Impact of Conditioned Medium of Decidual Stromal Cell Cluture on Proliferation,Apoptosis and Invasion of Trophoblast Cells / 实用妇产科杂志

Objective:To investigate the impact of conditioned medium of decidual stromal cell culture(DSCM) on proliferation,apoptosis and invasion of trophoblast cells.Methods:lsolution,culturing and indentifying the purity of decidual stromal cells from healthy women of early pregnancy to prepare different concentrations of DSCM (5％,20％,50％ and 100％);Proliferation was evaluated by MTT assay;Cell apoptosis was examined by flow cytometry using annexin V-FITC/PI staining;Cell invasion was assayed using a Transwell chamber;RT-PCR and gelatin zymography were used to explore the mechanism of cell invasion.Results:Using this method we obtained a purity over 90％ of decidual stromal cells.With the concentration of DSCM increased(5％,20％,50％,100％),the OD value of the MTT assay has elevated and the rate of apoptosis declined,the infiltrating cell increased as well (P ＜ 0.05);Compared with control group,DSCM treatment led to a significant increase in the mRNA and protein expression of MMP-2/9(P ＜0.05).Conclusions:Decidual microenviroment may promote trophoblast proliferation and inhibite its apoptosis besides could enhance its ability of invasion by altering the expression of MMP-2 and MMP-9.

Clinical study on the time and ways for pregnancy termination of patients with early onset severe preeclampsia / 中国综合临床

Objective To discuss the safety and operation effect of cesarean sectionof patients with early onset severe preeclampsia.Methods Clinical data were retrospectively analyzed,the treatment group made up of 236 patients with severe preeclampsia whose gestational age from 28 to 33 +6 weeks and the control group with 399 pregnancy women above 34 weeks.Main analytical items included:onset of gestational age,gestational age of termination of pregnancy,protensive of gestation,methods of termination of pregnancy,status of the occurrence of serious complications,fetal and neonatal mortality and the rate of neonatal asphyxia.Results The average conservative treatment time of treatment group was was significantly longer than that of control group [ ( 13.5 ± 1.2) d vs (9.6 ± 1.0 ) d,t =3.760,P ＜ 0.001].There was no significant difference on the cesarean section rate[70.8％ (167/236) vs 71.2％ (284/399),x2 =0.012,P =0.911 ] and neonatal mortality(2.5％vs 2.8 ％,x2 =0.026,P =0.871 ) between these two gourps.However there was significant difference on the rate of neonatal asphyxia(25.8％ vs 10.8％,x2 =20.792,P ＜ 0.001 ) and perinatal mortalit (22.0％ vs 6.9％,x2=27.782,P ＜ 0.001 ) between these two groups.Conclusion For the patients with severe early onset preeclampsia,to take conservative expectant treatment appropriately based on the safety of motherhood could avoid or reduce the possibility of the occurrence of serious complications,could extend the gestational age appropriately as well as reduce fetal and neonatal prevalence and mortality.Cesarean section is proper for the termination of pregnancy.

Teaching Reform Exploration in the Clinical Probationary Practice in Department of Obstetrics and Gynecology / 中国医学伦理学

Based on the professional characteristics of obstetrics and gynecology department,teaching reform should take clinical manifestations of diseases as the main direction of clinical probationary teaching,stress the formation cultivation of medical students' clinical logic,add human-oriented thought into clinical teaching and stress medical ethics education,and construct a novel teaching mode in the clinical probationary practice in department of obstetrics and gynecology so as to improve clinical teaching of obstetrics and gynecology.