[Research on the trend of the decrease of human chorionic gonadotropin in the treatment of cesarean scar pregnancy by different surgical treatments].

OBJECTIVE: To explore the clinical effect of different surgical methods in the treatment of cesarean scar pregnancy, the decline trend of human chorionic gonadotropin (hCG) and the indications of different treatment methods. METHODS: This study was a prospective cohort study. The clinical data of 120 patients with cesarean scar pregnancy who were treated with four different surgical methods in the Beijing Obstetrics and Gynecology Hospital from June 2013 to December 2014 were collected. Seven cases ultrasonic curettage, 63 cases uterine arterial embolization (UAE) with hysteroscopic pregnancy embryo removal surgery, 41 cases UAE + B-ultrasound or laparoscopic monitoring hysteroscopic pregnancy embryo clearance surgery and 9 cases UAE + hysteroscopic and laparoscopic removal of pregnancy scar and uterine repair. The clinical efficacy of different surgical methods and the decrease trend of serum HCG in postoperative period were analyzed. RESULTS: (1)The levels of serum beta hCG in patients with cesarean scar pregnancy after different surgical treatments decreased (84.5±9.7)%, (97.7±3.2)% and (99.6±1.2)% after the 2 days, 7 days and 14 days respectively. The average time of blood beta hCG level dropped to normal was (22.4±6.7) d. (2)There was a significant difference in the amount of bleeding and the time of hospitalization among the patients treated with different surgical methods. (3)There was a significant difference in the analysis of the decline percentage rate of serum beta hCG under the interactive effect between different surgical methods and postoperative recovery time (P<0.01). CONCLUSION: The level of serum beta hCG in patients with cesarean scar pregnancy were reduced to normal range after 3 weeks of operation. The choice of surgical approach should be based on the degree of implantation of embryo sac scar, the thinnest muscle thickness, local blood flow, serum beta hCG levels, gestational sac size, process to the bladder and fertility desire to determine.

[Observation on the fluidity of human erythrocyte membranes in patients with blood stasis syndrome].

In order to approach the relationship between the TCM typology of blood stasis syndrome and the fluidity of human erythrocyte membrane, the fluidity of human erythrocyte membrane was examined in 14 healthy volunteers, 21 patients with coronary heart disease and 14 patients with cancer by measuring the degree of fluorescence polarization using DPH as a fluorescent probe. The patients with coronary heart disease and the cancer patients were all of the TCM typology of blood stasis syndrome. The results showed: (1) The fluorescence polarization (P) of normal group was 0.294 +/- 0.007, and the microviscosity (pi) was 3.656 +/- 0.237. (2) The P of the group of coronary heart disease with blood stasis syndrome was 0.328 +/- 0.013, and the pi was 6.787 +/- 1.028. Both were significantly higher than those of the normal group (P less than 0.05). (3) The P of the group of cancer with blood stasis syndrome was 0.333 +/- 0.011, and the pi was 6.698 +/- 1.357. Both were significantly higher than those of the normal group (P less than 0.05). (4) Yet no significant difference was noticed between the group of coronary heart disease and the group of cancer (P greater than 0.05). The higher the pi of erythrocyte membrane, the lower the fluidity of erythrocyte membrane. The lower fluidity of erythrocyte membrane in patients with blood stasis syndrome can result in the declined ability of erythrocytic deform which can accelerate the disturbance of microcirculation. This accords with the TCM theory about blood stasis syndrome.