Selective arterial occlusion in the treatment of placenta percreta in late trimester of pregnancy / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the value of selective arterial occlusion in the treatment of placenta percreta in late trimester of pregnancy.@*METHODS@#Fifteen clinical patients ( gestational age ≥34 weeks), diagnosed with placenta percreta in Xiangya Hospital of Central South University from January 2003 to December 2010, were retrospectively analyzed. According to whether the selective arterial occlusion was used or not, the 15 patients were divided into 2 groups: an arterial occlusion group (n=8) and a non-arterial occlusion group (n=7). Based on the time of occlusion, the arterial occlusion group was divided into a prophylactic occlusion subgroup (n=4) and a remedial occlusion subgroup (n=4) (including 1 patient who was performed after the iliac artery balloon was taken out ). The blood loss, the rate of hysterectomy and complications were compared between the arterial occlusion group and the non-arterial occlusion group.@*RESULTS@#In all 15 patients, the average amount of blood loss was 3813 mL, and the rate of hysterectomy was 73.3% (11/15). The recent complication rate was 20.0% (3/15, including 2 blood coagulation dysfunctions and 1 lower extremity thrombosis), and long-term complication was not found. The average amount of blood loss in the occlusion group was 2512 mL, the hysterectomy rate was 62.5%(5/8); while the average amount of bleeding was 5549 mL and the hysterectomy rate was 85.7% in the non-occlusion group (6/7). There was significant difference between the 2 groups (P<0.05). The average amount of blood loss and the rate of hysterectomy in the prophylactic occlusion subgroup were lower than those in the remedial occlusion subgroup (1350 mL vs 3600 mL, 60.0% vs 66.7%, P<0.05).@*CONCLUSION@#Patients with placenta percreta in the third trimester of pregnancy may encounter severe postpartum hemorrhage, and the rate of hysterectomy is high. The amount of blood loss and the rate of hysterectomy may be reduced by the selective arterial occlusion before or in the cesarean section, but cannot be avoided completely.

Expression of NMBR in myometrium in pregnant mice at different gestational ages and its relation with parturition / 中南大学学报(医学版)

OBJECTIVE@#To investigate the spatiotemporal expression of neuromedin B receptor (NMBR) in mice myometrium at different pregnant stages, as well as its mechanism and relation with parturition.@*METHODS@#The pregnant mice were divided into no-pregnancy (NP), early pregnancy (EP), mid-pregnancy (MP), late-pregnancy (LP), parturition (PT) and postpartum (PP) groups (12 mice in each group), according to pregnant stage. The mRNA and protein expression of NMBR, HSP70 and IL-6 were detected in myometrium in pregnant mice by semi-quantitative RT-PCR and Western blot, while NF-kappaB-P65 DNA binding activity was determined by NoShift transcription factor assay kits, respectively. Their relation with parturition was analyzed.@*RESULTS@#The mRNA expression level of NMBR in the PT group was significantly higher than that in the NP, EP, LP and PP groups (P0.05). The NMBR protein in PT group was significantly higher than that in the other 5 groups (P<0.01). NF-kappaB-P65 DNA binding activity at PT group was remarkably higher than that in the NP, LP and PP groups (P<0.05). The expression of IL-6 mRNA was significantly higher than that in the NP, LP and PP groups (P<0.05), its protein expression in PT and LP groups was significantly higher than that in the NP and PP groups (P<0.05). The expression of HSP70 mRNA in the PT group was significantly higher than that in the NP and PP groups (P<0.05), and the protein of HSP70 was significantly up-regulated in PT and PP groups compared with in NP and LP groups (P<0.05). The DNA-binding activity of P65 was positively correlated to the mRNA expression of NMBR and IL-6 (r=0.40, P<0.01; r=0.30, P<0.05), so were positively correlated to DNA-binding activity of P65, mRNA expression of HSP70 and NMBR ( r=0.40, P<0.01; r=0.49, P<0.01). DNA-binding activity of P65 did not correlate with the mRNA expression of HSP70.@*CONCLUSION@#The mRNA and protein expressions of NMBR reach a peak at the onset of labor. NMBR may play an important role in the parturition via NF-kappaB P65-IL-6 signal transduction pathway. It may also influence the onset of labor by regulating HSP70, but this role does not rely on P65 pathway.

Effects of oxytocin,misoprostol and nimodiping on expression of L-type voltage dependant calcium channel mRNA of the uterine myometrium and left ventricular myocardial cells in late pregnant rats / 中华妇产科杂志

0.05). Conclusions Oxytocin, misoprostol or nimodipine can induce or inhibit labor through regulating expressions of VDCC L ? 1 and VDCC L ? 2 mRNA in the rat uterine myometrium and it may not have an adverse effect on heart function of normal pregnant rats. VDCC L may be the common channel of labor induced by internal or external factors.

Causes and Prevention of the Uterus Repture in an Outlying District of Hunan Province / 中国医师杂志

Objective To study the causes of the uterus rupture in an outlying district and prevent measures.Methods 17 cases of the uterus rupture in Yongshun county hospital were retrospectively analysized.Results Among 17 cases of uterus rupture,the average antenatal care was 0 4 times every pregnant women,bleeding volume were 1100 ml,12 cases of shock(70 6%) ,5 cases forced uterectomy(29 4%), 16 cases of perinatal death(94%). According to stages of taking place : ⑴15 cases had taken place during laboring without appointing inpatient ,13 patients giving birth at home while 2 patients in hospital , average total stages of labor 29.4h, abnormal fetal positions 14 cases, including 3 cases of primipara and 12 cases of multipara. ⑵ 2 cases of spontaneous uterus rupture occurred during pregnancy who have with the cesarean section history performed in small clinic in the country side.Conclusions In an outlying district, main causes of uterus rupture:⑴ Ignored antenatal care. ⑵ Producing at home so that dystocia were not dealt with properly during stage of labor, another was women with prolong labor treated incorrectly . ⑶ The Spontaneous rupture during pregnancy were close related to the history of the classical cesarean section .To prevent the uterus rupture should be enhanced prenatal care and examination forced pregnant women delivery in hospital, standarding medical practice of performing operation, so doing could sharply decrease the pregnant uterus rupture in an outlying district.

The Effect of ACA in Abnormal Delivery Women / 中国医师杂志

Objective To discuss the effect and the method of treatment of anti-cardiolipin antibody (ACA),ANA and ENA on abnormal delivery women,and their relationship with abnormal delivery.Methods The concentrations of plasman ACA,ANA,ENA and the times of abortion in abnormal delivery for 193 cases of abnormal delivery women and 100 cases of normal pregnancy were quarnlitatively detected and satistically analyzed.The 81 ACA positive patients were treated orally with aspirin,25 ACA and ANA/ENA positive patients were treated with aspirin combined with prednisone,and 3 ANA/ENA positive patients with prednisone treatment oral.Results The number of ACA and ANA positive patients was closely related to the types of abmormal delivery. The ANA and ENA positive patients was related to the times of abortion. There was no difference in the outcome of treatment between both therapies of aspirine and aspirine combined with prednisone in abnormal delivery women.Conclusions ACA is an important factor in causing abnormal delivery. No matter what ANA and ENA are in ACA positive patients,their can be treated with aspirin alone.

Quantitative study of kinetic turbidimetric limulus test for bacterial endotoxins in cisplatin injection / 中国药理学通报

AIM To investigate the feasibility of bacterial endotoxins test for cisplatin injection. METHODS Gel clot and kinetic turbidimetric limulus tests were applied. RESULTS After diluted to 0 14 g?L -1 ,six batches of cisplatin injection didn't interfere with the test for bacterial endotoxins, others except three also didn't interfere with the test at the concentration of 0 28 g?L -1 ; The content of bacterial endotoxins in all samples tested was not more than 1 8 ZU?g -1 . CONCLUSION The kinetic turbidimetric limulus test provides a new way to detect the content of endotoxins in cisplatin injection, samples can be diluted to 0 14 g?L -1 to refute their interfering effects on routine bacterial endotoxins test.