Objective To investigate the relationship between serum ATP binding cassette subfamily A member 1(ABCA1)and fatty acid binding protein 4(FABP4)levels and insulin resistance(IR)and pregnan-cy outcome in patients with gestational diabetes mellitus(GDM).Methods A total of 121 patients with GDM admitted to the hospital from October 2019 to October 2023(GDM group)and 65 healthy pregnant women during the same period(control group)were selected,and the patients with GDM were divided into a poor group(50 cases)and a good group(71 cases)according to the pregnancy outcome.Serum ABCA1 and FABP4 levels were detected by enzyme-linked immunosorbent assay,and Pearson correlation coefficients were used to analyze the correlation between the two and the IR index(MOMA-IR)assessed by steady state model.With pregnancy outcome in GDM patients as the dependent variable,multivariate Logistic regression was used to determine its influencing factors,and receiver operating characteristic curve was used to evaluate the predictive efficacy of serum ABCA1 and FABP4 levels.Results Serum ABCA1 level in the GDM group was lower than those in the control group,and FABP4 level and HOMA-IR were higher than those in the control group(t=12.818,P＜0.001,t=17.219,P＜0.001,t=17.543,P＜0.001).In the GDM patients,HOMA-IR was nega-tively correlated with serum ABCA1 levels and positively correlated with serum FABP4 levels(r=-0.739,t=0.724,both P＜0.001).The independent risk factors for adverse pregnancy outcomes in GDM patients were HOMA-IR(OR=1.449,95％CI:1.161-1.810)and FABP4(OR=1.024,95％CI:1.011-1.037),and the independent protective factor was ABCA1(OR=0.302,95％CI:0.163-0.559).The area under the curve of serum ABCA1 combined with FABP4 level to predict pregnancy outcome in GDM patients was 0.877(95％CI:0.805-0.930),which was greater than that of serum ABCA1 and FABP4 levels alone,which were predic-ted by 0.786(95％CI:0.702-0.855),0.787(95％CI:0.703-0.856).Conclusion Reduced serum ABCA1 levels and elevated FABP4 levels are associated with IR and adverse pregnancy outcomes in patients with GDM,and the combination of the two has high predictive efficacy.

Objective:To research the clinical effect of abdominal total hysterectomy on the patients with uterine fibroids and the serum vascular endothelial growth factor (VEGF) and interleukin 6 (IL-6),interleukin 8 (IL-8) levels.Methods:106 cases of patients with uterine fibroids from February 2014 to February 2016 were divided into the control group and the research group according to the lottery method,the control group was treated with total abdominal hysterectomy,while the research group was given abdominal total hysterectomy treatment,the operation time,blood loss,anal exhaust time,length of hospital stay,changes of serum VEGF,IL-6,IL-8,Follicle stimulating hormone (FSH),estradiol (E2) levels,resistance to seedling le tube hormone (AMH) before and after the surgery as well as the occurrence of complications were compared between two groups.Results:The operation time,blood loss,length of hospital stay,anal exhaust time of research group were significantly shorter than those of the control group (P＜0.05).Before surgery,the serum levels of VEGF,IL-6,IL-8,FSH,E2,AMH showed no difference between two groups (P＞0.05).After the operation,the serum levels of IL-6,IL-8,E2,AMH of research group were lower than those of the control group (P＜0.05),the serum level of FSH in research group was higher than that of the control group (P＜0.05).The serum level of VEGF showed no difference between the two groups (P＞0.05).The incidence rate of complications in research group was lower than that of the control group (P＜0.05).Conclusion:Abdominal total hysterectomy showed similar effect with the abdominal hysterectomy in the treatment of uterine fibroids patients,but the abdominal full hysterectomy induced less trauma,promoted the recovery of ovarian function after surgery,which might be related to the decrease of serum IL-6,IL-8 and VEGF levels.