Objective To analyze the levels of IL-35, IL-10 and TGF-β in women with or without pregnancy and to investigate the correlation between IL-35 and recurrent spontaneous abortion.MethodsLevels of IL-35, IL-10 and TGF-β in serum were analyzed by enzyme-linked immunosorbent assay (ELISA) in 120 gravidas with normal pregnancy, 40 gravidas with a history of recurrent spontaneous abortion, 40 healthy postpartum women and 40 healthy non-pregnant women of childbearing age.Single factor logistic regression analysis was used for correlation analysis.Results The level of serum IL-35 in normal pregnancies was significantly higher than that in non-pregnant women [333.6 (59.32, 1 391) pg/ml vs 123.9 (8.763, 471.7) pg/ml, P<0.001].The level of TGF-β increased significantly in the first trimester as compared with that in non-pregnant women [473.4 (398.0, 580.5) pg/ml vs 379.7 (311.0, 441.3) pg/ml, P<0.01].No significant difference in the level of serum IL-10 was observed between gravidas and non-gravidas [8.602 (5.854, 12.89) pg/ml vs 9.339 (5.691, 12.07) pg/ml, P>0.05].The level of serum IL-35 in gravidas with recurrent spontaneous abortion was significantly lower than that in healthy gravidas in their first trimester [220.4 (4.951, 702.0) pg/ml vs 386.5 (64.37, 1 355) pg/ml, P<0.05].Serum IL-35 was negatively correlated with the occurrence of recurrent spontaneous abortion (regression coefficient=-0.003, OR=0.997).Conclusion The level of serum IL-35 increases in healthy gravidas, but decreases in gravidas with recurrent spontaneous abortion.IL-35, rather than IL-10 or TGF-β, is recognized as an active player in maternal-fetal immune tolerance.

Objective To explore the serum lipids levels in healthy pregnant women,and to establish the reference intervals of serum lipids in middle and late pregnancy.Methods Triglyceride (TG),total cholesterol (TCH),high density lipoprotein (HDL),low density lipoprotein (LDL),apo-lipoprotein-A (APO-A) and apo-lipoprotein-B (APO-B) were measured in 3 200 pregnant women and 3 200 healthy women of childbearing age(the control group) from January 2014 to Febuary 2015 in Obstetrics and Gynecology Hospital of Fudan University.In the healthy pregnant women,serum lipids were measured at 14-20,24-28 and 37-40 gestational weeks,respectively.All the parameters were detected by Hitachi 7180 automatic biochemical analyzer.The test results were calculated and determined by the C28-A3 standard of the National Clinical and Laboratory Standards Institute.And the normal reference intervals of serum lipids in middle and late pregnancy were defined as 2.5％-97.5％.Results (1) The levels of TG,TCH,HDL,LDL,APO-A and APO-B in the control group were 0.8,4.2,1.0,2.7 mmol/L and 1.1,0.8 g/L,respectively.The levels of TG,TCH,HDL,LDL,APO-A and APO-B in middle and late pregnancy were significantly higher than those in the control group (P＜0.05).(2) The serum lipids levels at 14-20,24-28 and 37-40 gestational weeks in healthy pregnant women were compared with the control group as following.The TG levels were 1.9,3.8 and 4.4 folds of the control group;the TCH levels were 1.1,1.5 and 1.5 folds of the control group;the HDL levels were 1.2,1.6 and 1.5 folds of the control group;the LDL levels were 1.1,1.4 and 1.4 folds of the control group;the APO-A levels were 1.3,1.4 and 1.5 folds of the control group;and the APO-B levels were 1.1,1.5 and 1.5 fold of the control group respectively.The TG level was the most increased,and it increased gradually with gestational age (P＜0.01).(3) The median of LDL to HDL cholesterol ratio in the healthy pregnancy group at 14-20,24-28 and 37-40 gestational weeks were 2.7,2.5,2.6,respectively,which were significantly lower than that of the control group (2.8;P＜0.05).(4) Reference intervals of serum lipids at 14-20,24-28 and 37-40 gestational weeks in healthy pregnant women were as following.The TG levels were 0.7-3.9,1.7-6.3 and 1.6-8.1 mmol/L,respectively;the TCH were 3.3-6.9,4.3-8.3,4.3-8.7 mmol/L,respectively;the HDL were 0.8-1.8,1.0-2.1 and 1.0-2.1 mmol/L,respectively;the LDL were 2.1-4.5,2.7-5.1 and 2.6-5.2 mmol/L,respectively;the APO-A were 1.1-1.8,1.2-1.9 and 1.1-2.4 g/L,respectively;and the APO-B were 0.6-1.4,0.9-1.8 and 0.8-2.1 g/L,respectively.The LDL/HDL ratios were 2.3-3.1,2.2-2.9 and 2.1-3.0,respectively.Conclusions Serum lipids increased physiologically with gestational age in middle and late pregnancy.The establishment of reference intervals for serum lipids in pregnancy will help to distinguish abnormal serum lipid levels in middle and late pregnancy.

Objective To investigate the detection and significance of anti-Müllerian hormone (AMH) and inhibin B (INHB) in patients with polycystic ovary syndrome (PCOS). Methods This study randomly selected 240 PCOS patients from January to October 2018 in Obstetrics and Gynecology Hospital of Fudan University, and 240 healthy women who were admitted to the physical examination center of Obstetrics and Gynecology Hospital of Fudan University as control group during the same period. Retrospective study was adopted. Serum samples of patients were collected and the serum estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), sex hormone binding globulin (SHBG), AMH and INHB were detected. The data were analyzed by single sample Kolmogorov-Smimov test, independent sample T test and logistic regression analysis. Results The detection values of AMH, INHB, E2, LH, FSH, T, SHBG and INHB/AMH in PCOS group were (8.55±3.17) ng/ml, (101.7±15.2) pg/ml, (63± 50) pg/ml, (13.0±5.8) mIU/ml, (6.5±1.5) mIU/ml, (0.68±0.23) ng/ml, (62±52) nmol/ml and (24.03±26.35) respectively. In the control group, the detection values of AMH, INHB, E2, LH, FSH, T, SHBG, INHB and AMH were (4.34±2.07) ng/ml, (83.3±7.7) pg/ml, (66±25) pg/ml, (7.1±3.7) mIU/ml, (7.2±1.9) mIU/ml, (0.40± 0.11) ng/ml, (67±37) nmol/ml and (42.83±62.22). The detection values of AMH, INHB, LH, T and SHBG in PCOS group were higher than those in control group (the t values were 9.843, 7.373, 9.021, 9.349 and 3.867), and the difference was statistically significant (P<0.05). The detection values of E2 and FSH in PCOS group were lower than those in control group(the t values were 0.762 and -1.342), with no significant difference (P>0.05). The INHB/AMH value was lower than that in control group(the t value was -2.332), and the difference was statistically significant(P<0.05). The area under the curve of AMH, INHB and AMH+INHB in the diagnosis of PCOS was 0.762, 0.677 and 0.789, respectively. The cut-off value of AMH in predicting polycystic ovary syndrome was 6.96 ng/mL, the sensitivity was 61.0％, and the specificity was 82.1％. The cut-off value of INHB in predicting polycystic ovary syndrome was 94.9 pg/mL, with a sensitivity of 59.0％ and a specificity of 74.1％. The sensitivity and specificity of combined detection of AMH and INHB in predicting polycystic ovary syndrome were 83.6％ and 60.6％. The positive rates of ultrasound, T, AMH and INHB in PCOS group were 51.25％, 61.25％, 69.58％ and 66.25％, respectively. Conclusion The combined detection of AMH and INHB may improve the sensitivity and specificity of PCOS diagnosis, and its serum level is stable.

To investigate the distribution and diagnostic value of serum anti-Müllerian hormone (AMH) in healthy women of childbearing age, women with polycystic ovary syndrome (PCOS), ovarian dysfunction (DOR) and premature ovarian failure (POF). This study retrospectively selected female patients of childbearing age who were treated in the affiliated Obstetrics and Gynecology Hospital of Fudan University from January to December 2019. According to different clinical manifestations, they were divided into 133 cases in PCOS group, 120 cases in DOR group and 134 cases in POF group. 125 healthy women in the same period were selected as the control group. The values of serum AMH, estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) were measured in the four groups. Single sample Kolmogorov-Smirnov test, one-way ANOVA, independent sample t-test, Kruskal-Wallis H test, Mann-Whitney U test, logistic regression analysis and ROC curve were used for comparative analysis. The serum AMH levels of PCOS group, DOR group, POF group and control group were 9.10 (6.67, 11.49) ng/ml, 0.11 (0.05, 0.29) ng/ml, 0.03 (0.02, 0.06) ng/ml and 2.99 (1.57, 4.98) ng/ml, respectively [ M(Q1,Q3)], the differences were statistically significant ( P<0.001). The basal endocrine levels including E2, FSH, LH and T also had significant differences between groups ( P<0.001). The results of multiple comparisons showed that there were significant differences in AMH and LH between DOR, POF and PCOS groups and the control group. The T level of PCOS group was significantly higher than that of the control group, the E2, LH and T levels of DOR group were significantly higher than that of the control group, and the FSH level of POF group was significantly higher than that of the control group ( P<0.05). The area under the curve (AUC) of AMH and AMH+LH in the diagnosis of PCOS were 0.905 and 0.922, the sensitivity was 82.7% and 85.0%, and the specificity was 88.0% and 88.8%. The AUC of DOR was 0.861 and 0.971, the sensitivity was 89.0% and 92.5%, and the specificity was 63.0% and 92.0%. The AUC of POF was 0.950 and 0.998, the sensitivity was 98.3% and 99.2%, and the specificity was 75.9% and 97.0%, respectively. The AUC of AMH and AMH+LH combined indexes in the differential diagnosis of DOR and POF were 0.768 and 0.937, the sensitivity was 70.3% and 95.5%, and the specificity was 73.9% and 80.8%.

To investigate the distribution and diagnostic value of serum anti-Müllerian hormone (AMH) in healthy women of childbearing age, women with polycystic ovary syndrome (PCOS), ovarian dysfunction (DOR) and premature ovarian failure (POF). This study retrospectively selected female patients of childbearing age who were treated in the affiliated Obstetrics and Gynecology Hospital of Fudan University from January to December 2019. According to different clinical manifestations, they were divided into 133 cases in PCOS group, 120 cases in DOR group and 134 cases in POF group. 125 healthy women in the same period were selected as the control group. The values of serum AMH, estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) were measured in the four groups. Single sample Kolmogorov-Smirnov test, one-way ANOVA, independent sample t-test, Kruskal-Wallis H test, Mann-Whitney U test, logistic regression analysis and ROC curve were used for comparative analysis. The serum AMH levels of PCOS group, DOR group, POF group and control group were 9.10 (6.67, 11.49) ng/ml, 0.11 (0.05, 0.29) ng/ml, 0.03 (0.02, 0.06) ng/ml and 2.99 (1.57, 4.98) ng/ml, respectively [ M(Q1,Q3)], the differences were statistically significant ( P<0.001). The basal endocrine levels including E2, FSH, LH and T also had significant differences between groups ( P<0.001). The results of multiple comparisons showed that there were significant differences in AMH and LH between DOR, POF and PCOS groups and the control group. The T level of PCOS group was significantly higher than that of the control group, the E2, LH and T levels of DOR group were significantly higher than that of the control group, and the FSH level of POF group was significantly higher than that of the control group ( P<0.05). The area under the curve (AUC) of AMH and AMH+LH in the diagnosis of PCOS were 0.905 and 0.922, the sensitivity was 82.7% and 85.0%, and the specificity was 88.0% and 88.8%. The AUC of DOR was 0.861 and 0.971, the sensitivity was 89.0% and 92.5%, and the specificity was 63.0% and 92.0%. The AUC of POF was 0.950 and 0.998, the sensitivity was 98.3% and 99.2%, and the specificity was 75.9% and 97.0%, respectively. The AUC of AMH and AMH+LH combined indexes in the differential diagnosis of DOR and POF were 0.768 and 0.937, the sensitivity was 70.3% and 95.5%, and the specificity was 73.9% and 80.8%.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.