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Chinese Medical Journal 2024年第4期137卷 499-501页

作者： Xia Xu Yanni Guo Tingting Liao Huale Zhang Rumeng Jiang Shuyao Huang Jianying Yan Department of obstetrics and gynecology Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics&Gynecology and PediatricsFujian Medical UniversityFuzhouFujian 350001China

To the Editor:Gestational diabetes mellitus(GDM)is a pathologic condition in which glucose intolerance and insulin resistance develop to different degrees during pregnancy.Women with GDM have higher odds of adverse maternal and fetal outcomes.Patients with a history of GDM were at a significantly increased risk for recurrence of GDM in subsequent pregnancies.Our previous and some other studies found an increased incidence of adverse perinatal outcomes in pregnant with recurrent GDM.^([1])So far,women with a prior history of GDM are not recommended to refrain from subsequent pregnancy in light of the limited available data.What about those women with a history of recurrent GDM?Should women with recurrent GDM be recommended to avoid further pregnancy?Currently,studies on perinatal outcomes of women with re-recurrent GDM and their prognostic factors are very rare.Therefore,this retrospective cohort study was performed to explore perinatal outcomes of pregnant woman with re-recurrent GDM and their prognostic factors.

关键词： mellitus pregnancy diabetes

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Subsequent pregnancy outcomes and fertility rates in the case series that underwent bilateral hypogastric artery ligation(BHGAL)due to severe postpartum hemorrhage

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Asian pacific Journal of Reproduction 2024年第1期13卷 28-33页

作者： OKUTUCU Gulcan EVSEN Mehmet S PEKER Nurullah YAMAN TUNC Senem ICEN Mehmet S Department of obstetrics and gynecology Division of PerinatologyTurkish Ministry of Health Ankara City HospitalAnkaraTurkey Department of obstetrics and gynecology Dicle UniversitySchool of MedicineDiyarbakirTurkey

Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a tertiary care center between 2007 and 2018 were included in the study.The records of cases were obtained from the hospital database,retrospectively.Maternal demographic data,morbidities or complications associated with BHGAL surgery,any additional haemostatic interventional or surgical procedures,preoperative admission and lowest postoperative haematocrit-hemoglobin values,blood products given,type of anaesthesia,intensive care unit(ICU)and length of hospital stay were recorded.In cases without surgical sterilization,future fertility and subsequent pregnancy outcomes were assessed for at least two years after operation.Information was obtained through face-to-face or telephone interviews with patients whose long-term fertility and subsequent pregnancy outcomes were assessed.Results:Sixty-eight patients with BHGAL surgery history were included in the study.26 Of 37 cases(70%)that did not undergo surgical sterilization had a desire for pregnancy after the surgery.Six of these cases(23%)were diagnosed with secondary infertility.The fertility rate of these cases was 77%,and subsequent pregnancy was detected in 20 women.A total of 25 pregnancies,including first and second pregnancies,developed,and 15 of these pregnancies resulted in term delivery,six preterm births,one stillbirth,and three abortions.Conclusions:The postoperative pregnancy rate was found to be higher than the rate of women with infertility problems,and this surgery does not seem to adversely affect pregnancy outcomes.This is a tertiary center experience and cohort studies with large patient series are needed.

关键词： Fertility Iliac artery Ligations Postpartum hemorrhage Pregnancy outcomes

Histological Features of Uterine Myometrial Dysfunction:Possible Involvement of Localized Inflammation

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Current Medical Science 2024年第3期44卷 633-641页

作者： Sheng-lan ZHU Hui-ting ZHANG Yuan-yuan DU Yi JIANG Shao-shuai WANG Wen-cheng DING Ling FENG National Clinical Research Center for obstetrics and gynecology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of obstetrics and gynecology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Objective The latest perspective suggests that elevated levels of inflammation and cytokines are implicated in atonic postpartum hemorrhage.Lipopolysaccharide(LPS)has been widely used to induce inflammation in animal models.Therefore,this study aimed to induce uterine inflammation using LPS to investigate whether local inflammation triggers dysfunction and atrophy in the myometrium,as well as the potential underlying molecular mechanisms involved.Methods In vivo,an animal model was established by intraperitoneal injection of 300μg/kg LPS in rats on gestational day 21.Hematoxylin-eosin(H&E)staining and Masson staining were employed to determine morphological changes in the rat uterine smooth muscle.Enzyme-linked immunosorbent assay(ELISA)was used to detect inflammatory cytokines.Immunohistochemistry,tissue fluorescence,and Western blotting were conducted to assess the expression levels of the uterine contraction-related proteins Toll-like receptor 4(TLR4)and the nuclear factor kappa-B(NF-κB)signaling pathway.In vitro,human uterine smooth muscle cells(HUtSMCs)were exposed to 2μg/mL LPS to further elucidate the involvement of the TLR4/NF-κB signaling pathway in LPS-mediated inflammation.Results In this study,LPS induced uterine myometrial dysfunction in rats,leading to a disorganized arrangement,a significant increase in collagen fiber deposition,and widespread infiltration of inflammatory cells.In both in vivo animal models and in vitro HUtSMCs,LPS elevated IL-6,IL-1β,and TNF-αlevels while concurrently suppressing the expression of connexin 43(Cx43)and oxytocin receptor(OXTR).Mechanistically,the LPS-treated group exhibited TLR4 activation,and the phosphorylation levels of p65 and IκBαwere notably increased.Conclusion LPS triggered the TLR4/NF-κB signaling pathway,inducing an inflammatory response in the myometrium and leading to uterine myometrial dysfunction and uterine atony.

关键词： lipopolysaccharide inflammatory response TLR4 NF-κB myometrium

Development of immature ovarian teratoma after mature teratoma in a girl with familial ovarian teratoma:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1442-1447页

作者： U Chul Ju Woo Dae Kang Seok Mo Kim Department of obstetrics and gynecology Chonnam National University Medical SchoolGwangju 61469South Korea

BACKGROUND Immature ovarian teratoma is a rare and aggressive neoplasm that affects young women.This report is the first to describe the development of immature teratoma after ovarian cystectomy for mature teratoma of the ovary in an adolescent female with a family history of ovarian teratoma.CASE SUMMARY A 16-year-old girl who had undergone bilateral ovarian cystectomy for mature teratomas 3 years ago showed bilateral adnexal tumors during her regular ultrasonography follow-up every 6 months.She received laparoscopic bilateral ovarian cystectomy,and final histopathology showed grade-1 immature teratoma of the left ovary and mature teratoma of the right ovary.Laparoscopic left salpingo-oophorectomy and staging procedures were performed again.Her mother,maternal aunt,and maternal grandmother had also received surgeries for mature ovarian teratomas.CONCLUSION It is important to have guidance on management of patient and family members with familial ovarian teratomas.

关键词： Familial ovarian teratomas Adolescent female Immature ovarian teratoma Management Case report

Fertility preservation in patients with gynecologic cancer

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World Journal of Clinical Cases 2024年第14期12卷 2301-2303页

作者： Nicolae Gică Department of obstetrics and gynecology Carol Davila University of Medicine and PharmacyBucharest 775887Romania

In this editorial we comment on the article by Gu et al.We focus and debate the necessity of fertility sparing surgery in young women’s with gynecologic cancers,specifically on those patients with the desire to conceive.This type of individu-alized treatment options is often very difficult,due to the risk of disease evolution and multiple disparities in fertility preservation services among women in di-fferent countries and societies.For this reason national policy interventions are mandatory in order to ensure equitable access this procedures,in women with cancer.

关键词： Fertility sparing surgery Pregnancy Gynecologic cancer Endometrial cancer Ovarian cancer

Association between body mass index and in vitro fertilization/intra-cytoplasmic sperm injection outcomes: An analysis of 15,124 normal ovarian responders in China

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中华医学杂志(英文版) 2024年第7期137卷 837-845页

作者： Zheng Danlei Wang Yuanyuan Chen Lixue Zeng Lin Li Rong Department of obstetrics and gynecology Center for Reproductive Medicine Peking University Third Hospital Beijing 100191 China Research Center of Clinical Epidemiology

Background: High body mass index (BMI) results in decreased fecundity, and women with high BMI have reduced rates of clinical pregnancy and live birth inin vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Meanwhile, ovarian responses show great heterogeneity in patients with a high BMI. This study aimed to analyze the effects of a high BMI on IVF/ICSI outcomes in the Chinese female with normal ovarian response.Methods: We performed a retrospective cohort study comprising 15,124 patients from the medical record system of the Reproductive Center of Peking University Third Hospital, with 3530 (23.3%) in the overweight group and 1380 (9.1%) in the obese group, who had a normal ovarian response (5-15 oocytes retrieved) and underwent fresh embryo transfer (ET) cycles from January 2017 to December 2018, followed by linked frozen-thawed embryo transfer (FET) cycles from January 2017 to December 2020. Cumulative live birth rate (CLBR) was used as the primary outcome. Furthermore, a generalized additive model was applied to visually illustrate the curvilinear relationship between BMI and the outcomes. We used a decision tree to identify the specific population where high BMI had the greatest effect on IVF/ICSI outcomes.Results: High BMI was associated with poor IVF/ICSI outcomes, both in cumulative cycles and in separate fresh ET or FET cycles. In cumulative cycles, compared with the normal weight group, obesity was correlated with a lower positive pregnancy test rate (adjusted odds ratio [aOR]: 0.809, 95% confidence interval [CI]: 0.682-0.960), lower clinical pregnancy rate (aOR: 0.766, 95% CI: 0.646-0.907), lower live birth rate (aOR: 0.706, 95% CI: 0.595-0.838), higher cesarean section rate (aOR: 2.066, 95% CI: 1.533-2.785), and higher rate of large for gestational age (aOR: 2.273, 95% CI: 1.547-3.341). In the generalized additive model, we found that CLBR declined with increasing BMI, with 24 kg/m2 as an inflection point. In the decision tree, BMI only made a difference in the population aged ≤34.5 yea

关键词： Obesity Body mass index In vitro fertilization Live birth Decision trees Normal ovarian response

Chinese Population Reference Curves for Ultrasound-Measured Amniotic Fluid Deepest Vertical Pocket in Dichorionic Twin Pregnancies,and Their Associations With Pregnancy Outcomes

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Maternal-Fetal Medicine 2024年第1期6卷 29-36页

作者： Zhengxin Lyu Tianchen Wu Shan Lu Pengbo Yuan Yangyu Zhao Yuan Wei Department of obstetrics and gynecology Peking University Third HospitalBeijing 100191China

Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:This retrospective cohort study,conducted at Peking University Third Hospital from August 2011 to December 2020,used data from 375 women aged 20 to 45 years who had dichorionic twin pregnancies that were confirmed through first-trimester ultrasound.After exclusions,reference curves were developed using 318 women with 3,299 DVP scans,and the data analyzed included maternal demographics,pregnancy outcomes,ultrasound measurements,and neonatal information.DVPs were assessed via ultrasound at regular intervals and grouped by gestational age(GA)for analyses.Linear mixed models were used to create amniotic fluid reference curves.Associations between abnormalities and adverse perinatal outcomes were examined using Chi-squared or Fisher's exact tests.Logistic regression provided both crude and adjusted odds ratios,adjusting for pre-pregnancy weight,age,ethnicity,parity,and conception mode.Significance was set at P<0.05 with 95%confidence intervals(CI),and the analyses were conducted using SPSS ver.26.0(IBM Corp.,Armonk,NY)and SAS ver.9.4(SAS Institute Inc.,Cary,NC,USA)software.Results:DVP increased from the first trimester to a maximum at 26 weeks(95%confidence interval(CI),2.7–8.3 cm for twin 1 and 2.8–7.9 cm for twin 2)and then decreased gradually toward term.Differences between twins 1 and 2 were significant after 26 weeks(95%CI for twin 1:5.3,5.5;95%CI for twin 2:4.4,4.5;P<0.010).Polyhydramnios of twin 1 increased the risk of large for GA.Oligohydramnios of twin 1 increased the risk of small for GA.Polyhydramnios of twin 2 increased the risk of small for GA,premature birth,and neonatal complications.Oligohydramnios of twin 2 increased the risk of preeclampsia,hypertensive disorder complicating pregnancy,and premature rupture of membranes.Conclusion:Reference curves for twin amniotic fluid volumes vary by GA and

关键词： Amniotic fluid Amniotic fluid deepest vertical pocket Reference curve Dichorionic twin Pregnancy outcome Ultrasound examination

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Curcumin modulates oxidative stress to inhibit pyroptosis and improve the inflammatory microenvironment to treat endometriosis

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Genes & Diseases 2024年第3期11卷 102-105页

作者： Jie Ding Shanshan Mei Kaili Wang Wen Cheng Shuai Sun Zhexin Ni Xiaoqiu Wang Chaoqin Yu Department of gynecology of Traditional Chinese Medicine Changhai Hospital Affiliated to Naval Medical UniversityShanghai 200433China obstetrics and gynecology Department The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouZhejiang 310006China Department of Pharmaceutical Sciences Beijing Institute of Radiation MedicineBeijing 100850China obstetrics and gynecology Hospital of Fudan University Shanghai 200433China

Endometriosis(EM)is a common disease that affects approximately 10%-15%of women of childbearing age.The pathogenesis of EM is unclear,but studies have shown a strong association between EM and inflammation,as well as oxidative stress.^(1) Pyroptosis is also called inflammatory cell death.When pyroptosis occurs,it activates a strong inflammatory response.Pyroptosis is associated with oxidative stress,and Ros act as intermediate triggers to activate pyroptosi.

关键词： inflammatory death oxidative

Clinical observation on 90 cases of primary dysmenorrhea treated by buccal acupuncture therapy:a randomized controlled study

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Journal of Traditional Chinese Medicine 2024年第1期44卷 172-181页

作者： YANG Yi YE Huijun ZHENG Huiling JIN Lihua Department of obstetrics and gynecology the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityXinhua Hospital of Zhejiang ProvinceHangzhou 310005China

OBJECTIVE:To explore the short-term and long-term efficacy of buccal acupuncture therapy in the treatment of patients with primary dysmenorrhea(PD).METHODS:A total of 90 patients with PD who were admitted to the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2020 to December 2021 were included in this study and randomly divided into three groups,including the observation group,the control group,and the placebo group,with 30 patients in each group.Patients in the observation group were treated according to the syndrome types of Traditional Chinese Medicine,those in the control group were treated with Saridon,and those in the placebo group received a placebo.The visual analog scale(VAS)scores of these patients were evaluated at different time points(before treatment,5 min after needle retention,30 min after needle retention,1 h after treatment,2 h after treatment,1 d after treatment,and 2 d after treatment).The Cox Menstrual Symptom Scale(CMSS)scores were assessed before the treatment and after three courses of treatment.Besides,these two scales were also evaluated during follow-up.Moreover,the pain score and adverse reactions of these patients were assessed during treatment.RESULTS:After treatment,the VAS and CMSS scores in the observation group decreased significantly(P<0.05)5 and 30 min after needle retention and after treatment.CONCLUSION:Buccal acupuncture therapy is verified to have short-term efficacy in the treatment of PD.In addition,this therapy has an immediate analgesic effect and long-term efficacy in reducing the severity and frequency of PD.

关键词： buccal acupuncture therapy primary dysmenorrhea pain score randomized controlled trial

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Postpartum depression and partner support during the period of lactation:Correlation research and its influencing factors

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World Journal of Psychiatry 2024年第1期14卷 119-127页

作者： Ji-Ming Ruan Ling-Juan Wu Department of obstetrics and gynecology Huzhou Maternity and Child Health Care HospitalHuzhou 313000Zhejiang ProvinceChina

BACKGROUND Postpartum depression(PPD)not only affects the psychological and physiological aspects of maternal health but can also affect neonatal growth and development.Partners who are in close contact with parturient women play a key role in communication and emotional support.This study explores the PPD support relationship with partners and its influencing factors,which is believed to establish psychological well-being and improve maternal partner support.AIM To explore the correlation between PPD and partner support during breastfeeding and its influencing factors.METHODS Convenience sampling was used to select lactating women(200 women)who underwent postpartum examinations at the Huzhou Maternity and Child Health Care Hospital from July 2022 to December 2022.A cross-sectional survey was conducted on the basic information(general information questionnaire),depression level[edinburgh postnatal depression scale(EPDS)],and partner support score[dyadic coping inventory(DCI)]of the selected subjects.Pearson’s correlation analysis was used to analyze the correlation between PPD and DCI in lactating women.Factors affecting PPD levels during lactation were analyzed using multiple linear regression.RESULTS The total average score of EPDS in 200 lactating women was(9.52±1.53),and the total average score of DCI was(115.78±14.90).Dividing the EPDS,the dimension scores were:emotional loss(1.91±0.52),anxiety(3.84±1.05),and depression(3.76±0.96).Each dimension of the DCI was subdivided into:Pressure communication(26.79±6.71),mutual support(39.76±9.63),negative support(24.97±6.68),agent support(6.87±1.92),and joint support(17.39±4.19).Pearson’s correlation analysis demonstrated that the total mean score and individual dimension scores of EPDS during breastfeeding were inversely correlated with the total score of partner support,stress communication,mutual support,and cosupport(P<0.05).The total mean score of the EPDS and its dimensions were positively correlated with negative support(P<0.05).Multiple linear regression analy

关键词： Lactation period Puerpera Postpartum depression Partner support Correlation