ABSTRACT
Drug use during pregnancy is unavoidable. Therefore, it is vitally important for medical workers to help pregnant women take drugs correctly to reduce the incidence of spontaneous abortion, premature birth, and low birth weight. In our study, drug screening model with induced pluripotent stem cells (iPSCs) was used to find some improper drugs which will result in woman's abortion. With 3D culture in vitro, iPSCs can form embryoid bodies (EBs) and cerebral organoids, which simulated in vitro development of early embryos, from inner cell mass to germ-layer differentiation. In the experiment, EBs were exposed to mifepristone (RU486), and three experimental groups were divided randomly. They were control group (without RU486), low-dose group (L-RU486, 10 μg·mL-1), and high-dose group (H-RU486, 20 μg·mL-1). After mifepristone exposure, EBs were observed at days 5, 8, and 11, including size of EB, cell apoptosis, and differentiation of germ layers, by using inverted optical microscope, TUNEL assay, and immunofluorescent staining. The results showed that through 3D culture, iPSCs could develop into embryoid bodies, neural rosettes, and finally cerebral organoids. After mifepristone exposure, EBs' sizes were decreased (P < 0.01); the levels of cell apoptosis in EBs were increased after mifepristone exposure (P < 0.01); the development of EBs' germ layer was affected. Mifepristone exposure could inhibit the proliferation of embryonic stem cells, reduce the differentiation of ectoderm (P < 0.01) and promote the development of mesoderm (P < 0.05). In conclusion, iPSCs can be used as a screening model for abortion drug, and EBs’ diameter, cell apoptosis, and differentiation changes of the germ layers can serve as criteria of abortion drug screening.
ABSTRACT
OBJECTIVE: To investigate the clinical characteristics and the feasibility of laparoscopic treatment of ureteral endometriosis.METHODS: Retrospective analysis of the clinical characteristics,treatment methods and prognosis of 16 patients with ureteral endometriosis from Renji Hospital of Shanghai Jiao Tong University School of Medicine from January 2015 to February 2017.RESULTS: Ureteral stricture is the main symptom for all these 16 patients.15 patients merged with other deep infiltrating endometriosis(DIE)(15/16).All patients underwent laparoscopic surgery.Ureterolysis plus ureteral stent placement were performed in 8 patients,while laparoscopic ureteroneocystostomy in 6 and 2 abandoned surgery.Radical resection of DIE lesions were performed in 15 patients,hysterectomy in 4 patients,adenomyotomy in 2 patients,one-sided or double-sided ovarian cyst removal in 5 patients,ovariocystectomy and adnexectomy in 3 patients.More than 2 surgeries were performed in 1 patient.15 patients preserve ovarian function.No serious postoperative complications.CONCLUSION: Ureteral endometriosis is rare and difficult to diagnosis as lacking of specific symptoms.Laparoscopic treatment can achieve satisfactory therapeutic outcome.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the role of laparoscopic sentinel lymph node(SLN) detection with carbon nanoparticles tracer in cervical carcinoma.</p><p><b>METHODS</b>Totally 21 patients with confirmed early cervical cancer were enrolled in this study.Before laparoscopic extended hysterectomy and pelvic lymphadenoetomy(and para-aortic lymphadenoectomy) , they were injected with carbon nanoparticles suspension injection tracer from cervical neck before surgery. The black-staining lymph nodes were cut as SLN under the laparoscope for routine pathological examination.</p><p><b>RESULTS</b>Of these 21 patients, at least one SLN was successfully detected in 20 patients(95.24%) , and a total of 158 SLNs were detected.The conventional pathology results suggested that 5 patients(23.81%) had positive lymph nodes(n=16, including 14 in 4 patients) . The new approach showed a sensitivity of 80.0%(4/5) , accuracy of 100.0%(20/20) , and negative predictive value of 100.0%(16/16) for SLN detection.</p><p><b>CONCLUSION</b>Laparoscopic SLN detection with carbon nanoparticles tracer is a relative safe and sensitive method for in cervical carcinoma.</p>
Subject(s)
Female , Humans , Laparoscopy , Lymphatic Metastasis , Pathology , Nanoparticles , Predictive Value of Tests , Sensitivity and Specificity , Sentinel Lymph Node Biopsy , Methods , Uterine Cervical Neoplasms , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the feasibility and effectiveness of laparoscopic radical trachelectomy and lymphadenectomy in the treatment of early-stage cervical cancer.</p><p><b>METHODS</b>The clinical data of 6 patients (stage 1a2 to 1b1), who underwent laparoscopic fertility-preserving radical operation for cervical cancer in our department from February 2009 to October 2010, were retrospectively analyzed in terms of operation duration, intra-operative blood loss, postoperative pathology, complications, and pregnancy.</p><p><b>RESULTS</b>Both radical resection of cervical and pelvic lymph node dissection were completed under laparoscopy, and only the cervical and vaginal cuffs were closed from vagina. The operation duration ranged 155-210 min (mean: 185 min) and the intra-operative blood loss was approximately 60-120 ml(mean: 105 ml). The average length of hospital stay was 18 days without complications, postoperative infection, and bleeding. Postoperative pathology showed no lymph node metastasis, and no ligament, blood vessels, vaginal cutting margin, or upper part of cervix was invaded by tumor cells. During the 8-20-month follow-up, 1 patient had become pregnant for 4 months and no case experienced tumor recurrence.</p><p><b>CONCLUSION</b>Laparoscopic fertility-preserving lymphadenectomy and radical trachelectomy is feasible for patients with early-stage cervical cancer who have strong wish to have a child.</p>
Subject(s)
Adult , Female , Humans , Young Adult , Fertility Preservation , Follow-Up Studies , Hysterectomy , Methods , Laparoscopy , Retrospective Studies , Treatment Outcome , Uterine Cervical Neoplasms , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To explore the effectiveness and safety of laparoscopic presacral neurectomy (LPN) in treating endometriosis-associated pain.</p><p><b>METHODS</b>Totally 64 patients with endometriosis were divided into two groups using prospective non-random method. Patients in the control group received only the conventional laparoscopic resection of endometriosis lesions, while patients in the LPN group underwent LPN in addition to the resection of endometriosis lesions. The pre-operative pain scores, intra-operative staging results, surgical duration, intra-surgical blood loss, post-operative pain relief were compared between these two groups.</p><p><b>RESULTS</b>These two groups showed no significant differences in terms of age, body weight, pre-operative pain score, surgery staging, surgical duration, and intra-operative blood loss (all P > 0.05). All patients were followed up for 6 to 18 months (median: 12.8 months). The post-operative pain relief rate was 89.28% (25/ 28) in LPN group and 61.29% (19/31) in the control group (P = 0.030).</p><p><b>CONCLUSION</b>LPN can effectively and safely in treating endometriosis and its associated pain.</p>