Objective To evaluate the value of ultrasonography in the diagnosis of special ectopic pregnancy(SEP).Methods Ultrasonography was performed in 31 patients with SEP.The sonographic features of two-dimensional ultrasound and color Doppler of SEP were analyzed and the sonographic results were correlated with surgical and pathologic findings. Results Ultrasonography accurately diagnosed interstital tubal pregnancy in 21 cases,cervical pregnancy in 4,isthmus pregnancy in 2,rudimentary horn pregnancy in 1,and 3 cases were misdiagnosed,thus,the diagnostic accuracy of ultrasound for SPE was 90.3% .Conclusions Ultrasonography has an important role in diagnosing SEP.

Objective To reproduce a new canine model of benign esophageal stenosis and to observe its pathological changes at different periods. Methods The esophargus wall 32~35cm from the incisor was cauterized circumferentially with a electric current of 40J/s through an endoscope. 8 adult dogs were used. The morphological changes were examined endoscopically and microscopically at the end of 1st, 2nd, 4th and 8th week. Results At the end of one week, the Narrowing of the lumen was detected at the end of the 1st week. The mucosa became highly congested and swollen, with neerosis of tissue and infiltration of inflammatory cells. At the end of two weeks, the narrowing was getting worse, and granulation and fibrous tissue appeared in the submucosa with marked cellular infiltration. At the end of four and eight weeks, the narrowing was stable with a diameter of 0.4-0.6cm, and excessive granulation tissue and proliferation of fibrous tissues with reduction of inflammatory reaction were detected in the whole-hickness of the esophageal wall. Conclusion An animal model of benign esophageal stenosis as a result of cauterization is reliable, and it is characterized by inflammatory response, which is replaced gradually by granulation tissue and fibrosis.

Objective To investigate the safety and efficacy of endoscopic tissue adhesive injection combined with sequential endoscopic variceal ligation for gastroesophageal varices of Le,g type. Methods Twenty-three patients with gastroesophageal varices of Le,g type were enrolled to General Hospital of PLA from May 2013 to March 2015, who were treated with endoscopic tissue adhesive injection in the fundic and cardiac site in the first session, followed with endoscopic variceal ligation for esophageal varices. The clinical data, procedure complications and efficacy were retrospectively analysed. Results All procedures were successfully performed with no such evident complications as intraoperative and postoperative bleeding, embolization, mediastinal infection or death with an average hospitalization time of 15. 3±4. 09 days. Mild and moderate thoracalgia occurred in 13 patients(56. 5%), low-grade fever in 2 patients(8. 7%, recovered after symptomatic treatment for 1-2 days) . During the follow-up of 2 weeks, the rate of varices disappearance was 56. 5% (13/23) and no recurrent bleeding was observed. Six months after discharge, 10 patients underwent endoscopy again, varices disappeared in 4 and 6 with remains;the 13 others showed no hemorrhage according to follow-up call. Conclusion The therapy of endoscopic tissue adhesive injection with sequential endoscopic variceal ligation for gastroesophageal varices of Le,g type is safe and efficient.

Objective:To explore the isolation and culture of a better yield of purified human endometrial glandular epithelial cells and stromal cells. Methods:Digestion with high concentrated collagenase and DNase,filtratinn and adhesion purification were used to isolate,purify human endometrial glandular epithelial cells and stromal cells in 30samples. And the two kinds of cells were reproduced. Results:The endometrial cell culture was successfully established in 29 of 30 endometrium samples. From one gramme of endometrial tissue,the yields of glandular epithelial cells and stromal cells were (40～50)?10~6 and (40～50)?10~6 respectively. The purities of glandular epithelial cells and stromal cells were 96% and 98% respectively. Stromal cells could be reproduced into several passage. However,glandular epithelial cells could not be reproduced. Conclusion:A better yield of purified human endometrial glandular epithelial cells and stromal cells can be obtained by the modified culture procedure.

OBJECTIVETo evaluate the relationship between levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in serum and peritoneal fluid of endometriosis-associated infertility.

METHODSThe soluble Fas ligand and soluble Fas levels in serum and peritoneal fluid of 20 infertile patients with endometriosis were assessed with enzyme-linked immunosorbent assay, and were compared with 14 infertile patients due to chronic pelvic infectious disease and 16 fertile controls.

RESULTSThe sFasL levels were significantly higher in infertile patients with endometriosis (175.09 +/- 80.55 pg/mL in serum and 284.50 +/- 152.38 pg/mL in peritoneal fluid) than those of infertile controls (88.47 +/- 43.55 pg/mL in serum and 17.30 +/- 9.62 pg/mL in peritoneal fluid) and fertile controls (16.13 +/- 11.75 pg/mL in serum and 8.84 +/- 2.31 pg/mL in peritoneal fluid). In contrast, as for the sFas levels, infertile patients with endometriosis (828.60 +/- 429.65 pg/mL in serum and 349.61 +/- 288.89 pg/mL in peritoneal fluid) did not show any significant difference compared with those in infertile patients resulting from pelvic infectious disease (868.75 +/- 570.48 pg/mL in serum and 181.76 +/- 157.78 pg/mL in peritoneal fluid) and fertile control (822.26 +/- 129.12 pg/mL in serum and 318.42 +/- 145.16 pg/mL in peritoneal fluid).

CONCLUSIONSBased upon these results, high level of sFasL in serum and peritoneal fluid and thus apoptosis mediated by it may be implicated in the mechanism involved in endometriosis-related infertility.

Ascitic Fluid ; chemistry ; Endometriosis ; complications ; metabolism ; Fas Ligand Protein ; Female ; Humans ; Infertility, Female ; etiology ; metabolism ; Ligands ; Membrane Glycoproteins ; blood ; metabolism ; Pelvic Infection ; complications ; metabolism ; Solubility ; fas Receptor ; blood ; metabolism

OBJECTIVETo detect the expressions of Ras and Sos1 proteins in human epithelial ovarian cancer (EOC) tissues and explore their correlation with the clinicopathological features of the patients.

METHODSThe expressions of Ras and Sos1 proteins were detected immunohistochemically in 62 EOC tissues, 5 borderline ovarian cancer tissues, 15 benign epithelial ovarian neoplasm tissues, and 18 normal ovarian tissues.

RESULTSThe EOC tissues showed significantly higher expression levels of both Ras and Sos1 than the other tissues tested (P<0.05). In EOC tissues, Ras and Sos1 proteins were expressed mostly on the cell membrane and in the cytoplasm. The expression level of Ras was correlated with pathological types of the tumor (P<0.05) and was the highest in serous cystadenomcarcinoma; Sos1 expression did not show significant correlation with the clinicopathological indexes of the patients. High expressions of both Ras and Sos1 proteins were associated with shorter progression-free survival of the patients, but this association was not statistically significant.

CONCLUSIONSRas and Sos1 protein may participate in in the occurrence and development of EOC. The tissue-specific variation of Ras expression can lend support to a specific diagnosis of ovarian serous adenocarcinoma. The association of Ras and Sos1 protein expression with the tumor-free survival time of the patients awaits further investigation with a larger sample size.

Objective To investigate the safety and efficacy of ultrasound ablation in treatment of uterine fibroids. Methods Ninety-nine patients with 117 leiomyomas in total treated by Haifu JC focused ultrasound tumor therapeutic system were enrolled in prospective and non-randomized clinical trial in First Affiliated Hospital of Chongqing Medical University and Academy of Military Medical Sciences. Ultrasound ablation was performed guided by real-time ultrasonography under conscious sedation for single session. All patients were followed up at 6 months after treatment. On the day of treatment and after 1 month, patients were given by magnetic resonance imaging(MRI) exam to evaluate the effect of fibroids ablation. At 3 and 6months after treatment, the ratio of ablated area and volume reduction of fibroids more than 50% were evaluated by MRI exam again. The symptoms improvements were evaluated by uterine fibroid symptom (UFS) and complications were analyzed by guideline of society of international radiation (SIR). Results The average ablated area ratio of the target fibroid was (76 ± 24)%. The average reduction in fibroid volume determined by MRI at 3 and 6 months after treatment was (45 ± 21)% and (59 ± 26)%. Which were significantly decreased than those before treatment (P < 0. 05). At 6 months after treatment, 84. 6% (99/117) of patients showed more than 50% volume reduction, the rate of improved symptom score was 92%(66/72). All patients could resume normal daily activities at 2 hours after treatment. The adverse reactions of SIR C - D included delayed hospitalization, repeat treatment and increased level of nursing. E - F included permanent sequelae and death. In this study, no adverse reactions of C - F were recorded. Common complications (SIR A- B, only observation or simple management without sequelae) were 35% (35/99).Four cases with adverse reactions B of SIR were found, including 2 cases with skin burning of degree Ⅱ and 2 cases with febrile, they were administered by symptomatic therapy and changing dressing The other adverse reaction A of SIR included sorness of buttock, vaginal discharge, dysuria and painful urination, they were only suggested by follow-up. Conclusion It was efficacy and safe that ultrasound ablation as a single strategy were used in treatment of uterine fibroids.

OBJECTIVETo investigate the potential role of preoperative adjuvant chemotherapy on early stage cervical squamous carcinoma with bulky tumor.

METHODSOne hundred and forty-five patients with cervical squamous cancer stages Ib-IIa were investigated, among which 17 patients with bulky tumors (> or = 4 cm) were managed by cisplatin-based chemotherapy for 1-2 courses followed by radical hysterectomy and pelvic lymphadenectomy (BC group). The change of tumor size, pelvic lymph nodes metastasis, cervical wall invasion, the involvement of surgical specimen margin, and the blood loss during operation were assessed after operation and compared with those in 51 patients with bulky tumors (BN group) and 77 patients with small local tumors (S group) who underwent surgery directly.

RESULTS(1) The tumor size of 17 patients in BC group were decreased in various degrees after chemotherapy, with 13 patients of clinical effectiveness (76.47%). And the responsiveness pertained to neither histological differentiation nor size of local tumors. (2) Post-operative histology has showed that patients in BC and BN group have higher incidence of lymph node metastasis and deep cervical infiltration (5/68 and 3/68, respectively) than in S group (1/77 and 1/77, respectively) while with no statistical significance. (3) Blood loss during operation in BC group was less than BN and S group. (4) Seventeen patients, including those underwent surgeries of vaginal prolongation and/or ovarian transposition, appeared disease-free survival within the follow-up time.

CONCLUSIONSMost of patients with bulky early stage cervical squamous carcinoma are sensitive to cisplatin-based chemotherapy, which could greatly reduce local tumor size and in turn facilitate the following operation by well controlling blood loss.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; administration & dosage ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; secondary ; surgery ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Drug Administration Schedule ; Etoposide ; administration & dosage ; Female ; Humans ; Hysterectomy ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Preoperative Care ; Uterine Cervical Neoplasms ; drug therapy ; pathology ; surgery ; Vincristine ; administration & dosage

OBJECTIVETo identify the factors that affect the safety and efficacy of peroral endoscopic myotomy (POEM) for treatment of achalasia.

METHODSData of consecutive patients undergoing POEM for confirmed achalasia between December, 2010 and December, 2015 were collected, including the procedure time, approach of tunnel entry incision, approach of myotomy, complications and follow-up data.

RESULTSAmong the total of 439 patients enrolled, the overall complication rate was 28.7% (126/439). Treatment success (Eckardt score≤3) was achieved in 94.5% of 364 patients followed up for a median of 6 months (1-48 months), and the mean score was reduced significantly from 6.7∓1.5 before treatment to 1.2∓1.1 after the treatment (P<0.05). Logistic regression revealed that the year when POEM was performed and the approach of entry incision were two significant factors contributing to complications: with the year 2015 as the reference, the odds ratio (OR) was 9.454 (95% CI: 2.499-35.76) for the years before 2011, 2.177 (95% CI: 0.794-5.974) for 2012, 3.975 (95% CI: 1.904-8.298) for 2013, and 1.079 (95% CI: 0.601-1.940) for 2014; with the longitudinal entry incision as the reference, the OR was 0.369 (95% CI: 0.165-0.824) for inverted T entry incision and 0.456 (95% CI: 0.242-0.859) for transverse entry incision. The approach of myotomy was the significantly associated with symptomatic relapse: with full-thickness myotomy combined with indwelling an anti-reflux belt as the reference, the OR was 0.363 (95% CI: 0.059-2.250) for gradual full-thickness myotomy, 2.137 (95% CI: 0.440-10.378) for circular muscle myotomy, and 4.385 (95% CI: 0.820-23.438) for circular muscle myotomy in combination with balloon shaping; the recurrence rate was 0 with a full-thickness myotomy.

CONCLUSIONThe complication rates of POEM appears to decrease over time, and an inverted T entry incision is the best choice for controlling the complications. Gradual full-thickness myotomy is an excellent approach for treatment of achalasia in terms of the relapse rate, procedure time and the incidence of reflux esophagitis.

Endoscopy ; Esophageal Achalasia ; surgery ; Esophagitis, Peptic ; surgery ; Gastroesophageal Reflux ; Humans ; Muscles ; surgery ; Recurrence ; Treatment Outcome

A proportion of patients experience acute or even prolonged cognitive impairment after surgery, a condition known as postoperative cognitive dysfunction (POCD). It is characterized by impairment in different cognitive domains and neuroinflammation has been implicated as one of the inciting factors as strategies targeting inflammation tend to improve cognitive performance. Siegesbeckia Orientails L. (S. Orientails) is a common Chinese medicinal herb used for managing chronic inflammatory diseases. We investigated if pretreatment with S. Orientails before surgery confers any neuroprotective effects in postoperative animals in terms of reducing inflammation and mitigating cognitive impairment. Three-month-old male C57BL/6N mice were fed different doses of S. Orientails extract for 14 days before they underwent a laparotomy. After cognitive testing they were sacrificed on postoperative day (POD) 3. Our results showed that animals with extract pretreatment demonstrated memory improvement in a dose-dependent manner compared with control. Further, evidence for the attenuation of systemic and neuroinflammation was found in the pretreated animals, along with the inhibition of inflammatory pathways and significantly reduced tau phosphorylation in the hippocampus. Taken together, these results demonstrated a neuroprotective effect of S. Orientails in postoperative animals, indicating a therapeutic potential of S. Orientails in minimizing POCD and the possibility of utilizing this traditional Chinese medicine perioperatively.
Animals ; Asian Continental Ancestry Group ; Cognition Disorders ; Hippocampus ; Humans ; Inflammation* ; Laparotomy ; Male ; Medicine, Chinese Traditional ; Memory ; Mice ; Neuroprotective Agents ; Phosphorylation ; Plants, Medicinal