The Relationship between Different Delivery Timing and the Outcome of Premature Rupture of Membranes in Primiparous Women.

Objective: To investigate the relationship between different delivery timing and the outcome of premature rupture of membranes (PROM) in primiparous women. Methods: Within the context of exploring optimal delivery strategies for managing PROM, we conducted a retrospective study at Shijiazhuang Fourth Hospital. From May 2019 to May 2022, a total of 400 single pregnant women with premature rupture of membranes (PROM) at different gestational weeks (28-36 weeks) were enrolled. This study aims to understand the impact of delivery timing on pregnancy outcomes more clearly. Pregnant women were divided into two distinct groups based on gestational weeks: Group A (28 to 33 weeks, n=192) and Group B (34 to 36 weeks, n=208). The clinical data of pregnant women were analyzed retrospectively, and the methods of delivery, maternal and infant pregnancy outcomes, and factors affecting delivery outcomes were compared in different groups. Results: Compared with the delivery methods of the two groups, the proportion of vaginal delivery in group A (69.27%) was significantly higher than that in group B (49.04%). The proportion of assisted vaginal delivery and cesarean section (13.54% and 17.19%) was significantly lower than that in group B (18.75% and 32.21%) (P < .001). There was no difference in neonatal death outcomes between the two groups (P > .297). The incidence of chorioamnionitis, postpartum hemorrhage, and puerperal infection in group A (25.00%), (19.27%) and (11.46%) was significantly higher than that in group B (6.25%), (5.29%) and (2.40%), respectively. The incidence rates of neonatal asphyxia, neonatal respiratory distress syndrome (NRDS), and hypoxic-ischemic encephalopathy (HIE) in group A were 9.38%, 7.29%, and 6.77%, which were significantly higher than those in group B (1.92%, 0.48% and 0.48%) (P = .001). There was no difference in neonatal death outcomes at different delivery times (P = .259). The incidence rates of amniotic infection, postpartum hemorrhage, and puerperal infection were (3.98%), (7.39%) and (3.41%), which were significantly lower than those of pregnant women from PROM to delivery time ≥48 h (24.11%), (15.63%) and (9.38%). The incidence rates of neonatal asphyxia, NRDS, and HIE were (1.14%), (1.14%) and (2.27%) in neonates from PROM to delivery time < 48 h, significantly lower than those in neonates from PROM to delivery time ≥48 h (8.93%), (5.80%), and (4.46%) (P < .001). Logistic regression analysis showed that the older the gestational week was the protective factor for amniotic space infection, postpartum hemorrhage, puerperal infection, neonatal asphyxia, NRDS, and HIE. Late delivery time was an independent risk factor for amniotic cavity infection(P < .001), postpartum hemorrhage(P = .014), puerperal infection(P = .023), neonatal asphyxia(P = .004), and NRDS (P = .028). Conclusion: In pregnant women with PROM who are not at full term, a greater gestational week is associated with a lower rate of adverse delivery outcomes. In contrast, a longer time interval between membrane rupture and delivery is associated with a higher rate of adverse delivery outcomes.

The expression levels of NF-κB and IKKß in epithelial ovarian cancer and their correlation with drug resistance-related genes MDR1, TOPOII, and ERCC1.

OBJECTIVES: To explore the expression levels of nuclear factor kappa B (NF-κB) and inhibitor of nuclear factor kappa B kinase (IKKß) in epithelial ovarian cancer and the correlation analysis with multi-drug resistance-related genes 1 (MDR1), topoisomerase II (TOPOII) and nucleotide excision repair cross complementary group 1 (ERCC1). METHODS: Immunohistochemical methods were used to detect the expression levels of NF-κB and IKKß in epithelial ovarian cancer group (50 cases), ovarian benign tumor group (30 cases), and normal ovary group (10 cases). The expression levels of NF-κB, IKKß, MDR1, TOPOII and ERCC1 messenger ribonucleic acid (mRNA) and protein were analyzed using real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot. Student's t-test and one-way ANOVA were used for comparison of numerical data. Pearson's chi-squared and Fisher's exact tests were carried out for analysis of non-numerical data. RESULTS: The levels of NF-κB, IKKß, MDR1 and ERCC1 mRNA and protein were increased (P<0.05), and the expression levels of TOPOII were decreased (P<0.05) in the epithelial ovarian cancer group compared to the normal ovary and benign ovarian tumor groups. The expression of NF-κB and IKKß in epithelial ovarian cancer was significantly increased in patients with higher tumor stage, lower differentiation and presence of lymph node metastasis and positively correlated with MDR1 expression. NF-κB and IKKß were negatively correlated with the expression of TOPOII and antagonized each other with TOPOII. CONCLUSIONS: The expression of NF-κB and IKKß was positively correlated with the expression of MDR1, and negatively correlated with the expression of TOPOII. The correlation of NF-κB, IKKß and resistance related genes, including MDR1, TOPOII, ERCC1, can predict the resistance of chemotherapy individuals to chemotherapy.

Efficacy and Safety of the Bushen-Shugan Method in Pregnancy Outcomes in Patients with Recurrent Miscarriage Complicated by Anxiety and Depression: A Prospective Randomized Trial.

Objective: This study aimed to investigate the effect of the Bushen-Shugan (BSSG) method on pregnancy outcomes, serum D-dimer (D-D), platelet aggregation rate, homocysteine (Hcy) and antithrombin III (AT-III) in patients with recurrent miscarriage complicated by anxiety and depression. Methods: From December 2016 to December 2019, 100 patients with recurrent miscarriage combined with anxiety and depression were enrolled in our study, and a prospective randomized trial was carried out. Patients were randomly assigned to either the control group or the BSSG group via the random number table method. Traditional Chinese medicine (TCM) syndrome scores, laboratory indicators and psychological changes were compared in the 2 groups before and after treatment. Results: After treatment, the primary, secondary and total TCM syndrome scores in the 2 groups were lower, and the scores in the BSSG group were significantly lower than in the control group. The clinical curative effect in the BSSG group was significantly higher (92% vs 76%) than in the control group. The levels of ß-HCG, P, E2 and AT-III in the 2 groups were higher, while levels of D-D, platelet aggregation rate and Hcy were lower than before treatment. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were lower after treatment in both groups, and the scores in the BSSG group were significantly lower than in the control group. Conclusions: The BSSG method may be worthy of consideration because it improves pregnancy outcomes in patients with recurrent miscarriage complicated by anxiety and depression.