ABSTRACT
Objective@#To evaluate the effect of cervical lifting suture in treatment of placenta previa with increta and percreta.@*Methods@#From January 2016 to June 2017, 65 cases (0.78%, 65/8 322) were diagnosed placenta previa with increta and percreta by prenatal ultrasonic score system and confirmed by intraoperative findings in the department of obstetrics and gynecology of Peking University Third Hospital. Totally 62 cases (0.75%, 62/8 322) were included, because 3 cases underwent hysterectomy with placenta in situ. According to ultrasonic score system, 62 cases were divided into two groups, score 5-9 group (n=42, 67.7%) and score≥10 group (n=20, 32.3%) , cervical lifting suture techniques were all performed in cesarean sections. Demographic and clinical data were collected and compared.@*Results@#(1) There were no significant differences between two groups in age, gravidity, parity, cesarean section history ratio and gestational week of termination (all P>0.05) . (2) In score≥10 group, the median intraoperative bleeding volume was 4 000 ml (1 200-13 000 ml) , while in score 5-9 group, it was 1 600 ml (700-10 000 ml) , intraoperative blood transfusion volume was 2 000 ml (800-8 800 ml) in score≥10 group, while 1 200 ml (0-8 000 ml) in score 5-9 group. The median operation time was 240 minutes (108-1 200 minutes) in score≥10 group, significantly higher than that in score 5-9 group, which was 135 minutes (69-335 minutes; all P< 0.05). In 8 cases for hysterectomy (12.9%,8/62) , 3 cases in score 5-9 group, 5 cases in score≥10 group. (3) In score≥10 group, the rate of postoperative ICU registration was 80% and mean hospitalization time was (6.3±1.7) days, were significantly different, compared with those in score 5-9 group, which were 26%, (4.9±1.9) days. No serious postpartum complications were found in both groups, and there were no significant differences in Apgar score and weight of newborns (all P>0.05) .@*Conclusion@#Cervical lifting suture in placenta previa with increta and percreta could significantly reduce postpartum hemorrhage and retain uterine.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the correlation between human immunodeficiency virus (HIV) and the sexual behaviors of men who have sex with men (MSM) in Guangzhou in 2010.</p><p><b>METHODS</b>Anti-HIV antibody was detected in the volunteers undergoing HIV tests in the year 2010, and the differences in the sexual role, education, use of condom and complicated infection of syphilis were analyzed among these subjects.</p><p><b>RESULTS</b>A total of 1526 MSM volunteered to participate in the investigation, among whom 87 (5.70%) were confirmed to have HIV infection. The positivity rate of HIV infection was 3.54%, 7.14% and 6.70% in subjects reporting active anal copulation, passive anal copulation, and both, respectively, showing a significant difference in respect of the sexual role (χ(2)=6.450, P=0.040). The positivity rate also differed significantly among married, unmarried and divorced subjects (9.45%, 4.92%, and 4.17%, respectively; χ(2)=7.184, P=0.028). The positivity rate was 21.31% among those with syphilis, significantly higher than the rate in those without syphilis (5.06%, χ(2)=25.770, P<0.001). Use of condom was not associated with a significant reduction of HIV positivity rate (P>0.05).</p><p><b>CONCLUSION</b>The high anti-HIV positivity rate among MSM in Guangzhou indicates a high risk of unsafe sexual behaviors, especially anal copulations. The anal copulation receivers, often young and have a lower rate of condom use, constitute a high-risk group of HIV transmission.</p>