Objective　To investigate the effect of combining use of methotrexate and mifepristone on treating unruptured tubal pregnancy.Methods　Treatment consisted of 300mg of mifepristone administered orally one time and 20mg of methotrexate injected intravenously consecutively for 5 days.The previous cases who received only 20mg methotrexate injected intravenously were selected as control group.Results　The success rate of the combination group was 87.5% which was significantly higher than that of the control group.The effect of treatment was related to serum β-hcG levels and whether there was embryos with cardiac activity or not.Conclusion　The treatment of unruptured tubal pregnancy with the combination of methotrexate and mifepristone is safe and effective.It is suitable for the unruptured tubal pregnancy with stable vital signs,but without acute abdominal pain or embryonic cardiac activity and β-hCG＜30μg/L.

Objective　To investigate the dynamic changes of psychological states and the results of delivery in pregnant women,simultaneously,study the effective way to reduce the rate of cesarean section.Methods　Through applying the self-compiled test paper,the self-evaluating state table(SCL-90)and the table of overall feeling of happiness,we assessed the psychological states of 89 pregnant women.The results were recorded at 35 and 38 weeks of gestation and 72 hours postpartum.Results　48 delivered vaginally(53.93%).4 were managed by cesarean section(46.07%),including 12 non-indicated cesarean section(29.27%).The mark of anxiety,terror and depression factors increased in the group of non-indicated cesarean section before and after dilivery compared with the group of vaginal delivery and indicated cesarean section.There was remarkable difference(P＜0.01).The value of overall feeling of happiness in the group of non-indicated cesarean section was less than that in the group of vaginal delivery.The difference was extremely significant(P＜0.001).The rdevant analysis showed that the feeling of happiness,the desire of labor and educational level were related negatively to the level of symptom during pregnancy(P＜0.01).The mode of delivery was related positively to the psychological state of pregnant women(P＜0.01).Conclusion　Non-indicated cesarean section is mainly interrelated to anxiety,terror and depression that proceed gradually during pregnancy and delivery.So it is suggested that the aimed psychological education be beneficial to decrease the rate of cesarean section.

Objective To determine the change of maternal heart rate during the treatment with ritodrine for threatened premature labor. Methods110 cases of threatened premature labor were chosen. The ritodrine 100mg in 5% G. S 500mL was intravenously administered. The initial dosage was 6 drops/min, and the dose was increased until uterine contractions were inhibited. The treatment lasted for 40 to 48 hours after the uterine contractions were inhibited, then the oral tablets was recommended. If necessary, repeated treatment was given to some patients. The maternal heart rate was recorded in the whole process of treatment and was compared with the dosage administered. The labor time, fetal weight and Apgar′s score were also analyzed. Results The maternal basic heart rate was increased at first and then decreased. The increasing significantly increased( P ＜ 0.01 ) when the uterine contraction was inhibited. , but no difference showed among the groups of different gestational age( P＞0.05 ). The maternal heart rate was increased with the increasing of ritodrine( max. 140/min). labor time was significantly prolonged with the treatment of ritodrine( P＜0.01 ) ,while that of the idiopathic premature labor was prolonged most obviously ( P ＜ 0.05 ). Average fetal weight was (2.42 ± 0.49) kg, and the average Apgar′s score was≥8. Conclusion In the treatment of inhibiting uterine contractions,the increasing of maternal heart rate caused by ritodrine can be used as an indicator of therapeutic effect.

Objective To compare and analyse the elective and emergency hysterectomies in obstetric practice. Meth odsA retrospective study was performed to compare elective versus emergency cesarean hysterectomies in PUMC Hos pital from January 1969 to December 1998.ResultsObstetric hysterectomies were performed on 36 patients over 30 years out of 33207 deliveries. 26 emergency cesarean hysterectomies and 10 elective hysterectomies had been done. Pla cental disorder was the main indication of emergency hysterectomy. The perinatal mortality of newborn was 179.5‰. ConclusionObstetric hysterectomy has been proved to be one of the most useful life- saving procedure for patients with postpartum hemorrhage, especially at the time of cesarean section, particularly for patients with a history of benign or malignant gynecologic tumor or irregular vaginal bleeding before pregnancy.

Objective To observe the effects of renin - angiotensin system ( RAS ) and steroid hormones onpregnancy in in vitro fertilization and embryo transfer(IVF-ET). Methods .53 tubal infertility women underwent IV F-ET under control of ovarian hyperstimulation with GnRHa/FSH/hMG/hCG. Plasma total renin, serum estradiol(E2),progesterone(P) and testosterone(T) were measured on the day of injection of injection of hCG and 36h after hCG( before getting the oocytes). ResultsPlasma total renin level on the day of hCG in pregnant group was higher than that in nonpregnant group(P<0.05), E2 and P lower than that in nonpregnant group(P<0.05, P<0.01). Plasma total renin and E2 levels 36h after hCG in pregnant group were lower than that in nonpregnant group( P<0.05). There was no difference in other hormones between the two groups. ConclusionThe high concentration of total renin on the day of hCG injection and its low concentration 36h after hCG administration are probably conducive to pregnancy.

ObjectiveTo explore the relation of the expression of intron 9 in CD44 gene,nm23 gene and the serum levels of TGFα and TNFα to the development, metastasis and prognosis of epithelial ovarian cancer. Methods The expressions of intron 9 in CD44 gene, nm23 gene, TGFα and TNFα in epithelial ovarian cancer were measured by semi -quantitative RT - PCR, immunohistochemical technique and radioimmunoassay ( RIA ). Results There was positive expression of intron 9 in CD44 gene,nm23 gene,TGFα and TNFα in 36 cases of epithelial ovarian cancer. The higher levels of nm23 gene and TGFa were obvious in early stage of ovarian cancer. ConclusionTo study the ovarian cancers biologic behavior with these multipe factors can provide theoretical basis for early diagnosis, gene therapy and predicting prognosis.

Objective To determine the early diagnostic value of serum C -reactive protein (CRP)、 total complement( CH50 ) activity and complement 3 (C3) concentration of premature women in the subclinical infection.MethodsSolid phase enzyme linked immunosorbent assay ( ELISA method ) was used for measurements of serum CRP levels. According to modified Mayer simple tubular colorimetric method and simple agar immunodiffusion method, we determined the CH50、C3 concentration respectively.Results Premature women with subclinical chorioamnionitis showed higher serum CRP concentration than that of normal pregnancy women (P<0.01). In the subclinical chorioamnionitis, the more serious the infection, the higher the CRP concentration, while CH50 and C3 concentrations were correspondently decreased. Serum CRP concentration in premature labor was the most sensitive index that suggested subclinical chorioamnionitis. ConclusionsSerum CRP、CH50 and C3 concentrations in premature labor are simple,reliable and accurate indexes for early diagnosis of subclinical infection.

ObjectiveTo investigate the efficacy of mifepristone with or without tamoxifen in the treatment of leiomyomas. Methods173 symptomatic patients with leiomyomas were divided into 2 groups randomly. Group A (88cases) received mifepristone 25mg per day;Group B(85 cases) received mifepristone per day combined with tamoxifen l0mg twice a day from the first day of menstrul cycle for three months. Leiomyoma and uterine size were measured by B ultrasound, the changes of endometrium were examined pathologically. Estrogen and progesterone levels, hemoglobin and liver renal function were all measured, meanwhile, adverse effects of drugs were assessed. ResultsAll the patients in the 2 groups were amenorrhea with increased hemoglobin, the level of estrogen and progesterone remained in the early stage of proliferation phase. The uterus and leiomyoma sizes in two groups both reduced, but those in group B reduced less significantly(P＜0.01). Adverse effects showed similarity and needed no special control. ConclusionsBoth mifepristone and mifepristone combined with tamoxifen show good efficacy in the treatment of leiomyoma, but mifepristone combined with tamoxifen is more suitable.

Objective To furthur recognize the pathomorphological features of the endometrial stromal tumors.MethodsThe clinicopathological analysis was made for 19 cases of endometrial stromal tumors of uterus, including 1 of nodule, 15 of low-grade sarcomas and 3 of high-grade sarcomas. ResultsThe location of neoplasm predominated in submucosal in 4 cases, 4 cases of sarcomas recurred after operation. 4 cases showed extrauterine tumors. Sex-cord-like differentiation presented in 6 tumors. Smooth muscle differentiation was found in 7 cases. ConclusionLow-grade endometrial stromal sarcomas is the commonest histopathological pattern in the endometrial stromal tumors. Sex-cord-like differentiation and smooth muscle differentiation are not rare in endometrial stromal tumors.

ObjectiveTo study the effects of angiogenesis on the development of endometrial carcinoma. Methods Hysterectomy specimens were stained immunohistochemically by the marker of factor Ⅷ-related antigen for endothelium vessels in normal controls, patients with endometrial hyperplasia and with endometrial carcinoma. Results The microvascular density(MVD) in tumour increased gradually from normal endometrium to endometrial hyperplasia and to endometrial carcinoma(P<0.01). MVD correlated with the mvometrial invasion, histologic grades and the stages.ConclusionMYD in endometrial hyperplasia increases. MVD can be used as a prognostic factor.