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Table of Content

    25 January 2022, Volume 43 Issue 1
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    The protective effect of procyanidin B2 on cardiotoxicity induced by acute expose to PM2.5 in rats 
    REN Jing-yi, SHEN Qiang, CHEN Jun-lan, CHEN Meng-yuan, LYU Shuai-shuai, MA Yu-xia
    2022, 43(1):  7-11.  doi:10.3969/j.issn.1007-3205.2022.01.002
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    Objective  To explore the protective effect of procyanidin B2(PCB2) on  cardiotoxicity induced by acute exposure to PM2.5 in rats. 
    Methods  A total of 24 healthy adult male SD rats were divided into three groups: the normal saline control group(the rats were given distilled water by gavage three time a day for 21 consecutive days and were exposed to 0.9% saline by intratracheal instillation on the 8th, 10th, and 12th days), PM2.5 group(the rats were given distilled water by gavage three times a day for 21 consecutive days and were exposed to PM2.5 suspension by intratracheal instillation on the 8th, 10th, and 12th days), and PCB2 group(the rats were pretreated with PCB2 by gavage for 21 consecutive days and were exposed to PM2.5 suspension by intratracheal instillation on the 8th, 10th, and 12th days) according to random number table method. At 24 h after the last gavage, the rats were sacrificed and cardiac tissues were collected for prepartion of tissue section. The expressions of superoxide dismutase(SOD), glutathione peroxidase(GSH-Px), malondialdehyde(MDA), interleukin-1β(IL-1β), interleukin-6(IL-6) and interleukin-18(IL-18) were detected. 
    Results  Compared with the normal saline control group, the contents of IL-1β, IL-6, IL-18 and MDA in the heart tissue homogenate of PM2.5 group were significantly increased, while the contents of GSH-Px and SOD in PM2.5 group were decreased significantly, suggesting significant differences(P＜0.05). Compared with the PM2.5 group, the contents of IL-1β and IL-18 in the heart tissue homogenate of PCB2 group were significantly reduced, and the contents of SOD and GSH-Px in PCB2 group were increased significantly, suggesting significant differences(P＜0.05). 
    Conclusion  PM2.5 by acute intratracheal instillation can obviously cause inflammatory damage and oxidative stress changes in rats. PCB2 has a protective effect against heart damage caused by PM2.5.

    Changes of PLC-γ1 cartilage ossification of the posterior condyle of rats after functional mandibular protrusion
    SHENG Hai-ying, WANG Qiu-rui, WEI Jing, GUAN Xiu-juan, ZHAO Li-xia, ZUO Yan-ping
    2022, 43(1):  12-15,48.  doi:10.3969/j.issn.1007-3205.2022.01.003
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    Objective  To explore the mechanism of phospholipase C-γ1(PLC-γ1) in cartilage ossification of the posterior condyle of rats after functional mandibular protrusion. 
    Methods  Sixty four-week-old male Sprague-Dawley(SD) rats were adaptively fed for one week. The mandibular protrusion model of SD rats was established, and then the rats were divided into experimental group and control group equally and randomly. The experimental group was treated with self-made inclined plane appliance for mandibular protrusion(24 h /d), while the control group was not treated. Five rats in each group were sacrificed at 1, 3, 7, 14, 21, 28 d respectively after using inclined plane appliance. The bilateral condyles were fixed, decalcified, dehyded, and then embedded. The histological changes of the paraffin sections were observed by HE staining, and the expression of PLC-γ1 in posterior condylar cartilage was detected by immunohistochemistry combined with image analysis. 
    Results  The IHS value of PLC-γ1 expression in the posterior condyle cartilage of the experimental group was higher than that in the control group at 7, 14, 21, 28 d, and the difference was statistically significant(P＜0.05). The IHS value of PLC-γ1 expression was not significantly different between two groups at different time points(P＞0.05). 
    Conclusion  PLC-γ1 may be involved in the process of condylar cartilage ossification of rats after functional mandibular protrusion, and the detection of its level has important reference value for the study of cartilage ossification in condylar process.

    Study on current status and influencing factors of medication adherence in discharged patients with ischemic cerebrovascular disease
    MA Yue-xia, FENG Jun-yan, SUN Shu-hua, WANG Qian-ru, ZHANG Xiao, ZHU Chun-hua
    2022, 43(1):  16-21.  doi:10.3969/j.issn.1007-3205.2022.01.004
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    Objective  To analyze the current status and influencing factors of medication adherence in discharged patients with ischemic cerebrovascular disease. 
    Methods  A total of 360 discharged patients with ischemic cerebrovascular disease were selected. The patients′ general information, disease and medication status, and medication knowledge level were collected, and Morisky questionnaire on medication compliance, general self-efficacyscale(GSES), perceived social support scale(PSSS) and other data were used to analyze medication compliance status and its influencing factors. 
    Results  The medication compliance rate of discharged patients with ischemic cerebrovascular disease was 23.2%. There were significant differences in patients with good medication compliance and those with poor medication compliance with respect to education level, chronic disease, attention to disease, frequency of medicine use, adverse drug reactions after medication in the past two weeks, total score of medicine use knowledge and perceived social support score were the influencing factors of medication adherence(P＜0.05).Multivariate regression analysis showed that the degree of attention to the disease, perceived social support were influencing factors for medication compliance in discharged patients with ischemic cerebrovascular disease(P＜0.05). 
    Conclusion  The status of medication compliance in discharged patients with ischemic cerebrovascular disease is not optimistic. The degree of attention to the disease and perceived social support are the important factors affecting the medication compliance of patients with ischemic cerebrovascular disease.

    Effect of different pacing sites of permanent pacemaker on cardiac function of implanted patients
    WANG Ya-ling, ZHANG Yang, GUO An-jun, RAO Ming-yue, ZHANG Xiao-dan, MENG Jian-kang
    2022, 43(1):  22-25,30.  doi:10.3969/j.issn.1007-3205.2022.01.005
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    Objective  To explore the effect of different pacing sites of permanent pacemaker on cardiac function of implanted patients. 
    Methods   In total, 80 patients who received permanent pacemaker implantation in the Department of Cardiology of our hospital were included in the study, and were divided into group A(30 patients with permanent pacemaker implantation at the apex of the right ventricle) and group B(50 patients with permanent pacemaker implantation at the septum of the right ventricle) according to the pacing sites. The clinical data of the two groups were analyzed retrospectively. The levels of N-terminal brain natriuretic peptide(NT-proBNP), cardiac color ultrasound indicators［including left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD) and left ventricular ejection fraction(LVEF)］, quality of life score, and incidence of adverse cardiac events were compared between two groups. 
    Results  The levels of NT-proBNP after implantation in both groups were significantly lower than those before implantation(P＜0.05), while the levels of NT-proBNP after implantation in group B were lower than those in group A, suggesting significant differences(P＜0.05). The LVEF, LVEDD and LVESD after implantation were significantly improved in both groups(P＜0.05), while the LVEF in group B was higher than that in group A(P＜0.05), and the LVEDD and LVESD in group B were lower than that in group A, with significant difference(P＜0.05). The quality of life scores(emotional field, physical field, other fields and comprehensive scores) of the two groups were significantly lower after implantation than those before implantation(P＜0.05), while the quality of life scores(emotional field, physical field, other fields and comprehensive scores) after implantation in group B were lower than those in group A, with statistical significance(P＜0.05). At 6-month follow-up, there were 2 cases of atrial fibrillation, 1 case of heart failure and 2 cases of abnormal heart rate in group A, and 3 cases of atrial fibrillation, 3 cases of heart failure and 1 case of abnormal heart rate in group B. The incidence of adverse cardiac events in group A and group B was 16.67% and 14.00% respectively, and there was no significant difference between two groups(P＞0.05). 
    Conclusion  Implantation of permanent cardiac pacemakers at different pacing sites has certain influences on patients′ cardiac function. Implantation of permanent cardiac pacemakers into the right side of the interventricular septum can improve patients′ cardiac function better without increasing the risk of adverse cardiac events. 

    Predictive value of serum biomarkers in the prognosis of fibrosing interstitial lung diseases
    ZHAO Tie-mei, DUAN Zhi-mei, LIU Yang, LIU Kai-di, HUA Lin, SHENG Chao-jun
    2022, 43(1):  26-30.  doi:10.3969/j.issn.1007-3205.2022.01.006
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    Objective  To explore the predictive value of serum biomarkers associated with alveolar epithelial cell dysfunction in the prognosis of fibrosing interstitial lung diseases(FILD). 
    Methods  The patients were prospectively enrolled and clinical data were collected. Biomarkers were detected and they were followed up for 1 year to evaluate the condition. Survival analysis of competitive risk model and Fine-Gray regression model were used to extract the risk factors of progressive fibrotic phenotype and death. 
    Results  Of the 58 patients, 35 cases were diagnosed as idiopathic pulmonary fibrosis, 14 as interstitial lung disease associated with connective tissue diseases, 9 as pulmonary fibrosis caused by other causes. Of them, 12(20.69%) developed into progressive fibrotic phenotype, and 8(13.79%) died. Univariate analysis showed that the risk factor for the development of progressive fibrotic phenotype was the baseline elevation of carbohydrate antigen 125(CA-125), and the risk factor for death was the baseline elevation of carbohydrate antigen 19-9(CA19-9). Multivariate analysis showed that the baseline elevation of CA19-9 was the risk factor for death(regression coefficient 0.007，hazard ratio 1.007, 95% confidence interval: 1.001-1.061， P=0.044). 
    Conclusion  Patients with elevated CA-125 baseline have a higher risk of developing progressive fibrotic phenotype, while patients with elevated CA19-9 baseline have a higher risk of death.

    Application and diagnostic value of CTA in patients with acute intestinal obstruction
    PEI Lei, ZHAO Qi-kang, WANG Hai, RONG Wan-shui, SHANG Cun-hai
    2022, 43(1):  31-34.  doi:10.3969/j.issn.1007-3205.2022.01.007
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    Objective  To explore the application and diagnostic value of multi-slice spiral CT angiography(CTA) in patients with acute intestinal obstruction (AIO). 
    Methods  A total of 90 patients with AIO were selected as the research subjects, including 34 cases of mechanical intestinal obstruction, 29 cases of dynamic intestinal obstruction and 27 cases of hemovascular intestinal obstruction confirmed by operation. All patients were given X-ray plain film, CT plain scan and CTA examination, and surgical results were taken as the “gold standard” to analyze the diagnostic efficacy of X-ray plain film, CT plain scan and CTA examination. 
    Results  There was statistical significance in the detection rate of different causes of intestinal obstruction by the three diagnostic methods(P＜0.05). The detection rate of mechanical intestinal obstruction and acute blood-transporting intestinal obstruction by CTA was higher than that by X-ray plain film, and the difference was statistically significant(P＜0.05). The sensitivity, specificity and accuracy of CT plain scan and CTA in the diagnosis of AIO were higher than those of X-ray plain film. The sensitivity, specificity and accuracy of CTA in the diagnosis of AIO were higher than those of CT plain scan, and the difference was statistically significant(P＜0.05). 
    Conclusion  CTA has a high detection rate and good diagnostic efficiency in the diagnosis of AIO, which is of high value in clinical popularization.

    A case-control study of GPC-1 exosomes, CD82 exosomes and CA19-9 in the diagnosis of pancreatic cancer
    GUO Huai-bin, LI Feng-fei, LIU Yi-pan, ZHANG Wan-xing, KAN Jin-long
    2022, 43(1):  35-38.  doi:10.3969/j.issn.1007-3205.2022.01.008
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    Objective  To study the value of glypican-1(GPC-1)exosomes, cluster of differentiation(CD) 82 exosomes and CA19-9 in the diagnosis of pancreatic duct adenocarcinoma(PDAC). 
    Methods  In total, 31 PDAC patients(PDAC group) and 22 chronic pancreatitis(CP) patients(CP group) were selected. Fasting peripheral blood was collected in the early morning, and exosomes were isolated and stained with immunohistochemistry SP method.The ratio of GPC-1 exosomes to CD82 exosomes was determined by flow cytometry, and the content of CA19-9 was determined by electrochemiluminescence immunoassay. 
    Results  The expression of CA19-9 and GPC-1 exosomes in PDAC group was higher than that of CP group, and the difference was statistically significant(P＜0.05). No significant difference was found in the expression of CD82 exosomes in the two groups(P＞0.05). The area under ROC curve(AUC) of CA19-9, GPC-1 and the combination of CA19-9 and GPC-1 exosomes in the diagnosis was 0.771, 0.918 and 0.922 respectively; the diagnostic value of GPC-1 exosomes was superior to CA19-9 in PDAC, and the difference was statistically significant(P＜0.05). The diagnostic value of combination of plasma CA19-9 and GPC-1 exosomes was superior to CA19-9 alone in PDAC,and the difference was statistically significant(P＜0.05); but the diagnostic value of combination of plasma CA19-9 and GPC-1 exosomes was not superior to GPC-1 exosomes alone in PDAC, and the difference was no statistically significant(P＞0.05). And there was no correlation between CA19-9 in peripheral blood and GPC-1 exosomes in PDAC(r=0.237, P=0.200). 
    Conclusion  The diagnostic value of plasma GPC-1 exosomes in PDAC is superior to that of CA19-9, and combination of the two indicators can improve sensitivity and reduce the misdiagnosis rate.

    Application value of real-time fluorescent quantitative polymerase chain reaction technique in pathological diagnosis of renal tuberculosis
    FAN Zheng-chao, YIN Hang, LIU Jian-zhen, LI Chong-bin
    2022, 43(1):  39-43.  doi:10.3969/j.issn.1007-3205.2022.01.009
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    Objective  To investigate the application value of real-time fluorescent quantitative polymerase chain reaction(FQ-PCR) technique in pathological diagnosis of renal tuberculosis. 
    Methods  We retrospectively analyzed 55 patients with paraffin-embedded specimens after retroperitoneoscopic or open nephrectomy in Department of Urology of our hospital. Taking the results of preoperative urine Mycobacterium tuberculosis culture results as the gold standard, combined with the results of postoperative pathological diagnosis, the subjects were divided into tuberculos nephropathy group(positive group, n=25) and non-tuberculous nephropathy group(negative group, n=30). Each paraffin-embedded tissue specimen was detected using TaqMan-probe real-time FQ-PCR technique and and acid-fast staining technique, and the diagnostic efficiency of the two detection techniques in the pathological diagnosis of renal tuberculosis was compared and analyzed. A recevier operating characteristic(ROC) curve was drawn to evaluate the value of the two methods in the pathological diagnosis of renal tuberculosis. 
    Results  The sensitivity of real-time FQ-PCR and acid-fast staining was 80.0%(20/25) and 48.0%(12/25) respectively; the sensitivity of the former was higher by 32.0% than that of acid-fast staining,with significant difference(χ2=5.556， P=0.018). The specificity，the positive predictive value and the negative predictive value of real-time FQ-PCR were higher than that of acid-fast staining, but there was no significant difference between them（P＞0.05）. The accuracy of real-time FQ-PCR was higher than that of acid-fast staining（89.1% vs. 72.7%）, and there was significant difference between them（χ2=4.767， P=0.029）. The Kappa values of the two techniques for detecting pathogens in renal tuberculosis tissue specimens which were consistent with results of urine Mycobacterium tuberculosis culture were 0.777 and 0.429, respectively. ROC curve analysis showed that area under ROC curve(AUC)of real-time FQ-PCR technique and acid-fast staining technique was 0.883 and 0.707 respectively; the former was higher than the latter by 0.177, and the difference was statistically significant(Z=3.502, P＜0.05). 
    Conclusion  Real-time FQ-PCR technique is simple and has higher sensitivity and accuracy in the detection of pathogens in renal tuberculosis tissue, as compared with acid-fast staining technique. Real-time FQ-PCR technique shows good application value in pathological diagnosis of renal tuberculosis.

    Guiding role of CT classification in endoscopic decompression surgery for patients with lumbar spinal stenosis
    GUO Jia-quan, CHANG De-yong, HU Qing-yong, WANG Jian, DING Xu-bo, SUN Yun-chao
    2022, 43(1):  44-48.  doi:10.3969/j.issn.1007-3205.2022.01.010
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    Objective  To explore the guiding role of CT classification in endoscopic decompression surgery for patients with lumbar spinal stenosis(LSS). 
    Methods  In total, 64 LSS patients were selected and all received CT examination before operation. With results of surgical and pathological classification as the gold standard, the consistency between CT classification results and results of surgical and pathological classification was analyzed, and the selection of surgical methods and postoperative results were analyzed. 
    Results  CT diagnosis showed that there were 19 cases of type Ⅰ, 30 cases of type Ⅱ and 15 cases of type Ⅲ among the 64 patients. The pathological results showed that there were 18 cases of type Ⅰ, 30 cases of type Ⅱ and 16 cases of type Ⅲ among the 64 patients. The coincidence rate between CT classification and surgical and pathological classification was 98.44%; the accuracy of CT in diagnosing type Ⅰ, type Ⅱ and type Ⅲ LSS were 98.44%, 100.00% and 98.44%, respectively, and the Kappa values of consistency test with the results of surgical and pathological classification were 0.962, 1.000 and 0.957, respectively(P＜0.001). Of 64 patients, 18 patients with type Ⅰ underwent discectomy via translaminar approach; 30 patients with type Ⅱ underwent modified TESSY technique combined with nerve root decompression under foraminal microscopy; among the 16 patients with type Ⅲ LSS, 4 patients received modified TESSY technique combined with nerve root decompression under foraminal microscopy, and 12 patients received surgery via interlaminar approach. All patients had no postoperative complications such as permanent nerve injury and infection, and the clinical symptoms such as intermittent claudication, leg pain and lumbosacral pain were significantly relieved. 
    Conclusion  The accuracy of preoperative CT classification of LSS patients is relatively high, which has certain guiding significance for the selection of percutaneous endoscopic surgical approach in clinical practice.

    Impact of the thickness and morphology of the uterine junctive zone on the clinical outcome of frozen embryo transfer in patients with adenomyosis
    ZHU Bo-ya, JIANG Qian, ZHAO Jing-yun, LUO Zhao-yan, ZHEN Xiu-li, LYU Cui-ting
    2022, 43(1):  49-53.  doi:10.3969/j.issn.1007-3205.2022.01.011
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    Objective  To explore the impact of the thickness and morphology of the junctional zone(JZ) on the frozen embryo transfer(FET) in patients with adenomyosis. 
    Methods  A retrospective analysis was performd on the clinical data of 85 patients with adenomyosis who underwent FET in the Department of Reproductive Medicine, the Fourth Hospital of Hebei Medical University. Long-acting gonadotrophin releasing hormone agonist(GnRH-a) down-regulation was used before the endometrium preparation. According to presence of pregnancy, they were divided into pregnancy group(n=45) and non-pregnancy group(n=40). The relationship between the thickness and morphology of the uterine JZ and clinical outcome under three-dimensional vaginal ultrasound was analyzed. 
    Results  There were no significant differences between the two groups of patients in terms of age, years of infertility, body mass index, proportion of primary infertility, number of embryos transferred and thickness of endometrium(P＞0.05). There were no significant differences between the two groups of patients in thickness of uterine JZ during menstrual period, and after using GnRH-a once and twice(P＞0.05), however, there was a significant difference in the normal rate of JZ morphology between the two groups(P＜0.05). Multivariate logistic regression analysis related to the occurrence of pregnancy showed that JZ morphology after using GnRH-a twice was an independent protective factor for clinical pregnancy; the higher the normal morphological rate of the uterine JZ, the higher the pregnancy rate(P＜0.001).  
    Conclusion  Three-dimensional vaginal ultrasound in the evaluation of the morphology of the uterine JZ is a good indicator for predicting the pregnancy outcome of FET in patients with adenomyosis, which provides reference for the number of GnRH-a times the patient used to improve pregnancy outcome.

    The value analysis of neutrophil to lymphocyte ratio combined with hemoglobin level in predicting uterine fibroids combined with adenomyosis
    DING Ling, XU Lin, DOU Shu-lan
    2022, 43(1):  54-57,64.  doi:10.3969/j.issn.1007-3205.2022.01.012
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    Objective  To explore the value of neutrophil to lymphocyte ratio(NLR) combined with hemoglobin(Hb) level in predicting the occurrence of uterine fibroids combined with adenomyosis. 
    Methods  The clinical data of 167 patients with benign uterine lesions who underwent hysterectomy were retrospectively analyzed. According to the results of histopathological diagnosis, they were divided into simple uterine fibroids group(control group, n=95) and uterine fibroids combined with adenomyosis group(observation group, n=72). Blood routine indexes such as neutrophils count(NEUT), lymphocyte count(LY) and hemoglobin(Hb) level in peripheral blood were detected, and NLR was calculated. The clinical data and biochemical indicators of the two groups were compared. Multivariate Logistics regression was used to analyze the influencing factors of uterine fibroids and adenomyosis. Receiver operating characteristic curve(ROC) was used to assess the predictive value of peripheral blood NLR and Hb levels in  occurrence of uterine fibroids and adenomyosis symptom. 
    Results  The proportion of patients with history of diabetes and abortion, serum human epididymal protein 4(HE4), carbohydrate antigen 125(CA125) content, and peripheral blood NLR in the observation group were higher than those in the control group, and peripheral blood LY and Hb level were lower than those in the control group(P＜0.05). Multivariate Logistic analysis showed that serum HE4 content, serum CA125 content, peripheral blood NLR, and peripheral blood Hb level were risk factors affecting the occurrence of uterine fibroids and adenomyosis(OR=1.579, 5.726, 3.669, 1.833 ). The area under the ROC curve(AUC) of NLR, Hb level, NLR combined with Hb level in predicting uterine fibroids and adenomyosis were 0.759(95%CI: 0.681-0.836), 0.776(95%CI: 0.700-0.852), and 0.849(95%CI: 0.786-0.913), respectively. The AUC of NLR combined with Hb level in predicting the occurrence of uterine fibroids and adenomyosis was greater than that of NLR alone and Hb level alone(P＜0.05). 
    Conclusion  Peripheral blood NLR and Hb levels are risk factors for the occurrence of uterine fibroids and adenomyosis, which, therefore, can be used as reference indexes for early screening and diagnosis of uterine fibroids and adenomyosis.

    Application of PGT-A and PGT-SR in assisted reproduction
    SONG Chun-lan, ZUO Hai-yang, WANG Wei, CHEN Fu, SHANG Wei
    2022, 43(1):  58-64.  doi:10.3969/j.issn.1007-3205.2022.01.013
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    Objective  To summarize the application value of preimplantation genetic testing(PGT) in assisted reproduction. 
    Methods  The clinical data, laboratory data and pregnancy outcome data of couples assisted by PGT for aneuploidies(PGT-A )and PGT for structural rearrangements(PGT-SR) in the Sixth Medical Center of PLA General Hospital were retrospectively analyzed. The embryos with normal test results after blastocyst extracorporeal trophoblastic cell biopsy and genetic testing were selected for single blastocyst transfer. The general information, embryo status, embryo biopsy results and pregnancy outcome were compared between younger(＜35 years of age)and older(≥35 years of age) women. 
    Results  A total of 194 cycles, 635 embryos and 101 transfer cycles were included in PGT-A. A total of 92 cycles, 399 embryos and 40 transfer cycles were included in PGT-SR. In both PGT-A and PGT-SR, the number of retrieved oocytes of ≥35 years group was less than that of ＜35 years women(P＜0.05), and there was no statistical difference in the subsequent embryonic development(P＞0.05). However, the normal embryo rate of ≥35 years group in PGT-A and PGT-SR was significantly lower than that of ＜35 years group(P＜0.05), and with the increase of age, the normal rate of PGT-A embryo biopsy decreased gradually. There were 44 live births(43.56%) in 101 transfer cycles of PGT-A, and there was no statistical difference in pregnancy outcomes between two groups(P＞0.05). There were 19 live births(47.50%) in the 40 transfer cycles of PGT-SR, and there was no statistical difference in pregnancy outcomes between two groups(P＞0.05). All the children were healthy. 
    Conclusion  PGT is an effective treatment for recurrent abortion, elderly women and couples with chromosomal abnormalities. The clinical application of PGT can effectively improve the fertility status of elderly women, however, whether women after the age of 40 are suitable for PGT should be decided after weighing the pros and cons.

    The status quo analysis of dyadic coping in infertility patients and their spouses
    HU Shu-nan, LI Hai-hong, ZHANG Ping, HAN Ye-fen
    2022, 43(1):  65-69,79.  doi:10.3969/j.issn.1007-3205.2022.01.014
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    Objective  To explore the status quo of dyadic coping in infertility patients and their spouses, and to analyze the factors of differences in dyadic coping strategies between patients and their spouses. 
    Methods  With general information questionnaires and Dyadic Coping Inventory(DCI) as measurement tools, a convenient sampling method was used to investigate and study 195 female infertility patients and their spouses. 
    Results  A total of 188 pairs of valid questionnaires were collected for patients and their spouses. The dyadic coping level of infertility patients and their spouses was at a low normal level. There were statistically significant differences in the patients and their spouses with respect to stress communication,perceived pressure communication, self-agency supportive, perceived agency supportive, self-negative support coping, and perceived negative support coping(P＜0.05). The differences of self-positive support coping, perceived positive support coping, co-response and response evaluation between patients and their spouses was not statistically significant(P＞0.05). There are statistically significant differences in the dyadic coping scores of patients with different residences, years of marriage, education level, occupation, average monthly income, the only child, and duration of infertility(P＜0.05). Significant differences were found in spouses' dyadic coping scores with respect to different residences, years of marriage, education level, occupation and average monthly income(P＜0.05). The results of multiple linear regression model showed that education level and average monthly income were the influencing factors of patients' dyadic coping score, while year of marriage, education level, and average monthly income were the influencing factors of spouse's dyadic coping score(P＜0.05).
    Conclusion  The dyadic coping levels of infertility patients and their spouses need to be improved. and the dyadic coping strategies are different.

    Observation of MTHFR gene polymorphism and its relationship with VitB12, Hcy and SFA in women of childbearing age
    SUN Yan, QIANG Gui-yan, LI Chun-ling
    2022, 43(1):  70-74.  doi:10.3969/j.issn.1007-3205.2022.01.015
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    Objective  To explore 5, 10-methylene tetrahydrofolate reductase(MTHFR) gene polymorphism and its relationship with vitamin B12(VitB12), homocysteine(Hcy) and folic acid(SFA) in women of childbearing age. 
    Methods  In total, 124 cases of perinatal patients with adverse pregnancy history were included as group A, and another 124 perinatal women who underwent pregnancy examination in our hospital during the same period and had no history of adverse pregnancy were included as group B. After admission, 5, 10-MTHFR, methionine synthase reductase(MTRR) genes and serum VitB12, SFA and Hcy were detected in both groups. MTHFR(C677T, A1298C), MTRR(A66G) genotype and allele distribution were compared between two groups. Serum VitB12, Hcy and SFA levels were compared between two groups. Serum VitB12, Hcy and SFA levels of patients with different MTHFR C677T genotypes were compared. In addition, the correlation between serum VitB12, Hcy, SFA levels and MTHFR C677T genotype was analyzed. 
    Results  The detection rate of MTHFR C677T genotype CT, TT and T allele distribution in group A was significantly higher than that in group B, with statistically significant differences(P＜0.05). There was no significant difference in genotype and allele distribution of MTHFR A1298C between two groups(P＞0.05). No significant difference was found in MTHFR A66G genotype and allele distribution between two groups(P＞0.05). The Hcy level of group A was significantly higher than that of group B, and the SFA level was significantly lower than that of group B, with statistically significant differences(P＜0.05). The Hcy levels of MTHFR C677T genotype CT and TT were higher than those of CC genotype, and the SFA level was significantly lower than that of CC genotype, with statistically significant differences(P＜0.05). Correlation analysis confirmed that serum Hcy level was positively correlated with MTHFR C677T genotype CT and TT type, and serum SFA level was negatively correlated with MTHFR C677T genotype CT and TT type(P＜0.05). 
    Conclusion  There are SFA and Hcy fluctuations and MTHFR C677T gene mutations in women of childbearing age with previous adverse pregnancy history. Timely supplementation of SFA for WOMEN of childbearing age with MTHFR C677T genotype CT and TT may reduce the incidence of adverse pregnancy and improve pregnancy outcome.

    Risk factors of collateral artery formation in uterine artery embolization treatment for uterine scar pregnancy
    HOU Fang-juan, HAN Ning
    2022, 43(1):  75-79.  doi:10.3969/j.issn.1007-3205.2022.01.016
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    Objective  To investigate the risk factors of the formation of collateral artery in uterine artery embolization(UAE) for uterine scar pregnancy. 
    Methods  In total, 127 patients with uterine scar pregnancy in our hospital were selected as the research subjects. All patients were observed during UAE operation. The incidence of collateral artery was evaluated and calculated. According to the formation of collateral artery, the patients were divided into collateral artery group and non-collateral artery group. A comparative analysis was performed on the basic data and clinical examination indicators of the two groups. The risk factors of collateral artery formation after UAE were analyzed by univariate analysis and multivariate Logistic regression analysis. 
    Results  According to the statistical observation, 45 cases with collateral artery were found during UAE for uterine scar pregnancy, and the incidence was 35.43%. Univariate analysis showed that there was no significant difference in age, body mass index(BMI), smoking history, drinking history, gestational age, education level, time interval from the last cesarean section(C-section), history of hysteromyoma and other basic and clinical data between the two groups(P>0.05). There were significant differences in the incidence of placenta previa, pelvic inflammation, pregnancy complications, history of abortion, frequency of C-section between the two groups(P>0.05). Through the design of multiple Logistic regression analysis program and the corresponding variable assignment, the multivariate analysis showed that the history of placenta previa, the history of pelvic inflammation, the high incidence of complications during pregnancy, the history of abortion, and the number of C-section were the high-risk factors of collateral artery formation during UAE treatment for uterine scar pregnancy. 
    Conclusion  There is a high incidence of collateral artery formation during UAE treatment for uterine scar pregnancy in our hospital, among which the history of placenta previa and pelvic inflammation, high incidence of complications during pregnancy, history of abortion surgery and more times of C-section are all independent risk factors of collateral artery formation, which should warrant attention of clinicians.