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Objective To analyze the risk factors of persistent infection of high-risk human papillomavirus after radical hysterectomy for early cervical cancer. Methods A total of 159 early-stage cervical cancer patients who underwent radical hysterectomy or laparoscopic radical hysterectomy at the Kunming Maternal and Child Health Hospital between January 2021 and November 2023 were selected. Based on the postoperative 1a follow-up visit for HR-HPV persistent infection status, they were divided into two groups: HR-HPV positive group （n = 41） and HR-HPV negative group （ n = 118） . The general data, vaginal microbiota status，surgical approach, postoperative pathology results， etc.， of the two groups of patients were analyzed to study the risk factors associated with postoperative HR-HPV persistence in early-stage cervical cancer patients. Results Univariate and multivariate regression analysis showed that the HR-HPV persistent positive group and HR-HPV negative group, the risk factors of HR-HPV persistent positivity in patients with early cervical cancer after operation were menopause, late stage of operation, vaginal microecological disorder/sub-disorder （P < 0.05），but laparoscopic minimal invasive surgery was not. OR of vaginal microecological abnormality was 12.574，OR of menopause was 3.510. Conclusion Menopausal and vaginal microecological disorders are important risk factors for HR-HPV clearance in patients with radical hysterectomy for early cervical cancer. [ABSTRACT FROM AUTHOR]

Objective To observe the clinical efficacy and pregnancy outcome of hysteroscopic cold knife system in patients with moderate and severe intrauterine adhesions who planned to undergo assisted reproduction. Methods Patients with moderate and severe intrauterine adhesions who planned to undergo assisted reproduction were retrospectively analyzed and divided into cold knife group and electric energy group according to different surgical methods. The basic data and surgical data of all patients were collected, and the pregnancy outcomes of patients were followed up. Results (1) A total of 120 patients were collected in this experiment, including 60 patients in cold knife group and 60 patients in electric energy group. There were no significant differences in operation time, intraoperative blood loss, intraoperative complications, postoperative pregnancy rate and live birth rate between the two groups (P > 0.05). In the cold knife group, the proportion of the uterine cavity shape and endometrium restored to the condition of transplantation after two operations was 63.3%; Electrical energy group accounted for 43.3%. The median gestational month of the cold knife group was 2.5 months, which was 1 month earlier than that of the electric energy group. (2) To the extent to which caused by intrauterine adhesions, cold knife group, patients with severe caused by intrauterine adhesions in operative time and intraoperative blood loss and postoperative pregnancy rate and live-birth rate no statistical difference (P > 0.05) electrical energy group of uterine cavity adhesion of surgery in patients with severe bleeding amount of time and have more moderate caused by intrauterine adhesions, and statistically significant (P < 0.005). In the electrical energy group, only 7.7% of the patients with severe adhesions who achieved transplantation conditions after two operations were the lowest among all groups. Conclusions For the patients with moderate and severe intrauterine adhesions who need embryo transfer, the hysteroscopic cold knife system is safe and effective, and the number of operations to break down the adhesions to meet the intimal conditions of embryo transfer is less than that of electric energy instruments. For the pregnancy rate after transplantation, the method of operation and the degree of intrauterine adhesion did not affect the pregnancy rate and live birth rate. [ABSTRACT FROM AUTHOR]

Objective To observe the patency of fallopian tube and the rate of intrauterine pregnancy after hysteroscopy and treatment. Methods 39 cases of laparoscopic fenestration of fallopian tube due to previous tubal pregnancy were selected as the fenestration group, 35 cases of laparoscopic resection of fallopian tube were selected as the resection group. Three months after operation, hysteroscopy was performed in both groups to understand the patency of fallopian tube, and for the obstructed fallopian tube, interventional therapy was performed. The patency rate of fallopian tube was compared between the two groups, and the intrauterine pregnancy rate was observed in one year and two groups after hysteroscopy. Results (1) For the fenestration group, the tubal patency rate was 48. 72% ; the uninjured fallopian tube patency rate was 58. 97%. After interventional treatment with guide wire, the rate of affected fallopian tube was 89. 74%, and the rate of uninjured fallopian tube patency was 94. 87%. (2) For the resection group, the patency rate of uninjured fallopian tube was 77. 14%, and the patency rate of fallopian tube after interventional treatment was 91. 43%. (3) On the premise that the fallopian tubes were unobscured, pregnancy rate in the fenestration group was 40. 00% in 14 cases. Pregnancy rate was 34. 37% in 11 cases in the resection group. There was no significant difference in pregnancy rate between the two groups (P>0. 05). Among them, 12 cases were pregnant in the fenestration group within half a year after hysteroscopic surgery, accounting for 85. 74% of pregnancies. There were 10 pregnancies in the fenestration group, accounting for 90. 91% of all pregnancies in the resection group. There was no statistically significant difference in pregnancy rates between the two groups (P > 0. 05). Conclusions Hysteroscopy has significant recanalization effect on the blocked fallopian tubes after tubal pregnancy treatment, and a better repregnancy rate can be obtained half a year after recanalization. Under the condition that the tubal is unobstructed, there is no difference in the rate of second pregnancy between different tubal pregnancy treatments. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship between blood flow changes in myometrium and endometrial artery and intrauterine adhesions after uterine artery embolization by ultrasonography doppler. Methods From November 2017 to September 2018， patients diagnosed with 5-8 weeks gestation by type II cesarean section in the Gynecological Inpatient Department of Kunming Maternity and Child Care Hospital were selected as the experimental subjects. The subjects underwent hysteroscopic hysterectomy after bilateral uterine artery embolization. After the operation， FSH， LH and E2 values were measured on the 5th day of the 1st month and the 3rd month. The PI，RI and endometrial thickness of myometrium and endometrial blood flow were measured by transvaginal ultrasonography 3 days after the treatment. In patients with reduced menstrual volume or amenorrhea， hysteroscopy was performed to determine the degree of intrauterine adhesions and intrauterine adhesions. Results （1） A total of 30 subjects were included in this study， and the values of FSH， LH and E2 in the first and third months after uterine artery occlusion were within the normal range. There was no significant difference in FSH， LH and E2 values between the first and third months after embolization （ > 0.05） . （2） The blood flow PI and RI values of myometrium and intima decreased the most at 24h after embolization. And the myometrium and intima PI continued to decline until 3 months after embolization. RI values of myometrium and intima blood flow began to rise one month after embolization， and were still lower than the level before embolization three months after embolization. （3） There was a significant positive correlation between intrauterine adhesions and previous abortion times， intraoperative blood loss during curettage， and the time of menstruation after curettage. There was a significant negative correlation between RI of myometrial blood flow before embolization and PI of endometrial blood flow at 1 month after embolization. Logistic regression analysis showed that previous history of artificial abortion and PI of intimal blood flow at 1 month after embolization were independent risk factors for uterine cavity adhesion （ < 0.01） . Conclusion Bilateral uterine artery embolization has an effect on uterine myometrium and endometrial blood flow in pregnancy patients with cesarean section. The poor recovery of endometrial blood flow in 1 month after embolization was related to intrauterine adhesions. [ABSTRACT FROM AUTHOR]

Objective To observe the clinical efficacy of gonadotropin-releasing hormone agonist (GnRH-a) in patients with moderate or severe endometriosis after laparoscopic surgery. Methods From January 2015 to December 2016，100 patients who were diagnosed with moderate(stage III) or severe (stage IV) endometriosis were enrolled in a randomized clinical trial in Kunming Maternal and Child Health Hospital. After receiving conservative laparoscopic surgery， patients were randomly divided into a treatment group and a control group. The patients in the treatment group were injected 3.75 mg GnRH-a (commodity name: Dafilin) for 6 times as a complete treatment. The control group did not receive any drugs after surgery. The two groups were followed up for one year to observe the difference of carbohydrate antigen 125 (CA125) value，VAS scores of pelvic pain， recurrence rate and pregnancy rates between the two groups．Results (1) There was no significant difference between the two groups in CA125 value before and after operation (P>0.05) . (2) No significant difference was observed in VAS scores between two groups before and after surgery(P>0.05) . (3) The treatment group had 4 cases of recurrence(recurrence rate of 4%)， and the control group had 8 cases (8% of recurrence rate) . The comparison of recurrence rate between groups was significantly different(P<0.05) . (4) The pregnancy rate was 30% in the treatment group while that was 14 %in the control group. The observed difference in pregnancy rates was statistically significant(P<0.05). Besides， in the treatment group，9 patients with stage III endometriosis and 6 patients with stage IV were pregnant while in the control group， the number ofpregnant patients were 6 and 1 in patients with stage III and IV endometriosis．The difference in number of pregnant patients with different stages was statistically significant between two groups (P<0.05).The in-group comparison showed that there was a significant difference in the number of pregnancies in patient with stage IV endometriosis between the treatment group and the control group (P<0.05) . Age stratified analysis revealed that the pregnant rate among patients aged over 35 was significantly higher in the treatment group than that in the control group (with P<0.05) ．Conclusion Laparoscopic GnRH-a can reduce the recurrence rate of moderate and severe endometriosis and increase the rate of spontaneous pregnancy in patients over 35 years of age and patients with moderate or severe endometriosis. [ABSTRACT FROM AUTHOR]

Objective To investigate the application of the OSCE training on the intensive training of nursing skills for college students majoring in nursing in the fourth semester．Methods Students from 2013 undergraduate session were investigated．They were randomly divided into two groups. The experimental group (n = 134) was trained of the OSCE training, while the control group (n = 135) received of traditional training. After the training, analysis of test scores and questionnaires were used to survey the comments of the two groups of students on intensive training of nursing skills. After two months of practice, the clinical comprehensive ability of the students was evaluated by clinical teachers．Results The experimental group's theory and nursing skills were higher than those of the control group （P ＜0.01） . The experimental group had a positive attitude towards nursing OSCE training. Their familiarity with the operation skills, team cooperation spirits, presentation and communication ability, observation ability, clinical adaptation ability and health education ability were enhanced （P ＜0.01） ．Conclusion The comprehensive simulation training cannot only improve the effectiveness of OSCE training, but also strengthen the students' clinical comprehensive ability and promote the practice quality. [ABSTRACT FROM AUTHOR]

Objective To compare the efficacy of three different methods in the prevention of adhesion after the HEOS system for different degrees of intrauterine adhesions. Methods 284 patients with mild, moderate and severe intrauterine adhesions, who were treated with the HEOS system, were divided into three groups, the intrauterine device with sodium hyaluronate gel was placed in Group A, Foley water capsule tube with sodium hyaluronate gel was placed in Group B, and sodium hyaluronate gel was placed in Group C only. The recovery of uterine adhesion, improvement of menstruation, endometrial thickness, and adverse reactions were compared among the three groups. Results The mild intrauterine adhesions group showed statistical differences among the three groups(P<0.05). Group A had a higher menstrual improvement rate than Group C(P<0.017), and there was no significant difference in other therapeutic indicators (P>0.017). However, the adverse reaction rate in Group A was also higher than that in Group C( P<0.017). In the moderate intrauterine group, there was a significant difference in the improvement rate of intrauterine adhesions between Group B and the other two groups (P<0.017). Group A and B were higher than Group C in terms of menstrual status, endometrial thickness, and adverse reactions(P<0.017). In severe intrauterine adhesions, Group A had higher efficacy indicators than other groups( P<0.017). Conclusions The curative effect index and adverse reaction rate were analyzed, after operation. For the light, moderate, and severe intrauterine adhesions, sodium hyaluronate gel, Foley water capsule tube with sodium hyaluronate gel, and intrauterine device with sodium hyaluronate gel were the best choice for adhesion. Individual and hierarchical management can achieve good clinical effects, which is worth popularizing. [ABSTRACT FROM AUTHOR]