目的:研究血清成纤维细胞生长因子2(FGF2)、正五聚蛋白3(PTX3)对孕产妇发生妊娠期肝内胆汁淤积症的临床预测价值.方法:收集本院2019年5月至2022年2月期间就诊的82例妊娠期肝内胆汁淤积症孕产妇为观察组研究对象,同期选取未发生妊娠期合并症的正常孕产妇78例作为对照组研究对象,收集其一般资料.采用酶联免疫吸附法检测血清FGF2、PTX3水平,采用全自动生化分析仪检测肝功能指标总胆汁酸(TBA)、总胆红素(TBil)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平;采用Pearson相关分析妊娠期肝内胆汁淤积症患者血清FGF2、PTX3水平与肝功能指标相关性;绘制受试者工作特征(ROC)曲线分析血清FGF2、PTX3水平对妊娠期肝内胆汁淤积症的预测价值;采用多因素Logistic回归分析影响妊娠期肝内胆汁淤积症的因素.结果:观察组孕妇血清FGF2、PTX3水平及TBA、TBil、ALT、AST显著高于对照组(P<0.05).妊娠期肝内胆汁淤积症患者血清FGF2与PTX3水平呈正相关(r=0.574,P<0.05),且FGF2、PTX3与肝功能指标TBA、TBil、ALT、AST均呈正相关(P<0.05).FGF2、PTX3及二者联合预测妊娠期肝内胆汁淤积症的ROC曲线下面积(AUC)分别为0.807、0.867、0.902,敏感度分别为75.6％、74.4％、70.7％,特异性分别为74.4％、87.2％、93.6％.FGF2、PTX3是孕产妇发生妊娠期肝内胆汁淤积症的影响因素(P<0.05).结论:妊娠期肝内胆汁淤积症孕产妇血清FGF2、PTX3表达上调,二者对预测妊娠期肝内胆汁淤积症的发生有重要价值.

目的:分析比较供精助孕治疗和夫精助孕治疗夫妇婚姻关系.方法:选择2019年7月—2019年11月就诊于河南省某三级甲等医院生殖中心接受供精助孕夫妇95对(供精组)和夫精助孕夫妇100对(夫精组)作为研究对象,采用一般资料问卷、Locke-Wollance婚姻调适测定量表、婚姻适应量表对其进行问卷调查以分析比较两组夫妇的婚姻关系.结果:供精助孕夫妇的婚姻调适和婚姻适应得分均高于夫精助孕夫妇(P<0.05).结论:供精助孕夫妇婚姻关系相对较好,但仍需进一步验证,应该对接受助孕治疗的夫妇进行及时的评估和针对性心理干预.

目的 探讨线上与线下相结合的多途径宣教模式对辅助生殖技术(ART)助孕初诊患者的应用效果.方法 选取2019年1—6月在河南省某三甲医院生殖中心初次就诊的不孕症患者260例为研究组,选取2018年1-6月就诊的初诊不孕症患者260例为对照组.研究组采用线上与线下相结合的健康宣教方式,对照组采用常规的线下健康教育宣教模式.比较两组患者对就诊和检查流程的知晓程度、一次建档成功率、满意度等.结果 研究组患者就诊和检查流程的知晓程度、一次建档成功率、满意度及宣教内容的实用性、宣教方式的便捷性评价均高于对照组,差异均有统计学意义(P<0.05).结论 线上与线下相结合的多途径宣教模式可满足不同层次ART患者的需求,提高宣教质量和患者对宣教内容的知晓率和满意度.

目的:探讨单囊胚移植中囊胚质量对妊娠结局及子代的影响.方法:选取接受IVF-ET/FET治疗的患者,其中新鲜周期移植497例,冻融周期移植620例.移植囊胚按照质量分为优质囊胚和非优质囊胚.随访妊娠结局及子代情况.结果:新鲜周期移植优质囊胚组临床妊娠率为66.23％(406/613),高于非优质囊胚组的49.85％(167/335)(P<0.001);两组的流产率、早产率、低体重率、男婴比例及出生缺陷率比较,差异均无统计学意义(P>0.05).冻融周期移植优质囊胚组临床妊娠率及流产率分别为56.62％(402/710)和16.67％(67/402),非优质囊胚组临床妊娠率及流产率分别为45.77％(384/839)和23.18％(89/384)(P<0.05);两组的早产率、低体重率、男婴比例及出生缺陷率比较,差异均无统计学意义(P>0.05).结论:单囊胚移植中优质囊胚可以获得更好的临床妊娠率,但不同质量囊胚移植的出生结局及新生儿状况无差异.

Objective To investigate the influence of assisted reproductive technology (ART) on offspring neuropsychological development. Methods Two-year-old children born after receiving in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI)/frozen-thawed embryo transfer (FET) treatment at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from February 2014 to May 2015 (ART group, n=176) were selected and grouped according to their mother’s age, educational level, family income and children’s gender, etc. Children who were from the same age and were born in the Obstetrics and Gynecology Department of our hospital by natural conception during the same period were selected as control group (NC group, n=176). The neuropsychological development of the children was evaluated by developmental screening test (DST) scale and child developmental computer capacity (CDCC) scale. Results 1) There were no significant differences in birth weight, birth height, body weight and height at two-year-old and other physical development indicators between the two groups (P>0.05). 2) The ability of exercise, social adjustment, the intelligence development and development quotient (DQ) value of ART group showed slightly lower level than that of NC group. However, there was no significant difference between the two groups (P>0.05). 3) There were also no significant differences in the proportion of mental development index (MDI), psychomotor development index (PDI) and children who had abnormal ability between ART group and NC group (P>0.05). 4) No statistical significances were found in the DQ, MDI and PDI values of IVF group, ICSI group, FET group and NC group (P>0.05), though the values of DQ (94.26±9.47), MDI (101.99±15.73) and PDI (100.11±18.87) in ICSI group were lower than those of the other three groups (P>0.05). Conclusion Offspring from ART presented no significance in the values of MDI, PDI and DQ indicators than whom from the same age by natural conception, indicating that the neuropsychological development of children from ART was not affected. Key words: Reproductive techniques, assisted; Children; Neuropsychological development

目的 研究低碳水化合物饮食营养干预对肥胖型多囊卵巢综合征患者受孕率的作用.方法 随机选取郑州大学第三附属医院就诊低血糖负荷饮食干预的肥胖型多囊卵巢综合征患者80例为试验组,1∶1匹配未经饮食干预的患者为对照组,12周为1个疗程,1个疗程后分析两组患者的治疗效果.结果 试验组干预后BMI为(23.9±3.1)kg/m2,对照组为(29.1±4.5) kg/m2,两组变化差异有统计学意义(P＜0.01);饮食干预后试验组受孕12例与对照组0例差异有统计学意义(P＜0.01).结论 低碳水化合物饮食干预可有效降低肥胖型多囊卵巢综合征患者的体重,并有助于提升患者受孕率.

Aim: To compare the clinical outcomes of blastocyst culture and transfer between fresh cycles and vitrifiedthawed cycles,so as to choose the best scheme of blastocyst transfer. Methods: Retrospective analysis of clinical data with the patients undergoing in vitro fertilization / intracytoplasmic sperm injection and embryo transplantation( IVF / ICSI-ET)from Jan. 2012 to Aug. 2014 was performed. According to the cultivating method,the patients were divided into group A( D3 embryos conducting blastocyst culture and transfer,58 cycles),group B( transfering the vitrified-thawed blastocyst,285 cycles) and group C( vitrified-thawed embryos conducting blastocyst culture and transfer,84 cycles). The blastocyst forming rate and the available blastocyst forming rate for fresh embryos( group A and group B) and those for vitrified-thawed embryos( group C) were compared. The indexes such as biochemical pregnancy rate,clinical pregnancy rate,blastocyst implanting rate,multiplets rate and abortion rate among the three groups were compared. Results: The blastocyst forming rate and the available blastocyst forming rate for fresh embryos were higher than those for vitrified-thawed embryos( χ2=8. 561 and 4. 037,P 0. 05); there were statistical differences in the biochemical pregnancy rate,clinical pregnancy rate and abortion rate among the three groups( χ2= 44. 376,6. 255 and 9. 167,P 0. 05) and those for group B were improved compared with group A,while there were no statistical differences in blastocyst planting rate or multiplets rate( χ2= 4. 234 and 1. 172,P 0. 05). Conclusion: Fresh embryos have a higher blastocyst formation rate than vitrified-thawed embryos and selective vitrified-thawed blastocyst transfer can improve the pregnancy rate,which is the best scheme for blastocyst cultivation and transfer currently.

目的探讨GnRH-a短方案、GnRH-ant方案及来曲唑微刺激三种不同促排卵方案在IVF卵巢低反应患者促排卵中的应用效果及其对血清和卵泡液中GDF-9、BMP-15水平的影响。方法选择在我院生殖医学中心接受IVF/ICSI且卵巢低反应的不孕症患者共89例,随机地分为三组:A组（GnRH-a短方案组）33例,B组（GnRH-ant方案组）31例,C组（来曲唑微刺激方案组）25例。采用酶联免疫吸附试验（ELISA）检测所有患者HCG日血清及取卵日卵泡液内GDF-9、BMP-15水平,用化学发光法测定所有患者基础内分泌值和HCG日内分泌值,分析不同促排卵方案患者的Gn用量,Gn用药天数,获卵数,受精率,卵裂率,优质胚胎率,着床率,周期取消率,移植周期临床妊娠率,流产率等相关指标。结果 （1）Gn用药天数、获卵数、受精率、卵裂率、优质胚胎率、周期取消率、移植周期临床妊娠率、流产率、着床率在A、B、C三组之间无统计学差异（P＞0.05）;Gn总量在A、B两组明显高于C组（P＜0.05）;（2）A、B、C三组血清和卵泡液中的GDF-9水平无统计学差异（P＞0.05）;C组血清和卵泡液中的BMP-15水平均显著高于A、B两组（P＜0.05）;A、B、C三组血清的GDF-9和BMP-15水平均显著低于卵泡液中的水平（P＜0.05）。结论 IVF卵巢低反应患者应用GnRH-ant方案可以获得与GnRH-a短方案相似的临床效果;来曲唑联合小剂量Gn微刺激方案Gn用量较少,获得了与GnRH-a短方案及GnRH-ant方案相似的临床妊娠率,可能与来曲唑增加血清和卵泡液中BMP-15水平,提高了卵巢的反应性有关。

近年来,由于环境污染、饮食、工作压力及其他因素的影响,使不孕不育患者持续上升.男性因不可逆的无精子症、先天性无精症和染色体异常导致的不育症,而女方至少有一侧输卵管通畅.供精人工授精是可以解决其不孕难题的办法之一. 1 资料与方法 1.1 资料 2011年1月至2011年6月在郑州大学第三附属医院生殖医学中心就诊的249例不育患者.

Objective: To investigate the role of nursing care of hysterosalpingography in infertile patients.Methods: From January to May of 2011,450 infertile patients incurring a hysterosalpingography with the special nursing division within the reproductive centers of Third Affiliated Hospital of Zhengzhou University were collected and anlisysed.Results: All 450 patients had positive attitudes following surgery and achieved satisfactory results.Conclusion: Good nursing care can ensure the success of operation and improve the success rate of this surgery.