, pathological features or prognosis status were analyzed and compared. The survival rate of the patients with malignant tumors within 2 years was counted. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficiency of the deletions of hMLH1 and hMSH2 of the patients with malignant ovarian tumors for their prognosis. Results: The positive rate of Mt-p53 (88.1%) of the patients in group C was significantly higher than that (23.8%) of the patients in group B and that (9.4%) of the patients in group A. The positive rates of hMSH1 (66.7%) and hMSH2 (61.9%) of the patients in group C were significantly lower than those (90.5% and 90.5%) of the patients in group B and those (100.0% and 100.0%) of the patients in group A. The positive rates of hMLH1 and hMSH2 in the malignant germ cell tumors of the patients were significantly lower than those in the epithelial ovarian cancer. The positive rates of hMLH1 and hMSH2 in the moderately to highly differentiated malignant ovarian tumors of the patients were significantly higher than those in the poorly differentiated tissues, and the positive rate of Mt-p53 in the moderately to highly differentiated malignant ovarian tumors of the patients was significantly lower than that in poorly differentiated tissues. The overall survival rate of the patients with malignant tumor in 2 years was 54.8%, and the positive rate of Mt-p53 (78.3%) in the survival patients was significantly lower than that (100%) in the patients with death, and the positive rates of hMLH1 (87.0%) and hMSH2 (82.6%) in the survival patients were significantly higher than those (42.1% and 36.8%) in the patients with death (all P<0.05). There were 19 death patients with p53 gene mutation, and among them, there were 11 cases with hMLH1 gene deletion and 12 cases with hMSH2 gene deletion. ROC curve analysis showed that both the hMLH1 and the hMSH2 gene deletions of the patients with malignant ovarian tumors had the predictive efficacy for their prognosis, and the area under the curve of the hMLH1 and the hMSH2 gene deletions of the patients for their prognosis were 0.724 and 0.729 (P<0.05). Conclusion: The Mt-p53 high expression and the gene deletions of hMLH1 and hMSH2 of the patients are closely related to the occurrence and development of their malignant ovarian tumors, and the hMLH1 and hMSH2 gene deletions of the patients can also be used as the clinical indicators for predicting their prognosis.

2024 Vol. 32　(9):　2146- [Abstract]（ 56 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To exploration of the gene detection for the instructional aspirin precision medicine for patients with immune recurrent spontaneous abortion. Methods: 50 patients with recurrent spontaneous abortion who had treated in hospital between June 2022 and December 2023 were collected in this study. The genetic testing based on blood samples of these patients were conducted before their aspirin administration, and the medication regimen of aspirin was adjusted according to the genetic testing results. Results: Genetic testing was performed on 50 patients with recurrent spontaneous abortion. Three genotypes GG, GA, and AA of the aspirin resistance genes CYP2C19 and CHIA were detected, and three genotypes AC, CC, and AA of gene LTC4S were detected. Two genotypes CC and CT of drug efficacy gene GP1BA were detected. All the genotypes detected of gene PTGS1 were AA. Based on the gene test results, the subsequent guidance of aspirin administration was provided to the patients. Among 50 patients with aspirin used, 21 cases had changed their treatment regimens, and 3 cases had continual their treatment regimens but required close monitoring of their drug adverse reactions. Conclusion: Aspirin pharmacogenomic testing for the patients with recurrent miscarriage can precisely guide their clinical drug used.

2024 Vol. 32　(9):　2157- [Abstract]（ 70 ） HTML (0 KB)  PDF  (0 KB)  ( 8 )

To explore the predictive value of the combined levels of serum human epididymal secretion protein 4 (HE4), transmembrane 4-L six-family-1 (TM4SF1) and heat shock protein 90α (HSP90α) of women with ovarian cancer (OC) for their postoperative recurrence. Methods: The clinical data of 122 women with OC (in group A) who had undergone surgical treatment in the hospital from October 2018 to December 2020 were selected in this study, and these women were divided into group A1 (85 women without OC recurrence) and group A2 (37 women with OC recurrence) according to the postoperative recurrence situation of these women within 3 years of follow up after surgery. 102 women with benign ovarian tumor who also had been treated in the hospital during the same period were included in group B, and 115 healthy women who had undergone physical examinations in the hospital were included in group C. The levels of serum HE4, TM4SF1, and HSP90α of the women were compared among group A, group B and group C. Logistic regression was applied to analyze the influencing factors of the postoperative OC recurrence of the women in group A. Receiver operating characteristic (ROC) curve was applied to analyze the predictive values of the levels of serum HE4, TM4SF1, and HSP90αof the women in group A for their postoperative OC recurrence. Results: The levels of serum HE4 (158.49±41.27 pmol/L), TM4SF1 (171.28±42.33 ng/ml) and HSP90α(79.22±15.38 ng/ml) of the women in group A were significantly higher than those (34.53±8.39 pmol/L, 111.18±25.46 ng/ml and 58.19±10.24 ng/ml) of the women in group B and those (33.31±8.12 pmol/L, 102.37±22.39 ng/ml and 56.22±9.27 ng/ml) of the women in group C. The serum HE4, TM4SF1, HSP90αlevels of the women in group A2 were significantly higher than those of the women in group A1 (all P<0.05), while which of the women in group B had no significantly different from those of the women in group C (P>0.05). Logistic regression analysis showed that the FIGO stage III, poor differentiation and lymph node metastasis of OC, and the increased levels of serum HE4, TM4SF1 and HSP90α of the women with OC were the influencing factors of their postoperative OC recurrence. ROC curve analysis showed that the area under curve (AUC) of the HE4 level, the TM4SF1 level, and the HSP90α level of the women with OC for predicting their postoperative OC recurrence were 0.874, 0.828 and 0.872, respectively, the sensitivity of which were 89.2%, 89.2% and 89.2%, respectively, and the specificity of which were 66.8%, 69.2% and 63.3%, respectively. The AUC, the sensitivity and the specificity of the combined levels of serum HE4, TM4SF1 and HSP90αof the women with OC for predicting their postoperative OC recurrence were 0.958, 86.5%, and 78.3%, respectively, and the AUC of the combined levels of serum HE4, TM4SF1 and HSP90α of the women with OC for predicting their postoperative OC recurrence was the best (P<0.05). Conclusion: The levels of serum HE4, TM4SF1, and HSP90α of the women with the postoperative OC recurrence all elevate abnormally, and which are the risk factors of the postoperative OC recurrence of the women. The combined levels of serum HE4, TM4SF1 and HSP90α of the women with OC for predicting their postoperative OC recurrence has certain value.

2024 Vol. 32　(9):　2165- [Abstract]（ 56 ） HTML (0 KB)  PDF  (0 KB)  ( 8 )

To explore the application value of chromosome microarray analysis (CMA) combined with chromosome karyotype analysis for diagnosing Down’s syndrome. Methods: The clinical data of 122 high-risk pregnant women who had undergone amniotic fluid puncture from December 2022 to December 2023 were collected retrospectively. The results of the fetal chromosome karyotype analysis was as the gold standard, the diagnostic accuracy rate of the fetal Down’s syndrome was compared among the free DNA detection technology, CMA and CMA combined with the free DNA detection technology. Receiver operator characteristic (ROC) curve was drawn to analyze the efficacy of the chromosome karyotype analysis, CMA and CMA combined with karyotype analysis for diagnosing Down’s syndrome. The results of the karyotype analysis and CMA were compared among the women with different high-risk prenatal diagnostic indications. The karyotype detection results of the women with fetal chromosome abnormalities were observed. Results: In 122 high-risk pregnant women who had been given routine amniotic fluid puncture for antenatal examination, there were 14 cases with the detected fetal Down’s syndrome, with the detection rate of 11.5%. The accuracy, the area under the curve (AUC), the sensitivity and the specificity of the karyotype analysis for diagnosing fetal Down’s syndrome were 92.6%(113/122), 0.808, 64.3% and 96.3%, respectively. The accuracy, the area under the curve (AUC), the sensitivity and the specificity of CMA for diagnosing fetal Down’s syndrome were 94.3% (115/122), 0.843, 71.4% and 97.2%, respectively. The diagnostic accuracy and AUC of the combination of the karyotype analysis and CMA for diagnosing fetal Down’s syndrome were significantly higher than those of the karyotype analysis or CMA alone (P<0.05). The numbers of fetal Down’s syndrome diagnosed by the karyotype analysis alone, CMA alone, and the combined detection of the karyotype analysis and CMA for the women with ultrasound fetal neck thickening of the transparent layer (NT) were 2 cases, 1 case and 2 cases, respectively. The numbers of fetal Down’s syndrome diagnosed by the karyotype analysis alone, CMA alone, and the combined detection of the karyotype analysis and CMA for the women aged >35 years old were 0 case, 1 case and 2 cases, respectively. The numbers of fetal Down’s syndrome diagnosed by the karyotype analysis alone, CMA alone, and the combined detection of the karyotype analysis and CMA for the women with abnormal noninvasive prenatal testing (NIPT) were 5 cases, 5 cases and 6 cases, respectively. The numbers of fetal Down’s syndrome diagnosed by the karyotype analysis, CMA and the combined detection of the karyotype analysis and CMA for the women with high-risk fetal Down’s syndrome were 2 cases, 2 cases and 3 cases, respectively. The women with the fetal karyotype abnormalities included 7 cases with the chromosome numerical abnormalities and 2 cases with the chromosome structural abnormalities. Conclusion: The combined CMA and karyotype analysis for diagnosing the fetal Down’s syndrome has the highest accuracy and sensitivity, and which has important reference value for diagnosing fetal Down’s syndrome in clinical antenatal diagnosis.

2024 Vol. 32　(9):　2177- [Abstract]（ 46 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

To explore the status and the influencing factors of the postpartum pelvic floor dysfunction (PFD) of women after vaginal delivery. Methods: 190 women who had successfully undergone vaginal delivery in the hospital from February 2019 to October 2023, and had PFD screened in the 42th day after delivery were selected in this study. According to the presence or absence of PFD, these women were divided into group A (women with PFD) and group B (women without PFD). The maternal clinical and delivery data, the laboratory indicators of the women in the two groups were collected. Univariate and logistic multivariate regression analysis were used to determine the PFD high-risk factors of the women after vaginal delivery. Results: The incidence of PFD of the women after vaginal delivery was 35.8%. Univariate analysis showed that there were significant differences in the age, the gestational weeks, the labor analgesia situation, the second stage of labor, the episiotomy situation, the neonatal weight and the 25-hydroxyvitamin D level of the women after vaginal delivery between group A and group B. Multi-factor analysis showed that the advanced age, the more gestational weeks, the long second stage of labor, the episiotomy and the high neonatal weight of the women were the independent risk factors of their postpartum PFD after vaginal delivery, and the high 25 hydroxy vitamin D level of the women was their protection factor of the postpartum PFD after vaginal delivery (all P<0.05). Conclusion: The incidence of the postpartum PFD of the women after vaginal delivery is still high, and the age ≥35 years old, >40 gestational weeks, the duration of the second stage of labor >1.5h, the episiotomy, the neonatal weight >3.5 kg and the low 25-hydroxyvitamin D level of the women are the risk factors of their postpartum PFD, so which should be great paid attention to in clinic, and the target nursing intervention measures should be conducted to promote the physical and mental health of the postpartum women.

2024 Vol. 32　(9):　2187- [Abstract]（ 74 ） HTML (0 KB)  PDF  (0 KB)  ( 9 )

To explore the influencing factors of the breastfeeding duration of parturients, and to establish a regression prediction model for the duration of breastfeeding of the parturients. Methods: A total of 262 parturients who had given birth in the hospital from December 2022 to December 2023 were selected as the research objects. According to whether exclusive breastfeeding of parturients was performed or not within 6 months after delivery, these parturients were divided into group A (the parturients with exclusive breastfeeding within 6 months after delivery) and group B (the parturients without exclusive breastfeeding within 6 months after delivery). The general demographic data and the related clinical characteristics of the parturients in the two groups were collected. Multivariate logistic regression model was used to determine the independent influencing factors of the exclusive breastfeeding of the parturients within 6 months after delivery, and the regression prediction model was established based on these influencing factors, and the goodness of fit and predictive value of the model were determined. Results: A total of 262 questionnaires were distributed in this study, and 254 valid questionnaires were recovered, with an effective recovery rate of 97.0%. Among 254 parturients, 91 parturients were exclusively breastfed within 6 months after delivery, accounting for 35.8%. Multivariate logistic regression analysis showed that the employment status and the conscious lack of breast milk of the parturients were the independent risk factors of their absence of exclusive breastfeeding within 6 months after the delivery. The breastfeeding experience, the support for breastfeeding by the family members and the high score of the breastfeeding knowledge of the parturients were the independent protective factors of their exclusive breastfeeding (all P<0.05). A regression prediction model was established based on the regression coefficients of these five independent influencing factors, Logit (P)= 6.878 + 2.378 ×employment status (on-the-job=1, off-the-job=0) -2.264 ×breastfeeding experience (yes=1, no=0) -1.553 × breastfeeding supported status of family members (support =1, neutral /no support=0) + 2.261 ×conscious lack of breast milk (yes=1, no=0) -0.482 × breastfeeding knowledge score (points). Hosmer-Lemeshow test showed that the model had good goodness of fit. ROC curve showed that the area under the curve (AUC) of the regression prediction model for predicting the absence of exclusive breastfeeding of the parturients within 6 months after delivery was 0.949 (95% CI 0.925-0.973). When the maximum value of the Youden index was 0.721, the best predictive sensitivity, specificity and accuracy of the model for predicting the absence of exclusive breastfeeding were 85.3% 86.8% and 85.8%, respectively. Conclusion: The regression prediction model constructed in this study has good predictive value for the duration of breastfeeding of the parturients, and which can provide evidences for the clinical prediction of the duration of breastfeeding of the parturients.

2024 Vol. 32　(9):　2197- [Abstract]（ 55 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )

With the extensive use of the plastic products, the pollution of the microplastics has been widely concerned. The microplastics not only causes the environmental pollution, but also poses a great threat to the biological safety. Some studies have been found that the microplastics accumulates in the biological reproductive system of the human, and which has the toxic effects on their reproductive system and embryos. In this paper, the toxicity mechanism of the microplastics for the reproductive and embryonic development is reviewed, in order to provide theoretical and scientific evidences for preventing and controlling the reproductive toxicity caused by microplastics, and to strengthen the people's awareness of the environmental protection for maintaining their reproductive health.

2024 Vol. 32　(9):　2209- [Abstract]（ 47 ） HTML (0 KB)  PDF  (0 KB)  ( 10 )