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The Analysis of Ultrasonic Classification and Treatment Effect for Cesarean Scared Pregnancy

Journal of Practical Obstetrics and Gynecology.2017;33(7):538-540.

Objective:To explore the ultrasonic classification in cesarean scared pregnancy (CSP)and its effect on guiding the clinical treatment.Methods:The clinical data of 41 patients with CSP in the Third people's hospital of Chengdu from January 2013 to January 2016 were analyzed retrospectively.Diagnosis was confirmed according to the diagnostic criteria for ultrasound imaging by Godin etal and the history of cesarean section.Patients were divided into type Ⅰ group and type Ⅱ group through measuring the outside uterine muscle layer thickness of pregnant bursa,based on the criteria by Vial et al.Type Ⅰ:MTX intramuscular injection followed by ultrasound guided Dilation and Curettage(D&C)3 days later.Type Ⅱ]:Uterine artery chemo-embolization (UACE)followed by ultrasound guided D&C 2 days later,or lesion resection and repair of the uterus by trans-abdominal or laparoscopic or trans-vaginal operations 2 days later.Results:The outside uterine muscle layer of pregnant bursa in type Ⅱ] was more thinner than that in type Ⅰ (2.1 ± 1.1 mm vs 3.7 ±0.6 mm,P ＜ 0.05).The number of abortion in type Ⅱ was more than that in type Ⅰ (2.8 ± 0.7 vs 1.5 ± 0.6,P ＜ 0.05).There were no statistically significant differences in age,amenorrhea duration and the number of cesarean section (P ＞ 0.05).Patients from two group were treated successfully,and there was no statistical significance about,intraoperative bleeding volume,preoperative serum levels of β-HCG and average recovery time of serum β-HCG(P＞0.05).The average hospital stays and cost in type Ⅰ were less than that in type Ⅱ,with statistical significance (4.7 ± 2.5 vs 8.6 ± 2.7 days,5234.6 ± 1688.8 vs 15668.4 ±4623.4 RMB,P ＜ 0.05).Conclusions:The ultrasonic classification of CSP plays a directive role in making treatment option,with reliabe effect and the good prognosis.UACE as a pretreatment which can control intraoperative bleeding,is an effective method for CSP.For its higher cost,UACE should be selectively used in type Ⅱ[CSP,with cost-effective.MTX intramuscular injection used in type Ⅰ CSP before D&C is reliable and cost-effective.

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Clinical Observation of Lung Protective Ventilation Strategy in Gynecologic Laparoscopic Surgery

Hengyu CAI ; Hongyan GAO

Journal of Practical Obstetrics and Gynecology.2017;33(7):534-537.

Objective:By monitoring the lung compliance,oxygenation index(OI),CC16、IL-8 in plasma,observe whether the protective lung ventilation in patients undergoing gynecological laparoscopic surgery can improve the respiratoryw function and reduce lung injury.Methods:40 cases of ASA grade Ⅰ-Ⅱ were selected,and 40 patients were treated by elective laparoscopic radical resection of cervical cancer.The patients were divided into two groups according to the random number table method in 40 cases.Mechanical ventilation in general anesthesia,A group used traditional intermittent positive pressure ventilation mode,tidal volume is set to 10ml/KG (PBW);B group used lung protective ventilation strategy,tidal volume is set to 6ml/KG (PBW) + 5cmH2O PEEP + recruitment manoeuvres.For patients before pneumoperitoneum(T0),2 hours after pneumoperitoneum (T1),4 hours after pneumoperitoneum (T2)MAP,HR,CVP,RR and C were observed.In pneumoperitoneum (T0),2 hours after pneumoperitoneum(T1),4 hours after pneumoperitoneum (T2),2 hours after operation(T3),24 hours after surgery(T4) venous,IL-8,CC16 content detection.Results:Before pneumoperitoneum,two groups of patients with pulmonary compliancethe difference was statistically significant(P ＜0.05).Compared T1 、T2 with T0 in A group and B group,the pulmonary compliance all decreased and there existed significant deference(P＜0.05).Notably,A group decreased evidently(P＜0.05).T0,T1,T3,T4 time points in two groups of patients with oxygenation index,the difference was statistically significant (P ＜ 0.05).Two groups of patients with CC16,IL-8content in T1,T2,T3,T4 time point,the difference was statistically significant (P ＜ 0.05).Conclusions:Lung protective ventilation strategy can improve respiratory function in patients with gynecological laparoscopic surgery,and reduce the incidence of lung injury.

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Expression and its Clinical Pathological Correlation of Heat Shocking Protein 40 in Epithelial Ovarian Cancer

Hong MAI ; Fengyi LONG ; Guanmei WEN

Journal of Practical Obstetrics and Gynecology.2010;26(3):206-208,前插1.

Objective:The expression of Hsp40 in epithelial ovarian cancer and its correlation with clinical pathology were investigated. Methods:The expression of Hsp40 was detected by immunohistochemistry in 45 cases of epithelial ovarian cancer and 20 cases of benign ovarian tumor and 20 cases of normal ovary. Sta-tistical analysis was done to correlate the expression of Hsp40 with pathological characteristics. Results:The expression of Hsp40 in epithelial ovarian cancer was significantly higher than benign ovarian tumor and nor-mal ovary, the positive rates were 62.2% ,25.0% and 20.0% respectively ( P <0.01 ). There was no signifi-cant correlation between the expression of Hsp40 and clinical stages, histological grades,with or without me-testasis, with or without residual tumor. Kaplan-Meier survival curves and Log - rank analysis showed that the survival time in Hsp40 expression negative patients was significantly longer than those positive expression patients( P <0.01 ). Cox analysis showed residual tumor size was the only one covariant factor, the expres-sion of Hsp40 was not significantly relevant to prognosis. Conclusions. Hsp40 may play an important role in the occurrence and development of epithelial ovarian cancer.

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Isolation, Culture and Characterization of Endothelial Cells from Capillary Lymphantic Vessels of Human Skin

Ling WANG ; Zhiqing LIANG ; Yudi LI

Journal of Practical Obstetrics and Gynecology.2010;26(3):196-198,前插1.

Objective:Human capillary lymphatic endothelial cells (LECs) were isolated and cultured to assist further investigation of the function of lymphatic vessels generation during cancer metastasis. Methods:Human skin was digested by type I collagenase. Cells were isolated using magnetic beads which were marked by monoclonal antibodies against the extracellular domain of VEGFR-3, and purified by cloning col-umn. The morphology and structure of cells were observed by microscopy. Immunophenotype was identified by immunofluorescence. Cell growth curve was recorded to measure the effect of VEGF-C protein. Results:LECs exhibited the typical cobblestone morphology as monolayer growth pattem under microscopy. Enlarged nucleus and rich cytoplasm with bubbles were found under electromicroscopy. LECs specific markers inclu-ding VEGFR-3, LYVE-1, Podoplaninand D2-40 all were positive. VIII factor as specific marker of blood ves-sel endothelium cells (BVECs) was negative. VEGF-C induced a marked increase of cell proliferation. Con-clusions:Human dermal LECs could be harvested successfully using collagenase digestion, immunomagnet-ic beads sorting and clonic column purification.

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The Relationship between the Expression of RARα,RARβ,ER, PR and the Endometrial Carcinoma

Hong ZHOU ; Ling ZHONG ; Shufang CHANG

Journal of Practical Obstetrics and Gynecology.2010;26(4):296-299,后插1.

Objective:To evaluate the role of the retinoic acid raceptor α (RARα) , retinoic acid receptor β(RARp) , estrogen receptor(ER) and progesterone receptor(PR) in the clinical pathological stage, histologcal classification and the muscular invasive depth of the endometrial carcinoma through detecting the expression of these receptors.Methods:48 paraffin sections with endometrial carcinoma by pathological conformation ware selected.Immunohistochemistry was used to detect the expression of RARα, RARβ, ER and PR.The relationship between these raceptors and the clinical pathological parameters was evaluated.Results:①The positive expression ratio of the RARα and RARβ were 47.92% (23/48) and 25.00% (12/48) respectively.The level of RARα was higher than that of RARβ (P<0.05).②The expression of RARα in the endometrial carcinoma increased with the increasing of the pathological stage and the decreasing of the histological differentiation (P<0.05).But the expression of these two receptors had no significant relation with the histological classification and the muscular invasive depth (P >0.05).③The level of the RARβ was consistent with that of the ER and PR, and it decreased with the increasing of the malignant extent of the endometrial adenocarcinoma (P < 0.05) ,and had no significant relation with the pathological stage, the histological classification and the muscular invasive depth (P >0.05).④The expression of RARβ was positively correla ted to the expression of ER and PR, but the expression of RARα was negatively correlated to the expression ER and PR.Conclusions :There is expression of RARα、RARβ in endometrial carcinoma, and it has close relationship between the expression of RARα and the development of endometrial carcinoma.The absence of the RARβ expression and the high expression of the RARα are related to the histological classification of endometrial carcinoma.

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The Effect of the Gekko Gecko Ethanol Extract on the Granular Cells Apoptosis of Rat Ovaries

Xingwei JIANG ; Lina HU

Journal of Practical Obstetrics and Gynecology.2010;26(4):290-292,后插1.

Objective:To study the effects of the Gekko gecko ethanol extract on granular cells apoptosis of rat ovaries.Methods :3 month and 6 month female Wistar rats were taken in this study, and 20 rats were in each age group.Each age group were randomly divided into two groups(experimental group and control tragastric administration in experimental group, corresponding volume of 0.9% sodium chloride was given in control group by the same way.Apoptosis of granular cells and distribution of cell cycle in rat ovary were measured by terminal-deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL) and propidi-um iodide(PI) staining, AnnexinV/PI double labelling staining by flow cytometry (FCM) after administration for 15 days.Re8utts:The apoptosis numbers of granular cells in 3 month and 6 month age experimental group were 34 ±7 and 53 ±11, in control group were 48±9 and 76±17 respectively by TUNEL.There was signrficantly statistic difference (P <0.01).The apoptosis rates in 3 month and 6 month age experimental group were(6.06 ±2.01)% and (12.16 ±3.26) % , in the control group were (8.23±2.13) % and (23.69 ±6.28)% respectively by PI staining.There was significantly statistic drfference (P <0.05).However, no significant difference was found between two groups in cellular cycle distribution (P > 0.05).Early apoptosis rates in 3 month and 6 month age experimental group were (6.71±3.11) % and (23.74±6.28) % , in the control group were (19.05 ±5.78) % and (36.55± 8.35) % respectively by AnnexinV/PI double labelling staining FCM.There was significantly statistic difference (P <0.01).The apoptosis of granular cells were sig-nificantly less in experimental groups comparing wrth control groups both in 3 month and 6 month age group (P<0.01 or P<0.05).Conclusions :The ethanol extract of gekko gecko can inhibit the apoptosis of granu-lar cells in rat ovary, then improves the ovary function and delay ageing of rat.

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Stereological Study on Syncytial Cell of Human Placenta in Early-onset Severe Preeclampsia

Yuqin HU ; Yuanli HE ; Shilei PAN

Journal of Practical Obstetrics and Gynecology.2010;26(3):219-221,前插1.

Objective:The characteristics and changes of the three-dimensional micro structure of human placenta in Early-onset severe preeclampsia (EOSP) were quantified, and the relationship of morphologic features and the poor fetal prognosis was explored. Methods:10 patients were recruited in EOSP group, 10 normal blood pressure premature pregnancy were as control group. Ultrathin sections were observed by elec-tron microscope. The Vv,Sv,Nv of plancenta were measured by stereology method. These parameters were compared between the two groups. Results:①In EOSP group, the miorovillus at the bottom of syncytial was sparse and swollen. The mitochondria and endoplasmic reticulum were swollen and dilated. The deposition of lipid granules were increased.②The Vv, Sv of mitochondrial and endoplasmic reticulum in EOSP group were significant augmented than control groups( P<0.01 ). There was no significant difference of Nv in mitochon-drion and endoplasmic reticulum between two groups ( P >0.05). ③The Vv,Sv, Nv of microvilli in EOSP group were smaller than those in control group ( P < 0.01 ). Conclusions. In EOSP, the microstructure of placenta is impaired, thus the synthesis and transportation function of placenta were affected, so fetus could be injured subsequently.

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Study of Relationship between Hsp70 and Endothelial Activation in Placental Vascular Diseases

Yanxia LIU ; Jian XU ; Xin WANG

Journal of Practical Obstetrics and Gynecology.2010;26(3):222-224,前插1.

Objective:The pathogenesis of placental vascular disease(PVD) was further investigated. Methode:PVD group (study group) and normal pregnancy (control group) were recruited. Two-channel mi-croarray technique was applied to screen the most differently expressive genes of human genome, and veri-fied the different expressions in mRNA and protein levels by quantitative PCR and Westem-blot, also local-ized the expression of different genes in placental tissue by immunohistochemistry. Reeults:HspA6 and Hs-pA1A had extremely higher expression in placentas with PVD than normal pregnancy. These genes both en-coded Hsp70. Hsp70 was mostly expressed in endothelial and smooth muscle cells of placental microves-ssls. The expression of Hsp70 mRNA and protein were up-regulated in placental tissue and microvascular endothelial cells from PVD group compared with normal pregnancy ( P <0.05) ;The expression of Hsp70 mR-NA and protein had negative correlation with infant birth weight ( P < 0.05). Conclueione:Hsp70 was associ-ated with endothelial activation in the pathogenesis of PVD by initiating an innate immune response and in-flammatory reaction.

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Expressions of LKN-1,CCR1 and CCR3 in Placentas of Pregnant Women with Hypertensive Disorder

Nannan LI ; Yanxia LIU ; Xin WANG

Journal of Practical Obstetrics and Gynecology.2010;26(1):27-30,后插1.

Objective:To investigate the role of Leukotactin-1(LKN-1),CC receptor 1(CCR1)and CC receptor 3(CCR3)in the pathogenesis of hypertensive disorder complicating pregnancy(HDCP),the expressions of these factors in placentas were measured.Methods:The levels of LKN-1,CCR1 and CCR3 in placentas were measured from 32 patients with HDCP(study group)and 32 normal pregnant women(control group)by western blot(WB).The localization of these factorsin placentas were detected by immunohistochemistry(IHC).Results:LKN-1 protein expression was negative in placentas from the two groups by WB and IHC,while both CCR1 and CCR3 in the HDCP group were significantly lower than those in the control group(CCR1 0.66±0.06 vs 0.88±0.03.CCR3 0.17±0.01 vs 0.27±0.01,P<0.01).CCR1 was localized in vascular endothelial cells and stroma cells in both groups,but rare in the trophoblast layer.CCR3 was localized in vascular endothelial cells and trophoblast cells in both groups.Conclusions:There is no LKN-1expression in placentas from the two groups.Down regulation of CCR1 and CCR3 may associate with the pathogenesis of HDCP.

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Detection of Telomerase RNA Component Gene Amplification in Cervical In- traepithelial Neoplasia and Cervical Cancer with Fluorescence in Situ Hybridization and Its Clinical Significance

Wei LIU ; Lijun SUN

Journal of Practical Obstetrics and Gynecology.2010;26(2):124-127,插1.

Objective:To investigate the amplification of the telomerase RNA component (TERC) gene in cervical cancer and cervical intraepithelial neoplasia (CIN) using dual-color interphase fluorescence in situ hybridization (FISH) and its significance in screening of cervical lesion. Methods:Cervical cast-off cell specimens were screened from 120 outpatients with cervical lesion, including normal cell from liquid based cytology (20 cases), CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer cell from liquid based cytology (each of 25 cases). The amplification of TERC gene in cervical cast-off cells was detected by dual-color interphase FISH. The results of normal samples were used to set up the threshold. Results:①The percentages of abnormal cells in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer were significantly higher than threshold value ( P<0.05), and the percentage of abnormal cells was increased with the serious degree of pathological grade (P<0.01) ; ②The percentagesof 2:3,2:4,2:5 and great than or equal to 4:4 types in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer were significantdifferences (all P<0.01). The percentages of 2:4,2:5 and great than or equal to 4:4 types in cervical cancer were significant higher than that in CIN Ⅰ (P<0.001) while the percentage of 2:3 type was significant lower than that in it (P<0.001);③The percentage of abnormal cells was increased with the serious degree of cytological grade (P<0.01) in different cytological grades. The percentages of 2:3,2:5 and great than or equal to 4:4 types in atypical squamous cell of undetermined significance (ASCUS), low-grade squamous intraepithe-lial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) were significant differences (all P <0.01), and the percentages of 2:5 and great than or equal to 4:4 types in HSIL were significant higher than that in ASCUS( P <0.01) while the percentage of 2:3 type was significant lower than that in it ( P <0.01);④The detection rates of LSIL and HSIL with cytological examination in low grade and high grade CIN were 40% (10/25) and 62% (31/50) respectively, which were significant lower than the detection rates of FISH which was 100%(P<0.05).Conclusions:There is an abnormal amplification of TERC gene in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer, and its copy numbers are increased with the serious degree of pathological and cytological grades. Detection of amplification of TERC gene in cervical cast-off cells with FISH has a certain value for screening cervival lesion and prediction of lesion progression.

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