ABSTRACT
Objective To investigate the clinical features and management strategies of re-pregnant women with chronic hepatitis B virus infection after implementation of two-child policy.Methods A total of 173 women with chronic hepatitis B virus infection in a subsequent pregnancy were enrolled from Hangzhou Xixi Hospital, among whom 91 cases were before implementation of the policy (from January to August 2015, control group), and 82 cases were after policy implementation (from March to December 2016, study group).The clinical data including basic information, pregnancy complications, postpartum complications, delivery mode and perinatal complications were retrospectively analyzed,t test or χ2 test was used for comparison between the two groups.Results There were significant differences in proportion of age>35 years (31.71% vs.16.48%,χ2=5.528), frequency of abortion(3.2±0.3 vs.1.3±0.4,t=5.723), fertility interval with first pregancy[(57.8±21.4)months vs.(40.4±16.6)months,t=6.691],rate of assisted reproduction(14.63% vs.5.49%,χ2=4.066),proportion of abnormal liver function(13.41% vs.4.40%,χ2=4.618),antiviral treatment during pregnancy (34.14% vs.19.78%,χ2=4.561) and proportion of HBV DNA loads >105IU/mL(35.36% vs.20.88%,χ2=4.515)between study group and control group (all P<0.05).The incidences of gestational hypertension(12.20% vs.3.30%), gestational diabetes mellitus(14.63% vs.5.49%),placenta previa(9.76% vs.2.20%),placental implantation(3.66% vs.0), hydramnio (12.20% vs.3.30%), fetal distress (14.63% vs.5.49%) and preterm birth(14.63% vs.5.49%)were also statistically significant between two groups (χ2=4.914, 4.066, 4.524, 3.838, 4.914, 4.066 and 4.066,all P<0.05).The incidence of cesarean section again(50.00%), postpartum hemorrhage(14.63%)and postpartum anemia(19.51%) were significantly higher in the study group than that in the control group(35.16%,4.40% and 8.79%,χ2=3.892, 5.387 and 4.149,all P<0.05).Compared with the control group, the incidence of low birth weight(14.63% vs.5.49%), neonatal asphyxia(19.51% vs.6.59%)and neonatal HBV infection rate(15.85% vs.6.59%)were higher in the study group (χ2=4.066, 6.486 and 3.883,all P<0.05).Conclusions The clinical characteristics of re-pregnant women with chronic hepatitis B virus infection are more complex and suffer greater risk of pregnancy, so antenatal care should be further reinforced after the comprehensive implementation of two-child policy.
ABSTRACT
Objective To analyze the effects of Xiaogan capsule, Xiaoyao pill combined with Shu er capsule on hyperplasia of mammary gland and its effect on vascular endothelial growth factor ( VEGF ) and basic fibroblast growth factor ( bFGF ) .Methods 106 cases of patients with breast hyperplasia treated in our hospital from April 2013 to August 2016 were randomly divided into experimental group and control group according to the order of admission, with 53 cases in each group.The control group was treated with Xiaojin Capsule and Xiaoyao Pills.The experimental group was treated with Xiaojin Capsule, Xiaoyao Pill and Shuerjing Capsule.Analyze the total effective rate of clinical treatment, incidence of adverse reactions, visual analogue pain score and the influence on the expression of VEGF and bFGF in the two groups.Results The total effective rate was 96.23%(51/53) in the experimental group and 86.79%(46/53) in the control group,the total effective rate in the experimental group was much higher than that in the control group (P<0.05).The incidence of adverse reactions was 11.32%(6/53) in the experimental group and 13.21%(7/53) in the control group,there was no significant difference in adverse reactions between the two groups.The visual analogue pain score of the experimental group was (2.85 ±0.41) points, the visual analogue pain score of the control group was (5.25 ±1.84),the visual analogue pain score of the experimental group was significantly lower than that of the control group ( P <0.05 ) .After treatment, the expression of VEGF and bFGF in the patients with hyperplasia of mammary gland decreased, and the levels of VEGF and bFGF in the patients with hyperplasia of mammary glands were significantly higher than those in the untreated group (P<0.05),the expression of VEGF and bFGF in the control group was enhanced.Conclusion Xiaojin capsule,Xiaoyao pill and Shu er jing capsule have higher application value in the patients with hyperplasia of mammary gland , and significantly lower the expression of VEGF and bFGF .