Objective To assess the effect of clomiphene citrate(CC)on the proliferative stage of endometrium by the addition of low-doge estrogen(progynova,PGV)and aspirin.Methods Sixty women with unexplained infertility were divided into 4 groups randomly.Untreated group,CC treated group(C group),CC+PGV treated group(CE group)and CC+PGV+aspirin treated group(CEA group),each group Was 15 cases.Endometrium thickness,pattern of endometrium and resistant index(RI)of uterine artery were detected by ultrasound,all at end proliferative stage of endometrium.Results The endometrium thickness,the rate of the endometrium thickness≥8 mm and the rate of A-endometrium in C group were significantly less than those in other 3 groups(P<0.05).The rate of A-endometrium in CE group was significantly less than that in untreated group and CEA group(P<0.05).The number of follicle diameter≥15 mm in untreated group(1.01±0.25)was signifieantly less than that in other 3 groups(1.56±0.64,1.52±0.70,1.61±0.67)(P<0.os).RI of uterine artery in C group(0.93±0.07)and CE group(0.95±0.04)were significantly higher than that in untreated group(0.81±0.05)and CEA group(0.83±0.03)(P<0.05).Conclusion Low-dese estrogen can reverse the deleterious effect of CC on.endometrial development,and low-dose estrogen and aspirin can promote uterine perfusion and improve uterine compatibility.

Objective To study the diagnosis, management and prognosis of intracranial metastases of gestational trophoblastic tumour (GTT) patients who had emergency surgical decompression due to highly increased intracranial pressure. Methods Ninety-three patients with intracranial metastases of gestational trophoblastic tumour were hospitalized in our department of Peking Union Medical College Hospital from 1985 to 2004. Thirteen of them who underwent emergency craniotomy were retrospectively analyzed, and all of them presented with raised intracranial pressure and intracerebral haemorrhagic mass. Result Of the thirteen patients who underwent surgery in combination with multiagent systemic chemotherapy, seven achieved complete remission(CR), five had partial remission(PR), and one died of disease progression. Conclusions Emergency surgical treatment is the important method of choice for brain metastasis in patients displaying rapidly deteriorating signs. An undetermined intracranial haemorrhage in young female patients of reproductive age group should raise the suspicion of cerebral metastatic choriocarcinoma.