Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, i...Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.展开更多
Background: Over the past years, scientists have been working on the mechanisms of the scarless healing. The remarkable phenotypic differences between fetal and adult healing may lead us to find out their characterist...Background: Over the past years, scientists have been working on the mechanisms of the scarless healing. The remarkable phenotypic differences between fetal and adult healing may lead us to find out their characteristics in genetics, which represent potentially important mechanisms to explain the differences in the quality of wound repair observed in fetus versus adult tissues. Methods: Middle laparotomy and hysterotomy were performed on pregnant rabbits on 20-day gestation to expose the fetal back, and longitudinal incision which penetrated full skin was made on the back of fetus. The trauma fetus skin was harvested at 12 h post-operation (FT), the fetus control (FC) and trauma adult skin (AT) were taken at the same time. dscDNA was synthesized from total RNA of skin samples with SMART technology. An improved suppression subtractive hybridization (SSH) method was applied to analyze the samples. Having taken one of the three samples as Tester respectively, the other two together as Drivers, one forward and two reverse hybridization products were gotten. Having amplified by selective PCR, the products were inserted into vector, and then transferred into E.coli HB101. The colonies were screened by electrophoresis, reverse Northern afterwards, and the positive clones were sequenced. BLAST in NCBI was performed to compare and analyze the positive clones (expressed sequence Tag, ESTs). Results: Totally 298 clones were gotten and 61 positive clones were obtained after screening. The 61 selected positive clones were sequenced and 54 sequences were goten. Conclusion: Instead of traditional SSH, an improved SSH with 2 Drivers was applied in the experiment. The improved program is reasonable and correct in both theory and practice.展开更多
文摘Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.
文摘Background: Over the past years, scientists have been working on the mechanisms of the scarless healing. The remarkable phenotypic differences between fetal and adult healing may lead us to find out their characteristics in genetics, which represent potentially important mechanisms to explain the differences in the quality of wound repair observed in fetus versus adult tissues. Methods: Middle laparotomy and hysterotomy were performed on pregnant rabbits on 20-day gestation to expose the fetal back, and longitudinal incision which penetrated full skin was made on the back of fetus. The trauma fetus skin was harvested at 12 h post-operation (FT), the fetus control (FC) and trauma adult skin (AT) were taken at the same time. dscDNA was synthesized from total RNA of skin samples with SMART technology. An improved suppression subtractive hybridization (SSH) method was applied to analyze the samples. Having taken one of the three samples as Tester respectively, the other two together as Drivers, one forward and two reverse hybridization products were gotten. Having amplified by selective PCR, the products were inserted into vector, and then transferred into E.coli HB101. The colonies were screened by electrophoresis, reverse Northern afterwards, and the positive clones were sequenced. BLAST in NCBI was performed to compare and analyze the positive clones (expressed sequence Tag, ESTs). Results: Totally 298 clones were gotten and 61 positive clones were obtained after screening. The 61 selected positive clones were sequenced and 54 sequences were goten. Conclusion: Instead of traditional SSH, an improved SSH with 2 Drivers was applied in the experiment. The improved program is reasonable and correct in both theory and practice.
