1.Analysis of pregnancy outcome of laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical incompetence
Chinese Journal of Postgraduates of Medicine 2017;40(1):67-71
Objective To analyze the pregnancy outcome of laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical insufficiency. Methods The clinical data of 78 uterine cervical incompetence patients having underwent cervical cerclage before pregnancy were retrospectively analyzed. Among them 40 cases underwent laparoscopy cervical cerclage (laparoscopy group), and 38 cases underwent transvaginal cervical cerclage (transvaginal group). The operation time, complications, length of cervix in pregnancy, lengthen time of gestational weeks, gestational weeks, perinatal infant weight, survival rate of perinatal infants and infection rate of uterine cavity were compared between 2 groups. Results The length of cervix in pregnancy, lengthened time of gestational weeks, perinatal infant weight, term labor rate and survival rate of perinatal infants in laparoscopy group were significantly higher than those in transvaginal group: (4.35 ± 0.52) cm vs. (3.51 ± 0.66) cm, (116.7 ± 9.8) d vs. (90.2 ± 5.2) d, (3 050 ± 759) g vs. (2 500 ± 431) g, 60.0%(24/40) vs. 31.6%(12/38) and 95.0%(38/40) vs. 78.9%(30/38), and the infection rate of uterine cavity was significantly lower than that in transvaginal group: 2.5% (1/40) vs. 18.4% (7/38), and there were statistical differences (P<0.05). There were no statistical differences in operation time and incidence of complications (P > 0.05). Conclusions Laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical incompetence can effectively maintain the cervical length period of pregnancy, improve the success rate of surgery, prolong gestational weeks, and improve perinatal outcome.
2.The study on selecting pre-pregnancy cervical cerclage method in the different cervical length of uterine cervical incompetence patients
Chinese Journal of Postgraduates of Medicine 2017;40(3):254-258
Objective To study the pre- pregnancy cervical cerclage method in the different cervical length of uterine cervical incompetence patients. Methods The clinical data of 128 uterine cervical incompetence patients having underwent pre-pregnancy cervical cerclage were retrospectively analyzed. The preoperative cervical length was measured by transvaginal ultrasound. Cervical length >2.5 cm was in 60 cases, of which 34 cases underwent laparoscopic cervical cerclage, and 26 cases underwent transvaginal cervical cerclage; cervical length ≤ 2.5 cm was in 68 cases, of which 32 cases underwent laparoscopic cervical cerclage, and 36 cases underwent transvaginal cervical cerclage. Results For the patients with preoperative cervical length > 2.5 cm, there were no statistical differences in the postoperative pregnancy cervical length, gestational weeks time, perinatal birth weight, perinatal survival rate, gestational age of delivery and intrauterine infection rate between 2 methods (P>0.05). For the patients with preoperative cervical length ≤ 2.5 cm, the postoperative pregnancy cervical length, gestational weeks time, perinatal birth weight, perinatal survival rate and gestational age of delivery in laparoscopic cervical cerclage patients were significantly higher than those in transvaginal cervical cerclage patients: (3.85 ± 0.37) cm vs. (3.16 ± 0.49) cm, (101.75 ± 4.71) d vs. (80.62 ± 3.53) d, (2850 ± 323) g vs. (2330 ± 585) g, 90.6% (29/32) vs. 69.4% (25/36) and 50.0% (16/32) vs. 22.2%(8/36), but the intrauterine infection rate was significantly lower than that in transvaginal cervical cerclage patients:0 vs. 16.7%( 6/36), and there were statistical differences (P<0.05). All patients had no obvious complications. Conclusions For cervical length > 2.5 cm patients with uterine cervical incompetence, pre- pregnancy cervical cerclage can choose transvaginal or laparoscopic. But for patients with the cervical length≤2.5 cm or previous cervical cerclage failure, laparoscopic cervical cerclage is better than transvaginal cervical cerclage.
3.The relationship between dexamethasone and expression of brain derive neurotrophic factor and its receptor gene in experimental bacterial meningitis
Ling LI ; Quanxiang SHUI ; Shiqiang SHANG
Chinese Journal of Infectious Diseases 2000;0(02):-
Objective To investigate the relationship between dexamethasone and brain derive neurotrophic factor gene in experimental bacterial meningitis. Methods To construct the models of bacterial meningitis in 3 weeks old rats(n=33),then 23 of them were administed antibiotic and antibiotic plus dexamethasone respectively. BDNF mRNA and TrkB mRNA in brain was detected by in situ hybridization methods,respectively. Results After administration antibiotics, the expression of BDNF mRNA and TrkB mRNA in brain tissue were less than that in brain after infection 5 d(P 0.05), the expression of TrkB mRNA was stronger than that in brain at 5 d after infection(P
4.Clinical evaluation of cervical cerclage in the treatment of pregnant women with uterine cervical incompetence
Meili HU ; Quanxiang LI ; Feng YAN
Chinese Journal of Primary Medicine and Pharmacy 2016;23(2):256-258
Objective To evaluate the clinical effect of cervical cerclage in the treatment of pregnant with uterine cervical incompetence.Methods The clinical and follow -up data of 25 pregnant women with uterine cervi-cal incompetence who taken cervical cerclage were retrospectively analyzed.Results In 25 pregnant women with uterine cervical incompetence,there were 22 cases of neonatal survival,3 cases of abortion,surgical success rate was 88.0%.Conclusion Cervical cerclage is effective in the treatment of pregnant women with uterine cervical incompe-tence,and the timing of surgery should choose 14 -18 weeks gestation.
5.Variation of brain derived neurotrophic factor and its mRNA expression in infancy rats after experimental bacterial meningitis
Ling LI ; Quanxiang SHUI ; Xilin YU ; Jianping LI
Chinese Journal of Pathophysiology 1986;0(04):-
AIM: To investigate the expression and effect of brain derived neurotrophic factor (BDNF) mRNA and its protein in infancy rats after exposure to bacterial meningitis. METHODS: Three week old rats were used to construct the models of bacterial meningitis (n=30) and mormal(n=18). At 24 h, 48 h, 5 d after inoculating, the expression of BDNF mRNA and its protein were detected by in situ hybridization and immunohistochemical staining methods, respectively. RESULTS: The increase in BDNF mRNA expression was detected by in situ hybridization at 24 h in experiment( 0.13320? 0.02750) compared to control( 0.06269? 0.01147)(P0.05). Meanwhile, in the brain from the experiment rats, strong positive hybridization and immunoreactivity were observed in the infiltrated inflammatory cells in leptomeninges, subarachnoid cavity, ventricles and brain parenchyma. CONCLUSIONS: These results support the hypothesis that BDNF might play a neuroprotective role in brain damage process in bacterial meningitis attacked rats. BDNF might take part in imune response. These results also support the hypothesis that BDNF has some relationships with other inflammatory mediators during acute inflammatory response of bacterial meningitis.
6.Clinical Analysis and Mechanism Study of Conditioning of Postoperative Endometrial Carcinoma in Staging Ⅰ with Integrated Traditional Chinese and Western Medicine
Xintao SU ; Xiufang WANG ; Quanxiang LI ; Shuo LUO
International Journal of Traditional Chinese Medicine 2008;30(6):458,460-
Objective To investigate if the anticancer prescription Fuzhengyiaitang in combination with progestogen matching chems can have better clinical effects than progestogen alone.Methods Collecting 60 patients and grouped into two randomly.One group named the experimental group and the other is named the control.The experimental group is given Fuzhengyiaitang and progestogen and the control ine is given the progestogen alone.The clinical effects are investigated.Results The experimental group had better clinical effects than the other one and the results had statistical significance.The experimental group are stronger,had better immunal functions and less side effects.Conclusion Fuzhengyiaitang and progestogen match cbems Can have better clinical effects in treating the stage I's operation.
7.Analysis of laparoscopic cervical cerclage before pregnancy after pregnancy
Quanxiang LI ; Na YANG ; Yanhua GAO ; Feng YAN
Chinese Journal of Primary Medicine and Pharmacy 2016;23(18):2748-2751
Objective To analyze the pregnancy outcome of laparoscopic cervical cerclage before pregnancy, discuss the clinical value of the treatment of cervical incompetence.Methods 40 cases with cervical insufficiency during 2012.1 -2016.3 before pregnancy underwent laparoscopic ligation.All patients had a history of abortion or premature birth,and the average gestational age was 23.7 weeks.Preoperative cervical length was less than 2.5cm. The operation condition and the pregnancy outcome after operation were observed.Results The average time of oper-ation was 35.6(40.2 ±10.4)min and the amount of bleeding was 10.3(15.7 ±3.2)mL.Postoperative pregnancy cervical average length was 3.61 (4.35 ±0.52)cm.Pregnancy outcome:37 weeks of gestation and above delivery 20 cases (50.0%).34 -37 weeks 16 cases (40.0%),28 -34 weeks in 3 cases,received cesarean section,the aver-age gestational was 35.6 weeks.Compared with the preoperative abortion,the gestational week of delivery was pro-longed by 12.1 weeks.Neonatal survival in 38 cases (95.0%),1 case of gestational 28 +3 weeks premature death. Neonatal birth weight was 2 800(3 079 ±500)g;1 case (2.5%)was difficult to avoid abortion at 23 weeks of gesta-tion.Conclusion Laparoscopic pre -pregnancy cervical cerclage suture in cervix mouth,postoperative can maintain effective cervical length,prolong gestational age,improve the pregnancy outcome,can be used as effective treatment for the pregnant cerclage failure or cervical length less than 2.5cm of cervical insufficiency patients.
8.Significance of vaginal cervical double cerclage for cervical incompetence after pregnancy
Quanxiang LI ; Na YANG ; Yanhua GAO ; Feng YAN
Chinese Journal of Primary Medicine and Pharmacy 2016;23(14):2141-2144
Objective To observe the pregnancy by transvaginal double slit cervical pregnancy outcome after ligation,and evaluate its clinical application value.Methods The clinical data of 80 cases with cervical incompe-tence were analyzed.All patients had pregnant metaphase inevitable abortion history,the average abortion pregnant was 21.7 week.According to different treatment methods,80 cases were divided into two groups,treatment group (40 cases)in non pregnant women with silk thread woven tape by double vagina and cervix cerclage,another group of 40 cases in 15 -20 weeks of pregnancy by using polypropylene McDonald method with cerclage.The operation,preg-nancy cervical tube length and pregnancy outcome were observed.Results The average operation time and bleeding volume between the two groups had no statistically significant differences.The pregnancy cervical average length of the treatment group was 4.6(4.8 ±0.5)cm,which was significantly longer than 3.9(3.1 ±0.8)cm of the control group (t =2.732,P <0.05).In the treatment group,the full -term delivery rate,preterm delivery rate,mean gestational age at delivery were 55.0%(22 /40),40.0%(16 /40),35.8 weeks,the average abortion was extended 14.1 weeks com-pared with preoperation,fetal survival rate was 90.0%(36 /40),neonatal birth weight was (3 100.0 ±200.0)g;28 gestational weeks following the inevitable abortion rate was 2.5%(1 /40).In the control group,the term delivery rate was 35.0%(14 /40),the rate of premature birth was 50.0%(20 /40),and the rate of abortion was 15.0%(6 /40)in 28 weeks.Mean gestational age at delivery was 33.2 weeks,which was extended 11.5 weeks compared with preoperative average abortion,fetal survival rate was 85.0% (34 /40),neonatal body mass was (2 900.0 ±300.0)g. The term delivery rate,fetal survival rate and neonatal weight in the treatment group were higher than those in the con-trol group.Conclusion Pregnant by double vagina and cervix cerclage treatment cervical function can maintain preg-nancy,cervical length,prolong the time of pregnancy and improve the perinatal survival rate,simple operation,take out stitches convenient,it is worthy of clinical application.
9.Analysis of effect of pregnancy with double loop cerclage for cervical incompetence
Quanxiang LI ; Na YANG ; Yanhua GAO ; Feng YAN
Chinese Journal of Primary Medicine and Pharmacy 2016;23(17):2596-2600
Objective To observe the effect of pregnancy double loop cerclage for cervical incompetence. Methods 80 cases of cervical function incompetence according to the type of surgery were divided into two groups, 40 cases in each group,15 -20 weeks of surgery in pregnancy,the treatment group underwent double loop cerclage, the control group underwent McDonald single cerclage.The operation,postoperative cervical length and pregnancy outcome of the two groups were observed.Results There was no difference in operation time and blood loss between the two groups.The length of cervix in the treatment group was (4.63 ±0.52)cm,which was longer than (3.71 ± 0.82)cm of the control group(t =2.106,P <0.05).Pregnancy outcome:20 cases of the treatment group in term birth (50%),preterm birth in 18 cases (45%)(34 -37 weeks in 12 cases,28 -34 weeks in 6 cases),fetal survival in 36 cases (90%),less than 28 weeks pregnant inevitable abortion in 2 cases (5%),abortion did not survive.Average delivery gestational age was 35.2 weeks,and preoperative average abortion pregnant weeks contrast,treatment group delivery gestational weeks extended 13.5 weeks,the average weight of newborns was (3 200 ±200)g.The control group of full -term delivery was 14 cases (35%),premature in 20 cases (50%)(34 -37 weeks in 7 cases and 13 cases of 28 -34 weeks),fetal survival in 33 cases (82.5%),less than 28 weeks pregnant inevitable abortion in 4 cases (10%),abortion did not survive.Average delivery gestational age was 33.2 weeks,compared with the average abortion weeks before operation,the gestational age of the control group was extended by 11.5 weeks.The weight of newborn was (2 900 ±300)g.In the treatment group,the term labor rate,fetal survival rate,neonatal weight were higher than those of the control group,the difference was statistically significant (χ2 =7.83,P <0.05).Conclusion The second trimester cervical double cerclage can maintain effective cervical length,prolong gestational age,improve perinatal survival rate.
10.Clinical and pathological analysis of aggressive angiomyxoma
Xiuxia HAN ; Quanxiang LI ; Xiaofang SHEN ; Fangning WANG ; Yunli ZHAO
Chinese Journal of Postgraduates of Medicine 2014;37(30):36-39
Objective To summarize the clinical manifestations,pathological character,diagnosis and treatment of aggressive angiomyxoma (AAM).Methods A computer-based online search of PubMed database and CHKD database was undertaken for literature about AAM published from all the relevant documents with the key words of aggressive angiomyxon.According to the condition 210 articles were analyzed.All the articles were analyzed about natural history,clinical manifestation,diagnosis,pathological character,treatment and prognosis of AAM.Results A total of 282 cases in well-documented articles had been reported,among which 64 were male and 218 were female,with male to female ratio of 1:3.4.The age of the patients from 1 to 83 years(mean 40.38 years).The most common sites were the perineum,genital tract and soft tissue in pelvic cavity in females and the scrotum,spermatic cord and groin in males.None of the cases could be accurately diagnosed as AAM preoperatively.The minimum diameter of the tumors was 1 cm,and the maximum was 60 cm.All the specimens showed typical pathological features of AAM as reported previously.Immunohistochemistry indicated that AAM tended to be strongly positive for vimentin,CD34,Desmin,estrogen receptor,progesterone receptor but mostly negative for S-100 and Ki-67 and Actin.The medical history was from 1 month to 20 years.The recurrence of the postoperative follow-up was 2 months to 20 years.The diagnosis depended on pathological examination.Conclusions AAM is a sort of unusual soft connective tissue tumor.It is a kind of unknown cause,slow progression,locally invasive,easy to recur after tumor resection.Long-term follow-up is quite necessary because of the high rate of local recurrence.