Background: Premature birth (PTB) is a major cause of neonatal mortality and has enduring consequences. LIM Homeobox 1 (LHX1) is vital in embryonic organogenesis, while Inositol-Requiring Enzyme 1 (IRE-1) regulates endoplasmic reticulum stress (ERS). This study explores whether IRE-1 impacts PTB via LHX1 modulation. Methods: We analyzed LHX1 expression in placental samples from PTB patients and examined its impact on the viability, migration, invasion, and apoptosis of the human placental trophoblast cell line HTR8/Svneo, particularly when treated with the ERS inducer tunicamycin (TM). We also assessed the levels of ERS-related genes and autophagy activation in response to LHX1 deficiency. To gain mechanistic insights, we evaluated the ERS-mediated activation of the IRE-1/XBP1/CHOP signaling pathway in LHX1-silenced HTR8/Svneo cells. Additionally, we examined the transcriptional activation of IRE-1 and the binding of LHX1 to the IRE-1 promoter in HTR8/Svneo cells. We overexpressed IRE-1 in LHX1-silenced HTR8/Svneo cells to assess its effects on cell viability, migration, invasion, apoptosis, and autophagy. Finally, we induced LHX1 knockdown in mice through intraperitoneal injections of tunicamycin (TM) and Sh-LHX1 over a 24-h period to evaluate PTB symptoms. Results: We observed LHX1 overexpression in placental tissue from PTB cases and TM-induced HTR8/Svneo cells. LHX1 depletion enhanced cell viability, migration, and invasion while reducing autophagy and apoptosis. This reduction in LHX1 led to decreased levels of IRE-1, XBP1, CHOP, and other ERS-related genes, indicating LHX1's role in ERS induction and the activation of the IRE-1/XBP1/CHOP pathway. Mechanistically, LHX1 was found to bind to the IRE-1 promoter, inducing its transcriptional activation. Notably, overexpressing IRE-1 counteracted the impact of LHX1 depletion on trophoblast cell behavior, suggesting that LHX1 modulates IRE-1. In line with our in vitro studies, LHX1 knockdown ameliorated PTB symptoms in TM-treated mice. Conclusion: LHX1 contributes to the progression of PTB by regulating the IRE-1-XBP1-CHOP pathway.

Objective:To compare effects of Atosiban and Ritodrine in treatment of late abortion and threatened premature labor in twin pregnancy women.Methods:A prospective study was conducted on 80 twin pregnancy women with late abortion and threatened premature labor admitted to this hospital from August 2021 to August 2023.They were divided into control group and observation group according to the random number table method,40 cases in each group.The control group was treated with Ritodrine hydrochloride,while the observation group was treated with Atosiban.The excellent and good rate of uterine contraction inhibition,the prolonged pregnancy time,the levels of sex hormone indexes before and after the treatment,the incidence of adverse pregnancy outcomes,and the incidence of adverse reactions were compared between the two groups.Results:The excellent and good rate of uterine contraction inhibition in the observation group was 97.50%(39/40),which was higher than 70.00%(28/40)in the control group,and the difference was statistically significant(P<0.05).The prolonged pregnancy time in the observation group was longer than that in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of estriol in the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;the progesterone levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).The incidence of adverse pregnancy outcomes such as cesarean section,premature delivery,abortion,stillbirth and neonatal asphyxia in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Atosiban in the treatment of the twin pregnancy women with late abortion and threatened premature labor can improve the excellent and good rate of uterine contraction inhibition,prolong the pregnancy time,improve the levels of sex hormone indexes,and reduce the incidence of adverse pregnancy outcomes.Moreover,it is superior to Ritodrine treatment.

Objective:To investigate the correlation between inositol level and glycolipid metabolism in gravidas with gestational diabetes mellitus (GDM).Methods:A cross-sectional study was conducted on 80 GDM cases undergoing routine examination at Fujian Provincial Maternity and Children's Hospital from November 2018 to August 2019, who were selected as GDM groups. Another 50 women with uncomplicated pregnancies during the same period were selected as the control group. Blood and urine inositol level and serum glycolipid profiles were compared between the two groups, and their association was analyzed. Independent or paired-sample t test, Mann-Whitney test, Chi-square (or Fisher's exact) test, and Pearson correlation test were performed for statistical analysis. Results:The serum inositol concentration and high-density lipoprotein (HDL) cholesterol in the GDM group were significantly lower [322.1 ng/ml (279.1-364.1 ng/ml) vs 403.8 ng/ml (391.8-425.3 ng/ml), Z=-7.879; 1.8 mmol/L (1.5-2.0 mmol/L) vs 2.0 mmol/L (1.7-2.2 mmol/L), Z=-2.419; both P<0.05], while the concentration of urine inositol, lipoprotein-a (lipo-a), 0 h-, 1 h-, 2 h-oral glucose tolerance test (OGTT) glucose, fasting insulin, and glycosylated hemoglobin (HbA1c) were significantly higher when comparing to the control group [192.2 ng/ml (171.0-219.9 ng/ml) vs 143.8 ng/ml (121.1-158.6 ng/ml), Z=-6.834; 253.2 mg/L (65.0-349.0 mg/L) vs 148.5 mg/L(46.5-159.3 mg/L), Z=-0.187; 5.0 mmol/L (5.1-5.6 mmol/L) vs 4.4 mmol/L (4.2-4.6 mmol/L), Z=-5.547; 10.0 mmol/L (9.1-11.3 mmol/L) vs 7.8 mmol/L (7.0-8.4 mmol/L), Z=-6.987; 8.6 mmol/L(7.6-9.4 mmol/L) and 6.6 mmol/L (5.7-7.1 mmol/L), Z=-7.100; 18.2 mU/L(10.6-25.9 mU/L) vs 11.0 mU/L (6.3-12.7 mU/L), Z=-4.537; 5.4%(4.5%-5.5%) vs 5.1%(4.9%-5.4%), Z=-3.468; all P<0.05]. (2) Serum inositol concentration was negatively correlated with fasting insulin and 0 h-, 1 h-, 2 h- OGTT glucose level ( r=-0.386, -0.416, -0.350 and -0.407, respectively); urinary inositol concentration was positively correlated with 0 h-, 1 h-, 2 h-OGTT glucose levels ( r=0.402, 0.389 and 0.429, respectively) (all P<0.05). Conclusions:Serum inositol concentration was decreased, and urinary inositol excretion was increased in women with GDM. Measurement of changes in inositol levels during the second trimester may be helpful to assess the metabolic status of pregnant women.

Objectives To analyze the clinical characteristics and perinatal outcomes of umbilical cord vascular rupture, and to investigate the diagnosis and treatment strategies for reducing adverse perinatal outcomes. Methods Clinical data of patients with a singleton pregnancy with umbilical cord rupture who were admitted to Fujian Maternity and Child Health Hospital were collected. The incidence, related factors, clinical features and perinatal outcomes of umbilical cord rupture were retrospectively analyzed. Results There were eight cases of umbilical cord rupture (incidence rate: 1/8370). Among them, seven were secondary to umbilical cord insertion abnormality, and one may have been related to a relatively short umbilical cord and umbilical cord traction. There were eight cases of abnormal fetal heart rate, two of vaginal bleeding, five of bloody amniotic fluid, five of premature rupture of the membranes, and two of placental abruption. With regard to outcomes, 50% of patients had cesarean section, 12.5% had forceps delivery, and 50% had perinatal mortality. Conclusions Vaginal bleeding, amniotic fluid, fetal heart rate, and umbilical cord insertion should be closely monitored in pregnancy. When abnormal conditions occur, obstetricians should be aware of rupture of the umbilical vessels and terminate pregnancy as soon as possible, which could improve perinatal outcomes.

目的 探讨椎管内分娩镇痛对产程及妊娠结局的影响.方法 选取福建省妇幼保健院2017年1月—12月椎管内分娩镇痛经阴道分娩初产妇53例为观察组,随机抽取同期经阴道分娩非镇痛初产妇55例为对照组,比较观察组与对照组产程及妊娠结局(产后2 h出血量、羊水胎粪污染率、新生儿科转入率、缩宫素使用率、阴道检查率和破膜方式).结果 观察组与对照组第一产程分别为7.33(4.50～13.75)h与13.00(10.00～15.00)h,第二产程分别为0.48(0.37～0.74)h与0.75(0.38～1.12)h,总产程分别为8.02(5.10～14.56)h与14.08(10.80～16.25)h,两组相比差异均有统计学意义(Z=-4.085,P<0.001;Z=-2.315,P=0.021;Z=-4.290,P<0.001;);观察组与对照组缩宫素使用率分别为22.6％(12/53)与54.5％(30/55),阴道检查率分别为26.4％(14/53)与58.2％(32/55),两组相比差异均有统计学意义(χ2=11.560,P=0.001;χ2=11.139,P=0.001);观察组第三产程时间、产后2 h出血量、羊水胎粪污染率、新生儿科转入率及人工破膜率与对照组相比,差异无统计学意义(P>0.05).结论 分娩镇痛能有效减轻疼痛,缩短第一、第二产程及总产程,安全可靠,可推广应用于产科分娩.

目的:探讨椎管内分娩镇痛在一次剖宫产术后再次妊娠阴道试产中的可行性.方法:选取2017年1月至12月福建省妇幼保健院收治的一次剖宫产术后再次妊娠阴道试产的孕妇180例.根据是否实施椎管内镇痛分为镇痛组(93例)和非镇痛组(87例),回顾分析两组孕妇的分娩情况与新生儿结局.结果:镇痛组孕妇的中转剖宫产比例低于非镇痛组孕妇[6.45％ (6/93) vs 16.09％ (14/87),P=0.040];两组的阴道试产成功率、产钳助产率比较,差异均无统计学意义(P＞0.05).镇痛组孕妇的第一产程及总产程时间较非镇痛组孕妇明显缩短[8.33(5.50～11.00)h vs 12.50(8.29～14.46)h,8.92(6.19～12.03)h vs 13.03(9.27～15.18)h,Z=-4.69;P均＜0.001],两组间的第二及第三产程时间比较,差异无统计学意义(P＞0.05).镇痛组的缩宫素使用率低于非镇痛组[6.45％ (6/93) vs 25.29％ (22/87),P＜0.001],两组的人工破膜率、产后2h出血量比较,差异无统计学意义(P＞0.05).两组的新生儿出生体质量及出生后1 min Apgar评分比较,差异无统计学意义(P＞0.05).结论:一次剖宫产术后再次妊娠阴道试产的孕妇可在严密监护下行椎管内分娩镇痛,安全可靠,值得临床推广.

目的 观察消癥抗癌方对早中期宫颈癌患者免疫功能、生活质量的影响及其安全性.方法 将80例宫颈癌患者随机分为治疗组及对照组,每组各40例,两组予放疗后序贯完成紫杉醇加顺铂化疗,治疗组在此基础上加用消癥抗癌方,21天为1个周期,共4个周期.检测治疗前后免疫功能(CD3+、CD4+、CD8+、NK百分比)、血常规、肝肾功能,记录治疗前后生活质量评分,观察治疗后化疗相关性恶心呕吐情况.结果 治疗组CD3+、CD4+、NK细胞百分比及CD4+/CD8+分别为(68±7)％、(37±4)％、(26±3)％、(1.28±0.11),高于对照组[(61±6)％,(31±5)％,(22±3)％,(1.11±0.14),P＜0.05],躯体功能、角色功能、总体健康状况优于对照组(P ＜0.01,P＜0.05),治疗组骨髓抑制、腹泻发生率低于对照组(P＜0.05).两组化疗相关性恶心呕吐缓解情况差异无统计学意义(P＞0.05).结论 消癥抗癌方可提高早中期宫颈癌患者免疫功能,改善生活质量,减轻放化疗不良反应.

目的:探讨双胎妊娠不同分娩方式及临床结局关系.方法:回顾性分析2016年1-12月本院收治的双胎妊娠孕妇459例的临床资料,比较不同分娩方式下孕妇的一般资料、妊娠并发症和妊娠结局.结果:双胎妊娠选择剖宫产比率明显高于阴道分娩,臀/头位剖宫产比率最高;阴道分娩组孕妇的年龄、孕周及初产妇例数均显著低于剖宫产组(P<0.05);孕妇伴发妊娠期高血压疾病、妊娠期糖尿病、胎儿窘迫、胎膜早破及胎盘早剥等并发症时,选择剖宫产的比率高于阴道分娩(P<0.05);阴道分娩组胎儿的早产率高于剖宫产组(P<0.05),两组产后出血率比较,差异无统计学意义(P>0.05);新生儿体重较大者选择剖宫产的比率高于阴道分娩(P<0.05),两种分娩方式的第1胎生后的Apgar评分比较,差异无统计学意义(P>0.05),阴道分娩组第2胎生后的Apgar评分≤7分者明显高于剖宫产组(P<0.05).结论:双胎妊娠的孕妇在选择分娩方式时要综合考虑各项因素,改善妊娠结局及新生儿预后.