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1.
Article in Chinese | WPRIM | ID: wpr-910165

ABSTRACT

Objective:To study the risk factors of adverse pregnancy outcomes for induced abortion of cesarean scar pregnancy in midtrimester.Methods:A national multicenter retrospective study was conducted. A total of 154 singletons pregnant women with cesarean scar pregnancy during the second trimester induced abortion by various reasons in 12 tertiary A hospitals were selected, their pregnant outcomes were observed and the risk factors of serious adverse outcomes were analyzed with univariate and multivariate logstic regression; the role of ultrasound and MRI in predicting placenta accreta and severe adverse outcomes was evaluated, the effectiveness of uterine artery embolization (UAE) in preventing hemorrhage in pregnant women with and without placenta accreta was compared.Results:Among 154 subjects, the rate of placenta accreta was 42.2% (65/154), the rate of postpartum hemorrhage≥1 000 ml was 39.0% (60/154), the rate of hysterectomy was 14.9% (23/154), the rate of uterine rupture was 0.6% (1/154). The risk factor of postpartum hemorrhage≥1 000 ml and hysterectomy was placenta accreta ( P<0.01). For each increase in the number of parity, the risk of placenta accreta increased 2.385 times (95% CI: 1.046-5.439; P=0.039); and the risk of placenta accreta decreased with increasing ultrasound measurement of scar myometrium thickness ( OR=0.033, 95% CI: 0.001-0.762; P=0.033). The amount of postpartum hemorrhage and hysterectomy rate in the group with placenta accreta diagnosed by ultrasound combined with MRI were not significantly different from those in the group with placenta accreta diagnosed by ultrasound only or MRI only (all P>0.05). For pregnant women with placenta accreta, there were no significant difference in the amount of bleeding and hysterectomy rate between the UAE group [median: 1 300 ml; 34% (16/47)] and the non-embolization group (all P>0.05); in pregnant women without placenta accreta, the amount of bleeding in the UAE group was lower than that in the non-embolization group (median: 100 vs 600 ml; P<0.01), but there was no significant difference in hysterectomy rate [2% (1/56) vs 9% (3/33); P>0.05]. Conclusions:(1) Placenta accreta is the only risk factor of postpartum hemorrhage≥1 000 ml with hysterectomy for induced abortion of cesarean scar pregnancy in midtrimester; multi-parity and ultrasound measurement of scar myometrium thickness are risk factors for placenta accreta. (2) The technique of using ultrasound and MRI in predicting placenta accreta of cesarean scar pregnancy needs to be improved. (3) It is necessary to discuss of UAE in preventing postpartum hemorrhage for induced abortion of cesarean scar pregnancy in midtrimester.

2.
Article in Chinese | WPRIM | ID: wpr-700585

ABSTRACT

Objective The blending instructional teaching mode was used in the obstetrical resi-dent standardization training course and the effect was evaluated. Methods 36 resident physicians who attended obstetrical resident standardization training were chosen as blending instructional teaching group and traditional teaching group, 18 physicians per group. The physicians of blending instructional teaching group received blending instructional teaching mode, which included the obstetrical MOOC and Flipped Class, while the traditional teaching group only took part in the clinical management ruled by the hospital. Staging examination was performed according to the resident physician culture curriculum. Descriptive statistics, t test and chi-square test were performed by SPSS 21.0 lines. Results The average score of theory examination [(93.21±5.40) vs. (81.32±7.10)], practical skill [(89.75±4.70) vs. (68.96±8.20)] and clinical intellectual [(88.64±9.30) vs. (75.88±9.70)] in the blending instructional teaching group was significantly higher than that in the traditional teaching group (P<0.05). The physicians' satisfaction rate of manipulative ability in the blending instructional teaching group was significantly higher than that in the traditional teaching group (72.22% vs. 16.76%), which had statistical significance ( χ2=16.74, P=0.003); The physi- cians' satisfaction rate for the tutor in the blending instructional teaching group was significantly higher than that in the traditional teaching group (83.30% vs. 11.11%), which had statistical significance ( χ2=21.67, P=0.000). Conclusion The blending instructional teaching mode adapts to the development trend of teaching , and improves the effect of obstetrical resident standardization training course.

3.
Article in Chinese | WPRIM | ID: wpr-556305

ABSTRACT

Objective To construct a subtractive cDNA library of genes differentially expressed in human lymphoma cell line Jurkat cells treated with glycyrrhizin (GL), and to clone genes associated with its immunological regulation, and to further elucidate the molecular immune mechanism of GL. Methods The mRNA was isolated from Jurkat cells treated with either GL or 0.9 percent sodium chloride as a control, then cDNA was synthesized. Suppression subtractive hybridization (SSH) method was employed to analyze the differentially expressed DNA sequence between the two groups. The cDNA was sequenced and analyzed in GenBank with Blast search after the amplification of the subtractive library by PCR. Results The amplified library contained 28 positive clones. Colony PCR analysis showed that there were 22 clones containing 200-1 000 bp inserts. Sequence analysis was performed, and the full length sequences were obtained with bioinformatics method. Altogether 11 kinds of encoding sequences were achieved, including interleukin-12, interleukin-18, and thymosin ?1, etc. Conclusions A subtractive cDNA library of genes differentially expressed in Jurkat cells treated with GL using SSH technique was constructed successfully, and it might give some new clues for the study of the immune regulation mechanism of GL.

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