【Objective】 To investigate the morbidity trend of the preterm delivery.【Methods】 A retrospective study was done on the delivery data in our hospital from 1969 to 1998. Select the cases on annual August as the sam pling units, and divided those 253 cases into three decade groups, to analyze th e obsterical factors affecting the preterm delivery.【Results】 ① The morbidity of the preterm delivery in thirty years was 4.72%(95% CI 4.16, 5.32). ② The re were no obvious changes of the morbidity among the years, and had no seasonal aggregation. ③ The cesarean section rates in the third decade increased signif icantly than those in former two decades (P<0.05). ④ As time goes on, the i ncidence of premature rupture of membrane increased, and that of the preterm del ivery with no obvious complication decreased. The cases with the intrauterine fe tal distress and IVF-ET in the third decade were significantly increased. ⑤ Th e gestation age and birth weight increased significantly, especially in the thir d decade, but the neonatal mortality had no obvious change. 【Conclusions】 Ther e was no reduction of the morbidity of the preterm delivery, further studies sho uld be emphasized. It seems unlikely the increased of cesarean section rates wil l reduce the neonatal mortality. PROM is important factors affecting the preterm delivery, and the IVF women may be at higher risk of preterm delivery.

Objective To investigate whether no asphyxia neonates with intrauterine distress are complicated with myocardial injury and determine the sensitive biochemical diagnostic parameters. Methods A total of 89 neonates born in the First Affiliated Hospital of Sun Yat-sen University from July 2009 to December 2009 were enrolled. Fifty-three fetal distress cases with Apgar score ＞ 7 at 1 and 5 minites were enrolled in the study group; while the rest 36 healthy neonates, whose Apgar score = 10 at 1 and 5 minites, were the control group. Umbilical artery blood samples of all cases were collected for blood gas analysis and biochemical measurement. Results(1)pH(7.23±0.07) and BE [(-4.8±3.0)mmol/L] in the study group were significantly lower than pH (7.31 ±0.03) and BE [(-2.1±1.5)mmol/L] in the control group (P＜0.05).The lactic acid of study group [(5.2±2.3)mmol/L] was higher than that of the control group [(2.3±1.1)mmol/L], and the difference was significant (P＜0.01). However, there was no significant difference between the two groups in PaO2[(16.2±7.9)mm Hg(1 mm Hg=0.133 kPa) vs. (17.5±6.7)mm Hg] and PaCO2[(54.0±11.2)mm Hg vs. (48.5±5.4) mm Hg; P＞0. 05]. (2) The level of CK-MB in neonates with fetal distress[(48 ±59) U/L] was significantly higher than that of healthy neonates [(36±27)U/L]. However, no significant difference was found in CK [(194±73)U/L vs. (162±95) U/L]and BNP levels[(519±309)ng/L vs.(481±216)ng/L;P ＞ 0.05]. (3) Spearman rank correlation analysis showed that CK-MB level was negatively correlated with pH(r=-0.296, P＜0.05) and BE (r=-0.318,P＜0.05) of umbilical artery blood,while BNP level was positively correlated with umbilical lactic acid (r=0.278, P＜0.05). No correlation was found between other parameters (P＞0.05).Conclusions Intrauterine distress without neonatal asphyxia had effect on fetal myocardial injury. CK-MB can be used as a sensitive parameter for monitoring the development of myocardial injury. The severity of myocardial injury was related to fetal acidosis.

ObjectiveTo investigate the risk factors of preterm birth, as well as the clinical characteristics in dichorionic diamniotic (DCDA) twins and monochorionic diamniotic (MCDA) twins. MethodsA retrospective study was conducted on 290 premature cases out of 363 twin pregnancies who delivered alive babies in the First Affiliated Hospital, Sun Yat-sen University from September 2012 to March 2015. The selected cases, including 219 cases of DCDA and 71 cases of MCDA,were divided into three groups according to their gestational age at delivery: 28-31+6, 32-33+6 and 34-36+6 weeks. The clinical features, causes and risk factors were described between these three groups. Analysis of variance,Chi-square test and multi-variant Logistic regression were used for statistical analysis.ResultsThe incidence of premature delivery in twin pregnancies was 79.9% (290/363), while this figure was lower in DCDA twins than in MCDA [76.3%(219/287) vs 93.4%(71/76),χ2=10.955,P=0.001]. The three leading causes of preterm birth in DCDA twins were gestational age≥36 weeks (33.8%, 74/219), preterm labor (30.6%, 67/219) and preterm premature rupture of membrane (PPROM) (8.7%, 19/219), while in MCDA twins were preterm labor (31.0%, 22/71), selective intrauterine growth restriction (21.1%, 15/71) and gestational age≥36 weeks (19.7%, 14/71). Logistic regression analysis showed that the independent risk factors of preterm birth in twins at 28-31+6 weeks was PPROM (OR=2.390, 95%CI: 1.006-5.872,P=0.043), and for those twins at 32-33+6 weeks, the independent risk factors were MCDA (OR=2.758, 95%CI: 1.243-6.118,P=0.013), preeclampsia (OR=12.176, 95%CI:4.685-31.642,P=0.000), PPROM (OR=5.348, 95%CI: 2.151-13.294,P=0.000) and preterm labor (OR=3.274, 95%CI:1.453-7.375,P=0.004). MCDA (OR=3.666, 95%CI: 1.364-9.585,P=0.010) and preeclampsia (OR=8.086, 95%CI:1.044-62.617,P=0.045) were the risk factors in the group of 34-36+6 weeks.ConclusionsAlthough preterm birth in MCDA and DCDA twins is due to different reasons, the former has a higher incidence than the latter. The risk factors of premature delivery at different gestations are also different.

Objective To investigate the incidence,correlative factors and prevention of perimenopausal symptoms.Methods 146 perimenopausal women were investigated by using Kupperman menopausal index(KMI),life event scale,improved social support scale and self-made inventory.Results We got 112 available data,the incidence of perimenopausal symptoms was 75.0%,58.0%was mild,15.2%was moderate,1.8%was sevcre.The main correlative factors of perimenopausal symptoms were inhabited environment,self emotional controllability,history of gynecologic diseases,history of depression,dysmenorrhea,premenstrual syndrome,menopause,score of life eventscale,improved social support scale.Conclusions The incidence of perimenopausal symptoms is high.It is also related to factors of society,family and mentality,except hypogonadism.Preventing perimenopausal symptoms according to its cirrelative factors may decrease its incidence and enhance the life quality of women.

Objective To investigate safety and efficacy of dinoprostone suppositories(0.8 mm) used in cervical ripening and labor induction in women with term premature rupture of the membranes.Methods One hundred women of term monocyesis with premature rupture of the membranes,head presentation,bishop score less than 6(test group)and 180 women with intact fetal membranes(control group)were enrolled into this multicenter,prospective clinical study.The vaginal delivery system was inserted into the posterior foruix,and the patients were recumbent for 2 hours after insertion.The interval time from using dinoprostone suppositories to uterine contraction,to labor and delivery were recorded.The following index were also recorded and compared,including the mean inserted time of dinoprostone suppositories,fetal heart beat,meconium stained amniotic fluid,hyperstimulation of uterus and the other complications,mode of delivery,stage of labor,postpartum hemorrhage,status of neonates.Results Three cases intest group and 23 casesin control group weren't in labor within 24 hours.The rate of labor within 24 hours in test group was significant higher than that in control group(97.0% vs.87.2%,P<0.01).It was observed that 73 cases undergoing vaginal deliveries(75.3%,73/97)and 24 cases undergoing cesarean section dehveries(24.7%,24/97)in test group and 107 cases undergoing vaginal delivery(68.2%,107/157)and 50 cases undergoing cesarean section delivery(31.8%,50/157)in control group,when compared the rate of vaginal or cesarean section deliveries between two group,it didn't reach statistical difference (P >0. 05). It had no significant difference in the interval time from using dinoprostone suppositories to labor starting and the mean inserted time and the total labor time between two groups ( P > 0.05 ). The incidence of uterine tachysystole was 11.3% (11/97) in test group and 19. 1% (30/157) in control group (P>0. 05), which did not reach statistical difference (P>0. 05). There wasn't neonatal asphyxia in both groups. Conclusion It was safe and efficient to use dinoprostone suppositories for cervical ripening and induction of term pregnancy with premature rupture of the membranes, however, monitoring should be intensified.

Objective To investigate the relationship between time and mode of delivery and gestational outcomes in uncomplicated twin pregnancies.Methods A total of 347 women with uncomplicated twin pregnancies who gave birth in First Affiliated Hospital of Sun Yat-Sen University between November 2012 and June 2015 were reviewed retrospectively,including 291 dichorionic diamniotic twin pregnancies (DCDA) and 56 monochorionic diamniotic twin pregnancies (MCDA).The general information,gestational complications,time and mode of delivery,gestational outcomes were recorded and the relationship between time and mode of delivery and gestational outcomes in DCDA and MCDA groups were analyzed.Ttest,Chi-square,Fisher's exact test and logistic regression analysis were used for statistical analysis.Results (1) The incidence of adverse neonatal outcomes in DCDA group [49.1％ (281/572)] was significantly lower than in MCDA group [75.5％ (83/110)] (x2=25.698,P＜0.05).In DCDA group,women delivered at 36-36+6 weeks,37-37+6 weeks and 38 38+6 weeks had lower rates of admission to neonatal intensive care unit (NICU),neonatal respiratory distress syndrome (NRDS) and other neonatal diseases than those delivered at ＜34 weeks,34-34+6 weeks and 35-35+6 weeks (all P＜0.05),while those delivered at 38-38+6 weeks had a higher incidence of pathological jaundice (2/8) than at 36-36+6 weeks and 37-37+6 weeks (3.1％ and 1.9％) (x2=10.133 and 13.510,both P＜0.05).In MCDA group,the rate of admission to the NICU decreased gradually from 100.0％ (30/30) (＜35 weeks) to 3/12 (37-37+6 weeks) (P＜0.05).In DCDA group,the odds ratio (OR) and 95％ confidence interval(95％CI) of adverse neonatal outcomes in 35-35+6,36-36+6 and 37-37+6 weeks were 0.237(0.116-0.482),0.056(0.029-0.108) and 0.054(0.026-0.112),respectively (all P＜0.05).In MCDA group,OR (95％CI) of adverse neonatal outcomes in 34 34+6 and 35-35+6 weeks were 38.894 (3.084-490.552)and 18.858 (1.538-231.222),respectively (both P＜0.05).(2) With regard to mode of delivery,ten cases of DCDA and two cases of MCDA had vaginal deliveries.In DCDA group who gave birth at less than 34 weeks,the incidence of neonatal pathological jaundice in vaginal delivery group (8/14) was higher than that in cesarean delivery group [22.7％ (15/66)] (x2=5.104,P=0.024).Conclusions The optimal time of delivery for uncomplicated twins is 36-37+6 weeks.The appropriate mode of delivery should be determined by the status of both the mother and the twins.

[Objective]To establish a novel noninvasive fluorescent animal model for endometriosis in vitro and in vivo.[Methods]Adenovirus encoding enhancing green fluorescent protein(Ad-eGFP)was used to transfect endometrial glandular cells and stromal cells(cells transfection and injection,Method No.1),and fragments(tissues transfection and injection,Method No.2).Transfection efficiencies were compared between the two methods in vitro.Then GFP transfected glandular cells and stromal cells suspension were injected into nude mice subcutaneously(Method No.1),taking Method No.2 as a comparison.In vivo observation last for 25 days,and positive rates and duration times of fluorescent lesions were calculated.Histological examination was used to confirmed lesion formation.[Results]On the fifth day after injection,lesion positive rate of Method No.1 was 88.9%,which was statistically significantly higher than that of Method No.2(22.2%),P=0.015＜0.05.The fluorescent positive duration of Method No.1 and No.2 were 12 ± 8 days and 7±4 days.The structures of lesions were all identified as human original endometrium by histological examination,including HE staining and immunofluoresceney.[Conclusion]Noninvasive animal model of endometriosis can be built up by subcutaneously injection of Ad-EGFP transfected endometrial glandular cells and stromal cells suspension with higher positive rate and longer observation time

Objective:To study the risk factors for abnormal glucose metabolism in pregnant women with a history of gestational diabetes mellitus (GDM).Methods:A retrospective analysis was performed on pregnant women who had two consecutive deliveries and were was complicated by GDM in the previous pregnancy at the First Affiliated Hospital of Sun Yat-sen University from January 2011 to May 2019. Clinical data of both pregnancies were collected, including general information, fasting blood glucose in early pregnancy and 75 g oral glucose tolerance test (OGTT) results, glycosylated hemoglobin A1c and blood lipid profile at 24-28 gestational weeks. The incidence and risk factors of abnormal glucose metabolism in these cases during the present pregnancy were analyzed. Analysis of variance, Kruskal-Wallis test, SNK- q or LSD- t-test, and Chi-square test were used for data analysis. Single-factor logistic regression analysis was used to analyze the high-risk factors, and multifactor logistic regression analysis was performed to fit the model. Variable collinearity diagnosis was performed using the coldiag2 command. Results:(1) A total of 455 cases were enrolled in the study. According to the fasting glucose level in the first trimester and the OGTT results in the present pregnancy, they were divided into three groups: normal OGTT group ( n=240), GDM group ( n=189), and pre-gestational diabetes mellitus group (PGDM, n=26). The incidence of abnormal glucose metabolism in these patients during the present pregnancy was 47.2% (215/455). (2) Those with a history of GDM had higher pre-pregnancy weight, lower weight gain, higher cesarean section rate, smaller gestational age at delivery, and higher neonatal birth weight in the present pregnancy than those in the previous pregnancy [(55.6±8.5) vs (53.3±7.9) kg, t=-4.059; (11.2±4.2) vs (12.5±4.4) kg, t=4.435; 47.9% (218/455) vs 33.0% (150/455), χ2=20.481; (38.6±1.3) vs (38.8±1.3) weeks, t=2.288; (3 177±463) and (3 114±460) g, t=-2.044; all P<0.05]. (3) In the PGDM group, the 2-h plasma glucose level after 75 g OGTT was higher than that in the previous pregnancy [(11.4±1.1) vs (9.9±1.7) mmol/L, t=-3.299, P=0.002]. (4) In the present pregnancy, the PGDM group had the highest fasting blood glucose in early pregnancy, followed by the GDM group and the normal OGTT group [4.6 mmol/L (4.2-7.6 mmol/L), 4.3 mmol/L (4.0-4.6 mmol/L) and 4.1 mmol/L (3.8-4.4 mmol/L), χ2=34.498, P<0.001]. The PGDM group had the least postpartum weight retention, followed by the normal OGTT group and the GDM group [(1.2±3.9), (1.6±3.9), and (2.6±4.9) kg, F=3.086, P<0.05]. (5) Multivariate logistic regression analysis showed postpartum weight retention and the 1-h and 2-h plasma glucose levels after 75 g OGTT in the previous pregnancy were independent risk factors for abnormal glucose metabolism in pregnant women with a history of GDM (postpartum weight retention: OR=1.054, 95% CI: 1.005-1.106; 1-h plasma glucose: OR=1.284, 95% CI: 1.087-1.516; 2-h plasma glucose: OR=1.272, 95% CI: 1.071-1.511). Conclusions:The incidence of abnormal glucose metabolism is higher in subsequent pregnancy in women with GDM history, which may be related to various factors, such as postpartum weight retention and plasma glucose after 75 g OGTT in the previous pregnancy.

Objective To determine the effects of adiponectin on high glucose induced BeWo cell proliferation in vitro. Methods BeWo cells were seeded in 96-well plates at the appropriate density. After treatments with high glucose (25 mmol/L), western blot analysis of cyclin D1 and a colorimetric assay (cell counting kit-8, CCK-8) were used to analyse BeWo cells′proliferation, and western blot was used to detect the expression of adiponectin. Moreover, we added adiponectin (20μg/ml) in the culture medium and three methods were utilized for cell proliferation analysis: CCK-8, cell cycle analysis (by flow cytometry) and proliferating cell nuclear antigen (PCNA) immunocytochemical staining. Results Compared to BeWo cells cultured by normal glucose and high mannitol, the proliferation of BeWo cells treated by high glucose increased (P<0.05). Compared with BeWo cells cultured by high mannitol, the expression of adiponectin in BeWo cells treated by high glucose decreased. After added adiponectin in the culture medium, the proliferation of BeWo cells treated by adiponectin+high glucose decreased than that of cells treated by high glucose (0.770±0.050 versus 0.990±0.070, P<0.05);the proportion of G2+S phases of BeWo cells treated by adiponectin+high glucose decreased than that of cells treated by high glucose [(40.7±2.1)%versus (44.9± 3.9)%, P<0.05];the rate of PCNA positive cell in BeWo cells treated by adiponectin+high glucose decreased than that of cells treated by high glucose [(28 ± 5)% versus (44 ± 5)%, P<0.05]. Conclusion Adiponectin could inhibit proliferation of high glucose induced BeWo cells in vitro.

Objective To investigate gene expression profile in peripheral leucocytes of patients with severe preeclampsia (SPE) during 16-20 gestational weeks to see if there are different expression between normal pregnancy and SPE, and to provide the evidence for predicting the pathogenesis of preeclampsia in the future. Methods Eight hundred primipara who accepted pregnancy examination at the First Affiliated of Hospital SUN YAT-SEN University from August 2008 to December 2008 were selected into this study. The gestational age of all objects were confirmed as 16-20 weeks by ultrasonography. And they were followed up until delivered. Six patients developed severe preeclampsia (SPE group); and 40 pregnant women without any complications were chosen as the control. Human genome complementary DNA (cDNA) single-fluorescent chip were used to detect the different gene expression in peripheral leucocytes between normal pregnancy and SPE at 16-20 gestation weeks. Results There were different expressions in 983 genes between SPE group and control group, among which 719 genes were up-regulated and 264 genes were down-regulated in the SPE group. Up-regulating genes mainly involved in immunity, coagulation and fibrinolysis, signal transduction, cell adhesion, transcription and protein synthesis; and the expression of platelet and T cell activation antigen 1 (PTA1/CD226), bactericidal/permeability increasing protein (BPI), interleukin-8 (IL-8), protein kinase C (PKC), lymphocyte antigen 75 (LY-75), mucoprotein and EGFR pathway substrate 8 (EPS8) were significantly increased in SPE patients. Down-regulating genes mainly involved in apoptosis, calcium metabolism, lipid metabolism and cell transformation; and the expression of adrenomedullin (ADM), killer cell immunoglobulin-like receptors (KIR), vitamin D receptor (VDR), adipose differentiation-related protein (ADRP), parathyroid hormone (PTH) and mitogen-activated protein kinase kinase 4 (MKK4) were significantly decreased in SPE patients. Conclusions The gene expressions of peripheral leucocytes in pre-eclampsia patients were different from those of normal pregnant women during 16-20 gestational weeks. Gene CD226, BPI, IL-8, PKC, ADM, KIR and VDR might participate in the pathogenesis of SPE which should be further investigated.