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From December 2016 to February 2018,5 patients with type Ⅲ or mass type cesarean scar pregnancy (CSP) were treated in Zhejiang Taizhou Hospital.The clinical features,imaging findings and disease outcome were retrospectively analyzed.There were 3 cases of type Ⅲ and 2 cases of mass type,which were diagnosed by transvaginal ultrasound.The CSPs were resected with combination of laparoscopy and hysteroscopy,the average intraoperative blood loss was 80 ml (50-100 ml) and there were not postoperative complications.The average length of hospital stay was 9.4 days (8-12 d).Postoperative serum β-hCG returned to normal in average 22 days (14-30 d),and the menstruation recovered in 22-39 days after operation.The data indicates that resection of type Ⅲ or mass type caesarean scar pregnancy with a combination of laparoscopy and hysteroscopy is an effective treatment.
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Objective To compare the clinical efficacy of laparoscopic radical resection of cervical cancer and laparotomy in the treatment of early cervical cancer.Methods From March 2015 to March 2017,102 patients with early cervical cancer in Taizhou Hospital were selected and randomly divided into control group and study group according to the digital table,with 51 cases in each group.The control group received traditional open surgery,the study group received laparoscopic surgery for cervical cancer.The operation time,intraoperative blood loss,postoperative first exhaust time,postoperative hospital stay,pelvic lymph node dissection and complication occurred in both two groups were observed and recorded in hysteroscopic cervical cancer.Results The operation time of the study group was significantly longer than that of the control group [(239.3 ±66.7)min vs.(156.9 ±41.5)min,t=5.65,P<0.01],the amount of intraoperative blood loss,the time of first postoperative exhaust and postoperative hospital stay of the study group were significantly less/shorter than those of the control group [(299.8 ±49.2)mL vs.(361.4 ± 60.3)mL,(44.6 ±6.7)min vs.(62.5 ±7.0)min,(6.5 ±2.3)d vs.(10.9 ±4.4)d,t=7.49,13.19,6.33,all P<0.01].And the number of pelvic lymph node dissection of the study group was significantly higher than that of the control group[(28.2 ±3.9)vs.(18.8 ±4.1),t=11.86,P<0.01].The incidence rate of postoperative complications in the study group was 9.8％,which in the control group was 25.5％,the difference was statistically significant(χ2 =0.092,P=0.035).Conclusion Laparoscopic radical resection of cervical cancer is superior to traditional laparotomy in the treatment of early cervical cancer.It has advantages of good clinical efficacy and less complication.It is worthy of clinical application.
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Objective To investigate the clinical effect of methotrexate combined with dilatation and curettage on the treatment of cesarean section scar pregnancy and the effect on HCG (chorionic gonadotropin). Methods 130 cases with cesarean section scar pregnancy admitted in Taizhou hospital from January 2016 to March 2017 were randomly divided into two groups. The control group wasreceived dilatation and curettage. The study group was given methotrexate combined with dilatation and curettage.The effect and the influence to HCG in the two groups were compared. Results The effective rate in the study group was significantly higher than that in the control group (P<0.05). There was no significant difference in HCG level between the two groups before treatment. The levels of HCG in the study group were significantly lower than that in the control group (P<0.05). Conclusion Methotrexate combined with curettage on the treatment of cesarean scar pregnancy, can improve the therapeutic effect, reduce postoperative bleeding and hospitalization time, reduce the level of HCG.
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AIM:To analyze the mechanism of tumor-associated macrophage (TAMs) in the development of cervical cancer and to investigate its correlation with Th1/Th2 and Th17/CD4+ CD25+ Foxp3 + Treg.METHODS:Twenty seven cases of cervical cancer and 53 cases of cervical intraepithelial neoplasias (including 22 cases of CIN Ⅱ and 31 cases of CIN Ⅲ) were selected as subjects.The venous blood of patients before treatment was extracted to detect Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg with flow cytometry,and detect serum IFN-γ,IL-4,IL-17A,IL-17F,TGF-β1 and IL-10 levels with ELISA Kits.Furthermore,pathological tissues were extracted during operation,and its TAMsCD68 expression was detected by immunohistochemistry technique.RESULTS:The Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg of cervical cancer were both lower than those of CIN Ⅲ,and those of CIN Ⅲ were both lower than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The serum IFN-γ,IL-4,IL-17A,IL-17F,TGF-β1 and IL-10 levels of cervical cancer were all higher than those of CIN Ⅲ,and those of CIN Ⅲ were all higher than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The TAMsCD68 expression level of cervical cancer was higher than that of CIN Ⅲ,and that of CIN Ⅲ was lower than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The correlation analysis results showed TAMsCD68 expression level had negative correlations with Th1/Th2,Th17/CD4+CD25+ Foxp3+ Treg,and serum IL-17A level,whereas presented positive correlations with serum IL-10 and IL-4 level (P ＜ 0.05).CONCLUSION:TAMs is closely related with Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg in cervical cancer,and possibly is mediating the occurrence and development of cervical cancer through influencing the balance of these two systems.