Cesarean section under spinal anesthesia seven years after heart-lung transplantation: a case report / 中华围产医学杂志

This article reported a successful cesarean section performed on a woman with 37 +6 weeks of gestation after heart-lung transplantation (HLTx) at the Second Xiangya Hospital of Central South University. The patient was a 29-year-old woman with singleton pregnancy who underwent HLTx seven years ago. During pregnancy, she was treated with azathioprine and tacrolimus to suppress immune rejection. The patient was in New York Heart Association (NYHA) class Ⅰ and had no fever or shortness of breath. Prenatal examinations indicated that the mother and the fetus were in good condition. A baby girl was delivered successfully at full term by a transverse lower-segment cesarean section under spinal anesthesia. Both the mother and the child were healthy at follow-up of 42 d after discharge.

Diagnosis of placenta previa accreta by two dimensional ultrasonography and color doppler in patients with cesarean section / 中南大学学报(医学版)

OBJECTIVE@#To determine the accuracy of two dismensional sonography and color doppler in diagnosing placenta previa accreta in patients with previous cesarean section.@*METHODS@#Forty-one patients with previous cesarean sections were confirmed to have partial or total placenta previa in the current pregnancy and were given ultrasound examinations after the 28th week of gestation. Specific ultrasound features of the placenta and its interphase with the uterus and the bladder for placenta accreta were checked by two-dimensional ultrasonography and color Doppler. All the patients were traced until delivery. The golden standard in diagnosis was the intraoperative finding and the pathologic exam.@*RESULTS@#Twenty-two patients had ultrasonographic evidence of placenta previa, 20 of which were later confirmed placenta previa accreta intraoperatively. Nineteen patients had no ultrasound evidence of placenta previa, and 1 of which was later confirmed placenta previa accreta. The sensitivity and specificity of antenatal ultrasound diagnosis of placenta previa accreta were 95.24% and 94.74% respectively. The most prominent feature to suggest placenta accreta in twodismensional sonography was the presence of multiple lakes that represented dilated vessels extending from the placenta through the myometrium. The most prominent color Doppler feature was the presence of interphase hypervascularity with abnormal vessels linking the placenta to the bladder, and the rate was 95.24%.@*CONCLUSION@#Placenta previa accreta can be diagnosed made with a thorough two dimensional ultrasonographic and color Doppler examination in patients with previous cesarean scar and placenta previa.

A study of comprehensive evaluation of index system in the teaching quality of obstetrics and gynecology / 中华医学教育探索杂志

Objective To make quantity evaluation of the teaching quality of various teaching models and ways in Obstetrics and Gynecology. Methods By the way of expert scores,evaluation indexes of the teaching quality were screened and the weight of each index was evaluated in Obstetrics and Gynecology. Teaching circumstances of common class and international standard test class of five-year system clinical medicine in 2005 grade were evaluated by the evaluation system. Results A comprehensive evaluation of index system which was divided by two grade and had 11 evaluation indexes had been constructed . Based on the new evaluation system and the results of student questionnaire,the index of comprehensive evaluation in international standard test class was significantly higher than that in common class(t=2.257,P=0.027). Conclusion The constructed comprehensive evaluation system of the teaching quality in Obstetrics and Gynecology can reflect the teaching circumstances. By using the teaching model of organ system and the Problem-Based Learning teaching way,the teaching quality in Obstetrics and Gynecology has been improved.

New study of obstetrics and gynecology novitiate on how to increase medical students' practical ability in eight-year program / 中华医学教育探索杂志

Objective To study the ways of obstetrics and gynecology noviciate on how to increase medical students' practical ability in eight-year program. Methods The three aspect studies ,such as experimental technology teaching on gynecology, clinical observation and thought of emergency and ward practice,and simulation teaching of clinical skill,has been accomplished in 50 students of eight-year program in the grade of 2004. Results Teaching achievements has been made in three aspects,such as the settlement of the difficulties in obstetrics and gynecology teaching, the increase of clinical skill and enhancement of practical chance in obstetrics and gynecology. Conclusions The studies of obstetrics and gynecology noviciate provide referenced teaching modes for increase medical students' practical ability in eight-year program.