Chronic obstructive pulmonary disease (COPD) poses global health challenges owing to limited treatment options and high rates of morbidity and mortality. Airway organoids have recently become a valuable resource for the investigation of respiratory diseases. However, limited access to clinical tissue samples hinders the use of airway organoids to study COPD. Therefore, alternative models that can mimic human airway pathology without relying on human tissues are needed. In this study, airway organoids were developed from tracheal epithelial cells obtained from 8-week-old Sprague-Dawley rats and exposed to lipopolysaccharide (LPS) to induce COPD-like characteristics. Exposure to LPS leads to structural changes in organoids, including an increase in goblet cells, a decrease in ciliated cells, increased mucin production, and elevated levels of pro-inflammatory cytokines. The COPD drugs erdosteine and R-HP210 effectively reduced mucin secretion, although none was able to restore the function of ciliated cells. Inflammatory markers responded differently, with ensifentrine and erdosteine significantly reducing cytokine levels. These results demonstrate that rat airway organoids replicate important aspects of human COPD pathology, thus providing an accessible, ethical, and clinically relevant alternative to human tissues and traditional animal models to enhance our understanding of COPD pathogenesis and evaluate potential treatments.

OBJECTIVE:As the first model in predicting the failure of early medical abortion (EMA) was inefficient, this study aims to develop and validate a risk assessment model for predicting the failure of EMAs more accurately in a clinical setting. METHODS:The derivation cohort was obtained from a comprehensive systematic review and meta-analysis. The clinically significant risk factors were identified and combined with their corresponding odds ratios to establish a risk assessment model. The risk factors were assigned scores based on their respective weightings. The model's performance was evaluated by an external validation cohort obtained from a tertiary hospital. The outcome was defined as the incidence of EMA failure. RESULTS:A total of 126,420 patients who had undergone medical abortions were included in the systematic review and meta-analysis, and the pooled failure rate was 6.7%. The final risk factors consisted of gestational age, maternal age, parity, previous termination of pregnancy, marital status, type of residence, and differences between gestational age calculated using the last menstrual period and that measured via ultrasound. The risk factors were assigned scores based on their respective weightings, with a maximum score of 19. The clinical prediction model exhibited a good discrimination, as validated by external verification (402 patients) with an area under the curve of 0.857 (95% confidence interval 0.804-0.910). The optimal cutoff value was determined to be 13.5 points, yielding a sensitivity of 83.3% and specificity of 75.4%. CONCLUSION:This study effectively establishes a simple risk assessment model including seven routinely available clinical parameters for predicting EMA failure. In preliminary validation, this model demonstrates good performance in terms of predictive efficiency, accuracy, calibration, and clinical benefit. However, more research and validation are warranted for future application. TRIAL REGISTRATION NUMBER:CRD42023485388.

Ovarian cancer (OvCa) is characterized by early metastasis and high mortality rates, underscoring the need for deeper understanding of these aspects. This study explores the role of glucose transporter 3 (GLUT3) driven by zinc finger E-box-binding homeobox 1 (ZEB1) in OvCa progression and metastasis. Specifically, this study explored whether ZEB1 promotes glycolysis and assessed the potential involvement of GLUT3 in this process in OvCa cells. Our findings revealed that ZEB1 and GLUT3 were excessively expressed and closely correlated in OvCa. Mechanistically, ZEB1 activates the transcription of GLUT3 by binding to its promoter region. Increased expression of GLUT3 driven by ZEB1 dramatically enhances glycolysis, and thus fuels Warburg Effect to promote OvCa progression and metastasis. Consistently, elevated ZEB1 and GLUT3 expression in clinical OvCa is correlated with poor prognosis, reinforcing the profound contribution of ZEB1-GLUT3 axis to OvCa. These results suggest that activation of GLUT3 expression by ZEB1 is crucial for the proliferation and metastasis of OvCa via fueling glycolysis, shedding new light on OvCa treatment.

Cervical squamous cell carcinoma (CSCC) is a prevalent gynecological malignancy worldwide. Current treatments for CSCC can impact fertility and cause long-term complications, underscoring the need for new therapeutic strategies. Oncolytic virotherapy has emerged as a promising option for cancer treatment. Previous research has demonstrated the oncolytic activity of the coxsackievirus B3 strain 2035 A (CVB3/2035A) against various tumor types. This study aims to evaluate the clinical viability of CVB3/2035A for CSCC treatment, focusing on its oncolytic effect in patient-derived CSCC organoids. The oncolytic effects of CVB3/2035A were investigated using human CSCC cell lines in vitro and mouse xenograft models in vivo. Preliminary tests for tumor-selectivity were conducted on patient-derived CSCC tissue samples and compared to normal cervical tissues ex vivo. Three patient-derived CSCC organoid lines were developed and treated with CVB3/2035A alone and in combination with paclitaxel. Both cytotoxicity and virus replication were evaluated in vitro. CVB3/2035A exhibited significant cytotoxic effects in human CSCC cell lines and xenograft mouse models. The virus selectively induced oncolysis in patient-derived CSCC tissue samples while sparing normal cervical tissues ex vivo. In patient-derived CSCC organoids, which retained the immunohistological characteristics of the original tumors, CVB3/2035A also demonstrated significant cytotoxic effects and efficient replication, as evidenced by increased viral titers and presence of viral nucleic acids and proteins. Notably, the combination of CVB3/2035A and paclitaxel resulted in enhanced cytotoxicity and viral replication. CVB3/2035A showed oncolytic activity in CSCC cell lines, xenografts, and patient-derived tissue cultures and organoids. Furthermore, the virus exhibited synergistic anti-tumor effects with paclitaxel against CSCC. These results suggest CVB3/2035A could serve as an alternative or adjunct to current CSCC chemotherapy regimens.

目的 分析HPV52 和HPV58 感染与患者发生宫颈上皮病变风险的相关性.方法 选取2018年10月至2021年10月进行检查的 816例人乳头瘤病毒(HPV)感染者,患者分别接受宫颈液基薄层细胞学(TCT)检查、HPV基因分型检测、阴道微生态检查.将感染高危型HPV且TCT结果为宫颈上皮病变的294例患者分为低级别鳞状上皮病变组(LSIL)138例、高级别鳞状上皮病变组(HSIL)127例、宫颈癌组29例.分析不同宫颈上皮病变程度患者感染高危型HPV的型别分布情况,评估HPV52 和HPV58 感染、阴道微生态异常与宫颈上皮病变程度的相关性.结果 816例HPV感染者中检出高危型 HPV 感染者294例,其中感染率较高的型别是 HPV16、52、58,感染率分别为36.73%、15.99%、13.95%.LSIL组、HSIL组、宫颈癌组患者的HPV52 和HPV58 感染率以及pH值、白细胞酯酶、唾液酸苷酶、过氧化氢(H2O2)阳性率随着宫颈上皮病变程度加重而依次递升(P＜0.05).结论 HPV16、52、58 属于高危型HPV感染型别,其中HPV52 和HPV58 感染、阴道微生态异常与宫颈上皮病变程度呈正相关,感染率和阳性率随着宫颈上皮病变程度加重而升高.

目的 分析多囊卵巢综合征(PCOS)患者血清微RNA(miRNA)-29a、miR-143-3p表达与肥胖、糖脂代谢和胰岛素抵抗(IR)的关系.方法 选取 2019 年 6 月至 2022 年 6 月厦门大学附属中山医院(以下简称"我院")收治的 86 例PCOS患者为PCOS组,另选取我院同期 49 名体检健康志愿者为对照组.根据体重指数(BMI)将PCOS患者分为肥胖组(36例)与非肥胖组(50例),根据稳态模型评估(HOMA)-IR分为IR组(61例)与非IR组(25例).比较各组血清miR-29a、miR-143-3p表达,肥胖指标[BMI、腰臀比(WHR)]、糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]及HOMA-IR;分析PCOS患者血清miR-29a、miR-143-3p表达与肥胖指标、糖脂代谢指标和HOMA-IR的相关性.结果 PCOS组BMI、WHR、FBG、FINS、HOMA-IR、TC、TG、LDL-C、miR-29a、miR-143-3p高于对照组,HDL-C低于对照组(P＜0.05).肥胖组血清miR-29a、miR-143-3p表达高于非肥胖组(P＜0.05).IR组血清miR-29a、miR-143-3p表达高于非IR组(P＜0.05).PCOS患者血清miR-29a、miR-143-3p表达与BMI、WHR、FBG、FINS、HOMA-IR、TC、TG、LDL-C 呈正相关(r/rs＞0,P＜0.01),与 HDL-C 呈负相关(r＜0,P＜0.01).结论 PCOS 患者血清miR-29a、miR-143-3p高表达,与肥胖、糖脂代谢和IR密切相关.

Background: Solid pseudopapillary neoplasms (SPNs) are uncommon tumors of low malignancy with a generally favorable prognosis, mostly originating from the pancreas. To date, 12 cases of SPNs with a primary ovarian origin (SPN–Os) have been reported globally, and their detailed characteristics have not been fully elucidated. Case description: We reported the 13th SPN-O case, which occurred in a 52-year-old woman with an 18.5 cm left ovarian mass. Four imaging methods, including ultrasound, computed tomography, magnetic resonance imaging and positron emission tomography, were utilized before surgery. An elevated level of serum cancer antigen 125 was detected and a total hysterectomy plus bilateral salpingo-oophorectomy was performed. Microscopic examination revealed a typical solid pseudopapillary structure. The tumor cells were stained focally for pan-cytokeratin, synaptophysin, CD99 and CD10, while β-catenin, vimentin and CD56 were diffusely expressed. The Ki-67 proliferation index was 3%, and immunohistochemical (IHC) staining for chromogranin-A, inhibin-a, and E-cadherin was negative. No evidence of recurrence or metastasis was observed by clinical and imaging data during a 5-month postoperative follow-up. Conclusion: This is a report of an unusual case of a primary ovarian SPN with an up-to-date review of SPN-Os. A minimum combination of imaging methods and IHC stains was proposed for SPN-Os, which may prove beneficial in clinical practice.

目的 探讨毛蕊异黄酮对宫颈癌HeLa细胞增殖及凋亡的影响及其可能作用机制.方法 体外培养人宫颈癌细胞HeLa,设为对照组(未经毛蕊异黄酮处理)、毛蕊异黄酮-低组(25 μmol/L)、毛蕊异黄酮-中组(50 μmol/L)、毛蕊异黄酮-高组(100 μmol/L);经100 μmol/L毛蕊异黄酮培养24 h,细胞分别设为微小RNA(miR)-NC组、miR-4766-5p组、毛蕊异黄酮+anti-miR-NC组以及毛蕊异黄酮+anti-miR-4766-5p组.采用CCK-8法、平板克隆形成实验与流式细胞术分别检测细胞增殖、克隆形成及凋亡;采用实时荧光定量聚合酶链反应(qRT-PCR)和蛋白质免疫印迹(Western blot)分别检测miR-4766-5p和凋亡相关蛋白表达量.结果 与对照组比较,毛蕊异黄酮-低组、毛蕊异黄酮-中组、毛蕊异黄酮-高组的细胞增殖受到抑制,凋亡蛋白含量、miR-4766-5p表达量升高,且呈剂量依赖性,差异有统计学意义(P＜0.05).与癌旁组织比较,宫颈癌组织中miR-4766-5p的表达量降低,差异有统计学意义(P＜0.05).与miR-NC组比较,miR-4766-5p组细胞增殖能力降低,凋亡蛋白含量升高,差异有统计学意义(P＜0.05).毛蕊异黄酮+anti-miR-4766-5p组的细胞增殖抑制率、凋亡率和cleaved-caspase3、cleaved-caspase9蛋白水平低于毛蕊异黄酮+anti-miR-NC组,细胞克隆形成能力高于毛蕊异黄酮+anti-miR-NC组,差异有统计学意义(P＜0.05).结论 毛蕊异黄酮可通过上调miR-4766-5p表达抑制宫颈癌细胞增殖,诱导细胞凋亡.

目的 探讨宫腔镜子宫瘢痕憩室下缘电切开渠术和腹腔镜下折叠对接缝合术治疗剖宫产术后子宫瘢痕憩室所致经期延长的疗效.方法 回顾分析厦门大学附属中山医院2015年7月至2021年10月诊治的剖宫产术后子宫瘢痕憩室所致经期延长患者85例,其中采用宫腔镜子宫瘢痕憩室下缘电切开渠术治疗的58例为宫腔镜组,采用腹腔镜下折叠对接缝合术治疗的27例为腹腔镜组,分析两组患者的一般临床资料、围术期相关指标以及术后症状恢复状况.结果 宫腔镜组和腹腔镜组的患者围术期相关指标,术中出血量、手术时间、住院费用和住院天数差异有统计学意义(P＜0.05),但两组患者术后经期时间差异无统计学意义(P＞0.05);宫腔镜组和腹腔镜组患者术后经期时间相较于术前明显缩短,差异有统计学意义(P＜0.05).结论 宫腔镜子宫瘢痕憩室下缘电切开渠术和腹腔镜下折叠对接缝合术均能有效地改善剖宫产术后子宫瘢痕憩室所致经期延长的症状,但宫腔镜子宫瘢痕憩室下缘电切开渠术在操作简便性、手术创伤和住院费用等方面更具优势,更具临床推荐价值.

目的 探讨醋酸戈舍瑞林联合安宫黄体酮对子宫内膜异位症患者可溶性人类白细胞抗原-G(sHLA-G)、E-钙黏附蛋白(E-cadherin)的影响.方法 选取厦门大学附属中山医院自2020年1月至2021年1月收治的92例子宫内膜异位症患者为研究对象.采用随机数字表法将患者分为A组与B组,每组各46例.A组患者给予安宫黄体酮治疗.B组患者采用醋酸戈舍瑞林联合安宫黄体酮治疗.记录并比较两组患者治疗前后子宫内膜供血情况[子宫动脉搏动指数(PI)、阻力指数(RI)]、性激素水平[雌二醇(E2)、黄体生成素(LH)、促卵泡激素(FSH)]、sHLA-G与E-cadherin水平、炎性因子水平[白细胞介素8(IL-8)、中性粒细胞激活肽78(ENA-78)、基质金属蛋白酶9(MMP-9)].记录两组患者的临床疗效.结果 治疗后,两组患者PI、RI、E2、LH、FSH、sHLA-G、E-cadherin、IL-8、ENA-78、MMP-9均低于治疗前,且B组上述指标均低于A组,差异均有统计学意义(P<0.05).B组患者治疗的总有效率为95.65％(44/46),高于A组的80.43％(37/46),差异有统计学意义(P<0.05).结论 采用醋酸戈舍瑞林联合安宫黄体酮治疗子宫内膜异位症患者疗效显著,可有效降低sHLA-G、E-cadherin水平,促进疾病转归.

目的:探讨湿热敷在预防与缓解妇科腹腔镜术后季肋部疼痛、肩背酸痛等非切口疼痛的效果.方法:选取厦门大学附属中山医院妇科2020年8月至2021年11月期间腹腔镜术后患者132例,将2020年8月至2020年11月期间67例行腹腔镜手术患者分为对照组,2021年8月至2021年11月期间65例行腹腔镜手术患者分为观察组.对照组患者给予常规照护,观察组患者在对照组的基础上加湿热敷.比较两组患者手术后非切口疼痛评分、首次下床活动时间、肛门排气时间、恶心呕吐例数、非切口疼痛例数、焦虑自评量表(SAS)评分.结果:两组患者术后24 h、48 h疼痛分数均低于初始疼痛分数,且术后48 h疼痛分数均低于24 h疼痛分数,差异均具有统计学意义(P<0.05);观察组患者初始疼痛分数、术后24 h、术后48 h疼痛分数均低于对照组,差异具有统计学意义(P<0.05).观察组患者的下床活动时间、肛门排气时间均短于对照组,差异具有统计学意义(P<0.05).两组患者的恶心情况比较,差异无统计学意义(P>0.05);观察组患者的呕吐、非切口疼痛发生情况少于对照组,差异具有统计学意义(P<0.05).术后48 h观察组患者焦虑自评量表(SAS)评分均较术前、术后24降低,且术后24 h观察组患者SAS评分低于术前,差异均具有统计学意义(P<0.05).术后48 h观察组患者SAS评分较术前降低,差异均具有统计学意义(P<0.05).术后24 h对照组患者SAS与术前比较,差异无统计学意义(P>0.05).术前两组患者的SAS评分比较,及术后24 h对照组患者SAS评分与术前比较,差异无统计学意义(P>0.05);术后24 h、48 h观察组患者SAS评分均低于对照组,差异具有统计学意义(P<0.05).结论:湿热敷可明显缓解妇科腹腔镜患者术后季肋部疼痛、肩背酸痛等非切口疼痛,可有效减轻患者术后负性情绪,促进患者术后康复.

目的:探究剖宫产术后瘢痕子宫再次妊娠剖宫产的主要影响因素.方法:厦门大学附属中山医院妇产科2019年4-10月入院并接受问卷调查孕妇453例:剖宫产分娩218例,其中剖宫产术后瘢痕子宫再次妊娠剖宫产分娩117例(病例组),其它指征剖宫产分娩101例;阴道分娩235例(对照组).问卷调查结束后,采用SPSS20.0软件录入数据并运用该软件采用logistic回归方法进行统计分析.结果:单因素Logistic回归分析显示,剖宫产术后瘢痕子宫再次妊娠剖宫产的主要影响因素是:年龄、孕妇倾向的分娩方式、孕妇配偶倾向的分娩方式、孕妇其他家人倾向的分娩方式、提前住院待产.多因素Logistic回归分析显示,剖宫产术后瘢痕子宫再次妊娠剖宫产的主要影响因素是:年龄、孕妇倾向的分娩方式、提前住院待产.结论:剖宫产术后瘢痕子宫再次妊娠剖宫产的主要影响因素是年龄、孕妇倾向的分娩方式、提前住院待产.加强对剖宫产术后瘢痕子宫再次妊娠孕妇阴道分娩宣教和孕期管理,积极进行心理疏导,在技术条件成熟的情况下引导和鼓励孕妇阴道试产,提高剖宫产后阴道分娩率,将有利于降低我国剖宫产率.

目的:分析宫颈人乳头瘤病毒(HPV)分型检测联合宫颈液基薄层细胞(TCT)检查在宫颈病变早期筛查中的价值.方法:将2019年1月至2021年5月在厦门市湖里区妇幼保健院接受HPV分型检测、TCT检查的3000例宫颈病变早期筛查女性纳入研究,把活检病理结果作为诊断标准,分别计算单独HPV分型检测、TCT检查以及HPV分型检测联合TCT检查的诊断效能,诊断效能指标包括灵敏度、特异度、阴性预测值、阳性预测值.结果:HPV分型检测共检出宫颈病变阳性564例(18.8％),TCT检查共检出宫颈病变阳性316例(10.5％),HPV分型检测的灵敏度、特异度、阴性预测值、阳性预测值均高于TCT检查,差异均具有统计学意义(P<0.05).HPV分型检测联合TCT检查共检出宫颈病变阳性638例(21.03％),灵敏度、特异度、阴性预测值、阳性预测值均高于单独HPV分型检测、TCT检查,差异均具有统计学意义(P<0.05).结论:HPV分型检测联合TCT检查用于宫颈病变早期筛查的诊断效能较高,明显优于单独HPV分型检测、TCT检查.

目的:评价抗HPV生物凝胶敷料治疗慢性宫颈炎伴持续性人乳头瘤病毒(HPV)感染的疗效,并分析对患者疼痛与炎症因子的影响.方法:选入2020年5月～2022年3月我院收治的慢性宫颈炎伴持续性HPV感染患者156例,随机分为对照组和观察组,每组78例,其中对照组予以保妇康栓治疗,观察组应用抗HPV生物凝胶敷料治疗.评价两组的临床疗效、HPV转阴率、患者疼痛程度、炎症因子水平等指标,并进行统计比较.结果:治疗前,两组各项指标无明显差异(P＞0.05);治疗后,观察组疼痛VAS评分显著低于对照组(P＜0.05);观察组治疗后阴道灌洗液肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6和IL-4水平低于对照组(P＜0.05),γ-干扰素(IFN-γ)水平高于对照组(P＜0.05);观察组治疗后病毒载量较对照组低,HPV转阴率较对照组高(P＜0.05);观察组治疗总有效率96.15％,显著高于对照组的80.77％(P＜0.05).结论:抗HPV生物凝胶敷料治疗慢性宫颈炎伴持续性HPV感染疗效肯定,可有效缓解疼痛症状,提高HPV转阴率,改善宫颈局部炎症状态,提升临床疗效,且安全性良好,具有临床推广价值.

An increasing number of data have shown the pathogenesis of preeclampsia (PE) involves circular RNA (circRNA). The study aims to investigate the function and the potential mechanism of circ_0043610 in PE. The study was performed on two human placental trophoblastic cell lines (JEG-3 and HTR-8/SVneo). The expression of circ_0043610, microRNA-558 (miR-558), and RING1 and YY1 binding protein (RYBP) was detected by quantitative real-time polymerase chain reaction. The protein levels of N-cadherin, E-cadherin, and RYBP were assessed by Western blotting. Cell viability, proliferation, apoptosis, invasion, and migration were evaluated by cell counting kit-8, 5-Ethynyl-29-deoxyuridine, flow cytometry analysis, transwell invasion assay, and wound-healing assay, respectively. Dual-luciferase reporter assay, RNA immunoprecipitation assay, and RNA pull-down assay were performed to identify the associations among circ_0043610, miR-558, and RYBP. Compared with normal placental controls, the increased expression of circ_0043610 and RYBP and the decreased miR-558 expression were detected in PE placental tissues. The overexpression of circ_0043610 led to decreased trophoblast cell proliferation, invasion, and migration but increased cell apoptosis. Mechanistically, circ_0043610 acted as a miR-558 sponge, and miR-558 bound to RYBP. Besides, miR-558 introduction remitted circ_0043610-mediated effects in JEG-3 and HTR-8/SVneo cells. Moreover, RYBP participated in the regulation of miR-558 on trophoblast cell behaviors. Further, the ectopic expression of circ_0043610 led to RYBP upregulation through miR-558. Circ_0043610 induced RYBP production to promote trophoblast dysfunction by binding to miR-558 in PE.

目的 探讨妊娠期糖尿病(GDM)发病危险因素.方法 建档时招募孕妇入组,口服糖耐量实验后对GDM孕妇进行饮食指导,收集妊娠7～8周孕妇的静脉血及有关信息,检测血糖血脂水平;GDM组共471人,以同期产前检查的健康孕妇为对照组,共1 767人.比较两组孕妇一般情况及血糖血脂水平并分析.结果 GDM组年龄较大、孕前体质指数(pre-BMI)较高、经产妇比例较高、孕中期增重较多,孕早期血清空腹血糖水平(FBG)、甘油三酯(TG)、胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平较高,高密度脂蛋白胆固醇(HDL-C)水平较低;多因素logistic回归分析表明,高龄产妇(≥35岁,OR=1.81)、孕前超重/肥胖(pre-BMI≥24 kg/m2,OR=2.25)、孕中期增重较多(OR=1.12),以及孕早期FBG≥5.1 mmol/L(OR=3.47)、TG≥1.7 mmol/L(OR=2.24)、LDL-C≥3.4 mmol/L(OR=1.76),是 GDM 发病的危险因素.结论 为预防GDM发生,高龄、孕前超重、孕早期TG、FBG、LDL-C升高的孕妇应及早进行膳食管理.

目的 探讨葡萄糖调节蛋白78(GRP78)、可溶性血管内皮生长因子受体1(sFlt-1)、STOX1在子痫前期(PE)患者血清中的表达及相关性.方法 选取厦门大学附属中山医院自2020年4月至2021年4月收治的77例PE患者为研究对象.根据病情严重程度将其分为轻度PE组(n=42)与重度PE组(n=35).另选取50例同期于我院孕检的健康妊娠女性为健康组.记录并比较3组研究对象血清GRP78、sFlt-1、STOX1水平.应用Pearson相关性检验分析血清GRP78、sFlt-1、STOX1与PE发生的相关性.采用受试者工作特征(ROC)曲线分析血清GRP78、sFlt-1、STOX1单独及三者联合对PE的预测价值.结果 轻度PE组、重度PE组患者GRP78、sFlt-1、STOX1水平均高于健康组,差异均有统计学意义(P<0.05).重度PE组患者GRP78、sFlt-1、STOX1水平均高于轻度PE组,差异均有统计学意义(P<0.05).血清GRP78、sFlt-1、STOX1与PE发生呈正相关性(r=0.671、0.594、0.714,P<0.05).ROC曲线显示,与GRP78、sFlt-1、STOX1单项诊断相比,三项联合对PE的诊断价值较高(P<0.05).结论 血清GRP78、sFlt-1、STOX1在PE中异常表达,并与病情严重程度相关,测定孕妇GRP78、sFlt-1、STOX1表达水平可辅助诊断孕妇PE及病情严重程度.

目的 探讨超声脐动脉血流联合孕妇血清趋化因子12(CXCL12)、缺氧诱导因子α(HIF-α)对胎儿窘迫的诊断价值.方法 选取厦门大学附属中山医院自2020年5月至2021年5月收治的61例胎儿窘迫孕妇为研究对象.根据宫内窘迫程度将其分为轻度宫内窘迫组(n=37)与中重度宫内窘迫组(n=24).另选取同期于我院产检的65例健康孕妇为健康组.记录并比较3组孕妇脐动脉血流收缩期和舒张期比值(S/D)、阻力指数(RI)、搏动指数(PI)及CXCL12、HIF-α水平.比较超声脐动脉血流、CXCL12、HIF-α单独及三项联合对胎儿窘迫的检出率.采用受试者工作特征(ROC)曲线及ROC曲线下面积(AUC)分析超声脐动脉血流、CXCL12、HIF-α单独及三项联合对胎儿窘迫的诊断价值.结果 轻度宫内窘迫组、中重度宫内窘迫组的S/D、RI、PI值、CXCL12、HIF-α均高于健康组,差异均有统计学意义(P<0.05);中重度宫内窘迫组S/D、RI、PI值、CXCL12、HIF-α均高于轻度宫内窘迫组,差异均有统计学意义(P<0.05).超声脐动脉血流联合CXCL12、HIF-α胎儿窘迫检出率为93.44％(57/61),高于单独采用超声脐动脉血流的68.85％(42/61)、单独采用CXCL12的60.66％(37/61)及单独采用HIF-α的57.38％(35/61),差异有统计学意义(P<0.05).超声脐动脉血流、CXCL12及HIF-α三项联合的AUC值大于超声脐动脉血流、CXCL12、HIF-α单独诊断(P<0.05).结论 超声脐动脉血流参数、CXCL12、HIF-α均与胎儿宫内窘迫程度存在一定关联,可采用超声脐动脉血流联合孕妇血清CXCL12、HIF-α评估胎儿脐动脉血流变化,为胎儿窘迫的诊断提供重要依据.

目的 通过分析脐带挤压(UCM)与延迟脐带结扎(DCC)对于早产儿及产妇围生期各项指标的影响,探索脐带挤压及延迟脐带结扎对早产儿和产妇的意义.方法 以本院产科孕周28～37周经阴道分娩且符合早产儿诊断标准的240例新生儿及产妇作为研究对象,其中分为脐带挤压组(UCM组)80例、延迟脐带结扎组(DCC组)80例及立即脐带结扎组(ICC组)80例,比较各组早产儿血红蛋白(Hb)水平和红细胞比容(HCT)、血清总胆红素的水平及光疗率、新生儿坏死性小肠结肠炎(NEC)及脑室周围-脑室内出血(PIVH)的发病率、早产儿体温的情况及低血糖的发病率、产妇产后出血(PHH)发病率及分娩前后血红蛋白(Hb)水平.结果 UCM组和DCC组新生儿血红蛋白及红细胞比容均高于ICC组(P＜0.05),其中UCM组与DCC组相比,差异无统计学意义(P＞0.05);生后第3天及第5天UCM组和DCC组新生儿血清总胆红素水平均高于ICC组(P＜0.05),其中UCM组与DCC组相比,差异无统计学意义(P＞0.05),UCM组、DCC组、ICC组光疗率比较,差异无统计学意义(P＞0.05);UCM组和DCC组新生儿生后30 min体温均高于ICC组(P＜0.05),UCM组、DCC组生后低血糖发病率均低于ICC组(P＜0.05);UCM组和DCC组发生脑室周围-脑室内出血的比例较ICC组减少(P＜0.05),UCM组、DCC组、ICC组早产儿坏死性小肠结肠炎发病率相比,差异无统计学意义(P＞0.05);UCM组、DCC组、ICC组产妇产后出血发病率及分娩前、分娩后血红蛋白水平相比,差异无统计学意义(P＞0.05).结论 脐带挤压和脐带延迟结扎在提高早产儿血容量、防止低体温、降低新生儿低血糖及脑室周围-脑室内出血的发病率方面均有效果,且二者差异无统计学意义,对早产儿光疗率及产妇分娩出血量无显著影响.

目的 对比阴式与宫腹腔镜子宫瘢痕憩室修补术在剖宫产术后子宫瘢痕憩室治疗中的临床治疗效果.方法 方便选取该院2015年12月—2018年12月收治的剖宫产术后子宫瘢痕憩室患者70例,将患者随机分为对照组(n=35)、观察组(n=35).对照组采用宫腹腔镜手术治疗,观察组行阴式手术治疗.观察对比两组患者的手术有效率、手术情况、影像学变化及术后1年经期恢复情况.结果 观察组与对照组手术有效率对比差异无统计学意义(P>0.05);观察组患者手术时长(69.66±15.47)min、肛门排气时间(23.67±0.64)h、手术费用(5585.36±758.66)元显著低于对照组,差异有统计学意义(t=11.943、17.323、13.990,P<0.001);治疗后两组患者超声图像改善例数比较差异无统计学意义(P>0.05);两组术后异常阴道流血、经期时长>1周例数比较差异无统计学意义(P>0.05).结论 阴式手术治疗剖宫产术后子宫瘢痕憩室疗效确切,术后恢复速度快,手术式较为安全简单,且费用较低,临床上值得进行更多推广应用.