Objective To evaluate the clinical efficacy of methylprednisolone sodium succinate(MSS) as adjuvant therapy in the treatment of severe mycoplasma pneumoniae pneumonia in pediatric patients, and its impact on serum lactate dehydrogenase(LDH), C-reactive protein(CRP), and T lymphocyte subsets. Methods A total of 120 children with severe mycoplasma pneumonia admitted to the Department of Pediatrics at the Second Hospital of Hebei Medical University from January 2023 to January 2024 were selected. Three groups are divided, treatment group(conventional treatment and MSC) with 80 patients, including 40 patients treated with MSC for 3 days(Short-course group) and 40 patients for 5 days(extended group). The control group consisted of 40 cases receiving conventional treatment. Pairwise comparisons were conducted by comparing the time for body temperature to return to normal, resolution of cough and rales, as well as improvements in C-reactive protein(CRP) and lactate dehydrogenase(LDH) before and after treatment. Results Compared with the control group, the treatment group had a significantly shorter time for body temperature to return to normal, resolution of rales, and disappearance of cough(P<0.05), while there were no statistically significant differences for the parameters between the short-course and extended groups. In terms of inflammatory markers(CRP and LDH), there were no statistically significant differences between the two groups before treatment. After treatment, the improvement in the treatment group was better than that in the control group, with statistically significant differences. There were no statistically significant differences in the improvement of CRP and LDH before and after treatment within the treatment group. In the comparison of T lymphocyte subsets, the improvement of CD4⁺ and CD8⁺ in the treatment group was more significant compared to the control group, with statistically significant differences. There were no statistically significant differences in the improvement of CD4⁺ and CD8⁺ between the short-course and extended groups in the treatment group. Conclusion MSC as adjuvant therapy for children with severe mycoplasma pneumonia demonstrates significant clinical efficacy, which can shorten the the time for body temperature to return to normal, cough and rale to disappear, and can significantly improve the recovery of inflammatory indicators(CRP and LDH), thereby alleviating pain in children and shortening hospital stay.

目的 评估中重度新生儿缺氧缺血性脑病(HIE)亚低温(TH)治疗现状并探讨影响TH实施的因素。方法 回顾性分析2018年1月至2023年6月华中科技大学同济医学院附属湖北妇幼保健院新生儿重症监护病房收治的诊断中重度HIE且符合TH纳入标准的新生儿,收集母婴资料、医疗组织转运及TH治疗情况进行分析,采用单因素和多因素Logistic回归分析影响TH使用的因素。结果 54.1% 中重度HIE患儿未进行TH治疗,主要原因为超过TH治疗时间窗(55.6%),其次分别是患儿胎龄较小(16.0%)、实验室指标未达治疗标准(8.3%)、存在TH治疗禁忌症(14.6%)、家属放弃治疗(5.5%)。多因素分析显示,35~36周、中度HIE、市外转运患儿TH使用率较低,OR(95%CI)值分别为0.41(0.17~0.96)、0.27(0.14~0.52)、0.28(0.13~0.57)。结论 本研究中重度HIE患儿TH使用率偏低。胎龄35周 ~ 36周、中度HIE、市外转运的患儿TH使用率较低,需采取持续质量改进措施,加强HIE诊断与评估,提高TH使用率。

Objective To investigate the concentration and related factors of organophosphorus pesticides(OPs) exposure among pregnant women in their first trimester in Beijing. Methods Pregnant women in their first trimester were recruited at Beijing Obstetrics and Gynecology Hospital from July 2018 to October 2020. Questionnaires were used to collect the general demographic information of pregnant women and ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to determine the concentrations of six non-specific metabolites of OPs—dialkyl phosphates(DAPs) in the urine of pregnant women. Results A total of 232 pregnant women were included in the study. Detection rates of urinary DAPs ranged from 19.4% to 95.3%, with the detection rate of diethylphosphate(DEP) being the highest(95.3%). DEP and dimethylphosphate(DMP) were the major components of the six DAPs measured. The geometric mean(GM) concentration range of six DAPs was 0.07-17.28 ng/mg Cre after adjusted for creatinine, DEP and DMP were 17.28 ng/mg Cre and 6.46 ng/mg Cre, respectively. The results of multivariate linear regression analysis revealed that pre-pregnancy BMI was an influencing factor on the concentration of maternal organophosphorus exposure in early pregnancy, and the pregnant women with low pre-pregnancy BMI have higher concentrations of DAPs in their urine(P<0.05). Conclusion Pregnant women in their first trimester are widely exposed to organophosphorus pesticide in Beijing, and the overall exposure level was at a moderate level. The exposure was related to pre-pregnancy BMI, and attention needs to be paid to the impact of organophosphorus pesticide exposure during pregnancy on the health of mothers and infants.

塑料因其轻便、耐用、防水防潮、易于加工和成本低廉等优点,在现代社会被广泛使用。然而,这些优点也使塑料成为“隐形的杀手”。大量塑料分解产生数量更为庞大的微塑料,对人类健康产生了潜移默化的影响。本文结合了近年来国内外研究文献,系统综述了微塑料的来源及分类、对雌性哺乳动物生殖功能毒性的研究进展以及其作用机制,并对未来研究方向进行了展望。

目的 本研究旨在通过病例回顾研究,评估袋鼠式护理对新生儿高胆红素血症的治疗效果,关注其对光疗时间、峰值胆红素含量、住院时间及出院前24 h纯母乳喂养率的影响。方法 本研究回顾了2022年1月至2024年5月在火箭军特色医学中心儿科住院的112例胎龄≥35周的高胆红素血症新生儿,其中50例接受了袋鼠式护理作为袋鼠式护理组,62例未接受该护理者作为对照组。以光疗时间、峰值胆红素含量、住院时间及出院前24 h纯母乳喂养率为结局指标。结果 袋鼠式护理组新生儿的平均光疗时间[(23.4±8.2)h]显著短于对照组[(35.5±13.5)h,P<0.001],新生儿的平均住院时间[(4.2±2.1)d]也明显短于对照组[(6.2±3.9)d,P<0.001],但两组胆红素峰值[(15.8±1.9) vs.(15.7±1.9)mg/dL]和出院前24 h纯母乳喂养率(64.0% vs.46.8%)均无明显差异(P＞0.05)。结论 袋鼠式护理可以有效缩短高胆红素血症新生儿光疗时间以及住院时间,因此建议在临床实践中积极推广袋鼠式护理,以优化新生儿高胆红素血症的治疗效果。

目的 探究低度鳞状上皮内病变(LSIL)患者血清25羟基维生素D[25(OH)D]水平、阴道微生态变化与人乳头瘤病毒(HPV)感染的相关性。方法 选取本院2020年1月—2022年12月诊断为LSIL患者60例作为LSIL组,同期60例慢性宫颈炎患者作为慢性宫颈炎组及无宫颈病变的健康育龄女性60例作为对照组,检测各组血清25(OH)D水平、阴道微生态指标,并行HPV-DNA载量及亚型检测,分析血清25(OH)D水平、阴道微生态与LSIL及HPV持续感染的相关性。结果 对照组、慢性宫颈炎组、LSIL组血清25(OH)D水平呈逐渐降低趋势(P<0.05)。对照组、慢性宫颈炎组、LSIL组三组间菌群密度、菌群多样性、滴虫、乳酸杆菌、加德纳菌、pH值、孢子、唾液酸苷酶(SNA)阳性、白细胞酯酶(LE)阳性、阴道清洁度、Nugent评分、Donders评分异常情况比较差异显著(P<0.05),异常率呈上升趋势。对照组、慢性宫颈炎组、LSIL组HPV低危型感染率差异无统计学意义。LSIL组HPV高危型HPV-16、18等11个亚型的感染率与慢性宫颈炎组比较,差异具有(临界)统计学意义。根据HPV感染情况分为HPV阴性组和HPV阳性组,HPV阳性组慢性宫颈炎及LSIL患者较阴性组血清25(OH)D均出现不同程度下降,差异具有统计学意义。LSIL患者HPV阴性组和HPV阳性组菌群密度、菌群多样性、滴虫、乳酸杆菌、加德纳菌、pH值、孢子、唾液酸苷酶(SNA)阳性、白细胞酯酶(LE)阳性、阴道清洁度、Nugent评分、Donders评分异常比较,差异均具有统计学意义。Logistic回归分析结果表明阴道微生态异常、高危型HPV感染和25(OH)D降低为LSIL的风险因素(P<0.05)。结论 血清25(OH)D降低、阴道微生态变化及HPV感染与宫颈病变关系密切,并可能是LSIL患者HPV持续感染的发生发展的危险因素。

妊娠期高血压疾病(HDP)是一种妊娠期女性特有的疾病,以高血压、蛋白尿、心肝肾功能损害,甚至发生母儿死亡为临床特点。HDP对孕产妇和胎儿的危害不仅发生在妊娠时,与正常妊娠的女性相比,曾患有HDP的女性多年后罹患心血管疾病的风险增加。产后良好的自我管理可以有效减少远期心血管疾病的发病率、延迟发病时间。本综述总结目前慢性高血压患者的自我管理方案和妊娠高血压疾病患者产后的管理现状,并分析其优点及不足,为建立合理、全面的HDP自我管理方案,对患有HDP的女性产后进行健康指导及干预,改善远期健康提供支持帮助。

Objective The aim of this study was to quantify the contribution of different variables to the live birth outcome of In Vitro Fertilization and Embryo Transfer(IVF-ET) treatment and to identify the sensitive ranges of key variables, providing scientific decision-making references for clinicians and patients. Methods This retrospective cohort study was conducted based on an existing cohort, including a total of 5 859 fresh treatment cycles from the Reproductive Medicine Department of Yuhuangding Hospital in Yantai. A combination of univariate logistic regression analysis, multivariate Lasso regression analysis and random forest(RF) importance coefficient analysis was used for preliminary variable selection. Additionally, a literature search was conducted to supplement the preliminary variable set based on the correlation results of previous studies. The random forest algorithm was applied to construct a machine learning model with the selected variables, and the importance coefficients of the variables were calculated. Finally, partial dependence plots were used for quantitative analysis of key variables to determine their sensitive ranges. Results The live birth rate of fresh embryo transfer cycles included in this study was approximately 43%. Twenty-eight important variables were identified, with female age and the total number of high-quality embryos being the most important variables affecting the live birth outcome of embryo transfer. The success rate of live birth gradually decreased with increasing female age, and the decreasing trend became more pronounced when the female age was ≥37 years. When the total number of high-quality embryos reached 2, the probability of live birth increased to a peak and then leveled off. Conclusion Female patients undergoing IVF-ET fresh cycle treatment before the age of 37 and having a total of 2 high-quality embryos cultured are likely to achieve better live birth outcomes.

孤独症谱系障碍(ASD)起源于发育早期,通常为慢性终身性病程,可导致严重的疾病负担。本文以国内外发表的相关论文为基础,总结了ASD的病因学及流行状况研究进展,旨在为ASD的早期筛查和干预提供理论依据。结果发现主要的遗传因素包括单基因突变、拷贝数变异、多基因的相互作用和表观遗传学因素;主要的环境因素包括产前、围产期和产后危险因素环境暴露;流行趋势为:近年来患病率呈上升趋势,经济水平较高地区患病率更高,男性患病率高于女性。

Objective To explore the genes associated with oxidative stress response in the pathogenesis of type 1 diabetes mellitus(T1DM) in children. Methods The Genecards database was used to obtain the genes related to "oxidative stress (OS)", and the GEO dataset was used to GSE33440, which analyzed the gene expression of peripheral blood mononuclear cells of 16 children with type 1 diabetes mellitus (T1DM group) and 6 adult healthy controls (healthy subjects group) to determine the gene expression changes related to T1DM, and the molecular function and biological pathways of OS-related differential genes were explored by GO and KEGG enrichment analysis. Furthermore, combined with the single-cell transcriptome GSE141784 dataset, the dynamic changes of mRNA expression of candidate genes, the specificity of cell types and the biological processes involved in them were discussed. Results Compared with the healthy subjects, the expression of 250 genes in the T1DM group was increased and the expression of 296 genes decreased. GO and KEGG analyses showed that OS-DEGs were significantly enriched in C-type lectin receptor signaling pathway, lipid and atherosclerotic pathway, Salmonella infection pathway and toxoplasmosis pathway. Combined with PPI network analysis, 10 core differential genes were screened, including TLR4, PTGS2, IKBKG, etc. Single-cell data analysis showed that TLR4 and IKBKG were uniformly and highly expressed in all groups of cells during the pathogenesis of T1DM, while PTGS2 was mainly highly expressed in classical dendritic cells and macrophages. Conclusion TLR4, PTGS2 and IKBKG may be involved in the pathogenesis of T1DM by regulating oxidative stress, and TLR4 and PTGS2 may interact with each other.

Objective To observe the embryo development in vitro during pre-implantation using a time-lapse imaging culture system, and analyze the impact of fertilization methods on early embryo cleavage patterns and implantation outcomes. Methods Patients who entered the in vitro fertilization cycle at the Reproductive Medicine Department of Gulou Hospital in Nanjing from June 2022 to June 2023 were selected. A total of 130 cases of blastocyst culture and single blastocyst transfer cycles were selected from the time-lapse imaging culture system, and were divided into a conventional in vitro fertilization(IVF group, n=99) and an intracytoplasmic sperm injection(ICSI group, n=31) according to the method of fertilization, and a retrospective analysis was conducted. A total of 1422 embryos were obtained from the IVF group(n=1066) and the ICSI group(n=356), and 874 embryos were cultured to the blastocyst stage after 2PN, divided into the IVF group(n=641) and the ICSI group(n=233) according to the method of fertilization. The effects of different fertilization methods on cleavage patterns and blastocyst formation were analyzed, and the pregnancy outcomes of patients undergoing single blastocyst transfer in the IVF group(n=99) and the ICSI group(n=31) were tracked. Results Compared to the ICSI group, the IVF group had a significantly lower proportion of abnormal cleavage in the early embryo stage(P<0.01), and had better embryo development speed and cleavage synchronization; The blastocyst formation rate was significantly higher(P<0.05). In the normal cleavage mode, the rate of embryonic development was comparable between the two fertilization methods, with no significant difference in the blastocyst formation rate(P>0.05). The blastocyst formation rate for embryos with normal cleavage was significantly higher than that of embryos with abnormal cleavage(P<0.01). There was no significant difference in clinical pregnancy rate, miscarriage rate, and live birth rate among blastocysts derived from different fertilization and cleavage methods after transplantation(P>0.05). Conclusion Although the outcome of single blastocyst transfer is not affected by the method of fertilization, the overall blastocyst formation ability in ICSI cycles is lower than that in IVF cycles, which indicated that the fertilization method still has an impact on embryo utilization. In the daily clinical work, the selection of fertilization methods should be cautious, the indications for ICSI should be strictly controlled, ICSI operating procedures should be followed, and damage to oocytes should be minimized as much as possible. At the same time, single blastocyst transfer should be promoted to achieve optimal embryo selection, in order to improve pregnancy rates and reduce multiple pregnancies.

Objective To explore the effects of hypnotherapy combined with health education on menopausal symptoms Methods. Methods This study used prospective randomized controlled studies, 70 patients with mild to moderate menopause-related symptoms were selected as study participants from May 2019 to February 2022, and randomly divided into joint group and health education group according to a random number table 1∶1. Both groups were given perimenopausal health care related knowledge and health education, and the joint group was additionally given hypnotherapy to the patients twice a week for 4 weeks for a total of 8 sessions. The health education group was in a natural state after receiving health education. The modified Kupperman Rating Scale, Anxiety Self-rating Scale, Depression Self-rating Scale and Pittsburgh Sleep Quality Index Scale were used before the intervention and one month after the intervention to evaluate the two groups of patients. Results The median menopausal symptom score was 12.0(10.2, 15.2) in the joint group and 24.5(23.0, 30.0) in the health education group after 1 month of intervention, and the difference between the groups was statistically significant(P<0.05). One month after the intervention, the median scores of the anxiety self-assessment scale, depression self-assessment scale and Pittsburgh sleep scale in the joint group were 46.0(40.5, 50.0), 41.5(37.2, 43.0), 6.5(5.0, 11.0), which were significantly lower than the health education group of 51.0(48.0, 52.5), 50.0(45.7, 52.0), 12.5(11.0, 15.0), respectively(P<0.05). Conclusion Hypnotherapy combined with health education can effectively relieve menopausal symptoms, anxiety and depression, and improve sleep quality in perimenopausal patients.

目的 探究圆柱瘤蛋白(CYLD)介导TRAF6去泛素化调控NF-κB信号通路影响输卵管上皮细胞炎症水平的机制。方法 选取8～10周龄、性成熟但未交配生育的SPF级雌性SD大鼠,以大鼠输卵管上皮细胞为对象,采用LPS干预建立输卵管上皮细胞炎症模型。先设立免疫共沉淀组IP(si-NC组,si-CYLD组)、阳性对照组input(si-NC组,si-CYLD组)检测TRAF6、Ub(泛素分子)灰度;再分为oe-NC组,oe-CYLD组、oe-CYLD+oe-NC组、oe-CYLD+oe-TRAF6组。比较各组CYLD、TRAF6、NF-κBp65、p-p65、IkB-a、p-IkB-a表达、炎症因子含量及细胞活性。结果 oe-CYLD+oe-NC组的TRAF6灰度比oe-NC组浅;过表达各组均检测出NF-κBp65、p-p65、IkB-a、p-IkB-a与炎症因子,其中oe-NC组灰度最深、oe-CYLD组最浅、且oe-CYLD+oe-TRAF6组比oe-CYLD+oe-NC组灰度深;oe-CYLD组细胞活性最高,oe-NC组最低,oe-CYLD+oe-NC组细胞活性优于oe-CYLD+oe-TRAF6组。结论 CYLD高表达可减少TRAF6泛素化抑制NF-κB信号通路,从而降低输卵管炎症水平,改善输卵管炎性不孕。

Objective To investigate the pregnancy stress status of low-risk pregnant women in early pregnancy and explore its related factors. Methods In this study, we enrolled 416 pregnant women, aged 19-45 years, with gestational age <14 weeks, who attended the obstetrics outpatient clinic of Peking University Third Hospital during April 2022-December 2023 and were evaluated to be in the low-risk category by their doctors. The Pregnancy Stress Rating Scale(PSRS) was used to assess the pregnancy stress status of the pregnant women. The socio-demographic information, basic health condition and pregnancy status of the pregnant women were extracted from a self-administered questionnaire and medical records. Results The quartile distribution of total pregnancy stress in early pregnancy among low-risk pregnant women was 36.0(20.0, 57.0), and the dimension with the highest mean scores being "pressure to seek maternal and child safety services"; the number of births and a history of adverse maternal outcomes were influencing factors of the pregnancy stress status in early pregnancy. Conclusion Low-risk pregnant women have mild pregnancy stress in early period. Maternal adverse maternal history and number of deliveries were associated with maternal stress.

为了探究和比较不同类型脐动脉舒张末期血流消失胎儿的围产期结果,本研究采用系统回顾和荟萃分析的方法,检索了1990年1月—2022年9月在PubMed、Web of Science、Cochrane Library和Embase发表的相关研究,采用DerSimonian-Laird随机效应模型进行荟萃分析,采用Meta回归和多因素线性回归进行混杂因素调整,研究方案已在PROSPERO(CRD42022358537)注册。本研究共纳入了25项研究共3 413名血流消失胎儿,结果显示,脐动脉舒张末期血流消失胎儿与血流正常胎儿相比不良结果率更高,包括新生儿死亡(13.8％与2.5％),死产或胎死宫内(8.7％与2.4％),胎儿窘迫(51.7％与26.3％)和胎儿生长受限(68.4％与31.5％)等。持续血流消失胎儿与间断血流消失胎儿相比,分娩孕周更早,出生体重更低。因此,脐动脉舒张末期血流消失是脐动脉多普勒筛查不良预后的重要预测因子,而持续血流消失与更差的围产期结局相关。

Objective To screen the items suitable for the specific module of the infertility scale in the patient reported outcome instruments system for chronic disease (PROISCD-IN), and to lay the foundation for the development of a full scale. Methods Items were screened following a structured decision-making approach. Firstly, a topic group and core group were established and a pool of alternative items was proposed. After the first round of discussion, a preliminary scale was formed for pre-investigation. Infertility patients who attended the gynaecology and reproduction departments of Shunde Women′s and Children′s Hospital of Guangdong Medical University and staff working in the infertility clinic were interviewed in September-October 2022.The preliminary screening of items was completed using six methods including coefficient of variation, correlation coefficient, Cronbach′s alpha coefficient, factor analysis, patient importance score and medical importance score. The items were then modified and improved through discussions with experts, medical staffs and patients. Results Based on the six screening methods and the opinions of experts, medical staffs and patients, 14 items were finally selected to form a specific module of the infertility scale (PROISCD-IN). Conclusion The screening of specific module items in the PROISCD-IN outcome measurement scale for infertility patients was strictly adhered to, and the formed specific module has good reliability and validity, which can provide a scientific measurement tool for intergrating patient perspective evidence in the evaluation system of infertility patient.

目的 分析行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)不孕女性TORCH病原体感染对自然流产的影响。方法 选择2017年1月至2020年12月于山东大学附属生殖医院行IVF/ICSI-ET治疗的患者为研究对象,检测TORCH-免疫球蛋白M(IgM)和TORCH-免疫球蛋白G(IgG),随访患者自确立妊娠起至16个月记录妊娠结局,最终筛选出1 265名自然流产患者和4 562名正常分娩患者纳入研究,分析TORCH病原体感染与自然流产的关系。结果 倾向性评分匹配(PSM)前,巨细胞病毒(CMV)-IgM、单纯疱疹病毒(HSV)-IgM、风疹病毒(RV)-IgM会增加自然流产的发生。PSM后,CMV-IgM、HSV-IgM会增加自然流产的发生。CMV-IgM、HSV-IgM是自然流产的独立危险因素。结论 CMV感染、HSV感染与自然流产相关,应加强行IVF/ICSI-ET患者孕前的TORCH筛查并积极干预。

Objective To investigate the effect of transfer of low-grade single blastocyst transfer on Day 5 and high-grade single blastocyst on Day 6 on clinical pregnancy and perinatal outcomes in the freeze-thaw embryo transfer(FET) cycle. Methods A retrospective analysis was conducted among patients who underwent single blastocyst transplantation during the FET cycle(n=1991) at the Reproductive Medicine Department of Gulou Hospital Affiliated to Nanjing University School of Medicine from January 1, 2017 to June 30, 2022. Two groups are divided according to the embryo transfer period, low-grade single blastocyst transplantation group(Day 5, n=1083) and high-grade single blastocyst transplantation group(Day 6, n=908). The rate of clinical pregnancy, miscarriage, live birth, preterm birth, sex ratio and birth weight were compared, and subgroup analysis by age was conducted. Results There were no statistically significant differences in the clinical pregnancy rate(49.0% vs. 51.1%, P>0.05), miscarriage rate(20.3% vs. 24.4%, P>0.05), live birth rate(39.1% vs. 38.7%, P>0.05), preterm birth rate(10.6% vs. 14.5%, P>0.05), and birth weight(3381.1 ± 505.6 vs. 3502.1 ± 1845.0, P >0.05) between the low-grade single blastocyst transplantation group(Day 5) and high-grade single blastocyst transplantation group(Day 6), There was a statistical difference in the sex ratio of newborns(1.1 vs. 1.5, P<0.05), with a significantly higher proportion of male newborns born in the high-grade single blastocyst transplantation group(Day 6) compared to the low-grade single blastocyst transplantation group(Day 5). Meanwhile, after age stratification, it was found that for patients under 35 years old, the abortion rate in the low-grade single blastocyst transplantation group(Day 5) was significantly lower than that in the high-grade single blastocyst transplantation group(Day 6)(18.5% vs. 24.7%, P<0.05), and there was no statistically significant difference in the rate of clinical pregnancy and live birth. For patients aged ≥ 35 years old, there was no statistically significant difference in the rate of clinical pregnancy, abortion, and live birth between the two groups. Conclusion There is no statistically significant difference in clinical outcomes between the low-grade single blastocyst transplantation(Day 5) and high-grade single blastocyst transplantation(Day 6) in the FET cycle. However, high-grade single blastocyst transplantation in Day 6 may pose a risk of sex imbalance in newborns, and for younger patients, transplanting blastocysts in Day 6 may lead to an increase in miscarriage rates.

Objective To explore the serum molecular markers of different infiltration depth and tumor diameter of endometrial carcinoma Methods The clinicopathological data of 144 patients with endometrial cancer who underwent comprehensive staged surgery in the First Hospital of Shanxi Medical University from January 2018 to July 2023 were collected. The patient′s serum human epididymal protein E4 (HE4), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), Squamous cell carcinoma antigen (SCC), and alpha fetoprotein (AFP) levels at the time of admission were detected to analyze their relationships and the pathological parameters of EC. Logistic regression analysis was used to test the relationships and the endometrial cancer invasion depth ≥1/2 myometrial and the diameter of the tumor＞2 cm. The sensitivity, specificity and the receiver operating characteristics (ROC) curve were calculated in each index separately and combined to compare diagnostic efficiency. Results The expression level of HE4, CA125, CA199, and CEA in serum were statistically different between EC invasion depth＜1/2 myometrial and endometrial cancer invasion depth ≥1/2 myometrial (P＜0.05). CA125 and HE4 were statistically different in the diameter of tumor ≤ 2 cm and tumor diameter＞2 cm (P＜0.05). The sensitivity, specificity accuracy of CA125+CEA in the diagnosis of invasion depth ≥1/2, and accuracy of CA125+HE4 in the diagnosis of tumor diameter＞2 cm were relatively higher. The area under the ROC curve of CA125+HE4 in diagnosing depth ≥1/2 and the area under the ROC curve of CA125+CEA in diagnosing tumor diameter＞2 cm were larger than that of CA125 single diagnosis, CEA single diagnosis, and HE4 single diagnosis. Conclusion The combined detection of CA125 and CEA in serum supports diagnosing the invasion depth more than a half and the combined detection of CA125 and HE4 in serum supports diagnosing the tumor diameter greater than 2 cm and predicting high-risk factors of EC.

总结宁夏地区1例川崎病合并面神经麻痹患儿的临床资料和诊治经过,并结合文献进行复习,旨在提高临床医师对本病的认识。患儿,女,5月,主因“发热1周,口角歪斜3 d”入院。患儿临床表现为中度稽留热,右侧面瘫,颈部淋巴结肿大,血常规白细胞及C反应蛋白明显升高,抗感染治疗无效,考虑川崎病并发面神经麻痹,丙种球蛋白和阿司匹林治疗后体温恢复正常,炎症指标下降至正常,面瘫消失。川崎病偶可并发面神经麻痹,原发病治疗好转后,面神经麻痹多可自愈,不需特殊治疗,预后较好。

本文回顾性分析2例UBE3A基因突变导致Angelman综合征(AS)家系患者的临床表现及基因检测结果。UBE3A基因突变型变异少见,本文介绍了UBE3A基因两种新发突变,丰富了UBE3A基因突变谱,对于AS家系行遗传咨询和产前诊断具有重要意义。

目的 序贯检测可溶性血管内皮生长因子受体1(sFlt-1)/胎盘生长因子(PlGF)在子痫前期高危孕妇中随孕周变化趋势以确定最佳筛查时机及其对子痫前期(PE)的预测价值。方法 本研究为前瞻性研究,选取2022年7月—2023年7月于孕20周前在南京医科大学附属苏州医院暨苏州市立医院进行规律产检的具有PE高危因素的单胎孕妇577例,妊娠期内分为5个窗口期(妊娠≤20周、23～25周、28～30周、33～35周和≥36周)序贯检测sFlt-1/PlGF,比较最终发生PE孕妇(PE组,n=146)和未发生PE孕妇(未发生PE组,n=431)各窗口期的sFlt-1/PlGF比值。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),比较不同窗口期sFlt-1/PlGF比值对PE的预测价值。通过Kaplan-Meier生存曲线和COX比例风险回归分析sFlt-1/PlGF比值与PE发病时间的风险比例。结果 本研究中,高危人群中PE的发生率为25.3%(146/577),5个窗口期,PE组sFlt-1/PlGF均高于未发生PE组,除了20周前,其余4个窗口期两组间差异均存在统计学意义,且在28～30周时两组显示最大差异(z=-15.828)。将前四个孕周窗口期sflt-1/PlGF预测PE,除了孕20周前,其余三个窗口期的sFlt-1/PlGF对PE的发生均有预测能力(P均<0.05),其中28～30周时sFlt-1/PlGF的AUC(0.944)值最大;在28～30周时最佳截值为24.06,敏感度为82.9%,特异性为92.6%,PPV为43.9%,NPV为91.7%。生存曲线结果显示sFlt-1/PlGF四分位数各组的发病时间差异具有统计学意义,sFlt-1/PlGF越大,PE的中位发病时间越短;当sFlt-1/PlGF增加50%时,PE发病风险增加2.275倍。结论 在PE高危孕妇中sFlt-1/PlGF具有随孕周动态变化的趋势,对于PE及其发病时间均有良好的预测价值,28～30周为sFlt-1/PlGF的最佳筛查时间,当sFlt-1/PlGF≤24时可以排除90%以上的PE发生。

孤独症谱系障碍(ASD)是一种神经发育障碍性疾病,对儿童的健康及成年后的生活质量构成严重威胁,是5岁以下儿童致残的主要原因之一。ASD目前尚缺乏有效治疗药物,主要治疗途径为康复训练,通过早期发现、早期诊断、早期干预可不同程度改善患儿症状和预后。大多数儿童在3～4岁被正式确诊,少数典型症状明显的儿童可在18～24个月确诊,大部分ASD患儿在确诊时已经错过了更理想的干预窗口。为早期发现ASD,国际和国内学者进行了多项儿童ASD早期预测的研究。现对ASD早期预测的国内外进展情况进行综述。

Objective To examine the association between maternal exposure to airborne particulate matter during pregnancy and neonatal physical development status indicators and to evaluate the lag effects of particulate exposure to identify sensitive time windows. Methods This study included 14,148 mother-infant pairs from the Pregnancy Nutrition Intervention Program conducted in Hebei Province. Monthly average PM concentrations with a 1 km×1 km resolution were obtained from the China High Air Pollutants(CHAP) database. Exposure levels during first, second, and third trimesters, as well as the entire pregnancy period, were estimated using maternal residential addresses and gestational weeks. Neonatal physical development indicators were standardized as Z-scores by gestational age and sex according to Chinese reference standards. Multiple linear regression models were used to examine the associations between PM exposure and neonatal physical development status. Distributed lag linear models were applied to assess the lag effects of exposure at different pregnancy stages and determine critical windows of susceptibility. Results For every 10 μg/m³ increase in PM_2.5, PM₁₀, and PM_2.5-10 exposure during the entire pregnancy, the birth weight Z-score decreased by 0.03(95% CI:-0.04, -0.02), 0.03(95% CI:-0.04, -0.02), and 0.101(95% CI:-0.12, -0.08), respectively. Similar negative associations were found for birth length and head circumference, with the most significant effects observed for PM_2.5-10. Results from distributed lag linear models showed that early pregnancy and late pregnancy were critical windows for birth weight and length, while the sensitive window for head circumference was mainly in early pregnancy. Conclusion Maternal exposure to particulate matter during pregnancy is significantly associated with reduced neonatal physical development status, and the effect of PM_2.5-10 was the most prominent. Early and late pregnancy are critical windows for neonatal physical development affected by PM exposure. These findings provide important evidence to inform air pollution control and maternal health interventions.

双相情感障碍综合征是一种以情绪波动为主要特征的精神类疾病,以躁狂和抑郁反复发作和交替发作为特征,患者常常经历抑郁、躁狂、焦虑等情绪波动,可导致患者发生性功能障碍、不育,影响社交、工作、学习、劳动等能力,甚至给他人造成危险或不良后果等。对于患有这种疾病的已婚男性来说,如何生育子代同样也是一个重要、敏感且复杂的问题。本文将通过回顾1例患有双相情感障碍的已婚男性提出供精辅助生殖技术助孕的需求后,经过本院生殖医学伦理委员会讨论后准予实施的病例来引发该类疾病所涉及的伦理问题的思考,以供临床参考

Objective To explore the impact of worries about infection on pregnant and postpartum women's mental health and protective behaviors after releasing the Covid-19 pandemic control measures in China. Methods A total of 206 pregnant and postpartum women across the country were invited to complete the survey including Patient Health Questionnaire(PHQ-9), Generalized Anxiety Disorder scale(GAD-7), and Positive and Negative Affect Scale(PANAS). Results Worries about infection was positively correlated with uncertainty(r=0.452, P<0.01) and participation in protective behaviors(r=0.288, P<0.01), and was positively correlated with anxiety(r=0.383, P<0.01) and depression(r=0.179, P<0.01). Negative affect was positively correlated with anxiety(r=0.594, P<0.01) and depression(r=0.565, P<0.01). Uncertainty moderated the effect of worries about infection on protective behaviors. Negative affect partially mediated the impact of worries about infection on anxiety [0.504, 1.273], and depression [0.577, 1.394]. Conclusion Worries about infection predicted the participation of pregnant and postpartum women in protective behaviors, and this predictive effect was moderated by uncertainty. Worries about infection predicted anxiety and depression in pregnant and postpartum women by influencing negative affect.

Objective To describe phthalate(PAEs) concentrations in hair samples and explore the association between life behaviors and living conditions with hair concentrations of PAEs among participants with gestational hypertension(GH) in Beijing, China. Methods This study was based on the pregnancy cohort established by Beijing Haidian District Maternal and Child Health Hospital and the Institute of Reproductive and Child Health at Peking University. 2,731 pregnant women were recruited and completed follow-up from October 2017 to October 2018. According to the specific inclusion and exclusion standardization, a total of 206 GH women were included as participants in this study. We collected hair samples and baseline data on general characteristics, life behaviors and living conditions through questionnaires; we obtained follow-up data through the hospital's electronic medical record system. 12 components of PAEs in hair samples were detected by gas chromatography-coupled triple quadrupole mass spectrometry(GC-MS/MS). The median and quartiles were applied to characterize the distribution of PAEs concentrations, and logistic regression model was applied to explore the association between life behaviors and living conditions with PAEs levels. Results The detection rates of 12 PAEs in hair samples were more than 70%. The highest hair concentration was found in bis(2-ethylhexyl) phthalate(DEHP), with a median hair concentration of 7 770.2 ng/g. Cooking in the kitchen more than once a week in the last month was significantly associated with a higher level of diallyl phthalate(DAP) in hair among GH women(adjusted OR=2.52, 95%CI:1.17-5.44); not using cosmetics was significantly associated with a lower level of bis(2-methoxyethyl)phthalate(DMEP) in hair(adjusted OR=0.28, 95%CI:0.09-0.87); and home decoration in the last 1 year was significantly associated with a higher level of DMEP in hair(OR=3.09, 95%CI:1.24-7.68). Conclusion PAEs were commonly detected in the hair of GH women in Beijing, of which DEHP showed the highest concentration of 12 components. We found significant associations between various life behaviors and living conditions and specific PAEs exposures. Cooking in the kitchen and home decoration might be risk factors for exposure to DAP and DMEP, respectively. Not using cosmetics might be a protective factor to reduce exposure to DMEP.

Objective To compare the blood lipid concentrations between full-term newborns and late preterm newborns, and to explore related influencing factors. Methods A retrospective case-control study was conducted among pregnant women who underwent prenatal check ups and gave birth at Peking University People's Hospital from January to December 2020, as well as newborns admitted to the pediatric department. The study participants were divided into two groups based on the gestational age at delivery:full-term delivery group(gestational age ≥ 37 weeks) and late preterm delivery group(34 weeks ≤ gestational age<37 weeks). Newborns were also categorized into two groups based on their birth gestational age:full-term newborns(gestational age ≥ 37) and late preterm newborns(34 weeks ≤ gestation age<37). General basic characteristics information and lipid profiles of newborns and pregnant mothers were collected. Spearman rank correlation analysis and logistic regression models were used to analyze the correlation between maternal lipid concentrations and preterm delivery. Results 99 cases were included in the full-term newborn group, and 92 cases were included in the late preterm newborn group. The rate of cesarean section, the proportion of mothers with comorbid hyperuricemia and diabetes in the late preterm newborn group were higher than those in the full-term newborn group. After birth, serum total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), and low-density lipoprotein cholesterol(LDL-C) concentrations in the late preterm newborn group were higher than those in the full-term newborn group, while triglyceride(TG) concentrations were lower. Maternal TC and LDL-C in the early and late stages of pregnancy, as well as TC, TG, HDL-C, and LDL-C in the late stage of pregnancy in the late preterm newborn group, were lower than those in the full-term newborn group. Overall, newborn TG was positively correlated with gestational age and birth weight, while TC, HDL-C, and LDL-C were negatively correlated with gestational age and weight. Newborn TC was positively correlated with maternal TC in early pregnancy, newborn TG was positively correlated with maternal TG in late pregnancy, and newborn HDL was positively correlated with maternal HDL-C in each stage of pregnancy. No correlation was found between newborn LDL-C and maternal LDL-C during pregnancy. For mothers, a total of 185 cases were included in the late preterm delivery group and 2 330 cases in the full-term delivery group. With the changes in maternal mid-pregnancy TC, LDL-C, and late-pregnancy TC, TG, HDL-C, and LDL-C concentrations, there was a correlation with late preterm delivery. Conclusion There is a correlation between the blood lipid levels of newborns and their gestational age, birth weight, and maternal blood lipid levels. Abnormal blood lipids during pregnancy are associated with the risk of premature birth in pregnant women. Accurate management of maternal and neonatal blood lipid levels is of great significance for the short-term and long-term health of the mother and offspring.

产前超声是孕期最重要的检查,受孕周、声强、检查者经验等因素的影响,超声图像质量并不稳定。精准医疗是时下的一个热点,如何将人工智能与产前超声相结合,数据模型的建立是目前研究的热点和难点。文献复习结果表明,面临着数据来源各异、数量庞大、处理技术壁垒等问题,深度学习(DL)与产前超声相结合,可帮助优化图像质量,缩短检查时间,减轻临床负担,为产前超声自动化识别与测量方面提供便利。

转移性宫颈癌预后差,复发率高,目前尚无有效治疗方案,靶向治疗和免疫治疗可能使部分患者获益,从而延长生存期。本例转移性宫颈癌在传统治疗方案的基础上加用靶向治疗及免疫治疗,治疗后病灶基本消失,短期内未复发,治疗过程中并无严重不良反应发生,患者耐受较好。

目的 探讨妊娠期糖尿病(GDM)孕妇脐带血源外泌体LRG1和ECM1表达情况。方法 选取GDM孕妇15例,同期产检的健康孕妇(NGT)15例,收集两组脐带血,分离提取外泌体,利用免疫印迹和ELISA方法检测外泌体LRG1和ECM1含量。结果 GDM组脐带血源外泌体LRG1和ECM1水平均显著高于NGT组(P<0.05)。结论 脐带血源外泌体LRG1和ECM1可能与GDM发生发展有关,值得深入研究。

为了总结妊娠期女性亲密伴侣暴力管理的最佳证据,本文根据6S金字塔模型自上而下进行检索,系统查询国内外数据库和网站包括临床决策、指南、证据总结、系统评价和专家意见,检索时限为建库至2023年12月31日。最终纳入16篇文献,包括2篇临床决策、4篇指南、1篇证据总结、7篇系统评价和2篇专家意见。从筛查、评估、应对与预防4个维度总结了19条最佳证据,可为临床医护人员实践提供参考。实践过程中应根据具体临床情况结合专业判断、孕妇需求,以确保亲密伴侣暴力管理的有效性和安全性,从而降低亲密伴侣暴力带来的不良影响。

子痫前期(preeclampsia,PE)是妊娠期高血压疾病中发病率最高的一种,可对母婴妊娠结局造成较大影响。随着技术的进步,基因位点的单核苷酸多态性(single-nucleotide polymorphism,SNP)已经成为公认的第三代遗传标记,被广泛应用于分子诊断和遗传疾病等领域,大量PE易感基因及易感 SNP 位点被相继报道.基于PE的复杂性,进行多位点的SNP分析,对认识PE的发病机制并从遗传学角度预测PE的易感性具有重要的科学意义,本文就近年来所发现的PE相关基因SNP研究进行总结分析。

产后出血(PPH)是导致全球孕产妇死亡的重要原因,尤其在发展中国家负担较重。尽管已明确多种风险因素,但目前临床缺乏有效的PPH预测工具。近年来,人工智能(AI)和机器学习(ML)技术在妇产科领域逐渐应用,但在PPH风险预测方面研究仍较少。与传统方法相比,ML能够处理复杂非线性关系和多维数据,可显著提高预测的准确性和灵敏度。然而,现有模型多存在外部验证不足、数据集特征复杂等问题。未来研究应聚焦于高质量大数据分析,开发可靠的PPH定量预测模型,并在不同人群中验证其通用性。

Objective The impact of obstructive sleep apnoea (OSA) on polycystic ovary syndrome (PCOS) has not been extensively investigated. This study aims to investigate the occurrence of OSA in patients with PCOS and to elucidate the effect of OSA on the clinical features of PCOS patients and patients with PCOS alone. Methods PCOS patients who received infertility treatment at Peking University Third Hospital from January 2019 to August 2022 were included. Multiple physiological parameters, including physical indicators, sex hormone levels, inflammation and coagulation indicators, liver and kidney function were measured according to routine clinical measurements. Portable sleep monitoring was performed using Apnealink Plus from ResMed Ltd., Australia, and OSA was classified as mild, moderate, and severe based on respiratory distress index, AHI and nighttime minimum oxygen saturation. Results A total of 687 patients with PCOS were included in this study. Among them, 47% of PCOS patients were complicated with OSA, and 28 patients had severe OSA, accounting for 4%. The body mass index, the proportion of patients with hyperandrogenism (HA) and the proportion of insulin resistance (IR) increased in PCOS & OSA group (P<0.05). In terms of sex hormone, concentration of testosterone and free testosterone index (FAI) in PCOS & OSA group were higher than those in PCOS group alone, while progesterone (P), anti Mullerian hormone (AMH), and sex hormone binding globulin (SHBG) were lower than those in PCOS group alone (P<0.05). In terms of glucose and lipid metabolism indicators,glycated hemoglobin (HbA1c), fasting blood glucose level (Glu0), blood glucose level 30 minutes after oral administration of 75 g glucose (Glu30), blood glucose level 6 minutes after oral administration of 75 g glucose (Glu60), blood glucose level 12 minutes after oral administration of 75 g glucose (Glu120), fasting insulin level (INS0), serum insulin level 30 minutes after oral administration of 75 g glucose (INS30), serum insulin level 60 minutes after oral administration of 75 g glucose (INS60), serum insulin level 120 minutes after oral administration of 75 g glucose (INS120), steady-state model evaluation of insulin resistance index (HOMA-IR), steady-state model insulin secretion index (HOMA - β), beta cell function index (MBCI), low density lipoprotein (LDL) and triglycerides (TG) of PCOS & OSA patients were higher than those of PCOS patients alone. HDL was lower than that of PCOS patients (P<0.05). The US-CRP and prothrombin activity in PCOS & OSA patients were higher than those in PCOS alone (P<0.05). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and cystatin C in PCOS & OSA patients were higher than those in PCOS patients alone (P<0.05). Logistic regression analysis showed that higher high body mass index (BMI) (OR=8.51) and elevated glycosylated hemoglobin (OR=21.76) were associated with high incidence rate of OSA (P<0.05). Conclusion OSA has a high prevalence in Chinese female PCOS patients, and has negative effects on various clinical manifestations of these patients, such as body mass index, sex hormone levels, glucose and lipid metabolism, inflammation, coagulation and biochemical indicators, which worsen with the severity of OSA. High serum HbA1c level was associated with the onset of OSA in Chinese female PCOS patients. In the diagnosis and treatment of PCOS patients in China, attention should be paid to OSA, and corresponding health management and intervention should be provided.

Objective To investigate the impact of gestational diabetes mellitus(GDM) on social behavior in rat offspring. Methods Female Sprague-Dawley rats at 4 weeks of age were randomly divided into a control group(CON) and a gestational diabetes group(GDM) based on body weight. The GDM group was induced with a high-fat diet(HFD) and a low-dose injection of streptozotocin(STZ, 30 mg/kg·bw) to establish the disease model. After natural delivery, the offspring were subjected to open field test(OFT), elevated plus maze test(EPM), novel object recognition test(NOR), and three-chamber social test(3-CST) at three time points:postnatal day 21(PND 21, weaning), PND 56(sexual maturation), and PND 98(adulthood) to evaluate their social behavior. The concentrations of interleukin-1β(IL-1β), IL-4, IL-6 and IL-10 in offspring hippocampal tissues were measured at each time point. Results Compared to the CON group, female offspring in the GDM group showed a significant decrease in spontaneous activity scores in the OFT at PND 98(P<0.05). Male offspring in the GDM group exhibited a significant decrease in the percentage of time spent in the open arms in the EPM at PND 98(P<0.05). In the NOR, female offspring in the GDM group showed a significant decrease in the novelty preference index at PND 21(P<0.05). In the 3-CST, female offspring in the GDM group had a significant decrease in the social preference index at PND 21, and male offspring in the GDM group had a significant decrease in the social preference index at PND 98(P<0.05). The social novelty preference index was also significantly decreased in both male and female offspring in the GDM group at PND 98(P<0.05). In the hippocampus, compared to the CON group, among female offspring in the GDM group, the relative expression of p-ERK and p-CREB increased significantly while the relative expression of BDNF protein decreased significantly at PND 21(P<0.05), and the relative expression of p-TrkB decreased significantly at PND 56(P<0.05), and the relative expression of p-ERK and BDNF decreased significantly at PND 98(P<0.05). Compared to the CON group, among male offspring in the GDM group, the relative expression of p-ERK increased significantly while the relative expression of p-CREB decreased significantly at PND 21(P<0.05), the relative expression of p-TrkB decreased significantly at PND 56(P<0.05), and the relative expression of p-ERK decreased significantly at PND 98(P<0.05). Compared to the CON group, female offspring in the GDM group showed a significant decrease on the concentration of hippocampal IL-1β, IL-4 and IL-6 at PND 21(P<0.05), and their hippocampal IL-6 concentration had significantly increased at PND 56(P<0.05), and the IL-4 concentration decreased significantly, while the IL-10 concentration increased significantly at PND 98(P<0.05). Male offspring in the GDM group showed a significant decrease on the concentration of hippocampal IL-4, IL-6 and IL-10 at PND 21(P<0.05), and a significant increase on concentration of hippocampal IL-1β and IL-10 at PND 56(P<0.05), and their IL-4 concentration decreased significantly, while the IL-6 concentration increased significantly at PND 98(P<0.05). Conclusion The social behavior of GDM offspring does not show significant changes in early life but exhibits noticeable social impairments in adulthood, without significant gender specificity.

目的 评估Septin9甲基化检测在宫颈癌筛查中的应用价值。方法 选择2019年10月至2022年9月在青海红十字医院及本院全省医联体医院行宫颈癌筛查(高危HPV和TCT)的女性患者768例,其筛查结果符合转诊阴道镜活检指征并行Septin9甲基化检测与阴道镜活检组织病理学检测。以宫颈组织病理学结果作为金标准,将研究对象分为阴性组(组织病理学结果阴性及宫颈炎症)和阳性组(LSIL、HSIL、宫颈癌)。分别分析高危HPV检测、TCT、Septin9甲基化检测在各组织病理学检测结果中的检出率,以及Septin9甲基化检出率与宫颈病变程度之间是否存在关系;探讨与高危HPV检测、TCT、高危HPV检测联合TCT相比,Septin9甲基化检测对宫颈癌及癌前病变的诊断效能。结果 两组研究对象的基本特征比较,结果差异均无统计学意义(P均＞0.05),两组具有可比性;高危HPV检测、TCT在四组组织病理学检测结果中的检出率存在统计学差异(P均＜0.001);Septin9甲基化检测在各组织病理学检测结果中的检出率分别为:正常宫颈/宫颈炎为16.50%(68/412)、LSIL 为76.12%(153/201)、HSIL为96.35%(132/137)、宫颈癌为100%(18/18),四组阳性检出率存在统计学差异(P＜0.001),Septin9甲基化检出率与宫颈病变程度之间存在线性趋势(P＜0.05);与高危HPV检测相比,Septin9甲基化检测的特异度、阳性预测值、准确率及AUC较高(P均＜0.05),而灵敏度与阴性预测值无统计学差异(P均＞0.05);与TCT相比,Septin9基因甲基化检测的灵敏度、阴性预测值、准确率及AUC较高(P均＜0.05);而特异度与阳性预测值无统计学差异(P均＞0.05);与高危HPV联合TCT相比,Septin9基因甲基化检测的灵敏度、阴性预测值较高(P均＜0.05),而特异度、阳性预测值不及高危HPV联合TCT检测(P均＜0.05),其准确率与AUC与两者联合筛查对比差异无统计学意义(P均＞0.05)。结论 Septin9甲基化阳性检出率随着宫颈病变程度的增加逐渐升高,对HSIL与宫颈癌的阳性检出率较高。Septin9甲基化检测对高危HPV分流具有较高效能;高危HPV检测、TCT单独筛查时,Septin9甲基化检测较两者对宫颈癌及癌前病变的诊断效能更佳;两者联合筛查时,Septin9甲基化检测与两者联合筛查对宫颈癌及癌前病变的诊断效能相当。在转诊阴道镜活检之前先行Septin9甲基化检测能降低部分患者阴道镜活检转诊率。

目的 分析妊娠期糖尿病(GDM)孕妇以及单纯胰岛素释放异常孕妇的妊娠结局。方法 回顾性收集2022年8月—2023年1月山西医科大学第一医院收治的612例孕妇作为研究对象,根据孕24~28周OGTT试验和胰岛素释放试验结果,分为GDM组271例、胰岛素释放异常组263例以及对照组78例,比较三组孕妇一般情况以及不良妊娠结局。结果 与对照组比较,GDM组和胰岛素释放异常组甲状腺功能减退、胎膜早破以及高脂血症发生率显著升高(P＜0.05),GDM组剖宫产、子痫前期、高尿酸血症、新生儿高胆红素血症、早产及转儿科发生率显著升高(P＜0.05)。与胰岛素释放异常组比较,GDM组剖宫产、子痫前期、高脂血症、早产发生率显著升高(P＜0.05)。多因素Logistic回归分析结果显示,孕前BMI(OR＝1.16,95%CI为1.10~1.22),糖尿病家族史(OR＝2.62,95%CI为1.29~5.32)均是GDM发生的独立危险因素(P＜0.05)。结论 妊娠期糖尿病和单纯胰岛素释放异常孕妇不良妊娠结局发生率均高,加强对妊娠期糖尿病孕妇及单纯胰岛素释放异常孕妇的管理,可改善母婴结局。