1. Clinical characteristics of study participants
A total of 30 pregnant women were enrolled in this study. The demographic and obstetrical characteristics of all participants were shown in Table 2. All groups were similar in maternal age, body mass index(P>0.05). IPPH(Intractable postpartum hemorrhage) group had more postpartum bleeding, together with more duration of labor and neonatal weight(P<0.01).
2. Expressions of OTR in IPPH and other contraction groups in myometrium
Immunohistochemical results showed OTR was expressed in cytomembrane.The expression of OTR on myometrium in TNL group and TAL group showed moderate positive 40% and 40%, and strong positive 30% and 40% expressions, respectively, (Table 3). However, there was no moderate or strong positive expressions in IPPH group, which was 90% negative and 10% weak expression, indicating that the expression of OTR was significantly lost in IPPH, which was significantly different from the previous two groups (P<0.05) (Figure 1) .
3. Expression of acidosis, hypoxia factors in myometrium groups
As an indicator of hypoxia, HIF-1αexprsssion in the TNL group, with a moderate positive of 70%, and in the TAL group, with a moderate positive of 40% and a strong positive of 40% (Figure 2A). However, in IPPH group, the moderate positive decreased to 20% and the strong positive was 0% (Table 3), which was significantly lower than the TNL and TAL groups (P<0.05). The moderate positive expressions of ASIC1a in the three groups was TNL 50%, TAL 60%, and IPPH 40%, while the strong positive expression was TNL20%, TAL 10%, and IPPH 20%(Figure 2B). There was no significant difference in the positive expression rate between the three groups (P=0.910).(Table 3)
4. Expressions of lipid and glucose metabolism factors in myometrium groups
FATP1 was positively expressed with a certain degree on the myometrium membrane in three groups, in which the moderate positive was 50%(TNL) , 50%(TAL) , 40%(IPPH) (Figure 3A), with no significant statistical difference(P=0.948). However, FATP4 had less positive expression, with the moderate positive levels of 10% in all three groups(Figure 3B), also with no statistical difference in expression (P=0.804)(Table 4).
The positive expression rates of GLUT2 on the myometrium membrane were high(Figure 3C), with moderate positive 60%(TNL), 50%(TAL), 50%(IPPH),and strong positive 10%(TNL) ,20%(TAL), and 20%(IPPH), respectively, with no significant statistical difference(P=0.833).GLUT4 expression changes were similar to GLUT2(Figure 3D), with 60%(TNL) , 70%(TAL) , and 70%(IPPH) positive,respectively, also with no statistically significant difference (P=0.935)(Table 4).
5. Expression of apoptosis factors in myometrium groups
In classic apoptosis markers, Bax expression positive rates in TNL and TAL group were 90%, 60% compared to 10% in IPPH group (Figure 4A), with significant statistical difference(P<0.01). The expressions of caspase-3 and caspase-9 also showed the same trend as Bax. The overall positive expression rates were caspase-3 (TNL 70%, TAL 50%, IPPH 10%) and caspase-9 (TNL 60%, TAL 50%, IPPH 0%) (Figure 4C and 4D), in which expression was significantly all decreased in IPPH group.However, the expression of Bcl-2 in the three groups all presented a high positive expression rate (TNL 70%, TAL 70%, IPPH 80%)(Figure 4B), and with no significant statistical difference (P=0.899)(Table 5).