Objective:To analyze the management and outcome of pregnant woman with transposition of great arteries and to investigate the effect of multidisciplinary management during pregnancy on the pregnancy outcome.Methods:The clinical data of 11 pregnant women with transposition of great arteries under going treatment in Beijing Anzhen Hospital during January 2007 and December 2017 was studied retrospectively.The cardiac function, cardiac index, management during pregnancy and outcomes were assessed.Results:Eight patients (No.1～No.8) were complicated with corrected transposition of the great arteries (CTGA).one (No.9) was complicated with complete transposition of the great arteries (TGA).Two were complicated with double outlet right ventricle (DORV).Enlargement of left atrial enlargement and increase of left functional ventricular diameter were observed in all eight patients with CTGA.The left atrioventricular valve regurgitation was reported in these patients except the patient No.7 who had a mechanical valve replacement.Three cases had elevated BNP.Patient No.9 who was with TGA showed an enlargement of the right heart and a narrow inner diameter of left heart.Fetal death occurred in second trimester.The left ventricular enlargement, BNP elevation and atrioventricular valve regurgitation were observed in the two patients with DORV.The mean pregnancy length was 34.6±5.0 weeks.Nine had cesarean deliveries.One received cesarean section with fetal death.One had vaginal delivery.Average hemorrahge volume was 245±110 ml.One was fetal loss with cesarean section, while six were term delivery, and the other four cases were premature delivery.All eleven patients were discharges with an average hospitalization days 9.4±4.2 days.The average weight of fetus was 2659±1012 g.Three were low birth weight infants.Two newborns had mild asphyxia.No birth defects or fetal complications were reported.Conclusions:Pregnancy could be attempted in CTGA patients with normal cardiac function, no obvious cardiac valve regurgitation orventricular enlargement.They should be followed by multidisciplinary management during pregnancy.It is pregnancy contraindication for woman with TGA and DORV without surgical treatment.

Objective:To investigate the application of Aptima high-risk human papillomavirus (HR-HPV) E6/E7 mRNA (AHPV) and its genotyping (GT) in the risk assessment of low-grade squamous intraepithelial lesions (LSIL).Methods:The AHPV and its genotype (AHPV-GT) incervical exfoliated cells were detectedin 529 women with LSIL.The DNA-Based Hybrid Capture 2 HPV Test (HC2-HPV), colposcopy and cervical biopsy were performedsimultaneously.Results:① In 529 patients with LSIL, the positive rate of HC2-HPV in the group of ＜30 years old was significantly higher than that in the group of ≥30 years old (92.2％ vs 83.6％, P=0.026).There was no significant difference in AHPV positive rate among different age groups (82.5％ vs 77.7％, P=0.284).No significant difference of the genotyping (AHPV-GT) was detected between the two groups, either.In the 529 cases, 83 cases of HSIL+were confirmed by histology.81 cases (97.6％) were AHPV positive in the patients with HSIL+;② Compared with other 11 positive types of HR-HPV, the incidence of HSIL+in GT+ women increased significantly (P＜0.05).In the group ≥30 years old, the OR value of HSIL+exposure risk of AHPV16 positive women was the highest (141.00), which was significantly higher than that of 18/45+, GT +, AHPV + (P=0.005, 0.000, 0.000).However, in the group of ＜30 years old, the OR value of HSIL+exposure risk of AHPV16 positive women was 8.50, which showed no significant difference from that of 18/45+ and AHPV-(P=1.000, 0.070).③ In group over 30 years old, the specificity of detecting HSIL+by AHPV was higher than that by HC2-HPV (P＜0.05).There was no significant difference in detection specificity between AHPV and HC2-HPV in women under 30 years old.Conclusions:AHPV and its GT detection are reliable methods for colposcopic screening and risk stratification in women aged over 30 years old with LSIL, more attention should be focused on AHPV16 positive.Better biological markers should be explored for younger women.

Objective:To study the relationship between pregnancy outcomes and blood glucose index at different time points in 75 g oral glucose tolerance test (OGTT).Methods:A total of 403 pregnant women who receiveda 75 g OGTT were enrolled.Pregnant women were divided into three groups:group A with one abnormal blood glucose level (group A1:abnormal fasting glucose level;group A2:abnomal 1 hour glucose level;group A3:abnormal 2 hour glucose level), group B with two abnormal blood glucose level (group B1:abnormal fasting and 1 hour glucose level;group B2:abnormal fasting and 2 hours glucose level;group B3:abnormal 1 hour and 2 hours glucose level), and group C with abnormal blood glucose level in all three time points.Retrospective analysis of general information and pregnancy outcomes of pregnant women.Results:There were significant differences in A, B and C groups when comparing the incidence of hypothyroidism, hypertensive disorders of pregnancy, cesarean section rate, neonatal body mass index (BMI), chest circumference, macrosomia preterm birth and transfer to Neonatal Intensive Care Unit (P＜0.05), and the incidence of adverse outcomes in group C was higher than that in group A and B.The neonatal body mass index, chest circumference and fetal distress rate and cesarean section rate in the A2 group were significantly higher than those in the A1 and A3 groups (P＜0.05).The incidence of macrosomia and cesarean section in group B3 was lower than that in group B1 and B2 (P＜0.05).Conclusions:The maternal and neonatal adverse outcomes would increase if the abnormal glucose level was detected in all three time points in 75 g OGTT.When the fasting and 1 or 2 hour blood glucose level were abnormal, the incidence of neonatal macrosomia would increase.There could be a correlation between 1 hour blood glucose level and neonatal body mass index.

Objective:To investigate the relative expression of matrix metalloproteinases-2, 3 (MMP-2, 3) and tissue inhibitors of metalloproteinases-1, 2 (Tissue Inhibitor of Metalloproteinase-1, 2, TIMP-1, 2) in ovarian cancer cell line A2780 under different pressures controlled by carbon dioxide (CO2) changes at different time points and their meaning.Methods:Cell model was established by culture and grouping of A2780 ovarian cancer cell line in vitro.By simulation of laparoscopic CO2pneumoperitoneum environment under different pressure in vitro the pressure of carbon dioxide is controlled at 0 mmHg, 7 mmHg and 15 mmHg respectirely, the cells were collected at 0, 12, 24 and 48 hours after the CO2pressure was controlled for 3 hours.Total RNA was extracted and RT-qPCR was performed to detect the relative expression of MMP-2, 3, TIMP-1 and 2 mRNA in each group.Results:After CO2pressure control, the relative expression of MMP-2 mRNA in each sample under the same pressure decreased with the duration of culture.After CO2pressure control, the relative expression of MMP-2 in ovarian cancer cells decreased with the increase of CO2pressure at the same time point.After CO2pressure control, the relative expression of MMP-3 mRNA in each sample underthe same pressure decreased with the culture time.After CO2pressure control, the relative expression of MMP-3 in ovarian cancer cells decreased with the increase of CO2pressure at the same time point.There was no significant difference in the relative expression of TIMP-1 and TIMP-2 mRNA between the control group and the experimental group at different time points orunder different CO2pressures (P＞0.05).Conclusions:The simulated CO2pneumoperitoneum environment could inhibit the invasive ability of ovarian cancer cell line A2780.The relative expression of MMP-2 and MMP-3 decreased astime and pressure increasing.The simulated CO2pneumoperitoneum environment had no significant effect on the expression of A2780 TIMP-1 and 2 mRNA in ovarian cancer cell line A2780.

Objective:To investigate the association between polycystic ovary syndrome (PCOS) and cardiovascular risk factors and evaluate 10-year risk of cardiovascular disease (CVD) in women with PCOS.Methods:239 PCOS patients (PCOS group) and 134 age-matched non-PCOS participants (control) were enrolled in this retrospective study.The general data was collected and biochemical test, glucose tolerance, sex hormones were detected.The Framingham score (FRS) for all women was evaluated according to age, systolic blood pressure (SBP), serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and history of smoking.The clinical features, laboratory parameters and FRS of PCOS patients and non-PCOS controls were compared.The correlation between FRS and metabolic indicators and sex hormones was analyzed.Results:①Compared with those of the control group, SBP and diastolic blood pressure (DBP) significantly increased, the glucose and lipid metabolism was moredisordered, and the androgen level was higher in PCOS group (P＜0.05).② The FRS of the PCOS group was higher than that of the control women (P＜0.01).③ FRS were positively correlated with BP, FPG, PBG, FIns, PIns, HOMA-IR, TC, TG, LDL-C.FRS was negatively correlated with HDL-C and SHBG (P＜0.05).Conclusions:PCOS is correlated with major cardiovascular risk factors, such as hypertension, hyperglycemia, and hyperlipidemia.PCOS show a higher risk of 10-year CVD events than individuals without PCOS.The phenomenonis mainly related to blood pressure and glycolipid metabolism but not androgen.

Objective:To investigate the clinical effectiveness and reproductive outcome of fertility-preserving surgery(pelvic lymphadenoetomy +Vaginal radical trachelectomy(VRT)in women with early stage cervical cancer.Methods:A perspective observation of 16 patients who had undergone pelvic lymphadenoetomy + VRT with early stage cervical cancer(study group) since Jan 2011 to Dec 2015 was carried out.30 patients who undergone laparoscopic radical hysterectomy(LRH) + pelvic lymphadenoetomy with early stage cervical cancer were set as the control group.The clinical efficiency were compared between the two groups,and the cumulative pregnancy rate and pregnancy outcome were followed up in study group.Results:There was no statistic difference in age,clinical staging,pathologicalgrade,LVSI,SCC expression,operating-time,pastoper ationfever,operative complications,tumor recurrence between the two groups(P＞0.05).Compare to control group,the index of amount of bleeding was fewer and the average hospital stay was shorter in study group(P ＜ 0.05),12 patients got pregnant and cumulative pregnancy 15 times within one year after operation,there were 4 mature delivery(33.3％) and 11 fetal loss(73.3％).Conclusions:For the young patients with early stage cervical cancer,pelvic lymphadenoetomy + VRT is the treatment procedure with the same clinical effectiveness with radical hysterectomy + pelvic lymphadenoetomy and has the advantage of fertility preserving,but the pregnancy and reproductive outcome need to be improved.

Objective:To discuss the correlation between platelet count and thrombelastogram(TEG) parameters on pregnancy whose platelet count on the various levels,in order to find the intrinsic relations of platelet function and count,to provide the basis of the function evaluation of PLT during pregnancy and treatment.Methods:The PLT count,TEG parameters and coagulation function were tested in 200 pregnancy women from October 2014 to March 2016.Spearman test was used to analyze the correlation between the platelet count TEG parameters and coagulation function.Results:The TEG parameters which were positively correlatd with PLT count included MA(r =0.756,P ＜ 0.01),Angle (r =0.626,P ＜ 0.01),CI (r =0.635,P ＜ 0.01);The TEG parameters which were negatively correlatd with PLT count was K(r=-0.695,P ＜0.01);The TEG parameters which were not correlatd with PLT count included R、APTT、PT.In the mild lack of platelet group(PLT count 70 × 109/L-135 × 109/L) and the low value group(PLT count 135 × 109/L-200 × 109/L),platelet count was positive correlated with MA and Cl,ln the low value group and the high value group(PLT count ＞200 ×109/L),platelet count was positive correlated with Angle.In the mild lack of platelet group,the low value group and the high value group,platelet count was negatively correlated with K,In the severe lack of platelet group (PLT count 30 × 10 9/L-70 × 10 9/L),platelet count was negatively correlated with Fg.In the other group,there was no significant correlation between platelet count and TEG parameters、blood coagulation parameters.Conclusions:Platelet count was significantly correlated with MA,Angle and CI;But on the pregnancy with platelet count was extreme low value and high value,platelet count can not reflect the aggregation function,MA can more sensitively reflectthe platelet function.

Objective:To analyze the prognosis of twin intrauterine fetal death intrauterine surgery(SIUFD),and to investigate the pregnanct outcomes of SIUFD after different gestational weeks and chorionic twins,and to improve the monitoring and management of SIUFD.Methods:Data from January 1,2013 to December 31,2015 in Beijing Obstetrics and Gynecology Hospital of SIUFD delivered 37 cases(excluding twin transfusion syndrome,11 cases)were retrospectively analyzed,including the incidence of SIUFD gestational weeks,save work time to look for the cause of death,different gestational weeks and chorionic deposit work the prognosis,followed up neonatal growth by telephone.Results:The time of occurrence of SIUFD in this 37 cases of early pregnancy was common,accounted for 64.86％ (24/37);The period of expectant treatment after SIUFD was 1 day(the shortest),231 days(the longest),and 116 days (average);among the death-caused factors,umbilical cord and placenta abnormality accounted for 32.43％ (12/37) and fetal malformation accounted for 8.11％ (3/37);the survival of premature fetus(gestational age less than 37 weeks) were 9 cases,of which a minimum of 32 weeks of gestation,28 cases of full-term birth;premature birth,neonatal asphyxia,emergency caesarean section,pregnancy complications in monochorionic twins were significantly higher than those of in dichorionic twins;SIUFD gestational weeks ＞13 weeks survival fetal premature delivery,neonatal asphyxia,emergency cesarean section rate of less than≤13 weeks more than SIUFD.Conclusions:After SIUFD and survival fetal incidence of fetal gestational weeks and chorionicity,although not yet the study found that SIUFD occurred after the adverse neurological sequelae of child survival than dichorionic diamniotic twins higher in monchorionic twin dichorionic twinw,but still need long-term follow-up.

Objective:To explore the treatment effect on EMT in rats using different doses of letrozole and Medroxyprogesterone acetate (MPA) and their effects on liver,renal,skeletal and reproductive system.To provide lab evidence for treatment of EMT before menopause using letrozole.Methods:Endometriotic rat model was set up by surgical transplantation of autologous uterine tissues to ectopic site outside the uterus.70 EM model rats were randomly divided into 7 groups,each with 10:A ～C:LE 1 mg/(kg · d-1) and MPA [8、4、2 mg/(kg · d-1) respectively];D ～ F:LE 0.5mg/(kg · d-1) and MPA[8、4、2 mg/(kg · d-1) respectively];G:0.9％ saline (control group).The volume of ectopic lesion in each group was compared before and after the treatment.The expression of P450arom and Ki-67 and cell apoptosis in the endometriotic tissues of the rat models were detected.The serum levels of FSH,LH and E2 were determined and liver and renal functions were detected.Bone mineral density(BMD) was measured in the right femur.Results:①Except for group F,the volume of the endometriotic tissues of the five groups reduced significantly compared with the G group(P ＜ 0.05),and the greatest decrease in the volume were in group A and B (P＜0.01);②Compared with the G group,the expression of P450arom and Ki-67 protein decreased while the apoptotic rate increased in tissues of endometriosis (EM) on rat models among group A to group E (P＜0.05),in which group A and B were the most notable (P＜0.01);(③Compared with the G group,the level of FSH,LH and E2 reduced in group A、B and D (P＜0.05),moreover,the E2 level of group A and B was lower than that in group D (P＜0.05);④Compared with the G group,the ovarian weight in group C increased greatly,and the ovaries showed polycystic.The uterine weights decreased among group A to group E,and the endometrium presented atrophy or inhibition of proliferation;⑤There was no change on the bone density among each group(P ＞ 0.05);⑥Abnormal liver function was only detected in group A after treatment,and no ab normal renal function detected in any group(P＞0.05).Conclusions:LE 1 mg/(kg · d-1) associated with MPA 4mg/(kg · d-1) had the most effect on EM rat models.Moreover,it had no influence on liver or renal function.The mechanism may be decreasing the serum level of E2,reducing local estrogen along with increasing the apoptosis while decreasing the proliferation of the ectopic tissues.

Objective:To improve the accuracy of prediction of macrosomia by application of machine learning.Methods:Ultrasound measurement data and fetal birth weight of macrosomia and normal birth weight neonates were collected during January 2015 to December 2016 in Mindong Hospital Affiliated to Fujian Medical University.Ultrasound built-in Hadlock formula,multiple linear regression,k-nearest neighbor,support vector machine,random forest were evaluated and compared to predict macrosomia using actual fetal birth weight as the gold standard.Results:The sensitivity of built-in Hadlock formula to predict macrosomia was 40.86％ and Youden index was 39.95％.The sensitivity of the multivariate linear regression was 60.22％ and the Youden index was 58.85％.The sensitivity of the k-nearest neighbor was 86.21％ and the Youden index was 75.10％.The sensitivity of the support vector machine was 86.21％ and the Youden index was 73.51％.The sensitivity of the random forest was 81.03％ and the Youden index was 71.51％.The Youden index of multivariate linear regression was significantly bigger than that of built-in Hadlock(u =3.64,P ＜0.001).The Youden index of k-nearest neighbor,support vector machine and random forest was significantly bigger and built-in Hadlock and multivariate linear regression (P＜0.001,P＜ 0.05).Conclusions:The machine learning is of high accuracy and great value of application.