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OBJECTIVE@#To study the chemical constituents from the roots of Curcuma longa.@*METHODS@#The structures of the compounds were elucidated based on extensive spectral analysis, including 1D and 2D NMR, MS, UV, and CD analysis.@*RESULTS@#Two new sesquiterpene compounds (1S,2R,5R,7S,8R)-2,8-epoxy-5-hydroxybisabola-3,10-dioen-9-one ( 1), (1R,2R,5R,7S,8R)-2,8-epoxy-5-hydroxybisabola-3,10-dioen-9-one ( 2), and a new natural product 6-(4-Hydroxymethylphenyl)-2-methyl-hept-2-ene-4-one ( 3) together with three known compounds ar-turmerone ( 4), 2-methyl-6-(4-hydroxyphenyl-3-methyl)-2-hepten-4-one ( 5) and 2-methyl-6-(4-hydroxyphenyl)-2-hepten-4-one ( 6) were isolated from C. longa root extract with 95% ethanol.@*CONCLUSION@#In the study, three new compounds were isolated from C. longa, and their absolute configurations were determined.
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Objective:To analyze the value of laminin γ2 (LAMC2) in the diagnosis of hepatocellular carcinoma (HCC) and the difference in patients with different types of microvascular invasion (MVI).Methods:A cohort of 100 patients with HCC who underwent surgical treatment at the Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital from January 2021 to March 2022 were prospectively enrolled. There were 80 males and 20 females, aged (55.7±11.1) years. The data of 17 patients with hepatic hemangioma without cirrhosis who underwent operation at the same hospital during the study period were collected to serve as the control group (6 males, 11 females), aged (42.8±9.8) years. LAMC2 in serum was determined by enzyme linked immunosorbent assay. The levels of alpha-fetoprotein (AFP) and LAMC2 were compared between the two groups, and receiver operating characteristic (ROC) curves were drawn to compare these two markers in the diagnosis of HCC. The LAMC2 of different MVI patients were compared.Results:The levels of LAMC2 and AFP were 1 334.2(838.9, 2 656.0) pg/ml and 19.0(4.6, 778.6) μg/L in the HCC group, which were significantly higher than 375.2(221.2, 691.7)pg/ml and 3.3(2.5, 3.5) μg/L in the control group ( Z=-4.32, -4.63, both P<0.001). The areas under the ROC curve were 0.829(95% CI: 0.748-0.892) for LAMC2 and 0.852(95% CI: 0.769-0.910) for AFP, and was 0.949(95% CI: 0.911-0.988) for using both in the diagnoses. The diagnostic efficacy of combining LAMC2 and AFP was significantly better than that of LAMC2 alone and AFP alone (area under ROC: Z=3.15, 3.07, P=0.002, 0.002). When the patients were divided into the M0 group (61 patients), the M1 Group (25 patients) and the M2 Group (14 patients) based on MVIs, the concentrations of LAMC2 were 1 168.6(834.3, 2 521.4) pg/ml, 942.2(614.0, 2 056.6) pg/ml and 3 128.4(1 852.7, 7 191.3) pg/ml, respectively. The level of LAMC2 in the M2 group was significantly higher than that in the M0 and M1 groups ( Z=-3.46, -3.32, P=0.001, 0.004). Conclusion:The diagnostic efficacy of LAMC2 combined with AFP for HCC was significantly higher than that of either LAMC2 alone or AFP alone. Serum LAMC2 levels were significant different among the groups of HCC patients with different types of MVI.
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Objective:To investigate the clinical efficacy of ultrasound-guided closed reduction and percutaneous Kirschner wire fixation in the treatment of supracondylar fractures of the humerus in children.Methods:The clinical data of 78 children with Gartland type II and type III straight-type supracondylar fractures of the humerus who received treatment in The First Affiliated Hospital of Anhui Medical University from October 2019 to October 2022 were retrospectively analyzed. These children were divided into an observation group ( n = 38) and a control group ( n = 40) according to different treatment methods. The observation group was subjected to ultrasound-guided closed reduction and percutaneous Kirschner wire fixation. The control group was given C-arm fluoroscopy-guided closed reduction and percutaneous Kirschner wire fixation. Mayo elbow performance score (MEPS), clinical healing time, operative time, and the incidence of intraoperative complications such as vascular and nerve injury were compared between the two groups. Results:Both groups of children achieved closed reduction without open reduction. The operative time in the observation group was (30.68 ± 5.45) minutes, which was significantly shorter than (40.54 ± 5.78) minutes in the control group ( t = 2.30, P < 0.05). The healing time of the fracture in the observation and control groups was (32.73 ± 4.56) days and (36.47 ± 6.24) days, respectively, and there was no significant difference between the two groups ( P > 0.05). The range of joint motion and elbow hyperextension angle range in the observation group were (148.78 ± 3.81)° and (8.72 ± 8.92)°, respectively, and they were (147.24 ± 4.36)° and (7.98 ± 8.86)°, respectively in the control group. There were no significant differences in the range of joint motion and elbow hyperextension angle range between the two groups (both P > 0.05). The excellent and good rate of joint function in the control and observation groups was 92.5% (37/40) and 92.1% (35/38), respectively. There was no significant difference in excellent and good rate of joint function between the two groups ( P > 0.05). There were three cases of postoperative nerve damage in the control group and no vascular or nerve damage was observed in the observation group. There were significant differences in the number of cases of vascular or nerve injury between the two groups ( χ2 = 3.97, both P < 0.05). Conclusion:Ultrasound-guided closed reduction and percutaneous Kirschner wire fixation for the treatment of supracondylar fractures of the humerus can shorten the operative time, decrease the incidence of intraoperative nerve injury, and reduce the X-ray exposure time of doctors and patients.
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Objective To investigate the current distribution of ticks and predict the suitable habitats of ticks in the Yangtze River Delta urban agglomeration in 2017, so as to provide insights into tick control and management of tick-borne diseases in these areas. Methods All publications pertaining to tick and pathogen distribution in the Yangtze River Delta urban agglomeration were retrieved, and the geographical location of tick distribution was extracted. The effects of 19 climatic factors on the distribution of ticks were examined using the jackknife method, including the mean temperature of the wettest quarter, precipitation of the coldest quarter, mean temperature of the driest quarter, maximum temperature of the warmest month, precipitation of the driest month, minimal temperature of the coldest month, annual precipitation, mean daily temperature range, precipitation seasonality, annual temperature range, temperature seasonality, annual mean temperature, mean temperature of the warmest quarter, precipitation of the wettest quarter, isothermality, mean temperature of the coldest quarter, precipitation of the wettest month, precipitation of the driest quarter and precipitation of the warmest quarter. The distribution of ticks was analyzed in 2020 using the maximum entropy (MaxEnt) model, and the potential suitable habitats of ticks were predicted in 2070 using the MaxEnt model based on climatic data. Results A total of 380 Chinese and English literatures were retrieved, and 148 tick distribution sites were extracted, with 135 sites included in the subsequent analysis. There were 7 genera (Haemaphysalis, Rhipicephalus, Ixodes, Dermacentor, Boophilus, Hyalomma and Amblyomma) and 27 species of ticks detected in the Yangtze River Delta urban agglomeration. The climatic factors affecting the distribution of ticks in the Yangtze River Delta urban agglomeration mainly included the mean temperature of the wettest quarter and the precipitation of the coldest quarter, with 26.1% and 23.6% contributions to tick distributions. The high-, medium- and low-suitable habitats of ticks were 20 337.08, 40 017.38 km2 and 74 931.43 km2 in the Yangtze River Delta urban agglomeration in 2020, respectively. The climate changes led to south expansion of the suitable habitats of ticks in the Yangtze River Delta urban agglomeration in 2070, and the total areas of suitable habitats of ticks was predicted to increase by 18 100 km2. In addition, the high-, medium- and low-suitable habitats of ticks were predicted to increase to 24 317.84, 45 283.02 km2 and 83 766.38 km2 in the Yangtze River Delta urban agglomeration in 2070, respectively. Conclusions Multiple tick species are widespread in the Yangtze River Delta urban agglomeration, and the future climate changes may lead to expansion of tick distribution in these areas.
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Objective To evaluate the impact of environmental and climatic factors on the distribution of suitable habitats of Haemaphysalis longicornis, and to predict the potential distribution of H. longicornis under different climate patterns in China. Methods Data pertaining to the distribution of H. longicornis were retrieved from public literatures. The effects of 19 climatic factors (annual mean temperature, annual mean temperature difference between day and night, isothermality, standard deviation of seasonal variation of temperature, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest season, mean temperature of the driest season, mean temperature of the warmest season, mean temperature of the coldest season, annual mean precipitation, precipitation of the wettest month, precipitation of the driest month, coefficient of variance of precipitation, precipitation of the wettest season, precipitation of the driest season, precipitation of the warmest season and precipitation of the coldest season) and 4 environmental factors (elevation, slope, slope aspect and vegetation coverage) on the potential distribution of H. longicornis were assessed using the maximum entropy (MaxEnt) model based on the H. longicornis distribution data and climatic and environmental data, and the potential distribution of H. longicornis was predicted under the RCP 2.6 and 8.5 emissions scenarios. Results Among the environmental and climatic factors affecting the geographical distribution of H. longicornis in China, the factors contributing more than 10% to the distribution of H. longicornis mainly included the precipitation of the driest month (26.0%), annual mean temperature (11.2%), annual mean precipitation (10.0%) and elevation (24.2%). Under the current climate pattern, the high-, medium- and low-suitable habitats of H. longicornis are 1 231 900, 1 696 200 km2 and 1 854 400 km2 in China, respectively. The distribution of H. longicornis increased by 336 100 km2 and 367 300 km2 in 2050 and 2070 under the RCP 2.6 emissions scenario, and increased by 381 000 km2 and 358 000 km2 in 2050 and 2070 under the RCP 8.5 emissions scenario in China, respectively. Conclusions Climatic and environmental factors, such as precipitation, temperature and elevation, greatly affect the distribution of H. longicornis in China, and the suitable habitats of H. longicornis may expand in China under different climate patterns in future.
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Objective To evaluate the effects of environmental factors the distribution of Ixodes persulcatus, and to predict the future suitable habitats of I. persulcatus in China. Methods The known distribution sites of I. persulcatus in China were captured from national and international published literatures. The effects of 14 environmental factors on the distribution of I. persulcatus were examined using the Jackknife test, including mean annual temperature, mean monthly temperature range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the wet-test quarter, mean temperature of the coldest quarter, annual mean precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, precipitation of the warmest quarter, precipitation of the coldest quarter, elevation, slope, aspect and vegetation. The suitable habitats of I. persulcatus were predicted in China using the maximum entropy model and ArcGIS 10.7 software with the environmental factors. Results Currently, the highly suitable habitats of I. persulcatus covered an area of 886 600 km2 in China, which were predominantly located in northeastern China. The environmental factors that contributed more than 10% to the distribution of the suitable habitats of I. persulcatus in China included annual temperature variation range (39.1%), the coldest quarterly precipitation (23.2%), and the annual mean precipitation (11.9%). Based on the maximum entropy model, the suitable habitats of I. persulcatus were predicted to show a shrinking tendency towards northeastern China in 2070. Conclusions The suitable habitat of I. persulcatus strongly correlates with temperature and precipitation, and climate and environmental changes may lead to shrinking of the future suitable habitat of I. persulcatus in China.
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Objective To identify the environmental factors affecting the distribution of suitable habitats of Ixodes ovatus, and to examine the effects of environmental changes on the distribution of suitable habitats of I. ovatus. Methods Data pertaining to the distribution of I. ovatus in China were captured by literature review. The distribution of suitable habitats of I. ovatus in China was simulated using the maximum entropy model with the environmental variable data and the I. ovatus distribution data. In addition, the potential distribution of suitable habitats of I. ovatus was predicted based on the 2050 and 2070 environmental data. Results The current suitable habitats of I. ovatus cover 3.11 million km2, accounting for 32.28% of the total land area of China, and they are mainly concentrated in southwestern and northwestern China. Among the screened 16 environmental factors, the standard deviation of seasonal variation of temperature, average annual precipitation and altitude were predominant environmental factors affecting the distribution of suitable habitats of I. ovatus, and these three variables contributed 76.5% to the distribution of suitable habitats of I. ovatus in China. The suitable habitats of I. ovatus were predicted to showing a tendency towards expansion to northwestern and northeastern China in 2050 and 2070, and the proportion of highly suitable habitats of I. ovatus was predicted to increase. Conclusions Moderate climate, adequate precipitation and high altitude are favorable for the survival of I. ovatus. Future climate changes may cause expansion of suitable habitats of I. ovatus in China.
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Objective To identify the environmental factors affecting the geographical distribution of Rhipicephalus microplus in China, and to examine the impact of climate changes on the distribution of R. microplus in China. Methods The national and international publications pertaining to the geographical distribution of R. microplus in China were retrieved, and the geographical location was extracted. The suitable habitats of R. microplus and the dominant environmental factors affecting the distribution of suitable habitats of R. microplus were predicted in China based on the geographical data and environmental variables using the ArcGIS 10.7 software and the maximum entropy model. Results Among the main climatic factors affecting the geographical distribution of R. microplus in China, the factors contributing more than 10% to the suitable habitats of R. microplus mainly include the annual mean precipitation (38.2%), the average temperature of the coldest quarter (28.4%) and the precipitation of the driest month (14.2%). The current suitable habitats of R. microplus were mainly found in southern China, and the high-, medium- and low-suitable areas accounted for 8.6%, 13.1% and 10.5% of the total land area of China, respectively. The suitable habitats of R. microplus were predicted to increase by 399 800 km2 in China using the maximum entropy model under the RCP 4.5 emissions scenario in 2070, and the emerging suitable habitats were mainly distributed in Gansu Province, Ningxia Hui Autonomous Region, Qinghai Province, Hebei Province, Shaanxi Province, Liaoning Province, Inner Mongolia Autonomous Region, Shandong Province, Sichuan Province and Tibeten Autonomous Region. In addition, the suitable habitats of R. microplus were predicted to show an overall expansion towards northward from present to 2070. Conclusions Climate changes affect the distribution of suitable habitats of R. microplus in China, and annual mean precipitation may be a key factor affecting the distribution of suitable habitats of R. microplus.
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Since December, 2019, the epidemic of COVID-19 occurred in Wuhan, Hubei Province. In the late of January, 2020, a patient, who had exposed to a COVID-19 suspect, had a severed finger and underwent finger re- transplantation surgery in our hospital.
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Objective@#To investigate whether diffusion tensor imaging (DTI) and motor evoked potentials (MEP) can be used as biomarkers to assess the degree of motor dysfunction of stroke survivors.@*Methods@#Sixty partially-paralyzed stroke survivors were given Fugl-Meyer assessments (FMAs) and MEP tests and assessed using DTI seeking any correlations among the results. The receiver operating characteristics curves (ROCs) were prepared to determine the tests′ efficacy in assessing severe motor dysfunction.@*Results@#① Asymmetry in the fractional anisotropy (aFA) of the peduncles cerebra as measured by DTI was negatively correlated with the FMA scores of the upper and lower limbs on the affected side. The aFA values of the posterior limb of the internal capsule (PLIC) were negatively correlated with the FMA scores of the affected upper limb, but not with the FMA scores of the affected lower limbs. The abnormalities in central motor conduction time and motor threshold, which are MEP parameters, were negatively correlated with the FMA scores of the affected limbs. ② The ROCs showed that the aFA value of the PLIC was the best indicator for assessing severe upper limb motor dysfunction, with a cut-off value of 0.167 giving the best discrimination. MEP waveform loss could also be used. It has high sensitivity but low specificity. ③ A combination of DTI and MEP can improve specificity in assessing severe motor dysfunction in the upper limbs.@*Conclusion@#DTI and MEP can both be used to evaluate motor dysfunction in stroke survivors. They have high clinical value for assessing severe motor dysfunction of the upper limbs.
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Objective To investigate whether diffusion tensor imaging ( DTI) and motor evoked potentials (MEP) can be used as biomarkers to assess the degree of motor dysfunction of stroke survivors. Methods Sixty partially-paralyzed stroke survivors were given Fugl-Meyer assessments ( FMAs) and MEP tests and assessed using DTI seeking any correlations among the results. The receiver operating characteristics curves ( ROCs) were prepared to determine the tests' efficacy in assessing severe motor dysfunction. Results ① Asymmetry in the fractional ani-sotropy ( aFA) of the peduncles cerebra as measured by DTI was negatively correlated with the FMA scores of the up-per and lower limbs on the affected side. The aFA values of the posterior limb of the internal capsule ( PLIC) were negatively correlated with the FMA scores of the affected upper limb, but not with the FMA scores of the affected low-er limbs. The abnormalities in central motor conduction time and motor threshold, which are MEP parameters, were negatively correlated with the FMA scores of the affected limbs. ②The ROCs showed that the aFA value of the PLIC was the best indicator for assessing severe upper limb motor dysfunction, with a cut-off value of 0.167 giving the best discrimination. MEP waveform loss could also be used. It has high sensitivity but low specificity. ③A combination of DTI and MEP can improve specificity in assessing severe motor dysfunction in the upper limbs. Conclusion DTI and MEP can both be used to evaluate motor dysfunction in stroke survivors. They have high clinical value for assess-ing severe motor dysfunction of the upper limbs.
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Objective: To explore the value of nanoparticles (CN) in lateral cervical lymph node mapping in papillary thyroid carcinoma using carbon. Methods: Thyroid cancer patients with suspicious lymph node metastasis but without typical signs of metastatic disease from March 2016 to November 2017 in Fudan University Shanghai Cancer Center were prospectively included in the cohort. Neck dissection was performed in all patients (compartmentsⅡ-Ⅴ). Suspicious lateral lymph node metastasis was identified using pre-operative ultrasound or computed tomography. CN were used for lymph node mapping during surgery. Results: A total of 70 surgeries were performed in 67 patients, among which 57 were found to have lateral lymph node metastasis (81.4%). The median number of CN-dyed lateral lymph nodes was 6. Compartment IV had the highest number of CN-dyed positive lymph nodes as well as the highest rate of metastasis, followed by compartmentⅢ. In compartmentsⅢandⅣ, the incidence of lymph node metastasis was significantly higher in the CN-dyed group than in the CN-undyed group (P<0.001). When the final pathology of neck dissection was set as the gold standard, lateral CN-dyed lymph node biopsy was found to have a sensitivity of 86.0%; its negative predictive value was 61.9% and its overall accuracy was 88.6%. Conclusions:Injection of CN during surgery was a potential method of mapping lateral lymph nodes in papillary thyroid carcinoma. CompartmentⅢ-ⅣCN-dyed lymph node biopsy had a satisfactory sensitivity and thus, served as a reasonable range for lymph node biopsy.
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Objective To observe the reception of using pig bone marrow stromal cells (BMSCs) that were transfected with human tissue factor pathway inhibitor (TFPI) to resolve the dysregulation of coagulation after liver xenotransplantation.Methods Pig BMSCs were immortalized by transfection with lentivirus containing SV40T and then transfection with human TFPI.At last the cells were tested for their ability to inhibit clotting in a model by co-incubation of human plasma,human monocytes and pig aortic endothelial cells.Results After transfection with SV40T,pig BMSCs were immortalized and similar to primary cells.The immortalized pig BMSCs showed a stable TFPI expression after transfection with human TFPI by lentivirus.Moreover,they showed the potential of regulating coagulation dysregulation in vitro.Conclusion Pig BMSCs transfected with human TFPI could solve the regulation dysregulation caused by TF activation effectively,and have the potential of resolving coagulation dysregulation in liver xenotransplantation.
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Stanniocalcin (STC) was ifrst found as a calcium- and phosphate-regulating hormone produced in bony ifsh by the corpuscles of Stannius. In mammals, the homolog STC-1 displays a relative high amino acid sequence identity (nearly 50%) with ifsh STC, and STC-2 has a lower identity (nearly 35%) with STC-1 and ifsh STC. Both STC-1 and STC-2 are expressed in a variety of tissues. The functions of STC have not been understood. But some ifndings have been reported on their cellular localization, gene structure, and expression in different physiological and pathological conditions, which will be clues in elucidating the functions of STC in mammals. Moreover, STC-1 and STC-2 are expressed in many tumor cell lines, suggesting other biological functions of STC in mammals other than mineral metabolism.
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Objective To investigate the related factors on effects of uterine artery embolization (UAE) in the treatment of dysmenorrhea in patients with adenomyosis, and to construct and validate the efficacy prediction model. Methods A total of 127 cases of adenomyosis patients with symptoms of dysmenorrhea in Guangzhou No.1 People′s Hospital and Nanfang Hospital of Southern Medical University from June 1999 to December 2009 were reviewed. The evaluation standard was to improve the degree of dysmenorrhea, the related factors of efficacy were analysed. Combined with artificial neural network theory, the effect prediction model was constructed, and the effectiveness of the model was evaluated using receiver operating characteristic (ROC) curve, and the effectiveness of the cut-off point was calculated. The model was validated by 68 cases of patients with adenomyosis in the Nanfang Hospital from January 2010 to November 2014. Results (1) In 127 cases of dysmenorrhea patients, UAE treatment was effective in 98 cases, effective rate was 77.2% (98/127). (2) Age was an independent predictor of effective UAE treatment (HR=1.129, P=0.026);in the range of this study, the greater the age, the higher the UAE treatment efficiency. (3) The developing situation of ovary branches of uterine artery was an independent predictor of effective UAE treatment (HR=0.460, P=0.020), the efficiency of patients whose intraoperative bilateral uterine artery ovarian branch did not develop was 89.7%(35/39), the efficiency of patients whose unilateral uterine artery ovarian branch was developing was 84.1% (37/44) and the efficiency of patients whose bilateral uterine artery ovarian branch were developing was 59.1% (26/44). (4) Blood supply of adenomyosisis was an independent predictor of effective UAE treatment (HR=0.313, P=0.001). Type Ⅰ (bilateral predominated) patients, efficiency was 93.5%(43/46);typeⅡ(bilateral balanced) patients, efficiency was 78.0%(39/50);type Ⅲ (unilateral predominated) patients, efficiency was 51.6% (16/31). (5) UAE for the treatment of adenomyosis efficacy of artificial neural network prediction model was constructed, the model′s area under the ROC curve was 0.808, the optimal cut-off point was 0.669 13. Actual verification of the model, sensitivity was 96.5%, specificity was 81.8%, positive predictive value was 96.5%and negative predictive value was 81.8%, the total accuracy was 94.1%. Conclusions (1) Age, the developing situation of ovary branches and blood supply of adenomyosis are the independent predictors of effective UAE treatment. (2) The artificial neural network prediction model is satisfied with the accuracy and the accuracy of prediction.
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Induction of immune tolerance is characterized by high efficiency,low toxicity and economic advantages,and immune tolerance has very important significance in organ transplantation.In the establishment of immune tolerance,dendritic cells (DCs) play the key roles such as clonal deletion or clonal anerge,expressing t-cell inhibiting factors,activating helper T cells electively and inducing regulatory T cells,especially CD4 + CD25 + regulatory T cells,etc.Similarly,CD4 + CD25 + regulatory T cells whose primary target point is dendritic cell also have various functions such as affecting dendritic cells'maturing,restraining dendritic cells'antigen presentation to T cells,inhibiting the activation of T cells in non-specific ways and inducing immune tolerance.Current research shows,dendritic cells and CD4 + CD25 + regulatory T cells regard each other as target point and work synergetically.Here we mainly discuss the function and interaction of dendritic cells and CD4 + CD25 + regulatory T cells in the immune tolerance.
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Objective To analyze the relevance between the effect on dvsmenorrbea of uterine artery embolization(UAE)in treatment of adenomyosis(AM)in difierent periods of the menstrual cycle and the time of the operation.nethods Totally 225 cases with preoperative dysmenorrhea voluntarily chose UAE in treatment of AM.They were divided into two groups according to the different times of menstrual cycle(proliferative phase or secretory phase). We analyzed the relevance between the effect of dysmenorrhea of patients in the two groups with the time of surgery after 1,2,3 and4 years.Results(1)The numbers of the cases completely foilowed up were 142,128,119 and 101 each year in the foilowing four years.(2)The effective rate on dysmenorrhcainthetwo groups ofAM patientswas 81%(43/53)and 76%(68/89)after 1 year(P>0.05).(3)The effective rate was 75%(36/48)and 70%(56/80)after 2 years(P>0.05).(4)The effective rate was 70%(32/46)and 63%(46/73)after 3 years(P>0.05).(5)The effective rate was 63%(24/38)and 63%(40/63)after 4 years(P>0.05).Conclusion UAE has a good efficacy in treatment of AM,but the relevance is not significant between the time of surgery and tlle effectiveness on dysmenorrhea.
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Objective To assess the safety of emergent invasive treatment in severe postpartum hemorrhage. Methods Invasive treatment was performed in 18 patients with severe postpartum hemorrhage. The operation time, therapeutic effect, collateral circulation of uterus feeding arteries, pathological changes in uterine muscle after embolization and radiation dose received by the ovary during operation were investigated for safety assessment. Results (1) All eighteen patients who had been failed to conservative treatment were successfully cured with invasive treatment. The duration of hemostasis was 3 to 10 minutes, mean time (6?4) minutes. The operation time was 30 to 50 minutes, mean time (39?5) minutes. (2) Although both sides of internal iliac arteries or uterine arteries were embolized, a small amount of blood supply for uterus remains from ovary arteries, from branches external iliac arteries and from other arteries. (3) Uterine biopsies were performed in 3 patients 5 to 10 days after the invasive treatments for pathological examinations. Pathological findings showed that the necroses of uterine muscles were disconnected and the whole areas were blow 1/4. (4) The mean radiation dose received by the ovary in 5 cases was (17?7) cGy, which was within the safe limit. Conclusions The use of the emergency invasive treatment is safe in severe postpartum hemorrhage.