This study aims to investigate the effect of berberine on necroptosis in cervical H8 cells. CCK-8 assay was used to assess cell proliferation activity. The expression levels of necroptosis key markers Receptor-interacting protein kinase 1 (RIPK1), MLKL, p-MLKL, and apoptosis-related caspase-8, caspase-3 were analyzed through qRT-PCR, western blot, and immunofluorescence. Mechanistic studies were conducted using the RIPK1 kinase inhibitor necrostatin-1 (Nec-1). The results showed that berberine could inhibit H8 cell proliferation in a time- and dose-dependent manner (p<0.05). It increased the expression of RIPK1 and MLKL (p<0.05), while inhibiting the expression of caspase-8 and caspase-3 (p<0.05). Nec-1 inhibitor decreased the expression of RIPK1 and MLKL after the intervention of berberine (p<0.05). Therefore, berberine induces cervical H8 cell death through the activation of RIPK1-mediated necroptosis.

Objective:To observe the clinical curative effects of Huo-long comprehensive moxibustion and Kegal exercise in the treatment of mild to moderate postpartum stress urinary incontinence (PSUI) .Methods:A total of 90 patients with postpartum stress urinary incontinence who were admitted to Outpatient Department of Obstetrics and Gynecology in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to December 2022 were selected as the research objects by the convenient sampling method. They were divided into the control group ( n=45) and the observation group ( n=45) by the random number table method. The control group received Kegal exercise, while the observation group was given Huo-long comprehensive moxibustion on the basis of the treatment of the control group. Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) score, 24-hour urinary leakage frequency and Incontinence Quality of Life Questionnaire (I-QOL) score were compared between the two groups. Results:After 4 and 8 weeks of treatment, the ICIQ-SF score and 24-hour urine leakage frequency of PSUI patients of the two groups were lower than those before treatment, and those of the observation group were lower than the control group, and the differences were statistically significant ( P<0.05). The I-QOL score of PSUI patients of both groups were higher than those before treatment, and the observation group were higher than the control group, and the differences were statistically significant ( P<0.05). No adverse reactions occurred in both groups during treatment. Conclusions:The combination of Huo-long comprehensive moxibustion and Kegal exercise can effectively reduce the frequency of urinary leakage, alleviate adverse symptoms of urinary incontinence and improve quality of life, which has good safety in the treatment of mild to moderate postpartum stress urinary incontinence.

Objective: To survey the effects of herbs combined with physiotherapy on different degrees of pelvic floor dysfunction after delivery. Methods: All 360 delivery women suffering pelvic floor muscle weakness were chosen, and assigned to mild group（240 cases） and severe group（120 cases） according to the rating of pelvic floor muscle strength, the mild group and the severe group were allocated to physiotherapy group, herb group, the combination therapy group in light of random number table method in the ratio of 1∶ 1∶ 1. To assess clinical effects by analyzing hand-measured cross-sectional muscle strength, EMG value, fatigue and pelvic floor muscle tension. Results: In the mild group, total effective rate of the combination therapy group was [98.75%（79/80）],better than [78.75%（63/80）] of the herb group and [80.00%（64/80）] of physiotherapy group（P＞0.05）, the difference had no statistical meaning in total effective rate of herb group and physiotherapy group（P＞0.05）; in the severe group, total effective rates of the combination therapy group, the herb group and physiotherapy group were [92.5%（37/40）], [85.00%（34/40）] and [70%（28/40）], the efficacy showed a decreasing trend（P＞0.05）. After the treatment,hand-measured cross-sectional muscle strength, total EMG values, EMG values of type Ⅰ fiber, EMG values of type Ⅱ fiber, vaginal resting voltage and vaginal systolic pressure improved remarkably than before the treatment（P＜0.05）, and the effects of the combination therapy were the best. Conclusion: For the patients with mild pelvic floor dysfunction, single herbal therapy, single physiotherapy or the combination of both could effectively improve the symptoms, however, for severe patients, herb in combination with physiotherapy could produce synergistic action, and the effects are more noticeable.

目的 探讨子宫肌瘤组织中miR-590、miR-16表达的临床意义.方法 选取2018年10月至2020年8月江苏省苏州市中西医结合医院收治的186例子宫肌瘤患者为研究组,并选择同期120例因子宫脱垂实施手术治疗的患者为对照组.采用实时定量PCR检测子宫肌瘤组织与正常子宫组织miR-590、miR-16表达水平;多因素logistic回归分析探讨子宫肌瘤发生的影响因素;采用Pearson相关性分析miR-590、miR-16表达水平与子宫肌瘤大小、数目的关系.结果 研究组miR-590表达水平高于对照组,miR-16表达水平低于对照组(P<0.05).研究组合并糖尿病、月经紊乱、生殖道炎症占比高于对照组,流产次数多于对照组(P<0.05).logistic回归分析结果显示,月经紊乱,生殖道炎症,子宫组织miR-590、miR-16表达水平是子宫肌瘤发生的影响因素(OR=2.818、2.751、3.888、3.476,P<0.05).miR-590表达水平与子宫肌瘤大小、数目呈正相关(r=0.767、0.795,P<0.05),miR-16表达水平与子宫肌瘤大小、数目呈负相关(r=-0.743、-0.792,P<0.05).结论 miR-590在子宫肌瘤组织中呈高表达,miR-16则呈低表达,且miR-590、miR-16表达水平与子宫肌瘤的发生相关.

目的 基于丝裂原活化蛋白激酶/人Wnt-3a蛋白/哺乳动物雷帕霉素靶蛋白/血管内皮生长因子(MAPK/Wnt3a/mTOR/VEGF)信号通路探究上调miR-23对子宫肌瘤细胞凋亡、侵袭、迁移能力的影响.方法 选取子宫肌瘤细胞,经培养后分为对照组、下调组、上调组,对三组增殖、凋亡、侵袭、迁移能力进行检测,检测miR-23、肾素活性(PRA)、基质金属蛋白酶-2(MMP-2)、上皮型黏附蛋白(E-cadherin)、MAPK、Wnt3a、mTOR、VEGF表达量.结果 与对照组比较,下调组miR-23表达较低,PRA表达较高,上调组miR-23表达较高,PRA表达较低,差异具有统计学意义(P＜0.05).与对照组比较,下调组凋亡率、增殖抑制率较低,侵袭细胞数、迁移细胞数较高,上调组凋亡率、增殖抑制率较高,侵袭细胞数、迁移细胞数较低,差异具有统计学意义(P＜0.05).与对照组比较,下调组MAPK、Wnt3a、mTOR、VEGF、MMP-2相对表达量较高,E-cadherin相对表达量较低,上调组MAPK、Wnt3a、mTOR、VEGF、MMP-2相对表达量较低,E-cadherin相对表达量较高,差异具有统计学意义(P＜0.05).结论 上调子宫肌瘤细胞miR-23表达,能够调控MAPK/Wnt3a/mTOR/VEGF信号通路蛋白表达,进而调控子宫肌瘤细胞凋亡、侵袭、迁移能力.

目的 探讨桂枝茯苓方加味对子宫肌瘤疗效、性激素水平、超声指标及血清血管内皮生长因子(Vascular endothelial growth factor,VEGF)、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、B淋巴细胞瘤-2基因(B-cell lymphoma-2,Bcl-2)蛋白、雌激素受体(Estrogen receptor,ER)和孕激素受体(Progesterone re-ceptor,PR)水平的影响.方法 选取2018年10月—2020年10月期间于苏州市中西医结合医院接收治疗的160例子宫肌瘤患者作为研究对象,按随机数表法分为对照组和联合组,每组各80例.对照组给予米非司酮治疗,联合组在对照组基础上采用桂枝茯苓方加味治疗,两组患者均治疗3个月.观察比较两组患者治疗前后的月经症状(痛经、经量异常、小腹胀痛、经质浓稠、腰酸和经前乳胀)积分、性激素水平[促卵泡生成素(Follicle stimulating hor-mone,FSH)、黄体生成素(Luteinizing hormone,LH)、雌二醇(Estradiol,E2)和孕酮(Progesterone,P)]水平、超声指标(子宫体积和肌瘤体积)、血清VEGF、MMP-9、Bcl-2、ER、PR水平及临床疗效.结果 治疗后联合组总有效率95.00％(76/80)明显高于对照组77.50％(63/80),两组比较,差异有统计学意义(P<0.05).治疗后两组患者各项月经症状积分及子宫体积、肌瘤体积均较治疗前明显降低,差异有统计学意义(P<0.05);且联合组各项月经症状积分及子宫体积、肌瘤体积均较对照组明显降低,差异有统计学意义(P<0.05).治疗后两组患者FSH、LH、E2、P水平及VEGF、MMP-9、Bcl-2蛋白、ER、PR水平均较治疗前明显降低,差异有统计学意义(P<0.05);且联合组FSH、LH、E2、P水平及VEGF、MMP-9、Bcl-2蛋白、ER、PR水平较对照组明显降低,差异有统计学意义(P<0.05).结论 桂枝茯苓方加味治疗子宫肌瘤效果确切,可显著改善患者临床症状和超声指标,其作用机制可能与调节患者性激素水平和下调血清VEGF、MMP-9及Bcl-2蛋白水平有关.

目的 研究影响进行高强度聚焦超声治疗的子宫肌瘤妇女疗效的影响因素,以期提高患者预后.方法 388例子宫肌瘤患者的选取时间段为2015年3月至2018年3月,均在我院接受治疗,根据治疗后患者的子宫肌瘤消融率进行分组,其中低消融率患者为77例患者,低消融率定义为患者进行消融后病灶的直径降低率低于50％;中消融率组为132例患者,中消融率定义为患者进行消融后病灶的直径降低率在50％～75％之间;高消融率组为179例患者,高消融率定义为患者进行消融后病灶的直径降低率超过75％.上述所有患者均进行为期6个月的随访调查,查阅病案记录患者病灶相关情况,包括病灶的直径、位置以及超声时MRI信号,对上述获取的资料进行统计学分析,比较相关的影响因素.结果 低消融率组子宫肌瘤大小显著低于中和高消融组,子宫肌瘤大小在>50mm以上的患者占比比较发现,高消融组占比最高,三组患者的肌瘤位置也有显著差别,低消融组患者侧壁占比最高,中消融组和高消融组患者子宫肌瘤位置位于前壁占比最高(P<0.05);低消融率组T1WI增强强度和T2WI信号与其他组别比较可知,低消融组均较高,中等消融率组T1WI增强强度和T2WI信号强度均处于中等水平,高消融率组相较于其他两组的T1WI增强强度和T2WI信号强度均较低(P<0.05);对上述具有统计学差异的单因素进行多因素的回归分析,结果显示,患者的子宫肌瘤直径超过50mm、子宫肌瘤病灶位置位于子宫前壁、T1WI增强强度和T2WI信号强度较低,均会影响患者进行高强度聚焦超声治疗的效果.结论 患者的子宫肌瘤直径超过50mm、子宫肌瘤病灶位置位于子宫前壁、T1WI增强强度和T2WI信号强度较低,均会影响患者进行高强度聚焦超声治疗的效果,应在临床上引起重视并及时干预.

目的:探讨盆腔炎2号方治疗湿热瘀结型慢性盆腔炎临床疗效.方法:将2016年1月-2020年6月苏州市中西医结合医院妇产科收治的78例湿热瘀结型慢性盆腔炎患者随机分为治疗组41例和对照组37例.治疗组采用盆腔炎2号方灌肠,对照组采用甲硝唑灌肠.观察两组治疗1个月时血清C反应蛋白浓度、子宫血流动力学、中医证候积分和临床疗效.结果:治疗后,两组患者C反应蛋白浓度均显著低于治疗前,差异有统计学意义(P<0.05);治疗组患者C反应蛋白浓度低于对照组(P<0.05),但无临床意义.两组患者治疗后子宫动脉收缩期最大流速显著高于治疗前,搏动指数和血管阻力指数均显著低于治疗前(P<0.05);治疗组患者子宫动脉收缩期最大流速高于对照组,血管阻力指数低于对照组(P<0.05);两组搏动指数值差异无统计学意义(P>0.05).两组患者治疗后下腹痛、腰骶部酸痛和白带异常评分均显著低于治疗前(P<0.05);治疗组患者下腹痛、腰骶部酸痛和白带异常评分低于对照组(P<0.05);治疗组总有效率显著高于对照组(P<0.05).结论:盆腔炎2号方能有效治疗湿热瘀结型慢性盆腔炎.

目的 观察蒋氏扶正消癥方联合高强度聚焦超声治疗子宫肌瘤的临床疗效.方法 将2018年10月—2019年10月苏州市中西医结合医院收治的80例子宫肌瘤患者随机分为2组,对照组40例单纯采用高强度聚焦超声治疗,联合组40例行高强度聚焦超声治疗联合蒋氏扶正消癥方口服3个月经周期,观察2组治疗3个月后子宫肌瘤体积、中医症状积分变化,统计2组肌瘤疗效和中医症状疗效.结果 2组治疗后子宫肌瘤体积均较治疗前明显减小(P<0.05),中医症状积分均较治疗前明显降低(P<0.05),且联合组治疗后子宫肌瘤体积明显小于对照组(P<0.05),中医症状积分明显低于对照组(P<0.05).联合组肌瘤疗效和中医症状疗效均明显优于对照组(P<0.05).结论 蒋氏扶正消癥方联合高强度聚焦超声治疗子宫肌瘤可进一步加快肌瘤的坏死吸收,改善患者的临床症状,疗效更好.

目的:了解妊娠期孕妇血清中维生素A及E水平的变化趋势,从而通过产前指导孕妇合理饮食适当补充营养减少妊娠合并症的发生.方法:收集2017年3月至2018年2月期间我院孕妇妊娠期间(妊娠早期、晚期)血清样本600例,采用反相高效液相色谱法定量检测其血清中VA及VE水平,比较其数值的变化.分析这些孕妇妊娠期间血清中维生素E、维生素A的随着孕周增加的变化趋势.结果:妊娠早期、晚期孕妇血清中维生素A检测数据分别为(0.32±0.08)mg/L、(0.34±0.17)mg/L,总体异常的为21.04％,主要表现为缺乏(20.68％);极少数表现为过量(0.36％),妊娠早期缺乏率(25.31％)大于妊娠晚期(21.16％);妊娠早期、晚期孕妇血清维生素E检测数据为(09.43±2.42)mg/L、(15.76±4.78)mg/L,总体异常的为5.83％,均为维生素E过量.孕早期孕妇血清维生素E水平均正常范围,随着孕周的增加,维生素E异常率也逐步增加.结论:妊娠期间孕妇血清中维生素A、E含量存在差异,主要表现为维生素A的缺乏为主以及维生素E的过量.因此了解妊娠期妇女维生素A、E的情况,指导孕妇科学合理的营养补偿,能减少一系列妊娠合并症的发生,对保证母婴健康有着重大意义.

目的 分析在妊娠早期检测血清维生素A、E对预测子痫前期的价值.方法 分析病例方便选择于2017年7月—2018年12月期间该院接收的2416名孕妇,为开展该次研究,其中子痫前期孕妇143例,以此作为实验组,另选择143名健康孕妇,以此作为对照组,对两组孕妇检测血清维生素A、维生素E、血脂指标(TG、TC)、血糖指标(空腹血糖),对检测指标进行比较和分析.结果 相对比于健康孕妇维生素A(0.62±0.07)mg/mL、维生素E(18.67±4.05)mg/mL,子痫前期孕妇维生素A(0.48±0.08)mg/mL、维生素E(15.63±3.86)mg/mL下降明显,比较差异有统计学意义(t=22.273、9.189,P<0.05);轻度与重度各项指标差异有统计学意义(t=25.830、26.366,P<0.05);治疗后维生素A、维生素E水平改善明显,差异有统计学意义(t=29.136、24.280,P<0.05).结论 在妊娠早期检测血清维生素A、E可预测子痫前期.

目的:探讨快速康复外科(fast track surgery,FTS)在产科手术中的安全性及可行性.方法:收集择期剖宫产孕妇493例,随机分为快速康复组150例,对照组343例(包括止痛药组39例,止痛药+杜密克组29例,镇痛泵组71例,未用止痛药及杜密克镇痛泵组204例),比较术后排气时间、排尿时间、排便时间、并发症、子宫复旧、疼痛评分和住院时间.结果:快速康复组较对照组术后疼痛轻、子宫复旧好、胃肠功能及膀胱功能恢复快、术后住院时间短(P ＜0.05或P＜0.01),术后并发症及Hb下降值无明显差异(P＞0.05);在对照组中,止痛药+杜密克组排气排便更快(P＜0.05).结论:FTS方案可减轻患者术后疼痛、加快术后胃肠道功能及子宫复旧,降低术后住院时间、便秘发生率,同时并不增加尿潴留、腹胀发生率以及出血量.

目的:探讨子宫腺肌病患者中医证候与体质分布情况及两者之间的相关性,为中医临床诊治子宫腺肌病提供重要的参考依据.方法:收集250例子宫腺肌病患者的中医临床症状及舌苔脉象,判定其中医证候与体质类型,进一步统计分析两者的分布情况及相关性.结果:子宫腺肌病患者中医证候分布情况以气滞血瘀型为主,其次为肾虚血瘀、寒凝血瘀、气虚血瘀、痰瘀互结、湿热瘀结型;中医体质以气郁质为主,其次为平和质、阳虚质、阴虚质、气虚质、痰湿质、湿热质、瘀血质、特禀质;两者之间存在趋同性和矛盾性.结论:本次研究发现子宫腺肌病患者中医证候以气滞血瘀型为主,中医体质以气郁质为主,且证候与体质之间关系密切,在临床施治时需同时兼顾,缺一不可.

目的 探讨高强度聚焦超声(HIFU)治疗妇产科疾病有效性及安全性.方法 选取我院2015年3月～2016年2月期间接受HIFU治疗的妇科疾病患者对其术后1天、1月、3月、6月治疗前后体积变化、症状改善情况进行随访分析.结果 HI FU治疗后1天、1月、3月、6月瘤体体积均较治疗前有不同程度的缩小,其有症状者均有不同程度改善,且发生副反应者少.

Objective To study the influence of laparoscopic uterine artery occlusion combined with resection of adenomyosis on the endocrine hormone.Methods 70 cases of uterine fibroids were randomly divided into control group and observation group,35 cases in each group.The control group were given resection of adenomyosis.The observation group were given laparoscopic uterine artery occlusion combined with resection of adenomyosis.Serum endocrine hormones of two groups of the patients were measured before the operation,3 months after operation and 6 months after operation,such as:follicle stimulating hormone (FSH),(LH),estradiol (E2),progesterone (P).The amount of bleeding,operation time,postoperative exhaust time and hospital stay were compared between the two groups.Results The amount of bleeding and operation time in the observation group were significantly less than that in the control group,the mean length of stay was significantly shorter than that in the control group,the difference was statistically significant (P ＜ 0.05).There was no significant difference in the postoperative passing flatus (P ＞ 0.05).After 3 months,the level of E2 in the observation group was significantly lower than that before operation,and the level of FSH was significantly increased,the difference was statistically significant (P ＜ 0.05),and there was no significant difference in the level of FSH and E2 after 6 months (P ＞ 0.05).Conclusion Laparoscopic Uterine artery occlusion combined with resection of adenomyosis can effectively control the amount of bleeding,shorten the operation time and the mean length of stay and the effect on endocrine hormone is temporary.

目的 探究高强度聚焦超声联合GnRH-a治疗子宫腺肌病的疗效.方法 选择我院56例子宫腺肌病患者作为研究对象,按治疗方式的不同将其分成对照组和治疗组,每组28例.对照组患者采用GnRH-a治疗,治疗组患者采用高强度聚焦超声联合GnRH-a治疗,比较两组患者治疗前后的月经量、痛经视觉模拟评分(VAS)、癌抗原、病灶体积、血红蛋白水平、子宫肌瘤大小等变化情况.结果 两组患者的月经量、痛经视觉模拟评分、癌抗原、病灶体积、血红蛋白水平、子宫肌瘤大小在治疗前无明显差异(P>0.05);采取相应的治疗措施后,治疗组患者的月经量、病灶体积、痛经视觉模拟评分、子宫肌瘤大小均明显小于对照组,治疗组患者的血红蛋白水平明显大于对照组,两组对比差异显著(P<0.05).结论 采用高强度聚焦超声联合GnRH-a对子宫腺肌病患者进行治疗,不仅能缩小病灶体积和子宫肌瘤大小,并且还能有效改善患者的痛经症状和提升其机体的血红蛋白水平.

Objective To investigate the association of urine protein level and pregnancy outcomes in pregnant woman with preeclampsia.Methods The data of 1239 pregnant women with preeclampsia were retrospectively reviewed and the association between urine protein level and adverse pregnancy outcomes was amlyzed.Results On the basis of qualitative analysis of urinary protein,the pregnant women were assigned into three groups of "+1"(405 cases),"+2"(474 cases) and "≥+3" (360 cases),for which the maternal adverse outcomes were 3.21％,5.70％ and 13.89％,the fetal adverse outcomes were 5.19％,10.13％ and 15.56％,and the newborn adverse outcomes were 11.93 ％,25 ％ and 44.85 ％,respectively.Logistic regression analysis showed that the risk for adverse pregnancy outcomes was increased significantly as the increase of urine protein.Maternal adverse outcomes mainly included HELLP syndrome,placental abruption and retinal hemorrhage.Fetal adverse outcomes mainly included fetal growth restriction.Newborn adverse outcomes mainly included low bndyweight and newnatal mortality.All these adverse pregnancy outcomes were closely associated with the increase of urine protein level(P＜0.05 or P＜0.01).Conclusion Abnormal increase of urine protein is one of the important risk factors for adverse pregnancy outcomes in pregnant woman with hypertension and preeclampsia.

目的:分析子宫动脉栓塞术治疗妇产科出血性疾病的疗效及安全性.方法:收集我院2012年6月至2015年1月期间诊治的妇产科出血性疾病患者43例进行子宫动脉栓塞术,并对术后6个月、12个月月经情况进行随访.结果:43例患者均有效实施子宫动脉栓塞术,且均达到了有效的临床止血效果;另所有患者术后月经周期、经期、经量较术前无明显变化.结论:子宫动脉栓塞术对于治疗妇产科出血性疾病疗效显著,对月经情况无明显远期影响.

目的：观察基于络病理论自拟健脾祛痰通络方治疗肥胖型多囊卵巢综合征的临床疗效。方法：选取肥胖型多囊卵巢综合征患者45例，随机分为观察组23例、对照组22例。观察组口服健脾祛痰通络方中药煎剂，对照组口服二甲双胍，两组疗程均为3个月。观察两组治疗前后BMI、WHR、FPG、FINS、HOMA-IR、LH、FSH、T、TC、TG、HDL、LDL，以及月经恢复率，进行统计学分析。结果：观察组月经恢复率91%，对照组73%，差异有统计学意义（P<0.05）。健脾祛痰通络方缓解肥胖症状优于二甲双胍，两组治疗后BMI、WHR差异有统计学意义（P<0.05）；两组在治疗血脂、血糖代谢方面具有同等疗效，治疗后FPG、FINS、HOMA-IR、LH、FSH、T、TC、TG、HDL、LDL差异均无统计学意义（P>0.05）。结论：以络病理论为拟方依据的健脾祛痰通络方治疗肥胖型多囊卵巢综合征能有效地改善胰岛素抵抗，纠正代谢紊乱，调节月经周期，促进卵巢排卵。

Objective To study the influence of laparoscopic uterine artery occlusion(LUAO) combined with resection of adeno-myosis on the uterine and ovarian blood flow .Methods A total of 80 cases of uterine fibroids were divided into control group and observation group .The control group was given resection of adenomyosis .The observation group was given LUAO combined with resection of adenomyosis .The blood flow parameters of the uterine artery and ovarian artery ,including the maximum flow velocity (Vmax) ,the lowest blood flow velocity(Vmin) ,the resistance index(RI) and the pulse index(PI) ,of the two groups were measured and compared before the operation ,6 and 12 months after operation .Results At 6 and 12 months after operation ,the levels of Vmin and Vmax of uterine artery in control group and observation group were lower than those before operation ,while PI and RI were higher(P< 0 .05) .The Vmax and Vmin of uterine artery in observation group were significantly lower than control group ,and PI and RI were significantly higher(P< 0 .05) .There were no significant differences in the parameters of ovarian artery blood flow pa-rameters(Vmax ,Vmin ,RI ,PI) between the two groups before operation ,6 and 12 months after operation(P> 0 .05) .Conclusion LUAO combined with resection of adenomyosis could decrease uterine blood supply ,but without obvious effect on ovarian blood flow .