Objective To investigate the effect of local injection of human umbilical cord mesenchymal stem cells(hUC-MSCs)combined with sodium hyaluronate gel in the treatment of intrauterine adhesion in rats and its possible mecha-nisms.Methods Twenty-five specific pathogen-free female Sprague Dawley rats were divided into a blank control group,an intrauterine adhesion group,a sodium hyaluronate group,an hUC-MSCs group,and an hUC-MSCs+sodium hyaluronate group according to the random number table method,with 5 rats in each group.The rats in the blank control group received no treatment,while the rats in the rest four groups were injected with 950 mL·L-1 ethanol to prepare intrauterine adhesion models.One week following the establishment of the intrauterine adhesion models,100 μL of 1 × 1010 L-1 hUC-MSCs suspension was injected into the bilateral uterine horns of rats in the hUC-MSCs group and hUC-MSCs+sodium hyaluronate group;and 100 μL of normal saline was injected into the bilateral uterine horns of rats in the intrauterine adhesion group and sodium hyaluronate group.Subsequently,300 μL of sodium hyaluronate gel was injected into the bilateral uterine horns of rats in the sodium hyaluronate group and hUC-MSCs+sodium hyaluronate group;while,the same amount of normal saline was injected into the bilateral uterine horns of rats in the intrauterine adhesion group and hUC-MSCs group.After three days of intervention,all female rats in the five groups were combined with mature male rats possessing reproductive ability at a ratio of 1∶2 and then mated.The vaginal plugs of the female rats were observed for seven days to confirm successful mating.The abdominal aortic blood from pregnant rats in the five groups was extracted,and the serum levels of interleukin-6(IL-6)and interleukin-8(IL-8)were determined by using enzyme-linked immunosorbent assay.After blood collection,the rats were euthanized with excessive anesthesia,and subsequently,the uterus was removed and rinsed with normal saline.Firstly,the quantity of gestational sacs was counted;then,the endometrial tissues were meticulously separated,and the expression levels of matrix metalloproteinase-9(MMP-9)and transforming growth factor β,(TGF-β1)in the endometrial tissues of the rats were detected by using Western blot.Results The number of gestational sacs in rats in the intrauterine adhesion group,sodium hyaluronate group,hUC-MSCs group,and hUC-MSCs+sodium hyaluronate group was significantly fewer than that in the blank control group,the number of gestational sacs in rats in the sodium hyaluronate group,hUC-MSCs group,and hUC-MSCs+sodium hyaluronate group was significantly more than that in the intrauterine adhesion group,and the number of gestational sacs in rats in the hUC-MSCs+sodium hyaluronate group was significantly higher than that in the sodium hyaluronate group and the hUC-MSCs group(P＜0.05);there was no significant difference in the number of gestational sacs in rats between the sodium hyaluronate group and the hUC-MSCs group(P＞0.05).The serum IL-6 and IL-8 levels of rats in the intrauterine adhesion group,sodium hyaluronate group,hUC-MSCs group,and hUC-MSCs+sodium hyaluronate group were significantly higher than those in the blank control group,the serum IL-6 and IL-8 levels of rats in the sodium hyaluronate group,hUC-MSCs group,and hUC-MSCs+sodium hyaluronate group were significantly lower than those in the intrauterine adhesion group,and the serum IL-6 and IL-8 levels of rats in the hUC-MSCs+sodium hyaluronate group were significantly lower than those in the sodium hyaluronate group and the hUC-MSCs group(P＜0.05);there was no significant difference in the serum IL-6 and IL-8 levels of rats between the sodium hyaluronate group and the hUC-MSCs group(P＞0.05).The relative expression level of TGF-β,in the endometrial tissues of rats in the intrauterine adhesion group,sodium hyaluronate group,hUC-MSCs group,and hUC-MSCs+sodium hyaluronate group was significantly higher than that in the blank control group,while the relative expression level of MMP-9 was significantly lower than that in the blank control group(P＜0.05).The relative expression level of TGF-β,in the endometrial tissues of rats in the sodium hyaluronate group,hUC-MSCs group,and hUC-MSCs+sodium hyaluronate group was significantly lower than that in the intrauterine adhesion group,while the relative expression level of MMP-9 was significantly higher than that in the intrauterine adhesion group(P＜0.05).The relative expression level of TGF-β,in the endometrial tissues of rats in the hUC-MSCs+sodium hyaluronate group was significantly lower than that in the sodium hyaluronate group and the hUC-MSCs group,while the relative expression level of MMP-9 was significantly higher than that in the sodium hyaluronate group and the hUC-MSCs group(P＜0.05).There was no significant difference in the relative expression levels of TGF-β,and MMP-9 in the endometrial tissues of rats between the sodium hyaluronate group and the hUC-MSCs group(P＞0.05).Conclusion The combined injection of hUC-MSCs and sodium hyaluronate gel may up-regulate the expression level of MMP-9 protein and reduce the levels of TGF-β1 and inflammatory factors IL-6 and IL-8 in the endometrial tissues of rats with intrauterine adhesion,thereby repairing the damaged endometrium and increasing the number of gestational sacs.

Objective To compare the safety and efficacy of stent-assisted coil and non-stent-assisted coil for the treatment of ruptured posterior communicating artery aneurysms.Methods A total of 121 consecutive patients with ruptured posterior communicating artery aneurysm treated at the Department of Neurosurgery,Heze Municipal Hospital between June 2014 and June 2017 were enrolled retrospectively.They divided into either a stent group (n =63) or non-stent group (n =58) according to whether they used stent treatment or not.The two groups were compared,and their clinical data,surgical related complications,the degree of embolism immediately after aneurysm surgery,and the follow-up results of clinical and imaging were analyzed.Results Interventional embolization therapy was successfully performed in all the patients.(1) The proportion of wide-necked aneurysms of the stent group was higher than that of the non-stent group.There was significant difference (92.1％ [58/63] vs.8.6％ [5/58],x2 =84.249,P ＜ 0.01).There were no significant differences in age,aneurysm size,sex,and HuntHess grade (all P ＞ 0.05).(2) The incidences of intraoperative aneurysm rupture of the stent group and non-stent group were 4.8％ (3/63) and 3.4％ (2/58) respectively.There was no significant difference (x2 =0.132,P =0.717).The incidence of thromboembolie complication was 12.7％ (8/63) and 5.2％ (3/58)respectively.There was no significant difference (x2 =2.070,P =0.150).In the stent group,1 patient disabled and 1 died,and in the non-stent group,there were no cases with surgical related disability,and 1 died.(3) The comparison of immediate results after procedure between the stent group and non-stent group:there were no significant differences in the complete embolic rate (39.7％ [25/63] vs.37.9％[22/58],x2 =0.039),aneurysm neck residual rate (25.4％ [16/63] vs.39.7％ [23/58],x2 =2.811],and residual rate of aneurysm (34.9％ [22/63] vs.22.4％ [13/58],x2 =2.298,all P ＞ 0.05).(4) The recurrence rate of aneurysms (4.3％ [2/46]) of the stent group was lower than that of the non-stent group (31.8％ [14/44]).There was significant difference between the two groups (x2 =112.610,P =0.01).No rebleeding occurred in all aneurysms after procedure.Conclusion Compared with the non-stent-assisted coil embolization,the stent assisted embolization of ruptured posterior communicating artery aneurysms in acute phase may reduce the recurrence rate of aneurysms and without significantly increasing the incidence of surgery-related complications.