Objective To analyze the live birth situation after intrauterine adhesions separation opera-tion in the patients with different types of intrauterine adhesions(IUA)and its influencing factors.Methods The medical records data in 188 patients with hysteroscopic electrotomy separation for IUA and pregnancy within postoperative two years in the Affiliated Beijing Obstetrics and Gynecology Hospital of Cap-ital Medical University from January 2010 to January 2022 were analyzed retrospectively.The basic data and pregnancy outcomes of the patients were collected.The main influencing factors of postoperative live birth were analyzed by univariate analysis and multivariate logistics regression.Results Among 188 cases of IUA,there were 163 cases of live births with a live birth rate of 86.7％.There was no statistical difference in the composition situation of conception methods and delivery methods among the patients with different degrees of IUA(P＞0.05),and there was statistical difference in postpartum bleeding volume(P＜0.05).There were significant differences in the composition of placenta implantation,conducting clamp and uterine clearance a-mong the patients with different degrees of IUA(P＜0.05).The univariate analysis results showed that arti-ficial abortion,early pregnant curettage(P=0.008)and labor induction in second trimester(P＜0.001)were the influencing factors of postoperative live birth;the multivariate analysis results showed that induction of la-bor in the second trimester(95％CI:0.02-0.35,P=0.001)was the influencing factor of postoperative live birth.Conclusion Placenta-related diseases and postpartum hemorrhage are prone to occur after IUA opera-tion,and the uterine operation during delivery is increased.The patients with history of previous multiple in-duced abortions and mid-term induced labor should be vigilant against the occurrence of adverse pregnancy outcomes.

Objective:To make clear the duties of the clinical research coordinators (CRC) and evaluate any inadequacies in their management and training in the industry, ideas for ameliorating the construction of the CRC team and the promotion of clinical trial quality should be suggested.Methods:Drawing from the author′s experience in CRC management and a literature review, this paper assessed the current state of CRC work and management, and provides advice on how to improve CRC management.Results:In China, the CRC domain lacked a unified standard and access mechanism, leading to inconsistent levels of basic quality and business ability among CRC offerings within the sector.In order to maintain a steady CRC personnel team and promote the quality of clinical trials, it was essential to improve the training of CRC professionals, determine their career development paths, arrange different levels and fields of CRC training, adjust wages and appraisals, and take other suitable measures.Conclusions:It is proposed that the top medical organizations in China collaborate with sponsors and site management organizations to create a standardized and unified CRC occupational admission system and assessment criteria, in order to enhance the capacity and standard of CRC and addressing China′s increasing demand for clinical trials.

Objective:To explore the correlation between endogenous sex hormone factors and sexual function in Chinese women.Methods:A total of 711 women who met the criteria were investigated in the Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing Chaoyang District Taiyanggong Community Health Service Centre from April 2020 to March 2021. Sociodemographic data (data split into two groups according to educational background: high school or above and lower high school; and three categories based on marital relationship: satisfied, average, and dissatisfied) and serum levels of sex hormones were collected. Female sexual dysfunction (FSD) was evaluated using the female sexual function index (FSFI). Participants were divided into three groups according to the Stages of Reproductive Aging Workshop (STRAW+10): reproductive stage group, menopausal transition stage group and postmenopausal stage group. Spearman rank correlation analysis and multiple linear regression analyses were performed to determine the correlation between characteristics and scores of FSFI.Results:The multivariate logistic regression analysis revealed that postmenopausal stage, secondary education level, neutral and dissatisfied marital relations were significantly negatively correlated with total FSFI score (all P<0.01). Secondary education level, neutral and dissatisfied marital relations were negatively associated with nearly all FSFI domains apart from pain score (all P<0.05); postmenopausal stage was negatively associated with lubrication, satisfaction and pain (all P<0.05). FSH was negatively associated with all FSFI domain scores (all P<0.05). There was a significantly positive correlation between estradiol and scores of FSFI dimensions other than orgasm and satisfaction (all P<0.05). Total testosterone positively affected the score of total FSFI and desire (all P<0.05); free testosterone was positively related to orgasm ( P<0.05). Conclusion:Estradiol and total testosterone serve as protective factors for female sexual function.

Objective:To explore the correlation between endogenous sex hormone factors and sexual function in Chinese women.Methods:A total of 711 women who met the criteria were investigated in the Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing Chaoyang District Taiyanggong Community Health Service Centre from April 2020 to March 2021. Sociodemographic data (data split into two groups according to educational background: high school or above and lower high school; and three categories based on marital relationship: satisfied, average, and dissatisfied) and serum levels of sex hormones were collected. Female sexual dysfunction (FSD) was evaluated using the female sexual function index (FSFI). Participants were divided into three groups according to the Stages of Reproductive Aging Workshop (STRAW+10): reproductive stage group, menopausal transition stage group and postmenopausal stage group. Spearman rank correlation analysis and multiple linear regression analyses were performed to determine the correlation between characteristics and scores of FSFI.Results:The multivariate logistic regression analysis revealed that postmenopausal stage, secondary education level, neutral and dissatisfied marital relations were significantly negatively correlated with total FSFI score (all P<0.01). Secondary education level, neutral and dissatisfied marital relations were negatively associated with nearly all FSFI domains apart from pain score (all P<0.05); postmenopausal stage was negatively associated with lubrication, satisfaction and pain (all P<0.05). FSH was negatively associated with all FSFI domain scores (all P<0.05). There was a significantly positive correlation between estradiol and scores of FSFI dimensions other than orgasm and satisfaction (all P<0.05). Total testosterone positively affected the score of total FSFI and desire (all P<0.05); free testosterone was positively related to orgasm ( P<0.05). Conclusion:Estradiol and total testosterone serve as protective factors for female sexual function.

Objective:To estimate the safety of myomectomy in twin pregnant women with intramural myomas during cesarean section.Methods:The clinical data of 145 cases of twin pregnancies with intramural myomas who were delivered by cesarean section in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2013 to December 2021 were collected. Maternal demographics, fibroids′ characteristics, maternal and fetal outcomes were compared between groups of cesarean section with myomectomy (myomectomy group, 49 cases) and cesarean section only (non-myomectomy group, 96 cases).Results:Compared with non-myomectomy group, myomectomy group had significantly prolonged operative time [50.0 minutes (37.5-57.5 minutes) vs 40.0 minutes (35.0-50.0 minutes), respectively; P=0.007] and significantly longer postoperative hospital stay [4.0 days (3.0-4.0 days) vs 3.0 days (3.0-4.0 days), respectively; P=0.047). Other maternal and fetal outcomes such as estimated blood loss, hemoglobin difference, postpartum hemorrhage, blood transfusion, B-Lynch structure, uterine artery ligation, postoperative fever and neonatal Apgar score showed no significant differences (all P>0.05). For intramural myomas <5 cm, there were no significant differences in maternal and fetal outcomes between myomectomy group and non-myomectomy group (all P>0.05). For intramural myomas ≥5 cm, operative time [55.0 minutes (40.0-60.0 minutes) vs 42.5 minutes (40.0-50.0 minutes), respectively; P=0.019] was significantly prolonged, postoperative hospital stay [4.0 days (4.0-5.0 days) vs 4.0 days (3.0-4.0 days), respectively; P=0.048] was significantly longer in myomectomy group than non-myomectomy group, but there were no significant differences in other maternal and fetal outcomes (all P>0.05). Conclusion:For twin pregnancies with intramural myomas, it is safe and feasible to remove intramural myomas during cesarean section by experienced obstetricians.

Objective:To explore the progress and prospect of evaluation methods for infertility patients.Methods:From September 2017 to December 2020,199 cases of infertility patients who have accepted mini-hysteroscopy examination in the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients who had primary ovary insufficiency,tubal infertility were excluded;patients with hysteroscopy contradiction,such as acute or sub-acute vaginal tract inflammation,en-dometrium lesion or endometrium carcinoma,severe cardiovascular,liver or kidney insufficiency were excluded.40 patients were excluded and 15 patients lost follow up,144 patients were eventually included in the analysis.The patient's age,body mass index,infertility etiology,preoperative and postoperative stimulate ovulation cycle,pregnancy state and pregnancy time were recorded.The effect of mini-hysteroscopy on ovulation induction cycle was analyzed in pregnant patients.Results:The average age of 144 patients was 32.10±4.67 years old.96 (66.67％) patients were found to have intrauterine abnormalities,while 48 (33.33％) patients were found to have normal intrauterine cavity.48 cases of pregnancy,accounting for 33.33％;the median and interquartile ranges[M (Q1,Q3)]of ovulation induction cycles before and after surgery were respectively[3 (0,5)],[2 (1,3)],the difference was statistically significant(P ＜ 0.05).Among the 48 pregnant patients,32 of them had no structural lesions in hysteroscopy,the ovula-tion induction cycle of these patients before and after hysteroscopy were respectively[5 (0,9)],[1 (0,3)],the difference was statistically significant (P ＜ 0.05).Conclusion:Uterine cavity evaluation is important for the assessments of fertility.As an advanced diagnosis instrument,mini-hysteroscopy can not only timely detect the intrauterine abnormalities of patients,but also with great application value in shorten the ovulation cycle in infertility patients and increase the pregnancy rate.

Objective:To preserve fertility and endocrine function of an endometrial carcinoma patient by ovarian tissue cryopreservation and transplantation.Methods:Part of the ovary was harvested and cryopreserved when surgery for a 33-year-old woman who was diagnosed with endometrial carcinoma. After the cancer reached remission, the patient underwent cryopreserved ovarian tissue transplantation. The endocrine hormone, follicle growth, and menopausal syndromes were detected.Results:One month after the surgery of transplantation, the modified Kupperman scores decreased from 12 to 2, and the menopausal syndrome disappeared. Two months after the operation of transplantation, the concentration of follicle-stimulating hormone (FSH) decreased to 21.78 IU/L, the level of estradiol increased from 13.76 ng/L to 65.55 ng/L, and follicle growth was observed by ultrasound. Four months after the surgery of transplantation, the level of FSH decreased to 6.26 IU/L, the level of estradiol increased to 112.22 ng/L. Nine months after the operation of transplantation, the level of estradiol was 118.14 ng/L, the level of progesterone increased to 8.96 μg/L, and two corpus luteum after ovulation were detected by ultrasound.Conclusion:Two months after the surgery of transplantation, the ovarian function has returned to normal, which demonstrated the success of transplantation of frozen-thawed ovarian tissue.

Objective:To preserve fertility and endocrine function of an endometrial carcinoma patient by ovarian tissue cryopreservation and transplantation.Methods:Part of the ovary was harvested and cryopreserved when surgery for a 33-year-old woman who was diagnosed with endometrial carcinoma. After the cancer reached remission, the patient underwent cryopreserved ovarian tissue transplantation. The endocrine hormone, follicle growth, and menopausal syndromes were detected.Results:One month after the surgery of transplantation, the modified Kupperman scores decreased from 12 to 2, and the menopausal syndrome disappeared. Two months after the operation of transplantation, the concentration of follicle-stimulating hormone (FSH) decreased to 21.78 IU/L, the level of estradiol increased from 13.76 ng/L to 65.55 ng/L, and follicle growth was observed by ultrasound. Four months after the surgery of transplantation, the level of FSH decreased to 6.26 IU/L, the level of estradiol increased to 112.22 ng/L. Nine months after the operation of transplantation, the level of estradiol was 118.14 ng/L, the level of progesterone increased to 8.96 μg/L, and two corpus luteum after ovulation were detected by ultrasound.Conclusion:Two months after the surgery of transplantation, the ovarian function has returned to normal, which demonstrated the success of transplantation of frozen-thawed ovarian tissue.

Objective:This paper aimed to explore the problems and solutions in the management of Investigator-Initiated Trail (IIT) in medical institutions, to provide suggestions particularly in the absence of relevant high-level policy support.Methods:By combining literature review with working practice experiences, this paper analyzed the current situation of IIT’s management and the rationale, put forward suggestions.Results:IIT related problems identified including as the responsible entities of the management, research topics selection, protocol design, continuity, research team construction, ethical review and the cultivation of research management personnel. The centralized management will help the standardized management of such projects, the training of investigators and team building, the review awareness strengthening of the ethics committee, improvement of management ability.Conclusions:IIT plays an important role in promoting the development of medical scientific research. Medical institutions should integrate resources, provide platforms, train investigators assure the quality of IITs.

Objective Along with the fast increasing of scientific research capacity,more and more financial funding were available at hospital level,at the same time,the kinds and quantities of the reagents and consumables for scientific research uses are also increased.As a result,procurement risks become a gig concern in hospitals.Thus,how to increase the cost-effectiveness of their financial funds while lowering the risks and hidden troubles are the key issues need addressing urgently.Methods This paper took Beijing Obstetrics and Gynecology Hospital,Capital Medical University as an example,summarized its service conditions of reagents and consumables for scientific research uses in past three years (2014-2016),according to the comparison and analysis of their actual prices with the guiding prices on the same as indicated on the informational procurement platform,to discuss the existing issues and risks.Results Under the current procurement management system of reagents and consumables for scientific research uses,the purchasing price for some items are relatively high.Conclusions This paper specifically proposed some measures and advices on risk prevention and control during the period of transition with the intention to reduce the purchasing cost,increasing the costeffectiveness of the financial funds,and lowering the risks and hidden troubles in procurements.