Spontaneous Abortions in the Second Trimester of Pregnancy: Research and Analysis of Factors Associated at Laquintinie Hospital in Douala

Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.

Detection and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy

Objective:To investigate the changes and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy.Methods:Review the clinical data of threatened abortion in early pregnancy (include continuing pregnancy and miscarriages) and healthy pregnant women in the early pregnancy in our hospital, and the levels of reproductive hormones, prethrombotic state markers and coagulation related factors were compared between the three groups.Results: The results of single factor variance showed that the levels ofβ-HCG, progesterone, E2, PC, PLG, D-D, TAT, F1+2 and PAI-1 level were all statistically significant. Compared with the control group, the average levels ofβ-HCG, progesterone, E2 and PLG in the pregnancy maintenance group and the interrupted pregnancy group were significantly decreased, and the level of the interrupted pregnancy group was significantly lower than that of the pregnancy maintenance group. The levels of PC, D-D, TAT, F1+2 and PAI-1 in the pregnancy maintenance group and the interrupted pregnancy group were significantly higher than those in the control group, and the level of the interrupted pregnancy group was significantly higher than that of the pregnancy maintenance group. There was no significant difference in the level of AT III between the groups.Conclusion: There are significant abnormal levels of reproductive hormones, prethrombotic state markers and coagulation related factors in patients with threatened abortion in early pregnancy, the detection of its index level is of great value in predicting threatened abortion in the early stage.

Analysis of clinicopathological features and prognostic factors of breast cancer brain metastasis

BACKGROUND Breast cancer(BC)has become the most common malignancy in women.The incidence and detection rates of BC brain metastasis(BCBM)have increased with the progress of imaging,multidisciplinary treatment techniques and the extension of survival time of BC patients.BM seriously affects the quality of life and survival prognosis of BC patients.Therefore,clinical research on the clinicopathological features and prognostic factors of BCBM is valuable.By analyzing the clinicopathological parameters of BCBM patients,and assessing the risk factors and prognostic indicators,we can perform hierarchical diagnosis and treatment on the high-risk population of BCBM,and achieve clinical benefits of early diagnosis and treatment.AIM To explore the clinicopathological features and prognostic factors of BCBM,and provide references for diagnosis,treatment and management of BCBM.METHODS The clinicopathological data of 68 BCBM patients admitted to the Air Force Medical Center,Chinese People’s Liberation Army(formerly Air Force General Hospital)from 2000 to 2022 were collected.Another 136 BC patients without BM were matched at a ratio of 1:2 based on the age and site of onset for retrospective analysis.Categorical data were subjected to χ^(2) test or Fisher’s exact probability test,and the variables with P<0.05 in the univariate Cox proportional hazards model were incorporated into the multivariate model to identify high-risk factors and independent prognostic factors of BCBM,with a hazard ratio(HR)>1 suggesting poor prognostic factors.The survival time of patients was estimated by the Kaplan-Meier method,and overall survival was compared between groups by log-rank test.RESULTS Multivariate Cox regression analysis showed that patients with stage Ⅲ/Ⅳ tumor at initial diagnosis[HR:5.58,95% confidence interval(CI):1.99–15.68],lung metastasis(HR:24.18,95%CI:6.40-91.43),human epidermal growth factor receptor 2(HER2)-overexpressing BC and triple-negative BC were more prone to BM.As can be seen from the prognostic data,52 of the 68 BCBM patients had died by the end of follow-up,and the median time from diagnosis of BC to the occurrence of BM and from the occurrence of BM to death or last follow-up was 33.5 and 14 mo,respectively.It was confirmed by multivariate Cox regression analysis that patients with neurological symptoms(HR:1.923,95%CI:1.005-3.680),with bone metastasis(HR:2.011,95%CI:1.056-3.831),and BM of HER2-overexpressing and triple-negative BC had shorter survival time.CONCLUSION HER2-overexpressing,triple-negative BC,late tumor stage and lung metastasis are risk factors of BM.The presence of neurological symptoms,bone metastasis,and molecular type are influencing prognosis factors of BCBM.

Influencing factors of the neurodevelopment of high-risk infants

Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.

Seroprevalence of <i>Brucella</i>Antibodies and Risk Factors Associated with Human Brucellosis in High-Risk Occupational Groups of the Noun Division in the West Region of Cameroon

Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of Brucella from animals to humans can occur in different epidemiological settings of sub-Saharan African countries, little data has been published on human brucellosis. This study aimed to detect Brucella antibodies and the risk factors associated to brucellosis among high-risk occupational groups of people in the Noun Division of Cameroon. For this study, a structured questionnaire was used to assess risk factors associated with human brucellosis. Thereafter, blood samples were collected from high-risk occupational groups of people in four villages. Plasma was extracted from each sample and Brucella antibodies were detected using Rose Bengal Plate Test (RBPT) and indirect Enzyme-Linked Immunosorbent Assay (i-ELISA). Of the 273 participants enrolled, the overall seroprevalence of Brucella antibodies was 12.45% with RBPT and 10.26% with i-ELISA test. This seroprevalence was significantly (P = 0.04;X2 = 9.73) higher among livestock herdsmen (15.8%), slaughterhouse workers (9.8%), butchers (4.8%), participants having no educational level (14.3%) and those experiencing above 5 years of risky activity (15%). Raw milk consumption (OR: 4.8;P = 0.001), no formal education (OR: 6.4;P = 0.03) and assistance of animal during parturition (OR: 7.2;P < 0.0001) appeared as factors that may increase the risk of Brucella infections. The detection of Brucella antibodies indicates the risk of human brucellosis in some groups of people of the Noun division. Consuming unpasteurized milk, participating in parturition and lacking knowledge on brucellosis appeared as risk factors associated with human brucellosis in western Cameroon. It raises the need of developing and implementing control measures for human and animal brucellosis.

AIDS-Related High-Risk Behaviors and Affecting Factors of Men Who Have Sex with Men (MSM) in China's Mainland

Objectives: To describe and analyze HIV/AIDS/STD-related high risk behaviors and affecting factors of men who have sex with men (MSM) in China's Mainland~ Methods: 426 self-administered or interview-based questionnaires collected from MSM were analyzed with SPSS or SAS Systems. Results: Of the MSM, four-fifths had engaged in oral-genital intercourse, about half had engaged in anal intercourse, and in the past year more than two-fifths had casual sexual partner(s).Very few maintained monogamous sexual relationships, and nearly half also had intercourse with women. One fourth had previously been diagnosed with a venereal diseases. One HIV+individual was found among the 40 who reported having been tested for HIV. Only two men consistently used condoms among the one-third who had ever used condoms, despite almost universal knowledge of HIV and its transmission. Conclusions: MSM in China's Mainland are very sexually active, highlighting the possibility of a serious HIV epidemic that may be directly spread to the female population. However,AIDS interventions targeting MSM face severe obstructions resulting from cultural bias and other factors.

A Case-control Study on High-risk Factors for Newborn Hearing Loss in Seven Cities of Shandong Province

To investigate the high-risk factors for newborn hearing loss and to provide information for preventing the development of hearing loss and delaying its progression, from May 2003 to June 2006, neonates who failed to pass the universal newborn hearing screening （UNHS） were referred to Jinan Newborn Hearing Screening and Rehabilitation Center from 7 newborn hearing screening centers in seven cities of Shandong province. One-to-one pair-matched case-control method was employed for statistical analysis of the basic features of definitely identified cases. High-risk factors relating to the bilateral hearing loss were evaluated by univariate and multivariate Logistic regression analysis. Our results revealed that 721 transferred newborns who didn＇t pass the heating screening received audiological and medical evaluation and 367 were confirmed to have hearing loss. Of them, 177 neonates with hearing loss who met the matching requirements were included in the study as subjects. Univariate analysis showed that high-risk factors related to hearing loss incuded age of father, education backgrounds of parents, parity, birth weight, gestational weeks, craniofacial deformity, history of receiving treatment in neonatal intensive care unit （NICU）, neonatal disease, family history of otopathy and family history of congenital hearing loss. Multivariate Logistic regression analysis revealed that 4 independent risk factors were related to bilateral hearing loss, including parity （OR=16.285, 95% CI 3.379--78,481）, neonatal disease （OR=34;968, 95% CI 2.720 449.534）, family history of congenital hearing loss （OR=69.488, 95% CI 4.417--1093.300） and birth weight （OR=0.241, 95% CI 0.090--0.648）. It is concluded that parity, neonatal disease and family history of heating loss are the promoting factors of bilateral hearing loss in neonates and appropriate intervention measures should be taken to deal with the risk factors.

Increase of tumor necrosis factor receptor 1 expression in women with unexplained early spontaneous abortion

Objective: To investigate membrane tumor necrosis factor receptor 1 protein expression level in decidua and concentration of soluble tumor necrosis factor receptor 1 in serum in women with unexplained early spontaneous abortion, threatened abortion, and compare the levels with healthy pregnant women. Methods: Thirty-seven women with unexplained early spontaneous abortion, 27 women with threatened abortion, and 34 healthy pregnant women undergoing artificial abortion of pregnancy at 6 - 10 weeks of gestation were selected. Decidual samples were collected when women were undergoing artificial abortion, and blood samples were collected at the same time. The level of membrane tumor necrosis factor receptor 1 in decidua was detected by flow cytometer, and the concentration of soluble tumor necrosis factor receptor 1 in sera was measured with an enzyme-linked immunosorbent assay. Results: The percentages of membrane tumor necrosis factor receptor 1 positive decidual cells were 16.42 ± 7.10 Mean ± SD for women with unexplained early spontaneous abortion and 13. 14 ± 6.30 for healthy pregnant women ( P < 0.05). Serum concentration of soluble tumor necrosis factor receptor 1 was significantly higher in women with unexplained early spontaneous abortion than in healthy pregnant women and in women with threatened abortion, and no difference was found between healthy pregnant women and women with threatened abortion. Conclusion: Women with unexplained early spontaneous abortion present significantly higher expression of tumor necrosis factor receptor 1 than healthy pregnant women, suggesting that over-expression of tumor necrosis factor receptor 1 may contribute to the development of early spontaneous abortion.

Aberrant Expression of TNF-α and TGF-β_1 mRNA in Spontaneous Abortion

Objective To investigate the aberrant expressions of TNF-α and TGF-β1 in peripheral blood mononuclear cells （PBMCs） and placental tissues in patients with early spontaneous abortion Methods Using the technique of semi-quantitative reverse transcript-polymerase chain reaction （RT-PCR）, TNF-α mRNA and TGF-β1 mRNA in PBMCs were measured in spontaneous abortion group （30 cases）, normal pregnancy group （25 cases） and nonpregnant group （25 cases）. The expressive intension of TNF-α protein and TGF-β1 protein in placental tissues was also identified by immunohistochemistry. Results Both levels of TNF-α mRNA and TGF-β1 mRNA expressed in PBMCs were significantly different between the three groups respectively （P〈0.05）. Levels of TNF-α in syncytiotrophoblastic and cytotrophoblastic cells of the two aborted groups were substantially higher than those of the nonregnant group （P〈0.01）, but the levels of TGF-β1 in syncytiotrophoblastic cells of the two aborted groups were markedly lower than those of the non-pregnant group （P〈0.01）. Conclusion There is potential relation between TGF-β at the fetomaternal interface and spontaneous abortion. TGF-β1 may contribute to the maintenance of pregnancy, and low-level expression of TGF-β1 may be associated with pregnancy failure.

Large Population Screening Identified the Main Risk Factors of Stroke in Shashi District of Jingzhou City

Objective: This paper aims to screen and analyze the current status of high-risk stroke patients in Shashi District of Jingzhou City and the exposure levels of related risk factors, and provides suggestions as the references for prevention and treatment of stroke. Methods: Using cluster sampling, on-site investigations were conducted on 1060 permanent residents aged 40 years and over at 3 townships and 2 communities in Shashi District of Jingzhou City from January 2018 to December 2018. Risk assessment of stroke is based on the stroke risk screening form. Statistical analysis was performed by using SPSS 22.0 software. Results: After making a stroke risk assessment, a total of 313 high-risk stroke patients were screened, and the detection rate was 29.53%. The exposure rate of risk factors from high to low was hypertension (70.93%), dyslipidemia (46.33%), less physical exercise (46.01%), diabetes (36.10%), overweight (33.55%), smoking (33.23%), family history of stroke (24.92%), atrial fibrillation or valvular heart disease (7.35%). There are statistically significant differences among all risk factors between the high-risk group and middle and low-risk groups (P Conclusion: The detection rate of high-risk stroke patients in Shashi District of Jingzhou City is high. Hypertension, dyslipidemia and less physical exercise are the main risk factors of stroke occurrence and recurrence in the region. The prevention and treatment of risk factors for stroke should be strengthened to control the incidence and recurrence rate of stroke.

未婚先孕人工流产患者生殖健康认知调查及其影响因素探讨

目的调查未婚先孕人工流产患者生殖健康认知水平,并探讨其影响因素。方法采取简单随机抽样法选取2021年1月至2022年12月在首都医科大学附属北京妇产医院行人工流产的360例未婚女性患者作为研究对象,比较不同类型未婚先孕人工流产患者的生殖健康认知得分,并采用多元线性回归分析法分析影响生殖健康认知的因素。结果问卷有效回收率为98.33%(354/360),患者生殖健康认知调查问卷得分为10~47分,平均(33.80±5.41)分。未婚先孕人工流产患者生殖健康认知得分在不同年龄、不同户籍地、不同类型父母关系、不同文化程度、不同职业间差异具有统计学意义(P<0.05);多元线性回归分析结果显示,年龄、户籍地、父母关系、文化程度在初中及以下和高中或中专、职业为待业人员和工人/个体均是影响未婚先孕人工流产患者生殖健康认知水平的因素(P<0.05)。结论未婚先孕人工流产患者生殖健康认知水平较低,年龄、户籍地、父母关系、文化程度、职业均是影响未婚先孕人工流产患者生殖健康认知水平的因素。

绒毛膜下血肿及其合并复发性流产患者妊娠结局的影响因素分析

目的探讨绒毛膜下血肿(SCH)及其合并复发性流产(RSA)患者妊娠结局的影响因素。方法回顾性分析2019年6月—2021年6月就诊于石家庄市第四医院和河北医科大学第二医院的SCH患者204例,其中合并RSA 92例,单纯SCH 112例,通过对患者的年龄、BMI、诊断血肿时的孕龄、是否伴有阴道出血、孕产史、凝血指标[血小板聚集率(AA、ADP)、D-二聚体(D-D)]、有无复发性流产病史等因素分析,探讨其发生不良妊娠结局的高危因素。结果经Logistic分析发现,伴阴道出血(OR=3.443,95%CI 1.613~7.351,P=0.001)、复发性流产病史(OR=2.392,95%CI 1.136~5.035,P=0.022)、血小板聚集率ADP(OR=1.202,95%CI 1.118~1.292,P<0.001)是不良妊娠结局的危险因素,诊断血肿时的孕龄大(OR=0.963,95%CI 0.938~0.989,P=0.006)、既往活产次数多(OR=0.125,95%CI 0.047~0.330,P<0.001)是不良妊娠结局的保护因素。其中92例SCH合并RSA患者经Logistic分析发现,ADP(OR=1.171,95%CI 1.043~1.316,P=0.008)、D-D(OR=1.011,95%CI 1.002~1.020,P=0.020)高是不良妊娠结局的危险因素,既往活产次数多(OR=0.154,95%CI 0.061~0.392,P<0.001)是不良妊娠结局的保护因素。结论凝血功能异常(高凝状态)是单纯绒毛膜下血肿患者或者绒毛膜下血肿合并复发性流产患者不良妊娠结局的危险因素,需进行相应的抗凝治疗,以改善妊娠结局。

EGR-1和MMP-2在早期自然流产患者中的表达及临床意义

目的探讨早期生长反应因子(EGR-1)和基质金属蛋白酶-2(MMP-2)在早期自然流产患者绒毛中的表达及临床意义。方法采用RT-PCR和Westernblot检测20例早期自然流产患者(流产组)和20例正常早孕人工流产(对照组)绒毛组织中EGR-1和MMP-2的表达情况。结果流产组中EGR-1、MMP-2 mRNA和蛋白水平明显低于对照组,差异有统计学意义(P<0.05)。结论EGR-1和MMP-2在早孕绒毛组织中表达异常可能参与早期妊娠失败的发生。

人类胎盘基因CpG岛甲基化水平与自然流产的相关性

目的探讨人类胎盘基因CpG岛甲基化水平与孕妇自然流产的相关性。方法选取接受常规产前检查的孕妇55例为研究对象,其中25例自然流产(流产组),30例正常分娩(对照组)。收集入组孕妇的临床资料及人类胎盘组织样本。比较2组临床一般资料。分析相关胎盘基因的甲基化水平对孕妇自然流产结局的预测价值。采用Logistic回归分析法分析孕妇自然流产的影响因素。结果2组在孕妇年龄、流产儿/新生儿出生体质量、孕妇妊娠天数和流产儿/新生儿性别方面比较,差异有统计学意义(P<0.05)。MECP2-1、MECP2-4、HSD11B2、MECP2-3和MECP2-2基因甲基化与自然流产相关。流产组的MECP2-1、MECP2-4、HSD11B2和MECP2-3基因甲基化率高于对照组,差异有统计学意义(P<0.05)。MECP2-1、MECP2-4、HSD11B2、MECP2-3和MECP2-2的曲线下面积(AUC)分别为0.773、0.737、0.700、0.663和0.627。Logistic回归分析结果显示,MECP2-1是孕妇发生流产的独立影响因素(P<0.05)。结论MECP2-1、MECP2-4、HSD11B2、MECP2-3和MECP2-2基因甲基化水平和孕妇的自然流产结局有关。MECP2-1基因是自然流产发生的独立影响因素。

自拟安胎饮联合黄体酮注射液治疗对黄体功能不足致复发性流产患者子宫动脉血流指标、血清PLGF和CTRP12表达的影响

目的探讨自拟安胎饮联合黄体酮注射液治疗对黄体功能不足致复发性流产(RSA)患者子宫动脉血流指标、血清胎盘生长因子(PLGF)和C1q肿瘤坏死因子相关蛋白12(CTRP12)表达的影响。方法选取2020年1月至2023年8月安徽医科大学附属巢湖医院收治的80例黄体功能不足致RSA患者作为研究对象,随机分为研究组和对照组,每组40例。对照组采用黄体酮注射液治疗,研究组在对照组基础上联合自拟安胎饮治疗,两组均治疗10周。比较两组临床疗效、治疗前后中医肾虚证候积分、子宫动脉血流指标、血清PLGF和CTRP12水平、不良发应发生率。结果研究组治疗总有效率高于对照组(P<0.05)。治疗后,两组各项中医肾虚证候积分均降低,且研究组低于对照组(P<0.05)。治疗后,两组血管指数(VI)降低,血流指数(FI)、血管化血流指数(VFI)升高,且研究组VI低于对照组,FI、VFI高于对照组(P<0.05)。治疗后,两组PLGF和CTRP12水平均升高,且研究组PLGF和CTRP12水平均高于对照组(P<0.05)。研究组不良反应总发生率低于对照组(P<0.05)。结论黄体功能不足致RSA患者采用自拟安胎饮联合黄体酮注射液治疗,可提高临床疗效,改善子宫动脉血流、血清PLGF和CTRP12表达水平。

未婚女性人工流产术前焦虑情绪及预测因素分析

目的:了解未婚女性人工流产术前焦虑情绪情况,探究其影响因素及预测价值,为有效开展心理干预提供参考。方法:选择2020年5月-2022年5月本院拟行人工流产术的未婚女性,采用自制一般资料问卷、焦虑自评量表(SAS)、痛苦表露指数量表(DDI)进行匿名调查。以单因素分析、多因素logistic回归分析探讨未婚女性人工流产术前焦虑情绪影响因素,采用受试者工作特征(ROC)曲线分析相关影响因素对未婚女性人工流产术前焦虑的预测价值。结果:共纳入142例拟行人工流产术的未婚女性,术前SAS得分52.97±4.03分,其中发生焦虑102例(71.8%),SAS得分57.82±3.26分;未发生焦虑40例(28.2%),SAS得分40.61±4.59分。单因素分析显示,年龄、职业、人工流产史、生殖健康知识了解程度、流产方式、性伴侣避孕态度、自我表露与未婚女性人工流产术前焦虑情绪发生有关(P<0.05)。多因素分析显示,拟采用药物流产、年龄较小、生殖健康知识了解程度较差、自我表露水平较低的未婚女性术前焦虑发生风险更大(P<0.05)。ROC曲线分析显示,各影响因素均对未婚女性人工流产术前焦虑情绪发生有良好的预测价值,曲线下面积为0.622~0.655。结论:流产方式为药物流产、年龄较小、生殖健康知识了解程度较差、自我表露水平低均与未婚女性人工流产术前焦虑情绪发生相关,且有一定预测效能,临床可据此采取应对措施。

基于决策树模型的罗湖区人工流产方式流行病学特征及影响因素研究

目的:探讨基于决策树模型的罗湖区人工流产方式的流行病学特征及其影响因素。方法:回顾性纳入深圳罗湖区医院集团所属医疗机构在2021年9月—2022年10月收治的人工流产女性共9 245例,根据人工流产方式将其划分为药物组(2 004例)和手术组(7 241例),进行数据分析和结果评估。采用单因素和多因素法对人工流产方式的流行病学特征进行分析,确定影响人工流产方式选择的独立因素;同时基于决策树模型评估药物组和手术组两种人工流产方式的优缺点。结果:单因素分析结果显示,孕周、年龄、人工流产方式偏好情况、受教育程度、婚姻状况及生育情况均可能与人工流产方式选择有关(P<0.05)。多因素分析结果显示,孕周、年龄、人工流产方式偏好情况、受教育程度及生育情况是影响人工流产方式选择的独立因素(P<0.05)。决策树模型构建结果显示,孕周、人工流产方式偏好情况、婚姻状况及生育情况可直接影响人工流产方式选择,其中人工流产方式偏好情况影响最为显著。决策树模型预测分类与真实分类基本一致,模型预测错误率为10.00%,说明决策树模型的预测错误率与Logistic回归模型相同,均为10.00%,表明该模型具有良好的拟合度。结论:罗湖区人工流产方式选择受孕周、人工流产方式偏好情况、婚姻状况及生育情况等因素影响。其中,人工流产方式偏好情况对人工流产方式选择的影响最为显著。这些发现有助于优化人工流产的个体化治疗策略,提高人工流产个体的医疗体验和治疗效果。

育龄女性人工流产现状、生殖健康认知调查及其危险因素的单中心研究

目的调查育龄女性人工流产现状和生殖健康认知情况,分析影响生殖健康认知的危险因素。方法选取2021年1月至2022年12月在我院行人工流产的420例患者作为调查对象,采用人工流产现状问卷、生殖健康认知问卷进行相关调查,比较不同特征人工流产患者生殖健康认知得分,采用多元线性回归分析法分析影响人工流产患者生殖健康认知的危险因素。结果问卷有效回收率94.29%(396/420)。396例人工流产患者中初次流产占52.53%,重复流产占47.47%;本次流产原因为未采取避孕措施(占48.23%)和避孕失败(占51.77%);本次流产时孕周在10周以内占95.20%,10周以上占4.80%;流产相关知识主要获取途径包括网络(占49.24%)、医务人员(占32.83%)、家人/朋友/同事(占17.93%)。生殖健康认知问卷得分为11~36分,平均(26.12±5.44)分,其中得分最低的3项题目分别为人工流产相关并发症、排卵期时间、安全期时间。不同年龄、不同文化程度、性伴侣不同文化程度、不同婚姻状况、既往有无流产史、不同家庭月收入的人工流产患者生殖健康认知得分比较差异有统计学意义(P<0.05)。年龄小、文化程度低、性伴侣文化程度低、既往无人工流产史、家庭月收入低均是影响人工流产患者生殖健康认知的危险因素(P<0.05)。结论人工流产患者重复流产和避孕失败占比较高,生殖健康认知有待进一步提高;年龄、文化程度、性伴侣文化程度、既往人工流产史、家庭月收入均是人工流产患者生殖健康认知的影响因素。

女性膝骨关节炎疼痛及膝关节功能的影响因素分析

目的探究女性膝骨关节炎患者现状,分析不同因素对膝关节疼痛程度和膝关节功能的影响。方法纳入2020年1月至2022年12月于上海中医药大学附属曙光医院与无锡市锡山区中医医院就诊的449例女性膝骨关节炎患者进行研究,分析年龄、病程、体重指数、流产史、怀孕史因素对膝骨关节炎疼痛和膝关节功能影响的差异。结果怀孕次数增多、流产次数增多、年龄增长为加重女性膝骨关节炎疼痛因素(P<0.05);同样怀孕次数增多、流产次数增多、年龄增长为女性膝骨关节炎膝关节功能的影响因素(P<0.05)。结论怀孕、流产与年龄是导致女性膝骨关节炎疼痛和膝关节功能降低的重要因素,在临床诊疗中有必要关注其影响及相关因素处理。